bluuebunny/crossref_metadata_2025 huggingface dataset:
Zero emissions wellboat powered by hydrogen fuel cells hybridised with batteries
Authors: Meca Vladimir L. , Villalba-Herreros Antonio , d’Amore-Domenech Rafael , Leo Teresa J.
Published: September 2021

Due to the more stringent regulations on pollutant and greenhouse gas emissions in the maritime transport sector, solutions are being sought to reduce or avoid the emissions generated during the operation of ships. The onboard installation of hydrogen-fuelled fuel cells is a solution respectful with the environment and the marine ecosystem through which ships navigate. In this work, the design of a wellboat and its power plant based on fuel cells fed with hydrogen and hybridised with batteries is conducted, making it a zero-emissions ship that can navigate Emission Control Areas (ECAs). The fuel cells used are polymer electrolyte membrane fuel cells (PEMFCs), and the hydrogen they consume is stored in tanks pressurised at 35 MPa, grouping these tanks into three standard containers (Twenty-Foot Equivalent Units) installed on an exposed deck. The electrical and propulsion needs of the ship are covered by the installed power plant, providing an average power of 1266 kW and a peak power of 2624 kW, making it possible to avoid the emission of 10.8 t of CO2, 195 kg of NOx and 9 kg of SOx per 14 h mission.
Information sharing in community policing in Europe: Building public confidence
Authors: Aston Elizabeth V. , O’Neill Megan , Hail Yvonne , Wooff Andrew
Published: September 2021

The literature on the importance of procedural justice in policing is extensive. Using the context of information sharing in community policing, this paper argues that interactional, procedural and distributive justice are salient in interactions between the police and the public, both online and face-to-face. Structured interviews ( n = 161) were conducted with members of young minority groups and intermediaries (who work with minorities and police agencies) across nine countries in Europe. Our analysis of barriers and facilitators to sharing information with the police highlights processes of interactional, procedural and distributive justice in building public confidence. We highlight theoretical and practical implications of relevance to policing internationally. Our findings show that demonstrating aspects of interactional justice (attitude and behaviour, accessibility and communication, personal contact and relationships); procedural justice (responsiveness and efficiency, data protection and security); and distributive justice (outcomes and effectiveness, equity in distribution of policing services) have a role in building public confidence and facilitating information sharing with police online and face-to-face. We conclude that in addition to micro-level interactions, meso-level social processes (e.g. community policing models and data protection and security procedures) can be useful in enhancing public confidence.
Auditing Ethics: A Cost–Benefit Framework for Audit Studies
Authors: Crabtree Charles , Dhima Kostanca
Published: September 2021

The audit study design offers researchers a powerful tool to measure discrimination. Yet ethical concerns surround the use of this design. In this article, we introduce a cost–benefit framework that researchers should consider when conducting audit studies. One key insight of this framework is that when researchers evaluate audit studies due to ethical concerns, they must also evaluate the relative benefits of studying discrimination through other means. Building on this framework, we provide a set of practical recommendations that researchers can adopt to (1) minimize costs (i.e. ethical harm) and (2) maximize benefits (i.e. quality of their research). We hope that our suggestions contribute to the ongoing, important discussion about ethical issues involving audit studies and generate better work on discrimination.
Improvement in fracture toughness and impact resistance of E-glass/epoxy composites using layers composed of hollow poly(ethylene terephthalate) fibers
Authors: Laghaei Reyhaneh , Hejazi Seyyed Mahdi , Fashandi Hossein , Akbarzadeh Saleh , Shaghaghi Samira , Shamaei-Kashani Alireza
Published: September 2021

Incorporation of hollow fibers in polymer base composites has gained great interest due to their flexibility and lightweight structure. Among many research studies on this subject, the mechanical performance of polyester hollow fiber/E-glass reinforced polymer composites has not been investigated. The main objective of the present work was to investigate the fracture toughness and impact resistance of E-glass/epoxy composites hybridized by a separate layer of polyethylene terephthalate hollow fibers (PETHFs). The samples were prepared by placing a layer of PETHFs in different contents (0, 0.23, 1.18, or 2 wt.%) and in two different forms of filaments (PETHF-FIs) or staple fibers (PETHF-STs) between two layers of biaxial or triaxial E-glass fabrics. The mechanical behaviors of the samples were investigated by performing a set of tensile and impact tests. Scanning Electron Microscopy (SEM) and Field Emission Scanning Microscopy (FESEM) were also used to evaluate the surface morphologies of the hollow fibers and the fractured samples. The results revealed that, unlike PETHF-FIs, PETHF-STs could weaken the mechanical performance of the pristine E-glass/epoxy composites. The internal channel blockage of PETHF-STs was observed in the FESEM images of the fractured PETHF-STs hybrid samples. The highest toughening effects were observed with incorporation of 1.18 wt.% PETHF-FIs in biaxial E-glass/Epoxy composites and 2 wt.% PETHF-FIs in triaxial E-glass/Epoxy composites. The highest value of impact resistance belonged to the samples hybridized with 2 wt.% of PETHF-FIs. Crack deflection, fiber pull out, and fiber stretching were the predominant fracture mechanisms observed in the PETHF-FIs hybrid composites.
Connect Group is one of the Coping Stresses during the COVID-19 Pandemic
Authors: Mamahit Henny Christine
Published: September 2021

