bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of patients who had a stroke not initially identified during emergency prehospital assessment: a systematic review
Authors: Jones Stephanie P , Bray Janet E , Gibson Josephine ME , McClelland Graham , Miller Colette , Price Chris I , Watkins Caroline L
Published: February 2021

Background

Around 25% of patients who had a stroke do not present with typical ‘face, arm, speech’ symptoms at onset, and are challenging for emergency medical services (EMS) to identify. The aim of this systematic review was to identify the characteristics of acute stroke presentations associated with inaccurate EMS identification (false negatives).

Method

We performed a systematic search of MEDLINE, EMBASE, CINAHL and PubMed from 1995 to August 2020 using key terms: stroke, EMS, paramedics, identification and assessment. Studies included: patients who had a stroke or patient records; ≥18 years; any stroke type; prehospital assessment undertaken by health professionals including paramedics or technicians; data reported on prehospital diagnostic accuracy and/or presenting symptoms. Data were extracted and study quality assessed by two researchers using the Quality Assessment of Diagnostic Accuracy Studies V.2 tool.

Results

Of 845 studies initially identified, 21 observational studies met the inclusion criteria. Of the 6934 stroke and Transient Ischaemic Attack patients included, there were 1774 (26%) false negative patients (range from 4 (2%) to 247 (52%)). Commonly documented symptoms in false negative cases were speech problems (n=107; 13%–28%), nausea/vomiting (n=94; 8%–38%), dizziness (n=86; 23%–27%), changes in mental status (n=51; 8%–25%) and visual disturbance/impairment (n=43; 13%–28%).

Conclusion

Speech problems and posterior circulation symptoms were the most commonly documented symptoms among stroke presentations that were not correctly identified by EMS (false negatives). However, the addition of further symptoms to stroke screening tools requires valuation of subsequent sensitivity and specificity, training needs and possible overuse of high priority resources.
Examining the utility of extended laboratory panel testing in the emergency department for risk stratification of patients with COVID-19: a single-centre retrospective service evaluation
Authors: Ponsford Mark J , Burton Ross J , Smith Leitchan , Khan Palwasha Y , Andrews Robert , Cuff Simone , Tan Laura , Eberl Matthias , Humphreys Ian R , Babolhavaeji Farbod , Artemiou Andreas , Pandey Manish , Jolles Stephen R A , Underwood Jonathan
Published: February 2021

Background

The role of specific blood tests to predict poor prognosis in patients admitted with infection from SARS-CoV-2 remains uncertain. During the first wave of the global pandemic, an extended laboratory testing panel was integrated into the local pathway to guide triage and healthcare resource utilisation for emergency admissions. We conducted a retrospective service evaluation to determine the utility of extended tests (D-dimer, ferritin, high-sensitivity troponin I, lactate dehydrogenase and procalcitonin) compared with the core panel (full blood count, urea and electrolytes, liver function tests and C reactive protein).

Methods

Clinical outcomes for adult patients with laboratory-confirmed COVID-19 admitted between 17 March and 30 June 2020 were extracted, alongside costs estimates for individual tests. Prognostic performance was assessed using multivariable logistic regression analysis with 28-day mortality used as the primary endpoint and a composite of 28-day intensive care escalation or mortality for secondary analysis.

Results

From 13 500 emergency attendances, we identified 391 unique adults admitted with COVID-19. Of these, 113 died (29%) and 151 (39%) reached the composite endpoint. ‘Core’ test variables adjusted for age, gender and index of deprivation had a prognostic area under the curve of 0.79 (95% CI 0.67 to 0.91) for mortality and 0.70 (95% CI 0.56 to 0.84) for the composite endpoint. Addition of ‘extended’ test components did not improve on this.

Conclusion

Our findings suggest use of the extended laboratory testing panel to risk stratify community-acquired COVID-19 positive patients on admission adds limited prognostic value. We suggest laboratory requesting should be targeted to patients with specific clinical indications.
In silico trials predict that combination strategies for enhancing vesicular stomatitis oncolytic virus are determined by tumor aggressivity
Authors: Jenner Adrianne L , Cassidy Tyler , Belaid Katia , Bourgeois-Daigneault Marie-Claude , Craig Morgan
Published: February 2021

Background

Immunotherapies, driven by immune-mediated antitumorigenicity, offer the potential for significant improvements to the treatment of multiple cancer types. Identifying therapeutic strategies that bolster antitumor immunity while limiting immune suppression is critical to selecting treatment combinations and schedules that offer durable therapeutic benefits. Combination oncolytic virus (OV) therapy, wherein complementary OVs are administered in succession, offer such promise, yet their translation from preclinical studies to clinical implementation is a major challenge. Overcoming this obstacle requires answering fundamental questions about how to effectively design and tailor schedules to provide the most benefit to patients.

Methods

We developed a computational biology model of combined oncolytic vaccinia (an enhancer virus) and vesicular stomatitis virus (VSV) calibrated to and validated against multiple data sources. We then optimized protocols in a cohort of heterogeneous virtual individuals by leveraging this model and our previously established in silico clinical trial platform.

