bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical evaluation of the efficacy of a facial serum containing dioic acid, glycolic acid, salicylic acid, LHA, citric acid, and HEPES in treating post‐inflammatory hyperchromia and controlling oily skin in patients with acne vulgaris
Authors: Campos Valeria , Pitassi Luiza , Kalil Célia , Gonçalves Júnior José Euzébio , Sant’Anna Beatriz , Correia Priscila
Published: February 2021

Background

Acne is a chronic disease that affects the pilosebaceous follicle and is characterized by the presence of non‐inflammatory and/or inflammatory lesions, affecting both adolescents and adults. Inflammatory acne lesions are capable to increase their melanin production and promote a post‐inflammatory hyperchromia.

Aims

To assess the efficacy of a serum containing dioic acid, glycolic acid, salicylic acid, LHA, citric acid, and HEPES in treating post‐inflammatory hyperpigmentation and controlling skin oiliness in Brazilian patients with acne vulgaris.

Patients/Methods

A single‐center, prospective, open‐label clinical study included 42 subjects, from both genders, presenting acne (grade I or II), oily skin and a clinical diagnosis of acne post‐inflammatory hyperpigmentation. The study was conducted for 56 days, with clinical (skin quality and the number of post‐inflammatory hyperchromic lesions) and instrumental (Sebumetry) evaluations after 7, 28, and 56 days of treatment. Standardized pictures were obtained using a VISIA‐6® device.

Results

A significant decrease in the grade of post‐inflammatory hyperchromic lesions was observed after 28 and 56 days, while the number of lesions decreases by 29.4% after 56 days (p < 0.001). Sebumetry values showed a significant decrease of 30.7% in the oiliness after 7 days of treatment, and then stable during the study conduction period of 56 days (p < 0.001 for all measurements).

Conclusions

The daily treatment using the investigational product showed an interesting decrease both in the grade and the number of post‐inflammatory hyperchromia acne lesions after 56 days, and in the oiliness after 7 days, being stable for all study period.
Management of delirium within intraoperative settings for older adults with hip fracture: a scoping review
Authors: White Laura Beth , Coyne Elisabeth , Grealish Laurie
Published: February 2021

Background

Delirium is a common adverse event in older patients undergoing hip fracture repair surgery. The impact of hospital‐acquired delirium during intraoperative phase of their treatment can have a significant impact on post‐operative outcomes. While non‐pharmacological, multicomponent delirium prevention interventions are considered standard practice in acute medical units, delirium management in the intraoperative setting is less clear.

Objectives

The aim was to identify evidence‐based delirium management interventions which are, and could be, undertaken within the intraoperative setting for older patients undergoing hip fracture repair surgery.

Design

A scoping review following the principles developed by Arksey and O’Malley (2005).

Data Sources

Seven databases including Cochrane, CINAHL, Embase, MEDLINE, PsychINFO, PubMed and SCOPUS were systematically searched. The search was limited to the last 11 years (2009–2020). Research studies included both primary and secondary sources of evidence.

Results

A total of 2464 articles were initially identified. These articles were further refined using keyword searches and exclusion criteria, with a final set of 16 articles meeting the inclusion criteria. Three main themes were as follows: anaesthetic‐related interventions used to prevent delirium; recognising non‐modifiable and potentially modifiable risk factors; and screening and diagnosis of delirium.

Conclusions

While there is a strong focus on anaesthetist‐led interventions in the intraoperative setting, there are opportunities for more nurse‐led interventions through adequate pain management and haemodynamic monitoring that require further research. Identifying the best test for screening and diagnosing delirium in the intraoperative setting requires further research.
Spiritual care needs and associated factors among patients with ostomy: A Cross‐Sectional Study
Authors: Ayik Cahide , Özden Dilek , Kahraman Aysel
Published: February 2021

Aims and objectives

To investigate the spiritual care needs and associated factors in patients with ostomy.

Background

The significance of the spiritual care needs of the patients has been emphasised across countries and cultures in the literature.

Design

A descriptive, cross‐sectional study.

Methods

Outpatients with an ostomy (n = 127) were recruited from proctology, wound and stoma therapy unit and general surgery clinics between January and 28 March 2020. The data were collected using the Socio‐demographic Characteristics Form and Spiritual Care Needs Inventory (SCNI). SCNI has two components, namely ‘meaning and hope’ and ‘caring and respect’. Descriptive statistics, correlation, Student's t test, ANOVA and multiple linear regression analyses were used to analyse the data. The STROBE checklist was used to report the study.

Results

The mean scores of the spiritual care needs (65.31 ± 12.83), meaning and hope (37.35 ± 9.37), and caring and respect (27.96 ± 5.63) of the patients with ostomy were found to be moderate. The most significant factors affecting the meaning and hope component were the age, being female and decreases in the level of income. Scores of the patients who perceived the severity of the disease seriously and who practiced religious ritual regularly had more spiritual care needs for the component of caring and respect. Patients with ostomy needed interaction, respect for their privacy and dignity, to be shown concern and to be respected for their religious and cultural beliefs, which were the most salient needs.

Conclusions

There is an unambiguous requirement for nurses to ensure spiritual care for patients with ostomy. Showing interest and spending time for the interaction with patients with ostomy, need‐based spiritual practices and life review are key elements of spiritual care.

