bluuebunny/crossref_metadata_2025 huggingface dataset:
Properties and Degradation of Novel Fully Biodegradable PLA/PHB Blends Filled with Keratin
Authors: Mosnáčková Katarína , Opálková Šišková Alena , Kleinová Angela , Danko Martin , Mosnáček Jaroslav
Published: December 2020

The utilization of keratin waste in new materials formulations can prevent its environmental disposal problem. Here, novel composites based on biodegradable blends consisting of poly(lactic acid) (PLA) and poly(3-hydroxybutyrate) (PHB), and filled with hydrolyzed keratin with loading from 1 to 20 wt % were prepared and their properties were investigated. Mechanical and viscoelastic properties were characterized by tensile test, dynamic mechanical thermal analysis (DMTA) and rheology measurements. The addition of acetyltributyl citrate (ATBC) significantly affected the mechanical properties of the materials. It was found that the filled PLA/PHB/ATBC composite at the highest keratin loading exhibited similar shear moduli compared to the un-plasticized blend as a result of the much stronger interactions between the keratin and polymer matrix compared to composites with lower keratin content. The differences in dynamic moduli for PLA/PHB/ATBC blend filled with keratin depended extensively on the keratin content while loss the factor values progressively decreased with keratin loading. Softening interactions between the keratin and polymer matrix resulted in lower glass transitions temperature and reduced polymer chain mobility. The addition of keratin did not affect the extent of degradation of the PLA/PHB blend during melt blending. Fast hydrolysis at 60 °C was observed for composites with all keratin loadings. The developed keratin-based composites possess properties comparable to commonly used thermoplastics applicable for example as packaging materials.
Chronic Kidney Disease-Associated Inflammation Increases the Risks of Acute Kidney Injury and Mortality after Cardiac Surgery
Authors: Casas Angela , Mallén Adrián , Blasco-Lucas Arnau , Sbraga Fabrizio , Guiteras Jordi , Bolaños Núria , Castaño Esther , Torras Joan , Cruzado Josep M. , Navarro Estanislao , Hueso Miguel
Published: December 2020

Cardiovascular mortality increases with decreasing renal function although the cause is yet unknown. Here, we have investigated whether low chronic inflammation in chronic kidney diseases (CKD) could contribute to increased risk for coronary artery diseases (CAD). Thus, a prospective case–control study was conducted in patients with CAD and CKD undergoing coronary artery bypass graft surgery with the aim of detecting differences in cardiovascular outcomes, epicardial adipose tissue volume, and inflammatory marker activity associated with renal dysfunction. Expression of membrane CD14 and CD16, inflammatory cytokines and chemokines, mitogen-activated protein (MAP) kinases and hsa-miR-30a-5p were analyzed in peripheral blood mononuclear cells (PBMCs). Epicardial fat volume and tissue inflammation in perivascular adipose tissue and in the aorta were also studied. In the present study, 151 patients were included, 110 with CAD (51 with CKD) and 41 nonCAD controls (15 with CKD). CKD increased the risk of cardiac surgery–associated acute kidney injury (CSA-AKI) as well as the 30-day mortality after cardiac surgery. Higher counts of CD14++CD16+ monocytes were associated with vascular inflammation, with an increased expression of IL1β, and with CKD in CAD patients. Expression of hsa-miR-30a-5p was correlated with hypertension. We conclude that CKD patients show an increased risk of CSA-AKI and mortality after cardiovascular surgery, associated with the expansion of the CD14++CD16+ subset of proinflammatory monocytes and with IL1β expression. We propose that inflammation associated with CKD may contribute to atherosclerosis (ATH) pathogenesis.
Telocytes/CD34+ Stromal Cells in Pathologically Affected White Adipose Tissue
Authors: Díaz-Flores Lucio , Gutiérrez Ricardo , García Ma Pino , González-Gómez Miriam , Carrasco Jose Luís , Alvarez-Argüelles Hugo , Díaz-Flores Lucio
Published: December 2020

We studied telocytes/CD34+ stromal cells (TCs/CD34+SCs) in pathologically affected white adipose tissue after briefly examining them in normal fat. To this aim, we reviewed pathological processes, including original contributions, in which TCs/CD34+SCs are conserved, increased, and lost, or acquire a specific arrangement. The pathologic processes in which TCs/CD34+SCs are studied in adipose tissue include inflammation and repair through granulation tissue, iatrogenic insulin-amyloid type amyloidosis, non-adipose tissue components (nerve fascicles and fibres in neuromas and hyperplastic neurogenic processes) and tumours (signet ring carcinoma with Krukenberg tumour and colon carcinoma) growing in adipose tissue, adipose tissue tumours (spindle cell lipoma, dendritic fibromyxolipoma, pleomorphic lipoma, infiltrating angiolipoma of skeletal muscle and elastofibrolipoma), lipomatous hypertrophy of the interatrial septum, nevus lipomatosus cutaneous superficialis of Hoffman–Zurhelle and irradiated adipose tissue of the perirectal and thymic regions. Two highly interesting issues emerged: (1) whether the loss of CD34 expression in TCs/CD34+SCs is by changes in marker expression or the disappearance of these cells (the findings suggest the first possibility) and (2) whether in some invasive and metastatic malignant tumours, TCs/CD34+SCs that completely surround neoplastic cells act as nurse and/or isolating cells. Further studies are required on adipose tissue TCs/CD34+SCs, mainly in lipomatosis and obesity.
Effect of Severe External Airborne Agents’ Exposure on Dementia
Authors: Lee Seunghyun , Choi Joon Yul , Yoon Jin-Ha , Lee Wanhyung
Published: December 2020

