bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between small dense low-density lipoprotein cholesterol and neuroimaging markers of cerebral small vessel disease in middle-aged and elderly Chinese populations
Authors: Yu Xiaorong , Yu Yanhua , Wei Cunsheng , Wang Lin , Jiang Junying , Zhang Rui , Dai Qi , Kang Yue , Chen Xuemei
Published: November 2021

Background

Cerebral small vascular disease (CSVD) is one of the leading causes of death in the aged population and is closely related to abnormalities in low-density lipoprotein cholesterol (LDL-C). Our study aims to clarify the relationship between small and dense low-density lipoprotein cholesterol (sdLDL-C) (a subcomponent of LDL-C) and neuroimaging markers of CSVD.

Methods

In total, 1211 Chinese adults aged ≥45 years with cranial magnetic resonance imaging (MRI) were recruited in this retrospective study from January 2018 to May 2021. Serum lipids and other baseline characteristics were investigated in relation to the occurrence of CSVD. A logistic regression model was performed to analyze the relationships between LDL subtypes and CSVD risk, and the Pearson correlation coefficient was used to analyze the correlation between clinical characteristics and CSVD risk. ROC curves and AUCs were created and depicted to predict the best cutoff value of LDL-C subtypes for CSVD risk. Based on these data, we performed comprehensive analyses to investigate the risk factors for CSVD.

Results

Ultimately, 623 eligible patients were included in the present study. Of the 623 eligible patients, 487 were included in the CSVD group, and 136 were included in the group without CSVD (control group). We adjusted for confounders in the multivariate logistic regression model, and LDL-C3 was still higher in the CSVD patients than in the group of those without CSVD (OR (95% CI), 1.22(1.08–1.38), P < 0.05). Pearson correlation showed that there was a positive correlation between the levels of LDL-C3, LDL-C4, LDL-C5, glucose, age, hypertension, previous ischemic stroke and CSVD risk (r > 0.15, P < 0.01). Moreover, the best cutoff value of LDL-C3 to predict CSVD was 9.5 mg/dL with 68.4% sensitivity and 72.8% specificity, and the best cutoff value of LDL-C4 to predict CSVD was 5.5 mg/dL with 50.5% sensitivity and 90.4% specificity.

Conclusion

The results indicate that LDL-C3 is an independent risk factor for CSVD. A new prediction model based on LDL-C3 and LDL-C4 can help clinicians identify high-risk CSVD, even in people with normal LDL-C levels. The levels of sdLDL-C should be considered in the assessment and management of CSVD.
FXYD2 mRNA expression represents a new independent factor that affects survival of glioma patients and predicts chemosensitivity of patients to temozolomide
Authors: Zhou Kaijia , Jiang Tao , Liu Yanwei , Zhao Zheng , Huang Lijie , Li Guanzhang
Published: November 2021

Purpose

Glioma is the most common primary intracranial tumor. Owing to the poor prognosis associated with high-grade gliomas, there is an urgent need to identify biomarkers related to prognosis and treatment sensitivity. Here, we analyze the expression of FXYD2 mRNA in gliomas, and explore its clinical prognostic value and significance in this disease.

Methods

Clinical features, FXYD2 mRNA expression levels, and survival data were analyzed for 516 glioma patients from the Chinese Glioma Genome Map Project, 481 from the cancer genome map datbase and 268 from the molecular braintumor database. The expression patterns for FXYD2 mRNA were compared using the chi-square test, and overall survival (OS) of glioma patients was evaluated according to FXYD2 mRNA expression levels. The factors affecting glioma survival were evaluated by Cox univariate and multivariate regression analysis.

Results

FXYD2 mRNA expression was related to the grade of gliomas. The higher the level, the lower the expression. Meanwhile related to the pathological classification of gliomas. Oligodendroglioma, IDH-mutant and 1p/19q-codeleted was higher than Astrocytoma, IDH-mutant, higher than Glioblastoma, IDH-wildtype. Moreover, temozolomide (TMZ) chemotherapy was found to be an independent factor affecting survival in patients with high FXYD2 mRNA expression, but not in patients with low expression.

Conclusion

FXYD2 mRNA expression represents a new independent factor affecting the survival of glioma patients and may serve as an independent prognostic indicator to predict the sensitivity of gliomas to TMZ.
Spatial variation and determinants of childhood anemia among children aged 6 to 59 months in Ethiopia: further analysis of Ethiopian demographic and health survey 2016
Authors: Jember Tiruneh Ayele , Teshome Destaw Fetene , Gezie Lemma Derseh , Agegnehu Chilot Desta
Published: November 2021

Background

The magnitude of childhood anemia was increased from time to time. Thus, Even if the Ethiopian government applied tremendous efforts, anemia in children continues as a major public health problem. There is limited evidence on the spatial variation of and determinant factors of childhood anemia at the national level. Therefore, this study aimed to explore spatial distribution and determinants of anemia among children aged 6 to 59 months in Ethiopia.

Method

A stratified two-stage cluster sampling technique was used in Ethiopian Demographic Health Survey 2016 data. In this study 8602 children aged 6–59 months were included. Bernoulli model was used to explore the presence of purely spatial clusters of Anemia in children in age 6–59 months using Sat scan. ArcGIS version 10.3 was used to know the distribution of anemia cases across the country. A mixed-effects Logistic regression model was used to identify determinant factors of anemia.

