bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronary artery calcium scoring: an evidence‐based guide for primary care physicians
Authors: Cheong B. Y. C. , Wilson J. M. , Spann S. J. , Pettigrew R. I. , Preventza O. A. , Muthupillai R.
Published: October 2020

Primary care physicians often must decide whether statin therapy would be appropriate (in addition to lifestyle modification) for managing asymptomatic individuals with borderline or intermediate risk for developing atherosclerotic cardiovascular disease (ASCVD), as assessed on the basis of traditional risk factors. In appropriate subjects, a simple, noninvasive measurement of coronary artery calcium can help clarify risk. Coronary atherosclerosis is a chronic inflammatory disease, with atherosclerotic plaque formation involving intimal inflammation and repeated cycles of erosion and fibrosis, healing and calcification. Atherosclerotic plaque formation represents the prognostic link between risk factors and future clinical events. The presence of coronary artery calcification is almost exclusively an indication of coronary artery disease, except in certain metabolic conditions. Coronary artery calcification can be detected and quantified in a matter of seconds by noncontrast electrocardiogram‐gated low‐dose X‐ray computed tomography (coronary artery calcium scoring [CACS]). Since the publication of the seminal work by Dr. Arthur Agatston in 1990, a wealth of CACS‐based prognostic data has been reported. In addition, recent guidelines from various professional societies conclude that CACS may be considered as a tool for reclassifying risk for atherosclerotic cardiovascular disease in patients otherwise assessed to have intermediate risk, so as to more accurately inform decisions about possible statin therapy in addition to lifestyle modification as primary preventive therapy. In this review, we provide an overview of CACS, from acquisition to interpretation, and summarize the scientific evidence for and the appropriate use of CACS as put forth in current clinical guidelines.
Microbiological Profile and Human Immune Response Associated with Peri‐Implantitis: A Systematic Review
Authors: Kensara Anmar , Hefni Eman , Williams Mary Ann , Saito Hanae , Mongodin Emmanuel , Masri Radi
Published: October 2020

Purpose

To evaluate and synthesize the existing evidence on the microbiological and human immune response associated with peri‐implantitis in comparison to healthy implants.

Materials and methods

Three electronic databases (MEDLINE, Embase, and Cochrane Library) were searched in October 2019 to identify clinical studies evaluating the microbiota and the immune response associated with peri‐implantitis. Two reviewers independently screened the studies and used the full text to extract the data. A qualitative synthesis was performed on the extracted data and summary tables were prepared. Due to clinical and methodological heterogeneity among included studies, no meta‐analysis was performed.

Results

Forty studies were included in this review. Of these, 20 studies compared the microbiological profile of peri‐implantitis with healthy implants. Nineteen studies focused on the immune response associated with peri‐implantitis in comparison to healthy implants. Three studies focus on gene polymorphism associated with peri‐implantitis. The most commonly reported bacteria associated with peri‐implantitis were obligate anaerobe Gram‐negative bacteria (OAGNB), asaccharolytic anaerobic Gram‐positive rods (AAGPRs), and other Gram‐positive species. In regard to immune response, the most frequently reported pro‐inflammatory mediators associated with peri‐implantitis were IL‐1β, IL‐6, IL‐17, TNF‐α. Osteolytic mediator, e.g., RANK, RANKL, Wnt5a and proteinase enzymes, MMP‐2, MMP‐9, and Cathepsin‐K were also expressed at higher level in peri‐implantitis sites compared to control.

Conclusions

Peri‐implantitis is associated with complex and different microbiota than healthy implants including bacteria, archaea, fungi, and virus. This difference in the microbiota could provoke higher inflammatory response and osteolytic activity. All of this could contribute to the physiopathology of peri‐implantitis.
Lyophilized platelets versus cryopreserved platelets for management of bleeding in thrombocytopenic dogs: A multicenter randomized clinical trial
Authors: Goggs Robert , Brainard Benjamin M. , LeVine Dana N. , Calabro Janine , Harrell Karyn , Mills Tracy , Stone Richard , Davidson Benjamin , Iacovetta Christine , Harris Lauren , Gicking John , Aslanian Mary , Ziegler Ashley , Fulcher Brenda , Lightfoot Teresa , Miller Meredith , Loftus John , Walton Rebecca , Blong April , Kishbaugh Jennifer , Hale Anne S.
Published: October 2020

Background

Thrombocytopenia in dogs is common in critical care medicine, but availability of fresh platelet concentrates in veterinary medicine can be limiting. Lyophilized platelets have long shelf‐lives and can be easily transported, stored, and administered in various settings.

Objective

To evaluate the efficacy and safety of a novel trehalose‐stabilized canine lyophilized platelet product in thrombocytopenic dogs with clinically‐evident bleeding.

Animals

Eighty‐eight dogs with platelet counts <50 × 103/μL and a standardized bleeding assessment tool (DOGiBAT) score ≥2.

Methods

Multicenter, randomized, non‐blinded, non‐inferiority clinical trial comparing dimethyl sulfoxide (DMSO)‐stabilized cryopreserved platelet concentrates (CPP) with trehalose‐stabilized lyophilized platelets (LP) for control of bleeding in thrombocytopenic dogs. Dogs were randomized to receive 3 × 109 platelets/kg of LP or CPP. Primary outcome measures were change in DOGiBAT score, platelet count, need for additional red cell transfusion and all‐cause mortality.

