bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiments with Stand-Alone Sand-Screen Specimens for Thermal Projects
Authors: Fattahpour Vahidoddin , Roostaei Morteza , Hosseini Seyed Abolhassan , Soroush Mohammad , Berner Kelly , Mahmoudi Mahdi , Al-hadhrami Ahmed , Ghalambor Ali
Published: September 2020

Most of the test protocols developed to evaluate sand-screen designs were based on scaled-screen test coupons. There have been discussions regarding the reliability of such tests on scaled test coupons. This paper presents the results of tests on wire-wrapped screen (WWS) and slotted liner (SL) test coupons for typical onshore Canada McMurray formation sand.

A unique sand control evaluation apparatus has been designed and built to accommodate all common stand-alone screens that are 3.5 in. in diameter and 12 in. in height. This setup provides the capability to have a radial measurement of pressure across the sandpack and screen for three-phase flow. Certain challenges during testing such as establishing uniform radial flow and measuring the differential pressure are outlined. Produced sand is also measured during the test. The main outputs of the test are to assess the sand control performance and the mode of sanding in different flow directions, flow rates, and flow regimes.

It was possible to establish uniform radial flow in both high- and low-permeability sandpacks. However, the establishment of radial flow in sandpacks with very high permeability was challenging. The pressure measurement at different points in the radial direction around the screen indicated a uniform radial flow. Results of the tests on a representative particle size distribution (PSD) from the McMurray Formation on the WWS and SL test coupons with commonly used specifications in the industry (aperture sizes of 0.012, 0.014, and 0.016 in. for WWS and 0.012, 0.016, 0.018, and 0.020 in. for SL) have shown similar sanding and flow performances. We also included aperture sizes smaller and larger than the common practice. Similar to previous tests, narrower apertures are proven to be less resistant to plugging than wider slots for both WWS and SL. Accumulation of fines close to the screen causes significant pore plugging when conservative aperture sizes were used for both WWS and SL. In contrast, using the test coupon with a larger aperture size than the industry practice resulted in excessive sanding. The experiments under linear flow seem more conservative because their results show more produced sand and smaller retained permeability in comparison to the testing under radial flow.

This work discusses the significance, procedure, challenges, and early results of physical modeling of stand-alone screens in thermal operation. It also provides insight into the fluid flow, fines migration, clogging, and bridging in the vicinity of sand screens.
A phase I study of a dual PI3-Kinase/mTOR inhibitor BEZ235 in adult patients with relapsed or refractory acute leukemia
Authors: Lang Fabian , Wunderle Lydia , Badura Susanne , Schleyer Eberhard , Brüggemann Monika , Serve Hubert , Schnittger Susanne , Gökbuget Nicola , Pfeifer Heike , Wagner Sebastian , Ashelford Kevin , Bug Gesine , Ottmann Oliver
Published: September 2020

Background Combined inhibition of phosphatidylinositol 3-kinase (PI3K) and the mammalian target of rapamycin (mTOR) complexes may be an efficient treatment for acute leukemia. The primary objective of this phase I single center open label study was to determine the maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of the dual pan-class I PI3K and mTOR inhibitor BEZ235 in patients with advanced leukemia. Methods Herein patients > 18 years of age who had relapsed or showed refractory leukemia were treated with BEZ235 (orally at 300-400 mg BID (cohort -1/1)) to assess safety, tolerability, preliminary efficacy and pharmacokinetic (PK). Adverse events data and serious adverse events were analyzed and haematological and clinical biochemistry toxicities were assessed from laboratory test parameters. Response was assessed for the first time at the end of cycle 1 (day 29) and after every subsequent cycle. Pharmacokinetic and pharmacodynamic analyses of BEZ235 were also included (BEZ235 plasma levels, phosphorylation of AKT, S6 and 4EBP1). On statistics this trial is a multiple ascending dose study in which a following variant of the 3+3 rule (“Rolling Six”), a minimum of 6 and a maximum of 12 patients was recruited for the dose escalation and another 5 were planned for the expansion phase.Results Twenty-four patients with ALL (n=11) or AML (n=12) or CML-BP (n=1) were enrolled. All patients had failed one (n=5) or more lines of therapy (n=5) and 14 patients were in refractory / refractory relapse. No formal MTD was defined, stomatitis and gastrointestinal toxicity at 400 mg BID dose was considered incompatible with prolonged treatment. The RP2D of BEZ235 was defined as 300 mg BID. Four of 24 patients showed clinical benefit. Twenty-two of 24 patients discontinued because of progression, (median time to progression 27 days (4d-112d). There was no association between PK parameters and efficacy or tolerability. Conclusions Combined inhibition of PI3K and mTOR inhibits a clinically meaningful driver pathway in a small subset of patients with ALL, with no benefit in patients with AML.Trial registration ClinicalTrials.gov, identifier NCT01756118. retrospectively registered 19th December 2012, https://clinicaltrials.gov/ct2/show/NCT01756118.
Differential Diagnostic Value of Bilateral Inferior Petrosal Sinus Sampling (BIPSS) in ACTH-Dependent Cushing Syndrome: a Systematic Review and Meta-Analysis
Authors: Wang Hao , Ba Ying , Xing Qian , Cai Run-Ce
Published: September 2020

