bluuebunny/crossref_metadata_2025 huggingface dataset:
Form Factor Prediction Based on Ship Model Test Data by Statistical Method
Authors: Widodo  , Santoso Agoes , Erwandi  , Baidowi Achmad
Published: September 2022

The ship model resistance test is carried out on the towing tank with a certain scale to get the total resistance coefficient of the ship model. The value of the ship’s form factor is needed in extrapolation calculations to get the coefficient and total resistance value of a full-scale ship. The form factor can be obtained using the traditional method, namely testing the resistance of the ship model with a Froude Number between 0.1 – 0.2. This method is known as the Prohaska method. Another method or a more modern method is to use multiple linear regression statistics based on the ship model test. We used data from 41 displacement ship model tests conducted at the Hydrodynamics Technology Laboratory (LTH)-National Agency for Research & Innovation (BRIN). Data processing is done through statistical software using the OLS or Robust method which was previously done by transforming predictor variables to enlarge the variety of variables so that a good regression equation is obtained. The resulting form factor regression is a useful tool for predicting the ship’s Effective Power value.
The effect of safety climate on safety behavior with intervention
Authors: Pradeti Rahajeng , Widiarti Yuning , Santiasih Indri
Published: September 2022

Safety climate influences safety behavior and tends to unsafe behavior. Accidents caused by unsafe behavior are quite high, 80%-85% than unsafe conditions. Previous research has addressed the safety climate to safety behavior by looking at the impact and involvement of individuals and the result is controlled safety climate to increase in safety behavior. Changes in unsafe behavior need to be made by applying intervention methods. Based on this, research is carried out on the influence of safety climate on safety behavior by providing interventions to change behavior. The study was conducted on 198 production workers in manufacturing companies. The safety climate influence analysis was conducted using the NOSACQ-50 questionnaire and multivariate linear regression test, Structural Equation Model (SEM) to see who influenced worker behavior and T-Paired test to see results of the given intervention. Implementation of behavior change is done by intervention. Intervention is provided by installing special safety signs at work and training for workers. The results of the intervention were analyzed using the Critical Behavior Checklist (CBC). The results of the influence test showed that management had a large influence on worker behavior with 5 variables. Testing with SEM showed that there were 3 variables with significant values so that worker behavior was influenced by management opinions and attitudes. The T-Paired test showed that unsafe behavior decreased and safe behavior increased after the intervention was administered. Thus, management has a considerable influence on the formation of worker behavior so management needs to participate in realizing work safety.
Direct Measurement of Motion on Fast Ferries
Authors: Jamal  , Sulisetyono A , Aryawan W D
Published: September 2022

This paper describes a new identification method for the fast ferry motions by using the direct measurements on the ship’s board. The inertial sensor type of the Analog Devices (ADIS) 16364 is selected as a as suitable instrument to measure accelerations and velocity of the ship motions namely heave, pitch, and roll in time domain. Furthermore, the ship motion responses are transferred as the energy spectral density in frequency domain which are identified using the Fast Fourier Transform (FFT) method. For the case study, the measurement equipment was placed on the navigation room of MV. Dumai Line 12 recording in 15 minutes within ship voyage from Bengkalis to Batam in September 2021. Finally, the natural frequencies of heave, pitch, and roll motions are identified about 0.568 rad/s, 0.117 rad/s, and 0.227 rad/s, respectively.
Barrel Distortion Correction for Digital Optic-Based Motion Tracking in Ship Hydrodynamic Model Experiments
Authors: Irawanto Z , Ariana I M , Erwandi
Published: September 2022

In hydrodynamic ship-model experiments, motion tracking of ship model trajectory is employed to predict the maneuverability of the ship when operating in its actual environment. There are some systems for motion tracking, such as inertial measurement unit, radar, laser, and infrared sensors. The system has proven reliable, however, the disadvantage is that they are all relatively expensive. This paper proposes a low-cost digital optic-based motion tracking system using consumer-grade video camera. In order to examine the accuracy of the system, some experiments to apply the method were carried out in maneuvering offshore engineering basin at the Indonesian Hydrodynamics Laboratory, The National Agency for Research and Innovation. To cover a broader area of the trajectory, a wide-angle camera lens was utilized, consequently, the image recorded by the camera experienced a barrel distortion. As a reference for the measurements, gridlines spaced 2 meters apart were drawn on the floor of the basin. Using the grid pattern, the distortion was corrected by finding the relationship between the grid pattern in the object space and in the distorted image. A fourth-order polynomial regression was applied to solve the problem. The results showed that the method was effective for correcting distorted images with a relative standard error of 0.42%.
Robust Laboratory Scale Seakeeping Test Wave Measurement Method Use Ultrasonic Sensor
Authors: Zen Hardi , Kusuma Indra Ranu , Widjiati Endang
Published: September 2022

