bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic Framework Supply Chain through Kraljic Purchasing Portfolio in O&M Power Plant Company
Authors: Zemmy M , Setiyowati Rianti
Published: March 2021

This paper aims to determine a flexible and extensible model (strategic framework) in classifying the needs of materials/services as a procurement guideline for the company’s operating and maintenance service providers (O&M) power plants. PT PJB Services is a service provider of O&M which leads the market by managing power plants scattered across various islands facing problems related to the delay supply of spare parts. One of the efforts that can be done is to increase the efficiency of the procurement process by determining the model to identify important supply chains. This Model was obtained by the analysis of purchase portfolio using the Kraljics matrix. The design is based on a spare part position in the Kraljic portfolio Matrix consisting of a dimension of risk procurement and impact profit. The application of this model enables the determination of the critical company in the high lead time problem and the provider of materials/services involved. Analysis of critical needs position (including the suppliers involved) in the Kraljic matrix allows can be defined some strategies that may be applied to the lead time reduction.
Efforts to Reduce SO2 Emission in Paiton Coal-Fired Power Plant
Authors: Andri  , Basuki B H , Seputro E S , Kusuma E
Published: March 2021

Several breakthrough methods are needed to reduce the exhaust emissions of coal combustion in the boiler in order to meet the environmental quality standard requirements. The implementation of coal mixing is one of the short-term programs to reduce SO2 emissions, which is carried out by mixing several types of coal which have different calorific values and sulfur content to obtain the right coal mixture so that coal combustion will produce low SO2 emissions. Supply of coal with low sulfur content is getting smaller due to limited reserves, which causes the coal switching method will no longer be effective. Installation of flue gas desulfurization (FGD) facilities is an effective way to reduce SO2 emissions. Considering the condition and location of the Paiton 1-2 coal-fired power plant, the seawater desulfurization system is the most appropriate to be implemented because it is close to abundant seawater sources and the system has high reliability and effective economic value. By implementing flue gas desulphurization, SO removal efficiencies will be more than 95%.
Microstructure, Morphology, and Dielectric Properties of Ba1-xLaxTiO3 with Variation Mole Concentration of Lanthanum by Co-Precipitation Method
Authors: Ulfa U , Iriani Y , Kusumandari K
Published: March 2021

This study aims to determine the microstructure, morphology, and dielectric properties of Ba1-xLaxTiO3 modified with variations moles concentration of 10% and 15% Lanthanum at sintering temperatures of 1300°C and 1400°C for 4 hours. Ba1-xLaxTiO3 was synthesized using the co-precipitation method. The results of characterization using X-Ray Diffraction (XRD) showed that the greater concentration of La mole caused a diffraction angle shift to the right. The crystallite size decrease asthe increasing concentration of La mole and sintering temperature. The smallest crystallite size (36.63 nm) belong to a sample of Ba0,85La0,15TiO3 sintered at 1400°C. The intensity and the crystallinity decreased with increasing concentration of La mole. Scanning Electron Microscopy (SEM) photographs showed that grain size got smaller with increasing La mole concentration. The dielectric constant obtained from the results of characterization using a Resistance Inductance Capacitance meter (RLC meter) showed that the higher the concentration of La mole added, the greater the dielectric constant produced. The highest dielectric constant was 414 belonged to the sample Ba0,85La0,15TiO3 sintered at 1400°C.
Fabrication of PVDF/SiO2 Nanofiber Membrane as A Separator of Li-ion Battery by Double Jet Sprayers Electrospinning Method
Authors: Widiyandari H , Putra O A , Purwanto A , Subagio A
Published: March 2021

The temperature of the lithium-ion battery while running the electric vehicle becomes a severe safety issue. One way to keep the battery work at high temperatures is by a modified battery separator. The separator was used as a component to secure the battery by preventing short circuit current between the electrodes of opposite polarity. This current research reported the high-temperature shrinkage and excellent mechanical strength membrane separator based on PVDF/SiO2 nanofiber produced by double jet sprayers electrospinning method on rotating cylinder collectors. The independent variable in this research was the variation of a SiO2 polymer at 0 ppm, 500 ppm, 1000 ppm, and 3000 ppm. The results of PVDF/SiO2 nanofiber formed have beaded fiber structure with the average size of fiber’s diameter of ~192 nm. The highest amount of SiO2 addition (SiO2 3000 ppm) on PVDF nanofiber’s membrane causes an increase of porosity up to 69%. The addition of SiO2 also strengthens its mechanical and thermal shrinkage properties to 150°C. In the testing of the charge-discharge battery using separator PVDF/SiO2 nanofiber, the specific capacity value is 181 mAh/g.
A comparative study on the self-cleaning behavior and antibacterial activity of Portland cement by addition of TiO2 and ZnO nanoparticles
Authors: Dehkordi Bahzad Abasifard , Nilforoushan Mohammad Reza , Talebian Nasrin , Tayebi Morteza
Published: March 2021

