bluuebunny/crossref_metadata_2025 huggingface dataset:
Positionality-Weighted Aggregation Methods for Cumulative Voting
Authors: Kato Takeshi , Asa Yasuhiro , Owa Misa
Published: February 2021

Respecting minority opinions is vital in solving social problems. However, minority opinions are often ignored in general majority rules. To build consensus on pluralistic values and make social choices that consider minority opinions, we propose aggregation methods that give weighting to the minority's positionality on cardinal cumulative voting. Based on quadratic and linear voting, we formulated three weighted aggregation methods that differ in the ratio of votes to cumulative points and the weighting of the minority to all members, and assuming that the distributions of votes follow normal distributions, we calculated the frequency distributions of the aggregation results. We found that minority opinions are more likely to be reflected proportionately to the average of the distribution in two of the above three methods. This implies that Sen and Gotoh's idea of considering the social position of unfortunate people on ordinal ranking in the welfare economics, was illustrated by weighting the minority's positionality on cardinal voting. In addition, it is possible to visualize the number and positionality of the minority from the analysis of the aggregation results. These results will be useful to promote mutual understanding between the majority and minority by interactively visualizing the contents of the proposed aggregation methods in the consensus-building process. With the further development of information technology, the consensus building based on big data will be necessary. We recommend the use of our proposed aggregation methods to make social choices for pluralistic values such as social, environmental, and economic.
Reviewer Acknowledgements
Authors: Young James
Published: February 2021

International Journal of Social Science Studies (IJSSS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether IJSSS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 9, Number 2António Calha, Polytechnic Institute of Portalegre, PortugalAurora Pestaño, University of San Jose Recoletos (USJR), PhilippinesBassam Yousef Ibrahim Banat, Al-Quds University, PalestineFahri ÖZSUNGUR, Adana Science and Technology University, TurkeyFroilan Mobo, Philippine Merchant Marine Academy, PhilippinesHenry Poduthas, West Texas A&M University, USAIoannis Makris, High School of Pedagogical and Technical Education, GreeceJehu Onyekwere Nnaji, University of Naples II,Italy and Globe Visions Network Italy, ItalyJulia M. Mack, Gannon University, USALaura Diaconu Maxim, "Alexandru Ioan Cuza University" of Iasi, RomaniaMei-Ling Lin, National Open University, TaiwanNikias Sarafoglou, GMU, USASusheelabai Srinivasa, University of Texas Rio Grande Valley, United StatesYusramizza Md Isa, Universiti Utara Malaysia, Malaysia  James YoungEditorial AssistantOn behalf of,The Editorial Board of International Journal of Social Science StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAURL: http://ijsss.redfame.com
Simulation of the Super Critical Water Loop Using ATHLET Code During an Abnormal Scenario
Authors: Mazzini Guido , Musa Alis , Fukac Rostilav
Published: February 2021

Supercritical water (SCW) has advantages like high thermal efficiency and can operate at high temperature and pressure. At the same time, however, these properties bring up related issues, such as material compatibility and corrosion resistance. In an effort to fully investigate the operating conditions, and solutions to these issues, test facilities are being built by many research organizations. One such organization, the Research Center Řež (CVR) located in the Czech Republic, has developed an experimental supercritical water loop (SCWL). The purpose of this loop is to provide experimental data from material testing in various conditions, including operating under the neutron field. This will be achieved by inserting a test channel into the existing experimental reactor light water reactor 15 (LVR-15), which will require a license from the state nuclear regulator (State Office for Nuclear Safety (SUJB)). Part of the licensing documentation is the safety analysis, which combines results from developed models using the thermohydraulic code ATHLET 3.1 A patch 1, as well as the experimental out of pile data. Among the postulated scenarios, an abnormal sequence (labeled A2—Loss of power in the loop) was analyzed in order to provide a preliminary benchmark. This scenario is similar to the postulated in-pile A2 and it was used for the benchmark activity. The aim of this paper is to present this activity including the adopted assumptions in the model. In particular, the paper presents, how these assumptions influenced the results indicating the discrepancies obtained in the first part of the transient.
A Comparison Between Air and In-Service Welding on Oxygen Concentration and Microinclusions in E7018-1 Weld Metal
Authors: de Souza Gustavo José Suto , Alves Antonio do Nascimento Silva , Dalpiaz Giovani , Casanova Jaime , Brandi Sérgio Duarte
Published: February 2021

In the maintenance of in-service pipelines, the use of covered electrodes is usual due to several factors such as the flexibility of welding in hard-to-reach places and its low cost. During in-service welding of pipelines, the line remains in operation, which implies more rigorous temperature gradients that can result in microstructures more susceptible to failure. The objective of this work is to relate the welding current and cooling conditions, commonly used in-service welding, with the oxygen content and the volumetric fraction of microinclusions. In this step, the effect on the oxygen content and the volumetric fraction of microinclusions are analyzed based on experimental results using the technique of factorial experiments. Bead-on-plate samples were welded under two cooling conditions, air and cooling with water, and two nominal welding currents, 86 A and 98 A. The increase in oxygen content was observed with increasing welding current and with the cooling rate. In addition, the higher cooling rate reduced the mean microinclusions size, which can suppress the formation of acicular ferrite and, consequently, reduce the toughness and the ultimate stress limit of weld metal.
Adaptive Robust Tracking Control for Hybrid Models of Three-Dimensional Bipedal Robotic Walking Under Uncertainties
Authors: Gu Yan , Yuan Chengzhi
Published: February 2021

