bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic value of coronary vascular dysfunction assessed by rubidium-82 PET/CT imaging in patients with resistant hypertension without overt coronary artery disease
Authors: Gaudieri Valeria , Mannarino Teresa , Zampella Emilia , Assante Roberta , D’Antonio Adriana , Nappi Carmela , Cantoni Valeria , Green Roberta , Petretta Mario , Arumugam Parthiban , Cuocolo Alberto , Acampa Wanda
Published: February 2021

Purpose

The identification of coronary vascular dysfunction may enhance risk stratification in patients with resistant hypertension (RH). We evaluated if impaired coronary vascular function, assessed by rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) imaging, is associated with increased cardiovascular risk in patients with hypertension without overt coronary artery disease (CAD).

Methods

We studied 517 hypertensive subjects, 26% with RH, without overt CAD, and with normal stress-rest myocardial perfusion imaging at 82Rb PET/CT. The outcome end points were cardiac death, nonfatal myocardial infarction, coronary revascularization, and admission for heart failure.

Results

Over a median of 38 months (interquartile range 26 to 50), 21 cardiac events (4.1% cumulative event rate) occurred. Patients with RH were older (p < 0.05) and had a higher prevalence of left ventricular hypertrophy (p < 0.001), a lower hyperemic myocardial blood flow (MBF), and myocardial perfusion reserve (MPR) (both p < 0.001) compared to those without. Conversely, coronary artery calcium content and baseline MBF were not different between patients with and without RH. At univariable Cox regression analysis, age, RH, left ventricular ejection fraction, coronary artery calcium score, and reduced MPR were significant predictors of events. At multivariable analysis, age, RH, and reduced MPR (all p < 0.05) were independent predictors of events. Patients with RH and reduced MPR had the highest risk of events and the major risk acceleration over time.

Conclusion

The findings suggest that the assessment of coronary vascular function may enhance risk stratification in patients with hypertension.
A New Preoperative Risk Score for Predicting Postoperative Complications in Elderly Patients Undergoing Hepatectomy
Authors: Tomita Koichi , Koganezawa Itsuki , Nakagawa Masashi , Ochiai Shigeto , Gunji Takahiro , Yokozuka Kei , Ozawa Yosuke , Hikita Kosuke , Kobayashi Toshimichi , Sano Toru , Chiba Naokazu , Kawachi Shigeyuki
Published: February 2021

Background

Postoperative complications are not rare in the elderly population after hepatectomy. However, predicting postoperative risk in elderly patients undergoing hepatectomy is not easy. We aimed to develop a new preoperative evaluation method to predict postoperative complications in patients above 65 years of age using biological impedance analysis (BIA).

Methods

Clinical data of 59 consecutive patients (aged 65 years or older) who underwent hepatectomy at our institution between 2017 and 2020 were retrospectively analyzed. Risk factors for postoperative complications (Clavien‐Dindo ≥ III) were evaluated using multivariate regression analysis. Additionally, a new preoperative risk score was developed for predicting postoperative complications.

Results

Fifteen patients (25.4%) had postoperative complications, with biliary fistula being the most common complication. Abnormal skeletal muscle mass index from BIA and type of surgical procedure were found to be independent risk factors in the multivariate analysis. These two variables and preoperative serum albumin levels were used for developing the risk score. The postoperative complication rate was 0.0% with a risk score of ≤ 1 and 57.1% with a risk score of ≥ 4. The area under the receiver operating characteristic curve of the risk score was 0.810 (p = 0.001), which was better than that of other known surgical risk indexes.

Conclusion

Decreased skeletal muscle and the type of surgical procedure for hepatectomy were independent risk factors for postoperative complications after elective hepatectomy in elderly patients. The new preoperative risk score is simple, easy to perform, and will help in the detection of high‐risk elderly patients undergoing elective hepatectomy.
Early National Landscape of Surgical Stabilization of Sternal Fractures
Authors: Choi Jeff , Khan Suleman , Syed Maayez , Tennakoon Lakshika , Forrester Joseph D.
Published: February 2021

Background

Operative management of chest wall injuries aims to restore respiratory mechanics and mitigate pulmonary complications. Extensive studies support surgical stabilization of rib fractures (SSRF) for select patients, but role for surgical stabilization of sternal fractures (SSSF) remains unclear. We aimed to understand national prevalence of SSSF and compare outcomes after surgical stabilization and non‐operative management of sternal fractures.

Methods

We retrospectively analyzed adult patients (age ≥ 18 years) admitted with sternal fractures after blunt trauma using the 2016 National Trauma Data Bank. We compared odds of inpatient mortality, pneumonia, and respiratory failure for propensity score matched patients (4:1) who underwent non‐operative management vs SSSF. We characterized subgroup of patients with concurrent rib and sternal fractures who underwent concomitant SSRF‐SSSF.

Results

We identified 14,760 encounters of adults admitted with sternal fractures; 270 (1.8%) underwent SSSF. Compared to matched patients who underwent non‐operative management, patients who underwent SSSF had lower odds of mortality (OR [95%CI]: 0.19 [0.06–0.62], p = 0.006). Adjusted for trauma center level, Mantel–Haenszel mortality odds remained lower for patients who underwent SSSF. Odds of pneumonia and respiratory failure were similar between matched groups. Among 46% of patients who had concomitant rib fractures, 0.3% (n = 18) underwent concurrent SSRF‐SSSF and these patients survived hospitalization without pneumonia or respiratory failure.

