bluuebunny/crossref_metadata_2025 huggingface dataset:
Cellulose‐Reinforced Starch Biocomposite: Optimization of the Effects of Filler and Various Plasticizers using Design–Expert Method
Authors: Shahmaleki Mostafa , Beigmohammadi Faranak , Movahedi Farnaz
Published: August 2020

In this study, the effect of cellulose as a reinforcement agent and different ratio of glycerol/sorbitol as plasticizers to improve properties in starch biocomposite are optimized with Design–Expert method for the first time. Thermoplastic starch granule is produced with plasticized and cellulose‐reinforced starch by a twin extruder. After conditioning, the starch granule, is molded into sheet using a hot press with thick plates. Dynamic mechanical thermal analysis show that cellulose increases the glass transition temperature to 120 °C. Optimum point of the starch composite obtained by Design–Expert software 7.1.5, is run with 5 wt% cellulose, 17.5 wt% glycerol and 17.5wt% sorbitol that has water vapor permeability value equally of 7.81E‐10g s−1m−1Pa−1, tensile strength of 0.85 MPa, Young´s modulus equally of 377.65 MPa, and elongation at break of 7.08%. Field emission scanning electron microscopy of the optimized biocomposite shows uniform distribution of cellulose in the matrix. Hydroxyl stretching vibrations at 3286 cm−1is a result of new hydrogen bonding between cellulose and starch molecules and peaks at 3366 and 1702 cm−1are attributed to glycerol and sorbitol, respectively in the Fourier transform infrared spectra.
Effect of cement additive on physical and mechanical properties of high calcium fly ash geopolymer mortars
Authors: Kaya Mehmet , Köksal Fuat
Published: August 2020

Geopolymer mortars were produced by replacement of high calcium fly ash with cement at the percentages of 5%, 10%, 15%, 20%, 25%, and 100%. Sodium hydroxide was used as the activator and sodium/binder ratios, by weight, were 10%, 12%, 14%, 16%, 18%, and 20% in mortar mixtures. Some physical properties such as unit weight, water absorption, apparent porosity and ultrasound pulse velocity tests were performed on specimens kept in ambient temperature. Flexural and compressive strength tests were made on specimens kept in ambient temperature, and exposed to temperatures of 200°C, 400°C, 600°C, and 800°C for residual performances of mortars. After exposing of specimens to high temperatures, ultrasound pulse velocity and loss in weights were also determined for deterioration levels. An experimental design is also achieved to find optimum solutions for Na/binder and cement/fly ash ratios by using D‐optimal design method after establishing response surface models for compressive and flexural tensile strengths. The highest compressive strength of 35.65 MPa was obtained in mortar specimens containing 14% sodium at 20% cement replacement with fly ash. Similarly, residual strengths were observed higher than those of other mortar specimens at the same sodium and cement replacement ratios.
Single‐cell RNA expression profiling of SARS‐CoV‐2‐related ACE2 and TMPRSS2 in human trophectoderm and placenta
Authors: Cui D. , Liu Y. , Jiang X. , Ding C. , Poon L. C. , Wang H. , Yang H.
Published: August 2020

Objectives

To examine the characteristics and distribution of possible severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) target cells in the human trophectoderm (TE) and placenta.

Methods

Bioinformatics analysis was performed based on published single‐cell transcriptomic datasets of early TE and first‐ and second‐trimester human placentae. We conducted the transcriptomic analysis of 4198 early TE cells, 1260 first‐trimester placental cells and 189 extravillous trophoblast cells (EVTs) from 24‐week placentae (EVT_24W) using the SMART‐Seq2 method. In addition, to confirm the bioinformatic results, we performed immunohistochemical staining of three first‐trimester, three second‐trimester and three third‐trimester placentae from nine women recruited prospectively to this study. We evaluated the expression of the SARS‐CoV‐2‐related molecules angiotensin‐converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2).

Results

Via bioinformatic analysis, we identified the existence of ACE2 and TMPRSS2 expression in human TE as well as in first‐ and second‐trimester placentae. In the human TE, 54.4% of TE1 cells, 9.0% of cytotrophoblasts (CTBs), 3.2% of EVTs and 29.5% of syncytiotrophoblasts (STBs) were ACE2‐positive. In addition, 90.7% of TE1 cells, 31.5% of CTBs, 22.1% of EVTs and 70.8% of STBs were TMPRSS2‐positive. In placental cells, 20.4% of CTBs, 44.1% of STBs, 3.4% of EVTs from 8‐week placentae (EVT_8W) and 63% of EVT_24W were ACE2‐positive, while 1.6% of CTBs, 26.5% of STBs, 1.9% of EVT_8W and 20.1% of EVT_24W were TMPRSS2‐positive. Pathway analysis revealed that EVT_24W cells that were positive for both ACE2 and TMPRSS2 (ACE2 + TMPRSS2‐positive) were associated with morphogenesis of branching structure, extracellular matrix interaction, oxygen binding and antioxidant activity. The ACE2 + TMPRSS2‐positive TE1 cells were correlated with an increased capacity for viral invasion, epithelial‐cell proliferation and cell adhesion. Expression of ACE2 and TMPRSS2 was observed on immunohistochemical staining in first‐, second‐ and third‐trimester placentae.