Results

The finding indicates that the spatial distribution of childhood anemia was non-random in the country with Moran’s I: 0.65,p < 0.001. The SaT scan analysis identified a total of 180 significant primary clusters located in the Somali and Afar regions (LLR = 14.47,P-value< 0.001, RR = 1.47). Age of child 12–23 months (AOR = 0, 68, 95%CI: 0.55, 0.85), 24–35 months (AOR = 0.38, 95%CI: 0.31, 0.47), and36–47 months (AOR = 0.25, 95%CI, 0.20, 0.31), working mother (AOR = 0.87, 95%CI: 0.76, 0.99), anemic mother (AOR = 1.53, 95%CI, 1.35, 1.73), had fever in the last 2 weeks (AOR = 1.36,95%CI:1.13, 1.65), moderate stunting (AOR = 1.31,95%CI: 1.13, 1.50),Severely stunting (AOR = 1.82,95%CI: 1.54, 2.16), religion, wealth index, and number of under-five children in the household were statistically significant associated with childhood anemia.

Conclusion

Spatial variation of childhood anemia across the country was non-random. Age of the child, wealth index, stunting, religion, number of under-five children in the household, fever in the last 2 weeks, anemic mother, and working status of the mother were determinants of childhood anemia. Therefore, interventions should be a priority concern for high-risk (hot spot) areas regarding allocation of resources and improved access to health facilities, and to reduce the consequence of anemia among the generation policymakers and concerned bodies should be implemented these specific determinant factors.
Declining trends in smokeless tobacco use among Indian women: findings from global adult tobacco survey I and II
Authors: Ghosal Shishirendu , Sinha Abhinav , Kanungo Srikanta , Pati Sanghamitra
Published: November 2021

Background

Smokeless Tobacco (SLT) use is culturally rooted and more acceptable among women in India. SLT is a significant risk for oral cancers and has other adverse health outcomes on women’s general as well as reproductive health. This study aimed to estimate and compare the prevalence and correlates of SLT among adult females in India using Global Adult Tobacco Survey (GATS), 2009–2010 (GATS 1) and 2016–2017 (GATS 2).

Methods

Data from a nationally representative cross-sectional study GATS 1 (n = 35,529) and GATS 2 (n = 40,265) were analysed for adult female smokeless tobacco users. Correlates of SLT exposure were assessed separately using binary logistic regression. Multivariable logistic regression analysis was done for the variables which computedp < 0.1. The association was expressed as Adjusted Odds ratio with 95% confidence intervals.

Results

There was a reduction in prevalence of SLT use among women in India between GATS 1 (18.4%) and GATS 2 (12.8%). SLT use was highest among the North-Eastern women in both rounds [AOR: 4.567 (3.942–5.292) during GATS-1 and 9.149 (7.722–10.839) during GATS-2]. Odisha had highest prevalence of 56.53% while Himachal Pradesh had lowest 0.14% during the recent GATS 2 survey. 33.3% vs. 34.80% of the participants were willing to quit tobacco in Central region across both rounds of survey.

Conclusions

Although, smokeless tobacco prevalence among females has reduced between 2009 and 2016 in India, yet tobacco control strategies need further pace. Hence, more focused gender-based tobacco control programs and policies are the need of time.
The ontology of fast food facts: conceptualization of nutritional fast food data for consumers and semantic web applications
Authors: Amith Muhammad , Onye Chidinma , Ledoux Tracey , Xiong Grace , Tao Cui
Published: November 2021

Background

Fast food with its abundance and availability to consumers may have health consequences due to the high calorie intake which is a major contributor to life threatening diseases. Providing nutritional information has some impact on consumer decisions to self regulate and promote healthier diets, and thus, government regulations have mandated the publishing of nutritional content to assist consumers, including for fast food. However, fast food nutritional information is fragmented, and we realize a benefit to collate nutritional data to synthesize knowledge for individuals.

Methods

We developed the ontology of fast food facts as an opportunity to standardize knowledge of fast food and link nutritional data that could be analyzed and aggregated for the information needs of consumers and experts. The ontology is based on metadata from 21 fast food establishment nutritional resources and authored in OWL2 using Protégé.

Results

Three evaluators reviewed the logical structure of the ontology through natural language translation of the axioms. While there is majority agreement (76.1% pairwise agreement) of the veracity of the ontology, we identified 103 out of the 430 statements that were erroneous. We revised the ontology and publicably published the initial release of the ontology. The ontology has 413 classes, 21 object properties, 13 data properties, and 494 logical axioms.

Conclusion

With the initial release of the ontology of fast food facts we discuss some future visions with the continued evolution of this knowledge base, and the challenges we plan to address, like the management and publication of voluminous amount of semantically linked fast food nutritional data.
DRG grouping by machine learning: from expert-oriented to data-based method
Authors: Liu Xiaoting , Fang Chenhao , Wu Chao , Yu Jianxing , Zhao Qi
Published: November 2021

Background

Diagnosis-related groups (DRGs) are a payment system that could effectively solve the problem of excessive increases in healthcare costs which are applied as a principal measure in the healthcare reform in China. However, expert-oriented DRG grouping is a black box with the drawbacks of upcoding and high cost.

Methods

This study proposes a method of data-based grouping, designed and updated by machine learning algorithms, which could be trained by real cases, or even simulated cases. It inherits the decision-making rules from the expert-oriented grouping and improves performance by incorporating continuous updates at low cost. Five typical classification algorithms were assessed and some suggestions were made for algorithm choice. The kappa coefficients were reported to evaluate the performance of grouping.

