bluuebunny/crossref_metadata_2025 huggingface dataset:
Formation and Maintenance Mechanisms of the Subseasonal Eastern Pacific Pattern: Energetics Analysis
Authors: Wang Miao , Tan Benkui
Published: August 2021

Based on daily data from Japanese 55‐year Reanalysis (JRA‐55), this study examines the formation and maintenance mechanisms of the subseasonal eastern Pacific (EP) pattern from an energetics perspective. Results show that the baroclinic energy conversion (CPB) acts as an important energy source to overcome the thermal damping caused by the transient eddies and as a major kinetic energy (KE) source. The feedback forcing of transient eddies (CKE) acts as a major KE source during the growing stage and a major KE sink during the decay of the EP pattern. At the same time, the barotropic energy conversion (CKB) also makes substantial positive KE contribution. The results also suggest that the EP dynamics differ among different tropospheric layers. In the upper layer, CPB, CKB, and the anomalous geopotential height flux divergence (AGHFD) term all act as major KE source, while CKE acts as a major KE source (sink) during the growth (decay) stage of the EP pattern. The middle layer is mainly driven by CPB and AGHFD: CPB acts as a KE source while AGHFD as a sink. In the lower layer, CPB and AGHFD act as major KE sources with the later larger than the former, while the friction term damps the EP pattern heavily. It is found that the vertical component of the divergence of geopotential height flux anomaly plays a crucial role in the dynamic coupling of the different vertical parts of the EP pattern.
Lava from Bali Volcanoes Offers Window into Earth’s Mantle
Authors: Kelvey Jon
Published: August 2021

Lava from the Agung and Batur volcanoes provides a near-pristine picture of Earth’s mantle and raises questions about all volcanoes along the Indonesian Sunda Arc and beyond.
Ice Lenses May Cause Many Arctic Landslides
Authors: Rehnberg Morgan
Published: August 2021

When permafrost thaw reaches concentrations of ice underneath the surface, it may trigger local soil instability.
Trapping and Amplification of Unguided Mode EMIC Waves in the Radiation Belt
Authors: Wang Geng , Gao ZhongLei , Wu MingYu , Wang GuoQiang , Xiao SuDong , Chen YuanQiang , Zou ZhengYang , Zhang TieLong
Published: August 2021

Electromagnetic ion cyclotron (EMIC) waves can cause the scattering loss of the relativistic electrons in the radiation belt. They can be classified into the guided mode and the unguided mode, according to wave's propagation behavior. The guided mode waves have been widely investigated in the radiation belt, but the observation of the unguided mode waves have not been expected. Based on the observations of Van Allen Probes, we demonstrate for the first time the existence of the intense unguided L‐mode EMIC waves in the radiation belt according to the polarization characteristics. Growth rate analyses indicate that the hot protons with energies of a few hundred keV may provide the free energy for wave growth. The reflection interface formed by the spatial locations of local helium cutoff frequencies can be nearly parallel to the equatorial plane when the proton abundance ratio decreases sharply with ‐shell. This structure combined with hot protons may lead to the trapping and significant amplification of the unguided mode waves. These results may help to understand the nature of EMIC waves and their dynamics in the radiation belt.
Meteoroid Mass Estimation Based on Single‐Frequency Radar Cross Section Measurements
Authors: Tarnecki L. K. , Marshall R. A. , Stober G. , Kero J.
Published: August 2021

Both high‐power large aperture radars and smaller meteor radars readily observe the dense head plasma produced as a meteoroid ablates. However, determining the mass of such meteors based on the information returned by the radar is challenging. We present a new method for deriving meteor masses from single‐frequency radar measurements, using a physics‐based plasma model and finite‐difference time‐domain (FDTD) simulations. The head plasma model derived in Dimant and Oppenheim (2017), https://doi.org/10.1002/2017ja023963 depends on the meteoroids altitude, speed, and size. We use FDTD simulations of a radar pulse interacting with such head plasmas to determine the radar cross section (RCS) that a radar system would observe for a meteor with a given set of physical properties. By performing simulations over the observed parameter space, we construct tables relating meteor size, velocity, and altitude to RCS. We then use these tables to map a set of observations from the MAARSY radar (53.5 MHz) to fully defined plasma distributions, from which masses are calculated. To validate these results, we repeat the analysis using observations of the same meteors by the EISCAT radar (929 MHz). The resulting masses are strongly linearly correlated; however, the masses derived from EISCAT measurements are on average 1.33 times larger than those derived from MAARSY measurements. Since this method does not require dual‐frequency measurements for mass determination, only validation, it can be applied in the future to observations made by many single‐frequency radar systems.
Electromagnetic Characteristics of Fast Magnetosonic Waves in the Inner Magnetosphere
Authors: Yu Xiongdong , Yuan Zhigang , Yao Fei , Ouyang Zhihai , Wang Dedong
Published: August 2021

In evaluating the effects of fast magnetosonic (MS) waves on magnetospheric particles, their magnetic spectra are often obtained from satellite observations, while electric field components are usually derived under the cold plasma approximation. However, such an approximation has not been verified with in situ observations yet. In this study, we report the electromagnetic characteristic for MS waves in various plasma environments with observations of the Van Allen Probe A. It is found that a considerable number of observed MS waves consist of dominated electrostatic components, which also suggest the importance of inspecting the estimation algorithm for the electric field components. Moreover, the comparison between results from statistical and theoretical analysis shows that electromagnetic characteristics of the observed MS waves can be well predicted by cold plasma theory. Our result indicates the validation of cold plasma approximation to estimate the electric field components of MS waves from their magnetic counterparts in the inner magnetosphere.
Improving Seasonal Prediction of California Winter Precipitation Using Canonical Correlation Analysis
Authors: Wang Gaoyun , Zhuang Yizhou , Fu Rong , Zhao Siyu , Wang Hongqing
Published: August 2021