The seakeeping test is one of the tests done in the Indonesia Hydrodynamic Laboratory (IHL) test tank on a model ship or floating unit. In the test tank, a wave can be generated by using electric and mechanic wave flaps that are pre-programmed on a certain condition of the wave, i.e. different frequencies and amplitude. To measure waves, produced by a wave generator, a wave measuring instrument is needed that can measure changes in water level in the test tank. The current wave measuring instrument is in the form of a 600 mm twin wire wave probe. This instrument is can be used to measure waves in the test tank but has limitations because it is only placed in one location without being moved. Another method is developed to be used in making alternative measuring instruments using ultrasonic sensors. In this paper, this alternative wave measuring instrument shows that measuring waves even when moving the measurement point to a new point location or following a towing carriage can be done and gives better measurement results. Based on these results, this new measuring instrument can be used in a more complex configuration test in the tank.
Form Factor and Wake Fraction of Bulky Trimaran Hull Using CFD
Authors: Koenhardono ES , Baidhowi A , Arief IS
Published: September 2022

The value of form factor (1+k) and wake fraction significantly influence the ship propulsion design, including trimaran vessel. This paper presents the form factor and wake fraction of a single screw bulky trimaran using CFD. The model vessel is 1.92 m trimaran with scale to the actual vessel is 31.25 and evaluated in the range of Fn 0.1 to 0.2 based on ITTC recommendation. The results show that the form factor of the bulky trimaran is 1.433, which is close to the NPL series Trimaran value. The wake fraction was evaluated in two model speeds, 1.43 knot, which represent low speed and 6.26 knot which means high speed. The results show that the wake fraction pattern is similar to a single propeller vessel with the wake’s peak at 12 o’clock with the maximum value of wake around is 0.1.
Towards the use of artificial intelligence deep learning networks for detection of archaeological sites
Authors: Karamitrou Alexandra , Sturt Fraser , Bogiatzis Petros , Beresford-Jones David
Published: September 2022

While remote sensing data have long been widely used in archaeological prospection over large areas, the task of examining such data is time consuming and requires experienced and specialist analysts. However, recent technological advances in the field of artificial intelligence (AI), and in particular deep learning methods, open possibilities for the automated analysis of large areas of remote sensing data. This paper examines the applicability and potential of supervised deep learning methods for the detection and mapping of different kinds of archaeological sites comprising features such as walls and linear or curvilinear structures of different dimensions, spectral and geometrical properties. Our work deliberately uses open-source imagery to demonstrate the accessibility of these tools. One of the main challenges facing AI approaches has been that they require large amounts of labeled data to achieve high levels of accuracy so that the training stage requires significant computational resources. Our results show, however, that even with relatively limited amounts of data, simple eight-layer, fully convolutional network can be trained efficiently using minimal computational resources, to identify and classify archaeological sites and successfully distinguish them from features with similar characteristics. By increasing the number of training sets and switching to the use of high-performance computing the accuracy of the identified areas increases. We conclude by discussing the future directions and potential of such methods in archaeological research.
Fully printed MWCNT strain sensor over paper substrate for human motion monitoring
Authors: K Thiyagarajan , Rajini G K , Maji Debashis
Published: September 2022

Flexible strain sensors have been used in myriad of applications with studies in human physiological monitoring, robotic operation, and human–machine interaction being intensively explored in recent years. Achieving a cost effective, high-performance flexible strain sensor with high sensitivity, and capable of large-scale production have great importance particularly for next generation of wearable electronics. In the present work, the authors have proposed a strain sensor which has been fabricated by simple screen printing of multi walled carbon nanotube ink over paper substrate in a facile and cost-effective manner. A thin sheet of polyethylene terephthalate. was laminated over the sensor surface to ascertain its stability towards environmental effects and physical movements. The characteristics of the printed strain sensor were systematically analyzed for its electrical performance with strain variations, repeatability, dynamic response and durability of the same was also investigated. The strain sensor exhibited a maximum gauge factor of 31.9 within the applied strain of 0%–1.72% and durability of 1000 bending cycles with a response and a recovery time of ∼13 ms and ∼17 ms respectively. Further, the fabricated strain sensors was also attached to various locations around human joints (knee, finger, elbow and wrist) and demonstrated significant sensing performance under different bending strains with superior mechanical robustness suitable for stable human motion monitoring for healthcare application.
Laplace HypoPINN: physics-informed neural network for hypocenter localization and its predictive uncertainty
Authors: Izzatullah Muhammad , Yildirim Isa Eren , Waheed Umair Bin , Alkhalifah Tariq
Published: September 2022

Several techniques have been proposed over the years for automatic hypocenter localization. While those techniques have pros and cons that trade-off computational efficiency and the susceptibility of getting trapped in local minima, an alternate approach is needed that allows robust localization performance and holds the potential to make the elusive goal of real-time microseismic monitoring possible. Physics-informed neural networks (PINNs) have appeared on the scene as a flexible and versatile framework for solving partial differential equations (PDEs) along with the associated initial or boundary conditions. We develop HypoPINN—a PINN-based inversion framework for hypocenter localization and introduce an approximate Bayesian framework for estimating its predictive uncertainties. This work focuses on predicting the hypocenter locations using HypoPINN and investigates the propagation of uncertainties from the random realizations of HypoPINN’s weights and biases using the Laplace approximation. We train HypoPINN to obtain the optimized weights for predicting hypocenter location. Next, we approximate the covariance matrix at the optimized HypoPINN’s weights for posterior sampling with the Laplace approximation. The posterior samples represent various realizations of HypoPINN’s weights. Finally, we predict the locations of the hypocenter associated with those weights’ realizations to investigate the uncertainty propagation that comes from those realizations. We demonstrate the features of this methodology through several numerical examples, including using the Otway velocity model based on the Otway project in Australia.
Phylogeny of the Madagascar-centred tribe Danaideae (Rubiaceae) as a precursor to taxonomic revision: insights into its generic and species limits, affinities and distribution
Authors: Razafimandimbison Sylvain G , Wikström Niklas , Khodabandeh Anbar , Rydin Catarina
Published: September 2022

