bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross‐ownership and corporate social responsibility
Authors: Bárcena‐Ruiz Juan Carlos , Sagasta Amagoia
Published: April 2021

This paper introduces corporate social responsibility (CSR) into a quantity‐setting duopoly with cross‐participation at ownership level. One firm is fully owned by its shareholder, who also owns a minority participation in the rival firm (controlling shareholder). We analyze the shareholders’ strategic choice of whether to engage their firms in CSR or not. We find that high levels of cross‐ownership discourage the controlling shareholder from engaging his/her firm in CSR. When the level of cross‐ownership is low enough, in equilibrium both firms care about CSR, but the controlling shareholder makes his/her firm less concerned with CSR than the shareholder who runs the rival firm. We also find that, contrary to the usual result, when firms are concerned with social issues the controlling shareholder obtains a lower income than the other shareholder.
Entrustable professional activities in entry‐level health professional education: A scoping review
Authors: Bramley Andrea Louise , McKenna Lisa
Published: April 2021

Entrustable professional activities (EPAs) are a recent enhancement to competency‐based health professional education that describe the observable work done by a competent health professional. Through defining education outcomes in a work‐based context, EPAs offer potential to identify skill gaps in individual or student cohorts and focus improvements. Entrustable professional activities have been pioneered and gained rapid acceptance in postgraduate medical education; however, less is known about their application and use in undergraduate or entry‐level health professional education. The Joanna Briggs Institute scoping review methodology was used to explore how and in what context EPAs are being used in entry‐level health professional education. Databases searched include CINAHL, EMBASE, MEDLINE, Web of Science and PsycINFO. A total of 748 abstracts were returned after duplicates removed, and 127 full‐text articles were screened with 30 included for data extraction. Publications in this area have recently accelerated with disciplines of professions of medicine, pharmacy, dietetics and physician assistants reporting on EPA development, implementation and evaluation. EPA use has been reported in the United States, Canada, Europe Australia and Central America. Major motivation reported for EPA use is to improve patient safety by aligning performance and expectations and to improve student assessment. Several studies report on the use of EPAs to evaluate different curriculum models or identify curriculum gaps representing potential application in education research.
Meso‐scale modeling of chloride diffusivity in mortar subjected to corrosion‐induced cracking
Authors: Qiu Qiwen , Dai Jian‐Guo
Published: April 2021

This paper presents a methodology for numerically simulating the chloride diffusivity in mortar subjected to corrosion‐induced cracking with the aid of X‐ray microcomputed tomography (X‐ray µCT). In the research, the mortar sample with embedded steel rod was subjected to accelerated corrosion and then scanned by X‐ray µCT at consecutive corrosion periods of 0, 1,000, and 2,000 minutes. Upon the scanned CT images, a meso‐scale model consisting of multiple material phases with their intrinsic structures was built up and implemented into a finite element method for diffusion simulation. In the numerical simulation, the effects of multiple phases (void, crack, aggregate, rust, and interfacial transition zone between cement and aggregate) on the chloride diffusion of mortar are studied. Since the X‐ray µCT facilitates accurate local material information in time‐dependent and in situ manner, the diffusivity of mortar under different corrosion time and its spatial distribution characteristics (e.g., at different locations from the mortar surface) can be evaluated.
Impact of a sleep promotion protocol on off‐pump coronary artery bypass graft patients
Authors: Chen Lin , Zheng Jing , Lv Shanshan , Li Baobao , Yang Lijuan
Published: April 2021

Background

Sleep abnormalities frequently occur in intensive care unit (ICU) patients, and the consequences of sleep abnormalities in patients who undergo off‐pump coronary artery bypass graft (OPCABG) surgery are particularly significant. Although many interventions have been reported to improve sleep, few sleep promotion protocols have been designed specifically for patients in cardiac ICUs.

Aims and objectives

This study aimed to explore the effects of an evidence‐based sleep promotion protocol on patients who underwent OPCABG in a cardiac ICU.

Design

A quasi‐experimental study was conducted in a comprehensive hospital in Shandong province of China.

Methods

Overall, 67 participants were recruited (37 in the control group and 30 in the intervention group). An evidence‐based sleep promotion protocol was developed by a 10‐member interprofessional collaborative team and then applied. Sound levels, light intensity, and the number of nocturnal interventions were compared between groups. The Chinese version of the Richards−Campbell Sleep Questionnaire (RCSQ) was used to compare intergroup sleep status on two consecutive postoperative nights.

Results

No significant differences were found for demographics or disease severity between the groups. In the intervention group, sound levels and light intensity were significantly lower at various times, and nocturnal interventions were significantly less frequent over the two consecutive nights. RCSQ scores were significantly higher in the intervention group for both nights.

Conclusions

The sleep promotion protocol reduced sound levels, night‐time light intensity, the number of nocturnal interventions, and improved sleep among OPCABG patients in a cardiac ICU.

Relevance to clinical practice

Evidence‐based practice can help to promote good quality of care, improve patient outcomes, and advance nursing in clinical settings.
Perioperative management and considerations in pediatric patients with connective tissue disorders undergoing cardiac surgery
Authors: Berger Jessica A. , Huh Dana D. , Lee Teresa , Wadia Rajeev S. , Bembea Melania M. , Goswami Dheeraj K.
Published: April 2021

Background

Marfan syndrome and Loeys‐Dietz syndrome are connective tissue disorders associated with cardiac and vascular disease. Patients often require surgical repair, but limited data exist to describe their perioperative management.

