bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental investigation on dynamic mechanical properties and fracture evolution behavior of the underground openings with excavation damaged zones
Authors: Zhao Huatao , Tao Ming , Li Xibing , Hong Zhixian , Zhao Rui , Cao Wenzhuo
Published: July 2022

The existence of excavation damaged zone (EDZ) generally influences the stability and safety of the underground openings. To investigate the influence of EDZ on the stability of underground excavation under dynamic stress disturbances, underground excavations with EDZs are represented by holed rock specimens with damage zones. The fracture evolution and dynamic mechanical properties of damaged holed rock specimens under dynamic loads are investigated by using the improved Split Hopkinson Pressure Bar (SHPB). The results have shown that the stress-strain curve of the rock specimens with damage zones is divided into pre-peak and post-peak stages, without compaction and elastic deformation stages. The dynamic strength, peak deformation moduli, and crack initiation stress decrease while the strain rate, absorbed energy, and failure time of holed specimens increase with increasing damage around circular holes. The failure of the holed rock specimens always start from circular holes, and specimens without or with minor damage exhibit overall tensile-shear failure. However, the failure of rock specimens with a greater damage condition mainly appears within damage zones around circular holes in the form of spalling or compression-shear failure, and the failure zone increases with increasing damage of surrounding rocks. The failure around and away from circular holes of specimens without or with minor damage is respectively characterized by intergranular and transgranular cracks. The results of the present study provide implications to the disaster prevention and support design of underground openings with EDZ.
Diffracting Boundaries: Toward Post-Philosophies of Quantification and the Black Radical Tradition
Authors: Dixon-Román Ezekiel , Fernandez Arlene , Quiros Julian , Sansone Nicole
Published: July 2022

This article is derived from a webinar series conversation titled, “Post Philosophies and the Doing of Inquiry” co-hosted by Candace R. Kuby and Viv Bozalek. Featured in this conversation is Ezekiel Dixon-Román and he discusses some of the backgrounds to his scholarship and how he has come to his questions and approach of inquiry on/in quantification and the Black radical tradition. He and his students discuss their respective projects and the interventions they are making in the technologies and practices of quantification through their engagement with critical theory, Black radical thought, new materialisms, cybernetics, and media studies.
Misuse of Over the Counter and Prescription Only Medication by Adults Accessing Specialist Treatment Services in the UK: A Narrative Synthesis
Authors: Gittins Rosalind , Missen Louise , Maidment Ian
Published: July 2022

Background:

Concerns about the misuse of over the counter (OTC) and prescription only medication (POM) are due to their impact upon physical/mental wellbeing, drug interactions and drug-related deaths. Improving an understanding of the pattern of use by people accessing specialist substance misuse services (SMSs) should enable improvements to treatment provision.

Aim:

To review the literature on the misuse of OTC/POM among adults accessing SMS, including the pattern of use, types of medication and associated characteristics.

Methods:

This review is reported in line with PRISMA. The protocol has been registered on PROSPERO (CRD42020135216) and separately published. A search of Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases and grey literature was undertaken. Only English language publications outlining OTC/POM misuse by adults in receipt of psychological/pharmacological interventions for substance misuse were included. Two reviewers conducted the title, abstract and full-text reviews using predetermined selection criteria and a piloted data extraction form to ensure a consistent approach. A third reviewer resolved disagreements and the Mixed Methods Appraisal Tool assessed for bias. Ethical approval was not required.

Results:

Thirteen studies with notable heterogeneity were included in the narrative synthesis after non-UK-based and ineligible publications were excluded, from the 143 potentially relevant papers. To reduce bias all studies were included in the analysis and GRADE-CERQual was applied. ‘High confidence’ was identified for all review findings, despite moderate methodological limitations. Antihistamine, benzodiazepine and opioid misuse was mentioned most frequently. Usage patterns and supply sources varied. Adverse consequences and polypharmacy are concerning. Withdrawal symptoms perpetuated misuse, often alongside illicit substance use, comorbid psychiatric/pain disorders and street drug shortages.

Conclusion:

OTC/POM misuse is common amongst adults accessing SMS. A renewed approach to withdrawal management is required. The limited number of studies may impact on generalisability but allowed for a more detailed review. Restricting to UK studies improved relevance due to drug market variations and availability of medicines in different countries. Further UK-based research on OTC/POM misuse in SMS is needed to build upon the current paucity in the published literature.
Role of pre-strain on the corrosion behaviour of Al-Zn-Mg P/M alloy
Authors: Hari Krishna Katika , MJ Davidson , KS Rajmohan , Nithin Abeyram M
Published: July 2022

