bluuebunny/crossref_metadata_2025 huggingface dataset:
Warming mediates the resistance of aquatic bacteria to invasion during community coalescence
Authors: Vass Máté , Székely Anna J. , Lindström Eva S. , Osman Omneya A. , Langenheder Silke
Published: January 2021

The immigration history of communities can profoundly affect community composition. For instance, early‐arriving species can have a lasting effect on community structure by reducing the invasion success of late‐arriving ones through priority effects. This can be particularly important when early‐arriving communities coalesce with another community during dispersal (mixing) events. However, the outcome of such community coalescence is unknown as we lack knowledge on how different factors influence the persistence of early‐arriving communities and the invasion success of late‐arriving taxa. Therefore, we implemented a full‐factorial experiment with aquatic bacteria where temperature and dispersal rate of a better adapted community were manipulated to test their joint effects on the resistance of early‐arriving communities to invasion, both at community and population level. Our 16S rRNA gene sequencing‐based results showed that invasion success of better adapted late‐arriving bacteria equaled or even exceeded what we expected based on the dispersal ratios of the recipient and invading communities suggesting limited priority effects on the community level. Patterns detected at the population level, however, showed that resistance of aquatic bacteria to invasion might be strengthened by warming as higher temperatures (a) increased the sum of relative abundances of persistent bacteria in the recipient communities, and (b) restricted the total relative abundance of successfully established late‐arriving bacteria. Warming‐enhanced resistance, however, was not always found and its strengths differed between recipient communities and dispersal rates. Nevertheless, our findings highlight the potential role of warming in mitigating the effects of invasion at the population level.
Central nervous system demyelinating diseases in Hong Kong
Authors: Li Richard , Cheng Stephen Wing Ho , Chan Koon Ho , Lau Alexander Yuk‐Lun , Shiu Ka Lock , Cheng Wing Keung , Wu Shun Ping , Fung Lai Wah Eva , Ho Alvin Chi Chung , Liu Kam Tim , Cherk Sharon Wan Wah , Yung Ada Wing Yan , Lau Kwok Kwong , Tsoi Tak Hong , Li Patrick Chung Ki , Wong Winnie Wing Yin
Published: January 2021

Objective

To give an overview and update on central nervous system inflammatory demyelinating diseases in Hong Kong.

Findings

Using retrospective analysis of records from the Multiple Sclerosis (MS) Specialist Panel, the prevalence of MS in Hong Kong was estimated to be 6.9 per 100,000, while the annual incidence were 0.86 (SD = 0.135, 95% CI = 0.76 to 0.96) and 0.16 (SD = 0.11, 95% CI = 0.08‐0.23) per 100,000 for adult and pediatric populations, respectively. Preliminary data from the Hong Kong MS Society's NMOSD (neuromyelitis optica spectrum disorders) Registry showed that the local prevalence of NMOSD was 3.3 per 100 000, with a seropositivity rate of 80%. MS and NMOSD both had a female preponderance, and MS had younger disease onset age. NMOSD patients had more long‐term disability in terms of EDSS (expanded disability status scale) but MS patients had more cognitive impairment. Radiological features that discriminated MS and NMOSD were similar to other populations, and brain atrophy was observed in both diseases. The number of available treatment options for MS in Hong Kong has greatly increased in the past decade, including injectables, oral disease‐modifying agents, and immune‐reconstitution therapies. For NMOSD, corticosteroids and oral immunosuppressants were the mainstay of treatment.

The updated prevalence of MS and NMOSD in Hong Kong was higher than previously reported, and comparable with other Asian countries. The clinical, laboratory and imaging features of MS and NMOSD in Hong Kong were similar to those in neighboring regions.
Retrospective assessment of the availability of routine data related to the Amyotrophic Lateral Sclerosis Functional Rating Scale‐Revised in the electronic medical records of a university hospital
Authors: Nishikawa Yoko , Narita Yugo , Fukuroku Keiko , Shindo Akihiro , Taniguchi Akira , Tomimoto Hidekazu
Published: January 2021

Background

Nurses routinely access and use electronic medical record (EMR) systems. Suitable multidisciplinary care should be provided to each patient with amyotrophic lateral sclerosis (ALS). The Amyotrophic Lateral Sclerosis Functional Rating Scale‐Revised (ALSFRS‐R) has been used for patient assessments in clinical trials or healthcare evaluations.

Aim

Here, we aimed to retrospectively determine how efficiently ALSFRS‐R‐related data of clinically confirmed ALS patients were routinely recorded, especially by nurses, and how easily the data could be retrieved.

Methods

A quantitative and descriptive method was adopted for analyzing EMR admission records from April 2011 to March 2017. All the EMRs from the period were searched to retrieve ALSFRS‐R‐related data and relevant records. In cases that were difficult to categorize, the most appropriate level among neighboring levels was operatively assigned. We also attempted to assess how easily data could be retrieved based on the number of screen transitions.

Results

In total, 105 admission datasets (71 patients) were eligible. Fifty admissions with explicit ALSFRS‐R‐related data, 21 with translatable records, and 32 with ALSFRS‐R items in documents maintained for the government were retrieved. Two admission datasets contained no ALSFRS‐R‐related clues. No descriptions were identified as ALSFRS‐R items within the nursing records. Physicians recorded data mainly in the shallow levels of EMRs. Nurses recorded translatable data in both shallow and deep levels for 3 items: speech, swallowing, and dyspnea.

