bluuebunny/crossref_metadata_2025 huggingface dataset:
Interplay between non‐alcoholic fatty liver disease and cardiovascular risk in an asymptomatic general population
Authors: Pennisi Grazia , Di Marco Vito , Buscemi Carola , Mazzola Giovanni , Randazzo Cristiana , Spatola Federica , Craxì Antonio , Buscemi Silvio , Petta Salvatore
Published: April 2021

Background and Aims

Non‐alcoholic fatty liver (NAFLD) is a major cause of liver disease worldwide leading also to a higher risk of cardiovascular events. We aimed to evaluate the impact of fatty liver and fibrosis on cardiovascular risk in a general population.

Methods

Five hundred and forty‐two subjects included in the community‐based ABCD (Alimentazione, Benessere Cardiovascolare e Diabete) study were recruited. Steatosis (controlled attenuation parameter > 288 dB/m) and severe fibrosis (low risk, liver stiffness measurement [LSM] < 7.9 KPa with M probe and < 5.7 KPa with XL probe; intermediate risk, LSM 7.9–9.5 KPa with M probe and 5.7–9.2 KPa with XL probe; high risk, LSM ≥ 9.6 KPa with M probe and ≥ 9.3 KPa with XL probe) were assessed with FibroScan. Cardiovascular risk was evaluated by the atherosclerotic cardiovascular disease (ASCVD) risk estimator and defined low if < 5%, borderline if 5–7.4%, intermediate if 7.5–19.9% and high if ≥ 20%. Intima‐media thickness (IMT) was measured with ultrasound.

Results

Prevalence of steatosis and of severe fibrosis in this cohort was 31.7% and 4.8%, respectively. ASCVD score was evaluated in patients with and without steatosis and according to the risk of severe fibrosis. By ordinal regression analysis, both steatosis (odds ratio [OR] 1.62, 95% confidence interval [CI] 1.13–2.33, P = 0.009) and severity of fibrosis (OR 1.67, 95% CI 1.18–2.36, P = 0.003) were independent risk factors for a higher ASCVD risk after adjusting for obesity. Subjects with NAFLD, when compared with those without, did not differ for IMT (0.75 vs 0.72 mm; P = 0.11) and IMT ≥ 1 mm (15.6% vs 12.1%; P = 0.24). Higher prevalence of IMT ≥ 1 mm was found in patients at high or intermediate risk of severe fibrosis (24% and 28.6%, respectively) compared with those at low risk (12.1%) (P = 0.03); this association was maintained after adjusting for confounders (OR 2.70, 95% CI 1.01–2.86, P = 0.04).

Conclusion

In the setting of a general adult population, the presence of NAFLD and severe fibrosis are associated with to a higher cardiovascular risk profile, pointing towards the need for specific preventive measures.
Reciprocal regulation between the negative regulator PP2CG1 phosphatase and the positive regulator OST1 kinase confers cold response in Arabidopsis
Authors: Lv Jian , Liu Jingyan , Ming Yuhang , Shi Yiting , Song Chunpeng , Gong Zhizhong , Yang Shuhua , Ding Yanglin
Published: April 2021

Protein phosphorylation and dephosphorylation have been reported to play important roles in plant cold responses. In addition, phospho‐regulatory feedback is a conserved mechanism for biological processes and stress responses in animals and plants. However, it is less well known that a regulatory feedback loop is formed by the protein kinase and the protein phosphatase in plant responses to cold stress. Here, we report that OPEN STOMATA 1 (OST1) and PROTEIN PHOSPHATASE 2C G GROUP 1 (PP2CG1) reciprocally regulate the activity during the cold stress response. The interaction of PP2CG1 and OST1 is inhibited by cold stress, which results in the release of OST1 at the cytoplasm and nucleus from suppression by PP2CG1. Interestingly, cold‐activated OST1 phosphorylates PP2CG1 to suppress its phosphatase activity, thereby amplifying cold signaling in plants. Mutations of PP2CG1 and its homolog PP2CG2 enhance freezing tolerance, whereas overexpression of PP2CG1 decreases freezing tolerance. Moreover, PP2CG1 negatively regulates protein levels of C‐REPEAT BINDING FACTORs (CBFs) under cold stress. Our results uncover a phosphor/dephosphor‐regulatory feedback loop mediated by PP2CG1 phosphatase and OST1 protein kinase in plant cold responses.
Exploring newly qualified nurses’ experiences of support and perceptions of peer support online: A qualitative study
Authors: Jenkins Catharine , Oyebode Jan , Bicknell Sarah , Webster Natalie , Bentham Peter , Smythe Analisa
Published: April 2021

Aims and Objectives

To explore newly qualified nurses’ support needs and their perceptions of online peer support.

Background

The experience of being a newly qualified nurse is stressful and isolating. Support from colleagues and peers can enhance perceptions of competence and confidence in newly qualified nurses, improve well‐being and aid retention. However, despite initiatives such as preceptorship, support needs may remain unmet in busy clinical environments. Online support has potential to offer a partial solution to professional isolation, but there is a lack of research into how technology can support nurses’ emotional and social well‐being.

Design

A qualitative exploratory study was designed, employing semi‐structured focus groups, analysed using thematic analysis. The study is reported in accordance with the COnsolidated criteria for REporting Qualitative research checklist.

Methods

Eight focus groups, supplemented by one individual interview, were conducted with newly qualified nurses between June 2018–January 2019.

Findings

Two main themes arose. The first was Drowning, a lot of the time with two sub‐themes: (i) Feelings and emotions about being a Newly Qualified Nurse: ‘Absolutely terrified’ and (ii) Support within the role: ‘Somebody you can count on’. The second was Potential advantages and disadvantages of online modality: ‘Somebody is going to get in that phone!’ which included three sub‐themes (i) Potential advantages, (ii) Potential disadvantages and (iii) Preferences and recommendations.

