bluuebunny/crossref_metadata_2025 huggingface dataset:
Stressinduzierte vegetative Antwortreaktion des ärztlichen Personals bei herzchirurgischen Eingriffen
Authors: Böckelmann Irina , Pohl Robert , Awad George , Darius Sabine , Wippermann Jens , Thielmann Beatrice , Scherner Maximilian
Published: June 2021

Hintergrund

Chirurgen erleben in ihrem Arbeitsalltag eine hohe psychische Belastung. Die Herzfrequenzvariabilität (HRV) ist als vegetativer Beanspruchungsparameter zur Erfassung von psychischen Belastungen etabliert. Eine geringe HRV ist ein Indikator für hohen Stress.

Ziel der Arbeit

Ziel der Querschnittsstudie war es, die Aktivierung des autonomen Nervensystems als stressinduzierte Antwortreaktion und das Stressniveau bei chirurgisch tätigen Ärzten verschiedener Qualifikationsstufen während ihrer Tätigkeit anhand der HRV zu untersuchen.

Material und Methoden

Es wurde die HRV aus 31 EKG-Aufnahmen von 5 freiwilligen, klinisch gesunden männlichen Herzchirurgen während 25 aortokoronarer Bypassoperationen (ACB-OP) und der Stationsarbeit analysiert. Als Einschlusskriterium galt die Tätigkeit als Assistenzarzt bzw. Oberarzt, die berechtigt sind, herzchirurgische Eingriffe durchzuführen. Relevante Medikamente und Vorerkrankungen, die den Herzrhythmus beeinflussen und die Häufigkeit von Extrasystolen im EKG (> 1 % ) waren Ausschlusskriterien. Die Tätigkeit während der Operation und Nicht-Operationsphase wurde schriftlich dokumentiert. Bei der statistischen Auswertung kamen der Mann-Whitney-U-Test und das Allgemeine Lineare Modell mit der Anpassung nach Bonferroni unter Berücksichtigung der ärztlichen Funktion und der Art der Tätigkeit während der Operation als Kovariaten zur Anwendung.

Ergebnisse

Eine reduzierte HRV während der ACVB-OP fand sich bei den zeitbezogenen Parametern RMSSD (Root Mean Square of Successive Differences) und pNN50 (Prozentsatz der NN-Intervalle mit mindestens 50 ms Abweichung vom vorausgehenden NN-Intervall), dem frequenzbezogenen Parameter LF (Low Frequency) power sowie dem nichtlinearen Kurzzeitvariabilitätsparameter SD1 (Standard Deviation oder die Breite der Punktwolke) für Assistenzärzte im Vergleich zu den Oberärzten. 50,8 % der Arbeitszeit war im OP für die Assistenzärzte als hohe Stresssituation gekennzeichnet (Oberärzte: 11,7 %; p = 0,015). Die Beanspruchungsreaktion bei der Stationsarbeit zeigte sich als deutlich geringer ausgeprägt, wobei diese in beiden Gruppen vergleichbar war.

Diskussion

Es zeigt sich eine höhere stressinduzierte Antwortreaktion während der ACB-OP bei Assistenzärzten im Vergleich zu Oberärzten. Es sollten frühzeitig präventive und gesundheitsfördernde Maßnahmen bei hoher arbeitsbezogener Stressbelastung bei chirurgisch tätigen Ärzten insbesondere in der Facharzt-Weiterbildungsphase eingeleitet werden.
Study and performance test of 10 kW molten carbonate fuel cell power generation system
Authors: Lu Chengzhuang , Zhang Ruiyun , Yang Guanjun , Huang Hua , Cheng Jian , Xu Shisen
Published: June 2021

The use of high-temperature fuel cells as a power technology can improve the efficiency of electricity generation and achieve near-zero emissions of carbon dioxide. This work explores the performance of a 10 kW high-temperature molten carbonate fuel cell. The key materials of a single cell were characterized and analyzed using X-ray diffraction and scanning electron microscopy. The results show that the pore size of the key electrode material is 6.5 µm and the matrix material is α-LiAlO2. Experimentally, the open circuit voltage of the single cell was found to be 1.23 V. The current density was greater than 100 mA/cm2 at an operating voltage of 0.7 V. The 10 kW fuel cell stack comprised 80 single fuel cells with a total area of 2000 cm2 and achieved an open circuit voltage of greater than 85 V. The fuel cell stack power and current density could reach 11.7 kW and 104.5 mA/cm2 at an operating voltage of 56 V. The influence and long-term stable operation of the stack were also analyzed and discussed. The successful operation of a 10 kW high-temperature fuel cell promotes the large-scale use of fuel cells and provides a research basis for future investigations of fuel cell capacity enhancement and distributed generation in China.
Heat Transfer and Fluid Flow Analysis for Turbulent Flow in Circular Pipe with Vortex Generator
Authors: Rambhad Kishor S. , Kalbande Vednath P. , Kumbhalkar Manoj A. , Khond Vivek W. , Jibhakate Rahul A.
Published: June 2021

The performance of heat transfer enhancement (HTE) using modified inserts (MIs) as a vortex generator in pipe flow and fluid flow analysis using computational fluid dynamics (CFD) are evaluated in this article. The MIs are fastened to the central rod, and the circular sections of the MIs touched the circular wall of the test pipe. Heat transfer and fluid flow analyses are carried out for the various pitch to diameter ratios (P/D) and angles of the MIs. P/D ratios of 3, 4 and 6 and MIs angles of 15°, 30°, 45°, 60° and 90° are considered for experimental analysis. CFD analysis is carried out for P/D ratios of 3, 4 and 6 and MIs angles of 30°, 45° and 90°. Nusselt number (Nu/Nus) and friction factor (f/fs) ratios are evaluated using the same Reynolds number between 8000 and 17,000 in the experimental study. The MIs encourage the wall and core fluid to be combined thus helps in HTE. It is found that, as the P/D ratio increases, the Nu/Nus and f/fs decrease. If the distance between the MIs increases, the mixing of fluid weakens. With decreasing the P/D ratio, Nu/Nus increases. Increased fluid mixing leads to a higher coefficient of heat transfer and higher values of pressure drop. A P/D ratio of 4 and MIs angle of 45° results in greater heat interaction than others. Finally, recommendations for the best P/D ratio and angles of MIs are made for improved HTE on fluid flow through a circular pipe.