This paper introduces an adaptive robust trajectory tracking controller design to provably realize stable bipedal robotic walking under parametric and unmodeled uncertainties. Deriving such a controller is challenging mainly because of the highly complex bipedal walking dynamics that are hybrid and involve nonlinear, uncontrolled state-triggered jumps. The main contribution of the study is the synthesis of a continuous-phase adaptive robust tracking control law for hybrid models of bipedal robotic walking by incorporating the construction of multiple Lyapunov functions into the control Lyapunov function. The evolution of the Lyapunov function across the state-triggered jumps is explicitly analyzed to construct sufficient conditions that guide the proposed control design for provably guaranteeing the stability and tracking the performance of the hybrid system in the presence of uncertainties. Simulation results on fully actuated bipedal robotic walking validate the effectiveness of the proposed approach in walking stabilization under uncertainties.
Quantitative Analysis of Reynolds and Navier–Stokes Based Modeling Approaches for Isothermal Newtonian Elastohydrodynamic Lubrication
Authors: Scurria Leoluca , Tamarozzi Tommaso , Voronkov Oleg , Fauconnier Dieter
Published: February 2021

When simulating elastohydrodynamic lubrication, two main approaches are usually followed to predict the pressure and fluid film thickness distribution throughout the contact. The conventional approach relies on the Reynolds equation to describe the thin lubricant film, which is coupled to a Boussinesq description of the linear elastic deformation of the solids. A more accurate, yet a time-consuming method is the use of computational fluid dynamics in which the Navier–Stokes equations describe the flow of the thin lubricant film, coupled to a finite element solver for the description of the local contact deformation. This investigation aims at assessing both methods for different lubrication conditions in different elastohydrodynamic lubrication (EHL) regimes and quantify their differences to understand advantages and limitations of both methods. This investigation shows how the results from both approaches deviate for three scenarios: (1) inertial contributions (Re > 1), i.e., thick films, high speed, and low viscosity; (2) high shear stresses leading to secondary flows; and (3) large deformations of the solids leading to inaccuracies of the Boussinesq equation.
Elastic Metasurfaces for Full Wavefront Control and Low-Frequency Energy Harvesting
Authors: Lin Zhenkun , Tol Serife
Published: February 2021

Controlling and manipulating elastic/acoustic waves via artificially structured metamaterials, phononic crystals, and metasurfaces have gained an increasing research interest in the last decades. Unlike others, a metasurface is a single layer in the host medium with an array of subwavelength-scaled patterns introducing an abrupt phase shift in the wave propagation path. In this study, an elastic metasurface composed of an array of slender beam resonators is proposed to control the elastic wavefront of low-frequency flexural waves. The phase gradient based on Snell’s law is achieved by tailoring the thickness of thin beam resonators connecting two elastic host media. Through analytical and numerical models, the phase-modulated metasurfaces are designed and verified to accomplish three dynamic wave functions, namely, deflection, non-paraxial propagation, and focusing. An oblique incident wave is also demonstrated to show the versatility of the proposed design for focusing of wave energy incident from multiple directions. Experimentally measured focusing metasurface has nearly three times wave amplification at the designed focal point which validates the design and theoretical models. Furthermore, the focusing metasurface is exploited for low-frequency energy harvesting and the piezoelectric harvester is improved by almost nine times in terms of the harvested power output as compared to the baseline harvester on the pure plate without metasurface.
Experimental and Numerical Analysis of Shear Process of a High Particle Content Bonding Material
Authors: Yang Yizhan , Li Jiliang , Chen Jiankang
Published: February 2021

In this study, polymer-bonded sugar (PBS) is used as a substitute material for polymer-bonded explosive (PBX), and the shear failure process of PBS under compressive loading. First, the shear failure process of PBS was analyzed by a series of experiments, and it was found that the shear band appearing on the surface of the specimen was not symmetrical. Further theory analysis showed that it was triggered by the evolution of asymmetric damage caused by internal defects in the material. In addition, through investigating the distribution of experimental scatters, we found that the material undergoes a relatively long period of internal microstructure adjustment before shear failure occurs, this adjustment will undoubtedly affect the evolution of the shear band. More importantly, a data density method was used to quantify the adjustment process. Finally, by using finite element simulation, the effects of matrix–particle interface strength on the mechanical response or damage evolution of the PBS were thoroughly examined. This research has reference significance for understanding the damage evolution process of high particle content composite materials.
The Role of Geometrical Parameters in the Lubrication of the Swiss Lever Escapement
Authors: Roda-Buch Alejandro , Magnin Valentine A. M. , Maldonado Sandra Guadalupe , Mischler Stefano
Published: February 2021

The lubrication regimes of a contact pair escapement-ruby pallet of a Swiss lever escapement have been investigated combining the theory of fluid lubrication with a well-established kinematic and inverse dynamic multibody model. The kinematic analytical results have been confronted with experimental measurements. The developed model allows to easily obtain, for the three operating phases of the Swiss lever escapement, the relative speed and the contact forces and, by considering a hydrodynamic lubrication regime, the lubricant minimum film thickness and the coefficient of friction. The presented formulation allows to study the influence of crucial technical parameters in the Swiss lever escapement lubrication. The spout radii of curvature have been identified as the optimal parameters to control the lubrication regimes in the pallet/escapement contacts. In that sense, an interesting result is that the lubrication regime moves away from the boundary lubrication by increasing these radii.
A Bayesian Approach for Inferring Sea Ice Loads
Authors: Parno Matthew , Hodgdon Taylor , West Brendan , O’Connor Devin , Song Arnold
Published: February 2021