In the present study, the photocatalytic effect of the addition of nano-TiO2/ZnO particles with different molar ratios of polyethylene glycol on the self-cleaning behavior and antibacterial activity of Portland cement was investigated to evaluate its potential for dye decolorization, and inactivation of Escherichia coli and Streptococcus mutans. Moreover, the effect of PEG addition on the hydration and tensile strength properties of the cement samples was evaluated. Furthermore, to study the self-cleaning behavior of the cement samples, an azo dye was selected as an organic pollutant. The modified cement samples were characterized using x-ray diffraction, Fourier-transform infrared spectroscopy, energy-dispersive x-ray spectroscopy, and scanning electron microscopy to assess the pozzolanic reactivity of the cement paste in the presence of TiO2 and ZnO nanoparticles. The results showed that the bactericidal properties of the modified cement specimens were dependent on the hydration time and composition of the samples. Accordingly, the maximum inhibitory effect was observed for the specimens hydrated for 7 d. Additionally, the surface of the samples was able to effectively decompose the azo dye. This novel modified cement has a promising potential to be used as a self-cleaning and antibacterial coating for urban constructions.
The investigation of chemical vapor deposited copper-based niobium films
Authors: Li Min , Pu Guo , Luo Yuchuan , Ye Zongbiao , Wei Jianjun , Chen Shuwei , Wu Andong , Yang Li , Zhang Kun , Gou Fujun , Zhu Tongtong , Tan Teng , He Yuan , Guo Hengxin , Chen Jianjun , Chen Bo , Wang Hongbin
Published: March 2021

The deposition of niobium film on copper with excellent superconducting property at low-temperature conditions, used as superconducting radio frequency (SRF) cavity, is a serious and urgent technical problem to be solved at present. In this work, copper-based niobium (Nb) films with a thickness of 1.5–1.8 um, regulating the deposition temperature parameters and gas flow velocity in a tube furnace, were prepared by low-temperature chemical vapor depositing (CVD) method from the reaction between H2 and Niobium chloride (NbCl5) under pure Ar atmosphere. Fabricated Nb films were characterized by X-ray diffraction, scanning electron microscopy and energy dispersive spectroscopy, respectively. The results showed that the excellent crystalline quality and superconductive performance of Nb films were generated successfully by CVD at low temperatures of 650 °C–700 °C. The preparation process was optimized during deposition and the formation mechanism of Nb films was also discussed in detail. The magnetic moment versus temperature of the Nb sample prepared at 700 °C was also measured and the well-prepared Nb film deposited in the boundary layer region obtains the desired superconducting transition temperature of 9.1 K ± 0.1 K, almost equivalent to that of high pure Nb bulk material. The optimized CVD reaction method of Nb film with favorable morphology and expected superconductive property at low temperature provided a new strategy and technical process in designing the desired copper-based Nb film SRF cavity.
Opto-electronic properties and solar cell efficiency modelling of Cu2ZnXS4 (X = Sn, Ge, Si) kesterites
Authors: Ratz Thomas , Raty Jean-Yves , Brammertz Guy , Vermang Bart , Nguyen Ngoc Duy
Published: March 2021

In this work, first-principles calculations of Cu2ZnSnS4, Cu2ZnGeS4 and Cu2ZnSiS4 are performed to highlight the impact of the cationic substitution on the structural, electronic and optical properties of kesterite compounds. Direct bandgaps are reported with values of 1.32, 1.89 and 3.06 eV respectively for Cu2ZnSnS4, Cu2ZnGeS4 and Cu2ZnSiS4 and absorption coefficients of the order of 104 cm−1 are obtained, indicating the applicability of these materials as absorber layer for solar cell applications. In the second part of this study, ab initio results are used as input data to model the electrical power conversion efficiency of kesterite-based solar cells. In that perspective, we used an improved version of the Shockley–Queisser model including non-radiative recombination via an external parameter defined as the internal quantum efficiency. Based on predicted optimal absorber layer thicknesses, the variation of the solar cell maximal efficiency is studied as a function of the non-radiative recombination rate. Maximal efficiencies of 25.71%, 19.85% and 3.10% are reported respectively for Cu2ZnSnS4, Cu2ZnGeS4 and Cu2ZnSiS4 for vanishing non-radiative recombination rate. Using an internal quantum efficiency value providing experimentally comparable

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values, cell efficiencies of 15.88%, 14.98% and 2.66% are reported respectively for Cu2ZnSnS4, Cu2ZnGeS4 and Cu2ZnSiS4. We confirm the suitability of Cu2ZnSnS4 in single junction solar cells, with a possible efficiency improvement of nearly 10% enabled through the reduction of the non-radiative recombination rate. In addition, Cu2ZnGeS4 appears to be an interesting candidate as top cell absorber layer for tandem approaches whereas Cu2ZnSiS4 might be interesting for transparent photovoltaic windows.
Theoretical and experimental investigation of chemical mechanical polishing of W–Ni–Fe alloy
Authors: Guo Jiang , Shi Xiaolin , Song Chuanping , Niu Lin , Cui Hailong , Guo Xiaoguang , Tong Zhen , Yu Nan , Jin Zhuji , Kang Renke
Published: March 2021

Fine finishing of tungsten alloy is required to improve the surface quality of molds and precision instruments. Nevertheless, it is difficult to obtain high-quality surfaces as a result of grain boundary steps attributed to differences in properties of two-phase microstructures. This paper presents a theoretical and experimental investigation on chemical mechanical polishing of W–Ni–Fe alloy. The mechanism of the boundary step generation is illustrated and a model of grain boundary step formation is proposed. The mechanism reveals the effects of mechanical and chemical actions in both surface roughness and material removal. The model was verified by the experiments and the results show that appropriately balancing the mechanical and chemical effects restrains the generation of boundary steps and leads to a fine surface quality with a high removal rate by citric acid-based slurry.
Graphene-enabled block copolymer lithography transfer to arbitrary substrates
Authors: Lee Woo-Kyung , Robinson Jeremy T , Whitener Keith E
Published: March 2021

