bluuebunny/crossref_metadata_2025 huggingface dataset:
Natural abundance of 13C and 15N provides evidence for plant–soil carbon and nitrogen dynamics in a N‐fertilized meadow
Authors: Wang Ruzhen , Peñuelas Josep , Li Tian , Liu Heyong , Wu Hui , Zhang Yuge , Sardans Jordi , Jiang Yong
Published: March 2021

Natural abundance of carbon (C) and nitrogen (N) stable isotope ratios (δ13C and δ15N) has been used to indicate ecosystem C and N status and cycling; however, use of this approach to infer plant and microbial N preference under projected ecosystem N enrichment is limited. Here, we investigated natural abundance δ13C and δ15N of five dominant plant species, and soil δ15N of microbial biomass and available N forms under N addition in a meadow steppe. Additional N, applied as urea, led to decreases in δ15N of soil NO3− (δ15Nnitrate, from 3.0 to 0.4‰) and increases in δ15N of soil (δ15Nammonium, from −1.3 to 11‰) and dissolved organic N (δ15NDON, from 8.5 to 15‰) that reflected increased net nitrification rates, a possible increase in NH3 volatilization, and greater availability of the three N forms. An overall increase in δ15N of soil total N (δ15NTN) from 7.1 to 7.9‰ indicated accelerated and greater openness of soil N cycling that was also partially revealed by enhanced net N mineralization rates. Plant δ15N, which ranged from −1.8 to 2.1‰, generally decreased with N addition, indicating a greater reliance on soil NO3− under N‐enrichment conditions. Nitrogen addition decreased δ15N of microbial biomass N (from 14 to 2.8‰), possibly because of a shift in preferential N form (DON to ), that indicated a convergence of plant and microbial preferential N forms and an increase in plant–microbial N competition. Microbes were thus more flexible than plants in the use of different forms of N. Addition of N decreased plant litter δ13C, whereas plant species δ13C remained unaffected, likely because of a shift in the abundance of dominant species with a greater proportion of biomass coming from δ13C‐depleted species. Enrichment factor (the difference in plant δ15N relative to δ15NTN) of four nonlegume species was negatively related to soil inorganic N availability, net nitrification rate, and net N mineralization rate, and was proven to be a good indicator of ecosystem N status. Our study highlights the importance of natural abundance of 15N as an indicator of plant–microbial N competition and ecosystem N cycling in meadow steppe grasslands under projected ecosystem N enrichment.
Palliative key aspects are of importance for symptom relief during the last week of life in patients with heart failure
Authors: Årestedt Kristofer , Brännström Margareta , Evangelista Lorraine S. , Strömberg Anna , Alvariza Anette
Published: March 2021

Aims

This study aimed to describe symptom prevalence of pain, shortness of breath, anxiety, and nausea and to identify factors associated with symptom relief in patients with heart failure during their last week of life.

Methods and results

This nationwide study used data from the Swedish Register of Palliative Care and the Swedish Causes of Death Certificate Register. The sample included 4215 patients with heart failure as the underlying cause of death. Descriptive statistics and logistic regression were used to analyse data. Pain was the most prevalent symptom (64.0%), followed by anxiety (45.1%), shortness of breath (28.8%), and nausea (11.4%). Pain was the most often totally relieved (77.5%), followed by anxiety (68.4%), nausea (54.7%), and shortness of breath (37.1%). Key aspects of palliative care such as documented palliative care in the patient record, individual medication prescriptions by injection, symptom assessment with validated scales, documented end‐of‐life discussions with patients and/or family members, and external consultation were significantly associated with symptom relief. Relief of pain, shortness of breath, anxiety, and nausea were significantly better managed in nursing homes and hospice/inpatient palliative care compared with care in hospitals.

Conclusions

The results show that key aspects of palliative care during the last week of life are significantly associated with symptom relief. Increased access to palliative care could provide a way to improve care during the last week of life for patients with heart failure. Home‐based settings provided more symptom relief than hospitals, which may indicate that the latter focuses on treatments and saving lives rather than promoting life before death.
The G protein‐coupled receptor 15 (GPR15) regulates cutaneous immunology by maintaining dendritic epidermal T cells and regulating the skin microbiome
Authors: Sezin Tanya , Jegodzinski Lina , Meyne Lisa‐Maria , Gupta Yask , Mousavi Sadegh , Ludwig Ralf J. , Zillikens Detlef , Sadik Christian D.
Published: March 2021

The G protein‐coupled receptor 15 (GPR15) regulates homing of different T‐cell populations into the gut, thus, preserving tissue homeostasis. Its potential role in the preservation of homeostasis on other body interfaces, including the skin, is less well understood. We addressed the impact of GPR15 on cutaneous T‐cell populations and the skin microbiome under steady‐state conditions. Genetic deficiency in GPR15 substantially altered the composition of skin‐resident T‐cell populations. Precisely, dendritic epidermal T cells were almost absent in the epidermis of Gpr15–/– mice. The niche of dendritic epidermal T cells in the epidermis was, instead, populated by αβ TCR+ T cells. These changes were associated with shifts in the skin microbiota in Gpr15–/– mice. Collectively, our results uncover a role of GPR15 in the regulation of the cutaneous immune system and, thus, highlight the receptor as important general regulator of tissue homeostasis of exterior body interfaces.
Cognitive load and the effectiveness of distraction for acute pain in children
Authors: Gaultney Wendy M. , Dahlquist Lynnda M. , Quiton Raimi L.
Published: March 2021

Background

Distraction tasks that place continuous, high demand on executive resources have been shown to reduce pain intensity and pain unpleasantness ratings in some healthy adult samples. We examined the effects of a high‐demand ‘working memory’ 1‐back task compared to a low‐demand ‘motor control’ task on pain intensity and unpleasantness ratings in healthy children. Additionally, dispositional mindfulness was examined to explore the mechanisms of distraction on the affective processing of pain.

