bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct effect of artificial warming on communities is stronger than its indirect effect through body mass reduction
Authors: Bazin Simon , Diouloufet Virginie , Molina Ange , Peroux Tiphaine , Montoya Jose M. , Blanchet Simon , Edeline Eric , Jacquet Stéphan , Rasconi Serena , Fayolle Stéphanie , Campana Marina , Zambeaux Thalia , Leclerc Camille , Lassus Rémy , Morla Julie , Daufresne Martin , Sentis Arnaud
Published: July 2024

Theory predicts that morphological and bioenergetic constraints due to temperature‐induced body size reduction can modulate the direct effects of warming on biotic interactions, with consequent effects on trophic cascades and biomass distribution. However, these theoretical predictions have rarely been tested empirically. Our aim was to distinguish the indirect effects of warming‐induced body size reductions from the direct effects of warming on community structure. We conducted a mesocosm experiment manipulating factorially 1) body size reduction in the medaka fish Oryzias latipes using two populations raised for several generations under contrasted climate conditions and 2) warming (+4°C), to test their independent and interactive effects on the structure of prey and primary resource communities, the predator–prey biomass ratio and the biomass size spectra. We further dissected the effects of seasonal temperature variation from the effects of constant artificial warming. We found that the indirect effects of warming (i.e. fish body size reduction) on composition and structure of communities as well as their biomass size spectra were of marginal amplitude compared to the direct effects of seasonal temperature variation and constant warming. There were no changes in community composition in response to fish body size reduction or constant warming. However, the density of macroinvertebrates and zooplankton were maximal at intermediate seasonal water temperatures and lower in constantly‐heated mesocosms. Contrastingly, phytoplankton was not strongly affected by seasonal temperature or warming, but rather responded to grazing effects of zooplankton. Finally, we found a reduction in predator–prey biomass ratio under warming and at the warmest seasonal temperature, inducing a steeper slope of the biomass size spectra under increasing seasonal (but not constant) temperature. We conclude that the direct effects of climate change on freshwater communities are stronger than its indirect effects mediated by body mass reduction.
Immunomodulation Pathogenesis and Treatment of Bone Nonunion
Authors: Song Chao , Liu Yong , Tao Xingxing , Cheng Kang , Cai Weiye , Zhou Daqian , Zhou Yang , Wang Liquan , Shi Houyin , Hao Qi , Liu Zongchao
Published: July 2024

Fractures and bone nonunion commonly require surgical intervention. Serious outcomes of non‐healing in the late stages of fracture place a significant financial burden on society and families. Bone nonunion occurs when a fracture stops healing, for many reasons, and leads to a variety of bad outcomes. Numerous factors, including biomechanics and immunology, are involved in the complicated mechanisms of bone nonunion. The immune‐inflammatory response plays a significant part in the emergence of bone nonunion, and the occurrence, control, and remission of inflammation in the bone healing process have a significant influence on the ultimate success of bone tissue repair. In the bone microenvironment, immune cells and associated cytokines control bone repair, which is significantly influenced by macrophages, T cells, and fibroblast growth factor. To limit acute inflammation and  balance osteogenesis and osteoblastogenesis for tissue repair and regeneration, immune cells and various cytokines in the local microenvironment must be precisely regulated. As a bad complication of late‐stage fractures, bone nonunion has a significant effect on patients’ quality of life and socioeconomic development. Therefore, in‐depth research on its pathogenesis and treatment methods has important clinical value. To provide more precise, focused therapeutic options for the treatment of bone nonunion, we discuss the regulatory roles of the key immune cells engaged in bone healing within the microenvironment during bone healing and their effect on osteogenesis.
Challenges in Residual Bearing Removal: A Rare Case of Mobile Bearing Fracture in Unicompartmental Knee Arthroplasty with Literature Review
Authors: Shen Xianyue , Zhang Xianzuo , Liu Yang , Zhu Chen , Huang Wei
Published: July 2024

Background

Mobile bearing fracture is a rare long‐term complication of unicompartmental knee arthroplasty (UKA), and relevant reports are sparse. Hence, its treatment options need further exploration.

Case Presentation

This study presents the case of fracture of a polyethylene insert that occurred 12 years after mobile bearing medial UKA in a 75‐year‐old overweight woman who then underwent surgical intervention at our institution. However, we encountered significant challenges in removing the fragments from the broken bearing, resulting in retention of the remaining one‐third of the fragment. We solved this problem by replacing the fractured insert with thicker mobile bearing. During the 1‐month postoperative follow‐up, the patient achieved good range of motion and excellent satisfaction, with no reported complications and a Knee Society Score of 90. Additionally, we reviewed the literature on the treatment for mobile bearing fractures after UKA.

