bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-consistent homogenization-based parametrically upscaled continuum damage mechanics model for composites subjected to high strain-rate loading
Authors: Prakash Chandra , Ghosh Somnath
Published: November 2022

This paper develops a Parametrically Upscaled Continuum Damage Mechanics (PUCDM) model for carbon fiber/epoxy matrix composites subjected to high strain-rate loading. The PUCDM model for predicting high strain-rate induced deformation and damage evolution at the macroscopic scale, explicitly incorporates microstructural morphology and micro-inertia in its constitutive coefficients. It is developed using self-consistent homogenization that uses a concurrent multiscale model to account for the effect of micro-inertia and stress wave interaction with the microstructure. The concurrent model embeds a statistically equivalent representative volume element (SERVE) of the microstructure in an exterior domain, whose constitutive and damage response are described by the PUCDM model. Micromechanical modeling for the composite microstructure involves a unified cohesive zone enhanced phase-field damage model for fiber-matrix interface debonding, fiber breakage, and matrix cracking. The PUCDM model parameters for the upscaled domain are determined through micro-macro-scale energy equivalence, along with traction reciprocity and displacement continuity at the SERVE-exterior domain interface that are enforced using a Lagrange multiplier-based approach. Simulations using the concurrent model analyze stress wave propagation and damage evolution in composite microstructures with three different fiber volume fractions at multiple strain rates in the range of 102 − 105 s−1. The fiber volume fraction and spatial distributions affect the overall stiffness and damage evolution in the PUCDM model. Results of the analysis demonstrate the need for representation of micro-inertia, strain rates and microstructure morphology in the PUCDM-based stiffness and damage model parameters for high strain-rates above [Formula: see text].
Simulation and experimental investigation of the surgical needle deflection model during the rotational and steady insertion process
Authors: Barua Ranjit , Das Surajit , RoyChowdhury Amit , Datta Pallab
Published: November 2022

Needle insertion is executed in numerous medical and brachytherapy events. Exact needle insertion into inhomogeneous soft biological tissue is of useful importance due to its significance in clinical diagnosis (especially percutaneous) and treatments. The surgical needles used in such processes can deflect during the percutaneous process. Needle deflecting which affects needle — soft tissue interface and needle controllability have a crucial role in establishment precision. In this paper, we have analyzed a mechanics-based model both rotational and non-rotational needle insertion, and studied the deflection phenomenon in both insertion cases, we validated it with a real-time nonlinear Dassault Systèmes® ABAQUS simulation model. For definite contact force, the maximum the contact stiffness was, the minimum it inserted, the cohesive surface model was used to investigate the needle insertion analysis, where the fracture point was defined by a failure strain and with the help of the in, the fully failed components would be removed. Using living tissue comparable PVA gel materials, the needle insertion force model is developed from insertion experimentations with the help of two different processes (rotational and non-rotational needle insertion). In a rotational needle, deflection is less than in a non-rotational needle. The preliminary insertion was observed in the rotational needle at 1.261 mm (experiment), and 1.538 mm (simulation), and for non-rotational needle insertion, the initial insertion was noticed at 1.756 mm (experiment) and 1.982 mm (simulation). The main aim of this study is to navigate the surgical needle in an accurate way to reduce the erroneousness for a clinical diagnosis like anesthesia, brachytherapy, biopsy, and modern microsurgery operation.
Not the usual suspects: creating the conditions for and implementing co-production with marginalised young people in Glasgow
Authors: Cullingworth Jane , Brunner Richard , Watson Nicholas
Published: November 2022

Co-production is now an established part of public service delivery. Despite its popularity, there is only a limited understanding about how co-production works in practice, particularly with marginalised groups. This paper identifies and explores insights from three case studies of a successful co-productive approach in Glasgow, Scotland. Operation Modulus is a criminal justice initiative involving public and third sector partners in the co-production of services with marginalised young people to reduce their involvement in crime and antisocial behaviour. The data highlighted the importance of leadership, the role of public service professionals and the process of working with marginalised young people; these are explored, all within the context of the authorising environment created at the level of a collaborative governance body. The findings underscore, first, the importance of distributed leadership and process in developing trust amongst partners and in turn in the relationships of partners with young people. Second, the essential role of effective co-management amongst service providers in creating the requisite conditions for meaningful co-production with marginalised citizens. Third, the potential for and importance of shared management to facilitate changes in professional relationships and ways of working, even if these do not lead to organisational systems change. Fourth, the significance of public service professionals having the authority and agency to explore collaborative ways of working.
Processing of silicon added Fe-Cr-Co hard magnetic alloy by two stage thermomagnetic treatment technique
Authors: Haider Ali , Jaffery Syed Husain Imran , Khan Aamir Nusair , Khan Mushtaq
Published: November 2022

