bluuebunny/crossref_metadata_2025 huggingface dataset:
Herbivory and leaf traits of Amazonian tree species as affected by irradiance
Authors: Coelho da Silva D. , Guimarães Z. T. M. , Ferreira dos Santos V. A. H. , Grandis A. , Palacios C. E. , Ferreira M. J.
Published: October 2020

Herbivory is one of the major biotic stress factors that affect the establishment of plants. However, the main factors that drive herbivory in seedlings of Amazonian tree species are still not well understood. Here we investigated whether contrasting levels of irradiance influence herbivory according to different herbivory indicators and which leaf traits are most related to interspecific variation in herbivory under contrasting irradiance conditions.

We measured the leaf area lost as a result of insect herbivory in five tree species planted in a silvicultural system of secondary forest enrichment according to two indicators, herbivore damage (accumulated since plant germination) and herbivory rate (measured over time), and two irradiance conditions, understorey PPFD 2.6 mol·m−2·day−1) and gap PPFD 33.1 mol·m−2·day−1. Furthermore, we related the interspecific variation in herbivory to a set of leaf traits: SLA, RWC, sclerophylly, phenolic compound content, tannins, condensed tannins and non‐structural carbohydrates.

Herbivore damage was significantly affected by light availability and species, with the highest percentage variation observed in the Meliaceae (Carapa guianensis and Swietenia macrophylla). For the herbivory rate, only the interspecific variation was significant, with Bertholletia excelsa having the lowest rates. Chemical characteristics (phenolic compounds and tannins) were most related to herbivory rates, as well as highly influenced by light conditions. Non‐structural carbohydrates (starch and sucrose) were also related to the interspecific variation in herbivory.

The phenolic compounds and starch, as affected by light quantity, are species dependent. Thus, the selective pressure on herbivores may be driven by species‐dependent responses to light conditions.
A case of tuberculosis meningitis after allogeneic hematopoietic stem cell transplantation for relapsed Acute Myeloid Leukemia
Authors: Yang Jinyoung , Moon Sunghyun , Kwon Minsuk , Huh Kyungmin , Jung Chul Won
Published: October 2020

We report a case of tuberculosis (TB) meningitis after allogeneic hematopoietic stem cell transplantation (HSCT) for relapsed acute myeloid leukemia. The patient was 52‐year‐old woman who had relapsed leukemia with a remission duration of 7 months, and she received re‐induction with consolidation, allogeneic HSCT. After 4 days of engraftment, she had headache with fever and cerebrospinal fluid (CSF) analysis presented increased intracerebral pressure, white blood cell counts with dominant neutrophils, elevated glucose and protein level. Brain imaging showed diffuse leptomeningeal enhancement with scattered miliary TB lesions suggesting disseminated TB disease. Mycobacterium tuberculosis was detected in CSF and sputum anti‐TB medication was started. She was IGRA positive before transplantation but did not receive treatment for LTBI prior or during the transplant. Unfortunately, she expired because of intracerebral hemorrhage. TB meningitis is a rare but important complication of HSCT as it can cause serious neurologic sequelae, even death. So in transplant recipients having high risk of TB reactivation, LTBI treatment is recommended before or along with transplantation. If latent TB is not treated, vigilant suspicion and early diagnosis of TB meningitis could improve the transplant outcome.
Epidemiology, risk factors, and outcomes associated with cytomegalovirus in adult kidney transplant recipients: A systematic literature review of real‐world evidence
Authors: Raval Amit D. , Kistler Kristin D. , Tang Yuexin , Murata Yoshihiko , Snydman David R.
Published: October 2020

Kidney transplant recipients (KTRs) have increased risk for cytomegalovirus (CMV) infection/disease given the necessity of drug‐induced immunosuppression. A comprehensive review of published literature reporting real‐world data on prevention strategies utilized and associated CMV burden outcomes is limited. Such data could help inform future clinical practice and identify unmet needs in CMV management. We conducted a systematic review of observational studies published in Medline or EMBASE from January 2008 to November 2018 to identify current real‐world CMV management approaches, CMV infection/disease risk factors, and outcomes associated with CMV infection. Descriptive statistics and pooled quantitative analyses were conducted. From 1608 records screened, 86 citations, including 69 803 adult KTR, were included. Prophylaxis and preemptive therapy (PET) were predominant approaches among D+/R‐ and R + CMV serostatus transplants, respectively. Valganciclovir and ganciclovir were frequently utilized across CMV risk strata. Despite prevention approaches, approximately one‐fourth of KTR developed CMV infection. Age and D+/R‐ CMV serostatus were consistent risk factors for CMV infection/disease. CMV infection/disease was associated with increased mortality and graft loss. CMV was similarly associated with acute rejection (AR) risk, but with high heterogeneity among studies. Limited data were available on CMV and opportunistic infections (OIs) risk. CMV remains a significant issue. New strategies may be needed to optimize CMV management.
Pre‐transplant bariatric surgery is associated with increased fungal infection after liver transplant
Authors: Jorgenson Margaret R. , Gracon Adam S. , Hanlon Bret , Leverson Glen E. , Parajuli Sandesh , Smith Jeannina A. , Al‐Adra David P.
Published: October 2020

Aim

The impact of pre‐transplant (pre‐TXP) bariatric surgery (BS) on outcomes after liver transplant (LTX) has not been completely elucidated. Roux‐en Y gastric bypass (RYGB) is one of the most common BS procedures. The primary objective of this study was to identify the risk of infection in LTX recipients with pre‐TXP RYGB.

