bluuebunny/crossref_metadata_2025 huggingface dataset:
The Seeds of Penia: Radical Democracy’s Roots in Poverty & the Athenian Social Imaginary
Authors: Malouin Hayley Rose
Published: August 2023

This paper argues that the function and experience of poverty—what the Greeks call Penia—is a crucial and understudied aspect of Athenian democracy. It situates poverty as both a distinctly political experience and the principal feature of Athenian democracy that makes it such a potent source of democratic inspiration. Radical democratic theorist Cornelius Castoriadis - whose work on ancient Greece demonstrates the enduring relevance of Athens to ongoing democratic projects and thought - can decipher the significance of Penia by articulating vital links between poverty, political participation, and the imaginary institution of society. Castoriadis views democratic Athens a seed of germination from which new democratic projects can burst forth. I argue that these germs can be found most readily in the conceptual nature of Penia, which in turn gesture to the necessity of reanimating ongoing discussions of poverty’s role in democratic projects.
Cardiovascular Responses in Physically Elderly Active People Living with HIV
Authors: Rosario Martín G. , Kidwell McKenzie , Nelson Nicole
Published: August 2023

Cardiovascular system (CVS) problems are one of the various complications in people living with HIV (PLHIV). In PLHIV, the CVS' capacity to adapt to activities is inadequate.
Purpose: To distinguish the responses of the CVS to a step test in physically active PLHIV.
Results: Significant differences between resting HR and HR after the step test were identified, while there was no significant difference between recovery HR and HR at 76% capacity. Additionally, all cardiovascular measurements were significantly higher than the recovery heart rate.
Conclusion: It appears that physically active participants are experiencing some degree of autonomic dysfunction. However, physical activity seems to help slow down common CV effects.
Fatigue life of 3D-printed porous titanium dental implants predicted by validated finite element simulations
Authors: Vautrin Antoine , Aw Jensen , Attenborough Ed , Varga Peter
Published: August 2023

Introduction: Porous dental implants represent a promising strategy to reduce failure rate by favoring osseointegration or delivering drugs locally. Incorporating porous features weakens the mechanical capacity of an implant, but sufficient fatigue strength must be ensured as regulated in the ISO 14801 standard. Experimental fatigue testing is a costly and time-intensive part of the implant development process that could be accelerated with validated computer simulations. This study aimed at developing, calibrating, and validating a numerical workflow to predict fatigue strength on six porous configurations of a simplified implant geometry.

Methods: Mechanical testing was performed on 3D-printed titanium samples to establish a direct link between endurance limit (i.e., infinite fatigue life) and monotonic load to failure, and a finite element model was developed and calibrated to predict the latter. The tool was then validated by predicting the fatigue life of a given porous configuration.

Results: The normalized endurance limit (10% of the ultimate load) was the same for all six porous designs, indicating that monotonic testing was a good surrogate for endurance limit. The geometry input of the simulations influenced greatly their accuracy. Utilizing the as-designed model resulted in the highest prediction error (23%) and low correlation between the estimated and experimental loads to failure (R2 = 0.65). The prediction error was smaller when utilizing specimen geometry based on micro computed tomography scans (14%) or design models adjusted to match the printed porosity (8%).

Discussion: The validated numerical workflow presented in this study could therefore be used to quantitatively predict the fatigue life of a porous implant, provided that the effect of manufacturing on implant geometry is accounted for.
Case report: A complex case of valve-in-valve TAVI and left bundle branch pacing for severe aortic regurgitation with partially corrected type A aortic dissection and low ejection fraction
Authors: Mihailovič Peter Marko , Žižek David , Vitez Luka , Holc Primoz , Klokočovnik Tomislav , Bunc Matjaž
Published: August 2023

Background

Aortic regurgitation is a major concern following transcatheter aortic valve implantation (TAVI), as even low-grade regurgitation is associated with increased mortality. This is of particular concern to patients with pre-existing aortic disease who are at increased risk of TAVI valve slippage. Furthermore, conduction system disturbances after TAVI, namely left bundle branch block (LBBB), may have an additional detrimental effect on cardiac function.

Case presentation

This report documents a successful treatment strategy in a frail patient with a bicuspid aortic valve and aortic disease after valve-sparing surgical repair in 1998, who subsequently developed aortic stenosis and underwent TAVI with an Evolut R self-expanding aortic valve. The progression of aortic disease, aortic root dilatation, and leaflet degeneration over the following years caused aortic regurgitation of the self-expanding aortic valve, resulting in left ventricular dilatation and heart failure along with LBBB and left ventricular (LV) mechanical dyssynchrony. Diagnostic workup of the patient showed persistence of the aneurysm distal to the graft with a dissection spanning the ascending aorta, arch, and terminating proximal to the aortic isthmus. After consideration by the cardiac team, a balloon-expandable valve was chosen for a valve-in-valve (ViV) procedure to provide sufficient radial force to expand the existing valve and correct the regurgitation. Due to the anatomy, a J-wire and pigtail catheter were successfully used for a safe approach and placement of the valve. Following the procedure, intermittent complete atrioventricular block was observed in addition to the pre-existing left bundle branch block, necessitating resynchronization pacing. Due to anatomical considerations, ease of placement, and the expected good level of resynchronization due to the proximal block, we opted for left bundle branch pacing, which showed improvement in left ventricular dyssynchrony and LV function at follow-up.

