bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Speed Cutting of Synthetic Trabecular Bone—A Combined Experimental–Computational Investigation
Authors: O’Neill Macdarragh , Vaughan Ted J.
Published: September 2021

Orthopaedic surgical cutting instruments are required to generate sufficient forces to penetrate bone tissue while minimising the risk of thermal and mechanical damage to the surrounding environment. This study presents a combined experimental–computational approach to determine relationships between key cutting parameters and overall cutting performance of a polyurethane-based synthetic trabecular bone analogue under orthogonal cutting conditions. An experimental model of orthogonal cutting was developed, whereby an adaptable cutting tool fixture driven by a servo-hydraulic uniaxial test machine was used to carry out cutting tests on Sawbone® trabecular bone analogues. A computational model of the orthogonal cutting process was developed using Abaqus/Explicit, whereby an Isotropic Hardening Crushable Foam elastic-plastic model was used to capture the complex post-yield behaviour of the synthetic trabecular bone. It was found that lower tool rake angles resulted in the formation of larger discontinuous chips and higher cutting forces, while higher rake angles tended to lead to more continuous chip formation and lower cutting forces. The computational modelling framework provided captured features of both chip formation and axial cutting forces over a wide range of cutting parameters when compared with experimental observations. This experimentally based computational modelling framework for orthogonal cutting of trabecular bone analogues has the potential to be applied to more complex three-dimensional cutting processes in the future.
Thermo-Responsive Hydrogel-Based Soft Valves with Annular Actuation Calibration and Circumferential Gripping
Authors: Sivaperuman Kalairaj Manivannan , Banerjee Hritwick , Senthil Kumar Kirthika , Lopez Keith Gerard , Ren Hongliang
Published: September 2021

Valves are largely useful for treatment assistance devices, e.g., supporting fluid circulation movement in the human body. However, the valves presently used in biomedical applications still use materials that are rigid, non-compliant, and hard to integrate with human tissues. Here, we propose biologically-inspired, stimuli-responsive valves and evaluate N-Isopropylacrylamide hydrogels-based valve (NPHV) and PAAm-alginate hydrogels-based valve (PAHV) performances with different chemical syntheses for optimizing better valve action. Once heated at 40 ∘C, the NPHV outperforms the PAHV in annular actuation (NPHV: 1.93 mm displacement in 4 min; PAHV: 0.8 mm displacement in 30 min). In contrast, the PAHV exhibits a flow rate change of up to 20%, and a payload of 100% when the object is at 100 ∘C. The PAHV demonstrated a completely soft, stretchable circular gripper with a high load-to-weight ratio for diversified applications. These valves are fabricated with a simple one-pot method that, once further optimized, can offer transdisciplinary applications.
Response to Climate Change: Evaluation of Methane Emissions in Northern Australian Beef Cattle on a High Quality Diet Supplemented with Desmanthus Using Open-Circuit Respiration Chambers and GreenFeed Emission Monitoring Systems
Authors: Suybeng Bénédicte , Mwangi Felista W. , McSweeney Christopher S. , Charmley Edward , Gardiner Christopher P. , Malau-Aduli Bunmi S. , Malau-Aduli Aduli E. O.
Published: September 2021

The main objective of this study was to compare the effect of supplementing beef cattle with Desmanthus virgatus cv. JCU2, D. bicornutus cv. JCU4, D. leptophyllus cv. JCU7 and lucerne on in vivo methane (CH4) emissions measured by open-circuit respiration chambers (OC) or the GreenFeed emission monitoring (GEM) system. Experiment 1 employed OC and utilized sixteen yearling Brangus steers fed a basal diet of Rhodes grass (Chloris gayana) hay in four treatments—the three Desmanthus cultivars and lucerne (Medicago sativa) at 30% dry matter intake (DMI). Polyethylene glycol (PEG) was added to the diets to neutralize tannin binding and explore the effect on CH4 emissions. Experiment 2 employed GEM and utilized forty-eight animals allocated to four treatments including a basal diet of Rhodes grass hay plus the three Desmanthus cultivars in equal proportions at 0%, 15%, 30% and 45% DMI. Lucerne was added to equilibrate crude protein content in all treatments. Experiment 1 showed no difference in CH4 emissions between the Desmanthus cultivars, between Desmanthus and lucerne or between Desmanthus and the basal diet. Experiment 2 showed an increase in CH4 emissions in the three levels containing Desmanthus. It is concluded that on high-quality diets, Desmanthus does not reduce CH4 emissions.
Multifunctionality of Nanosized Calcium Apatite Dual-Doped with Li+/Eu3+ Ions Related to Cell Culture Studies and Cytotoxicity Evaluation In Vitro
Authors: Sobierajska Paulina , Pozniak Blazej , Tikhomirov Marta , Miller Julia , Mrowczynska Lucyna , Piecuch Agata , Rewak-Soroczynska Justyna , Dorotkiewicz-Jach Agata , Drulis-Kawa Zuzanna , Wiglusz Rafal J.
Published: September 2021

