bluuebunny/crossref_metadata_2025 huggingface dataset:
On the seasonal and sub‐seasonal factors influencing East China tropical cyclone landfall
Authors: Sparks Nathan , Toumi Ralf
Published: October 2020

To date it has proved difficult to make seasonal forecasts of tropical cyclones, particularly for landfall and in East China specifically. This study examines sources of predictability for the number of landfalling typhoons in East China on seasonal (June–October) and sub‐seasonal time scales. East China landfall count is shown to be independent of basin‐scale properties of TC tracks, such the genesis location, duration, basin track direction and length, and basin total count. Large‐scale environmental climate indices which are potential basin scale drivers are also shown to be largely uncorrelated with landfall prior to and throughout the season. The most important factor is the steering in the final stages to landfall. The seasonal landfall is strongly anti‐correlated with the more local zonal mid‐tropospheric wind field over the East China sea (r = −.61, p < .001). It is proposed that geopotential height anomalies over Korea/Japan cause anomalous easterly winds in the East China Sea and enhance landfall rates by steering typhoons onto the coast. Early, peak, and late sub‐seasonal landfall counts are shown to be independent of each other yet share this predictor. This local feature may be dynamically predictable allowing a potential hybrid dynamical‐statistical seasonal forecast of landfall.
The Familial Risk of Autism Spectrum Disorder with and without Intellectual Disability
Authors: Xie Sherlly , Karlsson Håkan , Dalman Christina , Widman Linnea , Rai Dheeraj , Gardner Renee M. , Magnusson Cecilia , Sandin Sven , Tabb Loni P. , Newschaffer Craig J. , Lee Brian K.
Published: October 2020

Autism spectrum disorder (ASD) is highly heritable, yet how its familial risk and heritability may vary by cognitive ability is not well understood. In this population‐based cohort study, we examined the familial risk and heritability of ASD with and without co‐occurring intellectual disability (ID). We estimated odds ratios and heritability of ASD with ID (ASD+ID) and ASD without ID (ASD−ID) using register‐based diagnosis data of 567,436 index persons born in 1984–2009 in Stockholm County, Sweden, and their parents, siblings, cousins, aunts, and uncles. The familial risk profile exhibited differences between ASD−ID and ASD+ID, most notably for index persons with affected parents. For example, for an index person who had at least one parent with ASD, the child's odds of ASD−ID and ASD+ID (95% confidence interval (CI)) increased by 16.2 (14.2–18.6) and 7.4 (5.5–10.0) folds, respectively. The more closely related a family member with ASD was, the greater the observed risk was of ASD in the index person, especially for ASD−ID. The broad‐sense heritability (95% CI) for ASD − ID and ASD+ID were 64.6% (46.0–100.0%) and 33.4% (14.4–58.4%), respectively. Familial risk and heritability of ASD may vary by intellectual ability, which implies that risk factors between these ASD phenotypes may differ. Our findings from the heritability analysis and familial risk analysis suggest that ASD−ID may have a greater genetic basis than ASD+ID, although this should be verified in future studies.

Lay Summary

Autism spectrum disorder (ASD) is highly heritable, yet how its familial risk and heritability may vary by cognitive ability is not well‐understood. In a population‐based cohort study on families of 567,436 index persons using Swedish registers data, we found that the familial risk profile differed between ASD with and without intellectual disability. Our findings from the heritability analysis and familial risk analysis suggest that ASD−ID may have a greater genetic basis than ASD+ID, although this should be verified in future studies.
Can COVID‐19 cause severe neutropenia?
Authors: López‐Pereira Patricia , Iturrate Isabel , de La Cámara Rafael , Cardeñoso Laura , Alegre Adrián , Aguado Beatriz
Published: October 2020

This is the first case of acquired severe neutropenia in the context of COVID‐19 reported to date. This could illustrate another less frequent hematological disorder related to this novel viral infection.
Effects of Graphene Oxide Nanosheets and Al2O3Nanoparticles on CO2Uptake in Semi‐clathrate Hydrates
Authors: Hassan Hussein , Javidani Amir Mohammad , Mohammadi Abolfazl , Pahlavanzadeh Hassan , Abedi-Farizhendi Saeid , Mohammadi Amir H.
Published: October 2020

Gas hydrate/clathrate hydrate formation is an innovative method to trap CO2into hydrate cages under appropriate thermodynamic and/or kinetic conditions. Due to their excellent surface properties, nanoparticles can be utilized as hydrate kinetic promoters. Here, the kinetics of the CO2+ tetra‐n‐butyl ammonium bromide (TBAB) semi‐clathrate hydrates system in the presence of two distinct nanofluid suspensions containing graphene oxide (GO) nanosheets and Al2O3nanoparticles is evaluated. The results reveal that the kinetics of hydrate formation is inhibited by increasing the weight fraction of TBAB in aqueous solution. GO and Al2O3are the most effective kinetic promoters for hydrates of (CO2+ TBAB). Furthermore, the aqueous solutions of TBAB + GO or Al2O3noticeably increase the storage capacity compared to TBAB aqueous solution systems.
Use of the Weibull model on sizing thickeners ‐ Part I: Sedimentation curve representation
Authors: Ferreira Daniel José de Oliveira , Fiuza Matheus Pires de Mattos , Cardoso Marcelo , de Oliveira Idalmo Montenegro
Published: October 2020