We have developed a canonical correlation analysis (CCA) model for improving seasonal winter rainfall prediction. It uses the anomalies of sea surface temperature (SST), vertically integrated vapor transport (IVT), and geopotential height at 250 hPa (Z250) in October and November, respectively, as the predictors for winter rainfall prediction. These predictors represent the processes that influence winter rainfall over California as documented in the literature, but their potential for improving predictability was previously unclear. This statistical model shows prediction skills higher than those of the baseline autoregressive model, the CCA‐based prediction model using only the SST anomalies, and the dynamic predictions by the North American Multi‐Model Ensemble (NMME). Averaged over California, the Pearson correlation (R) is 0.64, root mean squared error (RMSE) is 0.65, and Heidke skill score (HSS) is 0.42 when the CCA‐based model is initialized by the three predictor fields (SST, IVT, and Z250) in November. These skills are higher than those of the NMME predictions initialized in November (R, RMSE, and HSS are 0.30, 0.83, and 0.15, respectively) and those of the autoregressive baseline (R, RMSE, and HSS are 0.10, 0.79, and 0.08, respectively). Hindcasts of winter rainfall initialized by October observations show R, RMSE, and HSS of 0.53, 0.81, and 0.39, respectively, also higher than those of the NMME seasonal prediction initialized in October (0.32, 0.79, and 0.22 for R, RMSE, and HSS, respectively) and the autoregressive model (0.30, 0.75, and 0.16 for R, RMSE, and HSS, respectively).
Comparison of numerical and standard sarnat grading using the NICHD and SIBEN methods
Authors: Walsh Brian H. , Munster Chelsea , El-Shibiny Hoda , Yang Edward , Inder Terrie E. , El-Dib Mohamed
Published: August 2021

Objective

The NICHD and SIBEN assessments are adapted from the Sarnat grade, and used to determine severity of neonatal encephalopathy (NE). We compare NICHD and SIBEN methods, and their ability to define a minimum threshold associated with significant cerebral injury.

Study design

Between 2016 and 2019, 145 infants with NE (77-mild; 65-moderate; 3-severe) were included. NICHD and SIBEN grade and numerical scores were assigned. Kappa scores described agreement between methods, and ROC curves their ability to predict MR injury.

Results

Good agreement existed between grading systems (K = 0.86). SIBEN defined more infants as moderate, and less as mild, than NICHD (p < 0.001). Both numerical scores were superior to standard grades in predicting MR injury.

Conclusion

Despite good agreement between methods, SIBEN defines more infants as moderate NE. Both numerical scores were superior to standard grade, and comparable to each other, in defining a minimum threshold for cerebral injury. Further assessment contrasting their predictive ability for long-term outcome is required.
Elevated body fat increases amphetamine accumulation in brain: evidence from genetic and diet-induced forms of adiposity
Authors: Fu Xiuping , Shah Aparna P. , Keighron Jacqueline , Mou Ta-Chung M. , Ladenheim Bruce , Alt Jesse , Fukudome Daisuke , Niwa Minae , Tamashiro Kellie L. , Tanda Gianluigi , Sawa Akira , Cadet Jean-Lud , Rais Rana , Baraban Jay M.
Published: August 2021

Despite the high prevalence of obesity, little is known about its potential impact on the pharmacokinetics of psychotropic drugs. In the course of investigating the role of the microRNA system on neuronal signaling, we found that mice lacking the translin/trax microRNA-degrading enzyme display an exaggerated locomotor response to amphetamine. As these mice display robust adiposity in the context of normal body weight, we checked whether this phenotype might reflect elevated brain levels of amphetamine. To assess this hypothesis, we compared plasma and brain amphetamine levels of wild type and Tsn KO mice. Furthermore, we checked the effect of diet-induced increases in adiposity on plasma and brain amphetamine levels in wild type mice. Brain amphetamine levels were higher in Tsn KO mice than in wild type littermates and correlated with adiposity. Analysis of the effect of diet-induced increases in adiposity in wild type mice on brain amphetamine levels also demonstrated that brain amphetamine levels correlate with adiposity. Increased adiposity displayed by Tsn KO mice or by wild type mice fed a high-fat diet correlates with elevated brain amphetamine levels. As amphetamine and its analogues are widely used to treat attention deficit disorder, which is associated with obesity, further studies are warranted to assess the impact of adiposity on amphetamine levels in these patients.
Targeting of IL-10R on acute myeloid leukemia blasts with chimeric antigen receptor-expressing T cells
Authors: Chen Nianci , Xu Yingxi , Mou Junli , Rao Qing , Xing Haiyan , Tian Zheng , Tang Kejing , Wang Min , Wang Jiangxiang
Published: August 2021

