Primary Core Research Articles

KENDALA DAN STRATEGI GURU DALAM MEMOTIVASI ANAK UNTUK BELAJAR DARI RUMAH (BDR) PADA MASA PANDEMI COVID-19 DI PAUD NEGERI PERCONTOHAN KABUPATEN SIJUNJUNG

The COVID-19 pandemic has changed study practices and habits. Learning that is usually carried out in the education unit then moves to learning from home (BDR). Teachers and students are involved in distance learning which presents a number of challenges ranging from the obstacles experienced in BDR, both obstacles in planning, implementing and assessing learning, as well as requiring teachers to try to motivate children in implementing BDR during this pandemic. This is because changes in learning patterns that are so drastic have the risk of causing a decrease in the quality of learning. Whereas the quality of learning is the key to student learning outcomes. If the quality of learning decreases, the learning outcomes of students also tend to decrease (learning loss). This study aims to describe the obstacles experienced and the teacher's strategies in motivating children to learn from home (BDR) during the Covid-19 pandemic at PAUD Negeri Pilot Sijunjung Regency. This type of research is a qualitative research with a case study design. This research was carried out at the Pilot State PAUD in June and July 2021. The primary data sources or core informants in this study were 6 people, namely the teacher council, additional informants from the principal. The researcher acts as a key instrument, using supporting instruments in the form of interview guidelines and documentation studies. Secondary data in this study were related documents regarding BDR learning during the covid 19 pandemic. Data collection techniques were carried out by interviews and documentation studies, then the data collected was tested for validity using triangulation techniques. Then the data is analyzed using the opinions of Milles and Hubberman through reduction, data presentation and drawing conclusions. The results of the study indicate that the teacher's obstacles in implementing BDR include obstacles in BDR planning, teachers are constrained in determining learning indicators. In the implementation of BDR, the teacher has difficulty in determining activities according to the situation and condition of the child, while in the BDR assessment, the teacher is constrained in assessing aspects of child development because the child's development cannot be monitored by the teacher. The teacher's strategy in motivating children to BDR is to provide BDR activities according to the child's world, namely through games, creating whatshaap groups, delivering interesting learning videos, giving rewards in the form of words of praise and emoticons that add to the passion and enthusiasm of children in implementing BDR.

An international Delphi consensus process to determine a common data element and core outcome set for frailty: FOCUS (The Frailty Outcomes Consensus Project)

BackgroundDespite increased recognition of frailty and its importance, high quality evidence to guide decision-making is lacking. There has been variation in reported data elements and outcomes which makes it challenging to interpret results across studies as well as to generalize research findings. The creation of a frailty core set, consisting of a minimum set of data elements and outcomes to be measured in all frailty studies, would allow for findings from research and translational studies to be collectively analyzed to better inform care and decision-making. To achieve this, the Frailty Outcomes Consensus Project was developed to reach consensus from the international frailty community on a set of common data elements and core outcomes for frailty.MethodsAn international steering committee developed the methodology and the consensus process to be followed. The committee formulated the initial list of data elements and outcomes. Participants from across the world were invited to take part in the Delphi consensus process. The Delphi consisted of three rounds. Following review of data after three rounds, a final ranking round of data elements and outcomes was conducted. A required retention rate of 80% between rounds was set a priori.ResultsOne hundred and eighty-four panelists from 25 different countries participated in the first round of the Delphi consensus process. This included researchers, clinicians, administrators, older adults, and caregivers. The retention rate between rounds was achieved. Data elements and outcomes forming primary and secondary core sets were identified, within the domains of participant characteristics, physical performance, physical function, physical health, cognition and mental health, socioenvironmental circumstances, frailty measures, and other.ConclusionIt is anticipated that implementation and uptake of the frailty core set will enable studies to be collectively analyzed to better inform care for persons living with frailty and ultimately improve their outcomes. Future work will focus on identification of measurement tools to be used in the application of the frailty core set.