Conclusion

This study has shown that routine descriptions in the EMR system recorded by nurses were insufficient in terms of the amount, quality, and accessibility of ALSFRS‐R‐related information.
Infection control in the respiratory care of coronavirus disease‐19 patients with neuromuscular diseases
Authors: Matsumura Tsuyoshi , Saito Toshio , Mori Masahide , Kishida Miki , Tamagaki Kengo , Yoshida Yoshiaki , Ishikawa Yuka , Komai Kiyonobu , Goto Kazuya , Komori Tetsuo
Published: January 2021

Close contact is unavoidable in the care of patients with neuromuscular diseases (NMD). In addition, respiratory physiotherapy and noninvasive ventilation generate massive amounts of aerosols. Caring for a patient suffering from coronavirus disease‐19 raises concerns about the risk of infection not only to the caregiver and/or medical staff but also to other individuals in contact with these personnel. We reviewed the points to be noted in infection control when a patient with neuromuscular diseases receiving respiratory care is infected with COVID‐19 and summarizes the recommendation. Infected patients must be isolated in a negative‐pressure or actively ventilated room. Clear zoning separating clean and infected areas should be performed for pathogen containment. Caregivers should wear appropriate personal protective equipment and thoroughly clean their hands. Leak‐prevention measures and the use of proper respiratory circuits and filters with virus‐removal performance are crucial to reducing aerosols in noninvasive ventilation. Although respiratory physiotherapy is essential, treatment should be minimized in consideration of the infection state and sputum status, and alternative therapies such as postural drainage should be carefully considered. Infection control is distinctly obligate; however, it impairs the quality of life and activity of daily living significantly. We should implement it with enough ethical consideration, adequate explanation, and patient consent. We hope that this paper will contribute to appropriate COVID‐19 infection control in patients with neuromuscular diseases requiring respiratory care.
Percutaneous VDD leadless pacer implant post recent bioprosthetic tricuspid valve replacement for infective endocarditis
Authors: del Corral Maria Pia , Covas Pedro , Tracy Cynthia , Mercader Marco , Solomon Allen
Published: January 2021

In January 2020, the first Medtronic VDD leadless pacemaker Micra AV was approved by FDA to treat patients with advanced AV block, based on the encouraging results from the Micra Atrial tRacking using a Ventricular accELerometer 2 (MARVEL 2). There is reassuring data about safety and short‐term outcomes of traditional leadless pacemaker implant after recent surgical tricuspid valve replacement, but only few cases are reported in literature. No data was found regarding AV Micra implant safety and outcomes in patients following bioprosthetic tricuspid valve replacement as of today. Our patient is a 44‐year‐old gentleman with history of IV drug use who recently underwent tricuspid replacement with bioprosthesis for infective endocarditis complicated by postsurgical heart block, acute kidney insufficiency requiring hemodialysis, persistent bacteremia and candidemia, and progressive failure of the epicardial pacing wires. Given the elevated infective risk, the decision of attempting leadless pacer implant through the bioprosthetic valve was taken and our patient underwent successful Micra AV implant on postoperative day 30. To our knowledge, this is the first AV Micra placement following bioprosthetic tricuspid valve replacement. The uneventful procedure and the encouraging short‐term device follow‐up results seem to confirm the relative safety of this device in treating advanced atrioventricular conduction disorders in patients at elevated infective risk.
Metabolic engineering of rice endosperm towards higher vitamin B1 accumulation
Authors: Strobbe Simon , Verstraete Jana , Stove Christophe , Van Der Straeten Dominique
Published: January 2021

Rice is a major food crop to approximately half of the human population. Unfortunately, the starchy endosperm, which is the remaining portion of the seed after polishing, contains limited amounts of micronutrients. Here, it is shown that this is particularly the case for thiamin (vitamin B1). Therefore, a tissue‐specific metabolic engineering approach was conducted, aimed at enhancing the level of thiamin specifically in the endosperm. To achieve this, three major thiamin biosynthesis genes, THIC, THI1 and TH1, controlled by strong endosperm‐specific promoters, were employed to obtain engineered rice lines. The metabolic engineering approaches included ectopic expression of THIC alone, in combination with THI1 (bigenic) or combined with both THI1 and TH1 (trigenic). Determination of thiamin and thiamin biosynthesis intermediates reveals the impact of the engineering approaches on endosperm thiamin biosynthesis. The results show an increase of thiamin in polished rice up to threefold compared to WT, and stable upon cooking. These findings confirm the potential of metabolic engineering to enhance de novo thiamin biosynthesis in rice endosperm tissue and aid in steering future biofortification endeavours.
Myron Gordon Award paper: Microbes, T‐cell diversity and pigmentation
Authors: Le Poole I. Caroline
Published: January 2021

