bluuebunny/crossref_metadata_2025 huggingface dataset:
Secondary bacterial infection in COVID-19 patients is a stronger predictor for death compared to influenza patients
Authors: Shafran Noa , Shafran Inbal , Ben-Zvi Haim , Sofer Summer , Sheena Liron , Krause Ilan , Shlomai Amir , Goldberg Elad , Sklan Ella H.
Published: June 2021

Secondary bacterial infections are a potentially fatal complication of influenza infection. We aimed to define the impact of secondary bacterial infections on the clinical course and mortality in coronavirus disease 2019 (COVID-19) patients by comparison with influenza patients. COVID-19 (n = 642) and influenza (n = 742) patients, admitted to a large tertiary center in Israel and for whom blood or sputum culture had been taken were selected for this study. Bacterial culture results, clinical parameters, and death rates were compared. COVID-19 patients had higher rates of bacterial infections than influenza patients (12.6% vs. 8.7%). Notably, the time from admission to bacterial growth was longer in COVID-19 compared to influenza patients (4 (1–8) vs. 1 (1–3) days). Late infections (> 48 h after admission) with gram-positive bacteria were more common in COVID-19 patients (28% vs. 9.5%). Secondary infection was associated with a higher risk of death in both patient groups 2.7-fold (1.22–5.83) for COVID-19, and 3.09-fold (1.11–7.38) for Influenza). The association with death remained significant upon adjustment to age and clinical parameters in COVID-19 but not in influenza infection. Secondary bacterial infection is a notable complication associated with worse outcomes in COVID-19 than influenza patients. Careful surveillance and prompt antibiotic treatment may benefit selected patients.
A two-photon fluorescence silica nanoparticle-based FRET nanoprobe platform for effective ratiometric bioimaging of intracellular endogenous adenosine triphosphate
Authors: Li Dian , Liu Ying , Yu Shengrong , Zhang Dailiang , Wang Xiao , Zhong Hongmei , He Kangdi , Wang Ying , Wu Yong-Xiang
Published: June 2021

A novel nanoprobe platform with TP silica nanoparticles was developed for FRET-based ratiometric biosensing and bioimaging of endogenous ATP, and it shows satisfactory ratiometric TP fluorescence imaging in living cells and tissues.
Atomic-layered Pt clusters on S-vacancy rich MoS2−x with high electrocatalytic hydrogen evolution
Authors: Shi Feng , Wu Wenzhuo , Chen Jiafu , Xu Qun
Published: June 2021

S-Vacancy rich MoS2−x support embedded atomic-layered Pt clusters could maximize the Pt atoms’ utilization and synergistically improve the local H density around the active Pt clusters for an excellent HER activity.
Photodiodes based on a MAPbBr3/Bi3+-doped MAPbCl3single crystals heterojunction for the X-ray detection
Authors: Pan Yuzhu , Wang Xin , Zhao Jingda , Xu Yubing , Li Yuwei , Li Qing , Zhang Xiaobing , Zhao Zhiwei , Zhu Zhuoya , Jing Chen , Jun Wu , Emeka Elemike Elias , Bae Byung Seong , Lei Wei
Published: June 2021

The epitaxially fabricated MAPbBr3/Bi3+-doped MAPbCl3PSCs pN heterojunction shows advanced X-ray detection performance with decreased dark current density and faster response time under relatively high external reverse voltage.
C14H10 polycyclic aromatic hydrocarbon formation by acetylene addition to naphthalenyl radicals observed
Authors: Yang Jeehyun , Smith Mica C. , Prendergast Matthew B. , Chu Te-Chun , Green William H.
Published: June 2021

Primary reaction pathways for 2-naphthalenyl + acetylene predicted by the kinetic model under the experimental conditions in this work.
Chemical dynamics study on the gas-phase reaction of the D1-silylidyne radical (SiD; X2Π) with deuterium sulfide (D2S) and hydrogen sulfide (H2S)
Authors: Goettl Shane J. , Doddipatla Srinivas , Yang Zhenghai , He Chao , Kaiser Ralf I. , Silva Mateus X. , Galvão Breno R. L. , Millar Tom J.
Published: June 2021

Center-of-mass velocity flux contour map for the reaction of the D1-silylidyne radical (SiD) with deuterium sulfide (D2S) leading to the gas-phase formation of D2-silanethione (D2SiS).
Influence of the copper precursor on the catalytic transformation of oleylamine during Cu nanoparticle synthesis
Authors: Pesesse Antoine , Carenco Sophie
Published: June 2021

Copper nanoparticles prepared from copper acetylacetonate complex or acetate complex show significant differences in terms of reaction mechanism and further catalytic transformation of oleylamine.
Lignin promoted the fast formation of a robust and highly conductive deep eutectic solvent ionic gel at room temperature for a flexible quasi-solid-state supercapacitor and strain sensors
Authors: Wang Jiake , Deng Yongqi , Ma Zhongzheng , Wang Yan , Zhang Shangzhong , Yan Lifeng
Published: June 2021

The green synthesis of ionic gels using alternative feedstock enables the preparation of sustainable materials and devices.
History and recent developments in divergent electrolytes towards high-efficiency lithium–sulfur batteries – a review
Authors: Ponnada Srikanth , Kiai Maryam Sadat , Gorle Demudu Babu , Nowduri Annapurna
Published: June 2021

Lithium–sulfur batteries, with a high specific capacity, low cost and environmental friendliness, could be investigated as a next-generation energy-storage system.
Synthesis and spectroscopic characterization of a fluorescent phenanthrene-rhodamine dyad for ratiometric measurements of acid pH values
Authors: Srivastava Priyanka , Fürstenwerth Paul Christian , Witte Jan Felix , Resch-Genger Ute
Published: June 2021

