bluuebunny/crossref_metadata_2025 huggingface dataset:
Theoretical and Experimental Study on Rotary Compressor with Double Vapor Injection and Its System
Authors: Wei H J , Xu J , Yu B , Yang O X , He S G , Zhao H H , Hu Y P
Published: September 2021

This paper takes three kinds of double vapor injection compression cycle as the research object, that is, the two-stage compression cycle with double vapor injection on low-pressure cylinder and intermediate of two cylinders (Cycle A), the two-stage compression cycle with double vapor injection on high-pressure cylinder and intermediate of two cylinders (Cycle B), and the three-stage compression cycle with double vapor injection (Cycle C). According to the law of conservation of mass and energy, the thermodynamic analysis model of each cycle was established, and the influence of saturation temperature of double vapor injection on the performance of each cycle was analyzed. The theoretical analysis results indicated that the refrigeration capacity of cycle A, cycle B and cycle C increase by 12.5%, 3.5% and 4.6%, respectively, and COP of that increase by 3.09%, 2.23% and 3.22%, respectively, compared with that of single stage compression cycle. Based on cycle A, a single-machine two-stage rotary compressor with double vapor injection and its heat pump air conditioning are made. The experimental results showed that, the heating capacity of cycle A can increase by 14.6% when the heating COP is equivalent, and the heating COP can increase by 4.4% when the heating capacity is equivalent, compared with the two-stage compression cycle with single vapor injection, under the –15°C ambient temperature heating condition.
Current limits of CO2 compressors working in integrated mechanical subcooling cycles
Authors: Nebot-Andrés Laura , Sánchez Daniel , Cabello Ramón , Calleja-Anta Daniel , Fossi Carlos , Llopis Rodrigo
Published: September 2021

CO2 systems used in refrigeration are becoming more complex with the aim of improving their energy performance. The integrated mechanical subcooling system is being studied to enhance the COP and the cooling capacity of the plants as one of the possible solutions for hot climates in the last years.

Last studies determined their optimum working conditions where the COP is maximum. However, the compressor of the integrated mechanical subcooling cycle works out of the range of operation in some cases. This work presents the main technical limitations of this compressor in an experimental plant.

The main objective is to determine what these limits are and to highlight the need to develop new compressors for these applications. Improving the operation of these compressors will further increase the energy performance of the overall system.
Increasing Boiling Fluid Flowing Efficiency from Motive Nozzles of Two-Phase Ejectors
Authors: Sharapov Serhii , Chekh Oleh , Husiev Danylo , Klymenko Volodymyr , Shaparenko Oleksiy
Published: September 2021

The article contains the possibility of increasing boiling fluid flowing efficiency from expanding channels. This process takes place in the motive flow nozzle of a liquid-vapor ejector, working on the principle of thermal stream compression. Efficiency increasing by profiling the diffuser part of the nozzle. Modern industry uses nozzles, which are like de Laval nozzles, with straight walls of the diffusers. The authors suggest paying closer attention to profiling these nozzles, which might increase their efficiency and improve their gas-dynamic characteristics. For comparison, we choose a channel of a traditional form (with straight walls of the diffuser) and a channel of parabolic shape. The article contains a mathematical model to calculate the process of flowing the boiling fluid from the authors-designed channels – the peculiarities of this model that appear after changing the geometry of its streaming part. We obtain comparative analysis calculation results based on the mathematical model and the Ansys CFX workflow model. As a result of numerical calculation using the authors mathematical model and modelling in the Ansys CFX software package, it concludes that the parabolic shape of the diffuser is the most favourable. In the boiling process, the liquid central core is boiling at the optimum distance from the nozzle throat, and the flow of a stable vapor structure with the required pressure value for each regime forming at the outlet.
Photo- and magnetic-field-induced conductivity change in the BiFe1-xCoxO3 films
Authors: Kretinin V V , Begisheva O B , Zelenov F V , Mashkov P P , Pavlova A N
Published: September 2021

The magnetic and electrical properties of the polycrystalline BiFe1-xCoxO3 films have been investigated in the temperature range of 80–600 K and magnetic fields of up to 12 kOe. The photocurrent and the diode effect induced by the blue light laser illumination at room temperatures have been established. The ohmic conductivity has been determined from the I–V characteristics and the conductivity growth in a magnetic field has been observed. The deviation of the temperature dependence of the magnetization from the power law below room temperature has been found.
Research of physical and mechanical properties of plywood based on thermally modified veneer
Authors: Krivorotova A I , Orlov A A , Korchuk Yu A , Popov A A
Published: September 2021

The article presents the results of a study of the physical and mechanical properties of plywood based on thermally modified birch veneer. The implementation of a full-factor experiment in the temperature range from 160 to 200 °C with a duration of 120 to 240 min made it possible to establish the nature of the dependence of the change in strength in static bending and strength in shearing along the adhesive layer on the veneer heat treatment mode. The parameters of veneer heat treatment are determined, which do not lead to a decrease in the strength of plywood, but allow to reduce the indicators of water absorption and swelling by an amount from 20.4 to 33.5%. Plywood based on thermally modified veneer acquires higher strength and water resistance, which significantly expands the scope of application of glued wood based on urea-formaldehyde resins.
Carbon-containing materials for high-temperature friction units
Authors: Roshchin M N , Lukyanov A I , Krivosheev A Yu
Published: September 2021

