bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative effectiveness of dimethyl fumarate in multiple sclerosis
Authors: Bosco‐Lévy Pauline , Debouverie Marc , Brochet Bruno , Guillemin Francis , Louapre Céline , Maillart Elisabeth , Heinzlef Olivier , Lignot Séverine , Diez Pauline , Abouelfath Abdelilah , Lassalle Régis , Blin Patrick , Droz‐Perroteau Cécile
Published: September 2021

Aims

To assess the effectiveness of dimethyl fumarate (DMF) on annual rate of relapse subject to treatment (ARRt) and disability progression in multiple sclerosis (MS) compared to injectable immunomodulators (IMM), teriflunomide (TERI) and fingolimob (FTY), in real‐life setting.

Methods

A population‐based cohort study was conducted using data of the French nationwide claims database, SNDS. All patients initiating IMM, TERI, FTY or DMF between 1 July 2015 and 12 December 2017, with 4.5 years of database history and 1–3.5 years of follow‐up were included in this study. DMF patients were 1:1 matched to IMM, TERI or FTY using a high dimensional propensity score. Negative binomial regression and a logistic regression model were used to estimate the relative risk (RR ± [95% CI]) of ARRt and the odds ratio (OR ± [95% CI]) of disability progression, respectively.

Results

Overall, 9304 subjects were identified: 29.0% initiated DMF, 33.2% TERI, 5.6% FTY and 32.2% an IMM. The matched cohorts consisted of 1779 DMF‐IMM patients, 1679 DMF‐TERI patients, and 376 DMF‐FTY patients. DMF significantly reduced ARRt compared to IMM (RR 0.72 [0.61–0.86]) and TERI (0.81 [0.68–0.96]) and did not show any significant difference when compared with FTY. The risk of the progression of MS‐specific disability was not significantly different for any matched cohorts.

Conclusion

DMF is associated with lower risk of treated relapse for patients with RRMS than other first‐line RRMS agents (TERI and IIM).
Sex differences in the effect of chronic delivery of the buprenorphine analogue BU08028 on heroin relapse and choice in a rat model of opioid maintenance
Authors: Bossert Jennifer M. , Townsend E. Andrew , Altidor Lindsay K‐P , Fredriksson Ida , Shekara Aniruddha , Husbands Stephen , Sulima Agnieszka , Rice Kenner C. , Banks Matthew L. , Shaham Yavin
Published: September 2021

Background and Purpose

Maintenance treatment with opioid agonists (buprenorphine, methadone) decreases opioid use and relapse. We recently modelled maintenance treatment in rats and found that chronic delivery of buprenorphine or the μ opioid receptor partial agonist TRV130 decreased relapse to oxycodone seeking and taking. Here, we tested the buprenorphine analogue BU08028 on different heroin relapse‐related measures and heroin versus food choice.

Experimental Approach

For relapse assessment, we trained male and female rats to self‐administer heroin (6 h·day−1, 14 days) in Context A and then implanted osmotic minipumps containing BU08028 (0, 0.03 or 0.1 mg·kg−1·d−1). Effects of chronic BU08028 delivery were tested on (1) incubation of heroin‐seeking in a non‐drug Context B, (2) extinction responding reinforced by heroin‐associated discrete cues in Context B, (3) reinstatement of heroin‐seeking induced by re‐exposure to Context A and (4) re‐acquisition of heroin self‐administration in Context A. For choice assessment, we tested the effect of chronic BU08028 delivery on heroin versus food choice.

Key Results

Chronic BU08028 delivery decreased incubation of heroin seeking. Unexpectedly, BU08028 increased re‐acquisition of heroin self‐administration selectively in females. Chronic BU08028 had minimal effects on context‐induced reinstatement and heroin versus food choice in both sexes. Finally, exploratory post hoc analyses suggest that BU08028 decreased extinction responding selectively in males.

Conclusions and Implications

Chronic BU08028 delivery had both beneficial and detrimental, sex‐dependent, effects on different triggers of heroin relapse and minimal effects on heroin choice in both sexes. Results suggest that BU08028 would not be an effective opioid maintenance treatment in humans.
Maternal resources for care are associated with child growth and early childhood development in Bangladesh and Vietnam
Authors: Basnet Sulochana , Frongillo Edward A. , Nguyen Phuong Hong , Moore Spencer , Arabi Mandana
Published: September 2021

Background

Suboptimal child growth and development are significant problems in low‐ and middle‐income countries. Maternal resources for care may help to improve growth and development. This study examined the association of maternal resources for care on child length, motor development and language development of children 12–23.9 months old.

Methods

We used baseline data from the Alive & Thrive household surveys collected in Bangladesh (n = 803) and Vietnam (n = 635). Resources for care were represented by maternal education, knowledge, height, well‐nourishment, mental well‐being, decision‐making, employment, support in chores and perceived support. The regression analyses were adjusted for household wealth and other covariates on households, children and parents and accounted for geographical clustering.

