bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection and characterization of Leptospira spp. in dogs diagnosed with kidney and/or liver disease in Selangor, Malaysia
Authors: Rahman Sabri A. , Khor Kuan H. , Khairani-Bejo Siti , Lau Seng F. , Mazlan Mazlina , Roslan Azri , Goh Soon H.
Published: June 2021

Leptospirosis is a serious bacterial disease that affects both humans and animals. A wide range of symptoms have been described in humans; the disease in dogs is commonly associated with kidney and/or liver disease. In Malaysia, information about the common serovars infecting dogs is limited. Therefore, we investigated the occurrences of leptospirosis in 124 pet dogs diagnosed with kidney and/or liver disease. Blood, urine, abdominal effusion, and/or kidney and liver were collected from the dogs. Based on microscopic agglutination testing, 53 of 124 (42.7%) dogs were seropositive for leptospiral exposure. Sera were frequently positive to serovars Bataviae ( n = 12), Javanica ( n = 10), and Icterohaemorrhagiae ( n = 10). Direct detection using PCR showed that 42 of 124 (33.9%) of the whole blood and 36 of 113 (31.9%) urine samples were positive for pathogenic Leptospira spp. By PCR, 2 of 23 (9.1%) kidney and 2 of 23 (9.1%) liver were positive for pathogenic Leptospira spp. Abdominal effusion from 4 dogs were PCR-positive for pathogenic Leptospira spp. The species detected were L. interrogans, L. borgpetersenii, L. kirschneri, and L. kmetyi by partial 16S rRNA sequencing. We further identified and characterized 11 Leptospira spp. isolates from 8 dogs as serovars Bataviae, Javanica, and Australis. The mortality rate of the Leptospira-infected dogs was high (18 of 53; 34%).
Oxidative burst and phagocytic activity of phagocytes in canine parvoviral enteritis
Authors: du Preez Kelly , Rautenbach Yolandi , Hooijberg Emma H. , Goddard Amelia
Published: June 2021

Canine parvoviral enteritis (CPE) is a severe disease characterized by systemic inflammation and immunosuppression. The function of circulating phagocytes (neutrophils and monocytes) in affected dogs has not been fully investigated. We characterized the functional capacity of canine phagocytes in CPE by determining their oxidative burst and phagocytic activities using flow cytometry. Blood was collected from 28 dogs with CPE and 11 healthy, age-matched, control dogs. Oxidative burst activity was assessed by stimulating phagocytes with opsonized Escherichia coli or phorbol 12-myristate 13-acetate (PMA) and measuring the percentage of phagocytes producing reactive oxygen species and the magnitude of this production. Phagocytosis was measured by incubating phagocytes with opsonized E. coli and measuring the percentage of phagocytes containing E. coli and the number of bacteria per cell. Complete blood counts and serum C-reactive protein (CRP) concentrations were also determined. Serum CRP concentration was negatively and positively correlated with segmented and band neutrophil concentrations, respectively. Overall, no differences in phagocyte function were found between dogs with CPE and healthy control dogs. However, infected dogs with neutropenia or circulating band neutrophils had decreased PMA-stimulated oxidative burst activity compared to healthy controls. Additionally, CPE dogs with neutropenia or circulating band neutrophils had decreased PMA- and E. coli–stimulated oxidative burst activity and decreased phagocytosis of E. coli compared to CPE dogs without neutropenia or band neutrophils. We conclude that phagocytes have decreased oxidative burst and phagocytic activity in neutropenic CPE dogs and in CPE dogs with circulating band neutrophils.
Locomotion postural variability and coordination in boys with overweight
Authors: Parvinpour Shahab , Balali Marzie , Shafizadeh Mohsen , Samimi Pazhuh Fatemeh , Duncan Michael , Broom David R
Published: June 2021

The purpose of this study was to examine the variability and coordination of postural adaptations in normal weight children and those with overweight in running and hopping. Fifty-six boys between 7 and 10 years were classified into groups as overweight ( n = 33) or normal-weight ( n = 23). They performed two trials of running and hopping over a 20-m straight line distance. Accelerometers were attached on the trunk and head for collecting body movements in different directions from 15 strides. Postural variability and coordination were calculated by multiscale entropy and cross approximate entropy for the running and hopping trials, separately. Findings highlight overweight boys had significantly higher trunk-head coordination in mediolateral direction than normal-weight boys (0.72 vs. 0.68). The hopping movement pattern had highest variability (9.88 vs. 8.77) and trunk–head coordination (0.61 vs. 0.67) than running. Excess body mass demands additional postural adaptations to compensate for reducing the risk of losing balance laterally in boys with overweight.
The Intraseptal Course of the Superficial Peroneal Nerve: An Anatomic Study
Authors: Valisena Silvia , Gamulin Axel , Hannouche Didier
Published: June 2021

Background:

Anatomic and clinical studies show many variants of the superficial peroneal nerve (SPN) course and branching within the compartments and at the suprafascial layer. The anatomy of the transition zone from the compartment to the subcutaneous layer has been occasionally described in the literature, mainly in studies reporting the intraseptal SPN variant in 6.6% to 13.6% of patients affected by the SPN entrapment syndrome. Despite the little evidence available, the knowledge of the transition zone is relevant to avoid iatrogenic lesions to the SPN during fasciotomy, open approaches to the leg and ankle, and SPN decompression. Our anatomic study aimed to describe the SPN transition site and to evaluate the occurrence of a peroneal tunnel and of an intraseptal SPN variant.

