bluuebunny/crossref_metadata_2025 huggingface dataset:
Black patients and women have reduced access to liver transplantation for alcohol‐associated liver disease
Authors: Kaplan Alyson , Wahid Nabeel , Fortune Brett E. , Verna Elizabeth , Halazun Karim , Samstein Benjamin , Brown Robert S. , Rosenblatt Russell
Published: July 2022

Although sex and racial disparities for liver transplantation (LT) are known, it is unclear if disparities exist for patients with alcohol‐associated liver disease (ALD). We aimed to compare sex and racial/ethnic differences in mortality, LT listing, and LT rates in patients with and without ALD. We analyzed patients who were listed for LT and/or died of end‐stage liver disease (ESLD) between 2014 and 2018 using the United Network for Organ Sharing Standard Transplant Analysis and Research and Centers for Disease Control and Prevention Wide‐ranging OnLine Data for Epidemiologic Research databases, respectively. Patients with ALD were compared with non‐ALD patients. Our primary outcome was the ratio of listings for LT to deaths from ESLD—listing‐to‐death ratio (LDR)—a previously derived metric to assess access to the waiting list. Differences between sex and race/ethnicity were analyzed with chi‐square tests and multivariable linear regression. There were 65,588 deaths and 16,133 listings for ALD compared with 75,020 deaths and 40,194 listings for non‐ALD. LDR was lower for ALD (0.25 vs. 0.54; p < 0.001). Black patients had the lowest LDR in both ALD and non‐ALD (0.13 and 0.39 for Black patients vs. 0.26 and 0.54 for White patients; p < 0.001). Women with ALD had a lower LDR (0.21 vs. 0.26; p < 0.001), whereas women without ALD had higher LDR than men (0.69 vs. 0.47; p < 0.001). There were significant negative interactions between women and ALD in LDR and the transplant‐to‐death ratio. Multivariable analysis and a sensitivity analysis, with more liberal definitions of ALD and non‐ALD, confirmed these findings. Patients with ALD have lower access to LT. Among those with ALD, female and Black patients have the lowest access. New initiatives are needed to eliminate these inequities.
Standardized upfront Glissonean approach and liver hanging maneuver reduces bile leakage from the hepatic hilum in living donors
Authors: Hirukawa Kazuya , Masuda Yuki , Abe Yuta , Yagi Hiroshi , Ibuki Sho , Itano Osamu , Shinoda Masahiro , Kitago Minoru , Hasegawa Yasushi , Hori Shutaro , Tanaka Masayuki , Nakano Yutaka , Matsubara Kentaro , Obara Hideaki , Yamada Yohei , Kuroda Tatsuo , Hibi Taizo , Kitagawa Yuko
Published: July 2022

Biliary complications after hepatectomy in living donors have yet to be eradicated. We hypothesized that a standardized upfront Glissonean approach and liver hanging maneuver (GH) would prevent mechanical and thermal injuries to the hilar plate of the remnant liver by determining the point of bile duct division and the final destination of hepatectomy preceding liver parenchymal transection (safety) and facilitate liver transection deep within the parenchyma and allow maximum length of hilar structures (rationality). GH was implemented in 2016 and its incidence of bile leakage was retrospectively compared against the conventional technique. GH comprises six steps: (1) development of the retrohepatic avascular plane between the right hepatic vein (RHV) and the middle hepatic vein (MHV) and isolation of the hepatic vein(s); (2) isolation of the right or left Glissonean pedicle with the corresponding Glissonean pedicles of the caudate lobe; (3) for right liver grafts and left liver grafts with the caudate lobe, passage of the tape for the liver hanging maneuver along the retrohepatic avascular plane and above the hilar plate, and for left liver grafts without the caudate lobe and for left lateral section grafts, passage of the tape from between the RHV and the MHV, along the Arantius ligament, and to the right of the umbilical portion; (4) liver transection; (5) isolation of hilar structures; and (6) graft procurement. Until 2020, 62 consecutive living donors underwent GH (success rate, 100%). The incidence of bile leakage from the hepatic hilum (0%) was significantly lower than that among 59 donors who underwent the conventional technique in 2011–2015 (9%; p = 0.01). In conclusion, GH is highly effective in reducing bile leakage from the hepatic hilum in living donors.
Electrospun Antibacterial Composites for Cartilage Tissue Engineering
Authors: Samie Muhammad , Khan Ather Farooq , Hardy John George , Yameen Muhammad Arfat
Published: July 2022

Implantation of biomaterials capable of the controlled release of antibacterials during articular cartilage repair may prevent postoperative infections. Herein, biomaterials are prepared with biomimetic architectures (nonwoven mats of fibers) via electrospinning that are composed of poly(ɛ‐caprolactone), poly(lactic acid), and Bombyx mori silk fibroin (with varying ratios) and, optionally, an antibiotic drug (cefixime trihydrate). The composition, morphology, and mechanical properties of the nanofibrous mats are characterized using scanning electron microscope, Fourier transform infrared spectroscopy, and tensile testing. The nonwoven mats have nanoscale fibers (typical diameters of 324–725 nm) and are capable of controlling the release profiles of the drug, with antibacterial activity against Gram +ve and Gram −ve bacteria (two common strains of human pathogenic bacteria, Staphylococcus aureus and Escherichia coli) under in vitro static conditions. The drug loaded nanofiber mats display cytocompatibility comparable to pure poly(ɛ‐caprolactone) nanofibers when cultured with National Institutes of Health (NIH) NIH‐3T3 fibroblast cell line and have long‐term potential for clinical applications in the field of pharmaceutical sciences.
MOF‐Based Hierarchically Porous Monoliths Prepared via High Internal Phase Emulsion Template: Morphology, Thermal Stability, Mechanical Property, and MOF Accessibility
Authors: Wang Jierui , Qin Jianliang , Zhu He , Li Bo‐Geng , Zhu Shiping
Published: July 2022

