bluuebunny/crossref_metadata_2025 huggingface dataset:
Ductile Crack Growth Resistance and Rotation Behavior of Miniature C(T) Specimen
Authors: Shinko Tomoki , Yamamoto Masato
Published: December 2020

A utilization of a miniature compact tension (Mini-C(T)) specimen is expected to enable effective use of limited remaining surveillance specimens for the structural integrity assessment of a Reactor Pressure Vessel (RPV). For developing a direct fracture toughness evaluation method using Mini-C(T) specimen in the upper-shelf temperature range as well as ductile-brittle transition temperature range, this study is aimed to experimentally characterize the Mini-C(T) specimen’s size effect on ductile crack growth resistance and interpolate its mechanism. Mini-C(T) specimen and 0.5T-C(T) specimen were prepared from a Japanese RPV steel SQV2A, and the ductile crack growth tests were conducted on them at room temperature. As a result, the crack growth resistance of Mini-C(T) and 0.5T-C(T) specimens are comparable if the crack extension Δa is less than 0.5 mm. On the other hand, if Δa exceeds 0.5 mm, the crack growth resistance of Mini-C(T) specimen becomes lower than that of 0.5T-C(T) specimen. The measurements of stretch zone width and depth support the fact that the fracture toughness for ductile crack initiation of Mini-C(T) specimen is lower than that of 0.5T-C(T) specimen. From the rotational (crack mouth opening) deformation of Mini-C(T) specimen was measured by simultaneously measuring load-line and front face displacements. The distance between the crack tip and the rotation center of Mini-C(T) specimen is smaller than that of 0.5T-C(T) specimen during the test. Furthermore, The plastic zone in front of the crack tip reaches the rotation center up to the crack extension of Δa = 0.3 mm on Mini-C(T) specimen, indicating that the mechanism of the specimen size effect of Mini-C(T) specimen is likely a plastic constraint due to the influence of the rotation center locating near the crack tip. This suggests that the specimen size effect of Mini-C(T) specimen on ductile crack growth resistance is expected to be corrected by considering an effect of the plastic constraint.
Research on Implementation Method and Technical Application of Risk Assessment to Storage Tank at National Petroleum Reserves
Authors: Fang Zhou , Wang Zhe , Li Guanghai
Published: December 2020

The inspection method based on risk was studied about 23 large tanks of a national strategic oil reserve base, which was a relatively large research work, because the tank inspection was a non-statutory inspection that received little attention, and the risk assessment method of large oil storage tanks in the actual project application was not mature enough. The basic information of 23 nominal volume one hundred thousand cubic meters crude oil tank was collected and sorted. 23 storage tanks under the application of risk assessment are all aboveground atmospheric storage tanks. 23 storage tanks are all floating-roof tanks, whose host materials include SPV490Q, 16MnR, Q235-B, and Q235-A; the containing medium for storage tank are crude oil, and time-to-use starts from August 2006 to April 2007. The implementation process of tank risk assessment was described, and the process of implementing risk assessment was described in detail. The method of risk trend analysis is studied, and the routine maintenance and maintenance suggestions are given. The results show that the risk assessment method for the tank can be implemented, and has been recognized by the tank management unit, providing a rare real case.
Major Hazards Modeling of Pressurized Special Equipment in Chemical Industry Parks Based on FCBPSS Method
Authors: Song Pan , Pu Zhe , Ren Bin , Wang Jielu , Liu Shuhong
Published: December 2020

Based on the identification of major hazards of pressurized special equipment (PSE) in chemical industry parks, a domain model of major hazards using FCBPSS (Function-Context-Behavior-Principle-State-Structure) method is built in this paper. The characteristics of this model is that it studies major hazards of PSE in the perspective of system by learning its several important concepts, namely function, context, behavior, principle, state and structure, which provides theoretical basis for further study on the dynamic supervision. Furthermore, the model gives powerful technical support to the accident emergency response of pressurized special equipment in chemical industry parks.
Acceptance Criteria for the Mechanical Integrity of Clad/Base Metal Interface for High Temperature Nuclear Reactor Cladded Components
Authors: Barua B. , Messner M. C. , Rovinelli A. , Sham T.-L.
Published: December 2020

The existing Class A metallic materials qualified in the ASME Section III, Division 5 rules for high temperature nuclear reactors do not have optimal corrosion resistance for some reactor coolants such as liquid lead, lead/bismuth eutectic, and molten salts which is a major constraint on long life designs. A near term solution to this limitation is the use of cladded components — overlay the Class A materials with a thin layer of some corrosion resistant material. However, this necessitates the development of a design method for cladded components without requiring long-term testing of clad materials in order to support the near-term deployment of these advanced reactor systems. In two other PVP papers [PVP2020-21469, PVP2020-21493], the development of such design method along with a complete set of design rules and clad selection criteria are presented. However, the developed design rules and clad selection criteria are based on a priori assumption of perfect bonding between the clad and base materials. In practice the clad/base debonding may occur before the end of the design life of the component. Therefore, this paper focuses on developing a general acceptance test for checking whether the mechanical integrity of the clad/ base metal interface will be retained till the end of the design life. This work proposes to perform temperature cycling tests on cladded buttons of 12.7 mm diameter and a few mm thickness. A simple analytical expression is provided to determine the temperature range for the temperature cycling tests so that the clad/base interface shear stress intensity at the edge of the cladded button mimics the maximum interface shear stress intensity experienced by the component during the design transients. The paper also provides a method to determine the clad/base interfacial shear stress from finite element structural analysis of components.
Fatigue Life Modeling Using Nitinol Data
Authors: Harlow D. Gary
Published: December 2020

