bluuebunny/crossref_metadata_2025 huggingface dataset:
Historical-technological study, modeling and reconstruction to scale of the six-cylinder pump of Taqī ad-Dîn
Authors: Cabeza I M , Lopez R , Dorado R , Medina G
Published: October 2021

This work presents both a historical study and a technological analysis of one of the most ingenious Middle Ages’ mechanisms in the East. This time can be considered one of the darkest stages, as far as technological progress is concerned. However, we can refute this qualification by contributions such as the Taqī Ad-Dîn (1526-1585) one. This article has addressed a study of the great work of this inventor, “Al-Turuq al-samiyya fi al-alat al-ruhaniyya” or “The Sublime Methods for Spiritual Machines” (1551). Thus, within this work, we focus on his most relevant hydraulic machine, “The Six-Cylinder Pump”: a hydraulic machine for lifting water. This functionality is obtained through the use of six cylinders in line, unheard of at that time, with their corresponding pistons. We explain its operation and describe the mechanism’s multiple components, their role within this device, and its most significant characteristics and peculiarities. A virtual interpretation of “The Six-Cylinder Pump” has been made using CAD software. A virtual animation has also been carried out to appreciate the mode of operation. It is possible to accomplish the mechanical analysis of its most characteristic elements through the assisted engineering modules. Finally, we show a mock-up of the mechanism using different technologies and materials, which helps appreciate its performance.
Sugar cane industrial heritage in oriental coast of Málaga. A tourist route opportunity
Authors: Martín S , Trujillo F J , Bermudo C , Claver J , Sebastián M A , Sevilla L
Published: October 2021

Industrial heritage, as a historical and cultural heritage typology, can be considered a new opportunity to generate tourism interest in a zone. Along the 19th century and at the beginning of the 20th century, the oriental coast of Málaga (Spain) was considered a reference area in the sugar cane cultivation and manufacturing. Nowadays, different sugar cane factories assets remain. These assets can be considered an opportunity to increase visitors and to improve the economy of this area. In this work, six sugar cane factories have been evaluated. Different characteristics has been proposed and a value has been assigned to each one. Finally, a route to visit the proposed sugar cane factories has been designed. The main advantage of this tourism route is that can be done in one day, reinforcing the current touristic offer and attracting new visitors to this area.
Biosynthesized gold nanoparticles-doped hydroxyapatite as antibacterial and antioxidant nanocomposite
Authors: Fatimah Is , Citradewi Putwi Widya , Yahya Amri , Nugroho Bambang Hernawan , Hidayat Habibi , Purwiandono Gani , Sagadevan Suresh , Mohd Ghazali Sheikh Ahmad Izaddin Sheikh , Ibrahim Shariff
Published: October 2021

A composite of hydroxyapatite (HA) doped with green synthesized gold nanoparticles (Au NPs) was prepared. Au NPs were produced via the bioreduction of HAuCl4 with Clitoria ternatea flower extract and utilized in HA synthesis, using Ca(OH)2 and ammonium diphosphate as precursors. The aim of this research was to analyze the structure of the composite and conduct an antibacterial activity test involving Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus pyogenes. In addition, antioxidant activity was evaluated by 2,2-diphenyl-1-picrylhydrazyl radical scavenging. Au NP formation monitoring was conducted by UV–visible spectroscopy and particle size analysis, and the synthesized composite was studied using X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. The results revealed homogeneously dispersed Au NPs (particle size ranging from 5 to 80 nm) in the HA structure. The nanocomposite demonstrated enhanced antibacterial activity against the tested bacteria compared to HA, with minimum inhibition concentrations of 3 μg ml−1 for E.coli and S.aureus and 10 μg ml−1 for K. pneumoniae and S. pyogenes. The nanocomposite expressed antioxidant activity, as shown by 2,2-diphenyl-1-picrylhydrazyl scavenging activities of 66% and 58% at concentrations of 100 μg ml−1 and 50 μg ml−1, respectively.
Feasibility of a High-Volume Filter Sampler for Detecting SARS-CoV-2 RNA in COVID-19 Patient Rooms
Authors: Wilson Amanda M , Kaur Kamaljeet , Jones Rachael M , Kelly Kerry E
Published: October 2021

Aerosolization of SARS-CoV-2 by COVID-19 patients can put healthcare workers and susceptible individuals at risk of infection. Air sampling for SARS-CoV-2 has been conducted in healthcare settings, but methods vary widely and there is need for improvement. The objective of this study was to evaluate the feasibility of using a high-volume filter sampler, BioCapture z720, to detect SARS-CoV-2 in COVID-19 patient rooms in a medical intensive care unit, a dedicated COVID-19 ward, and at nurses’ stations. In some locations, the BioSpot-VIVAS, known for high efficiency in the collection of virus-containing bioaerosols, was also operated. The samples were processed for SARS-CoV-2 RNA with multi-plex nested polymerase chain reaction. One of 28 samples collected with the high-volume filter sampler was positive for SARS-CoV-2; all 6 samples collected with BioSpot-VIVAS were negative for SARS-CoV-2. The high-volume filter sampler was more portable and less intrusive in patient rooms than the BioSpot-VIVAS, but limits of detection remain unknown for this device. This study will inform future work to evaluate the reliability of these types of instruments and inform best practices for their use in healthcare environments for SARS-CoV-2 air sampling.
Quantitative model suggests both intrinsic and contextual features contribute to the transcript coding ability determination in cells
Authors: Kang Yu-Jian , Li Jing-Yi , Ke Lan , Jiang Shuai , Yang De-Chang , Hou Mei , Gao Ge
Published: October 2021

