bluuebunny/crossref_metadata_2025 huggingface dataset:
Puerarin improved growth performance and postmortem meat quality by regulating lipid metabolism of cattle under hot environment
Authors: Peng Tao , Shang Hanle , Yang Mingrui , Li Yanjiao , Luo Junrong , Qu Mingren , Zhang Xinyu , Song Xiaozhen
Published: March 2021

This study aims to evaluate the effect of puerarin on performance, meat quality, and serum indexes of beef cattle under hot environment. Thirty‐two bulls were divided into four groups and fed diet supplemented with puerarin at 0, 200, 400, or 800 mg/kg. Results showed that heat stress was employed for 54 out of 60 days, 400 mg/kg group declined serum cortisol (COR) contents, all treatments increased the contents of total cholesterol, high density lipoprotein cholesterol, and total superoxide dismutase activity; in addition, glutathione peroxidase activity of 200 mg/kg group were enhanced, only 800 mg/kg group enhanced immunoglobulin (IgA, IgM, and IgG) and low density lipoprotein cholesterol contents compared with the control (p < .05). Moreover, 400‐mg/kg puerarin increased serum growth hormone levels compared with 200 mg/kg group but declined COR concentrations compared with 200 mg/kg and 800 mg/kg groups (p < .05). More importantly, average daily gain and daily matter intake, and intramuscular fat contents of 400 mg/kg group were enhanced, but the shear force of beef in 400 mg/kg and 800 mg/kg groups were declined compared with the control (p < .05). These findings indicated that supplemental with puerarin enhanced immune and antioxidant, and 400 mg/kg of puerarin improved performance and meat quality by normalizing levels of stress hormones and increasing intramuscular fat deposition of beef cattle under hot environment.
Investigating the prescribing trajectory and geographical drug utilisation patterns of gabapentinoids in primary care in England: An ecological study
Authors: Gu Xinchun , Chen Teng‐Chou , Su Ting‐Li , Steinke Douglas , Chen Li‐Chia
Published: March 2021

Aims

This study aimed to investigate the prescribing trajectory, geographical variation and population factors, including socioeconomic status (SES), related to prescribing gabapentinoids in primary care in England.

Methods

This ecological study applied practice‐level dispensing data and statistics from the UK National Health Service Digital and Office for National Statistics from 2013 to 2019. The prescribing of gabapentinoids (in defined daily doses [DDDs]/1000 people) was measured annually and quarterly. General practices were categorised according to the quarterly prescribing in a group‐based trajectory model. The one‐year prescribing in 2018/19 was associated with practice‐level covariates in a mixed‐effects multilevel regression, adjusted for the cluster‐effects of Clinical Commissioning Groups (CCGs) and mapped geographically.

Results

The annual national prescription rate increased by 70% from 2800 to 4773 DDDs/1000 people in the time period 2013/14 to 2018/19. General practices were stratified into six trajectory groups. Practices with the highest level and the greatest increase in prescribing (n = 789; 9.8%) are mainly located in the north of England and along the east and south coastline. Socioeconomic status, demographic characteristics and relevant disease conditions were significantly associated with the prescribing. For every decrease in the Index of Multiple Deprivation decile (becoming less affluent), prescribing of gabapentinoids increased significantly by 203 (95% CI: 183–222) DDDs/1000 registrants.

Conclusions

Gabapentinoid prescribing trajectories varied across geographical regions and are associated with socioeconomic status, CCG locality (geography) and other population characteristics. These factors should be considered in future studies investigating the determinants of gabapentinoid prescribing and the risk of harms associated with gabapentinoids.
Heterogeneity in response to repeated intranasal oxytocin in schizophrenia and autism spectrum disorders: A meta‐analysis of variance
Authors: Martins Daniel , Paduraru Maria , Paloyelis Yannis
Published: March 2021

Intranasal oxytocin (OT) has been suggested as a putative adjunctive treatment for patients with schizophrenia and autism spectrum disorders (ASD). Here, we examine available evidence from trials investigating the effects of repeated administrations of intranasal OT on the core symptoms of patients with schizophrenia and ASD, focusing on its therapeutic efficacy and heterogeneity of response (meta‐ANOVA). Repeated administration of intranasal OT does not improve most of the core symptoms of schizophrenia and ASD, beyond a small tentative effect on schizophrenia general symptoms. However, we found significant moderator effects for dose in schizophrenia total psychopathology and positive symptoms, and percentage of included men and duration of treatment in schizophrenia general symptoms. We found evidence of heterogeneity (increased variance) in the response of schizophrenia negative symptoms to intranasal OT compared with placebo, suggesting that subgroups of responsive and non‐responsive patients might coexist. For other core symptoms of schizophrenia, or any of the core symptom dimensions in ASD, the response to repeated treatment with intranasal OT did not show evidence of heterogeneity.

