bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of group size, reproductive condition and time period on sexual segregation patterns in three vespertilionid bat species
Authors: Katsis L. K. D. , Linton D. M. , Macdonald D. W.
Published: November 2020

Sexual segregation is widespread across the animal kingdom, yet there is limited consensus on the factors that shape this behavioural phenomenon. Many of the existing theories are based on study species with high levels of sexual size dimorphism. Insights from studies on species with minimal sexual size dimorphism, such as vespertilionid bats, provide an opportunity to study the factors associated with segregation irrespective of body size effects. Using long‐term data pooled from multiple bat box monitoring schemes across the U.K., we investigated segregation patterns in maternity roosts of three vespertilionid bat species, Bechstein’s bat,Myotis bechsteinii,Natterer’s bat,M. nattereriand brown long‐eared bat,Plecotus auritus. We used the Sexual Segregation and Aggregation Statistic (SSAS) to evaluate temporal trends of sexual segregation of roosts over the reproductive period (divided into pre‐parturition, lactation and post‐lactation periods). Additionally, we used generalized linear mixed models and beta regression models to investigate the effect of group size on segregation patterns. Our results showed that the size of the maternity group was an important covariate of inter‐ and intra‐sexual segregation, with males and non‐breeding females typically segregated from large maternity groups across all three periods. Additionally, we demonstrate that reproductive condition and period influence segregation patterns, with breeding females segregated from non‐breeding females and males during the lactation period. Although sexual segregation may be caused by multiple mechanisms, our results show that group size, female reproductive condition and time period are key factors associated with segregation within bat roosts. These findings make a valuable contribution to the understanding of inter‐ and intra‐sexual segregation in vespertilionid bats and complement existing research on segregation in other mammalian taxa, providing further evidence that sexual size dimorphism is not a prerequisite for sexual segregation.
Equilibrium concepts for time‐inconsistent stopping problems in continuous time
Authors: Bayraktar Erhan , Zhang Jingjie , Zhou Zhou
Published: November 2020

A new notion of equilibrium, which we call strong equilibrium, is introduced for time‐inconsistent stopping problems in continuous time. Compared to the existing notions introduced in Huang, Y.‐J., & Nguyen‐Huu, A. (2018, Jan 01). Time‐consistent stopping under decreasing impatience. Finance and Stochastics, 22(1), 69–95 and Christensen, S., & Lindensjö, K. (2018). On finding equilibrium stopping times for time‐inconsistent markovian problems. SIAM Journal on Control and Optimization, 56(6), 4228–4255, which in this paper are called mild equilibrium and weak equilibrium, respectively, a strong equilibrium captures the idea of subgame perfect Nash equilibrium more accurately. When the state process is a continuous‐time Markov chain and the discount function is log subadditive, we show that an optimal mild equilibrium is always a strong equilibrium. Moreover, we provide a new iteration method that can directly construct an optimal mild equilibrium and thus also prove its existence.
Must We Love Non-Human Animals?: A Post-Laudato Si Thomistic Perspective
Authors: Berkman John
Published: November 2020

Drawing especially on Aquinas and Pope Francis, the paper argues that Christians are indeed called to love non-human animals. Human love (amor) for non-human animals follows from the Trinitarian example of divine love (amor), and includes affection, dilection, benevolence, and thus charity as friendship. Love for and fraternity with non-human animals constitutes a necessary dimension of Christian conversion. The specific form this love takes depends on the particular natures inherent in different species. So to show love to a dog will be very different from showing love to a wolf, which is in turn very different from how one shows love to a chicken, or to a frog, and so on.
Assessment of mustard vesicant lung injury and anti‐TNF‐α efficacy in rodents using live‐animal imaging
Authors: Murray Alexa , Gow Andrew J. , Venosa Alessandro , Andres Jaclynn , Malaviya Rama , Adler Derek , Yurkow Edward , Laskin Jeffrey D. , Laskin Debra L.
Published: November 2020

Nitrogen mustard (NM) causes acute lung injury, which progresses to fibrosis. This is associated with a macrophage‐dominant inflammatory response and the production of proinflammatory/profibrotic mediators, including tumor necrosis factor alpha (TNF‐α). Herein, we refined magnetic resonance imaging (MRI) and computed tomography (CT) imaging methodologies to track the progression of NM‐induced lung injury in rodents and assess the efficacy of anti‐TNF‐α antibody in mitigating toxicity. Anti‐TNF‐α antibody was administered to rats (15 mg/kg, every 8 days, intravenously) beginning 30 min after treatment with phosphate‐buffered saline control or NM (0.125 mg/kg, intratracheally). Animals were imaged by MRI and CT prior to exposure and 1–28 days postexposure. Using MRI, we characterized acute lung injury and fibrosis by quantifying high‐signal lung volume, which represents edema, inflammation, and tissue consolidation; these pathologies were found to persist for 28 days following NM exposure. CT scans were used to assess structural components of the lung and to register changes in tissue radiodensities. CT scans showed that in control animals, total lung volume increased with time. Treatment of rats with NM caused loss of lung volume; anti‐TNF‐α antibody mitigated this decrease. These studies demonstrate that MRI and CT can be used to monitor lung disease and the impact of therapeutic intervention.
Applying the theory of motivated information management to family health history
Authors: Kuang Kai , Gettings Patricia E.
Published: November 2020