Relevance to clinical practice

Evaluating patients with ostomy spiritually requires information about how spiritual needs may arise and how to talk about spiritual needs. The result of the present study may help nurses to begin the process of maintaining spiritual care for patients with ostomy.
What's going on after hospital? – Exploring the transition from hospital to home and patient experiences of nurse‐led follow‐up phone calls
Authors: Donsel Pernille Orloff , Missel Malene
Published: February 2021

Aims and Objectives

To explore the transition from hospital to home and patient experiences of nurse‐led post‐operative follow‐up phone calls after thoracic surgery.

Background

Enhanced Recovery After Surgery protocol places new demands on patients after hospital. Need for a proactive approach to improve the post‐operative follow‐up process in the home is required.

Design

Qualitative intervention study.

Methods

Interviews were conducted with patients who had received a post‐operative phone call after hospital discharge (n = 15). The analysis was inspired by Gadamer and Meleis. COREQ guidelines were followed.

Results

Two overall themes emerged: (1) The follow‐up phone call, which concerns experiences involving the actual call and (2) Transitioning from hospital to home, which through four subthemes illuminates; how patients describe their initial time at home, that patients experience a changed body after surgery, that patients feel alone after returning home and that a call from a nurse can help patients not to feel left out and finally why it is absolutely essential that nurses initiate the phone call.

Conclusion

Patients are at different stages in their transition process after hospital, making timing of follow‐up tricky. Being part of an Enhanced Recovery After Surgery programme has implications for the initial period after discharge; dominated by fatigue, pain and experiences of a changed body. Patients experience being left alone with their illness, and the phone call helps to relieve this isolation. It is essential that the nurse call the patient since the patients want to avoid disturbing the staff.

Relevance to clinical practice

Healthcare workers can use the findings to understand how patients experience the transition from hospital to home when enrolled in an Enhanced Recovery After Surgery programme. Need for support from a nurse following discharge is suggested.
Psychedelic Strategies; Alternative Phenomenologies, Translations, and Representations of the Human Body in Relation to Interior Space
Authors: Pellicano Emily
Published: February 2021

In the wake of a turning tide on the legalization of medicinal and recreational marijuana, and with the recent decriminalization of psilocybin in Denver, a psychedelic renaissance may too be on the horizon. Psychedelics have again become the subject of rigorous study at institutions such as Yale, UCLA, NYU, and Johns Hopkins. Many clinical accounts underscore the psychedelic experience with a “dissolution of the self” as an entity separate from the universe, producing a subjective–objective duality. By delving into clinical accounts of altered states of consciousness, this paper will identify potential “psychedelic strategies” which suggest alternative modes of translation and representation of the human body in relation to interior space, integrating the self with the built and natural environment, ultimately offering designers powerful tools to generate more socially, politically, and environmentally conscious interior futures, perhaps an alternate phenomenology of the interior.
Advance care planning among African American patients on haemodialysis and their end‐of‐life care preferences
Authors: Ahn Daniel , Williams Shellie , Stankus Nicole , Saunders Milda
Published: February 2021

Background

African Americans in the general population have been shown to be less likely than White ethnic groups to participate in advance care planning; however, advance care planning in the population receiving dialysis has not been well explored.

Objective

We examined the prevalence of African American patients receiving haemodialysis' advance care planning discussions, and whether advance care planning impacts end‐of‐life care preferences.

Design

In‐person interviewer‐administered surveys of African American patients receiving in‐centre haemodialysis.

Setting/Participants

About 101 participants at three large dialysis organisation units in Chicago.

Outcomes

Self‐reported advance care planning and preferences for life‐extending treatments at end‐of‐life.

Results

Most patients (69%) report no advance care planning discussions with their healthcare providers. Nearly all patients (92%) without prior advance care planning reported their healthcare providers approached them about advance care planning. While the majority of patients indicated preference for aggressive life‐extending care, prior conversations about end‐of‐life care wishes either with family members or a healthcare provider significantly decreased patients' likelihood of choosing aggressive life‐extending care across three scenarios (all p < 0.05). Significantly more patients reported that common end‐of‐life scenarios related to increased dependence/disability were “not worth living through” compared with those associated with increased burden on family, decreased cognitive function, and severe pain/discomfort.

Conclusion

African Americans with end‐stage renal disease need more frequent, culturally‐sensitive advance care planning discussions. Despite a preference for aggressive life‐sustaining treatments, individuals with prior advance care planning discussions were significantly less likely to support aggressive end‐of‐life care. End‐of‐life care discussions that focus on the impact of life‐extending care on patients' independence could be more concordant with the values and priorities of the African American patients.
Adolescents' use of online texts about US immigration: recognizing deeply personal meaning‐making
Authors: Rice Mary F. , Stevens Mark
Published: February 2021

Adolescents need help locating and evaluating information about immigration that reflects a panoply of views – particularly views that have been ignored in traditional texts. The purpose of this study was to gain insight into adolescents' engagement with online texts on the topic of immigration and associated concepts as they worked to develop critical digital literacies. The research question for this study was: How do adolescents make meaning about the political issue of immigration as they engage with and respond to online texts? As a theoretical framework, we used Barthes' notions ofpunctumandstudiumto illuminate how meaning was made in moments of deep engagement versus momentary reflection. During this study, meaning was made as students (1) clarified collective understandings in small groups, (2) confirmed or contrasted using personal experiences, and (3) held conclusions against a multiplicity of conceptual understandings aboutimmigrantsandimmigration. These findings illustrate the need to support adolescents, not only with multiple texts but also with multiple opportunities to consider and reconsider the texts in the context of their own experience with immigration.
Oral cancer development in lichen planus and related conditions—3.0 evidence level: A systematic review of systematic reviews
Authors: Ramos‐García Pablo , González‐Moles Miguel Ángel , Warnakulasuriya Saman
Published: February 2021