Acute myeloid leukemia (AML) is a biologically and clinically heterogeneous disease with a dismal prognosis and limited treatment options. Chimeric antigen receptor (CAR) T cells have achieved unprecedented clinical responses in patients with B cell malignancies but a dismal consequences in AML. In our previous study, we found that interleukin-10 receptor (IL-10R) was overexpressed in most AML cells, and played an important role in promoting the stemness of leukemia cells. In this study, we developed a novel ligand-based CAR-T cell targeting IL-10R, which displayed striking cytotoxicity both in vitro and in vivo against AML cells. Except for monocytes, it had no significant adverse effects on the normal hematopoietic system, including CD34+hematopoietic stem and progenitor cells (HSPCs). In addition, even though the incorporation of IL-10 in the CAR cassette led to phenotypes change, it had few adverse effects on the survival and biological activity of IL-10 CAR-T cells and did not cause excessive proliferation of leukemia cells. Therefore, we propose IL-10R is a novel promising therapeutic candidate for AML, and IL-10R targeted CAR-T therapy provides a new treatment strategy to improve the prognosis of AML.
CPT1α maintains phenotype of tubules via mitochondrial respiration during kidney injury and repair
Authors: Yuan Qi , Lv Yunhui , Ding Hao , Ke Qingqing , Shi Caifeng , Luo Jing , Jiang Lei , Yang Junwei , Zhou Yang
Published: August 2021

Impaired energy metabolism in proximal tubular epithelial cells (PTECs) is strongly associated with various kidney diseases. Here, we characterized proximal tubular phenotype alternations during kidney injury and repair in a mouse model of folic acid nephropathy, in parallel, identified carnitine palmitoyltransferase 1α (CPT1α) as an energy stress response accompanied by renal tubular dedifferentiation. Genetic ablation of Cpt1α aggravated the tubular injury and interstitial fibrosis and hampered kidney repair indicate that CPT1α is vital for the preservation and recovery of tubular phenotype. Our data showed that the lipid accumulation and mitochondrial mass reduction induced by folic acid were persistent and became progressively more severe in PTECs without CPT1α. Interference of CPT1α reduced capacities of mitochondrial respiration and ATP production in PTECs, and further sensitized cells to folic acid-induced phenotypic changes. On the contrary, overexpression of CPT1α protected mitochondrial respiration and prevented against folic acid-induced tubular cell damage. These findings link CPT1α to intrinsic mechanisms regulating the mitochondrial respiration and phenotype of kidney tubules that may contribute to renal pathology during injury and repair.
Highly specific detection of KRAS single nucleotide polymorphism by asymmetric PCR/SERS assay
Authors: Lyu Nana , Rajendran Vinoth Kumar , Li Jun , Engel Alexander , Molloy Mark P. , Wang Yuling
Published: August 2021

Integrating asymmetric PCR with surface-enhanced Raman spectroscopy (Asy-PCR/SERS) demonstrated detection of clinically important KRAS G12V mutation in a simple, sensitive, and specific manner.
The C-terminal loop of Arabidopsis thaliana guanosine deaminase is essential to catalysis
Authors: Jia Qian , Zeng Hui , Li Huanxi , Xiao Nan , Tang Jing , Gao Shangfang , Zhang Jinbing , Xie Wei
Published: August 2021

We report the crystal structures of the enzyme GSDA in various forms at high resolutions, which reveal its recognition and catalytic mechanism and may potentially aid in the development of novel deaminase-based gene-editing tools.
Novel design strategies for perovskite materials with improved stability and suitable band gaps
Authors: Zhang Bing , Wang Xiaogang , Yang Yang , Hu Bin , Tong Lei , Zhao Li , Lu Qiang
Published: August 2021

Different A site groups are proposed to tune band gaps or improve the structural stability of pervoskite materials through different mechanisms.
Photo-induced hydrophilicity at the ZnO(112̄0) surface: an evolutionary algorithm-aided density functional theory study
Authors: Bao Shen-Yuan , Li Dong-Zhi , Gong Xue-Qing
Published: August 2021

Evolutionary algorithm-aided density functional theory calculations were utilized to determine the stable adsorption structures of H2O at ZnO(112̄0) extensively under different coverages.
Catalytic hydroboration of carbonyl derivatives by using phosphinimino amide ligated magnesium complexes
Authors: Li Min , Liu Xinli , Cui Dongmei
Published: August 2021

Reduction of carbonyl derivatives by using Earth-abundant, cheap, and environmentally benign metal-based catalysts through an atom-efficient method is a challenging task.
An investigation into LA-spICP-ToF-MS uses for in situ measurement of environmental multi-elemental nanoparticles
Authors: Holbrook Timothy Ronald , Gallot-Duval Doriane , Reemtsma Thorsten , Wagner Stephan
Published: August 2021

A LA-spICP-ToF-MS method was developed and systematically compared with the traditional neb-spICP-ToF-MS. The method was shown to be of significant use for the measurement of environmental multi-elemental particles extracted from or embedded within a solid sediment.
Controllable room temperature phosphorescence, mechanoluminescence and polymorphism of a carbazole derivative
Authors: Zhang Hongyan , Ma Huili , Huang Wenbin , Gong Wenqi , He Zikai , Huang Guangxi , Li Bing Shi , Tang Ben Zhong
Published: August 2021

A carbazole derivative with room temperature phosphorescence, mechanoluminescence and polymorphism was designed and it was further utilized for preparing multicolored ML systems. The role of structure/packing on these novel properties was explored.
1,8-Naphthalimide appended propiolate-based fluorescent sensor for selective detection of cysteine over glutathione and homocysteine in living cells
Authors: Aydin Duygu , Karuk Elmas Sukriye Nihan , Akin Geyik Gonul , Bostanci Aykut , Arslan Fatma Nur , Savran Tahir , Sadi Gokhan , Yilmaz Ibrahim
Published: August 2021

