bluuebunny/crossref_metadata_2025 huggingface dataset:
Origami-based metamaterial with switchable abnormal expansion function
Authors: Zhang Cheng , Yang Qingsheng , Tao Ran
Published: May 2021

The coefficient of thermal expansion (CTE) is an important parameter for the thermophysical properties of materials. Mostly, in aerospace engineering, satellites, hypersonic vehicles, precision instruments and microelectronic packages, numerous thermal deformation structures in severe environment full of drastic temperature changes are required to be controlled precisely. Therefore, the development of adjustable thermal expansion materials is of significance in engineering applications. Based on the Miura-ori structure, this paper adopts materials with respectively diverse CTEs as components to generate thermal stresses mismatch principle and proposes a design method for origami metamaterials with adjustable in situ positive/negative/zero expansion functions. Employing the methods of finite element calculation and deformation analysis, the deformation results of this metamaterial are displayed and discussed. Also, an origami metamaterial with adjustable positive/negative/zero expansion function can be obtained by adjusting the material distribution of the structure. Moreover, the mapping relationship between the folding angle and the geometric parameter of the structure is established. In the light of this design method of tunable CTE metamaterials, additionally, the metamaterial can achieve precise control of thermal deformation and optimize service reliability in extreme environments.
Broadband quantum noise reduction via frequency dependent squeezing for Advanced Virgo Plus
Authors: Polini E
Published: May 2021

Quantum noise is limiting the sensitivity of ground based gravitational wave detectors both at high frequency, in the form of shot noise, and low frequency, in the form of radiation pressure noise. In the last observing run, the injection of frequency independent squeezing improved Virgo and LIGO sensitivities at high frequency, slightly worsening the performance at low frequency. A broadband quantum noise reduction can be achieved using frequency dependent squeezing, i. e. rotating the vacuum squeezed ellipse below 100 Hz by reflecting the squeezed vacuum off a Fabry–Perot cavity, called filter cavity. The frequency-dependent squeezed quadrature rotation with rotation frequency around a few tens of Hz has been proven at National Astronomical Observatory of Japan (NAOJ) and at Massachusetts Institute of Technology (MIT). The experiment at NAOJ uses the former TAMA facility, a 300 meter long filter cavity, reproducing in scale the ones planned to be installed in Virgo and LIGO. Once the frequency dependent squeezing is produced, it has to be injected into the interferometer. This interface is not trivial, since it requires the installation of additional benches and a 285 meter long cavity (in Advanced Virgo Plus) and also to couple the rotating squeezed vacuum with the detector. An important issue which can worsen the performance of frequency dependent squeezing or directly the interferometer sensitivity is the stray light. To avoid the propagation of additional stray light, we traced the ghost beam on squeezing benches, inside linking tubes and inside the filter cavity and several diaphragms and baffles will be installed to limit this problem.
Three-party reference frame independent quantum key distribution protocol*
Authors: Sekga Comfort , Mafu Mhlambululi
Published: May 2021

We present a three-party reference frame independent quantum key distribution protocol which can be implemented without any alignment of reference frames between the sender and the receiver. The protocol exploits entangled states to establish a secret key among three communicating parties. We derive the asymptotic key rate for the proposed protocol against collective attacks and perform a finite-size key security analysis against general attacks in the presence of statistical fluctuations. We investigate the impact of reference frame misalignment on the stability of our protocol, and we obtain a transmission distance of 180 km, 200 km, and 230 km for rotation of reference frames β = π/6, β = π/8 and β = 0, respectively. Remarkably, our results demonstrate that our proposed protocol is not heavily affected by an increase in misalignment of reference frames as the achievable transmission distances are still comparable to the case where there is no misalignment in reference frames (when β = 0). We also simulate the performance of our protocol for a fixed number of signals. Our results demonstrate that the protocol can achieve an effective key generation rate over a transmission distance of about 120 km with realistic 107 finite data signals and approximately achieve 195 km with 109 signals. Moreover, our proposed protocol is robust against noise in the quantum channel and achieves a threshold error rate of 22.7%.
Design, fabrication, and characterization of Ti/Au transition-edge sensor with different dimensions of suspended beams
Authors: Zhang Hong-Jun , Wen Ji , Mo Zhao-Hong , Liu Hong-Rui , Wang Xiao-Dong , Xiong Zhong-Hua , Zhang Jin-Wen , Shuai Mao-Bing
Published: May 2021

For photon detection, superconducting transition-edge sensor (TES) micro-calorimeters are excellent energy-resolving devices. In this study, we report our recent work in developing Ti-/Au-based TES. The Ti/Au TES devices were designed and implemented with a thickness ratio of 1:1 and different suspended structures using micromachining technology. The characteristics were evaluated and analyzed, including surface morphology, 3D deformation of suspended Ti/Au TES device structure, I–V characteristics, and low-temperature superconductivity. The results showed that the surface of Ti/Au has good homogeneity and the surface roughness of Ti/Au is significantly increased compared with the substrate. The structure of Ti/Au bilayer film significantly affects the deformation of suspended devices, but the deformation does not affect the I–V characteristics of the devices. For devices with the Ti/Au bilayer (150 – m × 150 μm) and beams (100 μ m × 25 μm), the transition temperature (T
c) is 253 mK with a width of 6 mK, and the value of the temperature sensitivity α is 95.1.
Dual-wavelength ultraviolet photodetector based on vertical (Al,Ga)N nanowires and graphene*
Authors: Zhou Min , Zhao Yukun , Bian Lifeng , Zhang Jianya , Yang Wenxian , Wu Yuanyuan , Xing Zhiwei , Jiang Min , Lu Shulong
Published: May 2021

