bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of metformin on outcomes of catheter ablation for atrial fibrillation
Authors: Deshmukh Amrish , Ghannam Michael , Liang Jackson , Saeed Mohammed , Cunnane Ryan , Ghanbari Hamid , Latchamsetty Rakesh , Crawford Thomas , Batul Syeda A. , Chung Eugene , Bogun Frank , Jongnarangsin Krit , Pelosi Frank , Chugh Aman , Morady Fred , Oral Elif , Oral Hakan
Published: February 2021

Background

Diabetes mellitus (DM) is a risk factor for atrial fibrillation (AF). The effect of antidiabetic medications on AF or the outcomes of catheter ablation (CA) has not been well described. We sought to determine whether metformin treatment is associated with a lower risk of atrial arrhythmias after CA in patients with DM and AF.

Methods and Results

A first CA was performed in 271 consecutive patients with DM and AF (age: 65 ± 9 years, women: 34%; and paroxysmal AF: 51%). At a median of 13 months after CA (interquartile range: 6–30), 100/182 patients (55%) treated with metformin remained in sinus rhythm without antiarrhythmic drug therapy, compared with 36/89 patients (40%) not receiving metformin (p = .03). There was a significant association between metformin therapy and freedom from recurrent atrial arrhythmias after CA in multivariable Cox hazards models (hazard ratio [HR]: 0.66; ±95% confidence interval [CI]: 0.44–0.98; p = .04) that adjusted for age, sex, body mass index, AF type (paroxysmal vs. nonparoxysmal), antiarrhythmic medication, obstructive sleep apnea, chronic kidney disease, coronary artery disease, left ventricular ejection fraction, and left atrial diameter. A Cox model that also incorporated other antidiabetic agents and fasting blood glucose demonstrated a similar reduction in the risk of recurrent atrial arrhythmias with metformin treatment (HR: 0.63; ±95% CI: 0.42–0.96; p = .03).

Conclusions

In patients with DM, treatment with metformin appears to be independently associated with a significant reduction in the risk of recurrent atrial arrhythmias after CA for AF. Whether this effect is due to glycemic control or pleiotropic effects on electroanatomical mechanisms of AF remains to be determined.
Efficacy and safety of the fixed‐ratio combination of insulin degludec and liraglutide by baseline glycated hemoglobin, body mass index and age in Japanese individuals with type 2 diabetes: A subgroup analysis of two phase III trials
Authors: Komatsu Mitsuhisa , Watada Hirotaka , Kaneko Shizuka , Ross Agner Bue F , Nishida Tomoyuki , Kaku Kohei
Published: February 2021

Aims/Introduction

To assess efficacy and safety of insulin degludec/liraglutide (IDegLira) in Japanese participants with type 2 diabetes across different baseline characteristics.

Materials and Methods

Data from two randomized controlled trials were used: DUAL I Japan (n = 819 insulin‐naïve participants) and DUAL II Japan (n = 210 insulin‐experienced participants). Outcomes were assessed according to baseline glycated hemoglobin ( HbA1c; <8.0%, ≥8.0–<9.0%, ≥9.0%), body mass index (<25, ≥25–<30, ≥30 kg/m2) and age (<65, ≥65 years).

Results

In DUAL I Japan, reductions in HbA1c with IDegLira versus degludec and liraglutide were observed across all subgroups (treatment differences: −0.48% to −0.72% vs degludec, −0.29% to −0.73% vs liraglutide). Results were similar with IDegLira versus degludec in DUAL II Japan (treatment differences: −0.82% to −1.61%). Treatment‐by‐subgroup interactions were significant for IDegLira versus liraglutide for baseline HbA1c and age in DUAL I Japan, and for IDegLira versus degludec for baseline HbA1c in DUAL II Japan. In DUAL I Japan, IDegLira was associated with less weight gain than degludec in most subgroups. In DUAL II Japan, IDegLira was associated with a small mean weight loss (except for baseline HbA1c ≥9.0%) versus a small gain for degludec (except for age ≥65 years subgroup); treatment‐by‐subgroup interactions were not significant. Total daily insulin dose was lower with IDegLira versus degludec across all categories, except for age >65 years in DUAL II Japan.

Conclusions

IDegLira reduced HbA1c in Japanese participants with type 2 diabetes across baseline HbA1c, body mass index and age categories, without unexpected safety issues.
Garcinia mangostana extract inhibits the attachment of chicken isolates of Listeria monocytogenes to cultured colorectal cells potentially due to a high proanthocyanidin content
Authors: Wang Yi , Baptist Jolene A. , Dykes Gary A.
Published: February 2021

