bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Trials Update: CAPRICORN, COPERNICUS, MIRACLE, STAF, RITZ‐2, RECOVER and RENAISSANCE and cachexia and cholesterol in heart failure. Highlights of the Scientific Sessions of the American College of Cardiology, 2001
Authors: Louis Amala , Cleland John G.F. , Crabbe Sheran , Ford Sarah , Thackray Simon , Houghton Tim , Clark Andrew
Published: July 2002

This is a synopsis of presentations made at the American College of Cardiology (ACC) in 2001 summarising recent research developments relating to heart failure. Clinical studies of particular interest to physicians with an interest in heart failure and its prevention are reviewed. The COPERNICUS trial lends further support to the use of the beta‐blocker, carvedilol, in severe heart failure and the CAPRICORN trial to its use in patients with post‐infarction left ventricular systolic dysfunction. The MIRACLE study reinforces the evidence from three smaller trials that cardiac resynchronisation therapy is an effective treatment for the relief of symptoms in patients with severe heart failure and cardiac dyssynchrony. The STAF trial casts further doubt on the wisdom of cardioversion as a routine strategy for the management of chronic atrial fibrillation. The RITZ‐2 trial suggests that an intravenous, non‐selective endothelin antagonist is effective in improving haemodynamics and symptoms and possibly in reducing morbidity in severe heart failure. Observational studies in heart failure suggest that a moderate excess of body fat and elevated blood cholesterol may be desirable in patients with heart failure, challenging the current non‐evidenced‐based vogue for cholesterol lowering therapy in heart failure. The RENAISSANCE and RECOVER outcome studies of etanercept, a tumour necrosis factor (TNF) receptor analogue that blocks the effect of TNF, were stopped because of lack of evidence of benefit shortly after the ACC.
Assessment of Breastfeeding Knowledge of Nurse Practitioners and Nurse‐Midwives
Authors: Hellings Pam , Howe Carol
Published: July 2002

The purpose of this study was to replicate a national study of physician knowledge, experience, and attitudes about breastfeeding. All family, pediatric, and women's health care nurse practitioners and nurse‐midwives in a northwestern state were surveyed using a mail questionnaire; the response rate was 60.4%. Respondents were nearly unanimous in believing that “breast is best” and in recommending breastfeeding to expectant mothers as a part of their role. In general, 70% of respondents considered themselves effective or very effective in meeting the needs of breastfeeding patients. Although respondents were very supportive of breastfeeding, they were less knowledgeable about specific management strategies. There were differences in attitudes among nursing specialties and with years of experience. Overall, this statewide sample of nurse practitioners and nurse‐midwives had a better understanding of the benefits of breastfeeding and an increased sense of effectiveness in managing breastfeeding problems than the physician participants in the national study. A national sample of nurse practitioners and nurse‐midwives is needed to verify and expand on the results from this single jurisdiction, where 40% of the respondents were graduates of the home institution of the co‐investigators.
Examining the Relationship Between Rheumatoid Arthritis, Multimorbidity, and Adverse Health‐Related Outcomes: A Systematic Review
Authors: Canning Jordan , Siebert Stefan , Jani Bhautesh D. , Harding‐Edgar Louisa , Kempe Isla , Mair Frances S. , Nicholl Barbara I.
Published: March 2021

Objective

Multimorbidity (the coexistence of two or more long‐term conditions) is highly prevalent in people who have rheumatoid arthritis (RA). The present work systematically reviewed the literature to determine the effect of multimorbidity on all‐cause mortality, functional status, and quality of life in RA.

Methods

Six electronic databases were searched: CINAHL, The Cochrane Library, Embase, Medline, PsycINFO, and Scopus. Full‐text longitudinal observational studies in English were selected. Quality appraisal of studies was undertaken using the Cochrane‐developed QUIPS tool and a narrative synthesis of findings conducted.

Results

The search strategy identified 5,343 articles, with 19 studies meeting the inclusion criteria. Nine studies had mortality as an outcome, 9 reported functional status and/or quality of life, and 1 study reported both mortality and functional status. The number of participants ranged from 183 to 18,485, with studies conducted between 1985 and 2018. The mean age of participants ranged from 52.0 to 66.6 years, and 60.0–88.0% were female. Nine studies showed a significant association between multimorbidity and higher risk of mortality in people with RA. Ten studies reported significant associations between multimorbidity and reduced functional status in RA. Three studies also showed a further association with reduced quality of life. Only one study investigated the influence of mental health comorbidities on outcomes.

Conclusion

Our review findings indicate that multimorbidity is a significant predictor for higher mortality and poorer functional status/quality of life in people with RA and should be considered in clinical management plans.
Phase Manipulating toward Molybdenum Disulfide for Optimizing Electromagnetic Wave Absorbing in Gigahertz
Authors: Ning Mingqiang , Jiang Peiheng , Ding Wei , Zhu Xuebin , Tan Guoguo , Man Qikui , Li Jingbo , Li Run‐Wei
Published: March 2021