Results

Enhancer multiplicity was shown to have little to no impact on the average response to therapy. However, the duration of the VSV injection lag was found to be determinant for survival outcomes. Importantly, through treatment individualization, we found that optimal combination schedules are closely linked to tumor aggressivity. We predicted that patients with aggressively growing tumors required a single enhancer followed by a VSV injection 1 day later, whereas a small subset of patients with the slowest growing tumors needed multiple enhancers followed by a longer VSV delay of 15 days, suggesting that intrinsic tumor growth rates could inform the segregation of patients into clinical trials and ultimately determine patient survival. These results were validated in entirely new cohorts of virtual individuals with aggressive or non-aggressive subtypes.

Conclusions

Based on our results, improved therapeutic schedules for combinations with enhancer OVs can be studied and implemented. Our results further underline the impact of interdisciplinary approaches to preclinical planning and the importance of computational approaches to drug discovery and development.
Epistemic injustice in psychiatric practice: epistemic duties and the phenomenological approach
Authors: Drożdżowicz Anna
Published: February 2021

Epistemic injustice is a kind of injustice that arises when one’s capacity as an epistemic subject (eg, a knower, a reasoner) is wrongfully denied. In recent years it has been argued that psychiatric patients are often harmed in their capacity as knowers and suffer from various forms of epistemic injustice that they encounter in psychiatric services. Acknowledging that epistemic injustice is a multifaceted problem in psychiatry calls for an adequate response. In this paper I argue that, given that psychiatric patients deserve epistemic respect and have a certain epistemic privilege, healthcare professionals have apro tanto epistemic dutyto attend to and/or solicit reports of patients’ first-person experiences in order to prevent epistemic losses. I discuss the nature and scope of this epistemic duty and point to one interesting consequence. In order to prevent epistemic losses, healthcare professionals may need to provide some patients with resources and tools for expressing their experiences and first-person knowledge, such as those that have been developed within the phenomenological approach. I discuss the risk of secondary testimonial and hermeneutical injustice that the practice of relying on such external tools might pose and survey some ways to mitigate it.
The capacity to designate a surrogate is distinct from decisional capacity: normative and empirical considerations
Authors: Navin Mark , Wasserman Jason Adam , Stahl Devan , Tomlinson Tom
Published: February 2021

The capacity to designate a surrogate (CDS) is not simply another kind of medical decision-making capacity (DMC). A patient with DMC can express a preference, understand information relevant to that choice, appreciate the significance of that information for their clinical condition, and reason about their choice in light of their goals and values. In contrast, a patient can possess the CDS even if they cannot appreciate their condition or reason about the relative risks and benefits of their options. Patients who lack DMC for many or most kinds of medical choices may nonetheless possess the CDS, particularly since the complex means-ends reasoning required by DMC is one of the first capacities to be lost in progressive cognitive diseases (eg, Alzheimer’s disease). That is, patients with significant cognitive decline or mental illness may still understand what a surrogate does, express a preference about a potential surrogate, and be able to provide some kind of justification for that selection. Moreover, there are many legitimate and relevant rationales for surrogate selection that are inconsistent with the reasoning criterion of DMC. Unfortunately, many patients are prevented from designating a surrogate if they are judged to lack DMC. When such patients possess the CDS, this practice is ethically wrong, legally dubious and imposes avoidable burdens on healthcare institutions.
COVID-19 and the burning issue of drug interaction: never forget the ECG
Authors: Sciaccaluga Carlotta , Cameli Matteo , Menci Daniele , Mandoli Giulia Elena , Sisti Nicolò , Cameli Paolo , Franchi Federico , Mondillo Sergio , Valente Serafina
Published: February 2021

The coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), has been rapidly escalating, becoming a relevant threat to global health. Being a recent virus outbreak, there are still no available therapeutic regimens that have been approved in large randomised trials and so patients are currently being treated with multiple drugs. This raises concerns regarding drug interaction and their implication in arrhythmic burden. In fact, two of the actually used drugs against SARS-CoV2, such as chloroquine and the combination lopinavir/ritonavir, might determine a QT (the time from the start of the Q wave to the end of the T wave) interval prolongation and they show several interactions with antiarrhythmic drugs and antipsychotic medications, making them prone to an increased risk of developing arrhythmias. This brief review focuses the attention on the most relevant drug interactions involving the currently used COVID-19 medications and their possible association with cardiac rhythm disorders, taking into account also pre-existing condition and precipitating factors that might additionally increase this risk. Furthermore, based on the available evidence and based on the knowledge of drug interaction, we propose a quick and simple algorithm that might help both cardiologists and non-cardiologists in the management of the arrhythmic risk before and during the treatment with the specific drugs used against SARS-CoV2.
Tracking missed opportunities for an early HIV diagnosis in a population of people living with HIV with known time of infection
Authors: Basoulis Dimitrios , Kostaki Evangelia Georgia , Paraskevis Dimitrios , Hatzakis Angelos , Psichogiou Mina
Published: February 2021

Purpose

The goal of 90-90-90 first requires the expansion of access to HIV testing. Our aim was to record frequencies of HIV indicator conditions (ICs) and identify missed opportunities for an early HIV diagnosis.

