bluuebunny/crossref_metadata_2025 huggingface dataset:
Lung adenocarcinoma patients with KEAP1 mutation harboring low immune cell infiltration and low activity of immune environment
Authors: Cheng Wanwan , Xu Bin , Zhang Haitao , Fang Shencun
Published: July 2021

Background

Kelch‐like ECH‐associated protein 1 (KEAP1) has been identified as a cancer driver gene in lung adenocarcinoma (LUAD), and increased evidence has given us clues about the association of KEAP1 mutation and immune characteristics. We assessed the association between KEAP1 mutation and tumor microenvironment in LUAD systematically.

Methods

With the data collected from The Cancer Genome Atlas (TCGA), we evaluated the association of KEAP1 mutation with tumor infiltrating leukocytes (TILs), including dendritic cell, CD8 T cell, CD4 T cell, neutrophil, B cells, and macrophage. Expression differences of the markers of those immune cells were also measured. We further compared the expression of antigen presentation genes and chemokines and the enrichment score of immune‐related pathways.

Results

KEAP1 mutation had significant association with lower TILs and cytotoxic T lymphocyte. Strikingly, almost all of antigen presentation genes and chemokine showed lower expression in KEAP1‐mutated tumors. Moreover, most of immune‐related pathways were less active in KEAP1‐mutated tumors. As expected, KEAP1‐wild type LUADs favored better overall survival after immunotherapy. Finally, one patient harboring KEAP1 mutation along with a lack of immune cells infiltration in tumor microenvironment failed to respond to checkpoint inhibitor despite high tumor mutational burden (TMB).

Conclusions

KEAP1 mutation has a significant effect on the tumor immune milieu of LUAD and may play as a predictive biomarker of immunotherapy for LUAD patients.
Should we inform women about the recognised risks of childbirth?
Authors: Giddings Hugh L. , Wong Jean , Meagher Alan P.
Published: July 2021

Background

At present in Australia women are not routinely, systematically informed of the risks of childbirth.

Aims

It is hoped this presentation of the perspective of some women who suffer unexpected obstetric complications will encourage change.

Materials and Methods

The experience of women involved in obstetric medicolegal reports prepared by a colorectal surgeon over ten years is analysed.

Results

Twenty women were identified. Sixteen had vaginal deliveries. All 16 suffered third or fourth‐degree tears, six developed rectovaginal fistulae, six required stomas and 11 developed faecal incontinence. Of the four women who delivered by caesarean section, there were two post‐operative caecal perforations, one unrecognised small bowel enterotomy, and one patient developed sepsis due to an infected haematoma. Seventeen of the 20 women were noted to suffer psychological sequalae. None of the women recollected being warned of the complication they suffered, and there was no record of such warnings in their medical records.

Conclusion

Informed written ‘consent’ for natural vaginal delivery is, understandably, a contentious topic. Although learning from medicolegal cases may go against the grain, as medical professionals it is very difficult to ethically justify the status quo, where women are not routinely simply informed of the risks of childbirth. This is not fair. Even if informing women does not decrease the incidence of complications, the women who subsequently suffer these complications may well handle them much better, recognising they could occur.
Ontologies of climate change
Authors: SCHNEGG MICHAEL
Published: July 2021

In Namibia, both Damara pastoralists (ǂNūkhoen) and scientists agree that it rains less frequently than before. To explain their observations, however, scientists refer to carbon dioxide molecules, while the pastoralists point to social tensions, neoliberalism, and failures of the postcolonial state. To understand this discrepancy, I ask whether what scientists call precipitation and what Damara call ǀnanus are really the same thing. Engaging with phenomenological theories, I propose a worldliness continuum that reveals substantial ontological difference between the two. While precipitation occurs independently of humans, ǀnanus encompasses everything—it is life and death. If the two are different things, it is unsurprising that one needs different explanations for them. Acknowledging this creates space to navigate between the recognition of multiple ontologies and the politicization of carbon dioxide emissions. [climate change, ontology, phenomenology, world, knowledge, environment, drought, Namibia]
The glaucoma intensive treatment study: interim results from an ongoing longitudinal randomized clinical trial
Authors: Bengtsson Boel , Lindén Christina , Heijl Anders , Andersson‐Geimer Sabina , Aspberg Johan , Jóhannesson Gauti
Published: July 2021

Purpose

The aim of the study was to determine the perimetric rate of glaucoma progression in the ongoing Glaucoma Intensive Treatment Study (GITS) after 3 years of follow‐up.

Design

This is a randomized, two‐centre, prospective open‐labelled treatment trial for open‐angle glaucoma (OAG).

Participants

The participants of this study were treatment‐naive patients with newly diagnosed OAG, aged 46–78 years, with early to moderate glaucomatous visual field loss scheduled to be followed for 5 years within the study.

Methods

Patients were randomized to initial treatment with either topical monotherapy or with an intensive approach using drugs from three different classes, plus 360° laser trabeculoplasty. Changes in treatment were allowed. Standard automated perimetry and tonometry were performed and side‐effects documented. All results are presented using intention‐to‐treat analysis.

