bluuebunny/crossref_metadata_2025 huggingface dataset:
Vision-based automated crack detection using convolutional neural networks for condition assessment of infrastructure
Authors: Rao Aravinda S , Nguyen Tuan , Palaniswami Marimuthu , Ngo Tuan
Published: November 2020

With the growing number of aging infrastructure across the world, there is a high demand for a more effective inspection method to assess its conditions. Routine assessment of structural conditions is a necessity to ensure the safety and operation of critical infrastructure. However, the current practice to detect structural damages, such as cracks, depends on human visual observation methods, which are prone to efficiency, cost, and safety concerns. In this article, we present an automated detection method, which is based on convolutional neural network models and a non-overlapping window-based approach, to detect crack/non-crack conditions of concrete structures from images. To this end, we construct a data set of crack/non-crack concrete structures, comprising 32,704 training patches, 2074 validation patches, and 6032 test patches. We evaluate the performance of our approach using 15 state-of-the-art convolutional neural network models in terms of number of parameters required to train the models, area under the curve, and inference time. Our approach provides over 95% accuracy and over 87% precision in detecting the cracks for most of the convolutional neural network models. We also show that our approach outperforms existing models in literature in terms of accuracy and inference time. The best performance in terms of area under the curve was achieved by visual geometry group-16 model (area under the curve = 0.9805) and best inference time was provided by AlexNet (0.32 s per image in size of 256 × 256 × 3). Our evaluation shows that deeper convolutional neural network models have higher detection accuracies; however, they also require more parameters and have higher inference time. We believe that this study would act as a benchmark for real-time, automated crack detection for condition assessment of infrastructure.
Tailoring Programs to Best Support Low-Income, First-Generation, and Racially Minoritized College Student Success
Authors: Kezar Adrianna , Kitchen Joseph A. , Estes Hilary , Hallett Ronald , Perez Rosemary
Published: November 2020

This article draws on a five-year mixed methods study and focuses on the way staff tailor support within a comprehensive college transition program to meet the needs of low-income, first-generation, and racially minoritized students by adapting programmatic offerings and requirements to fit students’ multifaceted needs. The study also identifies the way tailoring reduces cognitive load for students because the tailored interventions are embedded within a single program, rather than having students visit dozens of offices trying to piece together the support they need. The program created an approach to tailoring student support that draws on the best of predictive analytics and case management simultaneously while also being non-deficit and asset-based. Our study contributes to the literature by identifying the value of tailoring approaches to address students’ multiple needs and identities.
Achieving Access Parity for Inpatient Psychiatric Care Requires Repealing the Medicaid Institutions for Mental Disease Exclusion Rule
Authors: DuBose Briony Marie , Fry-Bowers Eileen K.
Published: November 2020

Approximately 3.4% of Americans have a mental health condition and suicide is the 10th leading cause of death. While the rate of mental health conditions has slightly increased for adult populations, America’s youth has experienced a significant rise in depression. From 2008 to 2017, occurrence of depression in the adolescent population increased from 8.3% to 13.3%. As adolescents mature into adults; it is likely the rate of mental health conditions for the adult population will rise as well as it is the common thread that binds the diseases of despair: drug abuse, alcoholism, and suicide. Arising out of the deinstitutionalization movement of the 1960s, the Medicaid Institutions for Mental Disease (IMD) Exclusion Rule (§1905(a)(B) of the Social Security Act) prohibits reimbursement for Medicaid recipients ages 21 to 64 years receiving inpatient care at a psychiatric hospital with 16 or more beds. Consequently, the rule limits payment for psychiatric treatment to general hospitals and smaller, nonspecialized centers, which blocks patients from receiving inpatient care and transfers the financial burden of care onto psychiatric hospitals. The IMD Rule is approaching its 55th anniversary. It requires reevaluation. Although a state waiver process is available, use of this option has the potential to increase the incidence of racial and ethnic disparities across states. Full repeal of the IMD Exclusion Rule could help provide immediate access to inpatient care that is consistent nationwide and be a vital step toward creating financial, treatment and ethical parity for mental health services.
Structure and performance analysis of flatter ribbon-like electrospun poly(L-lactic acid)/graphene oxide nanofiber webs
Authors: Ma Hui , Zhang Huanxia , Wang Dongsheng , Zeng Xiangyu , Yi Jie , Cao Jianda , Wu Wen
Published: November 2020

Polylactic acid matrix composites are widely used in packagings and biomaterials. The specific surface area, flexibility and degradation efficiency of the material are the key factors to determine its application in these fields. In this study, a series of poly(L-lactic acid) (PLLA)/graphene oxide (GO) composite nanofiber webs were prepared using electrospinning technique. The scanning electron microscope (SEM) image of PLLA/GO nanofibers showed a rougher surface and a smaller average diameter compared with that of pure PLLA nanofibers, and the nanofibers with 6 wt% GO in PLLA matrix looked like flatter ribbon. Accordingly, the tensile stress test of the electrospun webs with different GO contents showed high performance, 400% increment in the tensile stress at presence of 6 wt% GO. The hydrolytic degradation behavior of composite the nanofiber webs exhibited that the presence of GOs greatly improved the degradation rate, after 9 days, the degradation ratio of PLLA/GO can reach 16.83%. of the PLLA matrix, resulting from the better hydrophilic property and absorbability. Using GO to improve the preparation of new biocompatible materials from PLLA can provide a reference for problems in the field of packaging materials.
Mechanical properties and preferences of natural and artificial leathers, and their classification with a focus on leather for bags
Authors: Roh Eui Kyung
Published: November 2020

