bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Urethral Strictures in Transmasculine Patients
Authors: Waterschoot Mieke , Claeys Wietse , Hoebeke Piet , Verla Wesley , Waterloos Marjan , Wirtz Michel , Buncamper Marlon , Lumen Nicolaas
Published: August 2021

Background: Urethral strictures are a common complication after genital gender-affirming surgery (GGAS) in transmasculine patients. Studies that specifically focus on the management of urethral strictures are scarce. The aim of this systematic review is to collect all available evidence on the management of urethral strictures in transmasculine patients who underwent urethral lengthening. Methods: We performed a systematic review of the management of urethral strictures in transmasculine patients after phalloplasty or metoidioplasty (PROSPERO, CRD42021215811) with literature from PubMed, Embase, Web of Science and Cochrane. Preferred Reporting Items for Systematic reviews and Meta-Analysis-(PRISMA) guidelines were followed, and risk of bias was assessed for every individual study using the 5-criterion quality appraisal checklist. Results: Eight case series were included with a total of 179 transmasculine patients. Only one study discussed the management of urethral strictures after metoidioplasty. Urethral strictures were most often seen at the anastomosis between the fixed and pendulous urethra. For each stricture location, different techniques have been reported. All studies were at a high risk of bias. The current evidence is insufficient to favor one technique over another. Conclusions: Different techniques have been described for the different clinical scenarios of urethral stricture disease after GGAS. In the absence of comparative studies, however, it is impossible to advocate for one technique over another. This calls for additional research, ideally well-designed prospective randomized controlled trials (RCTs), focusing on both surgical and functional outcome parameters.
Association between Initial Severity of Facial Weakness and Outcomes of Bell’s Palsy
Authors: Yoo Myung Chul , Park Dong Choon , Yeo Seung Geun
Published: August 2021

To establish whether clinical prognostic factor outcomes differed based on the initial severity of facial weakness and to determine the association between the initial severity of facial weakness and favorable outcomes. This retrospective cohort study analyzed all patients with Bell’s palsy who visited the outpatient clinic of our university hospital from 1 January 2005 through 31 January 2021. The primary outcome was the rate of recovery at 6 months, evaluated separately in patients with initial House–Brackmann (H-B) grades 3–4 and 5–6. Secondary outcomes included clinical factors associated with favorable outcomes stratified by the initial H-B grade. The rate of favorable recovery was higher in patients with initial H-B grades 3–4 than initial H-B grades 5–6 (82.9% vs. 68.2%, p < 0.001). Multivariable logistic regression analysis showed that age 19–65 years and good electromyography (EMG) results were prognostic of good outcomes in patients with initial H-B grades 3–4. In addition, good EMG results, controlled hypertension, and combination antiviral therapy were significantly prognostic of favorable outcomes in patients with initial H-B grades 5–6. Subgroup analysis interactions showed that combination antiviral therapy (OR: 3.06, 95% CI 1.62–5.78, p < 0.001) in initial H-B grades 5–6 were associated with more favorable outcomes at 6 months than with initial H-B grades 3–4. Our results showed that the proportion of patients who achieved favorable outcomes at 6 months and multiple clinical factors affecting favorable outcomes differed significantly among patients differing in initial severity of Bell’s palsy.
Achalasia in Children—Clinical Presentation, Diagnosis, Long-Term Treatment Outcomes, and Quality of Life
Authors: Jarzębicka Dorota , Czubkowski Piotr , Sieczkowska-Gołub Joanna , Kierkuś Jarosław , Kowalski Adam , Stefanowicz Marek , Oracz Grzegorz
Published: August 2021

Background: In spite of the introduction of peroral endoscopic myotomy (POEM), Heller myotomy (HM) remains the mainstay of treatment and the role of pneumatic dilatation (PD) is being debated. The aim of this study was to present a single-center experience in the diagnostic approach and treatment of esophageal achalasia (EA), including the long-term assessment of the QoL. Methods: Data collection was based on the retrospective analysis of clinical notes and prospective interviews with patients and their parents. Results: The study group consisted of 60 patients with EA (F: 26, M: 34), with a median age of 12.0 (1–17) years at diagnosis. The time from the first symptoms until the diagnosis was 1.0 year (0.5–2.0) and the most common were: regurgitation (91.3%), dysphagia (84.8%), and chest pain (47.8%). The diagnostic approach showed a high sensitivity for barium X-ray follow through, esophageal manometry, and endoscopy. Overall, a long-term good outcome of HM was achieved in 27 out of 37 patients (73%) and it was negatively affected by the time between the first symptoms and the diagnosis. Out of the 16 patients who underwent PD before HM, a good outcome was achieved in 14 patients (87.5%), compared to 13 out of 21 patients (62%) who only underwent HM (p = 0.22). Concomitant fundoplication was routinely performed, and 18% required post-operative endoscopic dilatation. At the end of the 12.1 (0.7–26.6)-year follow up, most patients had a good QoL, which significantly corresponded with the treatment outcomes. Conclusions: Patients suspected of EA should undergo a thorough clinical evaluation including a manometry, a barium X-ray, and an endoscopy. HM is a safe and effective treatment for achalasia and the outcome is not worsened by a preceding endoscopic PD. In most patients, HM alleviates symptoms, although an impaired QoL is common in long-term follow ups.
A Standardized Prospective Memory Evaluation of the Effects of COVID-19 Confinement on Young Students
Authors: Pisano Francesca , Torromino Giulia , Brachi Daniela , Quadrini Agnese , Incoccia Chiara , Marangolo Paola
Published: August 2021