Results

Fifty dogs received LP and 38 received CPP. Baseline demographics and clinical characteristics of both groups were comparable. At 1‐hour post‐transfusion, LP were superior for change in DOGiBAT score, and non‐inferior at 24‐hours post‐transfusion. The LP were non‐inferior to CPP for change in platelet count, need for additional red blood cell units, and survival to discharge. The LP were superior for change in hematocrit at 1‐hour post‐transfusion, and non‐inferior at 24‐hours. No adverse effects were noted in either group.

Conclusions and Clinical Importance

A novel trehalose‐stabilized canine LP product appears to be logistically superior and is clinically non‐inferior to DMSO‐stabilized canine CPP for management of bleeding in thrombocytopenic dogs.
Composing print essays versus composing across modes: students' multimodal choices and overall preferences
Authors: Chen Cheryl Wei‐yu
Published: October 2020

The current study presents results from students' engagement of composing print essays and composing across modes on the same topic. It builds on the premise that print‐based reading and writing should complement and coexist with multimodal pedagogy. A group of Taiwanese adolescent students were invited to complete one print essay and one multimodal product on the same topic of “My favorite place in the world”. For their multimodal product, students were required to use at least two modes (e.g. words and image, sounds and words) in any medium (e.g. video, collage, scrapbook or website) of their choice. It was found that the most frequently used medium for students' multimodal projects was video which incorporated words, sounds and visuals. Most students felt that for the topic of “My favorite place in the world”, their multimodal products helped them to convey their ideas better because they provided the audience with more sensory information. To conclude the paper, a few future research directions are outlined to help move the research of multimodal composing forward.
An Undergraduate Student‐Led Neuroscience Outreach Program Shows Promise in Shifting Teen Attitudes About Drugs
Authors: Lichtenberg Nina T. , Thompson Andrew B. , Iguchi Martin Y. , Evans Christopher J. , Romero‐Calderón Rafael
Published: October 2020

Drug Outreach, Promoting Awareness (DOPA) is an undergraduate outreach program for local high school students designed to convey the neurobiological basis, risks, and addictive potential of commonly abused drugs. Here we describe DOPA and evaluate the program, including its impact on high school student attitudes about drug harm risk and addiction. Undergraduate neuroscience students versed in the neurobiology, physiology, and policy of drugs are trained in active learning methods, enabling them to create engaging and interactive classroom‐based educational materials. Survey results showed that participation in DOPA increased high school student perceptions of the addictive potential and harm risk of drugs, which studies have shown to be inversely correlated with drug‐taking. High school students also responded positively to the interactive nature of the program. These findings demonstrate how extensively trained undergraduates who are close peers to high school students can effectively lead science outreach initiatives and shift adolescent attitudes about drugs.
Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid
Authors: Sharma Priya , Yadlapati Rena
Published: October 2020

Gastroesophageal reflux disease (GERD) is a disorder due to the retrograde flow of refluxate into the esophagus. Although GERD is a common clinical diagnosis, its pathogenesis is quite complex. As a result of its multifactorial development, many patients continue to experience adverse symptoms due to GERD despite prolonged acid suppression with proton pump inhibitor therapy. The pathogenesis of GERD involves an interplay of chemical, mechanical, psychologic, and neurologic mechanisms, which contribute to symptom presentation, diagnosis, and treatment. As such, GERD should be approached as a disorder beyond acid. This review will investigate the major factors that contribute to the development of GERD, including factors related to the refluxate, esophageal defenses, and factors that promote pathologic reflux into the esophagus. In reviewing GERD pathogenesis, this paper will highlight therapeutic advances, with mention of future opportunities of study when approaching GERD.
The Use of Autologous Iliotibial Band With Gerdy's Tubercle for Irreparable Rotator Cuff Tears
Authors: Zhuo Hongwu , Zhu Fugui , Pan Ling , Li Jian
Published: October 2020

Objective

To determine the radiographic and functional outcomes after autologous iliotibial band with Gerdy's tubercle (ITB‐GT) interposition in patients with irreparable rotator cuff tears (IRCTs).

Methods

From December 2015 to March 2017, a total of 16 patients who underwent autologous ITB‐GT interposition for IRCTs were identified, including 4 males and 12 females. The mean age was 56.1 ± 10.3 years (range, 44–67 years). Functional assessment consisted of active range of motion (ROM), Visual Analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant–Murley score, and patient satisfaction rate. The tendon integrity and acromiohumeral interval (AHI) were assessed by postoperative magnetic resonance imaging (MRI).

Results

The mean duration of follow‐up was 25.3 ± 3.5 months. At final follow‐up, the patients exhibited significantly improved forward elevation, external rotation, and internal rotation (75.00° ± 13.16° to 159.37° ± 8.51°, t = 26.71, P = 0.001; 17.81° ± 11.54° to 35.31° ± 8.26°, t = 6.57, P = 0.001; 2 to 11, t = 13.10, P = 0.001). Other functional outcomes as measured by VAS score, ASES score, and Constant–Murley score also improved significantly (6.50 ± 1.41 to 1.06 ± 0.93, t = 11.68, P = 0.001; 38.50 ± 8.68 to 81.75 ± 6.80, t = 15.42, P = 0.001; 32.50 ± 8.53 to 77.12 ± 6.72, t = 17.28, P = 0.001). The overall satisfaction rate was 87.5%. The postoperative MRI showed that the tendon integrity was fully intact in 14 patients and partially intact in two patients. The AHI improved significantly from 3.63 ± 1.25 mm preoperatively to 8.37 ± 1.02 mm postoperatively (t = 11.78, P = 0.001).