The impact of occupational and environmental exposure to external airborne agents on cognitive function, especially in incidence of dementia, is understudied. The present study was conducted to elucidate the association between severe external airborne agents’ exposure and incidence of dementia among an elderly population and to explore the effects of exposure to severe external airborne agents on preclinical dementia using the screening test of dementia. From the National Health Insurance Service-Health Screening Cohort (NHIS-HealS, 2002–2015), 514,580 participants were used for data analysis. We estimated the standardized incidence ratio (SIR) according to the exposure to external airborne agents. Of the total participants (n = 514,580), 1340 (0.3%) experienced severe external airborne agents exposure, and 26,050 (5.1%) had been diagnosed with dementia. The SIRs (95%CI) of dementia in Alzheimer’s disease, vascular dementia, dementia in other diseases, and unspecific dementia were 1.24 (1.01–1.49), 0.88 (0.37–1.32), 1.16 (0.01–2.77), and 0.69 (0.36–1.02), respectively. The risk of testing positive in the dementia screening significantly increased with exposure to severe external airborne agents after adjusting for all confounding variables. This study found that exposure to severe external airborne agents is a potential risk factor for dementia, especially in Alzheimer’s disease. It is essential to create international awareness regarding the effect of airborne agents’ exposure on dementia.
Pulmonary Arterial Hypertension Associated with Congenital Heart Disease in Adults over the Age of 40 Years
Authors: Maurer Susanne J. , Stöckemann Katharina , Pujol Claudia , Hörer Jürgen , Ewert Peter , Tutarel Oktay
Published: December 2020

Background: Pulmonary arterial hypertension associated with adult congenital heart disease (PAH-ACHD) leads to significant mortality at a young age. Risk factors for a negative outcome in older adults are lacking. Methods: PAH-ACHD patients ≥ 40 years of age under active follow-up between January 2005 and December 2018 were included. Demographic data, as well as medical/surgical history, were retrieved from hospital records. The primary end-point was all-cause mortality. Results: In total, 65 patients (67.7% female, mean age 45.19 ± 6.75 years) were included. Out of these, 46 (70.8%) had a shunt lesion, 12 (18.5%) had PAH associated with complex congenital heart defects, and 7 (10.8%) had segmental pulmonary hypertension due to major aorto-pulmonary collaterals. Down syndrome was present in 13 patients (20.0%). During a median follow-up of 4.2 years (IQR 1.2–7.5), 16 patients (24.6%) died. On univariate analysis, NT-proBNP (log), creatinine, and a previous history of ventricular arrhythmias were predictors of all-cause mortality. Upon multivariate analysis, NT-proBNP (log) (HR: 4.1, 95% CI: 1.2–14.4, p = 0.029) and creatinine (HR: 16.3, 95% CI: 2.2–118.7, p = 0.006) remained as independent predictors of all-cause mortality. Conclusions: PAH-ACHD patients over the age of 40 years are burdened with significant mortality, of which NT-proBNP and creatinine are independent predictors.
Intellectual Abilities of Children with Narcolepsy
Authors: Thieux Marine , Zhang Min , Marcastel Agathe , Herbillon Vania , Guignard-Perret Anne , Seugnet Laurent , Lin Jian-Sheng , Guyon Aurore , Plancoulaine Sabine , Franco Patricia
Published: December 2020

High cognitive functioning could be a protective factor for school difficulties, behavioral and mood impairments in children with narcolepsy. To investigate this factor, we studied the intellectual abilities of 74 children with narcolepsy (43 boys, 11.7 years old at diagnosis, 91% of cataplexies, 64% obese, 100% HLA positive for DR-DQB1*06:02). All children underwent a one-night polysomnography followed by Multiple Sleep Latency Tests, an evaluation of intelligence quotient (IQ), and filled standardized questionnaires. Thirty-eight percent had high potentialities (HP defined by IQ > 130) and 48% had school difficulties. Using non-parametric tests, we found that HP children reported less difficulties at school and tended to have less impulsivity, conduct, and learning disorders than those without HP. They also tended to be less obese and had less desaturation. Using a multivariate regression analysis, we found an association between the REM sleep percentage and the IQ. REM sleep could be involved in the dynamic changes contributing to the equilibrium of intellectual functioning. This study highlights that despite their frequent school difficulties, narcolepsy per se is unlikely to be a cause of intellectual disability in children. Prompt diagnosis and management of comorbidities such as obesity and obstructive sleep apnea (OSA) could improve cognitive and school performances in these children.
Affected Ovary Relative Volume: A Novel Sonographic Predictor of Ovarian Reserve in Patients with Unilateral Endometrioma—A Pilot Study
Authors: Cosma Stefano , Carosso Andrea Roberto , Moretto Martina , Borella Fulvio , Ferraioli Domenico , Bovetti Marialuisa , Gervasoni Fiammetta , Filippini Claudia , Revelli Alberto , Ferrero Simone , Benedetto Chiara
Published: December 2020