Conclusion

A vast majority of patients who suffer sternal fractures undergo non‐operative management. Potential mortality benefit of SSSF and concurrent SSRF‐SSSF's role for commonly concomitant rib and sternal fractures deserve further study. Our preliminary findings call for delineating heterogeneity of sternal fractures and establishing consensus SSSF indications.
Comparative risk of infections among real-world users of biologics for juvenile idiopathic arthritis: data from the German BIKER registry
Authors: Thiele Franz , Klein Ariane , Windschall Daniel , Hospach Anton , Foeldvari Ivan , Minden Kirsten , Weller-Heinemann Frank , Horneff Gerd
Published: February 2021

To examine whether treatment with interleukin (IL)-1-, IL-6-, tumour necrosis factor α (TNFα)-inhibitors or Abatacept is associated with an increased risk of common infections, infections requiring hospitalization (SAE) or opportunistic infections among real-world juvenile idiopathic arthritis (JIA) patients. Furthermore, the influence of other patient-related covariates on the occurrence of infections was investigated. Patients diagnosed with JIA and treated with biologics were selected from the German BIKER registry. Incidence rates (IR) of infections per 100 person years were calculated and compared between the different cohorts. Using multivariate logistic regression, odds ratios with 95% confidence intervals (CI) were determined for the influence of patient-related covariates (age, diagnosis, laboratory data, concomitant medication, JIA activity, comorbidities, and premedication) on the occurrence of infections. 3258 patients entered the analysis. A total of 3654 treatment episodes were distributed among TNFα- (Etanercept, Adalimumab, Golimumab, Infliximab, n = 3044), IL-1- (Anakinra, Canakinumab, n = 105), IL-6- (Tocilizumab, n = 400) and T-cell activation inhibitors (Abatacept, n = 105). 813 (22.2%) patients had at least one infection, 103 (2.8%) patients suffered from an SAE infection. Both common and SAE infections were significantly more frequent in IL-1 (IR 17.3, 95% CI 12.5/24 and IR 4.3, 95% CI 2.3/8.3) and IL-6 cohort (IR 16.7, 95% CI 13.9/20 and IR 2.8, 95% CI 1.8/4.4) compared to TNFα-inhibitor cohort (IR 8.7, 95% CI 8.1/9.4 and IR 1, 95% CI 0.8/1.3). When comparing the influencing factors for various infectious diseases, the use of corticosteroids, younger age, cardiac comorbidities and higher JIA-activity are the most striking risk factors. Relative to TNFα inhibitors and Abatacept, IL-1 and IL-6 inhibitors were associated with an increased risk of common and SAE infections. The influencing covariates identified may be helpful for the choice of a suitable biologic to treat JIA.
Dynamic contrast-enhanced MRI of synovitis in knee osteoarthritis: repeatability, discrimination and sensitivity to change in a prospective experimental study
Authors: MacKay James W. , Nezhad Faezeh Sanaei , Rifai Tamam , Kaggie Joshua D. , Naish Josephine H. , Roberts Caleb , Graves Martin J. , Waterton John C. , Janiczek Robert L. , Roberts Alexandra R. , McCaskie Andrew , Gilbert Fiona J. , Parker Geoff J. M.
Published: February 2021

Objectives

Evaluate test-retest repeatability, ability to discriminate between osteoarthritic and healthy participants, and sensitivity to change over 6 months, of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) biomarkers in knee OA.

Methods

Fourteen individuals aged 40–60 with mild-moderate knee OA and 6 age-matched healthy volunteers (HV) underwent DCE-MRI at 3 T at baseline, 1 month and 6 months. Voxelwise pharmacokinetic modelling of dynamic data was used to calculate DCE-MRI biomarkers including Ktrans and IAUC60. Median DCE-MRI biomarker values were extracted for each participant at each study visit. Synovial segmentation was performed using both manual and semiautomatic methods with calculation of an additional biomarker, the volume of enhancing pannus (VEP). Test-retest repeatability was assessed using intraclass correlation coefficients (ICC). Smallest detectable differences (SDDs) were calculated from test-retest data. Discrimination between OA and HV was assessed via calculation of between-group standardised mean differences (SMD). Responsiveness was assessed via the number of OA participants with changes greater than the SDD at 6 months.

Results

Ktrans demonstrated the best test-retest repeatability (Ktrans/IAUC60/VEP ICCs 0.90/0.84/0.40, SDDs as % of OA mean 33/71/76%), discrimination between OA and HV (SMDs 0.94/0.54/0.50) and responsiveness (5/1/1 out of 12 OA participants with 6-month change > SDD) when compared to IAUC60 and VEP. Biomarkers derived from semiautomatic segmentation outperformed those derived from manual segmentation across all domains.

Conclusions

Ktrans demonstrated the best repeatability, discrimination and sensitivity to change suggesting that it is the optimal DCE-MRI biomarker for use in experimental medicine studies.