Nitinol is a shape memory alloy that has become very popular for medical applications. Specifically, Nitinol tubing is used as peripheral stents, cardio stents and other medical implant devices. Medical implants subjected to blood pressure experience approximately 40 million cycles per year, which necessitates a life expectancy of at least 600 million cycles. Consequently, modeling the fatigue life of Nitinol is critical because failure could result in severe consequences, if not death. The purpose of this work is to model a rather robust set of fatigue data for Nitinol tubes. A phenomenological distribution function for fatigue life is considered. The form of the distribution function includes a kernel that incorporates time dependent loading, mechanical breakdown, and statistical behavior. The approach is a form of the classical accelerated life model in which covariates are included to account for physical attributes that directly influence lifetime. Because of the generality in the formalism, the model is applicable for a variety of loading conditions. The modeling for the Nitinol data is a combination of traditional stress–life methods with a Weibull distribution function. The proposed approach incorporates stress dependencies in the distribution parameters. Also, the Weibull distribution is assumed to be in the form of a three–parameter distribution rather than the more frequently used two–parameter. To assess the validity of the proposed methodology confidence bounds will be estimated for the data.
A Moral Intervention Reduces Doping Likelihood in British and Greek Athletes: Evidence From a Cluster Randomized Control Trial
Authors: Kavussanu Maria , Hurst Philip , Yukhymenko-Lescroart Mariya , Galanis Evangelos , King Ailish , Hatzigeorgiadis Antonis , Ring Christopher
Published: December 2020

Objectives: The authors aimed to develop a moral intervention and to determine whether it was more effective in preventing doping than an educational (i.e., knowledge-based) intervention; their primary outcome was doping likelihood, and the secondary outcomes were moral identity, moral disengagement, moral atmosphere, and anticipated guilt. Methods: Eligible athletes (N = 303) in the United Kingdom and Greece took part in the study. The authors randomly assigned 33 clubs to either the moral or the educational intervention. They measured outcomes pre- and postintervention and at 3- and 6-month follow-up. Results: Athletes in both interventions in both countries reported lower doping likelihood and moral disengagement and higher guilt from pre- to postintervention. These effects were maintained at the 3- and 6-month follow-ups. There were no effects on moral identity or moral atmosphere. Conclusions: In addition to disseminating information about doping, doping prevention programs should include content that focuses on moral variables.
The long shot
Authors: Wadman Meredith
Published: December 2020

A little company chases its bigger competitors in the race for a coronavirus vaccine.
Complete Genome Sequence of
Adlercreutzia
sp. Strain 8CFCBH1, a Potent Producer of Equol, Isolated from Healthy Japanese Feces
Authors: Ogata Yusuke , Sakamoto Mitsuo , Ohkuma Moriya , Hattori Masahira , Suda Wataru
Published: December 2020

Here, we report the complete genome sequence of
Adlercreutzia
sp. strain 8CFCBH1, which was isolated from a Japanese fecal sample. The genome analysis revealed that the 8CFCBH1 strain potentially produces (
S
)-equol.
Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study
Authors: Eythorsson Elias , Helgason Dadi , Ingvarsson Ragnar Freyr , Bjornsson Helgi K , Olafsdottir Lovisa Bjork , Bjarnadottir Valgerdur , Runolfsdottir Hrafnhildur Linnet , Bjarnadottir Solveig , Agustsson Arnar Snaer , Oskarsdottir Kristin , Thorvaldsson Hrafn Hliddal , Kristjansdottir Gudrun , Armannsdottir Brynja , Bjarnason Agnar , Johannsson Birgir , Gudlaugsson Olafur , Gottfredsson Magnus , Sigurdsson Martin I , Indridason Olafur S , Palsson Runolfur
Published: December 2020

Objective

To characterise the symptoms of coronavirus disease 2019 (covid-19).

Design

Population based cohort study.

Setting

Iceland.

Participants

All individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) between 17 March and 30 April 2020. Cases were identified by three testing strategies: targeted testing guided by clinical suspicion, open invitation population screening based on self referral, and random population screening. All identified cases were enrolled in a telehealth monitoring service, and symptoms were systematically monitored from diagnosis to recovery.

Main outcome measures

Occurrence of one or more of 19 predefined symptoms during follow-up.

Results

Among 1564 people positive for SARS-CoV-2, the most common presenting symptoms were myalgia (55%), headache (51%), and non-productive cough (49%). At the time of diagnosis, 83 (5.3%) individuals reported no symptoms, of whom 49 (59%) remained asymptomatic during follow-up. At diagnosis, 216 (14%) and 349 (22%) people did not meet the case definition of the Centers for Disease Control and Prevention and the World Health Organization, respectively. Most (67%) of the SARS-CoV-2-positive patients had mild symptoms throughout the course of their disease.

