bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac medication management in Duchenne muscular dystrophy
Authors: Wittekind Samuel G. , Villa Chet R.
Published: March 2021

There have been significant improvements in the skeletal muscle and respiratory care for patients with Duchenne muscular dystrophy (DMD) over the last two decades. This has resulted in longer expected survival as many patients will live into their 20s and 30s. This timeline has resulted in a greater proportion of patients experiencing heart failure and cardiac‐related mortality. Herein, we describe the current indications for medical therapy for patients with DMD.
A novel behavioral health program for family caregivers of children admitted to a transitional chronic ventilator unit
Authors: Borschuk Adrienne P. , Williams Sara E. , McClure Jessica M. , Kendall Megan , Mack Lisa , Coleman Michelle , Gurbani Neepa , Benscoter Dan , Amin Raouf , Stark Lori J.
Published: March 2021

Background

The care of mechanically ventilated pediatric patients is complex and burdensome. It is essential to adequately support the family caregivers of these children to optimize outcomes; however, there is no literature describing interventions for caregivers in this population.

Research Question

This study described a novel behavioral health program and examined its impact on family caregiver engagement and psychological distress on a pediatric inpatient chronic ventilator unit.

Study Design and Methods

Electronic chart review was completed with retrospective and prospective participant enrollment for the purposes of longitudinal evaluation of caregiver engagement. For analytic purposes, participants were grouped into three categories: (1) preprogram, (2) postprogram, and (3) postprogram with completion of psychotherapy.

Results

The behavioral health program was associated with increased caregiver participation in rounds, t = 7.76, p = < .001. Parents who completed a course of psychotherapy within the behavioral health program demonstrated reduced time to training completion (F = 5.89; p < .01), higher staff‐rated caregiver engagement (F = 3.69; p < .05), and significantly reduced levels of caregiver distress (t = 2.09; p < .05).
Crystal Structure and Properties of an Energetic Perchlorate Complex Compound with Copper and Cytosine
Authors: Lewczuk Rafał , Rećko Judyta , Wojtulewski Sławomir
Published: March 2021

A coordination compound from copper(II) perchlorate with cytosine was synthesized. The molecule contains copper(II) cation, four cytosine ligands, and two perchlorate anions. The single crystals of the compound were grown from the methanol solution. The crystal structure was determined by single‐crystal X‐ray diffraction. The compound crystallizes in the orthorhombic system (Pbcnspace group) with crystal parameters: a=19.454(2) Å, b=10.185(2) Å, c=13.604(1) Å, V=2695.83(5) Å3, Z=4, and F(000)=1508 as a solvate with one methanol molecule in the asymmetric unit. It was characterized with elemental analysis, differential scanning calorimetry (temperature of decomposition – 270.1 °C), differential thermal analysis, infrared spectroscopy. Small‐scale safety testing was done to determine the impact and friction sensitivity. The title compound has sensitivity typical to secondary explosives (7.5 J, 230 N). Measured density and enthalpy of formation were used to calculate detonation parameters. With detonation velocity and pressure of 6132 m/s and 14.6 GPa, respectively, it has the moderate performance.
Primary Explosive Processing in the Resonant Acoustic Mixer
Authors: Beckel Eric , Oyler Karl , Mehta Neha , Khatri Natasha , Marin John , Shah Akash , Cordaro‐Gioia Emily , Decker Robert , Grau Henry , Stec Daniel
Published: March 2021

Over the last decade, resonant acoustic mixing (RAM) technology has rapidly matured for use in the defense sector. Its ability to rapidly mix even highly viscous substances through application of acoustic energy while avoiding the use of traditional blades has provided substantial leaps forward in both safety and efficiency. To date, RAM has been applied by the energetics community to a variety of secondary explosive and propellant formulations with no reported incidents; however, the technology has never been rigorously evaluated with highly sensitive energetic materials, such as primary explosives. The work described in this report was performed to facilitate the establishment of safe operating procedures for the RAM mixing of primary explosives and primary explosive formulations. Through a Design of Experiments (DOE) approach, an analysis of mixing conditions that produce an initiation event was performed, which were used to set boundaries for the safe mixing of primary explosives and primary explosive formulations. For initial trials, uncoated copper (I) 5‐nitrotetrazolate (DBX‐1) was utilized, and boundaries were set for the results of this material only.
How to use statistics to claim antagonism and synergism from binary mixture experiments
Authors: Ritz Christian , Streibig Jens C , Kniss Andrew
Published: March 2021

We review statistical approaches applicable for the analysis of data from binary mixture experiments, which are commonly used in pesticide science for evaluating antagonistic or synergistic effects. Specifically, two different situations are reviewed, one where every pesticide is only available at a single dose level and a mixture simply combines these doses, and one where the pesticides and their mixture are used at increasing doses. The former corresponds to using factorial designs whereas the latter corresponds to fixed‐ratio designs. We consider dose addition and independent action as references for lack of antagonistic and synergistic effects. Data from factorial designs should be analyzed using two‐way analysis of variance models whereas data from fixed‐ratio designs should be analyzed using non‐linear dose–response analysis. In most cases, independent action seems the more natural choice for factorial designs. In contrast, dose addition is more appropriate for fixed‐ratio designs although dose addition is not equally compatible with all types of dose–response data. Fixed‐ratio designs should be preferred as they allow validation of the assumed dose–response relationship and, consequently, provide much stronger claims about antagonistic and synergistic effects than factorial designs. Finally, it should be noted that, in any case, simple ways of summarizing pesticide mixture effects may come at the price of more or less restrictive modeling assumptions. © 2021 Society of Chemical Industry.
Sex‐based differences in severity and mortality in COVID‐19
Authors: Alwani Mustafa , Yassin Aksam , Al‐Zoubi Raed M. , Aboumarzouk Omar M. , Nettleship Joanne , Kelly Daniel , AL‐Qudimat Ahmad R. , Shabsigh Ridwan
Published: March 2021

