bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial Expression Wrinkles and Their Relaxation by a Synthetic Peptide
Authors: Campiche Remo , Pascucci Francesca , Jiang Lily , Vergne Thibault , Cherel Marie , Gougeon Sarah , Préstat-Marquis Elodie , François Ghislain , Laurent Guillaume , Gempeler Mathias
Published: November 2020

Expression wrinkles form over time due to repeated facial movements such as smiling and frowning. They have an imprint on facial skin in areas such as the corner of the eyes, where they take the form of crow’s feet, the forehead and the glabella, where they appear as frown lines, and around the mouth, as marionette lines. In the study presented here, we recruited two sets of volunteers. An older group of 57 volunteers aged 50 to 65 years, and a group of eight younger volunteers aged 21–35 who were the biological daughters of eight of the older volunteers. Using VISIA CR, we took images of the volunteers in relaxed, angry and smiling mode to assess similarities in expression wrinkle patterns. In addition, the older volunteers were split into a placebo group and an active group who applied a formulation of 4% of a cosmetic product containing the peptide diaminobutyroyl benzylamide diacetate (DABBA) for four weeks. Wrinkles were assessed by image analysis, expert grading and Primoslite measurements. Our study found striking similarities in the facial wrinkle patterns of mothers with relaxed faces and daughters with angry or smiling faces. We found a decrease in visible wrinkles in the group of older volunteers applying DABBA. We created a facial map for graded wrinkles showing these changes. Volunteers using the active formulation showed significantly less wrinkle area and length on the forehead when frowning compared to the placebo group (p < 0.05).
GPs’ views on the use of depression screening and GP-targeted feedback: a qualitative study
Authors: Braunschneider Lea-Elena , Lehmann Marco , Magaard Julia Luise , Seeralan Tharanya , Marx Gabriella , Eisele Marion , Scherer Martin , Löwe Bernd , Kohlmann Sebastian
Published: November 2020

Purpose

The first aim of this qualitative study was to identify general practitioners’ (GPs’) views on depression screening combined with GP-targeted feedback in primary care. The second aim was to determine the needs and preferences of GPs with respect to GP-targeted feedback to enhance the efficacy of depression screening.

Methods

A semistructured qualitative interview was conducted with officially registered GPs in Hamburg (Germany). Interviews were audio recorded and transcribed verbatim. An inductive approach was used to code the transcripts.

Results

Nine GPs (27 to 70 years; 5 male) from Hamburg, Germany, participated. Regarding depression screening combined with GP-targeted feedback, five thematic groups were identified: application of screening; screening and patient–physician relationships; GPs’ attitudes towards screening; benefits and concerns related to screening; and GPs’ needs and preferences regarding feedback. While the negative aspects of screening can be described in rather general terms (e.g., screening determines the mental health competence, screening threatens the doctor–patient relationship, revealing questions harm the patients), its advantages were very specific (e.g., promoting the identification of undetected cases, relief of the daily workload, wider communication channel to reach more patients). Standardized GP-targeted feedback of the screening results was perceived as helpful and purposeful. GPs preferred feedback materials that eased their clinical workload (e.g., short text with visuals, pictures, or images).

Conclusion

Addressing GPs’ needs is essential when implementing depression screening tools in clinical practice. To overcome prejudices and enhance the efficacy of screening, further education for GPs on the purpose and application on depression screening may be needed. Standardized GP-targeted feedback in combination with depression screening could be the missing link to improve the detection of depression in primary care.
Mapping choline metabolites in normal and transformed cells
Authors: Roci Irena , Watrous Jeramie D. , Lagerborg Kim A. , Jain Mohit , Nilsson Roland
Published: November 2020

Introduction

Choline is an essential human nutrient that is particular important for proliferating cells, and altered choline metabolism has been associated with cancer transformation. Yet, the various metabolic fates of choline in proliferating cells have not been investigated systematically.

Objectives

This study aims to map the metabolic products of choline in normal and cancerous proliferating cells.

Methods

We performed13C-choline tracing followed by liquid chromatography-high resolution mass spectrometry (LC-HRMS) analysis of metabolic products in normal and in vitro-transformed (tumor-forming) epithelial cells, and also in tumor-derived cancer cell lines. Selected metabolites were quantified by internal standards.

Results

Untargeted analysis revealed 121 LCMS peaks that were13C-labeled from choline, including various phospholipid species, but also previously unknown products such as monomethyl- and dimethyl-ethanolamines. Interestingly, we observed formation of betaine from choline specifically in tumor-derived cells. Expression of choline dehydrogenase (CHDH), which catalyzes the first step of betaine synthesis, correlated with betaine synthesis across the cell lines studied. RNAi silencing of CHDH did not affect cell proliferation, although we observed an increased fraction of G2M phase cells with some RNAi sequences, suggesting that CHDH and its product betaine may play a role in cell cycle progression. Betaine cell concentration was around 10 µM, arguing against an osmotic function, and was not used as a methyl donor. The function of betaine in these tumor-derived cells is presently unknown.

