bluuebunny/crossref_metadata_2025 huggingface dataset:
An In Vitro Evaluation of a Self-contained Cardioplegia Delivery Device
Authors: Viessman Thomas W. , Stammers Alfred H. , Mejak Brian L. , Vang SeeN. , Rauch Eric D.
Published: August 2023

Focus on improved myocardial protection has prompted the development of delivery systems which can accommodate the demands of increasingly refined cardioprotective strategies. The purpose of this study was to evaluate the Sorin Blood Cardioplegia Console™ (BCC) for accuracy and precision in the delivery of cardioplegia solutions. An in vitro model was designed to evaluate the following performance characteristics of the BCC: delivery volume (blood and crystalloid) at 50, 250, 375, and 500 mllmin flow rates; potassium end-delivery concentration at blood: crystalloid ratios of 4:1, 8:1, and 16:1; intermittent cardioplegia delivery; and heat transfer of the internal heater/cooler.

Differences in blood and cardioplegia volumes between measured and calculated values across all flow rates tested were found to be statistically significant and ranged from 1.4 to 21.5 ml; however, the differences were within the accepted variance of the instrument (±5%). Across all tested ratios, the measured end-potassium concentrations were all within 1 mEq of the expected values, except for the 16:1 ratio at 50 ml!min, which had a 2.52 mEq variance. All significant differences were within the accepted variance of the instrument (±5% ). In conclusion, the BCC accurately and delivered cardioplegia volumes and potassium concentrations across all tested conditions with reproducible performance.
Redo Cardiac Surgery in a Patient with Severe Peripheral Vascular Disease and Pericardia/ Adhesions Using Subclavian Arterial Cannulation and Port-Access Technology
Authors: Dennis Jon Rook , Megano Nestor , Habal Salem M. , David Irving B. , Strogen Charles
Published: August 2023

Patients viewed as conventionally inoperative candidates are now given alternative surgical choices. The ability to provide new technology such as the port-access minimally invasive approach, kinetic venous assist, and specialized cannulae have made this possible. This case report discusses the ability to apply and modify this new technology to provide a successful surgical outcome in a patient with severe peripheral vascular disease and dense mediastinal adhesions.
A Cardiopulmonary Bypass Perfusion Technique for the Surgical Repair of Aortic Type I Dissections Requiring the Elephant Trunk Procedure
Authors: Yang Tianyu , Sun Lizhong , Hei Feilong , Liu Yongmin
Published: August 2023

The effect of cerebral and spinal cord protection by a modified perfusion technique during the elephant trunk procedure was assessed. Between 1997 and 1998, six patients underwent selective cerebral perfusion (SCP) and lower half of the body perfusion (LBP), in which the right subclavian and left femoral arteries were separately cannulated and perfused by individual pump heads. Moderate systemic cooling was used (nasal temp. 20–30°C; rectal temp. 23–26°C). The open distal aortic repair was performed using only the selective cerebral perfusion; while the aortic arch reconstruction was performed using both selective cerebral and lower half of the body simultaneous perfusion. Blood oxygen saturation of the left jugular vein (SjO2) and regional oxygen saturation cerebral (rSO2) in the front region of the brain, was monitored along with the pressure of the left temporal superficial and femoral artery. The mean cardiopulmonary bypass time was 136 minutes, with a mean arrest time of 92 minutes. Mean duration of isolated selective cerebral perfusion was 23 minutes, with flow rates of 5–8 mL/kg/min; a left temporal superficial artery pressure of 50 mmHg; SjO2 65–80%, and rSO2 58–72%. Mean duration of simultaneous selective cerebral and lower half of the body perfusion was 27 minutes; cerebral flow rates 5–8 mL/kg/min; the left temporal superficial artery pressure of 45–50 mmHg; SjO2 70–85% and rSO2 55–76%. At the same time, lower half of the body flow rates were maintained within 30–50 mL/kg/min; with a femoral artery pressure 50–80 mmHg. Mean extubation time was 28 hours; mean ICU time was 4.5 days. There were no neurologic complications in any patient. All patients survived the operation and were discharged from the hospital. This modified perfusion technique of SCP and LBP worked well and provided satisfactory cerebral and spinal cord protection.
A Four-Year Experience with Patient Individualized Heparin and Protamine Dosing Using the Hemochron® RxDx™ System
Authors: Bennett Kim M. , Briggins Doris , Zucker Marcia , LaDuca Frank
Published: August 2023