Li+/Eu3+ dual-doped calcium apatite analogues were fabricated using a microwave stimulated hydrothermal technique. XRPD, FT-IR, micro-Raman spectroscopy, TEM and SAED measurements indicated that obtained apatites are single-phased, crystallize with a hexagonal structure, have similar morphology and nanometric size as well as show red luminescence. Lithium effectively modifies the local symmetry of optical active sites and, thus, affects the emission efficiency. Moreover, the hydrodynamic size and surface charge of the nanoparticles have been extensively studied. The protein adsorption (lysozyme, LSZ; bovine serum albumin, BSA) on the nanoparticle surface depended on the type of cationic dopant (Li+, Eu3+) and anionic group (OH−, Cl−, F−) of the apatite matrix. Interaction with LSZ resulted in a positive zeta potential, and the nanoparticles had the lowest hydrodynamic size in this protein medium. The cytotoxicity assessment was carried out on the human osteosarcoma cell line (U2OS), murine macrophages (J774.E), as well as human red blood cells (RBCs). The studied apatites were not cytotoxic to RBCs and J774.E cells; however, at higher concentrations of nanoparticles, cytotoxicity was observed against the U2OS cell line. No antimicrobial activity was detected against Gram-negative bacteria with one exception for P. aeruginosa treated with Li+-doped fluorapatite.
Cyclophilins and Their Functions in Abiotic Stress and Plant–Microbe Interactions
Authors: Olejnik Przemysław , Mądrzak Cezary Jerzy , Nuc Katarzyna
Published: September 2021

Plants have developed a variety of mechanisms and regulatory pathways to change their gene expression profiles in response to abiotic stress conditions and plant–microbe interactions. The plant–microbe interaction can be pathogenic or beneficial. Stress conditions, both abiotic and pathogenic, negatively affect the growth, development, yield and quality of plants, which is very important for crops. In contrast, the plant–microbe interaction could be growth-promoting. One of the proteins involved in plant response to stress conditions and plant–microbe interactions is cyclophilin. Cyclophilins (CyPs), together with FK506-binding proteins (FKBPs) and parvulins, belong to a big family of proteins with peptidyl-prolyl cis-trans isomerase activity (Enzyme Commission (EC) number 5.2.1.8). Genes coding for proteins with the CyP domain are widely expressed in all organisms examined, including bacteria, fungi, animals, and plants. Their different forms can be found in the cytoplasm, endoplasmic reticulum, nucleus, chloroplast, mitochondrion and in the phloem space. They are involved in numerous processes, such as protein folding, cellular signaling, mRNA processing, protein degradation and apoptosis. In the past few years, many new functions, and molecular mechanisms for cyclophilins have been discovered. In this review, we aim to summarize recent advances in cyclophilin research to improve our understanding of their biological functions in plant defense and symbiotic plant–microbe interactions.
The Effect of Acute and Chronic Thermotherapy on Type 2 Diabetic Skeletal Muscle Gene Expression and Inflammatory Markers
Authors: Bachnak Louay , Sparks Jean , Newmire Daniel E. , Gonzales Xavier F. , Omoruyi Felix O.
Published: September 2021

Background: Type 2 diabetes (T2D) is a chronic illness associated with resistance to or defective insulin secretion. This study investigates the effects of thermotherapy on cell viability, gene expression and inflammation in skeletal muscle cell lines. Methods: Healthy and T2D human skeletal muscle cell lines (HSMM and D-HSMM, respectively) were subjected to acute or chronic thermo-therapy (AT or CT, respectively). CT consisted of a 30 min exposure to 40 °C, three times a week for three weeks; AT was a one-time exposure. Results: A significant decrease in D-HSMM cell viability percentage followed AT; however, no significant change occurred in CT. HSMM yielded the highest elevations of genes following CT. In D-HSMM, both treatments yielded gene upregulation. Both treatments significantly down-regulated IL-1β, IL-6, IL-10 and TNF-α in HSMM. AT significantly decreased IL-1β, IL-6 and upregulated IL-10 and TNF-α levels in D-HSMM, while CT yielded a reduction in IL-4, TNF-α and an upregulation of IL-6 and IL-10. Conclusions: An increase in gene expression indicates actin activity and cellular responses, suggesting an increase in transcriptional regulation. The upregulation of IL-6 and IL-10 in D-HSMM negatively correlated with a decrease in TNF-α and IL-1β, indicating improved adverse inflammatory effects associated with the disease.
NF-κB-Dependent and -Independent (Moonlighting) IκBα Functions in Differentiation and Cancer
Authors: Espinosa Lluís , Marruecos Laura
Published: September 2021

IκBα is considered to play an almost exclusive role as inhibitor of the NF-κB signaling pathway. However, previous results have demonstrated that SUMOylation imposes a distinct subcellular distribution, regulation, NF-κB-binding affinity and function to the IκBα protein. In this review we discuss the main alterations of IκBα found in cancer and whether they are (most likely) associated with NF-κB-dependent or NF-κB-independent (moonlighting) activities of the protein.
Complement 3 and the Prognostic Nutritional Index Distinguish Kawasaki Disease from Other Fever Illness with a Nomogram
Authors: Huang Yi-Shuang , Liu Xiao-Ping , Xia Han-Bing , Cui Li-Na , Lang Xin-Ling , Liu Chun-Yi , Huang Wei-Dong , Zhang Jia-Yu , Liu Xi , Kuo Ho-Chang , Zhou Tao
Published: September 2021

