bluuebunny/crossref_metadata_2025 huggingface dataset:
First investigation of coherent terahertz radiation at a Super Tau Charm Factory
Authors: Gao W.W. , Lan J.Q. , Zhao F.Y. , Luo Q.
Published: January 2022

The coherent THz radiation with long-short beam operation
mode is discussed at a Super Tau Charm Factory. The beam dynamics,
RF parameters and some important issues are given. Two version of
short bunch length are designed. Results show that the 2.0 mm short
bunch length correspond to the frequency where the radiation power
decreased sharply. The short bunch length should minimized to
smaller than 1.5 mm at this facility to achieve proper coherent
radiation power at THz frequency region.
Present and future land surface and wet bulb temperatures in the Arabian Peninsula
Authors: Safieddine S , Clerbaux C , Clarisse L , Whitburn S , Eltahir E A B
Published: January 2022

The Arabian Peninsula exhibits extreme hot summers and has one of the world’s largest population growths. We use satellite observations and reanalysis as well as climate model projections to analyze morning and evening land surface temperatures (LSTs), to refer to processes at the surface, and wet bulb temperatures (WBTs) to measure human heat stress. We focus on three regions: the Persian Gulf and Gulf of Oman, the inland capital of Saudi Arabia, Riyadh and the irrigated agricultural region in Al-Jouf, Saudi Arabia. This study shows that the time of day is important when studying LST and WBT, with current and future WBT higher in the early summer evenings. It also shows that the effect of humidity brought from waterbodies or through irrigation can significantly increase heat stress. Over the coasts of the Peninsula, humidity decreases LST but increases heat stress via WBT values higher than 25 °C in the evening. Riyadh, located in the heart of the Peninsula has lower WBT of 15 °C–17.5 °C and LST reaching 42.5 °C. Irrigation in the Al-Jouf province decreases LST by up to 10° with respect to its surroundings, while it increases WBT by up to 2.5°. Climate projections over the Arabian Peninsula suggest that global efforts will determine the survivability in this region. The projected increase in LST and WBT are +6 °C and +4 °C, respectively, in the Persian Gulf and Riyadh by the end of the century, posing significant risks on human survivability in the Peninsula unless strict climate mitigation takes place.
Dynamic transitions of the magnetized spherical Couette flow between its base state and the return flow instability
Authors: Ogbonna J , Garcia F , Gundrum T , Seilmayer M , Stefani F
Published: January 2022

The transition between the stable base state of the magnetized spherical Couette (MSC) flow and the return flow instability is experimentally investigated. The experiments are conducted using an MSC setup consisting of insulating spheres with the ratio of the inner to the outer radii r
i/r
o = 0.5, Reynolds number Re = 1000 and Hartmann number Ha ∈ [25, 29]. The transition is characterized by changes in the power spectra of the azimuthal modes in the flow as Ha is dynamically changed. The transition occurs in the interval Ha ∈ [26.5, 27.5]. The evolution of the power spectra of the azimuthal modes exhibits hysteretic effect depending on whether Ha is increased or decreased within the experimental interval. The power spectra in the azimuthal modes m ∈ {3, 4} increases and remains dominant as Ha is increased, while the power spectra in m ∈ {2, 4} are dominant while the flow is time dependent due to return flow instability as Ha is decreased.
Effects of growth time on the material properties of CdTe/CdSe core/shell nanoparticles prepared by a facile wet chemical route
Authors: Kiprotich Sharon , Dejene F B , Onani Martin O
Published: January 2022

This study presents a facile synthetic approach used to prepare CdTe/CdSe core/shell nanoparticles (NPs). The effects of reaction time on the material properties of the CdTe/CdSe NPs are reported. It was realized that the reaction time has significant impact on the CdSe shell growth on the CdTe core. Various techniques were used to characterize the as-prepared CdTe/CdSe NPs. The x-ray diffraction (XRD) was used to study the crystal structure and the possible growth of the CdSe shell on the CdTe core. The results obtained indicated the formation of zinc blende crystal structure which was transformed from a polycrystalline to single crystalline structure. The XRD pattern displayed features that are intermediate between the CdTe and CdSe, a sign of shell formation and not two separate compounds formed. This was also supported by high resolution transmission electron microscope images obtained. The crystallite sizes estimated using Scherrer formula were all less than 3 nm showing that the NPs are in quantum confinement regime. Scanning electron microscope was used to determine the surface topography while the energy x-ray dispersive spectrometer displayed the elemental composition of the as-prepared NPs. SEM and HRTEM images showed uniformly distributed spherical NPs with some agglomerations observed at longer duration of synthesis. The optical properties (photoluminescence (PL) and absorbance) investigated at different reaction times (20, 40, 60 and 80 min) presented novel features which show the formation of a thin CdSe shell on the CdTe core NPs. The PL emission wavelength was dramatically red shifted upon the growth of the CdSe shell on the CdTe core (from 541–615 nm). Other unique features of the as-grown CdTe/CdSe NPs are discussed in detail. The obtained results displayed good material properties of the CdTe/CdSe NPs suitable for use in biomaging applications.
Microstructure and tribological property of a MXene derived from Ti3AlC2
Authors: Liu Fuyan , Liu Fujie , Zhang Rui , Chen Xinhong
Published: January 2022