We describe a method for phase separating and transferring block copolymer (BCP) nanoscale patterns to arbitrary substrates for surface-independent nanolithography. The enabling technology is a hydrogenated or oxidized graphene thin film that only weakly adheres to its substrate. BCPs are applied to these graphene-based materials and solvent annealed to effect nanoscale phase separation. Then, taking advantage of the weak interaction of the graphene film and its substrate, the BCP/graphene stack is delaminated easily in water. A target substrate is then used to retrieve the stack, which can then serve as a lithographic mask. The use of water as a lift-off agent allows for chemically mild retrieval of the phase-separated BCP, extending the BCP lithography technique to essentially arbitrary substrates. We demonstrate this graphene-enabled BCP lithography on silicon nitride and polyethylene. We also show that using reduced graphene oxide (RGO) as a thin film enables the transfer of wafer-scale BCP films and lithography on SiOx and Si. We use an RGO support to produce phase-separated BCP solvent-annealed patterns on polystyrene, a result which is not possible using standard BCP solvent annealing and which shows the utility of this technique. Finally, we demonstrate the ability to create nanopatterns of higher complexity by stacking multiple BCP masks, a capability that is not possible using conventional BCP lithography. This technique may have applications in fabricating nanoporous membranes and photonically active coatings.
Art as Political Discourse
Authors: Simoniti Vid
Published: March 2021

Much art is committed to political causes. However, does art contribute something unique to political discourse, or does it merely reflect the insights of political science and political philosophy? Here I argue for indispensability of art to political discourse by building on the debate about artistic cognitivism, the view that art is a source of knowledge. Different artforms, I suggest, make available specific epistemic resources, which allow audiences to overcome epistemic obstacles that obtain in a given ideological situation. My goal is to offer a general model for identifying cognitive advantages for artworks belonging to distinct artforms and genres (e.g. satire, visibility-raising artworks, caricatures, and so on), in a way that can account for each artwork’s historical and cultural specificity. More speculatively, however, my account also comments on the ancient struggle between philosophy and the arts as competing modes of persuasion, and expands our notion of legitimate political discourse to include a greater plurality of discursive genres.
106 A Whole Hospital Delirium Audit with 20 Week Follow-Up
Authors: Khambay E , Katz-Summercorn C , Speed J , Amarnani R , Enfield-Bance A , Mani S , Glasser M
Published: March 2021

Introduction

Delirium is a common manifestation of acute illness, characterised by fluctuating changes in mental state. Its aetiologies and presentations are diverse. This can lead to underdiagnosis. We screened all adult inpatients at Barnet Hospital for delirium. 20 weeks follow-up data was collected, including mortality and admission to institutional care.

Methods

The 4AT and Clinical Frailty Score (CFS) were recorded for every adult inpatient (n = 220) in Barnet Hospital on 13/03/2019. Hospital notes were reviewed to establish whether delirium assessments were performed during admission. Electronic records were used to establish length of stay, discharge destination, mortality and readmission rate over 20 weeks.

Results

30% (n = 65) of inpatients had possible delirium (4AT score ≥ 4). Delirium was more common in older, frailer patients (Table 1). Most patients with delirium were under the care of geriatric (40%) or acute medicine (26%). Only gastroenterology and gynaecology had no patients with delirium. Patients with delirium were 3 times more likely to die during their admission and were twice as likely to be discharged to institutional care (Table 1). 20 week mortality of patients with delirium was 26%.

Conclusion

Delirium is common in hospital inpatients. Delirium has a high morbidity and mortality. Better diagnosis of delirium in hospital may improve outcomes. Table 1: Mean(SD) unless stated. *p < 0.05 Delirium (n = 65) No Delirium (n = 155) Male: % 46 46 Age* 81(11) 71(20) Clinical Frailty Score* 5.6(1.7) 3.8(1.8) Dementia (%)* 53 10 Assisted living: n(%) o Pre-admission * 18.5 3.2 o Post Admission * 44.6 22.6 Length of stay 33 (25) 30.6 (28) Mortality (%) o Hospital * 10.7 3.9 o 20 Weeks * 26.2 14.2 Readmission rate (%) 30.8 31.
137 Specialist Medication Review as Part of the Comprehensive Geriatric Assessment in the Day Hospital Setting
Authors: Bailey L , Brewer L , Carroll J , Seebah S
Published: March 2021

Introduction

Medication use in older people is complex. Consequently, regular medication reviews as an integral part of healthcare provision for older people are necessary. Patients attending consultant-led, multidisciplinary, day hospital clinics have specialist medication reviews undertaken by our senior clinical pharmacist. “Pharmacy Interventions” (PIs) are suggested and typed prior to physician-led patient review.

Method

Data collected by our senior clinical pharmacist were reviewed including patient demographics, clinical characteristics, types of prescribed drugs and PIs. Clinical severity of PIs was assessed using the NCC MERP Medication error index and American Journal Health-Syst Pharm Medication error index. Scores, ranging in clinical severity from A-I (A = capacity to cause error, I = may have contributed to death) and 0–10 (0 = no potential effect, 10 = death) were assigned by the pharmacist and two physicians.

Results

100 patients were included, mean age 82y (range 65-99y). 62% were female and 63% were first time attenders. Mean number of regularly prescribed medications was 7.2 (range 1–16), 10% reported compliance issues. The most commonly prescribed drugs belonged to the “Alimentary tract and metabolism” class (24%), including PPIs, laxatives and blood-glucose lowering medications. 16% and 15% were on regularly prescribed neuroactive and psychoactive medications, respectively. Of suggested PIs, 46% were acted upon during physician review, a further 4% were acknowledged in clinical notes. PIs covered many prescribing issues including drug–drug interactions, incorrect dosing, drug monitoring and administration timing. The average PI scores assigned by the pharmacist, physicians 1 and 2 differed, at 6.4, 3.2 and 4.8, respectively.

