bluuebunny/crossref_metadata_2025 huggingface dataset:
‘I am put on quite a bit’: Recurrent complaining and the ambivalences of multigenerational near‐co‐residence
Authors: Heinrichsmeier Rachel
Published: April 2021

Many studies of complaints‐in‐interaction have examined long sequences. This paper, by contrast, scrutinises a series of complaints produced within the same participation framework across four successive encounters. The data comprise audio‐recorded talk between an older woman (the complainant) and her stylist in a hair salon. Drawing on conversation analysis and membership categorisation analysis, I show how the complainant recurrently, but implicitly, implicates her near‐co‐resident adult daughter as a culpable figure in her complaints. I argue that it is the longitudinal nature of the data that enables this identification of the daughter as the recurrent underlying target. The paper thereby contributes to studies of complaining‐in‐interaction. It also shows how we might address some of the methodological issues associated with implicitly designed complaints. Furthermore, I argue that through the detail of the way she designs her articulation of her troubles—as complaints, but with the culpability of her daughter often very implicit—the complainant discursively constructs the complexity of her familial relations and living situation. This paper thereby also contributes to sociolinguistic studies of social ageing by offering insights into some of the lived ambivalence of co‐residence arrangements in later life.
Effects of adding high‐dosing Aspergillus oryzae phytase to corn–wheat–soybean meal‐based basal diet on growth performance, nutrient digestibility, faecal gas emission, carcass traits and meat quality in growing‐finishing pigs
Authors: Dang De Xin , Kim In Ho
Published: April 2021

This study tests the effects of supplementation of high‐dosing Aspergillus oryzae phytase into the corn–wheat–soybean meal (SBM)‐based basal diet on growth performance, nutrient digestibility, faecal gas emission, carcass traits and meat quality in growing‐finishing pigs (29.73–110.86 kg live weight; 70‐day‐old to 166‐day‐old). A total of 56 crossbred pigs [(Landrace × Yorkshire) × Duroc] were divided into two dietary groups for a 96‐day experiment (growing period, days 0–42; finishing period, days 43–96) with a completely randomized block design. There were seven replicate pens in each dietary group, and each pen has four pigs (two barrows and two gilts). The dietary treatments consisted of a corn–wheat–SBM‐based nutrient sufficient basal diet or the basal diet supplemented with 1500 FTU/kg A. oryzae phytase. One phytase unit (FTU) was defined as the amount of enzyme that catalyses the release of one micromole phosphate from phytate/min at 37°C and pH 5.5. Higher average daily gain and lower feed conversion ratio were observed in growing‐finishing pigs consuming a high‐dosing A. oryzae phytase supplementing diet during days 0–42 and 0–96. Supplementing high‐dosing A. oryzae phytase to the diet of growing‐finishing pigs increased apparent total tract digestibility of phosphorus on days 42 and 96. Moreover, growing‐finishing pigs fed the diet supplemented with high‐dosing A. oryzae phytase had higher carcass back‐fat thickness than those fed the control diet. However, the faecal gas emission and meat quality were not affected by high‐dosing A. oryzae phytase supplementation. In conclusion, dietary supplementation of high‐dosing A. oryzae phytase (1500 FTU/kg) had beneficial effects on the growth performance, apparent phosphorus digestibility and carcass back‐fat thickness in growing‐finishing pigs.
The relationship between fruit and vegetable intake with functional dyspepsia in adults
Authors: Tabibian Seyed‐Reza , Hajhashemy Zahra , Shaabani Pouria , Saneei Parvane , Keshteli Ammar Hassanzadeh , Esmaillzadeh Ahmad , Adibi Peyman
Published: April 2021

Introduction

The association of fruit and vegetables with functional dyspepsia (FD) has been less studied, especially in Middle Eastern populations. This study investigated the relationship between fruit and vegetable consumption with FD and its related symptoms among a large group of Iranian adults.

Methods and Materials

This cross‐sectional research was conducted on 3362 middle‐age participants. Usual dietary intakes, including fruit and vegetable intake, during the last year were assessed using a validated 106‐item dish‐based food frequency questionnaire (FFQ). A modified Persian version of the Rome III questionnaire was used for assessment of FD.

Results

The prevalence of FD among study participants was 14.5%. After adjustment for confounders, the highest energy‐adjusted tertile of fruit consumption was related to 32% lower risk of FD, compared to the lowest intake (OR = 0.68, 95% CI:0.51–0.90). Fruit consumption was also significantly related to lower risk of early satiation (OR = 0.67, 95% CI:0.54–0.85) and post‐prandial fullness (OR = 0.75, 95% CI:0.61–0.92). Vegetable consumption was not related to the risk of FD in all models. Men who were in the third tertile of fruit and the third tertile vegetable consumption had lower risk of FD compared to the first tertile; but, in women, just fruit consumption was related to the reduced risk of FD, after adjustment for all confounders.

Conclusion

We found an inverse association between fruit intake and dyspepsia symptoms. In addition, high consumption of fruit was related to lower odds of early satiation and post‐prandial fullness. Higher intake of vegetables was associated with lower risk of FD, only in men.
Altered interaction between enteric glial cells and mast cells in the colon of women with irritable bowel syndrome
Authors: Meira de‐Faria Felipe , Casado‐Bedmar Maite , Mårten Lindqvist Carl , Jones Michael P. , Walter Susanna A. , Keita Åsa V.
Published: April 2021

Background

Enteric glial cells (EGC) and mast cells (MC) are intimately associated with gastrointestinal physiological functions. We aimed to investigate EGC‐MC interaction in irritable bowel syndrome (IBS), a gut‐brain disorder linked to increased intestinal permeability, and MC.

