bluuebunny/crossref_metadata_2025 huggingface dataset:
How to deal with moral challenges around the decision-making competence in transgender adolescent care? Development of an ethics support tool
Authors: de Snoo-Trimp Janine , de Vries Annelou , Molewijk Bert , Hein Irma
Published: September 2022

Background

Decision-making competence is a complex concept in the care for transgender and gender diverse adolescents, since this type of care concerns one’s developing gender identity and involves treatment options that often lack international consensus. Even despite competence assessments, moral challenges arise in the decision-making process. Here, traditional forms of clinical ethics support such as moral case deliberation might not fit as these do not provide thematic guidance. This study therefore aimed to develop a practice-oriented ethics support tool to assist care providers when dealing with moral challenges around decision-making competence in transgender adolescent care.

Methods

The study followed a participatory design to develop a tool in close collaboration with care providers; they had a say in all phases of development and dissemination. Firstly, nine care providers were interviewed about experienced moral challenges and needs for ethics support. Based on this, the structure and content of the tool was constructed and discussed in two focus group meetings, after which four care providers tested the tool and additional feedback was collected from the team and an advisory board. The final tool was presented to all Dutch care providers in transgender adolescent care.

Results

Care providers expressed a need for guidance in defining and assessing decision-making competence. Main moral challenges concerned discussing fertility options with young clients, dealing with co-occurring mental health difficulties and the decision-making role of parents. The final tool, named the Competence Consultant, is an interactive pdf containing four parts: (1) Clarify information; (2) Identify doubts and moral questions; (3) Guidance for conversations and (4) Overview and Conclusions.

Discussion

Developing an ethics support tool in a controversial care setting is highly relevant as it aims to help individual care providers in defining, discussing and dealing with their moral challenges in actual practice. The ‘Competence Consultant’ for transgender care providers contributes to their moral sensitivity and moral competence. It is an example of the development of innovative and integrative forms of thematic ethics support.
Changes in sensory, postural stability and gait functions depending on cognitive decline, and possible markers for detection of cognitive status
Authors: Kostic Emilija , Kwak Kiyoung , Kim Dongwook
Published: September 2022

Background

Numerous people never receive a formal dementia diagnosis. This issue can be addressed by early detection systems that utilize alternative forms of classification, such as gait, balance, and sensory function parameters. In the present study, said functions were compared between older adults with healthy cognition, older adults with low executive function, and older adults with cognitive impairment, to determine which parameters can be used to distinguish these groups.

Results

A group of cognitively healthy older men was found to have a significantly greater gait cadence than both the low executive function group (113.1 ± 6.8 vs. 108.0 ± 6.3 steps/min, p = 0.032) and the cognitively impaired group (113.1 ± 6.8 vs. 107.1 ± 7.4 steps/min, p = 0.009). The group with low executive function was found to have more gait stability than the impaired cognition group, represented by the single limb support phase (39.7 ± 1.2 vs. 38.6 ± 1.3%, p = 0.027). Additionally, the healthy cognition group had significantly greater overall postural stability than the impaired cognition group (0.6 ± 0.1 vs. 1.1 ± 0.1, p = 0.003), and the low executive function group had significantly greater mediolateral postural stability than the impaired cognition group (0.2 ± 0.1 vs. 0.6 ± 0.6, p = 0.012). The low executive function group had fewer mistakes on the sentence recognition test than the cognitively impaired (2.2 ± 3.6 vs. 5.9 ± 6.4, p = 0.005). There were no significant differences in visual capacity, however, the low executive function group displayed an overall greatest ability.

Conclusions

Older adults with low executive function showcased a lower walking pace, but their postural stability and sensory functions did not differ from those of the older adults with healthy cognition. The variables concluded as good cognitive status markers were (1) gait cadence for dividing cognitively healthy from the rest and (2) single limb support portion, mediolateral stability index, and the number of mistakes on the sentence recognition test for discerning between the low executive function and cognitive impairment groups.
A novel dynamic Bayesian network approach for data mining and survival data analysis
Authors: Sheidaei Ali , Foroushani Abbas Rahimi , Gohari Kimiya , Zeraati Hojjat
Published: September 2022

Background

Censorship is the primary challenge in survival modeling, especially in human health studies. The classical methods have been limited by applications like Kaplan–Meier or restricted assumptions like the Cox regression model. On the other hand, Machine learning algorithms commonly rely on the high dimensionality of data and ignore the censorship attribute. In addition, these algorithms are more sophisticated to understand and utilize. We propose a novel approach based on the Bayesian network to address these issues.

Methods

We proposed a two-slice temporal Bayesian network model for the survival data, introducing the survival and censorship status in each observed time as the dynamic states. A score-based algorithm learned the structure of the directed acyclic graph. The likelihood approach conducted parameter learning. We conducted a simulation study to assess the performance of our model in comparison with the Kaplan–Meier and Cox proportional hazard regression. We defined various scenarios according to the sample size, censoring rate, and shapes of survival and censoring distributions across time. Finally, we fit the model on a real-world dataset that includes 760 post gastrectomy surgery due to gastric cancer. The validation of the model was explored using the hold-out technique based on the posterior classification error. Our survival model performance results were compared using the Kaplan–Meier and Cox proportional hazard models.