Fe-Cr-Co is a typical spinodal decomposition type magnetic alloy. FeCrCo alloys being highly workable are important for slender feature designs and ductile applications. However, due to the rising prices of cobalt, research is increasingly being focused toward reducing the amount of cobalt in FeCrCo semi-hard magnetic alloys, without compromising on their magnetic properties. Silicon is ferrite stabilizer and therefore, can be utilized as a potential alloying element. Few researchers have reported work on addition of silicon in FeCrCo alloys, especially on the double isothermal magnetic field annealing. In this work, FeCrCo alloy with 2% silicon addition was produced and subjected to different heat treatments. An electromagnetic setup equipped with a tube furnace was designed based on Finite Element Method (FEM) analysis, and developed for thermomagnetic treatments. An increase in remanence for double thermomagnetic treatment was noted. This improvement could be attributed to the transformation of retained α phase into α1 phase. It was also observed that the squareness of the M-H curve improved with the double treatment.
Inhomogeneity of microstructure and mechanical properties in compression-type bulk formed specimens
Authors: Hwang Joong-Ki
Published: November 2022

The effect of elongation and spreading in a material on strain and microstructure inhomogeneity during compression-type bulk forming processes was investigated to improve the strain homogeneity of the materials. For systematic investigation, four different compression-type forming processes, namely wire flat rolling, plate flat rolling, wire caliber rolling, and uniaxial compression, were compared. Strain inhomogeneity and macroscopic shear bands (MSBs) were clearly observed during the compression-type bulk forming processes based on a comparative study on the shape change, effective strain and hardness distributions, and microstructural evolution in twinning-induced plasticity steel. The flat-rolled wire had the largest strain inhomogeneity, followed by the caliber-rolled wire, compressed specimen, and flat-rolled plate in the listed order. The inhomogeneity of the strain distribution along the horizontal direction tended to increase with the pure spreading during the forming process. Meanwhile, the inhomogeneity of the strain distribution along the vertical direction increased with decreasing elongation during the process. Therefore, a small pure spreading and large elongation of the specimen result in more homogeneous and higher quality products in the compression-type bulk forming process. For instance, the flat-rolled plate exhibited weak MSBs and low strain inhomogeneity because of the small pure spreading and large elongation during the forming process.
Underwater laser texturing for enhanced adhesive joint bonding strength of Al-Mg alloy
Authors: Kumar Nitish , Kumar Subrata , Prakash Shashi
Published: November 2022

In this research work, nanosecond pulsed fiber laser texturing was performed on Aluminum-Mg alloy (AA5754). Effect of laser texturing as a surface pre-treatment method in adhesive bonding process was investigated in details. Laser texturing was performed in under open air condition, under static water condition and under flowing water conditions. Grid shaped textures were fabricated on Al-Mg alloy work-pieces. The geometrical parameters of grid texturing were varied at two levels. Pitch of the lines were kept at 300 and 400 μm in both horizontal as well as vertical directions. Scanning speed of laser texturing process was also varied at two levels that is 2.5 and 5 mm/s. Total four experiments were conducted in each atmospheric conditions. Surface roughness and water contact angle of each surface was evaluated. Surfaces were also characterized using scanning electron microscope. Lap shear strength of each samples were evaluated using a universal tensile testing machine (UTM). Failed surfaces were analyzed to investigate the mode of failure. It was observed that the textures created in flowing water conditions resulted in cohesive mode of failure while samples fabricated in open air and in under static water conditions failed in adhesive and mixed mode respectively. Samples prepared in flowing water conditions resulted in higher lap shear strengths compared to static water, open air, and plain surfaces.
Can urbanization move ahead with energy conservation and emission reduction? New evidence from China
Authors: Wu Haitao , Sun Mengzhe , Zhang Wenjia , Guo Yunxia , Irfan Muhammad , Lu Mingyue , Hao Yu
Published: November 2022

In China, urbanization is mainly stimulated by resource flows, and industrialization is normally accompanied by an increase in the proportion of the urban population and urban land area. During the process, urbanization at a rapid pace often induces a huge consumption of energy and environmental emissions. Nevertheless, it is also worth considering whether urbanization positively affects urban environment promotion. With a more solid economic foundation, urban subjects will carry out energy conservation and emission reduction (ECER) from various aspects, primarily focusing on technological innovation, advancement of production mechanisms and structural optimization. Along these lines, this study aims to examine urbanization's direct and indirect impact on energy conservation and emission reduction using panel data consisting of 196 Chinese cities for the period of 2011–2018 with a Slacks-based model and transmission mechanism. Study results indicate that urbanization's development can give a direct impetus to ECER, which is quite robust after employing a series of robust tests, including instrumental variable estimation. Besides, urbanization indirectly influences ECER by promoting economic growth, better allocation of resources, internet advancement, and adjusting the employment structure. Further investigation suggests that the relationship between urbanization and ECER is nonlinear, depending on the levels of the above-mentioned mediating variables. Finally, essential policy suggestions are proposed, i.e. promoting high-quality development of urban clusters, accelerating the policies for ECER, and paying more attention to economic growth, resource allocation, internet technology, and employment structure.
Epilogue: Spatializing Cities, Exploring Urban Religion, Re-Imagining Urbanity
Authors: Steets Silke
Published: November 2022

As an epilogue to the essays in this special issue, the article revolves around the question of the specificity of urban religious experiences. In addressing this question, I will first elaborate on the conceptual notion of the city that fruitfully frames the essays, in order to show, by a second step, its strengths but also some blind spots. Finally, ways to illuminate the blind spots are suggested which at the same time may stimulate further research in the field of urban religion.
Addressing racism and Islamophobia under the rules of colorblindness: When social movements engage in category work to reform the meanings of regulatory categories
Authors: Buchter Lisa
Published: November 2022