Background and aims

The tribe Danaideae (Rubiaceae) is almost exclusively endemic to the Western Indian Ocean Region (WIOR), and encompasses the genera Danais, Payera and Schismatoclada that occur in humid, sub-humid and mountain and mountain bio climate zones. Much of the species diversity is endemic to restricted, remote and/or mountainous areas of Madagascar and recent field work on the island indicates substantial unknown diversity of the Danaideae. Furthermore, the monophyly of the Malagasy genera Payera and Schismatoclada has been questioned in previous work, species delimitations and phylogenetic relationships within the genera are poorly understood, and the distribution and evolution of gross morphological features have not been assessed.

Methods

We conducted morphological investigations, and produced robust phylogenies of Danaideae based on nuclear and plastid sequence data from 193 terminals. Ample plant material has been newly collected in the WIOR for the purpose of the present study, including potentially new species unknown to science. We performed Bayesian non-clock and relaxed-clock analyses employing three alternative clock models of a dataset with a dense sample of taxa from the entire geographical ranges of Danaideae. Based on the results, we discuss species diversity and distribution, relationships, and morphology in Danaideae.

Key results

Our results demonstrate the monophyly of Danaideae, its three genera and 42 species. Nine species are resolved as non-monophyletic. Many geographically distinct but morphologically heterogeneous lineages were identified, and morphological features traditionally considered diagnostic of subgroups of the genera, used for example in species identification keys, are not clade-specific.

Conclusions

Our results demonstrate that Madagascar contains ample previously undocumented morphological and species diversity of Danaideae. Our novel approach to molecular phylogenetic analyses as a precursor to taxonomic revisions provides numerous benefits for the latter. There are tentative indications of parallel northward diversification in Payera and Schismatoclada on Madagascar, and of geographical phylogenetic clustering despite the anemochorous condition of Danaideae.
Epidermal CCA1 and PMR5 contribute to nonhost resistance in Arabidopsis
Authors: Maeda Nami , Noguchi Takaya , Nakamichi Norihito , Suzuki Takamasa , Ishikawa Atsushi
Published: September 2022

Nonhost resistance (NHR) is the most robust and durable resistance in plants, but its spatiotemporal regulation is poorly understood. The circadian clock functions in a tissue-specific manner and regulates individual physiological processes in plants. Using mutant and RNA-seq analyses, we revealed a role of CIRCADIAN CLOCK ASSOCIATED1 (CCA1) in tissue-specific and time-of-day-specific regulation of NHR to Pyricularia oryzae (syn. Magnaporthe oryzae) in Arabidopsis thaliana (Arabidopsis). Targeted perturbation of CCA1 function in epidermis compromised time-of-day-specific regulation of NHR to P. oryzae in Arabidopsis. RNA-seq analysis showed that P. oryzae inoculation alters the transcriptome in penetration 2 (pen2) plants and identified POWDERY MILDEW RESISTANCE 5 (PMR5) as a candidate gene of direct targets of CCA1. Time-of-day-specific penetration resistance to P. oryzae was reduced in Arabidopsis pen2 pmr5 mutant plants. These findings suggest that epidermal CCA1 and PMR5 contribute to the establishment of time-of-day-specific NHR to P. oryzae in Arabidopsis.
Blood–brain barrier leakage and perivascular inflammation in cerebral amyloid angiopathy
Authors: Kozberg Mariel G , Yi Irvin , Freeze Whitney M , Auger Corinne A , Scherlek Ashley A , Greenberg Steven M , van Veluw Susanne J
Published: September 2022

Cerebral amyloid angiopathy is a small vessel disease associated with cortical microbleeds and lobar intracerebral haemorrhage due to amyloid-β deposition in the walls of leptomeningeal and cortical arterioles. The mechanisms of cerebral amyloid angiopathy–related haemorrhage remain largely unknown. Recent work has demonstrated that ruptured blood vessels have limited (or no) amyloid-β at the site of bleeding and evidence of local vascular remodelling. We hypothesized that blood–brain barrier leakage and perivascular inflammation may be involved in this remodelling process. This study examined cortical arterioles at various stages of cerebral amyloid angiopathy–related vascular pathology (without evidence of microhaemorrhage) in autopsy tissue from seven cases with definite cerebral amyloid angiopathy. We included temporo-occipital sections with microbleeds guided by ex vivo MRI from two cases with severe cerebral amyloid angiopathy and systematically sampled occipital sections from five consecutive cases with varying cerebral amyloid angiopathy severity. Haematoxylin and eosin stains and immunohistochemistry against amyloid-β, fibrin(ogen), smooth muscle actin, reactive astrocytes (glial fibrillary acidic protein) and activated microglia (cluster of differentiation 68) were performed. Arterioles were graded using a previously proposed scale of individual vessel cerebral amyloid angiopathy severity, and a blinded assessment for blood–brain barrier leakage, smooth muscle actin and perivascular inflammation was performed. Blood–brain barrier leakage and smooth muscle actin loss were observed in significantly more vessels with mild amyloid-β deposition (Grade 1 vessels; P = 0.044 and P = 0.012, respectively) as compared to vessels with no amyloid-β (Grade 0), and blood–brain barrier leakage was observed in 100% of vessels with evidence of vessel remodelling (Grades 3 and 4). Perivascular inflammation in the form of reactive astrocytes and activated microglia was observed predominantly surrounding arterioles at later stages of vessel pathology (Grades 2–4) and consistently around vessels with the same morphological features as ruptured vessel segments (Grade 4). These findings suggest a role for blood–brain barrier leakage and perivascular inflammation leading to arteriolar remodelling and haemorrhage in cerebral amyloid angiopathy, with early blood–brain barrier leakage as a potential trigger for subsequent perivascular inflammation.
Early prophylactic anticoagulation with heparin alleviates mortality in critically ill patients with sepsis: a retrospective analysis from the MIMIC-IV database
Authors: Zou Zhi-ye , Huang Jia-jia , Luan Ying-yi , Yang Zhen-jia , Zhou Zhi-peng , Zhang Jing-jing , Yao Yong-ming , Wu Ming
Published: September 2022