Due to the wide application of UV-A (320 nm–400 nm) and UV-C (200 nm–280 nm) photodetectors, dual-wavelength (UV-A/UV-C) photodetectors are promising for future markets. A dual-wavelength UV photodetector based on vertical (Al,Ga)N nanowires and graphene has been demonstrated successfully, in which graphene is used as a transparent electrode. Both UV-A and UV-C responses can be clearly detected by the device, and the rejection ratio (R
254 nm/R
450 nm) exceeds 35 times at an applied bias of –2 V. The short response time of the device is less than 20 ms. Furthermore, the underlying mechanism of double ultraviolet responses has also been analyzed systematically. The dual-wavelength detections could mainly result from the appropriate ratio of the thicknesses and the enough energy band difference of (Al,Ga)N and GaN sections.
Effect of external electric field on the terahertz transmission characteristics of electrolyte solutions*
Authors: Wang Jia-Hui , Wang Guo-Yang , Liu Xin , Shao Si-Yu , Huang Hai-Yun , Ding Chen-Xin , Su Bo , Zhang Cun-Lin
Published: May 2021

We fabricated a microfluidic chip with simple structure and good sealing performance, and studied the influence of the electric field on THz absorption intensity of liquid samples treated at different times by using THz time domain spectroscopy system. The tested liquids were deionised water and CuSO4, CuCl2, NaHCO3, Na2CO3 and NaCl solutions. The transmission intensity of the THz wave increases as the standing time of the electrolyte solution in the electric field increases. The applied electric field alters the dipole moment of water molecules in the electrolyte solution, which affects the vibration and rotation of the whole water molecules, breaks the hydrogen bonds in the water, increases the number of single water molecules and leads to the enhancement of the THz transmission spectrum.
Anisotropic photoresponse of layered rhenium disulfide synaptic transistors
Authors: An Chunhua , Xu Zhihao , Zhang Jing , Wu Enxiu , Ma Xinli , Pang Yidi , Fu Xiao , Hu Xiaodong , Sun Dong , Miao Jinshui , Liu Jing
Published: May 2021

Layered ReS2 with direct bandgap and strong in-plane anisotropy shows great potential to develop high-performance angle-resolved photodetectors and optoelectronic devices. However, systematic characterizations of the angle-dependent photoresponse of ReS2 are still very limited. Here, we studied the anisotropic photoresponse of layered ReS2 phototransistors in depth. Angel-resolved Raman spectrum and field-effect mobility are tested to confirm the inconsistency between its electrical and optical anisotropies, which are along 120° and 90°, respectively. We further measured the angle-resolved photoresponse of a ReS2 transistor with 6 diagonally paired electrodes. The maximum photoresponsivity exceeds 0.515 A⋅W−1 along b-axis, which is around 3.8 times larger than that along the direction perpendicular to b axis, which is consistent with the optical anisotropic directions. The incident wavelength- and power-dependent photoresponse measurement along two anisotropic axes further demonstrates that b axis has stronger light–ReS2 interaction, which explains the anisotropic photoresponse. We also observed angle-dependent photoresistive switching behavior of the ReS2 transistor, which leads to the formation of angle-resolved phototransistor memory. It has simplified structure to create dynamic optoelectronic resistive random access memory controlled spatially through polarized light. This capability has great potential for real-time pattern recognition and photoconfiguration of artificial neural networks (ANN) in a wide spectral range of sensitivity provided by polarized light.
Simulation of the gravitational wave frequency distribution of neutron star–black hole mergers*
Authors: Zhang Jianwei , Zhang Chengmin , Li Di , Cui Xianghan , Yang Wuming , Wang Dehua , Yang Yiyan , Bi Shaolan , Zhang Xianfei
Published: May 2021

LIGO-Virgo has observed the gravitational waves (GWs) from the coalescence of binary black hole (BBH) and binary neutron star (BNS) during O1 and O2, and the ones from NS-BH are expected to be hunted in the operating O3 run. The population properties and mass distribution of NS-BH mergers are poorly understood now, thus researchers simulated their chirp mass (

ℳ

) distribution by a synthetic model, in which the BHs and NSs were inferred by LIGO-Virgo (O1/O2), and obtained the values in the range of

2.1

M
⊙

<
ℳ
<
7.3

M
⊙

. In this paper, we further simulate the GW frequency (f
GW) distribution of NS-BH mergers by the above-stated synthetic model, with a basic binary system model through the Monte Carlo method. Our results predict that the median with 90% credible intervals is

165

−
64

+
475

Hz in the case of Schwarzschild BH when the system just before merger, and this GW frequency is expected to increase several times in the merger stage, which is lying in the frequency band of LIGO-Virgo, i.e., about 15 Hz to a few kHz. Our results provide an important reference for hunting the NS-BH mergers by the on-going O3 run of LIGO-Virgo.
Detection of influential nodes with multi-scale information*
Authors: Wang Jing-En , Liu San-Yang , Aljmiai Ahmed , Bai Yi-Guang
Published: May 2021

