bluuebunny/crossref_metadata_2025 huggingface dataset:
An Interesting Case of Bilateral Hilar Lymphadenopathy Presented with Visual Impairment
Authors: MT Chandramouli , Baikunje Nandakishore , Y. Sunil Kumar , K. Subrahmanya Bhat , Bajaj Darshan , Hosmane Giridhar Belur
Published: November 2021

Sarcoidosis is a systemic granulomatous disease of unknown etiology. It primarily affects the lungs and lymphatics; however, the presentation is not always pulmonary. Uveitis is the presenting symptom in 5% of patients, predominantly in females. Cystoid macular edema is the most important sight-threatening sequela of ocular sarcoidosis. Histopathological evidence of noncaseating epithelioid granulomas from a biopsy is the gold standard for the diagnosis of ocular sarcoidosis. Diagnosis of sarcoidosis is made by exclusion of other causes of granulomatous disease, mainly tuberculosis and fungal infection and documentation of involvement of at least one additional organ system. The authors present a case of a patient with sarcoidosis involving lungs and eyes, who had uveitis as an initial presentation.
A Clinical Decision Support System Design Framework for Nursing Practice
Authors: Lu Sheng-Chieh , Brown Rebecca J. , Michalowski Martin
Published: November 2021

Background As nurses increasingly engage in decision-making for patients, a unique opportunity exists to translate research into practice using clinical decision support systems (CDSSs). While research has shown that CDSS has led to improvements in patient outcomes and nursing workflow, the success rate of CDSS implementation in nursing is low. Further, the majority of CDSS for nursing are not designed to support the care of patients with comorbidity.

Objectives The aim of the study is to conceptualize an evidence-based CDSS supporting complex patient care for nursing.

Methods We conceptualized the CDSS through extracting scientific findings of CDSS design and development. To describe the CDSS, we developed a conceptual framework comprising the key components of the CDSS and the relationships between the components. We instantiated the framework in the context of a hypothetical clinical case.

Results We present the conceptualized CDSS with a framework comprising six interrelated components and demonstrate how each component is implemented via a hypothetical clinical case.

Conclusion The proposed framework provides a common architecture for CDSS development and bridges CDSS research findings and development. Next research steps include (1) working with clinical nurses to identify their knowledge resources for a particular disease to better articulate the knowledge base needed by a CDSS, (2) develop and deploy a CDSS in practice using the framework, and (3) evaluate the CDSS in the context of nursing care.
Management of Symptomatic Meckel's Diverticulum in Infants and Children
Authors: Ghritlaharey Rajendra K.
Published: November 2021

Objectives

The primary objective of the present study was to review the demographics of infants and children operated upon for Meckel's diverticulum. The secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and the outcome.

Materials and Methods

This study is a single-institutional, retrospective study and descriptive in nature. It consisted of infants and children below 12 years who were operated upon for Meckel's diverticulum at the author's institute and included data from January 1, 2000 to December 31, 2020.

Results

Eighty-four children below 12 years were operated upon for Meckel's diverticulum during the study period. The ratio for males to females was 3:1. This study consisted of infants, (n = 22, 26.19%), children of 1 to 5 years of age (n =19, 22.61%), and children of 6 to 12 years of age (n = 43, 51.19%). Clinically, children with Meckel's diverticulum presented in the following order of frequency: (1) intestinal obstruction (n = 59, 70.23%), (2) perforation peritonitis (n = 17, 20.23%), (3) lower gastrointestinal bleeding (n = 4, 4.76%), and (4) incidental finding (n = 4, 4.76%). In 35 (41.66%) children, bowel gangrene was detected. One-fifth (n = 17) of Meckel's diverticulum was responsible for the secondary intussusception. The surgical procedures were performed in the following order of frequency: (1) resection of Meckel's diverticulum, an adjacent segment of ileum and ileoileal anastomosis (n = 36, 42.85%); (2) Meckel's diverticulectomy (n = 32, 38.09%); (3) resection of Meckel's diverticulum, an adjacent segment of ileum with or without cecum and an ileostomy (n = 12, 14.28%); and (4) resection of Meckel's diverticulum, an adjacent segment of ileum, cecum, part of the colon, and ileocolic anastomosis (n = 4, 4.76%). In 8 (9.52%) children, complications were documented during the postoperative period. The present study observed three (3.57%) deaths during the postoperative period.

Conclusion

Meckel's diverticulum was one of the common causes of acute intestinal obstruction in infants and older children. Ninety percent of children with Meckel's diverticulum presented with features of an acute abdomen. Forty percent of children evidenced bowel gangrene during the surgical procedures. In these children, early diagnosis, timely referral, and institution of surgical therapy for acute abdomen/intestinal obstruction may prevent the development of bowel gangrene and the requirement of bowel resections to some extent.
A novel Nb superconducting joint with ultralow resistance fabricated by electron beam welding method for superconducting gravimeter
Authors: Zhang Zili , Huang Xing , Cui Chunyan , Wang Hao , Niu Feifei , Zhang Yuan , Kong Xiangdong , Han Li , Wang Lei , Hu Xinning , Wang Qiuliang
Published: November 2021

