bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal changes in dialysate [Na+] prescription from 1996 to 2018 and their clinical significance as judged from a meta‐regression of clinical trials
Authors: Marshall Mark R. , Karaboyas Angelo
Published: July 2020

Over the last two decades, the clinical care of dialysis patients has refocused sharply on fluid volume control. Dialysate [Na+] is a key, albeit under‐investigated, clinical tool for manipulation of fluid volume on dialysis. In the article, we firstly use data from the Dialysis Outcomes and Practice Patterns Study to document the global decrease in dialysate [Na+] that has occurred from 1996 to 2018, and demonstrate the virtual disappearance of [Na+] profiling from routine dialysis practice over the same period. Second, we used data from previously synthesized randomized clinical trial evidence combined with that of a more recently published trail to assess the clinical significance of these changes, estimating the effects of different levels of low dialysate [Na+] on key clinical outcomes. Our analyses suggest that current levels of dialysate [Na+] in some health jurisdictions are possibly causing harm to many patients, especially given that real world populations are significantly less robust and more vulnerable than clinical trial ones. To quote a recent editorial, “more evidence needed before lower dialysate sodium concentrations can be recommended.” That evidence is coming, and no further changes should be made to default customary practice until it is available.
Understanding by Testimony: A Reply to Malfatti
Authors: Gilbertson Eric
Published: July 2020

Federica Malfatti criticizes recent arguments against the possibility of understanding transmission. While she offers no positive argument for the claim that understanding can be transmitted, she does defend a liberal conception of transmission that allows for the possibility of understanding transmission. In this article, I have three aims. First, I will show that there is a stronger version of one of the arguments against understanding transmission that Malfatti considers, which avoids her objection. This argument also fails, however, and the reason it fails suggests that if understanding cannot be transmitted this is not due to the nature of epistemic trust. Second, I will offer a positive argument for understanding transmission on Malfatti's behalf, and defend the view of understanding on which it depends. Finally, I will raise a further challenge to the proponent of understanding transmission. The upshot is that although Malfatti is right that we have no clear reason to exclude the possibility of understanding transmission – and, if I am right, we have positive reason to accept it – nevertheless a puzzle remains about such transmission.
Syncopal‐type reactions tend to be delayed and result in falls among elderly blood donors
Authors: Namba Noriko , Ishimaru Fumihiko , Kondo Gaku , Hashizume Tatsuma , Kunii Noriko , Shibata Reiko , Sawamura Yoshihiro , Kato Tsuneo
Published: July 2020

Background

Delayed syncopal‐type complications are infrequent among blood donors, but sometimes have critical consequences, such as severe injury. We retrospectively investigated the characteristics of donors with delayed syncopal‐type complications or falls.

Study design and methods

We defined a delayed reaction (DR) as syncopal‐type complications occurring >20 min after needle removal. Subjects were stratified by sex, age, estimated blood volume (EBV), body mass index (BMI) and frequency of donation. Multiple logistic regression analysis and propensity score weighted M estimation were performed to evaluate the covariate‐adjusted risk of syncopal DRs among donors giving 400 ml of whole blood (WB). The DR rate was calculated as the number of DRs divided by the number of all syncopal‐type reactions after needle removal. The risk of falls was assessed similarly. Donors who discontinued before completing phlebotomy (donation of 400 ml) were excluded.

Results

Among 3818 syncopal‐type reactions after needle removal, there were 359 DRs and 93 falls. Elderly donors and female donors with syncopal‐type reactions had a significantly higher risk of DRs (P for trend < 0·001). Elderly donors with syncopal‐type reactions also had a higher risk of falls (P for trend < 0·001). Among all donors with syncopal‐type reactions, the risk of DRs or falls was not correlated with EBV, BMI or donation frequency.

Conclusion

In female donors and elderly donors (donating 400 ml of WB), syncopal‐type reactions tended to be delayed. Elderly donors with syncopal‐type reactions had a significantly higher risk of falls.
Dynamic characteristics of cerebrovascular reactivity or ventilatory response to change in carbon dioxide
Authors: Ogoh Shigehiko , Shibata Shigeki , Ito Go , Miyamoto Tadayoshi
Published: July 2020

New Findings

What is the central question of this study?

What are the dynamic characteristics of cerebrovascular carbon dioxide reactivity and the central respiratory chemoreflex?

What is the main finding and its importance?

The transfer function gain from the end‐tidal partial pressure of carbon dioxide to cerebral blood flow or ventilation decreased in the high frequency range at rest and during exercise. These findings indicate that the dynamic characteristics of both systems were not constant in all frequency ranges, and this trend was not modified by exercise.

