bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermal sensitive Poloxamer/Chitosan hydrogel for drug delivery in vagina
Authors: Wu Qian , Li Liang
Published: September 2020

In this paper, the composite gels based on poloxamer and chitosan with different contents were prepared for thermal sensitive mucosal drug delivery. The sol-gel transition temperature and rheological viscosity of the obtained gels were detected to select the optimum candidate for vaginal drug delivery. Electrochemistry impedance spectroscopy (EIS) was utilized to probe the hole structure in optimum hydrogel immersing in the vaginal fluid stimulant (VFS) for different time. The drug releasing rate of ethinyloestradiol loaded by the optimum hydrogel was examined. The drug releasing results suggested that the releasing rate satisfied with the Higuchi model, while the EIS results confirmed more pores in the composite gels would be formed during the immersing process in the VFS. The results indicated that the gel with the optimum formula met the requirements of vaginal medication. This research suggested poloxamer/chitosan might be an effective type of thermal gel for drug delivery in vagina.
Effect of annealing time on bimodal microstructures and tensile properties of Mg–6Sn–3Al–1Zn alloy
Authors: Wei Fuan , Wang Jinhui , Shi Bo , Zhang Zhengang
Published: September 2020

Although the Mg–6Sn–3Al–1Zn alloy with bimodal grain size distribution has excellent mechanical properties, its mechanical properties can further be improved by adjusting or controlling its microstructures through annealing. In this study, the effect of annealing time on microstructures and mechanical properties of the Mg–6Sn–3Al–1Zn alloy was systematically studied. The Mg–6Sn–3Al–1Zn alloy with bimodal microstructures was prepared through pack-rolling with two passes at 450 °C (55 % thickness reduction per pass, and the total rolling deformation is 80 %). Then the alloy was annealed for 10 min, 20 min, 30 min and 40 min at 350 °C, respectively. The results showed that volume fractions of Mg2Sn phase and recrystallization grains increased with increasing of the annealing time. The multi-modal microstructures were formed in alloys after annealing. When the annealing time ≤30 min, the average grain size of the alloy increased with increasing of the annealing time, while it decreased after annealed for 40 min. The intensity of {0001} texture decreased with increasing of annealing time (<20 min), which caused by dynamic recovery. When the annealing time reached 30 min, the generation of recrystallization led to the enhancement of {0001} texture. However, the {0001} texture intensity reduced after the alloy was annealed for 40 min, which caused by further dynamic recrystallization. In Mg–6Sn–3Al–1Zn alloy annealed for 30 min, the volume fractions of Mg2Sn phase and recrystallization grains were respectively 1.29 % and 56 %, and the average grain size was 6.28 μm. Moreover, the mechanical properties of the alloy reached optimum, i.e., the tensile strength, yield strength and elongation were 336 MPa, 194 MPa and 26 %, respectively.
Precise dot inkjet printing thought multifactorial statistical optimization of the piezoelectric actuator waveform
Authors: Bucciarelli Alessio , Reddy Chandraiahgari Chandrakanth , Adami Andrea , Mulloni Viviana , Lorenzelli Leandro
Published: September 2020

InkJet printing is a technique that in the last decades has attracted the attention of the scientific community because it allows producing customized patterns with a variety of inks and substrates, making it suitablemethod for the production of flexible circuits. However, the optimization of this technique is still problematic due to a large number of process variables. Among them the modification of the waveform parameters of the piezoelectric actuator that allows the ejections of the ink can be effective in tuning the printing quality. This work reports a study by a statistical method, namely Design of Experiments (DOE), to optimize the inkjet printing parameters for a nanoparticle-based silver (Ag) ink. This method showed the interplay of the waveform parameters into the definition of optimal drop reproducibility and the achievement of the optimal resolution. In particular, it is shown that mixed terms of the model have a statistical significance and therefore the proposed multifactorial approach provides a benefit in the optimization with respect to the more commonly used one-factor-at-a-time models (OFAT). For the first time, empirical equations have been reported within the corresponding 95% confidence intervals. These equations can be used as a tool to directly tune the properties of the printed dot by modifying the waveform parameters. As case study, we proposed the combinations of a commercial Ag nanoparticles ink with Kapton, a commonly used substrate for flexible electronics.
Recession and fossil fuel dependence undermine climate policy commitments
Authors: Ide Tobias
Published: September 2020

Knowledge on the determinants of more or less ambitious climate policies on the country level is still limited, especially with regards to the 2015 Paris Agreement to mitigate global climate change. This is a significant knowledge gap, especially given the review of many contributions to the Paris Agreement due in 2021. I analyse why some countries make insufficient pledges to reduce their greenhouse gas emissions under the Paris Agreement, while other countries pursue more ambitious climate change mitigation goals. Using qualitative comparative analysis (QCA), the study finds that economic recession, dependence on fossil fuels for energy generation, and levels of development are strong predictors of insufficient climate policies. These results are worrisome in the context of the economic recession triggered by the COVID-19 pandemic as well as the continued predominance of fossil fuels in the world’s energy mix.
Effect of rotating unbalance on nonlinear dynamic response of flexible rotors supported on tilting pad journal bearing
Authors: Dixit Harsh Kumar , Singh Ajit , Gupta T C
Published: September 2020