Methods

Fifty‐seven children (9–13 years old) experienced three randomly presented heat levels (not painful, slightly painful, moderately painful) during two distraction conditions involving different levels of cognitive load (a high load ‘working memory’ task and a low load ‘motor’ control task) in counter‐balanced order. Children completed measures of dispositional mindfulness, and attentional control and emotional control.

Results

As predicted, children's pain intensity and pain unpleasantness ratings were lower in the high load condition compared to the low load condition. These differences were amplified in the moderately painful heat trials. In contrast with predictions, dispositional mindfulness did not significantly predict the effectiveness of distraction. Dispositional mindfulness was significantly related to measures of children's attentional and emotional control abilities; however, an exploratory serial mediation model did not produce significant indirect or overall effects to suggest a strong influence of mindfulness on the effectiveness of distraction.

Conclusions

Results demonstrate that distraction that places higher demand on executive resources is more effective for acute pain management for children. Further research is needed to explore cognitive and affective moderators of the effectiveness of distraction for children.

Significance

This study is one of the first to demonstrate that working‐memory engagement can attenuate pain intensity and pain unpleasantness in children aged 9–13. The findings suggest that distraction tasks used in clinical settings for moderately painful medical procedures may benefit more children if they are adequately demanding of cognitive resources.
Proteomic Profiling of Hepatocellular Adenomas Paves the Way to Diagnostic and Prognostic Approaches
Authors: Dourthe Cyril , Julien Céline , Di Tommaso Sylvaine , Dupuy Jean‐William , Dugot‐Senant Nathalie , Brochard Alexandre , Le Bail Brigitte , Blanc Jean‐Frédéric , Chiche Laurence , Balabaud Charles , Bioulac‐Sage Paulette , Saltel Frédéric , Raymond Anne‐Aurélie
Published: March 2021

Background and Aims

Through an exploratory proteomic approach based on typical hepatocellular adenomas (HCAs), we previously identified a diagnostic biomarker for a distinctive subtype of HCA with high risk of bleeding, already validated on a multicenter cohort. We hypothesized that the whole protein expression deregulation profile could deliver much more informative data for tumor characterization. Therefore, we pursued our analysis with the characterization of HCA proteomic profiles, evaluating their correspondence with the established genotype/phenotype classification and assessing whether they could provide added diagnosis and prognosis values.

Approach and Results

From a collection of 260 cases, we selected 52 typical cases of all different subgroups on which we built a reference HCA proteomics database. Combining laser microdissection and mass‐spectrometry–based proteomic analysis, we compared the relative protein abundances between tumoral (T) and nontumoral (NT) liver tissues from each patient and we defined a specific proteomic profile of each of the HCA subgroups. Next, we built a matching algorithm comparing the proteomic profile extracted from a patient with our reference HCA database. Proteomic profiles allowed HCA classification and made diagnosis possible, even for complex cases with immunohistological or genomic analysis that did not lead to a formal conclusion. Despite a well‐established pathomolecular classification, clinical practices have not substantially changed and the HCA management link to the assessment of the malignant transformation risk remains delicate for many surgeons. That is why we also identified and validated a proteomic profile that would directly evaluate malignant transformation risk regardless of HCA subtype.

Conclusions

This work proposes a proteomic‐based machine learning tool, operational on fixed biopsies, that can improve diagnosis and prognosis and therefore patient management for HCAs.
Interactions between hybrid nanosized particles and convection melting inside an enclosure with partially active walls: 2D lattice Boltzmann‐based numerical investigation
Authors: Shojaeefard Mohammad Hassan , Jourabian Mahmoud , Rabienataj Darzi Ahmad Ali
Published: March 2021

The ice melting is investigated inside a square cavity with two isothermally partially active walls. The concept of dispersing hybrid alumina–Cu nanoparticles and hybrid silica–multiwalled carbon nanotubes (MWCNTs) nanoparticles is recommended for thermal performance enhancement in this thermal energy storage (TES) system. The two‐dimensional explicit lattice Boltzmann convection melting scheme in the single‐phase model is applied to account for the natural convection flow induced in the melt region and evolution of the solid–liquid interface. The complete melting time for the pure phase change material (PCM) using case (II) is 33.3% lower compared with other cases. If the price of hybrid Al2O3–Cu nanoparticles and heat storage capacity is important, the full melt time diminishes by 16.6% with a volume fraction of 0.01 in case (II). Once hybrid silica–MWCNT nanoparticles with a volume fraction of 0.01 are utilized inside case (II), the lowest charging time is achieved. The complete melting time abates by 23.66% in contrast to the pure PCM melting. The use of single/hybrid nanoparticles to enhance the PCM melting is not necessarily economical as efficient positions of active parts could further lessen the charging time. The efficiency of hybrid nanoparticles is linked to the type and weight proportions of nanoparticles, and positions of thermally active parts.
Genome‐wide estrogen receptor β chromatin binding in human colon cancer cells reveals its tumor suppressor activity
Authors: Indukuri Rajitha , Jafferali Mohammed Hakim , Song Dandan , Damdimopoulos Anastasios , Hases Linnea , Zhao Chunyan , Archer Amena , Williams Cecilia
Published: March 2021

