bluuebunny/crossref_metadata_2025 huggingface dataset:
Time to cardiovascular benefits of empagliflozin: a post hoc observation from the EMPA‐REG OUTCOME trial
Authors: Verma Subodh , Leiter Lawrence A. , Zinman Bernard , Sharma Abhinav , Mattheus Michaela , Fitchett David , George Jyothis , Ofstad Anne Pernille , Kosiborod Mikhail N. , Wanner Christoph , Inzucchi Silvio E.
Published: June 2021

Aims

In the EMPA‐REG OUTCOME trial, in patients with type 2 diabetes and established atherosclerotic cardiovascular (CV) disease, empagliflozin vs. placebo reduced the risk of hospitalization for heart failure (HHF) by 35%, CV death/HHF by 34%, and CV death by 38%, with an early separation of the cumulative incidence curves. We explored at what time point after randomization these benefits became apparent.

Methods and results

We expressed time trajectories for the effect of pooled empagliflozin doses vs. placebo on HHF, CV death/HHF, and CV death based on hazard ratios (95% confidence interval) and calculated the hazard ratio on the day the effect reached significance using Cox proportional hazards models. Overall, 7020 patients aged ≥18 years were treated with empagliflozin 10 mg (N = 2345), empagliflozin 25 mg (N = 2342), or placebo (N = 2333) once daily in addition to standard of care. Mean age (years ± SD) was 63.1 ± 8.6, and 72% were male. The benefit of empagliflozin on CV death first reached statistical significance on Day 59 (HR [95% confidence interval]) (0.28 [0.08, 0.96], P = 0.0424) and was generally sustained throughout the trial (overall 0.62 [0.49, 0.77], P < 0.0001). Risk reduction with empagliflozin on HHF reached statistical significance on Day 17 (0.10 [0.01, 0.87], P = 0.0372) and was sustained throughout the study (overall 0.65 [0.50, 0.85], P = 0.0017). For the composite outcome of CV death or HHF, risk reduction with empagliflozin reached statistical significance on Day 27 (0.28 [0.08, 0.97], P = 0.0445) and was sustained throughout follow‐up (overall 0.66 [0.55, 0.79], P < 0.0001).

Conclusions

In EMPA‐REG OUTCOME, the benefit of empagliflozin in reducing the risk of HHF, CV death/HHF, and CV death emerged within weeks after treatment initiation. The earliest benefit appears to be on HHF.
Study of mechanical properties and enhancing auxetic mechanism of composite auxetic structures
Authors: Shi Zengqin , Wang Qing , Li Yunfeng , Wang Ning , Lei Lulu , Li Xiaodong
Published: June 2021

The auxetic structures attract much attention because of their good properties, such as enhanced energy absorption capacity and buckling resistance. It is an important topic to combine the auxetic structures with other materials or structures to improve their mechanical properties. In this paper, a composite auxetic structure was proposed, in which the embedded structure and re‐entrant structure can deform independently to adjust the mechanical properties. Under uniaxial compression, the effects of changes in the embedded structure and re‐entrant structure on Poisson's ratio, relative Young's modulus, and energy absorption of the composite auxetic structure were studied. By introducing the rate of change of mechanical properties, the effects of the embedded structure and re‐entrant structure on the composite auxetic structure were studied. The results show that changing the embedded structure for Poisson's ratio and relative Young's modulus and changing the re‐entrant structure for energy absorption can maximize the material utilization. And changing the re‐entrant structure can make the mechanical properties of the composite auxetic structure reach a larger adjustable range. This study can provide a new way for the combination of future auxetic structures to meet the needs of different applications in civil engineering.
Evaluation of seismic performance of as‐built and retrofitted reinforced concrete frame structures with LAP splice deficiencies
Authors: Opabola Eyitayo A. , Elwood Kenneth J. , Liel Abbie B.
Published: June 2021

Several studies have looked at the development of hinge models to simulate the hysteretic response of flexure‐ and shear‐critical reinforced concrete (RC) beam‐column components from damage initiation to onset of gravity collapse. However, few studies have been conducted to develop similar models for older type bond‐critical beam‐column components. First, using existing experimental data, this paper describes the calibration of simple and efficient hinge models to simulate the inelastic hysteretic response of as‐built and retrofitted splice‐deficient columns. Subsequently, to demonstrate the applicability of the hinge models, the seismic performance of as‐built and fibre‐reinforced polymer (FRP) ‐retrofitted two‐ and four‐story nonductile RC frame buildings with splice‐deficient columns are assessed using nonlinear dynamic analysis procedures. The results show that buildings with bond‐critical columns may have a lower collapse potential than buildings with shear‐critical columns, implying that in certain cases a longer splice length may actually worsen performance. According to the analyses, local retrofitting of the columns can significantly improve the seismic performance of the buildings. Contrary to results presented in this study, a significant U.S. evaluation methodology for RC frame buildings, FEMA P‐2018, indicates that buildings with bond‐critical columns have similar collapse potential as buildings with shear‐critical columns. Modifications are proposed to improve the FEMA P‐2018 provisions. The modelling approach presented in this paper are recommended for incorporation into ASCE/SEI 41, engineering practice and future research.
Supraspinal nociceptive networks in neuropathic pain after spinal cord injury
Authors: Huynh Vincent , Lütolf Robin , Rosner Jan , Luechinger Roger , Curt Armin , Kollias Spyridon , Hubli Michèle , Michels Lars
Published: June 2021