In this study, the mechanical properties and preferences of natural and artificial leathers were analyzed. The leathers were classified based on mechanical properties affecting their preferences. The mechanical properties of the leathers were measured via the KES-FB system, and an expert survey was conducted to evaluate leather preference. Leathers possess different mechanical properties depending on the manufacturing process and structural characteristics. Furthermore, differences were observed in the mechanical properties of natural and artificial leather. The mechanical properties of the leathers were related to the preferences for hand and bags. Accordingly, the leather was classified into three clusters. The leathers that were preferred for hand were not preferred for bags, and those preferred for bags were not preferred for hand. Therefore, different development strategies are needed, depending on the type of leather. Natural leather for bags should be light and have good compression elasticity along with its existing mechanical properties, whereas artificial leather should be light and have improved tensile resilience.
Moral injury and the need to carry out ethically responsible research
Authors: Williamson Victoria , Murphy Dominic , Castro Carl , Vermetten Eric , Jetly Rakesh , Greenberg Neil
Published: November 2020

The need for research to advance scientific understanding must be balanced with ensuring the rights and wellbeing of participants are safeguarded, with some research topics posing more ethical quandaries for researchers than others. Moral injury is one such topic. Exposure to potentially morally injurious experiences can lead to significant distress, including post-traumatic stress disorder (PTSD), depression, and selfinjury. In this article, we discuss how the rapid expansion of research in the field of moral injury could threaten the wellbeing, dignity and integrity of participants. We also examine key guidance for carrying out ethically responsible research with participants’ rights to self-determination, confidentiality, non-maleficence and beneficence discussed in relation to the study of moral injury. We describe how investigations of moral injury are likely to pose several challenges for researchers including managing disclosures of potentially illegal acts, the risk of harm that repeated questioning about guilt and shame may pose to participant wellbeing in longitudinal studies, as well as the possible negative impact of exposure to vicarious trauma on researchers themselves. Finally, we offer several practical recommendations that researchers, research ethics committees and other regulatory bodies can take to protect participant rights, maximise the potential benefits of research outputs and ensure the field continues to expand in an ethically responsible way.
Inertial measurement units are ‘all g’: Inter-trial reliability when assessing upper and lower body impact loading in artistic gymnastics
Authors: Campbell Rhiannon A , Bradshaw Elizabeth J , Ball Nick , Hunter Adam , Spratford Wayne
Published: November 2020

The magnitude of loading artistic gymnasts experience during training is currently unknown. Inertial measurement units (IMUs) could assess loading, although the reliability of these devices must be established prior to implementation into the training environment. This study aimed to determine inter-trial reliability of using IMeasureU Blue Thunder IMUs to assess upper and lower limb loading when performing foundation gymnastics skills. A secondary aim investigated the effect of raw and filtered acceleration signals on reliability results. Sixteen competitive level artistic gymnasts (male, n = 8; female, n = 8) performed seven gymnastics skills while wearing four IMUs (upper back, lower back, forearm and tibia). The peak resultant acceleration (PRA) during ground contact for all skills was exported from raw and filtered acceleration data (fourth-order zero-lag Butterworth filter with 85 Hz cut-off). Descriptive statistics (median and inter-quartile range), Friedman’s ANOVA, intra-class correlations, coefficient of variation, mean difference and Cohen’s effect sizes were calculated. Overall, the IMU PRA measures showed very good inter-trial reliability, however filtered signals improved reliability statistics for five variables compared to raw. The forearm- and tibia-mounted IMUs demonstrated improved reliability (very good reliability) compared to back positions (good reliability). IMUs are considered reliable devices to measure upper and lower limb loading in gymnastics.
Sanctioning of breakdown infringements during the knockout stage of the 2019 rugby world cup
Authors: Mitchell Scott , Tierney Gregory J
Published: November 2020

The breakdown is a complex and dynamic facet of rugby union, often containing multiple players from each team. It is the responsibility of coaches and trainers to ensure players are prepared to comply with the World Rugby laws of the game to encourage safe and fair play between all participants. The aim of this study was to investigate player adherence and sanctioning of infringements at the breakdown during the knockout stages of the 2019 Rugby World Cup. Breakdown infringements according to World Rugby laws were identified using match video recordings of the 8 matches. Each breakdown was individually analysed by coding any infringement that had occurred and the sanctioning outcome of the breakdown. A total of 898 breakdowns were coded, of which 37.7% (n = 339) were deemed to involve illegal play. 79.9% of breakdowns involving illegal play were not penalised with the majority of infringements being “ head and shoulders below hips” (33.5%, n = 163), “ off feet” (13%, n = 63) and “ offside” (10.5%, n = 51). The attacking team were responsible for 70.0% (n = 340) of all breakdown infringements despite being penalised less than the defending team. A high number of infringements occurred at the breakdown and went unsanctioned in the knockout stages of the 2019 Rugby World Cup. Future work focused on technology, training or rule amendments may be required to improve player adherence and sanctioning of infringements at the breakdown, such that they protect players and are in keeping with the dynamics of the modern game.
Platelet-to-lymphocyte ratio, a novel biomarker to predict the severity of COVID-19 patients: A systematic review and meta-analysis
Authors: Simadibrata Daniel Martin , Pandhita Bashar Adi Wahyu , Ananta Muammar Emir , Tango Tamara
Published: November 2020

