bluuebunny/crossref_metadata_2025 huggingface dataset:
Air quality monitoring and gas leakage detection with automatic shut‐off using wireless sensor‐actuator networks
Authors: Muralidhara Shishir , Hegde Niharika
Published: May 2020

Real time monitoring of the environment for gas leakages is crucial in industrial applications as they involve the use of toxic and combustible gases. To ensure the safety of the personnel working in these environments, the concentrations of the gases must be monitored and maintained. To secure the environment and prevent a gas leak from escalating to disastrous proportions, only monitoring and alerting will not suffice, and there must be a mechanism in place to shut down the gas supply. To address this need, this paper proposes a smart, wireless sensor‐actuator network built upon the Internet of Things for the real‐time monitoring of the environment, detecting gas leakages and the subsequent automatic shut‐off via a solenoid valve accompanied by timely alerts. Due to the autonomous nature of the system, it is highly reliable in disaster management. The system proposed in this paper boasts easy integration into existing environments with minimal modifications, thus making it portable, efficient and economic.
MTD to set network slice security as a KPI
Authors: Cunha Vitor A. , Corujo Daniel , Barraca Joao P. , Aguiar Rui L.
Published: May 2020

Key Performance Indicators (KPIs) are a higher‐level characterization of the performance of a network slice, meant to be assessable at any time. Bodies such as the GSM Alliance have proposed the use of KPIs, including, but not limited to, latency, throughput, power consumption, and security. However, while latency, throughput, and power consumption are mensurable universally, security is much harder to measure. In this article, we propose using a Moving Target Defense (MTD) approach and measurable network properties to establish a new straightforward network security metric for underlying resilience against network‐centric attacks. We called it DynSec, a comprehensive model for basic network security within the network slice. Monte Carlo experimentation showed that DynSec is accurate and suitable as a
KPI.
Oncology clinical pharmacy services in Chinese hospitals
Authors: Wang Yanting , Dai Yuanyuan , Lau Alan H. , Yang Jun , Chen Wei , Li Guohui
Published: May 2020

In recent years, with an increasing number of oncology patients and continuous introduction of new antitumor drugs in China, the demand for oncology clinical pharmacy services is growing rapidly, which is both an opportunity and a challenge for clinical pharmacists. However, there have not been many reports about different types of oncology clinical pharmacy services in China. In this report, we have summarized different oncology clinical pharmacy services commonly practiced in Chinese hospitals based on our review of the literature and current practice in our hospital. We are reporting the training programs and the certification process for oncology clinical pharmacists, basic and advanced patient services, pharmacist‐driven and pharmacist‐participated guidelines/expert consensuses/books on oncology pharmacotherapy, as well as professional and public health education performed by pharmacists. Based on what we have observed, oncology clinical pharmacy services in China are relatively comprehensive, however, there are needs for expanding certain advanced pharmacy services. Increasing the time spent on clinical services, improving pharmacists' competency, and optimizing clinical pharmacy workflow and evaluation mechanisms are important for enhancing the value of oncology clinical pharmacists in China.
Situs inversus totalis and prenatal diagnosis of a primary ciliary dyskinesia
Authors: Burwick Richard M. , Govindappagari Shravya , Sanchez‐Lara Pedro A.
Published: May 2020

Situs inversus, a condition in which the major visceral organs are reversed from their normal positions in the body, can be detected by prenatal ultrasonography. Often benign, it may be associated with primary ciliary dyskinesia, an autosomal recessive disorder characterized by chronic respiratory disease. Yet, prenatal diagnosis of primary ciliary dyskinesia has not been reported. We describe a pregnancy in which situs inversus was diagnosed by fetal ultrasound at 20 weeks gestation. Prenatal testing for primary ciliary dyskinesia led to the discovery that both parents were asymptomatic carriers of a pathogenic mutation in the CCDC103 gene, with an affected neonate.
Three‐Dimensional Surface‐Based Analysis of Cartilage MRI Data in Knee Osteoarthritis: Validation and Initial Clinical Application
Authors: MacKay James W. , Kaggie Joshua D. , Treece Graham M. , McDonnell Stephen M. , Khan Wasim , Roberts Alexandra R. , Janiczek Robert L. , Graves Martin J. , Turmezei Tom D. , McCaskie Andrew W. , Gilbert Fiona J.
Published: May 2020

Background

Traditional quantitative analysis of cartilage with MRI averages measurements (eg, thickness) across regions‐of‐interest (ROIs) which may reduce responsiveness.

Purpose

To validate and describe clinical application of a semiautomated surface‐based method for analyzing cartilage relaxation times (“composition”) and morphology on MRI, 3D cartilage surface mapping (3D‐CaSM).

Study Type

Validation study in cadaveric knees and prospective observational (cohort) study in human participants.

Population

Four cadaveric knees and 14 participants aged 40–60 with mild–moderate knee osteoarthritis (OA) and 6 age‐matched healthy volunteers, imaged at baseline, 1, and 6 months.

Field Strength/Sequence

3D spoiled gradient echo, T1rho/T2 magnetization‐prepared 3D fast spin echo for mapping of T1rho/T2 relaxation times and delayed gadolinium enhanced MRI of cartilage (dGEMRIC) using variable flip angle T1 relaxation time mapping at 3T.

Assessment

3D‐CaSM was validated against high‐resolution peripheral quantitative computed tomography (HRpQCT) in cadaveric knees, with comparison to expert manual segmentation. The clinical study assessed test–retest repeatability and sensitivity to change over 6 months for cartilage thickness and relaxation times.