Neuropathic pain following spinal cord injury involves plastic changes along the whole neuroaxis. Current neuroimaging studies have identified grey matter volume (GMV) and resting‐state functional connectivity changes of pain processing regions related to neuropathic pain intensity in spinal cord injury subjects. However, the relationship between the underlying neural processes and pain extent, a complementary characteristic of neuropathic pain, is unknown. We therefore aimed to reveal the neural markers of widespread neuropathic pain in spinal cord injury subjects and hypothesized that those with greater pain extent will show higher GMV and stronger connectivity within pain related regions. Thus, 29 chronic paraplegic subjects and 25 healthy controls underwent clinical and electrophysiological examinations combined with neuroimaging. Paraplegics were demarcated based on neuropathic pain and were thoroughly matched demographically. Our findings indicate that (a) spinal cord injury subjects with neuropathic pain display stronger connectivity between prefrontal cortices and regions involved with sensory integration and multimodal processing, (b) greater neuropathic pain extent, is associated with stronger connectivity between the posterior insular cortex and thalamic sub‐regions which partake in the lateral pain system and (c) greater intensity of neuropathic pain is related to stronger connectivity of regions involved with multimodal integration and the affective‐motivational component of pain. Overall, this study provides neuroimaging evidence that the pain phenotype of spinal cord injury subjects is related to the underlying function of their resting brain.
The Matrisome Genes From Hepatitis B–Related Hepatocellular Carcinoma Unveiled
Authors: Chen Wei , Desert Romain , Ge Xiaodong , Han Hui , Song Zhuolun , Das Sukanta , Athavale Dipti , You Hong , Nieto Natalia
Published: June 2021

Chronic hepatitis B virus (HBV) infection changes the composition of the extracellular matrix (ECM) and enables the onset and progression of hepatocellular carcinoma (HCC). The ensemble of ECM proteins and associated factors is a major component of the tumor microenvironment. Our aim was to unveil the matrisome genes from HBV‐related HCC. Transcriptomic and clinical profiles from 444 patients with HBV‐related HCC were retrieved from the Gene Expression Omnibus (GEO) and Cancer Genome Atlas (TCGA) repositories. Matrisome genes associated with HBV‐related hepatocarcinogenesis, matrisome gene modules, HCC subgroups, and liver‐specific matrisome genes were systematically analyzed, followed by identification of their biological function and clinical relevance. Eighty matrisome genes, functionally enriched in immune response, ECM remodeling, or cancer‐related pathways, were identified as associated with HBV‐related HCC, which could robustly discriminate HBV‐related HCC tumor from nontumor samples. Subsequently, four significant matrisome gene modules were identified as showing functional homogeneity linked to cell cycle activity. Two subgroups of patients with HBV‐related HCC were classified based on the highly correlated matrisome genes. The high‐expression subgroup (15.0% in the TCGA cohort and 17.9% in the GEO cohort) exhibited favorable clinical prognosis, activated metabolic activity, exhausted cell cycle, strong immune infiltration, and lower tumor purity. Four liver‐specific matrisome genes (F9, HPX [hemopexin], IGFALS [insulin‐like growth‐factor‐binding protein, acid labile subunit], and PLG [plasminogen]) were identified as involved in HBV‐related HCC progression and prognosis. Conclusion: This study identified the expression and function of matrisome genes from HBV‐related hepatocarcinogenesis, providing major insight to understand HBV‐related HCC and develop potential therapeutic opportunities.
Conjugate heat transfer analysis of a rotor blade with coolant channels
Authors: Singh Alankrita , Pujari Arun Kumar , Prasad B. V. S. S. S.
Published: June 2021

The present study deals with the conjugate heat transfer analysis of a cooled high‐pressure turbine rotor blade consisting of eight cooling channels. Computational investigations are performed in a five‐bladed cascade to determine characteristics of flow and heat transfer at different values of mainstream and coolant flow rate. Surface temperature measurements using infrared thermography are performed for validating the computational fluid dynamics results. The results show nonuniform variation of surface effectiveness: (a) higher average surface temperature on the pressure side than on the suction side, (b) peak surface temperature at the pressure side trailing edge region, (c) lowest temperature at midspan region of both pressure and suction sides, (d) intermediate values of temperature on the leading edge, and (e) these temperature patterns vary with the changes in mainstream Reynolds number and coolant flow rates, signifying the importance of carrying out conjugate heat transfer analysis. This study also emphasizes the importance of considering realistic coolant channel geometry over the idealized, an illustration showed that the maximum Nusselt number may vary up to 200% due to idealization.
Individualized Bone-Protective Management in Long-Term Cancer Survivors With Bone Metastases
Authors: Rachner Tilman D , Coleman Robert , Hadji Peyman , Hofbauer Lorenz C
Published: June 2021

Antiresorptive therapy is an important component of a multimodal approach to treating patients with advanced malignancies and metastatic bone disease. Over the past decade, overall survival of affected patients has improved in most cancer entities, and long-term disease control is a realistic goal in many cases. There are emerging clinical studies showing the benefits of an initial antiresorptive therapy using bisphosphonates or denosumab. However, some adverse events of these therapies, such as osteonecrosis of the jaw, correlate with the cumulative doses given, and there is an increasing clinical need for new antiresorptive concepts to treat long-term survivors. This review summarizes the clinical evidence of antiresorptive therapies across different cancers with bone involvement and presents concepts of dose-reduction protocols for long-term survivors with established metastatic bone disease. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
ivTerm—An R package for interactive visualization of functional analysis results of meta‐omics data
Authors: Dong Xiaorui , Xue Hongzhang , Wei Chaochun
Published: June 2021