A systematic review of systematic reviews—aka overview of reviews, a novel type of study design providing a tertiary level of evidence—is presented on systematic reviews (SR) and meta‐analyses (MTA) evaluating the cancer development in oral lichen planus (OLP), oral lichenoid lesions (OLL), and oral lichenoid reactions (OLR). We searched for SR‐MTA published before January 2021. We evaluated the methodological quality of SR‐MTA using AMSTAR2 and checked the quality of evidence. Inclusion criteria were met by seven SR‐MTA. Oral cancer ratios ranged between 0.44% and 2.28% for OLP, between 1.88% and 3.80% for OLL, and 1.71% for OLR. Significant factors on cancer development reported in SR‐MTA were the presence of epithelial dysplasia, the consumption of tobacco and alcohol, the infection by the hepatitis C virus, the presence of atrophic and erosive lesions, and the location on the tongue. Only, one of the SRs assessed the quality of evidence, and most of them were judged to be of critically low methodological quality. In conclusion, based on the reported evidence on cancer incidence in OLP, our results reaffirm classifying OLP as an oral potentially malignant disorder. In relation to OLLs and OLRs, larger studies are necessary to provide further scientific evidence in this regard. Future follow‐up studies on OLP and related lesions should be carried out under stricter criteria that improve their quality of evidence and methodological quality.
Cyclometalated Iridium(III) Complexes as Mitochondria‐targeting Photosensitizers against Cisplatin‐resistant Cells†
Authors: Xiong Kai , Zhou Ying , Lin Xinlin , Kou Junfeng , Lin Mingwei , Guan Ruilin , Chen Yu , Ji Liangnian , Chao Hui
Published: February 2021

Four iridium (III) complexes Ir1‐Ir4 were synthesized and characterized. Possessing high singlet oxygen production ability and specific mitochondria‐localization, Ir1 was developed as a mitochondria‐targeting photosensitizer. Ir1 exhibited strong phototoxicity against cancer cell line A549 and its corresponding cisplatin‐resistant one A549R. In contrast, Ir1 showed low cytotoxicity toward normal cell HLF. This selectivity resulted from the different uptake amount. With 405 nm irradiation, Ir1 induced mitochondria‐mediated cell death in A549R cells, achieving the overcome of drug‐resistant.
Kicking Ash: Who (or What) is Winning the “War on Coal”?
Authors: Drake David F. , York Jeffrey G.
Published: February 2021

US coal‐fired generating capacity has shed nearly 25% of its footprint between 2011 and 2018. Multiple factors—regulation, natural gas prices, renewable energy adoption, and environmental activism—have each been lauded by various stakeholders for this trend. To improve our understanding of this environmental technology transition, it is important to determine the extent to which each of these factors has accelerated coal unit retirements. We do so in this study through an accelerated failure time model that utilizes data on US coal‐fired generating units from 2008 through 2016. Our findings indicate that environmental regulation, reduced natural gas price volatility, increased utilization of renewable capacity, and the Sierra Club’s Beyond Coal campaign have all accelerated coal unit retirements. We do not, however, find evidence that natural gas price levels or the penetration of renewable capacity have accelerated coal unit retirements. Among the significant drivers, we estimate that the Beyond Coal campaign has had the greatest effect per unit, reducing expected operating life by an average of 24.4 months. However, among these factors, federal regulation affected the greatest number of coal units, and thus had the greatest aggregate impact on coal retirements. In post hoc analysis, we estimate that 40% of the generation that had been provided by retired coal‐fired units spilled over to surviving coal‐fired units. However, we estimate the 60% that was displaced from the coal fleet resulted in a 103.6 to 178.2 million metric ton net reduction in [Formula: see text] emissions each year.
Migrants, State Responsibilities, and Human Dignity
Authors: Brownsword Roger
Published: February 2021

This article addresses two questions: First, how does the value of human dignity distinctively bear on a state’s responsibilities in relation to migrants; and, secondly, how serious a wrong is it when a state fails to respect the dignity of migrants? In response to these questions, a view is presented about the distinction between wrongs that violate cosmopolitan standards and wrongs that violate the standards that are distinctive to a particular community; about when and how the contested concept of human dignity might be engaged; and, elaborating a three‐tiered and lexically ordered scheme of state responsibilities, about how we should assess the seriousness of a state’s failure to respect the dignity of migrants.
Cone‐beam computed tomography versus computed tomography‐guided ultrathin bronchoscopic diagnosis for peripheral pulmonary lesions: A propensity score‐matched analysis
Authors: Kawakita Naoya , Takizawa Hiromitsu , Toba Hiroaki , Sakamoto Shinichi , Miyamoto Naoki , Matsumoto Daisuke , Takashima Mika , Tsuboi Mitsuhiro , Yoshida Mitsuteru , Kawakami Yukikiyo , Kondo Kazuya , Tangoku Akira
Published: February 2021

