bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of maternal death audits in refugee camps in UNHCR East and Horn of Africa and Great Lakes Region, 2017–2019
Authors: van Boekholt Tessa A. , Moturi Edna , Hölscher Hannah , Schulte‐Hillen Catrin , Tappis Hannah , Burton Ann
Published: October 2022

Objectives

To review the quality of maternal death audits and identify factors contributing to refugee maternal deaths in the East and Horn of Africa.

Methods

Maternal death audits submitted to The UN Refugee Agency (UNHCR) from 2017 to 2019 in 43 refugee camps in eight countries were analyzed for completeness, obstetric history, cause of death, and contributing factors.

Results

A total of 191 refugee maternal death audits were retrieved. The mean age of the deceased was 28 years (range, 15–45 years), and 13% were adolescents and 17% were of advanced maternal age. Most patients (55%) were grand multigravida (≥5 pregnancies). The majority (86%) attended antenatal care visits, with 51% attending four or more visits. Among women who delivered (n = 140), 91% were facility‐based deliveries. Most (68%) deaths occurred postpartum. Obstetric hemorrhage (49%) was the leading direct cause of death (with 77 cases of postpartum hemorrhage), followed by hypertensive disorder (19%) and infection (15%). Delays in care were identified in 185 (97%) cases. Delays in receiving care were more prevalent (81%) than in seeking (61%) and reaching (26%) care.

Conclusion

Factors contributing to delays in receiving care highlight the capacity gaps in provision of emergency obstetric care, including management of postpartum hemorrhage, requiring urgent additional investments. Audit findings also show the need for attention and action towards family planning, contraception, and adolescent sexual and reproductive health services.
Identification and management of cancer cachexia in patients: Assessment of healthcare providers' knowledge and practice gaps
Authors: Baracos Vickie E. , Coats Andrew J. , Anker Stefan D. , Sherman Lawrence , Klompenhouwer Tatiana ,   International Advisory Board, and Regional Advisory Boards for North America, Europe, and Japan
Published: October 2022

Background

Cancer cachexia negatively impacts patient outcomes, quality of life and survival. Identification and management of cancer cachexia remains challenging to healthcare professionals (HCPs). The aim of this assessment was to identify current gaps in HCPs' knowledge and practice for identifying and managing adults with cancer‐related cachexia. Results may guide development of new educational programmes to close identified gaps and improve outcomes of cancer patients.

Methods

An international assessment was conducted using a mixed‐methods approach including focus group interviews with subject matter experts and an electronic survey of practising HCP. The assessment was led by the Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD) and was supported by in‐country collaborating organizations.

Results

A quantitative survey of 58 multiple‐choice questions was completed by physicians, nurses dietitians and other oncology HCP (N = 2375). Of all respondents, 23.7% lacked confidence in their ability to provide care for patients with cancer cachexia. Patients with gastrointestinal, head and neck, pulmonary cancers and leukaemia/lymphoma were reported as those at highest risk for cachexia. Only 29.1% of respondents recognized a key criterion of cancer cachexia as >5% weight loss from baseline, but many (14.4%) did not utilize a standardized definition of cancer cachexia. Despite this, most clinicians (>84%) were able to identify causes of weight loss—reduced oral intake, progressive disease, side effects of therapy and disease‐related inflammation. Of all respondents, 52.7% indicated newly diagnosed patients with cancer should be screened for weight loss. In practice, 61.9% reported that patient weight was systematically tracked over time, but only 1125 (47.4%) reported they weigh their cancer patients at each visit. Treatment of cachexia focused on increasing the patient's nutritional intake by oral nutritional supplements (64.2%), energy and protein fortified foods (60.3%) and counselling by a dietitian (57.1%). Whereas many respondents (37.3%) considered cachexia inevitable, most (79.2%) believed that an interprofessional team approach could improve care and that use of standardized tools is critical.

Conclusions

Findings from this international assessment highlight the challenges associated with the care of patients with cancer cachexia, opportunities for interventions to improve patient outcomes and areas of variance in care that would benefit from further analysis.
Peak treadmill exercise echocardiography for ischemia detection
Authors: Peteiro Jesus
Published: October 2022

Of the stress echocardiographic methods, exercise should be the first choice for patients able to exercise, according to guidelines. Among ExE modalities, treadmill ExE with acquisition of images at peak exercise has several advantages, including high sensitivity and prognostic value. Overall, sensitivity of ExE is around 80%–85%, although figures for peak imaging on the treadmill are 85%–90%. Despite it, guidelines do not mention this method.
A Phase 3 clinical trial validating the potency and safety of an innovative, extra‐long‐acting interferon in chronic hepatitis C
Authors: Chen Chi‐Yi , Chuang Wan‐Long , Qin Albert , Zhang Wen‐Hua , Zhu Li‐Ying , Zhang Guo‐Qiang , Chen Jyh‐Jou , Lo Ching‐Chu , Zhou Xinmin , Mao Xiaorong , Shang Jia , Kuo Hsing‐Tao , Xie Wen , Chen Chien‐Hung , Lo Gin‐Ho , Jun Dae W , Dang Shuangsuo , Tsai Chan‐Yen , Wang Ting‐Fang , Lai Hsin‐Hui , Tseng Kuan‐Chiao , Huang Yi‐Wen , Chen Pei‐Jer
Published: October 2022

Background and Aim

Ropeginterferon alfa‐2b is a novel mono‐pegylated, extra‐long‐acting interferon. It is administered infrequently and showed good tolerability and clinical activity for the chronic hepatitis B or C treatment in our previous Phase 2 clinical trials. This study aims to validate the potency and safety of this novel agent in a Phase 3 chronic viral hepatitis setting.