Methods

Adult patients with LTX between 1/1/2001 and 9/30/2018 at our center were screened for pre‐TXP RYGB; patients with gastrectomy via sleeve or banding were excluded. Patients with no history of BS pre‐ or post‐transplant were placed in a comparator group, matched 2:1 via incidence density sampling on age epoch.

Results

There were 16 LTX recipients with pre‐TXP RYGB matched to 32 controls. Median time from RYGB to transplant was 11.7 years. Mean weight loss was 66 ± 19 kg. There were significantly more women with pre‐TXP RYGB than in the matched control (RYGB:68.8% vs control:25%, P = .009). Demographics were otherwise similar between groups. Pre‐TXP RYGB did not significantly increase hospital or ICU length of stay (P = .5, P = .3) but was associated with a significantly increased rate of fungal infection at 1 year (RYGB:33.4% vs control:9.7%, P = .01), and a numerical trend to increased bacterial infection (RYGB:56.2% vs control:32.2%, P = .09).

Conclusion

Despite the substantial weight loss attributed to BS, patients with pre‐TXP RYGB demonstrated increased rates of fungal infection after transplant and trended toward increased bacterial infection. While the anatomical complexity associated with LTX surgery after RYGB did not appear to significantly affect ICU or hospital length of stay, it may have contributed to overall infectious risk, and possibly to impaired survival. Additionally, bypass of the host natural barrier defenses of the stomach could also have contributed to infectious risk. Our findings highlight the complexity of this patient population. Future prospective studies are needed to investigate risk of infection after LTX in the setting of pre‐Txp BS. Potential modification in fungal prophylaxis protocols to include pre‐TXP RYGB may be warranted.
Zoonotic sporotrichosis in renal transplant recipients from Rio de Janeiro, Brazil
Authors: Fichman Vivian , Marques de Macedo Priscila , Francis Saraiva Freitas Dayvison , Carlos Francesconi do Valle Antonio , Almeida‐Silva Fernando , Reis Bernardes‐Engemann Andréa , Zancopé‐Oliveira Rosely Maria , Almeida‐Paes Rodrigo , Clara Gutierrez‐Galhardo Maria
Published: October 2020

Sporotrichosis is the main subcutaneous mycosis in the world. In the last two decades, zoonotic sporotrichosis transmitted by cats has become hyperendemic in Rio de Janeiro, Brazil. Renal transplant recipients are subject to invasive fungal infection because of the effects of immunosuppressive therapy, but sporotrichosis is rarely reported. The authors conducted a retrospective study describing epidemiological, clinical, and therapeutic data related to adult renal‐transplant‐recipient patients diagnosed with sporotrichosis. The molecular identification of fungal isolates was performed. Minimal inhibitory concentration (MIC) of amphotericin B (AMB), itraconazole (ITZ), posaconazole (POS), isavuconazole, and terbinafine (TRB) against the strains was determined using the protocol described by the Clinical and Laboratory Standards Institute (CLSI). Six cases were identified from a cohort with 2429 sporotrichosis patients. They were five men and one woman, with a mean age of 44.2 years (range: 34‐54 years). Four of them had cutaneous limited forms, and two patients had disseminated forms. The mean time between transplant and the onset of sporotrichosis symptoms was 25.5 (range: 6‐36) months. Sporothrix brasiliensis was identified as the causative agent. The isolates were classified as wild type for all antifungal drugs tested. Treatment schemes included AMB (deoxycholate and liposomal), ITZ, and TRB. Five patients evolved to cure, and one died as a result of disseminated disease. Renal transplant recipients may be a vulnerable group for sporotrichosis in endemic countries. The authors highlight the importance of sporotrichosis prevention, early diagnosis, and treatment to prevent disseminated disease and poor prognosis.
COVID‐19 vaccine research and development: ethical issues
Authors: Wibawa T.
Published: October 2020

The achievements of vaccine research and development bring a hope to our societies that we may cope with the COVID‐19 pandemic. There are two aspects that should be maintained in balance: the immediate necessity for speed of vaccine research and the inherent need for protection of research subjects, which is the foremost concern of research ethics. This narrative review highlights ethical issues in COVID‐19 vaccine research and development that every stakeholder needs to be aware of and to consider.
Comorbidities and the COVID‐19 pandemic dynamics in Africa
Authors: Anjorin A.A. , Abioye A.I. , Asowata O.E. , Soipe A. , Kazeem M.I. , Adesanya I.O. , Raji M.A. , Adesanya M. , Oke F.A. , Lawal F.J. , Kasali B.A. , Omotayo M.O.
Published: October 2020