Platelet-to-lymphocyte ratio (PLR), a novel inflammatory marker, has been suggested to predict the severity of COVID-19 patients. This systematic review aims to evaluate the association between PLR levels on admission and the severity of COVID-19 patients. A systematic literature search was done on 23 July 2020 to identify peer-reviewed studies, preprints, and grey literatures. Research articles comparing the PLR value on admission in adult patients with COVID-19 with varying degrees of severity were included in the analysis. The following keywords were used for the search: “COVID-19”, “PLR”, “severity”, and “mortality”. A total of seven studies were included in the meta-analysis, six of which were conducted in China. From a total of 998 participants included, 316 (31.7%) had severe diseases; and those in the severe group were generally older and had underlying diseases compared to the non-severe group. In comparison to non-severe patients, the meta-analysis showed that severe COVID-19 patients had higher PLR levels on admission (SMD 0.68; 95%CI 0.43-0.93; I2 =58%). High PLR levels on admission were associated with severe COVID-19 cases. Therefore, the on-admission PLR level is a novel, cost-effective, and readily available biomarker with a promising prognostic role for determining the severity of COVID-19 patients.
Challenging the dogma: severely angulated neck fractures of the fifth metacarpal must be treated surgically
Authors: Boeckstyns Michel E. H.
Published: November 2020

Cadaveric studies suggest that the acceptable deformity in fifth metacarpal neck fractures is maximally 30° palmar angulation. This systematic review verifies the validity of these threshold values. Eighteen prospective comparative studies on operative and/or conservative treatment options in adults were included. None of the studies demonstrated any correlation between the residual or initial angulation and the clinical results despite accepting more severe angular deformities. Closed reduction and immobilization without internal fixation improved the palmar angle by 5° to 9° in three studies and 29° in a fourth. Operative treatments compared with non-reducing conservative treatments showed no benefit of the surgery other than aesthetic issues. The synthesis of this review indicates that 90% of fractures of the metacarpal neck with apex angulation up to 70° can be treated successfully with a functional metacarpal brace without reduction. Disability of the Arm, Shoulder and Hand questionnaire scores <10 are uniformly reported. I modified my own practice accordingly a decade ago to treating these fractures conservatively regardless of the palmar angulation, except in patients with exceptional demands or other fracture deformities.
Management of primary and secondary osteoporosis in children
Authors: Sakka Sophia D. , Cheung Moira S.
Published: November 2020

Osteoporosis in children differs from adults in terms of definition, diagnosis, monitoring and treatment options. Primary osteoporosis comprises primarily of osteogenesis imperfecta (OI), but there are significant other causes of bone fragility in children that require treatment. Secondary osteoporosis can be a result of muscle disuse, iatrogenic causes, such as steroids, chronic inflammation, delayed or arrested puberty and thalassaemia major. Investigations involve bone biochemistry, dual-energy X-ray absorptiometry scan for bone densitometry and vertebral fracture assessment, radiographic assessment of the spine and, in some cases, quantitative computed tomography (QCT) or peripheral QCT. It is important that bone mineral density (BMD) results are adjusted based on age, gender and height, in order to reflect size corrections in children. Genetics are being used increasingly for the diagnosis and classification of various cases of primary osteoporosis. Bone turnover markers are used less frequently in children, but can be helpful in monitoring treatment and transiliac bone biopsy can assist in the diagnosis of atypical cases of osteoporosis. The management of children with osteoporosis requires a multidisciplinary team of health professionals with expertise in paediatric bone disease. The prevention and treatment of fragility fractures and improvement of the quality of life of patients are important aims of a specialised service. The drugs used most commonly in children are bisphosphonates, that, with timely treatment, can give good results in improving BMD and reshaping vertebral fractures. The data regarding their effect on reducing long bone fractures are equivocal. Denosumab is being used increasingly for various conditions with mixed results. There are more drugs trialled in adults, but these are not yet licenced for children. Increasing awareness of risk factors for paediatric osteoporosis, screening and referral to a specialist team for appropriate management can lead to early detection and treatment of asymptomatic fractures and prevention of further bone damage.
Multi-modality imaging evaluation of the dorsal arachnoid web
Authors: Nada A , Mahdi E , Mahmoud E , Cousins J , Ahsan H , Leiva-Salinas C
Published: November 2020

Purpose

Dorsal arachnoid web (DAW) is a rare intradural abnormality which is associated with progressive myelopathy. Our objective was to review multi-modality imaging techniques demonstrating the scalpel sign appearance in evaluation of DAW.

Methods

We retrospectively reviewed various imaging modalities of patients found to have DAW at our institution during January 2015 to February 2020. Five patients underwent surgical decompression with pathological correlation. The remaining patients were presumptively diagnosed based on the characteristic finding of scalpel sign. Clinical data were evaluated and correlated to imaging findings. All imaging modalities demonstrated the characteristic scalpel sign.