The present work aims to represent the sedimentation curve of different industrial pulps through the Weibull model PDF, which employs two parameters k and γ, dispensing the graphical methods to design thickeners and clarifiers, using exclusively mathematical equations. This provides greater accuracy and increases significantly the speed in sizing calculations. To ratify the use of the model, sedimentation curves of various types of pulps were generated in the laboratory, several types of curves were obtained through tests given in the literature and exhaustive comparison tests between the data obtained in the tests and those predicted by the model. The proposed model presented good data adjustment in relation to those obtained in several bibliographic references, presenting maximum error of 12%.
gauseR: Simple methods for fitting Lotka‐Volterra models describing Gause’s “Struggle for Existence”
Authors: Mühlbauer Lina K. , Schulze Maximilienne , Harpole W. Stanley , Clark Adam T.
Published: October 2020

Point 1: The ecological models of Alfred J. Lotka and Vito Volterra have had an enormous impact on ecology over the past century. Some of the earliest—and clearest—experimental tests of these models were famously conducted by Georgy Gause in the 1930s. Although well known, the data from these experiments are not widely available and are often difficult to analyze using standard statistical and computational tools.

Point 2: Here, we introduce the gauseR package, a collection of tools for fitting Lotka‐Volterra models to time series data of one or more species. The package includes several methods for parameter estimation and optimization, and includes 42 datasets from Gause's species interaction experiments and related work. Additionally, we include with this paper a short blog post discussing the historical importance of these data and models, and an R vignette with a walk‐through introducing the package methods. The package is available for download at github.com/adamtclark/gauseR.

Point 3: To demonstrate the package, we apply it to several classic experimental studies from Gause, as well as two other well‐known datasets on multi‐trophic dynamics on Isle Royale, and in spatially structured mite populations. In almost all cases, models fit observations closely and fitted parameter values make ecological sense.

Point 4: Taken together, we hope that the methods, data, and analyses that we present here provide a simple and user‐friendly way to interact with complex ecological data. We are optimistic that these methods will be especially useful to students and educators who are studying ecological dynamics, as well as researchers who would like a fast tool for basic analyses.
Prognostic value of D‐dimer in acute myocardial infarction complicated by heart failure with preserved ejection fraction
Authors: Zhang Xiaoyuan , Wang Shanjie , Sun Liping , Fang Shaohong , Yu Bo
Published: October 2020

Aims

The prevalence of heart failure (HF) after acute myocardial infarction (AMI) is common. Contemporary data are lacking on the prognostic utility of the measurement of biomarker for patients with AMI complicated by HF according to preserved (HFpEF) and reduced ejection fraction (HFrEF). We aim to assess the association between D‐dimer levels and all‐cause mortality in patients with AMI complicated by different HF subtypes during hospitalization in the context of other risk factors.

Methods and results

We enrolled 4495 patients with AMI with complete clinical and laboratory variable assessments in this cohort. D‐dimer levels were measured on admission immediately at baseline. We used Cox proportional hazards analysis to assess this association accounting for 18 relevant clinical variables. During the index hospitalization, 589 patients with AMI developed HFpEF, 513 patients with AMI developed HFrEF, and 3393 patients with AMI did not develop HF. The patients were divided into HFpEF, HFrEF, and non‐HF groups accordingly. The median length of follow‐up was 1 year (range: 1 to 24 months). During the whole follow‐up, 58 (15.5%), 107 (27.9%), and 96 (4.2%) of the patients experienced death event in HFpEF, HFrEF, and non‐HF groups, respectively. In each group, the patients were divided into high or low D‐dimer levels according to D‐dimer concentration (145 ng/mL). In the fully adjusted model, the risk of all‐cause mortality of those patients with high D‐dimer levels was 2.09 [95% confidence intervals (CI): 1.08 to 4.02, P = 0.02] times as high as the risk of patients with low D‐dimer levels in HFpEF group. When analysing D‐dimer as a continuous variable, this associations still existed. But there was no significant association between D‐dimer concentration and all‐cause mortality in HFrEF [hazard ratio (HR): 1.25, CI: 0.76 to 2.04, P = 0.37] or non‐HF (HR: 1.56, CI: 0.98 to 2.47, P = 0.06), respectively, after fully adjustment for other key clinical variables.

Conclusions

High D‐dimer levels on admission were found to be strongly associated with the subsequent cumulative incidence of all‐cause mortality in patients with AMI complicated by HFpEF.
Recurrent bladder cancer in aging societies: Importance of major histocompatibility complex class I antigen presentation
Authors: Wieczorek Edyta , Garstka Malgorzata A.
Published: October 2020

Aging is associated with an insufficient immune response that may lead to the initiation and progression of various malignancies. Bladder cancer (BC), prevalent in elderly patients, predominantly presents as recurrent nonmuscle invasive BC that requires further treatment. There is much interest in the activation of patients' immune cells with the focus on CD8+ T cells. Successful therapy should also ensure the efficient presentation of BC antigens by major histocompatibility complex (MHC) class I molecules. The purpose of this systematic review is to present the existing literature on the role of MHC class I in BC research and therapy. The bibliographic databases PubMed and Web of Science were searched for articles published between January 2009 and September 2020 that addressed MHC class I relationship to BC. We searched for available relevant publications on MHC class I and its role and regulation in BC, aging and MHC class I importance in BC immunotherapy. Based on the provided evidence, we propose that the loss of MHC class I expression in BC may lead to its recurrence after the transurethral resection and unresponsiveness to Bacillus Calmette‐Guerin immunotherapy. We discuss different ways to enhance MHC class I antigen presentation to CD8+ T cells in BC treatment. The immune status characterized by MHC class I expression patterns and cancer‐infiltrating immune cells may provide valuable prognostic information about which patients may benefit from transurethral resection of BC and additional immunotherapy.
Structural and biochemical modifications of model and native membranes of human immune cells in response to the action of zinc oxide nanoparticles
Authors: Czyżowska Agnieszka , Dyba Barbara , Rudolphi‐Szydło Elżbieta , Barbasz Anna
Published: October 2020