Conclusion

In the setting of broad access to RT-PCR testing, most SARS-CoV-2-positive people were found to have mild symptoms. Fever and dyspnoea were less common than previously reported. A substantial proportion of SARS-CoV-2-positive people did not meet recommended case definitions at the time of diagnosis.
Making information and communications technologies (ICTs) work for health: protocol for a mixed-methods study exploring processes for institutionalising geo-referenced health information systems to strengthen maternal neonatal and child health (MNCH) service planning, referral and oversight in urban Bangladesh
Authors: Islam Rubana , Adams Alayne Mary , Hasan Shaikh Mehdi , Ahmed Rushdia , Bhattacharyya Dipika Shankar , Shafique Sohana
Published: December 2020

Introduction

Disparities in health outcomes and access to maternal neonatal and child health (MNCH) are apparent among urban poor compared with national, rural or urban averages. A fundamental first step in addressing inequities in MNCH services is knowing what services exist in urban areas, where these are located, who provides them and who uses them. This study aims to institutionalise the Urban Health Atlas (UHA)—a novel information and communications technology (ICT) tool—to strengthen health service delivery and oversight and generate critical evidence to inform health policy and planning in urban Bangladesh.

Methods and analysis

This mixed-method implementation research will be conducted in four purposively selected urban sites representing larger and smaller cities. Research activities will include an assessment of information needs and task review analysis of information users, stakeholder mapping and cost estimation. To document stakeholder perceptions and experiences, key informant interviews and in-depth interviews will be conducted along with desk reviews to understand MNCH planning and referral decisions. The UHA will be refined to increase responsiveness to user needs and capacities, and hands-on training will be provided to health managers. Cost estimation will be conducted to assess the financial implications of UHA uptake and scale-up. Systematic documentation of the implementation process will be undertaken. Policy decision-making and ICT health policy process flowcharts will be prepared using desk reviews and qualitative interviews. Thematic analysis of qualitative data will involve both emergent and a priori coding guided by WHO PATH toolkit and Policy Engagement Framework. Stakeholder analysis will apply standard techniques and measurement scales. Descriptive analysis of quantitative data and cost estimation analysis will also be performed.

Ethics and dissemination

The study has been approved by the Institutional Review Board of icddr,b (# PR-16057). Study findings will be disseminated through national and international workshops, conferences, policy briefs and peer-reviewed publications.
Resilience support to enhance positive health outcomes for police officers in five Anglosphere nations: a scoping review protocol
Authors: Steenbeek Audrey , Giacomantonio Chris , Brooks Arlene , Holmvall Camilla , Yu Ziwa , Rothfus Melissa
Published: December 2020

Introduction

Law enforcement involves exposure to threatening situations and traumatic events that place police officers at risk for negative physical and mental health outcomes. Resilience support, among other elements of training, may help mitigate these risks, yet little is known about which aspects of resilience support help officers achieve better health and quality of life outcomes.

Methods and analysis

This review will consider all literature that examines the links between resilience support, physical/mental health and quality of life outcomes for police officers in five Anglosphere nations: Canada, the USA, Australia, New Zealand and the UK. This review will include all literature (including those that show null or negative links) involving any public policing agency that has a formal rank structure and includes a localized, uniformed emergency response function. Resilience support may include, but is not limited to: tools, policies, models, frameworks, programmes and organizational features that seek to promote positive, physical/mental health and quality of life outcomes at three levels of resilience: (1) readiness and preparedness, (2) response and adaptation, (3) recovery and adjustment. Peer reviewed and grey literature examining resilience support since 2000 that focuses on police officers are eligible for inclusion. Databases/sources to be searched will include: PsycINFO, Academic Search Premier, CINAHL, Public Affair Index, Campbell Collaboration, ProQuest Dissertations and Theses Global, Business Source Complete, Scopus and Google. Retrieval of full-text, English-language studies (and other literature), data extraction, data synthesis and data mapping will be performed independently by two reviewers, following Joanna Briggs Institute methodology.

Ethics and dissemination

Ethics approval is not required for this scoping review, and the literature search will start in November 2020 or upon acceptance of this protocol. The findings of the scoping review will be available [April 2021] and will be published in a peer reviewed journal.
Exclusion of enrolled participants in randomised controlled trials: what to do with ineligible participants?
Authors: Rehman Andrea M , Ferrand Rashida , Allen Elizabeth , Simms Victoria , McHugh Grace , Weiss Helen Anne
Published: December 2020

Objective

Post-randomisation exclusions in randomised controlled trials are common and may include participants identified as not meeting trial eligibility criteria after randomisation. We report how a decision might be reached and reported on, to include or exclude these participants. We illustrate using a motivating scenario from the BREATHE trial (Trial registration ClinicalTrials.gov,NCT02426112) evaluating azithromycin for the treatment of chronic lung disease in people aged 6–19 years with HIV in Zimbabwe and Malawi.

Key points

Including all enrolled and randomised participants in the primary analysis of a trial ensures an unbiased estimate of the intervention effect using intention-to-treat principles, and minimises the effects of confounding through balanced allocation to trial arm. Ineligible participants are sometimes enrolled, due to measurement or human error. Of 347 participants enrolled into the BREATHE trial, 11 (3.2%) were subsequently found to be ineligible based on lung function criteria. We assumed no safety risk of azithromycin treatment; their inclusion in the trial and subsequent analysis of the intervention effect therefore mirrors clinical practice. Senior trial investigators considered diurnal variations in the measurement of lung function, advantages of retaining a higher sample size and advice from the Data Safety and Monitoring Board and Trial Steering Committee, and decided to include these participants in primary analysis. We planned and reported analyses including and excluding these participants, and in our case the interpretation of treatment effect was consistent.