This paper presents a novel Nb superconducting joint with an ultralow resistance of 7.9 × 10−16 Ω, fabricated using the electron beam welding (EBW) method. After the EBW process, the two Nb filaments formed a single joint with a much larger grain size and smaller grain misorientation. More importantly, the resistance of the EBW Nb joint was nearly one magnitude lower than that of most conventional pressing joint. The ultralow resistance is essential for superconducting gravimeters, which require an extremely low drift rate. The EBW Nb joint allowed the superconducting gravimeter to have a much better performance when applied in the field of structural geology, geodesy, microgravity, and metrology. We believe that the EBW method could be one of the most promising joint fabrication methods for achieving maximum stability (less than 1 μgal yr−1).
Ultrafast proton transfer dynamics of 2-(2′-hydroxyphenyl)benzoxazole dye in different solvents
Authors: Sun Simei , Zhang Song , Song Jiao , Guo Xiaoshan , Jiang Chao , Sun Jingyu , Wang Saiyu
Published: November 2021

The excited-state intramolecular proton transfer of 2-(2′-hydroxyphenyl)benzoxazole dye in different solvents is investigated using ultrafast femtosecond transient absorption spectroscopy combined with quantum chemical calculations. Conformational conversion from the syn-enol configuration to the keto configuration is proposed as the mechanism of excited-state intramolecular proton transfer. The duration of excited-state intramolecular proton transfer is measured to range from 50 fs to 200 fs in different solvents. This time is strongly dependent on the calculated energy gap between the N-S0 and T-S1 structures in the S1 state. Along the proton transfer reaction coordinate, the vibrational relaxation process on the S1 state potential surface is observed. The duration of the vibrational relaxation process is determined to be from 8.7 ps to 35 ps dependent on the excess vibrational energy.
Analysis of electromagnetic pulses generated from ultrashort laser irradiation of solid targets at CLAPA
Authors: Xu Yi-Lin , Li Dong-Yu , Xia Ya-Dong , Zhang Si-Yuan , Wu Min-Jian , Yang Tong , Zhu Jun-Gao , Cheng Hao , Wang Chuan-Ke , Lin Chen , Li Ting-Shuai , Yan Xue-Qing
Published: November 2021

Electromagnetic pulses (EMPs) produced by the interaction of a TW femtosecond laser with solid targets at the Compact Laser Plasma Accelerator (CLAPA) are measured and interpreted. The statistical results confirm that the intensities of the EMPs are closely related to both target material and thickness. The signal of the titanium target is more abundant than that of the copper target with the same thickness, and the intensity of EMP is positively correlated with the target thickness for aluminium foil. With the boosted EMP radiations, the energy of accelerated protons is also simultaneously enhanced. In addition, EMPs emitted from the front of the target exceed those from the rear, which are also pertinent to the specific target position. The resonant waveforms in the target chamber are analyzed using the fast Fourier transform, and the local resonance and the attenuation lead to changes of the frequency spectra of EMPs with variation of detecting positions, which is well supported by the modeling results. The findings are beneficial to gaining insight into the mechanism of EMP propagation in a typical target chamber and providing more information for EMP shielding design.
Ultrafast plasmon dynamics in asymmetric gold nanodimers
Authors: Dana Bereket Dalga , Koya Alemayehu Nana , Song Xiaowei , Lin Jingquan
Published: November 2021

We theoretically investigate the effect of symmetry breaking on the ultrafast plasmon responses of Au nanodisk (ND) dimers by varying the diameter of one of the constituent nanodisks. In the case of a single ultrafast laser pulse, we demonstrate that the ultrafast responses of Au ND homodimer can be significantly modified due to the effect of symmetry breaking. The symmetric dimer shows a single broad spectral peak, whereas the size-asymmetric dimer shows three spectral peaks. The first system displays at most one temporal maximum and no beats in ultrafast temporal, whereas the second system may have three temporal maxima and two beats due to a combination of broken symmetry and the coherent superposition between various plasmon modes induced by the ultra-short laser pulse. Moreover, the shape of temporal dynamics of the size-asymmetric dimer is significantly deformed due to the excitation of local plasmon modes with different wavelength components. Furthermore, the decay time of the amplitude of the local field is longer and oscillates with a high frequency due to the narrower linewidth and red-shifted spectral peaks. We show that the ultrafast plasmon responses of both dimers can be controlled by varying the relative phase and time delays between a pair of two pulses. Our results will open new paths to understanding ultrafast plasmon responses in asymmetric heterodimers with suitable properties for different applications.
Simulation design of normally-off AlGaN/GaN high-electron-mobility transistors with p-GaN Schottky hybrid gate
Authors: He Yun-Long , Zhang Fang , Liu Kai , Hong Yue-Hua , Zheng Xue-Feng , Wang Chong , Ma Xiao-Hua , Hao Yue
Published: November 2021

