bluuebunny/crossref_metadata_2025 huggingface dataset:
Dexamethasone and p38 MAPK inhibition of cytokine production from human lung fibroblasts
Authors: Higham Andrew , Singh Dave
Published: November 2020

Lung fibroblasts are involved in airway inflammation and remodelling in COPD. We report an investigation of the effects of combining a p38 MAPK inhibitor with a corticosteroid on cytokine production by a human lung fibroblast cell line and primary fibroblasts obtained from human lung tissue. Our main interest was to determine whether additive or synergistic anti‐inflammatory effects would be observed. We observed inhibition of IL‐6 and CXCL8 secretion from both lung fibroblast models by dexamethasone (maximal inhibition 40–90%) and the p38 MAPK inhibitor BIRB (maximal inhibition 30–60%), used alone and evidence of increased anti‐inflammatory effects when used in combination. This combination effect was more apparent for TNF‐a stimulated cytokine production (maximal inhibition increased by 10–20%). Interaction ratio analysis showed this enhanced effect to be additive rather than synergistic interaction. Similar results were obtained using both fibroblast cell culture models. Combining a p38 MAPK to corticosteroids may help reduce fibroblast mediated inflammation in COPD.
A mechanistic and stochastic approach to fatigue crack nucleation in coarse grain RR1000 using local stored energy
Authors: Pan Yan Bin , Dunne Fionn P.E. , MacLachlan Duncan W.
Published: November 2020

The crystal plasticity finite element (CPFE) method is used in conjunction with a critical local stored energy criterion to predict crack nucleation life for Coarse Grain (CG) nickel superalloy RR1000. Artificial representative microstructures are generated using Dream3D, and through simulation of multiple microstructural instantiations, a distribution of simulated fatigue response is generated. Fatigue of CG RR1000 is studied at 300°C and 700°C and at two R ratios of R = 0.1 and R = −1 giving a range of conditions to test the stored energy method. At higher temperature failure frequently occurs from inclusions, these are represented in the model by adding an inclusion with cohesive zones between inclusion and matrix. The results at 300°C are very good with the one parameter model (the critical stored energy) able to predict the mean, slope and distribution of fatigue data. At 700°C, the results are also good; however, fatigue life at high strain amplitude is overpredicted.
Long non‐coding RNA GAS5 overexpression inhibits M2‐like polarization of tumour‐associated macrophages in SMCC‐7721 cells by promoting PTEN expression
Authors: Wang Xun , Li Fang‐yuan , Zhao Wei , Gao Zhi‐kang , Shen Bin , Xu Hao , Cui Yan‐feng
Published: November 2020

Tumour‐associated macrophage (TAM) polarization is associated with hepatocellular carcinoma but the molecular mechanism of this polarization is still unknown. Peripheral blood mononuclear cells were induced to differentiate into M0, M1 and M2 macrophages and TAMs. TAMs were transfected with pcDNA3.1‐GAS5, pcDNA3.1‐NC, si‐GAS5, si‐PTEN or si‐Ctrl. A human liver cancer cell line (SMCC‐7721) was incubated with the modified TAM supernatant. Quantitative real‐time PCR and Western blot were performed to detect gene and protein expression. The cell proliferation and invasion properties of the SMCC‐7721 cells were detected by MTT and Transwell assays. GAS5 is up‐regulated in M1 macrophages and down‐regulated in M2 macrophages and TAMs. GAS5 overexpression promoted M1‐like polarization of TAMs and inhibited M2‐like polarization of TAMs. Moreover, GAS5 promoted the expression of PTEN in TAMs. PTEN‐silenced TAM supernatant treatment promoted cell proliferative and invasive properties of the SMCC‐7721 cells and diminished the effect of GAS5‐overexpressed TAM supernatant on the cell proliferation and invasion by SMCC‐7721 cells. Our results demostrared that GAS5 overexpression inhibited M2‐like polarization of TAMs by enhancing PTEN expression, thereby inhibiting cell proliferation and invasion by SMCC‐7721 cells. Thus, our results suggest that GAS5 may be a new therapeutic target for HCC treatment.
Stigma model of welfare fraud and non‐take‐up: Theory and evidence from OECD panel data
Authors: Kurita Kenichi , Hori Nobuaki , Katafuchi Yuya
Published: November 2020

This paper attempts to challenge two puzzles in the welfare program. The first puzzle is “non‐take‐up welfare,” which occurs when needy people do not take up welfare. Second, in some countries, the benefit level is high, but the recipient ratio is low; while the other nations have lower benefit levels but higher recipient ratios. We present a model of welfare stigma in which both non‐take‐up and welfare fraud exist within the equilibrium. This shows the possibility for the recipient ratio to decrease as the benefit level increases in the comparative statics. Our empirical results are consistent with our theoretical results.
Effects of different types of potato resistant starches on intestinal microbiota and short‐chain fatty acids under in vitro fermentation
Authors: Liang Dan , Li Nan , Dai Xiaofeng , Zhang Hong , Hu Honghai
Published: November 2020

