bluuebunny/crossref_metadata_2025 huggingface dataset:
Fibrin airway cast obstruction: Experience, classification, and treatment guideline from Denver
Authors: Liptzin Deborah R. , McGraw Matthew D. , Houin Paul R. , Veress Livia A.
Published: October 2021

Background and Objectives

Plastic bronchitis (PB) is a condition characterized by the formation of thick airway casts leading to acute and often life‐threatening airway obstruction. PB occurs mainly in pediatric patients with congenital heart disease (CHO) who have undergone staged surgical palliation (Glenn, Fontan), but can also occur after chemical inhalation, H1N1, severe COVID‐19, sickle cell disease, severe asthma, and other diseases. Mortality risk from PB can be up to 40%–60%, and no treatment guideline exist. The objectives herein are to develop a standardized evaluation, classification, and treatment guideline for PB patients presenting with tracheobronchial casts, based on our experience with PB at the Children's Hospital of Colorado in Denver.

Methods

We describe 11 patients with CHO‐associated PB (post‐Fontan [n = 9], pre‐Fontan [n = 2]) who presented with their initial episodes. We utilized histopathological analysis of tracheobronchial casts to guide treatment in these patients, utilizing our hospital‐wide guideline document and classification system.

Results

We found that 100% of post‐Fontan PB patients had fibrinous airway casts, while pre‐Fontan PB casts were fibrinous only in one of two patients (50%). Utilizing histopathology as a guide to therapy, PB patients with fibrin airway casts were treated with airway‐delivered fibrinolytics and anticoagulants, as well as aggressive airway clearance and other supportive care measures. These therapies resulted in successful cast resolution and improved survival in post‐Fontan PB patients.

Conclusion

We have shown an improved outcome in PB patients whose treatment plan was based on Denver's PB classification schema and standardized treatment guideline based on tracheobronchial cast histopathology.
Branch‐and‐bound‐based algorithm for solving the multi‐type component assignment problem in a consecutive‐k$k$‐out‐of‐n$n$:F system
Authors: Nakamura Taishin , Yamamoto Hisashi
Published: October 2021

With the increasing scale and complexity of real‐world systems, it is crucial to improve system reliability in order to minimize occurrences of system failure. To achieve this, several prior studies have considered the component assignment problem for consecutive‐‐out‐of‐:F system models. This problem was extended to consider a system comprising multiple component types. This multi‐type component assignment problem (MCAP) aims to find an optimal component arrangement that achieves the maximum system reliability under the assumption that a component should be assigned only to a position of the same component type. A branch‐and‐bound (B&B) ‐based algorithm was developed to solve the MCAP in a consecutive‐‐out‐of‐:F system. The main principle of the proposed algorithm is the incorporation of the pruning conditions in the standard B&B framework to reduce the number of candidates for the optimal arrangement. It is experimentally demonstrated that the proposed algorithm can significantly improve the efficiency of the enumeration method in solving the MCAP. The proposed algorithm can obtain the optimal arrangement of a large system if the number of types is relatively large. The findings of this study can help in improving the reliability of any system that can be expressed as a consecutive‐‐out‐of‐:F system with multiple component types.
Linking flow alteration with fish assemblage structure in a river regulated by a small hydropower project in the Western Ghats of Karnataka, India
Authors: Rao Shishir , Krishnaswamy Jagdish , Bhalla Ravinder Singh
Published: October 2021

Small hydropower projects (SHPs) are promoted as low‐impact alternatives for large hydropower. SHPs are generally commissioned on small‐ to medium‐sized mountainous rivers, often in biodiverse regions, with backing in the form of subsidies, facultative policies and exemption from impact assessments as they are considered ‘green’. However, the ecological impacts of SHPs are understudied especially in highly seasonal tropical streams of Western Ghats of India, a global biodiversity hotspot and a distinct freshwater fish eco‐region. We compared SHP‐affected segments of a dammed and an undammed river in the Western Ghats of Karnataka, to assess how altered flow regime affects seasonal variability in habitat and water quality, and influences fish assemblage structure. We found that flow alteration by the SHP varied between different segments of the dammed river and with season. Furthermore, the nature of flow alteration influenced habitat variability, water quality and fish assemblage response in the dammed river. We observed that the dewatered segment of the dammed river experienced a lotic to lentic shift in habitat and water quality, which favoured fish species with eurytopic affinities. Fluctuating flows in the downstream segment subdued natural variability in flow regime and created novel habitats and water‐quality conditions, affecting fish assemblages. The upstream segment of the dammed river retained natural variability in habitat and water quality, but did not mimic the undammed river in terms of fish composition. We also observed potential constraints on recruitment for migratory species of fish in the dammed river. Based on our results, we suggest how the placement of dewatered segment, and timing the closure of SHP operation in dry season based on ecological thresholds are potential solutions to mitigate the impacts of the SHPs. Furthermore, we recommend effective impact assessments, and adaptive management with active interventions to maintain genetic and ecological connectivity, as key to enhance the sustainability of the SHPs.
Mass Transfer in Boronate Ester 2D COF Single Crystals
Authors: Naberezhnyi Daniil , Park SangWook , Li Wei , Westphal Michael , Feng Xinliang , Dong Renhao , Dementyev Petr
Published: October 2021