The debate around the COVID‐19 response in Africa has mostly focused on effects and implications of public health measures, in light of the socio‐economic peculiarities of the continent. However, there has been limited exploration of the impact of differences in epidemiology of key comorbidities, and related healthcare factors, on the course and parameters of the pandemic. We summarise what is known about (a) the pathophysiological processes underlying the interaction of coinfections and comorbidities in shaping prognosis of COVID‐19 patients, (b) the epidemiology of key coinfections and comorbidities, and the state of related healthcare infrastructure that might shape the course of the pandemic, and (c) implications of (a) and (b) for pandemic management and post‐pandemic priorities. There is a critical need to generate empirical data on clinical profiles and the predictors of morbidity and mortality from COVID‐19. Improved protocols for acute febrile illness and access to diagnostic facilities, not just for SARS‐CoV‐2 but also other viral infections, are of urgent importance. The role of malaria, HIV/TB and chronic malnutrition on pandemic dynamics should be further investigated. Although chronic non‐communicable diseases account for a relatively lighter burden, they have a significant effect on COVID‐19 prognosis, and the fragility of care delivery systems implies that adjustments to clinical procedures and re‐organisation of care delivery that have been useful in other regions are unlikely to be feasible. Africa is a large region with local variations in factors that can shape pandemic dynamics. A one‐size‐fits‐all response is not optimal, but there are broad lessons relating to differences in epidemiology and healthcare delivery factors, that should be considered as part of a regional COVID‐19 response framework.
Assessing desalination pretreatment conditions towards pilot scale‐up using Box‐Behnken experimental design
Authors: Hout Sarra , Salem Zineb , Tassalit Djilali , Tigrine Zahia , Aburideh Hanane , Boukendakji Hafida
Published: October 2020

The purpose of this study is to optimize the operating conditions in batch mode using Box‐Behnken Design (BBD), for the coagulation‐flocculation line sizing prior the sand filter in the pilot scale. Three coagulants were employed to achieve a high turbidity removal with a low concentration of residual metals. The results showed that the best turbidity removal was obtained with FeCl3. Using BBD (15 experiments), the optimal parameters were: coagulant dose = 5.5 mg FeCl3/L, slow stirring time = 33 min and slow stirring velocity = 45 rpm, in these conditions, the turbidity removal reached 94.89% and the residual iron concentration was 0.449 mg/L. Regarding the model fit, the obtained R2 values were 99.67% for turbidity removal and 99.47% for residual iron concentration. The optimum conditions obtained from this study could be scaled up and applied to desalination plants. BBD approach is of great interest because it allows the prediction of the response value without performing experiments.
Tool Life Stage Prediction in Micro-Milling From Force Signal Analysis Using Machine Learning Methods
Authors: Varghese Alwin , Kulkarni Vinay , Joshi Suhas S.
Published: October 2020

Tool condition monitoring is difficult in micro-milling due to irregular wear and chipping of the cutting edges, which lead to unexpected tool breakage. This study demonstrates the use of force data to reliably predict different tool life stages until tool breakage, while micro-milling hard materials like stainless steel (SS304) using tungsten carbide tools of 500 μm diameter. Extensive experiments involving machining of 465 slots over 62 min of machining time were performed in this study. The resulting voluminous force data were analyzed to divide the tool life into three stages based on the variation in the forces and other related features. The first stage is the initial 12.5% of the tool life, second stage consists of 12.5–70% of tool life, and the third stage is from 70% to 100% tool life. The analysis of the tool wear and cutting forces shows that the average tool diameter reduces by 32 μm, 67 μm and 108 μm, and the average resultant cutting force were 2.45 N, 4.17 N, and 4.93 N in stage 1, 2, and 3, respectively. To avoid catastrophic breakage of the tool, the tool life stages are predicted from the force data using machine learning models. Among the machine learning models, random forest method gave a better prediction accuracy of 88.5%. The model was further improved by incorporating the initial cutting edge radius as an additional feature, and the variance in the prediction was seen to drop by 48.76%.
Experimental Study of the Impact of a Vibrating Wire on Free Abrasive Machining as Correlated to the Modeling of Vibration Subject to an Oscillating Boundary Condition
Authors: Li Liming , Kao Imin
Published: October 2020

In this paper, we study experimentally the impact of a vibrating wire on the free abrasive machining (FAM) process in removing material from the surface of brittle materials, such as silicon. An experimental setup was designed to study the FAM process on silicon substrate surface by using a slurry-fed wire with a periodic excitation. An analytical solution of a wire moving axially, subject to an oscillating boundary condition with damping from abrasive slurry, was derived based on the partial differential equation of motion. Experiments were conducted on the apparatus using a wire with an oscillating boundary. It was found that the amplitudes of vibration were larger at the side of the oscillatory boundary, which caused more FAM interaction near the edge of the oscillatory boundary with larger material removal that was measured and validated. Furthermore, experiments were conducted to elucidate the effectiveness of brittle material removal using FAM with abrasive grits: (i) under dry condition, (ii) with water, and (iii) with abrasive slurry. Experimental results showed that the vibration of wire resulted in plastic deformation on the surface of silicon wafer. The abrasive grits in slurry driven by a vibrating wire generated material removal through observable grooves and fractures on the surface of silicon due to FAM in just a few minutes. The grooves from FAM process is an outcome of brittle machining through fracture formation and concatenation, generated by the indentation of abrasive grits on the silicon surface.
Microstructure Induced Shear Instability Criterion During High-Speed Machining of Ti–6Al–4V
Authors: Sharma Shiv , Meena Anil
Published: October 2020

