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The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied. We quantified long‐term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS. Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019. Data on patient demographics and postoperative treatment with nasal saline irrigation twice daily with and without dissolved steroids (mometasone or budesonide) was collected. Preoperative, and 1‐, 3‐, 6‐, 12‐, 18‐, and 24‐month postoperative Sino‐Nasal Outcome Test (SNOT‐22) scores were assessed. A total of 727 patients were assessed (53.4% males), with 479 patients in the no SI group and 248 patients in the SI group. Preoperative SNOT‐22 scores did not differ significantly (P= 0.19). 1‐, 3‐, 6‐, 12‐, 18‐, and 24‐month post‐op SNOT‐22 scores did not significantly differ between groups. However, mometasone irrigations resulted in significantly lower postoperative 2‐year SNOT‐22 scores compared to budesonide (P< 0.01) and saline (P= 0.03). Though corticosteroid irrigations are routine in managing inflammatory sinus disease, their role in postoperative management after ESBS for tumors is unclear. Our findings suggest that mometasone irrigation may be effective at improving postoperative quality of life in patients after ESBS.

Target class profiling (TCP) is a chemical biology approach to investigate understudied biological target classes. TCP is achieved by developing a generalizable assay platform and screening curated compound libraries to interrogate the chemical biological space of members of an enzyme family. In this work, we took a TCP approach to investigate inhibitory activity across a set of small-molecule methyltransferases (SMMTases), a subclass of methyltransferase enzymes, with the goal of creating a launchpad to explore this largely understudied target class. Using the representative enzymes nicotinamide N-methyltransferase (NNMT), phenylethanolamine N-methyltransferase (PNMT), histamine N-methyltransferase (HNMT), glycine N-methyltransferase (GNMT), catechol O-methyltransferase (COMT), and guanidinoacetate N-methyltransferase (GAMT), we optimized high-throughput screening (HTS)-amenable assays to screen 27,574 unique small molecules against all targets. From this data set, we identified a novel inhibitor which selectively inhibits the SMMTase HNMT and demonstrated how this platform approach can be leveraged for a targeted drug discovery campaign using the example of HNMT.

Road accidents are often caused by short abnormal events, including traffic violations, abrupt change in vehicular motion, driver fatigue, etc. Observing an accident event from the right camera perspective plays a crucial role while detecting accidents. However, it may not be possible to capture such abnormal events from a limited camera perspective. We present a deep learning framework to analyze the accident events recorded from multiple perspectives. First, we estimate feature similarity in videos recorded from multiple perspectives. We then divided the video samples into high and low feature similarity groups. Next, we extract spatio-temporal features from each group using two-branch DCNNs and fuse them using a rank-based weighted average pooling strategy followed by classification. We present a new road accident video dataset (MP-RAD), where each accident event is synthetically generated and captured from five independent camera perspectives using a computer gaming platform. Most of the existing road accident datasets use egocentric views or they are captured in fixed camera setups. However, our dataset is large and multi-perspective that can be used to validate ITS-related tasks such as accident detection, accident localization, traffic monitoring, etc. The dataset contains 400 accident events with a total of 2000 videos. We provide temporal annotations of all videos. The proposed framework and the dataset have been cross-validated with latest accident detection baselines trained on real-world road accident videos and vice-versa. The sub-optimal detection accuracy obtained using the baselines indicates that the proposed framework and the dataset can be useful for ITS related research. Code and dataset is available at: https://github.com/draxler1/MP-RAD-Dataset-ITS-

Lean is a philosophy that is seen as a solution to resolve the problem of efficiency in various industries. It can be used to eliminate all forms of waste in the workplace. The implementation of lean is not only applied in manufacturing but is very important to be applied in other fields, such as in Higher Education Institution. Studies on the topic of lean in the workplace have been carried out, but most of the study has been conducted within a manufacturing context. This study aims to determine the type of waste that is most important to be eliminated first by using the Waste Assessment Model and find the root of the waste problem. This study developed the relationship between waste and find out the effect of waste on each other in Higher Education Institution that focused on teaching and learning process. The steps of this study consist of three-step, such as waste identification, waste assessment, and root cause analysis. From data collection show that there are 46 forms of waste in the teaching and learning process. The results of the Waste Relationship Matrix showed three types of waste must be removed first, namely overproduction, defects, and non-utilized talents. 5-Why’s is used to find out the root causes of waste which is the most important to be eliminated first in the teaching and learning process.

