bluuebunny/crossref_metadata_2025 huggingface dataset:
Indirect Calorimetry Measurements Compared With Guideline Weight‐Based Energy Calculations in Critically Ill Stroke Patients
Authors: Smetana Keaton S. , Hannawi Yousef , May Casey C.
Published: October 2020

Background

Perturbations in resting energy expenditure (REE) among critically ill stroke patients are ill defined, and guidelines recommend weight‐based dosing when indirect calorimetry (IC) is not feasible to estimate daily energy requirements. We aimed to determine whether guideline‐recommended weight‐based dosing provides adequate energy requirements compared with guidelines recommended IC target.

Methods

IC data was collected on stroke patients admitted to a neurocritical care unit. We compared low‐weight‐based dosing (25 kcal/kg) and high (30 kcal/kg) with the IC REE target. Subsequently, we analyzed the effect of stroke subtype on the differences among these measurements.

Results

Seventy‐two metabolic studies were performed (45.1% intracerebral hemorrhage [ICH], 18.3% aneurysmal subarachnoid hemorrhage [aSAH], and 36.6% acute ischemic stroke [AIS]). Energy needs, estimated using low‐weight‐based group, were significantly lower than IC REE target (1496 kcal/day [IQR, 1224–1850] vs 1770 kcal/day [IQR, 1400–2150]; P = .003). High weight‐based group energy measurements were similar to IC REE target (1806 kcal/day [IQR, 1530–2236] vs 1770 kcal/day; P = .343). Subgroup analysis showed that low‐weight‐based calculations were significantly lower than those of IC in ICH and aSAH, but they were similar in AIS (P ≤ .001, .016, and .078, respectively). Linear regression analysis showed that weight, height, and hemorrhagic stroke subtype were associated with IC (P ≤ .001, .024, and .051, respectively).

Conclusion

Important differences between weight‐based estimation of energy needs and guideline‐recommended IC estimation exist for critically ill stroke patients. Low‐weight‐based calculations of REE underestimate energy needs in ICH and aSAH patients.
Characterising the immune microenvironment in liposarcoma, its impact on prognosis and the impact of radiotherapy
Authors: Snow Hayden , Mitchell Catherine , Hendry Shona , McKinley Madeleine , Byrne David , Ngan Sam , Chander Sarat , Chu Julie , Desai Jayesh , Bae Susie , Henderson Michael , Choong Peter , Gyorki David
Published: October 2020

Background and Objectives

Limited literature exists examining the immune microenvironment in liposarcoma, particularly with regard to the impact of radiotherapy. A major problem is the lack of scoring system for the tumour‐infiltrating lymphocytes (TILs) in sarcoma. This study aims to describe the immune environment pre‐ and postradiotherapy and identify the optimal immune infiltrate scoring system for sarcoma.

Methods

Thirty‐nine paired tissue samples (pre‐ and postradiotherapy) from patients with liposarcoma were scored by two pathologists for TILs using pre‐existing systems (for breast cancer and melanoma) and compared for interobserver reliability. Immunohistochemical staining was performed for various immune markers.

Results

The TIL scoring system for breast cancer yielded perfect agreement (κ = 1.000). 21% of patients had increased TILs after radiotherapy, 87.5% of whom had dedifferentiated liposarcoma. Immune suppressor expression was increased frequently after radiotherapy (CD68 increased in 59.4%, PD‐L1 increased in 25%). Immune effector expression (CD8) was unchanged in 84.4%.

Conclusions

Breast cancer TIL scoring is reproducible in liposarcoma and has high interobserver reliability. Radiotherapy was observed to have a limited impact on immune effectors but seemed to have more impact in upregulating immune suppressors, suggesting radiotherapy may contribute to disease control through immunomodulatory effects. Dedifferentiated liposarcoma represents a uniquely responsive subtype.
Role of Contrast‐Enhanced Ultrasound in the Detection of Complications After Ultrasound‐Guided Liver Interventional Procedures
Authors: Francica Giampiero , Meloni Maria Franca , Riccardi Laura , Giangregorio Francesco , Caturelli Eugenio , Terracciano Fulvia , de Sio Ilario
Published: October 2020

The role of contrast‐enhanced ultrasound (CEUS) in interventional ultrasound‐guided procedures in the liver has been increasingly recognized. However, little is known about the capability of CEUS for diagnosing complications after liver biopsy and ablation with special regard to postprocedural hemorrhage. The aim of this Pictorial Essay is to present the CEUS features of a wide spectrum of vascular complications (with or without bleeding) and injuries of the surrounding abdominal and chest wall occurring after liver interventional procedures.
Associations Between Doppler Internal Jugular Vein Blood Flow and Transverse Sinus Stasis Detected by Magnetic Resonance Imaging
Authors: İlhan Zeki , Açıkgözoğlu Saim , Demir Orhan
Published: October 2020

Objectives

This study aimed to compare the estimated internal jugular vein (IJV) volume flow with Doppler ultrasound in patients with slow flow in the transverse sinuses and normal transverse sinuses on brain magnetic resonance imaging (MRI).