Background: Previous studies have shown inconsistent results about the usefulness of bilateral inferior petrosal sinus sampling (BIPSS) in differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature.Methods: This study searched PubMed, Embase, Web of Science, Cochrane library, and Wanfang database for published data on the use of BIPSS in Cushing syndrome differential diagnosis as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data.Results: This meta-analysis included a total of 23 studies with 1,617 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91–0.96), 0.89 (95% CI: 0.79–0.95), 8.8 (95% CI: 4.3–17.9), and 0.07 (95% CI: 0.04–0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48–345) and 0.97 (95% CI: 0.95–0.98), respectively.Conclusion: This meta-analysis indicated that BIPSS had high diagnostic value for detecting ACTH in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as an effective method to identify ACTH-secretion sources.
Transtheoretical model-based nutritional interventions in adolescents: a systematic review
Authors: Langamer Jennifer Nakabayashi , Melo Giselle Rha-isa , Toral Natacha
Published: September 2020

Background: Literature has shown a tendency of inadequate dietary intake among youth, consequently, nutritional interventions are required. The transtheoretical model (TTM) classifies individuals based on their readiness to change. This model is widely used for health education interventions with proven efficacy. Purpose: This review aimed to weigh the strength of evidence about the TTM usage in nutritional interventions for adolescents and its effectiveness regarding dietary intake.Methods: This study followed the PRISMA guidelines. Eligible studies were input into Mendeley software. The Adolec, Google Scholar, LILACS, PsycINFO, PubMed, Science Direct and Web of Science databases were searched. Only full original articles written in English, Spanish or Portuguese on randomized controlled trials and quasi-experimental designs that applied the TTM in the design of nutritional interventions targeting adolescents were included, with no restrictions on publication date. The quality and risk of bias was evaluated with the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.Results: The initial search yielded 3779 results. Three studies were rated as strong, six as moderate and five as weak. The final sample of 14 articles included adolescents that were mostly recruited from schools, with interventions ranging from one month to three years. The TTM was used alone or combined with other behavior-change theories and most of the interventions involved digital technology. The nutritional topics covered included fruit and vegetable consumption, low-fat diet, and cooking skills. Four studies presented improvement in fruit and vegetable consumption and four progressed through stages of change. Participants from two interventions reduced fat intake. At the end of one intervention, all the participants were in action and maintenance stages. Conclusion: The TTM seems to be a successful strategy for nutritional intervention aiming at improving dietary intake in adolescents. Its application in different contexts shows that the TTM is flexible and possible to be implemented in many settings. The use of the model is shown to be restricted to the stage of change’ construct. Further studies should use all constructs of the TTM in the design and compare the TTM with other behavior-change theories to better understand its effectiveness.
Understanding the Role of Elastic Modulus in the Relationship Between Second Harmonic Generation Scattering and Tumor Cell Motility
Authors: Elias Tresa M. , Desa Danielle E. , Nguyen Phong K. , Goyal Ananya , Benoit Danielle , Buckley Mark R. , Kuo Catherine K. , Brown Edward
Published: September 2020

Background

Second harmonic generation (SHG) is an intrinsic optical property of fibrillar collagen. SHG directionality is quantified by F/B, the ratio of forward- to backward-propagating signal, which is affected by collagen fiber internal structure, specifically the diameter, spacing, and disorder of fibrils within a collagen fiber. We have previously shown that F/B of primary invasive ductal carcinoma sections is prognostic of metastatic outcome. One possible cause of this relationship was revealed by our observation that tumor cells’ motility on collagen I gels varied when collagen fiber internal structure in those gels was manipulated. The mechanism by which tumor cells sense changes in collagen fiber internal structure remains unknown: here we evaluate the role of elastic modulus in the relationship between collagen fiber internal structure (as reported by F/B) and tumor cell motility.

Methods

The 4T1 murine mammary adenocarcinoma, a model of metastatic triple negative breast cancer, (TNBC) and the 67NR line, a non-metastatic luminal phenotype, were introduced to a series of collagen-polyacrylamide mixed gels wherein collagen fiber internal structure and gel elastic modulus were independently controlled. F/B was measured with SHG, while elastic modulus was measured globally via rheometry and locally via atomic force microscopy (AFM). Tumor cell motility was quantified over three hours.

Results

The motility of both cell lines varied with F/B while elastic modulus was held constant, and did so at two physiological modulus values. Interestingly, 4T1 cell motility increased as F/B increased, while 67NR cell motility decreased.