Results

Sixteen patients (10 females, and six males) with multi-imaging modalities were evaluated. Their mean age was 52 year (range 23–74 years). Fifteen patients underwent conventional spine MRI. Further high-resolution MR imaging techniques, e.g. 3D T2 myelographic sequence, were utilized with two patients. MRI spine CSF flow study was performed to evaluate the flow dynamic across the arachnoid web in one patient. Eight patients were evaluated with CT myelogram. Syrinx formation was discovered in seven (44%) patients; five (71%) of them underwent surgical resection and decompression. Two patients underwent successful catheter-directed fenestration of the web with clinical improvement. We found a statically significant positive correlation between the degree of cord displacement and compression with syrinx formation (r = 0.55 and 0.65 with p-value of 0.03 and 0.009, respectively).

Conclusion

DAW has characteristic scalpel sign independent of imaging modality. Multi-modality imaging evaluation of DAW is helpful for evaluation and surgical planning.
Impact study of new formulations based on plasticized polyvinyl chloride (PVC)
Authors: Lardjane Nadia , Belhaneche-Bensemra Naima
Published: November 2020

The aim of this paper is the determination of the migration and biodegradation of the PVC additives in the soil. Epoxidized Sunflower Oil (ESO) was used as a thermal organic co-stabilizer for PVC; it was obtained by epoxidation of commercial sunflower oil. Two plasticizers were used: dioctyl phthalate (DOP) and diisononyl adipate (DINA). A natural aging test on site in a garden soil (Tizi Ouzou, Algeria) of the PVC samples was investigated for 6 months. The samples were characterized by Fourier transform infrared (FTIR).The morphological changes were followed by scanning electron microscopy (SEM). The evolution of the bacterial growth, identification using biochemical tests, variation of pH and variation of mass were investigated. The results showed that the nature of the plasticizer and heat stabilizer affects the properties of PVC as well as the phenomena of migration and biodegradation.
Membrane depolarization is required for pressure‐dependent pulmonary arterial tone but not enhanced vasoconstriction to endothelin‐1 following chronic hypoxia
Authors: Norton Charles E , Jernigan Nikki L , Walker Benjimen R , Resta Thomas C
Published: November 2020

Enhanced vasoconstriction is increasingly identified as an important contributor to the development of pulmonary hypertension. Chronic hypoxia results in enhanced Rho kinase mediated Ca2+ sensitization contributing to pressure‐dependent pulmonary arterial tone as well as augmented vasoconstriction to endothelin‐1 and depolarizing stimuli. We sought to investigate the interaction between these vasoconstrictor stimuli in isolated, pressurized, pulmonary arteries. We used the K+ ionophore, valinomycin, to clamp membrane potential (Vm) to investigate the role of membrane depolarization in endothelin‐1 and pressure‐dependent constriction, and endothelin‐1 receptor inhibitors to determine whether membrane depolarization or stretch signal through endothelin‐1 receptors. Clamping Vm prevented pressure‐dependent tone, but not enhanced vasoconstriction to endothelin‐1 following chronic hypoxia. Furthermore, endothelin‐1 receptor inhibition had no effect on either pressure‐dependent tone or vasoconstriction to KCl. As Src kinases contribute to both pressure‐dependent tone and enhanced endothelin‐1 vasoconstriction following chronic hypoxia, we further investigated their role in depolarization‐induced vasoconstriction. Inhibition of Src kinases attenuated enhanced vasoconstriction to KCl. We conclude that membrane depolarization contributes to pressure‐dependent tone but not enhanced vasoconstriction to ET‐1, and that Src kinases serve as upstream mediators facilitating enhanced Rho kinase‐dependent vasoconstriction following chronic hypoxia.
Development and Evaluation of a Pediatric Epilepsy Training Program for First Level Providers in Zambia
Authors: Patel Archana A. , Ciccone Ornella , Nkole Kafula Lisa , Kalyelye Prisca , Sham Lauren , Kielian Agnieszka , Berger Tamar , Huff Hanalise V. , Johnson Hannah F. , Sulu Mercy , Mathews Manoj , Mazumdar Maitreyi
Published: November 2020

Introduction. The developing world continues to face challenges in closing the large treatment gap for epilepsy, due to a high burden of disease and few experienced providers to manage the condition. Children with epilepsy are susceptible to higher rates of developmental impairments and refractory disease due to delays or absence of appropriate management as a result. We demonstrated that a structured education intervention on pediatric epilepsy can improve knowledge, confidence, and impact clinical practice of first level providers in Zambia. Methods. Three first-level facilities across Zambia were included. After initial pilot versions and revisions, the final course was implemented at each site. Pre- and post-intervention knowledge and confidence assessments were performed. Additionally, chart reviews were conducted prior to intervention and 4 months after completion of training at each site to assess change on management. Results. Twenty-three of the original 24 participants from all 3 sites completed the training; 48% clinical officers, 43% nurses, 9% other expertise. Of the 15 concepts tested by knowledge assessment, 12 showed trends in improvement, 7 of which were significant ( P < .05). Chart reviews demonstrated significant improvement in documentation of seizure description ( P = .008), seizure frequency ( P = .00), and possible causes of seizures/epilepsy ( P = .034). Discussion. Key elements of success to this program included hands on clinical skills building and case-based teaching, development of a program with direct and ongoing input from the target audience, and inclusion of assessments to monitor impact on clinical practice. Future studies looking at health outcomes are necessary to determine sustained impact.
Risk-taking behavior, earnings quality, and bank performance: A profit frontier approach
Authors: García-Alcober M. Pilar , Prior Diego , Tortosa-Ausina Emili , Illueca Manuel
Published: November 2020