Colorectal cancer (CRC) is the third leading cause of cancer death in the western world. In women, menopausal hormone therapy has been shown to reduce CRC incidence by 20%. Studies demonstrate that estrogen activating estrogen receptor beta (ERβ) protects against CRC. ERβ is a nuclear receptor that regulates gene expression through interactions with the chromatin. This molecular mechanism is, however, not well characterized in colon. Here, we present for the first time, the cistrome of ERβ in different colon cancer cell lines. We use cell lines engineered to express ERβ, optimize and validate an ERβ antibody for chromatin‐immunoprecipitation (ChIP), and perform ChIP‐Seq. We identify key binding motifs, including ERE, AP‐1, and TCF sites, and we determine enrichment of binding to cis‐regulatory chromatin sites of genes involved in tumor development, cell migration, cell adhesion, apoptosis, and Wnt signaling pathways. We compare the corresponding cistromes of colon and breast cancer and find that they are conserved for about a third of genes, including GREB1, but that ERβ tethering to TCF and KLF family motifs is characteristic for colon. We exemplify upregulation of putative CRC tumor suppressor gene CST5 where ERβ in colon cells binds to cis‐regulatory regions nearby (−351 bp) the transcriptional start site. Our work provides a foundation for understanding the mechanism of action of ERβ in CRC prevention.
Exploring the value of cesarean section diverticulum area to predict the safety of hysteroscopic management for cesarean scar pregnancy patients
Authors: Du Qinghua , Zhao Wancheng
Published: March 2021

Objective

To study indicators predicting the safety of hysteroscopic management for cesarean scar pregnancy (CSP) patients.

Methods

This was a retrospective study, starting from June 1, 2020. The study included 141 CSP patients who underwent hysteroscopic surgery and met the requirements of gestational age ≤12 weeks, stable vital signs, and preoperative magnetic resonance imaging. Patients were divided into control group and testing group according to surgical outcomes. Preoperative indicators were compared between the two groups, including a novel indicator, cesarean section diverticulum (CSD) area.

Results

Univariate analysis identified five statistically significant (P < 0.05) factors associated with hysteroscopy failure including a large CSD area. Multifactor logistic regression analysis showed that the only statistically significant indicator of all five factors was the CSD area. The area under the receiver operating characteristics curve of CSD area was 0.848. Next, we determined three cut‐off values for CSD area that can be used to predict the outcome of surgery: 138, 189, and 300 mm2.

Conclusion

For the first time, we found that CSD area could predict the safety of hysteroscopic management for CSP patients and might be helpful for clinical decision making. The findings need to be verified by further research.
Surgical management of pelvic organ prolapse in a high‐volume resource‐limited setting
Authors: Ntakwinja Mukanire , Borazjani Ali , Vodusek Ziga , Tambwe Albert Mwembo , Mukwege Denis
Published: March 2021

Objective

To describe the care pathway of patients with pelvic organ prolapse in a high‐volume resource‐limited setting and characterize patients undergoing surgery.

Methods

The patient care pathway at a large referral hospital in eastern Democratic Republic of Congo was determined through interviews with key personnel. Patients with apical prolapse (with or without anterior/posterior prolapse) who underwent surgery between January and December 2018 were included. Demographics and outcomes were characterized. Data were presented as means (standard deviation [SD]), medians (interquartile range), or number (percentages).

Results

A holistic care model was described. During the study period, 772 patients underwent prolapse repairs, 235 met inclusion criteria. Mean age was 55 (±14) years, and 75% (176/235) were postmenopausal. Median parity was 7 (5–9). A majority (56%, 131/233) had body mass index <18.5 (calculated as weight in kilograms divided by the square of height in meters). Most were farmers (77%, 182/235) and had no formal education (76%, 178/235). Postmenopausal patients underwent hysterectomy, whereas premenopausal patients were treated with uterine‐preserving techniques. Most repairs were performed vaginally (96%, 225/235), and 40% (94/234) had concurrent multicompartment repairs. Most common complications were hemorrhage (4%, 9/235, intraoperative) and urinary tract infection (5%, 11/235, postoperative).

Conclusion

High‐volume surgical services for treating prolapse can be integrated into existing healthcare delivery models. Our demographic of patients differs from studies in high‐income countries. The degree to which these studies can be generalized to patients in settings similar to ours represents an opportunity for further research.
Maternal sleep duration and neonate birth weight: A population‐based cohort study
Authors: Marinelli Marcella , Carsin Anne‐Elie , Turner Michelle C , Fernández‐Somoano Ana , Rodriguez‐Dehli Ana Cristina , Basterrechea Mikel , Santa‐Marina Loreto , Iñiguez Carmen , Lopez‐Espinosa Maria‐Jose , Sunyer Jordi , Julvez Jordi
Published: March 2021

Objective

To investigate the association between maternal sleep duration (an important health indicator) and neonate birth weight.

