bluuebunny/crossref_metadata_2025 huggingface dataset:
IoT and Renewable Energy systems based Connected Chair for Health Monitoring
Authors: Dhayalini K. , Priyadarshini S.A. , Abirami M.
Published: October 2020

Health monitoring of a system involve in various activities done in order to make the system operating condition feasible with certain constrains such as current systems states which includes repair and maintenance of the observations. Remote health monitoring is a process in which patients with numerous conditions such a heart disease or diabetics are monitored based on the latest technology. Internet of things and renewable energy sources are the brain of this work based smart wheel chair for special people for autonomous movement and also gathering person’s health information using smart sensors displayed in webpage. For this innovative work a digital single board computer for gathering sensor information and also transfer the status of the persons through inbuilt Wi-Fi, and also the smart chair movement dependent upon user’s voice, which the sceneries are recognized by connected camera to raspberry pi. Renewable energy system such as PV array or wind energy systems can be replaced for supply of the entire health monitoring system and connected chair system.
Visualization and Classification of Diseases using Deep Learning Based Convolution Neural Network
Authors: Janeera D.A , Amudhavalli P. , Sherubha P , Sasirekha S.P , Anantha Christu Raj P. , Sitharthan R
Published: October 2020

In the contemporary phase of big data, data visualization is one of the challenging segment of the discovery process. For a classifier, the primary goal is to identify the hidden levels of big data. The performance of classifiers depends on the feature space, number of classes and size of the data. To improve the reliability, efficiency and accuracy of the classifiers, new algorithms are required for analysis. This paper enables classification and visualization of information on diseases using a Deep Learning based Convolution Neural Network classifier. For feature selection and handling massive data in analysis of multivariate data is performed using particle swarm optimization (PSO) and principal component analysis (PCA) techniques. Real-world datasets are utilized for demonstration of the proposed learning algorithm. Deep learning classifiers are scientifically higher and offers better performance when compared to other classifiers according to the comparative study.
Estimation of Lifetime and Reliability of Input Rectifier in Variable Frequency Drives
Authors: Ramesh P , Govarthanan R , Palanisamy K , Paramasivam S
Published: October 2020

This research paper investigates the causes of power module failures in front-end rectifier of variable frequency drive (VFD) and their lifetime estimation. The front-end rectifier plays an important role in the electrical system for energy conversion. However, from the industrial survey it is found that they are sensitive to harsh operating conditions and are prone to damage. Hence, it becomes inevitable to analyse the causes of their failure and lifetime. Due to prolonged usage, sudden variations in supply and load, the power modules will be subjected to stresses such as overvoltage, voltage variations due to sag, phase unbalance, over current, temperature, harmonics and pre-distortions. The major causes of failure are due to several stresses such as solder joint break, bond wire lift-off, cracks in power modules are discussed. In this paper, the lifetime of the power module is estimated for a given mission profile data. The junction temperature profile is obtained from the VFD Front-end rectifier simulation model. The number of temperature cycles from the temperature profile is estimated using cycle counting methods. Lifetime estimation and damage modelling is done using Coffin-Manson rule and Palmgren Miner rules. All these modelling and simulations are done for a specific VFD power size using MATLAB and PLECS.
A new crystal plasticity modeling of uniaxial ratcheting behavior for face-centered cubic 6061 aluminum alloy
Authors: Dong Yawei , He Xu , Zhang Zhiyong
Published: October 2020

The uniaxial ratcheting behavior of face-centered cubic 6061 aluminum alloy is investigated theoretically based on the crystal plasticity theory. In this model, a simplified flow rule is adopted for convenient engineering application, and the classical Kocks-Mecking-Estrin isotropic hardening rule related to dislocation density is adopted to describe the cyclic hardening characteristic of the material. The classical Armstrong-Frederic kinematic hardening rule is modified associated with cumulative slip to predict the ratcheting behavior more accurately. The single crystal version of this model is expanded to metal polycrystalline using a simplified explicit scale transition rule. The capability of the proposed model to capture the uniaxial ratcheting response of metal polycrystalline is verified by comparing the predictions with the corresponding experimental results of 6061 aluminum alloy. The evolution of uniaxial ratcheting of 6061 aluminum alloy can be reasonably predicted by the proposed model, and the capability to simulate uniaxial ratcheting behavior in inter-granular scale is qualitatively discussed as well.
Shape-programmable and healable materials and devices using thermo- and photo-responsive vitrimer
Authors: Kuang Xiao , Mu Quanyi , Roach Devin J , Qi H Jerry
Published: October 2020