Conclusion

PIs suggested at senior pharmacy level are an important component of the comprehensive geriatric assessment, highlighting multiple complex prescribing issues. Clinical severity of PIs was scored lower by physicians, perhaps indicating an underestimation of prescribing errors. Senior pharmacy involvement in the care of frail older outpatients is an invaluable resource.
Association Between Gestational Exposure to Toxicants and Autistic Behaviors Using Bayesian Quantile Regression
Authors: Alampi Joshua D , Lanphear Bruce P , Braun Joseph M , Chen Aimin , Takaro Tim K , Muckle Gina , Arbuckle Tye E , McCandless Lawrence C
Published: March 2021

Autism spectrum disorder, which is characterized by impaired social communication and stereotypic behaviors, affects 1%–2% of children. Although prenatal exposure to toxicants has been associated with autistic behaviors, most studies have been focused on shifts in mean behavior scores. We used Bayesian quantile regression to assess the associations between log2-transformed toxicant concentrations and autistic behaviors across the distribution of behaviors. We used data from the Maternal–Infant Research on Environmental Chemicals study, a pan-Canadian cohort (2008–2011). We measured metal, pesticide, polychlorinated biphenyl, phthalate, bisphenol-A, and triclosan concentrations in blood or urine samples collected during the first trimester of pregnancy. Using the Social Responsiveness Scale (SRS), in which higher scores denote more autistic-like behaviors, autistic behaviors were assessed in 478 children aged 3–4 years old. Lead, cadmium, and most phthalate metabolites were associated with mild increases in SRS scores at the 90th percentile of the SRS distribution. Manganese and some pesticides were associated with mild decreases in SRS scores at the 90th percentile of the SRS distribution. We identified several monotonic trends in which associations increased in magnitude from the bottom to the top of the SRS distribution. These results suggest that quantile regression can reveal nuanced relationships and, thus, should be more widely used by epidemiologists.
Analyzing master regulators and scRNA-seq of COVID-19 patients reveals an underlying anti-SARS-CoV-2 mechanism of ZNF proteins
Authors: Qin Shijie , Xu Weijun , Wang Canbiao , Jiang Sizhu , Dai Wei , Yang Yang , Shen Jiawei , Jin Ping , Ma Fei , Xia Xinyi
Published: March 2021

Studies have demonstrated that both mortality and severe illness rates exist significant difference in different gender COVID-19 patients, but the reasons are still very mysterious to date. Here, we firstly find that the survival outcome of female patients is better to male patients through analyzing the 3044 COVID-19 cases. Secondly, we identify many important master regulators [e.g. STAT1/STAT2 and zinc finger (ZNF) proteins], in particular female patients can express more ZNF proteins and stronger transcriptional activities than male patients in response to SARS-CoV-2 infection. Thirdly, we discover that ZNF protein activity is significantly negative correlation with the SARS-CoV-2 load of COVID-19 patients, and ZNF proteins as transcription factors can also activate their target genes to participate in anti-SARS-CoV-2 infection. Fourthly, we demonstrate that ZNF protein activity is positive correlation with the abundance of multiple immune cells of COVID-19 patients, implying that the highly ZNF protein activity might promote the abundance and the antiviral activity of multiple immune cells to effectively suppress SARS-CoV-2 infection. Taken together, our study proposes an underlying anti-SARS-COV-2 role of ZNF proteins, and differences in the amount and activity of ZNF proteins might be responsible for the distinct prognosis of different gender COVID-19 patients.
PoseFilter: a PyMOL plugin for filtering and analyzing small molecule docking in symmetric binding sites
Authors: Williams Justine C , Kalyaanamoorthy Subha
Published: March 2021

‘PoseFilter’ is a PyMOL plugin that assists in analyses and filtering of docked poses. PoseFilter enables automatic detection of symmetric poses from docking outputs and can be accessed using both graphical user interface and command-line options within the PyMOL program. Two methods of analyses, root mean square deviations and interaction fingerprints, are available from this plugin. The capabilities of the plugin are demonstrated using docking outputs from different oligomeric protein-ligand complexes.

Availability and implementation

The plugin can be downloaded from the GitHub page, https://github.com/skalyaanamoorthy/PoseFilter.

Supplementary information

Supplementary data are available at Bioinformatics online.
Association of intraoperative hypotension with postoperative morbidity and mortality: systematic review and meta-analysis
Authors: Wijnberge M , Schenk J , Bulle E , Vlaar A P , Maheshwari K , Hollmann M W , Binnekade J M , Geerts B F , Veelo D P
Published: March 2021

Background

Intraoperative hypotension, with varying definitions in literature, may be associated with postoperative complications. The aim of this meta-analysis was to assess the association of intraoperative hypotension with postoperative morbidity and mortality.

Methods

MEDLINE, Embase and Cochrane databases were searched for studies published between January 1990 and August 2018. The primary endpoints were postoperative overall morbidity and mortality. Secondary endpoints were postoperative cardiac outcomes, acute kidney injury, stroke, delirium, surgical outcomes and combined outcomes. Subgroup analyses, sensitivity analyses and a meta-regression were performed to test the robustness of the results and to explore heterogeneity.