Linking data by finding matching instances in different datasets requires considering many characteristics, such as structural heterogeneity, implicit knowledge, and URI (Uniform Resource Identifier)-oriented identification. The authors propose a context-independent approach to align Linked data through an alignment process based on the ontological model’s components and considering data’s multidimensionality. The researchers experimented with the proposed approach against two methods for aligning linked data in two datasets and evaluated precision, recall, and f-measure metrics. The authors also conducted a case study in a real scenario considering a Brazilian publication dataset on computers and education. This study’s results indicate that the proposed approach overcomes the other methods (regarding the precision, recall, and f-measure metrics), requiring less work when changing the dataset domain. This work’s main contributions include enabling real datasets to be semi-automatically linked, presenting an approach capable of calculating resource similarity.

Background Aspirin-exacerbated respiratory disease (AERD) is optimally managed by endoscopic sinus surgery (ESS) followed by aspirin therapy after desensitization (ATAD). Most AERD quality of life (QOL) studies use the 22-item Sinonasal Outcomes Test (SNOT-22), which focuses predominantly on sinonasal outcomes.Objective This study seeks to assess QOL outcomes in AERD patients after ESS and ATAD via the 12-item Short Form Survey (SF-12), a well-validated QOL measure for general health status of chronic conditions.Methods Retrospective review of 112 AERD patients who underwent ESS followed by ATAD at our institution between 2016 and 2019. SF-12 was collected preoperatively, postoperatively/pre-AD, and serially post-AD (1–3, 4–6, 7–12, and >12?months). Optum® PRO CoRE software was used to compare data to national norms. ANOVA was performed comparing physical component summary (PCS), mental component summary (MCS) and eight health domains (physical functioning, role physical, general health, bodily pain, vitality, social functioning, role emotional, and mental health).Results AERD patients showed improvement in PCS scores across all timepoints after ESS and ATAD (p?=?0.004). When stratified by gender, women demonstrated an improvement in PCS scores (p?=?0.004). Within the domains, there were significant improvements in social functioning (SF), role physical (RP), and bodily pain (BP) at all timepoints (SF: p?=?0.006; RP: p?=?0.005; BP: p?

This article focuses on the thermal conductivity of 50 mm thick silver grey (infrared absorbing) expanded polystyrene (EPS) foam boards blown with pentane. The effect of short-term ageing from the point of production, by ambient conditioning at 23°C/50% RH, is compared to conditioning at an elevated temperature of 70°C. The declared thermal properties of the product and CE certification are fulfilled by the requirements of the European EPS product standard and SG19 Guidance. Measured thermal conductivity levels within 1% of the final value are acceptable and considered representative throughout the economic life of the product. Levels within the criteria were determined for 50 mm silver EPS after conditioning for 5 days at an elevated temperature of 70°C, whereas for conditioning at 23°C/50% RH the time taken was 23 days. The latter time is in good accord with retesting retained grey EPS boards of similar density and up to 9 years old, after initial testing 22 days from production, and conditioning at 23°C/50% RH. Elevated temperature conditioning increases the rate of diffusion of the blowing agent, but there has been concern about EPS beads softening above 60°C. Although there is little evidence from scanning electron microscopy of significant increase in perforation of the cell membranes at elevated temperatures, there is some indication of a small increase in wrinkling of the walls and intercell skeletal strands at 60°C and 70°C. It takes longer to eliminate the pentane gas by conditioning at 23°C/50% RH but there is no risk of material change from heat conditioning.

Diabetes is one of the most important comorbidities linked to the severity of all three known human pathogenic coronavirus infections, including severe acute respiratory syndrome coronavirus 2. Patients with diabetes have an increased risk of severe complications including Adult Respiratory Distress Syndrome and multi-organ failure. Depending on the global region, 20–50% of patients in the coronavirus disease 2019 (COVID-19) pandemic had diabetes. Given the importance of the link between COVID-19 and diabetes, we have formed an international panel of experts in the field of diabetes and endocrinology to provide some guidance and practical recommendations for the management of diabetes during the pandemic. We aim to briefly provide insight into potential mechanistic links between the novel coronavirus infection and diabetes, present practical management recommendations, and elaborate on the differential needs of several patient groups.