Methods

We retrospectively identified ICs in a population of 231 people living with HIV with known infection dates who attended our clinic. The study population was divided into four groups: (1) those self-tested pre-emptively (47/231, 20.3%), (2) those offered targeted testing based on risk factors (67/231, 29%), (3) those tested after an IC (73/231, 31.6%) and (4) those who were not offered testing after an IC (44/231, 19%). HIV acquisition dates were estimated by molecular clock analysis.

Results

A total of 169 healthcare contacts (HCCs) were recorded. The most frequent HCC was mononucleosis-like syndrome (20.1%), unexplained weight loss (10.7%) and STIs (10.1%). AIDS-defining conditions were detected in 11.8%. Only 62.4% (73/117) of those with an IC were offered testing after their first HCC. Patients in group 4 had statistically significant delay in diagnosis compared with group 3 (109.1 weeks (IQR 56.4–238.6) vs 71.6 weeks (IQR 32.3–124.6)). The proportion of patients diagnosed as late presenters in each group was: (1) 16/47 (34%), (2) 37/67 (55.2%), (3) 43/73 (58.9%) and (4) 27/44 (61.4%) (p=0.027).

Conclusions

Our study uses a combination of molecular and clinical data and shows evidence that late presentation occurs in a high proportion of patients even in the presence of an IC. Given that risk-based targeted testing has low coverage, IC-guided testing provides a reasonable alternative to facilitate earlier HIV diagnosis and to improve late diagnosis across Europe and globally.
Clinical outcomes of syphilis in HIV-negative and HIV-positive MSM: occurrence of repeat syphilis episodes and non-treponemal serology responses
Authors: Nieuwenburg Silvia Achia , Sprenger Ricardo Jamie , Schim van der Loeff Maarten Franciscus , de Vries Henry John Christiaan
Published: February 2021

Objectives

HIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored.

Methods

This retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3–6 months. We included data of participants with ≥1 syphilis diagnosis in 2014–2019. Pearson’s χ² test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses.

Results

We included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68/90 (75.6%) vs 96/265 (36.2%); p<0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7/73 (9.6%) vs 36/126 (28.6%)) and more often diagnosed with secondary syphilis (16/73 (21.9%) vs 17/126 (13.5%)) and early latent syphilis (50/73 (68.5%) vs 73/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138/143 (96.5%) vs 66/74 (89.2%); p=0.032).

Conclusions

In repeat syphilis, HIV infection is associated with advanced syphilis stages and with higher non-treponemal titres. HIV infection affects the serological outcome after treatment, as an adequate titre response was observed earlier in HIV-negative MSM.
Self-reported exposure of Indonesian adolescents to online and offline tobacco advertising, promotion and sponsorship (TAPS)
Authors: Septiono Wahyu , Kuipers Mirte A G , Ng Nawi , Kunst Anton E
Published: February 2021

Objectives

To quantify tobacco advertising, promotion and sponsorship (TAPS), self-reported exposure from online and offline platforms among adolescents in Indonesia.

Methods

A cross-sectional school-based survey was conducted in 2017. In total, 2820 students aged 13–18 years were recruited from 22 schools in seven cities. Respondents reported TAPS exposure on online (online news, YouTube, Facebook, Twitter and Instagram), and offline platforms (broadcast media, tobacco industry sponsored events and outdoor advertising). For outdoor advertisements, respondents reported the locations where they were exposed. We used multilevel analysis to assess TAPS exposure by age, gender, smoking status and city.

Results

Online TAPS exposure was high on Instagram (29.6%), and relatively low on Twitter (7.3%). Offline TAPS exposure was high via television (74.0%), billboards (54.4%) and live music events (46.2%), but low on radio (6.9%). In all cities, outdoor advertising was seen particularly on the streets and in minimarkets. Overall, TAPS exposure was higher among older than younger adolescents, boys than girls, and smokers than non-smokers.

Conclusions

Overall TAPS exposure was high on both online and offline platforms. Banning online tobacco advertising, in addition to complete bans on outdoor and television advertising, is essential to adequately protect Indonesian adolescents from tobacco advertising.
The QCD odderon in elastic (anti)proton scattering
Authors: Braun M. A.
Published: February 2021

The C-odd amplitude for the elastic pp and $$p\bar{p}$$

p

p

¯

scattering due to the exchange of the QCD odderon proposed by J. Bartels, L.N. Lipatov and G.P. Vacca is calculated with the Fukugita–Kwiecinski proton impact factor. The found amplitude is very small and cannot be felt in the differential cross-sections at 2.76 and 1.96 TeV respectively.
Evolutionary algorithms for hyperparameter optimization in machine learning for application in high energy physics
Authors: Tani Laurits , Rand Diana , Veelken Christian , Kadastik Mario
Published: February 2021

