bluuebunny/crossref_metadata_2025 huggingface dataset:
The Realization of Clinker-Reduced, Performance-Based Sustainable Concrete by the Micro-Filler, Eco-Filler Concept
Authors: Juhart Joachim , Autischer Michael , Sakoparnig Marlene , Krüger Markus
Published: August 2021

In times of climate change, the reduction in embodied greenhouse gas emissions is a premise for sustainable concrete infrastructure. As Portland cement clinker is mainly responsible for the high CO2 emissions of concrete, its reduction is necessary. In order to be sustainable, the concrete must meet processing, mechanical and durability properties while taking cost aspects into account. The paper presents (i) the “micro-filler/eco-filler concept” for achieving a clinker reduced, optimised binder and (ii) a performance-based approach to put sustainable “Eco-concrete” into practice. Clinker is substituted by locally available inert fillers by at least two different particle size fractions and supplementary cementitious materials. The method is based on particle packing optimisation, reduction in water demand and optimisation of the mix ratio of the binder blend, which allows the performance requirements to be met. The new Eco-concretes deliver the desired performance in terms of processability, strength and durability (water penetration, frost, carbonation and chloride resistance) while lowering the environmental impact in comparison to standard concrete. One of the new mixes was used for a small animal passage tunnel. The direct comparison of the developed Eco-concrete and standard concrete showed a 24% reduction in CO2, while achieving satisfactory workability, stripping strength and durability performance.
A Theoretical Model for Debonding Prediction in the RC Beams Externally Strengthened with Steel Strip and Inorganic Matrix
Authors: Bencardino Francesco , Nisticò Mattia
Published: August 2021

This paper shows a theoretical model for predicting the moment–curvature/load–deflection relationships and debonding failure of reinforced concrete (RC) beams externally strengthened with steel reinforced geopolymeric matrix (SRGM) or steel reinforced grout (SRG) systems. Force equilibrium and strain compatibility equations for a beam section divided into several segments are numerically solved using non-linear behaviour of concrete and internal steel bars. The deflection is then obtained from the flexural stiffness at a mid-span section. Considering the appropriate SRGM-concrete bond–slip law, calibrated on single-lap shear bond tests, both end and intermediate debonding failures are analysed. To predict the end debonding, an anchorage strength model is adopted. To predict intermediate debonding, at each pair of flexural cracks a shear stress limitation is placed at concrete–matrix interface and the differential problem is solved at steel strip–matrix interface. Based on the theoretical predictions, the comparisons with experimental data show that the proposed model can accurately predict the structural response of SRGM/SRG strengthened RC beams. It can be a useful tool for evaluating the behaviour of externally strengthened RC beams, avoiding experimental tests.
Microstructure and Corrosion Resistance of Underwater Laser Cladded Duplex Stainless Steel Coating after Underwater Laser Remelting Processing
Authors: Li Congwei , Zhu Jialei , Cai Zhihai , Mei Le , Jiao Xiangdong , Du Xian , Wang Kai
Published: August 2021

Combined with the technologies of underwater local dry laser cladding (ULDLC) and underwater local dry laser remelting (ULDLR), a duplex stainless steel (DSS) coating has been made in an underwater environment. The phase composition, microstructure, chemical components and electrochemical corrosion resistance was studied. The results show that after underwater laser remelting, the phase composition of DSS coating remains unchanged and the phase transformation from Widmanstätten austenite + intragranular austenite + (211) ferrite to (110) ferrite occurred. The ULDLR process can improve the corrosion resistance of the underwater local dry laser cladded coating. The corrosion resistance of remelted coating at 3 kW is the best, the corrosion resistance of remelted coating at 1kW and 5kW is similar and the corrosion resistance of (110) ferrite phase is better than grain boundary austenite phase. The ULDLC + ULDLR process can meet the requirements of efficient underwater maintenance, forming quality control and corrosion resistance. It can also be used to repair the surface of S32101 duplex stainless steel in underwater environment.
Parameter Study on Friction Surfacing of AISI316Ti Stainless Steel over EN8 Carbon Steel and Its Effect on Coating Dimensions and Bond Strength
Authors: Rethnam George S. N. , Manivel Subramanian , Sharma Vijay K. , Srinivas Chidurala , Afzal Asif , Razak R.K. Abdul , Alamri Sagr , Saleel C. Ahamed
Published: August 2021

Friction surfacing is a solid-state coating process that uses plastic deformation to improve the efficiency of the core metallic pattern, resulting in fine-grained coatings with superior wear and corrosion properties. This article focuses on the development of inherently homogeneous, non-diluted coating of AISI316Ti stainless steel above EN8 and also encloses the empirical relationship for the prediction of bond strength (Bs), coating thickness (Ct), and coating width (Cw). The key individualities for bonding geometry were believed to be the process parameters such as rotational speed (rpm), traverse speed (mm/s), and axial load (kN). The effect of input parameters on the bond’s external dimensions and strength was investigated using a multi-objective optimization approach through experimentation. The bond’s strength improved as the coating thickness was reduced and the coating width was increased. The grain-refined coatings superimposing martensitic microstructure with no deposition of carbide particles added value to the metallurgical study using the scanning electron microscope.
Study of Lapping and Polishing Performance on Lithium Niobate Single Crystals
Authors: Muratov Karim Ravilevich , Ablyaz Timur Rizovich , Gashev Evgeny Anatolevich , Sidhu Sarabjeet Singh , Shlykov Evgeny Sergeevich
Published: August 2021

