bluuebunny/crossref_metadata_2025 huggingface dataset:
Ruxolitinib mitigates steroid‐refractory CRS during CAR T therapy
Authors: Pan Jing , Deng Biping , Ling Zhuojun , Song Weiliang , Xu Jinlong , Duan Jiajia , Wang Zelin , Chang Alex H. , Feng Xiaoming , Tan Yue
Published: December 2020

Cytokine release syndrome (CRS) and immune effector cell‐associated neurotoxicity are two major CAR T related toxicities. With the interventions of Tocilizumab and steroids, many patients can recover from severe CRS. However, some patients are refractory to steroids and develop life‐threatening consequences. Ruxolitinib is an oral JAKs inhibitor and promising drug in inflammatory diseases. In this pilot study, we evaluate the efficacy of Ruxolitinib in CRS. Of 14 r/r B‐ALL children who received CD19 or CD22 CAR T cell therapies, 4 patients developed severe (≥grade 3) CRS with symptoms that were not alleviated with high‐dose steroids and thus received ruxolitinib. Rapid resolution of CRS symptoms was observed in 4 patients after ruxolitinib treatment. Serum cytokines significantly decreased after ruxolitinib intervention. All patients achieved complete remission on day 30 after infusion, and we could still detect CAR T expansion in vivo despite usage of ruxolitinib. There were no obvious adverse events related to ruxolitinib. In vitro assays revealed that ruxolitinib could dampen CAR T expansion and cytotoxicity, suggesting that the timing and dosage of ruxolitinib should be carefully considered to avoid dampening anti‐leukaemia response. Our results suggest that ruxolitinib is active and well tolerated in steroid‐refractory and even life‐threatening CRS.
What influences prescribing decisions in a multimorbidity and polypharmacy context on the acute medical unit? An interprofessional, qualitative study
Authors: Rivers Peter H , Langford Nigel , Whitehead Andrew , Harrison Tim
Published: December 2020

Rationale, aims and objectives

The primary aim of the study was to understand the mindset of doctors and pharmacists, as they embark upon prescribing in a multimorbidity and polypharmacy context during routine practice at a hospital acute admissions unit. The study also aimed to evaluate to what extent attitudes, embedded within real‐life decision‐making scenarios, relate to existing theory and models of prescribing decisions.

Methods

Anonymized case studies were identified from the medical notes of patients aged 65 and over with conditions likely to be associated with multimorbidity, medication issues and polypharmacy: namely: fall, urinary tract infection, confusion or lower respiratory tract infection. A total of 39 doctors based on the acute medical admissions unit and 9 pharmacists were recruited to one of three focus groups. Patient case‐studies provided the context for discussion from which verbatim transcripts were thematically analyzed using an interpretative, qualitative approach. Sub‐themes were matched to Murshid and Mohaidin's proposed model of physician prescribing decisions.

Results

Seven principal themes were identified that were associated with prescribing decisions on the acute medical unit, namely, “patient characteristics,” “drug characteristics,” “pharmacist factors,” “trustworthiness,” “reliability of medication history,” “competing priorities” and “responsibilities of prescribers.”

Conclusion

Prescribing decisions on the acute medical admissions unit were influenced by a variety of factors, some of which have already been acknowledged within existing theories and models. The findings provisionally offer new insights, which, subject to confirmation by further research, bring to light three attitudinal characteristics that may impact negatively upon the quality of prescribing decisions. These include, first, how perceived poor reliability of medication history may result in information gaps that compromise prescribing decisions; second, how competing priorities restrict doctors' aptitude to conduct a review of medication and finally, how doctors may rationalize the assignment of medication review to the GP.
Age and growth of grey triggerfish Balistes capriscus from trans‐Atlantic populations
Authors: Shervette Virginia R. , Rivera Hernández Jesús M. , Nunoo Francis Kofi Ewusie
Published: December 2020

Anthropogenic factors that negatively impact reef fishes can include changes in life‐history patterns of fisheries‐targeted species. Understanding these impacts on growth and population age structure is essential in the management of exploited populations of fishes. This is the first study to directly compare age and growth for a major fisheries species between east and west populations of a transatlantic reef fish. The main goal of this study was to document age and growth in grey triggerfish Balistes capriscus from coastal waters of Ghana in the Gulf of Guinea (GOG) and compare those with the previous growth studies from that region and with the western Atlantic population. A secondary objective of this study was to evaluate the use of otoliths to age triggerfish and to provide a preliminary comparison with spine‐derived age estimates. The results obtained from this study provided an updated understanding of the growth and age structure of the eastern B. capriscus population in GOG. The authors documented that shifts in population attributes occurred for B. capriscus after its major decline in abundance. The differences in physical and biotic characteristics of the East and West Atlantic regions and the differences in collection methods of samples make direct comparisons of growth parameters difficult. Nonetheless, overall differences in maximum sizes and ages were apparent; the western Atlantic population had a larger maximum size and older maximum age. The authors also documented that sagittal otoliths can be used to provide age estimates for triggerfish species, and otoliths as an ageing structure had better between‐reader precision compared to dorsal spines.
The effect of different exogenous kisspeptins on sex hormones and reproductive indices of the goldfish (Carassius auratus) broodstock
Authors: Valipour AbdolMajid , Heidari Behrooz , Asghari S. Mohsen , Balalaie Saeed , Rabouti Hanieh , Omidian Navid
Published: December 2020