The development of nanotechnology has led to the increased production of zinc oxide nanoparticles (ZnO‐NPs) and their application in a wide variety of everyday products. It creates the need for a full assessment of their safety for humans. The aim of the study was to assess the toxic effects of ZnO‐NPs on model human cells of the immune system: U‐937, HL‐60, HUT‐78, and COLO‐720L. Particular attention was paid to the direct interaction of the nanoparticles with membrane lipids and the role of zinc ions in the mechanism of their toxicity. Cell viability, lipid peroxidation, cell membrane integrity, and the amount of zinc ions released from nanoparticles were tested. Disruption in cell metabolism was noted for ZnO‐NPs concentrations from 6.25 mg/L. Contact with ZnO‐NPs caused lipid peroxidation of all cells and correlated with membrane disruption of HL‐60, HUT‐78, and COLO‐720L cells. Model monolayers (Langmuir technique) were used to assess the interaction of the nanoparticles with the studied lipids. Physicochemical parameters, such as the area per molecule at maximal layer compression, the pressure at which the monolayer collapses, and the static compression modulus, were calculated. The models of the HL‐60 and U‐937 cell membranes under ZnO‐NPs treatment reacted in a different way. It has also been shown that Zn2+ are not the main causative factor of ZnO‐NPs toxicity. Investigating the early stages of mechanism of nanoparticles toxicity will allow for a more complete risk assessment and development of methods for a safer synthesis of engineering nanomaterials.
Ultrastructural aspects of spermatogenesis in Calyptogena pacifica Dall 1891 (Vesicomyidae; Bivalvia)
Authors: Yurchenko Olga V. , Borzykh Oleg G. , Kalachev Alexander V.
Published: October 2020

The process of spermatogenesis and spermatozoon morphology was characterized from a deep‐sea bivalve, Calyptogena pacifica (Vesicomyidae, Pliocardiinae), a member of the superfamily Glossoidea, using light and electron microscopy. Spermatogenesis in C. pacifica is generally similar to that in shallow‐water bivalves but, the development of spermatogenic cells in this species has also some distinguishing features. First proacrosomal vesicles are observed in early spermatocytes I. Although, early appearance of proacrosomal vesicles is well known for bivalves, in C. pacifica, these vesicles are associated with electron‐dense material, which is located outside the limiting membrane of the proacrosomal vesicles and disappears in late spermatids. Another feature of spermatogenesis in C. pacifica is the localization of the axoneme and flagellum development. Early spermatogenic cells lack typical flagellum, while in spermatogonia, spermatocytes, and early spermatids, the axoneme is observed in the cytoplasm. In late spermatids, the axoneme is located along the nucleus, and the flagellum is oriented anteriorly. During sperm maturation, the bent flagellum is transformed into the typical posteriorly oriented tail. Spermatozoa of C. pacifica are of ect‐aqua sperm type with a bullet‐like head of about 5.8 μm in length and 1.8 μm in width, consisting of a well‐developed dome‐shaped acrosomal complex, an elongated barrel‐shaped nucleus filled with granular chromatin, and a midpiece with mainly four rounded mitochondria. A comparative analysis has shown a number of common traits in C. pacifica and Neotrapezium sublaevigatum.
Detection of HPV16/18 E6 Oncoproteins in Head and Neck Squamous Cell Carcinoma Using a Protein Immunochromatographic Assay
Authors: Menegaldo Anna , Schroeder Lea , Holzinger Dana , Tirelli Giancarlo , Dal Cin Elisa , Tofanelli Margherita , Rigo Stefania , Mantovani Monica , Stellin Marco , Del Mistro Annarosa , Dei Tos Angelo P. , Guerriero Angela , Niero Monia , Borsetto Daniele , Da Mosto Maria C. , Polesel Jerry , Pawlita Michael , Waterboer Tim , Boscolo‐Rizzo Paolo
Published: October 2020

Objectives/Hypothesis

The accurate diagnostic assessment of clinically relevant human papillomavirus (HPV) infections in patients with head and neck squamous cell carcinoma represents an urgent unmet medical need. The aim of this study was to determine feasibility, accuracy, and clinical significance of HPV16/18 E6 oncoprotein detection on cytological specimens from oropharyngeal squamous cell carcinoma (OPSCC) and neck lymph node metastasis of SCC from unknown primary tumor (CUP) via a protein immunochromatographic assay.

Study Design

Cross‐sectional study.

Methods

Cytological specimens from primary tumor and neck metastases were collected from 34 patients with OPSCC or CUP and applied to a lateral flow format test that detects HPV16 and HPV18 E6 oncoproteins. E6 oncoprotein positivity or negativity in these specimens was compared to the specimens' “HPV‐driven” reference status, defined by presence of HPV‐DNA in combination with p16INK4a overexpression and/or HPV E6 seropositivity.