Molybdenum disulfide (MoS2) has been proved to be a potential electromagnetic wave (EMW) absorber. However, the limited EMW attenuation mechanisms and conductivity have always been recognized as the major challenges impeding their further developments. In this study, a new dielectric tuning strategy giving rise to high EMW attenuation performance by manipulating phase content (with 0, 24, 50, and 100 wt% 1T phase) toward MoS2 is demonstrated. The greatly introduced 2H/1T interfaces facilitate the dipole distribution dynamics, and the metal‐semiconductor mixed phase enhances the electron transfer ability. Benefiting from the structural merits, the MoS2 with 50 wt% 1T absorber delivers the maximum reflection loss of −45.5 dB and effective absorbing bandwidth of ≈3.89 GHz, corresponding to nearly ten times higher than that of pure 2H counterpart. Moreover, the Computer Simulation Technology (CST) simulation and Lorentz transmission electron microscope are performed to visualize the structural advantages of MoS2 absorbers with mixed 2H/1T phases. By manipulating the phase compositions, this study provides a deep understanding and opens an avenue in developing efficient and high performance transition metal dichalcogenides (e.g., WS2, MoSe2, and WSe2) absorbers.
Experimental Study of Few‐Layer Graphene: Optical Anisotropy and Pseudo‐Brewster Angle Shift in Vacuum Ultraviolet Spectral Range
Authors: Malik Nadeem Ahmed , Nicolosi Piergiorgio , Jimenez Kety , Gaballah Ahmed , Giglia Angelo , Lazzarino Marco , Zuppella Paola
Published: March 2021

The optical properties of mono‐ and trilayer graphene on SiO2/Si substrate are studied at hydrogen Lyman‐alpha (121.6 nm) spectral line for the first time. The optical anisotropy of graphene at this wavelength is experimentally demonstrated by retrieving the anisotropic “effective” optical constants. The results confirm that the axis of symmetry is nearly perpendicular to the surface and coherently related to the π‐orbitals’ structural orientation. Furthermore, it is observed that graphene strongly affects the performances of the substrate by inducing a pseudo‐Brewster angle downshift, which depends on the number of graphene layers. This finding is in contrast with what occurs in the visible spectral range, where the upshift of the pseudo‐Brewster angle is experienced in similar samples.
Constitutive secretory expression and characterization of nitrilase from Alcaligenes faecalis in Pichia pastoris for production of R‐mandelic acid
Authors: Zhang Xinhong , Wang Chuyan , Ge Yang , Meng Qingnan , Zhang Yi
Published: March 2021

Nitrilases can directly hydrolyze nitrile compounds into carboxylic acids and ammonium. To solve the current problems of bioconversions using nitrilases, including the difficult separation of products from the resting cells used as the catalyst and high costs of chemical inducers, a nitrilase from Alcaligenes faecalis was heterologously expressed in Pichia pastoris X33. The stable nitrilase‐expressing strain No.39‐6‐4 was obtained after three rounds of screening based on a combined detection method including dot‐blot, SDS‐PAGE, and western blot analyses, which confirmed the presence of recombinant nitrilase with a molecular mass of about 50 kDa. The temperature and pH optima of the nitrilase were 45°C and pH 7.5, respectively. Cu2+, Zn2+, and Tween 80 strongly inhibited the enzyme activity, but the optical purity of the product R‐mandelic acid (R‐MA) was stable, with practically 100% enantiomeric excess (ee). The nitrilase‐producing P. pastoris strain developed in this study provides a basis for further research on the enzyme.
Ending a diagnostic odyssey—The first case of Takenouchi–Kosaki syndrome in an African patient
Authors: Flynn Kaitlyn , Feben Candice , Lamola Lindiwe , Carstens Nadia , Krause Amanda , Lombard Zané ,   for DDD‐Africa as members of the H3Africa Consortium
Published: March 2021

First reported case of Takenouchi–Kosaki syndrome in an African patient with a de novo likely pathogenic missense variant identified in the CDC42 gene.
Relationship between lymphocyte subsets values andC‐reactiveprotein inCOVID‐19 patients
Authors: Mangano Carmelo , Oliva Bianca Maria ,   The GOM‐COVID‐19 Working Group
Published: March 2021

We enrolled 33 patients with COVID‐19 (23 men and 10 women; age 59 ± 15; males,n= 23; females,n= 10) admitted to the Department of Infectious Diseases of Grande Ospedale Metropolitano “Bianchi‐Melacrino‐Morelli” of Reggio Calabria, Italy, between March and May 2020. Whole blood samples were collected before the start of therapeutic treatment using all virus spread containment measures. Sample preparation protocols were designed in order to minimize operators direct specimen's manipulation. On univariate analysis, circulating levels of CRP were strongly and inversely related to CD3+ (rho = −0.77,p < 0.001), CD3+4+ (rho = −0.74,p < 0.001), and CD3+8+ (rho = −0.66,p= 0.001) implying that the shared variances between absolute values T cells and CRP ranged from 44 to 59%. Of note, the strength of these associations was higher in patients with relatively lower (below the median value) white blood cells (WBC) as compared to those with WBC above the median value. CRP also correlated with NK bright (rho = −0.56,p= 0.005) but failed to be related with CD19+ (rho = −0.38,p= 0.07), CD4+/CD8+ ratio (rho = 0.03,p= 0.89), CD16+ CD56+ (rho = −0.18,p= 0.43), and NKdim (rho = −0.15,p= 0.49). Lymphocyte subsets alteration monitoring in COVID‐19 positive patients may be a valid aid to control treatment efficacy of therapy and to choose better clinical approach. In particular, the negative correlation between CD3+, CD3+CD4+, CD3+CD8+ T cells values and CRP could be a useful tool to predict patient's response to therapy, particularly in patients with relatively lower WBC.
Accurate Quantification of Nervous System Drugs in Aqueous Samples at Trace Levels by Binary Solvent Dispersive Liquid–Liquid Microextraction-Gas Chromatography Mass Spectrometry
Authors: Dalgıç Bozyiğit Gamze , Fırat Ayyıldız Merve , Selali Chormey Dotse , Onkal Engin Güleda , Bakırdere Sezgin
Published: March 2021