Ratiometric pH sensing by multichannel emission response utilizing excimer/monomer emissions of phenanthrene and rhodamine emission at single excitation wavelength.
Magnetically recyclable silica-coated ferrite magnetite-K10 montmorillonite nanocatalyst and its applications in O, N, and S-acylation reaction under solvent-free conditions
Authors: Tandon Nitin , Patil Shripad M. , Tandon Runjhun , Kumar Pushpendra
Published: June 2021

Novel silica-coated ferrite nanoparticles supported with montmorillonite (K10) have been prepared and explored for their catalytic activity for the O, N, and S-acylation reactions under solvent-free conditions.
On-site marine oil spillage monitoring probes formed by fixing oxygen sensors into hydrophobic/oleophilic porous materials for early-stage spotty pollution warning
Authors: Shi Yuxin , Xu Yong , Jiang Fei , Sun Zhijuan , Wang Gang , Zeng Zhixiang , Gao Congjie , Xue Qunji , Xue Lixin
Published: June 2021

The oil spillage monitoring probe is developed by oxygen consumption sensor and hydrophobic/oleophilic porous materials. The oils could be monitored when they absorbed into the pores of the material to deplete the oxygen level inside the material.
The photophysical properties of naphthalene bridged disilanes
Authors: Kumar Vipin B. , Fleming Cassandra L. , Murali Sai Shruthi , Hume Paul A. , Davis Nathaniel J. L. K. , Söhnel Tilo , Leitao Erin M.
Published: June 2021

The photophysical properties of different structural isomers of naphthalene bridged disilanes are distinct. The presence of the Si–Si bond is key to excimer formation in non-polar solvents.
Rapid hydrothermal synthesis of hierarchical ZSM-5/beta composite zeolites
Authors: Xiong Guang , Meng Feifei , Liu Jiaxu , Liu Liping , Zhao Leping
Published: June 2021

The hierarchical ZSM-5/beta composite zeolites synthesized via an innovative hydrothermal method exhibit superior catalytic performance in the cracking of 1,3,5-triisopropylbenzene.
Concentric/bipolar ordering of liquid crystalline graphene oxide nanosheets confined in microfluidically synthesized spherical droplets
Authors: Lee Ju Young , Oh Min Jun , Yoo Pil J.
Published: June 2021

Liquid crystalline ordering of graphene oxide nanosheets inside strongly confined microdroplets has been investigated, which rendered either concentric or bipolar ordering according to the magnitude of physical confinement.
Mapping the substrate specificity of the Plasmodium M1 and M17 aminopeptidases
Authors: Malcolm Tess R. , Swiderska Karolina W. , Hayes Brooke K. , Webb Chaille T. , Drag Marcin , Drinkwater Nyssa , McGowan Sheena
Published: June 2021

During malarial infection, Plasmodium parasites digest human hemoglobin to obtain free amino acids for protein production and maintenance of osmotic pressure. The Plasmodium M1 and M17 aminopeptidases are both postulated to have an essential role in the terminal stages of the hemoglobin digestion process and are validated drug targets for the design of new dual-target anti-malarial compounds. In this study, we profiled the substrate specificity fingerprints and kinetic behaviors of M1 and M17 aminopeptidases from Plasmodium falciparum and Plasmodium vivax, and the mouse model species, Plasmodium berghei. We found that although the Plasmodium M1 aminopeptidases share a largely similar, broad specificity at the P1 position, the P. falciparum M1 displays the greatest diversity in specificity and P. berghei M1 showing a preference for charged P1 residues. In contrast, the Plasmodium M17 aminopeptidases share a highly conserved preference for hydrophobic residues at the P1 position. The aminopeptidases also demonstrated intra-peptide sequence specificity, particularly the M1 aminopeptidases, which showed a definitive preference for peptides with fewer negatively charged intrapeptide residues. Overall, the P. vivax and P. berghei enzymes had a faster substrate turnover rate than the P. falciparum enzymes, which we postulate is due to subtle differences in structural dynamicity. Together, these results build a kinetic profile that allows us to better understand the catalytic nuances of the M1 and M17 aminopeptidases from different Plasmodium species.
Power system resilience assessment considering critical infrastructure resilience approaches and government policymaker criteria
Authors: Raoufi Habibollah , Vahidinasab Vahid
Published: June 2021

The electric power system is one of the most important critical infrastructures of a country. Recently, the number of natural and man‐made disasters is increased, which can impose extensive damages and costs to the power system. A resilient power system can withstand against, adapt to and recover from these disasters. Power system resilience is quantified by mathematical tools which are called “resilience metrics”. Currently, a lot of resilience metrics are proposed in the power system literature. In this paper, based on the extensive research in the critical infrastructure resilience literature which specifically concentrates on the “area‐based” resilience metrics, a new area‐based resilience metric is proposed which can measure the power system resilience considering the government policymaker criteria, which are rarely noticed before. The proposed and conventional area‐based resilience metrics are evaluated based on the real data from the 2012 Superstorm Sandy in the USA, which led to significant damage to the power distribution system. The simulation results show that the proposed area‐based resilience metric is very simple, can successfully address actual power system performance curves and is more meaningful and tangible than the conventional area‐based metrics for the government policymaker. The proposed area‐based resilience metric has also a general form and can be used for other critical infrastructures.
Digitale Gesundheitsanwendungen (DiGA)
Authors: Grahammer Manuel
Published: June 2021

