bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired working memory, cognitive flexibility and reward processing in mice genetically lacking Gpr88: Evidence for a key role for Gpr88 in multiple cortico‐striatal‐thalamic circuits
Authors: Thomson David M. , Openshaw Rebecca L. , Mitchell Emma J. , Kouskou Marianna , Millan Mark J. , Mannoury la Cour Clotilde , Morris Brian J. , Pratt Judith A.
Published: October 2020

The GPR88 orphan G protein‐coupled receptor is expressed throughout the striatum, being preferentially localised in medium spiny neurons. It is also present in lower densities in frontal cortex and thalamus. Rare mutations in humans suggest a role in cognition and motor function, while common variants are associated with psychosis. Here we evaluate the influence of genetic deletion of GPR88 upon performance in translational tasks interrogating motivation, reward evaluation and cognitive function. In an automated radial arm maze ‘N‐back’ working memory task, Gpr88 KO mice showed impaired correct responding, suggesting a role for GPR88 receptors in working memory circuitry. Associative learning performance was similar to wild‐type controls in a touchscreen task but performance was impaired at the reversal learning stage, suggesting cognitive inflexibility. Gpr88 KO mice showed higher breakpoints, reduced latencies and lengthened session time in a progressive ratio task consistent with enhanced motivation. Simultaneously, locomotor hyperactivity was apparent in this task, supporting previous findings of actions of GPR88 in a cortico‐striatal‐thalamic motor loop. Evidence for a role of GPR88 in reward processing was demonstrated in a touchscreen‐based equivalent of the Iowa gambling task. Although both Gpr88 KO and wild‐type mice showed a preference for an optimum contingency choice, Gpr88 KO mice selected more risky choices at the expense of more advantageous lower risk options. Together these novel data suggest that striatal GPR88 receptors influence activity in a range of procedures integrated by prefrontal, orbitofrontal and anterior cingulate cortico‐striatal‐thalamic loops leading to altered cognitive, motivational and reward evaluation processes.
Using corpora to foster L2 construction learning: A data‐driven learning experiment
Authors: Gilquin Gaëtanelle
Published: October 2020

This paper adopts a construction grammar approach to test the efficiency of data‐driven learning (DDL) when applied to constructions. High‐intermediate learners of English as a foreign language took part in an experiment consisting, for each construction, in (i) a pre‐test, in which the learners had to produce as many sentences as possible illustrating the constructions, (ii) a DDL intervention, which involved various concordance‐based activities, and (iii) several post‐tests, similar to the pre‐test, performed at regular intervals. The analysis looks at the number of (valid and invalid) constructions produced as well as the native‐like nature of these constructions, as established through a comparison with native corpus data. The analysis also examines the evolution of these results over the different post‐tests. Finally, it considers learners’ attitudes towards the DDL interventions, as evaluated through a questionnaire.
The Identity of Entrepreneurs: Providing Conceptual Clarity and Future Directions
Authors: Wagenschwanz Anna M.
Published: October 2020

The identity of entrepreneurs (IoE) has become a popular concept in entrepreneurship research, for example, to explain entrepreneurial behavior. Yet, despite growing interest in this topic, theoretical and terminological inconsistencies have hampered the development of a coherent understanding of the identity of entrepreneurs. I conduct a systematic literature review to provide an overview of different theoretical perspectives in IoE research and suggest consistent use of terminology and operationalizations. Further, I propose a framework to investigate the dynamic nature and multi‐level influences of the identity of entrepreneurs, and outline meaningful avenues for future research to unravel when, how, and with what consequences identity may become relevant in new venture creation.
Uptake of health services by youth living with HIV: a focused ethnography
Authors: Zgambo M. , Arabiat D. , Ireson D.
Published: October 2020

Background

Although several programs have been initiated to increase the uptake of health services amongst youth living with human immunodeficiency virus in the world, disparities in access to these care services still exist.

Aim

This study aimed to explore the experiences of young people as they attend the human immunodeficiency virus clinic and to identify factors affecting their uptake of health services in southern Malawi.

Methods

A focused ethnography was conducted to collect data from 20 youths living with human immunodeficiency virus and aged between 15 and 24 years through one‐on‐one in‐depth interviews and casual observations. The interviews data were analysed thematically following transcriptions.

Findings

Two themes emerged to describe the factors that facilitated or hindered the uptake of HIV‐health services. The first theme: Facilitators to the accessibility and utilization of HIV services consisted subthemes of Health personnel‐related factors and Innovative healthcare delivery approach. The second theme: Barriers to utilization and accessibility of HIV service comprised of the following subthemes: Ignorance of health services available, Clinic‐related factors and Consumer‐related factors.

Conclusion

Efforts to support health services that are youth‐friendly and easily accessible are needed to increase uptake, decrease mortality, prevent disability and promote the wellbeing of youth living with human immunodeficiency virus.