Ti3C2 layers with a layered two-dimensional structure are synthesized by immersing a precursor Ti3AlC2 with hydrofluoric acid solution. The microstructure of Ti3C2 layers is analyzed by SEM, XRD, Raman and AFM. Additionally, the tribological behavior of Ti3C2 layers is investigated at various loads and sliding speeds by sliding against Si3N4 balls on a UMT-2 tribometer. In comparison, the tribological behavior of Ti3AlC2 at various loads is tested under identical condition. The results indicate that the Ti3C2 layers have been successfully prepared and their thickness mainly distributes in the range of 2.3–3.1 nm. Moreover, the Ti3C2 layers exhibit better tribological behavior than its precursor -Ti3AlC2 in dry sliding. It is expected that the Ti3C2 layers will be applied as a solid lubricant additive for other materials.
Novel fabrication of marizomib-loaded chitosan-coated hydroxyapatite nanocarriers as a promising system for effective treatment of ovarian cancer
Authors: Xu Jia , Liao Meimei , Chen Yi , Chen Lingfeng
Published: January 2022

Cancer therapy might benefit significantly from nanotechnology. These nano-drug delivery systems (NDDS) have been established to improve the therapeutic benefits of anticancer medications by enhancing their bioavailability, degradation, and biocompatibility. One of the most promising NDDS for cancer therapy is high-performance hydroxyapatite (HA) nanoparticles, which have many advantages. The metabolite marizomib inhibits tumor cell growth and progression, functioning as a biochemical inhibitor in many malignancies. However, this substance’s low bioavailability is the most significant problem with its use. In this work, a pH-sensitive biopolymer was employed to encapsulate HA nanoparticles with chitosan to increase marizomib’s (MARI) efficacy and bioavailability. The sol-gel process was used to fabricate HA nanoparticles for this purpose. It was then coated with chitosan before encasing the marizomib drug in the nanocarrier, which was done under controlled circumstances. The newly fabricated nanoparticles effectively kill ovarian A2780 cancer cells and induce apoptosis. The morphological examination of the cancer cells was examined by AO/EB and DAPI staining methods. Further, the cell uptake was measured by the flow cytometry methods, and the result shows the nanoparticles were effectively uptake the cancer cells under different incubation times. In principle, nanoparticles have great potential for future pre-clinical applications in treating ovarian cancer cells and suppressing other types of tumors.
Effects of boron addition on the microstructure and creep properties of a Ni-Fe-based superalloy weld metal alloy
Authors: Xie Wencai , Wu Dong , Lu Shanping
Published: January 2022

The role of boron in the creep properties and grain boundary characteristics in a new Ni-Fe-based weld metal suitable for advanced ultra-supercritical (A-USC) coal-fired power plant applications has been investigated. Ni-Fe-based filler wires without boron and boron-doped (50 ppm wt% boron) were prepared for this study. Boron-doped weld metals exhibited longer rupture lives and lower steady creep rates during the creep rupture tests at 750 °C / 380 MPa and 750 °C / 210 MPa. This study explains the improvement mechanism of boron on creep resistance from the perspective of the effect of boron on M23C6. Boron increased the nucleation rate of M23C6 and participated in the formation of M23(C, B)6 type boron-carbides. After creep deformation, boron still existed stably in the M23(C, B)6. The higher density of discrete M23C6 particles due to boron addition could restrain grain boundary crack propagation and grain boundary sliding, and thereby improve the creep fracture resistance of the GH984G weld metal at 750 °C / (380/ 210 MPa).
Electromagnetic vortex topologies from sparse circular phased arrays
Authors: Wang H , Szekerczes K , Afanasev A
Published: January 2022

Structured vortex waves have numerous applications in optics, plasmonics, radio-wave technologies and acoustics. We present a theoretical study of a method for generating vortex states based on coherent superposition of waves from discrete elements of planar phased arrays, given limitations on an element number. Using Jacobi-Anger expansion, we analyze emerging vortex topologies and derive a constraint for the least number of elements needed to generate a vortex with a given leading-order topological charge.
Beyond structural analysis of molecular enzyme-inhibitor interactions
Authors: Welborn V Vaissier
Published: January 2022

Fast and effective drug discovery processes rely on rational drug design to circumvent the tedious and expensive trial and error approach. However, accurate predictions of new remedies, which are often enzyme inhibitors, require a clear understanding of the nature and function of the key players governing the interaction between the drug candidate and its target. Here, we propose to calculate electric fields to explicitly link structure to function in molecular dynamics simulations, a method that can easily be integrated within the rational drug discovery workflow. By projecting the electric fields onto specific bonds, we can identify the system components that are at the origin of stabilizing intermolecular interactions (covalent and non-covalent) in the active site. This helps to significantly narrow the exploration space when predicting new inhibitors. To illustrate this method, we characterize the binding of the non-covalent inhibitor X77 to the main protease of SARS-CoV-2, a particularly time-sensitive drug discovery problem. With electric field calculations, we were able to identify three key residues (Asn-142, Met-165 and Glu-166), that have functional consequences on X77. This contrasts with the nearly 20 residues reported in previous studies as being in close contact with inhibitors in the active site of the protease. As a result, the search for new non-covalent inhibitors can now be accelerated by techniques that look to optimize the interaction between candidate molecules and these residues.
Two-dimensional materials for artificial synapses: toward a practical application
Authors: Wang I-Ting , Chang Chih-Cheng , Chen Yen-Yu , Su Yi-Shin , Hou Tuo-Hung
Published: January 2022