Results

The search identified 2931 studies, of which 29 were included in the meta-analysis, consisting of 130 862 patients. Intraoperative hypotension was associated with an increased risk of morbidity (odds ratio (OR) 2.08, 95 per cent confidence interval 1.56 to 2.77) and mortality (OR 1.94, 1.32 to 2.84). In the secondary analyses, intraoperative hypotension was associated with cardiac complications (OR 2.44, 1.52 to 3.93) and acute kidney injury (OR 2.69, 1.31 to 5.55). Overall heterogeneity was high, with an I2 value of 88 per cent. When hypotension severity, outcome severity and study population variables were added to the meta-regression, heterogeneity was reduced to 50 per cent.

Conclusion

Intraoperative hypotension during non-cardiac surgery is associated with postoperative cardiac and renal morbidity, and mortality. A universally accepted standard definition of hypotension would facilitate further research into this topic.
Safety and feasibility of 2 h of normothermic machine perfusion of donor kidneys in the Eurotransplant Senior Program
Authors: Rijkse E , de Jonge J , Kimenai H J A N , Hoogduijn M J , de Bruin R W F , van den Hoogen M W F , IJzermans J N M , Minnee R C
Published: March 2021

Background

The 5-year graft survival rate of donor kidneys transplanted in the Eurotransplant Senior Program (ESP) is only 47 per cent. Normothermic machine perfusion (NMP) may be a new preservation technique that improves graft outcome. This pilot study aimed to assess safety and feasibility of this technique within the ESP.

Methods

Recipients were eligible for inclusion if they received a donor kidney within the ESP. Donor kidneys underwent 2 h of oxygenated NMP with a red cell-based solution at 37°C, additional to standard-of-care preservation (non-oxygenated hypothermic machine perfusion). The primary outcome was the safety and feasibility of NMP. As a secondary outcome, graft outcome was investigated and compared with that in a historical group of patients in the ESP and the contralateral kidneys.

Results

Eleven patients were included in the NMP group; the function of eight kidneys could be compared with that of the contralateral kidney. Fifty-three patients in the ESP, transplanted consecutively between 2016 and 2018, were included as controls. No adverse events were noted, especially no arterial thrombosis or primary non-function of the transplants. After 120 min of oxygenated NMP, median flow increased from 117 (i.q.r. 80–126) to 215 (170–276) ml/min (P = 0.001). The incidence of immediate function was 64 per cent in the NMP group and 40 per cent in historical controls (P = 0.144). A significant difference in graft outcome was not observed.

Discussion

This pilot study showed NMP to be safe and feasible in kidneys transplanted in the ESP. A well powered study is warranted to confirm these results and investigate the potential advantages of NMP on graft outcome.
Time trends in incidence and survival of small intestinal cancer in Sweden
Authors: Landerholm K
Published: March 2021

Background

Small intestinal cancer is less common than some other gastrointestinal malignancies. Tumours of different histological types and anatomical sites of origin have therefore often been described together. The aim of this study was to investigate the epidemiology for each of the four main subtypes: duodenal adenocarcinoma (D-AC), duodenal neuroendocrine tumour (D-NET), jejunoileal adenocarcinoma (J/I-AC), and jejunoileal neuroendocrine tumour (J/I-NET).

Methods

All patients with small intestinal cancer diagnosed between 1960 and 2015 were identified from the Swedish Cancer Register. The age-adjusted incidence rate with incidence rate ratios, as well as overall (OS) and net (NS) survival, were determined and temporal trends were analysed.

Results

The incidence rate was highest for J/I-NET, with 9.98 clinical diagnoses per million in 2010–2015. Clinical diagnosis of D-AC increased more than 10-fold and surpassed J/I-AC as the second most common subtype. D-NET was by far the least common subtype. Diagnosis at autopsy became less common over time, whereas clinical diagnoses increased significantly for all four subtypes. All subtypes except J/I-AC affected men more often than women. The age distribution was similar between subtypes, although patients with adenocarcinomas were slightly older. Survival was generally much better for patients with NET than for those with adenocarcinoma. Both OS and NS showed a negative association with advancing age. Survival improved only for J/I-NET from a 5-year NS of 0.69 in the 1960s to 0.81 in 2010–2015.

Conclusion

The incidence of small intestinal cancer is increasing, particularly for D-AC and in the elderly. Survival of patients with small intestinal cancer has improved only for J/I-NET over the last decades.
To what degree is late life cognitive decline driven by age-related neuropathologies?
Authors: Boyle Patricia A , Wang Tianhao , Yu Lei , Wilson Robert S , Dawe Robert , Arfanakis Konstantinos , Schneider Julie A , Bennett David A
Published: March 2021

