bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the Deviation of the Kinetic Energy Equation in Classical Physics and Theory of Relativity using Taylor Series
Authors: sha Shuo
Published: June 2022

Isaac Newton’s system of classical physics continued to be the prevalent physics theory until Albert Einstein’s establishment of the theory of relativity, which is now perceived as modern physics. However, what is the essential difference between these theories? And what are the practical implications of these deviations between classical and modern physics? This essay utilizes Taylor Series to examine the difference in the expressions for kinetic energy in both theories. In conclusion, the equation for kinetic energy in classical physics deviates from that of modern physics in terms of its precision: classical physics can be an efficient tool to employ when calculating the energy for low-velocity objects with less accurate results, whereas modern physics is more generally utilized for high-velocity objects with high demand for accuracy.
Multiple solutions for sublinear Schrödinger-Poisson equations
Authors: Xu Na , Yang Ruijun
Published: June 2022

We study the multiplicity result to the nonlinear equations with sign-changing potential{−Δu+a(x)u+λb(x)ϕ(x)u=g(x,u)inΩ,−Δϕ=b(x)u2,inΩ,u=0,ϕ=0,on∂Ωhere Ω is a bounded domain, λ> 0,gis a sign-changing nonlinearity and is a sublinear growth. Under appropriate assumptions for a(x), the multiplicity result is proved for λ >0 small enough.
Structure study of water in alcohol-water binary system based on Raman spectroscopy
Authors: Han Chunmiao , Gao Jiawang , Sun Wei , Han Cunxin , Li Fulu , Li Bing
Published: June 2022

The structure of water and the interaction between in the binary mixture of methanol-water and isopropanol-water at various mole fractions of alcohols were investigated by Raman spectroscopy. The results show that the tetrahedral hydrogen bonding network of water molecules is expanded at 0 < X methanol < 0.4, and the coordination number of water molecules becomes lower at 0.4 < Xmethanol < 0.5, which is due to the aggregation of methanol molecules under hydrophobic hydration as the molar fraction of methanol increases, resulting in a decrease in the total area of interaction between hydrophobic groups and water molecules in solution. In turn, the hydrophilic groups of methanol molecules break the hydrogen bonds between water molecules by forming hydrogen bonds with the free water molecules around them. When Xmethanol > 0.5, the hydrogen bonding network of water molecules becomes loose and eventually exists in solution as clusters of varying sizes. Due to the difference in chain length, the number of alkyl groups in isopropanol and methanol is different, so the hydrophobic group interacts with water more strongly and has a stronger effect on “breaking up” the water clusters.
Synchronization Tracking Of Uncertain Nonidentical Multi-USV system
Authors: Jiang Xiaolong , Bai Xiaoyong , Yang Zanfu , Ma Shuo
Published: June 2022

We propose a distributed adaptive synchronous tracking control algorithm for the heterogeneous multi-unmanned surface vehicles described by the Euler-Lagrange system. In multi-unmanned surface vehicles system, the inter-communication state can be represented by a directed topology graph, and only part of unmanned surface vehicles can directly acquire the accurate information of time-varying reference trajectory. The proposed algorithm can implement synchronous tracking for multiple unmanned surface vehicles without knowing global communication information by elaborately selecting Lyapunov functions. We conduct theoretical analysis of the stability of closed-loop systems according to the Lyapunov stability theory. And we also verify the effectiveness of proposed scheme through numerical simulation.
The Controller Design of Lower-extremity Wearable Exoskeleton Robot
Authors: Shi Lei , Yin Peng , Yang Ming , Qu Shengguan
Published: June 2022

The exoskeleton robot to assist load-carrying has received much attention in recent years. The work designs a novel control framework for a lower-limb power assist exoskeleton robot. In particular, the detailed design and verification of the mid-level controller for gait walking is carried out. By studying the characteristics of human-machine dynamics in different gait phases, the corresponding controller is designed to achieve optimal control, so as to achieve the compliant and coordinated control of human-machine system. At the same time, the designed controller can also greatly regulate the energy transfer between human and machine. Finally, the numerical simulation experiment is carried out in MATLAB/SIMULATION environment, and the simulation results verify the effectiveness of the control law.
Kinematics analysis and visualization simulation of 6-DOF intelligent cooperative robot
Authors: Wan Yipin , Li Hantao , Chen Xiaobin
Published: June 2022

Aiming at the kinematics analysis and visualization simulation of 6-DOF intelligent cooperative robot, Adams simulation technology is used to study it. The kinematic model of 6-DOF intelligent cooperative robot is established by using D-H parameter modeling method and virtual prototyping technology. According to the coordinate transformation, the kinematics equation of the robot is derived, and the forward kinematics solution is carried out. The visualization simulation analysis of the 6-DOF intelligent cooperative robot is realized, and the motion trajectory and limit motion space of the robot end are obtained. The simulation results of virtual prototype are within the range of the results of kinematic equation, which verifies the rationality of the kinematic equation and simulation model. The analysis method and results can provide reference for dynamics analysis and structural lightweight research of 6-DOF robot.
Land-use change emissions based on high-resolution activity data substantially lower than previously estimated
Authors: Ganzenmüller R , Bultan S , Winkler K , Fuchs R , Zabel F , Pongratz J
Published: June 2022