LINKED ARTICLES

This article is part of a themed issue on Building Bridges in Neuropharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.8/issuetoc
Deubiquitinating enzyme inhibitor alleviates cyclin A1‐mediated proteasome inhibitor tolerance in mixed‐lineage leukemia
Authors: Ge Maolin , Xu Qiongyu , Kang Ting , Li Dan , Wang Ruiheng , Chen Zhihong , Xie Shufeng , Wang Wenbin , Liu Han
Published: March 2021

Drug resistance is a significant obstacle to effective cancer treatment. Drug resistance develops from initially reversible drug‐tolerant cancer cells, which offer therapeutic opportunities to impede cancer relapse. The mechanisms of resistance to proteasome inhibitor (PI) therapy have been investigated intensively, however the ways by which drug‐tolerant cancer cells orchestrate their adaptive responses to drug challenges remain largely unknown. Here, we demonstrated that cyclin A1 suppression elicited the development of transient PI tolerance in mixed‐lineage leukemia (MLL) cells. This adaptive process involved reversible downregulation of cyclin A1, which promoted PI resistance through cell‐cycle arrest. PI‐tolerant MLL cells acquired cyclin A1 dependency, regulated directly by MLL protein. Loss of cyclin A1 function resulted in the emergence of drug tolerance, which was associated with patient relapse and reduced survival. Combination treatment with PI and deubiquitinating enzyme (DUB) inhibitors overcame this drug resistance by restoring cyclin A1 expression through chromatin crosstalk between histone H2B monoubiquitination and MLL‐mediated histone H3 lysine 4 methylation. These results reveal the importance of cyclin A1‐engaged cell‐cycle regulation in PI resistance in MLL cells, and suggest that cell‐cycle re‐entry by DUB inhibitors may represent a promising epigenetic therapeutic strategy to prevent acquired drug resistance.
A novel paired associative stimulation protocol with a high‐frequency peripheral component: A review on results in spinal cord injury rehabilitation
Authors: Shulga Anastasia , Lioumis Pantelis , Kirveskari Erika , Savolainen Sarianna , Mäkelä Jyrki P.
Published: March 2021

In recent decades, a multitude of therapeutic approaches has been developed for spinal cord injury (SCI), but few have progressed to regular clinical practice. Novel non‐invasive, cost‐effective, and feasible approaches to treat this challenging condition are needed. A novel variant of paired associative stimulation (PAS), high‐PAS, consists of non‐invasive high‐intensity transcranial magnetic stimulation (TMS) and non‐invasive high‐frequency electrical peripheral nerve stimulation (PNS). We observed a therapeutic effect of high‐PAS in 20 patients with incomplete SCI with wide range of injury severity, age, and time since injury. Tetraplegic and paraplegic, traumatic, and neurological SCI patients benefited from upper‐ or lower‐limb high‐PAS. We observed increases in manual motor scores (MMT) of upper and lower limbs, functional hand tests, walking tests, and measures of functional independence. We also optimized PAS settings in several studies in healthy subjects and began elucidating the mechanisms of therapeutic action. The scope of this review is to describe the clinical experience gained with this novel PAS approach. This review is focused on the summary of our results and observations and the methodological considerations for researchers and clinicians interested in adopting and further developing this new method.
Logical and natural life in Hegel
Authors: Kabeshkin Anton
Published: March 2021

In this article, I discuss the specific ways in which Hegel's account of life and organisms advances upon Kant's account of natural purposes in the third Critique. First of all, I argue that it is essential for Hegel's account that it contains two levels. The first level is that of logical life, the discussion of which does not depend on any empirical knowledge of natural organisms. I provide my reconstruction of this logical account of life that answers to the objection made by a number of Hegel scholars to the effect that Hegel does in fact rely on empirical knowledge at this place in the logic. The second level is that of natural organisms themselves. I argue that it is with the help of this separation of the logical and natural levels, as well as his doctrine of the impotence of nature, that Hegel, unlike Kant, (a) is able to claim that not everything in natural organisms is purposive, and (b) provide a philosophical, and not merely empirical, account of the distinction between plants and animals. In both of these respects, Hegel's position can be seen as a welcome advance over Kant.
Apolipoprotein E genotype predicts subarachnoid extension in spontaneous intracerebral haemorrhage
Authors: Ye Xiaodong , Li Guo , Liu Xiaoyan , Song Guini , Jia Yuchao , Wu Chunmei , Wang Xiong , Huang Shanshan , Zhu Suiqiang
Published: March 2021

Background and purpose

Spontaneous intracerebral haemorrhage (ICH) with subarachnoid extension (SAHE) predicts poor outcomes and haematoma expansion in spontaneous ICH and is also a potential predictor of the severity of vascular amyloid deposition. The biological underpinnings of SAHE remain elusive. A study was conducted to identify risk factors associated with SAHE.

Methods

A retrospective analysis was performed of an ongoing prospective cohort of primary spontaneous supratentorial ICH patients admitted to Tongji Hospital. SAHE was rated on baseline noncontrast computed tomography images by investigators blinded to the clinical data.

Results

A total of 189 patients were enrolled. Apolipoprotein E (APOE) ε2 copies (p = 0.020), but not APOE ε4 copies (p > 0.2), were more common in patients with SAHE in univariate analysis. After controlling for confounding factors in multiple logistic regression, lobar haematoma (odds ratio [OR] 14.21, 95% confidence interval [CI] 5.89–34.33; p < 0.001), large haematoma volume (OR 1.04, 95% CI 1.02–1.06; p < 0.001) and APOE ε2 copies (OR 3.07, 95% CI 1.05–8.97; p = 0.041) were three independent predictors of SAHE. For subgroup analysis stratified by location, APOE ε2 showed a possible association with SAHE in lobar ICH (p = 0.026) but not in deep ICH (p > 0.2). No significant association was found between APOE ε4 copies and either lobar (p > 0.2) or deep ICH (p > 0.2).