The analysis of vast amounts of data constitutes a major challenge in modern high energy physics experiments. Machine learning (ML) methods, typically trained on simulated data, are often employed to facilitate this task. Several choices need to be made by the user when training the ML algorithm. In addition to deciding which ML algorithm to use and choosing suitable observables as inputs, users typically need to choose among a plethora of algorithm-specific parameters. We refer to parameters that need to be chosen by the user as hyperparameters. These are to be distinguished from parameters that the ML algorithm learns autonomously during the training, without intervention by the user. The choice of hyperparameters is conventionally done manually by the user and often has a significant impact on the performance of the ML algorithm. In this paper, we explore two evolutionary algorithms: particle swarm optimization and genetic algorithm, for the purposes of performing the choice of optimal hyperparameter values in an autonomous manner. Both of these algorithms will be tested on different datasets and compared to alternative methods.
Analysis of strange quark stars in massive Brans–Dicke gravity
Authors: Sharif M. , Majid Amal
Published: February 2021

In this paper, we explore the behavior and anisotropic structure of quark stellar models in the framework of massive Brans–Dicke gravity. The system of field equations, representing a static sphere, is formulated by incorporating the MIT bag model. We use the Karmarkar condition for embedding class-one to formulate a relativistic model corresponding to a well-behaved radial metric function. The values of unknown parameters are determined through the matching of internal and external space–times at the hypersurface. The observed masses and radii of the strange star candidates (RXJ 1856-37, Her X-1 and PSR J1614-2230) specify the solution. Further, we evaluate the impact of the massive scalar field on state parameters and investigate the viability as well as stability of the self-gravitating objects. It is found that the obtained values of the bag constant (corresponding to each star) lie within the accepted range. Moreover, the anisotropic structure meets the necessary viability and stability criteria.
Current Differencing Buffered Amplifier-Based PID Controller Design
Authors: Gür Fethi , Anday Fuat
Published: February 2021

A new voltage mode Proportional-Integral-Derivative (PID) controller employing Current Differencing Buffered Amplifier (CDBA) is presented. The proposed PID controller employs a canonical number of capacitors without requiring any passive components matching conditions. The element values are expressed in terms of PID parameters. Workability of the proposed controller is demonstrated through SPICE simulations for which CDBA is realized using Current Feedback Amplifier (CFA). The simulation results are found in close agreement with the theoretical results.
CELLULAR FEEDBACK NETWORKS AND THEIR RESILIENCE AGAINST MUTATIONS
Authors: BAILEY LORA D. , KOMAROVA NATALIA L.
Published: February 2021

Many tissues undergo a steady turnover, where cell divisions are on average balanced with cell deaths. Cell fate decisions such as stem cell (SC) differentiations, proliferations, or differentiated cell (DC) deaths, may be controlled by cell populations through cell-to-cell signaling. Here, we examine a class of mathematical models of turnover in SC lineages to understand engineering design principles of control (feedback) loops, that may operate in such systems. By using ordinary differential equations that describe the co-dynamics of SCs and DCs, we study the effect of different types of mutations that interfere with feedback present within cellular networks. For instance, we find that mutants that do not participate in feedback are less dangerous in the sense that they will not rise from low numbers, whereas mutants that do not respond to feedback signals could rise and replace the wild-type population. Additionally, we asked if different feedback networks can have different degrees of resilience against such mutations. We found that all minimal networks, that is networks consisting of exactly one feedback loop that is sufficient for homeostatic stability of the wild-type population, are equally vulnerable. Mutants with a weakened/eliminated feedback parameter might expand from lower numbers and either enter unlimited growth or reach an equilibrium with an increased number of SCs and DCs. Therefore, from an evolutionary viewpoint, it appears advantageous to combine feedback loops, creating redundant feedback networks. Interestingly, from an engineering prospective, not all such redundant systems are equally resilient. For some of them, any mutation that weakens/eliminates one of the loops will lead to a population growth of SCs. For others, the population of SCs can actually shrink as a result of “cutting” one of the loops, thus slowing down further unwanted transformations.
Facile one-step synthesis and fluorescence performance study of nitrogen-doped carbon quantum dots
Authors: Huai Xu , Duan Weiwei , Li Jiayu , Zhang Qin , Dong Qian , Cao Yang , Wang Taisheng , Zhang Zewu , Hang Zusheng
Published: February 2021

A facile strategy is reported to synthesize nitrogen-doped carbon quantum dots (N-CQDs) with fluorescence emission by a one-step hydrothermal treatment under different temperatures with dicyanodiamide and citric acid as precursor materials of nitrogen and carbon sources, respectively. The as-produced N-CQDs display green or blue fluorescence under the ultraviolet lamp was controlled by the reaction temperature. Consequently, the as-prepared sample reacted at 200[Formula: see text]C (N-CQDs-200), within the range of 3 nm, exhibits blue fluorescence excited at 365 nm irradiation with the maximum quantum yield (QY) of ca. 30.6%. Moreover, the N-CQDs possess rich functional groups such as nitrous groups and multiple oxygenated groups, which result in a favorable solubility in most hydrophilic solvents. From the characterization and discussion of TEM, HRTEM, FT-IR, XPS, Raman and UV-Vis, it is illustrated that the fluorescence performance was largely related to the nanomorphology, nitrogen concentration, multi-surface emission sites and various forms of transitions derived from the nitrogen doping. With the excellent fluorescence performance and the favorable solubility in solvents, the products are potentially suitable for monitoring organics.
Global Stability of Switched HIV/AIDS Models with Drug Treatment Involving Caputo-Fractional Derivatives
Authors: Wang Xiying , Wang Wenfeng , Li Yuanxiao
Published: February 2021

