bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing the safety and effectiveness of dedicated radiofrequency transseptal wires to electrified metal guidewires
Authors: Wasserlauf Jeremiah , Knight Bradley P.
Published: January 2022

Background

Application of electrocautery to a metal guidewire is used by some operators to perform transseptal puncture (TSP). Commercially available dedicated radiofrequency (RF) guidewires may represent a better alternative. This study compares the safety and effectiveness of electrified guidewires to a dedicated RF wire.

Methods

TSP was performed on freshly excised porcine hearts using an electrified 0.014″ or 0.032″ guidewire under various power settings and was compared to TSP using a dedicated RF wire with 5 W power (0.035″ VersaCross RF System, Baylis Medical). The primary endpoint was the number of attempts required to achieve TSP. Secondary endpoints included the rate of TSP failure, TSP consistency, the effect of the distance between the tip of the guidewire and the tip of the dilator, and effect of RF power output level. Qualitative secondary endpoints included tissue puncture defect appearance, thermal damage to the TSP guidewire or dilator, and tissue temperature using thermal imaging.

Results

The RF wire required on average 1.10 ± 0.47 attempts to cross the septum. The 0.014″ electrified guidewire required an overall mean of 2.17 ± 2.36 attempts (2.0 times as many as the RF wire; p < .01), and the 0.032″ electrified guidewire required an overall mean of 3.90 ± 2.93 attempts (3.5 times as many as the RF wire; p < .01). Electrified guidewires had a higher rate of TSP failure, and caused larger defects and more tissue charring than the RF wire. Thermal analysis showed higher temperatures and a larger area of tissue heating with electrified guidewires than the RF wire.

Conclusion

Fewer RF applications were required to achieve TSP using a dedicated RF wire compared to an electrified guidewire. Smaller defects and lower tissue temperatures were also observed using the RF wire. Electrified guidewires required greater energy delivery and were associated with equipment damage and tissue charring, which may present a risk of thrombus, thermal injury, or scarring.
Differentiating left bundle branch pacing and left ventricular septal pacing: An algorithm based on intracardiac electrophysiology
Authors: Chen Xing , Qian Zhiyong , Zou Fengwei , Wang Yao , Zhang Xinwei , Qiu Yuanhao , Hou Xiaofeng , Zhou Xiaohong , Vijayaraman Pugazhendhi , Zou Jiangang
Published: January 2022

Background

Left bundle branch pacing (LBBP) is a new near‐physiological pacing modality. Distinguishing left ventricular septal only pacing (LVSP) from nonselective LBBP still needs clarification. This prospective study sought to establish a differentiation algorithm to confirm LBBP.

Methods and Results

LBBP was attempted in consecutive patients. If direct LBB capture (LBBP) could not be confirmed, LVSP was considered to have been achieved. Intracardiac left ventricular (LV) activation sequence and activation time were analyzed using coronary sinus (CS) electrogram mapping. Electrophysiological parameters including S‐CSmax, S‐CSmin, LV lateral wall activation time, ΔLV, and LBB potential were compared between LBBP and LVSP. Stimulated LV activation time (S‐LVAT) and stimulated QRS duration (S‐QRSd) were also compared between the two groups. Multivariate logistic regression analysis was used to develop a prediction algorithm for LBBP. Of the 43 prospectively enrolled patients, 27 underwent LBBP and 16 underwent LVSP. All LBBP patients showed identical LV activation sequences to their intrinsic rhythm while no LVSP patients maintained their intrinsic sequence. S‐CSmax, ΔLV, LV lateral wall activation time, and S‐LVAT during LBBP were significantly shorter than those during LVSP. Combining LBB potential with S‐LVAT had the largest area under the curve (AUC) of 0.985 for confirming LBBP with a sensitivity of 95.2% and a specificity of 93.7%.

Conclusions

Compared with LVSP, LBBP preserves a normal LV activation sequence and better electrical synchrony. A combination of LBB potential with S‐LVAT can be an effective and practical model to distinguish LBBP from LVSP during implantation in patients with normal LBB activation.
A combination of Vitreoscilla filiformis extract and Vichy volcanic mineralizing water strengthens the skin defenses and skin barrier
Authors: Gueniche A. , Valois A. , Kerob D. , Rasmont V. , Nielsen M.
Published: January 2022

Probiotics are live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host. Semiactive, non‐replicating bacteria or extracts used in dermocosmetics have interesting properties for skin quality. Vitreoscilla filiformis is cultured by a fermentation process to obtain an extract. It is considered as a probiotic fraction and topical application of this extract has shown activity to strengthen the skin physical barrier function and maintain good homeostasis of skin defenses. Vichy volcanic mineralizing water (VVMW) is a pure, highly mineralized water that has been shown to strengthen the skin against exposome aggressions. This manuscript reviews properties of probiotic fractions used in skin care, especially studies on an extract of V. filiformis grown in a medium containing VVMW (VfeV) and evaluated in combination with VVMW. Skin barrier function: In normal human epidermal keratinocyte cultures, the combination of 10% VVMW and 0.002% VfeV significantly increased transglutaminase, filaggrin, involucrin, claudin‐1, and zonula occludens‐1 in comparison with the controls. Antimicrobial peptide defenses: The combination of 16.7% VVMW and 0.1% VfeV increased the expression of β‐defensin‐4A and S100A7. Skin immune defense functions: In lipopolysaccharide‐stimulated peripheral blood mononuclear cells, the combination of 16.7% VVMW and 0.1% VfeV down‐regulated IL‐8, TNF‐α, IL‐12/IL‐23p40, and increased IL10 and IL‐10/IL‐12 ratio compared to the control. Additionally, the combination of 79% VVMW plus 5% VfeV protected Langerhans cells in skin explants exposed to ultraviolet radiation. In conclusion, the combination of VfeV plus VVMW has properties to strengthen the skin barrier by stimulating skin differentiation and tight junctions, biochemical defenses by stimulating antimicrobial peptides, and cellular immune defenses by increasing the IL‐10/IL‐12 ratio and by protecting Langerhans cells challenged by ultraviolet radiation.
Solanum palinacanthum Dunal as a potential eggplant rootstock resistant to root‐knot nematodes
Authors: Murata Gaku , Uehara Taketo , Lee Hyoung Jae , Mizutani Masaharu , Kadota Yasuhiro , Shinmura Yoshimi , Saito Takeo , Uesugi Kenta
Published: January 2022