Results

A total of 242 patients were randomized. After 3 years of follow‐up, eight patients were lost to follow‐up, six of whom were deceased. The median untreated baseline intraocular pressure (IOP) was 24 mmHg in both arms. The median IOP was almost constant over the 3 years of follow‐up: ≈17 mmHg in the mono‐arm and ≈14 mmHg in the multi‐treatment arm. Treatment was intensified in 42% of the mono‐treated patients and in 7% of the multi‐treated patients. Treatment was reduced in 13% of the multi‐treated patients. The median perimetric rate of progression was −0.5%/year in the mono‐treated group and −0.1%/year in the multi‐treated group (p = 0.03).

Conclusion

The rate of disease progression was significantly slower in the multi‐treated patients than in the mono‐treated patients. Further follow‐up will show whether this difference is sustained over time.
Assessment of the safety, pharmacokinetics and pharmacodynamics of GSK3335065, an inhibitor of kynurenine monooxygenase, in a randomised placebo‐controlled first‐in‐human study in healthy volunteers
Authors: Fernando Disala , Dimelow Richard , Gorey Ciara , Zhu Xinyi , Muya Catherine , Parker Connie , Wright Wayne , Soleman Sara , Walsh Sarah , Crause Madelein , Vlasakakis Georgios , Guiney William , Robertson Nicola , Bergeal Marylise , Cui Yi , Krug Alexander W. , Uings Iain
Published: July 2021

GSK3335065 is an inhibitor of kynurenine monooxygenase (KMO) being developed for the treatment of acute pancreatitis. Healthy male volunteers were administered ascending doses of GSK3335065 or matched placebo as a single intravenous bolus injection to assess safety, tolerability, pharmacokinetics and pharmacodynamics. GSK3335065 displayed an apparent volume of distribution between 20.6 L and 44.6 L, a clearance between 0.462 L/h and 0.805 L/hr and a terminal half‐life between 31.3 and 34.5 hr. In the single subject who received 1.3 mg GSK3335065, changes in tryptophan pathway metabolites were observed consistent with the changes seen in preclinical species suggesting that KMO enzyme activity was partially inhibited. However, a broad complex ventricular tachycardia was observed in this subject, which was judged to be a Serious Adverse Event (SAE) and resulted in early termination of the study. While development of GSK3335065 was subsequently discontinued, significant confounding factors hinder a clear interpretation that the tachycardia was directly related to administration of the compound.
Undetectable minimal residual disease is an independent prognostic factor in splenic marginal zone lymphoma
Authors: Lyu Rui , Wang Tingyu , Wang Yi , Xiong Wenjie , Wang Huijun , Yan Yuting , Wang Qi , Liu Wei , An Gang , Huang Wenyang , Sui Weiwei , Xu Yan , Zou Dehui , Wang Jianxiang , Qiu Lugui , Yi Shuhua
Published: July 2021

The role of minimal residual disease (MRD) in splenic marginal zone lymphoma (SMZL) has not been well studied. We prospectively designed a study to evaluate undetectable MRD (uMRD) by multiparameter flow cytometry as a prognostic factor. Residual disease level of <0·01% was defined as uMRD. A total of 71 newly diagnosed patients with bone marrow involvement were enrolled and all received rituximab‐based therapy. The overall response rate (ORR) was 98·5% (70/71), with a complete remission (CR) rate of 54·9% (39/71). There were a total of 295 MRD detections in bone marrow and 77·4% patients (55/71) had uMRD. The 5‐year progression‐free survival (PFS) [(74·8 ± 6·5)% vs. (31·4 ± 12·6)%, P < 0·001] and 5‐year overall survival (OS) [(87·2 ± 5·6)% vs. (68·9 ± 13·4)%, P = 0·035] were significantly higher in uMRD patients than in MRD‐positive patients. The 5‐year PFS in partial remission (PR) patients with positive MRD was significantly poorer than that of PR patients with uMRD [(21·1 ± 12·9)% vs. (83·3 ± 8·8)%, P = 0·005]. Multivariate prognostic analysis revealed that uMRD was an independent good prognostic factor for PFS (hazard ratio 0·162, 95% confidence interval 0·041–0·635; P = 0·009). All these results highlight uMRD as an independent prognostic factor in patients with SMZL, especially for patients who only achieve PR.
Effects of diapause duration on diapause termination and post‐diapause reproduction in Orius sauteri
Authors: Taniai Kiyoko , Kotaki Toyomi , Maeda Taro
Published: July 2021

To determine the duration of winter conditions necessary to achieve successful termination of diapause in Orius sauteri (Poppius) (Hemiptera: Anthocoridae), nymphs were subjected to a L12:D12 photoperiod at 18 °C and emerged females were maintained under the same conditions for 15, 30, 45, or 60 days. After the respective period, the females were subjected to a photoperiod of L16:D8 at 25 °C, and four parameters were evaluated: pre‐oviposition period, oviposition period, total number of eggs laid per female, and longevity. In females of all four groups of different rearing durations at 18 °C, oviposition commenced within 2 weeks. There was a strong correlation between the pre‐oviposition period and the duration of rearing at 18 °C, with the pre‐oviposition period of females reared for 60 days being 4.5 ± 0.7 days, which was equivalent to that of non‐diapause females. Although the pre‐oviposition period of females reared for a 30‐day period was approximately 10 days, these females laid the highest total number of eggs among the four treatment groups. Longevity was found to be negatively correlated with the length of rearing duration at 18 °C, whereas neither oviposition period nor total number of eggs per female was significantly correlated with the rearing duration. We subsequently subjected females collected in the field in late October to the same rearing conditions at 18 °C for 30, 45, 60, or 90 days, and accordingly found that the pre‐oviposition period of field‐captured females was longer than that of the laboratory‐bred females. However, the highest total number of eggs laid by field‐captured females was observed in those subjected to a 30‐day rearing period. Based on these observations, we can conclude that a period of 30 days under conditions of 18 °C is sufficient to induce diapause termination without reducing fecundity.
The association between white matter hyperintensities, cognition and regional neural activity in healthy subjects
Authors: Porcu Michele , Cocco Luigi , Cocozza Sirio , Pontillo Giuseppe , Operamolla Annunziata , Defazio Giovanni , Suri Jasjit S. , Brunetti Arturo , Saba Luca
Published: July 2021

