bluuebunny/crossref_metadata_2025 huggingface dataset:
Disordered hemostasis associated with severely depressed fibrinolysis demonstrated using a simultaneous thrombin and plasmin generation assay during L‐asparaginase induction therapy in pediatric acute lymphoblastic leukemia
Authors: Ishihara Takashi , Nogami Keiji , Ochi Satoshi , Ishida Toshiaki , Kosaka Yoshiyuki , Sawada Akihisa , Inoue Masami , Osone Shinya , Imamura Toshihiko , Hosoi Hajime , Shima Midori
Published: September 2019

Background

L‐asparaginase (L‐Asp)‐associated thromboembolisms are serious complications in pediatrics patients with acute lymphoblastic leukemia (ALL), especially at ≥10.0 years old, but the pathogenesis remains to be clarified.

Procedure

We conducted a multicenter, prospective study of 72 patients with ALL aged 1.0 to 15.2 years treated with either a Berlin‐Frankfurt‐Münster (BFM) 95‐ALL oriented regimen or Japan Association of Childhood Leukemia Study ALL‐02 protocol. We divided patients into each treatment protocol and investigated the dynamic changes in coagulation and fibrinolysis using simultaneous thrombin and plasmin generation assay. Patients’ plasma samples were collected at the prephase (T0), intermittent phase (T1), and postphase of L‐Asp therapy (T2), and postinduction phase (T3). Measurements of endogenous thrombin potential (T‐EP) and plasmin peak height (P‐Peak) were compared to normal plasma.

Results

None of the cases developed thromboembolisms. Median ratios of T‐EP and P‐Peak for the controls in the JACLS group were 1.06 and 0.87 (T0), 1.04 and 0.71 (T1), 1.02 and 0.69 (T2), and 1.20 and 0.92 (T3), respectively, while those in the BFM group were 1.06 and 1.00 (T0), 1.04 and 0.64 (T1), 1.16 and 0.58 (T2), and 1.16 and 0.85 (T3), respectively. In particular, P‐Peak ratios were depressed at T1 and T2 compared to T0 in the BFM group (P < .01). Moreover, P‐Peak ratios in patients ≥10.0 years old were lower at T1 in the BFM group (P = .02).

Conclusions

The results demonstrated that hemostatic dynamics appeared to shift to a hypercoagulable state with marked hypofibrinolysis associated with L‐Asp therapy, especially in patients ≥10.0 years old following the BFM regimen.
Disease spectrum analysis of hospitalized children in China: A study of 18 tertiary children's hospitals
Authors: Feng Guoshuang , Zeng Yueping , Tian Jian , Wang Xinyu , Tai Jun , Song Fei , Zhang Xin , Xu Xin , Chen Jun , Shi Tieliu , Ni Xin ,   Futang Research Center of Pediatric Development (FRCPD)
Published: September 2019

Importance

Morbidity and mortality of children are important indicators of the performance of the public health system in any country. In China, the children's disease spectrum has gradually changed in recent years. However, the gender‐ and age‐specific disease spectrum for hospitalized children under 15 years old is still unclear.

Objective

To explore the gender‐ and age‐based distribution of diseases in hospitalized children under 15 years in China.

Methods

Medical records home page data for 2016 to 2018 were collected from 18 tertiary children's hospitals in China. The gender‐ and age‐specific disease spectrum was analyzed, using the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD‐10).

Results

The most common diseases were those of the respiratory system (25.7% of all 2 232 142 hospitalized children). The top three diseases for boys were diseases of the respiratory system (25.6%), diseases of the digestive system (11.4%) and certain conditions originating in the perinatal period (8.6%). The top three diseases for girls were diseases of the respiratory system (25.9%), certain conditions originating in the perinatal period (10.1%), and factors influencing health status and contact with health services (9.4%). The most common diseases for children under 1 year old were certain conditions originating in the perinatal period (38.1%). For all other age groups, the most common conditions were respiratory diseases (33.8% for those aged 1–3 years, 25.2% for those aged 4–6 years, and 12.2% for those aged 7–14 years).

Interpretation

This study analyzed the medical records home pages of 18 children's hospitals to provide the first overview of the disease spectrum and its gender‐ and age‐specific distribution among children in China.
Foreign body ingestion in an infant: A high index of suspicion is required
Authors: Mohamad Ishak Luqman Afiq , Khor Kee Guan , Tan Shi Nee
Published: September 2019

Introduction

The incidence of foreign body ingestion in the upper gastrointestinal tract accounts for 75%–85% of foreign body ingestions in pediatric patients.

Case presentation

An 8‐month old boy presented with vomiting and was referred to the otorhinolaryngology team based on his mother's suspicion that her child might have ingested a foreign body. Flexible laryngoscopy revealed a phone screen protector at the vallecular region. The foreign body was removed in the operating theatre.

Conclusion

Foreign body ingestion should always be suspected in young patients. Consideration of the patient's symptoms, level of lodgement, and type of foreign body will determine whether immediate intervention or a conservative approach is warranted.
Anesthetic management in a 1‐year‐old child undergoing removal of a large metal tracheobronchial foreign body
Authors: Ren Yi , Zhang Jianmin , Xin Zhong
Published: September 2019

Introduction

Pediatric tracheobronchial foreign body aspiration can be a life‐threatening emergency, especially in young children because of their decreased respiratory reserve and smaller‐diameter airways.