Gene transcription and protein translation are two key steps of the ‘central dogma.’ It is still a major challenge to quantitatively deconvolute factors contributing to the coding ability of transcripts in mammals. Here, we propose ribosome calculator (RiboCalc) for quantitatively modeling the coding ability of RNAs in human genome. In addition to effectively predicting the experimentally confirmed coding abundance via sequence and transcription features with high accuracy, RiboCalc provides interpretable parameters with biological information. Large-scale analysis further revealed a number of transcripts with a variety of coding ability for distinct types of cells (i.e. context-dependent coding transcripts), suggesting that, contrary to conventional wisdom, a transcript’s coding ability should be modeled as a continuous spectrum with a context-dependent nature.
From communal duties to individual rights: The migration of Indian social workers to England
Authors: Hakak Yohai , Francis Toks
Published: October 2021

The demand for social workers in England has been outstripping supply for more than a decade. As a result, social work continues to be on the UK Shortage Occupation List (2021; available online at: https://www.gov.uk/guidance/immigration-rules/immigration-rules-appendix-shortage-occupation-list (accessed May 26, 2021), ensuring the migration of social workers will continue. While several studies have examined the experiences of migrating social workers, these studies largely neglected the impact culture plays in this transition. This article will focus on the experiences of social workers who were trained in India and migrated to England. It is part of a much larger study that used a mixed method approach to explore the migration to England of social workers from eight different countries. Indian social workers highlighted the significant differences between the individualistic character of English culture and the much more collectivist Indian culture. This difference shaped a range of attitudes towards the family and parenting, as well as the distinctions between what is ‘public’ or ‘communal’ and what is ‘private’. Other differences raised were regarding communication resulting from the more hierarchical tendencies of Indian society. In the final section, implications for practice are discussed and recommendations are made for the induction required to help future migrating social workers make a smoother transition.
Acquiescence and Its Role in the Settlement of Island Disputes: “Silence May also Speak”, But to What Extent?
Authors: Yan SONG
Published: October 2021

Acquiescence usually takes the form of silence or absence of protest in circumstances that reasonably call for objections. This notion has been frequently invoked by States in territorial cases, especially recent island disputes. Based on the latest international jurisprudence, this article will study whether, and to what extent, the special case of island disputes would affect international courts’ consideration of acquiescence. As suggested by this study, international jurisprudence has set a high threshold for proof regarding the elements of acquiescence. Nevertheless, acquiescence seldom constitutes a sole and independent legal title for the settlements of island disputes, but as an important element for the establishment of a historic title, treaty interpretation and the application of effectivités. In addition, it is of more frequent occurrence that international courts contemplate the possibility of transferring a title to an island based on the notion of acquiescence, but the conditions for the transfer of title are strictly defined.
A Role for CXCR3 Ligands as Biomarkers of Post-Operative Crohn’s Disease Recurrence
Authors: Walshe Margaret , Nayeri Shadi , Ji Jiayi , Hernandez-Rocha Cristian , Sabic Ksenija , Hu Liangyuan , Giri Mamta , Nayar Shikha , Brant Steven , McGovern Dermot P B , Rioux John D , Duerr Richard H , Cho Judy H , Schumm Phil L , Lazarev Mark , Silverberg Mark S
Published: October 2021

Background and Aims

Crohn’s disease [CD] recurrence following ileocolic resection [ICR] is common. We sought to identify blood-based biomarkers associated with CD recurrence.

Methods

CD patients undergoing ICR were recruited across six centres. Serum samples were obtained at post-operative colonoscopy. A multiplex immunoassay was used to analyse 92 inflammation-related proteins [Olink Proteomics]. Bayesian analysis was used to identify proteins associated with increasing Rutgeerts score. Identified proteins were used in receiver operating characteristic [ROC] analysis to examine the ability to identify CD recurrence [Rutgeerts score ≥i2]. Existing single cell data were interrogated to further elucidate the role of the identified proteins.

Results

Data from 276 colonoscopies in 213 patients were available. Median time from surgery to first and second colonoscopy was 7 (interquartile range [IQR] 6–9) and 19 [IQR 16–23] months, respectively. Disease recurrence was evident at 60 [30%] first and 36 [49%] second colonoscopies. Of 14 proteins significantly associated with Rutgeerts score, the strongest signal was seen for CXCL9 and MMP1. Among patients on anti-tumour necrosis factor drugs, CXCL9 and CXCL11 were most strongly associated with Rutgeerts score. Both are CXCR3 ligands. Incorporation of identified proteins into ROC analysis improved the ability to identify disease recurrence as compared to C-reactive protein alone: area under the curve [AUC] 0.75 (95% confidence interval [CI]: 0.66–0.82] vs 0.64 [95% CI 0.56–0.72], p = 0.012. Single cell transcriptomic data provide evidence that innate immune cells are the primary source of the identified proteins.

Conclusions

CXCR3 ligands are associated with CD recurrence following ICR. Incorporation of novel blood-based candidate biomarkers may aid in identification of CD recurrence.
Impact of COVID-19 on angioplasty service and outcome of patients treated for critical limb ischaemia
Authors: Rodway A , Giltinan C , Dehghan-Nayeri A , Santos A , Stafford M , Whyte M B , Allan C , Field B , Clark J , Pazos Casal F , Pankhania A , Loosemore T , Heiss C
Published: October 2021

Background

Peripheral artery disease (PAD) is a major challenge worldwide and endovascular revascularization is an important component of treatment that is affected by COVID-19 restrictions.

Purpose

Here, we evaluated the impact of COVID-19 restriction on angioplasty service and outcome of patients undergoing lower limb angioplasty.