Methods

Patients with chronic hepatitis C genotype 2 were randomized to receive subcutaneous injections of ropeginterferon alfa‐2b biweekly or the conventional pegylated interferon alfa‐2b weekly for 24 weeks, combined with ribavirin. The primary endpoint was to assess the safety and antiviral potency of ropeginterferon alfa‐2b by the non‐inferiority in sustained virologic response at 12 weeks after treatment.

Results

A total of 222 patients were enrolled. Ropeginterferon alfa‐2b group showed a favorable safety profile. Side effects that were generally associated with prior interferon therapies, including neutropenia, asthenia, fatigue, alopecia, dizziness, decreased appetite, nausea, flu‐like symptoms including myalgia, pyrexia, and headache, and administration site reactions, were notably less in the ropeginterferon alfa‐2b group. The cumulative incidence of adverse events of special interest was also notably higher in the control group. The primary endpoint was met and ropeginterferon alfa‐2b showed a better SVR12 rate of 79.8% than 71.9% of the control group.

Conclusion

Ropeginterferon alfa‐2b is efficacious and has a favorable safety profile as compared with the conventional pegylated interferon alfa‐2b. This study together with previous Phase 2 data validated ropeginterferon alfa‐2b to be a new treatment option for chronic hepatitis C genotype 2.
Immune senescence and periodontitis: From mechanism to therapy
Authors: Liu Jiaqi , Dan Ruichen , Zhou Xueman , Xiang Jie , Wang Jun , Liu Jin
Published: October 2022

Periodontitis is one of the most prevalent infectious inflammatory diseases, characterized by irreversible destruction of the supporting tissues of teeth, which is correlated with a greater risk of multiple systemic diseases, thus regarded as a major health concern. Dysregulation between periodontal microbial community and host immunity is considered to be the leading cause of periodontitis. Comprehensive studies have unveiled the double-edged role of immune response in the development of periodontitis. Immune senescence, which is described as age-related alterations in immune system, including a diminished immune response to endogenous and exogenous stimuli, a decline in the efficiency of immune protection, and even failure in immunity build-up after vaccination, leads to the increased susceptibility to infection. Recently, the intimate relationship between immune senescence and periodontitis has come into focus, especially in the aging population. In this review, both periodontal immunity and immune senescence will be fully introduced, especially their roles in the pathology and progression of periodontitis. Furthermore, novel immunotherapies targeting immune senescence are presented to provide potential targets for research and clinical intervention in the future.
Expression of Concern: The pathophysiological and immunological background of the monkeypox virus infection: An update
Authors: Mukherjee Anirban Goutam , Wanjari Uddesh Ramesh , Kannampuzha Sandra , Das Soumik , Murali Reshma , Namachivayam Arunraj , Renu Kaviyarasi , Ramanathan Gnanasambandan , Doss C. George Priya , Vellingiri Balachandar , Dey Abhijit , Valsala Gopalakrishnan Abilash
Published: October 2022

In addition to the COVID‐19 waves, the globe is facing global monkeypox (MPX) outbreak. MPX is an uncommon zoonotic infection characterized by symptoms similar to smallpox. It is caused by the monkeypox virus (MPXV), a double‐stranded DNA virus that belongs to the genus Orthopoxvirus (OPXV). MPXV, which causes human disease, has been confined to Africa for many years, with only a few isolated cases in other areas. Outside of Africa, the continuing MPXV outbreak in multiple countries in 2022 is the greatest in recorded history. The current outbreak, with over 10 000 confirmed cases in over 50 countries between May and July 2022, demonstrates that MPXV may travel rapidly among humans and pose a danger to human health worldwide. The rapid spread of such outbreaks in recent times has elevated MPX to the status of a rising zoonotic disease with significant epidemic potential. While the MPXV is not as deadly or contagious as the variola virus that causes smallpox, it poses a threat because it could evolve into a more potent human pathogen. This review assesses the potential threat to the human population and provides a brief overview of what is currently known about this reemerging virus. By analyzing the biological effects of MPXV on human health, its shifting epidemiological footprint, and currently available therapeutic options, this review has presented the most recent insights into the biology of the virus. This study also clarifies the key potential causes that could be to blame for the present MPX outbreak and draw attention to major research questions and promising new avenues for combating the current MPX epidemic.
Speaking without words: A meta‐analysis of over 70 years of research on the power of nonverbal cues in job interviews
Authors: Martín‐Raugh Michelle P. , Kell Harrison J. , Randall Jason G. , Anguiano‐Carrasco Cristina , Banfi Justin T.
Published: October 2022