Methods

The study included 2536 mother‐neonate pairs of a Spanish birth cohort (2004–2006, INMA project). The exposures were questionnaire‐based measures of sleep duration before and during pregnancy. The primary outcome was neonate birth weight score (g) standardized to 40 weeks of gestation.

Results

In women sleeping for <7 h/day before pregnancy, each additional hour of sleep increased birth weight score by 44.7 g (P = 0.049) in the minimally adjusted model, although findings were not statistically significant after considering other potential confounders (P > 0.05). However, increasing sleep duration for the group of mothers who slept for more than 9 h/day decreased birth weight score by 39.2 g per additional hour (P = 0.001). Findings were similar after adjusting for several sociodemographic confounders and maternal depression‐anxiety clinical history as an intermediate factor. Similar but attenuated associations were observed with sleep duration in the second trimester of pregnancy.

Conclusion

The relationship between maternal sleep duration before and during pregnancy and neonate birth weight is an inverse U‐shaped curve. Excessive sleep duration may adversely affect neonate health through its impact on birth weight.
Optimization of extracellular matrix production from human induced pluripotent stem cell‐derived fibroblasts for scaffold fabrication for application in wound healing
Authors: Marinkovic Milica , Sridharan Rukmani , Santarella Francesco , Smith Avi , Garlick Jonathan A. , Kearney Cathal J.
Published: March 2021

Extracellular matrix is a key component of all tissues, including skin and it plays a crucial role in the complex events of wound healing. These events are impaired in chronic wounds, with chronic inflammation and infection often present in these non‐healing wounds. Many tissue engineering approaches for wound healing provide a scaffold to mimic the native matrix. Fibroblasts derived from iPS cells (iPSF) represent a novel source of matrix rich in pro‐regenerative components, which can be used for scaffold fabrication to improve wound healing. However, in vitro production of matrix by cells for scaffold fabrication requires long cell culturing times which increases cost. The aim of this work is to optimize the iPSF matrix production by boosting matrix deposition, without affecting its composition. A good candidate technique to achieve this goal is macromolecular crowding, which is known to promote conversion of procollagen into mature collagen and its accumulation. We tested two molecular crowders, Ficoll and Carrageenan—in combination with ascorbic acid—over a prolonged period of time. Ficoll in combination with ascorbic acid notably increased collagen deposition and matrix dry weight compared to ascorbic acid alone, and did not affect matrix composition as measured by RT‐PCR. Interestingly, Carrageenan did not affect collagen quantity, but it significantly increased glycosaminoglycan deposition. Finally, we successfully fabricated scaffolds from harvested matrix and confirmed their ability for cell growth and viability. This work lays the foundation for development of a time and cost effective protocol for novel iPSF ECM production for tissue engineering scaffolds.
Antiosteoporosis effect of geraniin on ovariectomy‐induced osteoporosis in experimental rats
Authors: Wang Xiuhui , Wang Minghui , Cui Xu , Li Zhuokai , Guo Shengyang , Gao Feng , Ma Ming , Wang Zhe
Published: March 2021

Osteoporosis is a skeletal condition that is characterized by decreasing bone density and deteriorating bone mass. The plant‐based phytoconstituent such as geraniin possesses better therapeutic potentials in biomedical field. In the current experimental study, we planned to scrutinize the therapeutic potential of geraniin against ovariectomy (OVX)‐induced osteoporosis in rats and find the possible mechanism. Healthy Sprague Dawley rats were randomized into six groups and subjected to geraniin and alendronate (ALN) treatment for 10 weeks. Body weight, uterus, femur weight, bone biochemical, bone turnover markers, inflammatory cytokine, calcium, phosphorus, vitamin D (Vit D), urine, hormones, and antioxidant level were estimated. Geraniin significantly (p < .001) reduced the level of bone turnover markers including beta‐CrossLaps (β‐CTx), ALN, osteocalcin (OC), alkaline phosphatase (ALP), and bone Gla protein (BGP); reduced the biomechanical parameters including maximum load, energy, stiffness, maximum stress, and Young's modulus; reduced the level of calcium (Ca) and phosphorus (P); and increased the level of vitamin D (Vit D) as compared with OVX‐induced osteoporosis rats. Geraniin increased the level of bone structure parameters, namely bone mineral density, bone mineral content, tissue mineral density, bone volume fraction, and trabecular number; increased the level of osteoprotegerin (OPG) and OPG/RANKL; and reduced the level of receptor activator of nuclear factor kappa‐Β ligand (RANKL). Geraniin significantly (p < .001) increased the level of glutathione (GSH) and reduced the level of malonaldehyde (MDA) in the liver, intestine, and bone of OVX‐induced osteoporosis rats. Geraniin significantly (p < .001) decreased the level of tumor necrosis factor‐α (TNF‐α), interleukin‐1β (IL‐1β), and interleukin‐6 (IL‐6) pro‐inflammatory cytokines. We also argue that geraniin could be an excellent candidate to treat and control bone‐related disease or disorders.
Exploring racial and ethnic minority individuals’ journey to becoming genetic counselors: Mapping paths to diversifying the genetic counseling profession
Authors: Alvarado‐Wing Tatiana E. , Marshall Jennifer , Best Alicia , Gomez Joanne , Cragun Deborah
Published: March 2021

