bluuebunny/crossref_metadata_2025 huggingface dataset:
Worried, weary and worn out: mixed-method study of stress and well-being in final-year medical students
Authors: Lane Abbie , McGrath Jack , Cleary Eimear , Guerandel Allys , Malone Kevin M
Published: December 2020

Objective

Although there is much focus on burnout and psychological distress among doctors, studies about stress and well-being in medical students are limited but could inform early intervention and prevention strategies.

Design

The primary aim of this mixed-method, cross-sectional survey was to compare objective and subjective levels of stress in final-year medical students (2017) and to explore their perspectives on the factors they considered relevant to their well-being.

Setting

University College Dublin, the largest university in Ireland.

Participants

161 of 235 medical students participated in this study (response rate 69%).

Results

65.2% of students scored over accepted norms for the Perceived Stress Scale (34.8% low, 55.9% moderate and 9.3% high). 35% scored low, 28.7% moderate and 36.3% high on the Subjective Stress Scale. Thematic analysis identified worry about exams, relationships, concern about the future, work–life balance and finance; one in three students reported worry, irritability and hostility; many felt worn out. Cognitive impacts included overthinking, poor concentration, sense of failure, hopelessness and procrastination. Almost a third reported sleep and appetite disturbance, fatigue and weariness. A quarter reported a ‘positive reaction’ to stress. Positive strategies to manage stress included connection and talking, exercise, non-study activity and meditation. Unhelpful strategies included isolation and substance use. No student reported using the college support services or sought professional help.

Conclusion

Medical students experience high levels of psychological distress, similar to their more senior doctor colleagues. They are disinclined to avail of traditional college help services. Toxic effects of stress may impact their cognition, learning, engagement and empathy and may increase patient risk and adverse outcomes. The focus of well-being in doctors should be extended upstream and embedded in the curriculum where it could prevent future burnout, improve retention to the profession and deliver better outcomes for patients.
Maintenance of professional competence in Ireland: a national survey of doctors’ attitudes and experiences
Authors: Galvin Emer , Wiese Anel , Dahly Darren , O'Farrell Janet , Cotter Jantze , Bennett Deirdre
Published: December 2020

Objectives

Programmes to ensure doctors’ maintenance of professional competence (MPC) have been established in many countries. Since 2011, doctors in Ireland have been legally required to participate in MPC. A significant minority has been slow to engage with MPC, mirroring the contested nature of such programmes internationally. This study aimed to describe doctors’ attitudes and experiences of MPC in Ireland with a view to enhancing engagement.

Participants

All registered medical practitioners in Ireland required to undertake MPC in 2018 were surveyed using a 33-item cross-sectional mixed-methods survey designed to elicit attitudes, experiences and suggestions for improvement.

Results

There were 5368 responses (response rate 42%). Attitudes to MPC were generally positive, but the time, effort and expense involved outweighed the benefit for half of doctors. Thirty-eight per cent agreed that MPC is a tick-box exercise. Heavy workload, travel, requirement to record continuing professional development activities and demands placed on personal time were difficulties cited. Additional support, as well as higher quality, more varied educational activities, were among suggested improvements. Thirteen per cent lacked confidence that they could meet requirements, citing employment status as the primary issue. MPC was particularly challenging for those working less than full-time, in locum or non-clinical roles, and taking maternity or sick leave. Seventy-seven per cent stated a definite intention to comply with MPC requirements. Being male, or having a basic medical qualification from outside Ireland, was associated with less firm intention to comply.

Conclusions

Doctors need to be convinced of the benefits of MPC to them and their patients. A combination of clear communication and improved relevance to practice would help. Addition of a facilitated element, for example, appraisal, and varied ways to meet requirements, would support participation. MPC should be adequately resourced, including provision of high-quality free educational activities. Systems should be established to continually evaluate doctors’ perspectives.
Atypical lymphoid cells circulating in blood in COVID-19 infection: morphology, immunophenotype and prognosis value
Authors: Merino Anna , Vlagea Alexandru , Molina Angel , Egri Natalia , Laguna Javier , Barrera Kevin , Boldú Laura , Acevedo Andrea , Díaz-Pavón Mar , Sibina Francesc , Bascón Francisca , Sibila Oriol , Juan Manel , Rodellar José
Published: December 2020

Aims

Atypical lymphocytes circulating in blood have been reported in COVID-19 patients. This study aims to (1) analyse if patients with reactive lymphocytes (COVID-19 RL) show clinical or biological characteristics related to outcome; (2) develop an automatic system to recognise them in an objective way and (3) study their immunophenotype.

Methods

Clinical and laboratory findings in 36 COVID-19 patients were compared between those showing COVID-19 RL in blood (18) and those without (18). Blood samples were analysed in Advia2120i and stained with May Grünwald-Giemsa. Digital images were acquired in CellaVisionDM96. Convolutional neural networks (CNNs) were used to accurately recognise COVID-19 RL. Immunophenotypic study was performed throughflow cytometry.

Results

Neutrophils, D-dimer, procalcitonin, glomerular filtration rate and total protein values were higher in patients without COVID-19 RL (p<0.05) and four of these patients died. Haemoglobin and lymphocyte counts were higher (p<0.02) and no patients died in the group showing COVID-19 RL. COVID-19 RL showed a distinct deep blue cytoplasm with nucleus mostly in eccentric position. Through two sequential CNNs, they were automatically distinguished from normal lymphocytes and classical RL with sensitivity, specificity and overall accuracy values of 90.5%, 99.4% and 98.7%, respectively. Immunophenotypic analysis revealed COVID-19 RL are mostly activated effector memory CD4 and CD8 T cells.