Pharmaceutical products are widely consumed globally and are commonly found in wastewaters as a result of constant excretion and disposal into sewers. The present study proposes an efficient binary solvent dispersive liquid–liquid microextraction (BS-DLLME) method that was developed for preconcentration of 7 nervous system drug active compounds from aqueous media for their determination at trace levels by gas chromatography-mass spectrometry. The drug analytes included 3 antidepressants, 2 antipsychotics, 1 antiepileptic, and 1 antidementia. Optimum conditions of the BS-DLLME method were acquired by univariate optimization of parameters including type of binary solvents, ratio of binary solvents, type of disperser solvent, volume of binary solvents, and volume of disperser solvent. Detection and quantification limits were calculated in the range of 0.28 to 6.5 µg/L. Municipal wastewater, medical wastewater, synthetic domestic wastewater, and lake water were utilized as real samples in spike recovery experiments; and the results (94–106%) indicated the method's applicability and accuracy at quantifying the analytes in complex matrices. Environ Toxicol Chem 2021;40:1570-1575. © 2021 SETAC

Abstract

Graphical representation of the binary solvent dispersive liquid–liquid microextraction-gas chromatography mass spectrometry method. A mixture of 0.50 mL isopropyl alcohol, 37.5 µL carbon tetrachloride, and 112.5 µL 1,2-dichloroethane was used to preconcentrate the analytes from 8.0 mL aqueous sample solutions. CTC = carbon tetrachloride; 1,2-DCE = 1,2-dichloroethane.
Determination of Labile Cadmium in Soils Using a New Sodium Alginate-Polyglutamic Acid-Diffusive Gradient in Thin Films
Authors: Chen Rui , Wang Qi , Ren Fumin , Ding Guoyu , Shi Rongguang , Cheng Jing , Cai Xuying , Cheng Nuo , Liu Jiaxing , Li Lanxin
Published: March 2021

Sodium alginate-polyglutamic acid was used to develop a new diffusive gradient in thin films (SA-PGA-DGT) device, which was proven to be suitable for the investigation of labile Cd in soil. The adsorption capacity of Cd was calculated to be approximately 16.8 μg/cm2, which was hardly affected by factors including pH (5–9), ionic strength (0.1–100 mM), and the presence of other metals (Pb, Cu, Ni, and Cr). The SA-PGA gel has dense and uneven pores with large specific surface area, which ensures the adsorption of Cd by functional groups of the gel. A kinetics study indicated that the adsorption rate of Cd by the binding gel can be described as a pseudo-second-order reaction. Deployment of the SA-PGA-DGT in the soils of Tang Gu (located in Binhai New District, Tianjin, China) showed a strong positive linear correlation between Cd measured by the device and exchangeable Cd measured by the Tessier method (R = 0.73, p < 0.01). Cadmium determined by the SA-PGA-DGT device was less affected by soil properties. This new SA-PGA-DGT has obvious advantages over other methods in respect of the labile Cd analysis in soil. The innovative novel device expands the variety of existing DGT technologies and can be utilized to monitor the level of labile Cd in soil effectively. Environ Toxicol Chem 2021;40:1559–1569. © 2021 SETAC
A numerical study of mixed convection in a two‐sided lid‐driven tall cavity containing a heated triangular block for non‐Newtonian power‐law fluids
Authors: Kumar Sudhanshu , Gangawane Krunal M. , Oztop Hakan F.
Published: March 2021

The study of hydrodynamics and thermal characteristics inside a lid‐driven cavity has been one of the most captivating problems in computational fluid dynamics. In this numerical work, the mixed convection phenomenon inside a two‐dimensional, tall lid‐driven cavity with top and bottom lids moving in opposite directions, +x and –x, respectively, has been explored for non‐Newtonian power‐law fluids. The cavity contains a uniformly heated equilateral triangular obstacle at its geometric center.  Numerical experimentation is performed for a range of flow governing parameters, such as aspect ratio (0.25, 0.5, and 0.75), Prandtl number (1, 50, and 100) Richardson number (0.1, 1, and 10), power‐law index (0.6–1.4) and Grashof number of 104. The physical perceptions of the cavity are explained by using streamline and isotherm contours. The fluid movement is limited adjacent to the moving wall concerning the Richardson number at the lower Prandtl number. With a rise in the aspect ratio of the cavity, the flow‐pattern becomes more dispersed inside the cavity. Heat transfer enhancement is observed at a lower aspect ratio equal to 0.25.
IgG Immunocomplexes Drive the Differentiation of a Novel Subset of Osteoclasts Independent of RANKL and Inflammatory Cytokines
Authors: Zeng Ke-Qin , Gong Fang-Yuan , Pan Xiao-Hua , Miao Jie , Gong Zheng , Wang Jun , Zhong Qiao , Dai Xia-Qiu , Gao Xiao-Ming
Published: March 2021

