bluuebunny/crossref_metadata_2025 huggingface dataset:
Anthocyanin extract from Lycium ruthenicum enhanced production of biomass and polysaccharides during submerged fermentation of Agaricus bitorquis (Quél.) Sacc. Chaidam
Authors: Wu Shan , Lu Hong-Yun , Chen Qi-He , Xie Hui-Chun , Jiao Ying-Chun
Published: July 2021

Agaricus bitorquis (Quél.) Sacc. Chaidam (ABSC) is a wild edible fungus uniquely found in the Tibet Plateau. ABSC is rich in polysaccharides that are considered biologically active. This study aimed to determine the feasibility of enhancing exopolysaccharide (EPS) production by ABSC in shake flask culture by supplementing the fermentation medium with anthocyanin extract. Different concentrations of Lycium ruthenicum Murr. (LRM) anthocyanin crude extract were tested on ABSC fermentation. The activity of phosphoglucose isomerase (PGI), phosphoglucose mutase (PGM), and phosphomannose isomerase (PMI), enzymes presumably involved in EPS synthesis by ABSC, was determined. ABSC transcriptomic profile in response to the presence of anthocyanins during fermentation was also investigated. LRM anthocyanin crude extract (0.06 mg/mL) was most effective in increasing EPS content and mycelial biomass (by 208.10% and 105.30%, respectively, P < 0.01). The activity of PGI, PGM, and PMI was increased in a medium where LRM anthocyanin extract and its main components (proanthocyanidins and petunia anthocyanin) were added. RNA-Seq analysis showed that 349 genes of ABSC were differentially expressed during fermentation in the medium containing anthocyanin extract of LRM; 93 genes were up-regulated and 256 genes down-regulated. From gene ontology enrichment analysis, differentially expressed genes were mostly assigned to carbohydrate metabolism and signal transduction categories. Collectively, LRM anthocyanins extract positively affected EPS production and mycelial biomass during ABSC fermentation. Our study provides a novel strategy for improving EPS production and mycelial growth during ABSC liquid submerged fermentation.
Discrepancy properties and conjugacy classes of interval exchange transformations
Authors: Weiß Christian
Published: July 2021

Interval exchange transformations are typically uniquely ergodic maps and therefore have uniformly distributed orbits. Their degree of uniformity can be measured in terms of the star-discrepancy. Few examples of interval exchange transformations with low-discrepancy orbits are known so far and only for $$n=2,3$$

n
=
2
,
3

intervals, there are criteria to completely characterize those interval exchange transformations. In this paper, it is shown that having low-discrepancy orbits is a conjugacy class invariant under composition of maps. To a certain extent, this approach allows us to distinguish interval exchange transformations with low-discrepancy orbits from those without. For $$n=4$$

n
=
4

intervals, the classification is almost complete with the only exceptional case having monodromy invariant $$\rho = (4,3,2,1)$$

ρ
=
(
4
,
3
,
2
,
1
)

. This particular monodromy invariant is discussed in detail.
Differential Effects of Toll-Like Receptor Activation and Differential Mediation by MAP Kinases of Immune Responses in Microglial Cells
Authors: Kwon Jaedeok , Arsenis Christos , Suessmilch Maria , McColl Alison , Cavanagh Jonathan , Morris Brian J.
Published: July 2021

Microglial activation is believed to play a role in many psychiatric and neurodegenerative diseases. Based largely on evidence from other cell types, it is widely thought that MAP kinase (ERK, JNK and p38) signalling pathways contribute strongly to microglial activation following immune stimuli acting on toll-like receptor (TLR) 3 or TLR4. We report here that exposure of SimA9 mouse microglial cell line to immune mimetics stimulating TLR4 (lipopolysaccharide—LPS) or TLR7/8 (resiquimod/R848), results in marked MAP kinase activation, followed by induction of nitric oxide synthase, and various cytokines/chemokines. However, in contrast to TLR4 or TLR7/8 stimulation, very few effects of TLR3 stimulation by poly-inosine/cytidine (polyI:C) were detected. Induction of chemokines/cytokines at the mRNA level by LPS and resiquimod were, in general, only marginally affected by MAP kinase inhibition, and expression ofTNF,Ccl2andCcl5mRNAs, along with nitrite production, were enhanced by p38 inhibition in a stimulus-specific manner. Selective JNK inhibition enhanced Ccl2 and Ccl5 release. Many distinct responses to stimulation of TLR4 and TLR7 were observed, with JNK mediating TNF protein induction by the latter but not the former, and suppressing Ccl5 release by the former but not the latter. These data reveal complex modulation by MAP kinases of microglial responses to immune challenge, including a dampening of some responses. They demonstrate that abnormal levels of JNK or p38 signalling in microglial cells will perturb their profile of cytokine and chemokine release, potentially contributing to abnormal inflammatory patterns in CNS disease states.
The coSIR model predicts effective strategies to limit the spread of SARS-CoV-2 variants with low severity and high transmissibility
Authors: Xu Longchen , Zhang Haohang , Xu Hengyi , Yang Han , Zhang Lei , Zhang Wei , Gu Fei , Lan Xun
Published: July 2021

