bluuebunny/crossref_metadata_2025 huggingface dataset:
A Smart Jacket with Portable Thermoelectric Cooling System
Authors: Haque K M Jamiul , Nirjon Mashrur Jehan , Rinath Ragib Tahshin , Rahman Mohammad Rahath
Published: April 2024

This paper introduces a cutting-edge, self-contained cooling jacket design and its practical implementation. The jacket utilizes Peltier modules and a water circulation system to efficiently transfer heat, completely eliminating the need for traditional compressors or refrigerants. The key components of this innovative system include aluminum blocks housing Peltier modules, dual-loop water coolant systems, a compact suction fan, a radiator, two submersible pumps, and a rechargeable Lipo battery. The cooling process involves water circulating through the aluminum blocks to effectively dissipate heat generated by the Peltier modules. The heated water then traverses a path through plastic pipes, the radiator, and a holding tank, and ultimately returns to the aluminum blocks, while the cold water travels from the tank to the aluminum blocks via copper tubing. This ingenious configuration delivers remarkable cooling performance without relying on conventional cooling components. Extensive laboratory testing of the system confirmed its capability to achieve cooling temperatures up to 10°C below the ambient temperature. These results signify the promising potential of the cooling jacket across various applications, especially those requiring a portable and self-contained cooling solution. Such applications include critical scenarios like military and first responder operations, demanding industrial and construction settings, and scenarios involving individuals with medical conditions exacerbated by heat. The innovative cooling jacket offers a highly efficient and versatile solution for a wide range of practical needs.
Comparative Analysis of Aerodynamic Lift and Drag of Commercially Used Air-foil Incorporated with Co-flow Jet
Authors: Roy Souvik , Paul Tithi , Shawron Rashidul Hassan , Yasir Atif
Published: April 2024

In this research, a baseline airfoil is modified by incorporating a Co-flow Jet into the airfoil. Co-flow jet is also called zero net mass flux as the same amount of highly pressurized air is injected towards the streamlines of an airfoil from the leading edge and sucks this air without changing the amount in the trailing edge using an air pump. A performance boost is expected for the use of the Co-flow Jet. An airplane’s performance is based on a few parameters such as the coefficient of lift, coefficient of drag, boundary layer separation, and many others. In this research, a comparative analysis is run between a baseline airfoil and a CFJ airfoil. NACA-4412 is chosen as the target airfoil. The research shows how the incorporation of CFJ in an airfoil increases the coefficient of lift (CL) and decreases the coefficient of drag (CD). Thus, it is possible to maintain a better CL/CL ratio by using CFJ. The research also mentions the increase in stall angle due to the use of CFJ. It is a computational analysis performed in the software Ansys. For simplicity, the analysis is limited to two-dimensional analysis. This research may bring a better improvement in the aircraft and aerodynamic sectors. Though the results obtained from the research may not fully be similar to the hypothesis, it has been tried to maintain that the results of the simulation hardly differ from the theoretical analysis.
Contribution of BSM Particles on Electric Dipole Moment of Charged Leptons in the Minimal Left-Right Symmetric Model
Authors: Buksh Rafid , Alam Shahinoor , Nur-E-Mostafa
Published: April 2024

In this paper, the contribution of Beyond the Standard Model (BSM) particles on the Electric Dipole Moment (EDM) of charged lepton is calculated in a minimal Left-Right Symmetric Model. First-order quantum correction i.e., one loop correction, from relevant diagrams in the unitary gauge using Feynman parameterization is used because there is no tree-level contribution in Electric Dipole Moment due to non-renormalizability of the dipole term in the Lagrangian. This study mainly focuses on the BSM Higgs sector contribution to the EDM of charged leptons due to phenomenological interest. CP violation is directly connected to the EDM of fundamental particles. Matter-antimatter asymmetry is a mystery of the universe that demands CP symmetry to be violated. The standard model cannot explain the observed CP violation. Standard Model (SM) is so far the best description of nature. Despite having tremendous success, e.g., Electro-weak Symmetry Breaking and Higgs discovery, the Standard model is not complete. Moreover, experimentally, we observed small neutrino mass and neutrino mixing. The Seesaw Mechanism can explain neutrino mass smallness and mixing introducing a large Majorana mass. Left-right symmetric model is the most natural extension of SM which can accommodate the Seesaw mechanism. So EDM contributions from BSM particles in the Left-Right symmetric Model are a good probe of new physics beyond the SM. These contributions then can be used to do phenomenology and test the Model.
Jute Fiber Reinforced Biocomposite: Towards Developing Composite Bone Plate
Authors: Hoque Md Enamul , Rayhan Asif Mahmud
Published: April 2024