COVID-19 makes life more stressful. When we face it alone, it will make us not only stress but can depress. Connect with others through the right group can be the good Coping stress during COVID-19. Even though we cannot go anywhere, we cannot meet each other face to face, but COVID-19 has not defeated our social life.
Three-Dimensional Computed Tomography Bronchography and Angiography-Guided Thoracoscopic Segmentectomy for Pulmonary Nodules
Authors: Hu Cheng-guang , Yang Xiao-tang , Zhao Ming , Zheng Kang , Li Zhi-long , Liu Guan-hua , Zhao Yan-li , Lian Jian-hong , Guo Shi-ping
Published: September 2021

Background

Three-dimensional computed tomography bronchography and angiography (3D-CTBA) provides detailed imaging information for pulmonary segmentectomy. This study was performed to verify the feasibility of 3D-CTBA-guided thoracoscopic segmentectomy for the treatment of pulmonary nodules.

Methods

A retrospective analysis was performed on all patients who underwent 3D-CTBA-guided uniport thoracoscopic segmentectomies or subsegmentectomies for pulmonary nodules in the period from May 2019 to May 2020. All of the information related to perioperative management and surgical operations was retrieved from the medical records and operating notes for detailed analysis.

Results

A total of 104 eligible operations involving the resection of 110 nodules with diameters in the range of 5-20 mm were included. Under 3D-CTBA guidance, the pulmonary nodules were located with an accuracy of 100% (110/110) and the median resection margin was 24.3 mm (17-33 mm). Additionally, the segmental (subsegmental) bronchi, arteries, and veins were identified with accuracy rates of 100% (104/104), 96.2% (100/104), and 94.2% (98/104), respectively. The postoperative complications consisted of 3 cases of pulmonary infection (2.9%), 6 cases of arrhythmia (5.8%), 2 cases of hemoptysis (1.9%), 4 cases of air leak (3.8%), and 2 cases of subcutaneous emphysema (1.9%). No perioperative death occurred.

Conclusion

3D-CTBA-guided thoracoscopic segmentectomy is an effective surgical approach for the management of pulmonary nodules.
Magnetic resonance imaging quantitative T2* mapping to predict the red blood cell content of in vivo thrombi retrieved from patients with large vessel occlusions in acute ischemic stroke
Authors: Gilbert Alize , Detraz Lili , Alexandre Pierre-Louis , Serfaty Jean-Michel , Desal Hubert , Toquet Claire , Bourcier Romain
Published: September 2021

Background and purpose

Magnetic resonance imaging quantitative T2* mapping has shown reliable identification of thrombus red blood cell content in vitro. The thrombus composition has been in vivo, associated with outcomes after endovascular therapy for acute ischemic stroke. We aim to analyze the red blood cell content of thrombi retrieved from patients with large vessel occlusions in relation to the thrombus-T2* relaxation time in magnetic resonance imaging.

Material and methods

Consecutive acute ischemic stroke patients treated by endovascular therapy were scanned with an magnetic resonance imaging quantitative T2* mapping sequence. Quantitative histologic evaluations of red blood cell content were performed. A linear regression assessed the association between vascular risk factors, comorbidities, antithrombotic drugs intake, baseline National Institutes of Health Stroke Scale (NIHSS), intravenous thrombolysis before endovascular therapy, time between onset and groin puncture, patient's outcome at 3 months, magnetic resonance imaging quantitative T2* mapping results, and the red blood cell content of thrombi. The correlation between the mean thrombus-T2* relaxation time and red blood cell content was assessed by calculating the Pearson correlation coefficient.

Results

Among 31 thrombi, 16 were “Fibrin rich” and 15 “red blood cell dominant.” The median red blood cell content was 39 (range, 0–90; interquartile range, 37). The median (interquartile range) thrombus-T2* relaxation time was shorter in “red blood cell dominant” thrombi (21, interquartile range 6) than in “Fibrin rich” thrombi (24, interquartile range 7), without significant difference ( p = 0.15), as shown in the Box plot. An inverse correlation between thrombus-T2* relaxation time and red blood cell content was found, with a correlation coefficient of −0.41 (95% CI, −0.67 to −0.08, p = 0.02).

Conclusion

Our study shows that a shorter thrombus-T2* relaxation time is related to a higher red blood cell content within in vivo thrombi.
Evaluation of residual strength with ultrasonic pulse velocity relationship for concrete exposed to high temperatures
Authors: Choi Yeol , Kang Joo-Won , Hwang Tae-Yeon , Cho Chang-Geun
Published: September 2021

This paper presents the results of an experimental investigation on the relationship between strength and ultrasonic pulse velocity (UPV) of concrete exposed to high temperature, especially for a decision of building remodeling of concrete structures. The experiments were conducted at three different initial compressive strength levels for temperature up to 800°C. UPV, Compressive, and splitting tensile tests and UPV measurements were performed for unheated and heated concrete specimens. The measured UPV values in the present work were correlated with compressive and tensile strengths to estimate the strength of concrete. Based on the results, two linear equations for predicting compressive and tensile strength of concrete at elevated temperatures using UPV have been proposed. It is found that the difference of initial compressive strength of concrete does not have a significant effect on the strength reduction ratio after exposed to high temperatures. In addition, the reduction factors of compressive and tensile strengths in the present work do not well comply with the values of suggested by EN 1992-1-2.
Difficulties Detecting Clinically Relevant Factor Xa Inhibitor Levels Prior to Reversal With Andexanet Alfa for Intracranial Hemorrhage
Authors: Davis Sarah Elizabeth B. , Dehne Kelly A. , Rubinos Clio A. , Lau Winnie K. , Northam Kalynn A.
Published: September 2021