Conclusions

Our results suggest that elastic modulus does not play a significant role in the observed relationship between collagen fiber internal structure (as reported by F/B) and tumor cell motility, for two cell lines that are models of TNBC and luminal-like breast cancer. Our observation that the two lines exhibit opposite motility trends as F/B increases is consistent with the trends in metastatic outcome versus F/B observed in our published clinical data for luminal versus basal cohorts, and suggests that a tumor’s subtype may play a role in their response to collagen fiber internal structure.
The use of inappropriate anal douching tool associates with increased HIV infection among men who have sex with men: a cross-sectional study in Shenyang, China
Authors: Chu ZhenXing , Shen Guangquan , Hu Qinghai , Wang Hongyi , Zhang Jing , Dong Willa , Jiang Yongjun , Geng Wenqing , Shang Hong , Xu Junjie
Published: September 2020

Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is correlated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%, 25/307) before sex. The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD (adjusted odds ratio (AOR), 2.8; 95% confidence interval (CI), 1.4-5.5), practicing RD before sex (AOR, 2.3; 95% CI, 1.2–4.3), practicing RD after sex (AOR, 1.8; 95% CI, 1.0–3.1), using a shower hose for RD (AOR, 3.5; 95% CI, 1.1–13.0), CRAI (AOR, 2.9; 95% CI, 1.6–5.5), and an interaction effect of RD and CRAI (AOR = 4.2; 95 % CI, 2.2- 8.1) in the most recent anal intercourse.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools use (such as shower hose), the interaction effect between RD and CRAI associated with HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM. We recommend that cohort studies should be conducted to confirm the causal relationship between RD and acquiring HIV.
Comparison of practicability and effectiveness between unassisted HIV self-testing and directly assisted HIV self-testing in the Democratic Republic of the Congo: A randomized feasibility trial
Authors: Tonen-Wolyec Serge , Tshilumba Charles Kayembe , Batina-Agasa Salomon , Djang’eing’a Roland Marini , Hayette Marie-Pierre , Bélec Laurent
Published: September 2020

Background. HIV self-testing (HIVST) can be performed using directly assisted and unassisted approaches in facilities or communities to reach different populations. The aim of this study was to compare the practicability and effectiveness of the two delivery approaches for HIVST, unassisted HIVST (UH) and directly assisted HIVST (DAH), in the field setting of Kisangani, the Democratic Republic of the Congo (DRC).Methods. A randomized (1:1), non-blinded, non-inferiority trial using a blood-based and facility-based HIVST method was carried out in four facilities in Kisangani, the DRC, targeting populations at high risk for HIV infection. The primary outcome was the difference in the practicability of the HIV self-test between the two arms. Practicability was defined as successfully performing the test and correctly interpreting the result. Requests for assistance, positivity rate, linkage to care, and willingness to buy an HIV self-test kit constituted the secondary outcomes for HIVST effectiveness. The adjusted risk ratios (aRRs) were calculated using Poisson regression. Results. The rate of successfully performing the test was same (93.2%) in the UH and DAH arms. The rate of correctly interpreting the results was 86.9% in the UH arm versus 93.2% in the DAH arm, for a difference of -6.3%. After the follow-up 72 h later, participants in the UH arm had a significantly lower chance of correctly interpreting the test results than those in the DAH arm (aRR: 0.60; P=0.019). Although the positivity rate was 3.4% among the participants in the DAH arm and 1.7% among those in the UH arm, no significant differences were found between the two arms in the positivity rate, requests for assistance, and linkage to care. Willingness to buy an HIV self-test was higher in the UH arm than in the DAH arm (92.3% versus 74.1%; aRR: 4.20; P<0.001). Conclusion. The results of this study indicate that UH is as practicable and effective as DAH among individuals at high risk for HIV infection in Kisangani, the DRC. However, additional support tools need to be assessed to improve the interpretation of the self-test results when using the UH approach. Trial registration: PACTR201904546865585. Registered 03 April 2019 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=6032
The injury mechanisms and injury pyramids among children and adolescents in Zhuhai City, China
Authors: Yin Xiling , Dai Wencan , Du Yukai , Li Deyun
Published: September 2020

Background: The unclear mechanisms and severity of injuries in the injury pyramids for Chinese children and adolescents prevent the prioritization of interventions. This study aimed to describe the injury mechanisms and injury pyramids in this population to provide a priority for injury prevention strategies.Methods: Death, hospitalization, and outpatient/emergency department visit data from patients aged 0~17 years with injuries were obtained from January 1, 2013, to December 31, 2017, in Zhuhai City, China. The injury mechanism ratios were calculated, and the injury pyramid ratios were drawn in proportion using injury mortality and the incidence of both injury hospitalizations and outpatient/emergency department injury visits.Results: The top three mechanisms for injuries in children and adolescents treated in outpatient/emergency departments were falls (52.02%), animal bites (14.57%), and blunt injuries (10.60%). The top three mechanisms for injury hospitalizations were falls (37.33%), road traffic injuries (17.87%), and fire/burns (14.29%), while the top three mechanisms for injury deaths were drowning (32.91%), road traffic injuries (20.25%) and falls (13.92%). The incidence rate of outpatient/emergency department injury visits for children and adolescents was 11,210.87/100,000; the incidence rate of injury hospitalization was 627.09/100,000, and the injury death rate was 10.70/100,000. For each injury death, there were 59 injury hospitalizations and 1,047 outpatient/emergency injury visits.Conclusions: The injury mechanisms were different for injury-related outpatient/emergency department visits, hospitalizations, and deaths among children and adolescents. The injury mechanisms by sex at different stages of child development, and interventions should be formulated based on this finding. The ratios of the injury pyramids varied by age, sex, region, and injury mechanisms; minor nonfatal injuries were more common in children and adolescents. The differences in the severity and extent of the injuries suggested that injury interventions in children and adolescents still have a long way to go.
Experiences of oral health: before, during and after becoming a regular user of GC Tooth Mousse Plus ®
Authors: Sbaraini Alexandra , Adams Geoffrey G , Reynolds Eric C
Published: September 2020