Cardiac surgical case histories, collected over 4 years at Huntsville Hospital in Alabama, were reviewed for 2,293 patients. Patients were separated into two dosing groups for both heparin and protamine, hospital empirically dosed and Hemochron RxDx dosed. Review of the heparin dosing information found that incomplete data were collected for 47 patients, leaving 2,246 patients eligible to be evaluated for heparin dose comparison. Both RxDx recommended and empirically calculated doses were recorded, as well as the actual dose given. Of the 2,246 patients, 1671 were administered heparin according to the RxDx calculated dose, and the remaining 575 patients were dosed according to the hospital’s empirical protocol. The average RxDx calculated heparin dose was 17% greater then the empirically calculated heparin dose (350 U/kg) (p < .001). Anticoagulation to target ACT (480 sec) was achieved in 92% of the patients dosed according to the RxDx recommended dose; whereas, in the empirically dosed patient group only 80% of the patients reached the target ACT after initial heparin bolus dose. Incomplete protamine dosing data was recorded for 336 patients, leaving a total of 1,957 patients available for protamine dose evaluation. All patients had an RxDx protamine calculation, empirical protamine calculation, and actual amount of protamine dosed recorded. Of the 1,953 patients, 1,764 were dosed according to the RxDx recommended dose, with the remaining 189 patients dosed empirically (1 mg protamine/100 U of heparin). In both the RxDx and the empirical groups, 96% of the patients returned to baseline following initial protamine infusion. The overall RxDx dose (293 mg) was 16% lower than the average empirical dose (348 mg). The RxDx system has been shown to be an effective method for determining patient-specific dosing for both heparin and protamine. This long-term clinical experience demonstrates the consistency and reliability of patient maintenance using this individualized dosing system, which has been shown, in other independent evaluations, to lead to improved patient outcomes.
Maligne Neoplasien der Orbita
Authors: Bertelmann Eckart , von Sonnleithner Christoph
Published: August 2023

Weil die Erstsymptomatik maligner Neoplasien der Orbita häufig das Auge betrifft
(Exophthalmus, Diplopie, Schmerzen), ist der Augenarzt häufig der erste mit der
Problematik des jeweiligen Krankheitsbildes konfrontierte Arzt, von dessen
Kenntnissen, richtiger Einordnung und richtigen weiteren Entscheidungen die
adäquate weitere Therapiesteuerung und die Prognose des Patienten entscheidend
abhängen.
Learning how to fly from dandelion seeds
Authors: Johnson-Groh Mara
Published: August 2023

Understanding how dandelion seeds remain stable during flight could help design future aerial vehicles.
Classification of multi-frequency RF signals by extreme learning, using magnetic tunnel junctions as neurons and synapses
Authors: Leroux Nathan , Marković Danijela , Sanz-Hernández Dédalo , Trastoy Juan , Bortolotti Paolo , Schulman Alejandro , Benetti Luana , Jenkins Alex , Ferreira Ricardo , Grollier Julie , Mizrahi Frank Alice
Published: August 2023

Extracting information from radio-frequency (RF) signals using artificial neural networks at low energy cost is a critical need for a wide range of applications from radars to health. These RF inputs are composed of multiple frequencies. Here, we show that magnetic tunnel junctions can process analog RF inputs with multiple frequencies in parallel and perform synaptic operations. Using a backpropagation-free method called extreme learning, we classify noisy images encoded by RF signals, using experimental data from magnetic tunnel junctions functioning as both synapses and neurons. We achieve the same accuracy as an equivalent software neural network. These results are a key step for embedded RF artificial intelligence.
Investigating the flow characteristics and thermodynamic performance of curved detonation waves
Authors: Xiong Haochen , Qiu Ruofan , Han Xin , Yan Hao , You Yancheng
Published: August 2023

Oblique detonation waves (ODWs) are induced by oblique shock waves (OSWs) and hold significant research value for air-breathing ramjet engines due to their high thermodynamic efficiency and specific impulse. In this research, detonation is induced using a curved shock wave (CSW) that provides greater flexibility compared to an OSW. Curved detonation waves (CDWs) are classified into two categories based on the curvature of the CSW: positive-curvature curved detonation waves (PC-CDWs) and negative-curvature curved detonation waves (NC-CDWs). We conduct a numerical investigation of the flow characteristics and potential thermodynamic performance in curved detonation waves (CDWs) by solving the two-dimensional multi-species Euler equations with a detailed hydrogen combustion mechanism. In contrast to ODWs, we observe continuous compression and expansion effects in the flow fields of PC-CDWs and NC-CDWs, respectively. Continuous compression shortens the initiation length of the detonation wave and intensifies the compression wave preceding the combustion front, whereas continuous expansion produces the opposite outcome. Changes in the curvature of the CSW result in alterations to the flow characteristics of the CDW. These flow characteristic changes are manifested in their thermodynamic and propulsion-related performance. More specifically, a lower overdrive of the detonation wave corresponds to a reduced loss in total pressure.
Influence of morphological characteristics on the deposition of low-density lipoprotein in intracranial bifurcation aneurysms
Authors: Tian Yuqing , Li Xiao , Zhao Bing , Zhang Jianjian , Liang Fuyou
Published: August 2023

The increasingly demonstrated association of wall enhancement (WE) measured by vascular wall imaging with the instability/rupture of intracranial aneurysms (IAs) implies the significance of investigating the transport and accumulation of blood substances [e.g., low-density lipoprotein (LDL), lipoprotein (a)] related to WE in IAs. In the present study, we perform numerical simulations to explore the relationships between the distribution/severity of LDL deposition on the lumen surface and the morphological characteristics of aneurysm and its adjacent arteries as well as the underlying fluid dynamic mechanisms. Bifurcation aneurysms located at the middle cerebral artery are selected as the subject of investigation and for which both idealized and patient-specific models are built. Studies on the idealized models reveal that the aneurysm–parent (AP) artery angle is more powerful than other morphological parameters [e.g., daughter–parent (DP) artery angle, nonsphericity index (NI) of aneurysm] in determining the severity of LDL deposition. A bleb (i.e., secondary sac) can enhance local LDL deposition, especially when located in an LDL deposition-prone aneurysm wall region. In patient-specific models, the dominant effect on the LDL deposition of the AP angle remains identifiable, whereas the effects of the DP angle and NI are overwhelmed by confounding factors. Enhanced LDL deposition prefers to appear in wall regions perpendicular to the intra-aneurysmal vortex centerline. In comparison with wall shear stress magnitude, the normal-to-tangential near-wall velocity ratio and particle residence time can better predict the localization of enhanced LDL deposition.
Variable coefficient extended cKP equation for Rossby waves and its exact solution with dissipation
Authors: Yin Tianle , Ji Yucheng , Pang Jing
Published: August 2023