The restriction imposed worldwide for limiting the spread of coronavirus disease 2019 (COVID-19) globally impacted our lives, decreasing people’s wellbeing, causing increased anxiety, depression, and stress and affecting cognitive functions, such as memory. Recent studies reported decreased working memory (WM) and prospective memory (PM), which are pivotal for the ability to plan and perform future activities. Although the number of studies documenting the COVID-19 effects has recently blossomed, most of them employed self-reported questionnaires as the assessment method. The main aim of our study was to use standardized tests to evaluate WM and PM in a population of young students. A sample of 150 female psychology students was recruited online for the administration of two self-reported questionnaires that investigated psychological wellbeing (DASS-21), prospective, and retrospective memory (PRMQ). Subjects were also administered two standardized tests for WM (PASAT) and PM (MIST). We found increased anxiety, depression, and stress and decreased PM as measured by self-reports. The perceived memory failures agreed with the results from the standardized tests, which demonstrated a decrease in both WM and PM. Thus, COVID-19 restriction has strongly impacted on students’ mental health and memory abilities, leaving an urgent need for psychological and cognitive recovery plans.
Review of the 2020 ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation—What Has Changed and How Does This Affect Daily Practice
Authors: Tonko Johanna B. , Wright Matthew J.
Published: August 2021

The high prevalence of atrial fibrillation (AF) in the overall population and its association with substantial morbidity, increased mortality and health care cost has instigated significant basic and clinical research efforts over recent years. The publication of multiple new high-quality randomized multi-center trials in the area of AF management and the rapidly evolving technological progress in terms of diagnostic possibilities and catheter ablation in recent years demanded a revision of the previous ESC AF Guidelines from 2016. The 2020 guidelines provide up-to-date, evidence-based guidance for the management of AF. One of the most important innovations is the presentation of a new concept for structural characterization of AF (the “4S AF scheme”) replacing the traditional classification based on its temporal pattern alone (paroxysmal-persistent-permanent). The 4S-AF-scheme highlights the importance of systematic assessment of stroke risk, severity of symptoms, total AF burden and underlying substrate as the foundation for effective and individualized AF treatment for each and every patient. Further novelties relate to the presentation of an easy and intuitive management pathway (“ABC pathway”) and strengthening the recommendations for early rhythm control, in particular the role of first line catheter ablation in heart failure. Another core component of the guidelines is the focus on patient involvement to achieve optimal outcomes. Patient education, shared decision making and incorporation of patient values and patient reported outcome of treatment interventions as well as integrated care by a multidisciplinary team all have a central role in the proposed management pathway for AF.
What Can We Learn from the Past by Means of Very Long-Term Follow-Up after Aortic Valve Replacement?
Authors: Swinkels Ben , ten Berg Jurriën , Kelder Johannes , Vermeulen Freddy , van Boven Wim Jan , de Mol Bas
Published: August 2021

Background: Studies on very long-term outcomes after aortic valve replacement are sparse. Methods: In this retrospective cohort study, long-term outcomes during 25.1 ± 2.8 years of follow-up were determined in 673 patients who underwent aortic valve replacement with or without concomitant coronary artery bypass surgery for severe aortic stenosis and/or regurgitation. Independent predictors of decreased long-term survival were determined. Cumulative incidence rates of major adverse events in patients with a mechanical versus those with a biologic prosthesis were assessed, as well as of major bleeding events in patients with a mechanical prosthesis under the age of 60 versus those above the age of 60. Results: Impaired left ventricular function, severe prosthesis–patient mismatch, and increased aortic cross-clamp time were independent predictors of decreased long-term survival. Left ventricular hypertrophy, a mechanical or biologic prosthesis, increased cardiopulmonary bypass time, new-onset postoperative atrial fibrillation, and the presence of symptoms did not independently predict decreased long-term survival. The risk of major bleeding events was higher in patients with a mechanical in comparison with those with a biologic prosthesis. Younger age (under 60 years) did not protect patients with a mechanical prosthesis against major bleeding events. Conclusions: Very long-term outcome data are invaluable for careful decision-making on aortic valve replacement.
On the Effect of Bimodal Rehabilitation in Asymmetric Hearing Loss
Authors: Monini Simonetta , Filippi Chiara , De Luca Alessandra , Salerno Gerardo , Barbara Maurizio
Published: August 2021

Background: Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study was to assess the effects of wearing a conventional hearing aid in the contralateral ear on BCI in terms of an improved overall auditory performance. Methods: eleven AHL subjects wearing a BCI in their worse hearing ear underwent an auditory evaluation by pure tone and speech audiometry in free field. This study group was obtained by adding to the AHL patients those SSD subjects that, during the follow-up, showed deterioration of the hearing threshold of the contralateral ear, thus presenting with the features of AHL. Four different conditions were tested and compared: unaided, with BCI only, with contralateral hearing aid (CHA) only and with BCI combined with CHA. Results: all of the prosthetic conditions caused a significant improvement with respect to the unaided condition. When a CHA was adopted, its combination with the BCI showed significantly better auditory performances than those achieved with the BCI only. Conclusions: the present study suggests the beneficial role of a CHA in BCI-implanted AHL subjects in terms of overall auditory performance.
Analysis and Reliability of Anthropometric Measurements during Pregnancy: A Prospective Cohort Study in 208 Pregnant Women
Authors: Gómez-Carrascosa Inmaculada , Sánchez-Ferrer María L. , de la Cruz-Sánchez Ernesto , Arense-Gonzalo Julián J. , Prieto-Sánchez María T. , Alfosea-Marhuenda Emilia , Iniesta Miguel A. , Mendiola Jaime , Torres-Cantero Alberto M.
Published: August 2021