Implications for nursing practice and policy

Approaches used with this population should be youth‐centred and multifaceted, recognizing both the psychosocial challenges and the vulnerability that many youths in Malawi experience.
Experimental validation of genetic selection for resistance againstStreptococcus agalactiaevia different routes of infection in the commercial Nile tilapia breeding programme
Authors: Joshi Rajesh , Skaaurd Anders , Tola Alvarez Alejandro
Published: October 2020

The objective of this study was to validate the genetic selection for resistance to streptococcosis under experimental challenge conditions in a commercial population of Nile tilapia. Further, effects of using two different routes of infection ofStreptococcus agalactiae; intraperitoneal injection (IP) and cohabitation with the shedder fish (cohab), on the genomic parameters, prediction accuracy and response to selection are compared. The comparison was made between two different lines of fish; one selected forS. agalactiaeresistance for one generation and randomly mated for two generations (to mimic the multiplication activities occurring in distribution channels and hatcheries); and the other unselected. 1,500 fish, each from these two lines, were used for the experimental challenge test. Survival analysis using Kaplan–Meier estimators and Hazard's ratio was used to quantify differences in mortality between the two lines. Further genomic analysis was performed with 2,684 fish and 35,745 SNPs using both univariate and bivariate GBLUP models. Genetic selection for resistance toS. agalactiaeled to the significant (p < .001) reduction in the risk of death by 65% in the selected line, compared to the unselected line. Similarly, the risk of death via cohabitation route of infection significantly (p < .01) decreased by 80%, compared to IP. The genetic correlation between these two routes of infection was ~0.9. Genetic selection changed the impact of the routes of infection, with the change in the distribution of estimated breeding values and the gain of 3.04 ± 1.25 days as selection response (p < .05).
Feasibility of superior vena cava isolation in patients with cardiac implantable electronic devices
Authors: Kataoka Shohei , Ejima Koichiro , Yazaki Kyoichiro , Kanai Miwa , Yagishita Daigo , Shoda Morio , Hagiwara Nobuhisa
Published: October 2020

Introduction

Some patients with cardiac implantable electronic devices (CIEDs) require atrial fibrillation (AF) ablation, and the superior vena cava (SVC) has been identified as one of the most common non‐pulmonary vein foci of AF. This study aimed to investigate the interaction between SVC isolation (SVCI) and CIED leads implanted through the SVC.

Methods and Results

We studied 34 patients with CIEDs who had undergone SVCI as part of AF ablation (CIED group), involving a total of 71 CIED leads. A similar number of age‐, sex‐, and AF type‐matched patients without CIEDs formed a control group (non‐CIED group). Patients' background and procedural characteristics were compared between the groups. In the CIED group, lead parameters before and after AF ablation were compared, and lead failure after AF ablation was also examined in detail. Procedural characteristics other than fluoroscopic time were similar in both groups. The success rate of SVCI after the final ablation procedure was 91.2% in the CIED group and 100% in the non‐CIED group; however, these differences were not statistically significant. Lead parameters before and after the AF ablation did not significantly differ between the two groups. Lead failure was observed in three patients, with a sensing noise in one patient and an impedance increase in two patients after SVCI.

Conclusion

SVCI was achievable without lead failure and significant change in lead parameters in most patients with CIEDs; however, it should be noted that lead failure was observed in 8.8% of the study patients after SVCI.
Very long‐term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency?
Authors: Chaumont Corentin , Mirolo Adrian , Savouré Arnaud , Godin Bénédicte , Auquier Nathanaël , Viart Guillaume , Hatrel Amandine , Gillibert André , Eltchaninoff Hélène , Anselme Frédéric
Published: October 2020

Introduction

Either cryoenergy or radiofrequency can be used during atrioventricular nodal reentrant tachycardia (AVNRT) ablation. There are still limited data comparing their respective long‐term efficacy (>1 year). This study sought to compare the very long‐term outcomes of AVNRT ablation using radiofrequency or cryotherapy.

Methods

We retrospectively included all patients who had undergone a first AVNRT ablation in our institution between January 2010 and December 2017. The primary endpoint was recurrence of documented AVNRT.

Results

The study population consisted of 409 patients (274 females; mean age, 49.9 years). Ablation was performed using cryoenergy in 260 patients and radiofrequency in 149. High acute procedural success rate (>98%) was obtained and no permanent AV block was observed using both techniques. During a mean follow‐up of 3.3 ± 2.3 years, documented AVNRT recurrence occurred in 24 (9.2%) and 4 patients (2.7%) in the cryoablation (CA) and radiofrequency (RF) group, respectively. The risk of AVNRT recurrence was significantly higher in the CA group as compared with the RF group (hazard ratio [HR] = 3.7; 95% confidence interval [CI], 1.3–5.9). Most of the recurrences after CA occurred between 1‐ and 6‐year follow‐up (14/24; 58.3%), with one‐third of late recurrences after 3‐year follow‐up. In multivariable analysis, only Koch's triangle anatomical variant was associated with AVNRT recurrence after CA (HR = 6.7; 95% CI, 2.7–16.3).