Key Points

• Dynamic contrast-enhanced MRI (DCE-MRI) provides quantitative measures of synovitis in knee osteoarthritis which may permit early assessment of efficacy in experimental medicine studies.

• This prospective observational study compared DCE-MRI biomarkers across domains relevant to experimental medicine: test-retest repeatability, discriminative validity and sensitivity to change.

• The DCE-MRI biomarker Ktransdemonstrated the best performance across all three domains, suggesting that it is the optimal biomarker for use in future interventional studies.
High-definition videolaryngoscopy is superior to fiberoptic laryngoscopy: a 111 multi-observer study
Authors: Scholman Constanze , Westra Jeroen M. , Zwakenberg Manon A. , Dikkers Frederik G. , Halmos Gyorgy B. , Wedman Jan , Wachters Jan E. , van der Laan Bernard F. A. M. , Plaat Boudewijn E. C.
Published: February 2021

Purpose

This study aims to analyse differences in fiberoptic laryngoscopy (FOL) versus high definition laryngoscopy (HDL) by examining videolaryngoscopy images by a large group of observers with different levels of clinical expertise in ear, nose and throat (ENT) medicine.

Methods

This study is a 111 observer paired analysis of laryngoscopy videos during an interactive presentation. During a National Meeting of the Dutch Society of ENT/Head and Neck Surgery, observers assessed both FOL and HDL videos of nine cases with additional clinical information. Observers included 41 ENT consultants (36.9%), 34 ENT residents (30.6%), 22 researchers with Head and Neck interest (19.8%) and 14 with unspecified clinical expertise (12.6%). For both laryngoscopic techniques, sensitivity, specificity, positive and negative predictive value and diagnostic accuracy were determined for identifying a normal glottis, hyperkeratosis, radiotherapy adverse effects and squamous cell carcinoma. The sensitivities for FOL and HDL were analysed with regard to the different levels of clinical expertise.

Results

The overall sensitivity for correctly identifying the specific histological entity was higher in HDL (FOL 61% vs HDL 66.3%, p < 0.05). HDL was superior to FOL in identifying a normal glottis (FOL 68.1% vs HDL 91.6%, p < 0.01) and squamous cell carcinoma (FOL 70.86% vs HDL 79.41%, p = 0.02). Residents and researchers with Head and Neck interest diagnosed laryngeal lesions more correctly with HDL (p < 0.05).

Conclusions

In a large population of observers with different levels of clinical expertise, HDL is superior to FOL in identifying laryngeal lesions.
Neural signature of error processing in major depression
Authors: Malejko Kathrin , Hafner Stefan , Plener Paul L. , Bonenberger Martina , Groen Georg , Abler Birgit , Graf Heiko
Published: February 2021

The clinical presentation of major depression (MD) is heterogenous and comprises various affective and cognitive symptoms including an increased sensitivity to errors. Various electrophysiological but only few functional magnetic resonance imaging (fMRI) studies investigated neural error processing in MD with inconsistent findings. Thus, reliable evidence regarding neural signatures of error processing in patients with current MD is limited despite its potential relevance as viable neurobiological marker of psychopathology. We therefore investigated a sample of 16 young adult female patients with current MD and 17 healthy controls (HC). During fMRI, we used an established Erikson-flanker Go/NoGo-paradigm and focused on neural alterations during errors of commission. In the absence of significant differences in rates of errors of commission in MD compared to HC, we observed significantly (p < 0.05, FWE-corrected on cluster level) enhanced neural activations of the dorsal anterior cingulate cortex (dACC) and the pre-supplementary motor area (pre-SMA) in MD relative to HC and thus, in brain regions consistently associated to neural error processing and corresponding behavioral adjustments. Considering comparable task performance, in particular similar commission error rates in MD and HC, our results support the evidence regarding an enhanced responsivity of neural error detection mechanisms in MD as a potential neural signature of increased negative feedback sensitivity as one of the core psychopathological features of this disorder.
Biochemistry and physiology of zebrafish photoreceptors
Authors: Zang Jingjing , Neuhauss Stephan C. F.
Published: February 2021

All vertebrates share a canonical retina with light-sensitive photoreceptors in the outer retina. These photoreceptors are of two kinds: rods and cones, adapted to low and bright light conditions, respectively. They both show a peculiar morphology, with long outer segments, comprised of ordered stacks of disc-shaped membranes. These discs host numerous proteins, many of which contribute to the visual transduction cascade. This pathway converts the light stimulus into a biological signal, ultimately modulating synaptic transmission. Recently, the zebrafish (Danio rerio) has gained popularity for studying the function of vertebrate photoreceptors. In this review, we introduce this model system and its contribution to our understanding of photoreception with a focus on the cone visual transduction cascade.
The time course of salience: not entirely caused by salience
Authors: Krüger Alexander , Scharlau Ingrid
Published: February 2021