Anthropometric assessment during pregnancy is a widely used, low-technology procedure that has not been rigorously evaluated. Our objective is to investigate fat mass distribution during pregnancy by examining changes in anthropometrics measures, in order to evaluate the reliability of these measures. An observational, longitudinal, prospective cohort study was performed in 208 pregnant women. Anthropometric measurements were taken following the ISAK protocol during the three trimesters and a generalized linear model for repeated measures was used to evaluate differences. Variability was assessed using the coefficient of variation, and Propagated Error (PE) was used to sum of skinfold thicknesses (SFT). SFT showed a general increase in fat mass during the three trimesters of pregnancy (∑SFT7 p = 0.003), and was observed in specific anatomical locations as well: arms (∑Arm SFT, p = 0.046), trunk (∑Trunk SFT, p = 0.019), legs (∑Leg SFT, p = 0.001) and appendicular (∑Appendicular SFT, p = 0.001). Anthropometric measures for skinfold thickness were taken individually during pregnancy and were reliable and reproducible during the three trimesters, which could help to prevent adverse pregnancy outcomes.
The Efficacy and Safety of Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiography in Pediatric Patients with Surgically Altered Gastrointestinal Anatomy
Authors: Yokoyama Kensuke , Yano Tomonori , Kanno Atsushi , Ikeda Eriko , Ando Kozue , Miwata Tetsurou , Nagai Hiroki , Kawasaki Yuki , Tada Yamato , Sanada Yukihiro , Tamada Kiichi , Lefor Alan Kawarai , Yamamoto Hironori
Published: August 2021

Balloon enteroscopy-assisted endoscopic retrograde cholangiography (BEA-ERC) is useful and feasible in adults with pancreatobiliary diseases, but its efficacy and safety have not been established in pediatric patients. We compared the success rate and safety of BEA-ERC between adults and pediatric patients. This single-center retrospective study reviewed 348 patients (pediatric: 57, adult: 291) with surgically altered gastrointestinal anatomies who underwent BEA-ERC for biliary disorders from January 2007 to December 2019. The success rate of reaching the anastomosis or duodenal papilla was significantly lower in pediatric patients than in adult patients (66.7% vs. 88.0%, p < 0.01). The clinical success rate was also significantly lower in pediatric patients (64.9% vs. 80.4%, p = 0.014). The rate of adverse events was significantly higher in pediatric patients than in adults (14.2% vs. 7.7%, p = 0.037). However, if the anastomotic sites were reached in pediatric patients, the treatment was highly successful (97.3%). The time of reaching target site was significantly longer in pediatric patients than in adult patients. This study shows that BEA-ERC in pediatric patients is more difficult than that in adult patients. However, in patients where the balloon enteroscope was advanced to the anastomosis, clinical outcomes comparable to those in adults can be achieved.
Comparison of Glaucoma-Relevant Transcriptomic Datasets Identifies Novel Drug Targets for Retinal Ganglion Cell Neuroprotection
Authors: Enz Tim J. , Tribble James R. , Williams Pete A.
Published: August 2021

Glaucoma is a leading cause of blindness and is characterized by the progressive dysfunction and irreversible death of retinal ganglion cells. We aimed to identify shared differentially expressed genes (DE genes) between different glaucoma relevant models of retinal ganglion cell injury using existing RNA-sequencing data, thereby discovering targets for neuroprotective therapies. A comparison of DE genes from publicly available transcriptomic datasets identified 12 shared DE genes. The Comparative Toxicogenomics Database (CTD) was screened for compounds targeting a significant proportion of the identified DE genes. Forty compounds were identified in the CTD that interact with >50% of these shared DE genes. We next validated this approach by testing select compounds for an effect on retinal ganglion cell survival using a mouse retinal explant model. Folic acid, genistein, SB-431542, valproic acid, and WY-14643 (pirinixic acid) were tested. Folic acid, valproic acid, and WY-14643 demonstrated significant protection against retinal ganglion cell death in this model. The increasing prevalence of open access-omics data presents a resource to discover targets for future therapeutic investigation.
The Associations between Sex Hormones and Lipid Profiles in Serum of Women with Different Phenotypes of Polycystic Ovary Syndrome
Authors: Bizoń Anna , Franik Grzegorz , Niepsuj Justyna , Czwojdzińska Marta , Leśniewski Marcin , Nowak Artur , Szynkaruk-Matusiak Malwina , Madej Paweł , Piwowar Agnieszka
Published: August 2021

