bluuebunny/crossref_metadata_2025 huggingface dataset:
An Expert Health Care System Providing Recommendations.
Authors: Argiddi R V , Yaldandi R M
Published: May 2021

Today’s health information management system collects a huge quantity of healthcare data and information, that hold complex information related to patients and their medical conditions. In data mining, there has been an increase in the use of techniques on medical to determine usage patterns that are used in the analysis. Nowadays human disease is the main reason for human death, one person may suffer from more than one disease. This work is to predict disease by adding symptoms related to patients’ condition and behavior. In this developed system we enter symptoms, as per patients’ condition, the system analyzes symptoms and predicts diseases using data mining algorithm. The number of symptoms can be added in the search engine as per symptoms disease can be changed. This proposed work is developed to analyze the symptoms given by the user or patient for checking health condition, knowing their health conditions it predicts the disease without the need of a doctor, this work is implemented to save the time of patients’. This proposed system will not only predict the diseases also recommend the appropriate doctors from the doctor list based on a particular disease. In the existing system heart, kidney disease is predicted, whether the patient’s heart, kidney are healthy, or not using the K-Nearest Neighbors algorithm. This system is developed for predicting the disease based on the patient’s symptoms by using a data mining algorithm.
Development and Characterization of AA2024/SiC/Gr/Fly ash Hybrid Composite
Authors: Kumar Anil , Goyal Kapil Kumar , Bhardwaj Arvind , Sharma Neeraj
Published: May 2021

The use of hybrid composites now a days has been very attractive due to their light weight, low cost along with high strength to weight ratio. Lot of research is going on to develop the newer composites with improved mechanical, tribological and thermal properties. From the last two decades, Aluminium alloys have gained lot of attention owing to their practical usage and the ease of processing. Aluminium matrix composites are most versatile materials which has applications in advanced structure, aviation, marine and defence application due to their excellent properties. It is a known fact that stir casting is one of the economical method of fabrication of the metal matrix composite, moreover it is also easy to fabricate the composites by stir casting rather than other processes of fabrication. But, the quality of metal matrix composites being cast through stir casting route are highly dependent on the process parameters and achieving the homogenous distribution of reinforcement is a big challenge. In the present investigation, AA2024/SiC/Gr/flyash hybrid composites were fabricated with the stir casting technique (having reinforcement weight composition of SiC 10%, Graphite 5%, and fly ash 5%). The morphological characteristics of the developed Metal matrix composite (MMC) have been investigated using X-ray diffraction (XRD), scanning electron microscopy (SEM). The uniform distribution of the reinforcement particles clearly depicts the development of homogeneous composite.
A review of process characteristics of plasma electrolytic oxidation of aluminium alloy
Authors: Jadhav Priya , Bongale Arunkumar , Kumar Satish
Published: May 2021

The Plasma Electrolytic Method of Oxidation (PEMO ) is proved powerful for producing the wear and corrosion-resistant coating of the oxide layer for exclusive applications. This technique is having a better capability for industrial use for growing proactive coatings on material like Aluminium, Magnesium, Titanium for diverse application of lightweight and high temperature requirements applications. The paper consists of review of papers primarily based on the surface modification amendment method of plasma arc oxidation of aluminium and its alloy. Because the process characterized by the discharge generated by electrode, electrolyte composition and oxide coating morphology which might be crucial component for effectiveness of the technique. The purpose of the paper is to write the systematic review for electrodes, electrolyte compositions, and its effect in improving the characteristics of aluminium alloys. There is a large scope for enhancing the method and monitoring the electric parameters of PEMO for massive applications in regions of automotive wherein the modification in surfaces can replace the components by the lightweight aluminium alloy material. The attempt is made to pick the key elements inside the technique. The scope of designing numerous optimization algorithms and analytical modelling is a key area for further research which can help to screen the technique extra precisely to get an optimized coating microstructure.
Low Power Sub-threshold Domino AND Gate
Authors: Kumar Prashant , Vashishath Munish , Gupta Neeraj , Gupta Rashmi
Published: May 2021

A high performance digital system is the need of an hour, in the current scenario not only the area but the leakage power holds the key for the future devices. The development of handheld devices often gets restricted due to the limited power resources available in these devices. The conventional structure performs badly for these devices hence multiple design schemes like domino have surface for recent devices. The Domino logic circuits provide high speed operations in comparison to conventional structure. The problem of charge sharing, charge leakage in domino circuits results in improper output level which can be eliminated using Keeper and Pre-charge internal node technique. For achieving very low power all PMOS and NMOS transistors are conducted in sub threshold region. This paper has implemented ultra-low power Domino AND gate. Simulations has been done using Tanner 13 using 18u CMOS technology. A comparison has been carried out with different approaches available in literature and keeper circuit-based domino logic reveals least power consumption which makes it is suitable for ultra-low power devices.
A Review on Autonomous Remote Security and Mobile Surveillance Using Internet of Things
Authors: Diwakar Manoj , Sharma Kanika , Dhaundiyal Ravi , Bawane Sheetal , Joshi Kapil , Singh Prabhishek
Published: May 2021