Statistical Tests

Bland–Altman analysis was performed for the validation study and evaluation of test–retest repeatability. Six‐month changes were assessed via calculation of the percentage of each cartilage surface affected by areas of significant change (%SC), defined using thresholds based on area and smallest detectable difference (SDD).

Results

Bias and precision (0.06 ± 0.25 mm) of 3D‐CaSM against reference HRpQCT data were comparable to expert manual segmentation (−0.13 ± 0.26 mm). 3D‐CaSM demonstrated significant (>SDD) 6‐month changes in cartilage thickness and relaxation times in both OA participants and healthy controls. The parameter demonstrating the greatest 6‐month change was T2 relaxation time (OA median %SC [IQR] = 8.8% [5.5 to 12.6]).

Data Conclusion

This study demonstrates the construct validity and potential clinical utility of 3D‐CaSM, which may offer advantages to conventional ROI‐based methods.

Level of Evidence

2.

Technical Efficacy Stage

2. J. Magn. Reson. Imaging 2020;52:1139–1151.
Educating surgical oncology providers on perioperative opioid use: A departmental survey 1 year after the intervention
Authors: Kim Bradford J. , Lillemoe Heather A. , Newhook Timothy E. , Dewhurst Whitney L. , Arvide Elsa M. , Katz Matthew H. G. , Aloia Thomas A. , Vauthey Jean‐Nicolas , Lee Jeffrey E. , Tzeng Ching‐Wei D.
Published: May 2020

Background and Objectives

A department‐wide opioid reduction education program resulted in a 1‐month change in perceptions of opioid needs and prescribing recommendations for surgical oncology patients. This study's aim was to re‐evaluate if early trends were retained 1 year later.

Methods

Surgical Oncology attendings, fellows, and advanced practice providers at a Comprehensive Cancer Center were surveyed 1‐year after an August 2018 opioid reduction education program, to compare departmental and individual opioid prescribing habits.

Results

The September 2019 response rate was 54/93 (58%), with 41 completing both the post‐education and 1‐year follow‐up surveys. The departmental and matched cohort continued to recommend a lower quantity of discharge opioids for all five index operations (by >50%) and expected less postoperative days to zero opioid needs, when compared to pre‐education perceptions. Providers continued to agree that discharge opioid prescriptions should be based on a patient's last 24 hours of inpatient opioid use. There was universal agreement that each respondent's opioid administration had decreased in the past year.

Conclusions

The initial 1‐month improvements in perioperative opioid prescribing perceptions were retained 1 year later by Surgical Oncology providers who recommended fewer discharge opioids, faster weaning to zero opioids, and standardized patient‐specific discharge opioid volume calculations.
Endocrine Abnormalities in a Case of Neurodegeneration with Brain Iron Accumulation
Authors: Haeri Ghazal , Akhoundi Fahimeh Haji , Alavi Afagh , Abdi Siamak , Rohani Mohammad
Published: May 2020

View Supplementary Video 1
New AARS2 Mutations in Two Siblings With Tremor, Downbeat Nystagmus, and Primary Amenorrhea: A Benign Phenotype Without Leukoencephalopathy
Authors: De Michele Giovanna , Galatolo Daniele , Lieto Maria , Maione Luigi , Cocozza Sirio , Santorelli Filippo Maria , Filla Alessandro
Published: May 2020

View Supplementary Video 1
Protective Effects of Antioxidant Polyphenols against Hyperglycemia‐Mediated Alterations in Cerebral Endothelial Cells and a Mouse Stroke Model
Authors: Arcambal Angélique , Taïlé Janice , Couret David , Planesse Cynthia , Veeren Bryan , Diotel Nicolas , Gauvin‐Bialecki Anne , Meilhac Olivier , Gonthier Marie‐Paule
Published: May 2020

Scope

Hyperglycemia alters cerebral endothelial cell and blood‐brain barrier functions, aggravating cerebrovascular complications such as stroke during diabetes. Redox and inflammatory changes play a causal role. This study evaluates polyphenol protective effects in cerebral endothelial cells and a mouse stroke model during hyperglycemia.

Methods and results

Murine bEnd.3 cerebral endothelial cells and a mouse stroke model are exposed to a characterized, polyphenol‐rich extract of Antirhea borbonica or its predominant constituent caffeic acid, during hyperglycemia. Polyphenol effects on redox, inflammatory and vasoactive markers, infarct volume, and hemorrhagic transformation are determined. In vitro, polyphenols improve reactive oxygen species levels, Cu/Zn superoxide dismutase activity, and both NAPDH oxidase 4 and nuclear factor erythroid 2‐related factor 2 (Nrf2) gene expression deregulated by high glucose. Polyphenols reduce Nrf2 nuclear translocation and counteract nuclear factor‐ĸappa B activation, interleukin‐6 secretion, and the altered production of vasoactive markers mediated by high glucose. In vivo, polyphenols reduce cerebral infarct volume and hemorrhagic transformation aggravated by hyperglycemia. Polyphenols attenuate redox changes, increase vascular endothelial‐Cadherin production, and decrease neuro‐inflammation in the infarcted hemisphere.