Bone fractures are often treated with metallic bone plates which are inherited some fundamental issues such as stress shielding, bone atrophy, heavyweight, corrosion, and so on. This work aims to develop a jute epoxy composite to investigate its feasibility to use as a composite bone plate. In this work, the natural fiber-based composite made of jute extracted from the jute plant and epoxy resin obtained from LAPOX® METALAM - B is studied experimentally. The mechanical properties such as tensile, compressive, and bending strength of jute/epoxy composite were measured using the universal testing machine (UTM). Moisture absorption test and scanning electron microscope (SEM) image analysis were also performed. The preliminary results suggest that the jute/epoxy composite could be a potential material for a composite bone plate. However, further detailed studies are required to confirm its applicability as a composite bone plate.
Thermo-elastic Characteristics of Thermal Barrier Coating in a Gas Turbine Combustion Chamber with an Intermediate FGM Layer
Authors: Sultana Afsana , Alam Md Ahad Bin , Ali Md Afsar
Published: April 2024

This study is focused on the analysis of thermos-elastic characteristics of a gas turbine combustion chamber, where the inner surface experiences a higher temperature while the outer region of the wall should be thermally conductive to dissipate the heat of combustion. Using a single material is not suitable to ensure the above two requirements simultaneously. Instead of using a single material, a layered combustion chamber with high-temperature material at the inner region and thermally conductive material at the outer region can be a solution. This produces the problem of a sharp interface where disbonding occurs due to high thermal stresses. The problem of sharp interface can be eliminated by using a functionally graded material (FGM) layer in between the inner and outer layers of the combustion chamber. The present study considers a gas turbine combustion chamber consisting of three layers: the inner layer is used as a thermal barrier coating, the intermediate layer is a smooth transition from the inner layer to the outer layer, and the outer layer is a thermally conductive material. ANSYS simulation is used for the analysis of thermos-elastic characteristics of the combustion chamber with homogeneous and FGM intermediate layers. The effect of linear and nonlinear material distributions in the FGM layer on the thermos-elastic characteristics is studied. A comparison of results reveals that thermal stress smoothly changes from the inner layer to the outer layer in the case of the FGM intermediate layer compared to the homogeneous intermediate layer. This suggests that a combustion chamber with an FGM intermediate layer is more reliable than a homogeneous intermediate layer.
Texture feature similarity-based roughness intelligent evaluation: a case study applied to milled surfaces
Authors: Man Tianxue , Zhou Yuqing , Sun Bingtao , Ren Yan , Sun Weifang , Xiang Jiawei
Published: April 2024

Surface roughness is of great significance in maintaining mechanical performance and improving the reliability of the equipment. However, fast surface roughness evaluations that are sufficiently stable and efficient for engineering in situ use have not yet been realized. To address this issue, an image-driven roughness intelligent method is proposed in this research. By evaluating the texture similarity intelligently between the testing image and the reference image, the surface roughness of the testing image can be acquired. Firstly, with a proposed adaptive texture extraction method, the texture feature of an image can be extracted even under a complex background. Secondly, by establishing the graph structure of the texture grayscale features, the similarity between different images is evaluated. Finally, by establishing a sparrow-optimized support vector machine regression method, the mapping relationship between the similarity and the surface roughness can be acquired. The experimental results indicate that the proposed method for intelligent evaluation of roughness has superior prediction performance (the average relative prediction error of Ra and Rz are 8.8156% and 8.0571%, respectively). Therefore, this work provides a useful tool for non-contact detection of workpiece surface roughness.
Fault diagnosis of three-cylinder mud pump based on transfer learning
Authors: Yan Chang , Liu Zhiliang , Liao Feilong , Zhang Jiyang , Dai Menghang
Published: April 2024

Mud pumps serve as vital components within the circulating system of oil drilling platforms, primarily facilitating the circulation of drilling fluid. With the rapid advancement of deep learning technology, there has been a growing focus on fault diagnosis techniques for mud pumps based on deep learning methodologies. However, existing deep learning approaches often struggle with fault diagnosis of mud pumps under varying operational conditions, as adjustments to the working conditions are necessary in real-time based on drilling depth. To address this challenge, this study introduces an enhanced transfer learning method for diagnosing faults in mud pumps across different operating conditions. Initially, the collected vibration data undergoes resampling to standardize frequency, followed by the utilization of the short-term autocorrelation method to discern phase information of signal impact. Leveraging this phase information, the signal is segmented into distinct segments with uniform phases, thereby minimizing distribution discrepancies between the source and target domains. Subsequently, the transformer is employed as a feature extractor for the model. Finally, a deep sub-domain adaptation network is employed to facilitate transfer from the source domain to the target domain. Validation of the proposed method was conducted using an experimental dataset, with results demonstrating its efficacy compared to other contemporary approaches.
Introduction
Authors: Brinkmann Matthias
Published: April 2024

This introductory chapter describes the main lines of the book’s argument. Extant theories of political legitimacy, resting on consent, democracy, or public justification, are unpersuasive. Instead, we should move towards a liberal instrumentalist view, on which political institutions are legitimate if they promote justice best. Conceptually, legitimacy ought to be distinguished from authority and political obligation and defined as the permissibility of exercising power. Methodologically, we should be sceptical of appeal to intuition when thinking about political legitimacy, and approach the topic with a mixture of revisionist and preservationist attitudes. The chapter ends with a summary of the book.
An Abstract Theory of Justice
Authors: Brinkmann Matthias
Published: April 2024