A novel normally-off AlGaN/GaN high-electron-mobility transistor (HEMT) with a p-GaN Schottky hybrid gate (PSHG) is proposed, and compared with the conventional p-GaN normally-off AlGaN/GaN HEMTs. This structure can be realized by selective etching of p-GaN layer, which enables the Schottky junction and PN junction to control the channel charge at the same time. The direct current (DC) and switching characteristics of the PSHG HEMTs are simulated by Slivaco TCAD, and the p-GaN HEMTs and conventional normally-on HEMTs are also simulated for comparison. The simulation results show that the PSHG HEMTs have a higher current density and a lower on-resistance than p-GaN HEMTs, which is more obvious with the decrease of p-GaN ratios of the PSHG HEMTs. The breakdown voltage and threshold voltage of the PSHG HEMTs are very close to those of the p-GaN HEMTs. In addition, the PSHG HEMTs have a higher switching speed than the conventional normally-on HEMTs, and the p-GaN layer ratio has no obvious effect on the switching speed.
Determination of the surface states from the ultrafast electronic states in a thermoelectric material
Authors: Wu Tongyao , Wang Hongyuan , Yang Yuanyuan , Duan Shaofeng , Huang Chaozhi , Tang Tianwei , Guo Yanfeng , Luo Weidong , Zhang Wentao
Published: November 2021

We reveal the electronic structure in YbCd2Sb2, a thermoelectric material, by angle-resolved photoemission spectroscopy (ARPES) and time-resolved ARPES (trARPES). Specifically, three bulk bands at the vicinity of the Fermi level are evidenced near the Brillouin zone center, consistent with the density functional theory (DFT) calculation. It is interesting that the spin-unpolarized bulk bands respond unexpectedly to right- and left-handed circularly polarized probe. In addition, a hole band of surface states, which is not sensitive to the polarization of the probe beam and is not expected from the DFT calculation, is identified. We find that the non-equilibrium quasiparticle recovery rate is much smaller in the surface states than that of the bulk states. Our results demonstrate that the surface states can be distinguished from the bulk ones from a view of time scale in the nonequilibrium physics.
High power semiconductor laser array with single-mode emission
Authors: Jia Peng , Zhang Zhi-Jun , Chen Yong-Yi , Li Zai-Jin , Qin Li , Liang Lei , Lei Yu-Xin , Qiu Cheng , Song Yue , Shan Xiao-Nan , Ning Yong-Qiang , Qu Yi , Wang Li-Jun
Published: November 2021

The semiconductor laser array with single-mode emission is presented in this paper. The 6-μm-wide ridge waveguides (RWGs) are fabricated to select the lateral mode. Thus the fundamental mode of laser array can be obtained by the RWGs. And the maximum output power of single-mode emission can reach 36 W at an injection current of 43 A, after that, a kink will appear. The slow axis (SA) far-field divergence angle of the unit is 13.65°. The beam quality factor M
2 of the units determined by the second-order moment (SOM) method, is 1.2. This single-mode emission laser array can be used for laser processing.
Studies on aluminum powder combustion in detonation environment
Authors: Nie Jian-Xin , Kan Run-Zhe , Jiao Qing-Jie , Wang Qiu-Shi , Guo Xue-Yong , Yan Shi
Published: November 2021

The combustion mechanism of aluminum particles in a detonation environment characterized by high temperature (in unit 103 K), high pressure (in unit GPa), and high-speed motion (in units km/s) was studied, and a combustion model of the aluminum particles in detonation environment was established. Based on this model, a combustion control equation for aluminum particles in detonation environment was obtained. It can be seen from the control equation that the burning time of aluminum particle is mainly affected by the particle size, system temperature, and diffusion coefficient. The calculation result shows that a higher system temperature, larger diffusion coefficient, and smaller particle size lead to a faster burn rate and shorter burning time for aluminum particles. After considering the particle size distribution characteristics of aluminum powder, the application of the combustion control equation was extended from single aluminum particles to nonuniform aluminum powder, and the calculated time corresponding to the peak burn rate of aluminum powder was in good agreement with the experimental electrical conductivity results. This equation can quantitatively describe the combustion behavior of aluminum powder in different detonation environments and provides technical means for quantitative calculation of the aluminum powder combustion process in detonation environment.
Surface chemical disorder and lattice strain of GaN implanted by 3-MeV Fe10+ ions
Authors: Yang Jun-Yuan , Feng Zong-Kai , Jiang Ling , Song Jie , He Xiao-Xun , Chen Li-Ming , Liao Qing , Wang Jiao , Li Bing-Sheng
Published: November 2021

Chemical disorder on the surface and lattice strain in GaN implanted by Fe10+ ions are investigated. In this study, 3-MeV Fe10+ ions fluence ranges from 1 × 1013 ions/cm2 to 5 × 1015 ions/cm2 at room temperature. X-ray photoelectron spectroscopy, high-resolution x-ray diffraction, and high-resolution transmission electron microscopy were used to characterize lattice disorder. The transition of Ga-N bonds to oxynitride bonding is caused by ion sputtering. The change of tensile strain out-of-plane with fluence was measured. Lattice disorder due to the formation of stacking faults prefers to occur on the basal plane.
Strong chirality in twisted bilayer α-MoO3
Authors: Wu Bi-Yuan , Shi Zhang-Xing , Wu Feng , Wang Ming-Jun , Wu Xiao-Hu
Published: November 2021

