bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum vasohibin‐1 levels: A potential marker of dermal and pulmonary fibrosis in systemic sclerosis
Authors: Fukui Yuki , Nakamura Kouki , Hirabayashi Megumi , Miyagawa Takuya , Toyama Satoshi , Omatsu Jun , Awaji Kentaro , Ikawa Tetsuya , Norimatsu Yuta , Yoshizaki Ayumi , Sato Shinichi , Asano Yoshihide
Published: March 2021

Vasohibin‐1 (VASH‐1) is a potent anti‐angiogenic factor mainly produced by endothelial cells. In addition, VASH‐1 prevents TGF‐β–dependent activation of renal fibroblasts. Since systemic sclerosis (SSc) is an autoimmune disease characterized by vasculopathy and fibrosis of multiple organs, VASH‐1 may be involved in the development of this disease. In this study, we investigated the potential role of VASH‐1 in SSc by evaluating the clinical correlation between serum VASH‐1 levels and the expression of VASH‐1 in SSc‐involved skin. Serum VASH‐1 levels were higher in SSc patients, especially those with diffuse cutaneous involvement, than in healthy controls and positively correlated with skin score. Furthermore, SSc patients with interstitial lung disease had significantly elevated levels of serum VASH‐1 as compared to those without. Importantly, serum VASH‐1 levels correlated inversely with both the percentage of predicted vital capacity and the percentage of predicted diffusion lung capacity for carbon monoxide and positively with serum KL‐6 levels, but not serum surfactant protein D levels. In SSc‐involved skin, VASH1 mRNA was remarkably upregulated compared with healthy control skin, but the major source of VASH‐1 was not clear. Fli1 deficiency, a predisposing factor inducing SSc‐like endothelial properties, did not affect VASH‐1 expression in human dermal microvascular endothelial cells. Collectively, these results suggest that VASH‐1 upregulation in the skin and sera is linked to dermal and pulmonary fibrotic changes in SSc, while the contribution of VASH‐1 to SSc vasculopathy seems to be limited.
Quantification of artifacts during cardiac magnetic resonance in patients with leadless Micra pacemakers
Authors: Hála Pavel , Neužil Petr , Keller Jiří , Moučka Petr , Mudroch Martin , Dujka Libor , Janotka Marek , Žáček Radovan , Vymazal Josef , Reddy Vivek
Published: March 2021

Introduction

When cardiac magnetic resonance (MR) is performed after previous leadless transcatheter pacemaker implantation, an image distortion has to be expected in the heart region and evaluation of myocardial tissue can be affected. In this clinical prospective study, we aim to assess the extent and impact of this artifact on individual ventricular segments and compare it to conventional pacing devices.

Methods

Total of 20 patients with leadless pacemaker placed in the right ventricle underwent cardiac MR imaging in a 1.5 Tesla scanner. A multiplanar segmentation was used to demarcate the left and right ventricular myocardium as well as the pacemaker‐caused image artifact in systolic and diastolic time frames. Artifact size and its relative influence on myocardial segments were quantitatively assessed and expressed in AHA‐17 model.

Results

Implanted leadless pacemaker caused an image artifact with a volume of 48 ± 5 ml. Most distorted were the apical septal (53 ± 23%), apical inferior (30 ± 18%), and midventricular inferoseptal (30 ± 20%) segments. The artifact intersection with basal and lateral segments was none or negligible (up to 2%). The portion of left ventricular (LV) myocardium affected by the artifact was significantly higher in systole (8 ± 4%) compared to diastole (10 ± 3%; p < .001).

Conclusion

Implantation of leadless pacemaker represents no obstacle for cardiac MR imaging but causes an image artifact located mostly in septal, inferoseptal, and anteroseptal segments of apical and midventricular LV myocardium. With the exception of the apex, diastolic timing reduces the image distortion of all segments and improves global ventricular assessment.
Simplified rapid differentiation of Liriomyza chinensis Kato (Diptera; Agromyzidae) genotypes A and B using PCR‐RFLP
Authors: Takagi Motonori , Wari David , Ogawara Takashi , Uesugi Ryuji
Published: March 2021

The stone leek leafminer Liriomyza chinensis Kato is one of the most important pests of Allium spp. In recent years, a new genotype of L. chinensis, genotype B, has been shown to cause more severe damage to Allium spp. compared with the native genotype A in Japan. Thus, identification of the genotypes is important for establishing L. chinensis control strategies. In this study, we developed a simple and rapid method of genotype identification using PCR‐restriction fragment length polymorphism (RFLP). Primers were designed to mitochondria cytochrome oxidase subunit I gene (mtCOI) nucleotide sequences from both genotypes. Genotypes A and B were successfully identified using the restriction enzymes PvuI and DdeI, respectively. Using PCR‐RFLP, we identified the genotype of L. chinensis samples (n = 108) collected in seven Japanese bunching onion fields in Ibaraki Prefecture, Japan. All individuals were shown to be genotype B, as expected.
Evidence for the existence of extracellular vesicles in Renibacterium salmoninarum and related cytotoxic effects on SHK‐1 cells
Authors: Echeverría‐Bugueño Macarena , Balada Cristóbal , Irgang Rute , Avendaño‐Herrera Ruben
Published: March 2021

