bluuebunny/crossref_metadata_2025 huggingface dataset:
Potentially toxic elements in fly ash bricks and associated ecological health risk: An opinionated review
Authors: Naz Aliya , Chowdhury Abhiroop
Published: November 2024

Exposure to potentially toxic elements (PTE) from various sources seriously threatens the ecosystem in the modern era. Fly ash produced from coal and solid waste combustion contains a high concentration of PTE. Fly ash is a major by-product of coal-based thermal power plants and municipal solid waste incineration units. Due to the high demand for fly ash reuse due to its unique properties, fly ash is now in demand for manufacturing of various building materials and geo-liner for landfills. Brick is the primary building material used in construction. Fly ash bricks are very popular nowadays due to their low cost and high durability. This study reveals the ecological risk index through the exposure of heavy metals in fly ash reported in various studies. Results indicate extremely high ecological risk mainly due to Cd content in fly ash followed by Hg, As, Cu, and Pb. Fly ash is one of the causative agents for several diseases affecting the nervous system, skin, circulatory system, digestive system, reproductive system, and immune responses in the human body.
Strategic Optimization of PFC Coagulation for Saline Water Pre-treatment: Enhancing RO Filtration Efficiency in the Mekong Delta
Authors: Duong Do Vinh , Chi Sy Phung , Thai Nguyen Hoang , Trung Le Duc , Huynh Ngoc-Han T. , Tran Thanh
Published: November 2024

This study critically evaluates the application of Poly Ferric Chloride (PFC) as a pre-treatment coagulant in desalination, particularly for enhancing Reverse Osmosis (RO) filtration in the saline-affected Mekong Delta region. The research focuses on the optimization of PFC dosages and pH levels to maximize coagulation efficiency in varying salinity conditions. Through an extensive series of experiments, an optimal coagulation efficiency of 93.7% for Total Suspended Solids (TSS) removal was achieved with a PFC dosage of 0.7 ml at a pH of 11 in a 5 ppt saline solution. However, increasing salinity levels were found to complicate this relationship, revealing a nuanced interplay between PFC dosage, pH, and salinity. A particularly critical observation was the decreasing effectiveness of PFC as salinity levels rose, indicating a need for escalating PFC dosages in higher saline waters to sustain coagulation effectiveness. The study significantly contributes to the understanding of PFC pre-treatment in water desalination processes, highlighting the compound’s role in improving the input quality for RO systems and extending membrane longevity. These findings are pivotal for designing adaptive water treatment strategies, ensuring the sustainability and effectiveness of water purification in salinity-vulnerable contexts.
Sustainable utilisation of sugar cane molasses as a partial replacement to bitumen in bituminous pavements
Authors: Kuchu Jayasree
Published: November 2024

Energy consumption in manufacturing bitumen is high and limited availability of non-renewable energy resources in the production of bitumen lead to explore alternatives to bitumen in road construction. The alternatives included exploration of sugar molasses that is sustainable, nontoxic, economical and environment friendly option and obtained from industrial wastes. There are more than 700 sugar factories in India and they produce Molasses as by product. The objective of this study is to determine the effect of sugarcane waste molasses in bituminous mix design. Comparison of conventional bitumen and molasses bitumen is done using laboratory tests. Bitumen has been replaced with molasses from 0% to 11% and Marshall stability test has been performed. It was observed that 10% replacement of Molasses has shown optimal results in improving the performance of the mix.
Influence of the basalt fibre and fly ash on the structural properties of sustainable high-strength concrete
Authors: Pallavi Charitha S. , Vijaya Kumar S.
Published: November 2024

The present article describes the experimental research carried out to investigate the properties of concrete containing basalt fibre reinforcement and concrete containing basalt fibres and fly ash additives. Each test was done as per Indian standards (IS-516). The experiments sought to establish both fresh and hardened concrete properties. In respect of new concrete, slump, setting time, bleeding, temperature, and density were estimated to check its quality. Compressive, flexural and split tensile strength are the three main parameters for assessing those qualities in a solidified state. It was determined that the utilization of fly ash with 20%, 30% or 40% proportions of cement involved resulted in a stronger concrete mixture. To these samples, different contents of basalt fibres 0.25%, 0.5%, and 0.75% by volume were added respectively. Standard samples were cast, cured and tested accordingly. Thus, the studies show that it is possible to mix concrete with basalt fibres without any segregation or balling effect on it or even sticking together during the mixing processes. Modestly increased splitting tensile and bending strengths have been obtained due to the introduction of basalt fibres on this composite material using which improved workability can be achieved more rapidly than conventional hydration reactions based solely upon Portland Cement chemistry, moreover, thermal stability has also been considerably enhanced, besides that even basic physical-chemical properties should be very much similar to those of ordinary Portland cement. Based materials thus ensuring better compatibility during processing from raw constituents towards final composites up-to-date with known technological aspects related specifically towards production practices carried out in developing countries like India. Such situations usually result primarily due to poor engineering control exercised over construction activities. Resulting problems areas namely joint locations limited access space between steel reinforcement bars inside walls. So often appearing weak points in overall design yield inadequate structural performance compared to intended specifications. Another reason why sustainable building methods cannot be fully adopted has been found that they lack proper skilled manpower despite having all necessary resources that are easily renewable. By compared with traditional ones made up of non-renewable sources such as fossil fuels. However, fly ash used in place of concrete only makes it harder without improving workability and strength at the optimum percentage.
Assessing the impact and response to the disaster in Mananthavady Town: A Case Study
Authors: Bigith V.B. , Sooraj G. , Nainwal Rajat , Kumara H.S.
Published: November 2024