Unlike graphene and similar structures, 2D covalent organic frameworks (2D COFs) exhibit intrinsic porosity with a high areal density of well‐defined and uniform openings. Given the pore size adjustability, 2D COFs are likely to outperform artificially perforated inorganic layers with respect to their prospects in membrane separation. Yet, exploring the mass transport in 2D COFs is hidden by the lack of laterally extended free‐standing membranes. This work reports on direct molecular permeation measurements with single crystals of an interfacially synthesized boronate ester 2D COF. In accordance with the material topography, the atmospheric and noble gases readily pass the suspended nanosheets while their areal porosity is quantified to be almost 40% exceeding that in any 2D membranes known. However, bulkier aromatic hydrocarbons are found to deviate substantially from Graham's law of diffusion. Counterintuitively, the permeation rate is demonstrated to rise from benzene to toluene and further to xylene despite the increase in the molecular mass and dimensions. The results are interpreted in terms of adsorption‐mediated flow that appears to be an important transport mechanism for microporous planar nanomaterials.
PAS: A new powerful and simple quantum computing simulator
Authors: Bian Haodong , Huang Jianqiang , Tang Jiahao , Dong Runting , Wu Li , Wang Xiaoying
Published: October 2021

In recent years, many researchers have been using CPU for quantum computing simulation. However, in reality, the simulation efficiency of the large‐scale simulator is low on a single node. Therefore, striving to improve the simulator efficiency on a single node has become a serious challenge that many researchers need to solve. After many experiments, we found that much computational redundancy and frequent memory access are important factors that hinder the efficient operation of the CPU. This paper proposes a new powerful and simple quantum computing simulator: PAS (power and simple). Compared with existing simulators, PAS introduces four novel optimization methods: efficient hybrid vectorization, fast bitwise operation, memory access filtering, and quantum tracking. In the experiment, we tested the QFT (quantum Fourier transform) and RQC (random quantum circuits) of 21 to 30 qubits and selected the state‐of‐the‐art simulator QuEST (quantum exact simulation toolkit) as the benchmark. After experiments, we have concluded that PAS compared with QuEST can achieve a mean speedup of (QFT), (RQC) (up to , ) on the Intel Xeon E5‐2670 v3 CPU.
Genetic Diversity and Inter‐Relationships of Common Bean (Phaseolus vulgaris L.) Starch Traits
Authors: Narayanamoorthy Shwetha , Zhang Chuangchuang , Xu Zekun , Ma Mengting , Sui Zhongquan , Li Kehu , Corke Harold
Published: October 2021

The starch morphology, granule size distribution, apparent amylose content (AAC), pasting properties, textural properties, gelatinization, and retrogradation of 16 common bean varieties are studied. According to the observed phenotypic data, the genetic diversity and inter‐relationships of these starch traits are analyzed. Wide diversity in starch quality traits is observed. Both volume mean diameter and area diameter of starch granules range from 21.6 to 32.3 µm, AAC ranges from 30.6% to 45.7%, and gelatinization temperature (GT) varies from 64.7 °C to 76.8 °C. AAC is not significantly correlated to GT and other gelatinization parameters or to retrogradation parameters, but is significantly positively correlated to hardness, trough viscosity, final viscosity, and setback. Conclusion temperatures (Tc) and enthalpy of gelatinization (ΔHg) are significantly negatively correlated to retrogradation percentage. Thus, AAC mainly affects textural and pasting properties, and retrogradation mainly depends on gelatinization (ΔHg and Tc) rather than AAC. This study provides guidance for the processing and application of these starches.
ParallelMulti‐ScaleNetwork with Attention Mechanism for Pancreas Segmentation
Authors: Long Jianwu , Song Xinlei , An Yong , Li Tong , Zhu Jiangzhou
Published: October 2021

In this paper, we address the task of segmenting small organs (i.e., the pancreas) from abdominal CT scans. As the target often occupies a relatively small region in the input image, deep neural networks can be easily confused by complex and variable backgrounds. We propose a method that uses a parallel multi‐scale network with an attention mechanism for pancreas segmentation, which can better grasp the balance between the semantic segmentation, classification, and localization tasks. We use a parallel network to connect the feature maps between different bottleneck layers, which contain rich semantic information and complete spatial information. We apply an attention module to enhance the key features of semantic information. Then, we fuse the two modules and apply the fused module as attention information on the feature map to ensure the full fusion between contextual semantic information and spatial information, thereby improving segmentation accuracy. We conduct extensive experiments on the NIH pancreas segmentation data set. In particular, our model achieves a mean coefficient Dice of 86.6. © 2021 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC.
Inflammation‐modulating nanoparticles for pneumonia therapy
Authors: Muhammad Wali , Zhai Zihe , Wang Shuqin , Gao Changyou
Published: October 2021

Pneumonia is a common but serious infectious disease, and is the sixth leading cause for death. The foreign pathogens such as viruses, fungi, and bacteria establish an inflammation response after interaction with lung, leading to the filling of bronchioles and alveoli with fluids. Although the pharmacotherapies have shown their great effectiveness to combat pathogens, advanced methods are under developing to treat complicated cases such as virus‐infection and lung inflammation or acute lung injury (ALI). The inflammation modulation nanoparticles (NPs) can effectively suppress immune cells and inhibit inflammatory molecules in the lung site, and thereby alleviate pneumonia and ALI. In this review, the pathological inflammatory microenvironments in pneumonia, which are instructive for the design of biomaterials therapy, are summarized. The focus is then paid to the inflammation‐modulating NPs that modulate the inflammatory cells, cytokines and chemokines, and microenvironments of pneumonia for better therapeutic effects.