What candidates say in an interview is important—but so is how they say it. We draw on dual‐process theory to explain why interviewers rely on individuals' dynamic and static nonverbal cues to evaluate performance with quick, implicit inferences (System 1 processing). Yet, it remains unclear which cues most influence interviewers' judgments and whether moderators affecting interviewers' reliance on System 1 thinking (e.g., interview structure, modality, duration, and interviewee gender) impact the relationship between nonverbal cues and interview ratings. We performed the first meta‐analysis to address these questions, integrating findings across 63 studies (N = 4868). The nonverbal cues demonstrating the strongest association with interview performance were professional appearance (ρ = .62), eye contact (ρ = .45), and head movement (ρ = .43). Moderator analyses highlight the persistent power of nonverbal cues, as the results were largely unaffected by interview structure, modality, or duration. Experimental design did play a role, as did interviewees' gender, with stronger effects for certain nonverbal cues (e.g., facial expressions and professional appearance) for women than men, conveying interviewers' reliance on gender‐based stereotypes when judging their performance. Overall, these results suggest nonverbal cues and characteristics are an important influence on job applicants' success in employment interviews.
Fertilization depth effect on mechanized direct‐seeded winter rapeseed yield and fertilizer use efficiency
Authors: Chen Hui , Gao Liping , Li Mengcheng , Liao Yitao , Liao Qingxi
Published: October 2022

Background

Deep fertilization is effective for improving crop yield and fertilizer use efficiency. However, its impact on mechanized direct‐seeded rapeseed and the optimal fertilization depth are poorly understood. A field experiment was conducted to evaluate the fertilization depth effect on mechanized direct‐seeded rapeseed growth. Five treatments were designed: surface broadcast fertilizer, no fertilization, and fertilizer banded placement at soil depths of 5 (D5), 10 (D10), and 15 cm (D15).

Results

Compared with surface broadcast fertilizer, deep fertilization generally increased seed yield and partial factor productivity by 11.0%, agronomic efficiency (AE) by 22.7%, and recovery efficiency (RE) by 79.2% due to the increase of root mass density (16.8%), plant height (8.6%), height of the first branch (10.6%), stem diameter (22.4%), shoot biomass (16.1%), and shoot nitrogen (35.7%), phosphorus (29.7%), and potassium (26.2%) uptake. D10 had the highest seed yield, oil yield, fertilizer use efficiency, and economic benefits at different fertilization depth treatments. Compared with D5 and D15 respectively, D10 increased seed yield by 5.4% and 46.0%, oil yield by 7.7% and 50.5%, partial factor productivity by 5.4% and 46.0%, AE by 9.0% and 99.5%, RE of nitrogen by 48.9% and 34.9%, RE of phosphorus by 83.1% and 38.0%, and RE of potassium by 57.5% and 32.5%. The economic benefits of D10 were CNY 867.31 ha−1 and CNY 4864.23 ha−1 higher than D5 and D15 respectively.

Conclusion

Considering rapeseed growth and its economic benefits, this study shows that 10 cm is an appropriate placement depth with regard to mechanized direct‐seeded winter rapeseed production. © 2022 Society of Chemical Industry.
The Preliminary Application of Simultaneous Display of Contrast‐Enhanced Ultrasound and Micro‐Flow Imaging Technology in the Diagnosis of Hepatic Tumors
Authors: Han Hong , Ji Zhengbiao , Huang Beijian , Mao Lijuan , Cao Qiong , Fan Peili , Wang Wenping
Published: October 2022

Objectives

To evaluate the value of simultaneous display of contrast‐enhanced ultrasound and micro‐flow imaging technology (CEUS‐MFI) in intra‐tumoral vessel detection and hepatic tumor diagnosis.

Methods

A total of 82 patients with 82 focal liver lesions were enrolled in this study. Each patient received ultrasound exams including color Doppler flow imaging (CDFI), micro‐flow imaging (MFI), contrast‐enhanced ultrasound (CEUS), and CEUS‐MFI with a Philips EPIQ7 ultrasound imaging system. The intra‐tumoral vessels detected by CDFI, MFI, and CEUS‐MFI were compared, respectively. The accuracy and confidence of using CEUS and CEUS‐MFI in diagnosing hepatic tumors were also compared.

Results

CEUS‐MFI was capable of detecting more hepatic intra‐tumoral vessels than MFI (P = .000) and CDFI (P = .000). Compared with CEUS, CEUS‐MFI improved the diagnostic accuracy of hepatic lesions (P = .009). Particularly, among the correctly diagnosed hepatic lesions, the number of cases where radiologists diagnosed with great confidence was increased from 88.4% (61/69) with CEUS only to 92.4% (73/79) with CEUS‐MFI (P = .041).

Conclusions

CEUS‐MFI is sensitive in detecting hepatic intra‐tumoral vessels and can improve the accuracy and confidence of radiologists in diagnosing hepatic lesions.
Microbial pathogenesis and the evasion strategies from the legume plant protective immunity
Authors: Noor Rashed
Published: October 2022

Plants are stringent sources for the global food supply, and among them, legumes are considered to be the special ones since they have the specific capability to develop a symbiotic relationship with certain soil microorganisms (i.e., the rhizobial community) which deliberately fix the atmospheric nitrogen that is required for the further cellular synthesis. Biological nitrogen fixation (BNF) by the legume plants is essential for viable agricultural production and to decrease the use of synthetic nitrogen fertilizer in the agricultural fields. However, being the indigenous soil habitants, almost all plants are constantly encountering soil bacteria, viruses, fungi, nematodes, and so on, which may instigate an array of plant diseases conferring the global food security risk. Assimilation of plant nutrients is largely driven by the specific symbiotic interaction between rhizobial species and the leguminous plant roots through the formation of root nodules. Hence, in order to improve the crop yield and to ensure a sustainable supply of plant proteins and other nutrients, the protective immunity of the legume plants against the plant pathogens needs to be understood well because legumes comprise the maximum portion of all plants for serving as the human food and livestock feed. Present review emphasized on the bacterial pathogens and the virulent genes that are detrimental to plants including legumes. The evasion strategy of these harmful microorganisms from the plants' protective immunity is also discussed.
Primary Palliative Care in Huntington's Disease
Authors: Harrison Madaline B. , Morrissey Dana L. , Dalrymple W. Alex , D'Abreu Anelyssa , Daly Farrah N.
Published: October 2022