Conclusion

The decision, by senior investigators, on whether to exclude enrolled participants, should reflect issues of safety, treatment efficacy, statistical power and measurement error. As long as decisions are made prior to finalising the statistical analysis plan for the trial, the risk of exclusions creating bias should be minimal. The decision taken should be transparently reported and a sensitivity analysis can present the opposite decision.
Vaccination assessments using the Demographic and Health Survey, 2005–2018: a scoping review
Authors: Shenton Luke M , Wagner Abram L , Ji Mengdi , Carlson Bradley F , Boulton Matthew L
Published: December 2020

Objective

To characterise studies which have used Demographic and Health Survey (DHS) datasets to evaluate vaccination status.

Design

Scoping review.

Data sources

Electronic databases including PubMed, EBSCOhost and POPLINE, from 2005 to 2018.

Study selection

All English studies with vaccination status as the outcome and the use of DHS data.

Data extraction

Studies were selected using a predetermined list of eligibility criteria and data were extracted independently by two authors. Data related to the study population, the outcome of interest (vaccination) and commonly seen predictors were extracted.

Results

A total of 125 articles were identified for inclusion in the review. The number of countries covered by individual studies varied widely (1–86), with the most published papers using data from India, Nigeria, Pakistan and Ethiopia. Many different definitions of full vaccination were used although the majority used a traditional schedule recommended in the WHO’s Expanded Programme on Immunisation. We found studies analysed a wide variety of predictors, but the most common were maternal education, wealth, urbanicity and child’s sex. Most commonly reported predictors had consistent relationships with the vaccination outcome, outside of sibling composition.

Conclusions

Researchers make frequent use of the DHS dataset to describe vaccination patterns within one or more countries. A clearer idea of past use of DHS can inform the development of more rigorous studies in the future. Researchers should carefully consider whether a variable needs to be included in the multivariable model, or if there are mediating relationships across predictor variables.
Here’s something I prepared earlier: a review of the time to publication of cross-sectional reviews of smartphone health apps
Authors: Larsen Mark , Nicholas Jennifer , Han Jin , Lemon Christopher , Okun Kelsi , Torok Michelle , Wong David , Wong Iana , Wong Quincy , Huckvale Kit
Published: December 2020

Objectives

Across a range of health conditions, apps are increasingly valued as tools for supporting the delivery and coordination of healthcare. Research-led cross-sectional reviews of apps are a potential resource to inform app selection in face of uncertainties around content quality, safety and privacy. However, these peer-reviewed publications only capture a snapshot of highly dynamic app stores and marketplaces. To determine the extent to which marketplace dynamics might impact the interpretation of app reviews, the current study sought to quantify the lag between the reported time of app assessment and publication of the results of these studies.

Design

Searches were conducted on MEDLINE, Embase and PsycINFO to identify published cross-sectional reviews of health, fitness or wellness apps. Publication timeline metadata were extracted, allowing the primary outcome measure, the delay between app store search and manuscript publication, to be calculated. A secondary measure, the time between search and manuscript submission, was also calculated where possible.

Results

After screening, 136 relevant cross-sectional app review studies were analysed. The median time to publication was 431 days (approximately 14 months, range: 42–1054 days). The median time to submission was 269 days (approximately 9 months, range: 5–874 days). Studies which downloaded apps typically took longer to publish (p=0.010), however the number of apps reviewed did not impact the time to publication (p=0.964). Studies which recommended specific apps were not published more rapidly (p=0.998).

Conclusions

Most health app reviews present data that are at least a year out-of-date at the time of publication. Given the high rate of turnover of health apps in public marketplaces, it may not be appropriate, therefore, for these reviews to be presented as a resource concerning specific products for commissioners, clinicians and the public. Alternative sources of information may be better calibrated to the dynamics of the app marketplace.
Magnetic Properties of the Nano Brownmillerite KBiFe2O5: Monte Carlo Simulations
Authors: El Housni I. , Mtougui S. , El Mekkaoui N. , Khalladi R. , Idrissi S. , Ziti S. , Labrim H. , Bahmad L.
Published: December 2020

In this paper, we have used the Monte Carlo simulations (MCSs) to investigate the magnetic properties of the brownmillerite KBiFe2O5 (KBFO) compound. The different exchange coupling interactions [Formula: see text], [Formula: see text] and [Formula: see text] between different irons Fe atom have been outlined including the angles between Fe1-O-Fe2. The double exchange interaction is caused by the existence of the oxygen atoms. In a first step, we present the ground state phase diagrams in the absence of any temperature fluctuations, in different physical parameter planes. Then we present investigation of the magnetic properties and the behavior of the total magnetizations, the total susceptibilities, as a function of temperature, crystal field, the exchange coupling interactions and the external magnetic field. Also, we provide the dependency of the total magnetizations showing the hysteresis loops of the KBFO compound, for selected values of temperature, crystal field and the exchange coupling interactions.
A general framework for endowment effects in combinatorial markets
Authors: Ezra Tomer , Feldman Michal , Friedler Ophir
Published: December 2020