Conclusions

The APOE ε2 allele predicts SAHE in spontaneous supratentorial ICH. The association may predominantly apply to lobar ICH. Given the established relationship between the APOE ε2 allele and pathological cerebrovascular changes, our findings suggest that SAHE involves genetically driven vessel pathology.
Service life estimation of self‐piercing riveted joints by linear damage accumulation
Authors: Masendorf Lukas , Wächter Michael , Esderts Alfons , Otroshi Mortaza , Meschut Gerson
Published: March 2021

Tests under variable amplitude loading on self‐piercing riveted components with semi‐tubular rivets result in longer service lives than those calculated by linear damage accumulation. An overview of the literature shows that damage sums greater than one are found for other types of riveted joints either, while an explanation for this unusual behavior is still missing. Therefore, this behavior is examined in more detail. A correlation is shown between the damage sum and the hardness of the load spectrum. Considering this correlation, the accuracy of the service life estimation can be improved significantly.
Application of a digital image correlation bridge inspection methodology on geometrically complex bifurcated distortion‐induced fatigue cracking
Authors: Al‐Salih Hayder , Juno Mary , Collins William , Bennett Caroline , Li Jian
Published: March 2021

Distortion‐induced fatigue cracking is a concern for many aging steel bridges in the United States. Human visual inspections to characterize fatigue cracks have many drawbacks including inconsistencies in identification, significant time and monetary costs, and safety risks posed to the lives of both inspectors and the traveling public due to lane closures. Digital image correlation (DIC) is a vision‐based technology which has shown promise for identifying and characterizing fatigue cracks. Three‐dimensional DIC measurements can capture full‐field displacements and strains, allowing for detection and characterization of both in‐plane and distortion‐induced fatigue cracks. This paper describes an experimental study in which a half‐scale steel girder to crossframe subassembly was subjected to distortion‐induced fatigue loading to produce multiple geometrically complex cracks. A DIC‐based crack characterization methodology was applied to quantify the cracks, which was successful at characterizing cracks propagating in the girder web but struggled to characterize horizontal cracks. Additional work is needed to improve the accuracy of the DIC‐based crack characterization methodology to use as an automated bridge inspection tool.
Drought alters the carbon footprint of trees in soils—tracking the spatio‐temporal fate of 13C‐labelled assimilates in the soil of an old‐growth pine forest
Authors: Gao Decai , Joseph Jobin , Werner Roland A , Brunner Ivano , Zürcher Alois , Hug Christian , Wang Ao , Zhao Chunhong , Bai Edith , Meusburger Katrin , Gessler Arthur , Hagedorn Frank
Published: March 2021

Above and belowground compartments in ecosystems are closely coupled on daily to annual timescales. In mature forests, this interlinkage and how it is impacted by drought is still poorly understood. Here, we pulse‐labelled 100‐year‐old trees with 13CO2 within a 15‐year‐long irrigation experiment in a naturally dry pine forest to quantify how drought regime affects the transfer and use of assimilates from trees to the rhizosphere and associated microbial communities. It took 4 days until new 13C‐labelled assimilates were allocated to the rhizosphere. One year later, the 13C signal of the 3‐h long pulse labelling was still detectable in stem and soil respiration, which provides evidence that parts of the assimilates are stored in trees before they are used for metabolic processes in the rhizosphere. Irrigation removing the natural water stress reduced the mean C residence time from canopy uptake until soil respiration from 89 to 40 days. Moreover, irrigation increased the amount of assimilates transferred to and respired in the soil within the first 10 days by 370%. A small precipitation event rewetting surface soils altered this pattern rapidly and reduced the effect size to +35%. Microbial biomass incorporated 46 ± 5% and 31 ± 7% of the C used in the rhizosphere in the dry control and irrigation treatment respectively. Mapping the spatial distribution of soil‐respired 13CO2 around the 10 pulse‐labelled trees showed that tree rhizospheres extended laterally 2.8 times beyond tree canopies, implying that there is a strong overlap of the rhizosphere among adjacent trees. Irrigation increased the rhizosphere area by 60%, which gives evidence of a long‐term acclimation of trees and their rhizosphere to the drought regime. The moisture‐sensitive transfer and use of C in the rhizosphere has consequences for C allocation within trees, soil microbial communities and soil carbon storage.
Three walls
Authors: Pérezts Mar
Published: March 2021

A year into the COVID 19 pandemic, I reflect upon walls and the fact that the lockdown has exacerbated humanity's experience of walls in themselves and, guided by an act of pictorial rebelliousness, push for a feminist way of re‐enchanting them both materially and symbolically.
Cytokeratin 8/18‐negative somatotroph pituitary neuroendocrine tumours (PitNETs, adenomas) show variable morphological features and do not represent a clinicopathologically distinct entity
Authors: Soukup Jiri , Cesak Tomas , Hornychova Helena , Manethova Monika , Michnova Ludmila , Netuka David , Vitovcova Barbora , Cap Jan , Ryska Ales , Gabalec Filip
Published: March 2021

Aims

In somatotroph pituitary neuroendocrine tumours (adenomas), a pattern of cytokeratin (CK) 18 expression is used for tumour subclassification, with possible clinical implications. Rare somatotroph tumours do not express CK 18. We aimed to characterise this subset clinically and histologically.