A novel 1,8-naphthalimide-based fluorogenic chemoprobe NASP was designed and developed as a sensor platform for the selective detection of biologically important cysteine over glutathione and homocysteine in living-cells.
Harnessing the chemistry of 4aH-carbazoles: a consecutive rearrangements approach to carbazoles
Authors: Wei Bei , Dong Kaikai , Zhang Jingyang , Zu Liansuo
Published: August 2021

We report a mild method for the synthesis of 4aH-carbazole intermediates with significant synthetic flexibility and variability, and demonstrate the controllable rearrangements of such intermediates to carbazoles.
Taming the reactivity of alkyl azides by intramolecular hydrogen bonding: site-selective conjugation of unhindered diazides
Authors: Maegawa Koshiro , Tanimoto Hiroki , Onishi Seiji , Tomohiro Takenori , Morimoto Tsumoru , Kakiuchi Kiyomi
Published: August 2021

The intramolecular hydrogen bonding in the α-azido secondary acetamides (α-AzSAs) enabled site-selective integration onto the diazide modular hubs even without steric hindrance.
Pseudocapacitive porous hard carbon anode with controllable pyridinic nitrogen and thiophene sulfur co-doping for high-power dual-carbon sodium ion hybrid capacitors
Authors: Wang Chong , Zhao Ning , Li Bohan , Yu Qingtao , Shen Wanci , Kang Feiyu , Lv Ruitao , Huang Zheng-Hong
Published: August 2021

A new and efficient method to regulate the configuration of nitrogen dopants, increase the content of thiophene sulfur, create micropores and adjust the defect intensity synchronously.
Discovery of high performance thermoelectric chalcogenides through first-principles high-throughput screening
Authors: Fan Tao , Oganov Artem R.
Published: August 2021

Promising thermoelectric materials found in this study, using a simple yet highly efficient algorithm.
Advanced biofabrication strategies for biomimetic composite scaffolds to regenerate ligament‐bone interface
Authors: Jiang Nan , Mao Mao , Li Xiao , Zhang Weijie , He Jiankang , Li Dichen
Published: August 2021

The natural ligament–bone interface features gradient changes in matrix composition, architecture and cell phenotype, which play critical roles in reliable ligament fixation and smooth loading transfer. Mimicking such organisations in artificial composite tissue‐engineering scaffolds is important for realising functional fixation between ligament implants and host bones. Here, the authors aim to provide a comprehensive review on the latest strategies to fabricate biomimetic composite scaffolds for the regeneration of ligament‐to‐bone interface. The biomimetic composite scaffolds are divided into stratified and gradient scaffolds, which are characterised as layer‐specific and continuous changes, respectively, in scaffold materials and/or microstructures. Biofabrication strategies for different types of composite scaffolds are summarised. The effects of material/structural changes on cellular morphology, cell differentiation, in vivo osteointegration and multi‐tissue interface regeneration are highlighted. Finally, the potential challenges and future perspectives in engineering biomimetic composite scaffolds for ligament–bone interface regeneration are discussed.
A phase‐shift‐free synchronous reference frame filter‐based position sensorless control method for open‐winding permanent magnet generator system
Authors: Hao Wenjuan , Wang Yu
Published: August 2021

An open‐winding permanent magnet generator (OWPMG) system that offers features like fewer switching devices and high integration can be used in multi‐input generator systems. To achieve high‐accuracy position sensorless operation for the OWPMG system, this study investigates a phase‐shift‐free synchronous reference frame filter (SRFF‐PSF) for use in the sliding mode observer (SMO) position sensorless algorithm. The proposed SRFF‐PSF can completely restore the fundamental component of back‐electromotive force (EMF) without phase shift and filter out the high‐order harmonics owing to the following two improvements. First, the fundamental phase lag is eliminated by removing the low‐pass filter between the back‐EMF and the SRFF. Second, the error iteration of the output position angle is avoided by using the synchronous angle information from an additional phase locked loop module for the coordinate transformation of the SRFF. Based on the aforementioned improvements, the proposed method can effectively solve the phase shift problem in position estimation. The correctness and effectiveness of the method are verified by the experimental results.
China's practice of smart city standardisation and assessment
Authors: Zhang Dapeng , Wang Xi , Rong Wenge , Yang Yu
Published: August 2021

Smart city is one of the current trends of city evolvement. Smart city is a systematic project, which needs a holistic approach. As lots of pilot projects have been undertaken by cities, how to assess the ‘smartness’ of a city is of great importance. This study sums China's smart city standardisation and assessment practice, starting from the national policy evolvement, followed by the standardisation system, assessment and its key procedures and concludes with some possible future works regarding smart city standardisation and assessment.
Diagnosing Inherited Platelet Disorders: Modalities and Consequences
Authors: Zaninetti Carlo , Wolff Martina , Greinacher Andreas
Published: August 2021

Inherited platelet disorders (IPDs) are a group of rare conditions featured by reduced circulating platelets and/or impaired platelet function causing variable bleeding tendency. Additional hematological or non hematological features, which can be congenital or acquired, distinctively mark the clinical picture of a subgroup of patients. Recognizing an IPD is challenging, and diagnostic delay or mistakes are frequent. Despite the increasing availability of next-generation sequencing, a careful phenotyping of suspected patients—concerning the general clinical features, platelet morphology, and function—is still demanded. The cornerstones of IPD diagnosis are clinical evaluation, laboratory characterization, and genetic testing. Achieving a diagnosis of IPD is desirable for several reasons, including the possibility of tailored therapeutic strategies and individual follow-up programs. However, detailed investigations can also open complex scenarios raising ethical issues in case of IPDs predisposing to hematological malignancies. This review offers an overview of IPD diagnostic workup, from the interview with the proband to the molecular confirmation of the suspected disorder. The main implications of an IPD diagnosis are also discussed.
Comparison of double layer in argon helicon plasma and magnetized DC discharge plasma
Authors: WANG Yueqing , CUI Ruilin , HAN Ruoyu , HE Feng , ZHANG Tianliang , MIAO Jinsong , OUYANG Jiting
Published: August 2021