Methods

Parallel approaches were used to quantify EGC markers in colonic biopsies from healthy controls (HC) and patients with IBS. Data were correlated with MC, vasoactive intestinal polypeptide (VIP) and VIP receptors (VPAC1/VPAC2) expressions, and bacterial translocation through biopsies mounted in Ussing chambers. In addition, we investigated the effects of EGC mediators on colonic permeability and the pharmacological‐induced responses of EGC and MC cell lines.

Key Results

Immunofluorescence of IBS colonic mucosa, as well as Western blotting and ELISA of IBS biopsy lysates, revealed increased glial fibrillary intermediate filament (GFAP) expression, indicating EGC activation. Mucosal GFAP correlated with increased MC and VPAC1+MC numbers and decreased VIP+MC, which seemed to control bacterial translocation in HC. In the contrary, EGC activation in IBS correlated with less MC and VPAC1+ MC numbers, and more VIP+ MC. In vitro, MC and EGC cell lines showed intracellular calcium responses to each other's mediators. Furthermore, EGC mediators prevented VIP‐induced MC degranulation, while MC mediators induced a reactive EGC phenotype. In Ussing chambers, EGC mediators decreased paracellular passage through healthy colonic biopsies.

Conclusions & Inferences

Findings suggest the involvement of EGC and MC in the control of barrier function in the human colon and indicate a potential EGC‐MC interaction that seems altered in IBS, with detrimental consequences to colonic permeability. Altogether, results suggest that imbalanced EGC‐MC communication contributes to the pathophysiology of IBS.
Determining patient treatment preferences for management of acute pain episodes in irritable bowel syndrome
Authors: Almario Christopher V. , Eberlein Samuel , Khalil Carine , Spiegel Brennan M. R.
Published: April 2021

Background

Many patients with irritable bowel syndrome (IBS) experience acute and unexpected pain episodes over and above chronic background symptoms, and there are emerging medications designed to treat such pain. We aimed to use conjoint analysis—a technique that elucidates how people make complex decisions—to examine patient preferences for emerging medicines for breakthrough IBS pain.

Methods

We conducted a cross‐sectional conjoint analysis survey among patients with Rome IV IBS and recurrent episodes of acute pain to assess the relative importance of medication attributes in their decision‐making. We also assessed what respondents would require of subcutaneous (SQ) therapies to consider their use.

Key Results

Among 629 patients with Rome IV IBS, 606 (96.3%) reported ≥1 acute pain episodes in the past month. For the 461 participants with multiple attacks who completed the conjoint analysis, they prioritized medication efficacy (importance score 34.9%), avoidance of nausea (24.3%), and avoidance of constipation (12.2%) as most important in their decision‐making. These were followed by route of administration (10.3%), avoidance of headache (9.3%), and avoidance of drowsiness (8.9%). Moreover, 431 (93.5%) participants would consider SQ therapies for their acute pain; they had varying expectations on the minimum pain decrease and onset and duration of pain relief needed for considering their use.

Conclusions and Inferences

The vast majority of patients with IBS experience breakthrough pain, and when selecting among therapies, they prioritize efficacy and most are willing to use a rapid‐acting SQ treatment. These results support development of novel, effective medications—oral or SQ—for management of acute pain attacks.
Non‐uniform gastric wall kinematics revealed by 4D Cine magnetic resonance imaging in humans
Authors: Sclocco Roberta , Nguyen Christopher , Staley Rowan , Fisher Harrison , Mendez April , Velez Christopher , Kettner Norman W. , Kuo Braden , Napadow Vitaly
Published: April 2021

Background

Assessment of gastric function in humans has relied on modalities with varying degrees of invasiveness, which are usually limited to the evaluation of single aspects of gastric function, thus requiring patients to undergo a number of often invasive tests for a full clinical understanding. Therefore, the development of a non‐invasive tool able to concurrently assess multiple aspects of gastric function is highly desirable for both research and clinical assessments of gastrointestinal (GI) function. Recently, technological advances in magnetic resonance imaging (MRI) have provided new tools for dynamic (or “cine”) body imaging. Such approaches can be extended to GI applications.

Methods

In the present work, we propose a non‐invasive assessment of gastric function using a four‐dimensional (4D, volumetric cine imaging), free‐breathing MRI sequence with gadolinium‐free contrast enhancement achieved through a food‐based meal. In healthy subjects, we successfully estimated multiple parameters describing gastric emptying, motility, and peristalsis propagation patterns.

Key Results

Our data demonstrated non‐uniform kinematics of the gastric wall during peristaltic contraction, highlighting the importance of using volumetric data to derive motility measures.

Conclusions & Inferences

MRI has the potential of becoming an important clinical and gastric physiology research tool, providing objective parameters for the evaluation of impaired gastric function.
Hard times for high expectations from hydraulics: predicting drought‐induced forest mortality at landscape scales remains a challenge
Authors: Rowland Lucy , Martínez‐Vilalta Jordi , Mencuccini Maurizio
Published: April 2021

This article is a Commentary on Venturas et al., 230: 1896–1910.
Longitudinal monitoring of asthma in the clinic using respiratory oscillometry
Authors: Cottee Alice M. , Seccombe Leigh M. , Thamrin Cindy , Badal Tanya , King Gregory G. , Peters Matthew J. , Farah Claude S.
Published: April 2021

Background and objective

Asthma guidelines emphasize the importance of assessing lung function and symptoms. The forced oscillation technique (FOT) and its longitudinal relationship with spirometry and symptoms are unresolved. We examined concordance between longitudinal spirometry, FOT and symptom control, and determined FOT limits of agreement in stable asthma.