Multiple new variants of SARS-CoV-2 have been identified as the COVID-19 pandemic spreads across the globe. However, most epidemic models view the virus as static and unchanging and thus fail to address the consequences of the potential evolution of the virus. Here, we built a competitive susceptible-infected-removed (coSIR) model to simulate the competition between virus strains of differing severities or transmissibility under various virus control policies. The coSIR model predicts that although the virus is extremely unlikely to evolve into a “super virus” that causes an increased fatality rate, virus variants with less severe symptoms can lead to potential new outbreaks and can cost more lives over time. The present model also demonstrates that the protocols restricting the transmission of the virus, such as wearing masks and social distancing, are the most effective strategy in reducing total mortality. A combination of adequate testing and strict quarantine is a powerful alternative to policies such as mandatory stay-at-home orders, which may have an enormous negative impact on the economy. In addition, building Mobile Cabin Hospitals can be effective and efficient in reducing the mortality rate of highly infectious virus strains.
ClipAssistNet: bringing real-time safety feedback to operating rooms
Authors: Aspart Florian , Bolmgren Jon L. , Lavanchy Joël L. , Beldi Guido , Woods Michael S. , Padoy Nicolas , Hosgor Enes
Published: July 2021

Purpose

Cholecystectomy is one of the most common laparoscopic procedures. A critical phase of laparoscopic cholecystectomy consists in clipping the cystic duct and artery before cutting them. Surgeons can improve the clipping safety by ensuring full visibility of the clipper, while enclosing the artery or the duct with the clip applier jaws. This can prevent unintentional interaction with neighboring tissues or clip misplacement. In this article, we present a novel real-time feedback to ensure safe visibility of the instrument during this critical phase. This feedback incites surgeons to keep the tip of their clip applier visible while operating.

Methods

We present a new dataset of 300 laparoscopic cholecystectomy videos with frame-wise annotation of clipper tip visibility. We further present ClipAssistNet, a neural network-based image classifier which detects the clipper tip visibility in single frames. ClipAssistNet ensembles predictions from 5 neural networks trained on different subsets of the dataset.

Results

Our model learns to classify the clipper tip visibility by detecting its presence in the image. Measured on a separate test set, ClipAssistNet classifies the clipper tip visibility with an AUROC of 0.9107, and 66.15% specificity at 95% sensitivity. Additionally, it can perform real-time inference (16 FPS) on an embedded computing board; this enables its deployment in operating room settings.

Conclusion

This work presents a new application of computer-assisted surgery for laparoscopic cholecystectomy, namely real-time feedback on adequate visibility of the clip applier. We believe this feedback can increase surgeons’ attentiveness when departing from safe visibility during the critical clipping of the cystic duct and artery.
Prävention von Ballsportunfällen an Schulen mittels eines „serious game“: Konzeptvorstellung und begleitende Evaluation
Authors: Riemer Valentin , Schrader Claudia , Pollatos Olga
Published: July 2021

Hintergrund

Die Zahl der Ballsportunfälle im Schulsport ist seit Jahren konstant hoch. Zu den Hauptursachen zählt mangelnde Gefahrenkenntnis und eine daraus resultierende geringe Risikowahrnehmung bei Schülerinnen und Schülern (SuS).

Ziel der Arbeit

Ein Präventionskonzept wird vorgestellt, bestehend aus einem „serious game“ und didaktischen Begleitmaterialien für SuS und Lehrkräfte. Lernziele, Spielprinzipien und Anwendung in einem Blended-learning-Ansatz werden beschrieben. Zwei begleitende Evaluationsstudien und deren wichtigsten Ergebnisse werden berichtet.

Material und Methoden

Mittels teilstrukturierter Interviews wurden in Studie 1 (nSuS = 92; nLehrkräfte = 9) Vorwissen und Erwartungen der Zielgruppen erhoben. Nach Entwicklung eines Spielprototyps wurde dieser in einer Studie 2 (nSuS = 13; nLehrkräfte = 8; nExpert*innen = 5) eingesetzt und mittels Online-Fragebogen das Spielerleben sowie Einstellungen zur Nutzung des Präventionskonzepts erfasst.

Ergebnisse

Die SuS zeigten nur geringes Vorwissen zu Gefahren im Ballsport an Schulen. SuS berichteten ein generell positives Spielerleben. Lehrkräfte zeigten eine positive Einstellung zum Präventionskonzept.

Diskussion

Die Erkenntnisse aus den Studien flossen im Sinne eines Design-based-research-Ansatzes direkt in die weitere Entwicklung ein. Es wird eine hohe Anwendungsbereitschaft für das Präventionskonzept angenommen. Die Effektivität des Konzepts ist in einer abschließenden Evaluationsstudie zu prüfen.
Structured Lifestyle Modification Prior to Bariatric Surgery: How Much is Enough?
Authors: Brazil John , Finucane Francis
Published: July 2021

Many healthcare systems require patients to participate in a structured lifestyle modification programme prior to bariatric surgery, even though bariatric consensus guidelines do not recommend this. While there is good evidence that such programmes improve health in other conditions such as metabolic and cardiovascular diseases, there is no evidence that they improve outcomes after bariatric surgery. The distinction needs to be drawn between the well-established need for individualised multidisciplinary dietetic and physical activity care for bariatric surgical patients and the potential harms from mandating participation in compulsory structured lifestyle programmes of fixed duration, frequency and intensity, which may delay surgery, reinforce obesity stigma, or both. Large clinical trials might help to address some of the uncertainty and provide an evidence base for clinicians and policymakers.

Graphical abstract
The Effect of Virtual Mindfulness-Based Interventions on Sleep Quality: A Systematic Review of Randomized Controlled Trials
Authors: Jiang Amanda , Rosario Michael , Stahl Sara , Gill Jessica M. , Rusch Heather L.
Published: July 2021

Purpose of Review

We summarized peer-reviewed literature investigating the effect of virtual mindfulness-based interventions (MBIs) on sleep quality. We aimed to examine the following three questions: (1) do virtual MBIs improve sleep quality when compared with control groups; (2) does the effect persist long-term; and (3) is the virtual delivery method equally feasible compared to the in-person delivery method?