Background

Minimal data exist on anticoagulation use and timing and the dose of heparin in patients with sepsis, and whether heparin use improves sepsis survival remains largely unclear. This study was performed to assess whether heparin administration would provide a survival advantage in critically ill patients with sepsis.

Methods

A retrospective cohort study of patients with sepsis in the Medical Information Mart for Intensive Care (MIMIC)-IV database was conducted. Cox proportional hazards model and propensity score matching (PSM) were used to evaluate the outcomes of prophylactic anticoagulation with heparin administered by subcutaneous injection within 48 h of intensive care unit (ICU) admission. The primary outcome was in-hospital mortality. Secondary outcomes included 60-day mortality, length of ICU stay, length of hospital stay and incidence of acute kidney injury (AKI) on day 7. E-Value analysis were used for unmeasured confounding.

Results

A total of 6646 adult septic patients were included and divided into an early prophylactic heparin group (n = 3211) and a nonheparin group (n = 3435). In-hospital mortality in the heparin therapy group was significantly lower than that in the nonheparin group (prematched 14.7 vs 20.0%, hazard ratio (HR) 0.77, 95% confidence interval (CI) [0.68–0.87], p < 0.001, and postmatched 14.9 vs 18.3%, HR 0.78, 95% CI [0.68–0.89], p < 0.001). Secondary endpoints, including 60-day mortality and length of ICU stay, differed between the heparin and nonheparin groups (p < 0.01). Early prophylactic heparin administration was associated with in-hospital mortality among septic patients in different adjusted covariates (HR 0.71–0.78, p < 0.001), and only administration of five doses of heparin was associated with decreased in-hospital mortality after PSM (HR 0.70, 95% CI 0.56–0.87, p < 0.001). Subgroup analysis showed that heparin use was significantly associated with reduced in-hospital mortality in patients with sepsis-induced coagulopathy, septic shock, sequential organ failure assessment score ≥ 10, AKI, mechanical ventilation, gram-positive bacterial infection and gram-negative bacterial infection, with HRs of 0.74, 0.70, 0.58, 0.74, 0.73, 0.64 and 0.72, respectively (p <0.001). E-Value analysis suggested robustness to unmeasured confounding.

Conclusions

This study found an association between early administration prophylactic heparin provided to patients with sepsis and reduced risk-adjusted mortality. A prospective randomized-controlled study should be designed to further assess the relevant findings.
Current understanding of thermo(dys)regulation in severe burn injury and the pathophysiological influence of hypermetabolism, adrenergic stress and hypothalamic regulation—a systematic review
Authors: Mertin Viktoria , Most Patrick , Busch Martin , Trojan Stefan , Tapking Christian , Haug Valentin , Kneser Ulrich , Hundeshagen Gabriel
Published: September 2022

Background

In this systematic review, we summarize the aetiology as well as the current knowledge regarding thermo(dys)regulation and hypothermia after severe burn trauma and aim to present key concepts of pathophysiology and treatment options. Severe burn injuries with >20% total body surface area (TBSA) affected commonly leave the patient requiring several surgical procedures, prolonged hospital stays and cause substantial changes to body composition and metabolism in the acute and long-term phase. Particularly in severely burned patients, the loss of intact skin and the dysregulation of peripheral and central thermoregulatory processes may lead to substantial complications.

Methods

A systematic and protocol-based search for suitable publications was conducted following the PRISMA guidelines. Articles were screened and included if deemed eligible. This encompasses animal-based in vivo studies as well as clinical studies examining the control-loops of thermoregulation and metabolic stability within burn patients

Results

Both experimental animal studies and clinical studies examining thermoregulation and metabolic functions within burn patients have produced a general understanding of core concepts which are, nonetheless, lacking in detail. We describe the wide range of pathophysiological alterations observed after severe burn trauma and highlight the association between thermoregulation and hypermetabolism as well as the interactions between nearly all organ systems. Lastly, the current clinical standards of mitigating the negative effects of thermodysregulation and hypothermia are summarized, as a comprehensive understanding and implementation of the key concepts is critical for patient survival and long-term well-being.

