bluuebunny/crossref_metadata_2025 huggingface dataset:
Monolithic DWDM source with precise channel spacing
Authors: Hou Lianping , Tang Song , Marsh John H.
Published: April 2021

We report a low-cost manufacturing approach for fabricating monolithic multi-wavelength sources for dense wavelength division multiplexing (DWDM) systems that offers high yield and eliminates crystal regrowth and selective area epitaxy steps that are essential in traditional fabrication methods. The source integrates an array of distributed feedback (DFB) lasers with a passive coupler and semiconductor optical amplifier (SOA). Ridge waveguide lasers with sampled Bragg side wall gratings have been integrated using quantum well intermixing to achieve a fully functional four-channel DWDM source with 0.8 nm wavelength spacing and residual errors < 0.13 nm. The output power from the SOA is > 10 mW per channel making the source suitable for use in passive optical networks (PONs). We have also investigated using multisection phase-shifted sampled gratings to both increase the effective grating coupling coefficient and precisely control the channel lasing wavelength spacing. An 8-channel DFB laser array with 100 GHz channel spacing was demonstrated using a sampled grating with two π-phase-shifted sections in each sampling period. The entire array was fabricated by only a single step of electron beam lithography.
Four-wave mixing in silicon-nanocrystal embedded high-index doped silica micro-ring resonator
Authors: Li Yuhua , Wang Xiang , Davidson Roy , Little Brent E. , Chu Sai Tak
Published: April 2021

A nonlinear integrated optical platform that allows the fabrication of waveguide circuits with different material composition, and at small dimensions, offers advantages in terms of field enhancement and increased interaction length, thereby facilitating the observation of nonlinear optics effects at a much lower power level. To enhance the nonlinearity of the conventional waveguide structure, in this work, we propose and demonstrate a microstructured waveguide where silicon rich layer is embedded in the core of the conventional waveguide in order to increase its nonlinearity. By embedding a 20 nm thin film of silicon nanocrystal (Si-nc), we achieve a twofold increase of the nonlinear parameter, γ. The linear relationship between the four-wave mixing conversion efficiency and pump power reveals the negligible nonlinear absorption and small dispersion in the micro-ring resonators. This simple approach of embedding an ultra-thin Si-nc layer into conventional high-index doped silica dramatically increases its nonlinear performance, and could potentially find applications in all-optical processing functions.
High heat removal technique for a lithium neutron generation target used for an accelerator-driven BNCT system
Authors: Yoshihashi S. , Tsuneyoshi T. , Tsuchida K. , Furuzawa D. , Honda S. , Watanabe K. , Yamazaki A. , Tsuji Y. , Hamaji Y. , Tokitani M. , Tamura H. , Sagara A. , Kiyanagi Y. , Uritani A.
Published: April 2021

Accelerator-driven neutron sources have been developed worldwide for boron neutron capture therapy (BNCT) instead of nuclear reactors. Nagoya University is currently developing a compact DC accelerator driven BNCT system using a sealed lithium (Li) target. The target receives a high heat load by a proton beam, and the heat then requires efficient removal. This study developed a high-efficiency heat removal technique that uses V-shaped staggered ribs on the heat removal side of the flow channels. We performed experiments using an electron beam to confirm the technique performance. The results showed double the heat removal performance compared to the smooth surface channel. The value expected to sufficiently remove 6.6 MW/m2 of heat load provided by the proton beam at the Nagoya University neutron source for BNCT.
The persistence of flexible coal in a deeply decarbonizing energy system
Authors: Ding Yongbin , Li Mingquan , Abdulla Ahmed , Shan Rui , Gao Shuo , Jia Guozhu
Published: April 2021

Extensive literature has highlighted the difficulty in operating baseload power plants—especially coal-fired units—in a decarbonized electric power system with a high share of variable renewable energy, with some of it recommending immediate coal phaseouts. However, the coal fleet across China is large and young, making its imminent phaseout unrealistic. Moreover, power system operators and policy makers face other constraints in their pursuit of energy system decarbonization—chief among them the need to achieve high levels of reliability—something coal units could provide. We assess the persistence of coal in a decarbonizing power system under various retrofit scenarios that seek to enhance the flexibility of coal units: after all, energy transitions do not occur in a vacuum and owners of coal power plants will likely pursue innovations to extend the lifetimes and profits of their assets, even as the wider energy transition unfolds. We evaluate the economic and environmental impacts of improving coal power unit flexibility in Jiangsu’s power system under four levels of renewable energy penetration and three scopes of coal flexibility retrofits. Our results show that coal units persist even at very high renewable penetrations, and retrofits help them reduce power system costs, enable renewable energy integration, and marginally cut emissions. Smaller coal units become peaker rather than baseload units, providing the power system with flexibility rather than just energy. Our results show how challenging the low-carbon transition is likely to be without outright phaseouts of coal generation.
Trends of the digital economy development in Russia
Authors: Romanyuk Maria , Sukharnikova Maria , Chekmareva Natalia
Published: April 2021