Land-use and land-cover changes (LULCCs) contributed around one third to the cumulative, anthropogenic CO2 emissions from 1850 to 2019. Despite its great importance, estimates of the net CO2 fluxes from LULCC (ELUC) have high uncertainties, compared to other components of the global carbon cycle. One major source of uncertainty roots in the underlying LULCC forcing data. In this study, we implemented a new high-resolution LULCC dataset (HILDA+) in a bookkeeping model (BLUE) and compared the results to estimates from simulations based on LUH2, which is the LULCC dataset most commonly used in global carbon cycle models. Compared to LUH2-based estimates, results based on HILDA+ show lower total ELUC (global mean difference 1960–2019: 541 TgC yr−1, 65%) and large spatial and temporal differences in component fluxes (e.g. CO2 fluxes from deforestation). In general, the congruence of component fluxes is higher in the mid-latitudes compared to tropical and subtropical regions, which is to some degree explained with the different implementations of shifting cultivation in the underlying LULCC datasets. However, little agreement is reached on the trend of the last decade between ELUC estimates based on the two LULCC reconstructions. Globally and in many regions, ELUC estimates based on HILDA+ have decreasing trends, whereas estimates based on LUH2 indicate an increase. Furthermore, we analyzed the effect of different resolutions on ELUC estimates. By comparing estimates from simulations at 0.01∘ and 0.25∘ resolution, we find that component fluxes of estimates based on the coarser resolution tend to be larger compared to estimates based on the finer resolution, both in terms of sources and sinks (global mean difference 1960–2019: 36 TgC yr−1, 96%). The reason for these differences are successive transitions: these are not adequately represented at coarser resolution, which has the effect that—despite capturing the same extent of transition areas—overall less area remains pristine at the coarser resolution compared to the finer resolution.
Specifying nonlocality of a pure bipartite state and analytical relations between measures for bipartite nonlocality and entanglement
Authors: Loubenets Elena R , Namkung Min
Published: June 2022

For a multipartite quantum state, the maximal violation of all Bell inequalities constitutes a measure of its nonlocality (Loubenets 2012 J. Math. Phys. 53, 022201). In the present article, for the maximal violation of Bell inequalities by a pure bipartite state, possibly infinite-dimensional, we derive a new upper bound expressed in terms of the Schmidt coefficients of this state. This new upper bound allows us also to specify general analytical relations between the maximal violation of Bell inequalities by a bipartite quantum state, pure or mixed, and such entanglement measures for this state as ‘negativity’ and ‘concurrence’. To our knowledge, no any general analytical relations between measures for bipartite nonlocality and entanglement have been reported in the literature though, for a general bipartite state, specifically such relations are important for the entanglement certification and quantification scenarios. As an example, we apply our new results to finding upper bounds on nonlocality of bipartite coherent states intensively discussed last years in the literature in view of their experimental implementations.
Cancellation for Surfaces Revisited
Authors: Flenner H. , Kaliman S. , Zaidenberg M.
Published: June 2022

The celebrated Zariski Cancellation Problem asks as to when the existence of an isomorphism

X
×

A

n

≅

X
′

×

A

n

X\times \mathbb {A}^n\cong X’\times \mathbb {A}^n

for (affine) algebraic varieties

X
X

and

X
′

X’

implies that

X
≅

X
′

X\cong X’

. In this paper we provide a criterion for cancellation by the affine line (that is,

n
=
1

n=1

) in the case where

X
X

is a normal affine surface admitting an

A

1

\mathbb {A}^1

-fibration

X
→
B

X\to B

with no multiple fiber over a smooth affine curve

B
B

. For two such surfaces

X
→
B

X\to B

and

X
′

→
B

X’\to B

we give a criterion as to when the cylinders

X
×

A

1

X\times \mathbb {A}^1

and

X
′

×

A

1

X’\times \mathbb {A}^1

are isomorphic over

B
B

. The latter criterion is expressed in terms of linear equivalence of certain divisors on the Danielewski-Fieseler quotient of

X
X

over

B
B

. It occurs that for a smooth

A

1

\mathbb {A}^1

-fibered surface

X
→
B

X\to B

the cancellation by the affine line holds if and only if

X
→
B

X\to B

is a line bundle, and, for a normal such

X
X

, if and only if

X
→
B

X\to B

is a cyclic quotient of a line bundle (an orbifold line bundle). If

X
X

does not admit any

A

1

\mathbb {A}^1

-fibration over an affine base then the cancellation by the affine line is known to hold for

X
X

by a result of Bandman and Makar-Limanov.

If the cancellation does not hold then

X
X

deforms in a non-isotrivial family of

A

1

\mathbb {A}^1

-fibered surfaces

X
λ

→
B

X_\lambda \to B

with cylinders

X
λ

×

A

1

X_\lambda \times \mathbb {A}^1

isomorphic over

B
B

. We construct such versal deformation families and their coarse moduli spaces provided

B
B

does not admit nonconstant invertible functions. Each of these coarse moduli spaces has infinite number of irreducible components of growing dimensions; each component is an affine variety with quotient singularities. Finally, we analyze from our viewpoint the examples of non-cancellation constructed by Danielewski, tom Dieck, Wilkens, Masuda and Miyanishi, e.a.
The impact of genetic modifiers on variation in germline mutation rates within and among human populations
Authors: Milligan William R , Amster Guy , Sella Guy
Published: June 2022

