bluuebunny/crossref_metadata_2025 huggingface dataset:
Should We Monitor Glucose and Biomarkers in Diabetics over Heart Surgery?
Authors: Golukhova Elena Z. , Lifanova Ljubov S. , Pugovkina Yaroslava V. , Grigoryan Marina V. , Bulaeva Naida I.
Published: July 2021

Hyperglycemia is associated with adverse outcomes after coronary artery bypass grafting (CABG). While there is a consensus that blood glucose control may benefit patients undergoing CABG, the role of biomarkers, optimal method, and duration of such monitoring are still unclear. The aim of this study is to define the efficacy of a continuous glucose monitoring system (CGMS) and link it to pro-inflammatory biomarkers while on insulin pump therapy in diabetic patients undergoing CABG. We prospectively assessed CGMS for 72 h in 105 patients including 52 diabetics undergoing isolated CABG. In diabetics, CGMS was connected to an insulin pump for precise glucose control. On top of conventional biomarkers (HbA1C, lipid profile), high sensitive C-reactive protein (hs-CRP), Regulated upon Activation Normal T cell Expressed and presumably Secreted (RANTES), and leptin levels were collected before surgery, 1 h, 12 h, 7 days, and at 1 year after CABG. Overall, CGMS revealed high glucose independently from underlying diabetes during first 48 h following CABG but was higher (p < 0.05) in diabetics. The insulin pump improved glycemic control over early follow-up (72 h) post-CABG. There were no hypoglycemic episodes in patients on insulin pump therapy and those receiving bolus insulin therapy. We revealed a lower rate of postpericardiotomy syndrome (PCTS) in patients on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (p = 0.03). Hs-CRP and RANTES levels were lower in patients with T2DM on insulin pump therapy compared to patients prescribed bolus insulin therapy in the early postoperative period (p < 0.05). It is most likely due to the fact that insulin pump therapy decreases systemic inflammatory response. Further controlled trials should assess whether CGMS improves outcomes after cardiac surgery.
Acute Stress-Induced Blood Lipid Reactivity in Hypertensive and Normotensive Men and Prospective Associations with Future Cardiovascular Risk
Authors: Degroote Cathy , von Känel Roland , Thomas Livia , Zuccarella-Hackl Claudia , Pruessner Jens C. , Wiest Roland , Wirtz Petra H.
Published: July 2021

Hyperreactivity to stress may be one explanation for the increased risk of cardiovascular disease (CVD) in individuals with essential hypertension. We investigated blood lipid reactivity to the Montreal Imaging Stress Task (MIST), a psychosocial stressor, in hypertensive and normotensive men and tested for prospective associations with biological risk factors. Fifty-six otherwise healthy and medication-free hypertensive and normotensive men underwent the MIST. We repeatedly measured cortisol and blood lipid profiles (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG)) immediately before and up to 1 h after stress. Lipid levels were corrected for stress hemoconcentration. Thirty-five participants completed follow-up assessment 2.9 ± 0.12 (SEM) years later. CVD risk was assessed by prospective changes in TC/HDL-C ratio, IL-6, D-dimer, and HbA1c from baseline to follow-up. The MIST induced significant changes in all parameters except TC (p-values ≤ 0.043). Compared with normotensives, hypertensives had higher TC/HDL-C-ratio and TG (p-values ≤ 0.049) stress responses. Blood lipid stress reactivity predicted future cardiovascular risk (p = 0.036) with increases in HbA1c (ß = 0.34, p = 0.046), IL-6 (ß = 0.31, p = 0.075), and D-dimer (ß = 0.33, p = 0.050). Our results suggest that the greater blood lipid reactivity to psychosocial stress in hypertensives, the greater their future biological CVD risk. This points to lipid stress reactivity as a potential mechanism through which stress might increase CVD risk in essential hypertension.
Using Rotational Thromboelastometry to Identify Early Allograft Dysfunction after Living Donor Liver Transplantation
Authors: Hung Hao-Chien , Lee Chen-Fang , Lee Wei-Chen
Published: July 2021

Background: Diagnostic tests for early allograft dysfunction (EAD) after living donor liver transplantation (LDLT) vary widely. We aimed to evaluate the predictive value of rotational thromboelastometry (ROTEM)-derived parameters in EAD. Materials and Methods: A total of 121 patients were reviewed. The definition of EAD proposed by Olthoff et al. included the presence of any of the following at postoperative day 7: bilirubin level ≥ 10 mg/dL, INR ≥ 1.6, or serum AST or ALT levels > 2000 IU/L. All patients underwent ROTEM assay, which consisted of an extrinsically activated thromboelastometric test (EXTEM) before and 24 h after LDLT. Results: The 1-year/2-year OS were 68.%8/64.5% and 94.4%/90.8% for the EAD and non-EAD groups, respectively (p = 0.001). Two independent risks were identified for EAD, the postoperative clotting time (CT, p = 0.026) and time to maximum clot firmness (maximum clot firmness (MCF)-t, p = 0.009) on the EXTEM. CT yielded a specificity of 82.0% and negative predictive value of 83.0%, and MCF-t displayed a specificity of 76.4% and negative predictive value of 81.9% in diagnosing EAD. The use of the 24 h post-LDLT ROTEM increased the effectiveness of predicting overall survival (OS) compared to using the Olthoff’s EAD criteria alone (p < 0.001). Conclusion: We conclude that CT and MCF on EXTEM were independent predictors of EAD. The 24 h post-LDLT ROTEM can be used with conventional laboratory tests to diagnose EAD. It increases the effectiveness of predicting OS.
Clinical Scoring for Prediction of Acute Kidney Injury in Patients with Acute ST-Segment Elevation Myocardial Infarction after Emergency Primary Percutaneous Coronary Intervention
Authors: Kaladee Akaphol , Phinyo Phichayut , Chantadansuwan Thamarath , Patumanond Jayanton , Siribumrungwong Boonying
Published: July 2021