Conclusions

Bearing fracture is a rare cause of failure of mobile bearing UKA. This case highlights the challenges of UKA fracture bearing retrieval and underscores that mobile bearing replacement can be an effective intervention. The case we report shows that when removal of a residual meniscal bearing in a posterior dislocation is difficult to achieve, compromise may be an appropriate option because it does not cause additional complaints to the patient. This case emphasizes the importance of the surgeon having a thorough preoperative understanding of the location and potential pitfalls of fracture fragments in such situations.
The History of Classification Systems for Periprosthetic Femoral Fractures: A Literature Review
Authors: Yao Zhi‐Yuan , Fan Shu‐Yao , Zhao Wei‐Qiang , Huang Jie‐Feng
Published: July 2024

Periprosthetic femoral fractures (PPFFs) following total hip arthroplasty (THA) present a significant clinical challenge due to their increasing incidence with an aging population and evolving surgical practices. Historically, classifications were primarily based on anatomical fracture location, the stability of the implant, and bone quality surrounding the implant. We critically analyzed 25 classification systems, highlighting the emergence and adaptations of key systems such as the Vancouver classification system (VCS) and the Unified classification system (UCS), which are lauded for their simplicity and effectiveness yet require further refinement. VCS, developed in 1995, categorizes fractures based on the site, implant stability, and bone quality, and remains widely used due to its robust applicability across different clinical settings. Introduced in 2014, UCS expands the VCS to encompass all periprosthetic fractures with additional fracture types, aiming for a universal application. Despite their widespread adoption, these systems exhibit shortcomings, including the incomplete inclusion of all PPFF types and the imprecise assessment of implant stability and surrounding bone loss. These gaps can result in misclassification and suboptimal treatment outcomes. This paper suggests the necessity for ongoing improvements in classification systems to include emerging fracture types and refined diagnostic criteria, ensuring that they remain relevant to contemporary orthopedic practices and continue to facilitate the precise tailoring of treatment to patient‐specific circumstances. This comprehensive historical review serves as a foundation for future innovations in classification systems, ultimately aiming to standardize PPFF treatment and improve patient prognosis.
Perioperative Short‐Term Glucocorticoids Do Not Increase Incidence of Complications after Total Joint Arthroplasty in Patients with Rheumatoid Arthritis
Authors: Lai Yahao , Huang Chao , Cai Yongrui , Ding Zichuan , Fan Jiaxuan , Luo Zeyu , Zhou Zongke
Published: July 2024

Objectives

The safety and analgesic efficacy of perioperative glucocorticoids have been established for patients without rheumatoid arthritis. Therefore, our study aims to investigate whether similar benefits can be observed in patients with rheumatoid arthritis undergoing total joint arthroplasty. Specifically, we aim to explore the impact of perioperative glucocorticoid use on postoperative complications, opioid consumption, incidence of hypotension, hyperglycemia, 30‐day mortality, and 90‐day re‐admission in this patient population.

Methods

Approval for the study protocol was obtained from the Medical Research Ethics Committee at Sichuan University, aligning with the principles outlined in the Declaration of Helsinki. We retrospectively analyzed a consecutive series of patients with rheumatoid arthritis who underwent total joint arthroplasty at our medical center between November 2009 and April 2021 and who were not on chronic glucocorticoid therapy before surgery. Those who received glucocorticoids at any time during hospitalization were compared to those who did not in terms of acute complications within 90 days after surgery as well as postoperative rescue opioid consumption, hypotension, and hyperglycemia during hospitalization. The two groups were also compared in terms of overall duration of hospitalization, all‐cause mortality within 30 days, and readmission for any reason within 90 days. Continuous data were assessed for significance using the independent‐samples t test. Categorical data were assessed using the Pearson chi‐squared test.

Results

Of the 849 patients included in the analysis, 598 administered perioperative glucocorticoids and 251 did not. Prior to surgery, the two groups did not differ significantly in any clinicodemographic variable that we examined. The incidence of acute postoperative complications (2.3% vs. 4.0%, p = 0.187) and acute postoperative infection (2.0% vs. 2.8%, p = 0.482) was comparable between those who received perioperative glucocorticoids and those who did not, but the former group exhibited a significantly lower incidence of rescue opioid use (17.9% vs. 44.6%, p < 0.001) as well as significantly lower total rescue opioid consumption (4.7 ± 2.1 mg vs. 8.9 ± 4.6 mg, p < 0.001). However, the two groups showed similar incidences of postoperative hypotension, hyperglycemia, 30‐day mortality, and 90‐day re‐admission.

Conclusion

Perioperative glucocorticoids may reduce the need for rescue opioids after total joint arthroplasty of rheumatoid arthritis patients, without increasing the incidence of acute complications, hypotension or hyperglycemia.
Accidental allergic reactions to immediate‐type food allergens in Japanese children: A single‐center study
Authors: Miura Yoko , Nagakura Ken‐ichi , Takahashi Kyohei , Sato Sakura , Ebisawa Motohiro , Yanagida Noriyuki
Published: July 2024

Background

Few studies have assessed the nature of accidental allergic reactions (AAR). We assessed the prevalence and risk factors for AAR in Japanese children.

Methods

This study included children with immediate‐type hen's egg (HE), cow's milk (CM), wheat, or peanut allergy who developed allergic reactions within at least 2 years and were followed up regularly at a single national allergy center in Japan. From January to December 2020, low‐dose reactivity was defined as allergic reactions to ≤250, ≤102, ≤53, or ≤ 133 mg of HE, CM, wheat, or peanut protein, respectively. The annualized AAR rate showed the number of reactions per patient per year (95% confidence interval). AAR risk factors were analyzed using multiple logistic regression.