Interpreting functional analysis results derived from environmental samples using direct sequencing meta‐omics data, including metagenomics and meta‐transcriptomics data, is challenging due to their complexity. Visualization of functional analysis results can help researchers discover relevant biological insights. Despite the availability of many R packages, there lacks interactive and comprehensive graphic systems for displaying functional terms and corresponding genes in meta‐omics analysis results. Here, we present ivTerm, an R‐shiny package with a user‐friendly graphical interface that enables users to inspect functional annotations, compare results across multiple experiments, create customized charts, and download these charts. It provides various basic and innovative chart types to visualize functional terms and involved genes. Users can also browse the description of terms obtained from the database web servers automatically. Two examples, including a metagenome analysis data for human gut and a meta‐transcriptome data for coral symbiomes, are given to show the usage of ivTerm. In the end, we compared ivTerm with existing tools with similar functions, such as GOplot, ViSEAGO, and Chordomics. The tool ivTerm is convenient and efficient for biologists to gain an integrated view and develop deep insights by interactive analysis of meta‐omics data. It can accelerate the procedure to develop insights from complex meta‐omics data. The code for ivTerm is freely available at https://github.com/SJTU-CGM/ivTerm.
Evaluation of automated molecular tests for the detection of SARS‐CoV‐2 in pooled nasopharyngeal and saliva specimens
Authors: Al‐Hail Hamad , Mirza Faheem , Al Hashemi Alaa , Ahmad Muneera Naseer , Iqbal Muhammad , Tang Patrick , Hasan Mohammad Rubayet
Published: June 2021

Background

Pooling of samples for SARS‐CoV‐2 testing in low‐prevalence settings has been used as an effective strategy to expand testing capacity and mitigate challenges with the shortage of supplies. We evaluated two automated molecular test systems for the detection of SARS‐CoV‐2 RNA in pooled specimens.

Methods

Pooled nasopharyngeal and saliva specimens were tested by Qiagen QIAstat‐Dx Respiratory SARS‐CoV‐2 Panel (QIAstat) or Cepheid Xpert Xpress SARS‐CoV‐2 (Xpert), and the results were compared to that of standard RT‐qPCR tests without pooling.

Results

In nasopharyngeal specimens, the sensitivity/specificity of the pool testing approach, with 5 and 10 specimens per pool, were 77%/100% (n = 105) and 74.1%/100% (n = 260) by QIAstat, and 97.1%/100% (n = 250) and 100%/99.5% (n = 200) by Xpert, respectively. Pool testing of saliva (10 specimens per pool; n = 150) by Xpert resulted in 87.5% sensitivity and 99.3% specificity compared to individual tests. Pool size of 5 or 10 specimens did not significantly affect the difference of RT‐qPCR cycle threshold (CT) from standard testing. RT‐qPCR CT values obtained with pool testing by both QIAstat and Xpert were positively correlated with that of individual testing (Pearson's correlation coefficient r = 0.85 to 0.99, p < 0.05). However, the CT values from Xpert were significantly stronger (p < 0.01, paired t test) than that of QIAstat in a subset of SARS‐CoV‐2 positive specimens, with mean differences of −4.3 ± 2.43 and −4.6 ± 2 for individual and pooled tests, respectively.

Conclusion

Our results suggest that Xpert SARS‐CoV‐2 can be utilized for pooled sample testing for COVID‐19 screening in low‐prevalence settings providing significant cost savings and improving throughput without affecting test quality.
Is there an increased cardiovascular risk in patients with prolactinoma? A challenging question
Authors: Yazici Dilek , Sunbul Murat , Yasar Mehmet , Deyneli Oguzhan , Yavuz Dilek
Published: June 2021

Purpose

Epicardial adipose tissue thickness (EATT) is considered to be a surrogate for visceral fat and a novel cardiovascular risk indicator. Hyperprolactinemia has been shown to be associated with increased cardiovascular risk. The aim was to evaluate the association between EATT, carotid intima media thickness (CIMT), and cardiac functions in patients with prolactinoma.

Methods

Patients with the diagnosis of prolactinoma were included. The control group consisted of healthy age matched individuals with normal prolactin levels. Prolactin, fasting blood glucose (FBG), insulin, hemoglobin A1c (HbA1c), alanine aminotransferase (ALT), total cholesterol, triglycerides, and high (HDL) and low density lipoprotein (LDL) cholesterol were measured. EATT, CIMT, cardiac systolic, and diastolic functions were determined using echocardiography.

Results

We evaluated 67 patients with prolactinoma (aged 40.7 ± 11.9 years, F/M: 51/16) and 57 controls (aged 42.5 ± 7.4 years, F/M: 36/21). Of the 67 patients, 24 had normal prolactin levels. FBG level was higher in prolactinoma patients than in controls. Patients and controls had similar HbA1c, HOMA‐IR, ALT, total, HDL, LDL cholesterol, and triglycerides levels, and similar cardiac systolic and diastolic functions. Prolactinoma patients had greater EATT (3.0 ± 0.5 mm vs. 2.6 ± 0.4 mm, p < 0.001) and CIMT (0.57 ± 0.08 mm vs. 0.52 ± 0.04 mm, p = 0.03) than controls. EATT was correlated with body mass index, FBG, HbA1c, and triglyceride levels.

