bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic mechanical analysis with torsional rectangular geometry: A critical assessment of constrained warping models
Authors: Dessi Claudia , Coppola Salvatore , Vlassopoulos Dimitris
Published: March 2021

Dynamic mechanical oscillatory shear measurements with torsional rectangular geometry are widely carried out in order to determine the mechanical properties of soft solid materials in a quick and practical way. This technique has the advantage of avoiding slip effects, thus being particularly attractive for testing stiff elastomers such as vulcanized rubber compounds. However, one of its drawbacks is the clamping system required to keep the specimen edges in place. Since it imposes a constraint to warping deformations (i.e., out-of-plane cross-section distortions about the torsional axis), a certain increase of dynamic moduli with respect to their values in simple shear is observed and considered as an experimental artifact (i.e., de Saint-Venant's assumption of primary torsion of the specimen is no longer valid). The increase of dynamic moduli in torsion depends on the specimen's cross-section geometry and relative dimensions. We test here the capability of different torsion models to describe the constrained warping effect for an industrial rubber with rectangular specimen cross section using a wide range of different geometric parameters (length-to-width p ratio and width-to-thickness u ratio). We compare two theoretical models (Vlasov's model and Timoshenko's approach) and a phenomenological model (based on finite element simulations by Diani and Gilormini) with our experimental data set. We propose a slight modification of Vlasov's model to obtain realistic predictions of torsion over a wider parameter range. It is shown to be particularly useful in soft rubber testing, and the limitations in the choice of specimen geometry to obtain sufficient torque signal are overcome.
Temporal Location of High-Intensity Interval Training in Cycling Does Not Impact the Time Spent Near Maximal Oxygen Consumption
Authors: Mckee James R. , Wall Bradley A. , Peiffer Jeremiah J.
Published: March 2021

Purpose: To examine the influence of temporal location of high-intensity interval training (HIIT) within a cycling session on the time spent ≥90% of maximal oxygen consumption and physiological and perceptual responses. Methods: In a randomized, crossover design, 16 trained cyclists (male, n = 13 and female, n = 3) completed three 90-minute cycling sessions with HIIT placed at the beginning, middle, or end of the session (13, 36, and 69 min, respectively). Intervals consisted of three 3-minute efforts at 90% of the power output associated with maximal oxygen consumption interspersed with 3 minutes of recovery. Oxygen consumption, minute ventilation, respiratory rate, and heart rate were recorded continuously during work intervals. Rate of perceived exertion was recorded at the end of work intervals, and sessional rate of perceived exertion was collected 20 minutes after session completion. Results: No differences were observed for mean oxygen consumption (P = .479) or time spent ≥90% maximal oxygen consumption (P = .753) between condition. The mean rate of perceived exertion of all intervals were greater in the Middle (P < .01, effect size = 0.83) and End (P < .05, effect size = 0.75) compared with Beginning conditions. Mean minute ventilation was greater in the End compared with Beginning condition (P = .015, effect size = 0.63). However, no differences in mean respiratory rate were observed between conditions (P = .297). Conclusions: Temporal location of HIIT has no impact on oxygen consumption or cardiovascular stress within a cycling session. However, HIIT performed later in the session resulted in higher ventilation, which may indicate the need for greater anaerobic contribution to these intervals.
Inhibition of CRISPR-Cas12a DNA targeting by nucleosomes and chromatin
Authors: Strohkendl Isabel , Saifuddin Fatema A. , Gibson Bryan A. , Rosen Michael K. , Russell Rick , Finkelstein Ilya J.
Published: March 2021

CRISPR-Cas12a cuts DNA in liquid-like chromatin condensates but is inhibited near nucleosomes.
Manure-Based Amendments Influence Surface-Associated Bacteria and Markers of Antibiotic Resistance on Radishes Grown in Soils with Different Textures
Authors: Guron Giselle K. P. , Chen Chaoqi , Du Pang , Pruden Amy , Ponder Monica A.
Published: March 2021

In working toward a comprehensive strategy to combat the spread of antibiotic resistance, potential farm-to-fork routes of dissemination are gaining attention. The effects of preharvest factors on the microbiota and corresponding antibiotic resistance indicators on the surfaces of produce commonly eaten raw is of special interest.
Genome Sequence of Aspergillus aculeatinus IC_8, Isolated from an Indoor Air Sample of an Urban Housing Complex in Abidjan, Ivory Coast
Authors: Zhao Shu , Koffi David , Latge Jean-Paul , Sylla Karidia , Gibbons John G.
Published: March 2021

Aspergillus aculeatinus
is an industrially important species of
Aspergillus
section
Nigri
capable of producing bioactive, antibiotic, and antitumor compounds. We sequenced the genome of a strain of
A. aculeatinus
that was isolated from the interior of a housing complex in Abidjan, Ivory Coast.
Complete Genome Sequences of Two Staphylococcus saccharolyticus Strains Isolated from Prosthetic Joint Infections
Authors: Afshar Mastaneh , Poehlein Anja , Söderquist Bo , Brüggemann Holger
Published: March 2021

Staphylococcus saccharolyticus
is a human skin bacterium and is occasionally associated with prosthetic joint infections (PJIs). Here, we report the complete genome sequences of two strains that were isolated from shoulder and hip PJIs. The genomes show signs of reductive evolution; around 21% of all coding sequences are inactivated by frameshift mutations.
Complete Genome Sequence of
Curtobacterium
sp. Strain YC1, Isolated from the Surface of Nostoc flagelliforme Colonies in Yinchuan, Ningxia, China
Authors: Wei Yongjun , Gao Xiang
Published: March 2021