This article is categorized under:

Therapeutic Approaches and Drug Discovery > Nanomedicine for Respiratory Disease
Confronting SO(10) GUTs with proton decay and gravitational waves
Authors: King Stephen F. , Pascoli Silvia , Turner Jessica , Zhou Ye-Ling
Published: October 2021

Abstract

Grand Unified Theories (GUT) predict proton decay as well as the formation of cosmic strings which can generate gravitational waves. We determine which non-supersymmetric SO(10) breaking chains provide gauge unification in addition to a gravitational signal from cosmic strings. We calculate the GUT and intermediate scales for these SO(10) breaking chains by solving the renormalisation group equations at the two-loop level. This analysis predicts the GUT scale, hence the proton lifetime, in addition to the scale of cosmic string generation and thus the associated gravitational wave signal. We determine which SO(10) breaking chains survive in the event of the null results of the next generation of gravitational waves and proton decay searches and determine the correlations between proton decay and gravitational waves scales if these observables are measured.
The single copy of the gravitational holonomy
Authors: Alawadhi Rashid , Berman David S. , White Chris D. , Wikeley Sam
Published: October 2021

Abstract

The double copy is a well-established relationship between gravity and gauge theories. It relates perturbative scattering amplitudes as well as classical solutions, and recently there has been mounting evidence that it also applies to non-perturbative information. In this paper, we consider the holonomy properties of manifolds in gravity and prescribe a single copy of gravitational holonomy that differs from the holonomy in gauge theory. We discuss specific cases and give examples where the single copy holonomy group is reduced. Our results may prove useful in extending the classical double copy. We also clarify previous misconceptions in the literature regarding gravitational Wilson lines and holonomy.
Fermion singlet dark matter in a pseudoscalar dark matter portal
Authors: Sáez Bastián Díaz , Escalona Patricio , Norero Sebastián , Zerwekh Alfonso
Published: October 2021

Abstract

We explore a simple extension to the Standard Model containing two gauge singlets: a Dirac fermion and a real pseudoscalar. In some regions of the parameter space both singlets are stable without the necessity of additional symmetries, then becoming a possible two-component dark matter model. We study the relic abundance production via freeze-out, with the latter determined by annihilations, conversions and semi-annihilations. Experimental constraints from invisible Higgs decay, dark matter relic abundance and direct/indirect detection are studied. We found three viable regions of the parameter space, and the model is sensitive to indirect searches.
Muon g − 2 anomaly and neutrino magnetic moments
Authors: Babu K. S. , Jana Sudip , Lindner Manfred , P. K. Vishnu
Published: October 2021

Abstract

We show that a unified framework based on an SU(2)H horizontal symmetry which generates a naturally large neutrino transition magnetic moment and explains the XENON1T electron recoil excess also predicts a positive shift in the muon anomalous magnetic moment. This shift is of the right magnitude to be consistent with the Brookhaven measurement as well as the recent Fermilab measurement of the muon g − 2. A relatively light neutral scalar from a Higgs doublet with mass near 100 GeV contributes to muon g − 2, while its charged partner induces the neutrino magnetic moment. In contrast to other multi-scalar theories, in the model presented here there is no freedom to control the sign and strength of the muon g − 2 contribution. We analyze the collider tests of this framework and find that the HL-LHC can probe the entire parameter space of these models.
Genetic abnormalities in biopsy-proven, adult-onset hemolytic uremic syndrome and C3 glomerulopathy
Authors: Haydock Ludwig , Garneau Alexandre P. , Tremblay Laurence , Yen Hai-Yun , Gao Hanlin , Harrisson Raphaël , Isenring Paul
Published: October 2021

Atypical hemolytic uremic syndrome (aHUS) and C3 glomerulopathy (C3G) have been linked to mutations in many of the proteins that are involved in alternative complement pathway activation. Age and etiology confounded, the prevalence of such mutations has been reported to be over 30 to 50% in these diseases. However, the cohorts studied included many children or individuals with a familial history of complement-related disorders and genetic tests were usually limited to exome sequencing of known causative or risk-associated genes. In this study, a retrospective adult cohort of 35 patients with biopsy-proven thrombotic microangiopathy (the largest in Canada) and 10 patients with C3 glomerulopathy was tested through an extended exome panel to identify causative defects in associated or candidate genes including those of the alternative and terminal complement pathways. A variant of unknown significance was also analyzed for pathogenicity through in vitro studies. To our surprise, the prevalence of known causative or risk-associated variants in either of these cohorts was found to be less than ~ 15% overall. However, the panel used and analyses carried out allowed to identify novel variants of potential clinical significance and a number of candidate genes. The prevalence of known genetic defects in adult-onset aHUS and C3G is thus probably much lower than 30 to 50%. Our results also point towards the importance of investigating diseases of the alternative complement pathway through extended exome panels and in vitro analyses.