The effect of orientation of rotors and rotating unbalance at disc on the dynamic response of rotor supported by four pad tilting pad journal bearing (TPJB) is studied. The orientation of the rotor taken has a horizontal rotor (HR) and a vertical rotor (VR). The rotor element modeled as the Timoshenko beam element with four degrees of freedom per node. The disc is rigid and it is centrally mounted. The nonlinear forces by the fluid film in tilting pad journal bearing were determined by solving the Reynolds equation along with each pad. The infinite short bearing assumption has taken to find pressure distribution along with pads. Indigenous MATLAB® code has developed to solve the rotor-TPJB equation. The ODE-15s solver is used to find the related response data of journal and disc centers. Orbits, phase plots, and power spectrums used to analyze the behavior of the system. The sub-synchronous vibrations dominate at lower speeds and high rpm unbalance forces become much significant and overcome bearing fluid film forces causing catastrophically change in response of the system.
Improved green body strength using PMMA–Al2O3 composite particles fabricated via electrostatic assembly
Authors: Tan Wai Kian , Matsuzaki Tatsuya , Yokoi Atsushi , Kawamura Go , Matsuda Atsunori , Muto Hiroyuki
Published: September 2020

In additive manufacturing, indirect laser sintering is used to process and fabricate ceramic materials using a polymer–ceramics green body. The mechanical strength of the green body is important to hold the shape and to enable the use of laser with low power density during the laser sintering process. Because the microstructure of the green body will considerably affect the density of the final product, this study demonstrated a feasible controlled formation of Poly (methylmethacrylate) (PMMA)–Al2O3 composite particles by an electrostatic assembly method that was used for the fabrication of the green body with improved mechanical properties, which were determine using an indentation test. The controllable homogeneous decoration of desired submicron-sized PMMA particles on Al2O3 particles allowed an effective use of PMMA additives while exhibiting considerable mechanical property improvement of the green body compared to poly(vinyl alcohol)-bonded Al2O3. The findings of this study show good potential of green body formation with improved strength for ceramics fabrication via indirect laser sintering.
Self-assembly of plasmonic chiral superstructures with intense chiroptical activity
Authors: Chen Zhong , Lu Xingyu
Published: September 2020

Chiral nanostructures are asymmetric nanoarchitectures that cannot be superimposed with their mirrored-symmetric counterparts, which have attracted considerable attention due to their special photophysical properties and potential applications in plasmonics, spectroscopy and nanosensors. In particular, Self-Assembly of chiral nanostructures with symmetric or asymmetric objects might exhibit exceptional optical activity because those chiral superstructures can manipulate chiral states of light that leads to circular dichroism (CD) effect. This review highlights recent advances on the self-assembly of plasmonic chiral superstructures from simpler dimeric, and trimeric chiral nanoassemblies to complicated chiral nanoarchitectures, especially emphasizes the resulted superior optical activity and the corresponding principles.
Synthesis and characterization of barium titanate/polyacrylonitrile nanocomposite for electrochemical sensing of doxorubicin
Authors: Mehtab Sameena , Zaidi M G H , Joshi Pragati , Bawari Deependra
Published: September 2020

A microwave (MW) assisted process was evolved to synthesize a series of polymer nanocomposites (PNCs) through 2,2-azobisisobutyronitrile (AIBN) initiated free radical in situ polymerization of acrylonitrile (AN) in presence of nanobariumtitanate (NBT). The reaction conditions were optimized and microwave power ranging 25 to 100 W over 10 min was found to be most suited for the synthesis of PNCs. Synthesis of PNCs has been ascertained through UV–vis, FTIR spectroscopy and microstructure were investigated through XRD and AFM. TG-DTA-DTG proclaims that PNCs acquire lower moisture content and higher heat resistance as compared to polyacrylonitrile (PAN). The synthesized PNCs have been applied as sensing material to develop electrochemical probe for detection of doxorubicin (DOX). The presence of DOX (0.01%, w/v) in phosphate buffer at pH 7.4 has shown a remarkable increase in the peak current at PNCs modified glassy carbon electrode (GCE). Cyclic voltammetric (CV) studies proof good acceptance of nanocomposites as sensing material for anti cancerous drug DOX.
Brazil hosts the Olympic Games
Authors: Pereira Anthony W.
Published: September 2020

‘Brazil hosts the Olympic Games’ examines the opening ceremony of the 2016 Olympic Games in Rio de Janeiro on 5 August 2016. This was the first time the games took place in South America. Watched live by hundreds of millions of people around the world, the four-hour ceremony reveals something about Brazil and its national experience. It provides insights into what makes Brazilians proud to be Brazilian, as well as anxieties behind those sources of pride. The themes concern the importance of nature and its preservation; the importance of the future in Brazilians’ view of the world; Brazil’s alleged vocation for peaceful inclusion; and the informality of the Brazilian way of getting things done.
Democratic development or decay?
Authors: Pereira Anthony W.
Published: September 2020