The genus
Curtobacterium
belongs to the family
Microbacteriaceae
, within the phylum
Actinobacteria.
This genus includes a wide range of Gram-positive species associated with plants and soils. Here, we report the genome sequence of a new strain,
Curtobacterium
sp. strain YC1, which was isolated from the surface of
Nostoc flagelliforme
colonies. The genome of this strain contains one chromosome and one plasmid, and its size is 3.4 Mb.
Complete Genome Sequence of a Type III Ovine Strain of Mycobacterium avium subsp.
paratuberculosis
Authors: Bannantine John P. , Bayles Darrell O. , Biet Franck
Published: March 2021

The complete genome sequence of a type III strain of
Mycobacterium avium
subsp.
paratuberculosis
was determined. The genome size for this pathogen of sheep is 4,895,755 bp with no plasmid DNA. The chromosome contains 19 copies of the hallmark IS
900
element, which is routinely used to identify this subspecies.
Pathogenesis Study of Enterovirus 71 Using a Novel Human SCARB2 Knock-In Mouse Model
Authors: Jin Yuefei , Sun Tiantian , Zhou Guangyuan , Li Dong , Chen Shuaiyin , Zhang Weiguo , Li Xueyuan , Zhang Rongguang , Yang Haiyan , Duan Guangcai
Published: March 2021

Enterovirus 71 (EV71) is associated with severe hand-foot-mouth disease. Recently, outbreaks of EV71 infection with high mortality have been reported in the Asia-Pacific region, posing a great challenge for global public health.
‘Do I, don’t I?’ A qualitative study addressing parental perceptions about seeking healthcare during the COVID-19 pandemic
Authors: Watson Gabriella , Pickard Lucy , Williams Bhanu , Hargreaves Dougal , Blair Mitch
Published: March 2021

Background

Paediatric emergency departments have seen reduced attendance during the COVID-19 pandemic. Late paediatric presentations may lead to severe illness and even death. Maintaining provision of healthcare through a pandemic is essential. This qualitative study aims to identify changing care-seeking behaviours in child health during the pandemic and ascertain parental views around barriers to care.

Methods

Semistructured interviews were conducted with caregivers of children accessing acute paediatric services in a hospital in North-West London. Thematic content analysis was used to derive themes from the data, using a deductive approach.

Results

From interviews with 15 caregivers an understanding was gained of care-seeking behaviours during the pandemic. Themes identified were; influencers of decision to seek care, experience of primary care, other perceived barriers, experiences of secondary care, advice to others following lived experience. Where delays in decision to seek care occurred this was influenced predominantly by fear, driven by community perception and experience and media portrayal. Delays in reaching care were focused on access to primary care and availability of services. Caregivers were happy with the quality of care received in secondary care and would advise friends to seek care without hesitation, not to allow fear to delay them.

Conclusion

A pandemic involving a novel virus is always a challenging prospect in terms of organisation of healthcare provision. This study has highlighted parental perspectives around access to care and care-seeking behaviours which can inform us how to better improve service functioning during such a pandemic and beyond into the recovery period.
Grilling pains: case series of four patients needing operative intervention after accidental ingestion of a wire bristle
Authors: Gunasingha Rathnayaka Mudiyanselage Kalpanee , Bozzay Joseph D , Munoz Beau , Malone Debra L
Published: March 2021

Accidental ingestion of a grill brush wire bristle is a rare event. Retrieval rarely requires surgical intervention as the wire typically causes symptoms above the gastro-oesophageal junction and can frequently be removed endoscopically. There are few reported cases of gastrointestinal injury due to ingestion of wire bristles lodging past the gastro-oesophageal junction in adults. We present four cases of wire brush bristle ingestion that required operative intervention. Our case series illustrates how the commonly used wire grill brush may cause a serious injury. This diagnosis should be considered in patients who present with abdominal pain, non-specific symptoms and normal labs, with liner radio-opaque imaging findings and a history of grill use. Education as to the dangers of grill wire brushes to clean grills should be provided commercially.
Necrotising granulomatous mass of the foreskin with inguinal lymphadenopathy: a rare presentation of syphilis
Authors: Pham Cecile , Wang Luke , Lea Vivienne , Rathore Prem
Published: March 2021

We report the case of a 24-year-old man who presented with a 5-week history of painful right inguinal lymphadenopathy, weight loss and non-ulcerative foreskin mass. The patient’s symptoms progressed despite initial antibiotic therapy. The foreskin mass was clinically suspicious for squamous cell carcinoma; however, histopathology of both the foreskin mass and inguinal lymph node showed necrotising granulomatous inflammation. Extensive immunohistochemistry testing was inconclusive and could not identify a causative microorganism. Ultimately, serology was positive forTreponema pallidumand he was treated with intramuscular benzathine penicillin. This is an unusual case, which highlights the importance of extensive investigation for differential diagnoses of penile mass and exemplifies the resurgence of syphilis in developed countries.
Intraosseous administration of hydroxocobalamin after enclosed structure fire cardiac arrest
Authors: Mastenbrook Joshua , Zamihovsky Rachel , Brunken Nathan , Olsen Thomas
Published: March 2021