The current coronavirus disease (COVID‐19) pandemic caused by novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has a male bias in severity and mortality. This is consistent with previous coronavirus pandemics such as SARS‐CoV and MERS‐CoV, and viral infections in general. Here, we discuss the sex‐disaggregated epidemiological data for COVID‐19 and highlight underlying differences that may explain the sexual dimorphism to help inform risk stratification strategies and therapeutic options.
Covid‐19 and oral diseases: Crosstalk, synergy or association?
Authors: Brandini Daniela A. , Takamiya Aline S. , Thakkar Pari , Schaller Samantha , Rahat Rani , Naqvi Afsar R.
Published: March 2021

The coronavirus disease 2019 (Covid‐19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) that clinically affects multiple organs of the human body. Cells in the oral cavity express viral entry receptor angiotensin‐converting enzyme 2 that allows viral replication and may cause tissue inflammation and destruction. Recent studies have reported that Covid‐19 patients present oral manifestations with multiple clinical aspects. In this review, we aim to summarise main signs and symptoms of Covid‐19 in the oral cavity, its possible association with oral diseases, and the plausible underlying mechanisms of hyperinflammation reflecting crosstalk between Covid‐19 and oral diseases. Ulcers, blisters, necrotising gingivitis, opportunistic coinfections, salivary gland alterations, white and erythematous plaques and gustatory dysfunction were the most reported clinical oral manifestations in patients with Covid‐19. In general, the lesions appear concomitant with the loss of smell and taste. Multiple reports show evidences of necrotic/ulcerative gingiva, oral blisters and hypergrowth of opportunistic oral pathogens. SARS‐CoV‐2 exhibits tropism for endothelial cells and Covid‐19‐mediated endotheliitis can not only promote inflammation in oral tissues but can also facilitate virus spread. In addition, elevated levels of proinflammatory mediators in patients with Covid‐19 and oral infectious disease can impair tissue homeostasis and cause delayed disease resolution. This suggests potential crosstalk of immune‐mediated pathways underlying pathogenesis. Interestingly, few reports suggest recurrent herpetic lesions and higher bacterial growth in Covid‐19 subjects, indicating SARS‐CoV‐2 and oral virus/bacteria interaction. Larger cohort studies comparing SARS‐CoV‐2 negative and positive subjects will reveal oral manifestation of the virus on oral health and its role in exacerbating oral infection.
SMART Cast‐Monocrystalline p‐Type Silicon Passivated Emitter and Rear Cells: Efficiency Benchmark and Bulk Lifetime Analysis
Authors: Maus Stephan , Maischner Felix , Riepe Stephan , Greulich Johannes , Lohmüller Elmar , Schindler Florian , Saint-Cast Pierre , Krenckel Patricia , Hess Adam , Lohmüller Sabrina , Wolf Andreas , Preu Ralf
Published: March 2021

Herein, boron‐doped cast‐monocrystalline silicon wafers that have been fabricated using the Seed Manipulation for ARtificially controlled defect Technique (SMART mono‐Si) are examined. Their suitability for passivated emitter and rear cell (PERC) fabrication is investigated. Applying a zero busbar layout energy conversion efficiencies of η = 21.9% for SMART mono‐Si, η = 22.2% for gallium‐doped Cz‐Si (Cz‐Si:Ga), and η = 22.3% for boron‐doped Cz‐Si (Cz‐Si:B) are achieved at similar doping levels between 0.7 Ω cm ≤ ρB ≤ 1.0 Ω cm. Therefore, SMART mono‐Si PERCs show almost the same performance as Cz‐Si PERCs. Apart from the performance of SMART mono‐Si PERCs, the minority charge carrier bulk lifetime τB of the SMART mono‐Si wafers after different high‐temperature process steps in the PERC process flow is investigated. After emitter formation, this analysis confirms the high material quality of SMART mono‐Si yielding τB ≈ 1.3 ms at an injection level of Δn = 1015 cm−3. The bulk lifetime after firing is similar to the level determined for mCz‐Si:B and Cz‐Si:Ga reference wafers of similar doping level.
Flexural behavior of ultra‐high performance concrete filled high‐strength steel tube
Authors: Li Jiayue , Deng Zongcai , Sun Tong
Published: March 2021

To research the flexural performance of ultra‐high performance concrete (UHPC) filled high‐strength steel tube (UHPCFST) and UHPC filled double skin high‐strength steel tube (UHPCFDST) under bending load, an experimental investigation was presented. In this paper, four UHPCFST specimens, one UHPCFDST with square tube inner specimen and three UHPCFDST with circular tube inner specimens were designed to evaluate the influence of steel ratio, steel yield strength, and cross‐section combination form on the flexural performance of the specimens. Experimental results indicated that the composite action between UHPC and high‐strength steel tube was efficient, all specimens showed ductile failure under pure bending load. As the steel ratio and steel yield strength increased, the ultimate flexural capacity of specimens significantly increased, but the changes of flexural stiffness were not obvious. The results also demonstrated that when the hollow section ratio was 0.535 to 0.567, the UHPCFDST with circular tube inner specimens had higher ultimate flexural capacity and ductility than the UHPCFST specimens. Compared with square inner tube, when the steel ratio was the same, circular inner tube was recommended for UHPCFDST specimens. An analytical model of ultimate flexural capacity for UHPCFST and UHPCFDST specimens was proposed. Compared with the three current codes, the accuracy of the model was proved.
Prediction on concrete splitting strength from compressive strength of drilling‐core
Authors: Yang Su‐hang , Xu Zhi‐feng , Wang Jun‐xia
Published: March 2021