The paper considers frictional interaction of carbon-containing composites with steel at high temperatures. Material “Hardcarb-TPG” has better tribological characteristics than materials “Hardcarb” and “Hardcarb-TP”. At a speed of 0.16 m/s and a load of 1.0 MPa, the friction coefficient of the Hardcarb-TPG material is 23% lower than that of the Hardcarb-TP material. Thus, at a temperature of 500 °C and a load of 1.0 MPa, the friction coefficient of the Hardcarb-TPG material at a speed of 0.16 and 0.25 m/s is 8 and 14% higher than at a speed of 0.05 m/s, respectively. The friction coefficient of the Hardcarb-TPG material at a speed of 0.16 m/s and a load of 1.0 MPa in the temperature range 300…600 °C varies from 0.13 to 0.30.
Physicochemical regularities in highly filled polyaluminosilicate applied on aluminum base by 3D aerosol printing
Authors: Ivanov A A , Chermoshentseva A S
Published: September 2021

A modified technique has been used to synthesize a highly filled polyaluminosilicate with a controlled supramolecular structure during its applying on an aluminium base by 3D aerosol printing. It has been found how the pH medium affects the polyaluminosilicate ability to form fractal supramolecular formations. Methods to control the highly filled polyaluminosilicate structure directly along the aluminium base surface have been found.
Modeling of the stress-deformed state of a capacitive apparatus with geometric deviations when mounting on a foundation
Authors: Rubtsov A V , Arkhipova K S , Kulakov P A , Afanasenko V G , Zubkova O E , Mukhametzyanov Z R
Published: September 2021

The reliable and trouble-free operation of the capacitive equipment of hazardous production facilities is significantly influenced by the quality of the installation performed before commissioning. So, during the installation of capacitive equipment, various geometric inconsistencies and deviations may occur, which are established by the current regulatory and technical documents for the installation of technological equipment. If unacceptable deviations and inconsistencies established by regulatory and technical documents are found, they must be fully eliminated. However, in certain cases, the regulatory and technical documentation allows operation with various insignificant geometric deviations and inconsistencies that do not go beyond the established limits. This may relate to deviations from the design horizontal position of the apparatus when installed on a foundation. It should be noted that during operation, under the influence of increased pressure, temperature and other loads, an apparatus with deviations of this type can undergo a completely different stress-deformed state compared to an apparatus without geometric deviations, which is not taken into account in expert diagnostics, strength analysis and assessment of residual resource. The solution to this issue can be approached using software systems that allow building 3D models of the objects under consideration with the introduction of all the necessary parameters into these models and getting a real picture of the distribution of zones of increased stress. In this work, the stress-deformed state of the process vessel is simulated due to the impact of working loads and different directions of deviation from the horizontal design position of the body when the apparatus is mounted on the foundation.
Electromechanical stand for the process of throwing soil with a cutter-thrower
Authors: Gnusov M A , Drapalyuk M V , Druchinin D Yu , Bukhtoyarov L D
Published: September 2021

Every year in all countries of the world there are natural disasters, including forest fires. Quality wood is lost. Today the problem is dealt with both by research teams and production companies. The article presents one of the methods for studying the throwing process and adjusting the adequacy of simulation models. The creation of an electromechanical stand for the process of throwing loose elements allows you to monitor the process of separating portions of soil from the main layer, as well as track and digitize movements in molasses with various characteristics of the entire system under study.
Machine-building organization production using quality management methods
Authors: Priimak E V , Razina I S
Published: September 2021

Mechanical engineering is the leading industry in the world, which has a significant impact on the level of development of a country. It produces various machines, machine tools, mechanisms, devices. The machine-building sector provides equipment to all other sectors of the economy, so the results of the work of related areas depend on its level of development and product quality. Among the main problems of the sector in Russia are high depreciation of fixed assets and low level of innovation. As a result, the low competitiveness of domestic machine-building products in the world market. Competitive advantages can be achieved primarily by improving the quality of manufactured products. Prompt solution of problems related to product quality is achieved by implementing various methods aimed at preventing the appearance of defects. The study presents an algorithm for the development and implementation of the 8D methodology in order to prevent the recurrence of product defects at the enterprise of Aktanyshsky Aggregate Plant. With the help of simple tools that underlie the 8D methodology, the causes of the defect were identified and corrective and preventive measures were proposed.
Analysis of the stress-deformed state of a tube bundle at different values of partition thicknesses and their deviations from verticality
Authors: Zakirnichnaya M M , Rubtsov A V , Kulakov P A , Galiullina N
Published: September 2021

Shell and tube heat exchangers of hazardous industrial facilities are used to heat or cool working media and represent a rather complex individual design, which can consist of several structural elements, such as a body, bonnets, heat exchange tubes, tube sheets, partitions, etc. The failure of one element contributes to the failure of the entire heat exchanger. In the process of assembling or installing elements of the heat exchanger, the formation of various geometric deviations from design solutions is possible, which may be associated with violations of the technology of the assembly process, installation, etc. The presence of such deviations can negatively affect the reliable and trouble-free operation of the apparatus, serve as a scenario for the formation of places of increased stresses, leading to the initiation of defects in these zones and premature failure. One such deviation may be a change in thickness values and deviations from the vertical design of the transverse baffles of the tube bundle as supports for the heat exchange tubes. In the existing methods, the transverse partitions of the tube bundle do not pay attention and do not take into account their possible impact upon deflection on the stress-deformed state of the apparatus as a whole. In this work, the relationship of the effect of thicknesses, values and directions of deviation from the vertical location according to the design of transverse partitions of the pipe bundle on maximum equivalent stresses is investigated.
Dubrovin’s method and Ablowitz-Kaup-Newell-Segur hierarchy
Authors: Smirnov A O , Kolesnikov A S
Published: September 2021

