bluuebunny/crossref_metadata_2025 huggingface dataset:
Seasonal Dynamics of Carbon-Containing Compounds under Different Effects of Natural and Anthropogenic Factors
Authors: Mazirov M A , Matyuk N S , Savoskina O A , Polin V D
Published: September 2021

It was found that the processes of exchange of carbon compounds between the soil and the atmosphere are characterized by high variation in different periods of the annual cycle. It has been proved that CO2 emission, as well as the release and absorption of methane from the soil, is the main expenditure item in the balance of organic matter, which significantly affects the fertility and the level of productivity of agrobiocenoses. Soil fertility management and carbon gas cycle processes largely overlap. With an increase in the content of organic carbon from 0.55 to 0.98%, the loss of carbon dioxin and the absorption of methane compounds increase 1.5–4.3 times. A weak correlation was established between the release of carbon dioxin and the degree of soil cultivation (Kendall coefficient r = 0.23 at p = 0.05), seasonal dynamics of soil moisture r = 0,23 at p = 0,05) and a strong one (r = 0,87 at p = 0.000,2) with methane release / uptake dynamics. The same relationship was found between the dynamics of carbon dioxide release and the temperature of the soil layer 0–5 (Pearson’s coefficient r = 0.82–0.84 at p = 0.003–0.04), and 0-20 cm (r = 0.68–0.71 at p = 0.003–0.006).
Modern Technologies for Obtaining Innovative Therapeutic and Prophylactic Products from Plant Materials
Authors: Orobinskaya V N , Permyakov S A , Konovalova I D , Kholodova E N , Galdin E V
Published: September 2021

The economic recession amid the COVID-19 pandemic, the difficult socio-economic conditions of the Russian Federation associated with the introduction and distribution of functional food products are not only a factor in the formation of state policy in the field of healthy lifestyles., but are a necessary condition for the preservation of the health of the nation. The article discusses the problematic issues associated with the need to create sports nutrition products based on lentil, as plant materials rich in protein compounds. Sports nutrition (SP) is a specialized food product that compensates for the deficiency of missing protein substances, contributing to the rapid recovery of the body’s adaptive systems during periods of stress, both physical and immune. The analysis of the development of the sports nutrition market in the Russian Federation on the basis of marketing research of the agency “BusinessStat” is presented. Allows one to predict the prospects for the development of this direction. In order to obtain a high-quality target product, the possibility of using an electric-discharge effect on raw materials with a certain number of pulses to inactivate anti-nutritional compounds is presented, which prevents the assimilation of vegetable protein in the human body.
Enzymatic Activity of Sod-Podzolic Soil under Sosnowsky’s Hogweed
Authors: Rodicheva T V , Gamzayeva R S , Toshkina E A
Published: September 2021

The activity of soil phosphatase, urease and invertase enzymes in sod-podzolic soil under the influence of Sosnowsky’s hogweed in the spring has been studied. In soil samples under the mono-community of Sosnowsky’s hogweed, high activity of the phosphatase and urease enzymes has been noted; the indicator of invertase activity is characterized as very weak or absent.
Modeling Formulations of Food with Prophylactic Antidiabetic Properties
Authors: Sadovoy V V , Trubina I A , Shchedrina T V , Shaltumaev T Sh
Published: September 2021

Having analyzed the research literature, the authors identify biologically active compounds with antidiabetic properties. It has been established that brewer’s yeast, selenium active, chromium chelate and lecithin have a positive effect on reducing blood sugar. A technology for obtaining a modified yeast preparation by destroying cell walls has been proposed. A biologically active composition for the prevention of diabetes mellitus has been developed and used as an additive in the recipe for the diabetic boiled sausage. Laboratory animals were used to assess the prophylactic properties, biological value and safety of a sausage with a biologically active composition; as a result, the effectiveness of the developed technology was confirmed.
Influence of Deformation of Circadian Rhythms on Changes in Ontogenesis of Heracleum sosnowskyi Manden Plants
Authors: Semchuk N N , Balun O V , Gladkikh S N
Published: September 2021

The urgency of the problem of biodiversity conservation has grown significantly at present. In addition to the increasing anthropogenic impact on natural ecosystems, there is also a threat of changes in biocenoses due to the spread of invasive plant and animal species. The human factor also plays a significant role in this process. For example, the species Heracleum sosnowskyi Manden was used as an agricultural crop in the last century. Unfortunately, the specific properties of the plant made people refuse to use it as such. All varieties obtained by breeders were excluded from the State Register. However, the plasticity and biological aggressiveness of the species allowed it to successfully occupy an ecological niche in various biogeocenoses. Since the plant poses a real danger to human health, an intensive search is underway for ways to combat this poisonous invasive weed. The authors have developed a unique method of controlling plants Heracleum sosnowskyi M., effective and safe for humans and the environment.
Growing Broiler Chickens Using Compound Feed Enriched with Antioxidant “Bisphenol-5”
Authors: Shilov V N , Semina O V , Khakimova G A , Minnebaev D F , Akhmadullin R M
Published: September 2021

The article consider the use of the antioxidant “Bisphenol-5” in compound feed, as it can stabilize lipids, vitamins and other unsaturated compounds in feed used for growing broiler chickens; chemotherapeutic protection of young poultry against oxidative stress can be provided by selecting the optimal doses of the preparation in the diet. The research is based on the scientific and production experiment, as well as on the physiological experiment to study the digestibility and daily balance of nitrogen in experimental chickens. It is shown that reasonable doses of the preparation ensure the regulated lipid-protein metabolism, the increase in live weight; feed conversion and the economic efficiency of growing broiler chickens are significantly increased.
Study of the effect of quicklime on the sludge treatment and dehydration
Authors: Teleshova E N , Petuhova E A
Published: September 2021