‘Democratic development or decay?’ studies Luiz Inácio ‘Lula’ da Silva’s election as Brazil’s president in 2002, which demonstrated the resilience of Brazilian democracy. Lula’s election began a thirteen-and-a-half-year period when politicians from the Workers’ Party controlled the presidency. The contested history of these years explains much of the current polarization in Brazilian politics between a new ideological right and the left. The chapter then describes Brazil’s political system and examines the accomplishments and failures of the Workers’ Party in power. It also considers the political crisis that began in 2013 and contributed to the election of Jair Bolsonaro in 2018.
Exuberance and diversity
Authors: Pereira Anthony W.
Published: September 2020

‘Exuberance and diversity’ describes the Park of the City in Brasília, Brazil’s capital, which reflects the exuberance and diversity of Brazil. In the face of the innumerable challenges of the 21st century, it is useful to remember the obstacles that Brazil successfully overcame in the 20th. Brazil’s faces some interesting new challenges. Ultimately, the problems Brazil faces—inequality, poverty, violence, environmental degradation, political polarization, pandemics, and a gap between the populace and its representatives—are the world’s problems. Because Brazil occupies a pivotal position in the world, everyone should want Brazil to succeed as a nation.
3. New Lefts—enrichment and fragmentation
Authors: Newman Michael
Published: September 2020

In the second half of the twentieth century, new movements grew up that were not necessarily socialist but inspired by new intellectual influences combined with older traditions, such as more humanistic interpretations of Marxism. ‘New Lefts—enrichment and fragmentation’ focuses on two manifestations of the New Left, feminism, and green socialism, both of which questioned the dominant forms and structures of socialist groups. More recent developments include the recognition of intersectionality, which poses other challenges, and uprisings such as the Occupy movement and climate change activism, both of which recognize capitalism as a primary driver of inequality and climate change.
Love poetry
Authors: Morgan Llewelyn
Published: September 2020

'Love poetry' examines Ovid’s ventures into the sub-genre of love-elegy and describes the development of this exclusively Roman literary form over the previous two generations, and the conventions that Ovid had inherited. Ovid wrote three books on the subject of love, these are Amores (Loves), Ars Amatoria (Art of Love) and Remedia Amoris (Cures for Love), a meeting of love-elegy and the popular ancient tradition of didactic poetry. The Amores was the collection that launched Ovid’s poetic career, and it set the terms for the rest of it, marking him out as the leading proponent of elegiac verse in Rome. In his approach to love-elegy we also see a style that will characterize much of his later work, playful and intensely self-aware. The Amores is less poetry about love than poetry about love poetry, its primary appeal lying in witty manipulation of poetic convention. Meanwhile, the Ars Amatoria teaches men and women how to find and keep a lover, and then the Remedia Amoris explains how to ‘unlearn’ the lessons of the Ars.
Metamorphoses
Authors: Morgan Llewelyn
Published: September 2020

'Metamorphoses; focuses on the Metamorphoses, widely considered Ovid’s masterpiece. The Metamorphoses is a collection of transformation stories, but the principle of change characterizes every layer of the poem. The Metamorphoses is Ovid’s only epic poem, thus in form a departure from the elegiac tradition he otherwise champions. But Ovid’s epic is devoted to destabilizing the order and certainties that conventional epic, such as Virgil’s Aeneid, was designed to uphold, and metamorphosis as a theme is well adapted to advance that end. The metamorphic character of the Metamorphoses is not restricted to explicit descriptions of shape-shifting, but affects its narrative form, even its generation of meaning. The Metamorphoses is thus Ovid’s most ambitious exploration of the nature of poetry, an astonishingly sophisticated performance, but it is better known as a collection of brilliantly memorable tales, Midas’ golden touch, Narcissus, Icarus, Pygmalion, a tour de force in storytelling. The poem has in fact served as the authoritative encyclopaedia of Graeco-Roman folklore. The freshness and vibrancy of Ovid's storytelling has a lot to do with the irreverent and self-conscious approach he adopts to writing an epic poem.
TheFasti
Authors: Morgan Llewelyn
Published: September 2020

‘The Fasti’ is a study of the Fasti, Ovid’s poetic version of the Roman calendar. Each book of this poem corresponds to a month of the Roman calendar, and the books, like the Roman calendars they imitate, detail the religious observances associated with individual days. The Fasti is Ovid’s most topical poem, indirectly inspired by the great calendrical reform of Julius Caesar, from which our modern calendar derives. Of all Ovid’s poetry, then, this brings him closest to the concerns of Augustus, heir to Caesar, and his reformist regime. It is the most Roman of his poems, too, directly engaged with the religious, and hence political, culture of the city, and its sacred and secular topography. At the same time, this chapter explains, Ovid reverts to elegiac form from the epic form of the Metamorphoses, and while the poem contains much in the way of celebration of Augustus’ Rome, Ovid’s trademark wit and self-awareness are undiminished, and hints of a more dangerous irreverence are to be found.
George Bernard Shaw: A Very Short Introduction
Authors: Wixson Christopher
Published: September 2020

