bluuebunny/crossref_metadata_2025 huggingface dataset:
Power dynamics in families affected by parental alienation
Authors: Harman Jennifer J. , Maniotes Christopher R. , Grubb Caitlyn
Published: June 2021

The purpose of this study was to apply interdependence theory to understand the power dynamics in families affected by parental alienation. We hypothesized that the power dynamics between alienating and alienated parents are imbalanced such that this form of family violence (Harman et al., 2018) more closely resembles intimate terrorism than situational couple violence, where power dynamics are more similar between partners. We also hypothesized that shared parenting custodial arrangements would afford more power to targeted parents than unequal parenting plans and provide them with more opportunities for action. A qualitative analysis of transcripts from interviews with targeted parents of alienating behaviors (n = 79) using interdependence theory as a framework found support for our hypotheses: most situations described by parents were of asymmetric dependence, with power concentrated almost exclusively with the alienating parent, and/or were direct challenges made by the alienating parent to gain control over their children and the targeted parent. In addition, the proportion of situations in which asymmetries in power were described was highest when the alienating parent had primary or sole custody of the children. Discussion focuses on the need to better understand and consider the role of power in the assessment of parental alienation so that appropriate and effective interventions may be implemented to protect children and their family members.
Switching between newly learned languages impacts executive control
Authors: Jiao Lu , Liu Cong , Schwieter John W. , Chen Baoguo
Published: June 2021

Previous research has explored the relationship between language control and executive control based on performance in bilinguals' skilled languages. However, this relationship between bilingualism and executive control has not been examined at the very initial stage of language learning. In the present study, we trained Chinese speakers to learn words in German and Japanese, two languages with which they had no prior experience. In pre‐ and post‐training, we measured participants' electrophysiological data to investigate how switching between these two newly learned languages affected executive control. We observed that, while lacking the language switching effect in the behavioral data, a flanker task elicited larger N2 and P3 amplitudes in the post‐training session when participants were required to switch between German and Japanese compared to when they responded to only German or Japanese. These results provided evidence of language control of newly learned languages on domain‐general executive control, specifically at the (very) initial period of language learning. Our findings support the adaptive nature of the relationship between bilingual language control and executive control.
Radiation of waves by a submerged nearly circular rough plate in ice‐covered ocean
Authors: Das Arijit , De Soumen , Mandal B. N.
Published: June 2021

A rough nearly circular (and/or circular) plate submerged in some ice‐covered ocean is undergoing a heaving motion. This radiation problem is reduced to a hypersingular integral equation over the surface of the rough plate. Perturbation method further simplifies the governing equation to get a system of hypersingular integral equations. The geometry of nearly circular plate has been conformally mapped onto a unit disc and the modified equations have been solved by a spectral method proved to be efficient for the case of a circular disc. Both rough disc and rough nearly circular plate have been considered for the numerical results. The effects of the flexural rigidity of ice cover and submergence depth of the plate on added mass and damping coefficient have been investigated along with the effect of roughness of the plate on these hydrodynamic coefficients.
Characterizing the determinants of sexual dissatisfaction among heterosexuals: The specific role of dyadic coping
Authors: Wawrziczny Emilie , Nandrino Jean‐Louis , Constant Emilie , Doba Karyn
Published: June 2021

Sexual satisfaction is the most frequently studied sexual component of human sexuality related to its link with relationship satisfaction and stability (S. Sprecher & R. M. Cate, 2004. The handbook of sexuality in close relationships, pp. 235–256. Mahwah, NJ: Taylor & Francis). Previous studies have shown that sexual satisfaction is affected by personal, interpersonal, social and cultural variables, but few studies have considered the associations between these variables. The aim of this study was to evaluate a complex model of sexual satisfaction considering these various levels of variables and their associations. The study was conducted online and comprised 457 individuals in the final sample. The French version of the index of sexual satisfaction evaluated the level of sexual dissatisfaction. Personal, interpersonal, social and cultural variables were assessed with questionnaires and their associations were investigated with the partial least squares‐path method. The association between dyadic coping (positive and negative) and sexual dissatisfaction was mediated by relationship satisfaction. The model also showed three sequential mediations through dyadic coping and relationship satisfaction: first between intra‐individual vulnerability and sexual dissatisfaction, second between intra‐individual resources and sexual dissatisfaction, and third between conjugal characteristics and sexual dissatisfaction. The simple and sequential mediations were stronger for positive dyadic coping. The relationship between intra‐individual resources and positive dyadic coping was significantly stronger in women, while the relationship between conjugal characteristics and positive dyadic coping was stronger in men. Dyadic coping plays a key role in sexual dissatisfaction. Clinical interventions should reinforce positive self‐image (particularly in women), support emotional and physical vulnerabilities, and promote more supportive dyadic coping (particularly in men in a long‐term relationship).
Goodness‐of‐fit tests for Poisson count time series based on the Stein–Chen identity
Authors: Aleksandrov Boris , Weiß Christian H. , Jentsch Carsten
Published: June 2021

To test the null hypothesis of a Poisson marginal distribution, test statistics based on the Stein–Chen identity are proposed. For a wide class of Poisson count time series, the asymptotic distribution of different types of Stein–Chen statistics is derived, also if multiple statistics are jointly applied. The performance of the tests is analyzed with simulations, as well as the question which Stein–Chen functions should be used for which alternative. Illustrative data examples are presented, and possible extensions of the novel Stein–Chen approach are discussed as well.
Multilevel population and socioeconomic variation in health insurance coverage in India
Authors: Khan Pijush Kanti , Perkins Jessica M. , Kim Rockli , Mohanty Sanjay K. , Subramanian Sankaran V.
Published: June 2021

Objectives

This study explores population‐level variation in different types of health insurance coverage in India. We aimed to estimate the extent to which contextual factors at community, district, and state levels may contribute to place‐based inequalities in coverage after accounting for household‐level socioeconomic factors.