Melanocytes are static, minimally proliferative cells. This leaves them vulnerable in vitiligo. Yet upon malignant transformation, they form vicious tumors. This profound switch in physiology is accompanied by genetic change and is driven by environmental factors. If UV exposure in younger years supports malignant transformation and melanoma formation, it can likewise impart mutations on melanocytes that reduce their viability, to initiate vitiligo. A wide variety of microbes can influence these diametrically opposed outcomes before either disease takes hold. These microbes are vehicles of change that we are only beginning to study. Once a genetic modification occurs, there is a wide variety of immune cells ready to respond. Though it does not act alone, the T cell is among the most decisive responders in this process. The same biochemical process that offered the skin protection by producing melanin can become an Achilles heel for the cell when the T cells target melanosomal enzymes or, on occasion, neoantigens. T cells are precise, determined, and consequential when they strike. Here, we probe the relationship between the microbiome and its metabolites, epithelial integrity, and the activation of T cells that target benign and malignant melanocytes in vitiligo and melanoma.
Early kidney injury in immunoglobulin A vasculitis: Role of renal biomarkers
Authors: Türe Esra , Yazar Abdullah , Akın Fatih , Topcu Cemile , Aydın Arif , Balasar Mehmet , Ataş Bülent
Published: January 2021

Background

We aimed to determine whether urine kidney injury molecule 1 (KIM‐1) and neutrophil gelatinase‐associated lipocalin (NGAL) can be used as early noninvasive biomarkers of kidney injury in immunoglobulin A vasculitis.

Methods

Patients who were diagnosed with immunoglobulin A vasculitis were included in the study. Urine samples were collected for determination of urine KIM‐1 and NGAL levels. The control group consisted of age‐matched healthy children.

Results

Sixty‐one patients who were diagnosed with immunoglobulin A vasculitis were included in the study; 37.7% of these patients were determined to have renal involvement. Median KIM‐1 was found to be significantly higher in the patient group (69.59 pg/mL) than the control group (40.84 pg/mL) (P = 0.001). Median NGAL was determined to be statistically significantly higher in the patient group (59.87 ng/mL) compared with the control group (44.87 ng/mL) (P = 0.013). In 23.6% of the patients without renal involvement at admission renal involvement developed within the following 6 months. When median KIM‐1 and NGAL at admission of these patients were compared with the control group, they were determined to be statistically significantly higher (P = 0.001, P = 0.003).

Conclusions

The fact that our patients with late‐term nephropathy had no hematuria and / or proteinuria and that KIM‐1 and NGAL levels were determined to be high indicates that these biomarkers might be potentially reliable, noninvasive and early determinants of kidney injury.
Is ultraviolet radiation avoidance affecting bone health in melanoma patients?
Authors: Gariazzo Lodovica , Gasparini Giulia , Casabella Andrea , Carmisciano Luca , Clapasson Andrea , Murgioni Franca , Molfetta Luigi , Cozzani Emanuele , Parodi Aurora
Published: January 2021

Background

Ultraviolet (UV) radiation has numerous beneficial effects on human health, including stimulating vitamin D and serotonin production and immuno‐regulatory activities. Conversely, UV radiation is also classified as a group one carcinogen by the International Agency for Research on Cancer.

Purpose

To investigated the effects of UV radiation avoidance in melanoma patients in terms of vitamin D levels but also of bone mineral density and trabecular bone microarchitecture.

Methods

We conducted an observational study investigating the effects of UV radiation avoidance in 31 melanoma patients in terms of vitamin D levels but also of bone mineral density and trabecular bone microarchitecture by using dual‐energy X‐ray absorptiometry scan. Data were compared with two control groups of healthy subjects, who were chronically exposed or not exposed to UV radiation during their lifetime.

Results

Melanoma patients had on average slightly lower levels of vitamin D, without reaching statistical significance (P = .135). No significant difference was found across the three groups on T‐scores of femoral neck (P = .544), of total hip (P = .617) and of lumbar spineP = .155). No significant difference was found on and trabecular bone score across exposure groups (P = .895).

Conclusion

UV radiation avoidance does not seem to significantly impact vitamin D levels nor bone health in melanoma patients. Thus, UV protective behavior is advisable for all melanoma patients.
The HD‐Zip I transcription factor MdHB7‐like confers tolerance to salinity in transgenic apple (Malus domestica)
Authors: Zhao Shuang , Wang Haibo , Jia Xumei , Gao Hanbing , Mao Ke , Ma Fengwang
Published: January 2021

Salinity is a major environmental constraint that substantially limits global agricultural productivity. HD‐Zip I transcription factors are involved in plant responses to salt stress, but little is known about the HD‐Zip I genes in apple (Malus domestica). Here, we characterized the function of an apple HD‐Zip I gene (MdHB7‐like) and report that its expression is induced by salt stress. To further explore its role in salt stress, we created MdHB7‐like overexpressing and RNAi transgenic apple plants. The overexpression of MdHB7‐like improved the photosynthetic performance and reduced ROS and Na+ accumulation under salt stress. Plants that overexpressed MdHB7‐like also showed increased accumulation of proline and soluble sugars, which may have played an important role in their salt stress tolerance. RNAi suppression of MdHB7‐like had the opposite effects. Together, our results demonstrate that MdHB7‐like is an important regulator of salt tolerance in apple. Our results provide new insights for future research on the mechanisms by which MdHB7‐like promotes salt tolerance and provide a potential target for molecular breeding in apple.
Public Service in the Pandemic Era: A COVID Commentary
Authors: Stivers Camilla
Published: January 2021

