bluuebunny/crossref_metadata_2025 huggingface dataset:
Satellite Captures Detaching Iceberg in Near-Real Time
Authors: Sidder Aaron
Published: March 2021

NASA’s ICESat-2 satellite recorded the cleaving of a 315-billion-ton iceberg from Amery Ice Shelf in 2019, as well as years of subtle cracking and splitting prior to the calving event.
Seven Ways PIs Can Counteract Systematic Bias Right Now
Authors: Duncombe Jenessa
Published: March 2021

Principal investigators are the monarchs of their science kingdoms. Here are seven things they can do for the betterment of the realm—ehrm, lab group.
USP19 modulates cancer cell migration and invasion and acts as a novel prognostic marker in patients with early breast cancer
Authors: Rossi Fabiana Alejandra , Enriqué Steinberg Juliana Haydeé , Calvo Roitberg Ezequiel Hernán , Joshi Molishree Umesh , Pandey Ahwan , Abba Martin Carlos , Dufrusine Beatrice , Buglioni Simonetta , De Laurenzi Vincenzo , Sala Gianluca , Lattanzio Rossano , Espinosa Joaquín Maximiliano , Rossi Mario
Published: March 2021

Tumor cell dissemination in cancer patients is associated with a significant reduction in their survival and quality of life. The ubiquitination pathway plays a fundamental role in the maintenance of protein homeostasis both in normal and stressed conditions and its dysregulation has been associated with malignant transformation and invasive potential of tumor cells, thus highlighting its value as a potential therapeutic target. In order to identify novel molecular targets of tumor cell migration and invasion we performed a genetic screen with an shRNA library against ubiquitination pathway-related genes. To this end, we set up a protocol to specifically enrich positive migration regulator candidates. We identified the deubiquitinase USP19 and demonstrated that its silencing reduces the migratory and invasive potential of highly invasive breast cancer cell lines. We extended our investigation in vivo and confirmed that mice injected with USP19 depleted cells display increased tumor-free survival, as well as a delay in the onset of the tumor formation and a significant reduction in the appearance of metastatic foci, indicating that tumor cell invasion and dissemination is impaired. In contrast, overexpression of USP19 increased cell invasiveness both in vitro and in vivo, further validating our findings. More importantly, we demonstrated that USP19 catalytic activity is important for the control of tumor cell migration and invasion, and that its molecular mechanism of action involves LRP6, a Wnt co-receptor. Finally, we showed that USP19 overexpression is a surrogate prognostic marker of distant relapse in patients with early breast cancer. Altogether, these findings demonstrate that USP19 might represent a novel therapeutic target in breast cancer.
Controllable synthesis of SnS2flakes and MoS2/SnS2heterostructures by confined-space chemical vapor deposition
Authors: Fu Quangui , Mo Haoxin , Ostrikov Kostya (Ken) , Gu Xiaofeng , Nan Haiyan , Xiao Shaoqing
Published: March 2021

A halogen salt-assisted confined-space CVD method is used for the controllable synthesis of SnS2flakes, which are parallel to the substrate and have the characteristics of better crystallinity and fewer S vacancies.
1,2,5-ThiadiazolineS,S-dioxide derivatives as corrosion inhibitors for mild steel in sulphuric acid solution. Electrochemical studies and cytotoxic effect evaluation
Authors: Grillo Claudia Alejandra , Rodríguez Arroyo Nelson , Banera Mauro Jonathan , Mirífico María Virginia
Published: March 2021

The first report on 1,2,5-thiadiazolineS,S-dioxide derivatives as effective corrosion inhibitors is presented. The biological assay results evidence the necessity to perform cytotoxicity tests for the new compounds.
A polymer-coated template-confinement CsPbBr3 perovskite quantum dot composite
Authors: Shen Jianhua , Wang Yu , Zhu Yihua , Gong Yiqin , Li Chunzhong
Published: March 2021

CsPbBr3 QDs are in situ grown in mesoporous SiO2 microsphere due to confinement effect and work as photoinitiator to realize photocatalytic polymerization of CLA. The composite material maintain optical performance and have great water resistance.
Structural similarity induced improvement in the performance of organic solar cells based on novel terpolymer donors
Authors: Cheng Yujun , Jin Hui , Oh Jiyeon , Huang Xuexiang , Lv Ruizhi , Huang Bin , Ma Zaifei , Yang Changduk , Chen Lie , Chen Yiwang
Published: March 2021

Similar structural of BDT-SiCl and BDT-2F can minimize the disturbance of the molecular orderly packing caused by random copolymerization, then the terpolymer-based OSCs yielding overall improved device parameters than PM6-based device.
Exponential sampled‐data fuzzy stabilization of nonlinear systems and its application to basic buck converters
Authors: Gunasekaran Nallappan , Zhai Guisheng , Yu Qiang
Published: March 2021

This study focuses on the exponential stability and stabilization of nonlinear systems via fuzzy sampled‐data control technique. The stability and stabilization conditions are obtained through constructing suitable Lyapunov functional which contains the sampling information and the solvable linear matrix inequalities. Then, the dynamics of the nonlinear buck converter system and Lorenz system with the sampled‐data controller is analyzed and designed. Finally, the proposed method is validated with a basic buck converter system model designed to reflect the characteristics of the power metal‐oxide‐semiconductor field‐effect transistors in the numerical section. In addition, the superiority of the sufficient conditions obtained is shown by comparing with the existing methods of the Lorentz system.
A L2‐gain robust PID‐like protocol for time‐varying output formation‐containment of multi‐agent systems with external disturbance and communication delays
Authors: De Tommasi Gianmaria , Lui Dario Giuseppe , Petrillo Alberto , Santini Stefania
Published: March 2021