Conclusion

We found that COVID-19 RL are related to a better evolution and prognosis. They can be detected by morphology in the smear review, being the computerised approach proposed useful to enhance a more objective recognition. Their presence suggests an abundant production of virus-specific T cells, thus explaining the better outcome of patients showing these cells circulating in blood.
Dynamic characteristics of Canada's Parliament Hill towers from ambient vibrations and recorded earthquake data
Authors: Kolaj Michal , Adams John
Published: December 2020

The dynamic properties of Parliament Hill’s buildings (Ottawa, Canada) are of particular interest due to their important heritage value and because of the seismic retrofit project currently underway. To measure the dynamic properties directly, ambient vibration data were collected within the Peace Tower of Centre Block and the South-West Tower of East Block and processed together with weak to strong ground motions from six earthquakes. Both datasets found the fundamental mode to be 1.0–1.15 Hz for the Peace Tower and 2 Hz for the South-West Tower. The 2010 magnitude 5 Val-des-Bois earthquake induced peak accelerations of 49% g and 18% g in the top floors of the Peace and South-West towers, respectively, triggering a nonlinear response, causing the frequencies of the dominant modes to be reduced by 10%–15%. The reduction in frequency was temporary and the frequencies returned to baseline values, suggesting that there was no permanent structural damage.
Reflections on the organization and the physical state of chromatin in eukaryotic cells
Authors: Strickfaden Hilmar
Published: December 2020

In recent years, our perception of chromatin structure and organization in the cell nucleus has changed in fundamental ways. The 30 nm chromatin fiber has lost its status as an essential in vivo structure. Hi-C and related biochemical methods, advanced electron and super-resolved fluorescence microscopy, together with concepts from soft matter physics, have revolutionized the field. A comprehensive understanding of the structural and functional interactions that regulate cell cycle and cell type specific nuclear functions appears within reach, but it requires the integration of top-down and bottom-up approachs. In this review, I present an update on nuclear architecture studies with an emphasis on organization and the controversy regarding the physical state of chromatin in cells.
The critical temperature of the 2D-Ising model through deep learning autoencoders
Authors: Alexandrou Constantia , Athenodorou Andreas , Chrysostomou Charalambos , Paul Srijit
Published: December 2020

We investigate deep learning autoencoders for the unsupervised recognition of phase transitions in physical systems formulated on a lattice. We focus our investigation on the 2-dimensional ferromagnetic Ising model and then test the application of the autoencoder on the anti-ferromagnetic Ising model. We use spin configurations produced for the 2-dimensional ferromagnetic and anti-ferromagnetic Ising model in zero external magnetic field. For the ferromagnetic Ising model, we study numerically the relation between one latent variable extracted from the autoencoder to the critical temperatureTc. The proposed autoencoder reveals the two phases, one for which the spins are ordered and the other for which spins are disordered, reflecting the restoration of the ℤ2symmetry as the temperature increases. We provide a finite volume analysis for a sequence of increasing lattice sizes. For the largest volume studied, the transition between the two phases occurs very close to the theoretically extracted critical temperature. We define as a quasi-order parameter the absolute average latent variable z̃, which enables us to predict the critical temperature. One can define a latent susceptibility and use it to quantify the value of the critical temperatureTc(L) at different lattice sizes and that these values suffer from only small finite scaling effects. We demonstrate thatTc(L) extrapolates to the known theoretical value asL→∞suggesting that the autoencoder can also be used to extract the critical temperature of the phase transition to an adequate precision. Subsequently, we test the application of the autoencoder on the anti-ferromagnetic Ising model, demonstrating that the proposed network can detect the phase transition successfully in a similar way.

Graphical abstract
Consistency conditions for p-form field localization on codimension two braneworlds
Authors: Freitas L. F. F. , Alencar G. , Landim R. R.
Published: December 2020

In a recent work (Eur. Phys. J. C 80(5), 432, 2020), the present authors obtained general stringent conditions on the localization of fields in braneworlds by imposing the requirement that its zero mode must satisfy Einstein’s equations (EEs). In this manuscript, we continue this study by considering freep-form fields. These fields present an on-shell equivalency relation between ap-form and a$$(D-p-2)$$(D-p-2)-form, provided by a Hodge duality (HD) transformation. This symmetry will impose a new consistency condition, namely, confinement of ap-form on the brane must imply the localization of its dual. We apply the above two conditions to 6D braneworld models. With this, we find that in global string-like defects, for example, the 1-form field has a normalizable zero mode. By using the HD as a guide, we show that its bulk dual 3-form field also has a normalizable zero mode, making the confinement consistent with HD. However, these solutions cannot be made consistent with EE, therefore, these fields must be ruled out. In fact, by imposing both conditions, only the scalar field and its dual can be consistently localized in codimension two braneworlds. In this way, all the literature so far in which the free vector field (1-form) is localized in codimension two models should be reviewed. These results also point to the fact that the symmetries of the fields can be used to verify the consistency of their localization and even prohibit it.
Large eddy simulation of Rayleigh–Taylor mixing based on helicity model
Authors: Zhou Hao , Feng Qijing , Hao Pengcheng , Li Li
Published: December 2020