White matter hyperintensities (WMH) are common findings that can be found in physiological ageing. Several studies suggest that the disruption of white matter tracts included in WMH could induce abnormal functioning of the respective linked cortical structures, with consequent repercussion on the cerebral functions, included the cognitive sphere. In this cross‐sectional research, we analysed the effects of the total WMH burden (tWMHb) on resting‐state functional magnetic resonance imaging (rs‐fMRI) and cognition. Functional and structural MR data, as well as the scores of the trail making test subtests A (TMT‐A) and B (TMT‐B) of 75 healthy patients, were extracted from the public available Leipzig Study for Mind–Body–Emotion Interactions dataset. tWMHb was extracted from structural data. Spearman's correlation analyses were made for investigating correlations between WMHb and the scores of the cognitive tests. The fractional amplitude of low‐frequency fluctuations (fALFF) method was applied for analysing the rs‐fMRI data, adopting a multiple regression model for studying the effects of tWMHb on brain activity. Three different subanalyses were conducted using different statistical methods. We observed statistically significant correlations between WMHb and the scores of the cognitive tests. The fALFF analysis revealed that tWMHb is associated with the reduction of regional neural activity of several brain areas (in particular the prefrontal cortex, precuneus and cerebellar crus I/II). We conclude that our findings clarify better the relationships between WMH and cognitive impairment, evidencing that tWMHb is associated with impairments of the neurocognitive function in healthy subjects by inducing a diffuse reduction of the neural activity.
Improving time for administration of second‐line antiseizure medications for children with generalized convulsive status epilepticus using quality improvement methodology
Authors: Vidaurre Jorge , Albert Dara V. F. , Parker William , Naprawa Jim , Mittlesteadt Jackson , Idris Ali‐Shan , Patel Anup D.
Published: July 2021

Objective

Status epilepticus is a life‐threatening neurological emergency. However, delay in median time to administration of second‐line antiseizure medication exists. The aim of this quality improvement initiative was to decrease the average delay before fosphenytoin is administered for pediatric patients with generalized convulsive status epilepticus from 30 min (baseline data collected in 2013) to 15 min (50% reduction) by December 2015 and sustain this for 1 year.

Methods

Our team conducted an analysis of baseline data for patients with continuous generalized convulsive status epilepticus who received fosphenytoin after receiving first‐line benzodiazepine treatment. Using quality improvement methodology, areas for improvement were identified and specific interventions developed and implemented. A timeline of 15 min to initiate fosphenytoin administration after failure of first‐line treatment was considered reasonable and achievable as a project aim.

Results

A total of 199 patients were included in the dataset for the project. The database included patients aged 1 month and older. Ninety‐eight percent of patients were between 1 month and 19 years of age. The gender distribution was even, with 54% of patients being White or Caucasian, 30% African American or Black, and 16% classified as “other.” From January 2014 through December 2019, the average time before initiating fosphenytoin administration after failure of benzodiazepine therapy, for patients with generalized convulsive status epilepticus, decreased from 30 min (SD = 45.7) to 11.4 min (SD = 8.2, p = .043), thus reducing time to administration by 62%.

Significance

Quality improvement methodology can be successfully applied to decrease administration time between first‐ and second‐line antiseizure medications for status epilepticus.
Macrohomotoma gladiata Kuwayama, 1908 (Hemiptera: Psylloidea): a new pest of Ficus microcarpa L.f. in Tunisia
Authors: Harbi Ahlem , Abbes Khaled , Rapisarda Carmelo , Onillon Jean‐Claude , Chermiti Brahim
Published: July 2021

This paper reports for the first time the presence of the Ficus psyllid Macrohomotoma gladiata Kuwayama, 1908 (Hemiptera: Psylloidea) in Tunisia. It was detected infesting urban Ficus microcarpa L.f. planted along streets in Tunis, in September 2020. Brief notes on diagnostic features of both adult and juvenile instars, geographic distribution and symptoms are presented. The situation concerning this pest in Tunisia is described and possible phytosanitary risks and measures are discussed.
MCGDM with complex Pythagorean fuzzy ‐soft model
Authors: Akram Muhammad , Wasim Faiza , Karaaslan Faruk
Published: July 2021