The microstructure attributes are responsible for the deformation mechanism of material, which induces shear instability primarily in difficult-to-machine material like Ti–6Al–4V. Consequently, the dynamic cutting force yields serrations in the chip morphology. Therefore, microstructure induced shear instability has been investigated in the present work using an analytical tool to unveiled the deformation behavior in correlation with microstructural characteristics (grain sizes, phase fractions, and microhardness) and process parameters: temperature, strain, and strain rate. The combined effect of feed rate and high cutting speed was found to enhance the strain localization phenomena, which leads to a more pronounced cracking, inducing dynamic cutting force. Segmentation frequency and force-frequency correlation imply a significant transition exhibit from the static to dynamic nature of cutting force. The segmentation frequency of the equiaxed microstructure is lowest among the rest at lower cutting speed, revealing the shear instability dependency on the microstructure. The grain size effect restricts the dislocation movement at the higher cutting speed, which led to a larger strain in as-received microstructure followed by equiaxed and fully lamellar microstructure.
Experimental Study of Micromachining on Borosilicate Glass Using CO2 Laser
Authors: Posa Vishnu Vardhan , Sundaram Murali
Published: October 2020

Laser beam machining (LBM) is a versatile process that can shape a wide range of engineering materials such as metals, ceramics, polymers, and composite materials. However, machining of glass materials by LBM is a challenge as most of the laser energy is not absorbed by the surface. In this study, an attempt has been made to increase the absorptivity of the glass material by using a coating on the surface of the material. Glass has been used in this study because of its extensive applications in the micro-opto-electro-mechanical systems. The optimal machining depends on both laser parameters and properties of the workpiece material. There are number of laser parameters that can be varied in the laser machining process. It is difficult to find optimal laser parameters due to the mutual interaction of laser parameters. A statistical study based on design of experiment (DoE) has been made to study the effect of coating and parameters like laser power, laser scanning speed, angle of inclination of the workpiece on depth of the slot, width of the slot, aspect ratio, and material removal rate (MRR) in the laser machining process using 2k factorial design and analysis of variance (ANOVA). On an average, four times increase in depth of the slot, two times increase in width of the slot and seven times increase in the MRR were observed in the glass samples with coating when compared to uncoated glass work samples.
Modeling and Validation of a Two-Phase Flow Valve for Expanders in Waste Heat Recovery
Authors: Schweizer Fabian , Fürst Marius , Wachtmeister Georg
Published: October 2020

Waste heat recovery is a promising method to reduce fuel consumption and CO2 emissions in heavy-duty vehicles. An organic Rankine cycle (ORC) is used to convert the thermal energy of the exhaust gases into useable energy to support the power train. A key component of the ORC is the expansion machine where the conversion of thermal into mechanical energy takes place. In the case of volumetric expansion machines such as axial piston expanders, lubrication oil is mixed in with the working fluid to reduce friction and increase the component durability. However, the presence of oil also affects both the efficiency and the fluid dynamical behavior inside the expander. To implement a one-dimensional simulation model that considers the oil influence, a continuous flow approach is selected. Particular attention is dedicated to the inlet and outlet valve modeling, as these have to account for two-phase flow and multicomponent fluid mixtures. A valve model is built up in the simulation environment dymola based on the homogeneous nonequilibrium (HNE) approach. A virtual one-cylinder test bench is set up to calibrate and validate the model. The simulation results show good correspondence with the measurement data.
A Trypanosoma brucei ORFeome-Based Gain-of-Function Library Identifies Genes That Promote Survival during Melarsoprol Treatment
Authors: Carter McKenzie , Gomez Stephanie , Gritz Sam , Larson Stephen , Silva-Herzog Eugenia , Kim Hee-Sook , Schulz Danae , Hovel-Miner Galadriel
Published: October 2020

Trypanosomatid parasites threaten the health of more than 1 billion people worldwide. Because their genomes are highly diverged from those of well-established eukaryotes, conservation is not always useful in assigning gene functions. However, it is precisely among the trypanosomatid-specific genes that ideal therapeutic targets might be found. Forward genetics approaches are an effective way to identify novel gene functions. We used an ORFeome approach to clone a large percentage of
Trypanosoma brucei
genes and generate a gain-of-function parasite library. This library was used in a genetic screen to identify genes that promote resistance to the clinically significant yet highly toxic drug melarsoprol. Hits arising from the screen demonstrated the library’s usefulness in identifying known pathways and uncovered novel aspects of resistance mediated by proteins localized to the flagellum and mitochondrion. The powerful new genetic tools generated herein are expected to promote advances in trypanosomatid biology and therapeutic development in the years to come.
End-to-End Protocol for the Detection of SARS-CoV-2 from Built Environments
Authors: Parker Ceth W. , Singh Nitin , Tighe Scott , Blachowicz Adriana , Wood Jason M. , Seuylemezian Arman , Vaishampayan Parag , Urbaniak Camilla , Hendrickson Ryan , Laaguiby Pheobe , Clark Kevin , Clement Brian G. , O’Hara Niamh B. , Couto-Rodriguez Mara , Bezdan Daniela , Mason Christopher E. , Venkateswaran Kasthuri
Published: October 2020