Methods

Consecutive patients undergoing endovascular revascularisation between August 2018-March 2021 in a UK district general hospital were analysed retrospectively. Indications for angioplasty of all patients were discussed and agreed upon in multi-disciplinary teams. We compared time from referral to angioplasty, patient and procedural characteristics, technical success, peri-procedural complications, and outcome (wound healing, major amputation, target lesion revascularization, death) in patients treated 'before' and after February 2020 (“during COVID-19”).

Results

One hundred nineteen patients were treated 'before' (92% critical limb ischaemia [CLI]; 60% diabetes mellitus) and 72 were treated 'during COVID-19' (96% CLI; 61% diabetes mellitus). While the total monthly number of patients treated did not change, the number of outpatients treated as day cases increased (40% to 72%) and overnight stays for social reasons decreased (16% to 10%). Treatment of hospitalized patients decreased from 44% to 18%. The percentage of outpatients treated at <14 days after referral increased from 39% to 63% and hospitalized patients treated <5 days from 47% to 54%. Neither COVID-19 nor time to procedure affected wound healing (p(log Rank) = 0.451; median time to healing 168±25 days) and amputation free survival (p(log Rank) = 0.924; median survival 368±30 days) in all CLI patients significantly. However, amputation-free survival was significantly worse in hospitalized as compared to outpatients (p(log Rank) <0.001; median survival 155±20 vs 368±30 days) with similar wound healing in those that survived (p(log Rank) = 0.340; median time to wound healing 168±25 days). Of note, the known causes of death were sepsis (32%), pneumonia (18%), COVID pneumonia (18%), cardiac (16%) and stroke (8%).

Conclusions

Adapting to COVID-19 restriction we maintained a safe and effective angioplasty service while shortening waiting times. Very high mortality rates in patients after hospitalization indicated that CLI need to be treated much earlier and more aggressively to avoid disease progression requiring hospitalization.

Funding Acknowledgement

Type of funding sources: None.
Organic carbon from graminoid roots as a driver of fermentation in a fen
Authors: Meier Anja B , Oppermann Sindy , Drake Harold L , Schmidt Oliver
Published: October 2021

Fen Schlöppnerbrunnen is a moderately acidic methane-emitting peatland overgrown by Molinia caerulea and other wetland graminoids (e.g. Carex rostrata). Recently, the accumulation of H2, an indicator for fermentation, was observed with anoxically incubated C. rostrata roots but not with root-free fen soil. Based on this finding, we hypothesized that root-derived organic carbon has a higher capacity to promote fermentation processes than peat organic carbon from root-free fen soil. To address this hypothesis, C. rostrata and M. caerulea roots were anoxically incubated with or without fen soil and the product profiles of root treatments were compared with those of root-free soil treatments. Ethanol, acetate, propionate, butyrate, H2 and CO2 accumulated in root treatments and collective amounts of carbon in accumulating products were 20–200 times higher than those in root-free soil treatments, in which mainly CO2 accumulated. Analyses of 16S rRNA and 16S rRNA gene sequences revealed that Clostridium, Propionispira and Rahnella, representatives of butyrate, propionate and mixed acid fermenters, respectively, were relatively enriched in root treatments. In contrast, differences of the microbial community before and after incubation were marginal in root-free soil treatments. Collectively, these findings supported the assumed stimulatory effect of root-derived organic carbon on fen fermenters.
Predictors of Clinically Meaningful Gait Speed Response to Caloric Restriction Among Older Adults Participating in Weight Loss Interventions
Authors: Tse KaKi , Neiberg Rebecca H , Beavers Daniel P , Kritchevsky Stephen B , Nicklas Barbara J , Kitzman Dalane W , Rejeski W Jack , Messier Stephen P , Beavers Kristen M
Published: October 2021

Background

The purpose of this study was to examine whether select baseline characteristics influenced the likelihood of an overweight/obese, older adult experiencing a clinically meaningful gait speed response (±0.05 m/s) to caloric restriction (CR).

Methods

Individual level data from 1 188 older adults participating in 8, 5/6-month, weight loss interventions were pooled, with treatment arms collapsed into CR (n = 667) or no CR (NoCR; n = 521) categories. Exercise assignment was equally distributed across groups (CR: 65.3% vs NoCR: 65.4%) and did not interact with CR (p = .88). Poisson risk ratios (95% confidence interval [CI]) were used to examine whether CR assignment interacted with select baseline characteristic subgroups: age (≥65 years), sex (female/male), race (Black/White), body mass index (BMI; ≥35 kg/m2), comorbidity (diabetes, hypertension, cardiovascular disease) status (yes/no), gait speed (<1.0 m/s), or inflammatory burden (C-reactive protein ≥3 mg/L, interleukin-6 ≥2.5 pg/mL) to influence achievement of ±0.05 m/s fast-paced gait speed change. Main effects were also examined.

Results

The study sample (69.5% female, 80.1% White) was 67.6 ± 5.3 years old with a BMI of 33.8 ± 4.4 kg/m2. Average weight loss achieved in the CR versus NoCR group was −8.3 ± 5.9% versus −1.1 ± 3.8%; p < .01. No main effect of CR was observed on the likelihood of achieving a clinically meaningful gait speed improvement (risk ratio [RR]: 1.09 [95% CI: 0.93, 1.27]) or gait speed decrement (RR: 0.77 [95% CI: 0.57, 1.04]). Interaction effects were nonsignificant across all subgroups.