Conclusions

The available in vivo animal models have provided many insights into the interwoven pathophysiology of severe burn injury, especially concerning thermoregulation. We offer an outlook on concepts of altered central thermoregulation from non-burn research as potential areas of future research interest and aim to provide an overview of the clinical implications of temperature management in burn patients.
Time–frequency cross-coupling between cortical low-frequency neuronal calcium oscillations and blood oxygen metabolism evoked by ultrasound stimulation
Authors: Su Zhaocheng , Yan Jiaqing , Ji Hui , Liu Mengyang , Zhang Xiangjian , Li Xiaoli , Yuan Yi
Published: September 2022

Low-intensity transcranial ultrasound stimulation (TUS) can modulate the coupling of high-frequency (160–200 Hz) neural oscillations and cerebral blood oxygen metabolism (BOM); however, the correlation of low-frequency (0–2 Hz) neural oscillations with BOM in temporal and frequency domains under TUS remains unclear. To address this, we monitored the TUS-evoked neuronal calcium oscillations and BOM simultaneously in the mouse visual cortex by using multimodal optical imaging with a high spatiotemporal resolution. We demonstrated that TUS can significantly increase the intensity of the neuronal calcium oscillations and BOM; the peak value, peak time, and duration of calcium oscillations are functionally related to stimulation duration; TUS does not significantly increase the neurovascular coupling strength between calcium oscillations and BOM in the temporal domain; the time differences of the energy peaks between TUS-induced calcium oscillations and BOM depend on their spectral ranges; the frequency differences of the energy peaks between TUS-induced calcium oscillations and BOM depend on their time ranges; and TUS can significantly change the phase of calcium oscillations and BOM from uniform distribution to a more concentrated region. In conclusion, ultrasound stimulation can evoke the time–frequency cross-coupling between the cortical low-frequency neuronal calcium oscillations and BOM in mouse.
Darvadstrocel for Complex Perianal Fistulas in Japanese Adults with Crohn’s Disease: A Phase 3 Study
Authors: Furukawa Satomi , Mizushima Tsunekazu , Nakaya Ryo , Shibata Mari , Yamaguchi Takayoshi , Watanabe Kenji , Futami Kitaro
Published: September 2022

Background and Aims

Previous studies conducted in Europe suggested that darvadstrocel, a suspension of expanded, allogeneic, adipose-derived, mesenchymal stem cells, is safe and effective for treatment-refractory complex perianal fistulas in patients with Crohn’s disease. The aim of this study was to evaluate the efficacy and safety of darvadstrocel for the treatment of complex perianal fistulas in Japanese adults with Crohn’s disease.

Methods

This is a phase 3, open-label, single-arm study conducted at nine sites in Japan. Adult patients with non-active or mildly active Crohn’s disease and complex perianal fistulas received a single 24-mL intralesional injection of darvadstrocel [120 × 106 cells]. The primary endpoint was combined remission (clinically confirmed closure of all treated external openings that were draining at screening, and absence of collections >2 cm, [confirmed by magnetic resonance imaging] among treated fistulas) at Week 24.

Results

Between March 6, 2019 and February 1, 2021, 22 patients received darvadstrocel and completed the 52-week follow-up. The proportion of patients achieving combined remission at Week 24 was 59.1% (95% confidence interval [CI], 38.5–79.6). The effect was maintained at Week 52, with 68.2% [95% CI, 48.7–87.6] of patients achieving combined remission. Treatment-related adverse events included: one [4.5%] patient with worsening of Crohn’s disease and diarrhoea, and one [4.5%] patient with blood bilirubin increase. No new safety findings were identified in this study.

Conclusions

The efficacy and tolerability of darvadstrocel in Japanese adult patients with treatment-refractory complex perianal fistulas in Crohn’s disease were similar to those observed in the previous European study. ClinicalTrials.gov number, NCT03706456.
Cardiogenic shock due to Takotsubo cardiomyopathy associated with thyroid crisis: a case report
Authors: Fan Xiaojuan , Liu Ping , Bai Ling
Published: September 2022

Background

The development of cardiogenic shock due to the coexistence of Takotsubo cardiomyopathy and thyroid crisis in patients has been scarcely reported.

Case summary

A 46-year-old female presented with chest pain, palpitations, nausea, and vomiting for 8 h. She was initially considered to have acute myocardial infarction due to elevated cardiac markers and abnormal electrocardiogram changes. Immediately after the coronary angiography revealed a normal coronary artery, the patient developed refractory cardiogenic shock. Echocardiography demonstrated a typical apical ballooning type of Takotsubo cardiomyopathy with a left ventricular ejection fraction (LVEF) of 32%. A combination of norepinephrine and dopamine and an intra-aortic balloon pump (IABP) was used to support haemodynamic stability but failed to improve the patient’s condition. Immediately after the laboratory tests revealed previously unknown hyperthyroidism on the second hospital day, a rapid atrial fibrillation (AF) suddenly occurred. Nifekalant successfully restored sinus rhythm in a short time. The patient persistently complained of chest tightness, palpitations, and sweating for the first 4 days until levosimendan and antithyroid crisis treatment were used.