Background

Palliative care practices, including communication about patient‐centered goals of care and advance care planning (ACP), have the potential to enhance care throughout the course of Huntington's disease (HD) and related disorders. The goal of our project was to develop a pilot program that integrates primary palliative care practices with interdisciplinary care for HD.

Objectives

(1) To train HD team members to facilitate goals of care and ACP conversations at all stages of HD; (2) To create materials for care planning in HD focused on patient‐centered goals of care and health‐related quality of life; and (3) To modify clinic workflow to include goals of care and ACP discussions.

Methods

We defined planning domains to expand care planning beyond end‐of‐life concerns. We created a patient and family guide to advance care planning in HD. We conducted VitalTalk communications training with the HD team. We modified the interdisciplinary clinic workflow to include ACP and developed an EMR template for documentation.

Results

After communication training, more team members felt well prepared to discuss serious news (12.5% to 50%) and manage difficult conversations (25% to 62.5%). The proportion of clinic visits including advance care planning discussions increased from 12.5% to 30.6% during the pilot phase.

Conclusions

Provision of primary palliative care for HD in an interdisciplinary clinic is feasible. Integration of palliative care practices into HD specialty care requires additional training and modification of clinic operations.
A dedicated breast‐PET/CT scanner: Numerical observer study of lesion detection
Authors: Raylman Raymond R. , Stolin Alexander , Hays Savannah , Johnson Evan , Lankas Sarah , Mekonnen Mahder , Roemer Kathryn
Published: October 2022

Background

Dedicated, breast‐specific positron emission tomography (BPET)–cone‐beam computed tomography (BPET/CT) systems have been developed to improve detection and diagnosis of cancer in women with indeterminate mammograms caused by radiodense breasts. The absorption of X‐rays that often vexes mammography in this subset of women does not affect the detection of the high energy annihilation photons used in PET. PET imaging of the breast, however, is subject to limitations caused by their comparatively low spatial resolution (∼2 mm) and often moderate radiotracer uptake in lesions.

Purpose

The purpose of this investigation is to explore the PET‐based lesion detection capabilities of a BPET/CT scanner developed by the Department of Radiology Instrumentation group at West Virginia University.

Methods

The PET component of the system consists of a rotating pair of 96 × 72 arrays of 2 × 2 × 15 mm3 LYSO scintillator elements. The cone‐beam‐CT component utilized a pulsed X‐ray source and flat panel detector operated in portrait orientation. The density maps created by the CT scanner were used to correct the BPET data for photon attenuation and Compton scattering. The nonuniform uptake of 18F‐fluorodeoxyglucose (FDG) in normal breast tissue was emulated in a specially designed phantom consisting of an acrylic cylinder filled with a mixture of acrylic beads and liquid containing FDG. FDG‐avid lesions were simulated with agar spheres (3, 4, 6, 8, and 10 mm diameters) containing vary amounts of FDG to produce target‐to‐background ratios (TBR) of 6:1, 8:1, and 10:1. The spheres also contained X‐ray contrast agent to make even the smallest ones readily visible in CT images. Positions of all the lesions were identified in the CT images. These positions were used to extract signal present and signal absent sub‐images from the PET images. The sub‐images were then input to software that calculated areas‐under‐the‐curve for two numerical model observers (Laguerre–Gauss channelized Hotelling observer and non‐prewhitening matched filter).

Results

The results showed that the smallest detectable lesion with this system is no smaller than ∼3 mm in diameter with a TBR of 6:1. Simulated lesions with diameters of 4 mm and greater were calculated to have good to excellent likelihood of detection for all TBRs tested.

Conclusion

The results from this investigation identified the detectability capabilities and limitations for a dedicated breast‐PET/CT scanner. Its ability to detect relatively small simulated FDG‐avid breast lesions for a range of TBRs indicates its potential for clinical application. Finally, the study used methodologies that could be applied to a detectability assessment of other PET/CT scanners.
Traffic rate network tomography with higher‐order cumulants
Authors: Lev‐Ari Hanoch , Ephraim Yariv , Mark Brian L.
Published: October 2022

Network tomography aims at estimating source–destination traffic rates from link traffic measurements. This inverse problem was formulated by Vardi in 1996 for Poisson traffic over networks operating under deterministic as well as random routing regimes. In this article, we expand Vardi's second‐order moment matching rate estimation approach to higher‐order cumulant matching with the goal of increasing the column rank of the mapping and consequently improving the rate estimation accuracy. We develop a systematic set of linear cumulant matching equations and express them compactly in terms of the Khatri–Rao product. Both least squares estimation and iterative minimum I‐divergence estimation are considered. We develop an upper bound on the mean squared error (MSE) in least squares rate estimation from empirical cumulants. We demonstrate that supplementing Vardi's approach with the third‐order empirical cumulant reduces its minimum averaged normalized MSE in rate estimation by almost 20% when iterative minimum I‐divergence estimation was used.
Circular representative volume elements for strain localization problems
Authors: Hofman Pieter , Ke Lu , van der Meer Frans P.
Published: October 2022