Reasons for limited ethnic and racial diversity among genetic counselors in the United States may be elucidated through better understanding the experiences of individuals from racial/ethnic minority backgrounds who are enrolled in genetic counseling graduate programs as well as recent graduates. Semi‐structured interviews were conducted with racial/ethnic minority participants using Journey Mapping to elicit touchpoints that positively or negatively impact success at varying points along the path to becoming genetic counselors. Negative impacts observed at various touchpoints included the following: late awareness of the profession; observing lack of diversity in the field; financial burden of the application process; and microaggressions from peers, program leadership, and clinical supervisors. Positive impacts observed at various touchpoints included the following: group or personal mentors; opportunities to interact with practicing genetic counselors; opportunities to perform ‘mock’ admissions interviews; program interviews with a conversational interview style; and attending programs in cities with racially/ethnically diverse patient populations. Findings from this research suggest the lack of adequate infrastructure necessary to recruit and support racial/ethnic minority students is a critical systemic issue impeding progress toward diversifying the genetic counseling field. As such, this study reinforces the need for development, adaptation, and implementation of evidence‐based strategies to optimize experiences of racial and ethnic minority individuals throughout the entire process of becoming a genetic counselor.
Epidemiology of Chikungunya virus isolates 2016–2018 in Pakistan
Authors: Badar Nazish , Ikram Aamer , Salman Muhammad , Alam Muhammad Masroor , Umair Massab , Arshad Yasir , Mushtaq Nighat , Mirza Hamza Ahmad , Ahad Abdul , Yasin Muhammad Talha , Qazi Javaria
Published: March 2021

The chikungunya virus (CHIKV) is a mosquito‐transmitted alphavirus, which has infected millions of people in Africa, Asia, Americas, and Europe since it remerged in India and Indian Ocean regions in 2005–2006. The purpose of this study was to evaluate the genetic diversity and evolutionary changes in CHIKV from 2016 to 2018 in Pakistan. Blood specimens were collected and processed following the Centers for Disease Control and Prevention Trioplex Protocol. Sequencing and phylogenetic analysis of complete coding sequence of representative isolates from the CHIKV outbreak was carried out during December 2016 to July 2018, a total of 1549 samples were received, out of which 50% (n = 774) were found positive for CHIKV RNA. Mean age of chikungunya positive patients was 31.8 ± 15.7 years and most affected were between 21 and 40 years of age. The Pakistan CHIKV strains clustered with the Indian Ocean sublineage of East/Central/South African with cocirculation of some variants In the structural proteins region, two noteworthy changes (A226V and D284E) were observed in the membrane fusion glycoprotein E1. Key substitutions in the neutralizing epitopes site and a few changes indicative of adaptive to other insect cells were also detected in Pakistani strains. This study provides the emerging trend of CHIKV in the country for early identification of potential variants of high virulence and preventive measures for vector borne disease especially in the endemic areas.
Regional downscaled future change of clear‐air turbulence over East Asia under RCP8.5 scenario within the CORDEX‐EA‐II project
Authors: Hu Boyan , Tang Jianping , Ding Jinfeng , Liu Gang
Published: March 2021

Driven by four global coupled atmosphere–ocean models (GCMs) from the Coupled Model Intercomparison Project Phase 5 (CMIP5) ensemble (CNRM‐CM5, GFDL‐ESM2M, EC‐EARTH, and MPI‐ESM‐LR), future changes (2040–2059) of clear‐air turbulence (CAT) in winter over East Asia under Representative Concentration Pathway 8.5 (RCP8.5) scenario are projected with the regional climate model (RCM) RegCM4 and 18 CAT diagnostics based on the second phase of Coordinated Regional Downscaling Experiment East Asia (CORDEX‐EA‐II) framework. Evaluation of RegCM4 with ERA‐Interim shows that RegCM4 and diagnostics can well reproduce the spatial distribution of CAT potential. The probability of CAT potential is expected to increase over most East Asia between 35°N and 50°N, Southeast China, western Pacific, and North India in the future. The CAT potential that significantly affects aviation safety shows a remarkable increase over North and Northeast China, part of East China, and Tibet‐Plateau. In the whole domain of East Asia, the multi‐diagnostics ensemble‐average frequency increase is 6.9% for light CAT (with an intra‐ensemble range of 4.1–18%), 9.1% (5.0–24%) for light‐to‐moderate CAT, 12% (5.9–26%) for moderate CAT, 13% (7.2–29%) for moderate‐to‐severe CAT, and 15% (8.5–33%) for severe CAT. Stronger CAT is more likely to happen, which would be a constant threat, although greater scatter exists among these diagnostics, which implies the uncertainties are also significant in the projection.
Raman spectroscopic investigation of zircon in gem‐quality sapphire: Application in origin determination
Authors: Xu Wenxing , Krzemnicki Michael S.
Published: March 2021

In this study, zircon inclusions in selected 115 unheated sapphires originating from metamorphic deposits were studied by confocal micro‐Raman spectroscopy. By comparing Raman features of zircon inclusions in gem‐quality sapphires from Myanmar, India (Kashmir), Sri Lanka, and Madagascar, it could be established that those of younger age (sapphires from Myanmar and India [Kashmir]) contain zircon inclusion which exhibit relatively low ʋ1 and ʋ3 band positions and also smaller FWHM (ʋ3) than those in the older sapphires from Sri Lanka and Madagascar. Binary plotting of ʋ1 versus ʋ3 frequencies (Figure 3) and ʋ3 wavenumber versus FWHM of the studied zircon inclusions provide a method to distinguish young sapphires formed during Alpine‐Himalayan orogeny (Kashmir, Myanmar) from those related to the Pan‐African orogeny (Sri Lanka, Madagascar). This study shows the potential of the non‐destructive method on zircon inclusions in sapphires to be used to distinguish their origin as a service to the commercial gem trade.
Preoperative nomogram to predict posthepatectomy liver failure
Authors: Dhir Mashaal , Samson Kaeli K. , Yepuri Natesh , Yanala Ujwal R. , Smith Lynette M. , Are Chandrakanth
Published: March 2021

Background and Objectives

Posthepatectomy liver failure (PHLF) is associated with significant morbidity and mortality. However, it is often difficult to predict the risk of PHLF in an individual patient. We aimed to develop a preoperative nomogram to predict PHLF and allow better risk stratification before surgery.