Obesity Awareness Week runs from 13 to 19 March. Those with severe mental illness are notably at risk, says Dr Richard IG Holt. Obesity reduces life expectancy by around nine [...]

Achondrogenesis is a group of rare and fatal disorders occurring in approximately one in every 40,000-60,000 newborns. Achondrogenesis is classified in three groups, as Achondrogenesis type 1A (Houston-Harris type or AC-G1A), Achondrogenesis type 1B (Parenti-Fraccaro type or ACG1B) and Achondrogenesis type 2 (Langer-Saldino type or ACG2), depending on clinical and radiological findings. Achondrogenesis Type 2 is a lethal skeletal dysplasia that is typically characterized by short arms and legs, a small chest with short ribs, lung hypoplasia, a prominent forehead, a small chin, and an enlarged abdomen that may accompanied by polydramnios and hydrops. This study contributes to the literature by presenting a patient who was admitted to the Level ΙΙΙ Neonatal Intensive Care Unit (NICU), Bursa, Turkey), with extremely short extremities, a small chest, abdominal distention and respiratory distress, who was diagnosed with ACG2. On the COL2A1gene, genetic analysis with next generation sequencing (NGS), was revealed to have a heterozygous missense variation, c.2546G>A, p.Gly849Asp mutation, which is a different genetic variant that has not been previously described in the literature.

Junaid H Khan, MD(*); Russell D Stanten, MD; John Y Lee, PA-C; Doff B McElhinney, MD and Leigh IG Iverson, MD. Cardiothoracic Surgery, Summit Medical Center, Oakland, CA and Cardiothoracic [...]

Junaid H Khan, MD(*); Russell D Stanten, MD; Doff B McElhinney, MD and Leigh IG Iverson, MD. Cardiothoracic Surgery, Summit Medical Center, Oakland, CA and Cardiothoracic Surgery, Doctors Medical Center, [...]

In a surprising twist to a long-running saga, two previously bitter enemies in the Russian oil industry have come to an amicable resolution and agreed on a strategy to lift [...]

A linear drive used for the scanning system of a Fourier spectrometer is proposed based on a new type of linear actuator with a moving magnet. Models of the drive and scanning system are designed to assess the quality of a scanning system based on such a drive.

Cardiac electronic device implantation is a common and important intervention for patients with tachy- and bradyarrhythmia. An increasing number of patients are receiving more complex devices such as cardiac resynchronisation therapy or devices with a defibrillation function. Over the last 5 years, two new models of cardiac device have emerged, subcutaneous defibrillators and leadless pacemakers. With an ageing population and data demonstrating 2000 per 100,000 of the population aged over 75 years have a cardiac device, it is essential that the general physician remains updated on the common pacemaker indications and available therapies.

Stress-strain responses and microstructure of multi-phase CoCrCuMnNi and CoCrMnFeCu alloys in which Fe or Ni was replaced by Cu from Cantor alloy were studied. The deformation mechanisms of CoCrCuMnNi and CoCrMnFeCu were observed to be influenced by the presence of brittle sigma phase and the separated Cu-rich and the matrix phase. CoCrCuMnNi exhibited the relatively lower strength and excellent deformability, while CrMnFeCoCu alloy exhibited higher strength and lower ductility. The higher strength and the lower ductility of CoCrCuMnNi is associated with the presence more frequent and coarser sigma phase than those in CoCrCuMnNi.

Hot deformability and fracture of as-cast Fe-Cr-Mn-Ni stainless steel ingots with high nitrogen and high carbon contents were studied. Effective stress-strain curve indicates a decrease of the UTS from 510MPa to 90MPa with increase of temperatures from 600°C to 1200°C. Effective stress-strain curves exhibited typical work hardening until the final stage of fracture from 600°C up to 900°C. The fracture elongation decreased from 600°C with the increase of temperature up 850°C, but started to increase appreciably as the work softening becomes dominant in the stress-strain curves above 950°C, suggesting the increase of ductility above 950°C is associated with dynamic recrystallization. The high temperature deformability was enhanced above 1000°C by homogenization of the as-cast alloy due to the dissolution and redistribution of segregated particles, providing the homogeneous distribution of the nucleation site of dynamic recrystallization. . The presence of fatal crack at 1,250°C and the loss of hot ductility can be attributed to the partial melting in austenite grain boundaries at high temperatures.

