bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond the gyrotropic motion: Dynamic C-state in vortex spin torque oscillators
Authors: Wittrock Steffen , Talatchian Philippe , Romera Miguel , Menshawy Samh , Jotta Garcia Mafalda , Cyrille Marie-Claire , Ferreira Ricardo , Lebrun Romain , Bortolotti Paolo , Ebels Ursula , Grollier Julie , Cros Vincent
Published: January 2021

In the present study, we investigate a dynamical mode beyond the gyrotropic (G) motion of a magnetic vortex core in a confined magnetic disk of a nano-pillar spin torque nano-oscillator (STNO). It is characterized by the in-plane circular precession associated with a C-shaped magnetization distribution. We show a transition between G- and C-state modes, which is found to be stochastic in a current-controllable range. Supporting our experimental findings with micromagnetic simulations, we believe that the results provide further opportunities for the dynamic and stochastic control of STNOs, which could be interesting to be implemented, for example, in neuromorphic networks.
Robust ferroelectric polarization retention in harsh environments through engineered domain wall pinning
Authors: Zhang Dawei , Sando Daniel , Pan Ying , Sharma Pankaj , Seidel Jan
Published: January 2021

Robust retention of ferroelectric polarization in harsh environments is a requirement for the application of ferroelectric materials in space, liquids, and various chemical conditions. Surface screening of the polarization can significantly alter domain states and usually has a strong influence on domain stability in ferroelectrics, hindering applications that require defined and non-volatile polarization states. Here, we show that designer defects in BiFeO3 can be engineered to strongly pin domain walls, which even in harsh environments such as 100% humidity and elevated temperatures of 175 °C leads to a superior polarization retention of several years for domain sizes well below 100 nm.
Assessment of unsteady flow predictions using hybrid deep learning based reduced-order models
Authors: Bukka Sandeep Reddy , Gupta Rachit , Magee Allan Ross , Jaiman Rajeev Kumar
Published: January 2021

In this paper, we present two deep learning-based hybrid data-driven reduced-order models for prediction of unsteady fluid flows. These hybrid models rely on recurrent neural networks (RNNs) to evolve low-dimensional states of unsteady fluid flow. The first model projects the high-fidelity time series data from a finite element Navier–Stokes solver to a low-dimensional subspace via proper orthogonal decomposition (POD). The time-dependent coefficients in the POD subspace are propagated by the recurrent net (closed-loop encoder–decoder updates) and mapped to a high-dimensional state via the mean flow field and the POD basis vectors. This model is referred to as POD-RNN. The second model, referred to as the convolution recurrent autoencoder network (CRAN), employs convolutional neural networks (instead of POD) as layers of linear kernels with nonlinear activations, to extract low-dimensional features from flow field snapshots. The flattened features are advanced using a recurrent (closed-loop manner) net and up-sampled (transpose convoluted) gradually to high-dimensional snapshots. Two benchmark problems of the flow past a cylinder and the flow past side-by-side cylinders are selected as the unsteady flow problems to assess the efficacy of these models. For the problem of the flow past a single cylinder, the performance of both the models is satisfactory and the CRAN model is found to be overkill. However, the CRAN model completely outperforms the POD-RNN model for a more complicated problem of the flow past side-by-side cylinders involving the complex effects of vortex-to-vortex and gap flow interactions. Owing to the scalability of the CRAN model, we introduce an observer-corrector method for calculation of integrated pressure force coefficients on the fluid–solid boundary on a reference grid. This reference grid, typically a structured and uniform grid, is used to interpolate scattered high-dimensional field data as snapshot images. These input images are convenient in training the CRAN model, which motivates us to further explore the application of the CRAN-based models for prediction of fluid flows.
Effect of nitrogen capture ability of quantum dots on resistive switching characteristics of AlN-based RRAM
Authors: Duan Yiwei , Gao Haixia , Guo Jingshu , Yang Mei , Yu Zhenxi , Shen Xuping , Wu Shuliang , Sun Yuxin , Ma Xiaohua , Yang Yintang
Published: January 2021

This Letter studies the effect of the nitrogen capture ability of quantum dots on resistive switching characteristics of AlN-based resistive random access memory. We prepared a single layer AlN device and four types of AlN/PbS quantum dot stacked structure devices with different concentrations. Compared with the single layer AlN device, the AlN/PbS quantum dot stacked structure devices exhibit excellent resistive switching characteristics, such as forming-free, low power consumption, and excellent stability. We propose that the resistive switching process is determined by the migration of nitrogen ions and the lead sulfide (PbS) quantum dot layer as a natural nitrogen ion reservoir, which can improve the resistive switching characteristics. Moreover, the size of the natural nitrogen ion reservoir can be modulated by changing the concentration of quantum dots.
Enhancing hyperspectral EELS analysis of complex plasmonic nanostructures with pan-sharpening
Authors: Borodinov Nikolay , Banerjee Progna , Cho Shin Hum , Milliron Delia J. , Ovchinnikova Olga S. , Vasudevan Rama K. , Hachtel Jordan A.
Published: January 2021