Listeria monocytogenes are pathogenic microorganisms and of particular concern in the poultry industry. They are frequently isolated from raw chicken products due to their ability to attach to a wide variety of food and food‐contact surfaces. The application of synthetic antimicrobial agents is often limited by potential emergence of antimicrobial resistance and regulations associated to organic poultry products. Development of natural antimicrobial agents controlling Listeria monocytogenes contamination and pathogenesis represent an alternative approach. This study screened a range of plant extracts (including those from cranberry, mangosteen, persimmon, and roselle) for their ability to affect five Listeria monocytogenes strains with respect to their bacterial surface hydrophobicity, auto‐aggregation, and attachment to cultured human colorectal cells. Results show that mangosteen extracts showed significant inhibitory effects on the attachment of Listeria monocytogenes to the cell line, potentially due to a high level of proanthocyanidin content. In addition, the plant extracts influenced bacterial auto‐aggregation (increase in most of the cases) by increasing bacterial surface hydrophobicity. These results may support future development of alternative antimicrobial agents controlling the contamination and pathogenesis of Listeria monocytogenes.
Extending urban stocks and flows analysis to urban greenhouse gas emission accounting: A case of Odense, Denmark
Authors: Lanau Maud , Herbert Luca , Liu Gang
Published: February 2021

Cities generate greenhouse gas (GHG) emissions both in the construction phase of their built environment stocks and durable goods and in their operation phase with energy and material flows. Existing urban GHG accounting methods, however, focus largely on emissions related to energy and material flows and have rarely considered the role of urban stocks. In this article, we have extended urban stocks and flows analysis to urban GHG accounting, using bottom‐up and high‐resolution urban stocks and flows information for a case of Odense, Denmark. We introduced a complementary indicator of carbon replacement value (CRV) to account for emissions embodied in the urban stocks and determined the CRV of Odense as 10.7 megatons of CO2 equivalent (or 53 metric tons per capita) in 2017, equivalent to 13 years of Odense's operational emissions. The comparison between CRV and operational emissions across urban activities facilitates a better understanding of the carbon profile of the city and opportunities for decarbonization. Such urban metabolic based GHG accounting and inclusion of stocks can help to estimate the amount of GHG emissions to be expected from the further urbanization in developing countries as their urban stocks continue to increase and inform their potentials for leapfrogging in emission reduction.
Influence of perceived stress and workload on work engagement in front‐line nurses during COVID‐19 pandemic
Authors: Zhang Meng , zhang Ping , Liu Yu , Wang Hui , Hu Kaili , Du Meichen
Published: February 2021

Aims and objectives

To clarify both the potential influencing factors and the current status of front‐line nurses’ work engagement, and thus provide a reference for targeted interventions.

Background

After coronavirus disease 2019 outbreak, front‐line nurses embraced remarkable potential stress and huge workload when caring for coronavirus disease 2019 patients, which may lead to new challenges to work engagement.

Design

A large sample survey was conducted at the end of February 2020 in a designated hospital treating coronavirus disease 2019 patients in Wuhan, the capital of Hubei Province, in China. t Test, one‐way ANOVA, chi‐squared test, Pearson's correlation and hierarchical multiple regression were performed among 1,040 nurses using SPSS 24.0. The STROBE checklist was followed for observational studies.

Results

The final model interpreted 27.3% of the variance, of which each block could explain 11.7%, 10.3% and 7.9% R2 changes including sociodemographic characteristics, stress and workload, respectively. Work engagement was negatively correlated with stress and workload. The potential influencing factors included sociodemographic characteristics (married, rescue staff, cabin ward), stress (infection control, PPE discomfort) and workload (mental demand, performance, frustration).

Conclusions

Front‐line nurses perceived low stress and workload, but high work engagement, especially in self‐dedication. However, infection control, PPE discomfort and frustration were negatively associated with nurses’ work engagement, while mental demand and good performance were positively associated with nurses’ work engagement. Future interventions focused on decreasing front‐line staff's infection risk and enhancing their self‐confidence may be recommendable to promote their work engagement.
Academic‐clinical nursing partnership use an evidence‐based practice model
Authors: Bowles Wendy , Buck Jacalyn , Brinkman Bevra , Hixon Brenda , Guo Jinhong , Zehala Anita
Published: February 2021

Aims and objectives

The purpose of this study was to compare the experience of a new clinical model with traditional clinical teaching and examine the effects of evidence‐based practice strategies among staff and student nurses.

Background

This provides an innovative approach to nursing student clinical learning that emphasised the academic‐clinical partnership with the use of a new model called the Evidence‐based Clinical Academic Partnership (ECAP) model. The model incorporates three main components (a) unit transformation into an innovative hybrid version of a dedicated education unit (hDEU); (b) Evidence‐in‐Action (EIA) rounding; and (c) the cognitive apprenticeship theoretical framework.

Design

This pilot study used a mixed‐method, quasi‐experimental design.

Methods

The quantitative portion included a pre‐test, post‐test non‐randomised quasi‐experimental design using self‐reported survey data. The qualitative methodology used was a hermeneutic phenomenological approach to data interpretation of three focus groups with staff nurses and unit leaders. SQUIRE 2.0 guidelines were followed (Ogrinc et al., 2016).

Conclusions

The themes that emerged emphasised relationships and the partnership with this innovative approach to clinical teaching. The staff nurses emphasised the need for a collaborative approach and having the presence of the academic faculty member as a way to support the teaching and learning aspects with students.

Relevance to clinical practice

This study did provide significant contributions to the development of an innovative clinical model and highlighted the importance of the academic‐clinical partnership with the education of undergraduate nursing students. The study results provided insight to the ways the hDEU framework may be strengthened, such as increased communication and partnership in the implementation of the ECAP model. Implementing curricular change to include innovative clinical models within a nursing programme is vital in this time of healthcare transformation.
Identification and comparison of missed nursing care in the United States of America and South Korea
Authors: Lee Eunjoo , Kalisch Beatrice J.
Published: February 2021

Aims and objectives

This study aimed to identify and compare missed nursing care types and reasons between South Korea and the United States of America.