The
endowment effect
, coined by Nobel Laureate Richard Thaler, posits that people tend to inflate the value of items they own. Recently, Babaioff, Dobzinski and Oren [EC'18] introduced the notion of
endowed valuations
--- valuations that capture the endowment effect --- and studied the stability and efficiency of combinatorial markets with endowed valuations. They showed that under a specific formulation of the endowment effect, an
endowed equilibrium
--- market equilibrium with respect to endowed valuations --- is guaranteed to exist in markets with submodular valuations, but fails to exist under XOS valuations. We harness the endowment effect further by introducing a general framework that captures a wide range of different formulations of the endowment effect. The different formulations are (partially) ranked from weak to strong, based on a stability-preserving order. We then provide algorithms for computing endowment equilibria with high welfare for sufficiently strong endowment effects, and non-existence results for weaker ones. Among other results, we prove the existence of endowment equilibria under XOS valuations, and show that if one can pre-pack items into irrevocable bundles then an endowment equilibrium exists for arbitrary markets.
Characterization of cellular oxidative stress response by stoichiometric redox proteomics
Authors: Zhang Tong , Gaffrey Matthew J. , Li Xiaolu , Qian Wei-Jun
Published: December 2020

The thiol redox proteome refers to all proteins whose cysteine thiols are subjected to various redox-dependent posttranslational modifications (PTMs) including S-glutathionylation (SSG), S-nitrosylation (SNO), S-sulfenylation (SOH), and S-sulfhydration (SSH). These modifications can impact various aspects of protein function such as activity, binding, conformation, localization, and interactions with other molecules. To identify novel redox proteins in signaling and regulation, it is highly desirable to have robust redox proteomics methods that can provide global, site-specific, and stoichiometric quantification of redox PTMs. Mass spectrometry (MS)-based redox proteomics has emerged as the primary platform for broad characterization of thiol PTMs in cells and tissues. Herein, we review recent advances in MS-based redox proteomics approaches for quantitative profiling of redox PTMs at physiological or oxidative stress conditions and highlight some recent applications. Considering the relative maturity of available methods, emphasis will be on two types of modifications: 1) total oxidation (i.e., all reversible thiol modifications), the level of which represents the overall redox state, and 2) S-glutathionylation, a major form of reversible thiol oxidation. We also discuss the significance of stoichiometric measurements of thiol PTMs as well as future perspectives toward a better understanding of cellular redox regulatory networks in cells and tissues.
Platelet activation contributes to hypoxia-induced inflammation
Authors: Delaney Cassidy , Davizon-Castillo Pavel , Allawzi Ayed , Posey Janelle , Gandjeva Aneta , Neeves Keith , Tuder Rubin M. , Di Paola Jorge , Stenmark Kurt R. , Nozik Eva S.
Published: December 2020

Inflammation is central to the pathogenesis of pulmonary vascular remodeling and pulmonary hypertension (PH). Inflammation precedes remodeling in preclinical models, thus supporting the concept that changes in immunity drive remodeling in PH. Platelets are recognized as mediators of inflammation, but whether platelets contribute to hypoxia-driven inflammation has not been studied. We utilized a murine hypoxia model to test the hypothesis that platelets drive hypoxia-induced inflammation. We evaluated male and female 9-wk-old normoxic and hypoxic mice and in selected experiments included hypoxic thrombocytopenic mice. Thrombocytopenic mice were generated with an anti-GP1bα rat IgG antibody. We also performed immunostaining of lung sections from failed donor controls and patients with idiopathic pulmonary arterial hypertension. We found that platelets are increased in the lungs of hypoxic mice and hypoxia induces platelet activation. Platelet depletion prevents hypoxia-driven increases in the proinflammatory chemokines CXCL4 and CCL5 and attenuates hypoxia-induced increase in plasma CSF-2. Pulmonary interstitial macrophages are increased in the lungs of hypoxic mice; this increase is prevented in thrombocytopenic mice. To determine the potential relevance to human disease, lung sections from donors and patients with advanced idiopathic pulmonary arterial hypertension (iPAH) were immunostained for the platelet-specific protein CD41. We observed iPAH lungs had a two-fold increase in CD41, compared with controls. Our data provide evidence that the platelet count is increased in the lungs and activated in mice with hypoxia-induced inflammation and provides rationale for the further study of the potential contribution of platelets to inflammatory mediated vascular remodeling and PH.
Plastic changes in primate motor cortex following paired peripheral nerve stimulation
Authors: Habekost Bonne , Germann Maria , Baker Stuart N.
Published: December 2020

Paired stimulation of peripheral nerves for 1 h induced lasting changes in neural responses within the motor cortex to nerve stimulation and to performance of a behavioral task. These changes were sufficient to alter the efficiency with which activity could encode stimulus type. Stimuli that can be easily applied noninvasively in human subjects can alter central motor circuits.
Antioxidant, Anti-Inflammatory, and Analgesic Activities of Aqueous Extract of Diploknema butyracea (Roxb.) H.J. Lam Bark
Authors: Chhetri Sumit Bahadur Baruwal , Khatri Deepa , Parajuli Kalpana
Published: December 2020