Despite several studies on fish hormone therapy, finding new candidates may provide more reproductive efficiency in artificial propagation. Kisspeptins, being upstream of the hypothalamic–pituitary‐gonadal axis, appear to play a key role in the reproduction process. In the present study, the effect of different variants of kisspeptide, including goldfish (Carassius auratus) kiss1 kisspeptin (Kiss1), human kisspeptin (Hkiss), and their combination (Kiss1 + H), on the reproductive indices of goldfish broodstock in comparison to Ovaprim (a typical synthetic Gnrh hormone) was investigated. Peptides (Kiss1 and Hkiss) were synthesized using a solid‐phase synthesis approach. Kiss1 and Hkiss were injected at a dose of 100 μg kg−1 body weight, blood samples were taken 6 h after injection and sex hormones (E2, Dhp, and 11‐Kt), gonadotropins (Lh and Fsh), cortisol and reproductive indices (fecundity, fertilization and hatching percentage) were measured. The results showed a significant increase of plasma sex hormones and gonadotropins in fish treated with kisspeptins. In addition, the cortisol and lipoprotein lipase in Kiss1, Hkiss and Kiss1 + H were remarkably increased compared to Ovaprim. In conclusion, kisspeptins could be a more suitable candidate than Ovaprim for accelerating and synchronizing oocyte maturation in the fisheries industry.
The Effect of Orthostatic Hypotension Detected Pre‐Operatively on Post‐Operative Outcome
Authors: Hogan Alexandra M. , Luck Claire , Woods Sarah , Ortu Andrea , Petkov Svet
Published: December 2020

BACKGROUND

Exacerbation of or new onset orthostatic hypotension in perioperative patients can occur. There is complex underlying pathophysiology with further derailment likely caused by acute cardiovascular changes associated with surgery. The implications for post‐operative recovery are unclear, particularly in frail and older patients. We retrospectively explored patient notes for evidence of post‐operative orthostatic intolerance in relation to pre‐operative orthostatic hypotension.

METHODS

Supine and 1‐minute and 3‐minute standing blood pressure measures obtained from adult patients before mainly general, orthopedic or uro/gynecology surgery were compared to post‐operative outcome, specifically, evidence in patient notes about falls, feeling dizzy/unsteady and/or fearful to stand. Orthostatic hypotension was defined as a 20 mmHg or more and/or 10 mmHg or more fall in systolic and diastolic blood pressure, respectively, within ~3 minutes of standing after lying supine for an electrocardiogram.

RESULTS

Whilst all patients included had a 1‐minute standing blood pressure assessment (N = 170), 3‐minute assessment was performed less commonly (N = 113). Nevertheless, one‐quarter (23.5%; N = 40) of 170 patients had pre‐operative orthostatic hypotension. This was not clearly explained by cardiac or neurological disease or by common medications, but did occur more frequently in older patients and in those aged 65 years or more with higher clinical frailty scale scores. The COVID‐19 pandemic reduced the number of patients progressing to surgery within the planned study timescale (N = 143/170; 84.1%). Nevertheless, patients with orthostatic hypotension stayed longer in hospital post‐operatively and were more likely to have an episode of fall, unsteadiness and/or dizziness documented (un‐prompted) in their notes.

CONCLUSIONS

These data provide further impetus for research into modifiable perioperative risk factors associated with orthostatic hypotension. These risks are not confined to those with a pre‐existing dysautonomia diagnosis.
Debating Decolonization in the Caribbean: Assessment and Polyvocal Response to Island Anthropologies Workshop (March 18–20, 2019)
Authors: Jayaram Kiran C. , Kulstad‐González Tess , Rollins Castillo Luisa , Nau Nadège
Published: December 2020

This article presents a summary of and response to a conference on anthropological research held between March 18 and 20, 2019, on Hispaniola, the island where Haiti and the Dominican Republic are located. In the spirit of world anthropologies and the decolonization of knowledge that structured the event, we offer this review and assessment based in a collaboration effort involving one Dominican woman, one Dominican American woman, one Haitian American woman, and one Indian American man.1 We begin by contextualizing and summarizing the event. The second part is polyvocal, in that each of the co‐authors who attended the event independently crafted a critique and commentary on Island Anthropologies that reflects their positionality.
The dialog between neurons and microglia in Alzheimer's disease: The neurotransmitters view
Authors: Stolero Nofar , Frenkel Dan
Published: December 2020

Microglia play a vital role in maintaining brain homeostasis. Their continuous sensing of surrounding micro‐environments is crucial for their activity. Cross talk between specific neurons and microglia might occur through specific neurotransmitter receptors on microglia. Impairment with this interaction might result in pathological activity of microglia against potential insults. The reason for this activity in many neurodegenerative diseases such as Alzheimer's disease (AD) is not known. However, several papers report of the effects of different neurotransmitter agonists on microglial cells function that relate to their activity in AD. This review aims to summarize those works and to raise potential fundamental questions for future research.

