bluuebunny/crossref_metadata_2025 huggingface dataset:
Air Disinfection for Airborne Infection Control with a Focus on COVID‐19: Why Germicidal UV is Essential†
Authors: Nardell Edward A.
Published: March 2021

Aerosol transmission is now widely accepted as the principal way that COVID‐19 is spread, as has the importance of ventilation—natural and mechanical. But in other than healthcare facilities, mechanical ventilation is designed for comfort, not airborne infection control, and cannot achieve the 6 to 12 room air changes per hour recommended for airborne infection control. More efficient air filters have been recommended in ventilation ducts despite a lack of convincing evidence that SARS‐CoV‐2 virus spreads through ventilation systems. Most transmission appears to occur in rooms where both an infectious source COVID‐19 case and other susceptible occupants share the same air. Only two established room‐based technologies are available to supplement mechanical ventilation: portable room air cleaners and upper room germicidal UV air disinfection. Portable room air cleaners can be effective, but performance is limited by their clean air delivery rate relative to room volume. SARS‐CoV‐2 is highly susceptible to GUV, an 80‐year‐old technology that has been shown to safely, quietly, effectively and economically produce the equivalent of 10 to 20 or more air changes per hour under real life conditions. For these reasons, upper room GUV is the essential engineering intervention for reducing COVID‐19 spread.
Crude Contempt: Examining Local Pushback to Oil and Gas Development in California
Authors: Mahafza Zachary , Fisk Jonathan M. , Adams David P.
Published: March 2021

Investigating voter preferences has been a challenge for those studying the politics of fracking. Recent scholarship has assessed local fracking bans in Texas, Ohio, Colorado, and Pennsylvania. These findings suggest the importance of political ideology and voters' experience. This project continues to develop an understanding of local defiance and “fracking” attitudes, by extending this inquiry to California. Utilizing a novel dataset of over 400 voting precincts across three California counties, we find that political ideology, the presence of nearby spills, and education shape voters support for local bans on fracking.

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American Global Supremacy Under Threat? The Chinese Factor
Authors: Zaidi Syed Muhammad Saad
Published: March 2021

In contemporary times, the widely debated topic in international politics is the future of the United States as the sole superpower of the world. Many political analysts see the “unipolar moment” to be in grave danger, especially by a rapidly rising China. The advocates of China as the next superpower term the economic crisis of 2008 to be a watershed moment. Since the financial meltdown post‐2008, China began to unfold its geoeconomic might to the world, which in turn gave it great geopolitical capital to challenge—to an extent—the U.S. hegemonic status. However, when a purely empirical analysis is conducted between the power and capabilities of the United States and China, a totally contrasting picture is painted. This article critically analyzes the political, military, economic, and soft power—key essentials to assess “national power”—capabilities of the United States in comparison to China and other second‐tier powers to assess the future of the unipolar world order.

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Substrate membrane bearing close‐packed array of micron‐level pillars incrassates air‐exposed three‐dimensional epidermal equivalent model
Authors: Kumamoto Junichi , Fujimoto Koji , Kobayashi Yasuaki , Ohno Kota , Nagayama Masaharu , Denda Mitsuhiro
Published: March 2021

Background

We showed previously that a thick three‐dimensional epidermal equivalent can be constructed with passaged keratinocytes on a patterned surface.

Material and Methods

We first carried out computer simulations of a three‐dimensional epidermal equivalent model built on close‐packed arrays of 10 µm, 15 µm, 20 µm, 30 µm, and 60 µm diameter pillars. Based on these predictions, we evaluated epidermal equivalents built on a series of porous plastic membranes bearing arrays of pillars 15 µm, 20 µm, 25 µm, 30 µm, and 50 µm in diameter.

Results

The simulations predicted that a model having near‐physiological thickness would be formed on 15 ~ 30 µm pillars. In the results of in vitro study, the thickest epidermal equivalent was obtained on the 20 µm pillars. Epidermal differentiation markers, filaggrin and loricrin, were expressed at the upper layer of the epidermal equivalent model, and tight‐junction proteins, claudin‐1 and ZO‐1, were expressed on the cell membranes. BrdU‐positive cells were observed at the base and also at the top of the pillars.

Conclusion

The results of the study suggested that mathematical modeling might be a useful tool to guide biological studies.
Red blood cell storage duration and peri‐operative outcomes in paediatric cardiac surgery
Authors: Padiyath Asif , Lo Brian D. , Ong Chin Siang , Goswami Dheeraj , Steppan Diana A. , Frank Steven M. , Steppan Jochen
Published: March 2021

Background

Prior research on red blood cell (RBC) storage duration and clinical outcomes in paediatric cardiac surgery has shown conflicting results. The purpose of this study was to evaluate whether blood stored for a longer duration is harmful in these patients.

Methods

We performed a retrospective cohort study of paediatric patients undergoing cardiac surgery at our institution between January 2011 and June 2015. Patients were stratified based on whether they were transfused RBCs stored for ≤15 days (fresher blood) or >15 days (older blood). The primary outcome was composite morbidity, with prolonged length of stay (LOS) as a secondary outcome. Subgroup analyses were performed after stratification by RBC transfusion volume (≤2 vs. >2 RBC units). Multivariable logistic regression models were used to assess the impact of RBC storage duration on composite morbidity and prolonged LOS.