Previously, the Dubrovin method was used to construct spectral curves of multiphase solutions of such integrable models of nonlinear optics as vector and derived nonlinear Schrödinger equations. The method of constructing spectral curves of multiphase solutions of the scalar nonlinear Schrödinger equation was based on replacing matrix differential operator from the Lax pair by the scalar one. The present paper shows that Dubrovin’s method gives the same results. At the same time, it has the advantage that it consists in a simpler construction of multiphase solutions expressed in terms of elementary functions.
Spectral expansions of non-self-adjoint generalized Laguerre semigroups
Authors: Patie Pierre , Savov Mladen
Published: September 2021

We provide the spectral expansion in a weighted Hilbert space of a substantial class of invariant non-self-adjoint and non-local Markov operators which appear in limit theorems for positive-valued Markov processes. We show that this class is in bijection with a subset of negative definite functions and we name it the class of generalized Laguerre semigroups. Our approach, which goes beyond the framework of perturbation theory, is based on an in-depth and original analysis of an intertwining relation that we establish between this class and a self-adjoint Markov semigroup, whose spectral expansion is expressed in terms of the classical Laguerre polynomials. As a by-product, we derive smoothness properties for the solution to the associated Cauchy problem as well as for the heat kernel. Our methodology also reveals a variety of possible decays, including the hypocoercivity type phenomena, for the speed of convergence to equilibrium for this class and enables us to provide an interpretation of these in terms of the rate of growth of the weighted Hilbert space norms of the spectral projections. Depending on the analytic properties of the aforementioned negative definite functions, we are led to implement several strategies, which require new developments in a variety of contexts, to derive precise upper bounds for these norms.
Urinary sediment CCL5 messenger RNA as a potential prognostic biomarker of diabetic nephropathy
Authors: Feng Song-Tao , Yang Yang , Yang Jin-Fei , Gao Yue-Ming , Cao Jing-Yuan , Li Zuo-Lin , Tang Tao-Tao , Lv Lin-Li , Wang Bin , Wen Yi , Sun Lin , Xing Guo-Lan , Liu Bi-Cheng
Published: September 2021

Background

Urinary sediment messenger RNAs (mRNAs) have been shown as novel biomarkers of kidney disease. We aimed to identify targeted urinary mRNAs in diabetic nephropathy (DN) based on bioinformatics analysis and clinical validation.

Methods

Microarray studies of DN were searched in the GEO database and Nephroseq platform. Gene modules negatively correlated with estimated glomerular filtration rate (eGFR) were identified by informatics methods. Hub genes were screened within the selected modules. In validation cohorts, a quantitative polymerase chain reaction assay was used to compare the expression levels of candidate mRNAs. Patients with renal biopsy–confirmed DN were then followed up for a median time of 21 months. End-stage renal disease (ESRD) was defined as the primary endpoint. Multivariate Cox proportional hazards regression was developed to evaluate the prognostic values of candidate mRNAs.

Results

Bioinformatics analysis revealed four chemokines (CCL5, CXCL1, CXLC6 and CXCL12) as candidate mRNAs negatively correlated with eGFR, of which CCL5 and CXCL1 mRNA levels were upregulated in the urinary sediment of patients with DN. In addition, urinary sediment mRNA of CXCL1 was negatively correlated with eGFR (r = −0.2275, P = 0.0301) and CCL5 level was negatively correlated with eGFR (r = −0.4388, P < 0.0001) and positively correlated with urinary albumin:creatinine ratio (r = 0.2693, P = 0.0098); also, CCL5 and CXCL1 were upregulated in patients with severe renal interstitial fibrosis. Urinary sediment CCL5 mRNA was an independent predictor of ESRD [hazard ratio 1.350 (95% confidence interval 1.045–1.745)].

Conclusions

Urinary sediment CCL5 and CXCL1 mRNAs were upregulated in DN patients and associated with a decline in renal function and degree of renal interstitial fibrosis. Urinary sediment CCL5 mRNA could be used as a potential prognostic biomarker of DN.
Genetic analysis of plasmid-encoded mcr-1 resistance in Enterobacteriaceae derived from poultry meat in the Netherlands
Authors: Jamin Casper , Sanders Bazante K , Zhou Miaomiao , Costessi Adalberto , Duijsings Danny , Kluytmans Jan A J W , van Alphen Lieke B , Schrauwen Eefje J A
Published: September 2021

Background

Colistin is classified as the highest priority and critically important antimicrobial for human medicine by WHO as it is the last resort agent for treatment of carbapenem-resistant Enterobacteriaceae in humans. Additional research is necessary to elucidate the genetic structure of mcr-1 resistance genes, commonly found on plasmids, using WGS.