Conclusions

This study demonstrates that if barriers can be overcome, then online support has potential to contribute to newly qualified nurses’ well‐being. Further research is needed to explore technical and ethical issues around online support and evaluate its effectiveness for newly qualified nurses.

Relevance to clinical practice

Online support has the potential to add to existing strategies to support nurses during stressful times. This may be particularly relevant when many staff are working under increased pressure due to the COVID‐19 pandemic.
Outcome of in vitro fertilization cycles with automatic time‐lapse instrumentation combined with the early embryo viability assessment score
Authors: Kokunai Kana , Yamashita Yoshiki , Inoue Taketo , Taguchi Sayumi , Tsujimoto Yoshiko , Hirao Kayoko , Yamamoto Syuji , Nakamura Natsuho , Terai Yoshito , Ohmichi Masahide
Published: April 2021

Aim

To evaluate whether embryo selection using the early embryo viability assessment (EEVA) score increases the ongoing pregnancy rate of in vitro fertilization and intracytoplasmic sperm injection patients.

Methods

One hundred eighty‐one patients whose serum anti mullerian hormone (AMH) level was greater than 0.5 ng/μL were enrolled in the study. All patients received oocyte retrieval repeatedly from June 2017 to January 2019.

Transferred embryos were selected using the EEVA score and Veeck's criteria. We investigated the blastocyst rate according to the EEVA score and Veeck's criteria and also evaluated the clinical outcome following embryo transfer of the blastocysts.

Results

Blastocyst development rate (48.7%) and high‐quality blastocyst (42.4%) of Veeck 1 was statistically higher than others.

The blastocyst rate (71.4%) and high‐quality blastocyst rate (60.0%) for EEVA 1 was the highest, and a correlation between the EEVA score and the blastocyst rate was also identified in cases younger than 40 years. Blastocyst rate of EEVA 1 + 2 (69.8% 208/298) was statistically higher than that of Veeck 1 + 2 (40.1% 317/791) (p < 0.05) and high‐quality blastocyst rate of EEVA 1 + 2 (50.0% 104/208) was also higher than that of Veeck 1 + 2 (36.6% 117/320) (p < 0.05).

However, there was a significant correlation between EEVA and the pregnancy rate and pregnancy rate of EEVA 1 + 2 showed no statistical difference compared with Veeck 1 + 2.

Conclusions

Although it remains to be answered whether a computer can substitute Veeck's classification, the EEVA score could be a viable alternative to predict the blastocyst rate and to select those high‐potential embryos that improve the pregnancy rate.
The influence of mode of delivery, anthropometric indices, and infant's sex on the maternal and cord blood orexin‐A levels: A cohort study
Authors: Razavinia Fatemeh , Tehranian Najmeh , Sadatmahalleh Shahideh Jahanian , Kazemnejad Anoshirvan , Khajetash Shaghayegh , Daryasari Seyedeh Razieh Fazeli , Pahlavan Fattaneh , Jahanfar Shayesteh
Published: April 2021

Background

Orexin as an adipokin hormone plays an important role in appetite regulation, energy metabolism, obesity, diabetes, and cardiovascular disease. The main source of orexin secretion in nonpregnant and pregnant women is adipose tissue and placenta, respectively. This research was conducted to evaluate the association between orexin‐A level and the mode of delivery, anthropometric indices, and sex of the infant.

Methods

This prospective cohort study was conducted on 69 normal pregnant women. The samples of umbilical cord blood were obtained at the time of delivery, and maternal blood was taken within 24 h of delivery. Serum orexin‐A levels were measured by using enzyme‐linked immunosorbent assay. Statistical analyses were performed using SPSS and p < 0.05 was considered as significant.

Results

We found a significant difference between postpartum maternal and umbilical cord orexin‐A level both with the mode of delivery (p < 0.001). Also, a significant positive correlation was seen between maternal and umbilical cord serum orexin‐A levels (r = −0.61, p < 0.001). There was no relationship between serum orexin‐A levels with anthropometric indices and the sex of the neonate (p > 0.05).

Conclusion

Both maternal and umbilical cord serum orexin‐A levels were associated with the mode of delivery. Maternal and cord blood orexin‐A levels in normal vaginal delivery are higher than cesarean section.
A case of cervical clear cell carcinoma with serous component
Authors: Ebisawa Keiko , Sugiyama Takahiro , Itami Makiko , Maru Yoshiaki , Hippo Yoshitaka , Tanaka Naotake
Published: April 2021

Cervical clear cell carcinoma (CCCC) is rare. This report describes the case of CCCC with a serous component. A 22‐year‐old woman presented with vaginal bleeding. A cervical tumor was discovered: pelvic magnetic resonance imaging revealed a tumor measuring 46 mm. Radical hysterectomy was performed based on the diagnosis of stage IB2 cervical cancer. After histological examination of the specimen revealed a coexisting invasive clear cell carcinoma (95%) and serous carcinoma (5%), five cycles of nedaplatin and irinotecan therapy were administered as postoperative adjuvant chemotherapy. Local recurrence in the vaginal vault was observed at 7 months after surgery. Radiation therapy and chemotherapy were administered. The patient is alive without evidence of recurrence at 26 months after surgery.
Failure Load of Monolithic Lithium Disilicate Implant‐Supported Single Crowns Bonded to Ti‐base Abutments versus to Customized Ceramic Abutments after Fatigue
Authors: Spitznagel F. A. , Bonfante E. A. , Vollmer F. , Gierthmuehlen P. C.
Published: April 2021

Purpose

This laboratory study analyzed the influence of retention mode (screw‐ vs cement retained) and fatigue application on the failure load of monolithic lithium‐disilicate (LDS) implant‐supported single crowns (ISSC).