Cores were drilled from the panels made of different concrete mixtures. The compressive strength and splitting strength of core and cube specimens were tested at the ages of 7, 28, 60, 90, and 180 days. The effect of the diameter on concrete core splitting strength was examined. The strength correction factors were determined to convert the splitting strength of the core with diameter of 75 mm to that of the core with diameter of 100 mm. The regression analysis was carried out using experimental data to evaluate the core splitting strength as a function of the compressive strength of the concrete core. Then, the reliability of the proposed equation based on experimental data for compressive strength ranging from 20 to 80 MPa was assessed with the integral absolute error (IAE). Other existing relations between splitting strength and compressive strength of the cylinder were also evaluated with IAE, and most of the existing relations are not suitable for splitting strength of cores. The accurate power function relation formula is obtained with the test data. Only compressive test can be carried out by using drilling core samples in existing buildings, and the compressive strength and tensile strength of concrete can be obtained simultaneously, thus the numbers of splitting tests can be reduced and the mechanical property of existing buildings can be evaluated.
A proposed scheme for the monitoring of antibiotic resistance in veterinary pathogens of food animals in the UK
Authors: Teale Christopher , Borriello Peter
Published: March 2021

Background: Antibiotic resistance in bacteria is a global threat to both animal and public health, and detecting its occurrence is an important component of control strategies. Monitoring programmes for antibiotic resistance are currently in place in food‐producing animals in the European Union covering the zoonotic bacteria Salmonella enterica, Campylobacter coli and Campylobacter jejuni and the indicator bacteria Escherichia coli, Enterococcus faecalis and Enterococcus faecium. However, there is no equivalent pan‐European statutory monitoring programme covering the antibiotic susceptibility of veterinary bacterial pathogens in food animals. This paper considers that issue and aims to facilitate and stimulate further discussion.

Methods: Recommendations, proposed by the authors from the scientific literature and following expert discussion at international meetings, are presented for monitoring the susceptibility of key veterinary pathogens.

Results: The selected veterinary pathogens comprise Actinobacillus pleuropneumoniae, Bordetella bronchiseptica, E. coli, Histophilus somni, Mannheimia haemolytica, Pasteurella multocida, Staphylococcus aureus and Streptococcus spp. from the major food animal species cattle, pigs and poultry. The organisms are tested using harmonised panels of antibiotics over specified dilution ranges in a broth microdilution method.

Conclusion: The selected antibiotics and their respective dilution ranges are presented together with the underlying rationale for inclusion; the ranges chosen are suitable for incorporation into three microtitre plates, with each organism tested using a single plate. The recommendations are being implemented in 2020 in the UK for monitoring of the susceptibility of veterinary bacterial pathogens.
Occupational stress and coping strategies in experienced Australian veterinarians
Authors: Whitnall Vicki Margot , Simmonds Janette Graetz
Published: March 2021

Background: Veterinarians have been identified as being at particularly high risk of stress in the workplace, this predisposes them to anxiety, depression and suicide. Previous quantitative studies have identified causes of stress and common coping strategies used by veterinarians. The current research aimed to gain a deeper understanding of the experience of veterinarian stress and ways of coping using qualitative methods.

Method: Twelve practicing small animal veterinarians in Australia were recruited. They took part individually in semi‐structured research interviews. Interpretative phenomenological analysis (IPA) was used to design the study and to analyse the transcripts.

Results: Analyses of the interview data identified an overarching theme: spending less time working in clinical settings and four main themes: Preoccupation, self‐doubt, conflicting responsibilities (between care of the animal, the human client and financial demands of the business) and insufficient support.

Conclusion: The results give a deeper understanding of sources of stress and the difficulties experienced in coping. These findings can help explain why veterinarians are leaving the profession or reducing their work hours, as well as emphasize the importance of continuing education of veterinarians on self‐care and coping with stress, help with resolving ethical dilemmas, and working as a team.
Sero‐detection of Coxiella burnetii infection in cattle, sheep and goats in selected regions of Nepal
Authors: Paudyal Narayan , Poudel Subash , Pandey Durga , Khanal Doj R.
Published: March 2021

Coxiella burnetii, a Gram‐negative bacterium is a zoonotic agent causing coxiellosis in animals. Small ruminants and cattle are the primary reservoirs for human infection. This study was aimed to estimate the sero‐prevalence of C. burnetii in the ruminants of the selected region in Nepal. Field visits were carried out at four sites in different geographical regions of Nepal. A total of 522 sera samples were collected from 118 sheep, 242 goats and 162 cattle with the history of abortion, anoestrus and infertility. Sera were tested for the presence of antibodies against C. burnetii using a commercially available ready‐to‐use ELISA test kit. The overall true sero‐prevalence was 1.89% (95% CI: 0.33–3.45), the prevalence ranged between 4.35% and 23.21% in goats. Sero‐prevalence in goat was higher than that of cattle and sheep which ascertained that total freedom from coxiellosis cannot be confirmed in Nepal. This could complement the impacts of other infectious causes of the infertility in the farm animals as well as the public health of the farming households.
Doppler ultrasound measurements of the blood flow velocity in the fetal heart and aorta in Bulgarian White milk goats
Authors: Fasulkov Ivan R. , Karadaev Manol , Vasilev Nasko , Hristov Kalin , Fedev Ivan
Published: March 2021