Methods

We used data from the 2015–2016 National Family Health Survey in India, which provides the most recent and comprehensive information available on reports of different types of household health insurance coverage. We used multilevel regression models to estimate the relative contribution of different population levels to variation in coverage by national, state, and private health insurance schemes.

Results

Among 601,509 households in India, 29% reported having coverage in 2015–2016. Variation in each type of coverage existed between population levels before and after adjusting for differences in the distribution of household socioeconomic and demographic factors. For example, the state level accounted for 36% of variation in national scheme coverage and 41% of variation in state scheme coverage after adjusting for household characteristics. In contrast, the community level was the largest contextual source of variation in private insurance coverage (accounting for 24%). Each type of coverage was associated with higher socioeconomic status and urban location.

Conclusions

Contextual factors at community, district, and state levels contribute to variation in household health insurance coverage even after accounting for socioeconomic and demographic factors. Opportunities exist to reduce disparities in coverage by focusing on drivers of place‐based differences at multiple population levels. Future research should assess whether new insurance schemes exacerbate or reduce place‐based disparities in coverage.
The immune components ENHANCED DISEASE SUSCEPTIBILITY 1 and PHYTOALEXIN DEFICIENT 4 are required for cell death caused by overaccumulation of ceramides in Arabidopsis
Authors: Zeng Hong‐Yun , Liu Yu , Chen Ding‐Kang , Bao He‐Nan , Huang Li‐Qun , Yin Jian , Chen Yi‐Li , Xiao Shi , Yao Nan
Published: June 2021

Sphingolipids have key functions in plant membrane structure and signaling. Perturbations of plant sphingolipid metabolism often induce cell death and salicylic acid (SA) accumulation; SA accumulation, in turn, promotes sphingolipid metabolism and further cell death. However, the underlying molecular mechanisms remain unclear. Here, we show that the Arabidopsis thaliana lipase‐like protein ENHANCED DISEASE SUSCEPTIBILITY 1 (EDS1) and its partner PHYTOALEXIN DEFICIENT 4 (PAD4) participate in sphingolipid metabolism and associated cell death. The accelerated cell death 5 (acd5) mutants accumulate ceramides due to a defect in ceramide kinase and show spontaneous cell death. Loss of function of EDS1, PAD4 or SALICYLIC ACID INDUCTION DEFICIENT 2 (SID2) in the acd5 background suppressed the acd5 cell death phenotype and prevented ceramide accumulation. Treatment with the SA analogue benzothiadiazole partially restored sphingolipid accumulation in the acd5 pad4 and acd5 eds1 double mutants, showing that the inhibitory effect of the pad4‐1 and eds1‐2 mutations on acd5‐conferred sphingolipid accumulation partly depends on SA. Moreover, the pad4‐1 and eds1‐2 mutations substantially rescued the susceptibility of the acd5 mutant to Botrytis cinerea. Consistent with this, B. cinerea‐induced ceramide accumulation requires PAD4 or EDS1. Finally, examination of plants overexpressing the ceramide synthase gene LAG1 HOMOLOGUE2 suggested that EDS1, PAD4 and SA are involved in long‐chain ceramide metabolism and ceramide‐associated cell death. Collectively, our observations reveal that EDS1 and PAD4 mediate ceramide (especially long‐chain ceramide) metabolism and associated cell death, by SA‐dependent and SA‐independent pathways.
Mesophyll conductance variability of rice aquaporin knockout lines at different growth stages and growing environments
Authors: Huang Xianhong , Wang Zhixin , Huang Jianliang , Peng Shaobing , Xiong Dongliang
Published: June 2021

The plasma membrane subfamily of aquaporins [plasma membrane intrinsic proteins (PIPs)], which facilitates the CO2 diffusion across membranes, is proposed to play an important role in mesophyll conductance to CO2 (gm), a major limiting factor of photosynthesis. However, recent studies implied no causal relationship between gm and PIPs because they failed to repeat the previous observed differences in gm between PIP knockout lines and their wild‐type. The contrasting results on the role of PIPs in gm were interpreted as the different growth conditions among studies, which has never been tested. Here, we assessed whether the differences in gm between wild‐type and PIP knockout lines, Ospip1;1, Ospip1;2 and Ospip2;1, varied with growth condition (field versus pot condition) and growth stages in rice. Under field conditions, no differences were observed in plant performance, photosynthetic rate (A) and gm between PIP knockout lines and the wild‐type. However, in agreement with previous studies, two out of three knockout lines showed significant declines in tiller number, plant height, A and gm under pot conditions. Moreover, we found that the differences in A and gm between PIP knockout lines and the wild‐type varied with the growth stage of the plants. Our results showed that the differences in gm between PIP knockout lines and wild‐type were depending on the growth environments and stage of the plants, and further efforts are required to reveal the underlying mechanisms.
Multilingual legal practice and law student internships in Malaysia
Authors: Powell Richard , Saw Tiong Guan
Published: June 2021