Methods:

According to the institutional ethics committee requirements, 15 fresh-frozen lower limbs were dissected to study the SPN course and its branching, focusing on the transition site to the suprafascial layer.

Results:

The SPN was located in the anterior compartment in 2 cases and in the lateral in 13. An intraseptal tunnel was present in 10 legs (66%), at a mean distance of 10.67 cm from the lateral malleolus. Its mean length was 2.63 cm. The tunnel allowed the passage of the main SPN in 8 cases and of its branches in two. In the remaining 5 legs (33%), the SPN pierced a crural fascia window.

Conclusion:

In our sample a higher rate than expected of intraseptal SPN variants was found.

Clinical Relevance:

The knowledge of the anatomy of the SPN course and intraseptal variant is relevant to avoid iatrogenic lesions during operative dissection. Further studies are needed to evaluate the effective prevalence of an intraseptal tunnel, independently from the SPN entrapment syndrome, and how to avoid associated iatrogenic complications.
Trauma-Informed Care in Schools: A Necessity in the Time of COVID-19
Authors: Taylor Shanon S.
Published: June 2021

With students having experienced dramatic changes to their lives and perhaps personally experiencing serious illness and death within their immediate or extended families due to the COVID-19 pandemic, schools may have to examine how to broadly implement the use of trauma-informed care in schools. This article examines why experiences related to the pandemic are considered traumas and what supportive practices have been identified in the research that educators can use to help students.
Stop Banging Your Head: Changing Self-Injurious Behavior Into Communication
Authors: More Cori M. , Buchter Jennifer , Oh-Young Conrad
Published: June 2021

Self-injurious behavior is prevalent in early childhood and it affects almost 53% of young children with disabilities. Once these behaviors are consistently present, they may become resistant to intervention. The purpose of this article is to provide early care and education center providers and family caregivers with ways to effectively reduce self-injurious behavior.
Expressions of Anti-Black Biases, Job Satisfaction, and Turnover Intentions in the Full-Service Restaurant Industry
Authors: Brewster Zachary W. , Heffner Allen V.
Published: June 2021

Verbal and behavioral manifestations of anti-Black biases have been shown to be quite common in many full-service restaurant establishments. Such explicit expressions of anti-Black biases have been linked with servers’ endorsement of racial stereotypes depicting Black Americans as undesirable customers and their self-reported proclivities to withhold effort from their Black clientele. However, there have been limited efforts to advance our understanding of the broader consequences associated with working in an environment wherein Black customers are observed to be stereotyped, denigrated, and mistreated. In response, this research note presents results from an exploratory study assessing the relationships between observing anti-Black expressions in the workplace, employees’ job satisfaction, and their turnover intentions. In two relatively large and demographically diverse samples of current restaurant workers, observing expressions of anti-Black bias in restaurant workplaces was found to be associated with diminished levels of job satisfaction and greater intentions to quit in the next 6 months. This study adds to the growing list of financial and operational costs that restaurant operators are at risk of incurring as a result of some of their employees expressed anti-Black attitudes and discriminatory actions.
Impulsive Shopping Overseas: Do Sunk Cost, Information Confusion, and Anticipated Regret Have a Say?
Authors: Guan Jingjing , Ma Emily , Bi Jiaping
Published: June 2021

Building on three theoretical perspectives, Alchian–Allen theorem, sunk cost fallacy, and mental account theory, this study proposed and tested a model on Chinese outbound travelers’ impulse shopping behaviors as determined by sunk cost, information confusion, after-sale risk, and anticipated regret (both downward and upward). Using a sample of 314 Chinese outbound travelers, findings of the study suggested that sunk cost, after-sale risk, and downward anticipated regret significantly influence travelers’ impulsive shopping, with downward anticipated regret mediating the relationship between information confusion and impulsive purchase and between sunk cost and impulsive purchase. The study contributes to existing theories and literature for a better understanding of how sunk cost influences outbound travelers’ impulsive shopping behavior from three theoretical perspectives, particularly in a Chinese cultural context. The findings of the study also have important implications for destination stakeholders.
Vascular access and clinical competency: Which elements matter? The development of three bottom-up and evidence-grounded self-assessment tools
Authors: Rigo Carla , Grazioli Marco , Caravella Giuseppe , Ursino Francesco , Zerla Pietro , Magon Arianna , Dellafiore Federica , Caruso Rosario
Published: June 2021

Background:

Assessing competency in the speciality of vascular access is still limited, and few valid and reliable tools are available. Therefore, this study aimed to develop and validate three different tools for assessing competency in managing the care of short peripheral cannulas (SPCs), midlines, peripherally inserted central catheters (PICCs), centrally inserted central catheters (CICCs), and arterial catheters (ACs) (tool one), placing SPCs (tool two), placing PICCs and midlines (tool three).

