bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural and hemodynamic properties of murine pulmonary arterial networks under hypoxia-induced pulmonary hypertension
Authors: Chambers Megan J , Colebank Mitchel J , Qureshi M Umar , Clipp Rachel , Olufsen Mette S
Published: July 2020

Detection and monitoring of patients with pulmonary hypertension, defined as a mean blood pressure in the main pulmonary artery above 25 mmHg, requires a combination of imaging and hemodynamic measurements. This study demonstrates how to combine imaging data from microcomputed tomography images with hemodynamic pressure and flow waveforms from control and hypertensive mice. Specific attention is devoted to developing a tool that processes computed tomography images, generating subject-specific arterial networks in which one-dimensional fluid dynamics modeling is used to predict blood pressure and flow. Each arterial network is modeled as a directed graph representing vessels along the principal pathway to ensure perfusion of all lobes. The one-dimensional model couples these networks with structured tree boundary conditions representing the small arteries and arterioles. Fluid dynamics equations are solved in this network and compared to measurements of pressure in the main pulmonary artery. Analysis of microcomputed tomography images reveals that the branching ratio is the same in the control and hypertensive animals, but that the vessel length-to-radius ratio is significantly lower in the hypertensive animals. Fluid dynamics predictions show that in addition to changed network geometry, vessel stiffness is higher in the hypertensive animal models than in the control models.
The eating disorder recovery assemblage: Collectively generating possibilities for eating disorder recovery
Authors: LaMarre Andrea , Rice Carla
Published: July 2020

In this paper, we explore the affective-discursive-material aspects of the supportive eating disorder recovery assemblage. We approach recovery as an “assemblage” to facilitate an understanding of how human (people, systems of care, etc.) and nonhuman (affect, discourses, etc.) forces generate possibilities or impossibilities for recovery. Moving away from framings of recovery as an individual achievement, we consider the relationality and dynamism of eating disorder recovery in interviews with 20 people in recovery and 14 supporters of people in recovery. We draw from experiential accounts to theorize a supportive eating disorder recovery assemblage in relation to trust and love mobilized in interactions and relationships. This supportive eating disorder recovery assemblage can scaffold new understandings of recoveries as multiple and co-produced. Supportive eating disorder recovery assemblages generate improvisational spaces, albeit loosely contained and bounded, for different pathways to and manifestations of “recoveries”. This work builds on a body of feminist scholarship on eating disorders/disordered eating that takes up gendered relationships of power in treatment settings, extending toward and analysing material, affective, embodied, and potentially affirming dimensions of care and emotion in participants’ lives.
Telehealth mental health services during COVID-19: summary of evidence and clinical practice
Authors: Reay Rebecca E , Looi Jeffrey CL , Keightley Philip
Published: July 2020

Objective:

To provide a rapid clinical update on the evidence for telehealth in mental healthcare in the context of the COVID-19 pandemic public health measures.

Conclusions:

Telehealth has been rapidly implemented in metropolitan and rural settings and the existing evidence base demonstrates that it represents an effective mode of service delivery.
The impact of ‘cluster maintenance TMS’ on irritability occurring in major depressive disorder
Authors: Pridmore Saxby , Turnier-Shea Yvonne , Erger Sheila , May Tamara
Published: July 2020

Objective:

To determine the impact of clustered maintenance transcranial magnetic stimulation (TMS) on irritability occurring in treatment-resistant major depressive disorder (MDD).

Method:

A naturalistic study of 106 courses that includes pre- and posttreatment assessments of subjective and objective depression and a subjective measure of irritability developed for this study.

Results:

Forty-six participants (35 females), mean age 43.2 years (14.3), completed 106 courses. There was a significant reduction in irritability and depression scores ( p < .001). The change in irritability scores was significantly correlated with the change in depression scores, r = .40, p < .001.

Conclusion:

TMS has the capacity to reduce the irritability co-occurring with treatment-resistant MDD, known to be responsive to TMS. This increases the possibility of using TMS in the treatment of irritability co-occurring with other disorders or standing alone (should irritability be categorized as a stand-alone disorder).
Development of a two-dimensional piezoelectric traveling-wave generator
Authors: Lin Yu-Min , Hsu Yu-Hsiang , Su Wen-Chun , Kao Yuan-Ting , Lee Chih-Kung
Published: July 2020

In this article, we present a new method to control the direction of traveling waves in either an x-direction or y-direction on a two-dimensional square plate. The core structure was composed of a piezoelectric serial bimorph with four electrodes. Each electrode was spatially designed to activate one of the bending modes and which included the ability to reduce adjacent modes and minimize interference. Our new method differs from other reported methods in that the four electrodes were driven at designated resonant frequencies. In our wave generator, different driving amplitudes and phases were applied to induce the traveling waves to propagate in a specific direction. To design the directional movement and to better understand the pattern of induced traveling waves, an analytical solution was derived to assist in the design of the four driving electrodes. Using our newly developed analytical method, traveling waves can be controlled to travel in either the x-direction or y-direction using two different sets of electrodes, where each electrode can be driven at a specific but different bending mode. We found that both the voltage ratio and phase difference between the two driving electrodes are important factors for optimization.
Thermomechanical and electrical response of a superelastic NiTi shape memory alloy cable
Authors: Sherif Muhammad M , Ozbulut Osman E
Published: July 2020