Diagnostic yields of CT‐guided and CBCT‐guided transbronchial biopsy for peripheral pulmonary nodules were compared by propensity score‐matched analysis. Overall diagnostic yields were 47.9% for CT‐guided biopsy and 72.9% for CBCT‐guided biopsy. CBCT‐guided biopsy improved the diagnostic yield.
Can central bank communication help to stabilise inflation expectations?
Authors: Jung Alexander , Kuehl Patrick
Published: February 2021

This paper examines whether central bank communication stabilises euro area inflation expectations through the information and news channel. A novelty of the study is its use of data from Google Analytics on ECB website traffic as proxy for visitors’ attention to its communication. We conduct several econometric tests with daily data to measure the impact of ECB communication on the information demand of the public and ultimately on inflation expectations. Overall, this study shows that website attention, as captured by search volumes of visitors, influences euro area inflation expectations. We find that increased website attention contributes to narrowing the gap between market‐based forecasts and (the mean of) longer‐term professional inflation expectations. Our findings add to the theoretical evidence on the existence of an information and news channel.
Sprinting, Strength, and Architectural Adaptations Following Hamstring Training in Australian Footballers
Authors: Timmins Ryan G. , Filopoulos Dean , Nguyen Victor , Giannakis Jake , Ruddy Joshua D. , Hickey Jack T. , Maniar Nirav , Opar David A.
Published: February 2021

The aim of this study was to determine the sprinting, strength, and architectural adaptations following a hip‐dominant flywheel (FLY) or Nordic hamstring exercise (NHE) intervention in Australian footballers. Twenty‐seven male athletes were randomized to FLY (n = 13) or NHE (n = 14) training across a 39‐week period (inclusive of pre‐season and in‐season). Biceps femoris long head (BFlh) architecture was assessed throughout. Eccentric hamstring strength and 40 m sprint times (with force‐velocity profiling) were assessed at baseline, end of pre‐season, and following the intervention. After the intervention, BFlh fascicle length was longer in both groups compared to baseline (FLY: 1.16 cm, 95%CI: 0.66 to 1.66 cm, d = 1.99, p < 0.001; NHE: 1.08 cm, 95%CI: 95%CI 0.54 to 1.61 cm, d = 1.73, p < 0.001). Both groups also increased their eccentric strength (FLY: mean change 82 N, 95%CI 12 to 152 N, d = 1.34, p = 0.026; NHE: mean change 97 N, 95%CI 47 to 146 N, d = 1.77, p = 0.001). After pre‐season, the NHE group improved their 5 m sprint time by 3.5% (±1.2%) and were 3.7% (±1.4%) and 2.0% (±0.5%) faster than the FLY group across 5 m and 10 m, respectively. At the end of pre‐season, the FLY group improved maximal velocity by 3.4% (±1.4%) and improved horizontal force production by 9.7% in‐season (±2.2%). Both a FLY and NHE intervention increase BFlh fascicle length and eccentric strength in Australian Footballers. An NHE intervention led to enhanced acceleration capacity. A FLY intervention was suggested to improve maximal sprint velocity and horizontal force production, without changes in sprint times. These findings have implications for hamstring injury prevention but also programs aimed at improving sprint performance.
Expression and prognostic value of TRPM7 in canine mammary tumours
Authors: Lee Seulji , Lee Sungin , Kim Wan Hee
Published: February 2021

Canine mammary gland tumour (CMTs) are one of the most commonly found tumours in intact female dogs. A previous study on canine mammary glands demonstrated the presence of the transient receptor potential melastatin 7 (TRPM7) ion channels in healthy canine mammary tissues. However, the significance of TRPM7 in CMT is not yet known. TRPM7 is a Ca2+ and Mg2+ permeable cation channel that contains a protein kinase domain. The aim of this study was to determine TRPM7 expression in 57 benign and malignant CMT tissues of dogs using immunohistochemistry (IHC) and evaluate its correlation with clinicopathological features and explore the potential prognostic value of TRPM7 in a prospective survival study. IHC analysis shows that TRPM7 was expressed in the cytoplasm of neoplastic epithelial cells. Moreover, TRPM7 expression was significantly associated with tumour malignancy (P = .027), Ki‐67 index (P < .0001) and metastasis (P < .0001). Survival curve analysis indicates that high TRPM7 expression was significantly associated with poor disease‐free (P = .035) and overall survival (P = .011) in malignant CMTs. Our results demonstrate that TRPM7 is expressed in CMTs and that its expression is positively correlated with clinicopathological parameters. Thus, TRPM7 was assumed to be a potential prognostic factor for CMTs.
Assessing the inactivation capabilities of two commercially available platelet component pathogen inactivation systems: effectiveness at end of shelf life
Authors: McDonald Carl P. , Bearne Jennifer , Aplin Kate , Sawicka Danuta
Published: February 2021

Background and objectives

The inactivation capabilities of the two current commercially available pathogen inactivation (PI) systems for platelet components (PC), Mirasol and Intercept, were investigated by determination of the absence of viable bacteria at the end of shelf life by testing the entire contents of the PC by enrichment culture (terminal sterility).