From Generations, Security methods have always been improvised on the basis of modernisation of Technology. Now a day’s using man power for security have become less reliable as Humans can be manipulated using social/emotional hacking. Today most of the family members are employed and only the old aged members or toddlers of the family are left alone at home unattended and unguided. One of the best solutions to these problems is to use the things that are reliable and can’t be socially hacked. The primary aim that is achieved by this technology is to look after the unattended and other important activities. Problems like this can be handled by using IOT which involves Surveillance System, remote access, automated security systems, Cloud Computing and many more. Vast variety of problems can be solved by this technology. This can be used at personal level, organisational level or national level. This paper basically describes how Internet of things (i.e. Connecting multiple uncommon devices using internet and giving them instructions remotely as per required) can be used to achieve reliable high level security and can be used to make working simple and easy in some other important fields. IOT has limitless potential; it has the capacity to replace some previous technologies.
The synthesis of solid oxide fuel cell by electrolyte systems based Bi2O3 doped with Ho2O3,Dy2O3
Authors: Mustafa Mustafa Neamah , Kadhm Ameera Jawad , Abbas Israa Akram
Published: May 2021

In this study, Bi2O3couple system sample materials were synthesized using solid state reaction method sintering each of them. Structural and electrical properties of these electrolyte samples for solid oxide fuel cells (SOFCs) have been evaluated by means of XRD, TG / DTA, SEM and four-probe method. In this work, (Bi2O3)1-x-y(Dy2O3)x(Ho2O3)y tenary systems have been investigated. As a result of XRD measurements, δ (cubic)-phase samples were obtained with a stable structure. As a results of electrical conductivity measurements, (Bi2O3)1-x-y(Dy2O3)x(Ho2O3)y tenary system, increase Dy2O3 molar ratio corresponds to a fixed molar ratio of Ho2O3 conductivity value falls was obtained.
A Vigorous Chaotic Function Based Image Authentication Structure
Authors: Singh Amit Kumar , Gandhi Vaibhav C. , Madhusudhana Subramanyam M. , Kumar Sarvesh , Aggarwal Sandeep , Tiwari Shivam
Published: May 2021

In this work framework request picture square size and tumultuous capacity control as a piece of information. Here this builds the adaptability and mix of a secret phrase. As the quality of a secret key relies upon number bits or characters. So proposed work store entire square as the mystery key of the client. For creating an alternate arrangement of pictures proposed work utilize tumultuous capacity where an alternate arrangement of muddling is feasible for a similar picture. The proposed plan will be usable anyplace and whenever with a low mistake rate just as a quicker outcome confirmation. This exposition work primarily centered around the snap-based methodology and mix with the proposed algorithmic disorderly approach. A test was done on a genuine arrangement of pictures and results that that proposed work has high join rate, low execution time when contrasted with past secret word creation calculation.
A multi-level method noise based image denoising using convolution neural network
Authors: Chakraborty Alakananda , Jindal Muskan , Bajal Eshan , Singh Prabhishek , Diwakar Manoj , Arya Chandrakala , Tripathi Amrendra
Published: May 2021

Gaussian noise has been the bane of any and every denoising process under the sun. Being a very corrosive noise with huge disruptive potential, this has received much attention form the image restoration community. Building on the premise, a novel framework is proposed to leverage multi-level image denoising that iteratively removes gaussian noise while recovering details lost during processing. This framework uses existing deep learning based CNN systems whilst enhancing the same by the addition of method denoising to the process. This framework is habile in competing with state-of-the-art technologies and outperforming them in some cases.
An EPQ model with life-time items with multivariate demandwith markdown policy under shortages and inflation
Authors: Singh S. R. , Rani Monika
Published: May 2021

Shortages are quite common in command economics and inflation is a regular increment in the price of services and goods in an economy over a span of time. In this paper we established an EPQ model with life-time items with multivariate demand with markdown policy under shortages and inflation. We also discover an inventory model that gives the best markdown time with shortages and inflation and at the same time maximize annual profit. An inventory model by using mathematical tools is developed. The numerical experiments together with sensitivity analysis for relevant parameter is provided to show the behaviour of model.
The effective Hamiltonian as a necessary basis of the open quantum optical system theory
Authors: Basharov A M
Published: May 2021

Based on a model open system, the kinetic equation obtained from the initial exact Hamiltonian with anti-rotating terms is shown to differ from the kinetic equation from the approximate effective Hamiltonian without anti-rotating terms. The paper proves necessity of transition from the exact Hamiltonian to the effective Hamiltonian, with the main idea of its construction being the requirement for the absence of rapidly varying terms in the interaction representation. This requirement is necessary to obtain the correct kinetic equation.
Anthropology of student research activities
Authors: Zinnurova A F
Published: May 2021

The purpose of the article is to identify problem areas of students’ research activities and to show ways to improve this activity. An anthropological analysis of the professional training of students shows that an imitation of research activities prevails at present. The issues of tutoring and mentoring support not only of a particular student’s research activities, but also of the entire process of his education are still relevant. The tutoring system has been adopted in Russia, but it still does not work fully: students lack basic training to conduct full-fledged research. The article analyzes the experience of basic training of outstanding scientists, a two-stage structure of immersion in knowledge.
A missing source of uncertainty: forcing-dependent model parameter sensitivity
Authors: Zhu Xiuhua
Published: May 2021

