bluuebunny/crossref_metadata_2025 huggingface dataset:
Work satisfaction and burnout risk of gastroenterologists in Germany: results of a nationwide survey
Authors: Adarkwah Charles Christian , Labenz Joachim , Birkner Berndt , Beilenhoff UIrike , Hirsch Oliver
Published: June 2020

Background More and more gastroenterologists are not satisfied with their working conditions and run the risk of developing burnout symptoms. Little is known about the job satisfaction and burnout risk among physicians working in endoscopy units in Germany. This study examines the risk of burnout and job satisfaction among gastroenterologists in Germany.

Methods An electronic survey was distributed to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (BVGD, Berufsverband Gastroenterologie Deutschland e. V.). In addition to general demographic variables, job satisfaction was determined using the Work Satisfaction Questionnaires (WSQ), and burnout risk was determined using the Maslach Burnout Inventory (MBI).

Results A representative sample of gastroenterologists organized in the BVGD (Berufsverband Gastroenterologie Deutschland e. V.) took part in the study (n = 683, 22 %). Above all, we could demonstrate relevant differences with regard to burnout risk and job satisfaction depending on the place of work, clinic structure, position in the clinic, and age. Younger physicians had significantly higher depersonalization (p < 0.001) and exhaustion scores (p < 0.001) with almost medium and small effect sizes (δt = 0.45 and −0.31). The higher the position in the clinic, the higher the accomplishment scores (medium effect size 0.27). Older physicians were especially more satisfied in the areas of patient care (p < 0.001, medium effect size δt = −0.53). Employed doctors show a higher level of satisfaction in terms of “burden” compared to practice owners (p < 0.001, δt = −0.69). Compared to norms used in the EGPRN study which were adapted to physicians, almost one-third of our sample had high depersonalization scores, about 17 % had high exhaustion scores, and about half had low personal accomplishment scores showing a higher general burden among German gastroenterologists.

Conclusion Decreased work satisfaction and risk of burnout are important issues among German gastroenterologists. Specific actions should address this problem in order to avoid negative consequences, respectively.
Anterior Cruciate Ligament Surgery Performed Less Than 3 Weeks After Injury Is Not Inferior to Delayed Surgery
Authors: Chua Kenon , Kang Joseph Benjamin Yida , Fook-Chong Stephanie , Tan Andrew Hwee Chye
Published: June 2020

Performing anterior cruciate ligament (ACL) surgery in the immediate period after injury is controversial. However, there may be instances where the opportunity cost of delayed surgery for the patient may be unacceptable. Concomitant meniscus injuries may also prevent the patient from regaining range of motion in the preoperative period. Every week that surgery is delayed may increase pain and impair mobility for this group of patients. We investigate the functional and clinical outcomes in patients with ACL surgery in the immediate 3-week period following ACL injury. A cohort study was performed to compare the outcome of early ACL (less than 3 weeks after injury) and late ACL surgery (more than 3 weeks after surgery). A total of 58 patients were followed up at fixed time points over a 2-year period. Clinical measurements (range of motion and knee laxity scores) and functional outcome scores (International Knee Documentation Committee, Lysholm's Knee and Tegner's scores) were used to document outcomes over time. The mean time to surgery from the time of injury in the early ACL surgery group was 2 weeks (standard deviation [SD] = 0.45) and the 20 weeks (SD = 9.64) in the late ACL surgery group. The absence or presence of meniscal injuries had no significant effect on the improvement over time for both groups of patients (p > 0.05). Patients in the early ACL group had faster rates of improvement for clinical measurements and functional outcome scores but had started out initially with poorer outcomes at baseline. However, both groups had comparable outcomes (p > 0.05) at the 1- and 2-year mark postsurgery. Patients in both groups had no adverse outcomes. ACL Surgery within 3 weeks of injury (2 weeks SD = 0.45) is safe and has comparable outcomes compared to patients with delayed surgery (20 weeks SD = 9.64).
Importance of Three-Dimensional Evaluation of Surgical Transepicondylar Axis in Total Knee Arthroplasty
Authors: Ohmori Takaaki , Kabata Tamon , Kajino Yoshitomo , Inoue Daisuke , Ueno Takuro , Taga Tadashi , Yamamoto Takashi , Takagi Tomoharu , Yoshitani Junya , Ueoka Ken , Yamamuro Yuki , Tsuchiya Hiroyuki
Published: June 2020