In this work, hierarchically macro/microporous monolithic MOF composite materials are fabricated through the HIPE template. The effects of MOF loading on the pore structure, thermal stability, mechanical property, and MOF accessibility are systematically investigated. As the MOF loading increased, the average pore size and mechanical property decreased while the thermal stability increased. Meanwhile, when the MOF loading is low, the monolith exhibited a low BET surface area, suggesting a low MOF accessibility due to the clogging of MOF pores by polymer and the embedment of MOF particles inside the polymer matrix, while at high MOF loadings, the accessibility can be increased to ≈80% owing to the formation of percolation network of MOF particles inside the polymer matrix. Finally, the obtained monolith exhibited good catalytic performance and can be easily regenerated and reused. This work provides some fundamental understandings of the effect of MOF loading on the properties of HIPE‐based porous monoliths and can facilitate the further development of MOFs and their composites.
A mathematical assessment of the isolation random forest method for anomaly detection in big data
Authors: Morales Fernando A. , Ramírez Jorge M. , Ramos Edgar A.
Published: July 2022

We present the mathematical analysis of the Isolation Random Forest Method (IRF Method) for anomaly detection, proposed by Liu F.T., Ting K.M. and Zhou Z. H. in their seminal work as a heuristic method for anomaly detection in Big Data. We prove that the IRF space can be endowed with a probability induced by the Isolation Tree algorithm (iTree). In this setting, the convergence of the IRF method is proved, using the Law of Large Numbers. A couple of counterexamples are presented to show that the method is inconclusive and no certificate of quality can be given, when using it as a means to detect anomalies. Hence, an alternative version of the method is proposed whose mathematical foundation is fully justified. Furthermore, a criterion for choosing the number of sampled trees needed to guarantee confidence intervals of the numerical results is presented. Finally, numerical experiments are presented to compare the performance of the classic method with the proposed one.
Conformal microstrip array antenna with the omnidirectional pattern for 5G applications
Authors: Shaw Minakshmi , Choukiker Yogesh K.
Published: July 2022

This letter presents an omnidirectional conformal array microstrip patch antenna at 3.5 GHz band. The array of 1  2 elements are used as a radiating element and placed on the planar face of a regular six‐faced hexagonal structure connected with six faced feeding network. The feeding network consists of one three‐way power divider and two two‐way power dividers. These power dividers are serially connected to each other and form a six‐faced regular structure with 12 output ports. The response of the conformal antenna is verified experimentally. A measured reflection coefficient is well below  dB and isolation between the output ports are −20 dB. The proposed omnidirectional conformal antenna is low‐cost, easy to fabricate, and suitable for an omnidirectional radiation pattern for 5G applications.
Essentialism: A Philosophy in AR Product Development
Authors: Lu Lu
Published: July 2022

Adopting a philosophy of essentialism enables the delivery of minimally viable AR products in the eyewear form factor, and the ability to learn and iterate based on customers’ evolving needs in comfort, privacy, productivity, entertainment, and affordability.
Mixed impacts of protected areas and a cash crop boom on human well‐being in North‐Eastern Madagascar
Authors: Llopis Jorge C. , Diebold Clara L. , Schneider Flurina , Harimalala Paul C. , Andriamihaja O. Ravaka , Messerli Peter , Zaehringer Julie G.
Published: July 2022

Tropical forest frontier areas support the well‐being of local populations in myriad ways. Not only do they provide the material basis for people's livelihoods, they also sustain socio‐cultural foundations through relational values. They host some of the most biodiverse ecosystems and largest carbon stocks on the planet, and are thus a focus of global conservation efforts. They are also a prime location for the production of many global agricultural commodities. These dynamics—often intertwined—may trap local populations between powerful interests, with the potential to affect their well‐being.

We conducted 100 structured interviews in four biodiversity‐rich landscapes of north‐eastern Madagascar to investigate how multi‐dimensional human well‐being is affected by the recent establishment of protected areas and surge in cash crop prices. We asked households about their satisfaction—and changes in satisfaction—with locally relevant well‐being components, mapping their answers through Nussbaum's Central Capabilities approach. We also investigated the cultural significance of key natural resources beyond the material benefits they provide. All issues were explored along four variables: site, main source of rice, gender and household land use portfolio.

Our findings are as follows: first, human capabilities are interconnected and mutually interdependent, with relational values linking many of them. Second, subjective accounts of well‐being are influenced by cognitive biases, such as treadmill effects, adaptive preferences and recency bias. Third, while households perceived a positive influence of protected areas, those most reliant on forest land and products held a more negative view of conservation interventions. And fourth, while households more engaged in commercial agriculture may be benefitting economically from the recent increase in cash crop prices, these very dynamics might be leading to trade‐offs between capabilities. This is most notably so for the Bodily Health capability (e.g. greater spending on housing) and Affiliation and Bodily Integrity (i.e. worsening social relations and security).