Results

The simulation study shows the superiority of DBN in bias reduction for many scenarios compared with Cox regression and Kaplan–Meier, especially in the late survival times. In the real-world data, the structure of the dynamic Bayesian network model satisfied the finding from Kaplan–Meier and Cox regression classical approaches. The posterior classification error found from the validation technique did not exceed 0.04, representing that our network predicted the state variables with more than 96% accuracy.

Conclusions

Our proposed dynamic Bayesian network model could be used as a data mining technique in the context of survival data analysis. The advantages of this approach are feature selection ability, straightforward interpretation, handling of high-dimensional data, and few assumptions.
Malignant clonal evolution drives multiple myeloma cellular ecological diversity and microenvironment reprogramming
Authors: Liang Yuanzheng , He Haiyan , Wang Weida , Wang Henan , Mo Shaowen , Fu Ruiying , Liu Xindi , Song Qiong , Xia Zhongjun , Wang Liang
Published: September 2022

Background

Multiple myeloma (MM) is a heterogeneous disease with different patterns of clonal evolution and a complex tumor microenvironment, representing a challenge for clinicians and pathologists to understand and dissect the contribution and impact of polyclonality on tumor progression.

Methods

In this study, we established a global cell ecological landscape of the bone marrow (BM) from MM patients, combining single-cell RNA sequencing and single-molecule long-read genome sequencing data.

Results

The malignant mutation event was localized to the tumor cell clusters with shared mutation of ANK1 and IFITM2 in all malignant subpopulations of all MM patients. Therefore, these two variants occur in the early stage of malignant clonal origin to mediate the malignant transformation of proplasmacytes or plasmacytes to MM cells. Tumor cell stemness index score and pseudo-sequential clonal evolution analysis can be used to divide the evolution model of MM into two clonal origins: types I and IX. Notably, clonal evolution and the tumor microenvironment showed an interactive relationship, in which the evolution process is not only selected by but also reacts to the microenvironment; thus, vesicle secretion enriches immune cells with malignant-labeled mRNA for depletion. Interestingly, microenvironmental modification exhibited significant heterogeneity among patients.

Conclusions

This characterization of the malignant clonal evolution pattern of MM at the single-cell level provides a theoretical basis and scientific evidence for a personalized precision therapy strategy and further development of a potential new adjuvant strategy combining epigenetic agent and immune checkpoint blockade.
MIR99AHG inhibits EMT in pulmonary fibrosis via the miR-136-5p/USP4/ACE2 axis
Authors: Wang Jun , Xiang Yuan , Yang Sheng-Xi , Zhang Hui-Min , Li Hui , Zong Qi-Bei , Li Le-Wei , Zhao Li-Li , Xia Ruo-Han , Li Chao , Bao Le-Yuan , Zhang Tong-Cun , Liao Xing-Hua
Published: September 2022

Background

Long non-coding RNAs (lncRNAs) are closely related to the occurrence and development of cancer. Abnormally expressed lncRNA can be used as a diagnostic marker for cancer. In this study, we aim to investigate the clinical significance of MIR99AHG expression in lung adenocarcinoma (LUAD), and its biological roles in LUAD progression.

Methods

The relative expression of MIR99AHG in LUAD tissues and cell lines was analyzed using public databases and RT-qPCR. The biological functions of MIR99AHG were investigated using a loss-of-function approach. The effect of MIR99AHG on lung fibrosis was assessed by scratch assay, invasion assay and lung fibrosis rat model. FISH, luciferase reporter assay and immunofluorescence were performed to elucidate the underlying molecular mechanisms.

Results

LncRNA MIR99AHG expression level was downregulated in LUAD tissues and cell lines. Low MIR99AHG levels were associated with poorer patient overall survival. Functional analysis showed that MIR99AHG is associated with the LUAD malignant phenotype in vitro and in vivo. Further mechanistic studies showed that, MIR99AHG functions as a competitive endogenous RNA (ceRNA) to antagonize miR-136-5p-mediated ubiquitin specific protease 4 (USP4) degradation, thereby unregulated the expression of angiotensin-converting enzyme 2 (ACE2), a downstream target gene of USP4, which in turn affected alveolar type II epithelial cell fibrosis and epithelial–mesenchymal transition (EMT). In summary, the MIR99AHG/miR-136-5p/USP4/ACE2 signalling axis regulates lung fibrosis and EMT, thus inhibiting LUAD progression.

Conclusion

This study showed that downregulated MIR99AHG leads to the development of pulmonary fibrosis. Therefore, overexpression of MIR99AHG may provide a new approach to preventing LUAD progression.
Host-microbiome interactions regarding peri-implantitis and dental implant loss
Authors: Alves Carlos Henrique , Russi Karolayne Larissa , Rocha Natália Conceição , Bastos Fábio , Darrieux Michelle , Parisotto Thais Manzano , Girardello Raquel
Published: September 2022