Aims

Our goals were to review the perioperative features of patients with Marfan and Loeys‐Dietz syndrome that may affect anesthesia care and to describe the differences in preoperative clinical characteristics and intra‐operative anesthetic management.

Methods

We conducted a retrospective cohort study of patients with Marfan and Loeys‐Dietz syndrome who underwent cardiac surgery at a single institution. We collected demographic and perioperative data from the electronic medical record and performed descriptive statistics to characterize the patient populations and describe their anesthetic management.

Results

In 71 patients (40 Marfan, 31 Loeys‐Dietz), we found significant differences between the Marfan and Loeys‐Dietz patients in airway difficulty, preoperative weight, blood utilization, valvular disease, and age at first cardiac surgery. Patients with Loeys‐Dietz syndrome had higher preoperative rates of severe noncardiac comorbidities, including gastroesophageal reflux and asthma that required chronic medical therapy.

Conclusions

Despite undergoing similar surgical procedures, patients with Marfan and Loeys‐Dietz syndrome have different intrinsic patient characteristics and comorbidities that may affect their perioperative care. This retrospective cohort study identified some factors, but additional collection and reporting of patient data based on multicenter experience are essential for the ongoing optimization of perioperative care in these patient populations.
Intestinal outcome of bone marrow transplantation for monogenic inflammatory bowel disease
Authors: Morita Mari , Takeuchi Ichiro , Kato Motohiro , Migita Ohsuke , Jimbo Keisuke , Shimizu Hirotaka , Yoshimura Satoshi , Tomizawa Daisuke , Shimizu Toshiaki , Hata Kenichiro , Ishiguro Akira , Arai Katsuhiro
Published: April 2021

Background

Some monogenic inflammatory bowel diseases (IBDs) are known to be refractory to conventional treatments. Although allogeneic hematopoietic stem‐cell transplantation (allo‐HSCT) has become a curative therapeutic option for certain monogenic IBDs, its effectiveness regarding endoscopic improvements has not been clarified.

Methods

The clinical course and endoscopic findings of patients with monogenic IBDs who were treated with allo‐HSCT between December 2017 and November 2018 at the National Center for Child Health and Development, were retrospectively reviewed. The clinical disease activity was assessed using the weighted Pediatric Crohn's Disease Activity Index (wPCDAI) and the endoscopic finding was evaluated using the Simple Endoscopic Score for Crohn's Disease (SES‐CD). Clinical remission was defined as a wPCDAI <10 and endoscopic remission was defined as an SES‐CD of 2 or less.

Results

Four patients with severe monogenic IBDs, including three with X‐linked inhibitors of apoptosis protein (XIAP) deficiency and one with interleukin‐10 signaling defect, were treated with allo‐HSCT with reduced‐intensity conditioning. In four patients, the maximum scores of wPCDAI and SES‐CD before allo‐HSCT ranged from 67.5 to 120 and 20 to 34, respectively. After allo‐HSCT, all four patients showed a significant improvement in intestinal inflammation and achieved both clinical and endoscopic remission. Although patients with XIAP deficiency presented with post‐transplant hemophagocytic lymphohistiocytosis and a relatively late engraftment, all patients achieved prolonged clinical remission, and IBD medications were successfully discontinued in all patients.

Conclusion

Allo‐HSCT for monogenic IBD resulted in complete clinical resolution with endoscopically confirmed mucosal healing.
Empirically defining the preclinical stages of the Alzheimer's continuum in the Alzheimer's Disease Neuroimaging Initiative
Authors: Kiselica Andrew M. ,   for the Alzheimer's Disease Neuroimaging Initiative
Published: April 2021

Aim

The National Institute on Aging and the Alzheimer's Association published new research criteria defining the Alzheimer's continuum (AC) by the presence of positive amyloid‐β biomarkers. Symptom severity of those on the AC is staged across six levels, including two preclinical stages (stages 1 and 2). AC stage 2 is defined by the presence of at least one of the following: (i) transitional cognitive decline; (ii) subjective cognitive decline; or (iii) neurobehavioural symptoms. In contrast, AC stage 1 is defined by the absence of symptoms.

Methods

Initial empirical definitions for each symptom class were developed. These empirical criteria were then applied in a sample of 285 cognitively normal, amyloid‐positive individuals from the Alzheimer's Disease Neuroimaging Initiative for purposes of AC stage 1 and 2 classification.

Results

In this sample, 56.10% of participants were asymptomatic and classified as AC stage 1. In contrast, 42.46% of individuals were positive for at least one symptom class: 22.11% for transitional cognitive decline, 20.35% for subjective cognitive decline, and 14.74% for neurobehavioural symptoms. AC stage was a predictor of cognitive/functional decline over 4 years of follow up in a longitudinal growth model (B = 0.33, P < 0.001).