Results

Maternal height (Bangladesh β = 0.150 p < 0.001, Vietnam β = 0.156 p < 0.001), well‐nourishment (Vietnam β = 0.882 p = 0.007) and mental well‐being (Bangladesh β = 0.0649 p = 0.008, Vietnam β = 0.0742 p = 0.039) were associated with child length. Well‐nourishment (Vietnam β = 0.670 p = 0.042) and support in chores (Bangladesh β = 0.0983 p = 0.021) were associated with child motor development. Mental well‐being (Vietnam β = 0.0735 p = 0.013), decision‐making autonomy (Bangladesh β = 0.0886 p = 0.029) and perceived support (Vietnam β = 0.445 p = 0.003) were associated with child language development.

Conclusion

Maternal height, well‐nourishment, mental well‐being, decision‐making, support in chores and perceived social support were associated with child outcomes. Interventions that help to improve resources among mothers have potential to foster child growth and development.
Clinical and CT findings of adenovirus pneumonia in immunocompetent adults
Authors: Zhang Peiyao , Liu Min , Zhang Ling , Guo Xiaojuan , Lu Binghuai , Wang Yimin , Zhan Qingyuan
Published: September 2021

Introduction

Adenovirus pneumonia is not uncommon in children and immunocompromised patients. However, the study of the clinical and computed tomography (CT) characteristics of Adenovirus pneumonia in immunocompetent adults is still limited.

Objective

The objective of this study was to retrospectively observe the clinical and CT characteristics as well as their dynamic change of Adenovirus pneumonia in immunocompetent adults.

Methods

Twenty patients (18 males, median age, 36 years old) with Adenovirus pneumonia were retrospectively included from January 2018 to December 2019. Clinical information and chest CT at admission of all patients were reviewed. Twelve patients underwent serial CT scans, and the temporal changes of CT findings were summarized. Pneumonia severity index (PSI) was calculated according to clinical information.

Results

The median time interval from illness onset to admission was 6 days (interquartile range [IQR], 5–7.5 days). The clinical characteristics included the high fever (39.2 ± 0.8°C) with the normal white blood cell count, the decreased lymphocyte, and elevated C‐reactive protein. Ten cases complicated with mycoplasma infection at admission. Thirteen patients were mechanically ventilated, and two patients died during hospitalization. Consolidation was a predominant pattern found during the first 2 weeks and then resolved to minimal consolidation after the fourth week. There was no significant correlation between CT score and PSI score (r = 0.15, p = 0.41).

Conclusions

Predominant radiological finding of Adenovirus pneumonia was consolidation. Multilobular involvement, higher CT scores, and pleural effusion were found in more severe patients. The abnormal opacity peaked in 2 weeks of illness onset and gradually resolved after the third week. The temporal changes of radiological score are consistent with clinical findings.
Cooperative intentions and their implications on reciprocal cooperation in Norway rats
Authors: Schweinfurth Manon K.
Published: September 2021

One way to cooperate with others and avoid exploitation is reciprocal cooperation. Reciprocity is the selective helping of those who were cooperative before, which is commonly based on outcomes. Yet, outcomes may not reflect intentions, that is if an individual is unable but willing to help. Humans, including children, show such intention‐based reciprocity. However, it is unclear whether other animals consider intentions in reciprocal settings. Here, I tested whether Norway rats (Rattus norvegicus) reciprocate help based on intentions by manipulating the outcome while keeping the partner's cooperative intentions the same. Subjects experienced a partner that was able to help by providing food via a movable platform. In another condition, the same partner was unable to help because the platform was blocked. When the roles were exchanged afterwards, subjects provided food more often to “able” than “unable” partners, even though the latter attempted to help. I compared these findings to data using “willing” and “unwilling” partners that were able to help. Again, rats based their cooperative behaviour on outcomes rather than the intention to help. This suggests that rats reciprocate primarily based on outcomes and seem to not consider cooperative intentions. Although subjects provided consistently less food to partners that did not help, they provided them with some help. Potentially, rats use a cognitively less demanding strategy by helping defectors a bit to maintain cooperation. Thereby, cooperation might be resistant to situations in which an apparent defector was actually unable to help, but had cooperative intentions and might be a good cooperation partner in the future.
Co‐option and the evolution of food sharing in vampire bats
Authors: Carter Gerald G.
Published: September 2021

The function of cooperative traits can change over time. For example, helping behaviors that originally evolved by kin selection can later yield direct fitness benefits and be stabilized by partner choice. In such cases, there may be multiple interacting factors that drive cooperation. Here, I review evidence that food sharing in vampire bats evolved as form of extended maternal care that was co‐opted to yield reciprocal benefits, and that such reciprocal relationships may have led to investment strategies that balance the trade‐offs between greater quality and quantity of cooperative relationships.
Experience of social density during early life is associated with attraction to conspecific odour in the common vole (Microtus arvalis)
Authors: Schneeberger Karin , Eccard Jana A.
Published: September 2021

Social organisation in species with fluctuating population sizes can change with density. Therefore, information on (future) density obtained during early life stages may be associated with social behaviour. Olfactory cues may carry important social information. We investigated whether early life experience of different experimental densities was subsequently associated with differences in attraction to adult conspecific odours. We used common voles (Microtus arvalis), a rodent species undergoing extreme density fluctuations. We found that individuals originating from high experimental density populations kept in large outdoor enclosures invested more time in inspecting conspecific olfactory cues than individuals from low‐density populations. Generally, voles from both treatments spent more time with the olfactory cues than expected by chance and did not differ in their latency to approach the odour samples. Our findings indicate either that early experience affects odour sensitivity or that animals evaluate the social information contained in conspecific odours differently, depending on their early life experience of conspecific density.
From relationship orientation to task orientation: On the digitalization of clinical leaders
Authors: Pettersen Inger Johanne , Solstad Elsa
Published: September 2021