Mediated through hierarchical domestic institutions and a global system of jurisprudence that tends to view older jurisdictions as more authentic or authoritative legal sources, the language of common law is seldom explored through a world Englishes lens, but Malaysian law has opened up possibilities for indigenised and pluricentric common law by its use of Malay alongside English. While some studies have examined bilingualism in Malaysian public courtrooms, few have looked into the less accessible spaces of law office practice. This study investigates bilingual legal practice through the experiences of law students undertaking professional internships at various institutions nationwide. Although some sectors lean toward one language more than the other, most students reported intense and dynamic patterns of bilingualism. The findings offer scope for research specifically into Malaysian legal English from a language contact perspective.
Development of an Ontology-Based Visual Approach for Property Data Analytics
Authors: Janet Ge Xin , Zhang Jinson
Published: June 2021

Real estate is a complex market that consists of many layers of social, financial, and economic data, including but not limited to price, rental, location, mortgage, demographic and housing supply data. The sheer number of real estate properties around the world means that property transactions produce an extraordinary amount of data that is increasing exponentially. Most of the data are presented through thousands of rows on a spreadsheet or described in long paragraphs that are difficult to understand. The emergent data visualization techniques are intended to allow data to be processed and analytics to be displayed visually to enable an understanding of complex information and the identification of new patterns from the data. However, not all visualization techniques can achieve such a thing. Most techniques are able to display only visual low-dimensional data. This paper introduces an ontology visualisation methodology to explore the ontologies of property data behaviour for multidimensional data. The visualisation combines real estate data statistical analysis with several high dimensional data visualisation techniques, including parallel coordinates and stacked area charts. By using six residential suburbs in Sydney as a demonstration, we find that the developed data visualisation methodology can be applied effectively and efficiently to analyse complex real estate market behaviour patterns.
Sustainable Construction Projects: The Level of Understanding on Leadership Skills among Project Managers
Authors: Ahmad Latiffi Aryani , Zulkiffli Noorul Adharina
Published: June 2021

A project manager is a crucial factor of a project's success, especially in sustainable construction projects. Their role as a leader is also observable with regard to achieving sustainability objectives in sustainable construction projects. In contrast to conventional projects, sustainable construction projects face more nuanced issues. The influence of leadership skills of the project managers is therefore becoming essential for the success of sustainable construction projects. This study examines the level of understanding of leadership skills among project managers in sustainable construction projects and determines the correlation between their experience and understanding of leadership skills. A questionnaire survey was carried out among 153 project managers with experience in the management of sustainable construction projects in Malaysia. The IBM SPSS software version 24 was used to perform a descriptive statistic, a normality test, and a Spearman's correlation test on the data collected. The results indicate a very high level of understanding among project managers regarding leadership skills in sustainable construction projects. Apart from that, there is a positive correlation between years of experience in sustainable construction projects and the level of understanding of leadership skills among project managers in sustainable construction projects. The findings of this research will serve as an avenue for future researchers to identify the necessary leadership skills for project managers to manage sustainable construction projects effectively.
The Value of Fathering for Incarcerated Offenders: Implementing the “Parents as Teachers” Curriculum in Greene County, Missouri
Authors: Hass-Wisecup Aida , Kenny Erin , Adams-Derousse Kayleb
Published: June 2021

Research literature demonstrates the positive contributions of a nurturing father in the lives of young people as well as the reduction of recidivism for active fathers. The current study provides support for this model by highlighting the need for programming that enhances the relationship between incarcerated fathers and their children during their period of absence and while transitioning back into society and their family roles. The authors observed a parenting education program for incarcerated fathers twice weekly for a period of twelve weeks. The research noted three promising themes in the programming which could be expanded and implemented in other facilities. Fathers sought to improve their capacity to engage in “intentional conversations,” where they learned about modeling desirable behavior, being honest, and avoiding giving children mixed messages. Fathers also began the uncomfortable process of unpacking their own childhoods and overcoming poor parental models as they realized that “parenting makes a difference.” Through the program, fathers were encouraged to develop a “toolkit” of more positive parenting responsibilities and responses. Finally, fathers were introduced to the idea of “healthy relationships,” including creating strong boundaries and new types of relationship knowledge.
The distribution of the maximum of partial sums of Kloosterman sums and other trace functions
Authors: Autissier Pascal , Bonolis Dante , Lamzouri Youness
Published: June 2021

In this paper, we investigate the distribution of the maximum of partial sums of families of $m$-periodic complex-valued functions satisfying certain conditions. We obtain precise uniform estimates for the distribution function of this maximum in a near-optimal range. Our results apply to partial sums of Kloosterman sums and other families of $\ell$-adic trace functions, and are as strong as those obtained by Bober, Goldmakher, Granville and Koukoulopoulos for character sums. In particular, we improve on the recent work of the third author for Birch sums. However, unlike character sums, we are able to construct families of $m$-periodic complex-valued functions which satisfy our conditions, but for which the Pólya–Vinogradov inequality is sharp.
Prediction of Yield Strength of Selective Laser Melted Ti–6Al–4V Alloy Using Melt Pool Geometry
Authors: Mahdavi Mostafa , Liang Steven , Garmestani Hamid
Published: June 2021