Results

Eighteen of 29 OPSCC (62%) and three of five CUP (60%) were HPV‐driven according to our reference method. The E6 oncoprotein lateral flow test had a sensitivity of 94% (95% CI: 70%–100%) and a specificity of 100% (95% CI: 66%–100%) on primary tumor, and a sensitivity of 88% (95% CI: 64%–99%) and a specificity of 100% (95% CI: 74%–100%) on neck metastases. Test agreement between the E6 lateral flow test and the clinical reference method, HPV‐DNA plus p16INK4a was excellent, both for primary lesion and neck metastases.

Conclusions

We found the detection of HPV16/18 E6 oncoproteins to be a feasible, highly reliable, and low‐invasive method to assess “HPV‐driven” status in OPSCC and CUP.

Level of Evidence

II Laryngoscope, 131:1042–1048, 2021
Impact of Particulate Matter on the Clinical Characteristics of Rhinitis
Authors: Kim Jin Youp , Lee Dong Su , Woo Hyun‐Joon , Kim Hyung Gu , Son Bu‐Soon , Park Moo Kyun , Hong Seung‐No
Published: October 2020

Objectives/Hypothesis

To investigate the association between PM10 concentration and the severity of rhinitis symptoms.

Study Design

Retrospective cohort study.

Methods

Retrospective analysis of the data of 590 participants prospectively enrolled in a regional population‐based cohort study was performed. The ambient PM10 concentrations were measured at 12 different observatories located in three cities. All participants were screened for allergic sensitization by skin prick tests and asked to complete questionnaires regarding their rhinitis symptoms. The severity and duration of rhinitis were analyzed and compared at different levels of PM10 concentration.

Results

On multivariate analysis, the PM10 concentration significantly correlated with the severity of symptoms when adjusting for age, sex, presence of sensitized allergen, region, and the time of enrolment (β = 0.102, P = .021). Positive correlation was found between PM10 concentration and the duration of allergic rhinitis symptoms (β = 0.082, P = .077). In the stratified analysis on the atopic status, there was a significant correlation between PM10 concentration and the severity and duration of rhinitis symptoms in those without allergic sensitization (β = 0.104; P = .032 and β = 0.104; P = .011, respectively).

Conclusions

The significant correlation between the annual PM10 concentration and severity and duration of rhinitis symptoms suggests the necessity of intensive management of rhinitis patients exposed to elevated levels of ambient PM10 concentration.

Level of Evidence

3 Laryngoscope, 131:E1753–E1759, 2021
Simple, once‐off mapping of various, recurrent immunostaining patterns of proliferating cell nuclear antigen in spermatogonia at the immature pole of the testis of adult wild‐caught blue shark, Prionace glauca: Correlations with changes in testicular status
Authors: McClusky Leon M.
Published: October 2020

This study was a single time‐point mapping of various immunostaining patterns revealed with the proliferating cell nuclear antigen (PCNA) PC10 antibody in spermatogonia at the immature pole of the testis of the Blue shark (Prionace glauca). Scattered in the stroma of the germinal ridge that demarcates the immature pole's outer boundary were nests of variously immunoreactive A‐spermatogonia, each flanked by a fusiform cell. Spermatocysts were assembled from niche‐derived stromal cells, displaced A‐progenitors, and their progeny, which showed one of two main immunostaining patterns (i.e., an uneven light brown/globular and homogeneous dark [hod] brown appearance). The testes of wild‐caught Prionace showed two conditions, namely, extensive multinucleate cell death (MNC) near the mitosis–meiosis transition or an early recovery phase from the latter showing vacuolated areas. Both the proportion of cysts with immature Bhod‐spermatogonia and the frequency of mitotic figures in such cysts in the early recovery testis condition were significantly higher than the comparable parameters in MNC testis condition. Moreover, the post‐MNC recovery phase revealed a decrease in the proportion of immature cysts with uneven light brown/globular‐like spermatogonia. The protracted spread of a cell cycle signal in an anatomically discrete, syncytially connected spermatogonial clone manifests as different PCNA immunoreactivities.
Effect of nucleating agents on the non‐isothermal crystallization and degradation kinetics of poly(ethylene terephthalate)
Authors: Thamizhlarasan Anbarasan , Meenarathi Balakrishnan , Parthasarathy Vellaichamy , Jancirani Asirvatham , Anbarasan Ramasamy
Published: October 2020

Poly(ethylene terephthalate) (PET) was synthesized by two steps, namely (a) transesterification and (b) polycondensation. Various analytical instruments were used for the characterization of neat PET. The sodium salt of nucleating agents added with PET was synthesized by the in‐situ method under the same experimental conditions. The influence of CO2Na, ONa, SO3Na, PO3Na on the crystallization properties of PET was tested. The aromatic SO3Na nucleated PET exhibited the highest crystallization temperature (Tc) value of 211.4°C with the degradation temperature (Td) value of 446.9°C. The energy of activation (Ea) for the degradation and crystallization of PET was determined using various kinetic models. The modified Avrami equation showed the 3D crystal growth of PET, which was further evidenced by polarized optical microscopy (POM). The second stage of degradation consumed a higher amount of thermal energy. The experimental results were compared with the literature values.
Airborne transmission of SARS‐CoV‐2 via aerosols
Authors: Comber Laura , O Murchu Eamon , Drummond Linda , Carty Paul G. , Walsh Kieran A. , De Gascun Cillian F. , Connolly Máire A. , Smith Susan M. , O'Neill Michelle , Ryan Máirín , Harrington Patricia
Published: October 2020