Superelastic shape memory alloys are a unique class of smart materials that can recover up to 6% strains. Due to their appealing properties such as high energy dissipation and corrosion resistance, several researchers have assessed the use of such materials in numerous applications ranging from biomedical to civil engineering. This article investigates the thermomechanical and electrical response of a NiTi shape memory alloy cable with a complex configuration subjected to cyclic loading of various strain amplitudes ranging from 3% to 7%. The cable consists of several multi-layered strands with a cumulative outer diameter of 5.5 mm. The thermomechanical results indicate a good correlation of the change in cable temperature with the applied strains and maximum stresses. The temperature history can be used to map the degradation pattern of the shape memory alloy cable. In addition, due to the complex geometry of the cable, the global electrical resistance change does not predict the strain/stress state of the cable; however, it can be used to predict the onset of phase transformations.
Receptance-based frequency assignment for assembled structures
Authors: Zhang Shike , Ouyang Huajiang
Published: July 2020

For engineering structures, there is a strong need to assign natural frequencies to achieve desired dynamic performance. This study proposes a receptance-based frequency assignment method for assembled structures. Very often, the substructures involved are not allowed or are difficult to change. This method uses the links between the substructures as targets of structural modifications and determines the structural properties of the links that assign the desired frequencies cast as an optimisation problem. These links could be either simple discrete structural components such as masses and springs or complex continuous structures. Only a few receptances of the substructures are required in this method, which can be measured accurately and easily in practice. Two numerical examples are presented to show the validity of this method and its strength in dealing with complex assembled structures.
Commercial Saccharomyces cerevisiae as a starter culture in “Wanergao”: A traditional fermented food in China
Authors: Zeng Xuefeng , Wan Weiyang , He Laping , Deng Li , Fan Jin
Published: July 2020

To explore the effect of commercial Saccharomyces cerevisiae on the quality of traditional “Wanergao” for reasonable consuming guidance, the dominant microbes, physicochemical property, free amino acid content, texture, and sensory properties during fermentation of “Wanergao” were illustrated in this paper. Compared with the samples in the control group, “Wanergao” samples in the two groups that were subjected to S. cerevisiae inoculation had weaker acidity (the pH values dropped from 4.39 ± 0.08 to 4.36 ± 0.07 and 4.36 ± 0.07 within 2 h during fermentation), higher fermenting rate (volume increased from 100 ± 1.31 to 305 ± 4.61 and 316 ± 4.93 mL separately within 3 h), and the dominant lactic acid bacteria and yeast being leukonid and S. cerevisiae. More amylose, ethanol, and free amino acid were detected in “Wanergao” produced with S. cerevisiae inoculation compared with “Wanergao” produced by sourdough. The two kinds of “Wanergao” presented various hardness (2318 ± 112, 2279 ± 103), springiness (0.76 ± 0.03, 0.71 ± 0.03), chewiness (1.43 ± 0.05, 1.41 ± 0.06), and cohesiveness (0.68 ± 0.03, 0.62 ± 0.03) after fermentation. The result of sensory analysis revealed that “Wanergao” in the S. cerevisiae group had higher elasticity, aroma, and restoring force. The experiment demonstrated that “Wanergao” produced by using S. cerevisiae is a kind of fermented rice product with rich fragrance, high amount of nutrients, and strong elasticity.
Tree-based convolutional neural networks for object classification in segmented satellite images
Authors: Robinson Y Harold , Vimal S , Khari Manju , Hernández Fernando Carlos López , Crespo Rubén González
Published: July 2020

Satellite images have a very high resolution, which make their automatic processing computationally costly, and they suffer from artifacts making their processing difficult. This paper describes a method for the effective semantic segmentation of satellite images, and compares different object classifiers in terms of accuracy and execution time. In the paper, the image spectrum is used to reduce the computational cost during the segmentation and classification steps. Firstly, artifacts are corrected from the satellite images for facilitating the feature extraction process. After this, semantic representation is used to gather the semantic regions of downscaled images. As the images are very large, this scaling down significantly reduces the computing time with little degradation in the coarse object detection results. A deep neural forest classifier finds potential regions before executing the pixel-based segmentation. Finally, in our experiments, boundary detection and several classifiers are evaluated to find the objects associated with these regions. The paper details the set-up for our tree-based convolutional neural network. The results indicate that this tree-based convolutional neural network outperforms the other surveyed techniques in the literature.
A Study On The Influencing Factors Of Tourism Demand From Mainland China To Hong Kong
Authors: Liu Han , Liu Wei , Wang Yonglian
Published: July 2020

Tourism research increasingly uses search query data to forecast demand, but the literature rarely explores the mechanisms of the factors influencing demand. A time-varying parameter factor vector auto-regression model is constructed based on Baidu Index on six aspects (dining, shopping, transportation, tours, attractions, and lodging) of tourism demand from January 2011 to March 2019. The model can quantitatively and comprehensively analyze the mechanisms of tourism demand and its six important influencing factors, and can provide suggestions for subsequent planning, construction, and services in the tourism industry. The empirical results show that the relationship between the six factors and domestic tourism demand is time-varying. Dining, attractions, and shopping have a driving effect on tourism demand, and are thus stimulative factors; transportation, tours, and lodging hinder the growth of tourism demand, and are thus baffle factors.
Echocardiographic, morphometric and biomarker changes in female cats followed from 6 to 24 months of life
Authors: van Hoek Ingrid MJ , Laxalde Jeremy , Connolly David J , Rush John E , Freeman Lisa M
Published: July 2020

Objectives

The aim of the study was to evaluate cardiac size and early growth through echocardiographic, body weight (BW), body condition score (BCS), morphometric and biomarker changes in cats followed from 6 to 24 months of age.