Conclusion

Polyphenols protect against hyperglycemia‐mediated alterations in cerebral endothelial cells and a mouse stroke model. It is relevant to assess polyphenol benefits to improve cerebrovascular damages during diabetes.
B1 inhomogeneity correction of RARE MRI with transceive surface radiofrequency probes
Authors: Delgado Paula Ramos , Kuehne Andre , Periquito João S. , Millward Jason M. , Pohlmann Andreas , Waiczies Sonia , Niendorf Thoralf
Published: May 2020

Purpose

The use of surface radiofrequency (RF) coils is common practice to boost sensitivity in (pre)clinical MRI. The number of transceive surface RF coils is rapidly growing due to the surge in cryogenically cooled RF technology and ultrahigh‐field MRI. Consequently, there is an increasing need for effective correction of the excitation field (
) inhomogeneity inherent in these coils. Retrospective B1 correction permits quantitative MRI, but this usually requires a pulse sequence‐specific analytical signal intensity (SI) equation. Such an equation is not available for fast spin‐echo (Rapid Acquisition with Relaxation Enhancement, RARE) MRI. Here we present, test, and validate retrospective B1 correction methods for RARE.

Methods

We implemented the commonly used sensitivity correction and developed an empirical model‐based method and a hybrid combination of both. Tests and validations were performed with a cryogenically cooled RF probe and a single‐loop RF coil. Accuracy of SI quantification and T1 contrast were evaluated after correction.

Results

The three described correction methods achieved dramatic improvements in B1 homogeneity and significantly improved SI quantification and T1 contrast, with mean SI errors reduced from >40% to >10% following correction in all cases. Upon correction, images of phantoms and mouse heads demonstrated homogeneity comparable to that of images acquired with a volume resonator. This was quantified by SI profile, SI ratio (error < 10%), and percentage of integral uniformity (PIU > 80% in vivo and ex vivo compared to PIU > 87% with the reference RF coil).

Conclusion

This work demonstrates the efficacy of three B1 correction methods tailored for transceive surface RF probes and RARE MRI. The corrected images are suitable for quantification and show comparable results between the three methods, opening the way for T1 measurements and X‐nuclei quantification using surface transceiver RF coils. This approach is applicable to other MR techniques for which no analytical SI exists.
Thrombotic risks from pulling the “trigger” on intravenous immunoglobulin and plasma exchange
Authors: Caress James B. , Yang Chengwu
Published: May 2020

See article on pages 327–332 in this issue.
A telephonic single breath count test for screening of exacerbations of myasthenia gravis: A pilot study
Authors: Kukulka Klaudia , Gummi Rohit Reddy , Govindarajan Raghav
Published: May 2020

Background

Patients with myasthenia gravis (MG) may experience worsening symptoms outside of a clinical setting. A method of diagnosing and triaging such individuals would be valuable. This study gauged the viability of a nurse‐administered single breath count test (SBCT) over the telephone for assessing MG exacerbations.

Methods

This was a retrospective, single‐center review of a pilot study of 45 telephone calls from patients with MG who had worsening baseline symptoms. SBCTs were administered over the telephone to patients by trained nurses. Patients with a breath count of 25 or less were sent to the emergency department.

Results

Using a cutoff count of 25, the nurse‐administered telephonic SBCT had a positive predictive value of 71%, sensitivity of 80%, and specificity of 60% in diagnosing an MG exacerbation.

Conclusions

SBCT administered by trained nurses by means of telephone may be a useful screening tool for assessing decreased respiratory function in patients with MG.
Teaching water movement in soil through experiential activities
Authors: Howe Julie A. , Barrientos‐Velazquez Ana
Published: May 2020

Water movement in soil is often difficult for students to understand, particularly when soil texture changes within the profile. Students in introductory soil science courses may be able to define concepts of water movement, but not be able to apply the information in real scenarios due to reliance on intuition rather than fundamental concepts. To apply concepts, students need to experience them for themselves. Experiential learning can teach concepts of water movement through the soil in order to link fundamental concepts with real‐life experiences to improve understanding. A lesson was developed for an introductory soil science course for undergraduates utilizing small plastic soil columns that allow students to test scenarios of water movement through soil to prove concepts taught in class. The described lesson plan can be expanded or revised to adapt to a wide range of students, and activity materials are relatively inexpensive and reusable. Student feedback was positive. Assessment through exam questions showed an increase in correct responses for all types of soil water questions with experiential activities, except soil water forces and potentials. Substitution of demonstrations utilizing non‐graded self‐evaluation with experiential learning activities requiring submission of answers improved engagement during lab, which is translated into improved exam scores. Experiential learning activities appear to have improved understanding of soil and water concepts.
Overweight and Obesity Impair Academic Performance in Adolescence: A National Cohort Study of 10,279 Adolescents in China
Authors: Ma Lu , Gao Liwang , Chiu Dorothy T. , Ding Yixin , Wang Youfa , Wang Weidong
Published: May 2020

Objective

This study aimed to examine the associations of overweight and obesity (ov/ob) and changes in weight status with academic performance among Chinese adolescents.

Methods

Self‐reported weight and height were collected from adolescents (n = 10,279) each year from seventh grade (baseline, 2013‐2014) to ninth grade (2015‐2016). Academic performance included standardized scores on math, Chinese, and English examinations and responses to a school‐life experience scale.