Methods

Eighty patients between the ages of 18 and 80 years who did not have any signs of sinus vein thrombosis on brain MRI were included. On MRI, cases with hyperintensity due to a signal void loss in the transverse sinuses in coronal fluid attenuation inversion recovery sequences were included in the slow‐flow group. The presence of sinus thrombosis was excluded with other MRI pulse sequences and clinical findings. The participants were divided into 2 groups as having normal and slow flow according to MRI findings. Then bilateral IJV volume flow measurements were made by Doppler ultrasound. Bilateral volume flow was estimated by time‐averaged blood flow velocities sampled in the center of the IJV, and IJV cross‐sectional areas were measured. We defined the dominant IJV as the one having the higher estimated volume flow of the 2 sides.

Results

Total estimated IJV blood flow was lower (P < .001) in patients with slow flow on MRI (546 mL/min) compared to those without (768 mL/min). A similar finding was seen for the nondominant IJV. In a receiver operating characteristic analysis, the cutoff value for the total estimated IJV volume flow was determined to be 590 mL/min, and the cutoff value for nondominant estimated IJV volume flow was determined to be 202 mL/min to distinguish between the groups.

Conclusions

Low estimated volume blood flow in the IJV is associated with MRI evidence of stasis in the ipsilateral transverse sinus.
Studies on waterline corrosion processes and corrosion product characteristics of carbon steel in 3.5 wt% NaCl solution
Authors: Li Chuanpeng , Zhang Lunwu , Lu Zhonghai , Ding Rui , Zhao Xiaodong , Wang Bin , Cui Hongtao , Liu Jie
Published: October 2020

The waterline corrosion behaviors of carbon steel partially immersed in a 3.5 wt% NaCl solution were investigated using the wire beam electrode technique, and the effects of corrosion products on the processes of waterline corrosion were analyzed. The results demonstrated that the initial stage and development stage of waterline corrosion were mainly controlled by the concentration and diffusion of dissolved oxygen, respectively, and the deceleration stage of waterline corrosion was mainly affected by corrosion products. The main component of the yellow corrosion products was γ‐FeOOH, and γ‐FeOOH that exhibited a high reduction reactivity could be involved in the cathodic reaction. The black corrosion products were mainly composed of Fe3O4 with strong thermodynamic stability and the processes of dissolved oxygen diffusion and ion transports were obviously affected due to the continuous accumulation of Fe3O4 on the surface of the electrodes. Polarity reversals were observed on the single electrodes below the waterline, but the reasons for the phenomena were different from each other.
The development of the PlexiQoL: A patient‐reported outcome measure for adults with neurofibromatosis type 1‐associated plexiform neurofibromas
Authors: Heaney Alice , Wilburn Jeanette , Rouse Matthew , Langmead Shannon , Blakeley Jaishri O. , Huson Susan , McKenna Stephen P.
Published: October 2020

Background

To develop and validate a patient‐reported outcome (PRO) measure of quality of life (QoL), specific to patients with Neurofibromatosis Type 1 (NF1)‐associated plexiform neurofibromas (pNFs), suitable for use in clinical efficacy trials. The study was conducted in parallel in the UK and US.

Methods

Qualitative interviews were conducted with patients to generate questionnaire content. Face and content validity of the draft scale was assessed by cognitive debriefing interviews (CDIs). A postal validation survey was conducted to identify the final version of the questionnaire (the PlexiQoL), establish its unidimensionality, and assess its psychometric properties.

Results

Thematic analysis was performed on 42 interview transcripts. Thirty‐one CDIs revealed that patients found the draft scale to be comprehensible, relevant, and easy to complete. The postal validation survey was completed by 273 patients. Rasch analysis identified an 18‐item unidimensional scale that showed excellent internal consistency, reproducibility, and sensitivity to differences in patient‐perceived pNF severity, general health, and the use of pain medication.

Conclusions

The PlexiQoL is the first disease‐specific PRO assessing the ability of adults with NF‐1 associated pNFs to meet their basic human needs. Clinical trials are planned to assess the sensitivity to change of the PlexiQoL in people undergoing treatment for pNFs.
Rehabilitation following proximal humeral fracture in the UK National Health Service: A survey of publicly facing information
Authors: Rohun Jason , May Pauline , Littlewood Chris
Published: October 2020

Introduction

Proximal humeral fractures (PHF) are a common injury in the older population but there is limited research evaluating rehabilitation following PHF. The aim of this study was to understand current National Health Service (NHS) practice for rehabilitation following PHF as a platform for conducting future research.

Methods

Two reviewers independently undertook electronic searches for publicly available information sheets (PIS) from websites of NHS Trusts that included detail about rehabilitation following PHF, for example, duration of immobilisation. One reviewer extracted data and a second reviewer verified this.

Results

Seventeen PIS from 17 different NHS trusts were identified. All provided some information on the method of immobilisation but only six provided guidance on duration of immobilisation with the median time being 2 weeks (range 0–6). The median time to commencement of passive exercise was 2 weeks (range 0–4) and 9 weeks (range 6–12) for active exercise. Only one PIS reported on the time for commencement of resisted exercises and this was reported as 6 weeks. The median time recommended return to work was 7.5 weeks (range 6–12).

Conclusion

This study found limited publicly available information for rehabilitation following PHF in the NHS but offers some insight into current approaches. Our results will facilitate development of relevant information for patients and evaluation of rehabilitation strategies in future research.
Experience using multielectrode cardiac catheters for detection of electrophysiologic activity of the human urinary bladder
Authors: Ford Alexcis T. , Lloyd Michael , Iravanian Shahriar , Northington Gina , Kelley Robert S.
Published: October 2020

Aim

To determine the feasibility of commercially available multielectrode cardiac electrophysiology catheters to detect electrical activity in the human bladder.