Smoke inhalation is the most common cause of acute cyanide poisoning in the developed world. Hydroxocobalamin is an antidote for cyanide poisoning. There is little published about human intraosseous antidote administration. We present a case of intraosseous hydroxocobalamin administration in an adult smoke inhalation victim, found in cardiac arrest inside her burning manufactured home. Return of spontaneous circulation was achieved after 20 min of cardiopulmonary resuscitation. Five grams of hydroxocobalamin were subsequently given intraosseously. On hospital arrival, patient was found to have a respiratory-metabolic acidosis. She had red-coloured urine without haematuria, a known sequela of hydroxocobalamin administration. Patient’s neurological status deteriorated, and she died 4 days after admission. This case highlights that intraosseously administered hydroxocobalamin seems to adequately flow into the marrow cavity and enter the circulatory system despite the non-compressible glass antidote vial. This appears to be only the second reported human case of intraosseous hydroxocobalamin administration.
Pulmonary arteriovenous malformation with metal allergy
Authors: Takase Yoshiaki , Nakano Sachiko , Yamaki Ei , Kawashima Osamu
Published: March 2021

We present a rare case of single pulmonary arteriovenous malformation (PAVM) with multiple metal allergies, including for platinum. A 47-year-old woman presented to our hospital without any symptoms. Enhanced computed tomography showed a single PAVM in S6 of the right lung. Interviews prompted us to suspect a history of palmoplantar pustulosis associated with metal dental filling. Dermatology patch tests for metal allergy were positive for platinum, cobalt, tin and potassium dichromate. The first choice of treatment for PAVM is endovascular treatment using a metal coil. Since the coil is composed of platinum alloy, we performed partial lung resection for PAVM without metal implants. Although metal allergy is rare for endovascular treatment, it causes an additional stress of removal of causative metal or long-term steroidal treatment. Therefore, for single PAVM with multiple metal allergies to the implants, surgical treatment without metal implants should be considered.
Patient with Bartter syndrome in whom chronic potassium depletion was considered one of the causes of hyponatremia
Authors: Yoshioka Katsunobu
Published: March 2021

A 53-year-old man was admitted to our hospital because of general fatigue and disorientation. He had been diagnosed with Bartter syndrome in his teens and had been taking potassium preparations since then. However, his serum potassium concentration (K+s) remained persistently low. Ten days before admission, he developed fever. He was diagnosed as having bronchitis and was treated with antibiotics. Although his fever subsided, general fatigue worsened. Laboratory examination showed hyponatraemia (127 mEq/L), while K+swas 2.3 mEq/L. C reactive protein was negative. On admission, laboratory examination revealed deterioration of hyponatraemia (125 mEq/L). Although his serum sodium concentration (Na+s) was refractory to electrolyte replacement, the level increased towards normal after spironolactone administration, following normalisation of K+s, suggesting that hyponatraemia was caused by K+depletion. Physicians should be aware of the importance of the effects of exchangeable K+(K+e) on Na+s.
Diagnosing nail-patella syndrome: can it be so simple?
Authors: Sasidharan Rohit , Gupta Neeraj , Toteja Nisha , Yadav Bharti
Published: March 2021

We describe here an interesting case of a 7-day-old male infant brought with parental concerns of inability to extend both knees. Clinical evaluation revealed dysplastic fingernails, bilateral abnormal patellae, triangular lunules in conjunction with pathognomic iliac horns on pelvic radiographs suggesting the possibility of nail-patella syndrome (NPS). Other competing diagnoses with similar phenotypic features were considered and sequentially excluded. A definitive diagnosis was established by the identification of the principal mutation at the LMX1B gene locus of chromosome 9. NPS is seldom diagnosed in neonates due to the heterogeneity of clinical presentations as well as the subtlety of clinical clues in this population. NPS is a dominantly inherited disorder that is predominantly familial in origin and thus carries important implications for the prenatal diagnosis of future pregnancies as well as pre-emptive surveillance of nephropathy in the index child.
Severe covid-19 pneumonia: pathogenesis and clinical management
Authors: Attaway Amy H , Scheraga Rachel G , Bhimraj Adarsh , Biehl Michelle , Hatipoğlu Umur
Published: March 2021

Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 associated acute respiratory distress syndrome (CARDS). Autopsy studies of patients who died of severe SARS CoV-2 infection reveal presence of diffuse alveolar damage consistent with ARDS but with a higher thrombus burden in pulmonary capillaries. When used appropriately, high flow nasal cannula (HFNC) may allow CARDS patients to avoid intubation, and does not increase risk for disease transmission. During invasive mechanical ventilation, low tidal volume ventilation and positive end expiratory pressure (PEEP) titration to optimize oxygenation are recommended. Dexamethasone treatment improves mortality for the treatment of severe and critical covid-19, while remdesivir may have modest benefit in time to recovery in patients with severe disease but shows no statistically significant benefit in mortality or other clinical outcomes. Covid-19 survivors, especially patients with ARDS, are at high risk for long term physical and mental impairments, and an interdisciplinary approach is essential for critical illness recovery.
Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review
Authors: Pilleron Sophie , Gower Helen , Janssen-Heijnen Maryska , Signal Virginia Claire , Gurney Jason K , Morris Eva JA , Cunningham Ruth , Sarfati Diana
Published: March 2021

Objectives

To identify patterns of age disparities in cancer survival, using colon and lung cancer as exemplars.