Article Highlights

Modified inserts (MIs) are used inside the test pipe to check the heat transfer enhancement at various angles. Also, compared the performance with and without MIs.

Fluid flow analysis is checked by CFD (Fluent) in Ansys software.

Fluid flow patterns for various MIs angles and P/D ratios are compared.
Sustainable urban transportation development in China: A behavioral perspective
Authors: Ling Shuai , Ma Shoufeng , Jia Ning
Published: June 2021

The rapid development of economics requires highly efficient and environment-friendly urban transportation systems. Such requirement presents challenges in sustainable urban transportation. The analysis and understanding of transportation-related behaviors provide one approach to dealing with complicated transportation activities. In this study, the management of traffic systems is divided into four levels with a structural and systematic perspective. Then, several special cases from the perspective of behavior, including purchasing behaviors toward new energy vehicles, choice behaviors toward green travel, and behavioral reactions toward transportation demand management policies, are investigated. Several management suggestions are proposed for transportation authorities to improve sustainable traffic management.
Heavy metals risk assessment of water and sediments collected from selected river tributaries of the Mara River in Tanzania
Authors: Nkinda Mihayo Sahani , Rwiza Mwemezi Johaiven , Ijumba Jasper Nathan , Njau Karoli Nicholas
Published: June 2021

This study investigated the levels of Pb, Hg, Cr, Cd, and As in water and sediments from the tributaries of the Mara River, Tanzania. Pollution risk of water and sediments was investigated using seven indices and five metals. During the dry period, the highest concentration of Pb, Hg, Cr, Cd, and As in sediments was 17.45 ± 1.22, 0.01, 1.56 ± 0.5, 1.3 ± 0.09, and 30.81 ± 0.02 mg/kg, respectively. During the wet period, the highest concentration of Pb, Hg, Cr, Cd, and As in sediments was 4.37 ± 0.28, 0.012, 2.58 ± 0.57, 2.25 ± 0.35, and 53 ± 0.02 mg/kg, respectively. For surface water, the respective highest concentrations of Pb, Hg, Cr, Cd, and As were 0.76 ± 0.09, 0.04, 0.68 ± 0.09, 0.74 ± 0.1, and 0.47 ± 0.06 mg/L for the dry period. The wet period max concentrations for Pb, Hg, Cr, Cd, and As in surface water were 0.56, 0.03, 0.55 ± 0.03, 0.48 ± 0.03, and 0.4 ± 0.03 mg/L, respectively. Principal component analysis results indicated dominant loadings for Pb and As in sediments during the dry period. Comparison of sediment concentrations with sediment quality guidelines revealed that As and Cd were enriched. Correlation coefficient results indicated that As had a strong negative correlation with the rest of the elements in sediments during the dry period. In the wet period, As had a significant correlation with Cd (r = 0.92, p < 0.01) in sediments. The analysis of environmental risks indicated significant enrichment of sediments with As and Cd. It is important to put in place relevant control mechanisms targeting metals in the studied tributaries, with a focus on As and Cd.
Uncovering the Most Important Factors for Predicting Sexual Desire Using Explainable Machine Learning
Authors: Vowels Laura M. , Vowels Matthew J. , Mark Kristen P.
Published: June 2021

Background

Low sexual desire is the most common sexual problem reported with 34% of women and 15% of men reporting lack of desire for at least 3 months in a 12-month period. Sexual desire has previously been associated with both relationship and individual well-being highlighting the importance of understanding factors that contribute to sexual desire as improving sexual desire difficulties can help improve an individual’s overall quality of life.

Aim

The purpose of the present study was to identify the most salient individual (eg, attachment style, attitudes toward sexuality, gender) and relational (eg, relationship satisfaction, sexual satisfaction, romantic love) predictors of dyadic and solitary sexual desire from a large number of predictor variables.

Methods

Previous research has relied primarily on traditional statistical models which are limited in their ability to estimate a large number of predictors, non-linear associations, and complex interactions. We used a machine learning algorithm, random forest (a type of highly non-linear decision tree), to circumvent these issues to predict dyadic and solitary sexual desire from a large number of predictors across 2 online samples (N = 1,846; includes 754 individuals forming 377 couples). We also used a Shapley value technique to estimate the size and direction of the effect of each predictor variable on the model outcome.

Outcomes

The outcomes included total, dyadic, and solitary sexual desire measured using the Sexual Desire Inventory.

RESULTS

The models predicted around 40% of variance in dyadic and solitary desire with women’s desire being more predictable than men’s overall. Several variables consistently predicted dyadic sexual desire such as sexual satisfaction and romantic love, and solitary desire such as masturbation and attitudes toward sexuality. These predictors were similar for both men and women and gender was not an important predictor of sexual desire.

Clinical Translation

The results highlight the importance of addressing overall relationship satisfaction when sexual desire difficulties are presented in couples therapy. It is also important to understand clients’ attitudes toward sexuality.

Strengths & Limitations

The study improves on existing methodologies in the field and compares a large number of predictors of sexual desire. However, the data were cross-sectional and there may have been variables that are important for desire but were not present in the datasets.