Potentiation of receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis by IgG immunocomplexes (ICs) is generally considered an important pathway leading to cartilage and bone destruction in rheumatoid arthritis (RA). However, whether IgG ICs possess pro-osteoclastogenic potential independent of RANKL and inflammatory cytokines is unclear. Here we demonstrate that by fully cross-linking human FcγRIIa (hFcγRIIa) or co-ligating hFcγRIIa and TLR4, IgG ICs alone could drive the differentiation of human blood monocytes into nuclear factor of activated T cells cytoplasmic 1 (NFATc1-negative nonclassical osteoclasts (NOCs). Surprisingly, IgG ICs could also overrule RANKL-induced classical osteoclast (COC) differentiation in vitro. In mouse model of collagen-induced arthritis, hFcγRIIa-transgenic, but not nontransgenic control, mice suffered from cartilage/bone destruction accompanied by the presence of NFATc1− NOCs lining the eroded cartilage surface in affected joints. Our results not only identify a novel subset of IC-induced NOCs but also provide a possible explanation for the uncoupling of FcγR-mediated cartilage destruction from RANKL-related bone erosion in autoinflammatory arthritis. © 2021 American Society for Bone and Mineral Research (ASBMR)..
Application of ultrasound technology in the field of solid‐state fermentation: increasing peptide yield through ultrasound‐treated bacterial strain
Authors: Wang Yucheng , Xu Kangkang , Lu Feng , Wang Yining , Ouyang Ningning , Ma Haile
Published: March 2021

BACKGROUND

The increase of peptide yield contributed to reducing the usage of antibiotics in solid‐state fermented feed. Ultrasound technology is used in the field of liquid‐state fermentation to improve yield of fermented products but has not been utilized in the field of solid‐state fermentation (SSF). The main objective of this study was to investigate the feasibility of improving peptide yield in SSF products through ultrasound‐treated bacterial strain.

RESULTS

The highest peptides content in soybean meal SSF products reached 153.28 mg g−1, which increased by 15.05% compared with the control. This content value was acquired through treating the bacteria of Bacillus amyloliquefaciens by ultrasound before inoculating into soybean meal under the optimized mode and parameters (simultaneous dual‐frequency ultrasound mode, frequency combination of 40/60 kHz, total power density of 40 W L−1, time of 20 min, pulse‐on and pulse‐off times of 40 and 60 s, delayed inoculation time of 0 h). Fermenting with ultrasound‐treated bacterial strain can effectively increase peptide yield, biomass and protease activity of soybean meal fermented products during the SSF prophase. After treating by ultrasound, the latent phase and logarithmic phase of the bacterial strain shortened by 1 and 3 h while the generation time reduced by 23.64%. In qualitative test of protease activity, diameter ratio (DR) value of ultrasound‐treated bacterial cells enlarged by 12.0% compared with the control.

CONCLUSION

Peptide yield of soybean meal SSF products can be improved through ultrasound‐treated bacterial inoculum, which attributed to the promoting effect of ultrasound treatment on growth activity and protease production capability of bacterial cells. © 2021 Society of Chemical Industry
A two‐stage inverse data envelopment analysis approach for estimating potential merger gains in the US banking sector
Authors: Amin Gholam R. , Ibn Boamah Mustapha
Published: March 2021

Mergers and acquisitions are mainly due to financial and technological innovations but could also be due to changes in the structure of the economy, which alters the optimal production functions of banks. Banks that seek to be operationally efficient would focus more on expanding their asset size, in the face of bad loans, leading to the acquisition of less efficient banks. This paper develops two‐stage inverse data envelopment analysis (DEA) models for estimating potential gains from bank mergers for the top US commercial banks. The results show additional intermediate and final outputs at different predefined target levels of technical efficiencies.
Epidemiological trends of Bell's palsy treated with steroids in Korea between 2008 and 2018
Authors: Lee Jung Soo , Kim Yeo Hyung
Published: March 2021

Introduction

Contemporary epidemiological data on Bell's palsy are crucial to clarify disease burden and improve management strategies. We aimed to examine the epidemiology of, and factors associated with, Bell's palsy treated with steroids in Korea.

Methods

Using the National Health Insurance claims data from 2008 to 2018, we determined the incidence, recurrence rate, and management trends of Bell's palsy treated with steroids. We defined Bell's palsy cases based on diagnostic codes and concurrent treatment with steroids.

Results

The incidence of Bell's palsy showed an increasing trend (from 23.0 per 100 000 persons in 2008 to 30.8 per 100 000 persons in 2018). Age (60–69 y), sex (men), and month (January) were risk factors of Bell's palsy. The recurrence rate of Bell's palsy over the 11‐y period was 1.5%. Male sex (hazard ratio [HR], 1.1; 95% confidence interval [CI], 1.0–1.2) and physiotherapy (HR, 0.9; 95% CI, 0.8–0.99) were independently associated with the recurrence of Bell's palsy. During the study period, the use of electrodiagnostic testing steadily increased, whereas that of physiotherapy steadily decreased, and antiviral therapy fluctuated,.

Discussion

The incidence and recurrence rates presented in this study are comparable with those reported in earlier studies that included patients with Bell's palsy, regardless of the use of steroids, and documented an increase in the burden of Bell's palsy. Further randomized controlled trials are required to ascertain the long‐term effects of physiotherapy on recurrent Bell's palsy.
A procedure to estimate cutoff wall transport properties from monitoring wells
Authors: Guida Giulia , Musso Guido , Sanetti Gianluigi , di Prisco Claudio , Della Vecchia Gabriele
Published: March 2021