Recent Findings

Findings suggest that virtual MBIs are equivalent to evidence-based treatments, and to a limited extent, more effective than non-specific active controls at reducing some aspects of sleep disturbance. Overall, virtual MBIs are more effective at improving sleep quality than usual care controls and waitlist controls. Studies provide preliminary evidence that virtual MBIs have a long-term effect on sleep quality. Moreover, while virtual MBI attrition rates are comparable to in-person MBI attrition rates, intervention adherence may be compromised in the virtual delivery method.

This review highlights virtual MBIs as a potentially effective alternative to managing sleep disturbance during pandemic-related quarantine and stay-at-home periods. This is especially relevant due to barriers of accessing in-person interventions during the pandemic. Future studies are needed to explore factors that influence adherence and access to virtual MBIs, with a particular focus on diverse populations.
Intercultural Attitudes as Predictors of Student’s Prejudices Towards Refugees
Authors: Genkova Petia , Groesdonk Anna
Published: July 2021

One of the major challenges for modern western societies is the reduction of prejudice in order to achieve a sufficient level of integration of immigrants and especially refugees. The current literature thus presents a multitude of approaches to understand and reduce prejudices. Therefore, the following paper investigates the relationships between ethnic identity, acculturation attitudes, intercultural competence, and prejudice and how contact experiences shape these relationships for students in Germany with and without migration background. The results show that there is a significant relationship between prejudice and the social identity, cultural intelligence, and acculturation strategies. Furthermore, the results indicate that the experienced contact quality and quantity to refugees moderate the effect of acculturation strategies on overt prejudice and xenophobia. However, the relationship between acculturation strategies and covert prejudice is only moderated by contact quantity. Because of the relatively weak manifestations of the dependent variables in the study at hand, alternative instruments should be used for investigation. Based on the obtained results, this paper finally tries to give some guidance for the facilitation of diversity and reduction of prejudice at higher education institutions.
Varieties of dispositional essentialism about natural laws
Authors: Hirèche Salim
Published: July 2021

An important task for metaphysicians and philosophers of science is to account for laws of nature – in particular, how they distinguish themselves from ‘mere’ regularities, and the modal force they are endowed with, ‘natural necessity’. Dispositional essentialism about laws (for short: ‘essentialism’) is roughly the view that laws distinguish themselves by being grounded in the essences of natural entities (e.g. kinds, properties). This paper does not primarily concern how essentialism compares to its main rivals – Humeanism and Armstrongeanism. Rather, it distinguishes and comparatively assesses various brands of essentialism – which mainly differ as to where exactly they take laws to find their essentialistsources(e.g. in particular entities, like electrons, or in larger pluralities of entities, or in the world as a whole), and what they take to be thetargetsof laws, namely what they apply to. Yet, this internal comparison is not unrelated to the more general debate about laws: the main criteria with which I compare these essentialist views concern how they can deal with some of the main objections faced by essentialism in general (the modal status it typically attributes to laws, which some think is too strong; and its alleged incapacity to account for the most 'general' laws, like conservation laws), and how they can keep what is arguably the main intuitive advantage of essentialism over its rivals (the fact that, on this view, things “govern themselves”). Thus, the paper also concerns the relative position of essentialism in the larger debate about laws – ultimately bringing support to it.
ESMA as a Residual Lawmaker: The Political Economy and Constitutionality of ESMA’s Product Intervention Measures on Complex Financial Products
Authors: Iglesias-Rodríguez Pablo
Published: July 2021

This article proposes that product intervention constitutes a form of residual lawmaking by ESMA that allows it to tackle aspects of investor protection not addressed by EU incomplete financial laws. Whilst product intervention may bring about certain advantages and may contribute to mitigating regulatory arbitrage problems, it constitutes a highly intrusive regulatory mechanism that raises important questions concerning: (a) ESMA’s rationale and motivations for its use; (b) its compliance with the EU constitutional framework; and (c) its adequacy for the regulation of complex financial products. This article addresses these questions through an analysis of the rationale and consequences of ESMA’s product intervention measures on binary options and contracts for differences of May 2018–July 2019, and of recent reforms of ESMA’s powers. It offers three main contributions to the existing literature. First, it contributes to the literature on administrative discretion and agencies’ rulemaking through an analysis of the political economy of ESMA’s deployment of product intervention powers and, also, of what this reveals about the relationships between ESMA and the EU Institutions, on the one side, and ESMA and National Competent Authorities, on the other. Second, it contributes to the literature on the constitutionality of EU agencies through an examination of the compliance of ESMA’s product intervention measures with EU constitutional law and requirements. Third, it examines whether product intervention constitutes an adequate mechanism to address problems pertaining to investor protection in complex financial products markets and, in doing so, it contributes to the scholarly discussion on complex financial products’ regulation.
Analysis of serum levels of titanium and aluminium ions in patients with early onset scoliosis operated upon using the magnetic growing rod—a single centre study of 14 patients
Authors: Borde Mandar Deepak , Sapare Sarang , Schutgens Emile , Ali Chadi , Noordeen Hilali
Published: July 2021

Study design

A cross-sectional retrospective Level 3 study.