The article describes the objective prerequisites for the development of digitalization of the Russian economy. The characteristic of foreign and domestic approaches to theoretical and methodological generalization of digitalization processes is given. The article substantiates the current position of Russia in international ICT development ratings, the country’s share in the world market of ICT goods and services, and the degree of dependence on their imports. The analysis of the development of the state policy of Russia in the field of ICT was carried out, strategic goals, priorities and targets for the development of the digital society in Russia until 2030 were named. Analysis of the dynamics of ICT development showed that currently there is a positive trend only for one of the three goals of the National Program “Digital economy of the Russian Federation”, aimed at creating an information and telecommunications infrastructure. The strategic analysis of the Russian economy showed that with high rates of digitalization of social infrastructure and public administration, the contribution of ICT industries to the country’s GDP does not increase. So, according to the Strategy of development of the information society in the Russian Federation until 2030, the state directly regulates the direction of development of information infrastructure, while the introduction of digital technologies in the real sector of the economy is a matter of business initiatives.
A survey on data integrity verification schemes using blockchain technology in Cloud Computing Environment
Authors: Gangadevi K , Renuga Devi R
Published: April 2021

Cloud computing is the delivery of different services for business or any organization to store their data and utilize the various resources over the internet. The resources of cloud computing is storage, software, computing hardware and services. Usefulness of the cloud computing infrastructure is to grant services based on demand to the user. The security is a major concern in the cloud computing that are many modes of securities including accessibility, authentication, data integrity, data recovery and confidentiality. The data integrity is major role in the cloud computing security and storage service. Hence, the data integrity scheme provides the proof the truthfulness of the stored data in the cloud. In this paper, we are conducting a brief survey on data integrity verification schemes for cloud computing based on blockchain technology. The aim of this survey is to enhance the understanding the security issues and discuss the importance of data integrity scheme for outsourced data.
Sagnac interferometer and the quantum nature of gravity
Authors: Marletto Chiara , Vedral Vlatko
Published: April 2021

We use a quantum variant of the Sagnac interferometer to argue for the quantum nature of gravity assuming the equivalence principle, which we formulate in its quantum version. We first present an original derivation of the phase acquired in the conventional Sagnac matter-wave interferometer, within the Hamiltonian formalism. Then we modify the interferometer in two crucial respects. The interfering matter wave is interfered along two different distances from the centre and the interferometer is prepared in a superposition of two different angular velocities. We argue that if the radial and angular degrees of freedom of the matter wave become entangled through this experiment, then, via the equivalence principle, the gravitational field must be non-classical.
Edge states and sublattice imbalance of rectangular graphene nanoflakes
Authors: Yorikawa H
Published: April 2021

The energy states of π-electrons in a rectangular graphene flake with a pair of zigzag edges and a pair of armchair edges were studied using a tight-binding method. It is demonstrated that the known exact solution can be interpreted as the results derived from the analytical solutions for graphene nanoribbons on a brick-type lattice by considering the wavefunctions and sublattice imbalance. Edge states in rectangular graphene flakes with a symmetric structure, whose energies are not exactly zero but approach zero as the size increases, are characterized by discrete allowed modes, whereas the zero-energy state appears in rectangular graphene flakes with an asymmetric structure. By applying the edges states of rectangular graphene flakes, zero-energy states were examined in Y-shaped graphene flakes, which involve the same three zigzag edges as in the triangular graphene flakes. Sublattice imbalance in the model was found to force the edge states, including the undamped mode, into zero energy. Configurations of the allowed modes in the zero-energy state are revealed.
The photoacoustoelectric effect of the SAW amplification in the structure of Graphene-Piezocrystal LiNbO3
Authors: Tynyshtykbaev K B , Insepov Z
Published: April 2021

The work presents and analyzes the results of detecting the photoacoustoelectric effect of surface acoustic waves amplification by illumination of a hybrid graphene-LiNbO3 structure. This SAW photoamplification effect is associated with the appearance of an additional photoacoustoelectric current and a decrease of collisional scattering of photoinduced electrons under the action of the SAW electric field. Possible mechanisms of SAW amplification based on the analysis of modern data are discussed. This SAW photoamplification effect can be used to create optoacoustoelectronic devices on a graphene-piezoelectric structures for collecting, amplifying, and detecting superweak sources of THz-radiation photons.
Controlling the structure and photocatalytic properties of three—dimensional aerogels obtained by simultaneous reduction and self-assembly of BiOI/GO aqueous colloidal dispersions
Authors: Puig Julieta , de Castro Alves Lisandra , García Acevedo Pelayo , Arnosa Prieto Angela , Yáñez Vilar Susana , Teijeiro-Valiño Carmen , Piñeiro Yolanda , Hoppe Cristina E , Rivas José
Published: April 2021

Water pollution affects all living habitats, since it is the most basic element that sustains all life forms and, as an exceptional solvent, it readily makes any compound available for living cells, either nutrients or noxious substances. Elimination of molecular contaminants from water quality is one of the most challenging technical problems that conventional treatments like flocculation and filtration fail short to defeat. Particulate photocatalysts, used to degrade contaminants, have the main drawback of their recovery from the water matrices. The inclusion of photocatalytic nanoparticles (NPs) into a large supporting framework, is presented as an innovative approach aiming to ensure a facile separation from water. To this end, three-dimensional (3D) aerogels with photocatalytic properties were prepared by a simple and scalable method based on the reduction—induced self-assembly of graphene oxide (GO) in the presence of BiOI nanoparticles. With the help of ascorbic acid, as a green reducing agent, partial reduction of GO into reduced graphene oxide (RGO) and self-assembly of both kinds of nanostructures into a porous monolith was achieved. BiOI doped RGO aerogels were further stabilized and morphologically controlled using poly (ethylene glycol) as stabilizer. The photocatalytic performance of these aerogels was evaluated by following the discoloration of methylene blue (MB) solution, under visible light irradiation, showing that structure and dispersion degree of NPs to be fundamental variables. Hence, this methodology is proposed to produce hybrid aerogels with controlled morphology and photocatalytic performance that has the potential to be used in water cleaning procedures.
Art Concept Pluralism Undermines the Definitional Project
Authors: Magnus P D , Mag Uidhir Christy
Published: April 2021