Conclusion

Valve-in-valve implantation of a balloon-expandable Myval TAVI device to treat aortic regurgitation caused by slippage and right leaflet disfunction of slef valve is feasible in challenging anatomical scenarios. Left bundle branch pacing is a viable alternative to correct mechanical dyssynchrony in complex patients with LBBB and anatomical challenges necessitating resynchronization.
The weakest point of cardiac resynchronization therapy: new technologies facing old terminology
Authors: Marcantoni Lina , Pastore Gianni , Biffi Mauro , Zanon Francesco
Published: August 2023

Patients with symptomatic heart failure (HF) and left bundle branch block (LBBB) are currently treated with biventricular pacing (BiV) which has a Class IA recommendation. Given the possibility to re-establish the inter and intra-ventricular synchrony, BiV is commonly referred to as cardiac resynchronization therapy (CRT). This wording is widely utilized and over time the terms BiV and CRT have become interchangeable. Conduction system pacing (CSP) is emerging as a valid therapeutic opportunity to obtain CRT restoring the native conduction via the Purkinje network. Therefore the acronym CRT is no longer synonymous with BiV only but could also refer to CSP. A terminology update is needed to include the resource of CSP to ensure better communication among all the stakeholders involved in managing recipients of cardiac devices and should be a fundamental step in advancing the quality of patient care. Making use of the NBG code to describe the implantable cardiac device would ease such terminology update, since only the first three positions of the five letters NBG code are commonly utilized, while the last two are rarely used.
CLK2 in GABAergic neurons is critical in regulating energy balance and anxiety-like behavior in a gender-specific fashion
Authors: Norberto Sónia , Assalin Heloisa Balan , Guadagnini Dioze , Tobar Natália , Boer Patrícia Aline , Kang Min-Cheol , Saad Mario Jose Abdalla , Kim Young-Bum , Prada Patricia Oliveira
Published: August 2023

Introduction

Cdc2-like kinase (CLK2) is a member of CLK kinases expressed in hypothalamic neurons and is activated in response to refeeding, leptin, or insulin. Diet-induced obesity and leptin receptor-deficient db/db mice lack CLK2 signal in the hypothalamic neurons. The neurotransmiter gamma-aminobutyric acid (GABA) is among the most prevalent in the central nervous system (CNS), particularly in the hypothalamus. Given the abundance of GABA-expressing neurons and their potential influence on regulating energy and behavioral homeostasis, we aimed to explore whether the deletion of CLK2 in GABAergic neurons alters energy homeostasis and behavioral and cognitive functions in both genders of mice lacking CLK2 in Vgat-expressing neurons (Vgat-Cre; Clk2loxP/loxP) on chow diet.

Methods

We generated mice lacking Clk2 in Vgat-expressing neurons (Vgat-Cre; Clk2loxP/loxP) by mating Clk2loxP/loxP mice with Vgat-IRES-Cre transgenic mice and employed behavior, and physiological tests, and molecular approaches to investigate energy metabolism and behavior phenotype of both genders.

Results and discussion

We showed that deletion of CLK2 in GABAergic neurons increased adiposity and food intake in females. The mechanisms behind these effects were likely due, at least in part, to hypothalamic insulin resistance and upregulation of hypothalamic Npy and Agrp expression. Besides normal insulin and pyruvate sensitivity, Vgat-Cre; Clk2loxP/loxP females were glucose intolerant. Male Vgat-Cre; Clk2loxP/loxP mice showed an increased energy expenditure (EE). Risen EE may account for avoiding weight and fat mass gain in male Vgat-Cre; Clk2loxP/loxP mice. Vgat-Cre; Clk2loxP/loxP mice had no alteration in cognition or memory functions in both genders. Interestingly, deleting CLK2 in GABAergic neurons changed anxiety-like behavior only in females, not males. These findings suggest that CLK2 in GABAergic neurons is critical in regulating energy balance and anxiety-like behavior in a gender-specific fashion and could be a molecular therapeutic target for combating obesity associated with psychological disorders in females.
The effects of exercise training on insulin resistance in children and adolescents with overweight or obesity: a systematic review and meta-analysis
Authors: Kazeminasab Fatemeh , Sharafifard Fatemeh , Miraghajani Maryam , Behzadnejad Nasim , Rosenkranz Sara K.
Published: August 2023

Aim

The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with overweight or obesity.

Methods

PubMed, Web of Science, and Scopus were searched for original articles, published through October 2022 that included exercise versus control interventions on fasting glucose, insulin, HOMA-IR, and body weight outcomes in children and adolescents with overweight or obesity. Standardized mean differences (SMD) for fasting insulin, and weighted mean differences (WMD) for fasting glucose, HOMA-IR, body weight (BW), and 95% confidence intervals were determined using random effects models.

Results

Thirty-five studies comprising 1,550 children and adolescents with overweight and obesity were included in the present meta-analysis. Exercise training reduced fasting glucose (WMD=-2.52 mg/dL, p=0.001), fasting insulin (SMD=-0.77, p=0.001), HOMA-IR (WMD=-0.82, p=0.001), and BW (WMD=-1.51 kg, p=0.001), as compared to a control. Subgroup analyses showed that biological sex, intervention duration, type of exercise training, BMI percentile, and health status (with or without diagnosed condition), were sources of heterogeneity.