The prebiotic effects of potato resistant starches RS1, RS2, RS3a, RS3b and RS4 were studied using simulated gut fermentation in vitro. The intestinal microbial composition was significantly changed by resistant starch (RS) after 24‐h fermentation. All RSs (P < 0.05) decreased the ratio of Firmicutes/Bacteroidetes (F/B), and RS2 exhibited the lowest value of 0.95 ± 0.07. The relative abundance of Bifidobacterium was significantly increased by RS4, whereas Megamonas and Prevotella were promoted by RS2. Further, RS4 produced the highest levels of acetate (138.34 µM), whereas RS2 produced the highest levels of propionate (41.45 µM) and butyrate (21.65 µM). However, Bifidobacterium did not promote the production of propionate or butyrate, even though it was proficient in fermenting RS. Megamonas and Prevotella were positively associated with the higher production of propionate and butyrate. Here, different RSs played key roles in promoting intestinal health, and RS2 especially showed more abundant probiotic functions.
Impact of lecithin incorporation on gel properties of bigeye snapper (Priacanthus tayenus) surimi
Authors: Panpipat Worawan , Cheong Ling‐Zhi , Chaijan Manat
Published: November 2020

Gelling characteristics of bigeye snapper (Priacanthus tayenus) surimi functionalised by lecithin at different concentrations were investigated. Lecithin at ≤1 g 100 g−1 had no impact on breaking force and deformation (P > 0.05). Expressible drip tended to decrease with increasing lecithin level up to 1 g 100 g−1. Lecithin at 1–3 g 100 g−1 improved the whiteness (P < 0.05). Jointed clusters were formed in the gel microstructure with 1 g 100 g−1 lecithin. Gel without and with 1 g 100 g−1 lecithin had the same texture profile and likeness scores (texture, odour and flavour) (P > 0.05). Peroxide value, TBARS content and rancid odour score of gels were changed considerably during refrigerated storage (4 °C/polyethylene bag) for 15 days but lower values of all indices were noticeable in gel with lecithin. Therefore, lecithin at 1 g 100 g−1 was the optimum concentration for stabilising the texture, improving the water holding capacity, whitening the colour and retarding the lipid oxidation of bigeye snapper surimi gel.
Comparison of postoperative recovery after robot‐assisted partial nephrectomy of T1 renal tumors through retroperitoneal or transperitoneal approach: A Japanese single institutional analysis
Authors: Kobari Yuki , Takagi Toshio , Yoshida Kazuhiko , Ishida Hideki , Tanabe Kazunari
Published: November 2020

Objective

To evaluate the quality of recovery in patients who underwent robot‐assisted partial nephrectomy and to compare the outcomes of the transperitoneal or retroperitoneal approach.

Methods

This study included 121 patients who underwent robot‐assisted partial nephrectomy under general anesthesia from April 2019 to September 2019 at Tokyo Women’s Medical University, Tokyo, Japan. Quality of recovery was defined according to the QoR‐40 Japanese version. The participants responded to the QoR‐40 Japanese version on three designated days. The patients were assigned to two groups according to the surgical approach: transperitoneal or retroperitoneal. A multivariate logistic regression analysis was carried out to identify independent factors associated with better quality of recovery.

Results

Out of the 121 patients, 56 (46%) and 65 (54%) patients were included in the transperitoneal and retroperitoneal group, respectively. Although the QoR‐40 Japanese version scores were not different between the two groups at admission, a better quality of recovery was observed in the retroperitoneal group than in the transperitoneal group at discharge based on the total score: physical comfort, emotional state, physical independence and pain. A multivariate analysis showed that the retroperitoneal approach and male sex were associated with a better QoR‐40 Japanese version score at discharge.

Conclusions

A retroperitoneal approach offers better quality of recovery than a transperitoneal approach, and therefore it might represent the optimal approach in selected patients undergoing robot‐assisted partial nephrectomy.
How researchers should select the best outcomes for randomised clinical trials in paediatric dentistry?
Authors: Mendes Fausto M. , Braga Mariana M. , Pássaro Ana Laura , Moro Bruna L. P. , Freitas Raiza Dias , Gimenez Thais , Tedesco Tamara K. , Raggio Daniela P. , Pannuti Claudio M.
Published: November 2020

Randomised clinical trial (RCT) is the best study design to evaluate the effect of the treatment and preventive healthcare procedures. The effects of the tested treatments on patient's health are compared in terms of outcomes, which are used to evaluate the participants' health changes. However, these outcomes should be relevant for the target population. In that way, RCTs represent the type of primary study design that provides the most reliable evidence to implement therapies into the clinical practice. In this review, an outline of some aspects related to the choice of RCTs' outcomes was presented, focusing on the conduction of relevant trials in Paediatric Dentistry. The importance and necessity of defining a primary outcome were addressed, preferentially a clinically relevant endpoint. The patients should perceive this outcome, and changes in this variable should reflect directly patient's health improvement or impairment. Moreover, considerations about the objective or subjective variables, use of surrogate outcomes, and the increasing tendency to develop core outcome sets were also presented in this review. The main idea of this manuscript is the RCTs must evaluate outcomes relevant to the children's oral health in order to contribute to the implementation of treatments in the evidence‐based health practice.
Oxidation resistance and thermal stability of the SiC‐ZrB2 composite ceramic fibers
Authors: Zhang Hao , Ge Min , Zhang Huifeng , Kong Weijia , Yu Shouquan , Zhang Weigang
Published: November 2020