This chapter outlines an abstract theory of justice which forms the basis of the instrumentalist view defended in the rest of the book. The theory is based on two foundational features of individuals, their welfare and their dignity. These features contribute to the hybrid structure of the resulting theory of justice, which recognizes both constraints (actions that should never be done) and aims (outcomes that we should try to bring about). The chapter sketches the outlines of an argument why, on this theory of justice, substantive components of justice will be more important than procedural components.
In their own words: a qualitative survey of healthcare providers’ experiences with personal protective equipment during the COVID-19 pandemic
Authors: Becene Iris , Shah Aarushi , Nguyen Katie , West Madeline , Berrill Jane , Stuart Jennifer , Borba Christina , Rich-Edwards Janet
Published: April 2024

Background

At the beginning of the coronavirus disease (COVID-19) pandemic, healthcare personnel (HCP) faced a dire shortage of personal protective equipment (PPE). This shortage has been identified as a major source of distress among HCP during the early COVID-19 pandemic, though the specific consequences of this shortage have not been identified in the qualitative literature.

Methods

We sought to fill this gap by conducting a qualitative analysis of PPE related free-text comments from online surveys completed by 923 HCP during Spring 2020.

Results

We found that HCP used words such as “required” and “had” to describe how their use of non-standard PPE was imposed on them by their workplace, suggesting that they felt little control over their protection at work. HCP described cleaning PPE with novel methods, such as bleach, alcohol, hydrogen peroxide, and UV light, in addition to creating their own PPE out of materials such as garbage bags, sheets, and cloth. Furthermore, HCP expressed frustration with PPE policies at their workplaces, which continued throughout the early pandemic due to the rapidly changing guidelines and the inability to express their opinions to their institutions. The combination of these concerns left HCP scared of being infected with COVID-19 while at work and subsequently infecting their loved ones at home.

Conclusion

It is critical that healthcare institutions understand HCP’s experiences with and feelings towards PPE, as providing the proper protection is vital in ensuring an adequate HCP workforce.
Update on Blindness From Filler: Review of Prognostic Factors, Management Approaches, and a Century of Published Cases
Authors: Doyon Valerie C , Liu Chaocheng , Fitzgerald Rebecca , Humphrey Shannon , Jones Derek , Carruthers Jean D A , Beleznay Katie
Published: April 2024

Vision loss secondary to aesthetic filler treatment is a rare but disastrous complication. The aim of this review was to update the published cases of blindness after filler injection that have occurred since our group published reviews of 98 cases in 2015 and an additional 48 cases in 2019. A literature review was performed to identify all cases of visual complications caused by filler injection published between September 2018 and March 2023. The cases were analyzed independently and in combination with previously reviewed cases. Analyses were based on the number of cases with data available. A total of 365 new cases of partial or complete vision loss after filler injection were identified. The sites that were highest risk were the nose (40.6%), forehead (27.7%), and glabella (19.0%). The filler injected was hyaluronic acid in 79.6% of cases. The most common associated signs were ptosis (56.2%), ophthalmoplegia (44.1%), pain (31.2%), and skin changes (73.2%). Strokelike features were seen in 19.2% of cases. Of the cases reporting visual outcomes (318), 6.0% experienced complete vision recovery, 25.8% had partial improvement in visual acuity, and 68.2% had no vision recovery. Partially preserved visual acuity at onset was a significant predictor of visual improvement (P < .001). The 3 most common treatments were subcutaneous hyaluronidase at or near the filler site (70.1%), systemic steroids (57.3%), and intraarterial thrombolytic therapy (56.0%). No treatments were significantly associated with visual improvement (P > .05). Although blindness and stroke from fillers is a rare complication, practitioners who inject filler should have a thorough knowledge of prevention and management strategies.

Level of Evidence: 3
Identifying Levels of Competency in Aesthetic Medicine: A Questionnaire-based Study
Authors: Cotofana Sebastian , Mehta Tristan , Davidovic Kristina , Swift Arthur , Rohrich Rod J , Biesman Brian S , Gold Michael , Nikolis Andreas , Dayan Steven , Alfertshofer Michael
Published: April 2024

Background

In 2022, the US experienced a significant increase in demand for minimally invasive aesthetic procedures, underscoring its rising acceptance amid an unregulated educational environment for practitioners. The absence of standardized educational pathways and quality control in aesthetic medicine, primarily provided by nonacademic institutions, highlights a critical need for establishing educational standards to ensure practitioner competence and patient safety.

Objectives

The aim of this study was to identify levels of competency for the aesthetic practitioner and necessary achievement milestones during the educational path from novice to expert injector.

Methods

A total of n = 386 international study participants responded to an online questionnaire regarding their experience in aesthetic medicine practice. The questionnaire comprised 58 questions focusing on professional data, the perceived difficulty of injection, and risk for the occurrence of adverse events for specific facial regions in soft tissue filler and toxin injections.

Results

Regardless of medical specialty and experience level, averages of 3.85 (1.8) years, 786.4 (2628) filler injections and 549.9 (1543) toxin injections were estimated to progress from novice to advanced injector, while averages of 6.10 (3.7) years, 1842.2 (4793) filler injections, and 1308.5 (3363) toxin injections were estimated to advance from advanced to expert injector. The nose and the perioral region have been ranked as the facial regions where it is most difficult to achieve a perfect aesthetic outcome and with the greatest risk for the occurrence of adverse events for filler and toxin injections, respectively.