Material and Methods

A total of 72 samples of monolithic LDS (*Ivoclar Vivadent) ISSC were divided into three groups (n = 24) according to their type of retention mode: Group Ti‐CAD: Titanium base (SICvantage CAD/CAM Abutment red (SIC invent AG), screw‐retained milled monolithic LDS (IPS e.max CAD*); Group Ti‐P: Titanium base (SICvantage CAD/CAM Abutment red), screw‐retained pressed monolithic LDS (IPS e.max Press*) and Group Ti‐Cust: Titanium base with cemented press LDS (IPS e.max Press*) crown on a LDS (IPS e.max Press*) custom abutment. A mandibular first molar implant‐supported single crown model was investigated (Titanium implant: SICvantage‐max, SIC invent AG, diameter: 4.2 mm, length: 11.5 mm). Half of each group (n = 12) w​ere exposed to fatigue with cyclic mechanical loading (F = 198 N, 1.2 million cycles) and simultaneous thermocycling (5‐55°C). Single load to failure testing was performed, before (Subgroups Ti‐CAD, Ti‐P, and Ti‐Cust) and after (Subgroups Ti‐CAD‐F, Ti‐P‐F, and Ti‐Cust‐F) fatigue. Weibull distribution was used to determine the characteristic strength and Weibull modulus differences between groups. Probability of survival at 900N load was calculated.

Results

No samples failed during fatigue. Characteristic strength values were as follow: Ti‐CAD: 3259.5N, Ti‐CAD‐F: 2926N, Ti‐P: 2763N, Ti‐P‐F: 2841N, Ti‐Cust: 2789N, Ti‐Cust‐F: 2194N. Whereas no difference was observed between pressed or milled monolithic crowns cemented to Ti‐base, regardless of loading condition, fatigue decreased the characteristic strength of crowns cemented to custom abutments. Probability of survival at 900 N was not significantly different between groups.

Conclusions

Screw‐retained pressed or milled monolithic LDS ISSC, cemented directly to Ti‐base abutments or LDS crowns cemented to custom ceramic abutments resist physiological chewing forces after simulated 5‐year aging in the artificial mouth and presented equally high probability of survival. However, a significant decrease in load to failure was observed in LDS crowns cemented to custom ceramic abutments after fatigue. Prospective clinical trials are needed to confirm the results of this laboratory investigation.
Polyploidy in Cupressaceae: Discovery of a new naturally occurring tetraploid, Xanthocyparis vietnamensis
Authors: Farhat Perla , Siljak‐Yakovlev Sonja , Hidalgo Oriane , Rushforth Keith , Bartel Jim A. , Valentin Nicolas , Leitch Ilia J. , Adams Robert P.
Published: April 2021

While polyploidy (whole‐genome multiplication) is generally considered rare in extant gymnosperms (with the exception of Ephedra, Ephedraceae), the occurrence of sporadic polyploid individuals belonging to various genera in the conifer family Cupressaceae has been reported in the literature. In addition, recent studies have revealed that polyploidy is not uncommon in the genus Juniperus (Cupressaceae), with tetraploid and hexaploid individuals reported in individuals collected from wild populations. Given these findings, we undertook a comprehensive screening of ploidy levels in 32 species belonging to the four genera that are phylogenetically closest to Juniperus (i.e., Callitropsis, Hesperocyparis, Xanthocyparis, and Cupressus), referred to as the CaHXCu complex. In addition, we also determined the ploidy level of two accessions in the poorly studied tetraploid, Fitzroya cupressoides. Using flow cytometry together with published chromosome counts to assign ploidy levels, we show that all species of the CaHXCu complex are diploid except Xanthocyparis vietnamensis, which is tetraploid, with a genome size of 44.60 pg/2 C. This study opens up new opportunities for studying the impact and consequences of polyploidy on the evolution and adaptation of species in Cupressaceae.
Association between daytime napping and stroke: A dose–response meta‐analysis
Authors: Jin Xiaolin , Chen Hanze , Li Yuru , Xu Wenying , Chen Xinxin , Tian Li , Teng Weiyu
Published: April 2021

Daytime napping is common in many regions around the world and has been an important part of people's daily life. Daytime napping has attracted increasing attention in recent years. Thus, we conducted a meta‐analysis to evaluate the relationship between daytime napping and stroke, and help reduce the risk of stroke by improving living habits. The Embase, PubMed, Web of Science and PsycINFO databases were searched for cohort studies published before October 2020 and eight eligible studies with 524,408 participants and 5,875 stroke cases were included in the final analysis. The pooled relative risk (RR) of stroke was 1.47 (95% confidence interval [CI]: 1.24–1.74; p < .001) with significant heterogeneity (I2 = 58%, p for heterogeneity = 0.02). However, the heterogeneity decreased when the study in which adjusting for sleep duration and stratifying the results based on sleep duration was not performed was excluded (RR: 1.38; 95% CI: 1.19–1.60, I2 = 44%, p for heterogeneity = 0.10). In dose–response analysis, the linear trend indicated that for every 10‐min increase in daytime napping, the risk of stroke increased by 3%. Further well‐designed large studies are needed to explore the effects of daytime napping on stroke and the underlying biological mechanisms.
Medical student engagement during the COVID‐19 pandemic—Conflict in the workplace
Authors: Holloway Benjamin R.
Published: April 2021

Whilst the pandemic has accelerated the evaluation and implementation of pedagogical approaches, it has also amplified conflict for students between their role as a consumer of education and a provider of healthcare.
When I say … feedback literacy
Authors: Quigley Duana
Published: April 2021