Objective

To study the serum levels of Titanium and Aluminium ions in patients operated using the magnetically controlled growing rod (MCGR) system.

Summary of background data

14 consecutive patients of early onset scoliosis with varying etiology managed with MCGR system with a minimum follow-up of 24 months were selected for the study. The group consisted of two boys (14.3%) and 12 girls (85.7%). The average age of the patients at the time of surgery was 10.4 years (5–15 years). The average period of follow-up was 43.7 months (28–79 months). After informed consent of the subjects and their caretakers, serum levels of titanium and aluminium were measured. These levels were then assessed with regards to the number of screws used, number of distractions and complications.

Methods

The concentration of titanium and aluminium ions in the serum was measured using high resolution inductively coupled plasma mass spectrometry.

Results

For the sake of ease of assessment, patients were divided into three etiology-based groups—idiopathic (n = 6), neuromuscular (n = 2) and syndromic (n = 6). The mean serum titanium level was 15.9 μg/L (5.1–28.2 μg/L) while that of aluminium was 0.1 μmol/L (0.1–0.2 μmol/L). Of the 14 patients, 2 (14.2%) patients had mechanical failure (actuator pin dysfunction), 3 (21.4%) had rod breakage requiring revision surgery and one patient (7.1%) had surgical site infection managed with appropriate antibiotics. Patients undergoing revision for rod breakage did not show any metallosis of the tissues during surgery.

Conclusion

Analysis of patients with scoliosis operated using the magnetic growing rod system concludes that it is accompanied by presence of titanium in the blood but whether clinically significant or not needs to be ascertained by comparison of preoperative and postoperative blood concentrations of the titanium ions in individual subjects. The aluminium ion concentration remains within normal limits. Though implant malfunction may raise the titanium levels in the blood, its clinical significance needs to be determined. The aluminium levels are not affected irrespective to the presence or absence of complications. The long-term effects of raised titanium levels in the blood also warrant further prospective studies designed for precise and deeper analyses.
Charity Law and Accumulation
Authors: Murray Ian
Published: July 2021

Much has been written in charity law on the type of benefits that charities can provide - charitable purposes - and towards whom such benefits must be directed - the public benefit question. Almost nothing has been written about when benefits must be provided. However, accumulation of assets by charities raises profound ethical, economic and social considerations that are highlighted by the present retreat of the welfare state and the impact of the Global Financial Crisis and COVID-19. This book analyses the issue through a normative, doctrinal and comparative analysis of the legal constraints upon accumulation by charities. It reveals that the legal restraints contain significant gaps in relation to the intergenerational distribution of benefits and to the balance of decision-making between generations. In particular, the book asserts that there is room for law reform to better identify and incorporate principles of intergenerational justice into the regulation of charities.
Other knowings and experiencing otherness: Children’s perspectives of playing a hunting game in a nature reserve
Authors: Adams Dylan , Beauchamp Gary
Published: July 2021

This research study explored the experiences of children (aged 9–10 years), from four different primary schools, playing a hunting game in a nature reserve. Previous research shows that children’s play in green spaces can provide a number of benefits to children. However, there is a lack of research into children’s experiences of playing in bio-diverse environments. This study sought to find out how children (aged 9–10 years) “playing” the role of animals in a nature reserve could enable them to experience different ways of being and different ways of understanding their relationship with the world around them. The study employed a qualitative phenomenological design that aimed to interpret the first-person lived experiences of the children playing in the nature reserve. Four classes from four different primary schools took part in the study. Six children from each class were interviewed and analysis of their responses generated a number of different themes. The results suggest that playing the hunting game in a biodiverse environment does offer states of being and knowings that are not as accessible in schools. Playing the role of an animal had afforded the children with an accentuated, embodied experience, offering insight into the otherness of the more-than-human world.
Risks of Occupational-Related Adverse Events (ORAEs) and Effect of Bundled Interventions Among Health Care Workers in Novel Coronavirus Pneumonia Wards
Authors: Luo Tinggang , Guo Yao , Shi Ying , Song Yujian , Xu Wenchao , You Jianping
Published: July 2021

Objective:

The aims of the study were to investigate the burden for health care workers (HCWs) who suffer from occupational-related adverse events (ORAEs) while working in contaminated areas in a specialized hospital for novel coronavirus pneumonia, to explore related risk factors, to evaluate the effectiveness of bundled interventions, as well as to provide scientific evidence regarding the reduction of risks concerning ORAEs and occupational exposure events.

Methods:

The study was completed using a special team of 138 HCWs assembled for a specialized hospital for novel coronavirus pneumonia in Wuhan, dated from February 16 to March 26, 2020. The incidence of occupational exposure was determined by data reported from the hospital, while the prevalence of ORAEs was derived from questionnaire results. The relation coefficients of ORAEs and the variable potential risk factors are analyzed by logistic regression. After the risk factors were identified, targeted organized intervention was implemented and chi-square tests were performed to compare the incidence of occupational exposure and the prevalence of ORAEs in contaminated areas before and after the interventions.

Results:

Ninety one out of 138 (65.94%) had reported ORAEs with 300 (27.96%) cases of ORAEs being recorded in a total of 1073 entries into contaminated areas. The prevalence of different ORAEs include 205 tenderness (24.73%), 182 headache/dizziness (21.95%), 138 dyspnea (16.65%), 130 blurred vision (15.68%), and 95 nausea/vomiting (11.46%). Personal protective equipment (PPE) is significantly associated with ORAEs in contaminated areas (P < 0.05). Among non-PPE-related factors, insomnia is associated with the majority of ORAEs in contaminated areas. Significant differences were achieved after organized interventions in the incidence of occupational exposure of HCWs (χ2 = 39.07, P < 0.001) and the prevalence of ORAEs in contaminated areas (χ2 = 22.95, P < 0.001).

