bluuebunny/crossref_metadata_2025 huggingface dataset:
Semi-empirical estimation model of in-cylinder pressure for compression ignition engines
Authors: Lee Youngbok , Lee Seungha , Min Kyoungdoug
Published: June 2020

There have been significant efforts in recent years to comply with automotive emission regulations. To resolve the issue, researchers have strived to reduce the emissions through combustion control. The heat release rate, or in-cylinder pressure information, is necessary to model engine-out emissions, and can also be used to optimize efficiency and emissions by controlling combustion and estimating torque for torque-based engine dynamic control. Piezoelectric pressure sensors are widely used. However, because of cost and durability issues, there have been studies which estimate the in-cylinder pressure using data available only from the engine control unit to reduce engine costs. Therefore, in this study, in-cylinder pressure was predicted, without additional pressure sensors, in light-duty diesel engines. A variable polytropic exponent model was first adopted during the compression stroke, assuming a polytropic process. A Wiebe function was then applied for describing cumulative heat release rate during the combustion phase. Using the in-cylinder pressure model, it was possible to calculate combustion-related parameters which are frequently used such as ignition delay, combustion duration, peaked pressure, and MFB50 (mass fraction burned: timing when 50% of the fuel is burned) without pressure sensors. Notwithstanding the simplification of the model which is targeting real-time applications, the model can predict the in-cylinder pressure at steady-state conditions. The pressure at the end of compression stroke, at start of main combustion timing, and when it has a peaked value by the main combustion were estimated with accuracy of R2 0.996, 0.993, and 0.956, respectively, in test engine. The model was also validated against a second engine. This study can contribute to emission models that need to calculate in-cylinder temperature using pressure data, and other studies to establish engine control strategies, including optimization through combustion control and torque prediction, which can be applied to engine dynamic control.
The Earliest Origins of Genetic Nurture: The Prenatal Environment Mediates the Association Between Maternal Genetics and Child Development
Authors: Armstrong-Carter Emma , Trejo Sam , Hill Liam J. B. , Crossley Kirsty L. , Mason Dan , Domingue Benjamin W.
Published: June 2020

Observed genetic associations with educational attainment may be due to direct or indirect genetic influences. Recent work highlights genetic nurture, the potential effect of parents’ genetics on their child’s educational outcomes via rearing environments. To date, few mediating childhood environments have been tested. We used a large sample of genotyped mother–child dyads ( N = 2,077) to investigate whether genetic nurture occurs via the prenatal environment. We found that mothers with more education-related genes are generally healthier and more financially stable during pregnancy. Further, measured prenatal conditions explain up to one third of the associations between maternal genetics and children’s academic and developmental outcomes at the ages of 4 to 7 years. By providing the first evidence of prenatal genetic nurture and showing that genetic nurture is detectable in early childhood, this study broadens our understanding of how parental genetics may influence children and illustrates the challenges of within-person interpretation of existing genetic associations.
Textual and reader factors in narrative empathy: An empirical reader response study using focus groups
Authors: Fernandez-Quintanilla Carolina
Published: June 2020

This article contributes new insights into the interplay between textual and reader factors in experiences of narrative empathy, or empathy with characters in narrative. It adds to the rather scarce empirical evidence on the relationships between textual devices and readers’ (non-)empathetic responses to characters. This empirical study involved stylistic-narratological analysis of short stories by Eduardo Galeano and thematic analysis of focus group discussions. The study considers empathy in relation to victims and perpetrators in narratives of persecution and torture. Methodologically, the article emphasises the value of a qualitative approach to collecting and analysing readers’ responses that is half way between naturalistic and experimental orientations. The main findings, which revolve around the interaction between certain narrative techniques and readers’ moral evaluation of characters, challenge some theoretical claims from the scholarly literature about textual effects on readers’ empathy. In so doing, the article considers empathy as a highly flexible and context-dependent phenomenon, and suggests the need for a nuanced approach that accommodates the complex interaction between textual and reader factors in the reading context. The discussion spells out the broader implications of the study for stylistic research on the role of language in bringing about effects in readers and also for narrative empathy research. These implications will be of interest to scholars conducting reception studies or reader response research in the neighbouring fields of empirical stylistics, empirical narratology, and empirical literary studies.
Private metropolitan telepsychiatry in Australia during Covid-19: current practice and future developments
Authors: Looi Jeffrey CL , Pring William
Published: June 2020

Objective:

This paper discusses issues arising from the rapid implementation of metropolitan telepsychiatry in private practice during the Covid-19 public health emergency.