Case presentation

We herein present a case in which a 1‐year‐old female child aspirated a 9‐cm long metal chain into the lower trachea and right main bronchus. The chain was removed via low tracheotomy and rigid bronchoscopy under general anesthesia. An intravenous anesthetic alone with a muscle relaxant was used to ensure an immobile airway during surgery instead of the more commonly used inhalation anesthetics with spontaneous ventilation.

Conclusion

The case re‐affirms that the removal of some large and irregular airway foreign bodies is a challenging procedure that requires a proper anesthetic plan and coordination with surgeons.
Clinical outcomes for cystic fibrosis patients with Pseudomonas aeruginosa cross‐infections
Authors: Milczewska Justyna , Wołkowicz Tomasz , Zacharczuk Katarzyna , Mierzejewska Ewa , Kwiatkowska Monika , Walicka‐Serzysko Katarzyna , Sands Dorota
Published: September 2019

Introduction

Pseudomonas aeruginosa cross‐infections are related to increased morbidity and mortality in cystic fibrosis (CF).

Objectives

The aim of the study was to evaluate the incidence of cross‐infections with P. aeruginosa in children with CF.

Methodology

CF patients from whom at least one P. aeruginosa strain had been isolated were included in the study. The strain genotyping was performed using pulse‐field gel electrophoresis. The history of contacts between patients was established based on questionnaires.

Results

The study group consisted of 75 patients (aged 1.0‐19.2 years) and the material included 170 P. aeruginosa strains. Cross‐infections occurred in a group of 26 patients. In this group, the risk of the predicted occurrence of forced expiratory volume in 1 second ≤ 70% was five times greater and the risk of longer cumulative hospitalization time for intravenous antibiotic therapy (>14 days/year) was almost five times greater. In the clonal groups of strains, the multidrug‐resistance rate was significantly higher than in other groups. In 2011, all tested strains were susceptible to colistin, whereas in 2012, three strains from the largest clonal group showed high levels of resistance to colistin.

Conclusion

Cross‐infections with P. aeruginosa occurred in our group of patients and were associated with poor clinical outcomes. Antimicrobial resistance rate in the strains isolated from such infections was significantly higher, and this included three strains resistant to colistin.
A case of a pulmonary mucosa‐associated lymphoid tissue lymphoma with chromosomal aberration (49, XX, +3, +i(6)(p10), +mar)
Authors: Ojima Toshihiro , Homma Takahiro , Shimada Yoshifumi , Kitamura Naoya , Akemoto Yushi , Yoshimura Naoki
Published: September 2019

We report a case of a primary pulmonary mucosa‐associated lymphoid tissue (MALT) lymphoma with chromosomal aberration (49, XX, +3, +i(6)(p10), +mar). A 59‐year‐old woman was referred to our hospital for an abnormal chest shadow detected during a routine health check‐up in 2014. Chest computed tomography revealed a 3.2‐ × 2.3‐ × 2.0‐cm tumour shadow in the right middle lobe. Transbronchial biopsy did not result in the diagnosis of the tumour. Accordingly, as the tumour could have been malignant, right middle lobectomy was performed via video‐assisted thoracic surgery. On the basis of the results of immunohistochemical staining and gene analysis, the tumour was diagnosed as a primary pulmonary MALT lymphoma with chromosomal aberration (49, XX, +3, +i(6)(p10), +mar).
Treatment of airway stenosis with a customized bronchial stent using a three‐dimensional printer and flexible filaments
Authors: Ojima Toshihiro , Kitamura Naoya
Published: September 2019

Stent placement is recommended for patients with airway stenosis. However, ready‐made stents may be difficult to fit over lesioned areas. In the current case report, we describe the creation and placement of a custom stent in an 84‐year‐old woman with airway stenosis. We made a bronchial mould and customized stent with a three‐dimensional printer and flexible filaments. This stent was able to successfully maintain our patient's airway patency.
Cooperative digital magnetic‐elevation maps by small autonomous aerial robots
Authors: Azpúrua Héctor , Potje Guilherme A. , Rezeck Paulo A. F. , Freitas Gustavo M. , Uzeda Garcia Luis G. , Nascimento Erickson R. , Macharet Douglas G. , Campos Mario F. M.
Published: September 2019

One of the steps to provide fundamental data for planning a mining effort is the magnetic surveying of a target area, which is typically carried out by conventional aircraft campaigns. However, besides the high cost, fixed‐wing aerial vehicles present shortcomings especially for drape flights on mountainous regions, where steep slopes are often present. Traditional human‐crewed flights have to perform tedious and dangerous trajectories, under strict velocity and attitude constraints. In this paper, we deal with the problem of accomplishing digital magnetic‐elevation maps using autonomous and cooperative aerial robots. The proposed approach for autonomous mapping utilizes a custom‐built fluxgate sensor and off the shelf cameras adapted for small airborne platforms. We also propose an innovative approach for generating a digital magnetic‐elevation model from the gathered data. Our method was evaluated and validated in field tests in an industrial scenario to detect scrap metals in ore piles. Results show that the proposed method could reliably detect magnetic anomalies while generating accurate three‐dimensional magnetic maps.
Synthesis and Photocatalytic Study of Ferrocenium Ion Incorporated Lacunary Keggin Hybrid Material
Authors: Guru Sruthi , Ranga Rao G.
Published: September 2019