Mutation rates and spectra differ among human populations. Here, we examine whether this variation could be explained by evolution at mutation modifiers. To this end, we consider genetic modifier sites at which mutations, “mutator alleles,” increase genome-wide mutation rates and model their evolution under purifying selection due to the additional deleterious mutations that they cause, genetic drift, and demographic processes. We solve the model analytically for a constant population size and characterize how evolution at modifier sites impacts variation in mutation rates within and among populations. We then use simulations to study the effects of modifier sites under a plausible demographic model for Africans and Europeans. When comparing populations that evolve independently, weakly selected modifier sites (2Nes≈1), which evolve slowly, contribute the most to variation in mutation rates. In contrast, when populations recently split from a common ancestral population, strongly selected modifier sites (2Nes≫1), which evolve rapidly, contribute the most to variation between them. Moreover, a modest number of modifier sites (e.g. 10 per mutation type in the standard classification into 96 types) subject to moderate to strong selection (2Nes>1) could account for the variation in mutation rates observed among human populations. If such modifier sites indeed underlie differences among populations, they should also cause variation in mutation rates within populations and their effects should be detectable in pedigree studies.
APOK3, a pollen killer antidote in Arabidopsis thaliana
Authors: Simon Matthieu , Durand Stéphanie , Ricou Anthony , Vrielynck Nathalie , Mayjonade Baptiste , Gouzy Jérôme , Boyer Roxane , Roux Fabrice , Camilleri Christine , Budar Françoise
Published: June 2022

The principles of heredity state that the two alleles carried by a heterozygote are equally transmitted to the progeny. However, genomic regions that escape this rule have been reported in many organisms. It is notably the case of genetic loci referred to as gamete killers, where one allele enhances its transmission by causing the death of the gametes that do not carry it. Gamete killers are of great interest, particularly to understand mechanisms of evolution and speciation. Although being common in plants, only a few, all in rice, have so far been deciphered to the causal genes. Here, we studied a pollen killer found in hybrids between two accessions of Arabidopsis thaliana. Exploring natural variation, we observed this pollen killer in many crosses within the species. Genetic analyses revealed that three genetically linked elements are necessary for pollen killer activity. Using mutants, we showed that this pollen killer works according to a poison-antidote model, where the poison kills pollen grains not producing the antidote. We identified the gene encoding the antidote, a chimeric protein addressed to mitochondria. De novo genomic sequencing in 12 natural variants with different behaviors regarding the pollen killer revealed a hyper variable locus, with important structural variations particularly in killer genotypes, where the antidote gene recently underwent duplications. Our results strongly suggest that the gene has newly evolved within A. thaliana. Finally, we identified in the protein sequence polymorphisms related to its antidote activity.
Freshwater Colonization, Adaptation, and Genomic Divergence in Threespine Stickleback
Authors: Aguirre Windsor E , Reid Kerry , Rivera Jessica , Heins David C , Veeramah Krishna R , Bell Michael A
Published: June 2022

The Threespine Stickleback is ancestrally a marine fish, but many marine populations breed in fresh water (i.e., are anadromous), facilitating their colonization of isolated freshwater habitats a few years after they form. Repeated adaptation to fresh water during at least 10 My and continuing today has led to Threespine Stickleback becoming a premier system to study rapid adaptation. Anadromous and freshwater stickleback breed in sympatry and may hybridize, resulting in introgression of freshwater-adaptive alleles into anadromous populations, where they are maintained at low frequencies as ancient standing genetic variation. Anadromous stickleback have accumulated hundreds of freshwater-adaptive alleles that are disbursed as few loci per marine individual and provide the basis for adaptation when they colonize fresh water. Recent whole-lake experiments in lakes around Cook Inlet, Alaska have revealed how astonishingly rapid and repeatable this process is, with the frequency of 40% of the identified freshwater-adaptive alleles increasing from negligible (∼1%) in the marine founder to ≥50% within ten generations in fresh water, and freshwater phenotypes evolving accordingly. These high rates of genomic and phenotypic evolution imply very intense directional selection on phenotypes of heterozygotes. Sexual recombination rapidly assembles freshwater-adaptive alleles that originated in different founders into multilocus freshwater haplotypes, and regions important for adaptation to freshwater have suppressed recombination that keeps advantageous alleles linked within large haploblocks. These large haploblocks are also older and appear to have accumulated linked advantageous mutations. The contemporary evolution of Threespine Stickleback has provided broadly applicable insights into the mechanisms that facilitate rapid adaptation.
Corn processing, flake density, and starch retrogradation influence ruminal solubility of starch, fiber, protein, and minerals
Authors: Trotta Ronald J , Kreikemeier Kelly K , Royle Randy F , Milton Todd , Harmon David L
Published: June 2022