Conclusion

While AVNRT recurrence rates were similar at 1 year of follow‐up regardless of the energy used, long‐term efficacy appeared higher after radiofrequency ablation. Strikingly, recurrences occured much later after cryotherapy compared with radiofrequency ablation.
An Interprofessional Community‐Based Complex Care Course Grounded in Social Determinants of Health
Authors: Hart Sara E. , Turner Kyle , Farrell Timothy W.
Published: October 2020

See related Editorial by Salzman et al. in this issue.
Toilet training children with special needs using a Potty Monkey toy device
Authors: Bartos Natasha S O , Hamilton Sana , Barnes Elizabeth , Caldwell Patrina H Y
Published: October 2020

Aim

Toilet training children with special needs can be challenging and can result in long‐term consequences if inadequately addressed. This study evaluates the use of a ‘Potty Monkey’ toy for toilet training children with special needs.

Methods

A pilot study using a ‘Potty Monkey’ to model timed voiding in children with special needs. We collected parental feedback and examined the experience of families using a ‘Potty Monkey’ to toilet train their child. Using logistic regression we explored patient factors for association with outcomes.

Results

Of 21 children in our study, 15 were male. Age ranged 4–10 years (median 6.3 years). Days that ‘Potty Monkey’ was used ranged 0–156 (median 22 days). At 6 months, nine children had improved, five were unchanged and four were worse (three were unknown). We found no evidence of association between patient factors (age, gender, days using ‘Potty Monkey’, baseline toileting ability, Paediatric Incontinence Questionnaire score) and toileting outcome. The experience of families was ambivalent. 10 families reported ‘Potty Monkey’ had been helpful however many complained it interfered with family schedules. Reasons for the child not responding positively were due to sensory issues, embarrassment and being developmentally not ready. Our study demonstrated the practical challenges of conducting research among children with special needs.

Conclusion

Although some children's toileting improved after using ‘Potty Monkey’, we are uncertain ‘Potty Monkey’ is effective for toilet training children with special needs.
Semi‐supervised learning based on convolutional neural network and uncertainty filter for façade defects classification
Authors: Guo Jingjing , Wang Qian , Li Yiting
Published: October 2020

Developing a classifier to identify the defects from façade images using deep learning requires abundant labeled images. However, it is time‐consuming and uneconomical to label the collected images. Hence, it is desired to train an accurate classifier with only a small amount of labeled data. Therefore, this study proposes a semi‐supervised learning algorithm that uses only a small amount of labeled data for training, but still achieves high classification accuracy. In addition, based on the mean teacher algorithm, this study develops a novel uncertainty filter to select reliable unlabeled data for initial training epochs to further improve the classification accuracy. Validation experiments demonstrate that the proposed method can improve the model accuracy from 79.26% to 84.36% compared to the traditional supervised learning algorithm with 10% of labeled data in a dataset. From another perspective, compared to supervised learning algorithm, the proposed technique can help reduce the time and cost for preparing the labeled data.
Quorum sensing systems as a new target to prevent biofilm‐related oral diseases
Authors: Muras Andrea , Mallo Natalia , Otero‐Casal Paz , Pose‐Rodríguez José M. , Otero Ana
Published: October 2020

Objective

The present study summarizes the current knowledge on the role of bacterial extracellular signaling systems, known as quorum sensing (QS), in oral biofilm formation, and on the possibility of blocking these microbial communication systems as a potential approach to prevent and treat oral infectious diseases.

Methods

A detailed literature review of the current knowledge of QS in the oral cavity was performed, using the databases MEDLINE (through PubMed) and Web of Science.

Results

Accumulating direct and indirect evidence indicates an important role of QS molecules in the oral microbial ecosystem.

Conclusions

The mechanisms regulating gene expression through bacterial communication systems constitute a promising target to control oral biofilm formation. Although cell‐to‐cell communication is pivotal for biofilm formation of many pathogenic bacteria, knowledge concerning microbial interactions and signaling processes within multispecies biofilms in the oral cavity is still limited.
Configuring Supply Chain Dyads for Regulatory Disruptions: A Behavioral Study of Scenarios
Authors: Phadnis Shardul , Joglekar Nitin
Published: October 2020

This study examines the use of scenario planning—a strategic planning tool used for making decisions of long‐term nature—to adapt a buyer–supplier dyad for disruptions in their supply chain resulting from abrupt changes in regulations. We posit that dyadic scenarios, that is, those created jointly by a buyer and a supplier, alter the scope of supply chain design in relation to a regulatory disruption. We offer four hypotheses distinguishing dyadic scenario creation from the traditional single‐firm scenario creation and two additional hypotheses related specifically to scenarios of regulatory disruptions. Five of the six hypotheses are supported in a behavioral study of a regulatory context. We integrate these findings to propose a Supply Chain Regulation Preparedness (SRP) framework for assessing the effects of dyadic scenario creation in six regimens of regulatory disruptions. We discuss the implications of this framework for the theory and practice of organizational learning associated with supply chain configurations in the face of emergent public policies and highlight collaborative scenario planning as an emergent strategic‐level mechanism that supply chain partners can deploy jointly to address just‐in‐case uncertainties.
Bilateral comparison of traditional and alternate electrodermal measurement sites
Authors: Kasos Krisztian , Kekecs Zoltan , Csirmaz Luca , Zimonyi Szabolcs , Vikor Fanni , Kasos Eniko , Veres Andras , Kotyuk Eszter , Szekely Anna
Published: October 2020