Methods

Over a 3‐year period, adults with asthma attending a tertiary clinic completed the asthma control test (ACT), fraction of exhaled nitric oxide (FeNO), FOT and spirometry. Analysis included between‐visit concordance for significant change using Cohen's kappa (κ) and stable asthma FOT limits of agreement.

Results

Data (n = 186) from 855 visits (mean ± SD 4.6 ± 3.0 visits), 114 ± 95 days apart, were analysed. Between‐visit concordance was moderate between reactance at 5 Hz (X5) and forced expiratory volume in 1 s (FEV1) (κ = 0.34, p = 0.001), and weak between ACT and FEV1 (κ = 0.18, p = 0.001). Change in FeNO did not correlate with lung function or ACT (κ < 0.05, p > 0.1). Stable asthma between visits (n = 75; 132 visits) had reduced lung function variability, but comparable concordance to the entire cohort. Limits of agreement for FEV1 (0.42 L), resistance at 5 Hz (2.06 cm H2O s L−1) and X5 (2.75 cm H2O s L−1) in stable asthma were at least twofold greater than published values in health.

Conclusion

In adults with asthma, there is moderate concordance between longitudinal change in FOT and spirometry. Both tests relate poorly to changes in asthma control, highlighting the need for multi‐modal assessment in asthma rather than symptoms alone. The derivation of longitudinal FOT limits of agreement will assist in its clinical interpretation.
Spatial variation in the sedimentary architecture of a dryland fluvial system
Authors: Priddy Charlotte L. , Clarke Stuart M.
Published: April 2021

Ancient dryland terminal fluvial systems are often recognized within the rock record for having a progressive downstream decrease in the size and amalgamation of channel elements and systematic downstream increase in sheet and overbank elements, alongside the downstream decrease in grain size that is displayed by most fluvial systems. The spatial distribution and downstream trends displayed by the fluvial sediments of the Lower Jurassic Kayenta Formation of south‐western USA, have been examined quantitatively. The results indicate many trends that are similar to those of a dryland terminal fluvial system, including; a lack of confinement of the fluvial system, a downstream decrease in channel and sheet element amalgamation and width‐to‐thickness ratios, a downstream decrease in grain size, albeit very small, and an increase in the percentage of overbank elements downstream. However, the study highlights several downstream relationships that are atypical. While some of these relationships may be the result of external factors inherent in this study, others, including the thicknesses of channel‐fill and sheet elements that display no significant relationships to distance downstream, and channel‐fill elements that display no significant variation in average grain size with distance downstream, may be a consequence of fluvial interaction with a competing and coeval aeolian system. This work demonstrates the inherent complexity in arid dryland fluvial systems and the downstream architectural and compositional relationships that they depict. Consequently, models for fluvial style may provide only a first‐order approximation for downstream trends in dryland systems, because the controlling factors upon these systems are inherently difficult to unravel, and the sedimentary detail is strongly dependent upon external setting and internal complexity. Consequently, a generalized model may not always be applicable to these systems.
Maternal asthma during pregnancy and risks of allergy and asthma in progeny: a systematic review protocol
Authors: Roff Andrea J. , Morrison Janna L. , Tai Andrew , Clifton Vicki L. , Gatford Kathryn L.
Published: April 2021

Objective:

The primary objective of this systematic review is to synthesize the best available evidence on the relationship between in utero exposure to maternal asthma and postnatal allergy. Secondary objectives are to investigate the impact of asthma loss of control, asthma exacerbation, and asthma severity during pregnancy on risks of allergy and asthma in progeny.

Introduction:

Maternal asthma is a well-known risk factor for childhood asthma, with recent evidence suggesting that children of asthmatic mothers are also at increased risk of allergic diseases. Importantly, these do not appear to be purely genetic associations, since maternal asthma is more strongly associated with childhood asthma than paternal asthma. In addition, experimentally induced allergic asthma during pregnancy increases allergic responses to sensitization in mice. The strength of the relationships between exposure to maternal asthma or severity of maternal asthma, and progeny asthma and allergy are unknown.

Inclusion criteria:

This review will include primary studies that report incidence of physician-diagnosed asthma or allergic disease in human progeny who were exposed in utero to maternal asthma, in comparison to progeny not exposed to maternal asthma.

Methods:

Initial search terms include (pregnan∗ OR gestat∗) AND asthma∗ AND allerg∗. We will search the following electronic databases for published and unpublished evidence: PubMed, Embase, MEDLINE (Ovid), Web of Science, Cochrane Library, CINAHL, Scopus, Informit Health, MedNar, ProQuest, and Trove. There will be no restrictions on publication date. Only studies available as a full-text English publication will be considered for inclusion.