Conclusion

This study identifies novel metabolites of choline in cancer and normal cell lines, and reveals altered choline metabolism in cancer cells.
Investigating the effect of matrix acidizing injection pressure on carbonate-rich Marcellus shale core samples: an experimental study
Authors: Khalil Rayan , Emadi Hossein , Altawati Faisal
Published: November 2020

Near-wellbore damage, which significantly reduces hydrocarbon production, can happen during drilling, cementing, perforation, completion, and stimulation operations. The most common technique to remove or bypass this damage is matrix acidizing. The effects of matrix acidizing injection pressure on acid penetration rate, chemical reaction rate, solubility, porosity, and permeability of Marcellus core samples were investigated in this experimental study. To achieve a successful acid treatment, acid type and concentration must be carefully selected. The results of the X-ray powder diffraction (XRD) and the solubility test revealed that 15 wt.% hydrochloric acid (HCl) is the optimum acid. Matrix acidizing treatments were implemented on nine core samples, taken from Marcellus (shale gas reservoir), at the reservoir temperature (66 °C), confining pressure of 10.35 MPa, and three different acid injection pressures (1.72, 3.45, and 5.17 MPa). The results showed that performing acid treatments on the samples containing continuous carbonate layers created highly permeable channels (wormholes) resulting in significant improvement, up to 3900%, in the permeability of the samples. Additionally, the results of the acid penetration rate, chemical reaction rate, solubility, porosity, and permeability revealed that increasing the acid injection pressure resulted in increases in the aforementioned properties of the samples. The results also revealed that any increase in the injection pressure above 3.45 MPa did not demonstrate any significant enhancements in the properties of the samples. The results of the XRD analysis revealed that matrix-acidizing treatments dissolved 23.2% of calcite and 0.4% of dolomite existed in the samples.
Significant production improvement using optimization of completion and artificial lift: case studies from South-West Iran
Authors: Ashena Rahman , Bataee Mahmood , Jafarpour Hamed , Abbasi Hamid , Zolotukhin Anatoly , Mirhashemi Mohammad
Published: November 2020

Productivity of wells in South-West Iran has decreased due to completion and production problems in recent decades. This is a large risk against sustainable production from the fields. To allow stable production, an important measure is completion and production optimization including artificial lift methods. This was investigated using simulations validated by pilot field tests. Several case studies were considered in terms of their completion and production. Five scenarios were investigated: natural production through annulus and tubing (scenario-1 and 2), artificial gas lift production through annulus (scenario-3), through tubing using non-standard gas lift (scenario-4) and using standard gas lift (scenario-5). Scenario-1 is currently the case in most wells of the field. To find the optimal scenario and completion/production parameters, simulations of 11 wells of an oilfield in the region were carried out using nodal and sensitivity analysis. The optimized parameters include wellhead pressures (WHPs), tubing dimensions, maximum tolerable water cuts and gas oil ratios and artificial gas injection rate. Simulation results were validated by pilot field tests. In addition, appropriately selected wellhead and Christmas trees for all scenarios were depicted. Simulations confirmed by field pilot tests showed that optimization of completion and production mode and parameters can contribute largely to production improvement. The results showed that the current scenario-1 is the worst of all. However, production through tubing (scenario-2) is optimal for wells which can produce with natural reservoir pressure, with an increase of 800 STB/Day rate per well compared with scenario-1. However, for wells requiring artificial gas lift, the average production rate increase (per well) from the annulus to tubing production was 1185 STB/Day. Next, using the standard gas lift (scenario-5) was found to be the optimal mode of gas lifting and is strongly recommended. WHPs in scenario-5 were the greatest of all, whereas scenario-1 gave the lowest WHPs. The optimal tubing diameter and length were determined. The greatest maximum tolerable water cut was obtained using scenario-5, whereas the lowest was with scenario-1. The maximum tolerable GOR was around 1900 scf/STB. Changing of scenarios did not have significant effect on maximum tolerable GOR. The optimal artificial gas injection rates were found. This validated simulation work proved that completion and production optimization of mode and parameters had considerable contribution to production improvement in South-West Iran. This sequential comprehensive work can be applied in any other field or region.
Characterizing El Niño-Southern Oscillation Effects on the Blue Nile Yield and the Nile River Basin Precipitation using Empirical Mode Decomposition
Authors: Le Justin A. , El-Askary Hesham M. , Allali Mohamed , Sayed Eman , Sweliem Hani , Piechota Thomas C. , Struppa Daniele C.
Published: November 2020