Objective: This study aimed to establish a model to distinguish Kawasaki disease (KD) from other fever illness using the prognostic nutritional index (PNI) and immunological factors. Method: We enrolled a total of 692 patients (including 198 with KD and 494 children with febrile diseases). Of those, 415 patients were selected to be the training group and 277 patients to be the validation group. Laboratory data, including the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the prognostic nutritional index (PNI), and immunological factors, were retrospectively collected for an analysis after admission. We used univariate and multivariate logistic regressions and nomograms for the analysis. Result: Patients with KD showed significantly higher C3 and a lower PNI. After a multivariate logistic regression, the total leukocyte count, PNI, C3, and NLR showed a significance (p < 0.05) and then performed well with the nomogram model. The areas under the ROC in the training group and the validation group were 0.858 and 0.825, respectively. The calibration curves of the two groups for the probability of KD showed a near agreement to the actual probability. Conclusions: Compared with children with febrile diseases, patients with KD showed increased C3 and a decreased nutritional index of the PNI. The nomogram established with these factors could effectively identify KD from febrile illness in children.
A Compact Widely Tunable Bandpass Filter Dedicated to Preselectors
Authors: Magnuski Mirosław , Wójcik Dariusz , Surma Maciej , Noga Artur
Published: September 2021

This article presents a novel compact widely tunable bandpass filter. The filter consists of two resonators that are double-coupled, inductively, where the coupling inductances are elements of the input and output networks. The application of double-coupling enabled the transmission zero next to the upper cutoff frequency. This makes the filter useful for applications in preselector networks used in receiving systems with a low to intermediate frequency with the desired channel frequency lower than the image channel frequency. The article shows the practical realisation of the varactor-tuned example filter fabricated as a microstrip planar network of an overall size of 0.03λg × 0.045λg. The tuning range of the proposed filter is from 410 MHz to 880 MHz with the fractional bandwidth equal to 7.5–8.1% and an in-band insertion loss better than −3.4 dB. The achieved IP3 value exceeds 17.5 dBm.
Detecting Dye-Contaminated Vegetables Using Low-Field NMR Relaxometry
Authors: Shomaji Sumaiya , Masna Naren Vikram Raj , Ariando David , Deb Paul Shubhra , Horace-Herron Kelsey , Forte Domenic , Mandal Soumyajit , Bhunia Swarup
Published: September 2021

Dyeing vegetables with harmful compounds has become an alarming public health issue over the past few years. Excessive consumption of these dyed vegetables can cause severe health hazards, including cancer. Copper sulfate, malachite green, and Sudan red are some of the non-food-grade dyes widely used on vegetables by untrusted entities in the food supply chain to make them look fresh and vibrant. In this study, the presence and quantity of dye-based adulteration in vegetables are determined by applying 1H-nuclear magnetic resonance (NMR) relaxometry. The proposed technique was validated by treating some vegetables in-house with different dyes and then soaking them in various solvents. The resulting solutions were collected and analyzed using NMR relaxometry. Specifically, the effective transverse relaxation time constant, T2,eff, of each solution was estimated using a Carr–Purcell–Meiboom–Gill (CPMG) pulse sequence. Finally, the estimated time constants (i.e., measured signatures) were compared with a library of existing T2,eff data to detect and quantify the presence of unwanted dyes. The latter consists of data-driven models of transverse decay times for various concentrations of each water-soluble dye. The time required to analyze each sample using the proposed approach is dye-dependent but typically no longer than a few minutes. The analysis results can be used to generate warning flags if the detected dye concentrations violate widely accepted standards for food dyes. The proposed low-cost detection approach can be used in various stages of a produce supply chain, including consumer household.
Heavy Metal Levels in Milk and Cheese Produced in the Kvemo Kartli Region, Georgia
Authors: Al Sidawi Rami , Ghambashidze Giorgi , Urushadze Teo , Ploeger Angelika
Published: September 2021

Milk and dairy products are among the most important food sectors in Georgia, and milk is considered one of the most essential foods in the human diet according to Georgian food culture. Kvemo Kartli is one of the major regions in Georgia for milk production. This region suffers from heavy metal contamination in soil and water because of the mining industry. This study was conducted to determine the concentrations of cadmium, lead, iron, zinc, copper, chromium, manganese, cobalt, nickel, selenium and molybdenum in milk and cheese and to evaluate whether the concentrations of these elements correspond to the permissible levels of toxic elements in milk and cheese for Georgia and the EU. In total, 195 milk samples and 25 cheese samples (16 from Imeruli cheese and nine from Sulguni cheese) were collected from nine different villages in the Kvemo Kartli region in Georgia: Chapala, Vanati, Bolnisi, Mtskneti, Sabereti, Ratevani, Khidiskuri, Kazreti, Kvemo Bolnisi. The determination of heavy metal in all samples was carried out by inductively coupled plasma-mass spectrometry. The research results show that the concentration of these elements in most milk samples is fairly constant for all villages and is less than the permissible levels, except for seven samples from the following villages: Kvemo Bolnisi, Bolnisi, Mitskineti and Ratawani, where the concentration of lead in the milk samples was higher than the permissible limits mentioned in the literature, ranging from 0.027 to 1003 mg L−1. As for copper, its concentration in milk in Sabereti and Vanati villages was above the permissible limits according to the EU limit, ranging from 0.42 to 1.28 mg L−1. For cheese samples, the concentration of cadmium, lead, copper, Co and Ni in the two types of cheese was less than the permissible limit according to the laws of Georgia. Finally, the heavy metal concentrations in Imeruli and Sulguni cheese for manganese (Mn), chromium (Cr), selenium (Se), molybdenum (Mo) zinc (Zn) and iron (Fe) were above the permissible limit. Thus, the study results showed that the consumption of milk does not pose a direct and serious threat to the health of consumers. As for the two types of cheese, future studies and continuous monitoring are necessary to assess the cheese content of trace elements and the risk of its consumption to the consumer.
Comparative Study on Foaming Properties of Egg White with Yolk Fractions and Their Hydrolysates
Authors: Li Xin , Wang Yue-Meng , Sun Cheng-Feng , Lv Jian-Hao , Yang Yan-Jun
Published: September 2021