Eggplant (Solanum melongena) is susceptible to root‐knot nematodes (RKN, Meloidogyne spp.), which parasitizes host roots and intakes nutrients from nursing cells called ‘giant cells’. Grafting with RKN‐resistant rootstock is an effective way to reduce the damage caused by RKN. However, commercially available cultivars of RKN‐resistant rootstock for eggplant are limited, and resistance in RKN‐resistant plants is sometimes ineffective. A wild eggplant relative, Solanum palinacanthum, was recently found to be resistant against a wide range of Meloidogyne spp. In this study, we assessed the suitability of S. palinacanthum as an eggplant rootstock. First, we checked the grafting compatibility of S. palinacanthum rootstock to scions of commercial cultivars of eggplant. The scions of the eggplants and the rootstock of S. palinacanthum united well, and the grafted plants grew stably, whereas S. palinacanthum was seemingly incompatible with tomato. The grafting of eggplants on S. palinacanthum rootstock significantly suppressed the reproduction of Meloidogyne incognita in a pot experiment. The grafted plants also reduced the population densities of RKN infesting the experimental fields, whereas the grafting did not significantly change the yields. In addition, we measured the contents of representative alkaloids in the fruits of the grafted eggplant, which can be toxic if consumed in large amounts. The results show that the grafting did not make any difference in the contents of α‐solasonine and α‐solamargine in the fruit. These results support that S. palinacanthum is a promising eggplant rootstock for Integrated Pest Management (IPM) against RKNs.
Existence, uniqueness, and comparative statics of Nash equilibrium in a game of voluntary public good provision with two public goods
Authors: Suzuki Kenichi , Miyakoshi Tatsuyoshi , Itaya Jun‐ichi , Yamanashi Akitomo
Published: January 2022

This paper shows the uniqueness of a Nash equilibrium in the presence of many heterogeneous players with two public goods under Cobb–Douglas preferences. It provides a sufficient condition for a unique equilibrium including contributors providing both public goods, and shows that contributors providing both public goods appear frequently. This uniqueness property allows us to conduct a comparative statics analysis with a contributor and a free rider of both public goods, showing the role of the contributor providing both public goods.
Participatory research in practice: Understandings of power and embodied methodologies
Authors: Hore Katherine , Gaillard JC , Davies Tim , Kearns Robin
Published: January 2022

Participatory research (PR) has been increasingly used by geographers and other social scientists in recent decades. However, in practice PR often departs from the transformative and empowering characteristics that define it. This article uses candid reflections on the first author's attempt at PR to highlight areas where the under‐theorisation of the complexities of fieldwork and the co‐constitutive nature of research and emotions could be contributing to such depoliticised practice. Some problematic aspects of how power is understood in PR are also discussed, echoing the call from proponents of participation at large for more coherent frameworks to understand power relations.
Usefulness of a Multiplex PCR Assay for the Diagnosis of Prosthetic Joint Infections in the Routine Setting
Authors: Auñón Álvaro , Coifman Ismael , Blanco Antonio , García Cañete Joaquín , Parrón‐Cambero Raúl , Esteban Jaime
Published: January 2022

Objective

To evaluate the usefulness of a multiplex polymerase chain reaction (PCR) assay as a complementary tool in the diagnosis of prosthetic joint infections in the routine setting of a clinical microbiology laboratory, with a special focus on patients at high risk of culture‐negative infections and high suspicion of infection.

Methods

The results obtained in the routine care setting with the use of the commercial multiplex PCR (Unyvero i60©, Curetis AG, Holzgerlingen, Germany) were retrospectively reviewed. The test was performed in samples of patients with suspected prosthetic joint infection, which were also processed for conventional diagnostic methods, including sonication of the implant when possible. Patients selected for the test were those with negative cultures after a 24‐h incubation period.

Results

Ninety‐nine PCRs were performed, 57 of which were diagnostic of infection according to 2018 MSIS criteria. Nine patients received antibiotics within the 15 days prior to the diagnostic procedure. Tested samples included synovial fluid (33), sonication fluid (56) and tissue biopsies (10). The PCR test detected microorganisms in 26 samples: including two cases of polymicrobial infection. Eleven patients were diagnosed by using PCR only. The most frequently detected microorganism in PCR was Coagulase‐Negative Staphylococcus in 11 samples, followed by Staphylococcus aureus in five. One sample was positive for the bacteria universal primer, included in the 2.0 version of the kit. Only one discrepancy was detected between a negative PCR and a positive culture. One sample was also positive for a resistance marker (detection of mecA gene in a case of methicillin‐resistant S. aureus infection).