Background

Patient safety has become a significant task of the healthcare delivery systems worldwide. The omission of nursing care constitutes a growing concern because it threatens both patient safety and nursing care quality.

Design

This study used a cross‐sectional, descriptive and comparative design.

Methods

Data were collected from registered nurses working in two university‐affiliated tertiary hospitals and a general hospital in Korea and a Midwest United States tertiary hospital. In addition, the STROBE checklist was used in this study.

Results

While substantial, the level of missed nursing care reported by Korean nurses was lower than that of United States nurses. Only three nursing care activities, setting up meals, patient assessment and skin/wound care, did not significantly differed between two countries. More basic nursing care types such as ambulation, feeding and mouth care were missed more than others in both countries. The reasons for missed care differed between two countries. However, both Korean and US nurses reported labour resource problems as reasons for missed care.

Conclusions

Although the types of missed nursing care differed significantly between countries, both Korean and US nurses reported labour resource problems for the top reasons for missed care. Thus, comparing missed nursing care could assist nursing administrators in developing strategies to improve care quality and patient safety.

Relevance to clinical practice

The level and reasons for missed nursing care are very influential factors for patient outcomes and patient safety. Appropriate skill mix and staffing are needed to decrease extent of missed care, so that enhancing patient safety and quality of nursing care.
Is nursing and midwifery clinical documentation a burden? An empirical study of perception versus reality
Authors: Cooper Alannah L. , Brown Janie A. , Eccles Siobhan P. , Cooper Narelle , Albrecht Matthew A.
Published: February 2021

Aims and objectives

To measure time spent on clinical documentation and nurses and midwives’ perceptions of this aspect of their role.

Background

Nurses and midwives rely on accurate documentation when planning care. However, documenting and communicating care can be onerous, time‐consuming and at times duplicated or redundant. While documentation provides a record and means of communicating care, it should not detract from the delivery of care.

Design

An observational time and motion study and survey design reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Methods

The study was conducted with Western Australian nurses and midwives working in a private not‐for‐profit hospital from July–October 2019. An observational study was undertaken to measure the practice of documentation on each shift. Participants’ perceptions of clinical documentation were measured using a self‐report survey.

Results

A total of 120 hr of observation were undertaken. Total observed time spent on documentation was 28.1% on morning shifts, 22.7% on afternoon shifts and 20.9% on night duty. The mean self‐reported time for clinical documentation was 50.4% on morning shifts, 40.7% on afternoon shifts and 37.9% on night duty. Issues with duplication and unnecessary paperwork were identified.

Conclusions

Although participants tended to overestimate time spent on documentation, it still consumed a significant proportion of time. Frustrations with paperwork may amplify nurses' negative perceptions of documentation. Clinical documentation needs to be reviewed, revised and reduced to release time back to direct patient care and reduce clinician dissatisfaction.

Relevance to clinical practice

Clinical documentation is required in all areas of clinical practice and forms an important legal record. Understanding the demands of clinical documentation can assist in reviewing and improving documentation to release time back to direct patient care.
Severe coronavirus disease pneumonia in a pregnant woman at 25 weeks' gestation: A case report
Authors: Waratani Miyoko , Ito Fumitake , Tanaka Yukiko , Mabuchi Aki , Mori Taisuke , Kitawaki Jo
Published: February 2021

There are numerous reports on the effects of the coronavirus disease on mothers and fetuses during pregnancy. It is currently unknown whether pregnancy is associated with a high risk of severe coronavirus disease. We report a pregnant patient with coronavirus disease who underwent a cesarean section. A pregnant 39‐year‐old Japanese woman was diagnosed with coronavirus disease at 25 weeks of gestation. Her breathing condition worsened daily, and she required oxygen administration. On day 6 of her 26th week of gestation, she developed severe pneumonia and required tracheal intubation and artificial ventilation, and an emergency cesarean section was performed under general anesthesia. It is necessary to investigate the risk of increased coronavirus disease severity during pregnancy, the effects of coronavirus disease on perinatal prognosis, and the management of pregnancy with coronavirus disease.
Identification of critical miRNAs and mRNAs associated with polycystic ovary syndrome
Authors: Diao Xinghua , Yao Lijuan , Wang Yanlin , Zhang Xianghui , Sun Hongliang , Lao Kaixue , Ma He
Published: February 2021

Aim

Polycystic ovary syndrome (PCOS) is a complicated endocrine and metabolic abnormality diseases common in women of child‐bearing age. This study aims to screen out critical miRNAs and mRNAs associated with PCOS, which may be conducive to offer novel insights and treatment for the diseases.

Methods

Three mRNA datasets and one miRNA dataset derived from granulosa cells of patients with PCOS and normal controls were downloaded to obtain the differentially expressed mRNAs (DEmRNAs) and miRNAs (DEmiRNAs). Then, DEmiRNA‐target DEmRNAs analysis and functional annotation of DEmiRNA‐target DEmRNAs were performed. Quantitative real time polymerase chain reaction (qRT‐PCR) validation of the expression of the selected DEmRNAs and DEmiRNAs were performed.