Systematic review registration number:

PROSPERO CRD42020201538
Use of Cuckoo Search Algorithm for Performance Evaluation of Split Elliptic Shaped Fins for Enhanced Rate of Heat Transfer
Authors: Ranjan Alok , Das Ranjan , Pal Sagnik , Majumder Arindam , Deb Madhujit
Published: April 2021

Proper dissipation of thermal energy has always been a need for desirable efficiency of a system. Extended surface aids in releasing the heat to the immediate surrounding by inducing an extra area. This particular work assesses thermal and fluid flow behavior of extended surfaces with circular and elliptic shaped cross section. Extended surfaces of unvaried cross section are mounted over a square plate arrayed in a staggered manner. With the aid of different thermofluidic parameters, the elliptic shaped pin fin is established to provide a higher thermal performance enhancement of nearly 15% over cylindrical pin fin at inlet flow velocity of 2.35 m/s. Further, for elevating the interaction between the surface of the fin and the fluid, elliptic fins are reoriented to form a split. In contrast to cylindrical shaped fin, modification using split shows better result with the highest heat transfer increment of nearly 25%. Further, in order to maximize Nusselt number (Nu), a single objective cuckoo search optimization analysis is done by adopting the response surface method. After analyzing the optimization, it is found that the maximum value of Nu is obtained at dimensionless transverse offset (TO*) = 0.125 and dimensionless longitudinal offset (LO*) = 0, which has been further validated with the numerical result within 0.97% accuracy. Further, for the cylindrical fin, the present simulations agree with the available empirical correlation within 6.22% accuracy.
Influence of Coflow on Buoyant Plume Puffing
Authors: Bharadwaj Kuchimanchi K. , Das Debopam
Published: April 2021

This study investigates the influence of an annular coflowing air stream on the puffing behavior of a buoyant plume by employing the BiGlobal Linear Stability Analysis. An increase in the coflow is found to mitigate the puffing intensity and eventually stabilize the plumes. From the stability analysis, the critical coflow ratios, which represent the amount of coflow required to completely suppress the puffing, have been estimated for plumes spanning a wide range of nondimensional parameters. The analysis shows that the critical coflow ratio largely depends on the two buoyancy parameters, the Froude number, and the density ratio whereas it remains marginally affected by the plume Reynolds number. Plumes with higher buoyancy require larger coflow for suppressing puffing. From the instability analysis, we have obtained a correlation law for critical coflow ratios in buoyant plumes. Also, it is found that the plume puffing frequency increases with an increase in the coflow. We attempt to ascertain the reasons for instability mitigation and frequency increase in the puffing plumes because of coflow.
Tip Leakage Behavior and Large Coherent Perturbation Analysis of an Axial–Radial Combined Compressor With Outlet Distortion
Authors: Fu Li , Yang Ce , Hu Chenxing , Shi Xin
Published: April 2021

Increasing performance requirements and compact structure design promote the generation of axial–radial combined compressors. However, its complex structure and asymmetrical outlet boundary cause difficulty to get an in-depth comprehension of the flow unsteadiness associated with spike-stall. In this work, unsteady full-annular simulations of an axial–radial combined compressor coupled with performance experiment validations were carried out. Based on the overall understanding of outlet distortion on each component, the general feature of tip leakage flow with asymmetrical outlet boundary was extracted. The temporal and spatial development of large coherent perturbations was revealed by the decomposition and reconstruction of the transient flow data with the dynamic mode decomposition approach. The results demonstrate that the outlet distortion can propagate reversely to the compressor inlet and the degree of distortion decreases gradually, which leads to the highest possibility for radial rotor to suffer from flow unsteadiness. In the circumferential location with distortion affected, the leakage momentum of the adjacent blade leading edge is enhanced by the secondary leakage, inducing the expansion of tip leakage vortex and causing flow instability. Besides organized perturbation structures related to mean flow and blade passing frequency, two large low-frequency stall perturbations approximately one-third and three-fourth rotor frequency was captured by the dynamic mode decomposition method, which is caused by volute potential effect and stator/rotor interference, respectively. The former occurs in the radial rotor and decays during its propagation, while the latter always exists owing to the multiple rotor/stator or stator/rotor interference in the axial–radial combined compressor.
Close Supercritical Versus Inverse Brayton Cycles for Power Supply, Using Waste of a Biogas-Driven Open Brayton Cycle
Authors: Ebadollahi Mohammad , Rostamzadeh Hadi , Pourali Omid , Ghaebi Hadi , Amidpour Majid
Published: April 2021

Power generation via a biogas-driven Brayton cycle (BC) can be regarded as the best scenario for electricity supply of decentralized complexes or small communities. However, the central problem associated with such technology is the high temperature of its exhaust gases, which can be recovered via appropriate waste heat elimination schemes. Although various studies have previously discussed optimal operating conditions of the enhanced biogas-driven BC in terms of thermodynamics and economic, no comprehensive investigation in terms of selecting the best bottoming cycle for the biogas-driven BC has been carried out up to yet. This spurs the current investigation to recommend the it best bottoming cycle between a close supercritical BC (CSBC) and an inverse BC (IBC) for waste heat recovering of a biogas-driven BC around the optimum point. Another novelty of the present study is the inclusion of the environment index (EI) along with energy, exergy, and economic metrics in the performed multi-objective optimization scheme, resulting in the design of a highly sustainable energy system. The results indicated that no single optimal solution exists in selecting the best bottoming cycle by accounting energy, exergy, exergoeconomic, and exergoenvironmental metrics, simultaneously. Hence, a trade-off should be deliberated in selecting the best case in the design process. Accordingly, the integrated BC/CSBC system is superior to the BC/IBC system in terms of thermodynamics (i.e., both energy and exergy metrics) around both base and optimal design points; however, it is not commendable in terms of economic and exergoenvironmental viewpoints. Quantitatively speaking, selecting the BC/CSBC system can lead to thermal and exergetic performance enhancement of around 3.3%, while degrading economic and exergoenvironmental metrics around 7.2% and 8.3%, respectively.
A Novel Wave Propagation Method for Measuring Viscoelastic Properties of Prestrained Materials
Authors: Lemerle Pierre
Published: April 2021