Shape morphing materials have been extensively studied to control the formation of sophisticated three-dimensional (3D) structures and devices for a broad range of applications. Various methods, including the buckling of pre-strained bilayer composites, stimuli-responsive shape-shifting of shape memory polymers, and hydrogels, have been previously employed to transform 2D sheets to 3D structures and devices. However, the residual stress locked in these shape-shifting structures will drive them to gradually revert to their original layouts upon the removal of external stimuli or constrains. Here, we report a multistimuli-responsive vitrimer (m-vitrimer) bearing thermal- and photo-reversible disulfide bonds as shape programmable and healable materials for functional 3D devices. The mechanical properties and thermomechanical properties of vitrimer were tuned by altering the disulfide content and catalyst loading. Heat and light exposure induces effective stress relaxation and network rearrangement, enabling material shape programming and healing. We demonstrate that printed flexible smart electronics are fabricated using the m-vitrimer as a matrix and printed conductive silver nanoparticles as conductive wire. The printed electronics possess good electro-mechanical properties, strong interfacial bonding, and thermal- and photo-responsive shape programming. Moreover, the m-vitrimer can be healed upon damage by heat and light, which partially restores silver conductivity and protect the electronics from further damage. The converging of multi-stimuli-responsive polymers and printed electronics for functional 3D devices have the potential of finding broad applications in smart and morphing electronics, biomedical devices, and 4D printing.
A novel estimator of the interaction matrix in Graphical Gaussian Model of omics data using the entropy of non-equilibrium systems
Authors: Borzou Ahmad , Sadygov Rovshan G
Published: October 2020

Motivation

Inferring the direct relationships between biomolecules from omics datasets is essential for the understanding of biological and disease mechanisms. Gaussian Graphical Model (GGM) provides a fairly simple and accurate representation of these interactions. However, estimation of the associated interaction matrix using data is challenging due to a high number of measured molecules and a low number of samples.

Results

In this article, we use the thermodynamic entropy of the non-equilibrium system of molecules and the data-driven constraints among their expressions to derive an analytic formula for the interaction matrix of Gaussian models. Through a data simulation, we show that our method returns an improved estimation of the interaction matrix. Also, using the developed method, we estimate the interaction matrix associated with plasma proteome and construct the corresponding GGM and show that known NAFLD-related proteins like ADIPOQ, APOC, APOE, DPP4, CAT, GC, HP, CETP, SERPINA1, COLA1, PIGR, IGHD, SAA1 and FCGBP are among the top 15% most interacting proteins of the dataset.

Availability and implementation

The supplementary materials can be found in the following URL: http://dynamic-proteome.utmb.edu/PrecisionMatrixEstimater/PrecisionMatrixEstimater.aspx.

Supplementary information

Supplementary data are available at Bioinformatics online.
Double trouble: combined cardiovascular effects of particulate matter exposure and coronavirus disease 2019
Authors: Tanwar Vineeta , Adelstein Jeremy M , Wold Loren E
Published: October 2020

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly grown into a pandemic. According to initial reports, the lungs were thought to be the primary target, but recent case studies have shown its reach can extend to other organs including the heart and blood vessels. The severity of cardiac complications of COVID-19 depends on multiple underlying factors, with air pollutant exposure being one of them, as reported by several recent studies. Airborne particulate matter (PM) attracts heightened attention due to its implication in various diseases, especially respiratory and cardiovascular diseases. Inhaled PM not only carries microorganisms inside the body but also elicits local and systemic inflammatory responses resulting in altering the host’s immunity and increasing susceptibility to infection. Previous and recent studies have documented that PM acts as a ‘carrier’ for the virus and aids in spreading viral infections. This review presents the mechanisms and effects of viral entry and how pollution can potentially modulate pathophysiological processes in the heart. We aimed to concisely summarize studies examining cardiovascular outcomes in COVID-19 patients and postulate on how PM can influence these outcomes. We have also reviewed evidence on the use of renin–angiotensin system inhibitors, namely angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, in patients with COVID-19. The interplay of pollution and SARS-CoV-2 is essential to understanding the effects of accentuated cardiovascular effects of COVID-19 and deserves in-depth experimental investigations.
Hospital organization and thoracic oncological patient management during the coronavirus disease-2019 outbreak: a brief report from a nationwide survey of the Italian Society of Thoracic Surgery
Authors: Viggiano Domenico , Lococo Filippo , Dell’Amore Andrea , Crisci Roberto , Torre Massimo , Rea Federico , Muriana Giovanni ,   Italian Thoracic Surgery Society (SICT) Task Force on COVID-19 Pandemic
Published: October 2020

The current coronavirus disease 2019 (COVID-19) pandemic has made us aware of the weaknesses and often the inadequacies of our current technologies and practices and has presented us with a huge challenge: to reorganize the way we work and sometimes even think, in order to ensure the safety of our patients. The Italian Society of Thoracic Surgery has launched various initiatives in response to the COVID-19 pandemic, aimed at facilitating the exchange of information, strategies and personal experiences between institutions. This article presents the results of a survey amongst all Italian thoracic surgery units accredited to SICT, with the aim of providing a glimpse of the current working conditions in these units, and an understanding of the impact of COVID-19 on their daily activities and patient care.
A Fast Analytical Method for Determining Synthetic Cathinones in Oral Fluid by Liquid Chromatography–Tandem Mass Spectrometry
Authors: Pascual-Caro Sergi , Borrull Francesc , Calull Marta , Aguilar Carme
Published: October 2020