Combining the emerging two-dimensional materials (2DMs) and neuromorphic computing, 2DM-based synaptic devices (2DM synapse) are highly anticipated research topics with the promise of revolutionizing the present Si-based computing paradigm. Although the development is still in the early stage, the number of 2DM synapses reported has increased exponentially in the past few years. Nevertheless, most of them mainly focus on device-level synaptic emulations, and a practical perspective toward system-level applications is still lacking. In this review article, we discuss several important types of 2DM synapses for neuromorphic computing. Based on the cross-layer device-circuit-algorithm co-optimization strategy, non-ideal properties in 2DM synapses are considered for accelerating deep neural networks, and their impacts on system-level accuracy, power and area are discussed. Finally, a development guide of 2DM synapses is provided toward accurate online training and inference in the future.
Does racism equal prejudice plus power?
Authors: Scott Jordan
Published: January 2022

An increasingly common view is that ‘racism’ can be defined as prejudice plus power. However, this view is ambiguous between two interpretations. The first proposes a descriptive definition, claiming that a prejudice plus power account of ‘racism’ best accounts for our ordinary usage of the term. The second proposes a revisionary definition, claiming that we should adopt a new account of ‘racism’ because doing so will bring pragmatic benefit. In this paper, I argue that the prejudice plus power view is unsatisfying on either interpretation.
In Situ Otoacoustic Emission Monitoring to Assess the Effects of Noise Exposure on Hearing Health
Authors: Nadon Vincent , Voix Jérémie
Published: January 2022

Noise-induced hearing loss (NIHL) is the largest cause of action for indemnity in North American industries despite the widespread implementation of hearing conservation programs. Possible causes behind the onset of NIHL are the intervals between hearing tests which are generally too long and the tests are insufficiently sensitive to detect temporary hearing changes to act and prevent permanent hearing damage. Moreover, current noise regulations might be too lenient as to the permissible maximum noise levels. Short-interval hearing assessment could help to observe temporary changes in hearing health and prevent permanent damage. This study investigates the short-term effects of noise exposure characteristics using repeated measurements of otoacoustic emission (OAE) growth functions and presents the most significant predictors of hearing health changes as observed in sixteen individuals equipped with OAE earpieces. The experimental results of this study show that the impulsiveness and frequency spectrum of the noise level could be a possible cause of the decline in OAE levels. As a consequence, hearing conservation programs should consider taking these noise metrics into account for proper NIHL risk assessment. Such noise exposure and hearing health monitoring could greatly improve hearing conservation practices in the workplace by acting faster and eventually mitigate occupational hearing loss.
cropCSM: designing safe and potent herbicides with graph-based signatures
Authors: Pires Douglas E V , Stubbs Keith A , Mylne Joshua S , Ascher David B
Published: January 2022

Herbicides have revolutionised weed management, increased crop yields and improved profitability allowing for an increase in worldwide food security. Their widespread use, however, has also led to a rise in resistance and concerns about their environmental impact. Despite the need for potent and safe herbicidal molecules, no herbicide with a new mode of action has reached the market in 30 years. Although development of computational approaches has proven invaluable to guide rational drug discovery pipelines, leading to higher hit rates and lower attrition due to poor toxicity, little has been done in contrast for herbicide design. To fill this gap, we have developed cropCSM, a computational platform to help identify new, potent, nontoxic and environmentally safe herbicides. By using a knowledge-based approach, we identified physicochemical properties and substructures enriched in safe herbicides. By representing the small molecules as a graph, we leveraged these insights to guide the development of predictive models trained and tested on the largest collected data set of molecules with experimentally characterised herbicidal profiles to date (over 4500 compounds). In addition, we developed six new environmental and human toxicity predictors, spanning five different species to assist in molecule prioritisation. cropCSM was able to correctly identify 97% of herbicides currently available commercially, while predicting toxicity profiles with accuracies of up to 92%. We believe cropCSM will be an essential tool for the enrichment of screening libraries and to guide the development of potent and safe herbicides. We have made the method freely available through a user-friendly webserver at http://biosig.unimelb.edu.au/crop_csm.
‘Trap Life’: The psychosocial underpinnings of street crime in inner-city London
Authors: Reid Ebony
Published: January 2022

This article explores urban men’s involvement in the drug economy, examining the conditions in which they become ‘trapped’ in difficult lifeworlds and identities. Through an ethnographic exploration of what disadvantaged urban men term ‘trap life’, this article demonstrates how different ‘trapper’ identities, enacted to manage economic, social and psychological vulnerability, allows an understanding of the varied motivations to take part in criminality and violence. Whilst the terms ‘dangerous’, ‘pathological’ and ‘criminal’ are deployed to account for street lifestyles, such stereotypical imagery with roots in history, media, political discourse and policing practices, downplays the humanity of men living on the margins of society and neglects their version of reality. Far from being exclusively violent perpetrators, urban men are especially vulnerable as they are trapped in a never-ending existential crisis, which prevents successful transitions into mainstream life. I demonstrate that the issue of violence and the 21st century drug business must be placed in broader psychosocial contexts to provide a better understanding and perhaps one-day inform therapeutic and other practice interventions specifically tailored for those seeking to exit ‘trap life’.
Chagas Disease Prevalence in a Cohort of Neurocysticercosis Patients in a Nonendemic Setting
Authors: McAleese Katherine R , Guzmán Janitzio J , Thumm Lauren , Nutman Thomas B , Showler Adrienne , O’Connell Elise M
Published: January 2022