Methods:

A two-phase and multi-method design was adopted. Phase one was implemented to develop the initial pool of items for each tool, starting from a literature overview. Panel discussions were adopted for developing the items. In phase two, the developed items were tested for content and face validity, involving a panel of 10 experts. Once obtained adequate content validity, a cross-sectional data collection was implemented to enroll three samples of healthcare workers who had to assess their competency through the developed tools. Dimensionality was assessed by performing a principal component analysis (PCA) and assessing internal consistency (Cronbach’s α).

Results:

Tool one had 26 items, and the dimensionality was given by placement, risk assessment, procedure conformity and traceability, and patient education to self-care. Tool two had 35 items; its principal components were: risk evaluation, identification, clinical assessment and orientation to self-care, placement, and procedure registration shaped the competency of placing SPCs. Tool three had 31 items; its principal components were: risk assessment, placement, conformity to standards and procedure traceability, education, and orientation to self-care were the essential elements for adequately placing midlines and PICCs. Cronbach’s α values ranged between 0.806 and 0.959.

Conclusions:

The three developed tools reflected the core elements of competency in each application area, representing an initial framework that could be useful in future research and educational projects. Cross-national investigations are required to corroborate the described results.
Taurolidine lock in the treatment of colonization and infection of totally implanted venous access devices in cancer patients
Authors: Brescia Fabrizio , Pittiruti Mauro , Scoppettuolo Giancarlo , Zanier Chiara , Nadalini Elisa , Bottos Paola , Moreal Chiara , Da Ros Valentina , Fabiani Fabio
Published: June 2021

Background:

Taurolidine lock is known to be effective in preventing catheter-related infections in a variety of venous access devices, including long term venous access devices for chemotherapy. Though, literature about the use of taurolidine for treating catheter colonization or catheter-related blood stream infection is scarce.

Method:

We have retrospectively reviewed the safety and efficacy of 2% taurolidine lock for treatment of catheter-colonization and of catheter-related bloodstream infection in cancer patients with totally implanted venous access devices. Diagnosis of colonization or catheter-related infection was based on paired peripheral and central blood cultures, according to the method of Delayed Time to Positivity.

Results:

We recorded 24 cases of catheter-related infection and two cases of colonization. Taurolidine lock—associated with systemic antibiotic therapy—was successful in treating all cases of catheter-related infection, with disappearance of clinical symptoms, normalization of laboratory values, and eventually negative blood cultures. Taurolidine lock was also safe and effective in treating device colonization. No adverse effect was reported.

Conclusion:

In our retrospective analysis, 2% taurolidine lock was completely safe and highly effective in the treatment of both catheter-colonization and catheter-related bloodstream infection in cancer patients with totally implanted venous access devices.
Chest-to-arm tunneling: A novel technique for medium/long term venous access devices
Authors: Annetta Maria Giuseppina , Ostroff Matt , Marche Bruno , Emoli Alessandro , Musarò Andrea , Celentano Davide , Taraschi Cristina , Dolcetti Laura , Greca Antonio La , Scoppettuolo Giancarlo , Pittiruti Mauro
Published: June 2021

Background:

Chest-to-arm (CTA) tunneling has been described recently as a technique that allows an optimal exit site at mid-arm even in chronically ill patients with complex clinical issues and challenging problems of vascular access.

Method:

We adopted CTA tunneling in oncologic and in non-oncologic patients, in totally implanted and in external devices, for both medium and long-term intravenous treatments. We report our experience with 60 cases of CTA tunneling: 19 patients requiring a totally implantable device, who had bilateral contraindication to venous access at the arm and bilateral contraindication to placement of the pocket in the infra-clavicular area; 41 patients requiring an external central venous catheter, who had bilateral contraindication to insertion of peripherally inserted central catheters or femoral catheters, as well as contraindication to an exit site in the infraclavicular area. All venous access devices were inserted with ultrasound guidance and tip location by intracavitary electrocardiography, under local anesthesia.

Results:

There were no immediate or early complications. Patients with CTA-ports had no late complications. In patients with CTA-tunneled external catheters, there were two dislodgments, four episodes of central line associated blood stream infections, and one local infection. There were no episodes of venous thrombosis or catheter malfunction.