This paper studies how clinical leaders perceive their leadership tasks in the context of virtual interactions. We ask whether distant leadership involves a shift from relationship orientation to more task‐ and control‐oriented leaders in hospital settings. We explore two cases involving 10 clinical leaders in a university hospital in Norway. The study indicates that the leaders were aware that lack of direct communication hampers relationship‐oriented leadership, which weakens efforts to develop a common identity in the clinics. The absence of direct communication reduces opportunities for relationship‐oriented leadership, which may hamper the development of social and self‐controls in professional organizations. However, clinical leaders are dependent on professionals’ social and self‐controls to perform at high levels. Large distances reduce leaders’ ability to build personal relations with their staff. On the other hand, professionals in healthcare are highly educated, and thus they are to a large degree self‐governed. The possible effects of distant leadership may consequently not be that harmful in clinical settings.
Indigenous institutions and their role in socioeconomic affairs management: Evidence from indigenous institutions of the Awi people in Ethiopia
Authors: Genet Abraham
Published: September 2021

Indigenous institutions, local‐level organisations based on societal values, are receiving a positive appreciation for their acceptability and sustainability. The purpose of this research is to demonstrate the roles of indigenous institutions in the social and economic lives of people, presenting evidence from the three indigenous institutions of the Awi people in Ethiopia, namely: the “Awi Equestrian Association”, “Head of Cow”, and “Head of Water”. The research is based on an ethnographic approach and qualitative design. Informants were chosen by purposive sampling. Data were collected mainly through interviewing, complemented by focus group discussion, observation, and review of relevant literature, which were thematically analysed together with the primary data. The findings of the study reveal that the Awi Equestrian Association works on charity, social welfare, reconciliation, festivity, and recreation, whereas Head of Cow and Head of Water institutions are engaged in the efficient and equitable management of cattle and irrigation water resources, respectively, plus managing conflicts between people in their respective sectors. Conflict resolution and justice maintenance was found to be the common feature of all the three indigenous institutions. The research concludes that the three indigenous institutions of the Awi have remarkable roles in terms of social support, conflict resolution, resource management, and reinforcing social cohesion.
Volume‐based ranking method for a ranked voting system
Authors: Kim Jong Hyen , Ahn Byeong Seok
Published: September 2021

In a ranked voting system, candidates receive different votes in different ranking places. Many aggregation methods have been proposed to determine the ranking of the candidates competing for a limited number of positions. The most popular one is the weighted sum of votes that each candidate receives. The data envelopment analysis‐based models also aggregate the submitted ranked votes into the final ranking of candidates by using the most favorable weights for each candidate. Most of such models, however, attempt to solve the problem with the discriminating factors (i.e., gaps between successive ranks) given specifically by zero or more restrictive constraints. This study presents a new ranking method for a ranked voting system that explicitly considers the unknown discriminating factors as they are. Specifically, we solve a dual of a dominance problem for a pair of candidates to effectively manage the unknown discriminating factors and then compute the volume of a set of the discriminating factors in favor of a candidate over another. A decision rule indicates that a candidate in a pair of candidates is preferred to another if the pair of candidates results in a larger volume than the reversed pair of candidates in that more discriminating factors necessarily yield a larger volume and thus more evidence in favor of a candidate over another exists. Therefore, the volume‐based ranking method can be used to obtain the rank order of candidates in situations where any prior information on the discriminating factors is unavailable as is generally observed in real decision‐making contexts.
Network meta‐analyses in psoriasis: overview and critical discussion
Authors: Augustin M. , Valencia López M. , Reich K.
Published: September 2021

Network meta‐analyses (NMAs) increasingly assist in treatment decisions in disease areas such as psoriasis, where data from multiple clinical trials (CTs) on a growing number of different drugs become available. This study aimed to characterize NMAs published in psoriasis. A systematic literature search in PubMed was conducted using a structured search protocol based on the PRISMA criteria. Twenty‐seven NMAs were identified, including an average of 43 CTs per NMA. Only eight of 27 NMAs (29.6%) were documented in the PROSPERO registry and only 17 (63%) reported following the PRISMA criteria. The mean number of patients per NMA was 19 624 (range: 6113–51 749). Across all NMAs, the drugs most frequently included were ustekinumab (n = 27 NMAs), followed by adalimumab (n = 25), infliximab and etanercept (n = 24 each). In all n = 27 NMAs, placebo comparisons and in n = 25, comparisons with active controls were used for bridging. Effect estimates were performed in all cases, SUCRA in 14. Most frequently used outcomes were Psoriasis Area and Severity Index (PASI) 75 (n = 25) and PASI 90 (n = 24), and Dermatology Life Quality Index (n = 10). NMAs mostly measured induction efficacy (weeks 10–16, n = 25) but rarely long‐term outcomes (weeks 48–56, n = 4). Sensitivity analyses were performed in n = 17 (63%) of the studies. Main results varied considerably between studies and depended on the year of publication and thus the number of available drugs and studies. However, the concordance between NMA efficacy rankings based on PASI 75 was high. Although a large number of NMAs have been published on psoriasis showing highly comparable results on efficacy, no sufficient information on the quality criteria was reported, and PROSPERO registry criteria were not followed. This argues in favour of greater standardization of NMA methodology and reporting.
Effect of mifepristone and lithospermum combination regimen on medical abortion in early pregnancy rats
Authors: Yu Qiong , Hu Shihong , Hu Shifu
Published: September 2021

Objective

To investigate the optimal dose of mifepristone and lithospermum combination regimen on medical abortion in early pregnancy rats without increasing side effects.