Results

Of the 1096 participants, 609, 457, 138, and 90 had HE, CM, wheat, and peanut allergies, respectively. The median (interquartile range) age was 5.0 (2.3–8.6) years, 39% had completely eliminated allergenic food, and 24% had low‐dose reactivity. The annualized AAR rate was 0.130 (0.109–0.153) in all sub‐cohorts. Moderate and severe symptoms occurred in 50% and 0.7%, respectively, of children who experienced AAR. Multiple logistic regression revealed that low‐dose reactivity was a significant risk factor for AAR in the overall and CM cohorts, respectively (p < .001 and p = .036).

Conclusion

In this single‐center study in Japan, the annualized AAR rate was relatively low during the COVID‐19 pandemic; however, half of the participants with AAR had moderate to severe symptoms. Especially in the case of low‐dose reactivity, children would require careful AAR risk management.
Evaluating health literacy from an organizational perspective: A cross‐sectional study of community health centers
Authors: Chang Mei‐Chuan , Wang Ying‐Wei , Yu Jui‐Hung , Wei Mi‐Hsiu , Hsieh Jyh‐Gang
Published: July 2024

Objectives

To investigate community health centers’ (CHCs) health literacy.

Design

A cross‐sectional study.

Sample

A total of 374 CHCs were surveyed and 258 CHCs responded, with an effective questionnaire response rate of 69.0%.

Measurements

Data were collected by using a self‐developed health literacy assessment tool to survey CHCs’ health literacy throughout Taiwan from January to December 2019.

Results

The item of organizational health literacy (OHL) with the highest proportion of CHCs not implementing them was “Design of easy‐to‐use computer applications and new media” (47.3% not yet achieved), followed by “Involving target audiences in document and service development” (34.9% not yet achieved). CHCs located in northern Taiwan had higher health literacy achievement scores than those in other regions, and those in urban areas had higher health literacy achievement scores than those in general and remote areas.

Conclusions

This study identified items with poor implementation of OHL and found regional differences in health literacy among CHCs. The findings can inform the development of targeted interventions to improve health literacy in underperforming CHCs and guide policymakers in allocating resources to regions and areas in need of.
Utilizing self‐report diaries to explore task time distribution of school nurses in UAE
Authors: Al‐Yateem Nabeel , Hajras Islam , AlSaadi Anoud , Alkabi Shaikha , Abdi Zahra , Abdulhamed Mayedah , Subu Muhammad Arsyad , Ahmed Fatma Refaat , Saifan Ahmad Rajeh
Published: July 2024

Objective

This study aims to evaluate the roles and tasks of school nurses in the UAE, quantify the time spent on each, and identify areas for improvement in school health services. This aligns with the UAE government's initiative to enhance primary healthcare, focusing on illness prevention and health promotion for children and adolescents.

Methods

The research adopts an observational study design, utilizing self‐observation through diary recordings by school nurses to collect data on their daily tasks and time allocation. A sample of total of 2024 school nurse activities were recorded and analyzed over 126 days and 1084 h of observation by eight school nurses using self‐report diaries. This method allowed for the collection of detailed information on how nursing time is allocated between core and noncore tasks.

Results

In this study a total of 2024 tasks were observed over 1084 h. The findings reveal that core nursing tasks accounted for 78% of activities but only 53% of the total 1084 h observed, while non‐nursing tasks, making up 22% of activities, disproportionately consumed 47% of the hours. This discrepancy highlights the inefficiency of time allocation, with non‐nursing tasks such as administrative duties taking significantly longer than core patient care tasks.

Conclusions

The study highlights a significant opportunity to enhance school health services in the UAE by optimizing the allocation of nursing time towards more illness prevention and health promotion interventions. By addressing the identified challenges, including the gaps in nurse competencies and the lack of structured practice frameworks, school health services can be improved.
A prospective cohort study examining the association between the periconceptual vaginal microbiota and first‐trimester miscarriage in Kenyan women
Authors: McClelland R. Scott , Lokken Erica M. , Kinuthia John , Srinivasan Sujatha , Richardson Barbra A. , Jaoko Walter , Lannon Sophia , Pulei Anne , Fiedler Tina L. , Munch Matthew M. , Proll Sean , John‐Stewart Grace , Fredricks David N.
Published: July 2024

Background

Studies evaluating the association between the vaginal microbiota and miscarriage have produced variable results.

Objective

This study evaluated the association between periconceptual and first‐trimester vaginal microbiota and women's risk for miscarriage.

Methods

At monthly preconception visits and at 9–12 weeks gestation, women collected vaginal swabs for molecular characterisation of the vaginal microbiota. Participants who became pregnant were followed to identify miscarriage versus pregnancy continuing to at least 20 weeks gestation.

Results

Forty‐five women experienced miscarriage and 144 had pregnancies continuing to ≥20 weeks. A principal component analysis of periconceptual and first‐trimester vaginal bacteria identified by 16S rRNA gene PCR with next‐generation sequencing did not identify distinct bacterial communities with miscarriage versus continuing pregnancy. Using taxon‐directed quantitative PCR assays, increasing concentrations of Megasphaera hutchinsoni, Mageeibacillus indolicus, Mobiluncus mulieris and Sneathia sanguinegens/vaginalis were not associated with miscarriage. In exploratory analyses, these data were examined as a binary exposure to allow for multivariable modelling. Detection of Mobiluncus mulieris in first‐trimester samples was associated with miscarriage (adjusted relative risk [aRR] 2.14, 95% confidence interval [CI] 1.08, 4.22). Additional analyses compared women with early first‐trimester miscarriage (range 4.7–7.3 weeks) to women with continuing pregnancies. Mobiluncus mulieris was detected in all eight (100%) first‐trimester samples from women with early first‐trimester miscarriage compared to 101/192 (52.6%) samples from women with continuing pregnancy (model did not converge). Detection of Mageeibacillus indolicus in first‐trimester samples was also associated with early first‐trimester miscarriage (aRR 4.10, 95% CI 1.17, 14.31).