In a cohort of mostly Central American immigrants with confirmed neurocysticercosis (NCC), 3.1% were confirmed positive for Chagas disease (CD). The majority were diagnosed with NCC before age 50. Entry to care for NCC is an opportunity for early detection and possible treatment for CD in those from endemic areas.
Balance of Power Redux: Nuclear Alliances and the Logic of Extended Deterrence
Authors: Gheorghe Eliza
Published: January 2022

How do unbalanced nuclear alliances provide extended nuclear deterrence (END) to their members? Why have nuclear alliances chosen certain types of END strategy and not others? Existing accounts regard END as a function of the inter-alliance balance of power, regime type, or institutional design. END strategies inspired by theories focused on regime type and institutional design have not yet materialised, while the inter-alliance balance of power does not suffice to explain the choice of END strategy. To elucidate variations in END strategy, this article puts forward an argument centred on the intra-alliance balance of power. Drawing on the history of the US-led and the Soviet-led alliances during the Cold War, namely North Atlantic Treaty Organization and the Warsaw Pact, it shows how the two superpowers changed their approach to defending their allies with nuclear weapons according to quantitative and qualitative shifts in the distribution of power within the alliance.
Intracranial haemorrhage in adult patients on venoarterial extracorporeal membrane oxygenation
Authors: Lüsebrink Enzo , Zimmer Sebastian , Schrage Benedikt , Dabboura Salim , Majunke Nicolas , Scherer Clemens , Aksoy Adem , Krogmann Alexander , Hoffmann Sabine , Szczanowicz Lukasz , Binzenhöfer Leonhard , Peterss Sven , Kühn Christian , Hagl Christian , Massberg Steffen , Schäfer Andreas , Thiele Holger , Westermann Dirk , Orban Martin ,   for the ICH-VA-ECMO Investigator Group, Kupka Danny , Schmid Teresa , Mauthe Katharina , Joskowiak Dominik , Kääb Stefan , Petzold Tobias , Orban Mathias , Parhofer Klaus G
Published: January 2022

Aims

Intracranial haemorrhage (ICH) is one of the most serious complications of adult patients treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) and is associated with increased morbidity and mortality. However, the prevalence and risk factors of ICH in this cohort are still insufficiently understood. We hypothesized that a considerable proportion of patients undergoing VA-ECMO support suffer from ICH and that specific risk factors are associated with the occurrence of ICH. Therefore, the purpose of this study was to further investigate the prevalence and associated mortality as well as to identify risk factors for ICH in VA-ECMO patients.

Methods and results

We conducted a retrospective multicentre study including adult patients (≥18 years) treated with VA-ECMO in cardiac intensive care units (ICUs) at five German clinical sites between January 2016 and March 2020, excluding patients with ICH upon admission. Differences in baseline characteristics and clinical outcome between VA-ECMO patients with and without ICH were analysed and risk factors for ICH were identified. Among the 598 patients included, 70/598 (12%) developed ICH during VA-ECMO treatment. In-hospital mortality in patients with ICH was 57/70 (81%) and 1-month mortality 60/70 (86%), compared to 332/528 (63%) (P = 0.002) and 340/528 (64%) (P < 0.001), respectively, in patients without ICH. Intracranial haemorrhage was positively associated with diabetes mellitus [odds ratio (OR) 2, 95% confidence interval (CI) 1.11–3.56; P = 0.020] and lactate (per mmol/L) (OR 1.06, 95% CI 1.01–1.11; P = 0.020), and negatively associated with platelet count (per 100 G/L) (OR 0.32, 95% CI 0.15–0.59; P = 0.001) and fibrinogen (per 100 mg/dL) (OR 0.64, 95% CI 0.49–0.83; P < 0.001).

Conclusion

Intracranial haemorrhage was associated with a significantly higher mortality rate. Diabetes mellitus and lactate were positively, platelet count, and fibrinogen level negatively associated with the occurrence of ICH. Thus, platelet count and fibrinogen level were revealed as potentially modifiable, independent risk factors for ICH. The findings address an area with limited data, provide information about risk factors and the epidemiology of ICH, and may be a starting point for further investigations to develop effective strategies to prevent and treat ICH.
Price Floors and Externality Correction*
Authors: Griffith Rachel , O’Connell Martin , Smith Kate
Published: January 2022

We evaluate the impact of a price floor for alcohol introduced in Scotland in 2018, using a difference-in-differences strategy with England as a control group. We show that the policy led to the largest reductions in alcohol units purchased among the heaviest drinkers—the group who, at the margin, are likely to create the largest externalities from drinking. The price floor is well targeted at heavy drinkers because they buy a much greater fraction of their units from cheap products and switched away from these products strongly, with only limited substitution towards more expensive products. We show that if the marginal external cost of drinking is at least moderately higher for heavy than lighter drinkers, then a price floor outperforms an ethanol tax. However, more flexible tax systems can achieve similar reductions in externalities to the price floor, but avoid the large transfers from public funds to the alcohol industry that arise under the floor.
Prognostic impact of secondary prevention after coronary artery bypass grafting—insights from the TiCAB trial
Authors: Heer Tobias , von Scheidt Moritz , Boening Andreas , Heyken Clarissa , Gusmini Friederike , de Waha Antoinette , Kuna Constantin , Fach Andreas , Grothusen Christina , Oberhoffer Martin , Knosalla Christoph , Walther Thomas , Danner Bernhard C , Misfeld Martin , Wimmer-Greinecker Gerhard , Siepe Matthias , Grubitzsch Herko , Joost Alexander , Schaefer Andreas , Conradi Lenard , Cremer Jochen , Hamm Christian , Lange Rüdiger , Radke Peter W , Schulz Rainer , Laufer Günther , Grieshaber Philippe , Attmann Tim , Schmoeckel Michael , Meyer Alexander , Ziegelhöffer Tibor , Hambrecht Rainer , Sandner Sigrid E , Kastrati Adnan , Schunkert Heribert , Zeymer Uwe
Published: January 2022