Conclusion:

Our experience suggests that CTA tunneling is a safe maneuver, with very low risk of complications, and should be considered as an option in patients with complex venous access.
The effect of economic policy uncertainty on US tourism net exports
Authors: Hailemariam Abebe , Ivanovski Kris
Published: June 2021

This article models the endogenously interrelated relationship between global economic policy uncertainty (EPU), world industrial production (WIP), and the demand for US tourism net export (TNX) expenditures. To do so, we apply an identified structural vector autoregression model over monthly data spanning from January 1999 to October 2020. Our findings reveal that a positive shock in WIP has a significant positive effect on demand for TNXs. In contrast, unanticipated increases in price and EPU have a statistically significant negative effect on TNXs. Our results show that, in the long run, a one standard deviation shock in global EPU explains about 26.05% of the variations in tourism net service exports.
Evidence against risk as a motivating driver of COVID-19 preventive behaviors in the United States
Authors: Fullerton Mae K. , Rabb Nathaniel , Mamidipaka Sahit , Ungar Lyle , Sloman Steven A.
Published: June 2021

Does an individual’s risk profile predict their social distancing and mask wearing in the U.S. during the COVID-19 pandemic? Common sense and some health behavior theories suggest that as a perceived threat increases, an individual should be more likely to take preventive measures. We explore this hypothesis using survey responses collected from 1114 U.S. adults during April and October 2020, and find that neither perceived nor actual risk predicted these preventive behaviors. Instead, being an essential worker, partisanship, and believing compliance was important were more reliable predictors. These results provide guidance for better pandemic response policies and challenge models of health behavior.
Beyond the ‘thingification’ of worlds: Archaeology and the New Materialisms
Authors: Govier Eloise , Steel Louise
Published: June 2021

This article considers the application of the New Materialisms within archaeology, primarily in response to Witmore’s influential discussion article: Archaeology and the New Materialisms (2014), specifically his emphasis on things. This, the authors demonstrate, is peripheral to the main thrust of the New Materialisms discourse. They unravel complexities in the terminology and consider the etymological and epistemological framework of concepts such as matter and thing. This leads them to consider some important issues that arise applying Deleuzian assemblages to the archaeological record and the potential of employing Barad’s agential realist theory instead. Barad’s concept of phenomena moves beyond the notion of things as separate, bounded entities, emphasizing entanglements of matter and illustrates how matter (including humans) co-create the material world. The authors’ aim is to demonstrate how engaging with matter rather than things enables us to better make sense of the material world and our place within it.
The role of proficiency and pair formation method in language-related episodes: A study of young CLIL learners’ interaction
Authors: Gallardo del Puerto Francisco , Basterrechea María
Published: June 2021

Little is known about young CLIL (Content and Language Integrated Learning) learners’ attention to formal aspects of the target language when engaged in collaborative task-based interaction. Previous research on language-related episodes (LREs) with other populations indicates that certain variables (e.g. target language proficiency or pair formation method) may play a role in the production of LREs. This study investigates the amount, types and resolution of LREs produced by primary education CLIL learners in a collaborative picture-ordering + story-telling task depending on two variables – L2 English proficiency (grade 5 dyads vs. grade 6 dyads) and pairing method (proficiency-matched dyads vs. student self-selected dyads). Findings indicate that young CLIL learners’ interactive behaviour in L2 English, at least in terms of LRE production, does not differ as a consequence of target language proficiency, whereas pair formation method exerts some influence, self-selected pairs producing and resolving more meaning-based LREs. No differences were found for form-focused LREs.
Bond and flexural performance of basalt fiber–reinforced polymer bar–reinforced seawater sea sand glass aggregate concrete beams
Authors: Dong Zhiqiang , Wu Gang , Zhu Hong , Wei Yang , Zhao Xiao-Ling , Shao Xinxing
Published: June 2021

This article proposes a new type of basalt fiber–reinforced polymer (BFRP) bar–reinforced seawater sea sand glass aggregate concrete (SSGC) beam with broad application prospects in ocean engineering. Crushed tempered glasses were utilized as coarse aggregates in the concrete mixture to realize the efficient and harmless recycling of waste glass. First, the bond behaviors between the BFRP bars and SSGC with different glass aggregate replacement ratios were investigated. Then, four-point bending tests were conducted to investigate the flexural performance of the SSGC beams completely reinforced with BFRP bars. Based on this, the tested flexural strengths were compared with the calculated strengths to evaluate whether the existing specifications were still applicable to the design of the BFRP bar–reinforced SSGC beams. Test results showed that although the compressive strength of the SSGC gradually decreased with increased glass aggregate content, the bond performance between BFRP bars and SSGC did not follow the same degradation pattern. There were no obvious differences in the form of the bond–slip curves between BFRP bars and different types of SSGC. With increasing glass aggregate content, the ultimate bearing capacity and energy consumption of BFRP bar–reinforced SSGC beams decreased. All calculated ultimate flexural capacities were higher than the experimental values, which shows that the application of existing specifications to BFRP bar–reinforced SSGC beams needs to be studied further.
Design of a prospective follow-up study on early parenthood and smoking behaviour during pregnancy in Finnish primary healthcare
Authors: Ekblad Mikael O. , Wallin Hanna P. , Pajulo Marjukka , Korhonen Päivi E.
Published: June 2021