In this research article, we introduce the fundamental facts of a new multi‐skilled and powerful decision‐making methodology, namely, the complex Pythagorean fuzzy ‐soft TOPSIS (CPFNS‐TOPSIS) method. This newly developed strategy serves as a competent mathematical tool for the rating‐based modelling of two‐dimensional inconsistent parameterized data. The CPFNS‐TOPSIS method enables us to take advantage of both the decision‐making abilities of the TOPSIS method and the very general parametric theory of the complex Pythagorean fuzzy ‐soft (CPFNSS) model. The proposed technique is designed for the identification of an optimum solution which is nearest to the complex Pythagorean fuzzy ‐soft positive ideal solution (CPFNS‐PIS) and farthest from the complex Pythagorean fuzzy N‐soft negative ideal solution (CPFNS‐NIS). We put forward a complex Pythagorean fuzzy ‐soft weighted averaging (CPFNSWA) operator and a normalized Euclidean distance measure for the theoretical background of our strategy. The proposed technique permits the experts to dynamically express their independent assessments regarding the proficiency of the alternatives and the weightage of the decision criteria. We aggregate the evaluated interpretations of the experts in the light of the novel CPFNSWA operator. Further, we utilize a calibrated score matrix for the determination of CPFNS‐PIS and CPFNS‐NIS, and we employ the proposed distance measures to analyse the proximity of the alternatives from the ideal solutions. We hierarchically categorize the feasible set of alternatives in descending order given by their revised closeness index. Moreover, we elaborate the methodology of our CPFNS‐TOPSIS method with the help of an illustrative flow chart. In relation to potential applications, we investigate a case study that concerns the selection of the best earthwork construction equipment required for a newly endorsed heavy construction project. This exercise demonstrates the pertinence and feasibility of our approach. In addition, we conduct a comparative analysis of the proposed strategy with an existing multiple criteria group decision making strategy, namely, the Pythagorean fuzzy TOPSIS (PF‐TOPSIS) method. This speaks for the feasibility and authenticity of the technique developed in this paper. We also present a unified discussion of our comparative study along with an interpretative bar chart which illustrates the remarkable features of the proposed strategy by validating the compatibility and accuracy of quantified similar end‐results. To conclude, we explore the rationality of the developed methodology to justify its superiority over the available approaches.
PRL‐3 promotes a positive feedback loop between STAT1/2‐induced gene expression and glycolysis in multiple myeloma
Authors: Smith Caroline N. , Blackburn Jessica S.
Published: July 2021

Over 34 000 patients are diagnosed yearly with multiple myeloma (MM), which remains a fatal malignancy. Expression of the phosphatase PRL‐3 is associated with poor prognosis in MM patients, and Vandsemb et al. have demonstrated that PRL‐3 contributes to enhanced MM cell fitness through activation of a glycolysis‐associated feedback loop. PRL‐3 resulted in increased expression of signal transducer and activator of transcription 1 (STAT1) and 2 (STAT2) and increased glycolysis. Increased glucose metabolism in turn activated STAT1/2 and interferon 1‐related genes. This discovery advances the MM field by providing a new potential treatment avenue.

Comment on: https://doi.org/10.1111/febs.16058
Metabolomic profiling of stool of two‐year old children from the INSIGHT study reveals links between butyrate and child weight outcomes
Authors: Nandy Debmalya , Craig Sarah J. C. , Cai Jingwei , Tian Yuan , Paul Ian M. , Savage Jennifer S. , Marini Michele E. , Hohman Emily E. , Reimherr Matthew L. , Patterson Andrew D. , Makova Kateryna D. , Chiaromonte Francesca
Published: July 2021

Background

Metabolomic analysis is commonly used to understand the biological underpinning of diseases such as obesity. However, our knowledge of gut metabolites related to weight outcomes in young children is currently limited.

Objectives

To (1) explore the relationships between metabolites and child weight outcomes, (2) determine the potential effect of covariates (e.g., child's diet, maternal health/habits during pregnancy, etc.) in the relationship between metabolites and child weight outcomes, and (3) explore the relationship between selected gut metabolites and gut microbiota abundance.

Methods

Using 1H‐NMR, we quantified 30 metabolites from stool samples of 170 two‐year‐old children. To identify metabolites and covariates associated with children's weight outcomes (BMI [weight/height2], BMI z‐score [BMI adjusted for age and sex], and growth index [weight/height]), we analysed the 1H‐NMR data, along with 20 covariates recorded on children and mothers, using LASSO and best subset selection regression techniques. Previously characterized microbiota community information from the same stool samples was used to determine associations between selected gut metabolites and gut microbiota.

Results

At age 2 years, stool butyrate concentration had a significant positive association with child BMI (p‐value = 3.58 × 10–4), BMI z‐score (p‐value = 3.47 × 10–4), and growth index (p‐value = 7.73 × 10–4). Covariates such as maternal smoking during pregnancy are important to consider. Butyrate concentration was positively associated with the abundance of the bacterial genus Faecalibacterium (p‐value = 9.61 × 10−3).

Conclusions

Stool butyrate concentration is positively associated with increased child weight outcomes and should be investigated further as a factor affecting childhood obesity.
The health literacy disparity in adolescents with sickle cell disease
Authors: Perry Caldwell Elizabeth , Killingsworth Erin
Published: July 2021

Purpose

There are over 100,000 individuals with sickle cell disease (SCD) in the United States, most of whom are Black, poor, and publically insured. In combination with a chronic illness, these demographics lead to significant barriers to healthcare for patients with SCD, leaving them exceptionally vulnerable within the healthcare system. This unique vulnerability is especially notable when transitioning adolescents with SCD from pediatric to adult care, as this is a significant time of morbidity and mortality for these patients. It is postulated that health literacy influences transition from pediatric to adult care in adolescents with SCD. To better understand this relationship, more adolescent health literacy research must be conducted with both adolescents with and without SCD. Therefore, the purpose of this study is to systematically compare health literacy in adolescents with and without SCD.