Conclusions:

The relatively rapid uptake of private practice metropolitan telepsychiatry may further increase flexibility of the options for appointments through ongoing broad telepsychiatry access after the Covid-19 crisis. Telepsychiatry can be used to facilitate the temporary provision of psychiatric care, and has benefits and risks, but is not a longer-term replacement for the interpersonal richness of face-to-face consultations.
Interdisciplinary Patient Tracers
Authors: Logan Merranda , Seguin Claire , Snydeman Colleen , Deen Jana , Liu Xiu , Shahian David , Mort Elizabeth
Published: June 2020

Patient tracers and leadership WalkRounds proactively identify quality and safety issues. However, these programs have been inconsistent in application, results, and sustainability. The goal was to identify a more consistent and efficient approach to survey health care facilities. The authors developed a Peer-to-Peer Interdisciplinary Patient Tracer program to assess compliance with National Patient Safety Goals and to proactively identify areas of inpatient, ambulatory, and procedural risk. The program has been operational for more than 5 years, with continued expansion annually. In all, 96% of frontline leadership reported satisfaction; 100% reported that they would recommend the program to others (Kirkpatrick level 1 results). Mean absolute change in performance scores from 2014 to 2018 was 15%. All survey findings triggered the development of an improvement project. This novel integrated program advanced institutional improvement by strengthening internal peer-to-peer surveillance, engaging leadership, and creating an accountability structure for internal improvement efforts.
Methyl jasmonate alleviates chilling injury and keeps intact pericarp structure of pomegranate during low temperature storage
Authors: Chen Lan , Pan Yanfang , Li Haideng , Jia Xiaoyu , Guo Yanli , Luo Jinshan , Li Xihong
Published: June 2020

Pomegranate is a kind of fruit with low temperature sensitivity. Abnormal low temperature can easily lead to chilling injury, which negatively impacts the appearance of fruit, accelerates browning and deterioration, as well as seriously reduces the consumption quality and commodity value of pomegranate. This study was carried out to determine the effect of methyl jasmonate on chilling injury of pomegranate during low temperature storage. The result showed that methyl jasmonate treatment effectively maintained edible quality of pomegranate, suppressed the polyphenol oxidase activity and the development of chilling injury index, and inhibited the decline of total phenol content and the increase of malondialdehyde content and cell membrane permeability. In addition, methyl jasmonate could also enhance the disease resistance of fruit by increasing the content of soluble protein, and effectively maintain the integrity of epidermal cell structure and tissue structure. Overall, the conclusion of this paper is that methyl jasmonate can be used as an effective means to suppress chilling injury in postharvest storage of pomegranate.
Structural assessment of the optic nerve in patients with obstructive sleep apnea syndrome: Case–control study
Authors: Uslu Hasim , Kanra Ayşe Yagmur , Sarac Sema
Published: June 2020

Objective

Obstructive sleep apnea syndrome has been identified as a possible risk factor for optic nerve pathology such as glaucoma, nonarteritic ischemic optic neuropathy, and optic disk edema. Accordingly, we aimed to evaluate structural changes of the apparently normal optic nerve in obstructive sleep apnea syndrome patients with effects of its severity.

Materials and methods

In this prospective case–control study, 47 eyes of 47 obstructive sleep apnea syndrome patients diagnosed with polysomnography and 40 eyes of 40 healthy subjects were included. Spectral-domain optical coherence tomography was used to evaluate the peripapillary retinal nerve fiber layer thickness, optic nerve head topographic parameters, and retinal ganglion cell-inner plexiform layer thickness.

Results

The average peripapillary nerve fiber layer thickness was lower in obstructive sleep apnea syndrome patients than in controls (90.74 ± 7.98 vs 94.93 ± 6.13 μm; p = 0.008). The average cup/disk ratio and the vertical cup/disk ratio in patients with OSAS were significantly higher compared to the controls (both p < 0.001). However, no significant difference in retinal ganglion cell-inner plexiform layer thickness was found.

Conclusion

Even if the retinal ganglion cell-inner plexiform layer thicknesses did not significantly differ between the obstructive sleep apnea syndrome and control groups, obstructive sleep apnea syndrome patients showed a decreased peripapillary nerve fiber layer thickness and increased optic nerve head parameters. These findings can be used as an indicator of optic nerve damage in the early diagnosis of obstructive sleep apnea syndrome patients.
Implementing an emergency department vascular access team: A quality review of training, competency, and outcomes
Authors: Bell Jon A , Spencer Timothy R
Published: June 2020

Peripheral intravenous catheters are frequently used devices in emergency departments. Many patients now present with difficult anatomy and are labeled as difficult intravenous access patients. A common technology to address this challenge is ultrasound. While studies have examined the ability to train emergency staff, few have addressed how this should be done and the outcomes associated with such training. No studies were found with dedicated vascular access specialist teams in emergency departments. An emergency department vascular access specialist team was formed at a hospital in Bangor, Maine, United States to train, validate, and proctor clinicians with ultrasound-guided peripheral intravenous devices. A quality review of this process was compiled and determined that appropriate clinicians with dedicated training and guidance can achieve higher levels of procedural success. Furthermore, evidence substantiates that frequent practice is linked to a higher quality of care and that a significant need for such teams is present. This review examines how a team was implemented and its impact both department- and facility-wide. It is possible that hospitals benefit from the services of vascular access specialists to provide higher quality care. Successful implementation of such specialist teams requires foundational knowledge and skills in vascular access with ongoing quality measures to ensure competency and compliance with evidence-based practices.
Association of obesity with arterial stiffness: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Logan Jeongok G. , Kang Hyojung , Kim Soyoun , Duprez Daniel , Kwon Younghoon , Jacobs David R. , Forbang Nketi , Lobo Jennifer Mason , Sohn Min-Woong
Published: June 2020