Nanoscale hyperspectral techniques—such as electron energy loss spectroscopy (EELS)—are critical to understand the optical response in plasmonic nanostructures, but as systems become increasingly complex, the required sampling density and acquisition times become prohibitive for instrumental and specimen stability. As a result, there has been a recent push for new experimental methodologies that can provide comprehensive information about a complex system, while significantly reducing the duration of the experiment. Here, we present a pan-sharpening approach to hyperspectral EELS analysis, where we acquire two datasets from the same region (one with high spatial resolution and one with high spectral fidelity) and combine them to achieve a single dataset with the beneficial properties of both. This work outlines a straightforward, reproducible pathway to reduced experiment times and higher signal-to-noise ratios, while retaining the relevant physical parameters of the plasmonic response, and is generally applicable to a wide range of spectroscopy modalities.
Enabling the complete mode conversion of Lamb waves into shear horizontal waves via a resonance-based elastic metamaterial
Authors: Tian Yiran , Shen Yanfeng , Qin Xianggui , Yu Zhengyue
Published: January 2021

Manipulating the conversion phenomena among different wave modes is of great interest within the physics and engineering communities. In this Letter, a resonant elastic metamaterial is elaborately designed to achieve complete conversion from Lamb modes (A0 and S0) into the fundamental shear horizontal (SH0) mode. The key to achieving this interesting behavior resides in the design of a pillared perforated metamaterial, providing the strong coupling between the stub modes in shear resonant motion and the plate modes in the substrate medium. Both numerical modeling and experimental verification are conducted to validate the achievement of the mode conversion phenomenon.
Thermo physical properties and pressure induced phase transition in thorium and uranium sesquicarbide (Th2C3, U2C3)
Authors: Sahoo B. D. , Joshi K. D.
Published: January 2021

Carbides of actinide metals thorium and uranium are the potential candidates as a nuclear fuel for generation IV advanced reactors. With the aim to search for new probable structures under high pressures and to determine the thermo mechanical properties of two candidates Th2C3 and U2C3 of actinide–carbon system, the ab initio calculations in conjunction with an evolutionary structure search algorithm have been performed up to the pressure range of 200 GPa. Apart from reproducing the already established bcc structure at zero pressure, the calculations could predict the existence of some new high pressure phases such as orthorhombic structures (SG No. 69, Fmmm) and (SG No. 65, Cmmm) at 62 GPa and 120 GPa, respectively, for Th2C3 and triclinic phase (SG No. 2, P1¯) at 57 GPa for U2C3. In U2C3, the effect of including the Hubbard potential (GGA + U = 3 eV) and spin–orbit coupling on structural, electronic, vibrational properties, and pressure induced phase transitions has also been studied. Furthermore, to substantiate the stability of the high pressure structures so predicted by comparing the enthalpies, the elastic and lattice dynamic stability analysis has also been carried out. Additionally, the high temperature thermo-physical properties of Th2C3 and U2C3 in the cubic phase derived from the present lattice dynamic calculations within quasiharmonic approximations have been compared with the experimental data reported in the literature.
Study of impact velocity and curvature ratio on the dynamic characteristics of double droplets impacting super-hydrophobic tubes
Authors: Wang Kaimin , Chen Han , Ge Hongyu , Liu Xiaohua , Liu Hongsheng , shen Shengqiang
Published: January 2021

In this paper, the impact of successive double droplets on a super-hydrophobic tube surface is numerically studied using a three-dimensional model by the coupled level set and volume of fluid method. The effect of impact velocity on double droplets impact under different curvature ratios is studied. With the increase in impact velocity, two kinds of impact models (out-of-phase and in-phase impact) are obtained, and the coalescent liquid film presents rebound, breakup-rebound, and splash-rebound. With the increase in the curvature ratio, the spread of the liquid film along the circumferential direction is promoted, and the rim of leading liquid film up-warp can be observed earlier. The breakup of an extending liquid film is discussed in detail under the curvature ratio of 1, which is mainly influenced by the combined effects of local negative pressure, air flow motion, surface tension, and gravity of the gathering liquid. The air entrainment occurs for the impact velocity between 0.75 m/s (We = 15.4) and 1.25 m/s (We = 42.9), while no air entrainment occurs for the impact velocity exceeding 1.5 m/s (We = 61.7). The entrapped air bubbles would cause a center breakup of the liquid film or escape from the liquid film. The escaping direction is mainly determined by the pressure distribution in the liquid film.
Doping of ultra-thin Si films: Combined first-principles calculations and experimental study
Authors: Gity Farzan , Meaney Fintan , Curran Anya , Hurley Paul K. , Fahy Stephen , Duffy Ray , Ansari Lida
Published: January 2021

This paper presents comprehensive density functional theory-based simulations to understand the characteristics of dopant atoms in the core and on the surface of ultra-thin sub-5 nm Si films. Quantum confinement-induced bandgap widening has been investigated for doped Si films considering two different doping concentrations. Thickness-dependent evolution of dopant formation energy is also extracted for the thin films. It is evident from the results that doping thinner films is more difficult and that dopant location at the surface is energetically more favorable compared to core dopants. However, the core dopant generates a higher density of states than the surface dopant. Projecting the carrier states in the doped Si film onto those of a reference intrinsic film reveals dopant-induced states above the conduction band edge, as well as perturbations of the intrinsic film states. Furthermore, to experimentally evaluate the ab initio predictions, we have produced ex situ phosphorus-doped ultra-thin-Si-on-oxide with a thickness of 4.5 nm by the beam-line ion implantation technique. High-resolution transmission electron microscopy has confirmed the thickness of the Si film on oxide. Transfer length method test structures are fabricated, and the temperature-dependent electrical characterization has revealed the effective dopant activation energy of the ion-implanted phosphorus dopant to be ≤ 13.5 meV, which is consistent with our theoretical predictions for comparable film thickness. Ultra-thin Si films are essential in the next generation of Si-based electronic devices, and this study paves the way toward achieving that technology.
Herbaceous legumes provide several options for increasing beef cattle productivity in eastern Indonesia
Authors: Mayberry Dianne , Hau Debora Kana , Dida Philip Rido , Bria Dionisius , Praing Jefrianus , Mata Agustinus Dule , Budisantoso Esnawan , Dalgliesh Neal , Quigley Simon , Bell Lindsay , Nulik Jacob
Published: January 2021