A key consideration in the Covid‐19 pandemic is the dominant modes of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus. The objective of this review was to synthesise the evidence for the potential airborne transmission of SARS‐CoV‐2 via aerosols. Systematic literature searches were conducted in PubMed, Embase, Europe PMC and National Health Service UK evidence up to 27 July 2020. A protocol was published and Cochrane guidance for rapid review methodology was adhered to throughout. Twenty‐eight studies were identified. Seven out of eight epidemiological studies suggest aerosol transmission may occur, with enclosed environments and poor ventilation noted as possible contextual factors. Ten of the 16 air sampling studies detected SARS‐CoV‐2 ribonucleic acid; however, only three of these studies attempted to culture the virus with one being successful in a limited number of samples. Two of four virological studies using artificially generated aerosols indicated that SARS‐CoV‐2 is viable in aerosols. The results of this review indicate there is inconclusive evidence regarding the viability and infectivity of SARS‐CoV‐2 in aerosols. Epidemiological studies suggest possible transmission, with contextual factors noted. Viral particles have been detected in air sampling studies with some evidence of clinical infectivity, and virological studies indicate these particles may represent live virus, adding further plausibility. However, there is uncertainty as to the nature and impact of aerosol transmission of SARS‐CoV‐2, and its relative contribution to the Covid‐19 pandemic compared with other modes of transmission.
A Bayesian joint model for zero‐inflated integers and left‐truncated event times with a time‐varying association: Applications to senior health care
Authors: Piulachs Xavier , Andrinopoulou Eleni‐Rosalina , Guillén Montserrat , Rizopoulos Dimitris
Published: October 2020

Population aging in most industrialized societies has led to a dramatic increase in emergency medical demand among the elderly. In the context of private health care, an optimal allocation of the medical resources for seniors is commonly done by forecasting their life spans. Accounting for each subject's particularities is therefore indispensable, so the available data must be processed at an individual level. We use a large and unique dataset of insured parties aged 65 and older to appropriately relate the emergency care usage with mortality risk. Longitudinal and time‐to‐event processes are jointly modeled, and their underlying relationship can therefore be assessed. Such an application, however, requires some special features to also be considered. First, longitudinal demand for emergency services exhibits a nonnegative integer response with an excess of zeros due to the very nature of the data. These subject‐specific responses are handled by a zero‐inflated version of the hierarchical negative binomial model. Second, event times must account for the left truncation derived from the fact that policyholders must reach the age of 65 before they may begin to be observed. Consequently, a delayed entry bias arises for those individuals entering the study after this age threshold. Third, and as the main challenge of our analysis, the association parameter between both processes is expected to be age‐dependent, with an unspecified association structure. This is well‐approximated through a flexible functional specification provided by penalized B‐splines. The parameter estimation of the joint model is derived under a Bayesian scheme.
Liquid Metal‐Polymer Microlattice Metamaterials with High Fracture Toughness and Damage Recoverability
Authors: Zhang Wenqiang , Chen Juzheng , Li Xiang , Lu Yang
Published: October 2020

Biological materials exhibit excellent fracture toughness due to their ability to dissipate energy during crack propagating through the combination of various constituents with different stiffnesses. Replicating this mechanism in engineering materials is important in mechanical systems and emerging applications such as flexible electronics and soft robotics. Here a novel liquid metal (LM)‐filled polymer microlattice metamaterial, fabricated by projection micro‐stereolithography (PμSL) 3D printing and vacuum filling of gallium (Ga), exhibiting high fracture toughness of 0.8 MJ m−3, is reported. Moreover, the LM metamaterials demonstrate shape memory effect and even essentially recover its original shape upon severe fractures. These unique features arise from the tunable properties of gallium at a relatively low temperature range. The result offers new insights into design and manufacturing mechanical metamaterials with tunable properties and high recoverability for soft robots, flexible electronics, and biomedical applications.
Drug-Resistant Infection: Causes, Consequences, and Responses
Authors: Jamrozik Euzebiusz , Selgelid Michael J.
Published: October 2020

This chapter provides an overview of the causes and consequences of, and possible policy responses to, the problem of drug resistance. Throughout, we highlight the ways that ethical and conceptual analyses can help to clarify relevant issues and improve policy, especially in public health, broadly conceived. Drug resistant pathogens arise, persist, spread, and produce harm due to a complex set of causes: biological processes (e.g., related to microbial evolution, the transmission of genetic determinants of resistance between microbes, and human host immunity) as well as human behaviors (e.g., antimicrobial use and hygiene practices) and other social factors (e.g., access to clean water, sanitation, healthcare, and antimicrobials). Furthermore, the ethically salient consequences of drug resistance include not only morbidity and mortality from untreatable infections (that are often inequitably distributed), but also broader effects on human freedom, privacy, and well-being. Public health ethicists are ideally placed to identify and weigh the values that might be promoted or compromised by potential policies and/or interventions that aim to address the problem of drug resistance. This chapter concludes by discussing potential policy responses, including those related to surveillance, research, animal and human antimicrobial use, the broader social determinants of health, infection control practices, and vaccination.
Technological Fixes and Antimicrobial Resistance
Authors: King Nicholas B.
Published: October 2020