This paper focuses on large eddy simulation of Rayleigh–Taylor instability (RTI) based on helicity model (HM) which is derived from our previous research. Based on the RTI problem, we obtain from a priori test and theoretical analysis that the suggested model can automatically distinguish laminar flow and turbulence. Comparing the numerical simulation results with direct numerical simulation (DNS) and traditional model in RTI problem, we could find that the suggested model overcomes some defects of the traditional model, such as the traditional model cannot predict transition accurately and the suggested model can predict the turbulence mixing width and mass fraction precisely. It provides a beneficial tool for the research of RTI.
Blackbody radiation model inspired from black hole evaporation
Authors: Umetsu Koichiro
Published: December 2020

Hawking radiation presents a mechanism how a black hole decreases its energy. We would like to discuss the mesoscopic effect of the temperature of the blackbody by applying the analysis of particle’s self-gravitation by Parikh and Wilczek to the blackbody radiation without the heat bath. We then obtain an interesting result that the temperature of the system depends on photon energies by analyzing a gedanken experiment. We propose an experiment to examine the effect.
Cohomological invariants of representations of 3-manifold groups
Authors: Chen Haimiao
Published: December 2020

Suppose [Formula: see text] is a discrete group, and [Formula: see text], with [Formula: see text] an abelian group. Given a representation [Formula: see text], with [Formula: see text] a closed 3-manifold, put [Formula: see text], where [Formula: see text] is a continuous map inducing [Formula: see text] which is unique up to homotopy, and [Formula: see text] is the pairing. We extend the definition of [Formula: see text] to manifolds with corners, and establish a gluing law. Based on these, we present a practical method for computing [Formula: see text] when [Formula: see text] is given by a surgery along a link [Formula: see text]. In particular, the Chern–Simons invariant can be computed this way.
THE EFFECT OF IRON ON THE SURFACE GRAPHITIZATION OF SILICON CARBIDE
Authors: MERCAN ELIF , BUKE GOKNUR CAMBAZ
Published: December 2020

In order to decrease the decomposition temperature of SiC, 12[Formula: see text]nm Fe thin film is applied on SiC substrates as a catalyst layer using electron beam (e-beam) deposition. To investigate the mechanism of Fe-treated SiC decomposition, local Fe regions are formed through dewetting of the catalyst layer by hydrogen annealing. The results show that Fe decreases the decomposition temperature of SiC effectively and increases the kinetics of the graphitization. Studies showed that depending on the amount of Fe, crumpled and ordered graphene films can be synthesized simultaneously on SiC by using this method.
Classification of fusion categories generated by a self-dual simple object of FP-dimension 2
Authors: Wang Zhihua , Dong Jingcheng , Li Libin
Published: December 2020

In this paper, we consider fusion categories generated by a self-dual simple object of FP-dimension 2. We use the classification results of indecomposable generalized Cartan matrices to determine possible types of these fusion categories. It turns out that there are only five types for such categories. Moreover, the fusion rules of all types of these fusion categories are explicitly described according to their valued graphs. This gives a classification of these fusion categories up to Grothendieck equivalence.
Almost subnormal subgroups in division rings with generalized algebraic rational identities
Authors: Hai Bui Xuan , Dung Truong Huu , Bien Mai Hoang
Published: December 2020

In this paper, we study non-central almost subnormal subgroups of the multiplicative group of a division ring satisfying a nonzero generalized rational identity. The main result generalizes Chiba’s theorem on subnormal subgroups. As an application, we get a theorem on almost subnormal subgroups satisfying a generalized algebraic rational identity. The last theorem has several corollaries which generalize completely or partially some previous results.
Carbon-Coated Magnetic Iron Oxide Nanoparticles as Green Catalysts for Aromatic Nitration
Authors: Parthasarathy Meera , Adigopula Srikanth , Gownivari Harichandana , Mudhivedu Gnanaprasanna , Vasudevan Anitha , Ulaganadhan Dhinakaran Sorakka
Published: December 2020

Nitration of aromatic compounds is an important industrial process, which creates significant environmental pollution because of the harsh mineral acid catalysts. In this work, we report the synthesis and application of magnetic iron oxide nanoparticles as green catalysts for aromatic nitration. Magnetic iron oxide nanoparticles were synthesized by co-precipitation method and tested for nitration reactions on selected aromatic substrates, phenol, benzaldehyde, methylbenzoate, [Formula: see text]-cresol and [Formula: see text]-cresol. For the nitration reactions, sodium nitrite was used as the nitro-source and hydrogen peroxide as the oxidant. Effect of reaction conditions like, solvent, temperature and microwave treatment were studied. The magnetic nanoparticles were found to be more stable after coating with a carbon shell by a one-pot carbonization method. The reactions were fast with good product yield under solvent-free microwave conditions. The nano-catalyst was recovered magnetically after the reaction and reused for three batches of nitration, without significant loss in catalytic activity. The nanoparticles were characterized using scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDAX), X-ray diffractometry (XRD) and FTIR spectroscopy.
The Relationship Between Architectural Modularity and Platform Scale Up Performance: The Moderating Effects of Strategic Flexibility and Technology Turbulence
Authors: Padmanabhan Jaykumar , Raghunath S.
Published: December 2020

The emergence of digital platforms has had a deep impact on the way firms design and position their products. An open architecture is a key to successfully scale up platforms in terms of usage. Architectural modularity is an important feature that facilitates openness of platforms. Successful scaling of platforms needs a digital infrastructure layer that facilitates collaboration and creation and hence the role of modular systems in the development of platform ecosystems has increased substantially. In this paper, we study the relationship between modular architectures and platform scale up performance from a survey data of managers in the semiconductor industry with 232 data points. The findings from our study show that the scale-up performance of platforms has an inverted U-shaped relationship with modularity. We also find that the strategic flexibility of firms positively moderates this relationship.