The aim of the present study was to determine the parameters characterising the blood flow velocity in the fetal heart and aorta in goats by Doppler ultrasonography. Twenty‐four Bulgarian White milk goats, aged 4–6 years, weighing 45–51 kg were used in the study. Doppler ultrasound measurements of the blood flow velocity in fetal heart were done at the end of first, second and third trimesters of pregnancy, and in the fetal aorta – at the end of the second and third trimesters of pregnancy. Ultrasound investigations were carried out by transabdominal approach with linear and convex transducers, with frequency 8.0 MHz. Blood flow parameters that included maximum and minimum systolic velocity, end‐diastolic velocity, pulsatility index, resistance index and systolic/diastolic ratio were measured by spectral Doppler ultrasonography. The results showed that the highest maximum systolic velocity in the fetal heart was observed at the end of the first pregnancy trimester. Statistically significantly (p < 0.05) lower values of this parameter were registered in the second and third pregnancy trimesters. A similar tendency was observed for minimum systolic velocity, end‐diastolic velocity and systolic/diastolic ratio. The pulsatility index and resistance index had similar values for the three studied periods. Examination of the fetal aorta showed statistically significant differences (p < 0.05) of minimum systolic velocity, end‐diastolic velocity, pulsatility and resistance index in the third, compared with the second trimester of pregnancy. The analysis of the results suggested that Doppler ultrasonography can be used to monitor fetal blood flow changes during the various stages of pregnancy.
Why BDeu? Regular Bayesian network structure learning with discrete and continuous variables
Authors: Suzuki Joe
Published: March 2021

We consider the problem of Bayesian network structure learning (BNSL) from data. In particular, we focus on the score‐based approach rather than the constraint‐based approach and address what score we should use for the purpose. The Bayesian Dirichlet equivalent uniform (BDeu) has been mainly used within the community of BNs (not outside of it). We know that for any model selection and any data, the fitter the data to a model, the more complex the model, and vice versa. However, recently, it was proven that BDeu violates regularity, which means that it does not balance the two factors, although it works satisfactorily (consistently) when the sample size is infinitely large. In addition, we claim that the merit of using the regular scores over the BDeu is that tighter bounds of pruning rules are available when we consider efficient BNSL. Finally, using experiments, we compare the performances of the procedures to examine the claim. (This paper is for review and gives a unified viewpoint from the recent progress on the topic.)

This article is categorized under:

Statistical Learning and Exploratory Methods of the Data Sciences > Modeling Methods

Statistical and Graphical Methods of Data Analysis > Bayesian Methods and Theory
The Triple Salt 2(C7H9N4O2)[MoOCl4(H2O)] ⋅ 2(C7H9N4O2)Cl ⋅ (H17O8)Cl Containing a C2‐symmetrical Unbranched H+(H2O)8Zundel type Species in a Framework Composed of Theophyllinium, Aquatetrachloridooxidomolybdate and Chloride Ions
Authors: Wyshusek Maik , Reiss Guido J. , Frank Walter
Published: March 2021

From a concentrated hydrochloric acid solution of molybdenum‐(V) chloride and theophylline octaaquahydrogen(1+) tetrakis(theophyllinium) bis[aquatetrachloridooxidomolybdate(1−)] tri‐chloride, C7H9N4O2)4(H17O8)[MoOCl4(H2O)]2Cl3, (1) was obtained. The light emerald green inorganic‐organic hybrid material can be rationalized as a triple salt according to the formula 2(C7H9N4O2)[MoOCl4(H2O)] ⋅ 2(C7H9N4O2)Cl ⋅ (H17O8)Cl. The ions involved are connected by charge‐supported hydrogen bonds to form a 3D framework. The unique H17O8+ moiety features a chain of eight hydrogen bonded water molecules, with the excess proton defining a H5O2+ Zundel‐ion (O⋅⋅⋅O distance 240.3(6) pm) in the middle of the chain, and is placed with crystallographic site symmetry 2. Although engaged in strong O−H⋅⋅⋅O bonding to the neighboring water molecules in the chain (O⋅⋅⋅O distance 262.9(4) pm) and in hydrogen bonding to a carbonyl group of a theophyllinium ion, both the conformation of the H5O2+ unit and the geometry of the very strong central O−H−O bond fit to the C2‐symmetrical global minimum structure of an isolated H5O2+ species. The outer water molecules of the H17O8+ moiety are further engaged in N−H⋅⋅⋅O, O−H⋅⋅⋅Cl and O−H⋅⋅⋅O=C bonds.
Use of antidepressants among Finnish family caregivers: a nationwide register-based study
Authors: Mikkola Tuija M. , Kautiainen Hannu , Mänty Minna , von Bonsdorff Mikaela B. , Koponen Hannu , Kröger Teppo , Eriksson Johan G.
Published: March 2021

Purpose

The purpose of this study was to compare the use of antidepressants over 6 years between family caregivers providing high-intensity care and a matched control population using register-based data.