This viewpoint reflects on basic aspects of American public health and politics that are making the COVID crisis response less effective than it might be. The performance of public service during a crisis depends as much on self‐reflectiveness and hope as on the achievement of measurable results. Anthony Fauci is offered as an exemplar of authentic public service, understood as “living within the truth.”
When Illusion Met Illusion: How Interacting Biases Affect (Dis)trust within Coopetitive Policy Networks
Authors: Lee Junesoo
Published: January 2021

Coopetition is a universal relationship in policy networks where various organizations cooperate and also compete with one another. Dealing with the ambivalent relationships in policy networks, organizations in the network need to assess their internal and external environments. However, such assessments are usually inclined to be biased for various reasons. The question is “If multiple organizations’ assessment biases interact with one another, what happens to mutual trust or distrust?” This study explores the patterns and impact of interactions of assessment biases using surveys and interviews administered to nuclear‐related public institutions in South Korea. The findings imply that the interactions of individual biases impact trust and distrust differently according to diverse dimensions of bias, including power, cooperation, competition, and contribution in policy networks. What determines trust or distrust among network members may not only be whether biases exist but also how biases of network members are combined and matched.
Ecosystem restoration: challenges and opportunities for India
Authors: Singh Kripal , Singh Rana Pratap , Tewari Shri Krishna
Published: January 2021

Ninety‐six million hectares of degraded land, unprecedented loss of biodiversity, and extreme climatic events are the key ecological challenges for India. Offering livelihood opportunities to millions of workers who migrated to their villages and recovery from economic crisis due to covid‐19 pandemic have emerged as the biggest socio‐economic challenges for the country. A framework of different policies and strategies are in place to overcome these ecological and socio‐economic challenges. But they are loosely interconnected with independent aims and involvement of different governments' institutions and departments. This article, therefore, here briefs challenges and shows how aiming at ecosystem restoration and biodiversity conservation through these policies can provide a cost‐effective, efficient, and sustainable way for India to overcome its ecological and socio‐economic challenges.
The magmatic–hydrothermal evolution of the San Pedro porphyry Cu‐(Mo) deposit: Implications for the metallogenesis of the Permian magmatism in the western margin of Gondwana
Authors: Gómez Anabel Lina Rosina , Ulrich Thomas , Rubinstein Nora Alicia
Published: January 2021

The San Pedro porphyry Cu‐(Mo) deposit, located in the San Rafael Massif (Argentina), is characterized by multiple stockwork vein generations developed in a subvolcanic intrusion with porphyry‐type alteration and mineralization, as well as associated polymetallic veins. Previous works reveal that the intrusive rocks related to the San Pedro porphyry (263 Ma) show comparable trace element signatures to giant porphyry deposits elsewhere (i.e., high Sr/Y and low Y). The fluid inclusions investigated in this study show that typical early, high‐temperature magmatic fluids (up to 685°C; 81.3 wt% equiv. NaCl) evolved to lower‐temperature, moderately saline fluids (up to 454°C; 52.4 wt% equiv. NaCl) due to fluid–rock interaction. The waning stage of the system is characterized by secondary, aqueous inclusions that represent dilution by meteoric fluids (up to 390°C, 16.9 wt% equiv. NaCl). Fluid inclusions were studied from two veinlet generations (A and B veinlets) related to potassic alteration and analyzed by LA‐ICP‐MS. The trace element signatures in the fluid inclusions suggest that there were two pulses of magmatic fluids that subsequently evolved under similar physicochemical conditions. The Cu concentration in the earliest fluid is between 0.3 and 0.85 wt% and within the concentrations found in other mineralized porphyry systems in the world. However, in contrast to economic porphyry systems, where a significant change in Cu concentration during fluid evolution is observed, there is no distinct change in the fluid Cu concentration at the San Pedro deposit, which would indicate that Cu and Mo precipitation was ineffective in the hydrothermal system.
Citizens’ preferences for taxation of internationally mobile corporations: Evidence from Tanzania
Authors: Kolstad Ivar , Wiig Arne , Fjeldstad Odd‐Helge
Published: January 2021

The legitimacy of the tax system is likely to be compromised in the absence of public support. This article presents evidence from a discrete choice experiment designed to elicit the tax preferences of ordinary citizens on how corporations should be taxed. We find that respondents prefer higher taxes on more internationally mobile companies, which is inconsistent with the prescriptions of optimal tax theory. Moreover, it is at odds with the tax policy in many countries, which may reduce political support for taxation among citizens. The experiment was conducted in Tanzania, making this result all the more striking as developing countries are particularly sensitive to location decisions of corporations. We also find that citizens favor higher taxes on foreign‐owned companies compared to domestic ones and lower taxes on companies that have more local employees.
An invariant for colored bonded knots
Authors: Gabrovšek Boštjan
Published: January 2021

We equip a knot K with a set of colored bonds, that is, colored intervals properly embedded into . Such a construction can be viewed as a structure that topologically models a closed protein chain including any type of bridges connecting the backbone residues. We introduce an invariant of such colored bonded knots that respects the HOMFLYPT relation, namely, the HOMFLYPT skein module of colored bonded knots. We show that the rigid version of the module is freely generated by colored Θ‐curves and handcuff links, while the nonrigid version is freely generated by the trivially embedded Θ‐curve. The latter module, however, does not provide information about the knottedness of the bonds.
Aortic dilatation: Value of echocardiography in the systematic assessment of elite rugby players in the French National Rugby League (LNR)
Authors: Chevalier Laurent , Corneloup Luc , Carré Francois , Mignot Aude , Jaussaud Jérémie , Gencel Laurent , Clement‐Guinaudeau Stephanie , Pospiech Thomas
Published: January 2021

