bluuebunny/crossref_metadata_2025 huggingface dataset:
An Automated Optimize Utilization of Water and Crop Monitoring in Agriculture Using IoT
Authors: Dogiwal Sanwta Ram , Dadheech Pankaj , Kumar Ankit , Raja Linesh , Kumar Abhishek , Kumar Beniwal Mahender
Published: April 2021

AI Solution for Farmers is an agricultural based project, created to help farmers and to help them in increasing their productivity. Since the technologies are running the world, why agriculture must be deprived of it. Agriculture is one of the most important areas that have major impacts on the economy and society of a country. Technological developments serve as tools to share knowledge and practices of agricultural products and make more satisfactory lives for farmers, traders, policymakers, and the overall society. It is evident that knowledge has become a crucial component in production, society, food security, health, poverty, and other millennium development goals. The use of technology may provide a better approach to solve the problems arising from sowing the seed to harvest the crop. The new technologies like Machine Learning and Data Science may be great help to have an eye on the deciding factors to the growth of crop.
Multiple Watermarking Scheme for Video & Image for Authentication & Copyright Protection
Authors: Janu Neha , Kumar Ankit , Dadheech Pankaj , Sharma Gajanand , Kumar Ashutosh , Raja Linesh
Published: April 2021

Watermarking has been used frequently to authenticate the accuracy and security of the image and video files. In the world of computer technology, several watermarking strategies have developed during the past 20 years. Integrate a picture of identity that is not always concealed, such that no detail is not possible to delete. A monitoring code can also be used to deter unauthorized recording equipment. Another application is the watermark copyright control, which works at stopping the creator of the image from stealing photos unlawfully. A watermark is a promising option for the copyright transcendence of multi-media files, as embedded messages are still included. Due to the limits of fidelity, a watermark may be implemented in a small multimedia data space. There is no proof that Automated Watermarking technologies will fulfil the ultimate purpose of the cleaners of all sorts of copyright security operations to gather knowledge from the data they obtain. Relevant situations may be deemed more fairly expected with the usage of automated copyright marking technologies. A perfect device will not be able to add a digital watermark without the limit, which does not supply the whole object with details. In this work, a modern technique for watermarking includes injecting two or more messages or photographs into a single picture for protection purposes and repeating a similar procedure for N-frames for authentication in the film.
The effect of injection process for microcellular foaming on the cell morphology and surface quality of Polyamide 6
Authors: Jiang Tuanhui , Zhang Heng , Zeng Xiangbu , Zhang Chun , Gong Wei , He Li
Published: April 2021

Microcellular foamed polymers have been widely used in the traffic field. However, it is difficult to successfully manufacture microcellular foamed products that simultaneously possess good cell morphology, small size, high cell density, and great surface quality. In this paper, polyamide 6 (PA6) injection microcellular foams were manufactured via short-shot and core-back foaming process to investigate the effect of the foaming process on cell quality and surface quality. Results showed that the core-back injection PA6 foams possessed a smaller cell size, higher cell density, lower cell deformation, and greater surface glossiness than short-shot foams. The cell density of core-back PA6 microcellular foams reached to 12.5 × 105 cell/cm3, which is almost 3.5 times greater than that of the short-shot foams when the weight reduction was 10%. The PA6 microcellular foams manufactured via the core-back foaming process had higher surface glossiness with different weight reduction, whereas the surface glossiness of short-shot microcellular foams dramatically declined with an increase in weight reduction. Hence, the core-back foaming process can be used to fabricate microcellular foamed polymers with good cell morphology, small size, high cell density, and fine surface quality under high weight reduction; this was beneficial for producing products that have good surface quality and high weight reduction and are used in automobiles, high-speed trains, and airplanes to reduce energy consumption.
Highly compressible graphene aerogel with high thermal conductivity along both in-plane and through-plane directions
Authors: Lv Peng , Miao Haipeng , Ji Chenglong , Wei Wei
Published: April 2021

Graphene-based thermal interface materials (TIMs), such as horizontal graphene papers and vertical graphene monoliths, commonly possess high thermal conductivity (TC) only along either in-plane or through-plane direction due to their high anisotropy structure. Three-dimensional (3D) graphene monoliths with interconnected network can extend the excellent thermal transport performances of two-dimensional graphene to macro monoliths along multi-directions. However, the high porosity of 3D graphene monoliths usually leads to low TC. Here, highly compressible graphene aerogels (HCGAs) with closely packed cell walls and regularly cellular structure were prepared. The HCGAs can be highly compressed (95% compressive strain) to reduce the porosity while maintaining the continuously thermal transport paths. Significantly increased TC along both in-plane and through-plane directions can be obtained by directly mechanical compression of the aerogels. HCGAs with initial density of 11.5 mg cm−3 at 95% compressive strain possess in-plane TC of 167.2 W m−1K−1 and through-plane TC of 46.8 W m−1K−1, which outperforms other carbon-based TIMs reported previously.
Exploring lignin valorisation: the application of photocatalysis for the degradation of the β-5 linkage
Authors: Murnaghan Christopher W J , Skillen Nathan , Hardacre Christopher , Bruce John , Sheldrake Gary N , Robertson Peter K J
Published: April 2021