Methods

Ten subjects requiring cystoscopy for the evaluation of lower urinary tract pathology were eligible for participation in our study. After routine rigid cystoscopy with a 70° cystoscope, various multielectrode cardiac electrophysiology catheters were introduced into the bladder. One of three catheters with different electrode configurations was used per subject. Electroanatomical images of the bladder were created and spontaneous electrical activity was recorded. Subjective response to electrical stimuli delivered across the electrodes (20 mA at 5 ms pulse width, rate 100 ms) was also recorded. The responses were qualitatively compared with that from a prior study.

Results

Electrical activity recorded at the dome of the bladder was less than 0.5 mV and low frequency. Myopotentials resembling smooth muscle were detected at electrodes near or within the trigone. A sensory response was reported with the use of pacing stimuli, with the sensation in the trigone being reported more often than the dome of the bladder. Stimulation in the trigone triggered sensory urgency and voiding in a patient with a history of overactive bladder.

Conclusions

The use of multielectrode catheters to measure human bladder electrophysiologic activity is feasible. Issues with noise reduction still exist, though to a lesser extent with the multielectrode basket design than simple quadripolar one. Sensory responses to pacing stimuli may be useful for diagnostic and therapeutic purposes in the future.
Haar‐wavelet based approximation for pricing American options under linear complementarity formulations
Authors: Kumar Devendra , Deswal Komal
Published: October 2020

In this manuscript, we present a novel and highly accurate wavelet‐based approximation technique to explore the sensitivities and value of American options diagnosed by linear complementarity problems. For a detailed analysis of such financially relevant problems, we transform the actual final value problem into a dimensionless initial value problem. To avoid the unacceptable large truncation error, the unbounded domain is trimmed into a bounded domain. A remarkable observation is that to investigate the various physical and numerical aspects of the options' sensitivities; the proposed scheme is efficient as it explicitly provides the numerical approximation of all the derivatives of the solution function. The multiresolution technique of the wavelets and the convergence of the proposed wavelet scheme are comprehensively analyzed. The wavelet analysis is accompanied by illustrative examples to demonstrate the proficiency and robustness of the present method coupled with graphical representations. It has been shown that the present method is efficient to solve free boundary problems. It is worthy to note that the highly accurate and promising computational results are enough to confirm the performance of the proposed method. The simulated results of options' Greeks analyzed and discussed have vast applications in different financial institutes and trading markets.
Allopurinol‐induced severe cutaneous adverse drug reactions: Risk minimization measures in Malaysia
Authors: Panickar Rema , Wo Wee Kee , Ali Norleen M. , Tang Min Moon , Ramanathan G. R. Letchuman , Kamarulzaman Adeeba , Aziz Zoriah
Published: October 2020

Purpose

To describe risk minimization measures (RMMs) implemented in Malaysia for allopurinol‐induced severe cutaneous adverse drug reactions (SCARs) and examine their impact using real‐world data on allopurinol usage and adverse drug reaction (ADR) reports associated with allopurinol.

Methods

Data on allopurinol ADR reports (2000‐2018) were extracted from the Malaysian ADR database. We identified RMMs implemented between 2000 and 2018 from the minutes of relevant meetings and the national pharmacovigilance newsletter. We obtained allopurinol utilization data (2004‐2018) from the Pharmaceutical Services Programme. To determine the impact of RMMs on ADR reporting, we considered ADR reports received within 1 year of RMM implementation. We used the Pearson χ2 test to examine the relation between the implementation of RMMs and allopurinol ADR reports.

Results

The 16 RMMs for allopurinol‐related SCARs implemented in Malaysia involved nine risk communications, four prescriber or patient educational material, and three health system innovations. Allopurinol utilization decreased by 21.5% from 2004 to 2018. ADR reporting rates for all drugs (n = 144 507) and allopurinol (n = 1747) increased. ADR reports involving off‐label use decreased by 6% from 2011. SCARs cases remained between 20% and 50%. RMMs implemented showed statistically significant reduction in ADR reports involving off‐label use for August 2014 [χ2 (1, N = 258) = 5.32, P = .021] and October 2016 [χ2 (1, N = 349) = 3.85, P = .0499].

Conclusions

RMMs to promote the appropriate use of allopurinol and prescriber education have a positive impact. We need further measures to reduce the incidence and severity of allopurinol‐induced SCARs, such as patient education and more research into pharmacogenetic screening.
High affinity Na+ transport by wheat HKT1;5 is blocked by K+
Authors: Xu Bo , Hrmova Maria , Gilliham Matthew
Published: October 2020