Coagulation factor Xa (recombinant), inactivated-zhzo (andexanet alfa) is approved for reversal of life-threatening bleeding with rivaroxaban and apixaban use. Clinical decision-making to initiate reversal is reliant on dose taken and timing of last dose. In practice, timing of last dose may be unknown, and the turnaround time for drug-specific anti-factor Xa levels at some institutions may be prolonged, leaving clinicians balancing a difficult decision with limited tools. This report includes a series of 3 patients who presented to our institution with an intracranial hemorrhage and received andexanet alfa for apixaban reversal. These cases highlight the challenges clinicians are facing when using andexanet alfa for emergent rivaroxaban or apixaban reversal when the timing of last dose is unknown, or patients fall outside of the recommended timeframe for use and clinically relevant drug levels are still suspected. Based on our experiences, we encourage other institutions to evaluate their abilities to rapidly and accurately detect the presence of clinically relevant rivaroxaban and apixaban levels when utilizing andexanet alfa.
Primary Sjögren’s Syndrome Presenting as Recurrent Ischemic Strokes
Authors: Kesav Praveen , Hussain Syed Irteza , Devnani Preeti , Namas Rajaie , Al-Sharif Khalid , Thomas Moncy , Altrabulsi Basel , John Seby
Published: September 2021

Primary Sjogren’s Syndrome (PSS) is an autoimmune exocrinopathy, with protean manifestations affecting multiple organ systems. Neurological manifestations are documented in about 20% of PSS cohorts in literature, with peripheral manifestations being commoner. Central nervous system manifestations of PSS (CNS-SS) encompass ischemic strokes, demyelinating lesions, aseptic meningitis, encephalitis, cerebellar ataxia, cognitive impairment and movement disorders. Ischemic stroke as presenting manifestation of PSS is extremely rare. We hereby describe a 50-year-old male, who presented for evaluation of 2 episodes of discrete focal neurological deficits over a duration of 6 weeks, with neuro-imaging findings revealing evidence of acute-subacute bihemispheric infarcts. Further evaluation revealed evidence of strongly positive anti phospholipid antibodies (aPL), indirect immunofluorescence antinuclear antibody (IIF-ANA), anti Sjögren’s syndrome-A (SS-A/Ro) and anti-Ribonuclear protein (RNP) antibodies, with histopathological evidence of periductal and periacinar lymphocytic infiltration as well as acinar atrophy and interstitial fibrosis of minor salivary glands on lip biopsy, consistent with a diagnosis of Sjögren’s syndrome, constituting a diagnosis of Antiphospholipid syndrome (APS) associated with PSS.
Magnitude and factors associated with anemia among pregnant women admitted to labor ward of Hiwot Fana Specialized University Hospital, Eastern Ethiopia
Authors: Abdu Serkalem , Ali Tilahun , Debella Adera , Assefa Nega , Teji Roba Kedir
Published: September 2021

Objectives:

Anemia is a common medical problem among pregnant women that will influence pregnancy and birth outcomes. In Ethiopia, there is a paucity of evidences regarding the problem among pregnant women admitted to labor ward. Therefore, the objective of this study was to assess the magnitude and factors associated with anemia among pregnant women admitted to labor ward for deliveries at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Methods:

A cross-sectional study was conducted among 314 pregnant women admitted to labor ward at Hiwot Fana Specialized University Hospital in June 2020. Data were collected using an interviewer administered questionnaire and were entered into EpiData and analyzed using SPSS. Descriptive statistics and multiple logistic regression analysis were done to identify predictors of anemia.

Results:

In this study, the magnitude of anemia was 37.9% (95% confidence interval: 32.4, 43.0). Short birth interval (adjusted odds ratio = 2.5; 95% confidence interval: 1.02, 6.13), history of blood loss during pregnancy (adjusted odds ratio = 4.3; 95% confidence interval: 1.86, 9.9), less consumption of citrus fruit within a week (adjusted odds ratio = 2.9; 95% confidence interval: 1.2, 6.9), and meal frequency less than three times per day during pregnancy (adjusted odds ratio = 2.2; 95% confidence interval: 1.0, 4.6) were significantly associated with anemia, respectively.

