bluuebunny/crossref_metadata_2025 huggingface dataset:
Surface-modified carbon fiber for enhanced electromagnetic interference shielding performance in thermoplastic polyurethane composites
Authors: Yi Dongchan , Jeong Gwajeong , Park Seong-Dae , Yoo Myong Jae , Yang Hyunseung
Published: November 2022

There has been a growing interest in developing carbon-based polymer composites for electromagnetic interference (EMI) shielding materials. To achieve a high EMI shielding performance, the morphology of fillers in composites must be controlled. Although carbon fibers (CFs) have remarkable thermal and electrical properties and low density, their poor dispersion behavior within polymer matrix limits their practical applications as EMI shielding materials. In this study, we report an efficient method to disperse CFs within a thermoplastic polyurethane (TPU) matrix using pyranine-functionalized polyether (polyether–pyranine) as a dispersing agent. polyether–pyranine was grafted on the CF surfaces through π–π interactions between the CF and pyranine groups to produce surface-modified CFs (SCFs). Compared to CFs, the SCFs exhibited an improved dispersion stability within a TPU polymer matrix. Furthermore, a TPU composite with SCFs achieved an enhanced electrical conductivity and EMI shielding performance, which was primarily ascribed to the increased structural connectivity between the SCFs due to excellent dispersion.
Finite element-based homogenization model to determine effective properties of 0–3 and 1–3 electrostrictive composite
Authors: Singh Diwakar , Kumar Rajeev , Vaish Rahul
Published: November 2022

Representative volume element (RVE) based finite element method is employed to evaluate all the effective properties of electrostrictive composite. The attention is paid to designing the periodic boundary conditions to be applied to RVEs of electrostrictive study. The present study is conducted on particulate and fiber electrostrictive composites, in which electrostrictive ceramic (Pb(Mg1/3Nb2/3)O3-PbTO3- BaTiO3, PMN-PT-BT) is embedded into a non electrostrictive polymer (epoxy) matrix. In particulate composite, the spherical particles are randomly distributed and in fiber composites, cylindrical fibers are arranged in a square and hexagonal pattern. The study reveals that the electrostrictive composite does not only depends on the inclusion’s volume but also on their microstructure. The electrostrictive coefficient of the proposed composite is more than its constituent materials owing to the auxiliary flexibility of polymer matrix.
Study of ambipolar properties of organic-inorganic CH3NH3PbI3 perovskite for vertical field effect transistor
Authors: Agrawal Kalpana , Gupta Vinay , Srivastava Ritu , Rajput S S
Published: November 2022

A vertical field effect transistor (VFET) with short channel length of 120 nm, fabricated using organic-inorganic perovskite (CH3NH3PbI3) material shows the ambipolar properties and switches from P mode to N mode or vice versa, just by changing the polarity of applied bias. The operating voltage is as low as 0.5 V, which allows it to be integrated with solar cell devices and hence having the possibility of battery less mobile gadgets. To ensure the quality of VFET with CH3NH3PbI3 as a channel length, different parameters have been extracted. The transistor efficiency (TE), mobility (μ
p), and transconductance (gm) in P mode, have been estimated as 14 V−1, 1.5 cm2 V−1 s−1 and 500 ± 150 μS, respectively. For N mode, these parameters have been found to be as 4 V−1, 0.97 cm2V−1 s−1 and 60 ± 10 μS respectively. The hole and electron densities are found to be as ∼1016 cm−3 and ∼1014 cm−3 respectively which confirm the ambipolar nature of CH3NH3PbI3.
Pixel-wise classification in graphene-detection with tree-based machine learning algorithms
Authors: Cho Woon Hyung , Shin Jiseon , Kim Young Duck , Jung George J
Published: November 2022

Mechanical exfoliation of graphene and its identification by optical inspection is one of the milestones in condensed matter physics that sparked the field of two-dimensional materials. Finding regions of interest from the entire sample space and identification of layer number is a routine task potentially amenable to automatization. We propose supervised pixel-wise classification methods showing a high performance even with a small number of training image datasets that require short computational time without GPU. We introduce four different tree-based machine learning (ML) algorithms—decision tree, random forest, extreme gradient boost, and light gradient boosting machine. We train them with five optical microscopy images of graphene, and evaluate their performances with multiple metrics and indices. We also discuss combinatorial ML models between the three single classifiers and assess their performances in identification and reliability. The code developed in this paper is open to the public and will be released at github.com/gjung-group/Graphene_segmentation.
SoftHebb: Bayesian inference in unsupervised Hebbian soft winner-take-all networks
Authors: Moraitis Timoleon , Toichkin Dmitry , Journé Adrien , Chua Yansong , Guo Qinghai
Published: November 2022

Hebbian plasticity in winner-take-all (WTA) networks is highly attractive for neuromorphic on-chip learning, owing to its efficient, local, unsupervised, and on-line nature. Moreover, its biological plausibility may help overcome important limitations of artificial algorithms, such as their susceptibility to adversarial attacks, and their high demands for training-example quantity and repetition. However, Hebbian WTA learning has found little use in machine learning, likely because it has been missing an optimization theory compatible with deep learning (DL). Here we show rigorously that WTA networks constructed by standard DL elements, combined with a Hebbian-like plasticity that we derive, maintain a Bayesian generative model of the data. Importantly, without any supervision, our algorithm, SoftHebb, minimizes cross-entropy, i.e. a common loss function in supervised DL. We show this theoretically and in practice. The key is a ‘soft’ WTA where there is no absolute ‘hard’ winner neuron. Strikingly, in shallow-network comparisons with backpropagation, SoftHebb shows advantages beyond its Hebbian efficiency. Namely, it converges in fewer iterations, and is significantly more robust to noise and adversarial attacks. Notably, attacks that maximally confuse SoftHebb are also confusing to the human eye, potentially linking human perceptual robustness, with Hebbian WTA circuits of cortex. Finally, SoftHebb can generate synthetic objects as interpolations of real object classes. All in all, Hebbian efficiency, theoretical underpinning, cross-entropy-minimization, and surprising empirical advantages, suggest that SoftHebb may inspire highly neuromorphic and radically different, but practical and advantageous learning algorithms and hardware accelerators.
Tropical cyclone frequency: turning paleoclimate into projections
Authors: Wallace E J , Dee S G
Published: November 2022