Discussion

Takotsubo cardiomyopathy and thyroid crisis can co-occur and present as cardiogenic shock. In the presence of severe cardiac dysfunction and untreated hyperthyroidism, nifekalant is an ideal option for the new onset of AF. The combination of heart failure treatment and antithyroid crisis drugs can effectively restore cardiac function and is associated with good clinical outcomes.
Case report of a peripheral artery disease patient with its aetiology clarified by retrograde angioscopy
Authors: Yamane Haruya , Ueda Yasunori , Ikeoka Kuniyasu , Kosugi Shumpei
Published: September 2022

Background

Angioscopy plays an important role providing much information regarding vessel surfaces as macro-pathology in living patients. However, its viewing field is sometimes limited due to insufficient removal of blood flow and a catheter that cannot be controlled to view the intended direction. Angioscopy from a retrograde approach was found to overcome these limitations.

Case summary

A 68-year-old man was admitted to our hospital with acute intermittent claudication for 2 weeks. He was diagnosed with acute limb ischaemia (ALI) in his left superficial femoral artery, and revascularization by endovascular treatment was attempted. A bi-directional approach was needed for successful revascularization with thrombus aspiration and angioplasty. Subsequent angioscopic examination from the retrograde approach visualized a clear and adequate image of the vessel and helped identify the aetiology of the case as on-site thrombosis at an atherosclerotic lesion.

Discussion

It is important to understand the aetiology of ALI in each case for the management of the patient. Angioscopy can be a useful modality to identify the aetiology. It was found that retrograde angioscopy has several advantages over antegrade angioscopy in clear visualization and intentional control of the angioscopy catheter. This methodology may help us identify the aetiology of ALI by evaluating the vessel walls of patients with peripheral artery disease more precisely.
Abiotrophia defectiva endocarditis of bicuspid aortic valve: a case report
Authors: Fakhra Sadaf , Javaid Awad , Shafi Amaan , Ahsan Chowdhury
Published: September 2022

Background

Patients with a bicuspid aortic valve have increased risk of infective endocarditis, but common organisms are not always the culprit. We describe a case of an otherwise healthy young gentleman with bicuspid aortic valve who experienced Abiotrophia defectiva endocarditis. The aim of this case report is to highlight an uncommon cause of endocarditis associated with significant morbidity and mortality in order to improve the care provided by trainees and clinicians.

Case summary

A 37-year-old male presented with a 1-month history of fever, weight loss, myalgia, and night sweats. On transoesophageal echocardiography, he was found to have a bicuspid aortic valve with large vegetation and severe aortic insufficiency. Blood cultures were positive for A. defectiva. The endocarditis was successfully treated with surgical aortic valve replacement and 6 weeks of antibiotic therapy.

Discussion

Bicuspid valves are known to have increased susceptibility to endocarditis. The difficulty of isolating A. defectiva typically leads to delayed diagnosis and significant complications. This case is a reminder to have a high degree of suspicion for organisms which are rare and difficult to isolate because prompt recognition and surgical intervention may improve the outcome of care.
Successful treatment of doxorubicin-induced cardiomyopathy with low-dose sacubitril/valsartan: a case report
Authors: Bell Elisabeth , Desuki Alexander , Karbach Susanne , Göbel Sebastian
Published: September 2022

Background

Cancer therapy–related cardiac dysfunction (CTRCD) is a challenging and life-threatening complication of many chemotherapeutic regimens. CTRCD prevention, diagnosis, and therapy require both careful interdisciplinary assessment and management. For patients with CTRCD, current guidelines of the European Society of Cardiology (ESC) recommend an angiotensin-converting-enzyme inhibitor in combination with a beta-blocker. Recent studies indicate a beneficial effect of sacubitril/valsartan in this patient population.

Case summary

A 68-year-old female patient with a pleural epithelioid angiosarcoma developed heart failure with reduced ejection fraction and elevated serum biomarkers following doxorubicin treatment. After implementation of a recommended cardioprotective medical therapy including torasemide, ramipril, carvedilol, and spironolactone, the patient suffered two cardiac decompensations within 4 weeks after initiation of a paclitaxel regimen and pleural radiation therapy due to pain exacerbation. Despite a continuous application of the cardioprotective medical treatment regimen, no improvement of left-ventricular ejection fraction (LVEF) was detected in a 4-month follow up. Interestingly, after omitting ramipril and implementing low-dose sacubitril/valsartan (26/24 mg), we observed a decrease in serum biomarkers within 3 months as well as a significant improvement of LVEF within 6 months. After nearly 10 months of disease stabilization under paclitaxel, the patient suffered progressive cancer disease and deceased 1 week later after the initiation of a therapeutic attempt with pazopanib.

Discussion

This case report highlights the importance of interdisciplinary care in cancer patients as well as the promising role of (low-dose) sacubitril/valsartan in patients with CTRCD even in the setting of delayed initiation.
Arrhythmogenic right-ventricular cardiomyopathy with plakophilin-2 genetic variant concomitant with early manifestation of ventricular tachyarrhythmia: a case series
Authors: Kawano Kyoko , Kondo Hidekazu , Takahashi Masaki , Shinohara Tetsuji , Ohno Seiko , Horie Minoru , Takahashi Naohiko
Published: September 2022

Background

Arrhythmogenic right-ventricular cardiomyopathy (ARVC) is a hereditary cardiomyopathy characterized by fibro-fat replacement of the right-ventricular myocardium. There are many factors associated with poor prognosis in patients with ARVC. Among these factors, intensive physical exertion is considered an important risk factor for sudden cardiac death.