Background: The assessment of ovarian reserve in the case of endometrioma is of pivotal importance for planning a tailored management. However, both the antral follicle count (AFC) and the antimüllerian hormone (AMH) dosage are subject to a fair degree of variability in ovarian endometriosis. This study aimed to identify a sonographic parameter of ovarian reserve that could implement current available markers in patients with unilateral endometrioma. Methods: Patients with unilateral endometrioma admitted to our Endometriosis Center between March 2018 and April 2019 were enrolled. Transvaginal ultrasonography for the evaluation of eight sonographic indicators and AMH level determination were performed. The relationship between AMH level and each indicator was assessed. Results: Thirty-four women were included. There was a positive significant correlation between AMH level and the healthy ovary AFC (HO-AFC) (r = 0.36 p = 0.034). A stronger, negative correlation between AMH level and the ratio between the volume of the affected and the healthy ovary (affected ovary relative volume, AORV) (r = −0.47; p = 0.005) was evidenced. AORV had a satisfactory accuracy (AUC 0.73; CI 0.61–0.90; p = 0.0008), and the cut-off value of 5.96 had the best balance of sensitivity/specificity in distinguishing between patients with a good ovarian reserve (AMH ≥ 2 ng/mL) and those at risk of ovarian reserve depletion after excisional surgery. Conclusion: AORV may be a useful tool to assess ovarian reserve in patients with unilateral endometrioma without previous surgery and to guide physicians in clinical management.
Increased Fecal Calprotectin Is Associated with Worse Gastrointestinal Symptoms and Quality of Life Scores in Children with Cystic Fibrosis
Authors: Beaufils Fabien , Mas Emmanuel , Mittaine Marie , Addra Martin , Fayon Michael , Delhaes Laurence , Clouzeau Haude , Galode François , Lamireau Thierry , Bui Stéphanie , Enaud Raphaël
Published: December 2020

In cystic fibrosis (CF), cystic fibrosis transmembrane regulator (CFTR) dysfunction leads to digestive disorders that promote intestinal inflammation and dysbiosis enhancing gastrointestinal symptoms. In pancreatic insufficiency CF patients, both intestinal inflammation and dysbiosis, are associated with an increase in the fecal calprotectin (FC) level. However, associations between the FC level, gastrointestinal symptoms, and quality of life (QoL) remain poorly studied. We aimed to assess such associations in pancreatic insufficiency CF children. The FC level was measured in pancreatic insufficiency CF children’s stool samples. Children and their parents completed two questionnaires: The Gastrointestinal Symptoms Scales 3.0-PedsQLTM and the Quality of Life Pediatric Inventory 4.0-PedsQLTM. Lower scores indicated worse symptomatology or QoL. Thirty-seven CF children were included. A FC level above 250 µg/g was associated with worse gastrointestinal symptoms and QoL scores. The FC level was inversely correlated with several gastrointestinal scores assessed by children (i.e., Total, “Heart Burn Reflux”, “Nausea and Vomiting”, and “Gas and Bloating”). Several QoL scores were correlated with gastrointestinal scores. The FC level was weakly associated with clinical parameters. Some gastrointestinal and QoL scores were related to disease severity associated parameters. In CF, the FC level, biomarker previously related to intestinal inflammation and dysbiosis, was associated with worse digestive symptoms and QoL scores.
Identification of Markers Predicting Clinical Course in Patients with IgG4-Related Ophthalmic Disease by Unbiased Clustering Analysis
Authors: Tsubota Kinya , Usui Yoshihiko , Nemoto Rey , Goto Hiroshi
Published: December 2020

Purpose: To describe the clinical features of patients with immunoglobulin G4 (IgG4)-related ophthalmic disease (IgG4-ROD) grouped by unbiased cluster analysis using peripheral blood test data and to find novel biomarkers for predicting clinical features. Methods: One hundred and seven patients diagnosed with IgG4-ROD were divided into four groups by unsupervised hierarchical cluster analysis using peripheral blood test data. The clinical features of the four groups were compared and novel markers for prediction of clinical course were explored. Results: Unbiased cluster analysis divided patients into four groups. Group B had a significantly higher frequency of extraocular muscle enlargement (p < 0.001). The frequency of patients with decreased best corrected visual acuity (BCVA) was significantly higher in group D (p = 0.002). Receiver operating characteristic (ROC) curves for the prediction of extraocular muscle enlargement and worsened BCVA using a panel consisting of important blood test data identified by machine learning yielded areas under the curve of 0.78 and 0.86, respectively. Clinical features were compared between patients divided into two groups by the cutoff serum IgE or IgG4 level obtained from ROC curves. Patients with serum IgE above 425 IU/mL had a higher frequency of extraocular muscle enlargement (25% versus 6%, p = 0.004). Patients with serum IgG4 above 712 mg/dL had a higher frequency of decreased BCVA (37% versus 5%, p ≤ 0.001). Conclusion: Unsupervised hierarchical clustering analysis using routine blood test data differentiates four distinct clinical phenotypes of IgG4-ROD, which suggest differences in pathophysiologic mechanisms. High serum IgG4 is a potential predictor of worsened BCVA, and high serum IgE is a potential predictor of extraocular muscle enlargement in IgG4-ROD patients.
Review of Estimating Trophic Relationships by Quantitative Fatty Acid Signature Analysis
Authors: Zhang Junbo , Ren Chonglan , Zhang Hu , Yin Fang , Zhang Shuo , Wan Rong , Kitazawa Daisuke
Published: December 2020