Conclusion

The proportion of individuals experiencing a clinically meaningful gait speed change was similar for CR and NoCR conditions. This finding is consistent across several baseline subgroupings.
A Hybrid High-Order method for incompressible flows of non-Newtonian fluids with power-like convective behaviour
Authors: Castanon Quiroz Daniel , Di Pietro Daniele A , Harnist André
Published: October 2021

In this work, we design and analyse a Hybrid High-Order (HHO) discretization method for incompressible flows of non-Newtonian fluids with power-like convective behaviour. We work under general assumptions on the viscosity and convection laws, which are associated with possibly different Sobolev exponents $r\in (1,\infty )$ and $s\in (1,\infty )$. After providing a novel weak formulation of the continuous problem, we study its well-posedness highlighting how a subtle interplay between the exponents $r$ and $s$ determines the existence and uniqueness of a solution. We next design an HHO scheme based on this weak formulation, and perform a comprehensive stability and convergence analysis, including convergence for general data and error estimates for shear-thinning fluids and small data. The HHO scheme is validated on a complete panel of model problems.
Conflict Contagion: How Interdependence Shapes Patterns of Conflict and Cooperation in Polycentric Systems
Authors: McLaughlin Danielle M , Mewhirter Jack M , Lubell Mark
Published: October 2021

In this article, we bridge and extend concepts from behavioral game theory and the Ecology of Games Theory of Polycentricity (EGT) to test possible mechanisms for conflict contagion across the array of actors and policy forums that constitute a polycentric governance system. We argue that actors who experience conflict in one forum will develop similar strategies in other forums, which then impacts the level of conflict exhibited in within-forum interactions. This behavioral spillover of conflict is a different mechanism than conflict that might be experienced when two forums are addressing the same policy issue(s), which may be characterized by higher or lower levels of conflict. We use survey data collected in the Tampa Bay (FL) and California Delta (CA) water governance systems to examine conflict contagion across forums. Using a series of spatial autoregressive models, we find evidence that co-membership networks serve as a conduit for conflict contagion among forums. Our results show that forum deliberations can be strongly impacted by interactions from other institutions and processes. Consistent with the idea of path dependence, “new” forums are not necessarily independent of the forums they replace, but rather, preexisting levels of conflict and cooperation may constrain available outcomes.
Reading Creativity Forwards and Backwards: Process and Product Revisited with Herbert Von Karajan’s Legato Aesthetic and Hypermasculinity
Authors: Behan Adam
Published: October 2021

One issue central to research in musical performance studies concerns the notion of musical product and process. Most empirical studies of recorded music focus on products in the sense that they begin with finished articles—i.e. recordings—and work backwards. Similar observations can be made about score-based analytical research and—to a lesser extent—practice-based approaches. Several musicologists have challenged this recently and highlighted the neglect of creative processes in musicology and music performance studies, often by pursuing ethnographic studies of rehearsals. Building on this rethinking, this article considers the potential of merging the values of such ethnographic studies with techniques of performance analysis. In it, I pursue a case study of Herbert von Karajan’s 1965 rehearsal and performance of Robert Schumann’s Symphony No. 4 in D minor, Op. 120 with the Wiener Symphoniker. I critique what I call Karajan’s hypermasculinity in the film, assess how his legato aesthetic takes shape over the rehearsal, and analyse how both of these things come together in the subsequent performance of Schumann’s symphony.
TOI-2285b: A 1.7 Earth-radius planet near the habitable zone around a nearby M dwarf
Authors: Fukui Akihiko , Kimura Tadahiro , Hirano Teruyuki , Narita Norio , Kodama Takanori , Hori Yasunori , Ikoma Masahiro , Pallé Enric , Murgas Felipe , Parviainen Hannu , Kawauchi Kiyoe , Mori Mayuko , Esparza-Borges Emma , Bieryla Allyson , Irwin Jonathan , Safonov Boris S , Stassun Keivan G , Alvarez-Hernandez Leticia , Béjar Víctor J S , Casasayas-Barris Núria , Chen Guo , Crouzet Nicolas , de Leon Jerome P , Isogai Keisuke , Kagetani Taiki , Klagyivik Peter , Korth Judith , Kurita Seiya , Kusakabe Nobuhiko , Livingston John , Luque Rafael , Madrigal-Aguado Alberto , Morello Giuseppe , Nishiumi Taku , Orell-Miquel Jaume , Oshagh Mahmoudreza , Sánchez-Benavente Manuel , Stangret Monika , Terada Yuka , Watanabe Noriharu , Zou Yujie , Tamura Motohide , Kurokawa Takashi , Kuzuhara Masayuki , Nishikawa Jun , Omiya Masashi , Vievard Sébastien , Ueda Akitoshi , Latham David W , Quinn Samuel N , Strakhov Ivan S , Belinski Alexandr A , Jenkins Jon M , Ricker George R , Seager Sara , Vanderspek Roland , Winn Joshua N , Charbonneau David , Ciardi David R , Collins Karen A , Doty John P , Bachelet Etienne , Harbeck Daniel
Published: October 2021

We report the discovery of TOI-2285b, a sub-Neptune-sized planet transiting a nearby (42 pc) M dwarf with a period of 27.3 d. We identified the transit signal from the Transiting Exoplanet Survey Satellite photometric data, which we confirmed with ground-based photometric observations using the multiband imagers MuSCAT2 and MuSCAT3. Combining these data with other follow-up observations including high-resolution spectroscopy with the Tillinghast Reflector Echelle Spectrograph, high-resolution imaging with the SPeckle Polarimeter, and radial velocity (RV) measurements with the InfraRed Doppler instrument, we find that the planet has a radius of $1.74 \pm 0.08\, R_\oplus$, a mass of $\lt \!\!19.5\,M_\oplus$ ($95\%$ c.l.), and an insolation flux of 1.54 ± 0.14 times that of the Earth. Although the planet resides just outside the habitable zone for a rocky planet, if the planet harbors an H2O layer under a hydrogen-rich atmosphere, then liquid water could exist on the surface of the H2O layer depending on the planetary mass and water mass fraction. The bright host star in the near-infrared (Ks = 9.0) makes this planet an excellent target for further RV and atmospheric observations to improve our understanding of the composition, formation, and habitability of sub-Neptune-sized planets.
Nobeyama 45 m Local Spur CO survey. I. Giant molecular filaments and cluster formation in the Vulpecula OB association
Authors: Kohno Mikito , Nishimura Atsushi , Fujita Shinji , Tachihara Kengo , Onishi Toshikazu , Tokuda Kazuki , Fukui Yasuo , Miyamoto Yusuke , Ueda Shota , Kiridoshi Ryosuke , Tsutsumi Daichi , Torii Kazufumi , Minamidani Tetsuhiro , Saigo Kazuya , Handa Toshihiro , Sano Hidetoshi
Published: October 2021