Using new mathematical and data-driven techniques, we propose new indices to measure and predict the strength of different El Niño events and how they affect regions like the Nile River Basin (NRB). Empirical Mode Decomposition (EMD), when applied to Southern Oscillation Index (SOI), yields three Intrinsic Mode Functions (IMF) tracking recognizable and physically significant non-stationary processes. The aim is to characterize underlying signals driving ENSO as reflected in SOI, and show that those signals also meaningfully affect other physical processes with scientific and predictive utility. In the end, signals are identified which have a strong statistical relationship with various physical factors driving ENSO variation. IMF 6 is argued to track El Niño and La Niña events occurrence, while IMFs 7 and 8 represent another signal, which reflects on variations in El Niño strength and variability between events. These we represent an underlying inter-annual variation between different El Niño events. Due to the importance of the latter, IMFs 7 and 8, are defined as Interannual ENSO Variability Indices (IEVI) and referred to as IEVI α and IEVI β. EMD when applied to the NRB precipitation, affecting the Blue Nile yield, identifying the IEVI-driven IMFs, with high correlations of up to ρ = 0.864, suggesting a decadal variability within NRB that is principally driven by interannual decadal-scale variability highlighting known geographical relationships. Significant hydrological processes, driving the Blue Nile yield, are accurately identified using the IEVI as a predictor. The IEVI-based model performed significantly atp = 0.038 with Blue Nile yield observations.
QSAR, Ligand Based Design and Pharmacokinetic Studies of Parviflorons Derivatives as Anti-Breast Cancer Drug Compounds Against MCF-7 Cell Line
Authors: Abdulrahman Hadiza Lawal , Uzairu Adamu , Uba Sani
Published: November 2020

The anti-proliferative activities of Novel series of Parviflorons against MCF-7 breast cancer cell line was explored via in-silico studies like Quantitative Structure–Activity Relationship QSAR, designing new compounds and analyzing the pharmacokinetics properties of the designed compounds. From QSAR, model one emerged the best from the statistical assessments of (R2) = 0.9444, (R2adj) = 0.9273, (Q2) = 0.8945 and (R2pred) of 0.6214. The model was used in designing new derivative compounds, with higher effectiveness against estrogen positive breast cancer (MCF-7). The pharmacokinetics analysis carried out on the newly designed compounds showed that all the compounds passed the drug-likeness test and also the Lipinski rule of five, and they could further proceed to pre-clinical tests. The results indicates that the derivative compounds would serve as potent cure to estrogen positive breast cancer (MCF-7 cell line).
Effects of modifying the hypoeutectic AlMg5Si2Mn alloy via addition of Al10Sr and/or Al5TiB
Authors: Snopiński P. , Król M. , Wróbel T. , Matus K. , Woźniak A. , Tański T. , Palček P.
Published: November 2020

This work demonstrates that the combined addition of Al10Sr and Al5TiB master alloys to the AlMg5Si2Mn effectively refines the grain microstructure and partially modifies the eutectic Mg2Si phase. Thorough spectroscopic characterization reveals that the grain refinement effect is due to Al3Ti particles acting as nucleation sites for α-Al grains, and the increased nucleation temperature of α-Al is due to Al10Sr addition. It is also determined that TiB2 particles can act as nucleation substrates for the primary Mg2Si phase. The prepared alloy sample with the finest microstructure (treated with both Al10Sr and Al5TiB) exhibits the greatest corrosion resistance among all tested samples.
Completed secondary education among youth with prenatal substance exposure: A longitudinal register‐based matched cohort study
Authors: Nissinen Niina‐Maria , Gissler Mika , Sarkola Taisto , Kahila Hanna , Autti‐Rämö Ilona , Koponen Anne M.
Published: November 2020

Introduction

The dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out‐of‐home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring.

Methods

This is a longitudinal register‐based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18–23 years.

Results

The results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences in the secondary education completion between exposed and unexposed were diminished in the presence of covariates. A cumulative childhood adversity score and out‐of‐home care were not associated with secondary education completion in the multivariate models, whereas the different domains of offspring's mental and/or behavioural disorders including psychiatric disorders (AOR 0.65, 95% CI 0.45–0.96), neuropsychological disorders (AOR 0.35, 95% CI 0.23–0.54) and dual psychiatric and neuropsychological disorder (AOR 0.29, 95% CI 0.18–0.48) showed an independent negative effect on secondary education completion.

Conclusions

Inferior educational outcomes may not be directly linked with prenatal substance exposure but may rather reflect the extent of evolving offspring's mental and/or behavioural disorders over time influenced by childhood adversities.
Biomechanical Comparison of a Notched Head Locking T-Plate and a Straight Locking Compression Plate in a Juxta-Articular Fracture Model
Authors: Bird Guy , Glyde Mark , Hosgood Giselle , Hayes Alex , Day Robert
Published: November 2020

Objective This investigation compared the biomechanical properties of a 2.0 mm locking compression notched head T-plate (NHTP) and 2.0 mm straight locking compression plate (LCP), in a simple transverse juxta-articular fracture model.

Study Design Two different screw configurations were compared for the NHTP and LCP, modelling short (configuration 1) and long working length (configuration 2). Constructs were tested in compression, perpendicular and tension non-destructive four point bending and torsion. Plate surface strain was measured at 12 regions of interest (ROI) using three-dimensional digital image correlation. Stiffness and strain were compared between screw configurations within and between each plate.