Climate modelling groups usually work with a handful of model versions (parameter combinations) that reproduce certain targeted aspects of observed climate within a certain validity range and apply them for studying future climate change. What is of concern is whether these retained model versions, with respect to their de-selected counterparts, continue being optimal for future climate that is supposed to distinctly differ from the present one. Extrapolating model performances beyond their validity range requires model parameter sensitivity (i.e., changes in model output due to changes in model parameters) remains more or less stationary despite different forcing conditions. This requirement, however, is shown to be ill-grounded by exemplified analyses of resolution sensitivity in an Earth System Model under different forcing conditions, whereby model resolution is handled as a model parameter in a wider sense: (i) Model resolution sensitivity depends on the forcing conditions applied; moreover, (ii) The further the forcing deviates from a reference state, the earlier one can detect a systematic change in model resolution sensitivity, in particular, in its spatial details. Therefore, model parameter sensitivity and forcing conditions should be evaluated as a compound; failure to account for this relation leads to a systematic underestimation of uncertainty in forced responses of climate models, thereby imposing hazardous impacts on practical applications of CMIP outputs.
Design and validation of a reconfigurable polysonic wind tunnel
Authors: Warning S , Christianer M , Evans W , Coffey F , McQuilling M , Ising E
Published: May 2021

A new polysonic wind tunnel has been designed and constructed at Saint Louis University. The flow paths and flow conditioning needs were designed by PhD students and the structural design and manufacturing were accomplished by local pressure vessel and manufacturing firms. Starting with a set of two 25 hp air compressors, an air filter and dryer system with an operating pressure range between 100–200 psia, and a 14 m3storage tank, the total cost for additional components and labor was on the order of $750,000, where design and installation was completed in approximately 18 months. The facility is uniquely reconfigurable to accommodate straight and curved flow paths, with existing configurations supporting a supersonic shock wave-boundary layer interaction study in a rectangular channel and another study of a transonic linear cascade of high-pressure turbine airfoils. The design process and resulting components are described herein, and include how to improve supersonic nozzle design by adjusting for displacement thickness growth as well as how to diagnose and correct choked flow conditions which existed in the first iteration of the flow path circuit. Results also include a sample schlieren image of a normal shock wave-boundary layer interaction and airfoil static pressure distributions and total pressure ratio across the turbine showing successful configuration implementations.
Understanding star-fundamental algebras
Authors: Giambruno A. , La Mattina D. , Milies C.
Published: May 2021

Star-fundamental algebras are special finite dimensional algebras with involution∗*over an algebraically closed field of characteristic zero defined in terms of multialternating∗*-polynomials.

We prove that the upper-block matrix algebras with involution introduced in Di Vincenzo and La Scala [J. Algebra 317 (2007), pp. 642–657] are star-fundamental. Moreover, any finite dimensional algebra with involution contains a subalgebra mapping homomorphically onto one of such algebras.

We also give a characterization of star-fundamental algebras through the representation theory of the symmetric group.
Regular evolution algebras are universally finite
Authors: Costoya Cristina , Ligouras Panagiote , Tocino Alicia , Viruel Antonio
Published: May 2021

In this paper we show that evolution algebras over any given field

k
\Bbbk

are universally finite. In other words, given any finite group

G
G

, there exist infinitely many regular evolution algebras

X
X

such that

A
u
t
(
X
)
≅
G

Aut(X)\cong G

. The proof is built upon the construction of a covariant faithful functor from the category of finite simple (non oriented) graphs to the category of (finite dimensional) regular evolution algebras. Finally, we show that any constant finite algebraic affine group scheme

G

\mathbf {G}

over

k
\Bbbk

is isomorphic to the algebraic affine group scheme of automorphisms of a regular evolution algebra.
IgM Plasma Cell Myeloma
Authors: Lu Haiyan , Durkin Lisa , Zhao Xiaoxian , Nakashima Megan O
Published: May 2021

Objectives

Immunoglobulin M plasma cell myeloma (IgMPCM) is a rare entity that is difficult to distinguish from other IgM-related neoplasms. The study aims to characterize the clinicopathologic features of IgMPCM, including MYD88 L265P and CXCR4 mutations.

Methods

From our institutional archives, bone marrow biopsy specimens from January 1, 2008, to December 1, 2018, with monotypic plasma cells (PCs) expressing IgM that met current International Myeloma Working Group/World Health Organization criteria for PCM were included. Sanger sequencing was used to test for MYD88 L265P and WHIM-like CXCR4 mutations.

Results

Nine cases of IgMPCM were identified. Serum IgM paraproteins were detected in eight cases. CD138-positive PC burden averaged 41.9% (5%-80%). In four cases, PCs had lymphoplasmacytic morphology with cyclin D1 expression by immunohistochemistry. Three of four tested cases were positive for t(11;14) by fluorescence in situ hybridization, one with monosomy 13. The remaining case was positive for del13q14. All were negative for MYD88 L265P and WHIM-like CXCR4 mutations. Eight patients received immunochemotherapy, with four receiving autologous hematopoietic stem cell transplant. Median follow-up was 61 months (range, 11-120). All patients were alive except one.