CONCLUSION

Higher sexual satisfaction and feelings of romantic love toward one’s partner are important predictors of dyadic sexual desire whereas regular masturbation and more permissive attitudes toward sexuality predicted solitary sexual desire.
Amenable dynamical systems over locally compact groups
Authors: BEARDEN ALEX , CRANN JASON
Published: June 2021

We establish several new characterizations of amenable
$W^*$
- and
$C^*$
-dynamical systems over arbitrary locally compact groups. In the
$W^*$
-setting we show that amenability is equivalent to (1) a Reiter property and (2) the existence of a certain net of completely positive Herz–Schur multipliers of
$(M,G,\alpha )$
converging point weak* to the identity of
$G\bar {\ltimes }M$
. In the
$C^*$
-setting, we prove that amenability of
$(A,G,\alpha )$
is equivalent to an analogous Herz–Schur multiplier approximation of the identity of the reduced crossed product
$G\ltimes A$
, as well as a particular case of the positive weak approximation property of Bédos and Conti [On discrete twisted
$C^*$
-dynamical systems, Hilbert
$C^*$
-modules and regularity. Münster J. Math.5 (2012), 183–208] (generalized to the locally compact setting). When
$Z(A^{**})=Z(A)^{**}$
, it follows that amenability is equivalent to the 1-positive approximation property of Exel and Ng [Approximation property of
$C^*$
-algebraic bundles. Math. Proc. Cambridge Philos. Soc.132(3) (2002), 509–522]. In particular, when
$A=C_0(X)$
is commutative, amenability of
$(C_0(X),G,\alpha )$
coincides with topological amenability of the G-space
$(G,X)$
.
Approximating stationary deformation of flat and toroidal drops in compressional viscous flow using generalized Cassini ovals
Authors: Lavrenteva O.M. , Ee B.K. , Smagin I. , Nir A.
Published: June 2021

Viscous drops, subject to a linear flow in an immiscible viscous fluid, deform. When the resulting drop shape is simple the problem can be addressed by an asymptotic approach or by approximating the deformation using known simple shapes. When the resulting deformation is more complex, the problem is usually addressed numerically. In this paper, we address the problem of drops that are deforming in an axisymmetric compressional (bi-axial extensional) flow. Yielded shapes are flat drops, flat drops with dimples and toroidal drops. The latter two are highly unstable. We propose to approximate the solution of this problem, approximating the shapes by using generalized Cassini ovals, defined herein. The analysis reproduced the branches with shapes of stationary stable flat drops and stationary unstable toroidal drops, available from numerical calculation. Furthermore, it predicts the point of loss of stability of the flat drop to exhibit the transition branch that leads into the formation of the toroidal shapes, and shows that this branch shows stationary, yet unstable, flat drops with ever growing dimples up to collapse.
Cuisine at the Crossroads
Authors: Morell-Hart Shanti , Pugliese Melanie , McNeil Cameron L. , Barrios Edy
Published: June 2021

Investigations at sites across northwestern Honduras—inside and outside the Maya area—have revealed diverse food activities and ingredients. Paralleling the evidence from durable artifact assemblages, we see transformation over time in materials and practices, as well as the movement of elements across the landscape. Botanical evidence points toward a dynamic overlap between northern and southern societies, with northwestern Honduras serving as a sort of regional crossroads. In this article, we compare cuisines from several ancient communities in northwestern Honduras, using microbotanical and macrobotanical residues. We briefly address the political and historic context of the region and provide abridged biographies of several culinary taxa. Of particular interest are milpa annual crops such as maize and squash, managed and cultivated palm species, wild and managed herbaceous species, edible fruit species, and root and tuberous crops such aslerén, sweet potato, and manioc.
Changing environments and human interaction during the Pleistocene–Early Holocene from the shallow coastal area of Dor, Israel
Authors: Shtienberg Gilad , Gadol Omri , Levy Thomas E. , Norris Richard D. , Rittenour Tammy M. , Yasur-Landau Assaf , Tamberino Anthony , Lazar Michael
Published: June 2021

The protected Tel-Dor coastal embayment in the eastern Mediterranean preserves an unusually complete stratigraphic record that reveals human–environmental interactions throughout the Holocene. Interpretation of new seismic profiles collected from shallow marine geophysical transects across the bay show five seismic units were correlated with stratigraphy and age dates obtained from coastal and shallow-marine sediment cores. This stratigraphic framework permits a detailed reconstruction of the coastal system over the last ca. 77 ka as well as an assessment of environmental factors that influenced some dimensions of past coastal societies. The base of the boreholes records lowstand aeolian deposits overlain by wetland sediments that were subsequently flooded by the mid-Holocene transgression. The earliest human settlements are submerged Pottery Neolithic (8.25–7 ka) structures and tools, found immediately above the wetland deposits landward of a submerged aeolianite ridge at the mouth of the bay. The wetland deposits and Pottery Neolithic settlement remains are buried by coastal sand that records a middle Holocene sea-level rise ca. 7.6–6.5 ka. Stratigraphic and geographic relationships suggest that these coastal communities were displaced by sea-level transgression. These findings demonstrate how robust integration of different data sets can be used to reconstruct the geomorphic evolution of coastal settings as well as provide an important addition to the nature of human–landscape interaction and cultural development.
No effects of sweet taste exposure at breakfast for 3 weeks on pleasantness, desire for, sweetness or intake of other sweet foods: a randomised controlled trial
Authors: Appleton Katherine M. , Rajska Jessica , Warwick Sarah M. , Rogers Peter J.
Published: June 2021