Conclusion:

This study pointed out that more than one-third of pregnant women affected by anemia. Thus, interventions that could reduce anemia, such as counseling about increasing of meal frequency during pregnancy, foods rich in iron, and prevention and management of blood loss are recommended.
How realistic is the China–Pakistan–Iran economic corridor?
Authors: Rajmil Daniel , Morales Lucía , Andreosso-O’Callaghan Bernadette
Published: September 2021

The economic and political influence of China in the Asian region is growing amidst global geopolitical challenges. Economic corridors such as the new Silk Road have been identified as enablers of strategic growth and geo-economic power development in a context of significant political instability. Beijing's strategic approach and the importance of Pakistan and Iran to its aspiration to realise China's dream through its Belt and Road Initiative (BRI) are examined in this comparative study. The rising role of China in the region and its engagement with Iran and Pakistan and the part that these two countries can play need careful attention. Political and economic joint interests have brought together these three countries with significant links to China's economic corridor and energy projections. But the future of the partnership is very fragile as it is characterised by historical hostilities between Iran and Pakistan that can act as a major impendiment to China's ability to progress. In addition, economic and trade figures show an unbalanced relationship that clearly favours Chinese interests. The BRI and the Chinese plans for those territories still remain blurry as any long-term crisis that characterises fragile and complex international alliances.
Development and Refinement of a Persuasive Health Communication Intervention to Persuade Adult Emergency Department Patients to be Screened for HIV and Hepatitis C
Authors: Merchant Roland C. , Hernandez David , Estrela Dora , Fernandez Elsie , Clark Melissa A. , Carey Michael P.
Published: September 2021

Screening for HIV and hepatitis C (HCV) in emergency departments (EDs) allows patients to benefit from life-saving treatment; however, some patients at risk for these infections decline to be tested. Interventions that overcome patient reluctance to be screened are needed so that infected patients can be linked with care. In this project, we developed a very brief, theory-based, persuasive health communication intervention (PHCI) drawn from our previous research that can be integrated into usual clinical practice. The intervention was revised with the assistance of stakeholders who would likely either deliver the intervention (ED medical staff or HIV/HCV counselors) and those who would receive it (adult ED patients). The final version of the intervention was rated as both persuasive and respectful of ED patients who initially declined HIV/HCV testing.
Communism and the Christian Response
Authors: Bates M. Searle
Published: September 2021

This List of Readings succeeds those published on the same subject which were developed by the Missionary Study Fellowship on Christianity and Communism and were published in the Occasional Bulletin, Vol. II, No. 7 (August 1, 1951) and Vol, III, No. 6 (June 12, 1952). Since the Study Fellowship ceased in 1953, we have asked Dr. M. Searle Bates, Professor of Missions in Union Theological Seminary, to prepare an up-to-date list which would meet requests frequently received. Professor Bates long taught history, including a course in Russian History, in the University of Nanking and, since 1950, he has been carrying the Russian, East European, and Asian factors in the Seminary ocurse on Communism and Christianity, associated with Professors Reinhold Nisbuhr and John C. Bennett. He also worked with the Missionary Study Fellowship from 1951 to 1953.

The enormous field of “Christian alternatives to Communism” has had to be left aside, for the most part, since the range of materials on democracy, liberty, economic progress, improvement of government, and social reform of every sort, knows no bounds. Certain chapters in general bocks, of course, are relevant to such issues.–Ed.
Intracellular hydroxyproline imprinting following resolution of bleomycin-induced pulmonary fibrosis
Authors: Song Shengren , Fu Zhenli , Guan Ruijuan , Zhao Jie , Yang Penghui , Li Yang , Yin Hang , Lai Yunxin , Gong Gencheng , Zhao Simin , Yu Jiangtian , Peng Xiaomin , He Ying , Luo Yumei , Zhong Nanshan , Su Jin
Published: September 2021

Background

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with few treatment options. The poor success in developing anti-IPF strategies has impelled researchers to reconsider the importance of the choice of animal model and assessment methodologies. Currently, it is still not settled whether the bleomycin-induced lung fibrosis mouse model finally returns to resolution.

Methods

This study aimed to follow the dynamic fibrotic features of bleomycin-treated mouse lungs over extended durations through a combination of the latest technologies (micro-computed tomography imaging and histological detection of degraded collagens) and traditional methods. In addition, we also applied immunohistochemistry to explore the distribution of all hydroxyproline-containing molecules.

Results

As determined by classical biochemical methods, total lung hydroxyproline contents reached a peak at 4 weeks after bleomycin injury and maintained a steady high level thereafter until the end of the experiments (16 weeks). This result seemed to partially contradict with the changes of other fibrosis evaluation parameters, which indicated a gradual degradation of collagens and a recovery of lung aeration after the fibrosis peak. This inconsistency was well reconciled by our data from immunostaining against hydroxyproline and fluorescent peptide staining against degraded collagen, together showing large amounts of hydroxyproline-rich degraded collagen fragments detained and enriched within the intracellular regions at 10 or 16 weeks rather than at 4 weeks after bleomycin treatment.

Conclusions

Our present data not only offer respiratory researchers a new perspective towards the resolution nature of mouse lung fibrosis, but also remind them to be cautious when using the hydroxyproline content assay to evaluate the severity of fibrosis.
In vitroandin vivomodulation of NADPH oxidase activity and reactive oxygen species production in human neutrophils by α1-antitrypsin
Authors: Hawkins Padraig , McEnery Thomas , Gabillard-Lefort Claudie , Bergin David A. , Alfawaz Bader , Shutchaidat Vipatsorn , Meleady Paula , Henry Michael , Coleman Orla , Murphy Mark , McElvaney Noel G. , Reeves Emer P.
Published: September 2021

Oxidative stress from innate immune cells is a driving mechanism that underlies COPD pathogenesis. Individuals with α-1 antitrypsin (AAT) deficiency (AATD) have a dramatically increased risk of developing COPD. To understand this further, the aim of this study was to investigate whether AATD presents with altered neutrophil NADPH oxidase activation, due to the specific lack of plasma AAT.