George Bernard Shaw: A Very Short Introduction provides an accessible foundation for those discovering George Bernard Shaw’s writing for the first time. The verbosity and scope of Shaw’s writing can at times feel daunting. With a canon of plays astonishing in size, breadth, and ambition, Shaw is considered the second greatest playwright in English behind William Shakespeare. The range and popularity of his work as journalist, essayist, and polemicist as well as playwright made him one of the world’s most recognizable public intellectuals and literary figures. Charting the contours of what constitutes ‘Shavian’, this VSI traces the creative evolution of core themes and styles over Shaw’s long career.
4. ‘Puritan’
Authors: Wixson Christopher
Published: September 2020

‘Puritan’ focuses on George Bernard Shaw’s moulding of stage comedy to dramatize the workings of his emerging religion, christened ‘Creative Evolution’ in 1916. Under the aegis of the Life Force, Shaw’s ambition to create a ‘big book of devotion for modern people’ was fortified by an evangelism that would yoke all of his varied writings. The chapter then looks at Shaw’s Man and Superman (1901–2), which premiered at the Royal Court Theatre. Two other plays by Shaw—John Bull's Other Island (1904) and Major Barbara (1905)—continue his enquiry into how the institutions of worldly power can best be of service to the Life Force.
1. What are nuclear weapons?
Authors: Siracusa Joseph M.
Published: September 2020

How did nuclear weapons differ from what came before? ‘What are nuclear weapons?’ explains the science behind their creation by looking at the characteristics of the atom and the harnessing of its power for destructive purposes. The peaceful end of the Cold War was not the end of the nuclear threat. The detonation of a relatively small nuclear weapon in New York would be catastrophic, with the medical system unable to respond to the task of caring for the injured. After 9/11 and with an increased threat from rogue states, are we on the brink of a second nuclear age?
3. A choice between the quick and the dead
Authors: Siracusa Joseph M.
Published: September 2020

‘A choice between the quick and the dead’ looks at the immediate aftermath of World War II. Truman recognized that maintaining a US monopoly on nuclear technology would be impossible and focused on international agreements to control its uses. The scientific processes governing nuclear technology and energy were the same for benign as for malign uses; the two could not be separated. Presidential adviser Bernard Baruch’s proposal for an international agreement was the first of what would become hundreds, if not thousands, of multilateral and bilateral discussions on arms-control measures. Baruch’s plan was rejected by the Soviet Union, while the US refused disarmament without controls.
5. Nuclear deterrence and arms control
Authors: Siracusa Joseph M.
Published: September 2020

Did the nuclear revolution contribute to an era of peace? ‘Nuclear deterrence and arms control’ looks at the post-World War II stalemate and Cold War détente. The concept of deterrence did not come up until the second decade of the nuclear age. The introduction of thermonuclear weapons and nuclear-tipped, long-range intercontinental ballistic missiles turned foreign policy on its head. Mutual deterrence was less of a policy than a reality. With the Cuban Missile Crisis, Moscow mounted a show of defiance at a moment when it was relatively weak. The Carter and Reagan administrations were beset by external and internal disagreements, but prudence and luck prevailed.
7. Post-Cold War era
Authors: Siracusa Joseph M.
Published: September 2020

What significant lessons can be learned from the history of nuclear weapons? ‘Post-Cold War era’ considers post-Cold War attempts to curb nuclear proliferation. The clarity of the Cold War world has given way to the ambiguities and uncertainties of a world where global security is threatened by regime collapse, nuclear terrorism, new nuclear weapons states, regional conflict, and pre-existing nuclear arsenals. The nuclear rivalry with Russia, North Korea, and Iran gives the feeling of returning to the Cold War period, with the ever present threat of a deliberate or unintended confrontation. So far, we have avoided mutual destruction, but is this down to policy or luck?
Of ‘isms’
Authors: Craig Edward
Published: September 2020

Epistemology is the branch of philosophy concerned with knowledge, belief, and closely related notions like reasons and justification. ‘Of ‘isms’’ explains some philosophical ‘ism’ words, which are broad terms designating a certain general type of doctrine. René Descartes was one of the most famous exponents of dualism, as he worked on proving a doctrine that pre-dated him; materialism and idealism were based on earlier concepts, giving rise later to the dialectical materialism of Karl Marx. Idealism holds that everything has a mental or spiritual basis. Rationalism and empiricism are opposed to each other. Empiricists believe everything is filtered through our perceptions rather than reality having an inherently logical structure.
Role of the Healthcare Surface Environment in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission and Potential Control Measures
Authors: Kanamori Hajime , Weber David J , Rutala William A
Published: September 2020

The healthcare environment serves as one of the possible routes of transmission of epidemiologically important pathogens, but the role of the contaminated environment on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission remains unclear. We reviewed survival, contamination, and transmission of SARS-CoV-2 via environmental surfaces and shared medical devices as well as environmental disinfection of SARS-CoV-2 in healthcare settings. Coronaviruses, including SARS-CoV-2, have been demonstrated to survive for hours to days on environmental surfaces depending on experimental conditions. The healthcare environment is frequently contaminated with SARS-CoV-2 RNA in most studies but without evidence of viable virus. Although direct exposure to respiratory droplets is the main transmission route of SARS-CoV-2, the contaminated healthcare environment can potentially result in transmission of SARS-CoV-2 as described with other coronaviruses such as SARS and Middle East respiratory syndrome coronaviruses. It is important to improve thoroughness of cleaning/disinfection practices in healthcare facilities and select effective disinfectants to decontaminate inanimate surfaces and shared patient care items.
Epidemiological Correlates of Polymerase Chain Reaction Cycle Threshold Values in the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
Authors: Salvatore Phillip P , Dawson Patrick , Wadhwa Ashutosh , Rabold Elizabeth M , Buono Sean , Dietrich Elizabeth A , Reses Hannah E , Vuong Jeni , Pawloski Lucia , Dasu Trivikram , Bhattacharyya Sanjib , Pevzner Eric , Hall Aron J , Tate Jacqueline E , Kirking Hannah L
Published: September 2020