Methods and results

Clinical and pathological data for the study were derived from a previously published data set of a cohort of 110 patients with acromegaly. Data included serum levels of insulin‐like growth factor 1 (IGF1), growth hormone (GH), prolactin and thyroid‐stimulating hormone (TSH), tumour diameter, tumour invasion defined by Knosp grade and immunohistochemical data concerning the expression of Ki67, p53, E‐cadherin, somatostatin receptor (SSTR)1, SSTR2A, SSTR3, SSTR5 and D2 dopamine receptor. Additional immunohistochemical analysis (AE1/3, CK 8/18, vimentin, neurofilament light chain, internexin‐α) was performed. CK 18 was negative in 10 of 110 (9.1%) tumours. One of these tumours was immunoreactive with CK 8/18 antibody, while the remainder expressed only internexin‐α intermediate filament in patterns similar to CK 18 (perinuclear fibrous bodies). CK‐negative tumours showed no significant differences with respect to biochemical, radiological or pathological features. They showed significantly higher expression of SSTR2A compared to the sparsely granulated subtype and significantly lower expression of E‐cadherin compared to the non‐sparsely granulated subtypes of tumours. The tumours showed divergent morphology and hormonal expression: two corresponded to densely granulated tumours and three showed co‐expression of prolactin and morphology of either mammosomatotroph or somatotroph–lactotroph tumours. Four tumours showed morphology and immunoprofile compatible with plurihormonal Pit1‐positive tumours.

Conclusions

CK‐negative somatotroph tumours do not represent a distinct subtype of somatotroph tumours, and can be further subdivided according to their morphology and immunoprofile.
Managing pain associated with dermatologic procedures
Authors: Winsett Frank , Gleghorn Kristyna , Croley Julie , Wagner Richard F.
Published: March 2021

Dermatologists are faced with an aging population, accompanied by an increase in the incidence of skin cancer, especially nonmelanoma skin cancer. With this increase in cutaneous malignancy comes an increase in the number of dermatologic procedures being performed. A common concern of dermatologists and dermatology patients is the attenuation and management of pain associated with dermatologic procedures. Fortunately, there are several techniques that may be used in the preoperative, intraoperative, and postoperative periods to manage patient anxiety, minimize injection pain, and safely and effectively treat postoperative pain.
Adolescents report low opposition towards policy options to reduce consumption of sugary drinks
Authors: Miller Caroline Louise , Dono Joanne , Scully Maree , Morley Belinda , Ettridge Kerry
Published: March 2021

Background

Policy makers benefit from insight into consumer perceptions of potential sugary drink policy measures. Adolescents are among the highest consumers in Australia, yet their perceptions are unknown.

Objectives

To determine adolescents' perceptions of potential policies aimed at reducing sugary drink consumption and explore variation in perceptions.

Methods

Data were collected via a nationally representative survey of Australian secondary school students (aged 12‐17) using a stratified two‐stage probability design (n = 9102). Survey questions assessed receptiveness to five policy options, sugary drink consumption, perceptions of health effects and demographics.

Results

Low proportions (13%‐29%) were somewhat/strongly against policy options, 35% to 45% were neutral, and 27% to 52% were somewhat/strongly in favour. Highest support was observed for text warning labels on sugary drinks (52%), followed by tax with investment in healthy weight programmes (43%), standalone tax (36%), restricting school sales (30%) and restricting advertising to children (27%). Sex, sugary drink consumption and perceptions were significantly associated with most assessed policy options in bivariate analyses (P < .01). Significant associations between sex and consumption with selected policy options persisted in adjusted multilevel models.

Conclusions

Opposition towards policy options was low overall and neutrality was common. This creates opportunity for early intervention to increase public support for addressing specific health issues.
Recent advancements in melanoma management
Authors: Krishnan Tharani , Menzies Alexander M. , Roberts‐Thomson Rachel
Published: March 2021

The treatment options for patients with melanoma have expanded significantly over the past decade. In particular, the use of targeted therapy and immunotherapy has dramatically transformed the outlook for patients with advanced disease. These treatments are now being utilised as adjuvant therapy for patients with earlier stage melanoma after surgical resection. We review the latest updates for melanoma staging, surgical resection, radiotherapy and systemic therapies.
Managing inpatient hyperglycaemia and initiating sodium‐glucose cotransporter 2 inhibitor therapy in the setting of diabetes and acute coronary syndrome
Authors: Hitchen Sarah A. , Lan Nick S. R. , Hort Adam L. , Rankin James M. , Fegan P. Gerry , Yeap Bu B.
Published: March 2021

We previously showed that implementing algorithms for managing diabetes in acute coronary syndrome was associated with improved inpatient glycaemic control and increased sodium‐glucose cotransporter 2 (SGLT2) inhibitor prescriptions. The present study performed 1 year later found that inpatient hyperglycaemia had relapsed to pre‐intervention rates, although SGLT2 inhibitor prescriptions remained increased. We discuss the challenges of improving inpatient glycaemic control.
China’s development of a multi‐tier pension system
Authors: Chen Tianhong , Turner John A.
Published: March 2021

China has made a number of major changes to its pension system in the period 2014–2020, and is in the process of establishing a multi‐tier old‐age pension system, consisting of programmes provided by the government, voluntary programmes provided by enterprises, and voluntary programmes established by individuals. Policy objectives are to reduce the fragmentation in its pension system; deal with population ageing; and diversify risks by involving the government, enterprises as well as individuals. This article shows that while China has a complex system for urban workers, the coverage provided by its multi‐tier system is uneven, with the second and third tiers being in the early stages of development.
Influence of incentive nursing intervention on recovery of burn patients after vacuum sealing drainage
Authors: Ren Liqing , Zhang Cuina , Zhao Lihua , Li Cuikun , Zhang Li , Xue Xin
Published: March 2021