Visual salience is a key component of attentional selection, the process that guards the scarce resources needed for conscious recognition and perception. In previous works, we proposed a measure of visual salience based on a formal theory of visual selection. However, the strength of visual salience depends on the time course as well as local physical contrasts. Evidence from multiple experimental designs in the literature suggests that the strength of salience rises initially and declines after approximately 150 ms. The present article amends the theory-based salience measure beyond local physical contrasts to the time course of salience. It does so through a first experiment which reveals that—contrary to expectations—salience is not reduced during the first 150 ms after onset. Instead, the overall visual processing capacity is severely reduced, which corresponds to a reduced processing speed of all stimuli in the visual field. A second experiment confirms this conclusion by replicating the result. We argue that the slower stimulus processing may have been overlooked previously because the attentional selection mechanism had not yet been modeled in studies on the time course of salience.
The influence of associative reward learning on motor inhibition
Authors: Marchner Janina Rebecca , Preuschhof Claudia
Published: February 2021

Stimuli that predict a rewarding outcome can cause difficulties to inhibit unfavourable behaviour. Research suggests that this is also the case for stimuli with a history of reward extending these effects on action control to situations, where reward is no longer accessible. We expand this line of research by investigating if previously reward-predictive stimuli promote behavioural activation and impair motor inhibition in a second unrelated task. In two experiments participants were trained to associate colours with a monetary reward or neutral feedback. Afterwards participants performed a cued go/no-go task, where cues appeared in the colours previously associated with feedback during training. In both experiments training resulted in faster responses in rewarded trials providing evidence of a value-driven response bias as long as reward was accessible. However, stimuli with a history of reward did not interfere with goal-directed action and inhibition in a subsequent task after removal of the reward incentives. While the first experiment was not conclusive regarding an impact of reward-associated cues on response inhibition, the second experiment, validated by Bayesian statistics, clearly questioned an effect of reward history on inhibitory control. This stands in contrast to earlier findings suggesting that the effect of reward history on subsequent action control is not as consistent as previously assumed. Our results show that participants are able to overcome influences from Pavlovian learning in a simple inhibition task. We discuss our findings with respect to features of the experimental design which may help or complicate overcoming behavioural biases induced by reward history.
Primary uterine ectomesenchymoma harboring a DICER1 mutation: case report with molecular analysis
Authors: Davidson Ben , Kleinberg Lilach , Børresen Ida Marie , Slettevoll Frøydis , Fangberget Anne , Hindosh Dunia , Zahl Eriksson Ane Gerda , Bjerkehagen Bodil
Published: February 2021

Ectomesenchymoma is an exceedingly rare biphasic malignant tumor characterized by the presence of mesenchymal and neuroectodermal elements. The majority of patients are infants or children. We describe the first case of this entity diagnosed as a primary uterine tumor. A 72-year-old female presented with post-menopausal bleeding. Dilatation and curettage showed irregular mesenchymal proliferation of uncertain nature. In the hysterectomy specimen, a myxoid spindle cell tumor with areas of skeletal muscle and neural differentiation was found in the uterus, with direct invasion of the small intestine, and biphasic differentiation into rhabdomyosarcoma and ganglioneuroblastoma was unequivocally seen in a lymph node metastasis. The morphological findings were validated by immunohistochemistry. Massive parallel sequencing identifiedTP53,PTEN, andDICER1mutations in the tumor. This report describes the presence of ectomesenchymoma in an unusual primary organ and in an uncharacteristic age and presents novel data regarding the genetic characteristics of this tumor.
A novel adaptive control design method for stochastic nonlinear systems using neural network
Authors: Aghajary Mohammad Mahdi , Gharehbaghi Arash
Published: February 2021

This paper presents a novel method for designing an adaptive control system using radial basis function neural network. The method is capable of dealing with nonlinear stochastic systems in strict-feedback form with any unknown dynamics. The proposed neural network allows the method not only to approximate any unknown dynamic of stochastic nonlinear systems, but also to compensate actuator nonlinearity. By employing dynamic surface control method, a common problem that intrinsically exists in the back-stepping design, called “explosion of complexity”, is resolved. The proposed method is applied to the control systems comprising various types of the actuator nonlinearities such as Prandtl–Ishlinskii (PI) hysteresis, and dead-zone nonlinearity. The performance of the proposed method is compared to two different baseline methods: a direct form of backstepping method, and an adaptation of the proposed method, named APIC-DSC, in which the neural network is not contributed in compensating the actuator nonlinearity. It is observed that the proposed method improves the failure-free tracking performance in terms of the Integrated Mean Square Error (IMSE) by 25%/11% as compared to the backstepping/APIC-DSC method. This depression in IMSE is further improved by 76%/38% and 32%/49%, when it comes with the actuator nonlinearity of PI hysteresis and dead-zone, respectively. The proposed method also demands shorter adaptation period compared with the baseline methods.
Dynamic hip screw fixation of subtrochanteric femoral fractures
Authors: Arshad Zaki , Thahir Azeem , Rawal Jaikirty , Hull Peter D. , Carrothers Andrew D. , Krkovic Matija , Chou Daud T. S.
Published: February 2021

Introduction

A subtrochanteric proximal femur fracture occurs in the 5 cm of bone immediately distal to the lesser trochanter. UK national guidelines advise that adults with subtrochanteric fractures should be treated with an intramedullary nail (IMN). This study aims to compare peri-operative outcome measures of patients with subtrochanteric fractures treated with either an IMN or a dynamic hip screw (DHS) construct.