The Earth’s climate is rapidly changing and some of the most drastic changes can be seen in the Arctic, where sea ice extent has diminished considerably in recent years. As the Arctic climate continues to change, gathering in situ sea ice measurements is increasingly important for understanding the complex evolution of the Arctic ice pack. To date, observations of ice stresses in the Arctic have been spatially and temporally sparse. We propose a measurement framework that would instrument existing sea ice buoys with strain gauges. This measurement framework uses a Bayesian inference approach to infer ice loads acting on the buoy from a set of strain gauge measurements. To test our framework, strain measurements were collected from an experiment where a buoy was frozen into ice that was subsequently compressed to simulate convergent sea ice conditions. A linear elastic finite element model was used to describe the response of the deformable buoy to mechanical loading, allowing us to link the observed strain on the buoy interior to the applied load on the buoy exterior. The approach presented in this paper presents an instrumentation framework that could use existing buoy platforms as in situ sensors of internal stresses in the ice pack.
Memory-Efficient Modeling and Slicing of Large-Scale Adaptive Lattice Structures
Authors: Liu Shengjun , Liu Tao , Zou Qiang , Wang Weiming , Doubrovski Eugeni L. , Wang Charlie C. L.
Published: February 2021

Lattice structures have been widely used in various applications of additive manufacturing due to its superior physical properties. If modeled by triangular meshes, a lattice structure with huge number of struts would consume massive memory. This hinders the use of lattice structures in large-scale applications (e.g., to design the interior structure of a solid with spatially graded material properties). To solve this issue, we propose a memory-efficient method for the modeling and slicing of adaptive lattice structures. A lattice structure is represented by a weighted graph where the edge weights store the struts’ radii. When slicing the structure, its solid model is locally evaluated through convolution surfaces in a streaming manner. As such, only limited memory is needed to generate the toolpaths of fabrication. Also, the use of convolution surfaces leads to natural blending at intersections of struts, which can avoid the stress concentration at these regions. We also present a computational framework for optimizing supporting structures and adapting lattice structures with prescribed density distributions. The presented methods have been validated by a series of case studies with large number (up to 100 M) of struts to demonstrate its applicability to large-scale lattice structures.
A General Method for Constructing Planar Cognate Mechanisms
Authors: Sherman Samantha N. , Hauenstein Jonathan D. , Wampler Charles W.
Published: February 2021

Cognate linkages are mechanisms that share the same motion, a property that can be useful in mechanical design. This article treats planar curve cognates, that is, planar mechanisms with rotational joints whose coupler points draw the same curve, as well as coupler cognates and timed curve cognates. The purpose of this article is to develop a straightforward method based solely on kinematic equations to construct cognates. The approach computes cognates that arise from permuting link rotations and is shown to reproduce all of the known results for cognates of four-bar and six-bar linkages. This approach is then used to construct a cognate of an eight-bar and a ten-bar linkage.
Outgassing rate comparison of seven geometrically similar vacuum chambers of different materials and heat treatments
Authors: Fedchak James A. , Scherschligt Julia K. , Avdiaj Sefer , Barker Daniel S. , Eckel Stephen P. , Bowers Ben , O’Connell Scott , Henderson Perry
Published: February 2021

We have measured the water and hydrogen outgassing rates of seven vacuum chambers of identical geometry but constructed of different materials and heat treatments. Chambers of five different materials were tested: 304L, 316L, and 316LN stainless steels; titanium (ASTM grade 2); and 6061 aluminum. In addition, chambers constructed of 316L and 316LN stainless steel were subjected to a vacuum-fire process, where they were heated to approximately 950 °C for 24 h while under vacuum. These latter two chambers are designated as 316L-XHV and 316LN-XHV. Because all the chambers were of identical geometry and made by the same manufacturer, a relative comparison of the outgassing rates among these chambers can be made. Water outgassing rates were measured as a function of time using the throughput technique. The water outgassing results for 316L, 316LN, 316L-XHV, and 316LN-XHV were all similar but lower than those for 304L by a factor of 3–5 lower at 104 s. The water outgassing results for the Ti and Al chambers were closer to that of 304L, Ti being slightly lower. Hydrogen outgassing rates were measured using the rate-of-rise method and performed after a low-temperature bake of 125–150 °C for a minimum of 72 h. The Ti, Al, 316L-XHV, and 316LN-XHV chambers all have ultralow specific outgassing rates below 1 × 10−11 Pa l s−1 cm−2 and are a factor of 100 or better than the 304L chamber. The 304L, 316L, and 316LN chambers with no vacuum-fire heat treatment have larger hydrogen outgassing rates than the other chambers, with determined specific outgassing rates ranging between 4.0 and 8.0 × 10−11 Pa l s−1 cm−2. We conclude that Ti, Al, 316L-XHV, and 316LN-XHV have hydrogen outgassing rates that make them excellent choices for ultrahigh vacuum and extreme-high vacuum applications, the choice depending on cost and other material properties.
Steady active control of noise radiation from highly heated supersonic jets
Authors: Prasad Chitrarth , Morris Philip J.
Published: February 2021