Conclusions

Results provide a methodology to operationalize the National Institute on Aging and the Alzheimer's Association AC stage 1 and 2 criteria and include preliminary evidence of the validity of this approach. The methods outlined in this manuscript can be used to test hypotheses regarding prodromal Alzheimer's disease, as well as implemented in clinical trial selection procedures.
Dialectic and Metaphysical Skepticism in Jacob Anatoli
Authors: Halper Yehuda
Published: April 2021

Jacob Anatoli (c. 1181–c. 1247 CE) would seem an unlikely skeptic. As the Hebrew translator responsible for bringing a complete program of Aristotelian logic to European Jewry, he is an unlikely skeptic of science. As author of one of the most influential medieval commentaries on the Bible, he is an unlikely skeptic of religious belief. Still, he advances arguments against the possibility of certain knowledge of both Aristotelian science and the tenets of belief. Yet, he does not recommend that thoughtful people reject science and uncritically adopt religious beliefs in the face of uncertainty. Nor does Anatoli recommend a suspension of judgement (epoche) that would allow for freedom from worry (ataraxia) or tranquility. Instead, he pushes constant dialogue, even debate between competing claims to knowledge. The life of the mind that Anatoli recommends, then, is a dialectical interrogation of science and religion that provides not freedom and tranquility but intellectual disquiet and toil.
Retrospective assessment of radiation toxicity from a definitive‐intent, moderately hypofractionated image‐guided intensity‐modulated protocol for anal sac adenocarcinoma in dogs
Authors: Körner Maximilian , Staudinger Chris , Meier Valeria , Rohrer Bley Carla
Published: April 2021

A recent calculation study predicted acceptable toxicity in pelvic organs at risk for a new definitive‐intent, moderately hypofractionated radiation therapy (RT) protocol (12 x 3.8 Gy), when used with image‐guided intensity‐modulated radiation therapy (IG‐IMRT). We hypothesized this protocol to result in clinically acceptable radiation toxicities. Dogs diagnosed with and irradiated for anal sac adenocarcinoma (ASAC) were retrospectively assessed. Eleven dogs were included, six had prior surgery. Before any therapy, staging according to Polton et al. resulted in the following distribution: stage 1 (n = 1), stage 2 (n = 1), stage 3a (n = 6), stage 3b (n = 3). We scored radiation toxicities at the end of therapy, at weeks 1, 3 and every 3 months after RT according to Veterinary Radiation Therapy Oncology Group radiation toxicity criteria. Clinical follow‐up was maintained on regular intervals combined with computed tomography (n = 3). Median follow‐up time for dogs still alive was 594 days (range: 224–972 days). Within 1 week post treatment, eight dogs (73%) developed grade 2 and four dogs (36%) grade 1 acute toxicity in the perianal region. All acute toxicities resolved or improved to grade 1 within 3 weeks after treatment. Late toxicity, for example, chronic colitis/diarrhoea, ulcerations, strictures or myelopathies was not observed in any patient. Five dogs were euthanized 105, 196, 401, 508 and 908 days after RT and six dogs were still alive, one in spite of progressive disease. The median progression‐free survival was 908 days (95%CI: 215; 1602). The previous theoretically described definitive‐intent, moderately hypofractionated protocol using IG‐IMRT for the treatment of advanced ASAC showed clinically acceptable acute and late toxicities.
Monglish in post‐communist Mongolia
Authors: Tankosić Ana , Dovchin Sender
Published: April 2021

This article examines the emerging language practice in post‐communist Mongolia that we call ‘new Monglish’ – complex linguistic processes in which English may be deeply absorbed and integrated into the Mongolian language. The original forms of English have transformed as the Mongolian social media users manipulate English to function in the space of relocalisation – the linguistic process which is re‐adapted to the local context to yield new local meanings. This English relocalisation process has adjusted to Mongolian alphabetical and grammatical systems and is yielding new meanings understandable only to the speakers of Mongolian. English has been integrated into the Cyrillic and transliterated Roman Mongolian scripts, full Mongolian sentences, and the Mongolian grammatical, phonetic, lexical, semantic, and syntactic systems. Such relocalisation of English makes it a part of the local language rather than a separate system.
An Investigation of the Democratic Values, Problem-Solving Skills, and Attitude Levels toward Violence of Secondary School Students
Authors: Özbey Adnan
Published: April 2021

The main objective of this study is to examine the possible relationship between democratic values, problem-solving skills, and attitudes toward violence. In addition, it studies whether democratic values, problem solving skills and the tendency of attitudes toward violence differ according to different variables. Descriptive model was used in the research. The study group of the study consisted of a total of 326 students, 172 female and 154 male selected by appropriate sampling from three middle schools in Konya. It was used Basic Democratic Values Questionnaire, Problem Solving Inventory for Children, and the Adolescents' Attitudes Toward the Violence in the study. While the data were analyzing, t test, ANOVA test, Pearson Moment Product Correlation analysis and simple linear regression analysis were used. When the data obtained from the research were examined, there was a significant difference in the level of attitudes toward violence according to the gender variables. There was a significant difference in problem solving skills and attitudes toward violence according to grade variables. Pearson's correlation analysis revealed statistically significant and negative relationship between democratic values, problem-solving skills, and attitudes toward violence. As a result of simple regression analysis, democratic values have predictive role on problem solving skills; it is seen that problem-solving skills are important variables in the tendency towards violence.
Neuromuscular junction instability and altered intracellular calcium handling as early determinants of force loss during unloading in humans
Authors: Monti Elena , Reggiani Carlo , Franchi Martino V. , Toniolo Luana , Sandri Marco , Armani Andrea , Zampieri Sandra , Giacomello Emiliana , Sarto Fabio , Sirago Giuseppe , Murgia Marta , Nogara Leonardo , Marcucci Lorenzo , Ciciliot Stefano , Šimunic Boštjan , Pišot Rado , Narici Marco V.
Published: April 2021

Key points

Few days of unloading are sufficient to induce a decline of skeletal muscle mass and function; notably, contractile force is lost at a faster rate than muscle mass.