The purpose of this study was to examine the dynamic characteristics of cerebrovascular reactivity and ventilatory response to change in arterial CO2 in all frequency ranges at rest using frequency domain analysis, and also to examine whether this is modified by dynamic exercise as with the traditionally determined cerebrovascular CO2 reactivity. In nine healthy young subjects, at rest and during exercise (cycling exercise at constant predetermined work rate corresponding to a level of 0.90 l min−1), the dynamic characteristics of cerebrovascular CO2 reactivity and the central respiratory chemoreflex were assessed by transfer function analysis using a binary white‐noise sequence (0–7% inspired CO2 fraction) from the end‐tidal partial pressure of CO2 () to the mean middle cerebral artery mean blood velocity (MCA Vm) or minute ventilation (), respectively. In the high frequency range, both transfer function gains decreased but, interestingly, the cut‐off frequency in the transfer function gain from to MCA Vm response was higher than that from to response at rest (0.024 vs. 0.015 Hz) and during exercise (0.030 vs. 0.011 Hz), indicating that cerebrovascular CO2 reactivity or central respiratory chemoreflex was not constant in all frequency ranges, and this trend was not modified by exercise. These findings suggest that dynamic characteristics of the cerebrovascular CO2 reactivity or central chemoreflex need to be assessed to identify the whole system because the traditional method cannot identify the property of time response of these systems.
Overview of the 2018 Workshop on Iterative Errors in Unsteady Flow Simulations
Authors: Eça L. , Vaz G. , Hoekstra M. , Pal S. , Muller E. , Pelletier D. , Bertinetti A. , Difonzo R. , Savoldi L. , Zanino R. , Zappatore A. , Chen Y. , Maki K. J. , Ye H. , Drofelnik Jernej , Moss Benjamin , Da Ronch Andrea
Published: July 2020

Two workshops were held at the ASME V&V Symposiums of 2017 and 2018 dedicated to Iterative Errors in Unsteady Flow Simulations. The focus was on the effect of iterative errors on numerical simulations performed with implicit time integration, which require the solution of a nonlinear set of equations at each time-step. The main goal of these workshops was to create awareness to the problem and to confirm that different flow solvers exhibited the same trends. The test case was a simple two-dimensional, laminar flow of a single-phase, incompressible, Newtonian fluid around a circular cylinder at the Reynolds number of 100. A set of geometrically similar multiblock structured grids was available and boundary conditions to perform the simulations were proposed to the participants. Results from seven flow solvers were submitted, but not all of them followed exactly the proposed conditions. One set of results was obtained with adaptive grid and time refinement using triangular elements (CADYF) and another used a compressible flow solver with a dual time stepping technique and a Mach number of 0.2 (DLR-Tau). The remaining five submissions were obtained with five different incompressible flow solvers (ansyscfx 14.5, pimplefoam, refresco, saturne, starccm+ v12.06.010-R8) using implicit time integration in the proposed grids. The results obtained in this simple test case showed that iterative errors may have a significant impact on the numerical accuracy of unsteady flow simulations performed with implicit time integration. Iterative errors can be significantly larger (one to two orders of magnitude) than the residuals and/or solution changes used as convergence criteria at each time-step. The Courant number affected the magnitude of the iterative errors obtained in the proposed exercise. For the same iterative convergence criteria at each time-step, increasing the Courant number tends to increase the iterative error.
Structure-based design of prefusion-stabilized SARS-CoV-2 spikes
Authors: Hsieh Ching-Lin , Goldsmith Jory A. , Schaub Jeffrey M. , DiVenere Andrea M. , Kuo Hung-Che , Javanmardi Kamyab , Le Kevin C. , Wrapp Daniel , Lee Alison G. , Liu Yutong , Chou Chia-Wei , Byrne Patrick O. , Hjorth Christy K. , Johnson Nicole V. , Ludes-Meyers John , Nguyen Annalee W. , Park Juyeon , Wang Nianshuang , Amengor Dzifa , Lavinder Jason J. , Ippolito Gregory C. , Maynard Jennifer A. , Finkelstein Ilya J. , McLellan Jason S.
Published: July 2020

Stabilizing the prefusion SARS-CoV-2 spike

The development of therapeutic antibodies and vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is focused on the spike (S) protein that decorates the viral surface. A version of the spike ectodomain that includes two proline substitutions (S-2P) and stabilizes the prefusion conformation has been used to determine high-resolution structures. However, even S-2P is unstable and difficult to produce in mammalian cells. Hsieh
et al.
characterized many individual and combined structure-guided substitutions and identified a variant, named HexaPro, that retains the prefusion conformation but shows higher expression than S-2P and can also withstand heating and freezing. This version of the protein is likely to be useful in the development of vaccines and diagnostics.

Science
, this issue p.
1501
A Diverse Panel of Clinical Acinetobacter baumannii for Research and Development
Authors: Galac Madeline R. , Snesrud Erik , Lebreton Francois , Stam Jason , Julius Michael , Ong Ana C. , Maybank Rosslyn , Jones Anthony R. , Kwak Yoon I. , Hinkle Kate , Waterman Paige E. , Lesho Emil P. , Bennett Jason W. , Mc Gann Patrick
Published: July 2020

Over the past two decades,
Acinetobacter baumannii
has emerged as a leading cause of nosocomial infections worldwide. Of particular concern are panresistant strains, leading the World Health Organization (WHO) to designate carbapenem-resistant
A. baumannii
as a priority 1 (critical) pathogen for research and development of new antibiotics. A key component in supporting this effort is accessibility to diverse and clinically relevant strains for testing. Here, we describe a panel of 100 diverse
A. baumannii
strains for use in this endeavor.
Staphylococcus aureus Aggregates on Orthopedic Materials under Varying Levels of Shear Stress
Authors: Gupta Tripti Thapa , Gupta Niraj K. , Pestrak Matthew J. , Dusane Devendra H. , Harro Janette M. , Horswill Alexander R. , Stoodley Paul
Published: July 2020