This paper addresses the time‐varying output formation‐containment control problem for homogeneous high‐order linear Multi‐Agent Systems (MASs). In this context, a PID‐like output‐feedback control strategy is proposed capable to guarantee that all followers reach and maintain a time‐varying formation reference behaviour, as imposed by the multiple leaders, while keeping a prescribed offset with respect to it. Moreover, the proposed approach allows dealing with both communication impairments and external disturbances acting on agents dynamics. The asymptotic stability of the closed‐loop MAS is analytically proved by means of a Lyapunov–Krasovskii approach. Stability conditions are expressed as a feasibility problem with Linear Matrix Inequalities constraints, whose solution provides the proper tuning of the robust PID control gains. Extensive numerical analysis confirms the theoretical framework and discloses the effectiveness of the proposed approach in ensuring the output time‐varying formation‐containment.
Sideslip angle estimation of ground vehicles: a comparative study
Authors: Liu Jizheng , Wang Zhenpo , Zhang Lei , Walker Paul
Published: March 2021

Vehicle sideslip angle is a major indicator of dynamics stability for ground vehicles; but it is immeasurable with commercially‐available sensors. Sideslip angle estimation has been the focus of intensive research in past decades, resulting in a rich library of related literature. This study presents a comprehensive evaluation of state‐of‐the‐art sideslip angle estimation methods, with the primary goal of quantitatively revealing their strengths and limitations. These include kinematics‐, dynamics‐ and neural network‐based estimators. A hardware‐in‐loop system is purposely established to examine their performance under four typical manoeuvres. The results show that the dynamics‐based estimators are suitable at low vehicle velocities when tires operate in the linear region. In contrast, the kinematics‐based methods yield superior estimation performance at high vehicle velocities, and the inclusion of the dual GPS receivers is beneficial even when there is large disturbance to the steering angle. Of utmost importance, it is experimentally manifested that the neural network‐based estimator can perform well in all manoeuvres once the training datasets are properly selected.
A keypoint‐based object detection method with wide dual‐path backbone network and attention modules
Authors: Qu Zhong , Zhang Run , Bao Kang‐hua
Published: March 2021

Keypoint‐based object detection is one of the most efficient and speedy methods at present, yet its performance is often worse than the anchor‐based method. Without prior settings in the keypoint‐based method, the huge search space of the keypoints results in the high recall but low precision. In this paper, the wide dual‐path backbone network is introduced as a feature extractor to extract richer original information, which has fewer parameters and better classification performance. Then, the attention fusion module is designed to effectively fuse the dual‐path with the consideration of the respective advantages of the residual‐path and the densely connected path. In order to provide more accurate pixel‐level information for keypoint prediction, the upsample dual‐attention module is proposed to recover the spatial size of the feature map, which integrates multi‐scale of channel‐wise and spatial attention. Compared with other state‐of‐the‐art detectors, this method has achieved accuracy‐efficiency results with fewer parameters, lower FLOPs, and smaller model size. Experimental results show that the proposed wide dual‐path backbone network has achieved 4.98% top1‐error on the CIFAR‐10 classification dataset. On the PASCAL VOC object detection dataset, this model has achieved an accuracy‐efficiency tradeoff result of 78.3% mAP at the speed of 41 FPS.
Contrast-Enhanced Ultrasound (CEUS) in Non-Traumatic Abdominal Emergencies
Authors: Cozzi Diletta , Agostini Simone , Bertelli Elena , Galluzzo Michele , Papa Emanuela , Scevola Germano , Trinci Margherita , Miele Vittorio
Published: March 2021

Conventional ultrasound imaging (US) is the first-line investigation in acute non-traumatic abdominal emergencies, but sometimes it needs further examinations, such as computed tomography (CT), to reach a certain diagnosis. Contrast-enhanced ultrasound (CEUS), through injection of contrast medium, may provide the radiologist with additional information that could not be investigated with baseline US. It could help reach a diagnosis and rapidly determine the proper therapy in an emergency setting. The purpose of this review is to explain and illustrate the various possibilities and limitations of CEUS in acute non-traumatic abdominal diseases, in particular acute inflammation, parenchymal infarcts, and hemorrhages.
Clinical Awareness and Acceptance of Sonographically Diagnosed Epiploic Appendagitis (EA): A Retrospective Analysis of EA in a Single Tertiary Academic Referral Center
Authors: Safai Zadeh Ehsan , Kindermann Julia , Dietrich Christoph F. , Görg Christian , Bleyl Tobias , Alhyari Amjad , Trenker Corinna
Published: March 2021

Purpose To describe the clinical awareness and acceptance of ultrasound-diagnosed acute epiploic appendagitis (EA) and their importance to avoid unnecessary therapeutic and imaging measures.