Acute kidney injury (AKI) after a coronary intervention is common in patients with ST-segment elevation myocardial infarction (STEMI) and is associated with significant morbidity and mortality. Several scores have been developed to predict post-procedural AKI over the years. However, the AKI definitions have also evolved, which causes the definitions used in the past to be obsolete. We aimed to develop a prediction score for AKI in patients with STEMI requiring emergency primary percutaneous coronary intervention (pPCI). This study was based on a retrospective cohort of Thai patients with STEMI who underwent pPCI at the Central Chest Institute of Thailand from December 2014 to September 2019. AKI was defined as an increase in serum creatinine of at least 0.3 mg/dL from baseline within 48 h after pPCI. Logistic regression was used for modeling. A total of 1617 patients were included. Of these, 195 patients had AKI (12.1%). Eight significant predictors were identified: age, baseline creatinine, left ventricular ejection fraction (LVEF) < 40%, multi-vessel pPCI, treated with thrombus aspiration, inserted intra-aortic balloon pump (IABP), pre- and intra-procedural cardiogenic shock, and congestive heart failure. The score showed an area under the receiver operating characteristic curve of 0.78 (95% CI 0.75, 0.82) and was well-calibrated. The pPCI-AKI score showed an acceptable predictive performance and was potentially useful to help interventionists stratify the patients and provide optimal preventive management.
Potential Diagnostic Approaches for Prediction of Therapeutic Responses in Immune Thrombocytopenia
Authors: Jolink Anne-Tess C. , Nelson Vivianne S. , Schipperus Martin R. , Amini Sufia N. , Vidarsson Gestur , van der Schoot C. Ellen , Porcelijn Leendert , de Haas Masja , Kapur Rick
Published: July 2021

Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder in which, via unresolved mechanisms, platelets and megakaryocytes (MKs) are targeted by autoantibodies and/or T cells resulting in increased platelet destruction and impairment of MK function. Over the years, several therapeutic modalities have become available for ITP, however, therapeutic management has proven to be very challenging in several cases. Patients refractory to treatment can develop a clinically worsening disease course, treatment-induced toxicities and are predisposed to development of potentially life-endangering bleedings. It is therefore of critical importance to timely identify potential refractory patients, for which novel diagnostic approaches are urgently needed in order to monitor and predict specific therapeutic responses. In this paper, we propose promising diagnostic investigations into immune functions and characteristics in ITP, which may potentially be exploited to help predict platelet count responses and thereby distinguish therapeutic responders from non-responders. This importantly includes analysis of T cell homeostasis, which generally appears to be disturbed in ITP due to decreased and/or dysfunctional T regulatory cells (Tregs) leading to loss of immune tolerance and initiation/perpetuation of ITP, and this may be normalized by several therapeutic modalities. Additional avenues to explore in possible prediction of therapeutic responses include examination of platelet surface sialic acids, platelet apoptosis, monocyte surface markers, B regulatory cells and platelet microparticles. Initial studies have started evaluating these markers in relation to response to various treatments including glucocorticosteroids (GCs), intravenous immunoglobulins (IVIg) and/or thrombopoietin receptor agonists (TPO-RA), however, further studies are highly warranted. The systematic molecular analysis of a broad panel of immune functions may ultimately help guide and improve personalized therapeutic management in ITP.
Prone Positioning Is Safe and May Reduce the Rate of Intubation in Selected COVID-19 Patients Receiving High-Flow Nasal Oxygen Therapy
Authors: Vianello Andrea , Turrin Martina , Guarnieri Gabriella , Molena Beatrice , Arcaro Giovanna , Turato Cristian , Braccioni Fausto , Bertagna De Marchi Leonardo , Lionello Federico , Subotic Pavle , Masiero Stefano , Giraudo Chiara , Navalesi Paolo
Published: July 2021