To observe the effect of application of incentive nursing intervention (INI) on recovery in burn patients undergoing vacuum sealing drainage (VSD). From January 2017 to January 2020, a total of 82 consecutive burn patients were prospectively enrolled, and divided into INI group and routine nursing intervention (RNI) group according to random number table method. The causes of inadequate drainage were collected, the incidence was calculated, and the occurrence of inadequate drainage at different locations was compared. The pain degree and comfort status before and after the intervention were observed, and the wound healing time, hospital stay, and satisfaction after the intervention were recorded. The reasons for inadequate drainage during the treatment of VSD included negative pressure insufficient, drainage tube blockage because of escharosis, replacement of negative pressure internal sac not standard, loose sealing of the semi‐permeable membrane, and the negative pressure tube fell off, compressed or reflexed. The baseline characteristics between the two groups were comparable (P > .05). The incidence of each cause and total incidence of inadequate drainage in INI group were lower than those in RNI group (P < .05, respectively). The incidences of inadequate drainage of all burn sites in INI group were lower than those in RNI group, and the difference of limbs wound between the two group was statistically significant (P < .05). After intervention, the pain intensity of INI group was lower than that of RNI group (P < .05), and the holistic comfort of INI group was higher than that of RNI group (P < .05). The wound healing time and hospital stay time in INI group were lower than those in RNI group, and the total satisfaction rate in INI group was higher than that in RNI group (P < .05, respectively). Applying INI can effectively reduce the incidence of insufficient drainage, reduce pain, improve comfort, shorten wound healing time and hospital stay, and thus improve the overall satisfaction rate of patients, which is worthy of clinical promotion and application.
Lipid metabolism regulator human hydroxysteroid dehydrogenase‐like 2 (HSDL2) modulates cervical cancer cell proliferation and metastasis
Authors: Yang Yang , Han Anna , Wang Xinyue , Yin Xianglin , Cui Minghua , Lin Zhenhua
Published: March 2021

Human hydroxysteroid dehydrogenase‐like 2 (HSDL2) is a potent regulator in cancers and is also involved in lipid metabolism, but the role of HSDL2 in cervical cancer and whether it regulates the progress of cervical cancer through lipid metabolism remains unclear. In this study, we found that the overexpression of HSDL2 was in relation with cervical cancer progression including lymph nodes metastasis and recurrence. HSDL2 could serve as a novel marker of early diagnosis in cervical cancer. HSDL2 also gave impetus to tumorigenesis by initiating and promoting proliferation, invasion and migration of cervical cancer cells (Hela, C33A and SiHa) through EMT. Interestingly, we also searched that HSDL2 participated in oncogenesis by regulating lipid metabolism. In sum, our results gave the novel insight of HSDL2 functions which could be the potential for being the biomarker of prognosis and new target of therapy.
Management and outcomes of a COVID‐19 outbreak in a nursing home with predominantly Black residents
Authors: Beiting Kimberly J. , Huisingh‐Scheetz Megan , Walker Jacob , Graupner Jeffrey , Martinchek Michelle , Thompson Katherine , Levine Stacie , Gleason Lauren J.
Published: March 2021

Background/Objectives

Few studies present clinical management approaches and outcomes of coronavirus disease 2019 (COVID‐19) outbreaks in skilled nursing facilities (SNFs). We describe outcomes of a clinical management pathway for a large COVID‐19 outbreak in an urban SNF with predominantly racial minority (>90% black), medically complex, older residents.

Design

Single‐center, retrospective, and observational cohort study (March 1, 2020–May 31, 2020).

Setting and Participants

All subacute and long‐term care residents at an urban SNF between March 1, 2020 and May 31, 2020 (Chicago, IL).

Intervention

A multicomponent management pathway was developed to manage a large COVID‐19 outbreak in an SNF.

Measurements

Chart review was used to extract demographics, comorbidities, symptoms, lab results, and clinical outcomes over 12 weeks, which were summarized and compared between residents with and without COVID‐19.

Results

A multicomponent clinical management pathway was used to care for residents with COVID‐19, which included frequent scheduled clinical and laboratory evaluation, use of intravenous fluids, supplemental oxygen, antibiotics when indicated, and goals‐of‐care discussions. Of the 204 residents, 172 (84.3%) tested positive for SARS‐CoV‐2 during the 3‐month period, with 50.5% symptomatic, 9.3% presymptomatic, and 24.5% asymptomatic, with a 30‐day mortality rate of 15.7%. Predominant symptoms were low‐grade fever >99 °F, anorexia, delirium, and fatigue. While in the facility, approximately one‐quarter of residents experienced hypernatremia [Na > 145 mEq/L] (24.5%), acute kidney injury [Cr > 0.03 mg/dL or 1.5× baseline] (29.7%), or leukopenia [WBC < 4.8 1000/mm3] (39.4%).