Conclusions

Distinguishing IgMPCM from other IgM-related disorders requires correlation with clinical, laboratory, and radiologic findings. Exclusion of MYD88 L265P and WHIM-like CXCR4 mutations may be useful to diagnose IgMPCM.
Clinicopathologic Features of Gynecologic Malignancies Presenting Clinically as Colonic Malignancies
Authors: Fuller Lanisha D , Dunn Andrew , Huber Aaron R , Vyas Monika , Gonzalez Raul S
Published: May 2021

Objectives

To systematically evaluate gynecologic malignancies (adnexal or uterine) causing gastrointestinal (GI) signs (eg, mass on colonoscopy) or symptoms (eg, bloody stools) clinically mimicking a GI primary malignancy.

Methods

The archives of 2 institutions were retrospectively reviewed for gynecologic malignancies clinically manifesting as colonic lesions. For each case, available radiologic, endoscopic, and histologic findings were recorded.

Results

We identified 16 cases: 13 biopsies and 3 resections. The masses were localized in the rectosigmoid (14 cases [88%]), right (1 case [6%]), and transverse (1 case [6%]) colon. Gastrointestinal-type complaints included abdominal pain, weight loss, hematochezia, and obstruction; 1 case was asymptomatic and found during screening colonoscopy. Nine patients (56%) had no known prior gynecologic malignancy, and in only 2 of these patients was there some clinical suspicion of a noncolonic primary malignancy. Most cases (13 [81%]) were serous carcinoma, usually high-grade adnexal or primary peritoneal. Six cases (38%) directly extended into the colon, and 7 (44%) metastasized; route of spread was unclear in the others. Only 1 case (6%) showed mucosal involvement, and none showed desmoplasia or dirty necrosis. Four of the 13 serous carcinomas (31%) showed psammoma bodies.

Conclusions

Advanced gynecologic malignancies, most commonly serous carcinoma, can rarely manifest as GI lesions. Clues to noncolonic origin on biopsy include lack of colonic mucosal involvement/dysplasia, desmoplasia, or dirty necrosis.
Adapting pharmacy experiential education during COVID-19: Innovating remote preceptor resources, tools, and patient care delivery beyond virtual meetings
Authors: Law Elaine , Scott Marie C , Moon Yong S K , Lee Audrey J , Bandy Veronica T , Haydon Andrew , Shek Allen , Kang-Birken S Lena
Published: May 2021

Purpose

To describe the innovative teaching practices, tools, and resources for remote learning developed by a school of pharmacy with a decentralized experiential program to empower and support preceptors in response to the coronavirus disease 2019 (COVID-19) pandemic.

As the pandemic has continued, there have been significant shifts in pharmacy workflow, staffing, and patient care delivery. Pharmacy students are slowly being reintegrated into these learning environments. Although preceptors are willing and eager to teach, many lack the resources, tools, and support to create remote learning experiences at their facilities. The University of the Pacific Thomas J. Long School of Pharmacy has a decentralized experiential education model in which faculty regional coordinators with clinical practices and diverse expertise are disseminated throughout California. This model allowed us to collaborate and understand preceptor needs from a local level. We created a preceptor COVID-19 guidance document, introduced innovative virtual playbooks to pivot up to 100% remote rotations, and promoted the layered learning model to integrate pharmacy residents into the remote teaching space. Communication and flexibility are key to ensure student and preceptor safety while maintaining high-quality advanced pharmacy practice experiences and preserving patient-student relationships in telehealth.

Conclusion

Overall, we successfully created innovative solutions and leveraged our decentralized experiential model to meet the teaching and learning demands during an unanticipated crisis. We continue to adapt and plan to assess the effectiveness of the tools by administering surveys of preceptors and pharmacy students.
V—The Linguistic Approach to Ontology
Authors: Walters Lee
Published: May 2021

What are the prospects for a linguistic approach to ontology? Given that it seems that there are true subject-predicate sentences containing empty names, traditional linguistic approaches to ontology appear to be flawed. I argue that in order to determine what there is, we need to determine which sentences ascribe properties (and relations) to objects, and that there does not appear to be any formal criterion for this. This view is then committed to giving an account of what predicates do in sentences when they do not ascribe properties. I sketch an approach to the varieties of predication.
Transcriptomic studies revealed pathophysiological impact of COVID-19 to predominant health conditions
Authors: Nain Zulkar , Barman Shital K , Sheam Md Moinuddin , Syed Shifath Bin , Samad Abdus , Quinn Julian M W , Karim Mohammad Minnatul , Himel Mahbubul Kabir , Roy Rajib Kanti , Moni Mohammad Ali , Biswas Sudhangshu Kumar
Published: May 2021