Additive manufacturing (AM) method has attracted huge interest in the past decade due to its ability in building complicated geometries with a much lower cost than conventionally produced parts. In AM, the final mechanical properties can be controlled by the AM process parameters. In other words, the AM process parameters control the amount of energy that is transferred into the powder and consequently the resulting microstructure. In this study, the correlation between melt pool geometry and mechanical properties of selective laser melted (SLM) Ti–6Al–4V samples is investigated.
Derivation and Experimental Validation of the Equations of Motion of Magnetic Pendulums
Authors: Saeidi Hosseini R. S. , Heppler G. R. , Abdel-Rahman E.
Published: June 2021

A series of coaxial magnetic pendulums is studied as a simple physical surrogate for more general nonlinearly coupled almost-identical resonators that arise in quantum communications and the dynamics of social networks. The equations of motion for a series of coaxial magnetic pendulums are derived, and the solution is compared to experimental results. The equilibrium points and their stability are also determined.
A Simplified Fractional Order Modeling and Parameter Identification for Lithium-Ion Batteries
Authors: Liu Zheng , Qiu Yuan , Feng Jin , Chen Shaohang , Yang Chunshan
Published: June 2021

With the widespread development of new energy, the study of power lithium-ion batteries (LIBs) has broad prospects and great academic significance. The model and parameters are two essential prerequisites for LIB state estimation, which are used to provide a guarantee for the secure and convenient handling of LIBs. To obtain the reliable model and parameters, a simplified fractional order equivalent circuit model (FO-ECM) with high precision is presented in this article. The dynamic external electrical characteristic of LIBs is represented by the one-order FO-ECM, and then, the FO-ECM parameters are identified by the combination of Grunwald–Letnikov (G-L) definition-based factional order numerical calculation and noise compensation-based forgetting factor recursive least squares (FFRLS) method. The simplified FO-ECM can better characterize the nonlinear dynamic behaviors of LIBs, and the G-L definition-based FO-FFRLS algorithm can maintain good accuracy in the parameter estimation process. The results show that the simplified FO-ECM can improve the modeling precision and parameter identification performance compared with the common integer-order ECM in different test cycles.
Automatic Reservoir Model Identification Method based on Convolutional Neural Network
Authors: Liu Xuliang , Zha Wenshu , Qi Zhankui , Li Daolun , Xing Yan , He Lei
Published: June 2021

Well test analysis is a crucial technique to monitor reservoir performance, which is based on the theory of seepage mechanics, through the study of well test data, to identify reservoir models and estimate reservoir parameters. Reservoir model recognition is the first and essential step of well test analysis. It is usually judged by professionals’ experience, which results in low efficiency and accuracy. This paper is devoted to applying convolutional neural network (CNN) to well test analysis and proposes a new intelligent reservoir model identification method. Eight reservoir models studied in this paper include homogenous reservoirs with different outer boundaries such as infinite acting boundary, circular, single, angular, channel, U-shaped and rectangular sealing fault boundaries, and a radial composite reservoir with infinite acting boundary. Well testing data used in this paper, including actual field data and theoretical data, are generated by analytical solutions. To improve the classification accuracy of actual field data, noise processing was carried out on the data before training. The CNN that is most suitable for model recognition has been obtained through trial-and-error procedures. The availability of proposed CNN is proved with actual field cases of Daqing oil field, China. The method realizes the automatic identification of reservoir model with the total classification accuracy (TCA) of test data set of 98.68% and 95.18% for original data and noisy data, respectively.
Machine Learning Integration With Combustion Physics to Develop a Composite Predictive Model for Reactivity Controlled Compression Ignition Engine
Authors: Mishra Chinmaya , Subbarao P. M. V.
Published: June 2021

Phasing of combustion metrics close to the optimum values across operation range is necessary to avail benefits of reactivity controlled compression ignition (RCCI) engines. Parameters like start of combustion occurrence crank angle (CA) (θsoc), occurrence of burn rate fraction reaching 50% (θ50), mean effective pressure from indicator diagram (IMEP), etc. are described as combustion metrics. These metrics act as markers for the macroscopic state of combustion. Control of these metrics in RCCI engine is relatively complex due to the nature of ignition. As direct combustion control is challenging, alternative methods like combustion physics-derived models are a subject of research interest. In this work, a composite predictive model was proposed by integrating trained random forest (RF) machine learning and artificial neural networks (ANNs) to combustion physics-derived modified Livengood–Wu integral, parametrized double-Wiebe function, autoignition front propagation speed-based correlations, and residual gas fraction model. The RF machine learning established a correlative relationship between physics-based model coefficients and engine operating condition. The ANN developed a similar correlation between residual gas fraction parameters and engine operating condition. The composite model was deployed for the predictions of θsoc, θ50, and IMEP as RCCI engine combustion metrics. Experimental validation showed an error standard deviation (σ68.3,err) of 0.67°CA, 1.19°CA, 0.223 bar and symmetric mean absolute percentage error of 6.92%, 7.87%, and 4.01% for the predictions of θsoc, θ50, and IMEP, respectively, on cycle to cycle basis. Wide range applicability, lesser experiments for model calibration, low computational costs, and utility for control applications were the benefits of the proposed predictive model.
Study on Tribological Behavior of Zinc Phosphate Impregnated Graphite Under Oil Lubrication Condition
Authors: Chen Jianhang , Gao Siyang , Wang Peng , Xue Weihai , Li Shu , Duan Deli
Published: June 2021