These insights highlight the importance of addressing the multiple dimensions of well‐being when assessing the impacts of conservation and economic dynamics in forest frontier populations. Particular attention should be paid to the relational values ascribed to the natural resources the communities rely on.

Read the free Plain Language Summary for this article on the Journal blog.
The 28th Annual Prostate Cancer Foundation Scientific Retreat report
Authors: Miyahira Andrea K. , Soule Howard R.
Published: July 2022

Background

The 28th Annual Prostate Cancer Foundation (PCF) Scientific Retreat was held virtually over 4 days, on October 28−29 and November 4−5, 2021.

Methods

The Annual PCF Scientific Retreat is a leading global scientific conference that focuses on first‐in‐field, unpublished, and high‐impact basic, translational, and clinical prostate cancer research, as well as research from other fields with high probability for impacting prostate cancer research and patient care.

Results

Primary areas of research discussed at the 2021 PCF Retreat included: (i) prostate cancer disparities; (ii) prostate cancer survivorship; (iii) next‐generation precision medicine; (iv) PSMA theranostics; (v) prostate cancer lineage plasticity; (vi) tumor metabolism as a cancer driver and treatment target; (vii) prostate cancer genetics and polygenic risk scores; (viii) glucocorticoid receptor biology in castration‐resistant prostate cancer (CRPC); (ix) therapeutic degraders; (x) new approaches for immunotherapy in prostate cancer; (xi) novel technologies to overcome the suppressive tumor microenvironment; and (xii) real‐world evidence and synthetic/virtual control arms.

Conclusions

This article provides a summary of the presentations from the 2021 PCF Scientific Retreat. We hope that sharing this knowledge will help to improve the understanding of the current state of research and direct new advances in prostate cancer research and care.
Measuring green technology adoption across countries
Authors: Elgin Ceyhun , Özgür Gökçer , Cantekin Kerem
Published: July 2022

In this article, we construct an empirical framework to identify and measure the adoption of green technologies across countries. Using an annual dataset covering 89 countries from 1990 to 2016, we conduct a principal component analysis incorporating the different dimensions of the adoption of green technologies. The analysis allows us both to rank countries for their level of green technology adoption and also recommend policies to improve their current stance.
Bayesian unanchored additive models for component network meta‐analysis
Authors: Wigle Augustine , Béliveau Audrey
Published: July 2022

Component network meta‐analysis (CNMA) models are an extension of standard network meta‐analysis (NMA) models which account for the use of multicomponent treatments in the network. This article contributes innovatively to several statistical aspects of CNMA. First, by introducing a unified notation, we establish that currently available methods differ in the way they assume additivity, an important distinction that has been overlooked so far in the literature. In particular, one model uses a more restrictive form of additivity than the other which we term an anchored and unanchored model, respectively. We show that an anchored model can provide a poor fit to the data if it is misspecified. Second, given that Bayesian models are often preferred by practitioners, we develop two novel unanchored Bayesian CNMA models presented under the unified notation. An extensive simulation study examining bias, coverage probabilities, and treatment rankings confirms the favorable performance of the novel models. This is the first simulation study to compare the statistical properties of CNMA models in the literature. Finally, the use of our novel models is demonstrated on a real dataset, and the results of CNMA models on the dataset are compared.
Rank‐based Bayesian variable selection for genome‐wide transcriptomic analyses
Authors: Eliseussen Emilie , Fleischer Thomas , Vitelli Valeria
Published: July 2022

Variable selection is crucial in high‐dimensional omics‐based analyses, since it is biologically reasonable to assume only a subset of non‐noisy features contributes to the data structures. However, the task is particularly hard in an unsupervised setting, and a priori ad hoc variable selection is still a very frequent approach, despite the evident drawbacks and lack of reproducibility. We propose a Bayesian variable selection approach for rank‐based unsupervised transcriptomic analysis. Making use of data rankings instead of the actual continuous measurements increases the robustness of conclusions when compared to classical statistical methods, and embedding variable selection into the inferential tasks allows complete reproducibility. Specifically, we develop a novel extension of the Bayesian Mallows model for variable selection that allows for a full probabilistic analysis, leading to coherent quantification of uncertainties. Simulation studies demonstrate the versatility and robustness of the proposed method in a variety of scenarios, as well as its superiority with respect to several competitors when varying the data dimension or data generating process. We use the novel approach to analyze genome‐wide RNAseq gene expression data from ovarian cancer patients: several genes that affect cancer development are correctly detected in a completely unsupervised fashion, showing the usefulness of the method in the context of signature discovery for cancer genomics. Moreover, the possibility to also perform uncertainty quantification plays a key role in the subsequent biological investigation.
Thrombotischer Verschluss der extrakorporalen Zirkulation während hepatischer Chemosaturation trotz zielgerechter Antikoagulation
Authors: Kuhner M. , Tan B. , Fiedler M. O. , Biecker O. , Klein B. , Chang D. H. , Weigand M. A. , Dietrich M.
Published: July 2022