A Sampling Strategy to Develop a Primary Core Collection of Miscanthus spp. in China Based on Phenotypic Traits

Core collections can act as a genetic germplasm resource for biologists and breeders. Thirty-seven phenotypic traits from 471 Miscanthus accessions in China were used to design 203 sampling schemes to screen the genetic variations in different sampling strategies. The sampling was analyzed using the unweighted pair group method with arithmetic mean (UPGMA) and the Euclidean distance (Euclid). Several parameters including the variance of phenotypic value (VPV), Shannon–Weaver diversity index (H), coefficient of variation (CV), variance of phenotypic frequency (VPF), ratio of phenotype retained (RPR), the mean difference percentage (MD%) and the variance difference percentage of traits (VD%), the range coincidence rate (CR%) and the variable rate of quantitative traits (VR%) were used to evaluate the level of representation of the primary core collections developed by the different sampling schemes. Based on the optimal sampling strategies of prior selecting accessions, a primary core collection was constructed that maintained > 99.5% of the VPV and a CR% of 100%. This study indicates that the optimal sampling scheme consisted of prior and deviation sampling methods (PD) combined with a logarithmic proportional sampling strategy (LG) of 37.4% of the actual sampling ratio. Sampling before clustering can improve several parameters including the H, CV, RPR, VPF, and CR%. Sampling strategies including the genetic diversity index (G), logarithmic proportional (LG) and the square root proportional strategy (SG) can improve the H, whilst the constant strategy (C) can improve the RPR and VPF when the sampling scale was >30%. Furthermore, the proportional strategy (P) can improve the VPV.

Abstract P1-04-05: Multiplexed immunofluorescence staining of intra-tumoral immune cell populations and associations with immunohistochemical, clinical, and pathologic variables in breast cancer

Abstract Background: Although immune checkpoint inhibitors (ICI) are most widely used in PD-L1 positive, metastatic triple-negative breast cancer (TNBC), the clinical utility of ICI in other tumor subtypes and patient populations is not well defined. In this study, we measured infiltration of multiple immune cell populations in primary and metastatic HR+ tumors to infer potential benefit from ICI. We investigated how risk stratifying features such as pathologic grade and Oncotype Dx scores affect immune cell infiltration across subtypes. Lastly, we compared immune cell infiltration in breast tumors from younger versus older women, as our pre-clinical studies demonstrated differential enrichment of immune response pathways by age and association with improved response to ICI. Methods: ImmunoProfile, a multiplexed immunofluorescence (IF) assay, was performed on FFPE tissue from 167 archived breast cancer tumors from the Dana-Farber Cancer Institute (HR+/HER2- n=124, HER2+ n=21, TNBC n=22). Unmatched samples were obtained from either primary breast (HR+/HER2- n=104, HER2+ n=13, TNBC n=15) or metastatic core biopsies. IF staining signal was measured for T cell markers CD8 and co-localized CD8/PD-1, T regulatory cell marker FOXP3, PD-L1 and PD1 expression on tumor cells as well as PD-L1 expression on inflammatory cells. Inflammatory, tumoral (TPS) and combined inflammatory and tumor (CPS) pathologic PD-L1 scores were calculated. PD-L1 staining was also assessed by IHC (E1L3N) staining and compared to multiplexed IF stains. IF staining signal (Vectra analyzed, log2+1 transformed) was analyzed against clinical and pathologic variables, including tumor subtype, primary versus metastatic status, pathologic grade, and Oncotype Dx score, using non-parametric statistical comparisons. Given the decline in adaptive immunity that occurs with normal physiological aging and our own group’s previous reports, we also explored whether immune cell staining signal associated with age. Results: TPS, CPS, and inflammatory PD-L1 scores strongly correlated between IHC and IF staining methods (Spearman r = 0.660, 0.683, 0.638 respectively, p < 2.2e-16). When HR+/HER2- (n=124), HER2+ (n=21) and TNBC (n=22) cases were analyzed separately, there was no statistical difference between unmatched primary and metastatic cases in any of the analyzed immune cell population stains for any subtype. When all primary cases were analyzed, TNBC showed higher CD8, CD8/PD1, PD1 (all p < 0.05), and FOXP3 staining as well as IF CPS, TPS and inflammatory PD-L1 scores (all p < 0.005) than HR+ cases. HR+/HER2- cases from women < age 65 (n=56) showed higher intra-tumoral CD8 (p=0.039), PD1 (p=0.043), and CD8/PD1 (p=0.022) than cases from women > age 65 (n=38). There was a statistically significant step-wise increase in IF staining of all immune cell populations with increasing pathologic grade (I, II, III) as well as Oncotype Dx scores (< 11, 11-25, >25) among primary HR+/HER2- cases (n=74). Conclusions: Strong correlations between PD-L1 scores based on IF and IHC methods suggest clinical utility for multiplexed IF immune cell staining in therapeutic planning. ImmunoProfile demonstrated the previously known pattern that primary TNBC contains higher immune cell infiltration than HR+ or HER2+ tumors. Women < age 65 with HR+ cancer showed higher levels of CD8 and PD1 stained populations, suggesting there may be greater utility of ICI in younger patients. Lastly, the association of higher pathologic grade and Oncotype Dx score with increasing immune cell infiltration supports exploration of ICI in biologically unfavorable primary HR+ cancers. Citation Format: Tess A. O'Meara, Tanya E. Keenan, Adrienne G. Waks, Kristen D. Felt, Bijaya Sharma, Scott Rodig, Melissa Hughes, Nancy U. Lin, Judith Agudo, Jennifer L. Guerriero, Sandra S. McAllister, Elizabeth Mittendorf, Sara Tolaney. Multiplexed immunofluorescence staining of intra-tumoral immune cell populations and associations with immunohistochemical, clinical, and pathologic variables in breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-04-05.