In the present study, Al-Zn-Mg alloy has been fabricated through the powder metallurgy route by keeping Zn content at 5.6% and varying Mg from 0% to 3%. The optimum composition of Mg was found to be 2% based on relative density, microhardness and microstructure. Al-5.6Zn-2Mg was subjected to deformation at various temperatures (300 °C, 400°C and 500°C) and strain rates (0.5, 0.05 and 0.005). Potentiodynamic polarization and electrochemical impedance spectroscopy were used to assess the electrochemical behaviour of deformed preforms. Scanning electron microscopy was utilized to study the microstructure and corrosion morphology of Al-5.6Zn-2Mg under different conditions. In the present study, deformation behaviour (axial strain (εz), formability stress index (βσ)) has been related to mechanical (hardness) and electrochemical properties (corrosion rate, pitting potential (Epit)). By increasing deformation, potentiodynamic polarization results showed a decrease in corrosion current density (icorr) and an increase in pitting potential, which increased the corrosion resistance of the alloy. The corrosion resistance of the alloy increased significantly by increasing deformation temperature and lowering strain rate. Corrosion rate also decreases with an increase in axial strain and formability stress index. The corrosion mechanisms found in deformed preforms were pitting and intergranular corrosion. The corrosion morphologies also revealed the closure of pores due to increase in temperature and a decrease in strain rate.
My High Horse Is Dying: Agitating Internalized Neoliberalism in Higher Education With(Out) Compassion
Authors: Killam Rachel Keener
Published: July 2022

This critical, poststructural autoethnography agitates internalized neoliberalism in the higher education context. Provocative and experimental, it is intended to trouble neoliberal norms that shape professional selves and higher-education-the-collective, while also interweaving what it means to be/come a scholar. Nonlinear flares, manifested in theorization, images, vignettes, checklists, and poetry illuminate the subtleties of inescapable neoliberalism at individual and systemic levels. Offering compassion as a throughline of inquiry, I wonder if/how it is possible for compassion to disrupt neoliberalism through the precarity of individual and systemic enaction. As higher education goes on, and uncertain institutions contemplate staff/faculty retention, along with the telos of college education, how do we come to terms with neoliberalism’s stronghold that stifles emancipating onto-epistemic possibilities? Can/does compassion create breeches for new possibilities?
Toward Holistic Experience-Oriented Service Innovation: Co-Creating Sustainable Value With Customers and Society
Authors: Kandampully Jay , Bilgihan Anil , Van Riel Allard C. R. , Sharma Anuj
Published: July 2022

Hospitality exists from the grassroots level of society upward and plays a central role in the global economy. For the many organizations active in this sector and the societies they are based in, innovation in hospitality services is considered their lifeblood. Recent advancements in digitalization, artificial intelligence, robotics, communications technologies, and platform-based new business models are transforming the global business environment at a rapid pace. However, unlike many other service sectors, the hospitality and tourism sectors are unique in their focus on people, experiences, and the wider ecosystem (i.e., society and the environment). The unique makeup of the hospitality sector, therefore, demands a distinctive approach to innovation. This study aims to examine service innovation with a focus on the hospitality sector. It provides a holistic theoretical framework and proposes an agenda for future research. The framework suggests the hospitality experience to be at the core of innovation in this sector. Consequently, hospitality firms must focus on creating value through both technological and nontechnological innovation. This innovation must be facilitated in a symbiotic manner, with a strong focus on people at its center, showcasing the “soul” of the hospitality across the extended “footprints” of the experience.
Where Spirit Meets Bone: A Meditation on Embodied Qualitative Inquiry
Authors: Carless David
Published: July 2022

This performance autoethnography explores the ways that song writing and yoga, as forms of embodied practice, might inform the methodologies of autoethnography and qualitative inquiry. Throughout the piece, I share and reflect on moments in my own song writing and yoga practice which have helped me develop as a qualitative researcher.
Impact of COVID-19 policies on pedestrian traffic and walking patterns
Authors: Angel Avital , Cohen Achituv , Dalyot Sagi , Plaut Pnina
Published: July 2022

The spread of COVID-19 pandemic provoked new policies and restrictions, which had an unprecedented impact on urban mobility and traffic on local and global scales. While changes in motorized traffic were investigated and monitored throughout the recent pandemic crisis in many cities around the world, not much was done on the changes in pedestrian street-traffic and walking patterns during this time. This study aims to identify, quantify, and analyze the changes in pedestrian traffic and walking patterns induced by COVID-19 policies. The “first wave” period of COVID-19 policies in Tel-Aviv, Israel, is used as a case study in this work. The analysis includes over 116 million pedestrian movement records documented by a network of 65 Bluetooth sensors, between 1.2.2020 and 26.7.2020, with a comparison to the equivalent time in 2019 that signifies “normal” pre-COVID-19 conditions. The results show clear correlation between the various COVID-19 policy restrictions and pedestrian count. The shifts to work-from-home and closure of businesses were highly correlated with changes in walking patterns during weekdays, while distinguishing changes in commercial and residential street segments. Nevertheless, while the restrictions dramatically influenced pedestrian movement volume and time of walking, it did not significantly change where people chose to walk, signifying the essentialness of attractive streets, parks and squares for citizens living in urban areas. This study shows how policy affects walking behavior in cities, demonstrating the potential of passive crowdsourced sensing technologies to provide urban planners and decision makers an efficient tool for monitoring and evaluating pedestrian infrastructure implementation in cities.
Impaired microtubule dynamics contribute to microthrombocytopenia in RhoB-deficient mice
Authors: Englert Maximilian , Aurbach Katja , Becker Isabelle C. , Gerber Annika , Heib Tobias , Wackerbarth Lou M. , Kusch Charly , Mott Kristina , Araujo Gabriel H. M. , Baig Ayesha A. , Dütting Sebastian , Knaus Ulla G. , Stigloher Christian , Schulze Harald , Nieswandt Bernhard , Pleines Irina , Nagy Zoltan
Published: July 2022