Diploknema butyracea (Roxb.) H.J. Lam is a multipurpose tree used by the Nepalese indigenous people for medicinal purposes such as rheumatism, asthma, and ulcer and other purposes such as cooking and lighting. However, there is no scientific evidence for the medicinal uses of this plant. The present study aimed to explore the phytochemical constituents, estimate the total phenolic content, evaluate antioxidant activity, and investigate the in vivo anti-inflammatory and analgesic activities of aqueous extract of Diploknema butyracea (Roxb.) H.J. Lam bark (ADBB). Phytochemical screening was performed using standard methods. The total phenolic content was determined using the Folin–Ciocalteu method. The in vitro antioxidant activity was determined using 2, 2-diphenyl-1-picrylhydrazyl radical scavenging assay and nitric oxide radical scavenging assay. For the in vivo studies, the plant extract was given in three different doses (50, 100, and 200 mg/kg body weight) to male albino Wistar rats. Anti-inflammatory and analgesic studies were carried out using the carrageenan-induced rat paw edema and the hot plate method, respectively. Results revealed the presence of different phytoconstituents such as flavonoids, tannins, glycosides, terpenoids, and carbohydrates together with a considerable amount of phenolic compounds. Antioxidant assays indicated the potent antioxidant activity of the plant extracts. The higher dose of D. butyracea (200 mg/kg) exhibited a maximum and significant inhibition (53.20%) of rat hind paw edema volume at 4 h and showed a greater increment in latency time (12.15 ± 1.81 sec) in the hot plate test at 120 min. The present study demonstrated the antioxidant, anti-inflammatory, and analgesic potential of ADBB, which supports its traditional medicinal use.
Combined Endovascular and Surgical Treatment of Chronic Carotid Artery Occlusion: Hybrid Operation
Authors: Yan Long , Wang Zhe , Liu Zhanchuan , Yin Haoyuan , Chen Xuan
Published: December 2020

Objectives. The optimal treatment choice of chronic carotid artery occlusion (CAO) remains inconclusive. This study was aimed at exploring the safety and effectiveness of hybrid surgery in the treatment of CAO and at determining predictors for successful recanalization. Methods. In this study, we enrolled 37 patients with CAO who underwent hybrid surgical treatment during the period 2016–2018. We extracted and analyzed patients’ demographic data, disease characteristics, surgical success rates, perioperative complications, and prognosis. Results. A total of 37 patients with symptomatic CAO underwent hybrid surgical treatment. Thirty cases (81.1%) were successfully recanalized, while seven were not. Blood reflux after carotid endarterectomy occurred in 18 patients (60%) of the success group and 1 (14.3%) of the failure group (OR, 9.0; 95% CI, 0.95‐54.5; P = 0.042). The rate of distal ICA reconstruction below the clinoid segment was 20 (66.7%) in the success group and 1 (14.3%) in the failure group (OR, 12.0; 95% CI, 1.3‐113.7; P = 0.029). In patients with successful recanalization, no ischemic events occurred after surgery and during follow‐up, but restenosis of >50% was found in one case. In the failure group, two patients experienced recurrent ischemic events during follow‐up. Perfusion imaging in successful recanalization cases is significantly improved, preoperative I/C ratio was 1.44 (IQR 1.27‐1.55), and postoperative 1.12 (IQR 1.05‐1.23). National Institutes of Health Stroke Scale (NIHSS) score of successful recanalization cases was 5.35 (2.26) before surgery and 2.03 (1.40) at 6 months (P < 0.01). Conclusion. Hybrid surgery might be a safe and effective way to treat CAO. Distal internal carotid artery reconstruction to below the clinoid segment and blood reflux after carotid endarterectomy are predictors of successful recanalization.
Verruca Vulgaris and Seborrheic Keratosis Exacerbated by Immunosuppression
Authors: Iida Shohei , Sugioka Kyoko , Kondo Makoto , Matsushima Yoshiaki , Mizutani Kento , Habe Koji , Yamanaka Keiichi
Published: December 2020

Verruca vulgaris is an infectious disease caused by the human papillomavirus and characterized by hyperkeratotic papules or plaques with a clear boundary. Seborrheic keratosis is a commonly encountered lesion on the face, trunk, or extremities and is described as seborrheic verruca because of its clinical similarity to warts; furthermore, it is occasionally associated with immune suppression, especially in cases of Leser-trélat syndrome. Although these diseases are frequently found in healthy individuals, they typically show a good response to cryotherapy. However, cases in immunosuppressed patients are intractable to therapy. Overall immune status is evaluated via complete blood count (CBC); however, white blood count does not show the exact immune ability, and NK cell activity is often decreased in cases of malignancy. Here, we present two cases of exacerbated verruca vulgaris and seborrheic verruca observed in patients with malignancy. Although the patients seemed to be in good condition and had a normal CBC, immunosuppression was suspected based on the degree of skin rashes. NK cell activity was decreased in both patients, and both cases had malignancy. The measurement of NK cell activity may be a useful approach to evaluate immune status.
KLF5 Is Induced by FOXO1 and Causes Oxidative Stress and Diabetic Cardiomyopathy
Authors: Kyriazis Ioannis D. , Hoffman Matthew , Gaignebet Lea , Lucchese Anna Maria , Markopoulou Eftychia , Palioura Dimitra , Wang Chao , Bannister Thomas D. , Christofidou-Solomidou Melpo , Oka Shin-ichi , Sadoshima Junichi , Koch Walter J. , Goldberg Ira J. , Yang Vincent W. , Bialkowska Agnieszka B. , Kararigas Georgios , Drosatos Konstantinos
Published: December 2020

Rationale:

Diabetic cardiomyopathy (DbCM) is a major complication in type-1 diabetes, accompanied by altered cardiac energetics, impaired mitochondrial function, and oxidative stress. Previous studies indicate that type-1 diabetes is associated with increased cardiac expression of KLF5 (Krüppel-like factor-5) and PPARα (peroxisome proliferator–activated receptor) that regulate cardiac lipid metabolism.