The valorisation of lignin has gained significant interest in bioenergy, which is driven by the abundance of the material coupled with the potential to form value-added compounds. As a result, the range of technologies deployed for this application has increased and more recently includes advanced oxidation processes such as photocatalysis. The complexity of lignin is challenging however, and therefore model compounds, which represent key linkages in the native structure, have become crucial as both a tool for evaluating novel technologies and for providing an insight into the mechanism of conversion. Previously, the β-O-4 dimer, the most abundant linkage found in native lignin, has been extensively used as a model compound. Described herein, however, is the first report of photocatalytic TiO2 technology for the degradation of a β-5 model dimer. Under low power UV-light emitting diode irradiation, complete degradation of the β-5 compound (6.3 × 10−3 mg ml−1 min−1) was achieved along with formation and subsequent removal of reaction intermediates. Investigation into the mechanism revealed within the first 2 min of irradiation there was the formation of a diol species due to consumption of the alkene sidechain. Although the data presented highlights the complexity of the system, which is underpinned by multiple oxidative reaction pathways, an overview of the key photocatalytic processes are discussed including the impact of acetonitrile and role of reactive oxygen species.
Arc plasma ablation of quartz crystals
Authors: Corbella Carles , Portal Sabine , Keidar Michael
Published: April 2021

Spherical quartz stones of around 1 cm in diameter have been exposed to anodic arc discharges in a helium atmosphere at 300 Torr. The arc current flowing between the graphite electrodes was set either in continuous DC mode (30–150 A) or in pulsed mode at 2 Hz (220 A peak). The ablation rate in each sample was systematically measured after several seconds of arc plasma treatment. Optical emission spectroscopy (OES) diagnostics and 2D fluid simulations of the arc discharge have shed light on the heat flux transport and the heating mechanisms of the quartz crystals. A linear correlation is found between the absorbed power density and the resulting rate of penetration, which yields a maximal value of 15 cm h−1 for approximately 150 W cm−2. The linear fit on the slope provides a specific energy of 40 kJ cm−3. The incident energy flux onto the sample surface promoted a phase transition from crystalline to glassy silica, as characterized via Raman spectroscopy. This study points out the strong potential of arc plasma technology for geothermal drilling applications.
The coupled effects of an electron blocking layer beneath tribomaterials for boosted triboelectric nanogenerators
Authors: Hwang Hee Jae , Choi Dukhyun
Published: April 2021

Triboelectric nanogenerators (TENGs) have been studied from 2012 to help increase output performance. However, most studies are focused on negatively charged tribomaterials for high output performance. This study demonstrates the possibility of boosted triboelectric output performance by embedding an electron blocking layer (EBL) at the interface between electrode polymers in positively charged tribomaterials as well as negatively charged tribomaterials, as a coupled effect. We used TiO
x
with a high dielectric constant as an EBL and analyzed the orbital structure of TiO
x
to verify levels of charge transfer with different thicknesses of TiO
x
. As a result, we achieved the output performance (121.2 V, 5.1 μA) of a TENG by inserting a TiO
x
-EBL-100 nm with 2.5 Hz, 5 N, which is an increase of as much as eight times compared to the output performance without the TiO
x
-EBL. The increase in the output performance of the TENG is attributed not only to the excellent charge transport of the TiO
x
-EBL but also to the additive polarization in the electric field surface. We suggest this result presents a strategy to improve the output performance through the polymer used as both the positively charged material and a negatively charged material by embedding the ETL.
Complex systems of Kuramoto–sine-Gordon solitons
Authors: Lohe M A
Published: April 2021

The 1 + 1 dimensional Kuramoto–sine-Gordon system consists of a set of N nonlinear coupled equations for N scalar fields θ

i
, which constitute the nodes of a complex system. These scalar fields interact by means of Kuramoto nonlinearities over a network of connections determined by N(N − 1)/2 symmetric coupling coefficients a

ij
. This system, regarded as a chirally invariant quantum field theory, describes a single decoupled massless field together with N − 1 scalar boson excitations of nonzero mass depending on a

ij
, which propagate and interact over the network. For N = 2 the equations decouple into separate sine-Gordon and wave equations. The system allows an extensive array of soliton configurations which interpolate between the various minima of the 2π-periodic potential, including sine-Gordon solitons in both static and time-dependent form, as well as double sine-Gordon solitons which can be imbedded into the system for any N. The precise form of the stable soliton depends critically on the coupling coefficients a

ij
. We investigate specific configurations for N = 3 by classifying all possible potentials, and use the symmetries of the system to construct static solitons in both exact and numerical form.
Area efficient in-plane nanomagnetic multiplier and convolution architecture design
Authors: Sivasubramani Santhosh , Debroy Sanghamitra , Acharyya Amit
Published: April 2021

In this study, we propose a nanomagnetic logic (NML) based 2 bit multiplier architecture design for the first time to the best of author’s knowledge. This complex combinational logic (nanomagnetic multiplier) design proposed is built by exploiting shape, positional hybrid anisotropy and the ferromagnetically coupled fixed input majority gate. Subsequently, we extend this proposed multiplier architecture along with the NML adder architecture in introducing NML based convolution architecture design which is efficient in terms of number of nanomagnets, majority gates and clock-cycles. The proposed NML design yields ∼21%–72%, ∼26%–42%, ∼36%–63%, and ∼20%–68%, reduction in the required number of nanomagnets, majority gate, clock cycles and energy compared to the state-of-the-art designs.
Global Trends in Plastic Surgery on Social Media: Analysis of 2 Million Posts
Authors: Braun Sterling E , O’Connor Michaela K , Hornick Margaret M , Cullom Melissa E , Butterworth James A
Published: April 2021

Background

Plastic surgeons and patients increasingly use social media. Despite evidence implicating its importance in plastic surgery, the large volume of data has made social media difficult to study.