Study Design

Sixty sexually mature female Sprague Dawley (SD) rats with early pregnancy were randomly allocated into 10 groups, including a control group (treated with 0.5% CMC‐Na) and nine experiments (treated with 1 mg/kg mifepristone, and 90, 180, 270, and 540 mg/kg lithospermum, and 90/180/270/540 mg/kg lithospermum +1 mg/kg mifepristone, respectively). The hormone levels, factors associated with endometrial bleeding, oxidative stress, and apoptotic proteins in the endometrium, were then investigated.

Results

The results demonstrated that 540 mg/kg lithospermum plus 1 mg/kg mifepristone treatment significantly improved the abortion rate when compared with the control group. Compared with the 1 mg/kg mifepristone, 540 mg/kg lithospermum plus 1 mg/kg mifepristone treatment did not induce significant increase in factors associated with abnormal endometrial bleeding, such as matrix metalloproteinase‐9 (MMP9). However, mifepristone and lithospermum combination regimen promoted the expression level of malondialdehyde (MDA), activated caspase 3, caspase 9 and Bax, meanwhile, reduced the expression of superoxide dismutase (SOD) and Bcl‐2.

Conclusion

These findings provided strong evidence that mifepristone and lithospermum combination regimen can obtain satisfactory abortion effect without increasing the expression level of bleeding‐related factors.
Exercise‐induced airflow changes in horses with asthma measured by electrical impedance tomography
Authors: Herteman Nicolas , Mosing Martina , Waldmann Andreas D. , Gerber Vinzenz , Schoster Angelika
Published: September 2021

Background

Equine asthma (EA) causes airflow impairment, which increases in severity with exercise. Electrical impedance tomography (EIT) is an imaging technique that can detect airflow changes in standing healthy horses during a histamine provocation test.

Objectives

To explore EIT‐calculated flow variables before and after exercise in healthy horses and horses with mild‐to‐moderate (MEA) and severe equine asthma (SEA).

Animals

Nine healthy horses 9 horses diagnosed with MEA and 5 with SEA were prospectively included.

Methods

Recordings were performed before and after 15 minutes of lunging. Absolute values from global and regional peak inspiratory (PIF, positive value) and expiratory (PEF, negative value) flows were calculated. Data were analyzed using a mixed model analysis followed by Bonferroni's multiple comparisons test to evaluate the impact of exercise and diagnosis on flow indices.

Results

Control horses after exercise had significantly lower global PEF and PIF compared to horses with SEA (mean difference [95% confidence interval, CI]: 0.0859 arbitrary units [AU; 0.0339‐0.1379], P < .001 and 0.0726 AU [0.0264‐0.1188], P = .001, respectively) and horses with MEA (0.0561 AU [0.0129‐0.0994], P = .007 and 0.0587 AU [0.0202‐0.0973], P = .002, respectively). No other significant differences were detected.

Conclusions and Clinical Importance

Electrical impedance tomography derived PIF and PEF differed significantly between healthy horses and horses with SEA or MEA after exercise, but not before exercise. Differences between MEA and SEA were not observed, but the study population was small.
Deciphering the fingerprint of disturbance on the three‐dimensional structure of the world’s forests
Authors: Jucker Tommaso
Published: September 2021

Canopy gaps and the processes that generate them play an integral role in shaping the structure and dynamics of forests. However, it is only with recent advances in remote sensing technologies such as airborne laser scanning that studying canopy gaps at scale has become a reality. Consequently, we still lack an understanding of how the size distribution and spatial organization of canopy gaps varies among forests ecosystems, nor have we determined whether these emergent properties can be reconciled with existing theories of forest dynamics. Here, I outline a roadmap for integrating remote sensing with field data and individual‐based models to build a comprehensive picture of how environmental constraints and disturbance regimes shape the three‐dimensional structure of the world’s forests.
Nitrogen form‐mediated ethylene signal regulates root‐to‐shoot K+ translocation via NRT1.5
Authors: Chen Haifei , Zhang Quan , Wang Xueru , Zhang Jianhua , Ismail Abdelbagi M. , Zhang Zhenhua
Published: September 2021