In the present work, we report the synthesis of inorganic‐organic hybrid material of molecular formula
abbreviated as TBAFcPW11. This hybrid material has large surface area (142 m2 g−1) and shows photocatalytic activity due to the synergistic effect of photoexcitation property of polyoxometalate cluster and Fe2+/Fe3+ redox pair. It is a floating hybrid photocatalytic material capable of remediating organic pollutants, rhodamine B and p‐nitrophenol. Optimum conditions for photocatalytic degradation and extent of mineralization have been established by varying the reaction conditions and mineralization studies.
Improved Synthesis, Anticancer Activity and Electrochemical Characterization of Unusual Zwitterionic Palladium Compounds with a Ten‐Term Coordinative Ring.
Authors: Scattolin Thomas , Moro Giulia , Rizzolio Flavio , Santo Claudio , Moretto Ligia Maria , Visentin. Fabiano
Published: September 2019

A new improved synthetic protocol for the preparation of uncommon zwitterionic palladium(II) complexes with a ten‐term coordinative ring is reported. A suitable combination of reaction solvent and temperature allows to drastically reduce the reaction time and increase the yield. A detailed kinetic study, implemented by theoretical DFT calculations, clarifies and quantifies this solvent effect. The antiproliferative activity of the synthesized complexes was tested toward eight different cancer cell lines. The mesityl derivative showed potent and selective cytotoxicity toward several types of cancer cell lines, with IC50 values lower than cisplatin. Additionaly, the anticancer activity against cisplatin‐sensitive and cisplatin‐resistant ovarian cancer cells suggested a different mechanism of action with respect to traditional platinum chemotherapeutics. Aiming to easily determine these promising metallo‐drugs, a voltammetric study of their electrochemical fingerprint was carried out. For both compounds a suitable signal, ascribed to the reduction of the metallic center from palladium(II) to palladium(0), was identified and further investigated by Differential Pulse Voltammetry.
DFT Quantum Chemical Studies on Structural, Nonlinear Optical, Reactivity and Thermodynamic Properties of 4‐Methoxy‐2‐{(E)‐[(thiophen‐2‐yl)ethylimino]methyl}phenol
Authors: Tanak Hasan
Published: September 2019

The molecular structure of 4‐Methoxy‐2‐{(E)‐[(thiophen‐2‐yl)methylimino]methyl}phenol was optimized using the PBEPBE, B3PW91 and B3LYP methods with the 6–311++G(d,p) basis set and compared to experimental X‐ray data. Density functional computations of the interaction energies, molecular electrostatic potential, and thermodynamic functions have been carried out using the B3LYP method with the 6–311++G(d,p) basis set for the title molecule. The chemical reactivity behaviors of the tautomeric forms of the compound were analyzed at the B3LYP/6‐311++G(d,p) level. Additionally, the solvent effects have been investigated with the integral equation formalism polarizable continuum model. The dipole moment, first hyperpolarizability and linear polarizability values of the tautomeric forms of the compound were computed using the B3LYP/6‐311++G(d,p) method. The changes of the entropy, enthalpy and Gibbs free energy for the formation reaction of the compound have been predicted in different temperature utilizing the statistical thermodynamical technique.
Rapid and Low‐Temperature Salt‐Templated Production of 2D Metal Oxide/Oxychloride/Hydroxide
Authors: Gu Jianan , Zhang Chao , Du Zhiguo , Yang Shubin
Published: September 2019

2D materials have played an important role in electronics, sensors, optics, electrocatalysis, and energy storage. Many methods for the preparation of 2D materials have been explored. It is crucial to develop a high‐yield, rapid, and low‐temperature method to synthesize 2D materials. A general, fast (5 min), and low‐temperature (≈100 °C) salt (CoCl2·6H2O)‐templated method is proposed to prepare series of 2D metal oxides/oxychlorides/hydroxides in large scale, such as MoO3, SnO2, SiO2, BiOCl, Sb4O5Cl2, Zn2Co3(OH)10 2H2O, and ZnCo2O4. The as‐synthesized 2D materials possess an ultrathin feature (2–7 nm) and large aspect ratios. Additionally, these 2D metal oxides/oxychlorides/hydroxides exhibit good electrochemical properties in energy storage (lithium/sodium‐ion batteries) and electrocatalysis (hydrogen/oxygen evolution reaction).
An experimental study on the influence of zeolite on changes of pH and alkalinity in anaerobic treatment of compost leachate
Authors: Pirsaheb Meghdad , Hossaini Hiwa , Amini Jila
Published: September 2019