Results

A total of 1643 DEmRNAs, 88 DEmiRNAs, 2406 DEmiRNA (down)‐DEmRNA (up), and 2179 DEmiRNA (up)‐DEmRNA (down) pairs were obtained. The functional annotation of DEmiRNA‐target DEmRNAs revealed that C‐type lectin receptor signaling pathway, Steroid biosynthesis and Galactose metabolism were significantly enriched KEGG pathways.

Conclusion

These findings may provide make contribution to understanding PCOS pathogenesis, diagnosis, or treatment.
Long‐term corticosteroid use, adrenal insufficiency and the need for steroid‐sparing treatment in adult severe asthma
Authors: Gurnell M. , Heaney L. G. , Price D. , Menzies‐Gow A.
Published: February 2021

Secondary adrenal insufficiency (AI) occurs as the result of any process that disrupts normal hypothalamic and/or anterior pituitary function and causes a decrease in the secretion of steroid hormones from the adrenal cortex. The most common cause of secondary AI is exogenous corticosteroid therapy administered at supraphysiologic dosages for ≥ 1 month. AI caused by oral corticosteroids (OCS) is not well‐recognized or commonly diagnosed but is often associated with reduced well‐being and can be life‐threatening in the event of an adrenal crisis. Corticosteroid use is common in respiratory diseases, and asthma is a representative condition that illustrates the potential challenges and opportunities related to corticosteroid‐sparing therapies. For individuals with severe asthma (approximately 5%–10% of all cases), reduction or elimination of maintenance OCS without loss of control can now be accomplished with biologic therapies targeting inflammatory mediators. However, the optimal strategy to ensure early identification and treatment of AI and safe OCS withdrawal in routine clinical practice remains to be defined. Many studies with biologics have involved short evaluation periods and small sample sizes; in addition, cautious approaches to OCS tapering in studies with a placebo arm, coupled with inconsistent monitoring for AI, have contributed to the lack of clarity. If the goal is to greatly reduce and, where possible, eliminate long‐term OCS use in severe asthma through the increasing adoption of biologic treatments, there is an urgent need for clinical trials that address both the speed of OCS withdrawal and how to monitor for AI.
The impact of universal hepatitis B vaccine on the trend of liver cancer from the Global Burden of Disease Study 2017
Authors: Li Chenxi , He Wen‐Qiang
Published: February 2021

Aims

This study aims to assess the trend of hepatitis B virus (HBV)‐attributable liver cancer as well as the impact of HBV vaccine on it.

Methods

We retrieved data from Global Burden Disease study to estimate trends of HBV‐attributable liver cancer by region and age from 1990 to 2017 and HBV vaccine data from World Health Organization to assess its impact on these trends for children (0‐14 years), adolescents and young adults (15‐29 years). Change of cancer cases, age‐standardized incidence rate (ASR) and estimated annual percentage change (EAPC) were used to quantify the trends of HBV‐attributable liver cancer.

Results

In this study, reduction in HBV‐attributable cancer incident cases was found among children (from 2080 to 1430), adolescents and young adults (from 10 890 to 9090). In terms of ASR, overall reduction was observed globally by an average of −0.45% (95% CI: −0.62 to −0.29) per year in the same period. The highest reduction in ASR was found in adolescents and young adults with EAPC of −3.02 (95% CI: −3.57 to −2.46). Although the ASR has decreased from all the five regions with universal HBV immunization programme, it has increased in the region without universal vaccination and the highest increase was found among children with EAPC of 1.97 (95% CI: 1.71‐2.23).

Conclusion

Significant reduction in HBV‐attributable liver cancer among children was mainly because of the universal HBV vaccination. However, the increasing trend of HBV‐attributable liver cancer in region without universal HBV vaccination suggested the necessity of introducing universal immunization.
The genetic architecture of target‐site resistance to pyrethroid insecticides in the African malaria vectors Anopheles gambiae and Anopheles coluzzii
Authors: Clarkson Chris S. , Miles Alistair , Harding Nicholas J. , O’Reilly Andrias O. , Weetman David , Kwiatkowski Dominic , Donnelly Martin J. ,   The Anopheles gambiae 1000 Genomes Consortium
Published: February 2021

Resistance to pyrethroid insecticides is a major concern for malaria vector control. Pyrethroids target the voltage‐gated sodium channel (VGSC), an essential component of the mosquito nervous system. Substitutions in the amino acid sequence can induce a resistance phenotype. We use whole‐genome sequence data from phase 2 of the Anopheles gambiae 1000 Genomes Project (Ag1000G) to provide a comprehensive account of genetic variation in the Vgsc gene across 13 African countries. In addition to known resistance alleles, we describe 20 other non‐synonymous nucleotide substitutions at appreciable population frequency and map these variants onto a protein model to investigate the likelihood of pyrethroid resistance phenotypes. Thirteen of these novel alleles were found to occur almost exclusively on haplotypes carrying the known L995F kdr (knock‐down resistance) allele and may enhance or compensate for the L995F resistance genotype. A novel mutation I1527T, adjacent to a predicted pyrethroid‐binding site, was found in tight linkage with V402L substitutions, similar to allele combinations associated with resistance in other insect species. We also analysed genetic backgrounds carrying resistance alleles, to determine which alleles have experienced recent positive selection, and describe ten distinct haplotype groups carrying known kdr alleles. Five of these groups are observed in more than one country, in one case separated by over 3000 km, providing new information about the potential for the geographical spread of resistance. Our results demonstrate that the molecular basis of target‐site pyrethroid resistance in malaria vectors is more complex than previously appreciated, and provide a foundation for the development of new genetic tools for insecticide resistance management.
The effects of weather variability on patterns of genetic diversity in Tasmanian bettongs
Authors: Proft Kirstin M. , Bateman Brooke L. , Johnson Christopher N. , Jones Menna E. , Pauza Matthew , Burridge Christopher P.
Published: February 2021