The tribological behavior of zinc phosphate impregnated graphite (ZPIG) against nickel-based superalloy (GH4169) in oil environment was investigated, and the lubrication and wear mechanism were also determined in this study. Tribological tests were run under different tribological conditions using a ring-on-disk device. The results showed that, under any load conditions, zinc phosphate impregnated graphite had the lowest coefficient of friction (COF) and wear-rate at 200 rpm. Under the identical rotating speed condition, the minimum coefficient of friction and wear-rate were obtained when the load was 500 N and 1000 N. The lubrication mechanism, which could be reflected by the transfer layer of friction counterpart, was related to the coefficient of friction, wear-rate, and oil temperature to affect contact characteristics of two solid surfaces and formation ability of liquid film. The wear mechanism of zinc phosphate impregnated graphite under oil lubrication conditions was dominated by abrasive wear and material removal was achieved through the fracture mechanism.
Real-Time Image-Based Feedback Control of Laser Powder Bed Fusion
Authors: Shkoruta Aleksandr , Mishra Sandipan , Rock Stephen J.
Published: June 2021

This letter presents the design and experimental validation of a real-time image-based feedback control system for metal laser powder bed fusion (LPBF). A coaxial melt pool video stream is used to control laser power in real-time at 2 kHz. Modeling of the melt pool image response to changes in the input laser power is presented. Based on this identified model, a real-time feedback controller is implemented experimentally on a single track and part scales. On a single-track scale, the controller successfully tracks a time-varying melt pool reference. On a part-level scale, the controller successfully regulates the melt pool image signature to the desired reference value, reducing layer-to-layer signal variation and eliminating within-layer signal drift.
A Study on Using Image-Based Machine Learning Methods to Develop Surrogate Models of Stamp Forming Simulations
Authors: Zhou Haosu , Xu Qingfeng , Nie Zhenguo , Li Nan
Published: June 2021

In design for forming, it is becoming increasingly significant to develop surrogate models of high-fidelity finite element analysis (FEA) simulations of forming processes to achieve effective component feasibility assessment as well as process and component optimizations. However, surrogate models using traditional scalar-based machine learning methods (SBMLMs) fall short on accuracy and generalizability. This is because SBMLMs fail to harness the location information available from the simulations. To overcome this shortcoming, the theoretical feasibility and practical advantages of innovatively applying image-based machine learning methods (IBMLMs) in developing surrogate models of sheet stamp forming simulations are explored in this study. To demonstrate the advantages of IBMLMs, the effect of the location information on both design variables and simulated physical fields is first proposed and analyzed. Based on a sheet steel stamping case study, a Res-SE-U-Net IBMLM surrogate model of stamping simulations is then developed and compared with a baseline multilayer perceptron (MLP) SBMLM surrogate model. The results show that the IBMLM model is advantageous over the MLP SBMLM model in accuracy, generalizability, robustness, and informativeness. This article presents a promising methodology in leveraging IBMLMs as surrogate models to make maximum use of information from stamp forming FEA results. Future prospective studies that are inspired by this article are also discussed.
Local Application of Vancomycin in One-Stage Revision of Prosthetic Joint Infection Caused by Methicillin-Resistant Staphylococcus aureus
Authors: Wei Jian , Wen Yinxian , Tong Kai , Wang Hui , Chen Liaobin
Published: June 2021

The rate of eradication of periprosthetic joint infection (PJI) caused by methicillin-resistant
Staphylococcus aureus
(MRSA) is still not satisfactory with systemic vancomycin administration after one-stage revision arthroplasty. This study aimed to explore the effectiveness and safety of intraarticular (IA) injection of vancomycin in the control of MRSA PJI after one-stage revision surgery in a rat model.
Surviving Serum: the Escherichia coli
iss
Gene of Extraintestinal Pathogenic E. coli Is Required for the Synthesis of Group 4 Capsule
Authors: Biran Dvora , Sura Thomas , Otto Andreas , Yair Yael , Becher Dörte , Ron Eliora Z.
Published: June 2021

Extraintestinal pathogenic
Escherichia coli
(ExPEC) strains constitute a serious and emerging clinical problem, as they cause a variety of infections and are usually highly antibiotic resistant. Many ExPEC strains are capable of evading the bactericidal effects of serum and causing sepsis.
New Types of Three-Dimensional Vortices in the Heisenberg Model
Authors: Borisov A. B. , Dolgikh D. V.
Published: June 2021

The Heisenberg model for an isotropic magnet is considered in this work. A substitution that reduces the corresponding equations to equations with a simpler geometric interpretation is applied. One of the solutions of the latter describes a new magnetic structure comprised of two straight intersecting vortex filaments, which change the topological charge after intersection.
Life-threatening bronchopulmonary dysplasia: a British Paediatric Surveillance Unit Study
Authors: Naples Rebecca , Ramaiah Sridhar , Rankin Judith , Berrington Janet , Harigopal Sundeep
Published: June 2021

Objectives

To assess the minimum incidence of life-threatening bronchopulmonary dysplasia (BPD), defined as need for positive pressure respiratory support or pulmonary vasodilators at 38 weeks corrected gestational age (CGA), in infants born <32 weeks gestation in the UK and Ireland; and to describe patient characteristics, management and outcomes to 1 year.