Extracellular vesicles (EVs) in bacteria have been implicated in invasive and, through enzymes, infective processes. One Gram‐positive bacterium lacking any EV research, despite having commercial impacts on the aquaculture industry, is Renibacterium salmoninarum. We addressed this gap in knowledge by utilizing scanning electron microscopy to provide the first reported evidence for the production of EVs by R. salmoninarum strain H‐2. Dispersive light scattering detected that the EVs were heterogeneous in size, and the protein compositions were similar to the bacterial membrane and contained the virulent protein factors p22 and p57. The EVs additionally had a concentrated negative charge compared with R. salmoninarum H‐2, as determined by Z potential. Finally, these particles seemed to play a role in host invasion in vitro in the salmon head kidney cell line, as demonstrated by the occurrence of a cytotoxic effect within the first 48 hr post‐infection. Higher EV concentrations (i.e. 52.6 µg/ml) were more toxic than R. salmoninarum H‐2. This information serves as a foundation to develop and test possible uses for R. salmoninarum EVs in salmon aquaculture, inspiring future advances against bacterial kidney disease.
Experimental exposure to low concentrations of Neoparamoebaperurans induces amoebic gill disease in Atlantic salmon
Authors: Bridle Andrew R. , Hill Thomas , Smith Aaron , Crosbie Philip , Nowak Barbara F.
Published: March 2021

Amoebic gill disease (AGD) is a significant issue in Atlantic salmon mariculture. Research on the development of treatments or vaccines uses experimental challenges where salmon is exposed to amoebae concentrations ranging from 500 to 5,000/L. However, the water concentrations of N. perurans on affected salmon farms are much lower. The lowest concentration of N. perurans previously reported to cause AGD was 10/L. Here, we report that concentrations as low as 0.1/L of N. perurans can cause AGD. We propose that concentrations of N. perurans that reflect those measured on salmon farms should be used for future experimental challenges.
Dietary interventions with dietitian involvement in adults with chronic kidney disease: A systematic review
Authors: Brown Tamara J. , Williams Harriet , Mafrici Bruno , Jackson Helena S. , Johansson Lina , Willingham Fiona , McIntosh Ashleigh , MacLaughlin Helen L.
Published: March 2021

Background

A comprehensive evidence base is needed to support recommendations for the dietetic management of adults with chronic kidney disease (CKD). The present study aimed to determine the effect of dietary interventions with dietitian involvement on nutritional status, well‐being, kidney risk factors and clinical outcomes in adults with CKD.

Methods

Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, PsycINFO and EMBASE.com were searched from January 2000 to November 2019.

Intentional weight loss and single nutrient studies were excluded. Risk of bias was assessed using the Cochrane risk‐of‐bias tool. Effectiveness was summarised using the mean difference between groups for each outcome per study.

Results

Twelve controlled trials (1906 participants) were included. High fruit and vegetable intake, as well as a multidisciplinary hospital and community care programme, slowed the decline in glomerular filtration rate in adults with stage 3–4 CKD. Interventions addressing nutrition‐related barriers increased protein and energy intake in haemodialysis patients. A Mediterranean diet and a diet with high n‐3 polyunsaturated fatty acids improved the lipid profile in kidney transplant recipients.

Conclusions

A limited number of studies suggest benefits as a result of dietary interventions that are delivered by dietitians and focus on diet quality. We did not identify any studies that focussed on our primary outcome of nutritional status or studies that examined the timing or frequency of the nutritional assessment. This review emphasises the need for a wider body of high‐quality evidence to support recommendations on what and how dietetic interventions are delivered by dietitians for adults with CKD.
The impact of resilience on turnover intention in dialysis nurses: The mediating effects of work engagement and compassion fatigue
Authors: Cao Xiaoyi , Chen Lin
Published: March 2021

Aim

To describe the levels of turnover intention, and to explore the mediating effects of work engagement and compassion fatigue on the relationship between resilience and turnover intention in dialysis nurses.

Methods

A descriptive cross‐sectional study was conducted to recruit 496 dialysis nurses in 25 tertiary hospitals in Sichuan province, China. Structural equation modeling technique was used to examine the mediating roles of work engagement and compassion fatigue on the association between resilience and turnover intention.

Results

The prevalence of high and exceptionally high levels of turnover intention in dialysis nurses were 56.8% (282 nurses) and 8.7% (43 nurses), respectively. Resilience was a significant and direct contributor to work engagement (standardized direct effect = 0.62, p < .001) and compassion fatigue (standardized direct effect = −0.35, p < .001), respectively. However, resilience had no direct and significant effect on turnover intention (standardized direct effect = 0.15, p > .05). Work engagement and compassion fatigue had direct and significant effects on turnover intention (standardized direct effect = −0.40, p < .001; standard direct effect = 0.31, p < .001). Resilience affected turnover intention indirectly and significantly via the whole mediating effects of work engagement and compassion fatigue (standardized indirect effect = −0.36, p < .001).