Design and Methods

This is a cross‐sectional, descriptive, exploratory study. One hundred and thirty‐four adolescents with SCD and 105 adolescents without SCD were recruited for this study. The Newest Vital Sign (NVS) health literacy instrument was used to evaluate health literacy. Pearson correlations were conducted to evaluate relationships among health literacy and the influencing factors of age, grade level, income, and parental education level. Differences in NVS scores between groups were assessed using independent samples t tests.

Results

There was a significant relationship between health literacy, age (r = .286, p < .01) and grade level (r = .317, p = .00) in adolescents with SCD. In adolescents without SCD, there was a significant relationship between health literacy, income (r = .235; p < .05) and parental education (r = .263; p < .01). The mean NVS score was 2.66 for adolescents with SCD and 3.77 for adolescents without SCD. A statistically significant difference in NVS scores was found between groups (t = 4.772; p < .001). Adolescents with SCD demonstrated significantly lower NVS scores than adolescents without SCD.

Practice Implications

There are significant differences in health literacy scores and influencing factors in adolescents with and without SCD. Thus, this article provides unique insight for nurses as they design, implement and evaluate health promotion, patient education, and future research initiatives for adolescents and families, both with and without SCD. Further research is needed to gain more insight into this phenomenon.
How sleepy patients differ from non‐sleepy patients in mild obstructive sleep apnea?
Authors: Oksenberg Arie , Goizman Vlada , Eitan Edith , Nasser Kitham , Gadoth Natan , Leppänen Timo
Published: July 2021

To aim is investigate whether demographic, polysomnographic or sleep behaviour data differ between non‐sleepy, sleepy and very sleepy patients with mild obstructive sleep apnea. The study population consisted of 439 consecutive adult patients diagnosed with mild obstructive sleep apnea (5 ≤ apnea–hypopnea index < 15) after a complete polysomnographic evaluation. The patients were divided into three groups based on subjective sleepiness: very sleepy (Epworth Sleepiness Scale ≥ 16, n = 59); sleepy (10 < Epworth Sleepiness Scale < 16, n = 102); and non‐sleepy (Epworth Sleepiness Scale ≤ 10, n = 278). Demographic, polysomnographic and sleep behaviour data were compared between the groups. There were no statistically significant differences in breathing abnormality indices and most of the demographic features between the groups. The number of arousals was significantly higher in the very sleepy group compared with the non‐sleepy group (140.8 ± 105.2 versus 107.6 ± 72.2). Very sleepy patients reported feeling sleepy during the daytime more often (42.4% versus 31.7%) and sleeping significantly less during the week compared with non‐sleepy patients. Also, a significantly higher proportion of sleepy (47.1%) and very sleepy patients (44.1%) reported taking naps during weekends compared with non‐sleepy patients (35.6%). In a regression analysis, also total sleep time (β = 0.045), sleep efficiency (β = −0.160), apnea index (β = −0.397), apnea–hypopnea index in supine position (β = 0.044), periodic limb movement index (β = 0.196) and periodic limb movement‐related arousal index (β = −0.210) affected subjective daytime sleepiness. The results suggest that excessive daytime sleepiness in patients with mild obstructive sleep apnea appears to be related to inadequate sleeping habits (i.e. insufficient sleep during working days) and decreased sleep quality rather than differences in breathing abnormalities.
Diet and exercise in NAFLD/NASH: Beyond the obvious
Authors: Semmler Georg , Datz Christian , Reiberger Thomas , Trauner Michael
Published: July 2021

Lifestyle represents the most relevant factor for non‐alcoholic fatty liver disease (NAFLD) as the hepatic manifestation of the metabolic syndrome. Although a tremendous body of clinical and preclinical data on the effectiveness of dietary and lifestyle interventions exist, the complexity of this topic makes firm and evidence‐based clinical recommendations for nutrition and exercise in NAFLD difficult. The aim of this review is to guide readers through the labyrinth of recent scientific findings on diet and exercise in NAFLD and non‐alcoholic steatohepatitis (NASH), summarizing “obvious” findings in a holistic manner and simultaneously highlighting stimulating aspects of clinical and translational research “beyond the obvious”. Specifically, the importance of calorie restriction regardless of dietary composition and evidence from low‐carbohydrate diets to target the incidence and severity of NAFLD are discussed. The aspect of ketogenesis—potentially achieved via intermittent calorie restriction—seems to be a central aspect of these diets warranting further investigation. Interactions of diet and exercise with the gut microbiota and the individual genetic background need to be comprehensively understood in order to develop personalized dietary concepts and exercise strategies for patients with NAFLD/NASH.
Reversibility of total airway closure and alveolar consolidation in a COVID‐19 patient: A case study
Authors: Voicu Sebastian , Brudon Alexandre , Modestin Louis , Nitenberg Kiyoko , Gonde Antoine , Malissin Isabelle , Mégarbane Bruno
Published: July 2021

