bluuebunny/crossref_metadata_2025 huggingface dataset:
Modification and utility of a rat burn wound model
Authors: Hu Xiaoyan , Wang Xingxia , Hong Xudong , Fan Hao , Zhang Xudong , Chen Aifen , Wang Guangyi , Jin Jian , Xia Zhaofan
Published: August 2020

This study aimed to improve the conventional rat burn wound model and to validate its utility. In total, 60 Sprague‐Dawley rats were divided equally into the control and experimental groups. Altogether, 60 burn wound models with zones of stasis were created in each group. Gross visual assessments of the burn wounds were performed at 0, 24, and 48 hours after burn creation. The rates of necrosis in the zones of stasis were calculated, and the blood flow from the wounds was examined. Wound tissues were collected 48 hours after the burn and subjected to hematoxylin and eosin staining to determine whether the models were successfully established. The model success rates were calculated. The success rate of the burn wound models was significantly different between the control group and the experimental group (93.33% [56/60] vs 100%; P = .042). The Cronbach's alpha values and the respective correlation coefficients indicated that the stability of the zones of stasis in the models on the two sides of the spine was higher in the experimental group than in the control group. The standard deviations of the rate of necrosis, blood flow, and density of necrotic cells and apoptosis cell density, and inflammatory factor content in the zones of stasis were smaller in the experimental group than in the control group at 48 hours after model construction. This suggested that the stability of repeated procedures was higher in the experimental group than in the control group. The novel device for creating burns in animal models facilitated the effective creation of zones of stasis for rat burn wound models. Both the model success rate and stability were higher compared with the conventional model construction method. In addition, the use of the novel device can better align with the requirements of self‐controlled studies.
Circumstances of Human–Bat interactions and risk of lyssavirus transmission in metropolitan France
Authors: Parize Perrine , Travecedo Robledo Isabel Cristina , Cervantes‐Gonzalez Minerva , Kergoat Lauriane , Larrous Florence , Serra‐Cobo Jordi , Dacheux Laurent , Bourhy Hervé
Published: August 2020

Since the elimination of dog and terrestrial wild animal rabies, bat exposures remain the only source of autochthonous lyssavirus transmission to humans in Western Europe. European bats have already been found infected with several lyssaviruses, and human–bat interactions represent a risk of viral transmission and fatal encephalitis for humans. In this study, we aim to better characterize exposures to bats in metropolitan France from 2003 to 2016 and to identify circumstances associated with exposures to lyssavirus‐positive bats. Two complementary sources of data were analysed: 1/ data associated with bats responsible for human exposure received for Lyssavirus testing by the French National Reference Centre for Rabies (NRCR); and 2/ data pertaining to individuals seeking medical care through the French Anti‐Rabies Clinics network after contact with a bat. From 2003 to 2016, 425 bats originating from metropolitan France were submitted to the NRCR and 16 (4%) were found positive with a lyssavirus (EBLV‐1b was diagnosed in 9 bats, EBLV‐1a in 6 and BBLV in one specimen). The two factors associated with bat positivity in our study were the female sex and the bat belonging to the E. serotinus species. During the same study period, 1718 individuals sought care at an Anti‐Rabies Clinic after exposure to a bat resulting in an estimated incidence of human–bat interactions of 1.96 per 106 person‐years. The two most frequent circumstances of exposure were handling or bites. Interactions mostly involved one adult human being and one live and non‐sick‐looking bat. Our study provides new insights about circumstances of human–bat interactions and may be helpful to target prevention interventions to improve the awareness of the population of the risk of lyssavirus transmission.
Toxoplasmagondii oocysts, Giardia cysts and Cryptosporidium oocysts in outdoor swimming pools in Brazil
Authors: Pineda Carolina Ortiz , Leal Diego Averaldo Guiguet , Fiuza Vagner Ricardo da Silva , Jose Juliana , Borelli Guilherme , Durigan Mauricio , Pena Hilda Fátima Jesus , Bueno Franco Regina Maura
Published: August 2020

The accidental ingestion of treated recreational water is an important transmission route of waterborne protozoa worldwide. The present study aimed to provide the first evaluation of swimming pools in Brazil, analysing the presence of pathogenic protozoa (Toxoplasma gondii, Cryptosporidium spp. and Giardia spp.) by parasitological and molecular methods. A total of 57 samples were collected from 21 public swimming pools, either directly from the pool or filter backwash water and concentrated using the membrane filtration technique. Giardia cysts and Cryptosporidium oocysts were visualized by direct immunofluorescence assay after purification by immunomagnetic separation. Toxoplasma gondii oocysts were detected by autofluorescence visualization using the supernatant discarded during the purification step as a sample. Positive samples were submitted to molecular analysis. The molecular markers were used: SSU‐rRNA, tpi, gdh and bg, for Giardia DNA amplification, and 18S rRNA gene fragment amplification was used for the Cryptosporidium oocysts. The 529‐bp repeat element (REP529) fragment and the 35‐fold repetitive B1 gene were employed as a target for T. gondii. Amplified products were submitted to sequencing and phylogenetic analysis. Giardia cysts were detected in 19.0% and Cryptosporidium oocysts in 9.5% of swimming pools. In one swimming pool (4.7%), both protozoa were detected on at least one occasion. Structures similar to T. gondii oocysts were detected in 33.3% of the samples, ranging from one to 23 per slide. Giardia was confirmed by DNA amplification in three swimming pools; Giardia duodenalis Assemblage A was identified by the phylogenetic positioning of the β‐giardin gene. Toxoplasma gondii DNA was detected in 14.2% of swimming pools. The present study represents the first report of the occurrence of T. gondii oocysts in swimming pools. Recreational activity in swimming pools contaminated by chlorine‐resistant protozoa can represent a high risk of infection for bathers and swimmers.
Biomedical Manufacturing: A Review of the Emerging Research and Applications
Authors: Chen Roland , Chang Robert C. , Tai Bruce , Huang Yong , Ozdoganlar Burak , Li Wei , Shih Albert
Published: August 2020