Conclusion

Higher resilience leads to lower turnover intention via enhancing work engagement and reducing compassion fatigue in dialysis nurses. Nursing policies should be established to promote resilience training, enhance work engagement and reduce compassion fatigue in order to alleviate turnover intention in dialysis nurses.
Evaluating the effect of ursodeoxycholic acid on total bilirubin of neonates with glucose‐6‐phosphate dehydrogenase deficiency complicated by indirect hyperbilirubinaemia
Authors: Rezaie Mehrdad , Gholami Roya , Jafari Mahtab , Haghighinejad Hourvash
Published: March 2021

Aim

This study aimed to investigate the effect of adding ursodeoxycholic acid (UDCA) to phototherapy in neonates with glucose‐6‐phosphate dehydrogenase (G6PD) deficiency and hyperbilirubinaemia. G6PD deficiency is a common cause of severe hyperbilirubinaemia in neonates.

Methods

This study was a triple blind, clinical trial study of 40 neonates with G6PD deficiency and hyperbilirubinaemia who admitted for phototherapy in hospitals affiliated to the University of Medical Sciences. The treatment group (n = 20) received UDCA 10 mg/kg (2 cc/kg) daily divided into 2 doses every 12 h. The control group (n = 20) received the same volume of placebo syrup. The drug and placebo treatments were continued until the bilirubin level dropped below 171 μmol/L. Both the control and treatment group received continuous phototherapy. Independent sample t‐test, survival analysis and logrank test were used to statistically analyse the results.

Results

The mean total bilirubin level was 231.9 ± 18.8 μmol/L and 184.3 ± 18.6 μmol/L in the control and intervention group respectively, 24 h after drug administration and 209.7 ± 19.3 μmol/L and 157.4 ± 16.4 μmol/L, respectively, 48 h after intervention (P < 0.05). The median length of hospitalisation in the treatment group was approximately 1 day lower than the control group (logrank test P value: <0.001).

Conclusion

The study showed that the addition of UDCA to phototherapy accelerates the reduction of total bilirubin level in neonates with G6PD deficiency and can reduce the duration of hospitalisation.
How official nationalism fuels labour market discrimination against migrants in the Netherlands and its institutional alternatives
Authors: Siebers Hans , Koster Marissa
Published: March 2021

Official nationalism is on the rise, but its impact on relations between people with and without a migration background in institutions is under‐studied. This study, based on 55 interviews in a Dutch ministry in 2016, shows that official Dutch nationalist framings of those relations have been taken over by civil servants. These framings trigger boundary‐making between themselves and discrimination in access to career opportunities, in a climate of insecurity. However, official nationalism absorption, boundary‐making and discrimination are partially neutralized by respondents resorting to institutionally ‘nested’, work‐related and civic identities that enable cooperation, communication and fair allocation of career opportunities. Findings also highlight the exclusive continuities of various forms of imposed official nationalism, including ethno‐nationalism and multiculturalism. They all set people with migration backgrounds apart as culturally different, which foments insecurity among them. Non‐nationalist and institutionally ‘nested’ identities and procedures offer participation and inclusion to our respondents, not ethno‐nationalism nor multiculturalism.
Autoantibodies against the immunodominant sCha epitope discriminate the risk of sudden death in chronic Chagas cardiomyopathy
Authors: Rodríguez‐Angulo Héctor O. , Lamsfus‐Calle Andrés , Isoler‐Alcaráz Javier , Galán‐Martínez Javier , Herreros‐Cabello Alfonso , Callejas‐Hernández Francisco , Chorro‐de‐Villaceballos María A. , Maza María C. , Santi‐Rocca Julien , Poveda Cristina , Moral‐Salmoral Javier Del , Marques Juan , Mendoza Iván , Ramírez Juan David , Guhl Felipe , Carrillo Irene , Pérez‐Tanoira Ramón , Górgolas Miguel , Pérez‐Ayala Ana , Monge‐Maillo Begoña , Norman Francesca , Pérez‐Molina José A. , López‐Vélez Rogelio , Fresno Manuel , Gironès Núria
Published: March 2021

In Chagas disease (ChD) caused by Trypanosoma cruzi, new biomarkers to predict chronic cardiac pathology are urgently needed. Previous studies in chagasic patients with mild symptomatology showed that antibodies against the immunodominant R3 epitope of sCha, a fragment of the human basic helix‐loop‐helix transcription factor like 5, correlated with cardiac pathology. To validate sCha as a biomarker and to understand the origin of anti‐sCha antibodies, we conducted a multicenter study with several cohorts of chagasic patients with severe cardiac symptomatology. We found that levels of antibodies against sCha discriminated the high risk of sudden death, indicating they could be useful for ChD prognosis. We investigated the origin of the antibodies and performed an alanine scan of the R3 epitope. We identified a minimal epitope MRQLD, and a BLAST search retrieved several T. cruzi antigens. Five of the hits had known or putative functions, of which phosphonopyruvate decarboxylase showed the highest cross‐reactivity with sCha, confirming the role of molecular mimicry in the development of anti‐sCha antibodies. Altogether, we demonstrate that the development of antibodies against sCha, which originated by molecular mimicry with T. cruzi antigens, could discriminate electrocardiographic alterations associated with a high risk of sudden death.
Anesthetic management for percutaneous reverse Potts shunt creation in children with refractory idiopathic pulmonary arterial hypertension: A case series
Authors: Valent Arnaud , Nefzi Imene , Lopez Vanessa , Mirabile Cristian , Orliaguet Gilles
Published: March 2021