Aims: The primary aim of the study is to explore different factors affecting parents’ smoking behaviour, and especially how smoking may be connected with individual differences in the psychological process of becoming a parent. In the current paper, we present the study design together with basic information on the study population. Methods: The Central Satakunta Maternity and Child Health Clinic (KESALATU) Study is an ongoing prospective follow-up study in primary healthcare of the Satakunta region of southwest Finland. Families were recruited during their first maternity clinic visit between 1 September 2016 and 31 December 2019, and participation will continue until the child is 1.5 years of age. The study combines different sources and types of data: e.g. routine data obtained from primary healthcare clinic records, specific parental self-report data and data from a new exhaled carbon monoxide meter indicating maternal smoking. The data are collected using frequently repeated assessments both during pregnancy and postnatally. The methods cover the following areas of interest: family background factors (including smoking and alcohol use), self-reported parental–foetal/infant attachment and mentalization, self-reported stress, depression and quality of life. Results: 589 pregnant women and their partners were asked to participate in the study during the collection time period. The final study population consisted of 248 (42.1%) pregnant women and 160 (27.1%) partners. Conclusions: The new methods and study design have the potential to increase our understanding about the link between early parenting psychology, prenatal psychosocial risk factors and parental health behaviour.
Problems associated with mass border testing of COVID-19
Authors: Grunér Mathias , Nordberg Marika , Lönnroth Knut
Published: June 2021

We evaluated the yield of exit screening for SARS-Cov-2 performed in order for travellers to meet entry requirements to Sweden. Among 472 people screened, no infectious case of COVID-19 was detected, while two previously known cases were redetected after having already completed isolation. Our data suggest that depending on the epidemiological situation in the area of departure, border screening can lead to very low positive predictive values and very high costs per relevant case detected.
COVID-19 among young adults in Sweden: self-reported long-term symptoms and associated factors
Authors: Ekström Sandra , Andersson Niklas , Lövquist Alexandra , Lauber André , Georgelis Antonios , Kull Inger , Melén Erik , Bergström Anna
Published: June 2021

Aims:

The main aim of the study was to describe self-reported symptoms of COVID-19 and examine if long-term symptoms are associated with lifestyle factors or common chronic diseases among Swedish young adults. A secondary aim was to compare the prevalence of smoking and snuff use before and during the COVID-19 pandemic.

Methods:

The study population includes 1644 participants aged 23–26 years from the Swedish population-based birth cohort BAMSE. From August to November 2020, the participants answered a web questionnaire on COVID-19 symptoms, lifestyle and health. Information on tobacco use was compared against the previous study follow-up in 2016–2019.

Results:

The prevalence of suspected COVID-19 symptoms was 45.3% ( n=742), and 80 of these (10.8%) reported long-term symptoms (⩾4 weeks). There was no significant difference in sociodemographic or lifestyle factors in relation to the duration of suspected COVID-19 symptoms. Rhinitis, migraine and lower self-rated health before the pandemic was more common among participants with long-term symptoms. In addition, there was a tendency for higher prevalences of asthma, chronic bronchitis and depression in this group. The prevalence of smoking decreased from 18.9% before the pandemic to 14.7% during the pandemic, while snuff use increased from 12.7% to 22.4% ( P<0.001).

Conclusions:

Almost half of Swedish young adults have had symptoms of suspected COVID-19 from February up to August 2020. Among these, one out of 10 have had long-term symptoms for at least 4 weeks. Long-term symptoms of suspected COVID-19 were associated with several common chronic conditions. Smoking may have decreased during the pandemic, while snuff use may have increased.
Seven theses on critical empathy: a methodological framework for ‘unsavory’ populations
Authors: de Coning Alexis
Published: June 2021

Qualitative researchers of ‘unsavory’ populations experience a complex range of emotions as they sustain close contact with people and communities that are deemed reprehensible, dangerous, or toxic. Empathy, in particular, raises ethical and methodological challenges for scholars who must build rapport with people who may perpetuate racism, sexism, xenophobia, and so on. Drawing on existing qualitative literature and ethnographic fieldwork, I propose critical empathy as a methodological framework to account for the difficult and sometimes problematic emotional dimensions of research on ‘unsavory’ populations. Instead of trying to resolve the tensions between empathy and critique, critical empathy compels us to grapple with these tensions and make them apparent in our work.
Moral regulation as status politics: A critical reconstruction of Joseph R. Gusfield’s theory
Authors: Ruonavaara Hannu
Published: June 2021

Sociology of moral regulation has been interested in different kinds of morally charged social movements, such as the temperance movement, to investigate the social reasons why people take part in such movements. One answer is provided by Joseph Gusfield’s classic analysis of the American temperance movement, The Symbolic Crusade, published in 1963. The status politics theory developed therein provides a potential explanation of participation in moral regulation movements. This paper reconstructs the general logic of status politics explanations from an actor-centred perspective, explicating the actor image and the status anxiety mechanism inherent in the theory. Some of the problems discussed include third-person explanations and proof of status anxiety. With due caution, status politics theory provides one alternative for explaining mobilisation in moral regulation movements as well as populist politics.
Statistical guided-waves-based structural health monitoring via stochastic non-parametric time series models
Authors: Amer Ahmad , Kopsaftopoulos Fotis P
Published: June 2021