Methods

A pool‐and‐split method was used, with two treated units and one untreated control per inoculum concentration. Pairs of PC bags were inoculated with a single bacterial species. Three concentrations (n = 2 per concentration), which incremented tenfold, were tested initially based on published data from the manufacturer. Dependent on these results, the concentrations subsequently tested were either increased or decreased until the inactivation capability of the system was derived. Bacterial count was determined post‐spiking, immediately prior to treatment (2 h from spiking), immediately after treatment and at the end of shelf life (day seven). Enrichment culture was performed immediately prior to treatment, after treatment and at the end of shelf life.

Results

The inactivation capabilities, in CFU/ml, of Intercept and Mirasol, respectively, at the end of PC shelf life were as follows: Staphylococcus aureus ≥ 107, <101; Staphylococcus epidermidis ≥106, <102; Klebsiella pneumoniae 105, <101; Streptococcus bovis ≥107, 101, Escherichia coli ≥106, <101; Streptococcus pneumoniae ≥106, 103; Streptococcus mitis ≥107, 101; Listeria monocytogenes ≥107, 101; Streptococcus dysgalactiae ≥107, <101; Serratia marcescens 103, <101; Pseudomonas aeruginosa 103, Mirasol not tested; and Bacillus cereus < 102, Mirasol not tested.

Conclusion

The inactivation capability of Intercept was greater than that of Mirasol. Inactivation capability (by terminal sterility) is the most meaningful measure to evaluate a PI system for bacteria, rather than logarithmic reduction assessed immediately after treatment by plate count. PI offers a possible alternative to bacterial screening if treatment is performed at an appropriate time dependent on the inactivation capabilities of the system.
Renal venotomy for thrombectomy and kidney preservation in dogs with adrenal tumors and renal vein invasion
Authors: Chiti Lavinia E. , Mayhew Philipp D. , Massari Federico
Published: February 2021

Objective

To describe the surgical technique and report the outcomes of adrenalectomy and thrombus removal with kidney preservation by renal venotomy in a population of dogs with adrenal tumors and vascular invasion into the renal vein (RV) and caudal vena cava (CVC).

Study design

Short case series.

Animals

Five client‐owned dogs that underwent adrenalectomy.

Methods

Dogs with adrenal tumors and vascular invasion into the RV and CVC were retrospectively enrolled in this multi‐institutional study. Renal venotomy was performed at the time of adrenalectomy for tumor thrombus removal. Recorded data included signalment, clinical signs and results of laboratory testing, physical examination findings, diagnostic imaging results, surgical technique, surgical time, surgical complications, and outcome.

Results

Tumor thrombus was removed by renal venotomy in five dogs. In one dog with an ectopic adrenal tumor located ventral to the left kidney, the thrombus was occluding 90% of caval flow, and a small caval venotomy was required to remove it. Kidney preservation was achieved in all dogs. No significant intraoperative or postoperative complications occurred, and all dogs were discharged 3 to 4 days postoperatively. Median surgical time was 125 minutes (range, 80‐210). At the end of the study, four dogs were alive without signs of recurrence, while one dog died of a suspected pulmonary embolism at 510 days. Median follow‐up was 510 days (range, 279‐890).

Conclusion

Renal venotomy is feasible for thrombectomy in dogs with adrenal tumors and RV invasion and allowed for the preservation of the kidney in this case series, thus limiting perioperative morbidity.
Evaluation of a laparoscopic abdominal simulator assessment to test readiness for laparoscopic ovariectomy in live dogs
Authors: French Emily D. , Griffon Dominique J. , Kass Philip H. , Fahie Maria A. , Gordon‐Ross Paul , Levi Ohad
Published: February 2021

Objective

To predict readiness for laparoscopic ovariectomy of live dogs on the basis of performance on a high‐fidelity laparoscopic abdominal simulator and to determine interrater reliability of the assessment.

Study design

Experimental study.

Sample population

Seventeen fourth‐year veterinary students.

Methods

After a standardized laparoscopic training course, each participant performed a laparoscopic ovariectomy with a simulator. This performance was scored in real time by two evaluators using a rubric. Participants achieving a score of 112 of 160 performed a laparoscopic ovariectomy in a live dog, supervised by an instructor in the room. Two evaluators scored video recordings of each procedure using the rubric. Participants' opinions about the simulator were collected with a survey.

Results

All participants scored above the threshold (range, 126‐151) and successfully completed laparoscopic ovariectomy in a live dog, with an average of 10 of 17 participants requiring verbal guidance and 5 of 17 participants requiring intervention from the instructor. Interrater concordance was excellent for the rubrics used to score performance on the simulator (R = 0.91) and in vivo (R = 0.81). All participants agreed that the simulator should be used to assess trainee readiness prior to surgery in a live dog.

Conclusion

Participants achieving a score of at least 126 of 160 on the simulator were able to perform a laparoscopic ovariectomy in a live dog under supervision. The scoring system for the simulator had excellent interrater concordance.