We aimed to evaluate the relationship between selected serum sex hormones and lipid profiles in a group of women with polycystic ovary syndrome (PCOS) dividing according to four phenotypes, value of body mass index (BMI), and presence of hyperlipidemia. The study included 606 Caucasian women. Lipids and selected hormones were estimated using commercially available procedures during hospitalization in 2017. Phenotype of PCOS, BMI value, and hyperlipidemia were significant factors that influenced androgen hormone concentrations, such as total and free testosterone and androstenedione as well as the value of free androgen index (FAI). Moreover, significant changes in concentrations of dehydroepiandrosterone sulphate and sex hormone binding globulin (SHBG) were found between those groups. Higher quartiles of triglyceride concentrations increased the odds ratio of decreased concentrations of SHBG or increased values of FAI, while an adverse relation was found in case of HDL-C. The concentration of estradiol in the blood of women with PCOS was not associated with lipid profile parameters in any investigated groups. Probably, irregularities in sex hormone concentrations during PCOS is not directly associated with lipid profile parameters but could be reflective of the concentration of SHBG or the ratio of SHBG and total testosterone and their association with lipids.
Determination of the Standard Visual Criterion for Diagnosing and Treating Presbyopia According to Subjective Patient Symptoms
Authors: Tsuneyoshi Yukari , Masui Sachiko , Arai Hiroyuki , Toda Ikuko , Kubota Miyuki , Kubota Shunsuke , Tsubota Kazuo , Ayaki Masahiko , Negishi Kazuno
Published: August 2021

Presbyopia treatments using various modalities have been developed recently; however, no standard criteria exist for the diagnosis and treatment endpoint. This study assessed the relationship between the near visual acuity (NVA) and the subjective symptoms of phakic presbyopia and determined the numerical NVA threshold to diagnose phakic presbyopia and evaluate the effectiveness of presbyopia treatment. The binocular distance, NVA with habitual correction, and monocular conventional VA were measured. Patients were asked about their awareness of presbyopia and difficulty performing near tasks. This prospective observational study included 70 patients (mean age, 56 years; range, 32–77). Most patients became aware of presbyopia in their late forties, although some had difficulty with vision-related near tasks before becoming aware of presbyopia. Eighty three percent of patients (20/24) experienced difficulty with near vision-related tasks even with excellent NVA at 40 cm with habitual correction of 0.0 logMAR (20/20 in Snellen VA). In conclusion, the current study showed that patients became aware of presbyopia in their late forties, although some had difficulty with near vision-related tasks before becoming aware of presbyopia. Further investigation should include the proposal of appropriate diagnostic criteria for presbyopia and better management for patients with presbyopia.
Targeted Temperature Management after Cardiac Arrest: A Systematic Review and Meta-Analysis with Trial Sequential Analysis
Authors: Sanfilippo Filippo , La Via Luigi , Lanzafame Bruno , Dezio Veronica , Busalacchi Diana , Messina Antonio , Ristagno Giuseppe , Pelosi Paolo , Astuto Marinella
Published: August 2021

Target temperature management (TTM) in cardiac arrest (CA) survivors is recommended after hospital admission for its possible beneficial effects on survival and neurological outcome. Whether a lower target temperature (i.e., 32–34 °C) improves outcomes is unclear. We conducted a systematic review and meta-analysis on Pubmed and EMBASE to evaluate the effects on mortality and neurologic outcome of TTM at 32–34 °C as compared to controls (patients cared with “actively controlled” or “uncontrolled” normothermia). Results were analyzed via risk ratios (RR) and 95% confidence intervals (CI). Eight randomized controlled trials (RCTs) were included. TTM at 32–34 °C was compared to “actively controlled” normothermia in three RCTs and to “uncontrolled” normothermia in five RCTs. TTM at 32–34 °C does not improve survival as compared to normothermia (RR:1.06 (95%CI 0.94, 1.20), p = 0.36; I2 = 39%). In the subgroup analyses, TTM at 32–34 °C is associated with better survival when compared to “uncontrolled” normothermia (RR: 1.31 (95%CI 1.07, 1.59), p = 0.008) but shows no beneficial effects when compared to “actively controlled” normothermia (RR: 0.97 (95%CI 0.90, 1.04), p = 0.41). TTM at 32–34 °C does not improve neurological outcome as compared to normothermia (RR: 1.17 (95%CI 0.97, 1.41), p = 0.10; I2 = 60%). TTM at 32–34 °C increases the risk of arrhythmias (RR: 1.35 (95%CI 1.16, 1.57), p = 0.0001, I2 = 0%). TTM at 32–34 °C does not improve survival nor neurological outcome after CA and increases the risk of arrhythmias.
Viscoelastic Hemostatic Assays for Postpartum Hemorrhage
Authors: Liew-Spilger Alyson E. , Sorg Nikki R. , Brenner Toby J. , Langford Jack H. , Berquist Margaret , Mark Natalie M. , Moore Spencer H. , Mark Julie , Baumgartner Sara , Abernathy Mary P.
Published: August 2021

This article discusses the importance and effectiveness of viscoelastic hemostatic assays (VHAs) in assessing hemostatic competence and guiding blood component therapy (BCT) in patients with postpartum hemorrhage (PPH). In recent years, VHAs such as thromboelastography and rotational thromboelastometry have increasingly been used to guide BCT, hemostatic adjunctive therapy and prohemostatic agents in PPH. The three pillars of identifying hemostatic competence include clinical observation, common coagulation tests, and VHAs. VHAs are advantageous because they assess the cumulative contribution of all components of the blood throughout the entire formation of a clot, have fast turnaround times, and are point-of-care tests that can be followed serially. Despite these advantages, VHAs are underused due to poor understanding of correct technique and result interpretation, a paucity of widespread standardization, and a lack of large clinical trials. These VHAs can also be used in cases of uterine atony, preeclampsia, acute fatty liver of pregnancy, amniotic fluid embolism, placental abruption, genital tract trauma, surgical trauma, and inherited and prepartum acquired coagulopathies. There exists an immediate need for a point-of-care test that can equip obstetricians with rapid results on developing coagulopathic states. The use of VHAs in predicting and treating PPH, although in an incipient state, can fulfill this need.
Classification and Assessment of Medication Risk in the Elderly (CARE): Use of a Medication Risk Score to Inform Patients’ Readmission Likelihood after Hospital Discharge
Authors: SanFilippo Savanna , Michaud Veronique , Wei Juanqin , Bikmetov Ravil , Turgeon Jacques , Brunetti Luigi
Published: August 2021