In the last decades, the ortho-aesthetic-functional rehabilitation had significant advances with the advent of implantology. Despite the success in implantology surgeries, there is a percentage of failures mainly due to in loco infections, through bacterial proliferation, presence of fungi and biofilm formation, originating peri-implantitis. In this sense, several studies have been conducted since then, seeking answers to numerous questions that remain unknown. Thus, the present work aims to discuss the interaction between host-oral microbiome and the development of peri-implantitis. Peri-implantitis was associated with a diversity of bacterial species, being Porphiromonas gingivalis, Treponema denticola and Tannerella forsythia described in higher proportion of peri-implantitis samples. In a parallel role, the injury of peri-implant tissue causes an inflammatory response mediated by activation of innate immune cells such as macrophages, dendritic cells, mast cells, and neutrophils. In summary, the host immune system activation may lead to imbalance of oral microbiota, and, in turn, the oral microbiota dysbiosis is reported leading to cytokines, chemokines, prostaglandins, and proteolytic enzymes production. These biological processes may be responsible for implant loss.
Fluid balance neutralization secured by hemodynamic monitoring versus protocolized standard of care in critically ill patients requiring continuous renal replacement therapy: study protocol of the GO NEUTRAL randomized controlled trial
Authors: Bitker Laurent , Pradat Pierre , Dupuis Claire , Klouche Kada , Illinger Julien , Souweine Bertrand , Richard Jean-Christophe
Published: September 2022

Background

Fluid overload is associated with worse outcome in critically ill patients requiring continuous renal replacement therapy (CRRT). Net ultrafiltration (UFNET) allows precise control of the fluid removal but is frequently ceased due to hemodynamic instability episodes. However, approximately 50% of the hemodynamic instability episodes in ICU patients treated with CRRT are not associated with preload dependence (i.e., are not related to a decrease in cardiac preload), suggesting that volume removal is not responsible for these episodes of hemodynamic impairment. The use of advanced hemodynamic monitoring, comprising continuous cardiac output monitoring to repeatedly assess preload dependency, could allow securing UFNET to allow fluid balance control and prevent fluid overload.

Methods

The GO NEUTRAL trial is a multicenter, open-labeled, randomized, controlled, superiority trial with parallel groups and balanced randomization with a 1:1 ratio. The trial will enroll adult patients with acute circulatory failure treated with vasopressors and severe acute kidney injury requiring CRRT who already have been equipped with a continuous cardiac output monitoring device. After informed consent, patients will be randomized into two groups. The control group will receive protocolized fluid removal with an UFNET rate set to 0–25 ml h−1 between inclusion and H72 of inclusion. The intervention group will be treated with an UFNET rate set on the CRRT of at least 100 ml h−1 between inclusion and H72 of inclusion if hemodynamically tolerated based on a protocolized hemodynamic protocol aiming to adjust UFNET based on cardiac output, arterial lactate concentration, and preload dependence assessment by postural maneuvers, performed regularly during nursing rounds, and in case of a hemodynamic instability episode. The primary outcome of the study will be the cumulative fluid balance between inclusion and H72 of inclusion. Randomization will be generated using random block sizes and stratified based on fluid overload status at inclusion. The main outcome will be analyzed in the modified intention-to-treat population, defined as all alive patients at H72 of inclusion, based on their initial allocation group.

Discussion

We present in the present protocol all study procedures in regard to the achievement of the GO NEUTRAL trial, to prevent biased analysis of trial outcomes and improve the transparency of the trial result report. Enrollment of patients in the GO NEUTRAL trial has started on June 31, 2021, and is ongoing.

Trial registration

ClinicalTrials.gov NCT04801784. Registered on March 12, 2021, before the start of inclusion.
Disruption of grin2B, an ASD-associated gene, produces social deficits in zebrafish
Authors: Zoodsma Josiah D. , Keegan Emma J. , Moody Gabrielle R. , Bhandiwad Ashwin A. , Napoli Amalia J. , Burgess Harold A. , Wollmuth Lonnie P. , Sirotkin Howard I.
Published: September 2022

Background

Autism spectrum disorder (ASD), like many neurodevelopmental disorders, has complex and varied etiologies. Advances in genome sequencing have identified multiple candidate genes associated with ASD, including dozens of missense and nonsense mutations in the NMDAR subunit GluN2B, encoded by GRIN2B. NMDARs are glutamate-gated ion channels with key synaptic functions in excitatory neurotransmission. How alterations in these proteins impact neurodevelopment is poorly understood, in part because knockouts of GluN2B in rodents are lethal.

Methods

Here, we use CRISPR-Cas9 to generate zebrafish lacking GluN2B (grin2B−/−). Using these fish, we run an array of behavioral tests and perform whole-brain larval imaging to assay developmental roles and functions of GluN2B.

Results

We demonstrate that zebrafish GluN2B displays similar structural and functional properties to human GluN2B. Zebrafish lacking GluN2B (grin2B−/−) surprisingly survive into adulthood. Given the prevalence of social deficits in ASD, we assayed social preference in the grin2B−/− fish. Wild-type fish develop a strong social preference by 3 weeks post fertilization. In contrast, grin2B−/− fish at this age exhibit significantly reduced social preference. Notably, the lack of GluN2B does not result in a broad disruption of neurodevelopment, as grin2B−/− larvae do not show alterations in spontaneous or photic-evoked movements, are capable of prey capture, and exhibit learning. Whole-brain imaging of grin2B−/− larvae revealed reduction of an inhibitory neuron marker in the subpallium, a region linked to ASD in humans, but showed that overall brain size and E/I balance in grin2B−/− is comparable to wild type.