Experiments were performed using circulating neutrophils isolated from healthy controls and individuals with AATD. Superoxide anion (O2−) production was determined from the rate of reduction of cytochrome c. Quantification of membrane NADPH oxidase subunits was performed by mass spectrometry and Western blot analysis. The clinical significance of ourin vitrofindings was assessed in patients with AATD and severe COPD receiving intravenous AAT replacement therapy.

In vitro, AAT significantly inhibited O2−production by stimulated neutrophils and suppressed receptor stimulation of cyclic adenosine monophosphate and extracellular signal-regulated kinase (ERK)1/2 phosphorylation. In addition, AAT reduced plasma membrane translocation of cytosolic phox components of the NADPH oxidase.Ex vivo, AATD neutrophils demonstrated increased plasma membrane-associated p67phoxand p47phoxand significantly increased O2−production. The described variance in phox protein membrane assembly was resolved post-AAT augmentation therapyin vivo, the effects of which significantly reduced AATD neutrophil O2−production to that of healthy control cells.

These results expand our knowledge on the mechanism of neutrophil-driven airways disease associated with AATD. Therapeutic AAT augmentation modified neutrophil NADPH oxidase assembly and reactive oxygen species production, with implications for clinical use in conditions in which oxidative stress plays a pathogenic role.
Identification of driver genes based on gene mutational effects and network centrality
Authors: Tang Yun-Yun , Wei Pi-Jing , Zhao Jian-ping , Xia Junfeng , Cao Rui-Fen , Zheng Chun-Hou
Published: September 2021

Background

As one of the deadliest diseases in the world, cancer is driven by a few somatic mutations that disrupt the normal growth of cells, and leads to abnormal proliferation and tumor development. The vast majority of somatic mutations did not affect the occurrence and development of cancer; thus, identifying the mutations responsible for tumor occurrence and development is one of the main targets of current cancer treatments.

Results

To effectively identify driver genes, we adopted a semi-local centrality measure and gene mutation effect function to assess the effect of gene mutations on changes in gene expression patterns. Firstly, we calculated the mutation score for each gene. Secondly, we identified differentially expressed genes (DEGs) in the cohort by comparing the expression profiles of tumor samples and normal samples, and then constructed a local network for each mutation gene using DEGs and mutant genes according to the protein–protein interaction network. Finally, we calculated the score of each mutant gene according to the objective function. The top-ranking mutant genes were selected as driver genes. We name the proposed method as mutations effect and network centrality.

Conclusions

Four types of cancer data in The Cancer Genome Atlas were tested. The experimental data proved that our method was superior to the existing network-centric method, as it was able to quickly and easily identify driver genes and rare driver factors.
Psychiatric emergency admissions during and after COVID-19 lockdown: short-term impact and long-term implications on mental health
Authors: Ambrosetti Julia , Macheret Laura , Folliet Aline , Wullschleger Alexandre , Amerio Andrea , Aguglia Andrea , Serafini Gianluca , Prada Paco , Kaiser Stefan , Bondolfi Guido , Sarasin François , Costanza Alessandra
Published: September 2021

Background

The ‘lockdown’ measures, adopted to restrict population movements in order to help curb the novel coronavirus disease 2019 (COVID-19) pandemic, contributed to a global mental health crisis. Although several studies have extensively examined the impact of lockdown measures on the psychological well-being of the general population, little is known about long-term implications. This study aimed to identify changes in psychiatric emergency department (ED) admissions between two 8-week periods: during and immediately after lifting the lockdown.

Methods

Socio-demographic and clinical information on 1477 psychiatric ED consultations at the University Hospital of Geneva (HUG) were retrospectively analyzed.

Results

When grouped according to admission dates, contrary to what we expected, the post-lockdown group presented with more severe clinical conditions (as measured using an urgency degree index) compared to their lockdown counterparts. Notably, after the lockdown had been lifted we observed a statistically significant increase in suicidal behavior and psychomotor agitation and a decrease in behavior disorder diagnoses. Furthermore, more migrants arrived at the HUG ED after the lockdown measures had been lifted. Logistic regression analysis identified diagnoses of suicidal behavior, behavioral disorders, psychomotor agitation, migrant status, involuntary admission, and private resident discharge as predictors of post-lockdown admissions.

Conclusions

Collectively, these findings can have implications concerning the prioritization of mental health care facilities and access for patients at risk of psychopathological decompensation in time of confinement policies, but above all, provide a foundation for future studies focusing on the long-term impact of the pandemic and its associated sanitary measures on mental health.

Trial registration

Research Ethics Committee of Geneva, Registration number 2020–01510, approval date: 29 June 2020.
Arthroscopic findings and treatment of maisonneuve fracture complex
Authors: Fraissler Lukas , Mattiassich Georg , Brunnader Lars , Holzer Lukas A.
Published: September 2021

Background

The Maisonneuve fracture complex (MFC) is a well-known lower leg injury. However, the optimal treatment is still not clear and there is limited data on concomitant injuries of cartilage. Therefore, the aim of our study was to report the incidence of incidental cartilage injuries and their management in arthroscopic treatment of MFC.