The goal of the present investigation is to study the effect of using fluid inserts for noise control at high exhaust temperatures by performing a sequence of large eddy simulations on a typical military-style nozzle, both with and without fluid inserts, at jet inlet total temperature ratios of 2.5, 5, and 7. An exact physics-based splitting of the jet flow-field into its hydrodynamic, acoustic, and thermal components reveals clear evidence of a reduction in the radiation efficiency of Mach waves from the controlled jet. This effect is far more pronounced at afterburner conditions, where the location of the maximum noise reduction is observed to shift upstream with increase in jet temperature, thus matching the maximum location of the jet OASPL directivity. Moreover, the maximum noise reduction achieved at afterburner conditions exceeds that obtained at lower exhaust temperatures. This is encouraging and shows that the effectiveness of the fluid inserts improves with an increase in jet exhaust temperature. Furthermore, by accounting for the effect of bleeding off bypass air for the fluid inserts in the LES simulation, this noise reduction is predicted to be achieved at a conservative thrust loss estimate of under 2% at both laboratory and afterburner operating conditions.
Clonal expansion and activation of tissue-resident memory-like T
H
17 cells expressing GM-CSF in the lungs of patients with severe COVID-19
Authors: Zhao Yu , Kilian Christoph , Turner Jan-Eric , Bosurgi Lidia , Roedl Kevin , Bartsch Patricia , Gnirck Ann-Christin , Cortesi Filippo , Schultheiß Christoph , Hellmig Malte , Enk Leon U.B. , Hausmann Fabian , Borchers Alina , Wong Milagros N. , Paust Hans-Joachim , Siracusa Francesco , Scheibel Nicola , Herrmann Marissa , Rosati Elisa , Bacher Petra , Kylies Dominik , Jarczak Dominik , Lütgehetmann Marc , Pfefferle Susanne , Steurer Stefan , Schulze zur Wiesch Julian , Puelles Victor G. , Sperhake Jan-Peter , Addo Marylyn M. , Lohse Ansgar W. , Binder Mascha , Huber Samuel , Huber Tobias B. , Kluge Stefan , Bonn Stefan , Panzer Ulf , Gagliani Nicola , Krebs Christian F.
Published: February 2021

Tissue-resident memory-like T
H
17 cells are clonally expanded in bronchoalveolar lavage fluid of patients with severe COVID-19.
A TRAIL from gut to brain
Authors: Foley John F.
Published: February 2021

Natural killer cells licensed by gut microbiota drive a population of TRAIL
+
astrocytes to limit inflammation in the brain.
Developing Synergistic Drug Combinations To Restore Antibiotic Sensitivity in Drug-Resistant Mycobacterium tuberculosis
Authors: Omollo Charles , Singh Vinayak , Kigondu Elizabeth , Wasuna Antonina , Agarwal Pooja , Moosa Atica , Ioerger Thomas R. , Mizrahi Valerie , Chibale Kelly , Warner Digby F.
Published: February 2021

Tuberculosis (TB) is a leading global cause of mortality owing to an infectious agent, accounting for almost one-third of antimicrobial resistance (AMR) deaths annually. We aimed to identify synergistic anti-TB drug combinations with the capacity to restore therapeutic efficacy against drug-resistant mutants of the causative agent,
Mycobacterium tuberculosis
.
Horsing Around: Escherichia coli ST1250 of Equine Origin Harboring Epidemic IncHI1/ST9 Plasmid with
bla
CTX-M-1
and an Operon for Short-Chain Fructooligosaccharide Metabolism
Authors: Valcek Adam , Sismova Petra , Nesporova Kristina , Overballe-Petersen Søren , Bitar Ibrahim , Jamborova Ivana , Kant Arie , Hrabak Jaroslav , Wagenaar Jaap A. , Madec Jean-Yves , Damborg Peter , van Duijkeren Engeline , Ewers Christa , Hordijk Joost , Hasman Henrik , Brouwer Michael S. M. , Dolejska Monika
Published: February 2021

The relatedness of the equine-associated
Escherichia coli
strain ST1250 and its single- and double-locus variants (ST1250-SLV/DLV), obtained from horses in Europe, was studied by comparative genome analysis. A total of 54 isolates of
E. coli
ST1250 and ST1250-SLV/DLV from healthy and hospitalized horses across Europe (Czech Republic [
n
 = 23], The Netherlands [
n
 = 18], Germany [
n
 = 9], Denmark [
n
 = 3], and France [
n
 = 1]) from 2008 to 2017 were subjected to whole-genome sequencing.
Succession of the Resident Soil Microbial Community in Response to Periodic Inoculations
Authors: Wang Zhikang , Chen Ziyun , Kowalchuk George A. , Xu Ziheng , Fu Xiangxiang , Kuramae Eiko E.
Published: February 2021

Introducing beneficial microbes to the plant-soil system is an environmentally friendly approach to improve the crop yield and soil environment. Numerous studies have attempted to reveal the impacts of inoculation on the rhizosphere microbiome.
The DUG Pathway Governs Degradation of Intracellular Glutathione in Aspergillus nidulans
Authors: Gila Barnabás Csaba , Moon Heungyun , Antal Károly , Hajdu Márton , Kovács Réka , Jónás Andrea P. , Pusztahelyi Tünde , Yu Jae-Hyuk , Pócsi István , Emri Tamás
Published: February 2021