The reasons behind this disproportionate loss of muscle force are still poorly understood.

We provide strong evidence of two mechanisms only hypothesized until now for the rapid muscle force loss in only 10 days of bed rest.

Our results show that an initial neuromuscular junction instability, accompanied by alterations in the innervation status and impairment of single fibre sarcoplasmic reticulum function contribute to the loss of contractile force in front of a preserved myofibrillar function and central activation capacity.

Early onset of neuromuscular junction instability and impairment in calcium dynamics involved in excitation–contraction coupling are proposed as eligible determinants to the greater decline in muscle force than in muscle size during unloading.

Unloading induces rapid skeletal muscle atrophy and functional decline. Importantly, force is lost at a much higher rate than muscle mass. We aimed to investigate the early determinants of the disproportionate loss of force compared to that of muscle mass in response to unloading. Ten young participants underwent 10 days of bed rest (BR). At baseline (BR0) and at 10 days (BR10), quadriceps femoris (QF) volume (VOL) and isometric maximum voluntary contraction (MVC) were assessed. At BR0 and BR10 blood samples and biopsies of vastus lateralis (VL) muscle were collected. Neuromuscular junction (NMJ) stability and myofibre innervation status were assessed, together with single fibre mechanical properties and sarcoplasmic reticulum (SR) calcium handling. From BR0 to BR10, QFVOL and MVC decreased by 5.2% (P = 0.003) and 14.3% (P < 0.001), respectively. Initial and partial denervation was detected from increased neural cell adhesion molecule (NCAM)‐positive myofibres at BR10 compared with BR0 (+3.4%, P = 0.016). NMJ instability was further inferred from increased C‐terminal agrin fragment concentration in serum (+19.2% at BR10, P = 0.031). Fast fibre cross‐sectional area (CSA) showed a trend to decrease by 15% (P = 0.055) at BR10, while single fibre maximal tension (force/CSA) was unchanged. However, at BR10 SR Ca2+ release in response to caffeine decreased by 35.1% (P < 0.002) and 30.2% (P < 0.001) in fast and slow fibres, respectively, pointing to an impaired excitation–contraction coupling. These findings support the view that the early onset of NMJ instability and impairment in SR function are eligible mechanisms contributing to the greater decline in muscle force than in muscle size during unloading.
Jacobi Stability of Simple Chaotic Systems with One Lyapunov Stable Equilibrium
Authors: Li Changzhi , Chen Biyu , Liu Aimin , Tian Huanhuan
Published: April 2021

This paper presents Jacobi stability analysis of 23 simple chaotic systems with only one Lyapunov stable equilibrium by Kosambi-Cartan-Chern (KCC) theory, and analyzes the chaotic behavior of these systems from the geometric viewpoint. Different from Lyapunov stability, the unique equilibrium for each system is always Jacobi unstable. Moreover, the dynamical behaviors of deviation vector near equilibrium are discussed to reveal the onset of chaos for these 23 systems, and show furtherly the coexistence of unique Lyapunov stable equilibrium and chaotic attractor for each system geometrically. The obtaining results show that these chaotic systems are not robust to small perturbations of the equilibrium, indicating that the systems are extremely sensitive to internal environment. This reveals that the chaotic flows generated by these systems may be related to Jacobi instability of the equilibrium. It is hoped that the study of this paper can help reveal the true geometrical structure of hidden chaotic attractors.
Phased Array Ultrasonic Testing of Inconel 625 Produced by Selective Laser Melting
Authors: Allam Ahmed , Sugino Christopher , Harding Matthew , Bishop D. Paul , Erturk Alper , Ruzzene Massimo
Published: April 2021

We investigate the use of phased array ultrasonic testing (PAUT) as an offsite non-destructive quality assurance technique for parts made by selective laser melting (SLM). SLM is a popular additive manufacturing (AM) approach for fabricating high-value metallic components with complex geometries. Slight variations in the laser power during fabrication might lead to internal defect development within the part, which could compromise its mechanical strength and fatigue life. PAUT is employed to detect typical internal porosity generated in Inconel 625 samples due to laser power fluctuation during SLM. The typical defect size, shape, and distribution are first identified using metallography and X-ray computed tomography (XCT). B-Scan images of the defect region is then generated experimentally using a 5-MHz linear UT phased array probe. Finite elements simulate wave propagation using geometries obtained from XCT images. The simulation results are compared to the experimental imaging of large defect regions and then used to generate total focusing method images of isolated clusters of 50–200 μm defects. The testing technique illustrates a successful application of PAUT for quality inspection of SLM parts.
Effect of Utilizing a Novel Intake Manifold Design on Smoke Emissions and Particulate Size Distributions of a Gas-to-Liquid Diesel Engine
Authors: Elbashir Aboubaker M. , Saker Ahmad T. , Ahmed Samer F.
Published: April 2021