Megakaryocytes are large cells in the bone marrow that give rise to blood platelets. Platelet biogenesis involves megakaryocyte maturation, the localization of the mature cells in close proximity to bone marrow sinusoids, and the formation of protrusions, which are elongated and shed within the circulation. Rho GTPases play important roles in platelet biogenesis and function. RhoA-deficient mice display macrothrombocytopenia and a striking mislocalization of megakaryocytes into bone marrow sinusoids and a specific defect in G-protein signaling in platelets. However, the role of the closely related protein RhoB in megakaryocytes or platelets remains unknown. In this study, we show that, in contrast to RhoA deficiency, genetic ablation of RhoB in mice results in microthrombocytopenia (decreased platelet count and size). RhoB-deficient platelets displayed mild functional defects predominantly upon induction of the collagen/glycoprotein VI pathway. Megakaryocyte maturation and localization within the bone marrow, as well as actin dynamics, were not affected in the absence of RhoB. However, in vitro–generated proplatelets revealed pronouncedly impaired microtubule organization. Furthermore, RhoB-deficient platelets and megakaryocytes displayed selective defects in microtubule dynamics/stability, correlating with reduced levels of acetylated α-tubulin. Our findings imply that the reduction of this tubulin posttranslational modification results in impaired microtubule dynamics, which might contribute to microthrombocytopenia in RhoB-deficient mice. Importantly, we demonstrate that RhoA and RhoB are localized differently and have selective, nonredundant functions in the megakaryocyte lineage.
Third-party CMV- and EBV-specific T-cells for first viral reactivation after allogeneic stem cell transplant
Authors: Jiang Wei , Clancy Leighton E. , Avdic Selmir , Sutrave Gaurav , Street Janine , Simms Renee , McGuire Helen M. , Patrick Ellis , Chan Adam S. , McCaughan Georgia , Myers Nadav , Micklethwaite Kenneth P. , Antonenas Vicki , Selim Adrian G. , Ritchie David , Bateman Caroline M. , Shaw Peter J. , Blyth Emily , Gottlieb David J.
Published: July 2022

Virus-specific T-cells (VSTs) from third-party donors mediate short- and long-term antiviral effects in allogeneic hematopoietic stem cell transplant (HSCT) recipients with relapsed or refractory viral infections. We investigated early administration of third-party VSTs, together with antiviral therapy in patients requiring treatment for first cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection. Thirty HSCT patients were treated with 1 to 4 VST infusions (2 × 107 cells/m2; CMV n=27, EBV n=3) at a median of 4 days after initiation of antiviral treatment. The overall viral response rate was 100%, with a complete response (CR) rate of 94%. Of the 28 patients who achieved a CR, 23 remained virus PCR negative (n=9) or below quantitation limit (n=14) for the duration of follow-up. Four patients had brief episodes of quantifiable reactivation not requiring additional therapy, and one required a second infusion after initial CR, remaining PCR negative thereafter. All 3 patients treated for EBV post-transplant lymphoproliferative disorder achieved sustained CR. Rates of aGVHD and cGVHD after infusion were 13% and 23%, respectively. There were no serious infusion-related adverse events. VST infusion was associated with rapid recovery of CD8+CD45RA−CD62L− and a slower recovery of CD4+CD45RA−CD62L− effector memory T-cells; CMV-specific T-cells comprised up to 13% of CD8+ cells. At 1 year post-transplant, non-relapse mortality was 10%, cumulative incidence of relapse was 7%, overall survival was 88% and 25 of 27 patients had ECOG status of 0 or 1. Early administration of third-party VSTs in conjunction with antiviral treatment appears safe and leads to excellent viral control and clinical outcomes. Registered on Australian New Zealand Clinical Trials Registry as #ACTRN12618000343202.
Industry influence in healthcare harms patients: myth or maxim?
Authors: Trayer James , Rowbotham Nicola J. , Boyle Robert J. , Smyth Alan R.
Published: July 2022

Healthcare is a major global industry accounting for a significant proportion of government spending. Drug and medical device manufacturers are publicly traded companies with a responsibility to their shareholders to maximise profits by increasing sales. In order to achieve this, industry exerts influence over every part of healthcare including academic research, medical education, clinical guideline development, physician prescribing and through direct interactions with patients. In contrast, healthcare services seek to provide effective, safe and evidence-based treatments. This article examines interactions with industry across these domains and seeks to identify mutually beneficial relationships and potential conflict leading to patient harms. Case studies are used to illustrate these interactions.

There is no single solution for improving healthcare's relationship with industry, although increased transparency has raised awareness of this issue. We briefly discuss some successful interventions that have been tried at national and regulatory level. While industry influence is widespread in healthcare and this has benefits for shareholders, healthcare practitioners have an ethical obligation to prioritise their patients� best interests. Industry interactions with healthcare professionals have a valid role in product development and distribution, but industry sponsorship of healthcare education and practice, guideline development or regulatory decision-making can have harmful consequences for patients. Healthcare practitioners need to carefully consider these issues when deciding whether to collaborate with industry.