Results The LCP was stiffer than the NHTP in all three planes of bending and torsion (p < 0.05). The NHTP had greater strain than the LCP during compression bending and torsion at all ROI (p < 0.0005). The short working length was stiffer in all three planes of bending and in torsion (p < 0.05) than the longer working length for both plates. The long working length showed greater strain than the short working length at most ROI.

Conclusion In this experimental model, a 2.0 mm LCP with two screws in the short fragment was significantly stiffer and had lower plate strain than a 2.0 mm NHTP with three screws in the short fragment. Extending the working length significantly reduced construct stiffness and increased plate strain. These findings may guide construct selection.
Proficiency of Laryngeal Mask Airway Insertion Skill in NRP Certified Providers
Authors: Mani Srinivasan , Rawat Munmun
Published: November 2020

Objective In 2015, Neonatal Resuscitation Program (NRP) recommended laryngeal mask airway (LMA) as an alternative to the endotracheal tube (ETT) in situations where the provider is “unable to intubate and unable to ventilate.” LMA insertion is being taught in the NRP routinely. However, endotracheal intubation is the primary method considered as the standard of care in neonatal resuscitation. LMA insertion is a relatively simple procedure with an average insertion time of < 10 seconds. Newer generation LMA can have the added advantage of reducing the risk of aerosol generation and improving the safety of the providers. Only a few recent studies have evaluated the LMA insertion skills of neonatal resuscitation providers. We wanted to study the proficiency of NRP providers in the technique of LMA insertion. We hypothesized that NRP providers would have LMA insertion skills equivalent to the standard of care (ETT insertion).

Study Design A manikin-based study was done from July 2019 to December 2019. We enrolled 31 NRP providers with 1 or more years since the first certification and current valid NRP provider/instructor status. The participants were instructed to insert an ETT and LMA in the manikin. The procedures were video recorded. The time taken to insert and start ventilation with each device, including the number of attempts for successful insertion, was noted. A Likert scale questionnaire was filled by each participant indicating the level of confidence, perception of ease, and the ability to provide effective positive pressure ventilation (PPV) with each of the procedures. The paired t-test, chi-square test, and Kruskal–Wallis' test were used for the statistical analysis.

Results Eight (25.8%) out of the 31 participants failed to insert any one of the devices. So, 23 providers were analyzed for the outcomes. We found that the mean duration taken to insert the ETT and LMA was not statistically different (32 vs. 36 seconds). LMA insertion had a higher failure rate compared with ETT. Providers did not perceive confidence to insert LMA when compared with ETT. They did not recognize LMA insertion as a more effortless procedure relative to endotracheal intubation. The providers felt that their ability to provide effective PPV using LMA was inferior to ETT.

Conclusion The NRP certified providers in this study did not demonstrate proficiency in the insertion of LMA equivalent to the endotracheal intubation.

Key Points
New genomically enhanced reproduction breeding values for Merino sheep allow targeted selection for conception rate, litter size and ewe rearing ability
Authors: Bunter K. L. , Swan A. A. , Gurman P. M. , Brown D. J.
Published: November 2020

Context
Net reproduction rate defined as number of lambs weaned for joined ewes reflects conception, litter size and the ability of ewes to rear lambs to weaning age. These three attributes can be treated as separate traits for genetic evaluation, allowing breeders to focus selection for each appropriately.

Aims
The aim of the present paper was to present characteristics of the data, models and genetic parameters estimated from Merino data, along with results demonstrating the predictive capacity of breeding values, for conception, litter size, rearing ability, maternal behaviour and body condition score.

Methods
Industry data from MERINOSELECT were used to derive phenotypes for conception, litter size and rearing ability traits separately for yearling and adult ewes, along with maternal behaviour and body condition score. Indirect traits provided correlated information, including scrotal circumference, weight, scanned fat and eye muscle depths at up to three ages (post-weaning, yearling and hogget), along with pre-joining weight and condition score for ewes. Co-variances were estimated among the 19 traits included in the analysis. Breeding values were estimated using single step genomic methodology using consensus estimates of genetic parameters, with the predictive capacity of breeding values being estimated using forward-validation.

Key results
Heritabilities ranged from 0.04 to 0.06 for conception, litter size and rearing ability, and were moderate for maternal behaviour (0.13) and condition score (0.20). Component traits were genetically controlled by some common genes, but with genetic correlations less than 0.5, each component can be selected for independently. Weight, fat depth and muscle depth measures were moderately to highly correlated with body condition score. These body development traits generally had low, favourable genetic correlations with ewe reproductive traits.

Conclusions
These procedures provide better use of data recorded by breeders subject to both data limitations and opportunities, and provide separate breeding values for conception, litter size, rearing ability, maternal behaviour and body condition score.

Implications
New breeding values with good predictive ability are now available for the component traits of reproduction. Direct recording data of the traits is required to achieve accuracy of breeding values. Australian Merino breeders are now able to select directly for components of reproduction and specific maternal characteristics.
Analysis of the Columellar-Labial Angle in Perioral Aging
Authors: Felix Bravo Bruna , Bianco Stephanie , de Bastos Julien Totti , Luiz Lopes Fernando , Alcala Gelpi Berta , Gonçalves Bravo Leonardo
Published: November 2020

Background

The young face presents a convex and rounded aspect; with aging, this changes to a more concave and flattened aspect, with the angles of the face undergoing changes through soft tissue repositioning and bone remodeling. The columellar-labial angle is one of the features that change.