Existing risk tools that identify patients at high risk of medication-related iatrogenesis are not sufficient to holistically evaluate a patient’s entire medication regimen. This study used a novel medication risk score (MRS) which holistically evaluates medication regimens and provides actionable solutions. The main purpose of this study was to quantify adults ≥ 65 years with a high medication risk burden using the MRS and secondarily, appraise MRS association with hospital readmission. This retrospective cohort study included all consecutive patients in a 6-month period aged 65 years and older, admitted for at least 48 h, and prescribed at least five medications upon discharge. Out of 3017 patients screened, 1386 met all criteria. The primary outcome was the proportion of patients with a score of ≥20 and the secondary outcome was the 30-day readmission rate. In the overall population, 17% of patients had an MRS ≥ 20. For patients discharged home, there was a 19% readmission rate for a score ≥ 20 and 11% for <20 (p = 0.009). A score of ;≥20 was associated with a 1.8-fold increased risk of readmission in patients discharged home. Only 7% of patients met these criteria, which can help direct future use of the MRS at patients with the highest risk of medication-related iatrogenesis.
Adiposity Is Related to Inflammatory Disease Activity in Juvenile Idiopathic Arthritis
Authors: Diaz-Cordovés Rego Gisela , Núñez-Cuadros Esmeralda , Mena-Vázquez Natalia , Aguado Henche Soledad , Galindo-Zavala Rocío , Manrique-Arija Sara , Martín-Pedraz Laura , Redondo-Rodríguez Rocio , Godoy-Navarrete Francisco Javier , Fernández-Nebro Antonio
Published: August 2021

Objective: To identify factors associated with the higher proportion of fatty tissue and overweight/obesity observed in patients with juvenile idiopathic arthritis (JIA). Patients and methods: We performed a cross-sectional study of 80 JIA patients aged 4–15 years with 80 age- and sex-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry. The 27-joint Juvenile Arthritis Disease Activity score (JADAS27) was calculated. Two multivariate models were constructed to identify factors associated with overweight/obesity and fat mass index (FMI). Results: No differences were found between cases and controls in body mass index (BMI) or body composition. However, compared with controls, patients with a high inflammatory activity (JADAS27 > 4.2 for oligoarticular JIA or >8.5 for polyarticular disease) had higher values for BMI (p = 0.006); total fat mass (p = 0.003); FMI (p = 0.001); and fat in the legs (p = 0.001), trunk (p = 0.001), and arms (p = 0.002). The factors associated with overweight/obesity in patients were the duration of therapy with biological drugs, measured in months (OR [95% CI] = 1.12 [1.02–1.04]; p = 0.037), and physical activity (OR [95% CI] = 0.214 [0.07–0.68]; p = 0.010), while the factors associated with FMI were age (β [95% CI] = 0.30 [0.17–1.41]; p = 0.014), JADAS27 (β [95% CI] = 0.45 [0.16–1.08]; p = 0.009), and physical activity (β [95% CI] = −0.22 [−5.76 to 0.29]; p = 0.031). Conclusion: Our study revealed no differences between JIA patients with well-controlled disease and low disability and the healthy population in BMI or body composition. Furthermore, the association observed between inflammatory activity and adiposity could be responsible for poorer clinical course.
Prediction of Changes in Seafloor Depths Based on Time Series of Bathymetry Observations: Dutch North Sea Case
Authors: Toodesh Reenu , Verhagen Sandra , Dagla Anastasia
Published: August 2021

Guaranteeing safety of navigation within the Netherlands Continental Shelf (NCS), while efficiently using its ocean mapping resources, is a key task of Netherlands Hydrographic Service (NLHS) and Rijkswaterstaat (RWS). Resurvey frequencies depend on seafloor dynamics and the aim of this research is to model the seafloor dynamics to predict changes in seafloor depth that would require resurveying. Characterisation of the seafloor dynamics is based on available time series of bathymetry data obtained from the acoustic remote sensing method of both single-beam echosounding (SBES) and multibeam echosounding (MBES). This time series is used to define a library of mathematical models describing the seafloor dynamics in relation to spatial and temporal changes in depth. An adaptive, functional model selection procedure is developed using a nodal analysis (0D) approach, based on statistical hypothesis testing using a combination of the Overall Model Test (OMT) statistic and Generalised Likelihood Ratio Test (GLRT). This approach ensures that each model has an equal chance of being selected, when more than one hypothesis is plausible for areas that exhibit varying seafloor dynamics. This ensures a more flexible and rigorous decision on the choice of the nominal model assumption. The addition of piecewise linear models to the library offers another characterisation of the trends in the nodal time series. This has led to an optimised model selection procedure and parameterisation of each nodal time series, which is used for the spatial and temporal predictions of the changes in the depths and associated uncertainties. The model selection results show that the models can detect the changes in the seafloor depths with spatial consistency and similarity, particularly in the shoaling areas where tidal sandwaves are present. The predicted changes in depths and uncertainties are translated into a probability risk-alert map by evaluating the probabilities of an indicator variable exceeding a certain decision threshold. This research can further support the decision-making process when optimising resurvey frequencies.
Undercurrents in the Northeastern Black Sea Detected on the Basis of Multi-Model Experiments and Observations
Authors: Demyshev Sergey G. , Dymova Olga A. , Markova Natalia V. , Korshenko Evgenia A. , Senderov Maksim V. , Turko Nikita A. , Ushakov Konstantin V.
Published: August 2021