The dynamic predator–prey relations in the food web are vital for understanding the function and structure of ecosystems. Dietary estimation is a research hotspot of quantitative ecology, providing key insights into predator–prey relationships. One of the most promising approaches is quantitative fatty acid signature analysis (QFASA), which is the first generation of statistical tools to estimate the quantitative trophic predator–prey relationships by comparing the fatty acid (FA) signatures among predators and their prey. QFASA has been continuously widely applied, refined and extended since its introduction. This article reviewed the research progress of QFASA from development and application. QFASA reflects the long-term diet of predator, and provides the quantitative dietary composition of predator, but it is sensitive to the metabolism of predator. The calibration coefficients (CCs) and the FA subset are two crucial parameters to explain the metabolism of predators, but the incorrect construction or improper use of CCs and the FA subset may cause bias in dietary estimation. Further study and refinement of the QFASA approach is needed to identify recommendations for which CCs and subsets of FA work best for different taxa and systems.
Efficacy of LAMB against Emerging Azole- and Multidrug-Resistant Candida parapsilosis Isolates in the Galleria mellonella Model
Authors: Binder Ulrike , Arastehfar Amir , Schnegg Lisa , Hörtnagl Caroline , Hilmioğlu-Polat Suleyha , Perlin David S. , Lass-Flörl Cornelia
Published: December 2020

While being the third leading cause of candidemia worldwide, numerous studies have shown severe clonal outbreaks due to fluconazole-resistant (FLCR) Candida parapsilosis isolates associated with fluconazole therapeutic failure (FTF) with enhanced mortality. More recently, multidrug resistant (MDR) C. parapsilosis blood isolates have also been identified that are resistant to both azole and echinocandin drugs. Amphotericin B (AMB) resistance is rarely reported among C. parapsilosis isolates and proper management of bloodstream infections due to FLZR and MDR isolates requires prompt action at the time of outbreak. Therefore, using a well-established Galleria mellonella model, we assessed whether (a) laboratory-based findings on azole or echinocandin (micafungin) resistance in C. parapsilosis lead to therapeutic failure, (b) LAMB could serve as an efficient salvage treatment option, and (c) distinct mutations in ERG11 impact mortality. Our in vivo data confirm fluconazole inefficacy against FLCR C. parapsilosis isolates carrying Y132F, Y132F + K143R, Y132F + G307A, and G307A + G458S in Erg11p, while LAMB proved to be an efficacious accessible option against both FLCR and MDR C. parapsilosis isolates. Moreover, positive correlation of in vitro and in vivo data further highlights the utility of G. melonella as a reliable model to investigate azole and polyene drug efficacy.
Application of a Pharmacogenetics-Based Precision Medicine Model (5SPM) to Psychotic Patients That Presented Poor Response to Neuroleptic Therapy
Authors: Carrascal-Laso Lorena , Franco-Martín Manuel Ángel , García-Berrocal María Belén , Marcos-Vadillo Elena , Sánchez-Iglesias Santiago , Lorenzo Carolina , Sánchez-Martín Almudena , Ramos-Gallego Ignacio , García-Salgado M Jesús , Isidoro-García María
Published: December 2020

Antipsychotics are the keystone of the treatment of severe and prolonged mental disorders. However, there are many risks associated with these drugs and not all patients undergo full therapeutic profit from them. The application of the 5 Step Precision Medicine model(5SPM), based on the analysis of the pharmacogenetic profile of each patient, could be a helpful tool to solve many of the problematics traditionally associated with the neuroleptic treatment. In order to solve this question, a cohort of psychotic patients that showed poor clinical evolution was analyzed. After evaluating the relationship between the prescribed treatment and pharmacogenetic profile of each patient, a great number of pharmacological interactions and pharmacogenetical conflicts were found. After reconsidering the treatment of the conflictive cases, patients showed a substantial reduction on mean daily doses and polytherapy cases, which may cause less risk of adverse effects, greater adherence, and a reduction on economic costs.
Leveraging Stack4Things for Federated Learning in Intelligent Cyber Physical Systems
Authors: De Vita Fabrizio , Bruneo Dario
Published: December 2020

During the last decade, the Internet of Things acted as catalyst for the big data phenomenon. As result, modern edge devices can access a huge amount of data that can be exploited to build useful services. In such a context, artificial intelligence has a key role to develop intelligent systems (e.g., intelligent cyber physical systems) that create a connecting bridge with the physical world. However, as time goes by, machine and deep learning applications are becoming more complex, requiring increasing amounts of data and training time, which makes the use of centralized approaches unsuitable. Federated learning is an emerging paradigm which enables the cooperation of edge devices to learn a shared model (while keeping private their training data), thereby abating the training time. Although federated learning is a promising technique, its implementation is difficult and brings a lot of challenges. In this paper, we present an extension of Stack4Things, a cloud platform developed in our department; leveraging its functionalities, we enabled the deployment of federated learning on edge devices without caring their heterogeneity. Experimental results show a comparison with a centralized approach and demonstrate the effectiveness of the proposed approach in terms of both training time and model accuracy.
Gendered Migration and Agroforestry in Indonesia: Livelihoods, Labor, Know-How, Networks
Authors: Mulyoutami Elok , Lusiana Betha , van Noordwijk Meine
Published: December 2020

Migration connects land use in areas of origin with areas of new residence, impacting both through individual, gendered choices on the use of land, labor, and knowledge. Synthesizing across two case studies in Indonesia, we focus on five aspects: (i) conditions within the community of origin linked to the reason for people to venture elsewhere, temporarily or permanently; (ii) the changes in the receiving community and its environment, generally in rural areas with lower human population density; (iii) the effect of migration on land use and livelihoods in the areas of origin; (iv) the dynamics of migrants returning with different levels of success; and (v) interactions of migrants in all four aspects with government and other stakeholders of development policies. In-depth interviews and focus group discussions in the study areas showed how decisions vary with gender and age, between individuals, households, and groups of households joining after signs of success. Most of the decision making is linked to perceived poverty, natural resource and land competition, and emergencies, such as natural disasters or increased human conflicts. People returning successfully may help to rebuild the village and its agricultural and agroforestry systems and can invest in social capital (mosques, healthcare, schools).
Social-Ecological Connectivity to Understand Ecosystem Service Provision across Networks in Urban Landscapes
Authors: Egerer Monika , Anderson Elsa
Published: December 2020