In total knee arthroplasty, the surgical transepicondylar axis (SEA) is one of the most reliable rotation axes for stabilizing of the patellofemoral joint. The SEA is identified with reference to the lateral epicondyle and the medial sulcus of the medial epicondyle. However, these two structures rarely appear on the same plane on computed tomography (CT), and it is necessary to take two points in separate images. Many surgeons measure the SEA on the same image (pseudo SEA) instead. We aimed to determine the difference between true SEAs and pseudo SEAs. A total of 31 normal knees and 24 varus knees were included in this study. Three-dimensional (3D) models of the femur were reconstructed from CT images, and a reconstructed plane was made using the International Society of Biomechanics coordinate system. Pseudo SEAs drawn in the plane passing through the lateral epicondyle and medial sulcus were defined as l-SEA and m-SEA, respectively. L-SEA, m-SEA, true SEA, and posterior condylar axis (PCA) were projected onto the International Society of Biomechanics coordinate plane and, “p l-SEA,” “p m-SEA,” “p true SEA,” and “p PCA” were obtained. The true SEA angle was defined as the angle between p true SEA and p PCA. The l-SEA angle or m-SEA angle was defined as the angle between the p l-SEA or p m-SEA and p PCA, respectively. There were no statistically significant differences between true SEA angle (2.64 ± 2.01 degrees) and pseudo SEA angle (l-SEA angle: 2.74 ± 2.07 degrees, m-SEA: 2.54 ± 2.19 degrees). Conversely, 12 knees in the normal group and 2 knees in the varus group had differences of more than 1 degree (p = 0.01). Among them, 6 knees in the normal group and 0 knees in the varus group had a difference of 2 degrees or more (p = 0.03). In most cases, pseudo SEA can be substituted for true SEA.
Comparative Analysis and Long-Term Results of Various Septal Extension Graft Types
Authors: Brandstetter M. , Bhatt M. , Pham M. , Gubisch W. , Haack S.
Published: June 2020

Shape, tip projection, and position can be controlled by the use of septal extension grafts (SEG). A retrospective cohort study of patients undergoing primary and secondary rhinoplasty was reviewed. The purpose of this study was to analyze maintenance of nasal length, dorsal length, and nasolabial angle postoperatively comparing different types of SEG using standardized photography and digital measurement. Two-hundred twenty-one patients undergoing rhinoplasty were included. There was a statistically significant change regarding the nasolabial angle during the time of follow-up decreasing from 97.53 to 95.30 degrees. No changes could be found in dorsal and nasal length. There was no significant difference among the techniques used to fixate the SEG. The nasolabial angle appeared to decrease from the position 2 weeks postoperatively without changes in the dorsal and nasal length. This means that the decrease in the nasolabial angle depends on the swelling effect and not on drooping of the tip confirming the reliability of SEG over time.
On the relationship between SiF4 plasma species and sample properties in ultra low-k etching processes
Authors: Haase Micha , Melzer Marcel , Lang Norbert , Ecke Ramona , Zimmermann Sven , van Helden Jean-Pierre H. , Schulz Stefan E.
Published: June 2020

The temporal behavior of the molecular etching product SiF4 in fluorocarbon-based plasmas used for the dry etching of ultra low-k (ULK) materials has been brought into connection with the polymer deposition on the surface during plasma treatment within the scope of this work. For this purpose, time-resolved measurements of the density of SiF4 have been performed by quantum cascade laser absorption spectroscopy. A quantification of the non-linear time dependence was achieved by its characterization via a time constant of the decreasing SiF4 density over the process time. The time constant predicts how fast the stationary SiF4 density is reached. The higher the time constant is, the thicker the polymer film on top of the treated ultra low-k surface. A correlation between the time constant and the ULK damage was also found. ULK damage and polymer deposition were proven by Variable Angle Spectroscopic Ellipsometry and X-ray Photoelectron Spectroscopy. In summary, the observed decay of the etching product concentration over process time is caused by the suppressed desorption of the SiF4 molecules due to a more dominant adsorption of polymers.
Modeling large, complex levitated objects allows for applications in acoustic levitation
Authors: Bandari Anashe
Published: June 2020

Typical models cannot simulate the forces acting large and non-spherical levitated objects, which restricts advances in potential applications.
The impact of semimetal nanoparticles on the conduction of thick glass layer at Ag/Si contact interface
Authors: Ren Keming , Han Dan , Ye Tang , Zhang Yong , Ebong Abasifreke
Published: June 2020

This paper reports on the ohmic contact formed by the conductive glass layer found at the interface of Ag/Si contacts on lowly doped emitter silicon solar cells due to the presence of semimetal nanoparticles. The scanning electron microscopy and scanning transmission electron microscope analyses revealed an interface glass layer (IGL) thickness of greater than 380 nm, which was enriched with micro-sized alloys composed of semimetal nanoparticles. This IGL was conductive as confirmed by conductive atomic force microscopy (C-AFM). The presence of these semimetal nanoparticles, identified as Ag2Te and PbTe, was both endowed with low bandgap energies as confirmed by Raman spectroscopy and energy dispersive x-ray spectroscopy. These semimetal nanoparticles were found only in the IGL and formed a “bridge” to connect the Ag gridline and Si emitter for carrier transport. Based on the modified Fowler–Nordheim tunneling process, the modeled C-AFM I–V characteristic curve showed a barrier height of 0.1 eV corresponding to an IGL thickness of only 18 nm. Thus, the carrier transport mechanism “through the conductive bridge” was formed by the semimetal nanoparticles embedded in the IGL. Therefore, the high conductivity of the interface glass led to the specific contact resistance to be independent of the emitter peak doping concentration.
Enhancement of zero-field skyrmion density in [Pt/Co/Fe/Ir]2 multilayers at room temperature by the first-order reversal curve
Authors: Ma Mangyuan , Ang Calvin Ching Ian , Li Yong , Pan Zizhao , Gan Weiliang , Lew Wen Siang , Ma Fusheng
Published: June 2020