We have performed new large-scale 12CO, 13CO, and C18O J = 1–0 observations toward the Vulpecula OB association (l ∼ 60°) as part of the Nobeyama 45 m Local Spur CO survey project. Molecular clouds are distributed over ∼100 pc, with local peaks at the Sh 2-86, Sh 2-87, and Sh 2-88 high-mass star-forming regions in the Vulpecula complex. The molecular gas is associated with the Local Spur, which corresponds to the nearest inter-arm region located between the Local Arm and the Sagittarius Arm. We discovered new giant molecular filaments (GMFs) in Sh 2-86, with a length of ∼30 pc, width of ∼5 pc, and molecular mass of $\sim\!\! 4 \times 10^4\, M_{\odot }$. We also found that Sh 2-86 contains the three velocity components at 22, 27, and 33 km s−1. These clouds and GMFs are likely to be physically associated with Sh 2-86 because they have high 12CO J = 2–1 to J = 1–0 intensity ratios and coincide with the infrared dust emission. The open cluster NGC 6823 exists at the common intersection of these clouds. We argue that the multiple cloud interaction scenario, including GMFs, can explain cluster formation in the Vulpecula OB association.
What’s mine is yours: the joint interest exception to legal professional privilege in Lambie Trustee Limited v Addleman
Authors: Barber Simon
Published: October 2021

In Lambie Trustee Limited v Addleman, New Zealand’s Supreme Court sided with international authority in finding that trustees generally cannot assert legal professional privilege against beneficiaries to resist disclosure. The Court held that trustees and beneficiaries share a joint interest in trustees’ legal advice because courts will assume such advice is for the benefit of beneficiaries. Joint interest will cease when this is no longer true. Most often, this will occur when a beneficiary files proceedings against a trustee. The difficulty, however, will be telling when correspondence alchemizes into an adverse claim before any proceedings are filed.
Clinical manifestations, laboratory profile and outcomes of dengue virus infection in hospitalised older patients
Authors: Ng Wei Yao , Ngim Chin Fang , Chow Kuan Yee , Goh Sarah Xiu Ming , Zaid Masliza , Dhanoa Amreeta
Published: October 2021

Background

Due to an ageing population, dengue among older patients is encountered more frequently in many countries. Our study aimed to explore the clinico-laboratory parameters and outcomes among dengue-infected older patients in comparison with younger patients.

Methods

This retrospective chart review involved dengue patients with dengue non-structural protein 1 (NS1) antigen positivity admitted to a tertiary hospital in Malaysia from January to July 2015. A comparison was made between older people (aged ≥60 y) and others.

Results

Among 406 dengue patients, 43 (10.6%) were older people. Older dengue patients were less likely to present with persistent vomiting (adjusted OR [AOR] 0.247, 95% CI 0.093 to 0.656, p=0.005), while restlessness and confusion were more common at presentation (AOR 3.356, 95% CI 1.024 to 11.003, p=0.046). Older patients had significantly lower albumin upon admission (38 vs 40 g/L, p=0.036) and during hospital stay (35 vs 37 g/L, p=0.015). Compared with younger patients, older patients were more likely to have experienced nadir platelet counts of <50×109/L (AOR 2.897, 95% CI to 1.176 to 7.137, p=0.021). They were also more likely to require an extended hospital stay (AOR 3.547, 95% CI 1.575 to 7.986, p=0.002).

Conclusions

Diagnosis of dengue in older people may be challenging because of atypical presentations. Increased vigilance is necessary as there is an increased tendency to develop severe thrombocytopenia, hypoalbuminemia and prolonged hospitalisation in older people.
The association of Behçet's syndrome with HLA-B51 as understood in 2021
Authors: Takeno Mitsuhiro
Published: October 2021

Purpose of review

To discuss clinical and pathogenic roles of HLA-B∗51 in Behçet's syndrome.

Recent findings

HLA-B∗51 remains the most important genetic factor in Behçet's syndrome, despite the recent identification of several susceptibility genes. The prevalence of HLA-B∗51 has been shown to differ among phenotype-based clinical clusters in the same patient population. HLA-B∗51 shows epistatic interaction with the susceptible allele of endoplasmic reticulum aminopeptidase (ERAP)1 encoding the Hap10 allotype, which has the lowest trimming activity of the MHC-Class I binding peptides. Subsequent molecular studies have suggested that the disease-associated Hap10 allotype is implicated in the generation and selection of the disease protective or promoting peptides loading onto HLA-B∗51, although these pathogenic peptides have yet to be identified.