The identification of influential nodes in complex networks is one of the most exciting topics in network science. The latest work successfully compares each node using local connectivity and weak tie theory from a new perspective. We study the structural properties of networks in depth and extend this successful node evaluation from single-scale to multi-scale. In particular, one novel position parameter based on node transmission efficiency is proposed, which mainly depends on the shortest distances from target nodes to high-degree nodes. In this regard, the novel multi-scale information importance (MSII) method is proposed to better identify the crucial nodes by combining the network’s local connectivity and global position information. In simulation comparisons, five state-of-the-art algorithms, i.e. the neighbor nodes degree algorithm (NND), betweenness centrality, closeness centrality, Katz centrality and the k-shell decomposition method, are selected to compare with our MSII. The results demonstrate that our method obtains superior performance in terms of robustness and spreading propagation for both real-world and artificial networks.
Effect of nitrogen gas flow and growth temperature on extension of GaN layer on Si*
Authors: Xu Jian-Kai , Jiang Li-Juan , Wang Qian , Wang Quan , Xiao Hong-Ling , Feng Chun , Li Wei , Wang Xiao-Liang
Published: May 2021

The effect of nitrogen flow and growth temperature on extension of GaN on Si substrate has been studied. By increasing the nitrogen flow whose outlet is located in the center of the MOCVD (metal–organic chemical vapor deposition) gas/particle screening flange and by increasing the growth temperature of HT-AlN and AlGaN buffer layers near the primary flat of the wafer, the GaN layer has extended more adequately on Si substrate. In the meantime, the surface morphology has been greatly improved. Both the AlN and GaN crystal quality uniformity has been improved. X-ray diffraction results showed that the GaN (0002) XRD FWHMs (full width at half maximum) decreased from 579 arcsec∼ 1655 arcsec to around 420 arcsec.
Climate change-induced greening on the Tibetan Plateau modulated by mountainous characteristics
Authors: Teng Hongfen , Luo Zhongkui , Chang Jinfeng , Shi Zhou , Chen Songchao , Zhou Yin , Ciais Philippe , Tian Hanqin
Published: May 2021

Global terrestrial vegetation is greening, particularly in mountain areas, providing strong feedbacks to a series of ecosystem processes. This greening has been primarily attributed to climate change. However, the spatial variability and magnitude of such greening do not synchronize with those of climate change in mountain areas. By integrating two data sets of satellite-derived normalized difference vegetation index (NDVI) values, which are indicators of vegetation greenness, in the period 1982–2015 across the Tibetan Plateau (TP), we test the hypothesis that climate-change-induced greening is regulated by terrain, baseline climate and soil properties. We find a widespread greening trend over 91% of the TP vegetated areas, with an average greening rate (i.e. increase in NDVI) of 0.011 per decade. The linear mixed-effects model suggests that climate change alone can explain only 26% of the variation in the observed greening. Additionally, 58% of the variability can be explained by the combination of the mountainous characteristics of terrain, baseline climate and soil properties, and 32% of this variability was explained by terrain. Path analysis identified the interconnections of climate change, terrain, baseline climate and soil in determining greening. Our results demonstrate the important role of mountainous effects in greening in response to climate change.
All options, not silver bullets, needed to limit global warming to 1.5 °C: a scenario appraisal
Authors: Warszawski Lila , Kriegler Elmar , Lenton Timothy M , Gaffney Owen , Jacob Daniela , Klingenfeld Daniel , Koide Ryu , Costa María Máñez , Messner Dirk , Nakicenovic Nebojsa , Schellnhuber Hans Joachim , Schlosser Peter , Takeuchi Kazuhiko , Van Der Leeuw Sander , Whiteman Gail , Rockström Johan
Published: May 2021

Climate science provides strong evidence of the necessity of limiting global warming to 1.5 °C, in line with the Paris Climate Agreement. The IPCC 1.5 °C special report (SR1.5) presents 414 emissions scenarios modelled for the report, of which around 50 are classified as ‘1.5 °C scenarios’, with no or low temperature overshoot. These emission scenarios differ in their reliance on individual mitigation levers, including reduction of global energy demand, decarbonisation of energy production, development of land-management systems, and the pace and scale of deploying carbon dioxide removal (CDR) technologies. The reliance of 1.5 °C scenarios on these levers needs to be critically assessed in light of the potentials of the relevant technologies and roll-out plans. We use a set of five parameters to bundle and characterise the mitigation levers employed in the SR1.5 1.5 °C scenarios. For each of these levers, we draw on the literature to define ‘medium’ and ‘high’ upper bounds that delineate between their ‘reasonable’, ‘challenging’ and ‘speculative’ use by mid century. We do not find any 1.5 °C scenarios that stay within all medium upper bounds on the five mitigation levers. Scenarios most frequently ‘over use’ CDR with geological storage as a mitigation lever, whilst reductions of energy demand and carbon intensity of energy production are ‘over used’ less frequently. If we allow mitigation levers to be employed up to our high upper bounds, we are left with 22 of the SR1.5 1.5 °C scenarios with no or low overshoot. The scenarios that fulfil these criteria are characterised by greater coverage of the available mitigation levers than those scenarios that exceed at least one of the high upper bounds. When excluding the two scenarios that exceed the SR1.5 carbon budget for limiting global warming to 1.5 °C, this subset of 1.5 °C scenarios shows a range of 15–22 Gt CO2 (16–22 Gt CO2 interquartile range) for emissions in 2030. For the year of reaching net zero CO2 emissions the range is 2039–2061 (2049–2057 interquartile range).
Should energy efficiency subsidies be tied into housing prices?
Authors: Vimpari Jussi
Published: May 2021