Patients and methods

Between February 2018 and February 2021 all patients presenting with MFC in our department were treated with diagnostic ankle arthroscopy and percutaneous syndesmotic screw or suture-endobutton fixation. In case of instable cartilage, it was debrided and according to the International Consensus Meeting on Cartilage Repair of the Ankle, in grade IV lesions < 10 mm or < 100 mm2 area the subchondral bone was microfractured.

Results

Eighteen patients, 16 male and two female, with a mean age of 48.1 years, were included. In all cases, instability of the distal tibiofibular articulation was confirmed arthroscopically. Injuries of the cartilage were found in 56% of the cases and in 31% of the patients surgical intervention was required. In three talar and one tibial lesion additional arthroscopic bone marrow stimulation with microfracture of the subchondral bone was performed.

Conclusions

Ankle arthroscopy is a helpful method to guide fibular reduction and to detect and address associated cartilage injuries. Due to the high rate of chondral lesions, addressing these arthroscopically may contribute to better postoperative results.

Level of evidence

IV
Cytotoxicity, anti-angiogenic, anti-tumor and molecular docking studies on phytochemicals isolated from Polygonum hydropiper L.
Authors: Mahnashi Mater H. , Alqahtani Yahya S. , Alyami Bandar A. , Alqarni Ali O. , Ullah Farhat , Wadood Abdul , Sadiq Abdul , Shareef Azam , Ayaz Muhammad
Published: September 2021

Background

According to the recent global cancer statistics, breast cancer is the leading cause of deaths among women with 2.3 million new cases globally. Likewise, cervical cancer is also among the leading causes of mortality among women. Polygonum hydropiper is traditionally known for its cytotoxic effects and several bioactive cytotoxic compounds were isolated from it. This study was aimed to isolate potential anticancer compounds from its most potent fractions and evaluate their anticancer potentials.

Methods

Based on our earlier studies, active fractions including chloroform and ethyl acetate were subjected to column chromatography for isolation of compounds. Chemical structures of isolated compounds were confirmed via 1H NMR, 13C NMR, mass spectrometry. Purified compounds were tested for cytotoxicity against breast cancer cells (MCF-7), cervical cancer cells (HeLA) and NIH/3T3 fibroblasts cells cultures using MTT assy. Anti-angiogenic potentials of isolated compounds were evaluated via chorioallantoic membrane assay. Anti-tumor studies were done using Agrobacterium tumefaciens induced potato tumor assay. Furthermore, to understand the binding modes of Isolated compounds, molecular docking was performed against EGFR, HER2 and VEGFR using MOE as docking software.

Results

Two bioactive compounds PH-1 (4-methyl-5-oxo-tetrahydrofuran-3-yl acetate) and PH-2 (methyl 4-hydroxy-3-methoxybenzoate) were purified from the active fractions. In cytotoxicity studies, PH-1 exhibited highest cytotoxicity against HeLA cells with 87.50% lethality at 1 mgmL−1 concentration and LD50 of 60 µgmL−1. Likewise, PH-2 showed 82.33% cytotoxicity against HeLA cells with LD50 of 160 µgmL−1. Similarly, PH-1 and PH-2 exhibited LD50 of 170 and 380 µgmL−1 respectively. Moreover, PH-1 and PH-2 were also very potent cytotoxic compounds against NIH/3T3 cells with 81.45 and 85.55% cytotoxicity at 1 mgL−1 concentration and LD50 of 140 and 58 µgL−1 respectively. Isolated compounds exhibited considerable anti-angiogenic potentials with IC50 of 340 and 500 µgL−1 respectively for PH-1 and PH-2. In anti-tumor assay, PH-1 and PH-2 exhibited 81.15 and 76.09% inhibitions with LD50 of 340 and 550 µgL−1 respectively. Both compounds selectively binds with EGFR and HER2 receptors with low binding energies. Both compounds exhibited stronger interactions with VEGFR through binding pocket residues Lys868, Val916 and Asp1046.

Conclusions

Both compounds cause considerable cytotoxicity against cancer cells. The anti-angiogenic and anti-tumor results suggests additional tumor suppressive properties. Docking analysis suggests that these compound not only has the ability to bind to EGFR and HER2 but also equally binds to VEGFR and may act as potential anti-angiogenic agents.
The risk of COVID-19 in survivors of domestic violence and abuse
Authors: Chandan Joht Singh , Subramanian Anuradhaa , Chandan Jaidev Kaur , Gokhale Krishna M. , Vitoc Alecs , Taylor Julie , Bradbury-Jones Caroline , Bandyopadhyay Siddhartha , Nirantharakumar Krishnarajah
Published: September 2021