While the effects of climate (long‐term, prevailing weather) on species abundance, range and genetic diversity have been widely studied, short‐term, localized variations in atmospheric conditions (i.e., weather) can also rapidly alter species’ geographical ranges and population sizes, but little is known about how they affect genetic diversity. We investigated the relationship between weather and range‐wide genetic diversity in a marsupial, Bettongia gaimardi, using dynamic species distribution models (SDMs). Genetic diversity was lower in parts of the range where the weather‐based SDM predicted high variability in probability of B. gaimardi occurrence during 1950–2009. This is probably an effect of lower population sizes and extinction–recolonization cycles in places with highly variable weather. Spatial variation in genetic diversity was also better predicted by mean probabilities of B. gaimardi occurrence from weather‐ than climate‐based SDMs. Our results illustrate the importance of weather in driving population dynamics and species distributions on decadal timescales and thereby in affecting genetic diversity. Modelling the links between changing weather patterns, species distributions and genetic diversity will allow researchers to better forecast biological impacts of climate change.
Swimming, gliding, or hyphal riding? On microbial migration along the arbuscular mycorrhizal hyphal highway and functional consequences thereof
Authors: Jansa Jan , Hodge Angela
Published: February 2021

This article is a Commentary on Jiang et al. (2021), 230: 304–315.
Orofacial features in children with microcephaly associated with Zika virus: A scoping review
Authors: da Silva Sobrinho Adriano Referino , Ramos Letícia Francine Silva , Maciel Ytalo Lourenço , Maurício Herika de Arruda , Cartaxo Renata de Oliveira , Ferreira Stefânia Jeronimo , Sette‐de‐Souza Pedro Henrique
Published: February 2021

Objective

To analyze published scientific evidence about the most common orofacial disorders in children with microcephaly associated with ZIKV infection.

Methods

Through a scoping review, we respond to the search question was formulated: "What are the orofacial alterations in children with microcephaly associated with ZIKV?" It was performed a search in PubMed, EMBASE, Scopus, and Health Virtual Library. It was selected papers wrote in English, Portuguese, or Spanish. An evidence quality analysis was performed using the Agency for Healthcare Research and Quality classification.

Results

It was included 11 studies performed in the Brazilian Northeast region. The studies were carried out between 2018 and 2020. The main related alterations were delay in the tooth‐eruption and deformation in the oral structures.

Conclusion

The results observed in our work show moderate scientific evidence regarding the association of ZIKV with orofacial alterations in children with microcephaly due to the classifications of the quality of evidence of each one of the included studies. The main changes reported were in the chronology of tooth eruption, alteration in teeth, and oral structures.
FCN1 polymorphisms are not the markers of dental caries susceptibility in Polish children: A case‐control study
Authors: Olszowski Tomasz , Milona Marta , Janiszewska‐Olszowska Joanna , Safranow Krzysztof , Uzar Izabela , Walczak Alicja , Sikora Maciej , Chlubek Dariusz , Adler Grażyna
Published: February 2021

Objective

To examine the association of four FCN1 SNPs: −542G>A (rs10120023), −144C>A (rs10117466), +6658C>T (rs148649884), and +7895A>G (rs150625869) with dental caries in Polish children.

Subjects and Methods

The study group consisted of 261 15‐year‐old Polish teenagers: 82 children with “higher” caries experience (having Decayed Missing Filled Teeth, DMFT >5) and 179 children with “lower” caries experience (having DMFT ≤5). Moreover, in additional comparison, a group of 229 children with caries experience (DMFT ≥1) was compared to a caries‐free (DMFT =0) group of 32 children. Extraction of genomic DNA was performed from buccal swabs, and genotyping was performed by Real‐Time PCR.

Results

FCN1 SNPs +6658C>T and +7895A>G appeared to be monomorphic in our sample. The genotype, allele, or haplotype distributions in FCN1 SNPs −542G>A and −144C>A in children with “higher” caries experience did not differ significantly from those in “lower” caries experience group. Similar results with no significant differences were demonstrated for subjects with DMFT ≥1 compared to subjects with DMFT =0.