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Assessing the Association between Participation in Extracurricular Activities and Delinquent Behavior among Justice‐Involved Young Men
Authors: Simmons Cortney , Kan Emily , Simpkins Sandra , Datta Sachiko , Steinberg Laurence , Frick Paul J. , Cauffman Elizabeth
Published: December 2020

Extracurricular activities (ECAs) have been found to promote positive youth development and protect against misconduct and minor delinquency. However, little research has examined whether ECA participation predicts delinquency among at‐risk young men or considered how delinquent behavior, in turn, impacts ECA participation. This study examined extracurricular participation over three years in a sample of 1,216 justice‐involved young men (Mage = 15.29). Approximately half of the sample participated in ECA each year. A cross‐lagged panel model was used to examine the bidirectional association between ECA participation and two types of delinquency, school misconduct and criminal offending. The results suggest that ECA participation did not consistently predict subsequent delinquency. Rather, justice‐involved young men who engaged in more delinquency were less likely to participate in ECAs.
Interlocking systems of oppression and privilege impact African Australian health and well‐being in greater Melbourne: A qualitative intersectional analysis
Authors: Young Charlotte
Published: December 2020

Individual‐level factors are typically identified as barriers to health and well‐being for African Australians, whereas little attention is paid to the multiple intersecting dimensions of inequality. Without accounting for the interrelated nature of African Australians’ social locations and intersecting systems of oppression/privilege, practice and policy responses may have limited impact. This qualitative empirical study utilizes intersectional analysis to understand concerns about African Australian health and well‐being in Greater Melbourne gleaned from an Issues Paper produced by 50 African Australians, two group interviews, and 22 slow interviews. Participants included 35 African Australians and nine people of non‐African backgrounds working with, and for, African Australians in the community sector. Systems of oppression/privilege that impact health outcomes for certain African Australians are found at the intersections of migration pathway, age, and gender and manifest within three Australian institutions, including via segregation and othering in education, labor market discrimination, and gendered racism in health care provision. As such, intersectional and equity‐orientated practice and policy actions are recommended to shift the distribution of power across all social institutions and eradicate health inequities.
Intersectional patterns of prejudice confrontation by White, heterosexual, and cisgender allies
Authors: Case Kim A. , Rios Desdamona , Lucas Amy , Braun Kelsey , Enriquez Carrie
Published: December 2020

Scholarship produced by psychologists typically focuses on one area of social identity and oppression per study (e.g., only sexism) with very little intersectional analysis across systemic oppression and privilege. To better understand the intersecting patterns of ally behavior, we examined online confrontation behavior by privileged individuals in response to antigay, antitransgender, and racist comments. Study 1 explored rates and types of confrontation during encounters with anti‐Mexican and antigay comments. Study 2 used an experimental design to assess rates and types of confrontation of anti‐Arab and antitransgender comments in the presence of a second confederate who either confronted the prejudice or remained silent. When exposed to anti‐Mexican bias, men were initially more likely to speak up than women, whereas women were more likely to respond to antigay comments. In terms of anti‐Arab and antitransgender bias, social influence resulted in more direct confrontation for anti‐Arab statements and higher rates of confrontation for antitransgender bias. Applying an intersectional lens, patterns of power and privilege reveal gender socialization may impact ally responses to racism and antigay bias. For example, gender socialization and stereotypes equating femininity with gay men may both decrease ally behavior among men and increase confrontation of antigay bias among women. When another potential ally is present, social influence appears to become the most powerful predictor of both whether or not a participant confronts bias and how direct they are with the perpetrator. Intersectional examination of invisible norms for promoting ally confrontation informs development of effective equity and justice interventions.
Cell‐wall‐degrading enzymes produced by sesame leaf spot pathogen Corynespora cassiicola
Authors: Jia Min , Liu Xintao , Zhao Hui , Ni Yunxia , Liu Hongyan , Tian Baoming
Published: December 2020

Corynespora leaf spot (CLS) is one of the most important diseases in sesame and is caused by a fungal pathogen, Corynespora cassiicola. In this study, we investigated the role of cell‐wall‐degrading enzymes (CWDEs) in the process of pathogen infection and aimed to identify the enzyme that exerts positive effect. Corynespora cassiicola was inoculated in liquid culture and in sesame leaf. At 7 days postinoculation, CWDEs including polygalacturonase (PG), cellulase (CL), neutral xylanase (NEX) and laccase (LC) were detected in the supernatant and leaf extracts inoculated with Corynespora cassiicola. The result showed that the activities of LC and NEX were higher in liquid culture, while the activities of CL and PG were lower. In the sesame leaf infected by Corynespora cassiicola, the activity of NEX was the highest, those of CL and LC were the second highest and that of PG was the weakest, which indicated that NEX was the key enzyme in the process of sesame infection by Corynespora cassiicola. Secondly, the activities of the CWDEs secreted by Corynespora cassiicola were disparate in different sesame varieties. CWDEs activities of cultivar Jz were generally higher than cultivar Hn, and the activity change curve of Jz was also steeper than that of Hn. This indicates that the resistance mechanism of Hn may inhibit the activities of CWDEs and that the appearance and expansion of leaf necrosis spot is related to the comprehensive accumulation and action of various CWDEs. This is the first report investigating the association between CWDEs and pathogenesis of Corynespora cassiicola, causing Corynespora leaf spot in sesame.
Adjunctive systemic antimicrobials in the treatment of chronic periodontitis: A systematic review and network meta‐analysis
Authors: Sgolastra Fabrizio , Petrucci Ambra , Ciarrocchi Irma , Masci Chiara , Spadaro Alessandro
Published: December 2020