Objectives

The aim of this study was to provide a comprehensive assessment of plastic surgery social media content worldwide by utilizing techniques for analyzing large-scale data.

Methods

The hashtag “#PlasticSurgery” was used to search public Instagram posts. Metadata were collected from posts between December 2018 and August 2020. In addition to descriptive analysis, 2 instruments were created to characterize textual data: a multilingual dictionary of procedural hashtags and a rule-based text classification model to categorize the source of the post.

Results

Plastic surgery content yielded more than 2 million posts, 369 million likes, and 6 billion views globally over the 21-month study. The United States had the most posts of 182 countries studied (26.8%, 566,206). Various other regions had substantial presence including Istanbul, Turkey, which led all cities (4.8%, 102,208). The classification model achieved high accuracy (94.9%) and strong agreement with independent raters (κ = 0.88). Providers accounted for 40% of all posts (847,356) and included the categories physician (28%), plastic surgery (9%), advanced practice practitioners and nurses (1.6%), facial plastics (1.3%), and oculoplastics (0.2%). Content between plastic surgery and non–plastic surgery groups demonstrated high textual similarity, and only 1.4% of posts had a verified source.

Conclusions

Plastic surgery content has immense global reach in social media. Textual similarity between groups coupled with the lack of an effective verification mechanism presents challenges in discerning the source and veracity of information.
Facial Surface Anthropometric Features and Measurements With an Emphasis on Rhinoplasty
Authors: Celikoyar M Mazhar , Pérez Michael F , Akbaş M Ilhan , Topsakal Oguzhan
Published: April 2021

Background

Facial features and measurements are utilized to analyze patients’ faces for various reasons, including surgical planning, scientific communications, patient-surgeon communications, and post-surgery evaluations.

Objectives

There are numerous descriptions regarding these features and measurements scattered throughout the literature, and the authors did not encounter a current compilation of these parameters in the medical literature.

Methods

A narrative literature review of the published medical literature for facial measurements used for facial analysis in rhinoplasty was conducted through the electronic databases MEDLINE/PubMed and Google Scholar, along with a citation search.

Results

A total of 61 facial features were identified: 45 points (25 bilateral, 20 unilateral), 5 lines (3 bilateral, 2 unilateral), 8 planes, and 3 areas.

A total of 122 measurements were identified: 48 distances (6 bilateral, 42 unilateral), 57 angles (13 bilateral, 44 unilateral), and 17 ratios. Supplemental figures were created to depict all features and measurements utilizing a frontal, lateral, or basal view of the face.

Conclusions

This paper provides the most comprehensive and current compilation of facial measurements to date. The authors believe this compilation will guide further developments (methodologies and software tools) for analyzing nasal structures and assessing the objective outcomes of facial surgeries, in particular rhinoplasty. Moreover, it will improve communication as a reference for facial measurements of facial surface anthropometry, in particular rhinoplasty.
Total synthesis and biological evaluation of oscillatoxins D, E, and F
Authors: Araki Yusuke , Hanaki Yusuke , Kita Masaki , Hayakawa Koutaro , Irie Kazuhiro , Nokura Yoshihiko , Nakazaki Atsuo , Nishikawa Toshio
Published: April 2021

Oscillatoxins (OTXs) and aplysiatoxins are biosynthetically related polyketides produced by marine cyanobacteria. We previously developed a synthetic route to phenolic O-methyl analogs of OTX-D and 30-methyl-OTX-D during collective synthesis of these natural products. According to our synthetic strategy, we achieved total synthesis of OTX-D, 30-methyl-OTX-D, OTX-E, and OTX-F by deprotecting the O-methyl group in an earlier intermediate, and determined their biological activities. Although OTX-D and 30-methyl-OTX-D have been reported to show antileukemic activity against L1210 cell line, we found that their cytotoxicity in vitro against this cell line is relatively weak (IC50: 29-52 µm). In contrast, OTX-F demonstrated cell line-selective antiproliferative activity against DMS-114 lung cancer cells, which implies that OTXs target as yet unknown target molecules as part of this unique activity.
Omphaloprenol A: a new bioactive polyisoprenepolyol isolated from the mycelium of poisonous mushroom Omphalotus japonicus
Authors: Aoki Satoki , Aboshi Takako , Onodera Takumu , Kimura Ken-ichi , Arai Daisuke , Iizuka Yoshiaki , Murayama Tetsuya
Published: April 2021

Mushrooms of the Omphalotus genus are known to be rich in secondary metabolites. In the quest for new bioactive compounds, we analyzed the compounds isolated from the mycelium of the poisonous mushroom Omphalotus japonicus. As a result, a new polyisoprenepolyol, which was named omphaloprenol A, was identified, along with known substances such as hypsiziprenol A10 and A11, illudin S, and ergosterol. The chemical structure of omphaloprenol A was elucidated by nuclear magnetic resonance and infrared spectroscopies and mass spectrometry, and its bioactivity was investigated. Omphaloprenol A showed growth promoting activity against the root of lettuce seeds and cytotoxicity against HL60 cells. To the best of our knowledge, this is the first report on the isolation of a polyisoprenepolyol compound from Omphalotaceae mushrooms.
Effects of neurosecretory protein GL on food intake and fat accumulation under different dietary nutrient compositions in rats
Authors: Fukumura Keisuke , Shikano Kenshiro , Narimatsu Yuki , Iwakoshi-Ukena Eiko , Furumitsu Megumi , Naito Mana , Ukena Kazuyoshi
Published: April 2021