Conclusion

FCN1 SNPs are not the markers of dental caries susceptibility in Polish children.
A novel highly bio‐available itraconazole formulation (SUBA®‐Itraconazole) for anti‐fungal prophylaxis in lung transplant recipients
Authors: Whitmore Timothy James , Yaw Meow , Lavender Melanie , Musk Michael , Boan Peter , Wrobel Jeremy
Published: February 2021

Background

Antifungal prophylaxis remains a mainstay of lung transplantation, given invasive fungal infection is a common and serious complication after lung transplantation. Choice of systemic agent to prevent invasive fungal infection varies between centers and funding of agents remains challenging. Our center has recently changed from posaconazole to a highly bioavailable formulation of itraconazole (SUBA®‐itraconazole) at substantially reduced cost, but safety and toxicity require further assessment. A retrospective study of lung transplant patients receiving systemic antifungal prophylaxis from December 2016 through December 2019 following change from posaconazole to itraconazole as standard practice. 150 patients with lung transplants were managed in this time period, with 88 (59%) receiving at least 1 mold‐active triazole during the study period. 48 (58%) of these patients received SUBA®‐itraconazole; 68 (82%) received posaconazole and 10 (12%) received voriconazole. The average cost per patient during the study period was significantly lower on SUBA®‐itraconazole (mean $1548/patient/6 month course) than posaconazole (mean $16 921.35/patient/6 month course). Target trough concentrations for prophylaxis of itraconazole > 0.5 mg/L and posaconazole > 0.7 mg/L were achieved on empiric dosing in 49% and 68% respectively. Overall trough itraconazole (0.50 vs 1.12 mg/L, P < .001) and posaconazole (1.37 vs 2.10 mg/L P < .001) concentrations were significantly lower in patients with cystic fibrosis. Calcineurin inhibitor dose changes on introduction or cessation were similar for SUBA®‐itraconazole and posaconazole. Breakthrough invasive fungal infection and toxicity were rare. SUBA®‐itraconazole is well‐tolerated, associated with rare breakthrough invasive fungal infection, and lower cost. Prospective studies following general introduction are required to determine long‐term safety, tolerability, and efficacy.
The effect of exports on labour share: A semiparametric approach using Chinese manufacturing panel data
Authors: Tian Jinjing , Wang Taining , Hall Joshua
Published: February 2021

We distinguish the effects of export on labour share into a stand‐alone direct effect and indirect effects, which alter the marginal impact of three key determinants of labour share found in the literature. While the direct effect of export has been extensively studied, the potential indirect effects remain unexplored. We investigate both effects of exports using micro‐level Chinese firm‐level data from 1998 to 2007. We employ a fixed‐effect varying coefficient model to reveal the potential nonlinearity of the effects of exports while alleviating the risk of model mis‐specification. Our model is estimated by a spline‐backfitted kernel estimator, which is more efficient and computationally attractive than alternative estimators. We find that while exports directly increase labour share as expected, it declines labour share indirectly through intensifying the negative marginal impact of firms’ capital intensity, monopoly power and capital‐augmented technological progress on labour share. As a result, the net effect of exports is not beneficial to labour's share of income and varies in magnitude across firm characteristics, regions and time periods.
Sensitivity Coefficient-Based Inverse Heat Conduction Method for Identifying Hot Spots in Electronics Packages: A Comparison of Grid-Refinement Methods
Authors: Krane Patrick , Gonzalez Cuadrado David , Lozano Francisco , Paniagua Guillermo , Marconnet Amy
Published: February 2021

Estimating the distribution and magnitude of heat generation within electronics packages is pivotal for thermal packaging design and active thermal management systems. Inverse heat conduction methods can provide estimates using measured temperature profiles acquired using infrared imaging or discrete temperature sensors. However, if the heater locations are unknown, applying a fine grid of potential heater locations across the surface where heat generation is expected can result in prohibitively large computation times. In contrast, using a more computationally efficient coarse grid can reduce the accuracy of heat flux estimations. This paper evaluates two methods for reducing computation time using a sensitivity-coefficient method for solving the inverse heat conduction problem (IHCP). One strategy uses a coarse grid that is refined near the hot spots, while the other uses a fine grid but only considers heater locations near the hot spots. These methods are compared using input temperature maps acquired from a “numerical experiment,” where the outputs of a three-dimensional (3D) steady-state thermal model in FloTHERM are used for input temperatures, and temperature maps procured using infrared microscopy on a real electronics package, using sensitivity coefficients calculated with the FloTHERM model. Compared to the coarse-grid method, the fine-grid method is found to reduce computation time without significantly reducing accuracy, making it more convenient for designing and testing electronics packages. It also avoids the problem of “false hot spots” that occurs with the coarse-grid method. Overall, this approach provides a mechanism to predict hot spot locations during design and testing and a tool for active thermal management.
Clinical Translation of an Insertion Tool for Minimally Invasive Cochlear Implant Surgery
Authors: Riojas Katherine E. , Tran Emily T. , Freeman Michael H. , Noble Jack H. , Webster Robert J. , Labadie Robert F.
Published: February 2021