Context Increasing demand for livestock products in developing countries provides opportunities for smallholder farmers to increase and diversify their income through increased livestock production. However, livestock production in these systems is often limited by inadequate animal nutrition, and farmers need ways to increase the availability and quality of livestock feed without compromising yields of food crops or increasing the area of land planted to forages. Aim Using eastern Indonesia as a case study, we explore the potential for herbaceous legumes, integrated into existing mixed crop–livestock systems, to address specific production issues in smallholder beef systems. Methods Through a series of in-village feeding demonstrations, we tested three opportunities to increase livestock production through the use of herbaceous legumes: (i) increasing reproduction rates of cows by maintaining their liveweight (LW) and body condition score during the dry season; (ii) increasing the survival and LW gain of unweaned calves; and (iii) increasing LW gain of growing bulls. Key results Small amounts of legume (~10 g DM/kg LW) were enough to maintain LW of cows grazing poor-quality grasses and crop residues during the dry season. At higher levels of inclusion in the diet (~20 g DM/kg LW), feeding legumes increased the LW gain of growing cattle and survival of unweaned calves, providing benefits similar to a purchased concentrate, but at lower cost. Conclusions Our results demonstrate how strategic use of herbaceous legumes can increase beef production from low-input systems by maintaining LW of cows, and increasing survival of unweaned calves and LW gain of growing bulls. Implications Integration of herbaceous legumes into existing cropping systems removes many of the barriers to supplementary feeding. Improved livestock nutrition does not need to be based on purchased concentrates or increases in land used for forage production. The results are applicable to many other mixed crop–livestock systems throughout Southeast Asia.
Single-cell transcriptomic analysis reveals the immune landscape of lung in steroid-resistant asthma exacerbation
Authors: Wang Lingli , Netto Keilah G. , Zhou Lujia , Liu Xiaojie , Wang Ming , Zhang Guojun , Foster Paul S. , Li Fuguang , Yang Ming
Published: January 2021

Significance

Asthma exacerbation is not prevented by standard corticosteroid-based therapy and is the major burden in terms of morbidity, mortality, and health care costs associated with asthma. Etiology of disease exacerbation is highly heterogeneous. Using single-cell RNA deep sequencing, we undertook a large-scale, high-dimensional analysis of the immune landscape in lung following dexamethasone treatments in a mouse model of asthma exacerbation. We found multicellular signaling pathways closely associated with disease progression during the exacerbation. IL-13 produced by CD8+memory T cells, ILC2, and basophils is key a cytokine in driving the pathogenesis of asthma exacerbation in this model. These data provide important insights into how the immune landscape in lung during asthma exacerbation can shape the progress of disease.
Six-year follow-up study of residential displacement and health outcomes following the 2011 Japan Earthquake and Tsunami
Authors: Hikichi Hiroyuki , Aida Jun , Kondo Katsunori , Kawachi Ichiro
Published: January 2021

Significance

The long-term health consequences of residential relocation following large-scale natural disasters remain poorly understood. We implemented a longitudinal study following the 2011 Earthquake and Tsunami in which survivors were relocated to temporary housing by different means: group relocation versus individual relocation. Group relocation was adversely associated with weight gain and depressive symptoms. An implication of our findings is that moving survivors into a highly dense environment conducive to social gatherings may paradoxically promote unhealthy changes in behavior (e.g., drinking and snacking). By contrast, we found that individual relocation was associated with deteriorated instrumental activities of daily living and cognitive function. The resettlement of survivors can have complex effects on physical and mental well-being, depending on the method of relocation.
Lessons being learned from the Covid-19 pandemic for radiological emergencies and vice versa: report from expert discussions
Authors: Martell Meritxell , Perko Tanja , Zeleznik Nadja , Molyneux-Hodgson Susan
Published: January 2021

In order to examine what lessons radiological emergency management may offer for the management of the Covid-19 pandemic, and vice versa, a series of three online webinars were conducted with leading experts, scholars and practitioners from a wide range of disciplines essential for emergency management and long-term risk governance. The first webinar debated the lessons we are learning from the Covid-19 pandemic for radiological risk communication, the second explored issues around longer-term outcomes of a crisis and how to balance these with short-term actions whilst the third focused on the key challenges of the ‘transition phase’, using lessons learned from the Chernobyl (1986) and Fukushima Daichii (2011) accidents. This paper reviews the discussions and provides valuable lessons for the radiation protection community. Results of the discussions indicated that: (a) non-radiological and non-epidemiological consequences of emergencies, for example psychological (mental health), societal and economic, should not be underestimated; (b) multidisciplinary expertise is imperative for communication efforts and for effective emergency management, including decision-making in the application of protective measures; (c) stakeholder engagement, including the involvement of the potentially affected population, should be encouraged from an early stage; and (d) trust is increased if policy-makers and the main science agencies show a unified voice.
Magneto-induced Mullins effect of anisotropic MREs under compression mode
Authors: Gan Ruyi , Qi Song , Zhao Yi , Fu Jie , Li Shixu , Li Yaping , Yu Miao
Published: January 2021