Nitrogen–potassium synergistic and antagonistic interactions are the typical case of nutrient interactions. However, the underlying mechanism for the integration of the external N form into K+ homeostasis remains unclear. Here, we show that opposite effects of NO3− and NH4+ on root‐shoot K+ translocation were due to differential regulation of an ethylene signalling pathway targeting the NRT1.5 transporter. NH4+ upregulated the transcriptional activity of EIN3, but repressed the expression of NRT1.5. However, the addition of NO3− strongly suppressed the activity of EIN3, whereas its addition upregulated the expression of AtNRT1.5 and shoot K+ concentration. The 35S:EIN3/ein3eil1 plants, nrt1.5 mutants and nrt1.5/skor double mutants displayed a low K+ chlorosis phenotype, especially under NH4+ conditions with low K+ supply. Ion content analyses indicate that root‐to‐shoot K+ translocation was significantly reduced in these mutants. A Y1H assay, an EMSA and a transient expression assay confirmed that AtEIN3 protein could directly bind to the promoter of NRT1.5 to repress its expression. Furthermore, grafted plants with the roots of 35S:EIN3 and ein3eil1/nrt1.5 mutants displayed marked leaf chlorosis with a low K+ concentration. Collectively, our findings reveal that the interaction between N form and K+ was achieved by modulating root‐derived ethylene signals to regulate root‐to‐shoot K+ translocation via NRT1.5.
Foliar respiration is related to photosynthetic, growth and carbohydrate response to experimental drought and elevated temperature
Authors: Collins Adam D. , Ryan Michael G. , Adams Henry D. , Dickman Lee Turin , Garcia‐Forner Núria , Grossiord Charlotte , Powers Heath H. , Sevanto Sanna , McDowell Nate G.
Published: September 2021

Short‐term plant respiration (R) increases exponentially with rising temperature, but drought could reduce respiration by reducing growth and metabolism. Acclimation may alter these responses. We examined if species with different drought responses would differ in foliar R response to +4.8°C temperature and −45% precipitation in a field experiment with mature piñon and juniper trees, and if any differences between species were related to differences in photosynthesis rates, shoot growth and nonstructural carbohydrates (NSCs). Short‐term foliar R had a Q10 of 1.6 for piñon and 2.6 for juniper. Piñon foliar R did not respond to the +4.8°C temperatures, but R increased 1.4× for juniper. Across treatments, piñon foliage had higher growth, lower NSC content, 29% lower photosynthesis rates, and 44% lower R than juniper. Removing 45% precipitation had little impact on R for either species. Species differences in the response of R under elevated temperature were related to substrate availability and stomatal response to leaf water potential. Despite not acclimating to the higher temperature and having higher R than piñon, greater substrate availability in juniper suggests it could supply respiratory demand for much longer than piñon. Species responses will be critical in ecosystem response to a warmer climate.
Exploring stakeholders and their requirements in the process of home hemodialysis: A literature review
Authors: Khan Ilyas , Pintelon Liliane , Martin Harry , Khan Rahmat Ali
Published: September 2021

Providing home hemodialysis (HHD) therapy is a complex process that not only requires the use of a complex technology but also involves a diverse group of stakeholders, and each stakeholder has their requirements and may not share a common interest. Bringing them together will require the alignment of their interests. A process management perspective can help to accomplish the alignment of their interests. To align their interests, it is crucial to identify interest groups and understand their interests. The main objective of this paper is to identify the stakeholders and represents their interests as a list of requirements in the HHD process. An extensive literature review has been carried out and PubMed was used for literature extraction. In total, 1848 articles were retrieved of which 80 have fulfilled the inclusion criteria. A large array of actors is identified and their interests/requirements at different stages of the HHD process are represented in the form of a list. They have both common and conflicting requirements in the HHD process. If these requirements are aligned and balanced, a stakeholder's driven treatment process will be developed and a real improvement will be achieved in the treatment process.
Informal social protection: A conceptual synthesis
Authors: Mumtaz Zahid
Published: September 2021

Various informal networks such as extended and immediate family, religious organizations, and NGOs assist a large segment of the neglected poor population worldwide by providing informal social protection. However, it is hard to locate a comprehensive definition of informal social protection that may help measure its aggregate benefits. Hence, it represents a considerable gap in the literature. To fill this gap, we used existing literature to define and devise a new framework to conceptualize and categorize informal social protection into three components: informal assistance, informal insurance, and informal labour market measures. By doing so, this paper makes critical contributions to the social policy literature as follows: First, the study synthesizes a sizeable body of research to provide a comprehensive definition and conceptualizes informal social protection in three components. The primary sources of the provision of three components of informal social protection are also presented. Second, this conceptualisation would help measure the concept of informal social protection and its attributes. Last, the proposed framework helps compare informal with formal social protection, which can further integrate the two forms of social protection. These contributions will respond to the repeated calls in the literature to advance the scholarship and develop meaningful questions for research on the role of informal social protection.
The political science of Covid‐19: An introduction
Authors: Barberia Lorena , Plümper Thomas , Whitten Guy D.
Published: September 2021

Political decisions, constellations, and behaviors exert a large influence of the dynamics of the severe acute respiratory syndrome coronavirus 2 (Sars‐CoV‐2) pandemic. Politics influences the choice of containment policies and the compliance with these policies—and therefore ultimately the epidemiological situation in each country, state, district, or even neighborhood. This introduction puts the articles collected in this special issue into the broader perspective of the social science literature on Covid‐19.
Donor HLA genotyping of ex vivo expanded urine cells from kidney transplant recipients
Authors: Li Xirui , Wei Yongcheng , Li Jun , Deng Ronghai , Fu Qian , Nie Weijian , Zhang Huanxi , Wu Chenglin , Su Xiaojun , Wang Jiali , Cao Dajiang , Liu Xiangjun , Liu Longshan , Wang Changxi
Published: September 2021