Case summary

Herein, we report a case series of siblings with ARVC and an early manifestation of ventricular tachyarrhythmia. Plakophilin-2 (PKP2) genetic variant, which is one of the causative genetic variants of ARVC, was detected by genetic testing in all three siblings. They were young athletes with lethal/symptomatic ventricular tachycardias. The eldest sibling was implanted with a transvenous implantable cardioverter defibrillator (ICD) due to resuscitated cardiopulmonary arrest at 18 years of age; the next oldest patient was treated with successful catheter ablation at 17 years; the youngest patient was treated with catheter ablation and subcutaneous ICD implantation at 17 years.

Discussion

A recent experimental model revealed that physical exertion in PKP2 knockout mice diminished cardiac muscle mass and increased cardiac myocyte apoptosis, despite enhanced arrhythmogenicity such as increased fractional shortening and calcium transient amplitude. The three siblings were heterozygous for the previously reported pathologic splice site variant c.2489 + 1G > A in Intron 12 of the PKP2. The variant might play an important role in facilitating the vulnerability to arrhythmia under intensive endurance training. Most ARVC patients with PKP2 variant, especially pathologic splice site variant c.2489 + 1G > A in Intron 12 of the PKP2, might have to be managed strictly regarding daily exercise.
Su(var)2-10- and Su(var)205-dependent upregulation of the heterochromatic gene neverland is required for developmental transition in Drosophila
Authors: Ohhara Yuya , Kato Yuki , Kamiyama Takumi , Yamakawa-Kobayashi Kimiko
Published: September 2022

Animals develop from juveniles to sexually mature adults through the action of steroid hormones. In insect metamorphosis, a surge of the steroid hormone ecdysone prompts the transition from the larval to the adult stage. Ecdysone is synthesized by a series of biosynthetic enzymes that are specifically expressed in an endocrine organ, the prothoracic gland. At the late larval stage, the expression levels of ecdysone biosynthetic enzymes are upregulated through the action of numerous transcription factors, thus initiating metamorphosis. In contrast, the mechanism by which chromatin regulators support the expression of ecdysone biosynthetic genes is largely unknown. Here, we demonstrate that Su(var)2-10 and Su(var)205, suppressor of variegation [Su(var)] genes encoding a chromatin regulator Su(var)2-10 and nonhistone heterochromatic protein 1a, respectively, regulate the transcription of one of the heterochromatic ecdysone biosynthetic genes, neverland, in Drosophila melanogaster. Knockdown of Su(var)2-10 and Su(var)205 in the prothoracic gland caused a decrease in neverland expression, resulting in a defect in larval-to-prepupal transition. Furthermore, overexpression of neverland and administration of 7-dehydrocholesterol, a biosynthetic precursor of ecdysone produced by Neverland, rescued developmental defects in Su(var)2-10 and Su(var)205 knockdown animals. These results indicate that Su(var)2-10- and Su(var)205-mediated proper expression of neverland is required for the initiation of metamorphosis. Given that Su(var)2-10-positive puncta are juxtaposed with the pericentromeric heterochromatic region, we propose that Su(var)2-10- and Su(var)205-dependent regulation of inherent heterochromatin structure at the neverland gene locus is essential for its transcriptional activation.
Intrinsic base substitution patterns in diverse species reveal links to cancer and metabolism
Authors: Gelova Suzana P , Doherty Kassidy N , Alasmar Salma , Chan Kin
Published: September 2022

Analyses of large-scale cancer sequencing data have revealed that mutagenic processes can create distinctive patterns of base substitutions, called mutational signatures. Interestingly, mutational patterns resembling some of these signatures can also be observed in normal cells. To determine whether similar patterns exist more generally, we analyzed large data sets of genetic variation, including mutations from 7 model species and single nucleotide polymorphisms in 42 species, totaling >1.9 billion variants. We found that base substitution patterns for most species closely match single base substitution (SBS) mutational signature 5 in the Catalog of Somatic Mutations in Cancer (COSMIC) database. SBS5 is ubiquitous in cancers and also present in normal human cells, suggesting that similar patterns of genetic variation across so many species are likely due to conserved biochemistry. We investigated the mechanistic origins of the SBS5-like mutational pattern in Saccharomyces cerevisiae, and show that translesion DNA synthesis and sugar metabolism are directly linked to this form of mutagenesis. We propose that conserved metabolic processes in cells are coupled to continuous generation of genetic variants, which can be acted upon by selection to drive the evolution of biological entities.
The Role of Incarceration as a Risk Factor for Cognitive Impairment
Authors: Cox Robynn J A , Wallace Robert B
Published: September 2022

Objectives

The objective of this study was to understand disparities in cognitive impairment between middle-aged formerly incarcerated (FI) and nonincarcerated individuals.

Methods

The 1979 National Longitudinal Survey of Youth is a nationally representative longitudinal data set containing information on incarceration, cognitive functioning, and other health conditions. Using a modified version of the Telephone Interview for Cognitive Status (TICS-m), adapted from the Health and Retirement Study, we analyzed the association between incarceration and cognitive impairment, cognitive impairment—not dementia and dementia. Multivariable regression models were estimated, including prior incarceration status and covariates associated with incarceration and cognitive functioning.