Results

Based on tenfold cross-validation, experiments showed that data-based grouping had a similar classification performance to the expert-oriented grouping when choosing suitable algorithms. The groupings trained by simulated cases had less accuracy when they were tested by the real cases rather than simulated cases, but the kappa coefficients of the best model were still higher than 0.6. When the grouping was tested in a new DRGs system, the average kappa coefficients were significantly improved from 0.1534 to 0.6435 by the update; and with enough computation resources, the update process could be completed in a very short time.

Conclusions

As a new potential option, the data-based grouping meets the requirements of the DRGs system and has the advantages of high transparency and low cost in the design and update process.
Barriers and facilitators to kangaroo mother care implementation in Cote d’Ivoire: a qualitative study
Authors: Kourouma Kadidiatou Raïssa , Agbré-Yacé Marie Laurette , Doukouré Daouda , Cissé Lassina , Some-Méazieu Chantière , Ouattara Joseph , Tano-Kamelan Akoua , Konan Kouakou Virginie
Published: November 2021

Background

Kangaroo Mother Care (KMC) is a high impact, low technology and cost-effective intervention for the care of preterm and low birth weight newborn. Cote d’Ivoire adopted the intervention and opened the first KMC unit in 2019. This study aimed to assess barriers and facilitators of KMC implementation in Cote d’Ivoire, a year after its introduction, as well as proposed solutions for improving KMC implementation in the country.

Method

This was a qualitative study, using semi-structured interviews, carried out in September 2020 in the first KMC unit opened at the Teaching Hospital of Treichville. The study involved healthcare providers providing KMC and mothers of newborn who were receiving or received KMC at the unit. A thematic analysis was performed using both inductive and deductive (Consolidated Framework for Implementation Research-driven) approaches. NVivo 12 was used to assist with coding.

Results

A total of 44 semi-structured interviews were conducted, 12 with healthcare providers and 32 with mothers. The barriers identified were lack of supplies, insufficiency of human resources, lack of space for admission, lack of home visits, lack of food for mothers, lack of collaboration between health services involved in newborn care, increased workload, the beliefs of carrying the baby on the chest, father’s resistance, low rate of exclusive breastfeeding, lack of community awareness. Facilitators identified were training of healthcare providers, strong leadership, the low cost of KMC, healthcare providers’ perceived value of KMC, mothers−healthcare providers’ relationship, mothers’ adherence to KMC and the capacity of the KMC unit to network with external organizations. The proposed solutions for improving KMC implementation were volunteer staff motivation, intensifying education and counselling of mothers and families, the recruitment of a psychologist and the involvement of all stakeholders.

Conclusion

Our study highlighted the challenges to implement KMC in Cote d’Ivoire with unique and specific barriers to implementation. We recommend to researchers and decision makers to respectively design strategies and adopt intervention that specifically address these barriers and facilitators to a better uptake of KMC. Decision makers should also take into account the proposed solutions for a better implementation and scaling up of KMC.
Venues and methods to improve professional men’s access to HIV self-testing and linkage to HIV prevention or treatment: a qualitative study
Authors: Muwanguzi Patience A. , Nasuuna Esther M. , Namimbi Florence , Osingada Charles Peter , Ngabirano Tom Denis
Published: November 2021

Background

HIV testing among men in sub-Saharan Africa is sub-optimal. Despite several strategies to improve access to underserved populations, evidence regarding engaging men in professional and formal occupations in HIV testing is limited. This study explored employed professional men’s preferences for uptake of HIV self-testing, and linkage to HIV care, or prevention services.

Methods

This was an explorative-descriptive qualitative study where a sample of 33 men from six Ugandan urban centres. Participants were purposively selected guided by the International Standard Classification of Occupations to participate in in-depth interviews. The data were collected using an interview guide and the sample size was determined by data saturation. Eligibility criteria included fulltime formal employment for over a year at that organization. The data were analyzed manually using thematic content analysis.

Results

Three categories emerged: uptake of HIV self-tests, process of HIV self-testing and linkage to post-test services. The different modes of distribution of HIV self-test kits included secondary distribution, self-tests at typically male dominated spaces, delivery to workplaces and technology-based delivery. The process of HIV self-testing may be optimized by providing collection bins, and mHealth or mobile phone applications. Linkage to further care or prevention services may be enhanced using medical insurance providers, giving incentives and tele counselling.

Conclusion

We recommend utilization of several channels for the uptake of HIV self-tests. These include distribution of test kits both to offices and men’s leisure and recreation ‘hot spots’, Additionally, female partners, peers and established men’s group including social media groups can play a role in improving the uptake of HIV self-testing. Mobile phones and digital technology can be applied in innovative ways for the return of test results and to strengthen linkage to care or prevention services. Partnership with medical insurers may be critical in engaging men in professional employment in HIV services.
Effect of empagliflozin on ketone bodies in patients with stable chronic heart failure
Authors: Pietschner R. , Kolwelter J. , Bosch A. , Striepe K. , Jung S. , Kannenkeril D. , Ott C. , Schiffer M. , Achenbach S. , Schmieder R. E.
Published: November 2021

Background

Recent studies indicated that sodium glucose cotransporter (SGLT)2 inhibition increases levels of ketone bodies in the blood in patients with type 1 and 2 diabetes. Other studies suggested that in patients with chronic heart failure (CHF), increased myocardial oxygen demand can be provided by ketone bodies as a fuel substrate. Experimental studies reported that ketone bodies, specifically beta-hydroxybutyrate (β-OHB) may increase blood pressure (BP) by impairing endothelium-dependant relaxation, thereby leading to increased vascular stiffness. In our study we assessed whether the SGLT 2 inhibition with empagliflozin increases ketone bodies in patients with stable CHF and whether such an increase impairs BP and vascular function.