Antibody‐mediated rejection (AMR) induced by donor‐specific anti‐HLA antibodies (DSA) remains a major cause of long‐term graft loss after kidney transplantation. Currently, the presence of DSA cannot always be determined at a specific allele level, because existing donor HLA typing is low resolution and often incomplete, lacking HLA‐DP, and occasionally HLA‐C and HLA‐DQ information and historical donor DNA samples are not available for HLA retyping. Here we present a novel, non‐invasive technique for obtaining donor DNA from selectively expanded donor cells from urine of renal transplant recipients. Urine‐derived cells were successfully expanded ex vivo from 31 of 32 enrolled renal transplant recipients, and with DNA obtained from these cells, donor HLA typing was unambiguously determined for HLA‐A, ‐B, ‐C, ‐DRB1, ‐DQA1, ‐DQB1, ‐DPA1 and ‐DPB1 loci by next‐generation sequencing. Our results showed 100% concordance of HLA typing data between donor peripheral blood and recipient urine‐derived cells. In comparison, HLA typing showed that DNA derived from urine sediments mainly contained recipient‐derived DNA. We also present the successful application of our novel technique in a clinical case of AMR in a renal transplant recipient. Urine‐derived donor cells can be isolated from kidney transplant recipients and serve as a suitable source of donor material for reliable high‐resolution HLA genotyping. Thus, this approach can aid the assessment of DSA specificity to support the diagnosis of AMR as well as the evaluation of treatment efficacy in kidney transplant recipients when complete donor HLA information and donor DNA are unavailable.
Multicultural competencies training programs for health care staff and health students in academic and professional settings: a scoping review protocol
Authors: Teixeira-Santos Luísa , Camarneiro Ana Paula , Xavier Beatriz , Ventura Filipa , Cunha-Oliveira Aliete , Monteiro Ana Paula
Published: September 2021

Objective:

The aim of the proposed scoping review is to identify training programs in multicultural competencies for health care staff and health students in professional and academic settings.

Introduction:

Cultural competence training for health care professionals is an imperative challenge in today's culturally diverse societies to ensure that all people receive equitable and effective health care, particularly those from culturally diverse backgrounds.

Inclusion criteria:

This scoping review will consider literature with adult participants aged ≥ 18 years, health care staff, and health students who may have received or are receiving multicultural competencies training. Literature published since 1960 in English, Portuguese, Spanish, and French will be considered for inclusion. Literature will be excluded if it reports on multicultural competencies training programs for students outside the health domain or for non-professional high school programs.

Methods:

The search strategy, designed according to the inclusion and exclusion criteria, will aim to find both published and unpublished literature. The following electronic databases will be searched: MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection, Web of Science, Open Access Scientific Repository of Portugal (RCAAP), and Open Grey. Other sites to be searched include ClinicalTrials.gov; United Nations High Commissioner for Refugees (UNHCR); International Organization for Migration (IOM); and International Migration, Integration and Social Cohesion in Europe (IMISCOE). The screening process will consist of two steps carried out by two independent reviewers: firstly, screening by title and abstract; and secondly, by full text. Data will be charted to describe the body of literature according to the review research questions, which were defined following the Population, Concept, Context (PCC) mnemonic. Data will be presented graphically when possible, and accompanied by a narrative that describes the characteristics of the training programs.
Effect of very large body mass loss on energetics, mechanics and efficiency of walking in adults with obesity: mass‐driven versus behavioural adaptations
Authors: Malatesta Davide , Favre Julien , Ulrich Baptiste , Hans Didier , Suter Michel , Favre Lucie , Fernández Menéndez Aitor
Published: September 2021

Understanding the mechanisms involved in the higher energy cost of walking (NCw: the energy expenditure above resting per unit distance) in adults with obesity is pivotal to optimizing the use of walking in weight management programmes. Therefore, this study aimed to investigate the mechanics, energetics and mechanical efficiency of walking after a large body mass loss induced by bariatric surgery in individuals with obesity. Nine adults (39.5 ± 8.6 year; BMI: 42.7 ± 4.6 kg m–2) walked at five fixed speeds before (baseline) and after the bariatric surgery (post 1 and post 2). Gas exchanges were measured to obtain NCw. A motion analysis system and instrumented treadmill were combined to assess total mechanical work (Wtot). Mechanical efficiency (Wtot NCw–1) was also calculated. Participants lost 25.7 ± 3.4% of their body mass at post 1 (6.6 months; P < 0.001) and 6.1 ± 4.9% more at post 2 (12 months; P = 0.014). Mass‐normalized NCw was similar between baseline and post 1 and decreased at post 2 compared to that at baseline (−6.2 ± 2.7%) and post 1 (−8.1 ± 1.9%; P ≤ 0.007). No difference was found in mass‐normalized Wtot during follow‐up (P = 0.36). Mechanical efficiency was similar at post 1 and post 2 when compared to that at baseline (P ≥ 0.19), but it was higher (+14.1 ± 4.6%) at post 2 than at post 1 (P = 0.013). These findings showed that after a very large body mass loss, individuals with obesity may reorganize their walking pattern into a gait more similar to that of lean adults, thus decreasing their NCw by making their muscles work more efficiently.