Smoke emissions and particulate matter (PM) size distributions were investigated on a direct-injection (DI) single-cylinder diesel engine running on both gas-to-liquid (GTL) and diesel fuels utilizing a novel spiral-helical intake manifold design. Smoke opacity was measured at a wide range of engine loads and speeds with both fuels to examine the effect of using the new manifold on smoke emissions. In addition, total PM numbers of fine particles (PM diameter ≤ 1.0 μm) and coarse particles (˃1.0 μm) were quantified with both fuels. Moreover, high-resolution transmission electron microscopy (HRTEM) images were taken with different resolutions to observe the PM sizes produced from each fuel when using the new and normal manifolds. The results showed that using the novel manifold reduced smoke emissions for both GTL and diesel fuels with about 36% at low loads and 7% at high loads. However, using the new manifold with GTL fuel showed superior performance to reduce smoke with about 60% at low loads and 10% at high loads. For the PM size distribution, the new manifold reduced total PM emissions in general. However, significant reductions were obtained with fine PM sizes (0.3–1.0 μm) when GTL fuel was used with about 30% for constant load tests, and about 40% for constant speed tests. On the other hand, the new manifold tended to increase slightly the coarse PM sizes. The HRTEM images of the PM structure for both manifolds and fuels have confirmed the above results.
The Use of Constraint Management Techniques in the Generalized Reduced Gradient Method
Authors: Agrawal Rajiv , Cheng Junhua , Kinzel Gary L.
Published: April 2021

The Generalized Reduced Gradient (GRG) method has proven to be an effective strategy for solving constrained nonlinear programming problems, and this paper proposes the use of constraint management techniques to enhance the GRG method. Some of the troublesome issues in the method such as the selection of the initial basis and the problem of basis interchange can be resolved if the constraints are represented in the form of a nonlinear occurrence matrix. A heuristic algorithm is presented to determine an initial partition of the state and decision variables. The procedure is aimed at minimizing the nonlinear component in the set of state variables so that computational effort during the numerical iterations is reduced. Another algorithm is presented to automate the basis interchange by using a linearized model of the governing equations and a backward dependency procedure. An improved canonical form for the general nonlinear programming problem that has the objective function embedded in the set of equality constraints is also presented. Constraint management ideas are also used to decompose the basis Jacobian matrix into smaller irreducible subsets. Several mathematical and design problems are posed as test cases for the Constraint Management Based Generalized Reduced Gradient (CMB-GRG) procedure, and representative results are presented.
Optimum Reinforcement of Damaged Structures Using a Homogenization Method
Authors: Soto Ciro A. , Díaz Alejandro R. , Kikuchi Noboru
Published: April 2021

A new application of a homogenization method in optimal shape design is presented. Optimum reinforcement of damaged structures is achieved by a simple modification of the approach presented by Bendsøe and Kikuchi [1] for optimum structural shape synthesis. The method is applied to frame structures subject to specific damages.
A set of equations for numerically calculating the interaural level difference in the horizontal plane
Authors: Akeroyd Michael A. , Firth Jennifer , Graetzer Simone , Smith Samuel
Published: April 2021

The variation of interaural level difference (ILD) with direction and frequency is particularly complex and convoluted. The purpose of this work was to determine a set of parametric equations that can be used to calculate ILDs continuously at any value of frequency and azimuth in the horizontal plane. They were derived by fitting equations to ILDs derived from the azimuthal-dependence data tabulated by Shaw and Vaillancourt [(1985). J. Acoust. Soc Am. 78, 1120–1123] and assuming left-right symmetry. The equations are shown to fit those data to an overall RMS error less than 0.5 dB.
Reframing rankings in educational assessments
Authors: Pohl Steffi , Ulitzsch Esther , von Davier Matthias
Published: April 2021

Ability and test-taking behavior should be disentangled and jointly reported to improve interpretation and fairness
A fetal wave of human type 3 effector γδ cells with restricted TCR diversity persists into adulthood
Authors: Tan Likai , Fichtner Alina Suzann , Bruni Elena , Odak Ivan , Sandrock Inga , Bubke Anja , Borchers Alina , Schultze-Florey Christian , Koenecke Christian , Förster Reinhold , Jarek Michael , von Kaisenberg Constantin , Schulz Ansgar , Chu Xiaojing , Zhang Bowen , Li Yang , Panzer Ulf , Krebs Christian F. , Ravens Sarina , Prinz Immo
Published: April 2021

Innate-like human type 3 effector γδ T cells with canonical Vγ9Vδ2
+
TCR develop in the earliest fetal thymus and persist into adulthood.
Acetate Activates
Lactobacillus
Bacteriocin Synthesis by Controlling Quorum Sensing
Authors: Meng Fanqiang , Zhao Haizhen , Nie Ting , Lu Fengxia , Zhang Chong , Lu Yingjian , Lu Zhaoxin
Published: April 2021

Bacteriocins produced by lactic acid bacteria (LAB) are particularly useful in food preservation and food safety. Bacteriocins might increase bacterial competitive advantage against the indigenous microbiota of the intestines; at the same time, bacteriocins could limit the growth of undesired microorganisms in yogurt and other dairy products.
Early Cenozoic partial melting of meta-sedimentary rocks of the eastern Gangdese arc, southern Tibet, and its contribution to syn-collisional magmatism
Authors: Jiang Yuan-Yuan , Zhang Ze-Ming , Palin Richard M. , Ding Hui-Xia , Mo Xuan-Xue
Published: April 2021