We present in this paper the comparison of an electric double layer (DL) in argon helicon plasma and magnetized direct current (DC) discharge plasma. DL in high-density argon helicon plasma of 13.56 MHz RF discharge was investigated experimentally by a floating electrostatic probe and local optical emission spectroscopy (LOES). The DL characteristics at different operating parameters, including RF power (300–1500 W), tube diameter (8–60 mm), and external magnetic field (0–300 G), were measured. For comparison, DL in magnetized plasma channel of a DC discharge under different conditions was also measured experimentally. The results show that in both cases, DL appears in a divergent magnetic field where the magnetic field gradient is the largest and when the plasma density is sufficiently high. DL strength (or potential drop of DL) increases with the magnetic field in two different structures. It is suggested that the electric DL should be a common phenomenon in dense plasma under a gradient external magnetic field. DL in magnetized plasmas can be controlled properly by magnetic field structure and discharge mode (hence the plasma density).
State-Level Policy Stigma and Non-Prescribed Hormones Use among Trans Populations in the United States: A Mediational Analysis of Insurance and Anticipated Stigma
Authors: Hughes Landon D , Gamarel Kristi E , King Wesley M , Goldenberg Tamar , Jaccard James , Geronimus Arline T
Published: August 2021

Background

Medical gender affirmation (i.e., hormone use) is one-way transgender (trans) people affirm their gender and has been associated with health benefits. However, trans people face stigmatization when accessing gender-affirming healthcare, which leads some to use non-prescribed hormones (NPHs) that increase their risk for poor health.

Purpose

We examined whether healthcare policy stigma, as measured by state-level trans-specific policies, was associated with NPHs use and tested mediational paths that might explain these associations. Because stigmatizing healthcare policies prevent trans people from participation in healthcare systems and allow for discrimination by healthcare providers, we hypothesized that healthcare policy stigma would be associated with NPHs use by operating through three main pathways: skipping care due to anticipated stigma in healthcare settings, skipping care due to cost, and being uninsured.

Methods

We conducted analyses using data from the 2015 U.S. Transgender Survey. The analytic sample included trans adults using hormones (N = 11,994). We fit a multinomial structural equation model to examine associations.

Results

Among trans adults using hormones, we found that healthcare policy stigma was positively associated with NPHs use and operated through insurance coverage and anticipating stigma in healthcare settings. The effect sizes on key predictor variables varied significantly between those who use supplemental NPHs and those who only use NPHs suggesting the need to treat NPHs use as distinct from those who use supplemental NPHs.

Conclusions

Our work highlights the importance of healthcare policy stigma in understanding health inequities among trans people in the USA, specifically NPHs use.
Use of an argatroban systemic infusion and purge solution in a patient with a percutaneous ventricular assist device with suspected heparin-induced thrombocytopenia
Authors: Shtoyko Ashley N , Feldman Elizabeth A , Cwikla Gregory M , Darko William , Green G Randall , Seabury Robert W
Published: August 2021

Purpose

Thrombocytopenia can occur when using an Impella percutaneous ventricular assist device (pVAD), and heparin-induced thrombocytopenia (HIT) is often suspected. Data on heparin- and anticoagulant-free purge solutions in these devices are limited. Previous case reports have described argatroban-based purge solutions, both with and without systemic argatroban, at varying concentrations in patients with known or suspected HIT.

A 33-year-old male was transferred to our institution and emergently initiated on life support with venoarterial extracorporeal membrane oxygenation (ECMO), an Impella pVAD, and continuous venovenous hemofiltration to receive an urgent aortic valve replacement. Over the next several days, the patient’s platelet count declined with a nadir of 17 × 103/μL on hospital day 13. The patient’s 4T score for probability of HIT was calculated as 4. All heparin products were discontinued on hospital day 15, and the patient was initiated on systemic infusion with argatroban 1,000 μg/mL at a rate of 0.2 μg/kg/min with a purge solution of argatroban 0.05 mg/mL. The systemic infusion remained at a rate of 0.2 μg/kg/min, and the total argatroban dose was, on average, less than 0.25 μg/kg/min. On hospital day 21, the patient was transferred to another institution.

Conclusion

Systemic infusion and a purge solution with argatroban were used in a patient with an Impella pVAD with multisystem organ dysfunction and suspected HIT. The patient achieved therapeutic activated partial thromboplastin times without adjustment of the systemic argatroban infusion and did not experience bleeding or thrombosis. Further studies concerning the safety and effectiveness of argatroban-based purge solutions in patients with pVADs are needed.
Ontogeny, anatomical structure and function of lobed stems in the evolution of the climbing growth form in Malvaceae (ByttneriaLoefl.)
Authors: Luna-Márquez Lorena , Sharber Wyatt V , Whitlock Barbara A , Pace Marcelo R
Published: August 2021

Background and Aims

Byttneria is one of the few climbing genera in Malvaceae. Some Byttneria are known for their lobed stems. We explore the development of these stems, how they have evolved within the group and their relevance in the evolution of the climbing growth form in Malvaceae.