Methods

Data for patients undergoing a partial or major hepatectomy were extracted from the hepatectomy‐specific NSQIP database for years 2014–2016. Data set from 2017 was used for validation. Patients with Grade B/C liver failure were compared with patients with no liver failure.

Results

A total of 10 808 patients from 2014–2016 data set were included. Of these, 316 patients (2.9%) developed Grade B/C PHLF. In the multivariable model consisting of preoperative variables, the following were predictive of Grade B/C PHLF (all p < 0.05): male gender, biliary stent, neoadjuvant therapy, viral hepatitis B or C, concurrent resections, biliary reconstruction, low sodium, and low albumin (model c statistic‐0.78). This model was used to construct a nomogram. In the 2017 validation cohort of 4367 patients the nomogram again demonstrated good c‐statistic (0.78).

Conclusions

Our nomogram provides patient‐specific probabilities for PHLF, and is easy to use. This is a valuable tool that can be utilized for preoperative patient counseling and selection.
Saccade, Pupil, and Blink Responses in Rapid Eye Movement Sleep Behavior Disorder
Authors: Perkins Julia E. , Janzen Annette , Bernhard Felix P. , Wilhelm Karén , Brien Donald C. , Huang Jeff , Coe Brian C. , Vadasz David , Mayer Geert , Munoz Douglas P. , Oertel Wolfgang H.
Published: March 2021

Background

Parkinson's disease (PD) patients exhibit deficits in saccade performance, pupil function, and blink rate. Isolated REM (rapid eye movement) Sleep Behavior Disorder (RBD) is a harbinger to PD making them candidates to investigate for early oculomotor abnormalities as PD biomarkers.

Objectives

We tested whether saccade, pupillary, and blink responses in RBD were similar to PD.

Methods

RBD (n = 22), PD (n = 22) patients, and healthy controls (CTRL) (n = 74) were studied with video‐based eye‐tracking.

Results

RBD patients did not have significantly different saccadic behavior compared to CTRL, but PD patients differed from CTRL and RBD. Both patient groups had significantly lower blink rates, dampened pupil constriction, and dilation responses compared to CTRL.

Conclusion

RBD and PD patients had altered pupil and blink behavior compared to CTRL. Because RBD saccade parameters were comparable to CTRL, pupil and blink brain areas may be impacted before saccadic control areas, making them potential prodromal PD biomarkers. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
An edge scanning method for the continuous deviation‐flow refueling station location problem on a general network
Authors: Abbaas Omar , Ventura Jose A.
Published: March 2021

This study addresses the continuous deviation‐flow refueling station location problem on a general network. Instead of having a finite number of candidate locations, we consider any point in the network as a candidate location. In addition, vehicles are allowed to deviate from their prescribed (shortest) paths to refuel. At the beginning, we focus on the location of a single refueling facility, which is a relevant problem in the initial stages of development of a refueling infrastructure for alternative fuels in a transportation network. The objective is to maximize the traffic flow covered (in roundtrips per time unit). We propose an exact algorithm that determines the endpoints of all refueling segments on each edge of the network that cover the corresponding origin–destination flows. Then, the set with the best endpoints is shown to be optimal and can be used to determine the entire set of optimal locations. Network reduction rules and a network decomposition procedure are also discussed to reduce the size of the problem and improve the computational efficiency. Later, the entire set of endpoints is used in a set covering model to locate multiple refueling stations under the assumption that every vehicle only needs to refuel once on each way of the round trip. Moreover, we limit the allowed refueling deviation distance from the shortest path. Finally, a numerical example is provided to illustrate the proposed methodology.
Nurses’ competency in Saudi Arabian healthcare context: A cross‐sectional correlational study
Authors: Feliciano Evelyn E. , Feliciano Alfredo Z. , Maniago Jestoni D. , Gonzales Ferdinand , Santos Adelina M. , Albougami Abdulrhman , Ahmad Mehrunnisha , Al‐Olah Hadeel
Published: March 2021

Aim

To measure the competence and characteristics of nurses in Saudi Arabia delivering health care with significant correlations.

Design

A cross‐sectional correlational study.

Methods

Data were collected in 2019 using a standardized questionnaire, Competency Inventory for Registered Nurses (CIRN), that included a purposive sample of 621 nurses working in Saudi Arabia.