Damage detection in active-sensing, guided-waves-based structural health monitoring (SHM) has evolved through multiple eras of development during the past decades. Nevertheless, there still exist a number of challenges facing the current state-of-the-art approaches, both in the industry as well as in research and development, including low damage sensitivity, lack of robustness to uncertainties, need for user-defined thresholds, and non-uniform response across a sensor network. In this work, a novel statistical framework is proposed for active-sensing SHM based on the use of ultrasonic guided waves. This framework is based on stochastic non-parametric time series models and their corresponding statistical properties in order to readily provide healthy confidence bounds and enable accurate and robust damage detection via the use of appropriate statistical decision-making tests. Three such methods and corresponding statistical quantities (test statistics) along with decision-making schemes are formulated and experimentally assessed via the use of three coupons with different levels of complexity: an Al plate with a growing notch, a carbon fiber-reinforced plastic (CFRP) plate with added weights to simulate local damage, and the CFRP panel used in the Open Guided Waves project, all fitted with piezoelectric transducers under a pitch-catch configuration. The performance of the proposed methods is compared to that of state-of-the-art time-domain damage indices (DIs). The results demonstrate the increased detection sensitivity and robustness of the proposed methods, with better tracking capability of damage evolution compared to conventional approaches, even for damage-non-intersecting actuator–sensor paths. In particular, the Z statistic emerges as the best damage detection metric compared to conventional DIs, as well as the other proposed statistics. Overall, the proposed statistics in this study promise greater damage sensitivity across different components, with enhanced robustness to uncertainties, as well as user-friendly application.
Challenges and opportunities for artificial intelligence in surgery
Authors: Andreatta Pamela , Smith Christopher S. , Graybill John Christopher , Bowyer Mark , Elster Eric
Published: June 2021

Surgery is an exceptionally complex domain where multi-dimensional expertise is developed over an extended period of time, and mastery is maintained only through ongoing engagement in surgical contexts. Expert surgeons integrate perceptual information through both conscious and subconscious awareness, and respond to the environment by leveraging their deep understanding of surgical constructs. However, their ability to utilize these deep knowledge structures can be complicated by continuous advances in technology, medical science, pharmacology, technique, materials, operative environments, etc. that must be routinely accommodated in professional practice. The demands on surgeons to perform perfectly in ever-changing contexts increases cognitive load, which could be reduced through judicious use of accurate and reliable artificial intelligence (AI) systems. AI has great potential to support human performance in complex environments such as surgery; however, the foundational requirements for the rules governing algorithmic development of performance requirements necessitate the active involvement of surgeons to precisely model the quantitative measures of performance along the continuum of expertise. Providing the AI development community with these data will help assure that accurate and reliable systems are designed to supplement human performance in applied surgical contexts. The Military Health System’s Clinical Readiness Program is developing these types of metrics to support military medical readiness.
Design and simulation research of the double-spin folding mechanism based on a suspended missile
Authors: Yuan ZH , Guo SY , Zhang SN , Zhao JQ , Lu WJ , Zhao HZ
Published: June 2021

Based on the suspension of a missile using folding rotary wings and airbags, in order to improve the basic parameters and motion characteristics of the rotor during the unfolding process and analyze the aerodynamic characteristics of the entire device in the suspension state, after proposing a scheme of double-spin mechanism, the main folding and unfolding mechanism, initial driving device, rotating driving device, and locking mechanism were designed, and the simulation research is studied by the Automatic Dynamic Analysis of Mechanical System and Ansys Fluent Fluid Simulation software, respectively. The results show that the rotation rate was controlled at 41.8 mm/s, the various motion parameters are reasonable, and the operation process is relatively smooth, with high reliability. The speed and pressure value at the tip of the rotor are higher and the aerodynamic disturbance is obvious, which has a great influence on the aerodynamic performance. The speed and pressure distribution of the surrounding flow field is stable, the lift provided is 46 N, and the lift coefficient is 0.55, which can ensure the long-time suspension state of the missile. This paper puts forward a valuable design idea and has practical reference value for the research of the suspended missile.
Shipborne moving target indicator radar versus incoming sea-skimming missile mathematical modeling and simulation
Authors: Kostis Theodoros G.
Published: June 2021

Anti-ship missiles are a primary threat to naval targets because sea-skimming tactics enable the missile to approach the vessel while being obscured by sea clutter. In order to counteract this serious danger, the ship’s radar employs moving target indicator processing in order to detect and subsequently start the tracking of the incoming missile. In this paper, we set up a relevant simulation in order to examine the moving target indicator process for a naval scenario at horizon range which gives the greatest counter-reaction time, which usually is for very small grazing angles in a sea cluttered environment. Finally, the results of the simulator are beneficial to radar designers and educational professionals.
Amylase Is Not a Useful Indicator for Leakage Detection Following Sleeve Gastrectomy: A Prospective Study
Authors: Horn Amyt , Assalia Ahmad , Sayida Sa’d , Mahajna Ahmad
Published: June 2021