Background: Clinical trials and laboratory studies from around the world have shown that GC Tooth Mousse Plus® (TMP) is effective in protecting teeth from tooth decay and erosion, buffering dental plaque pH, remineralising white spot lesions and reducing dentine hypersensitivity. However, no other study has assessed the experiences of oral health, before, during and after individuals became regular users of TMP. Aim: To identify how participants’ oral health status changed after introducing TMP into their oral hygiene routine.Methods: A qualitative study using Charmaz’s grounded theory methodology was conducted. Fifteen purposively sampled regular users of TMP were interviewed. Transcripts were analysed after each interview. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation. Results: Participants described their experiences of oral health and disease, before, during and after introducing TMP into their daily oral hygiene routine, together with the historical, biological, financial, psychosocial, and habitual dimensions of their experiences. Before becoming a regular user of TMP, participants described themselves as having a damaged mouth with vulnerable teeth, dry mouth, and sensitivity. Various aspects of participants’ histories were relevant, such as, family history and history of oral disease. Having a damaged mouth with vulnerable teeth, dry mouth and sensitivity was explained by those elements. Despite some initial barriers, once being prescribed TMP by a dental professional, a three-fold process of change was initiated: starting a new oral hygiene routine, persevering daily and experiencing reinforcing outcomes. This process led to a fundamental lifestyle change. Participants transitioned from having a damaged mouth with vulnerable teeth to having a comfortable mouth with strong teeth; at the same time participants felt empowered by this newly found status of being able to keep their teeth for life. Barriers and facilitators for incorporating TMP on daily oral hygiene routine were also identified.Conclusions: Participants valued having a comfortable mouth with strong teeth, which did not require repeated restorations. Seeing concrete results in their mouths and experiencing a more comfortable mouth boosted adherence to daily applications of TMP, which was maintained over time.
The influence of the Municipal Human Development Index and maternal education on infant mortality: a parallel investigation in a retrospective cohort study in the extreme south of Brazil
Authors: Anele Carolina Ribeiro , Hirakata Vânia Naomi , Goldani Marcelo Zubaran , Silva Clécio Homrich da
Published: September 2020

Background

Infant mortality is considered an important and sensitive health indicator in several countries, especially in underdeveloped and developing countries. Most of the factors influencing infant mortality are interrelated and are the result of social issues. Therefore, this study performed a parallel investigation of the influence of the MHDI on the macro-region of residence and maternal education on infant mortality in a capital in the extreme south of Brazil.

Methods

It is a retrospective cohort study with data on births and deaths in the first year of live for the period of 2000-2017. The association between the independent variables and the outcome was done by bivariate analysis through simple Poisson regression. The variables that can potentially be considered confusing were used in a multiple Poisson regression for robust variances - adjusted model.

Results

The study included 311361 children, of whom 2271 died. Maternal education, individually and jointly analyzed with the MHDI, showed association with the outcome of infant death in the first year of life, particularly for children of mothers with lower maternal education (p<0.001). In relation to other related factors, maternal age; number of Prenatal Care Consultations; gestational age, weight, gender and Apgar Index (5th minute) of the newborn showed association with IM (p<0.001).

Conclusions

Although the HDI is considered a good predictor of infant mortality by some authors, the analyses of the present study did not present an association between the MHDI and death in the first year of life after adjustments for the other variables. Unlike the MHDI, maternal education under eight years of study maintained an association with infant death, proving to be a social determinant with relevant impact on infant mortality. Thus, it is concluded that maternal education, individually, is higher than the MHDI to assess the outcome of infant mortality and is easily accessible information.
Association between Short Sleep Duration and Overweight/Obesity among middle-school students: a cross-sectional study in Fuzhou, China
Authors: Li Guobo , Wei Shichao , Zheng Fuhao , Xu Xingyan , Cai Yingying , Wu Siying
Published: September 2020