Conclusions

ACE2‐ and TMPRSS2‐positive cells are present in the human TE and placenta in all three trimesters of pregnancy, which indicates the possibility that SARS‐CoV‐2 could spread via the placenta and cause intrauterine fetal infection. © 2020 International Society of Ultrasound in Obstetrics and Gynecology
Reduction of stillbirths in England from 2008 to 2017 according to uptake of the Growth Assessment Protocol: 10‐year population‐based cohort study
Authors: Hugh O. , Williams M. , Turner S. , Gardosi J.
Published: August 2020

Objective

Antenatal detection of small‐for‐gestational age (SGA) can reduce significantly the risk of stillbirth. The Growth Assessment Protocol (GAP) was developed to address the problem that most SGA fetuses are missed antenatally. We set out to analyze the effect that the GAP program has had on stillbirth rates in England.

Methods

We analyzed data from 2008 (the year before roll‐out of the GAP program) to 2017 (latest available Office for National Statistics (ONS) unit‐based data). The program consists of five elements: training, evidence‐based guidelines for risk assessment and surveillance of fetal growth, customized charts, recording of process and outcome indicators, and audit of missed SGA cases. All maternity units in England were categorized into one of three groups according to their GAP status in 2017: (1) not in the GAP program; (2) GAP implemented partially (incomplete adoption of protocol, no monitoring and audit); and (3) GAP implemented completely. A subset of the complete‐implementation group comprised the 20 units with the highest SGA detection rates. Unit‐level live‐birth and stillbirth data were obtained from the ONS for each of these groups.

Results

Stillbirth rates declined across all groups from 2008 to 2017, and significantly more in units in which GAP was implemented completely than in the non‐GAP units (P < 0.05). The steepest decline in stillbirth rate was observed in the 20 units with the highest SGA detection rates, which had a 24% lower stillbirth rate compared with the units not using GAP (P < 0.01) in 2017. This difference remained significant after mixed‐effects logistic regression analysis of potential confounding, including social deprivation (odds ratio, 0.76 (95% CI, 0.64–0.90)). Assessment of the nine Bradford Hill causality criteria and associated characteristics suggested that the association between implementation of the GAP program and reduction in stillbirth rate was causal.

Conclusions

There has been an overall reduction in stillbirth rates in England that is likely to be a result of increased awareness of the importance of antenatal detection of SGA as a key risk factor for stillbirth. The decline in stillbirth rates was significantly greater in maternity units that had fully implemented the GAP program, and was most pronounced in the units with the highest antenatal SGA detection rates. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Creative Aspiration and the Betrayal of Promise? The Experience of New Creative Workers
Authors: Taylor Stephanie , Luckman Susan
Published: August 2020

The promise of ‘doing what you love’ continues to attract new aspirants to creative work, yet most creative industries are so characterised by low investment, shifting foci and ongoing technological innovation that all promises must be unreliable. Some would-be creative workers negotiate their own pathways from the outset, ‘following their dream’ as they attempt to convert personal enthusiasms and amateur activities into income-earning careers. Others look to the proliferation of available training and education options, including higher education courses, as possible pathways into creative work. This chapter reviews recent research from the USA, Australia and the UK on the effectiveness—or otherwise—of higher education as preparation for a creative career. The chapter discusses the obstacles that many creative workers, including graduates, encounter on their creative pathways, for instance, as a result of informal work practices and self-employment. The chapter also looks at sources of advantage and disadvantage, such as those associated with particular geographic locations or personal identities. The chapter concludes by introducing the subsequent chapters in the collection. These critically explore the experience of new creative workers in a wide range of national contexts including Australia, Belgium, China, Ireland, Italy, Finland, the Netherlands, Russia and the UK.
Prevention of Illicit Trade in Tobacco Products: Experience of Lithuania
Authors: Švedas Gintaras
Published: August 2020

The chapter deals with Lithuanian legal framework related to illicit trade in tobacco products, criminological data and preventive measures on illicit trade in tobacco products in Lithuania. Also, various aspects of cooperation matters concerning control and prevention of the illicit trade of tobacco products in Lithuania.
The critical transition of Coulomb impurities in gapped graphene
Authors: Asorey M. , Santagata A.
Published: August 2020

The effect of supercritical charge impurities in graphene is very similar to the supercritical atomic collapses in QED for Z > 137, but with a much lower critical charge. In this sense graphene can be considered as a natural testing ground for the analysis of quantum field theory vacuum instabilities. We analyze the quantum transition from subcritical to supercritical charge regimes in gapped graphene in a common framework that preserves unitarity for any value of charge impurities. In the supercritical regime it is possible to introduce boundary conditions which control the singular behavior at the impurity. We show that for subcritical charges there are also non-trivial boundary conditions which are similar to those that appear in QED for nuclei in the intermediate regime 118 < Z < 137. We analyze the behavior of the energy levels associated to the different boundary conditions. In particular, we point out the existence of new bound states in the subcritical regime which include a negative energy bound state in the attractive Coulomb regime. A remarkable property is the continuity of the energy spectral flow under variation of the impurity charge even when jumping across the critical charge transition. We also remark that the energy levels of hydrogenoid bound states at critical values of charge impurities act as focal points of the spectral flow.
Exploring the VISTA of microglia: immune checkpoints in CNS inflammation
Authors: Borggrewe Malte , Kooistra Susanne M. , Noelle Randolph J. , Eggen Bart J. L. , Laman Jon D.
Published: August 2020