Percutaneous reverse Potts shunt improves right ventricular function in patients with suprasystemic idiopathic pulmonary arterial hypertension. There are no data regarding the anesthesia in this high‐risk procedure. We report our experience of the anesthetic management for the creation of percutaneous reverse Potts shunt in children with suprasystemic idiopathic pulmonary arterial hypertension. This study included 10 patients presenting with symptomatic idiopathic pulmonary arterial hypertension despite undergoing medical treatment. All patients underwent gradual induction of anesthesia to maintain hemodynamic stability (etomidate, n = 8; ketamine, n = 4). Four patients needed extracorporeal life support: 2 were rescued after cardiac arrest and 2 had elective extracorporeal life support due to preprocedural dysfunctional right ventricle and/or small left ventricle volumes with reduced cardiac output. All patients were admitted to the pediatric cardiac intensive care unit (4 [2–5] days). All patients with extracorporeal life support died. None of the six survivors needed pulmonary transplantation. Both ketamine and etomidate support hemodynamics. High‐dose opioid technique has the advantage of blunting noxious stimuli and subsequent increase in pulmonary vascular resistance. We recommend using multimodal monitoring with transesophageal echocardiography. The 100% mortality of extracorporeal life support patients, probably too sick to undergo such procedure, may question its usefulness. Further studies should identify suitable candidates for percutaneous reverse Potts shunt creation.
Does iron therapy have a place in the management of all breath‐holding spells?
Authors: Arslan Müjgan , Karaibrahimoğlu Adnan , Demirtaş Mehmet Semih
Published: March 2021

Background

Aim of this study was to analyze the effect of iron therapy in children with breath‐holding spells, irrespective of their hemoglobin level.

Method

All of the children were evaluated in terms of age, sex, age at onset of the attack, attack frequency, type of breath‐holding spell, family pedigree, laboratory values. All enrolled patients were given iron at the dose of 4 mg/kg/day as a single daily dose for 3 months. Patients were called for follow‐up appointments 1 and 3 months after the initiation of treatment to record the frequency and severity of spells.

Results

The mean age of the patients was 12.50 ± 9.51 months. Patients were divided into two groups according to the hemoglobin level. The frequency of anemia in children with spells was recorded as 27%. Out of 100 patients treated with iron, 43% showed complete remission at the end of 1 month. At the end of the 3 months, percentage of complete responders increased to 80%. After three‐month of iron treatment, 96.2% of the anemic and 73.97% of the non‐anemic patients were spell‐free. Eight children had mild adverse effects after iron therapy that did not require dose modification.

Conclusions

This study confirmed that iron therapy reduces spell frequency regardless of anemia in all breath‐holding spells. A three‐month empiric iron therapy should be offered to all children with spells.
Clinical features and prognosis of severe scorpion envenomation in children
Authors: Rebahi Houssam , Ba‐M’hamed Saadia , Still Megan Elizabeth , Mouaffak Youssef , Younous Said , Bennis Mohamed
Published: March 2021

Background

Scorpionism is endemic and represents a real public health problem in Morocco. The most dangerous arthropod in the central area is Androctonus mauretanicus (Am) scorpion. Its venom can be lethal, especially for children. This study aimed to determine a clinico‐epidemiological profile of severe scorpion envenomation among children and identify risk factors for mortality.

Methods

This retrospective cohort study included 606 children admitted for severe scorpion envenomation (SSE) from January 2010 to July 2015 in the Pediatric Intensive Care Unit (PICU) of Mohammed VI Teaching Hospital.

Results

The mean age of envenomed children was 6.3 ± 4.2 years. Seventy‐four percent of them came from rural settings. Envenomation occurred mostly during the summer months and 78.4% of stings were nocturnal. The time between the sting and evaluation was greater than 2 h in 83% of cases. Bivariate analysis indicated that from 1 to 24 months of age (P = 0.001), hyperthermia (P = 0.022), episodes of diarrhea (P < 0.001), tachycardia (P < 0.001), abdominal distention (P < 0.001), skin marbling (P < 0.001), signs of respiratory distress (P < 0.001), irritability (P < 0.001), generalized seizures (P = 0.053), and Glasgow Coma Score (GCS) of 3 to 9 (P < 0.001) were significantly correlated with mortality. On multivariate analysis, diarrhea (P = 0.007), skin marbling (P = 0.006), and respiratory distress (P = 0.002), and GCS 3‐9 (P = 0.007) were found to be independent risk factors for mortality in our patient population.