Magnetic skyrmions are novel topological spin textures on the nanoscale, and significant efforts have been taken to improve their zero-field density at room temperature (RT). In this work, we reported an approach of improving zero-field skyrmion density in [Pt/Co/Fe/Ir]2 multilayers at RT by using the first-order reversal curve (FORC) technique to obtain information on the irreversible or reversible behaviors in the magnetization switching process. It was found from the FORC diagram that the magnetization reversal mechanism can be characterized into three stages: (1) reversible labyrinth stripe domains expanding or shrinking stage; (2) irreversible stripe domains fracturing stage; and (3) irreversible skyrmion annihilation stage. Furthermore, the zero-field skyrmion density can be highly improved by choosing reversal fields from the irreversible stripe domains fracturing stage. The highest skyrmion density was approached according to the maximum FORC distribution ρ. Our results have established the FORC measurement as a valuable tool for investigating magnetic multilayers of high skyrmion densities.
Ion current collection by double flush-mounted probe in intermediate-pressure plasmas
Authors: Yu Pengcheng , Liu Yu , Ling Yiming , Zhang Zhongkai , Cao Jinxiang , Lei Jiuhou , Zhang Xiao
Published: June 2020

A double flush-mounted probe method is proposed to analyze the characteristics of intermediate-pressure plasmas (10–100 Pa) by a sheath criterion. The analytical model mainly focuses on the effect of the ion drift velocity in the sheath edge and then provides a correction factor for the measured ion-collection current. The reduction of the ion current is attributed to ion–neutral collisions leading to the modified Bohm velocity. To validate this method, the ion density is calculated and compared with that measured by two types of cylindrical probes, and the results agree well with the data measured by other probes. On the basis of this work, the double flush-mounted probe can be adopted to diagnose plasma parameters accurately, without a reference electrode, in collisional and certain complex plasma environments, such as the reentry plasma sheath.
Determination of the transition mass ratio for onset of galloping of a square cylinder at the least permissible Reynolds number of 150
Authors: Sourav Kumar , Sen Subhankar
Published: June 2020

The Den Hartog stability criterion tests for galloping of an oscillator. A square cylinder satisfies this and is susceptible to galloping. This criterion being necessary for occurrence of galloping appears insufficient as certain parameters, i.e., angle of incidence, α; mass ratio, m*; damping ratio, ζ; reduced speed, U*; and Reynolds number, Re; also assume key roles in determining if the oscillator motion is vortex-induced vibrations (VIV) or galloping. At Re ≈ 150 and U* ≈ 10 or smaller, a square cylinder does not gallop despite satisfying the Den Hartog criterion. By coupling U* and Re, K. Sourav and S. Sen [“Transition of VIV-only motion of a square cylinder to combined VIV and galloping at low Reynolds numbers,” Ocean Eng. 187, 106208-1–106208-19 (2019)] two-degrees-of-freedom motion over Re ≤ 250, the minimum m* or mtr* as 3.4 below which galloping cannot develop. For transverse-only motion, X. Li et al. [“Mode competition in galloping of a square cylinder at low Reynolds number,” J. Fluid Mech. 867, 516–555 (2019)] considered U* = 40 only and determined mtr*≈4 at the least permissible Re of 150. For α = 0° and ζ = 0, we determine the mtr* numerically at Re = 150. By analyzing the transverse response and oscillation frequency over an extended U* range of 10–60, a novel “VIV-galloping transition map” is generated in the m*–U* plane. From this map, the value of mtr* converges to 3.4. The mtr* decays as U*−2.36. The conditions leading to “VIV forever” of a square cylinder are also identified.
Strain suppressed Sn incorporation in GeSn epitaxially grown on Ge/Si(001) substrate
Authors: Stanchu Hryhorii V. , Kuchuk Andrian V. , Mazur Yuriy I. , Margetis Joe , Tolle John , Yu Shui-Qing , Salamo Gregory J.
Published: June 2020

The effects of lattice misfit strain in epitaxial GeSn/Ge/Si(001) heterostructures on Sn incorporation, misfit dislocations (MDs), and the critical thickness were investigated using high-resolution x-ray diffraction. By performing a simulation of the x-ray reciprocal space maps measured in the vicinity of an asymmetrical reflection, we determined the strong correlation between the strain relaxation, density of MDs, and Sn content in the GeSn alloy for a compositional range of 4 to 15 at. %. Herein, we quantitatively describe the phenomenon of strain-suppressed Sn incorporation in GeSn, leading to the formation of top Sn-rich, middle compositionally graded, and bottom Sn-poor regions at fixed growth conditions. It is shown that the thicknesses of the bottom Sn-poor region at which the composition spontaneously changes are correlated with the theoretically predicted critical thickness for the nucleation of MDs. Depending on the degree of strain relaxation in the bottom GeSn layer, the density of MDs at the GeSn/Ge interface varies in the range of ∼2–5 × 105 cm−1 as the Sn content increases from 4 to 12 at. %. The thickness of the compositionally graded region, 160 ± 25 nm, corresponds to the thickness at which the GeSn layer fully relaxes through the interaction/multiplication of MDs. These results contribute to the fundamental understanding that strain engineering is not only crucial to tune the bandgap of Sn-containing group-IV semiconductors but also a key factor for the growth of Sn-rich metastable GeSn layers for mid-infrared photonic devices.
Ocean Animals
Authors: Chapman Blake , Hicks Astred
Published: June 2020