Objectives

To map and compare the genetic characteristics of 35 mcr-1-mediated colistin-resistant Enterobacteriaceae isolated from chicken meat to highlight the genetic variation of the mcr-1-containing plasmids.

Methods

Sequencing was performed using Illumina HiSeq2500, Novaseq6000 and ONT’s GridION. GridION data was locally basecalled and demultiplexed using ONT’s Albacore 2.3.4 followed by Porechop 2.3. Quality filtering was performed using Filtlong 2.0. Hybrid Assembly was performed using Unicycler 4.7. Plasmids were compared with reference sequences in plasmid-RefSeq and pATLAS.

Results

A total of 35 mcr-1 positive Enterobacteriaceae were investigated, which resulted in 34 qualitatively robust hybrid assemblies of 2 Klebsiella pneumoniae and 32 Escherichia coli. mcr-1.1 was present in 33/34 isolates. One isolate contained an mcr-1.1-like resistance gene, due to a deletion of one codon. Two mcr-1.1 genes were located on the chromosome, while the majority of the mcr-1 genes were found on IncX4 type plasmids (n = 19). Almost all plasmids identified in this study were highly similar to plasmids found in human-derived strains.

Conclusions

The mcr-1.1-containing plasmids from retail chicken show high sequence similarity to human mcr-1.1 plasmids, suggesting that this may be a contributor to the presence of colistin resistance in humans.
Theoretical analysis of stress intensity factor for two unequal collinear cracks subjected to internal pressure and compressive stress
Authors: Zhang Xianshang , Long Qingming , Zheng Tao , Zhu Zheming , Wang Meng , Hou Peng
Published: September 2021

In this paper, a new solution of the stress intensity factors (SIFs) for two unequal collinear cracks is developed considering internal pressure, friction and compressive stress. The complex stress function and elliptic integral function are used to obtain the analytical solution of the SIFs, and it shows a good agreement with the previous researchers’ solutions and numerical results. The theoretical results show that the difference and interaction of the SIFs at cracks’ tips are caused by crack geometry parameters, and they also indicate that the internal pressure leads to the SIFs of a mode I crack and affects the SIFs of a mode II crack because of friction.
Post-vaccination COVID Toes (Chilblains) Exacerbated by Rituximab Infusion Suggests Interferon Activation as Mechanism
Authors: Qiao Jana W , Dan Yongwook , Wolf Michael E , Zoccoli Christina M , Demetriou Theodore J , Lennon Robert P
Published: September 2021

Coronavirus disease (COVID) toes are pernio-like skin lesions associated with severe acute respiratory syndrome coronavirus 2. We observed pernio-like skin findings presenting after a Pfizer BioNTech vaccine, which significantly worsened after an infusion of rituximab. This suggests that the mechanism for COVID toes is interferon activation. Military providers may avoid unnecessary referrals for this self-limiting condition by anticipating this adverse effect.
Compounding Effects of Traumatic Brain Injury, Military Status, and Other Factors on Pittsburgh Sleep Quality Index: A Meta-analysis
Authors: Babu Henry Samuel Immanuel , Breneman Charity B , Chun Timothy , Hamedi Arghavan , Murphy Rayelynn , Barrett John P
Published: September 2021

Introduction

Traumatic brain injury (TBI) or concussion is a known risk factor for multiple adverse health outcomes, including disturbed sleep. Although prior studies show adverse effects of TBI on sleep quality, its compounding effect with other factors on sleep is unknown. This meta-analysis aimed to quantify the effects of TBI on subjective sleep quality in the context of military status and other demographic factors.

Materials and Methods

A programmatic search of PubMed database from inception to June 2020 was conducted to identify studies that compared subjective sleep quality measured using Pittsburgh Sleep Quality Index (PSQI) in individuals with TBI relative to a control group. The meta-analysis included group-wise standard mean difference (SMD) and 95% CI. Pooled means and SDs were obtained for TBI and non-TBI groups with and without military service, and meta-regression was conducted to test for group effects. Exploratory analysis was performed to test for the effect of TBI, non-head injury, military status, sex, and age on sleep quality across studies.

Results

Twenty-six articles were included, resulting in a combined total of 5,366 individuals (2,387 TBI and 2,979 controls). Overall, individuals with TBI self-reported poorer sleep quality compared to controls (SMD = 0.63, 95% CI: 0.45 to 0.80). Subgroup analysis revealed differences in the overall effect of TBI on PSQI, with a large effect observed in the civilian subgroup (SMD: 0.80, 95% CI: 0.57 to 1.03) and a medium effect in the civilian subgroup with orthopedic injuries (SMD: 0.40, 95% CI: 0.13 to 0.65) and military/veteran subgroup (SMD: 0.43, 95% CI: 0.14 to 0.71). Exploratory analysis revealed that age and history of military service significantly impacted global PSQI scores.