Five ruminally cannulated steers (body weight = 390 ± 7.86 kg) were used in three experiments to evaluate effects of corn processing, flake density, and starch retrogradation on in situ ruminal degradation. In experiment 1, corn was left whole or processed with no screen, ground through a 6-mm screen, or ground through a 1-mm screen. In experiment 2, we produced steam-flaked corn at four densities: 309, 335, 360, and 386 g/L. These four flake densities were sifted for 20 s through a 4-mm screen to produce two particle sizes within each flake density: sifted flakes (>4 mm) and sifted fines (<4 mm). In experiment 3, sifted flakes (335 g/L) were stored for 3-d at either 23 °C (starch availability = 55%) or 55 °C to induce starch retrogradation (starch availability = 41%). All samples for each of the three experiments were weighed into nylon bags and ruminally incubated for 0-h to estimate the soluble fraction. The residue remaining was analyzed for nutrient composition. In experiment 1, whole shelled corn had lesser (P < 0.01) ruminal solubility of all nutrients measured compared with ground corn. Corn ground with a screen (6 and 1 mm) had greater (P < 0.01) ruminal solubility of all nutrients measured compared with corn ground with no screen. Corn ground through a 1-mm screen had greater (P < 0.03) ruminal solubility of DM, total starch, CP, ADF, AHF, P, Mg, K, S, Zn, Fe, and Mn compared with corn ground through a 6-mm screen. In experiment 2, increasing flake density linearly decreased (P < 0.02) the soluble fraction of DM, total starch, CP, ADF, AHF, P, K, S, and Zn of sifted flakes. The soluble DM fraction of sifted fines tended to decrease (P = 0.06) linearly with increasing flake density. Total starch, CP, NDF, and Zn soluble fractions of sifted fines were not influenced by flake density. In experiment 3, storage of sifted flakes in heat-sealed foil bags at 55 °C for 3-d decreased (P < 0.04) the soluble fractions of DM, total starch, CP, NDF, P, Mg, K, S, and Fe. With each increase in the degree of corn processing, there was an increase in the solubility of nutrients. Increasing flake density can decrease ruminal solubility of flakes; however, the soluble fraction of sifted fines is not influenced as much by changes in flake density. Inducing starch retrogradation decreases ruminal solubility of starch, nonstarch OM, and minerals.
Identification and functional annotation of long intergenic non-coding RNAs in Brassicaceae
Authors: Palos Kyle , Nelson Dittrich Anna C , Yu Li’ang , Brock Jordan R , Railey Caylyn E , Wu Hsin-Yen Larry , Sokolowska Ewelina , Skirycz Aleksandra , Hsu Polly Yingshan , Gregory Brian D , Lyons Eric , Beilstein Mark A , Nelson Andrew D L
Published: June 2022

Long intergenic noncoding RNAs (lincRNAs) are a large yet enigmatic class of eukaryotic transcripts that can have critical biological functions. The wealth of RNA-sequencing (RNA-seq) data available for plants provides the opportunity to implement a harmonized identification and annotation effort for lincRNAs that enables cross-species functional and genomic comparisons as well as prioritization of functional candidates. In this study, we processed >24 Tera base pairs of RNA-seq data from >16,000 experiments to identify ∼130,000 lincRNAs in four Brassicaceae: Arabidopsis thaliana, Camelina sativa, Brassica rapa, and Eutrema salsugineum. We used nanopore RNA-seq, transcriptome-wide structural information, peptide data, and epigenomic data to characterize these lincRNAs and identify conserved motifs. We then used comparative genomic and transcriptomic approaches to highlight lincRNAs in our data set with sequence or transcriptional conservation. Finally, we used guilt-by-association analyses to assign putative functions to lincRNAs within our data set. We tested this approach on a subset of lincRNAs associated with germination and seed development, observing germination defects for Arabidopsis lines harboring T-DNA insertions at these loci. LincRNAs with Brassicaceae-conserved putative miRNA binding motifs, small open reading frames, or abiotic-stress modulated expression are a few of the annotations that will guide functional analyses into this cryptic portion of the transcriptome.
High Inflation: Low Default Risk and Low Equity Valuations
Authors: Bhamra Harjoat S , Dorion Christian , Jeanneret Alexandre , Weber Michael
Published: June 2022

We develop an asset pricing model with endogenous corporate policies that explains how inflation jointly affects real asset prices and corporate default risk. Our model includes two empirically founded nominal rigidities: fixed nominal debt coupons (sticky leverage) and sticky cash flows. These two frictions result in lower real equity prices and credit spreads when expected inflation rises. A decrease in expected inflation has opposite effects, with even larger magnitudes. In the cross-section, the model predicts that the negative impact of higher expected inflation on real equity values is stronger for low leverage firms. We find empirical support for the model’s predictions.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Race, Religion, and Geopolitics: Dating and Romance Among South Asian Muslim Immigrants in Canada
Authors: Shams Tahseen
Published: June 2022

Using the “complex religion” framework, this article shows the importance of religion while recognizing how race, national origin, and geopolitics shape how Muslims navigate their romantic lives. Based on 50 in-depth interviews of South Asian Muslim immigrants in Canada on interfaith and interracial romance, I show that taken-for-granted labels “Muslim” and “South Asian” are ambiguous even for the participants as they navigate the search for compatible partners. Race and ethnicity are important components alongside religion and sect that together give meaning to negotiations about who is a “real” Muslim. And despite a sense of panethnic desi groupness, religion, sect, and nationality create fissures that challenge and limit notions of brown solidarity on the ground, even for children of immigrants. Finally, I identify how another important yet overlooked dimension of Muslimness—global geopolitics—shapes participants’ romantic pursuits. Overall, this article problematizes current approaches to studying Muslim immigrant experiences in the West.
Protease Inhibitors from Solanum chacoense Inhibit Pectobacterium Virulence by Reducing Bacterial Protease Activity and Motility
Authors: Joshi Janak R. , Brown Kitty , Charkowski Amy O. , Heuberger Adam L.
Published: June 2022