The article discusses the chemical processes causing the intensification of treatment and dehydration of sludge. Sediments dominate in industrial and domestic wastewaters. The effect of such additive as quicklime on a decrease in the degree of moisture and, accordingly, on a decrease in the volume of treatment facilities’ sludge over time has been studied. It has been proven that adding quicklime leads to an increase in the alkalinity of the sludge.
Optimization of Test Placer Composition for Express Colorimetric Determination of Mobile Forms of Phosphorus in Soil and Water Samples
Authors: Zhevnerov A V , Belopuhov S L , Bagnavets N L , Dmitrevskaya I I , Eliseeva O V
Published: September 2021

The paper presents the optimized methods of manufacturing test placers for quantitative and visual-blister colorimetric determination of phosphate ion concentration in a blister cell and a test tube. The test placer contains all the reagents for the analytical reaction. Placers allow the quantitative determination of phosphates in various objects without preliminary preparation of reagent solutions. In a blister cell with a diameter of 6 mm, a much more intense blue color was achieved with a solution layer of no more than 2 mm. The application of reagents to the surface of the silica gel allows them to avoid contact until the chemical analytical reaction takes place. The composition of placers and the conditions for applying reagents are improved. Hydrosulfate ions are able to provide a sufficiently high acidity when adding a few drops of the solution. The reaction proceeds in the volume of the added test solution, which is 2–3 drops.
Filled polyaluminosilicate in LED emitting element design to increase its limit thermoelectric modes
Authors: Ivanov A A , Soldatkin V S , Chermoshentseva A S
Published: September 2021

The reliability of a LED lamp is conditioned by the need to increase its service life including the lamp in an inhabited spacecraft. The results of a filled polyaluminosilicate application as a heat-conducting intermediate layer, onto which LED chips are bonded, are considered in the article. The filled polyaluminosilicate application in the LED emitting element design allows increasing its operation temperature due to its specific properties.
Implementation and investigation of a pulsed aluminum-air flame
Authors: Egorov A G
Published: September 2021

To implement a pulse combustion process in a flow of aerosolized particles, flow aerodynamics investigation and determination of the time of aluminum particle residence in a sudden expansion combustion chamber was conducted. The identified flow aerodynamics features and obtained values of the local residence time of aluminum particles made it possible to develop a combustion chamber for a pulse power plant. The temperature field of a pulsed aluminum-air flame was obtained and the type of temperature-time relationship along the flame axis was established in the course of plant tests. Integrated radiation flux density and distribution of radiant energy intensity of a pulsed aluminum-air flame was determined in the wavelength spectral range λ = 1.0 … 4.5 μm. The investigation results obtained in this work can be applied to create pulse power plants fired with powdered metal combustible.
Selection of an effective catalyst for the stage isoamyl alcohol dehydration during synthesis isoprene from isopentane
Authors: Aminova E K , Islamutdinova A A
Published: September 2021

The annual growth in the consumption of isoprene rubbers dictates manufacturers to searching for the new methods of its production. An intermediate product in the production of isoprene rubbers is the synthesis of a monomer - isoprene. The main industrial methods for its production in Russia are synthesis processes from isobutylene and formaldehyde and two-stage dehydrogenation of isopentane. The article analyzes and selects an effective catalyst for the stage of isoamyl alcohol dehydration in the synthesis of isoprene from isopentane.
Singular integrals in quantum Euclidean spaces
Authors: González-Pérez Adrían , Junge Marius , Parcet Javier
Published: September 2021

We shall establish the core of singular integral theory and pseudodifferential calculus over the archetypal algebras of noncommutative geometry: quantum forms of Euclidean spaces and tori. Our results go beyond Connes’ pseudodifferential calculus for rotation algebras, thanks to a new form of Calderón-Zygmund theory over these spaces which crucially incorporates nonconvolution kernels. We deduceLpL_p-boundedness and Sobolevpp-estimates for regular, exotic and forbidden symbols in the expected ranks. In theL2L_2level both Calderón-Vaillancourt and Bourdaud theorems for exotic and forbidden symbols are also generalized to the quantum setting. As a basic application of our methods, we proveLpL_p-regularity of solutions for elliptic PDEs.
Multi-parametric optimization of the catalytic pyrolysis of pig hair into bio-oil
Authors: Orugba Henry Oghenero , Chukwuneke Jeremiah Lekwuwa , Olisakwe Henry Chukwuemeka , Digitemie Innocent Eteli
Published: September 2021

The low yield and poor fuel properties of bio-oil have made the pyrolysis production process uneconomic and also limited bio-oil usage. Proper manipulation of key pyrolysis variables is paramount in order to produce high-quality bio-oil that requires less upgrading. In this research, the pyrolysis of pig hair was carried out in a fixed-bed reactor using a calcium oxide catalyst derived from calcination of turtle shells. In the pyrolysis process, the influence of three variables—temperature, heating rate and catalyst weight—on two responses—bio-oil yield and its higher heating value (HHV)—were investigated using Response Surface Methodology. A second-order regression-model equation was obtained for each response. The optimum yield of the bio-oil and its HHV were obtained as 51.03% and 21.87 mJ/kg, respectively, at 545oC, 45.17oC/min and 2.504 g of pyrolysis temperature, heating rate and catalyst weight, respectively. The high R2 values of 0.9859 and 0.9527, respectively, obtained for the bio-oil yield and its HHV models using analysis of variance revealed that the models can adequately predict the bio-oil yield and its HHV from the pyrolysis process.
Intrinsic Capacity Predicts Negative Health Outcomes in Older Adults
Authors: Stolz Erwin , Mayerl Hannes , Freidl Wolfgang , Roller-Wirnsberger Regina , Gill Thomas M
Published: September 2021