Conclusions

In this study we establish an educational framework in aesthetic medicine by defining the progression from novice to competent and expert injector levels, suggesting 4 years of practice and over 790 filler and 550 neuromodulator injections for competence, and at least 6 years with 1840 filler and 1310 neuromodulator injections for expertise. We also identify critical facial regions for targeted treatments by different expertise levels.

Level of Evidence: 4
Mark4 ablation attenuates pathological phenotypes in a mouse model of tauopathy
Authors: Sultanakhmetov Grigorii , Limlingan Sophia Jobien M , Fukuchi Aoi , Tsuda Keisuke , Suzuki Hirokazu , Kato Iori , Saito Taro , Weitemier Adam Z , Ando Kanae
Published: April 2024

Accumulation of abnormally phosphorylated tau proteins is linked to various neurodegenerative diseases, including Alzheimer’s disease and frontotemporal dementia. Microtubule affinity-regulating kinase 4 (MARK4) has been genetically and pathologically associated with Alzheimer’s disease and reported to enhance tau phosphorylation and toxicity in Drosophila and mouse traumatic brain-injury models but not in mammalian tauopathy models. To investigate the role of MARK4 in tau-mediated neuropathology, we crossed P301S tauopathy model (PS19) and Mark4 knockout mice. We performed behaviour, biochemical and histology analyses to evaluate changes in PS19 pathological phenotype with and without Mark4. Here, we demonstrated that Mark4 deletion ameliorated the tau pathology in a mouse model of tauopathy. In particular, we found that PS19 with Mark4 knockout showed improved mortality and memory compared with those bearing an intact Mark4 gene. These phenotypes were accompanied by reduced neurodegeneration and astrogliosis in response to the reduction of pathological forms of tau, such as those phosphorylated at Ser356, AT8-positive tau and thioflavin S-positive tau. Our data indicate that MARK4 critically contributes to tau-mediated neuropathology, suggesting that MARK4 inhibition may serve as a therapeutic avenue for tauopathies.
Investigating the brain’s neurochemical profile at midlife in relation to dementia risk factors
Authors: Dounavi Maria-Eleni , McKiernan Elizabeth , Langsen Michael , Gregory Sarah , Muniz-Terrera Graciela , Prats-Sedano Maria Angeles , Mada Marius Ovidiu , Williams Guy B , Lawlor Brian , Naci Lorina , Mackay Clare , Koychev Ivan , Malhotra Paresh , Ritchie Karen , Ritchie Craig W , Su Li , Waldman Adam D , O’ Brien John T
Published: April 2024

Changes in the brain’s physiology in Alzheimer’s disease are thought to occur early in the disease’s trajectory. In this study our aim was to investigate the brain’s neurochemical profile in a midlife cohort in relation to risk factors for future dementia using single voxel proton magnetic resonance spectroscopy. Participants in the multi-site PREVENT-Dementia study (age range 40–59 year old) underwent 3T magnetic resonance spectroscopy with the spectroscopy voxel placed in the posterior cingulate/precuneus region. Using LCModel, we quantified the absolute concentrations of myo-inositol, total N-acetylaspartate, total creatine, choline, glutathione and glutamate-glutamine for 406 participants (mean age 51.1; 65.3% female). Underlying partial volume effects were accounted for by applying a correction for the presence of cerebrospinal fluid in the magnetic resonance spectroscopy voxel. We investigated how metabolite concentrations related to apolipoprotein ɛ4 genotype, dementia family history, a risk score (Cardiovascular Risk Factors, Aging and Incidence of Dementia -CAIDE) for future dementia including non-modifiable and potentially-modifiable factors and dietary patterns (adherence to Mediterranean diet). Dementia family history was associated with decreased total N-acetylaspartate and no differences were found between apolipoprotein ɛ4 carriers and non-carriers. A higher Cardiovascular Risk Factors, Aging, and Incidence of Dementia score related to higher myo-inositol, choline, total creatine and glutamate-glutamine, an effect which was mainly driven by older age and a higher body mass index. Greater adherence to the Mediterranean diet was associated with lower choline, myo-inositol and total creatine; these effects did not survive correction for multiple comparisons. The observed associations suggest that at midlife the brain demonstrates subtle neurochemical changes in relation to both inherited and potentially modifiable risk factors for future dementia.
A model of ionization-induced reactions in CH4/N2 clusters in Titan's atmosphere: theoretical insights into mono- and divalent states
Authors: Matsubara Toshiaki
Published: April 2024