In this study, continuous SiC‐ZrB2 composite ceramic fibers were synthesized from a novel pre‐ceramic polymer of polyzirconocenecarbosilane (PZCS) via melt spinning, electron beam cross‐linking, pyrolysis, and finally sintering at 1800°C under argon. The ZrB2 particles with an average grain size of 30.7 nm were found to be uniformly dispersed in the SiC with a mean size of 59.7 nm, as calculated using the Scherrer equation. The polycrystalline fibers exhibit dense morphologies without any obvious holes or cracks. The tensile strength of the fibers was greater than 2.0 GPa, and their elastic modulus was ~380 GPa. After oxidation at 1200°C for 1 hour, the strength of the fibers did not decrease despite a small loss of elastic modulus. Compared to the advanced commercial SiC fibers of Tyranno SA, the fibers exhibited improved high‐temperature creep resistance in the temperature range 1300‐1500°C.
Evaluation of image quality of wideband single‐shot late gadolinium‐enhancement MRI in patients with a cardiac implantable electronic device
Authors: Schwartz Sarah M. , Pathrose Ashitha , Serhal Ali M. , Ragin Ann B. , Charron Jessica , Knight Bradley P. , Passman Rod S. , Avery Ryan J. , Kim Daniel
Published: November 2020

Introduction

While wideband segmented, breath‐hold late gadolinium‐enhancement (LGE) cardiovascular magnetic resonance (CMR) has been shown to suppress image artifacts associated with cardiac‐implanted electronic devices (CIEDs), it may produce image artifacts in patients with arrhythmia and/or dyspnea. Single‐shot LGE is capable of suppressing said artifacts. We sought to compare the performance of wideband single‐shot free‐breathing LGE against the standard and wideband‐segmented LGEs in CIED patients.

Methods and Results

We retrospectively identified all 54 consecutive patients (mean age: 61 ± 15 years; 31% females) with CIED who had undergone CMR with standard segmented, wideband segmented, and/or wideband single‐shot LGE sequences as part of quality assurance for determining best clinical practice at 1.5 T. Two raters independently graded the conspicuity of myocardial scar or normal myocardium and the presence of device artifact level on a 5‐point Likert scale (1: worst; 3: acceptable; 5: best). Summed visual score (SVS) was calculated as the sum of conspicuity and artifact scores (SVS ≥ 6 defined as diagnostically interpretable). Median conspicuity and artifact scores were significantly better for wideband single‐shot LGE (F = 24.2, p < .001) and wideband‐segmented LGE (F = 20.6, p < .001) compared to standard‐segmented LGE. Among evaluated myocardial segments, 72% were deemed diagnostically interpretable—defined as SVS ≥ 6—for standard‐segmented LGE, 89% were deemed diagnostically interpretable for wideband‐segmented LGE, and 94% segments were deemed diagnostically interpretable for wideband single‐shot LGE.

Conclusions

Wideband single‐shot LGE and wideband‐segmented LGE produced similarly improved image quality compared to standard LGE.
Endocardial versus epicardial left atrial appendage exclusion for stroke prevention in patients with atrial fibrillation: Midterm follow‐up
Authors: Litwinowicz Radoslaw , Burysz Marian , Mazur Piotr , Kapelak Boguslaw , Bartus Magdalena , Lakkireddy Dhanunjaya , Lee Randall J. , Malec‐Litwinowicz Michalina , Bartus Krzysztof
Published: November 2020

Background

Left atrial appendage closure (LAAC) became an alternative method for stroke prevention in patients with non‐valvular atrial fibrillation (AF) intolerant to long term oral anticoagulation therapy. This study aimed to compare endocardial (Amulet and LAmbere occluders) and epicardial (Lariat) LAAC techniques.

Methods

A retrospective, observational case‐control study included 223 consecutive CHA2DS2‐VAS score–matched patients with AF who underwent LAAC in two centers.

Results

There were 55 matched cases with the mean CHA2DS2‐VASs score 4.4 ± 1.22 (p = 1). Overall follow‐up was 308.2 patient‐years. The Endocardial group patients were older and more often females with congestive heart failure and peripheral vascular disease. The epicardial group more frequently had a stroke/transient ischemic attack history. There were no differences in hypertension, diabetes mellitus, and indications for procedure between both groups. The mean HAS‐BLED score was significantly higher in the endocardial group than in the epicardial group (4.3 ± 0.9 vs. 3.7 ± 1.3, p = .011). There were no differences in annual rates of thromboembolic events (2.6% vs 0.5%) and annual stroke (0.87% vs. 0%) between the endocardial and epicardial groups.

Conclusion

Endocardial and Epicardial LAAC techniques show comparable implantation outcomes and safety profile and stroke prevention in patients with AF. Future randomized studies are needed to corroborate these initial results and assess long term mortality.
Population genomics reveals repeated signals of adaptive divergence in the Atlantic salmon of north‐eastern Europe
Authors: Zueva Ksenia J. , Lumme Jaakko , Veselov Alexey E. , Primmer Craig R. , Pritchard Victoria L.
Published: November 2020