Potato is a major staple crop, and necrotrophic bacterial pathogens such as Pectobacterium spp. are a major threat to global food security. Most lines of cultivated potato ( Solanum tuberosum) are susceptible to Pectobacterium spp., but some lines of wild potato are resistant, including Solanum chacoense M6. Despite the discovery of resistance in wild potatoes, specific resistance genes are yet to be discovered. Crude protein extract from M6 had a global effect on Pectobacterium brasiliense Pb1692 (Pb1692) virulence phenotypes. Specifically, M6 protein extracts resulted in reduced Pectobacterium exo-protease activity and motility, induced cell elongation, and affected bacterial virulence and metabolic gene expression. These effects were not observed from protein extracts of susceptible potato S. tuberosum DM1. A proteomics approach identified protease inhibitors (PIs) as candidates for S. chacoense resistance, and genomic analysis showed higher abundance and diversity of PIs in M6 than in DM1. We cloned five PIs that are unique or had high abundance in M6 compared with DM1 and purified the proteins (g18987, g28531, g39249, g40384, g6571). Four of the PIs significantly reduced bacterial protease activity, with strongest effects from g28531 and g6571. Three PIs (g18987, g28531, g6571) inhibited disease when co-inoculated with Pectobacterium pathogens into potato tubers. Two PIs (g28531, g6571) also significantly reduced Pb1692 motility and are promising as resistance genes. These results show that S. chacoense PIs contribute to bacterial disease resistance by inhibiting exo-proteases, motility, and tuber maceration and by modulating cell morphology and metabolism.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Your role in infection prevention
Authors: Powers Jan , Rogers Candace
Published: June 2022

Nurses have the unique opportunity to reduce the potential for hospital-acquired infections. Utilizing the skills and knowledge of nursing practice, you can facilitate patient recovery while minimizing complications related to infections.
Biological Response Dynamics to Cochlear Implantation: Modeling and Modulating the Electrode–Tissue Interface
Authors: Ausili Sebastian A. , Parreño Matias , Fernandez Florencia , Boccio Carlos M. , Di Lella Federico A.
Published: June 2022

Objective:

The present study primarily aims to study and model the impedance dynamics following cochlear implant (CI) surgery in humans. Secondarily, to observe how the modulation of a single-dose topic dexamethasone alters this response.

Design:

CI impedance and impedance subcomponents were measured in a day-by-day basis between CI surgery and its activation (

1 month). Impedance dynamics were mathematically modeled. Furthermore, we conducted a randomized double-blind placebo-controlled clinical trial to evaluate the effect of dexamethasone application.

Results:

The model showed good fitting for all impedance’s measures and both modulations over time. The clinical impedance and impedance subcomponents showed different patterns between groups during the first week postimplantation. Single-dose topical dexamethasone had a transient effect on Impedances, postponing (for

3 days) but not preventing the rise in impedance and its application was mainly effective at the base of the cochlea.

Conclusions:

The proposed mathematical fitting properly resembles the impedance dynamics in humans and their modulation due to the dexamethasone. The impedance subcomponents’ dynamic pattern showed a time-course consistent with the biological processes of the foreign body reaction. Single-dose topic dexamethasone has a temporal reduction effect in impedance values on the basal turn of the cochlea but does not prevent the rise on the long-term.
A Time to Speak
Authors: Madden Melissa A. , McAlister Barbara S.
Published: June 2022

Incivility continues to create challenging work environments for healthcare workers. Nurses who experience incivility related to patient concerns or treatment often must confront power differentials and the fear of consequences if they speak up on behalf of the patient. This case report of a family's labor and delivery experience demonstrates the potential of harm to patients and long-term consequences of workplace incivility for the patient and the nurse. Moral courage and biblical insights to strengthen nurses' commitment to speak up for patients are discussed.
Comparative Effectiveness and Safety of Milrinone and Levosimendan as Initial Inotrope Therapy in Patients With Acute Heart Failure With Renal Dysfunction
Authors: Cui Xueyan , Wang Zhongsu , Dong Xue , Cheng Zijie , Zhang Le , Mu Yan , Huang Xin , Li Yan , Hong Yinglong , Han Yi
Published: June 2022

Levosimendan and milrinone are 2 effective inotropic drugs used to maintain cardiac output in acute heart failure (AHF). Using data from patients with AHF with and without abnormal renal function, we performed this single-center, retrospective cohort study to compare the effectiveness and safety of milrinone and levosimendan for the initial management of AHF. Patients admitted for heart failure between December 2016 and September 2019 who received levosimendan or milrinone as initial inotrope therapy in the cardiology department were identified. A total of 436 levosimendan and 417 milrinone patients with creatinine clearance (CrCl) ≥30 mL/min and 50 levosimendan and 71 milrinone patients with CrCl <30 mL/min or on dialysis were included. The primary outcome was a composite of changes in clinical status at 15 and 30 days after initial inotrope therapy discontinuation. Between subgroups of patients with CrCl ≥30 mL/min, there were no significant differences in primary outcomes; milrinone was associated with more frequent hypotension and cardiac arrhythmias during the infusion period (P < 0.01), while levosimendan was associated with more frequent cardiac arrhythmias within 48 hours after discontinuation (P < 0.05). Of the patients with CrCl <30 mL/min or on dialysis, more initial levosimendan than milrinone patients and those who switched to alternative inotropes experienced clinical worsening at 15 days and 30 days (P < 0.05). According to our results, patients with AHF with severe renal dysfunction should avoid initial inotrope therapy with levosimendan.
Histone Deacetylase 1 Depletion Alleviates Coronary Heart Disease Via the MicroRNA-182–Mediated Transforming Growth Factor β/Smad Signaling Pathway
Authors: Zhou Shengkai , Liu Peng , Zhang Guobao , Cheng Zhaoyun , Wang Sheng , Zhao Jian
Published: June 2022