Background: This study was designed to investigate the prevalence of short sleep duration and explore the association between short sleep duration and overweight or obesity in adolescents from middle school in Fuzhou, China. Methods: Questionaires focusing on short sleep duration and overweight or obesity related factors were collected. The sleep duration was self-reported by the subjects. The body weight and height of each subject were measured by the qualified personnel. Logistic regression analysis was used to evaluate the effects of short sleep duration on overweight or obesity in school students. Results: The overall rates of overweight and obesity were 12.1% and 7.1%, respectively. The prevalence of short sleep duration among students was 82.8%. The majority of high school students (92.5%) suffered from short sleep duration. Compared with male children with a sleep duration of over 8 hrs a day, the odds ratios (95% CI) of overweight/obesity for those with a sleep duration of less than 6 h or 6 - 8 h, were 1.63 (1.25-2.13) and 1.06 (0.88-1.27). After adjusting social and demographic status, mental health and lifestyle factors, the odds ratios of female children were 1.38(0.99-1.93) and 1.04 (0.79-1.35), respectively. Conclusions: A large number of adolescents suffered from short sleep duration. Short sleep duration was negatively correlated with overweight/obesity among male children.
Evolutionary engineering of Lactobacillus bulgaricus reduces enzyme usage and enhances conversion of lignocellulosics to D-lactic acid by simultaneous saccharification and fermentation
Authors: J. Vishnu Prasad , Sahoo Tridweep K. , S. Naveen , Jayaraman Guhan
Published: September 2020

BackgroundSimultaneous saccharification and fermentation (SSF) of pre-treated lignocellulosics to biofuels and other platform chemicals has long been a promising alternative to separate hydrolysis and fermentation processes. However, the disparity between the optimum conditions (temperature, pH) for fermentation and enzyme hydrolysis leads to execution of the SSF process at sub-optimal conditions, which can affect the rate of hydrolysis and cellulose conversion. The fermentation conditions could be synchronized with hydrolysis optima by carrying out the SSF at a higher temperature, but this would require a thermo-tolerant organism. Economically viable production of platform chemicals from lignocellulosic biomass (LCB) has long been stymied because of the significantly higher cost of hydrolytic enzymes. The major objective of this work is to develop an SSF strategy for D- lactic acid production by a thermo-tolerant organism, in which the enzyme loading could significantly be reduced without compromising on the overall conversion.ResultsA thermo-tolerant strain of Lactobacillus bulgaricus was developed by adaptive laboratory evolution (ALE) which enabled the SSF to be performed at 45 °C with reduced enzyme usage. Despite the reduction of enzyme loading from 15 Filter Paper Unit/ gLCB (FPU/gLCB) to 5 FPU/gLCB, we could still achieve ~8% higher cellulose to D-Lactic acid (D-LA) conversion in batch SSF, in comparison to the conversion by separate enzymatic hydrolysis and fermentation processes at 45 °C and pH 5.5. Extending the batch SSF to SSF with pulse-feeding of 5% pre-treated biomass and 5 FPU/gLCB, at 12-hour intervals (36th h – 96th h), resulted in a titer of 108 g/L D-LA and 60% conversion of cellulose to D-LA. This is one among the highest reported D-LA titers achieved from LCB.ConclusionsWe have demonstrated that the SSF strategy, in conjunction with evolutionary engineering, could drastically reduce enzyme requirement and be the way forward for economical production of platform chemicals from lignocellulosics. We have shown that fed-batch SSF processes, designed with multiple pulse-feedings of the pre-treated biomass and enzyme, can be an effective way of enhancing the product concentrations.
Sortilin levels correlate with major cardiovascular events of diabetic patients with peripheral artery disease following revascularization: a prospective study
Authors: Biscetti Federico , Nardella Elisabetta , Rando Maria Margherita , Cecchini Andrea Leonardo , Bonadia Nicola , Bruno Piergiorgio , Angelini Flavia , Stasi Carmine Di , Contegiacomo Andrea , Santoliquido Angelo , Pitocco Dario , Landolfi Raffaele , Flex Andrea
Published: September 2020

Background: Peripheral artery disease (PAD) represents one of the most relevant vascular complications of type 2 diabetes mellitus (T2DM). Moreover, T2DM patients suffering from PAD have an increased risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Sortilin, a protein involved in apolipoproteins trafficking, is associated with lower limb PAD in T2DM patients.Objective: To evaluate the relationship between baseline serum levels of sortilin, MACE and MALE occurrence after revascularization of T2DM patients with PAD and chronic limb-threatening ischemia (CLTI).Research Design and Methods: We performed a prospective non-randomized study including 230 statin-free T2DM patients with PAD and CLTI. Sortilin levels were measured before the endovascular intervention and incident outcomes were assessed during a 12-month follow-up.Results: Sortilin levels were significantly increased in individuals with more aggressive PAD (2.25 ± 0.51 ng/mL vs 1.44 ± 0.47 ng/mL, p < 0.001). During follow-up, 83 MACE and 116 MALE occurred. In patients, who then developed MACE and MALE, sortilin was higher. In particular, 2.46 ± 0.53 ng/mL vs 1.55 ± 0.42 ng/mL, p < 0.001 for MACE and 2.10 ± 0.54 ng/mL vs 1.65 ± 0.65 ng/mL, p < 0.001 for MALE. After adjusting for traditional atherosclerosis risk factors, the association between sortilin and vascular outcomes remained significant in a multivariate analysis. In our receiver operating characteristics (ROC) curve analysis using sortilin levels the prediction of MACE incidence improved (area under the curve [AUC] = 0.94) and MALE (AUC = 0.72).Conclusions: This study demonstrates that sortilin correlates with incidence of MACE and MALE after endovascular revascularization in a diabetic population with PAD and CLTI.
Baseline Well-being, Perceptions of Critical Incidents, and Openness to Debriefing in Community Hospital Emergency Department Clinical Staff Before COVID-19, a Cross-Sectional Study
Authors: Cantu Laura , Thomas Listy
Published: September 2020