As an excellent foaming agent, egg white protein (EWP) is always contaminated by egg yolk in the industrial processing, therefore, decreasing its foaming properties. The aim of this study was to simulate the industrial EWP (egg white protein with 0.5% w/w of egg yolk) and characterize their foaming and structural properties when hydrolyzed by two types of esterase (lipase and phospholipase A2). Results showed that egg yolk plasma might have been the main fraction, which led to the poor foaming properties of the contaminated egg white protein compared with egg yolk granules. After hydrolyzation, both foamability and foam stability of investigated systems thereof (egg white protein with egg yolk, egg white protein with egg yolk plasma, and egg white protein with egg yolk granules) increased significantly compared with unhydrolyzed ones. However, phospholipids A2 (PLP) seemed to be more effective on increasing their foaming properties as compared to those systems hydrolyzed by lipase (LP). The schematic diagrams of yolk fractions were proposed to explain the aggregation and dispersed behavior exposed in their changes of structures after hydrolysis, suggesting the aggregated effects of LP on yolk plasma and destructive effects of PLP on yolk granules, which may directly influence their foaming properties.
Beyond Purple Tomatoes: Combined Strategies Targeting Anthocyanins to Generate Crimson, Magenta, and Indigo Fruit
Authors: Butelli Eugenio , Bulling Katharina , Hill Lionel , Martin Cathie
Published: September 2021

The range of colours of many flowers and fruits is largely due to variations in the types of anthocyanins produced. The degree of hydroxylation on the B-ring affects the hue of these pigments, causing a shift from the orange end of the visible spectrum to the blue end. Besides colour, this modification can also affect other properties of anthocyanins, including the ability to protect the plant against different stresses or, when included in the human diet, to provide benefits for disease prevention. The level of hydroxylation of the B-ring is determined by the activity of two key hydroxylases, F3′H and F3′5′H, and by the substrate preference of DFR, an enzyme acting downstream in the biosynthetic pathway. We show that, in tomato, a strategy based on fruit-specific engineering of three regulatory genes (AmDel, AmRos1, AtMYB12) and a single biosynthetic gene (AmDFR), together with the availability of a specific mutation (f3′5′h), results in the generation of three different varieties producing high levels of anthocyanins with different levels of hydroxylation. These tomatoes show distinctive colours and mimic the classes of anthocyanins found in natural berries, thus providing unique near-isogenic material for different studies.
Impact of Sleep Telementorship in Primary Care: Sleep VA-ECHO (Veterans Affairs-Extension for Community Healthcare Outcomes)
Authors: Palen Brian N. , Mattox Elizabeth A. , He Ken , Beste Lauren A. , Borgerding Joleen , Patel Sarah , Au David H. , Chang Michael F. , Parsons Elizabeth C.
Published: September 2021

Sleep VA-ECHO (Veterans Affairs–Extension for Community Healthcare Outcomes) is a national telementorship program intended to improve knowledge about sleep disorders among non-specialty providers. The project goal was to describe the characteristics of Sleep VA-ECHO participants from primary care and their use of program-obtained knowledge in practice. Sleep VA-ECHO consisted of 10 voluntary, 75-min teleconference sessions combining didactics and case discussion. Out of 86 participants, 21 self-identified as primary care team members and completed a program evaluation. Participants self-reported their application of knowledge gained, including changes to practice as a result of program participation. These 21 participants represented 18 sites in 11 states and attended a median of 5.0 sessions. They included physicians (29%), nurse practitioners (24%), and registered nurses (24%). Nearly all participants (95%) reported using acquired knowledge to care for their own patients at least once a month; 67% shared knowledge with colleagues at least once a month. Eighty-five percent reported improved quality of sleep care for their patients, and 76% reported an expanded clinical skillset. The greatest self-reported change in practice occurred in patient education about sleep disorders (95%) and non-pharmacologic management of insomnia (81%).
The Role of Very Low Calorie Ketogenic Diet in Sympathetic Activation through Cortisol Secretion in Male Obese Population
Authors: Polito Rita , Messina Giovanni , Valenzano Anna , Scarinci Alessia , Villano Ines , Monda Marcellino , Cibelli Giuseppe , Porro Chiara , Pisanelli Daniela , Monda Vincenzo , Messina Antonietta
Published: September 2021

Adipose tissue is considered an endocrine organ, and its excess compromises the immune response and metabolism of hormones and nutrients. Furthermore, the accumulation of visceral fat helps to increase the synthesis of cortisol. The hypothalamus-pituitary-adrenal (HPA) axis is a neuroendocrine system involved in maintaining homeostasis in humans under physiological conditions and stress, and cortisol is the main hormone of the HPA axis. It is known that a stress-induced diet and cortisol reactivity to acute stress factors may be related to dietary behavior. In obesity, to reduce visceral adipose tissue, caloric restriction is a valid strategy. In light of this fact, the aim of this study was to assess the effects of a commercial dietary ketosis program for weight loss on the sympathetic nervous system and HPA axis, through evaluation of salivary cortisol and GSR levels. Thirty obese subjects were recruited and assessed before and after 8 weeks of Very Low Calorie Ketogenic Diet (VLCKD) intervention to evaluate body composition and biochemical parameters. Salivary cortisol levels and GSR significantly decreased after dietary treatment; in addition, body composition and biochemical features were ameliorated. The VLCKD had a short-term positive effect on the SNS and HPA axes regulating salivary cortisol levels. Finally, the effects of the VLCKD on the SNS and HPA axis may lead to more individualized treatment strategies that integrate obesity and stress and support the usefulness of such therapeutic interventions in promoting the reduction of the individual disease burden.
Epidemiology of Stroke in Sickle Cell Disease
Authors: Kirkham Fenella Jane , Lagunju Ikeoluwa A.
Published: September 2021