This discussion note addresses Caleb Hazelwood’s ‘Practice-Centered Pluralism and a Disjunctive Theory of Art’. Hazelwood advances a disjunctive definition of art on the basis of an analogy with species concept pluralism in the philosophy of biology. We recognize the analogy between species and art, we applaud attention to practice, and we are bullish on pluralism—but it is a mistake to take these as the basis for a disjunctive definition.
Preoperative comprehensive geriatric assessment and optimisation prior to elective arterial vascular surgery: a health economic analysis
Authors: Partridge Judith S L , Healey Andrew , Modarai Bijan , Harari Danielle , Martin Finbarr C , Dhesi Jugdeep K
Published: April 2021

Background

increasing numbers of older people are undergoing vascular surgery. Preoperative comprehensive geriatric assessment and optimisation (CGA) reduces postoperative complications and length of hospital stay. Establishing CGA-based perioperative services requires health economic evaluation prior to implementation. Through a modelling-based economic evaluation, using data from a single site clinical trial, this study evaluates whether CGA is a cost-effective alternative to standard preoperative assessment for older patients undergoing elective arterial surgery.

Methods

an economic evaluation, using decision-analytic modelling, comparing preoperative CGA and optimisation with standard preoperative care, was undertaken in older patients undergoing elective arterial surgery. The incremental net health benefit of CGA, expressed in terms of quality-adjusted life-years (QALYs), was used to evaluate cost-effectiveness.

Results

CGA is a cost-effective substitute for standard preoperative care in elective arterial surgery across a range of cost-effectiveness threshold values. An incremental net benefit of 0.58 QALYs at a cost-effectiveness threshold of £30k, 0.60 QALYs at a threshold of £20k and 0.63 QALYs at a threshold of £13k was observed. Mean total pre- and postoperative health care utilisation costs were estimated to be £1,165 lower for CGA patients largely accounted for by reduced postoperative bed day utilisation.

Conclusion

this study demonstrates a likely health economic benefit in addition to the previously described clinical benefit of employing CGA methodology in the preoperative setting in older patients undergoing arterial surgery. Further evaluation should examine whether CGA-based perioperative services can be effectively implemented and achieve the same clinical and health economic outcomes at scale.
Is Pathfinder a safe alternative to the emergency department for older patients? An observational analysis
Authors: Bernard Paul , Corcoran Grace , Kenna Lawrence , O’Brien Claire , Ward Peter , Howard William , Hogan Laura , Mooney Rebecca , Masterson Siobhan
Published: April 2021

Background

many patients brought to emergency departments (EDs) following an emergency medical services (EMS) call have non-urgent needs that could be treated elsewhere. Older people are particularly vulnerable to adverse events while attending the ED. Alternative care pathway models can reduce ED crowding and improve outcomes. Internationally, there is no consensus on which model is recommended.

Aim

the aim of this study is to investigate the impact of the Pathfinder model on ED conveyance rates and patient safety.

Methods

the Pathfinder service is a collaboration between the National Ambulance Service and Beaumont Hospital Occupational Therapy and Physiotherapy Departments. It is supported by the Government of Ireland’s Sláintecare Integration fund. This is a retrospective cohort study of the Pathfinder service over a 5-month period.

Results

one-hundred and seventy-eight patients were responded to by the Pathfinder ‘Rapid Response Team’. Average age was 79.6 years (standard deviation 7.6), median clinical frailty score was 6 (interquartile range: 5–6). Sixty-four percent remained at home following initial review. None re-presented to the ED within 24 hours, and 10% re-presented within 7 days. The majority (67%) of patients required follow-up by the Pathfinder ‘Follow-Up Team’ and/or another community-based service. Feedback demonstrates 99% patient satisfaction with the service.

Conclusion

the Pathfinder service is a safe alternative to ED conveyance for older people following an EMS call. It is the first model of this kind to be evaluated in Ireland. The overwhelmingly positive feedback confirms that older people want this service. This model could expand, with local adaptation, nationally and internationally.
Investigation of REFINED CNN ensemble learning for anti-cancer drug sensitivity prediction
Authors: Bazgir Omid , Ghosh Souparno , Pal Ranadip
Published: April 2021

Motivation

Anti-cancer drug sensitivity prediction using deep learning models for individual cell line is a significant challenge in personalized medicine. Recently developed REFINED (REpresentation of Features as Images with NEighborhood Dependencies) CNN (Convolutional Neural Network)-based models have shown promising results in improving drug sensitivity prediction. The primary idea behind REFINED-CNN is representing high dimensional vectors as compact images with spatial correlations that can benefit from CNN architectures. However, the mapping from a high dimensional vector to a compact 2D image depends on the a priori choice of the distance metric and projection scheme with limited empirical procedures guiding these choices.