The objective of this paper is to describe the development of a minimally invasive cochlear implant surgery (MICIS) electrode array insertion tool concept to enable clinical translation. First, analysis of the geometric parameters of potential MICIS patients (N = 97) was performed to inform tool design, inform MICIS phantom model design, and provide further insight into MICIS candidacy. Design changes were made to the insertion tool based on clinical requirements and parameter analysis results. A MICIS phantom testing model was built to evaluate insertion force profiles in a clinically realistic manner, and the new tool design was evaluated in the model and in cadavers to test clinical viability. Finally, after regulatory approval, the tool was used for the first time in a clinical case. Results of this work included first, in the parameter analysis, approximately 20% of the population was not considered viable MICIS candidates. Additionally, one 3D printed tool could accommodate all viable candidates with polyimide sheath length adjustments accounting for interpatient variation. The insertion tool design was miniaturized out of clinical necessity and a disassembly method, necessary for removal around the cochlear implant, was developed and tested. Phantom model testing revealed that the force profile of the insertion tool was similar to that of traditional forceps insertion. Cadaver testing demonstrated that all clinical requirements (including complete disassembly) were achieved with the tool, and the new tool enabled 15% deeper insertions compared to the forceps approach. Finally, and most importantly, the tool helped achieve a full insertion in its first MICIS clinical case. In conclusion, the new insertion tool provides a clinically viable solution to one of the most difficult aspects of MICIS.
Cyclic Ramberg–Osgood Parameters of 316SS Weld Metal Under In-Air and PWR-Water Environments
Authors: Park Jae Phil , Mohanty Subhasish , Bahn Chi Bum
Published: February 2021

At present, the available Ramberg–Osgood (R–O) parameters for different metals (e.g., in ASME code and other literatures) are static (generally based on a tensile curve). These static R–O parameters cannot accurately model the cyclic plasticity behavior. This work presents the cyclic R–O material hardening parameters for 316 stainless steel similar metal welds. The parameters were estimated under various conditions (in-air at room temperature, 300 °C in-air, and in-air at primary water conditions for a pressurized water reactor (PWR)). It is anticipated that the reported results would be useful for computational mechanics-based shakedown analysis and fatigue life estimation of PWR components.
Effect of Expansion Ratio and Wall Thickness on Large-Diameter Solid Expandable Tubular After Expansion
Authors: Shi Changshuai , Chen Kailin , Zhu Xiaohua , Cheng Feilong , Qi Yuekui , Li Jianan
Published: February 2021

The large-diameter solid expandable tubular (SET) with a smaller wall thickness faces the risk of internal pressure burst and external squeeze collapse in repairing damaged casing well. The internal pressure and external squeezing resistance calculation of the tubes using the analytical method require many expansion experiments and postexpansion tensile experiments, resulting in high costs and low efficiency. This paper gives a set of laboratory expansion and postexpansion performance test, which is based on the laboratory experiment and mechanical properties of material expansion. Two materials are studied: 316 L and 20G. Then it analyses the error and causes of the error in the traditional analytical algorithm. Besides, it establishes an accurate finite element (FE) model to study the quantitative influence of expansion ratio and wall thickness on the burst strengths and collapse strengths of the tube. The results show that the toughness and hardening ratio of 316 L is better than 20G at the same expansion ratio. The numerical simulation results of the model can effectively simulate the expansion process and the mechanical properties of SET in good agreement with the laboratory test results. The expansion ratio and wall thickness affect the mechanical properties after expansion. Thus the quantitative laws of the expansion driving force, internal pressure resistance, and external squeezing resistance under different variables are summarized. To ensure the integrity of the reinforced wellbore, the expansion ratio should not exceed 12.7%. The current study lays a theoretical basis and technical support for optimizing SET and preventing downhole accidents.
Experimental Investigation on an Ultra-High Temperature Air Source Heat Pump Water Heater
Authors: Xu Yu , Zhu Zihang , Fu Chunda , Xia Wenqing
Published: February 2021

To generate boiling water beyond 100 °C via heat pump technology, the prototype of an ultra-high temperature air source heat pump water heater (ASHPWH) based on a single-stage compression cycle of R134a was established, and an experimental investigation on it was conducted under an environment temperature of 25 °C. Then, thermodynamic analyses were carried out on the basis of the experimental results, especially when the prototype produced 95.9 and 100.3 °C water. The experimental and analytical results indicate that water beyond 100 °C was achieved through the prototype. When producing 100.3 °C water, the discharge temperature and compression ratio of the compressor of the prototype are only 108.4 °C and 4.07, respectively, which are in moderate levels. Correspondingly, the work input of the compressor is 0.622 kW, the heating capacity is 2.786 kW, and the heating coefficient of performance is 4.48. In addition, when producing 95.9 and 100.3 °C water, the system exergy efficiencies of the prototype are 50.76% and 49.73%, which are larger than those of the existing ASHPWHs, demonstrating that dividing the condensing process into two parts of high-grade exergy and low-grade exergy and utilizing them separately is effective. That is the essential reason of generating boiling water beyond 100 °C as expected only through the single-stage compression cycle.
Implicit Contact Model for Discrete Elastic Rods in Knot Tying
Authors: Choi Andrew , Tong Dezhong , Jawed Mohammad K. , Joo Jungseock
Published: February 2021