Methods

We combine developmental anatomical work with phylogenetic comparative methods. We use Byttneria divaricata and B. filipes as models in the anatomical work, a review of herbarium vouchers, and the most recent phylogeny of Byttneria and allies to elucidate how these stems evolved within the clade under maximum-likelihood and Bayesian approaches. We use Pagel94 tests to analyse the correlated evolution of lobed stems and prickles.

Key Results

Each lobe coincides with one of the five vascular bundles. By augmented activity of the fascicular cambium in the lobes coupled with reduced activity of the interfascicular cambium in the interlobes, secondary growth increases the lobulation already present during primary growth. Within Byttneria and allies, lobed young stems appeared at least three times, once in Ayenia and twice in the paraphyletic Byttneria. Lobed adult stems were conserved in Byttneria s.s., where lobed adult stems in combination with prickles were shown to have evolved as a climbing mechanism within the group; prickles were lost once within Byttneria s.s., in a shrubby subclade. Byttneria Clade 2 comprises climbers with twining cylindrical adult stems and no prickles, which constitutes a different climbing mechanism in the group.

Conclusions

We provide evidence of one of the few cambial variants known whose secondary body reflects the primary body vasculature and show that lobed adult stems and prickles in Byttneria could be used in the new delimitation of genera in the group. Lobed stems independently appeared in climbing Grewia, suggesting a convergence favouring the climbing growth form.
Between Remand and Verdict: Ethnic Minority Prisoners’ Legal and Penal Consciousness
Authors: Johansen Louise Victoria
Published: August 2021

This article combines the analytical perspectives ‘legal’ and ‘penal’ consciousness in order to analyse how ethnic minority prisoners in remand anticipate their upcoming court trial and how they subsequently make sense of the legal process and their sentence. Based on fieldwork in a Danish remand prison and courts, the study explores how prisoners’ experiences in prison and more broadly in society shape these expectations. Prisoners reflect critically on majority perceptions of immigration and social deprivation while simultaneously embracing these cultural schemas of difference by trying not to act and speak as ‘immigrants’ or ‘gang members’ in court. The article thus contributes to our understanding of how remand prisoners engage with law, combining notions of its neutrality with internalized notions of ‘important differences’.
The promise of artificial intelligence: a review of the opportunities and challenges of artificial intelligence in healthcare
Authors: Aung Yuri Y M , Wong David C S , Ting Daniel S W
Published: August 2021

Introduction

Artificial intelligence (AI) and machine learning (ML) are rapidly evolving fields in various sectors, including healthcare. This article reviews AI’s present applications in healthcare, including its benefits, limitations and future scope.

Sources of data

A review of the English literature was conducted with search terms ‘AI’ or ‘ML’ or ‘deep learning’ and ‘healthcare’ or ‘medicine’ using PubMED and Google Scholar from 2000–2021.

Areas of agreement

AI could transform physician workflow and patient care through its applications, from assisting physicians and replacing administrative tasks to augmenting medical knowledge.

Areas of controversy

From challenges training ML systems to unclear accountability, AI’s implementation is difficult and incremental at best. Physicians also lack understanding of what AI implementation could represent.

Growing points

AI can ultimately prove beneficial in healthcare, but requires meticulous governance similar to the governance of physician conduct.

Areas timely for developing research

Regulatory guidelines are needed on how to safely implement and assess AI technology, alongside further research into the specific capabilities and limitations of its medical use.
Factors influencing the residence’s intention to adopt solar photovoltaic technology: a case study from Klang Valley, Malaysia
Authors: Cheam Wei-Yong , Lau Lin-Sea , Wei Chooi-Yi
Published: August 2021

Recently, the Malaysian government has targeted to achieve the 20% renewable-energy goal by 2025. Despite the Malaysian government’s having taken initiatives in promoting the use of renewable energy for more than a decade, to date, more than three-quarters of the electricity supply in Peninsular Malaysia is generated from the burning of fossil fuels. Apparently, the development of renewable energy is still slow and in its infancy. The current study intends to identify the predictors (environmentalism, cost, knowledge and personal innovativeness) that influence the residential intention to adopt solar photovoltaic (PV) in Klang Valley. This study adopts the technology acceptance model as the theoretical framework to analyse the mediation effect on perceived ease of use and perceived usefulness between the determinants and the intention to adopt solar PV. Self-administered questionnaires are used to collect data from non-solar PV users who stay in Klang Valley. Structural equation modelling analysis was carried out on the 200 samples from data collection. The findings demonstrated that environmentalism is having a significant impact on the intention to adopt solar PV, followed by knowledge. The perceived usefulness mediates the relationship between the predictors and the intention to use solar PV, although no mediation effect was found for the perceived ease of use. Lastly, several implications are highlighted to the policymakers and solar-market practitioners to improve the existing policies and promote solar PV adoptions among residents.
Cortical Gyrification Morphology in ASD and ADHD: Implication for Further Similarities or Disorder-Specific Features?
Authors: Gharehgazlou Avideh , Vandewouw Marlee , Ziolkowski Justine , Wong Jimmy , Crosbie Jennifer , Schachar Russell , Nicolson Rob , Georgiades Stelios , Kelley Elizabeth , Ayub Muhammad , Hammill Christopher , Ameis Stephanie H , Taylor Margot J , Lerch Jason P , Anagnostou Evdokia
Published: August 2021