Biomedical manufacturing, which has seen rapid growth over the past decade, is an emerging research area for the manufacturing community. This growth trajectory is exemplified and coupled with a broadening scope of applications with biomedical manufacturing technology, including advancements in the safety, quality, cost, efficiency, and speed of healthcare service and research. The goal of this topical review is to offer a comprehensive survey of the current state-of-the-art in biomedical manufacturing and to summarize existing opportunities and challenges as a basis to guide future research activities in this emerging area. This article categorizes the key manufacturing process types that are currently being leveraged for the biomedical field of use, including machining, joining, additive manufacturing, and micro-/multi-scale manufacturing. For each of these manufacturing processes, notable applications are cited and discussed to provide insights and perspectives into how manufacturing processes can play an integral role in creating new and more sophisticated healthcare services and products.
Improvement of Single-Sided Resistance Spot Welding of Austenitic Stainless Steel Using Radial Magnetic Field
Authors: Qi Lin , Li Fangzhou , Zhang Qingxin , Xu Ye , Han Xiaohui , Li Yongbing
Published: August 2020

Magnetically assisted resistance spot welding (MA-RSW), which uses a pair of mutually repulsive ring-shaped axially magnetized magnets, has been demonstrated to have significant effect on weld quality of high strength steels and light metals. However, in manufacturing of metro car bodies, single-sided resistance spot welding processes is frequently adopted to achieve better surface quality, which poses a big challenge to the traditional double-sided MA-RSW apparatus. In this study, single-sided MA-RSW apparatus with four arc-shaped radially magnetized permanent magnets was developed to adapt the demand of the single-sided RSW process, and 1.5 + 2.5 mm austenitic stainless steels (ASSs) are used to evaluate its effectiveness in terms of weld quality and surface indentation. Meanwhile, a 3D finite element model taking three types of MA-RSW apparatus into account was created to reveal the improvement mechanism of the single-sided MA-RSW apparatus. The results showed that the novel single-sided MA-RSW apparatus can produce stronger radial magnetic field in effective welding region and thus provide a great potential and promotion effect to the weld quality in terms of macro-morphology, surface indentation, microstructure, microhardness, and mechanical properties.
Efficient Design of Lightweight Reinforced Tensegrities Under Local and Global Failure Constraints
Authors: Goyal Raman , Skelton Robert E. , Peraza Hernandez Edwin A.
Published: August 2020

Tensegrities are prestressable trusses that have been proven to support various load distributions with minimum mass. This article presents a novel efficient method for designing lightweight tensegrities under local and global failure constraints. Local failure includes buckling and material yielding of individual members in the tensegrity. Global failure refers to global buckling of the tensegrity, where it loses stability without undergoing local failure at its individual members. The formulation and numerical approach to determine the critical global buckling forces and mode shapes of tensegrities with arbitrary shape and topology are first provided. Next, the design method considering local and global failure is presented, which starts with the local sizing of the member areas of the given tensegrity for the prevention of local failure. The method then determines the dominant failure mode by comparing the external forces and the critical global buckling force of the locally sized structure. If the critical global buckling force is larger than the external force, the dominant mode is a local failure and the locally sized design is returned as the minimum mass design. Conversely, if global failure is the dominant mode, different global reinforcement approaches are applied to raise the critical buckling force of the structure until it matches the external force, preventing global buckling. These reinforcement approaches include increasing the areas of the members and increasing the prestress in the tensegrity. Representative examples are provided to demonstrate the effectiveness of the design method considering box and T-bar tensegrities.
The genus Amblyseius Berlese (Acari: Phytoseiidae) in Turkey with discussion on the identity of Amblyseius meridionalis