Negative checkpoint regulators (NCR) are intensely pursued as targets to modulate the immune response in cancer and autoimmunity. A large variety of NCR is expressed by central nervous system (CNS)-resident cell types and is associated with CNS homeostasis, interactions with peripheral immunity and CNS inflammation and disease. Immunotherapy blocking NCR affects the CNS as patients can develop neurological issues including encephalitis and multiple sclerosis (MS). How these treatments affect the CNS is incompletely understood, since expression and function of NCR in the CNS are only beginning to be unravelled. V-type immunoglobulin-like suppressor of T cell activation (VISTA) is an NCR that is expressed primarily in the haematopoietic system by myeloid and T cells. VISTA regulates T cell quiescence and activation and has a variety of functions in myeloid cells including efferocytosis, cytokine response and chemotaxis. In the CNS, VISTA is predominantly expressed by microglia and macrophages of the CNS. In this review, we summarize the role of NCR in the CNS during health and disease. We highlight expression of VISTA across cell types and CNS diseases and discuss the function of VISTA in microglia and during CNS ageing, inflammation and neurodegeneration. Understanding the role of VISTA and other NCR in the CNS is important considering the adverse effects of immunotherapy on the CNS, and in view of their therapeutic potential in CNS disease.
Young shoots of red cabbage are a better source of selected nutrients and glucosinolates in comparison to the vegetable at full maturity
Authors: Drozdowska Mariola , Leszczyńska Teresa , Koronowicz Aneta , Piasna-Słupecka Ewelina , Domagała Dominik , Kusznierewicz Barbara
Published: August 2020

Cruciferous vegetables are a valuable source of ingredients with health benefits. The most characteristic compounds of cruciferous vegetables with identified anticancer properties are glucosinolates. Young shoots and sprouts of red cabbage are becoming a popular fresh food rich in nutrients and bioactive compounds. The objective of this research was to determine, for the first time in a comprehensive approach, whether young shoots of red headed cabbage are a better source of selected nutrients and glucosinolates in the human diet in comparison to the vegetable at full maturity. The proximate composition (protein, fat, digestible carbohydrates, fiber), fatty acids profile, minerals (calcium, magnesium, potassium, sodium, iron, zinc, manganese, copper), as well as glucosinolates were examined. The red headed cabbage was characterized by a significantly larger amount of dry matter, and total and digestible carbohydrates in comparison to young shoots. The ready-to-eat young shoots, which are in the phase of intensive growth, are a better source of protein, selected minerals, and especially glucosinolates. The level of some nutrients can be enhanced and the intake of pro-healthy glucosinolates can be significantly increased by including young shoots of red cabbage into the diet.
Factors affecting outcome in the treatment of streptococcal periprosthetic joint infections: results from a single-centre retrospective cohort study
Authors: Andronic Octavian , Achermann Yvonne , Jentzsch Thorsten , Bearth Flurin , Schweizer Andreas , Wieser Karl , Fucentese Sandro F. , Rahm Stefan , Zinkernagel Annelies S. , Zingg Patrick O.
Published: August 2020

Purpose

To report and analyse factors affecting the outcome of streptococcal periprosthetic joint infections (PJIs).

Methods

A retrospective analysis of consecutive streptococcal PJIs was performed. Musculoskeletal Infection Society 2013 criteria were used. Outcome was compared with a prospective PJI cohort from the same institution.

Results

The most common isolated streptococcal species was Streptococcus dysgalactiae (9/22, 41%) among 22 patients included. Surgical treatment consisted of DAIR (debridement, antibiotics, irrigation and retention) in 12 (55%), one-stage revision arthroplasty in one (4%), two-stage revision arthroplasty in eight (37%) and implant removal in one (4%) patient. An infection free-outcome was achieved in 15 cases (68%), whilst seven (32%) patients failed initial revision and relapsed with the same pathogen, from which six were treated with DAIR and one with one-stage revision arthroplasty. No failures were observed in patients who received a two-stage revision. Failure rates did not differ in the cases treated with rifampin (1/5) from those without 6/17 (p = 0.55). There was no correlation between the length of antibiotic treatment and relapse (p = 0.723). In all failures, a persistent distant infection focus was identified at the time of relapse. Compared with our prospective PJI cohort, relapse rates were significantly higher 32% vs 12% (p < 0.05).

Conclusion

No correlation with the use of rifampin or length of antibiotic treatment was found. No failures were observed in patients who received a two-stage revision, which may be the surgical treatment of choice. A distant persisting infection focus could be the reason for PJI relapse with recurrent hematogenous seeding in the joint.
Evaluation of patient-reported severity of hand–foot syndrome under capecitabine using a Markov modeling approach
Authors: Schmulenson Eduard , Krolop Linda , Simons Sven , Ringsdorf Susanne , Ko Yon-Dschun , Jaehde Ulrich
Published: August 2020

Purpose

The inclusion of the patient’s perspective has become increasingly important when reporting adverse events and may assist in management of toxicity. The relationship between drug exposure and toxicity can be quantified by combining Markov elements with pharmacometric models. A minimal continuous-time Markov model (mCTMM) was applied to patient-reported outcomes using hand–foot syndrome (HFS) induced by capecitabine anti-cancer therapy as an example.

Methods

Patient-reported HFS grades over time of 150 patients from two observational studies treated with oral capecitabine were analyzed using a mCTMM approach. Grading of HFS severity was based on the Common Terminology Criteria for Adverse Events. The model was evaluated by visual predictive checks (VPC). Furthermore, a simulation study of the probability of HFS severity over time was performed in which the standard dosing regimen and dose adjustments according to HFS severity were investigated.