Shared etiological pathways are suggested in ASD and ADHD given high rates of comorbidity, phenotypic overlap and shared genetic susceptibility. Given the peak of cortical gyrification expansion and emergence of ASD and ADHD symptomology in early development, we investigated gyrification morphology in 539 children and adolescents (6–17 years of age) with ASD (n=197) and ADHD (n=96) compared to typically developing controls (n=246) using the local Gyrification Index (lGI) to provide insight into contributing etiopathological factors in these two disorders. We also examined IQ effects and functional implications of gyrification by exploring the relation between lGI and ASD and ADHD symptomatology beyond diagnosis. General Linear Models yielded no group differences in lGI, and across groups, we identified an age-related decrease of lGI and greater lGI in females compared to males. No diagnosis-by-age interactions were found. Accounting for IQ variability in the model (n=484) yielded similar results. No significant associations were found between lGI and social communication deficits, repetitive and restricted behaviours, inattention or adaptive functioning. By examining both disorders and controls using shared methodology, we found no evidence of atypicality in gyrification as measured by the lGI in these conditions.
Changes in left atrial structure and function over a decade in the general population
Authors: Olsen Flemming Javier , Johansen Niklas Dyrby , Skaarup Kristoffer Grundtvig , Lassen Mats Christian Højbjerg , Ravnkilde Kirstine , Schnohr Peter , Jensen Gorm Boje , Marott Jacob Louis , Søgaard Peter , Møgelvang Rasmus , Biering-Sørensen Tor
Published: August 2021

Aims

Assessing left atrial (LA) size and function is an important part of the echocardiographic examination. We sought to assess how LA size and function develop over time, and which clinical characteristics promote atrial remodelling.

Methods and results

We examined longitudinal changes of the LA between two visits in the Copenhagen City Heart Study (n = 1065). The median time between the examinations was 10.4 years. LA measurements included: maximal LA volume (LAVmax), minimal LA volume (LAVmin), and LA emptying fraction (LAEF). Clinical and echocardiographic accelerators were determined from linear regression. The value of LA remodelling for predicting incident atrial fibrillation (AF) and heart failure (HF) was examined by Cox proportional hazards regressions. During follow-up, LAVmax and LAVmin significantly increased by 8.3 and 3.5 mL/m2, respectively. LAEF did not change. Age and AF were the most impactful clinical accelerators of LA remodelling with standardized beta-coefficients of 0.17 and 0.28 for changes in LAVmax, and 0.18 and 0.38 for changes in LAVmin, respectively. Left ventricular (LV) systolic function, diameter, and mass were also significant accelerators of LA remodelling. Changes in both LAVmax and LAVmin were significantly associated with incident AF [n = 46, ΔLAVmax: HR = 1.06 (1.03–1.09), P < 0.001 and ΔLAVmin: HR = 1.14 (1.10–1.18), P < 0.001, per 1 mL/m2 increase] and HF [n = 27, ΔLAVmax: HR = 1.08 (1.04–1.12), P < 0.001 and ΔLAVmin: HR = 1.13 (1.09–1.18), P < 0.001, per 1 mL/m2 increase].

Conclusion

Both maximal and minimal LA volume increase over time. Clinical accelerators included age and AF. LV structure and systolic function also accelerate LA remodelling. LA remodelling poses an increased risk of clinical outcomes.
In Dubio Mitius: Advancing Clarity and Modesty in Treaty Interpretation
Authors: Fahner Johannes Hendrik
Published: August 2021

The principle of in dubio mitius stipulates that if treaty interpreters have doubts about the correct meaning of a provision, they should adopt the interpretation that imposes the less demanding obligation. Although the principle is commonly rejected by scholars, it keeps surfacing in international legal practice. This article describes the history of the principle and provides an overview of its treatment by international courts and tribunals. It then argues that in dubio mitius can be of renewed relevance, now that the legitimacy of international courts and tribunals has become increasingly controversial. The principle recognizes that some questions of treaty interpretation may not have a single permissible answer, even after an application of the customary rules of treaty interpretation, and instead allow for legitimate disagreement or ‘doubt’. In such circumstances, in dubio mitius provides treaty interpreters with a solution, advising them to limit the scope of vague provisions to a normative core that can be deduced with sufficient certainty. In doing so, the principle acknowledges that international courts and tribunals lack the authority to expand international law in the face of legitimate disagreement within and among states.
Incidence of ischaemic stroke and mortality in patients with acute coronary syndrome and first-time detected atrial fibrillation: a nationwide study
Authors: Petersen Jeppe Kofoed , Butt Jawad Haider , Yafasova Adelina , Torp-Pedersen Christian , Sørensen Rikke , Kruuse Christina , Vinding Naja Emborg , Gundlund Anna , Køber Lars , Fosbøl Emil Loldrup , Østergaard Lauge
Published: August 2021

Aims 

The aim of this study was to examine contemporary data on the 1-year prognosis of patients surviving acute coronary syndrome (ACS) and concomitant first-time detected atrial fibrillation (AF).

Methods and results

Using Danish nationwide registries, we identified all patients surviving a first-time admission with ACS from 2000 to 2018 and grouped them into (i) those without AF prior to or during ACS; (ii) those with a history of AF; and (iii) those with first-time detected AF during admission with ACS. With 1 year of follow-up, rates of ischaemic stroke, death, and bleeding were compared between study groups using multivariable adjusted Cox proportional hazards analysis. We included 161 266 ACS survivors: 135 878 (84.2%) without AF, 18 961 (11.8%) with history of AF, and 6427 (4.0%) with first-time detected AF at admission with ACS. Compared to those without AF, the adjusted 1-year rates of outcomes were as follows: ischaemic stroke [hazard ratio (HR) 1.38 (95% CI 1.22–1.56) for patients with history of AF and HR 1.67 (95% CI 1.38–2.01) for patients with first-time detected AF]; mortality [HR 1.25 (95% CI 1.21–1.31) for patients with history of AF and HR 1.52 (95% CI 1.43–1.62) for patients with first-time detected AF]; and bleeding [HR 1.22 (95% CI 1.14–1.30) for patients with history of AF and HR 1.28 (95% CI 1.15–1.43) for patients with first-time detected AF].