Future changes to tropical cyclone (TC) climate have the potential to dramatically impact the social and economic landscape of coastal communities. Paleoclimate modeling and paleohurricane proxy development offer exciting opportunities to understand how TC properties (like frequency) change in response to climate variability on long time scales. However, sampling biases in proxies make it difficult to ascertain whether signals in paleohurricane records are related to climate variability or just stochasticity. Short observations and simulation biases prevent TC models from capturing the full range of climate variability and TC characteristics. Integration of these two data types can help address these uncertainties. Robust data model comparison in paleotempestology will require (a) simulating TCs using new paleoclimate data assimilation products and climate model ensembles, (b) building a central repository of open access paleohurricane proxies, (c) compiling paleohurricane records, and (d) filling key gaps in the existing paleohurricane networks. Incorporating the combined information from both paleohurricane proxies and paleo TC simulations into risk assessments for coastal communities could help improve adaptation strategies.
Impediments to diffusion in quantum graphs: Geometry-based upper bounds on the spectral gap
Authors: Berkolaiko Gregory , Kennedy James , Kurasov Pavel , Mugnolo Delio
Published: November 2022

We derive several upper bounds on the spectral gap of the Laplacian on compact metric graphs with standard or Dirichlet vertex conditions. In particular, we obtain estimates based on the length of a shortest cycle (girth), diameter, total length of the graph, as well as further metric quantities introduced here for the first time, such as the avoidance diameter. Using known results about Ramanujan graphs, a class of expander graphs, we also prove that some of these metric quantities, or combinations thereof, do not to deliver any spectral bounds with the correct scaling.
𝑘-chain configurations of points over 𝑝-adic rings
Authors: Lichtin Ben
Published: November 2022

This paper uses exponential sum methods to detect the presence of

k
k

-chains of points whose endpoints belong to proper subsets of finite

p
p

-adic rings.
IBCOx-12 The Endoscopic Sleeve Gastroplasty Produces Durable Physiologic Changes: Results from a Randomized US Clinical Trial
Authors: Vargas E J , Kumbhari V , Chapman C , Teixeira A , Ujiki M , Thaemert B , Sharaiha R Z , Thompson C C , Abu Dayyeh B K
Published: November 2022

Background

Obesity is associated with faster gastric emptying and altered appetite. Endoscopic sleeve gastroplasty (ESG) has gained global adaptation, but our understanding of its physiologic mechanism of action and durability is limited. We sought to determine changes in gastric emptying, weight loss, and eating behaviors after ESG when compared to moderate-intensity lifestyle interventions (LS) in the short and long-term.

Methods

This is an a priori designed sub-study of a large ongoing multicenter US RCT (MERIT trial), where adults with BMI 30-40 kg/m2 were randomized to ESG versus moderate-intensity LS alone. We measured gastric emptying (T1/2) using a 4- hour gastric emptying breath test at baseline, 3 and 12 months into the study. We reported weight loss outcomes as percent total body weight lost (%TBWL). Changes in three eating behaviour domains (Cognitive Restraint [CR], Emotional Eating [EE], Uncontrolled Eating [UE]) were assessed using the Three-Factor Eating Questionnaire (TFEQ) at 6 months. The primary outcome was the change in T1/2 (minutes) at 3 months, and secondary outcomes were changes in T1/2 at 12 months, %TBWL, and eating behaviours. We used the t-test for the analyses. Linear regression was performed to determine the association between gastric emptying and weight loss.

Results

46 patients were randomized in the study (ESG n=26; LS n=20). Baseline characteristics were similar between the two groups. Out of n=46, n=43, and n=31 subjects have reached 3 and 12 months, respectively. Three patients dropped out of the study. At 3 months, T1/2 (minutes) was delayed in the ESG group (n=24) compared to the LS group (n=19) (170.8 vs. 87.5; p<0.0001). At 12 months, T1/2 was still delayed in the ESG group (n=17) vs. control group (n=14) (133.4 vs. 87.6; p=0.0005), and delayed compared to baseline. %TBWL in the ESG group was 12.3%, 15.1% and 15.7% at 3, 6 and 12 months (p <0.01 compared to baseline), while it was 2.3%, 2.2% and 0.3% (p>0.05 compared to baseline) in the LS group. Greater delays in gastric emptying at 3 months correlated with weight loss at all time points. (Figure 1) At 6 months, significant improvements in the EE and UE domains were seen in both groups, but for CR, only significant improvements were seen in the ESG group. Percent total fasting ghrelin, GLP-1, and PYY increased at 12 months in the ESG group compared to LS control (51%, 51%, 6.3% vs. -9%, 4%, -10.5%). Only 1 SAE managed endoscopically with full recovery was reported in the ESG group.