HLA-B∗51 is a hallmark of Behçet's syndrome but genetic markers are not very useful in the diagnosis of Behçet's syndrome. Rather, it is considered an important factor in determining clinical phenotypes in this heterogeneous condition. The epigenetic interaction of HLA-B∗51 with ERAP1 sheds light on pathogenesis.
Blood loss in hip reconstructive surgery in children with cerebral palsy: when do I need to be prepared for blood transfusion?
Authors: Oladeji Afolayan K. , Minaie Arya , Landau Andrew J. , Hosseinzadeh Pooya
Published: October 2021

The hip is the second most common joint involved in pediatric patients with cerebral palsy (CP). Hip reconstructive procedures are performed to improve function and comfort level. Blood loss can occur leading to blood transfusion in close to 1/3 of children with CP undergoing hip reconstruction. The purpose of this study was to report the rate and risk factors for blood transfusion after hip reconstruction in a large cohort of children with CP. We conducted a retrospective chart review of pediatric patients at our tertiary referral children’s hospital who underwent reconstructive hip osteotomy over an 8-year period. Binary logistic regression was employed to compare and model differences in transfusion between age greater than 4 or 6 years and the number of osteotomies. A total of 180 patients met our inclusion criteria. Thirty-seven patients (20.6%) received blood transfusion. Incidence of transfusion increased as number of osteotomies increased from 1 to 4 (3.7%, 7.3%, 34.0%, 58.3%, respectively). We did not find a significant effect of age greater than 4 or 6 years on the rate of blood transfusion (P = 0.676 and P = 0.323, respectively). The number of osteotomies was a significant factor in the rate of blood transfusion in both models (P < 0.001). Number of osteotomies and not age was a significant risk factor in the rate of blood transfusion. This data can help the orthopedic surgeons in preoperative planning for the possibility of blood transfusion in these patients.
Narrative Review of Antiplatelet and Anticoagulant Medications for Venous Thromboembolism Prevention in Spine Surgery
Authors: Louie Philip K. , Urakawa Hikari , Manzur Mustfa K. , Craig Chad M. , Qureshi Sheeraz A.
Published: October 2021

Study Design:

This was a narrative review.

Objective:

The objective of this study was to identify commonly utilized venous thromboembolism (VTE) prophylactic measures, spine surgeon perspective, and provide pharmacologic recommendations from the literature.

Summary of Background Data:

Considered a preventable cause of morbidity and mortality, VTE remains an important iatrogenic diagnosis of concern. Reported rates of VTE following spine surgery vary widely (0.3%–31.0%).

Materials and Methods:

A MEDLINE query identified literature reporting on VTE prevention and outcomes in the setting of spine surgery. Findings extracted from the included articles were summarized in a narrative review format to identify salient aspects of the current literature.

Results:

Sixty articles were summarized. Many anticoagulation medications that are described in the literature target factors involved in the coagulation cascade common pathway including aspirin and other antiplatelet medications, heparins, and warfarin. Newer direct inhibitors of thrombin and factor Xa are now being utilized for VTE prevention, although with limited use specifically in spine surgery.

Conclusions:

Perioperative management of antiplatelet and anticoagulation medications in spine surgery requires evidence-based protocols that can account for patient comorbidities and surgery-specific features. Future studies should prospectively focus on establishing stronger recommendations based on pathology, surgical indications, patient comorbidities, region of the spine, and broad surgical intervention to enable effective prophylaxis for VTE.

Level of Evidence:

Level II.
Transcatheter Aortic Valve Replacement for Severe Symptomatic Aortic Stenosis in Rheumatic Heart Disease: A Systematic Review
Authors: Fernandes Amanda D. F. , Fernandes Gilson C. , Grant Jelani , Knijnik Leonardo , Cardoso Rhanderson , Cohen Mauricio G. , Ferreira Alexandre C. , Alfonso Carlos E.
Published: October 2021

Transcatheter aortic valve replacement (TAVR) is well-established for severe symptomatic aortic stenosis (AS), but its use in rheumatic heart disease (RHD) has been limited. We systematically review the use of TAVR for severe symptomatic AS in RHD. Pubmed, Embase, and Scopus were searched for TAVR for symptomatic severe AS and proven or suspected RHD. Procedure characteristics, efficacy, and safety endpoints were collected and all definitions were based on the Valve Academic Research Consortium-2 (VARC-2) criteria. We included 3 case series and 12 case reports, with a total of 43 patients. Mean age was 76 years, 75% were female, and 85% had NYHA class III-IV symptoms. Follow up ranged from 1 to 29 months. Patients were moderate to high risk, with Society of Thoracic Surgery score ranging from 6.1% to 17.6%. The approach was transfemoral in 30 (83%) cases. Procedural success occurred in 37 (86%) patients. Of the 7 patients with periprocedural complications, 4 had valve dislodgement, 1 deployment failure, 1 unplanned cardiopulmonary bypass, and 1 moderate aortic regurgitation. Paravalvular leak was reported in 5 (11.6%) patients. Only 1 patient had heart block requiring pacemaker. Among 13 studies (23 patients), 30-day mortality was 0%. One case series with 19 patients had a 30-day, 1-year, 2-year, and 5-year mortality of 5%, 11%, 31%, and 48%, respectively. TAVR appears feasible for selected patients with rheumatic severe AS, albeit our results indicate a 14% incidence of device failure. Future randomized clinical trials may clarify the role of TAVR in this group.
Ecthyma Gangrenosum in Children With Cancer: Diagnosis at a Glance: A Retrospective Study From the Infection Working Group of Italian Pediatric Hematology Oncology Association
Authors: Muggeo Paola , Zama Daniele , Decembrino Nunzia , Onofrillo Daniela , Frenos Stefano , Colombini Antonella , Perruccio Katia , Calore Elisabetta , Giurici Nagua , Ficara Monica , La Spina Milena , Mura Rosamaria , De Santis Raffaella , Santoro Nicola , Cesaro Simone
Published: October 2021

Background:

To depict ecthyma gangrenosum (EG) clinical presentation and evolution in a large multicenter pediatric retrospective collection of children with malignancies or bone marrow failure syndromes, to facilitate early diagnosis.