This work investigated the effects of repeated sweet taste exposure at breakfast on perceptions and intakes of other sweet foods, while also examining the effects due to duration of exposure (1/3 weeks), test context (breakfast/lunch) and associations between taste perceptions and intakes. Using a randomised controlled parallel-group design, participants (n 54, 18 male, mean age: 23·9 (sd 5·8) years, mean BMI: 23·6 (sd 3·5) kg/m2) were randomised to consume either a sweet breakfast (cereal with sucralose) (n 27) or an equienergetic non-sweet breakfast (plain cereal) (n 27) for 3 weeks. On days 0 (baseline), 7 and 21, pleasantness, desire to eat and sweetness were rated for other sweet and non-sweet foods and sweet food consumption was assessed in an ad libitum meal at breakfast and lunch. Using intention-to-treat analyses, no statistically significant effects of exposure were found at breakfast (largest F2,104 = 1·84, P = 0·17, ηp2 = 0·03) or lunch (largest F1,52 = 1·22, P = 0·27, ηp2 = 0·02), and using Bayesian analyses, the evidence for an absence of effect in all rating measures was strong to very strong (smallest BF01 = 297·97 (BF01error = 2·68 %)). Associations between ratings of pleasantness, desire to eat and intake were found (smallest r = 0·137, P < 0·01). Effects over time regardless of exposure were also found: sugars and percentage energy consumed from sweet foods increased throughout the study (smallest (F2,104 = 4·54, P = 0·01, ηp2 = 0·08). These findings demonstrate no effects of sweet taste exposure at breakfast for 1 or 3 weeks on pleasantness, desire for, sweetness or intakes of other sweet foods in either the same (breakfast) or in a different (lunch) meal context.
Energy metabolism of cells in the macula flava of the newborn vocal fold from the aspect of mitochondrial microstructure
Authors: Sato K , Chitose S , Sato K , Sato F , Ono T , Umeno H
Published: June 2021

Objective

Cells in the vocal fold of maculae flavae are likely to be tissue stem cells. Energy metabolism of the cells in newborn maculae flavae was investigated from the aspect of mitochondrial microstructure.

Method

Five normal newborn vocal folds were investigated under transmission electron microscopy.

Results

Mitochondria consisted of a double membrane bounded body containing matrices and a system of cristae. However, these membranes were ambiguous. In each mitochondrion, the lamellar cristae were sparse. Intercristal space was occupied by a mitochondrial matrix. Some mitochondria had fused to lipid droplets and rough endoplasmic reticulum, and both the mitochondrial outer and inner membranes had incarcerated and disappeared.

Conclusion

The features of the mitochondria of the cells in the newborn maculae flavae showed that their metabolic activity and oxidative phosphorylation were low. The metabolism of the cells in the newborn maculae flavae seems to be favourable to maintain the stemness and undifferentiation of the cells.
Gender and payments for environmental services: impacts of participation, benefit-sharing and conservation activities in Viet Nam
Authors: McElwee Pamela , Lê Huệ Thị Văn , Nghiêm Tuyến Phương , Vũ Hương Diệu , Trần Nghị Hữư
Published: June 2021

There has been a rapid expansion in the use of payments for environmental services (PES) as a key conservation finance policy. However, there is insufficient understanding of how gender can affect PES implementation and outcomes. We present results from a case study in Viet Nam, where a national PES programme has been in place for a decade. Through panel household survey data, focus groups and interviews, we examined how women have been involved in PES policies, what the impacts have been on decision-making by men and women, participation rates and use of PES income over time, and the potential conservation outcomes. Our research confirms that resource use varies between men and women, and changes in access rights can fall disproportionately on women. Participation in PES has been lower for female-headed households and for women within male-headed households, although gradually more equitable participation has evolved within households. Female-headed households reported expending more yearly effort on PES activities despite protecting less land, and also increased their conservation activities over time as they presumably became more familiar with PES. Use of income from PES also showed differences between male and female-led households, with men more likely to spend funds on non-essential goods. Within households, although men initially decided how to spend PES money, decision-making has become more equitable over time. We conclude with some recommendations on how to increase attention to gender in PES projects and future research to improve outcomes.
Identity recognition on waterways: a novel ship information tracking method based on multimodal data
Authors: Huang Zishuo , Hu Qinyou , Mei Qiang , Yang Chun , Wu Zheng
Published: June 2021

Video monitoring is an important means of ship traffic supervision. In practice, regulators often need to use an electronic chart platform to determine basic information concerning ships passing through a video feed. To enrich the information in the surveillance video and to effectively use multimodal maritime data, this paper proposes a novel ship multi-object tracking technology based on improved single shot multibox detector (SSD) and DeepSORT algorithms. In addition, a night contrast enhancement algorithm is used to enhance the ship identification performance in night scenes and a multimodal data fusion algorithm is used to incorporate the ship automatic identification system (AIS) information into the video display. The experimental results indicate that the ship information tracking accuracies in the day and night scenes are 78⋅2% and 70⋅4%, respectively. Our method can effectively help regulators to quickly obtain ship information from a video feed and improve the supervision of a waterway.
#SupportLocal: how online food delivery services leveraged the COVID-19 pandemic to promote food and beverages on Instagram
Authors: Jia Si Si , Raeside Rebecca , Redfern Julie , Gibson Alice A , Singleton Anna , Partridge Stephanie R
Published: June 2021

Objective:

To explore the promotion of discretionary foods/beverages and marketing strategies employed by the top three online food delivery services’ (OFDS) Instagram accounts in three countries before and during the coronavirus disease 2019 (COVID-19) pandemic.