Conclusions

Poor sleep quality in TBI cohorts may be due to the influence of multiple factors. Military/veteran samples had poorer sleep quality compared to civilians even in the absence of TBI, possibly reflecting unique stressors associated with prior military experiences and the sequelae of these stressors or other physical and/or psychological traumas that combine to heightened vulnerability. These findings suggest that military service members and veterans with TBI are particularly at a higher risk of poor sleep and its associated adverse health outcomes. Additional research is needed to identify potential exposures that may further heighten vulnerability toward poorer sleep quality in those with TBI across both civilian and military/veteran populations.
HHV-6 Encephalitis After Chimeric Antigen Receptor T-cell Therapy (CAR-T): 2 Case Reports and a Brief Review of the Literature
Authors: Rebechi Melanie T , Bork Jacqueline T , Riedel David J
Published: September 2021

Human herpesvirus 6 (HHV-6) reactivation can occur in patients who are highly immunosuppressed, including those who have undergone hematopoietic stem cell transplantation (HSCT). HHV-6 encephalitis is a severe manifestation that is well described in the HSCT population. Chimeric antigen receptor T-cell (CAR-T) therapy is a novel cancer-directed immunotherapy that results in severe immunosuppression. Patients undergoing CAR-T therapy may be at risk for HHV-6 encephalitis, which can be difficult to distinguish from a common adverse effect of CAR-T therapy, neurotoxicity. Herein, we describe 2 patients diagnosed with HHV-6 encephalitis after CAR-T therapy and discuss the diagnostic approach and differential diagnosis for altered mental status after CAR-T therapy. Diagnosing HHV-6 encephalitis can be difficult in this patient population as altered mental status is common after CAR-T therapy and may be attributed to CAR-T-associated neurotoxicity.
Normalization of Peri-Arteriovenous Malformation Hemodynamics Prior to Direct Microsurgery: 2-Dimensional Operative Video
Authors: Rahme Rudy J , Turcotte Evelyn L , Patra Devi P , Welz Matthew E , Batjer H Hunt , Bendok Bernard R
Published: September 2021

Arteriovenous malformations (AVMs) are highly complex vascular lesions characterized by abnormal connections between arteries and an intervening nidus. Definitive and safe treatment of AVMs may require the combination of multiple treatment modalities to address the various complex features of the AVM.
1
Endovascular embolization can be used as an adjuvant to surgery in order to control deep feeders, reduce flow, and address high-risk features such as aneurysms. In addition, by progressively reducing the AVM flow, staged embolization can lead to normalization of peri-AVM hemodynamics and therefore may decrease the risk of postresection hemorrhage.
2,3
In this operative video, we present a case of a 41-yr-old female who presented with progressively worsening left-sided hemiparesis. Magnetic resonance imaging (MRI) and angiography revealed a complex right fronto-parietal AVM with significant associated edema, likely due to the vascular steal phenomenon. The area of edema, which included the motor cortex, was thought to be at high risk for postoperative hemorrhage from normal perfusion pressure breakthrough. We therefore decided to proceed with staged presurgical embolization to gradually normalize the perilesional hemodynamics, and therefore possibly reduce the risk of postoperative morbidity. The patient underwent 3 embolization sessions at 6-wk intervals. An MRI after the last embolization showed near-complete resolution of the fluid-attenuated inversion-recovery (FLAIR) signal around the AVM. Microsurgical resection was performed on the day after the last embolization. The patient tolerated the procedure well and was discharged at her neurological baseline with mild contralateral hemiparesis, which has continued to improve at follow-up. Postoperative angiography showed complete resection of the AVM. The patient consented to the procedure as shown in this operative video and gave informed written consent for use of her images in publication.
Resistance to Aspergillus flavus and Aspergillus parasiticus in Almond Advanced Selections and Cultivars and Its Interaction with the Aflatoxin Biocontrol Strategy
Authors: Moral Juan , Garcia-Lopez M. Teresa , Gordon Ana , Ortega-Beltran Alejandro , Puckett Ryan , Tomari Kenji , Gradziel Thomas M. , Michailides Themis J.
Published: September 2021

Aflatoxin contamination of almond kernels, caused by Aspergillus flavus and A. parasiticus, is a severe concern for growers because of its high toxicity. In California, the global leader of almond production, aflatoxin can be managed by applying the biological control strain AF36 of A. flavus and selecting resistant cultivars. Here, we classified the almond genotypes by K-Means cluster analysis into three groups (susceptible [S], moderately susceptible [MS], or resistant [R]) based on aflatoxin content of inoculated kernels. The protective effects of the shell and seedcoat in preventing aflatoxin contamination were also examined. The presence of intact shells reduced aflatoxin contamination >100-fold. The seedcoat provided a layer of protection but not complete protection. In kernel inoculation assays, none of the studied almond genotypes showed a total resistance to the pathogen. However, nine traditional cultivars and four advanced selections were classified as R. Because these advanced selections contained germplasm derived from peach, we compared the kernel resistance of three peach cultivars to that shown by kernels of an R (Sonora) and an S (Carmel) almond cultivar and five pistachio cultivars. Overall, peach kernels were significantly more resistant to the pathogen than almond kernels, which were more resistant than pistachio kernels. Finally, we studied the combined effect of the cultivar resistance and the biocontrol strain AF36 in limiting aflatoxin contamination. For this, we coinoculated almond kernels of R Sonora and S Carmel with AF36 72 h before or 48 h after inoculating with an aflatoxin-producing strain of A. flavus. The percentage of aflatoxin reduction by AF36 strain was greater in kernels of Carmel (98%) than in those of Sonora (83%). Cultivar resistance also affected the kernel colonization by the biological control strain. AF36 strain limited aflatoxin contamination in almond kernels even when applied 48 h after the aflatoxin-producing strain. Our results show that biocontrol combined with the use of cultivars with resistance to aflatoxin contamination can result in a more robust protection strategy than the use of either practice in isolation.
Biomechanical Evaluation of Semi-rigid Junctional Fixation Using a Novel Cable Anchor System to Prevent Proximal Junctional Failure in Adult Spinal Deformity Surgery
Authors: Doodkorte Remco J.P. , Roth Alex K. , Jacobs Eva , Arts Jacobus J.C. , Willems Paul C.
Published: September 2021

Study Design.