After the financial crisis of 2007–2008, some bank performance dimensions have been the subject of debate, two of which are bank efficiency and bank risk-taking behavior. The literature on bank efficiency and productivity has grown considerably over the past three decades, and has gained momentum in the aftermath of the financial crisis. Interest in bank risk-taking behavior, usually focusing on its links to monetary policy, has been relatively low, but has also increased exponentially in more recent years. This article combines these two streams of research. Specifically, we test whether more inefficient banks take greater risks when selecting borrowers, charging interests, and requiring collateral, and whether these links between inefficiency and risk change according to the type of bank. Our analysis centers on the Spanish banking system, which has been severely affected by the burst of the housing bubble and has undergone substantial restructuring. To test our hypotheses, we created a database with information on banks and savings banks, their borrowers (non-financial firms), and the links between them. The study also contributes to the literature by considering a novel profit frontier approach. Our results suggest that more inefficient banks take greater risks in selecting their borrowers, and that this high-taking behavior is not offset by higher interest rates.

JEL CLASSIFICATION C14; C61; G21; L50
Multilevel research: Foundations and opportunities in management
Authors: Molina-Azorín José F , Pereira-Moliner Jorge , López-Gamero María D , Pertusa-Ortega Eva M , José Tarí Juan
Published: November 2020

The purpose of this methodological insight is to analyze the foundations of multilevel research, answering two main questions: why this methodological approach is important for management research and how to conduct a multilevel study. We examine why multilevel research is relevant, emphasizing its potential, opportunities, and basic principles. Moreover, we point out the main theoretical, methodological, and analytic aspects to be considered for an appropriate application of multilevel research. The article refers throughout to the basic literature on multilevel research, reviewing conceptual, methodological, and empirical works.

JEL CLASSIFICATION: C18; M10
Early Years Research Elective: Changing Perspectives and Dealing with Uncertainty
Authors: Dawidziuk Aleksander , Gandhewar Rishikesh , Kulkarni Yash
Published: November 2020

Uncertainty is ever-present within the medical profession. To effectively manage uncertainty, future doctors must develop key competencies including resilience, creativity and adaptability along with the capacity for collaboration and embracing multiculturalism. The authors believe that attending an overseas clinical research placement as a junior medical student can benefit medical education by offering an early opportunity to develop these qualities. These views are supported by reflections on a clinical research module and placement in Guangzhou, China completed by the authors during the second year of medical school and aims to highlight key learning opportunities.
Negawatt resource frontiers: Extracting energy efficiency from private spaces
Authors: Thoyre Autumn
Published: November 2020

Energy saved through efficiency and conservation efforts is often framed as a “resource” in climate change mitigation policies because of the ways such “negawatts” can cost-effectively reduce greenhouse gas emissions. This research uses a case study of a US state alternative energy portfolio standard under which negawatts have been turned into new sources of profits for investor-owned electricity companies. Using archival policymaking data and analytical tools commonly used in the study of more traditional subsurface resources like fossil fuels, this paper analyzes how such companies have come to profit from negawatts. I show that, under this portfolio standard, negawatts are largely embedded in electricity customers’ private spaces, presenting a private property problem for capital accumulation similar to the challenge faced by capital seeking to extract more traditional subsurface resources. I argue that electricity companies resolve the negawatt private property problem in two ways. First, they discursively move negawatts out of private spaces through comparisons with resources like oil and gas. Second, the portfolio standard itself can be seen as granting electricity companies an enhanced spatial monopoly on negawatt extraction that functions like a mining concession. These discourses and regulations create a new and growing resource frontier which is likely to be a key accumulation space in the low-carbon economy. I conclude with recommendations for a more socially just and “deeper” politics of energy efficiency extraction.
Characterising the types of paediatric adverse events detected by the global trigger tool – CareTrack Kids
Authors: Hibbert Peter D , Runciman William B , Carson-Stevens Andrew , Lachman Peter , Wheaton Gavin , Hallahan Andrew R , Jaffe Adam , White Les , Muething Stephen , Wiles Louise K , Molloy Charlotte J , Deakin Anita , Braithwaite Jeffrey
Published: November 2020

Introduction

A common method of learning about adverse events (AEs) is by reviewing medical records using the global trigger tool (GTT). However, these studies generally report rates of harm. The aim of this study is to characterise paediatric AEs detected by the GTT using descriptive and qualitative approaches.

Methods

Medical records of children aged 0–15 were reviewed for presence of harm using the GTT. Records from 2012–2013 were sampled from hospital inpatients, emergency departments, general practice and specialist paediatric practices in three Australian states. Nurses undertook a review of each record and if an AE was suspected a doctor performed a verification review of a summary created by the nurse. A qualitative content analysis was undertaken on the summary of verified AEs.

Results

A total of 232 AEs were detected from 6,689 records reviewed. Over four-fifths of the AEs (193/232, 83%) resulted in minor harm to the patient. Nearly half (112/232, 48%) related to medication/intravenous (IV) fluids. Of these, 83% (93/112) were adverse drug reactions. Problems with medical devices/equipment were the next most frequent with nearly two-thirds (32/51, 63%) of these related to intravenous devices. Problems associated with clinical processes/procedures comprise one in six AEs (38/232, 16%), of which diagnostic problems (12/38, 32%) and procedural complications (11/38, 29%) were the most frequent.