Arterial stiffness (AS) and obesity are recognized as important risk factors of cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between AS and obesity. AS was defined as high augmentation index (AIx) and low elasticity (C1, large artery elasticity; C2, small artery elasticity) in participants enrolled in the Multi-Ethnic Study of Atherosclerosis at baseline. We compared AIx, C1, and C2 by body mass index (BMI) (< 25, 25–29.9, 30–39.9, ⩾ 40 kg/m2) and waist–hip ratio (WHR) (< 0.85, 0.85–0.99, ⩾ 1). The obesity–AS association was tested across 10-year age intervals. Among 6177 participants (62 ± 10 years old, 52% female), a significant inverse relationship was observed between obesity and AS. After adjustments for CVD risk factors, participants with a BMI > 40 kg/m2 had 5.4% lower AIx (mean difference [Δ] = −0.82%; 95% CI: –1.10, –0.53), 15.4% higher C1 (Δ = 1.66 mL/mmHg ×10; 95% CI: 1.00, 2.33), and 40.2% higher C2 (Δ = 1.49 mL/mmHg ×100; 95% CI: 1.15, 1.83) compared to those with a BMI < 25 kg/m2 (all p for trend < 0.001). Participants with a WHR ⩾ 1 had 5.6% higher C1 (∆ = 0.92 mL/mmHg ×10; 95% CI: 0.47, 1.37) compared to those with a WHR < 0.85. The WHR had a significant interaction with age on AIx and C2, but not with BMI; the inverse relationships of the WHR with AIx and C2 were observed only in participants < 55 years between the normal (WHR < 0.85) and the overweight (0.85 ⩽ WHR < 0.99) groups. Different associations of WHR and BMI with arterial stiffness among older adults should be further investigated.
Sanctifying the expansion of carceral control: Spiritual Supervision in the religious lives of criminalized Latinas
Authors: Guzman Melissa
Published: June 2020

Drawing from ethnographic data and interviews collected in a Latina/o Pentecostal organization based in Northern California’s Bay Area, this paper analyzes how a religious street ministry that offers rehabilitation services and spiritual aid to criminalized individuals enacts spiritual supervision. Spiritual supervision refers to the process by which religious organizations incentivize middle-class individuals to participate in the construction of a criminalized class of individuals, as part of how they practice their Christian identities. This article analyzes how middle-class congregants supervise the actions and behaviors of criminalized individuals who perform gendered physical labor and participate in public dramatizations of their criminal stigma in exchange for housing, food, and religious participation. Spiritual supervision provides a novel theoretical framework for analyzing how carceral state power spreads through the institutional missions and practices of institutions that aim to rehabilitate but also reinforce racialized, gendered, and classed hierarchies that further stigmatize and control criminalized people. As a less visible form of punishment imposed outside formal criminal justice institutions, spiritual supervision illuminates how carceral control operates and affects spiritual and religious landscapes.
Formaldehyde Vapor Characteristics in Varied Decontamination Environments
Authors: Choi Young W. , Sunderman Michelle M. , McCauley Martha W. , Richter William R. , Willenberg Zachary J. , Wood Joseph , Serre Shannon , Mickelsen Leroy , Willison Stuart , Rupert Rich , Ortiz Jorge G. Muñiz , Casey Sara , Calfee M. Worth
Published: June 2020

Introduction:

This effort investigated formaldehyde vapor characteristics under various environmental conditions by the analyses of air samples collected over a time-course. This knowledge will help responders achieve desired formaldehyde exposure parameters for decontamination of affected spaces after a biological contamination incident.

Methods:

Prescribed masses of paraformaldehyde and formalin were sublimated or evaporated, respectively, to generate formaldehyde vapor. Adsorbent cartridges were used to collect air samples from the test chamber at predetermined times. A validated method was used to extract the cartridges and analyze for formaldehyde via liquid chromatography. In addition, material demand for the formaldehyde was evaluated by inclusion of arrays of Plexiglas panels in the test chamber to determine the impact of varied surface areas within the test chamber. Temperature was controlled with a circulating water bath connected to a radiator and fan inside the chamber. Relative humidity was controlled with humidity fixed-point salt solutions and water vapor generated from evaporated water.

Results:

Low temperature trials (approximately 10°C) resulted in decreased formaldehyde air concentrations throughout the 48-hour time-course when compared with formaldehyde concentrations in the ambient temperature trials (approximately 22°C). The addition of clear Plexiglas panels to increase the surface area of the test chamber interior resulted in appreciable decreases of formaldehyde air concentration when compared to an empty test chamber.