Authors: Döker İsmail , Kazak Cengiz , Karut Kamil
Published: August 2020

Surveys were conducted to assess Phytoseiidae (Acari: Mesositgmata) diversity in various habitats and ecosystems (including natural and agricultural areas) since 2008 in Turkey. This paper aims to provide a review of the Turkish species belonging to genus Amblyseius Berlese (Acari: Phytoseiidae) based on materials collected during these surveys as well as previous records. As a result, A. nemorivagus Athias-Henriot was found for the first time for Turkish fauna. In addition, unknown male of A. bryophilus Karg is described and illustrated. A revised identification key is provided for the 13 Amblyseius species found in Turkey. Validity of some previous Turkish records, and identity of A. meridionalis Berlese, are discussed. There are series of discrete species reported under the name A. meridionalis, none of them truly match with the original description in terms of shape of ventrianal shield. Our results indicated that A. kadzhajai Gomelauri, A. meridionalis, A. nemorivagus and A. obtusus (Koch) sensu Karg, were found only on moss. Amblyseius andersoni (Chant), A. herbicolus (Chant) and A. swirskii Athias-Henriot are common in agricultural ecosystems or higher plants. According to results, there is a different geographic distribution between these three species; A. swirskii is reported only from east Mediterranean, while A. herbicolus only from North-East (Black Sea region), A. andersoni is common in western Turkey. Only a few specimens of Amblyseius adjaricus Wainstein & Vartapetov and A. bryophilus were collected, from cultivated plants from Black Sea region. Therefore, potential of Turkish populations of these five species and their using possibilities in biological control are warranted in Turkey.
Population Pharmacokinetics of Linezolid in Tuberculosis Patients: Dosing Regimen Simulation and Target Attainment Analysis
Authors: Alghamdi Wael A. , Al-Shaer Mohammad H. , An Guohua , Alsultan Abdullah , Kipiani Maia , Barbakadze Ketevan , Mikiashvili Lali , Ashkin David , Griffith David E. , Cegielski J. Peter , Kempker Russell R. , Peloquin Charles A.
Published: August 2020

The prolonged treatment duration for multidrug-resistant tuberculosis (MDR-TB) makes linezolid dosing difficult because of adverse effects associated with long-term use. We sought to find the optimal dosing regimen for linezolid across different MIC values. Pharmacokinetic (PK) data from TB patients were included from Brazil, Georgia, and two U.S. sites. Population PK modeling and simulation were performed. We used an
f
AUC (area under the unbound drug concentration-time curve)/MIC ratio of >119 as the PK/pharmacodynamic (PD) target and minimum (trough) concentrations of drug (
C
min
s) of 2 and 7 mg/liter as thresholds for toxicity.
Peptidoglycan Sensing Prevents Quiescence and Promotes Quorum-Independent Colony Growth of Uropathogenic Escherichia coli
Authors: DiBiasio Eric C. , Ranson Hilary J. , Johnson James R. , Rowley David C. , Cohen Paul S. , Camberg Jodi L.
Published: August 2020

Uropathogenic
Escherichia coli
(UPEC) is the leading cause of urinary tract infections (UTIs). During pathogenesis, UPEC cells adhere to and infiltrate bladder epithelial cells, where they may form intracellular bacterial communities (IBCs) or enter a nongrowing or slowly growing quiescent state. Here, we show
in vitro
that UPEC strains at low population density enter a reversible, quiescent state by halting division. Quiescent cells resume proliferation in response to sensing a quorum and detecting external signals, or cues, including peptidoglycan tetra- and pentapeptides.
Two Genetic Differences between Closely Related Zika Virus Strains Determine Pathogenic Outcome in Mice
Authors: Carbaugh Derek L. , Zhou Shuntai , Sanders Wes , Moorman Nathaniel J. , Swanstrom Ronald , Lazear Helen M.
Published: August 2020

Contemporary ZIKV strains are closely related and often used interchangeably in laboratory research. Here, we identify two strain-specific determinants of ZIKV virulence that are evident in only
Ifnar1
−/−
mice but not
Ifnar1
−/−
Ifngr1
−/−
DKO mice. These results identify a balanced polymorphism in the E protein that is sufficient to attenuate the PRVABC59 strain but not H/PF/2013. We further identify a second virulence determinant in the H/PF/2013 strain, which is driven by the viral nucleotide sequence but not the amino acid sequence. Altogether, our work identifies a large and previously unreported difference in virulence between two commonly used ZIKV strains, in two widely used mouse models of ZIKV pathogenesis. Our results highlight that even very closely related virus strains can produce significantly different pathogenic phenotypes in common laboratory models.
Human Immunodeficiency Virus Type 1 and Methamphetamine-Mediated Mitochondrial Damage and Neuronal Degeneration in Human Neurons
Authors: Teodorof-Diedrich Carmen , Spector Stephen A.
Published: August 2020

Human and animal studies show that HIV infection, combined with the long-term use of psychostimulants, increases neuronal stress and the occurrence of HIV-associated neurocognitive disorders (HAND). On the cellular level, mitochondrial function is critical for neuronal health. In this study, we show that in human primary neurons, the combination of HIV proteins and methamphetamine increases oxidative stress, DRP1-mediated mitochondrial fragmentation, and neuronal injury manifested by a reduction in neuronal network and connectivity. The use of NAC, a potent antioxidant, reversed the neurotoxic effects of HIV and methamphetamine, suggesting a novel approach to ameliorate the effects of HIV- and methamphetamine-associated cognitive deficits.
A Novel High-Potency Tetanus Vaccine
Authors: Przedpelski Amanda , Tepp William H. , Pellett Sabine , Johnson Eric A. , Barbieri Joseph T.
Published: August 2020

Chemical inactivation is a clinically effective mechanism to detoxify protein toxins to produce vaccines against microbial infections and to serve as a platform for production of conjugate polysaccharide vaccines. This method is widely used for the production of protein toxin vaccines, including tetanus toxoid. However, chemical modification alters the protein structure with unknown effects on antigenicity. Here, a recombinant full-length tetanus toxin (TT) is engineered with 8 mutations (8MTT) that inactivate three toxin functions: catalysis, translocation, and receptor binding. 8MTT is nontoxic and elicits a potent immune response in outbred mice. 8MTT also represents a malleable platform for the production of conjugate vaccines, which can facilitate a rapid vaccine response against emerging microbial pathogens.
A Genome-Wide CRISPR/Cas9 Screen Reveals that Riboflavin Regulates Hydrogen Peroxide Entry into HAP1 Cells
Authors: Chidawanyika Tamutenda , Mark Kenneth M. K. , Supattapone Surachai
Published: August 2020