The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (the virus responsible for coronavirus disease 2019 [COVID-19]) pandemic has led to a global slowdown with far-reaching financial and social impacts. The SARS-CoV-2 respiratory virus is primarily transmitted from person to person through inhalation of infected droplets or aerosols. However, some studies have shown that virions can remain infectious on surfaces for days and can lead to human infection from contact with infected surfaces. Thus, a comprehensive study was conducted to determine the efficiency of protocols to recover SARS-CoV-2 from surfaces in built environments. This end-to-end study showed that the effective combination for monitoring SARS-CoV-2 on surfaces required a minimum of 1,000 viral particles per 25 cm
2
to successfully detect virus from surfaces. This comprehensive study can provide valuable information regarding surface monitoring of various materials as well as the capacity to retain viral RNA and allow for effective disinfection.
A frog in my throat doctor, well perhaps a tadpole? An interesting case of a laryngeal arteriovenous malformation
Authors: Sooby Paul James , Tarmal Abdurahman , Townsley Richard
Published: October 2020

We present an interesting case of a woman presenting with globus symptoms. Following an assessment, the patient was identified as having a strange pedunculated lesion originating from the laryngeal surface of the epiglottis. Following formal surgical excision, this lesion was identified as an arteriovenous malformation.
Interhospital teleproctoring of endovascular intracranial aneurysm treatment using a dedicated live-streaming technology: first experiences during the COVID-19 pandemic
Authors: Bechstein Matthias , Elsheikh Samer , Wodarg Fritz , Taschner Christian A , Hanning Uta , Buhk Jan-Hendrik , McDonough Rosalie , Goebell Einar , Fiehler Jens , Bester Maxim
Published: October 2020

This is a report of the first three cases of endovascular aneurysm treatment that were proctored by a remote interventionalist using a novel high-resolution low-latency streaming technology. The proctor was located in a neurovascular centre and supported the treating interventional teams in two distant cities (up to 800 km/500 miles apart). All aneurysms were treated using the Woven EndoBridge (WEB) embolisation system, either electively or following subarachnoid haemorrhage. On-site proctoring was not possible due to travel restrictions during the COVID-19 pandemic. WEB placement was feasible in all cases. Good rapport between proctors and treating physicians was reported, enabled by the high-resolution image transmission and uninterrupted feedback/discussion via audiostream. No clinical complications were encountered. Short-term follow-up revealed adequate occlusion of all treated aneurysms. The employed streaming technology provided effective remote proctoring during complex aneurysm cases, including the management of technical complications.
Neurosarcoidosis presenting with hypopituitarism
Authors: Liu Elina , Rohr Axel , AlMehthel Mohammed
Published: October 2020

Hypothalamo-pituitary sarcoidosis is a rare manifestation of sarcoidosis, usually presenting alongside other symptoms of neurosarcoidosis. We describe the case of a 58-year-old man from Ghana who presented with progressive gait disturbance, cognitive dysfunction, hypothermia and bradycardia. He was found to have pituitary stalk thickening on imaging, and lymph node biopsy identified non-caseating granulomatous disease. Serology revealed gonadotropin deficiency, hypothyroidism and central adrenal insufficiency. Treatment with immunomodulatory therapy resulted in resolution of findings on imaging and improved cognition, though pituitary function never recovered. Treatment for his sarcoidosis unfortunately resulted in recurrent infections and avascular necrosis. Work-up, management and ongoing care required multidisciplinary cooperation between the admitting internal medicine team, infectious diseases, respirology, rheumatology, endocrinology and neurology.
Simultaneous bilateral aqueous misdirection following certolizumab therapy for rheumatoid arthritis
Authors: Hynnekleiv Leif , Thrane Alexander Stanley , Krohn Jørgen
Published: October 2020

Aqueous misdirection syndrome is a rare, incompletely understood, sight-threatening eye condition that is difficult to diagnose and treat. We present a case of simultaneous bilateral aqueous misdirection following the administration of certolizumab in a 41-year-old women with rheumatoid arthritis and no known risk factors. To our knowledge, aqueous misdirection has not previously been associated with the use of tumour necrosis factor-alpha inhibitors.
Primitive neuroectodermal tumour (PNET) of the renal capsule mimicking solid adrenal tumour
Authors: Israrahmed Amrin , Singh Somesh , Lal Hira , Jain Manoj
Published: October 2020

Primitive neuroectodermal tumour (PNET) of renal capsule is a rare entity. We report a case of a 17-year-old girl, who presented with symptoms of epigastric and right hypochondrium pain since 1 year. She was afebrile and physical examination revealed a soft, non-tender, firm, bimanually palpable and ballotable mass along right flank. Ultrasound abdomen showed a large heteroechoic mass in right suprarenal region with indistinct planes with upper pole of right kidney. On CT, a large right suprarenal mass was noted with origin likely from right adrenal gland. Surgery was done and intraoperatively, the large mass in right suprarenal region showed involvement of the upper pole of the right kidney. The right adrenal gland was small in size, compressed and displaced by the lesion. Histopathology revealed the mass to be PNET of kidney. We report the relevant imaging findings of the case with review of literature of this entity.
Adenocarcinomas presenting as abdominal wall masses
Authors: Vijayakumar Ammu , Grignol Valerie
Published: October 2020

Patients with abdominal wall masses as primary malignant tumours or metastatic disease are rare. Thorough evaluation with biopsy and imaging is required prior to surgical resection for treatment planning. We present a case series of three patients who presented with abdominal adenocarcinoma of unknown primary origin. All patients ultimately underwent surgical resection and final pathology showed a gynaecological origin for these tumours. Multidisciplinary management is required for these rare and complex tumours.
Posterior reversible encephalopathy syndrome in scrub typhus fever
Authors: Naveen Vivek , Gaba Saurabh , Gupta Monica , Kaur Daljinderjit
Published: October 2020