The filled elastomer materials exhibit obvious stress-softening phenomenon after initial stretching, which is called the Mullins effect. Since magnetorheological elastomers tend to work under a magnetic field, it will show a different magneto-induced Mullins effect of traditional materials. Therefore, in this paper, the effects of anisotropy, magnetic flux density, pre-strain and compression times on the magneto-induced Mullins effect were studied by rheometer. The results demonstrated that, under a fixed magnetic flux density, when the arrangement of magnetic particles is perpendicular to the magnetic field, the residual strain energy of the material is the smallest. This indicates that the magneto-induced Mullins effect is the weakest and the stability of the material is the best. Meanwhile, when the compression pre-strain is constant, the materials will show an obvious stress-hardening phenomenon under magnetic field. When the arrangement of magnetic particles is 30° to the magnetic field, the force between the particles is the smallest. This indicates that the magneto-induced Mullins effect is the weakest and the performance stability is the best. At the same time, this paper attempts to establish the corresponding model of the magneto-induced Mullins effect from the perspective of strain energy. The error between the fitting and the experimental results is less than 3%, which shows that the model can well explain the phenomena obtained in the experiment.
Direct comparison of ITS-90 and PLTS-2000 from 0.65 K to 1 K at LNE-CNAM
Authors: Pan Changzhao , Sparasci Fernando , Plimmer Mark , Risegari Lara , Daugas Jean-Michel , Rouille Gérard , Gao Bo , Pitre Laurent
Published: January 2021

In the temperature range between 0.65 K and 1 K, the international temperature scale of 1990 (ITS-90) is based on 3He vapour–pressure thermometers and overlaps with the provisional low temperature scale of 2000 (PLTS-2000) defined by the melting pressure of 3He. An indirect comparison at PTB revealed differences between the two scales of up to 1.5 mK at 0.65 K (Engert et al 2007 Metrologia 44 40–52). Stimulated by the PTB results, we have performed a direct comparison T
90–T
2000 from 0.65 K to 1 K at LNE-CNAM. To test repeatability, the experiment was conducted twice: in 2019 and 2020. We find differences T
90–T
2000 of 0.28 mK at 1 K, increasing to 1.58 mK at 0.65 K. The direct comparison, eliminates the uncertainty component due to the transfer resistance thermometer and its calibration. Except for a point near 1 K, the new results are in accordance with those obtained at PTB (differences of less than 0.22 mK), which makes it possible to improve the accuracy of the equation specified in ITS-90.
Multiscale space-time-frequency feature-guided multitask learning CNN for motor imagery EEG classification
Authors: Liu Xiuling , Lv Linyang , Shen Yonglong , Xiong Peng , Yang Jianli , Liu Jing
Published: January 2021

Objective. Motor imagery (MI) electroencephalography (EEG) classification is regarded as a promising technology for brain–computer interface (BCI) systems, which help people to communicate with the outside world using neural activities. However, decoding human intent accurately is a challenging task because of its small signal-to-noise ratio and non-stationary characteristics. Methods that directly extract features from raw EEG signals ignores key frequency domain information. One of the challenges in MI classification tasks is finding a way to supplement the frequency domain information ignored by the raw EEG signal. Approach. In this study, we fuse different models using their complementary characteristics to develop a multiscale space-time-frequency feature-guided multitask learning convolutional neural network (CNN) architecture. The proposed method consists of four modules: the space-time feature-based representation module, time-frequency feature-based representation module, multimodal fused feature-guided generation module, and classification module. The proposed framework is based on multitask learning. The four modules are trained using three tasks simultaneously and jointly optimized. Results. The proposed method is evaluated using three public challenge datasets. Through quantitative analysis, we demonstrate that our proposed method outperforms most state-of-the-art machine learning and deep learning techniques for EEG classification, thereby demonstrating the robustness and effectiveness of our method. Moreover, the proposed method is employed to realize control of robot based on EEG signal, verifying its feasibility in real-time applications. Significance. To the best of our knowledge, a deep CNN architecture that fuses different input cases, which have complementary characteristics, has not been applied to BCI tasks. Because of the interaction of the three tasks in the multitask learning architecture, our method can improve the generalization and accuracy of subject-dependent and subject-independent methods with limited annotated data.
A new method to build multiplex networks using canonical correlation analysis for the characterization of the Alzheimer’s disease continuum
Authors: Ruiz-Gómez Saúl J , Hornero Roberto , Poza Jesús , Santamaría-Vázquez Eduardo , Rodríguez-González Víctor , Maturana-Candelas Aarón , Gómez Carlos
Published: January 2021