The aim of this systematic review and network meta‐analysis was to assess the efficacy of antimicrobials adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis. The study was conducted according to the PRISMA statement. The protocol (CRD42020178621) was registered on the International Prospective Register of Systematic Reviews (PROSPERO). The MEDLINE, EMBASE, and CENTRAL databases were searched up to March 2020; furthermore, a manual search of relevant periodontal journals was conducted. Mean differences (MD) and standard deviations were calculated for clinical attachment level (CAL) gain and probing depth (PD) reduction at 6 and 12 months. A network meta‐analysis was performed to assess direct and indirect comparisons and to establish a ranking of treatments. A total of 21 randomized clinical trials (RCTs) were included in the systematic review. Network meta‐analysis showed that SRP + amoxicillin (AMX) + metronidazole (MTZ), as compared to SRP, reached the highest PD reduction at 6 [MD = 0.47; 95% CI (0.3; 0.64)] and 12 months [MD = 0.51; 95% CI (0.25; 0.78)], and CAL gain at 6 [MD = 0.54; 95% CI (0.27; 0.8)] and 12 months [MD = 0.37; 95% CI (0.05; 0.69)]. Network meta‐analysis indicated that AMX + MTZ adjunctive to SRP provided the best improvement in clinical parameters, followed by SRP + MTZ.
Differences in Mortality Rates between Haredi and Non‐Haredi Jews in Israel in the Context of Social Characteristics
Authors: Pinchas‐Mizrachi Ronit , Zalcman Beth G. , Shapiro Ephraim
Published: December 2020

Research indicates that mortality rates are lower among the religious. Israeli ultra‐orthodox Jews, called Haredim, have characteristics distinguishing them from the rest of the Jewish population in Israel. These include lower socioeconomic status, higher fertility rates and rates of young marriage, and isolation from the general population. Our retrospective cohort study aims to determine the difference in mortality rates between Haredi and non‐Haredi Jews in Israel. We collected data on sociodemographic variables, religious lifestyle, and all‐cause mortality for 1,230,636 Jewish Israelis (62,674 Haredim) between 1996 and 2016. Using Cox regression and adjusted Kaplan‐Meier curves, we constructed models to evaluate the relationship between identifying as Haredi and mortality. The mortality rate was significantly lower among the Haredi population compared to the non‐Haredi population (5.0 percent vs. 8.2 percent). After adjusting for sex, age, marital status, number of children, education, and socioeconomic status, we still found a higher mortality rate among non‐Haredim compared to Haredim (HR = 1.596; 99 percent CI = 1.519, 1.678). While causal mechanisms could not be analyzed in this study, a likely cause is increased social, psychological, and religious resources, highlighting the need to consider factors other than socioeconomic status when studying religious and other groups with other forms of capital.
Local Whittle estimation of long‐range dependence for functional time series
Authors: Li Degui , Robinson Peter M. , Shang Han Lin
Published: December 2020

This article studies stationary functional time series with long‐range dependence, and estimates the memory parameter involved. Semiparametric local Whittle estimation is used, where periodogram is constructed from the approximate first score, which is an inner product of the functional observation and estimated leading eigenfunction. The latter is obtained via classical functional principal component analysis. Under the restrictive condition of constancy of the memory parameter over the function support, and other conditions which include rather unprimitive ones on the first score, the estimate is shown to be consistent and asymptotically normal with asymptotic variance free of any unknown parameter, facilitating inference, as in the scalar time series case. Although the primary interest lies in long‐range dependence, our methods and theory are relevant to short‐range dependent or negative dependent functional time series. A Monte Carlo study of finite sample performance and an empirical example are included.
Correlation of minimally invasive imaging techniques to assess intestinal mucosal perfusion with established markers of chronic inflammatory enteropathy in dogs
Authors: Salavati Mazdak , Pérez‐Accino Jorge , Tan Yi Lin , Liuti Tiziana , Smith Sionagh , Morrison Linda , Salavati Schmitz Silke
Published: December 2020

Background

Minimally invasive diagnostic imaging techniques to detect intestinal inflammation in dogs are lacking. Contrast‐enhanced ultrasound (CEUS) and endoscopic narrow band imaging‐like endoscopy (Storz Professional Image Enhancement System [SPIES]) might allow quantification of intestinal mucosal perfusion and microvessel density in chronic inflammatory enteropathy (CIE) of dogs.

Hypothesis/Objectives

Markers of mucosal perfusion as determined by CEUS and SPIES endoscopy are potentially useful diagnostic markers to help characterize CIE and correlate with histological inflammation type and severity.

Animals

Thirty client‐owned dogs diagnosed with CIE at a referral hospital were prospectively enrolled.

Materials and Methods

Data from CEUS, SPIES, and white light (WL) endoscopy were correlated with World Small Animal Veterinary Association (WSAVA) endoscopy and histology scores and vessel density as determined by immunohistochemistry for von Willebrand factor (vWF). Automated linear modeling was used to determine predictors of endoscopic and histologic severity.