With the increase of urbanization, municipal solid waste has also increased. Therefore, the need for solid waste management is also increasing compared with earlier decades. Composting is a good option for the recycling of solid waste; however, it produces leachate, which requires proper treatment systems to prevent environmental degradation. Due to high chemical oxygen demand (COD) concentrations in compost leachate, anaerobic treatment is the best option for handling the effluent, and an anaerobic baffled reactor (ABR) is one such anaerobic reactor that can be used for its treatment. Because of high ammonia and heavy metal concentrations, as well as the possibility of sludge washout in ABRs, it is important to use proper media, such as zeolite, which can reduce inhibition effects and sludge washout from the reactor. Anaerobic treatment, especially during the methanogenesis phase, is sensitive, and pH and alkalinity are parameters that influence the treatment. Therefore, adjusting these parameters within a normal range is very important to the proper functioning of anaerobic systems. In this study, a pilot‐scale ABR was used, and the last 4 of the 8 ABR compartments were filled with zeolite. The bioreactor was operated at hydraulic retention times (HRT) of 3, 4, and 5 days, with zeolite filling ratios of 10%, 20%, and 30%, and influent COD concentrations of 10,000, 20,000, and 30,000 milligrams per liter (mg/L). In this study, pH value was 6.43 ± 0.1, 6.96 ± 0.3, and 6.96 ± 0.25 at filling ratios of 10%, 20%, and 30%, respectively. According to the results, in all filling ratios, no significant changes were observed in the pH value when the organic loading rate increased and its amount was within a constant range. Influent alkalinity was equal to 2015 ± 510, 2884 ± 505, and 4154 ± 233 milligrams of calcium carbonate per liter (mg CaCO3/L) at influent COD concentrations of 10,000, 20,000, and 30,000 mg/L, respectively, and in effluent, they were 2536 ± 336, 3379 ± 639, and 4377 ± 325 mg CaCO3/L, respectively. The amount of alkalinity in the effluent increased compared with the alkalinity in the influent. The results show that the amount of alkalinity in the influent and effluent was similar, and the alkalinity enhancement was lower when the filling ratio was increased from 10% to 20%, and 20% to 30%. Comparisons of the results from zeolite with and without biofilm showed that, in cases of zeolite with biofilm, the amounts of silica and oxygen decreased and the amount of carbon increased, and it showed the formation of biofilm on the surface of zeolite. In addition, the absence of sodium in the zeolite with the biofilm indicated that sodium was exchanged with ammonium ions. According to the results, zeolite can be used in anaerobic reactors as a medium, and it also reduces fluctuations in pH and alkalinity at different organic loading rates, providing a normal range for anaerobic treatment.
Response surface methodology mediated optimization of Indanthrene Blue RS by a novel isolated bacterial strain Bacillus flexus TS8
Authors: Mohanty Swati Sambita , Kumar Arvind
Published: September 2019

The enhanced decolorization and detoxification of Indanthrene Blue RS dye, under aerobic conditions, by a novel isolated anthraquinone‐degrading bacterium, Bacillus flexus TS8, has been presented in this paper. The optimal decolorization conditions were determined by response surface methodology based on Box–Behnken design. The results indicated that the strain TS8 possessed the highest decolorization efficacy at pH 10.26, temperature 30.97 ºC and an inoculum size of 10.48% (v/v). It also revealed that about 98.01% of 100 mg/L of Indanthrene Blue RS could be decolorized within 24 hr under these optimized conditions. The subsequent degradation of the dye and the formation of metabolites were studied using analytical techniques such as UV‐Vis spectroscopy, FTIR, and ESI/LC‐MS analysis. The UV‐Vis analysis of the colorless bacterial cells demonstrated that Bacillus sp. TS8 possessed this decolorizing activity through biodegradation. The degraded products obtained from ESI/LC‐MS analysis were identified as 1‐hydroxyanthracene‐9, 10‐dione (m/z‐224), 1, 4‐di‐hydroxyanthracene‐9, 10‐dione (m/z‐240), and phthalic acid (m/z‐168). This study investigated the highest decolorization efficacy of strain TS8 to be utilized in the biological treatment of wastewaters containing anthraquinone dyes.

Practitioner points

Enhanced decolorization of anthraquinone dye wastewater.

Ninety‐eight percentage of dye decolorization was obtained within 24 hr.

Optimization of process parameters through the response surface methodology.

ESI/LC‐MS analysis identified phthalic acid as the end product of Indanthrene Blue RS degradation.

Degradation pathway for Indanthrene Blue RS is outlined.
European maize landraces made accessible for plant breeding and genome-based studies
Authors: Hölker Armin C. , Mayer Manfred , Presterl Thomas , Bolduan Therese , Bauer Eva , Ordas Bernardo , Brauner Pedro C. , Ouzunova Milena , Melchinger Albrecht E. , Schön Chris-Carolin
Published: September 2019

Key message

Doubled-haploid libraries from landraces capture native genetic diversity for a multitude of quantitative traits and make it accessible for breeding and genome-based studies.

Maize landraces comprise large allelic diversity. We created doubled-haploid (DH) libraries from three European flint maize landraces and characterized them with respect to their molecular diversity, population structure, trait means, variances, and trait correlations. In total, 899 DH lines were evaluated using high-quality genotypic and multi-environment phenotypic data from up to 11 environments. The DH lines covered 95% of the molecular variation present in 35 landraces of an earlier study and represent the original three landrace populations in an unbiased manner. A comprehensive analysis of the target trait plant development at early growth stages as well as other important agronomic traits revealed large genetic variation for line per se and testcross performance. The majority of the 378 DH lines evaluated as testcrosses outperformed the commercial hybrids for early development. For total biomass yield, we observed a yield gap of 15% between mean testcross yield of the commercial hybrids and mean testcross yield of the DH lines. The DH lines also exhibited genetic variation for undesirable traits like root lodging and tillering, but correlations with target traits early development and yield were low or nonsignificant. The presented diversity atlas is a valuable, publicly available resource for genome-based studies to identify novel trait variation and evaluate the prospects of genomic prediction in landrace-derived material.
New insight into the mechanisms protecting bacteria during desiccation
Authors: Laskowska Ewa , Kuczyńska-Wiśnik Dorota
Published: September 2019