The ageing brain is vulnerable to a wide array of neuropathologies. Prior work estimated that the three most studied of these, Alzheimer’s disease, infarcts, and Lewy bodies, account for ∼40% of the variation in late life cognitive decline. However, that estimate did not incorporate many other diseases that are now recognized as potent drivers of cognitive decline [e.g. limbic predominant age-related TDP-43 encephalopathy (LATE-NC), hippocampal sclerosis, other cerebrovascular conditions]. We examined the degree to which person-specific cognitive decline in old age is driven by a wide array of neuropathologies. Deceased participants (n = 1164) from two longitudinal clinical-pathological studies, the Rush Memory and Aging Project and Religious Orders Study, completed up to 24 annual evaluations including 17 cognitive performance tests and underwent brain autopsy. Neuropathological examinations provided 11 pathological indices, including markers of Alzheimer’s disease, non- Alzheimer’s disease neurodegenerative diseases (i.e. LATE-NC, hippocampal sclerosis, Lewy bodies), and cerebrovascular conditions (i.e. macroscopic infarcts, microinfarcts, cerebral amyloid angiopathy, atherosclerosis, and arteriolosclerosis). Mixed effects models examined the linear relation of pathological indices with global cognitive decline, and random change point models examined the relation of the pathological indices with the onset of terminal decline and rates of preterminal and terminal decline. Cognition declined an average of about 0.10 unit per year (estimate = −0.101, SE = 0.003, P < 0.001) with considerable heterogeneity in rates of decline (variance estimate for the person-specific slope of decline was 0.0094, P < 0.001). When considered separately, 10 of 11 pathological indices were associated with faster decline and accounted for between 2% and 34% of the variation in decline, respectively. When considered simultaneously, the 11 pathological indices together accounted for 43% of the variation in decline; Alzheimer’s disease-related indices accounted for 30–36% of the variation, non-Alzheimer’s disease neurodegenerative indices 4–10%, and cerebrovascular indices 3–8%. Finally, the 11 pathological indices combined accounted for less than a third of the variation in the onset of terminal decline (28%) and rates of preterminal (32%) and terminal decline (19%). Although age-related neuropathologies account for a large proportion of the variation in late life cognitive decline, considerable variation remains unexplained even after considering a wide array of neuropathologies. These findings highlight the complexity of cognitive ageing and have important implications for the ongoing effort to develop effective therapeutics and identify novel treatment targets.
Maternal Adverse Childhood Experience and Depression in Relation with Brain Network Development and Behaviors in Children: A Longitudinal Study
Authors: Zhang Han , Wong Ting-Yat , Broekman Birit F P , Chong Yap-Seng , Shek Lynette P , Gluckman Peter D , Tan Kok Hian , Meaney Michael J , Fortier Marielle V , Qiu Anqi
Published: March 2021

Maternal childhood maltreatment and depression increase risks for the psychopathology of the offspring. This study employed a longitudinal dataset of mother–child dyads to investigate the developmental trajectories of brain functional networks and behaviors of children in relation with maternal childhood adverse experience and depression. Maternal childhood trauma was retrospectively assessed via childhood trauma questionnaire, whereas maternal depressive symptoms were prospectively evaluated during pregnancy and after delivery (n = 518). Child brain scans were acquired at age of 4.5, 6, and 7.5 years (n = 163) and behavioral problems were measured at 7.5 years using the Child Behavior Checklist. We found the functional connectivity of the language network with the sensorimotor, frontal, and attentional networks as a function of maternal adverse experience that interacted with sex and age. Girls exposed to mothers with depressive symptoms or childhood abuse showed the increased development of the functional connectivity of the language network with the visual networks, which was associated with social problems. Girls exposed to mothers with depressive symptoms showed the slower growth of the functional connectivity of the language network with the sensorimotor networks. Our findings, in a community sample, suggest the language network organization as neuroendophenotypes for maternal childhood trauma and depression.
Age-Related Changes in Malaria Clinical Phenotypes During Infancy Are Modified by Sickle Cell Trait
Authors: Zehner Nicholas , Adrama Harriet , Kakuru Abel , Andra Teddy , Kajubi Richard , Conrad Melissa , Nankya Felistas , Clark Tamara D , Kamya Moses , Rodriguez-Barraquer Isabel , Dorsey Grant , Jagannathan Prasanna
Published: March 2021

Background

Infants are protected against Plasmodium falciparum malaria. Mechanisms that drive this protection remain unclear due to a poor understanding of malaria clinical phenotypes during infancy.

Methods

We enrolled a birth cohort of 678 infants in Busia, Uganda, an area of high malaria transmission. We followed infants through 12 months of age and quantified protection against parasitemia and clinical disease.

Results

Symptomatic malaria incidence increased from 1.2 to 2.6 episodes per person-year between 0 and <6 months and between 6 and 12 months of age, while the monthly probability of asymptomatic parasitemia given infection decreased from 32% to 21%. Sickle cell trait (HbAS) was protective against symptomatic malaria (incidence rate ratio  = 0.57 comparing HbAS vs hemoglobin AA (HbAA); 95% confidence interval, 0.44–0.74; P < .001), but age modified this relationship (Pint = <0.001), with nonlinear protection that waned between 0 and 9 months of age before increasing. Increasing age was associated with higher parasite densities at the time of infection and, in infants with HbAS, a reduced ability to tolerate high parasite densities without fever.

Conclusions

Age-dependent changes in HbAS protective efficacy in infancy were accompanied by differential loss of antiparasite and antidisease protection among HbAS and HbAA infants. This provides a framework for investigating the mechanisms that underlie infant protection against malaria.

Clinical Trials Registration

NCT02793622.
Sex-specific differences in swimming, aerobic metabolism and recovery from exercise in adult coho salmon (Oncorhynchus kisutch) across ecologically relevant temperatures
Authors: Kraskura K , Hardison E A , Little A G , Dressler T , Prystay T S , Hendriks B , Farrell A P , Cooke S J , Patterson D A , Hinch S G , Eliason E J
Published: March 2021