Results

Of 461 patients, 122 (26·5%) received fresher blood and 339 (73·5%) received older blood. The overall rate of composite morbidity was 18·0% (n = 22) for patients receiving fresher blood and 13·6% (n = 46) for patients receiving older blood (P = 0·24). In the risk‐adjusted model, patients receiving older blood did not exhibit an increased risk of composite morbidity (OR: 0·74, 95% CI: 0·37–1·47, P = 0·40) or prolonged LOS (OR: 0·72, 95% CI: 0·38–1·35, P = 0·30) compared to patients receiving fresher blood. Similar results were seen after stratification by RBC transfusion volume.

Conclusions

Transfusing RBCs stored for a longer duration was not associated with an increased risk of morbidity or prolonged LOS in paediatric cardiac surgery patients.
Analysis of factors affecting return of first‐time blood donors in Japan: The role of small volume whole blood collection
Authors: Odajima Takeshi , Takanashi Minoko , Sugimori Hiroki , Sato Junichi , Kano Chiharu , Matsuda Yoshihiro , Tsuno Nelson Hirokazu , Muroi Kazuo
Published: March 2021

Acquiring and maintaining a repeat donor population is essential to keep a sufficient blood supply in Japan. To understand the factors associated with the return of first‐time blood donors, we conducted a retrospective analysis of first‐time blood donors who donated blood to the Japanese Red Cross Blood Services in the year 2017, by following them up for 2 years and then statistically analysing the returning donors in comparison with the non‐returning donors. The blood donors’ features were obtained from the Donor Management System and statistically analysed according to whether they returned or not to make another blood donation during the 2‐year period. Data from 421 415 first‐time donors were analysed, and the return rate was 39·6%. In a univariate analysis including all donors, the factors significantly associated with return donation were male gender, younger age, higher BW, 200 ml whole blood collection (200 WB) and higher Hb. In the subgroup analysis, we analysed student donors aged less than 23 years (157 847 donors) and found younger age, higher BW, 200 WB and female gender as factors significantly associated with returning. Among non‐students in the same age group (n = 42 623), younger age, higher BW, 400 WB and male gender were the factors associated with higher returning. The median age and BW of the non‐student group were higher compared with the students. Although 200 WB donation is not cost‐effective, from our results it seems to play a role in the acquisition of donors who are potential repeat blood donors, essential for maintaining the blood supply in Japan.
Low‐volume high‐intensity interval training for cardiometabolic health
Authors: Sabag Angelo , Little Jonathan P. , Johnson Nathan A.
Published: March 2021

High‐intensity interval training (HIIT) is characterised by short bouts of high‐intensity submaximal exercise interspersed with rest periods. Low‐volume HIIT, typically involving less than 15 min of high‐intensity exercise per session, is being increasingly investigated in healthy and clinical populations due to its time‐efficient nature and purported health benefits. The findings from recent trials suggest that low‐volume HIIT can induce similar, and at times greater, improvements in cardiorespiratory fitness, glucose control, blood pressure, and cardiac function when compared to more traditional forms of aerobic exercise training including high‐volume HIIT and moderate intensity continuous training, despite requiring less time commitment and lower energy expenditure. Although further studies are required to elucidate the precise mechanisms of action, metabolic improvements appear to be driven, in part, by enhanced mitochondrial function and insulin sensitivity, whereas certain cardiovascular improvements are linked to increased left ventricular function as well as greater central and peripheral arterial compliance. Beyond the purported health benefits, low‐volume HIIT appears to be safe and well‐tolerated in adults, with high rates of reported exercise adherence and low adverse effects.

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Multiple carrier transport in high-quality α-Sn films grown on CdTe (001) by molecular beam epitaxy
Authors: Ding Yuanfeng , Yao Jinshan , Yuan Ziyuan , Li Chen , Lu Ming-Hui , Lu Hong , Chen Yan-Feng
Published: March 2021

The epitaxial growth of tin in an alpha phase (α-Sn) is desired for its topological properties. In this study, we have successfully grown a series of α-Sn films on CdTe (001) substrates by molecular beam epitaxy with different thicknesses. A (2 × 1) surface reconstruction of CdTe is obtained due to efficient cleaning by atomic hydrogen, which favors the α-Sn growth. The high quality of the α-Sn films has been confirmed by x-ray diffraction, atomic force microscopy, etc. Thickness and temperature-dependent electrical transport properties have been studied. All the samples show a p-type transport at room temperature, but transitions in transport type are observed at lower temperatures. These transport behaviors can be well explained by a three-band model, and a phase diagram illustrating the transport behaviors in α-Sn is presented.
Acoustics modelling of open-cell foam materials from microstructure and constitutive properties
Authors: Semeniuk B. P. , Lundberg E. , Göransson P.
Published: March 2021