Periprosthetic joint infection occurring after artificial joint replacement is a major clinical issue that require repeated surgeries and antibiotic interventions. Unfortunately, 26% of patients die within 5 years of developing these infections.
Staphylococcus aureus
is the bacterium most commonly responsible for this problem and can form biofilms to provide protection from antibiotics as well as the immune system. Although biofilms are evident on the infected implants, it is unclear how these are attached to the surface in the first place. Recent
in vitro
investigations have shown that staphylococcal strains rapidly form aggregates in the presence of synovial fluid and provide protection to bacteria, thus allowing them time to attach to the implant surface, leading to biofilm formation. In this study, we investigated the attachment kinetics of
Staphylococcus aureus
aggregates on different orthopedic materials. The information presented in this article will be useful in surgical management and implant design.
Veterinary Students Have a Higher Risk of Contracting Cryptosporidiosis when Calves with High Fecal
Cryptosporidium
Loads Are Used for Fetotomy Exercises
Authors: Thomas-Lopez Daniel , Müller Luise , Vestergaard Lasse S. , Christoffersen Mette , Andersen Anne-Marie , Jokelainen Pikka , Agerholm Jørgen Steen , Stensvold Christen Rune
Published: July 2020

Cryptosporidium
spp. can cause severe diarrhea in infected individuals.
Cryptosporidium parvum
is zoonotic, and cattle are the main reservoir. In several countries, outbreaks of cryptosporidiosis have occurred in veterinary students after handling calves. We carried out a 1-year-long prospective study to investigate the occurrence of these recurrent cryptosporidiosis outbreaks in Denmark. Our investigation used a One Health approach and combined comprehensive epidemiological approaches and laboratory methods applied to both students and calves in the setting of the fetotomy exercises. Two outbreaks took place during the study period; additionally, we retrospectively identified two more suspected outbreaks prior to the study period. The results illustrated a high risk of contracting cryptosporidiosis among veterinary students in the setting of the fetotomy exercises, especially when using calves with high fecal
Cryptosporidium
loads. Our data can be used to inform future efforts to prevent transmission of
Cryptosporidium parvum
to students during fetotomy exercises.
Critical Residues and Contacts within Domain IV of Autographa californica Multiple Nucleopolyhedrovirus GP64 Contribute to Its Refolding during Membrane Fusion
Authors: Yu Qianlong , Bai Lisha , Ji Ning , Yue Xiaorong , Jiang Yuanyuan , Li Zhaofei
Published: July 2020

Baculovirus GP64 is grouped with rhabdovirus G, herpesvirus gB, and thogotovirus glycoproteins as a class III viral fusion protein. In their postfusion structures, these proteins contain five domains (domains I to V). Distinct from domain IV of rhabdovirus G and herpesvirus gB proteins, which is composed of β-sheets, domain IV of GP64 is a loop region; the same domain in thogotovirus glycoproteins has not been solved. In addition, domain IV is proximal to domain I (fusion domain) in prefusion structures of vesicular stomatitis virus (VSV) G and human cytomegalovirus (HCMV) gB but resides at the domain I-distal end of the molecule in a postfusion conformation. In this study, we identified that highly conserved residues and contacts within domain IV of AcMNPV GP64 are necessary for low-pH-triggered conformational change and fusion pore expansion. Our results highlight the roles of domain IV of class III viral fusion proteins in refolding during membrane fusion.
Role of Escape Mutant-Specific T Cells in Suppression of HIV-1 Replication and Coevolution with HIV-1
Authors: Zhang Yu , Kuse Nozomi , Akahoshi Tomohiro , Chikata Takayuki , Gatanaga Hiroyuki , Oka Shinichi , Murakoshi Hayato , Takiguchi Masafumi
Published: July 2020

Escape mutant-specific CD8+T cells were elicited in some individuals infected with escape mutants, but it is still unknown whether these CD8+T cells can suppress HIV-1 replication. We clarified that Gag280V mutation were selected by HLA-B*52:01-restricted CD8+T cells specific for the GagRI8 protective epitope, whereas the Gag280V virus could frequently elicit GagRI8-6V mutant-specific CD8+T cells. GagRI8-6V mutant-specific T cells had a strong ability to suppress the replication of the Gag280V mutant virus bothin vitroandin vivo. In addition, these T cells contributed to the selection of wild-type virus in HLA-B*52:01+Japanese individuals. We for the first time demonstrated that escape mutant-specific CD8+T cells can suppress HIV-1 replication and play an important role in the coevolution with HIV-1. Thus, the present study highlighted an important role of escape mutant-specific T cells in the control of HIV-1 and coevolution with HIV-1.
Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies
Authors: Naghshi Sina , Sadeghi Omid , Willett Walter C , Esmaillzadeh Ahmad
Published: July 2020

Objective

To examine and quantify the potential dose-response relation between intake of total, animal, and plant protein and the risk of mortality from all causes, cardiovascular disease, and cancer.

Design

Systematic review and meta-analysis of prospective cohort studies.

Data sources

PubMed, Scopus, and ISI Web of Science until December 2019, and references of retrieved relevant articles.

Study selection

Prospective cohort studies that reported the risk estimates for all cause, cardiovascular, and cancer mortality in adults aged 18 or older.

Data synthesis

Random effects models were used to calculate pooled effect sizes and 95% confidence intervals for the highest versus lowest categories of protein intake and to incorporate variation between studies. Linear and non-linear dose-response analyses were done to evaluate the dose-response relations between protein intake and mortality.