The study aims to assess the impact of a disaster on Mananthavady town, Kerala, and the response taken by the authorities to mitigate the effects of the disaster. The disaster in occurred in Wayanad was a severe flood that occurred in May 2018, which affected several regions of Kerala. The study uses a case study approach to examine the disaster’s impact on Mananthavady town, including the damage to infrastructure, loss of life and livelihoods, and the community’s resilience. Additionally, the study helps the government and local organizations to support the affected community and promote their recovery. The findings of the study contribute to the understanding of disaster management practices and their effectiveness in addressing the challenges posed by natural disasters.
Enhancing concrete performance and sustainability through carbonation curing: Effects of fly ash incorporation and mechanical properties evaluation
Authors: Joyson Silva P. , Sukumar Binu , Hemamathi A. , Ram Shankar P. , Aakash Bommu , Chaithanya Janda , Shanmugam P. B.
Published: November 2024

This research paper intends to assess the characteristics of various concrete samples exposed to carbonation curing. Carbonation curing is a technique used to quicken the solidifying process of concrete by exposing it to carbon dioxide. Concrete treated with carbonation exhibits mechanical and durability properties superior to those treated with moisture. In this study, carbonation-treated concrete was prepared by initially pre-curing and then subjecting it to carbonation curing. The research encompassed testing different properties of concrete specimens treated with carbonation, including compressive strength, tensile strength, and carbonation resistance. The addition of Fly Ash (FA) is renowned for enhancing the durability of reinforced concrete as supplementary contentious materials. In this investigation, concrete cubes were prepared with and without partial substitution of cement by Fly Ash and were encased in plastic covers tightly sealed to prevent air ingress, undergoing carbonation in a controlled environment. Results revealed that the compressive strength of carbonation-treated concrete exceeded that of moisture-cured concrete by 15% to 20% at the same age. These findings indicate that carbonation curing holds promise for enhancing concrete performance in specific applications.
Effect of infill walls on seismic performance of RC framed buildings
Authors: Bala Balaji Y. , Prasad S. A. V. , Kavitha B.
Published: November 2024

Infill walls are masonry walls constructed to fill the gaps between the structural frames. In structural analysis, these walls are considered non-structural members as they do not participate in the load transfer mechanism. These walls offer considerable resistance in terms of a diagonal strut when the bounding frame experiences lateral loads. This study focuses on the effect of infill walls on the seismic parameters by modelling different infill wall configurations of G+6 buildings by considering the infill resistance as a pin-jointed strut using SAP2000 software. The results from the response spectrum analysis of these models emphasized the importance of infill walls and their configuration in the seismic resistance of buildings.
Analysis and Design of Floating Concrete and its Applications
Authors: Rayabharapu Vijay Kumar , Petluru Prasanthi , Pallapu Kavya Sudha , Mella Bharat Sai
Published: November 2024

The main object of this paper is to experimentally explore the optimal design of light weight aggregate concrete, considering its compressive strength and density. This Project deals with the development of Floating type of concrete by using less weighted aggregates such as expanded clay, perlite, vermiculite, EPS beads etc. The usage of light weight aggregates has drastically reduced the overall mass of concrete when compared to nominal concrete. However, attaining the characteristic strength of nominal concrete was indeed a challenge. Numerous concrete test cubes of size 0.15×0.15×0.15 m3 were cast using cementitious materials and aggregates of different proportions and their characteristic compressive strength was tabulated. The appropriate mix design having adequate compressive strength and floating property was selected. This mix had a density of 866.63 kg/m3 and a compressive strength of 12.45 MPa which is quite optimal in comparison to the rest of the mixes.
Seismic analysis of vertically irregular RCC high-rise buildings: A study with provision of FVD at various locations
Authors: Ramanjaneyulu Batchu , Prasad Achina , Satish keshagoni , Keertan Tirukovela Sai , Bommisetty Jagadeesh
Published: November 2024

Irregular buildings are a significant part of urban infrastructure, often resulting from architectural, functional, and economic constraints. Among these, structures embracing vertical irregularities are predominantly receptive to dynamic loads, with earthquakes being the most damaging event. The dynamic forces acting on a structure during an earthquake generate vibrations and increase the energy within the structure. The primary role of a structure is to withstand these lateral loads and transmit them to the foundation. To enhance the seismic performance of such structures, various energy dissipation systems are employed to absorb and dissipate the released energy, thereby improving the building’s response to earthquake forces. This study focuses on the use of Fluid Viscous Dampers (FVDs) to dissipate energy from the structure. It involves a comparative analysis of effect due to inclusive and non-inclusiveness of fluid viscous dampers at various locations for Set-Back and Step-Back type vertical irregular high-rise buildings. The analysis aims to study key response parameters such as modal time-period, storey displacement, mode type, storey shear, torsional irregularity, and storey drift using ETABS software. The primary objective is to enhance understanding of the seismic behaviour of high-rise reinforced concrete structures with vertical irregularities and Fluid Viscous Dampers (FVDs) at different locations.
Properties and eco-cost effectiveness of concrete containing waste blast furnace slag and demolition waste
Authors: Majhi Rajib Kumar , Dash Saine Sikta , Moharana Madhusmita , Das Shiv Sankar
Published: November 2024