The dynamic relations for highly porous fibrous materials, having analytical expressions for dynamic viscous drag forces and oscillatory solid-to-fluid heat transfer, are now extended towards open-cell foam materials where the struts of the foam are considered to be primarily cylindrical except in the region of the joints. By also including analytical expressions for the stiffness of the foam cell, an entirely analytically-based model is presented for the acoustics of highly-porous, open-celled foam materials. This approach is extremely efficient, requiring only the mean cell size, mean strut diameter, and constitutive properties of the solid foam material and the surrounding viscous fluid as input. The acoustic performance prediction of not only isotropic foam cell designs, but also anisotropic ones may be performed rapidly and virtually, without the need for the determination of poroelastic material properties from existing material samples. The steps required for the development of the analytical foam-cell model are presented, along with the acoustic performance prediction of a typical Melamine foam cell, yielding very promising results in comparison against measurements. In order to understand the suitability of the cylindrical foam strut assumption, a viscous drag force comparison with foam struts having square and triangular cross-sectional profiles is also presented.
Daily rewiring of a neural circuit generates a predictive model of environmental light
Authors: Song Bryan J. , Sharp Slater J. , Rogulja Dragana
Published: March 2021

Daily physical remodeling of neurons changes the internal sense of daytime and nighttime.
LncRNA GIRGL drives CAPRIN1-mediated phase separation to suppress glutaminase-1 translation under glutamine deprivation
Authors: Wang Ruijie , Cao Leixi , Thorne Rick Francis , Zhang Xu Dong , Li Jinming , Shao Fengmin , Zhang Lirong , Wu Mian
Published: March 2021

When glutamine is limiting, lncRNA GIRGL inhibits glutaminase activity through phase separation to enable cancer cell survival.
Building new roads to stronger immunity
Authors: Wilson John T. , Lund Amanda W.
Published: March 2021

A new cancer vaccine technology builds a network of local lymphatic vessels that paves the way to stronger responses to immunotherapy.
Faciogenital Dysplasia 5 supports cancer stem cell traits in basal-like breast cancer by enhancing EGFR stability
Authors: Li Ke , Zhang Ting-ting , Zhao Chen-xi , Wang Feng , Cui Bing , Yang Zhao-na , Lv Xiao-xi , Yeerjiang Zaiwuli , Yuan Yu-fen , Yu Jin-mei , Wang Zhen-he , Zhang Xiao-wei , Yu Jiao-jiao , Liu Shan-shan , Shang Shuang , Huang Bo , Hua Fang , Hu Zhuo-wei
Published: March 2021

FGD5 promotes basal-like breast cancer tumorigenesis and progression by inducing and maintaining cancer stemness in an EGFR-dependent manner.
Transmission Dynamics of Shiga Toxin-Producing Escherichia coli in New Zealand Cattle from Farm to Slaughter
Authors: Browne A. Springer , Midwinter Anne C. , Withers Helen , Cookson Adrian L. , Biggs Patrick J. , Marshall Jonathan C. , Benschop Jackie , Hathaway Steve , Rogers Lynn , Nisa Shahista , Hranac Carter R. , Winkleman Taylor , French Nigel P.
Published: March 2021

Cattle are asymptomatic carriers of Shiga toxin-producing
E. coli
(STEC) strains, which can cause serious illness or death in humans. Contact with cattle feces and living near cattle are known risk factors for human STEC infection.
Nutrient and Energy Pathway Requirements for Surface Motility of Nonpathogenic and Uropathogenic Escherichia coli
Authors: Sudarshan Sushmita , Hogins Jacob , Ambagaspitiye Sankalya , Zimmern Philippe , Reitzer Larry
Published: March 2021

Urinary tract infections (UTIs) are one of the most common bacterial infections and are an increasing burden on the health care system because of recurrence and antibiotic resistance (
1
,
2
). The most common uropathogen is
E. coli
(
3
,
4
), which is responsible for about 80 to 90% of community-acquired UTIs and 40 to 50% of nosocomially acquired UTIs (
2
).
Draft Genome Sequences of
Dysgonomonas
sp. Strains GY75 and GY617, Isolated from the Hindgut of Reticulitermes flavipes
Authors: Bridges Charles M. , Gage Daniel J.
Published: March 2021

Dysgonomonas
species are facultative heterotrophs capable of growth on lignocellulose-derived polysaccharides.
Dysgonomonas
species harbor myriad genes involved in glycan modification and are well suited to the lignocellulose-rich conditions within the termite hindgut. Here, we report draft genome sequences for
Dysgonomonas
sp. strains GY75 and GY617, isolated from the hindgut of
Reticulitermes flavipes
.
Genome Sequences of Three SARS-CoV-2 P.1 Strains Identified from Patients Returning from Brazil to Italy
Authors: Delli Compagni Emiliano , Jurisic Lucija , Caporale Marialuigia , Bacà Federico , Scialabba Silvia , Fanì Sara , Perullo Alessia , Toro Michela , Marchegiano Alice , Martino Michele , Di Giacomo Daniela , Romualdi Teresa , Verzulli Serena , Ciarrocchi Eugenia , Secondini Barbara , Di Giuseppe Marta , Irelli Roberta , Di Lorenzo Alessio , Valleriani Fabrizia , Berjaoui Shadia , Puglia Ilaria , Curini Valentina , Mangone Iolanda , Lorusso Alessio
Published: March 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the current coronavirus disease 2019 (COVID-19) pandemic. We report the complete sequences of three SARS-CoV-2 P.1 strains obtained from nasopharyngeal swab specimens from three patients returning from Brazil to Italy.
Genome Sequence of the Virulent Model Herpes Simplex Virus 1 Strain McKrae Demonstrates the Presence of at Least Two Widely Used Variant Strains
Authors: Renner Daniel W. , Parsons Lance , Shreve Jacob T. , Engel Esteban A. , Kuny Chad V. , Enquist Lynn , Neumann Donna , Mangold Colleen , Szpara Moriah L.
Published: March 2021