Conclusions

ESG produces sustained physiologic alterations in appetite regulatory pathways and durable weight-loss. This provides further evidence supporting the clinical adoption of the technique as a durable and effective obesity therapy.
IBCOx-17 Safety of Single Stage Revision Laparoscopic Sleeve Gastrectomy Compared to Laparoscopic Roux-Y Gastric Bypass After Failed Gastric Banding
Authors: Janik M , Ibikunle C , Khan A , Aryaie A
Published: November 2022

Background

Reoperation, after failed gastric banding, is a controversial topic. A common approach is band removal with conversion to gastric bypass or sleeve gastrectomy in a single-step procedure. In 2017 the analysis of MBSQAIP Participant User File (PUF) from 2015 revealed that conversion to sleeve gastrectomy might be a safer approach when compared to gastric bypass surgery. We decided to utilize MBSAQIP data from 2015-2018 and replicate the study, addressing critical methodological flaws. This study aimed to assess the safety of revisional surgery to laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-Y gastric bypass (LRYGB) after failed laparoscopic adjustable gastric banding (LAGB) based on MBSAQIP Participant User File from 2015 to 2018.

Methods

Patients who underwent a one-stage conversion of LAGB to LSG (Conv-LSG) or LRYGB (Conv-LRYGB) were identified in the MBSAQIP PUF from 2015 to 2017. Conv-LRYGB cases were matched (1:1) with Conv-LSG patients using propensity scoring to control for potential confounding. The primary outcome was all-cause mortality. Secondary outcomes were readmission, reoperation, intervention, leak and bleed rates, and morbidity.

Results

A total of 9 974 patients (4987 matched pairs) were included in the study. The groups were closely matched as intended. was associated with higher risk for readmission Conv-LRYGB, as compared with conv-SG, was associated with a similar risk of mortality (0.02% vs. 0.02%; relative risk [RR], 0.33; 95% confidence interval [CI], 0.03 to 3.20, p=0.32). Conversion to LRYGB increased the risk for readmission (6.16% vs. 3.77%; RR, 1.63; 95%CI, 1.37 to 1.94, p<0.01); reoperation (2.15% vs. 1.36%; RR, 1.57; 95%CI, 1.17 to 2.12, p=<0.01); intervention (3.19% vs. 1.32%; RR, 2.41; 95%CI, 1.82 to 3.19, p<0.01); leak (1.76% vs. 1.02%; RR, 1.57; 95%CI, 1.72 to 2.42, p<0.01); bleeding (1.66% vs. 1.00%; RR, 1.66; 95%CI, 1.7 to 2.34, p<0.01); and morbidity (4.97% vs. 2.35%; RR, 2.12; 95%CI, 1.70 to 2.63, p<0.01).

Conclusions

The study confirms that a single stage conversion of failed gastric banding is associated with greater morbidity and higher complication rates when converted to LRYGB versus LSG in the first 30 days postoperatively. These differences are significant with regards to readmission, reoperation, intervention, leak and bleed rates, and morbidity.
Textbook outcome in hepato-pancreato-biliary surgery: systematic review
Authors: Pretzsch Elise , Koliogiannis Dionysios , D’Haese Jan Gustav , Ilmer Matthias , Guba Markus Otto , Angele Martin Konrad , Werner Jens , Niess Hanno
Published: November 2022

Background

Textbook outcome (TO) is a multidimensional measure reflecting the ideal outcome after surgery. As a benchmarking tool, it provides an objective overview of quality of care. Uniform definitions of TO in hepato-pancreato-biliary (HPB) surgery are missing. This study aimed to provide a definition of TO in HPB surgery and identify obstacles and predictors for achieving it.

Methods

A systematic literature search was conducted using PubMed, Embase, and Cochrane Database according to PRISMA guidelines. Studies published between 1993 and 2021 were retrieved. After selection, two independent reviewers extracted descriptive statistics and derived summary estimates of the occurrence of TO criteria and obstacles for achieving TO using co-occurrence maps.

Results

Overall, 30 studies were included. TO rates ranged between 16–69 per cent. Commonly chosen co-occurring criteria to define TO included ‘no prolonged length of stay (LOS)’, ‘no complications’, ‘no readmission’, and ‘no deaths’. Major obstacles for achieving TO in HPB surgery were prolonged LOS, complications, and readmission. On multivariable analysis, TO predicted better overall and disease-free survival in patients with cancer. Achievement of TO was more likely in dedicated centres and associated with procedural and structural indicators, including high case-mix index and surgical volume.

Conclusion

TO is a useful quality measure to benchmark surgical outcome. Future definitions of TO in HPB surgery should include ‘no prolonged LOS’, ‘no complications’, ‘no readmission’, and ‘no deaths’.
Chronic neuronal activation leads to elevated lactate dehydrogenase A through the AMP-activated protein kinase/hypoxia-inducible factor-1α hypoxia pathway
Authors: Ksendzovsky Alexander , Bachani Muznabanu , Altshuler Marcelle , Walbridge Stuart , Mortazavi Armin , Moyer Mitchell , Chen Chixiang , Fayed Islam , Steiner Joseph , Edwards Nancy , Inati Sara K , Jahanipour Jahandar , Maric Dragan , Heiss John D , Kapur Jaideep , Zaghloul Kareem A
Published: November 2022