Results

The VPC of the developed dose–toxicity model indicated an accurate description of HFS severity over time. Individual absolute daily dose was found to be a predictor for HFS. The simulation study demonstrated a reduction of severe HFS using the recommended dose adjustment strategy.

Conclusion

A minimal continuous-time Markov model was developed based on patient-reported severity of hand–foot syndrome under capecitabine. Thus, a modeling framework for patient-reported outcomes was created which may assist in the optimization of dosage regimens and adjustment strategies aiming at minimizing symptom burden during anti-cancer drug therapy.
Improved differentiation between primary lung cancer and pulmonary metastasis by combining dual-energy CT–derived biomarkers with conventional CT attenuation
Authors: Deniffel Dominik , Sauter Andreas , Fingerle Alexander , Rummeny Ernst J. , Makowski Marcus R. , Pfeiffer Daniela
Published: August 2020

Objectives

To assess the clinical utility of dual-energy CT (DE-CT)–derived iodine concentration (IC) and effective Z (Zeff) in addition to conventional CT attenuation (HU) for the discrimination between primary lung cancer (LC) and pulmonary metastases (PM) from different primary malignancies.

Methods

DE-CT scans of 79 patients with LC (3 histopathologic subgroups) and 89 patients with PM (5 histopathologic subgroups) were evaluated. Quantitative IC, Zeff, and conventional HU values were extracted and normalized to the thoracic aorta. Differences between groups were assessed by pairwise Welch’s t test. Correlation and linear regression analyses were used to examine the relationship of imaging parameters in LC and PM. Diagnostic accuracy was measured by the area under receiver operator characteristic curve (AUC) and validated based on resampling methods.

Results

Significant differences between subgroups of LC and PMs were noted for all imaging parameters, with the highest number of significant pairs for IC. In univariate analysis, only IC was a significant diagnostic feature for discriminating LC from PM (p = 0.03). All quantitative imaging parameters correlated significantly (p < 0.0001, respectively), with the highest correlation between IC and Zeff (r = 0.91), followed by IC and HU (r = 0.76) and Zeff and HU (r = 0.73). Diagnostic models combining IC or Zeff with HU (IC+HU: AUC = 0.73; Zeff+HU: AUC = 0.69; IC+Zeff+HU: AUC = 0.73) were not significantly different and outperformed individual parameters (IC: AUC = 0.57; Zeff: AUC = 0.57; HU: AUC = 0.55) in diagnostic accuracy (p < 0.05, respectively).

Conclusion

DE-CT-derived IC or Zeff and conventional HU represent complementary imaging parameters, which, if used in combination, may improve the differentiation between LC and PM.

Key Points

• Individual quantitative imaging parameters derived from DE-CT (iodine concentration, effective Z) and conventional CT (HU) provide complementary diagnostic information for the differentiation of primary lung cancer and pulmonary metastases.

• A combination of conventional HU and DE-CT parameters enhances the diagnostic utility of individual parameters.
Evaluation of efficacy of oxygen-enriched oil-based gel dressing in patients who underwent surgical repair of distal hypospadias: a prospective randomised clinical trial
Authors: Esposito Ciro , Del Conte Fulvia , Cerulo Mariapina , Coppola Vincenzo , Esposito Giovanni , Ricciardi Elisabetta , Crocetto Felice , Castagnetti Marco , Calignano Antonio , Escolino Maria
Published: August 2020

Purpose

This study aimed to evaluate the efficacy of oxygen-enriched oil-based gel dressing on wound healing and postoperative outcome in children who underwent distal hypospadias repair.

Methods

We included all patients with distal hypospadias, who underwent Snodgrass urethroplasty and preputioplasty over an 18-months period. The patients were randomized in two groups according to the type of medication: oxygen-enriched oil-based gel (G1) and hyaluronic acid cream (G2). After discharge, parents changed the dressing twice a day for 2–3 weeks postoperatively. The patients were evaluated at 7, 14, 21, 30, 60 and 180 postoperative days and thereafter annually.

Results

One-hundred and fourteen patients (median age 18 months) were included in the study and randomized in two groups, each of 57 patients. The wound healing was significantly faster in G1 compared with G2 (p = 0.001). G1 reported significantly higher SWAS and modified HOPE scores compared with G2 (p = 0.001) at all steps of follow-up. No adverse skin reactions occurred. Foreskin dehiscence and re-operations rates were significantly lower in G1 compared with G2 (p = 0.001). Postoperative foreskin retractability was better in G1, with a significantly higher incidence of secondary phimosis in G2 (p = 0.001). The median treatment costs were significantly lower in G1 compared with G2 (p = 0.001).