Mit dem Digitale-Versorgung-Gesetz (DVG) wurde vom Gesetzgeber 2020 ein Gesetz verabschiedet, welches die Digitalisierung der Gesundheitsversorgung voranbringen soll. Gemäß dem DVG haben Patient*innen einen Rechtsanspruch auf die Versorgung mit Digitalen Gesundheitsanwendungen (DiGA) – weltweit erstmalig. DiGA sind digitale Medizinprodukte, sogenannte „Apps auf Rezept“, die vom Bundesamt für Medizinprodukte (BfArM) zugelassen werden und höchste Anforderungen an Qualität, Datenschutz und Datensicherheit erfüllen müssen. DiGA sind indikationsspezifisch und auch in der Rheumatologie werden sie sich zur digitalen Therapiebegleitung und -überwachung etablieren. Traditionell ist die Rheumatologie Vorreiter beim Einsatz innovativer Behandlungsansätze und es besteht unter Rheumatolog*innen und Patient*innen bereits heute eine überaus hohe Bereitschaft zur Integration von digitalen Anwendungen in der Versorgung. DiGA fördern die aktive Einbindung der Patient*innen in den Behandlungsprozess und steigern Effizienz und Effektivität der Behandlung. Dadurch werden Zeit und Ressourcen der Rheumatolog*innen sinnvoller eingesetzt, Leitlinienprinzipien konsequenter umgesetzt und letztlich die Qualität der Versorgung nachhaltig verbessert. Mit diesem Artikel soll ein Überblick über die „Weltpremiere“ Digitale Gesundheitsanwendungen im rheumatologischen Versorgungskontext gewährt werden.
Infektionen der Beugesehnenscheide
Authors: Langer Martin Franz , Grünert Jörg G. , Unglaub Frank , Ueberberg Johanna , Glasbrenner Johannes , Oeckenpöhler Simon
Published: June 2021

Die Infektionen der Beugesehnenscheide gehören immer noch zu den gravierendsten und folgenschwersten Infektionen an der Hand. Wenn die typischen Kardinalzeichen einer Beugesehnenscheideninfektion nach Kanavel bestehen, sollte unverzüglich die Indikation zur Operation gestellt werden. Die Folgeschäden einer verzögerten oder verspäteten Operation mit enormen Bewegungseinschränkungen der Finger durch Zerstörung der Gleitschichten und massiven Verklebungen, die sich später häufig nur noch wenig durch Handtherapie verbessern lassen, sind so gravierend, dass sich konservative Therapieversuche nur sehr schwer rechtfertigen lassen. Das schnelle chirurgische Eingreifen und die frühzeitige Eröffnung und Entlastung sowie die Spülung der Sehnenscheide kann die Erkrankung, die Zerstörung der Gleitschichten sowie die starken Schmerzen fast augenblicklich beenden. Wichtig sind ein schnelles Erkennen und ein schnelles Handeln. Bei frühzeitiger Intervention kann häufig die normale Handfunktion komplett wiederhergestellt werden.
Simple Synthesis of Fluorinated Ene-Ynes via In Situ Generation of Allenes
Authors: Sletten Ellen M. , Jaye Joseph A.
Published: June 2021

Fluorination of small molecules is a key route toward modulating reactivity and bioactivity. The 1,3 ene-yne functionality is an important synthon towards complex products, as well as a common functionality in biologically active molecules. Here, we present a new synthetic route towards fluorinated ene-ynes from simple starting materials. We employ gas chromatography-mass spectrometry analysis to probe the sequential eliminations necessary for this transformation and observe an allene intermediate. The ene-yne products are sufficiently fluorous to enable purification via fluorous extraction. This methodology will allow facile access to functional, fluorous ene-ynes.
Comparison between laser induced plasmas in gas and in liquid
Authors: Dell'Aglio M. , Gardette V. , Jantzi S. C. , De Giacomo A.
Published: June 2021

In this work, the main peculiarities of Laser Induced Plasma (LIP) in liquid have been investigated by comparing the evolution of the LIP in water and in air. To this end, fast shadowgraphy and temporally resolved emission spectroscopy were used. The experimental results reveal a scenario where plasma under water remains in a high-density state, characterized by the condensation of electronic levels as a consequence of the confinement effect of the surrounding water. In this case, the plasma emission spectrum consists of continuum radiation. In contrast, LIP in air expands, reaching an ideal plasma state in a few hundred nanoseconds. In this condition, excited electronic levels are enabled and the spectrum is characterized by discrete emission lines, according to the Boltzmann statistics. These differences allow LIP in liquid and gas to be used in a wide variety of applications, ranging from analytical chemistry to nanomaterial production.
Impurity toroidal rotation profile measurement using upgraded high-resolution visible spectroscopic diagnostic on ADITYA-U tokamak
Authors: Shukla G. , Chowdhuri M. B. , Shah K. , Manchanda R. , Ramaiya N. , Tanna R. L. , Mayya K. B. K. , Ghosh J. ,   ADITYA-U team
Published: June 2021

A high-resolution spectroscopic diagnostic for the measurement of spatial profiles of impurity ion toroidal rotation velocities on the ADITYA-U tokamak has been upgraded to cover the complete plasma minor radius. Earlier, the coverage of diagnostics toward the plasma edge was restricted due to the placement of collection optics on the tangential port outside the vacuum vessel. The coverage of the full plasma minor radius, from 0 to 24 cm, has been achieved using the newly designed and developed collection optics that have seven lines of sight to view the tokamak plasma mounted inside a customized re-entrant view port which is installed in the shadow of the limiter inside the vacuum vessel. The upgraded diagnostic also includes a faster charged coupled device detector with a smaller pixel size for the detection of a small wavelength shift. The complete spatial profile has been measured using the Doppler shifted passive change exchange spectral line at 529.0 nm from the C5+ ion. In this article, we present the collection optics’ design, installation, calibration, and results obtained using the upgraded diagnostic.
Dissipation in the magnetic turbulence of reversed field pinch plasmas
Authors: Titus J. B. , Almagri A. F. , Terry P. W. , Sarff J. S. , Mezonlin E. D. , Johnson J. A.
Published: June 2021