Background

Monitoring trajectories of intrinsic capacity (IC) in older adults has been suggested by the World Health Organization as a means to inform prevention to avoid or delay negative health outcomes. Due to a lack of longitudinal studies, it is currently unclear how IC changes over time and whether repeatedly measured IC predicts negative health outcomes.

Methods

Based on 4 751 repeated observations of IC (range = 0–100) during 21 years of follow-up among 754 older adults 70 and older, we assessed longitudinal trajectories of IC, and whether time-varying IC predicted the risk of chronic activities of daily living disability, long-term nursing home stay, and mortality using joint models.

Results

Average IC declined progressively from 77 to 11 points during follow-up, with substantial heterogeneity between older adults. Adjusted for sociodemographics and chronic diseases, a 1-point lower IC value was associated with a 7% increase in the risk of activities of daily living disability, a 6% increase in the risk of a nursing home stay, and a 5% increase in mortality. Accuracy for 5- and 10-year predictions based on up to 3 repeated measurements of IC ranged between moderate and good (area under the receiver operating characteristic curve = 0.76–0.82).

Conclusions

Our study indicates that IC declines progressively and that it predicts negative health outcomes among older adults. Therefore, regular monitoring of IC could work as an early warning system informing preventive efforts.
New PCR-Based Assay for the Identification of Pectobacterium carotovorum Causing Potato Soft Rot
Authors: Suárez M. Belén , Diego Marta , Feria Francisco J. , Martín-Robles Manuel J. , Moreno Sergio , Palomo Jose Luis
Published: September 2021

Soft rot on potato tuber is a destructive disease caused by pathogenic bacterial species of the genera Pectobacterium and Dickeya. Accurate identification of the causal agent is necessary to ensure adequate disease management because different species may have distinct levels of aggressiveness and host range. One of the most important potato pathogens is Pectobacterium carotovorum, a highly heterogeneous species capable of infecting multiple hosts. The complexity of this species, until recently divided into several subspecies, has made it difficult to develop precise diagnostic tests. This study proposes a PCR assay based on the new pair of primers Pcar1F/R to facilitate the identification of potato isolates of P. carotovorum according to the most recent taxonomic description of this species. The new primers were designed on a variable segment of the 16S rRNA gene and the intergenic spacer region of available DNA sequences from classical and recently established species in the genus Pectobacterium. The results of the PCR analysis of genomic DNA from 32 Pectobacterium and Dickeya strains confirmed that the Pcar1F/R primers have sufficient nucleotide differences to discriminate between P. carotovorum and other Pectobacterium species associated with damage to potato crops, with the exception of Pectobacterium versatile, which improves the specificity of the currently available primers. The proposed assay was originally developed as a conventional PCR but was later adapted to the real-time PCR format for application in combination with the existing real-time PCR test for the potato-specific pathogen Pectobacterium parmentieri. This should be useful for the routine diagnosis of potato soft rot.
Effect of Digital Learning With an Interactive eBook on Electrocardiogram Interpretation Among Clinical Nurses
Authors: Hsieh Ching-Tsai , Liu Yi , Wang Yu-Hsin
Published: September 2021

In digital learning, the use of an interactive eBook is perceived as helpful for students. However, the effect of interactive eBooks on learning among clinical nurses has not been explored yet. This study used an interactive electrocardiogram eBook to explore the effect of digital learning on the promotion of electrocardiogram interpretation competence, confidence, knowledge retention, and learning satisfaction among clinical nurses. A single-group quasi-experimental study with three repeated measures was conducted. A total of 80 nurses from the emergency room, critical units, and medical-surgical units completed the measures. The results showed that digital learning is an effective method that significantly improved nurses' electrocardiogram competence, learning retention, confidence, and learning satisfaction. Most nurses were satisfied with the convenience and content design of this eBook. Few nurses reported drawbacks regarding loading speed and individual learning habits. It is recommended that more preset learning exercise questions should be created for trial and error so that nurses can have repeated practice for self-assessment. Specific feedback mechanisms should be established to promote motivation for digital self-learning.
Eosinophilic Vasculitis and Arteritic Anterior Ischemic Optic Neuropathy Associated With Anti-PD-L1 Therapy
Authors: Berry Ella C. , Mullany Sean , Quinlivan Alannah , Craig Amelia , New-Tolley Julia , Slattery James , Sukumaran Shawgi , Klebe Sonja , Craig Jamie E. , Siggs Owen M. , Wechalekar Mihir D.
Published: September 2021