Numerical simulation results of the Black Sea circulation obtained by four ocean dynamics models are compared to each other and to in situ data in order to determine the features of the Black Sea deep-water circulation such as deep-water undercurrents. The year 2011 is chosen as the test period due to the availability of deep-sea observations, including ARGO profiles and ADCP current velocities. Validation of the simulation results is based on comparison with the temperature and salinity measured by the ARGO floats. Anticyclonic currents (undercurrents) under the cyclonic Rim Current are detected by the results of all numerical models near the North Caucasian coast. The main characteristics of undercurrents are consistent with in situ data on current velocity up to a depth of 1000 m obtained by the Aqualog probe at the IO RAS test site near Gelendzhik in June 2011. The analysis of the spatio-temporal variability of the modeled salinity and velocity fields reveals that the most probable origin of the undercurrents is the horizontal density gradient of seawater in the region.
A Study of the Potential Impact of Dredging the Corpus Christi Ship Channel on Passive Particle Transport
Authors: Valseth Eirik , Loveland Mark D. , Dawson Clint , Buskey Edward J.
Published: August 2021

We present a study of the potential impact of deepening the Corpus Christi Ship Channel through Aransas Pass; in particular, we study the effect on the transport of red drum fish larvae due to the change in channel depth. The study was conducted by high resolution simulation of the circulation of the seawater entering and exiting the pass for the current and proposed Ship Channel depths. The computer model incorporates tides and meteorological forcing and includes the entire Gulf of Mexico and the North American Atlantic coast. The corresponding transport of larvae modeled as passive particles due to the sea water circulation is established by releasing particles in the nearshore region outside Aransas Pass and subsequently tracking their trajectories. We compare the difference in the number of larvae that successfully reach appropriate nursery grounds inside Aransas Pass for four distinctive initial larvae positions in the nearshore region. Our results indicate that the change in channel depth does not significantly alter the number of red drum larvae that reach suitable nursery grounds, overall, across all considered scenarios, we see a net increase of 0.5%.
A Cost-Effective Approach to the Risk Reduction of Cable Fault Triggered by Laying Repeaters of Fiber-Optic Submarine Cable Systems in Deep-Sea
Authors: Ogasawara Yukitoshi , Natsu Wataru
Published: August 2021

Long-distance submarine cable systems, such as the transoceanic system, generally consist of a series of cables and repeaters. Repeater units are spaced at regular intervals to boost the attenuated optical signal and presently contain optical amplifiers in a pressure vessel made of copper alloy. Since the repeater unit is more massive than the cable, it pulls the cable catenary locally toward the seabed. In the 1990s, several studies numerically simulated cable behavior in the water and showed that the seabed slack runs short, and the seabed cable tension increases just before the repeater reaches the seabed. Therefore, it has been pointed out that an unarmored cable with a polyethylene sheath can be easily damaged. However, no reports have been published regarding the actual situation of cable faults related to the laying of repeaters. This study quantitatively analyzes the mechanism of cable damage related to the laying of repeaters, based on experiments, simulations, maintenance records, and a comparative analysis between the simulation results and actual cable faults. Cost-effective methods to mitigate cable faults triggered by laying a repeater in the deep sea are also explored to ensure mechanical stability during the design lifetime.
Emission Abatement Technology Selection, Routing and Speed Optimization of Hybrid Ships
Authors: Ritari Antti , Spoof-Tuomi Kirsi , Huotari Janne , Niemi Seppo , Tammi Kari
Published: August 2021

This paper evaluates the effect of a large-capacity electrical energy storage, e.g., Li-ion battery, on optimal sailing routes, speeds, fuel choice, and emission abatement technology selection. Despite rapid cost reduction and performance improvement, current Li-ion chemistries are infeasible for providing the total energy demand for ocean-crossing ships because the energy density is up to two orders of magnitude less than in liquid hydrocarbon fuels. However, limited distance zero-emission port arrival, mooring, and port departure are attainable. In this context, we formulate two groups of numerical problems. First, the well-known Emission Control Area (ECA) routing problem is extended with battery-powered zero-emission legs. ECAs have incentivized ship operators to choose longer distance routes to avoid using expensive low sulfur fuel required for compliance, resulting in increased greenhouse gas (GHG) emissions. The second problem evaluates the trade-off between battery capacity and speed on battery-powered zero-emission port arrival and departure legs. We develop a mixed-integer quadratically constrained program to investigate the least cost system configuration and operation. We find that the optimal speed is up to 50% slower on battery-powered legs compared to the baseline without zero-emission constraint. The slower speed on the zero-emission legs is compensated by higher speed throughout the rest of the voyage, which may increase the total amount of GHG emissions.
Burger’s Bonded Model for Distinct Element Simulation of the Multi-Factor Full Creep Process of Soft Rock
Authors: Xia Chang , Liu Zhen , Zhou Cuiying
Published: August 2021