Patients and Methods The data were obtained of n=54 patients with acute, localized, peritonitic pain and EA diagnosed by B-mode ultrasound and contrast-enhanced ultrasound examination from November 2003 to September 2020. All examinations were performed by a German Society for Ultrasound in Medicine (DEGUM) Level III qualified examiner. Based on documentation by the treating physicians, the clinical awareness and acceptance of EA diagnosis was determined in all patients and compared between subgroups diagnosed before 2013 and from 2013 onwards. In 2013, a local educational training program regarding the diagnosis of and therapy for EA was initiated for physicians.

Results In all patients, EA was sonographically diagnosed by a DEGUM level III qualified examiner. At enrollment, EA was mentioned as a suspected clinical diagnosis in n=1/54 (1.9%) patient. Furthermore, in n=39/54 (72.2%) cases, the EA was documented and accepted by the treating physicians at the time of patient discharge as the final clinical diagnosis. The clinical acceptance was significantly higher from 2013 onwards compared with before 2013 (p<0.05). Moreover, in n=26/54 (48.1%) patients, unnecessary therapeutic measures were initiated, with no significant difference between pre-2013 and post-2013 numbers (p>0.05).

Conclusion In our retrospective study, we showed that awareness and acceptance of the disease EA are low. Low diagnostic acceptance of EA by the clinician leads to unnecessary therapeutic and imaging measures and is a general problem related to rare diseases in the healthcare system.
Investigating the Mediatory Role of Hope and Shame in the Relationship between Caregiver Burden and Quality of Life of Patients with Cancer
Authors: Shahvand Touraj , Sarafraz Mehdi Reza
Published: March 2021

Objective Patients suffering from cancer need to receive care from their family; however, their family caregivers do this without preparation or training, so their involvement in patients’ care results in a caregiving burden that may affect patient’s hope and quality of life (QOL).

Methods This study examines the effect of caregiving burden on the QOL of cancer patients (n = 100) with the mediatory role of hope and shame. To achieve this, Persian versions of Zarit Burden Interview, the World Health Organization QOL, Herth Hope Index, and Guilt and Shame Proneness Scale were used. Meanwhile, path regression analysis was implemented to analyze the relationship between caregiving burden and QOL.

Results The results implied a relation among caregiver burden, hope, and QOL of patients diagnosed with cancer. It was found that there is a direct and negative relationship between caregiver burden and hope. In addition, there was an indirect and positive relationship between caregiver burden and QOL. Hope and QOL also had a high correlation. Besides, it was shown that there was a negative relationship between the shame experienced by patients and their hope and QOL.

Conclusion caregiver burden was proved to be influential and negatively affected the factor for the QOL. Besides, patients’ hope decreases while caregiving burden increases; this will in turn affect patients’ recovery and their physical, mental, and cognitive functions. This study provides a foundation for future research in this critical area for oncology.
Indications for Preservation Rhinoplasty: Avoiding Complications
Authors: Ferraz Mario Bazanelli Junqueira , Sella Guilherme Constante Preis
Published: March 2021

Nasal dorsal preservation surgery was described more than 100 years ago, but recently has gained prominence. Our objective is to show the surgical technique, the main indications and counterindications, and the complications. It is a technique that does not cause the detachment of the upper lateral cartilage (ULC) from the nasal septum, and has the main following sequence: preparation of the septum and its resection can be at different levels (high or low, i.e., SPAR [septum pyramidal adjustment and repositioning] A or B); preparation of the pyramid; transversal osteotomy; lateral osteotomy(s); and septopyramidal adjustment. The result is a nose with a lower radix than the original, a deprojection of the nasal dorsum tending to maintain its original shape; an increase in the interalar distance (IAD) and enlargement of the nasal middle ⅓; and loss of projection of the nasal tip and roundness of the nostrils. Thus, the ideal candidate is the one who benefits from such side effects, that is: tension nose, that is, high radix with projected dorsum, projected anterior nasal septal angle (ANSA), narrow middle ⅓, narrow IAD, thin nostrils and straight perpendicular plate of the ethmoid (PPE), and, depending on the characteristics, the deviated nose. The counterindications are low radix, irregularities in the nasal dorsum, ANSA lower than rhinion, and a wide middle ⅓. And the main stigmas are: a nose with a very low radix, middle ⅓ enlarged, residual hump, and saddling of the supratip area. Other issues of this technique are: the shape of the radix; the need or not to remove PPE; wide dorsum; irregular dorsum; ANSA lower than rhinion; weak cartilages; long nasal bone; deviated PPE; and obsessive patient. We conclude that this is a great technique for noses with characteristics suitable to it; care must be taken with the stigmas it can cause.
Three-Dimensional Reconstruction of the Sphenoid Sinus Anatomy for Presurgical Planning with Free OSIRIX Software
Authors: Abarca-Olivas Javier , Bärtschi Patrick , Monjas-Cánovas Irene , González-López Pablo , García-Garrigós Elena , Sánchez-Payá Jose , Moreno-López Pedro
Published: March 2021

Background A preoperative three-dimensional (3D) surgical field understanding remains a key factor to achieve safer endonasal transsphenoidal endoscopic approaches (ETSE). The aim of this article is to describe how we can get a reliable 3D sphenoidal anatomical reconstruction for surgical planning by using a user-friendly, accurate, and free image software.