Results

All adolescents with ov/ob had lower academic performance than their counterparts without overweight (β = −0.46 to −0.08; P < 0.05), except for school‐life experience for boys. All adolescents with obesity had lower academic performance than their counterparts without obesity (β = −0.46 to −0.17; P < 0.01), except for English test scores for boys. Changes in weight status between grades 7 and 9 impacted academic performance at grade 9. Adolescents with ov/ob throughout grades 7 to 9 and those who developed ov/ob from normal weight had lower test scores (β = −0.80 to −0.25; P < 0.05) than those who maintained normal weight. Those who developed ov/ob after having normal weight had poorer school‐life experiences (β = −0.55 to −0.25; P < 0.05).

Conclusions

Ov/ob and maintaining and developing ov/ob had adverse academic impacts on adolescents. Relevant stakeholders should consider detrimental impacts of obesity on academic outcomes.
Repeatable molecularly recyclable semi‐aromatic polyesters derived from lignin
Authors: van Schijndel Jack , Molendijk Dennis , van Beurden Koen , Vermeulen Romy , Noël Timothy , Meuldijk Jan
Published: May 2020

The design of molecularly recyclable polymers contributes to a possible solution to the end‐of‐use issue of polymeric materials and gives a closed‐loop approach toward a circular materials economy. The biobased semi‐aromatic polyesters (e.g., poly(phloretic acid), poly(dihydroferulic acid), and poly(dihydro‐sinapinic acid)), described in this paper, can be derived entirely from biomass (mainly lignin). The described polyesters exhibit thermal properties similar to those of certain commodity polymeric materials. These polyesters with ligno‐phytochemicals as monomer have so far demonstrated complete and almost infinite molecular recyclability with a loss of total mass less than 5% per cycle. Moreover, molecular weight and thermal properties (Tg, Tm, and Tcryst) of the tenth generation polymeric material are identical to those of the first generation.
PDEGMA‐b‐PDIPAEMA copolymers via RAFT polymerization and their pH and thermoresponsive schizophrenic self‐assembly in aqueous media
Authors: Selianitis Dimitrios , Pispas Stergios
Published: May 2020

We report on a new doubly responsive polymeric system of amphiphilic diblock copolymers, namely poly(di‐[ethylene glycol] methyl ether methacrylate)‐b‐poly(2‐[diisopropylamino] ethyl methacrylate), PDEGMA‐b‐PDIPAEMA, obtained by the reversible addition‐fragmentation chain transfer (RAFT) polymerization technique. Molecular characterization by size exclusion chromatography (SEC), nuclearmagnetic resonance (1H‐NMR) and infrared spectroscopy (FT‐IR) confirms the successful synthesis of these novel block copolymers. The PDEGMA‐b‐PDIPAEMA block copolymers formed aggregates in aqueous media in response to solution pH and temperature changes, as evidenced by dynamic and static light scattering techniques, as well as fluorescence spectroscopy. Aggregates with PDEGMA core and PDIPAEMA corona domains are formed at elevated temperatures and low pH, whereas aggregates with PDIPAEMA cores and PDEGMA coronas are formed at neutral and high pH. Overall structural characteristics and solution behavior of the copolymers are affected by the copolymer composition. The obtained results provide valuable new information on the behavior and design guidelines for the construction of stimuli responsive, “schizophrenic” polymeric nanostructures with potential application in the biomedical field.
Cumulative hydropathic topology of a voltage‐gated sodium channel at atomic resolution
Authors: Xenakis Markos N. , Kapetis Dimos , Yang Yang , Heijman Jordi , Waxman Stephen G. , Lauria Giuseppe , Faber Catharina G. , Smeets Hubert J. , Westra Ronald L. , Lindsey Patrick J.
Published: May 2020

Voltage‐gated sodium channels (NavChs) are biological pores that control the flow of sodium ions through the cell membrane. In humans, mutations in genes encoding NavChs can disrupt physiological cellular activity thus leading to a wide spectrum of diseases. Here, we present a topological connection between the functional architecture of a NavAb bacterial channel and accumulation of atomic hydropathicity around its pore. This connection is established via a scaling analysis methodology that elucidates how intrachannel hydropathic density variations translate into hydropathic dipole field configurations along the pore. Our findings suggest the existence of a nonrandom cumulative hydropathic topology that is organized parallel to the membrane surface so that pore's stability, as well as, gating behavior are guaranteed. Given the biophysical significance of the hydropathic effect, our study seeks to provide a computational framework for studying cumulative hydropathic topological properties of NavChs and pore‐forming proteins in general.
Multicopper oxidases: modular structure, sequence space, and evolutionary relationships
Authors: Gräff Maike , Buchholz Patrick C. F. , Le Roes‐Hill Marilize , Pleiss Jürgen
Published: May 2020