Viscoelastic materials are widely used for vibroacoustic solutions due to their ability to dissipate energy and thus mitigate vibrations and structure-borne sound. Wave propagation methods belong to a growing family of material characterization techniques based on the analysis of waveform patterns in one-dimensional structures. The time evolution of patterns results from material elasticity and damping. Conversely, it is possible to identify these properties once the pattern's time evolution is known. The most frequently used propagation methods, namely, Hopkinson bar methods, assume no dispersion, i.e., the complex elasticity modulus is not frequency dependent. However, this is not relevant for resilient materials such as elastomers. More recent approaches have been developed to measure frequency-dependent properties from a pulse propagating in a slender bar. In the previous works, we showed how to adapt these methods for shorter samples of materials. This represented a real advance, as extrusion is a cumbersome process for many materials. The main concept was to reconstruct the time history of the wave propagating in a composite structure composed of a long incident bar made of a known material and extended by a shorter sample bar. The sample material's viscoelastic properties were then determined in the frequency domain by optimization and wave fitting in the time domain. In industry, most insulation solutions that rely on mounts and bushings have to support structural weights. Consequently, it is particularly useful to measure the tangent viscoelastic properties of the material around the static stressed state and not only in stress-free conditions. Measuring strained materials not only requires modifying the experimental apparatus but also extending the scope of the underlying theory as the waves propagate differently in composite structures made of strained media. Here, we show how to overcome this challenging issue. The theoretical framework and its numerical implementation are described, and the method was validated experimentally by characterizing an elastomer sample under prestrained conditions.
High responsivity solar-blind metal-semiconductor-metal photodetector based on α-Ga2O3
Authors: Bae Jinho , Jeon Dae-Woo , Park Ji-Hyeon , Kim Jihyun
Published: April 2021

α-Ga2O3, with an ultra-high energy bandgap of 5.1 eV, is an attractive material for applications in solar-blind photodetectors and high-power electronics. We fabricated an α-Ga2O3 metal-semiconductor-metal (MSM) interdigitated solar-blind photodetector, where an epitaxial α-Ga2O3 thin film was grown on a sapphire substrate using a hydride vapor-phase epitaxy technique. Excellent optoelectronic device properties including high responsivity (4.24 × 104 A/W), detectivity (1.77 × 1011 Jones), and external quantum efficiency (2.07 × 105) were demonstrated in response to ultraviolet (UV) C wavelength. Under sunlight, the α-Ga2O3 MSM photodetector exhibited stable solar-blind sensitivity to UVC wavelength without interference from the incoming solar spectrum. Our work proposes that α-Ga2O3 has great potential as a next-generation high-performance solar-blind photodetector.
The role of early and late reflections on perception of source orientation
Authors: Steffens Henning , van de Par Steven , Ewert Stephan D.
Published: April 2021

Sound radiation of most natural sources, like human speakers or musical instruments, typically exhibits a spatial directivity pattern. This directivity contributes to the perception of sound sources in rooms, affecting the spatial energy distribution of early reflections and late diffuse reverberation. Thus, for convincing sound field reproduction and acoustics simulation, source directivity has to be considered. Whereas perceptual effects of directivity, such as source-orientation-dependent coloration, appear relevant for the direct sound and individual early reflections, it is unclear how spectral and spatial cues interact for later reflections. Better knowledge of the perceptual relevance of source orientation cues might help to simplify the acoustics simulation. Here, it is assessed as to what extent directivity of a human speaker should be simulated for early reflections and diffuse reverberation. The computationally efficient hybrid approach to simulate and auralize binaural room impulse responses [Wendt et al., J. Audio Eng. Soc. 62, 11 (2014)] was extended to simulate source directivity. Two psychoacoustic experiments assessed the listeners' ability to distinguish between different virtual source orientations when the frequency-dependent spatial directivity pattern of the source was approximated by a direction-independent average filter for different higher reflection orders. The results indicate that it is sufficient to simulate effects of source directivity in the first-order reflections.
Mind–Body Interventions for an Occupational Athlete Following Total Knee Arthroplasty: A Clinical CASE Report
Authors: Bianco Lucas C.
Published: April 2021

A 58-year-old female had a total knee arthroplasty due to arthritic changes in her right knee, along with pain and loss of function. Mind and body intervention techniques were utilized to improve patient-centered outcomes. Protocols are in place for the rehabilitation of patients following a total knee arthroplasty. However, sometimes the mind–body connection can be disrupted, and plateaus in the rehabilitative process may benefit from innovative techniques. As patient-centered care, biopsychosocial models, and collaborative practice continue to push the athletic training profession, these types of cases that provide holistic approaches to expand health care will lead to future research.
Brain tumor T cells inhibited by their natural KLR(B1) instinct
Authors: Oxendine Seneca , O’Connor Kevin C.
Published: April 2021