Objectives

The objective of the present study was to analyze the columellar-labial angle at different stages of adult life and assess its contribution to facial changes during aging.

Methods

We analyzed a database (December 2017-March 2018) of 722 female patients, aged 21 to 88 years, and obtained anthropometric measurements of the columellar-labial angle with a Canfield Vectra 3D image analysis system. Our database originates from a private clinic where all patients were registered and photographed.

Results

Our analysis showed a decrease in the columellar-labial angle, mainly observed from patients aged 60 years and older. This decrease can be explained by the absorption of body structures that occurs during aging.

Conclusions

The columellar-labial angle decreases with age, and this finding may provide a better understanding of the transformation that occurs with aging. Obtaining a clearer view of the changes that occur in the face will improve treatments for facial rejuvenation, either conservative or surgical, and provide a basis for future studies and knowledge expansion.

Level of Evidence: 4
Cost-effectiveness analysis of thoracoscopic versus open esophagectomy for esophageal cancer: a population-based study
Authors: Chao Yin-Kai , Wen Yu-Wen
Published: November 2020

The question as to whether the clinical benefits of video-assisted thoracoscopic esophagectomy (VATE) do outweigh its increased costs remains unanswered. Here, we analyzed the cost-effectiveness of VATE versus open esophagectomy (OE) in a real-world setting. Using 2008–2015 Taiwanese Health Insurance claim data, we identified 3271 patients with esophageal cancer who underwent transthoracic esophagectomy. By taking into account nine confounding variables, we constructed a 1:1 propensity score-matched sample of patients who underwent VATE or OE (n = 629 each). Direct costs incurred within three years after surgery and survival were analyzed. There were no significant intergroup differences in terms of R0 resection rates, length of stay, as well as 30- and 90-day mortality and unplanned readmission rates. However, the number of dissected nodes was higher in the VATE group (median: 24 vs. 18, P < 0.001). While VATE had higher index hospitalization costs (median, 12331 USD vs. 10730 USD, P < 0.001), cost differences were reduced over time. The average accumulated cost person-month of VATE declined below that of OE at 14 months after hospital discharge. Overall survival (OS) figures were more favorable for patients treated with VATE (3-year OS: 47% vs. 41%; life expectancy: 4.04 life-years [LY] vs. 3.30 LY). The cost-effectiveness plane showed that only 0.3% of all VATE procedures were more costly and less effective than OE. The probabilities for VATE to be cost-effective at the willingness-to-pay (WTP) thresholds of 10000 and 50000 USD/LY were 63.5% and 92.4%, respectively. Using commonly accepted WTP thresholds, VATE was more cost-effective than OE for patients with esophageal cancer.
Cardiovascular Health and Mitochondrial Function: Testing an Association
Authors: Zampino Marta , Spencer Richard G , Fishbein Kenneth W , Simonsick Eleanor M , Ferrucci Luigi
Published: November 2020

Background

Although mitochondrial dysfunction appears to be a contributing factor in the pathogenesis of cardiovascular and metabolic diseases, empirical data on this association are still lacking. This study evaluated whether mitochondrial oxidative capacity, as assessed by phosphorus magnetic resonance spectroscopy, was associated with cardiovascular risk, as estimated by the Framingham Risk Score (FRS), and with a clinical history of cardiovascular disease (CVD), in community-dwelling adults.

Method

A total of 616 subjects from the Baltimore Longitudinal Study of Aging (mean age 66 years) underwent a comprehensive clinical evaluation. Mitochondrial oxidative capacity in skeletal muscle was assessed as post-exercise phosphocreatine recovery time constant by phosphorus magnetic resonance spectroscopy. Multivariate regression models were employed to determine the cross-sectional association of mitochondrial oxidative capacity with FRS and history of CVD.

Results

Decreased mitochondrial oxidative capacity was strongly associated with higher FRS independent of age, body composition, and physical activity. Lower oxidative capacity was also associated with a history of positive of CVD and higher number of CVD events.

Conclusions

We speculate that the observed association could reflect the effect of an excessive production of oxidative species by dysfunctional mitochondria. Furthermore, decreased energy production could hamper the functionality of heart and vessels. In turn, a malfunctioning cardiovascular apparatus could fail to deliver the oxygen necessary for optimal mitochondrial energy production, therefore creating a vicious cycle. Longitudinal studies are necessary to ascertain the directionality of the association and the eventual presence of common pathogenetic roots. In conclusion, mitochondria could represent an important target for intervention in cardiovascular health.
Aortic arch surgery at 32°C: mild hypothermia and unilateral antegrade cerebral perfusion
Authors: Jabagi Habib , Juanda Nadzir , Nantsios Alex , Boodhwani Munir
Published: November 2020

OBJECTIVES

With development of antegrade cerebral perfusion, the necessity of deep hypothermic circulatory arrest (CA) in aortic arch surgery has been called into question. To minimize the adverse effects of hypothermia, surgeons now perform these procedures closer to normothermia. This study examined postoperative outcomes of hemiarch replacement patients using unilateral selective antegrade cerebral perfusion and mild hypothermic CA.