Quigley defines the term ‘feedback literacy’ and describes how we can support healthcare students to make the most of feedback.
An agent‐based model to optimize transboundary management for the walleye pollock (Gadus chalcogrammus) fishery in the Gulf of Alaska
Authors: Williams Benjamin C. , Criddle Keith R. , Kruse Gordon H.
Published: April 2021

Because fish stocks often straddle state, national, and international boundaries, there is a need to coordinate fishery management across jurisdictions. This is particularly important when the abundance or spatial distribution of the stock varies through time. This is best achieved when management objectives and strategies align, and there is coordinated decision‐making and catch accounting among jurisdictions such that each fish stock is managed over its full geographic range. However, legal constraints or differing management objectives may not permit such coordinated decision making and policy development. This study introduces a framework for effectively simulating fleet dynamics, fishery quota allocation, and the implications of alternative management strategies while allowing for determination of economically optimal management approaches at the community level. As a case study, an agent‐based model (ABM) was developed to examine the interplay between transboundary management scenarios on the economic viability of a nascent Alaska state‐waters trawl fishery for walleye pollock (Gadus chalcogrammus) in the Gulf of Alaska, given a longstanding federally managed fishery. Under conditions characteristic of the recent past, the management strategy that produced the best overall improvements, relative to status quo, involved a scenario that allows for community‐based cooperatives in federal‐waters and an open access strategy in state‐waters. This case study allows us to demonstrate more generally how using an ABM allows for quantifying the impacts of and informing managers on anticipated, and novel, results of alternative management strategies for complex socioecological systems before implementation.

Recommendations for Resource Managers

Agent‐based modeling provides a method to realistically simulate fleet behavior within a fishery.

The approach enables a quantitative analysis of the effects of alternative management scenarios under consideration by policymakers.

“Best practices” for fishery management should include simulation analysis of management alternatives before selection of the preferred alternative for real‐world implementation.
The classical Confucian conception of Heaven's Mandate
Authors: Jia Jinhua
Published: April 2021

The belief in heaven's mandate (tianming 天命) in earlier documents referred to divine‐ethical sanctions of political rulers. It later developed multiple implications such as an individual's destiny or fate and became one of the most fundamental concepts in Chinese intellectual and cultural history. In modern times, this concept has received long‐lasting attention in the field of Chinese philosophy, and almost all major scholars have more or less been involved in discussions and debates, especially on the topic of the classical Confucian conception of heaven's mandate. Their discussions on this topic have largely focused on two major controversies: (i) whether early Confucians view heaven's mandate as prescriptive ethical command or descriptive amoral fate, and (ii) whether their attitude toward heaven's mandate is voluntarist or fatalistic. While this scholarship has been fruitful and insightful, it has continued for almost a century with certain variants. Therefore, it is time to address this topic with new approaches and hermeneutic horizons. In this essay, I propose a new approach and horizon to viewing the classical Confucian conception of heaven's mandate as their reflections on individual existence and self‐realization under the constraints of mandate or destiny. I examine the texts associated with Confucius and Mencius such as the Analects and the Mencius, as well as some recently unearthed texts, to suggest that early Confucians accommodate individual initiative and self‐determination of life choices through their conceptualization of heaven's mandate. To them, the vocabulary of heaven's mandate empowers individuals, especially through situating their places in society and the cosmos. By knowing and standing firmly on one's mandate or destiny, the individual not only realizes the value of their existence but also goes beyond the ultimate destiny of death. This fresh reading of heaven's mandate is grounded in the context of the development of Confucian ideas in the early period and presents an optimistic vision of Confucian humanism.
Measuring the impact of suicide attempt posttraumatic stress
Authors: O’Connor Stephen S. , McClay Michael M. , Powers Jeffery , Rotterman Erik , Comtois Katherine Anne , Ellen Wilson Jo , Nicolson Stephen E.
Published: April 2021

Objective

To examine the associations between posttraumatic stress symptoms (PTS) following a medically serious suicide attempt with suicidal ideation, related interpersonal constructs, and outpatient mental health service utilization.

Methods

The study utilized an existing data set from a clinical trial consisting of 66 patients recruited at a level 1 trauma center following medical admission for a suicide attempt. Measures of suicide attempt‐related PTS (SA‐PTS), suicidal ideation, perceived burdensomeness, thwarted belongingness, and outpatient medical and mental health utilization were completed at 1 and 3 months. A series of mixed‐effects regression models were used to analyze the data.

Results

Greater SA‐PTS at 1 month was associated with significantly greater suicidal ideation, thwarted belongingness, and perceived burdensomeness across 1 and 3 months.

Conclusions

Addressing PTS following a medically serious suicide attempt may aid in addressing suicide‐specific constructs and improve the recovery trajectory following hospitalization.
More frequent negative social exchanges are associated with higher suicide ideation and risk in men service members/veterans
Authors: Blais Rebecca K. , Cruz Rick A. , Serang Sarfaraz
Published: April 2021

Introduction

Suicide is a leading cause of death in military service members/veterans (SM/Vs). Positive social exchanges (e.g., emotional support) buffer against suicide risk but the influence of negative social exchanges (e.g., unwanted advice) is understudied.

Method

The current study explored (1) the contributions of positive and negative social exchanges as simultaneous correlates of suicide ideation and risk, (2) whether positive social exchanges mitigated the association of negative social exchanges and suicide ideation and risk, and (3) if facets of social exchanges were uniquely related to suicide ideation and risk. SM/Vs men (N = 508) completed self‐report questionnaires.