Coronavirus disease 2019 (COVID‐19) may be complicated by life‐threatening pneumonia requiring tracheal intubation, mechanical ventilation and veno‐venous extracorporeal membrane oxygenation (vvECMO). It is not yet clear to what extent and after which delay the most severe cases of COVID‐19 pneumonia are reversible. Here, we present a 39‐year‐old patient who developed a severe COVID‐19‐attributed acute respiratory distress syndrome (ARDS) resulting in complete alveolar consolidation and airway closure for several weeks. His remarkable ventilatory pattern was established using ventilator airway pressure curve analysis and computed tomography imaging. The patient was managed with supportive care, mechanical ventilation and vvECMO. He received dexamethasone and tocilizumab as immunomodulatory drugs. Despite multiple complications, he recovered and was weaned from vvECMO, ventilator and oxygen on days 75, 95 and 99 post‐intubation, respectively. He was discharged from hospital on day 113. This case study strongly supports the remarkable potential for reversibility of ARDS in COVID‐19 patients and discusses the implications for critical care nursing regarding mechanical ventilation and ECMO device management in patients who may become entirely dependent on vvECMO for oxygenation and carbon dioxide elimination.
Anesthesiologist‐related factors associated with risk‐adjusted pediatric anesthesia‐related cardiopulmonary arrest: a retrospective two level analysis
Authors: Christensen Robert , Haydar Bishr , Leis Aleda , Mentz Graciela , Reynolds Paul
Published: July 2021

Background

Pediatric anesthesia‐related cardiac arrest is an uncommon but catastrophic adverse event which has been, in a previous study, associated with anesthesiologist‐related factors such as number of days per year providing pediatric anesthesia. We aimed to replicate this and assess other anesthesiologist‐related risk factors for anesthesia‐related cardiac arrest after adjusting for known underlying risk factors present in the case mix.

Methods

We analyzed a large retrospectively collected patient cohort of anesthetics administered from 2006 to 2016 to children at a tertiary pediatric hospital. Three reviewers independently reviewed cardiac arrests and categorized whether they appeared to be related to anesthesia care. Anesthesiologist‐related factors including academic rank, experience, recent case mix, and days per year delivering pediatric anesthesia were assessed for association with anesthesia‐related cardiac arrest after adjustment for underlying case mix.

Results

Cardiac arrest occurred in 240 of 109 775 anesthetics (incidence 22/10 000 anesthetics); 82 (7/10 000 anesthetics) were classified as anesthesia‐related. In univariable analyses, anesthesia‐related cardiac arrest was associated with age, (infants ≤180 days, p < .001) American Society of Anesthesiologists Physical Status, (>2, p < .001) American Society of Anesthesiologists Physical Status Emergency, (p = .0035) cardiac surgery, (p < .001) operating room location, (p = .0066) and resident/fellow supervision, (p = .009) but none of the anesthesiologist factors. Even after adjusting for age and American Society of Anesthesiologist Status, none of the anesthesiologist factors were associated with anesthesia‐related cardiac arrest.

Conclusions

Case mix explained all associations between higher risk of pediatric anesthesia‐related cardiac arrest and anesthesiologist‐related variables at our institution.
Integrating mental health connections in community academic partnerships
Authors: Gotwals Beth , Adamshick Pamela
Published: July 2021

Background

Community academic partnerships (CAPs) connect students to interprofessional collaborations and expand clinical experiences beyond traditional settings. Serious and persistent mental health problems represent an important action area within population health. Mental health disorders across the lifespan are often co‐morbid with substance use, poverty, and community violence.

Aims

This article describes CAPs in a community course where students impact vulnerable populations while learning new roles and responsibilities. The process explains student engagement with the community, and using best practices for care of community, population health concerns, and mental health and well‐being.

Methods

We initiate and maintain collaborative relationships that guide culturally sensitive responses to health and illness. Four well‐established CAPs’ exemplars describe the interventions and outcomes.

Results

Students successfully integrated a variety of health promotion and mental health interventions within the CAPS clinical environments. The Socio‐Ecological framework is used to articulate student outcomes.

Conclusion

The CAPs are a dynamic system requiring ongoing maintenance and response to evolving epidemiological issues, such as increased incidence of alterations in mental health. The educational innovation provides an opportunity for students to understand aspects of holistic health in a community environment as they intervene at individual, relationship, community, and societal levels.
Planting, seeding, and sediment impact restoration success following dam removal
Authors: Chenoweth Joshua , Bakker Jonathan D. , Acker Steven A.
Published: July 2021

Large dam removals effectively restore geomorphic and hydrologic processes, but little is known about subsequent vegetation recovery and the role of active restoration. We studied whether planting and seeding affected vegetation recovery in a dewatered reservoir, and whether effects differed on landforms composed of fine or coarse‐textured sediments. The dewatered reservoir is behind the former Glines Canyon Dam, which was removed from the Elwha River in Washington State (U.S.A.) in 2011–2014. We measured bare ground in 2013–2017, and species richness, relative frequency of non‐native species, woody stem density, and species composition in 2016. Sediment texture affected all response variables. Several years after seeding, bare ground was reduced on coarse sediments and non‐native species frequency was reduced on both textures. Planting increased species richness. Seeding and planting altered species composition on both textures, with stronger effects on coarse sediments. High densities of riparian woody plants naturally established on fine sediments, reaching a mean of 34,000 stems/ha 5 years after dam removal began; density was only a fraction of this (5,000 stems/ha) on coarse sediments. Future dam removals should incorporate sediment texture into their revegetation plans. Seeding and planting can be valuable strategies for minimizing non‐native species frequency, increasing species richness, and establishing desirable target species after dam removal, particularly on landforms composed of coarse sediments.
Termites in restoration: the forgotten insect?
Authors: Wijas Baptiste , Atkinson Joe
Published: July 2021