Conclusions

EATT and CIMT were greater in patients with prolactinoma, although they had normal cardiac systolic and diastolic functions.
Access opening guide produced using a 3D printer (AOG‐3DP) as an effective tool in difficult cases for dental students
Authors: Choi Yiseul , Jeon Woo Seok , Cho Jung Min , Jeong Ho‐Gul , Shin Yooseok , Park Wonse
Published: June 2021

Objectives

The aim of this study was to determine the effectiveness of using an access opening guide in teaching ideal access opening shape and preventing excessive tooth loss, with a focus on predoctoral dental students.

Methods

Ninety teeth that were mounted in a box just below the level of the cementoenamel junction using tray resin were randomly divided into two study groups. An access opening guide produced using a 3D printer (AOG‐3DP) was designed using cone‐beam computed tomography (CBCT). The AOG‐3DP was applied in the test groups, while no aid was used in the control group. Access preparations in both groups performed by predoctoral dental students were scanned using CBCT to detect overpreparation. The preparation time and access cavity volume were evaluated.

Results

The mean times required for achieving access opening were 327.2 and 97.4 s in the control and AOG‐3DP groups, respectively, for premolars, and 547.4 and 104.5 s for molars. The mean volumes for premolars and molars differed from the ideal cavities by 38.1 and 72.2 mm3, respectively, in the control group, and by −2.0 and −8.7 mm3 the AOG‐3DP group.

Conclusions

Using the AOG‐3DP significantly reduced the access opening time for premolars and molars. However, there is a limitation in that CBCT DICOM images must be converted to stereolithographic .stl files in order to be printed via 3D technology. This requires additional preclinical treatment time for imaging and subsequent printing. It could be considered that this can be a useful method in difficult cases.
Participation pathways for women into university makerspaces
Authors: Tomko Megan , Alemán Melissa W. , Newstetter Wendy , Nagel Robert L. , Linsey Julie
Published: June 2021

Background

Engineering education has observed considerable growth in academic makerspaces with initial data indicating significant potential for makerspaces to support learning.

Purpose/Hypothesis

Given gender disparities in engineering as a professional community of practice (CoP) and indications for makerspaces as sites for learning, educational researchers need to forge a better understanding of women's pathways into makerspaces, including the barriers that inhibit and the catalysts that broaden participation.

Design/Method

This study employed qualitative interviews with 20 women students who were identified as makers in order to gain insights into the characteristics of their pathways into university makerspaces.

Results

Using grounded theory development, four major aspects of students' pathways emerged: (1) early forms of apprenticeship through mentors; (2) overcoming and resisting limiting gendered expectations imposed by others in early experiences in unfamiliar makerspace CoPs, resulting in failed articulations of related communities; (3) successful articulations of community grounded in making‐centered coursework and personal passions; and (4) relationships in college that expanded access, leadership, and visibility toward fuller participation in makerspace CoPs.

Conclusion

Educational interventions to broaden women's participation in makerspaces must be multipronged and attend to early childhood experiences, include supportive opportunities for women to participate in making in K‐12 and university curricula, expand definitions of making to legitimize the arts and crafts as part of design, and create apprenticeship opportunities for women to mentor women in makerspaces. We must change the narrative of who makers are, what making is, and who belongs in makerspaces to reduce barriers and create inclusive making communities.
Radiation therapist‐led telephone follow‐up: identifying patients who require post‐treatment care
Authors: Najem Fadila , Prosser Susan , Harris Jill , Beldham‐Collins Rachael , Cross Shamira , West Katrina
Published: June 2021

Introduction

Radiation therapists implemented telephone follow‐up (TFU) in 2015 as an additional point of care post‐treatment. The purpose of this study was to determine whether TFU identified patients who required additional post‐treatment care before the next scheduled review.

Methods

Between January 2015 and July 2016, all patients who were prescribed curative intent treatment aged 18 years or over were called 10 days post‐radiation therapy (RT). Eight questions were developed and included asking patients how they were coping, if their side effects were improving, if they needed to contact the hospital and if more dressings were required. Patients who could not be contacted after two attempts were excluded from the study. Microsoft Excel and Statistical Package for Social Sciences (SPSS) were used to analyse the responses.

Results

Data were collected from 850 patients. A total of 28/846 (3%) of patients reported they were not coping after RT, with 26/830 (3%) reporting their side effects were getting worse. A total of 97/826 (12%) of patients felt they needed to contact the hospital because they were unwell. This study identified 104/677 (15%) of patients who responded required more dressings, with 67/104 (65.7%) and 10/104 (9.8%) of this cohort identified in the breast, and head and neck groups, respectively.