This work aims to develop eco-friendly, cost-effective concrete using ground granulated blast furnace slag (GGBFS) and recycled coarse aggregate (RCA). Seven concrete mixes are prepared with different combinations of RCA and GGBFS. Properties like 28-day compressive strength, rapid chloride permeability and abrasion resistance have been studied. Physical and microstructural investigations have been carried out to justify the variation in the properties. Moreover, environmental impact and cost-effective analyses are performed. It is found that the strength of concrete mix with 50% RCA and 45% GGBFS closely satisfies the desired strength for M25 grade concrete. Also, the mix has shown good resistance against abrasion and chloride permeability. Physical examination reveals that ITZ has played a significant role in the strength variation. Similarly, microstructural investigation reveals that the formation of voids due to RCA and the filling of the voids by GGBFS are the two phenomena responsible for variation in durability. Further, the negative environmental impacts and cost of concrete can be reduced up to 62.93% and 11.9%, respectively, compared to the control concrete using RCA and GGBFS. Since this mix provides desired strength and durability, environmental benefit and cost benefit over normal concrete, this concrete becomes eco-cost efficient.
Utilization of e-waste as a partial replacement of coarse aggregate in concrete
Authors: Hinge Pawan , Thakur Keshar , Humane Rutuja , Tikle Vibhati , Shrirame Aditya , Chafle Suraj , Dharammali Umesh , Rathod Rohan
Published: November 2024

One of the fastest waste streams to generate and amass is electronic garbage, or “E-waste,” which is growing exponentially. This is a result of the development and expansion of other technical sectors as well as the information technology industry. In many places, improper handling such as open burning of e-waste and uncontrolled landfill disposal accelerates the release of greenhouse gases (GHG) into the sky, which is a direct cause of global warming. It presents serious worldwide environmental challenges. There is a thirty percent increase in the production of electronic waste, or “E-waste”. 90% of e-waste is collected and 70% is recycled in India, where the informal sector handles the majority of E-waste management. Important steps must be taken for the treatment of E-waste to decrease the volume of waste and reuse it for other purposes. This paper gives a review of how the repurposed E-waste used as a partial replacement in concrete affects the various properties of concrete.
Promoting Critical Conversations About SMART Goals in Clinical Simulations
Authors: Parker Vanessa L , Hsieh Wan-Jung , Carrington Allison A
Published: November 2024

Effective clinical practice involves integrating a variety of knowledge and skills, beginning with a clear definition of the presenting problem(s) from which clinical goals are developed. Goals that are specific, measurable, achievable, realistic, and time sensitive (SMART) are more likely to promote client success. This chapter features the use of simulations in a master’s of social work (MSW) program as a pedagogical approach for teaching SMART goals. Students participated in simulated sessions with tailored case scenarios integrated with cultural and diversity considerations. Evaluation included surveys and participation in focus groups to assess their overall experience with the simulation; understanding of SMART goals; skill enhancement; and themes related to diversity, cultural, and ethical considerations. Students shared that simulations helped them apply skills to formulate SMART goals in a more natural learning environment.
Using Simulations in Teaching Program Evaluation to MSW Students
Authors: Bui Tuyen
Published: November 2024

This chapter describes how simulations were used to teach program evaluation, building logic models, and needs assessments. It highlights the challenges, including anxiety and a lack of perceived relevance to clinical practice, faced by social work students in research-related courses. However, with the help of simulations, students can learn the intricacies of program evaluation and overcome their concerns. The chapter describes overcoming the challenges of implementing simulations in a macro practice course for the first time and doing so virtually. It was found that the students enthusiastically supported simulations and critically appraised the benefits of the simulations in building the knowledge and necessary skills to create a logic model and needs assessment within program evaluation.
Bringing Macro Social Work Education Into the Future Through Simulations
Authors: Iverson Melissa , Laursen Tiffany
Published: November 2024

This chapter explores the use of simulations in elevating macro social work education. It specifically focuses on the development and implementation of simulations within two distinct courses: a master of social work (MSW) Policy Practice and Advocacy course and a bachelor of social work (BSW) Social Entrepreneurship and Social Change course. The effectiveness of simulations as educational tools for macro social work is thoroughly examined. The chapter not only explores the details of simulation experiences but also addresses the common skills that simulations can cultivate across various social work micro, mezzo, and macro domains. By scrutinizing challenges and opportunities stemming from simulation implementation, the chapter provides valuable insights for educators to enhance student preparedness and actor engagement. The findings underscore the crucial role of simulations in honing critical skills for macro social work, emphasizing the need for their continued integration to better equip students for the intricate demands of policy, advocacy, and community leadership.
The Future of Simulations in Social Work Education
Authors: Tan Kevin , Wu Chi-Fang , Ostler Terry
Published: November 2024

Drawing on 5 years of teaching and research on simulations, this chapter reflects modest beginnings in implementing simulations in social work classes, growth and transformation over time, challenges faced, and future directions for social work education. Finding time and resources for implementing simulations, reluctance to utilize simulations in classes, and concerns about the potential for re-traumatization in simulations re-enacting cases involving police interactions or the perpetuation of stereotypes in simulations of individuals with mental illness or disabilities were challenges that required ongoing reflection and discussions. Being alive and accountable to the multifaceted complexities of experiences that social workers may confront were key. Overall, the simulations became a powerful learning tool that provided bachelor and master of social work and doctor of philosophy students with needed experiential learning to prepare them for real-world practice and teaching.
Effects of lignin on indigo-reducing activity and indigo particle size in indigo dye suspensions
Authors: Nakagawa Kasumi , Ohata Haruka , Takeuchi Michiki , Matsunaga Momoka , Sowa Keisei , Sakamoto Takaiku , Ando Akinori , Asada Chikako , Ogawa Jun , Kano Kenji , Sakuradani Eiji
Published: November 2024