Continental magmatic arcs are characterized by the accretion of voluminous mantle-derived magmatic rocks and the growth of juvenile crust. However, significant volumes of meta-sedimentary rocks occur in the middle and lower arc crust, and the contributions of these rocks to the evolution of arc crust remain unclear. In this paper, we conduct a systematic study of petrology, geochronology, and geochemistry of migmatitic paragneisses from the eastern Gangdese magmatic arc, southern Tibet. The results show that the paragneisses were derived from late Carboniferous greywacke, and underwent an early Cenozoic (69–41 Ma) upper amphibolite-facies metamorphism and partial melting at pressure-temperature conditions of ~11 kbar and ~740 °C, and generated granitic melts with enriched Hf isotopic compositions (anatectic zircon εHf(t) = −10.57 to +0.78). Combined with the existing results, we conclude that the widely distributed meta-sedimentary rocks in the eastern Gangdese arc deep crust have the same protolith ages of late Carboniferous, and record northwestward-decreasing metamorphic conditions. We consider that the deeply buried sedimentary rocks resulted in the compositional change of juvenile lower crust from mafic to felsic and the formation of syn-collisional S-type granitoids. The mixing of melts derived from mantle, juvenile lower crust, and ancient crustal materials resulted in the isotopic enrichment of the syn-collisional arc-type magmatic rocks of the Gangdese arc. We suggest that crustal shortening and underthrusting, and the accretion of mantle-derived magma during the Indo-Asian collision transported the supracrustal rocks to the deep crust of the Gangdese arc.
New statistical quantification of the impact of active deformation on the distribution of submarine channels
Authors: Pizzi Marco , Whittaker Alexander C. , Lonergan Lidia , Mayall Mike , Mitchell W. Hamish
Published: April 2021

Submarine channel systems play a crucial role in governing the delivery of sediments and pollutants such as plastics from the shelf edge to deep water. Understanding their distribution in space and time is important for constraining the locus, magnitude, and characteristics of deep-water sedimentation and for predicting stratigraphic architectures and depositional facies. Using three-dimensional seismic reflection data covering the outer fold-and-thrust belt of the Niger Delta, we determined the pathways of Miocene to Pliocene channels that crossed, at 173 locations, 11 fold-thrust structures for which the temporal and spatial evolution of strain rates has been constrained over a period of 11 m.y. We use a statistical approach to quantify strain and shortening rate distributions recorded where channels have crossed structures compared to the fault array as a whole. Our results prove unambiguously that these distributions are different. The median strain rate where channels cross faults is <0.6%/m.y. (~40 m/m.y.), 2.5× lower than the median strain rate of active fault segments (1.5%/m.y.) with a marked reduction in the number of channel-fault crossings where fault strain rates are >1%/m.y. Our results quantify the sensitivity of submarine channels to active deformation at a population level for the first time and enable us to predict the temporal and spatial routing of submarine channels affected by structurally driven topography.
Optimal outcome measures for a trial of not routinely measuring gastric residual
volume in neonatal care: a mixed methods consensus process
Authors: Gale Chris , Dorling Jon , Arch Barbara , Woolfall Kerry , Deja Elizabeth , Roper Louise , Jones Ashley P , Latten Lynne , Eccleson Helen , Hickey Helen , Pathan Nazima , Preston Jennifer , Beissel Anne , Andrzejewska Izabela , Valla Frederic , Tume Lyvonne
Published: April 2021

Background

Routine measurement of gastric residual volume to guide feeding is widespread in
neonatal units but not supported by high-quality evidence. Outcome selection is
critical to trial design.

Objective

To determine optimal outcome measures for a trial of not routinely measuring
gastric residual volume in neonatal care.

Design

A focused literature review, parent interviews, modified two-round Delphi survey
and stakeholder consensus meeting.

Participants

Sixty-one neonatal healthcare professionals participated in an eDelphi survey;
17 parents were interviewed. 19 parents and neonatal healthcare professionals took
part in the consensus meeting.

Results

Literature review generated 14 outcomes, and parent interviews contributed eight
additional outcomes; these 22 outcomes were then ranked by 74 healthcare professionals
in the first Delphi round where four further outcomes were proposed; 26 outcomes were
ranked in the second round by 61 healthcare professionals. Five outcomes were
categorised as ‘consensus in’, and no outcomes were voted ‘consensus out’. ‘No
consensus’ outcomes were discussed and voted on in a face-to-face meeting by 19
participants, where four were voted ‘consensus in’. The final nine consensus outcomes
were: mortality, necrotising enterocolitis, time to full enteral feeds, duration of
parenteral nutrition, time feeds stopped per 24 hours, healthcare-associated
infection; catheter-associated bloodstream infection, change in weight between birth
and neonatal discharge and pneumonia due to milk aspiration.

Conclusions and relevance

We have identified outcomes for a trial of no routine measurement of gastric
residual volume to guide feeding in neonatal care. This outcome set will ensure
outcomes are important to healthcare professionals and parents.
Periconception glycemic control and congenital anomalies in women with pregestational diabetes
Authors: Dude Annie M , Badreldin Nevert , Schieler Amanda , Yee Lynn M
Published: April 2021

Introduction

To assess the relationship between periconception glycemic control and congenital anomalies in a contemporary, diverse population of women with pregestational diabetes.

Research design and methods

This is a retrospective cohort study of all pregnant women with pregestational diabetes at a single institution (2003–2017) in the USA. The primary outcome was frequency of major or minor congenital anomalies. Glycemic control was assessed by periconception glycosylated hemoglobin (HbA1c). The association of periconception HbA1c with pregnancy outcomes was assessed using bivariable and multivariable analyses.