Chiral structures are promising in many applications, such as biological sensing and analytical chemistry, and have been extensively explored. In this paper, we theoretically investigate the chiral response of twisted bilayer α-MoO3. Firstly, the analytical formula for the transmissivity is derived when the structure is illuminated with circularly polarized plane waves. Furthermore, the results demonstrate that the twisted bilayer α-MoO3 can excite the strong chirality with the maximum circular dichroism (CD) of 0.89. In this case, the chirality is due to the simultaneous breaking the rotational symmetry and mirror symmetry, which originates from the relative rotation of two α-MoO3 layers. To better understand the physical mechanism, the polarization conversion between the left-hand circular polarization (LCP) and right-hand circular polarization (RCP) waves is discussed as well. Moreover, it is found that the structure can maintain the strong chirality (CD > 0.8) when the twisted angle varies from 69° to 80°, which effectively reduces the strictness in the requirement for rotation angle. In addition, the CD can be larger than 0.85 when the incidence angle of circularly polarized plane wave is less than 40°, implying that the chirality is robust against the angle of incidence. Our work not only provides an insight into chirality induced by the twisted bilayer α-MoO3, but also looks forward to applications in biological sensing.
Disorder in parity–time symmetric quantum walks
Authors: Xue Peng
Published: November 2021

We experimentally investigate the impact of static disorder and dynamic disorder on the non-unitary dynamics of parity–time (PT)-symmetric quantum walks. Via temporally alternating photon losses in an interferometric network, we realize the passive PT-symmetric quantum dynamics for single photons. Controllable coin operations allow us to simulate different environmental influences, which result in three different behaviors of quantum walkers: a standard ballistic spread, a diffusive behavior, and a localization, respectively, in a PT-symmetric quantum walk architecture.
Asteroids, Holoblack and Clearance Futurism
Authors: McConville Pat
Published: November 2021

In this paper, I argue that the video game Asteroids’ enduring appeal turns on its ability to be read as futurist text. I connect Asteroids’ black and white aesthetic to the phenomenologist Vivian Sobchack’s notion of postfuturism. Central to postfuturism is a change from representations of space as deep to representations of space as surface, incapable of concealment. I consider materials designed to absorb almost all visible light—which I call holoblacks—as pushing past representations of space as surface into a paradigm of non-representation of space or space as non-representation. I argue that this non-representation is what is meant by Martin Heidegger in the concept of a thing. I therefore offer an interpretation of Heidegger’s Lichtung, or clearing, in which holoblacks act as a vehicle for the gathering, disclosure and nearing of world which I call ‘clearance futurism’. I conclude by reading Asteroids as a clearance futurist text.
Immuno-informatics analysis predicts B and T cell consensus epitopes for designing peptide vaccine against SARS-CoV-2 with 99.82% global population coverage
Authors: Shukla Priyank , Pandey Preeti , Prasad Bodhayan , Robinson Tony , Purohit Rituraj , D’Cruz Leon G , Tambuwala Murtaza M , Mutreja Ankur , Harkin Jim , Rai Taranjit Singh , Murray Elaine K , Gibson David S , Bjourson Anthony J
Published: November 2021

The current global pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has taken a substantial number of lives across the world. Although few vaccines have been rolled-out, a number of vaccine candidates are still under clinical trials at various pharmaceutical companies and laboratories around the world. Considering the intrinsic nature of viruses in mutating and evolving over time, persistent efforts are needed to develop better vaccine candidates. In this study, various immuno-informatics tools and bioinformatics databases were deployed to derive consensus B-cell and T-cell epitope sequences of SARS-CoV-2 spike glycoprotein. This approach has identified four potential epitopes which have the capability to initiate both antibody and cell-mediated immune responses, are non-allergenic and do not trigger autoimmunity. These peptide sequences were also evaluated to show 99.82% of global population coverage based on the genotypic frequencies of HLA binding alleles for both MHC class-I and class-II and are unique for SARS-CoV-2 isolated from human as a host species. Epitope number 2 alone had a global population coverage of 98.2%. Therefore, we further validated binding and interaction of its constituent T-cell epitopes with their corresponding HLA proteins using molecular docking and molecular dynamics simulation experiments, followed by binding free energy calculations with molecular mechanics Poisson–Boltzmann surface area, essential dynamics analysis and free energy landscape analysis. The immuno-informatics pipeline described and the candidate epitopes discovered herein could have significant impact upon efforts to develop globally effective SARS-CoV-2 vaccines.
Outcome reporting in therapeutic mammaplasty: a systematic review
Authors: Lee Alice , Kwasnicki Richard M , Khan Hasaan , Grant Yasmin , Chan Abigail , Fanshawe Angela E E , Leff Daniel R
Published: November 2021

Background

Therapeutic mammaplasty (TM) is an oncological procedure which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated the oncological safety of TM but reporting of critically important outcomes, such as quality of life, aesthetic and functional outcomes, are limited, piecemeal or inconsistent. This systematic review aimed to identify all outcomes reported in clinical studies of TM to facilitate development of a core outcome set.

Methods

Medline, EMBASE, CINAHL and Web of Science were searched from inception to 5 August 2020. Included studies reported clinical outcomes following TM for adult women. Two authors screened articles independently for eligibility. Data were extracted regarding the outcome definition and classification type (for example, oncological, quality of life, etc.), time of outcome reporting and measurement tools.