In this paper, we present a method for simultaneously determining 11 synthetic cathinones in oral fluid (OF) by liquid chromatography–tandem mass spectrometry. Synthetic cathinones, a wide variety of which are available on the market, are constantly evolving. It is therefore important to provide efficient methods for determining cathinones in different matrices. A common matrix for detecting recent drug intake is OF, which can easily be collected using one of numerous commercial devices. Most methods aimed at determining drugs in biological samples such as OF require labor-intensive and time-consuming sample-preparation steps. However, the pretreatment of complex samples is often a challenge in the development of a method. For this reason, in this paper, we present a simple, easy-to-handle alternative that uses a Salivette® device and pretreats the sample in the same device. Matrix-matched calibration curves were used to cover the concentration range at which these substances are usually present in the OF from drug consumers. The method detection limits ranged from 0.003 to 0.03 ng/g, and the method quantification limits were set at 0.075 ng/g. This is a simple, rapid and sensitive method with good potential for determining recent drug consumption in OF.
Cerebral melioidosis in an immunocompromised traveller: an argument for prevention
Authors: Lim Kara , McShane Lauren , Rees Megan , Muhi Stephen
Published: October 2020

Melioidosis is a bacterial infection caused by Burkholderia pseudomalleleipseudomallei. This report discusses the case of an immunocompromised traveller who was found to haveacquired cerebral melioidosis during a visit to Thailand, and highlights the need for such travellers to seek specialised travel medicine review prior to travelling to melioidosis endemic regions to discuss preventative strategies.
Has the effectiveness of Australia’s travel bans against China on the importation of COVID-19 been overestimated?
Authors: McLure Angus , Lau Colleen L , Furuya-Kanamori Luis
Published: October 2020

In our re-analysis with adjusted assumptions, we found that a previous study substantially oversestimated the effectiveness of Australia’s complete travel ban against China in the introduction of SARS-CoV-2 into Australia.
Post-mTBI Pain Interference in a U.S. Military Population: A Chronic Effects of Neurotrauma Consortium Study
Authors: Khokhar Bilal R , Lindberg Megan A , Walker William C
Published: October 2020

Introduction

Chronic pain is a significant problem for service members and veterans with mild traumatic brain injury (mTBI). While the root cause of pain is not clearly understood, comorbidities may contribute to how their pain disrupts their functional status, a construct termed “pain interference.” The purpose of this study is to examine the associations between mTBI, other comorbidities, and pain interference.

Materials and Methods

The sample comprised participants with mTBI(s) from The Chronic Effects of Neurotrauma Consortium multicenter observational study. Potential concussive events were identified using a modified Ohio State University traumatic brain injury (TBI) Identification interview and then further with a structured interview. Pain interference was measured with the TBI quality-of-life pain interference score, which was categorized into insignificant, moderate, and high pain interference. Comorbidities of interest included anxiety, depression, post-traumatic stress disorder, insomnia, and arthritis. Multivariable relationships were analyzed using logistic regression.

Results

The analysis sample included 346 participants with mTBI(s). In adjusted analysis, those with high pain interference were more likely to have history of ≥ 3 TBIs (odds ratio (OR) 3.1, 95% confidence interval [CI] 1.4, 6.9) and to have clinical levels of post-traumatic stress disorder (OR 5.4, 95% CI 1.9, 15.7), depression (OR 2.5, 95% CI, 1.0, 6.1), anxiety (OR 4.9, 95% CI, 2.0, 11.7), and sleep disturbances (OR 6.1, 95% CI 2.0, 19.0) versus those with insignificant pain interference.

Conclusion

These results identify clinical features of veterans and service members with mTBI(s) who are at highest risk for pain-related disability. These findings also demonstrate the need to consider mental health and sleep problems in their pain evaluation and treatment approach.
Red Cell Distribution Width, Unlike Neutrophil Lymphocyte Ratio Is Unable to Accurately Gauge Enhanced Systemic Inflammation Associated With Panoramic Imaged Carotid Plaque
Authors: Chang Tina I , Wu Xiuju , Boström Kristina I , Tran Hoang-Anh , Friedlander Arthur H
Published: October 2020

Introduction

We have previously shown that panoramic X-rays (PXs) demonstrating calcified carotid artery atheromas (CCAA) are associated with increased systemic inflammation demonstrating increased neutrophil lymphocyte ratios (NLRs), a validated risk indicator of fatal myocardial infarctions arising from coronary artery atherosclerosis. Using this same cohort of patients (with minor adjustments because of missing data), we sought to determine if a like association existed between PXs evidencing CCAA and elevated red blood cell distribution width (RDW) given conflicting data as its reliability relative to NLR as a biologic marker of system inflammation. We hypothesized that CCAAs on PXs would simultaneously be associated with both increased NLR and RDW.

Materials and Methods

Investigators implemented a cross-sectional study design. Study sample consisted of patient medical records and PXs of white men ≥ 55 years. Two groups (N = 50 each) were constituted, one with atheromas (CCAA+) and without atheromas (CCAA–). The predictor variable was CCAA+ and outcome variables were NLR and RDW. Bootstrapping analysis was employed to analyze the differences in mean NLRs and RDWs between groups since the data was not normally distributed. Statistical significance determined to be ≤ 0.05 for all tests. The Medical Center’s Institutional Review Board approved the research protocol.