In this article, the variable coefficient (2 + 1)-dimensional extended cylindrical Kadomtsev–Petviashvili (cKP) equation describing Rossby waves was derived from the quasi-geostrophic potential vorticity equation. It is difficult for the variable coefficient cKP equation with dissipation to calculate the exact solution. For obtaining the exact solution, a new transformation was constructed for the first time to reduce the extended cKP equation to the extended KP equation. We emphasize that the exact solution, and not just approximate solution, in Rossby waves flow field can be obtained when dissipation is included. The exact lump and interaction solutions with dissipative effect are given according to the modified Hirota bilinear method, and physics for the evolution of Rossby waves is analyzed based on the obtained solutions. When the dissipative parameter μ0 increases, the structure of the amplitude A changes in the spatial scale y. And when the dissipative parameter increases to a certain value, the structure of Rossby waves tends to be stable. It is pointed out that the dissipative parameter μ0 determines not only the amplitude A of Rossby waves but also structures of Rossby waves flow field, with μ0 acting on the spatial scale y and the timescale t.
Assessment of turbulence correction for actuator-line model of a horizontal-axis tidal stream turbine in near-wake region
Authors: Kang Wei , Apsley David , Stallard Tim
Published: August 2023

Near-wake characteristics of a turbine play an important role in turbine–wake interactions and performance assessment in turbine arrays. In this study, the near-wake flow behind a laboratory-scale tidal stream turbine is simulated and compared with experimental data. An actuator-line model is used to represent the rotating blades. Further, two physics-based turbulence corrections are proposed for unsteady Reynolds-averaged Navier–Stokes (URANS) modeling of the tidal stream turbine. These corrections seek to model additional turbulent production near the blade boundary layer and in the tip shear region. The data analysis for the fluctuating velocity spectrum in the experiment highlights that the turbulence kinetic energy (TKE) can be decomposed into three parts: the background turbulence from the onset flow, rotor-scale turbulence, and blade-induced turbulence. The blade-induced turbulence dominates near the rotor plane and decreases sharply beyond one diameter downstream. Near-wake profiles of velocity and TKE are compared with experimental data. The results show that turbulence corrections in the URANS model enhance the production of turbulence induced by the blade rotation. It can improve turbulence prediction in the near-wake region with a minor impact on the loads and wake velocity.
SoxC transcription factors shape the epigenetic landscape to establish competence for sensory differentiation in the mammalian organ of Corti
Authors: Wang Xizi , Llamas Juan , Trecek Talon , Shi Tuo , Tao Litao , Makmura Welly , Crump J. Gage , Segil Neil , Gnedeva Ksenia
Published: August 2023

The auditory organ of Corti is comprised of only two major cell types—the mechanosensory hair cells and their associated supporting cells—both specified from a single pool of prosensory progenitors in the cochlear duct. Here, we show that competence to respond to Atoh1, a transcriptional master regulator necessary and sufficient for induction of mechanosensory hair cells, is established in the prosensory progenitors between E12.0 and 13.5. The transition to the competent state is rapid and is associated with extensive remodeling of the epigenetic landscape controlled by the SoxC group of transcription factors. Conditional loss of
Sox4
and
Sox11
—the two homologous family members transiently expressed in the inner ear at the time of competence establishment—blocks the ability of prosensory progenitors to differentiate as hair cells. Mechanistically, we show that Sox4 binds to and establishes accessibility of early sensory lineage–specific regulatory elements, including ones associated with Atoh1 and its direct downstream targets. Consistent with these observations, overexpression of
Sox4
or
Sox11
prior to developmental establishment of competence precociously induces hair cell differentiation in the cochlear progenitors. Further, reintroducing
Sox4
or
Sox11
expression restores the ability of postnatal supporting cells to differentiate as hair cells in vitro and in vivo. Our findings demonstrate the pivotal role of
SoxC
family members as agents of epigenetic and transcriptional changes necessary for establishing competence for sensory receptor differentiation in the inner ear.
Energy Levels and Transition Rates for Laser Cooling Os− and a General Approach to Produce Cold Atoms and Molecules
Authors: Lu Yuzhu , Zhang Rui , Song Changxian , Chen Chongyang , Si Ran , Ning Chuangang
Published: August 2023

High-resolution photoelectron energy spectra of osmium anions are obtained using the slow-electron velocity-map imaging method. The energy levels of excited states 4
F
7/2, 4
F
5/2 and 4
F
3/2 of Os− are determined to be 148.730(13), 155.69(15), and 176.76(13) THz [or 4961.09(41), 5193.4(49), and 5896.1(42) cm−1], respectively. The lifetime of the opposite-parity excited state