Recent studies suggest that changes in neuronal metabolism are associated with epilepsy. High rates of ATP depletion, lactate dehydrogenase A and lactate production have all been found in epilepsy patients, animal and tissue culture models. As such, it can be hypothesized that chronic seizures lead to continuing elevations in neuronal energy demand which may lead to an adapted metabolic response and elevations of lactate dehydrogenase A. In this study, we examine elevations in the lactate dehydrogenase A protein as a long-term cellular adaptation to elevated metabolic demand from chronic neuronal activation. We investigate this cellular adaptation in human tissue samples and explore the mechanisms of lactate dehydrogenase A upregulation using cultured neurones treated with low Mg2+, a manipulation that leads to NMDA-mediated neuronal activation. We demonstrate that human epileptic tissue preferentially upregulates neuronal lactate dehydrogenase A, and that in neuronal cultures chronic and repeated elevations in neural activity lead to upregulation of neuronal lactate dehydrogenase A. Similar to states of hypoxia, this metabolic change occurs through the AMP-activated protein kinase/hypoxia-inducible factor-1α pathway. Our data therefore reveal a novel long-term bioenergetic adaptation that occurs in chronically activated neurones and provide a basis for understanding the interplay between metabolism and neural activity during epilepsy.
Surgical removal of a bullet in the heart through a trans-mitral approach: a case report
Authors: Cammardella Antonio Giovanni , Lio Antonio , De Luca Leonardo , Bergonzini Marcello , Musumeci Francesco
Published: November 2022

Background

Retained cardiac missiles have been considered bullets, shrapnel, or pellets included in the heart or the pericardial sac. In asymptomatic patients with retained cardiac missiles, the role of surgery is still debated.

Case summary

We describe the case of successful surgical treatment of a retained missile localized within the left ventricle in close proximity of the posterior mitral leaflet. The operation was performed through a transatrial approach, detaching the posterior mitral leaflet. The post-operative course was uneventful. The patient was discharged on the seventh post-operative day. At 30-day follow-up visit, the patient was in good conditions, with normal mitral valve function.

Discussion

The management of retained cardiac missiles should be individualized. If a decision is made to operate, multiple imaging techniques including echocardiography and computed tomography scan are mandatory to precisely locate the bullet.
Clozapine therapeutic drug monitoring – experience from a large London NHS trust
Authors: Attard A , Miah M , Chopra P , Wakelam J , Stanniland C
Published: November 2022

Introduction

Clozapine is a high-risk drug that is used widely in Secondary and Tertiary Centres.1 Therapeutic Drug Monitoring (TDM) advice and recommendation is readily available from distinguished authors.2,3 The rate of clozapine TDM, appropriate sample collection for TDM, appropriate actions following a clozapine level varies between services and prescribers within our organisation.

Aim

To establish how many current West London NHS Trust (WLT) patients had a clozapine TDM, how many plasma samples collected for TDM were done appropriately, the proportion of patients with an appropriately collected plasma sample result within the largely accepted therapeutic range, and whether there was documentation that the plasma level was reviewed and if any prescription changes were made.

Methods

Approval to undertake the service evaluation was given by the Trust clinical governance and audit committee as ethical review as not required. No patient identifiable details were shared or collected. All patients who had been registered on the Trusts clozapine patient monitoring service for over 8 weeks were enrolled. Anonymised patient demographic data was collected including concomitant medication. Plasma levels were sought for every patient enrolled. The appropriateness of the samples taken were scrutinised. The plasma level result was collected. Electronic patient notes were also scrutinised to assess actions following the plasma level result. Data were collected in a binary yes/no format and results calculated as a percentage. Data was stored and collected in accordance to Trust General Data Protection Regulation (GDPR).

Results

In total 316 patients were included. 97% of these patients had evidence of TDM levels done during the time of the audit. 88% of these patients’ samples were done correctly. Only 45% of patients had levels within the widely acceptable therapeutic range. Of those patients whose levels fell outside the therapeutic range less than half (42%) had documentation that the level was reviewed.

Discussion/Conclusion

It is widely accepted that clozapine TDM when done accurately can be a vital source of information to inform prescribers on the appropriate dose, concordance and toxicity of clozapine therapy. Our Trust showed evidence of routine clozapine TDM. There was some variation in the appropriate sample collection but what was most alarming is the lack of documentation that action was taken when the TDM level was outside the general acceptable range. Standardising the actions following clozapine TDM needs to be a priority for the Trust if clozapine TDM is to continue to be carried out in almost 100% of the patient population.

References

1. Taylor DM, Barnes TRE, Young AH. The Maudsley Prescribing Guidelines in Psychiatry 14th Edition. Wiley Blackwell.

2. Taylor DM et al. The use of clozapine plasma levels in optimising therapy. Psych Bull 1995:19:753-755

3. Perry PJ. Therapeutic drug monitoring of antipsychotics. Psychopharmacology 200; 148:83-89
Antimicrobial resistance patterns of bacterial pathogens recovered from the urine of patients at Canadian hospitals from 2009 to 2020
Authors: Walkty Andrew , Karlowsky James A , Lagace-Wiens Philippe , Baxter Melanie R , Adam Heather J , Zhanel George G
Published: November 2022

Objectives

To investigate in vitro susceptibility patterns of bacterial pathogens recovered from the urine of outpatients (isolates from outpatient clinics or emergency departments) and hospital inpatients across Canada from 2009 to 2020 as part of the CANWARD study

Methods

Canadian hospital microbiology laboratories submitted bacterial pathogens cultured from urine to the CANWARD study coordinating laboratory on an annual basis (January 2009 to December 2020). Antimicrobial susceptibility testing was performed by CLSI broth microdilution, with MICs interpreted by current CLSI breakpoints.