Microbial indigo reduction is a key reaction in indigo dyeing; however, the mechanism of the interaction with indigo remains unclear. We hypothesized that lignin is a candidate substance that supports this interaction. The addition of lignin effectively enhanced the indigo reduction. The reducing activity of indigo correlated with the particle size after the addition of lignin.
Change in Blood Pressure, Weight, and Other Cardiovascular Disease Risk Factors After Switch From Protease Inhibitors to Dolutegravir: Post hoc Analysis of the 48-week Randomised Second-line Switch to Dolutegravir Trial
Authors: Ombajo Loice Achieng , Penner Jeremy , Nkuranga Joseph , Omodi Victor , Otieno Edwin , Ndinya Florentius , Wahome Simon , Pozniak Anton
Published: November 2024

Among 777 virally suppressed adults with human immunodeficiency virus on protease-inhibitor–based second-line antiretroviral regimens randomized 1:1 to switch to dolutegravir or remain on a protease inhibitor, there was no difference in incident hypertension (12% in each arm, P = .868) or change in blood pressure over the 48-week study period.
Accelerated atrial pacing reduces left-heart filling pressure: a combined clinical-computational study
Authors: van Loon Tim , Rijks Jesse , van Koll Johan , Wolffs Joey , Cornelussen Richard , van Osta Nick , Luermans Justin , Prinzen Frits , Linz Dominik , van Empel Vanessa , Delhaas Tammo , Vernooy Kevin , Lumens Joost
Published: November 2024

Background and Aims

Accelerated atrial pacing offers potential benefits for patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF), compared with standard lower-rate pacing. The study investigates the relationship between atrial pacing rate and left-heart filling pressure.

Methods

Seventy-five consecutive patients undergoing catheter ablation for AF underwent assessment of mean left atrial pressure (mLAP) and atrioventricular (AV) conduction delay (PR interval) in sinus rhythm and accelerated atrial pacing with 10 bpm increments up to Wenckebach block. Computer simulations (CircAdapt) of a virtual HFpEF cohort complemented clinical observations and hypothesized the modulating effects of AV coupling and atrial (dys)function.

Results

In the study cohort, 49(65%) patients had a high HFpEF likelihood (H2FPEF ≥ 5.0), and 28(37%) an elevated mLAP ≥ 15 mmHg at sinus rhythm. Optimal pacing rates of 100 [70–110]bpm (median [IQR]) significantly reduced mLAP from 12.8 [10.0–17.4]mmHg in sinus rhythm (55 [52–61]bpm) to 10.4 [7.8–14.8]mmHg (P < .001). Conversely, higher pacing rates (130 [110–140]bpm) significantly increased mLAP to 14.7 [11.0–17.8]mmHg (P < .05). PR interval and, hence, AV conduction delay prolonged incrementally with increasing pacing rates. Simulations corroborated these clinical findings, showing mLAP reduction at a moderately increased pacing rate and a subsequent increase at higher rates. Moreover, simulations suggested that mLAP reduction is optimized when AV conduction delay shortens with increasing rate.

Conclusions

Accelerated pacing acutely reduces left-heart filling pressure in patients undergoing AF catheter ablation and computer simulations with HFpEF features, suggesting it as a potential therapeutic strategy to alleviate congestion symptoms. Virtual HFpEF patient cohorts hypothesize that AV sequential pacing may further optimize this therapy's beneficial effects.
Dysregulation of alternative splicing is a transcriptomic feature of patient-derived fibroblasts from CAG repeat expansion spinocerebellar ataxias
Authors: Aliyeva Asmer , Lennon Claudia D , Cleary John D , Shorrock Hannah K , Berglund J Andrew
Published: November 2024

The spinocerebellar ataxias (SCAs) are a genetically heterogeneous group of rare dominantly inherited neurodegenerative diseases characterized by progressive ataxia. The most common mutation seen across the SCAs is a CAG repeat expansion, causative for SCA1, 2, 3, 6, 7, 12 and 17. We recently identified dysregulation of alternative splicing as a novel, presymptomatic transcriptomic hallmark in mouse models of SCAs 1, 3 and 7. In order to understand if dysregulation of alternative splicing is a transcriptomic feature of patient-derived cell models of CAG SCAs, we performed RNA sequencing and transcriptomic analysis in patient-derived fibroblast cell lines of SCAs 1, 3 and 7. We identified widespread and robust dysregulation of alternative splicing across all CAG expansion SCA lines investigated, with disease relevant pathways affected, such as microtubule-based processes, transcriptional regulation, and DNA damage and repair. Novel disease-relevant alternative splicing events were validated across patient-derived fibroblast lines from multiple CAG SCAs and CAG containing reporter cell lines. Together this study demonstrates that dysregulation of alternative splicing represents a novel and shared pathogenic process in CAG expansion SCA1, 3 and 7 and can potentially be used as a biomarker across patient models of this group of devastating neurodegenerative diseases.
The immune memory of innate immune systems
Authors: Kato Yasuhiro , Kumanogoh Atsushi
Published: November 2024