A ‘shadow pandemic’ of domestic violence and abuse (DVA) has emerged secondary to strict public health measures containing the spread of SARS-CoV-2. Many countries have implemented policies to allow the free movement of DVA survivors in attempts to minimise their exposure to abusive environments. Although these policies are well received, as a result there is a possibility of increased COVID-19 transmission within this vulnerable group who are not currently prioritised for vaccination. Therefore, we aimed to compare the risk of developing suspected or confirmed COVID-19 in women (aged over 16 years) exposed to DVA against age-sex-matched unexposed controls, following adjustment for known COVID-19 risk factors. A population-based retrospective open cohort study was undertaken between the 31 January 2020 and 28 February 2021 using ‘The Health Improvement Network’ database. We identified 10,462 eligible women exposed to DVA who were matched to 41,467 similarly aged unexposed women. Following adjustment for key covariates, women exposed to DVA were at an increased risk (aHR 1.57; 95% CI 1.29–1.90) of suspected/confirmed COVID-19 compared to unexposed women. These findings support previous calls for positive policy action improving DVA surveillance and prioritising survivors for COVID-19 vaccination.
Monocyte transcriptomes from patients with axial spondyloarthritis reveal dysregulated monocytopoiesis and a distinct inflammatory imprint
Authors: Karow Fabian , Smiljanovic Biljana , Grün Joachim R. , Poddubnyy Denis , Proft Fabian , Talpin Alice , Hue Christophe , Boland Anne , Deleuze Jean-François , Garchon Henri-Jean , Ergenç Ilkay , De Craemer Ann-Sophie , Erben Ulrike , Häupl Thomas , Elewaut Dirk , Breban Maxime , Grützkau Andreas , Syrbe Uta
Published: September 2021

Background

In patients with axial spondyloarthritis (axSpA), monocytes show a pre-activated phenotype. Gut inflammation is a trigger of monocyte activation and may also affect their development in the bone marrow (BM). As gut inflammation is commonly observed in axSpA patients, we performed a detailed analysis of monocyte transcriptomes of axSpA patients in two cohorts and searched for signs of activation and developmental adaptations as putative imprints of gut inflammation.

Methods

Transcriptomes of blood CD14+ monocytes of HLA-B27+ axSpA patients and healthy controls (HC) were generated by microarrays from cohort 1 and by RNA-sequencing from cohort 2. Differentially expressed genes from both analyses were subjected to gene set enrichment analysis (GSEA) and to co-expression analysis in reference transcriptomes from BM cells, blood cells and activated monocytes. As serological markers of translocation, 1,3 beta-glycan, intestinal fatty acid binding protein, and lipopolysaccharide binding protein (LBP) were determined by LAL and ELISA.

Results

Transcriptome analysis identified axSpA-specific monocyte signatures showing an imprint of LPS/cytokine-activated monocytes, late granulopoietic BM cells, blood neutrophils, and G-CSF-mobilized blood cells, which suggests LPS/TNF activation and more prominent BM adaptation promoting a neutrophil-like phenotype. GSEA mapped axSpA upregulated genes to inflammatory responses and TNFα signaling and downregulated probe-sets to metabolic pathways. Among translocation markers, LBP levels were significantly increased in axSpA patients vs. HC (p < 0.001).

Stratified analysis by disease activity and stage identified an “active disease signature” (BASDAI ≥ 4) with an imprint of LPS/cytokine-activated monocytes and CD16+ monocyte subsets. The “AS signature” (vs. non-radiographic axSpA) showed a reinforced neutrophil-like phenotype due to deprivation of dendritic cell transcripts.

Conclusions

The neutrophil-like phenotype of axSpA monocytes points towards a biased monocytopoiesis from granulocyte-monocyte progenitors. This shift in monocytopoiesis and the LPS/cytokine imprint as well as the elevated LBP levels are indicators of systemic inflammation, which may result from bacterial translocation. The BM adaptation is most prominent in AS patients while disease activity appears to be linked to activation and trafficking of monocytes.
Factors that impact burnout and psychological wellbeing in Australian postgraduate medical trainees: a systematic review protocol
Authors: Balhatchet Belinda , Schütze Heike , Williams Nicole , Ashford Bruce
Published: September 2021

Background

The stressful nature of medical training and other work-related factors put postgraduate medical trainees at high risk of burnout and poor psychological wellbeing. This has negative implications for patient care and the effectiveness of the healthcare system. The structure of the healthcare system and postgraduate medical education in Australia is different to that of other countries. Whilst a significant body of research exists on burnout and wellbeing in trainees in the USA, evidence specific to Australian trainees is lacking. The aim of this review is to synthesise the current knowledge on the factors that impact burnout and psychological wellbeing in Australian postgraduate medical trainees.

Methods/design

A systematic review will be conducted across eight digital databases: Academic Search Complete, MEDLINE, Embase, Web of Science, PsychInfo, Scopus, CINAHL Plus and Informit Health Collection. Peer reviewed empirical studies and relevant grey literature published after 2000 that address an aspect of burnout or psychological wellbeing in Australian postgraduate medical trainees will be included. Two reviewers will independently review each article against the inclusion and exclusion criteria, with disagreements resolved via discussion and consensus. Data will be extracted using a standard form and quality will be assessed using the assessment tools available from the Joanna Briggs Institute. A thematic narrative synthesis of the studies will be presented, along with an assessment of current gaps in the literature and areas for future research.

Discussion

This review will be the first to integrate the evidence on burnout and psychological wellbeing specific to Australian postgraduate medical trainees. The findings will contribute to a better understanding of the factors that impact burnout and psychological wellbeing in this population and will lay the foundation for future research into appropriate strategic interventions.