Results

32 prospective cohort studies were included in the systematic review and 31 in the meta-analysis. During the follow-up period of 3.5 to 32 years, 113 039 deaths (16 429‬ from cardiovascular disease and 22 303‬ from cancer) occurred among 715 128 participants. Intake of total protein was associated with a lower risk of all cause mortality (pooled effect size 0.94, 95% confidence interval 0.89 to 0.99, I2=58.4%, P<0.001). Intake of plant protein was significantly associated with a lower risk of all cause mortality (pooled effect size 0.92, 95% confidence interval 0.87 to 0.97, I2=57.5%, P=0.003) and cardiovascular disease mortality (pooled hazard ratio 0.88, 95% confidence interval 0.80 to 0.96, I2=63.7%, P=0.001), but not with cancer mortality. Intake of total and animal protein was not significantly associated with risk of cardiovascular disease and cancer mortality. A dose-response analysis showed a significant inverse dose-response association between intake of plant protein and all cause mortality (P=0.05 for non-linearity). An additional 3% energy from plant proteins a day was associated with a 5% lower risk of death from all causes.

Conclusions

Higher intake of total protein was associated with a lower risk of all cause mortality, and intake of plant protein was associated with a lower risk of all cause and cardiovascular disease mortality. Replacement of foods high in animal protein with plant protein sources could be associated with longevity.
Hepatic fat is a stronger correlate of key clinical and molecular abnormalities than visceral and abdominal subcutaneous fat in youth
Authors: Cioffi Catherine E , Narayan K M Venkat , Liu Ken , Uppal Karan , Jones Dean P , Tran ViLinh , Yu Tianwei , Alvarez Jessica A , Bellissimo Moriah P , Maner-Smith Kristal M , Pierpoint Bridget , Caprio Sonia , Santoro Nicola , Vos Miriam B
Published: July 2020

Introduction

Body fat distribution is strongly associated with cardiometabolic disease (CMD), but the relative importance of hepatic fat as an underlying driver remains unclear. Here, we applied a systems biology approach to compare the clinical and molecular subnetworks that correlate with hepatic fat, visceral fat, and abdominal subcutaneous fat distribution.

Research design and methods

This was a cross-sectional sub-study of 283 children/adolescents (7–19 years) from the Yale Pediatric NAFLD Cohort. Untargeted, high-resolution metabolomics (HRM) was performed on plasma and combined with existing clinical variables including hepatic and abdominal fat measured by MRI. Integrative network analysis was coupled with pathway enrichment analysis and multivariable linear regression (MLR) to examine which metabolites and clinical variables associated with each fat depot.

Results

The data divided into four communities of correlated variables (|r|>0.15, p<0.05) after integrative network analysis. In the largest community, hepatic fat was associated with eight clinical biomarkers, including measures of insulin resistance and dyslipidemia, and 878 metabolite features that were enriched predominantly in amino acid (AA) and lipid pathways in pathway enrichment analysis (p<0.05). Key metabolites associated with hepatic fat included branched-chain AAs (valine and isoleucine/leucine), aromatic AAs (tyrosine and tryptophan), serine, glycine, alanine, and pyruvate, as well as several acylcarnitines and glycerophospholipids (all q<0.05 in MLR adjusted for covariates). The other communities detected in integrative network analysis consisted of abdominal visceral, superficial subcutaneous, and deep subcutaneous fats, but no clinical variables, fewer metabolite features (280, 312, and 74, respectively), and limited findings in pathway analysis.

Conclusions

These data-driven findings show a stronger association of hepatic fat with key CMD risk factors compared with abdominal fats. The molecular network identified using HRM that associated with hepatic fat provides insight into potential mechanisms underlying the hepatic fat–insulin resistance interface in youth.
Association between topical beta-blockers and risks of cardiovascular and respiratory disease in patients with glaucoma: a retrospective cohort study
Authors: Chen Hsin-Yi , Huang Wei-Cheng , Lin Cheng-Li , Kao Chia-Hung
Published: July 2020

Objective

To determine if topical beta-blocker use is associated with increased risks of cardiovascular and respiratory diseases in patients with glaucoma.

Setting

A retrospective cohort analysis was conducted using the database from Taiwan’s National Health Insurance programme.

Participants

In total, 12 336 newly diagnosed patients with glaucoma from January 2000 to December 2010 were included. The patients with glaucoma were subdivided into two cohorts according to whether they used topical beta-blockers or combination drugs (BBCDs).

Primary outcome measures

The study endpoints included pneumonia, acute respiratory failure, stroke and coronary artery disease (CAD). Univariable and multivariable Cox proportional hazards regression models were used to estimate HRs and 95% CIs for the endpoints of both cohorts.

Results

The BBCD cohort had a slightly higher risk of acute respiratory failure (adjusted HRs=1.16, 95% CI 1.00 to 1.34) and lower risk of CAD (aHR=0.93, 95% CI 0.87 to 0.99) than the non-BBCD cohort. Additionally, the risk of stroke was significantly higher in BBCD cohort than in the non-BBCD cohort (aHR=1.39, 95% CI 1.23 to 1.58), especially the ischaemic stroke (aHR=1.44, 95% CI 1.26 to 1.64; aHR=1.44, 98.75% CI 1.21 to 1.71). After considering the multiplicative interaction of age and sex, the BBCD cohort do not have higher risk of all outcomes than the non-BBCD cohort. Further time-dependent regression analysis revealed BBCD cohort had higher risk of acute respiratory failure (aHR=1.17, 95% CI 1.01 to 1.35) and ischaemic stroke (aHR=1.44, 95% CI 1.26 to 1.65) than non-BBCD cohort. However, after considering the multiplicative interaction of age and sex, the BBCD cohort had no significantly higher risk of all outcomes than the non-BBCD cohort.