Key messages

The alternative complement pathway plays a major role in the pathogenesis of hemolytic uremic syndrome and C3 glomerulopathy.

Based on previous studies, both disorders have been commonly linked to variants in the various intermediates that sustain or regulate this pathway.

The prevalence of such mutations in the adult-onset and sporadic forms of these diseases is probably much lower than expected based on larger series.

The sporadic forms of complementopathies are likely to involve additional genes that are yet to be uncovered.
New perspectives in regenerative medicine and surgery: the bioactive composite therapies (BACTs)
Authors: Zocchi Michele L. , Facchin Federico , Pagani Andrea , Bonino Claudia , Sbarbati Andrea , Conti Giamaica , Vindigni Vincenzo , Bassetto Franco
Published: October 2021

Regenerative medicine and surgery is a rapidly expanding branch of translational research in tissue engineering, cellular and molecular biology.

To date, the methods to improve cell intake, survival, and isolation need to comply with a complex and still unclear regulatory frame, becoming everyday more restrictive and often limiting the effectiveness and outcome of the therapeutic choices. Thus, the authors developed a novel 360° regenerative strategy based on the synergic action of several new components called the bioactive composite therapies (BACTs) to improve grafted cells intake, and survival in total compliance with the legal and ethical limits of the current regulatory frame.

The rationale at the origin of this new technology is based on the evidence that cells need supportive substrate to survive in vitro and this observation, applying the concept of translational medicine, is true also in vivo. Bioactive composite mixtures (BACMs) are tailor-made bioactive mixtures containing several bioactive components that support cells’ survival and induce a regenerative response in vivo by stimulating the recipient site to act as an in situ real bioreactor. Many different tissues have been used in the past for the isolation of cells, molecules, and growth factors, but the adipose tissue and its stromal vascular fraction (SVF) remains the most valuable, abundant, safe, and reliable source of regenerative components and particularly of adipose-derived stems cells (ADSCs). The role of plastic surgeons as the historical experts in all the most advanced techniques for harvesting, manipulating, and grafting adipose tissue is fundamental in this constant process of expansion of regenerative procedures. In this article, we analyze the main causes of cell death and the strategies for preventing it, and we present all the technical steps for preparing the main components of BACMs and the different mixing modalities to obtain the most efficient regenerative action on different clinical and pathological conditions. The second section of this work is dedicated to the logical and sequential evolution from simple bioactive composite grafts (BACGs) that distinguished our initial approach to regenerative medicine, to BACTs where many other fundamental technical steps are analyzed and integrated for supporting and enhancing the most efficient regenerative activity. Level of Evidence: Not gradable
Reliability of pediatric ventricular function analysis by short-axis “single-cycle-stack-advance” single-shot compressed-sensing cines in minimal breath-hold time
Authors: Hatipoglu Suzan , Gatehouse Peter , Krupickova Sylvia , Banya Winston , Daubeney Piers , Almogheer Batool , Izgi Cemil , Weale Peter , Hayes Carmel , Firmin David , Pennell Dudley J.
Published: October 2021

Objectives

Cardiovascular magnetic resonance (CMR) cine imaging by compressed sensing (CS) is promising for patients unable to tolerate long breath-holding. However, the need for a steady-state free-precession (SSFP) preparation cardiac cycle for each slice extends the breath-hold duration (e.g. for 10 slices, 20 cardiac cycles) to an impractical length. We investigated a method reducing breath-hold duration by half and assessed its reliability for biventricular volume analysis in a pediatric population.

Methods

Fifty-five consecutive pediatric patients (median age 12 years, range 7–17) referred for assessment of congenital heart disease or cardiomyopathy were included. Conventional multiple breath-hold SSFP short-axis (SAX) stack cines served as the reference. Real-time CS SSFP cines were applied without the steady-state preparation cycle preceding each SAX cine slice, accepting the limitation of omitting late diastole. The total acquisition time was 1 RR interval/slice. Volumetric analysis was performed for conventional and “single-cycle-stack-advance” (SCSA) cine stacks.

Results

Bland–Altman analyses [bias (limits of agreement)] showed good agreement in left ventricular (LV) end-diastolic volume (EDV) [3.6 mL (− 5.8, 12.9)], LV end-systolic volume (ESV) [1.3 mL (− 6.0, 8.6)], LV ejection fraction (EF) [0.1% (− 4.9, 5.1)], right ventricular (RV) EDV [3.5 mL (− 3.34, 10.0)], RV ESV [− 0.23 mL (− 7.4, 6.9)], and RV EF [1.70%, (− 3.7, 7.1)] with a trend toward underestimating LV and RV EDVs with the SCSA method. Image quality was comparable for both methods (p = 0.37).

Conclusions

LV and RV volumetric parameters agreed well between the SCSA and the conventional sequences. The SCSA method halves the breath-hold duration of the commercially available CS sequence and is a reliable alternative for volumetric analysis in a pediatric population.

Key Points

• Compressed sensing is a promising accelerated cardiovascular magnetic resonance imaging technique.

• We omitted the steady-state preparation cardiac cycle preceding each cine slice in compressed sensing and achieved an acquisition speed of 1 RR interval/slice.