Results

In this article, we consider an ensemble of REFINED-CNN built under different choices of distance metrics and/or projection schemes that can improve upon a single projection based REFINED-CNN model. Results, illustrated using NCI60 and NCI-ALMANAC databases, demonstrate that the ensemble approaches can provide significant improvement in prediction performance as compared to individual models. We also develop the theoretical framework for combining different distance metrics to arrive at a single 2D mapping. Results demonstrated that distance-averaged REFINED-CNN produced comparable performance as obtained from stacking REFINED-CNN ensemble but with significantly lower computational cost.

Availability and implementation

The source code, scripts, and data used in the paper have been deposited in GitHub (https://github.com/omidbazgirTTU/IntegratedREFINED).

Supplementary information

Supplementary data are available at Bioinformatics online.
Epigenetic transgenerational inheritance, gametogenesis and germline development†
Authors: Ben Maamar Millissia , Nilsson Eric E , Skinner Michael K
Published: April 2021

One of the most important developing cell types in any biological system is the gamete (sperm and egg). The transmission of phenotypes and optimally adapted physiology to subsequent generations is in large part controlled by gametogenesis. In contrast to genetics, the environment actively regulates epigenetics to impact the physiology and phenotype of cellular and biological systems. The integration of epigenetics and genetics is critical for all developmental biology systems at the cellular and organism level. The current review is focused on the role of epigenetics during gametogenesis for both the spermatogenesis system in the male and oogenesis system in the female. The developmental stages from the initial primordial germ cell through gametogenesis to the mature sperm and egg are presented. How environmental factors can influence the epigenetics of gametogenesis to impact the epigenetic transgenerational inheritance of phenotypic and physiological change in subsequent generations is reviewed.
You cannot ablate the Lernaean Hydra: SCN5A mutation in a patient with multifocal ectopic Purkinje-related premature contractions syndrome treated with Flecainide and an implant of a subcutaneous defibrillator—a case report
Authors: Leventopoulos Georgios , Perperis Angelos , Karelas Dimitrios , Almpanis Georgios
Published: April 2021

Background

SCN5A mutations may present with different clinical phenotypes such as Brugada syndrome, long QT3 syndrome, sick sinus syndrome, atrial fibrillation, dilated cardiomyopathy, and the least known multifocal ectopic Purkinje-related premature contractions syndrome.

Case summary

We report a case of a 29-year-old woman with palpitations due to multifocal premature ventricular complexes (PVCs) and a family history of sudden death. The previous electrophysiological study had shown that PVCs arose from Purkinje fibres but catheter ablation was unsuccessful. Cardiac magnetic resonance (CMR) imaging demonstrated non-ischaemic areas of subendocardial fibrosis at multiple left ventricular (LV) segments with concomitant dilatation and mild systolic impairment. Amiodarone suppressed the ectopy but caused hyperthyroidism. Due to recent pregnancy, she received no antiarrhythmics which resulted in PVC burden increase and further deterioration of the ejection fraction (EF). After gestation, amiodarone was reinitiated and switched to flecainide after implantation of a subcutaneous defibrillator as a safety net. At follow-up, LV function had almost normalized. Genetic analysis confirmed an SCN5A mutation.

Discussion

Multifocal ectopic Purkinje-related premature contractions syndrome is associated with SCN5A mutation which in our case (R222Q) is the most common described. Flecainide can be an appropriate treatment option when ablation is ineffective. Defibrillator—even a subcutaneous type—could be implanted in cases of LV dysfunction or scar. PVCs suppression by flecainide and restoration of EF implies an arrhythmia—induced mechanism of LV impairment.
The maintenance of polygenic sex determination depends on the dominance of fitness effects which are predictive of the role of sexual antagonism
Authors: Meisel Richard P
Published: April 2021

In species with polygenic sex determination (PSD), multiple male- and female-determining loci on different proto-sex chromosomes segregate as polymorphisms within populations. The extent to which these polymorphisms are at stable equilibria is not yet resolved. Previous work demonstrated that PSD is most likely to be maintained as a stable polymorphism when the proto-sex chromosomes have opposite (sexually antagonistic) fitness effects in males and females. However, these models usually consider PSD systems with only two proto-sex chromosomes, or they do not broadly consider the dominance of the alleles under selection. To address these shortcomings, I used forward population genetic simulations to identify selection pressures that can maintain PSD under different dominance scenarios in a system with more than two proto-sex chromosomes (modeled after the house fly). I found that overdominant fitness effects of male-determining proto-Y chromosomes are more likely to maintain PSD than dominant, recessive, or additive fitness effects. The overdominant fitness effects that maintain PSD tend to have proto-Y chromosomes with sexually antagonistic effects (male-beneficial and female-detrimental). In contrast, dominant fitness effects that maintain PSD tend to have sexually antagonistic multi-chromosomal genotypes, but the individual proto-sex chromosomes do not have sexually antagonistic effects. These results demonstrate that sexual antagonism can be an emergent property of the multi-chromosome genotype without individual sexually antagonistic chromosomes. My results further illustrate how the dominance of fitness effects has consequences for both the likelihood that PSD will be maintained as well as the role sexually antagonistic selection is expected to play in maintaining the polymorphism.
Association of Intensive Lifestyle and Metformin Interventions With Frailty in the Diabetes Prevention Program Outcomes Study
Authors: Hazuda Helen P , Pan Qing , Florez Hermes , Luchsinger José A , Crandall Jill P , Venditti Elizabeth M , Golden Sherita H , Kriska Andrea M , Bray George A
Published: April 2021