Research at the intersection of social movements and categories has stressed how movements initiate and transform categories that influence the emergence, downfall, and restructuring of markets and industries. Yet, this literature tends to underestimate how social movement organizations are under pressure to align with powerful regulatory categories. This pressure is emplaced, depending on ideology and laws, and can be avoided by adopting reformist strategies and engaging in category work in free spaces. I discuss how Rainbow, a nonprofit organization, while seemingly aligned with the state-imposed categories of “underprivileged neighborhoods” and “diversity,” sought in practice to reform the meanings of these categories to address racism and islamophobia. Through ethnography, interviews, and textual analysis, I demonstrate how social movements facing pressure to comply with regulatory categories can engage in category reform, challenging the substance of these categories in free spaces and altering their meanings, while buffering oppositions through reformist strategies.
Management of Native Lung Malignancy in a Lung Transplant Recipient
Authors: Khalil Sarah I. , Espinosa Jairo A. , Bakhos Charles , Erkmen Cherie , Petrov Roman
Published: November 2022

A 75-year-old male patient with a history of previous right lung transplant presented with left upper lobe squamous cell carcinoma. Endobronchial ultrasound and positron emission tomography displayed no mediastinal lymphadenopathy. A ventilation-perfusion scan displayed minimal perfusion to the native lung. Left robot-assisted lysis of adhesions, decortication, left upper lobectomy, and mediastinal lymphadenectomy were performed. The patient tolerated the procedure well. Final pathology displayed pT2a, n0, m0. Lobectomy is a safe and efficient treatment of native lung malignancy in the setting of previous lung transplant with minimally functioning native lung.
Reflexive Han-Ness, Narratives of Moral Decline, Manchurian Subjects and “Mass” Societal Others: A Study of the Hanfu Movement in the Cities of Beijing, Chengdu, Shanghai, Wuhan, and Xi’an
Authors: Law Andrew Malcolm , Qin Qianqian
Published: November 2022

In recent years, a small but growing body of scholarly work has emerged on the Hanfu movement in China. Researchers have drawn attention to globalisation, westernisation, national lifestyles, and development, the renaissance of Chinese culture, Han racism, Han ethnocentrism and xenophobia as drivers for the movement. In this article, we suggest that of all the extant literature that currently exists on the movement, the ethnography conducted by Kevin Carrico is the most accurate portrayal of the movement as it stands. However, and drawing upon visual and interview-based fieldwork with members of the movement in 2013 and 2015, our main argument is that existing scholarship has not attended to several nuances in the movement that problematise ideas of race, the way the movement views the recent past and the othering of Manchurian subjects. Unpacking these problematics, this study advances upon existing scholarship: 1) by drawing attention to the way Hanfu enthusiasts demonstrate a great deal of reflexivity around the notion of race; 2) by focusing on the approaches by which Hanfuists interpret the Chinese past beyond narratives of Han ethnic decline; 3) by investigating the mode by which Hanfuists indirectly “other” Manchurian subjects; and 4) by exploring the manner in which Hanfuists hold a broad or “mass” societal “other” as responsible for a new era of moral decline in contemporary China.
Successful Fixation of Traumatic Articular Cartilage–Only Fragments in the Juvenile and Adolescent Knee: A Case Series
Authors: Husen Martin , Krych Aaron J. , Stuart Michael J. , Milbrandt Todd A. , Saris Daniel B.F.
Published: November 2022

Background:

Some surgeons are now considering fixation of traumatic chondral-only fragments in juvenile knees, but few data remain to guide treatment.

Purpose:

To determine if surgical fixation of chondral-only fragments in the juvenile knee results in an adequate healing response with successful imaging and clinical outcomes.

Study Design:

Case series; Level of evidence, 4.

Methods:

Data were collected on 16 skeletally immature patients treated with fixation of chondral-only fragments with a minimum 1-year follow-up. Patients were selected by the operating surgeons based on the quality and size of the chondral fragment. Demographic data, lesion characteristics, surgical procedure details, complications, and postoperative imaging were assessed. Validated outcome measures were collected pre- and postoperatively and included the following scores: International Knee Documentation Committee (IKDC), Marx Activity Scale, Knee injury and Osteoarthritis Outcome Score (KOOS), Hospital for Special Surgery Pediatric Functional Activity–Brief Scale (HSS Pedi-FABS), Patient-Reported Outcomes Measurement Information System (PROMIS)–Physical Health and PROMIS–Psychological Health, and Tegner.

Results:

The mean age of our patient cohort was 14.9 years. The mean size of the repaired defects measured 3.2 cm2. Injury sites included the patella (n = 1), medial femoral condyle (n = 3), trochlea (n = 4), and lateral femoral condyle (n = 8). Within the mean follow-up time of 42.3 months (range, 15-145), there was 1 clinical failure with loosening of the chondral fragment and the need for reoperation. At a mean follow-up of 3.5 years, the mean (interquartile range) patient-reported outcome scores were as follows: IKDC, 95.2 (94.3-100); Marx Activity Scale, 11.5 (11.5-16); KOOS, 95.81 (93.5-95.81); HSS Pedi-FABS, 16.94 (11.5-26); PROMIS–Physical Health, 93.75% (90%-100%); PROMIS–Psychological Health, 90% (88.75%-100%); and Tegner, 5.69 (4.75-7). All patients who were engaged in sports before injury returned to the same or higher level of competition with the exception of 1 patient.