Conclusion

Exercise training is effective for lowering fasting glucose, fasting insulin, HOMA-IR, and BW in children and adolescents with overweight or obesity and could provide an important strategy for controlling IR and related factors. With clear evidence for the effectiveness of exercise interventions in this vulnerable population, it is important to determine effective approaches for increasing exercise training in children and adolescents with overweight or obesity.
Metformin combined with spironolactone vs. metformin alone in polycystic ovary syndrome: a meta-analysis
Authors: Zeng Huamin , Zhang Ying , Huang Sikai , Wu Jinghua , Ren Wenrui , Zhou Lingru , Huang Leneng , Ye Yuyin
Published: August 2023

Aims

Due to its high heterogenicity and unclear etiology, there is currently no specific treatment for polycystic ovary syndrome (PCOS). Metformin, as an insulin sensitizer, combined with spironolactone, an antiandrogen medication, may exert complementary effects on PCOS. We therefore performed a meta-analysis of trials in which metformin combined with spironolactone was applied to treat PCOS to evaluate the efficacy and safety of the combination therapy.

Methods

We retrieved the PubMed, Embase, Scopus, Cochrane Library, CNKI, CBM, Wangfang, and VIP databases for literatures published from their inception to December 16, 2022 on the effects of metformin combined with spironolactone in the treatment of PCOS. Inclusion criteria according to P.I.C.O.S criteria were: PCOS patients, metformin combined with spironolactone interventions, metformin alone control group, and randomized controlled trials with the following outcome data: body mass index (BMI), hirsutism score, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), fasting blood glucose (FBG), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and side effects including nausea, vomiting, diarrhea and drug withdrawal.

Results

Our results revealed that metformin combined with spironolactone significantly reduced BMI and TT, but that it exerted no significant effects on hirsutism score, or on FSH or LH concentrations. Combined treatment also resulted in a significant diminution in FBG and insulin resistance using the HOMA-IR when the interventional time was greater than 6 months. In addition, the combination did not have a higher occurrence of adverse reactions than metformin alone.

Conclusion

Compared with metformin alone, metformin combined with spironolactone therapy may be more effective in reducing BMI and serum androgen levels, but the combination showed no significant effect on the hirsutism score or gonadotropin hormone levels, and was not associated with an elevation in side-effects. Moreover, when the treatment course was greater than 6 months, combination therapy reduced FBG and improved insulin resistance more effectively than metformin alone. However, more research is needed to determine the most effective course of treatment.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022355515.
Uneven vulnerability: characterizing population composition and change in the low elevation coastal zone in the United States with a climate justice lens, 1990–2020
Authors: Tagtachian Daniela , Balk Deborah
Published: August 2023

Fine scale data collection on vulnerability metrics is necessary for just policy outcomes. Those most likely to be disproportionately affected by specific climate risks should be identified early so that the needs of vulnerable communities (especially historically marginalized communities) can be addressed and mitigated in accordance with climate justice principles. While there is a growing body of event-specific and place-based studies, systematic studies on coastal populations at risk have typically not applied equity principles and have often ignored attributes such as race and ethnic composition, age structure, urban/rural classification, and housing tenure. Additionally, assumptions about future population trends depend on understanding past spatial patterns of change, as well as demographic and socioeconomic characteristics of the populations at risk, especially considering increasing coastal hazards. Yet, with few exceptions, research on coastal vulnerability has not analyzed changes in exposure over time and has not systematically addressed implications for communities of color over time. This paper seeks to fill these gaps. In this paper, using an equity lens and spatial demographic methods with the finest-resolution data available (census blocks), we estimate the extent of exposure and population change from 1990 to 2020 in the low elevation coastal zone in the continental United States. We find that the population of the LECZ has increased during this period, primarily by the growth of the urban population which has risen from about 22 million to 31 million persons. From 2000 to 2020, the urban population consistently grew at higher rates inside the LECZ than outside of it, reversing the pattern from the decade prior. We also examine changes in the population by race and Hispanic origin, urban and rural status, and a set of more expansive vulnerability themes. Our estimates, tabulated by counties and states, reveal the concentration and characteristics of exposure and changes to it over the past 30 years. Key findings include: residents of the LECZ are much older than average; Black residents are overrepresented in renter-occupied housing units in the urban LECZ; and from 2000 to 2020, Hispanic population growth was much higher in urban LECZ areas than urban areas elsewhere. These systematic insights into the demographic attributes of the populations most at risk of sea-level rise and associated coastal hazards can be used to ensure adaptation, mitigation, and disaster-related policies are tailored to the specific needs of these communities and actors at local, regional, and national scales. It also showcases how spatial methods can be used to understand demographic change and be put in place for future estimates of population in non-traditional units (e.g., coastal zones or other environmentally-vulnerable areas).
Fast degradation of carbamazepine in water by electric discharge plasma
Authors: Gao Shuzhan , Lu Fu , Abid Abid Ali , Yang Xiyao , Wu Zhengwei
Published: August 2023