Conclusion

Adverse drug reactions and issues with IVs are frequently identified AEs reflecting their common use in paediatrics. The qualitative approach taken in this study allowed AE types to be characterised, which is a prerequisite for developing and prioritising improvements in practice.
The Pathogenesis of Fever-Induced Febrile Seizures and Its Current State
Authors: Mosili Palesa , Maikoo Shreyal , Mabandla Musa, Vuyisile , Qulu Lihle
Published: November 2020

Febrile seizures, commonly in children between the ages of 3 months to 5 years, are a neurological abnormality characterized by neuronal hyper-excitability, that occur as a result of an increased core body temperature during a fever, which was caused by an underlying systemic infection. Such infections cause the immune system to elicit an inflammatory response resulting in the release of cytokines from macrophages. The cytokines such as interleukin (IL)- 1β, IL-6, and tumour necrosis factor-α (TNF-α) combat the infection in the localized area ultimately spilling over into circulation resulting in elevated cytokine levels. The cytokines, along with pathogen-associated molecular patterns (PAMPs) expressed on pathogens for example, lipopolysaccharide (LPS), interact with the blood brain barrier (BBB) causing a ‘leaky’ BBB which facilitates cytokines and LPS entry into the central nervous system. The cytokines activate the microglia which release their own cytokines, specifically IL1β. IL-β interacts with the brain endothelium resulting in the activation of cyclooxygenase 2 which catalyzes the production of prostaglandin 2 (PGE2). PGE2 enters the hypothalamic region and induces a fever. Abnormally increased IL-1β levels also progressively increases excitatory (glutamatergic) neurotransmission, and decreases inhibitory (GABAergic) neurotransmission, thus mediating the pathogenesis of convulsions. Current treatments for febrile seizures present with side effects that are detrimental to health, which fosters the need for an alternative, more affordable treatment with fewer adverse side effects, and 1 that is easily accessible, especially in low income areas that are also affected by other underlying socio-economic factors, in which febrile seizures are of growing concern.
Abortive γδTCR rearrangements suggest ILC2s are derived from T-cell precursors
Authors: Shin Samuel B. , Lo Bernard C. , Ghaedi Maryam , Scott R. Wilder , Li Yicong , Messing Melina , Hernaez Diana Canals , Cait Jessica , Murakami Taka , Hughes Michael R. , Leslie Kevin B. , Underhill T. Michael , Takei Fumio , McNagny Kelly M.
Published: November 2020

Innate lymphoid cells (ILCs) are a recently identified subset of leukocytes that play a central role in pathogen surveillance and resistance, modulation of immune response, and tissue repair. They are remarkably similar to CD4+ T-helper subsets in terms of function and transcription factors required for their development but are distinguished by their lack of antigen-specific receptors. Despite their similarities, the absence of a surface T-cell receptor (TCR) and presence of ILCs and precursors in adult bone marrow has led to speculation that ILCs and T cells develop separately from lineages that branch at the point of precursors within the bone marrow. Considering the common lineage markers and effector cytokine profiles shared between ILCs and T cells, it is surprising that the status of the TCR loci in ILCs was not fully explored at the time of their discovery. Here, we demonstrate that a high proportion of peripheral tissue ILC2s have TCRγ chain gene rearrangements and TCRδ locus deletions. Detailed analyses of these loci show abundant frameshifts and premature stop codons that would encode nonfunctional TCR proteins. Collectively, these data argue that ILC2 can develop from T cells that fail to appropriately rearrange TCR genes, potentially within the thymus.
CD34 expression does not correlate with immunophenotypic stem cell or progenitor content in human cord blood products
Authors: Mantri Sruthi , Reinisch Andreas , Dejene Beruh T. , Lyell Deirdre J. , DiGiusto David L. , Agarwal-Hashmi Rajni , Majeti Ravindra , Weinberg Kenneth I. , Porteus Matthew H.
Published: November 2020

Key Points

The CD34+ compartment of human cord blood contains a range of HSPC immunophenotypes, among which the Lin−CD34+CD38+CD127+ CLP is rare. There is no correlation between the frequencies of CD34+ cells and immunophenotypic HSC in umbilical cord blood products.
Frequency of venous thromboembolism in 6513 patients with COVID-19: a retrospective study
Authors: Hill Jason B. , Garcia David , Crowther Mark , Savage Bryan , Peress Shira , Chang Kevin , Deitelzweig Steven
Published: November 2020

Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appear to be at increased risk for venous thromboembolism (VTE), especially if they become critically ill with COVID-19. Some centers have reported very high rates of thrombosis despite anticoagulant prophylaxis. The electronic health record (EHR) of a New Orleans–based health system was searched for all patients with polymerase chain reaction–confirmed SARS-CoV-2 infection who were either admitted to hospital or treated and discharged from an emergency department between 1 March 2020 and 1 May 2020. From this cohort, patients with confirmed VTE (either during or after their hospital encounter) were identified by administrative query of the EHR.: Between 1 March 2020 and 1 May 2020, 6153 patients with COVID-19 were identified; 2748 of these patients were admitted, while 3405 received care exclusively through the emergency department. In total, 637 patients required mechanical ventilation and 206 required renal replacement therapy. Within the hospitalized cohort, the overall mortality rate was 24.5% and VTE occurred in 86 patients (3.1%). In the 637 patients who required mechanical ventilation at some point during their hospital stay, 45 developed VTE (7.2%). After a median follow-up of 14.6 days, VTE had been diagnosed in 3 of the 2075 admitted who were discharged alive (0.14%). Among 6153 patients with COVID-19 who were hospitalized or treated in emergency departments, we did not find evidence of unusually high VTE risk. Pending further evidence from prospective, controlled trials, our findings support a traditional approach to primary VTE prevention in patients with COVID-19.
Investigation on Yield Behavior of 7075-T6 Aluminum Alloy at Elevated Temperatures
Authors: Lin Jianping , Bao Xingyu , Hou Yong , Min Junying , Qu Xinlei , Tao Zhimin , Chen Jiajie
Published: November 2020

Aluminum alloys have drawn considerable attention in the area of automotive lightweight. High strength aluminum alloys are usually deformed at elevated temperatures due to their poor formability at room temperature. In this work, the yield behavior of 7075 aluminum alloy in T6 temper (AA7075-T6) within the temperature ranging from 25 °C to 230 °C was investigated. Uniaxial and biaxial tensile tests with the aid of induction heating system were performed to determine the stress vs. strain curves and the yield loci of AA7075-T6 at elevated temperatures, respectively. Von Mises, Hill48 and Yld2000-2d yield criteria were applied to predicting yield loci which were compared with experimentally measured yield loci of the AA7075-T6. Results show that yield stress corresponding to the same equivalent plastic strain decreases with increasing temperature within the investigated temperature range and the shape of yield loci evolves nearly negligibly. The experimental yield locus expands with an increase of equivalent plastic strain at the same temperature and the work hardening rate of AA7075-T6 exhibits obvious stress-state-dependency. The non-quadratic Yld2000-2d yield criterion describes the yield surfaces of AA7075-T6 more accurately than the quadratic von Mises and Hill48 yield criteria, and an exponent of 14 in the Yld2000-2d yield function gives the optimal predictions for the AA7075-T6 at all investigated temperatures.
hsa_circ_0006916 promotes hepatocellular carcinoma progression by activating the miR-337-3p/STAT3 axis
Authors: Zhou Xiao-Yong , Yang Hui , Bai Yang-Qiu , Li Xiu-Ling , Han Shuang-Yin , Zhou Bing-Xi
Published: November 2020

Background

Circular RNAs (circRNAs) are thought to be involved in the development of various malignancies. The expression and function of hsa_circ_0006916, a newly identified circRNA, in hepatocellular carcinoma remain unclear.

Methods

Quantitative RT-PCR was used to detect hsa_circ_0006916 in hepatocellular carcinoma. In vitro function assays were conducted to explore growth and invasion of hepatocellular carcinoma cells. Next, the mechanism of hsa_circ_0006916 function in hepatocellular carcinoma was determined by luciferase reporter and RIP assays.

Results

Hsa_circ_0006916 was substantially overexpressed in hepatocellular carcinoma tissues and cells. High levels of hsa_circ_0006916 in hepatocellular carcinoma patients were associated with advanced clinical characteristics. Down-regulation of hsa_circ_0006916 decreased the growth and invasion of hepatocellular carcinoma cells in vitro. The results suggested that hsa_circ_0006916 acted as a sponge of miR-337-3p and had an important functional use in the regulation of STAT3 levels in hepatocellular carcinoma cells. Moreover, miR-337-3p inhibition or STAT3 overexpression abolished the effect of hsa_circ_0006916 suppression on the progression of hepatocellular carcinoma cells.

Conclusions

Our data suggest a novel hsa_circ_0006916/miR-337-3p/STAT3 axis in hepatocellular carcinoma, and provide a new target for treatment.
Subclinical effects of remote ischaemic conditioning in human kidney transplants revealed by quantitative proteomics
Authors: Thorne Adam M. , Huang Honglei , O‘Brien Darragh P. , Eijken Marco , Krogstrup Nicoline Valentina , Norregaard Rikke , Møller Bjarne , Ploeg Rutger J. , Jespersen Bente , Kessler Benedikt M.
Published: November 2020

Background

Remote ischaemic conditioning (RIC) is currently being explored as a non-invasive method to attenuate ischaemia/reperfusion injuries in organs. A randomised clinical study (CONTEXT) evaluated the effects of RIC compared to non-RIC controls in human kidney transplants.

Methods

RIC was induced prior to kidney reperfusion by episodes of obstruction to arterial flow in the leg opposite the transplant using a tourniquet (4 × 5 min). Although RIC did not lead to clinical improvement of transplant outcomes, we explored whether RIC induced molecular changes through precision analysis of CONTEXT recipient plasma and kidney tissue samples by high-resolution tandem mass spectrometry (MS/MS).

Results

We observed an accumulation of muscle derived proteins and altered amino acid metabolism in kidney tissue proteomes, likely provoked by RIC, which was not reflected in plasma. In addition, MS/MS analysis demonstrated transient upregulation of several acute phase response proteins (SAA1, SAA2, CRP) in plasma, 1 and 5 days post-transplant in RIC and non-RIC conditions with a variable effect on the magnitude of acute inflammation.