Landscape connectivity is a critical component of dynamic processes that link the structure and function of networks at the landscape scale. In the Anthropocene, connectivity across a landscape-scale network is influenced not only by biophysical land use features, but also by characteristics and patterns of the social landscape. This is particularly apparent in urban landscapes, which are highly dynamic in land use and often in social composition. Thus, landscape connectivity, especially in cities, must be thought of in a social-ecological framework. This is relevant when considering ecosystem services—the benefits that people derive from ecological processes and properties. As relevant actors move through a connected landscape-scale network, particular services may “flow” better across space and time. For this special issue on dynamic landscape connectivity, we discuss the concept of social-ecological networks using urban landscapes as a focal system to highlight the importance of social-ecological connectivity to understand dynamic urban landscapes, particularly in regards to the provision of urban ecosystem services.
Effect of Complex Road Networks on Intensive Land Use in China’s Beijing-Tianjin-Hebei Urban Agglomeration
Authors: Zeng Chen , Zhao Zhe , Wen Cheng , Yang Jing , Lv Tianyu
Published: December 2020

Coupled with rapid urbanization and urban expansion, the spatial relationship between transportation development and land use has gained growing interest among researchers and policy makers. In this paper, a complex network model and land use intensity assessment were integrated into a spatial econometric model to explore the spatial spillover effect of the road network on intensive land use patterns in China’s Beijing–Tianjin–Hebei (BTH) urban agglomeration. First, population density, point of interest (POI) density, and aggregation index were selected to measure land use intensity from social, physical, and ecological aspects. Then, the indicator of average degree (i.e., connections between counties) was used to measure the characteristics of the road network. Under the hypothesis that the road network functions in shaping land use patterns, a spatial econometric model with the road network embedded spatial weight matrix was established. Our results revealed that, while the land use intensity in the BTH urban agglomeration increased from 2010 to 2015, the road network became increasingly complex with greater spatial heterogeneity. The spatial lag coefficients of land use intensity were positively significant in both years and showed a declining trend. The spatially lagged effects of sector structure, fixed asset investment, and consumption were also significant in most of our spatial econometric models, and their contributions to the total spillover effect increased from 2010 to 2015. This study contributes to the literature by providing an innovative quantitative method to analyze the spatial spillover effect of the road network on intensive land use. We suggest that the spatial spillover effect of the road network could be strengthened in the urban–rural interface areas by improving accessibility and promoting population, resource, and technology flows.
The Sound Pattern of Heritage Spanish: An Exploratory Study on the Effects of a Classroom Experience
Authors: Rao Rajiv , Fuchs Zuzanna , Polinsky Maria , Parra María Luisa
Published: December 2020

While heritage Spanish phonetics and phonology and classroom experiences have received increased attention in recent years, these areas have yet to converge. Furthermore, most research in these realms is cross-sectional, ignoring individual or group changes across time. We aim to connect research strands and fill gaps associated with the aforementioned areas by conducting an individual-level empirical analysis of narrative data produced by five female heritage speakers of Spanish at the beginning and end of a semester-long heritage language instruction class. We focus on voiced and voiceless stop consonants, vowel quality, mean pitch, pitch range, and speech rate. Our acoustic and statistical outputs of beginning versus end data reveal that each informant exhibits a change in between three and five of the six dependent variables, showing that exposure to a more formal register through a classroom experience over the course of a semester constitutes enough input to influence the heritage language sound system, even if the sound system is not an object of explicit instruction. We interpret the significant changes through the lenses of the development of formal speech and discursive strategies, phonological retuning, and speech style and pragmatic effects, while also acknowledging limitations to address in future related work.
Screening, Linkage to Care and Treatment of Hepatitis C Infection in Primary Care Setting in the South of Italy
Authors: Citarella Anna , Cammarota Simona , Bernardi Francesca F. , Coppola Carmine , D’Antò Maria , Fogliasecca Marianna , Giusto Elio , Masarone Mario , Salomone Megna Angelo , Sellitto Carmine , Servodio Rosa , Smaldone Massimo , Staiano Laura , Trama Ugo , Conti Valeria , Persico Marcello
Published: December 2020

Hepatitis C virus (HCV) infection remains a pressing public health issue. Our aim is to assess the linkage to care of patients with HCV diagnosis and to support the proactive case-finding of new HCV-infected patients in an Italian primary care setting. This was a retrospective cohort study of 44 general practitioners (GPs) who managed 63,955 inhabitants in the Campania region. Adults with already known HCV diagnosis or those with HCV high-risk profile at June 2019 were identified and reviewed by GPs to identify newly diagnosed of HCV and to assess the linkage to care and treatment for the HCV patients. Overall, 698 HCV patients were identified, 596 with already known HCV diagnosis and 102 identified by testing the high-risk group (2614 subjects). The 38.8% were already treated with direct-acting antivirals, 18.9% were referred to the specialist center and 42.3% were not sent to specialist care for treatment. Similar proportions were found for patients with an already known HCV diagnosis and those newly diagnosed. Given that the HCV infection is often silent, case-finding needs to be proactive and based on risk information. Our findings suggested that there needs to be greater outreach, awareness and education among GPs in order to enhance HCV testing, linkage to care and treatment.
Characterization of Sensorineural Hearing Loss in Children with Alport Syndrome
Authors: Boeckhaus Jan , Strenzke Nicola , Storz Celine , Gross Oliver ,   on behalf of the GPN Study Group,   EARLY PRO-TECT Alport Investigators
Published: December 2020