The proliferation of pharmaceuticals in the aqueous environment has adversely impact on human health and ecosystem balance. Pharmaceutical contaminations are difficult to remove effectively by conventional treatment technologies. In order to degrade carbamazepine (CBZ) efficiently, a common antiepileptic drug, three plasma discharge modes were studied, including liquid-phase discharge, air gas-liquid jet and dielectric barrier discharge. It is noteworthy that the degradation efficiency and energy yield reached to highest levels (0.11 g/kWh) when operating at 225 W input power under liquid phase discharge, compared with the other discharge modes. The parameters of concentration, electrode distance, volume, input power and frequency of the discharge were also evaluated and optimized. Plasma emission spectroscopy revealed the degradation process is mainly attributed to reactive oxygen species (ROS), while the role of reactive nitrogen species was not significant. The contributions of diverse ROS were assessed by radical quenching experiments, including p-benzoquinone, p-phthalic acid and tert-butanol. The possible degradation intermediates and pathways of CBZ were tested and analyzed by liquid chromatography-mass spectrometry (LC-MS). Comprehensively consideration of cleanliness, degradation efficiency and application difficulty, liquid-phase discharge treatment is a promising technology for water treatment.
Prognostic effect of lncRNA BBOX1-AS1 in malignancies: a meta-analysis
Authors: Lin Guangyao , Wang Yongzhou , Deng Li , Ye Tao
Published: August 2023

Background: With the increasing number of new cancer cases and mortality rates, cancer has become a serious global health problem, but there are no ideal cancer biomarkers for effective diagnosis. Currently, mounting evidence demonstrates that lncRNAs play a fundamental role in cancer progression. BBOX1 anti-sense RNA 1 (BBOX1-AS1) is a recently clarified lncRNA and has been identified as dysregulated in various carcinomas, and it contributes to poor survival in cancer patients.

Methods: We thoroughly searched six databases for eligible articles published as of 27, April 2023. The association of BBOX1-AS1 expression levels with prognostic and clinicopathological parameters was assessed by odds ratios (OR) and hazard ratios with 95% CIs. Additionally, we further validated our results utilizing the GEPIA online database.

Results: Eight studies comprising 602 patients were included in this analysis. High BBOX1-AS1 expression indicated poor overall survival (OS) (hazard ratios = 2.30, 95% Cl [1.99, 2.67], p < 0.00001) when compared with low BBOX1-AS1 expression. Furthermore, BBOX1-AS1 expression was positively correlated with lymph node metastasis (OR = 3.00, 95% CI [1.71–5.28], p = 0.0001) and advanced tumor stage (OR = 3.74, 95% CI [2.63–5.32], p < 0.00001) for cancer patients. Moreover, BBOX1-AS1 was remarkably upregulated in 12 malignancies, and the elevated BBOX1-AS1 expression predicted poorer OS and worse disease-free survival (DFS) confirmed through the GEPIA online gene analysis tool.

Conclusion: The findings highlight that BBOX1-AS1 was significantly associated with detrimental overall survival, disease-free survival, lymph node metastasis and tumor stage; thus, it could act as a novel promising biomarker to predict the clinicopathological characteristics and prognosis for various cancers.
Comparison of platelet-and endothelial-associated biomarkers of disease activity in people hospitalized with Covid-19 with and without HIV co-infection
Authors: van der Mescht Mieke A. , Steel Helen C. , de Beer Zelda , Abdullah Fareed , Ueckermann Veronica , Anderson Ronald , Rossouw Theresa M.
Published: August 2023

Introduction

SARS-CoV-2 elicits a hyper-inflammatory response that contributes to increased morbidity and mortality in patients with COVID-19. In the case of HIV infection, despite effective anti-retroviral therapy, people living with HIV (PLWH) experience chronic systemic immune activation, which renders them particularly vulnerable to the life-threatening pulmonary, cardiovascular and other complications of SARS-CoV-2 co-infection. The focus of the study was a comparison of the concentrations of systemic indicators o\f innate immune dysfunction in SARS-CoV-2-PCR-positive patients (n=174) admitted with COVID-19, 37 of whom were co-infected with HIV.

Methods

Participants were recruited from May 2020 to November 2021. Biomarkers included platelet-associated cytokines, chemokines, and growth factors (IL-1β, IL-6, IL-8, MIP-1α, RANTES, PDGF-BB, TGF-β1 and TNF-α) and endothelial associated markers (IL-1β, IL-1Ra, ICAM-1 and VEGF).

Results

PLWH were significantly younger (p=0.002) and more likely to be female (p=0.001); median CD4+ T-cell count was 256 (IQR 115 -388) cells/μL and the median HIV viral load (VL) was 20 (IQR 20 -12,980) copies/mL. Fractional inspired oxygen (FiO2) was high in both groups, but higher in patients without HIV infection (p=0.0165), reflecting a greater need for oxygen supplementation. With the exception of PDGF-BB, the levels of all the biomarkers of innate immune activation were increased in SARS-CoV-2/HIV-co-infected and SARS-CoV-2/HIV-uninfected sub-groups relative to those of a control group of healthy participants. The magnitudes of the increases in the levels of these biomarkers were comparable between the SARS-CoV-2 -infected sub-groups, the one exception being RANTES, which was significantly higher in the sub-group without HIV. After adjusting for age, sex, and diabetes in the multivariable model, only the association between HIV status and VEGF was statistically significant (p=0.034). VEGF was significantly higher in PLWH with a CD4+ T-cell count >200 cells/μL (p=0.040) and those with a suppressed VL (p=0.0077).