Conclusions

Children are at high risk of developing serious complications, even death, from severe scorpion envenomation. Here we identified multiple factors that appear to increase the mortality risk in children after scorpion envenomation, including previously described central nervous system alterations.
Inverse effects of time‐on‐task in task‐related and task‐unrelated theta activity
Authors: Arnau Stefan , Brümmer Tina , Liegel Nathalie , Wascher Edmund
Published: March 2021

The phenomenon of mental fatigue has recently been investigated extensively by means of the EEG. Studies deploying spectral analysis consistently reported an increase of spectral power in the lower frequencies with increasing time‐on‐task, whereas event‐related studies observed decreases in various measures related to task engagement and attentional resources. The results from these two lines of research cannot be aligned easily. (Frontal) theta power has been linked to cognitive control and was found to increase with time‐on‐task. In contrast, theoretical frameworks on mental fatigue suggest a decline in task‐engagement as causal for the performance decline observed in mental fatigue. The goal of the present study was to investigate mental fatigue in time–frequency space using linear regression on single‐trial data in order to obtain a better understanding about how time‐on‐task affects theta oscillatory activity. A data‐driven analysis approach indicated an increase of alpha and theta power during the intertrial interval. In contrast, task‐related theta activity declined. This reduction of stimulus‐locked theta power may be interpreted as a reduction of task engagement with increasing mental fatigue. The increase of theta spectral power in the intertrial interval, moreover, could possibly be explained by an increased idling of cognitive control networks. Alternatively, it might be the case that the increase of theta power with time‐on‐task is a by‐product an alpha power increase. As alpha peak frequency systematically decreases with time‐on‐task, the theta band might be affected as well.
Reply
Authors: Leong Tracy L.
Published: March 2021

See related letter

See related letter
Isentropic approximation of the compressible Euler equations in Besov spaces
Authors: Wu Xinglong
Published: March 2021

The article mainly studies the isentropic approximation of the compressible Euler equations in Besov space , provided the initial entropy changes closing a constant in the Besov spaces, which extends and improves the result in Sobolev space by Jia and Pan.
Pi-Tee Transformations in the Analysis of Mechanical Transmission Lines
Authors: Horvay G. , Pines S.
Published: March 2021

A method is given which simplifies the analysis of mechanical transmission systems without making use of “electrical analogies.” The method is applied to the problem of the viscous vibration damper.
Numerical and Network-Analyzer Solution of the Equivalent Circuits for the Elastic Field
Authors: Carter G. K.
Published: March 2021

This is a companion paper to one by Gabriel Kron. Particular cases of circuits in two independent variables are used. Test of these circuits by numerical substitution of known simple solutions indicates that the mesh size in the circuits need not be excessively small in order to give a useful accuracy of results. By trial of the a-c network analyzer, in similar cases, limitations on the use of the analyzer in its present form for the solution of elastic-field problems are studied. Finally, it is found by trial that solution of the circuits by hand, using a “relaxation” method, is practicable; and in this way the desirable objective of a solution of the elastic-field problem directly from given boundary conditions is achieved.
Analysis of the Valverde Thermostat
Authors: Wahl A. M.
Published: March 2021

In this paper, a method based on the theory of initially curved bars axially loaded is developed for calculating snapping temperatures and stresses in a new type of thermostat known as the Valverde thermostat. For facilitating practical use of the derived formulas, curves are given by means of which the effect of dimensional changes on the free snapping or buckling temperatures may easily be evaluated. The analysis has been found useful in the practical design of thermostats of this type.
Drawing Thin-Walled Tubing With a Moving Mandrel Through a Single Stationary Die
Authors: Sachs G. , Lubahn J. D. , Tracy D. P.
Published: March 2021

The fundamental equations for the drawing of tubing with a moving mandrel have been solved for the simplified cases of both cold-drawing and hot-drawing of thin-walled tubing through a stationary die. For the solution of the fundamental equation, a method of successive improvement can be used for any contour of the tools and any shape of the stress-strain curve. Algebraic solutions were developed for tapered tools and for a metal exhibiting a constant flow stress in cold-working, and for a metal with the flow stress depending exponentially upon the strain rate in hot-working. The effects of the die and punch contours and the friction coefficients between the metal and the die and punch, respectively, on the stresses in the metal, the draw forces, and the limits of drawing were determined. The calculations reveal that, with a small die angle and high friction on the mandrel, the process resembles extrusion rather than drawing, the limit being determined by the strength of the die rather than by the tensile strength of the metal.
The Effect of Blade Count on Body Force Model Performance for Axial Fans
Authors: Saini Palak , Defoe Jeffrey
Published: March 2021