A porcine cadaveric biomechanical study.

Objective.

To biomechanically evaluate a novel Cable Anchor System as semi-rigid junctional fixation technique for the prevention of proximal junctional failure after adult spinal deformity surgery and to make a comparison to alternative promising prophylactic techniques.

Summary of Background Data.

The abrupt change of stiffness at the proximal end of a pedicle screw construct is a major risk factor for the development of proximal junctional failure after adult spinal deformity surgery. A number of techniques that aim to provide a gradual transition zone in range of motion (ROM) at the proximal junction have previously been studied. In this study, the design of a novel Cable Anchor System, which comprises a polyethylene cable for rod fixation, is assessed.

Methods.

Ten T6–T13 porcine spine segments were subjected to cyclic 4 Nm pure-moment loading. The following conditions were tested: uninstrumented, 3 level pedicle screw fixation (PSF), and PSF with supplementary Cable Anchors applied proximally at 1-level (Anchor1) or 2-levels (Anchor2), transverse process hooks (TPH), and 2-level sublaminar tapes (Tape2). The normalized segmental range of motion in the junctional zone was compared using one-way analysis of variance and linear regression.

Results.

Statistical comparison at the level proximal to PSF showed significantly lower ROMs for all techniques compared to PSF fixation alone in all movement directions. Linear regression demonstrated a higher linearity for Anchor1 (0.820) and Anchor2 (0.923) in the junctional zone in comparison to PSF (1-level: 0.529 and 2-level: 0.421). This linearity was similar to the compared techniques (TPH and Tape2).

Conclusion.

The Cable Anchor System presented in this study demonstrated a gradual ROM transition zone at the proximal end of a rigid pedicle screw construct similar to TPH and 2-level sublaminar tape semi-rigid junctional fixation constructs, while providing the benefit of preserving the posterior ligament complex.

Level of Evidence: 5
Shoulder Balance in Adult Spinal Deformity Patients Undergoing Selective Lumbar Fusion
Authors: Alluri Ram Kiran , Sheikh Basel , Elysee Jonathan Charles , Lovecchio Francis , Shah Sachiin , Punyala Ananth , Ang Bryan , Lafage Renaud , Lafage Virginie , Schwab Frank , Kim Han Jo
Published: September 2021

Study Design.

Retrospective review.

Objective.

To analyze if shoulder balance continues to change in the postoperative period in patients undergoing selective lumbar fusion for adult spinal deformity (ASD), and secondarily, analyze if shoulder balance correlates with health-related quality of life (HRQOL) outcomes.

Summary of Background Data.

Shoulder balance in patients with ASD is poorly understood and has largely been extrapolated from adolescent scoliosis literature.

Materials and Methods.

Adult patients who underwent selective lumbar fusion (upper instrumented vertebra: Τ9–Τ12, lower instrumented vertebra: L4-Pelvis) for thoracolumbar or lumbar scoliosis (cobb angle > 30°) or sagittal plane deformity with thoracic compensatory curves (cobb angle > 10°) were identified. The clavicular angle (CA) was used to quantify shoulder balance. Shoulder balance was categorized into three groups postoperatively (balanced: CA <2°, mild imbalance: CA 2°–4°, severe imbalance: CA >4°). The average CA and proportion of patients in each shoulder balance group were compared at each postoperative period. Patients with 1-year postoperative HRQOL scores were identified.

Results.

Eighty-six patients were included. The preoperative CA was 2.7 ± 2.3° and did not significantly change at discharge (2.9 ± 2.4°), 6-weeks (2.5 ± 2.1°), 6-months (2.4 ± 2.2°), 1-year (2.4 ± 2.5°), or 2-years (2.3 ± 1.5°) postoperatively. The proportion of patients in each shoulder balance group did not significantly change from discharge to 6-weeks, 6-months, 1-year or 2-years postoperatively (P > 0.1). At 1-year follow-up, the CA demonstrated no significant correlation with Oswestry Disability Index, Scoliosis Research Society (SRS)-22 score, or SRS-22 subscores. There was no significant association between shoulder balance group and Oswestry Disability Index, SRS-22 score, or SRS-22 subscores.

Conclusions.

In patients with ASD undergoing selective lumbar fusion, shoulder balance did not change over the postoperative period. From a functional standpoint, shoulder balance demonstrated no correlation with HRQOL scores. In patients undergoing selective lumbar fusion for ASD, shoulder balance may not spontaneously correct over the postoperative period, but this may not be of functional consequence.