Objective. The aim of this study was to solve one of the current limitations for the characterization of the brain network in the Alzheimer’s disease (AD) continuum. Nowadays, frequency-dependent approaches have reached contradictory results depending on the frequency band under study, tangling the possible clinical interpretations. Approach. To overcome this issue, we proposed a new method to build multiplex networks based on canonical correlation analysis (CCA). Our method determines two basis vectors using the source and electrode-level frequency-specific network parameters for a reference group, and then project the results for the rest of the groups into these hyperplanes to make them comparable. It was applied to: (i) synthetic signals generated with a Kuramoto-based model; and (ii) a resting-state electroencephalography (EEG) database formed by recordings from 51 cognitively healthy controls, 51 mild cognitive impairment subjects, 51 mild AD patients, 50 moderate AD patients, and 50 severe AD patients. Main results. Our results using synthetic signals showed that the interpretation of the proposed CCA-based multiplex parameters (multiplex strength, multiplex characteristic path length and multiplex clustering coefficient) can be analogous to their frequency-specific counterparts, as they displayed similar behaviors in terms of average connectivity, integration, and segregation. Findings using real EEG recordings revealed that dementia due to AD is characterized by a significant increase in average connectivity, and by a loss of integration and segregation. Significance. We can conclude that CCA can be used to build multiplex networks based from frequency-specific results, summarizing all the available information and avoiding the limitations of possible frequency-specific conflicts. Additionally, our method supposes a novel approach for the construction and analysis of multiplex networks during AD continuum.
Behavioral Immunity and Social Distancing in the Wild: The Same as in Humans?
Authors: Butler Mark J , Behringer Donald C
Published: January 2021

The COVID-19 pandemic imposed new norms on human interactions, perhaps best reflected in the widespread application of social distancing. But social distancing is not a human invention and has evolved independently in species as dissimilar as apes and lobsters. Epidemics are common in the wild, where their spread is enhanced by animal movement and sociality while curtailed by population fragmentation, host behavior, and the immune systems of hosts. In the present article, we explore the phenomenon of behavioral immunity in wild animals as compared with humans and its relevance to the control of disease in nature. We start by explaining the evolutionary benefits and risks of sociality, look at how pathogens have shaped animal evolution, and provide examples of pandemics in wild animal populations. Then we review the known occurrences of social distancing in wild animals, the cues used to enforce it, and its efficacy in controlling the spread of diseases in nature.
Getting Real About Youth Substance Use and Crime: How ‘Realistic’ Theories can Improve Knowledge and Understanding for Practice
Authors: Turner Russell
Published: January 2021

Set against a backdrop of a need to develop new theories of youth ‘risk’ behaviour, a groundwork for how such theoretical work might be undertaken is described. Meta-theoretical principles from critical realism are used to help clarify issues such as causality in an open world, adolescents as stratified social agents, and science as a value-laden practice. A methodology for developing fallibilistic, context-sensitive knowledge is also outlined. These principles are applied to two influential risk behaviour theories—the social development model and problem behaviour theory—to illustrate how existing theory can be clarified and developed. In particular, current theories may negate adolescent agency in relation to different socio-ecological contexts. Moreover, there is a need for greater reflexivity about the moral frameworks that implicitly guide theory and thus practice. Examples of quantitative empirical studies are also discussed to demonstrate how they contribute towards building realistic theories for prevention practice.
Adjuvanted Influenza Vaccine and Influenza Outbreaks in US Nursing Homes: Results From a Pragmatic Cluster-Randomized Clinical Trial
Authors: Gravenstein Stefan , McConeghy Kevin W , Saade Elie , Davidson H Edward , Canaday David H , Han Lisa , Rudolph James , Joyce Nina , Dahabreh Issa J , Mor Vince
Published: January 2021

Background

Influenza outbreaks in nursing homes pose a threat to frail residents and occur even in vaccinated populations. We conducted a pragmatic cluster-randomized trial comparing adjuvanted trivalent influenza vaccine (aTIV) versus trivalent influenza vaccine (TIV). We report an exploratory analysis to compare the effect of aTIV versus TIV on facility-reported influenza outbreaks.

Methods

We evaluated the impact of the intent-to-treat vaccine assignment on outbreaks reported from November 2016 to March 2017. We collected data according to standard CDC definitions for both suspected outbreaks and those with a laboratory-confirmed case and adjusted for facility-level vaccination rates and resident characteristics in nursing homes.

Results

Of 823 randomized nursing homes, 777 (aTIV, n = 387; TIV, n = 390) reported information on influenza outbreaks. Treatment groups had similar characteristics at baseline except for race/ethnicity: homes assigned to TIV had a higher percentage of African-American residents (18.0% vs 13.7%). There were 133 versus 162 facility-reported suspected influenza outbreaks in aTIV versus TIV facilities, respectively; of these, 115 versus 140 were laboratory confirmed. The aTIV group experienced a 17% reduction in suspected (rate ratio, .83; 95% confidence interval, .65–1.05) and laboratory-confirmed (.83; .63–1.06) influenza outbreaks. Covariate adjustment increased the estimated reduction for suspected outbreaks to 21% (.79; .61–.99) and 22% for laboratory-confirmed outbreaks (.78; .60–1.02).

Conclusions

In an exploratory analysis of a cluster-randomized trial we observed 17–21% fewer outbreaks with aTIV than TIV.