Conclusion:

During the epidemic period of novel severe respiratory infectious disease, the burden of the ORAEs in contaminated areas and the risk of occupational exposure of HCWs were relatively high. In time, comprehensive and multi-level bundled interventions may help decrease the risk of both ORAEs and occupational exposure.
The Pandemic Is Not Occurring in a Vacuum: The Impact of COVID-19 and Other Disasters on Workforce Mental Health in Australia
Authors: Podubinski Tegan , Glenister Kristen M.
Published: July 2021

Objective:

Prior to coronavirus disease (COVID-19), many Australians experienced extreme bushfires, droughts, and floods. A history of experiencing these events might be a risk factor for increased psychological distress during COVID-19. This study aimed to provide insight into the mental health of Australian workers during the initial COVID-19 outbreak, with an additional focus on whether previous disaster exposure and impact from that disaster is a risk factor for increased psychological distress.

Methods:

A snowball recruitment strategy was used. Participants (n = 596) completed an online survey, which included the Depression Anxiety Stress Scales-21, and questions related to mental health and disaster exposure.

Results:

Overall, 19.2%, 13.4%, and 16.8% of participants were experiencing moderate to extremely severe depression, anxiety, and stress symptoms, respectively. Multiple regression found that higher depression, anxiety, and stress symptoms were associated with a pre-existing mental health diagnosis; only higher stress symptoms were associated with having experienced a disaster, with impact, in addition to COVID-19.

Conclusions:

People who have experienced impact from an additional disaster might need additional support to protect their mental health during COVID-19. A focus on the cumulative mental health impacts of multiple disasters and the implications for organizational communities where recovery work is undertaken, such as schools and workplaces, is needed.
Microbial bioburden of inpatient and outpatient areas beyond patient hospital rooms
Authors: Cadnum Jennifer L. , Pearlmutter Basya S. , Jencson Annette L. , Haydar Hanan , Hecker Michelle T. , Ray Amy J. , Tomas Myreen E. , Saade Elie A. , Donskey Curtis J.
Published: July 2021

Objective:

To investigate the frequency of environmental contamination in hospital areas outside patient rooms and in outpatient healthcare facilities.

Design:

Culture survey.

Setting:

This study was conducted across 4 hospitals, 4 outpatient clinics, and 1 surgery center.

Methods:

We conducted 3 point-prevalence culture surveys for methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridioides difficile, Candida spp, and gram-negative bacilli including Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter baumanii, and Stenotrophomonas maltophilia in each facility. In hospitals, high-touch surfaces were sampled from radiology, physical therapy, and mobile equipment and in emergency departments, waiting rooms, clinics, and endoscopy facilities. In outpatient facilities, surfaces were sampled in exam rooms including patient and provider areas, patient bathrooms, and waiting rooms and from portable equipment. Fluorescent markers were placed on high-touch surfaces and removal was assessed 1 day later.

Results:

In the hospitals, 110 (9.4%) of 1,195 sites were positive for 1 or more bacterial pathogens (range, 5.3%–13.7% for the 4 hospitals) and 70 (5.9%) were positive for Candida spp (range, 3.7%–5.9%). In outpatient facilities, 31 of 485 (6.4%) sites were positive for 1 or more bacterial pathogens (range, 2% to 14.4% for the 5 outpatient facilities) and 50 (10.3%) were positive for Candida spp (range, 3.9%–23.3%). Fluorescent markers had been removed from 33% of sites in hospitals (range, 28.4%–39.7%) and 46.3% of sites in outpatient clinics (range, 7.4%–82.8%).

Conclusions:

Surfaces in hospitals outside patient rooms and in outpatient facilities are frequently contaminated with healthcare-associated pathogens. Improvements in cleaning and disinfection practices are needed to reduce contamination.
TOPOLOGICAL 4-MANIFOLDS WITH 4-DIMENSIONAL FUNDAMENTAL GROUP
Authors: KASPROWSKI DANIEL , LAND MARKUS
Published: July 2021

Let$\pi$be a group satisfying the Farrell–Jones conjecture and assume that$B\pi$is a 4-dimensional Poincaré duality space. We consider topological, closed, connected manifolds with fundamental group$\pi$whose canonical map to$B\pi$has degree 1, and show that two such manifolds ares-cobordant if and only if their equivariant intersection forms are isometric and they have the same Kirby–Siebenmann invariant. If$\pi$is good in the sense of Freedman, it follows that two such manifolds are homeomorphic if and only if they are homotopy equivalent and have the same Kirby–Siebenmann invariant. This shows rigidity in many cases that lie between aspherical 4-manifolds, where rigidity is expected by Borel’s conjecture, and simply connected manifolds where rigidity is a consequence of Freedman’s classification results.
Minimally invasive permanent pacemaker implantation immediately after birth: from delivery room to heart surgery
Authors: Taşar Mehmet , Yaman Nur Dikmen , Arıcı Burcu , Aksoy Ömer Nuri , Dursin Huseyin , Ayaz Aslı , Citli Rümeysa , Özgür Senem , Sayıcı İlker Ufuk
Published: July 2021

Introduction:

Congenital atrioventricular block is diagnosed in uterine life, at birth, or early in life. Atrioventricular blocks can be life threatening immediately at birth so urgent pacemaker implantation techniques are requested. Reasons can be cardiac or non-cardiac, but regardless of the reason, operations are challenging. We aimed to present technical procedure and operative results of pacemaker implantation in neonates.