6

D

9
/
2

o

is determined to be 201(10) μs using a cold ion trap, about 15 times shorter than the previous result 3(1) ms. Our high-level multi-configuration Dirac–Hartree–Fock calculations yield a theoretical lifetime 527 μs. Our work shows that the laser cooling rate of Os− is as fast as that of Th−. The advantages of Os− are its near-IR range cooling transition and simple electronic structure, which make Os− a promising candidate for laser cooling of negative ions. We propose a general approach to produce cold atoms and molecules based on the sympathetic cooling of negative ions in combination with a threshold photodetachment.
Majorana Corner Modes and Flat-Band Majorana Edge Modes in Superconductor/Topological-Insulator/Superconductor Junctions
Authors: Chen 陈 Xiao-Ting 晓婷 , Liu 刘 Chun-Hui 春晖 , Xu 许 Dong-Hui 东辉 , Chen 陈 Chui-Zhen 垂针
Published: August 2023

Recently, superconductors with higher-order topology have stimulated extensive attention and research interest. Higher-order topological superconductors exhibit unconventional bulk-boundary correspondence, thus allow exotic lower-dimensional boundary modes, such as Majorana corner and hinge modes. However, higher-order topological superconductivity has yet to be found in naturally occurring materials. We investigate higher-order topology in a two-dimensional Josephson junction comprised of two s-wave superconductors separated by a topological insulator thin film. We find that zero-energy Majorana corner modes, a boundary fingerprint of higher-order topological superconductivity, can be achieved by applying magnetic field. When an in-plane Zeeman field is applied to the system, two corner modes appear in the superconducting junction. Furthermore, we also discover a two-dimensional nodal superconducting phase which supports flat-band Majorana edge modes connecting the bulk nodes. Importantly, we demonstrate that zero-energy Majorana corner modes are stable when increasing the thickness of topological insulator thin film.
Energy efficient half-flux-quantum circuit aiming at milli-kelvin stage operation
Authors: Li Feng , Pham Duong , Takeshita Yuto , Higashi Masayuki , Yamashita Taro , Tanaka Masamitsu , Fujimaki Akira
Published: August 2023

Half-flux-quantum (HFQ) circuits are based on 0–π superconducting quantum interference devices (SQUIDs) and is one of the energy-efficient superconductor digital circuits. The bit energy is determined by the critical current I
cn of 0–π SQUID, which can be easily tuned with the loop inductance and junction critical current. In this work, an alternative π–π–π SQUID is adopted to demonstrate HFQ circuits to simplify the fabrication process and enhance circuit energy efficiency. The properties of superconductor/ferromagnet/insulator/superconductor Josephson junctions (π-JJs) are measured with temperature dependence from 4.2 K down to 10 mK. HFQ toggle flip-flops (TFFs) are successfully demonstrated at frequencies of up to 6.7 GHz and 44.5 GHz at temperatures of 4.2 K and 10 mK, respectively. Comparing the HFQ TFF with its rapid single-flux quantum counterpart under the same fabrication process, it is anticipated that the HFQ TFF will exhibit approximately 70% reduction in both static and dynamic energy dissipation. This research establishes the foundation for developing cryogenic interface control and readout circuits for large-scale quantum computing in the future.
Low velocity impact performance of natural fibre reinforced polymer composites: a review
Authors: Mulla Mohammed Huzaifa , Norizan Mohd Nurazzi , Abdullah Che Ku , Mohd Rawi Nurul Fazita , Mohamad Kassim Mohamad Haafiz , Abdullah Norli , Faiz Norrrahim Mohd Nor , Manzoore Elahi M Soudagar
Published: August 2023

Natural fibre-reinforced polymer composites (NFRPC) are versatile and applicable materials for structural applications that require durability and reliability under various forces. However, these composites are susceptible to crack formation when exposed to low-velocity impact (LVI) loads, compromising their functionality and performance. Therefore, it is essential to investigate the influence of LVI on NFRPC and their characterization methods, testing standards, and failure mechanisms. This paper reviews the latest research and development on the characterization, testing, and modelling of NFRPCs under LVI loads. It also explores the impact behaviour of various natural fibres, such as kenaf, bamboo, mallow, buriti, and curaua, and the effect of fibre hybridization and nanofiller incorporation on the LVI response of NFRPCs. The paper evaluates the properties, failure mechanisms, and applications of NFRPCs in relation to LVI resistance. The paper provides useful information for developing advanced composite systems and achieving material efficiency for various structural applications. Finally, it highlights the potential applications and challenges of NFRPC as LVI-resistant materials for advanced composite systems.
Barriers to High-quality Therapy Services for Children with Autism Spectrum Disorder: An Analysis of Street-level Policy Practice of Therapy Service Organisations in China
Authors: Liu Ying , Fisher Karen R
Published: August 2023