Methods

Twenty-four female European shorthair colony cats were evaluated at birth for BW and at 6, 12, 18 and 24 months of age for BW, BCS, head length (HL) and head width (HW), N-terminal pro B-type natriuretic peptide (NT-proBNP), insulin-like growth factor-1 (IGF-1) and echocardiographic measurements.

Results

BCS, HW, left ventricular free wall in diastole, left atrium diameter and aortic diameter increased significantly between 6 and 12 months, while BW, HL and interventricular septum in diastole increased significantly between 6, 12 and 18 months, and BW decreased significantly between 18 and 24 months. NT-proBNP decreased significantly between 6 and 12 months. IGF-1 increased significantly between 6 and 12 months but decreased significantly between 12 and 18 months.

Conclusions and relevance

This study prospectively evaluated changes in echocardiographic measurements, BW, BCS, HL, HW, IGF-1 and NT-proBNP in cats during the first 2 years of life. Results show a comparable change over time for different variables. These findings contribute to the understanding of a possible relationship between cardiac measures and body size from young age through to adulthood.
Prevalence of and factors associated with difficult peripheral venipuncture in adult surgical patients
Authors: DAT Monteiro , JC de la Torre-Montero , AC Nicolussi , Reis RK , MH Barbosa , SEM Toffano
Published: July 2020

Objective:

To determine the prevalence of difficult venous access in adult patients admitted to a surgical unit.

Method:

This observational prospective cohort study included 235 patients from a Brazilian hospital. Clinical data were collected by direct observation and analyzed by descriptive, inferential statistics, and multiple binomial logistic regressions. Odds ratios were also calculated.

Results:

Most of the patients (66.4%) were men and self-reported as white (59.2%). The prevalence of difficult intravenous access was 32.8%. Predictors of peripheral intravenous cannula insertion failure were history of difficult intravenous access and nonvisibility of the vein.

Conclusion:

History of difficult intravenous access and a nonvisible venous network were significant predictors of peripheral cannula insertion failure in adults undergoing clinical surgery. The prevalence of difficult intravenous access was 32.8%.
Vitamin D Supplementation in Laboratory-Bred Mice: An In Vivo Assay on Gut Microbiome and Body Weight
Authors: Badger-Emeka Lorina Ineta , AlJaziri Zainab Yaseen , Almulhim Cereen Fahad , Aldrees Asma Saleh , AlShakhs Zainab Hamzah , AlAithan Reem Ibrahim , Alothman Fatimah Abdullah
Published: July 2020

Saudi Arabia is in a tropical geographical region with a population that has access to adequate diet. There is, however, a high level of vitamin D deficiency in the Kingdom, comorbid with other disease. There is the postulation of a correlation between a healthy gut microbiota and balanced levels of serum vitamin D. This investigation looks into the effect of vitamin D supplementation on the gut flora of laboratory-bred mice as well as any possible association on body weight. BALB/C mice weighing between 34 and 35.8 g were divided into 4 groups and placed on daily doses of vitamin D of 3.75 µg (low dose), 7.5 µg (normal dose), and 15 µg (high dose). The fourth group was the control group that did not receive any supplementation with vitamin D. Body weights were monitored on weekly basis, while faecal samples from the rectum were obtained for microbial culturing and the monitoring of bacterial colony count using the Vitek 2 Compact automated system (BioMerieux, Marcy-l’Etoile, France) according to manufacturer’s guidelines. The data presented as mean ± SD, while significant differences were determined with 2-way analysis of variance in comparing differences within and between treatment groups. The different doses of vitamin D showed varying effects on the body weight and gut microbial colonies of the mice. There was a highly significant difference between the control, 15 µg (high), and 7.5 µg (normal) dose groups. This is suggestive that supplementation with vitamin D could a role in the gut microbial flora in the gut which could reflect in changes in body weight.
Prospective Clinical Trial Comparing Curettage and Cryosurgery to Curettage and Electrodesiccation in the Management of Minimally Invasive Basal and Squamous Cell Carcinomas
Authors: Fournier Suzel , Laroche Alexandre , Leblanc Martin , Bourgeault Emilie , Ulrich Singbo Mahukpe Narcisse , Turcotte Stéphane , Blouin Marie-Michèle , Alain Jimmy
Published: July 2020

Background

Basal and squamous cell carcinomas represent the most common cancers in North America. Their management is an important issue.