Glutathione (GSH) is a widely distributed tripeptide in both eukaryotes and prokaryotes. Owing to its very low redox potential, antioxidative character, and high intracellular concentration, GSH profoundly shapes the redox status of cells.
Formaldehyde-Responsive Proteins TtmR and EfgA Reveal a Trade-off between Formaldehyde Resistance and Efficient Transition to Methylotrophy in Methylorubrum extorquens
Authors: Bazurto Jannell V. , Bruger Eric L. , Lee Jessica A. , Lambert Leah B. , Marx Christopher J.
Published: February 2021

All organisms produce formaldehyde as a by-product of enzymatic reactions and as a degradation product of metabolites. The ubiquity of formaldehyde in cellular biology suggests all organisms have evolved mechanisms of mitigating formaldehyde toxicity.
Impact of Activation of the Neotrehalosadiamine/Kanosamine Biosynthetic Pathway on the Metabolism of Bacillus subtilis
Authors: Saito Natsumi , Nguyen Huong Minh , Inaoka Takashi
Published: February 2021

Autoinducers enable bacteria to sense cell density and to coordinate collective behavior. NTD/kanosamine is an autoinducer produced by
B. subtilis
and several close relatives, although its physiological function remains unknown.
Genomic Background Governs Opposing Responses to Nalidixic Acid upon Megaplasmid Acquisition in
Pseudomonas
Authors: Baltrus David A. , Smith Caitlin , Derrick MacKenzie , Leligdon Courtney , Rosenthal Zoe , Mollico Madison , Moore Andrew , Clark Meara
Published: February 2021

Numerous studies have demonstrated that gene transfer events (e.g., plasmid acquisition) can entail a variety of costs that arise as by-products of the incorporation of foreign DNA into established physiological and genetic systems. These costs can be ameliorated through evolutionary time by the occurrence of compensatory mutations, which stabilize the presence of a horizontally transferred region within the genome but which also may skew future adaptive possibilities for these lineages.
The
Cytospora chrysosperma
Virulence Effector CcCAP1 Mainly Localizes to the Plant Nucleus To Suppress Plant Immune Responses
Authors: Han Zhu , Xiong Dianguang , Xu Zhiye , Liu Tingli , Tian Chengming
Published: February 2021

The data presented in this study provide a key resource for understanding the biology and molecular basis of necrotrophic pathogen responses to
Nicotiana benthamiana
resistance utilizing effector proteins, and CcCAP1 may be used in future studies to understand effector-triggered susceptibility processes in the
Cytospora chrysosperma
-poplar interaction system.
Sumatriptan dose increase-induced acute angle closure glaucoma in chronic migraine sufferer
Authors: Zormpas Sokratis , Matsou Artemis , Antunes Diandra Monique , Panos Chris
Published: February 2021

In this case study, we explore a case of bilateral acute angle closure (AAC) attack detected in a 52-year-old female patient with no other ophthalmic background or predisposition to angle closure, following an increase of her regular sumatriptan dose used for migraine relief. Even though the initial presentation was misinterpreted as migraine attack, it nevertheless alerted the treating physicians to immediate cessation of the drug, allowing for the pertinent ocular symptomatology to be unveiled. Drug-induced bilateral AAC is a rare occurrence and can lead to significant ocular morbidity if not detected and treated early. Clinicians of emergency care should be aware of this uncommon association, as prompt ophthalmology input is vital. Interestingly, although it would be anticipated that people prone to angle closure attack after sumatriptan intake would exhibit symptoms after initiation of the drug, our patient suffered an attack while on long-term treatment and following dose increase.
Orbitopalpebral and ocular sarcoidosis: what does the ophthalmologist need to know
Authors: Conti Marina Lourenço De , Osaki Midori Hentona , Sant'Anna Ana Estela , Osaki Tammy Hentona
Published: February 2021

Sarcoidosis is a chronic multisystemic disease of unknown aetiology, characterised by non-caseating granulomas. Ocular involvement rate ranges from 30% to 60% among individuals with sarcoidosis, and can vary widely, making the diagnosis a challenge to the ophthalmologist. Cutaneous manifestations occur in about 22% of sarcoidosis cases, but eyelid involvement is rare. Eyelid swelling and nodules are the most frequent forms of eyelid involvement, but other findings have been reported. The joint analysis of clinical history, ancillary exams and compatible biopsy is needed for the diagnosis, as well as the exclusion of other possible conditions. This review aims to describe the different forms of presentations, the clinical reasoning and treatment options for ocular, eyelid and orbital sarcoidosis.
Long-term outcomes following primary versus secondary Boston keratoprosthesis type 1 implantation
Authors: Nayman Taylor , Bostan Cristina , Szigiato Andrei-Alexandru , Harissi-Dagher Mona
Published: February 2021

Background/aims

To compare long-term outcomes of primary versus secondary (postgraft failure) Boston keratoprosthesis type 1 (KPro) implantation.

Methods

Medical records of patients at the Centre hospitalier de l’Université de Montréal having undergone KPro implantation between 2008 and 2017 were reviewed and included if they had a preoperative Snellen best-corrected visual acuity (BCVA) of 20/100 or worse and a minimum of 5 years of follow-up. Eighty-two eyes were separated into two cohorts (40 primary, 42 secondary KPro) and BCVA, complications and device retention were evaluated between groups.