Social workers with children with autism spectrum disorder (ASD) should assist them to have timely access to high-quality therapy services. This research addresses the gap between policy intention to improve the quality of therapy services and families’ unmet needs by examining the policy implementation practices of therapy service organisations. A longitudinal study was conducted in Beijing from 2013 to 2022. Qualitative data were obtained from policy documents and interviews with the managers of therapy service organisations (n = 17), therapists (n = 19) and families of children with ASD (n = 35). It found that the government policies created service challenges for the organisations. Managers adopted a short-term focus on organisational survival due to inadequate resources to implement the policy, intensified competition for therapists and service users and pressure from performance measurement. They focused on improving the sites, facilities, publicity and documentation of the organisations rather than the effectiveness of therapy services. Consequently, families still felt they were unable to access good quality therapy. The implications reinforce the significance for social workers to work with the government to actively supporting the training of therapists, establishing meaningful service quality measurement and promoting practical guidance about service quality standards to families of children with ASD.
Listening in Mental Health Clinical Practice
Authors: Aadam Bani , Poon Abner Weng Cheong , Fernandez Elizabeth
Published: August 2023

In mental health clinical practice, listening is viewed as a fundamental skill that clinicians should possess to support service users and enable recovery. Given its importance, this review sought to explore how listening is understood in mental health clinical practice. A scoping review was conducted to search for peer-reviewed articles reporting on literary and empirical studies. The search covered five databases (JSTOR, MEDLINE, Embase, CINAHL, Google Scholar) and the International Journal of Listening. A total of nineteen articles published from 2000 to 2022 were included for analysis. Thematic analysis was used to identify relevant themes. Findings showed that although listening was seen as critical to mental health treatment and care, little had been done to deconstruct the concept, examine the way it was practised and empirically verify its use. Further, listening was described and used differently, not only across different mental health professions but even within the same profession, between practitioners. This article will discuss these variations and how certain listening types can improve the therapeutic encounter. It will further look at whether listening can be regarded as a virtuous professional characteristic trait in achieving professional role responsibilities in social work.
Observational studies of treatment effectiveness in neurology
Authors: Kalincik Tomas , Roos Izanne , Sharmin Sifat
Published: August 2023

The capacity and power of data from cohorts, registries and randomized trials to provide answers to contemporary clinical questions in neurology has increased considerably over the past two decades. Novel sophisticated statistical methods are enabling us to harness these data to guide treatment decisions, but their complexity is making appraisal of clinical evidence increasingly demanding.

In this review, we discuss several methodological aspects of contemporary research of treatment effectiveness in observational data in neurology, aimed at academic neurologists and analysts specializing in outcomes research. The review discusses specifics of the sources of observational data and their key features. It focuses on the limitations of observational data and study design, as well as statistical approaches aimed to overcome these limitations. Among the examples of leading clinical themes typically studied with analyses of observational data, the review discusses methodological approaches to comparative treatment effectiveness, development of diagnostic criteria and definitions of clinical outcomes. Finally, this review provides a brief summary of key points that will help clinical audience critically evaluate design and analytical aspects of studies of disease outcomes using observational data.
The FSHD muscle–blood biomarker: a circulating transcriptomic biomarker for clinical severity in facioscapulohumeral muscular dystrophy
Authors: Banerji Christopher R S , Greco Anna , Joosten Leo A B , van Engelen Baziel G M , Zammit Peter S
Published: August 2023

Facioscapulohumeral muscular dystrophy (FSHD) is a prevalent, incurable skeletal myopathy. Clinical trials for FSHD are hindered by heterogeneous biomarkers poorly associated with clinical severity, requiring invasive muscle biopsy. Macroscopically, FSHD presents with slow fatty replacement of muscle, rapidly accelerated by inflammation. Mis-expression of the transcription factor DUX4 is currently accepted to underlie pathogenesis, and mechanisms including PAX7 target gene repression have been proposed. Here, we performed RNA-sequencing on MRI-guided inflamed and isogenic non-inflamed muscle biopsies from the same clinically characterized FSHD patients (n = 24), alongside isogenic peripheral blood mononucleated cells from a subset of patients (n = 13) and unaffected controls (n = 11). Multivariate models were employed to evaluate the clinical associations of five published FSHD transcriptomic biomarkers. We demonstrated that PAX7 target gene repression can discriminate control, inflamed and non-inflamed FSHD muscle independently of age and sex (P < 0.013), while the discriminatory power of DUX4 target genes was limited to distinguishing FSHD muscle from control. Importantly, the level of PAX7 target gene repression in non-inflamed muscle associated with clinical assessments of FSHD severity (P = 0.04). DUX4 target gene biomarkers in FSHD muscle showed associations with lower limb fat fraction and D4Z4 array length but not clinical assessment. Lastly, PAX7 target gene repression in FSHD muscle correlated with the level in isogenic peripheral blood mononucleated cells (P = 0.002). A refined PAX7 target gene biomarker comprising 143/601 PAX7 target genes computed in peripheral blood (the FSHD muscle–blood biomarker) associated with clinical severity in FSHD patients (P < 0.036). Our new circulating biomarker validates as a classifier of clinical severity in an independent data set of 54 FSHD patient and 29 matched control blood samples, with improved power in older patients (P = 0.03). In summary, we present the minimally invasive FSHD muscle–blood biomarker of FSHD clinical severity valid in patient muscle and blood, of potential use in routine disease monitoring and clinical trials.
Management of hypertension in patients with cancer: challenges and considerations
Authors: Pandey Shubhi , Kalaria Amar , Jhaveri Kenar D , Herrmann Sandra M , Kim Agnes S
Published: August 2023