Optimal Design of a Short Primary Double-Sided Linear Induction Motor for Urban Rail Transit

Linear induction motors (LIMs) have been widely used in rail transit. However, Due to the breaking of the primary core and the large air gap, the efficiency and power factor of LIMs are seriously damaged, causing a large amount of energy waste. To improve the efficiency and power factor of LIMs for urban rail transit, we present a new optimization method for the design of a short primary double-sided linear induction motor (SP-DLIM) with a rated speed of 45 km/h and small thrust. The method is based on a steady state equivalent circuit model and the differential evolutionary algorithm (DEA). Moreover, the design constraints and the objective functions are proposed for the optimization problem. Finally, the optimized SP-DLIM is simulated by 2D transient finite element method (FEM). The 2-D transient FEM results verify the accuracy of the optimization method proposed in this paper.

An Optimized Algorithm for CR-MIMO Wireless Networks

With the rapid development of wireless communication technology, the spectrum resources are increasingly strained which needs optimal solutions. Cognitive radio (CR) is one of the key technologies to solve this problem. Spectrum sensing not only includes the precise detection of the communication signal of the primary user (PU), but also the precise identification of its modulation type, which can then determine the a priori information such as the PU’ service category, so as to use this information to make the cognitive user (CU) aware to discover and use the idle spectrum more effectively, and improve the spectrum utilization. Spectrum sensing is the primary feature and core part of CR. Classical sensing algorithms includes energy detection, cyclostationary feature detection, matched filter detection, and so on. The energy detection algorithm has a simple structure and does not require prior knowledge of the PU transmitter signal, but it is easily affected by noise and the threshold is not easy to determine. The combination of multiple-input multiple-output (MIMO) with CR improves the spectral efficiency and multi-path fading utilization. To best utilize the PU spectrum while minimizing the overall transmit power, an iterative technique based on semidefinite programming (SDP) and minimum mean squared error (MMSE) is proposed. Also, this article proposed a new method for max-min fairness beamforming. When compared to existing algorithms, the simulation results show that the proposed algorithms perform better in terms of total transmitted power and signal-to-interference plus noise ratio (SINR). Furthermore, the proposed algorithm effectively improved the system performance in terms of number of iterations, interference temperature threshold and balance SINR level which makes it superior over the conventional schemes.

Teacher identity as inquirer: voices of teacher educators

ABSTRACT This qualitative study uses the dialogical self theory to explore teacher educators’ voices as they speak on the issue of teacher identity positioning, specifically when it comes to the position of teachers as inquirers. A content analysis of self-reports from 18 teacher educators yielded 3 primary teacher core I-positions. The results showed that the teacher educators viewed teachers more as mediators than as instructors or inquirers. Although all the participants acknowledged the relevance of the inquiry process in the teaching profession, they differed as to the value, purpose, and learning outcomes of adopting an inquiry position in the initial training of teachers.