Conclusion

The incorporation of the Unyvero ITI multiple PCR technique in patients selected by clinical experts is a useful tool for the diagnosis of bone and joint infections in a routine care setting. A close clinical‐microbiological collaboration improves the usefulness of this kit for the management of patients with these infections.
Ball Tip Technique for S2AI Screw Placement in Sacropelvic Fixation: A Comparative Study with Conventional Freehand Technique
Authors: Zhou Zhenhai , Tu Cheng , Yu Honggui , Xiong Jiachao , Liu Zhiming , Ma Shengbiao , Deng Wenqiang , Cao Kai
Published: January 2022

Objective

To evaluate the efficiency of the ball tip technique for S2AI screw placement and introduce this technique.

Methods

Sixty‐three patients who underwent pelvic fixation with S2AI screws were retrospectively reviewed. They were 29 males and 34 females with an average age of 59.6 ± 12.5 years. Among these patients, 35 patients (14 males and 21 females with an average age of 58.8 ± 11.3 years) received ball tip technique and 28 patients (15 males and 13 females with an average age of 63.7 ± 12.6 years) received conventional freehand technique. Ball tip technique was used in ball tip technique group. After a pedicle probe just penetrated the sacroiliac joint, a ball‐tipped probe consisting of a ball shaped metal tip with a flexible shaft was malleted to make a guide track within ilium. This ball‐tipped probe could bend automatically away from the cortex and forward through the cancellous bone when the tip met the cortical lamina of ilium, which can avoid penetration. After repeating the procedures, a guide hole was gradually formed. S2AI screw was inserted along the guide hole after tapping. In the conventional freehand group, S2AI screw was placed according to the conventional method. Postoperative computed tomography (CT) was used to assess the accuracy of screws. The time cost of screw insertion and screw‐related complications were recorded. Independent t‐test was used to compare the time cost between ball tip group and conventional freehand group. A chi‐square test was used to compare the accuracies of the ball tip group with the conventional group.

Results

There were 35 patients (70 S2AI screws) in ball tip group and 28 patients (56 S2AI screws) in conventional freehand group. No screw‐related complication occurred in all patients. Time costs were 9.8 ± 4.5 mins in ball tip group and 20.2.0 + 8.6 mins in conventional freehand group, respectively (P < 0.05). Four screws penetrated iliac cortex in the ball tip group vs 10 screws in conventional freehand group (5.7% vs 17.9%) (P < 0.05).

Conclusions

The ball tip technique enhances the accuracy of screw placement and has less time cost compared with conventional freehand technique.
A single nucleotide deletion in the third exon of FT‐D1 increases the spikelet number and delays heading date in wheat (Triticum aestivum L.)
Authors: Chen Zhaoyan , Ke Wensheng , He Fei , Chai Lingling , Cheng Xuejiao , Xu Huanwen , Wang Xiaobo , Du Dejie , Zhao Yidi , Chen Xiyong , Xing Jiewen , Xin Mingming , Guo Weilong , Hu Zhaorong , Su Zhenqi , Liu Jie , Peng Huiru , Yao Yingyin , Sun Qixin , Ni Zhongfu
Published: January 2022

The spikelet number and heading date are two crucial and correlated traits for yield in wheat. Here, a quantitative trait locus (QTL) analysis was conducted in F8 recombinant inbred lines (RILs) derived from crossing two common wheats with different spikelet numbers. A total of 15 stable QTL influencing total spikelet number (TSN) and heading date (HD) were detected. Notably, FT‐D1, a well‐known flowering time gene in wheat, was located within the finely mapped interval of a major QTL on 7DS (QTsn/Hd.cau‐7D). A causal indel of one G in the third exon of FT‐D1 was significantly associated with total spikelet number and heading date. Consistently, CRISPR/Cas9 mutant lines with homozygous mutations in FT‐D1 displayed an increase in total spikelet number and heading date when compared with wild type. Moreover, one simple and robust marker developed according to the polymorphic site of FT‐D1 revealed that this one G indel had been preferentially selected to adapt to different environments. Collectively, these data provide further insights into the genetic basis of spikelet number and heading date, and the diagnostic marker of FT‐D1 will be useful for marker‐assisted pyramiding in wheat breeding.
B cell class switching in intestinal immunity in health and disease
Authors: Fleming Aaron , Castro‐Dopico Tomas , Clatworthy Menna R.
Published: January 2022

The gastrointestinal tract is colonized by trillions of commensal microorganisms that collectively form the microbiome and make essential contributions to organism homeostasis. The intestinal immune system must tolerate these beneficial commensals, whilst preventing pathogenic organisms from systemic spread. Humoral immunity plays a key role in this process, with large quantities of immunoglobulin (Ig)A secreted into the lumen on a daily basis, regulating the microbiome and preventing bacteria from encroaching on the epithelium. However, there is an increasing appreciation of the role of IgG antibodies in intestinal immunity, including beneficial effects in neonatal immune development, pathogen and tumour resistance, but also of pathological effects in driving chronic inflammation in inflammatory bowel disease (IBD). These antibody isotypes differ in effector function, with IgG exhibiting more proinflammatory capabilities compared with IgA. Therefore, the process that leads to the generation of different antibody isotypes, class‐switch recombination (CSR), requires careful regulation and is orchestrated by the immunological cues generated by the prevalent local challenge. In general, an initiating signal such as CD40 ligation on B cells leads to the induction of activation‐induced cytidine deaminase (AID), but a second cytokine‐mediated signal determines which Ig heavy chain is expressed. Whilst the cytokines driving intestinal IgA responses are well‐studied, there is less clarity on how IgG responses are generated in the intestine, and how these cues might become dysfunctional in IBD. Here, we review the key mechanisms regulating class switching to IgA vs IgG in the intestine, processes that could be therapeutically manipulated in infection and IBD.
HLA‐C*01:224N, a novel null HLA‐C allele characterized by two next‐generation sequencing methods
Authors: Walencik Alexandre , Calvo De Olmos Orane , Bonneville Francoise , Blanchet Gaelle , Cesbron‐Gautier Anne
Published: January 2022