Results

Of 5709 de-duplicated records, 148 were included in the narrative synthesis. The majority of studies (n = 102, 68.9 per cent) reported measures of survival and/or recurrence; approximately three-quarters (n = 75, 73.5 per cent) had less than 5 years follow-up. Aesthetic outcome was reported in half of studies (n = 75, 50.7 per cent) using mainly subjective, non-validated measurement tools. The time point at which aesthetic assessment was conducted was highly variable, and only defined in 48 (64.0 per cent) studies and none included a preoperative baseline for comparison. Few studies reported quality of life (n = 30, 20.3 per cent), functional outcomes (n = 5, 3.4 per cent) or resource use (n = 28, 18.9 per cent).

Conclusion

Given the oncological equivalence of TM and mastectomy, treatment decisions are often driven by aesthetic and functional outcomes, which are infrequently and inconsistently reported with non-validated measurement tools.
Semantic scene-object consistency modulates N300/400 EEG components, but does not automatically facilitate object representations
Authors: Chen Lixiang , Cichy Radoslaw Martin , Kaiser Daniel
Published: November 2021

During natural vision, objects rarely appear in isolation, but often within a semantically related scene context. Previous studies reported that semantic consistency between objects and scenes facilitates object perception and that scene-object consistency is reflected in changes in the N300 and N400 components in EEG recordings. Here, we investigate whether these N300/400 differences are indicative of changes in the cortical representation of objects. In two experiments, we recorded EEG signals, while participants viewed semantically consistent or inconsistent objects within a scene; in Experiment 1, these objects were task-irrelevant, while in Experiment 2, they were directly relevant for behavior. In both experiments, we found reliable and comparable N300/400 differences between consistent and inconsistent scene-object combinations. To probe the quality of object representations, we performed multivariate classification analyses, in which we decoded the category of the objects contained in the scene. In Experiment 1, in which the objects were not task-relevant, object category could be decoded from ~100 ms after the object presentation, but no difference in decoding performance was found between consistent and inconsistent objects. In contrast, when the objects were task-relevant in Experiment 2, we found enhanced decoding of semantically consistent, compared with semantically inconsistent, objects. These results show that differences in N300/400 components related to scene-object consistency do not index changes in cortical object representations but rather reflect a generic marker of semantic violations. Furthermore, our findings suggest that facilitatory effects between objects and scenes are task-dependent rather than automatic.
Post-inflammatory Abdominal Pain in Patients with Inflammatory Bowel Disease During Remission: A Comprehensive Review
Authors: Takahashi Kazuya , Khwaja Iman Geelani , Schreyer Jocelyn Rachel , Bulmer David , Peiris Madusha , Terai Shuji , Aziz Qasim
Published: November 2021

Patients with inflammatory bowel disease often experience ongoing pain even after achieving mucosal healing (i.e., post-inflammatory pain). Factors related to the brain–gut axis, such as peripheral and central sensitization, altered sympatho-vagal balance, hypothalamic–pituitary–adrenal axis activation, and psychosocial factors, play a significant role in the development of post-inflammatory pain. A comprehensive study investigating the interaction between multiple predisposing factors, including clinical psycho-physiological phenotypes, molecular mechanisms, and multi-omics data, is still needed to fully understand the complex mechanism of post-inflammatory pain. Furthermore, current treatment options are limited and new treatments consistent with the underlying pathophysiology are needed to improve clinical outcomes.
Reinterventions and new aortic events after aortic surgery in Marfan syndrome
Authors: Toolan Caroline , Oo Shwe , Shaw Matthew , Field Mark , Kuduvalli Manoj , Harrington Deborah , Nawaytou Omar
Published: November 2021

OBJECTIVES

Pre-emptive strategies to manage the aortic complications of Marfan syndrome have resulted in improved life expectancy yet, secondary to the variation of phenotypic expression, anticipating the risk and nature of future aortic events is challenging. We examine rates of new aortic events and reinterventions in a Marfan cohort following initial aortic presentation.

METHODS

Retrospective cohort study of Marfan patients with aortic pathology presenting to our institution 1998–2018. Patients were grouped according to index event: aortic dissection or root aneurysm. Patients with aortic dissection were classified according to Debakey criteria. Incidence of new aortic events and frequency of reintervention were analysed.

RESULTS

One hundred and twenty-six aortic procedures were performed in 74 Marfan patients with a median follow-up of 7 years. Forty-seven patients had an index event of root aneurysm and 27 had aortic dissection. Following operative intervention in the aneurysm group, 7 patients developed Debakey III dissections raising the overall number of patients who developed dissection within this cohort to 34. Reinterventions were more frequent in the dissection group with full replacement of the native aorta in 5 patients.

CONCLUSIONS

After operative intervention on the proximal aorta, a proportion will develop distal pathology. A greater focus on factors contributing to future events, such as mapping genotypes to clinical course, may lead the way for targeted operative techniques and surveillance.
Perceived personal risk and vulnerability in recognizing and responding to symptoms of acute coronary syndrome: an integrative review
Authors: Blakeman John R , Prasun Marilyn A
Published: November 2021

Background

Simply knowing the common symptoms of acute coronary syndrome (ACS) is not sufficient to ensure prompt care-seeking when these symptoms occur. Factors other than symptom knowledge contribute to prompt care-seeking behaviours and correct symptom attribution to the heart.