Adult female Pacific salmon can have higher migration mortality rates than males, particularly at warm temperatures. However, the mechanisms underlying this phenomenon remain a mystery. Given the importance of swimming energetics on fitness, we measured critical swim speed, swimming metabolism, cost of transport, aerobic scope (absolute and factorial) and exercise recovery in adult female and male coho salmon (Oncorhynchus kisutch) held for 2 days at 3 environmentally relevant temperatures (9°C, 14°C, 18°C) in fresh water. Critical swimming performance (Ucrit) was equivalent between sexes and maximal at 14°C. Absolute aerobic scope was sex- and temperature-independent, whereas factorial aerobic scope decreased with increasing temperature in both sexes. The full cost of recovery from exhaustive exercise (excess post-exercise oxygen consumption) was higher in males compared to females. Immediately following exhaustive exercise (i.e. 1 h), recovery was impaired at 18°C for both sexes. At an intermediate time scale (i.e. 5 h), recovery in males was compromised at 14°C and 18°C compared to females. Overall, swimming, aerobic metabolism, and recovery energetics do not appear to explain the phenomenon of increased mortality rates in female coho salmon. However, our results suggest that warming temperatures compromise recovery following exhaustive exercise in both male and female salmon, which may delay migration progression and could contribute to en route mortality.
The role of phosphorylation in atrial fibrillation: a focus on mass spectrometry approaches
Authors: Safabakhsh Sina , Panwar Pankaj , Barichello Scott , Sangha Sarabjit S , Hanson Paul J , Petegem Filip Van , Laksman Zachary
Published: March 2021

Atrial fibrillation (AF) is the most common arrhythmia worldwide. It is associated with significant increases in morbidity in the form of stroke and heart failure, and a doubling in all-cause mortality. The pathophysiology of AF is incompletely understood, and this has contributed to a lack of effective treatments and disease-modifying therapies. An important cellular process that may explain how risk factors give rise to AF includes post-translational modification of proteins. As the most commonly occurring post-translational modification, protein phosphorylation is especially relevant. Although many methods exist for studying protein phosphorylation, a common and highly resolute technique is mass spectrometry (MS). This review will discuss recent evidence surrounding the role of protein phosphorylation in the pathogenesis of AF. MS-based technology to study phosphorylation and uses of MS in other areas of medicine such as oncology will also be presented. Based on these data, future goals and experiments will be outlined that utilize MS technology to better understand the role of phosphorylation in AF and elucidate its role in AF pathophysiology. This may ultimately allow for the development of more effective AF therapies.
Games and Sloth: Working for the Common Good in Late Medieval Flanders
Authors: Brown Andrew
Published: March 2021

Games, sloth and the common good are familiar subjects to scholars of late medieval Europe, yet the connections contemporaries made between them have never been properly explored. How these rhetorical ideas were aligned, how they were used and by whom, across a wide social spectrum, are the central questions in this article; and examining them reveals how malleable (and gendered) they were. Discourses on games, developed by schoolmen and other churchmen in relation to recreation, and integrated with ideas of sloth and the common good, were harnessed to serve the authority of rulers in late medieval Flanders and Burgundian lands. Yet they were also deployed to suit other agendas, especially during the troubled period of civil war from 1477 to 1492, by the rulers’ subjects—urban magistrates, elite or middling groups, but also men from lower social strata. Valuable evidence for the latter appears within the numerous pardon letters that survive from 1386 to 1500: these were specially granted by rulers to suppliants, many of whom were craftsmen, labourers and artisans. Suppliants often referred to their game-playing and recreational activities; while these cases suggest a process by which subjects were disciplined, they also show how discourses on games offered suppliants strategic room for manoeuvre.
Impact of bilateral bidirectional Glenn anastomosis on staged Fontan strategy and Fontan circulation
Authors: Imai Kenta , Hoashi Takaya , Okuda Naoki , Ohuchi Hideo , Kurosaki Kenichi , Ichikawa Hajime
Published: March 2021

OBJECTIVES

The aim of this study was to identify the impact of bilateral bidirectional Glenn (BBDG) anastomosis on staged Fontan strategy and late Fontan circulation.

METHODS

Of 267 patients who underwent bidirectional Glenn prior to Fontan completion between 1989 and 2013, 62 patients (23%) who underwent BBDG were enrolled in this study. Age at operation was 0.84 years (25th–75th percentile: 0.58–1.39). Thirty-three patients had heterotaxy syndrome (53%). The mean follow-up period was 12.7 ± 8.1 (max. 30.6) years.

RESULTS

The overall survival rate at 15 years was 73%. Although 49 patients (79.0%) went on to Fontan completion, 12 patients (19.4%) died without achieving it. Thrombus formation and poor development in a central pulmonary artery were not observed, but obstruction of the superior vena cava (SVC) occurred in 8 patients (13%), mainly those with right atrial isomerism (P = 0.037). SVC obstruction was not, however, a risk factor for mortality (P = 0.097) or Fontan completion (P = 0.41). The shape of BBDG anastomosis, symmetricity of pulmonary blood flow, impingement of caval blood flow returning from the superior and inferior vena cavae or coexisting interrupted inferior vena cava with azygos or hemi-azygos continuation did not affect late Fontan outcomes, such as overall survival, freedom from protein-losing enteropathy or pulmonary arterio-venous malformation rates.

CONCLUSIONS

SVC obstruction after BBDG frequently occurred, mainly in patients with right atrial isomerism; however, its direct impact on prognosis or achieving Fontan completion was not identified. Once Fontan circulation was established, the arrangement of the Fontan pathway did not affect late Fontan outcomes.
Effect of cerebrospinal fluid pressure elevation on spinal cord perfusion during aortic cross-clamping with distal aortic perfusion
Authors: Haunschild Josephina , Khachatryan Zara , von Aspern Konstantin , Herajärvi Johanna , Ossmann Susann , Naumann Jörg , Borger Michael A , Etz Christian D
Published: March 2021

OBJECTIVES

Distal aortic perfusion (DaP) is a widely accepted protective adjunct facilitating early reinstitution of visceral perfusion during extended thoracic and thoraco-abdominal aortic repair. DaP has also been suggested to secure distal inflow to the paraspinal collateral network via the hypogastric arteries and thereby reduce the risk of spinal cord ischaemia. However, an increase in cerebrospinal fluid (CSF) pressure is frequently observed during thoracoabdominal aortic aneurysm repair. The aim of this study was to evaluate the effects of DaP on regional spinal cord blood flow (SCBF) during descending aortic cross-clamping and iatrogenic elevation of cerebrospinal fluid pressure.