Background

Frailty is a geriatric syndrome of decreased physiologic reserve and resistance to stressors that results in increased vulnerability to adverse health outcomes with aging. Diabetes and hyperglycemia are established risk factors for frailty. We sought to examine whether the odds of frailty among individuals at high risk of diabetes randomized to treatment with intensive lifestyle (ILS), metformin, or placebo differed after long-term follow-up.

Method

The sample comprised participants in the Diabetes Prevention Program (DPP) clinical trial, who continued follow-up in the DPP Outcomes Study (DPPOS) and completed frailty assessments in DPPOS Years 8 (n = 2385) and 10 (n = 2289), approximately 12 and 14 years after DPP randomization. Frailty was classified using Fried Frailty Phenotype criteria. GEE models adjusting for visit year with repeated measures pooled for Years 8 and 10 were used to estimate pairwise odds ratios (ORs) between ILS, metformin, and placebo for the outcomes of frail and prefrail versus nonfrail.

Results

Frailty prevalence by treatment group was ILS = 3.0%, metformin = 5.4%, placebo = 5.7% at Year 8, and ILS = 3.6%, metformin = 5.3%, placebo = 5.4% at Year 10. Odds ratios (95% CI) estimated with GEE models were ILS versus placebo, 0.62 (0.42–0.93), p = .022; metformin versus placebo, 0.99 (0.69–1.42), p = .976; and ILS versus metformin, 0.63 (0.42–0.94), p = .022. Odds of being frail versus nonfrail were 37% lower for ILS compared to metformin and placebo.

Conclusions

Early ILS intervention, at an average age of about 50 years, in persons at high risk of diabetes may reduce frailty prevalence in later life. Metformin may be ineffective in reducing frailty prevalence.

Clinical Trials Registration Numbers

NCT00004992 (DPP) and NCT00038727 (DPPOS).
Neighborhood Characteristics and Inflammation Among Older Black Americans: The Moderating Effects of Hopelessness and Pessimism
Authors: Nguyen Ann W , Taylor Harry Owen , Lincoln Karen D , Qin Weidi , Hamler Tyrone , Wang Fei , Mitchell Uchechi A
Published: April 2021

Background

Research documents the adverse health effects of systemic inflammation. Overall, older Black Americans tend to have higher inflammation than older non-Hispanic White adults. Given that inflammation is related to a range of chronic health problems that disproportionately affect Blacks compared to Whites, this racial disparity in inflammation may contribute to racial disparities in particular chronic health problems. Thus, a better understanding of its determinants in the older Black population is of critical importance. This analysis examined the association between neighborhood characteristics and inflammation in a national sample of older non-Hispanic Black Americans. An additional aim of this study was to determine whether hopelessness and pessimism moderate the association between neighborhood characteristics and inflammation.

Methods

A sample of older non-Hispanic Black Americans aged 60+ were drawn from the Health and Retirement Study (N = 1004). Neighborhood characteristics included neighborhood physical disadvantage and neighborhood social cohesion. Inflammation was assessed by C-reactive protein.

Results

The analyses indicated that neighborhood physical disadvantage and social cohesion were not associated with C-reactive protein. Hopelessness and pessimism moderated the association between neighborhood physical disadvantage and C-reactive protein.

Conclusions

Knowledge regarding the role of hopelessness and pessimism as moderator in the neighborhood–inflammation association can inform cognitive-behavioral interventions targeted at changes in cognition patterns.
Neither Leg Muscle Strength Nor Balance Is Associated With the Incidence of Falls in Middle-Aged Women: A 5-Year Population-Based Prospective Study
Authors: Wang Mengmeng , Wu Feitong , Callisaya Michele L , Jones Graeme , Winzenberg Tania M
Published: April 2021

Background

Muscle strength and balance are major modifiable factors of falls in older adults, but their associations with falls in middle-aged adults are underinvestigated. We aimed to examine the association of baseline and change in leg muscle strength (LMS) and balance with the incidence of falls in a cohort of middle-aged women.

Methods

This was a 5-year follow-up of a population-based sample of 273 women aged 36–57 years at baseline (2011–2012). Data on LMS (by dynamometer) and balance (timed up and go test, step test, functional reach test, and lateral reach test) were obtained at baseline and 5 years later (2017–2018). After 5 years, falls were recorded monthly for 1 year by questionnaire (2017–2019). Negative binomial/Poisson and log-binomial regressions were used as appropriate to assess associations of baseline and change in LMS and balance with any falls, injurious falls, and multiple falls.

Results

Over 1 year, 115 participants (42%) reported at least one fall. Neither baseline nor 5-year change in LMS and balance measures was associated with the risk of any falls, injurious falls, or multiple falls 5 years later, with or without adjusting for confounders at baseline (incidence rate ratio/relative risk ranging from 0.85 to 1.19, 0.90 to 1.20, and 0.82 to 1.36, respectively; p > .05 for all).