Objectives

The evaluation of cure rates of minimally invasive cutaneous carcinomas with curettage-cryosurgery compared to curettage-electrodesiccation, as well as the assessment of the aesthetic appearance of scars.

Methods

This prospective trial randomized 117 patients 1:1 to treatments of curettage-cryosurgery or curettage-electrodesiccation. They were then followed at 6, 12, 18, and 24 months.

Results

At 12-month follow-up, only one (1/49) patient had a recurrence of cutaneous carcinoma in the curettage-cryosurgery group and none (0/43) in the curettage-electrodesiccation group. Farrington-Manning analysis with a 5% margin of error showed the non-inferiority of the first method ( P = .04). For the aesthetic appearance of scars after 12 months, better results with curettage-cryosurgery procedure has been observed, but this was not statistically significant ( P = .80 and P = .27 for evaluations of patients and clinicians respectively).

Limitations

This study was mainly limited by its small sample size.

Conclusion

We have demonstrated that curettage-cryosurgery compared to curettage-electrodesiccation for the treatment of minimally invasive carcinomas is noninferior (comparable) with regards to cure rates at 12-month follow-up. No significant difference has been demonstrated for the appearance of scars.
Experimental investigation, statistical modeling and multi-objective optimization of creep age forming of fiber metal laminates
Authors: Safari M , Salamat-Talab M , Abdollahzade A , Akhavan-Safar A , da Silva LFM
Published: July 2020

The experimental assessment of the creep age forming performance of fiber metal laminates was considered in this study. To this end, different fiber metal laminates with the stacking sequence of [Al/02/Al] were manufactured using aluminum alloy 6061 sheets as skins along with E-glass fiber-reinforced polypropylene and E-glass fiber-reinforced polyamide 6 as two different cores. Next, a comprehensive investigation was conducted on the impacts of two main parameters in the creep forming process, i.e. the effect of time and temperature on the spring-back properties of deformed fiber metal laminates. Initially, using the design of experiments and based on the response surface methodology, an imposed spring-back of the creep age formed fiber metal laminates was modeled and the governing linear regression equations were derived and verified. Then, to find the best combination yielding the minimum spring-back, the process inputs (time and temperature) were optimized. The results proved that with an increase in either time or temperature, the spring-backs of the two types of creep age formed fiber metal laminates decreased due to the decrease in elastic strains and the increase of creep strains. Also, to achieve a creep age formed fiber metal laminate with minimum spring-back according to multi-objective optimization in both fiber metal laminates, the most proper values of time and temperature should be taken as 6 h and approximately 160°C, respectively.
Interrogating the discourses of ‘teaching excellence’ in higher education
Authors: Wilcox Kim
Published: July 2020

Education policies can be understood as discursive strategies often used to foreground political ideologies and shape pedagogic practice. This chapter focuses on the ways in which the notion of ‘teaching excellence’ has received a renewed focus in the context of the introduction of a Teaching Excellence and Student Outcomes Framework for higher education in England. The study adopted a hybrid approach to Critical Discourse Analysis to explore the interplay of discourses underpinning teaching excellence in the context of a policy purporting to assess the standard of teaching in higher education. Drawing on the English case, textual data comprised a White Paper and two policy announcements outlining the introduction of the Teaching Excellence and Student Outcomes Framework alongside 22 written submissions to the ‘Assessing Quality in Higher Education’ inquiry. Findings revealed four competing discourses: quality enhancement, quality assurance, widening participation and graduate employability. A disjuncture between policy claims and institutional practice was highlighted, with discursive silences regarding access, participation and employability. It is argued that the performative culture generated by such a policy inadvertently encourages institutions to focus on accountability and reputational concerns at the expense of processes which reflect the broader value of establishing teaching excellence in higher education.
Two-stage Bayesian system identification using Gaussian discrepancy model
Authors: Zhang Feng-Liang , Au Siu-Kui , Ni Yan-Chun
Published: July 2020

System identification aims at updating the model parameters (e.g. mass and stiffness) associated with the mathematical model of a structure based on measured structural response. In this process, a two-stage approach is commonly adopted. In Stage I, modal parameters including natural frequencies and mode shapes are identified. In Stage II, the modal parameters are used to update structural parameters such as those related to stiffness, mass, and boundary conditions. A recent Bayesian formulation allows the identification results in the first stage to be incorporated in the second stage directly via Bayes’ rule without using a heuristic model (often based on classical statistics) that transfers the information from Stages I to II. This opens up opportunities for explicitly accounting for modeling error in the structural model (Stage II) through the conditional distribution of modal parameters given structural model parameters. Following this approach, this article investigates a methodology where the modeling error between the two stages is incorporated with Gaussian distributions whose statistical parameters are also updated with available data. Leveraging on special mathematical structure induced by the model, computational issues are resolved and an analytical investigation is performed that yields insights on the role of modeling error and whether its statistics can be distinguished from those of identification uncertainty (defined for given structural model). The proposed methodology is verified using synthetic data and applied to a laboratory-scale structure.
Predictive Value of Early Response to Chemoradiotherapy in Advanced Esophageal Squamous Cell Carcinoma by Diffusion-Weighted MR Imaging
Authors: Chen Wei , Wang Ya-ting , Guo Lili , Zhu Zhaohuan , Zhou Hai-fei , Bai Genji
Published: July 2020

Objective:

To explore the value of diffusion-weighted imaging for early response detection of locally advanced esophageal squamous cell carcinoma with concurrent chemoradiotherapy.