We propose a model for ionization-induced reactions between N2 and CH4, the main components of Titan's atmosphere, and examine their mechanism using quantum mechanical and molecular dynamics methods. Bimolecular CH4–N2 clusters form through collision, and their conformation depends on the encounter cross section due to weak intermolecular interaction. These clusters acquire a driving force through vertical ionization because the vertically ionized structure is not situated at the minimum of the potential energy surface in the ionized state. This leads to multiple reactions, overcoming energy barriers in the process. In the divalent state, a robust attractive interaction occurs between CH4 and N2 through charge transfer. Subsequently, the H4C–N2 covalent bond forms prior to reactions, resulting in the production of N2H+, CH3+, CH3N2+, and CH2N2+; otherwise only N2H+, CH3+, and CH2+ are generated. In contrast, when ionized to a monovalent state, although dissociation of N2H+ and isomerization to CH3NHN+ and CH3NNH+ occurs, a significant portion dissociates into CH4+ and N2 without undergoing further reactions. Additionally, the generation of N2H+ and CH3+ is limited in the monovalent state, primarily due to a lower driving force and the absence of Coulombic explosion. Our computational results highlight the pivotal role of divalent reactions within Titan's atmosphere, which are more efficient than monovalent reactions.
Investigating the different mechanisms in related neural activities: a focus on auditory perception and imagery
Authors: Gu Jin , Deng Kexin , Luo Xiaoqi , Ma Wanli , Tang Xuegang
Published: April 2024

Neuroimaging studies have shown that the neural representation of imagery is closely related to the perception modality; however, the undeniable different experiences between perception and imagery indicate that there are obvious neural mechanism differences between them, which cannot be explained by the simple theory that imagery is a form of weak perception. Considering the importance of functional integration of brain regions in neural activities, we conducted correlation analysis of neural activity in brain regions jointly activated by auditory imagery and perception, and then brain functional connectivity (FC) networks were obtained with a consistent structure. However, the connection values between the areas in the superior temporal gyrus and the right precentral cortex were significantly higher in auditory perception than in the imagery modality. In addition, the modality decoding based on FC patterns showed that the FC network of auditory imagery and perception can be significantly distinguishable. Subsequently, voxel-level FC analysis further verified the distribution regions of voxels with significant connectivity differences between the 2 modalities. This study complemented the correlation and difference between auditory imagery and perception in terms of brain information interaction, and it provided a new perspective for investigating the neural mechanisms of different modal information representations.
Localizing apraxia in corticobasal syndrome: a morphometric MRI study
Authors: Constantinides Vasilios C , Paraskevas George P , Velonakis Georgios , Stefanis Leonidas , Kapaki Elisabeth
Published: April 2024

Apraxia localization has relied on voxel-based, lesion-symptom mapping studies in left hemisphere stroke patients. Studies on the neural substrates of different manifestations of apraxia in neurodegenerative disorders are scarce. The primary aim of this study was to look into the neural substrates of different manifestations of apraxia in a cohort of corticobasal syndrome patients (CBS) by use of cortical thickness. Twenty-six CBS patients were included in this cross-sectional study. The Goldenberg apraxia test (GAT) was applied. 3D-T1-weighted images were analyzed via the automated recon-all Freesurfer version 6.0 pipeline. Vertex-based multivariate General Linear Model analysis was applied to correlate GAT scores with cortical thickness. Deficits in imitation of meaningless gestures correlated with bilateral superior parietal atrophy, extending to the angular and supramarginal gyri, particularly on the left. Finger imitation relied predominantly on superior parietal lobes, whereas the left angular and supramarginal gyri, in addition to superior parietal lobes, were critical for hand imitation. The widespread bilateral clusters of atrophy in CBS related to apraxia indicate different pathophysiological mechanisms mediating praxis in neurodegenerative disorders compared to vascular lesions, with implications both for our understanding of praxis and for the rehabilitation approaches of patients with apraxia.
Forecasting Hepatitis C Virus Status for Children in the United States: A Modeling Study
Authors: Hood Robert B , Norris Alison H , Shoben Abigail , Miller William C , Harris Randall E , Pomeroy Laura W
Published: April 2024

Background

Virtually all cases of hepatitis C virus (HCV) infection in children in the United States occur through vertical transmission, but it is unknown how many children are infected. Cases of maternal HCV infection have increased in the United States, which may increase the number of children vertically infected with HCV. Infection has long-term consequences for a child's health, but treatment options are now available for children ≥3 years old. Reducing HCV infections in adults could decrease HCV infections in children.

Methods

Using a stochastic compartmental model, we forecasted incidence of HCV infections in children in the United States from 2022 through 2027. The model considered vertical transmission to children <13 years old and horizontal transmission among individuals 13–49 years old. We obtained model parameters and initial conditions from the literature and the Centers for Disease Control and Prevention's 2021 Viral Hepatitis Surveillance Report.

Results

Model simulations assuming direct-acting antiviral treatment for children forecasted that the number of acutely infected children would decrease slightly and the number of chronically infected children would decrease even more. Alone, treatment and early screening in individuals 13–49 years old reduced the number of forecasted cases in children and, together, these policy interventions were even more effective.

Conclusions

Based on our simulations, acute and chronic cases of HCV infection are remaining constant or slightly decreasing in the United States. Improving early screening and increasing access to treatment in adults may be an effective strategy for reducing the number of HCV infected children in the United States.
The efficacy and safety of tacrolimus in treating refractory IgA vasculitis nephritis: a single-center retrospective study on 16 cases
Authors: Gan Yueheng , Chen Jiahuan , Wang Mo , Li Qiu , Wang Anshuo , Yang Haiping
Published: April 2024

Background

This study aimed to observe the efficacy and safety of tacrolimus in the treatment of refractory immunoglobulin A vasculitis nephritis (IgAVN).