Design

Systematic review of the literature.

Data sources

We searched Embase, MEDLINE, Scopus and Web of Science through 18 December 2020.

Eligibility criteria

We retained all original articles published in English including patients with colon or lung cancer. Eligible studies were required to be population-based, report survival across several age groups (of which at least one was over the age of 65) and at least one other characteristic (eg, sex, treatment).

Data extraction and synthesis

Two independent reviewers extracted data and assessed the quality of included studies against selected evaluation domains from the QUIPS tool, and items concerning statistical reporting. We evaluated age disparities using the absolute difference in survival or mortality rates between the middle-aged group and the oldest age group, or by describing survival curves.

Results

Out of 3047 references, we retained 59 studies (20 for colon, 34 for lung and 5 for both sites). Regardless of the cancer site, the included studies were highly heterogeneous and often of poor quality. The magnitude of age disparities in survival varied greatly by sex, ethnicity, socioeconomic status, stage at diagnosis, cancer site, and morphology, the number of nodes examined and treatment strategy. Although results were inconsistent for most characteristics, we consistently observed greater age disparities for women with lung cancer compared with men. Also, age disparities increased with more advanced stages for colon cancer and decreased with more advanced stages for lung cancer.

Conclusions

Although age is one of the most important prognostic factors in cancer survival, age disparities in colon and lung cancer survival have so far been understudied in population-based research. Further studies are needed to better understand age disparities in colon and lung cancer survival.

PROSPERO registration number

CRD42020151402.
Electromagnetic-guided versus endoscopic placement of nasoenteral feeding tubes: protocol for a systematic review and meta-analysis
Authors: Jin Zheng , Wei Yaping , Shen Guofan , Zhang Xiaofeng
Published: March 2021

Introduction

Current evidence supporting the utility of electromagnetic (EM)-guided method as the preferred technique for nasoenteral feeding tube placement is limited. We plan to provide a meta-analysis to compare the performance of EM-guided versus endoscopic placement.

Methods and analysis

Randomised controlled trials evaluating EM-guided versus endoscopic placement will be searched in MEDLINE, EMBASE and CENTRAL from database inception to 30 September 2020. Data on study design, participant characteristics, intervention details and outcomes will be extracted. Primary outcomes to be assessed are complications. Secondary outcomes include procedure success rate, total procedure time, patient recommendation, length of hospital stay and mortality. Study quality will be assessed using the Cochrane risk of bias tool. Data will be combined with a random effects model. The results will be presented as a risk ratio for dichotomous data and weighted mean difference for continuous data. Publication bias will be visualised using funnel plots. We will quantify the effect of potential effect modifiers by meta-regression if appropriate. The quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation framework.

Ethics and dissemination

This study will not use primary data, and therefore formal ethical approval is not required. The findings will be disseminated through peer-reviewed journals and committee conferences.

PROSPERO registration number

CRD42020172427.
Strategy to reduce adverse health outcomes in subjects highly vulnerable to COVID-19: results from a population-based study in Northern Italy
Authors: Russo Antonio Giampiero , Faccini Marino , Bergamaschi Walter , Riussi Antonio
Published: March 2021

Objectives

This study describes a new strategy to reduce the impact of COVID-19 on the elderly and other clinically vulnerable subjects, where general practitioners (GPs) play an active role in managing high-risk patients, reducing adverse health outcomes.

Design

Retrospective cohort study.

Setting

Population-based study including subjects resident in the province of Milan and Lodi.

Participants

127 735 residents older than 70 years, with specific chronic conditions.

Interventions

We developed a predictive algorithm for overall mortality risk based on demographic and clinical characteristics. All residents older than 70 years were classified as being at low or high risk of death from COVID-19 infection according to the algorithm. The high-risk group was assigned to their GPs for telephone triage and consultation. The high-risk cohort was divided into two groups based on GP intervention: patients who were not contacted and patients who were contacted by their GPs.

Outcome measures

Overall mortality, COVID-19 morbidity and hospitalisation.

Results

Patients with increased risk of death from COVID-19 were 127 735; 495 669 patients were not at high risk and were not included in the intervention. Out of the high-risk subjects, 79 110 were included but not contacted by their GPs, while 48 625 high-risk subjects were included and contacted. Overall mortality, morbidity and hospitalisation was higher in high-risk patients compared with low-risk populations. High-risk patients contacted by their GPs had a 50% risk reduction in COVID-19 mortality, and a 70% risk reduction in morbidity and hospitalisation for COVID-19 compared with non-contacted patients.

Conclusions

The study showed that, during the COVID-19 outbreak, involvement of GPs and changes in care management of high-risk groups produced a significant reduction in all adverse health outcomes.
Long COVID and the role of physical activity: a qualitative study
Authors: Humphreys Helen , Kilby Laura , Kudiersky Nik , Copeland Robert
Published: March 2021

Objectives

To explore the lived experience of long COVID with particular focus on the role of physical activity.

Design

Qualitative study using semistructured interviews.

Participants

18 people living with long COVID (9 men, 9 women; aged between 18–74 years; 10 white British, 3 white Other, 3 Asian, 1 black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with long COVID.

Setting

Telephone interviews with 17 participants living in the UK and 1 participant living in the USA.