Results

A study group of 50 CCAA+ men (mean age 71; range 58-89 years) demonstrated a mean NLR of 2.98 ± 1.38 and an RDW of 13.21 ± 0.85. A control group of 50 CCAA– males (mean age 70 range; 55-91 years) evidenced a mean NLR of 2.38 ± 0.77 and an RDW of 13.16 ± 0.77. Bootstrapping comparison of NLR values evidenced significant (P = 0.008) difference (95% confidence interval of difference of mean: − 0.4272, 0.4384; observed effect size: 0.579) between groups; however, there was no significant difference in RDW values between the groups. Furthermore, logistic regression modeling demonstrated that for a one unit increase in NLR the odds of being CCAA+ (vs. CCAA–) increases by a factor of 1.659.

Conclusion

The existence of CCAA seen on PXs of elderly white men is associated with significantly (P = 0.008) elevated NLR values but is not associated with increases in RDW.
Smoking and Physical Activity Patterns of U.S. Military Veterans With Chronic Obstructive Pulmonary Disease: An Analysis of 2017 Behavioral Risk Factor Surveillance System
Authors: Greiner Benjamin , Ottwell Ryan , Corcoran Adam , Hartwell Micah
Published: October 2020

Introduction

The prevalence of chronic obstructive pulmonary disease (COPD) in U.S. military veterans is higher than that of non-veterans. Smoking and physical activity behaviors of veterans with COPD have not been studied. Therefore, our objective was to determine whether smoking and physical activity behaviors of veterans with COPD differ from non-veterans with COPD. Our secondary objective was to describe lifestyle behaviors of veterans after being diagnosed with COPD.

Materials and Methods

A cross-sectional analysis of lifestyle behaviors in veterans and non-veterans with COPD from the 2017 BRFSS was conducted. Logistic regression models were constructed to obtain adjusted risk ratios (ARRs). All confidence intervals (CIs) were reported at 95%.

Results

The prevalence of COPD among veterans was 14.2% (13.45–14.99) and 11.1% (10.82–11.41) among the non-veteran population (X2: F(1, 250,985) = 62.71, P < 0.01) (n = 37,532, N = 16,587,340). Veterans with COPD were significantly less likely to have a quit attempt in the past 12 months (ARR = 0.89, CI 0.81–0.97). Female veterans were significantly more likely to be current smokers (ARR = 1.28, CI 1.06–1.55) and less likely to meet aerobic physical activity recommendations (ARR = 0.71, CI 0.54–0.93) compared with male veterans.

Conclusions

Veterans were significantly more likely to have COPD compared with non-veterans. Additionally, female veterans were significantly more likely to be current smokers following a diagnosis of COPD, which was not significant in male veterans, and both sexes were less likely to have a quit attempt compared with non-veterans. Finally, both male and female veterans were less likely to meet aerobic physical activity recommendations compared with non-veterans. Our findings suggest that further efforts should be made to increase the frequency of quit attempts and improve smoking rates and physical activity in veterans with COPD.
Characterization and mitigation of fragmentation enzyme-induced dual stranded artifacts
Authors: Gregory Thomas , Ngankeu Apollinaire , Orwick Shelley , Kautto Esko A , Woyach Jennifer A , Byrd John C , Blachly James S
Published: October 2020

High-throughput short-read sequencing relies on fragmented DNA for optimal sampling of input nucleic acid. Several vendors now offer proprietary enzyme cocktails as a cheaper and more streamlined method of fragmentation when compared to acoustic shearing. We have discovered that these enzymes induce the formation of library molecules containing regions of nearby DNA from opposite strands. Sequencing reads derived from these molecules can lead to artifact-derived variant calls appearing at variant allele frequencies <5%. We present Fragmentation Artifact Detection and Elimination (FADE), software to remove these artifacts from mapped reads and mitigate artifact-related effects on downstream analysis. We find that the artifacts principally affect downstream analyses that are sensitive to a 1–3% artifact bias in the sequencing reads, such as targeted resequencing and rare variant discovery.
Personal perspectives: having a series of cardiac events
Authors: Taylor-Robinson S D
Published: October 2020

It has never been clear to me whether being a medically qualified patient has positive or negative associations. In 2019, after a prostatectomy, where I had extended bleeding per urethra, I suffered two myocardial infarctions, underwent three coronary angiograms and eventually coronary stenting. Junior doctors never examined me at any point, while senior ones worried over the risk of stent placement in an actively bleeding patient. I report my views on how this seemed as a largely passive, but still actively thinking patient.
The Switchgrass Microbiome: A Review of Structure, Function, and Taxonomic Distribution
Authors: Hestrin Rachel , Lee Marissa R. , Whitaker Briana K. , Pett-Ridge Jennifer
Published: October 2020