• This modification called “single-cycle-stack-advance” enabled the acquisition of an entire short-axis cine stack in a single short breath hold.

• When tested in a pediatric patient group, the left and right ventricular volumetric parameters agreed well between the “single-cycle-stack-advance” and the conventional sequences.
ISS and integral-ISS of switched systems with nonlinear supply functions
Authors: Liu Shenyu , Tanwani Aneel , Liberzon Daniel
Published: October 2021

The problem of input-to-state stability (ISS) and its integral version (iISS) are considered for switched nonlinear systems with inputs, resets and possibly unstable subsystems. For the dissipation inequalities associated with the Lyapunov function of each subsystem, it is assumed that the supply functions, which characterize the decay rate and ISS/iISS gains of the subsystems, are nonlinear. The change in the value of Lyapunov functions at switching instants is described by a sum of growth and gain functions, which are also nonlinear. Using the notion of average dwell-time (ADT) to limit the number of switching instants on an interval, and the notion of average activation time (AAT) to limit the activation time for unstable systems, a formula relating ADT and AAT is derived to guarantee ISS/iISS of the switched system. Case studies of switched systems with saturating dynamics and switched bilinear systems are included for illustration of the results.
Point of care echocardiography and lung ultrasound in critically ill patients with COVID-19
Authors: Altersberger Martin , Schneider Matthias , Schiller Martina , Binder-Rodriguez Christina , Genger Martin , Khafaga Mounir , Binder Thomas , Prosch Helmut
Published: October 2021

Hundreds of millions got infected, and millions have died worldwide and still the number of cases is rising.

Chest radiographs and computed tomography (CT) are useful for imaging the lung but their use in infectious diseases is limited due to hygiene and availability.

Lung ultrasound has been shown to be useful in the context of the pandemic, providing clinicians with valuable insights and helping identify complications such as pleural effusion in heart failure or bacterial superinfections. Moreover, lung ultrasound is useful for identifying possible complications of procedures, in particular, pneumothorax.

Associations between coronavirus disease 2019 (COVID-19) and cardiac complications, such as acute myocardial infarction and myocarditis, have been reported. As such, point of care echocardiography as well as a comprehensive approach in later stages of the disease provide important information for optimally diagnosing and treating complications of COVID-19.

In our experience, lung ultrasound in combination with echocardiography, has a great impact on treatment decisions. In the acute state as well as in the follow-up setting after a severe or critical state of COVID-19, ultrasound can be of great impact to monitor the progression and regression of disease.
Twentieth century temperature and snow cover changes in the French Alps
Authors: Beaumet Julien , Ménégoz Martin , Morin Samuel , Gallée Hubert , Fettweis Xavier , Six Delphine , Vincent Christian , Wilhelm Bruno , Anquetin Sandrine
Published: October 2021

Changes in snow cover associated with the warming of the French Alps greatly influence social-ecological systems through their impact on water resources, mountain ecosystems, economic activities, and glacier mass balance. In this study, we investigated trends in snow cover and temperature over the twentieth century using climate model and reanalysis data. The evolution of temperature, precipitation and snow cover in the European Alps has been simulated with the Modèle Atmospherique Régional (MAR) applied with a 7-km horizontal resolution and driven by ERA-20C (1902-2010) and ERA5 (1981–2018) reanalyses data. Snow cover duration and snow water equivalent (SWE) simulated with MAR are compared to the SAFRAN - SURFEX-ISBA-Crocus - MEPRA meteorological and snow cover reanalysis (S2M) data across the French Alps (1958–2018) and in situ glacier mass balance measurements. MAR outputs provide a realistic distribution of SWE and snow cover duration as a function of elevation in the French Alps. Large disagreements are found between the datasets in terms of absolute warming trends over the second part of the twentieth century. MAR and S2M trends are in relatively good agreement for the decrease in snow cover duration, with higher decreases at low elevation ($\sim $
∼
5–10%/decade). Consistent with other studies, the highest warming rates in MAR occur at low elevations (< 1000 m a.s.l) in winter, whereas they are found at high elevations (> 2000 m a.s.l) in summer. In spring, warming trends show a maximum at intermediate elevations (1500 to 1800 m). Our results suggest that higher warming at these elevations is mostly linked to the snow-albedo feedback in spring and summer caused by the disappearance of snow cover at higher elevation during these seasons. This work has evidenced that depending on the season and the period considered, enhanced warming at higher elevations may or may not be found. Additional analysis in a physically comprehensive way and more high-quality dataset, especially at high elevations, are still required to better constrain and quantify climate change impacts in the Alps and its relation to elevation.
Long-term risk of shunt failure after brain tumor surgery
Authors: Hosainey Sayied Abdol Mohieb , Lykkedrang Benjamin Lassen , Meling Torstein R.
Published: October 2021