Herpes simplex virus 1 (HSV-1) strain McKrae was isolated in 1965 and has been utilized by many laboratories. Three HSV-1 strain McKrae stocks have been sequenced previously, revealing discrepancies in key genes. We sequenced the genome of HSV-1 strain McKrae from James Hill, to better understand the genetic differences between isolates.
Coexistence of medium chain acyl-CoA dehydrogenase deficiency (MCADD) and type 1 diabetes (T1D): a management challenge
Authors: Afreh-Mensah Donald , Agwu Juliana Chizo
Published: March 2021

Medium chain acyl-CoA dehydrogenase deficiency (MCADD) is an autosomal recessive fatty acid β-oxidation defect. The enzyme, medium chain acyl-CoA dehydrogenase is important in the breakdown of medium chain fats into acetyl-CoA to produce ketones. Ketones are used as an alternative energy source when glucose or hepatic glycogen stores become depleted during prolonged fasting. In MCADD during periods of fasting or acute illness, there are insufficient ketones to compensate for the glucose energy deficit, resulting in an hypoketotic hypoglycaemia alongside a build-up of fatty acids. This build-up of fatty acids can be neurotoxic and lead to altered brain function and even unexpected death. Management includes avoiding prolonged periods of starvation, consuming high carbohydrate drinks during periods of illness and in symptomatic patients, reversal of catabolism and sustained anabolism by provision of simple carbohydrates by mouth or intravenously. Coexistence of MCADD and type 1 diabetes (T1D) is rare, there is no causal association though there are some documented cases. A key goal of management in T1D is achievement of good glycaemic control to reduce risk of long-term complications. This can in some cases increase the risk of hypoglycaemia which can be catastrophic in the presence of MCAD
Torsades de pointes in SARS-CoV-2 (COVID-19) pneumonia: medicine reconciliation and careful monitoring of QTc interval may help prevent cardiac complications
Authors: Aslam Waqas , Lamb Carla R , Ali Nadia
Published: March 2021

Hydroxychloroquine has been widely prescribed to treat patients with COVID-19 pneumonia. A 73-year-0ld woman with COVID-19 pneumonia was treated with dexamethasone and hydroxychloroquine. Her home medications, citalopram and donepezil, were continued. The ECG prior to starting hydroxychloroquine showed normal sinus rhythm with prolonged corrected QT (QTc) of 497 ms, due to citalopram and donepezil therapy. Repeat ECG on days 3 and 4 of hydroxychloroquine therapy showed significantly prolonged QTc of 557 ms and 538 ms, respectively, despite normal serum electrolytes. All QT-prolonging medications including hydroxychloroquine were discontinued on day 4; however, she suffered a transient torsades de pointes lasting for about 15 s, which resolved before any intervention. QTc improved to 477 ms, after discontinuation of QT-prolonging medications. The patient had QTc prolongation and torsades de pointes due to therapy with multiple QT-prolonging medications. Medicine reconciliation and careful monitoring of QTc may help prevent cardiac complications in patients with COVID-19 treated with hydroxychloroquine.
A young man presenting with encephalopathy and seizures secondary to SARS-CoV-2
Authors: Jalil Bilal Athar , Ijaz Mohsin , Khan Amir Maqbul , Ledbetter Thomas Glenn
Published: March 2021

COVID-19 has now emerged from a respiratory illness to a systemic viral illness with multisystem involvement. There is still a lot to learn about this illness as new disease associations with COVID-19 emerge consistently. We present a unique case of a neurological manifestation of a patient with structural brain disease who was COVID-19 positive and developed mental status changes, new-onset seizures and findings suggestive of viral meningitis on lumbar puncture. We also review the literature and discuss our case in the context of the other cases reported. We highlight the value of considering seizures and encephalopathy as one of the presenting features of COVID-19 disease.
Lipid-rich variant of urothelial carcinoma: a lethal enigma
Authors: Chaudhary Kapil , Pareek Tarun , Sharma Aditya , Thirunavukkarasu Balamurugan
Published: March 2021

Invasive urothelial carcinoma shows marked propensity for divergent differentiation. Several of these ‘variant’ morphologies have been described in literature and recognised in the 2004 WHO classification. In this report, we detail a case of bladder tumour, diagnosed to be a lipid-rich variant on histopathology after transurethral resection of bladder tumour. Our case encompasses the complete clinical spectrum of this rare and aggressive subtype of urothelial carcinoma starting from initial presentation to postoperative follow-up and recurrence. A keen eye for recognising these variants can ensure a timely diagnosis of these variant and administration of a therapy distinctive from that used in conventional invasive urothelial carcinoma.
Management of colonic diverticulitis
Authors: Peery Anne F
Published: March 2021