Microstructure and mechanical properties of cast and cold-rolled equitomic CoCrFeCuNi alloy in which Mn was substituted by Cu from Cantor alloy was studied. The separation into two solid solutions (Cr-Co-Fe rich and Cu-rich phases) were observed in CoCrFeCuNi. Coarsening and widening of interdendritic Cu-rich phase after homogenization was observed after homogenization, suggesting Cu-rich phase is thermodynamically stable. The compressive stress-strain curves of homogenized cast CoCrFeCuNi alloy exhibited the reasonably high strength and excellent deformability for the cast alloy. The yield strength increased up to 960MPa after cold rolling from 265MPa of the homogenized cast alloy. The significant increase of yield strength is thought to be associated with the alignment of Cu-rich second phase in addition to cold work dislocation storage after cold rolling.

Silver nanocomposites were synthesized by the electrochemical method in the matrix of a copolymer of 1-vinyl-1,2,4-triazole with methacrylic acid, by combining the process of electrochemical polymerization with cathodic precipitation of metals on metal electrodes. In the electronic spectra of nanocomposites, absorption bands appear with a maximum in the region of 417–421 nm, which is typical for systems with zero valence silver. The IR spectra show that the polymer structure hardly changes during the formation of nanocomposites and films. The presence of silver in the amorphous polymer phase is indicated by the results of X-ray diffraction studies. The silver content in nanocomposites is 0–9%, which leads to an increase in the viscosity of nanocomposite solutions compared to solutions of the initial copolymers. Transmission electron microscopy data show that the synthesized nanocomposites consist of particles with a diameter of 1–12 nm, predominantly spherical.

A wide differential diagnosis exists for meningoencephalitis and meningitis: causes include tuberculosis and infections caused by viruses such as enteroviruses, human herpesviruses (types 1-4, 5 (cytomegalovirus), and 6), paramyxovirus (mumps), [...]

Microstructure and mechanical properties of equiatomic CrMnCoNiCu alloy in which Fe was substituted by Cu from Cantor alloy was studied. The separation of solid solution phase into two solid solutions (Cr-Co rich and Cu-rich phases) were observed in CrMnCoNiCu. The coarsening and widening of interdendritic Cu-rich phase after homogenization was observed and supported by the increase of XRD peak height from Cu-rich phase compared to that from Cr-Co rich phase after homogenization. The increase of the peak from Cu-rich phase can be attributed to the thermodynamic stability of Cu due to positive mixing enthalpy of adding Cu. The stress-strain curves of CrMnCoNiCu alloy exhibited the reasonably high strength and excellent deformability for the cast alloy. The yield stress of CrMnCoNiCu was observed to be 390MPa and it could be deformed without crack formation up to the true strain 0.85 to reach the flow stress as high as 662Mpa.

In this study, electro nickel coating was applied and its effect on the electrical conductivity and mechanical properties was investigated in Cu/Ni/Al/Ni/Cu clad composite after annealing at various temperature. After annealing at 300OC for 3hrs, the interface reaction layer at the Cu/Al interface was observed to be 3μm and no reaction layer was observed at the Ni/Al interface. After annealing above 400OC for 3hrs, the interface reaction layer at the Cu/Al interface in the absence of Ni layer was observed to grow more rapidly with increase of annealing temperature compared to that at the Ni/Al interface. The electrical conductivity increased after annealing up to 300OC for 3 hrs. possibly because of enhanced interface bonding and the recovery in the matrix. However, it was deteriorated after annealing above 400OC for 3 hrs. because of the formation of interface intermetallic. The more localized bending in the as-roll-bonded clad composite and that annealed at 200°C can be attributed to the near-zero and negative hardening rate in bending over the whole displacement. In this case, once bending occurs, bending continue to occur in the localized region because the work hardening due to the localized bending is negligible, leading to the localized fracture.