Immune checkpoint inhibitor therapy is frequently associated with immune-related adverse events, which occasionally manifest with visual symptoms. Here, we describe a case of unilateral and sudden-onset painless vision loss in an 82-year-old man with metastatic non–small cell lung cancer receiving immunotherapy with the anti–programmed death-ligand 1 agent atezolizumab. Examination demonstrated a right-sided relative afferent pupillary defect, diffusely swollen optic disc, and delayed choroidal and retinal arterial filling on fundus fluorescein angiography, consistent with an arteritic anterior ischemic optic neuropathy. Histology of an ipsilateral temporal artery biopsy revealed a transmural eosinophilic infiltrate without granulomas, while serology revealed the presence of antineutrophil cytoplasmic antibodies. Peripheral eosinophilia was also noted, which preceded treatment by several months. This report highlights the importance of clinician awareness of immune checkpoint inhibitors and their systemic and ophthalmic complications, which rarely appear to extend to eosinophilic temporal arteritis.
Risk factors in pediatric melanoma: a retrospective study of 39 cases
Authors: Fidanzi Cristian , Manzo Margiotta Flavia , Spinelli Claudio , Janowska Agata , Dini Valentina , Oranges Teresa , Romanelli Marco , Morganti Riccardo , Viacava Paolo , D’Erme Angelo M. , Bagnoni Giovanni
Published: September 2021

Pediatric melanoma is a rare form of the tumor whose epidemiology is widely increasing thanks to the improvement of dermoscopic and anatomopathologic diagnostic techniques. Although it is a tumor of considerable interest in adults, little has been described about the pediatric field. The objective of our study was then to identify the possible risk factors for the development of melanoma in the pediatric population. We performed a retrospective study conducted in the Melanoma and Skin Cancer Unit and Unit of Dermatology (Livorno, Italy). We analyzed a population of 38 children under 21 years with a diagnosis of melanoma. This population was compared with a control population of 114 children followed up in our dermatologic clinic. From our combined univariate-multivariate statistics analysis, the number of nevi [regression coefficient (RC) of 1.04 and odds ratio (OR) of 2.8 confidence interval (Cl, 1.2–6.6)], and family history of melanoma [RC of 1.99 and OR of 7.3 (Cl, 2.3–22.7)] emerged as possible risk factors for the development of melanoma. The identification of these elements would allow the physician to carry out a more targeted preliminary assessment of the patient, potentially decisive in cases of diagnostic doubt of the lesion. Our study also lays the foundations for identifying those children who, despite not having received a diagnosis of melanoma on histologic examination, should be considered as patients susceptible to a focused follow-up, because of the presence of the risk factors that emerged from our research.
The Transition from Pediatric to Adult Health Care in Young Adults with Spina Bifida: Demographic and Physician-Related Correlates
Authors: Stiles-Shields Colleen , Kritikos Tessa K. , Starnes Meredith , Smith Zoe R. , Holmbeck Grayson N.
Published: September 2021

Objective:

This study examined the transition to adult health care for individuals with spina bifida (SB) and explored demographic and relational associations with transition status.

Method:

Young adults with SB (18–30; n = 326) were recruited to complete an anonymous, online survey. Frequencies of reported experiences, behaviors, and satisfaction with the transition to adult health care were examined. Nonparametric tests and exploratory hierarchical regressions were used to examine demographic and relational factors with physicians between those (1) who had and had not yet transitioned and (2) who did and did not return to pediatric care.

Results:

Most of the sample reported having transitioned to adult health care, with three-quarters reporting that their primary physician is an adult primary care doctor. Individuals who had transitioned were more likely to be younger (p = 0.01) and to not have a shunt (p = 0.003). Beyond the effect of age and shunt status, relational factors with pediatric providers were not associated with transition (p > 0.1). After transition, over one-third reported returning to a pediatric provider. Those who did not return to pediatric care were more likely to have myelomeningocele, be a full-time student, and to not have a shunt (p < 0.001). Beyond the effect of age and shunt status, lower ratings of communication with adult providers were associated with a return to pediatric care (p = 0.04).

Conclusion:

The results highlight the need for additional research about barriers and facilitators to the transition to adult health care to target interventions that support this critical milestone in young adults with SB.
Comparison of perioperative hidden blood loss and analysis of risk factors in elderly patients with femoral intertrochanteric fractures with intramedullary fixation at different altitudes
Authors: Ma Xianzhi , Lv Ruiqiang , Ma Sichao , Liu Ming , Han Shengshou , Yan Wenqi , Wang Kai , Qi Wanle
Published: September 2021

Objective:

To compare the perioperative hidden blood loss (HBL) and analyze its risk factors in elderly patients undergoing intramedullary fixation after intertrochanteric fractures at different altitudes.

Materials and methods:

This prospective study collected the perioperative clinical data of 120 elderly femoral intertrochanteric fractures from February 2020 to February 2021 at different altitudes. Twenty-nine cases were from Nanjing, where an average altitude is 10 m (group A); 73 patients were from Xining, where an average altitude is 2300 m (group B); and 20 cases were from Yushu where an average altitude is 3600 m (group C). Demographic data of the included patients, preoperative and postoperative hemoglobin, hematocrit, prothrombin time (PT), activated partial thromboplastin time (APTT), preoperative and postoperative HBL, intraoperative visible blood loss, and perioperative blood transfusion rate, and other relevant indicators were recorded and the clinical data of the 3 groups were summarized.