The wheat sodium transporters TmHKT1;5‐A and TaHKT1;5‐D are encoded by genes underlying the major shoot Na+ exclusion loci Nax2 and Kna1 from Triticum monococcum (Tm) and Triticum aestivum (Ta), respectively. In contrast to HKT2 transporters that have been shown to exhibit high affinity K+‐dependent Na+ transport, HKT1 proteins have, with one exception, only been shown to catalyze low affinity Na+ transport and no K+ transport. Here, using heterologous expression in Xenopus laevis oocytes we uncover a novel property of HKT1 proteins, that both TmHKT1;5‐A and TaHKT1;5‐D encode dual (high and low) affinity Na+‐transporters with the high‐affinity component being abolished when external K+ is in excess of external Na+. Three‐dimensional structural modeling suggested that, compared to Na+, K+ is bound more tightly in the selectivity filter region by means of additional van der Waals forces, which is likely to explain the K+ block at the molecular level. The low‐affinity component for Na+ transport of TmHKT1;5‐A had a lower Km than that of TaHKT1;5‐D and was less sensitive to external K+. We propose that these properties contribute towards the improvements in shoot Na+‐exclusion and crop plant salt tolerance following the introgression of TmHKT1;5‐A into diverse wheat backgrounds.
Short Pulse Initiation of an RDX‐Based Explosive Using Large Diameter Flyer‐Plate Impacts
Authors: Neel Christopher , Sable Peter
Published: October 2020

Ten impact experiments are presented that probe the initiation behavior of an RDX‐based explosive. The explosive pellets were impacted by thin aluminum impactors supported by low‐impedance polymers, thereby subjecting the pellets to short duration shocks. Impact conditions were used to determine impact tilt, pulse pressure and duration, sample transit time, and whether or not a detonation occurred. Exploding Foil Initiator (EFI) launchers were used as a baseline for evaluating the technique, and it was found that the present technique addresses multiple shortcomings of EFI‐based systems. The aluminum foil allowed impacts with pressure durations of 70–80 ns, resulting in input conditions closely matching those of EFI‐based systems. The thicker aluminum plate impactors resulted in pulse durations of approximately 600 ns and allowed access to a previously inaccessible region of the initiation curve. Initiation thresholds were bracketed using both impactors, and the data is compared with complementary initiation data from EFI‐based systems with good agreement. Based on the results and closely related work, a novel, physically‐based criterion is proposed to allow the initiation curve to be predicted based on the explosive's unreacted equation of state and sustained‐pulse, shock‐to‐detonation run distance (the “Pop‐plot”), giving a physical basis for previously published observations. Finally, the criterion is applied to the data available to propose a relationship between pressure, pulse duration, and run distance, suggesting that input pulse durations of 50–100 % higher than the critical condition should be applied to approximate the run distance of a sustained pulse.
Extending Quantum Links: Modules for Fiber‐ and Memory‐Based Quantum Repeaters
Authors: van Loock Peter , Alt Wolfgang , Becher Christoph , Benson Oliver , Boche Holger , Deppe Christian , Eschner Jürgen , Höfling Sven , Meschede Dieter , Michler Peter , Schmidt Frank , Weinfurter Harald
Published: October 2020

Elementary building blocks for quantum repeaters based on fiber channels and memory stations are analyzed. Implementations are considered for three different physical platforms, for which suitable components are available: quantum dots, trapped atoms and ions, and color centers in diamond. The performances of basic quantum repeater links for these platforms are evaluated and compared, both for present‐day, state‐of‐the‐art experimental parameters as well as for parameters that can in principle be reached in the future. The ultimate goal is to experimentally explore regimes at intermediate distances—up to a few 100 km—in which the repeater‐assisted secret key transmission rates exceed the maximal rate achievable via direct transmission. Two different protocols are considered, one of which is better adapted to the higher source clock rate and lower memory coherence time of the quantum dot platform, while the other circumvents the need of writing photonic quantum states into the memories in a heralded, nondestructive fashion. The elementary building blocks and protocols can be connected in a modular form to construct a quantum repeater system that is potentially scalable to large distances.
Long‐term effects of lime and phosphogypsum on soil carbon and nitrogen and physical attributes under tropical no‐till
Authors: da Costa Claudio Hideo Martins , Wander Michelle M. , Crusciol Carlos Alexandre Costa , Ugarte Carmen , Rigon João Paulo Gonsiorkiewicz , Soratto Rogério Peres , Calonego Juliano Carlos
Published: October 2020

Lime and phosphogypsum applications are well‐established practices in weathered soils, and their surface application under no‐till (NT) can affect soil physical attributes and C and N fractions. This study determined the long‐term (10‐yr) effects of lime and phosphogypsum applications to the soil surface on soil C and N fractions of a tropical NT field. The experimental design was a randomized block with four treatments and four replications. The following treatments were applied in October 2002, November 2004, and October 2010, respectively: limestone (2,000 kg ha−1), phosphogypsum (2,100 kg ha−1), and limestone (2,000 kg ha−1) plus phosphogypsum (2,100 kg ha−1). In general, after 10 yr of liming, both alone and when associated with phosphogypsum, the cumulative crop straw inputs were increased at least 20% across the years, and the C fractions increased remarkably at different soil depths. Both treatments improved the SOC stocks by 24% (12.5–15.6 Mg ha−1) at 0.1–0.2‐m soil depths and by 10% (30.6–33.8 Mg ha−1) at 0–0.2‐m soil depths, and in general the soil aggregation at 0–0.4‐m soil depths. However, the particulate C and N fractions were reduced at 0–0.05‐m soil depth, suggesting a slight response to the transitory trend of soil organic C (SOC) depletion. Liming, both alone and when associated with phosphogypsum, overcame the transitory C pool depletion and improved soil aggregation, soil C fractions, and SOC stocks and could be considered an important factor that drives the sustainability of cropping systems under NT.
The incessant inbox: Evaluating the relevance of after‐hours e‐mail characteristics for work‐related rumination and well‐being
Authors: Minnen Molly E. , Mitropoulos Tanya , Rosenblatt Alexa K. , Calderwood Charles
Published: October 2020