Methods

In a prospective, double blind, placebo controlled, parallel-group single centre study 75 patients with CHF (left ventricular ejection fraction 39.0 ± 8.2%) were randomised (2:1) to the SGLT-2 inhibitor empagliflozin 10 mg orally once daily or to placebo, 72 patients completed the study. After a run-in phase we evaluated at baseline BP by 24 h ambulatory blood pressure (ABP) monitoring, vascular stiffness parameters by the SphygmoCor system (AtCor Medical, Sydney, NSW, Australia) and fasting metabolic parameters, including β-OHB by an enzymatic assay (Beckman Coulter DxC 700 AU). The same measurements were repeated 12 weeks after treatment. In 19 of the 72 patients serum levels of β-OHB were beneath the lower border of our assay (< 0.05 mmol/l) therefore being excluded from the subsequent analysis.

Results

In patients with stable CHF, treatment with empagliflozin (n = 36) was followed by an increase of β-OHB by 33.39% (p = 0.017), reduction in 24 h systolic (p = 0.038) and diastolic (p = 0.085) ABP, weight loss (p = 0.003) and decrease of central systolic BP (p = 0.008) and central pulse pressure (p = 0.008). The increase in β-OHB was related to an attenuated decrease of empagliflozin-induced 24 h systolic (r = 0.321, p = 0.069) and diastolic (r = 0.516, p = 0.002) ABP and less reduction of central systolic BP (r = 0.470, p = 0.009) and central pulse pressure (r = 0.391, p = 0.033). No significant changes were seen in any of these parameters after 12 weeks of treatment in the placebo group (n = 17).

Conclusion

In patients with stable CHF ketone bodies as assessed by β-OHB increased after treatment with empagliflozin. This increase led to an attenuation of the beneficial effects of empagliflozin on BP and vascular parameters.

Trial registration The study was registered at http://www.clinicaltrials.gov (NCT03128528).
Narciclasine induces autophagy-mediated apoptosis in gastric cancer cells through the Akt/mTOR signaling pathway
Authors: Yuan Yunfeng , He Xue , Li Xiang , Liu Yan , Tang Yueliang , Deng Huiming , Shi Xinyuan
Published: November 2021

Background

Gastric cancer is a common gastrointestinal cancer and currently has the third-highest mortality rate. Research shows that the natural compound narciclasine has a variety of biological activities. The present study aimed to investigate the effect of narciclasine on gastric cancer cells and its molecular mechanisms and determine whether this compound could be a novel therapy for gastric cancer.

Methods

MTT and clone assays were employed to detect the proliferation of gastric cancer cells. The cell apoptosis was detected by flow cytometry. The formation of autophagosomes and autophagosomal lysosomes was observed by transmission electron microscopy and laser confocal scanning microscopy. Western blotting was used to detect the expression of apoptosis, autophagy and Akt/mTOR pathway-related proteins.

Results

In this study, we found that narciclasine could inhibit the proliferation of gastric cancer cells and promote apoptosis in gastric cancer cells. Further experiments showed that narciclasine promoted the levels of autophagy proteins LC3-II, Atg-5 and Beclin-1, reduced the expression of the autophagy transporter p62, and increased autophagic flux. By using the autophagy inhibitors 3-MA and CQ, it was shown that narciclasine could induce autophagy-mediated apoptosis in gastric cancer cells. Finally, we found that narciclasine had no significant effects on the total content of Akt and mTOR in gastric cancer cells, and it involved autophagy in gastric cancer cells by reducing the phosphorylation level of p-Akt and p-mTOR.

Conclusions

Narciclasine can induce autophagy-dependent apoptosis in gastric cancer cells by inhibiting the phosphorylation level of Akt/mTOR and thus reduce the proliferation of gastric cancer cells.
Efficacy of preoperative testosterone therapy in hypospadias: a systematic review and meta-analysis
Authors: Sembiring Gozali , Sigumonrong Yacobda
Published: November 2021

Background

Bleeding, hematoma, edema, wound infection, and scar formation are the common problems linked with hypospadias reconstruction. Hormone treatment is recommended before surgical treatment to improve intraoperative circumstances. However, no meta-analysis has explored the effectiveness and side effects of testosterone treatment before surgery in hypospadias.

Main body of the abstract

The purpose of this paperwork is to evaluate the impact of preoperative testosterone treatment in hypospadias based on clinical data from published trials. This study searched MEDLINE, Science Direct, and the Cochrane Library without regard to year. However, only English journals were included, with a manual search using the Preferred Reporting Items for Systematic Reviews and Meta-analysis of Observational Studies in Epidemiology Guidelines supplementing the search. In this meta-analysis, five papers were considered. Two of these investigations were multicenter randomized clinical trials. Two of the studies were prospective, with a median follow-up of varying lengths. A retrospective investigation was conducted. There were 585 patients in all that took part in this trial. After surgery, the complication rate was measured in both the intervention and control groups, including meatal stenosis, fistula, glans dehiscence, scarring, reoperation rate, urethral diverticulum, fine pubic hair, and sexual precocity. The only significant difference between the intervention and control groups was that the intervention group had a decreased frequency of glans dehiscence following surgery (OR 0.40 with the 95% CI of 0.17 until 0.97).