This study applied the theory of motivated information management (TMIM) to examine how married couples manage uncertainty about partners' family health history. Spouses reported (N = 626) on TMIM variables and information seeking/provision at Time 1 and on actual information seeking/provision behavior 3 weeks later. Findings largely supported paths proposed in the TMIM, but the model did not predict actual information management behaviors. As the first TMIM study to analyze dyadic, two‐wave data, results underscore the interdependent nature of information management processes in that seeker's efficacy assessments were associated with provider's direct information provision, and these effects were mediated by provider's perceptions of seeker efficacy assessments. Information seeker's perceptions did not play as significant a role in the process.
Does attachment style moderate the effect of computer‐mediated versus face‐to‐face conflict discussions?
Authors: Pollmann Monique M. H. , Crockett Erin E. , Vanden Abeele Mariek M. P. , Schouten Alexander P.
Published: November 2020

Successful conflict resolution is important in romantic relationships. With the advent of computer‐mediated communication (CMC), partners can resolve conflict using CMC. But is CMC as effective as face‐to‐face communication for conflict resolution? And does the effectiveness depend on attachment style? We asked 100 romantic couples to discuss a conflict topic and randomly assigned them to do so face‐to‐face or via CMC. Levels of distress, anger, and conflict resolution did not differ between face‐to‐face and CMC discussions. Attachment style did not moderate these findings. A more anxious and a more avoidant attachment style were associated with higher levels of distress and anger. We conclude that there is no indication that resolving conflict face‐to‐face has advantages over resolving conflict via CMC.
Characterization of canine epidermal organoid cultures by immunohistochemical analysis and quantitative PCR
Authors: Wiener Dominique J. , Studer Isabelle C. , Brunner Magdalena A.T. , Hermann Andreas , Vincenti Simona , Zhang Meng , Groch Kátia R. , Welle Monika M.
Published: November 2020

Background

Keratinocyte organoids can be used as a tool to evaluate epidermal structure, function and dysfunction.

Objectives

To optimize the canine keratinocyte organoid system and produce organoids that are structurally equivalent to in vivo canine epidermis, in order to enable studies that focus on epidermal diseases and diseases resulting from an impaired epidermal barrier.

Animals

Skin biopsies were obtained from five recently euthanized dogs of different breeds with no skin abnormalities.

Methods and materials

Cells derived from microdissected interfollicular epidermis were seeded in basement membrane extract and epidermal organoids were grown under different media conditions. Organoids were characterized to assess cell morphology and architecture in haematoxylin and eosin‐stained slides and expression of selected epidermal markers (keratin 5, keratin 10, loricrin and filaggrin) by immunohistochemical analysis and quantitative reverse transcription PCR.

Results

The selected epidermal markers were expressed in the same epidermal layers in the organoids cultured in expansion medium and differentiation medium as in normal interfollicular epidermis, yet restriction to the distinct layers was best achieved with expansion medium. Comparison of the mRNA expression levels of these markers revealed that relative expression is similar in organoids cultured in expansion medium and normal canine epidermis, while it differs in organoids cultured in differentiation medium.

Conclusion and clinical importance

Organoids cultured in expansion medium have an equivalent structure to the interfollicular epidermis and express key marker proteins in similar proportions. Epidermal organoids are therefore a promising in vitro model to study epidermal structure, function and dysfunction.
Numerical and Experimental Studies of Ballistic Compression Process in a Soft Recovery System
Authors: Mathur Girijesh , Tiwari Nachiketa , Chaturvedi Neha
Published: November 2020

A ballistic compression type soft recovery system can stop a free-flying supersonic projectile in a controlled manner. The moment such a projectile enters the System, a normal shock gets created and starts hurtling down, to kick off a train of events involving shock reflections, diaphragm rupture, shock merger, creation of new shocks and contact discontinuities, and expansion wave-shock interactions. A good understanding of these phenomena and sensitivity of the System's performance to changes in design parameters is needed to design an efficient soft recovery system. Unfortunately, not much information is available about this. The present work fills this gap. We have developed a numerical model for the system and conducted sensitivity analyses using four design parameters; pressure, molecular weight, the ratio of specific heats, and temperature of gas used in the system. We show that while there is a strong, positive correlation between the first two parameters and projectile deceleration, the other two parameters are less critical. We conducted experiments to corroborate our conclusions and improve our numerical model. Post such improvements, we found the difference between simulation and experimental data to be acceptable. Experiments also confirmed the findings of our sensitivity studies. Finally, we conducted a two-dimensional finite volume analysis to understand the reasons underlying the residual difference between our numerical and experimental data. We show that such differences are due to pressure-rise at a point once a shock passes by it, and such a rise in pressure is attributable to boundary layer effects.
Radiological Risk Assessment of Radon Gas in Bricks Samples in Iraq
Authors: Abojassim Ali Abid
Published: November 2020