Conclusion

Radiation therapist‐led TFU has shown to be beneficial in identifying a small cohort of breast and head and neck cancer patients who required additional care post‐radiation treatment.
How do residents respond to negative environmental impacts from tourism? The role of community participation in empowering residents' environmentally responsible behavior
Authors: Xu Songjun , Hu Yaou
Published: June 2021

This study examined a model linking perceived negative environmental impacts, support for tourism development, environmentally responsible behavior (ERB), and community participation in the ecotourism setting. The findings reveal that perceived negative environmental impacts restrained residents' ERB. This relationship was mitigated by the moderation of community participation such that the suppression effect of perceived negative environmental impacts on ERB became less strong as community participation increased. Moreover, support for tourism development mediated the moderating effect. This study provides novel insights on understanding residents' attitudes and behaviors towards environmental impacts and identifying the role of community participation in empowering residents' ERB. Managerial implications and future research directions are discussed.
Deep Learning Pitfall: Impact of Novel Ultrasound Equipment Introduction on Algorithm Performance and the Realities of Domain Adaptation
Authors: Blaivas Michael , Blaivas Laura N , Tsung James W
Published: June 2021

Objectives

To test deep learning (DL) algorithm performance repercussions by introducing novel ultrasound equipment into a clinical setting.

Methods

Researchers introduced prospectively obtained inferior vena cava (IVC) videos from a similar patient population using novel ultrasound equipment to challenge a previously validated DL algorithm (trained on a common point of care ultrasound [POCUS] machine) to assess IVC collapse. Twenty‐one new videos were obtained for each novel ultrasound machine. The videos were analyzed for complete collapse by the algorithm and by 2 blinded POCUS experts. Cohen's kappa was calculated for agreement between the 2 POCUS experts and DL algorithm. Previous testing showed substantial agreement between algorithm and experts with Cohen's kappa of 0.78 (95% CI 0.49–1.0) and 0.66 (95% CI 0.31–1.0) on new patient data using, the same ultrasound equipment.

Results

Challenged with higher image quality (IQ) POCUS cart ultrasound videos, algorithm performance declined with kappa values of 0.31 (95% CI 0.19–0.81) and 0.39 (95% CI 0.11–0.89), showing fair agreement. Algorithm performance plummeted on a lower IQ, smartphone device with a kappa value of −0.09 (95% CI −0.95 to 0.76) and 0.09 (95% CI −0.65 to 0.82), respectively, showing less agreement than would be expected by chance. Two POCUS experts had near perfect agreement with a kappa value of 0.88 (95% CI 0.64–1.0) regarding IVC collapse.

Conclusions

Performance of this previously validated DL algorithm worsened when faced with ultrasound studies from 2 novel ultrasound machines. Performance was much worse on images from a lower IQ hand‐held device than from a superior cart‐based device.
Complex Airway Management in Patients with Tracheal Cartilaginous Sleeves
Authors: Noble Anisha R. , Cunningham Michael L. , Lam Austin , Wenger Tara L. , Sie Kathleen C. , Perkins Jonathan A. , Dahl John P.
Published: June 2021

Objectives/Hypothesis

A tracheal cartilaginous sleeve (TCS) is a rare anomaly characterized by anterior fusion of tracheal cartilages. TCS is associated with syndromic craniosynostoses including Apert, Crouzon and Pfeiffer syndromes and FGFR2, FGFR3, and TWIST1 variants. This study presents a 30‐year review of patients with syndromic craniosynostosis and TCS and describes diagnostic methods, genetic variants, surgical interventions, and long‐term outcomes.

Study Design

Retrospective, single‐institution review.

Methods

This review included patients with syndromic craniosynostosis and TCS treated at Seattle Children's Hospital from 1990 to 2020. Tracheostomy, genetic variants, and additional surgery were primary measures. Fisher's exact test compared need for tracheostomy in patients with proposed high‐risk (FGFR2 p.W290 or FGFR2 p.C342) versus low‐risk genetic variants.

Results

Thirty patients with TCS were identified. Average age at diagnosis was 12 months (range 2‐weeks to 7.9‐years; standard deviation 19.8 months). Syndromes included Pfeiffer (37%), Apert (37%), and Crouzon (26%). Severe obstructive sleep apnea was present in 76% of patients. Tracheostomy was performed in 17 patients (57%); five were successfully decannulated. Additional interventions included adenotonsillectomy (57%), nasal (20%), laryngeal (17%), and craniofacial skeletal surgery (87%). All patients with Pfeiffer syndrome and FGFR2 p.W290C variants and 83% of patients with FGFR2 p.C342 variants required tracheostomy, differing from other variants (P = .02, odds ratio 33, 95% confidence interval 1.56–697.96). One patient (3%) died.

Conclusion

TCS contributes to multilevel airway obstruction in patients with syndromic craniosynostosis. Genetic testing in patients with FGFR2‐related syndromic craniosynostoses may identify those at risk of TCS and facilitate early intervention. A better understanding of this patient population may foster individualized airway management strategies and improve outcomes.

Level of Evidence

4 Laryngoscope, 132:215–221, 2022
Fatigue‐creep interaction performance of Incoloy 825 nickel‐based superalloy at 650 °C
Authors: Huo X. , Li F. , Zhu Q. , Chen L. , Wang B.
Published: June 2021