Materials and methods:

Between June 2014 and February 2021, 10 neonates who had congenital atrioventricular block underwent surgical operation to implant permanent epicardial pacemaker by using minimally invasive technique. Six of the patients were female and four of them were male. Mean age was 4.3 days (0–11), while three of them were operated on the day of birth. Mean weight was 2533 g (1200–3300).

Results:

Operations were achieved through subxiphoidal minimally skin incision. Epicardial 25 mm length dual leads were implanted on right ventricular surface and generators were fixed on the right (seven patients) or left (three patients) diaphragmatic surface by incising pleura. There were no complication, morbidity, and mortality related to surgery.

Conclusion:

Few studies have characterised the surgical outcomes following epicardial permanent pacemaker implantation in neonates. The surgical approach is attractive and compelling among professionals so we aimed to present the techniques and results in patients who required permanent pacemaker implantation in the first month of life.
Wealth wars: how productivity gaps explain democratic erosion in advanced economies
Authors: Timoneda Joan C.
Published: July 2021

Why are democracies backsliding? I contend that a large productivity gap between economic groups motivates those with low productivity to capture the state for rent-seeking. They assess their relative position as weak and are willing to sacrifice certain democratic guarantees in exchange for favorable policies. Erosion takes two forms. (1) With high inter-class inequality and a large productivity gap among economic industries, losing economic elites capture the state through a political outsider who enacts favorable policy. Once in office, the outsider expands his personal executive control and attacks key democratic veto players. (2) When inter-class inequality is high but the inter-industry productivity gap is small, a united economic elite coordinate to stop a populist takeover. Traditional political elites respond to the populist threat by curtailing basic freedoms of speech and association. I use both quantitative and case study evidence from the US and Spain to support my main hypotheses.
Vertical Mixing in Stratified Fjords Near Tidewater Outlet Glaciers Along Northwest Greenland
Authors: Bendtsen Jørgen , Rysgaard Søren , Carlson Daniel F. , Meire Lorenz , Sejr Mikael K.
Published: July 2021

Vertical mixing of upper water masses in Arctic fjords is important for circulation and transport of nutrients and heat. However, the distribution of turbulent mixing is poorly known. Here we present hydrographic and microscale turbulence measurements from six fjords in Northwestern (69°N–75°N) Greenland. Water mass distributions showed the presence of warm bottom water of Atlantic origin in all fjord transects and a significant modification of upper water masses in fjords with tidewater outlet glaciers. Spatial and temporal distribution of turbulence in the fjords showed, in general, low rates of turbulent kinetic energy, ε (∼10−9 W kg−1), and strong stratification implies that vertical exchange in the upper ∼200 m was relatively weak. However, measurements within 2 km of the terminus of a tidewater outlet glacier showed values of ε and inferred turbulent diffusion coefficients >10−4 m2 s−1 that were about two orders of magnitude larger than elsewhere in the deep fjords. This elevated mixing corresponded to comparatively large heat and salt fluxes. These observations suggest that vertical mixing near tidewater outlet glaciers results in localized mixing hot spots, likely due to subglacial discharge and near‐glacial current shear, that contribute significantly to vertical exchange in the deep fjords.
Thousands of Stars View Earth as a Transiting Exoplanet
Authors: Kornei Katherine
Published: July 2021

Researchers have identified more than 2,000 stars whose past, present, or future vantage points afford a view of Earth passing directly in front of the Sun, a geometry useful for pinpointing planets.
The Impact of Perturbing Eddy Diffusion and Upper Boundary on the Ionosphere EnKF Assimilation System
Authors: He Jianhui , Yue Xinan
Published: July 2021

Accurate representation of ensemble members of coupled Ionosphere‐Thermosphere (I‐T) is crucial to the ionosphere forecast in the ensemble Kalman filter (EnKF) data assimilation system. In this paper, besides the model drivers used in previous studies, including the solar 10.7 cm radio flux (F10.7), auroral hemispheric power (HP) and cross‐tail potential drop (CP), the eddy diffusion coefficient (ED), and nighttime vertical O+ flux at the top boundary are also perturbed to generate ensemble members. Based on our developed EnKF data assimilation system, the impact of perturbing different model external forcing parameters on ensemble generation and forecast capability of ionosphere and thermosphere has been investigated in detail through a series of sensitivity tests and data assimilation experiments. This system uses the National Center for Atmospheric Research (NCAR) Thermosphere Ionosphere Electrodynamics General Circulation Model (TIEGCM) as a background model. The findings are summarized as follows: (a) Associated with perturbing two additional model forcing parameters, better ensemble members of ionosphere and thermosphere states of the background model can be generated during both daytime and nighttime. (b) The improvement of the forecast capability of the ionosphere and thermosphere variables can be further enhanced. This study can provide a reference for ensemble generating strategy for the coupled I‐T EnKF data assimilation in the future.
Non-hematopoietic IL-4Rα expression contributes to fructose-driven obesity and metabolic sequelae
Authors: Damen Michelle S. M. A. , Stankiewicz Traci E. , Park Se-Hyung , Helsley Robert N. , Chan Calvin C. , Moreno-Fernandez Maria E. , Doll Jessica R. , Szabo Sara , Herbert De’Broski R. , Softic Samir , Divanovic Senad
Published: July 2021

Objective

The risks of excess sugar intake in addition to high-fat diet consumption on immunopathogenesis of obesity-associated metabolic diseases are poorly defined. Interleukin-4 (IL-4) and IL-13 signaling via IL-4Rα regulates adipose tissue lipolysis, insulin sensitivity, and liver fibrosis in obesity. However, the contribution of IL-4Rα to sugar rich diet-driven obesity and metabolic sequelae remains unknown.