Conclusion

Postoperative dressing using oxygen-enriched oil-based gel was highly effective, promoting a faster wound healing in patients who underwent distal hypospadias repair. It reported a lower incidence of foreskin dehiscence and better foreskin retractability compared with the control group. It was cost-effective and clinically safe without allergy or intolerance to the product.
COVID-19: dealing with a potential risk factor for chronic neurological disorders
Authors: Schirinzi Tommaso , Landi Doriana , Liguori Claudio
Published: August 2020

SARS-CoV2 infection is responsible for a complex clinical syndrome, named Coronavirus Disease 2019 (COVID-19), whose main consequences are severe pneumonia and acute respiratory distress syndrome. Occurrence of acute and subacute neurological manifestations (encephalitis, stroke, headache, seizures, Guillain–Barrè syndrome) is increasingly reported in patients with COVID-19. Moreover, SARS-CoV2 immunopathology and tissue colonization in the gut and the central nervous system, and the systemic inflammatory response during COVID-19 may potentially trigger chronic autoimmune and neurodegenerative disorders. Specifically, Parkinson’s disease, multiple sclerosis and narcolepsy present several pathogenic mechanisms that can be hypothetically initiated by SARS-CoV2 infection in susceptible individuals. In this short narrative review, we summarize the clinical evidence supporting the rationale for investigating SARS-CoV2 infection as risk factor for these neurological disorders, and suggest the opportunity to perform in the future SARS-CoV2 serology when diagnosing these disorders.
Primary or secondary chronic functional dizziness: does it make a difference? A DizzyReg study in 356 patients
Authors: Habs Maximilian , Strobl Ralf , Grill Eva , Dieterich Marianne , Becker-Bense Sandra
Published: August 2020

In 2017, the term “persistent postural-perceptual dizziness” (PPPD) was coined by the Bárány Society, which provided explicit criteria for diagnosis of functional vertigo and dizziness disorders. PPPD can originate secondarily after an organic disorder (s-PPPD) or primarily on its own, in the absence of somatic triggers (p-PPPD). The aim of this database-driven study in 356 patients from a tertiary vertigo center was to describe typical demographic and clinical features in p-PPPD and s-PPPD patients. Patients underwent detailed vestibular testing with neurological and neuro-orthoptic examinations, video-oculography during water caloric stimulation, video head-impulse test, assessment of the subjective visual vertical, and static posturography. All patients answered standardized questionnaires (Dizziness Handicap Inventory, DHI; Vestibular Activities and Participation, VAP; and Euro-Qol-5D-3L). One hundred and ninety-five patients (55%) were categorized as p-PPPD and 162 (45%) as s-PPPD, with female gender slightly predominating (♀:♂ = 56%:44%), particularly in the s-PPPD subgroup (64%). The most common somatic triggers for s-PPPD were benign paroxysmal positional vertigo (27%), and vestibular migraine (24%). Overall, p-PPPD patients were younger than s-PPPD patients (44 vs. 48 years) and showed a bimodal age distribution with an additional early peak in young adults (about 30 years of age) beside a common peak at the age of 50–55. The most sensitive diagnostic tool was posturography, revealing a phobic sway pattern in 50% of cases. s-PPPD patients showed higher handicap and functional impairment in DHI (47 vs. 42) and VAP (9.7 vs. 8.9). There was no difference between both groups in EQ-5D-3L. In p-PPPD, anxiety (20% vs. 10%) and depressive disorders (25% vs. 9%) were more frequent. This retrospective study in a large cohort showed relevant differences between p- and s-PPPD patients in terms of demographic and clinical features, thereby underlining the need for careful syndrome subdivision for further prospective studies.
Spontaneous visual exploration during locomotion in patients with phobic postural vertigo
Authors: Penkava J. , Bardins S. , Brandt T. , Wuehr M. , Huppert D.
Published: August 2020

Background

Earlier studies on stance and gait with posturographic and EMG-recordings and automatic gait analysis in patients with phobic postural vertigo (PPV) or visual height intolerance (vHI) revealed similar patterns of body stiffening with muscle co-contraction and a slow, cautious gait. Visual exploration in vHI patients was characterized by a freezing of gaze-in-space when standing and reduced horizontal eye and head movements during locomotion.

Objective

Based on the findings in vHI patients, the current study was performed with a focus on visual control of locomotion in patients with PPV while walking along a crowded hospital hallway.

Methods

Twelve patients with PPV and eleven controls were recruited. Participants wore a mobile infrared video eye-tracking system that continuously measured eye-in-head movements in the horizontal and vertical planes and head orientation and motion in the yaw, pitch, and roll planes. Visual exploration behavior of participants was recorded at the individually preferred speed for a total walking distance of 200 m. Gaze-in-space directions were determined by combining eye-in-head and head-in-space orientation. Walking speeds were calculated based on the trial duration and the total distance traversed. Participants were asked to rate their feelings of discomfort during the walk on a 4-point numeric rating scale. The examiners rated the crowdedness of the hospital hallway on a 4-point numeric rating scale.

Results

The major results of visual exploration behavior in patients with PPV in comparison to healthy controls were: eye and head positions were directed more downward in the vertical plane towards the ground ahead with increased frequency of large amplitude vertical orientation movements towards the destination, the end of the ground straight ahead. The self-adjusted speed of locomotion was significantly lower in PPV. Particularly those patients that reported high levels of discomfort exhibited a specific visual exploration of their horizontal surroundings. The durations of fixating targets in the visual surroundings were significantly shorter as compared to controls.

Conclusion

Gaze control of locomotion in patients with PPV is characterized by a preferred deviation of gaze more downward and by horizontal explorations for suitable auxiliary means for potential postural support in order to prevent impending falls. These eye movements have shorter durations of fixation as compared to healthy controls and patients with vHI. Finally, the pathological alterations in eye–head coordination during locomotion correlate with a higher level of discomfort and anxiety about falling.
Muscle activity in asymmetric bench press among resistance-trained individuals
Authors: Saeterbakken Atle Hole , Solstad Tom Erik J. , Behm David G. , Stien Nicolay , Shaw Matthew Peter , Pedersen Helene , Andersen Vidar
Published: August 2020

Purpose

To determine the effects of asymmetric loads on muscle activity with the bench press.