Results

Four themes were generated. Theme 1 describes how participants struggled with drastically reduced physical function, compounded by the cognitive and psychological effects of long COVID. Theme 2 highlights challenges associated with finding and interpreting advice about physical activity that was appropriately tailored. Theme 3 describes individual approaches to managing symptoms including fatigue and ‘brain fog’ while trying to resume and maintain activities of daily living and other forms of exercise. Theme 4 illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability.

Conclusions

This study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with long COVID. Findings highlight the need for greater clarity and tailoring of physical activity-related advice for people with long COVID and improved support to resume activities important to individual well-being.
Utility of bedside leucocyte esterase testing to rule out septic arthritis
Authors: Knapper Thomas , Murphy Richard J , Rocos Brett , Fagg James , Murray Nick , Whitehouse Michael Richard
Published: March 2021

Introduction

Suspected septic arthritis is a common presentation to EDs. The underlying diagnosis is often non-infective pathology. Differentiating between aetiologies is difficult. A bedside test with high negative predictive value (NPV) may allow safe discharge of patients, reduce the time in the ED, hospital admission and associated costs. This study aims to evaluate the NPV of bedside leucocyte esterase (LE) in the assessment of these patients.

Methods

A prospective multicentre observational study of ED adult patients referred to orthopaedics with suspected native joint septic arthritis between October 2015 and April 2016. At three hospital sites in the Bristol region, the results of the LE test exposed to aspirated synovial fluid were recorded along with Gram stain, culture, haematinics and length of stay. A positive LE test was considered 2+ or 3+ leucocytes based on the test strip colour. Data were analysed to establish sensitivity, specificity, NPV and positive predictive value (PPV) against the gold standard 48-hour culture. We determined the potential number of inpatient bed-days that might be avoided using this bedside test.

Results

Eighty patients underwent joint aspiration. Five cases had positive 48-hour culture. All (5/5) infected cases showed ≥2+ LE, sensitivity of 100% (95% CI 47.8% to 100%) while the Gram stain was positive in only one case (sensitivity 20%, 95% CI 0.51% to 71.6%). Twenty-three LE were read negative or 1+, all with negative 48-hour culture results, resulting in an NPV of 100% (95% CI 82.1% to 1.00%) for a negative LE test. Specificity of a positive LE test was 30.7% (95% CI 20.5% to 42.45%) with PPV of 8.77% (95% CI 7.64% to 10.1%). It was calculated that 57 orthopaedic bed-days could have potentially been saved by immediately discharging those with a negative LE test.

Conclusions

LE point-of-care testing for suspected septic arthritis of native joints has a high NPV. Implementation of LE may facilitate more rapid discharge of patients with negative results. This test has the potential to reduce diagnostic uncertainty and costs to the healthcare system.
Improving the diagnosis of heart failure in patients with atrial fibrillation
Authors: Bunting Karina V , Gill Simrat K , Sitch Alice , Mehta Samir , O'Connor Kieran , Lip Gregory YH , Kirchhof Paulus , Strauss Victoria Y , Rahimi Kazem , Camm A John , Stanbury Mary , Griffith Michael , Townend Jonathan N , Gkoutos Georgios V , Karwath Andreas , Steeds Richard P , Kotecha Dipak
Published: March 2021

Objective

To improve the echocardiographic assessment of heart failure in patients with atrial fibrillation (AF) by comparing conventional averaging of consecutive beats with an index-beat approach, whereby measurements are taken after two cycles with similar R-R interval.

Methods

Transthoracic echocardiography was performed using a standardised and blinded protocol in patients enrolled in the RATE-AF (RAte control Therapy Evaluation in permanent Atrial Fibrillation) randomised trial. We compared reproducibility of the index-beat and conventional consecutive-beat methods to calculate left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and E/e’ (mitral E wave max/average diastolic tissue Doppler velocity), and assessed intraoperator/interoperator variability, time efficiency and validity against natriuretic peptides.

Results

160 patients were included, 46% of whom were women, with a median age of 75 years (IQR 69–82) and a median heart rate of 100 beats per minute (IQR 86–112). The index-beat had the lowest within-beat coefficient of variation for LVEF (32%, vs 51% for 5 consecutive beats and 53% for 10 consecutive beats), GLS (26%, vs 43% and 42%) and E/e’ (25%, vs 41% and 41%). Intraoperator (n=50) and interoperator (n=18) reproducibility were both superior for index-beats and this method was quicker to perform (p<0.001): 35.4 s to measure E/e’ (95% CI 33.1 to 37.8) compared with 44.7 s for 5-beat (95% CI 41.8 to 47.5) and 98.1 s for 10-beat (95% CI 91.7 to 104.4) analyses. Using a single index-beat did not compromise the association of LVEF, GLS or E/e’ with natriuretic peptide levels.

Conclusions

Compared with averaging of multiple beats in patients with AF, the index-beat approach improves reproducibility and saves time without a negative impact on validity, potentially improving the diagnosis and classification of heart failure in patients with AF.
Predicting drowning from sea and weather forecasts: development and validation of a model on surf beaches of southwestern France
Authors: Tellier Éric , Simonnet Bruno , Gil-Jardiné Cédric , Lerouge-Bailhache Marion , Castelle Bruno , Salmi Rachid
Published: March 2021

Objective

To predict the coast-wide risk of drowning along the surf beaches of Gironde, southwestern France.