We describe here the novel HLA‐C*01:224N allele which has a premature stop codon in exon 3.
Characterization of the novel HLA‐DRB1*04:315 allele by next‐generation sequencing
Authors: Hernández David Guillermo , Camacho Ramírez Nathalie , Mosquera Martínez Melissa , Cendales Paola Andrea , Camacho Bernardo Armando
Published: January 2022

HLA‐DRB1*04:315 differs from HLA‐DRB1*04:07:01:02 by a single nucleotide substitution in codon 147 of exon 3.
Are national treatment guidelines for falciparum malaria in line with WHO recommendations and is antimalarial resistance taken into consideration? – A review of guidelines in non‐endemic countries
Authors: Visser Marc T. , Zonneveld Rens , Peto Thomas J. , van Vugt Michele , Dondorp Arjen M. , van der Pluijm Rob W.
Published: January 2022

Objective

Plasmodium falciparum infections are a relatively rare but potentially deadly disease found in returning travellers. We compare the national treatment guidelines of non‐endemic countries with the WHO guidelines for the treatment of Plasmodium falciparum infections.

Methods

Review. We identified non‐endemic countries with an incidence rate of imported malaria of at least one per 100,000 population and at least 50 cases annually. Using PubMed and Google Search, we reviewed national guidelines published before 1 March 2021.

Results

Thirteen guidelines were identified. For uncomplicated falciparum malaria, 11 of 13 countries (85%) recommend an artemisinin‐based combination therapy as first‐line regimen in adults, of which artemether–lumefantrine was the most common. For severe malaria, all guidelines recommend the use of intravenous artesunate. Only three countries adjust treatment recommendations based on expected artemisinin resistance.

Conclusion

Treatment guidelines for uncomplicated falciparum malaria in non‐endemic countries generally adhere to WHO recommendations but often fail to mention the risk of drug resistance in returning travellers. Artemisinin‐based Combination Therapies (ACTs) should be the first choice for all uncomplicated malaria cases. Furthermore, the choice between ACTs should be based on regional resistance patterns.
On the construction of tame supercuspidal representations
Authors: Fintzen Jessica
Published: January 2022

Let $F$ be a non-archimedean local field of residual characteristic $p \neq 2$. Let $G$ be a (connected) reductive group over $F$ that splits over a tamely ramified field extension of $F$. We revisit Yu's construction of smooth complex representations of $G(F)$ from a slightly different perspective and provide a proof that the resulting representations are supercuspidal. We also provide a counterexample to Proposition 14.1 and Theorem 14.2 in Yu [Construction of tame supercuspidal representations, J. Amer. Math. Soc. 14 (2001), 579–622], whose proofs relied on a typo in a reference.
Unsteady Pressure Measurements in a Heated Rotating Cavity
Authors: Jackson Richard W. , Tang Hui , Scobie James A. , Pountney Oliver J. , Sangan Carl M. , Owen J. Michael , Lock Gary D.
Published: January 2022

The flow in the heated rotating cavity of an aero-engine compressor is driven by buoyancy forces, which result in pairs of cyclonic and anticyclonic vortices. The resultant cavity flow field is three-dimensional, unsteady, and unstable, which makes it challenging to model the flow and heat transfer. In this paper, properties of the vortex structures are determined from novel unsteady pressure measurements collected on the rotating disk surface over a range of engine-representative parameters. These measurements are the first of their kind with practical significance to the engine designer and for validation of computational fluid dynamics. One cyclonic/anticyclonic vortex pair was detected over the experimental range, despite the measurement of harmonic modes in the frequency spectra at low Rossby numbers. It is shown that these modes were caused by unequal size vortices, with the cyclonic vortex the larger of the pair. The structures slipped relative to the disks at a speed typically around 10%–15% of that of the rotor, but the speed of precession was often unsteady. The coherency, strength, and slip of the vortex pair increased with the buoyancy parameter, due to the stronger buoyancy forces, but they were largely independent of the rotational Reynolds number.
Fouling Mitigation for Laser Igniters in Natural Gas Engines
Authors: Gupta Sreenath B.
Published: January 2022

Due to several recent developments in lasers and optics, laser igniters can now be designed to be (i) compact so as to have the same footprint as a standard spark plug, (ii) have low power draw, usually less than 50 Watts, and (iii) have vibration and temperature resistance at levels typical of reciprocating engines. Primary advantages of these laser igniters remain (i) extension of lean or dilution limits for ignition of combustible mixtures, and (ii) improved ignition at higher pressures. Recently, tests performed in a 350 kW six-cylinder stationary natural gas reciprocating engine retrofitted with these igniters showed an extension of the operational envelope to yield efficiency improvements of the order of 2.6% points while being compliant with the mandated emission regulations. Even though laser igniters offer promise, fouling of the final optical element that introduces the laser into the combustion chamber is of concern. After performing a thorough literature search, a test plan was devised to evaluate various fouling mitigation strategies. The final approach that was used is a combination of three strategies and helped sustain an optical transmissivity exceeding 98% even after 1500 h of continuous engine operation at 2400 rpm. Based on the observed trend in transmissivity, it now appears that laser igniters can last up to 6000 h of continuous engine operation in a stationary engine running at 1800 rpm.
Capacitive electrical stimulation of a conducting polymeric thin film induces human mesenchymal stem cell osteogenesis
Authors: da Silva Rubens Araujo , Xue Ruikang , de Torresi Susana Inés Córdoba , Cartmell Sarah
Published: January 2022