Background: Patients with COVID-19 may experience hypoxemic Acute Respiratory Failure (hARF) requiring O2-therapy by High-Flow Nasal Cannula (HFNO). Although Prone Positioning (PP) may improve oxygenation in COVID-19 non-intubated patients, the results on its clinical efficacy are controversial. The present study aims to prospectively investigate whether PP may reduce the need for endotracheal intubation (ETI) in patients with COVID-19 receiving HFNO. Methods: All consecutive unselected adult patients with bilateral lung opacities on chest X-ray receiving HFNO after admission to a SARS-CoV-2 Respiratory Intermediate Care Unit (RICU) were considered eligible. Patients who successfully passed an initial PP trial (success group) underwent PP for periods ≥ 2 h twice a day, while receiving HFNO. The study’s primary endpoint was the intubation rate during the stay in the RICU. Results: Ninety-three patients were included in the study. PP was feasible and safe in 50 (54%) patients. Sixteen (17.2%) patients received ETI and 27 (29%) escalated respiratory support, resulting in a mortality rate of 9/93 (9.7%). The length of hospital stay was 18 (6–75) days. In 41/50 (80%) of subjects who passed the trial and underwent PP, its use was associated with clinical benefit and survival without escalation of therapy. Conclusions: PP is feasible and safe in over 50% of COVID-19 patients receiving HFNO for hARF. Randomized trials are required to confirm that PP has the potential to reduce intubation rate.
Prevalence of Depression among Healthcare Workers during the COVID-19 Outbreak: A Systematic Review and Meta-Analysis
Authors: Olaya Beatriz , Pérez-Moreno María , Bueno-Notivol Juan , Gracia-García Patricia , Lasheras Isabel , Santabárbara Javier
Published: July 2021

Background: There is evidence of a high psychological toll from the COVID-19 pandemic in healthcare workers. This paper was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among healthcare workers during the COVID-19 and estimating the pooled prevalence of depression. Methods: We searched for cross-sectional studies listed on PubMed from 1 December 2019 to 15 September 2020 that reported prevalence of depression in healthcare workers, nurses, medical doctors, and COVID-19 frontline professionals. The pooled proportions of depression were calculated with random effects models. Results: We identified 57 studies from seventeen countries. The pooled prevalence of depression in healthcare workers was 24% (95% CI: 20–28%), 25% for nurses (95% CI: 18–33%), 24% for medical doctors (95% CI: 16–31%), and 43% for frontline professionals (95% CI: 28–59%). Conclusions: The proportion of depression in nurses and medical doctors during the COVID-19 pandemic was similar to that found in the general population as previously reported in other meta-analyses conducted with smaller numbers of studies. Importantly, almost half of the frontline healthcare workers showed increased levels of depression. There is need for a comprehensive, international response to prevent and treat common mental health problems in healthcare workers.
Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation
Authors: Graceffa Giuseppa , Orlando Giuseppina , Cocorullo Gianfranco , Mazzola Sergio , Vitale Irene , Proclamà Maria Pia , Amato Calogera , Saputo Federica , Rollo Enza Maria , Corigliano Alessandro , Melfa Giuseppina , Cipolla Calogero , Scerrino Gregorio
Published: July 2021

Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).
Laser Therapy for the Treatment of Morphea: A Systematic Review of Literature
Authors: Szczepanik-Kułak Paulina , Michalska-Jakubus Małgorzata , Krasowska Dorota
Published: July 2021

Morphea, also known as localized scleroderma (LoS), comprises a set of autoimmune sclerotic skin diseases. It is characterized by inflammation and limited thickening and induration of the skin; however, in some cases, deeper tissues might also be involved. Although morphea is not considered a life-threatening disease, the apparent cosmetic disfigurement, functional or psychosocial impairment affects multiple fields of patients’ quality of life. Therapy for LoS is often unsatisfactory with numerous treatments that have only limited effectiveness or considerable side effects. Due to the advances in the application of lasers and their possible beneficial effects, the aim of this study is to review the reported usage of laser in morphea. We present a systematic review of available literature, performed with MEDLINE, Cinahl, Central, Scopus, Web of Science, and Google Scholar databases. We identified a total of twenty relevant studies (MEDLINE n = 10, Cinahl n = 1, Central n = 0, Scopus n = 2, Web of Science n = 5, Google Scholar n = 2) using laser therapy for LoS. Eight studies were focused on the use of PDL, six on fractional lasers (CO2 and Er:YAG), four on excimer, and two on either alexandrite or Nd:YAG.
Current and Prospective Treatment of Adenomyosis
Authors: Sharara Fady I. , Kheil Mira H. , Feki Anis , Rahman Sara , Klebanoff Jordan S. , Ayoubi Jean Marc , Moawad Gaby N.
Published: July 2021

(1) Background: Adenomyosis is a poorly understood entity which makes it difficult to standardize treatment. In this paper we review and compare the currently approved medical and surgical treatments of adenomyosis and present the evidence behind them. (2) Methods: A PubMed search was conducted to identify papers related to the different treatments of adenomyosis. The search was limited to the English language. Articles were divided into medical and surgical treatments. (3) Results: Several treatment options have been studied and were found to be effective in the treatment of adenomyosis. (4) Conclusions: Further randomized controlled trials are needed to compare treatment modalities and establish a uniform treatment algorithm for adenomyosis.
Cellulose Nanocomposites of Cellulose Nanofibers and Molecular Coils
Authors: Henderson Doug , Zhang Xin , Mao Yimin , Hu Liangbing , Briber Robert M. , Wang Howard
Published: July 2021