Die perkutane hepatische Chemosaturation ist eine Behandlungsoption bei nichtresektablen primären oder sekundären Lebertumoren. Dabei wird der Bereich der Lebervenenmündung der Vena cava inferior (VCI) mittels 2 Ballons von der Zirkulation isoliert, sodass die systemische Verteilung des über die Leberarterie applizierten Chemotherapeutikums Melphalan verhindert wird. Nach Passage der Leber und venöser Drainage aus der retrohepatischen VCI durchläuft das chemosaturierte Blut 2 parallel geschaltete extrakorporale Filter. Anschließend wird das gereinigte Blut jugulär rückgeführt. Das Verfahren geht oft mit einer ausgeprägten hämodynamischen Instabilität einher, deren Ursache nicht abschließend geklärt ist. Zusätzlich stellt das Gerinnungsmanagement eine Herausforderung dar. Die Autoren berichten von einem Fall, bei dem sich trotz ausreichender „activated clotting time“ (ACT) ein Thrombus im rückführenden Schenkel der extrakorporalen Zirkulation bildete. Gezielte Problemsuche und -lösung waren parallel zur hämodynamischen Stabilisierung und interdisziplinären Zusammenarbeit notwendig, um die Intervention erfolgreich durchzuführen und der Patientin eine sichere Therapie zukommen zu lassen.
Accurate vibration-free robotic milling electric discharge machining
Authors: Almeida Sergio , Mo John , Bil Cees , Ding Songlin
Published: July 2022

Traditional computer numeric control (CNC) machines have high accuracy but are limited by workpiece size and axes. Therefore, many researchers attempted to equip six-axis industrial robots (IRs) with milling end-effectors to explore the robot’s large and flexible working envelope. However, IRs lack stiffness and have limited force, resulting in low accuracy, poor surface roughness (SR), and low material removal rate (MRR). On the contrary, electric discharge machining (EDM) is a non-conventional process capable of shaping complex profiles in any conductive material. Since the EDM process has no physical contact between the electrode and the workpiece, it can machine diverse hard-to-cut materials accurately and free of vibration. However, to this day, EDM is found in limited conditions of CNC machines only. Thus, this research investigates a synergistic combination of IR and milling EDM. Adopting advanced CAM tools and offline programming, it examines pre-designed electrodes working analogue to conventional milling to perform the desired machining by intricate cutting paths. The results deliver a robotic machining technique able to cut hard materials using small industrial robots yet free of vibration and not pose dependent.
Identification of the initial reactive sites of micellar and non-micellar casein exposed to microbial transglutaminase
Authors: Duerasch Anja , Konieczny Maja , Henle Thomas
Published: July 2022

To investigate the influence of the internal micellar structure on the course of enzymatic cross-linking especially in the initial phase of the reaction, casein micelles isolated from raw milk via ultracentrifugation were incubated with microbial transglutaminase (mTG) in comparison with non-micellar sodium caseinate. Reactive lysine and glutamine residues were identified using a label-free approach, based on the identification of isopeptides within tryptic hydrolysates by targeted HRMS as well as manual monitoring of fragmentation spectra. Identified reactive sites were furthermore weighted by tracking the formation of isopeptides over an incubation time of 15, 30, 45 and 60 min, respectively. Fifteen isopeptides formed in the early stage of mTG cross-linking of caseins were identified and further specified concerning the position of lysine and glutamine residues involved in the reaction. The results revealed lysine K176 and glutamine Q175 of β-casein as the most reactive residues, which might be located in a highly flexible region of the molecule based on different possible reaction partners identified in this study. Except for the isopeptide αs1 K34–αs2 Q101 in sodium caseinate (SC), all reactive sites were detected in micellar and in non-micellar casein, indicating that the initial phase of enzymatic cross-linking is not affected by micellar aggregation of caseins.

Graphical abstract
Biomechanical evaluation of the proximal chevron osteotomy in comparison to the Lapidus arthrodesis for the correction of hallux valgus deformities
Authors: Kasparek Maximilian F. , Benca Emir , Hirtler Lena , Willegger Madeleine , Boettner Friedrich , Zandieh Shahin , Holinka Johannes , Windhager Reinhard , Schuh Reinhard
Published: July 2022

Purpose

The proximal chevron osteotomy and the modified Lapidus arthrodesis are both procedures utilized for deformity correction in patients with severe symptomatic hallux valgus. The aim of the current study was to compare their biomechanical stability when using locking plate fixation.

Methods

Twelve matched pairs of human anatomical lower leg specimens underwent on one side a proximal chevron osteotomy with a medial locking plate and on the other side a modified Lapidus arthrodesis with a plantar locking plate utilizing an interfragmentary compression screw. All specimens underwent bone mineral density (BMD) assessment and were tested in a servohydraulic load frame which applied a load on the centre of the metatarsal head over 1000 loading cycles with subsequently ultimate load testing. Displacement of the proximal and distal bone segment, ultimate load, and bending stiffness were analyzed.

Results

Mean displacement of both procedures showed no statistically significant difference throughout all the loading cycles (0.213 ≤ p ≤ 0.834). The mean ultimate load of the proximal chevron osteotomy was 227.9 N (± 232.4) and of the modified Lapidus arthrodesis 162.9 N (± 74.6) (p = 0.754). The proximal chevron osteotomy (38.2 N/mm (± 24.9)) had a significantly higher bending stiffness compared to the modified Lapidus arthrodesis (17.3 N/mm (± 9.9)) (p = 0.009). There was no correlation between BMD and displacement in all loading cycles, ultimate load, and bending stiffness of either procedure (p > 0.05).