Results

In total, 4644 urinary pathogens were included in this study. Escherichia coli was recovered most frequently (53.3% of all isolates), followed by Enterococcus faecalis, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa and Staphylococcus aureus. Together, these six species accounted for 84.2% of study isolates. Nitrofurantoin demonstrated excellent in vitro activity versus E. coli, with 97.6% of outpatient and 96.1% of inpatient isolates remaining susceptible. In contrast, E. coli susceptibility rates were lower for ciprofloxacin (outpatient 79.5%, inpatient 65.9%) and trimethoprim/sulfamethoxazole (outpatient 75.2%, inpatient 73.5%). The percentage of E. coli isolates that were phenotypically positive for ESBL production significantly increased from 4.2% (2009–11) to 11.3% (2018–20). A similar although less pronounced temporal trend was observed with ESBL-producing K. pneumoniae.

Conclusions

E. coli was the pathogen most frequently recovered from the urine of Canadian patients, and the proportion of isolates that were ESBL producers increased over time. Susceptibility data presented here suggest that ciprofloxacin and trimethoprim/sulfamethoxazole may be suboptimal for the empirical treatment of complicated urinary infections.
The Art of Visualising Reality: Jīva Gosvāmī’s Aesthetics and the Role of Ritual Imagination
Authors: Herbert Alan
Published: November 2022

This paper reconstructs an otherwise problematic role of ritual imagination in the sixteenth-century Gauḍīya Vaiṣṇava thinker Jīva Gosvāmī’s seminal treatise, Ṣaṭ-sandarbha. As part of his explanation of worship under the broader theme of bhakti as practice, the author recasts a set of Pāñcarātric visualisation rituals to suit Gauḍīya theology and praxis centred on devotional visualisations of divine forms. However, while explaining the rituals, he paradoxically claims that the visualised forms, despite being imagined, are not to be considered imaginative. I argue that this paradox dissolves if we view Jīva’s rationale on this issue through the lens of a similarly re-orientated version of ancient dramatic and poetic rasa theory that he employs to map the higher experiences of devotion at the culmination of his treatise. Although he does not mention using this strategy for the visualisation rituals, it can be inferred through the correlations I make between his descriptions of their visualised content and certain categories of rasa theory. Through this reconstructive analysis, the reality of the ritual imaginals can be explained and the paradox dissolved.
Up-regulation of HCN2 channels in a thalamocortical circuit mediates allodynia in mice
Authors: Yu Jun-Ma , Hu Rui , Mao Yu , Tai Yingju , Qun Sen , Zhang Zhi , Chen Danyang , Jin Yan
Published: November 2022

Chronic pain is a significant problem that afflicts individuals and society, and for which the current clinical treatment is inadequate. In addition, the neural circuit and molecular mechanisms subserving chronic pain remain largely uncharacterized. Herein we identified enhanced activity of a glutamatergic neuronal circuit that encompasses projections from the ventral posterolateral nucleus (VPLGlu) to the glutamatergic neurons of the hindlimb primary somatosensory cortex (S1HLGlu), driving allodynia in mouse models of chronic pain. Optogenetic inhibition of this VPLGlu→S1HLGlu circuit reversed allodynia, whereas the enhancement of its activity provoked hyperalgesia in control mice. In addition, we found that the expression and function of the HCN2 (hyperpolarization-activated cyclic nucleotide-gated channel 2) were increased in VPLGlu neurons under conditions of chronic pain. Using in vivo calcium imaging, we demonstrated that downregulation of HCN2 channels in the VPLGlu neurons abrogated the rise in S1HLGlu neuronal activity while alleviating allodynia in mice with chronic pain. With these data, we propose that dysfunction in HCN2 channels in the VPLGlu→S1HLGlu thalamocortical circuit and their upregulation occupy essential roles in the development of chronic pain.
Transgenic PDGF-BB sericin hydrogel potentiates bone regeneration of BMP9-stimulated mesenchymal stem cells through a crosstalk of the Smad-STAT pathways
Authors: Zhang Hui-Jie , Li Fu-Shu , Wang Feng , Wang Han , He Tong-Chuan , Reid Russell R , He Bai-Cheng , Xia Qingyou
Published: November 2022

Silk as a natural biomaterial is considered as a promising bone substitute in tissue regeneration. Sericin and fibroin are the main components of silk and display unique features for their programmable mechanical properties, biocompatibility, biodegradability and morphological plasticity. It has been reported that sericin recombinant growth factors (GFs) can support cell proliferation and induce stem cell differentiation through cross-talk of signaling pathways during tissue regeneration. The transgenic technology allows the productions of bioactive heterologous GFs as fusion proteins with sericin, which are then fabricated into solid matrix or hydrogel format. Herein, using an injectable hydrogel derived from transgenic platelet-derived GF (PDGF)-BB silk sericin, we demonstrated that the PDGF-BB sericin hydrogel effectively augmented osteogenesis induced by bone morphogenetic protein (BMP9)-stimulated mesenchymal stem cells (MSCs) in vivo and in vitro, while inhibiting adipogenic differentiation. Further gene expression and protein–protein interactions studies demonstrated that BMP9 and PDGF-BB synergistically induced osteogenic differentiation through the cross-talk between Smad and Stat3 pathways in MSCs. Thus, our results provide a novel strategy to encapsulate osteogenic factors and osteoblastic progenitors in transgenic sericin-based hydrogel for robust bone tissue engineering.
Religion as a Resource in an Increasingly Polarized Society
Authors: Cavendish James
Published: November 2022