Multicopper oxidases (MCOs) use copper ions as cofactors to oxidize a variety of substrates while reducing oxygen to water. MCOs have been identified in various taxa, with notable occurrences in fungi. The role of these fungal MCOs in lignin degradation sparked an interest due to their potential for application in biofuel production and various other industries. MCOs consist of different protein domains, which led to their classification into two‐, three‐, and six‐domain MCOs. The previously established Laccase and Multicopper Oxidase Engineering Database (https://lcced.biocatnet.de) was updated and now includes 51 058 sequences and 229 structures of MCOs. Sequences and structures of all MCOs were systematically compared. All MCOs consist of cupredoxin‐like domains. Two‐domain MCOs are formed by the N‐ and C‐terminal domain (domain N and C), while three‐domain MCOs have an additional domain (M) in between, homologous to domain C. The six‐domain MCOs consist of alternating domains N and C, each three times. Two standard numbering schemes were developed for the copper‐binding domains N and C, which facilitated the identification of conserved positions and a comparison to previously reported results from mutagenesis studies. Two sequence motifs for the copper binding sites were identified per domain. Their modularity, depending on the placement of the T1‐copper binding site, was demonstrated. Protein sequence networks showed relationships between two‐ and three‐domain MCOs, allowing for family‐specific annotation and inference of evolutionary relationships.
Effects of “soil‐like” particle size on gas transport and water retention properties in aged municipal solid waste from a Sri Lankan open dumpsite
Authors: Shanujah M. , Deepagoda T. K. K. Chamindu , Karunarathna A. K. , Nasvi M. C. M. , Shreedharan V. , Babu G. L. S. , Smits Kathleen M. , Oldenburg Curtis M.
Published: May 2020

Open dumps constitute a major source of greenhouse gases (GHGs), predominantly methane and carbon dioxide, in developing countries. In an aged dump, typical waste composition is dominated by the “soil‐like” fraction of which physical, hydraulic and gas transport characteristics markedly affect GHG emissions. This study characterized soil‐gas diffusivity (Dp/D0), soil‐water characteristics (SWC), and particle size distribution in “soil‐like” fractions of aged solid waste retrieved at 2.5–5 m depth from an old open dumpsite situated at Kurunegala, Sri Lanka. The “soil‐like” fraction was proportioned into three groups based on particle size (0–4.75, 4.75–9.5, and 9.5–25 mm) to investigate the particle size effect on Dp/D0 and SWC. The simulated methane concentration profiles in different size groups were also examined using the transport simulator TOUGH2‐EOS7CA based on the multiphase flow of multicomponent gas mixture (methane, water vapour and air) under dry and half‐saturation conditions across a predefined temperature gradient. The results highlighted distinct two‐region characteristics (i.e., inter‐aggregate and intra‐aggregate pore regions) in all three size fractions which could be adequately parameterized with existing and modified bimodal functions. We proposed a useful practical tool for estimating Dp/D0 for known mean particle size and volumetric water content in the absence of direct measurements. The results further revealed that Dp/D0 is particle‐size dependent; however, Dp/D0 remained invariant across all size fractions at the volumetric water content of ∼0.22–0.25 cm3 cm−3. Numerical results further showed a pronounced effect of particle size and soil moisture on gas transport properties.
Multiple Ethanolic‐Precipitation: An Approach to the Separation of Dextrin Fractions with Narrow Molecular Weight Distributions from Acid‐Hydrolyzed Waxy Corn Starch
Authors: Zhuang Xuechen , Zhang Shufen , Li Heping
Published: May 2020

Dextrin is widely used in the food, biomedical, and cosmetic industries. In this work, a new ethanolic fractionation method, the multiple ethanolic‐precipitation (MEP), is established to fractionate the acid‐hydrolyzed waxy corn starch (AHWCS) that consists of a high concentration of low‐molecular‐weight dextrin. Through these multiple precipitation processes, the effect of the dextrin concentration on fractionation is weakened, which makes the fractionation only dependant on the molecular weight of dextrin. Five dextrin fractions (P1, P2, P3, P4, and P5) with narrow molecular weight distributions are obtained. The weight‐average molar mass (Mw) and the molecular weight dispersity () of five fractions are 7.3 × 104 g mol−1 (2.0), 2.3 × 104 g mol−1 (2.1), 1.6 × 104 g mol−1 (2.2), 8.9 × 103 g mol−1 (2.1), and 4.5 × 103 g mol−1 (3.3), respectively. Additionally, the increase of molecular weight tends to decrease the moisture‐absorption but increase the viscosity and thermal stability, which can provide a basis for the application of different molecular weight dextrin fractions in different fields. These results suggest that the MEP method is a low cost and efficient approach for directly separating dextrin fractions with narrow molecular weight distributions from the AHWCS.
Sanitizing agents for virus inactivation and disinfection
Authors: Lin Qianyu , Lim Jason Y. C. , Xue Kun , Yew Pek Yin Michelle , Owh Cally , Chee Pei Lin , Loh Xian Jun
Published: May 2020

Viral epidemics develop from the emergence of new variants of infectious viruses. The lack of effective antiviral treatments for the new viral infections coupled with rapid community spread of the infection often result in major human and financial loss. Viral transmissions can occur via close human‐to‐human contact or via contacting a contaminated surface. Thus, careful disinfection or sanitization is essential to curtail viral spread. A myriad of disinfectants/sanitizing agents/biocidal agents are available that can inactivate viruses, but their effectiveness is dependent upon many factors such as concentration of agent, reaction time, temperature, and organic load. In this work, we review common commercially available disinfectants agents available on the market and evaluate their effectiveness under various application conditions. In addition, this work also seeks to debunk common myths about viral inactivation and highlight new exciting advances in the development of potential sanitizing agents.
Metabolism and growth adaptation to environmental conditions in Drosophila
Authors: Koyama Takashi , Texada Michael J. , Halberg Kenneth A. , Rewitz Kim
Published: May 2020