Histone deacetylase (HDAC) determines the acetylation status of histones, thereby regulating gene expression. HDAC inhibitors have been demonstrated to suppress cardiomyocyte growth in vitro and in vivo. We assessed here whether HDAC1 exerts an aggravating effect on coronary heart disease (CHD). Epigenetic probe array revealed that HDAC1 was overexpressed in patients with CHD. HDAC1 was then downregulated in rat cardiomyocytes, and microRNA microarray analysis was performed to detect downstream targets of HDAC1, followed by chromatin immunoprecipitation validation. HDAC1 inhibited miR-182 expression through deacetylation. miR-182 was poorly expressed in patients with CHD. Using enzyme-linked immunosorbent assay, Reverse transcription-quantitative PCR, hematoxylin–eosin staining, terminal deoxynucleotidyl transferase (TdT)–mediated 2′-deoxyuridine 5′-triphosphate (dUTP) nick-end labeling assay, and immunohistochemistry, we observed that HDAC1 downregulation promoted cardiac function, restored lipid levels, reduced myocardial injury markers and inflammatory factors, and alleviated myocardial tissue damage and apoptosis in CHD rats. By contrast, miR-182 downregulation exacerbated injury in rats in the presence of HDAC1 knockdown. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that the target genes of miR-182 were mainly enriched in the transforming growth factor (TGF)-β/Smad pathway. Western blot also validated that HDAC1/miR-182 modulated the TGF-β/Smad pathway activity. Our results demonstrated that HDAC1 repressed miR-182 and activated the TGF-β/Smad pathway to promote CHD.
RETINAL VASCULAR BED AREA IN EYES WITH RETINAL VEIN OCCLUSION ON ULTRA-WIDEFIELD FLUORESCEIN ANGIOGRAPHY
Authors: Fan Wenying , Fleming Alan , Hemert Jano Van , Wykoff Charles C. , Brown David M. , Robertson Gavin , Wang Kang , Falavarjani Khalil Ghasemi , Sadda Srinivas R. , Ip Michael
Published: June 2022

Purpose:

To compute retinal vascular bed area (RVBA) in square millimeters on distortion corrected ultra-widefield fluorescein angiography images in eyes with retinal vein occlusion (RVO).

Methods:

Prospective observational study. The peripheral distortion of baseline ultra-widefield fluorescein angiography (Optos 200Tx) images of 30 patients with RVO from the WAVE study (NCT01710839) and 13 control eyes of normal subjects was corrected using the stereographic projection method to compute RVBA in square millimeters.

Results:

In comparison with age- and sex-matched normal control eyes, eyes with RVO had a decreased global RVBA for the entire retina (50.5 ± 20.4 mm2 vs. 62.6 ± 12.2 mm2, P = 0.023). Eyes with RVO and the unaffected fellow eye had a similar RVBA globally (50.5 ± 20.4 mm2 vs. 46.2 ± 18.9 mm2, P = 0.523). The RVBA was observed to negatively correlate with nonperfusion area (R = −0.47, P = 0.009). However, RVBA was not related to the severity of macular edema (P > 0.05).

Conclusion:

Eyes with RVO have a similar RVBA to the unaffected fellow eyes but with a reduction when compared with normal control eyes. Retinal vascular bed area appears to be a surrogate biomarker of retinal ischemia on ultra-widefield fluorescein angiography but not the extent of macular edema.
Clinical Impact of Biotyping of Klebsiella pneumoniae Isolates From Health Care–Associated Infections Using MALDI-TOF-MS
Authors: Antonios Manal A.M. , Raouf May Moheb , Ghoniem Shaimaa Abdelwahab , Hassan Eman Hamza
Published: June 2022

Background

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) has revolutionized the identification of bacteria as being rapid reliable and cost-effective. This study aimed to assess MALDI-TOF-MS–based proteomic typing patterns of Klebsiella pneumoniae and interpret it with the clinical data of the studied cases.

Methods

A prospective cohort study was carried out over a period of 6 months in a tertiary pediatric university hospital. Hospital-associated infections were identified according to Centers for Disease Control and Prevention case definitions. Identification and antimicrobial resistance pattern were investigated. MALDI-TOF-MS was used for assessment of relatedness of the most frequent organism isolated.

Results

Fifty patients developed 64 hospital-associated infection episodes with 72 strains isolated. Pneumonia accounted for (39.1%) followed by bloodstream infection (34.4%) and urinary tract infections (26.6%). Gram-negative bacteria were the most common isolated pathogens in all episodes (70.8%, n = 51/72); K. pneumoniae accounted for almost half of them (25/51 isolates). Principal component analysis dendrogram categorized Klebsiella strains into 4 distinct subgroups at a cutoff value of 0.85. Clinical comparison showed that there is diversity in the severity and fatality between the 2 most prevalent subtypes.

Conclusions

MALDI-TOF-MS proteome profiling is not only a breakthrough for routine identification and biotyping of microorganisms but might also offer a fast and valuable tool to support microbiologists during nosocomial infections.
Tocilizumab Treatment Reduces Mortality in Hospitalized Patients With COVID-19: A Retrospective Cohort Study at a New York City Hospital
Authors: Saliaj Merjona , Li Matthew , Rizzo Vincent , Nassar Mahmoud , Nso Nso , Idrees Zarwa , Medina Luis A. , Novikov Anastasia , Yaghi Salim , Cuevas Francisco J. , Salafia Carolyn M. , Razaki Hamid , Berman Charles , Sachmechi Issac , Trandafirescu Theo , Brennessel Debra , Martin George T. , Mantis Jazila
Published: June 2022

Aims

This study aimed to investigate the potential of tocilizumab therapy in minimizing mortality and mechanical ventilation (MV) requirements among hospitalized COVID-19 patients.