Our ability to examine genetic variation across entire genomes has enabled many studies searching for the genetic basis of local adaptation. These studies have identified numerous loci as candidates for differential local selection; however, relatively few have examined the overlap among candidate loci identified from independent studies of the same species in different geographic areas or evolutionary lineages. We used an allelotyping approach with a 220K SNP array to characterize the population genetic structure of Atlantic salmon in north‐eastern Europe and ask whether the same genomic segments emerged as outliers among populations in different geographic regions. Genome‐wide data recapitulated the phylogeographic structure previously inferred from mtDNA and microsatellite markers. Independent analyses of three genetically and geographically distinct groups of populations repeatedly inferred the same 17 haploblocks to contain loci under differential local selection. The most strongly supported of these replicated haploblocks had known strong associations with life‐history variation or immune response in Atlantic salmon. Our results are consistent with these genomic segments harbouring large‐effect loci which have a major role in Atlantic salmon diversification and are ideal targets for validation studies.
Identifying carrot appearance quality by an improved dense CapNet
Authors: Zhu Hongfei , Yang Lianhe , Sun Yuxin , Han Zhongzhi
Published: November 2020

Carrot appearance quality is a significant concern of consumers and modern food process engineering. In the process of sorting in agricultural products, the agricultural products' appearance quality plays a particularly important role, so it is incredibly necessary to identify carrot appearance quality. In this study, we proposed an improved dense capsule network model (Modified‐DCNet) for carrot appearance quality identification. First, the initiator of Modified‐DCNet introduced the self‐attention layer that will reduce the interference of background information on the identification task. Specifically, the feature weight of the recognized area increased to reduce background information interference. Besides, the capsule layers of the improved model used a locally constrained dynamic routing algorithm to realize the sharing mechanism of capsule routing selection and transformation matrix in the local area, and this algorithm can reduce the size of network parameters and network training load. When the input image size is 227 × 227 pixels, the recognition accuracy of this model is 97.50%, and the parameter count is the only 5.2 M. The experimental results show that the improved dense capsule network model (Modified‐DCNet) has higher recognition accuracy and smaller parameter scales.

Practical Applications

In the design and manufacture of carrot sorter, it is vital to recognize the appearance quality of the carrot correctly. In this paper, Modified‐DCNet can achieve higher identification accuracy, dramatically reduce the burden of model parameter calculation. The carrot appearance plays a crucial role in quality assessment. Therefore, this work has practical application value.
The Relationship Between Psychological Capital and the Occupational Psychologic Risks of Nurses: The Mediation Role of Compassion Satisfaction
Authors: Yıldırım Nazmiye , Coşkun Hamit , Polat Şehrinaz
Published: November 2020

Purpose

The aim of the study was to explore the relationship between psychological capital (hope, self‐efficacy, resilience, and optimism) and burnout and compassion fatigue or secondary traumatic stress among general hospital nurses, and the mediating role of compassion satisfaction in this relationship.

Design

Cross‐sectional survey study. Participants were 697 nurses working in different nursing departments in tertiary university hospitals in a metropolitan city in Turkey.

Methods

The semistructured interview form, Professional Quality of Life Scale, and Psychological Capital Scale were used to gather data. Descriptive analysis, the Spearman correlation analyzer, hierarchical multiple linear regression analysis, and mediation analyzer with PROCESS and the Sobel test were used to analyze data.

Findings

There were moderate relationships between psychological capital total score, all subscales, and burnout, and weak negative correlations between these variables and compassion fatigue. For burnout, self‐efficacy and optimism in the first model explained 26% of the variance; when compassion satisfaction was added in the second model, 45% of the total variance was explained. For compassion fatigue, self‐efficacy in the first model explained 5% of the variance; adding compassion satisfaction in the second model, the variance did not change at all.

Conclusions

The findings of the current study may contribute to enhancing the protection of nurses' well‐being in their general hospital settings by developing knowledge about the resources that are needed to prevent or decrease occupational psychological risks. Increasing psychological capital levels of nurses enhances the quality of care and the sustainability of their working conditions.

Clinical Relevance

The findings of this study can be used to design interventions to better assist nurses in addressing their psychological health. Because psychological capital is a malleable resource, nursing managers can invest in the development and improvement of nurses' resources.
Initial morphological symmetry breaking in the foregut and development of the omental bursa in human embryos
Authors: Schäfer Tobias , Stankova Viktoria , Viebahn Christoph , de Bakker Bernadette , Tsikolia Nikoloz
Published: November 2020

Bilaterally symmetrical primordia of visceral organs undergo asymmetrical morphogenesis leading to typical arrangement of visceral organs in the adult. Asymmetrical morphogenesis within the upper abdomen leads, among others, to the formation of the omental bursa dorsally to the rotated stomach. A widespread view of this process assumes kinking of thin mesenteries as a main mechanism. This view is based on a theory proposed already by Johannes Müller in 1830 and was repeatedly criticized, but some of the most plausible alternative views (initially proposed by Swaen in 1897 and Broman in 1904) still remain to be proven. Here, we analyzed serial histological sections of human embryos between stages 12 and 15 at high light microscopical resolution to reveal the succession of events giving rise to the development of the omental bursa and its relation to the emerging stomach asymmetry. Our analysis indicates that morphological symmetry breaking in the upper abdomen occurs within a wide mesenchymal plate called here mesenteric septum and is based on differential behavior of the coelomic epithelium which causes asymmetric paragastric recess formation and, importantly, precedes initial rotation of stomach. Our results thus provide the first histological evidence of breaking the symmetry of the early foregut anlage in the human embryo and pave the way for experimental studies of left‐right symmetry breaking in the upper abdomen in experimental model organisms.
Correlation between emotional intelligence and negative emotions of front‐line nurses during the COVID‐19 epidemic: A cross‐sectional study
Authors: Sun Huili , Wang Shuling , Wang Wei , Han Guanghong , Liu Zhijian , Wu Qi , Pang Xiaoli
Published: November 2020

Aims and Objectives

The purpose of this study was to understand the emotional intelligence level (EI) and negative emotional status of the front‐line nurses in the epidemic situation and to further explore the relationship between them.