A common choice for multiscale modeling of the mechanical response of composites is to use periodic boundary conditions (PBCs) on square and cubical representative volume elements (RVEs). However, when strain localization occurs in the micromodel, these PBCs are unable to reproduce the transverse isotropy of composite materials with a random microstructure. Existing remedies to alleviate this issue have been proposed in literature by either rotating or shifting the periodicity constraints. However, this results in a mismatch of the microstructure on opposing edges which may prevent cracks to cross the boundary and consequently limit the supported localization angles. Furthermore, in absence of a strategy that ensures a single localization band to arise in a fracturing RVE, it is difficult to formulate a generic expression for the length scale parameter that is used to regulate the energy dissipation, which plays an important role in obtaining RVE‐size objective results. As an alternative to square (or cubical) RVEs, circular (or spherical) RVEs have been proposed in literature since they provide a response which is independent of the orientation due to shape of the RVE. However, it is shown in this work that the existing formulation with straightforward application of PBCs on a circular RVE fails to predict the correct softening behavior, due to over‐constraining when cracks reach the boundary. Therefore, a new formulation of PBCs on a circular RVE is proposed, which allows for a single fully developed localization band under arbitrary angle. The performance of the new formulation is tested with a series of simulations where macroscopic strains are imposed under varying orientations. It is demonstrated that the circular RVE with the new formulation of PBCs successfully predicts a transversely isotropic response with full softening without the issue of mismatching microstructure as with previously developed remedies for the square RVE. In addition, it is shown that the length scale parameter is well‐defined and independent of the orientation of the circular RVE.
NT‐proBNP and Zlog‐transformed NT‐proBNP values predict extubation failure in critically ill neonates with pulmonary hypertension and ventricular dysfunction
Authors: Schroeder Lukas , Kuelshammer Manuel , Dolscheid‐Pommerich Ramona , Holdenrieder Stefan , Mueller Andreas , Kipfmueller Florian
Published: October 2022

Objectives

Critically ill neonates with a history of pulmonary hypertension (PH) or ventricular dysfunction are at risk to experience an extubation failure (EF) after liberation from mechanical ventilation (MV). Due to insufficient data from neonatal cohorts, it remains unclear whether NT‐proBNP is an appropriate biomarker to predict EF in this cohort. The Zlog‐transformation of NT‐proBNP (further named NT‐proBNPZlog) is an additional tool to optimize the interpretation of NT‐proBNP since absolute NT‐proBNP values are varying with the age of these infants.

Patients and Methods

This was a retrospective single‐center analysis at the University Children's Hospital, Bonn, Germany, during the study period from January 2020 until December 2021. Forty‐three neonates met the inclusion criteria and were screened for study participation. Inclusion criteria: prolonged (>24 h) MV with at least one extubation attempt, with a history of PH and/or ventricular dysfunction in the echocardiographic assessment at admission to the neonatal intensive care unit or during the period of MV, NT‐proBNP measurements before (max. 24 h, baseline) and after (max. 24 h, follow‐up) the first extubation attempt. The primary clinical endpoint was defined as EF with need for reintubation (0–72 h). Neonates with an EF were allocated to group A and neonates with successful liberation from MV to group B.

Main Results

The primary clinical endpoint (EF) was reached in 21% (nine infants). Absolute mean NT‐proBNP values (NT‐proBNPabs) at baseline did not differ significantly in infants of group A and B (6931 vs. 7136 pg/ml, p = 0.227). NT‐proBNPZlog values at baseline (2.35 vs. 1.57, p = 0.073) tended to higher values in group A. NT‐proBNPabs values measured at follow‐up were significantly higher in infants allocated to group A (11120 vs. 7570 pg/ml, p = 0.027). Likewise, NT‐proBNPZlog values at follow‐up were significantly higher in infants allocated to group A (3.05 vs. 1.93, p = 0.009). NT‐proBNPabs values at follow‐up and NT‐proBNPZlog values at baseline correlated significantly with the severity of PH. Regarding the receiver operating characteristic‐analysis, a NT‐proBNPabs value at follow‐up of ≥4622 pg/ml was calculated as optimal cut‐off value for the prediction of EF (area under the curve [AUC] 0.742, p = 0.001). A NT‐proBNPZlog value at baseline of ≥1.63 and at follow‐up of ≥2.14 was calculated as optimal cut‐off for the prediction of EF (AUC: 0.690/p = 0.027, and 0.781/p = 0.000, respectively).