The survival rates of many cancers have significantly improved due to recent advancements in cancer screening and therapeutics. Although better cancer outcomes are encouraging, additional health challenges have surfaced, the utmost of which is the burden imposed by various cardiovascular and renal toxicities of anticancer therapies. To improve the overall outcome of patients with cancer, it is essential to understand and manage these treatment-related adverse effects. The cardiovascular side effects of antineoplastic therapies are well-known and include left ventricular dysfunction, heart failure, myocardial ischaemia, QT prolongation, arrhythmia and hypertension. Among these, hypertension is the most common complication, prevalent in about 40% of all cancer patients, yet frequently overlooked and undertreated. This review explores the intricate connection between cancer and hypertension and provides distinct approaches to diagnosing, monitoring and managing hypertension in patients with cancer. We also outline the challenges and considerations that are relevant to the care of patients receiving anticancer drugs with prohypertensive potential.
Unexpected deformation of the right coronary artery during percutaneous coronary intervention with venoarterial extracorporeal membrane oxygenation combined with Impella: a case report
Authors: Sugane Hiroki , Hoji Haruki , Kawai Kazuya
Published: August 2023

Background

The establishment of cautionary notes regarding percutaneous coronary intervention (PCI) with venoarterial extracorporeal membrane oxygenation combined with Impella (ECMELLA) is still lacking.

Case summary

A 68-year-old man was transferred to our hospital with cardiac arrest. ECMELLA insertion was performed via the bilateral femoral artery and vein for refractory ventricular fibrillation. Coronary angiography revealed an occluded lesion in the right coronary artery (RCA). Contrast injection was administered after confirming backflow through the guide catheter (GC) to avoid coronary dissection because the artery pressure was non-pulsatile during total circulation support. Prudent coronary angiography revealed a couple of accordion phenomena. Additionally, coronary angiography showed a shorter distance from the right border of the cardiac silhouette to the RCA and the venous line of extracorporeal membrane oxygenation than before PCI. This drastic change in the cardiac silhouette suggested that ECMELLA induced the collapse of the right heart system. Subsequently, a drug-eluting stent was implanted successfully. Final coronary angiography confirmed severe bending in the proximal segment of the RCA, which was absent in the reference coronary angiography. The patient had an uneventful course except for mild cognitive impairment. The computed tomography coronary angiography after ECMELLA removal indicated the RCA without deformation.

Discussion

In the present case, the collapse of the right heart system caused by ECMELLA resulted in RCA deformation. This case also underscored that contrast injection to the coronary artery in total circulation support should be administered after confirmation of backflow through a GC.
Organizational factors associated with primary care nurses’ self-efficacy in pandemic response: a multilevel study in China
Authors: Xu Tiange , Mitchell Rebecca , Wang Wenhua
Published: August 2023

Background

Building primary care nurses’ self-efficacy in the pandemic response has great potential to improve their well-being and work performance. We identified the organizational factors associated with their self-efficacy in pandemic response and propose potential management levers to guide primary care response for the pandemic.

Methods

We conducted a cross-sectional survey with 175 nurses working in 38 community health centres varying in size and ownership in Shanghai, Shenzhen, Tianjin, and Jinan. Guided by self-efficacy theory, 4 nurse-level factors and 2 organization-level factors were selected, and a linear regression model accounting for the cluster–robust standard errors was built to examine their association with primary care nurses’ self-efficacy in the pandemic response.

Results

Primary care nurses exhibited a high level of self-efficacy in responding to the pandemic (mean = 4.34, range: 0–5). For nurse-level factors, with a 1-point increase in job skill variety, job autonomy, work stress and perceived organizational support, primary care nurses’ pandemic response self-efficacy increased by 0.193 points, 0.127 points, 0.156 points, and 0.107 points, respectively. Concerning organization-level factors, each point of improvement in organizational structure, representing higher mechanical organizational structure, was associated with a 0.145-point increase in nurses’ self-efficacy.

Conclusions

Our study added the knowledge of organizational factors’ impact on the pandemic response self-efficacy among primary care nurses and identified the potential management levers for frontline primary care managers to build primary care nurses’ self-efficacy in the pandemic response.
Provider perspectives on nutrition interventions in primary care: the role of organizational structure and community partnerships
Authors: van den Berk-Clark Carissa , Schrodt Clare , Phan Christopher , Garfield Terry , Samuel Sandra ,   ARCHNet
Published: August 2023

Background

Poor nutrition remains a significant public health concern that is often managed within primary care settings. Meanwhile, to our knowledge, there have been few studies that evaluate the intent of primary care providers to offer nutrition services, nor what type of exchanges they engage in to ensure those programs can be implemented.

Methods

Semi-structured interviews were conducted with 16 primary care providers and support staff. Grounded theory analysis was utilized to identify themes and to develop a theoretical model of primary care nutrition program implementation.

Results

Three themes were identified. Patients approached primary care organizations with complex health beliefs, health severity, and barriers to care (theme 1). Providers and support staff responded by providing services that fit into existing organizational constraints, especially constraints related to workflow/time with patient, space and billing (theme 2). Providers see community as a major cue to action among patients but are unsure of the role of primary care (theme 3).