We recently identified a novel hypothalamic small protein, named neurosecretory protein GL (NPGL), which is involved in energy homeostasis in birds and mammals. However, whether the action of NPGL is influenced by nutritional composition remains unknown. Thus, we investigated the effect of chronic intracerebroventricular infusion of NPGL for 13 days on feeding behavior and body mass gain under a normal chow (NC) diet, high-fat diet, high-sucrose diet (HSD), and medium-fat/medium-sucrose diet (MFSD) in rats. NPGL stimulated food intake of NC and MFSD, especially during the light period. By contrast, NPGL decreased body mass gain under NC and increased total white adipose tissue mass in HSD- and MFSD-fed rats. These data suggest that the effects of NPGL on feeding behavior, body mass gain, and fat accumulation depend on nutrient type. Among them, sucrose in diets seems to contribute to fat accumulation elicited by NPGL.
Niclosamide’s potential direct targets in ovarian cancer
Authors: Sekulovski Nikola , MacLean James A , Bheemireddy Sambasiva R , Yu Zhifeng , Okuda Hiroshi , Pru Cindy , Plunkett Kyle N , Matzuk Martin , Hayashi Kanako
Published: April 2021

Recent evidence indicates that niclosamide is an anti-cancer compound that is able to inhibit several signaling pathways. Although niclosamide has previously been identified by high-throughput screening platforms as a potential effective compound against several cancer types, no direct binding interactions with distinct biological molecule(s) has been established. The present study identifies key signal transduction mechanisms altered by niclosamide in ovarian cancer. Using affinity purification with a biotin-modified niclosamide derivative and mass spectrometry analysis, several RNA-binding proteins (RBPs) were identified. We chose the two RBPs, FXR1 and IGF2BP2, for further analysis. A significant correlation exists in which high-expression of FXR1 or IGF2BP2 is associated with reduced survival of ovarian cancer patients. Knockdown of FXR1 or IGF2BP2 in ovarian cancer cells resulted in significantly reduced cell viability, adhesion, and migration. Furthermore, FXR1 or IGF2BP2 deficient ovarian cancer cells exhibited reduced response to most doses of niclosamide showing greater cell viability than those with intact RBPs. These results suggest that FXR1 and IGF2BP2 are direct targets of niclosamide and could have critical activities that drive multiple oncogenic pathways in ovarian cancer.
Impact of the SARS-CoV-2 (COVID-19) crisis on surgical training: global survey and a proposed framework for recovery
Authors:   Research Education INnovation in Surgery (REINS) initiative COVID-19 group, Yiasemidou M , Tomlinson J , Chetter I , Biyani Chandra Shekhar , Abdulhannan P , Andreou A , Badiani S , Boyapati R , Da Silva N , Dickerson P , Frezzini C , Giorga A , Glassman D , Gómez Rivas J , Ho M , James O P , Kalifatidis D , Lam W , Lewis C M B , Malik A , Mavor A , Murugesan J , Panagiotou D , Patel B , Robinson D B T , Sanchez Salas R , Sharma D , Sultan J , Van Cleynenbreugel B , Wellbelove Z , Wilson A
Published: April 2021

Background

The SARS-CoV-2 pandemic had a profound impact on surgical services, potentially having a detrimental impact on training opportunities. The aim of this global survey was to assess the impact of the COVID-19 crisis on surgical training and to develop a framework for recovery.

Methods

A cross-sectional, web-based survey was conducted. This was designed by a steering committee of medical educationalists and validated by a group of trainees before dissemination.

Results

A total of 608 responses were obtained from 34 countries and 15 specialties. The results demonstrated major disruption in all aspects of training. The impact was greatest for conferences (525 of 608) and hands-on courses (517 of 608), but less for inpatient care-related training (268 of 608). European trainees were significantly more likely to experience direct training disruption than trainees in Asia (odds ratio 0.15) or Australia (OR 0.10) (χ2 = 87.162, P < 0.001). Alternative training resources (webinars, 359 of 608; educational videos, 234 of 608) have emerged, although trainees expressed some dissatisfaction with them. The collective responses generated a four-pillar framework for training recovery that involved: guidance from training stakeholders with the involvement of trainees; prioritization of training, especially the roles of senior surgeons/trainers; provision of access to alternative/new teaching methods; and measures to address trainee anxiety.

Conclusion

Training has been greatly affected by the COVID-19 pandemic. The introduction of new teaching methods and a focus on training after the pandemic are imperative.
Targeted use of intraoperative frozen-section analysis lowers the frequency of completion thyroidectomy
Authors: Staubitz J I , Elmrich I , Musholt P B , Cámara R J A , Watzka F , Dralle H , Sekulla C , Lorenz K , Musholt T J ,   Prospective Evaluation Study Thyroid Surgery (PETS) 2 study group, Vorländer C , Lorenz K , Blankenburg C , Geffcken C , Steinmüller T , Trupka A , Steinert F , Schabram J , Albrecht L , Marschall C , Orlitsch C , Holzner K , Feller J , Weber T , Kaltofen D , Simon D , Kube R , Schultz K , Sahm M , Obermeier J , Roth C , Janson K , Thomusch O , Meier H , Weinhold A , Müller N , Tonndorf G , Sinn D , Klein E , Henke G , Rampf W , Rendel K , Cupisti K , Holzer K , Grothe D , Axt L , Müller I , Probst W , Guhr C , Schischke F , Schwörig T , Konrad Hospital M , Fielitz J , Stets R , Liese M , Weiss C- L , Zaage J , Bräuer T , Weitz J , Huster A , Kidess E , Lautermann J , Kizilirmak N , Jannasch O , Bittscheidt H , Lehmann D , Kröll K- P , Musholt T J , Sonsnowska C , Lorenc Z , Dudesek B , Smutny S , Brauckhoff M , Bareck E , Köberle-Wührer R
Published: April 2021

Background

The impact of intraoperative frozen section (iFS) analysis on the frequency of completion thyroidectomy for the management of thyroid carcinoma is controversial. Although specialized endocrine centres have published their respective results, there are insufficient data from primary and secondary healthcare levels. The aim of this study was to analyse the utility of iFS analysis.