The value of echocardiography in the screening of athletes in addition to the electrocardiogram is debated and still unclear. 336 rugby players in French professional divisions (Top 14, Pro D2) were prospectively assessed with electrocardiogram and echocardiography. 75% were Caucasian, 16.4% Pacific Islanders, and 8.6% Afro‐Caribbean. Six (1.8%) players had electrocardiogram abnormalities, exclusively negative T waves. Twenty‐one (6.25%) of them had abnormal echocardiography findings: one possible early hypertrophic cardiomyopathy, one anomalous origin of coronary artery, two left ventricular dilatations, one isolated bicuspid aortic valve, two aortic regurgitations, and 14 ascending aortic dilatations. The median aortic diameter was modestly correlated with age: 32 mm [23‐48] in players aged ≤25 years vs 33.5 mm [24‐50] in those aged >25 years (P = 0.02, correlation coefficient −.01). This tendency increased with cumulative hours of weight training: 34 mm [24‐50] in forwards vs 32 mm [25‐44] in backs (P = 0.01); and ethnicity, with Pacific Islanders having higher values in both raw data and body surface area or height‐indexed data than Afro‐Caribbeans and Caucasians: 34 [25‐50] vs 32 [27‐48] and 33 [23‐49] mm (P = 0.017); 15 [12.2‐21] vs 14.8 [11‐19.9] and 14.8 [10‐20.9] mm/m2 (P < 0.0001); 18.5 [14‐25] mm/m vs 17.4 [14.8‐25] mm/m and 17.6 [12.2‐25.3] mm/m (P = 0.0125). In a population of professional rugby players, echocardiography was contributive. The main anomaly was aortic dilatation (14/336, 4.2%). While this is proportionally much higher than in other sports, the cutoffs need to be defined more precisely by including the criterion of ethnicity, as is already the case for electrocardiography.
Bureaucratic conflict between transnational actor coalitions: The diffusion of British National Vocational Qualifications to China
Authors: Müller Armin
Published: January 2021

Quantitative studies of social policy diffusion face substantial challenges regarding their understanding of causal mechanisms. Knowledge of diffusion processes is particularly limited in authoritarian countries, in comparatively autonomous developing countries, and fields of social policy not characterized by hegemonic ideas and strong epistemic communities. This study focuses on technical and vocational education and training (TVET) in the People's Republic of China. The conceptual approach is based on the interaction‐oriented understanding of causal mechanisms in actor‐centred institutionalism, and the framework of lesson drawing. Methodologically, this study follows a process tracing approach, relying on semi‐structured interviews with Chinese experts, recently de‐classified project reports of the World Bank, and content analysis of Chinese legal and regulatory documents. Analysing why China introduced a system of vocational qualification certificates similar to English National Vocational Qualifications (NVQs), rather than German‐style dual vocational apprenticeships, it uncovers a mechanism of bureaucratic conflict between competing coalitions of domestic ministries and transnational actors from the UK and Germany in a context of organizational hierarchy with multiple principals. The World Bank here attempted to play the role of a neutral international principal, but could only do so in limited ways and insofar as its preferences were compatible with those of the leadership core of the Party‐state. The study illustrates how bureaucratic conflict mediates policy learning, explaining the diffusion and non‐diffusion of different policy options. Furthermore, it highlights doubts regarding the mechanism of coercion, which remained largely ineffective.
Democracy Beyond Secrecy: Assessing the Promises and Pitfalls of Collective Voting
Authors: Mueller Sean , Gerber Marlène , Schaub Hans‐Peter
Published: January 2021

This paper assesses collective voting as a specific mode of democratic decision‐making and compares it to secret voting. Under collective voting, voters gather in one place and decide by the show of hands. We theorise two potential advantages and two disadvantages of collective voting so defined. We then draw on original survey data from one of the largest polities practising collective voting, the citizen assembly of the Swiss canton of Glarus. We find that both the promises and pitfalls of non‐secret voting are exaggerated. Non‐secret voting’s suspected pitfalls – social pressure and abstention – do not generally materialise in our sample, although for women they do appear to be relevant to some extent. However, the promises of collective voting – enabling cue‐taking and discursive bridging and bonding – are equally realised to a limited extent only.
Bringing clerkship grading back to the bedside
Authors: Ryan Michael S. , Haley Kellen E. , Helou Marieka , Ryan Mark H. , Rigby Fidelma , Santen Sally A
Published: January 2021

Background

The hallmark of medical education is learning from patients through interactions at the bedside. However, many medical schools incorporate clinical clerkship grading systems that incentivize time away from patient care activities to focus on examinations of medical knowledge. The purpose of this innovation was to develop a grading system that encouraged development of competencies beyond medical knowledge, including patient care, communication, and professionalism skills.