Design:

Publicly available data were extracted for the top three OFDS Instagram accounts for Australia, United Kingdom (UK) and the United States of America (USA) from March to May 2019 and 2020. Food/beverage items from posts were classified as ‘discretionary’ or from the five food groups (FFG) according to the Australian Dietary Guidelines. Marketing strategies were coded using an existing framework. Posts referring to COVID-19 were coded under four marketing strategies: (i) appropriating frontline workers; (ii) combatting the pandemic; (iii) selling social distancing; and (iv) accelerating digitalisation.

Results:

From 581 posts, 618 food/beverage items were shown, of which 69 % (427/618) were classified as discretionary. In 2019, the most used marketing strategies were product imagery (unbranded) (137/195, 70 %), links (111/195, 57 %) and sponsorships/partnerships (58/195, 30 %). In 2020, the most used were links (252/386, 68 %), product imagery (unbranded) (179/386, 49 %) and branding elements (175/386, 45 %). The most common COVID-19 marketing strategy was combatting the pandemic (76/123, 62 %) followed by selling social distancing (53/123, 43 %), appropriating frontline workers (34/123, 28 %) and accelerating digitalisation (32/123, 26 %).

Conclusions:

Following the COVID-19 pandemic, OFDS adapted their marketing, creating content with the theme of ‘combatting the pandemic’. Due to the growing number of discretionary foods/beverages promoted on Instagram, this highlights the need for policy action to counter the potential influence social media platforms have on dietary behaviours.
Validity and reliability of the Turkish version of the Patient Dignity Inventory
Authors: Eskigülek Yasemin , Kav Sultan
Published: June 2021

Objective

The aim of this study was to investigate the validity and reliability of the Patient Dignity Inventory (PDI) in the Turkish society, which was developed to evaluate dignity-related distress in palliative care patients.

Methods

One hundred and twenty-seven adults with advanced cancer hospitalized in several clinics of two university hospitals were included in the study. The patients whose Palliative Performance Scale score was at least 40% were recruited to study. The data were collected with a patient demographic form, the Turkish version of Hospital Anxiety and Depression Scale (HADS-TR), and the Turkish version of the PDI (PDI-TR). The PDI-TR was finalized and back-translated after translating into Turkish and obtaining 10 expert opinions. Exploratory and confirmatory factor analysis, internal consistency, concurrent validity, and test–retest reliability analysis were performed.

Results

The Cronbach's α coefficient of PDI-TR was 0.94. Factor analysis resulted in a five-factor solution, and all items were loaded on factors. Factors were labeled as symptom distress, existential distress, self-confidence, dependency, and supportive care needs and accounted for 68.70% of the overall variance. The model's normed fit index, comparative fit index, and X2/SD were found between acceptable range (0.90, 0.93, and 2.64, respectively). A positive and strong correlation was found between subdimension scores of HADS-TR and the total score of PDI-TR (r = 0.70 for anxiety subdimension; r = 0.73 for depression subdimension). The test–retest reliability was conducted with 32 patients within the sample two weeks after the first application, and no significant difference was found between the two application scores as the result of paired-sample t-test (p > 0.05). An intraclass correlation coefficient of test–retest reliability was r = 0.855.

Significance of results

PDI-TR was found to be a valid and reliable tool in palliative care patients in Turkish society.
A single layer wideband metasurface absorber for electromagnetic interference minimization in Ku-band applications
Authors: Khanna Yogita , Awasthi Y. K.
Published: June 2021

In this paper, a wideband ultrathin metasurface absorber is investigated. The proposed absorber comprises a periodic array of a unit cell ring structure. The ring structure and patch inside are tuned to realize the desired frequency bandwidth. The structure has a frequency bandwidth of 7.4 GHz with a center frequency of 15 GHz and fractional bandwidth of 50%. Simulated and measured results show that the absorption at normal incidence is above 90% in the frequency range of 11.3–18.7 GHz. Furthermore, the thickness of the structure is 1.6 mm. The physical mechanism of the metasurface absorber has been analyzed and justified experimentally.
The contestation and construction of global governance authorities: A study from the global business and human rights regime
Authors: Mende Janne
Published: June 2021

The contestation of global governance institutions can strengthen or weaken, as well as transform, them. This article analyses the productive potential of contestation and justification of global governance institutions by examining the multiple authorities that are invoked as auxiliaries in the process. It studies the (re-)construction of these authorities by dissecting authority into three components: power, legitimacy and connection to public interests. Empirically, the article focuses on the issue area of business and human rights, examining the highly contested process of drafting a binding instrument in the United Nations Treaty Process. The analysis shows that the success of the Treaty Process not only hinges on its direct reaction to contestation, but also on its ability to (re-)construct the multiple related authorities. Ultimately, the article argues that the contestation of global governance institutions involves (re-)constructing multiple authorities. This demonstrates how contestation can also affect global governance institutions, actors and norms beyond the specific field of deliberation.
The Influence of Atmospheric Rivers on Cold‐Season Precipitation in the Upper Great Lakes Region
Authors: Mateling Marian E. , Pettersen Claire , Kulie Mark S. , Mattingly Kyle S. , Henderson Stephanie A. , L’Ecuyer Tristan S.
Published: June 2021

This study aims to identify the impacts of atmospheric rivers (AR) associated with cold‐season precipitation in the Upper Great Lakes region of the United States. A MERRA‐2‐derived AR dataset is combined with data from a suite of instruments hosted by the National Weather Service in Marquette, Michigan, including a profiling radar and a video disdrometer. ARs coincide with deep, synoptically‐forced precipitation 28% of the time during the cold season. These ARs are found to intrude from the southwest and are associated with warmer surface and upper‐level temperatures, increased radar reflectivity values, and enhanced precipitation rates. Warmer atmospheric temperatures aloft associated with ARs lead to a fourfold increase in the likelihood that cold‐season precipitation will be rain instead of snow. Additionally, inland ARs in the Upper Great Lakes region are correlated with the negative phases of the Pacific Decadal Oscillation and the Pacific‐North American pattern.
Symbiotic and Free‐Living N2 Fixation in Subtropical Pueraria lobata Communities of Southwest China
Authors: Zhou Junniu , Ma Jiangming , Li Dejun
Published: June 2021