Clinical significance

This simulator and scoring system can be used in laparoscopic training programs to assess readiness for progression to the operative setting.
Knowledge-Based Design Guidance System for Cloud-Based Decision Support in the Design of Complex Engineered Systems
Authors: Wang Ru , Milisavljevic-Syed Jelena , Guo Lin , Huang Yu , Wang Guoxin
Published: February 2021

The automation and intelligence highlighted in Industry 4.0 put forward higher requirements for reasonable trade-offs between humans and machines for decision-making governance. However, in the context of Industry 4.0, the vision of decision support for design engineering is still unclear. Additionally, the corresponding methods and system architectures are lacking to support the realization of value-chain-centric complex engineered systems design lifecycles. Hence, we identify decision support demands for complex engineered systems designs in the Industry 4.0 era, representing the integrated design problems at various stages of the product value chain. As a response, in this paper, the architecture of a Knowledge-Based Design Guidance System (KBDGS) for cloud-based decision support (CBDS) is presented that highlights the integrated management of complexity, uncertainty, and knowledge in designing decision workflows, as well as systematic design guidance to find satisfying solutions with the iterative process “formulation-refinement-exploration-improvement” (FREI). The KBDGS facilitates diverse multi-stakeholder collaborative decisions in end-to-end cloud services. Finally, two design case studies are conducted to illustrate the proposed work and the efficacy of the developed KBDGS. The contribution of this paper is to provide design guidance to facilitate knowledge discovery, capturing, and reuse in the context of decision-centric digital design, thus improving the efficiency and effectiveness of decision-making, as well as the evolution of decision support in the field of design engineering for the age of Industry 4.0 innovation paradigm.
Multi Observer-Based Sliding Mode Load Frequency Control With Input Delay Estimation
Authors: Dev Ark , Novella Rodríguez David Fernando , Anand Sumant , Sarkar Mrinal Kanti
Published: February 2021

The letter proposes frequency stability in power systems with input delay. A closed loop system can be oscillatory or even unstable without the exact knowledge of delay. Therefore, it is desirable to design a control scheme which is based on the estimation of unknown delay. The proposed design consists of an infinite dimensional observer with an adaptive time delay estimation and a sliding mode controller (SMC). The merit of the proposed concept lies in the fact that the unknown delay is valued by just estimating the smallest delay segment. The controller input is obtained from a set of sequential observers that predicts the system states and ensures asymptotic stability of the closed loop system with input delay estimation. The existence of sliding mode and the closed loop system stability is proved thanks to the Lyapunov and Lyapunov–Krasovskii candidate functionals, respectively. Simulation results confirm the effectiveness of the proposed design.
Noise Reduction of Ceiling Fans in Mass Production Applying DMAIC-Six Sigma Approach
Authors: Hasan Md. Zahid , Ahammed Rubel
Published: February 2021

Success and business reputation depend upon the quality of products where product quality relies on the capability of a process, yield value, sigma score, etc. The poor quality of ceiling fans was determined from the Pareto analysis of the define, measure, analyze, improve and control (DMAIC) model, which was humming noise during running, and further actions were undertaken regarding the reduction of the humming noise. Noise data were collected from random samples to determine the current sigma score, which was 3.14. Also, the weak value (1.05) of the Process Potential Index implied that the process condition was below the standard (< 1.33) and needed to be improved badly. Then, root cause analysis and relationship diagram were used to identify the possible causes. With the design of experiments and correlation analysis, it was clear that the air gap between the stator and rotor was the main culprit behind the humming noise. The suitable range of air gap was determined from boxplot analysis, which was 0.2 mm–0.225 mm and the corresponding amount of sound level in dB (37.5–40.3 dB) for a 0.225-mm air gap with the watt consumption (83 w) from the hypothesis test for the corresponding air gap. Finally, the updated sigma score and process capability analysis were performed with control charts to show the comparison after applying the DMAIC-Six Sigma methodology. The final sigma score was 5.1, which indicates a significant improvement of the process with the capability of saving 23,438 USD/year caused by the poor quality of ceiling fans.
Realization of a Novel Morphing Surface Using Additive Manufacturing and Its Active Control in Friction
Authors: Murashima Motoyuki , Imaizumi Yusuke , Kawaguchi Masato , Umehara Noritsugu , Tokoroyama Takayuki , Saito Toshiyuki , Takeshima Masayuki , Tsukiyama Yosuke , Nitta Isami
Published: February 2021

As the need for higher efficiency of engineering components increases, so does the demand for functional surfaces. While various tribosurfaces (e.g., texturing and coatings) have been developed, many researches are aimed at static functionality. On the other hand, due to a wide range of environmental adaptability and active control, active-morphing surfaces can be highly efficient and robust. In this paper, we demonstrate a novel morphing surface and its realization using additive manufacturing (AM). By using a diaphragm structure, morphing performance is achieved even if a hard resin material is used. When air pressure is applied to the backside of the diaphragm, it changes to a convex shape and vice versa. The concept requires a complex structure for arranging airflow and a solid morphing system. The AM is one great technique to create such complex structures. As a result of actual manufacturing, the created morphing structure realizes a large morphing of 600 μm or more. In addition, the shape changes reversibly depending on the air pressure. The surface also exhibits very interesting tribological characteristics. The surface shows a friction coefficient of about 0.3 with a concavity, and then increases to 0.5–1.7 with a convexity. A real-contact area measurement reveals that the novel property occurs due to change in the real-contact area depending on surface morphology. In conclusion, the present paper provides a new concept of a novel morphing tribosurface, which selectively performs as a low-friction or break-like surface, created using AM.
Generation of Genetic Tools for Gauging Multiple-Gene Expression at the Single-Cell Level
Authors: Mellini Marta , Lucidi Massimiliano , Imperi Francesco , Visca Paolo , Leoni Livia , Rampioni Giordano
Published: February 2021