Methods

Prospective national surveillance study performed via the British Paediatric Surveillance Unit from June 2017 to July 2018. Data were collected in a series of three questionnaires from notification to 1 year of age.

Results

153 notifications met the case definition, giving a minimum incidence of 13.9 (95% CI: 11.8 to 16.3) per 1000 live births <32 weeks’ gestation. Median gestation was 26.1 (IQR 24.6–28) weeks, and birth weight 730 g (IQR 620–910 g). More affected infants were male (95 of 153, 62%; p<0.05). Detailed management and outcome data were provided for 94 infants. Fifteen died at median age 159 days (IQR 105–182) or 49.6 weeks CGA (IQR 43–53). Median age last receiving invasive ventilation was 50 days (IQR 22–98) and total duration of pressure support for surviving infants 103 (IQR 87–134) days. Fifty-seven (60.6%) received postnatal steroids and 22 (23.4%) pulmonary vasodilators. Death (16%) and/or major neurodevelopmental impairment (37.3%) or long-term ventilation (23.4%) were significantly associated with need for invasive ventilation near term and pulmonary hypertension.

Conclusions

This definition of life-threatening BPD identified an extremely high-risk subgroup, associated with serious morbidity and mortality. Wide variability in management was demonstrated, and future prospective study, particularly in key areas of postnatal steroid use and pulmonary hypertension management, is required.
Bilious mask: parasite masquerading as malignant gall bladder polyp
Authors: Philip Chinnu Mariam , Eapen Malini , S Sudhindran
Published: June 2021

A 31-year-old woman, presenting with right upper quadrant pain, was suspected to have malignant gall bladder polyp based on MRI and CT scan findings. She underwent radical cholecystectomy with excision of bile duct and hepaticojejunostomy. Surprisingly, histology revealed parasitic remnants within the bile duct wall with no evidence of malignancy. A year later, this young woman suffers significant impairment of quality of life, perhaps an aftermath to the radicality of the surgery. Our case demonstrates a masquerade of ‘malignant biliary polyp’ by a parasite. This raises the need for extensive investigations such as endoscopic ultrasound guided biopsies, parasitic serology and positron emission tomography (PET) scans when patients present with probable malignant biliary lesions, even in difficult-to-access areas. A preoperative diagnosis might have averted an unnecessary major surgery in this young woman.
Outcomes of eyes with retinal vein occlusion that are lost to follow-up after antivascular endothelial growth factor therapy
Authors: Salabati Mirataollah , Mahmoudzadeh Raziyeh , Wong Jae-Chiang , Patel Dillan , Patel Samir N , Obeid Anthony , Sivalingam Arunan , Vander James F , Garg Sunir J , Ho Allen C , Regillo Carl D , Hsu Jason
Published: June 2021

Background/aims

To evaluate the outcomes of eyes with macular oedema due to retinal vein occlusion (RVO) that are lost to follow-up (LTFU) after antivascular endothelial growth factor (VEGF) injections.

Method

A retrospective, single-centre, consecutive case series of RVO patients receiving injections who were LTFU >6 months was conducted. Data were collected from the visit before LTFU; return visit; 3 months, 6 months and 12 months after return; and the final visit.

Results

Ninety eyes of 83 patients were included. Fifty (55.5%) eyes had branch RVO and 40 (44.5%) had central RVO. Mean LTFU duration was 277.8 days with additional mean follow-up for 748.1 days after return. Mean logarithm of the minimum angle of resolution visual acuity (VA) (Snellen) at the visit before LTFU was 0.72 (20/105) which worsened on return [1.04 (20/219), p<0.001) and remained worse at all timepoints after return: 0.92 (20/166) at 3 months (p<0.001), 0.97 (20/187) at 6 months (p<0.001), 0.94 (20/174) at 12 months (p<0.001) and 1.01 (20/205) at final visit (p<0.001). Mean central foveal thickness (CFT) increased from 252 µm at the visit before LTFU to 396 µm at the return visit (p<0.001). No difference in CFT was noted by 3 months (258 µm, p=0.71), 6 months (241 µm, p=0.54) or 12 months after return (250 µm, p=0.95). CFT was thinner at the final visit (215 µm, p=0.018).