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Key points

A higher net (above resting) energy cost of walking (lower gait economy) is observed in adults with obesity compared to lean individuals.

Understanding the mechanisms (i.e. mass driven, gait pattern and behavioural changes) involved in this extra cost of walking in adults with obesity is pivotal to optimizing the use of walking to promote daily physical activity and improve health in these individuals.

We found that very large weight loss induced by bariatric surgery significantly decreased the energy cost of walking per kg of body mass after 1 year with similar total mechanical work per kg of body mass, resulting in an increased mechanical efficiency of walking.

Individuals with obesity may reorganize their walking pattern into a gait more similar to that of adults of normal body mass, thus decreasing their energy cost of walking by making their muscles work more efficiently.
Computational Assessment of Hemodynamic Significance in Patients With Intramural Anomalous Aortic Origin of the Coronary Artery Using Virtually Derived Fractional Flow Reserve and Downstream Microvascular Resistance
Authors: Razavi Atefeh , Sachdeva Shagun , Frommelt Peter C. , LaDisa John F.
Published: September 2021

Anomalous aortic origin of a coronary artery (AAOCA) is the second most common cause of sudden cardiac death in young athletes. One of the hypothesized mechanisms of ischemia in these patients is the lateral compression of the anomalous artery with an intramural or interarterial course. The presence of a narrowing in the anomalous artery will cause physiologic changes in downstream resistance that should be included for computational assessment of possible clinical ramifications. In this study, we created different compression levels, i.e., proximal narrowing, in the intramural course of a representative patient model and calculated hyperemic stenosis resistance (HSR) as well as virtual fractional flow reserve (vFFR). Models also included the effect of the distal hyperemic microvascular resistance (HMR) on vFFR. Our results agreed with similar FFR studies indicating that FFR is increased with increasing HMR and that different compression levels could have similar FFR depending on the HMR. For example, vFFR at HSR: 1.0–1.3 and HMR: 2.30 mmHg/cm/s is 0.68 and close to vFFR at HSR: 0.6–0.7 and HMR: 1.6 mmHg/cm/s, which is 0.7. The current findings suggest that functional assessment of anomalous coronary arteries through FFR should consider the vascular resistance distal to the narrowing in addition to the impact of a proximal narrowing and provides computational approaches for implementation of these important considerations.
Material Identification on Thin Shells Using the Virtual Fields Method, Demonstrated on the Human Eardrum
Authors: Pires Felipe S. M. , Avril Stéphane , Livens Pieter , Cordioli Júlio A. , Dirckx Joris J. J.
Published: September 2021

Characterization of material parameters from experimental data remains challenging, especially on biological structures. One of such techniques allowing for the inverse determination of material parameters from measurement data is the virtual fields method (VFM). However, application of the VFM on general structures of complicated shape has not yet been extensively investigated. In this paper, we extend the framework of the VFM method to thin curved solids in three-dimensional, commonly denoted shells. Our method is then used to estimate the Young's modulus and hysteretic damping of the human eardrum. By utilizing Kirchhoff plate theory, we assume that the behavior of the shell varies linearly through the thickness. The total strain of the shell can then be separated in a bending and membrane strain. This in turn allowed for an application of the VFM based only on data of the outer surface of the shell. We validated our method on simulated and experimental data of a human eardrum made to vibrate at certain frequencies. It was shown that the identified material properties were accurately determined based only on data from the outer surface and are in agreement with literature. Additionally, we observed that neither the bending nor the membrane strain in an human eardrum can be neglected and both contribute significantly to the total strain found experimentally.
Binary Repetitive Model Predictive Active Flow Control Applied to an Annular Compressor Stator Cascade With Periodic Disturbances
Authors: Fietzke Benjamin , Mihalyovics Jan , King Rudibert , Peitsch Dieter
Published: September 2021

Novel pressure gain combustion concepts invoke periodic flow disturbances in a gas turbine's last compressor stator row. This contribution presents studies of mitigation efforts on the effects of these periodic disturbances on an annular compressor stator rig. The passages were equipped with pneumatic active flow control (AFC) influencing the stator blade's suction side, and a rotating throttling disk downstream of the passages inducing periodic disturbances. For steady blowing, it is shown that with increasing actuation amplitudes cμ, the extension of a hub corner vortex deteriorating the suction side flow can be reduced, resulting in an increased static pressure rise coefficient Cp of a passage. The effects of the induced periodic disturbances could not be addressed intrinsically, by using steady blowing actuation, Considering a corrected total pressure loss coefficient ζ*, which includes the actuation effort, the stator row's efficiency decreases with higher cμ due to the increasing costs of the actuation mass flow. Therefore, a closed-loop approach is presented to address the effects of the disturbances more specifically, thus lowering the actuation cost, i.e., mass flow. For this, a repetitive model predictive control (RMPC) was applied, taking advantage of the periodic nature of the induced disturbances. The presented RMPC formulation is restricted to a binary control domain to account for the used solenoid valves' switching character. An efficient implementation of the optimization within the RMPC is presented, which ensures real-time capability. As a result, Cp increases in a similar magnitude but with a lower actuation mass flow of up to 66%, resulting in a much lower ζ* for similar values of cμ.
An Investigation of the Tapered Strut on Aerodynamic Performance of the Exhaust Diffuser Under Different Swirls
Authors: Dong Yuxuan , Li Zhigang , Li Jun
Published: September 2021