Organisms adapt to changing environments by adjusting their development, metabolism, and behavior to improve their chances of survival and reproduction. To achieve such flexibility, organisms must be able to sense and respond to changes in external environmental conditions and their internal state. Metabolic adaptation in response to altered nutrient availability is key to maintaining energy homeostasis and sustaining developmental growth. Furthermore, environmental variables exert major influences on growth and final adult body size in animals. This developmental plasticity depends on adaptive responses to internal state and external cues that are essential for developmental processes. Genetic studies have shown that the fruit fly Drosophila, similarly to mammals, regulates its metabolism, growth, and behavior in response to the environment through several key hormones including insulin, peptides with glucagon-like function, and steroid hormones. Here we review emerging evidence showing that various environmental cues and internal conditions are sensed in different organs that, via inter-organ communication, relay information to neuroendocrine centers that control insulin and steroid signaling. This review focuses on endocrine regulation of development, metabolism, and behavior in Drosophila, highlighting recent advances in the role of the neuroendocrine system as a signaling hub that integrates environmental inputs and drives adaptive responses.
Mechanism, frequency, transfusion and outcome of severe trauma in coagulopathic paediatric patients
Authors: Driessen Arne , Wafaisade Arasch , Lefering Rolf , Migliorini Filippo , Fröhlich Matthias , Arbab Dariusch , Maegele Marc , Mutschler Manuel
Published: May 2020

Purpose

Acute traumatic coagulopathy can result in uncontrolled haemorrhage responsible for the majority of early deaths after adult trauma. Data on the frequency, transfusion practice and outcome of severe trauma haemorrhage in paediatric patients are inconsistent.

Methods

Datasets from paediatric trauma patients were retrieved from the registry of the German trauma society (TR-DGU®) between 2009 and 2016. Coagulopathy was defined by a Quick’s value < 70% (INR (international normalized ratio) > 1.4) and/or thrombocytes ≤ 100 k upon emergency room admission. Children were grouped according to age in 4 different groups (A: 1–5, B: 6–10, C: 11–15 and D: 16–17 years). Prevalence of coagulopathy was assessed. Demographics, injury severity, haemostatic management including transfusions and mortality were described.

Results

5351 primary admitted children ≤ 17 years with an abbreviated injury scale (AIS) ≥ 3 and complete datasets were included. The prevalence of coagulopathy was 13.7% (733/5351). The majority of the children sustained blunt trauma (more than 90% independent of age group) and a combination of traumatic brain injury (TBI) and any other trauma in more than 60% (A, C, D) and in 53.8% in group B. Coagulopathy occurred the most among the youngest (A: 18.2%), followed by all other age groups with approximately 13%. Overall mortality was the highest in the youngest (A: 40.9%) and among the youngest patients with traumatic brain injury (A: 71.4% and B: 47.1%). Transfusion of packed red blood cells (pRBCs) and fresh frozen plasma (FFPs) occurred almost in a 2:1 ratio (or less) across all age subgroups.

Conclusion

Traumatic haemorrhage in association with coagulopathy and severe shock is a major challenge in paediatric trauma across all age groups.
The correlation of retinol-binding protein-4 and lipoprotein combine index with the prevalence and diagnosis of acute coronary syndrome
Authors: Si Yueqiao , Liu Jingyi , Han Chao , Wang Ruijuan , Liu Tong , Sun Lixian
Published: May 2020

Retinol-binding protein-4 (RBP-4) along with the lipid profile plays crucial roles in Acute coronary syndrome (ACS). The study aimed to investigate the correlation of RBP-4, lipoprotein combine index (LCI), and RBP-4 + LCI with ACS. 163 ACS and 77 non-CAD in patients were consecutively enrolled in this study. The serum level of RBP-4 was measured via enzyme-linked immunosorbent assay. LCI was calculated using the formula: total cholesterol × triglyceride × low-density lipoprotein cholesterol/high-density lipoprotein cholesterol. RBP-4 ≥4 ng/ml, LCI ≥16 and LCI ≥16 + RBP-4 ≥4 ng/ml were new independent risk factors of ACS, and OR value of LCI ≥16 + RBP-4 ≥4 ng/ml was higher than that of RBP-4 and LCI combined (all p < 0.05). The AUC for LCI + RBP-4 was higher than that for LCI and RBP-4 individually. The risk of high LCI in 1 lesion vessel was greater than those of 2 or ≥3 lesion vessels (all p < 0.05). In 1 lesion vessel or ≥3 lesion vessels group, the risk associated with LCI and RBP-4 combined was higher than the risk of LCI or RBP-4 alone (all p < 0.05). The risk of hypertension, diabetes mellitus, smoking and history of MI increased with numbers of vessels lesion (all p < 0.05). Increase in RBP-4 and LCI values were found to be independent risk factors for ACS, and the risk of the combined rise in LCI and RBP-4 values was higher than LCI or RBP-4 alone. The combined tests of LCI and RBP-4 might be a potential diagnostic marker for ACS.
Therapeutic potential of mature adipocyte-derived dedifferentiated fat cells for inflammatory bowel disease
Authors: Ishioka Shigeki , Hosokawa Takashi , Ikeda Taro , Konuma Noriyoshi , Kaneda Hide , Ohashi Kensuke , Furuya Takeshi , Masuko Takayuki , Taniguchi Hiroaki , Kano Koichiro , Koshinaga Tsugumichi , Matsumoto Taro
Published: May 2020

Purpose

Our previous studies demonstrated that mature adipocyte-derived dedifferentiated fat (DFAT) cells possess similar multipotency as mesenchymal stem cells. Here, we examined the immunoregulatory potential of DFAT cells in vitro and the therapeutic effect of DFAT cell transplantation in a mouse inflammatory bowel disease (IBD) model.