Discussion

These findings suggest that HIV co-infection is not associated with increased intensity of the systemic innate inflammatory response during SARS-CoV-2 co-infection, which may underpin the equivalent durations of hospital stay, outcome and mortality rates in the SARS-CoV-2/HIV-infected and -uninfected sub-groups investigated in the current study. The apparent association of increased levels of plasma VEGF with SARS-CoV-2/HIV co-infection does, however, merit further investigation.
Role and regulatory mechanism of microRNA mediated neuroinflammation in neuronal system diseases
Authors: Zhang Jingdan , Li Ao , Gu Runze , Tong Yueyang , Cheng Jinbo
Published: August 2023

MicroRNAs (miRNAs) are small non-coding RNAs with the unique ability to degrade or block specific RNAs and regulate many cellular processes. Neuroinflammation plays the pivotal role in the occurrence and development of multiple central nervous system (CNS) diseases. The ability of miRNAs to enhance or restrict neuroinflammatory signaling pathways in CNS diseases is an emerging and important research area, including neurodegenerative diseases, stroke, and traumatic brain injury (TBI). In this review, we summarize the roles and regulatory mechanisms of recently identified miRNAs involved in neuroinflammation-mediated CNS diseases, aiming to explore and provide a better understanding and direction for the treatment of CNS diseases.
Mortality in an off-shore predator critical habitat during the Northeast Pacific marine heatwave
Authors: Gálvez Casandra , Raverty Stephen , Galván-Magaña Felipe , Field Cara L. , Elorriaga-Verplancken Fernando R.
Published: August 2023

Defining baseline mortality and trends in wildlife populations is imperative to understand natural and anthropogenic threats to overall population health and improve conservation measures for species, particularly in geographically confined habitats. The Guadalupe fur seal Arctocephalus townsendi (GFS) is a threatened pinniped that ranges throughout the west coast of Mexico with sporadic dispersion to higher latitudes. Their breeding habitat is restricted to Guadalupe Island, Mexico, which is vulnerable to periodic and cyclic warming of the Northeast Pacific Ocean. The impacts of environmental change on GFS health and reproductive success at Guadalupe Island are poorly defined and the aim of this study was to establish baseline pup (GFSn) mortality rates and primary causes of death during the 2013-2016 breeding seasons at Guadalupe Island. Interannual mortality rates and causes of death were compared by year, breeding seasons and by geographic location. The highest mortality rate in GFSn was in 2015 (14.7%), followed by 2014 (8.2%), 2016 (6.7%) and 2013 (5.6%). The presumptive causes of mortality of GFSn were consistent with other published long term otariids health surveys and included: emaciation (49%), trauma (24%), infectious disease (8%), drowning (4%) stillbirth/perinatal mortality (4%) and undetermined (11%). However, in 2015 and coinciding with northeast Pacific marine heatwave in 2014-2016, emaciation accounted for 54% of GFSn mortality in contrast to 9% in 2013. For GFSn, terrestrial habitat may influence mortality rates and causes of mortality but like other marine predators, marine habitat features, such as an increase in sea surface temperature are associated with changes in maternal care, nutritional status and pups survival. Monitoring mortality rate and causes in GFSn at Guadalupe Island is crucial to establish baseline health trends, document potential impacts on species demographics and recruitment during marine heatwaves and potential consequences in population recovery.
Seasonal nutrients variation, eutrophication pattern, and Chlorophyll a response adjacent to Guangdong coastal water, China
Authors: He Yingxian , Zhang Peng , Xu Fang , Zhao Lirong , Zhang Jibiao
Published: August 2023

Nutrients were the key biogenic elements for the primary production in coastal water, and the increase of nutrient concentration led to eutrophication and frequent occurrence of harmful algal blooms. However, the seasonal nutrients variation, eutrophication pattern, and Chlorophyll a (Chl-a) response adjacent to Guangdong coastal water were still scarcely. In this study, to clarity the seasonal nutrients variation, eutrophication pattern, and Chl-a, response adjacent to coastal water, the spatiotemporal dissolved inorganic nitrogen (DIN) and phosphorus (DIP) patterns and Chl-a were explored by field observation using 52 stations in the coastal waters of Guangdong Province during the dry (April and May), wet (July and August) and normal (October and November) seasons in 2020. The results showed that the variability of Chl-a, DIN and DIP were significantly different in seasons (P<0.01), and the mean concentrations of Chl-a, DIN and DIP were 11.97 ± 28.12 μg/L, 25.84 ± 35.72 μmol/L and 0.59 ± 0.71 μmol/L.Among them, the mean value of Chl-a increased significantly from 9.99 ± 9.84 μg/L in the dry season to 18.28 ± 38.07 μg/L in the wet season, and then decreased significantly to 7.65 ± 27.64 μg/L in the normal season.The mean DIN value decreased significantly from 30.68 ± 43.58 μmol/L in the dry season to 21.91 ± 35.45 μmol/L in the wet season, and then increased to 24.91 ± 26.12 μmol/L in the normal season. the mean DIP value decreased from 0.58 ± 0.73 μmol/L in the dry season to 0.48 ± 0.65 μmol/L in the wet season and then increased significantly to 0.70 ± 0.73μmol/L in the normal season. In addition, the DIN and DIP concentrations at most monitoring stations met the Grade II national seawater quality standards, and only a few monitoring stations fail to meet the Grade IV national seawater quality standard. The DIN/DIP ratios ranged from 2.05 to 259.47, with an average of 43.77 ± 41.01, far exceeding the Redfield ratio, indicating the presence of P limitation in the nearshore waters of Guangdong Province. Besides, the EI values in the coastal waters of Guangdong Province are higher at 0.00 and 82.51, with an average of 4.16 ± 10.90. DIN and DIP were significantly and positively correlated with COD in each season (P<0.05). Moreover, DIN/DIP showed significantly positive correlations with Chl-a in all seasons (P<0.01), indicating that high Chl-a concentrations could be sustained by the nutrients supply in marine ecosystems. Therefore, it is necessary to strengthen the integrated management of land and sea and effectively mitigate regional estuarine and coastal water eutrophication and harmful algal blooms.
Balancing the consequences of in-water cleaning of biofouling to improve ship efficiency and reduce biosecurity risk
Authors: Scianni Chris , Georgiades Eugene , Mihaylova Ralitsa , Tamburri Mario N.
Published: August 2023