METHODS

Single-centre retrospective review of 66 patients undergoing hemiarch replacement with mild hypothermic CA (32°C) and unilateral selective antegrade cerebral perfusion between 2011 and 2018. Antegrade cerebral perfusion was delivered using right axillary artery cannulation. Postoperative data included death, neurological dysfunction, acute kidney injury and renal failure requiring new dialysis. Additional intraoperative metabolic data and blood transfusions were obtained.

RESULTS

Eighty-six percent of patients underwent elective surgery. Mean age was 67 ± 3 years. Lowest mean core body temperature was 32 ± 2°C. Average CA was 17 ± 5 min. No intraoperative or 30-day mortality occurred. Survival was 97% at 1 year, 91% at 3 years and 88% at 5 years. Permanent and temporary neurological dysfunction occurred in 1 (2%) and 2 (3%) patients, respectively. Only 3 (5%) patients suffered postoperative stage 3 acute kidney injury requiring new dialysis. Intraoperative transfusions occurred in 44% of patients and no major metabolic derangements were observed.

CONCLUSIONS

In patients undergoing hemiarch surgery, mild hypothermia (32°C) with unilateral selective antegrade cerebral perfusion via right axillary cannulation is associated with low mortality and morbidity, offering adequate neurological and renal protection. These findings require validation in larger, prospective clinical trials.
Clustering, factor discovery and optimal transport
Authors: Yang Hongkang , Tabak Esteban G
Published: November 2020

The clustering problem, and more generally latent factor discovery or latent space inference, is formulated in terms of the Wasserstein barycenter problem from optimal transport. The objective proposed is the maximization of the variability attributable to class, further characterized as the minimization of the variance of the Wasserstein barycenter. Existing theory, which constrains the transport maps to rigid translations, is extended to affine transformations. The resulting non-parametric clustering algorithms include $k$-means as a special case and exhibit more robust performance. A continuous version of these algorithms discovers continuous latent variables and generalizes principal curves. The strength of these algorithms is demonstrated by tests on both artificial and real-world data sets.
Organizational characteristics and perceptions of clinical event notification services in healthcare settings: a study of health information exchange
Authors: Wiley Kevin K , Hilts Katy Ellis , Ancker Jessica S , Unruh Mark A , Jung Hye-Young , Vest Joshua R
Published: November 2020

Objective

Event notification systems are an approach to health information exchange (HIE) that notifies end-users of patient interactions with the healthcare system through real-time automated alerts. We examined associations between organizational capabilities and perceptions of event notification system use.

Materials and Methods

We surveyed representatives (n = 196) from healthcare organizations (n = 96) that subscribed to 1 of 3 Health Information Organizations’ event notification services in New York City (response rate = 27%). The survey was conducted in Fall 2017 and Winter 2018. Surveys measured respondent characteristics, perceived organizational capabilities, event notification use, care coordination, and care quality. Exploratory factor analysis was used to identify relevant independent and dependent variables. We examined the relationship between organizational capabilities, care coordination, and care quality using multilevel linear regression models with random effects.

Results

Respondents indicated that the majority of their organizations provided follow-up care for emergency department visits (66%) and hospital admissions (73%). Perceptions of care coordination were an estimated 57.5% (β = 0.575; P < 0.001) higher among respondents who reported event notifications fit within their organization’s existing workflows. Perceptions of care quality were 46.5% (β = 0.465; P < 0.001) higher among respondents who indicated event notifications fit within existing workflows and 23.8% (β = 0.238; P < 0.01) higher where respondents reported having supportive policies and procedures for timely response and coordination of event notifications.

Discussion and Conclusion

Healthcare organizations with specific workflow processes and positive perceptions of fit are more likely to use event notification services to improve care coordination and care quality. In addition, event notification capacity and patient consent procedures influence how end-users perceive event notification services.
Gödel justification logics and realization
Authors: Pischke Nicholas
Published: November 2020

We study the topic of realization from classical justification logics in the context of the recently introduced Gödel justification logics. We show that the standard Gödel modal logics of Caicedo and Rodriguez are not realized by the Gödel justification logics and moreover, we study possible extensions of the Gödel justification logics, which are strong enough to realize the standard Gödel modal logics. On the other hand, we study the fragments of the standard Gödel modal logics, which are realized by the usual Gödel justification logics. We prove the corresponding realization theorem by using Fitting’s merging of realizations as well as appropriate hypersequent calculi on the modal side, adapting the work by Metcalfe and Olivetti. For these hypersequent calculi, we also show a cut-elimination theorem. We provide natural semantical characterizations for all of these newly introduced logics.
Antidepressant Effect of Blue Light on Depressive Phenotype in Light-Deprived Male Rats
Authors: Meng Qinghe , Jiang Jianjun , Hou Xiaohong , Jia Lixia , Duan Xiaoxiao , Zhou Wenjuan , Zhang Qi , Cheng Zhiyuan , Wang Siqi , Xiao Qianqian , Wei Xuetao , Hao Weidong
Published: November 2020