OBJECTIVES

There are disparities in the adherence to guideline-recommended therapies after coronary artery bypass graft (CABG). We therefore sought to evaluate the effect of guideline-adherent medical secondary prevention on 1-year outcome after CABG.

METHODS

Data were taken from the randomized ‘Ticagrelor in CABG’ trial. From April 2013 until April 2017, patients who underwent CABG were included. For the present analysis, we compared patients who were treated with optimal medical secondary prevention with those where 1 or more of the recommended medications were missing.

RESULTS

Follow-up data at 12 months were available in 1807 patients. About half (54%) of them were treated with optimal secondary prevention. All-cause mortality [0.5% vs 3.5%, hazard ratio (HR) 0.14 (0.05–0.37), P < 0.01], cardiovascular mortality [0.1% vs 1.7%, HR 0.06 (0.01–0.46), P = 0.007] and major adverse events [6.5% vs 11.5%, HR 0.54 (0.39–0.74), P < 0.01] were significantly lower in the group with optimal secondary prevention. The multivariable model for the primary end point based on binary concordance to guideline recommended therapy identified 3 independent factors: adherence to guideline recommended therapy [HR 0.55 (0.39–0.78), P < 0.001]; normal renal function [HR 0.99 (0.98–0.99), P = 0.040]; and off-pump surgery [HR 2.06 (1.02–4.18), P = 0.045].

CONCLUSIONS

Only every second patient receives optimal secondary prevention after CABG. Guideline adherent secondary prevention therapy is associated with lower mid-term mortality and less adverse cardiovascular events after 12 months.
Risk factors for mortality after cardiovascular surgery in patients with functional single ventricle and right isomerism
Authors: Hirose Keiichi , Ikai Akio , Ito Hiroki , Ishidou Motonori , Nakatani Eiji , Sakamoto Kisaburo
Published: January 2022

OBJECTIVES

Cardiac malformations are a major component of heterotaxy syndrome that results in significant mortality and morbidity, especially in patients with a single ventricle and right isomerism (RI). The goal of this study was to evaluate the mortality after cardiovascular surgery in patients with a functional single ventricle and RI over a long follow-up period (∼40 years) and to determine the predicted risk factors for mortality.

METHODS

We performed a retrospective review of the medical records of 129 consecutive patients with functional single ventricle and RI who underwent pulmonary flow control operations at Mt. Fuji Shizuoka Children’s Hospital between 1979 and 2020. To evaluate mortality rates, the patients were divided into 2 groups (era 1: 1979–1999 and era 2: 2000–2020) based on the date of the first-stage palliation.

RESULTS

The estimated survival rate at 10 years was 36.4% in era 1 and 57.8% in era 2. The estimated survival rate improved significantly (P = 0.0268) between the 2 eras. The rate of Fontan procedure completion was also significantly better in the current era (P = 0.0392; 22/59 in era 1 and 38/66 in era 2). In the multivariable analysis, the date of the first-stage palliation was the only predictor of mortality.

CONCLUSIONS

The mortality rate after cardiovascular surgery in patients with a functional single ventricle and RI has improved over the past 20 years; however, it still remains high. This improvement may be attributed to our current surgical strategy and clinical management; however, further investigations are needed to prove this observation.
National evaluation of risk factors for unplanned readmission after lung resection
Authors: Pons Aina , Guirao Ángela , Fibla Juan J , Carvajal Carlos , Embun Raúl , Sánchez David , GEVATS  , Hernández Jorge
Published: January 2022

OBJECTIVES

Unplanned readmission is defined as the return to inpatient hospitalization within 30 days after discharge. Worldwide, its incidence after lung resection ranges between 8% and 50%, and it has been shown to impact both patient recovery and healthcare resources. Our goal was to identify the risk factors to prioritize early follow-ups.

METHODS

We analysed data from the database of the Grupo Español de Cirugía Torácica Video-Asistida from 33 thoracic surgery departments over 15 months. Standard tests were used to compare the different risk groups. Our goal was to present the most relevant explanatory variables for readmission.

RESULTS

A total of 174 of 2808 patients (6%) underwent unplanned readmission after a lobectomy. Of all the preoperative individual characteristics, only lung function was found to be a risk factor for readmission [forced expiratory volume in 1 s < 80%, risk ratio (RR) 1.78, P < 0.001; diffusing capacity of carbon monoxide <60%, RR 1.6, P = 0.02; and VO2 < 20 ml/kg/min, RR 1.59, P = 0.02]. The tumour’s characteristics and the stage of the disease did not have an influence on the readmission rates. In the readmitted cohort, an open approach or thoracotomy was associated with more frequent readmissions (RR 1.77; P < 0.001). Strong adhesions (RR 1.81; P < 0.001) or adhesions occupying more than half of the hemithorax (RR 1.73, P < 0.001) were also found to be risk factors for readmission and for longer operative times. A length of stay of >10 days after a lobectomy was found to be a risk factor for readmission (RR 1.9).