Materials and Methods

We retrospectively reviewed subtrochanteric fractures presenting at our institution over 4.5 years (October 2014–May 2019), classifying them into two treatment groups; IMN and DHS. These groups were compared on outcome measures including surgical time, blood loss, radiation dose area product (DAP), length of stay, re-operation rate and mortality.

Results

During the time period studied, 86 patients presented with a subtrochanteric fracture of the femur; with 74 patients (86%) receiving an IMN and 12 (14%) receiving a DHS. The comparative outcome measures reaching statistical significance were blood loss and radiation DAP. The DHS group showed a significantly lower mean blood loss of 776 ml compared to 1029 ml in the IMN group. Also, the DHS group showed a significantly lower mean DAP of 150.30 mGy cm2 compared to 288.86 mGy cm2 in the IMN group.

Conclusion

Although UK national guidelines recommend treating all subtrochanteric fractures with an IMN; the outcome measures assessed in our study did not show use of an IMN to be superior to a DHS. The DHS group showed a lower estimated blood loss and a reduced DAP. This, along with the reduced financial cost associated with a DHS, may support the use of DHS over IMN for certain subtrochanteric fractures of the femur. There may not be a single favourable implant for the treatment of subtrochanteric fractures as a whole; instead different subtypes of fracture may be amenable to a number of fixation devices. Choice of implant should be determined locally and based on existing and future clinical and health economic research.
Surgical exclusion of an idiopathic saccular aneurysm in the left main trunk of the coronary artery
Authors: Tadokoro Naoki , Fukushima Satsuki , Shimahara Yusuke , Saito Tetsuya , Kawamoto Naonori , Shimizu Hideyuki , Fujita Tomoyuki
Published: February 2021

Purpose

A coronary artery aneurysm (CAA) can result in critical cardiac events such as thromboembolic complications or rupture. A saccular CAA located in the left main trunk (LMT) is the most critical form of this pathology and its surgical repair is challenging. We conducted this single-center study to review the surgical outcomes of patients with a saccular CAA in the LMT.

Methods

Between May, 2012 and June, 2020, five patients with a saccular CAA in the LMT underwent surgery at our center. The median age at operation was 66.5 (59.7–69) years and the median diameter of the CAA was 13.0 mm (IQR 11–14 mm).

Results

The CAA was fully excluded by patch closure of the LMT orifice and direct closure of the distal LMT, supplemented by coronary artery bypass grafting with the exclusive use of arterial conduits. There was no in-hospital mortality, although one patient suffered graft spasm-related myocardial infarction with complete recovery. Post-operative angiography showed a fully excluded LMT in all patients. There was no mortality or adverse cardiac events during follow-up.

Conclusions

Our surgical policy for CAA in the LMT is feasible and safe; however, coronary blood flow is dependent on reliable bypasses.
The vaccinologist’s “dirty little secret”: a better understanding of structure-function relationships of viral immunogens might advance rational HIV vaccine design
Authors: Greslehner Gregor P.
Published: February 2021

I will offer a conceptual analysis of different notions of structure and function of viral immunogens and of different structure-function relationships. My focus will then be on the mechanisms by which the desired immune response is induced and why strategies based on three-dimensional molecular antigen structures and their rational design are limited in their ability to induce the desired immunogenicity. I will look at the mechanisms of action of adjuvants (thus the wordplay with Janeway’s “immunologist’s dirty little secret”). Strategies involving adjuvants and other (more successful) vaccination strategies rely on taking into account activities and functions (“what is going on”), and not just the structures involved (“who is there”), in binding in a “lock and key” fashion. Functional patterns as well as other organizational and temporal patterns, I will argue, are crucial for inducing the desired immune response and immunogenicity. The 3D structural approach by itself has its benefits – and its limits, which I want to highlight by this philosophical analysis, pointing out the importance of structure-function relationships. Different functional aspects such as antigenicity, immunogenicity, and immunity need to be kept separate and cannot be reduced to three-dimensional structures of vaccines. Taking into account different notions of structure and function and their relationships might thus advance our understanding of the immune system and rational HIV vaccine design, to which end philosophy can provide useful tools.
Cognitive dysfunction in young subjects with periodontal disease
Authors: Hategan Simona I. , Kamer Sabrina A. , Craig Ronald G. , Sinescu Cosmin , de Leon Mony J. , Jianu Dragos C. , Marian Catalin , Bora Bianca I. , Dan Traian-Flavius , Birdac Claudiu D. , Marcu Anca , Kamer Angela R. , Negrutiu Meda Lavinia
Published: February 2021

Background

Periodontal disease is an inflammatory, dysbiotic condition. Studies have shown that in the elderly, periodontal disease was associated with cognitive dysfunction and Alzheimer’s disease.

Objective

To investigate whether young healthy subjects with periodontal disease have lower cognition compared to those without periodontal disease. The salivary cytokines (IL-1β, TNF-α) levels in relation to cognition were also tested.