Conclusions

Provider respondents found that implementing nutrition programs in primary care settings is difficult and that effective interventions for nutrition within health settings are limited without community-based partnerships and programming. Additional research is needed to measure existing community ties and how such ties could improve patient nutrition.
Bacillus paralicheniformis 2R5 and its impact on canola growth and N-cycle genes in the rhizosphere
Authors: Świątczak Joanna , Kalwasińska Agnieszka , Felföldi Tamás , Swiontek Brzezinska Maria
Published: August 2023

Chemical fertilization has a negative impact on the natural environment. Plant growth-promoting (PGP) rhizobacterial biofertilizers can be a safer alternative to synthetic agrochemicals. In this research, a culture-based method was used to assess the population size of rhizobacteria at the vegetative, flowering, and maturity stages of canola. Rhizobacteria were then isolated from each of the canola growth stages, and their seven PGP traits were determined. The highest abundance of culturable bacteria was found at the vegetative stage of the plants. Furthermore, four out of seven PGP traits were produced by the highest % of isolates at the vegetative stage. In the greenhouse experiment that included six rhizobacterial strains with best PGP traits, the greatest canola growth promotion ability under sterile conditions was observed after the introduction of Bacillus paralicheniformis 2R5. Moreover, under nonsterile conditions, 2R5 significantly increased canola growth. The presence of the trpA, B, C, D, E, F and pstA, and S genes in the 2R5 genome could be associated with canola growth promotion abilities. The chiA and mbtH genes could contribute to 2R5 antifungal activity against fungal pathogens. Moreover, the introduction of 2R5 significantly increased the abundance of the narG, nosZ, nifH, and nirS genes, which can prove that the 2R5 strain may be an important member of the soil bacterial community.
Structure of the Gonghe Sedimentary Basin in the northeastern Tibetan Plateau: evidence from teleseismicPwaves recorded by a dense seismic array
Authors: Deng Yufeng , Li Zhiwei , Huang Song , Xu Ya , Hao Tianyao , Bao Feng , Zhang Senqi , Li Shengtao , Jia Xiaofeng , Tian Puyuan , Zhang Shengsheng , Zang Nan , Zhang Wei
Published: August 2023

The Gonghe Basin in the northeast Tibetan Plateau presents significant potential for hot dry rock (HDR) geothermal resources. A 1990 Mw 6.4 earthquake in the basin furthers the need for an improved understanding of its sedimentary structure. In this study, we utilize data from a dense seismic array of 88 short-period seismometers deployed at an interstation spacing of approximately 3 km to scrutinize the sedimentary structure of the Gonghe Basin. By analysing teleseismic P waveforms, we identify P-to-S converted waves (Ps wave) originating from the sedimentary basement. We then determine the delay time between the Ps waves and the direct P waves (P wave) through waveform cross-correlation. By integrating this delay time with empirical velocity structure models, HDR borehole data and results from teleseismic receiver function analysis, we derive a sediment thickness model of the Gonghe Basin for the Qabqa geothermal area. Our findings reveal a gradual increase in sediment thickness from around 500 m in the east to approximately 3000 m in the west, which is consistent with other geophysical surveys and borehole data. The thick sediments in the basin could potentially serve as an excellent thermal storage cover for HDR. The strong ground motion simulation using our sediment thickness model shows that thick sediments can amplify seismic waves, increasing the risk of seismic hazards. Moreover, our study indicates that the clear Ps waves can be effectively extracted to construct a dependable sediment thickness model using teleseismic P waves recorded by a short-period dense seismic array.
Development and stochastic validation of a parameterized model of maize stalk flexure and buckling
Authors: Ottesen Michael , Carter Joseph , Hall Ryan , Liu Nan-Wei , Cook Douglas D
Published: August 2023

Maize stalk lodging is the structural failure of the stalk prior to harvest and is a major problem for maize (corn) producers and plant breeders. To address this problem, it is critical to understand precisely how geometric and material parameters of the maize stalk influence stalk strength. Computational models could be a powerful tool in such investigations, but current methods of creating computational models are costly, time-consuming and, most importantly, do not provide parameterized control of the maize stalk parameters. The purpose of this study was to develop and validate a parameterized 3D model of the maize stalk. The parameterized model provides independent control over all aspects of the maize stalk geometry and material properties. The model accurately captures the shape of actual maize stalks and is predictive of maize stalk stiffness and strength. The model was validated using stochastic sampling of material properties to account for uncertainty in the values and influence of mechanical tissue properties. Results indicated that buckling is influenced by material properties to a greater extent that flexural stiffness. Finally, we demonstrate that this model can be used to create an unlimited number of synthetic stalks from within the parameter space. This model will enable the future implementation of parameter sweep studies, sensitivity analysis and optimization studies, and can be used to create computational models of maize stalks with any desired combination of geometric and material properties.
Effectiveness of adjunctive rifampicin for treatment of Staphylococcus aureus bacteraemia: a systematic review and meta-analysis of randomized controlled trials
Authors: Dotel R , Gilbert G L , Hutabarat S N , Davis J S , O’Sullivan M V N
Published: August 2023

Objectives

To assess whether the addition of rifampicin to conventional treatment of Staphylococcus aureus bacteraemia (SAB) reduces bacteriological or clinical failure or death.