Results:

The total HBL, preoperative HBL, and postoperative HBL of group C were greater than those of groups A and B, that is, total HBL: 740±380 mL in group A versus 850±530 mL in group B versus 1090±180 mL in group C, F=3.551, P=0.032; preoperative HBL: 460±320 mL in group A versus 410±300 mL in group B versus 590±120 mL in group C, F=9.086, P=0.011; Postoperative HBL: 270±220 mL in group A versus 440±420 mL in group B versus 500±140 mL in group C, F=13.138, P=0.001. Multiple linear regression analysis found that admission PT and APTT, fracture classification AO/OTA 31-A2.2–A3.3, male, body mass index, intraoperative blood transfusion, injury to operation time >5 days, longer operation time, and high altitude all were independent risk factors for perioperative HBL increase. There was a negative correlation between low altitude and hemoglobin on the first postoperative day and HBL.

Conclusion:

Elderly patients undergoing intramedullary fixation after intertrochanteric fractures develop massive HBL during the perioperative period, especially in patients in high altitude areas. Regular blood tests, PT, APTT during the perioperative period are vital to avoid perioperative anemia. Shortening the perioperative period and operation time will significantly reduce HBL.
Association of low birthweight and premature birth with hypertensive disorders in pregnancy: a systematic review and meta-analysis
Authors: Tsujimoto Yasushi , Kataoka Yuki , Banno Masahiro , Taito Shunsuke , Kokubo Masayo , Masuzawa Yuko , Yamamoto Yoshiko
Published: September 2021

Background:

Growing evidence suggests that women born preterm or small have an increased risk of experiencing hypertensive disorders during pregnancy; however, a quantitative summary of the evidence on this issue is unavailable.

Objective:

We aimed to systematically review the literature to describe the association between being born preterm, low birthweight (LBW), or small for gestational age (SGA), and future gestational hypertension, preeclampsia, or eclampsia.

Methods:

We searched the MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and ICTRP databases. We included all cohort and case–control studies examining the association between LBW, preterm birth, or SGA and hypertensive disorders in pregnancy. We pooled the odds ratios and 95% confidence intervals using the DerSimonian and Laird random-effects model. We assessed the certainty of evidence for each outcome using the Grading of Recommendations, Assessment, Development, and Evaluation criteria.

Results:

Eleven studies were identified, totalling 752 316 participants. Being born preterm, LBW, or SGA was associated with gestational hypertension [pooled odds ratio (OR), 1.31; 95% confidence interval (CI) 1.15–1.50; moderate certainty of evidence] and preeclampsia (pooled OR, 1.35; 95% CI 1.23–1.48; moderate certainty of evidence). No study measured eclampsia as an outcome.

Conclusion:

Women born preterm, LBW, or SGA have an increased risk of gestational hypertension and preeclampsia. The course of the mother's own birth might be used to identify women at risk of gestational hypertension and preeclampsia.
Utilization of Chest Pain Decision Aids in a Community Hospital Emergency Department: A Mixed-methods Implementation Study
Authors: Bean Glenn , Krishnan Uma , Stone Jason R. , Khan Madiha , Silva Angela
Published: September 2021

Introduction:

Chest pain is a common reason for emergency department (ED) visits. Evidence-based decision aids assessing risk for an adverse cardiac event are underused in community hospital emergency care. This study explored the acceptability, barriers, facilitators, and potential strategies for implementation of the HEART Score risk stratification tool, accelerated diagnostic pathway, and shared decision-making visual aid with physicians and chest pain patients ages >45 in a community hospital ED.

Methods:

Single center, mixed-methods study. (1) Physician semistructured interviews using The Consolidated Framework for Implementation Research for systematic analysis. (2) Patient and physician surveys. (3) 16-week intervention of physician training and pilot testing of decision aids with ED patients.

Results:

Physician interviews (n = 19); key facilitators: electronic medical record decision support, ease of use, risk stratification and disposition support, and shared decision-making training. Key barriers: time constraints, patient ability, and/or willingness to participate in shared decision-making, lack of integration with medical record and change in practice workflow. Patient study participants (n = 184) with a survey response rate of 92% (n = 170). Most patients (85%) were satisfied with the shared decision-making visual aid. Physicians surveyed (n = 84) with a response rate of 50% (n = 42). Most physicians, 95% (n = 40), support use of the HEART Score, with limited acceptance of the shared decision-making visual aid of 57% (n = 24).

Conclusions:

Using evidence-based chest pain decision aids in a community hospital ED is feasible and acceptable. Key barriers and facilitators for implementation were identified. Further research in community hospitals is needed to verify findings, examine generalizability, and test implementation strategies.
Parvimonas micra Necrotizing Panophthalmitis Involving the Sclera, Cornea, Uvea, Retina, and Orbit
Authors: Barnett Jonathan A. , Dempsey Katharine S. , Sobel Rachel K.
Published: September 2021

We present an unusual case of a patient who acquired a pansinusitis and orbital cellulitis with necrotizing features, subsequently developing scleritis, keratitis, and anterior uveitis. To date, there are no reported cases of the simultaneous involvement of these ocular structures from a pansinusitis. Our patient was urgently taken to the operating room for drainage of the abscesses within his sinuses and the orbit. Intraoperative cultures were positive for Parvimonas micra, an odontogenic anaerobic bacteria. He was additionally found to have a central retinal artery occlusion. He was treated with systemic and topical antibiotics as well as topical dilute hypochlorous acid. The mechanisms of virulence of P. micra, including its synergistic relationship with other bacteria, ability to bind plasminogen, and its expression of proteases, contributed to this diffuse infection.
Impact of intravascular ultrasound and final kissing balloon dilatation on long-term clinical outcome in percutaneous revascularization with 1-stent strategy for left main coronary artery stenosis in drug-eluting stent era
Authors: Yoon Jae Yong , Lee Jang Hoon , Choi Hyohun , Park Hyuk Kyoon , Lee Eunkyu , Kim Myeong Seop , Kwon Youngjoon , Jang Se Yong , Bae Myung Hwan , Yang Dong Heon , Park Hun Sik , Cho Yongkeun , Chae Shung Chull
Published: September 2021

Background

It remains uncertain whether intravascular ultrasound (IVUS) use and final kissing balloon (FKB) dilatation would be standard care of percutaneous coronary intervention (PCI) with a simple 1-stent technique in unprotected left main coronary artery (LMCA) stenosis. This study sought to investigate the impact of IVUS use and FKB dilatation on long-term major adverse cardiac events (MACEs) in PCI with a simple 1-stent technique for unprotected LMCA stenosis.