Methods

In a monocenter, cross-sectional study, forty subjects [mean age (SD) = 34 (5) and 48% female] from western Romania were classified into periodontal disease conditions using radiographic assessment: 10 subjects had aggressive periodontitis (AGG_P), 20 chronic mild-moderate periodontitis (CR_P), and 10 no periodontitis (NL_P). Neuropsychological assessment performed by standardized neurologists and psychologist included Rey Auditory Verbal Learning Test (RAVLT), Montreal Cognitive Assessment test (MOCA), Mini-Mental State Examination (MMSE), and Prague tests. Salivary cytokines levels were determined by ELISA.

Results

RAVLT and MOCA delayed recall scores were lower in AGG_P group compared to NL_P and CR_P. The learning curve was also different with subjects with AGG_P showing reduced learning performance. Contrary to our hypothesis, salivary IL-1β associated with immediate but not delayed cognitive scores.

Conclusions

These results showed for the first time that subjects with AGG_P had cognitive dysfunction and IL-1β may play a role in this process.
Decarbonising road freight: Is truck automation and platooning an opportunity?
Authors: Paddeu Daniela , Denby Jozef
Published: February 2021

Governments, industry and academia are paying high attention to autonomous vehicles and platooning, due to their high potential to transform public and private transport and reduce carbon emissions generated by road transport. The road freight sector is expected to be an early adopter of the autonomous technology due to the potential cost reduction for logistics companies. However, despite the expected fuel savings and polluting emission reductions due to truck platooning, actual benefits would strongly depend on the adopted technology and the operational conditions of the system. This paper investigates the potential for truck platooning to reduce carbon emissions from road freight, presenting a series of scenarios that vary by adoption rates, operational models and platoon size. Scenarios were co-designed with freight stakeholders to build a Truck Platooning Roadmap (2025–2050), considering a specific case study: the UK. Polluting emissions and related external costs are calculated across the different scenarios. Results show that there is high uncertainty for the adoption of truck platooning, with a potential first phase involving a small pool of low-automated trucks, and a second phase with a larger pool of high-automated trucks, reflecting higher economic and environmental benefits. A series of other technological and policy considerations are presented to support policymakers to draw a zero-carbon road freight strategy.

Graphic abstract
Design and Construction of a Tailings Dam over an Ancient Tailings Facility at La Parrilla Mine
Authors: Galera José Miguel , de la Fuente Fernando , García Juan , Calleja Manuel , Pozo Vanesa
Published: February 2021

La Parrilla is a tungsten and tin mine located in western Spain. The tailings facility has a total capacity for 3 Mm3 and will be executed in four different phases. The main constraint for the design and construction of the tailings dam is that it has been constructed over an existing one from the 1980s. The construction activities involved removal and substitution of the old tailings from the southern portion of the facility, ground improvement with gravel columns over an area of about 10,000 m2, and construction of the dyke’s dam. This article describes the main design and construction aspects, including monitoring, until the dam’s completion in June 2019.
Parametric modeling of quantile regression coefficient functions with count data
Authors: Frumento Paolo , Salvati Nicola
Published: February 2021

Applying quantile regression to count data presents logical and practical complications which are usually solved by artificially smoothing the discrete response variable through jittering. In this paper, we present an alternative approach in which the quantile regression coefficients are modeled by means of (flexible) parametric functions. The proposed method avoids jittering and presents numerous advantages over standard quantile regression in terms of computation, smoothness, efficiency, and ease of interpretation. Estimation is carried out by minimizing a “simultaneous” version of the loss function of ordinary quantile regression. Simulation results show that the described estimators are similar to those obtained with jittering, but are often preferable in terms of bias and efficiency. To exemplify our approach and provide guidelines for model building, we analyze data from the US National Medical Expenditure Survey. All the necessary software is implemented in the existing R package .
Autonomic cardiovascular alterations as therapeutic targets in chronic kidney disease
Authors: Seravalle Gino , Quarti-Trevano Fosca , Vanoli Jennifer , Lovati Chiara , Grassi Guido
Published: February 2021

Purpose

The present paper will review the impact of different therapeutic interventions on the autonomic dysfunction characterizing chronic renal failure.

Methods

We reviewed the results of the studies carried out in the last few years examining the effects of standard pharmacologic treatment, hemodialysis, kidney transplantation, renal nerve ablation and carotid baroreceptor stimulation on parasympathetic and sympathetic control of the cardiovascular system in patients with renal failure.

Results

Drugs acting on the renin–angiotensin system as well as central sympatholytic agents have been documented to improve autonomic cardiovascular control. This has also been shown for hemodialysis, although with more heterogeneous results related to the type of dialytic procedure adopted. Kidney transplantation, in contrast, particularly when performed together with the surgical removal of the native diseased kidneys, has been shown to cause profound sympathoinhibitory effects. Finally, a small amount of promising data are available on the potential favorable autonomic effects (particularly the sympathetic ones) of renal nerve ablation and carotid baroreceptor stimulation in chronic kidney disease.