Background

During the COVID‐19 epidemic, under the influence of multiple factors, nurses were vulnerable to negative emotions. While previous studies have explored, the role of emotional intelligence in negative emotions, the relationship between the two has not been sufficiently discussed in the context of COVID‐19.

Design

The study carried out a cross‐sectional survey. The STROBE was selected as the checklist in this study.

Methods

202 nurses from Wuhan makeshift hospital participated in the questionnaire survey. Data collection tools included a general data questionnaire designed by the researchers, Chinese version of EI scale (WLEIS‐C) and Chinese version of Depression Anxiety Stress Scale (DASS‐21). Descriptive statistics, single factor analysis and correlation analysis were used to analyse the data.

Results

The emotional intelligence of the front‐line nurses was in the upper middle range. Among the negative emotions, anxiety was the most prominent symptom.

Conclusions

Managers should pay attention to the negative emotional problems of front‐line nurses, improve their EI level and promote mental health and the progress of epidemic prevention.

Relevance to clinical practice

Improving the level of emotional intelligence can reduce the frequency and intensity of negative emotions. In clinical work, emotional intelligence can be used as a skill to carry out relevant training, which is conducive to playing a positive role in future emergencies.
Differences in knowledge and attitudes toward the intrauterine device: Do age and race matter?
Authors: Edwards Sara , Mercier Rebecca , Perriera Lisa
Published: November 2020

Aim

The intrauterine device (IUD) is highly effective birth control, but US IUD usage lags. Barriers to usage, including patient attitudes and lack of knowledge, are not well‐characterized. This study sought to investigate how attitudes and knowledge about IUD vary by age and race.

Methods

A survey was distributed to all women in the outpatient obstetrics and gynecology office of a large, urban, academic medical center in Philadelphia. Exclusion criteria included inability to read English or age less than 14 years. Surveys queried participant demographics, knowledge about and opinions of IUD. The authors performed exploratory bi‐variable analysis using t tests and chi‐square testing to determine which outcomes differed by age and race. For those differing significantly, the authors performed regression analysis to assess for confounding by other factors.

Results

Of 1366 women approached, 521 completed the survey (38% response rate). After controlling for confounding, only responses to the statement ‘Hormonal birth control is safe and effective’ differed significantly by age. Knowledge about IUD did not differ significantly by race, but black women were significantly more likely to perceive that they had insufficient knowledge about IUD compared to white women (odds ratio [OR]: 1.91; 95% confidence interval [CI]: 1.06–3.46). Black women had a more negative opinion of IUD safety (OR: 5.0; 95% CI: 2.35–10.66) and reliability (OR: 5.5; 95% CI: 2.20–14.13) than white women.

Conclusion

Attitudes and knowledge about IUD do not differ significantly by age. While knowledge about IUD is similar between races, black women may have more negative opinions of IUD.
Threatened uterine rupture following laparoscopic surgery in interstitial tubal pregnancy
Authors: Arakaki Yoshihisa , Mekaru Keiko , Shimoji Yuko , Nakamura Rie , Miyagi Maho , Aoki Yoichi
Published: November 2020

Contraception is recommended for a certain period following a hysterotomy; however, no consensus exists on the required duration of contraception. A 21‐year‐old female was brought to the emergency room in a state of shock due to intraperitoneal bleeding. An emergency laparoscopic cornuostomy indicated for ruptured interstitial pregnancy was performed. Despite contraception, the patient got pregnant 1.5 months after surgery. At 16 weeks of gestation, threatened uterine rupture was suspected, as magnetic resonance imaging (MRI) revealed hematogenous amniotic fluid and a subchorionic hematoma near the interstitial portion of the fallopian tube. An MRI at 21 weeks showed hematoma shrinkage and disappearance of the hematogenous amniotic fluid. At 37 weeks, an elective cesarean section was performed, which resulted in a live birth. Pregnancy shortly after surgery is a risk factor for uterine rupture. In such cases, MRI could be useful in the evaluation of threatened uterine ruptures.
Case report of Langerhans cell histiocytosis in a fetus detected by magnetic resonance imaging
Authors: Bao Zhongkun , Deng Meixiang , Zou Yu , Wang Hongzhu , Liang Jiawei , Mi Yanhong
Published: November 2020