Blue light has been previously reported to play a salient role in the treatment of seasonal affective disorder. The present study aimed to investigate whether blue light had antidepressant effect on light-deprivation-induced depression model, and the underlying visual neural mechanism. Blue light mitigated depression-like behaviors induced by light deprivation as measured by elevated sucrose preference and reduced immobility time. Blue light enhanced melanopsin expression and light responses in the retina. We also found the upregulation of serotonin and brain derived neurotrophic factor expression in the c-fos-positive areas of rats treated with blue light compared with those maintained in darkness. The species gap between nocturnal albino (Sprague-Dawley rat) and diurnal pigmented animals (human) might have influenced extrapolating data to humans. Blue light has antidepressant effect on light-deprived Sprague-Dawley rats, which might be related to activating the serotonergic system and neurotrophic activity via the retinoraphe and retinoamygdala pathways. Blue light is the effective component of light therapy for treatment of depression.
Creating a galaxy lacking dark matter in a dark matter-dominated universe
Authors: Macciò Andrea V , Prats Daniel Huterer , Dixon Keri L , Buck Tobias , Waterval Stefan , Arora Nikhil , Courteau Stéphane , Kang Xi
Published: November 2020

We use hydrodynamical cosmological simulations to show that it is possible to create, via tidal interactions, galaxies lacking dark matter (DM) in a DM-dominated universe. We select dwarf galaxies from the NIHAO project, obtained in the standard cold dark matter model and use them as initial conditions for simulations of satellite–central interactions. After just one pericentric passage on an orbit with a strong radial component, NIHAO dwarf galaxies can lose up to 80 per cent of their DM content, but, most interestingly, their central (≈8 kpc) DM-to-stellar mass ratio changes from a value of ∼25, as expected from numerical simulations and abundance matching techniques, to roughly unity as reported for NGC 1052-DF2 and NGC 1054-DF4. The stellar velocity dispersion drops from ∼30 $\, \rm km\, s^{-1}$ before infall to values as low as 6 ± 2 $\, \rm km\, s^{-1}$. These, and the half-light radius around 3 kpc, are in good agreement with observations from van Dokkum and collaborators. Our study shows that it is possible to create a galaxy without DM starting from typical dwarf galaxies formed in a DM-dominated universe, provided they live in a dense environment.
Understanding sleep disturbance in the context of malignant brain tumors: a qualitative analysis
Authors: Jeon Megan S , Agar Meera R , Koh Eng-Siew , Nowak Anna K , Hovey Elizabeth J , Dhillon Haryana M
Published: November 2020

Background

Sleep is an important element in health-related quality of life of cancer patients and caregivers. This study aimed to explore the experience of sleep disturbance in people with malignant brain tumors (BT) and their family caregivers.

Methods

Participants were recruited from ambulatory neuro-oncology clinics. Semi-structured interviews were conducted with 24 patients (67% with high-grade gliomas) and 14 caregivers. Data were analyzed thematically using a framework synthesis.

Results

We identified six themes relating to perceptions of the nature, impact, causal factors, and interventions for sleep disturbance, beliefs about sleep and impact, and personal coping strategies. Participants described their sleep disturbance in terms of insomnia symptoms; most commonly difficulties initiating and maintaining sleep. Participants had varied views on causal factors including the BT diagnosis and treatment and caregiver burden. However, excessive thinking and BT-related anxiety were evident in both patients and caregivers. The described impact on daytime functioning due to non-restful sleep and fatigue appeared to be significant and many participants needed daytime naps, although they understated the impact on individual functioning. Some participants were reluctant to seek help from clinicians for sleep disturbance due to previous experiences where sleep disturbance was overlooked, or because they held negative views toward pharmacological interventions. Participants reported various coping strategies, ranging from relaxation-promoting techniques to behaviors to distract thinking at night that may instead disturb sleep.

Conclusions

Psychological factors contribute to sleep disturbance in patients with BT and caregivers. This population may benefit from information about sleep disturbance and interventions targeting anxiety.
Performance of a Semiquantitative Multiplex Bacterial and Viral PCR Panel Compared With Standard Microbiological Laboratory Results: 396 Patients Studied With the BioFire Pneumonia Panel
Authors: Rand Kenneth H , Beal Stacy G , Cherabuddi Kartikeya , Couturier Brianne , Lingenfelter Beth , Rindlisbacher Cory , Jones Jay , Houck Herbert J , Lessard Kylie J , Tremblay Elizabeth E
Published: November 2020

Background

Microbiologic results are critical to optimal management of patients with lower respiratory tract infection, but standard methods may take several days. The multiplex polymerase chain reaction BioFire Pneumonia (PN) panel detects 15 common bacterial species semiquantitatively as copy number/mL, 8 viral species, and 7 resistance genes in about an hour within the clinical laboratory.