Educational aims

To explore the many areas where industry influences healthcare and the subsequent effects on patient care. Case studies are used to illustrate examples of beneficial and harmful effects of this influence.

To raise awareness of the effects of industry influence and for readers to consider their own potential conflicts of interest.

To suggest potential ways to improve the current system with a focus on solutions which have successfully been trialled already.
Visual stimulation and frequency of focal neurological symptoms engage distinctive neurocognitive resources in migraine with aura patients: a study of resting-state functional networks
Authors: Coppola Gianluca , Corbelli Ilenia , Di Renzo Antonio , Chiappiniello Andrea , Chiarini Pietro , Parisi Vincenzo , Guercini Giorgio , Calabresi Paolo , Tarducci Roberto , Sarchielli Paola
Published: July 2022

Introduction

Several functional neuroimaging studies on healthy controls and patients with migraine with aura have shown that the activation of functional networks during visual stimulation is not restricted to the striate system, but also includes several extrastriate networks.

Methods

Before and after 4 min of visual stimulation with a checkerboard pattern, we collected functional MRI in 21 migraine with aura (MwA) patients and 18 healthy subjects (HS). For each recording session, we identified independent resting-state networks in each group and correlated network connection strength changes with clinical disease features.

Results

Before visual stimulation, we found reduced connectivity between the default mode network and the left dorsal attention system (DAS) in MwA patients compared to HS. In HS, visual stimulation increases functional connectivity between the independent components of the bilateral DAS and the executive control network (ECN). In MwA, visual stimulation significantly improved functional connectivity between the independent component pairs salience network and DAS, and between DAS and ECN. The ECN Z-scores after visual stimulation were negatively related to the monthly frequency of aura.

Conclusions

In individuals with MwA, 4 min of visual stimulation had stronger cognitive impact than in healthy people. A higher frequency of aura may lead to a diminished ability to obtain cognitive resources to cope with transitory but important events like aura-related focal neurological symptoms.
Total knee arthroplasty in patients with haemophilic arthropathy is effective and safe according to the outcomes at a mid-term follow-up
Authors: Wang Rui , Wang Zhengming , Gu Yong , Zhang Jingjing , Wang Penghe , Tong Peijian , Lv Shuaijie
Published: July 2022

Background

Haemophilic arthropathy (HA), a common complication of haemophilia, is secondary to recurrent joint bleeding and increases the prevalence of end-stage osteoarthritis (OA). Total knee arthroplasty (TKA) is a reliable treatment for haemophilia patients. This study was performed to evaluate the mid-term outcomes of TKA for end-stage HA. We hypothesized that the rate of complications of TKA is higher for patients with haemophilia than for patients without haemophilia.

Methods

Patients with HA undergoing TKA from January 2015 to December 2016 in our centre were retrospectively reviewed. All patients were managed by a multidisciplinary team. The improvements in flexion contracture, range of motion (ROM), Knee Society Score (KSS; clinical and functional), Visual Analogue Scale (VAS) score, and satisfaction at final follow-up were analysed to evaluate the effectiveness of TKA in HA. The complications were analysed to evaluate the safety of TKA in HA.

Results

Twenty-eight patients (32 knees) were included in the study. The follow-up was 69.1 ± 5.1 months. Significant differences between the preoperative and final follow-up values of flexion contracture (which changed from 21.1 ± 6.5° to 14.3 ± 4.1°, P < 0.001), ROM (from 53.9 ± 15.0° to 70.3 ± 16.3°, P < 0.001), clinical KSS (from 33.5 ± 14.4° to 62.7 ± 9.5°, P < 0.001), functional KSS (from 46.1 ± 15.5° to 62.9 ± 9.7°, P < 0.001), and VAS score (from 6.8 ± 1.4 to 4.9 ± 1.3, P < 0.01) were observed. Importantly, the incidence of complications was 15.6% and the satisfaction was 100% in our mid-term study.

Conclusion

Under elaborative and comprehensive management, TKA is effective and safe in patients with advanced HA on the basis of mid-term follow-up outcomes.
Jobcenters’ strategies to promoting the inclusion of immigrant and native job seekers: a comparative analysis based on PASS survey data
Authors: Lehwess-Litzmann René , Söhn Janina
Published: July 2022

This paper comparatively analyzes strategies of German Jobcenters to bring native and immigrant job seekers into employment. It focuses on clients who receive means-tested basic income for the unemployed, based on data from the Panel Study Labour Market and Social Security (PASS) from year 2015 to 2020. By way of logistic regression, the study identifies the impact of being an immigrant on the clients’ probability of reporting different kinds of offers like job referrals or courses, controlling for a number of other influential factors. The study also looks deeper into the effects of immigrant-specific attributes, such as heterogeneous German language skills. We found that the likelihood of offers by Jobcenters largely depends on the amount of time since immigration. Recent immigrants have the lowest chance of reporting most of the studied measures of active labor market policies. For immigrants having stayed more than 4 years in Germany, however, we do not find a disadvantage, and some measures out of Jobcenters’ toolbox are even more often offered to the longer-settled immigrants than to native clients. A possible explanation for the moderately under-average support of recent immigrants in terms of Jobcenters’ measures could be an institutional focus on improving German language skills prior to approaching the labor market.
Species delimitation and coexistence in an ancient, depauperate vertebrate clade
Authors: Brownstein Chase Doran , Bissell Immanuel Chas
Published: July 2022