Using a genetic screen, we discovered that riboflavin controls the entry of hydrogen peroxide into a white blood cell line. To our knowledge, this is the first report of a vitamin playing a role in controlling transport of a small molecule across the cell membrane.
A Model
Roseobacter
, Ruegeria pomeroyi DSS-3, Employs a Diffusible Killing Mechanism To Eliminate Competitors
Authors: Sharpe Garrett C. , Gifford Scott M. , Septer Alecia N.
Published: August 2020

Bacteria carry out critical ecological and biogeochemical processes and form the foundations of ecosystems. Identifying the factors that influence microbial community composition and the functional capabilities encoded within them is key to predicting how microbes impact an ecosystem. Because microorganisms must compete for limited space and nutrients to promote their own propagation, they have evolved diverse mechanisms to outcompete or kill competitors. However, the genes and regulatory strategies that promote such competitive abilities are largely underexplored, particularly in free-living marine bacteria. Here, genetics and omics techniques are used to investigate how a model marine bacterium is capable of quickly eliminating natural competitors in coculture. We determined that a previously uncharacterized horizontally acquired gene cluster is required for this bacterium to kill diverse competitors. This work represents an important step toward understanding the mechanisms bacterial populations can use to become dominant members in marine microbial communities.
Shear-deformable hybrid finite-element formulation for lateral-torsional buckling analysis of composite thin-walled members
Authors: Erkmen R. Emre , Niki Vida , Afnani Ashkan
Published: August 2020

A shear deformable hybrid finite element formulation is developed for the lateral-torsional buckling analysis of fibre-reinforced composite thin-walled members with open cross-section. The method is developed by using the Hellinger–Reissner functional. Comparison to the displacement-based formulations the current hybrid formulation has the advantage of incorporating the shear deformation effects easily by using the strain energy of the shear stress field without modifying the basic kinematic assumptions of the thin-walled beam theory. Numerical results are validated through comparisons with results based on other formulations presented in the literature. Examples illustrate the effects of shear deformations and stacking sequence of the composite layers in predicting bucking loads.
RKKY interaction in topological crystalline insulators
Authors: Ganjipour Seyyed Hosein
Published: August 2020

We theoretically study the Ruderman–Kittle–Kasuya–Yosida (RKKY) interaction between two magnetic impurities embedded on the (001) surface of a topological crystalline insulator (TCI), using the Green’s function method. The highly anisotropic band structure of TCI, gives rise to a highly anisotropic magnetic exchange coupling. We show that the interaction is oscillatory; the amplitude and wavelength of oscillations have angular dependence arising from the anisotropy of the surface state band structure. The spatial configurations of the magnetic impurities can also dramatically change the quality and quantity of the RKKY interaction. We find a strong anisotropy of the exchange interaction and the magnetic ground state of two magnetic adatoms can be tuned by changing the rotational configuration of impurities. It is found that the three types of interactions contribute to the magnetic exchange coupling in the (001) TCI surfaces: the Heisenberg, Dzyaloshinsky–Moriya, and Ising types. Our results will open up a new route toward spintronics based on TCIs.
SIR approach in modeling data packets forwarding at a leaky bucket
Authors: Zhang Yaming , Koura Yaya H. , Su Yanyuan
Published: August 2020

When network users are intensively interacting during rush hour, avoiding data loss and latency is a concern in guaranteeing segment reliability. Implementing a leaky bucket could be needed to achieve flows effective monitoring by generating network of queues at given output link. Packets associated with different sessions and originated from different hosts may be mixed up and queuing delay may become longer, depending on network segment state, buffering strategy, users’ behavior among other factors. It is interesting to assimilate these stages of packets traveling through network segment to the concept of epidemic control. This paper proposes a SIR (Susceptible–Infected–Recovered) approach in modeling data packets transmission at a leaky bucket at peak hour. We focused our analysis on packets buffering and recovery strategy impact on segment forwarding performance in heavy load situation. Numerical results suggested adapting buffering strategy and packets recovery to enhance transmission and network overall performance.
Example-Based Microstructure Rendering with Constant Storage
Authors: Wang Beibei , Hašan Miloš , Holzschuch Nicolas , Yan Ling-Qi
Published: August 2020

Rendering glinty details from specular microstructure enhances the level of realism, but previous methods require heavy storage for the high-resolution height field or normal map and associated acceleration structures. In this article, we aim at dynamically generating theoretically infinite microstructure, preventing obvious tiling artifacts, while achieving constant storage cost. Unlike traditional texture synthesis, our method supports arbitrary point and range queries, and is essentially generating the microstructure implicitly. Our method fits the widely used microfacet rendering framework with multiple importance sampling (MIS), replacing the commonly used microfacet normal distribution functions (NDFs) like ground glass distribution (GGX) by a detailed local solution, with a small amount of runtime performance overhead.
Communication—Design, Development, and Evaluation of a High Resolution, Customizable 3D-Printed Flow-Type Electrochemical Microcell
Authors: Summers Kodi , Chidambaram Dev
Published: August 2020