Conclusion

Autologous ITB‐GT interposition was a useful treatment option for patients with IRCTs, which resulted in significant improvements in active ROM, subjective functional outcomes, and AHI with excellent tendon integrity at a minimum 2‐year follow‐up.
Psychoeducational intervention on burden and emotional well‐being addressed to informal caregivers of people with dementia
Authors: Frias Cindy E. , Risco Ester , Zabalegui Adelaida
Published: October 2020

Background

In dementia it is necessary that a family member become an informal caregiver. This labour has social, physical and emotional repercussions on the caregiver's health. The objective was to assesses the impact of the INFOSA‐DEM intervention on burden and emotional well‐being among caregivers of people with dementia, evaluating the effects at 3 and 6 months.

Method

We adopted an experimental, non‐randomised design with an intervention group and a control group. The intervention group received the intervention and the control group received usual care. The study was carried out in the catchment areas of three centres specialising in the care of people with cognitive impairment in the province of Barcelona.

Results

At 3 months, there was an improvement with respect to burden in the intervention group with a significant worsening (P < 0.012) in the control group. Similarly, a positive effect on emotional well‐being was observed in the intervention group compared with a small negative effect among controls.

Conclusions

Programs addressed to informal caregivers based on psychoeducational and cognitive‐behavioural therapies are effective in improving quality of life and emotional well‐being, and in reducing burden, with a positive effect on the quality of care provided at home.
The Effectiveness of a Large‐Scale Flood Risk Awareness Campaign: Evidence from Two Panel Data Sets
Authors: Osberghaus Daniel , Hinrichs Hendrik
Published: October 2020

In the context of integrated flood risk management, governments and public agencies aim to strengthen flood risk reduction and insurance at the household level. They often employ awareness campaigns in order to educate the public about flood risk and possible coping strategies. However, the effectiveness of these awareness campaigns has hardly been examined empirically, and the available analyses come to ambiguous conclusions. Evaluations based on longitudinal data of actual household behavior are missing. In this study, we perform two independent empirical analyses to assess whether a large‐scale awareness campaign in Germany affected private flood protection or insurance behavior. We thereby exploit the fact that different federal states initiated the campaign at different points in time between 2009 and 2017. In the first analysis, we use a longitudinal data set of a national sample of 6,729 household heads in the years 2012 and 2014 and focus on three federal states that launched the campaign in 2013. In the second analysis, we use flood damage and insurance penetration data at the federal state level from 2002 to 2018 (N = 256). Based on a fixed effects difference‐in‐differences estimator, we do not find that the campaign had a significant effect on households’ behaviors, damage, or insurance penetration. The results show that large‐scale flood risk awareness campaigns, as they are currently conducted in many countries, have a limited effectiveness in terms of strengthening actual flood protection or insurance behavior of households.
Becoming Academically Eligible: University Enrollment among First‐Generation, Rural College Goers*
Authors: Whiteside Jasmine L.
Published: October 2020

Scholarship on first‐generation students from rural areas has largely analyzed educational barriers to college going and completion rather than acknowledge the unique matriculation process and sources of support that aid in circumventing educational barriers. Building on prior educational mobility literatures and utilizing an anti‐deficit achievement framework, I draw from 20 in‐depth interviews with first‐generation, rural students to analyze support structures and the strategies these students employed to bypass class, race and geographic barriers to college enrollment. As my findings highlight, these students had limited access to college preparatory materials and classes while in high school, yet they and their families employed creative strategies and mechanisms that counteracted the educational resources they were lacking. My discussion highlights these strategies and mechanisms, and I conclude by suggesting future research directions—directions that recognize both challenges and opportunities for college going rural student populations.
Barriers to kidney transplantation in ESKD
Authors: Venkataraman Sandheep , Kendrick Jessica
Published: October 2020

Kidney transplantation is the ideal treatment option for patients with end‐stage kidney disease (ESKD). Since there is clear mortality benefit to receiving a transplant regardless of comorbidities and age, the gold standard of care should focus on attaining kidney transplantation and minimizing, or better yet eliminating, time on dialysis. Unfortunately, only a small percentage of patients with ESKD receive a kidney transplant. Several barriers to kidney transplantation have been identified. Barriers can largely be grouped into three categories: patient‐related, physician/provider‐related, and system‐related. Several barriers fall into multiple categories and play a role at various levels within the healthcare system. Acknowledging and understanding these barriers will allow transplant centers and dialysis facilities to make the necessary interventions to mitigate these disparities, optimize the transplant evaluation process, and improve patient outcomes. This review will discuss these barriers and potential interventions to increase access to kidney transplantation.
Preparing students for the future through developing evaluative judgement
Authors: Naidoo Ornissa , Tai Joanna , Penman Merrolee
Published: October 2020

In today’s environment, health students need to be prepared for an ever changing workplace and workforce. They need to understand what demonstrates good quality work and how to assess their standard of work. Evaluative judgement can contribute to student and graduate self‐regulation and autonomy in their learning. This toolbox article describes how to implement strategies for developing evaluative judgement in allied health placements. These strategies were developed as part of an occupational therapy program in rural Western Australia, where experiential education is provided through service‐learning with both direct and indirect supervision. Practical advice is provided on the use of peer‐assisted learning, rubrics, self‐assessment and feedback. Challenges and opportunities in implementing strategies to develop evaluative judgement, such as how to achieve effective feedback, are also discussed. The suggested toolbox may be adapted to various clinical placement contexts. Developing evaluative judgement can help to prepare our students to be lifelong learners. This article empowers educators to promote this capability in their students to create work ready graduates, who are able to operate independently and in rapidly evolving, technologically enabled environments
Inter‐donor variability in deformability of red blood cells in blood units
Authors: Barshtein Gregory , Rasmusen Tanja L. , Zelig Orly , Arbell Dan , Yedgar Saul
Published: October 2020

Objective

This study aimed to examine the donor‐to‐donor variability in the deformability of red blood cells (RBCs) from freshly collected blood donations (F‐RBC) and packed RBCs.