Methods

We tested 396 unique endotracheal or bronchoalveolar lavage specimens with the BioFire Pneumonia panel and compared the bacterial detections to conventional gram stain and culture results.

Results

Of the 396 patients, 138 grew at least 1 bacterium that had a target on the PN panel, and 136/138 (98.6%) were detected by the panel. A total of 177 isolates were recovered in culture and the PN panel detected 174/177 (98.3%). A further 20% of patients had additional targets detected that were not found on standard culture (specificity 69%, positive predictive value 63%, and negative predictive value 98.9%). Copy number was strongly related to standard semiquantitative growth on plates reported by the laboratory (eg, 1+, 2+, 3+ growths) and was significantly higher in those specimens that grew a potential pathogen. Both higher copy number and bacterial detections found by the PN panel, but not found in culture, were strongly positively related to the level of white blood cells reported in the initial gram stain.

Conclusions

Higher copy number and bacterial detections by the PN panel are related to the host respiratory tract inflammatory response. If laboratories can achieve a rapid turnaround time, the PN panel should have a significant impact both on patient management and on antibiotic stewardship.
Jugular Vein Thrombosis and Anticoagulation Therapy in Lemierre’s Syndrome—A Post Hoc Observational and Population-Based Study of 82 Patients
Authors: Nygren David , Elf Johan , Torisson Gustav , Holm Karin
Published: November 2020

Background

Lemierre’s syndrome is typically caused by Fusobacterium necrophorum where an oropharyngeal infection is followed by septic internal jugular vein thrombophlebitis with subsequent septic embolization. Yet, the pathogenesis of septic thrombophlebitis, differences dependent on the presence of jugular vein thrombosis, and the role of anticoagulant therapy are insufficiently understood.

Methods

Patients with invasive infection with F. necrophorum and Lemierre’s syndrome who had been investigated for jugular vein thrombosis were included from a previous population-based observational study in Sweden. Medical records were reviewed and compared in patients with and without jugular vein thrombosis. Then, patients with jugular vein thrombosis were compared by exposure to therapeutic, prophylactic, or no anticoagulation. Outcomes examined were thrombosis progression, early or late peripheral septic complications, chronic major sequelae, 30-day mortality, and major bleeding.

Results

Fifty-one of 82 (62%) radiologically investigated patients with Lemierre’s syndrome had jugular vein thrombosis. Patients with jugular vein thrombosis had lower platelet levels (median, 76 vs 112 ×109/L; P = .04) on presentation and more days to defervesence (12 vs 7 days; P = .03) yet similar rates of major sequelae and 30-day mortality. No significant differences in outcomes were seen between patients with jugular vein thrombosis exposed to therapeutic, prophylactic, or no anticoagulation therapy, yet study outcomes were rare.

Conclusions

Patients with Lemierre’s syndrome with jugular vein thrombosis were more severely affected, yet had similar prognosis. Most patients with jugular vein thrombosis recovered well without therapeutic anticoagulation therapy, though adverse events were similarly rare in anticoagulated patients. The observational design and rarity of study outcomes require cautious interpretation.
Cortical arousal frequency is increased in narcolepsy type 1
Authors: Brink-Kjaer Andreas , Christensen Julie A E , Cesari Matteo , Mignot Emmanuel , Sorensen Helge B D , Jennum Poul
Published: November 2020

Study Objectives

Hypocretin deficient narcolepsy (type 1, NT1) presents with multiple sleep abnormalities including sleep-onset rapid eye movement (REM) periods (SOREMPs) and sleep fragmentation. We hypothesized that cortical arousals, as scored by an automatic detector, are elevated in NT1 and narcolepsy type 2 (NT2) patients as compared to control subjects.

Methods

We analyzed nocturnal polysomnography (PSG) recordings from 25 NT1 patients, 20 NT2 patients, 18 clinical control subjects (CC, suspected central hypersomnia but with normal cerebrospinal (CSF) fluid hypocretin-1 (hcrt-1) levels and normal results on the multiple sleep latency test), and 37 healthy control (HC) subjects. Arousals were automatically scored using Multimodal Arousal Detector (MAD), a previously validated automatic wakefulness and arousal detector. Multiple linear regressions were used to compare arousal index (ArI) distributions across groups. Comparisons were corrected for age, sex, body-mass index, medication, apnea-hypopnea index, periodic leg movement index, and comorbid rapid eye movement sleep behavior disorder.

Results

NT1 was associated with an average increase in ArI of 4.02 events/h (p = 0.0246) compared to HC and CC, while no difference was found between NT2 and control groups. Additionally, a low CSF hcrt-1 level was predictive of increased ArI in all the CC, NT2, and NT1 groups.

Conclusions

The results further support the hypothesis that a loss of hypocretin neurons causes fragmented sleep, which can be measured as an increased ArI as scored by the MAD.