Conclusion

RVO patients receiving anti-VEGF injections who were LTFU experienced a decline in VA that did not return to the levels seen before LTFU despite improvement in CFT after restarting therapy, underscoring the importance of ongoing treatment.
White matter hyperintensity volume in pre-diabetes, diabetes and normoglycemia
Authors: Grosu Sergio , Lorbeer Roberto , Hartmann Felix , Rospleszcz Susanne , Bamberg Fabian , Schlett Christopher L , Galie Franziska , Selder Sonja , Auweter Sigrid , Heier Margit , Rathmann Wolfgang , Mueller-Peltzer Katharina , Ladwig Karl-Heinz , Peters Annette , Ertl-Wagner Birgit B , Stoecklein Sophia
Published: June 2021

Introduction

As white matter hyperintensities (WMHs) of the brain are associated with an increased risk of stroke, cognitive decline, and depression, elucidating the associated risk factors is important. In addition to age and hypertension, pre-diabetes and diabetes may play important roles in the development of WMHs. Previous studies have, however, shown conflicting results. We aimed to investigate the effect of diabetes status and quantitative markers of glucose metabolism on WMH volume in a population-based cohort without prior cardiovascular disease.

Research design and methods

400 participants underwent 3 T MRI. WMHs were manually segmented on 3D fluid-attenuated inversion recovery images. An oral glucose tolerance test (OGTT) was administered to all participants not previously diagnosed with diabetes to assess 2-hour serum glucose concentrations. Fasting glucose concentrations and glycated hemoglobin (HbA1c) levels were measured. Zero-inflated negative binomial regression analyses of WMH volume and measures of glycemic status were performed while controlling for cardiovascular risk factors and multiple testing.

Results

The final study population comprised 388 participants (57% male; age 56.3±9.2 years; n=98 with pre-diabetes, n=51 with diabetes). Higher WMH volume was associated with pre-diabetes (p=0.001) and diabetes (p=0.026) compared with normoglycemic control participants after adjustment for cardiovascular risk factors. 2-hour serum glucose (p<0.001), but not fasting glucose (p=0.389) or HbA1c (p=0.050), showed a significant positive association with WMH volume after adjustment for cardiovascular risk factors.

Conclusion

Our results indicate that high 2-hour serum glucose concentration in OGTT, but not fasting glucose levels, may be an independent risk factor for the development of WMHs, with the potential to inform intensified prevention strategies in individuals at risk of WMH-associated morbidity.
Are newly introduced criteria for the diagnosis of gestational diabetes mellitus associated with improved pregnancy outcomes and/or increased interventions in New South Wales, Australia? A population-based data linkage study
Authors: Randall Deborah A , Morris Jonathan M , Kelly Patrick , Glastras Sarah J
Published: June 2021

Introduction

The incidence of gestational diabetes mellitus (GDM) is increasing in Australia, influenced by changed diagnostic criteria. We aimed to identify whether the diagnostic change was associated with improved outcomes and/or increased obstetric interventions using state-wide data in New South Wales (NSW), Australia.

Research design and methods

Perinatal and hospital data were linked for singleton births, 33–41 weeks’ gestation, 2006–2015, NSW. An adjusted Poisson model was used to split pregnancies from 2011 onwards into those that would have been diagnosed under the old criteria (‘previous GDM’) and newly diagnosed cases (‘additional GDM’). We compared actual rates of total and early (<39 weeks) planned births, cesareans, and maternal and neonatal adverse outcomes for GDM-diagnosed pregnancies using three predicted scenarios, where the ‘additional GDM’ group was assumed to have the same rates as: the ‘previous GDM’ group <2011 (scenario A); the ‘non-GDM’ group <2011 (scenario B); or the ‘non-GDM’ group ≥2011 (scenario C).

Results

GDM incidence more than doubled over the study period, with an inflection point observed at 2011. For those diagnosed with GDM since 2011, the actual incidence of interventions (planned births and cesareans) and macrosomia was consistent with scenario A, which meant higher intervention rates, but lower rates of macrosomia, than those with no GDM. Incidence of neonatal hypoglycemia was lower than scenario A and closer to the other scenarios. There was a reduction in perinatal deaths among those with GDM, lower than that predicted by all scenarios, indicating an improvement for all with GDM, not only women newly diagnosed. Incidence of maternal and neonatal morbidity indicators was within the confidence bounds for all three predicted scenarios.

Conclusions

Our study suggests that the widely adopted new diagnostic criteria for GDM are associated with increased obstetric intervention rates and lower rates of macrosomic babies, but with no clear impacts on maternal or neonatal morbidity.
Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study
Authors: Mourino Nerea , Pérez-Ríos Mónica , Santiago-Pérez Maria Isolina , Lanphear Bruce , Yolton Kimberly , Braun Joseph M
Published: June 2021

Objectives

Cotinine is the gold standard to estimate prevalence of secondhand tobacco smoke (SHS) exposure, and assay limit of detection (LOD) cut-points are typically used regardless of age. Our aim was to compare the concordance between mother-reported SHS exposure and serum cotinine categorising children as exposed with the assay LOD or age-specific cut-points.

Design

Data from the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort.

Setting

Hospital or participants’ homes.

Participants

389 pregnant women aged 18 years and older, between 13 and 19 weeks of gestation, living in a five-county region of the Cincinnati, Ohio metropolitan area, and with follow-up on their children at birth and ages 12, 24, 36 and 48 months.