Effective environmental policy often involves introducing and maintaining important activities with positive outcomes while minimizing environmental consequences; essentially decoupling a positive activity from its negative impacts. In-water cleaning (IWC) of biofouling from ships’ submerged surfaces is an example of an activity with positive outcomes (e.g., maintaining optimal ship energy efficiency and decreased biosecurity risk) and unintended negative consequences (e.g., release of living organisms, biocides, and microplastics). Several approaches exist to mitigate these negative consequences, including debris capture, with primary and secondary treatment of removed particulate and dissolved materials. However, it is unlikely that these approaches will eliminate environmental risk. Policy makers should be aware of the full suite of risks related to ship IWC and the tradeoffs to consider when balancing mitigation approaches.
PGD based meta modelling of a lithium-ion battery for real time prediction
Authors: Schmid Alexander , Pasquale Angelo , Ellersdorfer Christian , Champaney Victor , Raffler Marco , Guévelou Simon , Kizio Stephan , Ziane Mustapha , Feist Florian , Chinesta Francisco
Published: August 2023

Despite the existence of computationally efficient tools, the effort for parametric investigations is currently high in industry. In this paper, within the context of Li-Ion batteries, an efficient meta-modelling approach based on the Proper Generalized Decomposition (PGD) is considered. From a suitable design of experiments, a parametric model is trained and then exploited to predict, in real time, the system response to a specific parameter combination. In particular, two different methods are considered, the sparse PGD (sPGD) and the anchored-ANOVA based one (ANOVA-PGD). As a use case for the method the dynamic indentation test of a commercial lithium-ion pouch cell with a cylindrical impactor is selected. The cell model considers a homogenised macroscopic structure suitably calibrated for explicit finite element simulations. Four parameters concerning the impactor are varied, both non-geometric (mass and initial velocity) and geometric (diameter and orientation). The study focuses on multi-dimensional outputs, such as curves and contour plots. Inspired by earlier studies, the sPGD is used to predict the force-displacement curves. As a further development, the impactor kinetic energy curve and the displacement contours are both predicted using its recently developed variant ANOVA-PGD. Moreover, a novel curve alignment technique based on the Gappy Proper Orthogonal Decomposition (Gappy-POD) is suggested here. The meta-model is compared to the results of an FE simulation and the resulting deviations are then discussed.
Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study
Authors: Wang Zonghua , Fan Jiangshan , Chen Ling , Xie Langlang , Huang Lingfang , Ruan Yang , Xu Xia , Liang Zeping
Published: August 2023

Background

Although the incidence of pressure injury in the prone position is high for the mechanically ventilated patients in the intensive care unit, evidence-based strategies are still lacking.

Propose

To conduct a systematic review of current evidence, and to propose a series of strategies to prevent pressure injuries among mechanically ventilated patients with prone position in the intensive care unit.

Methods

The study was guided by the Medical Research Council framework. After a systematic review of current evidence of original articles, guidelines, expert consensus and theories, a strategy draft was developed. Then we invited 20 experts to modify and refine these strategies through two rounds of Delphi consensus method.

Results

After two rounds of Delphi process, the importance of coefficient of variation (Cv) and Kendall’s coefficient of concordance in the strategies repository were 0.067 and 0.311, respectively. And the operability of Cv and Kendall’s coefficient of concordance in the strategy draft was 0.055 and 0.294, respectively. Ultimately, we established 31 strategies for including 7 themes (assess risk factors, assess skin and tissue, body position management, skin care, nutrition, preventing medical device-related pressure injuries, education and supervision). In addition, we also developed a strategy framework to clarify our strategies.