Dive in to the incredible world of ocean animals!
Ocean animals are truly awesome. They come in every size, colour and shape imaginable. They are also some of the weirdest, sneakiest and smartest animals on the planet!
This book focusses on the features and skills that make these creatures extra-incredible. You will discover animals that are masters of defence and others that use high speeds to eat or avoid being eaten. There are sea creatures that use their size as an advantage, both big and small, and others that are just really, really smart!
Whether you’re a fan of fish, a connoisseur of crustaceans, mad about molluscs or just love jellyfish, Ocean Animals has got you covered. You may even discover some fantastical creatures you never knew existed.
Full of fun facts, 'sea-lebrity' species profiles and amazing pictures, you will also learn about issues threatening marine life and tips on how to help protect our amazing ocean environments.
Deletion of the PDZ-binding kinase (Pbk) gene does not affect male fertility in mice
Authors: Miki Yuka , Devi Lalitha , Imai Yuji , Minami Naojiro , Koide Tsuyoshi , Goel Sandeep
Published: June 2020

The PDZ-binding kinase (PBK) protein is localised exclusively in spermatogenic cells, such as spermatogonia, spermatocytes and round spermatids, of the adult testis. However, its role in male fertility remains unknown. Analysis of adult Pbk-knockout (KO) male mice showed no significant difference in the weight of the testes, epididymis and seminal vesicle compared with adult wild-type (WT) mice. There were no significant differences in testis morphology, tubule diameter and the number of offspring born to females mated with KO or WT male mice. Sperm number, motility and morphology did not differ significantly between KO and WT mice. The oocyte fertilisation rate and embryo development following IVF were comparable between groups fertilised using spermatozoa from KO versus WT mice (P>0.05). Further analysis revealed that the phosphorylation of the mitogen-activated protein kinases (MAPKs) p38 kinase, c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinases was dysregulated in the testis of KO mice. In conclusion, Pbk-KO male mice are fertile and their spermatozoa and testis do not show any morphological and functional abnormalities despite the dysregulated phosphorylation of MAPKs. It is likely that functional redundancy of PBK and overlapping substrate specificities of the MAPK superfamily compensated for the loss of PBK from the testis.
Rationally designed C/Co9S8@SnS2 nanocomposite as a highly efficient anode for lithium-ion batteries
Authors: Zhang Peng , Liu Yang , Zhou Min , Xue Yuxiong , Zeng Xianghua , Qi Junlei , Chen Minghua , Sun Fenglian
Published: June 2020

Nanostructured transition metal sulfides are promising anode materials for lithium-ion batteries. Nevertheless, it is still a great challenge to prepare capacity-improved electrodes without reducing their rate capability and cycle stability. In this paper, we present a C/Co9S8@SnS2 composite material by loading SnS2 nanocrystals onto MOF-derived C/Co9S8 nanostructures. The C/Co9S8@SnS2 composite has multiple active sites to store lithium ions. The specific capacity reaches 3.1 mAh cm−2 when the current density is 0.224 mA cm−2. The asynchronous electrochemical reaction between Co9S8 and SnS2 offsets the volume expansion of the anode material. Meanwhile, the compact adhesion of carbon layers on the interfaces suppresses the destruction of the anode during the charging–discharging processes. Consequently, the synthesized electrode presents favorable capacity with high current density or under long-term cycling conditions. The prepared battery has a reversible specific capacity of 0.452 mAh cm−2 and a coulomb efficiency of 99.7% after 500 cycles with a high current density of 2.24 mA cm−2. The research results obtained in this work provides a feasible strategy to improve the performance of electrodes systematically.
A review of barriers in implementing dynamic electricity pricing to achieve cost-causality
Authors: Matisoff Daniel C , Beppler Ross , Chan Gabriel , Carley Sanya
Published: June 2020

Rapidly changing economics, customer preferences, and policy to address climate change and local environmental pollutants have driven increased deployment of a wide range of distributed energy resources in the U.S. electricity system. Distributed energy resources have enabled an expanded role for energy consumers and non-utility third parties to reshape system costs, drawing renewed attention to the potential of reforming electricity rate design based on the further application of cost-causal principals to improve overall system fairness and efficiency. One mechanism to move toward greater application of cost-causal rate design is dynamic pricing, which varies electricity prices across time and location to reflect costs of providing electricity to consumers under specific market conditions and grid operation conditions. While dynamic electricity pricing has penetrated some markets, and it has not been widely implemented, particularly for residential consumers. In this review article, we provide a brief summary of electricity rate design, including the possibility of introducing dynamic prices, and explain why dynamic prices are more reflective of the short-run marginal costs of electricity supply than volumetric rates. We then explore the barriers to the widespread adoption of residential dynamic pricing, emphasizing technical, economic, and political challenges. Our assessment reflects the ability of dynamic prices to engender more equitable and efficient outcomes by achieving the goal of cost-causality, and we argue that a move toward more dynamic pricing can constitute a welfare improvement over volumetric rates. However, dynamic pricing does not completely address the full set of challenges associated with rate design and, alone, is unlikely to enable the full recovery of fixed costs and the fair attribution of the positive and negative externalities of electricity provision. Therefore, electricity rate design requires tradeoffs, making it as much an art as a science. This analysis synthesizes literature across multiple fields and suggests avenues for further research.
Air quality and health impacts of vegetation and peat fires in Equatorial Asia during 2004–2015
Authors: Kiely Laura , Spracklen Dominick V , Wiedinmyer Christine , Conibear Luke , Reddington Carly L , Arnold Stephen R , Knote Christoph , Khan Md Firoz , Latif Mohd Talib , Syaufina Lailan , Adrianto Hari A
Published: June 2020