The degree of flexibility that system architecture should have is not only an important technical decision but is important from a business perspective as well. Ambiguity in terms of interfaces and the functionality of modules reduces the possibility of ex-ante specification of contracting terms and incentives and monitoring of incentives. The link between architectural modularity and the relationship to performance is important as this enables us to examine questions related to the success of task partitioning at an industry level.
Newly comprehensive understanding of Li2S8 as additive in liquid electrolyte for lithium-sulfur battery through reconstructing the cathode and SEI
Authors: He Gangguo , Zhao Lei , Han Jiayue , Huang Yun , Li Xing , Wang Mingshan , Cao Haijun
Published: December 2020

Adding Li2S8 as additive in liquid electrolyte (LE) for lithium-sulfur battery (LSB) is one of the most effective strategies which not only suppresses the shuffle effect of lithium polysulfide (LPS) through concentration difference but also maintains the excellent properties of ether-based electrolyte. However, previous researches on this strategy mostly focus on low-concentration Li2S8 additive (no more than 0.2 mol/L), which cannot provide comprehensive understanding of the special role of Li2S8. In this study, high-concentration Li2S8 is selected as the LE additive which is demonstrated inducing two marvelous reconstruction effects that have not been reported both for the cathode and solid electrolyte interphase (SEI). Through these two effects, the cathode and SEI are reconstructed to form denser and more stable structures, ensuring the battery to possess much higher discharge specific capacity and excellent cycle stability, with a Coulombic efficiency (CE) fade of only 0.091% per cycle. This exploration of Li2S8 additive helps to better understand the role of electrolyte additive and how the concentration of it influences the whole battery system.
Study of Residual Wall Thickness and Multiobjective Optimization for Process Parameters of Water-Assisted Injection Molding
Authors: Yang Jiangen , Yu Shengrui , Yu Ming
Published: December 2020

Residual wall thickness is an important indicator for water-assisted injection molding (WAIM) parts, especially the maximization of hollowed core ratio and minimization of wall thickness difference which are significant optimization objectives. Residual wall thickness was calculated by the computational fluid dynamics (CFD) method. The response surface methodology (RSM) model, radial basis function (RBF) neural network, and Kriging model were employed to map the relationship between process parameters and hollowed core ratio, and wall thickness difference. Based on the comparison assessments of the three surrogate models, multiobjective optimization of hollowed core ratio and wall thickness difference for cooling water pipe by integrating design of experiment (DOE) of optimized Latin hypercubes (Opt LHS), RBF neural network, and particle swarm optimization (PSO) algorithm was studied. The research results showed that short shot size, water pressure, and melt temperature were the most important process parameters affecting hollowed core ratio, while the effects of delay time and mold temperature were little. By the confirmation experiments for the best solution resulted from the Pareto frontier, the relative errors of hollowed core ratio and wall thickness are 2.2% and 3.0%, respectively. It demonstrated that the proposed hybrid optimization methodology could increase hollowed core ratio and decrease wall thickness difference during the WAIM process.
An Assessment of Public Knowledge and Potential Health Impacts of Global Warming in Ghana
Authors: Odonkor Stephen T. , Sallar Anthony M.
Published: December 2020

Global warming is a serious threat to human existence. The relatively higher level of global warming in recent times poses higher health risks to humans, both directly and indirectly. The aim of the study was to investigate public knowledge of global warming and its effects on human health. A nationally representative survey of Ghanaian adults (N = 1130) was conducted from November 1, 2018 to February 28, 2019. Results show that 84.4% of the respondents understood the meaning of global warming. Respondents’ perceived causes of global warming include natural processes, deforestation, act of the gods, burning of fossil fuel, and carbon dioxide (CO2) emission from vehicles and industries. The majority of the respondents (83.4%) indicated that global warming has an impact on human health, while 8.5% indicated that it does not. Majority (78.6%) of the respondents are willing to support efforts to reduce the intensity of global warming. Television (19.1%) and social media (18.6%) were the leading preferred methods for receipt of global warming information. These findings provide useful insights for policy directions. The Government of Ghana and other stakeholders in health should develop a communication strategy to increase and sustain publicity and education of the citizenry on global warming.
An Overview of In Vitro, In Vivo, and Computational Techniques for Cancer‐Associated Angiogenesis Studies
Authors: Rahman Heshu Sulaiman , Tan Bee Ling , Othman Hemn Hassan , Chartrand Max Stanley , Pathak Yashwant , Mohan Syam , Abdullah Rasedee , Alitheen Noorjahan Banu
Published: December 2020