Methods

Data on rescues and drownings were collected from the Medical Emergency Center of Gironde (SAMU 33). Seasonality, holidays, weekends, weather and metocean conditions were considered potentially predictive. Logistic regression models were fitted with data from 2011 to 2013 and used to predict 2015–2017 events employing weather and ocean forecasts.

Results

Air temperature, wave parameters, seasonality and holidays were associated with drownings. Prospective validation was performed on 617 days, covering 232 events (rescues and drownings) reported on 104 different days. The area under the curve (AUC) of the daily risk prediction model (combined with 3-day forecasts) was 0.82 (95% CI 0.79 to 0.86). The AUC of the 3-hour step model was 0.85 (95% CI 0.81 to 0.88).

Conclusions

Drowning events along the Gironde surf coast can be anticipated up to 3 days in advance. Preventative messages and rescue preparations could be increased as the forecast risk increased, especially during the off-peak season, when the number of available rescuers is low.
Gender dysphoria in adolescents: can adolescents or parents give valid consent to puberty blockers?
Authors: Giordano Simona , Garland Fae , Holm Soren
Published: March 2021

This article considers the claim that gender diverse minors and their families should not be able to consent to hormonal treatment for gender dysphoria. The claim refers particularly to hormonal treatment with so-called ‘blockers’, analogues that suspend temporarily pubertal development. We discuss particularly four reasons why consent may be deemed invalid in these cases: (1) the decision is too complex; (2) the decision-makers are too emotionally involved; (3) the decision-makers are on a ‘conveyor belt’; (4) the possibility of detransitioning. We examine each of these reasons and we show that none of these stand up to scrutiny, and that some are based on a misunderstanding of the nature and purposes of this stage of treatment and of the circumstances in which it is usually prescribed. Moreover, accepting these claims at face value could have serious negative implications, not just for gender diverse youth, but for many other minors and families and in a much broader range of healthcare settings.
Snake envenomation-induced acute kidney injury: prognosis and long-term renal outcomes
Authors: Kumar Manoj , Arcot Thanjan Maasila , Gopalakrishnan Natarajan , Jeyachandran Dhanapriya , Thanigachalam Dineshkumar , Ramanathan Sakthirajan
Published: March 2021

Background

Snake bite continues to be a significant cause of acute kidney injury (AKI) in India. There is paucity of data regarding long-term outcomes of such patients. In this study, we aim to assess the prognosis and long-term renal outcomes of such patients.

Methods

We analysed the hospital records of snake envenomation-induced AKI from January 2015 to December 2018. Predictors of in-hospital mortality were assessed. Survivors were advised to visit follow-up clinic to assess their kidney function.

Results

There were 769 patients with evidence of envenomation and of them, 159 (20.7%) had AKI. There were 112 (70.4%) males. Mortality occurred in 9.4% of patients. Logistic regression analysis identified shock (OR 51.949, 95% CI 4.297 to 628.072) and thrombocytopenia (OR 27.248, 95% CI 3.276 to 226.609) as predictors of mortality. Forty-three patients attended the follow-up. The mean follow-up duration was 30.4±15.23 months. Adverse renal outcomes (eGFR <60 mL/min/1.73 m2 or new-onset hypertension (HTN) or pre-HTN or urine protein creatinine ratio >0.3) occurred in 48.8% of patients. Older age (mean age (years) 53.3 vs 42.8, p=0.004) and longer duration on dialysis (median duration (days) 11.5 vs 5, p=0.024) were significantly associated with adverse renal outcomes.

Conclusions

The incidence of AKI in snake envenomation was 20.7%. The presence of shock and thrombocytopenia were associated with mortality. Adverse renal outcomes occurred in 48.8% of patients in the long term.
Predicting soil nitrogen availability to grain corn in Ontario, Canada
Authors: Stoeckli Jessica L. , Sharifi Mehdi , Hooker David C. , Thomas Ben W. , Khaefi Froogh , Stewart Greg , McDonald Ian , Deen Bill , Drury Craig F. , Ma Bao-Luo , Motaghian Hamid R.
Published: March 2021

Predicting the soil-available nitrogen (N) to grain corn over a growing season in humid temperate regions is the key for improving fertilizer N recommendations. The objective of this study was to evaluate a suite of soil-N tests to predict soil N availability to grain corn over two growing seasons at 13 individual sites with long-term history of synthetic N fertilization in Ontario, Canada (13 site-years). At each site, fertilizer N was applied at various rates (0–224 kg N·ha−1) to determine the crop response to N fertilizer, relative yield (RY), and the most economic rate of N (MERN). Across the entire dataset, water-extractable mineral N (WEMN) was the only soil test that strongly correlated to both RY (r = 0.74**) and MERN (r = −0.56*) indicating that in grain corn fields with long-term history of N fertilization, mineral forms of N in soil solution can be used for fertilizer N recommendations in southern and eastern Ontario. We also provide evidence that grouping soils based on clay content could further refine fertilizer-N recommendations for grain corn in Ontario. A multi-year validation of the WEMN test with more field sites and development of a fertilizer recommendation table for this soil test are recommended.
Reducing peat in growing media: impact on nitrogen content, microbial activity, and CO2 and N2O emissions
Authors: Messiga Aimé J. , Hao Xiuming , Ziadi Noura , Dorais Martine
Published: March 2021