Limitations

Zebrafish lacking GluN2B, while useful in studying developmental roles of GluN2B, are unlikely to model nuanced functional alterations of human missense mutations that are not complete loss of function. Additionally, detailed mammalian homologies for larval zebrafish brain subdivisions at the age of whole-brain imaging are not fully resolved.

Conclusions

We demonstrate that zebrafish completely lacking the GluN2B subunit of the NMDAR, unlike rodent models, are viable into adulthood. Notably, they exhibit a highly specific deficit in social behavior. As such, this zebrafish model affords a unique opportunity to study the roles of GluN2B in ASD etiologies and establish a disease-relevant in vivo model for future studies.
The first Jurassic coelacanth from Switzerland
Authors: Ferrante Christophe , Menkveld-Gfeller Ursula , Cavin Lionel
Published: September 2022

Coelacanths form a clade of sarcopterygian fish represented today by a single genus, Latimeria. The fossil record of the group, which dates back to the Early Devonian, is sparse. In Switzerland, only Triassic sites in the east and southeast of the country have yielded fossils of coelacanths. Here, we describe and study the very first coelacanth of the Jurassic period (Toarcian stage) from Switzerland. The unique specimen, represented by a sub-complete individual, possesses morphological characteristics allowing assignment to the genus Libys (e.g., sensory canals opening through a large groove crossed by pillars), a marine coelacanth previously known only in the Late Jurassic of Germany. Morphological characters are different enough from the type species, Libys polypterus, to erect a new species of Libys named Libys callolepis sp. nov. The presence of Libys callolepis sp. nov. in Lower Jurassic beds extends the stratigraphic range of the genus Libys by about 34 million years, but without increasing considerably its geographic distribution. Belonging to the modern family Latimeriidae, the occurrence of Libys callolepis sp. nov. heralds a long period, up to the present day, of coelacanth genera with very long stratigraphic range and reduced morphological disparity, which have earned them the nickname of ‘living fossils’.
Indirect optimization of staphylokinase expression level in dicistronic auto-inducible system
Authors: Shariati Fatemeh Sadat , Keramati Malihe , Cohan Reza Ahangari
Published: September 2022

Design of experiment (DOE) is a statistical approach for designing, performing, and interpreting a large set of data with the minimum number of tests. In our previous study, we developed a novel Hsp27 SILEX system for production of recombinant proteins. In the present study, we optimized indirectly the most effective factors including inoculation load, self-induction temperature, and culture media on autoinduction of staphylokinase (SAK) expression using RSM methodology and fluorometry. The expression level of SAK was assayed at different runs after 6 h incubation at 90 rpm. The results indicated all parameters significantly affect the SAK expression level (p < 0.05). The optimum expression condition was obtained with an inoculation load of 0.05, a temperature of 25 °C, and TB culture medium. The analysis of variance with a R2 value of 0.91 showed that a quadratic model well described this prediction (p < 0.05). Applying the optimized condition led to an approximately fourfold increase in the SAK expression level (from 1.3 to 5.2 µg/ml). Moreover, the recombinant protein was purified using immobilized metal affinity chromatography and the activity was also confirmed by semi-quantitative caseinolytic method.
Identification and spatial extent of understory plant species requiring vegetation control to ensure tree regeneration in French forests
Authors: Dumas Noé , Dupouey Jean-Luc , Gégout Jean-Claude , Boulanger Vincent , Bontemps Jean-Daniel , Morneau François , Dalmasso Marine , Collet Catherine
Published: September 2022

Key message

Fifteen species are most susceptible to require vegetation control during tree regeneration in the range of our study. Among these 15 species, Rubus fruticosus, Pteridium aquilinum, and Molinia caerulea cover each more than 300,000 ha of open-canopy forests.

Context

Vegetation control, i.e., the reduction of competitive species cover, is often required to promote tree seedling establishment during the forest regeneration stage. The necessity to control understory vegetation largely depends on the species to be controlled. In order to plan forest renewal operations, it is critical to identify which species require vegetation control during the regeneration stage and to quantify the forest area affected by these species.

Aims

We aimed at identifying the main species requiring vegetation control and at estimating the forest area they cover at the national level.

Methods

Using National Forest Inventory data, we created four indicators based on two levels of plant cover, cross-referenced with two levels of canopy opening, and compared them to the outcome of a survey of forest manager practices.

Results

The best indicator was the one that represented the proportion of forests with open canopy where the species was present with a large cover in the understory. In non-Mediterranean France, according to the indicator, a total of 15 species were found to frequently require vegetation control during the tree regeneration stage. Pteridium aquilinum, Molinia caerulea, and Rubus fruticosus were the main species, and each covered more than 300,000 ha of forest with open canopies, representing about 13% of the total forest area with open canopies outside of the Mediterranean area.