Background

Packed RBCs are supplied for transfusion by the first‐in‐first‐out (FIFO) criterion, assuming that their quality is the same for packed RBCs with equal storage duration. To challenge this notion, we determined the deformability of F‐RBC and packed RBCs stored for different durations.

Methods

Three RBC groups were employed: A. 79 samples of F‐RBC; B. 76 samples of packed RBC units, randomly used for transfusion at different storage durations; and C. 65 samples of outdated packed RBCs stored for 35 to 37 days. All packed RBC units were non‐leukofiltrated and stored in Citrate‐phosphate‐dextrose solution with adenine (CPDA‐1). RBC deformability was determined using a computerised cell‐flow properties analyser, which monitors the shape change of cells directly visualised in a narrow‐gap flow chamber and provides the cells' deformability distribution in a large RBC population.

Results

The F‐RBC deformability exhibited a wide‐range inter‐donor variability. The cold storage of packed RBCs exerted a mild reduction of deformability, which became significant, compared to the initial inter‐donor variability, only after 3 weeks of storage.

Conclusion

Packed RBCs are generally supplied for transfusion by the FIFO criterion based on the assumption that the storage duration is a key factor of RBC quality. This study demonstrates that the deformability of red blood cells is significantly different in donors, and substantial variability persists throughout the entire process of their storage. Therefore, the FIFO criterion is not sufficient for assessing the RBC deformability, which should, therefore, be specifically characterised for each unit.
Groups of piecewise linear homeomorphisms of flows
Authors: Matte Bon Nicolás , Triestino Michele
Published: October 2020

To every dynamical system$(X,\varphi )$over a totally disconnected compact space, we associate a left-orderable group$T(\varphi )$. It is defined as a group of homeomorphisms of the suspension of$(X,\varphi )$which preserve every orbit of the suspension flow and act by dyadic piecewise linear homeomorphisms in the flow direction. We show that if the system is minimal, the group is simple and, if it is a subshift, then the group is finitely generated. The proofs of these two statements are short and elementary, providing straightforward examples of finitely generated simple left-orderable groups. We show that if the system is minimal, every action of the corresponding group on the circle has a fixed point. These constitute the first examples of finitely generated left-orderable groups with this fixed point property. We show that for every system$(X,\varphi )$, the group$T(\varphi )$does not have infinite subgroups with Kazhdan's property$(T)$. In addition, we show that for every minimal subshift, the corresponding group is never finitely presentable. Finally, if$(X,\varphi )$has a dense orbit, then the isomorphism type of the group$T(\varphi )$is a complete invariant of flow equivalence of the pair$\{\varphi , \varphi ^{-1}\}$.
Descriptions of all active instars of a new species of Calyptostoma (Trombidiformes: Calyptostomatidae) from Iran

Authors: Masoumi Hamidreza , Saboori Alireza , Seiedy Marjan
Published: October 2020

The larva, deutonymph and adult of Calyptostoma seemani Masoumi & Saboori sp. nov. (Trombidiformes: Calyptostomatidae) are described from the Kandovan region, Alborz province, Iran. Larvae were reared from eggs laid by adults kept at room temperature in plastic pots. A key to larval and post-larval species of Calyptostoma of the world and corrections in the description of C. gorganica are presented.
Morphological ontogeny of Amerus polonicus (Acari: Oribatida: Ameridae), and comments on Amerus Berlese

Authors: Seniczak Stanisław , Kowalski Jarosław , Kaczmarek Sławomir , Seniczak Anna
Published: October 2020

The morphological ontogeny of Amerus polonicus Kulczynski, 1902 is described and illustrated, based on the individuals from laboratory culture. The juveniles of this species are unpigmented, with punctated integument. The larva has 11 pairs of gastronotal setae, including h2, the nymphs have 12 pairs. The nymphs are quadrideficient and eupheredermous, i.e. they carry the exuvial scalps of previous instars on the gastronotum, using mainly the inward curving setae la and lm to protect the exuvial scalps against loss. In all juveniles, seta d is present on all femora, genua and tibiae, and setae d on femur I and ft" on tarsus I are very long. All tarsi of juveniles are beaded, with long, thin distal parts. In the adult, seta d is lost on genua and tibiae I and II, but is retained on genua and tibiae III and IV.
Lima soundscape before confinement and during curfew. Airplane flights suppressions because of Peruvian lockdown
Authors: Montano Walter , Gushiken Elena
Published: October 2020

Peru declared a state of emergency on March 16 in order to prevent SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) transmissions; thus, the International Airport was closed and the soundscape of urban zones under the flight tracks have been changed in view of the fact that airplane traffic was suspended. The authors have been conducting noise monitoring since February and because of that sufficient noise data for knowing the soundscape before and during the lockdown were obtained. This article presents a case of aircraft annoyance noise in one of Lima's city districts, which is near the aircraft climbing curve, toward the ocean on departure from Lima.
Decreased Overall and Inappropriate Antibiotic Prescribing in a Veterans Affairs Hospital Emergency Department following a Peer Comparison-Based Stewardship Intervention
Authors: Buehrle Deanna J. , Phulpoto Rameez H. , Wagener Marilyn M. , Clancy Cornelius J. , Decker Brooke K.
Published: October 2020