In this paper, we formulate and investigate new switched HIV/AIDS models with drug treatment involving Caputo-fractional derivatives. Initially, due to the fractional derivative order related to the memory and hereditary effects and supposing that the model coefficients are time-varying parameters, we develop a Caputo-fractional order HIV/AIDS models with switching parameters and study their dynamics utilizing Lyapunov–Razumikhin technique. Furthermore, the results show that the fractional derivative

α

(

0
<
α
<
1

) and the switching parameters are related to the critical threshold value (

R
^

or

R
¯

) which ensures disease eradication under the condition of

R
^

<
1

or

R
¯

<
1

. Then, a treatment compartment is introduced into the above model from the asymptomatic infected individuals until the full blown AIDS individuals. Novel sufficient conditions on the threshold value are derived to verify that the disease is eventually cleared as the critical threshold parameter is below unity. Finally, some simulations are employed to support the main results and one future research direction is presented.
High-Quality Economic Development in Huaihe Economic Zone Level Measurement and Evaluation
Authors: Sun Xin , Fang Shu , Zhang Su
Published: February 2021

This article constructs a comprehensive evaluation index system from four aspects: economic vitality, innovation efficiency, green development, and people’s lives. Use the entropy method to comprehensively measure the urban competitiveness level of 25 counties and cities in the economic zone, clarify the differences in their high-quality development levels, and use spatial econometric analysis methods to study the spatial agglomeration and dispersion and spatial convergence of regional urban competitiveness. The results show that the following: (1) the overall high-quality development level of the Huaihe River Eco-Economic Zone is not high, and the overall time and space characteristics is “high in the east and low in the west”; (2) there is a positive spatial autonomy in urban competitiveness and the spatial distribution of the Huaihe River, and relevantly, the degree of closeness of spatial associations between cities is generally low; (3) the gap between the level of urban competitiveness in Jiangsu Province is shrinking, the development of other provinces has a time lag effect, and there are differences in the level of urban competitiveness. Finally, to promote the high-quality development of the Huaihe Economic Zone, we must follow the law of the basin and the characteristics of spatial distribution and implement targeted strategies.
Research on College Physical Education and Sports Training Based on Virtual Reality Technology
Authors: Li Dan , Yi Chao , Gu Yue
Published: February 2021

With the continuous development of society and the rapid development of science and technology, virtual reality technology is also developing rapidly. It has been widely used in all walks of life and is playing an irreplaceable role. Modern education has also begun to integrate with science. Sports are also constantly deepening the application of information technology. In order to make students have a new understanding of college physical education and sports training and improve the technical level and training quality of college sports athletes, this paper studies the application of virtual reality technology in physical education and sports training. In this paper, the semisupervised framework is used to implement motion input and interactive virtual scene algorithms. First, based on Q statistics, virtual simulation and differential selection algorithms are used to select athletic students with strong autonomous learning ability and then use the classifier’s neighbor confidence. The formula selects the student with the highest learning level and marks it. Experimental results show that this method can effectively assist physical education activities and improve students’ learning efficiency. Students’ efficiency in sports has increased by 30%. At the same time, 2/3 of people believe that their interest in sports training has increased 80% and another 90% of college coaches believe that the use of virtual reality technology in physical education is very necessary, which can improve the technical level and training quality of college sports athletes and contribute to the reserve of Chinese competitive sports talents.
New Purinyl-Steroid and Other Constituents from the Marine Fungus Penicillium brefeldianum ABC190807: Larvicidal Activities against Aedes aegypti
Authors: Hou Zong-Min , Yu Sen-Quan , Tao Min , Xia Cai-Bei , Xia Yu-Lian , Wu Xian-Feng , Dong Cun-Zhu
Published: February 2021

Mosquitoes historically threatened human health; the major mosquito-related global health issues include malaria, dengue fever, yellow fever, and Zika, as well as several other vector-borne outbreaks. Here, the EtOAc extract of the mangrove sediment fungus Penicillium brefeldianum ABC190807 exerted larvicidal activities against the third instar larvae of Aedes aegypti with an LC50 of 0.089 mg/mL. One new purinyl-steroid (ergosta-4,6,8(14),22-tetraen-3-(6-amino-9H-purin-9-yl) (1)), along with six (2–7) known compounds, were isolated from the EtOAc extract of Penicillium brefeldianum ABC190807. Structures of the compounds were elucidated via 1D/2D NMR and HR-ESI-MS data. Respective spectral data were compared with those of known compounds. Among all compounds whose larvicidal activity against the third instar larvae of Aedes aegypti was evaluated, compounds 2 and 7 showed larvicidal activity with respective LC50 values of 0.452 and 0.337 mg/mL.
Migration and Transformation of Heavy Metals in the Soil of the Water-Level Fluctuation Zone in the Three Gorges Reservoir under Simulated Nitrogen Deposition
Authors: Zhang Liuyi , Fu Kun , Yang Fumo , Chen Yang , Fu Chuan , Huang Yimin , Guo Zhengjun , Li Tingzhen
Published: February 2021