Systematic review registration

This protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020203195).
Questioning in TOEFL iBT speaking test: a case of washback and construct underrepresentation
Authors: Sayyadi Ali , Rezvani Reza
Published: September 2021

Admission in English-medium universities or institutions of higher education depends on the results obtained by candidates in large-scale proficiency tests including Test of English as a Foreign Language (TOEFL) internet-based test (iBT). The structure and administration procedure of the TOEFL iBT speaking test leaves no room for carrying out reciprocal interactions and, consequently, examining applicants’ questioning ability. This study highlights the significance of non-native students’ skills to ask oral English questions in academic contexts as experienced by non-native graduates from English-medium universities and in the view of Iranian TOEFL iBT instructors. Further, the washback of the absence of the skill in the TOEFL iBT test was investigated in speaking preparation classes. Twelve non-native graduates and nineteen Iranian TOEFL iBT instructors participated in the study. They were all interviewed about the significance of oral questioning. The instructors’ views were also sought about the consequences of the disregard of questioning in the test. To triangulate the data, two classes of the instructors were also observed. Classroom observations and interviews were analyzed through content analysis. The results indicated that the participants generally assumed questioning as indispensable in academic interactions. Despite their acknowledgment of its significance, as both the interviews and observations unveiled, the instructors, however, tended not to work on their students’ questioning because of the absence of the skill in the test, the students’ reluctance, limited preparation time, and dependence of their professional reputation on the test results rather than target situation performance. The study further discusses the implications of the findings for the test construct representation and preparation courses.
Are we asking the right questions? Working with the LGBTQ+ community to prioritise healthcare research themes
Authors: Crowe Sally , Barker Eleanor , Roberts Meg , Lloyd Lucy , de Barros Clara M. , Rebelo-Harris Ben , Meads Catherine , Saunders Catherine L.
Published: September 2021

Background

Conversations about research priorities with members of the public are rarely designed specifically to include people who identify as Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) and are not researchers.

Methods

Generally, to address this gap, and specifically, to inform future research for CLS, we carried out a rapid review of published research priority sets covering LGBTQ+ topics, and an online workshop to prioritise identified themes.

Results

Rapid review: results.

The rapid review identified 18 LGBTQ+ research priority sets. Some focussed on specific populations such as women or men, younger or older people or people living within families. Five addressed transgender and gender non- conforming populations. All of the research priority sets originated from English-speaking, high and middle-income countries (UK, US, Canada, and Australia), and date from 2016 onwards. Prioritization approaches were wide-ranging from personal commentary to expert workshops and surveys. Participants involved in setting priorities mostly included research academics, health practitioners and advocacy organisations, two studies involved LGBTQ+ public in their process. Research priorities identified in this review were then grouped into themes which were prioritised during the workshop.

Workshop: results.

For the workshop, participants were recruited using local (Cambridge, UK) LGBTQ+ networks and a national advert to a public involvement in research matching website to take part in an online discussion workshop. Those that took part were offered payment for their time in preparing for the workshop and taking part. Participants personal priorities and experiences contributed to a consensus development process and a final ranked list of seven research themes and participants’ experiences of healthcare, mental health advocacy, care homes, caring responsibilities, schools and family units added additional context.

Conclusions

From the workshop the three research themes prioritised were:healthcare services delivery,prevention,andparticular challenges / intersectionalityof multiple challenges for people identifying as LGBTQ+. Research themes interconnected in many ways and this was demonstrated by the comments from workshop participants. This paper offers insights into why these priorities were important from participants’ perspectives and detail about how to run an inclusive and respectful public involvement research exercise. On a practical level these themes will directly inform future research direction for CLS.
Advanced voltage control method for improving the voltage quality of low-voltage distribution networks with photovoltaic penetrations
Authors: Nakamura Marika , Yoshizawa Shinya , Ishii Hideo , Hayashi Yasuhiro
Published: September 2021

As the number of photovoltaic (PV) power generators connected to the distribution grid increases, applications of on-load tap changers (OLTCs), power conditioning systems, and static reactive power compensators are being considered to mitigate the problem of voltage violation in low voltage distribution systems. The reactive power control by power conditioning systems and static reactive power compensators can mitigate steep voltage fluctuations. However, it creates losses in generation opportunities. On the other hand, OLTCs are installed at the bases of distribution lines and can collectively manage the entire system. However, the conventional voltage control method, i.e., the line drop compensation (LDC) method, is not designed for the case in which a large number of PV systems are installed in the distribution network, which results in voltage violations above the limit of the acceptable range. This study proposes a method to determine the optimal LDC control parameters of the voltage regulator, considering the power factor of PV systems to minimize the magnitude of voltage violations based on the voltage profile analysis of low-voltage (LV) distribution networks. Specifically, during a measurement period of several days, the voltages at some LV consumers and pole transformers were measured, and the optimal parameters were determined by analyzing the collected data. The effectiveness of the proposed method was verified through a numerical simulation study using the actual distribution system model under several scenarios of PV penetration rates. Additionally, the difference in the effectiveness of voltage violation reduction was verified in the case where all the LV consumer’s consumer voltage data measured per minute were used as well as in the case where only the maximum and minimum values of the data within the measurement period were used. The results reveal that the proposed method, which operates within the parameters determined by the voltage analysis of the LV distribution network, is superior to the conventional method. Furthermore, it was found that even if only the maximum and minimum values of the measurement data were used, an effective voltage violation reduction could be expected.