Conclusions

Baseline or change in LMS and balance measures are not associated with incident falls among middle-aged women. The contributions of environmental and other intrinsic factors such as chronic conditions and gait/mobility problems need to be investigated.
Advance Directive Completion Among Older American Couples: A Dyadic Perspective on the Role of Cognitive Function and Other Factors
Authors: Lu Peiyi , Kong Dexia , Lee Jeongeun , Shelley Mack
Published: April 2021

Objective

Dyadic perspective is scarce in existing advance directive (AD) literature. Particularly, the significance of one’s own and/or one’s partner’s cognitive function on AD remains unknown. This study investigates the relationship of cognitive function and other factors with AD completion within the spousal context.

Method

Data from the Health and Retirement Study (2014–2015) were used. Older heterosexual couples (age ≥65) married for 10+ years were asked if they had a living will and/or appointed a durable power of attorney for health care (DPAHC). Structural equation models examined the actor and partner effects of sociodemographic, health, and couple-level characteristics on wife’s and husband’s AD, respectively.

Results

Moderate spousal interdependence was observed in living will (kappa coefficient, κ = .60) and DPAHC (κ = .53). Older age and higher education were related to both spouses having AD. Less household wealth and being racial/ethnic minority were associated with a lower probability of having AD. Notable gender contrasts in actor and partner effects were found. Wife’s higher level of cognitive function was associated with husband’s AD completion. Contrarily, husband’s lower level of cognitive function was associated with wife’s AD completion. Retirement status had primarily actor effects for both husbands and wives. More chronic conditions were linked to husband’s AD completion.

Discussion

The spousal interdependence of AD warrants practitioner efforts to facilitate family-oriented end-of-life planning. Wives and husbands may have different thoughts regarding their spouse’s cognitive capacity to surrogate. Facilitating couple-based discussions may be a feasible approach to promote engagement with AD among older adults.
Downregulation of ARID1B, a tumor suppressor in the WNT subgroup medulloblastoma, activates multiple oncogenic signaling pathways
Authors: Deogharkar Akash , Singh Satishkumar Vishram , Bharambe Harish Shrikrishna , Paul Raikamal , Moiyadi Aliasgar , Goel Atul , Shetty Prakash , Sridhar Epari , Gupta Tejpal , Jalali Rakesh , Goel Naina , Gadewal Nikhil , Muthukumar Sahana , Shirsat Neelam Vishwanath
Published: April 2021

Medulloblastoma, a common pediatric malignant brain tumor, consists of four distinct molecular subgroups WNT, SHH, Group 3 and Group 4. Exome sequencing of 11 WNT subgroup medulloblastomas from an Indian cohort identified mutations in several chromatin modifier genes, including genes of the mammalian SWI/SNF complex. The genome of WNT subgroup tumors is known to be stable except for monosomy 6. Two tumors, having monosomy 6, carried a loss of function mutation in the ARID1B gene located on chromosome 6. ARID1B expression is also lower in the WNT subgroup tumors compared to other subgroups and normal cerebellar tissues that could result in haploinsufficiency. The short hairpin RNA-mediated knockdown of ARID1B expression resulted in a significant increase in the malignant potential of medulloblastoma cells. Transcriptome sequencing identified upregulation of several genes encoding cell adhesion proteins, matrix metalloproteases indicating the epithelial–mesenchymal transition. The ARID1B knockdown also upregulated ERK1/ERK2 and PI3K/AKT signaling with a decrease in the expression of several negative regulators of these pathways. The expression of negative regulators of the WNT signaling like TLE1, MDFI, GPX3, ALX4, DLC1, MEST decreased upon ARID1B knockdown resulting in the activation of the canonical WNT signaling pathway. Synthetic lethality has been reported between SWI/SNF complex mutations and EZH2 inhibition, suggesting EZH2 inhibition as a possible therapeutic modality for WNT subgroup medulloblastomas. Thus, the identification of ARID1B as a tumor suppressor and its downregulation resulting in the activation of multiple signaling pathways opens up opportunities for novel therapeutic modalities for the treatment of WNT subgroup medulloblastoma.
Repeat Variation Resolves a Complete Aggregate Silk Sequence of Bolas Spider Mastophora phrynosoma
Authors: Stellwagen Sarah D , Burns Mercedes
Published: April 2021

Many species of spider use a modified silk adhesive, called aggregate glue, to aid in prey capture. Aggregate spidroins (spider fibroins) are modified members of the spider silk family; however, they are not spun into fibers as are their solid silk relatives. The genes that encode for aggregate spidroins are the largest of the known spidroin genes and are similarly highly repetitive. In this study, we used long read sequencing to discover the aggregate spidroin genes of the toad-like bolas spider, Mastophora phrynosoma, which employs the glue in a unique way, using only a single, large droplet to capture moths. While Aggregate Spidroin 1 (AgSp1) remains incomplete, AgSp2 is more than an extraordinary 62 kb of coding sequence, 20 kb longer than the longest spidroin on record. The structure of repeats from both aggregate silk proteins follows a similar pattern seen in other species, with the same strict conservation of amino acid residue number for much of the repeats’ lengths. Interestingly, AgSp2 lacks the elevated number and groupings of glutamine residues seen in the other reported AgSp2 of a classic orb weaving species. The role of gene length in glue functionality remains a mystery, and thus discovering length differences across species will allow understanding and harnessing of this attribute for the next generation of bio-inspired adhesives.
Evaluation of anticoagulant therapy management in a teaching hospital in Tunisia: information and education for vitamin k antagonist newly treated patients need to be improved
Authors: Jeddou Khouloud Ben , Abbassi Aïmen , M’barka Fatma Ben , Bedoui Yosra , Boukhris Imene , Baccar Hédi , Khalfallah Narjess , Ouahchi Zeineb
Published: April 2021

Objective

The objective of this study was to assess the level of Vitamin K antagonist (VKA) therapy knowledge among VKA newly treated patients.