Conclusion

NT‐proBNPabs and NT‐proBNPZlog might be valuable biomarkers for the prediction of EF in critically ill neonates. The Zlog‐transformation of NT‐proBNP allows an age‐independent interpretation of NT‐proBNP and should be considered for clinical routine.
BayeStab: Predicting effects of mutations on protein stability with uncertainty quantification
Authors: Wang Shuyu , Tang Hongzhou , Zhao Yuliang , Zuo Lei
Published: October 2022

Predicting protein thermostability change upon mutation is crucial for understanding diseases and designing therapeutics. However, accurately estimating Gibbs free energy change of the protein remained a challenge. Some methods struggle to generalize on examples with no homology and produce uncalibrated predictions. Here we leverage advances in graph neural networks for protein feature extraction to tackle this structure–property prediction task. Our method, BayeStab, is then tested on four test datasets, including S669, S611, S350, and Myoglobin, showing high generalization and symmetry performance. Meanwhile, we apply concrete dropout enabled Bayesian neural networks to infer plausible models and estimate uncertainty. By decomposing the uncertainty into parts induced by data noise and model, we demonstrate that the probabilistic method allows insights into the inherent noise of the training datasets, which is closely relevant to the upper bound of the task. Finally, the BayeStab web server is created and can be found at: http://www.bayestab.com. The code for this work is available at: https://github.com/HongzhouTang/BayeStab.
Are Virtual Consultations Suitable for Patients with Vulval Disease? A Multicentre Audit of Outcomes in the COVID-19 Pandemic
Authors: Lewis Fiona M. , McSweeney Sheila M. , Wendling Jeanne , Moyal-Barracco Micheline
Published: October 2022

Background

During the COVID-19 pandemic, virtual consultation (VC) was used to replace in-person consultations. This raises specific questions when dealing with vulval conditions.

Objectives

To assess the feasibility and the efficiency of VC with and without supplementary imaging, in patients with vulval conditions, and to evaluate the images provided as an aid to diagnosis.

Methods

This prospective multicentre audit took place in three specialized vulval clinics in London and Paris. Anonymized data on patients' clinical characteristics, consultation characteristics (including the number and quality of any supplementary images provided) and consultation outcomes (diagnostic certainty and physician satisfaction) were collected. Characteristics and outcomes in those with or without supplementary imaging were compared amongst both new and follow-up consultations.

Results

A total of 316 VCs were included. In total, 18.7% (n = 59) were new patient consultations and 81.3% (n = 257) were follow-up. Supplementary imaging (photographs and/or video recordings) were provided by 28.5% (n = 90) of the total cohort. Median photographic quality was significantly higher on a five-point Likert-type scale when photographs were taken by a third party as opposed to the patient themselves (4 vs. 3, Mann-Whitney U-test, p < 0.0001). There was no association between the provision of supplementary imaging and diagnostic certainty amongst new patient consultations. However, a higher proportion of follow-up patients who provided supplementary imaging received definitive management decisions (χ2 test, p < 0.001) and physician satisfaction with these consultations, as measured on a five-point Likert-type scale, was significantly higher (Mann-Whitney U-test, p < 0.0001). Furthermore, median physician satisfaction scores ≥4 were observed in follow-up consultations for candidiasis, lichen simplex/eczema and vulvodynia.

Conclusions

Although in-person consultation remains the gold standard of care, VC may have a role in the management of selected patients with vulval disease. It is possible to provide good-quality photographs for clinical assessment, particularly with the help of a third party and follow-up patients with an established, cancer-unrelated diagnosis may be best suited for this consultation modality.
Effect of water to cement (W/C) ratio and age on mechanical behavior of tire‐recycled steel fiber reinforced concrete
Authors: Karimi Hamid Reza , Ebneabbasi Pouyan , Shahni Karamzadeh Nima , Khedri Ehsan
Published: October 2022

The annual entrance of billions of used tires into landfills has caused tremendous environmental concerns, while the recycled steel fibers from these tires can improve the mechanical characteristics of construction materials, including cement concrete. In this paper effect of the addition of recycled steel fibers on mechanical characteristics of ordinary cement concrete with different water to cement ratios are studied; to achieve that, compressive and flexural specimens are exanimated using standard test methods with four general mix designs. The range of recycled steel fibers is chosen as 0%, 1%, 2%, 3%, and 4% (per unit weight), and optimal fiber percentages based on water to cement ratios are also calculated. Results show that using recycled steel fibers positively affects all the mix designs, especially ductility, and postfracture energy absorption increases with the increase of fiber content. Fiber addition increases the compressive and flexural strength by about 25% and 58%, respectively. Depending on the water to cement ratio, the optimum percentage of recycled steel fiber for concretes with 0.6, 0.5, and 0.4 water to cement ratios are 3.0%, 2.3%, and 1.8% of unit weight, respectively.
Order‐structured solid‐state electrolytes
Authors: Wu Jingyi , Rao Zhixiang , Wang Huanlei , Huang Yunhui
Published: October 2022

Solid‐state electrolytes (SSEs) are recognized as attractive candidates to realize safe and high‐energy‐density lithium metal batteries (LMBs). However, the practical application of SSEs still faces challenges such as insufficient room‐temperature ionic conductivity, unsatisfactory mechanical properties, and large internal resistance. Extensive research efforts have been made to explore new electrochemistry and technologies to address those challenges. Among them, the construction of order‐structured SSEs has emerged as a promising strategy. The anisotropic behavior induced by the orientation offers SSEs with desired properties targeting specific functions, and therefore the rational design of the order‐structured SSE provides an alternative solution to achieve an ideal SSE. This review discusses the structure‐property correlation of SSEs, and then summarizes the design strategies to construct order‐structured SSEs. Finally, the current challenges and possible future research directions for order‐structured SSEs for scalable high‐energy‐density LMBs are presented.
Responsive instructional design for students' epistemic agency: Documenting episodes of principled improvisation in storyline enactment
Authors: Cherbow Kevin
Published: October 2022