Conclusion:

Primary repair of chondral-only injuries with internal fixation can be a successful treatment option in selected patients. Clinical and imaging results at final follow-up suggest that reintegration of the cartilage fragment is achievable and leads to excellent clinical function and a high return-to-sports rate.
Nursing Students’ Satisfaction and Self-Confidence Levels After Their Simulation Experience
Authors: Alharbi Kholoud , Alharbi Manal F.
Published: November 2022

Background

Nursing students should be well prepared before going to clinical setting as they provide direct care to patient. Simulation gives the learners the opportunity to be active learners who practice, train, and give a reflection on a specific experience.

Objective

To obtain an understanding of the human patient simulation experience and nursing students’ perceptions of satisfaction and self-confidence.

Method

Cross-sectional, descriptive design was undertaken. Using purposive sampling, 273 nursing students were enrolled in basic adult nursing courses at levels four and five at female nursing college at King Saud University, Riyadh, Saudi Arabia. A questionnaire was used to measure the demographic characteristics, simulation design characteristics, and simulation educational practice context. Student Satisfaction and Self-confidence in Learning Scale was used to measure students’ satisfaction and self-confidence. Bivariate analyses were utilized where needed and multiple linear regression analysis was performed to find the relationship between variables.

Results

The current study revealed overall, nursing students were satisfied and self-confident after their human patient simulation experience. A relationship was observed between demographic characteristics, simulation design characteristics, and simulation educational practice context with students’ satisfaction and self-confidence.

Conclusion

Simulation is an effective teaching strategy that prepares nursing students for real clinical practice. Findings provided policymakers with information on nursing students’ current levels of satisfaction and self-confidence that can lead to developing future policies.
Genome-wide meta-analysis identifies new candidate genes for sickle cell disease nephropathy
Authors: Garrett Melanie E. , Soldano Karen L. , Erwin Kyle N. , Zhang Yingze , Gordeuk Victor R. , Gladwin Mark T. , Telen Marilyn J. , Ashley-Koch Allison E.
Published: November 2022

Sickle cell disease nephropathy (SCDN), a common SCD complication, is strongly associated with mortality. Polygenic risk scores calculated from recent transethnic meta-analyses of urinary albumin-to-creatinine ratio and estimated glomerular filtration rate (eGFR) trended toward association with proteinuria and eGFR in SCD but the model fit was poor (R2 < 0.01), suggesting that there are likely unique genetic risk factors for SCDN. Therefore, we performed genome-wide association studies (GWAS) for 2 critical manifestations of SCDN, proteinuria and decreased eGFR, in 2 well-characterized adult SCD cohorts, representing, to the best of our knowledge, the largest SCDN sample to date. Meta-analysis identified 6 genome-wide significant associations (false discovery rate, q ≤ 0.05): 3 for proteinuria (CRYL1, VWF, and ADAMTS7) and 3 for eGFR (LRP1B, linc02288, and FPGT-TNNI3K/TNNI3K). These associations are independent of APOL1 risk and represent novel SCDN loci, many with evidence for regulatory function. Moreover, GWAS SNPs in CRYL1, VWF, ADAMTS7, and linc02288 are associated with gene expression in kidney and pathways important to both renal function and SCD biology, supporting the hypothesis that SCDN pathophysiology is distinct from other forms of kidney disease. Together, these findings provide new targets for functional follow-up that could be tested prospectively and potentially used to identify patients with SCD who are at risk, before onset of kidney dysfunction.
Corrosion Resistance and Tribological Properties of Laser Cladding Layer of H13 Die Steel Strengthened by Ultrasonic Rolling
Authors: Zheng Kaikui , Lin Youxi , Cai Jianguo , Lei Chengqian
Published: November 2022

Laser cladding is a new surface repair method that can improve the wear and corrosion resistance of substrate surfaces. However, the cladding layer typically exhibits a rough surface, high hardness and large residual tensile stress, and thus requires further machining and finishing. Ultrasonic rolling (U-rolling) is a highly efficient finishing and strengthening process that combines ultrasonic technology with traditional rolling (T-rolling). In this study, an iron-based alloy was coated onto the surface of H13 die steel using laser cladding, and the surface of the cladding layer was polished using U-rolling. The effects of U-rolling on the surface quality, corrosion resistance and friction and wear properties of the laser-cladding layer were investigated and compared with those obtained by T-rolling. The surface roughness of the U-rolled sample was only 1/4 that of the T-rolled sample. The hardness and residual compressive stress of the laser cladding layer after U-rolling were higher than those after T-rolling. Similarly, the surface corrosion resistance of the laser cladding layer after U-rolling was higher than that after T-rolling. U-rolling changed the surface roughness, grain size, and residual stress of the material and thus affected the corrosion resistance of the laser cladding layer. The friction coefficient and wear rate of the U-rolled surface of the cladding layer were lower than those of the T-rolled surface. In addition, the tribological properties of the cladding layer were found to be related to the rolling direction. When the friction direction of the sample was the same as the rolling direction, its friction and wear performance were higher than those when the two directions were perpendicular.
The variability of terpenoids and flavonoids in native Lindera umbellata from the same region
Authors: Kusumoto Norihisa , Morikawa Takuya , Hashida Koh , Matsui Naoyuki , Ohira Tatsuro
Published: November 2022