Recent research in the social scientific study of religion has drawn attention to how distinct religious identities and cultures have supported nationalist impulses and fueled political polarization across a variety of national contexts. This growing body of literature makes it clear that religious ideals and identities can be used to frame issues, draw boundaries, and drive a wedge down the middle of the political landscape. What is less frequently analyzed are the various ways that religion can provide resources to depolarize society. This article identifies the various resources that religion can offer for depolarization, and calls for future research aimed not only at better understanding the extent and nature of religion’s deployment of these resources, but also their effectiveness in countering the polarizing dynamics in contemporary society.
Incorporation of rapid association/dissociation processes in tissues into the monkey and human physiologically based pharmacokinetic models for manganese
Authors: Campbell Jerry L , Clewell Harvey J , Van Landingham Cynthia , Gentry P Robinan , Keene Athena M , Taylor Michael D , Andersen Melvin E
Published: November 2022

In earlier physiologically based pharmacokinetic (PBPK) models for manganese (Mn), the kinetics of transport of Mn into and out of tissues were primarily driven by slow rates of association and dissociation of Mn with tissue binding sites. However, Mn is known to show rapidly reversible binding in tissues. An updated Mn model for primates, following similar work with rats, was developed that included rapid association/dissociation processes with tissue Mn-binding sites, accumulation of free Mn in tissues after saturation of these Mn-binding sites and rapid rates of entry into tissues. This alternative structure successfully described Mn kinetics in tissues in monkeys exposed to Mn via various routes including oral, inhalation, and intraperitoneal, subcutaneous, or intravenous injection and whole-body kinetics and tissue levels in humans. An important contribution of this effort is showing that the extension of the rate constants for binding and cellular uptake established in the monkey were also able to describe kinetic data from humans. With a consistent model structure for monkeys and humans, there is less need to rely on cadaver data and whole-body tracer studies alone to calibrate a human model. The increased biological relevance of the Mn model structure and parameters provides greater confidence in applying the Mn PBPK models to risk assessment. This model is also well-suited to explicitly incorporate emerging information on the role of transporters in tissue disposition, intestinal uptake, and hepatobiliary excretion of Mn.
Feasibility and Utility of Wearable Bluetooth and RFID Sensors to Measure Care Interactions
Authors: Wei Sijia , Wright-Freeman Kayla , McConnell Eleanor S , Caves Kevin , Corazzini Kirsten N
Published: November 2022

Clinical care interactions influence important health outcomes in older adults such as nosocomial infections, falls, and care satisfaction. However, traditional measurements of interactions are often time-consuming, costly, biased, or they interfere with normal clinical care. Wearable sensors measure interpersonal contact with a high degree of spatial and temporal detail and accuracy when applied to examining the spread of infection. This study aims to test the feasibility of implementing two types of commercially available wearable sensors to collect spatial and temporal data for measuring care interactions in health care settings. EMBC02 (Bluetooth) and OpenBeacon (RFID) sensors were tested in a simulation laboratory. Five nursing students wore the sensors along with name tags and enacted a scenario of a fallen nursing home resident. Sensor data were plotted in Python and compared with video recordings of the simulated care interaction to determine sensor usability, accuracy, and precision. EMBC02 and OpenBeacon detected multiple wearers and provided spatial and temporal data. OpenBeacon showed better usability and validity than EMBC02 for using proximity data collected by sensors to infer care interactions. Both OpenBeacon and EMCB02 showed some limitations in accuracy and precision, such as increased data missingness due to idling function and high data noise. Bluetooth and RFID sensors measure different aspects of proximity. OpenBeacon outperformed EMBC02 for measuring care interactions. Combining Bluetooth with RFID may provide richer information for measuring and understanding care interactions. Simulation laboratories can be leveraged to test health technology before use in clinical research.
Crossing the Cervicothoracic Junction
Authors: Vickery Justin W. , Varas Emil E. , Abtahi Amir M.
Published: November 2022

The cervicothoracic junction (CTJ) is the site of transition in biomechanical, osseous, and alignment properties of the spine. The interface between the highly mobile, lordotic cervical spine and the rigid, kyphotic thoracic spine results increased the biomechanical stress experienced at this junction. The concentration of stress at this level has led to high rates of failure when instrumenting near or across the CTJ. The changes in osseous anatomy from the cervical spine to the thoracic spine present additional challenges in construct planning. For these reasons, a thorough understanding of the complexity of the cervicothoracic junction is necessary when operating near or across the CTJ. There are multiple options for cervical fixation, including lateral mass screws, pedicle screws, and laminar screws, each with its own advantages and risks. Instrumentation at C7 is controversial, and there is data supporting both its inclusion in constructs and no risk when this level is skipped. Thoracic pedicle screws are the preferred method of fixation in this region of the spine; however, the connection between cervical and thoracic screws can be challenging due to differences in alignment. Transitional rods and rod connectors mitigate some of the difficulties with this transition and have shown to be effective options. Recently, more investigation has looked into the failure of posterior cervical constructs which end at or near the CTJ. The trend in data has favored fixation to T1 or T2 rather than ending a construct at C7 due to the decreased rates of distal junction kyphosis. Although data on patient-reported outcomes with a length of constructs and the lowest instrumented vertebra is scarce, preliminary reports show no difference at this time. As posterior cervical instrumentation continues to increase in frequency, the CTJ will continue to be an area of difficulty in navigation and instrumentation. A thorough understanding of this region is necessary and continued research is needed to improve outcomes.