Owing to their capability in limiting the transport of pollutants in the subsoil, cutoff walls are popular solutions for the confinement of contaminants. These barriers are often made of soil‐bentonite or cement‐bentonite mixtures, which are characterized by low hydraulic conductivity, low hydrodynamic dispersion, and long‐term durability. However, the aggressive chemical environment to which these walls are subjected might negatively impact on their performance. Assessment of their performance with time is thus a crucial issue in wall design. The use of dedicated monitoring wells, cast in place inside the wall during construction when the bentonitic mixture is still fluid, can be particularly suitable for both intercepting and detecting the fluids flowing through the barrier. In this research, the results of a numerical study aimed at providing a methodology to estimate the transport properties of the backfill material at the site scale are presented. The methodology relies on abaci and only requires (i) flow and concentration of contaminant data within a monitoring well inside the barrier and (ii) hydraulic head at inlet and outlet of the barrier to be known.
Comparative poisson clinical trials of multiple experimental treatments vs a single control using the negative multinomial distribution
Authors: Chiarappa Joseph A. , Hoover Donald R.
Published: March 2021

This paper introduces a method which conditions on the number of events that occur in the control group to determine rejection regions and power for comparative Poisson trials with multiple experimental treatment arms that are each compared to one control arm. This leads to the negative multinomial as the statistical distribution used for testing. For one experimental treatment and one control with curtailed sampling, this is equivalent to Gail's (1974) approach. We provide formulas to calculate exact one‐sided overall Type I error and pointwise power for tests of treatment superiority and inferiority (vs the control). Tables of trial design parameters for combinations of one‐sided overall Type I error = 0.05, 0.01 and pointwise power = 0.90, 0.80 are provided. Curtailment approaches are presented to stop follow‐up of experimental treatment arms or to stop the study entirely once the final outcomes for each arm are known.
Robust Co‐Embedded Nitrogen Doped Carbon Catalyst for Oxygen Reduction Reaction in Proton Exchange Membrane Fuel Cell
Authors: Bharti Abha , Natarajan Rajalakshmi
Published: March 2021

This work reports non‐noble, cobalt embedded nitrogen doped carbon (CoNC) catalysts for oxygen reduction reaction (ORR) in Nafion‐based acidic proton exchange membrane fuel cells (PEMFCs). CoNC catalysts are synthesized through direct pyrolysis of two different zeolitic imidazolate framework (ZIF) precursors, Zn‐ZIF and Co‐ZIF. Profiting from two different precursor approach, appropriate assimilation of metal, nitrogen and carbon components is achieved which boosts oxygen reduction. Electrochemical results exemplified CoNC 3–1 catalyst derived from Zn‐ZIF:Co‐ZIF precursor in the weight ratio of 3 : 1 as the better ORR catalyst. CoNC 3–1 catalyst exhibited the highest electrochemical surface area (ECSA) (570 cm2), highest limiting current density (‐5.14 mA cm−2) and followed near 4e− reduction of oxygen revealing superior ORR activity. The catalyst also demonstrated remarkable durability with loss of only 6 % of ECSA after 30,000 cycles of accelerated durability test. The enhanced ORR activity and durability is attributed to optimal balance of Co−Nx active sites along with appropriate N contents and graphitic carbon framework.
Epitaxial GaInP/GaAs/Si Triple‐Junction Solar Cell with 25.9% AM1.5g Efficiency Enabled by Transparent Metamorphic AlxGa1−xAsyP1−y Step‐Graded Buffer Structures
Authors: Feifel Markus , Lackner David , Schön Jonas , Ohlmann Jens , Benick Jan , Siefer Gerald , Predan Felix , Hermle Martin , Dimroth Frank
Published: March 2021

III–V/Si multi‐junction solar cells are potential successors to the silicon single‐junction cell due to their efficiency potential of up to 40% in the radiative limit.[1] Herein, latest results of epitaxially integrated GaInP/GaAs/Si triple‐junction cells are presented. To reduce parasitic absorption losses, which have limited the current density in the Si bottom cell in the previous devices, transparent AlxGa1–xAsyP1–y step‐graded metamorphic buffers are investigated. Compared with previous GaAsyP1–y step‐graded buffers, the transmittance is enhanced significantly, while no significant impact on the threading dislocation density is observed. Implemented into a new triple‐junction solar cell, an increase in short‐circuit current density from 10.0 to 12.2 mA cm−2 is achieved, leading to a new record conversion efficiency of 25.9% under AM1.5g conditions.
Stable Flexible Piezoresistive Sensors with Viscoelastic Ni Nanowires‐PDMS Composites and Ni Foam Electrodes
Authors: Luan Ruifei , An Hang , Chen Chen , Xue Yu , Guo Ailin , Chu Liang , Ahmad Waqar , Li Xing'ao
Published: March 2021

Flexible piezoresistive sensors with viscoelastic conductive free‐standing films have attracted tremendous interest for the great practical applications of human motion and health monitoring, and intelligent electronic skins. However, it is still a challenge to achieve stable and strong adhesion between the viscoelastic conductive films and two electrodes due to mismatched Young's modulus. Herein, the as‐prepared Ni nanowires were mixed with PDMS to form viscoelastic conductive composites, which were strongly contacted on and partly permeated into Ni foam electrodes for flexible strain sensors. Importantly, the binding between the viscoelastic conductive composites and Ni foams is strong and stable, which can be remained after a thousand forward and backward bent. The fabricated flexible piezoresistive sensors were utilized to monitor human motion including clicking mouse, finger bending, elbow bending, eye blinking and wrist bending. The typical respond and recovery times are fast to about 0.1 s. Thus, this sensor will have great potential for future real applications in smart wearable devices.
What is meant by “frailty” in undergraduate medical education? A national survey of UK medical schools
Authors: Winter Rebecca , Al-Jawad Muna , Wright Juliet , Shrewsbury Duncan , Van Marwijk Harm , Johnson Helen , Levett Tom
Published: March 2021

Purpose

All UK medical schools are required to include frailty in their curriculum. The term is open to interpretation and associated with negative perceptions. Understanding and recognising frailty is a prerequisite for consideration of frailty in the treatment decision-making process across clinical specialities. The aim of this survey was to describe how frailty has been interpreted and approached in UK undergraduate medical education and provide examples of educational strategies employed.