Methods

A single-center, retrospective, observational cohort study of 375 patients with severe COVID-19 (from March 1 to April 22, 2020) included 150 patients treated with tocilizumab and 225 consecutive control patients adjusted for age and sex. Both groups received concomitant standard of care treatments in addition to tocilizumab. The statistical methods relied on survival analyses, conditional logistic regression models, and contingency analyses. The outcomes included in-hospital mortality and the MV requirement.

Results

Tocilizumab associated with improved in-hospital mortality (34.7% vs 46.7%, P = 0.0136) and lower requirement for MV on days 1, 3, and 5 after treatment (P = 0.005, P < 0.0001, and P = 0.0021, respectively). Lower mortality was observed if tocilizumab was administered within 48 hours after admission (P = 0.0226). Older age and low blood oxygen saturation on admission decreased the odds of survival (P < 0.005).

Conclusions

Our study demonstrates a significant reduction in mortality and decreased requirement of MV with tocilizumab treatment in addition to the standard of care. Early administration of tocilizumab within 48 hours reduces the risk of mortality.
Goat Milk Based Infant Formula in Newborns: A Double-Blind Randomized Controlled Trial on Growth and Safety.
Authors: He T. , Woudstra F. , Panzer F. , Haandrikman A. , Verkade HJ , van Lee L.
Published: June 2022

Objectives:

We aimed to determine the growth and safety parameters in newborns fed a goat milk based infant formula (GMF) using a randomized double-blind trial, in which a cow milk formula (CMF) served as a control and a breast fed (BF) group as a reference.

Methods:

Healthy term infants (n = 218) aged up to 14 days were recruited from 25 European study centers and randomized to GMF or CMF. Weight, length, head circumference were measured at baseline, and at 14, 28, 56, 84, and 112 days at the study clinics. Adverse events were recorded and stool characteristics, reflux, fussiness, colic, and flatulence were self-reported by parents in 3-day diaries. Anthropometric measurements were transformed to WHO standardized age- and sex-adjusted z-scores. Analyses of covariance and linear mixed modeling were used to statistically analyze growth, while adjusting for potential confounders when studying the breast-fed group (n = 86).

Results:

Comparing the GMF to the CMF group, weight gain [mean difference 227.8 g (95% CI −16.6 to −439.0)] and z-scores for anthropometric measurements were similar after 112 days intervention. Infant formula groups showed greater mean (SD) weight z-scores than the BF group from 84 days onwards (GMF: 0.28 (0.84), CMF: 0.12 (0.88), BF −0.19 (1.02), P < 0.05), whereas length and head circumference z-scores were similar. Incidences of serious adverse events and reflux, fussiness, colic, and flatulence were similar among the three groups.

Conclusion:

Our data demonstrate that GMF provides adequate growth, has a good tolerability, and is safe to use in infants.
A Case Series on the Use of Dupilumab for Treatment of Refractory Eosinophilic Gastrointestinal Disorders
Authors: Patel Naiya , Goyal Aakash , Thaker Ameet , Troendle David , Parrish Christopher
Published: June 2022

The incidence and prevalence of eosinophilic esophagitis (EoE), eosinophilic gastritis (EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC) are increasing (1). These conditions will inevitably become more widely recognized and better understood. There is currently no Food and Drug Administration (FDA)–approved treatment for EoE, but there are standard-of-care treatments that are well established and widely used. In contrast, there is a paucity of data regarding standard-of-care treatment for non-EoE eosinophilic gastrointestinal disorders (EGID). We identified 3 patients that all achieved clinical and histopathologic remission on dupilumab, a monoclonal antibody that blocks the downstream signaling of interleukin (IL)-4 and IL-13. These patients had extra-esophageal forms of EGID with two patients failing to achieve remission on standard-of-care therapies and one patient experiencing significant side effects on swallowed budesonide therapy. The reduction in mucosal eosinophilia in several GI tract segments in these 3 patients highlights a new potential clinical indication for dupilumab in the treatment of pediatric EGID patients.
Ethical and Policy Implications of Financial Burden in Family Caregivers
Authors: Thomas Hebdon Megan C. , Phan Cuong T. , Phillips Carolyn , Wan Shaowei , Doyon Katherine , Gray Tamryn , Johnson Lee , Fischer Stacy M.
Published: June 2022

Palliative care nurses are key members of the health care team and provide support to patients and their families navigating chronic and life-limiting illness. Financial burden is an issue inherent to chronic illness, yet has not been fully addressed in family caregivers. The purpose of this article is to (1) provide a case study of a family caregiver navigating chronic illness with her daughter and the associated financial and employment consequences and (2) review the nursing ethical, policy, and practice implications of financial burden for family caregivers. The ethical implications of financial burden in family caregivers relate to health equity and health outcomes for both the patient and family caregiver in treatment access and quality. The policy implications include state and federal policies related to caregiver compensation and support and family medical leave. Palliative care nurses play an integral role in addressing caregiver financial burden through assessment, education, referral, and policy support. Family caregivers are essential to the palliative care team, and palliative care nurses have the opportunity to lead initiatives to support the financial well-being of family caregivers in practice, research, and policy settings.
An Innovative Approach to Teaching Evidence-Based Practice
Authors: Waszak Daria L. , Stec Melissa , Martini Kady , Mihal Christine C.
Published: June 2022

Background:

An innovative remote learning intervention, PICO Pal, was implemented with groups of undergraduate nursing students in a nursing research course to promote interactive learning, collaboration, and information literacy.