Antibiotic prescribing is very common in emergency departments (EDs). Optimal stewardship intervention strategies in EDs are not well defined. We conducted a prospective, observational cohort study in a Veterans Affairs ED in which clinician education and monthly e-mail-based peer comparisons were directed against all oral antibiotic prescribing for discharged patients. Oral antibiotic prescriptions were compared in baseline (June 2016 to December 2017) and intervention (January to June 2018) periods using an interrupted time series regression model.
Estradiol Enhances Antiviral CD4+Tissue-Resident Memory T Cell Responses following Mucosal Herpes Simplex Virus 2 Vaccination through an IL-17-Mediated Pathway
Authors: Bagri Puja , Ghasemi Ramtin , McGrath Joshua J. C. , Thayaparan Danya , Yu Emma , Brooks Andrew G. , Stämpfli Martin R. , Kaushic Charu
Published: October 2020

Herpes simplex virus 2 (HSV-2) is a highly prevalent sexually transmitted infection for which there is currently no vaccine available. Interestingly, the female sex hormone estradiol has been shown to be protective against HSV-2. However, the underlying mechanisms by which this occurs remains relatively unknown. Our study demonstrates that under the influence of estradiol treatment, intranasal immunization with an attenuated strain of HSV-2 leads to enhanced establishment of antiviral memory T cell responses in the upper respiratory tract and female reproductive tract. In these sites, estradiol treatment leads to greater Th17 memory cells, which precede enhanced Th1 memory responses. Consequently, the T cell responses mounted by tissue-resident memory cells in the female reproductive tract of estradiol-treated mice are sufficient to protect mice against vaginal HSV-2 challenge. This study offers important insights regarding the regulation of mucosal immunity by hormones and on potential strategies for generating optimal immunity during vaccination.
Subclinical Genital Herpes Shedding in HIV/Herpes Simplex Virus 2-Coinfected Women during Antiretroviral Therapy Is Associated with an Increase in HIV Tissue Reservoirs and Potentially Promotes HIV Evolution
Authors: Stinn Tajanna , Kuntz Steve , Varon Dana , Huang Meei-Li , Selke Stacy , Njikan Samuel , Ford Emily S. , Dragavon Joan , Coombs Robert W. , Johnston Christine , Bull Marta E.
Published: October 2020

Persons with HIV infection are frequently coinfected with chronic herpesviruses, which periodically replicate and produce viable herpes virions, particularly in anogenital and cervical tissues. Persistent protein expression results in proliferation of CD8
+
and CD4
+
T cells, and the latter could potentially expand and sustain HIV tissue reservoirs. We found HSV genital shedding rates were positively correlated with HIV DNA concentrations and HIV divergence from ancestral sequences in tissues. Our work suggests that immune responses to common coinfections, such as herpesviruses, may sustain HIV tissue reservoirs during suppressive ART, suggesting future cure strategies should study interventions to suppress replication or reactivation of chronic herpes infections.
Herpes Simplex Virus Entry by a Nonconventional Endocytic Pathway
Authors: Tebaldi Giulia , Pritchard Suzanne M. , Nicola Anthony V.
Published: October 2020

Herpes simplex virus 1 (HSV-1), the prototype alphaherpesvirus, is ubiquitous in the human population and causes lifelong infection that can be fatal in neonatal and immunocompromised individuals. HSV enters many cell types by endocytosis, including epithelial cells, the site of primary infection in the host. The intracellular itinerary for HSV entry remains unclear. We probed the potential involvement of several Rab GTPases in HSV-1 entry and suggest that endocytic entry of HSV-1 is independent of the canonical lysosome-terminal pathway. A nontraditional endocytic route may be employed, such as one that intersects with the
trans
-Golgi network (TGN). These results may lead to novel targets for intervention.
Deletion of Murine Gammaherpesvirus Gene
M2
in Activation-Induced Cytidine Deaminase-Expressing B Cells Impairs Host Colonization and Viral Reactivation
Authors: Owens Shana M. , Oldenburg Darby G. , White Douglas W. , Forrest J. Craig
Published: October 2020

Gammaherpesviruses establish lifelong chronic infections in cells of the immune system that can lead to lymphomas and other diseases. To facilitate colonization of a host, gammaherpesviruses encode gene products that manipulate processes involved in cellular proliferation and differentiation. Whether and how these viral gene products function in specific cells of the immune system is poorly defined. We report here the use of a viral genetic system that allows for deletion of specific viral genes in discrete populations of cells. We employ this system in an
in vivo
model to demonstrate cell-type-specific requirements for a particular viral gene. Our findings reveal that a viral gene product can function in distinct cellular subsets to direct gammaherpesvirus pathogenesis.
Design, development and evaluation of Artificial Breathing Capability Device (ABCD): a novel innovation for respiratory support
Authors: Mathew Joseph L , Sharma Manu , Gawri Ankush , Sukesha  , Kumar Navin , Chander Amanpreet , Mathew Preethy J
Published: October 2020

Objective

The paucity of mechanical ventilators necessitates development of innovative respiratory support devices.