A ‘technological fix’ reduces the negative impact of a problem without addressing its underlying political, economic, or social causes. This chapter examines antimicrobials’ central role in both the modern faith in technological fixes in medicine, and critiques of over-reliance on technological interventions that produce unintended consequences. The enduring appeal of technological fixes is rooted in their promise to provide simple, efficient, measurable, and effective solutions to complex problems; but this practically is purchased at the price of eliding important distributive concerns.
Antimicrobial Resistance and the Private Sector in Southeast Asia
Authors: Liverani Marco , Oliveira Hashiguchi Lauren , Khan Mishal , Coker Richard
Published: October 2020

Southeast Asia is considered a regional hotspot for the emergence and spread of antimicrobial resistance (AMR). A commonality across countries in the region, particularly those with lower incomes such as Cambodia, Myanmar, Lao PDR and Vietnam, is the high utilisation of private healthcare providers, often unregulated, which may play a role in driving AMR. In this chapter we discuss challenges to the control of AMR in Southeast Asia, with a focus on the role of the private sector. After providing an overview of the problem and current policy responses, we consider ethical issues of equity and fairness that may arise from the implementation of established and proposed interventions.
Collaborative Research for Future Space Transportation Systems
Authors: Haidn Oskar J. , Adams Nikolaus A. , Radespiel Rolf , Sattelmayer Thomas , Schröder Wolfgang , Stemmer Christian , Weigand Bernhard
Published: October 2020

This chapter book summarizes the major achievements of the five topical focus areas, Structural Cooling, Aft-Body Flows, Combustion Chamber, Thrust Nozzle, and Thrust-Chamber Assembly of the Collaborative Research Center (Sonderforschungsbereich) Transregio 40. Obviously, only sample highlights of each of the more than twenty individual projects can be given here and thus the interested reader is invited to read their reports which again are only a summary of the entire achievements and much more information can be found in the referenced publications. The structural cooling focus area included results from experimental as well as numerical research on transpiration cooling of thrust chamber structures as well as film cooling supersonic nozzles. The topics of the aft-body flow group reached from studies of classical flow separation to interaction of rocket plumes with nozzle structures for sub-, trans-, and supersonic conditions both experimentally and numerically. Combustion instabilities, boundary layer heat transfer, injection, mixing and combustion under real gas conditions and in particular the investigation of the impact of trans-critical conditions on propellant jet disintegration and the behavior under trans-critical conditions were the subjects dealt with in the combustion chamber focus area. The thrust nozzle group worked on thermal barrier coatings and life prediction methods, investigated cooling channel flows and paid special attention to the clarification and description of fluid-structure-interaction phenomena I nozzle flows. The main emphasis of the focal area thrust-chamber assembly was combustion and heat transfer investigated in various model combustors, on dual-bell nozzle phenomena and on the definition and design of three demonstrations for which the individual projects have contributed according to their research field.
Dual-Bell Nozzle Design
Authors: Génin Chloé , Schneider Dirk , Stark Ralf
Published: October 2020

The dual-bell nozzle is an altitude adaptive nozzle concept that offers two operation modes. In the framework of the German Research Foundation Special Research Field SFB TRR40, the last twelve years have been dedicated to study the dual-bell nozzle characteristics, both experimentally and numerically. The obtained understanding on nozzle contour and inflection design, transition behavior and transition prediction enabled various follow-ups like a wind tunnel study on the dual-bell wake flow, a shock generator study on a film cooled wall inflection or, in higher scale, the hot firing test of a thrust chamber featuring a film cooled dual-bell nozzle. A parametrical system study revealed the influence of the nozzle geometry on the flow behavior and the resulting launcher performance increase.
MINDS: A Translator to Embed Mathematical Expressions Inside SPARQL Queries
Authors: Graux Damien , Sejdiu Gezim , Stadler Claus , Napolitano Giulio , Lehmann Jens
Published: October 2020

The recent deployments of semantic web tools and the expansion of available linked datasets have given users the opportunity of building increasingly complex applications. These emerging use cases often require queries containing mathematical formulas such as euclidean distances or unit conversions. Currently, the latest SPARQL standard (version 1.1) only embeds basic math operators. Thus, to address this shortcoming, some popular SPARQL evaluators provide built-in tools to cover specific needs; however, such tools are not standard yet. To offer users a more generic solution, we propose and share MINDS, a translator of mathematical expressions into SPARQL-compliant bindings which can be understood by any evaluator. MINDS thereby facilitates the query design whenever mathematical computations are needed in a SPARQL query.
Generating minimal Pareto sets in multi-objective topology optimisation: an application to the wing box structural layout
Authors: Crescenti Fabio , Kipouros Timoleon , Munk David J. , Savill Mark A.
Published: October 2020