Methods:

EG episodes diagnosed in the period 2009–2019 were identified by a retrospective review of clinical charts at centers belonging to the Italian Pediatric Hematology Oncology Association.

Results:

Thirty-eight cases of EG occurring in children (male/female 16/22; median age 5.2 years) with hematologic malignancy (29), allogeneic stem cell transplantation (2) or relapsed/refractory solid tumor (3) were collected. The involved sites were: perineal region (19), limbs (10), trunk (6), head and the iliac crest (3). Bacteremia was present in 22 patients. Overall, the germs isolated werePseudomonas aeruginosa(30),Stenotrophomonas maltophilia(3) andEscherichia coli(1); 31% of them were multidrug-resistant. All patients received antibacterial treatment, while surgery was performed in 24 patients (63.1%). Predisposing underlying conditions for EG were severe neutropenia (97.3%), corticosteroid treatment (71%) and iatrogenic diabetes (23.7%). All patients recovered, but EG recurred in 5 patients. Nine patients (24%) showed sequelae (deep scars, with muscle atrophy in 2). Four patients (10.5%) died, 1 due to relapse of EG with Carbapenem-resistant Enterobacteriaceae co-infection and 3 due to the progression of the underlying disease.

Conclusions:

EG requires early recognition and a proper and timely treatment to obtain the recovery and to avoid larger necrotic lesions, eventually evolving in scarring sequelae.
Congenital Cytomegalovirus and Hepatic Failure
Authors: Souder J. Paige , Grimm Erica , Pinninti Swetha , Boppana Suresh , Hsu Evelyn , Horslen Simon , Pacheco M. Cristina , Kunz Anjali , Sainato Rebecca
Published: October 2021

Congenital cytomegalovirus infection is the most common congenital infection. Although most infants with congenital cytomegalovirus infection are asymptomatic at birth, a subset will have readily apparent clinical and/or laboratory manifestations including hepatitis; progression to hepatic failure has not previously been described in term infants who initiated antiviral treatment shortly after birth. We present 2 term infants with congenital cytomegalovirus infection and hepatitis who progressed to hepatic failure despite initial laboratory improvement on therapy.
The Impact of Severe Acute Respiratory Syndrome Coronavirus Type 2 on Children With Liver Diseases
Authors: Nicastro Emanuele , Ebel Noelle H. , Kehar Mohit , Czubkowski Piotr , Ng Vicky L. , Michaels Marian G. , Lobritto Steven J. , Martinez Mercedes , Indolfi Giuseppe
Published: October 2021

Children are seldom affected by severe forms of severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV2) infection; however, the impact of comorbidities in the clinical presentation and outcome of SARS‐CoV2 in children is poorly characterized including that of chronic liver disease (CLD) and those taking immunosuppressive medications for autoimmune liver disease or following liver transplantation (LT). Although not the main target organ, a spectrum of liver involvement has been described in children infected with SARS‐CoV2 and those presenting with Multisystem Inflammatory Syndrome in Children (MIS‐C). The Hepatology Committee of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the Society of Pediatric Liver Transplantation (SPLIT) present an evidence‐based position paper on liver involvement in children with SARS‐CoV2 infection and its impact on those with CLD as well as LT recipients. All children may exhibit acute liver injury from SARS‐CoV2 infection, and those with CLD and may experience hepatic decompensation. Preventative and therapeutic measures are discussed.
Evaluation and Perception of Clinical Pharmacist Participation in a Rapid Response Team During Cardiopulmonary Resuscitation
Authors: McGinnis Cory , Kim Catherine , Qureshi Abdullah , Scholle Carol , Ramanan Raj
Published: October 2021

Background and Objectives:

The addition of a pharmacist to rapid response teams (RRT) has been shown to improve adherence to advanced cardiac life support protocols and to decrease mortality. A quality improvement study was initiated at a single center to evaluate the addition of a pharmacist to the RRT during cardiopulmonary arrest.

Methods:

Data were prospectively collected on pharmacy response time and interventions performed. In addition, a pre- and post-intervention survey of the interprofessional medical emergency response improvement team (MERIT) was performed to assess the perception of pharmacist involvement.

Results:

From April to November 2019, the pharmacists responded to 19 RRT activations for cardiopulmonary arrest. An average of 29.8 minutes were spent at each event and an average of 5.5 interventions per event were made. The most common intervention made by pharmacists was medication procurement (54 interventions), followed by providing drug information (14 interventions). Pharmacists also ensured medication reimbursement (13 interventions). The majority of the MERIT strongly agreed or agreed that the addition of a pharmacist to RRT activations improved teamwork (83.1%), decreased medication turnaround time (84.6%), decreased medication errors (66.7%), and may have prevented a poor outcome (71.8%) in the post-implementation survey.

Conclusion:

Overall, pharmacists demonstrated value as a member of the RRT during cardiopulmonary arrest. The addition of a pharmacist was well received by interprofessional members of the MERIT.
Pontibacter cellulosilyticus sp. nov., a carboxymethyl cellulose-hydrolysing bacterium isolated from coastal water
Authors: Kang Minchung , Chhetri Geeta , Kim Jiyoun , Kim Inhyup , Seo Taegun
Published: October 2021

A Gram-stain-negative, rod-shaped, non-motile, red-pink bacterium designated SD6T was isolated from coastal marine water at Sadong Beach, Ulleung Island, South Korea. Cells of SD6T grew at 10–42 °C (optimum, 30 °C), pH 5.0–9.0 (optimum, pH 6.0–7.0) and at 0–8.0 % (w/v) NaCl (optimum, 0–3 %). Moreover, 16S rRNA gene sequence analysis indicated that strain SD6T was a member of the genus