Methods Free computer software (OSIRIX Medical Imaging Software) was used to create in a personal computer a three-dimensional (3D) reconstruction of the sphenoid sinus (SS) based on head computed tomography angiographies (CTAs) from a series of 67 patients who were operated for sellar tumors during a 4-year period (March 2016 to March 2020). The aim of the 3D reconstruction with OSIRIX was to reveal preoperatively the most important intrasphenoidal structures seen from the endonasal point of view.

Results The intraoperative visible sphenoidal structures were previously recognized in the virtual 3D reconstructed image with 100% of specificity (SP) and positive predictive value. The OSIRIX view by using region of interest points allowed us to see preoperatively the internal carotid artery parasellar course even in those cases in which it was hidden by bone or tumor. Moreover, the 3D reconstruction was able to provide a clear differentiation between the tumor and the pituitary gland when both structures were in contact with the sellar floor.

Conclusion Our experience with the OSIRIX software from CTA as preoperative planning for endonasal pituitary surgery was valuable, because it gave us access in simple way to a free and reliable 3D image of the SS.
Force analysis of HTS bulk in a reversed magnetic field
Authors: Hong Wei , Xin Ying , Wang Changqi , Li Wenxin
Published: March 2021

In the study of high temperature superconducting maglev, the analysis of the forces acted on a high temperature superconductor (HTS) bulk is a basic issue, which can directly reflect the levitation and guidance performances of an HTS maglev system. In previous studies, the electromagnetic guideway was verified to be an alternative guideway type for HTS maglev. Recently, we carried out experimental and simulation work to investigate how a field cooled HTS bulk to interact with a reversed magnetic field. An E-type electromagnet is used to generate the required magnetic field. During the field reversing, forces acted on the HTS bulk were measured with a 3D force measuring system. In this paper, the forces on an HTS bulk in a reversed magnetic field are analyzed according to the experimental data and the results of finite element simulation. The magnetized status of a field cooled HTS bulk in a reversed magnetic field is discussed with a two region supposition. The influences of a reversed magnetic field on HTS maglev are summarized. These results may be of great significance not only for further study of HTS maglev, but also for some other applications, such as superconducting magnetic bearing and superconducting magnetic shielding.
Silver Book II: an international framework for urgent care of older people in the first 72 hours from illness or injury
Authors: Hullick Carolyn J , McNamara Rosa , Ellis Brittany
Published: March 2021

The new edition of the Silver Book, Silver Book II, provides a framework for the urgent care of older people in the first 72 hours from illness or injury. It incorporates principles of geriatric medicine, quality improvement (including patient reported outcome measures) and interdisciplinary care in a balanced, practical and evidence-rich manual on unscheduled and emergent care for older adults. Silver Book II shows how frailty, comprehensive geriatric assessment and shared decision-making can be locally adapted according to national practice and policy across the world. The challenge for all providers is adapting our models of care to meet the changing needs of older patients and their caregivers as well as changes in the delivery of medical care in the 21st century.
A simple strategy to monitor the temporal and spatial distribution of alkaloids in sacred lotus leaves
Authors: Liu Jing , Shi Kaifeng , Shi Jia , Feng Yunluan , Hao Chenyang , Peng Jing , Chen Sha
Published: March 2021

Owing to the high degree of diversity of metabolite pools and complexity of spatial and temporal distributions within biological tissues, currently available methods for metabolite characterization face large challenges. In this study, the temporal and spatial distributions of the alkaloid components of the medicinal plant lotus (Nelumbo nucifera) were investigated over various growth phases. The results showed that alkaloid biosynthesis in lotus leaf is regulated by development and that there is maximum accumulation of alkaloids when the lotus leaf was completely expanded. Furthermore, alkaloid content tended to be stable in mature lotus leaves. However, there was significant variation in the alkaloid content of lotus leaves with different genotypes, suggesting that genetic background is an important factor that affects the temporal and spatial distributions of alkaloids in sacred lotus leaves. The dynamic contents of alkaloids during the growth and development of lotus leaves provide insight into basic biological differences when sampling.
Biosyntheses of geranic acid and citronellic acid from monoterpene alcohols by Saccharomyces cerevisiae
Authors: Ohashi Yuka , Huang Shuai , Maeda Isamu
Published: March 2021

Geraniol is one of the important aromatic ingredients in alcoholic beverages. Bioconversions of geraniol to other terpenoids and genes involved in the oxidation of geraniol were investigated. Geranic acid and citronellic acid were detected in yeast culture, where geraniol or nerol was added. Addition of citral, a mixture of geranial and neral, resulted in the production of geranic acid and citronellic acid, whereas the addition of citral or citronellal resulted in the production of citronellic acid, suggesting that citronellic acid might be produced through the conversion of citral to citronellal followed by the oxidation of citronellal. Consumption of geraniol and production of geranic acid, citronellic acid, and citronellol were affected in adh1Δ, adh3Δ, adh4Δ, and sfa1Δ yeast strains, which possess single deletion of a gene encoding alcohol dehydrogenase. This is the first report of the bioconversion of monoterpene alcohols, geraniol and nerol, to geranic acid and citronellic acid in yeast culture.
Venn diagrams in bioinformatics
Authors: Jia Anqiang , Xu Ling , Wang Yi
Published: March 2021