Methods

We developed the Artificial Breathing Capability Device (ABCD) to automate compression of self-inflating bags (SIB), while controlling peak inspiratory pressure (PIP), ventilation rate (VR) and inspiration to expiration time (I:E) ratio (as in a conventional ventilator). ABCD has additional smart features including self-regulatory checks, auto cut-off during cough, endotracheal tube disconnection and blockage alarms, and SIB disconnection alarm. ABCD was tested non-stop for 60 days with 396 user combinations, using adult-size and paediatric-size SIB. The device was evaluated for robustness, reliability and precision.

Results

ABCD did not have mechanical, electrical or electronic failures during continuous testing under various ambient conditions, confirming robustness. Reliability and precision evaluated by the proportion of user combinations showing <10% deviation from the set parameters showed: PIP 100%, VR 100% and I:E 84.3% with an adult SIB. The corresponding proportions with a paediatric-size SIB were 85.4%, 100% and 95.5%. With both SIB, the only combinations showing >10% deviation were outside the physiologic range.

Conclusion

ABCD is a safe, efficacious and cost-effective option, which could be considered for adults and children in the context of ventilator shortages especially during the COVID-19 pandemic.
Computed tomography aortic valve calcium scoring for the assessment of aortic stenosis progression
Authors: Doris Mhairi Katrina , Jenkins William , Robson Philip , Pawade Tania , Andrews Jack Patrick , Bing Rong , Cartlidge Timothy , Shah Anoop , Pickering Alice , Williams Michelle Claire , Fayad Zahi A , White Audrey , van Beek Edwin JR , Newby David E , Dweck Marc R
Published: October 2020

Objective

CT quantification of aortic valve calcification (CT-AVC) is useful in the assessment of aortic stenosis severity. Our objective was to assess its ability to track aortic stenosis progression compared with echocardiography.

Methods

Subjects were recruited in two cohorts: (1) a reproducibility cohort where patients underwent repeat CT-AVC or echocardiography within 4 weeks and (2) a disease progression cohort where patients underwent annual CT-AVC and/or echocardiography. Cohen’s d-statistic (d) was computed from the ratio of annualised progression and measurement repeatability and used to estimate group sizes required to detect annualised changes in CT-AVC and echocardiography.

Results

A total of 33 (age 71±8) and 81 participants (age 72±8) were recruited to the reproducibility and progression cohorts, respectively. Ten CT scans (16%) were excluded from the progression cohort due to non-diagnostic image quality. Scan-rescan reproducibility was excellent for CT-AVC (limits of agreement −12% to 10 %, intraclass correlation (ICC) 0.99), peak velocity (−7% to +17%; ICC 0.92) mean gradient (−25% to 27%, ICC 0.96) and dimensionless index (−11% to +15%; ICC 0.98). Repeat measurements of aortic valve area (AVA) were less reliable (−44% to +28%, ICC 0.85).

CT-AVC progressed by 152 (65–375) AU/year. For echocardiography, the median annual change in peak velocity was 0.1 (0.0–0.3) m/s/year, mean gradient 2 (0–4) mm Hg/year and AVA −0.1 (−0.2–0.0) cm2/year. Cohen’s d-statistic was more than double for CT-AVC (d=3.12) than each echocardiographic measure (peak velocity d=0.71 ; mean gradient d=0.66; AVA d=0.59, dimensionless index d=1.41).

Conclusion

CT-AVC is reproducible and demonstrates larger increases over time normalised to measurement repeatability compared with echocardiographic measures.
Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK
Authors: Ball Simon , Banerjee Amitava , Berry Colin , Boyle Jonathan R , Bray Benjamin , Bradlow William , Chaudhry Afzal , Crawley Rikki , Danesh John , Denniston Alastair , Falter Florian , Figueroa Jonine D , Hall Christopher , Hemingway Harry , Jefferson Emily , Johnson Tom , King Graham , Lee Kuan Ken , McKean Paul , Mason Suzanne , Mills Nicholas L , Pearson Ewen , Pirmohamed Munir , Poon Michael T C , Priedon Rouven , Shah Anoop , Sofat Reecha , Sterne Jonathan A C , Strachan Fiona E , Sudlow Cathie L M , Szarka Zsolt , Whiteley William , Wyatt Michael
Published: October 2020

Objective

To monitor hospital activity for presentation, diagnosis and treatment of cardiovascular diseases during the COVID-19) pandemic to inform on indirect effects.

Methods

Retrospective serial cross-sectional study in nine UK hospitals using hospital activity data from 28 October 2019 (pre-COVID-19) to 10 May 2020 (pre-easing of lockdown) and for the same weeks during 2018–2019. We analysed aggregate data for selected cardiovascular diseases before and during the epidemic. We produced an online visualisation tool to enable near real-time monitoring of trends.

Results

Across nine hospitals, total admissions and emergency department (ED) attendances decreased after lockdown (23 March 2020) by 57.9% (57.1%–58.6%) and 52.9% (52.2%–53.5%), respectively, compared with the previous year. Activity for cardiac, cerebrovascular and other vascular conditions started to decline 1–2 weeks before lockdown and fell by 31%–88% after lockdown, with the greatest reductions observed for coronary artery bypass grafts, carotid endarterectomy, aortic aneurysm repair and peripheral arterial disease procedures. Compared with before the first UK COVID-19 (31 January 2020), activity declined across diseases and specialties between the first case and lockdown (total ED attendances relative reduction (RR) 0.94, 0.93–0.95; total hospital admissions RR 0.96, 0.95–0.97) and after lockdown (attendances RR 0.63, 0.62–0.64; admissions RR 0.59, 0.57–0.60). There was limited recovery towards usual levels of some activities from mid-April 2020.