Objectives

To explore how perceived personal risk and perceived personal vulnerability towards ACS affect a person’s ACS symptom recognition and attribution and also how this perception affects a person’s response to ACS symptoms.

Design

An integrative review, using Whittemore and Knafl’s approach.

Data sources

PubMed, Academic Search Complete, CINAHL Complete, APA PsycINFO, and APA PsycARTICLES

Eligibility criteria for study selection

We included studies that (i) were original human-subjects research or secondary analyses of human-subjects research, (ii) provided information about how perceptions of risk or perceptions of vulnerability towards ACS or heart disease affect symptom recognition, attribution, and/or response to symptoms, and (iii) were published in English.

Results

Thirteen articles were included. Studies were conducted in nine different countries and were descriptive or exploratory in nature. The existing evidence suggests that perceived personal risk or vulnerability towards heart disease may promote earlier care-seeking for ACS symptoms and facilitates attribution of symptoms to the heart.

Conclusion

The designs of the included studies limit causal attribution, and additional prospective and intervention-based research is needed to determine how perceived risk/vulnerability may affect care-seeking and ACS symptom attribution. Increasing perceptions of vulnerability towards heart disease may reduce care seeking delay.
Antagonistic effects of chemical mixtures on the oxidative stress response are silenced by heat stress and reversed under dietary restriction
Authors: Arulalan Karthik Suresh , Huayta Javier , Stallrich Jonathan W , San-Miguel Adriana
Published: November 2021

Chemical agents released into the environment can induce oxidative stress in organisms, which is detrimental for health. Although environmental exposures typically include multiple chemicals, organismal studies on oxidative stress derived from chemical agents commonly study exposures to individual compounds. In this work, we explore how chemical mixtures drive the oxidative stress response under various conditions in the nematode Caenorhabditis elegans, by quantitatively assessing levels of gst-4 expression. Our results indicate that naphthoquinone mixtures drive responses differently than individual components, and that altering environmental conditions, such as increased heat and reduced food availability, result in dramatically different oxidative stress responses mounted by C. elegans. When exposed to heat, the oxidative stress response is diminished. Notably, when exposed to limited food, the oxidative stress response specific to juglone is significantly heightened, while identified antagonistic interactions between some naphthoquinone components in mixtures are abolished. This implies that organismal responses to xenobiotics are confounded by environment and stressor interactions. Given the high number of variables under study, and their potential combinations, a simplex centroid design was used to capture such non-trivial response over the design space. This makes the case for the adoption of Design of Experiments (DoE) approaches as they can greatly expand the experimental space probed in noisy biological readouts, and in combinatorial experiments. Our results also reveal gaps in our current knowledge of the organismal oxidative stress response, which can be addressed by employing sophisticated DoE approaches to identify significant interactions.
A conserved behavioral role for a nematode interneuron neuropeptide receptor
Authors: Chai Cynthia M , Chen Wen , Wong Wan-Rong , Park Heenam , Cohen Sarah M , Wan Xuan , Sternberg Paul W
Published: November 2021

Neuropeptides are evolutionarily conserved modulators of many aspects of animal behavior and physiology, and expand the repertoire of processes that can be controlled by a limited number of neurons. Deciphering the neuropeptidergic codes that govern distinct processes requires systematic functional analyses of neuropeptides and their cognate receptors. Even in well-studied model organisms like Caenorhabditis elegans, however, such efforts have been precluded by a lack of mutant reagents. Here, we generated and screened 21 C. elegans neuropeptide G-protein coupled receptor mutants with no pre-existing reagents for the touch-evoked escape response, and implicated six receptors expressed in diverse neuron classes representing multiple circuit levels in this behavior. We further characterized the mutant with the most severe phenotype, frpr-14, which was defective in multiple behavioral paradigms. We leveraged this range of phenotypes to reveal that FRPR-14 modulation of different precommand interneuron classes, AVH and AIB, can drive distinct behavioral subsets, demonstrating cellular context-dependent roles for FRPR-14 signaling. We then show that Caenorhabditis briggsae CBR-FRPR-14 modulates an AVH-like interneuron pair to regulate the same behaviors as C. elegans but to a smaller extent. Our results also suggest that differences in touch-evoked escape circuit architecture between closely related species results from changes in neuropeptide receptor expression pattern, as opposed to ligand–receptor pairing. This study provides insights into the principles utilized by a compact, multiplexed nervous system to generate intraspecific behavioral complexity and interspecific variation.
Age-Related Sexual Dimorphism on the Longitudinal Progression of Blood Immune Cells in BALB/cByJ Mice
Authors: Serre-Miranda Cláudia , Roque Susana , Barreira-Silva Palmira , Nobrega Claudia , Vieira Neide , Costa Patrício , Almeida Palha Joana , Correia-Neves Margarida
Published: November 2021