Level of Evidence: 4
Analysis of MNS16A VNTR polymorphic sequence variations of the TERT gene and associated risk for development of bladder cancer
Authors: Anwar Iqra , Pandith Arshad A. , Wani Mohammad S. , Mir Hyder , Godha Meena , Koul Aabid , Shah Zafar A. , Manzoor Usma , Amin Ina , Qasim Iqbal
Published: September 2021

Background:

The MNS16A variable number tandem repeat (VNTR) polymorphism of the human telomerase reverse transcriptase (hTERT) gene acts as a regulator of hTERT promoter activity and has been shown to have a role in the predisposition toward various cancers. The current study aimed to investigate the association between MNS16A VNTR alleles and genetic predisposition to bladder cancer in the Kashmir region of northern India.

Materials and methods:

A total of 130 patients with bladder cancer and 170 age- and gender-matched healthy controls were included in this study. Primer-specific polymerase chain reaction was used to genotype the different variants of VNTR alleles of the MNS16A VNTR polymorphism.

Results:

Short allele VNTR-243 (SS) genotype frequency significantly differed between cases (9.23%) and controls (3.52%) (OR = 3.08 [95% CI = 1.10–8.61], p = 0.042). The VNTR-243 short allele (S) was found significantly more frequent in bladder cancer cases (28.46%) than controls (20.88%) (OR = 1.50 [95% CI = 1.03–2.19], p = 0.034). Likewise, the long allele (LL) hTERT MNS16A genotype was distributed more frequently in low stage disease versus high stage disease (60.29% vs. 39.70%) (OR = 0.79 [95% CI = 0.39–1.60], p = 0.595).

Conclusion:

The MNS16A VNTR short allele (S) was associated with a higher risk for bladder cancer in our population as compared to long alleles.
Simultaneous laparoscopic nephroureterectomy and robot-assisted radical cystectomy: Lessons learned from our initial experience
Authors: Yajima Shugo , Nakanishi Yasukazu , Matsumoto Shunya , Tanabe Kenji , Masuda Hitoshi
Published: September 2021

Background:

In patients with high-risk bladder cancer and concomitant upper urinary tract malignancies, simultaneous cystectomy and nephroureterectomy is the principle oncological procedure of choice. Nevertheless, there are still not many reports of simultaneous robot-assisted radical cystectomy (RARC) and nephroureterectomy. Therefore, the aim of this study was to evaluate outcomes and complications of simultaneous RARC and laparoscopic nephroureterectomy in our institution.

Materials and methods:

This case series evaluated our initial clinical results of 3 patients who underwent simultaneous laparoscopic unilateral nephroureterectomy and RARC with the da Vinci Xi system between 2019 and 2020 at our hospital. Demographic data, preoperative parameters, and postoperative parameters were retrospectively analyzed.

Results:

All 3 patients were men whose median age was 75 years (range 73–89 years). The median total operative time was 435 minutes (range 429–484 minutes), median estimated blood loss was 377 mL (range 125–410 mL), and median hospital stay was 26 days (range 21–36 days). In all 3 cases, each trocar was used in 7 ports. The postoperative complications were stratified according to the Clavien-Dindo Classification system, and a grade 3B complication developed in 1 patient: trocar site herniation of the small bowel.

Conclusions:

We reported our initial experience of simultaneous laparoscopic nephroureterectomy and RARC. A large-scale prospective, randomized, controlled trial will be required to prove the feasibility and safety of simultaneous laparoscopic nephroureterectomy and RARC.
Sociodemographic and Biomedical Correlates of Developmental Delay in 2- and 4-Year-Olds with Sickle Cell Disease
Authors: Schatz Jeffrey , Reinman Laura , Bills Sarah E. , Johnston Julia D.
Published: September 2021

Background:

Developmental delay occurs frequently in sickle cell disease (SCD). Psychosocial and biomedical factors contribute to delays, but most studies have not examined the timing of risk factors and developmental delay. We examined sociodemographic and biomedical factors to evaluate whether risks of developmental delay differed across 2 developmental periods.

Methods:

We examined Ages and Stages Questionnaire, second edition (ASQ-2), outcomes in 2-year-olds (n = 100) and 4-year-olds (n = 101) with SCD. ASQ-2 data were obtained from routine developmental screenings administered as part of health care between 2009 and 2016 at a single hematology clinic. Medical record reviews were used to identify sociodemographic and biomedical factors associated with positive screenings for developmental delay.

Results:

Two-year-olds with positive ASQ-2 screenings (n = 32; 32%) were less likely to have private health insurance or to have been in formal daycare and more likely to have a severe SCD genotype. Four-year-olds with positive screenings (n = 40; 40%) were more likely to have a severe SCD genotype or an abnormal transcranial Doppler ultrasound (TCD) examination indicating high stroke risk. The strength of the association between positive screenings and insurance status, severe genotypes, and TCD examinations differed across the 2 age groups. Domain-level outcomes on the ASQ-2 also differed across the 2 age groups.