Conclusions

This study discovered that a patient who got testosterone before surgery had a considerably decreased complication risk for glandular dehiscence. Reoperation rate, urethral-cutaneous fistula, meatal stenosis, and penile scarring in children with hypospadias, on the other hand, revealed no significant difference in the testosterone-treated group against the control group.
Hypocalcemia as the Initial Presentation of Type 2 Bartter Syndrome: A Family Report
Authors: London Shira , Levine Michael A , Li Dong , Spiegel Ronen , Lebel Asaf , Halevy Rephael , Tenenbaum-Rakover Yardena
Published: November 2021

Context

Bartter syndrome (BS) is a group of rare autosomal-recessive tubulopathies characterized by hypokalemic, hypochloremic metabolic alkalosis in which the primary defect is a deficiency of transporters involved in sodium chloride reabsorption. Type 2 BS results from a defect in the renal outer medullary potassium channel encoded by the KCNJ1 gene. Type 2 BS presents with polyhydramnios, intrauterine growth retardation, prematurity, failure to thrive, polyuria, hypercalciuria, and life-threatening episodes of dehydration. Hypocalcemia is a very rare presenting symptom of BS, with only a few published cases reporting it as the initial manifestation of type 2 BS.

Objective

To describe a child who presented with hypocalcemic seizure at the age of 2.3 years that was first related to vitamin D deficiency and high-phosphate soft drink consumption.

Methods

Whole exome sequencing (WES) was used to evaluate the biochemical abnormalities of the proband.

Results

We identified a previously described homozygous missense mutation c.212C>T, p.T71M in the KCNJ1 gene associated with type 2 BS. Six additional family members with the same mutation and diagnosed clinically with BS are also reported, 2 presenting with hypocalcemia associated with vitamin D deficiency.

Conclusion

This report expands the clinical spectrum associated with KCNJ1 mutations and emphasizes the role of WES in unsolved cases of hypocalcemia when genetic disease is suspected. It also highlights the hazardous effects of phosphate-containing soft drinks on calcium metabolism.
Integrated molecular analysis identifies a conserved pericyte gene signature in zebrafish
Authors: Shih Yu-Huan , Portman Daneal , Idrizi Feston , Grosse Ann , Lawson Nathan D.
Published: November 2021

Pericytes reside in capillary beds where they share a basement membrane with endothelial cells and regulate their function. However, little is known about embryonic pericyte development, in part, due to lack of specific molecular markers and genetic tools. Here, we applied single cell RNA-sequencing (scRNA-seq) of platelet derived growth factor beta (pdgfrb)-positive cells to molecularly characterize pericytes in zebrafish larvae. scRNA-seq revealed zebrafish cells expressing mouse pericyte gene orthologs, and comparison with bulk RNA-seq from wild-type and pdgfrb mutant larvae further refined a pericyte gene set. Subsequent integration with mouse pericyte scRNA-seq profiles revealed a core set of conserved pericyte genes. Using transgenic reporter lines, we validated pericyte expression of two genes identified in our analysis: NDUFA4 mitochondrial complex associated like 2a (ndufa4l2a), and potassium voltage-gated channel, Isk-related family, member 4 (kcne4). Both reporter lines exhibited pericyte expression in multiple anatomical locations, and kcne4 was also detected in a subset of vascular smooth muscle cells. Thus, our integrated molecular analysis revealed a molecular profile for zebrafish pericytes and allowed us to develop new tools to observe these cells in vivo.
Bilateral Post Traumatic Myositis Ossificans of Adductor Longus in a Young Soccer Player: A Case Report and Literature Review
Authors: Iorio Raffaele , Massafra Carlo , Viglietta Edoardo , Mazza Daniele , Ferretti Andrea
Published: November 2021

Myositis ossificans traumatica (MOT) is a self-limiting and self-resolving pathology. In most cases, conservative treatment is chosen as the first step. Surgical treatment is reserved for cases of failure of conservative treatment with persistence of pain and mass. The case presented concerns an 18-year-old soccer player suffering from bilateral adductor longus (AL) MOT results following two different sports injuries. The patient reports the appearance of swelling and palpable mass at the proximal and medial region of the thigh, about 2 cm from the pubic symphysis, along the course of the adductor magnus. The radiological investigation showed the presence of a calcification along the course of the right and left AL muscles. Surgical treatment was considered for the right thigh injury, being symptomatic 1 year after the onset and refractory to other treatments. At 3 months of follow-up, the patient was asymptomatic and completed the rehabilitation program for the recovery of muscle strength and range of motion (ROM). In cases where MOT manifests with resistant pain, ROM restriction and daily activity reduction, surgical excision is the preferred option.
Interobserver reproducibility of contrast-enhanced ultrasound in diabetic nephropathy
Authors: Lin Lin , Wang Yiru , Yan Lin , Li Nan , Tian Xiaoqi , Li Qiuyang , Tang Jie , Luo Yukun
Published: November 2021

Objective:

To investigate the interobserver reproducibility of contrast-enhanced ultrasound (CEUS) in patients with diabetic nephropathy.

Methods:

A total of 40 patients with diabetic nephropathy were enrolled in this retrospective study. We measured peak intensity (PEAK), time-to-peak (TP), area under the curve (AUC) and mean transit time (MTT) of renal CEUS in each patient. Each parameter was performed by two independent observers. The interobserver reproducibility was assessed using intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs) and Bland–Altman plots by mean difference with 95% limits of agreement (LOAs).