Conclusions

Forests covered by species requiring vegetation control according to forest managers represent a large share of the forest area undergoing regeneration. This study provides the first list of species that require vegetation control based on a methodological protocol that makes it possible to calculate the area associated with each species.
Deficient-basis-complementary rank-constrained spatial covariance matrix estimation based on multivariate generalized Gaussian distribution for blind speech extraction
Authors: Kondo Yuto , Kubo Yuki , Takamune Norihiro , Kitamura Daichi , Saruwatari Hiroshi
Published: September 2022

Rank-constrained spatial covariance matrix estimation (RCSCME) is a blind speech extraction method utilized under the condition that one-directional target speech and diffuse background noise are mixed. In this paper, we propose a new model extension of RCSCME. RCSCME simultaneously conducts both the deficient rank-1 component complementation of the diffuse noise spatial covariance matrix, which is incompletely estimated by preprocessing methods such as independent low-rank matrix analysis, and the estimation of the source model parameters. In the conventional RCSCME, between the two parameters constituting the deficient rank-1 component, only the scale is estimated, whereas the other parameter, the deficient basis, is fixed in advance; however, how to choose the fixed deficient basis is not unique. In the proposed RCSCME model, we also regard the deficient basis as a parameter to estimate. As the generative model of an observed signal, we utilized the super-Gaussian generalized Gaussian distribution, which achieves better separation performance than the Gaussian distribution in the conventional RCSCME. Assuming the model, we derive new majorization-minimization (MM)- and majorization-equalization (ME)-algorithm-based update rules for the deficient basis. In particular, among innumerable ME-algorithm-based update rules, we successfully find an ME-algorithm-based update rule with a mathematical proof supporting the fact that the step of the update rule is larger than that of the MM-algorithm-based update rule. We confirm that the proposed method outperforms conventional methods under several simulated noise conditions and a real noise condition.
Intelligent radar HRRP target recognition based on CNN-BERT model
Authors: Wang Penghui , Chen Ting , Ding Jun , Pan Mian , Tang Sanding
Published: September 2022

Stable and reliable feature extraction is crucial for radar high-resolution range profile (HRRP) target recognition. Owing to the complex structure of HRRP data, existing feature extraction methods fail to achieve satisfactory performance. This study proposes a new deep learning model named convolutional neural network–bidirectional encoder representations from transformers (CNN-BERT), using the spatio–temporal structure embedded in HRRP for target recognition. The convolutional token embedding module characterizes the local spatial structure of the target and generates the sequence features by token embedding. The BERT module captures the long-term temporal dependence among range cells within HRRP through the multi-head self-attention mechanism. Furthermore, a novel cost function that simultaneously considers the recognition and rejection ability is designed. Extensive experiments on measured HRRP data reveal the superior performance of the proposed model.
Time-frequency analysis-based deep interference classification for frequency hopping system
Authors: Xu Changzhi , Ren Jingya , Yu Wanxin , Jin Yi , Cao Zhenxin , Wu Xiaogang , Jiang Weiheng
Published: September 2022

It is known that interference classification plays an important role in protecting the authorized communication system and avoiding its performance degradation in the hostile environment. In this paper, the interference classification problem for the frequency hopping communication system is discussed. Considering the possibility of the presence of multiple interferences in the frequency hopping system, in order to fully extract effective features of the interferences from the received signals, the linear and bilinear transform-based composite time-frequency analysis method is adopted. Then, the time-frequency spectrograms obtained from the time-frequency analysis are constructed as matching pairs and input to the deep neural network for classification. In particular, the Siamese neural network is used as the classifier, where the paired spectrograms are input into the two sub-networks of the deep networks, and these two sub-networks extract the features of the paired spectrograms for interference-type classification. The simulation results confirm that the proposed algorithm can obtain higher classification accuracy than both traditional single time-frequency representation-based approach and the AlexNet transfer learning or convolutional neural network-based methods.
Establishing a prediction model for recurrence of condyloma acuminatum
Authors: Zhan Mengyun , Tong Zhenzhen , Chen Song , Miao Yu , Yang Yun
Published: September 2022

We collected the clinical data of 156 patients diagnosed with condyloma acuminatum (CA), including age, gender, marriage, education level, stay up late, smoking, drinking, number of sexual partners, HPV infection status of sexual partners, genitourinary and anal diseases, condom use, other diseases of HPV infection, location and number of warts, HPV typing, etc. Analyze the risk factors affecting the recurrence of CA, explore the influencing factors and independent influencing factors of CA recurrence, establish the prediction model of CA recurrence, and evaluate its prediction value. Univariate analysis showed that stay up late, HPV infection status of sexual partners, urogenital diseases, condom use, other diseases of HPV infection and the number of CA were the influencing factors of CA recurrence. Multivariate analysis showed that condom use (OR = 0.166), HPV infection status of sexual partners (OR = 4.848), number of warts (OR = 1.212) and urogenital diseases (OR = 3.179) were independent factors affecting the recurrence of CA (P < 0.05). Therefore, the prediction model of CA recurrence can be established, and the area under the curve AUC of the prediction model was calculated to be 0.867 (95% CI 0.812–0.923). The model established in this study has certain prediction value for the recurrence of CA and can be used to preliminarily predict the recurrence of CA.
Research on Modified High-Performance Cement Mortar of Prefabricated Buildings Based on Orthogonal Test
Authors: Yuan Chengbin , Cai Yu , Gu Qiang , Sang Di
Published: September 2022