Results

Duodenal histology correlated with SPIES data (area percentage value,rho= 0.424,P= .04). White light endoscopy parameters correlated with SPIES parameters in the duodenum. Colonic histology correlated positively with CEUS, whereas colonic CEUS parameters correlated inversely with vWF expression. Several duodenal parameters combined predicted duodenal histology scores to a level of 73.4%. For the colon, 2 parameters contributed more than others to 73.1%.

Conclusion and Clinical Importance

Minimally invasive CEUS and SPIES appear feasible to assess intestinal perfusion in CIE. Use of SPIES endoscopy may be promising for assessing small intestinal inflammation, whereas CEUS could be used to assess colonic perfusion and inflammation. Both techniques need to be investigated further for their clinical utility.
Influences of pregravid liver enzyme levels on the development of gestational diabetes mellitus
Authors: Kim Woo Jeng , Chung Yoohyun , Park Jihyun , Park Jae‐Young , Han Kyungdo , Park Yonggyu , Park In Yang , Ko Hyun Sun
Published: December 2020

Background & Aims

Elevated liver enzymes are associated with later development of type 2 diabetes mellitus. The objective of this study was to assess the association between prepregnancy liver enzyme levels and subsequent risk of gestational diabetes mellitus.

Methods

Data from a total of 236,109 women who participated in the National Health Screening Examination between 2011 and 2015 was analysed. Multivariate logistic regression analyses were performed to estimate the risk of developing gestational diabetes mellitus in relation to pregravid liver enzyme levels. Subgroup analyses were performed according to pregravid obesity and metabolic syndrome (MetS).

Results

Approximately 5.7% and 1.1% of women developed gestational diabetes mellitus with and without insulin treatment requirement respectively. Pregravid gamma‐glutamyl transferase and alanine aminotransferase levels with greater than or equal to the 4th quartile were associated with significantly increased risks of gestational diabetes mellitus requiring insulin treatment in women with obesity and with MetS, (odds ratios [ORs] with 6.228 and 9.505, respectively, P < .001 for both). In women without obesity and without MetS, the risks of gestational diabetes mellitus requiring insulin treatment were also significant (ORs with 2.837 and 3.029, respectively, P < .001 for both). The elevated pregravid liver enzymes were associated with gestational diabetes mellitus without insulin treatment requirement, but minimally.

Conclusions/interpretation

The elevated pregravid liver enzyme levels were significantly associated with the subsequent risk of gestational diabetes mellitus, especially gestational diabetes mellitus requiring insulin treatment, not only in women with obesity or MetS, but also in women without obesity or MetS.
A pseudo‐outbreak of Rhinocladiella similis in a bronchoscopy unit of a tertiary care teaching hospital in London, United Kingdom
Authors: Abdolrasouli Alireza , Gibani Malick M. , de Groot Theun , Borman Andrew M. , Hoffman Peter , Azadian Berge S. , Mughal Nabeela , Moore Luke S.P. , Johnson Elizabeth M. , Meis Jacques F.
Published: December 2020

Outbreaks of fungal infections due to emerging and rare species are increasingly reported in healthcare settings. We investigated a pseudo‐outbreak of Rhinocladiella similis in a bronchoscopy unit of a tertiary care teaching hospital in London, UK. We aimed to determine route of healthcare‐associated transmission and prevent additional infections. From July 2018 through February 2019, we detected a pseudo‐outbreak of R. similis isolated from bronchoalveolar lavage (BAL) fluid samples collected from nine patients who had undergone bronchoscopy in a multispecialty teaching hospital, during a period of 8 months. Isolates were identified by MALDI‐TOF mass spectrometry. Antifungal susceptibility testing was performed by EUCAST broth microdilution. To determine genetic relatedness among R. similis isolates, we undertook amplified fragment length polymorphism analysis. To determine the potential source of contamination, an epidemiological investigation was carried out. We reviewed patient records retrospectively and audited steps taken during bronchoscopy as well as the subsequent cleaning and decontamination procedures. Fungal cultures were performed on samples collected from bronchoscopes and automated endoscope washer‐disinfector systems. No patient was found to have an infection due to R. similis either before or after bronchoscopy. One bronchoscope was identified to be used among all affected patients with positive fungal cultures. Physical damage was found in the index bronchoscope; however, no fungus was recovered after sampling of the affected scope or the rinse water of automated endoscope washer‐disinfectors. Use of the scope was halted, and, during the following 12‐month period, Rhinocladiella species were not isolated from any BAL specimen. All pseudo‐outbreak isolates were identified as R. similis with high genetic relatedness (>90% similarity) on ALFP analysis. The study emphasises the emergence of a rare and uncommon black yeast R. similis, with reduced susceptibility to echinocandins, in a bronchoscope‐related pseudo‐outbreak with a potential water‐related reservoir. Our findings highlight the importance of prolonged fungal culture and species‐level identification of melanised yeasts isolated from bronchoscopy samples. Possibility of healthcare‐associated transmission should be considered when R. similis is involved in clinical microbiology samples.
Botanical ingredients: Intakes, regulations, risks and attitudes
Authors: McDaid B. , Woodside J. V. , Neville C. E. , Nugent A. P.
Published: December 2020