All-cellulose nanocomposites have been produced from cellulose nanofiber (CNF) suspensions and molecular coil solutions. Morphology and small-angle neutron scattering studies show the exfoliation and dispersion of CNFs in aqueous suspensions. Cellulose solutions in mixtures of ionic liquid and organic solvents were homogeneously mixed with CNF suspensions and subsequently dried to yield cellulose composites comprising CNF and amorphous cellulose over the entire composition range. Tensile tests show that stiffness and strength quantities of cellulose nanocomposites are the highest value at ca. 20% amorphous cellulose, while their fracture strain and toughness are the lowest. The inclusion of amorphous cellulose in cellulose nanocomposites alters their water uptake capacity, as measured in the ratio of the absorbed water to the cellulose mass, reducing from 37 for the neat CNF to less than 1 for a composite containing 35% or more amorphous cellulose. This study offers new insights into the design and production of all-cellulose nanocomposites.
Fighting Deepfakes by Detecting GAN DCT Anomalies
Authors: Giudice Oliver , Guarnera Luca , Battiato Sebastiano
Published: July 2021

To properly contrast the Deepfake phenomenon the need to design new Deepfake detection algorithms arises; the misuse of this formidable A.I. technology brings serious consequences in the private life of every involved person. State-of-the-art proliferates with solutions using deep neural networks to detect a fake multimedia content but unfortunately these algorithms appear to be neither generalizable nor explainable. However, traces left by Generative Adversarial Network (GAN) engines during the creation of the Deepfakes can be detected by analyzing ad-hoc frequencies. For this reason, in this paper we propose a new pipeline able to detect the so-called GAN Specific Frequencies (GSF) representing a unique fingerprint of the different generative architectures. By employing Discrete Cosine Transform (DCT), anomalous frequencies were detected. The β statistics inferred by the AC coefficients distribution have been the key to recognize GAN-engine generated data. Robustness tests were also carried out in order to demonstrate the effectiveness of the technique using different attacks on images such as JPEG Compression, mirroring, rotation, scaling, addition of random sized rectangles. Experiments demonstrated that the method is innovative, exceeds the state of the art and also give many insights in terms of explainability.
The Approach for Studying Variability of Sea Wave Spectra in a Wide Range of Wavelengths from High-Resolution Satellite Optical Imagery
Authors: Bondur Valery , Murynin Alexander
Published: July 2021

The development and validation of a method for remote measurement of the spectra of sea waves, which significantly expands the capabilities to study surface waves in large water areas in a wide range of wavelengths, is described. The applied approach is based on the use of retrieving operators, which are constructed by the method of numerical simulation, taking into account the nonlinear nature of brightness field modulation by the slopes of the sea surface. Retrieving operators have a set of parameters that are adapted to the real conditions of aerospace imaging. To assess the adequacy of the retrieving of wave spectra recorded from satellite images, they are compared with the spectra obtained by ground-based means under controlled conditions. The studies have shown the adequacy of remote measurement of the spectra of slopes and elevations of sea waves with wavelengths in the range 0.1–1 m. The possibility of using the developed method for studying the variability of sea waves in the coastal zone under conditions of limited fetch, including in the presence of anthropogenic disturbances, is shown.
Seafloor Hydrothermal Activity around a Large Non-Transform Discontinuity along Ultraslow-Spreading Southwest Indian Ridge (48.1–48.7° E)
Authors: Chen Dong , Tao Chunhui , Wang Yuan , Chen Sheng , Liang Jin , Liao Shili , Ding Teng
Published: July 2021

Non-transform discontinuity (NTD) is one category of tectonic units along slow- and ultraslow-spreading ridges. Some NTD-related hydrothermal fields that may reflect different driving mechanisms have been documented along slow-spreading ridges, but the discrete survey strategy makes it hard to evaluate the incidence of hydrothermal activity. On ultraslow-spreading ridges, fewer NTD-related hydrothermal activities were reported. Factors contributing to the occurrence of hydrothermal activities at NTDs and whether they could be potential targets for hydrothermal exploration are poorly known. Combining turbidity and oxidation reduction potential (ORP) sensors with a near-bottom camera, Chinese Dayang cruises from 2014 to 2018 have conducted systematic towed surveys for hydrothermal activity around a large NTD along the ultraslow-spreading Southwest Indian Ridge (SWIR, 48.1–48.7° E). Five new potential hydrothermal anomaly sites (2 inferred and 3 suspected) of high or low temperature and the previously inferred Sudi hydrothermal field occurred in diverse morphotectonic settings along a 78 km long ridge axis. The calculated vent frequency (Fs, sites/100 km) was ~7.7 over the entire study area, higher than the modified value (Fs ≈ 6.5) between 48 and 52° E of SWIR. Even only for the 54 km long large NTD, three hydrothermal anomaly sites yielded an Fs of ~5.6, which is higher than that of most ridge sections and is comparable to some fast-spreading ridges with high-resolution surveys. This indicates that NTDs along ultraslow-spreading ridges could be promising areas in fertilizing hydrothermal activities. Moreover, the deeply penetrating faults on the rift valley walls and strain-focused areas may contribute to the formation of NTD-related hydrothermal circulations. We suggest that NTDs along ultraslow-spreading ridges may be potential targets for further exploration of hydrothermal activities and seafloor sulfide deposits.
Artificial Neural Network Model for the Evaluation of Added Resistance of Container Ships in Head Waves
Authors: Martić Ivana , Degiuli Nastia , Majetić Dubravko , Farkas Andrea
Published: July 2021