Methods:

Fifty-five (42 males, 13 females) patients with locally advanced esophageal cancer who were undergoing chemoradiotherapy were recruited for this study. Diffusion-weighted imaging was performed in all patients before therapy, at the first weekend, the second weekend, and the end of chemoradiotherapy. The rate of change in apparent diffusion coefficient value and the maximum diameter between pretherapy and posttherapy were calculated.

Results:

Fifty-five patients with locally advanced esophageal squamous cell carcinoma were classified as responders (40 cases) and nonresponders (15 cases). Before chemoradiotherapy, the responders group had a significantly lower apparent diffusion coefficient values than the nonresponders group ( t = −4.815, P = .000). At the 3 time points after chemoradiotherapy (first weekend, second weekend, and the end of chemoradiotherapy), there was no statistically significant difference in apparent diffusion coefficient values between responders and nonresponders ( P > .05). The responders group had a significantly higher rate of change in apparent diffusion coefficient value than the nonresponders group at each time point ( P < .05). At the first weekend of chemoradiotherapy, the rate of change in the maximum diameter was not significantly different in the 2 groups ( t = 0.928, P = .357). There was a negative correlation between the tumor apparent diffusion coefficient value of pretherapy and the reduction ratio of tumor maximum diameter at the end of chemoradiotherapy ( r = −0.592, P = .000).

Conclusions:

The change rate of apparent diffusion coefficient value by the end of the first week after beginning chemoradiotherapy may be a sensitive indicator to detect the early response to locally advanced esophageal squamous cell carcinoma.
Improving two-dimensional braided composite tensile properties by including low angle yarn twist: Production, experimental verification, and modeling
Authors: Cheung Benjamin KO , Carey Jason P
Published: July 2020

Tubular braided composites combine manufacturing technologies from textiles and composites industries. The design of the reinforcing textile structure plays a significant role in the mechanical characteristics of the final composite. Twisted yarns have shown improved strength over untwisted ones, even for continuous multifilament yarns where twist is not necessary for the manufacturing process. In this work, a manufacturing process is piloted in which twisted yarns are introduced to the braiding process. Static testing is then done to determine the impact of yarn twist on the stiffness and strength. Finally, the Ramberg–Osgood model is adapted to the results in order to provide a descriptive model for the behavior of tubular braided composites beyond the proportional limit.
Mechanical thrombectomy using the new Tigertriever in acute ischemic stroke patients – A Swiss prospective multicenter study
Authors: Gruber Philipp , Diepers Michael , von Hessling Alexander , Weber Johannes , Kahles Timo , Anon Javier , Berberat Jatta , Nedeltchev Krassen , Liebeskind David S , Remonda Luca
Published: July 2020

Purpose

Tigertriever is a novel operator-adjustable clot retriever designed to enhance the operator's options to control the interaction of retriever and clot. The aim of this study was to assess the feasibility, safety and efficacy of the Tigertriever device system.

Methods

Prospective multi-center registry study at three comprehensive stroke centers in Switzerland from 2017 to 2019 of patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO) using Tigertriever as a first-line device.

Results

30 AIS patients (median age 72.5 years (IQR 64–79), 50% women) with a median NIHSS on admission of 11 (IQR 6-13) and a median ASPECT score of 9 (IQR 7–10) were treated with the new Tigertriever and included in this study. The first-pass effect was 24% (n = 7). A good recanalization (eTICI 2 b/2c/3) was achieved in 94% of the cases. Median mRS at 90 days was 1 (IQR 1–2).

Conclusion

This study demonstrated feasibility, safety and effectiveness of the Tigertriever in AIS patients with LVO with a high reperfusion rate.
Safety and efficacy study of the wound care 360° SiteSeal® vascular closure device in percutaneous cardiac catheterization procedures
Authors: Sharma Suresh , Patel Nilay , Jeevanantham Vinodh , Gupta Kamal , Earnest Matthew B
Published: July 2020

Objectives

Vascular access site complications after percutaneous transfemoral cardiovascular procedures remain a common cause of morbidity and mortality. We evaluated the SiteSeal® VCD for achieving hemostasis following diagnostic cardiac catheterization.

Methods

We conducted a prospective case control single center study to assess the safety and efficacy of SiteSeal® VCD compared to standard manual compression following diagnostic cardiac catheterization. Forty patients were enrolled in study to receive either SiteSeal® device or manual compression (20 in each group).

Results

Patients in the SiteSeal® group achieved hemostasis in a significantly shorter time (4 ± 2.4 vs. 19 ± 2.4 min, P < 0.001), had shorter time from hemostasis to ambulation (95 ± 44 vs. 388 ± 63 min, P < 0.001) and significantly earlier device deployment to discharge time compared to the manual compression group (4.7 ± 1.1 vs. 8.9 ± 4.8 h, P = 0.001). There was one non-major bleeding event in the SiteSeal® group which occurred >24 h after discharge from the hospital and was managed conservatively. In the remaining device patients, there was no clinical or Doppler ultrasound evidence of major or minor vascular complication with good overall patient comfort at discharge, 7 days and 30 days follow-up.