While many employees read and respond to work‐related e‐mails in the evenings after work, the mechanisms through which after‐hours e‐mailing influences well‐being remain poorly understood. In particular, there has been limited consideration of whether different characteristics of after‐hours e‐mails (frequency, duration, perceived tone) may trigger work‐related rumination that influences employee well‐being at bedtime (i.e., the end of the post‐work period). To address this gap in the literature, data were collected from 59 employees during a 5‐day daily survey period. We expected after‐hours e‐mail frequency, duration, and perceived tone to indirectly relate to employee vigour and fatigue at bedtime (two common well‐being criteria) via affective rumination and problem‐solving pondering (two major forms of work‐related rumination). Our results indicated that a more negatively perceived after‐hours e‐mail tone influenced both vigour and fatigue via affective rumination. Further, our findings suggested diverging implications of after‐hours e‐mailing frequency and duration for problem‐solving pondering, with longer duration and more frequent after‐hours e‐mailing co‐varying with higher and lower levels of this form of rumination, respectively. These findings demonstrate the importance of considering various characteristics of after‐hours e‐mailing and corresponding implications of work‐related rumination when studying employee well‐being.
Better to have led and lost than never to have led at all? Lost leadership and effort provision in dynamic tournaments
Authors: Gutierrez Cédric , Obloj Tomasz , Frank Douglas H.
Published: October 2020

Research Summary

In this paper, we develop and test a behavioral theory of lost leadership. Using insights from the literature on goals as reference points and goal‐setting theory, we predict that former leaders exert more effort compared to otherwise identical competitors. We test this prediction using two contexts. The first data comes from an educational business simulation game. The second setting draws on field data from a 2‐month banking sales contest. We find that provision of effort increases following the loss of leadership. We also explore whether past leaders exert more effort in general or shift effort from other, potentially less‐salient goals. We find evidence of both mechanisms. Finally, investigating the temporal effects, we find that having been a leader has an attenuating effect on subsequent behavior.

Managerial Summary

Many competitions—such as sports championships, sales contests, idea‐sourcing challenges, and competitions for promotions—can be understood as dynamic tournaments, in which rivals rise and fall in the provisional rankings as they compete over time for a terminal prize. This performance volatility can have important consequences for contestants' behavior. Focusing on the event of lost leadership, we show that former leaders try harder: those that are displaced from a prize‐eligible position exert more effort in subsequent rounds, compared with identically placed rivals who have never led. Former leaders provide more effort overall, and also shift attention away from other tasks. Our results, which suggest that setbacks can be motivational, have implications for the optimal design of dynamic competitions.
Desolation sound: Social practices of natural beauty
Authors: Lopes Dominic McIver ,   Philosophy Documentation Center
Published: October 2020

Instances of natural beauty are widely regarded as counterexamples to practice-based theories of aesthetic value. They are not. To see that they are not, we require the correct account of natural beauty and the correct account of social practices.
Process hybridization schemes for multiscale engineered tissue biofabrication
Authors: Chansoria Parth , Schuchard Karl , Shirwaiker Rohan A.
Published: October 2020

Recapitulation of multiscale structure–function properties of cells, cell‐secreted extracellular matrix, and 3D architecture of natural tissues is central to engineering biomimetic tissue substitutes. Toward achieving biomimicry, a variety of biofabrication processes have been developed, which can be broadly classified into five categories—fiber and fabric formation, additive manufacturing, surface modification, remote fields, and other notable processes—each with specific advantages and limitations. The majority of biofabrication literature has focused on using a single process at a time, which often limits the range of tissues that could be created with relevant features that span nano to macro scales. With multiscale biomimicry as the goal, development of hybrid biofabrication strategies that synergistically unite two or more processes to complement each other's strengths and limitations has been steadily increasing. This work discusses recent literature in this domain and attempts to equip the reader with the understanding of selecting appropriate processes that can harmonize toward creating engineered tissues with appropriate multiscale structure–function properties. Opportunities related to various hybridization schemes and a future outlook on scale‐up biofabrication have also been discussed.

This article is categorized under:

Nanotechnology Approaches to Biology > Nanoscale Systems in Biology

Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement
Did the COVID‐19 Pandemic Cause a Delay in the Diagnosis of Acute Appendicitis?
Authors: Turanli Sevim , Kiziltan Gamze
Published: October 2020

Background

Appendectomy for acute appendicitis remains one of the most common surgical procedures. This study aims to assess the clinical presentation and delays in diagnosing acute appendicitis during the COVID‐19 pandemic.

Methods

We evaluated data of all adult patients who underwent an appendectomy at our hospital between June 1, 2019 and June 1, 2020. Demographic data, admission type to the emergency room, radiological findings, pathological findings, and hospitalization time were noted. Patients were divided into four groups of 3‐month periods, pre (Groups 5, 4, 3, 2) and during the pandemic (Group 1). Hospitalization time and perforation status of each group were compared. The hospital admission type and their effect on perforation were also evaluated.