Despite the association of prevalent health conditions with coronavirus disease 2019 (COVID-19) severity, the disease-modifying biomolecules and their pathogenetic mechanisms remain unclear. This study aimed to understand the influences of COVID-19 on different comorbidities and vice versa through network-based gene expression analyses. Using the shared dysregulated genes, we identified key genetic determinants and signaling pathways that may involve in their shared pathogenesis. The COVID-19 showed significant upregulation of 93 genes and downregulation of 15 genes. Interestingly, it shares 28, 17, 6 and 7 genes with diabetes mellitus (DM), lung cancer (LC), myocardial infarction and hypertension, respectively. Importantly, COVID-19 shared three upregulated genes (i.e. MX2, IRF7 and ADAM8) with DM and LC. Conversely, downregulation of two genes (i.e. PPARGC1A and METTL7A) was found in COVID-19 and LC. Besides, most of the shared pathways were related to inflammatory responses. Furthermore, we identified six potential biomarkers and several important regulatory factors, e.g. transcription factors and microRNAs, while notable drug candidates included captopril, rilonacept and canakinumab. Moreover, prognostic analysis suggests concomitant COVID-19 may result in poor outcome of LC patients. This study provides the molecular basis and routes of the COVID-19 progression due to comorbidities. We believe these findings might be useful to further understand the intricate association of these diseases as well as for the therapeutic development.
Bayesian neural network with pretrained protein embedding enhances prediction accuracy of drug-protein interaction
Authors: Kim QHwan , Ko Joon-Hyuk , Kim Sunghoon , Park Nojun , Jhe Wonho
Published: May 2021

Motivation

Characterizing drug–protein interactions (DPIs) is crucial to the high-throughput screening for drug discovery. The deep learning-based approaches have attracted attention because they can predict DPIs without human trial and error. However, because data labeling requires significant resources, the available protein data size is relatively small, which consequently decreases model performance. Here, we propose two methods to construct a deep learning framework that exhibits superior performance with a small labeled dataset.

Results

At first, we use transfer learning in encoding protein sequences with a pretrained model, which trains general sequence representations in an unsupervised manner. Second, we use a Bayesian neural network to make a robust model by estimating the data uncertainty. Our resulting model performs better than the previous baselines at predicting interactions between molecules and proteins. We also show that the quantified uncertainty from the Bayesian inference is related to confidence and can be used for screening DPI data points.

Availability and implementation

The code is available at https://github.com/QHwan/PretrainDPI.

Supplementary information

Supplementary data are available at Bioinformatics online.
CONSTAX2: improved taxonomic classification of environmental DNA markers
Authors: Liber Julian A , Bonito Gregory , Benucci Gian Maria Niccolò
Published: May 2021

CONSTAX—the CONSensus TAXonomy classifier—was developed for accurate and reproducible taxonomic annotation of fungal rDNA amplicon sequences and is based upon a consensus approach of RDP, SINTAX and UTAX algorithms. CONSTAX2 extends these features to classify prokaryotes as well as eukaryotes and incorporates BLAST-based classifiers to reduce classification errors. Additionally, CONSTAX2 implements a conda-installable command-line tool with improved classification metrics, faster training, multithreading support, capacity to incorporate external taxonomic databases and new isolate matching and high-level taxonomy tools, replete with documentation and example tutorials.

Availability and implementation

CONSTAX2 is available at https://github.com/liberjul/CONSTAXv2, and is packaged for Linux and MacOS from Bioconda with use under the MIT License. A tutorial and documentation are available at https://constax.readthedocs.io/en/latest/. Data and scripts associated with the manuscript are available at https://github.com/liberjul/CONSTAXv2_ms_code.

Supplementary information

Supplementary data are available at Bioinformatics online.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectivity by Viral Load, S Gene Variants and Demographic Factors, and the Utility of Lateral Flow Devices to Prevent Transmission
Authors: Lee Lennard Y W , Rozmanowski Stefan , Pang Matthew , Charlett Andre , Anderson Charlotte , Hughes Gareth J , Barnard Matthew , Peto Leon , Vipond Richard , Sienkiewicz Alex , Hopkins Susan , Bell John , Crook Derrick W , Gent Nick , Walker A Sarah , Peto Tim E A , Eyre David W
Published: May 2021

Background

How severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity varies with viral load is incompletely understood. Whether rapid point-of-care antigen lateral flow devices (LFDs) detect most potential transmission sources despite imperfect clinical sensitivity is unknown.

Methods

We combined SARS-CoV-2 testing and contact tracing data from England between 1 September 2020 and 28 February 2021. We used multivariable logistic regression to investigate relationships between polymerase chain reaction (PCR)-confirmed infection in contacts of community-diagnosed cases and index case viral load, S gene target failure (proxy for B.1.1.7 infection), demographics, SARS-CoV-2 incidence, social deprivation, and contact event type. We used LFD performance to simulate the proportion of cases with a PCR-positive contact expected to be detected using 1 of 4 LFDs.

Results

In total, 231 498/2 474 066 (9%) contacts of 1 064 004 index cases tested PCR-positive. PCR-positive results in contacts independently increased with higher case viral loads (lower cycle threshold [Ct] values), for example, 11.7% (95% confidence interval [CI] 11.5–12.0%) at Ct = 15 and 4.5% (95% CI 4.4–4.6%) at Ct = 30. B.1.1.7 infection increased PCR-positive results by ~50%, (eg, 1.55-fold, 95% CI 1.49–1.61, at Ct = 20). PCR-positive results were most common in household contacts (at Ct = 20.1, 8.7% [95% CI 8.6–8.9%]), followed by household visitors (7.1% [95% CI 6.8–7.3%]), contacts at events/activities (5.2% [95% CI 4.9–5.4%]), work/education (4.6% [95% CI 4.4–4.8%]), and least common after outdoor contact (2.9% [95% CI 2.3–3.8%]). Contacts of children were the least likely to test positive, particularly following contact outdoors or at work/education. The most and least sensitive LFDs would detect 89.5% (95% CI 89.4–89.6%) and 83.0% (95% CI 82.8–83.1%) of cases with PCR-positive contacts, respectively.