Renewable materials including coir, biochar, and composts are investigated worldwide in the horticultural industry to partially substitute peat in growing media. In this study, we assessed the effects of biochar and vermicompost as partial substitution of peat and compared these peat-based growing media with coir in terms of NH4+-N and NO3−-N content, CO2-C and N2O-N emissions and their microbial biomass carbon and nitrogen. Six growing media mixtures (peat; peat + biochar 9:1 v/v; peat + vermicompost 9:1 v/v; coir; coir + biochar 9:1 v/v; coir + vermicompost 9:1 v/v) replicated three times were incubated in growth chambers during a 60 d period. At day 0 of incubation (DAI), peat amended with biochar retained around 12.81% of NH4+-N compared with peat alone. The concentrations of NO3−-N peaked at 275 mg·kg−1 at 33 DAI for peat and 552 mg·kg−1 at 46 DAI for coir amended with vermicompost. The substitution of peat with biochar resulted in large CO2-C [2070 μg CO2-C·g−1 dry weight (DW)] and N2O-N (62.78 μg N2O-N·g−1 DW) emissions, but not coir. The substitution of coir with vermicompost increased N2O-N emissions at a much lower level (47.53 μg N2O-N·g−1 DW) than peat (111.82 μg N2O-N·g−1 DW). Our results showed that supplements of vermicompost in peat and coir improved N supply which could benefit plant growth, while substituting part of peat with biochar increased CO2-C and N2O-N emissions. In contrast, no effect of biochar was observed with coir, which is beneficial for the environmental footprint of short-cycle growing crops.
The Institutional Foundations of Religious Freedom
Authors: Koyama Mark
Published: March 2021

How did religious freedom emerge? I address this question by building on the framework of Johnson and Koyama’s Persecution & Toleration: The Long Road to Religious Freedom (2019). First, I establish that premodern societies, reliant on identity rules, were incapable of liberalism and religious freedom. Identity rules and restrictions on religious freedom were part of a political-economy equilibrium that ensured social order. Second, I examine developments like the Reformation and the Industrial Revolution, as shocks to this premodern identity rules and conditional toleration equilibrium. Finally, I consider several examples that support the claim that the move from identity rules to general rules allowed religious freedom to flourish.
Why an Android App Is Classified as Malware
Authors: Wu Bozhi , Chen Sen , Gao Cuiyun , Fan Lingling , Liu Yang , Wen Weiping , Lyu Michael R.
Published: March 2021

Machine learning–(ML) based approach is considered as one of the most promising techniques for Android malware detection and has achieved high accuracy by leveraging commonly used features. In practice, most of the ML classifications only provide a binary label to mobile users and app security analysts. However, stakeholders are more interested in the reason why apps are classified as malicious in both academia and industry. This belongs to the research area of interpretable ML but in a specific research domain (i.e., mobile malware detection). Although several interpretable ML methods have been exhibited to explain the final classification results in many cutting-edge Artificial Intelligent–based research fields, until now, there is no study interpreting why an app is classified as malware or unveiling the domain-specific challenges.

In this article, to fill this gap, we propose a novel and interpretable ML-based approach (named
XMal
) to classify malware with high accuracy and explain the classification result meanwhile. (1) The first classification phase of
XMal
hinges multi-layer perceptron and attention mechanism and also pinpoints the key features most related to the classification result. (2) The second interpreting phase aims at automatically producing neural language descriptions to interpret the core malicious behaviors within apps. We evaluate the behavior description results by leveraging a human study and an in-depth quantitative analysis. Moreover, we further compare
XMal
with the existing interpretable ML-based methods (i.e., Drebin and LIME) to demonstrate the effectiveness of
XMal
. We find that
XMal
is able to reveal the malicious behaviors more accurately. Additionally, our experiments show that
XMal
can also interpret the reason why some samples are misclassified by ML classifiers. Our study peeks into the interpretable ML through the research of Android malware detection and analysis.
Symmetry Breaking and Nonlinear Electric Transport in van der Waals Nanostructures
Authors: Ideue Toshiya , Iwasa Yoshihiro
Published: March 2021

The recent development of artificially fabricated van der Waals nanostructures makes it possible to design and control the symmetry of solids and to find novel physical properties and related functionalities. A characteristic physical property reflecting such symmetry breaking is the nonlinear response, which is typically studied as the second harmonic generation of light, although studies have recently expanded to include various transport phenomena. An important aspect of nonlinear transport for modern condensed matter physics is that it is not only a unique functionality of noncentrosymmetric systems but also an emergent property reflecting underlying physics such as spin–orbit interaction, superconductivity, magnetism, and band geometry/topology.

In this article, we review the nonlinear electrical transport in noncentrosymmetric van der Waals nanostructures obtained by exfoliation, nano-structure fabrication, or the application of an electric field, in particular, nonreciprocal transport resulting from inversion symmetry breaking and the bulk photovoltaic effect in nanomaterials without conventional p- n junctions.
Social Inequality and the Future of US Life Expectancy
Authors: Gutin Iliya , Hummer Robert A.
Published: March 2021