Langerhans cell histiocytosis (LCH) is a rare disease, and the diagnosis of LCH is mainly based on clinical manifestation, imaging and pathological examinations. But during pregnancy, imaging examinations especially play an important role in the diagnosis and prognostic assessment of fetal LCH. Up to now, there has been no report about magnetic resonance imaging (MRI) features of fetal LCH. We reported a 32‐year‐old woman at 36 weeks' gestation took fetal MRI because of fetal anomalies diagnosed by ultrasonography. On the fetus's MR images, the thymus was slightly enlarged with smooth or lobulated contour in supra anterior mediastinum, displayed heterogeneous signals and contained multiple small cysts on T2WI. Innumerable irregular nodules and patchy shadows were present throughout both lungs. Pulmonary lesions were bilateral and diffuse with relative sparing of the costophrenic angles. The margins of these lesions were fluffy and indistinct. These lesions showed heterogeneous signals on T2WI. MRI showed no lesions in skin region. After birth, lots of round or oval skin lesions distributed all over the baby's body presenting as ulcerated or blister‐like rashes. The chest computer tomography (CT) showed punctate calcification and heterogeneous enhancement in the thymus and bilateral diffuse reticular or reticulonodular opacities in both lungs with fluffy and indistinct margins. Pathological finding was consistent with LCH. Through reporting MRI features of LCH in one fetus, this study aims to improve awareness of fetal LCH in radiologists and clinicians, to improve the prenatal diagnostic rate of this disorder.
fMRI in Bell's Palsy: Cortical Activation is Associated with Clinical Status in the Acute and Recovery Phases
Authors: Calistri Valentina , Mancini Patrizia , Raz Eytan , Nicastri Maria , Tinelli Emanuele , Russo Francesca Yoshie , Fiorelli Marco , De Seta Elio , Carpentieri Daniele , De Vincentiis Marco , Caramia Francesca
Published: November 2020

BACKGROUND AND PURPOSE

Using functional magnetic resonance imaging (fMRI), we explored cortical activation in patients with acute Bell's palsy (BP) and analyzed its correlates with clinical status in the acute phase, and with 6‐month outcome.

METHODS

Twenty‐four right‐handed patients with acute BP within 15 days of onset and 24 healthy controls underwent fMRI during performance of unilateral active (hemi‐smiling) and passive lip movement tasks with both the paretic and the normal lip. The degree of paresis was evaluated during the acute stage and at the 6‐month follow up using the House‐Brackmann (HB) grading scale. Complete recovery was defined as HB grade II or less at the end of the 6‐month period. The difference in the HB grade (ΔHB) between the acute stage and the 6‐month follow up was used to evaluate clinical improvement.

RESULTS

There were 24 patients with unilateral acute BP. HB grades ranged from III to VI. At 6 months, 11 patients (46%) had completely recovered and 12 (50%) were partially improved. Compared with healthy subjects, BP patients had a significantly greater activation of the frontal areas and the insula ipsilateral to the paretic side. In BP patients, there was an inverse correlation between the activation of the ipsilateral hemisphere when moving the paretic side and the degree of paresis at baseline. An association was also observed between activation and clinical outcome (both complete recovery and ΔHB).

CONCLUSIONS

In patients with BP, fMRI may represent a useful tool to predict long‐term outcome, guide therapeutic approach, and monitor treatment response.
Early Head Computed Tomography Abnormalities Associated with Elevated Intracranial Pressure in Severe Traumatic Brain Injury
Authors: Murray Nick M. , Wolman Dylan N. , Mlynash Michael , Threlkeld Zachary D. , Christensen Soren , Heit Jeremy J. , Harris Odette A. , Hirsch Karen G.
Published: November 2020

BACKGROUND AND PURPOSE

Intracranial pressure (ICP) monitoring is recommended in severe traumatic brain injury (sTBI), yet invasive monitoring has risks, and many patients do not develop elevated ICP. Tools to identify patients at risk for ICP elevation are limited. We aimed to identify early radiologic biomarkers of ICP elevation.

METHODS

In this retrospective study, we analyzed a prospectively enrolled cohort of patients with a sTBI at an academic level 1 trauma center. Inclusion criteria were nonpenetrating TBI, age ≥16 years, Glasgow Coma Scale (GCS) score ≤8, and presence of an ICP monitor. Two independent reviewers manually evaluated 30 prespecified features on serial head computed tomography (CTs). Patient characteristics and radiologic features were correlated with elevated ICP. The primary outcome was clinically relevant ICP elevation, defined as ICP ≥ 20 mm Hg on at least 5 or more hourly recordings during postinjury days 0‐7 with concurrent administration of an ICP‐lowering treatment.

RESULTS

Among 111 sTBI patients, the median GCS was 6 (interquartile range 3‐8), and 45% had elevated ICP. Features associated with elevated ICP were younger age (every 10‐year decrease, odds ratio [OR] 1.4), modified Fisher scale (mFS) score at 0‐4 hours postinjury (every 1 point, OR 1.8), and combined volume of contusional hemorrhage and peri‐hematoma edema (10 ml, OR 1.2) at 4‐18 hours postinjury.

CONCLUSIONS

Younger age, mFS score, and volume of contusion are associated with ICP elevation in patients with a sTBI. Imaging features may stratify patients by their risk of subsequent ICP elevation.
Disrupting the Disruptors or Enhancing Them? How Blockchain Reshapes Two‐Sided Platforms
Authors: Trabucchi Daniel , Moretto Antonella , Buganza Tommaso , MacCormack Alan
Published: November 2020

The importance of platform‐based businesses in the modern economy is growing continuously and becoming increasingly relevant. Specifically, the deployment of digital technologies has enhanced the applicability of two‐sided business models, enabling companies to act not just as builders and owners of assets, but also as orchestrators of external resources. Management research has, therefore, focused increasingly on the unique aspects of this model. At the center of a two‐sided platform there is a platform provider that enables a transaction between the sides, reducing the relative transaction costs. However, in recent years, a new technology emerged that challenges some of the underlying assumptions of this model: the blockchain. Blockchain enables the creation of a peer‐to‐peer network that is able to authenticate transactions, upon which applications and services may be built. It allows users to conduct transactions without the need for a central platform.