Pervasive, unavoidable and uncontrollable creep failure generated in soft-rock engineering occasionally happens and therefore attracts extensive attention recently. However, due to soft rock’s multi-factor creep mechanism, it is still difficult to simulate the full-stage creep with the Distinct Element Method (DEM). In this study, we proposed an improved simulation method based on the classical Burger’s model and the Parallel Bonded model in Particle Flow Code (PFC). We apply the abovementioned models together to simulate the full-stage creep process in soft rock. The proposed process has considered the mesoscopic mechanical characteristics of DEM carefully and finally resulted in a parallel physical model, which is called Burger’s Bonded model in this paper. The DEM simulation test using Burger’s Bonded model was designed to compare with experiments. The experiments include a normal creep test and a uniaxial loading test with prefabricated cracks. In contrast to experimental results, the numerical results show that the average error during the whole creep process is less than 3%; the stress–strain curves and crack development process show great agreement. It is also found that the wing crack coalescence in soft rock is independent of the prefabricated crack angle, propagating with a fixed dip angle. The results show that the numerical method proposed in this paper can simulate the multi-factor-caused full stage (attenuated, steady, accelerated) creep process of soft rock in DEM, which provides new insights for theoretical research and engineering design.
Round Robin Testing: Exploring Experimental Uncertainties through a Multifacility Comparison of a Hinged Raft Wave Energy Converter
Authors: Davey Thomas , Sarmiento Javier , Ohana Jérémy , Thiebaut Florent , Haquin Sylvain , Weber Matthieu , Gueydon Sebastien , Judge Frances , Lyden Eoin , O’Shea Michael , Gabl Roman , Jordan Laura-Beth , Hann Martyn , Wang Daming , Collins Keri , Conley Daniel , Greaves Deborah , Ingram David M. , Murphy Jimmy
Published: August 2021

The EU H2020 MaRINET2 project has a goal to improve the quality, robustness and accuracy of physical modelling and associated testing practices for the offshore renewable energy sector. To support this aim, a round robin scale physical modelling test programme was conducted to deploy a common wave energy converter at four wave basins operated by MaRINET2 partners. Test campaigns were conducted at each facility to a common specification and test matrix, providing the unique opportunity for intercomparison between facilities and working practices. A nonproprietary hinged raft, with a nominal scale of 1:25, was tested under a set of 12 irregular sea states. This allowed for an assessment of power output, hinge angles, mooring loads, and six-degree-of-freedom motions. The key outcome to be concluded from the results is that the facilities performed consistently, with the majority of variation linked to differences in sea state calibration. A variation of 5–10% in mean power was typical and was consistent with the variability observed in the measured significant wave heights. The tank depth (which varied from 2–5 m) showed remarkably little influence on the results, although it is noted that these tests used an aerial mooring system with the geometry unaffected by the tank depth. Similar good agreement was seen in the heave, surge, pitch and hinge angle responses. In order to maintain and improve the consistency across laboratories, we make recommendations on characterising and calibrating the tank environment and stress the importance of the device–facility physical interface (the aerial mooring in this case).
Fungal Jasmonate as a Novel Morphogenetic Signal for Pathogenesis
Authors: Liu Yingyao , Pagac Martin , Yang Fan , Patkar Rajesh N. , Naqvi Naweed I.
Published: August 2021

A key question that has remained unanswered is how pathogenic fungi switch from vegetative growth to infection-related morphogenesis during a disease cycle. Here, we identify a fungal oxylipin analogous to the phytohormone jasmonic acid (JA), as the principal regulator of such a developmental switch to isotropic growth and pathogenicity in the rice-blast fungus Magnaporthe oryzae. Using specific inhibitors and mutant analyses, we determined the molecular function of intrinsic jasmonates during M. oryzae pathogenesis. Loss of 12-Oxo-phytodienoic Acid (OPDA) Reductase and/or consequent reduction of jasmonate biosynthesis, prolonged germ tube growth and caused delayed initiation and improper development of infection structures in M. oryzae, reminiscent of phenotypic defects upon impaired cyclic AMP (cAMP) signaling. Chemical- or genetic-complementation completely restored proper vegetative growth and appressoria in opr1Δ. Mass spectrometry-based quantification revealed increased OPDA accumulation and significantly decreased jasmonate levels in opr1Δ. Most interestingly, exogenous jasmonate restored proper appressorium formation in pth11Δ that lacks G protein/cAMP signaling; but failed to do so in the Mitogen-activated protein (MAP) kinase mutants. Epistasis analysis placed jasmonate upstream of the cAMP pathway in rice blast. Mechanistically, intrinsic jasmonate orchestrates timely cessation of the vegetative phase and induces pathogenic development via a complex regulatory interaction with the cAMP-PKA cascade and redox signaling in rice blast.
Identification of Clinical Isolates of Candida albicans with Increased Fitness in Colonization of the Murine Gut
Authors: Alonso-Monge Rebeca , Prieto Daniel , Coman Ioana , Rochas Sara , Arana David M. , Hidalgo-Vico Susana , Román Elvira , Pla Jesús
Published: August 2021