Immune memory has long been considered a function specific to adaptive immune systems; however, adaptive immune memory alone has not fully explained the mechanism by which vaccines exert their protective effects against nontarget pathogens. Recently, trained immunity, in which human monocytes vaccinated with bacillus Calmette–Guérin become highly responsive to pathogens other than Mycobacterium tuberculosis, has been reported. However, a phenomenon called endotoxin tolerance is also known, in which monocyte responsiveness is attenuated after the first lipopolysaccharide stimulation. These phenomena represent an altered innate immune response after the initial exposure to the stimulus, indicating that memories are formed in the innate immune system. In this review, we discuss trained immunity and endotoxin tolerance, known as innate immune memory, and innate immune memory formation by mRNA vaccines, which have been newly used in the coronavirus disease 2019 (COVID-19) pandemic and are considered important vaccine modalities in the future.
Bacterial Rps3 counters oxidative and UV stress by recognizing and processing AP-sites on mRNA via a novel mechanism
Authors: Afsar Mohammad , Shukla Ankita , Ali Faiz , Maurya Rahul Kumar , Bharti Suman , Kumar Nelam , Sadik Mohammad , Chandra Surabhi , Rahil Huma , Kumar Sanjay , Ansari Imran , Jahan Farheen , Habib Saman , Hussain Tanweer , Krishnan Manju Yasoda , Ramachandran Ravishankar
Published: November 2024

Lesions and stable secondary structures in mRNA severely impact the translation efficiency, causing ribosome stalling and collisions. Prokaryotic ribosomal proteins Rps3, Rps4 and Rps5, located in the mRNA entry tunnel, form the mRNA helicase center and unwind stable mRNA secondary structures during translation. However, the mechanism underlying the detection of lesions on translating mRNA is unclear. We used Cryo-EM, biochemical assays, and knockdown experiments to investigate the apurinic/apyrimidinic (AP) endoribonuclease activity of bacterial ribosomes on AP-site containing mRNA. Our biochemical assays show that Rps3, specifically the 130RR131 motif, is important for recognizing and performing the AP-endoribonuclease activity. Furthermore, structural analysis revealed cleaved mRNA product in the 30S ribosome entry tunnel. Additionally, knockdown studies in Mycobacterium tuberculosis confirmed the protective role of Rps3 against oxidative and UV stress. Overall, our results show that prokaryotic Rps3 recognizes and processes AP-sites on mRNA via a novel mechanism that is distinct from eukaryotes.
The fungal effector AaAlta1 inhibits PATHOGENESIS-RELATED PROTEIN10-2-mediated callose deposition and defense responses in apple
Authors: Gong Shun , Tang Jinqi , Xiao Yi , Li Tianzhong , Zhang Qiulei
Published: November 2024

Apple leaf spot, caused by Alternaria alternata f. sp mali (ALT), poses a substantial threat to the global apple (Malus × domestica Borkh.) industry. Fungal effectors promote pathogen infestation and survival by interfering with plant immune responses. In our study, we investigated the secretion of effector proteins by the virulent ALT7 strain. Using mass spectrometry, we identified the effector AaAlta1, which belongs to the Alt a 1 protein family (AA1s). Further analysis confirmed that ALT7 secretes AaAlta1. AaAlta1 knockdown mutants displayed reduced pathogenicity in apple tissue culture seedlings, while overexpression strains exhibited enhanced pathogenicity compared to the wild-type ALT7 strain. Using immunoprecipitation followed by mass spectrometry, we isolated pathogenesis-related protein 10-2 (PR10-2) as an interaction partner of AaAlta1 in apple. Knockdown mutants of AaAlta1 showed increased PR10-2-mediated callose deposition in apple, a critical plant defense response. The enhanced defense responses in apple substantially reduced their susceptibility to infection by these ALT7 mutants. Our findings delineate an infection strategy whereby ALT7 secretes AaAlta1 to suppress PR10-2, thereby circumventing the apple defense system.
Elevated serum interferon-α2 associates with activity and flare risk in juvenile-onset systemic lupus erythematosus
Authors: Natoli Valentina , Crow Yanick J , Hunt David P J , Tharmaratnam Kukatharmini , Jorgensen Andrea L , Beresford Michael W , Hedrich Christian M , Smith Eve M D
Published: November 2024

Objectives

This study investigated serum IFN-α2 as a putative marker of disease activity and predictor of disease flares in juvenile systemic lupus erythematosus (jSLE).

Methods

A total of 222 serum samples were analysed, including 28 healthy controls (HCs), 88 jSLE (159 samples) and 35 juvenile idiopathic arthritis (JIA) patients. IFN-α2 levels were determined using single-molecule array (Simoa). Cross-sectionally, median IFN-α2 levels were compared between patient groups and disease activity state sub-groups. Time to flare was analysed by linear regression. Longitudinally, the ability of the IFN-α2 and other traditional biomarkers (erythrocyte sedimentation rate/ESR, low C3 and anti-dsDNA antibodies) to detect and predict flares was assessed via a generalised linear mixed model.