Research on Segmented Primary Consequent-Pole Permanent Magnet Linear Synchronous Motor with Symmetric and Periodic End Force

The end force of North-South permanent magnet linear synchronous motor (NS-PMLSM) fluctuates symmetrically with a period of one pole. Different from it, the end force’s fluctuation cycle of the consequent-pole permanent magnet linear synchronous motor (CP-PMLSM) is usually two poles and asymmetrical. Especially, within two half cycles, the end force presents complex asymmetric characteristics. In this paper, a piecewise function model of the end force of CP-PMLSM is established. Then a primary segmented design method for adjusting the period, symmetry and phase of the end force waveform is proposed. The two-segment and grouped four-segment modular distances are combined and matched to eliminate the odd-numbered harmonics of the end force and suppress the thrust ripple. A slotless primary core experimental platform and a slotted CP-PMLSM prototype are manufactured and tested to verify the theoretical analysis and simulation results.

Electromagnetic Design and Vibration Analysis of a Homopolar Linear Synchronous Motor

In this paper, the electromagnetic and mechanical characteristics of the improved homopolar linear synchronous motor (H-LSM) have been studied. Firstly, the influence of the ratio of the width and pitch of the rotor teeth is investigated on the magnetic field distribution and vibration traits. By establishing a simplified three-dimensional magnetic circuit model, the distribution of air gap flux density is attained. Secondly, the time and space distributions of the air gap flux density is decomposed, and the ratio of tooth width to tooth pitch with larger fundamental component is selected as the key index to design the H-LSM. Thirdly, through the modal analysis of the primary core, detailed investigation on the harmonics response is carried out, and the resonance frequency domain in the working process is clarified. Finally, 1-10th order frequency spectrum on the H-LSAM resonance is decomposed, which can provide a judgment for the fault diagnosis.

EFFECT OF COFLOW ON SONIC JET

The sonic coflow effect on the core length of sonic primary jet was experimentally investigated in this research work. A circular convergent nozzle was used for both core and coflow jet studies. The 1mm annular gap was maintained between the coflow and core nozzles. The nozzle pressure ratio (NPR) was varied from 3 to 5, insteps of 1 for both the nozzles. For each primary NPR, the NPR of coflow was varied, and the shadowgraph flow visualization was carried out. From the shadowgraph visualization results it was observed that the sonic primary jet core length increases with increasing pressure ratio without coflow. With sonic coflow, the primary jet core length started to increase further with increasing coflow NPR. That is, the increase of sonic coflow NPR at each sonic primary jet NPR resulted in the elongation of core. Therefore, the introduction of coflow has resulted in core length elongation at all the levels of underexpansion. The primary jet core elongation due to the presence of coflow resulted in the weakening of shock strength in the primary jet core.

Genetic Diversity and Primary Core Collection Construction of Turnip (Brassica rapa L. ssp. rapifera Matzg) Landraces in Tibet Revealed via Morphological and SSR Markers

Turnip, one of the oldest groups of cultivated Brassica rapa species, is a traditional crop as well as a form of animal fodder, a vegetable, and a herbal medicine that is widely cultivated in farming and farming-pastoral regions in Tibet. Different regions of the Qinghai–Tibet Plateau (QTP) are home to a rich diversity of turnip owing to their high altitudes and variable climate types. However, information on the morphology and genetic diversity of Tibetan turnip remains limited. Therefore, the genetic diversity of 171 turnip varieties from China and elsewhere (Japan, Korea, and Europe) was analyzed using 58 morphological characteristics and 31 simple sequence repeat (SSR) markers in this study. The varieties showed that the genetic distance ranged from 0.12 to 1.00, and the genetic similarity coefficient ranged between 0.73 and 0.95. Cluster tree showed two distinct clusters. Both morphotype and geography contributed to the group classification. A combination of morphological traits and molecular markers could refine the precision of accurate identification compared to the separate morphological and molecular data analyses. The sampling ratio of 15% to utmost precisely represent the initial population was compared to ratios of 10% and 20%, and the sampling ratio of 15% is recommended for future works when a primary core collection of turnip resources is constructed. These results could furnish a foundation for germplasm conservation and effective turnip breeding in future studies.