Conclusions

Substantial reductions in total and cardiovascular activities are likely to contribute to a major burden of indirect effects of the pandemic, suggesting they should be monitored and mitigated urgently.
CD47/SIRPα blocking peptide identification and synergistic effect with irradiation for cancer immunotherapy
Authors: Wang Hongfei , Sun Yixuan , Zhou Xiuman , Chen Chunxia , Jiao Ling , Li Wanqiong , Gou Shanshan , Li Yanying , Du Jiangfeng , Chen Guanyu , Zhai Wenjie , Wu Yahong , Qi Yuanming , Gao Yanfeng
Published: October 2020

Background

Immunotherapy has achieved remarkable advances via a variety of strategies against tumor cells that evade immune surveillance. As important innate immune cells, macrophages play important roles in maintaining homeostasis, preventing pathogen invasion, resisting tumor cells and promoting adaptive immune response. CD47 is found to be overexpressed on tumor cells and act as a don’t eat me’ signal, which contributes to immune evasion. Macrophages mediated phagocytosis via blockade CD47/SIRPα (signal regulatory protein alpha) interaction was proved to induce effective antitumor immune response.

Methods

A novel peptide pep-20, specifically targeting CD47 and blocking CD47/SIRPα interaction, was identified via high-throughput phage display library bio-panning. The capability to enhance the macrophage-mediated phagocytosis activities and antitumor effects of pep-20 were investigated. The mechanism of pep-20 to induce T-cell response was explored by ex vivo analysis and confirmed via macrophage depleting strategy. The structure-activity relationship and D-amino acid substitution of pep-20 were also studied. The antitumor effects and mechanism of a proteolysis resistant D-amino acid derivate pep-20-D12 combined with irradiation (IR) were also investigated.

Results

Pep-20 showed remarkable enhancement of macrophage-mediated phagocytosis to both solid and hematologic tumor cells in vitro, and inhibited tumor growth in immune-competent tumor-bearing mice. Furthermore, pep-20 promoted macrophages to mobilize the antitumor T-cell response with minimal toxicity. Furthermore, systemic administration of the derivate pep-20-D12 showed robust synergistic antitumor efficacy in combination with IR.

Conclusion

In summary, these results demonstrated that CD47/SIRPα blocking peptides, pep-20 and its derivate, could serve as promising candidates to promote macrophages-mediated phagocytosis and immune response in cancer immunotherapy.
Immune checkpoint inhibitor associated reactivation of primary membranous nephropathy responsive to rituximab
Authors: Lin Jamie S , Wang Daniel Y , Mamlouk Omar , Glass William F , Abdelrahim Maen , Yee Cassian , Abudayyeh Ala
Published: October 2020

The same mechanisms that mediate antitumor immunity from checkpoint inhibitors (CPIs) can also lead to unintended targeting of normal tissues, characterized as immune-related adverse events (irAEs). Those with pre-existing autoimmune disease are believed to be particularly vulnerable for exacerbating underlying autoimmunity or inducing severe irAEs. We report the first case of CPI-associated reactivation of primary membranous nephropathy (MN) in a patient with pleural mesothelioma responding to immunotherapy. Due to its specificity in targeting B-lymphocytes, rituximab was used to treat primary MN with the expectation that this would not interfere with the benefits gained from T cell-mediated antitumor immunity. Rituximab was effective in treating CPI-associated reactivation of MN, and the patient was successfully rechallenged with nivolumab and maintained stable kidney function and sustained clinical antitumor effect. While exacerbation of pre-existing autoimmune diseases from CPIs is common, therapy for autoimmune reactivation can be rationally directed by an understanding of the immunosuppressive mechanism with goals of cancer treatment.
Non-invasive dye dilution method for measuring an atrial septal defect shunt size
Authors: Muroke Valtteri , Jalanko Mikko , Simonen Piia , Holmström Miia , Ventilä Markku , Sinisalo Juha
Published: October 2020

Aims

Objective of this study was to evaluate the feasibility of the non-invasive dye dilution method to quantify shunt size related to atrial septal defects (ASD).

The diagnostic accuracy of shunt size determination in ASD’s has been suboptimal with common non-invasive methods. We have previously developed a cost-effective and time-effective non-invasive dye dilution method. In this method, the indocyanine green solution is injected into the antecubital vein and the appearance of the dye is detected with an earpiece densitometer.

Methods and results

We studied 192 patients with an ASD. Mean pulmonary blood flow/systemic blood flow (Qp/Qs) was measured with dye dilution technique and compared with following methods: Fick’s invasive oximetry (n=49), transoesophageal echocardiography (TEE) measuring ASD size (n=143) and cardiac MR (CMR) (n=9).

For the first 49 patients, Qp/Qs was 2.05±0.70 with the Fick’s invasive oximetry and 2.12±0.68 with dye dilution method with an excellent correlation between the two methods (R=0.902, p<0.001). In the second study sample, the ASD size by TEE was 15±6 mm on average, and the mean Qp/Qs 2.16±0.65 measured with dye dilution method with a good correlation between the methods (R=0.674, p<0.001). Qp/Qs measured with CMR was 1.87±0.40 resulting in a good correlation with the dye dilution method (R=0.696, p=0.037).