Reversed field pinch (RFP) plasmas are subject to tearing instability that creates a broad spectrum of magnetic fluctuations. The dominant fluctuations have poloidal and toroidal mode numbers (m,n)=(1,6−10) and can grow to 2–3% of the mean magnetic field. Through nonlinear coupling, this growth culminates in a strong reconnection event and broadening of the magnetic spectrum extending to the ion gyroradius scale. Multiple developments occur during the reconnection stage: ions and electrons are energized, magnetic fluctuation amplitudes increase, plasma flow is halted, and the toroidal magnetic flux increases in a sawtooth-like fashion as the RFP dynamo becomes stronger. Magnetic fluctuations are measured in the plasma edge at multiple radial locations from r/a = 0.75 to 0.96 to assess and characterize the magnetic turbulence. The measured spectrum perpendicular to the mean field, S(k⊥), can be fit to a model spectrum consisting of power-law and exponential component with one free parameter that characterizes dissipation. The measured dissipation is much larger than estimated from classical viscous or resistive dissipation, but it is consistent with a flow damping measurement of anomalous viscosity. The measurements show an evolution of the spectrum during which fluctuation power builds up in the smallest wavenumbers and cascades to the larger wavenumber due to the nonlinear coupling between the linear (m, n) = (1, > 6) and the nonlinear (m, n) = (0, 1) tearing modes.
An exact irrotational solution for a hemispherically bounded cyclonic flowfield
Authors: Williams Langston L. , Majdalani Joseph
Published: June 2021

This study focuses on the development of an internal potential flow solution in the context of a hemispherically bounded cyclonic chamber. The analysis proceeds from the Bragg–Hawthorne equation, which is quite effective in the treatment of steady, inviscid, and axisymmetric flows when expressed in terms of the streamfunction. Once the streamfunction is obtained, other flow properties are readily deduced; these include the principal velocity and pressure distributions, swirl intensity, crossflow velocity, and mantle location. Furthermore, given the overarching spherical geometry, two different types of mantles are identified and related to the coexistence of axially bidirectional and circularly bipolar regions. The first, axial mantle, which is traditionally used in the analysis of cylindrical and conical cyclone separators, consists of a rotating, non-translating interfacial layer along which the axial velocity vanishes. It thus separates the outer, vertical updraft, from the inner, swirling downdraft. The second, polar mantle, which arises in the context of a hemispherical flow configuration, coincides with the spherical interface along which the polar velocity vanishes. It hence partitions the flow domain into a much larger outer region, where the flow direction remains strictly counterclockwise, and a proportionally smaller inner region, where the outflow becomes clockwise. Despite their dissimilar structures, both axial and polar mantles meet in the exit plane at a fractional radius of 1/e2 or 13.53%. In this study, the unique characteristics of the resulting irrotational motion, which reduces to a continuously looping, hemispherically cyclonic potential vortex, are evaluated and discussed.
Non-conventional bell-shaped diffuse scattering in low-energy electron diffraction from high-quality epitaxial 2D-materials
Authors: Omambac K. , Kriegel M. , Brand C. , Finke B. , Kremeyer L. , Hattab H. , Janoschka D. , Dreher P. , Meyer zu Heringdorf F.-J. , Momeni Pakdehi D. , Pierz K. , Schumacher H. W. , Petrović M. , van Houselt A. , Poelsema B. , Tringides M. C. , Horn-von Hoegen M.
Published: June 2021

A broad, bell-shaped intensity component is observed in low-energy electron diffraction from high-quality epitaxial 2D-systems. Three 2D-systems, graphene on Ir(111), graphene on SiC(0001), and hexagonal boron nitride on Ir(111), have been prepared in situ under ultra-high vacuum conditions. In all three systems—independent of substrate material—similar strong diffuse intensity is observed, exhibiting a width as large as 50% of the Brillouin zone and an integrated intensity more than 10 times the intensity of the Bragg spots. The presented experimental results provide evidence for a common origin of such diffuse diffraction intensity in different atomically thin 2D-materials.
On the dynamics of jet wiping: Numerical simulations and modal analysis
Authors: Barreiro-Villaverde David , Gosset Anne , Mendez Miguel A.
Published: June 2021

We analyze the flow of a planar gas jet impinging on a thin film dragged by a vertical moving wall. In the coating industry, this configuration is known as jet wiping, a process in which impinging jets control the thickness of liquid coatings on flat plates withdrawn vertically from a coating bath. We present three-dimensional (3D) two-phase flow simulations combining large eddy simulation (LES) and volume of fluid techniques. Three wiping configurations are simulated and the results are validated with experimental data from previous works. Multiscale modal analysis is used to analyze the dynamic interaction between the gas flow and the liquid film. In particular, we present a combination of multiscale Proper Orthogonal Decomposition (mPOD) and correlation analysis. The mPOD is used to identify the dominant traveling wave pattern in the liquid film flow, and the temporal structures are used to determine the most correlated flow features in the gas jet. This allows for revealing a two-dimensional mechanism for wave formation in the liquid coat. Finally, we use the numerical results to analyze the validity of some of the critical assumptions underpinning the derivation of integral film models of jet wiping.
An 18.3 MJ charging and discharging pulsed power supply system for the Space Plasma Environment Research Facility (SPERF): The subsystem for the magnetopause shape control coils
Authors: E Peng , Guan Jian , Jin Chenggang , Mao Aohua , Ma Xun , Deng Weijun , Ding Mingjun , Kang Chuanhui , Li Songjie , Xiao Jinshui , Tong Weiming , Li Hongtao
Published: June 2021