Insight into Shenqi Jiangtang Granule on the improved insulin sensitivity by integrating in silico and in vivo approaches

Ethnopharmacological relevancePresently, insulin resistance has been a growing concern that urgently needs to be addressed, because it not only places patients at risk of developing type 2 diabetes mellitus but also results in metabolic syndrome and different aspects of cardiovascular diseases. Shenqi Jiangtang Granule (SJG) is a classic traditional Chinese medicine (TCM) prescription that is widely used to treat diabetes mellitus and its complications in clinical practice. While studies have revealed that SJG with multi-ingredients and multi-targets characteristics possesses potential anti-insulin resistance pharmacological properties, its mechanisms of action and molecular targets for the treatment of insulin resistance are still obscure, which prompt us to conduct an in-depth research. Aim of the studyThis study was purposed to uncover the pharmacological mechanism of SJG against insulin resistance through integrating network pharmacology and experimental validation. Materials and methodsThe putative ingredients of SJG and its related targets were discerned from the TCMSP database. Subsequently, insulin resistance-associated targets were retrieved from GeneCard, OMIM, and GEO database. Compound-target, protein-protein interaction (PPI), and compound-target-pathway networks were established using Cytoscape software. GO and KEGG pathway analyses were performed to identify possible enrichment of genes with specific biological themes. Molecular docking was used to verify the correlation between the main active ingredients and hub targets. Optimal docking conformation was further analyzed by molecular dynamics (MD) simulation. Finally, the potential molecular mechanisms of SJG acting on insulin resistance, as predicted by the network pharmacology analyses, were validated experimentally in insulin-resistant rat model. Results136 active compounds, 211 corresponding targets in addition to 1463 disease-related targets were collected, of which 94 intersection targets were obtained. 29 key targets including AKT1, VEGFA, IL-6, CASP3, and PTGS2 were identified through PPI network analysis. Hub module of PPI network was closely associated with inflammation. GO and KEGG analyses also revealed that inflammation-related pathways may be a central factor for SJG to modulate insulin resistance. Molecular docking test showed a good binding potency between primary active ingredients and core targets, and the binding mode of optimal docking conformation was stable in MD simulation. A rat model of insulin resistance was successfully induced by chronic high-fat diet (HFD) consumption. Through a series of in vivo studies, including HEC, ITT, and HOMA-IR measurement, it was revealed that SJG exhibited a beneficial effect on ameliorating insulin resistance, as demonstrated by a significant increase of GIR and a significant decrease of AUCITT and HOMA-IR index value. Further molecular biological analysis showed that SJG can decrease the mRNA expression level and serum concentration of inflammatory cytokines (TNF-α, IL-6, and IL-1β), along with suppressing the p-NFκB protein overexpression, indicating its anti-inflammatory activity. Also, it can contribute to the reversal of the impaired hepatic insulin signaling pathway, as evidenced by up-regulated protein expression of p-Akt and GLUT2. ConclusionsThrough in silico and in vivo approaches, the present study not only provides a unique insight into the possible mechanism of SJG in insulin resistance after successfully filtering out associated key target genes and signaling pathways, but also suggests a novel promising therapeutic strategy for curing insulin resistance.

Characteristics of shock tube generated compressible vortex rings at very high shock Mach numbers

Compressible vortex rings are usually formed at the open end of a shock tube. They show exciting flow phenomena during their formation, evolution, and propagation depending on the shock Mach number (Ms) and exit flow conditions. This study considers high shock tube pressure ratio (PR) cases showing hitherto unknown, spectacular flow structures. With hydrogen as a driver section gas at high PR, a supersonic compressible vortex ring having vortex ring Mach number (Mv) >1 is obtained for the first time. The formation of multiple triple points and the corresponding slipstream shear layers and, thus, multiple counter-rotating vortex rings (CRVRs) behind the primary vortex ring at different radial locations, in addition to the usual CRVRs, appears to be a unique characteristic for high Mach number vortex rings. During the formation stage, a vortex layer of reverse circulation than that of the primary vortex ring gets generated from the outer wall of the shock tube. The instability of such a vortex layer creates another series of opposite circulation vortices, which later interfere with the primary vortex core considerably. Also, a near stationary slipstream vortex and multiple fast-moving tiny vortices of opposite circulation to the slipstream vortex are observed near the central zone. Mechanisms for the formation of these complex vortical structures are identified. The implications of these phenomena on the vortex ring's geometric and kinematic characteristics, such as ring diameter, core diameter, circulation, and translational velocity, are discussed in detail, illustrating their differences with low vortex ring Mach number cases considering 0.31 < Mv < 1.08.