Conclusion

Topical beta-blocker is not associated with increased risks of cardiovascular and respiratory diseases in patients with glaucoma.
Cohort profile: targeted antenatal screening for haemoglobinopathies in Basel
Authors: Amstad Bencaiova Gabriela , Geissler Franziska , Hoesli Irene
Published: July 2020

Purpose

The pregnancy cohort was established to examine the prevalence and variety of haemoglobinopathies in a high-risk group of pregnant women.

Participants

The pregnancy cohort is located in the Department of Obstetrics and Antenatal Care, University Hospital of Basel. The pregnant women were recruited in the first trimester between June 2015 and May 2019. Family origin questionnaires were used to screen pregnant women for the risk of a haemoglobin variant. Based on the questionnaire, pregnant women were divided into two groups: women with a high risk and women with a low risk of a haemoglobin variant. In women with a high risk, red blood cell indices, iron status and chromatography were conducted.

Findings to date

1785 pregnant women were recruited. Out of the 1785 women, 929 were identified as a part of the high-risk group. Due to the missing data of 74 pregnant women with a high risk, the final analysis was conducted in the remaining 855 women. The prevalence of haemoglobinopathies in the high-risk group was 14.5% (124/855).

Future plans

This cohort will be used to: (1) implement the screening in prenatal care in Basel; (2) recommend the screening among pregnant women with a high risk of a haemoglobin variant in Switzerland; (3) improve prenatal and neonatal care in patients with a haemoglobin variant; (4) examine adverse pregnancy outcomes in women with a haemoglobin variant and (5) reduce maternal and neonatal morbidity and mortality in the future.

Trial registration number

ClinicalTrials.gov Registry (NCT04029142).
A multicentre observational study on neonates exposed to SARS-CoV-2 in China: the Neo-SARS-CoV-2 Study protocol
Authors: Xiao Tiantian , Xia Shiwen , Zeng Linkong , Lin Guang , Wei Qiufen , Zhou Wei , Zhuang Deyi , Chen Xiao , Yi Bin , Li Long , Mi Hongying , Yin Zhaoqing , Cheng Xiuyong , Wang Laishuan , Hu Xiaojing , Zhou Wenhao
Published: July 2020

Introduction

An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China starting in December 2019. Yet the clinical features and long-term outcomes of neonates with SARS-CoV-2 exposure are lacking. The purpose of this study is to describe the clinical course and prognosis of the neonates exposed to SARS-CoV-2.

Methods and analysis

This is a multicentre observational study conducted at the designated children and maternal and child hospitals in the mainland of China. Neonates exposed to SARS-CoV-2 infection will be recruited. The data to be collected via case report forms include demographic details, clinical features, laboratory and imaging results, as well as outcomes. Primary outcomes are the mortality of neonates with COVID-19 and SARS-CoV-2 infection of neonates born to mothers with COVID-19. Secondary outcomes are the birth weight, premature delivery and neurological development of neonates exposed to SARS-CoV-2. The neurological development is assessed by the Chinese standardised Denver Developmental Screening Test at the corrected age of 6 months.

Ethics and dissemination

This study has been approved by the Children's Hospital of Fudan University ethics committee (No. (2020)31). The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences in order to improve the understanding of the clinical course among neonates exposed to SARS-CoV-2 and to provide evidence-based treatment and prevention strategies for this group.

Trial registration number

NCT04279899.
Impact of parallel processing of regional anesthesia with block rooms on resource utilization and clinical outcomes: a systematic review and meta-analysis
Authors: El-Boghdadly Kariem , Nair Ganeshkrishna , Pawa Amit , Onwochei Desire N.
Published: July 2020

Block rooms allow parallel processing of surgical patients with the purported benefits of improving resource utilization and patient outcomes. There is disparity in the literature supporting these suppositions. We aimed to synthesize the evidence base for parallel processing by conducting a systematic review and meta-analysis. A systematic search was undertaken of Medline, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Health Service (NHS) National Institute for Health Research Centre for Reviews and Dissemination database, and Google Scholar for terms relating to regional anesthesia and block rooms. The primary outcome was anesthesia-controlled time (ACT; time from entry of the patient into the operating room (OR) until the start of surgical prep plus surgical closure to exit of patient from the OR). Secondary outcomes of interest included other resource-utilization parameters such as turnover time (TOT; time between the exit of one patient from the OR and the entry of another), time spent in the postanesthesia care unit (PACU), OR throughput, and clinical outcomes such as pain scores, nausea and vomiting, and patient satisfaction. Fifteen studies were included involving 8888 patients, of which 3364 received care using a parallel processing model. Parallel processing reduced ACT by a mean difference (95% CI) of 10.4 min (16.3 to 4.5; p<0.0001), TOT by 16.1 min (27.4 to 4.8; p<0.0001) and PACU stay by 26.6 min (47.1 to 6.1; p=0.01) when compared with serial processing. Moreover, parallel processing increased daily OR throughout by 1.7 cases per day (p<0.0001). Clinical outcomes all favored parallel processing models. All studies showed moderate-to-critical levels of bias. Parallel processing in regional anesthesia appears to reduce the ACT, TOT, PACU time and improved OR throughput when compared with serial processing. PROSPERO CRD42018085184.
Development and preliminary validation of the Behçet’s syndrome Overall Damage Index (BODI)
Authors: Piga Matteo , Floris Alberto , Espinosa Gerard , Serpa Pinto Luísa , Kougkas Nikolaos , Lo Monaco Andrea , Lopalco Giuseppe , Orlando Ida , Pirani Vittorio , Santos Ernestina , Bertsias George , Cantarini Luca , Cauli Alberto , Cervera Ricard , Correia João , Govoni Marcello , Iannone Florenzo , Neri Piergiorgio , Martins Silva Ana , Vasconcelos Carlos , Muntoni Monica , Mathieu Alessandro
Published: July 2020

Objective

To develop and validate the evidence-based and consensus-based Behçet’s Syndrome Overall Damage Index (BODI).