Left sided colonic diverticulitis is a common and costly gastrointestinal disease in Western countries, characterized by acute onset of often severe abdominal pain. Imaging is necessary to make an initial diagnosis and determine disease severity. Colonoscopy should be done six to eight weeks after diagnosis to rule out a missed colon malignancy. Antibiotic treatment is used selectively in immunocompetent patients with mild acute uncomplicated diverticulitis. The clinical course of diverticulitis commonly includes unpredictable recurrences and chronic gastrointestinal symptoms, which are a detriment to quality of life. A better understanding of prognosis has prompted a shift toward non-operative approaches. The decision to undergo prophylactic colon resection should be individualized to consider the severity of diverticulitis, the patient’s health and immune status, and the patient’s preferences and values, as well as benefits and risks. Because only a section of colon is removed, recurrent diverticulitis remains a risk. Acute diverticulitis with an abscess is treated with antibiotics that cover Gram negative and anaerobic bacteria, with or without percutaneous drainage. Acute diverticulitis with purulent or feculent contamination of the peritoneal cavity is managed with surgery; primary resection and anastomosis is the procedure of choice in stable patients.
Sex-based differences in and risk factors for metabolic syndrome in adults aged 40 years and above in Northeast China: Results from the cross-sectional China national stroke screening survey
Authors: Li Feng-E , Zhang Fu-Liang , Zhang Peng , Liu Dong , Liu Hao-Yuan , Guo Zhen-Ni , Yang Yi
Published: March 2021

Objectives

Low levels of income and education are risk factors for metabolic syndrome in the population of Northeast China, which has a high incidence of metabolic syndrome and cardiovascular diseases. This study aimed to determine sex-based differences associated with the prevalence of and risk factors for metabolic syndrome among people older than 40 years in Northeast China; this has not been previously investigated.

Design

This study analysed a portion of the large sample data of the national cross-sectional screening of China from 2016. Metabolic syndrome was defined as the presence of any three of the following five risk factors: abnormal waist circumference; high levels of triglycerides, high-density lipoprotein cholesterol or fasting plasma glucose; and elevated blood pressure. Multiple regression analysis was used to investigate sex-based differences in the prevalence of, and risk factors for metabolic syndrome.

Setting

The study was conducted in Dehui City, Jilin Province, China.

Participants

A total of 4052 participants with complete questionnaire information and laboratory examination results were included.

Results

The prevalence of metabolic syndrome was 50.1% overall (38.4% in men and 57.9% in women; p<0.001). High body mass index and hip circumference were associated with metabolic syndrome in both sexes. In addition, physical inactivity (OR and 95% CI 1.44 (1.06 to 1.97); p=0.022) in men and advanced age (OR and 95% CI 1.54 (1.15 to 2.04); p=0.003) in women were factors associated with metabolic syndrome. Women with junior high school education or above and living in rural areas were less likely to have metabolic syndrome. For men, education and rural or urban living had no association with metabolic syndrome.

Conclusions

The risk factors for metabolic syndrome have similarities and differences in different sexes; thus, the prevention and treatment of metabolic syndrome should be based on these sex differences.
Clinical outcomes of patients undergoing percutaneous left atrial
appendage occlusion in general anaesthesia or conscious sedation: data from
the prospective global Amplatzer Amulet Occluder Observational Study
Authors: Piayda Kerstin , Hellhammer Katharina , Nielsen-Kudsk Jens Erik , Schmidt Boris , Mazzone Patrizio , Berti Sergio , Fischer Sven , Lund Juha , Montorfano Matteo , Della Bella Paolo , Gage Ryan , Zeus Tobias
Published: March 2021

Objective

To evaluate the safety and efficacy of percutaneous left atrial
appendage occlusion (LAAO) using conscious sedation (CS).

Background

Several percutaneous structural heart disease interventions are
safely and efficiently performed using CS instead of general anaesthesia
(GA). This concept has not been evaluated in a large multicenter cohort
of patients undergoing LAAO.

Methods

Patients from the prospective, global Amplatzer Amulet Occluder
Observational Study were divided into two groups (GA vs CS). Baseline
information, periprocedural and postprocedural efficacy and
complications, as well as outcomes through 7 days post implant were
compared.

Results

Patients undergoing transesophageal-guided implants were categorised
by GA (n=607, 64%) or CS (n=342, 36%) usage. Mean age was 75 years in
both groups. LAAO technical success was achieved in 99% of both groups.
The procedure duration (GA: 35±22 min vs CS: 27±19 min, p<0.001),
total amount of contrast medium (GA: 105±81 mL vs CS: 86±66 mL,
p<0.001) and fluoroscopic time (GA: 13±9 min vs CS: 12±13 min,
p<0.001) were less in CS cases. Procedure-related or device-related
serious adverse events during the first 7 days were numerically higher
in the CS group (GA: 4.9% vs CS: 7.6%, p=0.114). Peridevice residual
flow was absent or ≤5 mm 1–3 months after the procedure in 99.7% of the
GA and in 100% of the CS group (p=1.000).

Conclusions

In a large global study, LAAO with the Amplatzer Amulet occluder is
safe and feasible using CS. Procedure duration and total amount of
contrast were less with CS than GA cases.

Trial registration number

NCT02447081; Results.
Impact of sensory interventions on the quality of life of long-term care residents: a scoping review
Authors: Backman Chantal , Demery-Varin Melissa , Cho-Young Danielle , Crick Michelle , Squires Janet
Published: March 2021

Introduction and purpose

Residents in long-term care exhibit diminishing senses (hearing, sight, taste, smell or touch). The purpose of this study was to examine the available literature on the impact of sensory interventions on the quality of life of residents living in long-term care settings.