Methods

Sixteen patients with IgAVN who had been previously treated with cyclophosphamide shock therapy at least five times, some of whom had also received mycophenolate but still had persistent proteinuria, were enrolled. The clinical and pathological data were collected and analysed.

Results

The average (mean ± standard deviation) age at the initial assessment for the group of 16 patients was 10 ± 2.7 years. Finally, at the end of their respective follow-up time point, 6 of the 16 patients achieved complete remission (37.5%), 5 achieved partial remission (31.2%), and 5 had no remission (31.2%). A significant difference was found in the median proteinuria before and after a 6-month course of tacrolimus treatment [19.2 (11.2, 31.9) vs 7.8 (4.3, 13.9) mg/kg/day] (P < .05). During the first 6 months of tacrolimus treatment, all patients’ estimated glomerular filtration rate levels remained normal. The mean tacrolimus blood concentration was 6.0 ± 2.6 ng/mL. The median prednisone dosage was decreased from 10 mg/day to 5 mg/day, and prednisone was eventually stopped in three individuals. No drug-related adverse effects were observed during treatment.

Conclusions

Tacrolimus has demonstrated efficacy in increasing remission rates, significantly lowering urinary protein levels, and reducing steroid use in children with refractory IgAVN. Further research is required to investigate its optimal blood concentrations, long-term effects and renoprotective properties.
Prosthetic valve infective endocarditis with severe mitral stenosis caused by Cutibacterium acnes: a case report
Authors: Bando Gakuto , Okada Taiji , Tsubota Hideki , Furukawa Yutaka
Published: April 2024

Background

Infective endocarditis rarely results in mitral stenosis. This report presents a case of prosthetic valve infective endocarditis caused by Cutibacterium acnes infection, which resulted in mitral stenosis and was difficult to diagnose.

Case summary

A 78-year-old Japanese man underwent aortic and mitral bioprosthetic valve replacement six years prior to the initiation of hormone therapy for prostate cancer. Three weeks after hormone therapy initiation, the patient developed exertional dyspnoea that progressively worsened and ultimately led to orthopnoea. Chest radiography revealed pulmonary congestion, and transthoracic echocardiography revealed mitral stenosis that was not present three months previously. The patient progressed to heart failure, and bicuspid valve replacement was performed. The excised aortic and mitral bioprosthetic valves were covered with vegetations, and pathological examination confirmed the presence of C. acnes. Therefore, the cause of mitral stenosis was infective endocarditis.

Discussion

In patient with rapidly progressive prosthetic valve stenosis after valve replacement, infective endocarditis due to C. acnes should be suspected even if blood cultures are negative.
The new 2023 ESC guidelines for the management of cardiomyopathies: a guiding path for cardiologist decisions
Authors: Grasso Maurizia , Bondavalli Davide , Vilardo Viviana , Cavaliere Claudia , Gatti Ilaria , Di Toro Alessandro , Giuliani Lorenzo , Urtis Mario , Ferrari Michela , Cattadori Barbara , Serio Alessandra , Pellegrini Carlo , Arbustini Eloisa
Published: April 2024

In the ESC 2023 guidelines, cardiomyopathies are conservatively defined as ‘myocardial disorders in which the heart muscle is structurally and functionally abnormal, in the absence of coronary artery disease, hypertension, valvular disease, and congenital heart disease sufficient to cause the observed myocardial abnormality’. They are morpho-functionally classified as hypertrophic, dilated, restrictive, and arrhythmogenic right ventricular cardiomyopathy with the addition of the left ventricular non-dilated cardiomyopathy that describes intermediate phenotypes not fulfilling standard disease definitions despite the presence of myocardial disease on cardiac imaging or tissue analysis. The new ESC guidelines provide ‘a guide to the diagnostic approach to cardiomyopathies, highlight general evaluation and management issues, and signpost the reader to the relevant evidence base for the recommendations’. The recommendations and suggestions included in the document provide the tools to build up pathways tailored to specific cardiomyopathy (phenotype and cause) and define therapeutic indications, including target therapies where possible. The impact is on clinical cardiology, where disease-specific care paths can be assisted by the guidelines, and on genetics, both clinics and testing, where deep phenotyping and participated multi-disciplinary evaluation provide a unique tool for validating the pathogenicity of variants. The role of endomyocardial biopsy remains underexploited and confined to particular forms of restrictive cardiomyopathy, myocarditis, and amyloidosis. New research and development will be needed to cover the gaps between science and clinics. Finally, the opening up to disciplines such as bioinformatics, bioengineering, mathematics, and physics will support clinical cardiologists in the best governance of the novel artificial intelligence–assisted resources.
Unlocking the enigma: decoding premature ventricular complexes for effective clinical assessment and risk management
Authors: Calo' Leonardo , Tatangelo Mario , Panattoni Germana , Crescenzi Cinzia , Squeglia Marianna , Fanisio Francesca , Romeo Fabiana , Toto Federica , de Ruvo Ermenegildo , Rebecchi Marco
Published: April 2024