Conclusion

We present the first available clinical strategy guiding the medical management of a COVID‐19 syndrome in an urban SNF, caring for largely black residents, which may lead to improved mortality.
The link between product service lifetime and GHG emissions: A comparative study for different consumer products
Authors: Glöser‐Chahoud Simon , Pfaff Matthias , Schultmann Frank
Published: March 2021

The production, use, and final disposal of goods are directly linked to various environmental impacts caused along their supply chains and over their entire life cycles. When assessing these impacts for energy‐consuming products such as consumer electronics, not only the emissions caused during production but also the energy consumption during the use phase need to be taken into account in order to provide a holistic view on environmental impacts. However, the interplay between a product's lifetime, reduction of demand through higher durability, energy consumption, and related greenhouse gas (GHG) emissions cannot be generalized but requires very specific analyses, which take into account product‐related aspects and their temporal changes as well as the (changing) properties of the energy and use system. This contribution provides a quantitative assessment of the interrelation between product lifetime and environmental impacts, particularly GHG emissions, using refrigerators and mobile phones as exemplary products with differing characteristics. Whereas in the case of refrigerators, the strongest impact is caused during the use phase because of high energy consumption and related emissions, mobile phones as representatives of classical consumer electronics have their highest environmental impact during production. To assess impacts for both product categories, two simulation models of product life cycles based on methods from dynamic material flow analysis (MFA) are linked with life cycle inventory (LCI) data and LCA results for the respective products, focusing on the impact category of global warming potential (GWP). By systematically evaluating different scenarios, we show major influences on the overall GHG emissions over a product's lifetime capturing temporal developments and modifications within the target system at European scale. In the case of refrigerators, we show that there is a trend towards increasing optimum lifetimes and that current energy efficiency improvements of new devices do not justify early replacement of older devices and, hence, a reduction of service lifetime. This is also because the GHG emissions of electricity production have continuously decreased with an increasing share of renewable energy sources. Regarding mobile phones, we emphasize the counterproductive effect of unused storage time (hibernation) when taking efforts for increasing the service lifetimes aiming at a reduction of demand for new, resource‐consuming devices.
Cost‐effective Analyses of an Urban Public School District's Classroom Breakfast Program
Authors: Walker Elaine , Sutherland Marcia E. , Coppola Nanci , Williams‐Barker Annalesa
Published: March 2021

BACKGROUND

We assessed the cost‐effectiveness and student outcomes related to providing breakfast in the classroom (BIC) setting versus breakfast in the traditional school cafeteria (Cafe).

METHODS

The sample included 2906 African American and Hispanic students attending urban elementary and middle schools in a city in the Northeastern United States. Teachers and other school personnel completed interviews. Teachers completed an online survey.

RESULTS

School absences were lower for students in the BIC program than in the Cafe program. The school suspension rate was lower for the BIC students than the Cafe students. A larger percentage of BIC students (80%) ate breakfast than Cafe students (30%). The BIC program was more cost‐effective than the Cafe program.

CONCLUSIONS

Our findings demonstrate that low‐income students in the BIC program showed improved attendance and increased breakfast consumption. Students who consume a healthy in‐class breakfast may develop better eating habits and academic performance.
Dorsal mediastinal haemorrhage in dogs: 4 cases (2010–2018)
Authors: Peak K. , Walker D. , Agthe P.
Published: March 2021

Objective

This retrospective case series describes the clinical presentation and CT findings of dogs with presumed mediastinal haemorrhage with no apparent identifiable underlying cause.

Materials and Methods

Medical records were searched for dogs with presumed or suspected mediastinal haemorrhage of non‐thymic origin. For all dogs, data on signalment, history, physical examination, treatment and outcome were collected by reviewing the medical records. Follow‐up information was collected by telephone interviews with the owners and/or their primary‐care veterinarians.

Results

Four dogs were included. All survived to discharge with apparent resolution of the mediastinal haemorrhage (based on repeat imaging and/or clinical signs) with supportive treatment alone. Follow‐up information was available from 2 months to 5 years following discharge, and none of the patients showed a recurrence of clinical signs during this period.

Clinical Significance

This case series highlights that presumed haemorrhage into the mediastinum can occur in dogs without an obviously identifiable cause and, whilst rare, should be considered as a cause of dorsal mediastinal masses and may be successfully managed with supportive care alone.
Complex reticulate evolution of speckled brush‐furred rats (Lophuromys) in the Ethiopian centre of endemism
Authors: Komarova Valeria A. , Kostin Danila S. , Bryja Josef , Mikula Ondřej , Bryjová Anna , Čížková Dagmar , Šumbera Radim , Meheretu Yonas , Lavrenchenko Leonid A.
Published: March 2021

The Ethiopian highlands represent a remarkable biodiversity ‘hot spot’ with a very high number of endemic species, even among vertebrates. Ethiopian representatives of a species complex of speckled brush‐furred rats (Lophuromys flavopunctatus sensu lato) inhabit highland habitats ranging from low‐elevation forests to Afroalpine grasslands. These may serve as a suitable model for understanding evolutionary processes leading to high genetic and ecological diversity in montane biodiversity hot spots. Here, we analyse the most comprehensive genetic data set of this group, comprising 315 specimens (all nine putative Ethiopian Lophuromys taxa sampled across most of their distribution ranges) genotyped at one mitochondrial and four nuclear markers, and thousands of SNPs from ddRAD sequencing. We performed phylogenetic analyses, delimited species and mapped their distribution and estimated divergence time between species (under the species‐tree framework) and mitochondrial lineages. We found significant incongruence between mitochondrial and nuclear phylogenies, most probably caused by multiple interspecific introgression events. We discuss alternative scenarios of Ethiopian Lophuromys evolution, from retention of ancestral polymorphism to hybridization upon secondary contact of partially reproductively isolated lineages leading to reticulate evolution. Finally, we use the diversity of the speckled brush‐furred rats for the description of the main biogeographic patterns in the fauna of the Ethiopian highlands.
Diagnostic yield of a bronchoalveolar lavage fluid galactomannan assay in patients with negative serum galactomannan results suspected to have invasive pulmonary aspergillosis
Authors: Lim So Yun , Lee Yun Woo , Jung Jiwon , Kim Min Jae , Chong Yong Pil , Lee Sang‐Oh , Choi Sang‐Ho , Kim Yang Soo , Choi Eun‐Ji , Park Han‐Seung , Lee Jung‐Hee , Lee Je‐Hwan , Lee Kyoo‐Hyung , Kim Sung‐Han
Published: March 2021