Methods

Starting from 120 literature-retrieved preliminary items, the BODI underwent multiple Delphi rounds with an international multidisciplinary panel consisting of rheumatologists, internists, ophthalmologists, neurologists, and patient delegates until consensus was reached on the final content. The BODI was validated in a cross-sectional multicentre cohort of 228 patients with Behçet’s syndrome (BS) through the study of (a) correlation between BODI and Vasculitis Damage Index (VDI) and (b) correlation between BODI and disease activity measures (ie, Behçet’s Disease Current Activity Form (BDCAF), Physician Global Assessment (PGA), Patient Global Assessment (PtGA)), c) content and face validity and (d) feasibility.

Results

The final BODI consists of 4 overarching principles and 46 unweighted-items grouped into 9 organ domains. It showed good to excellent reliability, with a mean Cohen’s k of 0.84 (95% CI 0.78 to 0.90) and a mean intra-class correlation coefficient of 0.88 (95% CI 0.80 to 0.95). Overall, 128 (56.1%) patients had a BODI score ≥1, with a median score of 1.0 (range 0–14). The BODI significantly correlated with the VDI (r=0.693, p<0.001), demonstrating to effectively measure damage (construct validity), but had greater sensitivity in identifying major organ damage and did not correlate with disease activity measures (ie, BDCAF: p=0.807, PGA: p=0.820, PtGA: p=0.794) discriminating damage from the major confounding factor. The instrument was deemed credible (face validity), complete (content validity) and feasible by an independent group of clinicians.

Conclusions

Pending further validation, the BODI may be used to assess organ damage in patients with BS in the context of observational and controlled trials.
Differential regulation of TGFβ type-I receptor expressions in TGFβ1-induced myofibroblast differentiation
Authors: Gah Asma , Adil Mir S. , Sabbineni Harika , Verma Arti , Somanath Payaningal R.
Published: July 2020

Fibroblast-to-myofibroblast (FibroMF) differentiation is crucial for embryogenesis and organ fibrosis. Although transforming growth factor-β (TGFβ) is the primary mediator of FibroMF differentiation, the type-I receptor (TGFβRI) responsible for this has not yet been confirmed. In the current study, we investigated the ALK1 and ALK5 expressions in TGFβ1-stimulated NIH 3T3 fibroblasts to compare with the data from the Gene Expression Omnibus (GEO) repository. In our results, whereas TGFβ1 treatment promoted FibroMF differentiation accompanied by increased ALK5 expression and reduced ALK1 expression, TGFβ1-induced FibroMF differentiation and increased α-smooth muscle actin (αSMA) and ALK5 expression were inhibited by co-treatment with ALK5 inhibitor SB431542. GEO database analysis indicated increased ALK5 expression and reduced ALK1 expression in fibrotic compared to normal mouse or human tissues correlating with organ fibrosis progression. Finally, the inhibitors of Akt, mTOR, and β-catenin suppressed TGFβ1-induced ALK5 expression, indicating that the Akt pathway promotes FibroMF differentiation via ALK5 expression and fibrosis.
Born–Infeld black holes in 4D Einstein–Gauss–Bonnet gravity
Authors: Yang Ke , Gu Bao-Min , Wei Shao-Wen , Liu Yu-Xiao
Published: July 2020

A novel four-dimensional Einstein-Gauss-Bonnet gravity was formulated by Glavan and Lin (Phys. Rev. Lett. 124:081301, 2020), which is intended to bypass the Lovelock’s theorem and to yield a non-trivial contribution to the four-dimensional gravitational dynamics. However, the validity and consistency of this theory has been called into question recently. We study a static and spherically symmetric black hole charged by a Born–Infeld electric field in the novel four-dimensional Einstein–Gauss–Bonnet gravity. It is found that the black hole solution still suffers the singularity problem, since particles incident from infinity can reach the singularity. It is also demonstrated that the Born-Infeld charged black hole may be superior to the Maxwell charged black hole to be a charged extension of the Schwarzschild-AdS-like black hole in this new gravitational theory. Some basic thermodynamics of the black hole solution is also analyzed. Besides, we regain the black hole solution in the regularized four-dimensional Einstein–Gauss–Bonnet gravity proposed by Lü and Pang (arXiv:2003.11552).
Spiking Neural P Systems with Delay on Synapses
Authors: Song Xiaoxiao , Valencia-Cabrera Luis , Peng Hong , Wang Jun , Pérez-Jiménez Mario J.
Published: July 2020