Particulate matter (PM) emissions from vegetation and peat fires in Equatorial Asia cause poor regional air quality. Burning is greatest during drought years, resulting in strong inter-annual variability in emissions. We make the first consistent estimate of the emissions, air quality and public health impacts of Equatorial Asian fires during 2004–2015. The largest dry season (August—October) emissions occurred in 2015, with PM emissions estimated as 9.4 Tg, more than triple the average dry season emission (2.7 Tg). Fires in Sumatra and Kalimantan caused 94% of PM emissions from fires in Equatorial Asia. Peat combustion in Indonesian peatlands contributed 45% of PM emissions, with a greater contribution of 68% in 2015. We used the WRF-chem model to simulate dry season PM for the 6 biggest fire years during this period (2004, 2006, 2009, 2012, 2014, 2015). The model reproduces PM concentrations from a measurement network across Malaysia and Indonesia, suggesting our PM emissions are realistic. We estimate long-term exposure to PM resulted in 44 040 excess deaths in 2015, with more than 15 000 excess deaths annually in 2004, 2006, and 2009. Exposure to PM from dry season fires resulted in an estimated 131 700 excess deaths during 2004–2015. Our work highlights that Indonesian vegetation and peat fires frequently cause adverse impacts to public health across the region.
Stationary Markov jump processes in terms of average transition times: setup and some inequalities of kinetic and thermodynamic kind
Authors: Frezzato Diego
Published: June 2020

The parametrization of continuous-time stationary Markov jump processes is worked out in terms of average times at which the site-to-site transitions take place again (recurrence) or occur starting from a given initial localization of the system (occurrence). The foremost result is the solution of the inverse problem of achieving the rate constants from an essential set of average occurrence/recurrence times. Then we provide the expression of the average entropy production rate at the stationary state in terms of average recurrence times only, elaborate the randomness parameter (squared coefficient of variation) which quantifies the relative precision of the timing of a given transition of interest, and derive some inequalities in which only a partial amount information about the network does enter. In particular, we get lower bounds on the randomness parameter and derive inequalities of both kinetic and thermodynamic kind.
Effects of cellulose nanofibrils on the cure kinetics of the phenol formaldehyde resin
Authors: Liu Cong , Wang Siqun , Zhang Yang
Published: June 2020

Phenol formaldehyde (PF) resin were treated with cellulose nanofibrils (CNF), and its effects on the cure kinetics of PF resin were evaluated. The curing of PF resin was a polycondensation exothermic reaction forming insoluble polymer. The Differential scanning calorimetry (DSC) analysis showed 3% CNF addition had prolonged the curing process of PF resin, and the Kissinger equation and Crane equation were introduced to show that the curing activate energy and reaction order of 3%-CNF-added-PF resin sample were obviously lower than control ones. The scanning probe microscopy (SPM) results exhibited that CNF particles were well-dispersed in the PF matrix. The non-isothermal kinetic study indicated that CNF had played a major role during late stage of non-isothermal polymerization, increasing the crosslinking points in the PF resin and reducing the energy needed for PF resin curing. Thus, the addition of CNF had a positive effect on the curing of PF and made the curing more perfect.
Potential Impact of the 2017 High Blood Pressure Guideline Beyond the United States: A Case Study of the People’s Republic of China
Authors: Barszczyk Andrew , Yang Deye , Wei Jing , Huang Wendy , Feng Zhong-Ping , Lee Kang , Luo Hong
Published: June 2020

BACKGROUND

The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) (US) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults expanded the definition of hypertension and now considers atherosclerotic cardiovascular disease (ASCVD) risk in determining treatment for people with hypertension. US guidelines are influential around the world and it is therefore justified to study their impact in other settings. Our study determined the impact of adopting the 2017 ACC/AHA guideline in China.

METHODS

We analyzed the population impact of the 2017 ACC/AHA guideline using the 2011–2012 year of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative sample of Chinese adults 45–74 years of age (n = 11,822). Our analysis was unique because for the first time it used a population-appropriate equation to calculate ASCVD risk instead of the US Pooled Cohort Equation (the latter misrepresents risk in non-US populations).

RESULTS

Adopting the 2017 ACC/AHA guideline in China would increase the prevalence of hypertension from 44.1% to 56.4% (12.3 percentage points) and increase the number of adults recommended for antihypertensive medication from 41.6% to 49.1% (7.5 percentage points) in the 45–74-year age range. According to Chinese (but not US) risk calculations, the 2017 ACC/AHA guideline more selectively assigns antihypertensive medication to patients at higher risk for ASCVD.

CONCLUSIONS

The 2017 ACC/AHA guideline brings potential for risk reduction in China and selectively recommends medication for those who would benefit most. Realizing such benefits would ultimately depend on the acceptance, adherence, and feasibility of adopting this guideline.
Does Estradiol Level in Platelet-Rich Plasma Improve Efficacy of Androgenic Alopecia Treatment?
Authors: Ince Bilsev , Kendir Munur Selcuk , Kilinc Ibrahim , Avunduk Mustafa Cihat , Dadaci Mehmet , Savaci Nedim
Published: June 2020

Background

Although some studies in the literature report that autologous and homologous platelet-rich plasma (PRP) can be employed in the treatment of androgenic alopecia (AGA), no study, to the authors’ knowledge, has examined the estrogen concentration of prepared PRP.