Electroactive materials based on conductive polymers are promising options for tissue engineering and regenerative medicine applications. In the present work, the conducting copolymers of poly (3,4-ethylenedioxythiophene) and poly (d, l-lactic acid) (PEDOT-co-PDLLA) with PEDOT:PDLLA molar ratios of 1:50, 1:25, and 1:5 were synthesized and compared to the insulating macromonomer of EDOT-PDLLA as an experimental control. Bone marrow-derived human mesenchymal stem cells (hMSC-BM) were cultured on the copolymers and the macromonomer thin films inside a bioreactor that induced a capacitive electrical stimulation (CES) with an electric field of 100 mV/mm for 2 h per day for 21 days. Under CES, the copolymers exhibited good cell viability and promoted the differentiation from hMSC-BM to osteogenic lineages, revealed by higher mineralization mainly when the contents of conducting segments of PEDOT (i.e., copolymer with 1:25 and 1:5 PEDOT:PDLLA ratios) were increased. The results indicate that the intrinsic electrical conductivity of the substrates is an important key point for the effectiveness of the electric field generated by the CES, intending to promote the differentiation effect for bone cells.
Scattering analysis of a partitioned membrane-bounded cavity with material contrast
Authors: Afzal Muhammad , Satti Junaid Uzair , Wahab Abdul , Nawaz Rab
Published: January 2022

The acoustic performance of a silencer containing elastic membranes backed by cavities and porous material is investigated. The modeled waveguide configuration contains porous screens as well as the metallic fairings at interfaces between the inlet and outlet and the expansion chamber. The mode-matching solution is developed to analyze the attenuation of the silencer. The governing eigen-sub-systems are Sturm–Liouville and non-Sturm–Liouville types. In the latter case, the exploitation of generalized orthogonality conditions reveals the point-wise convergence of the solution to the governing eigen-systems. The study shows that by tuning the material parameters of the isotropic membranes and altering the bounding wall conditions, the performance of the physical device can be improved. It enables the model configuration to be adopted as a passive or reactive noise control device.
Glacial earthquake-generating iceberg calving in a narwhal summering ground: The loudest underwater sound in the Arctic?
Authors: Podolskiy Evgeny A. , Murai Yoshio , Kanna Naoya , Sugiyama Shin
Published: January 2022

Measurements of underwater sound are still scarce in the rapidly changing Arctic. Tele-seismically detectable glacial earthquakes caused by iceberg calving have been known for nearly two decades but their underwater sound levels remain undocumented. Here, we present near-source underwater sound records from a kilometer-scale iceberg calving associated with a glacial earthquake. Records were obtained using an ocean-bottom lander deployed near the calving front of a Greenlandic tidewater Bowdoin Glacier in July 2019. An underwater-detonation-like signal with an overall duration of 30 min and two major phases owing to iceberg detachment and disintegration corresponded to extreme source sound levels (225 ± 10 dBp2p re 1 μPa) and acoustic energy on the order of 108–10 J or 0.1–7.6 tonnes TNT-equivalent. Our estimates and comparison with other anthropogenic and natural sources suggest that this type of geophysical event is among the loudest sounds in the Arctic. Such high sound levels are important for estimating the noise budget of the ocean and possible impacts on endemic Arctic species exposed to such sounds. The sound of calving may cause direct mechanical damage to the hearing of marine mammals such as narwhals and seals present in the glacial fjord.
Triangular body-cover model of the vocal folds with coordinated activation of the five intrinsic laryngeal muscles
Authors: Alzamendi Gabriel A. , Peterson Sean D. , Erath Byron D. , Hillman Robert E. , Zañartu Matías
Published: January 2022

Poor laryngeal muscle coordination that results in abnormal glottal posturing is believed to be a primary etiologic factor in common voice disorders such as non-phonotraumatic vocal hyperfunction. Abnormal activity of antagonistic laryngeal muscles is hypothesized to play a key role in the alteration of normal vocal fold biomechanics that results in the dysphonia associated with such disorders. Current low-order models of the vocal folds are unsatisfactory to test this hypothesis since they do not capture the co-contraction of antagonist laryngeal muscle pairs. To address this limitation, a self-sustained triangular body-cover model with full intrinsic muscle control is introduced. The proposed scheme shows good agreement with prior studies using finite element models, excised larynges, and clinical studies in sustained and time-varying vocal gestures. Simulations of vocal fold posturing obtained with distinct antagonistic muscle activation yield clear differences in kinematic, aerodynamic, and acoustic measures. The proposed tool is deemed sufficiently accurate and flexible for future comprehensive investigations of non-phonotraumatic vocal hyperfunction and other laryngeal motor control disorders.
Assessment
In Vitro
of the Antimalarial and Transmission-Blocking Activities of Cipargamin and Ganaplacide in Artemisinin-Resistant
Plasmodium falciparum
Authors: Yipsirimetee Achaporn , Chiewpoo Pornpawee , Tripura Rupam , Lek Dysoley , Day Nicholas P. J. , Dondorp Arjen M. , Pukrittayakamee Sasithon , White Nicholas J. , Chotivanich Kesinee
Published: January 2022