Naturally occurring radioactive radon gas is produced from radioactive decay of naturally radioactive element radium and emits alpha particles. The radon gas is the main source of natural background radiation that contributes to about more than 60% of the annual radiation dose to humans on Earth. In this research, radon concentrations (222Rn) in brick samples that are available in Iraqi markets were measured using solid state nuclear track (CR-39). Also, uranium-238 (238U), radium-226 (226Ra) were calculated in all samples under study together with some radiation parameters such as exhalation of radon gas rate (FO), annual effective dose (DRn), and excess lifetime cancer risk (ELCR). It was found that, the average value of 222Rn, 238U, and 226Ra concentrations in studied samples were 48.75 ± 10.61 Bq/m3, 0.084 ± 0.02 ppm, and 115.57 ± 29.60 mBq/kg, respectively. Also, it was found that the average of each of FO, DRn, and ELCR were 27.54 ± 5.99 μBq/m2.h, 0.88 ± 0.17 nSv/y, and (3.01 ± 0.65)×10−3, respectively. After data analysis, the resulted data were examined and compared with the global average and the permissible limits which recommended by the international scientific agencies such as International Commission on Radiological Protection (ICRP 2010), United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR 2017), Organization for Economic Cooperation and Development (OECD 2009). It was found that radiation levels from brick samples used in local markets for most models fell within the permissible limits and may not cause any danger to human beings.
Assessment of Turbulence Models for Low Reynolds Number Flows and Their Computational Costs, Part 1: Staggered Tube Bank
Authors: Mancuso Thomas , Mukherjee Abhijit
Published: November 2020

This study investigates the accuracy of computational fluid dynamics (CFD) models to predict heat transfer in turbulent separated flows at low Reynolds numbers. This article will focus on flow in a staggered tube bank, while its companion articular will focus on a square prism (cylinder) in cross flow. Experimental data for both local heat transfer and velocity profiles are available for these cases and have been used extensively in the literature to evaluate various CFD methods. Six unsteady models were used and the results show that the unsteady shear stress transport (SST) model provided good overall accuracy relative to the mean Nusselt number for both cases. However, the SST model failed to accurately predict local variations. The partially averaged Navier–Stokes (PANS) variant of the SST model did show a marked improvement over the baseline SST model. The dynamic Smagorinsky large eddy simulation (LES) showed a much-improved fidelity to the local Nusselt number but unpredicted the actual values. The computational cost for the LES model was significant and it was found that the computationally expensive models with higher degrees of resolved turbulence did not necessarily return better results. Finally, the pressure drop results for the six models were scaled to predict the mean Nusselt number with the generalized Leveque method and were found to be very accurate. This method should prove useful to predict heat transfer performance with computationally less expensive cold flow results.
Visualizing and Isolating Iron-Reducing Microorganisms at the Single-Cell Level
Authors: Gan Cuifen , Wu Rongrong , Luo Yeshen , Song Jianhua , Luo Dizhou , Li Bei , Yang Yonggang , Xu Meiying
Published: November 2020

Visualization and isolation of FeRM from samples containing multiple species are commonly needed by researchers from different disciplines, such as environmental microbiology, environmental sciences, and geochemistry. However, no available method has been reported.
A Targeted Computational Screen of the SWEETLEAD Database Reveals FDA-Approved Compounds with Anti-Dengue Viral Activity
Authors: Moshiri Jasmine , Constant David A. , Liu Bowen , Mateo Roberto , Kearnes Steven , Novick Paul , Prasad Ritika , Nagamine Claude , Pande Vijay , Kirkegaard Karla
Published: November 2020

No antiviral therapeutics are currently available for dengue virus infections. By computationally overlaying the three-dimensional (3D) chemical structures of compounds known to inhibit dengue virus over those of compounds known to be safe in humans, we identified three FDA-approved compounds that are attractive candidates for repurposing as antivirals. We identified targets for two previously identified antiviral compounds and revealed a previously unknown potential anti-dengue compound, vandetanib. This computational approach to analyze a highly curated library of structures has the benefits of speed and cost efficiency. It also leverages mechanistic work with query compounds used in biomedical research to provide strong hypotheses for the antiviral mechanisms of the safer hit compounds. This workflow to identify compounds with known safety profiles can be expanded to any biological activity for which a small-molecule query compound has been identified, potentially expediting the translation of basic research to clinical interventions.
Management of inferior dislocation of a StopLoss Jones tube after conjunctivodacryocystorhinostomy
Authors: Nowak Rafal
Published: November 2020

Persistent epiphora significantly worsens one’s quality of life. A commonly known method of treatment of complete obstruction of the lacrimal canaliculi is conjunctivodacryocystorhinostomy with placement of a glass Jones tube. Unfortunately, the use of such a prosthesis of the lacrimal tract often results in certain complications, the most frequent of which include extrusion or superior and inferior migration. For the last several years, a modified version of the Jones tube—the StopLoss Jones tube (SLJT)—has been available. It almost eliminates the possibility of extrusion. However, inferior migration still remains an important problem. When that happens, it is necessary to proceed surgically. In this paper, we describe an endoscopically-guided technique of management of an inferiorly dislocated SLJT.
Intraductal papillary neoplasm of bile duct: all rare in one
Authors: Chaturvedi Aprajita , Pol Manjunath Maruti , Jangra Kirti , Singh Priyanka
Published: November 2020