To reduce the complexity intrinsic to LD manipulation, software tools are used to publish or consume data associated to LD activities. However, few developers have a broad understanding of how software tools may be used in publication or consumption of Linked Data. The goal of this work is to investigate the use of software tools in Linked Data publication and consumption processes. More specifically, understanding how these software tools are related to process of publication or consumption of LD. In order to meet their goal, the authors conducted a Systematic Literature Review (SLR) to identify the studies on the use of software tools in these processes. The SLR gathered 6473 studies, of which only 80 studies remained for final analysis (1.25% of the original sample). The highlights of the study are: (1) initial steps of the publication process are fairly supported by the software tools; (2) Non-RDF serialization is fairly supported in publication and consumptions process by the software tools; and (3) there are non-supported steps in consumption and publication processes by the tools.

In this study, electro nickel coating was applied and its effect on the interfacial stability and cracking behaviors were investigated in the multi-layered Ni-plated-Cu/Al/Ni-plated-Cu clad composite. Ni plating with 5μm thickness on the Cu sheet before cladding does not form a continuous layer between Cu and Al because of its low ductility. Ni layer covers the part of the Cu/Al interface. In the interface region without Ni layer, CuAl2, CuAl and Cu9Al4 were found to be formed after annealing whereas Al3Ni2 and Al3Ni were found to be formed in the interface region with Ni layer. After bending, interface crack developed initially in the interface region with plated Ni layer. On the other hand, the interface region with no Ni layer, no interface cracks were found to formed, suggesting that the bonding between Al and Ni is not strong enough. After interface crack formation, cracks developed in the Al layer, which may lead to the fatal fracture.

One of the important issue in the production of the industrial scale Cu/Al/Cu clad plate is the evolution of residual stress/strain during rolling the stack of thick slabs into thin wide and long plates. In this study, the effect of residual stress/strain and annealing on the bend forming behaviors of Cu/Al/Cu clad composite were studied. Tensile strength of separated convex side Cu layer from the bent Cu/Al/Cu clad plate was observed 350MPa, smaller than that of concave side Cu-layer (380MPa). The lower strength and higher fracture strain in the convex side Cu layer is attributed to the presence of the compressive residual strain in the convex side. After heat-treatment at 380°C no pronounced interface debonding and separation between Cu and Al layers were noted, supporting a reliable interface bonding between Cu and Al. The ductility of Cu/Al/Cu clad plate was observed to be greater than that of Al, which can be explained by the co-deformation induced the interaction and constraint between bonded Al and Cu layers. The bend forming behavior of the bent Cu-Al-Cu clad composite was not greatly influenced by the residual stress/strain developed during rolling because of the thick Al layers with negligible residual stress between Cu.

In the present study, the microstructural stability and mechanical properties of a MnFeCoNiCu alloy in which Cr was replaced by Cu from Cantor composition (CoCrFeMnNi) was studied. In the as-cast alloy, the dendrite arms are enriched with Cu and Mn and matrix between dendrite arms is enriched with Fe and Co. Ni was richer in the matrix, but also observed in the dendrite arms. Cu and Mn tend to segregate and solidify initially because the melting temperatures of Cu and Mn are lower than Fe and Co, resulting in the growth of Cu-Mn dendrite. After homogenization, the dendrites structure disappeared and grain boundaries are visible, indicating the segregated elements in the dendrite structure were homogenized. The presence of single phase FCC structure was confirmed after homogenization. The tensile strength of 1220 MPa with the ductility of 6 % was obtained in MnFeCoNiCu alloy.

In this study, creep properties and fracture behavior of CrMnFeCoNi high entropy alloy (HEA) were studied at intermediate temperatures. The invert-type transient primary creep behaviors were observed in CrMnFeCoNi high entropy alloy. Creep behaviors of HEA are similar to those of class I solid solution alloys. The transient creep curves upon increase of stress by 5MPa in the steady state creep region did not change much except the sudden strain increase. And, no decrease of creep rate was observed upon increase of stress. Instead, the slightly invert transient creep or almost straight creep curves were observed, supporting the high friction stress. CrMnFeCoNi high entropy alloy has a stress exponent of 3.75 and the creep activation energy was calculated to be 278KJ/mole. The fracture strain increased from 1.3 to 1.6 with the decrease of stress from 96 MPa to 48MPa. The lower stress exponent along with the invert type primary creep curves strongly suggest that the creep of CrMnFeCoNi high entropy alloy at 600°C~650°C occurs by a glide controlled process.