Methods

The study includes all individuals, who received family caregiver’s allowance in Finland in 2012 (n = 29,846 females, mean age 66 years; n = 12,410 males, mean age 71 years) and a control population matched for age, sex, and municipality of residence (n = 59,141 females; n = 24,477 males). Information on purchases of antidepressants, including the number of defined daily doses (DDD) purchased, between 2012 and 2017 was obtained from the national drugs reimbursement register.

Results

During the follow-up, 28.5% of female caregivers and 23.5% of the female controls used antidepressants, while the numbers for males were 21.1% and 16.4%, respectively. Adjusted for socioeconomic status, female caregivers used 43.7 (95% confidence interval 42.4–45.0) and their controls used 36.2 (35.3–37.2) DDDs of antidepressants per person-year. Male caregivers used 29.6 (27.6–31.6) and their controls used 21.6 (20.2–23.0) DDDs of antidepressants per person-year. Among female caregivers, the relative risk for use of antidepressants was similar (about 1.3) from 20 to 70 years, after which the relative risk declined. In male caregivers, the relative risk was highest (about 1.4–1.5) between 45 and 65 years.

Conclusions

Family caregivers providing high-intensity care use more antidepressants and hence, are likely to have poorer mental health than the age-matched general population in virtually all age groups. However, the magnitude of the higher use varies as a function of age and gender.
Cannabinoids, reward processing, and psychosis
Authors: Gunasekera Brandon , Diederen Kelly , Bhattacharyya Sagnik
Published: March 2021

Background

Evidence suggests that an overlap exists between the neurobiology of psychotic disorders and the effects of cannabinoids on neurocognitive and neurochemical substrates involved in reward processing.

Aims

We investigate whether the psychotomimetic effects of delta-9-tetrahydrocannabinol (THC) and the antipsychotic potential of cannabidiol (CBD) are underpinned by their effects on the reward system and dopamine.

Methods

This narrative review focuses on the overlap between altered dopamine signalling and reward processing induced by cannabinoids, pre-clinically and in humans. A systematic search was conducted of acute cannabinoid drug-challenge studies using neuroimaging in healthy subjects and those with psychosis

Results

There is evidence of increased striatal presynaptic dopamine synthesis and release in psychosis, as well as abnormal engagement of the striatum during reward processing. Although, acute THC challenges have elicited a modest effect on striatal dopamine, cannabis users generally indicate impaired presynaptic dopaminergic function. Functional MRI studies have identified that a single dose of THC may modulate regions involved in reward and salience processing such as the striatum, midbrain, insular, and anterior cingulate, with some effects correlating with the severity of THC-induced psychotic symptoms. CBD may modulate brain regions involved in reward/salience processing in an opposite direction to that of THC.

Conclusions

There is evidence to suggest modulation of reward processing and its neural substrates by THC and CBD. Whether such effects underlie the psychotomimetic/antipsychotic effects of these cannabinoids remains unclear. Future research should address these unanswered questions to understand the relationship between endocannabinoid dysfunction, reward processing abnormalities, and psychosis.
Coriolis and buoyancy effects on heat transfer in viewpoint of field synergy principle and secondary flow intensity for maximization of internal cooling
Authors: Hosseinalipour Seyed Mostafa , Shahbazian Hamidreza , Sunden Bengt
Published: March 2021

The present investigation emphases on rotation effects on internal cooling of gas turbine blades both numerically and experimentally. The primary motivation behind this work is to investigate the possibility of heat transfer enhancement by dean vortices generated by Coriolis force and U-bend with developing turbulent in the view point of the field synergy principle and secondary flow intensity analysis. A two-passage internal cooling channel model with a 180° U-turn at the hub section is used in the analysis. The flow is radially outward at the first passage of the square channel and then it will be inward at the second passage. The study covers a Reynolds number (Re) of 10,000, Rotation number (Ro) in the range of 0–0.25, and Density Ratios (DR) at the inlet between 0.1–1.5. The numerical results are compared to experimental data from a rotating facility. Results obtained with the basic RANS SST k-ω model are assessed completely as well. A field synergy principle analysis is consistent with the numerical results too. The results state that the secondary flows due to rotation can considerably improve the synergy between the velocity and temperature gradients up to 20%, which is the most fundamental reason why the rotation can enhance the heat transfer. In addition, the Reynolds number and centrifugal buoyancy variations are found to have no remarkable impact on increasing the synergy angle. Moreover, vortices induced by Rotation number and amplified by Reynolds number increase considerable secondary flow intensity which is exactly in compliance with Nusselt number enhancement.
Sex-specific hormone changes during immunotherapy and its influence on survival in metastatic renal cell carcinoma
Authors: Tulchiner Gennadi , Pichler Renate , Ulmer Hanno , Staudacher Nina , Lindner Andrea Katharina , Brunner Andrea , Zelger Bettina , Steinkohl Fabian , Aigner Friedrich , Horninger Wolfgang , Thurnher Martin
Published: March 2021