METHODS

Eight juvenile pigs underwent central cannulation for cardiopulmonary bypass according to our established experimental protocol followed by aortic cross-clamping of the descending thoracic and abdominal aorta—mimicking sequential aortic clamping—with the initiation of DaP. Thereafter, CSF pressure elevation was induced by the infusion of blood plasma until baseline CSF pressure was tripled. At each time-point, microspheres of different colours were injected allowing for regional SCBF analysis.

RESULTS

DaP led to a pronounced hyperperfusion of the distal spinal cord [SCBF up to 480%, standard deviation (SD): 313%, compared to baseline]. However, DaP provided no or only limited additional flow to the upper and middle segments of the spinal cord (C1–Th7: 5% of baseline, SD: 5%; Th8–L2: 24%, SD: 39%), which was compensated by proximal flow only at C1–Th7 level. Furthermore, DaP could not counteract an experimental CSF pressure elevation, which led to a further decrease in regional SCBF most pronounced in the mid-thoracic spinal cord segment.

CONCLUSIONS

Protective DaP during thoraco-abdominal aortic repair may be associated with inadequate spinal protection particularly at the mid-thoracic spinal cord level (‘watershed area’) and result in the adverse effect of a potentially dangerous hyperperfusion of the distal spinal cord segments.
Genome Mining and Evolutionary Analysis Reveal Diverse Type III Polyketide Synthase Pathways in Cyanobacteria
Authors: Larsen Joachim Steen , Pearson Leanne Andrea , Neilan Brett Anthony
Published: March 2021

Cyanobacteria are prolific producers of natural products, including polyketides and hybrid compounds thereof. Type III polyketide synthases (PKSs) are of particular interest, due to their wide substrate specificity and simple reaction mechanism, compared with both type I and type II PKSs. Surprisingly, only two type III PKS products, hierridins, and (7.7)paracyclophanes, have been isolated from cyanobacteria. Here, we report the mining of 517 cyanobacterial genomes for type III PKS biosynthesis gene clusters. Approximately 17% of the genomes analyzed encoded one or more type III PKSs. Together with already characterized type III PKSs, the phylogeny of this group of enzymes was investigated. Our analysis showed that type III PKSs in cyanobacteria evolved into three major lineages, including enzymes associated with 1) (7.7)paracyclophane-like biosynthesis gene clusters, 2) hierridin-like biosynthesis gene clusters, and 3) cytochrome b5 genes. The evolutionary history of these enzymes is complex, with some sequences partitioning primarily according to speciation and others putatively according to their reaction type. Protein modeling showed that cyanobacterial type III PKSs generally have a smaller active site cavity (mean = 109.035 Å3) compared with enzymes from other organisms. The size of the active site did not correlate well with substrate size, however, the “Gatekeeper” amino acid residues within the active site were strongly correlated to enzyme phylogeny. Our study provides unprecedented insight into the distribution, diversity, and molecular evolution of cyanobacterial type III PKSs, which could facilitate the discovery, characterization, and exploitation of novel enzymes, biochemical pathways, and specialized metabolites from this biosynthetically talented clade of microorganisms.
Pain Characteristics, Cardiovascular Risk Factors, and Cardiovascular Disease
Authors: Rodríguez-Sánchez Isabel , Ortolá Rosario , Graciani Auxiliadora , Martínez-Gómez David , Banegas Jose R , Rodríguez-Artalejo Fernando , García-Esquinas Esther
Published: March 2021

Background

There is unclear evidence that chronic pain may increase the risk of cardiovascular disease (CVD) incidence and mortality. This work evaluated the association between chronic pain, incidence of CVD, and changes in CVD risk factors.

Methods

Cohort of 1091 community-dwelling individuals of at least 60 years, free from CVD at baseline, followed up for 6 years. Data on psychosocial factors and CVD risk factors were obtained through validated questionnaires and laboratory measurements. A pain scale ranging from 0 (no pain) to 6 (worst pain) was created according to pain frequency, location, and intensity.

Results

The cumulative incidence of CVD was 4.2% at 3 years and 7.7% at 5 years of follow-up. Compared to individuals without pain in the first 3 years (2012–2015), those with maintained scores of at least 2 showed a mean reduction of 3.57 (−5.77 to −1.37) METs-h/week in recreational physical activity, a 0.38-point (0.04–0.73) increase in psychological distress, and a 1.79 (1.03–3.11) higher odds of poor sleep. These associations held in the second follow-up period, when individuals with maintained pain also worsened their diet quality. A 1-point increase in the pain scale in 2012 was associated with a 1.21 (1.03–1.42) and 1.18 (0.97–1.44) increased CVD incidence in 2015 and 2017, respectively; none of the studied factors mediated this relationship.

Conclusions

Older adults with chronic pain show important reductions in recreational physical activity and deterioration in mental health, sleep, and diet quality, which may well aggravate pain. Future studies should evaluate whether these factors mediate the increased risk of CVD observed in older adults with chronic pain.