Results

BCVA improved from baseline in both groups at each year; this was significant at all five postoperative years in the primary group and the first 3 years in the secondary group (p<0.05). Mean BCVA was similar between groups at 5 years (logarithm of minimal angle resolution 1.3±0.8 in the primary group vs 1.5±0.8 p<0.05). Idiopathic vitritis, choroidal detachment and new glaucoma occurred more after primary KPro (n=7, 17.5% vs n=1, 2.4%; n=11, 27.5% vs n=3, 7.14% and n=14, 35% vs n=6, 14%, respectively; p<0.05). Primary KPro had lower retention (n=28, 70% vs n=38, 91%, p<0.05) at final follow-up. There was more aniridia in the primary group (n=19, 48% vs n=6, 14%, p<0.01). Within each group, 50% of removals occurred in aniridic eyes.

Conclusion

Primary KPro yielded favourable long-term visual outcomes but had more complications and lower retention rates than secondary KPro, likely explained by preoperative indications. Primary device implantation represents a favourable option for patients for whom grafts are likely to fail.
Association between body mass index and diabetic retinopathy in Asians: the Asian Eye Epidemiology Consortium (AEEC) study
Authors: Sabanayagam Charumathi , Sultana Rehena , Banu Riswana , Rim Tyler , Tham Yih Chung , Mohan Sunita , Chee Miao Li , Wang Ya Xing , Nangia Vinay , Fujiwara Kohta , Tai E Shyong , Song Su Jeong , Bikbov Mukharram M , Raman Rajiv , Cheng Ching Yu , Wong Tien Yin , Jonas Jost B
Published: February 2021

Background/aims

Obesity is a well-known risk factor for diabetes, but its association with diabetic retinopathy (DR) is inconclusive, in particular in Asians. We aimed to assess whether body mass index (BMI) is associated with the presence and severity of DR in Asian populations with diabetes.

Methods

Pooled analysis of individual-level cross-sectional data from 10 010 adults with diabetes who participated in 12 population-based studies conducted in China, India, Japan, Russia (Asian), Singapore and South Korea that were part of the Asian Eye Epidemiology Consortium (AEEC). BMI was calculated as weight in kilograms divided by height in square metres and categorised into normal (<25 kg/m2, reference), overweight (25–29.9 kg/m2) and obese (≥30 kg/m2). Any-DR (n=1669) and vision-threatening DR (VTDR, n=489) were assessed from digital retinal photographs and graded according to standard protocols. Each study was analysed separately using multivariable logistic regression models adjusted for age, sex, haemoglobin A1c%, systolic blood pressure and diabetes duration, and the estimated odds ratios (ORs) and 95% confidence interval (CIs) from all studies were then combined using random-effects models.

Results

In multivariable models, obesity showed a significant inverse association with any-DR (pooled OR (95% CI) =0.74 (0.59 to 0.91)) and VTDR (0.75 (0.60 to 0.93)). Similarly, in continuous analysis, BMI showed a significant inverse association with both any-DR (0.93 (0.87 to 0.99)) and VTDR (0.79 (0.68 to 0.92) per SD increase). Overweight did not show a significant association with any-DR.

Conclusions

Among Asian adults with diabetes, both BMI and obesity showed an inverse association with DR. These findings warrant confirmation in further longitudinal studies.
Mental health among elite athletes in Norway during a selected period of the COVID-19 pandemic
Authors: Pensgaard Anne Marte , Oevreboe Tom Henning , Ivarsson Andreas
Published: February 2021

Objective

To investigate the prevalence of mental health problems and satisfaction with life among different groups of elite athletes during a selected period of the COVID-19 pandemic and examine how COVID-19 related consequences were associated with these variables.

Design

Cross-sectional data collection during a selected period of the COVID-19 pandemic in Norway.

Participants

378 elite athletes, mean age 26.86 (range 18–59), 159 females and 219 males, divided into Olympic-level and Paralympic-level athletes (n=194) and elite and semielite athletes (n=184).

Main outcome measures

Hopkins Symptoms Check List − 10; symptoms of anxiety and depression; Bergen Insomnia Scale; Eating Disorder Examination Questionnaire Short; Canadian Problem Gambling Index and Satisfaction with Life Scale. In addition, we included specific COVID-19 questions (eg, financial concern, keeping daily routines, perceived coping and motivation).

Results

Symptoms of insomnia (38.3%) and depression (22.3%) were most prevalent within the sample. Symptoms of eating disorders more prevalent among female athletes (8.8% vs 1.4%) while symptoms of gambling problems were higher among male athletes (8.6% vs 1.3%). Olympic and Paralympic athletes reported lower levels of anxiety and depression symptoms than elite and semielite athletes. Financial concerns were associated with an increased risk of mental health problems, while daily routines and perception of coping were associated with less mental health problems and higher satisfaction with life.

Conclusion

Symptoms of insomnia and depression were the two most common mental health problems reported during this selected phase of the COVID-19 pandemic. Elite and semielite athletes reported financial concerns as a risk factor for mental health problems at a larger degree than Olympic and Paralympic athletes.
Relative survival after aortic valve surgery in patients with bicuspid aortic valves
Authors: Glaser Natalie , Jackson Veronica , Eriksson Per , Sartipy Ulrik , Franco-Cereceda Anders
Published: February 2021

Objectives

The objective of this cohort study was to analyse long-term relative survival in patients with bicuspid aortic valve (BAV) who underwent aortic valve surgery.