Objective:

In this study, we investigated the involvement of KLF5 in DbCM and its transcriptional regulation.

Methods and Results:

KLF5 mRNA levels were assessed in isolated cardiomyocytes from cardiovascular patients with diabetes and were higher compared with nondiabetic individuals. Analyses in human cells and diabetic mice with cardiomyocyte-specific FOXO1 (Forkhead box protein O1) deletion showed that FOXO1 bound directly on the
KLF5
promoter and increased KLF5 expression. Diabetic mice with cardiomyocyte-specific FOXO1 deletion had lower cardiac KLF5 expression and were protected from DbCM. Genetic, pharmacological gain and loss of KLF5 function approaches and AAV (adeno-associated virus)-mediated
Klf5
delivery in mice showed that KLF5 induces DbCM. Accordingly, the protective effect of cardiomyocyte FOXO1 ablation in DbCM was abolished when KLF5 expression was rescued. Similarly, constitutive cardiomyocyte-specific KLF5 overexpression caused cardiac dysfunction. KLF5 caused oxidative stress via direct binding on NADPH oxidase (
NOX
)4 promoter and induction of NOX4 (NADPH oxidase 4) expression. This was accompanied by accumulation of cardiac ceramides. Pharmacological or genetic KLF5 inhibition alleviated superoxide formation, prevented ceramide accumulation, and improved cardiac function in diabetic mice.

Conclusions:

Diabetes-mediated activation of cardiomyocyte FOXO1 increases KLF5 expression, which stimulates NOX4 expression, ceramide accumulation, and causes DbCM.
Inhibition of miR‐155 Attenuates Detrimental Vascular Effects of Tobacco Cigarette Smoking
Authors: Frati Giacomo , Forte Maurizio , di Nonno Flavio , Bordin Antonella , Chimenti Isotta , Picchio Vittorio , Cavarretta Elena , Stanzione Rosita , Bianchi Franca , Carnevale Roberto , Nocella Cristina , Schiavon Sonia , Vecchio Daniele , Marchitti Simona , De Falco Elena , Rubattu Speranza , Paneni Francesco , Biondi‐Zoccai Giuseppe , Versaci Francesco , Volpe Massimo , Pagano Francesca , Sciarretta Sebastiano
Published: December 2020

Background

The role of microRNAs dysregulation in tobacco cigarette smoking–induced vascular damage still needs to be clarified. We assessed the acute effects of tobacco cigarette smoking on endothelial cell‐related circulating microRNAs in healthy subjects. In addition, we investigated the potential role of microRNAs in smoking‐dependent endothelial cell damage.

Methods and Results

A panel of endothelial‐related microRNAs was quantified in healthy subjects before and after smoking 1 tobacco cigarette. Serum levels of miR‐155 were found to be significantly increased shortly after smoking. We also observed a progressive and significant miR‐155 accumulation in culture media of human endothelial cells after 30 minutes and up to 4 hours of cigarette smoke condensate treatment in vitro without evidence of cell death, indicating that miR‐155 can be released by endothelial cells in response to smoking stress. Cigarette smoke condensate appeared to enhance oxidative stress and impair cell survival, angiogenesis, and NO metabolism in human endothelial cells. Notably, these effects were abrogated by miR‐155 inhibition. We also observed that miR‐155 inhibition rescued the deleterious effects of cigarette smoke condensate on endothelial‐mediated vascular relaxation and oxidative stress in isolated mouse mesenteric arteries. Finally, we found that exogenous miR‐155 overexpression mimics the effects of smoking stress by inducing the upregulation of inflammatory markers, impairing angiogenesis and reducing cell survival. These deleterious effects were associated with downregulation of vascular endothelial growth factor and endothelial NO synthetase.

Conclusions

Our results suggest that miR‐155 dysregulation may contribute to the deleterious vascular effects of tobacco smoking.
Current state of reflective learning in anaesthesiology residents: a call for ‘reflection-on-action’ training in Singapore
Authors: Goy RWL , Lee JSE , Ithnin F , Sng BL
Published: December 2020

INTRODUCTION Reflective learning is the cognitive process whereby information from new experiences is integrated into existing knowledge structures and mental models. In our complex healthcare system, reflective learning (specifically ‘reflection on action’) is important for postgraduate learners. We observed that our anaesthesiology residents were not building on their competence through deliberate experiential and reflective practice. This qualitative study explored the current state and challenges of reflective learning in anaesthesia training in Singapore. METHODS This study was conducted at KK Women’s and Children’s Hospital, Singapore, from 1 January 2018 to 31 October 2018. A semi-structured interview format was used in focus groups. Information collection continued until data saturation was reached. The interviews were coded and analysed, and themes were identified. Seven focus group interviews involving 19 participants were conducted. RESULTS Reflective learning was found to be poor. It was of concern that the stimuli for reflection and reflective learning emerged from medical errors, critical incidents and poor patient outcomes. Challenges identified were: (a) lack of an experiential learning framework; (b) need for reflective training; (c) quality of experiential triggers; (d) clinical pressures; and (e) poor learner articulation and feedback. We described some strategies to frame, teach and stimulate reflective learning. CONCLUSION This study described the state and challenges of reflective learning in anaesthesia training. We advocate the implementation of reflective training strategies in postgraduate training programmes in Singapore. Research is warranted to integrate patient feedback and outcomes into reflective practice.
The obesity paradox: association of obesity with improved survival in medically managed severe aortic stenosis
Authors: Ngiam JN , Chew N , Tan BYQ , Sim HW , Sia CH , Kong WKF , Yeo TC , Poh KK
Published: December 2020