Clinical Trials Registration. (NCT02882100).
Controlled experiments to explore the use of a multi-tissue approach to characterizing stress in wild-caught Pacific halibut (Hippoglossus stenolepis)
Authors: Kroska Anita C , Wolf Nathan , Planas Josep V , Baker Matthew R , Smeltz T Scott , Harris Bradley P
Published: January 2021

The integration of multiple tissues in physiological and ecological analyses can enhance methodological approaches, increase applications for data and extend interpretation of results. Previous investigations of the stress response in fish have focused primarily on cortisol levels in a single matrix—blood plasma—which confines interpretations of cortisol levels to a short temporal frame. Epidermal mucus has been proposed as an alternative or complement to plasma that may provide a view to cortisol levels over a different temporal window allowing comparative assessment. Here, we explore the potential for multi-tissue cortisol analysis using both plasma and epidermal mucus in Pacific halibut (Hippoglossus stenolepis). The relative timing at which cortisol increased and decreased in the two matrices as well as cortisol concentrations at estimated peak levels were compared in two trials after (i) inducing cortisol synthesis by adrenocorticotropic hormone (ACTH1–24) administration and (ii) inducing cortisol elimination using cortisol (hydrocortisone, 98%) injection. The ACTH treatment elicited a peak plasma cortisol response approximately 12 hours post-injection, while mucus cortisol concentrations peaked later at approximately 62 hours post-injection. Exogenous cortisol treatments suggested relatively little transfer of cortisol from plasma to mucus, potentially reflecting differential effects of endogenous and exogenous cortisol. Our results suggest the potential utility of mucus as a sampling matrix that provides an extended window for detection of the stress response as compared to plasma. Results also suggest the utility of a multi-tissue approach to cortisol analysis with potential applications to applied fisheries research. Increased understanding of the relative scale of the cortisol response to stress (e.g. capture) will allow researchers and managers to better interpret the physiological condition and survival outcome of fish subjected to regulatory discard.
The 2019 European guidelines on pulmonary embolism illustrated with the aid of an exemplary case report
Authors: Gallo Andrea , Valerio Luca , Barco Stefano
Published: January 2021

Background

The European Society of Cardiology guidelines for the diagnosis and management of acute pulmonary embolism (PE) developed in collaboration with the European Respiratory Society (ERS) has been updated in 2019. Recommendations were added or updated on all stages of the evaluation and management of pulmonary embolism, encompassing diagnosis, early treatment, and long-term management.

Case summary

We illustrate an exemplary case, assembled for the purposes of this review, of a 70-year-old woman who presented at the emergency department with dyspnoea and thoracic pain. She was diagnosed with intermediate–high-risk acute PE and promptly treated with low molecular weight heparin. After 24 h of stay in intensive care unit, she was transferred to the cardiology department and switched to non-vitamin K-dependent oral anticoagulant apixaban 10 mg b.i.d. for 7 days and then 5 mg b.i.d. After discharge from the hospital 8 days later, she received standard-dose apixaban 5 mg b.i.d. for 6 months; the dose was reduced to 2.5 mg b.i.d. for long-term secondary prevention. During follow-up, investigations for PE sequelae were performed due to persisting dyspnoea.

Discussion

This exemplary case report puts into context the main novel recommendations from the 2019 ESC Guidelines, including the combination of clinical (pre-test) probability and adjusted D-dimer cut-offs for diagnosis of acute PE, the key role of right ventricular dysfunction in risk stratification, the choice and dosage of oral anticoagulant agents in early and extended anticoagulation, and the identification and management of chronic sequelae in the long-term follow-up.
Chemoprevention Agents to Reduce Mammographic Breast Density in Premenopausal Women: A Systematic Review of Clinical Trials
Authors: Salazar Ana S , Rakhmankulova Malika , Simon Laura E , Toriola Adetunji T
Published: January 2021

Background

Higher mammographic breast density (MBD) is associated with an increased risk of breast cancer when compared with lower MBD, especially in premenopausal women. However, little is known about the effectiveness of chemoprevention agents in reducing MBD in premenopausal women without a history of breast cancer. Findings from this review should provide insight on how to target MBD in breast cancer prevention in premenopausal women with dense breasts.

Methods

We searched 9 electronic databases for clinical trials in English, Spanish, French, or German published until January 2020. Articles evaluating the association of pharmacological agents and MBD were included. Data were extracted on methods, type and dose of intervention, outcomes, side effects, and follow up. Quality of the studies was assessed using the US Preventive Services Task Force criteria.

Results

We identified 7 clinical trials evaluating the associations of 6 chemoprevention agents with changes in MBD in premenopausal women without history of breast cancer. The studies evaluated selective estrogen-receptor modulators (n = 1); gonadotropin-releasing hormone agonists (n = 2); isoflavones (n = 1); vitamin D (n = 1); and Boswellia, betaine, and mayo-inositol compound (n = 1). Hormonal interventions were associated with net reductions in percent density (tamoxifen [13.4%], leuprolide acetate [8.9%], and goserelin [2.7%]), whereas nonhormonal (vitamin D and isoflavone) interventions were not. However, MBD returned to preintervention baseline levels after cessation of gonadotropin-releasing hormone agonists.