Results

A positive evaluation of nurses’ overall core competency components is recognizably measured with greater competency levels in their workplace, scoring highest in “legal/ethical practice” while “critical thinking and research aptitude” represented the lowest dimension. Nurses’ marital status, years of graduation, length of service, duty hours and nurse–patient ratio affect their competency level. Nurses’ competence and their sociodemographic characteristics are significantly correlated attributes. Medical ward nurses are likely to have the greatest competence in delivering safe nursing care within training's legal borders.
Consumer innovativeness, innovation characteristics, and consumer resistance to innovation: A communication perspective from the public sector universities
Authors: Abbas Mazhar , Raza Syed Hassan , Al‐Ghazali Basheer M. , Alaghbari Mohammed Abdulrazzaq
Published: March 2021

Innovation generates significant benefits for business, the economy, and society as a whole. An innovative product brings significant benefits and improved features to the market. This study aims to explore the effect of innovation characteristics on consumer resistance to innovation in the Smartphone industry. The data have been collected from 310 university students in Pakistan. The findings revealed that factors of innovation characteristics (relative advantage, perceived risk, and e‐word of mouth) have significant relationships with consumer resistance to innovation. Consumer innovativeness has shown the moderating effect on the relationships between innovation characteristics and consumer resistance to innovation. Limitations of the study, implications for theory and practice, and future research directions have been discussed.
Urban renewal as policy innovation in China: From growth stimulation to sustainable development
Authors: Ye Lin , Peng Xiangeng , Aniche Laura Quadros , Scholten Peter H. T. , Ensenado Elena Marie
Published: March 2021

A major policy innovation in China, urban renewal creates an opportunity to promote sustainable inner‐city development and to foster economic growth in an environmentally and culturally sound way, which demands a close investigation of its context, internal and external dynamics, and policy features. Property‐led redevelopment dominated China's urban renewal since the early 1990s, as a result of the market reform and political decentralization. Recently, it has become important to meet the interests of local communities and the diverse stakeholders in the effort to preserve the urban history and cultural fabric of cities. Contextual factors in urban renewal policy and its innovation are investigated by analyzing a pioneering case in Guangzhou from a longitudinal study approach. The impact of the structural‐instrumental, cultural‐institutional, and environmental perspective on policy innovation with the change of contextual factors that transformed the development ideology and the managerial practice are identified to provide a new angle of studying policy innovation in the urban field.
Simulation of the Air Bubble Temperature in the Firing Projectile
Authors: Bagheri Sina , Tavangar Saeed , Soury Hosein , Shariati Seyyed Hadi Motamed
Published: March 2021

It is important to know the process of hot spot creation to improve the safety of working with melted TNT. One of the probabilities is the air bubbles in TNT that melted during the firing and internal ballistics, which are the results of casting problems. Thus, in this paper, the accuracy of this probability was studied. Melted TNT is a highly viscous fluid, so in this study by improving the numerical code, the effects of the temperature‐dependent physical properties have been seen in the calculations. The results show that the viscosity work makes the bubble heated and rises, its temperature in comparison with the fluid environment. But the variations are a maximum of 4 °K. Therefore, it seems that the studied factors in this paper can′t be the reason for melted TNT undesirable ignition.
Targeting backdoor androgen synthesis through AKR1C3 inhibition: A presurgical hormonal ablative neoadjuvant trial in high‐risk localized prostate cancer
Authors: Graham Laura S. , True Lawrence D. , Gulati Roman , Schade George R. , Wright Jonathan , Grivas Petros , Yezefski Todd , Nega Katie , Alexander Katerina , Hou Wen‐Min , Yu Evan Y. , Montgomery Bruce , Mostaghel Elahe A. , Matsumoto Alvin A. , Marck Brett , Sharifi Nima , Ellis William J. , Reder Nicholas P. , Lin Daniel W. , Nelson Peter S. , Schweizer Michael T.
Published: March 2021

Background

Localized prostate cancers (PCs) may resist neoadjuvant androgen receptor (AR)‐targeted therapies as a result of persistent intraprostatic androgens arising through upregulation of steroidogenic enzymes. Therefore, we sought to evaluate clinical effects of neoadjuvant indomethacin (Indo), which inhibits the steroidogenic enzyme AKR1C3, in addition to combinatorial anti‐androgen blockade, in men with high‐risk PC undergoing radical prostatectomy (RP).

Methods

This was an open label, single‐site, Phase II neoadjuvant trial in men with high to very‐high‐risk PC, as defined by NCCN criteria. Patients received 12 weeks of apalutamide (Apa), abiraterone acetate plus prednisone (AAP), degarelix, and Indo followed by RP. Primary objective was to determine the pathologic complete response (pCR) rate. Secondary objectives included minimal residual disease (MRD) rate, defined as residual cancer burden (RCB) ≤ 0.25cm3 (tumor volume multiplied by tumor cellularity) and elucidation of molecular features of resistance.

Results

Twenty patients were evaluable for the primary endpoint. Baseline median prostate‐specific antigen (PSA) was 10.1 ng/ml, 4 (20%) patients had Gleason grade group (GG) 4 disease and 16 had GG 5 disease. At RP, 1 (5%) patient had pCR and 6 (30%) had MRD. Therapy was well tolerated. Over a median follow‐up of 23.8 months, 1 of 7 (14%) men with pathologic response and 6 of 13 (46%) men without pathologic response had a PSA relapse. There was no association between prostate hormone levels or HSD3B1 genotype with pathologic response.