The accumulation of heavy metals (HMs) in the water-level fluctuation zone (WLFZ) of the Three Gorges Reservoir (TGR) area is potentially harmful to the water environment. In order to reveal whether nitrogen (N) deposition is a potential driving factor for the migration and transformation of HMs (Cd, Cr, Cu, Ni, and Pb), a simulated N deposition experiment was performed on the soil in the WFLZ of the TGR. The results showed that the accumulative release amounts of HMs increased with the increase of N deposition. It was found that the Elovich equation, double-constant equation, and parabolic diffusion equation could well describe the release process of Cu, Cd, Cr, and Ni, while the double-constant equation, parabolic diffusion equation, and first-order equation could be applicable for Pb. The exchangeable fractions of HMs increased to varying degrees after the N deposition treatment, wherein Ni was most significant, indicating that N deposition could increase the ecological risk of HM pollution in the TGR area. The results provide insight into the major factors affecting the release of different HMs under N deposition in this vulnerable region ecologically.
Study Design and Data Analysis of Artificial Pancreas Device Systems with Closed-Loop Glucose-Sensing Insulin Delivery
Authors: Shankara Sravya B. , Liu Yujia , Zheng Qingfeng , Guo Jing , Wang Guixia , Zhang Bo
Published: February 2021

Objective. The objective of this article is to provide a high-profile review and discussion on the study design and statistical analysis of pivotal clinical trials conducted to demonstrate the safety and effectiveness of closed-loop investigational artificial pancreas device systems (APDSs) in premarket approval applications. Methods. The United States Food and Drug Administration (FDA) guidance on the content of investigational device exemption and premarket approval applications for APDSs is reviewed with special emphasis on study design and statistical analysis of the pivotal clinical trials. The two pivotal studies for the MiniMed 670G hybrid closed-loop system by Medtronic in their premarket approval application are summarized and discussed. Results. The United States FDA established detailed recommendations on the study design and statistical analysis of pivotal clinical trials for the industry that seek market investigational APDSs and for FDA scientific reviewers that regulate the device applications. The recommendations cover specifics regarding patient population, clinical endpoints, and strategies for data analysis. However, the two pivotal studies that demonstrated the effectiveness of the FDA-approved MiniMed 670G hybrid closed-loop system were not typical randomized controlled trials as per FDA recommendations. Conclusion. The development and regulation of investigational APDSs require careful and sophisticated clinical study designs and data analysis in premarket approval applications. The regulatory evaluation process of the APDSs is rather complicated since the devices consist of multiple components that collaboratively function to mimic human pancreases.
Aortoenteric Fistula after Endovascular Aneurysm Repair
Authors: Gunawardena Thilina , Saseekaran Balasubramanium , Abeywickrama Sachith , Cassim Rezni , Wijeyaratne Mandika
Published: February 2021

Aortoenteric fistula is a rare complication following endovascular abdominal aortic aneurysm repair. However, there is a significant morbidity and mortality associated with this complication. Patients can present with gastrointestinal hemorrhage, fever, or nonspecific features of chronic infection. Extra anatomic bypass with complete graft explanation is the standard management.
Angelica Polysaccharide Ameliorates Sepsis-Induced Acute Lung Injury through Inhibiting NLRP3 and NF-κB Signaling Pathways in Mice
Authors: Zhu Yan , Meng Taocheng , Sun Aichen , Li Jintao , Li Jinlai
Published: February 2021

Objective. This study aimed to explore the role of angelica polysaccharide (AP) in sepsis-induced acute lung injury (ALI) and its underlying molecular mechanism. Methods. A sepsis model of cecal ligation and puncture (CLP) in male BALB/C mice was used. Then, 24 h after CLP, histopathological changes in lung tissue, lung wet/dry weight ratio, and inflammatory cell infiltration were analyzed. Next, levels of inflammatory cytokines (tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, and IL-18), as well as the activity of myeloperoxidase (MPO), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH), were measured to assess the role of AP. The protein expression of NF-κB p65, p-NF-κB p65, IκBα, p-IκBα, nucleotide-binding domain- (NOD-) like receptor protein 3 (NLRP3), ASC, and caspase-1 was detected by western blot. In addition, the expression of p-NF-κB p65 and NLRP3 was detected by immunohistochemistry. Results. AP treatment ameliorated CLP-induced lung injury and lung edema, as well as decreased the number of total cells, neutrophils, and macrophages in bronchoalveolar lavage fluid (BALF). AP reduced the levels of TNF-α, IL-1β, IL-6, and IL-18 in BALF, as well as in serum. Moreover, AP decreased MPO activity and MDA content, whereas increased SOD and GSH levels. AP inhibited the expression of p-NF-κB p65, p-IκBα, NLRP3, ASC, and caspase-1, while promoted IκBα expression. Conclusion. This study demonstrated that AP exhibits protective effects against sepsis-induced ALI by inhibiting NLRP3 and NF-κB signaling pathways in mice.
Research on Carrying Capacity of T‐Shaped Stiffened Concrete‐Filled Steel Tubular Columns Subjected to Eccentrically Compressive Load
Authors: Yang Yuanlong , Han Xinchen , Nan Bo , Tang Xin
Published: February 2021