Background and objectives

There are limited data in real clinical practice on the diagnostic value of a bronchoalveolar lavage (BAL) fluid galactomannan (GM) assay in patients with suspected invasive pulmonary aspergillosis (IPA) who had negative serum GM results. Thus, we investigated the diagnostic performance of a BAL GM assay in patients with negative serum GM assay results who were suspected to have IPA.

Methods

This retrospective study was performed between May 2008 and April 2019 at a tertiary‐care hospital in Seoul, South Korea. All patients with suspected IPA whose serum GM assays revealed negative results who sequentially underwent BAL were enrolled in this study.

Results

A total of 341 patients with suspected IPA including four cases of proven IPA, 38 cases of probable IPA, 107 cases of possible IPA and 192 patients without IPA were enrolled. Of these 341 patients, 107 (31%) with possible IPA were excluded from the final analysis. Of 42 patients with proven and probable IPA who had initial negative serum GM results, 24 (57%) had positive BAL GM results (n = 24) or BAL fungal culture results (n = 8). In addition, BAL revealed evidence of other opportunistic infections including Pneumocystis jirovecii pneumonia (14% [26/190]), cytomegalovirus (CMV) pneumonia (5% [9/188]) and respiratory viral pneumonia (6% [12/193]).

Conclusion

Sequential BAL in patients with suspected IPA who had initial negative serum GM results provided additional diagnostic yield in approximately half of patients with evidence of another co‐infection.
Comparison of the effectiveness of Ankaferd Blood Stopper® and Emdogain in periodontal regeneration
Authors: Güler Şevki , Cetinkaya Burcu Ozkan , Kurt Bayrakdar Sevda , Ayas Bülent , Keles Gonca Cayir
Published: March 2021

Objectives

The present study was performed to compare the effectiveness of Ankaferd Blood Stopper® (ABS) with enamel matrix derivatives (EMD) for treating fenestration defects in rats.

Materials and Methods

Forty‐eight male Wistar rats were randomly divided into six groups (each n = 8). Fenestration defects were created in all rats, to which ABS, EMD, or saline (S) was then applied. The rats were grouped and sacrificed at one of two different time points, as follows: ABS‐10‐group, ABS‐treatment/sacrifice on day 10; EMD‐10‐group, EMD‐treatment/sacrifice on day 10; S‐10‐group, S‐treatment/sacrifice on day 10; ABS‐38‐group, ABS‐treatment/sacrifice on day 38; EMD‐38‐group, EMD‐treatment/sacrifice on day 38; and S‐38‐group, S‐treatment/sacrifice on day 38. Then, histomorphometric analysis including measurements of new bone area (NBA) and new bone ratio (NBR), and immunohistochemical analysis including the determination of osteopontin (OPN) and type‐III‐collagen (C‐III) expression were performed.

Results

The NBA and NBR were significantly higher in the ABS‐10‐group and EMD‐10‐group compared to the S‐10‐group (p < .05), and in the EMD‐38‐group compared to the S‐38‐group (p < .05). The levels of C‐III and OPN immunoreactivity were significantly higher in the ABS‐10‐group compared to the S‐10‐group (p < .017).

Conclusions

The results of this study suggested that ABS can promote early periodontal regeneration, although its efficacy seems to decrease over time.
Congenital cutaneous non‐neural granular cell tumor mimicking herpetic infection: Case report and review of the literature
Authors: Mancuso Jennifer Brescoll , Haddock Ellen S. , Tucker Suzanne , Newbury Robert , Hinds Brian , Tom Wynnis L.
Published: March 2021

We present a case of a female neonate with a cluster of six skin colored to yellowish pseudovesicular papules on her right forearm present since birth, initially thought to be a herpes simplex virus infection. Punch biopsy with immunostaining revealed a diagnosis of S100‐negative, CD163‐positive congenital cutaneous non‐neural granular cell tumor. Only four other reports are presented in the literature of this entity, three of which also presented on the arm with somewhat similar clinical findings. We briefly reviewed the subtypes of classic and S100‐negative non‐neural granular cell tumors.
An Unconfident Public: Explaining Perceptions of the 2016 Presidential Nominations
Authors: Jewitt Caitlin E.
Published: March 2021

Using an AP‐NORC survey, I analyze the impact of the electoral rules, voter demographics, and perceptions of the 2016 nominations on confidence in the fairness of the presidential nominations. I reveal that perceptions of outsider candidates affect confidence in the parties' processes. Believing that superdelegates are a good idea is associated with feeling more confident. Also, when citizens experience an electoral environment that matches what they believe to be the fairer rule, higher levels of confidence in the fairness of the processes result. These findings matter not only in their own right, but also for the potential influence on participation, the legitimacy of democracy, and party decisions about nominating rules.
Multilevel Climate Governance, Anticipatory Adaptation, and the Vulnerability‐Readiness Nexus
Authors: Kim Hyun , Marcouiller David W. , Woosnam Kyle Maurice
Published: March 2021