Venn diagrams are widely used tools for graphical depiction of the unions, intersections and distinctions among multiple datasets, and a large number of programs have been developed to generate Venn diagrams for applications in various research areas. However, a comprehensive review comparing these tools has not been previously performed. In this review, we collect Venn diagram generators (i.e. tools for visualizing the relationships of input lists within a Venn diagram) and Venn diagram application tools (i.e. tools for analyzing the relationships between biological data and visualizing them in a Venn diagram) to compare their functional capacity as follows: ability to generate high-quality diagrams; maximum datasets handled by each program; input data formats; output diagram styles and image output formats. We also evaluate the picture beautification parameters of the Venn diagram generators in terms of the graphical layout and briefly describe the functional characteristics of the most popular Venn diagram application tools. Finally, we discuss the challenges in improving Venn diagram application tools and provide a perspective on Venn diagram applications in bioinformatics. Our aim is to assist users in selecting suitable tools for analyzing and visualizing user-defined datasets.
Historical diversification and biogeography of the endemic southern African dung beetle genus, Epirinus (Scarabaeidae: Scarabaeinae)
Authors: Daniel Gimo M , Sole Catherine L , Scholtz Clarke H , Davis Adrian L V
Published: March 2021

The role of the geological uplift and climatic changes during the late Cenozoic on the species diversification of southern African dung beetles is not fully understood. Therefore, we use a divergence-time-estimated phylogeny, macroevolutionary analyses and ecological niche modelling under different climatic scenarios to investigate diversification of the endemic southern African genus, Epirinus. We predict the ancestral range and vegetation type occupied by Epirinus and how late Cenozoic climatic fluctuations and resulting vegetation changes affected speciation and extinction of Epirinus species. Our results suggest that the genus originated in forest with radiation into three geographical centres: (a) north-east escarpment forest and highland grassland; (b) south-east forest; and (c) south-west lowlands to north-east uplands in open vegetation. Reduced speciation rates in the mid-Miocene and increased extinction rates during the drier and cooler Plio-Pleistocene coincide with the replacement of forest by grassland or savanna in southern Africa. The drier climate in southern Africa may have driven extensive contraction of shaded vegetation, forcing an adaptation of forest inhabitants to upland grassland environments, or driving Epirinus species to extinction. Our study supports hypothesis of climatically driven diversification of Epirinus whereas ecological niche modelling across different geological periods suggest that the south-east and, to a lesser extent, the west coast of South Africa as stable areas.
Expanded criteria for pretreatment staging CT in breast cancer
Authors: Roszkowski N , Lam S S , Copson E , Cutress R I , Oeppen R
Published: March 2021

Background

There is wide variation in the approach to staging for distant metastatic disease in breast cancer. This study sought to identify factors predictive of distant metastatic disease at presentation to enable appropriate selection of patients for pretreatment CT.

Methods

Data were collected retrospectively for all patients with newly diagnosed breast cancer (screening and symptomatic) over 3 years (2014–2017). Detailed demographic, pathological, biological, and management data were recorded at presentation, and outcome data were recorded after follow-up. Binomial logistic regression was used to identify variables independently associated with distant metastatic disease at presentation.

Results

A total of 1377 patients with newly diagnosed breast cancer were identified, of whom 1025 had complete data; 323 staging CT examinations were performed. Distant metastases were identified at presentation in 47 (4.6 per cent). Some 30 of 47 patients with metastatic disease met established criteria for staging (T4, recurrence, symptoms of possible distant metastases), leaving 17 patients with metastatic disease potentially missed by use of these criteria alone. Multivariable analysis showed that tumour size at least 3 cm combined with sonographically abnormal axillary lymph nodes predicted a high probability of distant metastatic disease at presentation (positive predictive value 18.8 per cent, odds ratio 4.83, P < 0.001). Addition of this criterion increased the positive CT rate to 17.1 per cent.

Conclusion

Selective pretreatment CT staging can be further optimized with the addition of tumour size at least 3 cm with abnormal axillary nodes to established staging criteria.
SomaticMAP3K3andPIK3CAmutations in sporadic cerebral and spinal cord cavernous malformations
Authors: Hong Tao , Xiao Xiao , Ren Jian , Cui Bing , Zong Yuru , Zou Jian , Kou Zqi , Jiang Nan , Meng Guolu , Zeng Gao , Shan Yongzhi , Wu Hao , Chen Zan , Liang Jiantao , Xiao Xinru , Tang Jie , Wei Yukui , Ye Ming , Sun Liyong , Li Guilin , Hu Peng , Hui Rutai , Zhang Hongqi , Wang Yibo
Published: March 2021