Results

Roughly 27% endorsed suicide ideation. Between 23.62 and 41.14% reported elevated suicide risk. Adjusted analyses revealed higher negative social exchanges, particularly insensitive behaviors, and lower positive social exchanges were associated with higher suicide ideation and risk. The magnitude of positive and negative social exchanges with suicide ideation or risk was statistically similar. Higher positive social exchanges did not attenuate the association of negative social exchanges and suicide ideation or risk (p > 0.05).

Conclusion

Higher negative social exchanges are equally strong correlates of suicide ideation and risk as positive social exchanges. Decreasing insensitive behaviors may reduce suicide ideation and risk in men SM/Vs.
Pre‐schoolers fundamental movement skills predict BMI, physical activity, and sedentary behavior: A longitudinal study
Authors: Duncan Michael J. , Hall Charlotte , Eyre Emma , Barnett Lisa M. , James Rob S.
Published: April 2021

Aims

This study aimed to predict the variation in future fundamental movement skills (FMS), physical activity (PA) and body mass index (BMI) from prior FMS, PA, and BMI in British pre‐schoolers.

Methods

British pre‐schoolers (n = 177) underwent assessment of FMS, via the Test of Gross Motor Development 2 (TGMD‐2), BMI, and PA, via accelerometer at two time points one year apart. Regression analysis was used to predict the change in PA and BMI in Year 2 from FMS variables in Year 1 and Year 2.

Results

Variation in FMS performance between individuals predicted a significant amount of change in BMI, with 12.3 and 9.8% of the change in Year 2 BMI data explained by change in Year 1 and Year 2 FMS data, respectively. Change in FMS performance between individuals predicted a significant amount of change in PA, but was better at predicting change in sedentary activity rather than light or moderate‐vigorous activities. A combination of run, throw, dribble, and kick performance predicted 46.1% of the change in sedentary activity between individuals in the 2nd year of testing.

Conclusions

FMS mastery at four years of age predicts children's BMI and time spent sedentary at five years of age.
Unusual presentation of toxoplasmosis with gastro‐intestinal involvement in HLA non‐identical stem cell transplantation
Authors: Hoellinger Baptiste , Ursenbach Axel , Villard Odile , Guffroy Blandine , Simand Célestine , Lioure Bruno
Published: April 2021

Toxoplasmosis is a life‐threatening infection in allogenic stem cell recipients usually involving the brain or retina and more rarely lungs or bone marrow. Digestive involvement has only been reported in AIDS patient. We report about a 38‐year‐old man who received a haploidentical allograft for acute myeloid leukemia and developed an unusual digestive presentation with severe protein‐losing enteropathy following grade III acute digestive GvHD treated with steroids and ruxolitinib. Diagnosis was brought up because of concomitant brain involvement. Digestive symptoms fully recovered after treatment with sulfamethoxazole‐trimethoprim. Digestive toxoplasmosis could be considered as a differential diagnosis or complication of severe digestive GvHD.
Effect of Heat Treatment and Electric Discharge Alloying on the Tribological Performance of Selective Laser Melted AlSi10Mg
Authors: Thasleem P. , Kuriachen Basil , Kumar Deepak , Ahmed Afzaal , Joy M. L.
Published: April 2021

Selective laser melting (SLM) is an emerging additive manufacturing (AM) technology for fabrication of complex lightweight components along with improved mechanical properties. However, the properties are highly influenced by the continual heating and cooling during deposition, variation in local temperature, size, and shape of melt pool, and solidification growth rate. Therefore, postprocessing is very often required to control various properties of additive manufactured components. The present work investigates the influence of various postprocessing methods such as heat treatment and electric discharge alloying (EDA) on ambient and elevated temperature wear behavior of selective laser melted AlSi10Mg alloy and compared with its tribological behavior with cast AlSi10Mg. The dry wear tests were conducted using a pin on disk (POD) tribometer with EN-31 as counter body. The EDA treated SLM AlSi10Mg showed the least wear-rate and coefficient of friction (COF) at both ambient and elevated temperatures (1.05 × 10−4 mm3/Nm and 0.434 and 3.12 × 10−5 mm3/Nm and 0.531, respectively) due to its higher hardness (189.8 HV) as compared with other samples. The wear-rate and COF of cast specimen are found to be highest among all specimens at both ambient and elevated temperatures (1.34 × 10−4 mm3/Nm and 0.528 and 4.49 × 10−5 mm3/Nm and 0.724, respectively). Lower wear-rate and higher COF are observed at elevated temperature due to the excessive formation of wear-resistant oxides (Al2O3, SiO2, and MgO) and glaze layers for all samples compared with ambient temperature wear behaviors of its counterparts. Abrasive wear, adhesive wear, oxidation wear, and surface delamination are the prominent wear mechanisms observed for ambient and elevated temperatures for all the specimens.
An Enhancement of the Warping Shear Functions of Refined Zigzag Theory
Authors: Sorrenti M. , Di Sciuva M.
Published: April 2021

The paper presents an enhancement in Refined Zigzag Theory (RZT) for the analysis of multilayered composite plates. In standard RZT, the zigzag functions cannot predict the coupling effect of in-plane displacements for anisotropic multilayered plates, such as angle-ply laminates. From a computational point of view, this undesirable effect leads to a singular stiffness matrix. In this work, the local kinematic field of RZT is enhanced with the other two zigzag functions that allow the coupling effect. In order to assess the accuracy of these new zigzag functions for RZT, results obtained from bending of angle-ply laminated plates are compared with the three-dimensional exact elasticity solutions and other plate models used in the open literature. The numerical results highlight that the enhanced zigzag functions extend the range of applicability of RZT to the study of general angle-ply multilayered structures, maintaining the same seven kinematic unknowns of standard RZT.
Comparison of Rotary and Linear Cutting Methodology in Determining Specific Cutting Energy of Granite
Authors: Kazi Aamer , Kao Yi-Tang , Tai Bruce L.
Published: April 2021