A 45-year-old woman was referred from Department of Dermatology to Surgery outpatient department with pruritus since 6 months and an episode of jaundice that lasted for 15 days about 6 months ago. She was referred with a contrast-enhanced MRI finding that showed a small lesion in the lower end of common bile duct. Endoscopy-guided biopsy was performed twice at our hospital, the second revealed low grade dysplasia. Consequently, she underwent pancreaticoduodenectomy. Intraoperatively, there were both vascular and biliary anatomical variations that were missed on preoperative images. On histopathological examination, it turned out to be a mixed variety of intraductal papillary neoplasm of bile duct (IPNB). As all findings were rare in one, hence, we present this case of IPNB that presented to us with variable clinical, radiological, surgical and pathological findings.
Study of potentially preventable hospitalisations (PPH) for chronic conditions: what proportion are preventable and what factors are associated with preventable PPH?
Authors: Johnston Jennifer , Longman Jo , Ewald Dan , King Jonathan , Das Sumon , Passey Megan
Published: November 2020

Introduction

The proportion of potentially preventable hospitalisations (PPH) which are actually preventable is unknown, and little is understood about the factors associated with individual preventable PPH. The Diagnosing Potentially Preventable Hospitalisations (DaPPHne) Study aimed to determine the proportion of PPH for chronic conditions which are preventable and identify factors associated with chronic PPH classified as preventable.

Setting

Three hospitals in NSW, Australia.

Participants

Community-dwelling patients with unplanned hospital admissions between November 2014 and June 2017 for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes complications or angina pectoris. Data were collected from patients, their general practitioners (GPs) and hospital records.

Outcome measures

Assessments of the preventability of each admission by an Expert Panel.

Results

323 admissions were assessed for preventability: 46% (148/323) were assessed as preventable, 30% (98/323) as not preventable and 24% (77/323) as unclassifiable. Statistically significant differences in proportions preventable were found between the three study sites (29%; 47%; 58%; p≤0.001) and by primary discharge diagnosis (p≤0.001).

Significant predictors of an admission being classified as preventable were: study site; final principal diagnosis of CHF; fewer diagnoses on discharge; shorter hospital stay; GP diagnosis of COPD; GP consultation in the last 12 months; not having had a doctor help make the decision to go to hospital; not arriving by ambulance; patient living alone; having someone help with medications and requiring help with daily tasks.

Conclusions

That less than half the chronic PPH were assessed as preventable, and the range of factors associated with preventability, including site and discharge diagnosis, are important considerations in the validity of PPH as an indicator. Opportunities for interventions to reduce chronic PPH include targeting patients with CHF and COPD, and the provision of social welfare and support services for patients living alone and those requiring help with daily tasks and medication management.
Only eye study 2 (OnES 2): ‘Am I going to be able to see when the patch comes off?’ A qualitative study of patient experiences of undergoing high-stakes only eye surgery
Authors: Jones Lee , Taylor Deanna J , Sii Freda , Masood Imran , Crabb David P , Shah Peter
Published: November 2020

Objectives

Ocular surgery is a source of significant concern for many patients, especially in high-stakes circumstances. The purpose of this study was to explore patient experiences of undergoing surgery on their only-seeing eye.

Design

A qualitative investigation using semistructured face-to-face interviews. Transcripts were analysed using thematic analysis.

Setting

Hospital eye service in the UK.

Participants

Twelve participants with a diagnosis of glaucoma with worse eye visual acuity <3/60± end-stage visual field loss. All participants had experience of undergoing surgery on their better-seeing (ie, ‘only’) eye.

Results

Data were coded into three key themes relating to (1) emotional impact of surgery, (2) burden of visual loss and (3) coping with surgery. Patients reported depressive symptoms at all stages of their surgical journey; concern about poor visual outcomes was a common feature. Only eye surgery imposes an emotional burden due to the uncertainty regarding individuals’ ability to continue daily activities and maintaining social roles. Burden extended to the inconvenience of frequent hospital visits and difficulties with follow-up care. Participants’ ability to cope effectively with surgery appeared to be linked to extent of support from healthcare professionals. Key areas in developing trust and support were an open and transparent dialogue between surgeons and patients, continuity of care, patient inclusion in decision-making, and observable empathy.

Conclusions

The findings indicate a need for an enhanced model of care in only eye surgery to better target patient preferences and allay concerns inherent with these procedures.
Using multiple objective calibrations to explore uncertainty in extreme event modeling
Authors: Roche A. David , Lence Barbara J. , Vaags Eric
Published: November 2020

Deterministic watershed models are often used to estimate the probable maximum flood (PMF). An approach for investigating the uncertainty in extreme flood modeling is proposed. Using different calibration objectives, several automatic calibrations of the University of British Columbia watershed model (UBCWM) are conducted and the resulting collection of optimal combinations of parameter values are used to simulate the extreme event. An application to the Coquitlam River Watershed above Coquitlam Dam in southwestern British Columbia shows that the variability among the PMF estimates is relatively small in comparison with the potential uncertainties in estimating extreme events, with coefficient of variation values for peak flow, event volume, and time to peak of 4%, 1%, and 1%, respectively. The PMF-based simulations are relatively insensitive to the different measures of calibration performances.
Assessment of Directional Connectivity Between Neural Sources Using Effective Connectivity Measures and Particle Filters
Authors: Veeramalla Santhosh Kumar , Hanumantha Rao T. V. K.
Published: November 2020