Background

Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has principally been performed through the use of real-time reverse-transcription polymerase chain reaction testing. Results of such tests can be reported as cycle threshold (Ct) values, which may provide semi-quantitative or indirect measurements of viral load. Previous reports have examined temporal trends in Ct values over the course of a SARS-CoV-2 infection.

Methods

Using testing data collected during a prospective household transmission investigation of outpatient and mild coronavirus disease 2019 cases, we examined the relationships between Ct values of the viral RNA N1 target and demographic, clinical, and epidemiological characteristics collected through participant interviews and daily symptom diaries.

Results

We found that Ct values are lowest (corresponding to a higher viral RNA concentration) soon after symptom onset and are significantly correlated with the time elapsed since onset (P < .001); within 7 days after symptom onset, the median Ct value was 26.5, compared with a median Ct value of 35.0 occurring 21 days after onset. Ct values were significantly lower among participants under 18 years of age (P = .01) and those reporting upper respiratory symptoms at the time of sample collection (P = .001), and were higher among participants reporting no symptoms (P = .05).

Conclusions

These results emphasize the importance of early testing for SARS-CoV-2 among individuals with symptoms of respiratory illness, and allow cases to be identified and isolated when their viral shedding may be highest.
Rotational atherectomy through a coronary artery bypass graft after transcatheter aortic valve implantation: a case report
Authors: Illescas Edgar , Cuisset Thomas , Spychaj Jean-Charles , Deharo Pierre
Published: September 2020

Background 

Aortic stenosis (AS) in the elderly is frequently associated with complex coronary artery disease. Rotational atherectomy (RA) in this clinical setting is challenging because coronary slow flow could lead to haemodynamic instability aggravated by the severe AS.

Case summary 

We present the case of an 83-year-old woman with symptomatic severe AS, mildly decreased left ventricular ejection fraction and history of coronary artery bypass grafting with right internal mammary artery (RIMA) to the right coronary artery (RCA) and left internal mammary artery to the left anterior descending artery and further percutaneous coronary intervention (PCI) to the circumflex. First, we performed a transcatheter aortic valve implantation (TAVI) to treat the severe AS. Because of persistent symptoms despite good result, we then performed RA of the native RCA through the RIMA with a Guidezilla® guide extension catheter.

Discussion 

A two-staged procedure of TAVI and PCI with RA of the RCA via RIMA was successfully performed. We decided to perform the PCI after the TAVI to allow a better haemodynamic tolerance of the complex coronary intervention. This procedure needs caution as the conduit is fragile and could be easily damaged during the RA. No data are available about feasibility and safety of RA through a native graft, but this could be a first step to consider it.
Safety and efficacy of double vs. triple antithrombotic therapy in patients with atrial fibrillation with or without acute coronary syndrome undergoing percutaneous coronary intervention: a collaborative meta-analysis of non-vitamin K antagonist oral anticoagulant-based randomized clinical trials
Authors: Gargiulo Giuseppe , Cannon Christopher P , Gibson Charles Michael , Goette Andreas , Lopes Renato D , Oldgren Jonas , Korjian Serge , Windecker Stephan , Esposito Giovanni , Vranckx Pascal , Valgimigli Marco
Published: September 2020

Aims

Safety and efficacy of antithrombotic regimens in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) may differ based on clinical presentation. We sought to compare double vs. triple antithrombotic therapy (DAT vs. TAT) in AF patients with or without acute coronary syndrome (ACS) undergoing PCI.

Methods and results

A systematic review and meta-analysis was performed using PubMed to search for non-vitamin K antagonist oral anticoagulant (NOAC)-based randomized clinical trials. Data on subgroups of ACS or elective PCI were obtained by published reports or trial investigators. A total of 10 193 patients from four NOAC trials were analysed, of whom 5675 presenting with ACS (DAT = 3063 vs. TAT = 2612) and 4518 with stable coronary artery disease (SCAD; DAT = 2421 vs. TAT = 2097). The primary safety endpoint of ISTH major bleeding or clinically relevant non-major bleeding was reduced with DAT compared with TAT in both ACS (12.2% vs. 19.4%; RR 0.63, 95% CI 0.56–0.71; P < 0.0001; I2 = 0%) and SCAD (14.6% vs. 22.0%; RR 0.68, 95% CI 0.55–0.85; P = 0.0008; I2 = 66%), without interaction (P-int = 0.54). Findings were consistent for secondary bleeding endpoints, including intra-cranial haemorrhage. In both subgroups, there was no difference between DAT and TAT for all-cause death, major adverse cardiovascular events, or stroke. Myocardial infarction and stent thrombosis were numerically higher with DAT vs. TAT consistently in ACS and SCAD (P-int = 0.60 and 0.86, respectively). Findings were confirmed by multiple sensitivity analyses, including a separate analysis on dabigatran regimens and a restriction to PCI population.