Single polycrystalline diamond compact (PDC) cutting is a practical technique to understand the rock–tool interactions in drag-bit-type geothermal drilling operations. This paper introduces a rotary cutting method to determine specific cutting energy (SCE) and compares it with the conventional linear cutting method. In this work, granite is selected to represent hard rock formations in geothermal drilling. Cutting tests are conducted on a Computer Numerical Control (CNC) machine with a realistic cutting speed of 12.7 m/min and several chip loads ranging from 0.08 to 0.25 mm. The cutting force is measured using a dynamometer and then converted to specific cutting energy (SCE). The results show that the rotary method produces an inverse relationship between SCE and chip load, whereas the linear method shows the opposite. As a result, the produced SCE by the rotary method tends to be lower than that of the linear method at a higher chip load at and over 0.16 mm. The difference may be attributed to the cutting configuration and associated force components.
Water-Based Interventions for People With Neurological Disability, Autism, and Intellectual Disability: A Scoping Review
Authors: Naumann Karlee , Kernot Jocelyn , Parfitt Gaynor , Gower Bethany , Davison Kade
Published: April 2021

The purpose of this study was to produce a descriptive overview of the types of water-based interventions for people with neurological disability, autism, and intellectual disability and to determine how outcomes have been evaluated. Literature was searched through MEDLINE, EMBASE, Ovid Emcare, SPORTDiscus, Google Scholar, and Google. One hundred fifty-three papers met the inclusion criteria, 115 hydrotherapy, 62 swimming, 18 SCUBA (self-contained underwater breathing apparatus), and 18 other water-based interventions. Common conditions included cerebral palsy, spinal cord injury, Parkinson’s disease, and intellectual disability. Fifty-four papers explored physical outcomes, 36 psychosocial outcomes, and 24 both physical and psychosocial outcomes, with 180 different outcome measures reported. Overall, there is a lack of high-quality evidence for all intervention types. This review provides a broad picture of water-based interventions and associated research. Future research, guided by this scoping review, will allow a greater understanding of the potential benefits for people with neurological disability, autism, and intellectual disability.
The Influence of Muscle Fiber Typology on the Pacing Strategy of 200-m Freestyle Swimmers
Authors: Mallett Adam , Bellinger Phillip , Derave Wim , McGibbon Katie , Lievens Eline , Kennedy Ben , Rice Hal , Minahan Clare
Published: April 2021

Purpose: To determine the influence of muscle fiber typology (MFT) on the pacing strategy of elite swimmers competing in the 200-m freestyle event. Method: The top 3 career-best performances from 25 elite 200-m freestyle swimmers were analyzed—12 women (1:58.0 [0:01.3] min:s) and 13 men (1:48.4 [0:02.5]). Muscle carnosine concentration was quantified by proton magnetic resonance spectroscopy in the gastrocnemius and soleus muscles and expressed as a carnosine aggregate z score (CAZ score) relative to an age- and gender-matched nonathlete control group to estimate MFT. Linear regression models were employed to examine the influence of MFT on the percentage of overall race time spent in each 50-m lap. Results: Swimmers with a higher CAZ score spent a greater percentage of race time in lap 3 compared with swimmers with a lower CAZ score (0.1%, 0.0% to 0.2%; mean, 90% confidence interval, P = .02). For every 1% increase in the percentage of race time spent in lap 1, the percentage of race time spent in lap 3 decreased by 0.4% for swimmers with a higher CAZ score (0.2% to −0.5%, P = .00, r = −.51), but not for swimmers with a lower CAZ score (−0.1%, −0.3% to 0.1%, P = .28, r = −.18). The percentage of race time spent in lap 4 decreased by 0.8% for higher-CAZ-score swimmers (−0.5% to −1.0%, P = .00, r = −.66) and by 0.9% for lower-CAZ-score swimmers (−0.6% to −1.3%, P = .00, r = −.65) when lap 1 percentage increased by 1%. Conclusion: MFT may influence the pacing strategy of swimmers in the 200-m freestyle event, which provides an avenue for maximizing individualized pacing strategies of elite swimmers.
Outpatient Fluoroquinolone Prescription Fills in the United States, 2014 to 2020: Assessing the Impact of Food and Drug Administration Safety Warnings
Authors: Buehrle Deanna J. , Wagener Marilyn M. , Clancy Cornelius J.
Published: April 2021

The impact of United States Food and Drug Administration (FDA) safety warnings on outpatient fluoroquinolone use is unclear. Annual changes in outpatient ciprofloxacin, levofloxacin, and moxifloxacin prescription fills (IQVIA National Prescription Audit databases) were assessed using a regression model.
Impact of Amino Acid Substitutions in Region II and Helix K of Herpes Simplex Virus 1 and Human Cytomegalovirus DNA Polymerases on Resistance to Foscarnet
Authors: Zarrouk Karima , Zhu Xiaojun , Pham Van Dung , Goyette Nathalie , Piret Jocelyne , Shi Rong , Boivin Guy
Published: April 2021

Amino acid substitutions conferring resistance to foscarnet (PFA) to herpes simplex virus 1 (HSV-1) and human cytomegalovirus (HCMV) are located in the genes
UL30
and
UL54
, respectively, encoding the DNA polymerase (pol). In this study, we analyzed the impact of substitutions located in helix K and region II that are involved in the conformational changes of the DNA pol.
Gene-Gene Interactions Dictate Ciprofloxacin Resistance in Pseudomonas aeruginosa and Facilitate Prediction of Resistance Phenotype from Genome Sequence Data
Authors: Rehman Attika , Jeukens Julie , Levesque Roger C. , Lamont Iain L.
Published: April 2021