In this study, the effect of carbon addition the cast and rolled microstructures of Cantor alloy type FeCoCrNiMn high entropy alloys. Both as-cast FeCoCrNiMn and FeCoCrNiMnC0.1 alloys have dendritic microstructure. Small particles, which may be associated carbon addition exist in the dendrite arms in FeCoCrNiMnC0.1 alloy. After homogenization treatment at 1327K for 24 hrs., dendritic structure was completely eliminated after annealing. Dendritic structure was converted to the structure with elongated grains, especially for carbon added FeCoCrNiMnC0.1. The development of elongated grains is associated with the direction of the primary arms in the dendritic structure. Carbides are segregated at the grain boundaries in FeCoCrNiMnC0.1 alloy. It also appears that growth of grains is impeded by the segregation of carbides. It is apparent that the grain boundary precipitates are Cr-rich. Both the strength and ductility of FeCoCrNiMnC0.1 increased over FeCoCrNiMn with the addition of 0.1 wt. % carbon. The increase of ductility in FeCoCrNiMnC0.1 may be caused by the rapid hardening in FeCoCrNiMnC0.1 due to dislocation-solute interaction.

A significant temperature inversion with temperature differences larger than 3°C was observed in the southeastern Yellow Sea (YS) during February 2016. By analyzing in situ hydrographic profiles and results from a regional ocean model for the YS, this study examines the spatiotemporal evolution of the temperature inversion and its connection with wind-induced currents in winter. Observations reveal that in winter, when the northwesterly wind prevails over the YS, the temperature inversion occurs largely at the frontal zone southwest of Korea where warm/saline water of a Kuroshio origin meets cold/fresh coastal water. Our model successfully captures the temperature inversion observed in the winter of 2016 and suggests a close relation between northwesterly wind bursts and the occurrence of the large inversion. In this respect, the strong northwesterly wind drove cold coastal water southward in the upper layer via Ekman transport, which pushed the water mass southward and increased the sea level slope in the frontal zone in southeastern YS. The intensified sea level slope propagated northward away from the frontal zone as a shelf wave, causing a northward upwind flow response along the YS trough in the lower layer, thereby resulting in the large temperature inversion. Diagnostic analysis of the momentum balance shows that the westward pressure gradient, which developed with shelf wave propagation along the YS trough, was balanced with the Coriolis force in accordance with the northward upwind current in and around the inversion area. Significant temperature inversion observed in southwestern YS in February 2016Occurrence of large temperature inversion closely related to northwesterly wind burst.Northward propagation of sea level elevation results in large temperature inversion

IntroductionMen who have sex with men (MSM) are at high risk for anorectal chlamydia and gonorrhoea infections. Many MSM use rectal douches in preparation for sex, which might break down the mucosal barrier function and facilitate the acquisition of STI. We determined whether rectal douching or sharing douching equipment was associated with anorectal chlamydia and gonorrhoea.MethodsIn a cross-sectional study among 994 MSM attending the STI outpatient clinic of Amsterdam between February and April 2011, data were collected on rectal douching, sexual behaviour and STI. We used multivariable logistic regression analysis to determine the association between rectal douching, including sharing of douching equipment, and anorectal chlamydia and gonorrhoea for those reporting receptive anal sex. We adjusted for other risk behaviour, that is, condom use, number of partners and HIV status.ResultsOf 994 MSM, 46% (n=460) practised rectal douching, of whom 25% (n=117) shared douching equipment. Median age was 39 years (IQR 30–47), median number of sex partners in the 6 months prior to consult was five (IQR 3–10) and 289 (29.0%) participants were HIV positive. The prevalence of anorectal chlamydia and/or gonorrhoea for those reporting receptive anal sex was 9.6% (n=96). In multivariable analysis, HIV positivity (aOR=2.2, 95% CI 1.3 to 3.6), younger age (aOR=2.5, CI 1.4 to 4.5 for those aged <35 years compared with those aged ≥45 years), and more sexual partners (aOR=1.2, 95% CI 1.0 to 1.5 for 1 log increase) were significantly associated with anorectal STI. However, rectal douching or sharing douching equipment were not significantly associated with anorectal chlamydia and/or gonorrhoea (p=0.647).ConclusionsAlmost half of MSM used rectal douching and a quarter of these shared douching equipment. Though using douching equipment does not appear to contribute to anorectal chlamydia and gonorrhoea in this study, STI prevalence remains high and prevention strategies like early testing and treatment remain of utmost importance.