In this paper, in order to further study the mechanical behavior of T‐shaped stiffened concrete‐filled steel tubular (CFST) columns, numerical programs of eccentrically compressive T‐shaped stiffened CFST columns were developed to calculate moment M‐ϕ curvature curves of cross section and column. The calculated curves with the numerical programs agree well with the experimental results. A parametric analysis was carried out to calculate M‐N correlation curves of cross section and column to investigate influence of concrete strength fck, steel yielding strength fy, steel tube thickness t, slenderness ratio λ, and loading angle θ. On the basis of parametric analysis, simplified resistance models of T‐shaped CFST section and column were proposed and verified by the numerical analysis results. The simplified resistance models are reliable to predict the mechanical behavior for engineering application.
Triaxial Shear Behavior of a Gravelly Sand with Different Forms of Reinforcement
Authors: Wang Jia-Quan , Hou Sen-Lei , Xue Jian-Feng , Lin Zhi-Nan , Tang Yi
Published: February 2021

To study the effect of three‐dimensional reinforcement arrangement on the behavior of a gravelly sand, triaxial tests were performed on specimens reinforced with geogrid sheet, geogrid cell, and one and two layers of geogrid sheet and geocell combination. Specimens with a diameter of 100 mm and a height of 200 mm are sheared under drained condition to monitor the variation of axial and volumetric strains with axial loading under different confining pressures. The results showed that the reinforcement schemes have different effects on soil strength improvement. The inclusion of double layers of geogrid sheet and geocell reinforcement could increase both the apparent cohesion and friction of the reinforced soil. The stress‐strain relationship could be modelled with a modified hyperbolic model, which can capture the softening strain behavior of the specimens after peak strength.
Effect Modifiers of Low-Dose Tamoxifen in a Randomized Trial in Breast Noninvasive Disease
Authors: DeCensi Andrea , Puntoni Matteo , Johansson Harriet , Guerrieri-Gonzaga Aliana , Caviglia Silvia , Avino Franca , Cortesi Laura , Ponti Antonio , Pacquola Maria Grazia , Falcini Fabio , Gulisano Marcella , Digennaro Maria , Cariello Anna , Cagossi Katia , Pinotti Graziella , Lazzeroni Matteo , Serrano Davide , Briata Irene Maria , Buttiron Webber Tania , Boni Luca , Bonanni Bernardo
Published: February 2021

Purpose:

Low-dose tamoxifen halved recurrence after surgery in a phase III trial in breast noninvasive disease without increasing adverse events. We explored the effect of low-dose tamoxifen in clinically relevant subgroups, including menopausal status, estradiol levels, smoking, body mass index, and proliferation of baseline lesion.

Patients and Methods:

Incidence of invasive breast cancer or ductal carcinoma in situ was the primary endpoint. HRs and interaction terms were estimated using Cox models.

Results:

A favorable HR and 95% confidence interval (CI) could be demonstrated for postmenopausal status (HR = 0.30; 95% CI, 0.11–0.82 vs. HR = 0.73; 95% CI, 0.30–1.76 in premenopausal women; Pinteraction = 0.13), women with estradiol less than 15.8 pg/mL, presence of menopausal symptoms at baseline, and never smoking (Pinteraction = 0.07), although the interaction P value was >0.05 for all characteristics. Efficacy was similar in all body mass index categories. Tumors with Ki-67 above the median level of 10% had a greater benefit (HR = 0.27; 95% CI, 0.09–0.81) than those with Ki-67 ≤10% (HR = 1.58; 95% CI, 0.45–5.60; Pinteraction = 0.04).

Conclusions:

The efficacy of low-dose tamoxifen seems to be greater in postmenopausal women and in women with lower estradiol levels. Benefits appear to be larger also in women with menopausal symptoms, never smokers, and tumors with Ki-67 >10%. Our results by menopausal status provide important insight into low-dose tamoxifen personalized treatment, although caution is necessary given their exploratory nature. Observation of an improved response in tumors with Ki-67 >10% is consistent but the use of the marker in this setting is investigational.