The leaves and twigs of Lindera spp. have long been used as a herbal medicine and toothpicks in Japan. However, little is known about individual variations in the extractives of these species, because many previous studies have not distinguished extractives between individuals. In this study, we investigated the extractives of L. umbellata at the individual level. The detailed identification of the inter- and intra-individual variations in the major terpenoids and flavonoids in native L. umbellata may greatly contribute to the development of cultivation techniques and the effective use of forest resources. The contents of major components of L. umbellata, including four terpenoids (1,8-cineole, linalool, geraniol, and geranyl acetate) and five low-molecular-weight phenolics (pinocembrin chalcone, pinocembrin, pinostrobin chalcone, pinostrobin, and 5,6-dehydrokawain), were analyzed in leaves and twigs seasonally (June, August, and October). The compositions of the major terpenoids were strongly dependent on the properties of each individual and were generally independent of leaves and twigs. Moreover, geranyl acetate was characteristically present in the twigs of some individuals. As new findings regarding linalool, some individuals showed characteristic enantiomeric excesses, presumably because of biotic factors, and the proportion of these enantiomers was kept constant in each individual, regardless of the season. The total phenolic contents in leaves were more than twice those detected in twigs, and the leaves tended to contain more chalcones and twigs more flavanones. Furthermore, the contents of chalcones (pinocembrin chalcone vs. pinostrobin chalcone) and flavanones (pinocembrin vs. pinostrobin) were positively correlated in both leaves and twigs. The coefficient of variation (CV) clearly showed that the content of the major terpenoids was determined by inter-individual rather than intra-individual differences. Although the results obtained in this study should at present only be applicable to a limited population native to specific regions, our findings provide key knowledge in considering the sustainable use of L. umbellata.
Survival time and predictors of death among HIV infected under five children after initiation of anti -retroviral therapy in West Amhara Referral Hospitals, Northwest Ethiopia
Authors: Alemu Gebrie Getu , Nigussie Zelalem Mehari , Amlak Baye Tsegaye , Achamyeleh Anemaw Asrat
Published: November 2022

Background

Acquired immune deficiency syndrome is an infectious disease caused by the human immunodeficiency virus (HIV) that primarily targets an individual's immune system. In Ethiopia, nearly 24% of HIV-related deaths occur in children under the age of five. However, studies regarding the survival time of HIV-positive under-five children after anti-retroviral therapy initiation are limited with poor evidence of predictors of death.

Objective

To assess survival time and predictors of death among HIV infected under-five children after initiation of anti-retroviral therapy in West Amhara Referral Hospitals, Northwest Ethiopia, 2021.

Methods

A multicenter institution-based retrospective follow-up study was conducted among 432 HIV-positive under-five children on anti-retroviral therapy selected by simple random sampling from January 2010 to December 2019. A standardized data extraction tool was employed, which was adapted from anti-retroviral therapy entry and follow-up forms. The event of interest for this study is death, whereas the absence of experience of death is censored. Data were entered into Epi-Data version 3.1 and exported to STATA version 14. The Kaplan–Meier curve was used to estimate the survival probability. The Cox regression model was used to identify independent predictors of death.

Results

Among the 415 records included in the final analysis, 25 (6.02%) of the individuals were died. The incidence rate of death was found to be 2.87 per 1000 child-months (95%CI: 1.94–4.25). The cumulative survival probabilities of children after 6, 12, 24, and 36 months were 0.97, 0.95, 0.92, and 0.85 respectively. HIV-infected under-five children who lived in rural areas (AHR 3.32:-95% CI 1.17–9.39), with poor adherence to anti-retroviral therapy (AHR = 3.36; CI: 1.06, 10.69), without Isoniazide prophylaxis (AHR = 3.15; CI: 1.11, 8.94) and with anemia (AHR: 3.05, 95% CI: 1.16, 8.03) were at higher risk of death.

Conclusion and recommendation

Death of HIV-infected under-five children on anti-retroviral therapy is high within the first one year after enrolment. Living in rural area, had poor adherence, lacked Isoniazide prophylaxis, and anemia were predictors of death. Therefore, clinicians shall emphasize for those specific risk factors of death and take action accordingly.
Decreased serum superoxide dismutase concentration has a high value for the diagnosis of periprosthetic joint infection—a single-center, retrospective study
Authors: Yan Shuo , Zhang Xiaofei , Lyu Zhen , Liu Jun
Published: November 2022

Purpose

As the most serious complication of total knee arthroplasty (TKA), periprosthetic joint infection (PJI) often leads to disastrous consequences. An accurate preoperative diagnosis plays a significant role in saving prostheses and optimizing treatment outcomes. Through this retrospective case–control study, we aimed to investigate the potential of superoxide dismutase (SOD) as a novel serum biomarker in the diagnosis of PJI.

Methods

We conducted a retrospective review of all patients who underwent TKA and received adequate follow-ups in our hospital from June 2015 to December 2021. A total of 50 patients were enrolled in the PJI group based on the 2018 International Consensus Meeting (ICM) criteria. Besides that, we enrolled 100 patients who underwent TKA in the same period and had a good postoperative course in the control group. Patient characteristics, comorbidities, laboratory results (serum, synovial, and microbial), and intraoperative findings (purulence and histopathology) were documented and compared by univariate analysis. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity, specificity, and diagnostic performance.