Few restoration studies consider soil invertebrates such as termites although these are present throughout many ecosystems worldwide and provide a range of ecosystem services as soil engineers. The few studies that do consider the recovery of termites after human‐induced disturbance are geographically concentrated in Africa and South America and tropical seasonal savannah ecosystems. These studies suggest that termites can in some cases recover to pre‐disturbance levels after a few years, or take up to 30 years, although with altered community composition. While termites could potentially have negative impacts on restoration efforts by damaging vegetation, their recovery was shown to have benefits on ecosystems which warrants further research into their recovery across a wider range of continents and biomes.
Changes in EMG and movement velocity during a set to failure against different loads in the bench press exercise
Authors: Tsoukos Athanasios , Brown Lee E. , Terzis Gerasimos , Wilk Michal , Zajac Adam , Bogdanis Gregory C.
Published: July 2021

This study examined changes in movement velocity and surface electromyographic (sEMG) activity of the pectoralis major (PM) and triceps brachii (TB) muscles during the bench press exercise to failure against different loads. Fourteen men performed a set to failure with maximum intended velocity, against low (40%‐1 repetition maximum‐RM), moderate (60%‐1RM), and heavy loads (80%‐1RM). Number of repetitions, volume load, mean and peak velocity, and total time increased with decreasing load (40% > 60% > 80%, p < 0.01). sEMG comparisons between different loads were performed by matching time under tension at the initial, middle, and last part of the set. sEMG was higher in the middle and last repetitions, compared with the initial, for all loads in both muscles (p < 0.001). sEMG activity of both muscles was higher in the 60% and 80%‐1RM conditions compared with the 40%1‐RM (p < 0.007). Also, sEMG of both muscles was similar for the 60%‐1RM and 80%‐1RM loads at the initial, middle, and last repetitions, with the exception of the last repetitions for the TB muscle. In contrast, sEMG integrated activity was higher for the 40% 1‐RM and 60% 1‐RM (p < 0.01) compared with the 80% 1‐RM load. Mean velocity loss at exhaustion and drop in sEMG median frequency were greater in the 40% and 60%‐1RM compared with the 80%‐1RM condition (p < 0.05). It was concluded that performing a set to exhaustion with maximum intended velocity using a load of 60% 1‐RM combines the characteristics of the high average sEMG activity of heavier loads, and the high total integrated sEMG observed at lighter loads.
Identification of a novel HLA‐C*07 allele, HLA‐C*07:943, in a Spanish individual
Authors: Calvo‐Ferrer Maria‐Alicia , Martin‐Rodriguez Samuel , Sanz‐Izquierdo Maria‐Pilar , Samaniego‐Jimenez Laura , Bernardo‐Gonzalez Ivan
Published: July 2021

HLA‐C*07:943 differs from C*07:01:01:01 at positions 648 (c.648C > T) and 652 (c.652C > G) in exon 4.
Integrating GIS and location modeling: A relational approach
Authors: Lei Ting L.
Published: July 2021

Planners and geospatial analysts have long been using GIS and optimization methods to solve a wide range of spatial decision problems from routing and facility location to political redistricting. However, there has been a notable disconnection between the tools of GIS and optimization, constraining the capability of spatial decision‐making in GIS. This article presents relational linear programming (RELP), a new framework and tool for bridging the gap between the two fields by integrating a generic optimization solver into GIS: a solver for integer linear programming (ILP). In particular, we choose relational/spatial databases as the GIS platform. We demonstrate that not only data, but also programs for spatial problems (in the form of ILP) can be managed and executed in SQL inside spatial databases. The main focus of this article is on location modeling, and we show how classic models can be formulated succinctly in a declarative way using SQL. The declarative approach of RELP allows researchers to focus onformulatingnew spatial decision problems without being bogged down in sophisticated programming. The integrated approach allows data processing and decision‐making in one language. Therefore, it brings the power of location modeling to non‐specialist GIS practitioners.
Liquid biopsy can detect BRCA2 gene variants in female dogs with mammary neoplasia
Authors: de Oliveira Jéssica Rodrigues , Colombo Jucimara , Gonçalves Francine Moraes , de Carvalho Lucas Amoroso Lopes , Costa Douglas Santos , Henrique Tiago , Novais Adriana Alonso , Moschetta‐Pinheiro Marina Gobbe , Chuffa Luiz Gustavo de Almeida , Coutinho Luiz Lehmann , Santana Áureo Evangelista , Zuccari Debora Aparecida Pires de Campos
Published: July 2021