Results

Cross-sectional analysis showed higher median IFN-α2 levels in the active/intermediate group (median 3185 fg/ml, IQR 48–13 703) compared with the LDAS (571 fg/ml, IQR 57–1310 fg/ml, P = 0.04) and remission sub-groups (271 fg/ml, IQR 3–56, P <0.001). IFN-α2 was higher in all JSLE patients (median 587 fg/ml, IQR 11–2774) as compared with JIA patients (median 7 fg/ml, IQR 3–236, P = 0.0017) and HCs (P = 0.017). JSLE patients in remission or LDAS with abnormal IFN-α2 levels had a shorter time to flare over the subsequent six months compared with those with normal IFN-α2 levels (P = 0.022). Longitudinally, multivariable analysis demonstrated high IFN-α2 to be the only predictor of an ongoing flare (P = 0.028).

Conclusion

Serum IFN-α2 levels associate with disease activity and can predict ongoing and future flares in jSLE. These findings suggest that quantification of IFN-α2 may support risk stratification and disease monitoring in these patients.
Serum Concentration of Antidepressant Drugs in Geriatric Day Care Patients With Renal Insufficiency and Multimorbidity
Authors: Reber Sibylle , Herr Alexandra S. , Unterecker Stefan , Scherf-Clavel Maike
Published: November 2024

Background:

Geriatric depression is challenging to treat owing to age-related changes in pharmacokinetics and comorbidities. Although renal insufficiency and multimorbidity are typical geriatric complications that cannot be completely separated from each other, no study has examined the influence of these factors on the serum concentrations of antidepressants. For the first time, we evaluated the effects of these factors in combination on the dose-corrected serum concentration (C/D) of antidepressants in geriatric patients.

Methods:

In this retrospective study, data from 123 geriatric patients in a gerontopsychiatric day care unit at the University Hospital of Würzburg were analyzed. Multiple linear regression analysis and analysis of variance with confounders were used to examine the associations between glomerular filtration rate (GFR) and stages of renal impairment and the C/D of venlafaxine, mirtazapine, sertraline, and escitalopram corrected for multimorbidity, sex, lithium intake, and the number of triple whammy drugs.

Results:

GFR (P < 0.001, ß = −0.070) was associated with the C/D of the active moiety of venlafaxine (N = 32). GFR, multimorbidity, and sex were not associated with the C/D of mirtazapine, escitalopram, or sertraline.

Conclusions:

As the influence of sex may be less pronounced than that of decreasing GFR in terms of the C/D of the active moiety of venlafaxine in geriatric patients, we recommend considering the GFR for dose adjustment rather than sex. In conclusion, even in patients with mild renal impairment, serum venlafaxine concentration should be monitored to prevent overdosing. Mirtazapine, sertraline, and escitalopram may be well-suited antidepressants for geriatric patients with renal function impairment stage 2–3 as well as multimorbidity.
Diversity in the US Academic Microsurgery Pathway
Authors: Musavi Leila , Malapati Sri Harshini , Hemal Kshipra , Chen Wendy , Broach Robyn , Yost Mark T. , Butler Paris D.
Published: November 2024

Although the representation of women and ethnic minority students in the US medical schools has recently increased, discrepancies in representation among plastic surgery residents and faculty continue. The state of sex and ethnic diversity in academic microsurgery remains minimally investigated. We aimed to evaluate the sex, race, and ethnicity demographics among academic microsurgeons and identify underrepresentation along the leadership pathway. The US-based microsurgery fellowship programs provided contact information of fellowship graduates from 2006 to 2020. An anonymous electronic survey was distributed, and demographic, training background, mentorship, and career path data were collected. Program websites were reviewed to collect data on academic microsurgery faculty nationwide. We found that women and non-White surgeons reported similar rates of effective mentorship in training. Compared with White surgeons, non-White surgeons had lower probability of holding an academic position directly after fellowship (odds ratio = 0.28, P = 0.023) and reported fewer perceived opportunities for professional advancement (61% versus 91%, P = 0.007). The majority of academic leadership positions were held by White surgeons (72%). Overall, women faculty were earlier in their careers than men (mean time out of fellowship 7.2 years for women versus 14.8 years for men, P < 0.001), signifying a lack of senior female faculty. Male faculty had higher rates of leadership than female faculty (24.7% versus 8.0%, P = 0.01). Our results demonstrate that women and non-White surgeons are not adequately represented in academic microsurgery faculty and leadership positions. Future interventions seeking to increase diversity can help improve the delivery of equitable reconstructive care.
Surgical outcomes of tractional maculopathy associated with familial exudative vitreoretinopathy in children
Authors: Ma Jing , Yuan Ming-Zhen , Liu Jing-Hua , Li Song-Feng , Deng Guang-Da , Li Liang , Lu Hai
Published: November 2024

Purpose:

To evaluate the surgical outcomes of pediatric familial exudative vitreoretinopathy (FEVR) complicated by tractional maculopathy.

Methods:

Retrospective case series. Chart review of 14 children (15 eyes) diagnosed with tractional maculopathy-complicated FEVR who received vitrectomy.

Results:

The mean age at surgery was 7.2 years. The mean follow-up duration was 14.1 months. The logarithm of the minimum angle of resolution (logMAR) of best-corrected visual acuity (BCVA) improved from 1.0±0.6 (20/200 Snellen) to 0.6±0.6 (20/80 Snellen) post-operation (t=4.293, p=0.001). The peripapillary temporal inner angle (PTIA, 63.9(15.7) ° vs. 71.1(31.2) °, z=-2.726, p=0.006) and peripapillary temporal outer angle (PTOA, 63.4±25.2° vs. 69.6±23.5°, t=-2.820, p=0.014) widened post-operation. Postoperative BCVA was superior in eyes with a shorter time between symptom onset and surgery (r=0.688, p=0.019), better preoperative logMAR BCVA (r=0.830, p<0.001), and preoperative widening of the outer nuclear layer (ONL, r-pb=0.730, p=0.007) and foveal avascular zone (FAZ, r-pb=0.794, p=0.002), and in eyes with postoperative ellipsoid (r-pb=0.641, p=0.018) and interdigitation zones integrity (r-pb=0.614, p=0.026), widening of the ONL(r-pb=0.816, p=0.001) and FAZ (r-pb=0.940, p<0.001), and absence of the inner retinal layer at the fovea (r-pb=0.672, p=0.012).