Conclusions

DAT, compared with TAT, is associated with lower bleeding risks, including intra-cranial haemorrhage, and a small non-significant excess of cardiac ischaemic events in both patients with or without ACS.
Elective replacement of the ascending aorta: is the 5.5-cm threshold appropriate? The insidious, small aorta
Authors: Papakonstantinou Nikolaos A , Rorris Filippos-Paschalis
Published: September 2020

OBJECTIVES

As thoracic aortic aneurysm disease continues to cause significant morbidity and mortality in the general population, the cardiovascular community continues the search for the golden threshold of elective surgical replacement of the ascending aorta.

METHODS

Thoracic aortic aneurysm is a common disease, classified within the 20 most common causes of death in patients over 65 years old. Once aortic complications like dissection or rupture occur, they can prove fatal. Prophylactic surgical replacement of the ascending aorta remains the mainstay of treatment to prevent these complications. Current American and European guidelines agree that the threshold for the diameter for elective replacement of the ascending aorta in non-syndromic, asymptomatic aneurysmal disease is 5.5 cm. Overall, aortic dissection is related to poor prognosis, thus making early intervention paramount.

RESULTS

There is a critical size above which the risk of dissection or rupture becomes extremely high. However, a significant post-dissection increase in diameter is reported, thus rendering the predissection aortic diameter well below the current threshold for elective surgical replacement of the ascending aorta. Moreover, it is widely reported that the majority of acute aortic dissections would not meet the criteria for prophylactic surgery prior to dissection. Additionally, elective surgical ascending aortic replacement in the current era shows a significantly improved risk-benefit ratio, which justifies a more aggressive approach in the management of aortic aneurysmal disease.

CONCLUSIONS

As a result, there is a lot of discussion in the literature about the requirement of a leftward shifting of the surgical threshold for elective aortic replacement.
Arrhythmogenic right ventricular cardiomyopathy and sports activity: from molecular pathways in diseased hearts to new insights into the athletic heart mimicry
Authors: Gasperetti Alessio , James Cynthia A , Cerrone Marina , Delmar Mario , Calkins Hugh , Duru Firat
Published: September 2020

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited disease associated with a high risk of sudden cardiac death. Among other factors, physical exercise has been clearly identified as a strong determinant of phenotypic expression of the disease, arrhythmia risk, and disease progression. Because of this, current guidelines advise that individuals with ARVC should not participate in competitive or frequent high-intensity endurance exercise. Exercise-induced electrical and morphological para-physiological remodelling (the so-called ‘athlete’s heart’) may mimic several of the classic features of ARVC. Therefore, the current International Task Force Criteria for disease diagnosis may not perform as well in athletes. Clear adjudication between the two conditions is often a real challenge, with false positives, that may lead to unnecessary treatments, and false negatives, which may leave patients unprotected, both of which are equally inacceptable. This review aims to summarize the molecular interactions caused by physical activity in inducing cardiac structural alterations, and the impact of sports on arrhythmia occurrence and other clinical consequences in patients with ARVC, and help the physicians in setting the two conditions apart.
Free-stream coherent structures in the unsteady Rayleigh boundary layer
Authors: Johnstone Eleanor C , Hall Philip
Published: September 2020

Results are presented for nonlinear equilibrium solutions of the Navier–Stokes equations in the boundary layer set up by a flat plate started impulsively from rest. The solutions take the form of a wave–roll–streak interaction, which takes place in a layer located at the edge of the boundary layer. This extends previous results for similar nonlinear equilibrium solutions in steady 2D boundary layers. The results are derived asymptotically and then compared to numerical results obtained by marching the reduced boundary-region disturbance equations forward in time. It is concluded that the previously found canonical free-stream coherent structures in steady boundary layers can be embedded in unbounded, unsteady shear flows.
Automorphisms of Contact Graphs of CAT(0) Cube Complexes
Authors: Fioravanti Elia
Published: September 2020

We show that, under weak assumptions, the automorphism group of a $\textrm{CAT(0)}$ cube complex $X$ coincides with the automorphism group of Hagen’s contact graph $\mathcal{C}(X)$. The result holds, in particular, for universal covers of Salvetti complexes, where it provides an analogue of Ivanov’s theorem on curve graphs of non-sporadic surfaces. This highlights a contrast between contact graphs and Kim–Koberda extension graphs, which have much larger automorphism group. We also study contact graphs associated with Davis complexes of right-angled Coxeter groups. We show that these contact graphs are less well behaved and describe exactly when they have more automorphisms than the universal cover of the Davis complex.
Uniform Property Γ
Authors: Castillejos Jorge , Evington Samuel , Tikuisis Aaron , White Stuart
Published: September 2020