Advances in 3D-printing technology was used to design and develop a customizable flow-type electrochemical microcell with analytical resolution similar to conventional glass capillary-based microcells. The advantages of this design are better and easier reproducibility, increased durability, and better control over design parameters. 3D printing was combined with conventional machining to enable rapid prototyping and testing of various flow designs and apertures sizes. Results from potentiodynamic polarization of copper demonstrated repeatability and accuracy in spatial resolution. Reproducibility of experimental area had 1.9% variation between different spots. The ease of use and endurance of the design was demonstrated through repeated use.
Mitochondrial-derived peptides in energy metabolism
Authors: Merry Troy L. , Chan Alex , Woodhead Jonathan S. T. , Reynolds Joseph C. , Kumagai Hiroshi , Kim Su-Jeong , Lee Changhan
Published: August 2020

Mitochondrial-derived peptides (MDPs) are small bioactive peptides encoded by short open-reading frames (sORF) in mitochondrial DNA that do not necessarily have traditional hallmarks of protein-coding genes. To date, eight MDPs have been identified, all of which have been shown to have various cyto- or metaboloprotective properties. The 12S ribosomal RNA ( MT-RNR1) gene harbors the sequence for MOTS-c, whereas the other seven MDPs [humanin and small humanin-like peptides (SHLP) 1–6] are encoded by the 16S ribosomal RNA gene. Here, we review the evidence that endogenous MDPs are sensitive to changes in metabolism, showing that metabolic conditions like obesity, diabetes, and aging are associated with lower circulating MDPs, whereas in humans muscle MDP expression is upregulated in response to stress that perturbs the mitochondria like exercise, some mtDNA mutation-associated diseases, and healthy aging, which potentially suggests a tissue-specific response aimed at restoring cellular or mitochondrial homeostasis. Consistent with this, treatment of rodents with humanin, MOTS-c, and SHLP2 can enhance insulin sensitivity and offer protection against a range of age-associated metabolic disorders. Furthermore, assessing how mtDNA variants alter the functions of MDPs is beginning to provide evidence that MDPs are metabolic signal transducers in humans. Taken together, MDPs appear to form an important aspect of a retrograde signaling network that communicates mitochondrial status with the wider cell and to distal tissues to modulate adaptative responses to metabolic stress. It remains to be fully determined whether the metaboloprotective properties of MDPs can be harnessed into therapies for metabolic disease.
Autophagy in Age-Related Macular Degeneration: A Regulatory Mechanism of Oxidative Stress
Authors: Zhang Zi-Yuan , Bao Xiao-Li , Cong Yun-Yi , Fan Bin , Li Guang-Yu
Published: August 2020

Age-related macular degeneration (AMD) is a leading cause of severe visual loss and irreversible blindness in the elderly population worldwide. Retinal pigment epithelial (RPE) cells are the major site of pathological alterations in AMD. They are responsible for the phagocytosis of shed photoreceptor outer segments (POSs) and clearance of cellular waste under physiological conditions. Age-related, cumulative oxidative stimuli contribute to the pathogenesis of AMD. Excessive oxidative stress induces RPE cell degeneration and incomplete digestion of POSs, leading to the continuous accumulation of cellular waste (such as lipofuscin). Autophagy is a major system of degradation of damaged or unnecessary proteins. However, degenerative RPE cells in AMD patients cannot perform autophagy sufficiently to resist oxidative damage. Increasing evidence supports the idea that enhancing the autophagic process can properly alleviate oxidative injury in AMD and protect RPE and photoreceptor cells from degeneration and death, although overactivated autophagy may lead to cell death at early stages of retinal degenerative diseases. The crosstalk among the NFE2L2, PGC-1, p62, AMPK, and PI3K/Akt/mTOR pathways may play a crucial role in improving disturbed autophagy and mitigating the progression of AMD. In this review, we discuss how autophagy prevents oxidative damage in AMD, summarize potential neuroprotective strategies for therapeutic interventions, and provide an overview of these neuroprotective mechanisms.
Atypical Presentation of Severe Dengue in a Patient following a Major Abdominal Surgery
Authors: Jayarajah Umesh , Basnayake Oshan , Nagodavithane Kavinda , Jayasinghe Jayan , Samarasekera Dharmabandhu N.
Published: August 2020

Severe dengue infections in a postoperative patient may lead to significant derangement in the body’s homeostasis resulting in morbidity and sometimes even mortality. Reports on presentation and clinical manifestations of dengue in patients following major surgical procedures are scarce and restricted to few case reports. We describe a 26-year-old male with atypical presentation and late detection of dengue haemorrhagic fever following a major abdominal surgery. On postoperative day 6, he developed spontaneous bleeding from the drain site and moderate-to-massive bilateral pleural effusion with respiratory distress. His dengue IgM and IgG were positive. Therefore, a diagnosis of dengue haemorrhagic fever with bilateral lower zone pneumonia was made. A right-sided intercostal tube was inserted. Intensive care was given and was managed with intravenous antibiotics, targeted fluid therapy, and supportive care. He recovered from the infection and was discharged uneventfully. This case is unique because during the postoperative period, he went into critical phase with significant fluid leakage and developed bleeding manifestations without a clear febrile phase and deterioration in the haemodynamic parameters. High degree of suspicion and early detection are necessary to guide the fluid therapy and provide organ support in such patients.
Patient-Specific CT-Based Fluid-Structure-Interaction Aorta Model to Quantify Mechanical Conditions for the Investigation of Ascending Aortic Dilation in TOF Patients
Authors: Zuo Heng , Ling Yunfei , Li Peng , An Qi , Zhou Xiaobo
Published: August 2020