Problem:

Evidence-based practice (EBP) is a challenging topic to teach nursing students, especially in a remote learning environment.

Approach:

PICO Pal used Apple Numbers to facilitate remote group work on a PICOT poster. The approach was evaluated using pre- and posttest surveys with 50 undergraduate nursing students at a small private university in New Jersey.

Outcomes:

The evaluation showed positive perceptions of the assignment and gains with knowledge of EBP. However, there were no gains in the perceptions of group work.

Conclusions:

The assignment was effective at teaching aspects of the EBP process but should be reevaluated to maximize group work dynamics and comfort with use of technology.
Simulated Home Visit to Promote Chronic Disease Management Competencies in Prelicensure Nursing Students
Authors: Perry Julie , Powers S. Cole , Haskell Brittany , Plummer Carrie
Published: June 2022

Background:

Conducting a best possible medication history (BPMH), while using effective patient communication skills, falls within the nursing scope of practice and is recommended at all care levels. Nursing students should be taught these skills before entering clinical practice, but evidence about effective teaching strategies is limited.

Approach:

A standardized patient-facilitated home visit simulation was utilized in a prelicensure nursing program to practice a BPMH while using effective patient communication skills.

Outcomes:

All students correctly identified medications listed on the patient history, and most identified omitted medications (90.1%), transposed medications (91.6%), and incorrect medication usage (91.6%). All students demonstrated effective patient communication skills—using open-ended questions and inquiring about medication usage.

Conclusion:

Incorporating a standardized patient-facilitated home visit BPMH simulation allows students the opportunity to practice and achieve BPMH competency essential for nurses.
The Utilization of Critical Care Resources in Pediatric Neurocritical Care Patients*
Authors: DeSanti Ryan L. , Balakrishnan Binod , Rice Tom B. , Pineda Jose A. , Ferrazzano Peter A.
Published: June 2022

OBJECTIVES:

To define the prevalence of neurologic diagnoses and evaluate the utilization of critical care and neurocritical care (NCC) resources among children admitted to the PICU.

DESIGN:

Retrospective cohort analysis.

SETTING:

Data submitted to the Virtual Pediatric Systems (VPS) database.

PATIENTS:

All children entered in VPS during 2016 (January 1, 2016, to December 31, 2016).

INTERVENTIONS:

None.

MEASUREMENTS and MAIN RESULTS:

There were 128,688 patients entered into VPS and were comprised of 24.3% NCC admissions and 75.7% general PICU admissions. The NCC cohort was older, represented more scheduled admissions, and was more frequently admitted from the operating room. The NCC cohort also experienced a greater decline in prehospitalization to posthospitalization functional status and required more frequent use of endotracheal intubation, arterial lines, and foley catheters but had an overall shorter duration of PICU and hospital length of stay with a higher mortality rate. One thousand seven hundred fifteen patients at 12 participating institutions were entered into a novel, pilot NCC module evaluating sources of secondary neurologic injury. Four hundred forty-eight patients were manually excluded by the data entrant, leaving 1,267 patients in the module. Of the patients in the module, 75.8% of patients had a NCC diagnosis as their primary diagnosis; they experienced a high prevalence of pathophysiologic events associated with secondary neurologic insult (ranging from hyperglycemia at 10.5% to hyperthermia at 36.8%).

CONCLUSIONS:

In children admitted to a VPS-contributing PICU, a diagnosis of acute neurologic disease was associated with greater use of resources. We have identified the most common etiologies of acute neurologic disease in the 2016 VPS cohort, and such admissions were associated with significant decrease in functional status, as well as an increase in mortality.
Feasibility of a patient-centered method to determine meaningful change in pain intensity on a survey of patients with a history of cancer
Authors: Jones Salene M.W. , Unger Joseph M.
Published: June 2022

Introduction:

Current methods of determining minimally important differences (MIDs) in patient-reported outcomes (PROs) do not incorporate individual patient values.

Objectives:

This study tested the feasibility of having cancer patients define a personally meaningful change in pain intensity, a method we have termed Precision PROs.

Methods:

Adults with cancer and pain (n = 231) completed an electronic questionnaire twice over 2 weeks. Participants were then given their pain intensity scores with an explanation of score meaning. Participants then defined their own MIDs for an increase and decrease in pain intensity. Participants also answered 3 questions testing their understanding of the MID concept.

Results:

The majority of participants could define an individually meaningful increase (97% [n = 223]) and individually meaningful decrease (98% [n = 226]) in pain intensity. Seventy-two percent of participants (n = 166) answered all test questions correctly and 26% (n = 60) answered 2 of 3 correctly. Using the individual MID, 32% (95% CI: 25.3, 40.0) of the sample experienced a meaningful change between the 2 surveys, more than other methods (z-test: 14%, 95% CI: 9.4, 20.6; distribution-based method: 24%, 95% CI: 17.7, 31.1).

Conclusions:

This study showed the feasibility of the Precision PRO individual MID, which could be used in clinical care or clinical trials. Further studies are needed to compare the individual MID to current methods.