Level of Evidence:

Level V.
Baicalin suppresses the migration and invasion of breast cancer cells via the TGF-β/lncRNA-MALAT1/miR-200c signaling pathway
Authors: Li Jiafeng , Liu Huixin , Lin Qiwang , Chen Huajiao , Liu Liya , Liao Hongjuan , Cheng Ying , Zhang Xiuli , Wang Zhenlong , Shen Aling , Chen Guolong
Published: November 2022

Metastasis is the major cause of death and failure of cancer chemotherapy in patients with breast cancer (BC). Activation of TGF-β/lncRNA-MALAT1/miR-200c has been reported to play an essential role during the metastasis of BC cells. The present study aimed to validate the suppression of BC-cell migration and invasion by baicalin and explore its regulatory effects on the TGF-β/lncRNA-MALAT1/miR-200c signaling pathway. We found that baicalin treatment inhibited cell viability and migration and invasion. Mechanistically, baicalin treatment significantly downregulated the expression of TGF-β, ZEB1, and N-cadherin and upregulated E-cadherin on both mRNA and protein levels. Additionally, baicalin treatment significantly downregulated the expression of lncRNA-MALAT1 and upregulated that of miR-200c. Collectively, baicalin significantly suppresses cell viability, migration, and invasion of BC cells possibly by regulating the TGF-β/lncRNA-MALAT1/miR-200c pathway.
Aggressive angiomyxoma of pelvis: A case report and literature review
Authors: Lin Xue-Mei , Wang Li , Wang Qiong
Published: November 2022

Rationale:

Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor primarily involving the lower genital tract of reproductive females. It often shares pathologic morphology with other mesenchymal lesions, which result in diagnostic difficulties for pathologists.

Patient concerns and diagnoses:

We described the case of a 32-year-old female presenting with a pelvic mass. Imaging examination showed a “swirling sign” within the mass. The mass was 10.2 × 10 × 7.7 cm, located in the right front of the uterus, with unclear demarcation from the surrounding organs and tissues. The gross appearance was grayish brown with a solid section and a myxedematous cut surface. Microscopically, it was a mesenchymal tumor with a presence of perivascular smooth muscle fibers radiating from the blood vessel and an infiltrative growth pattern. The pelvic AAM was diagnosed based on clinicopathologic and imaging features.

Interventions and outcomes:

A surgery with local excision of the mass was performed. The patient experienced 1 relapse during 2-year follow-up and underwent the radiation therapy.

Lessons:

When the pathological morphology of AAM overlaps with other mesenchymal lesions, the comprehensive understanding of tumor clinicopathological characteristics combined with imaging features is important for the accurate diagnosis of AAM.
Effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane maintained during one-lung ventilation: A case–control study
Authors: Wang Yewen , Gong Chunzhi , Yu Fei , Zhang Quanyi
Published: November 2022

Background:

The effects of dexmedetomidine on the circulatory system are complex. It is difficult to predict its effects on intrapulmonary shunts and hypoxic pulmonary vasoconstriction in patients with one-lung ventilation. This study aimed to investigate the effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane during one-lung ventilation.

Methods:

Forty patients requiring thoracoscopic lobectomy were randomly divided into the dexmedetomidine group (Group D, n = 20) and the normal saline group (Group N, n = 20). The arterial partial pressure of oxygen (PaO2), pulmonary shunt fraction (Qs/Qt), mean end-tidal sevoflurane concentration, mean arterial pressure, and heart rate were compared between the 2 groups at 3 time points: (i) after 5 minutes of two-lung ventilation (T0), (ii) after 30 minutes of one-lung ventilation (OLV) (T1), and (iii) after 45 minutes of OLV (T2). The dosage of sevoflurane from the beginning of OLV to T2 was calculated.

Results:

There were no significant differences in age, body mass index, and FEV1/FVC between Groups D and N (P > .05). At T0, T1, and T2, the PaO2 levels of Group D and Group N were similar (P > .05), and the PaO2 levels of Group D and Group N decreased after OLV. The Qs/Qt level of Groups D and N were similar at T0 (P > .05), and the level of Groups D and N at T1 and T2 was higher than that at T0. The Qs/Qt of Group D was statistically significantly lower than that of Group N at T1 and T2 (P < .05).

Conclusion:

Compared with the control group, we found that dexmedetomidine can reduce the intrapulmonary shunt fraction and improve the body’s status during OLV.
Comparison of high or modified low tie of the inferior mesenteric artery in laparoscopic rectal cancer surgery: A meta-analysis
Authors: Zhong Wu , Liu Chuanyuan , Zhang Lei , Zhong Junqiao , He Xianping , Fang Chuanfa , Liu Hongquan , Xia Laiyang , Zuo Zhengyun , Zhang Leichang
Published: November 2022

Objective:

The purpose of this study was to perform a meta-analysis comparing the oncological, intraoperative and safety outcomes in laparoscopic rectal cancer surgery with and without preservation of the left colic artery (LCA).

Method:

We searched several databases including PubMed, Web of Science, Cochrane Library, and Embase databases. This meta-analysis included randomized clinical trials, prospective, and retrospective comparative studies regarding high- or modified low-tie ligation of the inferior mesenteric artery in laparoscopic rectal cancer surgery.