Biological N2 fixation plays crucial roles in determining the pattern and pace of ecological succession and carbon sequestration. Nevertheless, the rates and controls of symbiotic (SNF) and free‐living (FNF) N2 fixation have rarely been investigated simultaneously. Here we measured SNF and soil FNF rates for eight early succession ecosystems dominated by kudzu (Pueraria lobata (Willd.) Ohwi) in a subtropical region of China in growing and nongrowing seasons. N2 fixation rates were measured using acetylene reduction assay against a 15N2 uptake method. Both SNF and soil FNF rates were significantly higher in the growing season than in the nongrowing season. The two forms of N2 fixation contributed equally to total N2 fixation rate across the eight sites with soil FNF being higher than SNF in half of the sites. Total N2 fixation rates ranged from 7.12 to 61.93 kg N ha−1 yr−1 with an average of 22.93 ± 6.52 kg N ha−1 yr−1. N2 fixation contributed significantly to soil nitrogen and carbon accumulation. Both SNF and FNF were significantly related to soil moisture. Additionally, SNF and soil FNF were strongly correlated with phosphorus availability and vanadium/iron availability, respectively, most likely implying that SNF was limited by phosphorus and soil FNF was limited by vanadium or iron. Our findings suggest that SNF and soil FNF may be limited by different sets of nutrients within an ecosystem.
Epicardial adipose tissue differentiates in patients with and without coronary microvascular dysfunction
Authors: Mahmoud Ihab , Dykun Iryna , Kärner Luisa , Hendricks Stefanie , Totzeck Matthias , Al-Rashid Fadi , Rassaf Tienush , Mahabadi Amir A.
Published: June 2021

Background/Objectives

Coronary microvascular dysfunction (CMD) is a common disorder, leading to symptoms similar to obstructive coronary artery disease and bears important prognostic implications. Local inflammation is suggested to promote development of CMD. Epicardial adipose tissue (EAT) is a local visceral fat depot surrounding the heart and the coronary arteries, modifying the inflammatory environment of the heart. We compared EAT in patients with and without CMD.

Methods

We retrospectively included consecutive patients undergoing diagnostic coronary angiography as well as transthoracic echocardiography between March and October 2016. EAT thickness was defined as space between the epicardial wall of the myocardium and the visceral layer of the pericardium and EAT index was calculated as EAT thickness/body surface area. Logistic regression analysis was used to determine the association of EAT index with the presence of CMD.

Results

Overall, 399 patients (mean age 60.2 ± 14.0 years, 46% male) were included. EAT thickness was significantly higher in patients with CMD compared to patients without CMD (EAT thickness 4.4 ± 1.8 vs. 4.9 ± 2.4 mm, p = 0,048 for patients without and with CMD, respectively). In univariate regression analysis, EAT index was associated with a 30% higher frequency of CMD (odds ratio [95% confidence interval]: 1.30 [1.001–1.69], p = 0.049). Effect sizes remained stable upon adjustment for body mass index (BMI, 1.30 [1.003–1.70], p = 0.048), but were attenuated when ancillary adjusting for age and gender (1.17 [0.90–1.54, p = 0.25). The effect was more pronounced in patients >65 years of age and independent of BMI and sex (1.85 [1.14–3.00], p = 0.013).

Conclusion

EAT thickness is independently associated with CMD and can differentiate between patients with and without CMD especially in older age groups. Our results support the hypothesis that modulation of local inflammation by epicardial fat is involved in the development of CMD.
Preclinical evaluation of eltrombopag in a PDX model of myelodysplastic syndromes
Authors: Schmitt Nanni , Jann Johann-Christoph , Altrock Eva , Flach Johanna , Danner Justine , Uhlig Stefanie , Streuer Alexander , Knaflic Antje , Riabov Vladimir , Xu Qingyu , Mehralivand Arwin , Palme Iris , Nowak Verena , Obländer Julia , Weimer Nadine , Haselmann Verena , Jawhar Ahmed , Darwich Ali , Weis Cleo-Aron , Marx Alexander , Steiner Laurenz , Jawhar Mohamad , Metzgeroth Georgia , Boch Tobias , Nolte Florian , Hofmann Wolf-Karsten , Nowak Daniel
Published: June 2021

Preclinical research of myelodysplastic syndromes (MDSs) is hampered by a lack of feasible disease models. Previously, we have established a robust patient-derived xenograft (PDX) model for MDS. Here we demonstrate for the first time that this model is applicable as a preclinical platform to address pending clinical questions by interrogating the efficacy and safety of the thrombopoietin receptor agonist eltrombopag. Our preclinical study included n = 49 xenografts generated from n = 9 MDS patient samples. Substance efficacy was evidenced by FACS-based human platelet quantification and clonal bone marrow evolution was reconstructed by serial whole-exome sequencing of the PDX samples. In contrast to clinical trials in humans, this experimental setup allowed vehicle- and replicate-controlled analyses on a patient–individual level deciphering substance-specific effects from natural disease progression. We found that eltrombopag effectively stimulated thrombopoiesis in MDS PDX without adversely affecting the patients’ clonal composition. In conclusion, our MDS PDX model is a useful tool for testing new therapeutic concepts in MDS preceding clinical trials.
Phase I First-in-Human Dose Escalation Study of the oral SF3B1 modulator H3B-8800 in myeloid neoplasms
Authors: Steensma David P. , Wermke Martin , Klimek Virginia M. , Greenberg Peter L. , Font Patricia , Komrokji Rami S. , Yang Jay , Brunner Andrew M. , Carraway Hetty E. , Ades Lionel , Al-Kali Aref , Alonso-Dominguez Juan M. , Alfonso-Piérola Ana , Coombs Catherine C. , Deeg H. Joachim , Flinn Ian , Foran James M. , Garcia-Manero Guillermo , Maris Michael B. , McMasters Malgorzata , Micol Jean-Baptiste , De Oteyza Jaime Perez , Thol Felicitas , Wang Eunice S. , Watts Justin M. , Taylor Justin , Stone Richard , Gourineni Vikram , Marino Alyssa J. , Yao Huilan , Destenaves Benoit , Yuan Xiaobin , Yu Kun , Dar Sara , Ohanjanian Lernik , Kuida Keisuke , Xiao Jianjun , Scholz Catherine , Gualberto Antonio , Platzbecker Uwe
Published: June 2021