Angiogenesis is a crucial area in scientific research because it involves many important physiological and pathological processes. Indeed, angiogenesis is critical for normal physiological processes, including wound healing and embryonic development, as well as being a component of many disorders, such as rheumatoid arthritis, obesity, and diabetic retinopathies. Investigations of angiogenic mechanisms require assays that can activate the critical steps of angiogenesis as well as provide a tool for assessing the efficacy of therapeutic agents. Thus, angiogenesis assays are key tools for studying the mechanisms of angiogenesis and identifying the potential therapeutic strategies to modulate neovascularization. However, the regulation of angiogenesis is highly complex and not fully understood. Difficulties in assessing the regulators of angiogenic response have necessitated the development of an alternative approach. In this paper, we review the standard models for the study of tumor angiogenesis on the macroscopic scale that include in vitro, in vivo, and computational models. We also highlight the differences in several modeling approaches and describe key advances in understanding the computational models that contributed to the knowledge base of the field.
Observer-Based Adaptive Fuzzy Predefined Performance Control of a Class of Nonlinear Pure-Feedback Systems with Input Delay
Authors: Li Xin , Zhang Qiang , He Dakuo
Published: December 2020

This paper presents a problem of observer-based adaptive fuzzy predefined performance control of a class of nonlinear pure-feedback systems with input delay and unknown control direction. Compared with the existing research, a novel predefined performance controller is proposed, which relaxes the assumption that the initial error is known. In addition, it is difficult to design the controllers due to input delay and nonaffine properties of the pure-feedback systems, which can be simplified by Pade approximation. Moreover, dynamic surface control and Nussbaum functions are applied to overcome the calculation explosion caused by repeated differentiations and unknown control direction, respectively. Based on the above methods, an adaptive fuzzy predefined performance controller is proposed, and it is proved that all the signals of a closed-loop system are semiglobally uniformly ultimately bounded (SGUUB). The tracking errors converge within a predefined range, while the observer estimation errors converge within a small zero region. Finally, the simulation results demonstrate the effectiveness of the proposed control system.
Research and Comparative Analysis of Flow Field Characteristics and Load-Independent Power Losses of Internal and External Gear Pairs
Authors: Zeng Qing-liang , Sun Zhi-yuan , Wan Li-rong , Yang Yang , Dai Han-zheng , Yang Zhi-kuan
Published: December 2020

Power loss analysis of gear transmission in a transmission system is of great significance to improve the efficiency of the power system, and load-independent power losses are an important part of the power losses of gear transmission. Based on the computational fluid dynamics (CFD) method, the hydrodynamic models of internal and external gear pairs are established. By analyzing the pressure field and the velocity field, the windage and squeezing power losses and the pressure and viscous power losses, the influence of rotation speed and tooth width on flow field characteristics, and load-independent power losses of internal gear pair are studied. In addition, we compare the flow field characteristics and the load-independent power losses between external and internal gear pairs and discuss the difference between them. The results show that the pressure and fluid velocity in the meshing area of the gear pair are greatly affected by rotation speed and tooth width, and the load-independent power losses increase with the increase of rotation speed and tooth width. At the same rotation speed, the transmission ratio and number of teeth, windage, and squeezing power losses of the external gear pair are smaller than those of the internal gear pair. Compared with the internal gear pair, the external gear pair has more advantages in controlling the load-independent power losses. The difference of the load-independent power losses of the two meshing modes mainly comes from the viscous power losses of the wheel gear of internal gear pair. This paper provides a basis for the selection of the gear meshing mode and the analysis of load-independent power losses of the transmission system.
Multidisciplinary Approach to Rehabilitation after Tumor Resective Jaw Surgery: A 9-Year Follow-Up
Authors: Smojver Igor , Vuletić Marko , Manojlović Spomenka , Gabrić Dragana
Published: December 2020

A 36-year-old male patient presented at the Department of Maxillofacial Surgery, University Hospital Clinic Zagreb in December 2010 due to a swelling of the left body of the mandible that was noticed 4 months earlier. The patient was referred regarding an atypical clinical and radiological finding in the form of a multicystic appearance in the corpus of the left mandible and teeth mobility in the same region. A probatory biopsy was performed under local anesthesia and sent for histopathologic examination which reported odontogenic myxoma. The tumor was removed with a marginal resection of the mandible from the left first incisor to the left second molar. Two years after surgery, in January 2013, the patient was referred to the oral surgeons for implant-prosthodontic rehabilitation. Two narrow implants were placed at positions 32 and 36, and three months afterwards, implant-retained denture was made using locator connections to compensate lost teeth and to correct the ratio of soft tissues and facial contours. The patient was followed-up for 9 years without any functional and aesthetic problems. Loosing function and aesthetic morbidity, after radical surgical treatment, often have compromised the quality of life of this group of patients. It is important to highlight the need for multidisciplinary collaboration for the complete rehabilitation of the patient after surgical oncology of the maxillofacial region.
Ultrasound Measured Depth of Pelvic Free Fluid Correlates Well with Blood Loss Volume in Patients with Ectopic Pregnancy
Authors: Tang Shuai , Zhou Qing , Zhang Yuelun , Chen Lin , Yu Xuerong , Zhang Yanming , Qi Zhenhong , Xia Yu , Huang Yuguang
Published: December 2020