Advances in mobile and wireless technology have expanded the scope of electrodermal research. Since traditional electrodermal measurement sites are not always suitable for laboratory research and are rarely appropriate for ambulatory measurements, there is a need to explore and contrast alternate measurement locations. We evaluated bilateral electrodermal activity (EDA) from five measurement sites (fingers, feet, wrists, shoulders, and calves). In a counterbalanced, randomized, within‐subjects design study, participants (N = 115) engaged in a 4‐min‐long breathing exercise and were exposed to emotionally laden and neutral stimuli. High within‐subject correlations were found between the EDA measured from fingers bilaterally (r =.89), between the left fingers and both feet (r= .72). Moderate correlations were found between EDA measured from the left fingers and wrists (r= .30 andr= .33), low correlations between the left fingers and the shoulders (r= −.03 andr= −.06) or calves (r= .05 andr= .14). Response latency was the shortest on the fingers while it was the longest on the lower body. Short response windows would miss some of the responses from the palmar surfaces and a substantial number from other evaluated locations. The fingers and the feet are the most reliable locations to measure from, followed by the wrists. We suggest setting site‐specific response windows for different measurement locations. An investigation of repeatability showed that within‐subject correlations, response frequencies, response amplitudes show a similar pattern from the first measurement time to a later one.
Commutativity of quaternion‐matrix–valued functions and quaternion matrix dynamic equations on time scales
Authors: Li Zhien , Wang Chao , Agarwal Ravi P. , O'Regan Donal
Published: October 2020

In this paper, we obtain some basic results of quaternion algorithms and quaternion calculus on time scales. Based on this, a Liouville formula and some related properties are derived for quaternion dynamic equations on time scales through conjugate transposed matrix algorithms. Moreover, we introduce the quaternion matrix exponential function by homogeneous quaternion matrix dynamic equations. Also a corresponding existence and uniqueness theorem is proved. In addition, the commutativity of quaternion‐matrix–valued functions is investigated and some sufficient and necessary conditions of commutativity and noncommutativity are established on time scales. Also the fundamental solution matrices of some basic quaternion matrix dynamic equations are obtained. Examples are provided to illustrate the results, which are completely new on hybrid domains particularly when the time scales are the quantum case and the discrete case ; , both of which are significant for the study of quaternion q‐dynamic equations and quaternion difference dynamic equations. Finally, we present several applications including multidimensional rotations and transformations of the submarine, the gyroscope, and the planet whose dynamical behaviors are depicted by quaternion dynamics on time scales and the corresponding iteration numerical solution for homogeneous quaternion dynamic equations are provided on various time scales.
The turnaround from transgression to regression of Holocene barrier systems in south‐eastern Australia: Geomorphology, geological framework and geochronology
Authors: McBride Randolph A. , Oliver Thomas S. N. , Dougherty Amy J. , Tamura Toru , Carvalho Rafael C. , Short Andrew D. , Woodroffe Colin D.
Published: October 2020

Holocene regressive strandplains that preserve a series of former shorelines are extensive on coasts that were remote from major Pleistocene ice sheets (for example, Australia and Brazil), whereas transgressive barrier islands are typical in glacial forebulge regions (for example, North America and Europe). In strandplains, the regressive phase of strandline development was preceded by a transgressive phase during the final stages of postglacial sea‐level rise. This study examines the turnaround from transgression to regression through chronostratigraphic description of three barrier systems in south‐eastern Australia: Seven Mile Beach, Bengello Beach and Pedro Beach. The authors reconstruct geomorphic and depositional histories using ground‐penetrating radar and vibracores along transects across the landwardmost ridges, and optically‐stimulated luminescence and radiocarbon dating. At the Seven Mile Beach barrier system, extensive washover deposits are preserved that include distinctive, landward‐directed, flame‐shaped washover fans along the bayside shoreline of the landwardmost ridge. Landward‐dipping ground‐penetrating radar reflections in radargrams provide evidence of the culmination of the transgressive phase and transition into the regressive phase dominated by progradation, evidenced by the change to seaward‐dipping reflections. A similar progradational plain formed at the Bengello Beach barrier system, but transgressive deposits are largely absent at the site investigated, where an eroded headland created limited accommodation space until sand supply was sufficient for progradation. The Pedro Beach barrier system depositional history is more complex. There, a smaller embayment filled rapidly during the mid‐Holocene, and transgressive sands were deposited as sea level reached its present level and impounded a wetland. Accommodation space in the embayment was filled by ca 4000 years ago. Overall, results indicate that the Holocene turnaround transition occurred between 8400 and 7000 years ago, and was preserved at the landward margin of these three strandplains. Holocene morphostratigraphy differs among sites primarily as a function of sea level, sediment supply and antecedent topography.
Efficacy of low‐level light therapy for improving healing of diabetic foot ulcers: A systematic review and meta‐analysis of randomized controlled trials
Authors: Zhou Yuanpei , Chia Hoon Woon Audrey , Tang Huey Weng Krystle , Lim Su Ying Jasmine , Toh Wen Ya , Lim Xin Ling , Cheng Ling Jie , Lau Ying
Published: October 2020