Background. Some adult patients with Tetralogy of Fallot (TOF) were found to simultaneously develop ascending aortic dilation. Severe aortic dilation would lead to several aortic diseases, including aortic aneurysm and dissection, which seriously affect patients’ living quality and even cause patients’ death. Current practice guidelines of aortic-dilation-related diseases mainly focus on aortic diameter, which has been found not always a good indicator. Therefore, it may be clinically useful to identify some other factors that can potentially better predict aortic response to dilation. Methods. 20 TOF patients scheduled for TOF repair surgery were recruited in this study and were divided into dilated and nondilated groups according to the Z scores of ascending aorta diameters. Patient-specific aortic CT images, pressure, and flow rates were used in the construction of computational biomechanical models. Results. Simulation results demonstrated a good coincidence between numerical mean flow rate at inlet and the one obtained from color Doppler ultrasonography, which implied that computational models were able to simulate the movement of the aorta and blood inside accurately. Our results indicated that aortic stress can effectively differentiate patients of the dilated group from the ones of the nondilated group. Mean ascending aortic stress-P1 (maximal principal stress) from the dilated group was 54% higher than that from the nondilated group (97.97 kPa vs. 63.47 kPa, p value = 0.044) under systolic pressure. Velocity magnitude in the aorta and aortic wall displacement of the dilated group were also greater than those of the nondilated group with p value < 0.1. Conclusion. Computational modeling and ascending aortic biomechanical factors may be used as a potential tool to identify and analyze aortic response to dilation. Large-scale clinical studies are needed to validate these preliminary findings.
Functional Evaluation of Upper Urinary Tract with Diuretic Mercaptoacetyltriglycine Renal Scans in Patients with Benign Prostatic Obstruction before and after Surgical Intervention: A Pilot Study
Authors: Cho Sung Yong , Ko Kyungtae , Koo Kyo Chul , Kim Hyung Joon , Bang Woo Jin , Choo Min Soo , Lee Sang Hyub , Yoon Young Eun , Jung Wonho , Choi Jae Young , Lee Dong Sup ,   Young Endourological Study (YES) Group
Published: August 2020

Introduction. We investigated which benign prostatic hyperplasia‐related lower urinary parameters are related to upper urinary tract obstruction and whether transurethral prostatectomy could improve upper urinary tract obstruction. Materials and Methods. Patients with prostate size over 30 g and urodynamically proven bladder outlet obstruction were enrolled in this prospective observational study. Bladder wall thickness and prostate size were measured by ultrasonography. A urodynamic study with laboratory tests including serum creatinine, prostate‐specific antigen, and urinalysis was performed. Finally, a diuretic scintigraphy using mercaptoacetyltriglycine was performed. Tests except the urodynamic evaluation were repeated after transurethral prostatectomy. Results. In total, 24 patients were enrolled, and 19 patients completed the present study. The mean values of age (yrs), prostate size (mL), bladder thickness (mm), bladder compliance (ΔmL/Δpr), and the bladder outlet obstruction index were 68.42 ± 8.25, 72.29 ± 32.78, 4.42 ± 1.14, 50.17 ± 32.15, and 82.11 ± 34.68, respectively. The mean T1/2 (min) was 17.51 ± 16.34 on the left side and 15.30 ± 11.96 on the right side. Statistical analysis showed that bladder compliance and bladder thickness were preoperatively related to upper urinary tract obstruction (p = 0.001 and p = 0.007, respectively). Diuretic mercaptoacetyltriglycine scan in 19 patients showed improvement 6 months after prostate surgery. Clinically significant proteinuria was associated with upper urinary tract obstruction, and proteinuria was also improved after prostate surgery. Conclusion. Storage‐phase bladder dysfunction could be a reliable urodynamic factor for the indication of upper urinary tract obstruction in patients with benign prostatic hyperplasia, and upper urinary tract obstruction with subsequent kidney damage could be improved by surgical decompression of benign prostatic obstruction.
Epidemiological Trends in the Form of Childhood Tuberculosis in a Referral Tuberculosis Hospital in Shandong, China
Authors: Wang Mao-Shui , Wang Jun-Li , Liu Xin-Jie
Published: August 2020

Background. In China, the prevalence of tuberculosis (TB) diseases and epidemiological trends in the TB forms among children are still unclear; a retrospective study was conducted aiming to assess it. Methods. Between January 2007 and September 2020, 1577 consecutive childhood TB patients (aged ≤ 15 years) were included in the study. Data, including demographic information and underlying diseases, were collected from medical records. Then, patients were categorized and reported according to the anatomical site of TB disease. To analyze the epidemiological trends in the proportion of each form of TB disease, a linear‐by‐linear association was used, and a P value of <0.05 was considered to indicate that a significant change had occurred in the proportion of TB disease over the studied period. Results. During the fourteen‐year study period, a total of 1577 children patients were enrolled, including 954 boys (60.5%) and 623 girls (39.5%), with a mean age of 9.26 ± 5.18 years. Among the studied patients, 810 (51.4%) patients have pulmonary TB, 1137 (72.1%) have extrapulmonary TB, 372 (23.6%) have both conditions, and another 765 (48.5%) extrapulmonary cases presented in isolated form. Pleural TB (29.0%) and tuberculous lymphadenitis (23.7%) were the most frequent two forms of childhood TB. In addition, during the past decade, the proportions of pulmonary TB, pleural TB, and tuberculous lymphadenitis showed an increasing trend (all P < 0.05). However, no significant trends in the proportions of other forms of TB disease, such as extrapulmonary TB (P > 0.05), tuberculous meningitis (P > 0.05), endobronchial TB (P > 0.05), and disseminated TB (P > 0.05), were found. Conclusion. Our findings suggest that childhood TB is facing new challenges, and the policy should be adjusted timely to fit the real situation.
Valuable Role of Neutrophil CD64 and Highly Sensitive CRP Biomarkers for Diagnostic, Monitoring, and Prognostic Evaluations of Sepsis Patients in Neonatal ICUs
Authors: Hashem Heba E. , El Masry Sherin A. , Mokhtar Amira M. , Ismail Eman A. , Abdelaal Noureldin M.
Published: August 2020