Conclusions

In this first clinical experience, the SiteSeal® VCD achieved safe and efficient hemostasis, allowed for earlier ambulation and faster discharge compared to manual compression.
Covid 19 – Impact and new normal for pharmaceutical industry (Part – I)
Authors: Barshikar Ranjit
Published: July 2020

This review article shares New Normal as part of impact of Covid 19, on Pharmaceutical Industry globally as whole & Manufacturing Operations as preventive measures or cure of Covid 19. Based on known transmissions & spreading routes, the Pharmaceutical Industry Manufacturing Operations needs to learn to avoid such impacts of transmissions & spreads. The pharmaceutical and healthcare operations need to take care to protect personnel

As such The Pharmaceutical Industry does take very good care to avoid cross contaminations as part of Good Manufacturing Practices (GMP). But now keeping in mind seriousness of virus spread, the Pharmaceutical Industry has to take precautions to avoid transmission & spread during travel in buses, entry & exit procedures, change rooms, avoid hand touch to doors, handles etc. at office work places & throughout the manufacturing operations at site

This article looks at various stages the Pharmaceutical Manufacturing Operation sites has to take care depending types of products & human involvement in such operations

As per WHO, key major steps to protect against the infection are:  • Social distancing  • Use of Masks/Face- Shields  • Frequent Washing of Hands with soap & water or Sanitisation with proper sanitisers containing min. 70% Alcohol.  • Segregation of staff in essential & non-essential at manufacturing site.  • Non-essential staff to work from home

Essential staff are the ones who are required to work in person at manufacturing site

The Pharmaceutical Industry is moving forward very confidently by amending concerned SOP’s to meet Covid – 19 impact & challenges. This article describes “New Normal – impacts” of Covid-19 & basic requirements like Personal hygiene, Entry/Exit procedures to Protect the Workplace & Safety of the Workforce.
Perspective-taking is spontaneous but not automatic
Authors: O’Grady Cathleen , Scott-Phillips Thom , Lavelle Suilin , Smith Kenny
Published: July 2020

Data from a range of different experimental paradigms—in particular (but not only) the dot perspective task—have been interpreted as evidence that humans automatically track the perspective of other individuals. Results from other studies, however, have cast doubt on this interpretation, and some researchers have suggested that phenomena that seem like perspective-taking might instead be the products of simpler behavioural rules. The issue remains unsettled in significant part because different schools of thought, with different theoretical perspectives, implement the experimental tasks in subtly different ways, making direct comparisons difficult. Here, we explore the possibility that subtle differences in experimental method explain otherwise irreconcilable findings in the literature. Across five experiments we show that the classic result in the dot perspective task is not automatic (it is not purely stimulus-driven), but nor is it exclusively the product of simple behavioural rules that do not involve mentalising. Instead, participants do compute the perspectives of other individuals rapidly, unconsciously, and involuntarily, but only when attentional systems prompt them to do so (just as, for instance, the visual system puts external objects into focus only as and when required). This finding prompts us to clearly distinguish spontaneity from automaticity. Spontaneous perspective-taking may be a computationally efficient means of navigating the social world.
Clinical and radiographic outcomes of total shoulder arthroplasty with a partially cemented all-polyethylene pegged bone-ingrowth glenoid component: a systematic review
Authors: Malahias Michael-Alexander , Kostretzis Lazaros , Gkiatas Ioannis , Chronopoulos Efstathios , Brilakis Emmanouil , Antonogiannakis Emmanouil
Published: July 2020

Background

Several articles have been published reporting on the clinical performance of a novel pegged, all-polyethylene glenoid component design which features a central peg, circumferentially fluted, interference-fit peg for tissue integration and three small peripheral pegs for cementing. However, no systematic review exists to this date.

Methods

The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications up to May 2020.

Results

Overall, 13 articles were included for analysis (560 operated shoulders, range of mean follow-up: 2–6 years). The survival rate was 98.2% (550 out of 560 cases), while the rate of aseptic loosening was 0.2% (1 out of 560 cases). There were 139 cases (out of 399 reported; 34.1%) with peri-glenoid radiolucency, and 35 cases (out of 223 reported; 15.7%) of asymptomatic central peg osteolysis, with 1 of them undergoing revision.

Conclusions

There was fair quality of evidence to show that partially cemented all-polyethylene pegged bone-ingrowth glenoid components produce promising results, with a low revision rate in the short- to medium-term follow-up. Nevertheless, this analysis showed high rates of both radiolucency of the glenoid component and osteolysis around the central peg which raise concern for potential failure of this glenoid component in the long-term follow-up.

Level of evidence

Systematic review, IV.
The management of the shoulder skin microbiome (Cutibacterium acnes) in the context of shoulder surgery: a review of the current literature
Authors: Moore Nathan FE , Batten Timothy J , Hutton Christopher EJ , White William James , Smith Christopher D
Published: July 2020

Background

This review aims to establish current knowledge of the shoulder skin microbiome and how to manage the bacteria that reside within it.