Methods

In the Prospective Evaluation Study Thyroid Surgery (PETS) 2 study, 22 011 operations for benign and malignant thyroid disease were registered prospectively in 68 European hospitals from 1 July 2010 to 31 December 2012. Group 1 consisted of 569 patients from University Medical Centre (UMC) Mainz, and group 2 comprised 21 442 patients from other PETS 2 participating hospitals. UMC Mainz exercised targeted but liberal use of iFS analysis for suspected malignant nodules. iFS analysis was compared with standard histological examination regarding the correct distinction between benign and malignant disease. The percentage of completion thyroidectomies was assessed for the participating hospitals.

Results

iFS analysis was performed in 35.70 per cent of patients in group 1 versus 21.80 per cent of those in group 2 (risk ratio (RR) 1.6, 95 per cent c.i. 1.5 to 1.8; P < 0.001). Sensitivity of iFS analysis was 75.0 per cent in group 1 versus 63.50 per cent in group 2 (RR 1.2, 1.2 to 1.3; P = 0.040). Completion surgery was necessary in 8.10 per cent of patients in group 1 versus 20.8 per cent of those in group 2 (RR 0.4, 0.2 to 0.7; P = 0.001).

Conclusion

iFS analysis is a useful tool in determining the appropriate surgical management of thyroid disease. Targeted use of iFS was associated with a significantly higher sensitivity for the detection of malignancy, and with a significantly reduced necessity for completion surgery.
Study to Change Destiny. Elements That Promote Successful Trajectories in Young People who Have Been in Residential Care
Authors: Gairal-Casadó Regina , Garcia-Yeste Carme , Munté Pascual Ariadna , Padrós Cuxart Maria
Published: April 2021

Scientific evidence shows that young people who have been in alternative care are more vulnerable than youth in the general population. This disadvantage is even more pronounced in the case of those who have been in residential care. A main factor associated with this greater vulnerability is low academic attainment, which is reflected in the scarcity of these youth accessing higher education. This qualitative research gathers the voices of twelve youth who have lived in residential care and are studying or have studied at university to explore those elements that have helped them overcome the obstacles to accessing higher education and have better opportunities in all areas of life. Following a communicative approach, the participants were also involved in the analysis. Besides identifying some of the great difficulties faced, the findings reveal that the participants were aware of the opportunities presented by a university degree and encouraged by relevant educators. Furthermore, most of the residential centres of the participants gave priority to their studies and provided extra support in a protective environment. The results provide valuable insights to child welfare decision makers and residential caregivers for improving services.
Distinctive alteration of presynaptic proteins in the outer molecular layer of the dentate gyrus in Alzheimer’s disease
Authors: Haytural Hazal , Jordà-Siquier Tomàs , Winblad Bengt , Mulle Christophe , Tjernberg Lars O , Granholm Ann-Charlotte , Frykman Susanne , Barthet Gaël
Published: April 2021

Synaptic degeneration has been reported as one of the best pathological correlates of cognitive deficits in Alzheimer’s disease. However, the location of these synaptic alterations within hippocampal sub-regions, the vulnerability of the presynaptic versus postsynaptic compartments, and the biological mechanisms for these impairments remain unknown. Here, we performed immunofluorescence labelling of different synaptic proteins in fixed and paraffin-embedded human hippocampal sections and report reduced levels of several presynaptic proteins of the neurotransmitter release machinery (complexin-1, syntaxin-1A, synaptotagmin-1 and synaptogyrin-1) in Alzheimer’s disease cases. The deficit was restricted to the outer molecular layer of the dentate gyrus, whereas other hippocampal sub-fields were preserved. Interestingly, standard markers of postsynaptic densities (SH3 and multiple ankyrin repeat domains protein 2) and dendrites (microtubule-associated protein 2) were unaltered, as well as the relative number of granule cells in the dentate gyrus, indicating that the deficit is preferentially presynaptic. Notably, staining for the axonal components, myelin basic protein, SMI-312 and Tau, was unaffected, suggesting that the local presynaptic impairment does not result from axonal loss or alterations of structural proteins of axons. There was no correlation between the reduction in presynaptic proteins in the outer molecular layer and the extent of the amyloid load or of the dystrophic neurites expressing phosphorylated forms of Tau. Altogether, this study highlights the distinctive vulnerability of the outer molecular layer of the dentate gyrus and supports the notion of presynaptic failure in Alzheimer’s disease.
Altered Thalamocortical Connectivity in 6-Week-Old Infants at High Familial Risk for Autism Spectrum Disorder
Authors: Nair Aarti , Jalal Rhideeta , Liu Janelle , Tsang Tawny , McDonald Nicole M , Jackson Lisa , Ponting Carolyn , Jeste Shafali S , Bookheimer Susan Y , Dapretto Mirella
Published: April 2021