Purpose. The ultrasonic finding of pelvic free fluid which suggests the possibility of internal haemorrhage helps the determination of the severity of patients. Methods. We conducted a retrospective study investigating ultrasonic measurements and haemorrhage volumes in patients having an ectopic pregnancy in a single centre from January 2013 to November 2016. The logistic regression model was used to establish the prediction model for haemorrhage volumes. The diagnostic accuracy was evaluated by area under ROC curve (AUC) analysis. We employed 800 ml as the cut-off point of the haemorrhage and further set it to 1000 ml and 1200 ml in the sensitivity analysis. Results. The mean pelvic free fluid depths measured by TVS and TAS were 4.45 ± 2.15 cm and 4.45 ± 2.56 cm in the haemorrhage ≥800 ml group, while they were 2.48 ± 1.51 cm and 2.55 ± 1.19 cm in <800 ml group. AUCs and the corresponding cut-off points were 0.741 (95% CI 0.677 to 0.804) and 0.118 when predicted by the standardised depths of TVS and TAS, 0.784 (95% CI 0.696–0.872) and 2.95 cm by the raw depths of TVS, and 0.748 (95% CI 0.665–0.831) and 3.35 cm by the raw depths of TAS. Conclusions. The depth of pelvic free fluid measured by TVS and TAS can be used to predict blood loss volume in patients having an ectopic pregnancy. TVS may perform better than TAS.
Numerical Simulation for Rock Fracture Viscoelastic Creep under Dry Conditions
Authors: Kang Hao , Einstein Herbert , Brown Stephen , Germaine John
Published: December 2020

In many rock engineering projects such as hydrocarbon extraction and geothermal energy utilization, the hydraulic and mechanical behavior of rock fractures significantly affects the safety and profitability of the project. In field conditions, the hydraulic and mechanical behavior of rock fractures changes with time (the rock fractures creep), and this creep is not negligible even under dry conditions. In addition, creep is strongly affected by the rock fracture surface geometry. However, there is not much literature systematically studying the effect of surface geometry on rock fracture creep under dry conditions. This paper presents the results of a numerical study considering the effect of surface geometry on rough fracture viscoelastic deformations. An in-house numerical code has been developed to simulate the viscoelastic deformation of rough fractures. In addition, another numerical code has been developed to generate synthetic rough fracture surfaces by systematically changing the surface roughness parameters: the Hurst exponent, mismatch length, and root mean square roughness. The results indicate that by increasing the Hurst exponent or decreasing the mismatch length or decreasing the root mean square roughness, the fracture mean aperture decreases, and the contact ratio (number of contacting cells/total number of cells) increases faster with time.
A Solitary Choroidal Mass with Spontaneous Resolution
Authors: Ghassemi Fariba , Ebrahimiadib Nazanin , Riazi-Esfahani Hamid , Khojasteh Hassan , Mahdizad Zahra , Pour Elias Khalili
Published: December 2020

Background. To report an atypical case of a transient choroidal mass lesion with spontaneous resolution. Case Presentation. A solitary choroidal mass with an overlying neurosensory retinal detachment was seen in an otherwise healthy 31-year-old female. General physical examinations and serum chemistry were unremarkable. The patient had spontaneous resolution two weeks after initial examination without treatment. Conclusions. Inflammatory choroidal masses may be self-limited, but complete diagnostic measures must always be performed in these patients to distinguish between important causes such as tuberculosis, sarcoidosis, and tumors.
TRPV2: A Cancer Biomarker and Potential Therapeutic Target
Authors: Siveen Kodappully S. , Nizamuddin Parveen B. , Uddin Shahab , Al-Thani Mohamed , Frenneaux Michael Paul , Janahi Ibrahim A. , Steinhoff Martin , Azizi Fouad
Published: December 2020

The Transient Receptor Potential Vanilloid type-2 (TRPV2) channel exhibits oncogenicity in different types of cancers. TRPV2 is implicated in signaling pathways that mediate cell survival, proliferation, and metastasis. In leukemia and bladder cancer, the oncogenic activity of TRPV2 was linked to alteration of its expression profile. In multiple myeloma patients, TRPV2 overexpression correlated with bone tissue damage and poor prognosis. In prostate cancer, TRPV2 overexpression was associated with the castration-resistant phenotype and metastasis. Loss or inactivation of TRPV2 promoted glioblastoma cell proliferation and increased resistance to CD95-induced apoptotic cell death. TRPV2 overexpression was associated with high relapse-free survival in triple-negative breast cancer, whereas the opposite was found in patients with esophageal squamous cell carcinoma or gastric cancer. Another link was found between TRPV2 expression and either drug-induced cytotoxicity or stemness of liver cancer. Overall, these findings validate TRPV2 as a prime candidate for cancer biomarker and future therapeutic target.
Autoimmune Inner Ear Disease among Patients with Selective IgA Deficiency
Authors: Magen Eli , Blum Idan , Waitman Dan Andrey , Kahan Natan , Forer Boaz
Published: December 2020