Cavernous malformations affecting the CNS occur in ∼0.16–0.4% of the general population. The majority (85%) of cavernous malformations are in a sporadic form, but the genetic background of sporadic cavernous malformations remains enigmatic. Of the 81 patients, 73 (90.1%) patients were detected carrying somatic missense variants in two genes: MAP3K3 and PIK3CA by whole-exome sequencing. The mutation spectrum correlated with lesion size (P = 0.001), anatomical distribution (P < 0.001), MRI appearance (P = 0.004) and haemorrhage events (P = 0.006). PIK3CA mutation was a significant predictor of overt haemorrhage events (P = 0.003, odds ratio = 11.252, 95% confidence interval = 2.275–55.648). Enrichment of endothelial cell population was associated with a higher fractional abundance of the somatic mutations. Overexpression of the MAP3K3 mutation perturbed angiogenesis of endothelial cell models in vitro and zebrafish embryos in vivo. Distinct transcriptional signatures between different genetic subgroups of sporadic cavernous malformations were identified by single cell RNA sequencing and verified by pathological staining. Significant apoptosis in MAP3K3 mutation carriers and overexpression of GDF15 and SERPINA5 in PIK3CA mutation carriers contributed to their phenotype. We identified activating MAP3K3 and PIK3CA somatic mutations in the majority (90.1%) of sporadic cavernous malformations and PIK3CA mutations could confer a higher risk for overt haemorrhage. Our data provide insights into genomic landscapes, propose a mechanistic explanation and underscore the possibility of a molecular classification for sporadic cavernous malformations.
The Doctor–Patient Relationship: Does Christianity Make a Difference?
Authors: Delaney James J
Published: March 2021

The nature of the doctor–patient relationship is central to the practice of medicine and thus to bioethics. The American Medical Association (in AMA principles of medical ethics, available at: https://www.ama-assn.org/delivering-care/ethics/patient-physician-relationships, 2016) states, “The practice of medicine, and its embodiment in the clinical encounter between a patient and a physician, is fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering.” In this issue of Christian Bioethics, leading scholars consider what relevance (if any) Christianity brings to the relationship between physician and patient: does Christianity make a difference? The contributors consider this question from several different perspectives: the proper model of medicine, the role that the Christian moral tradition can play in medicine in a secular pluralistic society, how a Christian understanding of virtue can inform practices such as perinatal hospice and physician-assisted suicide, and whether or not appeals to Christian values can (or should) ground a physician’s right to conscientious objection.
Solidarity, Trust, and Christian Faith in the Doctor–Patient Relationship
Authors: Tollefsen Christopher , Curlin Farr A
Published: March 2021

In this article, we first give a normative account of the doctor–patient relationship as: oriented to the good of the patient’s health; motivated by a vocational commitment; and characterized by solidarity and trust. We then look at the difference that Christianity can, and we believe, should, make to that relationship, so understood. In doing so, we consolidate and expand upon some claims we have made in a forthcoming book, Ethics and the Healing Profession (Curlin and Tollefsen, 2021).1
Results of the Seventh Scientific Workshop of ECCO: Precision Medicine in IBD—Disease Outcome and Response to Therapy
Authors: Verstockt Bram , Noor Nurulamin M , Marigorta Urko M , Pavlidis Polychronis , Deepak Parakkal , Ungaro Ryan C ,   Scientific Workshop Steering Committee, Fiocchi Claudio , Torres Joana , Scharl Michael
Published: March 2021

Inflammatory bowel diseases [IBD] are a heterogeneous spectrum with two extreme phenotypes, Crohn’s disease [CD] and ulcerative colitis [UC], which both represent numerous phenotypical variations. Hence, we should no longer approach all IBD patients similarly, but rather aim to rethink clinical classifications and modify treatment algorithms to usher in a new era of precision medicine in IBD. This scientific ECCO workshop aims to provide a state-of-the-art overview on prognostic and predictive markers, shed light on key questions in biomarker development, propose best practices in IBD biomarker development [including trial design], and discuss the potential for multi-omic data integration to help drive further advances to make precision medicine a reality in IBD.
New-onset acute rapidly deteriorating case of calciphylaxis after open heart surgery: a case report
Authors: Diasty Mohammad El , Cuenca Jose
Published: March 2021

Background 

Calciphylaxis is a rare life-threatening condition that is characterized by calcification of small blood vessels and soft tissues. This condition is classically described in uraemic patients with end-stage renal failure who are on dialysis or had previous renal transplant. It has also been reported in non-uraemic patients and those who are on warfarin therapy. It is typically associated with high calcium/phosphorus product. Patients classically present with painful skin lesion that evolve into painful ulcers. There are multiple risk factors that were reported to trigger or worsen calciphylaxis. Treatment is a multidisciplinary approach that involves elimination of risk factors, wound management, pain control, and optimization of calcium/phosphorus metabolism. Reported mortality rates are very high especially in the uraemic group.

Case summary 

Here we present a case of a patient, who is on chronic renal dialysis for stage renal failure, who underwent mechanical mitral valve replacement and tricuspid valve repair. In the perioperative period, she was exposed to multiple risk factors that are known to potentially trigger prophylaxis. In the early postoperative period, she developed new-onset rapidly deteriorating skin lesions and the histopathological diagnosis confirmed calciphylaxis. Her treatment plan included pain control, frequent wound care, and optimization of nutritional and metabolic status.

Discussion 

Calciphylaxis is a very serious condition that is usually associated with poor outcome. In this case, we discuss the unusual presentation of this condition with particular emphasis on the multiple perioperative risk factors that can potentially trigger the onset of calciphylaxis in postoperative cardiac patients. We also discuss the epidemiology, pathogenesis, diagnosis, histopathological findings, and different lines of treatment of this serious condition and the potential preventative strategies.
A case report about successful treatment of refractory ventricular tachycardia with ablation under prolonged haemodynamic support with extracorporeal membrane oxygenation
Authors: Najjar Emil , Dalén Magnus , Schwieler Jonas , Lund Lars H
Published: March 2021

Background

In patients with severe left ventricular dysfunction, recurrent ventricular tachycardia (VT) non-responsive to antiarrhythmic therapies may cause further deterioration of cardiac function and haemodynamic instability. The use of extracorporeal membrane oxygenation (ECMO) in the setting of haemodynamically unstable VT may allow rhythm stabilization and can be effective in providing haemodynamic stability during VT ablation procedures.