Desiccation is a common stress that bacteria face in the natural environment, and thus, they have developed a variety of protective mechanisms to mitigate the damage caused by water loss. The formation of biofilms and the accumulation of trehalose and sporulation are well-known strategies used by bacteria to survive desiccation. Other mechanisms, including intrinsically disordered proteins and the anti-glycation defence, have been mainly studied in eukaryotic cells, and their role in bacteria remains unclear. We have recently shown that the impairment of trehalose synthesis results in higher glucose availability, leading to the accumulation of acetyl phosphate and enhanced protein acetylation, which in turn stimulates protein aggregation. In the absence of trehalose synthesis, excess glucose may stimulate non-enzymatic glycosylation and the formation of advanced glycation end products (AGEs) bound to proteins. Therefore, we propose that trehalose may prevent protein damage, not only as a chemical chaperone but also as a metabolite that indirectly counteracts detrimental protein acetylation and glycation.
Diagnosing Coherent Structures in the Convective Boundary Layer by Optimizing Their Vertical Turbulent Scalar Transfer
Authors: Efstathiou Georgios A. , Thuburn John , Beare Robert J.
Published: September 2019

A new method is introduced to identify coherent structures in the convective boundary layer, based on optimizing the vertical scalar flux in a two-fluid representation of turbulent motions as simulated by a large-eddy simulation. The new approach partitions the joint frequency distribution (JFD) of the vertical velocity and a transported scalar into coherent structures (fluid 2) and their environment (fluid 1) by maximizing that part of the scalar flux resolved by the mean properties in fluid 2 and fluid 1. The proposed method does not rely on any a priori criteria for the partitioning of the flow nor any pre-assumptions about the shape of the JFD. Different flavours of the optimization approach are examined based on maximizing either the total (fluid 1 $$+$$+ fluid 2) or the fluid-2 resolved scalar flux, and on whether all possible partitions or only a subset are considered. These options can result in different derived area fractions for the coherent structures. The properties of coherent structures diagnosed by the optimization method are compared to the conditional sampling of a surface-emitted decaying tracer, in which coherent structures are defined as having tracer perturbation greater than some height-dependent threshold. Results show that the optimization method is able to smoothly define coherent thermal structures in both the horizontal and the vertical. Moreover, optimizing the turbulent transfer by the fluid-2 resolved flux produces very similar coherent structures to the tracer threshold method, especially in terms of their area fraction and updraft velocities. Nonetheless, further analysis of the partitioning of the JFD reveals that, even though the area fraction of coherent structures might be similar, their definition can occupy different quadrants of the JFD, implying the contribution of different physical mechanisms to the turbulent transfer in the boundary layer. Finally, the kinematic and thermodynamic characteristics of the coherent structures are examined based on their definition criteria.
Almost‐Maximization as a Behavioral Theory of the Firm: Static, Dynamic and Evolutionary Perspectives
Authors: Dixon Huw
Published: September 2019

In this paper we consider the effect of epsilon maximization on firm behavior. In particular we focus on the dynamic behavior of firms with the use of the example of price‐setting: We show how almost-rational firms can be more volatile in their behavior. However, if a lexicographic preference for simplicity is made, then we can explain nominal price rigidity as a result of epsilon optimization. The behavior of the firm—which is consistent with its long‐term survival—is examined. We argue that epsilon-optimization is consistent with survival in any context in which something is optimized: such as sales revenue.
The Effect of the Polymer Structure in Composite Alumina/Polyetheretherketone Coatings on Corrosion Resistance, Micro-mechanical and Tribological Properties of the Ti-6Al-4V Alloy
Authors: Moskalewicz Tomasz , Zimowski Sławomir , Fiołek Aleksandra , Łukaszczyk Alicja , Dubiel Beata , Cieniek Łukasz
Published: September 2019

This paper describes ways of improving the tribological properties of the Ti-6Al-4V titanium alloy at room and elevated temperatures by electrophoretic deposition of Al2O3/PEEK708 composite coatings and post-heat treatment. The microstructure of the coating components and the coatings was examined by scanning and transmission electron microscopy as well as x-ray diffractometry. The influence of cooling rate after heating of the coated alloy on the PEEK structure and coating surface topography was investigated. It was found that slow cooling with a furnace produced a semi-crystalline structure, whereas fast cooling in water generated an amorphous polymer structure. The semi-crystalline coatings exhibited a more developed surface topography than the amorphous ones. The coatings with a semi-crystalline structure revealed higher scratch resistance than the amorphous ones. The corrosion resistance of the uncoated and coated specimens was examined using electrochemical techniques in a 3.5 wt.% NaCl aqueous solution. Both coatings increased the corrosion resistance of the alloy. The friction and wear properties of the coated specimens against an alumina ball in dry sliding contact at room temperature and elevated temperatures of 150 and 260 °C at ball-on-disk were examined. Both amorphous and semi-crystalline coatings increased the wear resistance and decreased the friction coefficient of the titanium alloy at room temperature. In addition, the semi-crystalline coating was also very effective in improving the titanium alloy’s tribological properties at elevated temperatures. The obtained results clearly show that the composite alumina/PEEK coatings are promising for tribological applications in mechanical engineering.
Associations of Pregnancy Physical Activity with Maternal Cardiometabolic Health, Neonatal Delivery Outcomes and Body Composition in a Biethnic Cohort of 7305 Mother–Child Pairs: The Born in Bradford Study
Authors: Collings Paul J. , Farrar Diane , Gibson Joanna , West Jane , Barber Sally E. , Wright John
Published: September 2019