The fatigue‐creep interaction performance of Incoloy 825 nickel‐based superalloy at 650 °C was investigated through introducing the tensile, compressive, and tensile‐compressive strain hold time at the controlled total strain amplitude Δϵt = 0.3 %∼0.7 %. The results show that the Incoloy 825 nickel‐based superalloy exhibits the cyclic hardening behavior, the cyclic hardening behavior followed by cyclic softening behavior and the cyclic hardening behavior followed by cyclic stability during the cyclic deformation with tensile strain hold time, while the alloy exhibits the cyclic hardening behavior and the cyclic hardening behavior followed by the cyclic stability during the cyclic deformation with compressive and tensile‐compressive strain hold time. The relationship between both plastic and elastic strain amplitudes with reversals to failure for the alloy shows a single slope linear behavior, which can be described by the Coffin‐Manson and Basquin equations, respectively. The deformation mechanism of the alloy under three loading condition of fatigue‐creep interaction is mainly the planar slip. In addition, under three loading condition of fatigue‐creep interaction, the cracks initiate and propagate in the transgranular mode.
Shape memory and mechanical characterization of polylactic acid wood composite fabricated by fused filament fabrication 4D printing technology
Authors: Sharma A. , Singholi A.K.S.
Published: June 2021

The present study focuses on fabrication and characterization of polylactic acid wood composite fabricated using fused filament fabrication 4D printing technology. The major tests performed to investigate the effect of nanosilica and nanoalumina included shape recovery rate, hardness, compressive strength, dynamic mechanical properties and Thermo‐gravimetric analysis. The result of mechanical test indicated that the addition of 2 wt.% nanoalumina improved the hardness, compressive strength and flexural strength by 40 %, 25 % and 3.3 % respectively. On the other hand, the addition of 2 wt.% nanosilica improved the hardness, compressive strength and flexural strength by 60 %, 55 % and 10 % respectively. Further, the addition of nanosilica and nanoalumina improved the thermal stability and decreased the maximum shape recovery rate of wood polylactic acid composite. Nanosilica reinforced wood polylactic acid composite indicated a better choice as compared to nanoalumina reinforced wood polylactic acid composite in terms of mechanical properties, thermal properties and maximum shape recovery rate.
Design and validation of an MRI‐compatible mechatronic system for needle delivery to localized prostate cancer
Authors: Knull Eric , Bax Jeffrey Scott , Park Claire Keun Sun , Tessier David , Fenster Aaron
Published: June 2021

Purpose

Prostate cancer is the most common non‐cutaneous cancer among men in the United States and is the second leading cause of cancer death in American men. (Siegel et al. [2019] CA: A Cancer J Clin.69(1):7‐34.) Focal laser ablation (FLA) has the potential to control small tumors while preserving urinary and erectile function by leaving the neurovascular bundles and urethral sphincters intact. Accurate needle guidance is critical to the success of FLA. Multiparametric magnetic resonance images (mpMRI) can be used to identify targets, guide needles, and assess treatment outcomes. The purpose of this work was to design and evaluate the accuracy of an MR‐compatible mechatronic system for in‐bore transperineal guidance of FLA ablation needles to localized lesions in the prostate.

Methods

The mechatronic system was constructed entirely of non‐ferromagnetic materials, with actuation controlled by piezoelectric motors and optical encoders. The needle guide hangs between independent front and rear two‐link arms, which allows for horizontal and vertical translation as well as pitch and yaw rotation of the guide with a 6.0 cm range of motion in each direction. Needles are inserted manually through a chosen hole in the guide, which has been aligned with the target in the prostate. Open‐air positioning error was evaluated using an optical tracking system (0.25 mm RMS accuracy) to measure 125 trajectories in free space. Correction of systematic bias in the system was performed using 85 of the trajectories, and the remaining 40 were used to estimate the residual error. The error was calculated as the horizontal and vertical displacement between the axis of the desired and measured trajectories at a typical needle insertion depth of 10 cm. MR‐compatibility was evaluated using a grid phantom to assess image degradation due to the presence of the system, and induced force, heating, and electrical interference in the system were assessed qualitatively. In‐bore positioning error was evaluated on 25 trajectories.

Results

Open‐air mean positioning error at the needle tip was 0.80 ± 0.36 mm with a one‐sided 95% confidence interval of 1.40 mm. The mean deviation of needle trajectories from the planned direction was 0.14 ± 0.06∘. In the MR bore, the mean positioning error at the needle tip was 2.11 ± 1.05 mm with a one‐sided 95% prediction interval of 3.84 mm. The mean angular error was 0.49 ± 0.26∘. The system was found to be compatible with the MR environment under the specified gradient‐echo sequence parameters used in this study.

Conclusion

A complete system for delivering needles to localized prostate tumors was developed and described in this work, and its compatibility with the MR environment was demonstrated. In‐bore MRI positioning error was sufficiently small for targeting small localized prostate tumors.
Guidelines for genetic testing of muscle and neuromuscular junction disorders
Authors: Nicolau Stefan , Milone Margherita , Liewluck Teerin
Published: June 2021

Despite recent advances in the understanding of inherited muscle and neuromuscular junction diseases, as well as the advent of a wide range of genetic tests, patients continue to face delays in diagnosis of sometimes treatable disorders. These guidelines outline an approach to genetic testing in such disorders. Initially, a patient's phenotype is evaluated to identify myopathies requiring directed testing, including myotonic dystrophies, facioscapulohumeral muscular dystrophy, oculopharyngeal muscular dystrophy, mitochondrial myopathies, dystrophinopathies, and oculopharyngodistal myopathy. Initial investigation in the remaining patients is generally a comprehensive gene panel by next‐generation sequencing. Broad panels have a higher diagnostic yield and can be cost‐effective. Due to extensive phenotypic overlap and treatment implications, genes responsible for congenital myasthenic syndromes should be included when evaluating myopathy patients. For patients whose initial genetic testing is negative or inconclusive, phenotypic re‐evaluation is warranted, along with consideration of genes and variants not included initially, as well as their acquired mimickers.
Numerical modeling of thermo‐mechanical failure processes in granitic rock with polygonal finite elements
Authors: Saksala Timo
Published: June 2021