Conclusion:

This work has shown that environmental variables and surface-to-volume ratios in the decontaminated space may affect the availability of formaldehyde in the air and, therefore, may affect decontamination effectiveness.
Generation of broadcasting for fractal adaptive Internet of things reconfiguration under the swarm intelligence paradigm
Authors: Moreno Jaime , Morales Oswaldo , Tejeida Ricardo , Quintana Hugo , Sidorov Grigori
Published: June 2020

Recently, a wide range of small devices, such as Wi-Fi Internet of things development boards, which are a kind of the microcontroller units in a general purpose board, are interrelated throughout the planet. In addition, certain microcontroller units interact inside our homes when turning lights on or detecting movements, measuring various parameters, such as gas concentrations, [Formula: see text], humidity, and the temperature inside a room, or adjusting the intensity of the lights inside and outside of the house. Likewise, there is a great diversity of microcontroller units, ranging from smart cellular telephones or reduced general purpose devices, ESP8266 or RaspberryPi3 to any type of Internet of things devices. Therefore, the general way of connecting the microcontroller units to the Internet is through hub nodes, so that the information can be propagated and shared among them. The main purpose of this article is to yield an adaptive reconfiguration algorithm to link all the sensor nodes (microcontroller units) of a network based on the fractal topology, avoiding the use of hub nodes, in order for the microcontroller units to share all the parameters established in the Internet of things network only through two adjacent sensor nodes as long as any sensor node in the network knows all the parameters of the other ones, even if the sensor nodes are not adjacent. To achieve the above, in this work, an Internet of things network was built based on the Hilbert fractal for being a filling-space curve yielded from the L-systems paradigm, so this fractal Hilbert topology allows access to the entire Internet of things network in a dynamic way, and it is possible to reconfigure the network topology when a new sensor node is attached by applying artificial intelligence to intelligent and dynamic environments.
Bayesian inference for a novel hierarchical accelerated degradation model considering the mechanism variation
Authors: Wang Hongyu , Ma Xiaobing , Zhao Yu
Published: June 2020

For highly reliable products, accelerated thermal degradation tests are efficient to provide feedback on reliability information. In accelerated thermal degradation tests, the degradation data collected at the elevated temperatures are used to extrapolate the performance of products at the normal temperature. An important tool in such extrapolation is the Arrhenius model, in which the activation energy is generally assumed to be constant. However, in some practical accelerated thermal degradation tests of polymeric materials, a variation of the underlying degradation mechanism is induced when the temperature rises to a certain high level, resulting in a change in the activation energy. Motivated by this phenomenon, we propose a two-stage Arrhenius model. The two stages correspond to the lower and higher temperature ranges with different activation energies. Then, this new model is incorporated to the degradation model, yielding a novel hierarchical model for the accelerated thermal degradation test data from polymeric materials involving a mechanism variation. Furthermore, the Bayesian method is adopted for parameter inference, and the lifetime distribution is obtained subsequently. A practical example of polysiloxane rubbers demonstrates the effectiveness of the proposed model.
Rapid and precise diagnosis of T. marneffei pulmonary infection in a HIV-negative patient with autosomal-dominant STAT3 mutation: a case report
Authors: Zhang Wei , Ye Jian , Qiu Chenhui , Wang Limin , Jin Weizhong , Jiang Chunming , Xu Lihui , Xu Jianping , Li Yue , Wang Liusheng , Jin Hualiang
Published: June 2020

Background:

Talaromyces marneffei, also named Penicillium marneffei, is an opportunistic pathogen that can cause systemic or limited infection in human beings. This infection is especially common in human immunodeficiency virus (HIV)-infected hosts; however, it has also been recently reported in HIV-negative hosts. Here, we report a very rarely seen case of T. marneffei pulmonary infection in a non-HIV-infected patient with signal transducer and activator of transcription 3 ( STAT3) mutation.

Case presentation:

A 34-year-old woman was admitted to our hospital for uncontrollable nonproductive cough and dyspnea with exercise. She had been immunocompromised since infancy. Computerized tomography scan showed multiple ground glass opacities with multiple bullae in both lungs. Next generation sequencing (NGS) of the bronchoalveolar lavage fluid identified T. marneffei nucleotide sequences. Culture of bronchoscopy specimens further verified the results. The patient was HIV negative, and blood gene detection indicated STAT3 mutation. To date, following the application of itraconazole, the patient has recovered satisfactorily.

Conclusion:

In clinical practice, T. marneffei infection among HIV-negative individuals is relatively rare, and we found that patients who are congenitally immunocompromised due to STAT3 mutation may be potential hosts. Early diagnosis and timely treatment are expected to improve the prognosis of T. marneffei infection. NGS is a powerful technique that may play an important role in this progress. The reviews of this paper are available via the supplemental material section.
Return to sports, functional outcomes, and recurrences after arthroscopic Bankart repair in soccer players
Authors: Pasqualini Ignacio , Rossi Luciano A , Tanoira Ignacio , Ranalletta Maximiliano
Published: June 2020

Background

There is a shortage of relevant reports about the results obtained after shoulder stabilization in soccer players. Therefore, this retrospective study aims to report return to sports, functional outcomes, and recurrences after arthroscopic Bankart repair in soccer players.

Methods

A total of 156 soccer players were treated for anterior shoulder instability at a single institution between 2008 and 2017. The Rowe score and Athletic Shoulder Outcome Scoring System were used to assess functional outcomes. Return to sport and recurrence rates were also evaluated.

Results

The Rowe and Athletic Shoulder Outcome Scoring System scores showed statistical improvement after surgery (P < .001). Overall, 148 soccer players (94.8%) returned to sports, and 122 (78.2%) returned to the same level. The mean time to return to sport was 4.8 months. The recurrence rate was 5.2%.