Body force models enable inexpensive numerical simulations of turbomachinery. The approach replaces the blades with sources of momentum/energy. Such models capture a “smeared out” version of the blades’ effect on the flow, reducing computational cost. The body force model used in this paper has been widely used in aircraft engine applications. Its implementation for low speed, low solidity (few blades) turbomachines, such as automotive cooling fans, enables predictions of cooling flows and component temperatures without calibrated fan curves. Automotive cooling fans tend to have less than 10 blades, which is approximately 50% of blade counts for modern jet engine fans. The effect that has on the body force model predictions is unknown, and the objective of this paper is to quantify how varying blade count affects the accuracy of the predictions for both uniform and non-uniform inflow. The key findings are that reductions in blade metal blockage combined with spanwise flow redistribution drives the body force model to more accurately predict work coefficient as the blade count decreases and that reducing the number of blades is found to have negligible impacts on upstream influence and distortion transfer in non-uniform inflow until extremely low blade counts (such as 2) are applied.
On the Electro-Mechanical Stability of Elastomeric Coaxial Fibers
Authors: Clarke D. R. , Hutchinson J. W.
Published: March 2021

The stability of cylindrical coaxial fibers made from soft elastomeric materials is studied for electro-static loadings. The general configuration considered is a three-component axisymmetric fiber having a conducting core bonded to a dielectric annulus in turn bonded to an outer conducting annular sheath. A voltage difference between the conducting components is imposed. The stresses and actuated elongation in the perfectly concentric fiber are analyzed, and the critical voltage at which stability of the concentric configuration is lost is determined via solution of the non-axisymmetric bifurcation problem. The role of the geometry and moduli contrasts among the components is revealed, and the sub-class of two-component fibers is also analyzed. The idealized problem of a planar layer with conducting surfaces that is bonded to a stiff substrate on one surface and free on the other exposes the importance of short wavelength surface instability modes.
Atomic layer deposition of AlN using atomic layer annealing—Towards high-quality AlN on vertical sidewalls
Authors: Österlund Elmeri , Seppänen Heli , Bespalova Kristina , Miikkulainen Ville , Paulasto-Kröckel Mervi
Published: March 2021

Atomic layer deposition (ALD) of aluminum nitride (AlN) using in situ atomic layer annealing (ALA) is studied for microelectromechanical systems (MEMS). Effective piezoelectric in-plane actuation and sensing requires deposition of high crystal quality and (0002) oriented AlN on vertical sidewalls of MEMS structures. Previous studies have shown that the crystal quality of ALD AlN can be significantly improved using ALA but have not studied the conformal coverage or crystal quality on metal electrodes, which are required for piezoelectric MEMS devices. In this study, AlN thin films are deposited on Si, Al, Pt, and on vertical sidewalls etched into Si. The AlN microstructure and properties are studied using x-ray diffraction methods, transmission electron microscopy, and Fourier transform infrared spectroscopy. The conformal coverage is evaluated by measuring the film thickness on the vertical sidewalls. The effects of postdeposition annealing are studied as well. This study aims to enable effective piezoelectric actuation and sensing for MEMS sensors. The conformal coverage of the ALA ALD process is excellent and AlN has the best crystal quality and degree of orientation when deposited on Al. The as-deposited films contain oxygen impurities, which might be detrimental to the piezoelectric properties of AlN. Annealing at high temperatures reduced the number of impurities but did not improve the crystal quality.
Weathering the storm
Authors: Mervis Jeffrey
Published: March 2021

As president, Donald Trump has battered science. But increased spending by Congress and some supportive agency heads have provided relief.
Structural and mechanistic bases for a potent HIV-1 capsid inhibitor
Authors: Bester Stephanie M. , Wei Guochao , Zhao Haiyan , Adu-Ampratwum Daniel , Iqbal Naseer , Courouble Valentine V. , Francis Ashwanth C. , Annamalai Arun S. , Singh Parmit K. , Shkriabai Nikoloz , Van Blerkom Peter , Morrison James , Poeschla Eric M. , Engelman Alan N. , Melikyan Gregory B. , Griffin Patrick R. , Fuchs James R. , Asturias Francisco J. , Kvaratskhelia Mamuka
Published: March 2021

Attacking HIV by stabilizing its capsid

Current HIV treatments require drugs that must be taken daily, and care would be improved with an effective drug that is long-acting. GS-6207 (Lenacapavir) is a drug developed by Gilead Sciences that shows potential for a 6-month dosing interval and is in phase 2/3 clinical trials. Bester
et al.
describe structural and biophysical studies that provide a basis for the potent antiviral activity of GS-6207. The HIV capsid is cone shaped, and GS-6207 binds two neighboring capsid subunits and stabilizes the curved capsid. GS-6207 also interferes with capsid binding of cofactors that play a role in viral infection. This insight into GS-6207 activity provides a platform for the rational development of improved long-acting therapies.