Background: Emergency department personnel routinely bear witness to traumatic experiences and critical incidents that can affect their own well-being. Peer support through debriefing has demonstrated positive impacts on clinicians’ well-being following critical incidents. This study explored community hospital emergency department staff’s perceptions of critical incidents, assessed openness to debriefing and measured baseline well-being. Our analysis provides a baseline of provider well-being immediately prior to the local onset of COVID-19. The potential need for additional resources to support frontline providers during the pandemic can be evaluated. Method: We conducted a cross-sectional study for 4-weeks prior to the first COVID-19 case in Connecticut using a survey offered to an interprofessional group of emergency department clinical staff. The main outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Professional Quality of Life (ProQOL) scale. Pearson’s chi-square test was used to identify significant differences in perceptions of critical incidents and debriefings between professional categories. One-way ANOVA and Tukey’s test were used to analyze significant differences in well-being between professional categories. Results: Thirty-nine clinical personnel from St. Vincent’s Emergency Department responded to the survey. Events frequently selected as critical incidents were caring for critically ill children (89.7%), mass casualty events (84.6%), and death of a patient (69.2%). Critical incidents were commonly reported (81.6%) as occurring once per week. Additionally, 76.2% of participants reported wanting to discuss a critical incident with their team. Across all respondents, 45.7% scored borderline or abnormal for anxiety, 55.9% scored moderate for burnout, and 55.8% scored moderate to high for secondary traumatic stress.Conclusions: At baseline, providers reported caring for critically ill children, mass casualty events, and death of a patient as critical incidents, which typically occurred once per week. Death of a patient occurs at increased frequency during the protracted mass casualty experience of COVID-19 and threatens provider well-being. Receptiveness to post-event debriefing is high but the method is still underutilized. With nearly half of staff scoring borderline or abnormal for anxiety, burnout, and secondary traumatic stress at baseline, peer support measures should be implemented to protect frontline providers’ well-being during and after the pandemic.
Target screening of plant secondary metabolites in river waters by liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS)
Authors: Nanusha Mulatu Yohannes , Krauss Martin , Schönsee Carina D. , Günthardt Barbara F. , Bucheli Thomas D. , Brack Werner
Published: September 2020

Background: Substantial efforts have been made to monitor potentially hazardous anthropogenic contaminants in surface waters while for plant secondary metabolites (PSMs) almost no data on occurrence in the water cycle are available. These metabolites enter river waters through various pathways such as leaching, surface run-off and rain sewers or input of litter from vegetation and might add to the biological activity of the chemical mixture. To reduce this data gap we conducted a LC-HRMS target screening in river waters from two different catchments for 150 plant metabolites which were selected from a larger database considering their expected abundance in the vegetation, their potential mobility, persistence and toxicity in the water cycle and commercial availability of standards. Results: The screening revealed the presence of 12 out of 150 possibly toxic PSMs including coumarins (bergapten, scopoletin, fraxidin, esculetin and psoralen), a flavonoid (formononetin) and alkaloids (lycorine and narciclasine). The compounds narciclasine and lycorine were detected at concentrations up to 3 µg/L while esculetin and fraxidin occurred at concentrations above 1 µg/L. Nine compounds occurred at concentrations above 0.1 µg/L, the Threshold for Toxicological Concern (TTC) for non-genotoxic and non-endocrine disrupting chemicals in drinking water. Conclusions: Our study provides an overview of potentially biologically active PSMs in surface waters and recommends their consideration in monitoring and risk assessment of water resources. This is currently hampered by a lack of effect data including toxicity to aquatic organisms, endocrine disruption and genotoxicity and demands for involvement of these compounds in biotesting.
Accuracy of Implant Surgical Guides Fabricated Using Computer Numerical Control Milling for Edentulous Jaws: A Pilot Clinical Trial
Authors: Chai Jinyou , Liu Xiaoqian , Schweyen Ramona , Setz Jürgen , Pan Shaoxia , Liu Jianzhang , Zhou Yongsheng
Published: September 2020