Electrical neural activity monitoring and recording will increase our understanding of how the human brain works. Tracking mechanisms of neural activity led to better diagnosis and management of severe neurological conditions such as Parkinson’s disease and epilepsy. More importantly, these approaches were used to distinguish between various types of seizures based on the location and direction of the seizure foci, thereby increasing the outcomes of epilepsy surgery. A detailed study was carried out on the role of neural synchrony in brain functions with Electroencephalography (EEG). Most studies had been conducted on EEG connectivity analysis at sensor level. It is not easy to evaluate the connected networks because the volume conductive effect significantly distorts signals because of the electrical conductiveness of the head and often scalp electrodes derive input from the same sources in the brain. These factors help to estimate the real connectivity between brain regions inaccurately. The suggested approach is referred to as EEG source connectivity. The inverse problem is the estimation of the localized current dipole model from the EEG measurements. In order to solve the inverse EEG problem, advanced signal-processing algorithms such as the efficient implementation of PF have been built to facilitate direct exposure to neural dipole sources in real time and measure the connectivity of neural sources time courses using functional and effective connectivity measures.
Regular Expression Learning from Positive Examples Based on Integer Programming
Authors: Gao Juntao , Zhang Yingqian
Published: November 2020

This paper presents a novel method to infer regular expressions from positive examples. The method consists of a candidate’s construction phase and an optimization phase. We first propose multiscaling sample augmentation to capture the cycle patterns from single examples during the candidate’s construction phase. We then use common substrings to build regular expressions that capture patterns across multiple examples, and we show this algorithm is more general than those based on common prefixes or suffixes. Furthermore, we propose a pruning mechanism to improve the efficiency of useful common substring mining, which is an important part of common substring-based expression building algorithm. Finally, in the optimization phase, we model the problem of choosing a set of regular expressions with the lowest cost as an integer linear program, which can be solved to obtain the optimal solution. The experimental results on synthetic and real-life samples demonstrate the effectiveness of our approach in inferring concise and semantically meaningful regular expressions for string datasets.
Profinite groups in which the probabilistic zeta function has no negative coefficients
Authors: Detomi Eloisa , Lucchini Andrea
Published: November 2020

To a finitely generated profinite group [Formula: see text], a formal Dirichlet series [Formula: see text] is associated, where [Formula: see text] and [Formula: see text] denotes the Möbius function of the lattice of open subgroups of [Formula: see text] Its formal inverse [Formula: see text] is the probabilistic zeta function of [Formula: see text]. When [Formula: see text] is prosoluble, every coefficient of [Formula: see text] is nonnegative. In this paper we discuss the general case and we produce a non-prosoluble finitely generated group with the same property.
Study of the nuclear structure of some exotic nuclei using nonrelativistic and relativistic mean-field methods
Authors: Allami Abbas A. , Alzubadi Ali A.
Published: November 2020

The nuclear shell model with the Skyrme–Hartree–Fock (SHF), as a nonrelativistic approach, and the Relativistic Hartree–Fock–Bogoliubov (RHFB) methods have been used to study the nuclear structure of some exotic nuclei at the proton and neutron drip lines. Different Skyrme parametrizations, in particular SkM*, SkX, SkO, SLy4, Skxs25 and Z, have been used in the nonrelativistic region. In the relativistic region, the density-dependence meson-exchange models and density-dependence point-coupling models are used. Both methods are used to study ground state properties such as binding energy, mass radial density distribution and the corresponding root mean square (rms) mass radii. The fragmentation reaction cross-section is used as an important property to investigate the halo structure. Strong evidence for existence of a neutron halo in [Formula: see text]Li and [Formula: see text]Be and proton halo in [Formula: see text]Ne, [Formula: see text]Al and [Formula: see text]P are found using the SHF model and reaction cross-section. The ability of the SHF model to study the exotic structure with shell model occupation probability is confirmed.
Transboundary Pollution Abatement, Emission Permits Trading and Compensation Mechanism: A Differential Game Analysis
Authors: Guo Genlong , Li Huiquan , Jian Zhaoquan
Published: November 2020

In this paper, we consider a pollution control problem along a river basin where a portion of the pollution emitted by the upstream region can be transferred to the downstream region. Our model has three significant features: first, we take into account the pollution abatement investment, and the stock of pollution abatement capital follows standard differential equation of motion; second, we introduce the emission permits trading system so that each region has the choice between buying pollution permits or pollution abatement investment; third, we consider the pollution compensation mechanism so that the downstream region pays pollution compensation for the upstream region. We explore and compare the optimal decisions of both the upstream and downstream regions under the cases of the cooperative and no-cooperative strategies, respectively. We find that although the flow of emissions can be better controlled by cooperation between the upstream and downstream regions, the pollution abatement investment is not necessarily higher in the cooperative equilibrium. Further, a sensitivity analysis is also conducted on the parameters of the transboundary river basin pollution.
Is GLUT4 translocation the answer to exercise-stimulated muscle glucose uptake?
Authors: Richter Erik A.
Published: November 2020