Diabetic foot ulcers are prevalent among patients with diabetes and negatively affect mortality and life expectancy. This study aimed to synthesize and systematically review the best evidence to assess the efficacy of low‐level light therapy in improving healing of diabetic foot ulcers. We search CINAHL, Cochrane Library, EMBASE, ProQuest, PubMed, Scopus, and Web of Science from inception until September 30, 2019. Meta‐analysis was performed using the Comprehensive Meta‐analysis 3.0 software. Overall effect was measured using Hedges' g and determined using the Z‐statistic at a significance level of P < .05. Heterogeneity was assessed using χ2 and I2 statistics. Twelve randomized controlled trials were included. Meta‐analysis revealed that 30.90% of the ulcer area was significantly reduced in the therapy group compared with the control group (Z = 3.95, P < .001) with a very large effect (g = 2.81). A 4.2 cm2 reduction of the ulcer area was observed in the therapy group compared with the control group (Z = 2.17, P = .03) with a very large effect (g = 1.37). In addition, diabetic foot ulcers in the therapy group was 4.65 times more likely to heal completely than those in the control group (Z = 3.02, P = .003). Low‐level light therapy accelerates wound healing and reduces the size of diabetic foot ulcers. However, our review does not allow any recommendation for the best treatment parameters required to achieve improved healing. Future trials need to include a good design and large sample size in defining the optimal treatment parameters for ulcers of different sizes.
A Nonlinear Analysis of the Wahl–Fischer Torsional Instability
Authors: Infante E. F. , Doughty S.
Published: October 2020

This is an extension to a previous study of the Wahl–Fischer torsional instability problem (Infante and Doughty, “An Old Problem Reconsidered: The Wahl–Fischer Torsional Instability Problem”, J. Appl. Mech. Trans. ASME, 2020, 87(10), p. 101004). There, we provided a mathematical explanation of the reasons for the existence of torsional oscillations observed in numerical simulations and in actual mechanical devices such as the exhaust fan system studied by Wahl and Fischer. That explanation was mostly based on linear analysis. This paper presents an additional mathematical explanation of the nature and form of the large self-excited oscillations, due to the strongly nonlinear nature of the system and the large amplitude of these oscillations. Because the oscillations are large, their study requires the use of nonlinear methods.
Aerial Contact Manipulation With Soft End-Effector Compliance and Inverse Kinematic Compensation
Authors: Sheng Xinjun , Ma Zhao , Zhang Ningbin , Dong Wei
Published: October 2020

This paper presents the development of a six degrees-of-freedom manipulator with soft end-effector and an inverse kinematic compensator for aerial contact manipulation. Realizing the fact that aerial manipulators can hardly achieve precise position control, a compliant manipulator with soft end-effector is first developed to moderate end-effector positioning errors. The manipulator is designed to be rigid-soft combined. The rigid robotic arm employs the lightweight but high-strength materials. The compliance requirement is achieved by the soft end-effector so that the mechanical design for the joints are largely simplified. These two features are beneficial to lighten the arm and to ensure the accuracy. In the meantime, the pneumatic soft end-effector can further moderate the probable insufficient accuracy by endowing the manipulator with compliance for impact resistance and robustness to positioning errors. With the well-designed manipulator, an inverse kinematic compensator is then proposed to eliminate lumped disturbances from the aerial platform. The compensator can ensure the stabilization of the end-effector by using state estimation from the aerial platform, which is robust and portable as the movement of the platform can be reliably obtained. Both the accuracy and compliance have been well demonstrated after being integrated into a hexarotor platform, and a representative scenario aerial task repairing the wind turbine blade-coating was completed successfully, showing the potential to accomplish complex aerial manipulation tasks.
Limits of Extramobile and Intramobile Motion of Cylindrical Developable Mechanisms
Authors: Butler Jared , Greenwood Jacob , Howell Larry L. , Magleby Spencer
Published: October 2020

Mechanisms that can both deploy and provide motions to perform desired tasks offer a multifunctional advantage over traditional mechanisms. Developable mechanisms (DMs) are devices capable of conforming to a predetermined developable surface and deploying from that surface to achieve specific motions. This paper builds on the previously identified behaviors of extramobility and intramobility by introducing the terminology of extramobile and intramobile motions, which define the motion of developable mechanisms while interior and exterior to a developable surface. The limits of motion are identified using defined conditions. It is shown that the more difficult of these conditions to kinematically predict may be treated as a non-factor during the design of cylindrical developable mechanisms given certain assumptions. The impact of toggle positions for each case is discussed. Physical prototypes demonstrate the results.
Inverted Honeycomb Cell as a Reinforcement Structure for Building Soft Pneumatic Linear Actuators
Authors: Schmitt François , Piccin Olivier , Bayle Bernard , Renaud Pierre , Barbé Laurent
Published: October 2020