The Space Plasma Environment Research Facility currently under construction at the Harbin Institute of Technology in China uses four magnetosheath coils (flux cores) and a dipole coil to generate the magnetic field required for the study on the magnetopause magnetic reconnection. Two groups of magnetopause shape control coils (labeled CK coils) are used to slightly adjust the magnetic field distribution on the magnetopause. A capacitive pulsed power supply (PPS) system with a modular design is developed to excite CK coils. The PPS system consists of six sets of PPS with the same principle and structure, which are used to excite six sub-coils of the CK coils, respectively. Each set of PPS consists of ten modules and one local controller, and each module consists of a charger and discharge unit. Each set of PPS can provide a pulsed current of no less than 400 kA for the corresponding sub-coil at 0.11 ms when the charging voltage is 20 kV, and the duration of the pulsed current from the peak to 10% of the peak is no more than 0.6 ms. The detailed design of the PPS is discussed in this paper, and the discharge test of the PPS is carried out to verify the design of the PPS. Because there are acquisition and control devices in the discharge unit, the electromagnetic interference immunity design is also discussed to ensure the normal operation of the PPS.
Likelihood of implementing fuel reduction treatments on nonindustrial private forest lands
Authors: Shrestha Anusha , Grala Robert K. , Grado Stephen C. , Roberts Scott D. , Gordon Jason S.
Published: June 2021

Nonindustrial private forest (NIPF) landowners are a dominant forest landownership group in the south-eastern United States and play a crucial role in regular fuel management for effective landscape-level wildfire hazard reduction. However, little is known about their intentions to implement fuel reduction treatments in the future. This study estimated the likelihood that NIPF landowner will implement a fuel reduction treatment in the next 5 years using a binary logistic regression model. This likelihood was associated with landowner attitudes towards wildfires, forest landownership and socioeconomic characteristics, and forest location attributes. Approximately 30% of landowners were likely to implement a fuel reduction treatment and a majority were interested in treating pine plantations. Management of undesired vegetation, promotion of tree growth, wildlife habitat improvements and reduction of wildfire severity were primary motivations for implementing treatments. Past implementation of fuel reduction treatments, previous wildfire experiences, concern about wildfire-related property damage, familiarity with wildfire prevention programs, ecosystem service maintenance as an ownership objective, forest land area owned and implementation of fuel treatments by neighbouring landowners were positively associated with the likelihood of fuel reduction treatments. Findings will be helpful in developing more effective programs encouraging landowners to regularly treat hazardous fuels in their forests.
Identification of a novel hybrid zone within the black-footed rock-wallaby (
Authors: Eldridge Mark D. B. , Pearson David J. , Potter Sally
Published: June 2021

It is increasingly recognised that intertaxon hybridisation is more common in vertebrates than previously thought. However, recent hybridisation has rarely been reported from wild marsupials, with only three instances of first generation (F1) hybrids reported, all in macropodids. In the 1990s a chromosomally anomalous population of black-footed rock-wallaby (Petrogale lateralis) was identified in the Townsend Ridges in central eastern Western Australia. Individuals from this population had chromosomes characteristic of two P. lateralis subspecies (P. l. centralis and P. l. kimberleyensis). This unusual mixture is suggestive of a novel hybrid zone between subspecies, but it could also represent a P. l. centralis population in which a 9–10 chromosome fusion has independently arisen. To test between these hypotheses, we compared mitochondrial DNA Control Region (CR) sequence data from Townsend Ridges individuals to published data for all P. lateralis subspecies. Two divergent lineages of CR haplotypes were identified at Townsend Ridges, suggesting that it represents a novel rock-wallaby hybrid zone, the third reported in the genus. While one CR haplotype clustered with those typical of P. l. centralis, the other Townsend Ridges haplotypes clustered with those from three different P. lateralis subspecies but not with P. l. kimberleyensis. Additional studies with multiple nuclear genes will be necessary to fully understand the nature of this novel hybrid zone.
Foam film stratification studies probe intermicellar interactions
Authors: Ochoa Chrystian , Gao Shang , Srivastava Samanvaya , Sharma Vivek
Published: June 2021

Significance

Quantitative characterization of intermicellar distances and interactions requires the use of bespoke, expensive techniques like small angle X-ray or neutron scattering, surface force apparatus, and atomic force microscopy. Here, we utilize Interferometry Digital Imaging Optical Microscopy (IDIOM) protocols to characterize nanoscopic topographical changes and stepwise thinning in stratifying micellar foam films. We find that the step size equals the intermicellar distance obtained using small-angle X-ray scattering experiments on bulk solutions. Our direct comparison of these length-scales unequivocally supports the hydrodynamic mechanism for stratification based on thin-film equation and disjoining pressure computed using liquid-state theory. We envision that our contributions will inspire scientists to explore foam film studies as simple but effective methods for characterizing nanoscopic colloidal interactions and forces.
Assembly factors chaperone ribosomal RNA folding by isolating helical junctions that are prone to misfolding
Authors: Huang Haina , Karbstein Katrin
Published: June 2021