Conclusion 

In patients with ACS, first-time detected AF appeared to be at least as strongly associated with the 1-year rates of ischaemic stroke, mortality, and bleeding as compared with patients with a history of AF.
The effect of slow breathing exercise on heart rate and blood pressure in patients undergoing percutaneous coronary intervention: a randomized controlled trial
Authors: Zou Yan , Wu Qing , Liu Ting , Wang Jing-Yuan , Liu Lin , Wang Xiao-Hua
Published: August 2021

Aim

To determine the effects of slow breathing exercise (SBE) on heart rate (HR) and blood pressure (BP) in patients after percutaneous coronary intervention (PCI).

Methods and results

The study is a single-blind, randomized controlled trial. Seventy-eight eligible patients after primary PCI were divided randomly into either the control group or the trial group. The control group only received routine post-PCI care. In addition to routine care, participants in the trial group performed SBE at home, two to three times for a total of 30 min every day for 12 weeks. The main outcomes were HR and BP measured in the office and at home. The secondary outcome was compliance with the breathing exercise. Patients allocated to the trial group, on average, performed 5.21 days/week for 26.00 min/day. The trial group showed a significant reduction in HR of 3.95 b.p.m. (P = 0.004) measured in the office. The reduction in HR measured in the office was greater for the trial group, with a significant difference between the two groups (P = 0.005). There was no significant difference between the two groups in HR measured at home. There was also no significant difference in BP measured in the office or at home between the two groups.

Conclusion

Slow breathing exercise is an effective non-pharmacological method to reduce HR in patients undergoing PCI. Further study is needed to confirm whether the intervention is effective on BP.

Registration

The trial was registered at the Chinese Clinical Trial Registry: ChiCTR-IOR-17012525
Multiple Losses of MSH1, Gain of mtMutS, and Other Changes in the MutS Family of DNA Repair Proteins in Animals
Authors: Muthye Viraj , Lavrov Dennis V
Published: August 2021

MutS is a key component of the mismatch repair (MMR) pathway. Members of the MutS protein family are present in prokaryotes, eukaryotes, and viruses. Six MutS homologs (MSH1–6) have been identified in yeast, of which three function in nuclear MMR, while MSH1 functions in mitochondrial DNA repair. MSH proteins are believed to be well conserved in animals, except for MSH1—which is thought to be lost. Two intriguing exceptions to this general picture have been found, both in the class Anthozoa within the phylum Cnidaria. First, an ortholog of the yeast-MSH1 was reported in one hexacoral species. Second, a MutS homolog (mtMutS) has been found in the mitochondrial genome of all octocorals. To understand the origin and potential functional implications of these exceptions, we investigated the evolution of the MutS family both in Cnidaria and in animals in general. Our study confirmed the acquisition of octocoral mtMutS by horizontal gene transfer from a giant virus. Surprisingly, we identified MSH1 in all hexacorals and several sponges and placozoans. By contrast, MSH1 orthologs were lacking in other cnidarians, ctenophores, and bilaterian animals. Furthermore, while we identified MSH2 and MSH6 in nearly all animals, MSH4, MSH5, and, especially, MSH3 were missing in multiple species. Overall, our analysis revealed a dynamic evolution of the MutS family in animals, with multiple losses of MSH1, MSH3, some losses of MSH4 and MSH5, and a gain of the octocoral mtMutS. We propose that octocoral mtMutS functionally replaced MSH1 that was present in the common ancestor of Anthozoa.
Consumer Attitudes Towards Deprescribing: A Systematic Review and Meta-Analysis
Authors: Weir Kristie Rebecca , Ailabouni Nagham J , Schneider Carl R , Hilmer Sarah N , Reeve Emily
Published: August 2021

Background

Harmful and/or unnecessary medication use in older adults is common. This indicates deprescribing (supervised withdrawal of inappropriate medicines) is not happening as often as it should. This study aimed to synthesize the results of the Patients’ Attitudes Towards Deprescribing (PATD) questionnaire (and revised versions).

Methods

Databases were searched from January 2013 to March 2020. Google Scholar was used for citation searching of the development and validation manuscripts to identify original research using the validated PATD, revised PATD (older adult and caregiver versions), and the version for people with cognitive impairment (rPATDcog). Two authors extracted data independently. A meta-analysis of proportions (random-effects model) was conducted with subgroup meta-analyses for setting and population. The primary outcome was the question: “If my doctor said it was possible, I would be willing to stop one or more of my medicines.” Secondary outcomes were associations between participant characteristics and primary outcome and other (r)PATD results.

Results

We included 46 articles describing 40 studies (n = 10,816 participants). The meta-analysis found the proportion of participants who agreed or strongly agreed with this statement was 84% (95% CI 81%–88%) and 80% (95% CI 74%–86%) in patients and caregivers, respectively, with significant heterogeneity (I2 = 95% and 77%).

Conclusion

Consumers reported willingness to have a medication deprescribed although results should be interpreted with caution due to heterogeneity. The findings from this study moves toward understanding attitudes toward deprescribing, which could increase the discussion and uptake of deprescribing recommendations in clinical practice.