Sickle cell disease is the most common cause of stroke in childhood, both ischaemic and haemorrhagic, and it also affects adults with the condition. Without any screening or preventative treatment, the incidence appears to fall within the range 0.5 to 0.9 per 100 patient years of observation. Newborn screening with Penicillin prophylaxis and vaccination leading to reduced bacterial infection may have reduced the incidence, alongside increasing hydroxyurea prescription. Transcranial Doppler screening and prophylactic chronic transfusion for at least an initial year has reduced the incidence of stroke by up to 10-fold in children with time averaged mean of the maximum velocity >200 cm/s. Hydroxyurea also appears to reduce the incidence of first stroke to a similar extent in the same group but the optimal dose remains controversial. The prevention of haemorrhagic stroke at all ages and ischaemic stroke in adults has not yet received the same degree of attention. Although there are fewer studies, silent cerebral infarction on magnetic resonance imaging (MRI), and other neurological conditions, including headache, epilepsy and cognitive dysfunction, are also more prevalent in sickle cell disease compared with age matched controls. Clinical, neuropsychological and quantitative MRI screening may prove useful for understanding epidemiology and aetiology.
Serous Borderline Ovarian Tumor Diagnosis, Management and Fertility Preservation in Young Women
Authors: Carbonnel Marie , Layoun Laetitia , Poulain Marine , Tourne Morgan , Murtada Rouba , Grynberg Michael , Feki Anis , Ayoubi Jean Marc
Published: September 2021

Borderline ovarian tumors (BOT) represent about 10 to 20 percent of all epithelial tumors of the ovary. They constitute intermediate lesions between benign ovarian cysts and invasive carcinomas. They often occur in young women of reproductive age, and, albeit with a favorable prognosis, it may recur on the ipsilateral or contralateral ovary. Controversies surround the diagnostic criteria used for their assessment, and the optimal management to minimize their risk of recurrence and/or transformation into malignant carcinoma. Fertility preservation (FP) is considered a priority in the management of these patients, and studies aim at finding the safest and most effective way to help women with BOT history conceive with minimal risk. We present the experience of a single institution in managing three cases of serous BOT in young nulliparous women, followed by a thorough review of the existing literature, highlighting controversies and exploring the possible FP techniques for these women.
Implementation of Computed Tomography Angiography (CTA) and Computed Tomography Perfusion (CTP) in Polish Guidelines for Determination of Cerebral Circulatory Arrest (CCA) during Brain Death/Death by Neurological Criteria (BD/DNC) Diagnosis Procedure
Authors: Bohatyrewicz Romuald , Pastuszka Joanna , Walas Wojciech , Chamier-Cieminska Katarzyna , Poncyljusz Wojciech , Dabrowski Wojciech , Wojczal Joanna , Luchowski Piotr , Guzinski Maciej , Jurkiewicz Elzbieta , Bekiesinska-Figatowska Monika , Owczuk Radoslaw , Walecki Jerzy , Rowinski Olgierd , Zukowski Maciej , Kusza Krzysztof , Piechota Mariusz , Piotrowski Andrzej , Migdal Marek , Zielinska Marzena , Sawicki Marcin
Published: September 2021

Background: Brain death/death by neurologic criteria (BD/DNC) guidelines are routinely analyzed, compared and updated in the majority of countries and are later implemented as national criteria. At the same time, extensive works have been conducted in order to unify clinical procedures and to validate and implement new technologies into a panel of ancillary tests. Recently evaluated computed tomography angiography and computed tomography perfusion (CTA/CTP) seem to be superior to traditionally used digital subtraction angiography (DSA), transcranial Doppler (TCD) and cerebral perfusion scintigraphy for diagnosis of cerebral circulatory arrest (CCA). In this narrative review, we would like to demonstrate scientific evidence supporting the implementation of CTA/CTP in Polish guidelines for BD/DNC diagnosis. Research and implementation process: In the first of our base studies concerning the potential usefulness of CTA/CTP for the confirmation of CCA during BD/DNC diagnosis procedures, we showed a sensitivity of 96.3% of CTA in a group of 82 patients. CTA was validated against DSA in this report. In the second study, CTA showed a sensitivity of 86% and CTP showed a sensitivity of 100% in a group of 50 patients. In this study, CTA and CTP were validated against clinical diagnosis of BD/DNC supported by TCD. Additionally, we propose our CCA criteria for CTP test, which are based on ascertainment of cerebral blood flow (CBF) < 10 mL/100 g/min and cerebral blood volume < 1 mL/100 g in regions of interest (ROIs) localized in all brain regions. Based on our research results, CTA/CTP methods were implemented in Polish BD/DNC criteria. To our knowledge, CTP was implemented for the first time in national guidelines. Conclusions: CTA and CTP-derived CTA might be in future the tests of choice for CCA diagnosis, proper and/or Doppler pretest might significantly increase sensitivity of CTA in CCA diagnosis procedures. Whole brain CTP might be decisive in some cases of inconclusive CTA. Implementation of CTA/CTP in the Polish BD/DNC diagnosis guidelines does not show any major obstacles. We believe that in next edition of “The World Brain Death Project” CTA and CTP will be recommended as ancillary tests of choice for CCA confirmation during BD/DNC diagnosis procedures.
Soluble IL-2R Levels Predict in-Hospital Mortality in COVID-19 Patients with Respiratory Failure
Authors: Jang Hye Jin , Leem Ah Young , Chung Kyung Soo , Ahn Jin Young , Jung Ji Ye , Kang Young Ae , Park Moo Suk , Kim Young Sam , Lee Su Hwan
Published: September 2021