Charting the gene-expression landscape of glioma-infiltrating T cells demonstrates that these T cells can express NK cell receptors, which inhibit the killing of glioma cells.
Trends of Antimicrobial Resistance and Combination Susceptibility Testing of Multidrug-Resistant Pseudomonas aeruginosa Isolates from Cystic Fibrosis Patients: a 10-Year Update
Authors: Okoliegbe Ijeoma N. , Hijazi Karolin , Cooper Kim , Ironside Corinne , Gould Ian M.
Published: April 2021

Antimicrobial combination therapy is a time/resource-intensive procedure commonly employed in the treatment of cystic fibrosis (CF) pulmonary exacerbations caused by
Pseudomonas aeruginosa
. Ten years ago, the most promising antimicrobial combinations were proposed, but there has since been the introduction of new β-lactam plus β-lactamase inhibitor antimicrobial combinations.
Skeletal sarcoidosis; an uncommon mimic of metastatic disease
Authors: Sarvesvaran Matthew , Chandramohan Muthusamy
Published: April 2021

A 66-year-old man with pulmonary sarcoidosis was referred to the urology team for assessment of troublesome lower urinary tract symptoms. An elevated blood serum prostate-specific antigen raised concern for prostate cancer. An MRI of the prostate demonstrated a potentially aggressive prostate lesion, along with low T1 signal skeletal lesions, suggestive of metastatic disease. Subsequent bone scan and MRI whole spine demonstrated further skeletal lesions. In cases of known prostate cancer, sometimes a presumptive diagnosis of skeletal metastases is made without histological diagnosis from the skeletal lesions. However, there were certain factors in this case whereby skeletal biopsy was deemed prudent prior to further therapy. Factors included atypical MRI signal characteristics for metastatic disease, absence of a positive tissue diagnosis from the prostate and the clinical background of sarcoidosis. The biopsy confirmed skeletal sarcoid rather than metastatic disease, thereby avoiding inappropriate and potentially toxic treatment for the patient.
Severe deep neck space infection caused byEggerthia catenaformis
Authors: Krarup Jens Fabricius , Nielsen Hans Linde , Danstrup Christian Sander
Published: April 2021

A 64-year-old woman was acutely referred to the Department of Otorhinolaryngology, Head and Neck Surgery, Aalborg University Hospital due to rapidly progressing neck swelling, fever and dysphagia. Clinical examination revealed submental swelling, trismus and laryngeal inflammation. A contrast-enhanced CT scan showed infection in the deep neck spaces with multiple abscesses. The patient underwent acute surgery and antimicrobial therapy was initiated and she was transferred to an intensive care unit. Three additional surgical procedures were needed before sufficient drainage was achieved. There was growth of different oral commensals from four separate pus aspirates, whileEggerthia catenaformiswas cultured in all samples. Due to the extent of the infection, the patient stayed in the intensive care unit for 16 days, but recovered completely due to adequate surgery and antimicrobial therapy for 4 weeks. Here we present the third reported case of a severe deep neck space infection with multiple abscesses due toE. catenaformis.
Ubr5 Inhibits the Radiosensitivity of Non-Small Cell Lung Cancer Cells via the Activation of the Pi3K/Akt Pathway
Authors: Gu Yong-Fei , Ge Xing-Ping
Published: April 2021

Ubiquitin protein ligase E3 component n-recognin 5 (UBR5) has been identified as an oncogene in diverse cancers; however, whether its expression was associated with radiosensitivities of non-small cell lung cancer (NSCLC) cells remains unclear. Expression levels of UBR5 in NSCLC tissues and cell lines were examined by immunohistochemical staining and western blotting. Colony formation assay, CCK-8 cell viability assay, flow cytometry, and caspase-3 activity assay were performed to evaluate the radiosensitization of UBR5 knockdown in NSCLC cells, and the underlying mechanism in vitro was also investigated. UBR5 was highly expressed in NSCLC tissues, and its high expression was associated with the poor prognosis in 50 patients with NSCLC. After X-ray irradiation, the protein expression levels of UBR5 were also increased in NSCLC cells. UBR5 inhibition enhanced the radiosensitivity of NSCLC cells by inhibiting the cell viability and inducing apoptosis. Further investigation indicated that UBR5 knockdown-mediated radiosensitization involved the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway. Knockdown of UBR5 radiosensitizes NSCLC cells via the inactivation of the PI3K/AKT signal, which provided a novel therapeutic target for NSCLC radiosensitization.
Patients with KCNH1-related intellectual disability without distinctive features of Zimmermann-Laband/Temple-Baraitser syndrome
Authors: Aubert Mucca Marion , Patat Olivier , Whalen Sandra , Arnaud Lionel , Barcia Giulia , Buratti Julien , Cogné Benjamin , Doummar Diane , Karsenty Caroline , Kenis Sandra , Leguern Eric , Lesca Gaetan , Nava Caroline , Nizon Mathilde , Piton Amelie , Valence Stéphanie , Villard Laurent , Weckhuysen Sarah , Keren Boris , Mignot Cyril
Published: April 2021

De novo missense variants in KCNH1 encoding Kv10.1 are responsible for two clinically recognisable phenotypes: Temple-Baraitser syndrome (TBS) and Zimmermann-Laband syndrome (ZLS). The clinical overlap between these two syndromes suggests that they belong to a spectrum of KCNH1-related encephalopathies. Affected patients have severe intellectual disability (ID) with or without epilepsy, hypertrichosis and distinctive features such as gingival hyperplasia and nail hypoplasia/aplasia (present in 20/23 reported cases).