Recent reforms in K‐12 science education call for curricular materials that are designed to be “coherent for students.” This form of coherence arises when the classroom community sees their science work as addressing their questions and problems. In enactment, the teacher sometimes has to improvise from the planned trajectory of the storyline to follow students' emergent science work. In this single instrumental case study, I used interaction analysis to identify and describe episodes of whole group storyline discussion where one expert middle school science teacher worked with his students as their science work diverged from the storyline. The descriptive account for each episode documents how the teacher attended to the conceptual, epistemic, and/or interactive facets in the substance of students’ talk. It also traces how collective knowledge objects (i.e., consensus model, driving questions board, and experimental graph) were developed through this attentional work in each episode. The results suggest that the teacher facilitated episodes of principled improvisation (PI) related to the students’ interactive role in the discussion, the science ideas they raised for a consensus model, and the measurement errors they experienced in an investigation. These episodes were principled because the teacher foregrounded particular trajectories in the storyline to mediate and add rigor to the students’ divergent lines of science work. They were improvisational because the teacher backgrounded other storyline trajectories to more effectively address and work with students’ emergent ideas. In each PI, the teacher shared epistemic agency with students to co‐develop each collective knowledge object. These findings show the analytical and practical value in conceptualizing epistemic agency and teachers’ instructional design work in relation to students’ convergent and divergent science work in the curriculum.
An assessment of the UV/nFe0/H2O2 system for the removal of refractory organics in the effluent produced by the biological treatment of landfill leachate
Authors: Feng Ke , Mu Shiqi , Fang Feiyan , Xie Mingde
Published: October 2022

The removal efficiency and mechanism of the ultraviolet/nanoscale Fe0/H2O2 (UV/nFe0/H2O2) system for refractory organics in membrane bioreactor effluent were investigated. The most effective removal of organics was achieved at initial pH = 3.0, H2O2 dosage = 50 mM, nFe0 dosage = 1.0 g/L, and UV power = 15 W, with a reaction time of 60 min. Under these conditions, the absorbance at 254 nm, chromaticity, and total organic carbon removal efficiencies were 65.13%, 79.67%, and 61.51%, respectively, and the aromaticity, humification, molecular weight, and polymerization of organics were all significantly reduced. The surface morphology and elemental valence analysis of nano zero‐valent iron (nFe0) before and after the reaction revealed the formation of iron‐based (hydrated) oxides, such as Fe2O3, Fe3O4, FeOOH, and Fe (OH)3, on the surface of the nFe0. Refractory organics were removed by Fenton‐like reactions in the homogeneous and heterogeneous adsorption–precipitation of iron‐based colloids. At the same time, UV radiation accelerated the formation of Fe2+ on the nFe0 surface and promoted the Fe3+/Fe2+ redox cycle to a certain extent, enhancing the removal of refractory organics. The results provide a theoretical basis for the application of the UV/nFe0/H2O2 system to remove refractory organics in the effluent produced by the biological treatment of landfill leachate.

Practitioner points

The UV/nFe0/H2O2 process is effective in refractory organics removal in leachate treatment.

Humus in leachate was largely destroyed and mineralized by the UV/nFe0/H2O2 process.

Active nFe0 material participated in the Fenton‐like process and was promoted by UV.

The effects of nFe0 material and UV introduction were investigated.
Endohedral Ten‐Vertex Clusters [Ga@Tl10]8− in the Mixed Trielides A8GaTl10 (A=K, Rb, Cs)
Authors: Lehmann Bernard , Röhr Caroline
Published: October 2022

The mixed Ga/Tl trielides A8GaTl10 (A=K, Rb, Cs), which were yielded from stoichiometric melts of the elements, crystallize in the tetragonal K8ZnIn10‐type structure (SG P4/nnc, a=1018.58(3)/1047.14(6)/1077.74(10), c=1363.71(5)/1400.07(8)/1435.4(2) pm, Z=2, R1=0.0187/0.0209/0.0218 for A=K/Rb/Cs). The structures contain isolated ten‐vertex endohedral Ga‐centered clusters [Ga@Tl10]8−, in which the Tl atoms adopt a bicapped square antiprismatic shape. Although the crystallographic point group is 422 only, the cluster shape deviates only slightly from the ideal
m2 (D4d) symmetry. The Ga−Tl distances of the two axial Tl(1) atoms are with 305 to 312 pm significantly longer than the eight Ga−Tl(2) bonds (approx. 290 pm). The clusters are enclosed by a shell of 24 (4 : 8 : 8 : 4) alkali cations. For K8GaTl10 and the Zn‐analog K8ZnTl10 the band structures were calculated within the framework of the APW+lo DFT method. Whereas the electron precise 10d+40 valence electron zinc compound exhibits the expected small band gap, the 41 v.e. cluster in K8GaTl10 is a radical with a half‐occupied band crossing the Fermi level. As shown from energy‐selected electron density plots, the large DOS at the Fermi level results from a half‐occupied a1 state dominated by apical Tl(1) pz contributions, which is consistent with molecular DFT studies for related ten‐vertex clusters. The bonding features in the Ga‐centered 41 v.e. clusters of the title compounds are thus intermediate between the 10d+40 Zn‐trielide [Zn@Tl10]8− and the 10d+42 v.e. systems like [Ni@Pb10]2−.
Holographic dissipation from the symplectic current
Authors: Donos Aristomenis , Kailidis Polydoros , Pantelidou Christiana
Published: October 2022