Methods

We conducted a mixed-methods scoping review using Arksey and O’Malley’s framework. Seven databases (Medline (Ovid), PubMed (non-Medline-Ovid), CINAHL (EBSCO), Embase (Ovid), Ageline, PsycINFO (Ovid), Cochrane Central Register of Controlled Trials until 1 December 2020) were searched. Two reviewers independently screened the studies for sensory interventions using a two-step process. Eligible studies underwent data extraction and results were synthesised descriptively.

Results

We screened 5551 titles and abstracts. A total of 52 articles met our inclusion criteria. Some interventions involved only one sense: hearing (n=3), sight (n=12), smell (n=4) and touch (n=15). Other interventions involved multiple senses (n=18). We grouped the interventions into 16 categories (music programmes, environmental white noise, bright light interventions, visual stimulations, olfactory stimulations, massages, therapeutic touch, tactile stimulations, physical activity plus night-time programmes, pet therapies, various stimuli interventions, Snoezelen rooms, motor and multisensory based strategies, Namaste care, environmental modifications and expressive touch activities).

Conclusion

This preliminary review summarised some of the available sensory interventions that will help inform a series of future systematic reviews on each of the specific interventions. The evidence-based knowledge for sensory interventions will also inform a future audit programme for assessing the presence of sensory interventions in long-term care.
Scoping review protocol of service delivery-related interventions to improve maternal and newborn health in low-income and middle-income countries
Authors: Mianda Solange , Todowede Olamide O , Schneider Helen
Published: March 2021

Introduction

This review will explore the characteristics of service delivery-related interventions to improve maternal and newborn health in low-income and middle-income countries, comparing three common framing approaches of these interventions (referred to as archetypes), namely, quality improvement (QI), health system strengthening (HSS) and implementation science (IS), over the last 20 years.

Methods and analysis

This study will review the literature on health service interventions from 2000 to 2020. This will be achieved by searching for English peer-reviewed articles in the following electronic databases EBSCOhost, PubMed, Web of Science, MASCOT/Wotro Map of Maternal Health Research and Google scholar. We will develop a systematic search strategy using a combination of keywords and Boolean operators AND/OR. Eligibility screening and data extraction will be conducted by two independent reviewers, and disagreements resolved by a third independent reviewer. Analyses will be conducted in two steps, a quantitative and a qualitative phase. The quantitative phase will provide a descriptive profile of papers, including the category (QI, HSS, IS, mixed or other) of papers. In the follow-up qualitative phase, all three reviewers will independently code for key concepts in a subset of papers, jointly selected as representing each archetype, and analysed in batches until concept saturation is achieved.

Ethics and dissemination

This review does not require ethical approval. The results will be published as an article in a peer-reviewed journal and presented to stakeholders involved in implementing health system interventions in maternal and newborn.
Helpful explanatory models for somatoform symptoms (HERMES): study protocol of a randomised mixed-methods pilot trial
Authors: Hüsing Paul , Löwe Bernd , Olde Hartman Tim C , Frostholm Lisbeth , Weigel Angelika
Published: March 2021

Introduction

Persistent somatic symptoms (PSS) are common both in the general population and primary care. They are bothersome in terms of psychological and somatic symptom burden. Health professionals often struggle with communication, as there is a lack of scientifically supported explanatory models for PSS or a focus merely on somatic aspects of the complaints, which both frustrate patients’ needs. The objective of the present study is therefore to develop a psychoeducational intervention based on a current evidence-based explanatory model, to examine its feasibility and form the basis for a large-scale randomised controlled trial.

Methods and analysis

In a randomised controlled mixed-methods pilot trial, 75 adult psychosomatic outpatients with PSS (duration of symptoms ≥6 months) and accompanying psychological (Somatic Symptom B-Criteria Scale total score ≥18) and somatic symptom burden (Patient Health Questionnaire-15 score >10) and no prior psychosomatic treatment will be eligible. Participants will be presented with either the explanatory model without (intervention group 1, n=25) or with elements of personalisation (intervention group 2, n=25). Participants in the control group (n=25) will receive information on current PSS guidelines. Participants will be blinded to group assignment and interventions will be shown on tablet computers at the outpatient clinic. After 1 month, qualitative follow-up telephone interviews will be conducted. As primary outcomes, mean changes in psychological and somatic symptom burden will quantitatively be compared between groups, respectively. Behavioural change mechanisms and feasibility of the three interventions will be evaluated using quantitative and qualitative measures.

Ethics and dissemination

Ethics approval has been granted by the medical ethics board of the Hamburg Medical Chamber (PV5653). Results from this study will be published in peer-reviewed journals and presented at national and international conferences.

Trial registration number

DRKS00018803.
Prevalence of liver fibrosis and associated risk factors in the Korean general population: a retrospective cross-sectional study
Authors: Nah Eun-Hee , Cho Seon , Kim Suyoung , Chu Jieun , Kwon Eunjoo , Cho Han-Ik
Published: March 2021

Objectives

The health burden of chronic liver disease is increasing worldwide. Its main histological consequence is liver fibrosis, and eventually cirrhosis. This process is rarely diagnosed at the pre-cirrhotic stage due to it being asymptomatic. Little is known about the prevalence of liver fibrosis and associated risk factors in the general population. The aims of this study were to determine the prevalence and distribution of liver fibrosis using magnetic resonance elastography (MRE), as well as the risk factors associated with liver fibrosis in the asymptomatic general population.