Renal cell carcinoma (RCC) is a highly vascularized and immunogenic tumor, being an ideal candidate for checkpoint blockade-based immunotherapy. Accordingly, checkpoint inhibitors have demonstrated clinical efficacy in patients with metastatic RCC (mRCC). Sex-specific differences in cancer immunotherapy may be explained by the interaction of sex hormone signaling, genetic and environmental factors, affecting the innate and adaptive immune response in men and women in different ways. The aim of this prospective study was to monitor for the first time changes in sex hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio and 17-ß-estradiol (E2) in 22 mRCC patients (12 male and 10 female) receiving nivolumab therapy. In contrast to female patients, male patients showed a significant increase in E2 (p = 0.006) and LH/FSH ratio (p = 0.013) from the beginning of nivolumab therapy to week 12 of follow-up. Moreover, survival analysis revealed a significant negative association between LH/FSH ratio and progression-free survival (PFS) (p = 0.022) as well as between therapy response (p = 0.009) in males compared to females at interim evaluation (week 6/8). Our findings may therefore be the first reference to sex hormone changes during immunotherapy.
Pancreatoduodenectomy for Neuroendocrine Tumors in Patients with Multiple Endocrine Neoplasia Type 1: An AFCE (Association Francophone de Chirurgie Endocrinienne) and GTE (Groupe d’étude des Tumeurs Endocrines) Study
Authors: Santucci Nicolas , Gaujoux Sébastien , Binquet Christine , Reichling Cynthia , Lifante Jean‐Christophe , Carnaille Bruno , Pattou François , Mirallié Eric , Facy Olivier , Mathonnet Muriel , Goudet Pierre
Published: March 2021

Aim

To assess postoperative complications and control of hormone secretions following pancreatoduodenectomy (PD) performed on multiple endocrine neoplasia type 1 (MEN1) patients with duodenopancreatic neuroendocrine tumors (DP‐NETs).

Background

The use of PD to treat MEN1 remains controversial, and evaluating the right place of PD in MEN1 disease makes sense.

Methods

Thirty‐one MEN1 patients from the Groupe d’étude des Tumeurs Endocrines MEN1 cohort who underwent PD for DP‐NETs between 1971 and 2013 were included. Early and late postoperative complications, secretory control and overall survival were analyzed.

Results

Indication for surgery was: Zollinger–Ellison syndrome (n = 18; 58%), nonfunctioning tumor (n = 9; 29%), insulinoma (n = 2; 7%), VIPoma (n = 1; 3%) and glucagonoma (n = 1; 3%). Mean follow‐up was 141 months (range 0–433). Pancreatic fistulas occurred in 5 patients (16.1%), distant metastases in 6 (mean onset of 43 months; range 13–110 months), postoperative diabetes mellitus in 7 (22%), and pancreatic exocrine insufficiency in 6 (19%). Five‐year overall survival was 93.3% [CI 75.8–98.3] and ten‐year overall survival was 89.1% [CI 69.6–96.4]. After a mean follow‐up of 151 months (range 0–433), the biochemical cure rate for MEN‐1 related gastrinomas was 61%.

Conclusion

In MEN1 patients, pancreatoduodenectomy can be used to control hormone secretions (gastrin, glucagon, VIP) and to remove large NETs. PD was found to control gastrin secretions in about 60% of cases.
Comparative investigation of lasing and amplification performance in cryogenic Yb:YLF systems
Authors: Demirbas Umit , Kellert Martin , Thesinga Jelto , Hua Yi , Reuter Simon , Kärtner Franz X. , Pergament Mikhail
Published: March 2021

We present detailed experimental results with cryogenic Yb:YLF gain media in rod-geometry. We have comparatively investigated continuous-wave (cw) lasing and regenerative amplification performance under different experimental conditions. In the cw lasing experiments effect of crystal doping, cw laser cavity geometry and pump wavelength on lasing performance were explored. Regenerative amplification behavior was analyzed and the role of depolarization losses on performance was investigated. A recently developed temperature estimation method was also employed for the first time in estimating average crystal temperature under lasing conditions. It is shown that the thermal lens induced by transverse temperature gradients is the main limiting factor and strategies for future improvements are discussed. To the best of our knowledge, the achieved results in this study (375 W in cw, and 90 W in regenerative amplification) are the highest average powers ever obtained from this system via employing the broadband E//a axis.
Concomitant injuries in patients with thoracic vertebral body fractures—a systematic literature review
Authors: Spiegl Ulrich J. , Osterhoff Georg , Bula Philipp , Hartmann Frank , Scheyerer Max J. , Schnake Klaus J. , Ullrich Bernhard W.
Published: March 2021

Purpose

The aim of this study was to give a systematic overview over the rate and location of concomitant injuries, the probability of suffering from neurological deficits, and to give evidence of the timing of surgery in severely injured patients with unstable thoracic vertebral body fractures.

Methods

This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to November 2020 dealing with unstable fractures of the mid-thoracic spine.

Results

Altogether, 1109 articles were retrieved from the literature search. A total of 1095 articles were excluded. Thus, 16 remaining original articles were included in this systematic review depicting the topics timing of surgery in polytraumatized patients, outcome neurologic deficits, and impact of concomitant injuries. The overall level of evidence of the vast majority of studies is low.

Conclusion

The evidence of the available literature is low. The cited studies reveal that thoracic spinal fractures are associated with a high number of neurological deficits and concomitant injuries, particularly of the thoracic cage and the lung. Thereby, diagnostic algorithm should include computer tomography of the whole thoracic cage if there is any clinical sign of concomitant injuries. Patients with incomplete neurologic deficits benefit from early surgery consisting of decompression and long-segmental stabilization.
Cancer risk in adrenalectomy: are adrenal lesions equal or more than 4 cm a contraindication for laparoscopy?
Authors: Balla Andrea , Corallino Diletta , Ortenzi Monica , Palmieri Livia , Meoli Francesca , Guerrieri Mario , Paganini Alessandro M.
Published: March 2021

Background

Some authors consider adrenal lesions size of less than 4 cm as a positive cut-off limit to set the indications for minimally invasive surgery due to a lower risk of malignancy. Aim of this study is to report the risk of cancer for adrenal lesions measuring 4 cm or more in diameter, assessed as benign at preoperative workup (primary outcome), and to evaluate the feasibility and safety of laparoscopic adrenalectomy (LA) in these cases (secondary outcome).