Ciprofloxacin is one of the most widely used antibiotics for treating
Pseudomonas aeruginosa
infections. However,
P. aeruginosa
acquires mutations that confer ciprofloxacin resistance, making treatment more difficult.
Beyond Homeostasis: Potassium and Pathogenesis during Bacterial Infections
Authors: Do Elyza A. , Gries Casey M.
Published: April 2021

Potassium is an essential mineral nutrient required by all living cells for normal physiological function. Therefore, maintaining intracellular potassium homeostasis during bacterial infection is a requirement for the survival of both host and pathogen.
Membrane Env Liposomes Facilitate Immunization with Multivalent Full-Length HIV Spikes
Authors: Leaman Daniel P. , Stano Armando , Chen Yajing , Zhang Lei , Zwick Michael B.
Published: April 2021

A vaccine that induced broadly neutralizing antibodies against HIV would likely end the AIDS pandemic. Such antibodies target
m
embrane-embedded
env
elope glycoprotein spikes (mEnv) that HIV uses to enter cells.
Tax Induces the Recruitment of NF-κB to Unintegrated HIV-1 DNA To Rescue Viral Gene Expression and Replication
Authors: Irwan Ishak D. , Cullen Bryan R.
Published: April 2021

Integrase-deficient expression vectors based on HIV-1 are becoming increasingly popular as tools for gene therapy
in vivo
due to their inability to cause insertional mutagenesis. However, many IN
−
lentiviral vectors are able to achieve only low levels of gene expression, and methods to increase this low level have not been extensively explored.
Intraspecies Transcriptional Profiling Reveals Key Regulators of Candida albicans Pathogenic Traits
Authors: Wang Joshua M. , Woodruff Andrew L. , Dunn Matthew J. , Fillinger Robert J. , Bennett Richard J. , Anderson Matthew Z.
Published: April 2021

Infectious fungal species are often treated uniformly despite clear evidence of genotypic and phenotypic heterogeneity being widespread across strains. Identifying the genetic basis for this phenotypic diversity is extremely challenging because of the tens or hundreds of thousands of variants that may distinguish two strains.
Free-Living, Psychrotrophic Bacteria of the Genus
Psychrobacter
Are Descendants of Pathobionts
Authors: Welter Daphne K. , Ruaud Albane , Henseler Zachariah M. , De Jong Hannah N. , van Coeverden de Groot Peter , Michaux Johan , Gormezano Linda , Waters Jillian L. , Youngblut Nicholas D. , Ley Ruth E.
Published: April 2021

Bacteria and archaea predate the evolution of eukaryotic cells; logically, it follows that host-associated microbes have evolved from free-living ones. The evolutionary transition of microbes in the opposite direction, from host associated toward free living, is theoretically possible and has been predicted based on phylogenetic data but has not been studied in depth.
Can EEG accurately predict 2-year neurodevelopmental outcome for preterm infants?
Authors: Lloyd Rhodri O , O'Toole John M , Livingstone Vicki , Filan Peter M , Boylan Geraldine B
Published: April 2021

Objective

Establish if serial, multichannel video electroencephalography (EEG) in preterm infants can accurately predict 2-year neurodevelopmental outcome.

Design and patients

EEGs were recorded at three time points over the neonatal course for infants <32 weeks’ gestational age (GA). Monitoring commenced soon after birth and continued over the first 3 days. EEGs were repeated at approximately 32 and 35 weeks’ postmenstrual age (PMA). EEG scores were based on an age-specific grading scheme. Clinical score of neonatal morbidity risk and cranial ultrasound imaging were completed.

Setting

Neonatal intensive care unit at Cork University Maternity Hospital, Ireland.

Main outcome measures

Bayley Scales of Infant Development III at 2 years’ corrected age.

Results

Sixty-seven infants were prospectively enrolled in the study and 57 had follow-up available (median GA 28.9 weeks (IQR 26.5–30.4)). Forty had normal outcome, 17 had abnormal outcome/died. All EEG time points were individually predictive of abnormal outcome; however, the 35-week EEG performed best. The area under the receiver operating characteristic curve (AUC) for this time point was 0.91 (95% CI 0.83 to 1), p<0.001. Comparatively, the clinical course AUC was 0.68 (95% CI 0.54 to 0.80, p=0.015), while abnormal cranial ultrasound was 0.58 (95% CI 0.41 to 0.75, p=0.342).

Conclusion

Multichannel EEG is a strong predictor of 2-year outcome in preterm infants particularly when recorded around 35 weeks’ PMA. Infants at high risk of brain injury may benefit from early postnatal EEG recording which, if normal, is reassuring. Postnatal clinical complications can contribute to poor outcome; therefore, we state that a later EEG around 35 weeks has a role to play in prognostication.
Flaps in adult urethrocutaneous fistula repair: a report of two cases with the review of literature
Authors: Bokka Sri Harsha , Kodakkattil Sreenivasan Sreerag , Mehra Ketan , Meethale Thiruvoth Friji
Published: April 2021