Conclusion

Although the bending stiffness of the chevron osteotomy was higher, there was no statistically significant difference between the surgical techniques in mean displacement and ultimate load. The BMD did not influence the overall stability of either reconstruction. Locking plate fixation increases the clinical value of the modified Lapidus arthrodesis by outweighing most of the biomechanical disadvantages in comparison to the proximal chevron osteotomy.
Academic Output in Global Surgery after the Lancet Commission on Global Surgery: A Scoping Review
Authors: Fowler Zachary , Dutta Rohini , Kilgallon John L. , Wobenjo Adili , Bandyopadhyay Soham , Shah Priyansh , Jain Samarvir , Raykar Nakul P. , Roy Nobhojit
Published: July 2022

Background

The Lancet Commission on Global Surgery (LCoGS) published its seminal report in 2015, carving a niche for global surgery academia. Six years after the LCoGS, a scoping review was conducted to see how the term ‘global surgery’ is characterized by the literature and how it relates to LCoGS and its domains.

Methods

PubMed was searched for publications between January 2015 and February 2021 that used the term ‘global surgery’ in the title, abstract, or key words or cited the LCoGS. Variables extracted included LCoGS domains, authorship metrics, geographic scope, and clinical specialty.

Results

The search captured 938 articles that qualified for data extraction. Nearly 80% of first and last authors had high‐income country affiliations. Africa was the most frequently investigated region, though many countries within the region were under‐represented. The World Journal of Surgery was the most frequent journal, publishing 13.9% of all articles. General surgery, pediatric surgery, and neurosurgery were the most represented specialties. Of the LCoGS domains, healthcare delivery and management were the most studied, while economics and financing were the least studied.

Conclusion

A lack of consensus on the definition of global surgery remains. Additional research is needed in economics and financing, while obstetrics and trauma are under‐represented in literature using the term ‘global surgery’. Efforts in academic global surgery must give a voice to those carrying the global surgery agenda forward on the frontlines. Focusing on research capacity‐building and encouraging contribution by local partners will lead to a stronger, more cohesive global surgery community.
Feasibility and Safety of Ambulatory Transoral Endoscopic Thyroidectomy via Vestibular Approach (TOETVA)
Authors: Van Den Heede Klaas , Brusselaers Nele , Gaujoux Sébastien , Menegaux Fabrice , Chereau Nathalie
Published: July 2022

Background

In search of an ideal cosmesis, transoral endoscopic thyroidectomy via vestibular approach (TOETVA) has recently been introduced to avoid a visible scar. Although ambulatory thyroid surgery is considered safe in carefully selected patients, this remains unclear for TOETVA.

Methods

All consecutive adult patients who underwent ambulatory TOETVA or open thyroid surgery at a French university hospital were prospectively enrolled from 12/2020 until 11/2021. The primary outcome was postoperative morbidity (recurrent laryngeal nerve (RLN) palsy, re‐intervention for bleeding, wound morbidity, or hospital readmission). The secondary outcome was quality of life (QoL), measured by a survey including a validated questionnaire (SF‐12) and a modified thyroid surgery questionnaire six weeks after surgery.

Results

Throughout the study period, 374 patients underwent a unilateral lobectomy or isthmectomy in ambulatory setting, of which 34 (9%) as TOETVA (including 21 (62%) for a possible malignancy). In the TOETVA group, younger age (median 40 (IQR 35–50) vs. 51 (40–60) years, P < 0.001) and lower BMI (median 23.1 (20.9–25.4) vs. 24.9 (22.1–28.9) kg/m2, P = 0.001) were noted. No cases were converted to open cervicotomy. TOETVA was at least as good as open cervicotomy with nil versus four (1%) re‐interventions for bleeding, one temporary (5%) versus 13 (4%) (temporary) RLN palsies, and one (<1%) wound infection (open cervicotomy group). No hospital readmissions occurred in all ambulatory surgery patients. No differences were found in physical (P = 0.280) and mental (P = 0.569) QoL between TOETVA and open surgery.

Conclusions

In carefully selected patients, the feasibility and safety of ambulatory TOETVA are comparable to open surgery.
Self-implementation of social choice correspondences in Nash equilibrium
Authors: Mukherjee Saptarshi , Peters Hans
Published: July 2022

A social choice correspondence is Nash self-implementable if it can be implemented in Nash equilibrium by a social choice function that selects from it as the game form. We provide a complete characterization of all unanimous and anonymous Nash self-implementable social choice correspondences when there are two agents or two alternatives. For the case of three agents and three alternatives, only the top correspondence is Nash self-implementable. In all other cases, every Nash self-implementable social choice correspondence contains the top correspondence and is contained in the Pareto correspondence. In particular, when the number of alternatives is at least four, every social choice correspondence containing the top correspondence plus the intersection of the Pareto correspondence with a fixed set of alternatives, is self-implementable.
Characterization of industrial low-density polyethylene: a thermal, dynamic mechanical, and rheological investigation
Authors: Poh Leslie , Wu Qi , Chen Yidan , Narimissa Esmaeil
Published: July 2022