Artemisinin resistance in
Plasmodium falciparum
has emerged and spread widely in the Greater Mekong Subregion, threatening current first-line artemisinin combination treatments. New antimalarial drugs are needed urgently.
uvrY
Deletion and Acetate Reduce Gut Colonization of Crohn’s Disease-Associated Adherent-Invasive Escherichia coli by Decreasing Expression of Type 1 Fimbriae
Authors: Miki Tsuyoshi , Hoshino Yusuke , Sudo Naoki , Ito Masahiro , Haneda Takeshi , Okada Nobuhiko
Published: January 2022

Adherent-invasive
Escherichia coli
(AIEC) is involved in onset and/or exacerbation of Crohn’s disease (CD). AIEC adapts to the gut environment by altering gene expression programs, leading to successful gut-lumen colonization.
Evidence for cGAS-STING Signaling in the Female Genital Tract Resistance to Chlamydia trachomatis Infection
Authors: Su Xin , Xu Hong , French Maegan , Zhao Yujie , Tang Lingli , Li Xiao-dong , Chen Jianlin , Zhong Guangming
Published: January 2022

Sexually transmitted
Chlamydia trachomatis
can ascend to the upper genital tract due to its resistance to innate immunity in the lower genital tract.
C. trachomatis
can activate the cGAS-STING signaling pathway in cultured cells via either cGAS or STING. This study was designed to evaluate the role of the cGAS-STING pathway in innate immunity against
C. trachomatis
in the mouse genital tract.
Fracture of pubic rami during hip fracture fixation: a rare case of traction table–related injury
Authors: Gomindes Austin , Remtulla Mohammedabbas , Cooper Julian , Nikolaides Anastasios P
Published: January 2022

We present a case of an elderly and comorbid patient who was scheduled to undergo a hip fracture fixation using an intramedullary nail. Unfortunately, this was delayed by 3 weeks as the patient was unfit to undergo this procedure. She was placed onto the traction table and intraoperatively sustained a superior and inferior pubic rami fracture while attempting reduction on the traction table. Closed-reduction techniques using traction tables and perineal posts are not without morbidity. Risk factors such as osteoporosis and delayed-fixation should be accounted for when managing this complex and often frail group of patients.
Viral neuromyopathy associated with acute hepatitis B infection
Authors: Maramattom Boby Varkey , Syed Akheel A
Published: January 2022

Viral myositis is commonly seen with influenza and COVID-19 infections. While it has been described with acute viral hepatitis, concomitant involvement of the peripheral nerves causing a neuromyopathy has not been reported. A 67-year-old man with acute hepatitis B infection developed a severe myalgia and lower limb weakness around 1 month into his illness. Investigations revealed a neuromyopathy and rhabdomyolysis. MRI whole body with short tau inversion recovery sequences showed scattered muscle hyperintensities in the upper and lower limbs. He was treated with intravenous immunoglobulin and improved. This is the first report of an acute neuromyopathy associated with acute hepatitis B viral infection and demonstration of muscle MRI abnormalities in this condition.
Cluster randomised controlled trial to assess a tailored intervention to reduce antibiotic prescribing in rural China: study protocol
Authors: Cong Wenjuan , Chai Jing , Zhao Linhai , Cabral Christie , Yardley Lucy , Yao Guiqing Lily , Zhang Tingting , Cheng Jing , Shen XingRong , Liu Rong , Little Paul , Stuart Beth , Hu Xiaowen , Sun Ye-Huan , Oliver Isabel , Zheng Bo , Lambert Helen , Wang DeBin
Published: January 2022

Introduction

Up to 80% of patients with respiratory tract infections (RTI) attending healthcare facilities in rural areas of China are prescribed antibiotics, many of which are unnecessary. Since 2009, China has implemented several policies to try to reduce inappropriate antibiotic use; however, antibiotic prescribing remains high in rural health facilities.

Methods and analysis

A cluster randomised controlled trial will be carried out to estimate the effectiveness and cost effectiveness of a complex intervention in reducing antibiotic prescribing at township health centres in Anhui Province, China. 40 Township health centres will be randomised at a 1:1 ratio to the intervention or usual care arms. In the intervention group, practitioners will receive an intervention comprising: (1) training to support appropriate antibiotic prescribing for RTI, (2) a computer-based treatment decision support system, (3) virtual peer support, (4) a leaflet for patients and (5) a letter of commitment to optimise antibiotic use to display in their clinic. The primary outcome is the percentage of antibiotics (intravenous and oral) prescribed for RTI patients. Secondary outcomes include patient symptom severity and duration, recovery status, satisfaction, antibiotic consumption. A full economic evaluation will be conducted within the trial period. Costs and savings for both clinics and patients will be considered and quality of life will be measured by EuroQoL (EQ-5D-5L). A qualitative process evaluation will explore practitioner and patient views and experiences of trial processes, intervention fidelity and acceptability, and barriers and facilitators to implementation.

Ethics and dissemination

Ethical approval was obtained from the Biomedical Research Ethics Committee of Anhui Medical University (Ref: 20180259); the study has undergone due diligence checks and is registered at the University of Bristol (Ref: 2020-3137). Research findings will be disseminated to stakeholders through conferences and peer-reviewed journals in China, the UK and internationally.