Results

Two hundred and fourteen patients were included; 135 patients were male, and 57 were female. The median age was 39 years. In Group 1 (pandemic period), 28.8% of patients were referred to us from pandemic hospitals. The median hospitalization time was 7.3 h before pandemics (Group 2–5), 5 h in the pandemic period (Group 1). Perforation rates were 27.8% in Group 1, 23.3% in Group 2, 16.3% in Group 3, 14.0% in Group 4, and 18.6% in Group 5 (0 = 0.58). There was no difference in the patients in Group 1 in the rate of perforated appendicitis in patients who were referred from other pandemic hospitals (29.4) and those admitted via our own emergency room (16.6%) (p = 0.27) during the pandemic period.

Conclusion

We did not observe any clear increase in the diagnosis of perforated appendicitis during the pandemic period, even in patients who were transferred from other hospitals.
Haplotype data and forensic evaluation of 23 Y-STR and 12 X-STR loci in eight ethnic groups from Eritrea
Authors: Bini Carla , Sarno Stefania , Tangorra Elisabetta , Iuvaro Alessandra , De Fanti Sara , Tseghereda Yohannes Ghebremedhin , Pelotti Susi , Luiselli Donata
Published: October 2020

Eritrea is a multi-ethnic country of over 3 million of people consisting of different ethnic groups, having each its own language and cultural tradition. Due to the lack of population genetic data for markers of forensic interest, in this study, we analyzed the genetic polymorphisms of 23 Y-chromosome STR loci and of 12 X-chromosome STR loci in a sample of 255 unrelated individuals from 8 Eritrean ethnic groups, with the aim to generate a reference haplotype database for anthropological and forensic applications. X- and Y-chromosomes markers may indeed offer information especially in personal identification and kinship testing, when relying on the availability of large local population data to derive sufficiently accurate frequency estimates. The population genetic analyses in the Eritrean sample for both the two set of Y- and X-STR markers showed high power of discrimination both at country-based and population levels. Comparison population results highlight the importance of considering the ethnic composition within the analyzed country and the necessity of increasing available data especially when referring to heterogeneous populations such as the African ones.
„Psychotherapie im Tageszentrum für Borderlinestörung“ Institut für Psychotherapie mit Tageszentrum für Borderlinestörung, Psychosoziale Dienste in Wien
Authors: Margreiter Susanne
Published: October 2020

Dieser Artikel beschäftigt sich mit der Behandlung von Patient_innen mit der Diagnose „Borderline Persönlichkeitsstörung“ in einem ambulanten, therapeutischen Setting. Seit September 2009 Jahren bieten wir im Tageszentrum des Instituts für Psychotherapie des PSD Wien (Psychosoziale Dienste Wien) ein intensives, störungsspezifisches, verhaltenstherapeutisch basiertes Therapieprogramm über 12 Wochen für betroffene Patient_innen an. Tagesklinische Angebote haben viele Vorteile, z. B. den direkteren Transfer des Gelernten in den Alltag, erfordern aber auch viel Flexibilität und Unmittelbarkeit in der Behandlung.

Patient_innen, die an einer Borderline Störung erkrankt sind, benötigen, je nach Schweregrad der Erkrankung, häufig ein sehr komplexes Behandlungsangebot, das im Rahmen einer spezialisierten Institution leichter angeboten werden kann, als in Einzelpraxen. Als psychotherapeutische Einrichtung des PSD Wien sind wir gut vernetzt und können auch im Krisenfall schnell und effizient handeln. Die Versorgungssituation betroffener Patient_innen in Österreich ist prekär, die ambulanten Angebote für diese Patient_innengruppe sind nicht in ausreichender Menge vorhanden.

Generell stellt die psychiatrisch-psychotherapeutische Versorgungssituation von Patient_innen mit einer Borderline Persönlichkeitsstörung (BPS) für alle Behandlungseinrichtungen eine große therapeutische aber auch finanzielle Herausforderung dar. Mit Anteilen von 8–30 % in der ambulanten und 15–20 % in der stationären allgemeinpsychiatrischen Versorgung sowie 60–80 % im forensischen Bereich ist die BPSdiePersönlichkeitsstörung mit der höchsten klinischen Relevanz (Bolm 2009).

Nach kurzer Darstellung der zugrundeliegenden fachlichen Konzepte wird das Therapieprogramm des Tageszentrums für Borderlinestörung (TAZ-B) vorgestellt.

Anhand von zwei Fallbeispielen werden therapeutische Prozesse und Problemstellungen dieses Krankheitsbildes verdeutlicht. Mit einem Ausblick in die Zukunft der Behandlung von Patient_innen mit Borderline Persönlichkeitsstörung schließt der Artikel.
Darcy-Forchheimer flow with nonlinear mixed convection
Authors: Hayat T. , Haider F. , Alsaedi A.
Published: October 2020

An analysis of the mixed convective flow of viscous fluids induced by a nonlinear inclined stretching surface is addressed. Heat and mass transfer phenomena are analyzed with additional effects of heat generation/absorption and activation energy, respectively. The nonlinear Darcy-Forchheimer relation is deliberated. The dimensionless problem is obtained through appropriate transformations. Convergent series solutions are obtained by utilizing an optimal homotopic analysis method (OHAM). Graphs depicting the consequence of influential variables on physical quantities are presented. Enhancement in the velocity is observed through the local mixed convection parameter while an opposite trend of the concentration field is noted for the chemical reaction rate parameter.
Influence of social learning on the completion rate of massive online open courses
Authors: Crane R. A. , Comley S.
Published: October 2020