Based on the feature and communication of neurons in animal neural systems, spiking neural P systems (SN P systems) were proposed as a kind of powerful computing model. Considering the length of axons and the information transmission speed on synapses, SN P systems with delay on synapses (SNP-DS systems) are proposed in this work. Unlike the traditional SN P systems, where all the postsynaptic neurons receive spikes at the same instant from their presynaptic neuron, the postsynaptic neurons in SNP-DS systems would receive spikes at different instants, depending on the delay time on the synapses connecting them. It is proved that the SNP-DS systems are universal as number generators. Two small universal SNP-DS systems, with standard or extended rules, are constructed to compute functions, using 56 and 36 neurons, respectively. Moreover, a simulator has been provided, in order to check the correctness of these two SNP-DS systems, thus providing an experimental validation of the universality of the systems designed.
Hedge Fund Performance in Japan
Authors: Kanuri Srinidhi
Published: July 2020

The decades of 1990s and 2000s in Japan are periods of economic stagnation and price deflation or the ‘lost 20’. Stock market has been anemic while the bond market has underperformed most developed markets. Hedge Funds (HFs) have played an extremely important role over the last two decades in Japan by forcing firms to increase distributions and making changes required to increase firm value. This paper looks at the performance of HFs in Japan using survivor bias free Eurkeahedge HF Index from January 2000 to September 2018 and compares them to Japanese stocks, bonds, and real estate. We find that HFs have significantly outperformed stocks and bonds but underperformed real estate. However, risk-adjusted performance (Sharpe, Sortino, and Omega Ratios) of HFs was much better compared to all other asset classes. HFs also had the smallest maximum drawdown, the shortest recovery period and have created the most wealth. HFs also had significantly positive alpha. Overall, results indicate that HFs in Japan have created lot of value compared to Japanese stocks and bonds.
Controlling the Rotor Angle Stability of Single Machine Infinite Bus System in the Presence of Wiener and Alpha-Stable Levy Type Power Fluctuations
Authors: Savacı F. Acar , Yılmaz Serpil
Published: July 2020

The integration of renewable energy sources into the power systems and the growth of electricity consumption leads to a considerable increase in the power fluctuations. In the first part of this study, the control of the rotor angle stability of single machine infinite bus system in the presence of Wiener type power fluctuations has been achieved by minimizing the corresponding stochastic sensitivity function. In the second part, the power fluctuations have been modeled by alpha-stable Levy processes and since stochastic sensitivity function is not available for alpha-stable Levy processes, then the control of the rotor angle stability has been numerically achieved by minimizing the corresponding rotor angle dispersion for the first time in the literature.
Network motif-based analysis of regulatory patterns in paralogous gene pairs
Authors: Melkus Gatis , Rucevskis Peteris , Celms Edgars , Čerāns Kārlis , Freivalds Karlis , Kikusts Paulis , Lace Lelde , Opmanis Mārtiņš , Rituma Darta , Viksna Juris
Published: July 2020

Current high-throughput experimental techniques make it feasible to infer gene regulatory interactions at the whole-genome level with reasonably good accuracy. Such experimentally inferred regulatory networks have become available for a number of simpler model organisms such as S. cerevisiae, and others. The availability of such networks provides an opportunity to compare gene regulatory processes at the whole genome level, and in particular, to assess similarity of regulatory interactions for homologous gene pairs either from the same or from different species.

We present here a new technique for analyzing the regulatory interaction neighborhoods of paralogous gene pairs. Our central focus is the analysis of S. cerevisiae gene interaction graphs, which are of particular interest due to the ancestral whole-genome duplication (WGD) that allows to distinguish between paralogous transcription factors that are traceable to this duplication event and other paralogues. Similar analysis is also applied to E. coli and C. elegans networks.

We compare paralogous gene pairs according to the presence and size of bi-fan arrays, classically associated in the literature with gene duplication, within other network motifs. We further extend this framework beyond transcription factor comparison to obtain topology-based similarity metrics based on the overlap of interaction neighborhoods applicable to most genes in a given organism.

We observe that our network divergence metrics show considerably larger similarity between paralogues, especially those traceable to WGD. This is the case for both yeast and C. elegans, but not for E. coli regulatory network. While there is no obvious cross-species link between metrics, different classes of paralogues show notable differences in interaction overlap, with traceable duplications tending toward higher overlap compared to genes with shared protein families. Our findings indicate that divergence in paralogous interaction networks reflects a shared genetic origin, and that our approach may be useful for investigating structural similarity in the interaction networks of paralogous genes.
Danger-Aware Adaptive Composition of DRL Agents for Self-Navigation
Authors: Zhang Wei , Zhang Yunfeng , Liu Ning
Published: July 2020

Self-navigation, referred as the capability of automatically reaching the goal while avoiding collisions with obstacles, is a fundamental skill required for mobile robots. Recently, deep reinforcement learning (DRL) has shown great potential in the development of robot navigation algorithms. However, it is still difficult to train the robot to learn goal-reaching and obstacle-avoidance skills simultaneously. On the other hand, although many DRL-based obstacle-avoidance algorithms are proposed, few of them are reused for more complex navigation tasks. In this paper, a novel danger-aware adaptive composition (DAAC) framework is proposed to combine two individually DRL-trained agents, obstacle-avoidance and goal-reaching, to construct a navigation agent without any redesigning and retraining. The key to this adaptive composition approach is that the value function outputted by the obstacle-avoidance agent serves as an indicator for evaluating the risk level of the current situation, which in turn determines the contribution of these two agents for the next move. Simulation and real-world testing results show that the composed Navigation network can control the robot to accomplish difficult navigation tasks, e.g. reaching a series of successive goals in an unknown and complex environment safely and quickly.
Between Fear and Hope: Belt and Road Initiative in Southeast Asia
Authors: Pamungkas Cahyo , Hakam Saiful , Indriasari Devi Tri
Published: July 2020