In this article, the inverted honeycomb cell, known to exhibit an auxetic behavior, is considered to design two pneumatic linear actuators. The actuators are built using a combination of soft and rigid structures. They present complementary performances in terms of displacement, force, and stiffness. Experimental evaluations are conducted using prototypes produced using multimaterial additive manufacturing to combine soft and rigid materials with freedom of shape. The first actuator is inspired by origami structures. The possibility to obtain large deformations under low pressure is observed. The second actuator is based on a cylindrical auxetic structure based on the inverted honeycomb cell. Smaller deformation is reached but the design favors the off-axis stiffness, so the component can be integrated without any additional mechanical joint for translation. A discussion on the relative performances of these two actuators and their possible uses conclude the paper.
Investigation of Active Disassembly in Large Force Applications
Authors: Abuzied Hoda , Abbas Ayman , Awad Mohamed , Senbel Hesham
Published: October 2020

Active disassembly (AD) is an emerging field of research in design for disassembly that enables a cost-effective nondestructive separation of product components. It is based on using active joints and fasteners that enables the self-disassembly of products without any direct contact between the product and the operator, where these joints and fasteners must be inserted in the product during its design and manufacturing phases. Generally, active joints and fasteners are made of smart materials such as shape memory alloys (SMAs), that can generate the necessary disassembly forces required to separate the different components of the product. Most of the exerted effort in this field of research was focused on separating products requiring small disassembly forces either in the electronic or automotive sectors. All these active disassembly applications were based on using shape memory alloy snap fits, clips, or wires that are characterized by their ability to generate small forces with large displacements. As, up to the authors knowledge, none of the exerted efforts were concerned with investigating the possibility of using the large disassembly forces that could be generated using shape memory alloy actuators in large force active disassembly applications. Consequently, the presented research aims to examine the possibility of applying active disassembly with products requiring large disassembly forces, having tapered surfaces and large mechanical structure. By presenting two case studies to validate the possibility of using active disassembly with large force applications, in addition to investigating the capability of using shape memory alloy actuators assembled either concentric or eccentric with the product structure.
Computational Analysis on Weld Formation Mechanism during Self-Reacting Friction Stir Welding
Authors: Zhao Chenyu , Liu Xun
Published: October 2020

Three-dimensional computational fluid dynamics models are developed to understand physical principles of self-reacting friction stir welding process. A novel approach of predicting the weld microstructure based on plastic strain distribution at cross-section behind the tool is proposed and verified with experimental results. Limitations and credibility of shear stress and velocity tool/workpiece boundary condition are evaluated from the perspective of the weld formation mechanism. The importance of the shear layer and its sticking/sliding transition state in weld formation mechanism is emphasized. From modeling perspective, shear stress boundary, which only represents a sliding condition, neglects the movement and effects of this shear layer. When shear layer is formed, due to the velocity discontinuity which could not be captured in fluid model, velocity boundary condition, which represents an averaging effect of sticking/sliding transition between tool and shear layer, is needed.
Clinical Changes in Cervical Neuromuscular Control Following Subconcussive Impacts
Authors: Cheever Kelly , Howard Jeffrey T. , Kawata Keisuke
Published: October 2020

Context: Increased injury rates following concussive injury have been attributed to decreased neuromuscular coordination frequently documented following a concussion. However, altered integration between the vestibular system and oculomotor pathways following impacts at subconcussive thresholds implicate all sports-related impacts not just those at a concussive threshold in future musculoskeletal injury. While, several studies have explored the utility of vestibular and oculomotor clinical testing to detect altered neuromuscular control and then correlated those alterations to future injury risk, no research has explored the use of cervical clinical tests in the same capacity. Outcome Measures: Cervical joint position error test, Neck Disability Index and head acceleration. Interventions: Soccer headers, fatigue protocol, soccer headers + fatigue. Objective: To explore the clinical utility of a novel clinical approach to measuring changes in cervical neuromuscular control following subconcussive impacts in a controlled lab environment. Participants: 40 current female colligate club soccer athletes were recruited. Inclusion criteria included between the age of 18 and 25 and a minimum of 4-year soccer heading experience. Setting: Laboratory.  Design: A repeated-measures design with 4 groups was utilized to test the hypothesis. Results: A 65%, 54%, and 49% increased error was observed following the soccer heading, fatigue only, and soccer heading + fatigue interventions, respectively. Meanwhile, the controls saw a 6% decrease in neck position error. Concussion: While, cervical joint position error testing was sensitive to decreased neuromuscular coordination following soccer heading, it was not specific enough to rule out an exercise effect in the absence of subconcussive impacts. Further research is warranted to explore the clinical utility and specificity of cervical joint position error testing to measured alterations in supraspinal processing following subconcussive impacts, and how these alterations may lead to decreased coordination and movement of the body during sports-related task.
The Initial Gut Microbiota and Response to Antibiotic Perturbation Influence Clostridioides difficile Clearance in Mice
Authors: Tomkovich Sarah , Stough Joshua M. A. , Bishop Lucas , Schloss Patrick D.
Published: October 2020