We explore how blockchain technology reshapes two‐sided platforms, focusing in particular on the role of the platform provider. The research is based upon multiple case studies, using an inductive approach to explore this emerging phenomenon. Our findings show there is a significant shift in the role of the central player that links the two sides of a transaction using blockchain. We frame this as a shift from a “platform provider” to a “service provider,” leveraging the blockchain as a Platform‐as‐a‐Service. Our work examines the peculiarities of this model, unveiling new dynamics in these businesses. Specifically, we show that different variables must be considered to classify two‐sided platforms using blockchain. Furthermore, the essential characteristics of two‐sided platforms must also be enlarged. For example, traditional platform theories emphasize the importance of cross‐side network externalities in creating value. In blockchain‐enabled platforms however, we show the use of “tokens” play a key role in creating different types of externalities between the two sides.
Baseline Hypothalamic–Pituitary–Adrenal Axis and Parasympathetic Nervous System Activity Interact to Predict Executive Functions in Low‐Income Children
Authors: Braren Stephen H. , Brandes‐Aitken Annie , Perry Rosemarie E. , Williams Kevon , Lyons Krystalle , Rowe‐Harriott Sashana , Blair Clancy
Published: November 2020

We examined interactions between baseline hypothalamic–pituitary–adrenal (HPA) axis and parasympathetic nervous system (PNS) activity in relation to executive functions (EF) in a sample (n = 1,005) of children in low wealth, nonurban communities at age 48 months. Salivary cortisol and respiratory sinus arrhythmia (RSA) represented baseline HPA axis and PNS activity, respectively. The interaction between RSA and cortisol predicted EF such that children with either lower RSA and lower cortisol, or higher RSA and higher cortisol had higher EF scores. These findings suggest a potential compensatory relation in which the PNS and HPA axis counterbalance each other to support cognition.
Well‐being curriculum for anesthesiology residents: Development, processes, and preliminary outcomes
Authors: Janosy Norah R. , Beacham Abbie , Vogeli Jo , Brainard Alison
Published: November 2020

Physician burnout and healthcare worker stress are well‐covered topics in both the medical and lay press. Burnout in physicians can start as early as medical school. Well‐being initiatives, programming, and access to support for all medical professionals are of paramount importance. In 2014, the Accreditation Council for Graduate Medical Education (ACGME) Milestones for Resident/Fellow Education in Anesthesiology added Professionalism as a milestone. A subcategory of Professionalism includes:A responsibility to maintain personal, emotional, physical, and mental health. This subcategory charges all residency and fellowship programs with establishing a curriculum in well‐being. The development, execution, and evaluation of these programs are left to the individual institutions. In this paper, the development, processes, and preliminary outcomes of a resident well‐being curriculum are presented.
The Decline of the US Labor Share Across Sectors
Authors: Mendieta‐Muñoz Ivan , Rada Codrina , von Arnim Rudi
Published: November 2020

We provide novel insights on the functional distribution of income in the postwar US economy, based on a Log Mean Divisia Index decomposition of the labor share by 14 sectors. We identify contributions from four components: real compensation, labor productivity, employment shares, and relative prices. The results are presented for the entire period as well as golden age (1948–1979) and neoliberal era (1979–2017), painting a detailed picture of structural changes. We find that (1) real compensation and labor productivity dominate; (2) manufacturing plays an important role in the recent decline of the labor share; (3) employment shifts toward service sectors with higher labor shares have buffered the decline; and (4) relative prices of services are increasing. We discuss these results in the context of Baumol’s and Lewis’s seminal contributions. Both theories build on the notion of coexistence of progressive and stagnant activities, which is documented in our sectoral decomposition.
Quantifying Longevity Gaps Using Micro-Level Lifetime Data
Authors: van Berkum Frank , Antonio Katrien , Vellekoop Michel
Published: November 2020

Using flexible Poisson regressions, we analyse a huge micro-level lifetime dataset from a Dutch pension fund, including categorical, continuous and spatial risk factors collected on participants in the fund. The availability of granular lifetime data allows us to quantify the longevity gap between the national population and the fund on the one hand, and between participants within the fund on the other hand. We identify the most important risk factors using statistical criteria that measure the in- and out-of-sample performance of the regression models. We evaluate the financial performance of the models by introducing a novel type of backtest, which selects the risk factors that contribute most to an accurate prediction of future pension liabilities. For this portfolio, the most relevant risk factors (next to age and gender) are the salary, the time spent in disability and working at irregular hours. The resulting personalized mortality risk profiles show substantial differences between the remaining life expectancies for the most-favourable and least-favourable risk profiles. Our method to estimate these longevity gaps will help policymakers to assess wanted and unwanted consequences of longevity risk sharing in pension schemes.
Measuring implicit intergroup biases
Authors: Lai Calvin K. , Wilson Megan E.
Published: November 2020