Despite decades of progress, the future of life expectancy in the United States is uncertain due to widening socioeconomic disparities in mortality, continued disparities in mortality across racial/ethnic groups, and an increase in extrinsic causes of death. These trends prompt us to scrutinize life expectancy in a high-income but enormously unequal society like the United States, where social factors determine who is most able to maximize their biological lifespan. After reviewing evidence for biodemographic perspectives on life expectancy, the uneven diffusion of health-enhancing innovations throughout the population, and the changing nature of threats to population health, we argue that sociology is optimally positioned to lead discourse on the future of life expectancy. Given recent trends, sociologists should emphasize the importance of the social determinants of life expectancy, redirecting research focus away from extending extreme longevity and toward research on social inequality with the goal of improving population health for all.
Effect of smoking cessation on chronic waterpipe smoke inhalation-induced airway hyperresponsiveness, inflammation, and oxidative stress
Authors: Nemmar Abderrahim , Al-Salam Suhail , Beegam Sumaya , Zaaba Nur E. , Ali Badreldin H.
Published: March 2021

Waterpipe smoking (WPS) prevalence is increasing globally. Clinical and laboratory investigations reported that WPS triggers impairment of pulmonary function, inflammation, and oxidative stress. However, little is known if smoking cessation (SC) would reverse the adverse pulmonary effects induced by WPS. Therefore, we evaluated the impact of WPS inhalation for 3 mo followed by 3 mo of SC (air exposure) compared with those exposed for either 3 or 6 mo to WPS or air (control) in C57BL/6 mice. To this end, various physiological, biochemical, and histological endpoints were evaluated in the lung tissue. Exposure to WPS caused focal areas of dilated alveolar spaces and foci of widening of interalveolar spaces with peribronchiolar moderate mixed inflammatory cells consisting of lymphocytes, macrophages, and neutrophil polymorphs. The latter effects were mitigated by SC. Likewise, SC reversed the increase of airway resistance and reduced the increase in the levels of myeloperoxidase, matrix metalloproteinase 9, granulocyte-macrophage colony-stimulating factor, tumor necrosis factor-α, interleukin (IL)-6, and IL-1β in lung tissue induced by WPS. In addition, SC attenuated the increase of oxidative stress markers including 8-isoprostane, glutathione, and catalase induced by WPS. Similarly, DNA damage, apoptosis, and the expression of NF-κB in the lung induced by WPS inhalation were alleviated by CS. In conclusion, our data demonstrated, for the first time, to our knowledge, that SC-mitigated WPS inhalation induced an increase in airway resistance, inflammation, oxidative stress, DNA injury, and apoptosis, illustrating the benefits of SC on lung physiology.
NAMF: A Nonlocal Adaptive Mean Filter for Removal of Salt-and-Pepper Noise
Authors: Zhang Houwang , Zhu Yuan , Zheng Hanying
Published: March 2021

In this paper, a novel algorithm called a Nonlocal Adaptive Mean Filter (NAMF) for removing salt-and-pepper (SAP) noise from corrupted images is presented. We employ an efficient window detector with adaptive size to detect the noise. The noisy pixel is then replaced by the combination of its neighboring pixels, and finally, a SAP noise based nonlocal mean filter is used to reconstruct the intensity values of noisy pixels. Extensive experimental results demonstrate that NAMF can obtain better performance in terms of quality for restoring images at all levels of SAP noise.
A Customized Differential Evolutionary Algorithm for Bounded Constrained Optimization Problems
Authors: Mashwani Wali Khan , Rehman Zia Ur , Bakar Maharani A. , Koçak Ismail , Fayaz Muhammad
Published: March 2021

Bound‐constrained optimization has wide applications in science and engineering. In the last two decades, various evolutionary algorithms (EAs) were developed under the umbrella of evolutionary computation for solving various bound‐constrained benchmark functions and various real‐world problems. In general, the developed evolutionary algorithms (EAs) belong to nature‐inspired algorithms (NIAs) and swarm intelligence (SI) paradigms. Differential evolutionary algorithm is one of the most popular and well‐known EAs and has secured top ranks in most of the EA competitions in the special session of the IEEE Congress on Evolutionary Computation. In this paper, a customized differential evolutionary algorithm is suggested and applied on twenty‐nine large‐scale bound‐constrained benchmark functions. The suggested C‐DE algorithm has obtained promising numerical results in its 51 independent runs of simulations. Most of the 2013 IEEE‐CEC benchmark functions are tackled efficiently in terms of proximity and diversity.
Influence of Weakening Groove on Cutting Results of Composites Subjected to Shaped Charge Jet
Authors: Ren Mingfa , Weng Fei , Sun Jing , Tang Ke , Feng Lina , Chen Rong
Published: March 2021

Carbon‐fiber‐reinforced polymer (CFRP) has been widely used in aerospace structures for its high strength to weight ratio and high stiffness to weight ratio. However, current pyrotechnic separation devices are mainly made of metal materials, the cutting research on CFRP composites is limited, and the effect of weakening groove on cutting results of composites is unclear under the action of shaped charge jet. In this paper, there firstly established a three‐dimensional model of explosive cutting of CFRP composites by nonlinear finite element analysis (FEA), and based on the separation time, delamination, and kinetic energy of the laminate, the influence of weakening grooves on cutting results to the laminate is discussed. The results show that, in contrast to laminates with weakening grooves, laminates without weakening grooves increase the delamination of laminates. At the same time, here, we carried out the explosive cutting test on CFRP composites to verify the rationality of the simulation model. In addition, in order to obtain a better model under the action of shaped charge jet, we optimized the width and height of weakening groove by simulation calculation. Therefore, it proves that this study can guide the application of CFRP composites subjected to shaped charge jet in aerospace separation engineering.