Exercise in humans increases muscle glucose uptake up to 100-fold compared with rest. The magnitude of increase depends on exercise intensity and duration. Although knockout of glucose transporter type 4 (GLUT4) convincingly has shown that GLUT4 is necessary for exercise to increase muscle glucose uptake, studies only show an approximate twofold increase in GLUT4 translocation to the muscle cell membrane when transitioning from rest to exercise. Therefore, there is a big discrepancy between the increase in glucose uptake and GLUT4 translocation. It is suggested that either the methods for measurements of GLUT4 translocation in muscle grossly underestimate the real translocation of GLUT4 or, alternatively, GLUT4 intrinsic activity increases in muscle during exercise, perhaps due to increased muscle temperature and/or mechanical effects during contraction/relaxation cycles.
eQTL variants in COL22A1 are associated with muscle injury in athletes
Authors: Miyamoto-Mikami Eri , Kumagai Hiroshi , Kikuchi Naoki , Kamiya Nobuhiro , Miyamoto Naokazu , Fuku Noriyuki
Published: November 2020

The myotendinous junction (MTJ) is at high risk of muscle injury, and collagen XXII is strictly expressed at tissue junctions, specifically at the MTJ. We investigated the hypothesis that single-nucleotide polymorphisms (SNPs) related to collagen type XXII α-1 chain gene ( COL22A1) mRNA expression are associated with susceptibility to muscle injury in athletes. History of muscle injury was assessed in 3,320 Japanese athletes using a questionnaire, and two expression quantitative trait loci (eQTL) SNPs for COL22A1 (rs11784270 A/C and rs6577958 T/C) were analyzed using the TaqMan SNP Genotyping Assay. rs11784270 [odds ratio (OR) = 1.80, 95% confidence interval (CI) = 1.27–2.62, P = 0.0006] and rs6577958 (OR = 1.45, 95% CI = 1.10–1.94, P = 0.0083) were significantly associated with muscle injury under A and T allele additive genetic models, respectively. These results suggest that the expression level of COL22A1 at the MTJ influences muscle injury risk in athletes.
An Innovative Immune Score‐Based Prognostic Nomogram for Patients with Cervical Cancer
Authors: Qi Xingling , Fu Yipeng , Zhang Meng , Lu Chong , Wang Yumeng , Peng Jing , Li Guiling
Published: November 2020

Background. In the past few years, the immune system and tumor immune microenvironment are becoming increasingly popular as more work has been accomplished in this field. However, nomograms based on immune‐related characteristics for prognosis prediction of cervical cancer have not been fully explored to our knowledge. We constructed a novel immune score‐based nomogram to predict patients with high risk and poor prognosis. Materials and Methods. 198 patients with cervical cancer from The Cancer Genome Atlas (TCGA) database were included in our study. Immune scores were generated with Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) algorithm, and clinic‐pathological characteristics were also included for subsequent analysis. Cox proportional hazards regression models were performed for univariate and multivariate analyses to screen the significant factors, and a prognostic nomogram was built. Bootstrap resampling analysis was used for internal validation. The calibration curve and concordance index (C‐index) were used to assess the predictive performance of the nomogram. Results. Patients were split into three subgroups based on immune scores. We found that patients with high immune scores conferred significantly better overall survival (OS) compared with those with medium and low immune scores (hazard ratio (HR), 0.305; 95% confidence interval (CI), 0.108‐0.869). A nomogram with a C‐index of 0.720 had a favorable performance for predicting survival rate for clinical use by combining immune scores with other clinical features. The calibration curves at 3 and 5 years suggested a good consistency between the predicted OS and the actual OS probability. Conclusions. Our work highlights the potential clinical application significance of immune score‐based nomogram in predicting the OS of cervical cancer patients.
Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment
Authors: Dubovsky Steven L. , Ghosh Biswarup M. , Serotte Jordan C. , Cranwell Victoria
Published: November 2020

Psychotic depression was initially considered to be at one end of a continuum of severity of major depression. Subsequent experience demonstrated that psychosis is an independent trait that may accompany mood disorders of varying severity. While much has been learned about the impact of severe mood congruent delusions and hallucinations on the course and treatment response of depression, less is known about fleeting or mild psychosis, mood incongruent features, or psychotic symptoms that reflect traumatic experiences. Acute treatment of psychotic unipolar depression generally involves the combination of an antidepressant and an antipsychotic drug or electroconvulsive therapy. There is inadequate information about maintenance treatment of unipolar psychotic depression and acute and chronic treatment of psychotic bipolar disorder. Decision-making therefore still must rely in part on clinical experience.
Abstract 108: Work of Breathing Scale to Assess Need of Intubation in Covid-19 Pneumonia
Authors: Gazmuri Raul J , Apigo Mylene , Fanapour Philip , Nadeem Amin
Published: November 2020