Results

The median serum SOD level in the PJI and control group was 135.95 ± 24.47 U/ml (IQR, 111.85–158.30 U/ml) and 173.83 ± 13.9 U/ml (IQR,162.83–183.5 U/ml) (p < 0.05), respectively. With the calculated cutoff of SOD at 149.5U/L, the area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were 0.919, 0.72, 0.97, 0.923, and 0.874, respectively. In subgroup analysis, the specificity of SOD in diagnosing culture-negative PJI remained extremely high (0.98). Combined diagnosis of serum SOD and C-reactive protein (CRP) made AUC increase to 0.972.

Conclusion

Serum SOD showed great potential in the diagnosis of PJI.
Structures for the care of people with dementia: a European comparison
Authors: Schmachtenberg Tim , Monsees Jessica , Thyrian Jochen René
Published: November 2022

Background

Dementia is a disease that impacts people with dementia, their families, and the healthcare system. In 2018, the number of people with dementia in the EU, the European Free Trade Association (EFTA), and the UK was estimated to be 9.1 million. National dementia strategies and publications by organisations such as Alzheimer Europe outline how dementia-specific care should be designed. This study aims to provide insights into existing formal care structures, models of good practise, and gaps in dementia-specific care for people with dementia in 17 European countries.

Methods

The research is based on guided interviews with
country-specific care experts. A mixed-methods approach with a combination of
open and closed questions was used. All interviews were
recorded and transcribed verbatim based on the transcription rules of Kuckarts
(2010). For data evaluation, the qualitative content analysis model of Mayring
(2014) was used.

Results

In all 17 countries, efforts for
dementia-friendly care and models of good care practise exist. However, there
are large differences between European countries regarding the spread of
dementia-specific services. In nine countries (Bulgaria, Finland, Italy,
Liechtenstein, Luxembourg, the Netherlands, Norway, Sweden, the UK), there are
already nationwide structures, while in five countries (Belgium, Greece,
Ireland, Portugal, Romania), services are only available in certain regions. In
three countries (Austria, Denmark, Germany) dementia-specific outpatient
services are widespread nationwide, whereas inpatient services are not.
Simultaneously, in all countries, areas with major care gaps exist. Several
European states have an urgent need for action concerning the expansion of the
provision of dementia-specific services, the reduction of regional differences
regarding the provision of care, the elimination of barriers to access to care,
the dementia-friendliness of services, and the participation of people with dementia
and their relatives in care and research.

Conclusions

To reduce the existing structural inequalities
in care between and within European countries, and to establish quality-related
minimum standards in the care of people with dementia, transnational concepts
are needed. The EU, in cooperation with care planners, research institutions,
care providers, and patient organisations, should develop European care
guidelines or dementia plans that contain concrete measures, schedules, and
budgets.
Impact of parasite genomic dynamics on the sensitivity of Plasmodium falciparum isolates to piperaquine and other antimalarial drugs
Authors: Wakoli Dancan M. , Ondigo Bartholomew N. , Ochora Douglas O. , Amwoma Joseph G. , Okore Winnie , Mwakio Edwin W. , Chemwor Gladys , Juma Jackeline , Okoth Raphael , Okudo Charles , Yeda Redemptah , Opot Benjamin H. , Cheruiyot Agnes C. , Juma Dennis , Roth Amanda , Ogutu Benhards R. , Boudreaux Daniel , Andagalu Ben , Akala Hoseah M.
Published: November 2022

Background

Dihydroartemisinin-piperaquine (DHA-PPQ) is an alternative first-line antimalarial to artemether-lumefantrine in Kenya. However, recent reports on the emergence of PPQ resistance in Southeast Asia threaten its continued use in Kenya and Africa. In line with the policy on continued deployment of DHA-PPQ, it is imperative to monitor the susceptibility of Kenyan parasites to PPQ and other antimalarials.

Methods

Parasite isolates collected between 2008 and 2021 from individuals with naturally acquired P. falciparum infections presenting with uncomplicated malaria were tested for in vitro susceptibility to piperaquine, dihydroartemisinin, lumefantrine, artemether, and chloroquine using the malaria SYBR Green I method. A subset of the 2019–2021 samples was further tested for ex vivo susceptibility to PPQ using piperaquine survival assay (PSA). Each isolate was also characterized for mutations associated with antimalarial resistance in Pfcrt, Pfmdr1, Pfpm2/3, Pfdhfr, and Pfdhps genes using real-time PCR and Agena MassARRAY platform. Associations between phenotype and genotype were also determined.