Conclusion

The dye dilution method with earpiece densitometer recording is a clinically feasible and reliable method to assess shunt size in ASDs.
Presence of mitral stenosis is a risk factor of new development of acute decompensated heart failure early after transcatheter aortic valve implantation
Authors: Okai Tsukasa , Mizutani Kazuki , Hara Masahiko , Yamaguchi Tomohiro , Ogawa Mana , Ito Asahiro , Iwata Shinichi , Izumiya Yasuhiro , Takahashi Yosuke , Shibata Toshihiko , Yoshiyama Minoru
Published: October 2020

Aims

Acute decompensated heart failure (ADHF) can occur early after transcatheter aortic valve implantation (TAVI), but the risk factors or mechanisms associated with it have not been fully determined. This hypothesis-generating study aimed to investigate the clinical indices associated with the development of ADHF within 72 hours after TAVI and to improve procedural approaches for TAVI.

Method and results

In this single-centre hypothesis generating prospective observational study, we enrolled 156 consecutive patients with severe aortic stenosis who underwent TAVI between January 2016 and February 2018 at our institution. We set the primary endpoint as the new development of ADHF within 72 hours after TAVI, and clinical indices associated with it were evaluated using a multivariable logistic model. The median age of the patients was 83 (quartile range 80–86) years, 48 (30.8%) were men and the median Society of Thoracic Surgery-Predicted Risk of Mortality was 7.1 (range 5.2–10.4). Mitral stenosis (MS), defined as mean transmitral valve pressure gradient ≥5 mm Hg, was present in 15 (9.6%) patients. After TAVI, the invasive mean transaortic valve pressure gradient (mAVPG) decreased from 48 (36–66) to 7 (5–11) mm Hg, and 12 (7.7%) patients developed ADHF within 72 hours after TAVI. Multivariable logistic regression analysis showed that MS (adjusted OR, 14.227; 95% CI 2.654 to 86.698; p=0.002) and greater decreases in mAVPG (1.038; 1.003 to 1.080; p=0.044) were associated with ADHF.

Conclusions

MS and drastic improvement of mAVPG were associated with new development of ADHF within 72 hours after TAVI.
Analytic study of solutions for a two-component Novikov system
Authors: Gao Hui , Wang Gangwei
Published: October 2020

Under investigation in this paper is a two-component Novikov system (also called Geng-Xue equation), which was proposed by Geng and Xue in 2009. Firstly, via the Lie symmetry method, infinitesimal generators, commutator table of Lie algebra and symmetry groups of the two-component Novikov system are presented. At the same time, some group invariant solutions are computed through similarity reductions. In particular, we construct peakon solution by applying the distribution theory. In addition, based on obtained group invariant solutions and symmetry transformations, we derive some new exact solutions, which include stationary solutions, smooth solutions, and a weak solution. The analytical properties to some of group invariant solutions and new exact solutions are discussed, such as decay, asymptotic behavior, and boundedness.
Thermal effect on wave propagation behavior of viscoelastic carbon nanotubes conveying fluid with the spinning and longitudinal motions
Authors: Tang Ye , Wang Tao , Zheng Yanchang
Published: October 2020

In this paper, the thermal effect on wave dispersion characteristic induced by the spinning and longitudinal motions in the viscoelastic carbon nanotubes (CNTs) conveying fluid is presented. Hamilton’s principle is utilized to derive the governing equation of this nanotube based on the non-local strain gradient and Euler–Bernoulli beam theories. Then, the dispersion solution is found by using the Naiver method. Based on this, the influences of the spinning and longitudinal motion velocities, structural damping, temperature and flow velocity on dispersion relation of the nanotubes are discussed according to numerical simulation. In view of the results of numerical examples, some interesting conclusions can be drawn. The existence of spinning motion leads to the coupling between the vibration in the [Formula: see text] and [Formula: see text] directions, which induces that the first-order transverse wave frequency increases/decreases for small/large wave number and the second-order one increases. The important solutions presented in the work will provide the useful information for the designation of the nanotubes conveying fluid with the spinning and longitudinal motion.
Global Phase Portraits for a Planar ℤ2-Equivariant Kukles Systems of Degree 3
Authors: Dias Fabio Scalco , Ribeiro Ronisio Moises , Valls Claudia
Published: October 2020

We provide normal forms and the global phase portraits on the Poincaré disk of all planar Kukles systems of degree [Formula: see text] with [Formula: see text]-equivariant symmetry. Moreover, we also provide the bifurcation diagrams for these global phase portraits.
Color Image Encryption with Cipher Feedback and Coupling Chaotic Map
Authors: Liu Hongjun , Kadir Abdurahman , Xu Chengbo
Published: October 2020

Based on the classic quadratic map (CQM) with abundant bifurcations and periodic windows, a new 3D improved coupling quadratic map (3D-ICQM) is constructed, and its phase diagram, Lyapunov exponent (LE) and randomness testing by TestU01 demonstrated that it has better ergodicity, more complex nonlinear behavior, larger chaotic range and better randomness. To investigate its application in cryptography, a 3D-ICQM based color image encryption algorithm with round key expansion is designed. To further enhance the randomness of key stream, the hash value of intermediate cipher of the previous round is converted into new initial values and fed back into 3D-ICQM, to generate the key stream for the current round. The security and statistical analyses demonstrated that the encryption scheme has better security performance than several existing algorithms.
Chaos in Iterated Function Systems
Authors: Mohtashamipour Maliheh , Bahabadi Alireza Zamani
Published: October 2020

In the present paper, we study chaos in iterated function systems (IFS), namely dynamical systems with several generators. We introduce weak Li–Yorke chaos, chaos in branch, and weak topological chaos to perceive the role of branches to create chaos in an IFS. Moreover, we define another type of chaos, [Formula: see text]-chaos, on an IFS. Further, we find the necessary conditions to create the chaotic iterated function systems.