COVID-19 pneumonia presents in most patients with significant hypoxemia but without substantial impairment of lung compliance that would increase the work of breathing (WOB) to levels requiring invasive mechanical ventilation. Thus, the ability to assess the WOB independent of the oxygen needs could help guide management and possibly avoid intubation. We previously developed and implemented in our ICU a WOB scale based on respiratory physiology ranging from 1 to 7 by assigning points to the respiratory rate level and the use of respiratory accessory muscles. We analyzed the use of our WOB scale in 10 patients admitted to our ICU with severe COVID-19 pneumonia. All patients had radiographic evidence of extensive lung disease with significant hypoxemia and multiple risk factors associated with poor outcome. Hypoxemia was successfully managed using high-flow nasal cannula. The WOB level was measured every 4 hours. The maximum WOB was 4.3 ± 0.9, contributed primarily by the respiratory rate with a score of 3.6 ± 0.5 but with infrequent use of respiratory accessory muscles. All 10 patients survived without need of intubation. For comparison, three other patients who needed intubation had a maximal work of breathing within the preceding 24 hours of 5.3 ± 1.2 with a respiratory rate score of 3.7 ± 0.6, as in non-intubated patients, but with more often use of respiratory accessory muscles. Our data suggest that patients with COVID-19 pneumonia can be supported for extended periods using HFNC despite tachypnea provided there is only infrequent use of respiratory accessory muscles, corresponding to a WOB scale ≤ 4, prompting closer assessment for possible intubation when WOB > 4. This approach would be especially advantageous under conditions of high disease intensity when avoidance of intubation is likely to result in a better outcome.
Abstract 113: Effects of Anticoagulation and Thrombolytic Therapy in a Porcine Model of Prolonged Out-of-hospital Cardiac Arrest Treated with ECPR
Authors: Harvey Stephen L , Hill Joseph E , VanZalen Jensyn J , Hala Pavel , Gok Emre , Phillips Anne G , Pak Olivia L , Willett Noah , Ali Tasneem , Jung Joshua H , Mergos Joshua , Bartlett Robert H , Rojas-Peña Alvaro , Neumar Robert W
Published: November 2020

Background:
Extracorporeal cardiopulmonary resuscitation (ECPR) has been used in patients with refractory out-of-hospital cardiac arrest (OHCA). However, recovery of organ function and survival are potentially impaired due to microvascular coagulation causing a “no-reflow” phenomenon.

Hypothesis:
Early anticoagulant therapy (argatroban) during CPR and/or thrombolytic therapy (streptokinase) at ECPR onset improves recovery of organ function in an OHCA porcine model.

Methods:
In a blinded and randomized study, 48 swine (40±5kg) were subjected to 8min of ventricular fibrillation cardiac arrest (CA) followed by 30min of goal directed CPR (gdCPR), and 8h of ECPR (33°C) with heparin anticoagulation during ECPR. Animals (n=12) were randomized to one of 4 groups with 350mg/kg argatroban (Arg) or placebo (20mL NSS) given 12min after CA onset and 1.5 MU streptokinase (STK) or placebo (50mL NSS) given at ECPR initiation: Group 1 (placebo and placebo); Group 2 (Arg and placebo); Group 3 (placebo and STK); and Group 4 (Arg and STK). Recovery of cardiac function measured by a cardiac resuscitablity score (CRS), see Table. Recovery of neurologic function measured by amplitude recovery of cortical somatosensory evoked potentials (cSSEP). Data analysis: Kruskal Wallis and single factor ANOVA tests with (
p
<0.05 significant).

Results:
Average CRS and cSSEP recovery were not significantly different between groups. However, the combined average CRS of the argatroban groups (2&4) was 3.2±2.1 compared to 2.0±1.6 for the groups without it (1&3),
p
=0.03 single factor ANOVA. Furthermore, more animals in groups 2&4 (n=8) achieved a robust recovery in cSSEP amplitude (≥30% amplitude return) than in groups 1&3 (n=4).

Discussion:
These results provide evidence that argatroban given early during CPR potentially improves early recovery of cardiac and neurological function in a porcine model of OHCA. However, the impact of these therapies on long term recovery remains to be determined.
Abstract 115: Extracorporeal Cardiopulmonary Resuscitation for Refractory Out of Hospital Cardiac Arrest (EROCA) - Results of a Randomized Feasibility Trial of Expedited Prehospital Transport
Authors: Meurer William J , Domeier Robert , Hsu Cindy H , Fowler Jennifer , Whitmore Sage , Bassin Benjamin , Gunnerson Kyle , Haft Jonathan , Lynch William , Nallamothu Brahmajee , Havey Renee , Kidwell Kelley , Stacey William , Silbergleit Robert , Bartlett Robert , Neumar Robert W
Published: November 2020

Introduction:
Extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) is promising but is unproven, and outcomes are strongly dependent on time to initiation of therapy. Expedited transport may facilitate opportunities for ECPR in clinical practice and future trials.

Hypotheses:
We hypothesized that a real-time dispatch-based computer algorithm could select refractory OHCA patients who could be reliably transported to the emergency department (ED) within 30 min of the 911 call, and that Emergency Medicine physicians could initiate ECPR in eligible patients within 30 min of ED arrival.

Methods:
In a 2-tiered EMS system serving a US city of 100k in 29 square miles with an ECPR capable primary destination hospital, adults with refractory shockable or witnessed OHCA were randomized 4:1 to expedited transport (ET) or standard prehospital care (SC) if the predicted 911 to ED arrival time was <30 min. A maximum sample size of 24 was planned. The study required exception from informed consent. The primary outcomes were the proportion of patients with 911 to ED arrival <30 min and ED arrival to ECPR flow <30 min.