Conclusions

Further studies are needed to clarify several aspects of the autonomic responses to therapeutic interventions in chronic renal disease. These include (1) the potential to normalize sympathetic activity in uremic patients by the various therapeutic approaches and (2) the definition of the degree of sympathetic deactivation to be achieved during treatment.
GNSS-to-GNSS time offsets: study on the broadcast of a common reference time
Authors: Sesia Ilaria , Signorile Giovanna , Thai Tung Thanh , Defraigne Pascale , Tavella Patrizia
Published: February 2021

We present two different approaches to broadcasting information to retrieve the GNSS-to-GNSS time offsets needed by users of multi-GNSS signals. Both approaches rely on the broadcast of a single time offset of each GNSS time versus one common time scale instead of broadcasting the time offsets between each of the constellation pairs. The first common time scale is the average of the GNSS time scales, and the second time scale is the prediction of UTC already broadcast by the different systems. We show that the average GNSS time scale allows the estimation of the GNSS-to-GNSS time offset at the user level with the very low uncertainty of a few nanoseconds when the receivers at both the provider and user levels are fully calibrated. The use of broadcast UTC prediction as a common time scale has a slightly larger uncertainty, which depends on the broadcast UTC prediction quality, which could be improved in the future. This study focuses on the evaluation of two different common time scales, not considering the impact of receiver calibration, at the user and provider levels, which can nevertheless have an important impact on GNSS-to-GNSS time offset estimation.
Correction to: Views on ageing: a lifespan perspective
Authors: Kornadt Anna E. , Kessler Eva‑Marie , Wurm Susanne , Bowen Catherine E. , Gabrian Martina , Klusmann Verena
Published: February 2021

The article “Views on ageing: a lifespan perspective”, written by Anna E. Kornadt, Eva-Marie Kessler, Susanne Wurm, Catherine E. Bowen, Martina Gabrian and Verena Klusmann., was originally published electronically on the publisher’s internet portal on 11 October 2020 without open access.
Soft Liver Phantom with a Hollow Biliary System
Authors: Tan Xiangzhou , Li Dandan , Jeong Moonkwang , Yu Tingting , Ma Zhichao , Afat Saif , Grund Karl-Enrst , Qiu Tian
Published: February 2021

Hepatobiliary interventions are regarded as difficult minimally-invasive procedures that require experience and skills of physicians. To facilitate the surgical training, we develop a soft, high-fidelity and durable liver phantom with detailed morphology. The phantom is anatomically accurate and feasible for the multi-modality medical imaging, including computer tomography (CT), ultrasound, and endoscopy. The CT results show that the phantom resembles the detailed anatomy of real livers including the biliary ducts, with a spatial root mean square error (RMSE) of 1.7 ± 0.7 mm and 0.9 ± 0.2 mm for the biliary duct and the liver outer shape, respectively. The sonographic signals and the endoscopic appearance highly mimic those of the real organ. An electric sensing system was developed for the real-time quantitative tracking of the transhepatic puncturing needle. The fabrication method herein is accurate and reproducible, and the needle tracking system offers a robust and general approach to evaluate the centesis outcome.
Analysis of airborne pollen time series originating from Hirst-type volumetric samplers—comparison between mobile sampling head oriented toward wind direction and fixed sampling head with two-layered inlet
Authors: Mimić Gordan , Šikoparija Branko
Published: February 2021

In this study, we have compared time series of pollen concentration originating from two Hirst-type volumetric samplers that were equipped with different sampling heads. To collect airborne pollen, we have used classic sampler with mobile sampling head including wind vane and adapted sampler with fixed sampling head having two-layered inlet, like in Sigma-2 passive sampler. The devices were placed at the roof level, on the top of the building of the Faculty of Sciences located in Novi Sad, Serbia. The sampling of airborne pollen was performed from February until October 2019. Along with the pollen data, meteorological conditions were recorded with an automated weather station measuring solar radiation, air temperature, relative humidity, wind speed and precipitation. Time series of daily pollen concentrations expressed high correlations, although there were large differences on the hourly basis. Absolute difference between hourly values showed very weak correlation with relevant meteorological parameters: temperature, humidity, precipitation, wind speed and turbulent kinetic energy, leading to the conclusion that sampling with both heads was not affected by meteorological conditions. Counting the pollen grains from the whole sample and not just from 10% of the area, which is the minimum requirement, was done for the six days in the season and proved that error introduced by subsampling during analysis was the main reason for differences in time series. To conclude, replacing mobile sampling head with fixed sampling head having two-layered inlet does not notably affect the quantity of pollen recorded by the Hirst-type volumetric method.
Rotational effects on exchange flows across a submerged sill
Authors: Cuthbertson A. , Berntsen J. , Laanearu J. , Asplin Magdeli
Published: February 2021