The study of immune system aging is of relevance, considering its myriad of interactions and role in protecting and maintaining body homeostasis. While mouse models have been extensively used to study immune system aging, little is known on how the main immune populations progress over time and what is the impact of sex. To contribute to filling this gap, male and female BALB/cByJ mice were longitudinally evaluated, from 3 to 18 months old, for the main blood populations, assessed by flow cytometry. Using linear mixed-effect models, we observed that the percentages of neutrophils, monocytes, eosinophils, and total natural killer (NK) cells increase with aging, while those of B cells, T cells (including CD4+ and CD8+ subsets), and Ly6C+ NK cells decrease. Males present higher percentages of neutrophils and classical monocytes Ly6Chigh over time, while females present higher percentages of total T cells, both CD4+ and CD8+, eosinophils, and NK cells. Males and females display similar percentages of B cells, even though with opposite accelerated progressions over time. This study revealed that mouse models recapitulate what is observed in humans during aging: an overall proportional decrease in the adaptive and an increase in the innate immune cells. Additionally, it uncovers an age-related sexual dimorphism in the proportion of immune cells in circulation, further strengthening the need to explore the impact of sex when addressing immune system aging using mouse models.
Urinary Incontinence and Depressive Symptoms: The Mediating Role of Physical Activity and Social Engagement
Authors: Park Gum-Ryeong , Park Sujeong , Kim Jinho
Published: November 2021

Objectives

This study investigates longitudinal within-person associations between urinary incontinence (UI) and depressive symptoms among older women. Drawing on activity theory, this study also adds to limited knowledge about the mediating role of physical activity and social engagement in the association between UI and depressive symptoms.

Methods

Using 6 waves of a nationally representative longitudinal study of older adults in Korea between 2008 and 2018, this study examined the relationship between UI and depressive symptoms among women aged 70 and older. Fixed effects models were estimated to account for unobserved time-invariant confounding factors. Sobel mediation tests were conducted to formally test for mediation.

Results

Fixed effects estimates showed that, after adjusting for a wide array of time-varying covariates, having UI is positively associated with depressive symptoms among older women (b = 0.238, p < .05). Results revealed that individuals who begin to experience UI tend to have less frequent social interactions and participate in fewer social activities. UI, however, is only marginally associated with a decrease in physical activity. Reductions in physical activity, social connections, and social activities jointly explain about 22% of the association between UI and depressive symptoms, rendering it statistically insignificant.

Discussion

UI poses a threat to psychological well-being among older women. This is partly explained by a decrease in physical activity and disruption in social engagement. This study reaffirms the significance of the programs that promote physical and social activity among older adults.
Feeding of a magma chamber by an ascending magma bubble
Authors: Dragoni Michele
Published: November 2021

There is evidence that magma chambers are not fed by a continuous flow, but in the form of discrete magma batches. The possibility is considered that the chamber is fed by a magma bubble ascending through the region underneath, driven by buoyancy force. Due to the high ambient temperatures, it is assumed that the bubble moves through a viscoelastic medium with temperature-dependent viscosity. The motion of a spherical magma bubble and its inflow into the chamber are studied. The bubble volume is assumed to be at least equal to magma volumes in typical effusive eruptions on Mount Etna, corresponding to bubble radii of a few hundred metres. Under some simplifying assumptions, the problem is solved analytically. The bubble velocity is directly proportional to the square of its radius and inversely to the viscosity of surrounding rocks, but it is independent of magma viscosity. Velocity can reach values of the order of tens of metres per year in the proximity of the chamber. Since the characteristic time for heat diffusion is several hundred years, the bubble can cover several kilometres with only moderate cooling. During ascent, forced convection takes place in the bubble. Equations for convection streamlines are obtained and traveltimes of magma are calculated, giving a mixing time of the order of hundred years below the chamber. Inflow of the bubble in the magma chamber produces a pulse in flow rate. Under reasonable assumptions, pulse shape and duration are calculated analytically. Pulse duration can be several tens of years and can give rise to a sequence of eruptions, depending on the size of the bubble and the critical overpressure for eruption.
Anti-Suit Injunctions, FRAND Policies and the Conflict between Overlapping Jurisdictions
Authors: Haedicke Maximilian
Published: November 2021

Numerous courts worldwide consider themselves competent to determine the FRAND compliance of global SEP license agreements and to set worldwide FRAND rates. A court deciding a FRAND case involving a global FRAND rate may issue an injunction which prohibits the filing or enforcement of an action in another jurisdiction (anti-suit injunction, hereinafter ‘ASI’). The parties litigating in the courts of another country may request this court to enjoin the filing or execution of the ASI – (anti-anti-suit injunction, hereinafter ‘AASI’). This article argues that the extraterritorial effects of both ASIs and AASIs may unduly impede court proceedings. However, ASIs and AASIs may in certain cases legitimately protect the interests that sovereign states have in undisturbed court proceedings. Self-restraint should be exercised because each ASI/AASI contains the risk of escalation. The article gives guidelines as to under which conditions ASIs/AASIs may be issued and accepted by the courts. It also aims to raise awareness among policymakers so that internationally binding rules which ease the conflicts may be implemented.
Follow-up Interactive Long-Term Expert Ranking (FILTER): a crowdsourcing platform to adjudicate risk for survivorship care
Authors: Cheng Alex C , Wen Li , Li Yanwei , Koyama Tatsuki , Berry Lynne D , Pal Tuya , Friedman Debra L , Osterman Travis J
Published: November 2021

Objectives

To develop an online crowdsourcing platform where oncologists and other survivorship experts can adjudicate risk for complications in follow-up.