Results:
Out of 156 cardiac arrest runs, 15 participants (10%) were randomized prior to ending the trial for slow accrual. Five of 12 patients randomized to expedited transport had an ED arrival time of <30 min (mean 32.5+7.1). All ECPR eligible patients were cannulated, 3 of 5 receiving ECPR had flow initiated <30 min of ED arrival (mean 32.4+10.9), and 7 were ECPR ineligible. One patient (randomized to SC) survived to 30 days, and no patients in either group survived with a good neurological outcome.

Conclusions:
EROCA demonstrated a functional model for selecting patients with refractory OHCA for ET in an ECPR capable system but did not meet predefined time-interval targets. These results provide important insight into the feasibility of ECPR clinical trials and clinical practice based on selected target intervals.
Abstract 116: Impella Device Success: Walking Home After Cardiogenic Shock From Ventricular Fibrillation
Authors: Smith Christopher , Menon Vivek , Smith Dantwan
Published: November 2020

Ventricular fibrillation is a fatal arrhythmia due to its detrimental impact on cardiac output. Managing patients in V-Fib arrest is often challenging, but newer mechanical support devices such as Impella CP 5.0 (Abiomed, Danvers, MD) are proving to be an excellent adjunct to inotrope and vasopressor therapy.

We present a 75-year-old female with a medical history of atrial fibrillation and obstructive sleep apnea that presented to the ER unresponsive. On arrival, the patient was pulseless and initial rhythm on telemetry revealed ventricular fibrillation. The patient demonstrated minimally reactive pupils to light, negative corneal reflex, and lower extremity clonus.

ROSC was achieved with electric defibrillation and two rounds of CPR. Chest radiograph revealed mild bilateral pulmonary congestion. Head CT revealed no acute intracranial pathology. The patient was placed on targeted temperature management protocol for the next 48 hours. Emergent left heart catheterization revealed no signs of occlusive coronary disease. TTE revealed left ventricular ejection fraction 5-10%, likely from stunned myocardium.

The patient continued to clinically decline and decision was made to place an Impella device for further hemodynamic support. Unlike ECMO, the Impella fully unloaded the LV and allowed diastolic coronary filling. The patient ultimately demonstrated significant improvement and repeat TTE revealed an improved EF of 45-50%.

Prior to hospital discharge, an AICD was placed for primary SCD prevention. The patient maintained close outpatient follow-up with her cardiologist and PCP. This case illustrates the importance life-saving mechanical support devices such as Impella in the setting of cardiogenic shock, even from non-ischemic ventricular fibrillation.
Abstract 122: Effects of Early Administration of Argatroban on CPR Quality in Porcine Model of Prolonged Out-of-Hospital Cardiac Arrest
Authors: VanZalen Jensyn J , Phillips Annie G , Harvey Stephen L , Hill Joseph E , Pak Olivia L , Enciso Alyssa J , Mitchell Megan A , Jung Joshua H , Hala Pavel , Gok Emre , Bartlett Robert H , Rojas-Peña Alvaro , Neumar Robert W
Published: November 2020

Background:
The effectiveness of CPR declines over time during prolonged cardiac arrest (CA). Intravascular thrombosis may be a contributing factor. As part of a larger study examining antithrombotic therapy in a porcine model of prolonged CA, the impact of early administration of argatroban on CPR hemodynamics is reported.

Hypothesis:
Early administration of argatroban during CPR improves the quality of goal-directed CPR (gdCPR).

Methods:
In a blinded and randomized study, 48 swine (40±5kg) underwent an 8min untreated period of ventricular fibrillation CA followed by a gdCPR protocol for 30min (total arrest time 38min). Manual and mechanical chest compressions with the use of an impedance threshold device (ITD) were introduced to maintain end-tidal CO
2
(Et-CO
2
) >20mmHg. Argatroban (350mg/kg) or placebo (20mL NSS) were administered to respective groups (n=24 per group) 12mins after initiation of CA. Et-CO
2
, coronary perfusion pressure (CPP), end-diastolic pressure (EDP), and intracranial pressure (ICP) were monitored continuously. Averages were taken over the course of gdCPR for hemodynamic parameters. Arterial blood gases (ABGs) were obtained at the end of gdCPR. Analysis between groups was performed using an unpaired t-test (significance =
p
<0.05).

Results:
Average hemodynamic parameters were not statistically different between argatroban vs. placebo groups (Et-CO
2
22.6±6.7 vs. 21.5±5.9 mmHg; EDP 25.6±10.7 vs. 23.7±9.6 mmHg; ICP 25.7±2.0 vs.20.9±2.7 cmH
2
O; CPP 8.7±11.2 vs. 7.0±11.2 mmHg). Final ABG values were also not statistically different between argatroban vs. placebo groups (pH 7.23±0.1 vs. 7.23±0.2; PaO
2
187.4±146.3 vs. 132.2±187.4 mmHg; PaCO
2
38.8±16.6 vs. 43.0±26.1 mmHg; lactate 8.5±1.7 vs. 8.8±1.4 mmol/L).

Conclusion:
These results demonstrate that early administration of argatroban during CPR did not have a significant effect on gdCPR quality in a porcine model of prolonged CA.