Background: To evaluate the accuracy of a computer numerical control (CNC) milled surgical guide for implant placement in edentulous jaws.Methods: Edentulous patients seeking implants treatment were recruited in this prospective cohort study. Radiographic guides with diagnostic templates were fabricated from wax-up dentures. Patients took cone-beam computed tomography (CBCT) wearing the radiopaque radiographic guides. Implant positions were virtually designed in the planning software based on the CBCT data, and the radiographic templates were converted into surgical guides using CNC milling technique. Forty-four implants were placed into 12 edentulous jaws following guided implant surgery protocol. Post-surgery CBCT scans were made for each jaw, and the deviations between the planned and actual implant positions were measured. Deviation of implant position was compared between maxilla and mandible, and between cases with and without anchor pins using independent t-test.Results: Nine patients (3 males and 6 females) with 12 edentulous jaws were recruited. The mean age of patients was 59.2±13.9 years old. All 44 implants was placed without complication and survived, The mean three dimensional linear deviation of implant position between virtual planning and actual placement was 1.53 ±0.48mm at the implant neck and 1.58 ±0.49 mm at the apex. The angular deviation was 3.96 ±3.05 degrees. No significant difference was found in the deviation of implant position between maxilla and mandible (P=0.28 at neck, 0.08 at apex), nor between cases with and without anchor pins (P=0.87 at neck, 0.06 at apex). Conclusions: The guides fabricated using the CNC milling technique provided comparable accuracy as those fabricated by Stereolithography. The displacement of the guides on edentulous arch might be the main contributing factor of deviation.Trial registration: Chinese Clinical Trial Registry, ChiCTR-ONC-17014159
Developing EU environmental standards for the food, drink and milk industries: key environmental issues and data collection
Authors: Santonja German Giner , Karlis Panagiotis
Published: September 2020

Background

The European Commission organised the review of the best available techniques reference document for the food, drink and milk industries according to the provisions of the Industrial Emissions Directive (Directive 2010/75/EU). Under this policy, an exchange of information between Member States, industrial organisations, non-governmental organisations promoting the protection of the environment and the European Commission took place.

Results

A crucial part for developing these EU environmental standards was a systematic determination of the key environmental issues of the food, drink and milk sector. Key environmental issues were defined for emissions to air and water, and for energy and water consumption. The key environmental issues were systematically determined by using four criteria proposed by the European Commission. Moreover, a data collection procedure was designed and real-plant emissions and consumption data were obtained for the first time from a representative variety of food, drink and milk installations across the European Union.

Conclusions

The development of the EU environmental standards for the food, drink and milk sector are based on a systematic determination of the key environmental issues and on a representative data collection for this sector. This paper also highlights the main normative, organisational and procedural factors addressed during the environmental policy integration carried out to develop these standards.
Frictional properties of anorthite (feldspar): Implications for the lower boundary of the seismogenic zone
Authors: Masuda Koji
Published: September 2020

Earthquake magnitude is closely related to the depth extent of the seismogenic zone, and higher magnitude earthquakes occur where the seismogenic zone is thicker. The frictional properties of the dominant mineral constituents of the crust, such as feldspar-group minerals, control the depth extent of the seismogenic zone. Here, the velocity dependence of the steady-state friction of anorthite, the calcic endmember of the feldspar mineral series, was measured at temperatures from 20 to 600 °C, pore pressures of 0 (“dry”) and 50 MPa (“wet”), and an effective pressure of 150 MPa. The results support previous findings that the frictional properties of feldspar play a dominant role in limiting the depth extent of the seismogenic zone. This evidence suggests that brittle deformation of anorthite may be responsible for brittle fault movements in the brittle–plastic transition zone.
Modeling Acute Ethanol-Induced Impairment with Gastric Organoids
Authors: Wang Wanjuan , Zhao Ying , Su Zeqi , Chu Fuhao , Li Tao , Li Yuan , Song Xiaoyu , Liu Xu , Liu Xing , Ding Xia
Published: September 2020

Background: Ethanol have been linked to atrophic gastritis and gastric carcinoma. Although it is well known that ethanol can result in hypochlorhydria, the molecular mechanisms underlying this phenomenon remain poorly understood.Results: Here we used gastric organoids to show that ethanol permeabilized the apical membrane of gastric parietal cells and induced ezrin hypochlorhydria. The functional consequences of ethanol on parietal cell physiology were studied using organoids. Gastric organoids were pre-incubated in the basic medium or with EGTA or E64 , and incubated at 37℃ in either medium alone, or medium containing 6% ethanol. We assessed ezrin proteolysis. Ethanol permeabilization induced activation of calpainⅠand subsequent proteolysis of ezrin, which resulted in the liberation of ezrin from the apical membrane of the parietal cells. Significantly, expression of calpain-resistant ezrin restored the functional activity of parietal cells in the presence of ethanol.Conclusion: Taken together, our data indicated that ethanol disrupted the apical membrane-cytoskeletal interactions in gastric parietal cells and thereby caused hypochlorhydria.
Pacemaker-generated stress fracture of the second rib: a case report
Authors: Ksela Jus , Racman Mark , Zbacnik Rok , Djordjevic Anze , Jan Matevz
Published: September 2020