Background

A major challenge to understanding how biodiversity has changed over time comes from depauperons, which are long-lived lineages with presently low species diversity. The most famous of these are the coelacanths. This clade of lobe-finned fishes occupies a pivotal position on the vertebrate tree between other fishes and tetrapods. Yet only two extant species and fewer than 100 extinct forms are known from the coelacanth fossil record, which spans over 400 million years of time. Although there is evidence for the existence of additional genetically isolated extant populations, a poor understanding of morphological disparity in this clade has made quantifying coelacanth species richness difficult.

Results

Here, we quantify variation in a sample of skulls and skeletons of the Triassic eastern North American coelacanth †Diplurusthat represents the largest assemblage of coelacanth individuals known. Based on the results of these quantitative comparisons, we identify a diminutive new species and show that multiple lacustrine ecosystems in the Triassic rift lakes of the Atlantic coastline harbored at least three species of coelacanths spanning two orders of magnitude in size.

Conclusions

Conceptions about the distribution of species diversity on the tree of life may be fundamentally misguided when extant diversity is used to gauge signals of extinct diversity.

Our results demonstrate how specimen-based assessments can be used to illuminate hidden biodiversity and show the utility of the fossil record for answering questions about the hidden richness of currently species-poor lineages.
Runs of homozygosity in Sable Island feral horses reveal the genomic consequences of inbreeding and divergence from domestic breeds
Authors: Colpitts Julie , McLoughlin Philip Dunstan , Poissant Jocelyn
Published: July 2022

Background

Understanding inbreeding and its impact on fitness and evolutionary potential is fundamental to species conservation and agriculture. Long stretches of homozygous genotypes, known as runs of homozygosity (ROH), result from inbreeding and their number and length can provide useful population-level information on inbreeding characteristics and locations of signatures of selection. However, the utility of ROH for conservation is limited for natural populations where baseline data and genomic tools are lacking. Comparing ROH metrics in recently feral vs. domestic populations of well understood species like the horse could provide information on the genetic health of those populations and offer insight into how such metrics compare between managed and unmanaged populations. Here we characterized ROH, inbreeding coefficients, and ROH islands in a feral horse population from Sable Island, Canada, using ~41 000 SNPs and contrasted results with those from 33 domestic breeds to assess the impacts of isolation on ROH abundance, length, distribution, and ROH islands.

Results

ROH number, length, and ROH-based inbreeding coefficients (FROH) in Sable Island horses were generally greater than in domestic breeds. Short runs, which typically coalesce many generations prior, were more abundant than long runs in all populations, but run length distributions indicated more recent population bottlenecks in Sable Island horses. Nine ROH islands were detected in Sable Island horses, exhibiting very little overlap with those found in domestic breeds. Gene ontology (GO) enrichment analysis for Sable Island ROH islands revealed enrichment for genes associated with 3 clusters of biological pathways largely associated with metabolism and immune function.

Conclusions

This study indicates that Sable Island horses tend to be more inbred than their domestic counterparts and that most of this inbreeding is due to historical bottlenecks and founder effects rather than recent mating between close relatives. Unique ROH islands in the Sable Island population suggest adaptation to local selective pressures and/or strong genetic drift and highlight the value of this population as a reservoir of equine genetic variation. This research illustrates how ROH analyses can be applied to gain insights into the population history, genetic health, and divergence of wild or feral populations of conservation concern.
Transcriptomic comparison sheds new light on regulatory networks for dimorphic flower development in response to photoperiod in Viola prionantha
Authors: Li Qiaoxia , Li Kunpeng , Zhang Zhengrong , Li Jigang , Wang Bo , Zhang Zuoming , Zhu Yuanyuan , Pan Chaochao , Sun Kun , He Chaoying
Published: July 2022

Background

Chasmogamous (CH)–cleistogamous (CL) dimorphic flowers are developed in Viola prionantha. However, the environmental and genetic factors necessary for the CH–CL transition are unknown.

Results

In the present work, short-day (SD) conditions induced CH flowers, whereas long days (LDs) triggered CL flowers in V. prionantha. Compared to fully developed CH flowers, CL flowers had less mature stamens, no nectar glands, and immature petals. Comparative transcriptomics revealed differentially expressed genes (DEGs) during CL and CH development. Core genes in the photoperiod pathway, such as V. prionantha orthologs of GIGANTEA (GI), CONSTANS (CO), and SUPPRESSOR OF OVEREXPRESSION OF CONSTANS 1 (SOC1), which promote floral induction, were highly expressed in CL flowers, whereas UNUSUAL FLORAL ORGANS (UFO) and B-class MADS-box genes for floral organ identity and development showed an opposite alteration. Moreover, genes in the glycolytic process, sucrose metabolic process, and fatty acid biosynthetic process were all highly expressed in CH flowers. Interestingly, V. prionantha orthologs of the B-class MADS-box genes APETALA3 (AP3) and PISTILLATA (PI) might relate to these sugar–fatty acid processes and were co-expressed with GAIP-B-like and YABBY5 (YAB5), which regulate the development of the petal, stamen, and nectary. Compared to CH flowers, DEGs and hub genes in the most significantly correlated modules of the gene co-expression network, which are involved in abiotic and biotic responses, were upregulated in CL flowers.