Results:

The parameters of the left and right kidneys showed moderate or good reliability. The best was the left kidney AUC parameters (ICC,0.945),with a 95% CI of 0.896–0.971.The Bland–Altman plots showed that the mean differences between the right renal parameters (PEAK, TP, AUC and MTT) obtained between the observers 1 and 2 were −6.63%,2.54%,−11.30%,−2.22%, and the 95% LOAs are −30.78 to 17.52%, −30.15 to 35.23%, −43.95 to 21.35%, −44.50 to 40.06%. While the left ones were −2.89%, 0.32%, −8.26%, 1.25% , and the 95% LOAs were −38.50 to 32.72%, −31.98 to 32.62%, −57.89 to 41.37%, −37.21 to 39.71%, respectively.

Conclusion:

Quantitative CEUS can show good interobserver reproducibility, which is better for the right kidney. It seems necessary to establish standardized techniques for obtaining contrast-enhanced quantitative analysis of renal blood perfusion.

Advances in knowledge:

Quantitative assessment of renal perfusion by CEUS in patients with diabetic nephropathy provides diagnostic information. Furthermore, renal perfusion assessment in patients with diabetic nephropathy using CEUS has good reproducibility.
Neanderthal archaeology in MIS 3 Western Europe
Authors: Γαρεφαλάκης Χαράλαμπος
Published: November 2021

Η διατριβή αυτή ασχολείται μετην κατοίκηση συγκεκριμένων περιοχών της Δυτικής Ευρώπης, κατά την πρώιμη περίοδο του Ισοτοπικού Σταδίου 3, δηλαδή μεταξύ 60.000 και 40.000 χρόνια πριν από σήμερα. Εξετάζει τα αρχαιολογικά δεδομένα, με έμφαση στα λίθινα εργαλεία,από τη Βρετανία, το Βέλγιο και τη Νοτιοδυτική Γαλλία με σκοπό να φωτίσει την κατοίκηση αυτών των περιοχών, τόσο σε συγχρονικό, όσο και σε διαχρονικό επίπεδο. Για το σκοπό αυτό χρησιμοποιούνται δύο ερμηνευτικά μοντέλα. Το πρώτο ενσωματώνει αρχαιολογικά, κλιματικά και περιβαλλοντικά δεδομένα, ενώ το δεύτερο συνδυάζει τα αρχαιολογικά δεδομένα με εθνογραφικές πληροφορίες από τη ζωή των σύγχρονων κυνηγών-τροφοσυλλεκτών και την οικολογία των σύγχρονων κοινωνικών σαρκοβόρων ζώων. Τα δύο μοντέλα δοκιμάζονται σε επιλεγμένες θέσεις από τις τρεις περιοχές και η κάθε περιοχή εξετάζεται αρχικά σα μια ξεχωριστή μελέτη περίπτωσης. Τα αποτελέσματα για την κάθε θέση συζητούνται ξεχωριστά και στη συνέχεια γίνεται μια συνολική αποτίμηση για την κάθε μελέτη περίπτωσης. Όλα τα δεδομένα και από τις τρεις περιοχές εξετάζονται μαζί στο τέλος τη διατριβής και ακολουθεί συζήτηση των αποτελεσμάτων. Τα δεδομένα που προκύπτουν από αυτή την προσέγγιση, συνολικά, παραπέμπουν σε πιθανές μετακινήσεις των Νεάντερταλ, μεταξύ των τριών περιοχών, ως αντίδραση στις κλιματικές και περιβαλλοντικές αλλαγές κατά το Ισοτοπικό Στάδιο 3. Επίσης, παραπέμπουν σε ένα βαθμό ποικιλίας στον τρόπο που οι Νεάντερταλ χρησιμοποιούσαν το περιβάλλον τους που δε μπορεί να εξηγηθεί με τα συνήθη άκαμπτα ερμηνευτικά μοντέλα για τη χρήση των θέσεων.
Artificial cognitive systems: the next generation of the digital twin. An opinion.
Authors: Jones David
Published: November 2021

The digital twin is often presented as the solution to Industry 4.0 and, while there are many areas where this may be the case, there is a risk that a reliance on existing machine learning methods will not be able to deliver the high level cognitive capabilities such as adaptability, cause and effect, and planning that Industry 4.0 requires. As the limitations of machine learning are beginning to be understood, the paradigm of strong artificial intelligence is emerging. The field of artificial cognitive systems is part of the strong artificial intelligence paradigm and is aimed at generating computational systems capable of mimicking biological systems in learning and interacting with the world. This paper presents an argument that artificial cognitive systems offer solutions to the higher level cognitive challenges of Industry 4.0 and that digital twin research should be driven in the direction of artificial cognition accordingly. This argument is based on the inherent similarities between the digital twin and artificial cognitive systems, and the insights that can already be seen in aligning the two approaches.
The changing face of MedEdPublish
Authors: Hays Richard , Gibbs Trevor , Hunt Julie , Jennings Barbara , Masters Ken
Published: November 2021