Conclusion:

Vitrectomy is effective for pediatric FEVR complicated by tractional maculopathy. Patient selection is crucial and iatrogenic complications should be avoided.
Local Betamethasone Versus Triamcinolone Injection In Management of Thyroid Eye Disease-Related Upper Eyelid Retraction With Proptosis
Authors: Awad Rawda A. , Abo-Ghadir Ahmed A. , Hussien Mohamed Shehata , Awad Ahmad A. , Kedwany Salma M. , Mohammad Abd El-Nasser A.
Published: November 2024

Purpose:

To compare the efficacy of local injection of both betamethasone and triamcinolone in the management of thyroid eye disease-related upper eyelid retraction with proptosis.

Methods:

This prospective, double-blind, randomized clinical trial was conducted at Assiut University Hospital, Upper Egypt in the period between December 2021 and December 2023. The study included 45 patients (77 eyes) and was divided into: A (betamethasone) group and B (triamcinolone) group. The steroid was injected peri-levator (1 ml) and retrobulbar (1.5 ml). The injection was repeated every month for up to 5 injections if there was an improvement in margin reflex distance 1 (MRD1) and Hertel measurements. The injection was stopped if measurements reached the normal value or if 2 successive injections caused no improvement. The postinjection outcome was divided into; 1) effective if measurements reached the normal (MRD1 ≤4.5 mm and Hertel ≤18 mm); 2) partially effective if measurements were improved but did not reach the normal; and 3) ineffective if there was no improvement in measurements. The follow-up ranged from 6 to 20 months.

Results:

In group A, the injection was effective in 35 eyes (89.74%) and partially effective in 4 eyes (10.26%). In group B, the injection was effective in 22 eyes (57.9%), partially effective in 8 eyes (21.05%) and ineffective in 8 eyes (21.05%). The mean injection number was significantly lower in group A than in group B; 2.54 ± 0.51 versus 3.74 ± 1.18.

Conclusions:

This study’s results suggest that betamethasone is more effective with a small number of injections than triamcinolone in the management of thyroid eye disease-related upper eyelid retraction with proptosis.
Pouching System Leakage and Peristomal Skin Complications Following Ostomy Surgery in the Immediate Postoperative Period
Authors: Zamarripa Cecilia , Craig Alexandra , Kelly Matthew T. , Mathews Carol , Folk Amy
Published: November 2024

PURPOSE

The purpose of this study was to explore the performance of pouching systems with respect to leakage and the development of peristomal skin complications (PSCs) in an acute care setting immediately following ostomy creation.

DESIGN

Non-experimental, retrospective cohort study.

SUBJECTS AND SETTING

The sample comprised 214 patients admitted for stoma-creation surgery at one of the 2 University of Pittsburgh Medical Center Presbyterian-Shadyside campuses located in the Northeastern United States (Pittsburgh, PA). Patients were seen in an in-patient care setting.

METHODS

Electronic health records from patients who were in the hospital for ostomy creation surgery were reviewed by wound ostomy continence nurses from each hospital. Demographic and selected clinical data were collected. The main outcome variables used to evaluate pouching system performance were leakage and PSCs. These outcomes were assessed starting at pouch placement in the operating room and at every subsequent pouch change (up to 5) through discharge or 2 weeks following surgery.

RESULTS

Use of an elastic tapeless barrier (ETB) significantly reduced the risk of leakage compared to a ceramide-infused tape-border barrier (CIB) for patients (41% reduced risk of leakage, P = .011). Use of the ETB also reduced leakage risk compared to the CIB for patients who experienced leakage 2 or more times during the observation period (31% reduction in leakage risk, P = .043). Five types of PSCs occurred during the study and statistical analysis indicated no significant differences in the number of PSCs was documented between barrier types.

CONCLUSION

The use of an ETB significantly reduced the risk of leakage compared to a CIB.
A Comparative Randomized Cross-Over Trial to Examine Efficacy of Urine Capture and Comfort of Two Male External Urine Collection Devices in Healthy Male Volunteers
Authors: Wagg Adrian , Redmond Danielle R.
Published: November 2024

PURPOSE

This study assessed the efficiency of urine collection using external urine collection devices over two voids in a group of morbidly obese and non-obese men.

DESIGN

Prospective single-blind comparative crossover study.

MATERIALS AND METHOD

We assessed the comparative urine capture efficiency of two commercially available male external urine management systems. Continent consenting men were randomized to use each device for a single void. The proportion of urine captured by each device expressed as a percentage of the total volume voided in grams was calculated and compared. Results were compared between morbidly obese (BMI ≥ 40 kg/m2) and non-morbidity (BMI ≤ 40 kg/m2) men.