Results:

Of 641 potentially eligible articles, 16 studies with 3050 participants met the eligibility criteria and were included in the meta-analysis. There was no significant difference in estimated blood loss (WMD −2.63, 95% CI −5.69 to 0.43; P = .09), the number of harvested lymph nodes (WMD −0.35, 95% CI −1.60 to 0.20; P = .50), the number of apical lymph node yield (WMD −0.19, 95% CI −0.52 to 0.13; P = .24), the number of apical lymph node metastasis (OR 0.76, 95% CI 0.40 to 1.45; P = .40), rate of conversion to open surgery (OR 0.74, 95% CI 0.50 to 1.09; P = .513), rate of urinary dysfunction (OR 1.39, 95% CI 0.71 to 2.74; P = .34), rate of recurrence and metastasis (OR 1.10, 95% CI 0.75 to 1.61; P = .64), 5-year survival rate (OR 0.89, 95% CI 0.67 to 1.18; P = .42). However, this meta-analysis demonstrated a statistically significant difference in operating time (WMD −9.92, 95% CI −15.49 to −5.84; P = .0005), rate of diverting stom (OR 1.42, 95% CI 1.06 to 1.92; P = .02), rate of anastomotic leakage (OR 2.673, 95% CI 1.91 to 3.62; P < .00001), time to first flatus (WMD 0.29, 95% CI 0.11 to 0.48; P = .002), time of hospitalization (WMD 0.64, 95% CI 0.14 to 1.15; P = .01) between the 2 surgical techniques.

Coclusion:

The available evidence suggests that preserving the left colic artery is a safe, effective technique for patients with laparoscopic rectal cancer. nique for patients with laparoscopic rectal cancer.
Trends of fecal calprotectin levels and associations with early life experience in preterm infants
Authors: Xu Wanli , Zhang Yiming , Zhao Wenxiao , Chen Jie , Maas Kendra , Hussain Naveed , Henderson Wendy A. , Cong Xiaomei
Published: November 2022

Background:

Preterm infants are at risk for severe infections due to their immature immune systems. Factors such as early life pain/stress experiences and feeding may influence immune activation and maturation of immune systems. However, the underlying mechanism remains unclear. Fecal calprotectin (FCP) is a noninvasive surrogate biomarker of mucosal inflammation in the gastrointestinal tract and has been used in detecting intestinal inflammation in specific pediatric gastrointestinal disorders.

Objective:

To describe the longitudinal trajectory of FCP levels in preterm infants and investigate the contributing factors that are associated with FCP levels.

Design:

A longitudinal study design was used.

Settings:

Preterm infants were recruited from 2 neonatal intensive care units (NICU) of a children’s medical center in the North-eastern US.

Methods:

Preterm infants were followed during their first 4 weeks of NICU hospitalization. Stool samples were collected twice per week to quantify the FCP levels. Cumulative pain/stress experiences and feeding types were measured daily. A linear mixed-effect model was used to examine the associations between FCP levels and demographic and clinical characteristics, cumulative pain/stress, and feeding over time.

Results:

Forty-nine preterm infants were included in the study. Infants’ FCP levels varied largely with a mean of 268.7±261.3 µg/g and increased over time. Preterm infants experienced an average of 7.5±5.0 acute painful procedures and 15.3±20.8 hours of chronic painful procedures per day during their NICU stay. The mean percentage of mother’s own milk increased from the first week (57.1±36.5%) to the fourth week (60.7±38.9%) after birth. Elevated FCP concentration was associated with acute and cumulative (chronic) pain/stress levels, mother’s own milk, non-White race, and higher severity of illness score.

Conclusions:

FCP levels were elevated in preterm infants with wide interindividual and intraindividual variations. Cumulative pain/stress during the NICU hospitalization, feeding, race, and health status may influence FCP concentrations in early life that may be associated with inflammatory gut processes.
Immunoexpression of CXCL12 and CXCR4 in Radicular Cysts, Dentigerous Cysts, and Odontogenic Keratocysts
Authors: Andrade Allany de Oliveira , Mesquita Ricardo Alves , Gordón-Núñez Manuel Antonio , Alves Pollianna Muniz , Nonaka Cassiano Francisco Weege
Published: November 2022

The aim of this study was to evaluate the immunoexpression of chemokine CXCL12 and its receptor CXCR4 in radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs), and to correlate the findings with morphologic parameters of RCs (inflammatory infiltrate and cystic epithelium). Twenty RCs, 20 DCs, and 20 OKCs were submitted to immunohistochemistry. The percentages of cytoplasmic (CXCL12 and CXCR4) and nuclear (CXCR4) staining in epithelial and fibrous capsule cells were determined. RCs and DCs exhibited higher epithelial expression of CXCL12 than OKCs (P<0.05). The expression of CXCL12 in the fibrous capsule was higher in DCs than in RCs and OKCs (P<0.05). Higher cytoplasmic expression of CXCR4 was observed in the epithelial lining and fibrous capsule of RCs and DCs compared with OKCs (P<0.05). In the fibrous capsule, DCs exhibited higher nuclear expression of CXCR4 than OKCs (P<0.05). No significant differences in the immunoexpression of CXCL12 or CXCR4 were observed according to the morphologic parameters of RCs (P>0.05). Strong positive correlations were found between cytoplasmic and nuclear expression of CXCR4 in the epithelial lining of RCs and DCs and in the fibrous capsule of all groups (P<0.05). The results suggest the participation of CXCL12 and CXCR4 in the pathogenesis of RCs, DCs, and OKCs. These proteins may be particularly relevant for the development of odontogenic cysts with less aggressive biological behavior, irrespective of their nature (inflammatory or developmental). In RCs, the expression of CXCL12 and CXCR4 may not be related to the intensity of the inflammatory infiltrate or the status of cystic epithelium.