Intelligent tutoring systems (ITSs) are effective to provide instruction for students in several situations. Many works have been using gamification by adding game elements to learning contexts aiming to engage students and to drive desired learning behaviours. However, the design of gamified ITS should deal with a huge variability. Software product lines (SPLs) promise to offer rapid product development and more affordable development costs to build software from the same family. A key factor to successfully implement a product-line approach is to structure commonalities and variabilities into a product line architecture (PLA). In this paper, we propose a PLA for developing gamified ITSs that uses an ontology-driven feature modelling strategy. We illustrate how our architecture could be applied to instantiate a product on the basic math domain. We also discuss a set of implications of using it as well as how it could support the evolution/changing of gamified ITSs.

Carboxyl-functionalized carbon black nanoparticles (CB-NPs) are widely used in various industries. Studies on the dispersion and aggregation of nanomaterials in the aquatic environment are being actively conducted these days. In this study, the aggregation and sedimentation of carboxyl-functionalized CB-NPs were investigated according to the changes in the solution chemistry (0.1–10 mM NaCl and 0.01–1 mM CaCl2) and in the presence/absence of natural organic matter (1 and 5 mg L−1humic acid) in the aquatic environment. Overall, humic acid was found to have the greatest effect on the stability of CB-NPs under the aquatic conditions investigated. Specifically, the sedimentation caused by CB-NP aggregation was more actively observed in NaCl than in CaCl2. With the increase in the ionic strength of the NaCl solution, the aggregation rate of CB-NPs also increased, whereas in the CaCl2solution, the CB-NPs suspension stability was almost insensitive to the ionic strength. The reason was that the divalent cation Ca2+was specifically adsorbed onto CB-NPs in the CaCl2solution to reverse the negative CB-NP zeta potential, and increase the electrostatic repulsive force between CB-NPs. In the presence of humic acid in the NaCl and CaCl2solutions, stability improved in the whole ionic strength range. A comparison of the classical Derjaguin–Landau–Verwey–Overbeek (DLVO) theory with the modified DLVO theory considering the steric force revealed that the enhanced stability of a CB-NP suspension in the presence of humic acid is attributed to a steric repulsive force as well as a stronger electrostatic repulsive force caused by humic acid adsorption.

•Optimal management of type 1 diabetes can been defined by seven criteria, as recommended in the ADA and EASD consensus report on the management of type 1 diabetes in adults. We studied the percentage and the characteristics of adults with diabetes who met these criteria.•Older people and people identifying as White were more likely to meet all seven glycemic targets.•Women across all age groups spent less time in range and spent more time above range than men, whereas men spent more time below range.•Hybrid-closed loop insulin delivery systems were a powerful predictor of meeting all seven glycemic targets

This study aimed to evaluate the potential toxicity and safety of ethyl hydrogen adipate (EHA) by determining its effect on the reproductive function and development of Sprague-Dawley (SD) rats at dose levels of 0 (control), 200, 400, and 800 mg/kg/day. One male and five females of the 800 mg/kg/day died. Body weight loss was observed in the males of the 800 mg/kg/day and in females of the 400 and 800 mg/ kg/day. In addition, mating indices decreased and pre-implantation loss rates increased in parental animals of the 400 and 800 mg/kg/day. The gestation index decreased in the male and female rats of the 800 mg/ kg/day. Moreover, the body weight of the pups from the 800 mg/kg/day group decreased on post-parturition day 4. These results indicated that the no-observed-adverse-effect level of EHA for parental males and females was 400 mg/kg/day and 200 mg/kg/day, respectively, and that for pups was 400 mg/kg/day.

Satellite‐based sea surface temperature (SST) measurements revealed an abnormal cooling anomaly over the Yellow Sea (YS) in the summer of 2011. Using in situ hydrographic profiles, meteorological fields, and an ocean circulation model with a passive tracer experiment, we identified the cold SST anomaly and its connection with the YS Bottom Cold Water (YSBCW), which occupies the central part of the YS below the thermocline in the summer. The summer SST anomalies in the YS showed three cold peaks in 1993, 2003, and 2011 over the past 20 years, but the reasons for the cooling events were different, as one was due to weakened surface heating and the other was attributed to mixing with the YSBCW. In 1993 and 2003, relatively weak surface heating made the surface water cooler compared with that during the other years, whereas in 2011, a strong vertical mixing of water was induced by a typhoon that passed through the central YS, causing the surface water to cool by ∼8°C and the bottom water to warm up by ∼4°C. A tracer experiment further confirmed that the vertical heat transfers between the warm surface and the cold bottom water masses when the typhoon passed through the YS interior. An abnormal cooling of SST has been observed in the entire YS in August 2011YSBCW largely contributes the SST reduction through typhoon‐induced vertical mixingSST cooling mixed with the YSBCW has implications for predicting air local temperature changes

One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes.