Significance

While RNAs are known to misfold, the causes of this remain unknown, especially for large RNAs. Similarly, how RNA chaperones promote native folding remains unclear. By studying 18S rRNA folding in yeast, we show that three-helix junctions are prone to misfolding. Furthermore, the data also show that assembly factors function as folding chaperones by isolating helical junctions, thereby allowing them to fold to the native state without interference from kinetic traps. Moreover, chaperones bind interaction partners, not the junctions themselves, thus acting indirectly. This local activity of chaperones contrasts with the role of protein chaperones which unfold the protein. These data provide insight into the folding of complex RNAs and show how chaperones function in RNA folding.
Single-cell analysis of the cellular heterogeneity and interactions in the injured mouse spinal cord
Authors: Milich Lindsay M. , Choi James S. , Ryan Christine , Cerqueira Susana R. , Benavides Sofia , Yahn Stephanie L. , Tsoulfas Pantelis , Lee Jae K.
Published: June 2021

The wound healing process that occurs after spinal cord injury is critical for maintaining tissue homeostasis and limiting tissue damage, but eventually results in a scar-like environment that is not conducive to regeneration and repair. A better understanding of this dichotomy is critical to developing effective therapeutics that target the appropriate pathobiology, but a major challenge has been the large cellular heterogeneity that results in immensely complex cellular interactions. In this study, we used single-cell RNA sequencing to assess virtually all cell types that comprise the mouse spinal cord injury site. In addition to discovering novel subpopulations, we used expression values of receptor–ligand pairs to identify signaling pathways that are predicted to regulate specific cellular interactions during angiogenesis, gliosis, and fibrosis. Our dataset is a valuable resource that provides novel mechanistic insight into the pathobiology of not only spinal cord injury but also other traumatic disorders of the CNS.
Doping effects on mechanical and thermodynamic properties of zirconium carbide systems: a first-principles study
Authors: Huang Shimin , Xu Shuang , Xu Yurong , Zhou Zixiang , Li Jun
Published: June 2021

Zirconium carbide (ZrCx) is an important high temperature structural material, whose wide engineering applications are limited by carbon vacancies. Doping various impurity elements (O, B, etc) into ZrCx may lead to a significant change in its mechanical properties and thermodynamic properties behaviors. In this paper, based on the density functional theory, the effects of carbon vacancy contents and dopant on mechanical properties and deformation behaviors of zirconium carbide were discussed. With the increase of the carbon vacancy contents, the Young’s modulus, bulk modulus, and shear modulus decrease gradually. When the tensile strain is greater than 0.4, ZrC0.75 has stronger plasticity than ZrC0.875, ZrC0.9375 and ZrC. Furthermore, the mechanical properties of ZrC, ZrC0.75O0.25, ZrC0.75B0.25 and ZrC0.75 were studied. Compared with ZrC0.75, the mechanical properties of ZrC0.75O0.25 and ZrC0.75B0.25 are improved, and the mechanical properties of the systems are improved the most by doping O atoms. Based on the quasi-harmonic approximation, the influence of doping atoms on thermodynamic properties of ZrC0.75O0.25, ZrC0.75B0.25 and ZrC0.75 was also investigated. Doping O and B atoms in ZrC0.75 can improve the thermal conductivity at high temperature, and ZrC0.75B0.25 has the highest thermal conductivity. The results also show that the thermal properties of ZrC0.75 can be improved by doping O and B atoms. With the increase of temperature, ZrC0.75O0.25 has the largest thermal expansion.
Kudla–Rapoport cycles and derivatives of local densities
Authors: Li Chao , Zhang Wei
Published: June 2021

We prove the local Kudla–Rapoport conjecture, which is a precise identity between the arithmetic intersection numbers of special cycles on unitary Rapoport–Zink spaces and the derivatives of local representation densities of hermitian forms. As a first application, we prove the global Kudla–Rapoport conjecture, which relates the arithmetic intersection numbers of special cycles on unitary Shimura varieties and the central derivatives of the Fourier coefficients of incoherent Eisenstein series. Combining previous results of Liu and Garcia–Sankaran, we also prove cases of the arithmetic Siegel–Weil formula in any dimension.
Voice-based screening for SARS-CoV-2 exposure in cardiovascular clinics
Authors: Sharma Abhinav , Oulousian Emily , Ni Jiayi , Lopes Renato , Cheng Matthew Pellan , Label Julie , Henriques Filipe , Lighter Claudia , Giannetti Nadia , Avram Robert
Published: June 2021

Aims

Artificial intelligence (A.I) driven voice-based assistants may facilitate data capture in clinical care and trials; however, the feasibility and accuracy of using such devices in a healthcare environment are unknown. We explored the feasibility of using the Amazon Alexa (‘Alexa’) A.I. voice-assistant to screen for risk factors or symptoms relating to SARS-CoV-2 exposure in quaternary care cardiovascular clinics.

Methods and results

We enrolled participants to be screened for signs and symptoms of SARS-CoV-2 exposure by a healthcare provider and then subsequently by the Alexa. Our primary outcome was interrater reliability of Alexa to healthcare provider screening using Cohen’s Kappa statistic. Participants rated the Alexa in a post-study survey (scale of 1 to 5 with 5 reflecting strongly agree). This study was approved by the McGill University Health Centre ethics board. We prospectively enrolled 215 participants. The mean age was 46 years [17.7 years standard deviation (SD)], 55% were female, and 31% were French speakers (others were English). In total, 645 screening questions were delivered by Alexa. The Alexa mis-identified one response. The simple and weighted Cohen’s kappa statistic between Alexa and healthcare provider screening was 0.989 [95% confidence interval (CI) 0.982–0.997] and 0.992 (955 CI 0.985–0.999), respectively. The participants gave an overall mean rating of 4.4 (out of 5, 0.9 SD).

Conclusion

Our study demonstrates the feasibility of an A.I. driven multilingual voice-based assistant to collect data in the context of SARS-CoV-2 exposure screening. Future studies integrating such devices in cardiovascular healthcare delivery and clinical trials are warranted.