Introduction. Gastric leak after laparoscopic sleeve gastrectomy (LSG) is a severe complication that may lead to sepsis and even death. Early diagnosis and treatment are critical. The aims of this prospective study are to establish normal amylase levels and investigate elevated amylase levels, especially in the drain, for detecting anastomotic leakage following LSG. Material and Methods. One hundred sixty-one patients who underwent LSG during 1 year at Rambam Health Care Campus were included prospectively in the study. Demographic and medical background, peri- and postoperative complications, and laboratory data including amylase levels in blood, urine, and drain were evaluated. Univariate and multivariate analyses were performed to examine independent variables that can predict increases in amylase values. Results. Thirty-five (21.8%) patients had high levels of amylase in blood, urine, and/or drain and 126 (78.2%) normal values of amylase until discharge. No significant differences were found in operation duration, length of hospitalization, or occurrence of complications. One patient had a staple-line leak diagnosed in the third postoperative day that was treated conservatively with endoscopic approach. His amylase levels in the blood and drain were normal, with only a slight hyperamylasuria. Conclusions. High amylase levels after LSG does not necessarily indicate a major complication such as staple-line leak, and in the vast majority of cases, it seems to have no clinical relevancy. Therefore, it should not automatically lead to a full investigation in the absence of further clinical signs. It is suggested that there is no clinical justification to test amylase routinely after LSG.
Can we replace computed tomography angiography by contrast-enhanced ultrasound in the surveillance of patients submitted to aortoiliac aneurysm repair?
Authors: Park Jong Hun , Filho Alvaro Razuk , Pires Ana Paula M , Telles Gustavo José P , Esteves Fernando P , Caffaro Roberto Augusto , Parrillo Eduardo F
Published: June 2021

Objectives

This study was designed for evaluation of CEUS (contrast-enhanced ultrasound) for the detection of endoleaks after EVAR (endovascular aortic aneurysms repair) as an alternative to CTA (computed tomography angiography), the gold standard in post-EVAR surveillance.

Methods

Post-EVAR surveillance of patients who underwent CEUS and CTA was retrospectively analyzed to compare the accuracy of CEUS compared to CTA. For that, the following parameters were analyzed: the largest aneurysm diameter, type of endoleaks, and the time elapsed after EVAR using both surveillance tests.

Results

The study involved 110 pairs of exams in patients with infrarenal aortoiliac or isolated iliac artery aneurysm, covering predominantly a male population (89%). The time elapsed after EVAR using CEUS or CTA exams were statistically similar, ranging from one to 58 months (mean 12.2) and one to 65 months (mean 9.7), respectively ( p = 0.124). CEUS sensitivity was 75.5%, specificity 96.7%, false positives were 24.5%, and false negatives were 3.3%. The accuracy between the two exams was 87.3%. A secondary analysis, comparing CTA with CEUS as a reference standard, revealed CEUS sensitivity of 24.5%, higher than CTA for detecting endoleaks, with a concordance rate of true positive results of 75.5%. Among the endoleaks detected solely by CEUS (12 cases), one case was type Ia and eleven were type II, while those detected only by CTA (2 cases), one was type Ia and one type II. Additionally, a type II endoleak associated with type Ib, identified by CEUS, was seen as type II for CTA only. There was no difference between the pre-EVAR and the post-EVAR diameters of aortoiliac aneurysm ( p = 0.058), both for CEUS and CTA. Computed tomography angiography, on the other hand, showed significant aneurysm diameter reduction compared to CEUS for isolated iliac artery aneurysms ( p < 0.001).

Conclusion

Contrast-enhanced ultrasound was more effective than CTA in identifying and characterizing endoleaks in patients undergoing EVAR, especially type II endoleaks. The advantages include efficacy and, particularly, safety, and must be considered in EVAR surveillance protocols so that its use becomes widespread. We understand that CEUS, as a surveillance exam, considerably reduces risks to patients compared to CTA.
Carotid intraplaque neovascularisation as a predictive factor for future vascular events in patients with mild and moderate carotid stenosis: an observational prospective study
Authors: Cui Liuping , Xing Yingqi , Zhou Yangyang , Wang Lijuan , Liu Kangding , Zhang Daofu , Chen Ying
Published: June 2021

Background:

Intraplaque neovascularisation (IPN) increases the vulnerability of plaques, which makes them more likely to rupture and increases the risk of vascular events. However, it is unclear whether IPN can predict future vascular events (stroke recurrence and cardiovascular events). Previous studies on IPN have focused on patients with severe stenosis but overlooked patients with mild and moderate stenosis. This study aimed to investigate whether IPN assessed by contrast-enhanced ultrasonography (CEUS) in patients with mild and moderate degrees of stenosis is associated with future vascular events.

Methods:

One hundred and twenty-one patients participated in this study. 76 patients who met the inclusion and exclusion criteria were included in the final dataset of the study. IPN was graded from 0 to 2 according to the extent of the microbubbles assessed using CEUS. The degree of carotid stenosis was graded as mild, moderate, or severe. We recorded future vascular events during the follow-up. Univariate and multivariate logistic regression analyses were used to evaluate risk factors for future vascular events.