Conclusions

We proposed an integrative model for transcription regulation of genes in the photoperiod pathway, floral organ development, stress response, and sugar–fatty acid processes to determine CH–CL flower development in V. prionantha. Particularly, under LDs, activated GI may induce genes involved in the stress-response pathways, and then downregulated AP3 and PI or UFO to inhibit the sugar–fatty acid metabolic processes, together forming CL flowers. In contrast, CH flowers were produced under SDs. This work provides novel insights into the developmental evolution of dimorphic flowers in Viola.
Effectiveness of intraoperative cell salvage combined with a modified leucocyte depletion filter in metastatic spine tumour surgery
Authors: Zong Ya-nan , Xu Chuan-ya , Gong Yue-qing , Zhang Xiao-qing , Zeng Hong , Liu Chang , Zhang Bin , Xue Li-xiang , Guo Xiang-yang , Wei Feng , Li Yi
Published: July 2022

Background

To compare the effectiveness of intraoperative cell salvage (IOCS) combined with a modified leucocyte depletion filter (MLDF) with IOCS combined with a regular leucocyte depletion filter (RLDF) in eliminating tumour cells from blood salvage during metastatic spine tumour surgery (MSTS).

Methods

Patients with a known primary epithelial tumour who underwent MSTS were recruited for this study. Blood samples were collected in 5 stages: from the patients’ vein before anaesthesia induction (S1), from the operative field at the time of maximum tumour manipulation (S2), and from the operative blood after IOCS processing (S3) and after IOCS+RLDF (S4) and IOCS+MLDF (S5) processing. The polyploids of tumour cells in the blood samples were collected and counted with immunomagnetic separation enrichment and fluorescence in situ hybridization.

Results

We recruited 20 patients. Tumour cells were detected in 14 patients (70%) in S1, 16 patients (80%) in S2, 13 patients (65%) in S3, and 12 patients (60%) in S4. MLDF was added in 8 patients. Tumour cells were detected in only 1 of 8 patients in S5 (12.5%). There were significantly fewer tumour cells in the samples collected after MLDF processing (S5) than in the samples collected after RLDF (S4) and around the tumour (S2) (P = 0.016 and P = 0.039, respectively). Although no significant difference was observed between S4 and S1, a downward trend was observed after IOCS+RLDF processing.

Conclusions

Tumour cells could be removed by IOCS combined with RLDF from blood salvaged during MSTS, but residual tumour cells remained. The findings support the notion that MLDF eliminates tumour cells more effectively than RLDF. Hence, this technique can be applied to MSTS.

Trial registration

ChiCTR1800016162 Chinese Clinical Trial Registry.
Effect of sigh in lateral position on postoperative atelectasis in adults assessed by lung ultrasound: a randomized, controlled trial
Authors: Li Caifeng , Ren Qian , Li Xin , Han Hongqiu , Peng Min , Xie Keliang , Wang Zhiqiang , Wang Guolin
Published: July 2022

Background

Postoperative atelectasis occurs in 90% of patients receiving general anesthesia. Recruitment maneuvers (RMs) are not always effective and frequently associated with barotrauma and hemodynamic instability. It is reported that many natural physiological behaviors interrupted under general anesthesia could prevent atelectasis and restore lung aeration. This study aimed to find out whether a combined physiological recruitment maneuver (CPRM), sigh in lateral position, could reduce postoperative atelectasis using lung ultrasound (LUS).

Methods

We conducted a prospective, randomized, controlled trial in adults with open abdominal surgery under general anesthesia lasting for 2 h or longer. Subjects were randomly allocated to either control group (C-group) or CPRM-group and received volume-controlled ventilation with the same ventilator settings. Patients in CPRM group was ventilated in sequential lateral position, with the addition of periodic sighs to recruit the lung. LUS scores, dynamic compliance (Cdyn), the partial pressure of arterial oxygen (PaO2) and fraction of inspired oxygen (FiO2) ratio (PaO2/FiO2), and other explanatory variables were acquired from each patient before and after recruitment.

Results

Seventy patients were included in the analysis. Before recruitment, there was no significant difference in LUS scores, Cdyn and PaO2/FiO2 between CPRM-group and C-group. After recruitment, LUS scores in CPRM-group decreased significantly compared with C-group (6.00 [5.00, 7.00] vs. 8.00 [7.00, 9.00], p = 4.463e-11 < 0.05), while PaO2/FiO2 and Cdyn in CPRM-group increased significantly compared with C-group respectively (377.92 (93.73) vs. 309.19 (92.98), p = 0.008 < 0.05, and 52.00 [47.00, 60.00] vs. 47.70 [41.00, 59.50], p = 6.325e-07 < 0.05). No hemodynamic instability, detectable barotrauma or position-related complications were encountered.