Conclusion

According to the Medical Research Council framework, we developed 7 themes and 31 strategies to prevention prone-position pressure injuries among the intensive care unit mechanically ventilated patients. This study was considered to improve the clinical management of pressure injuries among prone position patients in the intensive care unit settings.
Validity and reliability of the Berlin questionnaire for the detection of moderate or severe obstructive sleep apnea in patients aged 40 years or older detected from primary care
Authors: Navarrete-Martínez Esther , Muñoz-Gómez Rafaela , Serrano-Merino Jesús , Perula-de Torres Luis Angel , Vaquero-Abellán Manuel , Silva-Gil Fátima , Roldán-Villalobos Ana , Martín-Rioboó Enrique , Ruiz-Moruno Javier , Romero-Rodríguez Esperanza , González-Lama Jesús , Montes-Redondo Gertrudis
Published: August 2023

Background

The obstructive sleep apnea syndrome (OSA) is a highly prevalent condition. In Spain and other countries, only 5%–9% of patients with OSA have been diagnosed and treated. The lack of accessibility to diagnosis is considered the main cause of this situation through easy-to-use screening instruments, it is necessary to check their validity and reliability in the context where they are to be used.

Objective

To validate the Spanish translation of the Berlin questionnaire for screening for moderate or severe OSA in patients aged 40 years or more detected in primary care.

Methods

A descriptive observational study, with a first qualitative phase of transcultural adaptation to Spanish using the translation-back-translation method. Setting: primary care level of the Spanish National Health System. A total of 255 patients recruited from 7 healthcare centers completed the study. The Berlin questionnaire was administered to the recruited patients, and subsequently, a respiratory polygraphy was performed to confirm the diagnosis of OSA. The concurrent criterion validity of the questionnaire and its reliability in terms of internal consistency and reproducibility (intra-observer agreement) were analyzed.

Results

The patients’ mean age was 54.76 years (SD: 6.57; 95% CI: 53.53–54.99), and 54.12% were men (95% CI: 47.96–60.27). We found that 61.57% (95% CI: 55.57–67.57) presented OSA (apnea-hypopnea index-AHI >5), and 45.5% (95% CI: 17.05–57.92) presented moderate or severe (AHI >15) OSA. The Berlin questionnaire, with a cut-off point of 4.5, showed a sensitivity of 76.77% (95% CI: 67.94–85.59), a specificity of 74.49% (95% CI: 65.35–83.63), a positive predictive value of 75.25% (95% CI: 66.34–84.16), a negative predictive value of 76.04% (95% CI: 66.98–85.10), and an area under the curve of 0.786 (95% CI: 0.721–0.851). Cronbach’s alpha coefficient was 0.730 (95% CI: 0.668–0.784), and the Kappa index was 0.739 (95% CI, 0.384–1.000).

Conclusion

The Spanish adaptation of the Berlin questionnaire has good validity and reliability as a test for the diagnostic screening of moderate or severe OSA in patients aged 40 years or older. The findings of our study confirm that primary care physicians should use such screening tools to predict OSA.
Comparison of the pathological outcome and disease progression of two Mycobacterium caprae experimental challenge models in goats: endobronchial inoculation vs. intranasal nebulization
Authors: Melgarejo Cristian , Cobos Alex , Planas Carles , Fondevila Jaume , Martín Maite , Cervera Zoraida , Cantero Guillermo , Moll Xavier , Espada Yvonne , Domingo Mariano , Vidal Enric , Pérez de Val Bernat
Published: August 2023

Background

Goats are natural hosts of tuberculosis (TB) and are a valid animal model to test new vaccines and treatments to control this disease. In this study, a new experimental model of TB in goats based on the intranasal nebulization of Mycobacterium caprae was assessed in comparison with the endobronchial route of infection.

Methods

Fourteen animals were divided into two groups of seven and challenged through the endobronchial (EB) and intranasal (IN) routes, respectively. Clinical signs, rectal temperature, body weight, and immunological responses from blood samples were followed up throughout the experiment. All goats were euthanized at 9 weeks post-challenge. Gross pathological examination, analysis of lung lesions using computed tomography, and bacterial load quantification in pulmonary lymph nodes (LNs) by qPCR were carried out.

Results

The IN-challenged group showed a slower progression of the infection: delayed clinical signs (body weight gain reduction, peak of temperature, and apparition of other TB signs) and delayed immunological responses (IFN-γ peak response and seroconversion). At the end of the experiment, the IN group also showed significantly lower severity and dissemination of lung lesions, lower mycobacterial DNA load and volume of lesions in pulmonary LN, and higher involvement of the nasopharyngeal cavity and volume of the lesions in the retropharyngeal LN.

Conclusion

The results indicated that the IN challenge with M. caprae induced pathological features of natural TB in the lungs, respiratory LN, and extrapulmonary organs but extremely exaggerating the nasopharyngeal TB pathological features. On the other hand, the EB route oversized and accelerated the pulmonary TB lesion progression. Our results highlight the need to refine the inoculation routes in the interest of faithfully reproducing the natural TB infection when evaluating new vaccines or treatments against the disease.
Identifying structural and dynamic changes during the Biliverdin Reductase B catalytic cycle
Authors: Lee Eunjeong , McLeod Matthew J. , Redzic Jasmina S. , Marcolin Barbara , Thorne Robert E. , Agarwal Pratul , Eisenmesser Elan Zohar
Published: August 2023