Multi-objective topology optimisation problems are often tackled by compromising the cost functions according to the designer’s knowledge. Such an approach however has clear limitations and usually requires information which especially at the preliminary design stage could be unavailable. This paper proposes an alternative multi-objective approach for the generation of minimal Pareto sets in combination with density-based topology optimisation. Optimised solutions are generated integrating a recently revised method for a posteriori articulation of preferences with the Method of Moving Asymptotes. The methodology is first tested on an academic two-dimensional structure and eventually employed to optimise a full-scale aerospace structure with the support of the commercial software Altair OptiStructⓇ. For the academic benchmark, the optimised layouts with respect to static and dynamic objectives are visualised on the Pareto frontier and reported with the corresponding density distribution. Results show a progressive and consistent transition between the two extreme single-objective layouts and confirm that the minimum number of evaluations was required to fill the smart Pareto front. The multi-objective strategy is then coupled with Altair OptiStruct and used to optimise a full-scale wing box, with the clear purpose to fill a gap in multi-objective topology optimisation applied to the wing primary structure. The proposed methodology proved that it can generate efficiently non-dominated optimised configurations, at a computational cost that is mainly driven by the model complexity. This strategy is particularly indicated for the preliminary design phase, as it releases the designer from the burden to assign preferences. Furthermore, the ease of integration into a commercial design tool makes it available for industrial applications.
Subcuticular Sutures Versus Staples for Wound Closure in Open Liver Resection: A Randomised Clinical Trial
Authors: Matsuno Yoritaka , Yamazaki Shintaro , Mitsuka Yusuke , Abe Hayato , Moriguchi Masamichi , Higaki Tokio , Takayama Tadatoshi
Published: October 2020

Background

Subcuticular sutures reduce wound complication rates only in clean surgeries. Repeat resection is frequently required in liver surgery, due to the high recurrence rate (30–50%) of liver cancers. The aim of this study is to assess that subcuticular sutures is superior to staples in liver surgery.

Methods

This single‐centre, single‐blinded, randomised controlled trial was conducted at a university hospital between January 2015 and October 2018. Patients were randomly assigned (1:1) to receive either subcuticular sutures or staples for skin closure. Three risk factors (repeat resection, diabetes mellitus and liver function) were matched preoperatively for equal allocation. The primary endpoint was the wound complication rate, while secondary endpoints were surgical site infection (SSI), duration of postoperative hospitalisation and total medical cost. Subset analyses were performed only for the 3 factors allocated as secondary endpoints.

Results

Of the 581 enrolled patients, 281 patients with subcuticular sutures and 283 patients with staples were analysed. As the primary outcome, the wound complication rate with subcuticular sutures (12.5%) did not differ from that with staples [15.9%; odds ratio (OR), 1.33; 95% confidence interval (CI), 0.83–2.15; p = 0.241]. As secondary outcomes, no significant differences were identified between the two procedures in the overall cohort while overall wound complications [7 patients (8.5%) vs. 17 patients (20.0%); OR, 2.68; 95% CI, 1.08–7.29; p = 0.035] with repeat incision were significantly less frequent with subcuticular sutures.

Conclusion

Subcuticular sutures were not shown to reduce wound complications compared to staples in open liver resection, but appear beneficial for repeat incisions.
The Potential Role of Preoperative Trabecular Bone Score in Predicting Changes in Bone Mineral Density After Parathyroidectomy
Authors: Lui David Tak Wai , Fung Matrix Man Him , Lee Chi Ho , Fong Carol Ho Yi , Loong Connie Hong Nin , Lam Allan Hoi Kin , Tan Kathryn Choon Beng , Woo Yu Cho , Lang Brian Hung Hin
Published: October 2020

Background

The skeletal indication for parathyroidectomy for primary hyperparathyroidism (PHPT) is based on bone mineral density (BMD) T‐score <  − 2.5. Whether trabecular bone score (TBS) additionally identifies patients who benefit from parathyroidectomy in terms of bone health is unknown. We aimed to study changes in BMD and TBS among Chinese who underwent curative parathyroidectomy for PHPT, in relation to their preoperative parameters, especially in those with worst site BMD T‐score ≥  − 2.5 (non‐osteoporotic range).

Methods

We included consecutive Chinese individuals who underwent curative parathyroidectomy during 2002–2015 for PHPT and completed preoperative and postoperative BMD and TBS measurements in Queen Mary Hospital. Correlations between preoperative parameters and changes in densitometric parameters were studied.

Results

45 Chinese individuals (13 men, 32 women) were included (mean age 62.0 ± 10.0 years and BMI 24.6 ± 4.7 kg/m2). After parathyroidectomy, BMD at lumbar spine (LS) improved by 6.7% (p < 0.001) while TBS did not change. Among women, peak preoperative parathyroid hormone and calcium levels independently predicted LS BMD gain. Among women with BMD in non‐osteoporotic range, LS BMD also improved after parathyroidectomy, where preoperative TBS was the only significant variable inversely correlating with percentage change in LS BMD (ρ − 0.775, p = 0.005). Particularly, those with preoperative TBS ≤ 1.25 gained 7.1% LS BMD post‐parathyroidectomy (p = 0.003).

Conclusions

LS BMD, but not TBS, improved after parathyroidectomy. Among non‐osteoporotic PHPT women, preoperative TBS inversely correlated with postoperative BMD improvement. Hence, low preoperative TBS may be an additional indication for surgical benefit with parathyroidectomy in non‐osteoporotic PHPT women, as those with worse preoperative TBS tend to benefit more from surgery.
Factors Associated with Attrition and Performance Throughout Surgical Training: A Systematic Review and Meta‐Analysis
Authors: Hope Carla , Reilly John‐Joe , Griffiths Gareth , Lund Jon , Humes David
Published: October 2020

Background

Attrition within surgical training is a challenge. In the USA, attrition rates are as high as 20–26%. The factors predicting attrition are not well known. The aim of this systematic review is to identify factors that influence attrition or performance during surgical training.