Trial registration number

ISRCTN30652037.
Economic evaluation of an Australian nurse home visiting programme: a randomised trial at 3 years
Authors: Bohingamu Mudiyanselage Shalika , Price Anna M H , Mensah Fiona K , Bryson Hannah E , Perlen Susan , Orsini Francesca , Hiscock Harriet , Dakin Penelope , Harris Diana , Noble Kristy , Bruce Tracey , Kemp Lynn , Goldfeld Sharon , Gold Lisa
Published: January 2022

Objectives

To investigate the additional programme cost and cost-effectiveness of ‘right@home’ Nurse Home Visiting (NHV) programme in relation to improving maternal and child outcomes at child age 3 years compared with usual care.

Design

A cost–utility analysis from a government-as-payer perspective alongside a randomised trial of NHV over 3-year period. Costs and quality-adjusted life-years (QALYs) were discounted at 5%. Analysis used an intention-to-treat approach with multiple imputation.

Setting

The right@home was implemented from 2013 in Victoria and Tasmania states of Australia, as a primary care service for pregnant women, delivered until child age 2 years.

Participants

722 pregnant Australian women experiencing adversity received NHV (n=363) or usual care (clinic visits) (n=359).

Primary and secondary outcome measures

First, a cost–consequences analysis to compare the additional costs of NHV over usual care, accounting for any reduced costs of service use, and impacts on all maternal and child outcomes assessed at 3 years. Second, cost–utility analysis from a government-as-payer perspective compared additional costs to maternal QALYs to express cost-effectiveness in terms of additional cost per additional QALY gained.

Results

When compared with usual care at child age 3 years, the right@home intervention cost $A7685 extra per woman (95% CI $A7006 to $A8364) and generated 0.01 more QALYs (95% CI −0.01 to 0.02). The probability of right@home being cost-effective by child age 3 years is less than 20%, at a willingness-to-pay threshold of $A50 000 per QALY.

Conclusions

Benefits of NHV to parenting at 2 years and maternal health and well-being at 3 years translate into marginal maternal QALY gains. Like previous cost-effectiveness results for NHV programmes, right@home is not cost-effective at 3 years. Given the relatively high up-front costs of NHV, long-term follow-up is needed to assess the accrual of health and economic benefits over time.

Trial registration number

ISRCTN89962120.
Biomarker discovery studies for patient stratification using machine learning analysis of omics data: a scoping review
Authors: Glaab Enrico , Rauschenberger Armin , Banzi Rita , Gerardi Chiara , Garcia Paula , Demotes Jacques
Published: January 2022

Objective

To review biomarker discovery studies using omics data for patient stratification which led to clinically validated FDA-cleared tests or laboratory developed tests, in order to identify common characteristics and derive recommendations for future biomarker projects.

Design

Scoping review.

Methods

We searched PubMed, EMBASE and Web of Science to obtain a comprehensive list of articles from the biomedical literature published between January 2000 and July 2021, describing clinically validated biomarker signatures for patient stratification, derived using statistical learning approaches. All documents were screened to retain only peer-reviewed research articles, review articles or opinion articles, covering supervised and unsupervised machine learning applications for omics-based patient stratification. Two reviewers independently confirmed the eligibility. Disagreements were solved by consensus. We focused the final analysis on omics-based biomarkers which achieved the highest level of validation, that is, clinical approval of the developed molecular signature as a laboratory developed test or FDA approved tests.

Results

Overall, 352 articles fulfilled the eligibility criteria. The analysis of validated biomarker signatures identified multiple common methodological and practical features that may explain the successful test development and guide future biomarker projects. These include study design choices to ensure sufficient statistical power for model building and external testing, suitable combinations of non-targeted and targeted measurement technologies, the integration of prior biological knowledge, strict filtering and inclusion/exclusion criteria, and the adequacy of statistical and machine learning methods for discovery and validation.

Conclusions

While most clinically validated biomarker models derived from omics data have been developed for personalised oncology, first applications for non-cancer diseases show the potential of multivariate omics biomarker design for other complex disorders. Distinctive characteristics of prior success stories, such as early filtering and robust discovery approaches, continuous improvements in assay design and experimental measurement technology, and rigorous multicohort validation approaches, enable the derivation of specific recommendations for future studies.
Rationale and study design of the MINERVA study: Multicentre Investigation of Novel Electrocardiogram Risk markers in Ventricular Arrhythmia prediction—UK multicentre collaboration
Authors: Ng G Andre , Mistry Amar , Newton Michelle , Schlindwein Fernando Soares , Barr Craig , Bates Matthew GD , Caldwell Jane , Das Moloy , Farooq Mohsin , Herring Neil , Lambiase Pier , Osman Faizel , Sohal Manav , Staniforth Andrew , Tayebjee Muzahir , Tomlinson David , Whinnett Zachary , Yue Arthur , Nicolson Will B
Published: January 2022

Introduction

The purpose of this study is to assess the ability of two new ECG markers (Regional Repolarisation Instability Index (R2I2) and Peak Electrical Restitution Slope) to predict sudden cardiac death (SCD) or ventricular arrhythmia (VA) events in patients with ischaemic cardiomyopathy undergoing implantation of an implantable cardioverter defibrillator for primary prevention indication.