Conclusions

Together, our results indicate sub-clinical systemic and organ-localised effects of RIC.
Clinical value of CT-guided percutaneous fine-needle aspiration biopsy for peritoneal lesions
Authors: Yu Hualong , Zhang Chuanyu , Liu Shihe , Jiang Gang , Li Shaoke , Zhang Liang , Wang Yongjie , Xu Wenjian
Published: November 2020

Background

To investigate the clinical value of CT-guided percutaneous fine-needle aspiration biopsy for peritoneal lesions of unknown nature.

Methods

A retrospective analysis was conducted of 84 patients with peritoneal thickening for unknown reasons. There were 26 males and 58 females who underwent CT-guided percutaneous fine-needle aspiration biopsy for peritoneal lesions.

Result

Among these 84 patients, no definite pathologic diagnosis was made in 3 patients, who were lost to the follow-up. The accuracy rate of CT-guided percutaneous fine-needle aspiration biopsy was 95.1% (77/81). Sixty lesions were pathologically-diagnosed with malignancies (74.1%), including 55 with peritoneal metastases, 4 with malignant mesotheliomas, and 1 with a lymphoma. Twenty-four patients (33.8%) were diagnosed as benign lesions, including 11 with tuberculosis and 13 with inflammatory lesions. The complications of CT-guided percutaneous fine-needle aspiration biopsy included bleeding in 1 patient and ascites leakage in 2 patients.

Conclusion

CT-guided percutaneous fine-needle aspiration biopsy is a safe and effective method for diagnosing peritoneal lesions.
NGS-based expanded carrier screening for genetic disorders in North Indian population reveals unexpected results – a pilot study
Authors: Singh Kanika , Bijarnia-Mahay Sunita , Ramprasad V. L. , Puri Ratna Dua , Nair Sandhya , Sharda Sheetal , Saxena Renu , Kohli Sudha , Kulshreshtha Samarth , Ganguli Indrani , Gujral Kanwal , Verma Ishwar C.
Published: November 2020

Background

To determine the carrier frequency and pathogenic variants of common genetic disorders in the north Indian population by using next generation sequencing (NGS).

Methods

After pre-test counselling, 200 unrelated individuals (including 88 couples) were screened for pathogenic variants in 88 genes by NGS technology. The variants were classified as per American College of Medical Genetics criteria. Pathogenic and likely pathogenic variants were subjected to thorough literature-based curation in addition to the regular filters. Variants of unknown significance were not reported. Individuals were counselled explaining the implications of the results, and cascade screening was advised when necessary.

Results

Of the 200 participants, 52 (26%) were found to be carrier of one or more disorders. Twelve individuals were identified to be carriers for congenital deafness, giving a carrier frequency of one in 17 for one of the four genes tested (SLC26A4, GJB2, TMPRSS3andTMC1in decreasing order). Nine individuals were observed to be carriers for cystic fibrosis, with a frequency of one in 22. Three individuals were detected to be carriers for Pompe disease (frequency one in 67). None of the 88 couples screened were found to be carriers for the same disorder. The pathogenic variants observed in many disorders (such as deafness, cystic fibrosis, Pompe disease, Canavan disease, primary hyperoxaluria, junctional epidermolysis bullosa, galactosemia, medium chain acyl CoA deficiency etc.) were different from those commonly observed in the West.

Conclusion

A higher carrier frequency for genetic deafness, cystic fibrosis and Pompe disease was unexpected, and contrary to the generally held view about their prevalence in Asian Indians. In spite of the small sample size, this study would suggest that population-based carrier screening panels for India would differ from those in the West, and need to be selected with due care. Testing should comprise the study of all the coding exons with its boundaries in the genes through NGS, as all the variants are not well characterized. Only study of entire coding regions in the genes will detect carriers with adequate efficiency, in order to reduce the burden of genetic disorders in India and other resource poor countries.
Association of intraoperative hypotension with acute kidney injury after liver resection surgery: an observational cohort study
Authors: Liao Pingping , Zhao Shuo , Lyu Lin , Yi Xuanlong , Ji Xiangyu , Sun Jian , Jia Yanfang , Zhou Zangong
Published: November 2020

Background

Acute kidney injury (AKI) is a major complication following liver resection. The aim of this study was to determine the risk factors for AKI after hepatic resection and whether intraoperative hypotension (IOH) was related to AKI.

Methods

Adult patients (≥ 18 years) undergoing liver resection between November 2017 and November 2019 at our hospital were retrospectively reviewed. AKI was defined as ≥50% increase in serum creatinine from baseline value within 48 h after surgery. IOH was defined as the lowest absolute mean arterial pressure (MAP) < 65 mmHg for more than 10 cumulative minutes during the surgery. Patients were divided into AKI group and non-AKI group, and were stratified by age ≥ 65 years.

Results

796 patients who met our inclusion and exclusion criteria were analyzed. After multivariable regression analysis, the IOH (OR, 2.565;P = 0.009) and age ≥ 65 years (OR, 2.463;P = 0.008) were risk factors for AKI. The IOH (OR, 3.547;P = 0.012) and received red blood cell (OR, 3.032;P = 0.036) were risk factors of AKI in age ≥ 65 years patients.

Conclusions

The IOH and age ≥ 65 years were risk factors for postoperative AKI, and IOH was associated with AKI in age ≥ 65 years patients following liver resection.