Design, setting and participants

This cross-sectional retrospective study consecutively selected subjects who underwent health check-ups including MRE at 13 health promotion centres in Korea between 2018 and 2020. Liver fibrosis was estimated using MRE with cut-off values for significant and advanced liver fibrosis of 2.90 and 3.60 kPa, respectively.

Primary and secondary outcome measures

The Χ2 test was used to compare the prevalence of liver fibrosis according to sex and age groups. Multivariable logistic regression analyses were performed to identify the factors for significant and advanced liver fibrosis.

Results

Among the 8183 subjects, 778 (9.5%) had ≥significant fibrosis (≥2.9 kPa), which included 214 (2.6%) subjects with ≥advanced fibrosis (≥3.6 kPa). Multivariable analysis revealed that liver fibrosis was associated with age (OR=1.34, 95% CI=1.18 to 1.51), male sex (OR=3.18, 95% CI=1.97 to 5.13), diabetes (OR=2.43, 95% CI=1.8 to 3.28), HBsAg positivity (OR=3.49, 95% CI=2.55 to 4.79), abnormal liver function test (OR=1.9, 95% CI=1.49 to 2.42) and obesity (OR=1.77, 95% CI=1.35 to 2.32) (all p<0.001), as well as metabolic syndrome (OR=1.4, 95% CI=1.05 to 1.87) (p=0.024).

Conclusions

The prevalence of significant or more liver fibrosis was high in the Korean general population and much higher among individuals with risk factors. This suggests that screening of liver fibrosis should be considered in general population, especially among high-risk groups.
Breaking bad news: tackling cultural dilemmas
Authors: Holmes Sophie Nilusha , Illing Jan
Published: March 2021

Requesting that serious diagnoses be concealed from patients, a widespread phenomenon in many cultures, presents a professional dilemma. Practical and sensitive communication strategies are needed.

Methodology

In this paper, we use analysis of the existing literature to develop a communication tool for practitioners facing requests for diagnostic non-disclosure. Our approach builds on existing strategies, in providing a mnemonic communication tool, permitting more than one outcome, and focusing on the need for mutual understanding and cooperation.

Results

Existing work on this dilemma highlights the need to appreciate the family's standpoint, affirm their benevolent intentions and correct misperceptions. To this end, we have developed a mnemonic tool, 'ARCHES', to be used in situations where the family has requested diagnostic non-disclosure. The model has six stages: acknowledge the request for non-disclosure, build the relationship, find common ground, honour the patient's preferences and outline the harm of non-disclosure, provide emotional support and devise a supportive solution.

Conclusion

Facing requests for diagnostic non-disclosure is a challenge of communication. The dilemma is particularly marked when practising across cultures. Our model gives a structure for building rapport with the family and realigning their misperceptions while upholding the patient's right to knowledge.
Dynamics of cerebral perfusion and oxygenation parameters following endovascular treatment of acute ischemic stroke
Authors: Brugnara Gianluca , Herweh Christian , Neuberger Ulf , Bo Hansen Mikkel , Ulfert Christian , Mahmutoglu Mustafa Ahmed , Foltyn Martha , Nagel Simon , Schönenberger Silvia , Heiland Sabine , Ringleb Peter Arthur , Bendszus Martin , Möhlenbruch Markus , Pfaff Johannes Alex Rolf , Vollmuth Philipp
Published: March 2021

Background

We studied the effects of endovascular treatment (EVT) and the impact of the extent of recanalization on cerebral perfusion and oxygenation parameters in patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO).

Methods

Forty-seven patients with anterior LVO underwent computed tomography perfusion (CTP) before and immediately after EVT. The entire ischemic region (Tmax>6 s) was segmented before intervention, and tissue perfusion (time-to-maximum (Tmax), time-to-peak (TTP), mean transit time (MTT), cerebral blood volume (CBV), cerebral blood flow (CBF)) and oxygenation (coefficient of variation (COV), capillary transit time heterogeneity (CTH), metabolic rate of oxygen (CMRO2), oxygen extraction fraction (OEF)) parameters were quantified from the segmented area at baseline and the corresponding area immediately after intervention, as well as within the ischemic core and penumbra. The impact of the extent of recanalization (modified Treatment in Cerebral Infarction (mTICI)) on CTP parameters was assessed with the Wilcoxon test and Pearson’s correlation coefficients.

Results

The Tmax, MTT, OEF and CTH values immediately after EVT were lower in patients with complete (as compared with incomplete) recanalization, whereas CBF and COV values were higher (P<0.05) and no differences were found in other parameters. The ischemic penumbra immediately after EVT was lower in patients with complete recanalization as compared with those with incomplete recanalization (P=0.002), whereas no difference was found for the ischemic core (P=0.12). Specifically, higher mTICI scores were associated with a greater reduction of ischemic penumbra volumes (R²=−0.48 (95% CI –0.67 to –0.22), P=0.001) but not of ischemic core volumes (P=0.098).