Mammary tumours (MT) are one of the most prevalent malignancies in female dogs and women. Currently, molecular analyzes have shown that each tumour type presents its own genetic signature. In this context, liquid biopsy allows a comprehensive genetic characterisation of the tumour, enabling early diagnosis and personalised treatment of patients. In women, deleterious mutations inherited in BRCA2 gene are associated with an increased risk of breast cancer, resistance to therapies and worse prognosis. In female dogs, there are many divergent data on the involvement of BRCA2 gene with mammary carcinogenesis and what its pathogenic potential is. Therefore, the objective was to identify BRCA2 gene variants in 20 plasma DNA samples, from 10 newly diagnosed dogs with mammary cancer (RD), five control (CTR) and five mastectomized patients. Eleven single nucleotide polymorphisms (SNPs) were detected, most of them in the exon 11 and two indels (deletion/insertion) in the BRCA2 gene. However, there was no statistically significant difference in the SNPs/indels detected between the groups. In addition, only one SNP (p.T1425P) and one deletion (p.L2307del) were considered deleterious using in silico computational models. Interestingly, most common variants were present in the plasma of all groups, except for the Ile2614Thr, Ile2614Val, Thr1425Pro and p.L2307del variants. Thus, we observed that SNPs are common in the BRCA2 gene of female dogs with MT, with a similar condition identified in women with breast cancer. Liquid biopsy approach in dogs with MT is useful for genetic and therapeutic proposals.
Entre tierras y límites: desafíos para la gestión ambiental territorial en Trujillo y Restrepo (Valle del Cauca)
Authors: Pérez Martínez Manuel Enrique , Vargas Navarro Fernando , Rojas Pinilla Humberto , Ortiz Villa Juan Andrés , Arango Laura María
Published: July 2021

En esta investigación se presentan los resultados obtenidos en el estudio sobre las trayectorias y dinámicas económicas, políticas y culturales de las organizaciones sociales e institucionales para la gestión ambiental en los municipios de Trujillo y Restrepo, en el departamento del Valle del Cauca. Tiene como propósito conocer y avalar las formas de participación ciudadana que vienen generando acciones de preservación de los derechos colectivos y ambientales con incidencia en la sociedad civil y la cohesión sostenible del territorio. Así, se privilegia la voz de los actores sociales que se encuentran sujetos a las condiciones de cambio económico estructural, producto del aceleramiento de la industrialización, la explotación de recursos y la urbanización, además de la consecuente disminución y afectación de ecosistemas estratégicos y recursos vitales, la amenaza del cambio climático y las actuales circunstancias de vulnerabilidad social y pobreza. Los hallazgos y aprendizajes servirán para retroalimentar la contribución de nuevos emprendimientos socioambientales en la orientación de políticas ambientales, diseño e implementación de sistemas de monitoreo y valoración de la gestión, desarrollo de nuevas líneas de investigación y en la formulación de programas y proyectos ambientales que contribuirán de manera eficaz en la sostenibilidad de los territorios en estos dos municipios.
Making Better Swirl Brakes Using Computational Fluid Dynamics: Performance Enhancement From Geometry Variation
Authors: Yang Jing , San Andrés Luis
Published: July 2021

A fluid with a large swirl (circumferential) velocity entering an annular pressure seal influences the seal cross-coupled dynamic stiffness coefficients, and hence it affects system stability. Typically comprising a large number of angled vanes around the seal circumference, a swirl brake (SB) is a mechanical element installed to reduce (even reverse) the swirl velocity entering an annular seal. SB design guidelines are not readily available, and existing configurations appear to reproduce a single source. By using a computational fluid dynamics (CFD) model, the paper details a process to engineer a SB upstream of a 16-tooth labyrinth seal (LS) with tip clearance Cr = 0.203 mm. The process begins with a known nominal SB* geometry and considers variations in vane length (LV* = 3.25 mm) and width (WV* = 1.02 mm), and stagger angle (θ* = 0 deg). The vane number NV* = 72 and vane height HV* = 2.01 mm remain unchanged. The SB–LS operates with air supplied at pressure PS = 70 bar, a pressure ratio PR = exit pressure Pa/PS = 0.5, and rotor speed Ω = 10.2 krpm (surface speed ΩR = 61 m/s). Just before the SB, the preswirl velocity ratio = average circumferential velocity U/shaft surface speed (ΩR) equals α = 0.5. For the given conditions, an increase in LV allows more space for the development of vortexes between two adjacent vanes. These are significant to the dissipation of fluid kinetic energy and thus control the reduction of α. A 42% increase in vane length (LV = 4.6 mm) produces a ∼43% drop in swirl ratio at the entrance of the LS (exit of the SB), from αE = 0.23 to 0.13. Based on the SB with LV = 4.6 mm, the stagger angle θ varies from 0 deg to 50 deg. The growth in angle amplifies a vortex at ∼70% of the vane height, while it weakens a vortex at 30% of HV. For θ = 40 deg, the influence of the two vortexes on the flow produces the smallest swirl ratio at the LS entrance, αE = −0.03. For a SB with LV = 4.6 mm and θ = 40 deg, the vane width WV varies from 0.51 mm to 1.52 mm (±50% of WV*). A reduction in WV provides more space for the strengthening of the vortex between adjacent vanes. Therefore, a SB with greater spacing of vanes also reduces the inlet circumferential velocity. For WV = 0.51 mm, αE further decreases to −0.07. Besides the design condition (α = 0.5), the engineered SB having LV = 4.6 mm, θ = 40 deg, and WV = 0.51 mm effectively reduces the circumferential velocity at the LS entrance for other inlet preswirl ratios equaling α = 0 and 1.3. Rather than relying on extensive experiments, the CFD analysis proves effective to quickly engineer a best SB configuration from the quantification of performance while varying the SB geometry and inlet swirl condition.