Background. Neonatal sepsis (NS) is a very critical medical situation associated with high morbidities and mortalities. There is an utmost need for a new tool helping in early diagnosis and proper management of sepsis neonates. Neutrophil CD64 (nCD64) shows a very promising value in this concerning issue. Aim. Evaluate the diagnostic, monitoring, and prognostic performances of nCD64 and highly sensitive CRP (hs‐CRP) in NS as well as the possible best panel of biomarkers that can achieve the most desirable results. Methods. Patients were enrolled from three neonatal intensive care units (NICUs) (n = 121 patients) and classified according to their initial sepsis evaluation into three groups: disease control group (n = 30), proven sepsis group (n = 17), and clinical sepsis group (n = 74). Laboratory evaluation included hs‐CRP, complete blood count (CBC), and blood culture in addition to nCD64 (done by flow cytometry technique). Besides the diagnostic evaluations, follow‐up evaluations were done for 40 patients after five days from the first time; patients were reclassified according to their outcome into the improved sepsis neonates’ group (n = 26) and sepsis neonates without improvement (n = 14). Results. Significant increase in nCD64 and hs‐CRP results were present in sepsis groups compared to the disease controls (P < 0.001); nCD64 at 43% cutoff value could detect the presence of sepsis with 85.6% sensitivity and 93% specificity. Additionally, delta change percentage (dC%) between improved sepsis neonates and sepsis neonates without improvement showed a significant difference in the levels of both nCD64 (P < 0.001) and hs‐CRP (P = 0.001). Conclusion. Besides the promising diagnostic performance documented by nCD64 which is higher than the other laboratory sepsis biomarkers used routinely in NICUs, nCD64 has a valuable role in sepsis patients’ monitoring and prognostic evaluation. hs‐CRP was moderate in its diagnostic and monitoring results being less than that achieved by nCD64. Combined measurement of nCD64% and hs‐CRP gives better diagnostic and monitoring performance than that achieved by any of them alone.
A Successful Treatment Regimen for the Prevention of Sinusitis after Maxillary Sinus Floor Elevation Surgery in a High-Risk Case
Authors: Suzuki-Yamazaki Mikiko , Takahashi Keiso , Takada Satoshi , Kato Yasumasa , Baba Yuh
Published: August 2020

Maxillary sinus floor elevation (sinus lift) is a widely recognized dental-surgical approach for dental implant placement. However, for an otorhinolaryngological high-risk patient with severe anatomic-structural impairments of the maxillary sinus drainage pathway, surgical intervention is recommended before sinus lift to avoid postsinus lift maxillary sinusitis. Here, we show a case that postsinus lift maxillary sinusitis in such a high-risk patient was noninvasively prevented by the collaboration of otorhinolaryngologist and dentist. A 48-year-old Japanese male intended to undergo a sinus lift for dental implant placement by periodontist. Otorhinolaryngologist found septal deviation, concha bullosa, the presence of Haller cell, and nasal mucosal swelling by the nasal allergy, while no sinusitis and diagnosed him as a “high-risk case” for postsinus lift maxillary sinusitis. The patient was administered preoperative topical steroid and leukotriene receptor antagonist in addition to perioperative antibiotic prophylaxis so that his complication was noninvasively prevented. Thus, this case suggested that consultation from dentist to otorhinolaryngologist provides benefit to the patients who have been diagnosed as “high-risk case” for postsinus lift maxillary sinusitis.
DE-CNN: An Improved Identity Recognition Algorithm Based on the Emotional Electroencephalography
Authors: Wang Yingdong , Wu Qingfeng , Wang Chen , Ruan Qunsheng
Published: August 2020

In the past few decades, identification recognition based on electroencephalography (EEG) has received extensive attention to resolve the security problems of conventional biometric systems. In the present study, a novel EEG-based identification system with different entropy and a continuous convolution neural network (CNN) classifier is proposed. The performance of the proposed method is experimentally evaluated through the emotional EEG data. The conducted experiment shows that the proposed method approaches the stunning accuracy (ACC) of 99.7% on average and can rapidly train and update the DE-CNN model. Then, the effects of different emotions and the impact of different time intervals on the identification performance are investigated. Obtained results show that different emotions affect the identification accuracy, where the negative and neutral mood EEG has a better robustness than positive emotions. For a video signal as the EEG stimulant, it is found that the proposed method with 0–75 Hz is more robust than a single band, while the 15–32 Hz band presents overfitting and reduces the accuracy of the cross-emotion test. It is concluded that time interval reduces the accuracy and the 15–32 Hz band has the best compatibility in terms of the attenuation.
An Update on the Emerging Role of Visfatin in the Pathogenesis of Osteoarthritis and Pharmacological Intervention
Authors: Han Dong-Feng , Li Yang , Xu Hui-Ying , Li Rong-Hang , Zhao Ding
Published: August 2020