Objectives: Autoimmune inner ear disease (AIED) is a distinct clinical entity from sudden sensorineural hearing loss. The purpose of this study was to investigate the clinical characteristics of AIED in patients with selective IgA deficiency (sIgAD). Materials and Methods: This retrospective observational study was based on data from the Leumit Healthcare Services database in Israel. We searched all subjects aged ≥12 years who had undergone serum total IgA measurements during 2004–2014 for any reason. The sIgAD patients included all subjects with serum IgA of ≤7 mg/dL (0.07 g/L). A control group was randomly sampled from the full study population (n ≈ 730,000) with a case-control ratio of 10 controls for each case (1:10). Results: Among 347 subjects with sIgAD, we identified 9 patients with concomitant AIED (sIgAD + AIED group). This group was characterized by a higher prevalence of allergic diseases (8 patients; 88.9%) than sIgAD patients without AEID (sIgAD + AIED group; 153 patients; 45.2%; p = 0.014). Both systemic diseases (3 patients; 33.3%) and organ-specific autoimmune diseases (7 patients; 77.8%) were more prevalent in the sIgAD + AIED group (sIgAD + AIED group: 19 patients 5.5%, p = 0.015; sIgAD − AEID group: 76 patients, 21.9%, p < 0.001), with an OR of 8.39 (1.94–36.19; p = 0.004). sIgAD patients with and without AIED were characterized by a higher prevalence of documented episodes of acute otitis media, allergic diseases, and autoimmune diseases than the control group. Conclusion: The study exposes a significant association between AIED and sIgAD. We believe that sIgAD has to be excluded in AIED patients.
Clinical Application of 7T Magnetic Resonance Imaging in Patients with Focal Cortical Dysplasia IIa and Epilepsy
Authors: Liu Tinghong , Liang Huilou , Cui Jianfei , Sun Kaibao , Zhang Shaohui , Yuan Liu , Wang Yangshuo , Xue Rong , Liang Shuli
Published: December 2020

Background: Focal cortical dysplasia (FCD) is one of the most important pathogenic findings in patients with extratemporal lobe epilepsy. Magnetic resonance imaging (MRI)-negative is the most important negative factor to predict postoperative seizure freedom; however, FCD-I and part of FCD-IIa are MRI-negative on routine MRI. Objectives: To explore the diagnostic values of 7T MRI and its new scan sequences in epilepsy patients with FCD-IIa. Methods: To include patients with focal seizure and suspicious focal abnormal imaging on 3T MRI during preoperative evaluation and perform a 7T MRI scan with white matter-suppressed (WMS) and gray-white matter tissue border enhancement (GWBE) sequences, resective epilepsy surgery, and postoperative pathological finding of FCD-IIa. The preoperative qualitative and localization significance of 7T MRI and 3T MRI in lesions with FCD-IIa was compared, and then, the imaging characteristics of lesions with FCD-IIa on 7T MRI were analyzed. Results: Ten cases were enrolled in this study. Seven tesla MRI presented high spatial resolutions and a high signal-to-noise ratio. WMS and GWBE could selectively suppress the signal of special tissue and improved the possibility of FCD findings. FCD-IIa showed abnormal thickness of gray matter and a blurring border and was hypointense on 7T MRI compared with 3T MRI. Seven patients showed improvement in the qualitative diagnosis strength grade of FCD, and 6 subjects showed improvement in the localization strength grade of the lesion border after careful reading of the 7T MR images. Significant differences were found in the qualitative diagnosis of FCD (p < 0.05) and localization of the lesion border (p < 0.05) between the neuroimaging diagnoses based on 3T MRI and the findings based on 7T MRI. Conclusion: 7T MRI with WMS and GWBE sequences shows application value in the preoperative imaging diagnosis of lesions with FCD-IIa in epilepsy patients.
TMEM16A Regulates Pulmonary Arterial Smooth Muscle Cells Proliferation via p38MAPK/ERK Pathway in High Pulmonary Blood Flow-Induced Pulmonary Arterial Hypertension
Authors: Liu Dongli , Wang Kai , Su Danyan , Huang Yanyun , Shang Lifeng , Zhao Yijue , Huang Jinglin , Pang Yusheng
Published: December 2020

Objective: Pulmonary arterial hypertension (PAH) is a complex disease of the small pulmonary arteries that is mainly characterized by vascular remodeling. It has been demonstrated that excessive proliferation of pulmonary arterial smooth muscle cells (PASMCs) plays a pivotal role in vascular remodeling during PAH. The present study was undertaken to explore the role of TMEM16A in regulating PASMCs proliferation in high pulmonary blood flow-induced PAH. Methods: Aortocaval shunt surgery was undertaken to establish an animal model. Pulmonary artery pressure and pulmonary vascular structure remodeling (PVSR) were tested. Immunohistochemical staining and Western blot were performed to investigate the expression of TMEM16A. The proliferation of PASMCs was tested by the MTT assay. After treating PASMCs with TMEM16A-siRNA, the expression of proliferating cell nuclear antigen (PCNA), phosphorylated p38 mitogen-activated protein kinase (p-p38MAPK), and phosphorylated extracellular signal-regulated kinase (p-ERK) signaling in PASMCs were tested. Results: PAH and PVSR developed 11 weeks postoperation. Elevated expression of TMEM16A accompanied by high expression of PCNA in pulmonary arteries of the shunt group was observed. The increased proliferation of PASMCs and increased expression of TMEM16A and PCNA, along with activated p-p38MAPK and p-ERK signaling in PASMCs of the shunt group, were all attenuated by siRNA-specific TMEM16A knockdown. Conclusion: TMEM16A regulates PASMCs proliferation in high pulmonary blood flow-induced PAH, and the p38MAPK/ERK signaling pathway is probably involved.
Fragile-X-Associated Tremor/Ataxia Syndrome or Alcohol-Induced Cerebellar Degeneration? A Case Report
Authors: Grigioni Giulia , Saleh Christian , Jaszczuk Phillip , Wand Dorothea , Wilmes Stefanie , Hund-Georgiadis Margret
Published: December 2020