INTRODUCTION The obesity paradox, where obesity is associated with improved survival, has been described in patients undergoing haemodialysis and in those with heart failure. It was also demonstrated in patients undergoing valve replacement for aortic stenosis (AS). We explored this phenomenon in medically managed severe AS. METHODS 154 patients with medically managed severe AS (aortic valve area index [AVAi] < 0.6 cm2/m2; mean pressure gradient > 40 mmHg and peak velocity > 400 cm/s) and preserved left ventricular ejection fraction (> 50%) were categorised into the obese (body mass index [BMI] Asian cut-off ≥ 27.5 kg/m2) and non-obese groups. Their clinical and echocardiographic profiles were compared. RESULTS 24 (15.6%) patients were obese. Obese patients were similar to non-obese patients in age (68.5 ± 11.6 years vs. 68.9 ± 13.1 years) but had higher prevalence of cardiovascular risk factors. Left atrial diameter (43.7 ± 6.7 mm vs. 38.5 ± 10.2 mm) was larger in obese patients, while left ventricular outflow tract diameter (19.5 ± 1.7 mm vs. 20.4 ± 2.1 mm) was smaller. Despite lower AVAi in obese patients (0.36 ± 0.10 cm2/m2 vs. 0.43 ± 0.11 cm2/m2), there was lower mortality (37.5% vs. 41.0%, log-rank 4.06, p = 0.045) on follow-up (8.0 ± 5.7 years). After adjusting for age and AVAi, higher BMI ≥ 27.5 kg/m2 remained protective for mortality (hazard ratio 0.38, 95% confidence interval 0.15 to 0.98, p = 0.046). CONCLUSION We demonstrated that obesity was associated with improved survival in severe AS despite lower AVAi and increased prevalence of cardiovascular risk factors.
Compared to What? Establishing Environmental Baselines for Tornado Warning Skill
Authors: Anderson-Frey Alexandra K. , Brooks Harold
Published: December 2020

In any discussion of forecast evaluation, it is tempting to fall back on statements reflecting unverified assumptions: “this tornado warning had lower skill because the underlying meteorology reflected a complicated or atypical scenario,” or “that forecast performed worse than we would have expected given the straightforward setup.” These statements of what is and is not a reasonable expectation for warning skill are particularly relevant as the meteorological community’s focus has begun to emphasize non-classic storm environments (e.g., tornadoes spawned by quasi-linear convective systems). In this paper, we build a proof-of-concept methodology to quantify the effect of the near-storm environment on tornado warning skill, and we then test these methods on a 15-yr dataset composed of tens of thousands of tornado events and warnings over the contiguous United States. Our findings include that significant tornadoes rated (E)F2+ have a higher probability of detection (POD) than expected based on their near-storm environments, that nocturnal tornadoes have both worse POD and false alarm ratio (FAR) than even their marginal near-storm environments would suggest, and that tornadoes occurring during the summer months also show worse POD and FAR than their environment-based expectation. Quantifying these shifts in performance in an environmental skill score framework allows us to target the situations in which the greatest improvements may be possible, in terms of forecaster training and/or conceptual models. This work also highlights the essential question that should always be asked in the context of forecast verification: what, exactly, is the baseline standard to which we are comparing forecast performance?
Doctrine de la découverte : préciser les enjeux théologiques d’une revendication autochtone
Authors: Roussel Jean-François
Published: December 2020

La doctrine de la découverte est issue de bulles papales du XVe siècle et de leur tradition d’interprétation. Elle est réputée avoir fortement entravé la reconnaissance de droits ancestraux des peuples autochtones, en droit international et dans la jurisprudence des états coloniaux jusqu’à aujourd’hui. Ainsi au Canada, le rapport final de la Commission de vérité et réconciliation réclame l’abolition officielle de la doctrine de la découverte par le Gouvernement, les Églises et les coalitions œcuméniques. Cependant, le Saint-Siège se refuse toujours à le faire, en plaidant que la doctrine a été invalidée de fait par divers développements historiques et qu’elle relève maintenant exclusivement des états et des tribunaux séculiers. Qu’en est-il ? Cet article retrace des étapes marquantes dans l’histoire de la doctrine, depuis les bulles Dum Diversas (1452), Romanus Pontifex (1455) et Inter Caetera (1493), jusqu’à deux jugements marquants de la Cour suprême des États-Unis et de la Cour suprême du Canada qui ont inscrit la doctrine dans la jurisprudence au XIXe siècle. Il apparaît que la doctrine s’est largement affranchie des bulles papales pour prendre appui sur des sources ultérieures. Cependant, l’évolution de la doctrine de la découverte invite à l’aborder au-delà de la question de l’abolition des bulles concernées, pour une étude à trois volets : 1) historique et conceptuel, en théologie et en droit ; 2) critique culturelle décoloniale du christianisme ; et 3) étude empirique de pratiques qui déconstruisent la doctrine de la découverte, dans des mouvements chrétiens et non confessionnels au sein de la société civile.