Rod–rod contact is critical in simulating knots and tangles. To simulate contact, typically a contact force is applied to enforce nonpenetration condition. This force is often applied explicitly (Euler forward). At every time-step in a dynamic simulation, the equations of motions are solved over and over again until the right amount of contact force successfully imposes the nonpenetration condition. There are two drawbacks: (1) Explicit implementation brings numerical convergence issues. (2) Solving equations of motion iteratively to find this right contact force slows down the simulation. In this article, we propose a simple, efficient, and fully implicit contact model with high convergence properties. This model is shown to be capable of taking large time-steps without forfeiting accuracy during knot tying simulations when compared to previous methods. We introduce a new contact potential, based on a smoothed segment–segment distance function, that is an analytic function of the four endpoints of the two contacting edges. Since this contact potential is differentiable, we can incorporate its force (negative gradient of the energy) and Jacobian (negative Hessian of the energy) into the elastic rod simulation.
Steering Flexural Waves by Amplitude-Shift Elastic Metasurfaces
Authors: Su Guangyuan , Zhang Yunhao , Liu Yongquan , Wang Tiejun
Published: February 2021

As 2D materials with subwavelength thicknesses, elastic metasurfaces show remarkable abilities to manipulate elastic waves at will through artificial boundary conditions. However, current elastic metasurfaces are still far away from arbitrary wave manipulations since they just play a role of phase compensator. Herein, we present the next generation of elastic metasurfaces by incorporating amplitude discontinuities as an additional degree of freedom. A general theory predicting target wave fields steered by metasurfaces is proposed by modifying the Huygens–Fresnel principle. As examples, two amplitude-shift metasurfaces concerning flexural waves in thin plates are carried out: one is to transform a cylindrical wave into a Gaussian beam by elaborating both amplitude and phase shifts, and the other one is to focus incident waves by metasurfaces of amplitude modulations only. These examples coincide well over theoretical calculations, numerical simulations, and experimental tests. This work may underlie the design of metasurfaces with complete control over guided elastic waves and may extend to more sophisticated applications, such as analog signal processing and holographic imaging.
The Heriot-Watt FeatureFinder: A Graph-Based Approach to Recognition
Authors: Little G. , Tuttle R. , Clark D. E. R. , Corney J.
Published: February 2021

This paper describes the functionality of a Feature Recognition system, known as FeatureFinder. The system’s algorithm has been developed from a graph-based approach to feature recognition and is now capable of identifying a variety of features on a wide range of machined components. The system has been designed to be used within a solids machining package and identifies features from a specified tool approach direction. The paper details the result of applying the algorithm to the CIE97 test pieces. Features are identified on all of the components and the paper concludes with a brief description of on-going work designed to extend the range of components FeatureFinder’s algorithm can analyse.
Synthesis of Distributed Compliant Mechanisms for Adaptive Structures Application: An Elasto-Kinematic Approach
Authors: Saggere Laxminarayana , Kota Sridhar
Published: February 2021

Compliant mechanisms are a class of mechanisms that achieve desired force and motion transmission tasks by undergoing elastic deformations as opposed to rigid-body displacements in the conventional rigid-link mechanisms. Most of the previously reported synthesis studies in compliant mechanisms related to either partially-compliant mechanisms or fully-compliant mechanisms with joint compliance. Methods developed for fully-compliant mechanisms with link compliance addressed the issue of topology generation for desired deflections at discrete points on the mechanism. This paper presents a new, first-principles based synthesis procedure for fully-compliant mechanisms with link compliance — that is, distributed-compliant mechanisms — for continuous shape change requirements in a particular segment of a mechanism.

The general approach presented in this paper for the synthesis of distributed compliant mechanisms is shown to be well suited for application in the design of adaptive structures, an emerging class of high-performance structural systems. The current trend in the design of adaptive structures is to embed structures with force or strain inducing “smart” materials to serve as distributed actuators. Potential advantages of using the distributed compliance scheme over the distributed actuation scheme in the design of adaptive structures include a significant reduction in the number of required actuators and controls.
Multiobjective Flywheel Design: A DOE-Based Concept Exploration Task
Authors: Lautenschlager Uwe , Eschenauer Hans A. , Mistree Farrokh
Published: February 2021

In structural design, expensive function evaluations can be replaced by accurate function approximations to facilitate the effective solution of multiobjective problems. In this paper we address the question: How can we solve multiobjective shape optimization problems effectively using a Design-of-Experiments (DOE) -based approach? To answer this question we address issues of creating non-orthogonal experimental designs, when dependencies among the parameters that represent shape functions are present. A screening strategy is used to gain knowledge about the structural behavior within the design space and the trade-off among multiple design objectives is efficiently modeled through employing response surfaces during design optimization. The shape optimization of a flywheel where two conflicting design goals are present is used to illustrate the approach. Our focus is on the method rather than the results per se.
Vibration Control by Active Tuned Liquid Damper Using Magnetic Fluid
Authors: Abé Masato , Fujino Yozo , Sano Yasuyuki
Published: February 2021

To enhance the performance of tuned liquid dampers (TLD), active TLD which contains magnetic fluid activated by electromagnet is proposed. At the first half of the paper, characteristics of sloshing motion of magnetic fluid subject to dynamic magnetic field is experimentally studied. Sloshing motion and base shear force are found to be effectively controlled by magnetic force. Then, a rule-based control law is constructed and applied to the vibration control of a model building. Vibration suppression effect of passive TLD is improved by applying appropriately scheduled dynamic magnetic field.