The study of commercial low-density polyethylenes (LDPEs) has always focused on the effects of the molecular architecture of the polymer on its shear and extensional rheological properties due to their direct influence on manufacturability. However, the complex morphology of industrial-grade LDPEs also affects the crystallization kinetics and dynamic mechanical properties of the polymers, which are key to the processibility and applications. Therefore, a comprehensive investigation was conducted into the areas of crystallization kinetics, crystallinity, dynamic mechanical, and linear and non-linear shear rheological properties of two industrial-grade LDPEs to build a cohesive insight into the influence of morphology on these material properties. We further analyzed the steady-state and transient shear viscosity data obtained from the two LDPEs in comparison with constitutive model predictions using the hierarchical multi-mode molecular stress function (HMMSF) and found excellent agreement within experimental accuracy between predictions by the HMMSF model and shear stress as well as normal stress data of the LDPEs investigated.
Acute Effect of Bronchodilator on Intrathoracic Airway Wall Compliance in COPD Patients
Authors: Pini Laura , Ziletti Giulia Claudia , Ciarfaglia Manuela , Giordani Jordan , Tantucci Claudio
Published: July 2022

Purpose

In patients with chronic obstructive pulmonary disease (COPD), bronchial responsiveness after acute administration of short acting bronchodilators is conventionally assessed by measuring the improvement of forced expiratory volume in the first second (FEV1) during a maximal forced expiratory maneuver. This study aimed to measure the variation of intrathoracic airway wall compliance (AWC) after acute administration of short acting beta-2 agonist in COPD patients since this might influence the final modification of airway caliber during maximal expiratory effort and the resulting bronchodilation as inferred by FEV1 changes.

Methods

In a group of 10 patients suffering from COPD, intrathoracic AWC was measured at middle (50% of Forced Vital Capacity (FVC) and low (75% of FVC) lung volumes using the interrupter method during forced expiratory maneuver in basal conditions and after acute inhalation of albuterol (salbutamol) (400 mcg by MDI). Ten healthy subjects were examined similarly as a control group.

Results

Lower values of baseline intrathoracic AWC at both lung volumes were found in COPD patients (1.72 ± 0.20 ml/cmH2O and 1.08 ± 0.20 ml/cmH2O, respectively) as compared to controls (2.28 ± 0.27 ml/cmH2O and 1.44 ± 0.22 ml/cmH2O, respectively) (p < 0.001). In COPD patients, AWC increased significantly at both lung volumes after salbutamol, amounting to 1.81 ± 0.38 ml/cmH2O and 1.31 ± 0.39 ml/cmH2O, respectively (p < 0.01), but the relative change was not different from that observed in controls.

Conclusion

In COPD patients, AWC is reduced compared to controls, but after bronchodilator, the intrathoracic airways become more compliant. The consequent increased collapsibility under high positive pleural pressure could limit the airway caliber improvement seen after bronchodilator, as assessed by the FEV1 changes during the forced expiratory maneuver, underestimating the effective bronchodilation achieved in these patients.
How fluid infiltrates dry crustal rocks during progressive eclogitization and shear zone formation: insights from H2O contents in nominally anhydrous minerals
Authors: Kaatz Lisa , Reynes Julien , Hermann Jörg , John Timm
Published: July 2022

Granulites from Holsnøy (Bergen Arcs, Norway) maintained a metastable state until fluid infiltration triggered the kinetically delayed eclogitization. Interconnected hydrous eclogite-facies shear zones are surrounded by unreacted granulites. Macroscopically, the granulite–eclogite interface is sharp and there are no significant compositional changes in the bulk chemistry, indicating the fluid composition was quickly rock buffered. To better understand the link between deformation, fluid influx, and fluid–rock interaction one cm-wide shear zone at incipient eclogitization is studied here. Granulite and eclogite consist of garnet, pyroxene, and plagioclase. These nominally anhydrous minerals (NAMs) can incorporate H2O in the form of OH groups. H2O contents increase from granulite to eclogite, as documented in garnet from ~ 10 to ~ 50 µg/g H2O, pyroxene from ~ 50 to ~ 310 µg/g H2O, and granulitic plagioclase from ~ 10 to ~ 140 µg/g H2O. Bowl-shape profiles are characteristic for garnet and pyroxene with lower H2O contents in grain cores and higher at the rims, which suggest a prograde water influx into the NAMs. Omphacite displays a H2O content range from ~ 150 to 425 µg/g depending on the amount of hydrous phases surrounding the grain. The granulitic plagioclase first separates into a hydrous, more albite-rich plagioclase and isolated clinozoisite before being replaced by new fine-grained phases like clinozoisite, kyanite and quartz during ongoing fluid infiltration. Results indicate a twofold fluid influx with different mechanisms to act simultaneously at different scales and rates. Fast and more pervasive proton diffusion is recorded by NAMs that retain the major element composition of the granulite-facies equilibration where hydrogen decorates pre-existing defects in the crystal lattice and leads to OH increase. Contemporaneously, slower grain boundary-assisted aqueous fluid influx enables element transfer and results in progressive formation of new minerals, e.g., hydrous phases. Both mechanisms lead to bulk H2O increase from ~ 450 to ~ 2500 µg/g H2O towards the shear zone and convert the system from rigid to weak. The incorporation of OH groups reduces the activation energy for creep, promotes formation of smaller grain sizes (phase separation of plagioclase), and synkinematic metamorphic mineral reactions. These processes are part of the transient weakening, which enhance the sensitivity of the rock to deform.
Immunolocalization of zinc transporters and metallothioneins reveals links to microvascular morphology and functions
Authors: Tran Hai B. , Jakobczak Rachel , Abdo Adrian , Asare Patrick , Reynolds Paul , Beltrame John , Hodge Sandra , Zalewski Peter
Published: July 2022