Implicit intergroup biases are automatically activated prejudices and stereotypes that may influence judgments of others on the basis of group membership. We review evidence on the measurement of implicit intergroup biases, finding: implicit intergroup biases reflect the personal and the cultural, implicit measures vary in reliability and validity, and implicit measures vary greatly in their prediction of explicit and behavioral outcomes due to theoretical and methodological moderators. We then discuss three challenges to the application of implicit intergroup biases to real‐world problems: (1) a lack of research on social groups of scientific and public interest, (2) developing implicit measures with diagnostic capabilities, and (3) resolving ongoing ambiguities in the relationship between implicit bias and behavior. Making progress on these issues will clarify the role of implicit intergroup biases in perpetuating inequality.
Ultrasonographic findings of gastrointestinal histoplasmosis in dogs
Authors: Chávez‐Peón Berle Erica , KuKanich Kate , Biller David
Published: November 2020

Histoplasmosis, a mycotic infection caused byHistoplasmaspp, can infect the gastrointestinal tract of dogs. Clinical signs of gastrointestinal histoplasmosis can include diarrhea, profound weight loss, anorexia, and vomiting. Rectal scrape for cytology can provide a quick diagnosis, but if negative abdominal ultrasound is often pursued. Ultrasonographic abnormalities in dogs with gastrointestinal histoplasmosis have rarely been reported. This retrospective, single‐center case series aimed to describe the ultrasonographic features of gastrointestinal histoplasmosis in dogs. Nineteen cases with a diagnosis of gastrointestinal histoplasmosis confirmed with gastrointestinal cytology or histopathology (N = 15) or gastrointestinal lymph node cytology (N = 4) that had undergone an abdominal ultrasound examination from 2005 to 2020 were included. Ultrasound images were reviewed by an American College of Veterinary Radiology (ACVR)‐certified veterinary radiologist and diagnostic imaging resident. Eighteen cases had sonographic abnormalities within the gastrointestinal tract. The colon was the most affected organ. Colonic thickening and abnormal wall layering were the most frequent findings (N = 16 dogs); thickening ranged from 0.36 to 1.2 cm. Diffuse, multifocal, and focal thickening patterns were seen. Sixteen patients had abnormal wall layering of the colon (complete loss of layering or altered with partial loss of layering). Other frequent findings included lymphadenopathy, small intestinal thickening with abnormal wall layering and peritoneal effusion. Based on the authors’ review of the literature, this is the first description of ultrasonographic findings of gastrointestinal histoplasmosis in a group of dogs. Although abnormal gastrointestinal wall layering seen sonographically is most frequently associated with neoplasia, this is not pathognomonic. Gastrointestinal histoplasmosis should be considered as a differential diagnosis due to the similarities and overlap of ultrasonographic features.
Modeling and Parametric Analysis of Multilayer Piezocomposite Actuators
Authors: Wright Cody , Bilgen Onur
Published: November 2020

Design space for morphing structures using single layer commercial piezocomposite actuators are often restricted due to limitations in actuation authority. Optimal designs are those in which the substrate-actuator composite is stiff enough to maintain shape when subjected to surface pressures but allow for the desired curvature under excitation. This trade-off limits substrate to actuator thickness ratios in applications where dynamic pressures are high. One way to improve actuation authority while maintaining stiffness is to use multiple piezocomposite actuators. This paper explores the benefits and drawbacks of using multilayer piezocomposite actuators. The actuators are modeled using the finite element method and are characterized using well-known free strain and blocked force conditions in a four-point loading condition. Material properties for substrate, piezocomposite, and glue layers are modeled based on previous experimental analysis of curvature over a range of thickness ratios for single element actuators. A parametric analysis is conducted on multilayer piezocomposites varying thickness ratio, substrate material and number of piezocomposite layers. Results for the parametric analysis are presented in the form of maximum curvature, work done, and work done normalized by number of layers. A discussion of new design space potential for multilayer actuators is provided.
A Method of Crack Monitoring for Electrically Activated SMA Wires Using Thermography
Authors: Theren Benedict , Kuhlenkötter Bernd , Schuleit Marvin , Esen Cemal
Published: November 2020

Predicting the remaining lifetime of an operating shape memory actuator is a great goal to achieve to increase its reliability. The shape memory wires used in these actuators are mostly activated using Joule Heating. Therefore the electrical resistance during activation can easily be measured. Studies show an increase in electrical resistance with an increasing number of activations due to fatigue. Therefore monitoring the electrical resistance leads to a prediction regarding the remaining lifetime of the actuator. The electrical resistance depends on the ambient temperature and the load case (yielded stress, activation frequency, voltage, and current) resulting in different maximum activation temperatures of the wire. The increase in electrical resistance should lead to a higher wire temperature. Before the wire fails due to fracture cumulating cracks should appear. These cracks decrease the diameter of the wire that leads to locally increased electrical resistance and therefore a local higher temperature. This work investigates if those hotspots can be monitored using thermal imaging. Binary Ni50Ti50 wires with a diameter of 0.28 mm were investigated. Measuring the exact temperature of the wires is difficult since the specimens are round and the emission coefficient is unknown. Therefore only qualitative measurement of the temperature is performed.

10 experiments at different stresses and voltages were performed. The results show some indications, that the position and the moment of the fracture can be determined using this setup. Several models are matching the wire temperature after activation to its fracture strength and fatigue behavior. Further investigations must be performed combining the presented models to the results of this work.