Within a bacterial population, single cells can differently express some genes, even though they are genetically identical and experience the same chemical and physical stimuli. This phenomenon, known as phenotypic heterogeneity, is mainly driven by gene expression noise and results in the emergence of bacterial subpopulations with distinct phenotypes.
Differential Outcome between BALB/c and C57BL/6 Mice after Escherichia coli O157:H7 Infection Is Associated with a Dissimilar Tolerance Mechanism
Authors: Bernal Alan M. , Fernández-Brando Romina Jimena , Bruballa Andrea Cecilia , Fiorentino Gabriela A. , Pineda Gonzalo Ezequiel , Zotta Elsa , Vermeulen Mónica , Ramos María Victoria , Rumbo Martin , Palermo Marina Sandra
Published: February 2021

Enterohemorrhagic
Escherichia coli
(EHEC) infections can result in a wide range of clinical presentations despite that EHEC strains belong to the O157:H7 serotype, one of the most pathogenic forms. Although pathogen virulence influences disease outcome, we emphasize the concept of host-pathogen interactions, which involve resistance or tolerance mechanisms in the host that determine total host fitness and bacterial virulence.
All You Need to Know and More about the Diagnosis and Management of Rare Mold Infections
Authors: Hoenigl Martin , Levitz Stuart M. , Schuetz Audrey N. , Zhang Sean X. , Cornely Oliver A.
Published: February 2021

Invasive mold infections caused by molds other than
Aspergillus
spp. or Mucorales are emerging. The reported prevalences of infection due to these rare fungal pathogens vary among geographic regions, driven by differences in climatic conditions, susceptible hosts, and diagnostic capabilities.
Evaluation of Microbe-Driven Soil Organic Matter Quantity and Quality by Thermodynamic Theory
Authors: Zhang Jianwei , Feng Youzhi , Wu Meng , Chen Ruirui , Li Zhongpei , Lin Xiangui , Zhu Yongguan , Delgado-Baquerizo Manuel
Published: February 2021

Microbial communities are known to be important drivers of organic matter (OM) accumulation in terrestrial ecosystems. However, despite the importance of these soil microbes and processes, the mechanisms behind these microbial-SOM associations remain poorly understood.
Toward a Comprehensive Analysis of Posttranscriptional Regulatory Networks: a New Tool for the Identification of Small RNA Regulators of Specific mRNAs
Authors: Han Kook , Lory Stephen
Published: February 2021

With the recognition of the importance of posttranscriptional regulation mediated by bacterial small RNAs (sRNAs), their contribution to global gene expression regulatory networks needs to be addressed in a truly comprehensive manner. While a single sRNA targets multiple RNAs, an mRNA can be regulated by multiple sRNAs that can be either transcribed individually or derived by processing of mRNAs.
Microbiome Metadata Standards: Report of the National Microbiome Data Collaborative’s Workshop and Follow-On Activities
Authors: Vangay Pajau , Burgin Josephine , Johnston Anjanette , Beck Kristen L. , Berrios Daniel C. , Blumberg Kai , Canon Shane , Chain Patrick , Chandonia John-Marc , Christianson Danielle , Costes Sylvain V. , Damerow Joan , Duncan William D. , Dundore-Arias Jose Pablo , Fagnan Kjiersten , Galazka Jonathan M. , Gibbons Sean M. , Hays David , Hervey Judson , Hu Bin , Hurwitz Bonnie L. , Jaiswal Pankaj , Joachimiak Marcin P. , Kinkel Linda , Ladau Joshua , Martin Stanton L. , McCue Lee Ann , Miller Kayd , Mouncey Nigel , Mungall Chris , Pafilis Evangelos , Reddy T. B. K. , Richardson Lorna , Roux Simon , Schriml Lynn M. , Shaffer Justin P. , Sundaramurthi Jagadish Chandrabose , Thompson Luke R. , Timme Ruth E. , Zheng Jie , Wood-Charlson Elisha M. , Eloe-Fadrosh Emiley A.
Published: February 2021

Microbiome samples are inherently defined by the environment in which they are found. Therefore, data that provide context and enable interpretation of measurements produced from biological samples, often referred to as metadata, are critical.
Discovery of a large subsoil nitrate reservoir in an arroyo floodplain and associated aquifer contamination
Authors: Linhoff Benjamin S. , Lunzer John J.
Published: February 2021