Case summary

We describe the clinical course of a patient with ischaemic cardiomyopathy and recurrent VTs in the early post-myocardial infarction (MI) period. Nineteen days after MI, the patient started to experience recurrent attacks of VT, which became more frequent and non-responsive to medical treatment including amiodarone and lidocaine. The patient developed cardiogenic shock and a decision was made to institute ECMO. The patient was supported with ECMO for 32 days because of heart failure, refractory VT, and recurrent infections. An electrophysiological study was performed 4 days after ECMO initiation, which revealed a large scar area in the left ventricle. Radiofrequency energy was applied 69 times, rendering the VT non-inducible. Subsequently, VT attacks disappeared and the patient was weaned from ECMO after 32 days. The patient received a left ventricular assist device 5 days post-ECMO weaning and was then transplanted.

Discussion

There is still no evidence or guidelines regarding patients with refractory VT; however, ECMO support has been successfully used during VT ablation procedures. In this case report, VT ablation had a crucial role in treating the culprit arrhythmia while the implementation of ECMO allowed a complex ablation procedure to be completed safely.
The relationship between three-dimensional craniofacial and upper airway anatomical variables and severity of obstructive sleep apnoea in adults
Authors: Wang Xiaoya , Chen Hui , Jia Lu , Xu Xin , Guo Jing
Published: March 2021

Objective

The aim of this study was to evaluate the relationship between three-dimensional craniofacial and upper airway anatomical variables and severity of obstructive sleep apnoea (OSA) using cone beam computed tomography (CBCT).

Methods

This was a prospective observational study, consisted of 95 adult OSA whose polysomnography and CBCT were available. Three-dimensional craniofacial and upper airway anatomical analysis were performed using 12 CBCT variables, including sagittal and vertical jaw relationships, maxillary width, the volume, length and minimum axial area of upper airway. The severity of OSA was evaluated through the apnea-hypopnea index (AHI). A hierarchical regression was performed to analyze the relationship between OSA severity and craniofacial and upper airway anatomical variables after controlling patients’ demographic characteristics (gender, age, and BMI).

Results

After controlling patients’ gender, age, and BMI, individual CBCT variables including MAA, V-RPA, L-RPA and Go-Me were related to AHI. The final hierarchical regression model with demographic variables in Step 1 and CBCT variables (MAA, L-RPA and Go-Me) in Step 2 indicated that CBCT variables added additional explanatory power for AHI (ΔF(3,88) = 5.176, P = 0.002). Among these variables, L-RPA and Go-Me were statistically significant (P < 0.05).

Limitation

The OSA severity was expressed by AHI alone.

Conclusions

Three-dimensional craniofacial and upper airway morphology played an essential role in OSA severity. The most relevant anatomical characteristic with OSA severity were the length of retropalatal airway and mandibular body, which could be used to recognize severe OSA patients and as estimators for selecting the most appropriate treatment modality for OSA patients.
Psychosocio-economic impacts of COVID-19 on gastroenterology and endoscopy practice
Authors: Shen Jing-Jing
Published: March 2021

Beyond posing a major health crisis, the COVID-19 pandemic has inflicted profound psychological, social, and economic impacts on populations worldwide. Mass quarantines and social isolation have affected the mental health of the wider population, exacerbating other stressors, including fear of the virus and its repercussions, general uncertainty, and financial insecurity. The pandemic has challenged the broader delivery of healthcare––ranging from the need to triage limited hospital resources to balancing risk mitigation with maintaining medical care. Specific to gastroenterology, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not only been associated with complicating extant medical conditions of the gastrointestinal (GI) tract, but has also forced a shift in the practice of gastroenterology by patients, families, and healthcare providers alike. The gastroenterology field has been required to adapt its practices to minimize the possibility of viral spread while still upholding patient care. Healthcare practitioners in GI have helped to treat COVID-19 patients, stratified inpatient and outpatient visits and procedures, and shifted to telemedicine. Still, as is the case with much of the general population, healthcare providers working in GI practice or endoscopy have faced personal and professional stressors, mental health difficulties, social isolation, financial pressures, and familial burdens––all of which can take a toll on practitioners and, by extension, the provision of GI care overall. This article will highlight how the COVID-19 pandemic has affected the psychological wellbeing, social engagement, and economic conditions of the public, healthcare providers, and GI professionals specifically. Recommendations for strategies that can continue GI services while maintaining safety for both caregivers and patients are put forth to help uphold critical GI care during this worldwide crisis.
Association Between Music Engagement and Episodic Memory Among Middle-Aged and Older Adults: A National Cross-Sectional Analysis
Authors: Rouse Hillary J , Jin Ying , Hueluer Gizem , Huo Meng , Bugos Jennifer A , Veal Britney , Torres Mia , Peterson Lindsay , Dobbs Debra , Meng Hongdao
Published: March 2021

Objectives

To determine whether music engagement influences middle-aged and older adults’ performance on episodic memory tasks.