Conclusions

The primary analyses in this study demonstrated no association between periconceptual or first‐trimester vaginal microbiota and miscarriage. Exploratory analyses showing strong associations between first‐trimester detection of Mobiluncus mulieris and Mageeibacillus indolicus and early first‐trimester miscarriage suggest the need for future studies to determine if these findings are reproducible.
Sexual orientation disparities in gestational diabetes and hypertensive disorders of pregnancy
Authors: Chakraborty Payal , Everett Bethany G. , Reynolds Colleen A. , Hoatson Tabor , Stuart Jennifer J. , McKetta Sarah C. , Soled Kodiak R. S. , Huang Aimee K. , Chavarro Jorge E. , Eliassen A. Heather , Obedin‐Maliver Juno , Austin S. Bryn , Rich‐Edwards Janet W. , Haneuse Sebastien , Charlton Brittany M.
Published: July 2024

Background

Sexual minority (SM) individuals (e.g., those with same‐sex attractions/partners or who identify as lesbian/gay/bisexual) experience a host of physical and mental health disparities. However, little is known about sexual orientation‐related disparities in gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP; gestational hypertension [gHTN] and preeclampsia).

Objective

To estimate disparities in GDM, gHTN and preeclampsia by sexual orientation.

Methods

We used data from the Nurses' Health Study II—a cohort of nurses across the US enrolled in 1989 at 25–42 years of age—restricted to those with pregnancies ≥20 weeks gestation and non‐missing sexual orientation data (63,518 participants; 146,079 pregnancies). Our primary outcomes were GDM, gHTN and preeclampsia, which participants reported for each of their pregnancies. Participants also reported their sexual orientation identity and same‐sex attractions/partners. We compared the risk of each outcome in pregnancies among heterosexual participants with no same‐sex experience (reference) to those among SM participants overall and within subgroups: (1) heterosexual with same‐sex experience, (2) mostly heterosexual, (3) bisexual and (4) lesbian/gay participants. We used modified Poisson models to estimate risk ratios (RR) and 95% confidence intervals (CI), fit via weighted generalised estimating equations, to account for multiple pregnancies per person over time and informative cluster sizes.

Results

The overall prevalence of each outcome was ≤5%. Mostly heterosexual participants had a 31% higher risk of gHTN (RR 1.31, 95% CI 1.03, 1.66), and heterosexual participants with same‐sex experience had a 31% higher risk of GDM (RR 1.31, 95% CI 1.13, 1.50), compared to heterosexual participants with no same‐sex experience. The magnitudes of the risk ratios were high among bisexual participants for gHTN and preeclampsia and among lesbian/gay participants for gHTN.

Conclusions

Some SM groups may be disparately burdened by GDM and HDP. Elucidating modifiable mechanisms (e.g., structural barriers, discrimination) for reducing adverse pregnancy outcomes among SM populations is critical.
The Historical Presidency: I like Ike: The origins of broadcast presidential campaign advertising
Authors: Endersby James W.
Published: July 2024

The first televised presidential campaign commercials ran in the 1952 electoral contest between Dwight Eisenhower and Adlai Stevenson, specifically as part of the effort to draft and then elect General Eisenhower. These first spot ads were developed not by political parties or the candidates but by an independent citizens group, Citizens for Eisenhower. The group developed two distinct styles of television advertising. The best known of these stemmed from the hard‐sell Madison Avenue tradition of public relations and its advertising innovator, Rosser Reeves, who produced the “Eisenhower Answers America” campaign. Less well known is an ad created by volunteer workers from the Disney Corporation, who produced an animated, musical rendition promising that “We'll Take Ike to Washington.” Unlike Reeves's more substantive ads that focused on issues, the Disney ads emphasized the image and character of the candidate. Using archival sources, this article shows that the televised marketing of the presidency stemmed not only from the public relations experts and Madison Avenue advertisers like Reeves but also from those connected to the entertainment industry who sought to manipulate the public through character appeals.
Beyond racial resentment: Systemic racism beliefs and public attitudes toward criminal justice institutions and reforms
Authors: Silver Eric , Iceland John , Goff Kerby
Published: July 2024

Introduction

Systemic racism theory has become a central part of academic and public discussions about criminal justice institutions and reforms. Little, however, is known about the association between people's belief in the ubiquity of systemic racism and their attitudes toward criminal justice institutions and reforms.

Methods

To fill this gap, we examine the association between systemic racism beliefs and support for police, police reform, and the BLM movement using a national YouGov sample of 1125 U.S. adults.

Results

Systemic racism beliefs are associated with Americans’ attitudes toward all three outcomes, net of a wide range of controls, including negative experiences with police, political ideology, and most notably, racial resentment.