We conducted a phase I clinical trial of H3B-8800, an oral small molecule that binds Splicing Factor 3B1 (SF3B1), in patients with MDS, CMML, or AML. Among 84 enrolled patients (42 MDS, 4 CMML and 38 AML), 62 were red blood cell (RBC) transfusion dependent at study entry. Dose escalation cohorts examined two once-daily dosing regimens: schedule I (5 days on/9 days off, range of doses studied 1–40 mg, n = 65) and schedule II (21 days on/7 days off, 7–20 mg, n = 19); 27 patients received treatment for ≥180 days. The most common treatment-related, treatment-emergent adverse events included diarrhea, nausea, fatigue, and vomiting. No complete or partial responses meeting IWG criteria were observed; however, RBC transfusion free intervals >56 days were observed in nine patients who were transfusion dependent at study entry (15%). Of 15 MDS patients with missense SF3B1 mutations, five experienced RBC transfusion independence (TI). Elevated pre-treatment expression of aberrant transcripts of Transmembrane Protein 14C (TMEM14C), an SF3B1 splicing target encoding a mitochondrial porphyrin transporter, was observed in MDS patients experiencing RBC TI. In summary, H3B-8800 treatment was associated with mostly low-grade TAEs and induced RBC TI in a biomarker-defined subset of MDS.
Neurexin 1 variants as risk factors for suicide death
Authors: William Nancy , Reissner Carsten , Sargent Robert , Darlington Todd M. , DiBlasi Emily , Li Qingqin S. , Keeshin Brooks , Callor William B. , Ferris Elliott , Jerominski Leslie , Smith Ken R. , Christensen Erik D. , Gray Douglas M. , Camp Nicola J. , Missler Markus , Williams Megan E. , Coon Hilary
Published: June 2021

Suicide is a significant public health concern with complex etiology. Although the genetic component of suicide is well established, the scope of gene networks and biological mechanisms underlying suicide has yet to be defined. Previously, we reported genome-wide evidence that neurexin 1 (NRXN1), a key synapse organizing molecule, is associated with familial suicide risk. Here we present new evidence for two non-synonymous variants (rs78540316; P469S and rs199784139; H885Y) associated with increased familial risk of suicide death. We tested the impact of these variants on binding interactions with known partners and assessed functionality in a hemi-synapse formation assay. Although the formation of hemi-synapses was not altered with the P469S variant relative to wild-type, both variants increased binding to the postsynaptic binding partner, leucine-rich repeat transmembrane neuronal 2 (LRRTM2) in vitro. Our findings indicate that variants in NRXN1 and related synaptic genes warrant further study as risk factors for suicide death.
Activated T cell-derived exosomal PD-1 attenuates PD-L1-induced immune dysfunction in triple-negative breast cancer
Authors: Qiu Yufan , Yang Yi , Yang Riyao , Liu Chunxiao , Hsu Jung-Mao , Jiang Zhou , Sun Linlin , Wei Yongkun , Li Chia-Wei , Yu Dihua , Zhang Jin , Hung Mien-Chie
Published: June 2021

Programmed cell death 1 (PD-1) is widely expressed in tumor-infiltrating lymphocytes (TILs) of triple-negative breast cancer (TNBC). As a dominant inhibitory immune checkpoint (ICP) receptor, cell surface PD-1 is well-known to transduce negative signaling of effector T cell activity during cell–cell contact. However, despite its well-documented inhibitory effects, higher PD-1 expression in TILs is significantly associated with longer survival in TNBC patients. This phenomenon raises an interesting question whether PD-1 harbors positive activity to enhance anti-tumor immunity. Here, we show that PD-1 is secreted in an exosomal form by activated T cells and can remotely interact with either cell surface or exosomal programmed death-ligand 1 (PD-L1), induce PD-L1 internalization via clathrin-mediated endocytosis, and thereby prevent subsequent cellular PD-L1: PD-1 interaction, restoring tumor surveillance through attenuating PD-L1-induced suppression of tumor-specific cytotoxic T cell activity. Our results, through revealing an anti-PD-L1 function of exosomal PD-1, provide a positive role to enhance cytotoxic T cell activity and a potential therapeutic strategy of modifying the exosome surface with membrane-bound inhibitory ICP receptors to attenuate the suppressive tumor immune microenvironment.
Kras activation in endometrial organoids drives cellular transformation and epithelial-mesenchymal transition
Authors: Maru Yoshiaki , Tanaka Naotake , Tatsumi Yasutoshi , Nakamura Yuki , Itami Makiko , Hippo Yoshitaka
Published: June 2021