MedEdPublish has come a long way since it was launched in 2016 by AMEE as an independent academic e-journal that supports scholarship in health professions education. Beginning as a relatively small, in-house publication on a web platform adapted for the purpose, we invited members of our community of practice to submit articles on any topic in health professions education, and encouraged a wide range of article types. All articles were published so long as they met editing criteria and where within scope. Reviews were welcomed from both members of our Review panel and the general readership, all published openly with contributors identified. Many articles attracted several reviews, responses and comments, creating interactive discussion threads that provided learning opportunities for all. The outcome surpassed our expectations, with over 500 articles submitted during 2020, beyond the capacity of our editing team and platform to achieve our promise of rapid publishing. We have now moved to a much larger and powerful web platform, developed by F1000 Research and within the Taylor and Francis stable, the home of AMEE’s other journal, Medical Teacher. Most of our innovations are supported by the new platform and there is scope for further developments. We look forward to an exciting new phase of innovation, powered by the F1000 platform.
Emergency Rapid Response to Epileptic Seizures - A Novel IOT Framework for Smart Cities
Authors: Ziyad Shabana R , Ziyad Armaan
Published: November 2021

Epilepsy is a common neurological disorder that results in seizures in patients of all ages. The frequency of seizure episodes can be controlled by prescribing anti-seizure drugs. Drug-resistant epilepsy is a condition where the seizures are uncontrolled by strong medications. Such patients are at a high risk of getting seizures frequently and prone to injuries due to sudden falls. Many countries prohibit epileptic patients from driving as sudden seizure attacks can cause loss of lives and property. In the past decades immense work has been carried out in the to monitor the seizure activity in patients and alert caregivers to extend help in emergencies. The study proposes a smart health care Internet of things framework to provide immediate help to the epileptic patient during an episode while travelling in a self-driving car. In the proposed framework, the seizure alert from a wearable device of the patient is transmitted to the control application via cloud. The control application also receives data from the vision, ultrasonic, and radar sensors. The critical information of seizure alert and the sensor data commands the car to force stop. The seizure google map location of the car is sent to the patient’s caregiver as well as the registered hospital. Many applications are being developed to provide luxury and comfort to fully automated car drivers. Far from providing luxury to the driver Emergency Rapid Response to Epileptic Seizure aims to propose a solution that could save the life of an epileptic patient who is drug-resistant or prone to frequent attacks despite severe medications. The experimental results on synchonization of clouds show that the minimum time is 30 sec 30 ms and maximum time is 31 sec 63 ms. The experimental results prove that its recommended to alert the patient's caregiver directly from control application rather than alerting via cloud.
PERFORMANCE OF ADDITIVELY MANUFACTURED CHOPPED FIBER COMPOSITES AS A FUNCTION OF POROSITY
Authors: GEISE LUKE , ABBOTT ANDREW , RAPKING DANIEL , FLORES MARK
Published: November 2021

Additive manufacturing (AM) of short-fiber reinforced composites are actively being considered for construction of low-cost, weight reducing alternatives to non-structural metal components. In addition AM parts are being used for rapid manufacturing of composite tooling. AM is notorious for generating parts with higher porosity than more traditional manufacturing technologies. Due to the aerospace industry’s low risk tolerance, novel material systems require comprehensive characterization of their associated manufacturing defects and the impact of defects on performance in order to receive certification. AM short fiber composites still require this analysis. Although traditional composite manufacturing methods, such as an autoclave or VARTM can produce porosity, the origin and transport of porosity has been thoroughly studied and acceptable limits for part qualification have been established to minimize the effect on performance. In AM components studies establishing the origination of porosity origin and processing defect related minimization strategies are lacking. A preliminary study on the impacts of porosity caused by print parameters such print speed, layer height, first layer height, and step-over distance has been undertaken. Direct Ink Writing (DIW) was selected for this study using an epoxy-based ink filled with clay and chopped carbon fiber. To understand performance, fracture and shear specimens were fabricated with different test parameters based on the assumed levels of porosity from screening tests. Samples were then mechanically tested using a novel in-plane shear test method and a single edge notch tension test. This study explores the processing parameter’s contribution to porosity and establishes general trends to understand the influence of porosity on performance for additively manufactured chopped fiber composites.
THREE-DIMENSIONAL HEAT TRANSFER ANALYSIS OF HOT GAS TORCH (HGT)-ASSISTED AUTOMATED FIBER PLACEMENT OF THERMOPLASTIC COMPOSITES
Authors: ZACHERL LORENZ , FONTES ALLYSON , SHADMEHRI FARJAD
Published: November 2021

In-situ manufacturing of thermoplastic composites using the Automated Fiber Placement (AFP) process consists of heating, consolidation, and solidification steps. During the heating step using Hot Gas Torch (HGT) as a moving heat source, the incoming tape and the substrate are heated up to a temperature above the melting point of the thermoplastic matrix. The convective heat transfer occurs between the hot gas flow and the composites in which the convective heat transfer coefficient h plays an important role in the heat transfer mechanism, which in turn significantly affects temperature distribution along the length, width, and through the thickness of the deposited layers. Temperature is the most important process parameter in AFP in-situ consolidation that affects bonding quality, crystallization, and consolidation. Although it is well known that the convective heat transfer coefficient h is not constant and has a distribution, most studies have assumed a constant value for h for heat transfer analysis, which leads to discrepancies between numerical and experimental results. It has already been shown by the authors that, unlike other studies assuming constant h value, using a distribution function to approximate the convective heat transfer coefficient h in a three-dimensional finite element transient heat transfer analysis the temperature distribution can be well predicted in thermoplastic composite parts and matches experimental data. In this study, the use of the proposed h distribution function is analysed and validated by several measuring points. Furthermore, experimental trials are carried out to validate the results from the simulation.
DIRECT-INK-WRITING (DIW) OF HIGHER WEIGHT CONCENTRATION OF MILLED CARBON FIBER (MCF) REINFORCED EPOXY COMPOSITE
Authors: MONDAL ANIRBAN , MAITY KUNTAL , SAHA MRINAL C. , LIU YINGTAO
Published: November 2021