Methods

A review was undertaken of the current literature through OvidSP. All abstracts were reviewed by three independent researchers.

Results

Thirty-five studies met the inclusion criteria. With forward referencing an additional 14 were included. None commented on organisms specific to the shoulder microbiome other than Cutibacterium acnes. Therefore, this review is focussed on the current knowledge of C. acnes.

Discussion

C. acnes is a skin commensal within the pilo-sebaceous glands reported to be the primary pathogen in up to 86% of shoulder joint infections. Pre-operative culture of unprepared skin can be indicative of underlying joint infection in shoulder arthroplasty revision. Intra-articular biopsies may have a high false positive due to skin contamination. Correlating the number of positive samples and certain associated signs can give a greater than 90% probability of a true infection. Standard surgical skin preparation, peri-surgical intravenous antibiotics and oral pre-operative antibiotics do not reduce bacterial load within the skin. However, topical benzoyl peroxide and clindamycin have both demonstrated significantly reduced bacteria load. Phylogenetically there are six main types. Patients may have more than one phenotype present during infection.
Next-generation sequencing to confirm clinical familial hypercholesterolemia
Authors: Reeskamp Laurens F , Tromp Tycho R , Defesche Joep C , Grefhorst Aldo , Stroes Erik SG , Hovingh G Kees , Zuurbier Linda
Published: July 2020

Background

Familial hypercholesterolemia is characterised by high low-density lipoprotein-cholesterol levels and is caused by a pathogenic variant in LDLR, APOB or PCSK9. We investigated which proportion of suspected familial hypercholesterolemia patients was genetically confirmed, and whether this has changed over the past 20 years in The Netherlands.

Methods

Targeted next-generation sequencing of 27 genes involved in lipid metabolism was performed in patients with low-density lipoprotein-cholesterol levels greater than 5 mmol/L who were referred to our centre between May 2016 and July 2018. The proportion of patients carrying likely pathogenic or pathogenic variants in LDLR, APOB or PCSK9, or the minor familial hypercholesterolemia genes LDLRAP1, ABCG5, ABCG8, LIPA and APOE were investigated. This was compared with the yield of Sanger sequencing between 1999 and 2016.

Results

A total of 227 out of the 1528 referred patients (14.9%) were heterozygous carriers of a pathogenic variant in LDLR (80.2%), APOB (14.5%) or PCSK9 (5.3%). More than 50% of patients with a Dutch Lipid Clinic Network score of ‘probable’ or ‘definite’ familial hypercholesterolemia were familial hypercholesterolemia mutation-positive; 4.8% of the familial hypercholesterolemia mutation-negative patients carried a variant in one of the minor familial hypercholesterolemia genes. The mutation detection rate has decreased over the past two decades, especially in younger patients in which it dropped from 45% in 1999 to 30% in 2018.

Conclusions

A rare pathogenic variant in LDLR, APOB or PCSK9 was identified in 14.9% of suspected familial hypercholesterolemia patients and this rate has decreased in the past two decades. Stringent use of clinical criteria algorithms is warranted to increase this yield. Variants in the minor familial hypercholesterolemia genes provide a possible explanation for the familial hypercholesterolemia phenotype in a minority of patients.
Persistence of oncogenic and non-oncogenic human papillomavirus is associated with human immunodeficiency virus infection in Kenyan women
Authors: Tong Yan , Tonui Philip , Ermel Aaron , Orang’o Omenge , Wong Nelson , Titus Maina , Kiptoo Stephen , Muthoka Kapten , Loehrer Patrick J , Brown Darron R
Published: July 2020

Objectives:

Cervical cancer is caused by persistent infection with oncogenic, or “high-risk” types of human papillomaviruses, and is the most common malignancy in Kenyan women. A longitudinal study was initiated to investigate factors associated with persistent human papillomavirus detection among HIV-infected and HIV-uninfected Kenyan women without evidence of cervical dysplasia.

Methods:

Demographic/behavioral data and cervical swabs were collected from HIV-uninfected women (n = 82) and HIV-infected women (n = 101) at enrollment and annually for 2 years. Human papillomavirus typing was performed on swabs (Roche Linear Array). Logistic regression models of human papillomavirus persistence were adjusted for demographic and behavioral characteristics.

Results:

HIV-infected women were older and less likely to be married and to own a home and had more lifetime sexual partners than HIV-uninfected women. All HIV-infected women were receiving anti-retroviral therapy at enrollment and had satisfactory CD4 cell counts and HIV viral loads. One- and two-year persistent human papillomavirus detection was significantly associated with HIV infection for any human papillomavirus, high-risk human papillomavirus, International Agency for the Research on Cancer-classified high-risk human papillomavirus, and non-oncogenic “low-risk” human papillomavirus.