Heat pumps are a key technology for improving energy efficiency as they can significantly reduce energy costs and emissions. Given the significant role of heat pumps in carbon neutrality pathways, and pressure for related national energy efficiency programs, it is important to examine economic profitability of heat pump investments and their relative environmental and social benefits. This paper aims to answer the following main research question: are areas with lower housing prices and income less likely to invest into energy efficiency? The paper finds that in Finland heat pumps are already very profitable and converting buildings’ heating systems into heat pumps creates major environmental and economic benefits for the residents. The cost of heating and heat pump investment costs does not vary between locations whereas housing prices, rents and income do. Neighborhoods with lower housing prices have less motivation and capability to invest into heat pumps. Urban areas with positive housing price development, higher income and better financing options will likely invest into energy efficiency without subsidies. Potential subsidies should be allocated into areas with lower housing prices, because emissions are evenly distributed, and lower income areas pay relatively more for energy. Energy efficiency subsidies could be tied into housing prices or more specifically into property tax, which is universally collected in most countries. Property tax could be used to guide energy efficiency investments into locations where they would not be carried out otherwise. For areas that do not need subsidies, this paper recommends that awareness should be increased, because the economic and carbon emission reduction potential of energy efficiency measures is still not well understood.
A microphysiological system combining electrospun fibers and electrical stimulation for the maturation of highly anisotropic cardiac tissue
Authors: López-Canosa Adrián , Perez-Amodio Soledad , Yanac-Huertas Eduardo , Ordoño Jesús , Rodriguez-Trujillo Romen , Samitier Josep , Castaño Oscar , Engel Elisabeth
Published: May 2021

The creation of cardiac tissue models for preclinical testing is still a non-solved problem in drug discovery, due to the limitations related to the in vitro replication of cardiac tissue complexity. Among these limitations, the difficulty of mimicking the functional properties of the myocardium due to the immaturity of the used cells hampers the obtention of reliable results that could be translated into human patients. In vivo models are the current gold standard to test new treatments, although it is widely acknowledged that the used animals are unable to fully recapitulate human physiology, which often leads to failures during clinical trials. In the present work, we present a microfluidic platform that aims to provide a range of signaling cues to immature cardiac cells to drive them towards an adult phenotype. The device combines topographical electrospun nanofibers with electrical stimulation in a microfabricated system. We validated our platform using a co-culture of neonatal mouse cardiomyocytes and cardiac fibroblasts, showing that it allows us to control the degree of anisotropy of the cardiac tissue inside the microdevice in a cost-effective way. Moreover, a 3D computational model of the electrical field was created and validated to demonstrate that our platform is able to closely match the distribution obtained with the gold standard (planar electrode technology) using inexpensive rod-shaped biocompatible stainless-steel electrodes. The functionality of the electrical stimulation was shown to induce a higher expression of the tight junction protein Cx-43, as well as the upregulation of several key genes involved in conductive and structural cardiac properties. These results validate our platform as a powerful tool for the tissue engineering community due to its low cost, high imaging compatibility, versatility, and high-throughput configuration capabilities.
Fabrication and characterization of rizatriptan loaded pullulan nanofibers as oral fast-dissolving drug system
Authors: Mehdi Mujahid , Hussain Sadam , Gao Bin Bin , Shah Kiramat Ali , Mahar Faraz Khan , Yousif Muhammad , Hussain Sadam , Ahmed Farooq
Published: May 2021

Fast drug-dissolving systems have been introduced to mediate the drugs which are difficult to swallow or having poor water solubility. Rizatriptan benzoate is a drug recommended for the patients of migraine which effect one out of every 5 women and 15 men globally. But least bioavailability (40%–50%) and reduced on set action always increases the demand of a drug carrier in order to overcome these limitations. Here in pullulan mediated fast drug-dissolving systems was developed by using rizatriptan benzoate as a model drug. While rizatriptan loaded pullulan nanofiber mat was prepared via electrospinning. Physiochemical outcomes (SEM, FTIR, and XRD) revealed good compatibility of pullulan nanofibers and rizatriptan thoroughly distributed on electrospun NFs matrix. Wetting time (1 s) and dissolutions time (3 s) suggests burst release of the drug from the polymers matrix as dissolution time is directly proportional with release profile. Further, this was confirmed by UV-release profile studies and maximum release was found within 30 s. In vitro release kinetics were analyzed by fitting the results with higuchi and korsmeyer models.
Rapid subsurface damage detection of SiC using inductivity coupled plasma
Authors: Zhang Yi , Zhang Linfeng , Chen Keyu , Liu Dianzi , Lu Dong , Deng Hui
Published: May 2021