Results

Our sample included 351 women, of which 63.8% had type 2 diabetes. Our study cohort is racially and ethnically diverse, with approximately equal numbers of women identifying as white non-Hispanic, black non-Hispanic and Hispanic, with 3.4% identifying as Asian. Of these 351 women, 52 (14.8%) had a fetus with a congenital anomaly, of whom the majority (n=43) had a major anomaly. Over half (51.1%) of all major anomalies were cardiovascular. Compared with the group with the best glycemic control (HbA1c ≤7.4%), which had an anomaly frequency of 10.2%, the frequency of congenital anomalies increased significantly with each category of worsening glycemic control (HbA1c 7.5%–9.4%: 20.6%, adjusted OR (aOR) 2.35, 95% confidence interval (CI) 1.08 to 5.13; HbA1c 9.5% to 11.4%: 25.8%, aOR 2.86, 95% CI 1.08 to 7.59; HbA1c ≥11.5%: 37.5%, aOR 7.66, 95% CI 2.27 to 25.9).

Conclusion

In a diverse cohort of women with pregestational diabetes, higher periconception HbA1c, especially HbA1c >9.5, was significantly associated with major congenital fetal anomalies. Our study sample is reflective of the current population of pregnant women with diabetes, including women with type 2 diabetes and from racial and ethnic minorities.
Evaluation of CogSport for acute concussion diagnosis in cricket
Authors: James Kira , Saw Anna E , Saw Richard , Kountouris Alex , Orchard John William
Published: April 2021

Objective

The diagnosis of sport-related concussion is a challenge for practitioners given the variable presentation and lack of a universal clinical indicator. The aim of this study was to describe the CogSport findings associated with concussion in elite Australian cricket players, and to evaluate the diagnostic ability of CogSport for this cohort.

Methods

A retrospective study design was used to evaluate CogSport performance of 45 concussed (male n=27, mean age 24.5±4.5 years; female n=18, 23.5±3.5 years) compared with 45 matched non-concussed (male n=27, mean age 27.3±4.5 years; female n=18, 24.1±4.5 years) elite Australian cricket players who sustained a head impact during cricket specific activity between July 2015 and December 2019.

Results

Median number of reported symptoms on the day of injury for concussed players was 7 out of 24, with a median symptom severity of 10 out of 120. CogSport performance deteriorated significantly in concussed cricket players’ Detection speed (p<0.001), Identification speed (p<0.001), One Back speed (p=0.001) and One Back accuracy (p=0.022) components. These components, when considered independently and together, had good diagnostic utility.

Conclusion

This study demonstrated good clinical utility of CogSport for identifying concussed cricket players, particularly symptoms and Detection, Identification and One Back components. Therefore, CogSport may be considered a useful tool to assist concussion diagnosis in this cohort, and the clinician may place greater weight on the components associated with concussion diagnosis.
Pathologists’ assistants, an essential healthcare workforce: the experience of a surgical pathology department in Italy
Authors: Bortesi Mara , Marchetti Marialisa , Arpaia Ilaria , Marchi Letizia , Ganassi Marilena , Zanetti Eleonora , Fontanesi Cristina , Costantini Massimo , Piana Simonetta
Published: April 2021

Aims

The progressive increase of both the workload and the complexity of laboratory procedures, along with shortage of staff, has made evident the need to increase the efficiency in the pathology departments. To support the pathologists, a new technical professional role, the pathologists’ assistant (PA), has been introduced.

Methods

We decided to carry out a retrospective analysis on PAs’ performance. This was compared with that of junior/senior pathologists in the amount and type of surgical specimens examined, the number of lymph node retrieved in colorectal resections, the number of cases needing a second grossing procedure and the average time spent in grossing. As the COVID-19 pandemic period in fact resulted in a dramatic reduction of histological cases in our department, we divided PA activities into two periods, according to the COVID-19 pandemic.

Results

‘Simple’ specimens made up the majority (92%) of the specimens examined by PAs in pre-COVID-19 period while ‘complex’ specimens, often neoplastic, represented the minor part (7%). However, ‘simple’ specimens dropped to 81% and ‘complex’ specimens rose to 18% in the COVID-19 period, when PAs had the chance to test themselves with more complicated surgical samples, under the supervision of a pathologist. Lymph node retrieval rate and average time spent in grossing are in line with literature data and confirm that PAs performance is comparable with pathologists’ one, in selected settings.

Conclusion

In our experience, PA has represented a fundamental time-saving resource for the pathologists, who can devote time almost exclusively to diagnostic reporting.
Early atypical signs and insula hypometabolism predict survival in multiple system atrophy
Authors: Grimaldi Stephan , Boucekine Mohamed , Witjas Tatiana , Fluchere Frederique , Azulay Jean-Philippe , Guedj Eric , Eusebio Alexandre
Published: April 2021

Objective

We aim to search for predictors of survival among clinical and brain 18F-FDG positron emission tomography (PET) metabolic features in our cohort of patients with multiple system atrophy (MSA).

Methods

We included patients with a ‘probable’ MSA diagnosis for whom a clinical evaluation and a brain PET were performed early in the course of the disease (median 3 years, IQR 2–5). A retrospective analysis was conducted using standardised data collection. Brain PET metabolism was characterised using the Automated Anatomical Labelling Atlas. A Cox model was applied to look for factors influencing survival. Kaplan-Meier method estimated the survival rate. We proposed to develop a predictive ‘risk score’, categorised into low-risk and high-risk groups, using significant variables entered in multivariate Cox regression analysis.