In order to improve the construction technology level of the connection nodes of prefabricated buildings and improve the mechanical properties, fluidity and economy of the connection mortar, this paper adopts the orthogonal experimental design to improve the cement mortar by adding polymer dispersible polymer powder. A modified high-performance mortar with 1d compressive strength of 11Mpa, 3d compressive strength of 19Mpa, 7d compressive strength of 26Mpa, fluidity of 102 mm and final compressive strength higher than M25 was studied. The factors and levels of the orthogonal test are: mortar ratio 1:3,1:4,1:5; silica powder content of 4%,6%,8%; dispersible polymer powder content of 3%,5%,7%. After research, the optimal mixing ratio of modified high-performance mortar is 1:3, the content of silicon powder is 6%, the content of redispersible latex powder is 3%, the content of early strength water reducing agent is 0.1%, and the content of defoamer is 0.5%. The new modified high-performance cement mortar is characterized by short setting time and high early strength, which provides a new idea for the connecting materials of prefabricated buildings, which is of great significance for improving the integrity of prefabricated buildings and the durability of the connection.
Bruton tyrosine kinase inhibitors in B-cell lymphoma: beyond the antitumour effect
Authors: Wang Haoran , Guo Hao , Yang Jingyi , Liu Yanyan , Liu Xingchen , Zhang Qing , Zhou Keshu
Published: September 2022

Targeting B-cell receptor signalling using Bruton tyrosine kinase (BTK) inhibitors (BTKis) has become a highly successful treatment modality for B-cell malignancies, especially for chronic lymphocytic leukaemia. However, long-term administration of BTKis can be complicated by adverse on- and/or off-target effects in particular cell types. BTK is widely expressed in cells of haematopoietic origin, which are pivotal components of the tumour microenvironment. BTKis, thus, show broad immunomodulatory effects on various non-B immune cell subsets by inhibiting specific immune receptors, including T-cell receptor and Toll-like receptors. Furthermore, due to the off-target inhibition of other kinases, such as IL-2-inducible T-cell kinase, epidermal growth factor receptor, and the TEC and SRC family kinases, BTKis have additional distinct effects on T cells, natural killer cells, platelets, cardiomyocytes, and other cell types. Such mechanisms of action might contribute to the exceptionally high clinical efficacy as well as the unique profiles of adverse effects, including infections, bleeding, and atrial fibrillation, observed during BTKi administration. However, the immune defects and related infections caused by BTKis have not received sufficient attention in clinical studies till date. The broad involvement of BTK in immunological pathways provides a rationale to combine BTKis with specific immunotherapies, such as immune checkpoint inhibitor or chimeric antigen receptor-T-cell therapy, for the treatment of relapsed or refractory diseases. This review discusses and summarises the above-mentioned issues as a reference for clinicians and researchers.
Metagenomics-resolved genomics provides novel insights into chitin turnover, metabolic specialization, and niche partitioning in the octocoral microbiome
Authors: Keller-Costa Tina , Kozma Lydia , Silva Sandra G. , Toscan Rodolfo , Gonçalves Jorge , Lago-Lestón Asunción , Kyrpides Nikos C. , Nunes da Rocha Ulisses , Costa Rodrigo
Published: September 2022

Background

The role of bacterial symbionts that populate octocorals (Cnidaria, Octocorallia) is still poorly understood. To shed light on their metabolic capacities, we examined 66 high-quality metagenome-assembled genomes (MAGs) spanning 30 prokaryotic species, retrieved from microbial metagenomes of three octocoral species and seawater.

Results

Symbionts of healthy octocorals were affiliated with the taxaEndozoicomonadaceae, CandidatusThioglobaceae,Metamycoplasmataceae, unclassifiedPseudomonadales,Rhodobacteraceae, unclassifiedAlphaproteobacteriaand Ca.Rhabdochlamydiaceae. Phylogenomics inference revealed that theEndozoicomonadaceaesymbionts uncovered here represent two species of a novel genus unique to temperate octocorals, here denoted Ca.Gorgonimonaseunicellaeand Ca.Gorgonimonasleptogorgiae. Their genomes revealed metabolic capacities to thrive under suboxic conditions and high gene copy numbers of serine-threonine protein kinases, type 3-secretion system, type-4 pili, and ankyrin-repeat proteins, suggesting excellent capabilities to colonize, aggregate, and persist inside their host. Contrarily, MAGs obtained from seawater frequently lacked symbiosis-related genes. AllEndozoicomonadaceaesymbionts harbored endo-chitinase and chitin-binging protein-encoding genes, indicating that they can hydrolyze the most abundant polysaccharide in the oceans. Other symbionts, includingMetamycoplasmataceaeand Ca.Thioglobaceae, may assimilate the smaller chitin oligosaccharides resulting from chitin breakdown and engage in chitin deacetylation, respectively, suggesting possibilities for substrate cross-feeding and a role for the coral microbiome in overall chitin turnover. We also observed sharp differences in secondary metabolite production potential between symbiotic lineages. SpecificProteobacteriataxa may specialize in chemical defense and guard other symbionts, includingEndozoicomonadaceae, which lack such capacity.