Methods

The effect of DFAT cell co-culture on T cell proliferation and expression of immunosuppression-related genes in DFAT cells were evaluated. To create IBD, CD4+CD45RBhigh T cells were intraperitoneally injected into SCID mice. One week later, DFAT cells (1 × 105, DFAT group) or saline (Control group) were intraperitoneally injected. Subsequently bodyweight was measured every week and IBD clinical and histological scores were evaluated at 5 weeks after T cell administration.

Results

The T cell proliferation was inhibited by co-cultured DFAT cells in a cell density-dependent manner. Gene expression of TRAIL, IDO1, and NOS2 in DFAT cells was upregulated by TNFα stimulation. DFAT group improved IBD-associated weight loss, IBD clinical and histological scores compared to Control group.

Conclusion

DFAT cells possess immunoregulatory potential and the cell transplantation promoted recovery from colon damage and improved clinical symptoms in the IBD model. DFAT cells could play an important role in the treatment of IBD.
An evaluation of trans-anal rectoscopic-assisted minimally invasive surgery (ARAMIS): a new platform for transanal surgery
Authors: Polese Lino , Rizzato Roberto , Porzionato Andrea , Da Dalt Gianfranco , Bressan Alice , De Caro Raffaele , Merigliano Stefano
Published: May 2020

Purpose

The study aimed to evaluate the feasibility and safety of a new trans-anal rectoscopic-assisted minimally invasive surgery (ARAMIS) platform to treat rectal lesions.

Methods

ARAMIS was first compared with two transanal minimally invasive surgery platforms (SILS Port and GelPOINT Path) on human cadavers. Surgeons with different experience performed running sutures at different distances, at four quadrants, using the three platforms and gave a score to visibility, safety, and maneuverability. ARAMIS was then utilized on patients affected with rectal neoplasia who met the inclusion criteria. Patients and tumor characteristic and results were prospectively collected. The follow-up examinations included proctoscopy at 3, 6, and 12 months.

Results

According to surgeons’ scores, ARAMIS improves visibility and safety with respect to other platforms for distances beyond 10 cm. The procedure, which lasted an average of 59 min, was successfully carried out in 14 patients. No intraoperative or postoperative complications were reported. The mean tumor size was 3 cm; they were located a mean of 11 cm from the anal verge. Complete removal of the lesion was possible in 13/14 patients. There was one case of adenoma recurrence at follow-up.

Conclusion

Study results showed that ARAMIS, which is equipped with an adjustable rectoscope, can be considered a safe, effective platform for transanal surgery. The rectoscope protects the rectum during the procedure, a particularly important consideration when proximal rectal lesions are being treated. Further clinical studies are warranted to confirm these encouraging results.
Neuropathology of COVID-19: a spectrum of vascular and acute disseminated encephalomyelitis (ADEM)-like pathology
Authors: Reichard R. Ross , Kashani Kianoush B. , Boire Nicholas A. , Constantopoulos Eleni , Guo Yong , Lucchinetti Claudia F.
Published: May 2020

We report the neuropathological findings of a patient who died from complications of COVID-19. The decedent was initially hospitalized for surgical management of underlying coronary artery disease. He developed post-operative complications and was evaluated with chest imaging studies. The chest computed tomography (CT) imaging results were indicative of COVID-19 and he was subsequently tested for SARS-CoV-2, which was positive. His condition worsened and he died after more than 2 weeks of hospitalization and aggressive treatment. The autopsy revealed a range of neuropathological lesions, with features resembling both vascular and demyelinating etiologies. Hemorrhagic white matter lesions were present throughout the cerebral hemispheres with surrounding axonal injury and macrophages. The subcortical white matter had scattered clusters of macrophages, a range of associated axonal injury, and a perivascular acute disseminated encephalomyelitis (ADEM)-like appearance. Additional white matter lesions included focal microscopic areas of necrosis with central loss of white matter and marked axonal injury. Rare neocortical organizing microscopic infarcts were also identified. Imaging and clinical reports have demonstrated central nervous system complications in patients’ with COVID-19, but there is a gap in our understanding of the neuropathology. The lesions described in this case provide insight into the potential parainfectious processes affecting COVID-19 patients, which may direct clinical management and ongoing research into the disease. The clinical course of the patient also illustrates that during prolonged hospitalizations neurological complications of COVID may develop, which are particularly difficult to evaluate and appreciate in the critically ill.
Bilateral versus ipsilateral neck dissection in oral and oropharyngeal cancer with contralateral cN0 neck
Authors: Knopf Andreas , Jacob Sven , Bier Henning , Scherer Elias Q.
Published: May 2020

Objective

Contralateral elective neck dissection (cEND) in oral and oropharyngeal squamous cell cancer (OC/OPC) is still a matter of debate. The current study analyzed the outcome in OC/OPC patients with/without cEND.

Methods

OC/OPC patients (n = 471) were diagnosed with contralateral N0 after CT/MRI-scan combined with neck ultrasound. Clinico-pathological features were analyzed using Chi-square/Fisher exact/Student’s t test. Survival rates were calculated using Kaplan–Meier and log-rank test. Prognostic variables were evaluated by Cox regression. Primary/secondary endpoints were overall/recurrence-free survival (OS/RFS).