Objectives

The authors aimed to determine the presence of estrogen in PRP and to investigate the effect of estrogen concentration of PRP on AGA treatment.

Methods

Between 2017 and 2018, 30 male patients with hair loss complaints were included in this prospective study. Autologous PRP was injected in patients in Group 1. Homologous PRP with high estrogen levels was injected in the patients in Group 2. PRP was injected in both groups 4 times at 0, 1, 3, and 6 months. The obtained photographs were evaluated and hair densities of each patient at controls were calculated.

Results

The mean estrogen level measured in PRP was statistically significantly higher in Group 2. In both groups, the increase in hair density was observed from the first month, but this increase was statistically significantly higher in all controls in Group 2. In Group 2, there was a statistically significant increase in the 1st and 3rd months compared with the previous control, but there was no difference between the 6th and 12th months and the 3rd month.

Conclusions

Increased hair density is greater and earlier in the group receiving estrogen-rich PRP than in the group utilizing autologous PRP. The authors think that estrogen-rich PRP may be employed in the treatment of AGA in the presence of an appropriate donor.

Level of Evidence: 2
Reoperative Transaxillary Approach Algorithm: Extending the Surgical Alternatives for Secondary Breast Augmentation in the Era of Scarless Surgery
Authors: Munhoz Alexandre Mendonça
Published: June 2020

Background

Although the transaxillary approach (TAA) is useful in primary breast augmentation (BA) surgery, drawbacks of this technique include the need to correct complications arising from reuse of the axillary incision.

Objectives

The purpose of this study was to assess the outcomes of secondary BA procedures performed via the TAA in a cohort of patients operated on by a single surgeon and to provide an algorithm for reoperative TAA technique selection.

Methods

Sixty-two patients (122 breasts) underwent secondary TAA BA, which was indicated for capsular contracture (CC) in 35 patients (56.4%). Periods for analysis included less than 10 days, 1, 3, 6, and 12 months, and then at 2-year intervals postprocedure.

Results

Forty-three patients (69.3%) had a previous premuscular (PM) pocket; in 35 (81.3%) of these patients the new pocket was kept in the same position. Nineteen patients (30.7%) had a previous submuscular pocket, and 15 patients (78.9%) had the new pocket transferred to the PM plane. Ten cases of complications were observed in 8 patients (16.1%), Baker grade II/III CC in 3 (4.8%), and axillary banding in 2 (3.2%), during a mean follow-up of 72 months (range, 6-170 months). Fifty-nine patients (95.1%) were either very satisfied or satisfied with their aesthetic result.

Conclusions

Recent progress in surgical techniques has led to significant improvements in aesthetic outcomes following BA. The TAA can play a useful role in secondary BA cases and our results show this procedure to be useful, with acceptable complication rates, and the added bonus of avoiding additional scarring on the breast.

Level of Evidence: 4
Tensor decomposition with relational constraints for predicting multiple types of microRNA-disease associations
Authors: Huang Feng , Yue Xiang , Xiong Zhankun , Yu Zhouxin , Liu Shichao , Zhang Wen
Published: June 2020

MicroRNAs (miRNAs) play crucial roles in multifarious biological processes associated with human diseases. Identifying potential miRNA-disease associations contributes to understanding the molecular mechanisms of miRNA-related diseases. Most of the existing computational methods mainly focus on predicting whether a miRNA-disease association exists or not. However, the roles of miRNAs in diseases are prominently diverged, for instance, Genetic variants of miRNA (mir-15) may affect the expression level of miRNAs leading to B cell chronic lymphocytic leukemia, while circulating miRNAs (including mir-1246, mir-1307-3p, etc.) have potentials to detecting breast cancer in the early stage. In this paper, we aim to predict multi-type miRNA-disease associations instead of taking them as binary. To this end, we innovatively represent miRNA-disease-type triples as a tensor and introduce tensor decomposition methods to solve the prediction task. Experimental results on two widely-adopted miRNA-disease datasets: HMDD v2.0 and HMDD v3.2 show that tensor decomposition methods improve a recent baseline in a large scale (up to $38\%$ in Top-1F1). We then propose a novel method, Tensor Decomposition with Relational Constraints (TDRC), which incorporates biological features as relational constraints to further the existing tensor decomposition methods. Compared with two existing tensor decomposition methods, TDRC can produce better performance while being more efficient.
MiRNA-155 regulates cumulus cells function, oocyte maturation, and blastocyst formation
Authors: Dehghan Zeinab , Mohammadi-Yeganeh Samira , Salehi Mohammad
Published: June 2020