Results

Eighty-five patients were included. The overall median survival was 8 years (CI 6.64 to 9.36). Poor prognostic factors were orthostatic hypotension (HR=6.04 (CI 1.58 to 23.12), p=0.009), stridor (HR=3.41 (CI 1.31 to 8.87), p=0.012) and glucose PET hypometabolism in the left insula (HR=0.78 (CI 0.66 to 0.92), p=0.004). Good prognostic factors were time to diagnosis (HR=0.68 (CI 0.54 to 0.86), p=0.001) and use of selective serotonin reuptake inhibitor (SSRI) (HR=0.17 (CI 0.06 to 0.46), p<0.001). The risk score revealed a 5-year gap separating the median survival of the two groups obtained (5 years vs 10 years; HR=5.82 (CI 2.94 to 11.49), p<0.001).

Conclusion

The clinical prognosis factors we have described support published studies. Here, we also suggest that brain PET is of interest for prognosis assessment and in particular in the search for left insula hypometabolism. Moreover, SSRIs are a potential drug candidate to slow the progression of the disease.
Physiological and prognostic differences between types of exercise stress echocardiography for functional mitral regurgitation
Authors: Kagiyama Nobuyuki , Toki Misako , Yuri Takuya , Aritaka Shingo , Hayashida Akihiro , Sengupta Partho P , Yoshida Kiyoshi
Published: April 2021

Objective

Secondary mitral regurgitation (MR) demonstrates dynamic change during exercise. This prospective observational study aimed to compare exercise stress echocardiography (ESE) where handgrip exercise (handgrip-ESE) or semisupine ergometer exercise was performed (ergometer-ESE) for patients with secondary MR.

Methods

Handgrip-ESE and symptom-limited ergometer-ESE were performed for 53 patients (median age (IQR): 68 (58–78) years; 70% male) on the same day. Baseline global longitudinal strain (GLS) was 9.2% (6.0%–14.0%) and MR volume was 20 (14–26) mL. All-cause death and cardiac hospitalisation were tracked for median 439 (101–507) days.

Results

Handgrip-ESE induced slightly but significantly greater degrees of MR increase (median one grade increase; p<0.001) than ergometer-ESE, although the changes in other parameters, including GLS (+1.1% vs −0.6%, p<0.001), were significantly smaller. Correlations between the two examinations with respect to the changes in the echocardiographic parameters were weak. Kaplan-Meier analyses revealed poor improvement in GLS during ergometer-ESE, but not the change in MR, was associated with adverse events (p=0.0065). No echocardiographic change observed during handgrip-ESE was prognostic. After adjusting for a clinical risk score, GLS changes during ergometer-ESE remained significant in predicting the adverse events (HR 0.39, p=0.03) A subgroup analysis in patients with moderate or greater MR at baseline (n=27) showed the same results as in the entire cohort.

Conclusions

The physiological and prognostic implications of handgrip-ESE and ergometer-ESE findings significantly differ in patients with left ventricular dysfunction and secondary MR. The type of exercise to be performed in ESE should be carefully selected.
Icosapent ethyl: scientific and legal controversies
Authors: Curfman Gregory , Shehada Emile
Published: April 2021

Icosapent ethyl (Vascepa) is a purified preparation of the omega-3 fatty acid eicosapentaenoic acid, which is marketed by Amarin Pharma based in Ireland. The product was initially approved by the US Food and Drug Administration for the use of a high dose (4 g/day) in the treatment of hypertriglyceridaemia. On the basis of the results of the REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl Intervention Trial), the agency later granted a label extension to include the additional indication of a reduction in risk of cardiovascular events in persons with serum triglyceride levels of 150 mg/dL or greater and established cardiovascular disease or diabetes. Data supporting the efficacy of omega-3 fatty acids in the prevention of cardiovascular disease have been inconsistent and controversial. The story of the development of icosapent ethyl has been fraught with challenges, including the invalidation of six core patents on the product, and recently, the completion of a new clinical trial, STRENGTH (Long-Term Outcomes Study to Assess STatin Residual Risk Reduction With EpaNova in HiGh CV Risk PatienTs With Hypertriglyceridemia), that directly contradicts REDUCE-IT and calls into question whether icosapent ethyl is actually effective in the secondary prevention of cardiovascular events. This article traces the course of the development of this fascinating product and discusses its complex medical, regulatory and legal history, which is still continuing to unfold.
Mechanical performance of lintel-column joint of Chinese traditional style architecture with viscous damper
Authors: JinShuang Dong , Yan Sui , Jianyang Xue
Published: April 2021

Using a fast dynamic loading method, six Chinese traditional style lintel-column joints were tested and studied, and seismic performance indicators of the joints were obtained. The results indicate that the seismic behavior of Chinese traditional style architecture with the lintel-column joint was superior to that of the contemporary beam-column connection, and the load-bearing capacity and dissipation energy capacity of specimens with viscous dampers were superior to those of specimens without viscous dampers. Compared with single lintel-column joints, dual-lintel-column joints exhibit higher bearing capacity stiffness and fuller hysteretic curves. The dual-lintel-column structure located in the outer eave column plays a role similar to that of the ring beam, which could enhance the overall performance of the structure. A series of damage models was used to evaluate the entire process damage for the six specimens. Furthermore, the results and proposals not only benefit the further development of Chinese traditional style structures but also have reference value for the design, construction, and research of Chinese traditional style structures.