Objective

Physical activity is advocated for a range of benefits to the uncomplicated pregnancy. We investigated associations of mid-pregnancy physical activity with maternal and neonatal health in white British and Pakistani-origin women from a deprived urban setting.

Methods

The study was performed in 6921 pregnant women (53% Pakistani-origin) who contributed data for 7305 singleton births. At 26–28 weeks gestation, women were grouped into four activity levels (inactive/somewhat active/moderately active/active) based on their self-reported physical activity. Linear regression with robust standard errors was used to calculate adjusted mean differences in health markers between the four groups of physical activity (reference group: inactive).

Results

Three-quarters (74%) of Pakistani-origin women and 39% of white British women were inactive. Trend-tests revealed that more active white British women tended to be less adipose, had lower fasting and postload glucose levels, lower triglyceride concentrations, and their babies were less adipose (smaller triceps and subscapular skinfolds) than less active white British women. Somewhat active Pakistani-origin women exhibited lower triglyceride concentrations and systolic blood pressure, higher high-density lipoprotein cholesterol levels, and their babies were less adipose (smaller mid-upper arm and abdominal circumferences; lower cord-blood leptin concentration) compared to inactive Pakistani-origin women. No associations were observed for gestational age or birth weight.

Conclusions

Physical activity performed mid-pregnancy was beneficially associated with maternal cardiometabolic health and neonatal adiposity, without influencing gestational age or birth weight. Associations were dose-dependent in white British women, and even a small amount of mid-pregnancy physical activity appeared to benefit some health markers in Pakistani-origin women.
Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta‐analysis
Authors: Jia Shanshan , Wei Xiaowei , Ma Ling , Wang Yanfu , Gu Hui , Liu Dan , Ma Wei , Yuan Zhengwei
Published: September 2019

Objective

Neural tube defects [NTDs] are severe congenital anomalies. The etiology of NTDs is not fully known, and studies on the potential risk factors of NTDs present inconsistent results. Thus, we conducted a systematic review and meta‐analysis to investigate the maternal, paternal, and neonatal risk factors for NTDs.

Study design

We systematically reviewed relative original studies published through October 6, 2018 available in Pubmed, Embase and the Cochrane Library without restrictions for language. The selected studies measured maternal, paternal, and neonatal risk factors and examined their associations with NTDs. A meta‐analysis, including subgroup analysis and sensitivity analysis, was conducted to estimate the pooled effect measures. Two reviewers independently extracted data using a predesigned data collection form.

Results

Forty‐five studies were eligible for inclusion in the meta‐analysis, and twelve potential risk factors were analyzed. The factors that were associated with NTDs risk included stressful life events [odds ratio [OR],1.61; 95% confidence interval [CI], 1.24―2.08; p < 0.001; I2 = 59.2%], low maternal education level [OR, 1.42; 95% CI, 1.19―1.70; p < 0.001; I2 = 47.7%], pregestational diabetes [OR, 2.24; 95% CI, 1.21―4.12; p < 0.010; I2 = 56.3%], low paternal age [OR, 1.41; 95% CI, 1.10―1.81; p = 0.007; I2 = 0.0%], low birth weight [OR, 5.53; 95% CI, 1.95―15.70; p = 0.001; I2 = 98.5%], and neonatal female gender [OR, 1.54; 95% CI, 1.10―2.14; p = 0.012; I2 = 67.8%].

Conclusion

Stressful life events, pregestational diabetes, low birth weight, and neonatal female gender are risk factors associated with NTDs. Low maternal education level and low paternal age are factors that are moderately associated with NTDs. Further cohort studies are required to verify the factors associated with NTDs and control the risk of this severe birth defect.
Self-Efficacy Mediates the Attachment-Pain Association in Couples with Provoked Vestibulodynia: A Prospective Study
Authors: Charbonneau-Lefebvre Véronique , Vaillancourt-Morel Marie-Pier , Brassard Audrey , Steben Marc , Bergeron Sophie
Published: September 2019

Introduction

Attachment influences the way individuals anticipate, react, and seek support when faced with chronic pain. Although cross-sectional research indicates that attachment insecurity and pain self-efficacy are associated with pain intensity in chronic pain populations, little is known about their long-term effects on pain, and about the directionality of associations between these constructs. Furthermore, whereas attachment is a relational concept, few studies on genito-pelvic pain have espoused a couples’ perspective.

Aim

Using a prospective dyadic design, the present study aimed to examine the directionality of the associations among attachment dimensions, pain self-efficacy, and pain intensity in couples coping with provoked vestibulodynia (PVD). A second aim was to test whether pain self-efficacy mediated the attachment-pain association.