Acute respiratory distress syndrome is the primary cause of death in patients with coronavirus disease 2019 (COVID-19) pneumonia. Our study aims to determine the association between serum markers and mortality in COVID-19 patients with respiratory failure. This retrospective study was conducted in a tertiary care hospital in South Korea. Forty-nine patients with COVID-19, who required high flow nasal cannulation or mechanical ventilation from February 2020 to April 2021, were included. Demographic and laboratory data were analyzed at baseline and on Day 7 of admission. We found that serum creatinine, troponin, procalcitonin, and soluble interleukin-2 receptor (sIL-2R) at baseline were more elevated in the non-survivor group, but were not associated with mechanical ventilator use on Day 7. Older age, PaO2/FiO2 ratio, lymphocyte and platelet counts, lactate dehydrogenase, IL-6, C-reactive protein, and sIL-2R on Day 7 were significantly associated with mortality. Delta sIL-2R (Day 7–Day 0) per standard deviation was significantly higher in the non-survivor group (adjusted hazard ratio 3.225, 95% confidence interval (CI) 1.151–9.037, p = 0.026). Therefore, sIL-2R could predict mortality in COVID-19 patients with respiratory failure. Its sustained elevation suggests a hyper-inflammatory state, and mirrors the severity of COVID-19 in patients with respiratory failure, thereby warranting further attention.
The Effect of Lifestyle Intervention on Systemic Oxidative Stress in Women with Obesity and Infertility: A Post-Hoc Analysis of a Randomized Controlled Trial
Authors: Wang Zheng , Bourgonje Arno R. , Groen Henk , Abdulle Amaal E. , Cantineau Astrid E. P. , van Oers Anne M. , van Dammen Lotte , Bulthuis Marian L. C. , Wekker Vincent , Mol Ben W. J. , Roseboom Tessa J. , van Goor Harry , Hoek Annemieke
Published: September 2021

We aimed to study whether lifestyle intervention could reduce systemic oxidative stress (OS) and the association between OS and cardiometabolic outcomes in women with obesity and infertility. From 2009 to 2012, infertile women with a BMI ≥ 29 kg/m2 were randomly assigned to a six-month lifestyle intervention followed by infertility treatment (N = 289) or to prompt infertility treatment (N = 285). Fasting serum free thiols (FT) concentrations were determined by colorimetry at baseline, at three and six months after randomization. Generalized estimating equations and restricted cubic spline regressions were used to estimate mean differences in serum FT levels between groups and to explore associations between serum FT levels and cardiometabolic outcomes. Baseline serum FT levels did not differ between the two groups (N = 203 in the intervention group vs N = 226 in the control group, 222.1 ± 48.0 µM vs 229.9 ± 47.8 µM, p = 0.09). Body weight decreased by 3.70 kg in the intervention group compared with the control group at six months (95% confidence interval [CI]: −7.61 to 0.21, p = 0.06). No differences in serum FT levels were observed between groups at either three months (N = 142 vs N = 150, mean differences: −1.03 µM, 95% CI: −8.37 to 6.32, p = 0.78) or six months (N = 104 vs N = 96, mean differences: 2.19 µM, 95% CI: −5.90 to 10.28, p = 0.60). In a pooled analysis of all available measurements, triglycerides (crude B: 5.29, 95% CI: 1.08 to 9.50, p = 0.01), insulin (crude B: 0.62, 95% CI: 0.26 to 0.98, p = 0.001), and homeostasis model assessment of insulin resistance (crude B: 2.50, 95% CI: 1.16 to 3.38, p < 0.001) were positively associated with serum FT levels. High-sensitivity C-reactive protein (hs-CRP) was negatively associated with serum FT levels (crude B: −0.60, 95% CI: −1.11 to −0.10, p = 0.02). The change in hs-CRP during the lifestyle intervention was strongly and inversely associated with serum FT levels (crude B: −0.41, 95% CI: −0.70 to −0.13, p = 0.005). No significant deviations from linear associations were observed between serum FT and hs-CRP. We do not observe an improvement in systemic OS in women with obesity and infertility with modest weight loss. There were potential associations between OS and biomarkers of cardiometabolic health. Trial registration: This trial was registered on 16 November 2008 at the Dutch trial register (NTR1530).
Executive Function and Sensory Processing in Dichotic Listening of Young Adults with Listening Difficulties
Authors: Pascoinelli Aline Tocchini , Schochat Eliane , Murphy Cristina Ferraz Borges
Published: September 2021