Long-term risks and survival times of ventriculoperitoneal (VP) shunts implanted due to hydrocephalus (HC) after craniotomy for brain tumors are largely unknown. The aim of this study was to establish the overall VP shunt survival rates during a decade after shunt insertion and to determine risks of shunt failure after brain tumor surgery in the long-term period. In this population-based cohort from a well-defined geographical region, all adult patients (> 18 years) from 2004 to 2013 who underwent craniotomies for intracranial tumors leading to VP shunt dependency were included. Our brain tumor database was cross-linked to procedure codes for shunt surgery (codes AAF) to extract brain tumor patients who became VP shunt dependent after craniotomy. The VP shunt survival time, i.e. the shunt longevity, was calculated from the day of shunt insertion after brain tumor surgery until the day of its failure. A total of 4174 patients underwent craniotomies, of whom 85 became VP shunt dependent (2%) afterwards. Twenty-eight patients (33%) had one or more shunt failures during their long-term follow-up, yielding 1-, 5-, and 10-year shunt success rates of 77%, 71%, and 67%, respectively. Patient age, sex, tumor location, primary/repeat craniotomy, placement of external ventricular drainage (EVD), ventricular entry, post-craniotomy hemorrhage, post-shunting meningitis/infection, and multiple shunt revisions were not statistically significant risk factors for shunt failure. Median shunt longevity was 457.5 days and 21.5 days for those with and without pre-craniotomy HC, respectively (p < 0.01). This study can serve as benchmark for future studies.
Assessment of the efficiency of different chemical treatments and ultrasonic cleaning for defatting of cancellous bone samples
Authors: Wang Fangxing , Metzner Florian , Osterhoff Georg , Schleifenbaum Stefan
Published: October 2021

Our study aimed to asses the defatting efficiency of different methods, which are commonly used and easily available in the laboratory in order to find a method that is effective, convenient, safe, and economical. Cylindrical cancellous bone specimens were obtained from fresh-frozen human cadaver femoral condyles, cut into multiple small specimens (Ø8 × 2 mm), and assigned to two groups that were treated with either chemical solvent soaking (Solvent group) or ultrasonic cleaning (Ultrasound group). Each group was divided into several subgroups based on different treatments. Digital photographs were taken of each specimen. The difference of material density (Δρb), apparent density (Δρapp), and porosity (ΔP) before and after treatment were used as evaluation indicators. For the solvent group, in Δρb, only the combination of 99% ethanol and detergent solution showed a significant difference before and after treatment (P = 0.00). There was no significant difference in ΔP among acetone, the mixture of 99% ethanol and acetone, and the combination of 99% ethanol and detergent solution (P = 0.93). For the ultrasound group, the median of all subgroups in Δρapp and ΔP were all lower than the solvent group. The combination of 99% ethanol and detergent solution (v/v = 1:20), as well as the mixture of 99% ethanol and acetone (v/v = 1:1), seem to be the optimal defatting methods for 2 mm thick cancellous bone slices due to their effectiveness, availability, low-cost and safety. Chemical soaking for 24 h is more effective than ultrasonic cleaning with 99% ethanol or acetone for 20 or 40 min.
The Role of Individual Differences in Sourcing: a Systematic Review
Authors: Anmarkrud Øistein , Bråten Ivar , Florit Elena , Mason Lucia
Published: October 2021

This article reviews how individual differences have been conceptualized and researched within the area of multiple document literacy, in particular the extent to which proposed relationships between individual differences and the multiple document literacy process of sourcing have been supported by the empirical research. The findings showed that although the majority of the individual differences included in theoretical models of multiple document literacy have been researched, the empirical backing of proposed relationships is rather ambiguous. Still, in-depth analyses of the most researched individual differences in relation to sourcing revealed some interesting and interpretable patterns. Further, the review suggested that relationships between individual differences and sourcing may vary not only with the way sourcing is measured but also with the domain or topic addressed in the reading materials. We discuss the current status of research on individual differences in the context of multiple document literacy with a focus on sourcing and suggest potential avenues for further clarifications.
Deep current structure in the Toyama Deep-Sea Channel in the Japan Sea
Authors: Senjyu Tomoharu
Published: October 2021

The flow field in the Toyama Deep-Sea Channel (TDSC) in the Japan Sea was investigated based on mooring observations. An asymmetric current system accompanying offshore and onshore currents over the east- and west-side slopes in the channel, respectively, is suggested. A bottom intensified flow characteristic was observed at the offshore stations in the Yamato Basin. The asymmetric current system in the channel is also suggested by the asymmetric distribution of water characteristics across the TDSC in Toyama Bay; a cold dense water mass with higher dissolved oxygen (DO) and higher transmittance (Tr) was found over the west-side slope of the channel, whereas a water mass with lower DO and lower Tr was distributed over the east-side slope, suggesting a turbidity current from the head of Toyama Bay. The currents facing the shallower depth on their right-hand-side, along with the density distribution in the TDSC, suggest a density current system under the influence of the earth’s rotation. The dissolved oxygen concentration in the TDSC was significantly lower than that in the offshore region of the same temperature range. This suggests that the water mass over the west-side slope in the TDSC is a modified offshore water mass which experienced significant mixing with the low DO water mass over the east-side slope in the TDSC, probably due to strong shear between the offshore and onshore currents in the narrow channel.
The Acceptance and Use of the e-Health Instrument ‘The Personal Health Check’ in Four Dutch Municipalities: Lessons Learned
Authors: Rombouts M. , Raaijmakers L. G. M. , Kuunders T. J. M. , Van Steijn-Martens R. , de Vuijst T. , van Donkersgoed H. , van de Goor L. A. M.
Published: October 2021