Methods

In 2016, the authors convened a diverse workgroup to reform the clerkship grading approach at their institution. The group reviewed relevant literature and discussed approaches used by other institutions. They developed a competency‐based criterion system. For each of four competency domains (patient care, medical knowledge (examination score), professionalism, and communication/teamwork), students received a designation of inadequate, competent, or exemplary. The highest grade (“honors”) was awarded to students who met the criteria for exemplary performance in at least two domains. It was a primarily compensatory model, although to achieve competency (pass) scoring was non‐compensatory (acceptable performance in all categories).

Results

A total of 231 medical students received 1499 clerkship grades during the 2018–2019 year. Compared to previous years, more students (40% vs. 15%) received honors. A substantial proportion (43%) received honors without achieving an exemplary designation in the medical knowledge domain (i.e., standardized examination).

Findings and Discussion

The revised grading system provided several avenues for students to excel and receive honors in their clerkships allowing for recognition of students who excelled in patient care‐related areas other than standardized examinations.
Dacryops with extensive lacrimal and maxillary bone defects in four dogs
Authors: Steinmetz Andrea , von Bomhard Wolf , Mülling Christoph
Published: January 2021

Objective

To describe and discuss ventromedial orbital lacrimal gland or duct cysts (dacryops) in dogs with extensive bone defects based on their symptoms, results of diagnostic imaging and histopathological examination, and therapy and discuss their potential origin based on the morphology.

Animals studied

Four dogs of different breeds, age, and sex were presented with a unilateral round, slow growing, indolent, and non‐tender process ventromedial to the nasal canthus of the eye.

Procedures

Transverse computed tomography showed a low‐density, non‐contrast‐enhancing cystic process ventromedial to the globe with extensive defects in the lacrimal and maxillary bones in all cases. The cystic character of the structure was confirmed by the aspiration of the brownish fluid without cellular and microbiological contents. For treatment, the cystic fluid was aspirated, and the sclerosing agent polidocanol was injected in three cases. Cystorhinostomy (nasal marsupialisation) was performed in one case as the first choice and in another case following failure of sclerotherapy. Histopathological examination of the cyst walls was performed in two cases and confirmed the diagnosis of dacryops.

Results

Follow‐up between 2 and 18 months showed no recurrence and very good to excellent cosmetic results.

Conclusions

Aberrant lacrimal gland or duct tissue with secondary development of dacryops should be included in the differential diagnoses of ventromedial orbital cysts. Large cysts near the lacrimal drainage system with extensive bone defects in dogs should be treated by nasal marsupialization. Treatments such as evacuation of the cyst and inducing sclerosis (sclerotherapy) should be reserved for exceptional cases.
First annual report of Chinese haemovigilance network
Authors: Yin Yonghua , Tian Xue , Li Ling , Kong Yujie , Wang Jue , Lin Feng , Song Ning , Chen Qiang , Gan Jia , Peng Tao , Li Xiying , Wu Yanyun , Ge Hongwei , Wang Hongjie , Jiang Jingmei , Bai Lianjun , Ji Hongwen , Zhao Guohua , Huang Yuguang , Liu Zhong ,   Chinese Haemovigilance Network
Published: January 2021

Background and objectives

Haemovigilance involves surveillance of the whole chain of blood transfusion with the aim of identifying adverse events and errors and improving outcomes for patients. The Chinese Haemovigilance Network, founded in August 2017, has witnessed a rapid development in the last three years.

Materials and methods

Based on the 1,022 cases in 2019, we analysed the adverse reactions (ARs) by blood component, clinical outcome severity and demography of recipients in an effort to publish the first annual Chinese haemovigilance report.

Results

The AR rate associated with blood transfusion in 2019 was 0·2% in China. Allergic reactions and FNHTR were the two most common adverse symptoms, accounting for 97·7% of the reports. Two‐thirds of the TAD, AHTR and TACO and all of the HTR and DHTR resulted in hospitalization or prolongation of hospitalization. Plasma and AP were usually associated with allergic reaction (81·1%), whereas red cells more commonly cause FNHTR (68·8%) and all the AHTR, HTR, DSTR and DHTR. 84·1% of patients were aged 16 years or over, and the majority of the TAD, AHTR, TACO and HTR involved patients aged 60 and above. The ratio of serious adverse reactions (SARs) was 8·2%. Allergic reaction and FNHTR were top two (85·7%) SARs. The first case related to anti‐D immunoglobulin was detected in a DHTR report.

Conclusion

This report provides the world’s first overview of transfusion‐related adverse reactions in China. This report is useful for better understanding transfusion risks in China.
Spatial Boundaries, Abounding Spaces
Authors: Chandna Mohit
Published: January 2021

Colonialism advanced its project of territorial expansion by changing the very meaning of borders and space. The colonial project scripted a unipolar spatial discourse that saw the colonies as an extension of European borders. In his monograph, Mohit Chandna engages with narrations of spatial conflicts in French and Francophone literature and film from the nineteenth to the early twenty-first century. In literary works by Jules Verne, Ananda Devi, and Patrick Chamoiseau, and film by Michael Haneke, Chandna analyzes the depiction of ever-changing borders and spatial grammar within the colonial project. In so doing, he also examines the ongoing resistance to the spatial legacies of colonial practices that act as omnipresent enforcers of colonial borders. Literature and film become sites that register colonial spatial paradigms and advance competing narratives that fracture the dominance of these borders. Through its analyses Spatial Boundaries, Abounding Spaces shows that colonialism is not a finished project relegated to our past. Colonialism is present in the here and now, and exercises its power through the borders that define us.
Central fatigue aetiology in prolonged trail running races
Authors: Espeit Loic , Brownstein Callum G , Royer Nicolas , Besson Thibault , Martin Vincent , Millet Guillaume Y , Lapole Thomas
Published: January 2021

New Findings

What is the central question of this study?