CONCLUSIONS

We identified preoperative, intraoperative and postoperative risk factors for readmission. This information can be a useful tool to help with the prioritization of early follow-ups, especially in centres with high workloads.
Intermediate-term outcomes of deferred Norwood strategy
Authors: Hoashi Takaya , Imai Kenta , Okuda Naoki , Komori Motoki , Kurosaki Kenichi , Ichikawa Hajime
Published: January 2022

OBJECTIVE

The aim of this study was to assess outcomes of the deferred Norwood strategy, i.e. planned Norwood following routine bilateral pulmonary artery banding and ductal stenting or continuous prostaglandin E1 administration.

METHODS

Forty-five patients with hypoplastic left heart syndrome and its variants treated with the deferred Norwood strategy between 2012 and 2021 were enrolled. Mid-term outcomes were retrospectively reviewed. The median follow-up period after Norwood in hospital survivors was 4.6 years (interquartile range: 1.9, 6.8).

RESULTS

Fourteen patients (31.1%) had no risk factors. The median age and weight at Norwood were 1.8 months (0.9, 3.5) and 3.1 kg (2.7, 3.6). Transplant-free survival at 6 years was 84.5%. Birth weight ≤2.5 kg and systemic atrioventricular valve (SAVV) regurgitation ≥ moderate after birth were not risk factors for mortality; body weight at Norwood ≤2.5 kg, however, was a risk factor [hazard ratio (HR), 11.3; 95% confidence interval (CI), 1.2–11; P = 0.036]. Twenty-two (48.9%) underwent Fontan with no mortalities, and 7 (15.5%) are awaiting Fontan. Freedom from SAVV surgery at 5 years was 53.1%. SAVV regurgitation ≥ moderate after birth was a risk factor for SAVV surgery (HR, 16; 95% CI, 3.6–71; P < 0.001); however, ductal stenting had a protective effect against SAVV surgery (HR, 0.09; 95% CI, 0.01–0.68; P = 0.019). Freedom from both surgical and catheter-based pulmonary artery intervention at 3 years was 27.1%

CONCLUSIONS

Although deferred Norwood provided acceptable intermediate-term survival, the Fontan completion rate was unsatisfactory. SAVV surgery and pulmonary artery intervention were frequently required.
Performance of prolonged air leak scoring systems in patients undergoing video-assisted thoracoscopic surgery segmentectomy
Authors: Gonzalez Michel , Karenovics Wolfram , Bédat Benoît , Forster Celine , Sauvain Marc-Olivier , Triponez Frédéric , Christodoulou Michel , Krueger Thorsten , Perentes Jean Yannis
Published: January 2022

OBJECTIVES

We assessed the accuracy of 3 validated lobectomy scoring systems to predict prolonged air leak (PAL) in patients undergoing video-assisted thoracoscopic surgery (VATS) segmentectomy.

METHODS

We reviewed all consecutive patients who had a VATS segmentectomy between January 2016 and October 2020. We determined PALs on postoperative day 5. These findings were correlated with the calculated Brunelli (gender, age, body mass index [BMI], forced expiratory volume in 1 s < 80 and pleural adhesion), Epithor (gender, location, dyspnoea score, BMI, type of resection and pleural adhesion) and European Society of Thoracic Surgeons (ESTS) (gender, BMI and forced expiratory volume in 1 s) scores of each patient.

RESULTS

A total of 453 patients (mean age: 66.5 years, female/male sex ratio: 226/227) underwent a VATS segmentectomy for malignant (n = 400) and non-malignant (n = 53) disease. Postoperative cardiopulmonary complications and in-hospital mortality rates were 19.6% and 0.4%, respectively. Median chest tube drainage duration and hospital stay were 2 (interquartile range: 1-4) and 4 (interquartile range: 3-7) days, respectively. On day 5, the prevalence of PAL was 14.1%. The ESTS, Brunelli and Epithor scores for the treated population were, respectively, class A (6.8%), class B (3.2%), class C (10.8%) and class D (28.2%); very low and low (0%), moderate (5%), high (6.3%) and very high (21%); and class A (7%), class B (13.2%), class C (24%) and class D (27.8%). All scores correlated with PAL (p ≤ 0.001). The areas under the receiver operating characteristic (ROC) curve were 0.686, 0.680 and 0.644, respectively.

CONCLUSIONS

All 3 scoring systems were correlated with PAL > 5 days following the VATS segmentectomies. ESTS scores seem easier to introduce in clinical practice, but validation by a multicentre cohort is mandatory.
A classification of abdominal lymphatic perfusion patterns after Fontan surgery
Authors: Schroeder Christian , Moosmann Julia , Cesnjevar Robert , Purbojo Ariawan , Rompel Oliver , Dittrich Sven
Published: January 2022

OBJECTIVES

Complications after Fontan surgery have been associated with arise and classification of abnormal thoracic lymphatic perfusion pattern. This study compiles abnormal abdominal lymphatic perfusion patterns and investigates their impact on serum protein readings.