Discussion

Soccer players who underwent an arthroscopic isolated Bankart repair for anterior glenohumeral instability have shown remarkable outcomes, with most of the patients returning to sports, and at the same level they had before surgery with a low rate of recurrence.
Osteogenic potential of poly(ethylene glycol)-amorphous calcium phosphate composites on human mesenchymal stem cells
Authors: Chahal Aman S , Schweikle Manuel , Lian Aina-Mari , Reseland Janne E , Haugen Håvard J , Tiainen Hanna
Published: June 2020

Synthetic hydrogel-amorphous calcium phosphate composites are promising candidates to substitute biologically sourced scaffolds for bone repair. While the hydrogel matrix serves as a template for stem cell colonisation, amorphous calcium phosphate s provide mechanical integrity with the potential to stimulate osteogenic differentiation. Here, we utilise composites of poly(ethylene glycol)-based hydrogels and differently stabilised amorphous calcium phosphate to investigate potential effects on attachment and osteogenic differentiation of human mesenchymal stem cells. We found that functionalisation with integrin binding motifs in the form of RGD tripeptide was necessary to allow adhesion of large numbers of cells in spread morphology. Slow dissolution of amorphous calcium phosphate mineral in the scaffolds over at least 21 days was observed, resulting in the release of calcium and zinc ions into the cell culture medium. While we qualitatively observed an increasingly mineralised extracellular matrix along with calcium deposition in the presence of amorphous calcium phosphate-loaded scaffolds, we did not observe significant changes in the expression of selected osteogenic markers.
Caring geographies: The COVID-19 interregnum and a return to mutual aid
Authors: Springer Simon
Published: June 2020

Mutual aid is the fundamental basis of all human societies, an understanding that is exemplified with striking clarity during times of crises. The coronavirus pandemic has brought the caring geographies of mutual aid into sharp relief with the failings of both capitalism and the state. Beyond fear and uncertainty, this commentary examines the one single theme that has resonated with the COVID-19 pandemic more than all others: care.
Ventral incisional hernia case report: A therapeutic challenge
Authors: de Oliveira Leite Túlio Fabiano , Pires Lucas Alves Sarmento , Chagas Carlos Alberto Araujo
Published: June 2020

Incisional hernias are a very common condition and they still are considered to be a surgical challenge due to their recurrence rate. Smoking, obesity and age are risk factors for developing these abdominal wall defects. Despite recent advances in hernia repairs, the recurrence rates of hernias did not significantly diminished, even after the introduction of meshes. The aim of this article is to report a case of a ventral incisional hernia in a 37-year-old man and its successful treatment with a procedure known as the Alcino-Lázaro technique repair. This procedure has been shown to be very effective in incisional hernias, especially in obese patients. Furthermore, it is as cheap as it is reliable, since it can be performed without technological aid or expensive materials (mesh); thus, patients in low-income countries can greatly benefit from this procedure.
Microendoscope-Assisted Decompression Surgery With Resection of Bony Fragment for Treating a Separation of Lumbar Posterior Ring Apophysis in Young Athletes
Authors: Okada Motohiro , Yoshida Munehito , Minamide Akihito , Nomura Kazunori , Maio Kazuhiro , Yamada Hiroshi
Published: June 2020

Study Design:

Case series.

Objectives:

To report the clinical outcomes of the decompression procedure using the microendoscopic discectomy system for the treatment of a separation of lumbar posterior ring apophysis in young active athletes.

Methods:

We retrospectively reviewed 17 cases that underwent the microendoscopic surgery to treat a symptomatic separated lumbar ring apophysis between 2001 and 2014 at our institute or our associated hospital. The cases consisted of 15 males and 2 females, with their ages ranging from 12 to 19 years. The surgeries were performed at total of 18 lumbar levels, including 15 L4/5 and 3 L5/S1 levels. All patients were young athletes. We evaluated the following: (1) the Japanese Orthopaedic Association (JOA) score for low back pain, (2) recovery rates using Hirabayashi’s method, (3) operating time, (4) intraoperative blood loss, (5) perioperative complications, (6) the status of comeback to sports, and (7) the period taken to return to sports.

Results:

The JOA score was improved after the surgery in all cases. Recovery rate was 92.0% ± 8.1%. The mean operating time per level was 89.2 ± 33.3 minutes. The mean intraoperative blood loss per level was 95.3 ± 93.1 mL. A pinhole size dural tear occurred in one case as a perioperative complication. All cases returned to sports. The mean period taken to return to sports was 10.9 ± 3.5 weeks.