The identification of ventricular premature complexes during a cardiological evaluation necessitates the implementation of diagnostic processes aimed at discerning the clinical context that may predispose individuals to a high risk of sudden cardiac death. Epidemiological studies reveal that ventricular premature beats occur in approximately 75% of healthy (or seemingly healthy) individuals, as long as there is no evidence of underlying structural heart disease, such as benign idiopathic ventricular extrasystole originating from the right and left ventricular outflow tracts. In the real world, however, ventricular ectopic beats with morphologies very similar to seemingly benign occurrences are not uncommon. They are notable in subjects exhibiting rapid and complex repetitive forms during exercise testing and Holter electrocardiogram. Additionally, these subjects may display more or less extensive scarring signs on cardiac magnetic resonance and may have a family history of cardiomyopathy and/or sudden cardiac death. Therefore, the purpose of this review is to critically analyse the process of evaluating premature ventricular complexes, which is crucial for accurate risk stratification. The latter cannot overlook some inevitable elements, including morphology, origin, complexity, and the associated clinical setting (absence or presence of structural heart disease).
Efficacy of cryoablation in atrial fibrillation: comparison with antiarrhythmic therapy
Authors: Magnani Silvia , Cappato Riccardo
Published: April 2024

Atrial fibrillation (AF) represents the most common arrhythmia in clinical practice, characterized by irregular atrial electrical activity originating mainly in and around the pulmonary veins. This condition can manifest itself symptomatically or silently but still dangerously. Complications associated with AF include stroke, heart failure, worst clinical outcome in patients with underlying conditions, increased emergency room visits, hospitalizations, and cardiovascular mortality. Currently, according to the main international guidelines, antiarrhythmic therapy is considered the first choice for rhythm control in patients with AF despite modest efficacy and non-negligible side effects. In recent decades, radiofrequency catheter ablation has emerged as an alternative to antiarrhythmic drugs for rhythm control. Cryoablation was developed with the aim of reducing procedural times and reducing complications related to the ablative procedure with radiofrequency without losing efficacy. Recent studies conducted with rigour and scientific solidity have demonstrated on the one hand that the results of this technique are not inferior compare with radiofrequency. This study aims to compare data on the safety and efficacy of cryoablation with those obtained from antiarrhythmic drugs through a review of the most recent scientific evidence.
Is the response to antihypertensive drugs heterogeneous? Rationale for personalized approach
Authors: Muselli Mario , Bocale Raffaella , Necozione Stefano , Desideri Giovambattista
Published: April 2024

Arterial hypertension represents the most important cardiovascular risk factor with a direct responsibility for a large share of cardiovascular mortality and morbidity in the world. Despite the wide availability of antihypertensive therapies with documented effectiveness, blood pressure control still remains largely unsatisfactory in large segments of the population. Guidelines for the management of arterial hypertension suggest the preferential use of five classes of drugs—angiotensin-converting enzyme inhibitors, angiotensin II type I receptor inhibitors, calcium channel blockers, thiazide/thiazide-like diuretics, and beta-blockers—recommending the use of combination therapy, preferably in pre-established combinations, for the majority of hypertensive patients. The evidence of a non-negligible heterogeneity in the response to different antihypertensive drugs in different patients suggests the opportunity for personalization of treatment. The notable phenotypic heterogeneity of the population of hypertensive patients in terms of genetic structure, behavioural aspects, exposure to environmental factors, and disease history imposes the need to consider all the potential determinants of the response to a specific pharmacological treatment. The progressive digitalization of healthcare systems is making enormous quantities of data available for machine learning systems which will allow the development of management algorithms for truly personalized antihypertensive therapy in the near future.
A comparative experimental study on the collection and analysis of DNA samples from under fingernail material
Authors: Yüksel Elif , Karadayı Sukriye , Ozbek Tulin , Karadayı Beytullah
Published: April 2024

In cases of murder and rape where there is physical contact between the perpetrator and the victim, analysis of the victim’s nail material is quite valuable. Although it is possible that the foreign DNA detected in the fingernail material does not belong to the perpetrator of the incident, ıf it belongs to the perpetrator of the incident, it may provide useful findings for solve the incident. Fingernail material collected after the incident often contains resulting in mixed DNA. The efficiency of sample collection procedures is of particular importance, as this process may pose some problems in the interpretation of autosomal STR analyses used for the identification of the individual or individuals. The aim of this study is to compare 3 different fingernail material collection procedures (thick-tipped swabbing and thin-tipped swabbing and nail clipping) to determine the most efficient sample collection procedure and to contribute to routine investigations to identify the assailant in forensic cases. In our study, under fingernail material was collected from 12 volunteer couples by three different methods. To help comparing the efficiency of the three different methods, the profiles obtained were classified based on the number of female and men alleles detected. Obtained STR profiles, while nail clipping yielded 58.3% (n:7) ‘High level DNA mixture’ as a profile containing 12 or more than 12 female alleles, 75% (n:9) of the samples taken with cotton-toothpick swabs (thin-tipped) yielded ‘Full Male Profile’. In conclusion, our study shows that cotton toothpick swabs (thin-tipped) are the most efficient method for determining the male DNA profile among three different fingernail material collection procedures. We suggest that using thin-tipped swabs produced in a specific standard instead of the commonly used size swabs that are frequently used in routine crime investigations to identify perpetrator from fingernail material may improve efficiency of processing the nails and evaluation of the evidence.
A reference quality genome assembly for the jewel scarab Chrysina gloriosa
Authors: Sylvester Terrence , Hoover Zachary , Hjelmen Carl E , Jonika Michelle M , Blackmon Leslie T , Alfieri James M , Johnston J Spencer , Chien Sean , Esfandani Tahmineh , Blackmon Heath
Published: April 2024