Switchgrass (Panicum virgatum L.) has been championed as a promising bioenergy crop due to its high productivity across a wide environmental range. The switchgrass microbiome—including bacteria, archaea, fungi, and other microbiota inhabiting soil and plant tissues—can influence plant function substantially. We conducted a review of the literature investigating switchgrass microbiome structure, key functional roles, and taxa isolated from field-grown plants. Although site conditions and plant compartment (i.e., location within shoots, roots, or root-influenced soil) appear to be the strongest drivers of switchgrass microbiome structure, the microbiome is also shaped by climate, season, and host genotype. Studies comparing across plant species show that the switchgrass microbiome is more similar to the microbiomes of other perennial plants than to the microbiomes of annual plants. Members of the switchgrass microbiome confer several benefits to their host. Most notably, mycorrhizal fungi can increase plant biomass many-fold, associative nitrogen-fixing bacteria can provide a substantial portion of the plant’s nitrogen demand, and fungal endophytes can improve plant tolerance to drought. Although the fungi and bacteria cultured from switchgrass represent only a portion of the microbiome, these serve as a valuable resource for researchers interested in investigating functional outcomes of the switchgrass microbiome. We highlight areas where additional research is necessary for a more comprehensive understanding of switchgrass microbiome structure, function, and potential to enhance sustainable bioenergy production. Key gaps include the role of understudied organisms (e.g., viruses, microeukaryotes, and nonmycorrhizal fungi), multitrophic relationships, mechanisms underpinning switchgrass–microbiome interactions, and field-scale validation of experimental findings.
The Design and Validation of Three Interprofessional Simulations: A Feasibility Study
Authors: Klenke-Borgmann Laura , Cantrell Mary Ann
Published: October 2020

This article provides pragmatic guidance on how to operationalize the INACSL Standards of Best Practice: SimulationSM. The purpose of this feasibility study was to determine content validity and intervention fidelity of three interprofessional simulations where clinical judgment is required to provide care to simulated patients. The process met all 11 criteria of the INACSL standards. The mean item-content validity indices for the scenarios ranged from .98 to 1. The scale-content validity indices ranged from .86 to 1. These findings advance the science of simulation design as an exemplar of the integration of best practices in simulation.
Are asymmetric tibial baseplates superior in primary total knee arthroplasty? A systematic review of clinical studies
Authors: Gouveia Kyle , Gyemi Lauren , Ekhtiari Seper , Bhandari Mohit , Sancheti Parag , Tapasvi Sachin
Published: October 2020

Background:

Despite the asymmetric nature of the native tibial condyles, traditional primary total knee arthroplasty (TKA) has overwhelmingly employed the use of symmetric tibial baseplates. However, designs exist utilizing an asymmetric tibial baseplate that mimics normal tibial anatomy. The purpose of this review was to assess the functional and radiographic outcomes of asymmetric tibial base plates.

Methods:

Embase, MEDLINE, and Web of Science were searched for relevant literature from database inception until September 2019, and after screening by two reviewers, studies investigating the use of asymmetric tibial baseplates in primary TKA were included. Demographic data as well as data on revision rates, functional and radiographic outcomes, and complications were recorded. A risk of bias assessment was performed for all studies.

Results:

Overall, 24 studies were identified with a total of 4776 patients (4937 knees). Seventeen studies (1895 knees) reported a pooled revision rate of 2.4% (45/1845) at a mean follow-up of 72.9 mo. TKA with an asymmetric baseplate resulted in improvement of range of motion and functional outcome scores postoperatively, as well as radiographic evidence of good tibial component positioning and bone coverage. Lastly, the overall pooled complication rate of reporting studies was 12.7%.

Conclusions:

The use of an asymmetric tibial baseplate in primary TKA is a safe and effective option, with the potential for improved component alignment and tibial coverage. However, more evidence is needed to determine if there are significant differences in failure rates and postoperative functional outcomes before justifying the implementation of a new and potentially more costly technology.

Level of Evidence:

Level IV.
The Older Adults With Rectal Cancer—Does Age Matter?
Authors: Shulman Katerina , Musallam Samar , Epelbaum Ron , Haim Nissim , Ben-Yosef Rahamim , Kaidar-Person Orit
Published: October 2020

Objectives:

Oncological treatments of older patients have many unresolved questions mainly because of the fact that these patients were not eligible to be included in most clinical trials. The aim of this study was to evaluate the treatment approach to localized rectal cancer in the older population, including complication rates and overall survival in patients treated with curative intent.

Materials and Methods:

A retrospective review of patients older than 80 years old (group A) who were treated for clinical stages II to III rectal cancer. The data collection included demographics, comorbidities, treatment protocols, adverse events, time of death, and a comparison with a group of patients aged 65 to 75 years (group B).

Results:

A total of 88 patients were included in the analysis (group A, 35; group B, 53). The groups were balanced with regards to sex, comorbidities, pretreatment albumin, and hemoglobin levels (for all categories P>0.05). More patients in group A (25%) received preoperative treatment as in-patients (P=0.022) and were treated with radiation only (P<0.0001) as the initial treatment approach. In group A, in 82% of patients the initial chemotherapy dose was reduced to 75% or less of the calculated dose compared with 7% in group B (P<0.001). Discontinuation of chemotherapy was needed in 55% in group A and 31% in group B (P=0.07). Median overall survival was 33 months in group A and 55 months in group B (P=0.06), 5-year overall survival was 27% and 60%, respectively (P=0.004).

Conclusions:

The age has a significant implication on preoperative treatment, chemotherapy dose, hospitalization rates, and survival.
Effect of bevel direction on the tracheal tube pathway during nasotracheal intubation
Authors: Won Dongwook , Kim Hyerim , Chang Jee-Eun , Lee Jung-Man , Min Seong-Won , Jung Jiyun , Yang Hyo Jun , Hwang Jin-Young , Kim Tae Kyong
Published: October 2020

BACKGROUND

For nasotracheal intubation, the nasal pathway between the inferior turbinate and hard palate (lower pathway) is preferred for patient safety. However, selecting the lower pathway can be challenging because passage of the tube through the nasal pathway is usually performed blindly.