Methods

WT, IL-4Rα-deficient (IL-4Rα−/−) and STAT6-deficient mice (STAT6−/−) male mice were fed low-fat chow, high fat (HF) or HF plus high carbohydrate (HC/fructose) diet (HF + HC). Analysis included quantification of: (i) body weight, adiposity, energy expenditure, fructose metabolism, fatty acid oxidation/synthesis, glucose dysmetabolism and hepatocellular damage; (ii) the contribution of the hematopoietic or non-hematopoietic IL-4Rα expression; and (iii) the relevance of IL-4Rα downstream canonical STAT6 signaling pathway in this setting.

Results

We show that IL-4Rα regulated HF + HC diet-driven weight gain, whole body adiposity, adipose tissue inflammatory gene expression, energy expenditure, locomotor activity, glucose metabolism, hepatic steatosis, hepatic inflammatory gene expression and hepatocellular damage. These effects were potentially, and in part, dependent on non-hematopoietic IL-4Rα expression but were independent of direct STAT6 activation. Mechanistically, hepatic ketohexokinase-A and C expression was dependent on IL-4Rα, as it was reduced in IL-4Rα-deficient mice. KHK activity was also affected by HF + HC dietary challenge. Further, reduced expression/activity of KHK in IL-4Rα mice had a significant effect on fatty acid oxidation and fatty acid synthesis pathways.

Conclusion

Our findings highlight potential contribution of non-hematopoietic IL-4Rα activation of a non-canonical signaling pathway that regulates the HF + HC diet-driven induction of obesity and severity of obesity-associated sequelae.
AHR-dependent genes and response to MTX therapy in rheumatoid arthritis patients
Authors: Wajda Anna , Walczuk Ewa , Stypińska Barbara , Lach Jakub , Yermakovich Danat , Sivitskaya Larysa , Romanowska-Próchnicka Katarzyna , Wysocki Tomasz , Jarończyk Małgorzata , Paradowska-Gorycka Agnieszka
Published: July 2021

Methotrexate (MTX) is the first-line therapy for rheumatoid arthritis. Nevertheless, MTX resistance is quite a common issue in clinical practice. There are some premises that aryl hydrocarbon receptor (AhR) gene battery may take part in MTX metabolism. In the present retrospective study, we analyzed genes expression of AHR genes battery associated with MTX metabolism in whole blood of RA patients with good and poor response to MTX treatment. Additionally, sequencing, genotyping and bioinformatics analysis of AHR repressor gene (AHRR) c.565C > G (rs2292596) and c.1933G > C (rs34453673) have been performed. Theoretically, both changes may have an impact on H3K36me3 and H3K27me3. Evolutionary analysis revealed that rs2292596 may be possibly damaging. Allele G in rs2292596 and DAS28 seems to be associated with a higher risk of poor response to MTX treatment in RA. RA patients with poor response to MTX treatment revealed upregulated AhR and SLC19A1 mRNA level. Treatment with IL-6 inhibitor may be helpful to overcome the low-dose MTX resistance. Analysis of gene expression revealed possible another cause of poor response to MTX treatment which is different from that observed in the case of acute lymphoblastic leukemia.
G6PD distribution in sub-Saharan Africa and potential risks of using chloroquine/hydroxychloroquine based treatments for COVID-19
Authors: da Rocha Jorge E. B. , Othman Houcemeddine , Tiemessen Caroline T. , Botha Gerrit , Ramsay Michèle , Masimirembwa Collen , Adebamowo Clement , Choudhury Ananyo , Brandenburg Jean-Tristan , Matshaba Mogomotsi , Simo Gustave , Gamo Francisco-Javier , Hazelhurst Scott ,   as members of the H3Africa Consortium, da Rocha Jorge E. B.
Published: July 2021

Chloroquine/hydroxychloroquine have been proposed as potential treatments for COVID-19. These drugs have warning labels for use in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Analysis of whole genome sequence data of 458 individuals from sub-Saharan Africa showed significant G6PD variation across the continent. We identified nine variants, of which four are potentially deleterious to G6PD function, and one (rs1050828) that is known to cause G6PD deficiency. We supplemented data for the rs1050828 variant with genotype array data from over 11,000 Africans. Although this variant is common in Africans overall, large allele frequency differences exist between sub-populations. African sub-populations in the same country can show significant differences in allele frequency (e.g. 16.0% in Tsonga vs 0.8% in Xhosa, both in South Africa, p = 2.4 × 10−3). The high prevalence of variants in the G6PD gene found in this analysis suggests that it may be a significant interaction factor in clinical trials of chloroquine and hydroxychloroquine for treatment of COVID-19 in Africans.
Alternations of interhemispheric functional connectivity in children with strabismus and amblyopia: a resting-state fMRI study
Authors: Peng Jiaxin , Yao Fan , Li Qiuyu , Ge Qianmin , Shi Wenqing , Su Ting , Tang Liying , Pan Yicong , Liang Rongbin , Zhang Lijuan , Shao Yi
Published: July 2021