Massive open online courses (MOOCs) are now well-established as a highly effective, flexible and large participation capacity distance learning tool. They have enabled unprecedented access to educational material for millions of people worldwide, however, still suffer from significant student non-completion. Various theories have been proposed but we still lack a comprehensive understanding of why such attrition occurs. Herein we have analysed data from all MOOCs offered by the University of Exeter (UK) in 2018 in order to investigate whether “Social Learners” (i.e. those which comment on MOOC forums) exhibit differential non-completion than “Non-Social Learners”. Results demonstrate that the former are considerably more likely to complete MOOCs, with median steps (i.e. “click points” within each MOOC) accessed (as a percentage of total steps) for Social and Non-Social Learners ranging from 50 to 100% and 9–46% respectively. In addition, the number of Non-Social Learners enrolled onto each MOOC was consistently greater than the number of Social Learners, with ratios of Non-Social Learners to Social Learners for each MOOC ranging from 1.75–11.30. Results therefore suggest that whilst Social Learners are in the minority Social Learning is an important tool to prevent student attrition. More research is therefore required in order to further understand the multifaceted value of Social Learning (i.e. technical vs purely social) in order to inform future MOOC design to maximise such benefits for students.
The Development and Growth of Non-Governmental Conservation in Peru: Privately and Communally Protected Areas
Authors: Shanee Sam , Shanee Noga , Lock Will , Espejo-Uribe Maria Jose
Published: October 2020

While legislation for the creation of protected areas in Peru has existed since the 1960s, legislation relating to privately and/or communally protected areas (PCPAs) dates only to the early 2000s, from which point the number of PCPAs has grown rapidly. We examine the growth of PCPAs in Peru, the laws key to their creation, and the actors who have shaped them, highlighting where national-level data obscures local dynamics that have driven or sustained their growth. Combined with ethnographic research in the region of San Martín, we show that while PCPAs have spread through processes of conservation contagion, increasing legal and economic requirements, lack of support, and negative interactions with state agents are discouraging local conservationists. At the same time, the promotion of conservation as an economic opportunity is encouraging foreign interest in developing market-based projects, risking increasing exclusion of local populations and ongoing sustainability of PCPAs in Peru.
Mitochondrial oxygen monitoring with COMET: verification of calibration in man and comparison with vascular occlusion tests in healthy volunteers
Authors: Ubbink R. , Wefers Bettink M. A. , van Weteringen W. , Mik E. G.
Published: October 2020

Mitochondria are the primary consumers of oxygen and therefore an important location for oxygen availability and consumption measurement. A technique has been developed for mitochondrial oxygen tension (mitoPO2) measurement, incorporated in the COMET. In contrast to most textbooks, relatively high average mitoPO2 values have been reported. The first aim of this study was to verify the validity of the COMET calibration for mitoPO2 measurements in human skin. The second aim was to compare the dynamics of mitoPO2 to several other techniques assessing tissue oxygenation. Firstly, we performed a two-point calibration. Mitochondrial oxygen depletion was achieved with vascular occlusion. A high mitoPO2 was reached by local application of cyanide. MitoPO2 was compared to the arterial oxygen partial pressure (PaO2). Secondly, for deoxygenation kinetics we compared COMET variables with the LEA O2C, SenTec OxiVenT™ and Medtronic INVOS™ parameters during a vascular occlusion test. 20 healthy volunteers were recruited and resulted in 18 datasets (2 times 9 subjects). The lowest measured mitoPO2 value per subject had a median [IQR] of 3.0 [1.0–4.0] mmHg, n = 9. After cyanide application the mitoPO2 was 94.1 mmHg [87.2–110.9] and did not differ significantly (n = 9, p = 0.5) from the PaO2 of 101.0 [98.0–106.0] mmHg. In contrast to O2C, OxiVenT™ and INVOS parameters, mitoPO2 declined within seconds with pressure on the probe. The kinetics from this decline are used to mitochondrial oxygen consumption (mitoVO2). This study validates the calibration of the COMET device in humans. For mitoVO2 measurements not only blood flow cessation but application of local pressure is of great importance to clear the measurement site of oxygen-carrying erythrocytes.
Effective callus induction and plant regeneration in callus and protoplast cultures of Nigella damascena L.
Authors: Klimek-Chodacka Magdalena , Kadluczka Dariusz , Lukasiewicz Aneta , Malec-Pala Aneta , Baranski Rafal , Grzebelus Ewa
Published: October 2020

In this study we report the development of effective in vitro systems for a medicinal plant Nigella damascena L. comprising: (1) callus induction, (2) somatic embryogenesis in callus cultures with subsequent plant regeneration, and (3) isolation and regeneration of callus-derived protoplasts. Callus development was achieved on 83–100% of hypocotyl and cotyledon explants, whereby Murashige and Skoog medium (MS) supplemented with 3 mg L−1 6-benzylaminopurine and 0.5 mg L−1α-naphthaleneacetic acid (NAA; BN medium) was more advantageous than MS with kinetin and NAA (KN medium). Histological observations of calli revealed the presence of embryogenic zones from which somatic embryos developed on the hormone-free medium. Plant regeneration was observed on 76–95% of calli. A high capacity to form somatic embryos and regeneration was maintained in long-lasting cultures, i.e. even in 2 year old callus.