Numerous oocytes are retrieved during in vitro fertilization from patients with polycystic ovary syndrome (PCOS). The poor quality of these oocytes leads to lower fertilization and decreases in cleavage and implantation. MiR-155 is one of the microRNA (miRNA) that is increased in serum and granulosa cells of PCOS patients. In this study, we investigate the effects of miR-155 expression and its target genes on oocyte maturation and embryo development. We used the calcium phosphate protocol to transfect vectors that contained miR-155 or miR-off 155 and alone eGFP into cumulus oophorus complex (COCs) of B6D2F1 female mice for in vitro maturation. Cumulus expansion, nuclear, and cytoplasmic maturation, as well as cleavage rates were determined in groups transfected and compared with the control groups. Quantitative real-time polymerase chain reaction was performed to analyze expression levels of miR-155 and the target genes in the cumulus cells, oocytes, and blastocysts. MiR-155 overexpression in COCs suppressed cumulus expansion, oocyte maturation, and inhibition of endogenous miR-155 by miR-off 155 improved cumulus expansion and oocyte maturation by downregulation and expression increase of the Smad2 and Bcl2 genes. On the other hand, overexpression and downregulation of miR-155 in the COCs led to increase and decrease in cleavage rates by changes in expressions of the Mecp2, Jarid2, and Notch1 genes, respectively (P < 0.05). These results suggested that miR-155 overexpression in granulosa cells of PCOS patients can negatively affect nuclear and cytoplasmic maturation, but this miRNA expression has a positive impact on embryo development.
IRX3 and IRX5 collaborate during ovary development and follicle formation to establish responsive granulosa cells in the adult mouse†
Authors: Fu Anqi , Koth Megan L , Brown Ryan M , Shaw Sarah A , Wang Linda , Krentz Kathleen J , Zhang Xiaoyun , Hui Chi-chung , Jorgensen Joan S
Published: June 2020

Healthy development of ovarian follicles depends on appropriate interactions and function between oocytes and their surrounding granulosa cells. Previously, we showed that double knockout of Irx3 and Irx5 (Irx3/5 DKO) in mice resulted in abnormal follicle morphology and follicle death. Further, female mouse models of individual Irx3 or Irx5 knockouts were both subfertile but with distinct defects. Notably, the expression profile of each gene suggests independent roles for each; first, they are colocalized in pre-granulosa cells during development that then progresses to include oocyte expression during germline nest breakdown and primordial follicle formation. Thereafter, their expression patterns diverge between oocytes and granulosa cells coinciding with the formulation and maturation of intimate oocyte–granulosa cell interactions. The objective of this study was to investigate the contributions of Irx5 and somatic cell-specific expression of Irx3 during ovarian development. Our results show that Irx3 and Irx5 contribute to female fertility through different mechanisms and that Irx3 expression in somatic cells is important for oocyte quality and survival. Based on evaluation of a series of genetically modified mouse models, we conclude that IRX3 and IRX5 collaborate in the same cells and then in neighboring cells to foster a healthy and responsive follicle. Long after these two factors have extinguished, their legacy enables these intercellular connections to mature and respond to extracellular signals to promote follicle maturation and ovulation.
mHealth-based experience sampling method to identify fatigue in the context of daily life in haemodialysis patients
Authors: Brys Astrid D.H. , Stifft Frank , Van Heugten Caroline M , Bossola Maurizio , Gambaro Giovanni , Lenaert Bert
Published: June 2020

Background

Fatigue in haemodialysis (HD) patients is a prevalent but complex symptom impacted by biological, behavioural, psychological and social variables. Conventional retrospective fatigue questionnaires cannot provide detailed insights into symptom variability in daily life and related factors. The experience sampling methodology (ESM) overcomes these limitations through repeated momentary assessments in patients’ natural environments using digital questionnaires. This study aimed to gain in-depth understanding of HD patients’ diurnal fatigue patterns and related variables using a mobile Health (mHealth) ESM application and sought to better understand the nature of their interrelationships.

Methods

Forty HD patients used the mHealth ESM application for 7 days to assess momentary fatigue and potentially related variables, including daily activities, self-reported physical activity, social company, location and mood.

Results

Multilevel regression analyses of momentary observations (n = 1777) revealed that fatigue varied between and within individuals. Fatigue was significantly related to HD treatment days, type of daily activity, mood and sleep quality. Time-lagged analyses showed that HD predicted higher fatigue scores at a later time point (β = 0.22, P = 0.013). Interestingly, higher momentary fatigue also significantly predicted more depressed feelings at a later time point (β = 0.05, P = 0.019) but not the other way around.

Conclusions

ESM offers novel insights into fatigue in chronic HD patients by capturing informative symptom variability in the flow of daily life. Electronic ESM as a clinical application may help us better understand fatigue in HD patients by providing personalized information about its course and relationship with other variables in daily life, paving the way towards personalized interventions.
Optimizing the timing of nephrology referral for patients with diabetic kidney disease
Authors: Martínez-Castelao Alberto , Soler María José , Górriz Teruel José Luis , Navarro-González Juan F , Fernandez-Fernandez Beatriz , de Alvaro Moreno Fernando , Ortiz Alberto
Published: June 2020

Age-standardized rates of diabetes mellitus (DM)-related complications, such as acute myocardial infarction, stroke or amputations, have decreased in recent years, but this was not associated with a clear reduction of the incidence of advanced chronic kidney disease (CKD) requiring renal replacement therapy. The early detection of diabetic kidney disease (DKD) is a key to reduce complications, morbidity and mortality. Consensus documents and clinical practice guidelines recommend referral of DM patients to nephrology when the estimated glomerular filtration rate falls below 30 mL/min/1.73 m2 or when albuminuria exceeds 300 mg/g urinary creatinine. Conceptually, it strikes as odd that patients with CKD are referred to the specialist caring for the prevention and treatment of CKD only when >70% of the functioning kidney mass has been lost. The increasing global health burden of CKD, driven in large part by DKD, the suboptimal impact of routine care on DKD outcomes as compared with other DM complications, the realization that successful therapy of CKD requires early diagnosis and intervention, the advances in earlier diagnosis of kidney injury and the recent availability of antidiabetic drugs with a renal mechanism of action and lack of hypoglycaemia risk, which additionally are cardio- and nephroprotective, all point towards a paradigm shift in the care for DM patients in which they should be referred earlier to nephrology as part of a coordinated and integrated care approach.
SAGER: a database of Symbiodiniaceae and Algal Genomic Resource
Authors: Yu Liying , Li Tangcheng , Li Ling , Lin Xin , Li Hongfei , Liu Chichi , Guo Chentao , Lin Senjie
Published: June 2020