RESULTS

Fifty-nine men completed the study; their mean (standard deviation, SD) age was 40.8 (SD 12.4) years. For void 1, the mean proportion of urine capture for Device A was 97.8% (SD 10.0); for Device B it was 90.7% (SD 20.7). For void 2, the mean proportion of urine capture for Device A was 91.1% (SD 25.8); for Device B it was 85.2% (SD 21.7). The mean difference between devices was 6.6% (95% CI 0.18, 13.0), P = .044. Stratified by weight, in the morbidly obese men, Device A captured 99.7% (SD 0.88) of the first void versus 83.5% (SD 32.2) for Device B. Analysis of the second voids found that Device A captured 80.8% (SD 36.9) versus 79.3% (SD 23.3) for Device B.

CONCLUSION

Device A (the investigational device) performed significantly better than Device B in capture rates when compared based on voided volume, order of void, or BMI category. Device A male external catheter system is an effective option for urine management in both obese and non-obese men.
Characteristics of Diaper Dermatitis in Patients Aged 0-24 Months After Congenital Heart Disease and the Effects of a Diaper Dermatitis Care Bundle
Authors: Chin Pei-Ju , Liao Li-Na , Huang Li-Chi
Published: November 2024

PURPOSE

The purpose of this study was to examine characteristics of diaper dermatitis (DD) in critically ill patients aged 0 to 24 months following surgery for congenital heart disease (CHD), the effects of a diaper dermatitis care bundle (DDCB), and factors associated with the development of DD in this population.

DESIGN

Nonrandomized comparison cohort study with a historical comparison group.

SUBJECTS AND SETTING

Convenience sampling was used to identify children aged 0 to 24 months undergoing CHD and cared for in a pediatric intensive care unit in central Taiwan (Taichung). The sample comprised 54 participants; 24 were in the historical comparison group and 30 received the DDCB.

METHODS

The rate of DD from the historical comparison group was compared to that in an intervention group managed with a bundle of interventions used to prevent and manage DD, which includes the routine use of a topical skin protectant. The participants in the historical comparison group received usual care to prevent and manage DD including routine cleansing with a moistened, disposable cloth every 3 hours and following defecation or urination. The DDCB comprised diaper changes at least every 3 hours and as needed after soiling, along with the routine application of a dimethicone and sodium hyaluronate-based skin protectant before diaper changes. Both groups were evaluated for use of an antifungal cream when candidiasis was present.

RESULTS

Participants managed with the DDCB have a significantly lower rate of DD than the historical comparison group who received routine care (41.65% vs 6.67%, P = .002). Univariate logistic regression showed an odds ratio of 0.10 (95% confidence interval of 0.019-0.520, P = .006), suggesting that the DDCB acted as a protective factor against the development of DD. Multivariate analysis of the historical comparison group indicated that non-cyanotic heart disease was associated with a lower likelihood of postoperative DD compared to those with cyanotic heart disease (odds ratio = 0.01, 95% confidence interval of 0.000-0.946, P = .047).

CONCLUSIONS

Managing critically ill patients with a DDCB recovering from cardiac surgery significantly decreased the incidence of DD. We recommend routine use of this type of care bundle for preventing DD in this vulnerable population in all children with CHD, with particular attention being paid to this with cyanotic CHD.
Modified dilepton production rate from charged pion-pair annihilation in the inhomogeneous chiral condensed phase
Authors: Hayashi Kentaro , Tsue Yasuhiko
Published: November 2024

We investigate the dilepton production rates from annihilation processes of charged pion pairs with modified pion dispersion relations in the inhomogeneous chiral condensed phase. We assume a dual chiral density wave as an inhomogeneous chiral condensate, and obtain the dispersion relations of the Nambu-Goldstone modes in the inhomogeneous chiral condensed phase. We use a low energy effective Lagrangian based on the O(4) symmetry which is expanded by the order parameter up to the sixth order. The obtained dispersion relations are anisotropic and quadratic for the momentum. We evaluate the electron-positron production rates by charged pion-pair annihilations as functions of an invariant mass using the obtained dispersion relations. Basically, the production rate in the inhomogeneous chiral condensed phase has a steeper overall slope with respect to an invariant mass than that in the homogeneous chiral condensed phase. Therefore, the production rate may be enhanced when the invariant mass is around twice the pion mass.

Published by the American Physical Society
2024
Prospects of five-dimensional
Lμ−Lτ
gauge interactions in the light of elastic neutrino-electron scatterings: The scope of the DUNE near detector
Authors: Chakraborty Dibyendu , Chatterjee Arindam , Kaushik Ayushi , Nishiwaki Kenji
Published: November 2024

We discuss the future prospects of a minimally five-dimensional version of the well-motivated scenario for addressing the discrepancy in the muon anomalous magnetic moment, the U(1)Lμ−Lτ extension of the standard model gauge symmetry. Here, multiple associated massive gauge bosons appear thanks to the five-dimensional U(1)Lμ−Lτ gauge symmetry, and they contribute to the muon (g−2) and also other processes. We focus on the powerful probe of elastic neutrino-electron scatterings since the upcoming DUNE experiment will explore MeV-scale uncharted regions by previous experiments (e.g., CHARM-II and Borexino) in the near future. We found that even with small kinetic mixing parameters, much of the parameter space, including those satisfying the muon (g−2) process, can be probed using several years of data from the DUNE experiment, focusing on the near detector. In our scenario, interference effects between intermediate-state gauge bosons play an important role. Our results include comparisons between flat and warped extra dimensions.

Published by the American Physical Society
2024