Botanical ingredients have been used for centuries in food and in medicines, typically to support and maintain physiological functions and as remedies for many ailments. Today, botanical ingredients are still ingested as part of food supplements or herbal medicines (HM). Industry reports suggest growing global sales of and revenue from HM and food supplements containing botanicals, hereafter called botanical food supplements (BFS). In the context of this suggested growing popularity, this article will introduce both BFS and HM and then explore the available data on BFS intakes and consumer attitudes to their use. It will describe the EU regulatory framework within which BFS sit and mention research suggesting possible interactions between botanical ingredients, HM and traditional medicines. It is intended as a brief overview rather than a comprehensive review of the area.
Oil pulling to relieve medication‐induced xerostomia: A randomized, single‐blind, crossover trial
Authors: Ludwar Lena , Mannel Hilke , Hamacher Stefanie , Noack Michael Johannes , Barbe Anna Greta
Published: December 2020

Objectives

To determine the subjective effectiveness of oilpulling on medication‐induced xerostomia with regard to symptom relief, quality of life, taste, mucosal moisture and oral parameters.

Materials and Methods

In a randomized, single‐blind, crossover trial in participants with medication‐induced xerostomia (n = 26; mean age 64.71 (standard deviation (SD) 15.60) years), we investigated oilpulling efficacy (sunflower oil) versus mineral water after one‐week use. Xerostomic burden (visual analogue scale, VAS), symptom relief and oral examinations (gingivitis index, plaque index, whole stimulated and unstimulated salivation rates) were investigated at baseline and the end of the follow‐up.

Results

Oilpulling reduced the xerostomic burden (baseline value 6.46 (SD 1.80), decreasing to 4.93 (SD 2.97)) (p = .003), without difference between oil versus water (p = .067). Baseline values for water were 6.08 (SD 2.17) decreasing to 5.72 (SD 2.17) (p = .124). Compared to water, oil made swallowing easier (p = .031), caused a pleasant mouthfeel (p = .031) and caused less waking up at night (p = .031). Effectiveness (p = .002) and duration (p = .007) of symptom relief showed differences between products in favour of oil.

Conclusions

Oil pulling alleviated the overall xerostomic burden. In the comparison between oil and water, no difference regarding symptom relief could be shown. Patients should be informed of possibilities and limitations of oilpulling as inexpensive and easy‐to‐obtain alternative to commercially available products for short‐term symptom relief.
The intracellular ROS accumulation in elicitor‐induced immunity requires the multiple organelle‐targeted Arabidopsis NPK1‐related protein kinases
Authors: Marti Lucia , Savatin Daniel‐Valentin , Gigli‐Bisceglia Nora , de Turris Valeria , Cervone Felice , De Lorenzo Giulia
Published: December 2020

Recognition at the plasma membrane of danger signals (elicitors) belonging to the classes of the microbe/pathogen‐ and damage‐associated molecular patterns is a key event in pathogen sensing by plants and is associated with a rapid activation of immune responses. Different cellular compartments, including plasma membrane, chloroplasts, nuclei and mitochondria, are involved in the immune cellular program. However, how pathogen sensing is transmitted throughout the cell remains largely to be uncovered. Arabidopsis NPK1‐related Proteins (ANPs) are mitogen‐activated protein kinase kinase kinases previously shown to have a role in immunity. In this article, we studied the in vivo intracellular dynamics of ANP1‐ and ANP3‐GFP fusions and found that under basal physiological conditions both proteins are present in the cytosol, while ANP3 is also localized in mitochondria. After elicitor perception, both proteins are present also in the plastids and nuclei, revealing a localization pattern that is so far unique. The N‐terminal region of the protein kinases is responsible for their localization in mitochondria and plastids. Moreover, we found that the localization of ANPs coincides with the sites of elicitor‐induced ROS accumulation and that plants lacking ANP function do not accumulate intracellular ROS.
Social anxiety tendency and autism spectrum disorder in Japanese adolescence
Authors: Minami Kazuya , Horikawa Etsuo
Published: December 2020

Background

In Japanese high schools, understanding of school non‐attendance and students with developmental disabilities, including autism spectrum disorder (ASD), is gradually improving. On the other hand, few people recognize social anxiety disorder (SAD), the onset of which commences during youth. Social anxiety disorder and ASD share various overlapping characteristics but have different diagnostic criteria. The anxiety caused by these disorders sometimes appears as school non‐attendance. This study examines the relationship between SAD, ASD, and history of school non‐attendance in high school students.

Methods

One hundred and fifty‐eight students at one Japanese high school that accepts school non‐ attending students were investigated. To understand the features of ASD and how it relates to SAD tendencies, the Liebowitz Social Anxiety Scale – Japanese (LSAS‐J) and Autism‐Spectrum Quotient – Japanese (AQ‐J) were used. Based on the LSAS‐J cutoff point, participants were divided into high and low anxiety groups and then data were compared between the two groups. Potential factors associated with a high‐SAD trend were evaluated using multivariate logistic regression.

Results

The results showed that students with high ASD scores were more likely to have SAD and that a lack of "social skill," a subscale of ASD, was closely associated with a social anxiety trend. However, the relationship between school non‐attendance and social anxiety could not be confirmed.