Methods

From January 1994 to February 2019, 579 patients underwent adrenalectomy. Fifty patients with a preoperative diagnosis of primary adrenal cancer or metastases were excluded. The remaining 529 patients were included and divided in five subgroups based on adrenal lesion size at definitive histology: group A, 4–5.9 cm (137 patients); group B, 6–7.9 cm (64 patients); group C, 8–9.9 cm (13 patients); group D, ≥ 10 cm (11 patients); group E, < 4 cm (304 patients). Each group was further divided based on diagnosis of benign or malignant lesions at definitive histology.

Results

Four (2.9%) malignant lesions were observed in group A, 5 (7.8%) in group B, 2 (15.4%) in Groups C and D (18.2%) and 13 (4.3%) in Group E. Comparing the cancer risk among the groups, no statistically significant differences were observed. Operative time increased with increasing lesion size. However, no statistically significant differences were observed between benign and malignant lesions in each group comparing operative time, conversion and complication rates, postoperative hospital stay and mortality rate.

Conclusions

Adrenal lesions measuring 4 cm or more in diameter are not a contraindication for LA neither in terms of cancer risk nor of conversion and morbidity rates, even if the operative time increases with increasing adrenal lesion diameter. Further prospective studies with a larger number of patients are required to draw definitive conclusions.
Modellbasierte urbane Überflutungsvorsorge
Authors: Reinstaller Stefan , Muschalla Dirk
Published: March 2021

Jährlich verursachen zahlreiche konvektive Starkniederschlagsereignisse enorme Schäden und Kosten in den österreichischen Kommunen. Aufgrund ihrer komplexen räumlichen Strukturen und des von der Urbanisierung hervorgerufenen steigenden Versiegelungsgrads ist das Risiko einer Überflutung in urbanen Einzugsgebieten besonders hoch. Daher bedarf es Methoden und Werkzeuge, um mit dem steigenden Überflutungsrisiko in urbanen Einzugsgebieten umgehen zu können. Die Ausweisung von Überflutungsflächen innerhalb eines Einzugsgebiets gilt dabei als wesentliche Grundlage für die Ableitung geeigneter Maßnahmen zur Reduktion des Überflutungsrisikos. Integrierte 1D-2D-Modelle, welche die hydrologische Abflussbildung einerseits sowie den Oberflächenabfluss und den Kanalabfluss hydrodynamisch andererseits berücksichtigen, sind ein zuverlässiges Werkzeug, um die benötigten Zielgrößen – Wasserstand und Fließgeschwindigkeit – zur Ermittlung dieser Überflutungsflächen bestimmen und im Anschluss daran eine Risikoanalyse durchführen zu können. Das Ergebnis sind Überflutungsrisikokarten, die eine wertvolle Planungsgrundlage für die Kommunen darstellen. Die in diesem Beitrag vorgestellte Methodik beschreibt ein Schritt-für-Schritt-Vorgehen, wie Risikokarten in urbanen Einzugsgebieten von Planungsbüros und Kommunen erstellt werden können. Die Methodik ist gegliedert in eine Voruntersuchung zur Identifizierung der neuralgisch wichtigen Stellen, eine Detailanalyse für den Aufbau des integrierten 1D-2D-Modells sowie eine Risikoanalyse zur Erstellung der Überflutungsrisikokarten.
Leveraging the Bhattacharyya coefficient for uncertainty quantification in deep neural networks
Authors: Van Molle Pieter , Verbelen Tim , Vankeirsbilck Bert , De Vylder Jonas , Diricx Bart , Kimpe Tom , Simoens Pieter , Dhoedt Bart
Published: March 2021

Modern deep learning models achieve state-of-the-art results for many tasks in computer vision, such as image classification and segmentation. However, its adoption into high-risk applications, e.g. automated medical diagnosis systems, happens at a slow pace. One of the main reasons for this is that regular neural networks do not capture uncertainty. To assess uncertainty in classification, several techniques have been proposed casting neural network approaches in a Bayesian setting. Amongst these techniques, Monte Carlo dropout is by far the most popular. This particular technique estimates the moments of the output distribution through sampling with different dropout masks. The output uncertainty of a neural network is then approximated as the sample variance. In this paper, we highlight the limitations of such a variance-based uncertainty metric and propose an novel approach. Our approach is based on the overlap between output distributions of different classes. We show that our technique leads to a better approximation of the inter-class output confusion. We illustrate the advantages of our method using benchmark datasets. In addition, we apply our metric to skin lesion classification—a real-world use case—and show that this yields promising results.
Characterisation of homogeneous fractional Sobolev spaces
Authors: Brasco Lorenzo , Gómez-Castro David , Vázquez Juan Luis
Published: March 2021