KRAS, an oncogene, is frequently activated by mutations in many cancers. Kras-driven adenocarcinoma development in the lung, pancreas, and biliary tract has been extensively studied using gene targeting in mice. By taking the organoid- and allograft-based genetic approach to these organs, essentially the same results as in vivo models were obtained in terms of tumor development. To verify the applicability of this approach to other organs, we investigated whether the combination of Kras activation and Pten inactivation, which gives rise to endometrial tumors in mice, could transform murine endometrial organoids in the subcutis of immunodeficient mice. We found that in KrasG12D-expressing endometrial organoids, Pten knockdown did not confer tumorigenicity, but Cdkn2a knockdown or Trp53 deletion led to the development of carcinosarcoma (CS), a rare, aggressive tumor comprising both carcinoma and sarcoma. Although they originated from epithelial cells, some CS cells expressed both epithelial and mesenchymal markers. Upon inoculation in immunodeficient mice, tumor-derived round organoids developed carcinoma or CS, whereas spindle-shaped organoids formed monophasic sarcoma only, suggesting an irreversible epithelial-mesenchymal transition during the transformation of endometrial cells and progression. As commonly observed in mutant Kras-driven tumors, the deletion of the wild-type Kras allele was identified in most induced tumors, whereas some epithelial cells in CS-derived organoids were unexpectedly negative for KrasG12D. Collectively, we showed that the oncogenic potential of KrasG12D and the histological features of derived tumors are context-dependent and varies according to the organ type and experimental settings. Our findings provide novel insights into the mechanisms underlying tissue-specific Kras-driven tumorigenesis.
New genetic variants associated with major adverse cardiovascular events in patients with acute coronary syndromes and treated with clopidogrel and aspirin
Authors: Liu Xiaomin , Xu Hanshi , Xu Huaiqian , Geng Qingshan , Mak Wai-Ho , Ling Fei , Su Zheng , Yang Fang , Zhang Tao , Chen Jiyan , Yang Huanming , Wang Jian , Zhang Xiuqing , Xu Xun , Jia Huijue , Zhang Zhiwei , Liu Xiao , Zhong Shilong
Published: June 2021

Although a few studies have reported the effects of several polymorphisms on major adverse cardiovascular events (MACE) in patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary intervention (PCI), these genotypes account for only a small fraction of the variation and evidence is insufficient. This study aims to identify new genetic variants associated with MACE end point during the 18-month follow-up period by a two-stage large-scale sequencing data, including high-depth whole exome sequencing of 168 patients in the discovery cohort and high-depth targeted sequencing of 1793 patients in the replication cohort. We discovered eight new genotypes and their genes associated with MACE in patients with ACS, including MYOM2 (rs17064642), WDR24 (rs11640115), NECAB1 (rs74569896), EFR3A (rs4736529), AGAP3 (rs75750968), ZDHHC3 (rs3749187), ECHS1 (rs140410716), and KRTAP10-4 (rs201441480). Notably, the expressions of MYOM2 and ECHS1 are downregulated in both animal models and patients with phenotypes related to MACE. Importantly, we developed the first superior classifier for predicting 18-month MACE and achieved high predictive performance (AUC ranged between 0.92 and 0.94 for three machine-learning methods). Our findings shed light on the pathogenesis of cardiovascular outcomes and may help the clinician to make a decision on the therapeutic intervention for ACS patients.
TNF-α induces endothelial–mesenchymal transition promoting stromal development of pancreatic adenocarcinoma
Authors: Adjuto-Saccone Marjorie , Soubeyran Philippe , Garcia Julie , Audebert Stéphane , Camoin Luc , Rubis Marion , Roques Julie , Binétruy Bernard , Iovanna Juan Lucio , Tournaire Roselyne
Published: June 2021

Endothelial–mesenchymal transition (EndMT) is an important source of cancer-associated fibroblasts (CAFs), which facilitates tumour progression. PDAC is characterised by abundant CAFs and tumour necrosis factor-α (TNF-α). Here, we show that TNF-α strongly induces human endothelial cells to undergo EndMT. Interestingly, TNF-α strongly downregulates the expression of the endothelial receptor TIE1, and reciprocally TIE1 overexpression partially prevents TNF-α-induced EndMT, suggesting that TNF-α acts, at least partially, through TIE1 regulation in this process. We also show that TNF-α-induced EndMT is reversible. Furthermore, TNF-α treatment of orthotopic mice resulted in an important increase in the stroma, including CAFs. Finally, secretome analysis identified TNFSF12, as a regulator that is also present in PDAC patients. With the aim of restoring normal angiogenesis and better access to drugs, our results support the development of therapies targeting CAFs or inducing the EndMT reversion process in PDAC.
CT45A1 promotes the metastasis of osteosarcoma cells in vitro and in vivo through β-catenin
Authors: Wen Mingxin , Ren Hui , Zhang Shouqiang , Li Tao , Zhang Jiefeng , Ren Peng
Published: June 2021

Increased expression of cancer/testis antigens (CTAs) is reported in various tumors. However, the unique role of CTAs in tumor genesis has not yet been verified. Here, we first report the functional role of CT45A1 in the carcinogenesis of osteosarcoma. RNA sequencing and immunohistochemistry confirmed that elevated expression of CT45A1 was detected in osteosarcoma, especially in metastatic tissues of osteosarcoma. Furthermore, osteosarcoma patients with poorer prognosis showed high expression of CT45A1. In cell tests, CT45A1 overexpression was shown to strengthen the proliferation, migration, and invasion abilities of osteosarcoma cells, while silencing CT45A1 markedly elicited the opposite effects in these tests by disrupting the activation of β-catenin. In summary, we identify a novel role of CT45A1 in osteosarcoma. Furthermore, our results suggested that CT45A1 may contribute to the development of osteosarcoma and could be a possible therapeutic target for osteosarcoma patients.