This paper proposes a method for the rapid detection of subsurface damage (SSD) of SiC using atmospheric inductivity coupled plasma. As a plasma etching method operated at ambient pressure with no bias voltage, this method does not introduce any new SSD to the substrate. Plasma diagnosis and simulation are used to optimize the detection operation. Assisted by an SiC cover, a taper can be etched on the substrate with a high material removal rate. Confocal laser scanning microscopy and scanning electron microscope are used to analyze the etching results, and scanning transmission electron microscope (STEM) is adopted to confirm the accuracy of this method. The STEM result also indicates that etching does not introduce any SSD, and the thoroughly etched surface is a perfectly single crystal. A rapid SSD screening ability is also demonstrated, showing that this method is a promising approach for the rapid detection of SSD.
Current trends and challenges in the downstream purification of bispecific antibodies
Authors: Chen Serene W , Zhang Wei
Published: May 2021

Bispecific antibodies (bsAbs) represent a highly promising class of biotherapeutic modality. The downstream processing of this class of antibodies is therefore of crucial importance in ensuring that these products can be obtained with high purity and yield. Due to the various fundamental structural similarities between bsAbs and monoclonal antibodies (mAbs), many of the current bsAb downstream purification methodologies are based on the established purification processes of mAbs, where affinity, charge, size, hydrophobicity and mixed-mode-based purification are frequently employed. Nevertheless, the downstream processing of bsAbs presents a unique set of challenges due to the presence of bsAb-specific byproducts, such as mispaired products, undesired fragments and higher levels of aggregates, that are otherwise absent or present in lower levels in mAb cell culture supernatants, thus often requiring the design of additional purification strategies in order to obtain products of high purity. Here, we outline the current major purification methods of bsAbs, highlighting the corresponding solutions that have been proposed to circumvent the unique challenges presented by this class of antibodies, including differential affinity chromatography, sequential affinity chromatography and the use of salt additives and pH gradients or multistep elutions in various modes of purification. Finally, a perspective towards future process development is offered.
COVID-19 point-of-care testing in care homes: what are the lessons for policy and practice?
Authors: Buckle Peter , Micocci Massimo , Tulloch John , Kierkegaard Patrick , Parvulescu Paula , Thompson Carl , Spilsbury Karen , Allen A Joy , Body Richard , Hayward Gail , Buchan Iain , Gordon Adam L
Published: May 2021

COVID-19 has devastated care homes. Point-of-care tests (POCTs), mainly using lateral flow devices (LFDs), have been deployed hurriedly without much consideration of their usability or impact on care workflow. Even after the pandemic, POCTs, particularly multiplex tests, may be an important control against spread of SARS-CoV-2 and other respiratory infections in care homes by enabling identification of cases. They should not, however, replace other infection control measures such as barrier methods and quarantine. Adherence to LFDs as implemented among care home staff is suboptimal. Other tests—such as point-of-care polymerase chain reaction and automated antigen tests—would also need to be accommodated into care home workflows to improve adherence. The up-front costs of POCTs are straightforward but additional costs, including staffing preparation and reporting processes and the impacts of false positive and negative tests on absence rates and infection days, are more complex and as yet unquantified. A detailed appraisal is needed as the future of testing in care homes is considered.
Associations Between Kidney Function, Proteinuria, and the Risk of Kidney Cancer: A Nationwide Cohort Study Involving 10 Million Participants
Authors: Park Jinsung , Shin Dong Wook , Han Kyungdo , Kim Dahye , Chun Sohyun , Jang Hye Ryoun
Published: May 2021

Chronic kidney disease in its later stages is associated with increased risk of kidney cancer. We investigated whether chronic kidney disease at milder stages is associated with increased kidney cancer risk, using a retrospectively selected cohort of 9,809,317 adults in the Republic of Korea who participated in a nationwide health screening (2009–2016). We examined the impact of estimated glomerular filtration rate (eGFR), dipstick proteinuria, and interactive associations between the 2 factors on the risk of incident kidney cancer. During a median follow-up period of 7.3 years, 10,634 kidney cancers were identified. After adjustment for multiple confounders, participants with a reduced eGFR had an increased risk of kidney cancer (for eGFR <30 mL/minute/1.73 m2, adjusted hazard ratio = 1.18 (95% confidence interval: 1.01, 1.39); for eGFR 30–59 mL/minute/1.73 m2, adjusted hazard ratio = 1.22 (95% confidence interval: 1.14, 1.31)) compared with those with an eGFR of 60–89 mL/minute/1.73 m2. A dose-response relationship between the severity of proteinuria and incident kidney cancer was observed. Analyses of joint effects of eGFR and dipstick proteinuria showed that with the presence of proteinuria, kidney cancer incidence was markedly increased along with decreasing eGFR. Reduced eGFR and proteinuria are significantly associated with subsequent risk of kidney cancer, possibly in a synergistic manner.
Transportation of a commercial premixed intravenous insulin product through a pneumatic tube system
Authors: Leja Noah , Wagner Deborah , Smith Kirsten , Hurren Jeff
Published: May 2021

Purpose

Delivery of insulin products via pneumatic tubes is often avoided in health systems, as agitation may cause insulin proteins to destabilize, resulting in loss of function through denaturation, aggregation, or other processes. The actual loss of potency due to delivery via pneumatic tubes has not been reported for new, ready-to-use insulin products.

Methods

Samples were drawn from 7 commercial intravenous (IV) bags containing a 100 units/100 mL premixed solution of regular insulin in sodium chloride injection (Myxredlin, Baxter). The bags were then exposed to 7 unique long-distance pneumatic tube routes. The posttransportation bags were visually inspected for evidence of foaming. Samples were drawn from the posttransportation bags and insulin concentrations were analyzed via an enzyme immunoassay and compared to pretransportation concentrations.