OBJECTIVES

We investigated whether facing the bevel of the tracheal tube in the cephalad direction of the patient could help in advancing the tracheal tube through the lower pathway during nasotracheal intubation.

DESIGN

A randomised, blinded trial.

SETTING

SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea from January 2019 to March 2020.

PATIENTS

Sixty-eight adult patients undergoing oromaxillary surgeries were enrolled in this study.

INTERVENTIONS

Patients were randomly allocated to undergo nasotracheal intubation with the bevel of the tube facing the cephalad direction (intervention group) or to the left (conventional group).

MAIN OUTCOME MEASURES

The effects of bevel direction on the pathway of the tube in the nasal cavity, and the incidence of epistaxis were evaluated by fibreoptic bronchoscopy.

RESULTS

The success rate of the tracheal tube passing through the lower pathway was significantly higher in the intervention group than the conventional group (79.4 vs. 55.9%, relative risk 1.421, 95% CI 1.007 to 2.005, P = 0.038). The incidence of epistaxis was also lower in the intervention group than in the conventional group (41.2 vs. 73.5%, relative risk 0.560, 95% CI 0.357 to 0.878, P = 0.007).

CONCLUSIONS

Facing the bevel of the tracheal tube in the cephalad direction of the patient facilitated selection of the lower pathway and reduced the incidence of epistaxis during nasotracheal intubation in patients undergoing oromaxillary surgery.

TRIAL REGISTRATION

ClinicalTrial.gov, NCT03740620.
VITREOUS SEEDING OF CHOROIDAL MELANOMA
Authors: Raval Vishal , Bowen Randy C. , Soto Hansell , Biscotti Charles , Yeaney Gabrielle , Sears Jonathan , Singh Arun
Published: October 2020

Purpose:

To report a case of vitreous seeding in a medium-sized choroidal melanoma and review the literature.

Methods:

Observational case report and review of literature for pathogenesis, role of vitreous biopsy, and treatment outcomes.

Results:

A case of 57-year-old man diagnosed with vitreous seeding in the left eye 1 year after episcleral brachytherapy for medium-sized choroidal melanoma. The patient was initially diagnosed to have subretinal and vitreous hemorrhage due to rupture of a retinal artery macroaneurysm for which focal laser and intravitreal antivascular endothelial growth factor injections were administered. Over the next 9 months, the vitreous hemorrhage cleared and choroidal melanoma with retinal invasion became evident. One year after brachytherapy, the primary tumor regressed with resolution of surrounding subretinal fluid and hemorrhage. However, gradual decline in the visual acuity from 20/50 to 20/500 with increase of pigmented debris over the retinal surface and in the vitreous cavity was noted. A vitreous biopsy confirmed the presence of viable melanoma cells (epithelioid type), and the eye was enucleated. Histopathology showed microscopic persistence of primary tumor with diffuse vitreous seeding.

Conclusion:

Vitreous seeding of choroidal melanoma poses a diagnostic and management challenge.
Work-Sampling Study of an Innovative Care Coordination Program Aimed at Children With Chronic Health Conditions
Authors: Talon Brian , Gerges Michael , Perry-Bell Kenita , Caskey Rachel N. , Van Voorhees Benjamin , Martin Molly A. , Touchette Daniel R.
Published: October 2020

Purpose of Study:

To estimate time allocation and labor cost for care coordinators (CCs), community health workers (CHWs), and mental health workers (MHWs) to conduct care coordination tasks in a pediatric care coordination program.

Primary Practice Setting:

A public tertiary academic medical center in Chicago, IL.

Methodology and Sample:

A work-sampling study was conducted using a text message-based survey on 5 CCs, 20 CHWs, and 4 MHWs who volunteered to participate. Workers were randomly sampled within working hours to collect information on who was the subject of interaction and what service was being delivered over a 6-month period. Time allocation of workers to different subjects and services was summarized using descriptive statistics.

Results:

Care coordinators allocated 41% of their time to managing CHW teams. Community health workers allocated 37% of time providing services directly to children and 26% to the parent/caregiver. Mental health workers allocated 16% of time providing services to children and 29% to the parent/caregiver. The care coordination program serviced 5,965 patients, with a total annual labor cost of $1,455,353.

Implications for Case Management Practice:

Community health workers spent the majority of time working with patients and their families to conduct assessments. Mental health workers primarily addressed children's needs through their caregivers. Care coordinators primarily supported CHWs in coordinating care. Results may be used to inform development of such programs by determining services most often utilized, and labor cost may be used to inform program implementation and reimbursement.
Effect of Pudendal Blockade on Bladder Emptying After Midurethral Sling: A Randomized Controlled Trial
Authors: Maheshwari Deepali , Sierra Tania , Leung Katherine , Hall Cynthia , Flynn Michael
Published: October 2020

Objectives

To evaluate the effect of bilateral pudendal nerve blockade on immediate postoperative bladder emptying after midurethral sling.