Results

The PPQ median IC50 interquartile range (IQR) remained stable during the study period, 32.70 nM (IQR 20.2–45.6) in 2008 and 27.30 nM (IQR 6.9–52.8) in 2021 (P=0.1615). The median ex vivo piperaquine survival rate (IQR) was 0% (0–5.27) at 95% CI. Five isolates had a PSA survival rate of ≥10%, consistent with the range of PPQ-resistant parasites, though they lacked polymorphisms in Pfmdr1 and Plasmepsin genes. Lumefantrine and artemether median IC50s rose significantly to 62.40 nM (IQR 26.9–100.8) (P = 0.0201); 7.00 nM (IQR 2.4–13.4) (P = 0.0021) in 2021 from 26.30 nM (IQR 5.1–64.3); and 2.70 nM (IQR 1.3–10.4) in 2008, respectively. Conversely, chloroquine median IC50s decreased significantly to 10.30 nM (IQR 7.2–20.9) in 2021 from 15.30 nM (IQR 7.6–30.4) in 2008, coinciding with a decline in the prevalence of Pfcrt 76T allele over time (P = 0.0357). The proportions of piperaquine-resistant markers including Pfpm2/3 and Pfmdr1 did not vary significantly. A significant association was observed between PPQ IC50 and Pfcrt K76T allele (P=0.0026).

Conclusions

Circulating Kenyan parasites have remained sensitive to PPQ and other antimalarials, though the response to artemether (ART) and lumefantrine (LM) is declining. This study forms a baseline for continued surveillance of current antimalarials for timely detection of resistance.
Malaria among under-five children in rural communities of Al-Mahweet governorate, Yemen
Authors: Al-Quhaiti Mona A. A. , Abdul-Ghani Rashad , Mahdy Mohammed A. K. , Assada Methaq A.
Published: November 2022

Background

Malaria burden among under-five children living in endemic areas of Yemen is largely unknown due to the lack of community-based studies. Therefore, this study determined the prevalence and risk factors associated with falciparum malaria among under-five children in rural communities of Al-Mahweet governorate, Yemen.

Methods

This community-based, cross-sectional study recruited 400 under-five children from two rural districts of Al-Mahweet governorate in December 2019. Demographic characteristics (gender, age, education and occupation of the child’s parents, and household size) and risk factors associated with malaria were collected through interviews with children’s caregivers using a structured questionnaire. Finger-prick blood was screened for Plasmodium falciparum and non-falciparum species using rapid diagnostic tests (RDTs), and duplicate Giemsa-stained thick and thin blood films were examined for malaria parasites. The density of asexual P. falciparum stages was also estimated. Data were then analysed, and the agreement between the results of thick-film microscopy and RDTs for diagnosing falciparum malaria was assessed using the kappa index. Statistical significance was set at a P-value of < 0.05.

Results

Plasmodium falciparum was prevalent among 9.8% (95% CI 7.0–13.1) of under-five children in the rural communities of Al-Mahweet, with a median asexual parasite density of 763 ± 2606 parasites/μl of blood (range: 132–4280) and low-to-moderate parasitaemia levels. Approximately one-third of microscopy-confirmed cases were gametocyte carriers. Multivariable logistic regression analysis confirmed that age of three years or older (AOR = 5.6, 95% CI 1.6–19.8; P = 0.007), not sleeping under a mosquito net the previous night of the survey (AOR = 8.0, 95% CI 2.4–27.4; P = 0.001), sleeping outdoors at night (AOR = 4.4, 95% CI 2.0–10.0; P < 0.001), and absence of indoor residual spraying (IRS) during the last year (AOR = 4.2, 95% CI 1.9–9.4; P < 0.001) were the independent predictors of falciparum malaria among under-five children in the rural communities of Al-Mahweet. The observed percentage agreement between thick-film microscopy and RDTs was 98.5%, with a very good agreement (k-index = 0.9) between the two methods for falciparum malaria diagnosis that was statistically significant.

Conclusion

Approximately one in ten under-five children in rural communities of Al-Mahweet is infected with P. falciparum based on microscopy and RDTs. Age of three years or older, not sleeping under mosquito nets, sleeping outdoors at night and absence of IRS can independently predict falciparum malaria among them. The very good agreement between thick-film microscopy and RDTs for diagnosing falciparum malaria in children supports the usefulness of using RDTs in such resource-limited rural communities.
Integrating Single-cell RNA-seq to construct a Neutrophil prognostic model for predicting immune responses in non-small cell lung cancer
Authors: Pang Jianyu , Yu Qian , Chen Yongzhi , Yuan Hongjun , Sheng Miaomiao , Tang Wenru
Published: November 2022

Non-small cell lung cancer (NSCLC) is the most widely distributed tumor in the world, and its immunotherapy is not practical. Neutrophil is one of a tumor’s most abundant immune cell groups. This research aimed to investigate the complex communication network in the immune microenvironment (TIME) of NSCLC tumors to clarify the interaction between immune cells and tumors and establish a prognostic risk model that can predict immune response and prognosis of patients by analyzing the characteristics of Neutrophil differentiation. Integrated Single-cell RNA sequencing (scRNA-seq) data from NSCLC samples and Bulk RNA-seq were used for analysis. Twenty-eight main cell clusters were identified, and their interactions were clarified. Next, four subsets of Neutrophils with different differentiation states were found, closely related to immune regulation and metabolic pathways. Based on the ratio of four housekeeping genes (ACTB, GAPDH, TFRC, TUBB), six Neutrophil differentiation-related genes (NDRGs) prognostic risk models, including MS4A7, CXCR2, CSRNP1, RETN, CD177, and LUCAT1, were constructed by Elastic Net and Multivariate Cox regression, and patients’ total survival time and immunotherapy response were successfully predicted and validated in three large cohorts. Finally, the causes of the unfavorable prognosis of NSCLC caused by six prognostic genes were explored, and the small molecular compounds targeted at the anti-tumor effect of prognostic genes were screened. This study clarifies the TIME regulation network in NSCLC and emphasizes the critical role of NDRGs in predicting the prognosis of patients with NSCLC and their potential response to immunotherapy, thus providing a promising therapeutic target for NSCLC.
Circular RNAs in organ injury: recent development
Authors: Wong Ryan , Zhang Yiwen , Zhao Hailin , Ma Daqing
Published: November 2022