We report a series of seven patients with ID and de novo pathogenic KCNH1 variants identified by whole-exome sequencing or an epilepsy gene panel in whom the diagnosis of TBS/ZLS had not been first considered. Four of these variants, p.(Thr294Met), p.(Ala492Asp), p.(Thr493Asn) and p.(Gly496Arg), were located in the transmembrane domains S3 and S6 of Kv10.1 and one, p.(Arg693Gln), in its C-terminal cyclic nucleotide-binding homology domain (CNBHD). Clinical reappraisal by the referring clinical geneticists confirmed the absence of the distinctive gingival and nail features of TBS/ZLS.

Our study expands the phenotypical spectrum of KCNH1-related encephalopathies to individuals with an attenuated extraneurological phenotype preventing a clinical diagnosis of TBS or ZLS. This subtype may be related to recurrent substitutions of the Gly496, suggesting a genotype–phenotype correlation and, possibly, to variants in the CNBHD domain.
Taking the burden off: a study of the quality of ethics consultation in the time of COVID-19
Authors: Kana Lulia , Shuman Andrew , De Vries Raymond , Firn Janice
Published: April 2021

Background

The quality of ethics consults is notoriously difficult to measure. Survey-based assessments cannot capture nuances of consultations. To address this gap, we conducted interviews with health professionals who requested ethics consults during the initial phase of the COVID-19 pandemic.

Method

Healthcare professionals requesting ethics consultation between March 2020 and May 2020 at a tertiary academic medical centre were eligible to participate. We asked participants to comment on the consults they called and thematically analysed responses to identify features associated with optimal quality consultations.

Results

Of 14 healthcare providers, 8 (57%) were women and professions were as follows: 11 (79%) medical doctors, 1 (7%) social worker, 1 (7%) physician assistant and 1 (7%) nurse practitioner. Two aspects of quality emerged: satisfaction and value. Themes within the domain of satisfaction included: responsiveness of the ethics consultant, willingness to consult, institutional role of the ethics service and identifying areas for improvement. When describing value, respondents spoke of the intrapersonal and interpersonal worth of consultation.

Conclusion

Participants were generally satisfied with ethics consultation services, similar to opinions of those found in pre-COVID-19 survey studies. Our qualitative approach allowed for a richer exploration of the value of ethics consultation during the pandemic and has implications for ethics consultation services more broadly. Ethics consultation—emphasising both the process and outcome—created valuable moral spaces, promoting thoughtful and ethical responses to dilemmas in patient care. Future assessments should incorporate patient and family/surrogate perspectives and explore the domain of education as an additional quality measure.
High-definition ultrasound imaging defines the paraneural sheath and fascial compartments surrounding the cords of the brachial plexus at the costoclavicular space and lateral infraclavicular fossa
Authors: Areeruk Pornpatra , Karmakar Manoj Kumar , Reina Miguel A , Mok Louis Y H , Sivakumar Ranjith Kumar , Sala-Blanch Xavier
Published: April 2021

Background and objectives

The paraneural sheath is a multilayered network of collagen fibers that surround the brachial plexus. Currently, there are no sonographic data on the paraneural sheath of the brachial plexus, which this study aimed to evaluate.

Methods

Ultrasound imaging datasets of 100 patients who received a costoclavicular brachial plexus block, using high-definition ultrasound imaging, were retrospectively reviewed. Video files, representing sonograms before and after the local anesthetic injection, from the costoclavicular space and lateral infraclavicular fossa were collated and reviewed by three experienced anesthesiologists. Frequency (yes/no) of ultrasound visualization of the paraneural sheath, septum, and the anterior and posterior compartments was assessed. Representative sonograms from the costoclavicular space and lateral infraclavicular fossa were visually correlated with archived cadaver microanatomic sections from the same location.

Results

Datasets of the 98 patients who achieved surgical anesthesia were evaluated. The paraneural sheath, septum, and the anterior and posterior compartments were visualized in 17.3%, 7.1%, 5.1% and 5.1%, respectively, at the costoclavicular space before the brachial plexus block; this contrasts (p<0.001) with their visibility post-block (94.9%, 75.5%, 75.5% and 75.5%, respectively). At the lateral infraclavicular fossa, the corresponding visibility of these structures post-block were 67.7%, 81.5%, 81.5% and 81.5%, respectively. Ultrasound images of the paraneural sheath and septum correlated well with that in the cadaver microanatomic sections.

Conclusion

We have demonstrated the paraneural sheath and fascial compartments surrounding the cords of the brachial plexus at the costoclavicular space and lateral infraclavicular fossa using high-definition ultrasound imaging.