The jewel scarab Chrysina gloriosa is one of the most charismatic beetles in the United States and is found from the mountains of West Texas to the Southeastern Arizona sky islands. This species is highly sought by professional and amateur collectors worldwide due to its gleaming metallic coloration. However, the impact of the large-scale collection of this beetle on its populations is unknown, and there is a limited amount of genetic information available to make informed decisions about its conservation. As a first step, we present the genome of C. gloriosa, which we reconstructed using a single female specimen sampled from our ongoing effort to document population connectivity and the demographic history of this beetle. Using a combination of long-read sequencing and Omni-C data, we reconstructed the C. gloriosa genome at a near-chromosome level. Our genome assembly consisted of 454 scaffolds spanning 642 MB, with the 10 largest scaffolds capturing 98% of the genome. The scaffold N50 was 72 MB, and the BUSCO score was 95.5%. This genome assembly will be an essential tool to accelerate understanding C. gloriosa biology and help make informed decisions for the conservation of Chrysina and other species with similar distributions in this region. This genome assembly will further serve as a community resource for comparative genomic analysis.
Animal models of inflammatory bowel disease: category and evaluation indexes
Authors: Wen Changlin , Chen Dan , Zhong Rao , Peng Xi
Published: April 2024

Inflammatory bowel disease (IBD) research often relies on animal models to study the etiology, pathophysiology, and management of IBD. Among these models, rats and mice are frequently employed due to their practicality and genetic manipulability. However, for studies aiming to closely mimic human pathology, non-human primates such as monkeys and dogs offer valuable physiological parallels. Guinea pigs, while less commonly used, present unique advantages for investigating the intricate interplay between neurological and immunological factors in IBD. Additionally, New Zealand rabbits excel in endoscopic biopsy techniques, providing insights into mucosal inflammation and healing processes. Pigs, with their physiological similarities to humans, serve as ideal models for exploring the complex relationships between nutrition, metabolism, and immunity in IBD. Beyond mammals, non-mammalian organisms including zebrafish, Drosophila melanogaster, and nematodes offer specialized insights into specific aspects of IBD pathology, highlighting the diverse array of model systems available for advancing our understanding of this multifaceted disease. In this review, we conduct a thorough analysis of various animal models employed in IBD research, detailing their applications and essential experimental parameters. These include clinical observation, Disease Activity Index score, pathological assessment, intestinal barrier integrity, fibrosis, inflammatory markers, intestinal microbiome, and other critical parameters that are crucial for evaluating modeling success and drug efficacy in experimental mammalian studies. Overall, this review will serve as a valuable resource for researchers in the field of IBD, offering insights into the diverse array of animal models available and their respective applications in studying IBD.
Antimicrobial stewardship markers and healthcare-associated pneumonia threshold criteria in UK hospitals: analysis of the MicroGuideTm application
Authors: Moore Luke S P , Baltas Ioannis , Amos James , Cooray Mineli , Hughes Stephen , Freeman Rachel , Ashfield Tom
Published: April 2024

Background

To address antimicrobial resistance, antimicrobial stewardship (AMS) principles must be implemented and adhered to. Clinical decision aids such as the MicroGuideTM app are an important part of these efforts. We sought to evaluate the consistency of core AMS information and the diversity of classification thresholds for healthcare-associated pneumonia (HAP) in the MicroGuide app.

Methods

Guidelines in the MicroGuide app were extracted and analysed for content related to AMS and HAP. Guidelines were characterized according to HAP naming classification; community-acquired pneumonia (CAP) classifications were analysed to serve as a comparator group.

Results

In total, 115 trusts (119 hospitals) were included. Nearly all hospitals had developed MicroGuide sections on AMS (n = 112/119, 94%) and sepsis management (n = 117/119, 98%). Other AMS sections were outpatient parenteral antimicrobial therapy (47%), antifungal stewardship (70%), critical care (23%) and IV to oral switch therapy (83%). Only 9% of hospitals included guidance on the maximum six key AMS sections identified. HAP definitions varied widely across hospitals with some classifying by time to onset and some classifying by severity or complexity. The largest proportion of HAP guidelines based classification on severity/complexity (n = 69/119, 58%). By contrast, definitions in CAP guidelines were uniform.

Conclusions

The high heterogeneity in HAP classification identified suggests inconsistency of practice in identifying thresholds for HAP in the UK. This complicates HAP management and AMS practices. To address HAP in alignment with AMS principles, a comprehensive strategy that prioritizes uniform clinical definitions and thresholds should be developed.