This paper presents new laboratory-scale numerical simulations of density-driven exchange flows generated across an idealised, submerged sill obstruction under both non-rotating and rotating frames of reference using the Bergen Ocean Model (BOM), a three-dimensional general ocean circulation model. Initial non-rotating BOM simulations are compared directly with previous laboratory data obtained in a large-scale channel facility incorporating an idealised trapezoidal sill. These laboratory experiments demonstrate that the saline intrusion flux across the sill is initially reduced and then eventually fully blocked under increasing net-barotropic flow conditions imposed in the counterflowing upper freshwater layer, with the saline blockage also more evident for reduced sill submergence depths. These parametric dependences are also demonstrated in the equivalent BOM simulations of the non-rotating sill exchange flows, although the numerical model results tend to overpredict both the interfacial velocity and density gradients across the sill (as indicative of suppressed interfacial mixing), as well as the fresh-saline source flux ratio at which full blockage of the saline intrusion occurs. The BOM simulations are then extended to consider rotating sill exchange flow dynamics. In particular, these additional runs demonstrate that Coriolis forces increase the overall blockage of the saline intrusion layer compared to equivalent non-rotating exchange flows, especially when the Rossby number associated with the saline intrusion flow across the sill is considerably less than unity. This effect is largely attributed to the development of Ekman boundary layer dynamics and associated secondary circulations within the bi-directional exchange flows. These are shown to impose strong control on the transverse distribution and extent of the lower saline intrusion flow across the sill and, hence, the parametric conditions under which full saline intrusion blockage is achieved in rotating sill exchange flows.
Finite element simulation of ductile fracture in polycrystalline materials using a regularized porous crystal plasticity model
Authors: Khadyko Mikhail , Frodal Bjørn Håkon , Hopperstad Odd Sture
Published: February 2021

In the present study, a hypoelastic–plastic formulation of porous crystal plasticity with a regularized version of Schmid’s law is proposed. The equation describing the effect of the voids on plasticity is modified to allow for an explicit analytical solution for the effective resolved shear stress. The regularized porous crystal plasticity model is implemented as a material model in a finite element code using the cutting plane algorithm. Fracture is described by element erosion at a critical porosity. The proposed model is used for two test cases of two- and three-dimensional polycrystals deformed in tension until full fracture is achieved. The simulations demonstrate the capability of the proposed model to account for the interaction between different modes of strain localization, such as shear bands and necking, and the initiation and propagation of ductile fracture in large scale polycrystal models with detailed grain description and realistic boundary conditions.
TORCH: a TOSCA-Based Orchestrator of Multi-Cloud Containerised Applications
Authors: Tomarchio Orazio , Calcaterra Domenico , Di Modica Giuseppe , Mazzaglia Pietro
Published: February 2021

The growth in the number and types of cloud-based services offered to IT customers is supported by the constant entry of new actors in the market and the consolidation of disruptive technologies such as AI, Big Data and Micro-services. From the customer’s perspective, in a market landscape where the cloud offer is highly diversified due to the presence of multiple competing service providers, picking the service that best accommodate their specific needs is a critical challenge. Once the choice is made, so called “cloud orchestration tools” (orchestrators) are required to take care of the customer application’s life-cycle. While big players offer their customers proprietary orchestrators, in the literature quite a number of open-source initiatives have launched multi-cloud orchestrators capable of transparently managing applications on top of the most representative cloud platforms. In this paper, we propose TORCH, a TOSCA-based framework for the deployment and orchestration of cloud applications, both classical and containerised, on multiple cloud providers. The framework assists the cloud customer in defining application requirements by using standard specification models. Unlike other multi-cloud orchestrators, adopts a strategy that separates the provisioning workflow from the actual invocation of proprietary cloud services API. The main benefit is the possibility to add support to any cloud platforms at a very low implementation cost. In the paper, we present a prototypal implementation of TORCH and showcase its interaction with two different container-based cluster platforms. Preliminary performance tests conducted on a small-scale test-bed confirm the potential of TORCH.
Management of RAASi-associated hyperkalemia in patients with cardiovascular disease
Authors: Silva-Cardoso José , Brito Dulce , Frazão João Miguel , Ferreira Aníbal , Bettencourt Paulo , Branco Patrícia , Fonseca Cândida
Published: February 2021

Renin–angiotensin–aldosterone system inhibitors (RAASi) reduce morbidity and mortality in heart failure (HF) with reduced ejection fraction in a dose-dependent manner. They also have a positive impact in other cardiovascular diseases (CVDs). However, RAASi may induce hyperkalemia, a potentially life-threatening disorder. This risk is further increased in those with concomitant chronic kidney disease, diabetes mellitus, and/or in patients with hypertension. Current treatment guidelines recommend maximal RAASi dosing to improve clinical outcomes; however, this is often limited by the development of hyperkalemia. When this occurs, current guidelines recommend RAASi down-titration/interruption, which, while improving short-term prognosis, is associated with a negative long-term prognostic impact. At present, the European Society of Cardiology suggests the consideration of novel potassium binders (patiromer and sodium zirconium cyclosilicate) for the management of RAASi-associated hyperkalemia. Both drugs can reduce serum potassium levels and prevent recurrent hyperkalemia. Additionally, patiromer showed enabling of RAASi optimization in high-risk patients. Nevertheless, precise recommendations on the use of these drugs are lacking. Building upon current HF guideline recommendations, a multidisciplinary expert panel convened to design an algorithm providing practical guidance on the use of novel potassium binders/patiromer in patients with HF and/or other CVD. As a result of that effort, we present an evidence-based treatment algorithm for the management of hyperkalemia with novel potassium binders/patiromer in patients with HF and/or other CVD receiving RAASi, including the necessary monitoring to avoid induction of hypokalemia. This algorithm aims to maintain or up-titrate RAASi to optimized doses, while maintaining normokalemia, improved clinical outcomes, and long-term prognosis.