Methods and analysis

Multicentre Investigation of Novel Electrocardiogram Risk markers in Ventricular Arrhythmia prediction is a prospective, open label, single blinded, multicentre observational study to establish the efficacy of two ECG biomarkers in predicting VA risk. 440 participants with ischaemic cardiomyopathy undergoing routine first time implantable cardioverter-defibrillator (ICD) implantation for primary prevention indication are currently being recruited. An electrophysiological (EP) study is performed using a non-invasive programmed electrical stimulation protocol via the implanted device. All participants will undergo the EP study hence no randomisation is required. Participants will be followed up over a minimum of 18 months and up to 3 years. The first patient was recruited in August 2016 and the study will be completed at the final participant follow-up visit. The primary endpoint is ventricular fibrillation or sustained ventricular tachycardia >200 beats/min as recorded by the ICD. The secondary endpoint is SCD. Analysis of the ECG data obtained during the EP study will be performed by the core lab where blinding of patient health status and endpoints will be maintained.

Ethics and dissemination

Ethical approval has been granted by Research Ethics Committees Northern Ireland (reference no. 16/NI/0069). The results will inform the design of a definitive Randomised Controlled Trial (RCT). Dissemination will include peer reviewed journal articles reporting the qualitative and quantitative results, as well as presentations at conferences and lay summaries.

Trial registration number

NCT03022487.
Significant ketoacidosis at autopsy: a single-centre systematic review
Authors: Gwiti Paida , Davidson Fiona , Beresford Peter , Gallagher Patrick J
Published: January 2022

Aim

To examine the value of vitreous beta-hydroxybutyrate and serum acetone in the investigation of sudden unexpected death.

Methods

Coroners’ autopsy reports from a provincial UK city, with a population of approximately 900 000, over a 24-month period with significant ketoacidosis were studied. Demographic features, medical history, anatomical and histological findings, and biochemical parameters, including renal function, vitreous glucose, serum and vitreous alcohol, were analysed.

Results

Forty-two cases (28 males and 14 females) were identified; 55% had a history of alcohol and/or substance misuse, and mental health problems, particularly depression and anxiety, and 16% were diabetic. In all, 50% of subjects had alcoholic ketoacidosis (AKA), 19% had diabetic ketoacidosis (DKA) and 12% had a history of both diabetes and alcohol abuse. In 19% of cases, an exact cause of ketoacidosis was established. In AKA, the subjects typically had low vitreous glucose and low or undetected blood alcohol levels. All of the subjects with raised vitreous glucose levels had DKA.

Conclusion

Ketoacidosis is relatively common and should be considered as a cause of sudden death, especially in alcoholic patients and patients with diabetes with no clear cause of death at autopsy.
Central nervous system infections in patients with systemic lupus erythematosus: a systematic review and meta-analysis
Authors: Molooghi Kasra , Sheybani Fereshte , Naderi Hamidreza , Mirfeizi Zahra , Morovatdar Negar , Baradaran Ashkan
Published: January 2022

We aimed to conduct a systematic review and meta-analysis of studies on central nervous system (CNS) infections in patients with SLE, in order to describe their clinical and microbiological characteristics, and outcomes. A systematic search of PubMed/Medline and Embase electronic databases was performed (March 2021) to identify all published studies on CNS infections and their characteristics in patients with SLE. A random-effects model was adopted and findings were reported with 95% CI. Overall, 6 studies involving 17 751 patients with SLE and 209 SLE cases with CNS infection were included in our meta-analysis. The frequency rate of CNS infections in patients with SLE was 0.012 (95% CI: 0.008 to 0.018). Meningitis was the most common clinical syndrome (93.5%, n=109/114, 95% CI: 82.6% to 97.8%) andCryptococcus neoformans(35.9%, n=55, 95% CI: 27.2% to 45.7%) andMycobacterium tuberculosis(27.1%, n=43, 95% CI: 14.6% to 44.8%) were the most common causative pathogens. Our patient-pool showed a mean SLE Disease Activity Index (SLEDAI) score of 7.9 (95% CI: 6.1 to 9.6), while 92.4% (n=72/76, 95% CI: 83.0% to 96.8%) of cases were on oral systemic corticosteroids, with a prednisone equivalent mean daily dose of 30.9 mg/day (95% CI: 18.0 to 43.7). Our meta-analysis revealed a mortality rate of 29.0% (95% CI: 15.0% to 48.6%). Clinicians should maintain a high index of suspicion for cryptococcal and tuberculosis (TB) meningitis in patients with SLE with suspected CNS infection, particularly in those with higher SLEDAI and on higher doses of systemic corticosteroids. In conclusion, initiation of empiric antituberculous treatment for patients with SLE who are highly suspected to have CNS TB is warranted while awaiting the results of diagnostic tests. Antifungals might also be potentially useful empirically in patients with SLE who are suspected to have fungal CNS infections. However, with respect to side effects such as toxicity and high cost of antifungals, decision regarding early antifungal therapy should be guided by early and less time-consuming fungal diagnostic tests.
A new touch temperature of the event horizon and Rindler horizon in the Kinnersley spacetime
Authors: Zhang Jie , Liu Menquan , Liu Zhie , Yang Shuzheng
Published: January 2022

The Kinnersley spacetime not only describes a non-spherical symmetric, non-stationary and accelerating black hole, but also can be used to explore the characteristics of collision of two black holes because it has two horizons: the Rindler horizon and the event horizon. Previous research shows Rindler horizon and the event horizon cannot touch due to violation of the third law of thermodynamics. By solving a fermion dynamical equation including the Lorentz dispersion relation, we obtain a modified radiation temperature at the event horizon of the black hole, as well as the colliding temperature at the touch point of Rindler horizon and the event horizon. We find the temperature at the touch point is not equal to zero if $${\dot{r}}_H\ne 0$$

r
˙

H

≠
0

. This result indicates that the event horizon and Rindler horizon can collide without violation of the third law of thermodynamics when Lorentz dispersion relation is considered.