Fragile-X-associated tremor/ataxia syndrome (FXTAS) is a neurodegenerative disorder that manifests with intention tremor, progressive gait ataxia, and cognitive impairment. The disease is genetically characterized by a premutation of the FMR1gene on the X-chromosome manifesting with a CGG triplet expansion between 55 and 200. Given the phenotypical variety of this disease, diagnosis is frequently delayed. We present and discuss a male patient whose diagnosis of FXTAS was delayed due to his concomitant alcohol abuse.
Language Impairment with a Partial Duplication of DOCK8
Authors: Benítez-Burraco Antonio , Fernández-Urquiza Maite , Jiménez-Romero Mª Salud
Published: December 2020

Duplications of the distal region of the short arm of chromosome 9 are rare, but are associated with learning disabilities and behavioral disturbances. We report in detail the cognitive and language features of a child with a duplication in the 9p24.3 region, arr[hg19] 9p24.3(266,045–459,076)×3. The proband exhibits marked expressive and receptive problems, which affect both structural and functional aspects of language. These problems might result from a severe underlying deficit in working memory. Regarding the molecular causes of the observed symptoms, they might result from the altered expression of selected genes involved in procedural learning, particularly some of components of the SLIT/ROBO/FOXP2 network, strongly related to the development and evolution of language. Dysregulation of specific components of this network can result in turn from an altered interaction between DOCK8, affected by the microduplication, and CDC42, acting as the hub component of the network encompassing language-related genes.
Factors Associated with Intention to Donate Hematopoietic Stem Cells among Blood Donors
Authors: Ting Chuo Yew , Lee Yew Fong , Lim Chien Joo , Ting Rachel Sing Kiat , MD Zahrin Mohammad Masrin , Ahmad Abu Sufian , Wong Jack Siew Yu , Arip Masita , Zakaria Zubaidah , Ahmad Zaidi Adruce Shahren , Tnay Jessie Koh Sing , Wong Yi Shen
Published: December 2020

Introduction: Past studies pay little attention to the intention to donate hematopoietic stem cells (HSC) among blood donors. This study investigated the level of and the influence of socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC among blood donors. Methods: This cross-sectional study recruited blood donors at selected public hospitals in the Malaysian State of Sarawak in 2019. A structured questionnaire was developed based on the review of relevant literature. It gathered information on socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC. Variables with a p value <0.200 in bivariate analysis were included in the variable selection for regression modeling to examine their associations with the intention to donate HSC. Results: A total of 569 blood donors participated (94.5% response rate). Overall, 87.1% reported a positive intention to donate HSC. In the regression model, the factor with the greatest association with intention to donate HSC was subjective norms about HSC donation (β = 0.35, 95% CI 0.27–0.42), followed by attitude about regulations of HSC donation (β= 0.21, 95% CI 0.13–0.35), self-efficacy on HSC donation (β = 0.15, 95% CI 0.09–0.32), attitude about the potential side effects of HSC donation (β = 0.14, 95% CI 0.02–0.10) and highest education level (β = 0.10, 95% CI 0.03–0.44). Conclusions: The findings can be used to formulate a better strategy in promoting HSC donation among blood donors in the region.
Human Acellular Dermal Matrix (Epiflex®) in Immediate Implant-Based Breast Reconstruction after Skin- and Nipple-Sparing Mastectomy and Treatment of Capsular Fibrosis: Results of a Multicenter, Prospective, Observational NOGGO-AWOGyn Study
Authors: Beier Lea , Faridi Andree , Neumann Corina , Paepke Stefan , Mau Christine , Keller Maren , Strittmatter Hans Joachim , Gerber-Schäfer Claudia , Bauer Lelia , Karsten Maria Margarete , Kümmel Sherko , Blohmer Jens-Uwe
Published: December 2020

Background: Over the last decades, the number of acellular dermal matrix (ADM)-assisted implant-based breast reconstructions (IBBR) has substantially increased. However, there is still a lack of prospective data on complication rates. Methods: We performed a non-interventional, multicenter, prospective cohort study to evaluate complication rates of a human ADM in patients undergoing an IBBR after skin- and nipple-sparing mastectomies. Patients with primary reconstruction (cohort A) and patients undergoing a secondary reconstruction after capsular fibrosis (cohort B) using the human ADM Epiflex® (DIZG gGmbH, Berlin, Germany) were enrolled in this study. Patients were followed-up for 12 months after surgery. Results: Eighty-four eligible patients were included in this study of whom 28 women underwent a bilateral breast reconstruction, leading to 112 human ADM-assisted reconstructions in total (cohort A: 73, cohort B: 39). In 33.0% of the reconstructed breasts at least one of the complications of primary interest occurred, including implant loss 7.1%, seroma 15.2%; infection 5.4%, rash 8.0%, and Baker grade III/IV capsular fibrosis 2.7%, with no statistically significant differences between the cohorts. Previous radiation therapy was significantly associated with occurrence of any postoperative complication (OR 20.41; p value 0.027). Conclusion: The rates of most complications were comparable to the rates reported for other ADMs with relatively low rates of capsular fibrosis and infections. The rate of seroma was increased in our study. Prior radiation therapy increased the risk of any postoperative complications. Therefore, the use of ADM in these patients should be considered carefully.