Conclusions

A limited number of chemoprevention agents have been shown to reduce MBD in premenopausal women. Identification of new and well-tolerated chemoprevention agents targeting MBD and larger studies to confirm agents that have been studied in small trials are urgent priorities for primary breast cancer prevention in premenopausal women with dense breasts.
Collecting Objective Measures of Visual and Auditory Function in a National in-Home Survey of Older Adults
Authors: Hu Mengyao , Freedman Vicki A , Ehrlich Joshua R , Reed Nicholas S , Billington Catherine , Kasper Judith D
Published: January 2021

Maintenance of visual and auditory function is important for preventing the onset of activity limitations and preserving quality of life in later life. To date, national panel studies focused on health and aging have mostly collected subjective (self-reported) measures of visual and auditory function. The National Health and Aging Trends Study (NHATS), a study of Medicare beneficiaries ages sixty-five and older, recently developed a protocol for measuring objective visual and auditory function for its annual, in-home data collection conducted by trained interviewers. The protocol includes three vision tests—distance and near acuity and contrast sensitivity—and one hearing test—pure-tone audiometry—conducted using a tablet platform with results recorded in a scannable booklet. To identify operational issues and evaluate data quality for the proposed set of vision and hearing tests, NHATS incorporated a pilot study into its 2019 round (N = 417 participants and N = 9 interviewers). Using these pilot study data, the objectives of this paper are to: (1) describe the NHATS protocols to collect objective measures of visual and auditory function; (2) evaluate the quality of the data collected; and (3) assess whether results are influenced by interviewers. We found that respondents were highly likely to participate, with cooperation rates for each test about 90 percent. Data were high quality, with low rates of missingness, test results significantly associated with age and self-reported items, and percentages with poor vision or hearing consistent with prior population-based studies. Objective measures were more likely than self-reports to classify participants as having visual and auditory impairments and had stronger relationships with demographic correlates. Interviewer effects were small and not statistically significant in this small sample. Results of this study have demonstrated that objective visual and auditory functioning can be successfully incorporated into an interviewer-administered home-based protocol.
Implementing a Protocol to Reduce Opioid Prescriptions in Military Otolaryngology: A Quality Improvement Initiative
Authors: Neighbors CindyLee P , Noller Michael W , Avillion Michael P , Neighbors John W , Spaw Mark C , Biello Andrew R , Theler Jared M , Camacho Macario
Published: January 2021

Introduction

To compare pain medication refill rates for adult septoplasty and rhinoplasty patients before and after initiating a multimodal analgesic protocol for reducing opioid prescriptions (PROP).

Materials and Methods

Data from 58 adult patients were retrieved by retrospective chart review (19 septoplasties and 10 rhinoplasties before initiating PROP in September 2018 and 21 septoplasties and 8 rhinoplasties after PROP). We selected consecutive septoplasties and rhinoplasties, at which time a new discharge order set was implemented. The new order set consisted of 10 oxycodone tabs (5 mg), 100 acetaminophen tabs (325 mg), and 28 celecoxib tabs (200 mg). The primary outcome variable was the number of initial opioid prescriptions and refills filled by any provider.

Results

Among the septoplasties, there was a 46% decrease in total morphine milligram equivalent (MME) prescribed, from a mean of 202.0 mg in the non-PROP group (95% CI, 235.4, 174.6) to 108.6 mg in the PROP group (95% CI, 135.8, 81.4), with no difference in refill rates. Among the rhinoplasties, there was a 51% decrease in total MME prescribed, from a mean of 258.8 mg in the non-PROP group (95% CI, 333.4, 184.1) to 126.6 mg in the PROP group (95% CI, 168.1, 85.0) with no difference in refill rates.

Conclusions

The outcomes after PROP implementation for septoplasty and rhinoplasty at our institution suggest that opioid prescription rates can be significantly decreased to manage postoperative pain, with no difference in opioid refill rates. The results also warrant further investigation into patient pain, satisfaction, provider efficiency, and healthcare costs.
The Erosion of Public Trust and SARS-CoV-2 Vaccines— More Action Is Needed
Authors: Nahum Ari , Drekonja Dimitri M , Alpern Jonathan D
Published: January 2021

As states and health systems prepare to deliver severe acute respiratory syndrome coronavirus 2 vaccines to the American public, a confluence of factors has the potential to interfere with these efforts: misinformation about coronavirus disease 2019, vaccine hesitancy, and the erosion of the American public’s trust in the vaccine regulatory process due to recent and ongoing events. Broad action is needed to address these issues, including improved and consistent communication by the Food and Drug Administration, restoration of the Centers for Disease Control as an independent and science-driven institution, and more aggressive policies to counteract misinformation, particularly on social media platforms.
COVID-19 Vaccine Acceptance: We Need to Start Now
Authors: Kuppalli Krutika , Brett-Major David M , Smith Tara C
Published: January 2021

In this perspective, we discuss the importance of developing a vaccine to help curb transmission of severe acute respiratory syndrome coronavirus 2. The question remains: Once a safe and effective vaccine is developed, will the public be willing to get it? We present information from one of the first tracking polls to assess public attitudes and perceptions toward a possible coronavirus disease 2019 vaccine that suggests public hesitancy over a potential vaccine, concern regarding accelerating clinical trials, and unease over the vaccine approval process. Public health experts, government officials, advocates, and others in the scientific community should respect the signals of hesitancy and communicate sensitivity, applying lessons not only to how we message, but also in how we build this urgently needed vaccine if we are to have successful uptake once available.
Microbial Assessment of Health Care–Associated Pathogens on Various Environmental Sites in Patient Rooms After Terminal Room Disinfection
Authors: Kanamori Hajime , Rutala William A , Gergen Maria F , Sickbert-Bennett Emily E , Knelson Lauren P , Anderson Deverick J , Sexton Daniel J , Weber David J
Published: January 2021