Background: In computer-supported collaborative learning (CSCL), the implementation of instructional design (ID) of collaborative learning (CL) scenarios is a complex task that requires practice and experience. To solve this problem, many computer-based systems have been proposed for automating the ID of these scenarios. Aims: This study identifies, classifies and compares the current computer-based systems for automating ID of CL scenarios. To perform this classification and comparison, we also propose a framework based on the specialisation of existing ID models for the case of CL scenarios. Method: The standard systematic literature review (SLR) method was used with searches in three electronic scientific databases. Results: Of 39 selected studies, we identify 18 computer-based systems and 2 plugins, where the two most evaluated, adaptable and with high coverage of authoring activities that are automated are the systems WebCollage (including the plugins AP and MAPIS3) with GluePS and CHOCOLATO.

Minimal Hepatic Encephalopathy (MHE) is characterized by very subtle cognitive changes that are diagnosed with the Psychometric hepatic encephalopathy score (PHES) and critical flickering frequency (CFF). Patients with MHE are slower in attention tests evaluated with visual cognitive evocative potentials, which are late indicators. However, it is unknown whether there is also slowness in automatic responses of early visual perception, such as those of stationary visual potential P100. This study aimed to detect early visible changes in patients with minimal hepatic encephalopathy.

The clinical alterations of Minimal Hepatic Encephalopathy (MHE) include subtle changes in cognitive processes detectable only with tests such as the Psychometric hepatic encephalopathy score (PHES) and critical blink rate (FCP) or P300 cognitive evoked potentials. After treatment with L-Ornithine, L-Aspartate (LOLA) 18 grams/30 days, a decrease or normalization in the PHES score, an increase in FCP, and a reduction in the latency of the P300 potential have been observed. In the short term, it is unknown if there are changes in these three indicators of the cognitive status of patients with MHE. This study aimed to detect changes in the potential cognitive P300 of patients treated with LOLA 18g/3 days.

MHE is related to a higher risk of accidents and deterioration in the quality of life; it can be detected with PHES and CFP. There is currently insufficient evidence that treatment with oral LOLA improves performance in PHES and CFP in patients with MHE. This study aimed to verify the response and safety of LOLA treatment in a real-life cohort of patients with MHE.

Practitioners have often wondered whether, during ride measurement with inertial devices, the motion of the laser through pavement texture introduces nonrepresentative values of international roughness index (IRI), particularly in certain textures. In response to this problem, a special texture study created a nontextured strip by a recession of the middle 4 ft of a texturing broom dragged longitudinally behind the paver. The study measured IRI and other surface properties in adjacent textured and nontextured strips by using a lightweight profiler outfitted with a line laser and a triple laser arranged in tandem. IRI measurements were performed after sufficient concrete strength gain and repeated as soon as the joints were sawn. The same measurements were repeated after the joints were deployed. Results showed a significant difference between the IRI of a textured strip and that of an nontextured strip. Further analysis indicated that, although texture appears to affect IRI, this effect was amplified by the type of laser used, as the triple laser appeared to indicate higher IRIs in comparison with the RoLine laser. Although the RoLine is not a reference profiler for IRI values unaffected by texture, the prevalence of the RoLine and the triple laser in construction acceptance testing is sufficient reason to be concerned about the difference inherent in the obtained results. Chi-square and t-test statistical analysis showed that laser type induced comparable and even higher IRI anomalies than did the experimental drag texture. In addition, the texture-induced IRI anomaly can be minimized by measuring smoothness for acceptance at least 2 weeks after paving.

Diabetes has been defined on the basis of different biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA1c. We assessed the effect of different diagnostic definitions on both the population prevalence of diabetes and the classification of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in different regions.