This pilot study assessed the acceptance and use of the e-Health instrument “the Personal Health Check” (PHC) among clients and professionals in primary care settings. By filling in the online PHC instrument, participants were provided insights into their health and lifestyle. When results revealed an increased health risk, participants were advised to undertake additional lab tests measuring blood pressure and haemaglobin levels. Based on the online questionnaire and optional lab tests, participants then received a report that included individually-tailored feedback from the e-Health application about personal health risks and suggestions for health interventions. The PHC was implemented in 2016 in four Dutch municipalities that determined which neighbourhood(s) the PHC targeted and how participants were invited. The Unified Theory of Acceptance and Use of Technology was used as a theoretical framework to address our research questions. Methods used to assess acceptance were: PHC instrument data, data from additional questionnaires completed by PHC participants, focus groups with PHC participants and professionals in primary care, and telephone interviews with non-responders to the invitation to participate in the online PHC. Of the 21,735 invited, 12% participated. Our results showed that participants and professionals in this pilot were predominantly positive about the PHC. Participants reported that they made an effort to apply the PHC lifestyle advice they received. Almost all had the knowledge and resources needed to use the PHC online instrument. Invitations from general practitioners almost doubled participation relative to invitations from the sponsoring municipalities. The overall low response rate, however, suggests that the PHC is unsuitable as a foundation on which to develop local public health policy.
Traveling between worlds: repositioning methods and theory for research into coupled socio-ecological systems
Authors: Gerrits Lasse
Published: October 2021

Context

This paper engages with the question of how one can arrive at more coherent explanations of social behavior in coupled socio-ecological systems.

Objectives

The paper aims to give a counterargument to the assumption that social theory in coupled socio-ecological systems can only be developed in one way, as such showing that the premise of the special issue deserves further scrutiny.

Methods

Current issues are identified and categorized based on a literature survey; likewise, the solutions derive from methodological literature, in particular from the realm of critical realism.

Results

The paper shows how a set of assumptions about the nature of socio-ecological systems and about the nature of theory derived from observations prohibit a deeper understanding of how social theory may be developed at the nexus of coupled socio-ecological systems. Researchers should engage more clearly with movements between theories, models and data, and movements between ontology, epistemology and data.

Conclusions

Landscape ecology can—and should—accommodate social theory in its analysis but from a different premise than is currently often the case. The proposed operations will contribute to a complexity-informed understanding of human behavior in coupled socio-ecological systems.
Forgotten coast, forgotten people: sustainable development and disproportionate impacts from Hurricane Michael in Gulf County, Florida
Authors: Boda Chad S. , Scown Murray W. , Faran Turaj
Published: October 2021

A central challenge for sustainable development is how societies are to avoid, minimize or address impacts from anthropogenic climate change. However, competing perspectives on “what should be sustained” lead to widely different understandings of what mitigation, adaptation and loss and damage entail and how best to approach them. We provide a novel conceptual and empirical comparison of two contrasting sustainable development-based approaches to the study of impacts from climate-related extreme events: Capital Theory and capability-based Human Development. We use our analysis of immediate residential property value and housing capacity impacts caused by Hurricane Michael in Gulf County, Florida, to demonstrate how the sustainable development theory used to assess and interpret impacts greatly affects the identification of whom and where is objectively “most impacted.” Through a comparison of the two approaches, we identify relative advantages and disadvantages, emphasizing that while both provide coherent, comprehensive, and integrative approaches to climate-related impact assessment, the capability approach is much less likely to lead researchers and practitioners to overlook the most disadvantaged communities when compared to Capital Theory.
Adipogenic progenitors in different organs: Pathophysiological implications
Authors: Favaretto Francesca , Bettini Silvia , Busetto Luca , Milan Gabriella , Vettor Roberto
Published: October 2021

In physiological conditions, the adipose organ resides in well-defined areas, where it acts providing an energy supply and as an endocrine organ involved in the control of whole-body energy metabolism. Adipose tissue adipokines connect the body’s nutritional status to the regulation of energy balance. When it surrounds organs, it provides also for mechanical protection. Adipose tissue has a complex and heterogenous cellular composition that includes adipocytes, adipose tissue-derived stromal and stem cells (ASCs) which are mesenchymal stromal cells, and endothelial and immune cells, which signal to each other and to other tissues to maintain homeostasis. In obesity and in other nutrition related diseases, as well as in age-related diseases, biological and functional changes of adipose tissue give rise to several complications. Obesity triggers alterations of ASCs, impairing adipose tissue remodeling and adipose tissue function, which induces low-grade systemic inflammation, progressive insulin resistance and other metabolic disorders. Adipose tissue grows by hyperplasia recruiting new ASCs and by hypertrophy, up to its expandability limit. To overcome this limitation and to store the excess of nutrients, adipose tissue develops ectopically, involving organs such as muscle, bone marrow and the heart. The origin of ectopic adipose organ is not clearly elucidated, and a possible explanation lies in the stimulation of the adipogenic differentiation of mesenchymal precursor cells which normally differentiate toward a lineage specific for the organ in which they reside. The chronic exposition of these newly-formed adipose depots to the pathological environment, will confer to them all the phenotypic characteristics of a dysfunctional adipose tissue, perpetuating the organ alterations. Visceral fat, but also ectopic fat, either in the liver, muscle or heart, can increase the risk of developing insulin resistance, type 2 diabetes, and cardiovascular diseases. Being able to prevent and to target dysfunctional adipose tissue will avoid the progression towards the complications of obesity and other nutrition-related diseases. The aim of this review is to summarize some of the knowledge regarding the presence of adipose tissue in particular tissues (where it is not usually present), describing the composition of its adipogenic precursors, and the interactions responsible for the development of organ pathologies.
Reactivity of selected markers of innate and adaptive immunity in rabbits experimentally infected with antigenic variants of RHD (Lagovirus europaeus/GI.1a)
Authors: Niedźwiedzka-Rystwej Paulina , Tokarz-Deptuła Beata , Deptuła Wiesław
Published: October 2021