Methods

All UK medical schools were invited to complete an electronic survey. Schools described educational strategies used to teach and assess frailty and provided frailty-related learning outcomes. Learning Outcomes were grouped into categories and mapped to the domains of Outcomes for Graduates (knowledge, skills and values).

Results

25/34 Medical schools (74%) participated. The interpretation of what frailty is vary widely and the diversity of teaching strategies reflect this. The most common Learning outcomes included as “Frailty” are about the concept of frailty, Comprehensive Geriatric Assessments and Roles of the MDT. Frailty teaching is predominantly opportunistic and occurred within geriatric medicine rotations in all medical schools. Assessments focus on frailty syndromes such as falls and delirium.

Conclusion

There is variation regarding how frailty has been interpreted and approached by medical schools. Frailty is represented in an array of teaching and assessment methods, with a lack of constructive alignment to related learning outcomes. Consensus should be agreed as to what frailty means in medical education. Further research is required to explore which frailty-specific educational strategies in undergraduate medical education enhance learning.
An efficient low bit rate image watermarking and tamper detection for image authentication
Authors: Kabir Md. Ahasan
Published: March 2021

This study presents the vulnerability of digital documents and its effective way to protect the ownership and detection of unauthorized modification of multimedia data. Watermarking is an effective way to protect vulnerable data in a digital environment. In this paper, a watermarking algorithm has been proposed based on a lossy compression algorithm to ensure authentication and detection of forgery. In this proposed method, the CDF9/7 biorthogonal wavelet is used to transform the watermark image and encoded the wavelet coefficients using Set Partition in Hierarchical Tree algorithm. Then, the encoded bits are encrypted by shuffling and encrypting using symmetric keys. After that the encrypted bits are inserted into the Least Significant Bit position of the cover image. In addition, two tamper detection bits are generated based on texture information and pixel location and inserted in the watermarked image. The proposed algorithm reconstructs the watermark and the tampering region more efficiently and achieved 56.5463 dB PSNR for STARE database. Experimental result shows that the proposed algorithm is effectively prevented different attacks and ensure the integrity of watermark bits within the watermarked image. Also finds the tampered region more efficiently compared with the existing state of art algorithms.
Comparative assessment of validity of gradient wind models for a translating tropical cyclone
Authors: Eguchi Yuzuru , Hattori Yasuo , Nomura Mitsuharu
Published: March 2021

Accurate and conservative evaluations of the gradient wind in the free atmosphere are needed to account for high-wind hazards when designing wind resistance for critical infrastructure. This paper compared the validity of three existing gradient wind models to select an appropriate evaluation model, which enables us to accurately compute the asymmetric gradient wind field of a translating tropical cyclone under the condition of a symmetric pressure distribution and a constant translation velocity. The validity of the three models was assessed by evaluating the residuals in momentum conservation equations for the gradient wind under a specific tropical cyclone condition. The magnitude of the residuals was considered to be the measure of error in the gradient wind derived from each model. The results showed that the most frequently used model yielded the largest magnitude of residuals with the lowest maximum wind speed among the three models. The wind characteristics of the three models were validated using archived observation data of hurricanes. The physical reason for the difference in maximum wind speed among the three models was explained by the difference in the streamline feature of the gradient wind field. It was also revealed that the differences in maximum wind speed and magnitude of residuals became more pronounced as the translation speed and the intensity of a tropical cyclone increased. The comparative assessment of the three gradient wind models allowed us to identify the best model for use in conservative wind-resistant design and high-wind risk estimates.
Iranian Qara Qat fruit (redcurrant) in Arasbaran forests as the resource of anthocyanin pigments in formation of [ACN-Mg2+/Al3+/Ga3+/ Sn2+/Cr3+/Fe3+] chelation clusters
Authors: Mollaamin Fatemeh , Mohammadian Nayer T. , Najaflou Narges , Monajjemi Majid
Published: March 2021

Clusters of metallic cations (Mg2+, Al3+, Ga3+, Sn2+, Cr3+ and Fe3+) jointed to anthocyanins in water media were studied for unraveling the color shifting of different complexes of these structures in the low ranges of pH. Anthocyanin jointed to metallic cation progresses the color expression range of anthocyanin in more different range of pH. In this verdict, it has been studied the metallic cations diffusing of deprotonating for the anthocyanin (B)-ring of cyanidin (Cy), delphinidin (Dp) and petunidin (Pt) in two media of gas and water, transforming flavylium cations to the blue quinonoidal bases at lower range of pH applying the infrared method by approaching Beer Lambert law for getting the physico-chemical parameters of frequency, intensity, and absorbance of the compounds, respectively. In previous investigation, it has been indicated that the important factor for enhancing the absorbance in a positive non-linear fashion due to deviating from the Beer Lambert law is the self-association of anthocyanins of cyanidin, delphinidin and petunidin of anthocyanin structures. The difference of heat of formation (∆HR) among clusters of metallic cations jointed to anthocyanins has been illustrated toward the double bonds and carbonyl groups by the chelation of (B)-ring for cyanidin, delphinidin and petunidin anthocyanins in two media of gas and water that explains the stability and color of [anthocyanin-metallic cations] cluster chelation of cyanidin (Cy), delphinidin (Dp) and petunidin (Pt) colorful pigments in a weak acidic medium. By this work we exhibited that the color of the anthocyanin chelates is an important factor for estimating the efficiency of these types of food colorants.
Differential Splicing of Skipped Exons Predicts Drug Response in Cancer Cell Lines
Authors: Simpson Edward , Chen Steven , Reiter Jill L. , Liu Yunlong
Published: March 2021