We further examine the concept of uniform property $\Gamma $ for $C^*$-algebras introduced in our joint work with Winter. In addition to obtaining characterisations in the spirit of Dixmier’s work on central sequences in II$_1$ factors, we establish the equivalence of uniform property $\Gamma $, a suitable uniform version of McDuff’s property for $C^*$-algebras, and the existence of complemented partitions of unity for separable nuclear $C^*$-algebras with no finite dimensional representations and a compact (non-empty) tracial state space. As a consequence, for $C^*$-algebras as in the Toms–Winter conjecture, the combination of strict comparison and uniform property $\Gamma $ is equivalent to Jiang–Su stability. We also show how these ideas can be combined with those of Matui–Sato to streamline Winter’s classification by embeddings technique.
Deciding without data: clinical decision-making in pediatric orthopedic surgery
Authors: Nathan Karthik , Uzosike Maechi , Sanchez Uriel , Karius Alexander , Leyden Jacinta , Segovia Nicole , Eppler Sara , Hastings Katherine G , Kamal Robin , Frick Steven
Published: September 2020

Objective

Identifying when and how often decisions are made based on high-quality evidence can inform the development of evidence-based treatment plans and care pathways, which have been shown to improve quality of care and patient safety. Evidence to guide decision-making, national guidelines and clinical pathways for many conditions in pediatric orthopedic surgery are limited. This study investigated decision-making rationale and quantified the evidence supporting decisions made by pediatric orthopedic surgeons in an outpatient clinic.

Design/Setting/Participants/Intervention(s)/Main Outcome Measure(s)

We recorded decisions made by eight pediatric orthopedic surgeons in an outpatient clinic and the surgeon’s reported rationale behind the decisions. Surgeons categorized the rationale for each decision as one or a combination of 12 possibilities (e.g. ‘Experience/anecdote,’ ‘First principles,’ ‘Trained to do it,’ ‘Arbitrary/instinct,’ ‘General study,’ ‘Specific study’).

Results

Out of 1150 total decisions, the most frequent decisions were follow-up scheduling, followed by bracing prescription/removal. The most common decision rationales were ‘First principles’ (n = 310, 27.0%) and ‘Experience/anecdote’ (n = 253, 22.0%). Only 17.8% of decisions were attributed to scientific studies, with 7.3% based on studies specific to the decision. As high as 34.6% of surgical intervention decisions were based on scientific studies, while only 10.4% of follow-up scheduling decisions were made with studies in mind. Decision category was significantly associated with a basis in scientific studies: surgical intervention and medication prescription decisions were more likely to be based on scientific studies than all other decisions.

Conclusions

With increasing emphasis on high value, evidence-based care, understanding the rationale behind physician decision-making can educate physicians, identify common decisions without supporting evidence and help create clinical care pathways in pediatric orthopedic surgery. Decisions based on evidence or consensus between surgeons can inform pathways and national guidelines that minimize unwarranted variation in care and waste. Decision support tools and aids could also be implemented to guide these decisions.
In vitroassessment of CSA-131 and CSA-131 poloxamer form for the treatment ofStenotrophomonas maltophiliainfections in cystic fibrosis
Authors: Oyardi Özlem , Savage Paul B , Erturan Zayre , Bozkurt-Guzel Cagla
Published: September 2020

Background

Stenotrophomonas maltophilia is a Gram-negative bacterium resistant to several antibiotics and its prevalence in cystic fibrosis (CF) patients is increasing.

Objectives

To evaluate the effects of ceragenins, non-peptide mimics of antimicrobial peptides, against both planktonic and biofilm forms of S. maltophilia and the cytotoxicity of ceragenins to the IB3-1 CF cell line.

Methods

Ceragenin CSA-131, with and without 5% Pluronic® F127 (a non-ionic amphiphilic poloxamer), and ceragenin CSA-13 were evaluated against S. maltophilia clinical isolates (n = 40). MICs and MBCs of ceragenins and conventional antibiotics were determined. Time–kill curve experiments were performed with 1×, 2× and 4× MICs of ceragenins. The highest non-cytotoxic concentrations of ceragenins against IB3-1, a CF cell line, were determined by MTT assay. The effects of ceragenins against biofilm adhesion, formation and mature biofilms were investigated.

Results

CSA-131 with Pluronic® F127 displayed the lowest MICs (MIC50/MIC90: 1/2 mg/L) followed by CSA-131 (MIC50/MIC90: 2/4 mg/L), while those of CSA-13 were much higher (MIC50/MIC90: 16/32 mg/L). According to time–kill curve results, all concentrations at 4× MICs of ceragenins showed bactericidal activity (3 log reduction) after 4 h. While CSA-131 and CSA-131-poloxamer inhibited biofilm adhesion and formation by 87.74% and 83.42%, respectively, after 24 h, CSA-131 was more effective on mature biofilms. Formulating CSA-131 in poloxamer micelles did not affect the cytotoxicity of CSA-131 to IB3-1 cells.