The decrease in ship added resistance in waves fits into both the technical and operational measures proposed by the IMO to reduce the emissions of harmful gases from ships. Namely, the added resistance in waves causes an increase in fuel consumption and the emission of harmful gases in order for the ship to maintain the design speed, especially in more severe sea states. For this reason, it is very important to estimate the added resistance in waves with sufficient accuracy in the preliminary design phase. In this paper, the possibility of applying an ANN to evaluate added resistance in waves at the different sea states that the ship will encounter during navigation is investigated. A numerical model, based on the results of hydrodynamic calculations in head waves, and ANN is developed. The model can estimate the added resistance of container ships with sufficient accuracy, based on the ship characteristics, sailing speed, and the sea state using two wave energy spectra.
A Review and Meta-Analysis of Underwater Noise Radiated by Small (<25 m Length) Vessels
Authors: Parsons Miles J. G. , Erbe Christine , Meekan Mark G. , Parsons Sylvia K.
Published: July 2021

Managing the impacts of vessel noise on marine fauna requires identifying vessel numbers, movement, behaviour, and acoustic signatures. However, coastal and inland waters are predominantly used by ‘small’ (<25 m-long) vessels, for which there is a paucity of data on acoustic output. We reviewed published literature to construct a dataset (1719 datapoints) of broadband source levels (SLs) from 17 studies, for 11 ‘Vessel Types’. After consolidating recordings that had associated information on factors that may affect SL estimates, data from seven studies remained (1355 datapoints) for statistical modelling. We applied a Generalized Additive Mixed Model to assess factors (six continuous and five categorical predictor variables) contributing to reported SLs for four Vessel Types. Estimated SLs increased through ‘Electric’, ‘Skiff’, ‘Sailing’, ‘Monohull’, ‘RHIB’, ‘Catamaran’, ‘Fishing’, ‘Landing Craft’,’ Tug’, ‘Military’ to ‘Cargo’ Vessel Types, ranging between 130 and 195 dB re 1µPa m across all Vessel Types and >29 dB range within individual Vessel Types. The most parsimonious model (22.7% deviance explained) included ‘Speed’ and ‘Closest Point of Approach’ (CPA) which displayed non-linear, though generally positive, relationships with SL. Similar to large vessels, regulation of speed can reduce SLs and vessel noise impacts (with consideration for additional exposure time from travelling at slower speeds). However, the relationship between speed and SLs in planing hull and semi-displacement vessels can be non-linear. The effect of CPA on estimated SL is likely a combination of propagation losses in the shallow study locations, often-neglected surface interactions, different methodologies, and that the louder Vessel Types were often recorded at greater CPAs. Significant effort is still required to fully understand SL variability, however, the International Standards Organisation’s highest reporting criteria for SLs requires water depths that often only occur offshore, beyond the safe operating range of small vessels. Additionally, accurate determination of monopole SLs in shallow water is complicated, requiring significant geophysical information along the signal path. We suggest the development of appropriate shallow-water criteria to complete these measurements using affected SLs and a comprehensive study including comparable deep- and shallow-water measures.
Numerical Study of the Dynamic Stall Effect on a Pair of Cross-Flow Hydrokinetic Turbines and Associated Torque Enhancement Due to Flow Blockage
Authors: Doan Minh N. , Obi Shinnosuke
Published: July 2021

An open-source 2D Reynolds-averaged Navier–Stokes (RANS) simulation model was presented and applied for a laboratory-scaled cross-flow hydrokinetic turbine and a twin turbine system in counter-rotating configurations. The computational fluid dynamics (CFD) model was compared with previously published experimental results and then used to study the turbine power output and relevant flow fields at four blockage ratios. The dynamic stall effect and related leading edge vortex (LEV) structures were observed, discussed, and correlated with the power output. The results provided insights into the blockage effect from a different perspective: The physics behind the production and maintenance of lift on the turbine blade at different blockage ratios. The model was then applied to counter-rotating configurations of the turbines and similar analyses of the torque production and maintenance were conducted. Depending on the direction of movement of the other turbine, the blade of interest could either produce higher torque or create more energy loss. For both of the scenarios where a blade interacted with the channel wall or another blade, the key behind torque enhancement was forcing the flow through its suction side and manipulating the LEV.
Nanoscale Carbon-Polymer Dots for Theranostics and Biomedical Exploration
Authors: Sharker Shazid Md. , Do Minjae
Published: July 2021

In recent years, new carbonized nanomaterials have emerged in imaging, sensing, and various biomedical applications. Published literature shows that carbon dots (CDs) have been explored more extensively than any other nanomaterials. However, its polymeric version, carbon polymer dots (CPDs), did not get much attention. The non-conjugated and single-particle CPDs have all the merits of polymer and CDs, such as photoluminescent properties. The partially carbonized CPDs can be applied like CDs without surface passivation and functionalization. This merit can be further enhanced through the selection of desired precursors and control of carbonization synthesis. CPDs can absorb UV-visible-NIR light and can enhance the photoresponsive chemical and biochemical interactions. This review aims to introduce this area of renewed interest and provide insights into current developments of CPDs nanoparticles and present an overview of chemical, biological, and therapeutic applications.
Severe Posaconazole-Induced Glucocorticoid Deficiency with Concurrent Pseudohyperaldosteronism: An Unfortunate Two-for-One Special
Authors: Villar-Prados Alejandro , Chang Julia J. , Stevens David A. , Schoolnik Gary K. , Wang Samantha X. Y.
Published: July 2021