Conclusion

Our study provides compelling evidence that belief in systemic racism is an important driver of Americans’ support for police, police reforms, and BLM.
An empirical study on sample size for the central limit theorem using Japanese firm data
Authors: Fukuda Kosei
Published: July 2024

In statistics classes, the central limit theorem has been demonstrated using simulation‐based illustrations. Known population distributions such as a uniform or exponential distribution are often used to consider the behavior of the sample mean in simulated samples. Unlike such simulations, a number of real‐data‐based simulations are here implemented in which the populations are empirical distributions of data selected from Japanese firms. The dataset chosen contains 38 variables familiar to business students, such as sales and assets. The maximum population size of the variables is 2243. One thousand samples with replacement are selected for specific variable–sample size combinations. Hypothesis testing results indicate that the normality hypothesis for the sample mean is rejected for 31 variables at the 0.1% level even with a sample size of 500. It is emphasized that the data for these variables indicate that this should not be a surprise, and emphasize the importance of looking at data.
Automatic delineation of rational service areas and health professional shortage areas in GIS based on human movements and health resources
Authors: Liang Yunlei , Gao Song
Published: July 2024

How people travel to receive health services is essential for understanding healthcare shortages. The rational service areas (RSAs) are defined to represent local healthcare markets and used as the basic units to evaluate whether people have access to health resources. Therefore, finding an appropriate way to develop RSAs is important for understanding the utilization of health resources and supporting accurate resource allocation to the health professional shortage areas (HPSAs). Existing RSAs are usually developed based on the local knowledge of public health needs and are created through time‐intensive manual work by health service officials. In this research, a travel data‐driven and spatially constrained community detection method based on human mobility flow is proposed to automate the process of establishing the statewide RSAs and further identifying HPSAs based on healthcare criteria in a geographic information system (GIS) software. The proposed method considers the difference between rural and urban populations by assigning different parameters and delineates RSAs with the goal of reducing health resource inequalities faced by rural areas. Using the data in the State of Wisconsin, our experiment shows that the proposed RSA delineation method outperforms other baselines including the traditional Dartmouth method in the aspects of RSA compactness, region size balances, and health shortage scores. Furthermore, the whole process of delineating RSAs and identifying HPSAs is automated using Python toolboxes in ArcGIS to support future analyses and practices in a timely and repeatable manner.
Evolving trends in immunosuppression use and cytomegalovirus infection risk over the past decade in kidney transplantation
Authors: Soliman Karim , Calimlim Isabel K. , Perry Amy , Andrade Erika , Overstreet Morgan , Patel Neha , Bartlett Felicia , Taber David J.
Published: July 2024

Background

The goal was to determine trends in immunosuppression use and its impact on cytomegalovirus (CMV) outcomes over the past 10 years.

Methods

This was a single‐center longitudinal cohort study of adult kidney recipients transplanted between Jan 2012 and June 2021. Baseline and follow‐up data were gathered via chart abstraction and analyzed using univariate and multivariate analyses.

Results

Of 2392 kidney transplants conducted, 131 patients did not meet inclusion criteria. The mean age was 52 years, 41% were female, 57% were black, and 19% were CMV high‐risk. The use of rabbit anti‐thymocyte globulin (RATG) induction (odds ratio [OR] 1.6, 1.3–2.1), tacrolimus (FK) level >8 ng/mL (OR 1.1, 1.09–1.11), CMV D+/R‐ rates (OR 1.06, 1.02–1.10), white blood cell count <3000 (OR 1.22, 1.18–1.26) and valganciclovir prophylaxis (OR 1.7, 1.6–1.9) have significantly increased over the past 10 years.  Rejection rates (OR 0.86, 0.82–0.91) and BK viremia >2000 (OR 0.91, 0.91–0.98) have decreased. RATG induction (adjusted hazard ratio [aHR] 1.35, 1.2–1.5), FK >8 ng/mL (aHR 3.5, 3.2–3.9), Belatacept conversion (aHR 2.5, 2.1–3.1), and rejection (aHR 1.8, 1.6–2.0) were significant risk factors for developing CMV infection, while mycophenolate mofetil <1500 mg (aHR 0.52, 0.47–0.59), mammalian target of rapamycin inhibitor (mTORi) conversion (0.77, 0.56–0.89), cyclosporine‐A conversion (aHR 0.68, 0.56–0.84) were associated with lower risk of CMV infection.

Conclusion

Increasing use of potent immunosuppression coupled with higher CMV D+/R‐ F rates may be driving higher rates of CMV infection. Cyclosporine and mTORi conversion appears to be protective against CMV.  A more individualized immunosuppression regimen based on infection risk merits consideration.

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The performance of bronchoalveolar lavage Aspergillus PCR testing in solid organ transplant recipients with invasive pulmonary aspergillosis
Authors: Mutcali Sibel Islak , Hussain Nadeem , Nematollahi Saman , Lainhart William , Zangeneh Tirdad T. , Al‐Obaidi Mohanad M.
Published: July 2024

Background

Invasive aspergillosis affects solid organ transplant (SOT) recipients, carrying a high risk of mortality and morbidity in this population. Rapid and accurate diagnosis is essential to ensure the initiation of correct antifungal therapy. We aimed to evaluate the performance of the bronchoalveolar lavage (BAL) Eurofins Viracor Aspergillus PCR (AspPCR) in diagnosing invasive pulmonary aspergillosis (IPA) in SOT recipients.