Results

Pre-therapeutic imaging revealed a significantly over-staged N-status (p = 0.01), while occult contra-lateral N + was diagnosed in one patient only (0.4%). OC patients did not show differences in OS/RFS between the groups (ipsi- vs. bi-lateral). There was a strong tendency towards a better OS in OPC patients who underwent ipsi-lateral ND (p = 0.07). Cox-regression demonstrated that only tumor recurrence was associated with a fivefold increased risk of recurrence-associated death (p < 0.0001) that referred to a significant higher recurrence rate at primary tumor site (rT +) and increased distant metastatic outgrowth in OPC who underwent bi-lateral neck dissection (p = 0.03). While RFS of any cause (rT + /rN + /rM +) was significantly better in OPC with ipsi-lateral ND (p < 0.05), RFS of contralateral lymph node recurrence (rN2c) was comparable in both groups.

Conclusion

END of the contralateral cN0 neck is not correlated by an increased RFS or OS. Standard imaging techniques including CT/MRI scan and neck ultrasound warrant watchful waiting for neck dissection of the contralateral cN0 neck.
A gifted SNARC? Directional spatial–numerical associations in gifted children with high-level math skills do not differ from controls
Authors: He Yunfeng , Nuerk Hans- Christoph , Derksen Alexander , Shi Jiannong , Zhou Xinlin , Cipora Krzysztof
Published: May 2020

The SNARC (Spatial-Numerical Association of Response Codes) effect (i.e., a tendency to associate small/large magnitude numbers with the left/right hand side) is prevalent across the whole lifespan. Because the ability to relate numbers to space has been viewed as a cornerstone in the development of mathematical skills, the relationship between the SNARC effect and math skills has been frequently examined. The results remain largely inconsistent. Studies testing groups of people with very low or very high skill levels in math sometimes found relationships between SNARC and math skills. So far, however, studies testing such extreme math skills level groups were mostly investigating the SNARC effect in individuals revealing math difficulties. Groups with above average math skills remain understudied, especially in regard to children. Here, we investigate the SNARC effect in gifted children, as compared to normally developing children (overall n = 165). Frequentist and Bayesian analysis suggested that the groups did not differ from each other in the SNARC effect. These results are the first to provide evidence for the SNARC effect in a relatively large sample of gifted (and mathematically highly skilled) children. In sum, our study provides another piece of evidence for no direct link between the SNARC effect and mathematical ability in childhood.
Lipschitz constrained GANs via boundedness and continuity
Authors: Liu Kanglin , Qiu Guoping
Published: May 2020

One of the challenges in the study of generative adversarial networks (GANs) is the difficulty of its performance control. Lipschitz constraint is essential in guaranteeing training stability for GANs. Although heuristic methods such as weight clipping, gradient penalty and spectral normalization have been proposed to enforce Lipschitz constraint, it is still difficult to achieve a solution that is both practically effective and theoretically provably satisfying a Lipschitz constraint. In this paper, we introduce the boundedness and continuity (BC) conditions to enforce the Lipschitz constraint on the discriminator functions of GANs. We prove theoretically that GANs with discriminators meeting the BC conditions satisfy the Lipschitz constraint. We present a practically very effective implementation of a GAN based on a convolutional neural network (CNN) by forcing the CNN to satisfy the BC conditions (BC–GAN). We show that as compared to recent techniques including gradient penalty and spectral normalization, BC–GANs have not only better performances but also lower computational complexity.
Bioabsorbable mesh use in midline abdominal wall prophylaxis and repair achieving fascial closure: a cross-sectional review of stage of innovation
Authors: Kamarajah S. K. , Smart N. J. , Daniels I. R. , Pinkney T. D. , Harries R. L.
Published: May 2020

Background

Achieving stable closure of complex or contaminated abdominal wall incisions remains challenging. This study aimed to characterise the stage of innovation for bioabsorbable mesh devices used during both midline closure prophylaxis and complex abdominal wall reconstruction and to evaluate the quality of current evidence.

Methods

A systematic review of published and ongoing studies was performed until 31st December 2019. Inclusion criteria were studies where bioabsorbable mesh was used to support fascial closure either prophylactically after midline laparotomy or for repair of incisional hernia with midline incision. Exclusion criteria were: (1) study design was a systematic review, meta-analysis, letter, review, comment, or conference abstract; (2) included less than p patients; (3) only evaluated biological, synthetic or composite meshes. The primary outcome measure was the IDEAL framework stage of innovation. The key secondary outcome measure was the risk of bias in non-randomised studies of interventions (ROBINS-I) criteria for study quality.

Results

Twelve studies including 1287 patients were included. Three studies considered mesh prophylaxis and nine studies considered hernia repair. There were only two published studies of IDEAL 2B. The remainder was IDEAL 2A studies. The quality of the evidence was categorised as having a risk of bias of a moderate, serious or critical level in nine of the twelve included studies using the ROBINS-I tool.

Conclusion

The evidence base for bioabsorbable mesh is limited. Better reporting and quality control of surgical techniques are needed. Although new trial results over the next decade will improve the evidence base, more trials in emergency and contaminated settings are required to establish the limits of indication.
A Kobayashi and Bergman complete domain without bounded representations
Authors: Shcherbina Nikolay , Zhang Liyou
Published: May 2020

We construct an unbounded strictly pseudoconvex Kobayashi hyperbolic and complete domain in $${\mathbb {C}}^2$$

C

2

, which also possesses complete Bergman metric, but has no nonconstant bounded holomorphic functions.