Alternative splicing of pre-mRNA transcripts is an important regulatory mechanism that increases the diversity of gene products in eukaryotes. Various studies have linked specific transcript isoforms to altered drug response in cancer; however, few algorithms have incorporated splicing information into drug response prediction. In this study, we evaluated whether basal-level splicing information could be used to predict drug sensitivity by constructing doxorubicin-sensitivity classification models with splicing and expression data. We detailed splicing differences between sensitive and resistant cell lines by implementing quasi-binomial generalized linear modeling (QBGLM) and found altered inclusion of 277 skipped exons. We additionally conducted RNA-binding protein (RBP) binding motif enrichment and differential expression analysis to characterize cis- and trans-acting elements that potentially influence doxorubicin response-mediating splicing alterations. Our results showed that a classification model built with skipped exon data exhibited strong predictive power. We discovered an association between differentially spliced events and epithelial-mesenchymal transition (EMT) and observed motif enrichment, as well as differential expression of RBFOX and ELAVL RBP family members. Our work demonstrates the potential of incorporating splicing data into drug response algorithms and the utility of a QBGLM approach for fast, scalable identification of relevant splicing differences between large groups of samples.
Direct Comparative Analyses of 10X Genomics Chromium and Smart-Seq2
Authors: Wang Xiliang , He Yao , Zhang Qiming , Ren Xianwen , Zhang Zemin
Published: March 2021

Single-cell RNA sequencing (scRNA-seq) is generally used for profiling transcriptome of individual cells. The droplet-based 10X Genomics Chromium (10X) approach and the plate-based Smart-seq2 full-length method are two frequently used scRNA-seq platforms, yet there are only a few thorough and systematic comparisons of their advantages and limitations. Here, by directly comparing the scRNA-seq data generated by these two platforms from the same samples of CD45− cells, we systematically evaluated their features using a wide spectrum of analyses. Smart-seq2 detected more genes in a cell, especially low abundance transcripts as well as alternatively spliced transcripts, but captured higher proportion of mitochondrial genes. The composite of Smart-seq2 data also resembled bulk RNA-seq data more. For 10X-based data, we observed higher noise for mRNAs with low expression levels. Approximately 10%−30% of all detected transcripts by both platforms were from non-coding genes, with long non-coding RNAs (lncRNAs) accounting for a higher proportion in 10X. 10X-based data displayed more severe dropout problem, especially for genes with lower expression levels. However, 10X-data can detect rare cell types given its ability to cover a large number of cells. In addition, each platform detected distinct groups of differentially expressed genes between cell clusters, indicating the different characteristics of these technologies. Our study promotes better understanding of these two platforms and offers the basis for an informed choice of these widely used technologies.
Quantitative Secretome Analysis Reveals Clinical Values of Carbonic Anhydrase II in Hepatocellular Carcinoma
Authors: Xing Xiaohua , Yuan Hui , Liu Hongzhi , Tan Xionghong , Zhao Bixing , Wang Yingchao , Ouyang Jiahe , Lin Minjie , Liu Xiaolong , Huang Aimin
Published: March 2021

Early detection and intervention are key strategies to reduce mortality, increase long-term survival, and improve the therapeutic effects of hepatocellular carcinoma (HCC) patients. Herein, the isobaric tag for relative and absolute quantitation (iTRAQ)-based quantitative proteomic strategy was used to study the secretomes in conditioned media from HCC cancerous tissues, surrounding noncancerous tissues, and distal noncancerous tissues to identify diagnostic and prognostic biomarkers for HCC. In total, 22 and 49 dysregulated secretory proteins were identified in the cancerous and surrounding noncancerous tissues, respectively, compared with the distal noncancerous tissues. Among these proteins, carbonic anhydrase II (CA2) was identified to be significantly upregulated in the secretome of cancerous tissues; correspondingly, the serum concentrations of CA2 were remarkably increased in HCC patients compared with that in normal populations. Interestingly, a significant increase of serum CA2 in recurrent HCC patients after radical resection was also confirmed compared with HCC patients without recurrence, and the serum level of CA2 could act as an independent prognostic factor for time to recurrence and overall survival. Regarding the mechanism, the secreted CA2 enhances the migration and invasion of HCC cells by activating the epithelial mesenchymal transition pathway. Taken together, this study identified a novel biomarker for HCC diagnosis and prognosis, and provided a valuable resource of HCC secretome for investigating serological biomarkers.
Epidemiology and transmission characteristics of early COVID-19 cases, 20 January–19 March 2020, in Bavaria, Germany
Authors: Böhm S. , Woudenberg T. , Chen D. , Marosevic D. V. , Böhmer M. M. , Hansen L. , Wallinga J. , Sing A. , Katz K.
Published: March 2021