Method

Secondary data analysis of a sample (N = 4,592) of cognitively healthy adults from the 2016 Health and Retirement Study was used for this study. Multivariable regression models were used to analyze the cross-sectional differences in performance on tasks of episodic memory between participants who listened to music (n = 3,659) or sang or played an instrument (n = 989).

Results

On average, participants recalled 10.3 words out of a possible 20. Regression analyses showed that both listening to music and singing or playing an instrument were independently associated with significantly better episodic memory.

Discussion

The findings provide the first population-based evidence that music engagement is associated with better episodic memory among middle-aged and older adults. Future studies should examine whether the relationship between music engagement and episodic memory can be replicated in other populations and that the association persists in longitudinal studies.
The heart of the maritime world: London’s ‘mercantile’ coffee houses in the Seven Years’ War and the American War of Independence, 1756–83
Authors: Brinkman-Schwartz Anna
Published: March 2021

This article focuses on the role of mercantile coffee houses during the Seven Years’ War and the American War of Independence. The purpose is to examine mercantile coffee houses as public and private spaces, and to examine why people chose them as spaces in which to conduct business. The article examines how London’s mercantile coffee houses enabled the maritime population to understand, and remain informed about, maritime affairs during both wars. This includes how their presence facilitated the co-ordination of transoceanic trade, how their existence concentrated people in one place, and how they helped facilitate maritime and naval logistics.
The People's Paving Stones: The Material Politics of International Human Rights in the Baldosas por la Memoria of Buenos Aires
Authors: Carver Terrell , Amat Dolores , Ravecca Paulo
Published: March 2021

Baldosas por la memoria are memorial paving stones handcrafted by loosely networked activists. Produced continuously from 2006 to an informally established protocol, they memorialize “the disappeared” and others murdered by the state terrorism of the Argentinian dictatorship (1976–1983). As a synecdoche of the “down and dirty” everyday pavements, they function as a metonym for democratic struggle and popular sovereignty. Aesthetically, they work against the “forgetting” and kitschification to which conventional memorials become subject. Through remediation into books and a DVD documentary, they participate in controversies within the international politics of human rights. Using a “material turn” within visual analysis, yet distinct from the “new materialism,” this article explains how they function within familiar genres of memorialization but in wholly novel ways. Baldosas create ethical complexity and moral ambiguity by troubling collective memory. Thus, we examine their relation to guilt, complicity, trauma, and affect.
Regulatory Contestation: Steering toward Consistency in International Norm Implementation
Authors: Jacob Cecilia
Published: March 2021

Over the past three decades, there has been a notable expansion in the number and remit of global norms of human protection, informing the rationale and reform of international law and institutions in significant ways. Yet, the inconsistent and selective implementation of these norms undermines their legitimacy and strength. Drawing on interviews with United Nations (UN) officials, diplomats, non-governmental organizations, and experts, this article examines the challenge of strengthening consistency in the implementation of international human protection norms. It argues that diversity in practice is a strength for their consistent implementation when understood through a broader account of the regulatory function of international norms. Dominant accounts of the regulatory function of international norms in international law (compliance) and international relations (internalization) seek consistency of norm implementation through mechanisms such as legal/institutional reform and socialization, respectively. These accounts, I argue, are strengthened by a socio-legal approach to responsive regulation that pays attention to the way that norms operate “in reality” to regulate actor behavior, identifying the generative and creative function of international norms in steering the flow of events toward desired outcomes. It then examines efforts to extend human protection norms into new territory and toward improved preventive capacity with an increased emphasis on accountability through the UN Human Rights Council. This article introduces the concept of regulatory contestation that extends analytical attention to the governance processes through which norms shape international politics and practice.
Engineering Bacillus subtilis ATCC 6051a for the production of recombinant catalases
Authors: Ji Minghua , Liu Yunhui , Wu Haiying , Li Sijie , Duan Haiyan , Shi Jiping , Sun Junsong
Published: March 2021

Catalases are a large group of enzymes that decompose hydrogen peroxide to oxygen and hydrogen, and have been applied widely in numerous areas. Bacillus subtilis ATCC 6051a is a well-known host strain for high level secretion of heterologous peptides. However, the application of 6051a was seriously hampered by insufficient transformation efficiency. In this study, D-xylose inducible comK was integrated into the genome of B. subtilis ATCC 6051a, generating 164S, a mutant owns a transformation efficiency of 1 000-fold higher than its parent strain, thus allowing gene replacement by double crossover recombination using linear dsDNAs. The efficiency of the flanking arms for homologous recombination was then analyzed. We found that 400 bp was the minimal length of homologous fragments required to initiate efficient recombination in the 164S strain. In addition, DNA cassettes encoding two mesophilic catalases (Orf 2-62 and Orf 2-63) from B. licheniformis were integrated onto 164S. The catalytic properties of recombinant Orf 2-62 and Orf 2-63 were analyzed, and were found to be predominantly secreted into the fermentation broth, although they obviously lack any known secretory signal peptide. This work demonstrated that B. subtilis 164S is an excellent cell tool, not only for its superior secretion capacity, but also for its convenience in genetic modification.