Conclusion:

Microendoscopic decompression surgery is useful for treating a separation of lumbar posterior ring apophysis.
Patient‐Specific 3‐Dimensional Printed Models for Planning Nasal Osteotomy to Correct Nasal Deformities Due to Trauma
Authors: Jung Yong Gi , Park Hanaro , Seo Jiwon
Published: June 2020

Nasal deformities due to trauma are more challenging to correct with rhinoplasty than nasal deformities of nontraumatic causes. Nasal osteotomy is an essential procedure for bone deviations. Preoperative planning is vital in these cases, but it is challenging to comprehend 3‐dimensional (3D) structures of the nasal bone on 2‐dimensional facial photographs and computed tomography images. We used a 3D‐printing technique to fabricate real‐size facial bone models with similar physical properties and texture as the actual bone. Furthermore, we established a precise surgical plan using simulated osteotomy on the 3D‐printed model. Fused deposition modeling–type desktop 3D printer with polylactic acid filaments was used. A surgical plan was established using simulated osteotomy in 11 cases, and the actual surgery was performed as planned in 10 cases (90.9%). The 3D‐printed model and stimulated osteotomy were useful for precise planning of osteotomy to correct nasal deformities due to trauma.
Enhanced Recovery After Surgery–Based Perioperative Protocol for Head and Neck Free Flap Reconstruction
Authors: Bertelsen Caitlin , Hur Kevin , Nurimba Margaret , Choi Janet , Acevedo Joseph R. , Jackanich Anna , Sinha Uttam K. , Kochhar Amit , Kokot Niels , Swanson Mark
Published: June 2020

Objectives

Evaluate an enhanced recovery after surgery (ERAS)–based free flap management protocol implemented at our center.

Study Design

Prospective cohort study of patients after implementation of an ERAS‐based perioperative care protocol for patients undergoing free flap reconstruction of the head and neck as compared with a historical control group.

Setting

Tertiary care academic medical center.

Participants and Methods

All patients undergoing free flap reconstruction were prospectively enrolled in the ERAS protocol group. A retrospective control group was identified by randomly selecting an equivalent number of patients from a records search of those undergoing free flap surgery between 2009 and 2015. Blood transfusion, complications, 30‐day readmission rates, intensive care unit (ICU) and hospital length of stay, and costs of hospitalization were compared.

Results

Sixty‐one patients were included in each group. Patients in the ERAS group underwent less frequent flap monitoring by physicians and had lower rates of intraoperative (70.5% vs 86.8%, P =. 04) and postoperative (49.2% vs 27.2%, P =. 026) blood transfusion, were more likely to be off vasopressors (98.3% vs 50.8%, P <. 01) and ventilator support (63.9% vs 9.8%, P <. 01) at the conclusion of surgery, and had shorter ICU stays (2.11 vs 3.39 days, P =. 017). Length of stay, readmissions, and complication rates did not significantly differ between groups.

Conclusion

ERAS‐based perioperative practices for head and neck free flap reconstruction can reduce time on the ventilator and in the ICU and the need for vasopressors, blood transfusions, and labor‐intensive flap monitoring, without adverse effects on outcomes.
A Conceptual Introduction to Bayesian Model Averaging
Authors: Hinne Max , Gronau Quentin F. , van den Bergh Don , Wagenmakers Eric-Jan
Published: June 2020

Many statistical scenarios initially involve several candidate models that describe the data-generating process. Analysis often proceeds by first selecting the best model according to some criterion and then learning about the parameters of this selected model. Crucially, however, in this approach the parameter estimates are conditioned on the selected model, and any uncertainty about the model-selection process is ignored. An alternative is to learn the parameters for all candidate models and then combine the estimates according to the posterior probabilities of the associated models. This approach is known as Bayesian model averaging (BMA). BMA has several important advantages over all-or-none selection methods, but has been used only sparingly in the social sciences. In this conceptual introduction, we explain the principles of BMA, describe its advantages over all-or-none model selection, and showcase its utility in three examples: analysis of covariance, meta-analysis, and network analysis.
Yap1-Scribble polarization is required for hematopoietic stem cell division and fate
Authors: Althoff Mark J. , Nayak Ramesh C. , Hegde Shailaja , Wellendorf Ashley M. , Bohan Breanna , Filippi Marie-Dominique , Xin Mei , Lu Q. Richard , Geiger Hartmut , Zheng Yi , Diaz-Meco Maria T. , Moscat Jorge , Cancelas Jose A.
Published: June 2020

Yap1 and its paralogue Taz largely control epithelial tissue growth. We have identified that hematopoietic stem cell (HSC) fitness response to stress depends on Yap1 and Taz. Deletion of Yap1 and Taz induces a loss of HSC quiescence, symmetric self-renewal ability, and renders HSC more vulnerable to serial myeloablative 5-fluorouracil treatment. This effect depends on the predominant cytosolic polarization of Yap1 through a PDZ domain-mediated interaction with the scaffold Scribble. Scribble and Yap1 coordinate to control cytoplasmic Cdc42 activity and HSC fate determination in vivo. Deletion of Scribble disrupts Yap1 copolarization with Cdc42 and decreases Cdc42 activity, resulting in increased self-renewing HSC with competitive reconstitution advantages. These data suggest that Scribble/Yap1 copolarization is indispensable for Cdc42-dependent activity on HSC asymmetric division and fate. The combined loss of Scribble, Yap1, and Taz results in transcriptional upregulation of Rac-specific guanine nucleotide exchange factors, Rac activation, and HSC fitness restoration. Scribble links Cdc42 and the cytosolic functions of the Hippo signaling cascade in HSC fate determination.
A prospective real-world analysis of erenumab in refractory chronic migraine
Authors: Lambru Giorgio , Hill Bethany , Murphy Madeleine , Tylova Ivona , Andreou Anna P.
Published: June 2020

Background

Clinical trials have shown the safety and clinical superiority of erenumab compared to placebo in chronic migraine (CM). The aim of this analysis is to evaluate the effectiveness and tolerability of erenumab in a real-world setting in patients with refractory CM.