Method

Seventeen resistance-trained men performed one familiarization session including testing one repetition maximum (1RM) and three 5 repetition maximum (RM) lifts; using symmetric loads, 5% asymmetric loads, and 10% asymmetric loads. The asymmetric loading (i.e., reduced load on one side) was calculated as 5% and 10% of the subject`s 1RM load. In the experimental session, the three conditions of 5RM were conducted with electromyographic activity from the pectoralis major, triceps brachii, biceps brachii, anterior deltoid, posterior deltoid, and external oblique on both sides of the body.

Results

On the loaded side, asymmetric loads reduced triceps brachii activation compared to symmetric loads, whereas the other muscles demonstrated similar muscle activity between the three conditions. On the de-loaded side, 10% asymmetry in loading resulted in lower pectoralis major, anterior deltoid, and biceps brachii activation compared to 5% asymmetric and symmetric loading. On the de-loaded side, only pectoralis major demonstrated lower muscle activation than symmetric loads. Furthermore, asymmetric loads increased external oblique activation on both sides compared to symmetric loads.

Conclusions

Asymmetric bench press loads reduced chest and shoulder muscle activity on the de-loaded side while maintaining the muscle activity for the loaded side. The authors recommend resistance-trained participants struggling with strength imbalances between sides, or activities require asymmetric force generation (i.e., alpine skiing or martial arts), to implement asymmetric training as a supplement to the traditional resistance training.
Preoperative identification of microvascular invasion in hepatocellular carcinoma by XGBoost and deep learning
Authors: Jiang Yi-Quan , Cao Su-E , Cao Shilei , Chen Jian-Ning , Wang Guo-Ying , Shi Wen-Qi , Deng Yi-Nan , Cheng Na , Ma Kai , Zeng Kai-Ning , Yan Xi-Jing , Yang Hao-Zhen , Huan Wen-Jing , Tang Wei-Min , Zheng Yefeng , Shao Chun-Kui , Wang Jin , Yang Yang , Chen Gui-Hua
Published: August 2020

Purpose

Microvascular invasion (MVI) is a valuable predictor of survival in hepatocellular carcinoma (HCC) patients. This study developed predictive models using eXtreme Gradient Boosting (XGBoost) and deep learning based on CT images to predict MVI preoperatively.

Methods

In total, 405 patients were included. A total of 7302 radiomic features and 17 radiological features were extracted by a radiomics feature extraction package and radiologists, respectively. We developed a XGBoost model based on radiomics features, radiological features and clinical variables and a three-dimensional convolutional neural network (3D-CNN) to predict MVI status. Next, we compared the efficacy of the two models.

Results

Of the 405 patients, 220 (54.3%) were MVI positive, and 185 (45.7%) were MVI negative. The areas under the receiver operating characteristic curves (AUROCs) of the Radiomics-Radiological-Clinical (RRC) Model and 3D-CNN Model in the training set were 0.952 (95% confidence interval (CI) 0.923–0.973) and 0.980 (95% CI 0.959–0.993), respectively (p = 0.14). The AUROCs of the RRC Model and 3D-CNN Model in the validation set were 0.887 (95% CI 0.797–0.947) and 0.906 (95% CI 0.821–0.960), respectively (p = 0.83). Based on the MVI status predicted by the RRC and 3D-CNN Models, the mean recurrence-free survival (RFS) was significantly better in the predicted MVI-negative group than that in the predicted MVI-positive group (RRC Model: 69.95 vs. 24.80 months, p < 0.001; 3D-CNN Model: 64.06 vs. 31.05 months, p = 0.027).

Conclusion

The RRC Model and 3D-CNN models showed considerable efficacy in identifying MVI preoperatively. These machine learning models may facilitate decision-making in HCC treatment but requires further validation.
The short-term impact of methylprednisolone on patient-reported sleep in patients with advanced cancer in a randomized, placebo-controlled, double-blind trial
Authors: Jakobsen Gunnhild , Engstrøm Morten , Hjermstad Marianne Jensen , Rosland Jan Henrik , Aass Nina , Albert Eva , Kaasa Stein , Fayers Peter , Klepstad Pål , Paulsen Ørnulf
Published: August 2020

Purpose

Although corticosteroids are frequently used in patients with advanced cancer, few studies have examined the impact of these drugs on patient-reported sleep. We aimed to examine the short-term impact of methylprednisolone on patient-reported sleep in patients with advanced cancer.

Methods

Patient-reported sleep was a predefined secondary outcome in a prospective, randomized, placebo-controlled, double-blind trial that evaluated the analgesic efficacy of corticosteroids in advanced cancer patients (18+), using opioids, and having pain ≥ 4 past 24 h (NRS 0–10). Patients were randomized to the methylprednisolone group with methylprednisolone 16 mg × 2/day or placebo for 7 days. The EORTC QLQ-C30 (0–100) and the Pittsburgh Sleep Quality Index questionnaire (PSQI) (0–21) were used to assess the impact of corticosteroids on sleep at baseline and at day 7.