Conclusions

CSA-131 could be a potential antimicrobial agent for the treatment of S. maltophilia infections in CF, due to its low cytotoxicity on the CF cell line and good antimicrobial and antibiofilm effects.
Online Turbulent Flow Extraction and Column Switching for the Confirmatory Analysis of Stimulants in Urine by Liquid Chromatography–Mass Spectrometry
Authors: De Wilde Laurie , Roels Kris , Van Eenoo Peter , Deventer Koen
Published: September 2020

Stimulants are often used to treat attention deficit disorders and nasal congestion. As they can be misused and overdosed, the detection of stimulants is relevant in the toxicological field as well as in the doping control field. The effects of stimulants can indeed be beneficial for athletes. Therefore, their in-competition use is prohibited by the World Anti-Doping Agency (WADA). As stimulants represent one of the most detected categories of prohibited substances, automation of methods to detect and confirm their presence is desirable. Previous work has shown the advantages of using turbulent flow online solid-phase extraction liquid chromatography–tandem mass spectrometry (online SPE LC–MS-MS) for the detection and confirmation of diuretics and masking agents. Hence, a turbulent flow online SPE LC–MS-MS method, compliant with the WADA’s identification criteria, was developed and validated for the detection and confirmation of 80 stimulants or metabolites with limits of identification varying between 10 (or possibly lower) and 100 ng/mL. As several metabolites are common metabolites for multiple administered stimulants, this means that with this method, misuse of well over 100 compounds can be detected. As the developed method uses the same columns and mobile phases as our turbulent flow online SPE LC–MS-MS method for the confirmation of diuretics and masking agents, there is no need to change the configuration of the instrument when switching between the diuretics method and the developed stimulants method.
The Bitome: digitized genomic features reveal fundamental genome organization
Authors: Lamoureux Cameron R , Choudhary Kumari Sonal , King Zachary A , Sandberg Troy E , Gao Ye , Sastry Anand V , Phaneuf Patrick V , Choe Donghui , Cho Byung-Kwan , Palsson Bernhard O
Published: September 2020

A genome contains the information underlying an organism's form and function. Yet, we lack formal framework to represent and study this information. Here, we introduce the Bitome, a matrix composed of binary digits (bits) representing the genomic positions of genomic features. We form a Bitome for the genome of Escherichia coli K-12 MG1655. We find that: (i) genomic features are encoded unevenly, both spatially and categorically; (ii) coding and intergenic features are recapitulated at high resolution; (iii) adaptive mutations are skewed towards genomic positions with fewer features; and (iv) the Bitome enhances prediction of adaptively mutated and essential genes. The Bitome is a formal representation of a genome and may be used to study its fundamental organizational properties.
DNAmoreDB, a database of DNAzymes
Authors: Ponce-Salvatierra Almudena , Boccaletto Pietro , Bujnicki Janusz M
Published: September 2020

Deoxyribozymes, DNA enzymes or simply DNAzymes are single-stranded oligo-deoxyribonucleotide molecules that, like proteins and ribozymes, possess the ability to perform catalysis. Although DNAzymes have not yet been found in living organisms, they have been isolated in the laboratory through in vitro selection. The selected DNAzyme sequences have the ability to catalyze a broad range of chemical reactions, utilizing DNA, RNA, peptides or small organic compounds as substrates. DNAmoreDB is a comprehensive database resource for DNAzymes that collects and organizes the following types of information: sequences, conditions of the selection procedure, catalyzed reactions, kinetic parameters, substrates, cofactors, structural information whenever available, and literature references. Currently, DNAmoreDB contains information about DNAzymes that catalyze 20 different reactions. We included a submission form for new data, a REST-based API system that allows users to retrieve the database contents in a machine-readable format, and keyword and BLASTN search features. The database is publicly available at https://www.genesilico.pl/DNAmoreDB/.
mMGE: a database for human metagenomic extrachromosomal mobile genetic elements
Authors: Lai Senying , Jia Longhao , Subramanian Balakrishnan , Pan Shaojun , Zhang Jinglong , Dong Yanqi , Chen Wei-Hua , Zhao Xing-Ming
Published: September 2020

Extrachromosomal mobile genetic elements (eMGEs), including phages and plasmids, that can move across different microbes, play important roles in genome evolution and shaping the structure of microbial communities. However, we still know very little about eMGEs, especially their abundances, distributions and putative functions in microbiomes. Thus, a comprehensive description of eMGEs is of great utility. Here we present mMGE, a comprehensive catalog of 517 251 non-redundant eMGEs, including 92 492 plasmids and 424 759 phages, derived from diverse body sites of 66 425 human metagenomic samples. About half the eMGEs could be further grouped into 70 074 clusters using relaxed criteria (referred as to eMGE clusters below). We provide extensive annotations of the identified eMGEs including sequence characteristics, taxonomy affiliation, gene contents and their prokaryotic hosts. We also calculate the prevalence, both within and across samples for each eMGE and eMGE cluster, enabling users to see putative associations of eMGEs with human phenotypes or their distribution preferences. All eMGE records can be browsed or queried in multiple ways, such as eMGE clusters, metagenomic samples and associated hosts. The mMGE is equipped with a user-friendly interface and a BLAST server, facilitating easy access/queries to all its contents easily. mMGE is freely available for academic use at: https://mgedb.comp-sysbio.org.
Hierarchy in materials for maximized efficiency
Authors: Chen Li-Hua , Li Yu , Su Bao-Lian
Published: September 2020

This perspective article gives the future research direction on the application of the generalized Murray's law for the design of porous hierarchy in materials and the establishment of a general materials design theory 'law of hierarchy' taking four types of hierarchy into account.