A 56-year-old Hispanic man with a history of disseminated coccidioidomycosis was diagnosed with persistent glucocorticoid insufficiency and pseudohyperaldosteronism secondary to posaconazole toxicity. This case was notable for unexpected laboratory findings of both pseudohyperaldosteronism and severe glucocorticoid deficiency due to posaconazole’s mechanism of action on the adrenal steroid synthesis pathway. Transitioning to fluconazole and starting hydrocortisone resolved the hypokalemia but not his glucocorticoid deficiency. This case highlights the importance of recognizing iatrogenic glucocorticoid deficiency with azole antifungal agents and potential long term sequalae.
Emotional Intelligence and Professional Boredom among Nursing Personnel in Greece
Authors: Papathanasiou Ioanna V. , Fradelos Evangelos C. , Nikolaou Eleftheria , Tsaras Konstantinos , Kontopoulou Lamprini , Malli Foteini
Published: July 2021

Occupational (professional) boredom results in low performance at work. It has been positively associated with high levels of anxiety and depression as well as premature death. However, occupational boredom has not been extensively studied among working nurses. This study aimed to investigate the relationship between emotional intelligence and occupational boredom in nurses working in both public (52.9%) and private (47.1%) health units in Greece. A cross-sectional study was conducted among a convenience sample of 189 nurses (84.7% females) with an average age of 40 years. Emotional intelligence was evaluated with the use of The Trait Emotional Intelligence Questionnaire-Short Form and Professional boredom was assessed with the use of the Boredom Proneness Scale. The majority of Nurses showed relatively high values of total Emotional Intelligence (EI), and marginally low values of overall Professional Boredom. A statistically significant negative correlation was found between the overall Professional Boredom of Nurses and the Well-being, Self-control, Emotionality and Sociability subscales of EI, as well as total EI (p < 0.001). Multiple linear regression analyses showed that the three dimensions of EI (Well-being, Self-Control and Emotionality) explained 39.0% of the variability of the total Professional Boredom of the working Nurses.
Effects of Inositol Hexaphosphate and Myo-Inositol Administration in Breast Cancer Patients during Adjuvant Chemotherapy
Authors: Amabile Maria , De Luca Alessandro , Tripodi Domenico , D’Alberti Elena , Melcarne Rossella , Imbimbo Giovanni , Picconi Orietta , D’Andrea Vito , Vergine Massimo , Sorrenti Salvatore , Molfino Alessio
Published: July 2021

Background: Treatment of breast cancer (BC) includes locoregional and systemic therapies depending on tumor and patient’s characteristics. Inositol hexaphosphate (IP6) is known as a strong antioxidant agent, able to improve local (i.e., breast region) side effects, functional status and quality-of-life. We investigated some potential beneficial effects, including hematological and local, of the combined therapy with oral myo-inositol administration and topical IP6 application in patients undergoing surgery for BC and eligible to adjuvant chemotherapy. Methods: We considered BC patients randomly assigned to the Inositol Group (oral myo-inositol + IP6 local application for the entire neoadjuvant treatment period) and to the Control Group (standard of care). The EORTC QLQ-BR23 and QLQ-C30 questionnaires were administered to both groups and blood parameters were assessed as per clinical routine practice at baseline (before starting adjuvant chemotherapy), T1 (after the first two doses of epirubicin-cyclophosphamide regimen), T2 (at the end of epirubicin-cyclophosphamide regimen), T3 (after the first six doses of paclitaxel regimen), and T4 (at the end of the paclitaxel treatment). Results: A total of 36 BC patients were considered, 18 in the Inositol Group and 18 in the Control Group. The Inositol Group showed a lower decrease in red blood cells, hemoglobin levels and white blood cells with respect to controls (p ≤ 0.02), as well as amelioration in scores related to breast and arm local symptoms (p ≤ 0.02), body image (p = 0.04) and quality-of-life related symptoms (p ≤ 0.04). Conclusions: In our cohort of BC patients, a combined treatment with oral myo-inositol + IP6 local application was able to improve local symptoms and quality-of-life related symptoms which represent clinically relevant aspects associated with patient’s prognosis.
Factors and Prognostic Significance of Impaired Exercise Tolerance in Women over 40 with Arterial Hypertension
Authors: Bielecka-Dabrowa Agata , Gryglewska Katarzyna , Sakowicz Agata , von Haehling Stephan , Janikowski Kamil , Maciejewski Marek , Banach Maciej
Published: July 2021