Additive manufacturing or 3D printing of short carbon fiber composites is highly inclined toward thermoplastic material. Recently, there is some interest in developing 3D printing technology for thermosetting polymers and composites. Direct-ink-writing (DIW) of short fiber epoxy composites containing milled carbon fibers (MCF) exhibits the potential to replace the traditional composite material as it showcases the inherent capability of fabricating complex geometries, facile material processing, continuous printing capability coupled with low cost. Previous research in 3D printing of short carbon fiber epoxy composites suffered heavily from the limitation of printing low carbon fiber weight concentrations. This study developed a straightforward technique of designing the epoxy ink containing high weight concentration MCF (~40wt%) and a small concentration of thixotropic filler (3-wt%) for DIW using a pneumatic pressure-driven extruder having micron size tapered nozzle. This paper also intends to contribute to a better understanding of the effect of printing parameters on DIW. Furthermore, the printing parameters were optimized using non-dimensionalized constant C. Optimized printing condition was further used to print different geometry ranging from dog bone with 100% infill to 4-layer hollow circle and 3-layer hollow square with 0% infill. Lastly, ink exhibits the capability to self-support multi-layer geometrical structures during printing.
ANALYSIS OF PRINTING PARAMETERS IN 3D PRINTED CARBON FIBER COMPOSITES USING DESIGN OF EXPERIMENTS
Authors: SYCHLA JAKUB , ZHANG CHAO , TAN K. T.
Published: November 2021

Additive manufacturing of carbon fiber reinforced polymers (CFRP) provides the advantage of quick prototyping of complex geometries, while maintaining light-weight characteristics and keeping structural integrity. This paper presents flexural strength data from 3D printing of an onyx and carbon fiber composites. A MarkForged Mark 2 3D printer, with a dual printer head, is used to 3D print several configurations of CFRP composites. The configurations are set to examine the extreme parameters of the rectangular fill pattern, including fill density, roof and floor layers, and wall layers. The print angle along with the fill pattern stays consistent. Each sample comprises twenty- four layers of CFRP and undergoes a three-point bend test. Test data of load, deflection, and maximum stress are compared among the different configurations. Results show that the roof/floor layer has the largest impact on the flexural strength for each configuration. The configurations with less roof/floor layers are able to take on a larger load, because there are more CFRP layers present; while specimens with more roof/floor layers withstand less load and behave more ductile. These results show that the amount of roof/floor layers can change the CFRP composite from its usual brittle characteristic to a ductile behavior.
BRIDGING OF CARBON FIBERS IN CF/EPOXY COMPOSITES USING ELECTROSTATICALLY INDUCED CNT ALIGNMENT
Authors: ZHANG DANDAN , SHE XINGKANG , HE YIPENG , CHAPKIN, WESLEY A. , BREGMAN VI T. , WANG RUMIN , TAUB ALAN
Published: November 2021

Carbon fiber reinforced polymer (CFRP) composites are lightweight materials with superior strength but are expensive due to the increased cost of carbon fibers (CFs). The addition of carbon nanotubes (CNTs) to polymer nanocomposites are becoming an excellent alternative to CF due to their unique combination of electrical, thermal, and mechanical properties. With the application of an electric field across the CNT/polymer mixture before curing, CNTs will not only be aligned along the electric field direction, but also form networks after reaching to a certain degree of alignment. In this study, an alternating current (AC) electric field was applied continuously to CNT/CF/Epoxy hybrid composites before curing. By cutting off the applied voltage when the monitored electric current increased, the degree of networking of CNTs between two CF tows was controlled. The relative electric field strength around the end of conductive carbon fiber tows in the epoxy matrix was modeled using COMSOL Multiphysics. It increased after applying AC electric field parallel to the CF tows, thereby increasing the alignment degree of CNTs and building a network to bridge the CF tows. The preliminary results indicate that the microhardness and tensile modulus between two CF tows are increased due to the networking of CNTs in this area. The fracture surface of the specimens after tensile tests were characterized to reveal more details of the microstructure.
INTRODUCTION TO C3HARME PROJECT
Authors: ZOLI LUCA , SCITI DILETTA
Published: November 2021

High-speed aviation brings many challenges, one being the materials used ensure the aircraft and rockets travelling at hypersonic speed arrive at their destination safely. Control surfaces and thermal protection systems for vehicles flying at Mach 5 or above must withstand extremely hot temperatures and intense mechanical vibrations at launch, during cruising and re-entry into the Earth’s atmosphere. UHTCMCs (Ultra-High Temperature Ceramic Matrix Composites) belong to a new subclass of ceramic matrix composites (CMCs) with superior properties in terms of structural and chemical stability at elevated temperature and erosion/ablation resistance keeping excellent strength-to-weight ratio, thermal shock resistance and adequate damage tolerance. They are the latest potential candidates for thermal protection systems (TPSs), able to outperform bulk ultra-high temperature ceramics (UHTCs). C3HARME is a 4-years EU funded program involving 12 European partners from 6 countries focused on the design, fabrication and testing of UHTCMCs for nearzero erosion nozzles and near-zero ablation TPS tiles. C3harme will look at different technologies coming from the science of bulk ceramics and CMCs and combine them to find out new approaches for their manufacturing. Novel theoretical models and testing methodologies are necessary to characterize properly these materials. This talk will summarize some of the findings and advances of the program, with special emphasis on the innovative approaches that we have implemented.