Are spinal and/or supraspinal perturbations implicated in central fatigue induced in the plantar flexor muscles following prolonged trail running races?

What is the main finding and its importance?

The study confirmed the presence of central fatigue following various trail running distances from 40 to 170 km. The reduction in the V‐wave in conjunction with the lack of change in the H‐reflex suggests that a major component of this central fatigue may arise from supraspinal mechanisms in the plantar flexor muscles.

Trail running races are known to induce considerable impairments in neuromuscular function of which central mechanisms are a substantial component. However, the loci of this central fatigue (i.e. supraspinal and/or spinal) is not well identified. The aim of this study was to better understand central fatigue aetiology induced in the plantar flexor muscles by various trail running distances from 40 to 170 km. Eighteen runners participated in the study and neuromuscular function of their plantar flexors was tested before (PRE) and after (POST) various races during the Ultra‐Trail du Mont Blanc. Neuromuscular function was evaluated with voluntary and evoked contractions using electrical tibial nerve stimulation. H‐reflex and V‐wave responses were also measured during submaximal and maximal voluntary contraction, respectively. Reductions in maximal voluntary contraction torque (−29%; P < 0.001) and voluntary activation level (−12%; P < 0.001) were observed after trail running races. The V‐wave was reduced in soleus (−35%; P = 0.003) and gastrocnemius medialis (−28%; P = 0.031), with no changes for the H‐reflex in soleus (P = 0.577). The present study confirmed the presence of central fatigue following trail running exercise. The reduction in the V‐wave in conjunction with the lack of change in the H‐reflex suggests that a major component of this central fatigue may arise from supraspinal mechanisms.
Impact of pre‐exercise feeding status on metabolic adaptations to endurance‐type exercise training
Authors: Edinburgh Robert M. , Koumanov Francoise , Gonzalez Javier T.
Published: January 2021

Nutrition and exercise metabolism are vibrant physiological fields, yet at times it feels as if greater progress could be made by better integrating these disciplines. Exercise is advocated for improving metabolic health, in part by increasing peripheral insulin sensitivity and glycaemic control. However, when a modest‐to‐high carbohydrate load is consumed before and/or during each exercise bout within a training programme, increases in oral glucose insulin sensitivity can be blunted in both men of a healthy weight and those with overweight/obesity. Exercise training‐induced adaptation in the energy sensing AMP‐activated protein kinase (AMPK) and the insulin‐sensitive glucose transporter GLUT4 protein levels are sensitive to pre‐exercise feeding status in both healthy individuals and individuals classified as overweight or obese. Increased lipid oxidation may, in part, explain the enhanced adaptive responses to exercise training performed before (i.e. fasted‐state exercise) versus after nutrient ingestion. Evidence in individuals with type 2 diabetes currently shows no effect of altering nutrient–exercise timing for measured markers of metabolic health, or greater reductions in glycated haemoglobin (HbA1c) concentrations with exercise performed after versus before nutrient provision. Since the metabolic inflexibility associated with type 2 diabetes diminishes differences in lipid oxidation between the fasted and fed states, it is plausible that pre‐exercise feeding status does not alter adaptations to exercise when metabolic flexibility is already compromised. Current evidence suggests restricting carbohydrate intake before and during exercise can enhance some health benefits of exercise, but in order to establish clinical guidelines, further research is needed with hard outcomes and different populations.

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Enhancing Cavitation Intensity in Co-Flow Water Cavitation Peening With Organ Pipe Nozzles
Authors: Vidvans A. N. , Melkote S. N. , Sanders D. G.
Published: January 2021

Co-flow water cavitating jets induce compressive residual stress through cavitation impacts produced by the collapse of the cavitation cloud. Co-flow water cavitation peening causes minimal surface alteration when compared with conventional processes such as shot peening, which is a major advantage. However, enhancement of cavitation intensity for co-flow water cavitation peening nozzles is required for practical applications requiring greater process capability. Scaling of co-flow cavitation peening nozzles to achieve greater cavitation intensity requires higher flowrates, thus requiring pumps of higher capacities. In contrast, organ pipe geometry nozzles can enhance cavitation intensity without a significant increase in pump capacity and have been used in deep-sea drilling applications. The objective of this work is to study the effects of organ pipe inner jet nozzle geometry on co-flow water cavitation intensity and peening performance relative to a standard (unexcited) inner jet nozzle geometry through experiments on aluminum alloy Al 7075-T651. Nozzle performance is characterized via extended mass loss and strip curvature tests, high-speed visualization of the cavitation cloud, analysis of impulse pressures, and through-thickness residual stress measurements. It is found that the optimum organ pipe inner jet nozzle geometry enhances the mass loss and peak strip curvature by 61% and 66%, respectively, when compared with the unexcited inner jet nozzle. Residual stress measurements show that the organ pipe inner jet nozzle produces deeper compressive residual stresses in the material than the unexcited inner jet nozzle.
Comparing Filtering Multifidelity Optimization Strategies With a Simulation-Based Multidisciplinary Aircraft Model
Authors: Chell Brian , Hoffenson Steven , Philippe Cory J. G. , Blackburn Mark R.
Published: January 2021