Most adults with Alport syndrome (AS) suffer from progressive sensorineural hearing loss. However, little is known about the early characteristics of hearing loss in children with AS. As a part of the EARLY PRO-TECT Alport trial, this study was the first clinical trial ever to investigate hearing loss in children with AS over a timespan of up to six years Nine of 51 children (18%) had hearing impairment. Audiograms were divided into three age groups: in the 5–9-year-olds, the 4-pure tone average (4PTA) was 8.9 decibel (dB) (n = 15) in those with normal hearing and 43.8 dB (n = 2, 12%) in those with hearing impairment. Among the 10–13-year-olds, 4PTA was 4.8 dB (healthy, n = 12) and 41.4 dB (hearing impaired, n = 6.33%). For the 14–20-year-olds, the 4PTA was 7.0 dB (healthy; n = 9) and 48.2 dB (hearing impaired, n = 3.25%). On average, hearing thresholds of the hearing impaired group increased, especially at frequencies between 1–3 kHz. In conclusion, 18% of children developed hearing loss, with a maximum hearing loss in the audiograms at 1–3 kHz. The percentage of children with hearing impairment increased from 10% at baseline to 18% at end of trial as did the severity of hearing loss.
Effect of Multi-Phosphonate Coating of Titanium Surfaces on Osteogenic Potential
Authors: Wehner Christian , Behm Christian , Husejnagic Selma , Moritz Andreas , Rausch-Fan Xiaohui , Andrukhov Oleh
Published: December 2020

The aim of this study was to evaluate the impact of a novel multi-phosphonate (MP) coating strategy of dental implant surfaces on the expression of osteogenesis-related factors in vitro. MG-63 human osteoblast-like cells, bone marrow mesenchymal stem cells (BM-MSCs), and human periodontal ligament stem cells (hPDLSCs) were cultured separately on titanium disks with and without MP coating. Cell attachment was visualized by focal adhesion and actin cytoskeleton staining. The proliferation and gene expression of the markers related to osteogenesis and bone turnover were measured after 48 and 120 h of cell culture. Actin cytoskeleton assembly and focal adhesion were similar between test surfaces within each cell type but differed from those on tissue culture plastic (TCP). The proliferation of MG-63 cells and PDLSCs was comparable on all surfaces, while BM-MSCs showed an increase on tissue culture plastic (TCP) versus titanium. The gene expression of osteoprotegerin and receptor activator of nuclear factor-kappa B ligand was higher in MG-63 cells grown on MP-coated surfaces. At the same time, osteocalcin was decreased compared to the other surfaces. Collagen type I gene expression after 120 h was significantly lower in hPDLSCs cultivated on MP-coated surfaces. Within the limitations of this study, MP coating on titanium surfaces might have a slight beneficial effect on bone turnover in vitro.
Setting Characteristics and High Compressive Strength of an Anti-washout, Injectable Calcium Phosphate Cement Combined with Thermosensitive Hydrogel
Authors: Xie Yao , Liu Jia , Cai Shu , Bao Xiaogang , Li Qianqian , Xu Guohua
Published: December 2020

In this work, a thermosensitive poly(D,L-lactide-co-glycolide)-poly(ethylene glycol)-poly(D,L-lactide-co-glycolide) (PLGA-PEG-PLGA) hydrogel was introduced into calcium phosphate cement (CPC) to enhance the anti-washout property of CPC. The effects of the hydrogel on the setting time, injectability, anti-washout property and compressive strength of CPC were thoroughly investigated. The results showed that the hydrogel significantly increased the injectability and anti-washout property of CPC, meanwhile maintained the setting time with an acceptable range. Moreover, the hydrogel improved the initial compressive strength of CPC. The composite cement with 20% v/v hydrogel in the liquid phase showed fine crystals of hydration product, a more compact microstructure and lower porosity compared with control CPC. The analysis of X-ray diffraction (XRD), infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) indicated that suitable volume ratio of hydrogel (20% v/v) in the setting liquid of CPC could promote the formation of hydroxyapatite in the early hydration period. The degradation behavior of the cement was characterized by immersion tests in simulated body fluid. The hydrogel had no adverse effect on the degradation rate of CPC over the immersion period of 23 days. This study indicated that incorporating PLGA-PEG-PLGA hydrogel could be a promising strategy to reinforce the handing properties and initial compressive strength of calcium phosphate cement.
Structure and Properties of Poly(ethylene terephthalate) Fiber Webs Prepared via Laser-Electrospinning and Subsequent Annealing Processes
Authors: Tokuda Tomoki , Tsuruda Ryo , Hara Takuya , Kobayashi Haruki , Tanaka Katsufumi , Takarada Wataru , Kikutani Takeshi , Hinestroza Juan P. , Razal Joselito M. , Takasaki Midori
Published: December 2020