Symbiodiniaceae dinoflagellates are essential endosymbionts of reef building corals and some other invertebrates. Information of their genome structure and function is critical for understanding coral symbiosis and bleaching. With the rapid development of sequencing technology, genome draft assemblies of several Symbiodiniaceae species and diverse marine algal genomes have become publicly available but spread in multiple separate locations. Here, we present a Symbiodiniaceae and Algal Genomic Resource Database (SAGER), a user-friendly online repository for integrating existing genomic data of Symbiodiniaceae species and diverse marine algal gene sets from MMETSP and PhyloDB databases. Relevant algal data are included to facilitate comparative analyses. The database is freely accessible at http://sampgr.org.cn. It provides comprehensive tools for studying gene function, expression and comparative genomics, including search tools to identify gene information from Symbiodiniaceae species, and BLAST tool to find orthologs from marine algae and protists. Moreover, SAGER integrates transcriptome datasets derived from diverse culture conditions of corresponding Symbiodiniaceae species. SAGER was developed with the capacity to incorporate future Symbiodiniaceae and algal genome and transcriptome data, and will serve as an open-access and sustained platform providing genomic and molecular tools that can be conveniently used to study Symbiodiniaceae and other marine algae.

Database URL: http://sampgr.org.cn
Genomic consequences of dietary diversification and parallel evolution due to nectarivory in leaf-nosed bats
Authors: Gutiérrez-Guerrero Yocelyn T , Ibarra-Laclette Enrique , Martínez del Río Carlos , Barrera-Redondo Josué , Rebollar Eria A , Ortega Jorge , León-Paniagua Livia , Urrutia Araxi , Aguirre-Planter Erika , Eguiarte Luis E
Published: June 2020

Background

The New World leaf-nosed bats (Phyllostomids) exhibit a diverse spectrum of feeding habits and innovations in their nutrient acquisition and foraging mechanisms. However, the genomic signatures associated with their distinct diets are unknown.

Results

We conducted a genomic comparative analysis to study the evolutionary dynamics related to dietary diversification and specialization. We sequenced, assembled, and annotated the genomes of five Phyllostomid species: one insect feeder (Macrotus waterhousii), one fruit feeder (Artibeus jamaicensis), and three nectar feeders from the Glossophaginae subfamily (Leptonycteris yerbabuenae, Leptonycteris nivalis, and Musonycteris harrisoni), also including the previously sequenced vampire Desmodus rotundus. Our phylogenomic analysis based on 22,388 gene families displayed differences in expansion and contraction events across the Phyllostomid lineages. Independently of diet, genes relevant for feeding strategies and food intake experienced multiple expansions and signatures of positive selection. We also found adaptation signatures associated with specialized diets: the vampire exhibited traits associated with a blood diet (i.e., coagulation mechanisms), whereas the nectarivore clade shares a group of positively selected genes involved in sugar, lipid, and iron metabolism. Interestingly, in fruit-nectar–feeding Phyllostomid and Pteropodids bats, we detected positive selection in two genes: AACS and ALKBH7, which are crucial in sugar and fat metabolism. Moreover, in these two proteins we found parallel amino acid substitutions in conserved positions exclusive to the tribe Glossophagini and to Pteropodids.

Conclusions

Our findings illuminate the genomic and molecular shifts associated with the evolution of nectarivory and shed light on how nectar-feeding bats can avoid the adverse effects of diets with high glucose content.
‘AI-Generated Inventions’: Time to Get the Record Straight?
Authors: Kim Daria
Published: June 2020

This article attempts to clarify the notion of an ‘AI-generated’ invention, an issue which has triggered an intense debate on the future of patent law and policy. While there is a general consensus that such inventions are incompatible with the concept of human inventorship, it remains largely unclear to what extent concerns regarding ‘non-human’ ingenuity can be justified. Most uncertain is how AI ‘autonomously generates’ inventions, and in what way 'AI-generated' inventions differ from inventions developed with the aid of AI.

Drawing on the extensive literature review, this article depicts AI techniques as methods of computational problem solving. It emphasises that such methods should not be equated with a computer’s ‘cognitive autonomy’. Further, it clarifies that the types of AI that have been most debated in the patent law literature ‒ artificial neural networks and evolutionary algorithms ‒ essentially require detailed instructions that determine how the relation between inputs and outputs is derived through computation. Accordingly, it is argued that, as long as computers rely on instructions defined by a human as to how solve a problem, the separation between human and non-human (algorithmic) ingenuity is, in itself, artificial. Ultimately, the article calls for a broader technical inquiry that would elucidate the relevance of the currently debated normative concerns over ‘non-human inventorship’ against the background of the technological state of the art.