Conclusions

Sigh in lateral position can effectively reduce postoperative atelectasis even without causing severe side effects. Further large-scale studies are necessary to evaluate it’s long-term effects on pulmonary complications and hospital length of stay.

Trial registration

ChiCTR1900024379. Registered 8 July 2019,
Anaesthetic management of an abdominal aortic aneurysmorrhaphy in Klippel-Trenaunay-Weber syndrome: a case report
Authors: Tanaka Yuichi , Sakamoto Shun-Ichiro , Bito Hiroyasu , Sakamoto Atsuhiro
Published: July 2022

Background

Klippel-Trenaunay-Weber syndrome (KTWS) is a rare congenital malformation. Although there have been few reports on anaesthetic management of patients with KTWS, there is a lack of data on anaesthetic management for abdominal aortic aneurysm (AAA) surgeries in these patients.

Case presentation

A 74-year-old man (height, 160 cm and body weight, 51.5 kg) with KTWS was scheduled for AAA replacement. Abdominal computed tomography (CT) showed prominent tortuosity below the abdominal aorta with an infrarenal abdominal aortic aneurysm, right common iliac artery aneurysm, and right external iliac artery aneurysm. Moreover, a remarkably noted arteriovenous fistula had developed between the aneurysm and peripheral artery. General anaesthesia was induced. Furthermore, a central venous catheter and an 8.5 French sheath in the left internal jugular vein were inserted. During the operation, bleeding from a collateral vessel in the cross-clamped aorta led the surgeon to decide to perform aneurysmorrhaphy. Intraoperatively, blood loss was 1500 ml, and 20 units of red blood cell concentrate were used.

Conclusions

Regarding AAA procedures in patients with KTWS, aortic cross-clamping may not sufficiently intercept blood flow due to collateral vessels. In these patients, the anaesthesiologist must be prepared to transfuse blood more rapidly and frequently than during normal AAA procedures.
Time to recovery and its predictors among critically ill patients on mechanical ventilation from intensive care unit in Ethiopia: a retrospective follow up study
Authors: Tilahun Lehulu , Molla Asressie , Ayele Fanos Yeshanew , Nega Aytenew , Dagnaw Kirubel
Published: July 2022

Introduction

For critically ill patients, mechanical ventilation is considered a pillar of respiratory life support. The mortality of victims in intensive care units is high in resource-constrained Sub-Saharan African countries. The recovery and prognosis of mechanically ventilated victims are unknown, according to evidence. The goal of the study was to see how long critically ill patients on mechanical ventilation survived.

Methods

A retrospective follow-up study was conducted. A total of 376 study medical charts were reviewed. Data was collected through reviewing medical charts. Data was entered into Epi-data manager version 4.6.0.4 and analyzed through Stata version 16. Descriptive analysis was performed. Kaplan- Meier survival estimates and log rank tests were performed. Cox proportional hazard model was undertaken.

Results

Median recovery time was 15 days (IQR: 6–30) with a total recovery rate of 4.49 per 100 person-days. In cox proportional hazard regression, diagnosis category {AHR: 1.690, 95% CI: (1.150- 2.485)}, oxygen saturation {AHR: 1.600, 95% CI: (1.157- 2.211)}, presence of comorbidities {AHR: 1.774, 95% CI: (1.250–2.519)}, Glasgow coma scale {AHR: 2.451, 95% CI: (1.483- 4.051)}, and use of tracheostomy {AHR: 0.276, 95% CI: (0.180–0.422)} were statistically significant predictors.

Discussion

Based on the outcomes of this study, discussions with suggested possible reasons and its implications were provided.

Conclusion and Recommendations

Duration and recovery rate of patients on mechanical ventilation is less than expected of world health organization standard. Diagnosis category, oxygen saturation, comorbidities, Glasgow coma scale and use of tracheostomy were statistically significant predictors. Mechanical ventilation durations should be adjusted for chronic comorbidities, trauma, and use of tracheostomy.
Prediction of the need for emergency endoscopic treatment for upper gastrointestinal bleeding and new score model: a retrospective study
Authors: Sasaki Yoshihiro , Abe Tomoko , Kawamura Norio , Keitoku Taisei , Shibata Isamu , Ohno Shino , Ono Keiichi , Makishima Makoto
Published: July 2022

Background

Gastrointestinal bleeding is one of the major gastrointestinal diseases. In this study, our objective was to compare Glasgow-Blatchford score (GBS), AIMS65 score, MAP score, Modified GBS, and Iino score as outcome measures for upper gastrointestinal bleeding. In addition, we extracted factors associated with hemostatic procedures including endoscopy, and proposed a new robust score model.

Methods

From January 2015 to December 2019, 675 patients with symptoms such as hematemesis who visited the National Hospital Organization Disaster Medical Center and underwent urgent upper endoscopy with diagnosis of suspected non-variceal upper gastrointestinal bleeding were retrospectively reviewed. We evaluated the GBS, AIMS65 score, MAP score, Modified GBS, and Iino score, and assessed the outcomes of patients requiring hemostatic treatments at the subsequent emergency endoscopy. We performed logistic regression analysis of factors related to endoscopic hemostasis and upper gastrointestinal bleeding, created a new score model, and evaluated the prediction of hemostatic treatment and mortality in the new score and the existing scores.