Science
, this issue p.
360
ROP16-Mediated Activation of STAT6 Suppresses Host Cell Reactive Oxygen Species Production, Facilitating Type III Toxoplasma gondii Growth and Survival
Authors: Kochanowsky Joshua A. , Thomas Kaitlin K. , Koshy Anita A.
Published: March 2021

Toxoplasma gondiiis an obligate intracellular parasite that infects up to one-third of the world’s population. Control of the parasite is largely accomplished by IFN-γ-dependent mechanisms that stimulate innate and adaptive immune responses.
In Vivo
Competitions between Fibrobacter succinogenes, Ruminococcus flavefaciens, and Ruminoccus albus in a Gnotobiotic Sheep Model Revealed by Multi-Omic Analyses
Authors: Yeoman Carl J. , Fields Christopher J. , Lepercq Pascale , Ruiz Philippe , Forano Evelyne , White Bryan A. , Mosoni Pascale
Published: March 2021

Ruminant animals, including cattle and sheep, depend on their rumen microbiota to digest plant biomass and convert it into absorbable energy. Considering that the extent of meat and milk production depends on the efficiency of the microbiota to deconstruct plant cell walls, the functionality of predominant rumen cellulolytic bacteria,
Fibrobacter succinogenes
,
Ruminococcus albus
, and
Ruminococcus flavefaciens
, has been extensively studied
in vitro
to obtain a better knowledge of how they operate to hydrolyze polysaccharides and ultimately find ways to enhance animal production.
Valgus-impacted fracture of neck of femur in a 12-year-old child
Authors: Murali Sujayendra Davanagere , Hegde Nikhil , Shah Hitesh
Published: March 2021

Though uncommon, fracture of neck of femur in children is a devastating injury due to the complications it may cause. Treatment depends on the age of the child, the displacement of the fracture and the type of fracture based on Delbet classification. Surgical treatment is indicated in displaced fractures. We report a case of an impacted fracture of neck of femur in a 12-year-old girl. The girl was managed non-operatively. The fracture united uneventfully. An impacted fracture of neck of femur is common in the adult population. To the best of our knowledge, this fracture pattern has not been reported in the paediatric age group.
2021 consensus statement for preventing and managing low back pain in elite and subelite adult rowers
Authors: Wilson Fiona , Thornton Jane S , Wilkie Kellie , Hartvigsen Jan , Vinther Anders , Ackerman Kathryn E , Caneiro J P , Trease Larissa , Nugent Frank , Gissane Conor , McDonnell Sarah-Jane , McGregor Alison , Newlands Craig , Ardern Clare L
Published: March 2021

Purpose

To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice.

Methods

There were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice.

Results

The scope of the consensus statement included epidemiology; biomechanics; management; the athlete’s voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged.

Conclusion

Recommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.
Protocol for an interdisciplinary cross-sectional study investigating the social, biological and community-level drivers of antimicrobial resistance (AMR): Holistic Approach to Unravel Antibacterial Resistance in East Africa (HATUA)
Authors: Asiimwe Benon B , Kiiru John , Mshana Stephen E , Neema Stella , Keenan Katherine , Kesby Mike , Mwanga Joseph R , Sloan Derek J , Mmbaga Blandina T , Smith V Anne , Gillespie Stephen H , Lynch Andy G , Sandeman Alison , Stelling John , Elliott Alison , Aanensen David M , Kibiki Gibson E , Sabiiti Wilber , Holden Matthew T G
Published: March 2021

Introduction

Antimicrobial resistance (AMR) is a global health threat that requires urgent research using a multidisciplinary approach. The biological drivers of AMR are well understood, but factors related to treatment seeking and the social contexts of antibiotic (AB) use behaviours are less understood. Here we describe the Holistic Approach to Unravel Antibacterial Resistance in East Africa, a multicentre consortium that investigates the diverse drivers of drug resistance in urinary tract infections (UTIs) in East Africa.

Methods and analysis

This study will take place in Uganda, Kenya and Tanzania. We will conduct geospatial mapping of AB sellers, and conduct mystery client studies and in-depth interviews (IDIs) with drug sellers to investigate AB provision practices. In parallel, we will conduct IDIs with doctors, alongside community focus groups. Clinically diagnosed patients with UTI will be recruited from healthcare centres, provide urine samples and complete a questionnaire capturing retrospective treatment pathways, sociodemographic characteristics, attitudes and knowledge. Bacterial isolates from urine and stool samples will be subject to culture and antibiotic sensitivity testing. Genomic DNA from bacterial isolates will be extracted with a subset being sequenced. A follow-up household interview will be conducted with 1800 UTI-positive patients, where further environmental samples will be collected. A subsample of patients will be interviewed using qualitative tools. Questionnaire data, microbiological analysis and qualitative data will be linked at the individual level. Quantitative data will be analysed using statistical modelling, including Bayesian network analysis, and all forms of qualitative data analysed through iterative thematic content analysis.

Ethics and dissemination

Approvals have been obtained from all national and local ethical review bodies in East Africa and the UK. Results will be disseminated in communities, with local and global policy stakeholders, and in academic circles. They will have great potential to inform policy, improve clinical practice and build regional pathogen surveillance capacity.
E-health ecosystem with integrated and stepped psychosocial services for breast cancer survivors: study protocol of a multicentre randomised controlled trial
Authors: Ochoa-Arnedo Cristian , Medina Joan Carles , Flix-Valle Aida , Anastasiadou Dimitra
Published: March 2021

Introduction

Psychosocial interventions for patients with breast cancer (BC) have demonstrated their effectiveness at reducing emotional distress and improving quality of life. The current digitisation of screening, monitoring and psychosocial treatment presents the opportunity for a revolution that could improve the quality of care and reduce its economic burden. The objectives of this study are, first, to assess the effectiveness of an e-health platform with integrated and stepped psychosocial services compared with usual psychosocial care, and second, to examine its cost–utility.