Method

The review was performed in line with PRISMA guidelines and registered with the Open Science Framework (OSF). Medline, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were searched for articles. Risk of bias was assessed using the Newcastle–Ottawa scale. Pooled estimates were calculated using random effects meta‐analyses in STATA version 15 (Stata Corp Ltd). A sensitivity analysis was performed including only multi‐institutional studies.

Results

The searches identified 3486 articles, of which 31 were included, comprising 17,407 residents. Fifteen studies were based on multi‐institutional data and 16 on single‐institutional data. Twenty‐nine of the studies are based on US residents. The pooled estimate for overall attrition was 17% (95% CI 14–20%). Women had a significantly higher pooled attrition than men (24% vs 16%, p < 0.001). Some studies reported Hispanic residents had a higher attrition rate than non‐Hispanic residents. There was no increased risk of attrition with age, marital or parental status. Factors reported to affect performance were non‐white ethnicity and faculty assessment of clinical performance. Childrearing was not associated with performance.

Conclusion

Female gender is associated with higher attrition in general surgical residency. Longitudinal studies of contemporary surgical cohorts are needed to investigate the complex multi‐factorial reasons for failing to complete surgical residency.
Macrophage frequency in the bone marrow correlates with morphologic subtype of myeloproliferative neoplasm
Authors: Molitor David C. A. , Boor Peter , Buness Andreas , Schneider Rebekka K. , Teichmann Lino L. , Körber Ruth-Miriam , Horvath Gabor L. , Koschmieder Steffen , Gütgemann Ines
Published: October 2020

Bone marrow (BM) fibrosis in myeloproliferative neoplasms (MPNs) is associated with a poor prognosis. The development of myelofibrosis and differentiation of mesenchymal stromal cells to profibrotic myofibroblasts depends on macrophages. Here, we compared macrophage frequencies in BM biopsies of MPN patients and controls (patients with non-neoplastic processes), including primary myelofibrosis (PMF, n = 18), essential thrombocythemia (ET, n = 14), polycythemia vera (PV, n = 12), and Philadelphia chromosome–positive chronic myeloid leukemia (CML, n = 9). In PMF, CD68-positive macrophages were greatly increased compared to CML (p = 0.017) and control BM (p < 0.001). Similar findings were observed by CD163 staining (PMF vs. CML: p = 0.017; PMF vs. control: p < 0.001). Moreover, CD68-positive macrophages were increased in PV compared with ET (p = 0.009) and reactive cases (p < 0.001). PMF had higher frequencies of macrophages than PV (CD68: p < 0.001; CD163: p < 0.001) and ET (CD68: p < 0.001; CD163: p < 0.001). CD163 and CD68 were often co-expressed in macrophages with stellate morphology in Philadelphia chromosome–negative MPN, resulting in a sponge-like reticular network that may be a key regulator of unbalanced hematopoiesis in the BM space and may explain differences in cellularity and clinical course.
Endocannabinoids, endocannabinoid-like molecules and their precursors in human small intestinal lumen and plasma: does diet affect them?
Authors: Tagliamonte Silvia , Gill Chris I. R. , Pourshahidi L. Kirsty , Slevin Mary M. , Price Ruth K. , Ferracane Rosalia , Lawther Roger , O’Connor Gloria , Vitaglione Paola
Published: October 2020

Purpose

To determine the small intestinal concentration of endocannabinoids (ECs), N-acylethanolamines (NAEs) and their precursors N-acylphosphatidylethanolamines (NAPEs) in humans. To identify relationships between those concentrations and habitual diet composition as well as individual inflammatory status.

Methods

An observational study was performed involving 35 participants with an ileostomy (18W/17M, aged 18–70 years, BMI 17–40 kg/m2). Overnight fasting samples of ileal fluid and plasma were collected and ECs, NAEs and NAPEs concentrations were determined by LC-HRMS. Dietary data were estimated from self-reported 4-day food diaries.

Results

Regarding ECs, N-arachidonoylethanolamide (AEA) was not detected in ileal fluids while 2-arachidonoylglycerol (2-AG) was identified in samples from two participants with a maximum concentration of 129.3 µg/mL. In contrast, mean plasma concentration of AEA was 2.1 ± 0.06 ng/mL and 2-AG was 4.9 ± 1.05 ng/mL. NAEs concentrations were in the range 0.72–17.6 µg/mL in ileal fluids and 0.014–0.039 µg/mL in plasma. NAPEs concentrations were in the range 0.3–71.5 µg/mL in ileal fluids and 0.19–1.24 µg/mL in plasma being more abundant in participants with obesity than normal weight and overweight. Significant correlations between the concentrations of AEA, OEA and LEA in biological fluids with habitual energy or fat intakes were identified. Plasma PEA positively correlated with serum C-reactive protein.

Conclusion

We quantified ECs, NAEs and NAPEs in the intestinal lumen. Fat and energy intake may influence plasma and intestinal concentrations of these compounds. The luminal concentrations reported would allow modulation of the homeostatic control of food intake via activation of GPR119 receptors located on the gastro-intestinal mucosa.

Clinical trial registry number and website

NCT04143139; www.clinicaltrials.gov.