Methods

Between June 2006 and December 2012, 255 patients who underwent PCI with 1 drug-eluting stent for LMCA stenosis were analyzed. Mean follow-up duration was 1663 ± 946 days. Long-term MACEs were defined as death, nonfatal myocardial infarction (MI) and repeat revascularizations.

Results

During the follow-up, 72 (28.2%) MACEs occurred including 38 (14.9%) deaths, 21 (8.2%) nonfatal MIs and 13 (5.1%) revascularizations. The IVUS examination and FKB dilatation were done in 158 (62.0%) and 119 (46.7%), respectively. IVUS use (20.3 versus 41.2%; log-rank P < 0.001), not FKB dilatation (30.3 versus 26.5%; log-rank P = 0.614), significantly reduced MACEs. In multivariate analysis, IVUS use was a negative predictor of MACEs [hazards ratio 0.51; 95% confidence interval (CI) 0.29–0.88; P = 0.017], whereas FKB dilatation (hazard ratio 1.68; 95% CI, 1.01–2.80; P = 0.047) was a positive predictor of MACEs. In bifurcation LMCA stenosis, IVUS use (18.7 versus 48.0%; log-rank P < 0.001) significantly reduced MACEs. In nonbifurcation LMCA stenosis, FKB dilatation showed a trend of increased MACEs (P = 0.076).

Conclusion

IVUS examination is helpful in reducing clinical events in PCI for LMCA bifurcation lesions, whereas mandatory FKB dilatation after the 1-stent technique might be harmful in nonbifurcation LMCA stenosis.
Cervical Small Cell Variant of Paraganglioma With Sarcomatous Transformation: Report of a Unique Case
Authors: Razack Rubina , Butt Jennifer L. , Coetzee Liezel , Hostein Isabelle , Croce Sabrina , De Wet Daniel R. , McCluggage W. Glenn
Published: September 2021

We report a unique primary cervical neoplasm in a 44-yr-old woman which we believe, based on the morphology and immunophenotype, represents an extremely unusual small cell variant of paraganglioma. This represents the first report of a primary cervical paraganglioma. Following chemoradiation treatment, the tumor underwent malignant transformation into an S100 and SOX10 positive sarcoma, morphologically and immunohistochemically resembling a malignant peripheral nerve sheath tumor, which we believe represents a sarcoma derived from the sustentacular cells of the paraganglioma. Mutational analysis detected a nonsense mutation of NF1 gene in the sarcoma. This further supports the diagnosis as both somatic and germline NF1 mutations have been associated with paragangliomas and malignant peripheral nerve sheath tumors. Targeted RNA sequencing (ARCHER, expanded sarcoma panel) covering many known genes implicated in sarcoma development, did not reveal any other molecular alteration (fusion or internal tandem duplication).
AI-Based Quantitative CT Analysis of Temporal Changes According to Disease Severity in COVID-19 Pneumonia
Authors: Ardali Duzgun Selin , Durhan Gamze , Basaran Demirkazik Figen , Irmak Ilim , Karakaya Jale , Akpinar Erhan , Gulsun Akpinar Meltem , Inkaya Ahmet Cagkan , Ocal Serpil , Topeli Arzu , Ariyurek Orhan Macit
Published: September 2021

Objective

To quantitatively evaluate computed tomography (CT) parameters of coronavirus disease 2019 (COVID-19) pneumonia an artificial intelligence (AI)-based software in different clinical severity groups during the disease course.

Methods

From March 11 to April 15, 2020, 51 patients (age, 18–84 years; 28 men) diagnosed and hospitalized with COVID-19 pneumonia with a total of 116 CT scans were enrolled in the study. Patients were divided into mild (n = 12), moderate (n = 31), and severe (n = 8) groups based on clinical severity. An AI-based quantitative CT analysis, including lung volume, opacity score, opacity volume, percentage of opacity, and mean lung density, was performed in initial and follow-up CTs obtained at different time points. Receiver operating characteristic analysis was performed to find the diagnostic ability of quantitative CT parameters for discriminating severe from nonsevere pneumonia.

Results

In baseline assessment, the severe group had significantly higher opacity score, opacity volume, higher percentage of opacity, and higher mean lung density than the moderate group (all P ≤ 0.001). Through consecutive time points, the severe group had a significant decrease in lung volume (P = 0.006), a significant increase in total opacity score (P = 0.003), and percentage of opacity (P = 0.007). A significant increase in total opacity score was also observed for the mild group (P = 0.011). Residual opacities were observed in all groups. The involvement of more than 4 lobes (sensitivity, 100%; specificity, 65.26%), total opacity score greater than 4 (sensitivity, 100%; specificity, 64.21), total opacity volume greater than 337.4 mL (sensitivity, 80.95%; specificity, 84.21%), percentage of opacity greater than 11% (sensitivity, 80.95%; specificity, 88.42%), total high opacity volume greater than 10.5 mL (sensitivity, 95.24%; specificity, 66.32%), percentage of high opacity greater than 0.8% (sensitivity, 85.71%; specificity, 80.00%) and mean lung density HU greater than −705 HU (sensitivity, 57.14%; specificity, 90.53%) were related to severe pneumonia.