Primary and secondary outcome measures

Children’s serum cotinine, mother-reported active smoking and SHS exposure were available at birth and during follow-up visits. We used Cohen’s kappa index to assess concordance between maternal self-report and child’s serum cotinine concentrations. We estimated optimal age-specific cut-points, their sensitivity–specificity and positive–negative predictive values with receiver operating characteristic curves.

Results

Self-reported exposure and cotinine data were available for 280 women who gave birth to singleton child. When applying the assay LOD (0.015 ng/mL), concordance between maternal report and serum cotinine, without accounting for age, was below 0.23 at all times. When using age-specific cut-points (12 months: 0.11 ng/mL; 24 months: 0.08 ng/mL; 36 months: 0.05 ng/mL and 48 months: 0.04 ng/mL), concordance improved, being low at 12 months (0.39), moderate at 24 and 36 months (0.47 and 0.43) and high at 48 months (0.62).

Conclusions

Concordance between mother-reported SHS exposure among children under 5 years and serum cotinine improved considerably after applying the cohort-specific and age-specific cut-points. Future studies are necessary to verify these results.
Model-based economic evaluation of ice cleat distribution programmes for the prevention of outdoor falls among adults from a Swedish societal perspective
Authors: Bonander Carl , Holmberg Robin , Gustavsson Johanna , Svensson Mikael
Published: June 2021

Background

Slipping on snow or ice poses a significant health risk among older adults in Sweden. To combat this problem, about 80 Swedish municipalities have distributed ice cleats to older citizens (65+ years old) over the last decade. This paper details a cost–benefit analysis of such programmes.

Materials and methods

We developed a decision-analytical model to estimate the costs and benefits of ice cleat programmes in Swedish municipalities compared with a business-as-usual scenario. The modelled benefits of the programme were based on effect estimates from previous research, data from population and healthcare registers and a survey of attitudes to and actual ice cleat use. The modelled costs of the programme were based on resource use data collected from 34 municipalities with existing ice cleat programmes. We assessed heterogeneity in the potential impact and benefit-to-cost ratios across all Swedish municipalities as a function of the average number of days with snow cover per year. Uncertainty in the cost–benefit results was assessed using deterministic and probabilistic sensitivity analyses.

Results

The average benefit-to-cost ratio was 87, ranging from about 40 in low-risk municipalities to 140 in high-risk municipalities, implying that the potential benefits of ice cleat programmes greatly outweigh their costs. Probabilistic and deterministic sensitivity analyses support the robustness of this conclusion to parameter uncertainty and large changes in assumptions about the magnitude of the impact on ice cleat use and injuries.

Conclusion

The benefits of distributing ice cleats to older adults appear to outweigh the costs from a Swedish societal perspective.
Gene of the month: lymphocyte-activation gene 3 (LAG-3)
Authors: Lythgoe Mark P , Liu Daniel Si Kit , Annels Nicola E , Krell Jonathan , Frampton Adam Enver
Published: June 2021

Lymphocyte-activation gene 3 (LAG-3) is a coreceptor found on activated T-lymphocytes activated B-lymphocytes and natural killer (NK) cells. It is closely related to CD4 where it shares multiple common and divergent features. It contains specific binding sites with high affinity to major histocompatibility complex (MHC) Class II and functions as an inhibitor of T-cell signalling. Tumour-infiltrating lymphocytes with high LAG-3 expression have been found in many solid tumours including ovarian cancer, melanoma, colorectal cancer and haematological malignancies including Hodgkin and diffuse large B-cell lymphoma. LAG-3 antagonism has been demonstrated to restore the anti-tumourigenic function of T-cells in vivo, however, mechanistic knowledge remains relatively poorly defined. As other immune checkpoint inhibitors have transformed the management of difficult to treat cancers, such as melanoma, it is hoped that LAG-3 might have the same potential. This review will explore LAG-3 modulation as an anticancer therapy, highlighting recent clinical developments.
Twin pregnancy reduction is not an ‘all or nothing’ problem: a response to Räsänen
Authors: Begović Dunja , Romanis Elizabeth Chloe , Verweij EJ
Published: June 2021

In his paper, ‘Twin pregnancy, fetal reduction and the ‘all or nothing problem’, Räsänen sets out to apply Horton’s ‘all or nothing’ problem to the ethics of multifetal pregnancy reduction from a twin to a singleton pregnancy (2-to-1 MFPR). Horton’s problem involves the following scenario: imagine that two children are about to be crushed by a collapsing building. An observer would have three options: do nothing, save one child by allowing their arms to be crushed, or save both by allowing their arms to be crushed. Horton offers two intuitively plausible claims: (1) it is morally permissible not to save either child and (2) it is morally impermissible to save only one of the children, which taken together lead to the problematic conclusion that (3) if an observer does not save both children, then it is better to save neither than save only one. Räsänen applies this problem to the case of 2-to-1 MFPR, arguing ultimately that, in cases where there is no medical reason to reduce, the woman ought to bring both fetuses to term. We will argue that Räsänen does not provide adequate support for the claim, crucial to his argument, that aborting only one of the fetuses in a twin pregnancy is wrong, so the ‘all or nothing’ problem does not arise in this context. Furthermore, we argue that the scenario Räsänen presents is highly unrealistic because of the clinical realities of 2-to-1 MFPR, making his argument of limited use for real-life decision making in this area.