Lagovirus europaeus/GI.1 causes a fatal viral condition in rabbits characterized by acute viral hepatitis and disseminated intravascular coagulation. Due to rapid viral and environmental changes variants (Lagovirus europaeus/GI.1a and GI.2) have appeared and few immunological studies were performed. The aim of the study was to determine innate and adaptive immunity parameters in rabbits infected with six Lagovirus europeus/GI.1a viruses. To achieve the goal several methods were used, i.e. cytometry, microscopy, biochemical and cytochemical tests, spectrophotometry. The results show that three immunotypes exists among the studied strains and they differ in innate (mainly) and adaptive immunity, partly depending on hemagglutination. The peak of changes is 24 h post infection in phagocytosis markers of polymorphonuclear cells and CD8+ T cells. Lagovirus europaeus/GI.1a strains differ from Lagovirus europaeus/GI.1 in terms of immunological response based on our previous work concerning the same parameters in immunological response against this disease.
Betriebliche Konflikte und Konfliktmanagement
Authors: West-Leuer Beate
Published: October 2021

Arbeits- und Betriebsmediziner sind weder Konfliktmanager noch Konfliktmoderatoren noch Konfliktmediatoren. Doch haben sie täglich mit betrieblichen Konflikten zu tun, mal als Beobachter, mal als Beteiligte. Nolens volens werden sie sich mit diesen Konflikten befassen und versuchen, Lösungsstrategien zu entwickeln. Der folgende Beitrag zeigt Parameter für diese Konfliktdiagnosen und die daraus abgeleiteten Interventionsplanungen auf, die eine psychodynamische Tiefenebene mit einbeziehen. Im Konfliktfall soll dadurch das Verständnis der Konfliktparteien füreinander und damit die Kompromissbereitschaft erhöht werden. Der Konflikt wird befriedet oder verursacht zumindest keinen weiteren Schaden im innerbetrieblichen Miteinander.
The ethical challenges facing the widespread adoption of digital healthcare technology
Authors: Zarif Azmaeen
Published: October 2021

With the rise of telemedicine, wearable healthcare, and the greater leverage of ‘big data’ for precision medicine, various challenges present themselves to organisations, physicians, and patients. Beyond the practical, financial, and clinical considerations, we must not ignore the ethical imperative for fair and just applications to improve the field of healthcare for all. Given the increasing personalisation of medicine and the role technology will play at the interface of healthcare delivery, a thorough understanding of the challenges presented is critical for future physicians who will navigate a novel environment. This article aims to explore the ethical challenges that the adoption of digital healthcare technology presents, contextualised at multiple levels. Potential solutions are suggested to initiate a discussion about the future of medicine and digital healthcare.
Enterococcus faecalis bloodstream infection: does infectious disease specialist consultation make a difference?
Authors: Cattaneo Chiara , Rieg Siegbert , Schwarzer Guido , Müller Matthias C. , Blümel Benjamin , Kern Winfried V.
Published: October 2021

Purpose

To evaluate the relationship between mortality or relapse of bloodstream infection (BSI) due to Enterococcus faecalis and infectious diseases specialist consultation (IDC) and other factors potentially associated with outcomes.

Methods

In a tertiary-care center, consecutive adult patients with E. faecalis BSI between January 1, 2016 and January 31, 2019, were prospectively followed. The management of E. faecalis BSI was evaluated in terms of adherence to evidence-based quality-of-care indicators (QCIs). IDC and other factors potentially associated with 90-day-mortality or relapse of E. faecalis BSI were analyzed by multivariate logistic regression.

Results

A total of 151 patients with a median age of 68 years were studied. IDC was performed in 38% of patients with E. faecalis BSI. 30 cases of endocarditis (20%) were diagnosed. All-cause in-hospital mortality was 23%, 90-day mortality was 37%, and 90-day relapsing E. faecalis BSI was 8%. IDC was significantly associated with better adherence to 5 QCIs. Factors significantly associated with 90-day mortality or relapsing EfB in multivariate analysis were severe sepsis or septic shock at onset (HR 4.32, CI 2.36e7.88) and deep-seated focus of infection (superficial focus HR 0.33, CI 0.14e0.76).

Conclusion

Enterococcus faecalis bacteremia is associated with a high mortality. IDC contributed to improved diagnostic and therapeutic management.