Trial registration number

ClinicalTrials.gov Registry (NCT04370184), (https://www.clinicaltrials.gov/).
FDA’s reduced exposure marketing order for IQOS: why it is not a reliable global model
Authors: Lempert Lauren Kass , Bialous Stella , Glantz Stanton
Published: April 2021

The US Food and Drug Administration (FDA) issued orders in July 2020 authorising Philip Morris Products S.A. to market its heated tobacco product (HTP) IQOS inside the USA with claims that it reduces exposure to some dangerous substances. FDA’s ‘reduced-exposure’ orders explicitly prohibit the marketing of IQOS with claims that IQOS will reduce harm or the risk of tobacco-related diseases. Under US law, FDA’s IQOS orders are problematic because FDA disregarded valid scientific evidence that IQOS increases exposure to other dangerous toxins and that Philip Morris Products S.A. failed to demonstrate that consumers understand the difference between reduced-exposure and reduced-harm claims. Unfortunately, both ‘reduced-exposure’ and ‘reduced-harm’ are classified as ‘modified risk tobacco products’ under US law. Exploiting this confusion, Philip Morris International used the FDA decision as the basis for marketing and public relations campaigns outside the USA to press governments to reverse policies that ban or regulate the sales and marketing of HTPs, including IQOS. Parties to the WHO Framework Convention on Tobacco Control should reject tobacco companies’ unsubstantiated explicit or implied claims of reduced harm associated with HTPs and resist Philip Morris International’s and other companies’ calls to relax HTP regulations based on the FDA’s actions. Instead, parties should adopt policies aligned with the Framework Convention on Tobacco Control when dealing with HTPs and other novel tobacco products.
Effect of the COVID-19 pandemic on health insurance coverage among trauma patients: a study of six level I trauma centers
Authors: Sercy Erica , Duane Therese M , Lieser Mark , Madayag Robert M , Berg Gina , Banton Kaysie L , Hamilton David , Bar-Or David
Published: April 2021

Background

Increased unemployment during the COVID-19 pandemic has likely led to widespread loss of employer-provided health insurance. This study examined trends in health insurance coverage among trauma patients during the COVID-19 pandemic, including differences in demographics and clinical characteristics by insurance type.

Methods

This was a retrospective study on adult patients admitted to six level 1 trauma centers between January 1, 2018 and June 30, 2020. The primary exposure was hospital admission date: January 1, 2018 to December 31, 2018 (Period 1), January 1, 2019 to March 15, 2020 (Period 2), and March 16, 2020 to June 30, 2020 (Period 3). Covariates included demographic and clinical variables. χ² tests examined whether the rates of patients covered by each insurance type differed between the pandemic and earlier periods. Mann-Whiney U and χ² tests investigated whether patient demographics or clinical characteristics differed within each insurance type across the study periods.

Results

A total of 31 225 trauma patients admitted between January 1, 2018 and June 30, 2019 were included. Forty-one per cent (n=12 651) were admitted in Period 1, 49% (n=15 258) were from Period 2, and 11% (n=3288) were from Period 3. Percentages of uninsured patients increased significantly across the three periods (Periods 1 to 3: 15%, 16%, 21%) (ptrend=0.02); however, there was no accompanying decrease in the percentages of commercial/privately insured patients (Periods 1 to 3: 40%, 39%, 39%) (ptrend=0.27). There was a significant decrease in the percentage of patients on Medicare during the pandemic period (Periods 1 to 3: 39%, 39%, 34%) (p<0.01).

Discussion

This study found that job loss during the COVID-19 pandemic resulted in increases of uninsured trauma patients. However, there was not a corresponding decrease in commercial/privately insured patients, as may have been expected; rather, a decrease in Medicare patients was observed. These findings may be attributable to a growing workforce during the study period, in combination with a younger overall patient population during the pandemic.

Level of evidence

Retrospective, level III study.
Group hunting in harbour porpoises (Phocoena phocoena)
Authors: Torres Ortiz Sara , Stedt Johanna , Midtiby Henrik Skov , Egemose Henrik Dyrberg , Wahlberg Magnus
Published: April 2021

Cooperative hunting involves individual predators relating in time and space to each other’s actions to more efficiently track down and catch prey. The evolution of advanced cognitive abilities and sociality in animals are strongly associated with cooperative hunting abilities as has been shown in lions, chimpanzees, and dolphins. Much less is known about cooperative hunting in seemingly unsocial animals, such as the harbour porpoise (Phocoena phocoena (Linnaeus, 1758)). Using drones, we were able to record 159 hunting sequences of porpoises, out of which 95 sequences involved more than one porpoise. To better understand if the harbour porpoises were individually attracted by the fish school or formed an organized hunting strategy, the behaviour of each individual porpoise in relation to the targeted fish school was analysed. The results indicate role specialization, which is considered the most sophisticated form of collaborative hunting and only rarely seen in animals. Our study challenges previous knowledge about harbour porpoises and opens up for the possibility of other seemingly non-social species employing sophisticated collaborative hunting methods.
A New True Random Number Generator Based on Differential Variable Ring Oscillator Robust Against PVT Variation
Authors: Salighehdar Niloofar Khayyat , Mousazadeh Morteza , Khoei Abdolah
Published: April 2021

In this paper, a new true random number generator (TRNG) based on a new variable differential ring oscillator has been presented. In this structure, the ring oscillator’s jitter is considered a random phenomenon. The jitter of the proposed ring oscillator is driven by thermal noise and flicker noise so that the generated jitter is random. In this paper, a new variable differential ring oscillator has been designed. The stage of this ring oscillator is changed randomly in order to create random jitter. A new differential delay cell has been proposed to boost the speed of TRNG and random jitter. The proposed random number generator (RNG) is robust against temperature variations of [Formula: see text]40–120[Formula: see text] and voltage variations from 0.8 to 1.8[Formula: see text]V. The proposed system’s bitrate is 50[Formula: see text]MB/s and its efficiency is 30.03[Formula: see text]Mb/mJ. This process has been implemented in the 0.18[Formula: see text]um CMOS process. Simulation results have been presented in Hspice software and cadence. The output bit images have been displayed by Matlab software.