The commensal and opportunistic pathogen Candida albicans is an important cause of fungal diseases in humans, with the gastrointestinal tract being an important reservoir for its infections. The study of the mechanisms promoting the C. albicans commensal state has attracted considerable attention over the last few years, and several studies have focused on the identification of the intestinal human mycobiota and the characterization of Candida genes involved in its establishment as a commensal. In this work, we have barcoded 114 clinical C. albicans isolates to identify strains with an enhanced fitness in a murine gastrointestinal commensalism model. The 114 barcoded clinical isolates were pooled in four groups of 28 to 30 strains that were inoculated by gavage in mice previously treated with antibacterial therapy. Eight strains that either exhibited higher colonization load and/or remained in the gut after antibiotic removal were selected. The phenotypic analysis of these strains compared to an RFP-tagged SC5314 wild type strain did not reveal any specific trait associated with its increased colonization; all strains were able to filament and six of the eight strains displayed invasive growth on Spider medium. Analysis of one of these strains, CaORAL3, revealed that although mice required previous bacterial microbiota reduction with antibiotics to be able to be colonized, removal of this procedure could take place the same day (or even before) Candida inoculation. This strain was able to colonize the intestine of mice already colonized with Candida without antibiotic treatment in co-housing experiments. CaORAL3 was also able to be established as a commensal in mice previously colonized by another (CaHG43) or the same (CaORAL3) C. albicans strain. Therefore, we have identified C. albicans isolates that display higher colonization load than the standard strain SC5314 which will surely facilitate the analysis of the factors that regulate fungal colonization.
Trends and Applications of Omics Technologies to Functional Characterisation of Enzymes and Protein Metabolites Produced by Fungi
Authors: Ijoma Grace N. , Heri Sylvie M. , Matambo Tonderayi S. , Tekere Memory
Published: August 2021

Identifying and adopting industrial applications for proteins and enzymes derived from fungi strains have been at the focal point of several studies in recent times. To facilitate such studies, it is necessary that advancements and innovation in mycological and molecular characterisation are concomitant. This review aims to provide a detailed overview of the necessary steps employed in both qualitative and quantitative research using the omics technologies that are pertinent to fungi characterisation. This stems from the understanding that data provided from the functional characterisation of fungi and their metabolites is important towards the techno-economic feasibility of large-scale production of biological products. The review further describes how the functional gaps left by genomics, internal transcribe spacer (ITS) regions are addressed by transcriptomics and the various techniques and platforms utilised, including quantitive reverse transcription polymerase chain reaction (RT-qPCR), hybridisation techniques, and RNA-seq, and the insights such data provide on the effect of environmental changes on fungal enzyme production from an expressional standpoint. The review also offers information on the many available bioinformatics tools of analysis necessary for the analysis of the overwhelming data synonymous with the omics approach to fungal characterisation.
Mucormycosis in CAPA, a Possible Fungal Super-Infection
Authors: Saltini Paola , Palomba Emanuele , Castelli Valeria , Fava Marco , Alagna Laura , Biscarini Simona , Mantero Marco , Blasi Francesco , Grancini Anna , Bandera Alessandra , Gori Andrea , Muscatello Antonio , Lombardi Andrea
Published: August 2021

The occurrence of pulmonary fungal superinfection due to Aspergillus spp. in patients with COVID-19 is a well-described complication associated with significant morbidity and mortality. This can be related to a directed effect of the virus and to the immunosuppressive role of the therapies administered for the disease. Here, we describe the first case of pulmonary infection due to Mucorales occurring in a patient with a concomitant diagnosis of COVID-19-associated pulmonary aspergillosis.
Association between Domperidone Administered via Feeding Tube and Feeding Success in Critically Ill Patients with Enteral Feeding Intolerance
Authors: Cheng Yisong , Chen Chaoyue , Yang Hao , Fu Min , Zhong Xi , Wang Bo , Hu Zhi , He Min , Zhang Zhongwei , Jin Xiaodong , Kang Yan , Wu Qin
Published: August 2021

One nutritional challenge in critically ill patients is enteral feeding intolerance (EFI), but current prokinetic agents have uncertain efficacy and safety profiles. We conducted a longitudinal, single-center, retrospective study to evaluate the efficacy and safety of domperidone administered via the feeding tube versus intravenous (IV) metoclopramide among adult patients with EFI. The primary outcome was feeding success, defined as the proportion of patients with average percentage of daily protein prescription >80% of the target dose. The secondary outcomes were safety endpoints. Among 28,814 intensive care unit (ICU) admissions, 552 patients with EFI were included, 38 receiving IV metoclopramide and 514 receiving tube feeding domperidone. The proportion of feeding success in patients receiving tube feeding domperidone and IV metoclopramide was 42.02% and 21.05%, respectively. After 1:2 matching (IV metoclopramide to tube feeding domperidone), the proportion of feeding success was 40.79% in patients receiving tube feeding domperidone. Basically, after matching, there were no differences in any safety endpoints (mortality and length of stay during ICU and hospitalization, organ-support-treatment free days) or adverse events (recurrence of EFI, electrolyte disturbance, abdominal and other symptoms) between the two groups (p > 0.05). A logistic regression analysis in the matched cohort indicated that domperidone administered via the feeding tube was independently associated with feeding success. We found that tube feeding domperidone was efficient in increasing enteral nutrition delivery performance among critically ill adult patients with EFI.