Results

All seven posttransportation insulin samples were within 10% of their respective pretransportation sample. No foaming was observed in any of the Myxredlin bags after transportation through the pneumatic tube system.

Conclusion

Transporting 100 unit/100 mL Myxredlin i.v. bags through a pneumatic tube system does not result in a clinically significant loss of potency. Therefore, delivery of this drug product via a pneumatic tube system to patient care areas can be considered in daily practice.
Balanced Cantilever Graft for Supporting the Cartilaginous Side Wall of Nose
Authors: Raghavan Ullas , Daoud Mahmoud , Heywood Emily G , Ullas Gautham
Published: May 2021

Background

Many locations for the nasal valve have been suggested, and more recently the concept of the flow-limiting segment was introduced. Rather than being controlled by an internal and external valve, flow through the nose is regulated by the cartilaginous side wall, septum, and inferior turbinate.

Objectives

The aim of this study was to assess the balanced cantilever graft (BCLG) as a technique to support the lateral nasal wall.

Methods

Patients undergoing primary open septorhinoplasty over a 2-year period were studied. Follow-up period was a minimum of 6 months to a maximum of 24 months. Subjective improvement of function was measured with a visual analog scale (VAS) and aesthetic outcomes by FACE-Q score. Objective assessment of the airway was performed with a nasal peak inspiratory flow (NPIF) meter. Strips of septal cartilage of sufficient dimensions were placed in submucosal pockets created under the area of the lateral wall to be supported.

Results

Sixty patients received BCLGs. The VAS score for nasal obstruction increased from 2.6 preoperatively to 8.1 postoperatively. FACE-Q increased from 16.7 preoperatively to 36.6 postoperatively. NPIF was 74.9 L/minute preoperatively, improving to 95 L/minute postoperatively. Statistically significant improvements were seen in these functional and aesthetic scores.

Conclusions

BCLGs support the weakened part of lateral nasal wall by their elastance. Minimal cartilage is required and the graft can be altered to support various parts of the lateral nasal wall. This graft does not cause an aesthetic deficiency whilst providing adequate support.

Level of Evidence: 4
A Novel Fat Making Strategy With Adipose-Derived Progenitor Cell-Enriched Fat Improves Fat Graft Survival
Authors: Fan Pengju , Fang Man , Li Jingjing , Solari Mario G , Wu Dingyu , Tan Wuyuan , Wang Yongjie , Yang Xinghua , Lei Shaorong
Published: May 2021

Background

A low survival rate is one of the main challenges in fat grafting.

Objectives

This study aimed to evaluate whether microfat obtained by a novel strategy promoted the survival and retention of fat grafts.

Methods

A 5-mm-diameter blunt tip cannula with large side holes (~30 mm2/hole) was used to obtain macrofat. A novel strategy based on a newly invented extracorporeal cutting device was then used to cut the macrofat into microfat, which was named adipose-derived progenitor cell enrichment fat (AER fat); Coleman fat was used as the control. Aliquots (0.5 mL) of both types of fat were transplanted into 10 nude mice and analyzed 10 weeks later. Western blotting, flow cytometry, and immunofluorescence were performed to assess the AER fat characteristics and underlying mechanisms.

Results

The retention rate of fat grafts in AER fat–treated animals was significantly higher than that in the Coleman group (mean [standard deviation] 54.6% [13%] vs 34.8% [9%]; P < 0.05) after 10 weeks. AER fat contained more dipeptidyl peptidase-4–expressing progenitor cells (3.3 [0.61] × 103 vs 2.0 [0.46] × 103 cells/mL; P < 0.05), adipose-derived plastic-adherent cells (6.0 [1.10] × 104 vs 2.6 [0.17] × 104 cells/mL; P < 0.001), and viable adipocytes than Coleman fat. Moreover, histologic analysis showed that AER fat grafts had better histologic structure and higher capillary density.

Conclusions

AER fat transplantation is a potential strategy to improve the survival and long-term retention of fat grafts. AER fat contained more dipeptidyl peptidase-4–expressing progenitor cells.
C1QTNF6 participates in the pathogenesis of PCOS by affecting the inflammatory response of granulosa cells
Authors: Yan Sisi , Ding Jinli , Zhang Yi , Wang Jiayu , Zhang Sainan , Yin Tailang , Yang Jing
Published: May 2021