Melt-electrospinning is an eco-friendly method for producing ultra-fine fibers without using any solvent. We prepared webs of poly(ethylene terephthalate) (PET) through melt-electrospinning using CO2 laser irradiation for heating. The PET webs comprised ultra-fine fibers of uniform diameter (average fiber diameter = 1.66 μm, coefficient of variation = 19%). The co-existence of fibers with high and low molecular orientation was confirmed through birefringence measurements. Although the level of high orientation corresponded to that of commercial highly oriented yarn, crystalline diffraction was not observed in the wide-angle X-ray diffraction (WAXD) analysis of the webs. The crystallinity of the webs was estimated using differential scanning calorimetry (DSC). The fibers with higher birefringence did not exhibit any cold crystallization peak. After annealing the web at 116 °C for 5 min, a further increase in the birefringence of the fibers with higher orientation was observed. The WAXD results revealed that the annealed webs showed crystalline diffraction peaks with the orientation of the c-axis along the fiber axis. In summary, the formation of fibers with a unique non-crystalline structure with extremely high orientation was confirmed.
Superplastic Deformation of Al–Cu Alloys after Grain Refinement by Extrusion Combined with Reversible Torsion
Authors: Rodak Kinga , Kuc Dariusz , Mikuszewski Tomasz
Published: December 2020

The binary as-cast Al–Cu alloys Al-5%Cu, Al-25%Cu, and Al-33%Cu (in wt %), composed of the intermetallic θ-Al2Cu and α-Al phases, were prepared from pure components and were subsequently severely plastically deformed by extrusion combined with reversible torsion (KoBo) to refinement of α-Al and Al2Cu phases. The extrusion combined with reversible torsion was carried out using extrusion coefficients of λ = 30 and λ = 98. KoBo applied to the Al–Cu alloys with different initial structures (differences in fraction and phase size) allowed us to obtain for alloys (Al-25%Cu and Al-33%Cu), with higher value of intermetallic phase, large elongations in the range of 830–1100% after tensile tests at the temperature of 400 °C with the strain rate of 10−4 s−1. The value of elongation depended on extrusion coefficient and increase, with λ increasing as a result of α-Al and Al2Cu phase refinement to about 200–400 nm. Deformation at the temperature of 300 °C, independently of the extrusion coefficient (λ), did not ensure superplastic properties of the analyzed alloys. A microstructural study showed that the mechanism of grain boundary sliding was responsible for superplastic deformation.
Fuzzy Simheuristics: Solving Optimization Problems under Stochastic and Uncertainty Scenarios
Authors: Oliva Diego , Copado Pedro , Hinojosa Salvador , Panadero Javier , Riera Daniel , Juan Angel A.
Published: December 2020

Simheuristics combine metaheuristics with simulation in order to solve the optimization problems with stochastic elements. This paper introduces the concept of fuzzy simheuristics, which extends the simheuristics approach by making use of fuzzy techniques, thus allowing us to tackle optimization problems under a more general scenario, which includes uncertainty elements of both stochastic and non-stochastic nature. After reviewing the related work, the paper discusses, in detail, how the optimization, simulation, and fuzzy components can be efficiently integrated. In order to illustrate the potential of fuzzy simheuristics, we consider the team orienteering problem (TOP) under an uncertainty scenario, and perform a series of computational experiments. The obtained results show that our proposed approach is not only able to generate competitive solutions for the deterministic version of the TOP, but, more importantly, it can effectively solve more realistic TOP versions, including stochastic and other uncertainty elements.
On the Role of Ionic Modeling on the Signature of Cardiac Arrhythmias for Healthy and Diseased Hearts
Authors: Ramírez William A. , Gizzi Alessio , Sack Kevin L. , Filippi Simonetta , Guccione Julius M. , Hurtado Daniel E.
Published: December 2020

Computational cardiology is rapidly becoming the gold standard for innovative medical treatments and device development. Despite a worldwide effort in mathematical and computational modeling research, the complexity and intrinsic multiscale nature of the heart still limit our predictability power raising the question of the optimal modeling choice for large-scale whole-heart numerical investigations. We propose an extended numerical analysis among two different electrophysiological modeling approaches: a simplified phenomenological one and a detailed biophysical one. To achieve this, we considered three-dimensional healthy and infarcted swine heart geometries. Heterogeneous electrophysiological properties, fine-tuned DT-MRI -based anisotropy features, and non-conductive ischemic regions were included in a custom-built finite element code. We provide a quantitative comparison of the electrical behaviors during steady pacing and sustained ventricular fibrillation for healthy and diseased cases analyzing cardiac arrhythmias dynamics. Action potential duration (APD) restitution distributions, vortex filament counting, and pseudo-electrocardiography (ECG) signals were numerically quantified, introducing a novel statistical description of restitution patterns and ventricular fibrillation sustainability. Computational cost and scalability associated with the two modeling choices suggests that ventricular fibrillation signatures are mainly controlled by anatomy and structural parameters, rather than by regional restitution properties. Finally, we discuss limitations and translational perspectives of the different modeling approaches in view of large-scale whole-heart in silico studies.
Are There Any Beneficial Effects of Spirulina Supplementation for Metabolic Syndrome Components in Postmenopausal Women?
Authors: Bobescu Elena , Bălan Andreea , Moga Marius Alexandru , Teodorescu Andreea , Mitrică Maria , Dima Lorena
Published: December 2020