Registration

https://clinicaltrials.gov/ct2/show/NCT04508972.
Low-dose rivaroxaban plus aspirin in older patients with peripheral artery disease undergoing acute limb revascularization: insights from the VOYAGER PAD trial
Authors: Krantz Mori J , Debus Sebastian E , Hsia Judith , Patel Manesh R , Anand Sonia S , Nehler Mark R , Hess Connie N , Capell Warren H , Bracken Taylor , Szarek Michael , Mátyás Lajos , Krievins Dainis K , Nault Patrice , Stefanov Stefan , Haskell Lloyd P , Berkowitz Scott D , Muehlhofer Eva , Hiatt William R , Bauersachs Rupert M , Bonaca Marc P
Published: June 2021

Aims

In this secondary analysis of the VOYAGER trial, rivaroxaban 2.5 mg twice/day plus aspirin 100 mg/day was assessed in older adults. Advanced age is associated with elevated bleeding risk and unfavourable net benefit for dual antiplatelet therapy in chronic coronary artery disease. The risk–benefit of low-dose rivaroxaban in patients ≥75 years with peripheral artery disease (PAD) after lower extremity revascularization (LER) has not been described.

Methods and results

The primary endpoint was a composite of acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke, or cardiovascular death. The principal safety outcome was thrombolysis in myocardial infarction (TIMI) major bleeding analysed by the pre-specified age cut-off of 75 years. Of 6564 patients randomized, 1330 (20%) were >75 years. Absolute 3-year Kaplan–Meier cumulative incidence rates for primary efficacy (23.4% vs. 19.0%) and safety (3.5% vs. 1.5%) endpoints were higher in elderly vs. non-elderly patients. Efficacy of rivaroxaban (P-interaction 0.83) and safety (P-interaction 0.38) was consistent irrespective of age. The combination of intracranial and fatal bleeding was not increased in patients >75 years (2 rivaroxaban vs. 8 placebo). Overall, benefits (absolute risk reduction 3.8%, number needed to treat 26 for the primary endpoint) exceeded risks (absolute risk increase 0.81%, number needed to harm 123 for TIMI major bleeding).

Conclusion

Patients ≥75 years with PAD are at both heightened ischaemic and bleeding risk after LER. No excess harm with respect to major, intracranial or fatal bleeding was seen in older patients yet numerically greater absolute benefits were observed. This suggests that low-dose rivaroxaban combined with aspirin should be considered in PAD after LER regardless of age.
Coming to consensus: the Delphi technique
Authors: Niederberger Marlen , Köberich Stefan ,   members of the DeWiss Network
Published: June 2021

Delphi techniques are used in health care and nursing to systematically bring together explicit and implicit knowledge from experts with a research or practical background, often with the goal of reaching a group consensus. Consensus standards and findings are important for promoting the exchange of information and ideas on an interdisciplinary and transdisciplinary basis, and for guaranteeing comparable procedures in diagnostic and therapeutic approaches. Yet, the development of consensus standards using Delphi techniques is challenging because it is dependent on the willingness of experts to participate and the statistical definition of consensus.
Asymptotics for 2D whispering gallery modes in optical micro-disks with radially varying index
Authors: Balac Stéphane , Dauge Monique , Moitier Zoïs
Published: June 2021

Whispering gallery modes [WGM] are resonant modes displaying special features: they concentrate along the boundary of the optical cavity at high polar frequencies and they are associated with complex scattering resonances very close to the real axis. As a classical simplification of the full Maxwell system, we consider 2D Helmholtz equations governing transverse electric or magnetic modes. Even in this 2D framework, very few results provide asymptotic expansion of WGM resonances at high polar frequency $m\to \infty $ for cavities with radially varying optical index. In this work, using a direct Schrödinger analogy, we highlight three typical behaviors in such optical micro-disks, depending on the sign of an ‘effective curvature’ that takes into account the radius of the disk and the values of the optical index and its derivative. Accordingly, this corresponds to abruptly varying effective potentials (step linear or step harmonic) or more classical harmonic potentials, leading to three distinct asymptotic expansions for ground state energies. Using multiscale expansions, we design a unified procedure to construct families of quasi-resonances and associate quasi-modes that have the WGM structure and satisfy eigenequations modulo a super-algebraically small residual ${\mathscr{O}}(m^{-\infty })$. We show using the black box scattering approach that quasi-resonances are ${\mathscr{O}}(m^{-\infty })$ close to true resonances.
Association between incidental statin use and skeletal myopathies in patients treated with immune checkpoint inhibitors
Authors: Drobni Zsofia D , Murphy Sean P , Alvi Raza M , Lee Charlotte , Gong Jingyi , Mosarla Ramya C , Rambarat Paula K , Hartmann Sarah B , Gilman Hannah K , Zubiri Leyre , Raghu Vineet K , Sullivan Ryan J , Zafar Amna , Zlotoff Daniel A , Sise Meghan E , Guidon Amanda C , Reynolds Kerry L , Dougan Michael , Neilan Tomas G
Published: June 2021

Objectives

Skeletal myopathies are highly morbid, and in rare cases even fatal, immune-related adverse events (irAE) associated with immune checkpoint inhibitors (ICI). Skeletal myopathies are also a recognized statin-associated side effect. It is unknown whether concurrent use of statins and ICIs increases the risk of skeletal myopathies.

Methods

This was a retrospective cohort study of all patients who were treated with an ICI at a single academic institution (Massachusetts General Hospital, Boston, MA, USA). The primary outcome of interest was the development of a skeletal myopathy. The secondary outcome of interest was an elevated creatine kinase level (above the upper limit of normal).