This paper considers numerical modeling of intensive heating induced thermo‐mechanical failure processes in granitic rock. For this end, a numerical method based on polygonal finite elements and a damage‐plasticity model is developed. A staggered scheme is employed to solve the global thermo‐mechanical problem. The rock failure is described by a Rankine‐Mohr‐Coulomb plasticity model with separate scalar damage variables for tension and compression. Consistent tangent operator is derived for this model. Special attention is given to the temperature dependence of the thermo‐mechanical material properties of heterogeneous rock. In the numerical examples, the method is first verified with an analytical solution of thermal stresses in a hollow cylinder, and then qualitatively validated with the problems of thermal cracking of concentric cylinders and uniaxial compressive test on rock under elevated temperatures. Finally, the method is applied in novel simulations inspired by the degradation of sauna stones under slow heating‐rapid cooling and the comminution by rapid heating‐cooling cycles.
The accuracy and safety of using the electrocardiogram positioning technique in localizing the peripherally inserted central catheter tip position: A systematic review and meta‐analysis
Authors: Yu Chen , Shulan Luo , Juan Wang , ling Lin , Chun‐Mei Luo
Published: June 2021

Aim

We performed a systematic review and meta‐analysis to examine the accuracy and safety of using the electrocardiogram (ECG) positioning technique to localize the peripherally inserted central catheter (PICC) tip position to provide objective evidence for its clinical application.

Methods

We searched the literature for randomized controlled trials evaluating the diagnostic analysis of using electrocardiograms to localize PICC tip positions in the MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) and PsycINFO databases. We used a risk ratio with accompanying 95% confidence interval (CI) to express estimates. Reviewer Manager (RevMan) 5.1.0 was used to complete all statistical analyses.

Results

This systematic review identified 9 studies (N = 3,194 patients). Overall, the results of the meta‐analysis revealed that, for patients in whom the ECG positioning method was used compared with patients in whom the landmark positioning method was used, the RR for accurate catheter tip positioning was RR = 1.17, and the difference was statistically significant. The RR for the incidence of complications was RR = 0.28, and the difference was statistically significant.

Conclusions

The application of ECGs in PICC tip positioning can improve the accuracy of catheter tip positioning and reduce the incidence of related complications.
Treated with preventive anticoagulation therapy in atrial fibrillation: The patients’ perspective
Authors: Olsson Karin , Hörnsten Åsa , Hellström Ängerud Karin
Published: June 2021

Aim

The aim of this study was to explore patients’ experiences of preventive anticoagulation therapy in atrial fibrillation.

Design

This was a descriptive qualitative study based on interviews.

Methods

Individual interviews with 15 patients, 6 women and 9 men, treated with preventive oral anticoagulant due to atrial fibrillation, were conducted. The interviews were analysed with qualitative content analysis.

Results

Based on the analysis, the theme Managing a necessary evil emerged. The theme comprised the three categories: Coping with anxiety and changes in daily life, Having confidence in care and Being a partner or only a receiver of treatment. Patients described it like being faced with a situation where a treatment perceived as vital was weighed against undesirable consequences and risks. Patients trusted caregivers and had confidence in care, but there was a risk of being a receiver of care instead of becoming a partner.
Unifying ultrafast laser imaging and spectroscopy
Authors: Leburn Christopher G.
Published: June 2021

Advancements in recent years have shown rapid growth in the application of ultrashort pulsed lasers as a light source for sophisticated biological imaging techniques, including multiphoton microscopy. Conversely, ultrafast laser systems are increasingly used to drive advances in Raman spectroscopy or using Fourier‐transform infrared spectroscopy (FTIR) to identify chemical and biological signatures.
Smart monitoring of battery welding processes
Authors: Dupriez Nataliya Deyneka
Published: June 2021

One of the key laser application areas in the e‐automotive industry is the welding of the battery. Sensor systems from Lessmüller Lasertechnik ensure reliable, high‐precision joining, which is vital in the assembly of any battery. Installed to various remote and fixed welding optics, the OCT, WELDCHECK, and WELDEYE sensor systems demonstrate real‐time monitoring capability with great accuracy and over a wide dynamic range, enabling faster, cost‐effective e‐automotive laser processes and streamlined production.
Multidimensional conceptualization of identity and psychopathology: Assessing mental health disparities from an intersectional and dimensional framework
Authors: Langwerden Robbert J. , Thompson Michelle G. , Wagner Eric F.
Published: June 2021

Black, Indigenous, and People of Color (BIPOC) currently constitute 40% of the US population and will become the majority by 2045. Current mental health systems have not sufficiently accounted for disparities, inequities, and social determinants impacting BIPOC lives. We outline several advances that could improve mental health disparities research. Research on BIPOC requires mental health assessment accurately capturing multiple facets of one's identity, taking into account the complexities of multifaceted historical oppression. Assessing (personality) psychopathology in a dimensional and hierarchical manner could provide greater insight into mental health disparities between diverse identity individuals. We encourage studying moderators that are protective assets for BIPOC—such as resiliency and community factors—as opposed to deficit‐dominant, category‐based, and majority‐dominant assessments.
Rock temperature prior to failure: Analysis of 209 rockfall events in the Mont Blanc massif (Western European Alps)
Authors: Legay Alexandre , Magnin Florence , Ravanel Ludovic
Published: June 2021