Methods

We studied 865 patients with BAVs who participated in three prospective cohort studies of elective, open-heart, aortic valve surgery at the Karolinska University Hospital, Stockholm, Sweden, between 2007 and 2020. The expected survival for the age, sex and calendar year-matched general Swedish population was obtained from the Human Mortality Database. The Ederer II method was used to calculate relative survival, which was used as an estimate of cause-specific survival.

Results

No differences were found in the observed versus expected survival at 1, 5, 10 or 12 years: 99%, 94%, 83% and 76% vs 99%, 93%, 84% and 80%, respectively. The relative survival at 1, 5, 10 and 12 years was 100% (95% CI 99% to 100%), 101% (95% CI 99% to 103%), 99% (95% CI 95% to 103%) and 95% (95% CI 87% to 102%), respectively. The relative survival at the end of follow-up tended to be lower for women than men (86% vs 95%). The mean follow-up was 6.3 years (maximum 13.3 years).

Conclusions

The survival of patients with BAV following aortic valve surgery was excellent and similar to that of the general population. Our results suggest that the timing of surgery according to current guidelines is correct and provide robust long-term survival rates, as well as important information about the natural history of BAV in patients following aortic valve surgery.
Comparison between 1973 and 2004/2016 WHO grading systems in patients with Ta urothelial carcinoma of urinary bladder
Authors: Collà Ruvolo Claudia , Würnschimmel Christoph , Wenzel Mike , Nocera Luigi , Califano Gianluigi , Tian Zhe , Shariat Shahrokh F , Saad Fred , Chun Felix K H , Briganti Alberto , Verze Paolo , Imbimbo Ciro , Mirone Vincenzo , Karakiewicz Pierre I
Published: February 2021

Aims

To compare the 1973 WHO and the 2004/2016 WHO grading systems in patients with urothelial carcinoma of urinary bladder (UCUB), since no consensus has been made which classification should supersede the other and since both are recommended in clinical practice.

Methods

Newly diagnosed patients with Ta UCUB treated with transurethral resection of bladder tumour were abstracted from the Surveillance, Epidemiology and End Results database (2010–2016). Kaplan-Meier plots and multivariable Cox regression models (CRMs) tested cancer-specific mortality (CSM), according to 1973 WHO (G1 vs G2 vs G3) and to 2004/2016 WHO (low-grade vs high-grade) grading systems.

Results

Of 35 986 patients, according to 1973 WHO grading system, 8165 (22.7%) were G1, 17 136 (47.6%) were G2 and 10 685 (29.7%) were G3. According to 2004/2016 WHO grading system, 24 961 (69.4%) were low-grade versus 11 025 (30.6%) high-grade. In multivariable CRMs, G3 (HR: 2.05, p<0.001), relative to G1, and high-grade(HR: 2.13, p<0.001), relative to low-grade, predicted higher CSM. Conversely, G2 (p=0.8) was not an independent predictor. The multivariable models without consideration of either grading system were 74% accurate in predicting 5-year CSM. After addition of 1973 WHO or 2004/2016 WHO grade, the accuracy increased to 76% and 77%, respectively.

Conclusions

From a statistical standpoint, it appears that the 2004/2016 WHO grading system holds a small, although measurable advantage over the 1973 WHO grading system. Other considerations, such as intraobserver and interobserver variability may represent an additional matric to consider in deciding which grading system is better.
Role of Topical Tacrolimus in the Management of Proctitis, Perianal Manifestations in Crohn's Disease, and Chronic Pouchitis: A Systematic Review
Authors: Salem George , Ding Kai , Sakuraba Atsushi , Cohen Russell
Published: February 2021

Several published studies have evaluated the safety and effectiveness of oral and intravenous tacrolimus for the management of patients with inflammatory bowel disease (IBD). However, little is known about the effectiveness of topical tacrolimus in this patient population. The aim of this systematic review was to evaluate the current state of literature to evaluate the safety and effectiveness of rectal administration of topical tacrolimus, in the form of suppository, ointment, and/or enema in patients with ulcerative proctitis, perianal Crohn's disease (CD), and chronic refractory pouchitis. Electronic database searches were conducted in international databases since their inception until February 2020. Study subjects were categorized into three groups: topical tacrolimus for patients with proctitis, perianal CD, and chronic refractory pouchitis. The primary end point of this study was the remission rate. Secondary end points were response rate and the incidence of AEs. Eleven studies were included in the final assessment in this systematic review. This provided information from 188 patients. Tacrolimus was administered topically as suppositories, ointment, or enema. Clinical remission was achieved in 57.1%, 57.14%, and 70.0% in patients with proctitis, fistulizing perianal CD, and chronic pouchitis. The most commonly reported side effect was perianal itching and burning. Reversible nephrotoxicity occurred in a single patient. No clear correlation was found between blood levels and clinical outcomes. Topical tacrolimus is effective for a subset of patients with IBD. The adverse effects were minimal and tolerable. Well-designed randomized clinical trials are warranted to establish the appropriate dose and administration method.
Diagnostic criteria for constitutional mismatch repair deficiency (CMMRD): recommendations from the international consensus working group
Authors: Aronson Melyssa , Colas Chrystelle , Shuen Andrew , Hampel Heather , Foulkes William D , Baris Feldman Hagit , Goldberg Yael , Muleris Martine , Wolfe Schneider Kami , McGee Rose B , Jasperson Kory , Rangaswami Arun , Brugieres Laurence , Tabori Uri
Published: February 2021