Converging evidence from neuroimaging studies has revealed altered connectivity in cortical–subcortical networks in youth and adults with autism spectrum disorder (ASD). Comparatively little is known about the development of cortical–subcortical connectivity in infancy, before the emergence of overt ASD symptomatology. Here, we examined early functional and structural connectivity of thalamocortical networks in infants at high familial risk for ASD (HR) and low-risk controls (LR). Resting-state functional connectivity and diffusion tensor imaging data were acquired in 52 6-week-old infants. Functional connectivity was examined between 6 cortical seeds—prefrontal, motor, somatosensory, temporal, parietal, and occipital regions—and bilateral thalamus. We found significant thalamic-prefrontal underconnectivity, as well as thalamic-occipital and thalamic-motor overconnectivity in HR infants, relative to LR infants. Subsequent structural connectivity analyses also revealed atypical white matter integrity in thalamic-occipital tracts in HR infants, compared with LR infants. Notably, aberrant connectivity indices at 6 weeks predicted atypical social development between 9 and 36 months of age, as assessed with eye-tracking and diagnostic measures. These findings indicate that thalamocortical connectivity is disrupted at both the functional and structural level in HR infants as early as 6 weeks of age, providing a possible early marker of risk for ASD.
Novel use of intravascular lithotripsy for coral reef aorta: a case report
Authors: Chag Milan C , Thakre Anuj A
Published: April 2021

Background

The coral reef aorta (CRA) is a rare disease of extreme calcification in the juxtarenal aorta. These heavily calcified exophytic plaques grow into the lumen and can cause significant stenoses, leading to visceral ischaemia, renovascular hypertension, and claudication. Surgery or percutaneous intervention with stenting carries a high risk of complications and mortality.

Case summary

A 67-year-old female had presented with severe hypertension and exercise limiting claudication for 18 months. On evaluation, she was found to have severe bilateral renal artery stenoses with juxtarenal CRA causing subtotal occlusion. Both renal arteries were stented. For CRA, we used intravascular lithotripsy (IVL) assisted plain balloon angioplasty to minimize possibilities of major dissection and perforation and avoided chimney stent-grafts required to protect visceral and renal arteries. We used a double-balloon technique using a 6 × 60 mm IVL Shockwave M5 catheter and a 9 × 30 mm simple peripheral balloon catheter, inflated simultaneously at the site of CRA as parallel, hugging balloons to have an effective delivery of IVL. Shockwaves were given in juxta/infrarenal aorta to have satisfactory dilatation without any complication. The gradient across aortic narrowing reduced from 80 to 4 mmHg. She had an uneventful recovery and has remained asymptomatic at 6-month follow-up.

Discussion

When CRA is juxtarenal with no safe landing zones for stent-grafts, IVL may be a safe, less complex and effective alternative to the use of juxtarenal aortic stent-graft with multiple chimney or snorkel stent-grafts. This is the first report of a novel use of IVL to treat CRA.
Anticoagulation in atrial fibrillation and liver disease: a pooled-analysis of >20 000 patients
Authors: Chen Shaojie , Pürerfellner Helmut , Meyer Christian , Sommer Philipp , Kiuchi Márcio Galindo , Martinek Martin , Futyma Piotr , Zanchi Simone , Zhu Lin , Schratter Alexandra , Wang Jiazhi , Acou Willem-Jan , Liu Shaowen , Ling Zhiyu , Yin Yuehui , Ouyang Feifan , Chun Julian K R , Schmidt Boris
Published: April 2021

Aims

Anticoagulation for atrial fibrillation patients with liver disease represents a clinical dilemma. We sought to evaluate the efficacy/safety of different anticoagulation, i.e. vitamin K antagonist (VKA) and non-VKA oral anticoagulants (NOACs) in such patient group.

Methods and results

This was a pooled-analysis enrolling up-to-date clinical data. Two subsets: subset A (VKA vs. Non-Anticoagulation) and subset B (NOACs vs. VKA) were pre-specified. The study outcomes were ischaemic stroke (IS)/thromboembolism (TE), major bleeding (MB), intracranial bleeding (ICB), gastrointestinal bleeding (GIB), and all-cause mortality. A total of 20 042 patients’ data were analysed (subset A: N = 10 275, subset B: N = 9767). Overall mean age: 71 ± 11 years, mean CHA2DS2-VASc score: 4.0 ± 1.8, mean HAS-BLED score: 3.6 ± 1.2. The majority of the patients had Child-Pugh category (A-B). As compared with Non-Anticoagulation, VKA seemed to reduce the risk of IS/TE [odds ratio (OR): 0.60, P = 0.05], but heighten the risk of all-bleeding events including MB (OR: 2.81, P = 0.01), ICB (OR: 1.60, P = 0.01), and GIB (OR: 3.32, P = 0.01). When compared with VKA, NOACs had similar efficacy in reducing the risk of IS/TE (OR: 0.82, P = 0.64), significantly lower risk of MB (OR: 0.54, P = 0.0003) and ICB (OR: 0.35, P < 0.0001), and trend towards reduced risk of GIB (OR: 0.72, P = 0.12) and all-cause mortality (OR: 0.79, P = 0.35). The favourable effects were maintained in subgroups of individual NOAC.