Zinc homeostasis is vital to immune and other organ system functions, yet over a quarter of the world’s population is zinc deficient. Abnormal zinc transport or storage protein expression has been linked to diseases, such as cancer and chronic obstructive pulmonary disorder. Although recent studies indicate a role for zinc regulation in vascular functions and diseases, detailed knowledge of the mechanisms involved remains unknown. This study aimed to assess protein expression and localization of zinc transporters of the SLC39A/ZIP family (ZIPs) and metallothioneins (MTs) in human subcutaneous microvessels and to relate them to morphological features and expression of function-related molecules in the microvasculature. Microvessels in paraffin biopsies of subcutaneous adipose tissues from 14 patients undergoing hernia reconstruction surgery were analysed for 9 ZIPs and 3 MT proteins by MQCM (multifluorescence quantitative confocal microscopy). Zinc regulation proteins detected in human microvasculature included ZIP1, ZIP2, ZIP8, ZIP10, ZIP12, ZIP14 and MT1-3, which showed differential localization among endothelial and smooth muscle cells. ZIP1, ZIP2, ZIP12 and MT3 showed significantly (p < 0.05) increased immunoreactivities, in association with increased microvascular muscularization, and upregulated ET-1, α-SMA and the active form of p38 MAPK (Thr180/Tyr182 phosphorylated, p38 MAPK-P). These findings support roles of the zinc regulation system in microvascular physiology and diseases.
Evolution of endoscopic vacuum therapy for upper gastrointestinal leakage over a 10-year period: a quality improvement study
Authors: Reimer Stanislaus , Seyfried Florian , Flemming Sven , Brand Markus , Weich Alexander , Widder Anna , Plaßmeier Lars , Kraus Peter , Döring Anna , Hering Ilona , Hankir Mohammed K. , Meining Alexander , Germer Christoph-Thomas , Lock Johan F. , Groneberg Kaja
Published: July 2022

Background

Endoscopic vacuum therapy (EVT) is an effective treatment option for leakage of the upper gastrointestinal (UGI) tract. The aim of this study was to evaluate the clinical impact of quality improvements in EVT management on patients’ outcome.

Methods

All patients treated by EVT at our center during 2012–2021 were divided into two consecutive and equal-sized cohorts (period 1 vs. period 2). Over time several quality improvement strategies were implemented including the earlier diagnosis and EVT treatment and technical optimization of endoscopy. The primary endpoint was defined as the composite score MTL30 (mortality, transfer, length-of-stay > 30 days). Secondary endpoints included EVT efficacy, complications, in-hospital mortality, length-of-stay (LOS) and nutrition status at discharge.

Results

A total of 156 patients were analyzed. During the latter period the primary endpoint MTL30 decreased from 60.8 to 39.0% (P = .006). EVT efficacy increased from 80 to 91% (P = .049). Further, the need for additional procedures for leakage management decreased from 49.9 to 29.9% (P = .013) and reoperations became less frequent (38.0% vs.15.6%; P = .001). The duration of leakage therapy and LOS were shortened from 25 to 14 days (P = .003) and 38 days to 25 days (P = .006), respectively. Morbidity (as determined by the comprehensive complication index) decreased from 54.6 to 46.5 (P = .034). More patients could be discharged on oral nutrition (70.9% vs. 84.4%, P = .043).

Conclusions

Our experience confirms the efficacy of EVT for the successful management of UGI leakage. Our quality improvement analysis demonstrates significant changes in EVT management resulting in accelerated recovery, fewer complications and improved functional outcome.
Optimizing laparoscopic training efficacy by ‘deconstruction into key steps’: a randomized controlled trial with novice medical students
Authors: Widder A. , Backhaus J. , Wierlemann A. , Hering I. , Flemming S. , Hankir M. , Germer C.-T. , Wiegering A. , Lock J. F. , König S. , Seyfried F.
Published: July 2022

Background

Simulator training is an effective way of acquiring laparoscopic skills but there remains a need to optimize teaching methods to accelerate learning. We evaluated the effect of the mental exercise ‘deconstruction into key steps’ (DIKS) on the time required to acquire laparoscopic skills.

Methods

A randomized controlled trial with undergraduate medical students was implemented into a structured curricular laparoscopic training course. The intervention group (IG) was trained using the DIKS approach, while the control group (CG) underwent the standard course. Laparoscopic performance of all participants was video-recorded at baseline (t0), after the first session (t1) and after the second session (t2) nine days later. Two double-blinded raters assessed the videos. The Impact of potential covariates on performance (gender, age, prior laparoscopic experience, self-assessed motivation and self-assessed dexterity) was evaluated with a self-report questionnaire.