Pontibacter

, sharing similarities to

Pontibacter aydingkolensis

XAAS-1T (98.0 %),

Pontibacter amylolyticus

9-2T (97.3 %),

Pontibacter korlensis

X14-1T (97.2 %) and

Pontibacter soli

HYL7-26T (96.8 %). The predominant fatty acids of strain SD6T were identified as iso-C15 : 0 and summed feature 4 (comprising anteiso-C17 : 1 B and/or iso-C17 : 1 I) and the sole respiratory quinone was identified as MK-7 (menaquinone 7). Major polar lipids included phosphatidylethanolamine, one unidentified phosphoglycolipid, two unidentified glycolipids and one unidentified lipid. The average nucleotide identity and in silico DNA–DNA hybridization values of strain SD6T with its closely related strains were 72.8–79.8 % and 19.2–22.6 %, respectively. The genomic DNA G+C content was 45.4 mol%. In accordance with the results of phenotypic, chemotaxonomic and phylogenetic data, strain SD6T represents a novel species of the genus

Pontibacte

r, for which the name Pontibacter cellulosilyticus sp. nov. is proposed. The type strain is SD6T (=KACC 21543T=NBRC 114313T=JCM 31022T).
Taxonomy and molecular phylogeny of a new freshwater ciliate Frontonia apoacuminata sp. nov. (Protista, Ciliophora, Oligohymenophorea) from Qingdao, PR China
Authors: Li Tao , Pan Xuming , Lu Borong , Miao Miao , Liu Mingjian
Published: October 2021

The morphology and ciliature of a new freshwater ciliate, Frontonia apoacuminata sp. nov., isolated from an artificial pond in Qingdao, PR China, were investigated using live observation and silver staining methods. The main features separating F. apoacuminata sp. nov. from its congeners are as follows: a broad elliptical body that is slightly pointed at the posterior end, four ophryokineties, one or two spherical micronuclei of a ‘compact’ type, a dorsally positioned contractile vacuole, and peniculi 1–3 each with five kinetosome rows though the left-most two rows in peniculus 3 are extremely shortened (with only two or three kinetosomes each). Additionally, an improved diagnosis of F. acuminata is provided. Phylogenetic analyses based on the small subunit ribosomal RNA (SSU rRNA) gene show that F. apoacuminata sp. nov. clusters with F. atra, F. minuta, F. acuminata and F. terricola. These five species group with Disematostoma, Marituja and Stokesia rather than with other Frontonia species, causing polyphyly of the genus Frontonia.
COVID-19 Vaccination Mandates and Vaccine Uptake
Authors: Karaivanov Alexander , Kim Dongwoo , Lu Shih En , Shigeoka Hitoshi
Published: October 2021

We evaluate the impact of government-mandated proof of vaccination requirements for access to public venues and non-essential businesses on COVID-19 vaccine uptake. We find that the announcement of a mandate is associated with a rapid and significant surge in new vaccinations (more than 60% increase in weekly first doses), using the variation in the timing of these measures across Canadian provinces in a difference-in-differences approach. Time-series analysis for each province and for France, Italy and Germany corroborates this finding. Counterfactual simulations using our estimates suggest the following cumulative gains in the vaccination rate among the eligible population (age 12 and over) as of October 31, 2021: up to 5 percentage points (p.p.) (90% CI 3.9–5.8) for Canadian provinces, adding up to 979,000 (425,000-1,266,000) first doses in total for Canada (5 to 13 weeks after the provincial mandate announcements), 8 p.p. (4.3–11) for France (16 weeks post-announcement), 12 p.p. (5–15) for Italy (14 weeks post-announcement) and 4.7 p.p. (4.1–5.1) for Germany (11 weeks post-announcement).
General dimensions of human brain morphometry inferred from genome-wide association data
Authors: Fürtjes Anna E. , Arathimos Ryan , Coleman Jonathan R. I. , Cole James H. , Cox Simon R. , Deary Ian J. , de la Fuente Javier , Madole James W. , Tucker-Drob Elliot M. , Ritchie Stuart J.
Published: October 2021

Background

Understanding the neurodegenerative mechanisms underlying cognitive declines in the general population may facilitate early detection of adverse health outcomes in late life. This study investigates biological pathways shared between brain morphometry, ageing, and cognitive ability.

Methods

We develop Genomic Principal Components Analysis (genomic PCA) to model general dimensions of variance in brain morphometry within brain networks at the level of their underlying genetic architecture. With genomic PCA we extract genetic principal components (PCs) that index global dimensions of genetic variance across phenotypes (unlike ancestral PCs that index genetic similarity between participants). Genomic PCA is applied to genome-wide association data for 83 brain regions which we calculated in 36,778 participants of the UK Biobank cohort. Using linkage disequilibrium score regression, we estimate genetic overlap between brain networks and indices of cognitive ability and brain ageing.

Results

A genomic principal component (PC) representing brain-wide dimensions of shared genetic architecture accounted for 40% of the genetic variance across 83 individual brain regions. Genomic PCs corresponding to canonical brain networks accounted for 47-65% of the genetic variance in the corresponding brain regions. These genomic PCs were negatively associated with brain age (rg = −0.34). Loadings of individual brain regions on the whole-brain genomic PC corresponded to sensitivity of a corresponding region to age (r = - 0.27). We identified positive genetic associations between genomic PCs of brain morphometry and general cognitive ability (rg= 0.17-0.21).

Conclusion

These results demonstrate substantial shared genetic etiology between connectome-wide dimensions of brain morphometry, ageing, and cognitive ability, which will help guide investigations into risk factors and potential interventions of ageing-related cognitive decline.