Methods

This is a prospective single centre real-world audit conducted in patients with CM with and without medication overuse, refractory to established preventive medications, who received monthly erenumab for 6 months.

Results

Of 164 patients treated, 162 patients (female = 135, mean age 46 ± 14.3 years old) were included in the audit. Patients had failed a mean of 8.4 preventive treatments at baseline and 91% of patients failed Botulinum toxin type A at baseline. The mean reduction in monthly migraine days was 6.0 days at month 3 (P = 0.002) and 7.5 days at month 6 (P < 0.001) compared to baseline. The mean reduction in monthly headache days was 6.3 days (P < 0.001) at month 3 and 6.8 days (P < 0.001) at month 6. At month 3, 49%, 35% and 13% and at month 6, 60%, 38% and 22% of patients obtained at least a 30%, 50% and 75% reduction in migraine days, respectively. The percentage of patients with medication overuse was reduced from 54% at baseline to 20% at month 3 and to 25% at month 6. Compared to baseline, the mean reduction of Headache Impact Test-6 score was 7.7 points at month 3 (from 67.6 ± 0.4 to 59.9 ± 0.9) (P < 0.001) and of 7.5 points at month 6 (60.1 ± 1.3) (P = 0.01). The percentage of patients with severe headache-related disability (HIT-6: 60–78) was reduced from 96% at baseline to 68% after three monthly treatments and to 59% after six treatments. At least one side effect was reported by 48% of patients at month 1, 22% at month 3 and 15% at month 6. Constipation (20%) and cold/flu-like symptoms (15%) were the most frequent adverse events reported.

Conclusion

Erenumab may be an effective and well tolerated therapy for medically refractory CM patients with and without medication overuse.
Chitosan-capped enzyme-responsive hollow mesoporous silica nanoplatforms for colon-specific drug delivery
Authors: Cai Defu , Han Cuiyan , Liu Chang , Ma Xiaoxing , Qian Jiayi , Zhou Jianwen , Li Yue , Sun Yiming , Zhang Changting , Zhu Wenquan
Published: June 2020

An enzyme-responsive colon-specific delivery system was developed based on hollow mesoporous silica spheres (HMSS) to which biodegradable chitosan (CS) was attached via cleavable azo bonds (HMSS–N=N–CS). Doxorubicin (DOX) was encapsulated in a noncrystalline state in the hollow cavity and mesopores of HMSS with the high loading amount of 35.2%. In vitro drug release proved that HMSS–N=N–CS/DOX performed enzyme-responsive drug release. The grafted CS could increase the biocompatibility and stability and reduce the protein adsorption on HMSS. Gastrointestinal mucosa irritation and cell cytotoxicity results indicated the good biocompatibility of HMSS and HMSS–N=N–CS. Cellular uptake results indicated that the uptake of DOX was obviously increased after HMSS–N=N–CS/DOX was preincubated with a colonic enzyme mixture. HMSS–N=N–CS/DOX incubated with colon enzymes showed increased cytotoxicity, and its IC50 value was three times lower than that of HMSS–N=N–CS/DOX group without colon enzymes. The present work lays the foundation for subsequent research on mesoporous carriers for oral colon-specific drug delivery.
Proteomic analysis of human synovial fluid reveals potential diagnostic biomarkers for ankylosing spondylitis
Authors: Lee Ji-Hyun , Jung Jae Hun , Kim Jeesoo , Baek Won-Ki , Rhee Jinseol , Kim Tae-Hwan , Kim Sang-Hyon , Kim Kwang Pyo , Son Chang-Nam , Kim Jong-Seo
Published: June 2020

Background

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease affecting the axial skeleton and peripheral joints. The etiology of this disease remains poorly understood, but interactions between genetic and environmental factors have been implicated. The present study identified differentially expressed proteins in the synovial fluid (SF) of AS patients to elucidate the underlying cause of AS.

Methods

A cohort of 40 SF samples from 10 AS and 10 each of rheumatoid arthritis (RA), gout, and osteoarthritis (OA) patients were analyzed by liquid chromatography tandem mass spectrometry (LC–MS/MS) to identify differentially expressed proteins specific to AS. The label-free LC–MS/MS results were verified by western blotting.

Results

We identified 8 proteins that were > 1.5-fold upregulated in the SF of AS patients compared to that of the disease control groups, including HP, MMP1, MMP3, serum amyloid P-component (APCS), complement factor H-related protein 5 (CFHR5), mannose-binding lectin 2 (MBL2), complement component C9 (C9), and complement C4-A (C4A). CFHR5 and C9 were previously found in serum from AS patients, while APCS was previously found in SF as well as in serum. However, the present study has identified C4A, and MBL2 as potential AS biomarkers for the first time. The expression levels of MMP3, C9, and CFHR5 were verified in AS SF using western blotting.