Methods

We conducted a multicenter retrospective study of SOT recipients in Arizona from February 2019 to December 2022 who had AspPCR done at the time of the clinical encounter. Probable IPA was defined as a positive BAL culture with Aspergillus spp. with clinical and imaging findings of IPA per EORTC/MSGERC criteria.

Results

Ninety‐nine SOT recipients with 131 encounters with BAL AspPCR testing were included. The median age was 66, the majority were White, non‐Hispanics (60%), and males (66%). Among the participants, 93 lung transplant recipients with 87 of the encounters received antifungal prophylaxis active against Aspergillus spp. Sixty‐four encounters had BAL galactomannan (GM), all of which had BAL GM <1 OD, and one case had a serum GM of 10 OD. Nine cases met the definition of IPA. The sensitivity of the BAL AspPCR was 67% (95% CI 30%–93%), and the specificity was 98% (95% CI 93%–99%).

Conclusion

BAL AspPCR had moderate sensitivity and high specificity in identifying IPA in our cohort of SOT recipients. Further studies in populations with a higher prevalence of IPA are needed to evaluate the performance of this test.

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Isocitrate lyase promotes Puccinia striiformis f. sp. tritici susceptibility in wheat (Triticum aestivum) by suppressing accumulation of glyoxylate cycle intermediates
Authors: Ibe Carol N. , Bailey Sarah L. , Korolev Andrey V. , Brett Paul , Saunders Diane G. O.
Published: July 2024

Plant fungal parasites manipulate host metabolism to support their own survival. Among the many central metabolic pathways altered during infection, the glyoxylate cycle is frequently upregulated in both fungi and their host plants. Here, we examined the response of the glyoxylate cycle in bread wheat (Triticum aestivum) to infection by the obligate biotrophic fungal pathogen Puccinia striiformis f. sp. tritici (Pst). Gene expression analysis revealed that wheat genes encoding the two unique enzymes of the glyoxylate cycle, isocitrate lyase (TaICL) and malate synthase, diverged in their expression between susceptible and resistant Pst interactions. Focusing on TaICL, we determined that the TaICL B homoeolog is specifically upregulated during early stages of a successful Pst infection. Furthermore, disruption of the B homoeolog alone was sufficient to significantly perturb Pst disease progression. Indeed, Pst infection of the TaICL‐B disruption mutant (TaICL‐BY400*) was inhibited early during initial penetration, with the TaICL‐BY400* line also accumulating high levels of malic acid, citric acid, and aconitic acid. Exogenous application of malic acid or aconitic acid also suppressed Pst infection, with trans‐aconitic acid treatment having the most pronounced effect by decreasing fungal biomass 15‐fold. Thus, enhanced TaICL‐B expression during Pst infection may lower accumulation of malic acid and aconitic acid to promote Pst proliferation. As exogenous application of aconitic acid and malic acid has previously been shown to inhibit other critical pests and pathogens, we propose TaICL as a potential target for disruption in resistance breeding that could have wide‐reaching protective benefits for wheat and beyond.
Radiographic characterization of the maxillary septum and septal bullae in horses: An ex vivo study
Authors: Lima Aymara Eduarda de , Piñeros Diego Darley Velasquez , Alibrando Bruno Braghetta , Bittar Mauricio José , de Souza Anderson Fernando , Mendes Rubens Peres , de Freitas Silvio Henrique , Bernardino Thiago , Corrêa Rodrigo Romero
Published: July 2024

The anatomical variations of the maxillary septum and the septal bullae can generate challenges during the interpretation of radiographs of the horses’ heads and make it difficult to accurately identify the sites affected in sinus disorders. The description of the radiographic appearance of these structures is currently scarce in the scientific literature. This work aims to describe the anatomical and radiographic characteristics of the maxillary septum and maxillary septal bullae in horses. Six chemically preserved equine cadaver heads were used which, after being submitted to the maxillary osseous flap, the maxillary septum and its respective bullae were identified. Radiographic examinations before and after contrast impregnation on these structures were performed. The positioning of the maxillary septum varied between the anatomical specimens and between the sides of the same specimen. The 30° oblique dorsoventral lateral and lateral projections allowed the identification of the maxillary septum and septal bullae. However, the bullae remained superimposed on the dental arches in the dorsoventral projections with the mandible in a neutral position or with the mandible displaced. The oblique offset radiographic positioning was suggested and proved effective for the examination of the maxillary septal bullae, where the mandible was displaced to the side of the bullae to be examined, and the radiographic beam inclined in the same direction. The maxillary septum and its bullae could be properly identified in a macroscopic way after the osseous flap and the contrasted radiographic examination allowed its adequate interpretation. Variations in size and position are considered normal for the equine species.
Performance Analysis of Forest Canopy Height Model Generated from UAV and InSAR
Authors: Shin Alvin Lau Meng , Chen Wenxi , Okuda Toshinori , Sim Hui Lin , Tam T. H. , Chew W. C.
Published: July 2024