Methods

We performed a double-blinded, randomized, placebo-controlled trial of women undergoing a midurethral sling procedure between October 2017 and February of 2019. Women older than 18 years were eligible if they were undergoing a midurethral sling with no concomitant procedures and had no preoperative urinary retention. Participant demographics and medical conditions that may affect bladder emptying were recorded preoperatively. Participants were randomized to a bilateral pudendal injection of either bupivacaine or normal saline. After induction of anesthesia, the pudendal injection was administered before any incisions. No other local anesthesia was used. The primary outcome was the rate of passing a standardized void trial. Secondary outcomes included perioperative pain scores, analgesia use, and complications.

Results

Ninety-one participants were enrolled in the study. One patient had a delayed void trial on postoperative day 1, leaving 90 participants for the final analysis. Demographic and perioperative characteristics were similar between the groups. Adjusted logistic regression showed that the administration of a bupivacaine pudendal block led to a higher rate of void trial failure (43% vs 20%, odds ratio = 0.32, P = 0.02 adjusted for age, body mass index, and comorbidities). Postoperative pain scores and analgesia use were similar between the groups. Postoperative complications, including urinary tract infection, mesh erosion, pelvic hematoma, or urinary retention within 6 weeks were similar between the groups.

Conclusions

Our prospective trial demonstrates that a bilateral pudendal blockade before midurethral sling procedure worsens postoperative bladder emptying.
QSM Reconstruction Challenge 2.0: a realistic in silico head phantom for MRI data simulation and evaluation of susceptibility mapping procedures
Authors: Marques José P. , Meineke Jakob , Milovic Carlos , Bilgic Berkin , Chan Kwok-Shing , Hedouin Renaud , van der Zwaag Wietske , Langkammer Christian , Schweser Ferdinand
Published: October 2020

Purpose

To create a realisticin-silicohead phantom for the second Quantitative Susceptibility Mapping (QSM) Reconstruction Challenge and for future evaluations of processing algorithms for QSM.

Methods

We created a digital whole-head tissue property phantom by segmenting and post-processing high-resolution (0.64mm isotropic), multi-parametric MRI data acquired at 7T from a healthy volunteer. We simulated the steady-state magnetization at 7T using a Bloch simulator and mimicked a Cartesian sampling scheme through Fourier-based processing. Computer code for generating the phantom and performing the MR simulation was designed to facilitate flexible modifications of the phantom in the future, such as the inclusion of pathologies, as well as the simulation of a wide range of acquisition protocols. Specifically, the following parameters and effects were implemented: repetition time and echo time, voxel size, background fields, and RF phase biases. Diffusion weighted imaging phantom data is provided allowing future investigations of tissue microstructure effects in phase and QSM algorithms.

Results

The brain-part of the phantom featured realistic morphology with spatial variations in relaxation and susceptibility values similar to the in vivo setting. We demonstrated some of the phantom’s properties, including the possibility of generating phase data with non-linear evolution over echo time due to partial volume effects or complex distributions of frequency shifts within the voxel.

Conclusion

The presented phantom and computer programs are publicly available and may serve as a ground truth in future assessments of the faithfulness of quantitative susceptibility reconstruction algorithms.
Adaptive conformational restraints for interactive model rebuilding in Cartesian and torsion space
Authors: Croll Tristan I , Read Randy J
Published: October 2020

When building atomic models into weak and/or low-resolution density, a common strategy is to restrain its conformation to that of a higher-resolution model of the same or similar sequence. When doing so, it is important to avoid over-restraining to the reference model in the face of disagreement with the experimental data. The most common strategy for this is the use of “top-out” potentials. These act like simple harmonic restraints within a defined range, but gradually weaken when the deviation between the model and reference grows larger than a defined transition point. In each current implementation, the rate at which the potential flattens beyond the transition region follows a fixed form – although the form chosen varies between implementations. A restraint potential with a tuneable rate of flattening would provide greater flexibility to encode the confidence in any given restraint. Here we describe two new such potentials: a Cartesian distance restraint derived from a recent generalisation of common loss functions, and a periodic torsion restraint based on a renormalisation of the von Mises distribution. Further, we describe their implementation as user-adjustable/switchable restraints in ISOLDE, and demonstrate their use in some real-world examples.

Synopsis

New forms of adaptive or top-out distance and torsion restraints are described, suitable for restraining a model to match a reference structure during interactive rebuilding. In addition, their implementation in ISOLDE is described along with some illustrative example applications.
Effect of FMRFamide on voltage-dependent currents in identified centrifugal neurons of the optic lobe of the cuttlefish,Sepia officinalis
Authors: Chrachri Abdesslam
Published: October 2020

Whole-cell patch-clamp recordings from identified centrifugal neurons of the optic lobe in a slice preparation allowed the characterization of five voltage-dependent currents; two outward and three inward currents. The outward currents were; the 4-aminopyridine-sensitive transient potassium or A-current (IA), the TEA-sensitive sustained current or delayed rectifier (IK). The inward currents were; the tetrodotoxin-sensitive transient current or sodium current (INa). The second is the cobalt- and cadmium-sensitive sustained current which is enhanced by barium and blocked by the dihydropyridine antagonist, nifedipine suggesting that it could be the L-type calcium current (ICaL). Finally, another transient inward current, also carried by calcium, but unlike the L-type, this current is activated at more negative potentials and resembles the low-voltage-activated or T-type calcium current (ICaT) of other preparations.