Methods

213 couples coping with PVD completed self-report questionnaires at baseline (T1) and at a 2-year follow-up (T2).

Main Outcome Measure

(1) Experiences in Close Relationships – Revised; (2) Painful Intercourse Self-Efficacy Scale; and (3) 10-point Numerical Rating Scale for pain intensity.

Results

Autoregressive cross-lagged models revealed that women’s greater attachment anxiety and avoidance at T1 predicted their greater pain intensity at T2. Women’s greater attachment anxiety at T1 predicted their poorer pain self-efficacy at T2, and poorer pain self-efficacy in women at T1 predicted their higher pain intensity at T2. A mediation model showed that women’s lower pain self-efficacy at T2 fully mediated the association between women’s higher attachment anxiety at T1 and their higher pain intensity at T2. Partners’ attachment dimensions did not predict their own or women’s pain self-efficacy nor pain intensity.

Clinical Implications

Results suggest that greater attachment anxiety may contribute to women with PVD’s lower confidence that they can manage their pain, which leads to long-term persistent pain. This study highlights the importance of assessing attachment and pain self-efficacy in women with genito-pelvic pain and to consider interventions targeting these variables, as they have far-reaching consequences.

Strength & Limitations

The use of longitudinal and dyadic data inform interpersonal processes and the long-term implications of attachment and pain self-efficacy in PVD. The use of self-report measures may introduce a social desirability and recall bias.

Conclusion

This prospective dyadic study adds to a body of literature on PVD and chronic pain by empirically supporting theoretical models on attachment, pain self-efficacy, and persistent pain, and supports the role of psychosocial factors in the adjustment to PVD.
Black Markets
Authors: Goodwin Michele
Published: September 2019

In America, in direct response to indefinite delays on the national transplantation waitlists and an inadequate supply of organs, a growing number of terminally ill Americans are turning to international underground markets and coordinators or brokers for organs. Chinese inmates on death-row and the economically disadvantaged in India and Brazil are the often compromised co-participants in the private negotiation process, which occurs outside the legal process - or in the shadows of law. These individuals supply kidneys and other organs for Americans and other Westerners willing to shop and pay in the private process. This book contends that exclusive reliance on the present altruistic tissue and organ procurement processes in the United States is not only rife with problems, but also improvident. The author explores how the altruistic approach leads to a 'black market' of organs being harvested from Third World individuals as well as compelled donations from children and incompetent persons.
Novel morphing wing actuator control-based Particle Swarm Optimisation
Authors: Khan S. , Grigorie T. L. , Botez R. M. , Mamou M. , Mébarki Y.
Published: September 2019

The paper presents the design and experimental testing of the control system used in a new morphing wing application with a full-scaled portion of a real wing. The morphing actuation system uses four similar miniature brushless DC (BLDC) motors placed inside the wing, which execute a direct actuation of the flexible upper surface of the wing made from composite materials. The control system of each actuator uses three control loops (current, speed and position) characterised by five control gains. To tune the control gains, the Particle Swarm Optimisation (PSO) method is used. The application of the PSO method supposed the development of a MATLAB/Simulink® software model for the controlled actuator, which worked together with a software sub-routine implementing the PSO algorithm to find the best values for the five control gains that minimise the cost function. Once the best values of the control gains are established, the software model of the controlled actuator is numerically simulated in order to evaluate the quality of the obtained control system. Finally, the designed control system is experimentally validated in bench tests and wind-tunnel tests for all four miniature actuators integrated in the morphing wing experimental model. The wind-tunnel testing treats the system as a whole and includes, besides the evaluation of the controlled actuation system, the testing of the integrated morphing wing experimental model and the evaluation of the aerodynamic benefits brought by the morphing technology on this project. From this last perspective, the airflow on the morphing upper surface of the experimental model is monitored by using various techniques based on pressure data collection with Kulite pressure sensors or on infrared thermography camera visualisations.
Simulation-based research in emergency medicine in Canada: Priorities and perspectives
Authors: Chaplin Timothy , Thoma Brent , Petrosoniak Andrew , Caners Kyla , McColl Tamara , Forristal Chantal , Dakin Christa , Deshaies Jean-Francois , Raymond-Dufresne Eliane , Fotheringham Mary , Ha David , Holm Nicole , Huffman James , Lonergan Ann-Marie , Mastoras George , O'Brien Michael , Paradis Marie-Rose , Sowers Nicholas , Stern Errol , Hall Andrew K.
Published: September 2019

Objective

Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM).

Methods

Simulation-leads from Canadian departments or divisions of EM associated with a general FRCP-EM training program surveyed and documented active EM simulation-based research at their institutions and identified the perceived facilitators and barriers. Priorities for simulation-based research were generated by simulation-leads via a second survey; these were grouped into themes and finally endorsed by consensus during an in-person meeting of simulation leads. Priority themes were also reviewed by senior simulation educators.

Results

Twenty simulation-leads representing all 14 invited institutions participated in the study between February and May, 2018. Sixty-two active, simulation-based research projects were identified (median per institution = 4.5, IQR 4), as well as six common facilitators and five barriers. Forty-nine priorities for simulation-based research were reported and summarized into eight themes: simulation in competency-based medical education, simulation for inter-professional learning, simulation for summative assessment, simulation for continuing professional development, national curricular development, best practices in simulation-based education, simulation-based education outcomes, and simulation as an investigative methodology.