The strut structure directly affects the flow-field characteristics and aerodynamic performance of the gas turbine exhaust diffuser. Based on verifying the reliability of the numerical method, the exhaust diffuser with different struts was numerically calculated by solving three-dimensional Reynolds-averaged Navier–Stokes. The flow process and flow loss mechanism in the diffuser were analyzed, the influence of two different structures of tapered struts on the aerodynamic performance of the exhaust diffuser under different inlet preswirls was explored, and the aerodynamic performance of the exhaust diffuser with tapered struts was compared with a conventional exhaust diffuser with linear struts. The results show that, compared with the conventional linear strut, under different inlet preswirls, two different tapered struts can both weaken the flow separation in the exhaust diffuser, thereby reducing the total pressure loss. When the inlet preswirl is greater than 0.35, the total pressure loss coefficient of the exhaust diffuser with structure-C tapered struts decreases by up to 0.07. The two types of tapered struts also change the flow structure at the exhaust diffuser outlet, which affects the uniformity of the outlet airflow, and then affect the static pressure recovery coefficient. Under different inlet preswirls, two types of tapered struts can be effective to increase the static pressure recovery coefficient of the exhaust diffuser, for the exhaust diffuser with structure-C tapered struts, the static pressure recovery coefficient can be increased by up to 0.065, relative increase of 20%. The research in this paper shows that the tapered structure can significantly improve the aerodynamic performance of the exhaust diffuser under different inlet preswirls.
Experimental Study of the Skin-Friction Topology Around the Ahmed Body in Cross-Wind Conditions
Authors: Tran The Hung , Anyoji Masayuki , Nakashima Takuji , Shimizu Keigo , Le Anh Dinh
Published: September 2021

In this study, skin friction around a ½-scale Ahmed body was measured experimentally at a Reynolds number of Re = 2 × 105. The slant angle of the Ahmed body was 25 deg, and the yaw angles ranged from 0 deg to 8 deg. This study focused on the flow structure on the slant surface under different cross-wind conditions. A force balance system was applied to measure the aerodynamic drag of the model. The global skin-friction topology was measured by applying a luminescent oil layer with a subgrid data processing algorithm. The method used to measure the skin friction was conducted for the first time on the Ahmed body. The results indicated that the technique is highly capable of extracting the skin-friction topology. For a yaw angle below 3 deg, the flow on the slant surface was not significantly affected by the cross-wind condition, and the drag of the model was nearly constant. However, at yaw angles above 3 deg, the flow on the slant surface was highly affected by the roof longitudinal vortexes on the windward side, leading to a dramatic increase in the drag of the model. High consistency in the drag and skin-friction fields was observed. The detailed skin-friction structure at different yaw angles will be discussed in this study.
An intrusive method for estimating speech intelligibility from noisy and distorted signals
Authors: Mamun Nursadul , Zilany Muhammad S. A. , Hansen John H. L. , Davies-Venn Evelyn E.
Published: September 2021

An objective metric that predicts speech intelligibility under different types of noise and distortion would be desirable in voice communication. To date, the majority of studies concerning speech intelligibility metrics have focused on predicting the effects of individual noise or distortion mechanisms. This study proposes an objective metric, the spectrogram orthogonal polynomial measure (SOPM), that attempts to predict speech intelligibility for people with normal hearing under adverse conditions. The SOPM metric is developed by extracting features from the spectrogram using Krawtchouk moments. The metric's performance is evaluated for several types of noise (steady-state and fluctuating noise), distortions (peak clipping, center clipping, and phase jitters), ideal time-frequency segregation, and reverberation conditions both in quiet and noisy environments. High correlation (0.97–0.996) is achieved with the proposed metric when evaluated with subjective scores by normal-hearing subjects under various conditions.
Immunological and pathological outcomes of SARS-CoV-2 challenge following formalin-inactivated vaccine in ferrets and rhesus macaques
Authors: Bewley Kevin R. , Gooch Karen , Thomas Kelly M. , Longet Stephanie , Wiblin Nathan , Hunter Laura , Chan Kin , Brown Phillip , Russell Rebecca A. , Ho Catherine , Slack Gillian , Humphries Holly E. , Alden Leonie , Allen Lauren , Aram Marilyn , Baker Natalie , Brunt Emily , Cobb Rebecca , Fotheringham Susan , Harris Debbie , Kennard Chelsea , Leung Stephanie , Ryan Kathryn , Tolley Howard , Wand Nadina , White Andrew , Sibley Laura , Sarfas Charlotte , Pearson Geoff , Rayner Emma , Xue Xiaochao , Lambe Teresa , Charlton Sue , Gilbert Sarah , Sattentau Quentin J. , Gleeson Fergus , Hall Yper , Funnell Simon , Sharpe Sally , Salguero Francisco J. , Gorringe Andrew , Carroll Miles
Published: September 2021

No evidence of vaccine-enhanced disease was observed following inactivated SARS-CoV-2 vaccine in ferrets or rhesus macaques.