Application of the neuropeptide FMRFamide caused a significant attenuation to the peak amplitude of both sodium and sustained calcium currents without any apparent effect on the transient calcium current. Furthermore, FMRFamide also caused a reduction of both outward currents in these centrifugal neurons. The fact that FMRFamide reduced the magnitude of four of five characterized currents could suggest that this neuropeptide may act as a strong inhibitory agent on these neurons.

FMRFamide modulate the ionic currents in identified centrifugal neurons in the optic lobe of cuttlefish: thus, FMRFamide could play a key role in visual processing of these animals.
BCR-induced protein dynamics and the emerging role of SUMOylation revealed by proximity proteomics
Authors: Awoniyi Luqman O. , Sarapulov Alexey V. , Hernández-Pérez Sara , Runsala Marika , Cunha Diogo M. , Tejeda-González Blanca , Šustar Vid , Özge Balci M. , Petrov Petar , Mattila Pieta K.
Published: October 2020

Successful B cell activation, critical for high-affinity antibody production, is controlled by the B cell antigen receptor (BCR). However, we still lack a comprehensive protein-level view of the very dynamic multi-branched cellular events triggered by antigen binding. Here, we employed APEX2 proximity biotinylation to study antigen-induced changes, 5-15 min after receptor activation, at the vicinity of the plasma membrane lipid rafts, wherein BCR enriches upon activation. The data reveals dynamics of signaling proteins, as well as various players linked to the subsequent processes, such as actin cytoskeleton remodelling and endocytosis. Interestingly, our differential expression analysis identified dynamic responses in various proteins previously not linked to early B cell activation. We demonstrate active SUMOylation at the sites of BCR activation in various conditions and report its functional role in BCR signaling through Akt and MAPK axes.
Cardiac Sex Differences are Established Prior to Gonad Formation
Authors: Shi Wei , Sheng Xinlei , Dorr Kerry M. , Hutton Josiah E. , Davies Haley A. , Andrade Tia D. , Greco Todd M. , Hashimoto Yutaka , Federspiel Joel D. , Robbe Zachary L. , Chen Xuqi , Arnold Arthur P. , Cristea Ileana M. , Conlon Frank L.
Published: October 2020

Male and female disease states differ in their prevalence, treatment responses, and survival rates. In cardiac disease, women almost uniformly fare far worse than men. Though sex plays a critical role in cardiac disease, the mechanisms underlying sex differences in cardiac homeostasis and disease remain unexplained. Here, in adult and embryonic hearts we reveal sex-specific transcriptomes and proteomes and show that cardiac sex differences are predominately accounted for by post-transcriptional mechanisms. We found differential expression of male-female proteins in the cardiomyocytes. Using a quantitative proteomics-based approach, we characterized differential sex-specific enriched cardiac proteins, protein complexes, and biological sex processes in the context of global genetic diversity of the Collaborative Cross, an established surrogate for human diversity. We also found that sex differences in cardiac protein expression are established by both hormonal and sex chromosomal mechanisms. We have demonstrated the onset of sex-biased protein expression and discovered that sex disparities in heart tissue occur at the earliest stages of heart development at a period that preceeds mammalian gonadal development. Collectively, these findings may explain why congenital heart disease, a leading cause of death whose origin is often developmental, is sex biased. Our results reveal molecular foundations for differences in cardiac tissue that underlie sex disparities in health, disease, and treatment outcomes.
Reversal of visual feedback modulates somatosensory plasticity
Authors: Goldenkoff Elana R. , McGregor Heather R. , Mergos Joshua , Gholizadeh Puyan , Bridenstine John , Brown Matt J.N. , Vesia Michael
Published: October 2020

Reversed visual feedback during unimanual training increases transfer of skills to the opposite untrained hand and modulates plasticity in motor areas of the brain. However, it is unclear if unimanual training with reversed visual feedback also affects somatosensory areas. Here we manipulated visual input during unimanual training using left-right optical reversing spectacles and tested whether unimanual training with reversed vision modulates somatosensory cortical excitability to facilitate motor performance. Thirty participants practiced a unimanual ball-rotation task using the right hand with either left-right reversed vision (incongruent visual and somatosensory feedback) or direct vision (congruent feedback) of the moving hand. We estimated cortical excitability in primary somatosensory cortex (S1) before and after unimanual training by measuring somatosensory evoked potentials (SEPs). This was done by electrically stimulating the median nerve in the wrist while participants rested, and recording potentials over both hemispheres using electroencephalography. Performance of the ball-rotation task improved for both the right (trained) and left (untrained) hand after training across both direct and reversed vision conditions. Participants with direct vision of the right hand during training showed SEPs amplitudes increased bilaterally. In contrast, participants in the reversed visual condition showed attenuated SEPs following training. The results suggest that cortical suppression of S1 activity supports skilled motor performance after unimanual training with reversed vision, presumably by sensory gating of afferent signals from the movement. This finding provides insight into the mechanisms by which visual input interacts with the sensorimotor system and induces neuroplastic changes in S1 to support skilled motor performance.