Adapting to the social, economic, environmental, and health threats resulting from climate change requires successful multilevel governance and improved decision‐making processes. In this study, we evaluate explanatory relationships that support climate change adaptation. Based on the existing literature, we develop and apply a mixed‐methods approach to examine refined drivers of the vulnerability‐readiness nexus. This study examines the context of multilevel governance and the role of anticipatory adaptation in coping with climate risks at the county level in the U.S. Mississippi River Basin between 1990 and 2010. Our focus is on adaptation to climate change within the context of multilevel governance. Our results suggest that anticipatory adaptation and higher levels of regional capacities are particularly effective in adapting to climate change.
Fan Aerodynamics With a Short Intake at High Angle of Attack
Authors: Mohankumar Ben , Hall Cesare A. , Wilson Mark J.
Published: March 2021

Fans that are designed to maintain thrust at the high angle of attack (AOA) flight condition could exploit the cruise fuel burn benefit of a shorter intake design. This article considers how the fan rotor radial pressure ratio distribution and tip velocity triangle can be designed to improve thrust when coupled to a short intake operating at high AOA. Two AOA values are investigated using unsteady computational fluid dynamics: 20 deg (attached flow) and 35 deg (separated flow). Thrust at high AOA is governed by three key loss and work input mechanisms. (i) Rotor choking loss: flow is accelerated around the intake bottom lip and enters the rotor with high Mach numbers. Fans designed with a tip-high radial pressure ratio distribution reduced choking loss with a separated intake compared to a mid-high design, particularly when the tip velocity triangle was designed with high diffusion instead of high camber. (ii) Rotor–separation interaction loss: the rotor ingests low mass flow when operating inside the separation and the casing boundary layer separates. High diffusion tip designs strengthened the casing separation, but this penalty did not outweigh improved choking loss. (iii) Work input in radial flows: high AOA generates strong radial flows through the rotor, which alter both the amount and the way work is imparted on the flow. Fans designed with a mid-high radial pressure ratio distribution imparted high work on streamlines migrating toward the hub. Consolidating these findings, we propose two design philosophies for improved thrust at high AOA: high work (mid-high radial pressure ratio distribution) or low loss (tip-high radial pressure ratio distribution with high diffusion tip velocity triangle).
Effect of Axial Casing Groove Geometry on Rotor-Groove Interactions in the Tip Region of a Compressor
Authors: Koley Subhra Shankha , Chen Huang , Saraswat Ayush , Katz Joseph
Published: March 2021

This experimental study characterizes the interactions of axial casing grooves (ACGs) with the flow in the tip region of an axial turbomachine. The tests involve grooves with the same inlet overlapping with the rotor blade leading edge, but with different exit directions located upstream. Among them, U grooves, whose circumferential outflow opposes the blade motion, achieve a 60% reduction in stall flowrate, but degrade the efficiency around the best efficiency point (BEP) by 2%. The S grooves, whose outlets are parallel to the blade rotation, improve the stall flowrate by only 36%, but do not degrade the BEP performance. To elucidate the mechanisms involved, stereo-PIV measurements covering the tip region and interior of grooves are performed in a refractive index-matched facility. At low flowrates, the inflow into both grooves, which peaks when they are aligned with the blade pressure side (PS), rolls up into a large vortex that lingers within the groove. By design, the outflow from S grooves is circumferentially positive. For the U grooves, fast circumferentially negative outflow peaks at the base of each groove, causing substantial periodic variations in the flow angle near the blade leading edge. At BEP, interactions with both grooves become milder, and most of the tip leakage vortex (TLV) remains in the passage. Interactions with the S grooves are limited; hence, they do not degrade the efficiency. In contrast, the inflow into and outflow from the U grooves reverses direction, causing entrainment of secondary flows, which likely contribute to the reduced BEP efficiency.
Large Questions, Small Questions, and Leaky Ones Too
Authors: Kretchmar Scott
Published: March 2021

An examination of the kinds of questions we ask ourselves provides a window through which to interpret our history and imagine our future. I suggest that there are three kinds of questions—large ones, small ones, and leaky ones. Those that are identified as large and small map onto the value structures we have created for ourselves in higher education. I call these structures caste systems in which some subdisciplines are valued over others, and theoreticians stand above both practitioners and skill teachers. Leaky questions are those that cross boundaries because they cannot be effectively answered by those residing in any one area or at any one level. I argue that leaky questions generate humility, mutual respect, and incentives for collaboration. I trace my own attempts to address all three kinds of questions as a sport philosopher and conclude that our brighter future in kinesiology, including our attempts to address the harms created by the caste system, requires us to see that most of the questions we find interesting are, in fact, leaky in nature.
Actions on sustainable food production and consumption for the post-2020 global biodiversity framework
Authors: Delabre Izabela , Rodriguez Lily O. , Smallwood Joanna Miller , Scharlemann Jörn P. W. , Alcamo Joseph , Antonarakis Alexander S. , Rowhani Pedram , Hazell Richard J. , Aksnes Dag L. , Balvanera Patricia , Lundquist Carolyn J. , Gresham Charlotte , Alexander Anthony E. , Stenseth Nils C.
Published: March 2021

Actions to transform food systems are key to addressing biodiversity loss.