Materials and Methods

This platform, called Follow-up Interactive Long-Term Expert Ranking (FILTER), prompts participants to adjudicate risk between each of a series of pairs of synthetic cases. The Elo ranking algorithm is used to assign relative risk to each synthetic case.

Results

The FILTER application is currently live and implemented as a web application deployed on the cloud.

Discussion

While guidelines for following cancer survivors exist, refinement of survivorship care based on risk for complications after active treatment could improve both allocation of resources and individual outcomes in long-term follow-up.

Conclusion

FILTER provides a means for a large number of experts to adjudicate risk for survivorship complications with a low barrier of entry.
Effect of aspirin to intentionally induce leaky gut on performance, inflammation, and carcass characteristics of feedlot cattle
Authors: Briggs Nathan G , Silva Breno C , Godoi Letícia A , Schoonmaker Jon P
Published: November 2021

The negative impacts of stress on gastrointestinal tract (GIT) barrier function can result in compromised animal growth and health. Aspirin is known to cause mucosal injury leading to increased gut permeability and tight junction damage and can be used as a model to study leaky gut in cattle. The objective of this study was to determine the long-term impact of aspirin-induced chronic leaky gut on cattle growth and carcass attributes. Two treatments were evaluated in two studies: control (no aspirin) or 0.25% of the diet dry matter (DM) aspirin fed daily. Diets consisted of 50% corn, 24% dried distillers grains, 20% corn silage, and 6% supplement on a DM basis. In experiment 1, sixteen Angus × Simmental heifers, allotted by body weight (BW) and breed composition, were fed diets for 154 d. On day 155, heifers were dosed with 1 liter of a 180-mM Cr–ethylenediaminetetraacetic acid solution using an esophageal tube and had urine collected every 1.5 to 3 h for 48 h for analysis of Cr as a measure of gut leakiness. In experiment 2, ninety-six Simmental × Angus steers (355.0 ± 14.8 kg) were allotted by BW and breed composition and fed treatment diets for 159 d. Weight was recorded monthly and serum was collected on day 159 and analyzed for lipopolysaccharide-binding protein (LBP), interleukin-6 (IL-6), serum amyloid A (SAA), haptoglobin, and aspartate aminotransferase (AST). Data were analyzed using the MIXED procedure of SAS. Heifers fed 0.25% aspirin in experiment 1 excreted more Cr into urine compared with heifers not fed aspirin (overall treatment effect, P = 0.01). In experiment 2, aspirin tended to increase serum LBP (P = 0.06) but had no effect on concentrations of IL-6, haptoglobin, SAA, or AST (P ≥ 0.25). Aspirin tended to decrease average daily gain (P = 0.10), decreased hot carcass weight and rib-eye area (P ≤ 0.05), and increased fat thickness, marbling score, and yield grade (P ≤ 0.02). Aspirin tended to increase kidney, pelvic, and heart fat percentage (P = 0.10) and had no effect on liver abscesses (P ≥ 0.80). This study indicates that leaky gut induced by long-term administration of aspirin has negative impacts on feedlot performance and carcass composition. The negative impact of aspirin-induced leaky gut on animal performance suggests that chronic leaky gut caused by other factors (subacute acidosis, stress) may be a significant problem for the feedlot industry.
Volume as an Indicator for Outcomes for Severe Maternal Morbidity in the Military Health System
Authors: Hunter Aimee , Banaag Amanda , Lutgendorf Monica A , Staat Col Barton , Koehlmoos Tracey P
Published: November 2021

Background

Maternal obstetric morbidity is a growing concern in the USA, where rates of maternal morbidity exceed Europe and most developed countries. Prior studies have found that obstetric case volume affects maternal morbidity, with low-volume facilities having higher rates of morbidity. However, these studies were done in civilian healthcare systems that are different from the Military Health System (MHS). This study evaluates whether obstetric case volume impacts severe maternal morbidity (SMM) in military hospitals located in the continental United States.

Methods

This cross-sectional study included all military treatment facilities (MTFs) (n = 35) that performed obstetric deliveries (n = 102,959) from October 2015 to September 2018. Data were collected from the MHS Data Repository and identified all deliveries for the study time period. Severe maternal morbidity was defined by the Centers for Disease Control. The 30-day readmission rates were also included in analysis. Military treatment facilities were separated into volume quartiles for analysis. Univariate logistic regressions were performed to determine the impact of MTF delivery volume on the probability of SMM and 30-day maternal readmissions.

Results

The results for all regression models indicate that the MTF delivery volume had no significant impact on the probability of SMM. With regard to 30-day maternal readmissions, using the upper middle quartile as the comparison group due to the largest number of deliveries, MTFs in the lower middle quartile and in the highest quartile had a statistically significant higher likelihood of 30-day maternal readmissions.

Conclusion

This study shows no difference in SMM rates in the MHS based on obstetric case volume. This is consistent with previous studies showing differences in MHS patient outcomes compared to civilian healthcare systems. The MHS is unique in that it provides families with universal healthcare coverage and access and provides care for approximately 40,000 deliveries annually. There may be unique lessons on volume and outcomes in the MHS that can be shared with healthcare planners and decision makers to improve care in the civilian setting.