The aim of this study was to identify factors influencing maximal oxygen uptake (VO2max) and early identification of the profile of hypertensive women in the perimenopausal period at risk of heart failure. This study included 185 female patients. Regression analyses determined predictors of the lowest VO2max (quartile 1: VO2max < 17 mL/kg/min). Females with the lowest oxygen consumption had a significantly higher level of high sensitive cardiac Troponin T (hs-cTnT) (p = 0.001), higher values of the left atrial (LA) volume, late diastolic mitral annulus velocity (A′), E/E′ (p = 0.0003, p = 0.02, p = 0.04; respectively), higher BMI and fat content (kg and %) (p < 0.0001), higher fat free mass (FFM) (kg) (p < 0.0001), total body water content (TBW) (p = 0.0002) as well as extracellular body water content (ECW) (p < 0.0001) and intracellular body water content (ICW) (p = 0.005), ECW/TBW × 100% (p < 0.0001) and metabolic age (p < 0.0001) and lower E′ (p = 0.001) compared to controls. In a multiple logistic regression model independently associated with VO2max were: ECW/TBW × 100% (OR 4.45, 95% CI: 1.77–11.21; p = 0.002), BMI (OR 7.11, 95% CI: 2.01–25.11; p = 0.002) and hs-cTnT level (OR 2.69, 95% CI: 1.23–5.91; p = 0.013). High-sensitivity cardiac troponin may serve as an early biomarker of heart failure in hypertensive women. Hydration status should be considered in overall hypertensive women care. There is an importance of body mass compartments analysis in the early identification of hypertensive females at risk of heart failure. Optimization and personalization of body structure may be a preventive method for this disease. ClinicalTrials.gov Identifier: NCT04802369.
Planning Peri-Urban Open Spaces: Methods and Tools for Interpretation and Classification
Authors: Gottero Enrico , Cassatella Claudia , Larcher Federica
Published: July 2021

Today, planning an urban–rural interface requires redefining the planner’s role and toolbox. Global challenges such as food security, climate change and population growth have become urgent issues to be addressed, especially for the implications in land use management. Urban–rural linkages, socio-economic interactions and ecological connectivity are the main issues on which the new urban agenda and sustainable development goals focus. Thus, urban and peri-urban agriculture (professional and not professional) in urban–rural interfaces has a crucial role in the maintenance and enhancement of landscape quality, urban green spaces and ecosystem services. The research presented in this article adopts a holistic approach, with a special focus on open spaces, in order to understand the complexity of peri-urban landscapes and to identify homogeneous units. It also defines map-based indices to characterize peri-urban landscape types and identify main functions to maintain and enhance. The method was applied to the peri-urban area of Turin (Italy), and maps of spatial and functional classification at the landscape unit level were generated, as well as a map of critical areas to improve. Despite some minor limitations, the method and tools proposed appear to have a range of applications in the context of global challenges and from a landscape perspective.
Oxidative Stress and the Neurovascular Unit
Authors: Rinaldi Carmela , Donato Luigi , Alibrandi Simona , Scimone Concetta , D’Angelo Rosalia , Sidoti Antonina
Published: July 2021

The neurovascular unit (NVU) is a relatively recent concept that clearly describes the relationship between brain cells and their blood vessels. The components of the NVU, comprising different types of cells, are so interrelated and associated with each other that they are considered as a single functioning unit. For this reason, even slight disturbances in the NVU could severely affect brain homeostasis and health. In this review, we aim to describe the current state of knowledge concerning the role of oxidative stress on the neurovascular unit and the role of a single cell type in the NVU crosstalk.
Structure and Function of Protein Arginine Methyltransferase PRMT7
Authors: Halabelian Levon , Barsyte-Lovejoy Dalia
Published: July 2021

PRMT7 is a member of the protein arginine methyltransferase (PRMT) family, which methylates a diverse set of substrates. Arginine methylation as a posttranslational modification regulates protein–protein and protein–nucleic acid interactions, and as such, has been implicated in various biological functions. PRMT7 is a unique, evolutionarily conserved PRMT family member that catalyzes the mono-methylation of arginine. The structural features, functional aspects, and compounds that inhibit PRMT7 are discussed here. Several studies have identified physiological substrates of PRMT7 and investigated the substrate methylation outcomes which link PRMT7 activity to the stress response and RNA biology. PRMT7-driven substrate methylation further leads to the biological outcomes of gene expression regulation, cell stemness, stress response, and cancer-associated phenotypes such as cell migration. Furthermore, organismal level phenotypes of PRMT7 deficiency have uncovered roles in muscle cell physiology, B cell biology, immunity, and brain function. This rapidly growing information on PRMT7 function indicates the critical nature of context-dependent functions of PRMT7 and necessitates further investigation of the PRMT7 interaction partners and factors that control PRMT7 expression and levels. Thus, PRMT7 is an important cellular regulator of arginine methylation in health and disease.
A Comprehensive Analysis of Hungarian MODY Patients—Part II: Glucokinase MODY Is the Most Prevalent Subtype Responsible for about 70% of Confirmed Cases
Authors: Gaál Zsolt , Szűcs Zsuzsanna , Kántor Irén , Luczay Andrea , Tóth-Heyn Péter , Benn Orsolya , Felszeghy Enikő , Karádi Zsuzsanna , Madar László , Balogh István
Published: July 2021