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) led to a significant disease burden and disruptions in health systems. We describe the epidemiology and transmission characteristics of early coronavirus disease 2019 (COVID-19) cases in Bavaria, Germany. Cases were reverse transcription polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infections, reported from 20 January−19 March 2020. The incubation period was estimated using travel history and date of symptom onset. To estimate the serial interval, we identified pairs of index and secondary cases. By 19 March, 3546 cases were reported. A large proportion was exposed abroad (38%), causing further local transmission. Median incubation period of 256 cases with exposure abroad was 3.8 days (95%CI: 3.5–4.2). For 95% of infected individuals, symptom onset occurred within 10.3 days (95%CI: 9.1–11.8) after exposure. The median serial interval, using 53 pairs, was 3.5 days (95%CI: 3.0–4.2; mean: 3.9, s.d.: 2.2). Travellers returning to Germany had an important influence on the spread of SARS-CoV-2 infections in Bavaria in early 2020. Especially in times of low incidence, public health agencies should identify holiday destinations, and areas with ongoing local transmission, to monitor potential importation of SARS-CoV-2 infections. Travellers returning from areas with ongoing community transmission should be advised to quarantine to prevent re-introductions of COVID-19.
Improving Access to Paleoclimate Data
Authors: Kaushal Nikita , Comas-Bru Laia , Lechleitner Franziska , Hatvani Istv�n , Kern Zolt�n
Published: March 2021

Paleoclimate databases are powerful tools for improving climate models. The recent work of speleothem researchers offers lessons on creating a lasting database and fostering the needed mindset.
Evaluation of fireground exposures using urinary PAH metabolites
Authors: Hoppe-Jones Christiane , Griffin Stephanie C. , Gulotta John J. , Wallentine Darin D. , Moore Paul K. , Beitel Shawn C. , Flahr Leanne M. , Zhai Jing , Zhou Jin J. , Littau Sally R. , Dearmon-Moore Devi , Jung Alesia M. , Garavito Fernanda , Snyder Shane A. , Burgess Jefferey L.
Published: March 2021

Background

Firefighters have increased cancer incidence and mortality rates compared to the general population, and are exposed to multiple products of combustion including known and suspected carcinogens.

Objective

The study objective was to quantify fire response exposures by role and self-reported exposure risks.

Methods

Urinary hydroxylated metabolites of polycyclic aromatic hydrocarbons (PAH-OHs) were measured at baseline and 2–4 h after structural fires and post-fire surveys were collected.

Results

Baseline urine samples were collected from 242 firefighters. Of these, 141 responded to at least one of 15 structural fires and provided a post-fire urine. Compared with baseline measurements, the mean fold change of post-fire urinary PAH-OHs increased similarly across roles, including captains (2.05 (95% CI 1.59–2.65)), engineers (2.10 (95% CI 1.47–3.05)), firefighters (2.83 (95% CI 2.14–3.71)), and paramedics (1.84 (95% CI 1.33–2.60)). Interior responses, smoke odor on skin, and lack of recent laundering or changing of hoods were significantly associated with increased post-fire urinary PAH-OHs.

Significance

Ambient smoke from the fire represents an exposure hazard for all individuals on the fireground; engineers and paramedics in particular may not be aware of the extent of their exposure. Post-fire surveys identified specific risks associated with increased exposure.
Exposure to maternal high-fat diet induces extensive changes in the brain of adult offspring
Authors: Fernandes Darren J. , Spring Shoshana , Roy Anna R. , Qiu Lily R. , Yee Yohan , Nieman Brian J. , Lerch Jason P. , Palmert Mark R.
Published: March 2021

Maternal environmental exposures, such as high-fat diets, diabetes and obesity, can induce long-term effects in offspring. These effects include increased risk of neurodevelopmental disorders (NDDs) including autism spectrum disorder (ASD), depression and anxiety. The mechanisms underlying these late-life neurologic effects are unknown. In this article, we measured changes in the offspring brain and determined which brain regions are sensitive to maternal metabolic milieu and therefore may mediate NDD risk. We showed that mice exposed to a maternal high-fat diet display extensive brain changes in adulthood despite being switched to a low-fat diet at weaning. Brain regions impacted by early-life diet include the extended amygdalar system, which plays an important role in reward-seeking behaviour. Genes preferentially expressed in these regions have functions related to feeding behaviour, while also being implicated in human NDDs, such as autism. Our data demonstrated that exposure to maternal high-fat diet in early-life leads to brain alterations that persist into adulthood, even after dietary modifications.
Rapid multi-directed cholinergic transmission in the central nervous system
Authors: Sethuramanujam Santhosh , Matsumoto Akihiro , deRosenroll Geoff , Murphy-Baum Benjamin , Grosman Claudio , McIntosh J Michael , Jing Miao , Li Yulong , Berson David , Yonehara Keisuke , Awatramani Gautam B.
Published: March 2021

In many parts of the central nervous system, including the retina, it is unclear whether cholinergic transmission is mediated by rapid, point-to-point synaptic mechanisms, or slower, broad-scale ‘non-synaptic’ mechanisms. Here, we characterized the ultrastructural features of cholinergic connections between direction-selective starburst amacrine cells and downstream ganglion cells in an existing serial electron microscopy data set, as well as their functional properties using electrophysiology and two-photon acetylcholine (ACh) imaging. Correlative results demonstrate that a ‘tripartite’ structure facilitates a ‘multi-directed’ form of transmission, in which ACh released from a single vesicle rapidly (~1 ms) co-activates receptors expressed in multiple neurons located within ~1 µm of the release site. Cholinergic signals are direction-selective at a local, but not global scale, and facilitate the transfer of information from starburst to ganglion cell dendrites. These results suggest a distinct operational framework for cholinergic signaling that bears the hallmarks of synaptic and non-synaptic forms of transmission.