We examined the microbial burden on hospital room environmental sites after standard (quaternary ammonium [Quat]) or enhanced disinfection (quat/ultraviolet light [UV-C], bleach, or bleach/UV-C). An enhanced terminal room disinfection reduced the microbial burden of epidemiologically important pathogens on high-touch surfaces in patient rooms, especially sites around the bed, better than standard room disinfection.
Restriction Factor Expression in Vertically Infected Children Living With HIV-1
Authors: Bortlik Martin , Copertino Dennis C. , Brailey Phillip M. , Beckerle Greta A. , Ormsby Christopher E. , Rosenberg Michael G. , Wiznia Andrew A. , Raposo Rui André Saraiva , Nixon Douglas F. , de Mulder Rougvie Miguel
Published: January 2021

Introduction:

Around 1.7 million children are estimated to live with HIV-1 worldwide, and about 160,000 infants are newly infected every year. Since adaptive immunity takes time to mature and develop in infants, and maternal antibodies provide limited antiviral activity, innate and intrinsic immunity against HIV-1 in the young is of critical importance. Intrinsic restriction factors are cellular proteins that effectively inhibit HIV-1 replication in vitro, but there is limited understanding of their role in vivo, and little to no data has been reported on the expression of host restriction factors in children. We hypothesized that restriction factor expression might be particularly important in children living with HIV-1 and correlate with disease progression.

Methods:

We analyzed gene expression of APOBEC3A, APOBEC3C, APOBEC3G, APOBEC3H, SAMHD1, ISG15, CDKN1A, MX2, TRIM5, and SLFN11 by qPCR in 121 samples of CD4+ T cells from vertically infected children living with HIV-1. Cell surface expression of BST-2/tetherin and markers of CD4+ T-cell activation were analyzed by flow cytometry.

Results:

After adjusting for gender and age, BST-2/tetherin expression on CD4+ T cells showed significant positive correlation with viral load (P = 0.0006; ρ = 0.33), CD4+ T-cell activation (P < 0.0001; ρ = 0.53), CD8+ T-cell activation (P < 0.0001; ρ = 0.53), and a negative correlation with CD4+ T-cell counts (P = 0.0008; ρ = −0.33). The expression of SAMHD1 correlated negatively with markers of T-cell activation (P = 0.046; ρ = −0.22).

Discussion:

These results suggest an important role of some restriction factors in the pathogenesis of HIV-1 in children.
Disseminated Tuberculosis Complicated With Pneumatoceles in 2 Infants
Authors: Guillén Martín Sara , Callejas Caballero Ignacio , Berzosa Sánchez Arancha , Illán Ramos Marta , Soto Sánchez Beatriz , Ramos Amador José Tomás
Published: January 2021

Pneumatoceles are rare complications of pulmonary tuberculosis in children. We present 2 cases in infants of disseminated tuberculosis complicated by pneumatoceles with different evolution. This complication should be considered if worsening of respiratory symptoms occurs after initiating anti-tuberculous treatment. Treatment of pneumatoceles is usually conservative and surgical treatment should be used in patients with giant cysts which cause respiratory distress.
A new valid Walking Aid Scale better predicts distance walked by prosthesis users than Prosthetic Mobility Questionnaire 2.0 and Activities-Specific Balance Confidence Scale
Authors: Burger Helena , Bavec Andrej , Giordano Andrea , Franchignoni Franco
Published: January 2021

The availability of psychometrically-sound and parsimonious outcome measures is key for optimizing decision-making about prosthetic fitting and rehabilitation in lower limb prosthesis users. Despite the increasing clinical use of observational and self-reported scales for assessing mobility and balance, there is currently no scale that accounts for the use of assistive devices while walking under conditions of increasing difficulty. Therefore, the purpose of this study was to develop and validate a Walking Aid Scale (WAS) in a cross-sectional sample of 144 prosthesis users. Specifically, we examined internal consistency and concurrent validity of WAS against two commonly used self-report measures of prosthetic mobility and balance confidence – the Prosthetic Mobility Questionnaire 2.0 (PMQ 2.0) and Activities-Specific Balance Confidence Scale (ABC-5). The predictive value of WAS, in comparison to PMQ 2.0 and ABC-5, was assessed using a 6-Minute Walk Test (6MWT) and participants’ characteristics. The WAS showed significant moderate-to-good correlations with PMQ 2.0 and ABC-5, and all scales correlated well with age and 6MWT. Participants who relied less on walking aids reported higher mobility levels, greater balance confidence, and walked longer distances. Age was associated with greater use of walking aids and lower mobility and balance confidence. In the stepwise linear regression analysis, age, amputation level, time since amputation, and WAS predicted about two-thirds of the variability in 6MWT with no significant contribution of PMQ 2.0 and ABC-5. These findings indicate that WAS is a valid instrument and a better predictor of walking distance than PMQ 2.0 and ABC-5 in the lower limb prosthesis users.