Data Sources

PubMed, Embase and Cochrane CENTRAL databases were searched from inception to 31 December 2022. Reference lists and PubMed citations of eligible studies were checked.

Review methods

Two study authors independently identified randomized controlled trials (RCTs) involving adult participants with SAB, in which an intervention group received adjunctive rifampicin and the control group received usual care with or without a placebo. Dichotomous data (bacteriological and clinical failure and deaths) were analysed and pooled across studies using risk ratio (RR) with 95% confidence intervals (CI) using a Mantel-Haenszel random-effect model. The key variable of interest being whether rifampicin was used.

Results

Six RCTs including 894 participants—of which 758 (85%) were from one trial—met the inclusion criteria. The addition of rifampicin to conventional treatment of SAB significantly reduced bacteriological failure by 59% (RR 0.41, 95% CI 0.21–0.81, I2 = 0%, number need to treat 27). However, it did not reduce clinical failure (RR 0.70, 95% CI 0.47–1.03, I2 = 0%) or deaths (RR 0.96, 95% CI 0.70–1.32, I2 = 0%). Further, it did not reduce the duration of bacteraemia, or the length of hospital stay. Adjunctive rifampicin reduced SAB recurrences (1% versus 4%, P = 0.01). Emergence of rifampicin resistance during treatment was uncommon (<1%).

Conclusion

Although adjunctive rifampicin reduced the risk of bacteriological failure and recurrences, we found no mortality benefit to support its use in SAB.
Archived rilpivirine-associated resistance mutations among ART-naive and virologically suppressed people living with HIV-1 subtype C in Botswana: implications for cabotegravir/rilpivirine use
Authors: Maruapula Dorcas , Moraka Natasha O , Bareng Ontlametse T , Mokgethi Patrick T , Choga Wonderful T , Seatla Kaelo K , Kelentse Nametso , Koofhethille Catherine K , Zuze Boitumelo J L , Gaolathe Tendani , Pretorius-Holme Molly , Makhema Joseph , Novitsky Vlad , Shapiro Roger , Moyo Sikhulile , Lockman Shahin , Gaseitsiwe Simani
Published: August 2023

Objectives

Pre-existing rilpivirine resistance-associated mutations (RVP-RAMs) have been found to predict HIV-1 virological failure in those switching to long-acting injectable cabotegravir/rilpivirine. We here evaluated the prevalence of archived RPV-RAMs in a cohort of people living with HIV (PWH).

Methods

We analysed near full-length HIV-1 pol sequences from proviral DNA for the presence of RPV-RAMs, which were defined according to the 2022 IAS–USA drug resistance mutation list and Stanford HIV drug resistance database.

Results

RPV-RAMs were identified in 757/5805 sequences, giving a prevalence of 13.0% (95% CI 12%–13.9%). Amongst the ART-naive group, 137/1281 (10.7%, 95% CI 9.1%–12.5%) had at least one RPV-RAM. Of the 4524 PWH with viral suppression on ART (VL <400 copies/mL), 620 (13.7%, 95% CI 12.7%–14.7%) had at least one RPV-RAM. E138A was the most prevalent RPV-RAM in the ART-naive group (7.9%) and the ART-suppressed group (9.3%). The rest of the mutations observed (L100I, K101E, E138G, E138K, E138Q, Y181C, H221Y, M230L, A98G, V179D, G190A, G190E and M230I) were below a prevalence of 1%.

Conclusions

RPV-RAMs were present in 10.7% of ART-naive and 13.7% of ART-suppressed PWH in Botswana. The most common RPV-RAM in both groups was E138A. Since individuals with the E138A mutation may be more likely to fail cabotegravir/rilpivirine, monitoring RPV-RAMs will be crucial for effective cabotegravir/rilpivirine implementation in this setting.
Comparison of multiple international metrics for benchmarking antibiotic usage (ABU) using UK beef and sheep data
Authors: Davies Peers , Hyde Robert , Corbishley Alexander
Published: August 2023

Background

Accurate surveillance of livestock antibiotic usage (ABU) at the farm level is an increasingly important part of national antibiotic stewardship initiatives. Numerous ABU indicators or metrics have been developed in Europe and North America but the comparability of these metrics is poorly understood. For policymakers, understanding the relationship between metrics is important when considering the risks posed by ABU and how to regulate them, at the national level, and regulate international trade access in livestock products between countries who use different ABU metrics.

Objectives

To quantify the patterns of ABU among beef (cattle) and lamb (sheep) production systems. To explore ABU variation between farm types across seven ABU metrics developed in Europe and North America using a common dataset of sheep and beef farms’ antibiotic purchases from the UK.

Methods

A dataset of >16 200 antibiotic sales events to 686 farm enterprises of different types underwent quantitative analysis. Correlation matrixes were generated for seven international ABU metrics.

Results

ABU was significantly higher among calf-rearers. Across all farm types, tetracyclines and β-lactams were the predominant groups by mass, but represent a similar dose equivalent to macrolides across most farm types. Good agreement (>0.9) was observed between metrics.

Conclusions

Reliable metrics to accurately benchmark farms are crucial for maintaining confidence of farmers in the fairness of any surveillance system, especially when the ranking of any given system may be linked to financial subsidies or penalties and also when negotiating import and export access for livestock products between countries.