Results:

After a follow-up period of 30 ± 6 months, 30 patients (39.5%) experienced subsequent vascular events. Compared with the ‘non-recurrent’ group, the ‘recurrent’ group showed a higher proportion of grade 2 neovascularisation ( p < 0.05), and it was an independent predictor of subsequent vascular events (odds ratio 6.066, 95% confidence interval 1.565–23.512, p < 0.05). Furthermore, in patients with mild and moderate stenosis, future vascular events occurred in an unexpectedly high proportion (up to 42.9%). In the ‘recurrent’ group, 55% of patients with mild and moderate stenosis had grade 2 neovascularisation.

Conclusion:

IPN by CEUS was an independent predictor of future vascular events in patients with recent ischemic stroke, and the high proportion of neovascularisation in patients with mild and moderate stenosis requires more attention.
Effect of Low Nutrition and T-2 Toxin on C28/I2 Chondrocytes Cell Line and Chondroitin Sulfate–Modifying Sulfotransferases
Authors: Deng Huan , Chilufya Mumba Mulutula , Liu Jiaxin , Qiao Lichun , Xiao Xiang , Zhao Yan , Guo Ziwei , Lv Yizhen , Wang Wenyue , Zhang Jiaheng , Han Jing
Published: June 2021

Objective

To investigate the effects of low nutrition and trichothecenes-2 toxin (T-2) on human chondrocytes cell line C28/I2 and the gene expression levels of some chondroitin sulfate (CS)–modifying sulfotransferases.

Methods

The chondrocytes were divided into 4 intervention groups: (a) control group (Dulbecco’s modified Eagle’s medium/Nutrient Mixture F-12 [DMEM/F-12] with fetal bovine serum [FBS]), (b) low-nutrition group (DMEM/F-12 without FBS), (c) T-2 group (DMEM/F-12 with FBS plus 20 ng/mL T-2), and (d) combined group (DMEM/F-12 without FBS plus 20 ng/mL T-2). Twenty-four hours postintervention, ultrastructural changes in the chondrocytes were observed by transmission electron microscopy (TEM). Live cell staining and methyl thiazolyl tetrazolium (MTT) assay were performed to observe cell viability. The expression of CS-modifying sulfotransferases, including carbohydrate sulfotransferase 3, 12, 13, 15 (CHST-3, CHST-12, CHST-13, and CHST-15, respectively), and uronyl 2-O-sulfotransferase (UST) were examined by quantitative real-time polymerase chain reaction (RT-qPCR) analysis.

Results

The cells in the T-2 group and combined group had significantly lower live cell counts and relative survival rates than the control group. TEM pictures revealed decreased electron density of mitochondria in the low-nutrition group. The T-2 group and combined group both caused mitochondrial swelling, damage, and reduction in mitochondrial number. RT-qPCR showed a trend of altered expression of CHST and increased expression of UST genes under low-nutrition, T-2 toxin and combined interventions.

Conclusions

These results show early-stage Kashin-Beck disease chondrocyte pathophysiology, consisting of chondrocyte cell damage and compensatory upregulation of CHST and UST genes.
Opioid dependence disorder and comorbid chronic pain: comparison of groups based on patient-attributed direction of the causal relationship between the two conditions
Authors: Higgins Cassie , Smith Blair H , Matthews Keith
Published: June 2021

Background:

Chronic pain is highly prevalent in treatment-seeking opioid-dependent patients; therefore, this comorbid presentation is an important clinical consideration for both addiction and pain specialists. The objectives of the present study were to examine whether the direction of causal attribution of opioid dependence disorder and chronic pain resulted in two distinct clinical populations, and, if so, to compare treatment received during the 5-year follow-up period.

Methods:

Participants comprised opioid-dependent patients with chronic pain who reported a perceived causal relationship, in either direction, between the development of these two conditions ( n = 252). A range of health- and addiction-related instruments were used at study inception. Treatment characteristics were obtained for the follow-up period from national health registers.

Results:

Those reporting that pain caused opioid dependence disorder ( n = 174; 69%) were characterised by poorer pain-related health, more illicit cannabinoid use ( p = 0.031), more frequent illicit use of opioid analgesics ( p = 0.025) and they were in receipt of higher doses of prescribed opioid analgesics. Those reporting that opioid dependence disorder caused pain ( n = 78; 31%) were characterised by poorer overall physical health ( p = 0.002), more severe psychiatric symptoms and more overall drug use ( p = 0.001).

Conclusion:

Two distinct clinical populations were identified, determined by how participants perceive the causal relationship between opioid dependence disorder and chronic pain. These two populations have differing clinical profiles and treatment requirements: those reporting that pain caused opioid dependence disorder were characterised by poorer pain-related health and more illicit use of drugs with analgesic properties; and those reporting that opioid dependence disorder caused pain were characterised by more overall use of substances, multiple substance use and more intravenous substance use and poorer general health. Identifying the causal direction, where such a relationship exists, could help addiction and pain services to develop more effective, individualised treatment strategies.