Conclusion

This study summarized simulation-based research activity in EM in Canada, identified its perceived facilitators and barriers, and built national consensus on priority research themes. This represents the first step in the development of a simulation-based research agenda specific to Canadian EM.
KL2 mentored career development programs at clinical and translational science award hubs: Practices and outcomes
Authors: Sorkness Christine A. , Scholl Linda , Fair Alecia M. , Umans Jason G.
Published: September 2019

Introduction:

NIH Clinical and Translational Science Awards (CTSAs) include KL2 mentored career development awards for faculty commencing clinical and translational research. A survey of KL2 leaders revealed program practices, curricular elements and compelling data about scholar characteristics and outcomes.

Methods:

We conducted a literature review, framed the survey construct, and obtained input from across the CTSA consortium. A REDCap survey was emailed in fall 2016 to 61 active programs.

Results:

Fifty-five programs (90.2%) responded. Respondents had been funded from 3 to 11 years, including 22 “mature” hubs funded for ≥8 years. Program cohort sizes were 56% “small”, 22% “medium”, and 22% “large.” Hubs offer extensive competency-aligned training opportunities relevant to clinical and translational research, including graduate degrees, mentorship, and grant-writing. Seventy-two percent of hubs report parallel “KL2-equivalent” career development programs. All hubs share their training and facilitate intermingling with other early stage investigators. A total of 1,517 KL2 scholars were funded. KL2 awardees are diverse in their disciplines, research projects, and representation; 54% are female and 12% self-identified as underrepresented in biomedical research. Eighty-seven percent of scholars have 2–3 mentors and are currently supported for 2–3 years. Seventy-eight percent of alumni remain at CTSA institutions in translational science. The most common form of NIH support following scholars’ KL2 award is an individual career development award.

Conclusions:

The KL2 is a unique career development award, shaped by competency-aligned training opportunities and interdisciplinary mentorship that inform translational research pathways. Tracking both traditional and novel outcomes of KL2 scholars is essential to capture their career trajectories and impact on health.
Composting and computing: On digital security compositions
Authors: Bellanova Rocco , González Fuster Gloria
Published: September 2019

Making sense of digital security practice requires grasping how data are put to use to compose the governing of individuals. Data need to be understood in their becoming, and in their becomingsomethingacross diverse practices. To do this, we suggest embracing two conceptual tropes that jointly articulate the being together of, and in, data compositions:compostingandcomputing. With composting, we approach data as lively entities, and we explore the decaying and recycling processes inside Big Data security. With computing, we approach data as embodied and embodying elements, and we unpack the surveillance of ‘asylum speakers’. Together, composting and computing challenge recurrent images of data. Our conceptual composition takes sound as a necessary sensory counterpoint to popular data visions, notably in light of Ryoji Ikeda's artworks.
Antimicrobial activity of a continuously active disinfectant against healthcare pathogens
Authors: Rutala William A. , Gergen Maria F. , Sickbert-Bennett Emily E. , Anderson Deverick J. , Weber David J. ,   for the CDC Prevention Epicenters Program
Published: September 2019

A novel disinfectant studied using an EPA protocol demonstrated sustained antimicrobial activity (ie, 3–5 log10 reduction) in 5 minutes after 24 hours for Staphylococcus aureus, vancomycin-resistant Enterococcus, Candida auris, carbapenem-resistant Escherichia coli and antibiotic-susceptible E. coli, and Enterobacter spp. Only ∼2 log10 reduction occurred with carbapenem-resistant Enterobacter spp and K. pneumoniae, and antibiotic-susceptible K. pneumoniae.
Needlestick and sharps injuries in orthopedic surgery residents and fellows
Authors: Snavely Joseph E. , Service Benjamin C. , Miller Daniel , Langford Joshua R. , Koval Kenneth J.
Published: September 2019

Objective:

Needlestick and sharps injury (NSSI) is a common occupational hazard of orthopedic surgery training. The purpose of this study was to examine the incidence and surrounding circumstances of intraoperative NSSI in orthopedic surgery residents and fellows and to examine postexposure reporting.

Design:

A 35-question cross-sectional survey.

Setting:

The study was conducted by orthopedic surgery residents and faculty at a nonprofit regional hospital.

Participants:

The questionnaire was distributed to US allopathic orthopedic surgery residency and fellowship programs; 300 orthopedic surgery trainees participated in the survey.

Results:

Of 223 trainees who had completed at least 1 year of residency, 172 (77.1%) sustained an NSSI during residency, and 57 of 63 trainees (90.5%) who had completed at least 4 years sustained an NSSI during residency. The most common causes of NSSI were solid needles, followed by solid pins or wires. The surgical activity most associated with NSSI was wound closure, followed by fracture fixation. The type of surgery most frequently associated with NSSI was orthopedic trauma, followed by hip and knee arthroplasty. Of 177 trainees who had sustained a prior NSSI, 99 (55.9%) failed to report all events to their institution’s occupational health department.

Conclusions:

The incidence of NSSI during residency training is high, with >90% of trainees in their fifth year or later of training having received an injury during their training, with a mean of >4 separate events. Most trainees with an NSSI did not report all of their events, which implies that changes are needed in the incident reporting process universally.