Multi-timescale and multi-centrality layered node selection for efficient traffic monitoring in SDNs

With the assistance of global view in software-defined networks (SDNs), some switch nodes can be selected for traffic monitoring, which ensures the security of SDNs with a minimum cost. However, identifying the flow-based smallest subset of switches with the maximum coverage for node selection is always an NP-hard problem. To address this challenge, a two-stage parameter-rectifying-based selection (TSPRS) scheme is presented for efficient traffic monitoring in SDNs. In this novel scheme, a multi-timescale and multi-centrality layered virtual network (MMLVN) model is first built according to the different network structures over various time periods. By virtue of the MMLVN model, a tensor-based eigenvector multi-centrality computing (TEMC) method is employed at the first-stage selection to identify the smallest subset of switches with the maximum coverage for obtaining the subset of primary core nodes. To obtain more accurate parameters of real-time flows, a modified MMLVN model is further built by combining the results of a bandwidth cost-effective polling (BCeP) algorithm and the first-stage selection. Then, based on the modified MMLVN model, the TEMC method is reused to obtain the final optimization subset of the core nodes for efficient traffic monitoring at the second-stage selection. Extensive simulation experiments demonstrate that the proposed scheme can achieve a desirable tradeoff between the monitoring overhead and accuracy, and also reduce the communication bandwidth cost, which is superior to the existing state-of-the-art schemes.

Monitoring and Modeling the Patterns and Trends of Urban Growth Using Urban Sprawl Matrix and CA-Markov Model: A Case Study of Karachi, Pakistan

Understanding the spatial growth of cities is crucial for proactive planning and sustainable urbanization. The largest and most densely inhabited megapolis of Pakistan, Karachi, has experienced massive spatial growth not only in the core areas of the city, but also in the city’s suburbs and outskirts over the past decades. In this study, the land use/land cover (LULC) in Karachi was classified using Landsat data and the random forest algorithm from the Google Earth Engine cloud platform for the years 1990, 2000, 2010, and 2020. Land use/land cover classification maps as well as an urban sprawl matrix technique were used to analyze the geographical patterns and trends of urban sprawl. Six urban classes, namely, the primary urban core, secondary urban core, sub-urban fringe, scatter settlement, urban open space, and non-urban area, were determined for the exploration of urban landscape changes. Future scenarios of LULC for 2030 were predicted using a CA–Markov model. The study found that the built-up area had expanded in a considerably unpredictable manner, primarily at the expense of agricultural land. The increase in mangroves and grassland and shrub land proved the effectiveness of afforestation programs in improving vegetation coverage in the study area. The investigation of urban landscape alteration revealed that the primary urban core expanded from the core districts, namely, the Central, South, and East districts, and a new urban secondary core emerged in Malir in 2020. The CA–Markov model showed that the total urban built-up area could potentially increase from 584.78 km2 in 2020 to 652.59 km2 in 2030. The integrated method combining remote sensing, GIS, and an urban sprawl matrix has proven invaluable for the investigation of urban sprawl in a rapidly growing city.

Purposeful Incorporation of Patient Narratives in the Medical Record in the Netherlands.

Structuring patient and practice data into episodes formed the foundation of the earliest evidence base of family medicine. We aim to make patients' narratives part of the evidence base for family medicine by incorporating coded and structured information on the patient's reason to visit the family physician (FP) and adding the patient's personal and contextual characteristics to routine registration data. This documentation allows studies of relations between morbidity and elements of the patient story, providing more insight into the range of problems presented to primary care and in the patient-centeredness applied by FPs. The Dutch Practice-Based Research Network (PBRN), named FaMe-Net, is the world's oldest PBRN. Seven Dutch family practices provide regular primary care and participate in the PBRN. It contains all morbidity data of the approximately 40,000 listed patients (308,000 patient-years and 2.2 million encounters from 2005 until 2019). All information belonging to 1 health problem is ordered in 1 episode. Morbidity (diagnoses), reasons for encounter (RFE), and interventions are coded according to the International Classification of Primary Care (ICPC-2). Registration occurs within the electronic health record (EHR), specially designed to facilitate the extensive registration for the PBRN. Since 2016, the network expanded routine registration with the duration of symptoms and coded personal and contextual characteristics (eg, country of birth, level of education, family history, traumatic events) obtained through the self-reported 'context survey' of listed patients. These data are added to the EHR. Registered data are extracted from the EHR and processed for scientific research.We present data on the differences in RFEs of the most prominent symptoms of COVID-19 between 2019 and 2020; the relation between the diagnosis of pneumonia and presentation of the symptom 'cough,' and how personal determinants influence the chances of final diagnoses. Lastly, we show the relation of self-reported abuse with patient's contact frequency and psychosocial problems. Prompt introduction of registration rules brought insight into COVID-19-related symptoms early in the pandemic. In March 2020, symptoms related to COVID-19 were presented more often than in March 2019. Chronic conditions and prevention showed a collapsing contact frequency. Telephone, email, and video consultations increased from 31% to 53%.Episodes of pneumonia most frequently started with the RFE 'cough.' A combination of 'cough' and 'fever' as RFE increases the likelihood of pneumonia, as does cough in the presence of comorbid COPD among older men. The prevalence of pneumonia is higher among patients with low socioeconomic status. The Dutch PBRN FaMe-Net has started to add elements of patients' narratives and context to decades of morbidity registration, creating options for a scientific approach to primary care's core values. Assumptions of 'pre/post chances' of the final diagnosis, already existing implicitly in FPs minds, can be elaborated and quantified by investigating the associations between multiple registered variables, including parts of patients' 'stories.' This way, we aim to make visible what is intuitively already known by FPs.