See related commentary by Fabian, p. 3510
Laboratory Evaluation of Production Efficiency for Removable Partial Denture Frameworks Using In-House Casting vs Outsourced Additive Manufacturing Techniques
Authors: Ali Zaid , Wood Duncan , Elmougy Abdulrahman , Kelleher Paul , Martin Nicolas
Published: February 2021

Purpose: To compare the production efficiency of selective laser sintering (SLS) to traditional casting for the fabrication of metal prosthodontic frameworks in a prospective pilot evaluation in a hospital prosthodontic laboratory setting. Materials and Methods: The time taken to complete each of the identified stages in the production of 50 removable partial denture frameworks made using either SLS (n = 25) or casting (n = 25) workflows was measured. The mean time for production was calculated for each workflow, and the difference was tested for statistical significance. Results/Conclusion: The results indicate that an SLS workflow may be more time-efficient, and further cost-effectiveness research is indicated.
Linear Statecraft along the Nile: Landscapes and the Political Phenomenology of Ancient Egypt
Authors: Smith Monica L.
Published: February 2021

States in archaeological and historical parlance generally are large and dynamic entities with continually fluctuating borders and boundaries across large land masses. States also are characterized by multiple nodes of settlement and multiple regions of resource availability within those large land masses, including agricultural fields, animal pastures, raw materials, and labor power. The northeastern African continent however provides a rather different spatial configuration for states’ prerequisites of agricultural intensification and social integration: the ancient Egyptian state—and all subsequent political entities called “Egypt”—have been framed by the valley of the Nile as a long and narrow corridor of human viability. Using “flow” as a phenomenological concept in which experiences are heightened by restraint conditions, this article examines the characteristics of political and social cohesion given geographic limitations on communication, migration and territorial expansion. The constraints of a viable landmass surrounded by uninhabitable desert parallel the conditions experienced by island states, enabling the productive application of island and archipelagic models to the analysis of the ancient Egyptian state.
Ancient Egyptian Urbanism in a Comparative, Global Context
Authors: Smith Michael E.
Published: February 2021

For more than 50 years, archaeologists have debated whether or not Egypt was a “civilization without cities.” The publication of Nadine Moeller’s book, The Archaeology of Urbanism in Ancient Egypt: From the Predynastic Period to the End of the Middle Kingdom, provides the opportunity to reconsider this issue, using a more complete record of the relevant archaeological finds. I present a new, flexible approach to urban definition, and then I examine the ways in which ancient Egyptian urbanism resembled and differed from other early urban traditions. I conclude that Egypt was indeed an urban society, and that Egyptian urban patterns were highly distinctive within the canon of ancient urban systems. I place these points within the context of competing ideas about the nature of global history.
Bridging the Digital Publishing Divide
Authors: Robinson Hal
Published: February 2021

An anthropological view of the publishing industry sees it as a culture with its own assumptions and patterns, in which publishing companies are macro-communities associated with micro-communities of readers. Anthropology sees ‘digital culture’ in a comparable way. Awareness of the cultural characteristics of publishing as a culture and of digital culture can turn their differences into synergies that benefit both. Examples from anthropological research and from publishing show that some processes are comparable. One is the process in which material value is transformed into cultural value, with the benefit of increasing the cohesion of a community. Another occurs when communities interlink their cultural processes in cultural–commercial ecosystems, to mutual benefit. Anthropological insights suggest how strategies, at project level and at the level of international cooperation, can bridge the cultural divide between traditional publishing values and digital opportunities and so help businesses survive and succeed in times of change.
Jesuits in Spanish America before the Suppression
Authors: Jackson Robert H.
Published: February 2021

From the late sixteenth century until their expulsion in 1767, members of the Society of Jesus played an important role in the urban life of Spanish America and as administrators of frontier missions. This study examines the organization of the Society of Jesus in Spanish America in large provinces, as well as the different urban institutions such as colegios and frontier missions. It outlines the spiritual and educational activities in cities. The Jesuits supported the royal initiative to evangelize indigenous populations on the frontiers, and particularly the outcomes that did not always conform to expectations. One reason for this was the effects of diseases such as smallpox on the indigenous populations. Finally, it examines the 1767 expulsion of the Jesuits from Spanish territories. Some died before leaving the Americas or at sea. The majority reached Spain and were later shipped to exile in the Papal States.
Myrcia (Myrtaceae) in the state of Paraná, Brazil
Authors: LANNOY LAURA C. DE , OLIVEIRA AYRTON I. DE , GOLDENBERG RENATO , LIMA DUANE F.
Published: February 2021

Myrtaceae is one of the largest families in number of species within the order Myrtales and one of the richest families in Brazil. Myrcia is the fourth largest genus of Myrtaceae, with approximately 770 species distributed from Central America and the Caribbean to southern South America. In Brazil Myrcia is represented by 397 species, of which 309 are endemic. In this study, we present the taxonomic treatment for all species of Myrcia that occur in Paraná state, Brazil. Analyses of herbarium specimens, online databases, and bibliography were performed. Fifty-three species of Myrcia occur in Paraná, distributed in all vegetation types. Twenty-three names were excluded from previous lists of species or listed as doubtful species. Neither of the recorded species is endemic to Paraná, but this state is the southern and northern limit of distribution of six and two species, respectively. We present an identification key, taxonomic descriptions, figures, maps, and comments on phenology, habitat, and morphology for each species.