Clostridioides difficile
is a leading nosocomial infection. Although perturbation to the gut microbiota is an established risk, there is variation in who becomes asymptomatically colonized, develops an infection, or has adverse infection outcomes. Mouse models of
C. difficile
infection (CDI) are widely used to answer a variety of
C. difficile
pathogenesis questions. However, the interindividual variation between mice from the same breeding facility is less than what is observed in humans. Therefore, we challenged mice from 6 different breeding colonies with
C. difficile
. We found that the starting microbial community structures and
C. difficile
persistence varied by the source of mice. Interestingly, a subset of the bacteria that varied across sources were associated with how long
C. difficile
was able to colonize. By increasing the interindividual diversity of the starting communities, we were able to better model human diversity. This provided a more nuanced perspective of
C. difficile
pathogenesis.
A Human IRE1 Inhibitor Blocks the Unfolded Protein Response in the Pathogenic Fungus Aspergillus fumigatus and Suggests Noncanonical Functions within the Pathway
Authors: Guirao-Abad José P. , Weichert Martin , Albee Aaron , Deck Katie , Askew David S.
Published: October 2020

The unfolded protein response (UPR) is a signaling pathway that maintains endoplasmic reticulum (ER) homeostasis, with functions that overlap virulence mechanisms in the human-pathogenic mold
Aspergillus fumigatus
. The canonical pathway centers on HacA, its master transcriptional regulator. Translation of this protein requires the removal of an unconventional intron from the cytoplasmic mRNA of the
hacA
gene, which is achieved by an RNase domain located in the ER-transmembrane stress sensor IreA. Here, we show that targeting this RNase activity with a small-molecule inhibitor effectively blocked UPR activation, resulting in effects that mirror the consequences of genetic deletion of the RNase domain. However, these phenotypes were surprisingly narrow in scope relative to those associated with a complete deletion of the
hacA
gene. These findings expand the understanding of UPR signaling in this species by supporting the existence of noncanonical functions for the unspliced
hacA
mRNA in ER stress response.
Carotid artery stiffness in rural adult Chinese: a cross-sectional analysis of the community-based China stroke cohort study
Authors: Wei Yao , Wang Ming , Gui Yang , Piao Xuemei , Sun Conghui , Zhang Xuehe , Zhai Feifei , Zhu Yicheng , Cui Liying , Zhang Shuyang , Dai Qing , Yang Meng
Published: October 2020

Objectives

To derive normative carotid artery stiffness data in rural adult Chinese population-based study of ultrasound measurements of carotid elasticity by using quality arterial stiffness (QAS), and to assess the changes of relevant parameters in Chinese adults 40 years of age and older.

Design

A China stroke cohort study (total number: 1586) in the northern countryside were carried out between June 2013 and April 2016, designed to investigate the risk factors of cardiovascular and age-related diseases.

Setting

The present study was a cross-sectional analysis of an ongoing community-based Shunyi cohort study in China.

Participants

A total of 583 participants (227 men and 356 women; aged 40–80 years) with ultrasound carotid QAS examination were retrieved from the study to analyse.

Primary and secondary outcome measures

Arterial stiffness parameters included diastolic diameter (Dd), pulse wave velocity (PWV), stiffness indices α and β were calculated by QAS. Other clinical indicators included physical measurements, medical histories and blood biochemical test.

Results

In the entire study sample, mean Dd was 7.93±0.88 mm, mean PWV was 9.4±2.4 m/s, mean α was 7.65±5.13 and mean β was 15.53±10.29. PWV was significant higher in participants with hypertension (9.9 m/s vs 9.2 m/s in those without, p=0.002), and with diabetes (10.3 m/s vs 9.2 m/s in those without, p=0.003). PWV were significantly higher in participants with HbA1c at 5.8%–6.4% versus <5.8%, but no difference was found between subjects with glycohaemoglobin (HbA1c) at 5.8%–6.4% versus >6.4% (p=0.005, p=0.955, respectively). Age increase by every 10 years was associated with Dd increased by 0.27 mm, PWV increased by 1.2 m/s, α increased by 1.34 and β increased by 2.71. Systolic blood pressure (SBP) increase by every 10 mm Hg was associated with Dd increased by 0.15 mm, PWV increased by 0.35 m/s, α increased by 0.13 and β increased by 0.15.

Conclusion

Among the participants older than 40 years, stiffness of the carotid artery had differences between hypertension and non-hypertension adults, as well as between diabetes and non-diabetes adults. Stiffness of the carotid artery also have differences between adults with HbA1c at 5.8%–6.4% versus <5.8%. Stiffness of the carotid artery increases with increasing age and increasing SBP at a range from 40 and up.
Anticoagulation strategies in critical care for the treatment of atrial fibrillation: a protocol for a systematic review and meta-analysis
Authors: Johnston Brian , Nelson Alexandra , Waite Alicia C , Lemma Gedeon , Welters Ingeborg
Published: October 2020

Introduction

Atrial fibrillation (AF) is the most common cardiac arrhythmia in critically ill patients and is associated with an increased risk of thromboembolic events and mortality. Oral anticoagulation for thromboembolism prophylaxis is a key component of managing AF in the general population and is recommended by National Institute for Health and Care Excellence guidelines. However, assessment tools used to aid decision making about anticoagulation have not yet been validated in the critical care setting. There is a paucity of data assessing the impact of anticoagulation strategies on clinical outcomes in critically ill patients with AF. We present a protocol for a systematic review and meta-analysis to evaluate the effectiveness of anticoagulation strategies for AF used specifically in critical care.