Systematic Investigation of the Effect of Powerful Tianma Eucommia Capsule on Ischemic Stroke Using Network Pharmacology.

Background Ischemic stroke (IS) is a serious disease with a high rate of death and disability, and a growing number of people are becoming victims. Existing drugs not only have limited therapeutic effects but also have obvious side effects. Most importantly, drug resistance due to long-term or improper use of drugs is detrimental to patients. Therefore, it is urgent to find some alternative or supplementary medicines to alleviate the current embarrassment. Powerful Tianma Eucommia Capsule (PTEC) is mainly used to treat IS in China for thousands of years; however, the molecular mechanism is not clear. Methods Pharmacology ingredients and target genes were filtered and downloaded from websites. A pharmacology ingredient-target gene network was constructed to predict the molecular interactions between ingredients and target genes. Enrichment analysis was performed to explore the possible signal pathways. LeDock was used to simulate the interaction form between proteins and main active ingredients and to deduce key amino acid positions. Results Two hundred eighty-nine target genes and seventy-four pharmacological ingredients were obtained from public databases. Several key ingredients (quercetin, kaempferol, and stigmasterol) and primary core target genes (PTGS1, NCOA2, and PRSS1) were detected through ingredient-target gene network analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis demonstrated that ingredients affect networks mainly in nuclear receptor activity and G protein-coupled amine receptor activity; besides, fluid shear stress and atherosclerosis, human cytomegalovirus infection, and hepatitis B signaling pathways might be the principal therapy ways. A series of presumed key amino acid sites (189ASP, 190SER, 192GLN, 57HIS, and 99TYE) were calculated in PRSS1. Six of the target genes were differentially expressed between male and female patients. Conclusions Seven new putative target genes (ACHE, ADRA1A, AR, CHRM3, F7, GABRA1, and PRSS1) were observed in this work. Based on the result of GO and KEGG analysis, this work will be helpful to further demonstrate the molecular mechanism of PTEC treatment of IS.

The 30 ROC trial: Precision intra-treatment imaging guiding major radiation reduction in human papillomavirus related oropharyngeal cancer.