Conclusion

This is the first study to recover MAGs from dominant symbionts of octocorals, including those of so-far unculturableEndozoicomonadaceae, Ca.ThioglobaceaeandMetamycoplasmataceaesymbionts. We identify a thus-far unanticipated, global role forEndozoicomonadaceaesymbionts of corals in the processing of chitin, the most abundant natural polysaccharide in the oceans and major component of the natural zoo- and phytoplankton feed of octocorals. We conclude that niche partitioning, metabolic specialization, and adaptation to low oxygen conditions among prokaryotic symbionts likely contribute to the plasticity and adaptability of the octocoral holobiont in changing marine environments. These findings bear implications not only for our understanding of symbiotic relationships in the marine realm but also for the functioning of benthic ecosystems at large.
Understanding Your Baby: protocol for a controlled parallel group study of a universal home-based educational program for first time parents
Authors: Væver Mette Skovgaard , Krogh Marianne Thode , Stuart Anne Christine , Madsen Eva Back , Haase Tina Wahl , Egmose Ida
Published: September 2022

Background

Infant mental health represents a significant public health issue. The transition to parenthood provides optimal opportunities for supporting parenting competence. Especially parental mentalization, i.e. the caregiver’s ability to notice and interpret the child’s behavior in terms of mental states, is important in infancy where the caregiver-infant communication is based solely on the infant’s behavioral cues.

Methods

This study evaluates the efficacy of the intervention Understanding Your Baby (UYB) compared to Care As Usual (CAU) in 10 Danish municipalities. UYB aims at promoting parental competence in new parents by supporting them in noticing their infants’ behavioral cues and interpreting them in terms of mental states. Participants will be approximately 1,130 singletons and their parents. Inclusion criteria are first-time parents, minimum 18 years old, living in one of the 10 municipalities, and registered in the Danish Civil Registration Register (CPR). Around 230 health visitors deliver the UYB as part of their routine observation of infant social withdrawal in the Danish home visiting program. During an interaction between the health visitor and the infant, the health visitor articulates specific infant behaviors and helps the caregivers interpret these behaviors to mental states. The study is a controlled parallel group study with data obtained at four time points in two phases: First in the control group receiving the publicly available postnatal care (CAU), secondly in the intervention group after UYB implementation into the existing postnatal services. The primary outcome is maternal competence. Secondary measures include paternal competence, parental stress, parental mentalizing, and infant socioemotional development. Analysis will employ survey data and data from the health visitors’ register.

Discussion

Results will provide evidence regarding the efficacy of UYB in promoting parenting competences. If proved effective, the study will represent a notable advance to initiating the UYB intervention as part of a better infant mental health strategy in Denmark. Conversely, if UYB is inferior to CAU, this is also important knowledge in regard to promoting parenting competence and infant mental health in a general population.

Trial registrationhttps://ClinicalTrials.gov with ID no. NCT03991416. Registered at 19 June 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03991416
The safe removal of a superior mediastinal foreign body by mediastinoscopy: a case report
Authors: Sakuma Takashi , Tamura Tatsuro , Nambara Mikio , Gyobu Ken , Yoshii Mami , Toyokawa Takahiro , Lee Shigeru , Tanaka Hiroaki , Muguruma Kazuya , Yashiro Masakazu , Ohira Masaichi , Maeda Kiyoshi
Published: September 2022

Background

Mediastinal foreign bodies might cause mediastinal organ injury or mediastinal abscess. The prompt removal surgery of mediastinal foreign bodies is needed to prevent those complications. We report a case in which a mediastinal foreign body was removed by video-mediastinoscopy.

Case presentation

The patient, a 74-year-old man with a chief complaint of hoarseness, was referred to our department for surgical management of a wooden foreign body that had traumatically migrated into the superior mediastinum. During the surgery, the video-mediastinoscopy was introduced under the pneumomediastinal pressure. We could dissect the scar tissue and remove the azalea tree branch safely and carefully, without damaging the other mediastinal organs. He was discharged on postoperative day 5, with no complications.

Conclusions

Video-mediastinoscopic approach under pneumomediastinal pressure is minimally invasive and could provide wide surgical view. Therefore, we consider it useful and effective for removal of foreign bodies in the mediastinum.
Risk factors associated with sickle cell retinopathy: findings from the Cooperative Study of Sickle Cell Disease
Authors: Nawaiseh Mohammed , Roto Allaa , Nawaiseh Yara , Salameh Mohammad , Haddadin Rund , Mango Lana , Nawaiseh Hussam , Alsaraireh Doha , Nawaiseh Qais , AlRyalat Saif Aldeen , Alwreikat Amer , Ramsey David J. , Abu-Yaghi Nakhleh
Published: September 2022

Background

Sickle cell retinopathy (SCR) is one of the most important ocular manifestations of sickle cell disease (SCD). This study aims to assess the prevalence of SCR in SCD, identify risk factors for its development and progression to proliferative sickle cell retinopathy (PSCR), and evaluate the potential implications of these results on clinical practice.

Methods

This research is a secondary analysis of patients diagnosed with SCD from the epidemiological, multicenter Cooperative Study of Sickle Cell Disease (CSSCD). We included all patients who completed a full ophthalmic evaluation. We identified clinical and laboratory SCD characteristics associated with SCR using multivariate logistic regression models. Proliferative sickle cell retinopathy (PSCR) was diagnosed according to the Goldberg classification system.