Conclusions

An AI-based quantitative CT analysis is an objective tool in demonstrating disease severity and can also assist the clinician in follow-up by providing information about the disease course and prognosis according to different clinical severity groups.
MicroRNA-541-5p REgulates Type II Alveolar Epithelial Cell Proliferation and Activity by Modulating the HMGB1 Expression
Authors: Shen Jie , Yan Jun , Wang Qiuyun , Zhuang Lei , Luo Yan
Published: September 2021

Acute lung injury (ALI) is characterized by excessive production of inflammatory factors and alveolar epithelial damage, type II alveolar epithelial (ATII) cells participate in the repairment of the damaged lung tissue in ALI. Recently, microRNAs (miRNAs) have been found to play crucial roles in the amelioration of various inflammation-induced diseases, including ALI. However, the biological function and the mechanisms of action of miRNAs in the regulation of inflammation, and how ATII cells repair damaged lung tissue in ALI remain unknown. In this study, a model of ALI was established using LPS, and ATII cells were isolated and treated with LPS. Hematoxylin and eosin staining revealed the injury to lung tissues. In this study we found that miR-541-5p expression was significantly decreased in ALI tissue and in the LPS-induced ATII cell model. Additionally, the LPS-induced model showed suppression of ATII cell proliferation and activity. Furthermore, overexpression of miR-541-5p was found to promote cell activity and proliferation in the LPS-induced ATII cell model. Moreover, a luciferase assay illustrated that HMGB1 is a target of miR-541-5p, HMGB1 knockdown blocked the inhibitory effect of miR-541-5p on LPS-induced ATII cells. Ultimately, our study demonstrated that expression of p38, JNK, and ERK in LPS-induced ATII cells increased significantly. These results suggest that miR-541-5p is a key effector in ALI tissue, and that LPS-induced ATII cells act by regulating HMGB1 expression. This effect may be related to excessive activation of the JNK/ERK/p38 signaling pathway.
Agricultural methane emissions and the potential formitigation
Authors: Smith Pete , Reay Dave , Smith Jo
Published: September 2021

Agriculture is the largest anthropogenic source of methane (CH4), emitting 145 Tg CH4 y−1to the atmosphere in 2017. The main sources are enteric fermentation, manure management, rice cultivation and residue burning. There is significant potential to reduce CH4from these sources, with bottom-up mitigation potentials of approximately 10.6, 10, 2 and 1 Tg CH4 y−1from rice management, enteric fermentation, manure management and residue burning. Other system-wide studies have assumed even higher potentials of 4.8–47.2 Tg CH4 y−1from reduced enteric fermentation, and 4–36 Tg CH4 y−1from improved rice management. Biogas (a methane-rich gas mixture generated from the anaerobic decomposition of organic matter and used for energy) also has the potential to reduce unabated CH4emissions from animal manures and human waste. In addition to these supply side measures, interventions on the demand-side (shift to a plant-based diet and a reduction in total food loss and waste by 2050) would also significantly reduce methane emissions, perhaps in the order of greater than 50 Tg CH4 y−1. While there is a pressing need to reduce emissions of long-lived greenhouse gases (CO2and N2O) due to their persistence in the atmosphere, despite CH4being a short-lived greenhouse gas, the urgency of reducing warming means we must reduce any GHG emissions we can as soon as possible. Because of this, mitigation actions should focus on reducing emissions of all the three main anthropogenic greenhouse gases, including CH4.

This article is part of a discussion meeting issue 'Rising methane: is warming feeding warming? (part1)'.
The added value of satellite observations of methane forunderstanding the contemporary methane budget
Authors: Palmer Paul I. , Feng Liang , Lunt Mark F. , Parker Robert J. , Bösch Hartmut , Lan Xin , Lorente Alba , Borsdorff Tobias
Published: September 2021

Surface observations have recorded large and incompletely understood changes to atmospheric methane (CH
4
) this century. However, their ability to reveal the responsible surface sources and sinks is limited by their geographical distribution, which is biased towards the northern midlatitudes. Data from Earth-orbiting satellites designed specifically to measure atmospheric CH
4
have been available since 2009 with the launch of the Japanese Greenhouse gases Observing SATellite (GOSAT). We assess the added value of GOSAT to data collected by the US National Oceanic and Atmospheric Administration (NOAA), which have been the lynchpin for knowledge about atmospheric CH
4
since the 1980s. To achieve that we use the GEOS-Chem atmospheric chemistry transport model and an inverse method to infer
a posteriori
flux estimates from the NOAA and GOSAT data using common
a priori
emission inventories. We find the main benefit of GOSAT data is from its additional coverage over the tropics where we report large increases since the 2014/2016 El Niño, driven by biomass burning, biogenic emissions and energy production. We use data from the European TROPOspheric Monitoring Instrument to show how better spatial coverage and resolution measurements allow us to quantify previously unattainable diffuse sources of CH
4
, thereby opening up a new research frontier.