Background: Pocket-related complications following the implantation of cardiovascular implantable electronic devices primarily include pocket hematoma, infection, skin erosion or decubitus, device migration, and Twiddler's syndrome, with other pathologies such as nerve impairment or bone lesions being extremely rarely encountered. We report a case of a 20-year old asthenic, non-athlete female patient presenting with a device-generated fracture of the second rib several months after sub-muscular permanent pacemaker implantation due to repeated bilateral pre-pectoral pocket infections.Case presentation: A 20-year old female patient was readmitted to our institution 9 months following sub-pectoral implantation of a permanent pacemaker, complaining of severe pocket-related pain, which arose spontaneously in the absence of direct trauma, intense physical activity or vigorous coughing, and was associated with normal day-to-day activity. To rule out a pacemaker re-infection, a native computed tomography and a positron emission tomography - computed tomography of the thorax were performed. Both modalities excluded an infection but showed a healing fracture and a focus of enhanced metabolic activity in the anterolateral part of the right second rib, indicating a non-traumatic or stress fracture of the bone. Consequently, a complete extraction of the pulse generator and both leads was performed and the smallest available single-chamber pulse generator with a single atrial electrode was implanted in the sub-fascial, pre-muscular pocket in the now recovered and uninfected left subclavicular region, alleviating patient’s severe pain symptoms and significantly enhancing her quality of life.Conclusions: In the absence of direct trauma, intense physical activity or vigorous coughing, we assume that in this asthenic girl a normal day-to-day motion of the right shoulder has persistently forced the sub-muscularly placed pulse generator toward thoracic wall, putting increased repetitive pressure force on the underlying bones, finally causing a fatigue stress fracture of the second rib. In asthenic phenotype patients with small thorax and short subclavicular distance, a sub-muscular pacemaker implantation can potentially cause unique and unexpected pocket-related adverse events necessitating advanced diagnostics and timely treatment.
NOD1 mediates interleukin-18 processing in epithelial cells
responding to Helicobacter pylori infection
Authors: Ferrero Richard , Tran Le Son , Ying Le , D'Costa Kimberley , Wray-McCann Georgie , Kerr Genevieve , Le Lena , Allison Cody , Ferrand Jonathan , Chaudhry Hassan , Emery Jack , De Paoli Amanda , Creed Sarah , Kaparakis-Liaskos Maria , Como Julia , Dowling Jennifer , Johanesen Priscilla , Kufer Thomas , Pedersen John , Mansell Ashley , Philpott Dana , Elgass Kirstin , Abud Helen , Nachbur Ueli , Croker Ben , Masters Seth
Published: September 2020

The interleukin-1 family members, IL-1β and IL-18, are processed into their biologically active forms by multi-protein complexes, known as inflammasomes. Although the inflammasome pathways that mediate IL-1β processing in myeloid cells have been well defined, those involved in IL-18 processing, particularly in non-myeloid cells, are still not well understood. Here, we report that the host defence molecule NOD1 regulates IL-18 processing in epithelial cells to the mucosal pathogens, Helicobacter pylori and Pseudomonas aeruginosa. We show that IL-18 is important in protecting against pre-neoplastic changes induced by gastric H. pylori infection in vivo. NOD1 mediates IL-18 processing via homotypic CARD-CARD interactions with caspase-1, and independently of canonical inflammasome proteins (NLRP3, ASC). These findings reveal an unanticipated role for NOD1 in the formation of bioactive IL-18, thereby underlining the differences in inflammasome functions between haematopoietic and non-haematopoietic cells.
For-Profit Hospitals Have a Unique Opportunity to Serve as Anchor Institutions in the U.S.
Authors: Cronin Cory E. , Franz Berkeley , Choyke Kelly , Rodriguez Vanessa , Gran Brian K.
Published: September 2020

Background

Hospitals serve as anchor institutions in many U.S. communities and make contributions to bolster population health and reduce preventable death. Most studies to date have focused on nonprofit hospitals, but there may be significant opportunity for for-profits to fill this role in both urban and rural communities.
Methods

We calculated descriptive statistics and a multivariate regression model to assess economic and health characteristics for all U.S. counties that contain for-profit as compared to nonprofit or public hospitals.
Results

For-profit hospitals are more likely to be located in counties with higher uninsurance rates and lower self-rated health. After controlling for hospital and county characteristics, we found a significant and positive relationship between for-profit hospital presence and higher county unemployment, higher uninsured rates, and the number of residents reporting poor/fair health. For-profit hospitals were also less likely to be located in states that had expanded Medicaid or which had certificate-of-need laws.
Conclusions

There is substantial opportunity for for-profit hospitals to serve as anchor institutions in many U.S. communities, despite this label more traditionally being applied to nonprofit hospitals. Given that there is not currently a regular reporting mechanism for documenting the community health contributions of for-profit hospitals, policymakers and researchers should evaluate the current state of these contributions and develop incentives to encourage more anchor activities to benefit economically vulnerable communities in the U.S.