Osteoarthritis (OA) is one of the most common degenerative joint diseases that affects millions of people worldwide, mainly the aging population. Despite numerous published reports, little is known about the pathology of this disease, and no feasible treatment plan exists to stop OA progression. Recently, extensive basic and clinical studies have shown that adipokines play a key role in OA development. Moreover, some drugs associated with adipokines have shown chondroprotective and anti‐inflammatory effects on OA. Visfatin has been shown to play a detrimental role in the progression of OA. It increases the production of matrix metalloproteinases and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), induces the production of interleukin (IL)‐1β, IL‐6, and tumor necrosis factor‐α, affects the differentiation of mesenchymal stem cells to adipocytes, and induces osteophyte formation by inhibiting osteoclastogenesis. Although some side effects of chemical visfatin inhibitors have been reported, they were shown to be successful in the treatment of diabetes, cancer, and other diseases that can utilize Chinese herbs, further suggesting that similar therapeutic strategies could be used in OA prevention and treatment. Here, we describe the pathophysiological mechanism of visfatin in OA and discuss some potential pharmacological interventions using Chinese herbs.
Acute Joint Blockage due to Abrasion-Related Dislocation of a Silastic Radial Head Prosthesis: A Histological Examination after 14 Years of Durability
Authors: Meyer Heinz-Lothar , Polan Christina , Bernstein Anke , Abel Benedikt , Burggraf Manuel , Dudda Marcel , Kauther Max Daniel
Published: August 2020

The implantation of a radial head prosthesis can take place as a therapeutic option after radial head fracture. There are various implants for this purpose. Many studies and case reports about silastic radial head prosthesis implantation describe foreign body reactions with accompanying synovitis and poor functional results. A few studies have investigated the reason for the material failure and the accompanying synovitis. The case report presented shows an unusually long durability of an in situ 14-year silastic radial head prosthesis. 14 years after implantation, a previously full-time working and healthy patient presented himself with a dislocation of the silastic radial head prosthesis and atraumatic joint blockage of the right elbow triggered by a negligible movement. The prosthesis was removed surgically. We found a macroscopic foreign body reaction intraoperatively. In a histopathological examination, with hematoxylin and eosin staining (HE) in 40x and 100x magnification, we have seen an aseptic inflammatory response to foreign bodies with activated epithelial cells and multinucleated giant cells with intracytoplasmic foreign material. Due to these problems, the silastic radial head prosthesis is no longer used today. However, there are still patients with the implanted silastic radial head prosthesis, which should therefore be checked regularly. A metal prosthesis also does not seem to be an optimal alternative due to cartilage wear and loss of ROM. The choice of prosthesis material should be selected carefully and patient-specific in radial head prosthetics according of the results presented.
Recurrent Multifocal Mycoplasma orale Infection in an Immunocompromised Patient: A Case Report and Review
Authors: Ketchersid Jeffrey , Scott Jake , Lew Thomas , Banaei Niaz , Kappagoda Shanthi
Published: August 2020

A young woman with mixed connective tissue disease complicated by erosive arthritis, secondary hypogammaglobulinemia due to rituximab, and a history of many infectious complications developed multiple nonhealing wounds, polyarticular joint pain, and leukocytosis. Radiographic studies demonstrated multiple scattered areas of osteomyelitis and complex abscesses. Purulent fluid drained from multiple sites did not yield a microbiologic diagnosis by standard culture technique, but Mycoplasma orale was ultimately identified using 16 S ribosomal RNA gene amplification and sequencing. We describe this unique case and review the literature.
Euglycemic Ketoacidosis in a Patient with Metastatic Non-Small-Cell Lung Adenocarcinoma and Concomitant Pulmonary Embolism
Authors: O’Neill Robert Sean , Tyack Lauren , Freeman Mary , Hussein Hussein Soudy
Published: August 2020

Euglycemic ketoacidosis is a recognised side effect secondary to sodium-glucose cotransporter 2 inhibitor use in the treatment of type 2 diabetes mellitus; however, there is scarce evidence to suggest whether preexisting comorbid conditions contribute to the development of this potentially life-threatening complication. We describe a case of euglycemic ketoacidosis in a patient with type 2 diabetes mellitus in the context of empagliflozin use after a recent diagnosis of metastatic lung adenocarcinoma. The diagnosis was complicated by a pulmonary embolism and hospital-acquired pneumonia, and was subsequently established after an anion-gap metabolic acidosis was identified on arterial blood gas and serum ketone measurement. The patient required admission to the intensive care unit for fluid resuscitation and regular intravenous insulin to ensure resolution of acidosis and maintenance of normoglycaemia. The patient was discharged to home for outpatient single-agent pembrolizumab for treatment of his lung adenocarcinoma. This article highlights the importance or awareness of oral hypoglycaemic medications and their side effects, along with providing further evidence for the potential contribution of malignancy to the development of euglycemic ketoacidosis in a patient with type 2 diabetes mellitus.