METHODS

We performed a retrospective analysis of patients who underwent magnetic resonance imaging with T2-weighted lymphatic imaging and serum protein measurements 6 months after having Fontan surgery. The abdominal lymphatic images were classified according to the anatomical lymphatic drainage patterns into 2 categories: (1) para-aortic (types 1–4); (2) portal-venous (types 1–3). Thoracic lymphatic images were classified (types 1–4) as described earlier.

RESULTS

A total of 71 patients were included in the study. Para-aortic lymphatic perfusion patterns were classified as type 1 in 4, type 2 in 13, type 3 in 37 and type 4 in16 out of 71 patients. Portal-venous lymphatic perfusion patterns were classified as type 1 in 20, type 2 in 10 and type 3 in 41 patients. Thoracic lymphatic perfusion patterns were classified as type 1 in 8, type 2 in 11, type 3 in 39 and type 4 in 13 patients. The serum protein level was 66 (interquartile range: 7.5) g/l (< standard value in 37%). Higher-grade para-aortic (p = 0.0062), portal-venous (p = 0.022) and thoracic (p = 0.011) lymphatic abnormalities were correlated with lower total serum protein levels. Higher ratings of para-aortic lymphatic abnormalities were significantly associated with higher ratings of portal-venous abnormalities (p < 0.0001). Ratings of para-aortic and portal-venous classifications were correlated with the thoracic classification (p < 0.001).

CONCLUSIONS

Abnormal abdominal lymphatic perfusion patterns can be classified according to anatomical structures with increasing severity. Higher grade abdominal and thoracic lymphatic perfusion patterns are associated with lower serum protein values.
Early- and longer-term outcomes of David versus Florida sleeve procedure: propensity-matched comparison
Authors: Holubec Tomas , Rashid Hiwad , Hecker Florian , Karimian-Tabrizi Afsaneh , Miskovic Alexandra , Hlavicka Jan , Zacek Pavel , Van Linden Arnaud , Moritz Anton , Walther Thomas
Published: January 2022

OBJECTIVES

The aim of this study was to compare short- and longer-term outcomes of David (DV) versus Florida sleeve (FS) procedure in patients requiring valve-sparing aortic root replacement.

METHODS

Between January 1996 and December 2020 285 patients received a DV procedure (median age 60 years; 26% females) and 57 patients underwent an FS procedure (median age 64 years; 19% females) in our department. Propensity score matching using patient characteristics led to 58 (DV) versus 57 (FS) patients. End points were defined as primary: freedom from aortic valve and/or aortic root-related reoperation and freedom from aortic regurgitation ≥moderate and secondary: early and late survival.

RESULTS

Thirty-day mortality was 2% (DV) and 0% (FS) (P = 0.319). There was 1 early stroke in each group (P = 0.990). Follow-up was complete in 99% with only 1 patient (FS) lost. The 5- and 10-year freedom from aortic valve and/or aortic root related reoperation was 98 ± 2% and 96 ± 3% in the DV group and 92 ± 5% and 84 ± 9% in the FS group, respectively (P = 0.095). The 5- and 10-year freedom from aortic regurgitation ≥moderate was 88 ± 5% and 80 ± 8% in the DV group and 92 ± 5% and 78 ± 1% in the FS group, respectively (P = 0.782). The 5- and 10-year survival rates were 93 ± 4% and 82 ± 6% (DV) vs 75 ± 7% and 67 ± 10% (FS), respectively (P = 0.058). No case of endocarditis (DV) and 3 cases of endocarditis (FS) (P = 0.055) were observed during follow-up.

CONCLUSIONS

Both DV and FS resulted in similar early and longer-term outcomes with a trend to slightly better performance and survival in the DV group. Florida sleeve procedure might be an alternative approach for patients with higher-risk profiles requiring valve-sparing aortic root replacement.
Longitudinal Trajectories of Quality of Life Among People With Mild-to-Moderate Dementia: A Latent Growth Model Approach With IDEAL Cohort Study Data
Authors: Clare Linda , Gamble Laura D , Martyr Anthony , Sabatini Serena , Nelis Sharon M , Quinn Catherine , Pentecost Claire , Victor Christina , Jones Roy W , Jones Ian R , Knapp Martin , Litherland Rachael , Morris Robin G , Rusted Jennifer M , Thom Jeanette M , Collins Rachel , Henderson Catherine , Matthews Fiona E
Published: January 2022

Objectives

We aimed to examine change over time in self-rated quality of life (QoL) in people with mild-to-moderate dementia and identify subgroups with distinct QoL trajectories.

Methods

We used data from people with mild-to-moderate dementia followed up at 12 and 24 months in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study (baseline n = 1,537). A latent growth model approach examined mean change over time in QoL, assessed with the QoL-AD scale, and investigated associations of baseline demographic, cognitive, and psychological covariates with the intercept and slope of QoL. We employed growth mixture modeling to identify multiple growth trajectories.

Results

Overall mean QoL scores were stable and no associations with change over time were observed. Four classes of QoL trajectories were identified: 2 with higher baseline QoL scores, labeled Stable (74.9%) and Declining (7.6%), and 2 with lower baseline QoL scores, labeled Stable Lower (13.7%) and Improving (3.8%). The Declining class had higher baseline levels of depression and loneliness, and lower levels of self-esteem and optimism, than the Stable class. The Stable Lower class was characterized by disadvantage related to social structure, poor physical health, functional disability, and low psychological well-being. The Improving class was similar to the Stable Lower class but had lower cognitive test scores.