The clinical course of a 40-year-old female patient, who presented with acute febrile illness due to scrub typhus fever became complicated by seizures and posterior reversible encephalopathy syndrome (PRES), leading to a fatal outcome. She had normal blood pressure at admission; however, she later developed hypotension and shock. PRES is a syndrome of vasogenic cerebral oedema and accompanying neurological deficits resulting from the breakdown of blood-brain barrier due to high blood pressure or radical blood pressure changes. PRES is a clinico-radiographic diagnosis of heterogeneous aetiologies and is rare in the context of infections. Although there are many neurological manifestations in scrub typhus, to the best of our knowledge, PRES has never been reported.
Prolonged viral shedding in an immunocompetent patient with COVID-19
Authors: McKie Anthony Michael , Jones Timothy Peter Wynne , Sykes Catriona
Published: October 2020

We present a case of COVID-19 in an immunocompetent patient with risk factors for severe disease who recovered after prolonged swab positivity of 61 days postsymptom onset without significant respiratory and organ dysfunction. We discuss the reasons behind her prolonged swab positivity in the context of current SARS-CoV-2 knowledge, document the trend in her inflammatory response and swab results, and discuss the implications swab positivity had on her isolation and recovery.
Mantle cell lymphoma: a rare cause for a swollen palate
Authors: Mohamed Ayah , Cowie Rachel , Shanahan Dáire
Published: October 2020

We describe the case of a 68-year-old woman who was referred to the Oral Medicine Department in the Bristol Dental Hospital in November 2018 regarding a mass in the hard palate. The patient was previously diagnosed with stage IV mantle cell lymphoma of the upper tarsal conjunctiva in December 2014. Further investigations revealed lymphomatous deposits in other sites throughout the body. This patient underwent six cycles of chemotherapy, followed by consolidation LACE autograph and maintenance rituximab. While mantle cell lymphoma very rarely presents on the hard palate, knowledge of its clinical features and differential diagnoses is imperative in its accurate diagnosis and appropriate management.
Non-convulsive status epilepticus: COVID-19 or clozapine induced?
Authors: Sokolov Elisaveta , Hadavi Shahrzad , Mantoan Ritter Laura , Brunnhuber Franz
Published: October 2020

We present a case of non-convulsive status epilepticus in a 57-year-old woman with a schizoaffective disorder, without an antecedent seizure history, with two possible aetiologies including SARS-CoV-2 infection and clozapine uptitration. We discuss the presentation, investigations, differential diagnosis and management. In particular, we focus on the electroencephalogram (EEG) findings seen in this case and the electroclinical response to antiepileptic medication. We review the literature and discuss the relevance of this case to the SARS-CoV-2 global pandemic. We emphasise the importance of considering possible neurological manifestations of SARS-CoV-2 infection and highlight seizure disorder as one of the possible presentations. In addition, we discuss the possible effects of clozapine on the electroclinical presentation by way of possible seizure induction as well as discuss the possible EEG changes and we highlight that this needs to be kept in mind especially during rapid titration.
Automatic Brain Cancer Segmentation on PET Image
Authors: Wang Ching-Lin , Chan Chi-Shiang , Wang Wei-Jyun , Chan Yung-Kuan , Tsai Meng-Hsiun , Chuang Chia-Yi , Cheng Wen-Yu , Yu Shyr-Shen
Published: October 2020

When treating a brain tumor, a doctor needs to know the site and the size of the tumor. Positron emission tomography (PET) can be effectively applied to diagnose such cancers based on the heightened glucose metabolism of early-stage cancer cells. The purpose of this research is to extract the regions of skull, brain tumor, and brain tissue from a series of PET brain images and then a three-dimensional (3D) model is reconstructed from the extracted skulls, brain tumors, and brain tissues. Knowing the relative site and size of a tumor within the skull is helpful to a doctor. The contours obtained by the segmentation method proposed in this study are quantitatively compared with the contours drawn by doctors on the same image set since the ground truth is unknown. The experimental results are impressive.
Non-naturally reductive Einstein metrics on normal homogeneous Einstein manifolds
Authors: Yan Zaili , Deng Shaoqiang
Published: October 2020

A quadruple of Lie groups [Formula: see text], where [Formula: see text] is a compact semisimple Lie group, [Formula: see text] are closed subgroups of [Formula: see text], and the related Casimir constants satisfy certain appropriate conditions, is called a basic quadruple. A basic quadruple is called Einstein if the Killing form metrics on the coset spaces [Formula: see text], [Formula: see text] and [Formula: see text] are all Einstein. In this paper, we first give a complete classification of the Einstein basic quadruples. We then show that, except for very few exceptions, given any quadruple [Formula: see text] in our list, we can produce new non-naturally reductive Einstein metrics on the coset space [Formula: see text], by scaling the Killing form metrics along the complement of [Formula: see text] in [Formula: see text] and along the complement of [Formula: see text] in [Formula: see text]. We also show that on some compact semisimple Lie groups, there exist a large number of left invariant non-naturally reductive Einstein metrics which are not product metrics. This discloses a new interesting phenomenon which has not been described in the literature.
Weak deflection angle by asymptotically flat black holes in Horndeski theory using Gauss–Bonnet theorem
Authors: Javed Wajiha , Abbas Jameela , Kumaran Yashmitha , Övgün Ali
Published: October 2020