Previous studies have suggested that varying attention demands in dichotic listening (DL) tasks might be a clinically feasible method to distinguish ‘bottom-up’ from ‘top-down’ deficits in listening. This study aims to investigate DL processing in adults with listening difficulties (LD). We assessed the performance of a listening difficulties group (LDG) (n = 24, mean age = 24, backward digit span = 4.0) and a control group (CG) (n = 25, mean age = 29.2, backward digit span = 6.4) in DL tests involving non-forced and both right and left-forced attention. The results indicated an overall significantly worse performance of LDG compared to the CG, which was greater for forced-left condition. This same result was observed when controlling for working memory (WM) variance. Both groups presented an overall right ear advantage with no difference in terms of the magnitude of advantage. These results indicate that LD presented by the LDG might be due to a combination of sensory and cognitive deficits, with emphasis on the cognitive component. However, the WM, although impaired in the LDG group, was not the main factor in segregating both groups. The role of the additional cognitive processes such as inhibitory control in LD is discussed.
Intravesical Prostatic Protrusion and Prognosis of Non-Muscle Invasive Bladder Cancer: Analysis of Long-Term Data over 5 Years with Machine-Learning Algorithms
Authors: Lee Junghoon , Choo Min Soo , Yoo Sangjun , Cho Min Chul , Son Hwancheol , Jeong Hyeon
Published: September 2021

We aim to investigate the significance of intravesical prostate protrusion (IPP) on the prognosis of non-muscle invasive bladder cancer (NMIBC) after the transurethral resection of bladder tumors (TURBT). For newly diagnosed NMIBC, we retrospectively analyzed the association between prognosis and IPP for at least a 5-year follow-up. A degree of IPP over 5 mm in a preoperative CT scan was classified as severe. The primary endpoint was recurrence-free survival, and the secondary endpoint was progression-free survival. The machine learning (ML) algorithm of a support vector machine was used for predictive model development. Of a total of 122 patients, ultimately, severe IPP was observed in 33 patients (27.0%). IPP correlated positively with age, BPH, recurrence, and prognosis. Severe IPP was significantly higher in the recurrence group and reduced in the recurrence-free survival group (p = 0.038, p = 0.032). Severe IPP independently increased the risk of intravesical recurrence by 2.6 times. The addition of IPP to the known oncological risk factors in the prediction model using the ML algorithm improved the predictability of cancer recurrence by approximately 6%, to 0.803. IPP was analyzed as a potential independent risk factor for NMIBC recurrence and progression after TURBT. This anatomical feature of the prostate could affect the recurrence of bladder tumors.
Acute Recanalization of Large Vessel Occlusion in the Anterior Circulation Stroke: Is Mechanical Thrombectomy Alone Better in Patients over 80 Years of Age? Findings from a Retrospective Observational Study
Authors: Krajíčková Dagmar , Krajina Antonín , Herzig Roman , Vyšata Oldřich , Šimůnek Libor , Vališ Martin
Published: September 2021

Real-world data report worse 3-month clinical outcomes in elderly patients with acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT). The aim was to identify factors influencing clinical outcome in elderly patients with anterior circulation AIS treated with MT (±intravenous thrombolysis (IVT)). In a retrospective, monocentric study, analysis of prospectively collected data of 138 patients (≥80 years) was performed. IVT was an independent negative predictor (OR 0.356; 95% CI: 0.134–0.942) and female sex an independent positive predictor (OR 4.179, 95% CI: 1.300–13.438) of 3-month good clinical outcome (modified Rankin scale 0–2). Female sex was also an independent negative predictor of 3-month mortality (OR 0.244, 95% CI: 0.100–0.599). Other independent negative predictors of 3-month good clinical outcome were older age, lower pre-stroke self-sufficiency, more severe neurological deficit and longer procedural intervals. Mortality was also independently predicted by longer procedural interval and by the occurrence of symptomatic intracerebral hemorrhage (p < 0.05 in all cases). Our results demonstrated, that in patients aged ≥80 years with anterior circulation AIS undergoing MT (±IVT), IVT reduced the chance of 3-month good clinical outcome and female sex was associated with a greater likelihood of 3-month good clinical outcome and lower probability of 3-month mortality.
Importance of Translabial Ultrasound for the Diagnosis of Pelvic Organ Prolapse and Its Correlation with the POP-Q Examination: Analysis of 363 Cases
Authors: Nam Gina , Lee Sa-Ra , Kim Sung-Hoon , Chae Hee-Dong
Published: September 2021

The incidence of pelvic organ prolapse (POP) is increasing in our aging society. We aimed to evaluate the clinical usefulness of translabial ultrasound (TLUS) by comparing the findings of POP-Q examination and TLUS in advanced POP patients and we also aimed to evaluate the prevalence of rectocele and enterocele on the TLUS. We analyzed the TLUS and POP-Q exam findings of 363 symptomatic POP patients who visited our clinic from March 2019 to April 2021. We excluded three patients who had conditions mimicking POP, as revealed by the TLUS. The most common POP type was anterior compartment POP (68.61%), followed by apical compartment (38.61%) and posterior compartment (16.11%) POP. Agreement between the POP-Q exam and TLUS was tested using Cohen’s kappa (κ). p values < 0.05 were considered statistically significant. The incidence of rectocele or enterocele was only 1.67% (6/360) and there was no rectocele or enterocele in most patients (246/252, 96.63%) when the POP-Q exam revealed posterior compartment POP, suggesting that they only had posterior vaginal wall relaxation. The positive predictive value of the POP-Q exam for detecting rectocele or enterocele (as revealed by TLUS) was only 2.38%, whereas the negative predictive value was 100%. In conclusion, the application of TLUS is useful in the diagnosis of POP, especially for differentiation of true POP from conditions mimicking POP. The correlation between the POP-Q exam and TLUS is low, especially in posterior compartment POP, and therefore, patients with POP-Q exam findings suggesting posterior compartment POP should undergo TLUS to check for rectocele or enterocele. The use of TLUS in the diagnosis of POP patients can improve the accuracy of the diagnosis of POP patients in conjunction with a POP-Q exam.
A Design Method to Assess the Primary Strength of the Delta-Type VLFS
Authors: Gafter Roy , Drimer Nitai
Published: September 2021