The obtained callus was also a good source tissue for protoplast isolation. By applying a mixture of cellulase and pectolyase, the acceptable yield of viable protoplasts was achieved, especially from hypocotyl-derived callus maintained on BN medium. Protoplasts embedded in an alginate matrix and cultured in modified Kao and Michayluk media re-constructed their cell wall and re-entered mitotic divisions. About 30% of small cell aggregates formed microcalli, which, after the release from alginate, proliferated continuously on KN and BN media, irrespective of the tissue variant used as the protoplast source. Somatic embryo formation and plant regeneration were successful on hormone-free media. An effective plant regeneration system of N. damascena protoplast cultures has been developed and is being reported for the first time.
Quality of life and mental health in breast cancer survivors compared with non-cancer controls: a study of patient-reported outcomes in the United Kingdom
Authors: Carreira Helena , Williams Rachael , Dempsey Harley , Stanway Susannah , Smeeth Liam , Bhaskaran Krishnan
Published: October 2020

Purpose

There is limited high-quality evidence on quality of life, anxiety, and depressive symptoms in breast cancer survivors and women with no history of cancer. We aimed to address this by comparing patient-reported outcomes between breast cancer survivors and women with no history of breast cancer.

Methods

Breast cancer survivors and women with no prior cancer were selected from the UK Clinical Practice Research Datalink GOLD primary care database, which includes population-based primary care electronic health record data. Breast cancer survivors and controls were frequency matched by age and primary care practice. Outcomes were assessed with validated instruments via postal questionnaire. Linear and logistic regression models were fitted to estimate adjusted associations between breast cancer survivorship and outcomes.

Results

A total of 356 breast cancer survivors (8.1 years post diagnosis) and 252 women with no prior cancer participated in the study. Compared with non-cancer controls, breast cancer survivors had poorer QoL in the domains of cognitive problems (adjusted β (aβ) = 1.4, p = 0.01), sexual function (aβ = 1.7, p = 0.02) and fatigue (aβ = 1.3, p = 0.01), but no difference in negative feelings, positive feelings, pain, or social avoidance. Breast cancer survivors had higher odds of borderline-probable anxiety (score ≥ 8) (adjusted OR = 1.47, 95%CI:1.15–1.87), but no differences in depression. Advanced stage at diagnosis and chemotherapy treatment were associated with poorer QoL.

Conclusions

Compared with women with no history of cancer, breast cancer survivors report more problems with cognition, sexual function, fatigue, and anxiety, particularly where their cancer was advanced and/or treated with chemotherapy.

Implications for Cancer Survivors

Breast cancer survivors with more advanced disease and/or treated with chemotherapy should be closely monitored and, when possible, offered evidence-based intervention for fatigue, cognitive dysfunction, and sexual problems.
Trends in engineering education for additive manufacturing in the industry 4.0 era: a systematic literature review
Authors: Motyl Barbara , Filippi Stefano
Published: October 2020

Additive manufacturing represents one of the most promising and innovative technologies of the moment. In fact, it is considered among the nine technological pillars on which Industry 4.0 is based. In particular, it has received a lot of interest from industries, educational institutions and government agencies. For these reasons, it is necessary to develop and train a specialised workforce and to prepare it for these new opportunities. This work aims to investigate, through the completion of a survey based on a systematic review of the literature, the current state of education and dissemination of educational practices related to the training of young engineers at university on the issues of additive manufacturing and related to Industry 4.0. The results show that the introduction of additive manufacturing education represents an important leverage in the preparation of young engineers who benefit from it both in terms of personal preparation and in terms of learning and refining different skills. However, certain aspects, linked to the need to have adequate equipment and a properly trained teaching staff, should not be overlooked.
A two-stage stochastic MILP model for generation and transmission expansion planning with high shares of renewables
Authors: Micheli Giovanni , Vespucci Maria Teresa , Stabile Marco , Puglisi Cinzia , Ramos Andres
Published: October 2020

This paper is concerned with the generation and transmission expansion planning of large-scale energy systems with high penetration of renewable energy sources. Since expansion plans are usually provided for a long-term planning horizon, the system conditions are generally uncertain at the time the expansion plans are decided. In this work, we focus on the uncertainty of thermal power plants production costs, because of the important role they play in the generation and transmission expansion planning by affecting the merit order of thermal plants and the economic viability of renewable generation. To deal with this long-term uncertainty, we consider different scenarios and we define capacity expansion decisions using a two-stage stochastic programming model that aims at minimizing the sum of investment, decommissioning and fixed costs and the expected value of operational costs. To be computationally tractable most of the existing expansion planning models employ a low level of temporal and technical detail. However, this approach is no more an appropriate approximation for power systems analysis, since it does not allow to accurately study all the challenges related to integrating high shares of intermittent energy sources, underestimating the need for flexible resources and the expected costs. To provide more accurate expansion plans for power systems with large penetration of renewables, in our analysis, we consider a high level of temporal detail and we include unit commitment constraints on a plant-by-plant level into the expansion planning framework. To maintain the problem computationally tractable, we use representative days and we implement a multi-cut Benders decomposition algorithm, decomposing the original problem both by year and by scenario. Results obtained with our methodology in the Italian energy system under a 21-year planning horizon show how the proposed model can offer professional guidance and support in strategic decisions to the different actors involved in electricity transmission and generation.