This article is part of a discussion meeting issue ‘Rising methane: is warming feeding warming? (part 1)’.
Yellow fever disease severity is driven by an acute cytokine storm modulated by an interplay between the human gut microbiome and the metabolome
Authors: Pelletier Adam-Nicolas , Tomazella Mateus , de Carvalho Karina , Nicolau Andre , Marmoratto Marianna , Silveira Cassia , Khalil Jorge , Nakaya Helder , Kallas Esper , Diamond Michael , Sekaly Rafick-Pierre
Published: September 2021

Infection with Yellow Fever (YF) can lead to multiple outcomes ranging from death from total organ failure to clearance of viremia and survival. The mechanisms underlying these differences in clinical outcomes have yet to be defined. We had access to a cohort of YF infected subjects that showed these range of outcomes. An unbiased integrated OMICs approach was used to identify pathways and effector molecules that drive the severe disease and death as compared to resolution of infection. We used the MELD and SIC score as objective markers of disease severity. We show that a specific signature of upregulated innate pro-inflammatory cytokines significantly demarcates subjects with severe disease leading to death from subjects who clear virus. Pathogen sequencing showed heightened levels of proteolytic bacteria at the i.e Actinobacteria and these were correlated to lower levels of tryptophan and tyrosine amino acids measured by untargeted metabolomics. These two features were significantly associated to MELD scores synonymous of milder disease. Propionate a bacterial metabolite that triggers Treg differentiation that can as well limit the hyperimmune activation associated to severe outcome was also associated to improved outcome. Our results suggest a model whereby proteolytic bacteria limit the availability of the aromatic amino acid pool available for cytokine production thereby preventing the induction of the cytokine storm that is associated to severe disease and death.
Spontaneous nucleation and fast aggregate-dependent proliferation of α-synuclein aggregates within liquid condensates at physiological pH
Authors: Dada Samuel T. , Hardenberg Maarten C. , Mrugalla Lena K. , McKeon Mollie O. , Klimont Ewa , Michaels Thomas C. T. , Vendruscolo Michele
Published: September 2021

It is well-established that α-synuclein aggregation may proceed through an initial lipid-dependent aggregate formation and, if at acidic pH, a subsequent aggregate-dependent proliferation. It has also been recently reported that the aggregation of α-synuclein may also take place through an alternative pathway, which takes place within dense liquid condensates produced through liquid-liquid phase separation. The microscopic mechanism of this process, however, remains to be clarified. Here, we developed a fluorescence-based assay to perform a kinetic analysis of the aggregation process of α-synuclein within liquid condensates, and applied it to determine the corresponding mechanism of aggregation. Our analysis shows that at pH 7.4 the aggregation process of α-synuclein within dense condensates starts with spontaneous primary nucleation followed by rapid aggregate-dependent proliferation. Taken together, these results reveal a highly efficient pathway for the appearance and proliferation of α-synuclein aggregates at physiological pH.
An innate immune activation state prior to vaccination predicts responsiveness to multiple vaccines
Authors: Fourati S. , Tomalin LE. , Mulè MP. , Chawla DG. , Gerritsen B. , Rychkov D. , Henrich E. , Miller HER. , Hagan T. , Diray-Arce J. , Dunn P. ,   The Human Immunology Project Consortium (HIPC), Levy O. , Gottardo R. , Sarwal M. , Tsang JS. , Suárez-Fariñas M. , Pulendran B. , Sékaly RP. , Kleinstein SH.
Published: September 2021

Many factors determine whether an individual responding to vaccination will generate an immune response that can lead to protection. Several studies have shown that the pre-vaccination immune state is associated with the antibody response to vaccines. However, the generalizability and mechanisms that underlie this association remain poorly defined. Here, we sought to identify a common pre-vaccination signature and mechanisms that could predict the immune response across a wide variety of vaccines. We leveraged the “Immune Signatures Data Resource” created by the NIH Human Immunology Project Consortium (HIPC) to integrate data from 28 studies involving 13 different vaccines and associate the blood transcriptional status of 820 healthy young adults with their responses. An unsupervised analysis of blood transcriptional profiles across studies revealed three distinct pre-vaccination states, characterized by the differential expression of genes associated with a pro-inflammatory response, cell proliferation, and metabolism alterations downstream of NFκB and IRF7. Innate and adaptive immune cell subset-specific genes were also associated with the three pre-vaccination states. Importantly, individuals whose pre-vaccination state was enriched in pro-inflammatory response genes known to be downstream of NFκB tended to have higher serum antibody responses one month after vaccination. A supervised analysis of the same data resulted in a single classifier, also enriched for NFκB regulated genes, that predicted the antibody response across most of the vaccines. Projection into single-cell RNA-sequencing data suggested that this pre-vaccination state was attributable to the signature of activation of non-classical monocytes and myeloid dendritic cells. Transcriptional signatures of acute responses to bacterial and not viral infections were enriched in the high pro-inflammatory pre-vaccination state and also included NFκB regulated genes. The pro-inflammatory pre-vaccination state was highly reminiscent of the innate activation state triggered by TLR ligands or adjuvants. These results demonstrate that wide variations in the transcriptional state of the immune system in humans can be a key determinant of responsiveness to vaccination. They also define a transcriptional signature NFκB activation at baseline, that is associated with a greater magnitude of antibody response to multiple vaccines, and suggest that modulation of the innate immune system by next-generation adjuvants targeting NFκB before vaccine administration may improve vaccine responsiveness.