Conclusions

Focusing on the lack of social skills in ASD may provide an opportunity to identify students with high SAD tendencies. This study will contribute to the understanding of high school students with high SAD tendencies in Japan.
Time is of the essence: A single‐center experience of hepatic arterial supply impairment management in pediatric liver transplant recipients
Authors: Gautier Sergey , Monakhov Artem , Tsiroulnikova Olga , Mironkov Boris , Voskanov Mikhail , Dzhanbekov Timur , Azoev Elkhan , Khizroev Khizri , Dzhiner Deniz , Pashkova Irina
Published: December 2020

Background

Impairment of hepatic arterial flow including hepatic arterial thrombosis (HAT), hepatic arterial stenosis (HAS), and splenic artery steal syndrome (SASS) is potentially life‐threatening complications. The proposed early diagnosis and urgent treatment strategy of graft arterial flow reduction aim to decrease morbidity and mortality.

Methods

Pediatric patients with known hepatic arterial flow impairment were retrospectively reviewed. Patients were grouped by occlusive (HAT) and non‐occlusive (HAS/SASS) arterial flow reduction. Patients with HAT were further divided in two groups based on the estimated maximal hepatic artery occlusion time ≤8 and >8 hours.

Results

Impairment of hepatic arterial flow developed in 32 of 416 pediatric liver transplant recipients. HAT, HAS, and SASS incidences were 4.1% (n = 17), 2.2% (n = 9), and 1.4% (n = 6), respectively. Neither graft loss nor death occurred in the non‐occlusive group. The probabilities of sepsis (OR, 1.7; 95% CI, 1.14‐2.53; P=.008) and graft loss or death (OR, 1.42; 95% CI, 1.04‐1.92; P=.046) were higher in the occlusive group. Patients with estimated maximal duration of hepatic artery occlusion ≤ 8 hours (n = 7; 41.2%) did not have ischemic‐type biliary lesions and sepsis (P=.044 and 0.010, respectively) but had excellent 3‐year graft survival compared with > 8 hours group (100% vs 40%; P=.037). Multivariate analysis revealed HAT manifestation by fever was associated with increased chances of graft loss or death.

Conclusion

Occlusive arterial complications impose higher risks of graft loss and death. Thorough arterial supply monitoring by Doppler ultrasonography and urgent endovascular arterial flow restoration may salvage both graft and the recipient.
The Family Farming Culture of Dairy Farmers: A Case‐Study of the Illawarra Region, New South Wales
Authors: Hu Ren , Gill Nicholas
Published: December 2020

Since the 1980s, many parts of rural Australia have experienced persistent financial difficulties. However, there is a lack of account on how farmers have improved business performance while maintaining traditional farming culture. By focusing on dairy farmers in the Illawarra region in New South Wales, Australia, this study examines the evolution of family farming culture under global agricultural change. Dairy farming dominates Illawarra agriculture, and has been constantly pressured by neoliberal policy reform and adverse market conditions. This study draws on public data, semi‐structured interviews, and participant observation. In recent decades, dairy farming has shown a trend of declining farm numbers. A long‐standing culture of family farming has existed in the Illawarra and continues to shape farmers’ lifestyle and business. Farmer interviewees shared this culture, and continued farming partly for non‐economic reasons. However, under economic pressures farmers both compromised some elements of this traditional farming culture, and drew on the strategic value of other elements.
A nonparametric two‐sample test using a generalφ‐divergence‐based mutual information
Authors: Guha Apratim , Biswas Atanu , Ghosh Abhik
Published: December 2020

Nonparametric two‐sample problems are extremely important for applications in different applied disciplines. We define a general MI based on theφdivergences and use its estimate to propose a new general class of nonparametric two sample tests for continuous distributions. We derive the asymptotic distribution of the estimates ofφ‐divergence‐based MI (φDMI) under the assumption of independence in the hybrid setup of one binary and one continuous random variables. Additionally, for finite sample cases, we describe an algorithm for obtaining the bootstrap‐based critical value of our proposed two‐sample test based on the estimatedφDMI. We demonstrate through extensive simulations that the proposed class of tests work exceptionally well in many situations and can detect differences where other two‐sample tests fail. Finally, we analyze an application of our proposed tests to assess a solution to information leakage in e‐passport data.
In Search of Spatial Perceptions: The Balkans as A Vernacular Region
Authors: Pleić Tvrtko , Glasnović Vedran , Prelogović Vedran , Radeljak Kaufmann Petra
Published: December 2020

The Balkans are still an imprecisely defined and relatively unknown area in southeastern Europe. They are a historical‐political term, often provoking negative associations that are synonymous with underdevelopment, backwardness, and primitiveness. This research is aimed primarily at exploring how the Balkans are perceived by students of geography in Zagreb and Maribor and what associations they provoke. It further seeks to investigate whether the Balkans are primarily a cognitive construct that is spatially determined on an individual level, based on an individual’s own insights, attitudes, values, and other determinants. Therefore, a questionnaire survey regarding perceptions of the Balkans was conducted. The results indicate that the Balkans can be seen as a sort of vernacular anti‐region: the kind from which states in or near its boundaries attempt to exclude themselves, while simultaneously trying to include their neighbors to the south and east.
Material Impact With Package Solution for 5G RF Application
Authors: Su Po Yuan (James) , Wang Yu Po , Pai Yu Cheng , Lu Ying Wei , Shih Teny , Kang Andrew , Lai David , Jiang Don Son
Published: December 2020

From the fifth-generation (5G) of system architecture evolution, there are more and more demands which require high data rate communication, low latency, and massive connectivity for network data transmission. For millimeter-wave (mm-wave), communications, the antenna size for mobile application is shunk from PCB level to package level, therefore Antenna in Package (AiP) is developed.