The principal objective of this project is to investigate the gravitational lensing by asymptotically flat black holes in the framework of Horndeski theory in weak field limits. To achieve this objective, we utilize the Gauss–Bonnet theorem to the optical geometry of asymptotically flat black holes and apply the Gibbons–Werner technique to achieve the deflection angle of photons in weak field limits. Subsequently, we manifest the influence of plasma medium on deflection of photons by asymptotically flat black holes in the context of Horndeski theory. We also examine the graphical impact of deflection angle on asymptotically flat black holes in the background of Horndeski theory in plasma medium as well as non-plasma medium.
Spectrum of SYK model II: Central limit theorem
Authors: Feng Renjie , Tian Gang. , Wei Dongyi.
Published: October 2020

In our previous paper [R. Feng, G. Tian and D. Wei, Spectrum of SYK model, Peking Math. J. 2 (2019) 41–70], we derived the almost sure convergence of the global density of eigenvalues of random matrices of the SYK model. In this paper, we will prove the central limit theorem for the linear statistics of eigenvalues of the SYK model and compute its variance.
Effect of Implementing Subgoals in Code.org's Intro to Programming Unit in Computer Science Principles
Authors: Margulieux Lauren E. , Morrison Briana B. , Franke Baker , Ramilison Harivololona
Published: October 2020

The subgoal learning framework has improved performance for novice programmers in higher education, but it has only started to be applied and studied in K-12 (primary/secondary). Programming education in K-12 is growing, and many international initiatives are attempting to increase participation, including curricular initiatives like Computer Science Principles and non-profit organizations like Code.org. Given that subgoal learning is designed to help students with no prior knowledge, we designed and implemented subgoals in the introduction to programming unit in Code.org's Computer Science Principles course. The redesigned unit includes subgoal-oriented instruction and subgoal-themed pre-written comments that students could add to their programming activities. To evaluate efficacy, we compared behaviors and performance of students who received the redesigned subgoal unit to those receiving the original unit. We found that students who learned with subgoals performed better on problem-solving questions but not knowledge-based questions and wrote more in open-ended response questions, including a practice Performance Task for the AP exam. Moreover, at least one-third of subgoal students continued to use the subgoal comments after the subgoal-oriented instruction had been faded, suggesting that they found them useful. Survey data from the teachers suggested that students who struggled with the concepts found the subgoals most useful. Implications for future designs are discussed.
Interactive Stitch Sampler
Authors: Jayathirtha Gayithri , Kafai Yasmin B.
Published: October 2020

Electronic textiles, which integrate computation with fabrics through a redesigned interface of microcontrollers, sensors, and actuators, have expanded possibilities not only for engineering, fashion, and human-computer interaction but also for computer science education itself. While individual studies involving electronic textiles have shown promise to diversify participation, raise interest, and deepen learning in computing, especially for female students, we recognized a need to synthesize findings across studies to understand the overall contribution of electronic textiles to computing education. In this article, we report our findings from a meta-synthesis of 64 educational electronic textiles studies to answer the following questions in computing: (1) Did electronic textiles broaden access and participation? (2) How did electronic textiles support learners’ interests and sustain participation? (3) What and how did students learn from electronic textile projects? Our meta-synthesis revealed that although electronic textiles successfully broadened access, supported learners’ interests, and introduced basic computational concepts to novice learners, questions around equitable participation and deeper disciplinary engagement persist. We discuss directions for future design and research efforts to explore the full potential of e-textiles in computer science education.
A Qualitative Study to Explore the Experiences of Older People Utilising Outpatient Healthcare Services from a Teaching Hospital in Ghana
Authors: Adatara Peter , Amooba Philemon Adoliwine
Published: October 2020

Background. Empirical evidence suggests that when older people are provided with quality and affordable healthcare services, their health status can be improved. However, in low‐ and middle‐income countries, healthcare services may not be fully resourced, leading to difficulties for older people utilising those services. There is a paucity of research studies regarding the experiences of older persons accessing healthcare services in sub‐Saharan Africa including Ghana. Aim. The purpose of this study was to explore and describe the experiences of older people utilising outpatient healthcare services from a Teaching hospital in Ghana. Methods. This study adopted a descriptive qualitative approach to describe the experiences of older persons utilising outpatient healthcare services. Participants included a total of twelve older people between the ages of 60 and 80 years who utilised outpatient healthcare services at the hospital. A semistructured interview guide was used to conduct interviews with participants, and their views were analysed into descriptive themes. Results. The results in this study showed that the participants experienced the following in utilising outpatient healthcare services: long waiting hours in accessing outpatient healthcare, poor attitudes from health staff, lack of drugs from the healthcare facility, inadequate information from health staff in the healthcare facility, lack of specialist care at the healthcare facility, and high confidence and trust in the efficacy of the orthodox healthcare. Conclusion. The findings from this qualitative study demonstrated that the participants encountered some challenges in accessing outpatient healthcare services. There is the need for government and other stakeholders to address the challenges encountered by older people in accessing healthcare in order to facilitate the utilisation of healthcare among older persons for better health outcomes.
АДИПОКІНИ ТА ГІПЕРТОНІЧНА ХВОРОБА: КЛІНІЧНЕ ТА ТЕРАПЕВТИЧНЕ ЗНАЧЕННЯ
Authors: Fylenko Y. M.
Published: October 2020

В огляді представлені сучасні дані літератури про фізіологічну та патофізіологічну роль гормонів жирової тканини (лептину, резистину, оментину, вісфатину).