Forest canopy height is a crucial parameter in ecosystem process modelling, yet research on generating canopy height models (CHMs) using photogrammetry method from UAV data remains limited compared to methods such as light detection and ranging (LiDAR). This study investigates the performance of accuracy and effectiveness of CHM generated from low-cost Unmanned Aerial Vehicle (UAV) via the photogrammetry method together with the well-known long-established Interferometric Synthetic Aperture Radar (InSAR). Leveraging advancements in UAV technology for three-dimensional land surface modelling, this research focuses on the Pasoh Research Station (nearby the Arboretum area) of Pasoh Forest Reserve in Negeri Sembilan, Malaysia. A series of images were captured at ten different UAV flying altitudes ranging from 120m to 500m above the mean sea level. Subsequently, CHMs were derived from both UAV and InSAR data, and compared against field measurements of tree height. The results indicate that UAV with a flying height below 200m can generate much more accurate results (with average height difference less than 10m) than InSAR (average height difference of 10.532m). It is noticeable that when comparing the InSAR-generated CHM to field measurements at lower altitudes (below 150m), the canopy height obtained from InSAR data is less accurate (more than 10m difference with field measurement) than the CHM obtained via UAV photogrammetry processing (only 5.353 m difference with field measurement). However, when UAV flying height is above 200m, InSAR data is performed more reliably.  A 120m UAV flying height has a good potential to generate canopy height that is closer to the field measurement.
Spectral large deviations of sparse random matrices
Authors: Ganguly Shirshendu , Hiesmayr Ella , Nam Kyeongsik
Published: July 2024

Eigenvalues of Wigner matrices has been a major topic of investigation. A particularly important subclass of such random matrices, useful in many applications, are what are known as sparse or diluted random matrices, where each entry in a Wigner matrix is multiplied by an independent Bernoulli random variable with mean . Alternatively, such a matrix can be viewed as the adjacency matrix of an Erdős–Rényi graph equipped with independent and identically distributed (i.i.d.) edge‐weights. An observable of particular interest is the largest eigenvalue. In this paper, we study the large deviations behavior of the largest eigenvalue of such matrices, a topic that has received considerable attention over the years. While certain techniques have been devised for the case when is fixed or perhaps going to zero not too fast with the matrix size, we focus on the case , that is, constant average degree regime of sparsity, which is a central example due to its connections to many models in statistical mechanics and other applications. Most known techniques break down in this regime and even the typical behavior of the spectrum of such random matrices is not very well understood. So far, results were known only for the Erdős–Rényi graph without edge‐weights and with Gaussian edge‐weights. In the present article, we consider the effect of general weight distributions. More specifically, we consider entry distributions whose tail probabilities decay at rate with , where the regimes and correspond to tails heavier and lighter than the Gaussian tail, respectively. While in many natural settings the large deviations behavior is expected to depend crucially on the entry distribution, we establish a surprising and rare universal behavior showing that this is not the case when . In contrast, in the case, the large deviation rate function is no longer universal and is given by the solution to a variational problem, the description of which involves a generalization of the Motzkin–Straus theorem, a classical result from spectral graph theory. As a byproduct of our large deviation results, we also establish the law of large numbers behavior for the largest eigenvalue, which also seems to be new and difficult to obtain using existing methods. In particular, we show that the typical value of the largest eigenvalue exhibits a phase transition at , that is, corresponding to the Gaussian distribution.
Large convex sets in difference sets
Authors: Bhowmick Krishnendu , Lund Ben , Roche‐Newton Oliver
Published: July 2024

We give a construction of a convex set with cardinality such that contains a convex subset with cardinality . We also consider the following variant of this problem: given a convex set , what is the size of the largest matching such that the set
is convex? We prove that there always exists such an with , and that this lower bound is best possible, up to a multiplicative constant.
A lower bound on the mean value of the Erdős–Hooley Delta function
Authors: Ford Kevin , Koukoulopoulos Dimitris , Tao Terence
Published: July 2024

We give an improved lower bound for the average of the Erdős–Hooley function , namely for all and any fixed , where is an exponent previously appearing in work of Green and the first two authors. This improves on a previous lower bound of of Hall and Tenenbaum, and can be compared to the recent upper bound of of the second and third authors.
Development of an Esophageal Sleeve With Variable Stiffness and Internal Diameter for Endoscopic Surgery
Authors: Wang Haibo , Liu Xinwei , Chang Zongyu
Published: July 2024

In natural orifice transluminal endoscopic surgery (NOTES), the flexible endoscopic surgical robot utilizes a continuum configuration to navigate narrow, multicurvature esophageal pathways. However, the tool channel's dimensional limitations and the restricted internal layout make it challenging to reduce the outside diameter and highly efficient variable stiffness function significantly. As a result, safe insertion into the esophagus and precise operation remains hugely challenging. In this paper, an esophageal sleeve with variable stiffness and internal diameter is developed for endoscopic procedures. The proposed esophageal sleeve adopts specially designed spiral elastic deployable parts that allow for variations in internal diameter. Furthermore, the elastic deployable parts are designed with serrated protrusion structures that can realize rapid transition between rigidity and flexibility under negative pressure. Fundamental experimental results showed that the outer diameter of the proposed esophageal sleeve can expand from 17 mm to 20 mm, providing inner access up to 13 mm for endoscopic instruments. The serrated protrusion structure allows the esophageal sleeve to rapidly transition from a flexible to a rigid state, resulting in a stiffness gain of approximately 5. Phantom experiments validated the effectiveness and usability of the proposed esophageal sleeve in assisting endoscope insertion, demonstrating its potential clinical value in endoscopic procedures. The significance of this study is the development of a device that can better assist endoscopic procedures.
Structural Synthesis of Platform Type Manipulators via Connection-Based Adjacency Matrix: Topology Generation
Authors: Volkan Yazıcı Mustafa , Kocak Mertcan , Uslu Tugrul , Gezgin Erkin
Published: July 2024