Methods and analysis

We will conduct a systematic review of the literature by searching MEDLINE, EMBASE, CENTRAL and PubMed databases for articles published from January 1990 to October 2019. Studies reporting anticoagulation strategies for AF in adults (>18 years) admitted to a general critical care setting will be assessed for inclusion. Outcomes of interest will include (1) percentage of patients started on anticoagulation in critical care for AF, (2) incidence of thromboembolism, (3) incidence of bleeding events, (4) intensive care unit (ICU) mortality, (5) hospital mortality, (6) ICU length of stay and (7) hospital length of stay. We will conduct a meta-analysis of trials. Risk of bias will be assessed using the Cochrane Risk of Bias tool for randomised trials or the Newcastle-Ottawa Risk of Bias assessment tool for non-randomised studies. This protocol and subsequent systematic review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.

Ethics and dissemination

This proposed systematic review will include data extracted from published studies; therefore, ethical approval is not required. The results of this review will be published in clinical specialty journals and presented at international meetings and conferences.

Trial registration number

CRD42020158237.
Cerebrovascular accident and acute coronary syndrome and perioperative outcomes (CAPO) study protocol: a 10-year database linkage between Hospital Episode Statistics Admitted Patient Care, Myocardial Infarction National Audit Project and Office for National Statistics registries for time-dependent risk analysis of perioperative outcomes in English NHS hospitals
Authors: Luney Matthew Stephen , Lindsay William , McKeever Tricia M , Moppett Iain Keith
Published: October 2020

Introduction

An increasing number of people who have a history of acute coronary syndrome or cerebrovascular accident (termed cardiovascular events) are being considered for surgery. Up-to-date evidence of the impact of these prior events is needed to inform person-centred decision making. While perioperative risk for major adverse cardiac events immediately after a cardiovascular event is known to be elevated, the duration of time after the event for which the perioperative risk is increased is not clear.

Methods and analysis

This is an individual patient-level database linkage study of all patients in England with at least one operation between 2007 and 2017 in the Hospital Episode Statistics Admitted Patient Care database. Data will be linked to mortality data from the Office for National Statistics up to 2018, for 30-day, 90-day and 1-year mortality and to the Myocardial Ischaemia National Audit Project, a UK registry of acute coronary syndromes. The primary outcome will be the association between time from cardiovascular event to index surgery and 30-day all-cause mortality. Additional associations we will report are all unplanned readmissions, prolonged length of stay, 30-day hospital free survival and incidence of new cardiovascular events within one postoperative year. Important subgroups will be surgery specific (invasiveness, urgency and subspecialty), type of acute coronary syndrome (ST or non-ST elevation myocardial infarction) and type of cerebrovascular accident (ischaemic or haemorrhagic stroke).

Ethics and dissemination

Ethical approval for this observational study has been obtained from East Midlands—Nottingham 1 Research Ethics Committee; REC reference: 18/EM0403. The results of the study will be made available through peer-reviewed publications and via the Health Services Research Centre of the Royal College of Anaesthetists, London.
Cardio-ankle vascular index (CAVI) measured by a new device: protocol for a validation study
Authors: Rico Martín Sergio , Vassilenko Valentina , de Nicolás Jiménez Jorge M , Rey Sánchez Purificación , Serrano Andreia , Martínez Alvarez Mariana , Calderón García Julián F , Sánchez Muñoz-Torrero Juan F
Published: October 2020

Introduction

Cardio‐ankle vascular index (CAVI) is a new marker of arterial stiffness (AS) that can assess vascular wall stiffness in the aorta, femoral artery and tibial artery. CAVI is less affected by blood pressure at the time of measurement than the gold standard method (carotid-femoral pulse wave velocity (PWV)). Our group has developed a device called VOPITB (Velocidad Onda de Pulso Índice Tobillo Brazo) that uses the oscillometric method and easily and accurately measures the PWV in the arms and legs separately, allowing new AS indices to be studied. This article describes the research protocol to determine CAVI using VOPITB and to validate the device against a reference device (VaSera VS-1500) and assess its clinical utility.

Methods and analyses

A cross-sectional, descriptive and observational study will be conducted. In all, 120 subjects (a minimum of 40% of subjects from any one gender) will be evaluated. CAVI will be determined from the measurement by VOPITB and VaSera VS-1500. For each subject, the average of the three readings taken with each device will be calculated. The Bland-Altman plot will be used to determine whether any bias exists in the data—that is, a tendency of the size of the difference to vary with the mean. The participants will be divided roughly equally between the following age bands: <30, 30–60 and >60 years.

Ethics and dissemination

The study has been approved by the ethics committee of the Hospital San Pedro de Alcántara, Cáceres, Spain. The participants will be required to sign an informed consent form before inclusion in the study, in accordance with the Declaration of Helsinki and WHO standards for observational studies. The dissemination plan of the research study results will be through presentations in relevant national and international conferences and scientific publications in peer-reviewed journals.

Trial registration number

NCT04303546.