In an area of elevated nitrate (NO3) groundwater concentrations in the northern Chihuahuan Desert in central New Mexico (United States), a large reservoir of nitrate was found in the subsoil of an arroyo floodplain. Nitrate inventories in the floodplain subsoils ranged from 10,000 to 38,000 kg NO3-N/ha—over twice as high as any previously measured arid region. The floodplain subsoil NO3 reservoir was over 100 times higher than the adjacent desert (59–95 kg NO3-N/ha). Chloride mass balance calculations of subsoils indicate arroyo floodplain subsoils have undergone negative recharge since 2600–8600 yr ago, while the surrounding desert has had negative recharge since 13,000–17,000 yr ago. Compared to the adjacent desert, plant communities are larger and more abundant in the floodplain, though subsoil NO3 is apparently not utilized. We demonstrate that NO3 accumulates in the subsoil of the floodplain through evaporation of monsoon season precipitation funneled into the arroyo. Through a one-dimensional vadose zone model, we show that the NO3 inventories in the arroyo floodplain could be acquired 8 to 75 times faster than through atmospheric deposition through the lateral movement of water from the arroyo channel to the adjacent unsaturated zone. As aquifer recharge occurs through the arroyo, channel migration across the floodplain likely flushes subsoil NO3 to the aquifer. High NO3 concentrations and molar ratios of NO3 to Cl in monitoring wells beneath the arroyo floodplain indicate a subsoil NO3 source. These results have major implications for land-use planning in arroyo and ephemeral stream floodplains as well as arid region soil biogeochemistry.
Redefining the age of the lower Colorado River, southwestern United States
Authors: Crow R.S. , Schwing J. , Karlstrom K.E. , Heizler M. , Pearthree P.A. , House P.K. , Dulin S. , Jänecke S.U. , Stelten M. , Crossey L.J.
Published: February 2021

Sanidine dating and magnetostratigraphy constrain the timing of integration of the lower Colorado River (southwestern United States and northern Mexico) with the evolving Gulf of California. The Colorado River arrived at Cottonwood Valley (Nevada and Arizona) after 5.24 Ma (during or after the Thvera subchron). The river reached the proto–Gulf of California once between 4.80 and 4.63 Ma (during the C3n.2r subchron), not at 5.3 Ma and 5.0 Ma as previously proposed. Duplication of section across newly identified strands of the Earthquake Valley fault zone (California) probably explains the discrepancy. The data also imply the start of focused plate motion and basin development in the Salton Trough (California) at 6–6.5 Ma and relative tectonic stability of the southernmost part of the lower Colorado River corridor after its integration. After integration, the Colorado River quickly incised through sediment-filled basins and divides between them as it also likely excavated Grand Canyon (Arizona). The liberated sediment from throughout the system led to deposition of hundreds of meters of Bullhead Alluvium downstream of Grand Canyon after 4.6 Ma as the river adjusted to its lower base level.
External signal preservation in halokinetic stratigraphy: A discrete element modeling approach
Authors: Cumberpatch Zoë A. , Finch Emma , Kane Ian A.
Published: February 2021

Subsurface salt movement in the absence of external tectonic forces can affect contemporaneous sediment deposition, mask allocyclic signals, and deform older strata. We used a discrete element model (DEM) to better understand salt-related modification of a sedimentary sequence with an increasing sedimentation rate. This permitted quantification of thinning rates and analysis of the lateral extent of synkinematic layers. Results show realistic evolution of salt-related faults, defining two salt-withdrawal basins, beyond which strata are undeformed. Thinning of stratigraphy is four times greater between the salt flank and crest than between the undeformed zone and flank, confirming an intense zone of halokinetic modulation adjacent to the diapir. Early, slowly aggrading layers are isolated within the salt-withdrawal basin and strongly influenced by salt growth, whereas later, quickly aggrading layers are more laterally extensive, matching inferences made from subsurface and outcrop data. Halokinetic modulation reduces up the stratigraphic section, mirroring observations around the Pierce diapirs, in the North Sea, offshore UK. Our DEM provides quantitative insights into the dynamic interplay between halokinetic and allocyclic controls on salt-stratigraphic relationships.
Supplemental Material: Shock-deformed zircon from the Chicxulub impact crater and implications for cratering process
Authors: Zhao Jiawei , Xiao Long , al. et
Published: February 2021

Additional details on the methods (Item S1), summary of EBSD mapping results (Table S1), shock effects in zircon from different depths (Table S2), and zircon data from different depths (Item S2).
Unusual cause of a painless soft tissue mass of the scalp: a rare presentation of primary intracranial neuroendocrine neoplasm
Authors: Manivannan Susruta , Sharouf Feras , Lammie George , Leach Paul
Published: February 2021

Incidental soft tissue lumps in the scalp are a common presenting complaint in clinical practice. However, they may signify more sinister underlying pathologies. Our report examines a 63-year-old man presenting with impaired co-ordination in his left hand following a 3-month history of a painless left retroauricular scalp lump. MRI revealed a large left occipital soft tissue mass eroding through the underlying skull with infiltration into the underlying cerebellum and temporal lobe. Open biopsy confirmed a diagnosis of high-grade intracranial neuroendocrine tumour (NET). At approximately 5 months following successful tumour resection and adjuvant chemotherapy, he developed tumour recurrence and was subsequently palliated, and died at 1 year post diagnosis. Herein, we review other cases of primary intracranial NET, clinical findings, histopathological features and prognosis.
Transient total locked-in syndrome due to vertebral and basilar artery dissection
Authors: Inatomi Yuichiro , Nakajima Makoto , Yonahara Toshiro
Published: February 2021

A 52-year-old woman suddenly presented with right conjugate eye deviation, anarthria and quadriplegia, and appeared to be in a deep coma. MRI revealed a new infarct in the left cerebellar hemisphere and stenosis in the distal portion of the basilar artery caused by arterial dissection. Her deficits improved within 6 hours of onset. Moreover, on day 1, she described that she had been alert and her vision, hearing and somatic sensation had been preserved during the illness. Total locked-in syndrome should be considered while assessing patients with total immobility who are unable to communicate.