Conclusions

VKA appears to reduce the risk of IS/TE but increase all-bleeding events. NOACs have similar effect in reducing the risk of IS/TE and have significantly lower risk of MB and ICB as compared with VKA. NOACs seem to be associated with better clinical outcome than VKA in patients with mild–moderate liver disease.
Common atrioventricular valve surgery in children with functional single ventricle
Authors: Mayr Benedikt , Burri Melchior , Strbad Martina , Cleuziou Julie , Hager Alfred , Ewert Peter , Hörer Jürgen , Lange Rüdiger , Ono Masamichi
Published: April 2021

OBJECTIVES

A common atrioventricular valve (CAVV) is considered to be a risk factor for early and late deaths in patients with functional single ventricle (FSV). CAVV surgery in patients with FSV is challenging and there is limited knowledge of the outcomes of CAVV repair with univentricular physiology.

METHODS

We reviewed all CAVV surgical procedures in patients with FSV who underwent univentricular palliation. End points of the study were survival after CAVV surgery and cumulative incidence of reoperation.

RESULTS

Between 1984 and 2019, 66 children with CAVV and FSV underwent single-ventricle palliation, of whom 45.5% (30/66) required CAVV surgery. Indication for surgery was moderate CAVV regurgitation in 40% (12/30) and severe CAVV regurgitation in 60% (18/30). CAVV repair was performed in 93.3% (28/30) and CAVV replacement in 6.7% (2/30). The median age and weight at surgery were 0.9 years (interquartile range 0.3–1.8) and 6.5 kg (interquartile range 3.9–8.7), respectively. Operative and late mortality were 23.3% and 8.7%, respectively. Survival and cumulative incidence of reoperation at 4 years after CAVV surgery were 68.9% [standard deviation (SD): 8.7] and 35.8% (SD: 9.1), respectively. Fontan completion was achieved in 60% (18/30). Survival at 4 years after birth was 69.7% (SD: 8.5) in 30 patients with CAVV surgery, whereas it was 83% (SD: 6.3) in 36 patients without CAVV surgery (P = 0.32).

CONCLUSIONS

CAVV surgery in patients with FSV is associated with substantial mortality and a high incidence of reoperation.
Comparisons of costs and treatment effects—an RCT on headgear activator treatment of excessive overjet in the mixed and late mixed dentition
Authors: Kallunki Jenny , Bondemark Lars , Paulsson Liselotte
Published: April 2021

Objectives

To compare the costs and treatment effects of headgear activator treatment of Class II malocclusion with excessive overjet between treatments started in the mixed (MD) and late mixed dentition (LMD).

Trial design

Two-arm parallel-group single-centre randomized controlled trial (RCT).

Material and methods

A total of 56 children presenting Class II malocclusion with excessive overjet were assessed and invited to an RCT designed as intention-to-treat. The children were randomized, by an independent person not involved in the trial into two groups, treatment with headgear activator in the MD starting at the age of 9 or to treatment with a headgear activator in LMD, starting at the age of 11. The primary outcome measure was to compare the treatment costs between the two groups. Societal costs (the sum of direct and indirect costs) were calculated for successful treatments only and when unsuccessful treatments were included. Secondary outcomes were comparisons of oral health-related quality of life (OHRQoL), dental and skeletal treatment effects, lip closure, and trauma incidence. Data collections were performed before and after treatment, corresponding to a treatment period of 2 years. Blinding was accomplished when assessing outcomes.

Results

No group differences in costs were found of successful treatments or when unsuccessful treatments were included. The most pronounced treatment effects in both groups were the reduction of overjet and improved molar relation. Treatment started in MD or in LMD were equal and without significant differences regarding effects on OHRQoL, skeletal effects, lip closure, and incidence of trauma.

Harms

No harm was observed, but 8 of 30 children (27%) in the MD and 6 of 21 children (29%) in the LMD group showed unsuccessful results.

Limitations

Costs depend on local factors and can thereby not be directly transferred to other settings. It was a single-centre trial and can thus be less generalizable.

Conclusions

Regarding costs and treatment effects, there is no difference if headgear activator treatment of excessive overjet starts in the MD or LMD.

Clinical trial registration

NCT04508322.
Proximity to the descending aorta predicts regional fibrosis in the adjacent left atrial wall: aetiopathogenic and prognostic implications
Authors: Caixal Gala , Althoff Till , Garre Paz , Alarcón Francisco , NuñezGarcia Marta , Benito Eva Maria , Borras Roger , Perea Rosario J , Prat-González Susana , Gunturiz Clara , Sanchez Paula , Olivas Dahyr , Tolosana J Maria , Arbelo Elena , Roca-Luque Ivo , Brugada Josep , Sitges Marta , Guasch Eduard , Mont Lluis
Published: April 2021

Aims

Left atrial (LA) fibrosis is present in patients with atrial fibrillation (AF) and can be visualized by magnetic resonance imaging with late gadolinium enhancement (LGE-MRI). Previous studies have shown that LA fibrosis is not randomly distributed, being more frequent in the area adjacent to the descending aorta (DAo). The objective of this study is to analyse the relationship between fibrosis in the atrial area adjacent to the DAo and the distance to it, as well as the prognostic implications of this fibrosis.

Methods and results

Magnetic resonance imaging with late gadolinium enhancement was obtained in 108 patients before AF ablation to analyse the extent of LA fibrosis and the distance DAo-to-LA. A high-density electroanatomic map was performed in a subgroup of 16 patients to exclude the possibility of an MRI artifact. Recurrences after ablation were analysed at 1 year of follow-up. The extent of atrial fibrosis in the area adjacent to the DAo was inversely correlated with the distance DAo-to-LA (r = −0.34, P < 0.001). This area had the greatest intensity of LGE [image intensity ratio (IIR) 1.14 ± 0.15 vs. 0.99 ± 0.16; P < 0.001] and also the lowest voltage (1.07 ± 0.86 vs. 1.54 ± 1.07 mV; P < 0.001) and conduction velocity (0.65 ± 0.06 vs. 0.96 ± 0.57 mm/ms; P < 0.001). The extent of this regional fibrosis predicted recurrence after AF ablation [hazard ratio (HR) 1.02, 95% CI 1.01–1.03; P = 0.01], however total fibrosis did not (HR = 1.01, 95% CI 0.97–1.06, P = 0.54).