Conclusions

SARS-CoV-2 infectivity varies by case viral load, contact event type, and age. Those with high viral loads are the most infectious. B.1.1.7 increased transmission by ~50%. The best performing LFDs detect most infectious cases.
Gender differences in complications following catheter ablation of atrial fibrillation
Authors: Ngo Linh , Ali Anna , Ganesan Anand , Woodman Richard , Adams Robert , Ranasinghe Isuru
Published: May 2021

Aims

Population studies that provide unbiased estimates of gender differences in risk of complications following catheter ablation of atrial fibrillation (AF) are sparse. We sought to evaluate the association of female gender and risk of complications following AF ablation in a nationwide cohort.

Methods and results

We identified 35 211 patients (29.5% females) undergoing AF ablations from 2008 to 2017 using national hospitalization data from Australia and New Zealand. The primary outcome was any procedural complication occurring up to 30-days after discharge. Logistic regression was used to adjust for differences in baseline characteristics between sexes. Compared with males, females were older (mean age 64.9 vs. 61.2 years), had higher rates of hypertension (14.0% vs. 11.6%) and haematological disorders (5.3% vs. 3.8%) and experienced a higher rate of procedural complications (6.96% vs. 5.41%) (all P < 0.001). This gender disparity remained significant after adjustment [odds ratio (OR) 1.25 (95% confidence interval 1.14–1.38), P < 0.001] and was driven by an increased risk of vascular injury [OR 1.86 (1.23–2.82), P = 0.003], pericarditis [OR 1.86 (1.16–2.67), P = 0.008], pericardial effusion [OR 1.71 (1.35–2.17), P < 0.001), and bleeding [OR 1.30 (1.15–1.46), P < 0.001]. Notably, the gender difference persisted over time [OR for the most recent period 1.19 (1.003-1.422), P = 0.046] despite a declining complication rate in both men and women.

Conclusion

Females undergoing AF ablations experienced a 25% higher risk of procedural complications compared with males, a disparity that has persisted over time despite a falling complication rate. Efforts to reduce this gender disparity should focus on reducing the incidence of pericardial effusion, pericarditis, vascular injury, and bleeding.
Swordplay: Lord Mountbatten, Count Terauchi and the Japanese Surrender in Southeast Asia
Authors: Sturma Michael
Published: May 2021

Field Marshal Count Terauchi’s personal surrender of swords to Admiral Lord Louis Mountbatten in November 1945 highlights some of the complexities related to the Japanese surrender in Southeast Asia. Japanese swords served as important symbols for both their owners and the Allies. Mountbatten’s determination to dispossess the Japanese of their swords reflected his views on Japan’s militarism and a desire to impress upon soldiers their subservience to British authority when most had not been directly defeated in battle. On the other hand, Mountbatten was constrained by the huge area placed under his command, the lack of resources at his disposal and rising nationalist resistance. In these circumstances, Mountbatten sought the co-operation of surrendered Japanese personnel in British interests. The issue of surrendering Japanese swords underlines Mountbatten’s conflicting objectives and Count Terauchi’s efforts to manipulate the situation.
‘Distrust all Advice … and Make No Exception in Favour of our Advice’: Financial Knowledge and Knowingness in Late Victorian Britain
Authors: Taylor James
Published: May 2021

Over the past two decades, our understanding of the development of financial markets in the nineteenth century has been transformed by scholars working in two broad areas. Economic sociologists and literary scholars have explored the discursive underpinnings of the institutions of modern finance, deftly tracing the ways in which stock markets were legitimised through a growing association with science and statistics, and a simultaneous distancing from gambling and chance. From a very different perspective, quantitative analysis of shareholder registers and other archival records by economic historians and historical geographers has provided rich data giving a more precise picture of who invested and what they invested in. Valuable though this work has been, the gulf between the two approaches has resulted in a dearth of empirically grounded studies of the social and cultural dimensions of investment. An area particularly in need of greater exploration is the booming late Victorian print culture which purported to explain finance to new investors. This article offers a close reading of the financial journalism of Henry Labouchere, better known for his subsequent political career as a Liberal MP. Labouchere’s writings are deliberately riddled with contradictions, simultaneously legitimising and questioning the stock market, and switching between the roles of moral crusader and self-interested speculator. This carefully crafted performance encouraged an attitude of ‘knowingness’ towards finance among his readers which helps to explain why the stock market was able to grow in popularity even when it remained so closely associated with fraud.
Efficacy of central extracorporeal life support for patients with fulminant myocarditis and cardiogenic shock
Authors: Tadokoro Naoki , Fukushima Satsuki , Minami Kimito , Taguchi Takura , Saito Tetsuya , Kawamoto Naonori , Kakuta Takashi , Seguchi Osamu , Watanabe Takuya , Nakajima Doi Seiko , Kuroda Kensuke , Suzuki Keisuke , Yanase Masanobu , Asaumi Yasuhide , Shimizu Hideyuki , Fukushima Norihide , Fujita Tomoyuki
Published: May 2021

OBJECTIVES

Fulminant myocarditis with cardiogenic shock requires extracorporeal life support (ECLS) and has poor outcomes. To improve outcomes, we have converted patients with severely impaired cardiac and multiorgan function from peripheral to central ECLS. In this study, we reviewed these patients’ clinical outcomes and investigated associated factors.