Multifidelity optimization leverages the fast run times of low-fidelity models with the accuracy of high-fidelity models (HFMs), in order to conserve computing resources while still reaching optimal solutions. This work focuses on the multifidelity multidisciplinary optimization of an aircraft system model with finite element analysis and computational fluid dynamics simulations in the loop. A two-step filtering method is used where a lower fidelity model is optimized, and then the solution is used as a starting point for a higher-fidelity optimization routine. By starting the high-fidelity routine at a nearly optimal region of the design space, the computing resources required for optimization are expected to decrease when using local algorithms. Results show that, when using surrogates for the lower fidelity models, the multifidelity workflows save statistically significant amounts of time over optimizing the original HFM alone. However, the impact on solution quality varies depending on the model behavior and optimization algorithm.
Pressure Losses at Moderate Reynolds Numbers in Diamond-Shaped Cylinders Arrays: Application to Microregenerators
Authors: Sochinskii A. , Colombet D. , Medrano Muñoz M. , Ayela F. , Luchier N.
Published: January 2021

Cylinders with an elliptical, oblong, lenticular, sinus, or diamond transveral shape are very interesting geometries for the design of compact heat exchangers. This work investigates the role of the porosity and of the apex angle of diamond-shaped cylinders networks on the pressure losses, at moderate Reynolds numbers, inside microheat regenerators. The design of the geometry under test has been chosen so that the cross section of the flow remains almost constant along the path of the flow between cylinders. Experiments have been performed at 1 ⩽ Re ⩽ 30 and a porosity range 0.40<ε<0.90 for an apex angle of α=33deg. Numerical simulations have been conducted using the same Reynolds and porosity ranges but varying the apex angle 33deg ⩽ α ⩽ 90deg. Experimental measurements and dimensional analysis have shown that the friction factor can be affected by the porosity. Two-dimensional numerical simulations confirmed that the friction factor increases with the porosity but also with the apex angle. An analysis at the scale of a channel flanked by adjacent cylinders has provided an original correlation able to describe easily the evolution of the Poiseuille number and the collective effects on the drag coefficient as a function of α and ε. Such a diamond-shaped design is found to induce much lower Poiseuille numbers than those expected from conventional stacked spheres, woven wires, and circular cylinders arrays. The findings of this study can help for better understanding the optimization of low pressure drop regenerators and how to reduce associated hydraulic power.
Optimization of NARX Neural Models Using Particle Swarm Optimization and Genetic Algorithms Applied to Identification of Photovoltaic Systems
Authors: Silva Ronnyel Carlos Cunha , de Menezes Júnior José Maria Pires , de Araújo Júnior José Medeiros
Published: January 2021

In this study, genetic algorithms (GAs) and particle swarm optimization (PSO) are used to make an automated choice of hyperparameters of the multilayer perceptron (MLP)-NARX, extreme learning machine (ELM)-NARX, and echo state network (ESN)-NARX neural models applied to the identification of two photovoltaic systems: one installed in Teresina, in Brazil, and another in Hamburg, Germany. The automatic optimization process results showed that the PSO algorithm presents superior performance compared to the GA algorithm. Likewise, the identification carried out aimed to estimate the power generated by photovoltaic systems from two different approaches: linear mathematical models and neural identification models. Thus, the neural models implemented are more efficient and accurate than the linear mathematical models compared. From accuracy, the neural models ESN-NARX and MLP-NARX were considered the best in identifying Hamburg and Teresina’s photovoltaic systems, respectively.
Numerical Assessment of Density Ratio and Mainstream Turbulence Effects on Leading Edge Film Cooling: Heat and Mass Transfer Methods
Authors: Ravelli S. , Abdeh H. , Barigozzi G.
Published: January 2021

Within the context of leading edge film cooling in a high-pressure turbine vane, the present study is a step forward towards modelling showerhead performance for a baseline geometry (namely 4 staggered rows of cylindrical holes) at engine like conditions, starting from a previous investigation, at low speed flow (exit isentropic Mach number of Ma2is = 0.2), low inlet turbulence intensity of Tu1 = 1.6% and density ratio of DR ∼ 1. Those operating conditions, dictated by experimental constraints, were essential to validate results from delayed detached-eddy simulation (DDES) against off-the-wall measurements of velocity, vorticity and turbulent fluctuations, for the coolant-to-mainstream blowing ratio of BR = 3 (momentum flux ratio of I = 9). Here, the potential of DDES is exploited to predict the aero-thermal features of the flow in the leading edge region in the presence of larger density ratio (DR ∼ 1.5) and turbulent mainstream (Tu1 = 13%), while matching either BR or I. The experimental database contains surface measurements of film cooling adiabatic effectiveness (η), obtained by using the pressure sensitive paint (PSP) technique. DDES predictions of η were computed by means of the species transport model (i.e. mass transfer), for comparison against the conventional thermal method, based on creating a temperature differential between the mainstream and the coolant (i.e. heat transfer). The simulated film cooling performance was found to depend on the method used, thus suggesting that other parameters than DR, BR, I and Tu1 should be taken into account when the goal is matching engine-like conditions.