Periglacial rock walls are affected by an increase in rockfall activity attributed to permafrost degradation. While recent laboratory tests have asserted the role of permafrost in bedrock stability, linking experimental findings to field applications is hindered by the difficulty in assessing bedrock temperature at observed rockfall locations and time. In this study, we simulated bedrock temperature for 209 rockfalls inventoried in the Mont Blanc massif between 2007 and 2015 and 209,000 random events artificially created at observed rockfall locations. Real and random events are then compared in a statistical analysis to determine their significance. Permafrost conditions (or very close to 0°C) were consistently found for all events with failure depth > 6 m, and for some events affecting depths from 4 to 6 m. Shallower events were probably not related to permafrost processes. Surface temperatures were significantly high up to at least 2 months prior to failure, with the highest peaks in significance 1.5–2 months and 1–5 days before rockfalls. Similarly, temperatures at scar depths were significantly high, but steadily decreasing, 1 day to 3 weeks before failure. The study confirms that warm permafrost areas (> −2°C) are particularly prone to rockfalls, and that failures are a direct response to extraordinary high bedrock temperature in both frozen and unfrozen conditions. The results are promising for the development of a rockfall susceptibility index, but uncertainty analysis encourages the use of a greater rockfall sample and a different sample of random events.
Suppression of phosphoinositide 3‐kinase/phosphoinositide‐dependent kinase‐1/serum and glucocorticoid‐induced protein kinase pathway
Authors: Han Hyuk Gyu , Lee Hyo‐Jung , Sim Deok Yong , Im Eunji , Park Ji Eon , Park Woon Yi , Kim Seok Young , Khil Jae‐Ho , Shim Bum Sang , Kim Sung‐Hoon
Published: June 2021

In the current study, the pivotal roles of serum and glucocorticoid‐induced protein kinase (SGK1) and NF‐kB related signalings known as prognostic biomarkers in cervical cancers were explored in the antitumor effect of a ginseng saponin metabolite compound K (CK) in HeLa and SiHa cervical cancer cells. CK exerted significant cytotoxicity, induced sub‐G1 accumulation, and attenuated the expression of proPoly (ADP‐ribose) polymerase (pro‐PARP) and Pro‐cysteine aspartyl‐specific protease (pro‐caspase3) in HeLa cells more than in SiHa cells. CK inhibited phosphorylation of SGK1 and its upstream genes, phosphoinositide 3‐kinases (PI3K), and phosphoinositide‐dependent kinase‐1 (PDK1) in HeLa cells. In addition, CK suppressed the phosphorylation of SGK1, NF‐κB, and inhibitor of kappa B (IκB) and also NF‐κB target genes such as X‐linked inhibitor of apoptosis protein and B‐cell lymphoma 2 (Bcl‐2) in HeLa cells. Notably, Immunoprecipitation revealed that SGK1 binds to PI3K or PDK1 and also CK disturbed the binding between SGK1 and PI3K or PDK1 in HeLa cells. Furthermore, PI3K inhibitor LY294002 decreased expression of PI3K, p‐PDK1, p‐SGK1, and pro‐caspase3 and SGK1 inhibitor GSK650394 also reduced expression of NF‐κB and pro‐caspase3 just like CK in HeLa cells. Overall, these findings suggest that CK induces apoptosis via suppression of PI3K/PDK1/SGK1 and NF‐κB signaling axis.
Genesis of severe cyclonic storm Mora in the presence of tropical waves over the North Indian Ocean
Authors: Emmanuel Rongmie , Deshpande Medha , Ganadhi Mano Kranthi , Ingle Sophan T.
Published: June 2021

Tropical cyclone (TC) genesis is still a crucial mysterious problem in tropical meteorology. Over the North Indian Ocean (NIO), TC Mora genesis commenced as a depression on May 28, 2017. Kalpana‐IR satellite images indicate a disturbance that developed as a depression within Intertropical Convergence Zone (ITCZ). Tropical Rainfall Measuring Mission (TRMM) rainfall shows the organization of convection that started with clustering of clouds on May 24; thereafter, cloud patches remained intact and became a depression on May 28. During the pre‐genesis period (May 20–28), the Madden–Julian oscillation (MJO) was in phase 2 with amplitude greater than 1 and equatorial Rossby (ER) wave was also active over the Indian Basin. These waves facilitated intense convection through the supply of mid‐level moisture and low‐level vorticity required for the genesis. The presence of ER wave resulted in the formation of circulation at 850 hPa over the equatorial region. From May 22 to 23, the existence of a quasiclosed circulation (QCC) region within ER wave indicates a continuous buildup of moisture and vorticity, separating the region of moist and dry air. Later, the QCC became self‐sustained and evolved into a depression on May 28. The streamline overturning point is the inflection point (IP), and the approximate circulation center is the stagnant point (SP). The coexistence of IP and SP along with the minimum stream function and maximum column integrated total precipitable water (TPW) confirms the potential area of genesis. This criterion is applied to track the seeding of vorticity as the preferred genesis location, 5 days before genesis. These locations match well with the best track data locations provided by the India Meteorological Department after May 28. Processes within the QCC are also studied following the QCC during the formation of the depression.