METHODS

We retrospectively studied 70 consecutive patients with fulminant myocarditis under peripheral support from 2006 to 2020. Forty-eight patients underwent surgical conversion to central support, and the remaining patients continued peripheral support. The end point was survival and ventricular assist device-free survival.

RESULTS

More severe pulmonary congestion and multiorgan failure were present in patients with central than peripheral support. Weaning from ECLS was achieved in 95% and 62% of patients with peripheral and central support, respectively. Five-year survival was not significantly different between patients with central and peripheral support (71.2% vs 87.5%, respectively; P = 0.15). However, the ventricular assist device-free survival rate was significantly higher in patients with central than peripheral support (82.2% vs 52.0%, respectively; P = 0.017). A peak creatine kinase-MB level of >180 IU/l, rhythm disturbance and aortic valve closure were detrimental to functional recovery in patients with central support.

CONCLUSIONS

Conversion to central ECLS is feasible and safe in patients with fulminant myocarditis. Patients with severe myocardial injury as shown by a high creatine kinase-MB level, rhythm disturbance and aortic valve closure should be converted to a durable left ventricular assist device.
Reduction of oral liquid controlled drugs discrepancy in day-to-day practice
Authors: Mohanasundaram Shalini , Rutter Paul , Fox Andrew , Wood Kelly , Roldo Marta
Published: May 2021

Objectives

The storage, use and disposal of controlled drugs (CDs) in hospitals and other healthcare centres are governed by a combination of government legislation and local policy. In the UK, a running balance must be kept for Schedule 2 CDs and when discrepancies arise, they must be investigated and reconciled. Policies on acceptable discrepancies are varied and based on anecdotal evidence. This study was designed to simulate dosing and stock check procedures for oxycodone oral solution, as a sample CD solution, and evaluate where the volume losses that cause discrepancies could arise from.

Methods

Hypromellose solutions were formulated to simulate oxycodone commercial solutions. These were used to simulate dosing and stock check practices. Quantification of volume loss during simulated routine dosing and stock check of viscous oral CD formulations were performed in triplicate.

Key findings

Dosing with enteral syringes via a fitted rubber bung never resulted in volume loss. Volume loss was always observed during stock checks with no statistical difference between methods used.

Conclusions

The findings of this study support the following recommendations. Hospital pharmacy departments should provide oxycodone and other CD liquid formulation bottles pre-fitted with a bung and make sure personnel use enteral syringes that are compatible with the chosen adaptor and of the most appropriate size for the intended dose. Stock checks should be limited to the minimum required by law or local policy.
β-d-N4-hydroxycytidine Inhibits SARS-CoV-2 Through Lethal Mutagenesis But Is Also Mutagenic To Mammalian Cells
Authors: Zhou Shuntai , Hill Collin S , Sarkar Sanjay , Tse Longping V , Woodburn Blaide M D , Schinazi Raymond F , Sheahan Timothy P , Baric Ralph S , Heise Mark T , Swanstrom Ronald
Published: May 2021

Mutagenic ribonucleosides can act as broad-based antiviral agents. They are metabolized to the active ribonucleoside triphosphate form and concentrate in genomes of RNA viruses during viral replication. β-d-N4-hydroxycytidine (NHC, initial metabolite of molnupiravir) is >100-fold more active than ribavirin or favipiravir against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with antiviral activity correlated to the level of mutagenesis in virion RNA. However, NHC also displays host mutational activity in an animal cell culture assay, consistent with RNA and DNA precursors sharing a common intermediate of a ribonucleoside diphosphate. These results indicate highly active mutagenic ribonucleosides may hold risk for the host.
Optimization of the rapid carbapenem inactivation method for use with AmpC hyperproducers
Authors: Muntean Mădălina Maria , Muntean Andrei-Alexandru , Guerin François , Cattoir Vincent , Creton Elodie , Cotellon Garance , Oueslati Saoussen , Popa Mircea Ioan , Girlich Delphine , Iorga Bogdan I. , Bonnin Rémy A. , Naas Thierry
Published: May 2021

Objectives

Detection of carbapenemase-producing Enterobacterales (CPEs) is sometimes difficult with AmpC-hyperproducing Enterobacterales (AHEs), as they may falsely be classified as CPEs. Here, we present a rapid Carbapenem Inactivation Method (rCIM) optimized for AmpC producers (rCIM-A) that allows rapid and easy discrimination between AHEs and CPEs.