This article focuses on the design procedures of Alizade's direct and Gezgin's inverse structural synthesis methodologies for platform type manipulators. These task-based synthesis procedures include versatile methodologies for any designer to generate various platform-type manipulators with respect to given constraints via simple universal mobility formulation. However, they rely on the manual generation of mobility-independent coarse topological structures, where it is nearly impossible to generate all possible results. In light of this, the current study introduces a unique connection-based adjacency matrix (CAM) for topology representation, in which legs connected to the fixed ground and platform connections (hinges and branches) are treated separately. The main objective of CAM is to ensure an efficient transition from manual topology generation to automated methods by providing compatibility with software algorithms to describe topologies. Throughout the article, CAM-based automated topology generation algorithm that reveals all possible unique coarse topologies with respect to given design constraints is also presented along with examples. Introduced algorithm both allows investigation of isomorphism and eliminates necessity of inversion.
Reviewing Welding Procedures—Checklists for Nuclear Power Systems
Authors: Zhang Zengkui , Wu Chongzhi , Peng Zhenguo , Li Mingkai
Published: July 2024

To ensure effective control of the welding process, nuclear power architecture and engineering (AE) companies routinely undertake the review of procedure qualification records (PQRs) and welding procedure specifications (WPSs) for safety-related structures, systems, and components (SSCs), as qualified by manufacturers and construction contractors. Given the substantial quantity of PQRs and WPSs necessitating evaluation, along with the multitude of variables inherent in these documents, a set of review checklists has been devised. These checklists, developed from the perspective of AE companies' welding engineers, transform welding procedure qualification rules and requirements into intuitive descriptions, assessments of correctness, or numerical comparisons of scale. AE companies' welding engineers employ these review checklists to scrutinize PQRs and WPSs, facilitating a comprehensive, accurate, and efficient review process.
Influence of the Presence of Different Signatures on the Heat Transfer Profile of Laminar Flow Inside a Microchannel
Authors: Kakati Arupjyoti , Gupta Saurabh , Bit Arindam
Published: July 2024

The process of transferring heat and mass involves a high-pressure decline. Hence microchannels are utilized in extremely efficient heat and mass transfer processes, such as in the systems of the lungs and kidneys. Due to their high surface-to-volume ratio and compact volume, microchannels have demonstrated superior thermal performance. In this work, micro-fins of different topologies and arrangements were used inside microchannels for modulating heat transfer from the surface of the fins, in the presence of flowing media. The influx of media was simulated in sinusoidal form, reproducing simplified form of physiological circulatory blood flow. The study was conducted in numerical domain, while heat transfer and mass transfer equations were solved using pardiso solver. Temperature modulation at the fin surfaces was conducted to examine the transient profile of heat transfer, as function of both variable fluid velocity as well as variable feeding heat sources. In case of different input boundary conditions, the effect of heat distributions on fluid flow with respect to spatial distribution of micro-fins within a microchannel was evaluated. Results revealed the difference in heat transfer profiles in microchannels in presence of different sets of fin configurations. It was found that rectangular fins have the highest heat transfer in fluid at all its spatial configurations; while semi-ellipsoidal-shaped fins had shown the least heat transfer profile at same surface area. At the same time, it was also observed that the rate of heat dissipation was faster and limited in semi-ellipsoidal-shaped fins configuration; while the heat transfer rate was found symmetrical and low in presence of rectangular fins. Hence, this article emphasizes the modulation of temperature and velocity variations within the working fluid by emphasizing the thermo-fluid coupling effects in microchannels.
Thermal-Hydraulic Characterization of a Thermosyphon Cooling System for Highly Compact Edge MicroDataCenter
Authors: Minazzo Enzo M. , Rouaze Gautier , Marcinichen Jackson B. , Thome John R. , Buining Fred
Published: July 2024

In the European project BRAINE, an extremely efficient passive thermosyphon cooling system was developed for a novel type of Edge MicroDataCenter (EMDC) with high heat fluxes to dissipate on individual computer cards and high heat dissipation rate per unit volume in the dense array of these cards. The primary objective was the cooling of 11 nodes (which include central processing units (CPUs), field programmable gate arrays, graphics processing units, and storage) considering one heat sink evaporator per node. This study shows the experimental results obtained with the new environmentally friendly refrigerants R1233zd(E) and R1234ze(E) as well as a validation of the solver used to design the thermosyphon for a first demo EMDC with four slots (i.e., four nodes). The maximal total dissipated power was 950 W, and performance ratios of heat dissipation-to-cooling fan power up to 98-to-1 were obtained. The solver validation was performed by comparing pressure drop of the different components as well as the maximum temperature of heaters mimicking CPUs for 232 simulated datapoints and proved extremely good accuracy without any scaling or empirical factors: 99%, 78%, 53%, and 95% of the datapoints for the evaporator, riser, condenser, and total pressure drop, respectively, were within ±30% of the experimental results, which is accuracy comparable to the best two-phase pressure drop correlations in the literature, so a very good validation results. For the temperature validation, 97% of the datapoints were within ±5 °C of the experimental measurements, highlighting the robustness of the solver.