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease. It has been reported that chronic low-grade inflammation might participate in its pathogenesis. C1q and TNF related 6 (C1QTNF6) is a newly identified adiponectin paralog associated with inflammation. The aim of the present study was to investigate the role of C1QTNF6 in the development of chronic inflammation in PCOS and the underlying molecular mechanism. After analyzing the expression of C1QTNF6 in the serum and granulosa cells (GCs) of PCOS patients and healthy controls, we verified the roles of C1QTNF6 in inflammation through dehydroepiandrosterone-induced PCOS mouse models and cell models of lipopolysaccharide (LPS)-induced inflammation. The results demonstrated that C1QTNF6 expression in the serum and GCs of patients with PCOS was significantly elevated compared with those of the controls, and similar results were observed in the serum and ovary of PCOS mouse models. In PCOS mice and C1QTNF6-overexpressing PCOS mice, serum levels of pro-inflammatory factors including C-reactive protein (CRP), interleukin 6 (IL6), and tumor necrosis factor-α (TNFα) were increased, while the opposite effects were observed when C1QTNF6 was down-regulated in PCOS mice. Furthermore, C1QTNF6 overexpression up-regulated the levels of TNFα, IL6, and CRP and activated the AKT/NF-κB pathway in LPS-treated KGN cells, whereas C1QTNF6 knockdown and BAY-117082 (an NF-κB inhibitor) treatment resulted in the opposite effects. Taken together, our results indicate that C1QTNF6 is involved in the pathogenesis of PCOS by affecting the inflammatory response via the AKT/NF-κB signaling pathway.
Inclusive Sustainability Approaches in Common-Pool Resources from the Perspective of Blackologists
Authors: Yitbarek Senay , Bailey Karen , Tyler Shakara , Strickland Jeramie , McCary Matthew , Harris Nyeema C
Published: May 2021

The tragedy of the commons posits that depletion of common resources harms all stakeholders. Although such a downward spiral is plausible, the potential outcomes are far more complex. In the present article, we report on this coupled feedback between resource strategies and the environment from the perspective of Blackologists. We fully embrace that our understanding and appreciation for nature are inherently shaped by our identity, culture, and lived experiences. First, we deconstruct the uses and beneficiaries of the shared resource. Then, we identify potential cascades of conflict through the lens of resource partitioning, plasticity, and mitigation strategies recognizing the inherent human dimension nested within these dynamics. We emphasize that who studies these processes can alter the framing and outcome of the tragedy through several case studies. We recommend that avoidance of environmental tragedies is possible with inclusive engagement, interdisciplinarity, and oversight at different spatial and temporal scales.
28 Shifting to Virtual MDT in the COVID-19 Era and Beyond
Authors: Vijayan D , Malik K , Natarajan K , Berland J , Morton D , Beggs A , Ashraf S
Published: May 2021

Aim

The COVID19 pandemic has accelerated the need for staff to work remotely. Our aim was to demonstrate how a next-generation digital platform could be used to create a virtual MDT ecosystem in order to manipulate holographic 2D and 3D images in real-time.

Method

This study involved setting up a mock virtual MDT using de-identified DICOM files from a patient who had been treated for colorectal cancer and then subsequently found to have a liver metastasis. The image file was segmented and converted into a 2D and 3D format for visualisation within Microsoft HoloLens 2 ® (smart glasses) using Holocare Solutions ® (Mixed Reality software).

Results

A seamless cross-border pipeline was developed that involved "clinician" training, DICOM segmentation and virtual connection. We successfully performed a virtual MDT with participants able to visualise and manipulate a virtual 3D organ in real-time. The digital network remotely connected sites in England and Norway. The streaming quality was stable and HIPAA compliant. Each participant could observe others as "avatars" interacting with images within the virtual ecosystem allowing image characteristics to be highlighted.

Conclusions

We successfully conducted a virtual MDT using novel hardware and software. Our intention is to conduct a large-scale study to assess the platform's effectiveness in “Real World" MDTs.
30 Novel Technique of Gastrojejunostomy Tube Insertion to Control Retracted Proximal Stoma
Authors: Allen N , McBride R , Lindsay R , Wallace W
Published: May 2021

Introduction

Extensive small bowel resection for ischaemia can require formation of a proximal jejunostomy. Depending on length of remaining jejunum, a major potential complication is stoma retraction with resultant peritonitis, intra-abdominal sepsis and enterocutaneous fistula formation.

We describe a case using a novel technique of inserting a retrograde gastrojejunostomy tube to gain control of an acutely retracted stoma in a 61-year-old patient who developed an enterocutaneous fistula shortly after major resection due to ischaemia.

Method

Under fluoroscopic guidance, the retracted proximal limb of the jejunostomy was cannulated antegradely by guide wire. A gastro-jejunostomy tube was inserted retrograde over the guide wire and the tip placed within the stomach. The proximal tube fenestrations were sited within the duodenum and the balloon was inflated to limit enteric content spilling into the peritoneal cavity.

Conclusions

This technique enabled drainage of gastroduodenal fluid, minimised spillage into the peritoneal cavity, reduced fistula output and controlled sepsis. This allowed time for nutritional optimisation, better glycaemic control, and endovascular revascularisation in preparation for restoration of intestinal continuity at an appropriate time.

This method offered a useful alternative to surgery, in a patient for whom emergency re-exploration of the abdomen would carry significant risk of morbidity or mortality.
105 The Mustaq Method: Could This be The Simplest Shoulder Dislocation Reduction Method?
Authors: Eltayeb M , Ilo K , Mushtaq A
Published: May 2021

Introduction

The Mushtaq Method is a new shoulder reduction technique. It is a simple, reliable, and less traumatic time modulated procedure.

Method

Patients are placed in the supine position if plausible. Fully adducting the affected arm with the elbow at right angle. The practitioner applies gentle traction above the elbow with the other hand placed deep into the axilla, palpation of the humeral head is followed by lateral pressure resulting in a successful relocation. Internal rotation and a broad arm sling complete the technique. No assistants are needed, and simple analgesia was often enough.

Results

95% had a successful reduction within 5 minutes. 75% required analgesia alone, and no periprocedural complications were observed.