Methods

Enterobacterales (n = 249), including natural AmpC producers, AHEs, CPEs and non-carbapenemase-producing carbapenem-resistant control strains were evaluated, using Carba NP, rCIM and rCIM-A. The rCIM-A differs from the rCIM by the addition of cloxacillin (400 μg/mL) to the initial antibiotic incubation step.

Results

The rCIM-A yielded a sensitivity and specificity of 84.26% (95% CI: 76.00%–90.55%) and 99.29% (95% CI: 96.11%–99.98%), respectively, while those of the rCIM were 86.11% (95% CI: 78.13%–92.01%) and 80.85% (95% CI: 73.38%–86.99%), respectively; those of Carba NP were lower at 84.04% (95% CI: 75.05%–90.78%) and 91.37% (95% CI: 85.41%–95.46%), respectively, due to indeterminate results. The rCIM-A was capable of discriminating between AHEs and true CPEs, but still failed to identify OXA-23-producing Proteus mirabilis isolates and remained only partially reliable for identifying IMI-like producers and a few MBL (2 NDM-1, 1 LMB-1, 1 TMB-1 and 1 IMP-13) producers. One chromosomally encoded AmpC variant, MIR-10, gave repeatedly positive results using all three tests and was thus considered a false positive.

Conclusions

Specificity for AHEs greatly improved with the rCIM-A without altering the test performance for the other resistance mechanisms. It may replace the rCIM as a cheap, easy, rapid and accurate CPE detection test.
Development of Three Molecular Diagnostic Tools for the Identification of the False Codling Moth (Lepidoptera: Tortricidae)
Authors: Rizzo D , Da Lio D , Bartolini L , Cappellini G , Bruscoli T , Salemi C , Aronadio A , Del Nista D , Pennacchio F , Boersma N , Rossi E , Sacchetti P
Published: May 2021

Three molecular protocols using qPCR TaqMan probe, SYBR Green, and loop-mediated isothermal amplification (LAMP) methods were set up for the identification of larvae and adults of an African invasive moth, Thaumatotibia leucotreta (Meyrick, 1913) (Lepidoptera: Tortricidae). The DNA extracts from larval and adult samples of T. leucotreta were perfectly amplified with an average Ct value of 19.47 ± 2.63. All assays were demonstrated to be inclusive for T. leucotreta and exclusive for the nontarget species tested; the absence of false positives for nontarget species showed a 100% of diagnostic specificity and diagnostic sensitivity for all assays. With the SYBR Green protocol, the Cq values were only considered for values less than 22 (cutoff value) to prevent false-positive results caused by the late amplification of nonspecific amplicons. The limit of detection (LoD) for the qPCR probe protocol was equal to 0.02 pg/µl while a value equal to 0.128 pg/µl for the qPCR SYBR Green assay and LAMP method were established, respectively. The intrarun variabilities of reproducibility and repeatability in all the assays evaluated as CV%, ranged between 0.21 and 6.14, and between 0.33 and 9.52, respectively; the LAMP values were slightly higher than other assays, indicating a very low interrun variability. In order for an operator to choose the most desirable method, several parameters were considered and discussed. For future development of these assays, it is possible to hypothesize the setup of a diagnostic kit including all the three methods combined, to empower the test reliability and robustness.
Transnational Experts Wanted: Nigerian Oil Spills before the Dutch Courts
Authors: Bertram Daniel
Published: May 2021

This analysis recapitulates the Hague Court of Appeal’s decisions in a series of lawsuits brought by Nigerian farmers against Dutch oil giant Shell. The ruling upholds Shell’s civil liability for the pollution ensuing from several oil spills and has been widely hailed as a blueprint for similar claims before European courts. Beyond these headlines, the judgment charters unexplored legal territories and elicits burning questions about judicial and environmental expertise in complex transnational settings. I propose a three-pronged analysis to cut through this complexity. First, the case deals with the international ‘anchor’ jurisdiction of Dutch courts over claims against foreign defendants. Secondly, the ruling marks a significant contribution to the jurisprudence on tort liability across corporate structures. Finally, the verdict sheds a new light on the interplay between environmental rights and tort actions. The confluence of these three perspectives projects a kaleidoscopic vision of environmental liability across borders.
Policy-Specific Expertise and the Importance of Organizational Leadership in Shared Administrative Governance: Evidence from US Federal Cooperative Agreements
Authors: Krause George A , Zarit Matthew
Published: May 2021

This study analyzes US federal cooperative agreements (CAs) that reflect federal agencies’ willingness to invest in shared administrative governance with third-party organizations. A logic anchored in organizational economics predicts that US federal agency investments to collaborate with other non-federal organizations is positively related to an agency head’s policy-specific expertise, and that this relationship will take on greater importance when collaborating with nonprofits and private firms. These propositions are tested analyzing a novel database of 241,730 US federal CA decisions awarded by 31 federal agencies between 1988 and 2008. The statistical findings reveal support for this logic, especially for larger, more complex CAs with non-governmental organizations. The evidence also reveals that federal agencies’ CA award decisions generally have little, if any, discernible statistical association; other agency level factors such as an agency leader’s managerial skills, agency politicization, agency staff professionalism, and the loyalty of agency heads to appointing presidents (JEL H11, H57, H83, L33, & M59).