Results

Both the IG (n = 58) and the CG (n = 68) improved their performance after each training session (p < 0.001) but with notable differences between sessions. Whereas the CG significantly improved their performance from t0 –t1 (p < 0.05), DIKS shortened practical exercise time by 58% so that the IG outperformed the CG from t1 -t2, (p < 0.05). High self-assessed motivation and dexterity associated with significantly better performance (p < 0.05). Male participants demonstrated significantly higher overall performance (p < 0.05).

Conclusion

Mental exercises like DIKS can improve laparoscopic performance and shorten practice times. Given the limited exposure of surgical residents to simulator training, implementation of mental exercises like DIKS is highly recommended. Gender, self-assessed dexterity, and motivation all appreciably influence performance in laparoscopic training.
Perinatal depression screening: a systematic review of recommendations from member countries of the Organisation for Economic Co-operation and Development (OECD)
Authors: El-Den Sarira , Pham Lily , Anderson Isobel , Yang Shan , Moles Rebekah J. , O’Reilly Claire L. , Boyce Philip , Raine Karen Hazell , Raynes-Greenow Camille
Published: July 2022

Perinatal depression (PND) screening recommendations are made by national, state-based and professional organisations; however, there is disagreement regarding screening timing, provider responsible, screening setting, screening tool as well as the follow-up and referral pathways required post-screening. This systematic review aimed to identify, describe and compare PND screening recommendations from member countries of the Organisation for Economic Co-operation and Development (OECD). Publications were identified through systematically searching PubMed, Google and the Guidelines International Network (GIN). Recommendations regarding PND screening endorsement, timing, frequency, responsible provider, tools/assessments and follow-up and referral were extracted. Twenty-one publications, including guidelines, from five countries were included. Most made recommendations in support of PND screening using the Edinburgh Postnatal Depression Scale. Details differed regarding terminology used, as well as frequency of screening, follow-up mechanisms and referral pathways. A broad range of health providers were considered to be responsible for screening. This is the first review to identify and compare PND screening recommendations from OECD member countries; however, only online publications published in English, from five countries were included. Heterogeneity of publication types and inconsistency in definitions rendered quality assessment inappropriate. While most publications generally endorsed PND screening, there are exceptions and the associated details pertaining to the actual conduct of screening vary between and within countries. Developing clear, standardised recommendations based on current evidence is necessary to ensure clarity amongst healthcare providers and a comprehensive approach for the early detection of PND.
Study of protease-mediated processes initiating viral infection and cell–cell viral spreading of SARS-CoV-2
Authors: Thaingtamtanha Thanawat , Baeurle Stephan A.
Published: July 2022

Viral-cell entry and cell–cell viral spreading processes of SARS-CoV-2 are subjected to fast evolutionary optimization because of its worldwide spreading, requiring the need for new drug developments. However, this task is still challenging, because a detailed understanding of the underlying molecular processes, mediated by the key cellular proteases TMPRSS2 and furin, is still lacking. Here, we show by large-scale atomistic calculations that binding of the ACE2 cell receptor at one of the heteromers of the SARS-CoV-2 spike leads to a release of its furin cleavage site (S1/S2), enabling an enhanced furin binding, and that this latter process promotes the binding of TMPRSS2 through the release of the TMPRSS2 cleavage site (S2′) out of the ACE2-binding heteromer. Moreover, we find that, after proteolytic cleavage, improved furin binding causes that parts of the S2 subunit dissociate from the complex, suggesting that furin promotes the fusion of the S2 subunit with the cell membrane before transfer of the viral RNA.

Graphical abstract

Here we show by computational means that binding of the ACE2-cell receptor at one of the heteromers of the SARS-CoV-2 spike leads to an enhanced binding of the protease furin, promoting the binding of the protease TMPRSS2. Moreover, we show that, after proteolytic cleavage, improved furin binding causes that parts of the heteromer dissociate from the spike.
The entire lifetime of a distinct double-diffusive staircase in crater Lake Nyos, Cameroon
Authors: Wüest Alfred , Issa  , Dinkel Christian , Halbwachs Michael , Müller Beat
Published: July 2022

Lake Nyos, a deep crater lake, located in the north-west of Cameroon, was permanently stratified below 50 m depth due to subaquatic sources supplying warm, salty and CO2-enriched water into the deepest reaches. The high CO2 content in these source waters caused the 1986 limnic eruption. The deep inflowing water is denser than the hypolimnetic water and maintains the stability of the water column, which is double-diffusively stratified. During the dry season in Feb 2002, cooling triggered the formation of a double-diffusive (DD) staircase, a sequence of homogeneously mixed layers separated by distinct stable interfaces. The initiation of the staircase was slightly below the permanent chemocline at ~ 50 m depth, from where the staircase expanded vertically in a diffusion-type manner for ~ 750 days to a maximal vertical extension of ~ 37 m. The staircase pattern caused the upward heat fluxes to increase which depleted the driving temperature gradient. Subsequently, the density ratio increased and reduced the upward heat flux divergence until DD progressively weakened and finally the staircase structure eroded. Based on 39 CTD profiles, we describe the DD phenomenon, explain the three distinct phases of this unique DD event, which lasted for ~ 850 days, and discuss the vertical extension of the DD zone in relation to the rates of new layer formation and layer decay. To our knowledge, this is the only observation over the entire lifespan—“from birth to death”—of a DD event in a natural water body.