Conclusions

Atrial fibrosis was predominantly located in the area adjacent to the DAo, and increased with the proximity between the two structures. Furthermore, this regional fibrosis better predicted recurrence after AF ablation than total atrial fibrosis.
Prognostic markers of all-cause mortality in patients with atrial fibrillation: data from the prospective long-term registry of the German Atrial Fibrillation NETwork (AFNET)
Authors: Nabauer Michael , Oeff Michael , Gerth Andrea , Wegscheider Karl , Buchholz Anika , Haeusler Karl Georg , Hanrath Peter , Meinertz Thomas , Ravens Ursula , Sprenger Claudia , Tebbe Ulrich , Vettorazzi Eik , Kirchhof Paulus , Breithardt Günter , Steinbeck Gerhard ,   the AFNET registry investigators
Published: April 2021

Aims

Atrial fibrillation (AF) is associated with a high risk of cardiovascular and non-cardiovascular death, even on anticoagulation. It is controversial, which conditions—including concomitant diseases and AF itself—contribute to this mortality. To further clarify these questions, major determinants of long-term mortality and their contribution to death were quantified in an unselected cohort of AF patients.

Methods and results

We established a large nationwide registry comprising 8833 AF-patients with a median follow-up of 6.5 years (45 345 patient-years) and central adjudication of adverse events. Baseline characteristics of the patients were evaluated as predictors of mortality using Cox regression and C-indices for determination of predictive power. Annualized mortality was highest in the first year (6.2%) and remained high thereafter (5.2% in men and 5.5% in women). Thirty-eight percent of all deaths were cardiovascular, mainly due to heart failure or sudden death. Sex-specific age was the strongest predictor of mortality, followed by concomitant cardiovascular and non-cardiovascular conditions. These factors accounted for 25% of the total mortality beyond age and sex and for 84% of the mortality differences between AF types. Thus, the electrical phenotype of the disease at baseline contributed only marginally to prediction of mortality.

Conclusion

Mortality is high in AF patients and arises primarily from heart failure, peripheral artery disease, chronic obstructive lung disease, chronic kidney disease, and diabetes mellitus, which, therefore, should be targeted to lower mortality. Parameters related to the electrical manifestation of AF did not have an independent impact on long-term mortality in our representative cohort.
Effectiveness of collaboration in older adults: do interprofessional teams improve nutritional status more compared to usual care?
Authors: Mawardi Fitriana , Lestari Ayuningtyas S , Kusnanto Hari , Sasongko Elsa P S , Hilmanto Dany
Published: April 2021

Background

Ageing is accompanied by many changes that make it more difficult for nutritional needs to be met. Management of malnutrition in older adults requires collaboration among multiple clinical disciplines.

Objective

This study aimed to determine the effectiveness of interprofessional collaboration and practice (IPCP) implementation for older adults with malnutrition compared to usual care.

Methods

This was a quasi-experimental study using an untreated control group design with dependent pretest and posttest sample of older adults with malnutrition. The intervention group worked as a team to give the intervention based on their own roles and responsibilities. The older adults of the control group received usual care from primary health care. Outcome measurement of nutritional status used the Mini Nutritional Assessment (MNA).

Results

The study results show significant differences between before and after IPCP implementation in the intervention group which had better scores of MNA after implementation. In the control group, there was no significant difference between before and after implementation of usual care. The statistical analysis showed there was a significant difference between the control and intervention groups who had improved nutritional status after IPCP implementation. IPCP had strong correlation with nutritional status based on correlation analysis. These results demonstrate that the collaboration by more than one health profession can improve nutritional status better than usual daily care.

Conclusion

IPCP has a strong and significant correlation with the nutritional status in older adults. The IPCP implementation could significantly improve their nutritional status after the IPCP implementation compared to usual care.
Twin-arginine translocation (Tat) mutants in Salmonella enterica serovar Typhimurium have increased susceptibility to cell wall targeting antibiotics
Authors: M Brauer Adrienne , R Rogers Alexandra , R Ellermeier Jeremy
Published: April 2021

The twin-arginine translocation (Tat) system is a protein secretion system that is conserved in bacteria, archaea and plants. In Gram-negative bacteria, it is required for the export of folded proteins from the cytoplasm to the periplasm. There are 30 experimentally verified Tat substrates in Salmonella, including hydrogenase subunits, enzymes required for anaerobic respiration and enzymes involved in peptidoglycan remodeling during cell division. Multiple studies have demonstrated the susceptibility of tat mutants to antimicrobial compounds such as SDS and bile; however, in this work, we use growth curves and viable plate counts to demonstrate that cell wall targeting antibiotics (penicillins, carbapenems, cephalosporins and fosfomycin) have increased killing against a Δtat strain. Further, we demonstrate that this increased killing is primarily due to defects in translocation of critical Tat substrates: MepK, AmiA, AmiC and SufI. Finally, we show that a ΔhyaAB ΔhybABC ΔhydBC strain has an altered ΔΨ that impacts proper secretion of critical Tat substrates in aerobic growth conditions.