Мета – провести аналіз публікацій, що відображають уже відомі аспекти біологічної дії і регуляції адипокінів, та продемонструвати результати останніх досліджень, а також показати тенденції та перспективи розвитку у дослідженні клініко-патогенетичного значення гормонів жирової тканини.

Результати. Основним механізмом негативного впливу жирової тканини на серцево-судинну систему є її гормональна активність. Існує позитивна кореляційна залежність між цифрами артеріального тиску та рівнем адипокінів у плазмі крові. У статті детально розглянута роль адипокінів в розвитку артеріальної гіпертензії, адже вони беруть безпосередню участь у механізмах підвищення артеріального тиску, атерогенезі, регуляції оксидативного стресу, згортанні крові та розвитку неінфекційного запалення В огляді наведені результати зарубіжних досліджень про взаємозв’язок артеріальної гіпертензії, ліпідного обміну та адипокінового дисбалансу.

Висновки. Порушення секреції та функціонування адипокінів можуть бути провідним фактором у розвитку артеріальної гіпертензії та серцево-судинних захворювань. Дані пептиди мають різноспрямований вплив на організм і при порушенні взаємодії сприяють розвитку соціально значущих захворювань, таких як інфаркт міокарда, артеріальна гіпертензія, інсульт, атеросклероз, метаболічний синдром.
DYNAMICS OF FREE RADICAL OXIDATION INDICES AND ANTIOXIDANT PROTECTION IN MALE RATS’ HEART UNDERGONE VARIOUS TYPES OF STRESS
Authors: Denefil O. V. , Riabokon S. S. , Mits I. R.
Published: October 2020

Any change of external or internal environment causes body’s responses that facilitate its adaptation. Pathogenesis of stress reaction study is always topical as it is aimed at the investigation of optimal adaptation mechanisms to impaired agents.

The aim – to study the dynamics of free-radical oxidation indices and antioxidant protection in male rats’ heart undergone chronic prenatal, postnatal stress and their combination.

Material and Methods. The study was performed on 44 white non-pedigreed pubertal three-month-rats. Prenatal stress was induced by keeping pregnant female rats in narrow pencil case for an hour. Postnatal stress was induced in 1.5 to three-month- rats by keeping them in cages with living space restriction twice as much. Combined stress comprised using two methods. Contents of peroxide lipids oxidation products and antioxidant protection were determined in the heart.

Results. Psycho-emotional stress in three-month-rats causes activation processes of peroxide lipids oxidation and antioxidant protection regardless of stressor’s period action. On the basis of correlations study it was proved that development mechanisms of chronic stress depend on life-period when stress was sustained.

Conclusions. Processes of peroxide lipids oxidation in all modelling types of stress are intensified in young male-rats’ heart during the effect of chronic psycho-emotional stress. Activity of enzyme part of antioxidant protection increases simultaneously with the increase of LPO products in the heart. It is more manifested in prenatal and postnatal stress. Intensification of glutathione system action and disturbances of its activity, especially in animals that undergone prenatal stress were also marked.
КОМПЛАЄНС ХВОРИХ НА ГЛАУКОМУ ЯК МЕДИКО-СОЦІАЛЬНА ПРОБЛЕМА
Authors: Koshchynets O. B. , Panko O. M.
Published: October 2020

Мета – вивчити комплаєнс хворих на глаукому та проаналізувати причини його недостатності.

Матеріал і методи. За спеціальною програмою на базі трьох офтальмологічних відділень стаціонарів трьох центральних районних лікарень Івано-Франківської області обстежили 515 хворих на глаукому у віці понад 55 років. Серед них було 261 жінка і 254 чоловіків (50,7 % та 49,3 %), 249 мешканців міст і 266 сільських жителів (48,3 % і 51,7 %).

Застосовано соціологічний, бібліосемантичний і медико-статистичний методи.

Результати. Встановлено, що про необхідність постійного прийому ліків знають усі 100 % опитаних хворих на глаукому. Проте більш як третина (36,0 %) респондентів не завжди дотримуються рекомендацій офтальмологів і нерегулярно приймають призначені ліки. Однією із основних причин є те, що 20,4 % респондентів боїться побічних ефектів ліків від глаукоми і ще 54,7 % мають сумніви у їх безпеці. Зрозуміло, що така ситуація є наслідком недостатньої поінформованості пацієнтів щодо терапії, яка їм призначена. 96,9 % опитаних сказали, що отримують відомості про хворобу від медичних працівників. Серед претензій до медичного обслуговування лише 5,4 % складали скарги на медперсонал, а дві третини (67,6 %) з числа респондентів, невдоволених медичною допомогою, скаржилися на високу вартість ліків і медичних послуг. 69,0 % опитаних заявляли, що іноді чи постійно мають труднощі із оплатою ліків через нестачу коштів.

Висновки. Значна частка хворих на глаукому не дотримуються рекомендацій лікаря та режиму прийому ліків. Причинами низького комплаєнсу є недостатня поінформованість пацієнтів про переваги і ризики лікування, підвищене відчуття тривоги та депресії, самотність, переважно низький рівень матеріального благополуччя і освіти респондентів.