Biliverdin Reductase B (BLVRB) is an NADPH-dependent reductase that catalyzes the reduction of multiple substrates and is therefore considered a critical cellular redox regulator. In this study, we sought to address whether both structural and dynamics changes occur between different intermediates of the catalytic cycle and whether these were relegated to just the active site or the entirety of the enzyme. Through X-ray crystallography, we determined the apo BLVRB structure for the first time, revealing subtle global changes compared to the holo structure and identifying the loss of a critical hydrogen bond that “clamps” the R78-loop over the coenzyme. Amide and Cα chemical shift perturbations were used to identify environmental and secondary structural changes between intermediates, with more distant global changes observed upon coenzyme binding compared to substrate interactions. NMR relaxation rate measurements provided insights into the dynamic behavior of BLVRB during the catalytic cycle. Specifically, the inherently dynamic R78-loop that becomes ordered upon coenzyme binding persists through the catalytic cycle while similar regions experience dynamic exchange. However, the dynamic exchange processes were found to differ through the catalytic cycle with several groups of residues exhibiting similar dynamic responses. Finally, both local and distal structural and dynamic changes occur within BLVRB that are dependent solely on the oxidative state of the coenzyme. Thus, through a comprehensive analysis here, this study revealed structural and dynamic alterations in BLVRB through its catalytic cycle that are not simply relegated to the active site, but instead, are allosterically coupled throughout the enzyme.
Autonomous driving controllers with neuromorphic spiking neural networks
Authors: Halaly Raz , Ezra Tsur Elishai
Published: August 2023

Autonomous driving is one of the hallmarks of artificial intelligence. Neuromorphic (brain-inspired) control is posed to significantly contribute to autonomous behavior by leveraging spiking neural networks-based energy-efficient computational frameworks. In this work, we have explored neuromorphic implementations of four prominent controllers for autonomous driving: pure-pursuit, Stanley, PID, and MPC, using a physics-aware simulation framework. We extensively evaluated these models with various intrinsic parameters and compared their performance with conventional CPU-based implementations. While being neural approximations, we show that neuromorphic models can perform competitively with their conventional counterparts. We provide guidelines for building neuromorphic architectures for control and describe the importance of their underlying tuning parameters and neuronal resources. Our results show that most models would converge to their optimal performances with merely 100–1,000 neurons. They also highlight the importance of hybrid conventional and neuromorphic designs, as was suggested here with the MPC controller. This study also highlights the limitations of neuromorphic implementations, particularly at higher (> 15 m/s) speeds where they tend to degrade faster than in conventional designs.
Axonal transport during injury on a theoretical axon
Authors: Chandra Soumyadeep , Chatterjee Rounak , Olmsted Zachary T. , Mukherjee Amitava , Paluh Janet L.
Published: August 2023

Neurodevelopment, plasticity, and cognition are integral with functional directional transport in neuronal axons that occurs along a unique network of discontinuous polar microtubule (MT) bundles. Axonopathies are caused by brain trauma and genetic diseases that perturb or disrupt the axon MT infrastructure and, with it, the dynamic interplay of motor proteins and cargo essential for axonal maintenance and neuronal signaling. The inability to visualize and quantify normal and altered nanoscale spatio-temporal dynamic transport events prevents a full mechanistic understanding of injury, disease progression, and recovery. To address this gap, we generated DyNAMO, a Dynamic Nanoscale Axonal MT Organization model, which is a biologically realistic theoretical axon framework. We use DyNAMO to experimentally simulate multi-kinesin traffic response to focused or distributed tractable injury parameters, which are MT network perturbations affecting MT lengths and multi-MT staggering. We track kinesins with different motility and processivity, as well as their influx rates, in-transit dissociation and reassociation from inter-MT reservoirs, progression, and quantify and spatially represent motor output ratios. DyNAMO demonstrates, in detail, the complex interplay of mixed motor types, crowding, kinesin off/on dissociation and reassociation, and injury consequences of forced intermingling. Stalled forward progression with different injury states is seen as persistent dynamicity of kinesins transiting between MTs and inter-MT reservoirs. DyNAMO analysis provides novel insights and quantification of axonal injury scenarios, including local injury-affected ATP levels, as well as relates these to influences on signaling outputs, including patterns of gating, waves, and pattern switching. The DyNAMO model significantly expands the network of heuristic and mathematical analysis of neuronal functions relevant to axonopathies, diagnostics, and treatment strategies.
Biological rhythms and epilepsy treatment
Authors: Næsgaard Jon Andreas Rugstad , Gjerstad Leif , Heuser Kjell , Taubøll Erik
Published: August 2023

Approximately one-third of patients with epilepsy are drug-refractory, necessitating novel treatment approaches. Chronopharmacology, which adjusts pharmacological treatment to physiological variations in seizure susceptibility and drug responsiveness, offers a promising strategy to enhance efficacy and tolerance. This narrative review provides an overview of the biological foundations for rhythms in seizure activity, clinical implications of seizure patterns through case reports, and the potential of chronopharmacological strategies to improve treatment. Biological rhythms, including circadian and infradian rhythms, play an important role in epilepsy. Understanding seizure patterns may help individualize treatment decisions and optimize therapeutic outcomes. Altering drug concentrations based on seizure risk periods, adjusting administration times, and exploring hormone therapy are potential strategies. Large-scale randomized controlled trials are needed to evaluate the efficacy and safety of differential and intermittent treatment approaches. By tailoring treatment to individual seizure patterns and pharmacological properties, chronopharmacology offers a personalized approach to improve outcomes in patients with epilepsy.