MODY2 is caused by heterozygous inactivating mutations in the glucokinase (GCK) gene that result in persistent, stable and mild fasting hyperglycaemia (5.6–8.0 mmol/L, glycosylated haemoglobin range of 5.6–7.3%). Patients with GCK mutations usually do not require any drug treatment, except during pregnancy. The GCK gene is considered to be responsible for about 20% of all MODY cases, transcription factors for 67% and other genes for 13% of the cases. Based on our findings, GCK and HNF1A mutations together are responsible for about 90% of the cases in Hungary, this ratio being higher than the 70% reported in the literature. More than 70% of these patients have a mutation in the GCK gene, this means that GCK-MODY is the most prevalent form of MODY in Hungary. In the 91 index patients and their 72 family members examined, we have identified a total of 65 different pathogenic (18) and likely pathogenic (47) GCK mutations of which 28 were novel. In two families, de novo GCK mutations were detected. About 30% of the GCK-MODY patients examined were receiving unnecessary OAD or insulin therapy at the time of requesting their genetic testing, therefore the importance of having a molecular genetic diagnosis can lead to a major improvement in their quality of life.
Taking Lessons from Silent Spring: Using Environmental Literature for Climate Change
Authors: Meyer Craig
Published: July 2021

Rachel Carson’s Silent Spring (1962) created a new genre termed “science nonfiction literature.” This genre blended environmental science and narrative while ushering in a new era of awareness and interest for both. With the contemporary climate crisis becoming more dire, this article returns to Carson’s work for insight into ways to engage deniers of climate change and methods to propel action. Further, it investigates and evaluates the writing within Silent Spring by considering its past in our present. Using the corporate reception of Carson’s book as reference, this article also examines ways climate change opponents create misunderstandings and inappropriately deceive and misdirect the public. Through this analysis, connections are made that connect literature, science, and public engagement, which can engender a broader, more comprehensive awareness of the importance of environmental literature as a medium for climate awareness progress.
Fly Ash-Based Eco-Efficient Concretes: A Comprehensive Review of the Short-Term Properties
Authors: Amran Mugahed , Fediuk Roman , Murali Gunasekaran , Avudaiappan Siva , Ozbakkaloglu Togay , Vatin Nikolai , Karelina Maria , Klyuev Sergey , Gholampour Aliakbar
Published: July 2021

Development of sustainable concrete as an alternative to conventional concrete helps in reducing carbon dioxide footprint associated with the use of cement and disposal of waste materials in landfill. One way to achieve that is the use of fly ash (FA) as an alternative to ordinary Portland cement (OPC) because FA is a pozzolanic material and has a high amount of alumina and silica content. Because of its excellent mechanical properties, several studies have been conducted to investigate the use of alkali-activated FA-based concrete as an alternative to conventional concrete. FA, as an industrial by-product, occupies land, thereby causing environmental pollution and health problems. FA-based concrete has numerous advantages, such as it has early strength gaining, it uses low natural resources, and it can be configurated into different structural elements. This study initially presents a review of the classifications, sources, chemical composition, curing regimes and clean production of FA. Then, physical, fresh, and mechanical properties of FA-based concretes are studied. This review helps in better understanding of the behavior of FA-based concrete as a sustainable and eco-friendly material used in construction and building industries.
Low-Roughness-Surface Additive Manufacturing of Metal-Wire Feeding with Small Power
Authors: Li Bobo , Wang Bowen , Zhu Greg , Zhang Lijuan , Lu Bingheng
Published: July 2021

Aiming at handling the contradiction between power constraint of on-orbit manufacturing and the high energy input requirement of metal additive manufacturing (AM), this paper presents an AM process based on small-power metal fine wire feed, which produces thin-wall structures of height-to-width ratio up to 40 with core-forming power only about 50 W. In this process, thermal resistance was introduced to optimize the gradient parameters which greatly reduces the step effect of the typical AM process, succeeded in the surface roughness (Ra) less than 5 μm, comparable with that obtained by selective laser melting (SLM). After a 10 min electrolyte-plasma process, the roughness of the fabricated specimen was further reduced to 0.4 μm, without defects such as pores and cracks observed. The ultimate tensile strength of the specimens measured about 500 MPa, the relative density was 99.37, and the Vickers hardness was homogeneous. The results show that the proposed laser-Joule wire feed-direct metal deposition process (LJWF-DMD) is a very attractive solution for metal AM of high surface quality parts, particularly suitable for rapid prototyping for on-orbit AM in space.
Combined Use of Modal Analysis and Machine Learning for Materials Classification
Authors: Abdelkader Mohamed , Noman Muhammad Tayyab , Amor Nesrine , Petru Michal , Mahmood Aamir
Published: July 2021

The present study deals with modal work that is a type of framework for structural dynamic testing of linear structures. Modal analysis is a powerful tool that works on the modal parameters to ensure the safety of materials and eliminate the failure possibilities. The concept of classification through this study is validated for isotropic and orthotropic materials, reaching up to a 100% accuracy when deploying the machine learning approach between the mode number and the associated frequency of the interrelated variables that were extracted from modal analysis performed by ANSYS. This study shows a new classification method dependent only on the knowledge of resonance frequency of a specific material and opens new directions for future developments to create a single device that can identify and classify different engineering materials.