Conclusion:

Persistent detection of oncogenic and non-oncogenic human papillomavirus was strongly associated with HIV infection in Kenyan women with re-constituted immune systems based on satisfactory CD4 cell counts. In addition to HIV infection, factors associated with an increased risk of human papillomavirus persistence included a higher number of lifetime sex partners. Factors associated with decreased risk of human papillomavirus persistence included older age and being married. Further studies are needed to identify the immunological defects in HIV-infected women that allow human papillomavirus persistence, even in women receiving effective anti-retroviral therapy. Further studies are also needed to determine the significance of low-risk human papillomavirus persistence in HIV-infected women.
Covid-19 and the accelerating smart home
Authors: Maalsen Sophia , Dowling Robyn
Published: July 2020

Home, digital technologies and data are intersecting in new ways as responses to the COVID-19 pandemic emerge. We consider the data practices associated with COVID-19 responses and their implications for housing and home through two overarching themes: the notion of home as a private space, and digital technology and surveillance in the home. We show that although home has never been private, the rapid adoption and acceptance of technologies in the home for quarantine, work and study, enabled by the pandemic, is rescripting privacy. The acceleration of technology adoption and surveillance in the home has implications for privacy and potential discrimination, and should be approached with a critical lens.
Starch or Saline After Cardiac Surgery: A Double-Blinded Randomized Controlled Trial
Authors: Nagpal A. Dave , Cowan Andrea , Li Linna , Nusca Graeme , Guo Linrui , Novick Richard J. , Harle Chris C. , House Andrew A. , Fox Stephanie , Jones Philip M.
Published: July 2020

Background:

Despite decades of investigation, the balance of clinical risks and benefits of fluid supplementation with starch remain unresolved. Patient-centered outcomes have not been well explored in a “real-world” trial in cardiac surgery.

Objective:

We sought to compare a starch-based fluid strategy with a saline-based fluid strategy in the cardiac surgery patient.

Design:

A pragmatic blinded randomized controlled trial comparing starch-based with saline-based fluid strategy.

Setting:

A large tertiary academic center in London Ontario between September 2009 and February 2011.

Participants:

Patients undergoing planned, isolated coronary revascularization.

Measurements:

Serum creatinine and patient weight were measured daily postoperatively.

Methods:

Patients were randomized to receive 6% hydroxyethyl starch (Voluven) or saline for perioperative fluid requirements. Fluid administration was not protocolized. Co-primary outcomes were incidence of acute kidney injury (AKI) and maximum postoperative weight gain. Secondary outcomes included bleeding, transfusion, inotropic and ventilator support, and fluid utilization.

Results:

The study was prematurely terminated due to resource limitations. A total of 69 patients (19% female, mean age = 65) were randomized. Using RIFLE criteria for AKI, “risk” occurred in 12 patients in each group (risk ratio [RR] = 1.0; 95% confidence interval [CI] = 0.5-1.9; P = 1.00), whereas “injury” occurred in 7 of 35 (20%) and 3 of 34 (9%) of patients in the starch and saline groups, respectively (RR = 2.3; 95% CI = 0.6-8.1; P = .31). Maximum weight gain, bleeding and blood product usage, and overall fluid requirement were similar between groups.

Limitations:

The study had to be prematurely terminated due to resource limitations which led to a small sample size which was not sufficiently powered to detect a difference in the primary outcomes.

Conclusions:

This pragmatic double-blinded randomized controlled trial revealed a number of interesting hypothesis-generating trends and confirmed the feasibility of undertaking a logistically complex trial in a pragmatic fashion.
Effects of betulinic acid on synovial inflammation in rats with collagen-induced arthritis
Authors: Kun-Liu  , Wang Jian-Ying , Zhang Lei , Pan Ying-Yi , Chen Xiao-Yun , Yuan Ying
Published: July 2020

Betulinic acid (BA) inhibits the migration, invasion, and cytoskeletal reorganization of fibroblast-like synoviocytes (RA-FLS) in patients with rheumatoid arthritis. Here, to further explore the mechanism of action of BA in collagen-induced arthritis (CIA) rats, we investigated the pharmacodynamic effects of BA on synovial inflammation in a rat model of type II CIA. After inducing hind paw swelling, the rats were divided into four groups: healthy controls (normal), and rats that underwent CIA and received methotrexate treatment (MTX), BA treatment (BA), or no treatment (CIA). Body weight and hind paw swelling were determined regularly, and arthritis scores were calculated weekly. On day 35, rats were sacrificed and their hind ankle joints sectioned and stained with hematoxylin and eosin for histopathological evaluation. BA significantly reduced CIA-induced hind paw swelling, synovial tissue proliferation, cartilage destruction, and vasospasm. BA treatment also decreased serum interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α) levels in rats with CIA. The CCK-8 assay was used to detect the proliferation of isolated vimentin+CD68− RA-FLS; RA-FLS were stimulated with TNF-α in vitro. BA significantly inhibited TNF-α-stimulated RA-FLS proliferation, as well as IL-1β and IL-6 secretion. BA also downregulated the transcription of vascular endothelial growth factor (VEGF) and transforming growth factor β (TGF-β) and decreased the expression of the NF-кB pathway proteins (NF-kB-P65, IkBα, and IKKα/β) in the TNF-α-stimulated RA-FLS. These results indicate that BA alleviated the symptoms of CIA by inhibiting synoviocyte proliferation, modifying TNF-α- and NF-кB-related inflammatory pathways, and downregulating inflammatory mediators and growth factors including IL-1β, IL-6, VEGF, and TGF-β.