Circular ribonucleic acids (circRNAs) are a class of long non-coding RNA that were once regarded as non-functional transcription byproducts. However, recent studies suggested that circRNAs may exhibit important regulatory roles in many critical biological pathways and disease pathologies. These studies have identified significantly differential expression profiles of circRNAs upon changes in physiological and pathological conditions of eukaryotic cells. Importantly, a substantial number of studies have suggested that circRNAs may play critical roles in organ injuries. This review aims to provide a summary of recent studies on circRNAs in organ injuries with respect to (1) changes in circRNAs expression patterns, (2) main mechanism axi(e)s, (3) therapeutic implications and (4) future study prospective. With the increasing attention to this research area and the advancement in high-throughput nucleic acid sequencing techniques, our knowledge of circRNAs may bring fruitful outcomes from basic and clinical research.
HNRNPA2B1-mediated m6A modification of TLR4 mRNA promotes progression of multiple myeloma
Authors: Jia Chuiming , Guo Yiwei , Chen Yao , Wang Xinya , Xu Qiuting , Zhang Yu , Quan Lina
Published: November 2022

Background

Multiple myeloma (MM) is a malignancy of plasma cells that remains incurable. Toll-like receptor 4 (TLR4) acts as a stress-responsive signal, protecting mitochondria during proteasome inhibitor (PI) exposure, maintaining mitochondrial metabolism and increasing drug resistance in MM. However, the mechanism of TLR4 regulation remains elusive.

Aims

The purpose of this study was to investigate the methylation pattern of multiple myeloma and its effect on the expression of HNRNPA2B1 and downstream targets.

Methods

The methylation level in MM and normal bone marrow specimens was detected using a colorimetric assay. HNRNPA2B1 gene knockdown was achieved in RPMI 8226 MM cells via adenovirus transfection. CCK8 and flow cytometric assays were used to detect proliferation and apoptosis, respectively. Transcriptome sequencing and m6A methylation MeRIP sequencing were applied, and differentially expressed genes (DEGs) were detected. Three independent NCBI GEO datasets were applied to examine the effects of HNRNPA2B1 and TLR4 expression on MM patient survival.

Results

HNRNPA2B1 promoted MM progression. Clinical data from database revealed that HNRNPA2B1 was adverse prognostic factor for survival among MM patients. Furthermore, transcriptome sequencing and methylation sequencing showed that HNRNPA2B1 recognized and was enriched at the m6A sites of TLR4 and TLR4 was down-regulated of both the m6A level and transcription level in HNRNPA2B1-knockdown MM cells. Moreover, TLR4 was an adverse survival prognostic factor based on database analysis.

Conclusion

Overall, our study implies that the RNA-binding protein HNRNPA2B1 increases cell proliferation and deregulates cell apoptosis in MM through TLR4 signaling. Our study suggests HNRNPA2B1 as a potential therapeutic target for MM.
Hemophagocytic lymphohistocytosis in trisomy 21: successful treatment with interferon inhibition
Authors: Guild Allison , Fritch Jordan , Patel Sachit , Reinhardt Adam , Acquazzino Melissa
Published: November 2022

Background

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition of immune dysregulation primarily driven by the cytokine interferon gamma. It can be either a genetic or acquired disorder associated with infection, malignancy, and rheumatologic disorders. Trisomy 21 can express a wide range of phenotypes which include immune dysregulation and shares inherent pathophysiology with a group of disorders termed interferonopathies. Knowledge of this overlap in seemingly unrelated conditions could provide a basis for future research, and most importantly, alternative therapeutic interventions in acute life threatening clinical scenarios. Herein, we describe two patients with trisomy 21 presenting with HLH that was refractory to conventional treatment. Both patients were successfully managed with novel interventions targeting the interferon pathway.

Case presentation

We describe a 17-month-old male and 15-month-old female with trisomy 21 presenting with a myriad of signs and symptoms including fever, rash, cytopenias, and hyperferritinemia, both ultimately diagnosed with HLH. Each had relapsing, refractory HLH over time requiring several admissions to the hospital receiving conventional high dose corticosteroids and interleukin-1 inhibition therapy. Successful steroid-free remission was achieved after targeting interferon inhibition with emapalumab induction followed by long-term maintenance on baricitinib.

Conclusion

To our knowledge, these are the first reported cases of relapsed, refractory HLH in patients with trisomy 21 successfully treated with emapalumab and transitioned to a steroid-sparing regimen with oral baricitinib for maintenance therapy. Trisomy 21 autoimmunity and HLH are both thought to be driven by interferon gamma. Targeting therapy toward interferon signaling in both HLH and autoimmunity in trisomy 21 may have potential therapeutic benefits. Further investigation is needed to determine if trisomy 21 may predispose to the development of HLH given this common pathway.