Results

FI individuals had lower unadjusted scores on TICS-m (−2.5, p < .001) and had significantly greater unadjusted odds ratios (OR) for scoring in the cognitive impairment (OR = 2.4, p < .001) and dementia (OR = 2.7, p < .001) range. Differences were largely explained by a combination of risk factors associated with incarceration and cognition. Education and premorbid cognition (measured by Armed Forces Qualification Test) separately and completely explained differences in the odds of dementia. Regardless of incarceration status, Blacks and Hispanics had significantly greater odds of cognitive impairment and dementia relative to Whites, holding other factors constant.

Discussion

The association between prior incarceration and cognitive impairment in middle age was largely explained by differences in educational attainment and premorbid cognitive functioning, supporting the cognitive reserve hypothesis. Greater prevalence of cognitive impairment and dementia among the FI could create challenges and should be considered in reentry planning. Structural and institutional factors should be considered when addressing health disparities in Alzheimer’s Disease and Related Dementias.
People do care about the deep sea. A comment on Jamieson et al. (2020)
Authors: Armstrong Claire W , Aanesen Margrethe , Hynes Stephen , Tinch Rob
Published: September 2022

In a paper in this journal entitled “Fear and loathing of the deep sea: why don't people care about the deep sea?”, Jamieson et al. (2020) pose this question and answer it with many interesting perspectives from psychology, ocean literacy and philosophy. However, there is an inherent assumption in the question they ask that people do not care about the deep sea. In order to assess this assumption, we contend that the first question to ask is: do people care about the deep sea? Based on the cultural significance of the theme of the deep ocean in art and literature, the results of ocean attitudinal surveys and the work done on deep sea economic valuation in recent years, we suggest that the answer is that people do care about many different aspects of the deep sea, not only the ones that hold market value, but also non-market values. It is nonetheless argued that the welfare benefits that societies gain from the deep sea are not at the fore in political discussions or marine policy making.
Reply to: People do care about the deep sea. A comment on Jamieson et al. (2020)
Authors: Jamieson Alan J , Linley Thomas D , Arasu Prema
Published: September 2022

Why don’t people care about the deep sea? was a question addressed in a 2020 Food for Thought article in this journal. That article delivered an extensive critique of misleading statements, poorly structured analogies, and common misconceptions to challenge the largely negative or unnecessarily sensationalist narrative when the deep sea is communicated to the public. The overarching sentiment of that article has been countered by a Comment in which it is argued that people do in fact care about the deep sea. However, this counter argument is based on very little to do with the deep sea but rather a corpus of studies relating mostly to cold water corals and people’s willingness to pay for their conservation and restoration in the event of impending or recent destruction. We do not feel that the Comment addresses the same problem as discussed in the original article. Here, we explain that the seeming differences of opinion about whether people care about the deep sea are based on two things: the title of the article commented on (not its content) and how the original article, and the Comment on it, define the deep sea.
Prevalence of inverse psoriasis subtype with immune checkpoint inhibitors
Authors: Jfri Abdulhadi , Leung Bonnie , Said Jordan T , Semenov Yevgeniy , LeBoeuf Nicole R
Published: September 2022

Background

Cutaneous immune-related adverse events (irAEs) are the most common irAEs caused by immune-checkpoint inhibitors (ICI). Psoriasiform eruptions, both de novo and flares, may occur. Evidence is lacking on inverse psoriasis subtype.

Methods

A retrospective study was conducted at Dana-Farber Cancer Institute/Mass General Brigham through February 2020 using databases. Confirmed inverse psoriasis cases pre-/post-ICI initiation either independently or in conjunction with other psoriasis subtypes were included. Known psoriasis cases without flare post-ICI were excluded.

Results

A total of 262 (3%) individuals with any ICI-mediated psoriasiform cutaneous irAE were identified out of the 8683 DFCI ICI-treated patients. Of these, 13 (5% of psoriasis patients) had inverse psoriasis (mean age 68.7 years; 7/13 male sex). Median (range) time from ICI initiation to inverse psoriasis development or flare was 7 (4–12) and 3.5 (2–6) weeks, respectively. Pruritus occurred in 12/13 (92.30%) cases. 11 (85%) had inguinal involvement; other sites included gluteal cleft (6; 46%), inframammary (3; 23%), perianal (2; 15%), axilla (2; 15%), umbilicus (2; 15%), and infra-abdominal folds (1; 8%). Most (9/13) individuals had more than one site involved. The Common Terminology Criteria for Adverse Events severity was 1 in 10 (76.92%) individuals and 2 in 3 (15.38%) individuals. Six (46.15%) patients were treated initially by oncology with topical (nystatin, econazole, or clotrimazole) or systemic antifungals (fluconazole) for median (range) of 3.5 (1–7) months without improvement, for presumed candida intertrigo.

Conclusion

Patients on ICI may develop inverse psoriasis, which may be initially confused for fungal intertrigo. Delayed diagnosis can prolong symptoms, while patients are treated ineffectively with topical/systemic antifungals for presumed candida infection. Oncologist and dermatologist awareness is important to improve diagnosis of ICI-mediated inverse psoriasis, its management and affected patients’ quality of life.