Results

Fifty patients were randomized of which 25 were analyzed in the intervention group and 22 in the control group. Mean age was 64 years, mean Karnofsky performance status was 67 (SD 13.3), 51% were female, and the mean oral daily morphine equivalent dose was 223 mg (SD 222.77). Mean QLQ-C30 sleep score at baseline was 29.0 (SD 36.7) in the methylprednisolone group and 24.2 (SD 27.6) in the placebo group. At day 7, there was no difference between the groups on QLQ-C30 sleep score (methylprednisolone 20.3 (SD 32.9); placebo 28.8 (SD 33.0),p = 0.173). PSQI showed similar results.

Conclusions

Methylprednisolone 16 mg twice daily for 7 days had no impact on patient-reported sleep in this cohort of patients with advanced cancer.

Trial registration

Clinical trial information NCT00676936 (13.05.2008)
Does the crystal structure of vanadium nitrogenase contain a reaction intermediate? Evidence from quantum refinement
Authors: Cao Lili , Caldararu Octav , Ryde Ulf
Published: August 2020

Recently, a crystal structure of V-nitrogenase was presented, showing that one of the µ2 sulphide ions in the active site (S2B) is replaced by a lighter atom, suggested to be NH or NH2, i.e. representing a reaction intermediate. Moreover, a sulphur atom is found 7 Å from the S2B site, suggested to represent a storage site for this ion when it is displaced. We have re-evaluated this structure with quantum refinement, i.e. standard crystallographic refinement in which the empirical restraints (employed to ensure that the final structure makes chemical sense) are replaced by more accurate quantum–mechanical calculations. This allows us to test various interpretations of the structure, employing quantum–mechanical calculations to predict the ideal structure and to use crystallographic measures like the real-space Z-score and electron-density difference maps to decide which structure fits the crystallographic raw data best. We show that the structure contains an OH−-bound state, rather than an N2-derived reaction intermediate. Moreover, the structure shows dual conformations in the active site with ~ 14% undissociated S2B ligand, but the storage site seems to be fully occupied, weakening the suggestion that it represents a storage site for the dissociated ligand.

Graphic abstract
George Frankl: an undervalued voice in the history of autism
Authors: Muratori Filippo , Calderoni Sara , Bizzari Valeria
Published: August 2020

This paper aims to propose that the psychiatrist George Frankl had more than a marginal role in the early history of autism. Frankl’s conception of autism as characterized by a lack of affective language has influenced both Asperger and Kanner. First, this proposal is historically supported; second it is corroborated by Frankl’s unpublished manuscript on Autism. We found that Frankl’s perspective about autism was, and still can be, considered innovative for multiple reasons. Specifically, Frankl proposed that autism could cover a spectrum of conditions; that it is a state of mind that is not necessarily abnormal; and that it is a neurobiological condition, which primarily needs to be understood by others. Finally, Frankl’s concepts of affective contact and affective language are reconsidered with reference to contemporary neuropsychology from which autism emerges not as a higher-order cognitive deficit, but as a result of an impairment of primordial ability to process low level sensory, motor and perceptual information gained through experiencing other persons.
Thinking digital libraries for preservation as digital cultural heritage: by R to R4 facet of FAIR principles
Authors: Barbuti Nicola
Published: August 2020

The Art. 2 of the UE Council conclusions of 21 May 2014 on cultural heritage as a strategic resource for a sustainable Europe (2014/C 183/08) states: “Cultural heritage consists of the resources inherited from the past in all forms and aspects—tangible, intangible and digital (born digital and digitized), including monuments, sites, landscapes, skills, practices, knowledge and expressions of human creativity, as well as collections conserved and managed by public and private bodies such as museums, libraries and archives”. Starting from this assumption, we have to rethink digital and digitization as social and cultural expressions of the contemporary age. We need to rethink digital libraries produced by digitization as cultural entities and no longer as mere dataset for enhancing fruition of cultural heritage, by defining clear and homogeneous criteria to validate and certify them as memory and sources of knowledge for future generations. By expanding R: Re-usable of the FAIR Guiding Principles for scientific data management and stewardship into R4: Re-usable, Relevant, Reliable and Resilient, this paper aims to propose a more reflective approach to creation of descriptive metadata for managing digital resource of cultural heritage, which can guarantee their long term preservation.
Family Reunification Decision-Making in Dutch Family Foster Care: A Dual Perspective Approach
Authors: Teunissen Mirte S. L. , Goemans Anouk , van Holen Frank , Vanderfaeillie Johan , Nefs Harold T. , Pijnenburg Huub M. , Damen Harm , Vedder Paul H.
Published: August 2020

Background

An important responsibility of the child welfare system, is taking decisions on the reunification of children with their birth parents after the children have lived in foster families. We currently lack evidence-based knowledge to guide the reunification decision-making process.

Objective

The present study uses concept mapping as an exploratory method, to identify themes that seem to be used by two groups of professionals in their judgement and decision making on reunification.

Method

First, we consulted 78 foster care workers and studied 172 legal cases to examine criteria important for reunification. Next, unique criteria were grouped and rated by 35 foster care workers and also by 12 family judges separately. The data was analysed with multidimensional scaling and cluster analysis which resulted in a concept map for each group of professionals.

Results

Both foster care workers and family judges suggested the following themes in the reunification decision-making process: (a) birth parents’ functioning and parenting abilities, (b) birth parents’ acceptance of support, and (c) the child’s functioning, developmental needs and wishes. Besides parallel themes, both foster care workers and family judges also seem to consider unique themes.