Results

Among 2757 patients, 861 (31.2%) were treated with a statin at the time of ICI start. Statin users were older, more likely to be male and had a higher prevalence of cardiovascular and non-cardiovascular co-morbidities. During a median follow-up of 194 days (inter quartile range 65–410), a skeletal myopathy occurred in 33 patients (1.2%) and was more common among statin users (2.7 vs. 0.9%, P < 0.001). Creatine kinase (CK) elevation was present in 16.3% (114/699) and was higher among statin users (20.0 vs. 14.3%, P = 0.067). In a multivariable Cox model, statin therapy was associated with a >2-fold higher risk for skeletal myopathy (HR, 2.19; 95% confidence interval, 1.07–4.50; P = 0.033).

Conclusion

In this large cohort of ICI-treated patients, a higher risk was observed for skeletal myopathies and elevation in CK levels in patients undergoing concurrent statin therapy. Prospective observational studies are warranted to further elucidate the potential association between statin use and ICI-associated myopathies.
Phenotypes of engagement with mobile health technology for heart rhythm monitoring
Authors: Lee Jihui , Turchioe Meghan Reading , Creber Ruth Masterson , Biviano Angelo , Hickey Kathleen , Bakken Suzanne
Published: June 2021

Objectives

Guided by the concept of digital phenotypes, the objective of this study was to identify engagement phenotypes among individuals with atrial fibrillation (AF) using mobile health (mHealth) technology for 6 months.

Materials and Methods

We conducted a secondary analysis of mHealth data, surveys, and clinical records collected by participants using mHealth in a clinical trial. Patterns of participants’ weekly use over 6 months were analyzed to identify engagement phenotypes via latent growth mixture model (LGMM). Multinomial logistic regression models were fitted to compute the effects of predictors on LGMM classes.

Results

One hundred twenty-eight participants (mean age 61.9 years, 75.8% male) were included in the analysis. Application of LGMM identified 4 distinct engagement phenotypes: “High-High,” “Moderate-Moderate,” “High-Low,” and “Moderate-Low.” In multinomial models, older age, less frequent afternoon mHealth use, shorter intervals between mHealth use, more AF episodes measured directly with mHealth, and lower left ventricular ejection fraction were more strongly associated with the High-High phenotype compared to the Moderate-Low phenotype (reference). Older age, more palpitations, and a history of stroke or transient ischemic attack were more strongly associated with the Moderate-Moderate phenotype compared to the reference.

Discussion

Engagement phenotypes provide a nuanced characterization of how individuals engage with mHealth over time, and which individuals are more likely to be highly engaged users.

Conclusion

This study demonstrates that engagement phenotypes are valuable in understanding and possibly intervening upon engagement within a population, and also suggests that engagement is an important variable to be considered in digital phenotyping work more broadly.
Small bowel obstruction due to a congenital adhesion: a rare case report
Authors: Tepelenis Kostas , Stefanou Stefanos K , Stefanou Christos K , Tepelenis Nikolaos , Margariti Persefoni , Christopoulou Amalia , Gogos-Pappas George , Vlachos Konstantinos
Published: June 2021

The exact incidence of small bowel obstruction (SBO) due to congenital adhesions remains unclear. Herein, we report a 59-year-old male who appeared in the emergency department with diffuse abdominal pain associated with vomiting. The patient reported no previous medical or surgical history. Clinical examination revealed a soft, distended abdomen and diffuse tenderness. Computed tomography indicated a close loop obstruction. A congenital band extending from mesentery to ileum and causing an internal hernia was identified via a midline incision. The band was ligated and divided. There is no difference in the clinical presentation, and the initial work-up of SBO on account of congenital adhesions was compared to other bowel obstruction causes. Surgical exploration is crucial for the diagnosis and treatment of congenital adhesions. Although laparotomy is considered the cornerstone of surgical management, laparoscopy has emerged as a feasible and safe alternative for the diagnosis and treatment of these congenital bands.
Rare appendiceal escapades in childhood: the Grande experience!
Authors: Shrestha Ashish Lal , Adhikari Govinda , Kattel Gaurav , Amatya Manim
Published: June 2021

Acute appendicitis in children is known to present in two broad forms: (1) uncomplicated and (2) complicated. Apart from this, a variety of atypical presentations can occur that may pose difficulty in diagnosis or treatment approach. We hereby present a series of such rare experiences namely appendiceal oxyuriasis, sub-hepatic appendicitis and appendiceal mucocele that were encountered and managed accordingly.
Principles of Medical Professionalism
Authors: Merlo Gia
Published: June 2021

Principles of Medical Professionalism will inform both future physicians and current practitioners that being a medical professional is not about being perfect, but rather about being human and recognizing our own limitations. The reader can therefore learn to manage their expectations about the profession while becoming more resilient to disruptions in the medical field such as artificial intelligence and the changing patient–doctor relationship. This book takes into consideration challenges to the uniform integration of a formal medical professionalism curriculum and addresses the critical need for support of practitioners’ professional development and identity formation throughout the various stages and transitions in their medical career. Overall, each chapter of this book aims to challenge the reader to engage in a process of self-reflection using the framework of the Gibb’s reflective cycle and provides health professionals of all levels with practical tools and techniques that will allow them to become more competent caregivers and leaders in their field. Indeed, the ultimate goal of the book is to encourage a medical educational framework supporting personal and professional transformation that may lead to more resilient and happier physicians. Thus, physicians may be better equipped to attend to the tasks of patient care that incorporate attention to healing, caring, and, compassion, while upholding their duty to serve the patient and society.