Our aim is to characterize the homogeneous fractional Sobolev–Slobodeckiĭ spaces$$\mathcal {D}^{s,p} (\mathbb {R}^n)$$Ds,p(Rn)and their embeddings, for$$s \in (0,1]$$s∈(0,1]and$$p\ge 1$$p≥1. They are defined as the completion of the set of smooth and compactly supported test functions with respect to the Gagliardo–Slobodeckiĭ seminorms. For$$s\,p < n$$sp<nor$$s = p = n = 1$$s=p=n=1we show that$$\mathcal {D}^{s,p}(\mathbb {R}^n)$$Ds,p(Rn)is isomorphic to a suitable function space, whereas for$$s\,p \ge n$$sp≥nit is isomorphic to a space of equivalence classes of functions, differing by an additive constant. As one of our main tools, we present a Morrey–Campanato inequality where the Gagliardo–Slobodeckiĭ seminorm controls from above a suitable Campanato seminorm.
Educators’ experiences with governance in curriculum change processes; a qualitative study using rich pictures
Authors: Velthuis Floor , Dekker Hanke , Coppoolse Remco , Helmich Esther , Jaarsma Debbie
Published: March 2021

In the midst of continuous health professions curriculum reforms, critical questions arise about the extent to which conceptual ideas are actually put into practice. Curricula are often not implemented as intended. An under-explored aspect that might play a role is governance. In light of major curriculum changes, we explored educators’ perspectives of the role of governance in the process of translating curriculum goals and concepts into institutionalized curriculum change at micro-level (teacher–student). In three Dutch medical schools, 19 educators with a dual role (teacher and coordinator) were interviewed between March and May 2018, using the rich pictures method. We employed qualitative content analysis with inductive coding. Data collection occurred concurrently with data analysis. Different governance processes were mentioned, each with its own effects on the curriculum and organizational responses. In Institute 1, participants described an unclear governance structure, resulting in implementation chaos in which an abstract educational concept could not be fully realized. In Institute 2, participants described a top–down and strict governance structure contributing to relatively successful implementation of the educational concept. However it also led to demotivation of educators, who started rebelling to recover their perceived loss of freedom. In Institute 3, participants described a relatively fragmentized process granting a lot of freedom, which contributed to contentment and motivation but did not fully produce the intended changes. Our paper empirically illustrates the importance of governance in curriculum change. To advance curriculum change processes and improve their desired outcomes it seems important to define and explicate both hard and soft governance processes.
The living fossil concept: reply to Turner
Authors: Lidgard Scott , Love Alan C.
Published: March 2021

Despite the iconic roles of coelacanths, cycads, tadpole shrimps, and tuataras as taxa that demonstrate a pattern of morphological stability over geological time, their status as living fossils is contested. We responded to these controversies with a recommendation to rethink the function of the living fossil concept (Lidgard and Love in Bioscience 68:760–770, 2018). Concepts in science do useful work beyond categorizing particular items and we argued that the diverse and sometimes conflicting criteria associated with categorizing items as living fossils represent a complex problem space associated with answering a range of questions related to prolonged evolutionary stasis. Turner (Biol Philos 34:23, 2019) defends the living concept against a variety of recent skeptics, but his criticism of our approach relies on a misreading of our main argument. This misreading is instructive because it brings into view the value of three central themes for rethinking the living fossil concept—the function of concepts in biology outside of categorization, the methodological importance of distinguishing parts and wholes in conceptualizing evolutionary phenomena, and articulating diverse explanatory goals associated with these phenomena.
Digital well-being under pandemic conditions: catalysing a theory of online flourishing
Authors: Dennis Matthew J.
Published: March 2021

The COVID-19 pandemic has catalysed what may soon become a permanent digital transition in the domains of work, education, medicine, and leisure. This transition has also precipitated a spike in concern regarding our digital well-being. Prominent lobbying groups, such as the Center for Humane Technology (CHT), have responded to this concern. In April 2020, the CHT has offered a set of ‘Digital Well-Being Guidelines during the COVID-19 Pandemic.’ These guidelines offer a rule-based approach to digital well-being, one which aims to mitigate the effects of moving much of our lives online. The CHT’s guidelines follow much recent interest in digital well-being in the last decade. Ethicists of technology have recently argued that character-based strategies and redesigning of online architecture have the potential to promote the digital well-being of online technology users. In this article, I evaluate (1) the CHT’s rule-based approach, comparing it with (2) character-based strategies and (3) approaches to redesigning online architecture. I argue that all these approaches have some merit, but that each needs to contribute to an integrated approach to digital well-being in order to surmount the challenges of a post-COVID world in which we may well spend much of our lives online.
Offshore wind farms and the attraction–production hypothesis: insights from a combination of stomach content and stable isotope analyses
Authors: Mavraki Ninon , Degraer Steven , Vanaverbeke Jan
Published: March 2021

Offshore wind farms (OWFs) act as artificial reefs, attracting high abundances of fish, which could potentially increase their local production. This study investigates the feeding ecology of fish species that abundantly occur at artificial habitats, such as OWFs, by examining the short- and the long-term dietary composition of five species: the benthopelagicGadus morhuaandTrisopterus luscus, the pelagicScomber scombrusandTrachurus trachurus, and the benthicMyoxocephalus scorpioides. We conducted combined stomach content and stable isotope analyses to examine the short- and the time-integrated dietary composition, respectively. Our results indicated that benthopelagic and benthic species utilize artificial reefs, such as OWFs, as feeding grounds for a prolonged period, since both analyses indicated that they exploit fouling organisms occurring exclusively on artificial hard substrates.Trachurus trachurusonly occasionally uses artificial reefs as oases of highly abundant resources.Scomber scombrusdoes not feed on fouling fauna and therefore its augmented presence in OWFs is probably related to reasons other than the enhanced food availability. The long-termed feeding preferences of benthic and benthopelagic species contribute to the hypothesis that the artificial reefs of OWFs could potentially increase the fish production in the area. However, this was not supported for the pelagic species.