Results

The factors associated with endoscopic treatment were hematemesis, heart rate, HB (hemoglobin), blood pressure, blood urea nitrogen (BUN). Based on these predictors and the partial regression coefficients, a new score named H3B2 (using the initial letters of hematemesis, heart rate, HB, blood pressure, and BUN) was generated. H3B2 score was slightly more discriminatory compared to GBS and Modified GBS (area under the receiver operating characteristic curves (AUROC): 0.73 versus 0.721 and 0.7128, respectively) in predicting hemostatic treatment in emergency endoscopy. The H3B2 score also showed satisfactory prediction accuracy for subsequent deaths (AUROC: 0.6857. P < 0.001).

Conclusions

We proposed a new score, the H3B2 score, consisting of simple and objective indices in cases of suspected upper gastrointestinal bleeding. The H3B2 score is useful in identifying high-risk patients with suspected upper gastrointestinal bleeding who require urgent hemostatic treatment including emergency endoscopy.
Association between testosterone and serum soluble α-klotho in U.S. males: a cross-sectional study
Authors: Zhang Zilong , Qiu Shi , Huang Xinyi , Jin Kun , Zhou Xianghong , Lin Tianhai , Zou Xiaoli , Yang Qiuxiang , Yang Lu , Wei Qiang
Published: July 2022

Purpose

Testosterone plays a crucial role in males, and the deficiency of testosterone leads to multiple adverse health conditions. Klotho is a recently discovered protein encoded by antiaging gene klotho. Both the levels of testosterone and klotho change with aging, so the relationship between them is worth exploring. The purpose of this study was to investigate whether total testosterone is associated with serum klotho levels in U.S. males aged 40–79 years.

Methods

Included in this study were 3750 male participants from the 2011 to 2016 National Health and Nutrition Examination Survey, aged 40–79 years with included information on klotho and sex hormones. The sex steroid hormone levels and klotho concentrations were assayed in laboratories using the recommended methods according to Nutrition Examination Survey guidelines. The association between sex hormones and klotho was calculated using multivariate linear regression models after adjustment for several possible confounding variables.

Results

Among the 3750 participants, the total testosterone concentration was 399.048 ± 184.780 ng/dL, and the testosterone deficiency prevalence was 1160 (30.942%). The geometric mean of serum klotho levels was 791.000 pg/mL. In the adjusted models, klotho increased 0.165 pg/mL for every 1 ng/dL increase of total testosterone (p = 0.004). In addition, estradiol (β 2.232; 95% CI 0.588–3.876; p = 0.032) and sex hormone-binding globulin (β 2.013; 95% CI 1.173–2.583; p = 0.002) were also positively associated with klotho concentrations.

Conclusion

This study reported a significant association between klotho and sex hormones in the U.S. male population. The levels of klotho in men increased with total testosterone, estradiol and sex hormone-binding globulin levels, which may have implications for future research and clinical practice.
Results of a worldwide external quality assessment of cfDNA testing in lung Cancer
Authors: Fairley Jennifer A. , Cheetham Melanie H. , Patton Simon J. , Rouleau Etienne , Denis Marc , Dequeker Elisabeth M. C. , Schuuring Ed , van Casteren Kaat , Fenizia Francesca , Normanno Nicola , Deans Zandra C.
Published: July 2022

Background

Circulating cell free DNA (cfDNA) testing of plasma for EGFR somatic variants in lung cancer patients is being widely implemented and with any new service, external quality assessment (EQA) is required to ensure patient safety. An international consortium, International Quality Network for Pathology (IQNPath), has delivered a second round of assessment to measure the accuracy of cfDNA testing for lung cancer and the interpretation of the results.

Methods

A collaboration of five EQA provider organisations, all members of IQNPath, have delivered the assessment during 2018–19 to a total of 264 laboratories from 45 countries. Bespoke plasma reference material containing a range of EGFR mutations at varying allelic frequencies were supplied to laboratories for testing and reporting according to routine procedures. The genotyping accuracy and clinical reporting was reviewed against standardised criteria and feedback was provided to participants.

Results

The overall genotyping error rate in the EQA was found to be 11.1%. Low allelic frequency samples were the most challenging and were not detected by some testing methods, resulting in critical genotyping errors. This was reflected in higher false negative rates for samples with variant allele frequencies (VAF) rates less than 1.5% compared to higher frequencies. A sample with two different EGFR mutations gave inconsistent detection of both mutations. However, for one sample, where two variants were present at a VAF of less than 1% then both mutations were correctly detected in 145/263 laboratories. Reports often did not address the risk that tumour DNA may have not been tested and limitations of the methodologies provided by participants were insufficient. This was reflected in the average interpretation score for the EQA being 1.49 out of a maximum of 2.

Conclusions

The variability in the standard of genotyping and reporting highlighted the need for EQA and educational guidance in this field to ensure the delivery of high-quality clinical services where testing of cfDNA is the only option for clinical management.