Conclusions

With so many options already, available it is essential to understand what dictates the success and failures of these methods. We have a new, safe, easy to use method requiring minimal force. We hope to increase our cohort size in the future to draw firm conclusions.
146 Ligamentization and Remnant Integration: Implications for Scapholunate Reconstruction
Authors: Lindsay T , Myers H , Tham S
Published: May 2021

Introduction

Scapholunate interosseous ligament (SLIL) injuries are common but remain a therapeutic challenge. Current treatment modalities prioritize restoration of normal anatomy with reconstruction where appropriate. To date, no reconstructive technique has been described that discusses the potential benefit of the preservation of the scapholunate ligament remnant. Little is known about the ‘ligamentization’ of grafts within the wrist. However, a growing body of knee literature suggests that remnant sparing may confer some benefit. In the absence of wrist specific studies, this literature must guide areas for potential augmentation of current surgical practices.

Method

We conducted a systematic review of the literature using Pubmed, Embase and Medline. Keywords were ‘Ligament’ AND ‘Reconstruction’ AND ‘Remnant’. We identified 366 original studies for title and abstract review. A total of 5 studies were included in the final analysis.

Results

In 5 animal studies, remnant stump integration resulted in enhanced ligamentization of grafted tissue as measured by vascularity, biomechanics, and proprioception.

Conclusions

Our review demonstrates a trend towards enhanced early ligamentization in grafts that incorporate the remnant stump. Remnant preservation is not currently performed in SLIL reconstruction and may provide an avenue for enhanced therapies. As such, it is a promising area for further, wrist specific, research.
162 An Examination of Scar Modelling and Assessment Methods for the Evaluation of Scar Treatments
Authors: Mistry R
Published: May 2021

Introduction

Scarring is the final common pathway for healing within the skin. Scars can be itchy, painful, tight, and disfiguring. Despite advances in surgery there is currently no reliably effective treatment for reducing or preventing scarring. The primary aim of this research is to assess the currently available models for scarring and evaluate/further develop the utility of current assessment tools, in an effort to design a pilot randomised control trial (RCT) for silicone gel treatment of scars.

Method

A systematic review of scar models in humans and animals. Examination of currently used subjective and objective scar assessment tools in a plastic surgery scar clinic. A retrospective cohort study assessing long-term scar outcomes in paediatric burn patients.

Results

Limitations and drawbacks of many existing methods to assess scar treatments were found. No statistically significant difference in long-term scarring outcomes was found between paediatric burns patients treated surgically versus conservatively. A RCT for silicone gel sheeting in the treatment of scars was set up and successful in recruitment.

Conclusions

Here, we have demonstrated difficulties in establishing a scientific scar treatment model; and created a pilot study that will help to provide high-quality evidence for the efficacy of silicone gel sheeting as a treatment for scars.
225 Clinical application and efficacy of Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d): A Systematic Review and Meta-Analysis
Authors: Mantelakis A
Published: May 2021

Background

This study evaluates the current clinical evidence of Negative Pressure Wound Therapy with Instillation and dwell time (NPWTi-d) to establish its clinical application and efficacy.

Method

MEDLINE, EMBASE, and CENTRAL databases were searched from 1946 to July 2019 for studies reporting clinical outcomes on wounds treated with NPWTi-d. The primary outcome was proportion of wounds with complete healing. The secondary outcomes were mean time for healing, NPWTi-d settings, cost, length of stay and adverse events.

Results

Thirteen articles were included with a total of 624 wounds in 542 patients involving wounds of various aetiology. The pooled proportion of wound that achieved complete healing was 93.65% (95%CI: 84.02-99.04). Normal saline was the most commonly used instillation solution with the mean dwell time of 14.23 minutes (95%CI: 10.88-17.59) and instillation cycle every 4.17 ± 2.32 hourly. The mean therapy duration was 10.69 days (95%CI: 10.46-10.91) with daily cost of $194.80. The mean hospital stay was 18.1 days (95%CI: 17.20-19.00). There were no severe adverse effects reported.

Discussion

NPWTi-d is an adjuntive therapy to aid complete healing of the vast majority of wounds. However, the current data is limited by the lack of level 1 evidence.
293 Enhancing Your Recovery: A Mobile Application for Patients Undergoing Vascular Surgery
Authors: Hodge S , Pattabathula K , Jenkins J , Ogg M
Published: May 2021

Aim:

With increasing demands on the healthcare system, a central (and currently essential) push for remote consultations, and an increasing number of co morbidities in the surgical population, the aim was to create an application that placed the focus on pre-hospital optimisation, education and autonomy – addressing these sector trends to enhance outcomes for patients and ease the burden on healthcare settings.

Method

After obtaining baseline data, I worked alongside students from the Queensland University of Technology to produce an application suitable for both iOS and android platforms.

Results

The application has four facets which mirror a patient’s journey from their initial outpatient appointment through to recovery. The application is easy to use, free to download and readily accessible. On opening the application, the user can select their planned operation and navigate along a personalised decision tree.

Conclusions

The application has been designed to educate and empower a patient to become an active participant in their care, leading to long-term changes in healthcare. Assessment is ongoing but early indications suggest that this will be a valuable tool in optimising outcomes for patients undergoing vascular surgery – leading to fewer post-operative complications and earlier restoration of functional status.