Methods and analysis

This study is a multicentre randomised controlled trial with two parallel groups: E-health intervention with integrated and stepped psychosocial services vs usual psychosocial care. An estimated sample of 338 patients with BC in the acute survival phase will be recruited from three university hospitals in Catalonia (Spain) and will be randomly assigned to one of two groups. All participants will be evaluated at the beginning of the study (T1: recruitment), 3 months from T1 (T2), 6 months from T1 (T3) and 12 months from T1 (T4). Primary outcome measures will include number of clinical cases detected, waiting time from detection to psychosocial intervention and proportion of cases successfully treated in the different steps of the intervention, as well as outcomes related to emotional distress, quality of life, post-traumatic stress and growth, treatment adherence and therapeutic alliance. Secondary outcomes will include the acceptability of the platform, patients’ satisfaction and usability. For the cost–utility analysis, we will assess quality-adjusted life years and costs related to healthcare utilisation, medication use and adherence, work absenteeism and infrastructure-related and transport-related costs.

Ethics and dissemination

This study was approved by the Ethics committee of the Institut Català d’Oncologia network in Hospitalet, Spain. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences among the scientific community, workshops with patients and media press releases.

Trial registration number

Online Psychosocial Cancer Screening, Monitoring and Stepped Treatment in Cancer Survivors (ICOnnectat-B),NCT04372459.
Effectiveness of integrated treatment for eating disorders in Spain: protocol for a multicentre, naturalistic, observational study
Authors: Grau Touriño Antoni , Feixas Guillem , Medina Joan Carles , Paz Clara , Evans Chris
Published: March 2021

Introduction

Eating disorders (EDs) are complex pathologies which require equally complex treatment strategies. These strategies should be multidisciplinary, personalised interventions, performed in appropriate settings along a healthcare continuum from inpatient to community care. Personalisation, and the complexity of levels of care and interventions make evaluation of treatments difficult. The present study aims to measure the effectiveness of a complex treatment programme for EDs which includes hospitalisation, day hospital and outpatient settings. Our purpose is to assess the complete therapeutic process of each patient through all these levels of care, capturing the multiplicity of trajectories that a programme of these characteristics involves.

Methods and analysis

This protocol describes a multicentre, naturalistic, observational study. All patients starting between November 2017 and October 2020 in a healthcare network for EDs in Spain are being invited to participate. The first phase of intensive change monitoring to November 2020 is followed by lower intensity follow-up until October 2025. In the first phase progress of all participants is assessed every 3 weeks using specific measures for ED and the Clinical Outcomes Routine Evaluation system, a family of instruments specifically designed to measure change in psychotherapy. In the second phase data collection will happen quarterly. Both cross-sectional and longitudinal analyses will be conducted, with a special focus on patterns and predictors of change studied through multilevel linear models.

Ethics and dissemination

The study has been approved by the Research Bioethics Committee of the University of Barcelona (no. IRB00003099) and the ethical committee of ITA Mental Health, the organisation to which all participating centres belong. Dissemination will be in papers for peer-reviewed research journals and to clinicians working with ED.

Trial registration number

NCT04127214.
Knowledge on neonatal jaundice and its associated factors among mothers in northern Ethiopia: a facility-based cross-sectional study
Authors: Demis Asmamaw , Getie Addisu , Wondmieneh Adam , Alemnew Birhan , Gedefaw Getnet
Published: March 2021

Objective

This study aimed to assess mother’s knowledge on neonatal jaundice (NNJ) and its associated factors in northern Ethiopia.

Design

Facility-based cross-sectional study.

Setting

Referral hospitals in Amhara region, Ethiopia.

Participants

The study was done among 380 mothers selected using a systematic random sampling technique at referral hospitals in the Amhara region, northern Ethiopia, from 1 March 2019 to 30 July 2019.

Primary outcome

Mother’s knowledge on NNJ, modelled using binary logistic regression.

Secondary outcome

Factors associated with mother’s knowledge about NNJ

Results

This study revealed that the overall mother’s knowledge on NNJ was 39.2%. Having favourable attitude (AOR=2.05, 95% CI: 1.25 to 3.34), having a history of NNJ in previous children (AOR=7.51, 95% CI: 3.12 to 18.05), having a history of NNJ in the current child (AOR=1.97, 95% CI: 1.19 to 3.27), antenatal care (ANC) follow-up (AOR=3.85, 95% CI: 1.24 to 14.55) and resided in the urban area (AOR=2.63, 95% CI: 1.32 to 5.25) were factors significantly associated with mother’s knowledge on NNJ.

Conclusions

This study showed that mothers' knowledge on NNJ was low. The attitude of mothers on NNJ, previous and current child history of NNJ, ANC follow-up and residence were variables that had a significant association with mother’s knowledge on NNJ. Enhancing NNJ educational programmes targeting mothers in raising awareness on the prevention of NNJ in the population are the recommended interventions.