Conclusions

In men with high‐risk PC, pCR rates remained low even with combinatorial AR‐directed therapy, although rates of MRD were higher. Ongoing follow‐up is needed to validate clinical outcomes of men who achieve MRD.
Identifying anticholinergic burden in clinical practice
Authors: Bell Brian , Avery Anthony
Published: March 2021

Anticholinergic medications are associated with a wide range of adverse effects to which elderly patients are particularly susceptible. This article discusses the various ways that anticholinergic burden can be measured, how these can be used to help clinicians identify patients at risk from the adverse effects of anticholinergics, and how to address these risks.
An update on medical cannabis prescribing in the UK
Authors: Dowden Angela
Published: March 2021

In November 2018, legalisation of medical cannabis in the UK was announced, following media reports about children with unmanageable epilepsy being denied the drug. Over two years on, the number of patients who have received NHS prescriptions for licensed cannabis medicines is estimated to be in the low hundreds, but the number of prescriptions issued for unlicensed products has been vanishingly small. This article examines the reasons why, and discusses the future role of medical cannabis.
Intersecting categories in the dissolution of transnational marriages: A socio‐legal perspective
Authors: Fresnoza‐Flot Asuncion
Published: March 2021

As divorces take place increasingly across national borders, many former partners find themselves in complex situations entangled in more than one state during which some categories of difference intersect, (re)creating inequalities and precarity. Through a socio‐legal perspective combined with transnational and intersectional approaches, the present study elucidates the link between these intersections and the legal aspects of divorce. Examining Filipino migrant women's divorces in transnational social spaces, it unveils that social class, gender, legal statuses, and filiation intersect in specific situations: when the legal problem arises or implicates communal properties in another country; when a family member residing abroad interferes in the divorce settlement; and when the divorce process occurs in the context of domestic violence and involves an institution espousing women's spatial mobility to protect them. In such situations, the social class differences between partners become particularly pronounced (rather than their supposed cultural differences) and intersect with other categories.
Constrained Extrapolation Problem and Order‐Dependent Mappings
Authors: Wellenhofer Corbinian , Phillips Daniel R. , Schwenk Achim
Published: March 2021

The problem of extrapolating the perturbation series for the dilute Fermi gas in three dimensions to the unitary limit of infinite scattering length and into the BEC region is considered, using the available strong‐coupling information to constrain the extrapolation problem. In this constrained extrapolation problem (CEP), the goal is to find classes of approximants that give well‐converged results already for low perturbative truncation orders. First, it is shown that the standard Padé and Borel methods are too restrictive to give satisfactory results for this CEP. A generalization of Borel extrapolation is given by the so‐called maximum‐entropy (MaxEnt) extrapolation method. However, it is shown that MaxEnt requires extensive elaborations to be applicable to the dilute Fermi gas and is, thus, not practical for the CEP in this case. Instead, order‐dependent‐mapping extrapolation (ODME) as a simple, practical, and general method for the CEP is proposed. It is found that the ODME approximants for the ground‐state energy of the dilute Fermi gas are robust with respect to changes of the mapping choice and agree with results from quantum Monte Carlo simulations within uncertainties.
Relationship between follicular size and developmental capacity of oocytes under controlled ovarian hyperstimulation in assisted reproductive technologies
Authors: Tamura Isao , Kawamoto‐Jozaki Mai , Fujimura Taishi , Doi‐Tanaka Yumiko , Takagi Haruka , Shirafuta Yuichiro , Mihara Yumiko , Taketani Toshiaki , Tamura Hiroshi , Sugino Norihiro
Published: March 2021

Purpose

We investigate the relationships between oocyte developmental capacity and follicular size of its origin in Japanese women: those undergoing conventional IVF (cIVF) and ICSI, respectively.

Methods

A total of 3377 follicles were punctured separately and were classified into three groups (large, medium, and small) by their diameters. A total of 1482 retrieved oocytes were individually cultured and received cIVF or ICSI. The oocytes receiving ICSI were denuded and the number of mature (MII) oocytes was counted.

Results

The oocyte retrieval rates and the proportion of MII oocytes were significantly lower in small follicles than in large follicles. Under cIVF, the fertilization rate was significantly lower in oocytes from small follicles than large follicles. Under ICSI, the fertilization rate for MII oocytes was not significantly related to follicular size. Follicular size was not significantly related to the development potential to blastocyst and pregnancy rate for either the cIVF oocytes or the ICSI oocytes.

Conclusions

Although the fertilization rate by cIVF is low in oocytes from small follicles due to the lower proportion of mature oocytes, their development potential is comparable to that of oocytes from larger follicles if they could be fertilized. Under ICSI using mature oocytes, their development potential is not related to follicular size.
Approximation error ofFourierneural networks
Authors: Zhumekenov Abylay , Takhanov Rustem , Castro Alejandro J. , Assylbekov Zhenisbek
Published: March 2021

The paper investigates approximation error of two‐layer feedforward Fourier Neural Networks (FNNs). Such networks are motivated by the approximation properties of Fourier series. Several implementations of FNNs were proposed since 1980s: by Gallant and White, Silvescu, Tan, Zuo and Cai, and Liu. The main focus of our work is Silvescu's FNN, because its activation function does not fit into the category of networks, where the linearly transformed input is exposed to activation. The latter ones were extensively described by Hornik. In regard to non‐trivial Silvescu's FNN, its convergence rate is proven to be of orderO(1/n). The paper continues investigating classes of functions approximated by Silvescu FNN, which appeared to be from Schwartz space and space of positive definite functions.