Methods

Questionnaire-based interviews were administered in a university hospital to VKA newly treated patients covering both cognitive (i.e. indication, route of administration, treatment monitoring and side effects) and know-how (i.e. safety precautions, what affects anticoagulant therapy and the management of overdose signs) aspects of therapy knowledge.

Key findings

A total of 55 patients were included. The mean overall score of patients’ knowledge was 5.78 (SD = 3.425) out of 20. The mean scores of cognitive and practical knowledge were 3.8 (2.26) and 1.98 (1.78) out of 10, respectively. Factors associated with an insufficient level of VKA therapy knowledge included low level of education, lack of access to therapy information and continuous access to this information.

Conclusions

Knowledge about VKA therapy among newly treated patients is insufficient. Patient’s medication knowledge should be improved to ensure better adherence.
Physical activity levels and sociodemographic factors associated with meeting recommended levels among shop attendants in Mbarara municipality, Uganda
Authors: Nimusiima Evas , Wafula Solomon T , Mendoza Hilbert , Ndejjo Rawlance , Atusingwize Edwinah
Published: April 2021

Background

Shop attendants are urban dwellers who may spend significant periods in sedentary lifestyles exposing them to non-communicable diseases. This study assessed the physical activity levels and sociodemographic factors associated with meeting the WHO recommended physical activity levels among shop attendants in Mbarara municipality, Uganda.

Methods

We conducted a cross-sectional study among 301 shop attendants. We used the global physical activity questionnaire to assess participants’ physical activity levels. Modified Poisson regression was used to assess the sociodemographic factors associated with meeting recommended physical activity levels.

Results

Of the 301 participants, 234 (77.7%) met the WHO physical activity recommendations, especially through work-related physical activity of moderate intensity 194 (64.5%). The median weekly duration of all moderate-intensity physical activity was 180 min (IQR=90 to 360). The median daily sedentary time was 300 min (IQR=300 to 360). Being male (adjusted prevalence ratio=1.33, 95% CI 1.17 to 1.51) was significantly associated with meeting recommended physical activity levels.

Conclusion

The physical activity levels among shop attendants were high and were mostly achieved through work-related activities of moderate intensity, with males being more likely to meet recommended physical activity levels. Findings suggest a need for gender-sensitive initiatives to increase physical activity levels, especially among female shop attendants.
Concordance between the results of randomized and non-randomized interventional clinical trials assessing the efficacy of drugs for COVID-19: a cross-sectional study
Authors: Shepshelovich Daniel , Yahav Dafna , Ben Ami Ronen , Goldvaser Hadar , Tau Noam
Published: April 2021

Objectives

To assess whether results of observational studies of potential anti-COVID-19 drugs were reproduced in subsequent randomized controlled trials (RCTs).

Methods

This was a retrospective cross-sectional study, including studies published online between 1 January and 27 October 2020 that evaluated potential COVID-19 treatments and reported all-cause mortality.

Results

Of 133 comparisons included in 117 studies, most were non-randomized (104/133, 78%). Hydroxychloroquine was the most common drug type, combined with azithromycin (n = 27, 20%) or alone (n = 22, 16%), followed by IL-6 inhibitors (n = 36, 27%) and corticosteroids (n = 26, 20%). Seventy-one percent (74/104) of non-randomized studies reported adjusted survival results and only 8% (8/104) adjusted for immortal time bias. Only two RCTs (2/29, 7%) reported significant survival benefit, both reporting treatment with corticosteroids, while 32/104 (31%) non-randomized studies showed statistically significant survival benefit associated with the intervention arm. The results of the majority (28/32, 88%) of non-randomized studies reporting survival benefit were not replicated by large-scale RCTs.

Conclusions

The results of most non-randomized studies reporting survival benefit of potential anti-COVID-19 drugs were not replicated by large RCTs. Regulators and healthcare professionals should exercise caution and resist the pressure to approve and prescribe drugs of unproven efficacy and potential toxicity to optimize patient care and maintain public trust in medical science.
Early supplementation with Lactobacillus plantarum in liquid diet modulates intestinal innate immunity through toll-like receptor 4-mediated mitogen-activated protein kinase signaling pathways in young piglets challenged with Escherichia coli K88
Authors: Yang Kuanmin M , Zhu Cui , Wang Li , Cao Shuting T , Yang Xuefen F , Gao Kaiguo G , Jiang Zongyong Y
Published: April 2021