Background

Constitutional mismatch repair deficiency syndrome (CMMRD) is the most aggressive cancer predisposition syndrome associated with multiorgan cancers, often presenting in childhood. There is variability in age and presentation of cancers and benign manifestations mimicking neurofibromatosis type 1. Genetic testing may not be informative and is complicated by pseudogenes associated with the most commonly associated gene,PMS2. To date, no diagnostic criteria exist. Since surveillance and immune-based therapies are available, establishing a CMMRD diagnosis is key to improve survival.

Methods

In order to establish a robust diagnostic path, a multidisciplinary international working group, with representation from the two largest consortia (International Replication Repair Deficiency (IRRD) consortium and European Consortium Care for CMMRD (C4CMMRD)), was formed to establish diagnostic criteria based on expertise, literature review and consensus.

Results

The working group established seven diagnostic criteria for the diagnosis of CMMRD, including four definitive criteria (strong evidence) and three likely diagnostic criteria (moderate evidence). All criteria warrant CMMRD surveillance. The criteria incorporate germline mismatch repair results, ancillary tests and clinical manifestation to determine a diagnosis. Hallmark cancers for CMMRD were defined by the working group after extensive literature review and consultation with the IRRD and C4CMMRD consortia.

Conclusions

This position paper summarises the evidence and rationale to provide specific guidelines for CMMRD diagnosis, which necessitates appropriate surveillance and treatment.
Changes in work and life patterns associated with depressive symptoms during the COVID-19 pandemic: an observational study of health app (CALO mama) users
Authors: Sato Koryu , Sakata Ryohei , Murayama Chiaki , Yamaguchi Mai , Matsuoka Yoko , Kondo Naoki
Published: February 2021

Background

During the COVID-19 pandemic, many people refrained from going out, started working from home (WFH), and suspended work or lost their jobs. This study examines how such pandemic-related changes in work and life patterns were associated with depressive symptoms.

Methods

An online survey among participants who use a health app called CALO mama was conducted from 30 April to 8 May 2020 in Japan. Participants consisted of 2846 users (1150 men (mean age=50.3) and 1696 women (mean age=43.0)) who were working prior to the government declaration of a state of emergency (7 April 2020). Their daily steps from 1 January to 13 May 2020 recorded by an accelerometer in their mobile devices were linked to their responses. Depressive symptoms were assessed using the Two-Question Screen.

Results

On average, participants took 1143.8 (95% CI −1557.3 to −730.2) fewer weekday steps during the declaration period (from 7 April to 13 May). Depressive symptoms were positively associated with female gender (OR=1.58, 95% CI 1.34 to 1.87), decreased weekday steps (OR=1.22, 95% CI 1.03 to 1.45) and increased working hours (OR=1.73, 95% CI 1.32 to 2.26). Conversely, starting WFH was negatively associated with depressive symptoms (OR=0.83, 95% CI 0.69 to 0.99).

Conclusions

Decreased weekday steps during the declaration period were associated with increased odds of depressive symptoms, but WFH may mitigate the risk in the short term. Further studies on the longitudinal effects of WFH on health are needed.
Relationship between sleep disorders, HIV status and cardiovascular risk: cross-sectional study of long-haul truck drivers from Southern Africa
Authors: Roche Johanna , Vos Alinda G , Lalla-Edward Samanta T , Venter W D Francois , Scheuermaier Karine
Published: February 2021

Objectives

Long-haul truck drivers (TDs) may have lifestyles that promote cardiovascular disease (CVD), including diet, sleep and activity issues. Most studies conducted among truckers investigated the relationship between poor sleep and cardiometabolic health, but none assessed whether suspected obstructive sleep apnoea (OSA) and shortened sleep were associated with markers of cardiometabolic risk. We determined whether sleep disorders and circadian misalignment were associated with chronic inflammation and CVD risk in TDs from Southern Africa.

Methods

Participants were recruited at roadside wellness centres in Gauteng and Free State Provinces, South Africa. OSA risk was assessed using the Berlin Questionnaire, while sleep duration and sleep quality were assessed using items from the Pittsburgh Sleep Quality Index. Clinical information, neck circumference (NC), metabolic profile, elevated BP, HIV status and C-reactive protein (CRP) were collected. CVD risk was assessed using the Framingham Risk Score (FRS).

Results

Out of 575 participants aged on average 37.7 years, 17.2% were at OSA risk, 72.0% had elevated BP, 9.4% had HIV and 28.0% were obese. Mean sleep duration was 7.4±1.8 hours, and 49.6% reported working night shift at least once a week. Shortened sleep, OSA risk, age, body mass index, NC and years as full-time TD were associated with greater FRS independently of HIV status and night shift. Working night shift was associated with higher CRP levels in HIV+ compared with HIV− participants.

Conclusions

Circadian misalignment in HIV, and OSA and short sleep duration in all truckers were associated with increased CVD risk. Truckers should be given careful attention in terms of health management and sleep education.