Very large floating structure (VLFS) is a sustainable concept centered around creating solid platforms at sea. The Delta is a new type of VLFS, designed to withstand open-sea conditions and to form, in addition to a broad deck areas, a sheltered basin of year-round operability. The design of this unique hull relies on direct calculations in order to identify critical load cases and assess their load effects. This study formulates a theoretical procedure for the initial assessment of the primary strength. The procedure analytically integrates the floatation loads while the hull rests at hydrostatic equilibrium on a wave surface and obtains the vertical and horizontal bending moment. This preliminary assessment tool enables a fast review of many load cases and provides the basic insights necessary for a reasonable initial design. Using the procedure, we conducted a primary load assessment for the design of Delta. By calculating the load response to 588 load cases, we identified the critical load scenario and the maximal axial stress. As the stress was too high, we improved the geometry in order to reduce loads and assessed proper scantlings for the critical section. We present the formulation of the procedure, the validation of the results, and the implementation for the structural design of the Delta VLFS.
Research on the Tensile Mechanical Properties of a Braided Corrugated Hose and Its Axial Stiffness Model
Authors: Huang Dacheng , Zhang Jianrun
Published: September 2021

Braided corrugated hoses are widely used in displacement compensation and vibration absorption environments due to their excellent flexibility and energy dissipation properties; however, the axial stiffness has rarely been discussed before as an important physical property of braided corrugated hoses. In this paper, the theoretical axial stiffness model for braided corrugated hoses is established based on the energy method and the theory of the curved beam. The influences of the braiding parameters of the metallic braided tube and the structural parameters of the bellows on the axial stiffness are also discussed. Through finite element tensile testing, the axial stiffness curves of the braided corrugated hose under different braiding angles and different wire diameters are obtained. The theoretical axial stiffness model is in good agreement with the simulation experiment, which reflects the nonlinear effects of the braiding angle and wire diameter on the braided corrugated hose. This paper provides an accurate method and basis for the design of braided corrugated hoses in the future.
Laser Powder Bed Fusion of a Topology Optimized and Surface Textured Rudder Bulb with Lightweight and Drag-Reducing Design
Authors: Scarpellini Alessandro , Finazzi Valentina , Schito Paolo , Bionda Arianna , Ratti Andrea , Demir Ali Gökhan
Published: September 2021

This work demonstrates the advantages of using laser powder bed fusion for producing a rudder bulb of a moth class sailing racing boat via laser powder bed fusion (LPBF). The component was designed to reduce weight using an AlSi7Mg0.6 alloy and incorporated a biomimetic surface texture for drag reduction. For the topological optimization, the component was loaded structurally due to foil wing’s lift action as well as from the environment due to hydrodynamic resistance. The aim was to minimize core mass while preserving stiffness and the second to benefit from drag reduction capability in terms of passive surface behavior. The external surface texture is inspired by scales of the European sea bass. Both these features were embedded to the component and produced by LPBF in a single run, with the required resolution. Drag reduction was estimated in the order of 1% for free stream velocity of 2.5 m s−1. The production of the final part resulted in limited geometrical error with respect to scales 3D model, with the desired mechanical properties. A reduction in weight of approximately 58% with respect to original full solid model from 452 to 190 g was achieved thanks to core topology optimization. Sandblasting was adopted as finishing technique since it was able to improve surface quality while preserving fish scale geometries. The feasibility of producing the biomimetic surfaces and the weight reduction were validated with the produced full-sized component.
Mercury in Macrolepiota procera (Scop.) Singer and Its Underlying Substrate—Environmental and Health Risks Assessment
Authors: Jančo Ivona , Šnirc Marek , Hauptvogl Martin , Demková Lenka , Franková Hana , Kunca Vladimír , Lošák Tomáš , Árvay Július
Published: September 2021

Wild-growing edible mushrooms are valuable food with a high content of proteins, fibers, antioxidants, and they are characterized by their specific taste and flavor. However, from an ecotoxicological point of view, they are a risk commodity because of their extremely high bioaccumulative capacity to accumulate the risk elements and contaminants from the environment. In the present study, we examined mercury (Hg) contamination in 230 fruiting bodies of Macrolepiota procera (Scop.) Singer and 230 soil/substrate samples, which were collected in foraging seasons 2015–2019 from 22 different locations in Slovakia. Total mercury content was determined by cold-vapor AAS analyzer AMA 254. The level of contamination and environmental risks were assessed by contamination factor (Cf), index of geoaccumulation (Igeo), and potential environmental risk index (PER). Bioaccumulation factor (BAF) was calculated for individual anatomical parts of M. procera. Mercury content in the soil/substrate samples varied between 0.02 and 0.89 mg kg−1 DW, and in mushroom samples between 0.03 and 2.83 mg kg−1 DW (stems), and between 0.04 and 6.29 mg kg−1 DW (caps). The obtained results were compared with the provisional tolerable weekly intake for Hg defined by WHO to determine a health risk resulting from regular and long-term consumption of M. procera.