Urethrocutaneous fistula (UCF) poses a challenge to the reconstructive urologist in terms of its location, patient’s expectations, availability of tissues for interposition, wound infection and chances of recurrence. Also, patient-related factors, such as uncontrolled diabetes, local surgery with extensive tissue loss, prior history of radiation, poor nutritional status and presence of any distal obstruction in the urethra severely affect the outcomes of a good repair with vascularised flap. We report two cases of UCF repair in adults using scrotal and gracilis muscle flaps (GMFs), their anatomic basis, technicality and advantages. The scrotal flap was used in the first case where it was freely available and GMF in second case where the patient had already undergone extensive local tissue debridement for Fournier’s gangrene and hence, we had to look for a distant flap for protection of the UCF repair. Both patients had an uneventful recovery, there were no early or late treatment-related complications and follow-up after the third and sixth month of surgery revealed no recurrence and the patients are voiding well.
Multidrug-resistant novelNocardia neocaledoniensisbrain abscess in sarcoidosis
Authors: Hazarika Kasturi , Sahoo Rasmi Ranjan , Ekbote Digvijay , Dixit Ajai Kumar , Marak Rungmei S , Wakhlu Anupam
Published: April 2021

Central nervous system nocardiosis is a rare, life-threatening infection seen commonly in immunocompromised individuals.Nocardia neocaledoniensisis a novel species seldom causing infections in humans. We describe a patient of sarcoidosis on immunosuppression, who presented with altered sensorium due to a frontal lobe abscess secondary toN. neocaledoniensisinfection. Despite appropriate and adequate antibiotic coverage, and timely surgical intervention, the patient succumbed to her illness on day 6 of hospitalisation. This case warrants the consideration of novel infections in patients on immunosuppression and the need for aggressive management.
Prevention of postoperative delirium through the avoidance of potentially inappropriate medications in a geriatric surgical patient
Authors: Burfeind Kevin G , Tirado Navales Andrés A , Togioka Brandon Michael , Schenning Katie
Published: April 2021

We demonstrate the utility of risk stratification for postoperative delirium in geriatric patients and show that postoperative delirium can be prevented in high-risk patients when potentially inappropriate medications (PIMs) (medications that are best avoided in older adults) are avoided. In this case, a 65-year-old woman underwent two debridement procedures with similar presurgical risk for postoperative delirium. There was no risk stratification or preoperative cognitive assessment in the first procedure, she received PIMs and developed postoperative delirium. In the second procedure, PIMs were intentionally avoided and postoperative delirium did not occur. This case supports recent recommendations from the European Society of Anaesthesiology, the American Society of Anesthesiologists and the American Geriatrics Society that providers assess a patient’s cognitive function and delirium risk profile preoperatively to appropriately guide perioperative management.
Definity, echo contrast, induced cardiac arrest: brief review of the literature
Authors: Mir Tanveer , Uddin Mohammed M , Watson Kayleigh , Meir Eliezer Bar , Abdo Alward
Published: April 2021

Definity is a contrast media used to enhance the endocardium during echocardiography. Cardiac arrest as an adverse reaction to Definity is still a debate. We are presenting a rare case of a 69-year-old male patient who developed cardiopulmonary arrest immediately after Definity injection during resting echocardiography.
Case of right ventricular and aortic thrombi in a patient with severe COVID-19
Authors: Afari Henrietta , Tefera Leben , Rosovsky Rachel P
Published: April 2021

Emerging evidence suggests that novel COVID-19 is associated with increased prothrombotic state and risk of thromboembolic complications, particularly in severe disease. COVID-19 is known to predispose to both venous and arterial thrombotic disease. We describe a case of a 61-year-old woman with history of type II diabetes, hypertension and hyperlipidaemia who presented with dry cough and acute abdominal pain. She was found to have a significantly elevated D-dimer, prompting imaging that showed thrombi in her right ventricle and aorta. She had rapid clinical deterioration and eventually required tissue plasminogen activator with subsequent durable clinical improvement. This case highlights a rare co-occurrence of venous and arterial thrombi in a patient with severe COVID-19. Further studies are needed to clarify the molecular mechanism of COVID-19 coagulopathy, the utility of D-dimer to predict and stratify risk of thrombosis in COVID-19, and the use of fibrinolytic therapy in patients with COVID-19.
Systemic light-chain amyloidosis incidentally diagnosed after subtotal parathyroidectomy and thyroid lobectomy
Authors: Tsai Karen , Yu Alice Chen , Livhits Masha J , Sajed Dipti , Leung Angela M , Cheung Dianne S
Published: April 2021

A 74-year-old woman with a history of primary hyperparathyroidism, thyroid nodules, atrial fibrillation and pacemaker placement for sick sinus syndrome presented with fatigue, constipation and persistent lower extremity oedema. She underwent subtotal parathyroidectomy and left thyroid lobectomy. Histopathology revealed amyloidosis affecting the thyroidand parathyroids confirmed by Congo Red Staining with Mayo Clinic subtyping of light chain kappa-type amyloidosis. She was found to have combined systolic and diastolic cardiac dysfunction, carpal tunnel neuropathy and pre-diabetes suggestive of systemic amyloidosis with involvement of the heart, nerves and pancreas. Congo red stain was positive for amyloidosis on bone marrow biopsy suggestive of a diagnosis of systemic amyloidosis. She was treated with daratumumab with good clinical response. This case illustrates the necessity of considering systemic amyloidosis in patients with incidentally discovered diffuse amyloid deposits on biopsy of an endocrine organ, as endocrine effects are a rare but likely underdiagnosed consequence of systemic amyloidosis.
Haemoptysis in third trimester-sole manifestation of stage IV gestational choriocarcinoma
Authors: Basida Brinda , Zalavadiya Nirav , Khicher Suman , York Russel
Published: April 2021

Gestational choriocarcinoma is a rare neoplasm of pregnancy that is often undiagnosed until the advanced stage manifests with metastatic complications. Herein, we present a case of a 22-year-old young woman with metastatic gestational choriocarcinoma with unidentified primary origin, who presented with haemoptysis as a chief problem in her third trimester. The case emphasises on the rarity of this neoplasm in a viable pregnancy. Prompt diagnosis and treatment is the key for good maternal and fetal prognosis.