6019 Background: Our previously published proof-of-concept trial using functional imaging to select patient with human papillomavirus (HPV) oropharyngeal carcinoma (OPC) for radiation de-escalation showed promising results. Here we report the outcome of a larger validation trial using the same paradigm where select HPV+ OPC patients received a definitive dose of 30Gy concurrently with chemotherapy and were subsequently observed. Methods: The trial enrolled patients who had p16+, T0-2, N1-N2c, M0 OPC by AJCC 7th TNM. Patients were required to have resection of the primary site (negative margin not required) or core biopsy of lymph node if unknown primary. In addition to standard positron emission tomography (PET), a pre-radiation dynamic 18F-FMISO (fluoromisonidazole) PET was performed to identify hypoxia in gross nodal disease. Patients with evidence of hypoxia ( > 1.2 tumor to muscle standard uptake value on 18F-FMISO) underwent repeat18F-FMISO PET around 2 weeks into radiation. Patients without pre-radiation hypoxia or with resolution of hypoxia on 18F-FMISO PET received 30Gy with 2 cycles of concurrent chemotherapy (cisplatin 100mg/m2 or carboplatin AUC 1.25 x 4 with 5-fluorouracil 2400 mg/m2). Results: From 11/2/17-1/4/21, 158 HPV+ OPC patients consented and were enrolled on trial. Patient characteristics were as follows: male (90%); ages 36-80 years; T-stage T0(26), T1(77), T2(55); N stage N1(19), N2a(15), N2b(95), N2c(29). Of the 114 patients with pre-treatment hypoxia, 24 had persistent hypoxia and received 70Gy. 128 patients were de-escalated to 30Gy and chemotherapy (86% cisplatin). 6 patients withdrew from trial [3 decided to receive standard of care; 3 refused 18F-FMISO PET]. Acute mucositis rates were 11% grade 0, 59% grade 1, and 30% grade 2, respectively. Acute xerostomia rates were 92% grade 1 and 8% grade 2, respectively. Weight loss was infrequent and only 19% complained of grade 1 and 5% complained of grade 2 weight loss. Six patients experienced grade 3 adverse events (diarrhea (2), syncope (2), vasovagal (1), dysphagia (1)). No patients required PEG tubes. With a median follow-up is 12 months (range: 2 months to 40 months), the 1-year locoregional control, distant metastasis-free overall survival rates were 94%, 100%, and 100%, respectively. Among the 30Gy de-escalated patients, none failed in the primary site. 8 patients had recurrent nodal disease underwent successful salvage surgery of which no additional therapy was given to 4 patients. Conclusions: Major de-escalation to 30Gy using patient specific treatment response based on hypoxia resolution resulted in excellent locoregional control with significant toxicity reduction. Updated results along with detailed correlative analysis will be presented. Clinical trial information: NCT03323463.

Secondary Eddy Current Losses Reduction in a Double-Sided Long-Primary Fractional Slot Concentrated Winding Permanent Magnet Linear Synchronous Motor

A novel design method for the primary structure of a double-sided long-primary fractional-slot concentrated winding permanent magnet linear synchronous motor (DSLP-FSCW-PMLSM) is proposed in this article. Different from the traditional symmetric primary structure, the primary structure obtained by the proposed design method has two asymmetric primary cores and two asymmetric primary windings. This unique structure can reduce the variation of the flux density caused by the primary core slotting, and can effectively reduce the slot harmonic contents of the armature reaction magnetic field; thus, it can significantly reduce secondary eddy current losses. First, the basic structure is introduced. The air-gap magnetic field of permanent magnet and armature reaction are analyzed in detail. Second, the performance of the proposed motor is analyzed by means of three dimensional finite element method and compared with the traditional motor. The focus is on secondary materials, secondary eddy current losses, thrust, pole arc coefficient, magnet skew angle, and efficiency. Last, experiments are conducted on two prototypes of DSLP-FSCW-PMLSM. The validity of the proposed topology is verified by the test results of static thrust, back electromotive force, and armature reaction air-gap magnetic field.

A study of cool core resiliency and entropy mixing in simulations of galaxy cluster mergers

ABSTRACT We present results from a suite of binary merging cluster simulations. The hydrodynamical cluster simulations are performed employing a smoothed particle hydrodynamics formulation in which gradient errors are strongly reduced by means of an integral approach. We consider adiabatic as well as radiative simulations, in which we include gas cooling, star formation, and energy feedback from supernovae. We explore the effects of merging on the thermodynamic structure of the intracluster gas of the final merger remnant. In particular, we study how core entropy is generated during the merging and the stability properties of the initial cool-core profile against disruption. To this end, we consider a range of initial mass ratio and impact parameters. Final entropy profiles of our adiabatic merging simulations are in good accord with previous findings, with cool-cores being disrupted for all of the initial merging setups. For equal-mass off-axis mergers, we find that a significant contribution to the final primary core entropy is due to hydrodynamic instabilities generated by rotational motions, which are induced by tidal torques during the first pericentre passage. In radiative simulations, cool-cores are more resilient against heating processes; none the less, they are able to maintain their integrity only in the case of off-axis mergers with very unequal masses. We suggest that these results are robust against changes in the gas physical modelling, in particular to the inclusion of AGN thermal feedback. Our findings support the view that the observed core cluster morphology emerges naturally in a merging cluster context, and conclude that the merging angular momentum is a key parameter in shaping the thermodynamical properties of the final merger remnant.