This paper aims to describe the reason of China to change its governance of investment mainly the Belt and Road Initiative (BRI) in Southeast Asia. Although many countries in this region need huge investment to improve and build their infrastructure as well as infrastructure’s connectivity between countries, there is some fear involving China’s investment in the past. These are unintended consequences of China’s investment on environmental, social, and debt-trap in certain poor countries. Nevertheless, there is still hope for better Chinese investment such as consideration of local people’s aspirations and more transparency. At the regional level, the BRI can synergize with local connectivity initiatives, such as the Master Plan on ASEAN Connectivity (MPAC) and Indonesia’s Global Maritime Fulcrum, and encourage the integration of the ASEAN Economic Community. Different from the previous studies, this paper also uses the historical approach by learning the relation between China and Southeast Asian countries in the past. Our argument is Southeast Asian countries do not need to fear Chinese economic expansions based on history that China is not a political threat in the region. However, China should change the governance of BRI to accommodate the interest of people in Southeast Asian countries.
Critically stressed fractures: analysis of the Shaikan Field, Kurdistan Region of Iraq
Authors: Gilchrist Callum J. D. , Cosgrove John W. , Parmassar Kevin J.
Published: July 2020

The Shaikan Field is a large producing oil field in the Kurdistan region of Iraq. It consists of multiple fractured reservoirs consisting of limestones, calcareous sandstones and mudstones. The surrounding tectonic terrane is situated in the seismically active Zagros–Taurus orogenic zone, where present-day stresses are high. The regional stresses are found to impose conditions that satisfy failure along reservoir-bound fractures, suggesting that a significant proportion of fractures are likely to be critically stressed. The
in situ
maximum principal stress magnitudes are estimated using three methods, namely, the tensile and compressive strengths of reservoir rock, and leak-off test (LOT) data. Stress-field orientations are determined from wellbore image log data, which are used to interpret wellbore breakouts and the associated induced tensile fractures. Reservoir pressure has declined since production started and poroelastic responses have been assessed and used to estimate the present-day stress-state and the criticality of those fractures that are most likely to fail or slip. Although a conventional approach has been used the present authors argue that a new approach to stress response with changing pore pressure should be taken. Unlike the previous theory of criticality in which a reduction in pore pressure is considered to lead to a stabilization of the fracture network, the present study suggests that a system may remain critically stressed regardless of pressure decline.

Thematic collection:
This article is part of the The Geology of Fractured Reservoirs collection available at:
https://www.lyellcollection.org/cc/the-geology-of-fractured-reservoirs
Internationalizing Teacher Education through Virtual Connections and Blended Learning
Authors: Risner Mary E. , Kumar Swapna
Published: July 2020

This project used blended learning and virtual connections to infuse global perspectives in U.S. curriculum by preparing pre-service teachers with intercultural competence, understanding of global issues from diverse viewpoints, and the ability to use online technologies to develop critical thinking and digital literacy. Global themes were addressed in online synchronous sessions with teachers in other countries and purposefully combined with pre-readings and online and classroom discussions.
Review—Meta-Review of Fire Safety of Lithium-Ion Batteries: Industry Challenges and Research Contributions
Authors: Bravo Diaz Laura , He Xuanze , Hu Zhenwen , Restuccia Francesco , Marinescu Monica , Barreras Jorge Varela , Patel Yatish , Offer Gregory , Rein Guillermo
Published: July 2020

The Lithium-ion battery (LIB) is an important technology for the present and future of energy storage, transport, and consumer electronics. However, many LIB types display a tendency to ignite or release gases. Although statistically rare, LIB fires pose hazards which are significantly different to other fire hazards in terms of initiation route, rate of spread, duration, toxicity, and suppression. For the first time, this paper collects and analyses the safety challenges faced by LIB industries across sectors, and compares them to the research contributions found in all the review papers in the field. The comparison identifies knowledge gaps and opportunities going forward. Industry and research efforts agree on the importance of understanding thermal runaway at the component and cell scales, and on the importance of developing prevention technologies. But much less research attention has been given to safety at the module and pack scales, or to other fire protection layers, such as compartmentation, detection or suppression. In order to close the gaps found and accelerate the arrival of new LIB safety solutions, we recommend closer collaborations between the battery and fire safety communities, which, supported by the major industries, could drive improvements, integration and harmonization of LIB safety across sectors.
The effect of dietary nitrate supplementation on the speed-duration relationship in mice with sickle cell disease
Authors: Ferguson Scott K. , Redinius Katherine M. , Harral Julie W. , Pak David I. , Swindle Delaney C. , Hirai Daniel M. , Blackwell Jamie R. , Jones Andrew M. , Stenmark Kurt R. , Buehler Paul W. , Irwin David C.
Published: July 2020

Sickle cell disease compromises muscle O2delivery resulting in exercise intolerance. Dietary nitrate supplementation increases skeletal muscle blood flow during exercise and may improve exercise capacity in a mouse model of sickle cell disease. We investigated the effects of dietary nitrate supplementation on exercise tolerance in a mouse model of sickle cell disease using the treadmill speed-duration relationship (critical speed). Mice with sickle cell disease provided with a dietary nitrate supplement had a critical speed not significantly different from healthy wild-type mice.