Results

Of the 1904 study participants with SCD who met the inclusion criteria, 953 (50.1%) had retinopathy; of which 642 (67.3%) had bilateral disease. SCR was associated with older age (p < 0.001), history of smoking (p = 0.001), hematuria (p = 0.050), and a lower hemoglobin F (HbF) level (p < 0.001). PSCR risk increased with smoking (p = 0.005), older age (p < 0.001) higher hemoglobin level (p < 0.001) and higher white blood cell count (p = 0.011). Previous blood transfusion (p = 0.050), higher reticulocyte count (p = 0.019) and higher HbF level (p < 0.001) were protective factors against the development of PSCR. Ocular symptoms were associated with progression to PSCR in patients with SCR (p = 0.021).

Conclusion

In this cohort of individuals with SCD, half of the participants had signs of SCR. Smoking and blood hemoglobin level were the two modifiable risk factors associated with increased retinopathy progression. Screening to identify the different stages of retinopathy, actively promoting smoking cessation, and optimizing the hematological profile of patients with SCD should guide treatment protocols designed to prevent the vision-threatening complications of the disease.
Numerical simulations of noisy quantum circuits for computational chemistry
Authors: Wright Jerimiah , Gowrishankar Meenambika , Claudino Daniel , Lotshaw Phillip C. , Nguyen Thien , McCaskey Alexander J. , Humble Travis S.
Published: September 2022

The opportunities afforded by near-term quantum computers to calculate the ground-state properties of small molecules depend on the structure of the computational ansatz as well as the errors induced by device noise. Here we investigate the behavior of these noisy quantum circuits using numerical simulations to estimate the accuracy and fidelity of the prepared quantum states relative to the ground truth obtained by conventional means. We implement several different types of ansatz circuits derived from unitary coupled cluster theory for the purposes of estimating the ground-state energy of sodium hydride using the variational quantum eigensolver algorithm. We show how relative error in the energy and the fidelity scale with the levels of gate-based noise, the internuclear configuration, the ansatz circuit depth, and the parameter optimization methods.
Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment
Authors: Assadi Hosamadin , Uthayachandran Bhalraam , Li Rui , Wardley James , Nyi Tha H. , Grafton-Clarke Ciaran , Swift Andrew J. , Solana Ana Beatriz , Aben Jean-Paul , Thampi Kurian , Hewson David , Sawh Chris , Greenwood Richard , Hughes Marina , Kasmai Bahman , Zhong Liang , Flather Marcus , Vassiliou Vassilios S. , Garg Pankaj
Published: September 2022

Background

To validate the k-adaptive-t autocalibrating reconstruction for Cartesian sampling (kat-ARC), an exclusive sparse reconstruction technique for four-dimensional (4D) flow cardiac magnetic resonance (CMR) using conservation of mass principle applied to transvalvular flow.

Methods

This observational retrospective study (2020/21-075) was approved by the local ethics committee at the University of East Anglia. Consent was waived. Thirty-five patients who had a clinical CMR scan were included. CMR protocol included cine and 4D flow using Kat-ARC acceleration factor 6. No respiratory navigation was applied. For validation, the agreement between mitral net flow (MNF) and the aortic net flow (ANF) was investigated. Additionally, we checked the agreement between peak aortic valve velocity derived by 4D flow and that derived by continuous-wave Doppler echocardiography in 20 patients.

Results

The median age of our patient population was 63 years (interquartile range [IQR] 54–73), and 18/35 (51%) were male. Seventeen (49%) patients had mitral regurgitation, and seven (20%) patients had aortic regurgitation. Mean acquisition time was 8 ± 4 min. MNF and ANF were comparable: 60 mL (51−78) versus 63 mL (57−77), p = 0.310). There was an association between MNF and ANF (rho = 0.58, p < 0.001). Peak aortic valve velocity by Doppler and 4D flow were comparable (1.40 m/s, [1.30−1.75] versus 1.46 m/s [1.25−2.11], p = 0.602) and also correlated with each other (rho = 0.77, p < 0.001).

Conclusions

Kat-ARC accelerated 4D flow CMR quantified transvalvular flow in accordance with the conservation of mass principle and is primed for clinical translation.
Tandem bullets: case report and ballistic analysis
Authors: Passalacqua Pierluigi , Pallocci Margherita , De Luca Lucilla , Zanovello Claudia , Sacchetti Giulio , Treglia Michele
Published: September 2022

Background

In forensic ballistics, the phenomenon of tandem bullets occurs when two or more bullets are ejected from the barrel of a firearm in a single shot. The injuries caused by these bullets have been described in the literature and include several possibilities, whose severity seems to be especially related to the mass increase of the exploded cartridges and to the distance at which the shots are fired, as a result of the sudden drop in kinetic energy that occurs.

Case presentation

We report the case of a subject hit by a tandem bullet, during an attempted robbery, describing the injury reported in relation to the ballistic analysis of the case and examining the dynamics in which this circumstance occurred.

Conclusions

The ballistic analysis conducted in our case confirmed that the harmful potential of “tandem bullets” is inversely correlated to the mass of the fired bullets. In our case, the exploded shot, consisting of two 38 Special caliber bullets fused together, hit the body of the subject involved with minimal kinetic energy and penetrating potential. We believe that further ballistic studies should be conducted on a cadaveric model by exploiting cadaveric donation programs for scientific research purposes, in order to investigate the wide spectrum of possible injuries that can occur, also simulating the effects of unjacketed tandem bullets.