Discussion

Understanding individual trajectories can contribute to personalized care planning. Efforts to prevent decline in perceived QoL should primarily target psychological well-being. Efforts to improve QoL for those with poorer QoL should additionally address functional impairment, isolation, and disadvantage related to social structure.
Revisit the theory of Earth rotation—anatomy of the Liouville equation
Authors: Fang Ming , Hager Bradford H , Liao Xinhao , Zhou Yonghong , Xu Xueqing
Published: January 2022

By anatomizing the classic Liouville equation (LE), an alternative theoretical framework is established for the Earth polar motion where the turbulent time derivative of the fluid forcing, Lforce, is eliminated. The observed polar motion is found a lumped signal of two physical variables, one of which is the forced polar motion, mforce, that balances out the fluid forcing through a simple algebraic identity. The second component is the inertial polar motion, minert, which conserves the total angular momentum by the restoring power of the equatorial bulge. Aside from its numerical difficulties, the time derivative dLforce/dt has proved to be a redundant artefact that mixes the physical signals in the solution of the LE. By an analytical appraisal, we find that for non-Chandler forced polar motions, the dLforce/dt term in the excitation function of the classic LE is 100 per cent responsible for the forced term, mforce, and contributes 0.3 per cent of the inertial term, minert. The Chandler signal originates exclusively from the inertial polar motion minert. The artefact dLforce/dt perturbs the true Chandler signal from the classic LE by 0.3 per cent. Anatomy of the LE allows us to show that a linearized mechanism for the Chandler Wobble excitation is valid, since the linearized governing equation for the inertial polar motion minert stands as part of the exact solution of the full nonlinear equation. Anatomized polar motion equations are also considered in the presence of ocean tides, under the lunisolar torque, and on an elastically deformable Earth. Inaccuracies and misinterpretations associated with the classic LE under those circumstances are clarified in formulating the anatomized polar motion equation group.
Salutogenic-based interventions among community-dwelling older adults: a systematic review and meta-analysis
Authors: Chow Edmund Kit Mun , Seah Betsy , Chan Janice Jia Ying , Wang Wenru
Published: January 2022

Salutogenesis is a health-promoting orientation and sense of coherence (SOC) is a vital coping factor associated with quality of life (QOL) and self-efficacy. Although salutogenic-based interventions showed potential in improving health outcomes, the application of salutogenic concepts and effectiveness on SOC, QOL and self-efficacy among community-dwelling older adults remained unclear. This review aimed to consolidate evidence on salutogenic approaches and evaluate the effectiveness of salutogenic-based interventions on SOC, QOL and self-efficacy in community-dwelling older adults.

Databases systematically searched include PubMed, CINAHL, Embase, Cochrane Central Register of Controlled Trials, Scopus, Medline, PsycINFO and ProQuest Dissertations & Theses Global electronic databases. Two reviewers screened study eligibility, assessed risk of bias and extracted data of included studies independently. Meta-analyses on SOC and QOL were performed using RevMan. Where meta-analysis was not possible, narrative synthesis was employed. Eight studies involving 1201 older adults were included in this review. Subgroup analysis on SOC showed significant effects favouring salutogenic-based interventions using the empowering self-management model or strengths/resource-based approaches. However, results were mixed for the reflection-based approach. No significant effect favouring salutogenic-based interventions on QOL outcomes were found. High heterogeneity was observed for the outcome on self-efficacy. Two SOC strengthening processes, empowerment and reflection, were found to potentially underlie salutogenic-based intervention mechanisms. Effectiveness of salutogenic-based interventions on SOC, QOL and self-efficacy among community-dwelling older adults remained inconclusive due to high heterogeneity. Future salutogenic-based interventions should employ longitudinal designs and standardization on intervention delivery, utilizing a dual pathway via empowerment and reflection.
Quantitative uncertainty estimation in biophysical models of fish larval connectivity in the Florida Keys
Authors: Chaput Romain , Sochala Pierre , Miron Philippe , Kourafalou Vassiliki H , Iskandarani Mohamed
Published: January 2022

The impacts of seven uncertain biological parameters on simulated larval connectivity in the Florida Keys are investigated using Polynomial chaos surrogates. These parameters describe biological traits and behaviours—such as mortality, swimming abilities, and orientation—and modulate larval settlement as well as dispersal forecasts. However, these parameters are poorly constrained by observations and vary naturally between individual larvae. The present investigation characterizes these input uncertainties with probability density functions informed by previous studies of Abudefduf saxatilis. The parametric domain is sampled via ensemble calculations, then a polynomial-based surrogate is built to explicitly approximate the dependence of the model outputs on the uncertain model inputs, which enables a robust statistical analysis of uncertainties. This approach allows the computation of probabilistic dispersal kernels that are further analyzed to understand the impact of the parameter uncertainties. We find that the biological input parameters influence the connectivity differently depending on dispersal distance and release location. The global sensitivity analysis shows that the interactions between detection distance threshold, orientation ontogeny, and orientation accuracy, are the dominant contributors to the uncertainty in settlement abundance in the Florida Keys. Uncertainties in swimming speed and mortality, on the other hand, seem to contribute little to dispersal uncertainty.