Previous neuroimaging studies demonstrated that patients with strabismus or amblyopia can show significant functional and anatomical changes in the brain, but alterations of interhemispheric functional connectivity (FC) have not been well studied in this population. The current study analyzed whole-brain changes of interhemispheric FC in children with strabismus and amblyopia (CSA) using voxel-mirrored homotopic connectivity (VMHC).A total of 24 CSA (16 males and 8 females) and 24 normal controls (NCs) consisting of 16 and 8 age-, sex, and education-matched males and females, respectively, underwent functional magnetic resonance imaging (fMRI) scans in the resting state. According to Gaussian random field theory, changes in the resting state FC (rsFC) between hemispheres were evaluated using the VMHC method. The relationships between mean VMHC values in multiple brain regions and behavioral performance were evaluated by Pearson correlation analysis. In contrast to NCs, the CSA group showed significantly decreased VMHC values in the bilateral cerebellum, bilateral frontal superior orbital (frontal sup orb), bilateral temporal inferior(temporal inf),and bilateral frontal superior(frontal sup). CSA have abnormal interhemispheric FC in many brain regions, which may reflect dysfunction of eye movements and visual fusion. These findings might provide insight into the underlying pathogenetic mechanisms of CSA.
Development of a local empirical model of ionospheric total electron content (TEC) and its application for studying solar-ionospheric effects
Authors: Davoudifar Pantea , Tabari Keihanak Rowshan , Shafigh Amir Abbas Eslami , Ajabshirizadeh Ali , Bagheri Zahra , Akbarian Tork Abad Fakhredin , Shayan Milad
Published: July 2021

Regular and irregular variations in total electron content (TEC) are one of the most significant observables in ionospheric studies. During the solar cycle 24, the variability of ionosphere is studied using global positioning system derived TEC at a mid-latitude station, Tehran (35.70N, 51.33E). Based on solar radio flux and seasonal and local time-dependent features of TEC values, a semi-empirical model is developed to represent its monthly/hourly mean values. Observed values of TEC and the results of our semi-empirical model then are compared with estimated values of a standard plasmasphere–ionosphere model. The outcome of this model is an expected mean TEC value considering the monthly/hourly regular effects of solar origin. Thus, it is possible to use it for monitoring irregular effects induced by solar events. As a result, the connection of TEC variations with solar activities are studied for the case of coronal mass ejections accompanying extreme solar flares. TEC response to solar flares of class X is well reproduced by this model. Our resulting values show that the most powerful flares (i.e. class X) induce a variation of more than 20 percent in daily TEC extent.
Viability of acellular biologic graft for nipple-areolar complex reconstruction in a non-human primate model
Authors: Caronna Vincent C. , Rosenberg Allison F. , Graham David M. , Heim William M. , Grasperge Brooke F. , Sullivan Scott K. , Chaffin Abigail E. , Bunnell Bruce A. , Pashos Nicholas C.
Published: July 2021

Many of the > 3.5 million breast cancer survivors in the US have undergone breast reconstruction following mastectomy. Patients report that nipple-areolar complex (NAC) reconstruction is psychologically important, yet current reconstruction techniques commonly result in inadequate shape, symmetry, and nipple projection. Our team has developed an allogeneic acellular graft for NAC reconstruction (dcl-NAC) designed to be easy to engraft, lasting, and aesthetically pleasing. Here, dcl-NAC safety and host-mediated re-cellularization was assessed in a 6-week study in rhesus macaque non-human primates (NHPs). Human-derived dcl-NACs (n = 30) were engrafted on the dorsum of two adult male NHPs with each animal’s own nipples as controls (n = 4). Weight, complete blood counts, and metabolites were collected weekly. Grafts were removed at weeks 1, 3, or 6 post-engraftment for histology. The primary analysis evaluated health, re-epithelialization, and re-vascularization. Secondary analysis evaluated re-innervation. Weight, complete blood counts, and metabolites remained mostly within normal ranges. A new epidermal layer was observed to completely cover the dcl-NAC surface at week 6 (13–100% coverage, median 93.3%) with new vasculature comparable to controls at week 3 (p = 0.10). Nerves were identified in 75% of dcl-NACs (n = 9/12) at week 6. These data suggest that dcl-NAC is safe and supports host-mediated re-cellularization.
Dietary salt exacerbates intestinal fibrosis in chronic TNBS colitis via fibroblasts activation
Authors: Amamou Asma , Rouland Matthieu , Yaker Linda , Goichon Alexis , Guérin Charlène , Aziz Moutaz , Savoye Guillaume , Marion-Letellier Rachel
Published: July 2021

Intestinal fibrosis is a frequent complication in inflammatory bowel diseases (IBD). It is a challenge to identify environmental factors such as diet that may be driving this risk. Intestinal fibrosis result from accumulation of extracellular matrix (ECM) proteins secreted by myofibroblasts. Factors promoting intestinal fibrosis are unknown, but diet appears to be a critical component in its development. Consumption of salt above nutritional recommendations can exacerbate chronic inflammation. So far, high salt diet (HSD) have not been thoroughly investigated in the context of intestinal fibrosis associated to IBD. In the present study, we analyze the role of dietary salt in TNBS chronic colitis induced in rat, an intestinal fibrosis model, or in human colon fibroblast cells. Here, we have shown that high-salt diet exacerbates undernutrition and promoted ECM-associated proteins in fibroblasts. Taken together, our results suggested that dietary salt can activate intestinal fibroblasts, thereby contributing to exacerbation of intestinal fibrosis. Dietary salt may be considered as a putative environmental factor that drives intestinal fibrosis risk.