This study was conducted to investigate the effects of early supplementation during 4 to 18 d of age with Lactobacillus plantarum (LP) in liquid diets on intestinal innate immune response in young piglets infected with enterotoxigenic Escherichia coli (ETEC) K88. Seventy-two barrow piglets at 4 d old were assigned to basal or LP-supplemented liquid diet (5 × 1010 CFU·kg−1). On day 15, piglets from each group were orally challenged with either ETEC K88 (1 × 108 CFU·kg−1) or the same amount of phosphate-buffered saline. The intestinal mucosa, mesenteric lymph node (MLN), and spleen samples were collected on day 18. Here, we found that LP pretreatment significantly decreased the mRNA relative expression of inflammatory cytokines (interleukin [IL]-1β, IL-8, and tumor necrosis factor-α), porcine β-defensin 2 (pBD-2), and mucins (MUC1 and MUC4) in the jejunal mucosa in piglets challenged with ETEC K88 (P < 0.05). Moreover, LP significantly decreased the ileal mucosa mRNA relative expression of IL-8 and MUC4 in young piglets challenged with ETEC K88 (P < 0.05). Furthermore, the piglets of the LP + ETEC K88 group had lower protein levels of IL-8, secretory immunoglobulin A, pBD-2, and MUC4 in the jejunal mucosa than those challenged with ETEC K88 (P < 0.05). Besides, LP supplementation reduced the percentage of gamma/delta T cells receptor (γδTCR) and CD172a+ (SWC3+) cells in MLN and the percentage of γδTCR cells in the spleen of young piglets after the ETEC K88 challenge. Supplementation with LP in liquid diets prevented the upregulated protein abundance of toll-like receptor (TLR) 4, phosphorylation-p38, and phosphorylation-extracellular signal-regulated protein kinases in the jejunal mucosa induced by ETEC K88 (P < 0.05). In conclusion, LP supplementation in liquid diet possesses anti-inflammatory activity and modulates the intestinal innate immunity during the early life of young piglets challenged with ETEC K88, which might be attributed to the suppression of TLR4-mediated mitogen-activated protein kinase signaling pathways. Early supplementation with LP in liquid diets regulates the innate immune response, representing a promising immunoregulation strategy for maintaining intestinal health in weaned piglets.
Introduction by Editors: Power in Forced Migration Research Methods
Authors: Saltsman Adam , Jacobsen Karen
Published: April 2021

When it comes to field research in contexts of forced migration, many of the challenges relate to questions of power. Most research is plagued by a power imbalance between those who call themselves ‘researcher’ or ‘technical expert’ and the forced migrants who participate in the research in various ways. This Special Section considers how this imbalance influences the production of research and how we might address the challenges created by research practices that are exclusionary, even if unwittingly so. What, for example, are the politics of designing methods for research with/on refugees? What kinds of negotiations and gatekeeping take place in determining the assemblage of actors involved in crafting and carrying out the research? Who has a seat at the table to design the research, interpret results, and write up outcomes? The three contributing articles that follow this introduction each discuss strategies the authors deployed, i.e. how they attempted to upend dominant research practices by centreing the voices of migrants and refugees, and re-balancing power inequities. In this article, we offer an introduction to how this Special Section conceptualizes power in the context of research with forced migrants.
Granuloma after breast conserving surgery—a report of three cases
Authors: Ichinose Yuki , Kosaka Yoshimasa , Saeki Toshiaki , Fujimoto Akihiro , Nukui Asami , Asano Aya , Shimada Hiroko , Matsuura Kazuo , Hasebe Takahiro , Osaki Akihiko
Published: April 2021

Granulomatous mastitis is a rare breast disease that is categorized as a benign tumor with chronic inflammation. Since the cause of the chronic inflammation is usually unknown, it is sometimes called idiopathic granulomatous mastitis (IGM). Although imaging modalities, such as ultrasound, magnetic resonance imaging and mammography can detect tumors, they are sometimes unable to differentiate between benign and malignant tumors. In such cases, biopsy is needed to make a correct diagnosis. We experienced three cases of IGM after breast conserving surgery in breast cancer patients in whom we needed to rule out recurrence of breast cancer. In our cases, tumorectomy was performed in two cases for pathological diagnosis, since neither biopsy nor cytology was able to reveal a conclusive pathological diagnosis. Our management of these three cases might suggest the appropriate management of granulomatous tumors after breast conserving surgery in breast cancer survivors.
Metastatic neuroendocrine tumor with metastases to the right liver in a patient with absent left portal vein
Authors: Mahoney Reid C , Awad Kyrillos , Maldini Gregorio
Published: April 2021

The patient is a 50-year-old female that underwent routine screening colonoscopy during which she was found to have a neuroendocrine tumor in the right colon. The patient underwent computed tomography and magnetic resonance imaging scans that demonstrated metastatic disease in segments 5 and 7 of the liver. Notably, the patient was found to have an absent left portal vein. The metastatic lesions abut the right portal vein; the right portal vein also supplies the left lobe of the liver in place of an absent left portal vein. She underwent a laparoscopic-assisted right hemicolectomy to remove the primary tumor. The patient recovered uneventfully from surgery and is currently being monitored by a multidisciplinary team regarding her metastatic disease. Neuroendocrine tumors can cause long-term effects on health and ultimately death if left untreated. We present a case of metastatic midgut neuroendocrine tumor that has metastasized to the liver in a patient with absent left portal vein.