Spirulina is a phytosynthetic filamentous cyanobacterium with microscopic dimensions, which naturally grows in the highly-salted alkaline lakes of Africa, Mexico, America, and Asia. Several bioactive peptides extracted from Spirulina were demonstrated to possess antimicrobial, antiviral, antitumor, immunomodulatory, antiallergic and antihypertensive properties. It has been reported that the consumption of Spirulina could prevent or manage metabolic syndrome components. In women, metabolic disorders are more prevalent during menopause. Postmenopausal women present higher waist circumference, increased blood pressure, hypertriglyceridemia, hyperglycemia, and decreased HDL-cholesterol values, leading to an increased risk of cardiovascular events. Therefore, in order to prevent cardiovascular diseases, it is essential to manage the components of the metabolic syndrome during the postmenopausal period. As recent reports indicated the efficiency of Spirulina supplementation in the management of the metabolic syndrome components, our study aims to review all the clinical trials conducted on this topic. Our main objective is to have a better understanding of whether and how this cyanobacterium could manage the abnormalities included in the metabolic syndrome and if it could be used as a therapeutic approach in postmenopausal women with this condition. We selected relevant articles from PubMed, Google Scholar and CrossRef databases, and a total number of 20 studies met our criteria. All included clinical trials indicated that Spirulina has positive effects in managing metabolic syndrome components. Spirulina is a valuable cyanobacterium that can be used as a food supplement for the management of metabolic syndrome, and it is able to reduce the risk of cardiovascular events. The optimal dose and period of administration remain a debated subject, and future investigations are required. Considering the beneficial effects reported against each component of the metabolic syndrome, Spirulina could also be effective in the postmenopausal period, when this syndrome is the most prevalent, but there is a strong need for human clinical trials in order to sustain this observation.
Echocardiography, an Indispensable Tool for the Management of Diabetics, with or without Coronary Artery Disease, in Clinical Practice
Authors: Katogiannis Konstantinos , Vlastos Dimitrios , Kousathana Foteini , Thymis John , Kountouri Aikaterini , Korakas Emmanouil , Plotas Panagiotis , Papadopoulos Konstantinos , Ikonomidis Ignatios , Lambadiari Vaia
Published: December 2020

Diabetes mellitus is a major factor contributing to the development of cardiovascular disease. As morbidity and mortality rates rise dramatically, when target organ damage develops pre-symptomatic assessment is critical for the management of diabetic patients. Echocardiography is a noninvasive and reproducible method that may aid in risk stratification and in evaluation of treatment effects. The aim of this review is to analyze the echocardiographic techniques which can detect early alteration in cardiac function in patients with diabetes.
Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts
Authors: Tolegenuly Almas , Ordiene Rasa , Mamedov Arslan , Unikas Ramunas , Benetis Rimantas
Published: December 2020

Background and Objectives: To assess the correlation between the degree of target coronary artery stenosis measured by instantaneous wave-free ratio (iFR) and the intraoperative transit time flow measurement (TTFM) of attached grafts as well as evaluate flow competition between the native coronary artery and the attached graft according to the severity of stenosis. Materials and Methods: In total, 89 grafts were subjected to intraoperative transit time flow measurement after coronary artery bypass grafting (CABG) in 25 patients with multivessel coronary artery disease (CAD). The iFR was evaluated for all coronary arteries with grafts. The coronary artery stenoses were divided into three groups based on the iFR value: iFR < 0.86 (group 1); iFR 0.86–0.90 (group 2); and iFR > 0.90 (group 3). Results: The mean graft flow (MGF) was 46.9 ± 18.4 mL/min for group 1, 45.3 ± 20.9 mL/min for group 2, and 31.3 ± 18.5 mL/min for group 3. A statistically significant difference was confirmed between groups 1 and 3 (p = 0.002) and between groups 2 and 3 (p = 0.025). The pulsatility index (PI) was 2.49 ± 1.20 for group 1, 2.66 ± 2.13 for group 2, and 4.70 ± 3.66 for group 3. A statistically significant difference was found between groups 1 and 3 (p = 0.006) and between groups 2 and 3 (p = 0.032). Backward flow was detected in 7.5% of grafts for group 1, in 16.6% of grafts for group 2, and in 16% of grafts for group 3. A statistically significant difference was found between groups 1 and 2 (p = 0.025) and between groups 1 and 3 (p = 0.029). Conclusions: The iFR is a useful tool for predicting the impact of competitive flow observed between a native artery and an attached graft. The effect of competitive flow significantly increases when the graft is attached to a vessel with mild coronary stenosis. In a coronary artery where the iFR was not hemodynamically significant, the MGF was lower, the PI was higher, and a larger proportion of grafts with backward flow (BF) was detected compared to when there was significant stenosis (iFR < 0.86).
Rapid Joining of Commercial-Purity Ti to 304 Stainless Steel Using Joule Heating Diffusion Bonding: Interfacial Microstructure and Strength of the Dissimilar Joint
Authors: Suzuki K. T. , Sato Y. S. , Tokita S.
Published: December 2020

A new solid-state bonding technique, Joule heating diffusion bonding, was used for the dissimilar bonding of commercial-purity Ti to 304 stainless steel within a short time without macroscopic deformation of the workpieces. The tensile strengths of the joints produced at various bonding parameters were examined at room temperature, and the microstructures of the joints and the fracture surfaces were analyzed to clarify the effect of the microstructural factors on the tensile strength of the joints. The tensile strength of the joints increased with the increase in the fraction of the sufficiently bonded interface. In the joints with the well-bonded interface, the tensile strength decreased with the increase in the thickness of the brittle Fe-Ti-type intermetallic compound layers at the joint interface. This study suggested that the high tensile strength could be achieved in the Joule heating diffusion bonded joints with the well-bonded interface where the thickness of the Fe-Ti-type intermetallic compound layers was thinner than 0.5 µm.