Abstract

We develop analytic techniques to construct the leading dissipative terms in a derivative expansion of holographic fluids. Our basic ingredient is the Crnkovic-Witten symplectic current of classical gravity which we use to extract the dissipative transport coefficients of holographic fluids, assuming knowledge of the thermodynamics and the near horizon geometries of the bulk black hole geometries. We apply our techniques to non-conformal neutral fluids to reproduce previous results on the shear viscosity and generalise a known expression for the bulk viscosity.
New generalized uncertainty principle with parameter adaptability for the minimum length
Authors: Du Xin-Dong , Long Chao-Yun
Published: October 2022

Abstract

There have been many papers suggesting that the parameter of the generalized uncertainty principle should be negative rather than positive in some specific scenarios, and the negative parameter can remove the minimum length. However, the minimum length is a model-independent feature of quantum gravity and it should not be affected by the specific scenarios. In order to solve this contradiction, we derive a new generalized uncertainty principle to reflect a fixed and unified minimum length in both cases of positive and negative parameters.
Flavour-kinematics duality for Goldstone modes
Authors: de Neeling Dijs , Roest Diederik , Veldmeijer Sam
Published: October 2022

Abstract

Three scalar effective field theories have special properties in terms of non-linear symmetries, soft limits and on-shell constructability that arise from their Goldstone nature: the non-linear σ-model, multi-DBI theory and the special Galileon. We discuss how these theories are related via flavour-kinematics duality, analogous to the colour-kinematics duality between gravity and gauge theories. At the off-shell level, we identify a specific mapping between the three theories that is crucially dependent on their non-linear symmetries. Similarly, we demonstrate how the on-shell amplitudes factorise into BCJ numerators describing flavour and a scalar version of kinematics, naturally leading to the inclusion of graviton exchange in the SO(M, N) non-linear σ-model. Finally, we map those numerators onto each other, and comment on a similar relation to tensor kinematics. Our results highlight a common structure that underlies the physics of different Goldstone modes.
Phenotypic description of Egyptian endemic centipedes, genus Scolopendra Linnaeus, 1758 with a histological study of its venom glands
Authors: Mona Mahy Mohammed , Atlam Aalaa I.
Published: October 2022

Centipedes are widely distributed over all continents. They have significant medicinal value and high toxicity, making them an intriguing subject for evolutionary research. The current study aims to provide the first comprehensive analysis of the morphology, description, and distribution preferences of the Egyptian Scolopendromorpha centipede fauna. According to surveillance research in Egypt, two Scolopendra species have been re-described. Scolopendra canidensNewport.1844 were discovered in only one location, whereas Scolopendra morsitans s Linnaeus,1758 was more abundant. Both venomous glands were histochemically investigated. This study is the first comparative report on the histology and histochemistry of the venom glands of the Egyptian centipede species. Both species’ glands are primarily composed of columnar secretory cells radially arranged side by side and open through pores in a central chitinous duct. Each secretory cell is enclosed in striated muscle fibers. The secretion of both glands takes the shape of small PAS-positive granules, suggesting the presence of neutral polysaccharides. According to this surveillance study, the most abundant species was Scolopendra morsitans s Linnaeus,1758. Scolopendra canidens canidensNewport.1844 were found only on the Northwest coast of Egypt. The findings also revealed that the analyzed species are comparable in terms of their venom morphology and fundamental chemical composition.
Preoperative stents for the treatment of obstructing left-sided colon cancer: a national analysis
Authors: Hadaya Joseph , Verma Arjun , Sanaiha Yas , Mabeza Russyan Mark , Chen Formosa , Benharash Peyman
Published: October 2022

Background

Given the risks associated with urgent colectomy for large bowel obstruction, preoperative colonic stenting has been utilized for decompression and optimization prior to surgery. This study examined national trends in the use of colonic stenting as a bridge to resection for malignant large bowel obstruction and evaluated outcomes relative to immediate colectomy.

Methods

Adults undergoing colonic stenting or colectomy for malignant, left/sigmoid large bowel obstruction were identified in the 2010–2016 Nationwide Readmissions Database. Patients were classified as immediate resection (IR) or delayed resection (DR) if undergoing colonic stenting prior to colectomy. Generalized linear models were used to evaluate the impact of resection strategy on ostomy creation, in-hospital mortality, and complications.

Results

Among 9,706 patients, 9.7% underwent colonic stenting, which increased from 7.7 to 16.4% from 2010 to 2016 (p < 0.001). Compared to IR, the DR group was younger (63.9 vs 65.9 years, p = 0.04), had fewer comorbidities (Elixhauser Index 3.5 vs 3.9, p = 0.001), and was more commonly managed at high-volume centers (89.4% vs 68.1%, p < 0.001). Laparoscopic resections were more frequent among the DR group (33.1% vs 13.0%, p < 0.001), while ostomy rates were significantly lower (21.5% vs 53.0%, p < 0.001). After risk adjustment, colonic stenting was associated with reduced odds of ostomy creation (0.34, 95% confidence interval 0.24–0.46), but similar odds of mortality and complications.

Conclusion

Colonic stenting is increasingly utilized for malignant, left-sided bowel obstructions, and associated with lower ostomy rates but comparable clinical outcomes. These findings suggest the relative safety of colonic stenting for malignant large bowel obstruction when clinically appropriate.

Graphical abstract