Conclusion

We performed quantitative comparative proteomic analysis using by LC–MS/MS of the SF from four disease states: RA, gout, and OA. This systematic comparison revealed novel differentially expressed proteins in AS SF, as well as two previously reported candidate biomarkers. We further verified the expression of MMP3, C9 and CFHR5 by western blot. These proteins may serve as diagnostic or prognostic biomarkers in patients with AS, and may thus improve the clinical outcomes of this serious disease.
An empirical comparison of population genetic analyses using microsatellite and SNP data for a species of conservation concern
Authors: Zimmerman Shawna J. , Aldridge Cameron L. , Oyler-McCance Sara J.
Published: June 2020

Background

Use of genomic tools to characterize wildlife populations has increased in recent years. In the past, genetic characterization has been accomplished with more traditional genetic tools (e.g., microsatellites). The explosion of genomic methods and the subsequent creation of large SNP datasets has led to the promise of increased precision in population genetic parameter estimates and identification of demographically and evolutionarily independent groups, as well as questions about the future usefulness of the more traditional genetic tools. At present, few empirical comparisons of population genetic parameters and clustering analyses performed with microsatellites and SNPs have been conducted.

Results

Here we used microsatellite and SNP data generated from Gunnison sage-grouse (Centrocercus minimus) samples to evaluate concordance of the results obtained from each dataset for common metrics of genetic diversity (HO,HE,FIS,AR) and differentiation (FST,GST,DJost). Additionally, we evaluated clustering of individuals using putatively neutral (SNPs and microsatellites), putatively adaptive, and a combined dataset of putatively neutral and adaptive loci. We took particular interest in the conservation implications of any differences. Generally, we found high concordance between microsatellites and SNPs forHE,FIS,AR, and all differentiation estimates. Although there was strong correlation between metrics from SNPs and microsatellites, the magnitude of the diversity and differentiation metrics were quite different in some cases. Clustering analyses also showed similar patterns, though SNP data was able to cluster individuals into more distinct groups. Importantly, clustering analyses with SNP data suggest strong demographic independence among the six distinct populations of Gunnison sage-grouse with some indication of evolutionary independence in two or three populations; a finding that was not revealed by microsatellite data.

Conclusion

We demonstrate that SNPs have three main advantages over microsatellites: more precise estimates of population-level diversity, higher power to identify groups in clustering methods, and the ability to consider local adaptation. This study adds to a growing body of work comparing the use of SNPs and microsatellites to evaluate genetic diversity and differentiation for a species of conservation concern with relatively high population structure and using the most common method of obtaining SNP genotypes for non-model organisms.
Formation of ultralong DH regions through genomic rearrangement
Authors: Smider Brevin A. , Smider Vaughn V.
Published: June 2020

Background

Cow antibodies are very unusual in having exceptionally long CDR H3 regions. The genetic basis for this length largely derives from long heavy chain diversity (DH) regions, with a single “ultralong” DH, IGHD8–2, encoding over 50 amino acids. Many bovine IGHD regions have sequence similarity but have several nucleotide repeating units that diversify their lengths. Genomically, most DH regions exist in three clusters that appear to have formed from DNA duplication events. However, the relationship between the genomic arrangement and long CDR lengths is unclear.

Results

The DH cluster containing IGHD8–2 underwent a rearrangement and deletion event in relation to the other clusters in the region corresponding to IGHD8–2, with possible fusion of two DH regions and expansion of short repeats to form the ultralong IGHD8–2 gene.

Conclusions

Length heterogeneity within DH regions is a unique evolutionary genomic mechanism to create immune diversity, including formation of ultralong CDR H3 regions.
Anodal transcranial direct current stimulation reduces motor slowing in athletes and non-athletes
Authors: Seidel-Marzi Oliver , Ragert Patrick
Published: June 2020

Background

Motor fatigability describes a phenomenon that occurs when exhaustive exercise or physically demanding tasks are executed over an extended period of time. Concerning fast repetitive movements, it is noticeable by a reduction in movement speed (motor slowing, MoSlo) and occurs due to both central and peripheral factors. The aim of the present study was to examine the presence of MoSlo during hand- (HTT) and foot-tapping tasks (FTT) comparing trained football (FB) and handball players (HB) and non-athletes (NA). Furthermore, we were interested in how far anodal transcranial direct current stimulation (tDCS) might be capable of modulating MoSlo as compared to sham.

Methods

A total number of 46 participants were enrolled in a sham-controlled, double-blinded, cross-over study. HTT and FTT were performed before, during, after as well as 30 min after 20 min of tDCS over the leg area of the primary motor cortex (M1).

Results

We could demonstrate that MoSlo during HTT and FTT is a general phenomenon that is observed independent of the type of sports and/or training status. Furthermore, we were able to show a tDCS-induced reduction in MoSlo specifically during FTT in both trained athletes and NA. No such effects could be observed for HTT, indicating local specificity of tDCS-induced effects on a behavioral level.

Conclusion

We could demonstrate that tDCS is capable of reducing motor fatigability during fast repetitive movements. These findings are of pivotal interest for many sports where fatigability resistance is a limiting factor in maintaining repetitive movement patterns.