Conclusions

The suggested similarities and differences between the two groups of professionals possibly reflect different professional frameworks. The foster care workers’ considerations seem to have an orientation towards permanency planning while the family judges’ considerations seem to be linked to the legal framework. Gaining insight in the perspective of different groups of professionals involved in the process of reunification, is a small but important step towards reaching consensus through discussion in order to achieve the optimal implementation of the decisions considered in the best interest of children’s future.
The role of advanced end-use technologies in long-term climate change mitigation: the interlinkage between primary bioenergy and energy end-use
Authors: Tsutsui Junichi , Yamamoto Hiromi , Sakamoto Shogo , Sugiyama Masahiro
Published: August 2020

The role of advanced end-use technologies has been investigated in multiple series of scenarios using an integrated assessment model BET-GLUE, which comprises an energy-economic module (BET) and a bioenergy-land-use module (GLUE). The scenarios consider different technology assumptions on the availability of bioenergy with carbon capture and storage (BECCS) and end-use efficiencies featuring electrification under a wide range of carbon price trajectories, which start at 1–690 USD/tCO2 in 2030, increase at 4.5%/year, and level off in 2100. This scenario design allows close examination of energy, economic, and environmental implications of different levels of policy stringency and carbon budgets. While improving end-use efficiencies consistently decrease policy costs for a wide range of carbon budgets, the value of BECCS availability in terms of cost reduction is crucial only in a limited range toward lower budgets. Constraints on BECCS, including those indirectly imposed by the limited bioenergy supply, also tend to narrow the lower range of attainable budget levels, indicating technological and economic challenges, although they may have an impact on reducing the total budget including land-use emissions. Overall, the advanced end-use efficiency has a significant effect on the required level of policy stringency for a given climate goal, so that it can compensate for the biomass constraints.
STRA-MI-VT (STereotactic RadioAblation by Multimodal Imaging for Ventricular Tachycardia): rationale and design of an Italian experimental prospective study
Authors: Carbucicchio C. , Jereczek-Fossa B. A. , Andreini D. , Catto V. , Piperno G. , Conte E. , Cattani F. , Rondi E. , Vigorito S. , Piccolo C. , Bonomi A. , Gorini A. , Pepa M. , Mushtaq S. , Fassini G. , Moltrasio M. , Tundo F. , Marvaso G. , Veglia F. , Orecchia R. , Tremoli E. , Tondo C.
Published: August 2020

Background

Ventricular tachycardia (VT) is a life-threatening condition, which usually implies the need of an implantable cardioverter defibrillator in combination with antiarrhythmic drugs and catheter ablation. Stereotactic body radiotherapy (SBRT) represents a common form of therapy in oncology, which has emerged as a well-tolerated and promising alternative option for the treatment of refractory VT in patients with structural heart disease.

Objective

In the STRA-MI-VT trial, we will investigate as primary endpoints safety and efficacy of SBRT for the treatment of recurrent VT in patients not eligible for catheter ablation. Secondary aim will be to evaluate SBRT effects on global mortality, changes in heart function, and in the quality of life during follow-up.

Methods

This is a spontaneous, prospective, experimental (phase Ib/II), open-label study (NCT04066517); 15 patients with structural heart disease and intractable VT will be enrolled within a 2-year period. Advanced multimodal cardiac imaging preceding chest CT-simulation will serve to elaborate the treatment plan on different linear accelerators with target and organs-at-risk definition. SBRT will consist in a single radioablation session of 25 Gy. Follow-up will last up to 12 months.

Conclusions

We test the hypothesis that SBRT reduces the VT burden in a safe and effective way, leading to an improvement in quality of life and survival. If the results will be favorable, radioablation will turn into a potential alternative option for selected patients with an indication to VT ablation, based on the opportunity to treat ventricular arrhythmogenic substrates in a convenient and less-invasive manner.
Effect of carboxymethyl cellulose on the flow behavior of lithium-ion battery anode slurries and the electrical as well as mechanical properties of corresponding dry layers
Authors: Gordon Ronald , Orias Raquel , Willenbacher Norbert
Published: August 2020

We present a holistic view on the role of polymeric binders in waterborne LiB anodes, including preparation and processing of wet slurries as well as microstructure, electrical conductivity and mechanical integrity of dry electrode layers. We focus on carboxymethyl cellulose (CMC), with respect to technical application the influence of soft, nano-particulate styrene–butadiene rubber (SBR) as secondary binder is also addressed. We discuss the influence of CMC concentration, molecular weight (Mw) and degree of substitution (DS) on flow behavior of anode slurries. Rheological data are not only relevant for processing, here we use them to characterize the adsorption of CMC on active material particles and dispersion of these particles in the slurry at technically relevant concentrations. The fraction of CMC adsorbed onto graphite particles increases with increasingMwand decreasing DS. Electrical conductivity increases withMw, i.e. with decreasing free polymer deteriorating conductive carbon black pathways. CMC does not contribute to the adhesion of electrode layers, irrespective ofMwor DS, technically feasible adhesion is inferred by SBR. Cohesive strength of anode layers, determined here for the first time under well-defined mechanical load, increases with increasingMwand decreasing DS, i.e. with increasing fraction of adsorbed CMC and corresponding improved particle dispersion. Strong cohesion and high electrical conductivity are correlated to an alignment of graphite particles as revealed by electron microscopy, presumably enabled by higher particle mobility in well-dispersed slurries. Accordingly, targeted choice of CMC is a valuable means to control processing, electrical conductivity and mechanical strength of LiB electrodes.