Conclusion:

The cross-sectional data indicate biomedical and psychosocial risks are related to developmental delay, but the association with specific risk factors differs across age.
Second and Third Trimester Fetal Death in the Setting of COVID-19: A California 2020 Case Series
Authors: Plotzker Rosalyn E. , Sowunmi Similoluwa , Eckert Valorie , Barnes Emily , Ngo Van , Stockman Lauren J. , LeMarchand Chloe , Halai Umme-Aiman
Published: September 2021

Maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the second and third trimesters of pregnancy may impact fetal development via vertical transmission, complications of coronavirus disease 2019 (COVID-19), or placental injury. However, potential associations between prenatal SARS-CoV-2 infection and fetal loss are not well understood. This case series of thirteen second and third trimester fetal losses reported by local public health departments to California's state public health surveillance included maternal clinical and demographic characteristics as well as placental pathology, fetal autopsy reports, and coroner report. There was no evidence that maternal COVID-19 disease severity, placental injury, or SARS-CoV-2 vertical transmission contributed to pregnancy loss. However, this case series is a limited sample; more research is needed to identify factors of prenatal SARS-CoV-2 that may contribute to fetal death in the second and third trimesters.
Anesthesia providers as stakeholders to adoption of pharmacogenomic information in perioperative care
Authors: Truong Tien M. , Apfelbaum Jeffrey L. , Schierer Emily , Danahey Keith , Borden Brittany A. , Karrison Theodore , Shahul Sajid , Anitescu Magdalena , Gerlach Rebecca , Knoebel Randall W. , Meltzer David O. , Ratain Mark J. , O’Donnell Peter H.
Published: September 2021

Objectives

Integration of pharmacogenomics into clinical care is being studied in multiple disciplines. We hypothesized that understanding attitudes and perceptions of anesthesiologists, critical care and pain medicine providers would uncover unique considerations for future implementation within perioperative care.

Methods

A survey (multiple choice and Likert-scale) was administered to providers within our Department of Anesthesia and Critical Care prior to initiation of a department-wide prospective pharmacogenomics implementation program. The survey addressed knowledge, perceptions, experiences, resources and barriers.

Results

Of 153 providers contacted, 149 (97%) completed the survey. Almost all providers (92%) said that genetic results influence drug therapy, and few (22%) were skeptical about the usefulness of pharmacogenomics. Despite this enthusiasm, 87% said their awareness about pharmacogenomic information is lacking. Feeling well-informed about pharmacogenomics was directly related to years in practice/experience: only 38% of trainees reported being well-informed, compared to 46% of those with 1–10 years of experience, and nearly two-thirds with 11+ years (P < 0.05). Regarding barriers, providers reported uncertainty about availability of testing, turnaround time and whether testing is worth financial costs.

Conclusions

Anesthesiology, critical care and pain medicine providers are optimistic about the potential clinical utility of pharmacogenomics, but are uncertain about practical aspects of testing and desire clear guidelines on the use of results. These findings may inform future institutional efforts toward greater integration of genomic results to improve medication-related outcomes.
A Summary of Residential Radon Surveys and the Influence of Housing Characteristics on Indoor Radon Levels in Canada
Authors: Chen Jing
Published: September 2021

Based on community and nationwide radon surveys with long-term radon measurements in a total of 21,818 homes, radon distribution characteristics in Canada have been reassessed with the population-weighted arithmetic mean radon concentration of 82 Bq m−3, geometric mean radon concentration of 55 Bq m−3, and geometric standard deviation of 2.45. The major pathway for the influx of radon into Canadian homes is from the surrounding soil. Statistical analysis has shown that radon levels in houses with a basement are, on average, about twice the radon levels in houses without a basement, and houses with private wells also tend to have higher radon concentrations than houses with municipal water supply.
Guidelines for the Diagnosis and Treatment of Dengue in China
Authors: Zhang Fuchun , He Jianfeng , Peng Jie , Tang Xiaoping , Qin Chengfeng , Lu Hongzhou , Li Xingwang , Liu Qingquan , Zhao Hong , Sheng Jifang , Wang Guiqiang
Published: September 2021

Dengue is the most prevalent and rapidly spreading mosquito-borne viral disease. As a dengue non-endemic country, China has experienced several dengue outbreaks in recent years. However, dengue patients in China display clinical characteristics that are distinct from those of patients in dengue-endemic countries. To standardize the diagnosis and treatment of dengue fever, the experts at the Society of Infectious Diseases, Society of Tropical Medicine and Parasitology of the Chinese Medical Association, and the Society of Emergency Medicine of China Association of Chinese Medicine have developed a guideline after reviewing the following guidelines and data: guidelines for diagnosis, treatment, prevention, and control of dengue (World Health Organization, 2009); the guidelines for diagnosis and treatment of dengue (National Health and Family Planning Commission of the People's Republic of China, 2014, Edition 2); health industry standard of the People's Republic of China “diagnosis for dengue fever (WS216-2018)”; and systemic reports on dengue. The new guideline includes eight aspects: introduction, terminology, epidemiology and prevention, etiology and pathogenesis, clinical features, diagnosis, treatment, and problems to be solved.
Scleral Contact Lens as Initial Management in a Neonate With a Large Upper Eyelid Coloboma
Authors: Mortensen Zachary Q. , Simmons Brittany A. , Shriver Erin M. , Carter Keith D. , Downes Sara J.
Published: September 2021

A neonate presented with a large full-thickness upper eyelid coloboma with near-complete exposure of the cornea. After failing lubrication and a moisture chamber, he was fit with a customized scleral contact lens that protected the ocular surface. It was tolerated well, and ocular surface health was maintained for 13 months to permit the growth of eyelid tissue for future oculoplastic surgery. Delaying reconstruction by using scleral contact lenses as management for large eyelid colobomas has not been previously described. A temporizing measure such as this could be considered for large eyelid colobomas in neonates.