Recently, high bandwidth with high performance data rate transmission is the key for 5G and that also can provide the lower latency than current fourth generation. That is the reason can be explained that millimeter-wave (mm-wave) of bandwidth can offer excellent network coverage in the city and the antenna design for 5G wireless telcommcation is getting important. All frequency of signal have to use the networking devices to achieve high speed data transmission requirement. As we known, mm-wave is used for mobile phone of signal transmission, and the material with the package design become really important. The mm-wave performance can be impacted by material with structure design, and DK, DF and package level design will be the material portion to effect the signal performance.

In this paper, material selection, antenna array and package design will be the key for the Antenna in Package (AiP). For antenna design, we need the lower DF, DK, phase array and structure design to help our signal performance which means lowest insertion loss will be the best for signal transmission. We will do the comparsion for the paper discussion for the material, package and beamforming with antenna array design. Finally, this paper will provide the advanced package solution for future application.
Fan-Out MCM Solutions Study for Heterogeneous Integration on Intelligent Computing Application
Authors: Hung Chu-Pao (Otis) , Wang Yu-Po , Chen Steven , Wan Katch
Published: December 2020

In recent years, semiconductor products have developed rapidly, from desktop computers with basic computing to Internet-connected smartphones, to emerging intelligent and perceived smart system products, such as mass-produced of smart home appliances, smart watches, and under development of smart glasses. The product trend is toward high performance, multi-functional integration, thinner profile and lower cost features. These requirements are interrelated with wafer technology and assembly process development. The advanced wafer technology, such as 5nm / 3nm, will provide higher performance. However, as Moore’s Law is approaching the physical limit, the industry has turned to the development of advanced packaging solution technologies to break through this bottleneck. At present, the industry’s forward-looking packaging platform includes 2.5 D, 3D, Fan-out and SiP modules, etc., which technologies can integrate chiplet, chip stack, passive components as heterogeneous integrated packaging solutions.

Fan-Out MCM Platform has integrative characteristics for homogeneous / heterogeneous wafers and passives, lower cost and lower profile advantage than 2.5D, also provided comparable performance to 2.5D by proper RDL / Substrate layout design. In addition, in order to meet the high-performance characteristics of products, toward developing multi-layer RDL layers (more than 3 layers). This article will plan a series of multi-RDL layers sample tests, RDL sample build of line width/line space of 1/1um and introduce the related process challenge, microstructure data.
Experimental Validation and Design Simulations of a Passive Two-Phase Cooling System for Datacenters
Authors: Marcinichen Jackson B. , Thome John R. , Amalfi Raffaele L. , Cataldo Filippo
Published: December 2020

Thermosyphon cooling systems represent the future of datacenter cooling, and electronics cooling in general, as they provide high thermal performance, reliability and energy efficiency, as well as capture the heat at high temperatures suitable for many heat reuse applications. On the other hand, the design of passive two-phase thermosyphons is extremely challenging because of the complex physics involved in the boiling and condensation processes; in particular, the most important challenge is to accurately predict the flow rate in the thermosyphon and thus the thermal performance. This paper presents an experimental validation to assess the predictive capabilities of JJ Cooling Innovation’s thermosyphon simulator against one independent data set that includes a wide range of operating conditions and system sizes, i.e. thermosyphon data for server-level cooling gathered at Nokia Bell Labs. Comparison between test data and simulated results show good agreement, confirming that the simulator accurately predicts heat transfer performance and pressure drops in each individual component of a thermosyphon cooling system (cold plate, riser, evaporator, downcomer (with no fitting parameters), and eventually a liquid accumulator) coupled with operational characteristics and flow regimes. In addition, the simulator is able to design a single loop thermosyphon (e.g. for cooling a single server’s processor), as shown in this study, but also able to model more complex cooling architectures, where many thermosyphons at server-level and rack-level have to operate in parallel (e.g. for cooling an entire server rack). This task will be performed as future work.
High Performance Computing Package With Chip Module on Substrate Solutions
Authors: Chen Ching Chia , Lai David , Lin Vito , Wang Yu Po
Published: December 2020

With die size increasing and bump pitch decreasing on FCBGA (flip chip ball grid array), warpage is the first challenge that processes of package assembly and SMT (surface mount technology) will have. The main factor is CTE (coefficient of thermal expansion) mismatch between chip and substrate. The larger die size, the more significant elongation difference which could cause warpage. Furthermore, serious warpage can cause manufacture difficulties, such as bump bridge, bump non-wet and underfill (UF) void. As the result, in order to control package warpage, additional force, such as high modulus UF or metal heat sink are usually applied to restrict package deformation. However, the more additional force is applied, the more stress may be transferred to chip and causes chip corner or UF crack where easily cause stress concentration.

In this paper, large package > 70 * 70 mm is studied for the challenges of on substrate process and reliability, meanwhile simulation is performed for stress prediction. In addition, possible solutions from material and process are discussed and studied.