Conclusions

Our study demonstrates that the ischemic penumbra is the key target of successful EVT in patients with AIS and largely determines its efficacy on a tissue level. Furthermore, we confirm the validity of the mTICI score as a surrogate parameter of interventional success on a tissue perfusion level.
Influence of statistical sample size on evaluation of overall strength of cement-treated soil column
Authors: Namikawa Tsutomu
Published: March 2021

The quality of cement-treated soil columns is normally assured based on the unconfined compressive strength qu of core samples. qu of core samples varies spatially and the statistical parameters of qu (i.e., mean µqu, variance [Formula: see text], and autocorrelation distance θqu) are adopted in quality assurance procedures. The statistical parameters of qu evaluated from the core sample strengths have a statistical uncertainty depending on the statistical sample size. The present study investigates the influence of the statistical sample size on the evaluation of overall strength of a cement-treated soil column. A probabilistic framework in which a Bayesian inference analysis and a finite element method analysis are incorporated is used to calculate the overall strength while simultaneously considering the statistical uncertainty and spatial variability of core strength. The probabilistic framework is briefly described, and a parametric analysis is performed to investigate the influence of the statistical sample size on the evaluation of the overall strength of a full-scale column. The numerical results show that the sample size and spatial correlation influence the variability of the overall strength, and the influence can be reasonably described using an equivalent number of independent data.
Anti-hyperglycaemic effects of dioxidovanadium complexcis-[VO2(obz)py] avert kidney dysfunction in streptozotocin-induced diabetic male Sprague–Dawley rats
Authors: Mbatha Bonisiwe , Khathi Andile , Sibiya Ntethelelo , Booysen Irvin , Mangundu Patrick , Ngubane Phikelelani
Published: March 2021

Despite the success of antidiabetic drugs in alleviation of hyperglycaemia, diabetic complications, including renal dysfunction, continue to be a burden. This raises the need to seek alternative therapies that will alleviate these complications. Accordingly, the aim of this study was to investigate the effects of dioxidovanadium(V) complex cis-[VO2(obz)py] on renal function in diabetic rats. Streptozotocin-induced diabetic rats were treated with cis-[VO2(obz)py] (40 mg·kg–1) twice every third day for five weeks. Diabetic untreated and insulin-treated rats served as the diabetic control and positive control, respectively. Blood glucose concentrations, water intake, urinary output, and mean arterial pressure (MAP) were monitored weekly for five weeks. Rats were then euthanized, and blood and kidney tissues were collected for biochemical analysis. Significant decreases in blood glucose concentrations, MAP, glomerular filtration rate (GFR), and SGLT2 expression, as well as plasma angiotensin and aldosterone concentrations, were observed in the treated groups compared with the diabetic control. The complex also increased urinary glucose concentrations, antioxidant enzymes GPx and SOD concentrations, and decreased MDA concentrations and kidney injury molecule (KIM-1) concentrations. These findings suggest that the anti-hyperglycaemic effects of this vanadium complex may ameliorate kidney dysfunction in diabetes.
FRACTAL PROPAGATION AND IMMUNITY ON NETWORK
Authors: NIAN FUZHONG , YANG YANG , SHI YAYONG
Published: March 2021

In this paper, the epidemic spreading was investigated from the point of view of fractal. Firstly, the real network was abstracted as a fully connected fractal network. Based on the fractal network, the fractal spreading process was studied. The fractal spreading process was simulated to analyze the change of infection density during transmission. The results showed that the infection density presented an upward trend of the ladder-shaped, and a jumping change in infection density occurred during a certain time. As an illustration, the pandemic of COVID-19 was analyzed, the results indicated that the proposed method was valid. Experiments and analyses have shown that intervention at key jump points in virus propagation can effectively control the spread of the virus.
DYNAMICAL ANALYSIS OF A SELF-CONNECTION FRACTIONAL-ORDER NEURAL NETWORK
Authors: YUAN JUN , ZHAO LINGZHI , HUANG CHENGDAI , XIAO MIN
Published: March 2021

This paper researches the problem of bifurcation for a ring fractional-order neural network (FONN) with self-connection delay and communication delay. Self-connection delay is firstly regarded as a bifurcation parameter to examine the bifurcations of the developed FONN, and the critical values of bifurcations with respect to self-connection delay are derived. Second, communication delay is further taken as a bifurcation parameter to investigate the bifurcations of the designed FONN, and the stability zones and bifurcation points are determined. It reveals that FONN exhibits excellent stability performance when electing a lesser value of them, and the stability performance is devastated and Hopf bifurcation arises upon taking a larger one. Eventually, the efficiency of the developed theory is appraised on account of numerical verifications.
FRACTAL ANALYSIS OF NON-NEWTON FLUID GROUTING IN SOIL COMPOSED OF ARBITRARY CROSS-SECTIONAL CAPILLARIES
Authors: KOU LEI , MIAO RONGHU , MIAO FENGYANG
Published: March 2021

The fractal theory has been applied to understand the transport law for the non-Newton Herschel–Bulkley (H-B) fluid grouting in fractal soil consisting of a bunch of arbitrary cross-sectional tortuous capillaries. The fractal models for the average flow velocity, starting pressure gradient and effective permeability are the functions of the cross-sectional geometric factors of capillaries, minimum and maximum cross-sectional area of capillaries, porosity, fractal dimensions and characteristic parameters of H-B fluid. The proposed models are verified by comparing with the available models, and then the effects of cross-sectional shapes of capillaries and the characteristic parameters of H-B fluid on the average flow velocity, starting pressure gradient and effective permeability are also analyzed. The results show that the present models relate the characteristics of H-B fluid to the microstructure of soil, and both are the most important factors in determining the grouting effect.