Recently, the range of crystal materials used in industrial microelectronics has significantly increased. Lithium niobate single crystals are most often used in integrated optics, due to the high values of optical and electro-optical coefficients. An integral-optical circuit based on a lithium niobate single crystal is a key element in the production of local high-precision fiber-optic gyroscopic devices used in civil and military aviation and marine technologies. In the process of production of an integral-optical circuit, the most labor-intensive operations are mechanical processing, such as lapping and polishing. Technological problems that arise while performing these operations are due to the physical and mechanical properties of the material, as well as target surface finish. This work shows the possibility to achieve the required surface quality of lithium niobate single crystal plates by mechanization of lapping and polishing process in this article.
Corrosion Behavior of Niobium-Coated 316L Stainless Steels as Metal Bipolar Plates for Polymer Electrolyte Membrane Fuel Cells
Authors: Kim Yu-Sung , Lee In-Sik , Choi Jin-Young , Jun Shinhee , Kim Daeil , Cha Byung-Chul , Kim Dae-Wook
Published: August 2021

Niobium was coated on 316L stainless steel by pulsed direct-current (DC) magnetron sputtering to improve corrosion behavior. The applied bias voltage highly affected the microstructure and crystallographic features, which lead to improved corrosion behavior. Due to the increased bias voltage, the microstructure of the niobium coating layer presented a smaller crystallite size and a densified structure, which obviously reduced the number of pinholes in the coated layer. Additionally, an increase in the degree of orientation toward the (110) plane, the most densely packed plane, lead to reduced dissolution of metal ions. Therefore, a pure niobium coating layer effectively protected the metal bipolar plate from a highly corrosive environment of polymer electrolyte membrane fuel cell (PEMFC) stacks. In particular, higher bias voltages of 600 and 800 V induced improved corrosion resistance, which satisfied the demand for the bipolar plate.
A Mathematical Analysis of HDV Genotypes: From Molecules to Cells
Authors: Zakh Rami , Churkin Alexander , Totzeck Franziska , Parr Marina , Tuller Tamir , Etzion Ohad , Dahari Harel , Roggendorf Michael , Frishman Dmitrij , Barash Danny
Published: August 2021

Hepatitis D virus (HDV) is classified according to eight genotypes. The various genotypes are included in the HDVdb database, where each HDV sequence is specified by its genotype. In this contribution, a mathematical analysis is performed on RNA sequences in HDVdb. The RNA folding predicted structures of the Genbank HDV genome sequences in HDVdb are classified according to their coarse-grain tree-graph representation. The analysis allows discarding in a simple and efficient way the vast majority of the sequences that exhibit a rod-like structure, which is important for the virus replication, to attempt to discover other biological functions by structure consideration. After the filtering, there remain only a small number of sequences that can be checked for their additional stem-loops besides the main one that is known to be responsible for virus replication. It is found that a few sequences contain an additional stem-loop that is responsible for RNA editing or other possible functions. These few sequences are grouped into two main classes, one that is well-known experimentally belonging to genotype 3 for patients from South America associated with RNA editing, and the other that is not known at present belonging to genotype 7 for patients from Cameroon. The possibility that another function besides virus replication reminiscent of the editing mechanism in HDV genotype 3 exists in HDV genotype 7 has not been explored before and is predicted by eigenvalue analysis. Finally, when comparing native and shuffled sequences, it is shown that HDV sequences belonging to all genotypes are accentuated in their mutational robustness and thermodynamic stability as compared to other viruses that were subjected to such an analysis.
Weighted Fractional-Order Transform Based on Periodic Matrix
Authors: Zhao Tieyu , Chi Yingying
Published: August 2021

Tao et al. proposed the definition of the linear summation of fractional-order matrices based on the theory of Yeh and Pei. This definition was further extended and applied to image encryption. In this paper, we propose a reformulation of the definitions of Yeh et al. and Tao et al. and analyze them theoretically. The results show that many weighted terms are invalid. Therefore, we use the proposed reformulation to prove that the effective weighted terms depend on the period of the matrix. This also shows that the image encryption methods based on the weighted fractional-order transform will lead to the security risk of key invalidation. Finally, our hypothesis is verified by the unified theoretical framework of multiple-parameter discrete fractional-order transforms.
Intelligent Decision Support System for Predicting Student’s E-Learning Performance Using Ensemble Machine Learning
Authors: Saleem Farrukh , Ullah Zahid , Fakieh Bahjat , Kateb Faris
Published: August 2021

Electronic learning management systems provide live environments for students and faculty members to connect with their institutional online portals and perform educational activities virtually. Although modern technologies proactively support these online sessions, students’ active participation remains a challenge that has been discussed in previous research. Additionally, one concern for both parents and teachers is how to accurately measure student performance using different attributes collected during online sessions. Therefore, the research idea undertaken in this study is to understand and predict the performance of the students based on features extracted from electronic learning management systems. The dataset chosen in this study belongs to one of the learning management systems providing a number of features predicting student’s performance. The integrated machine learning model proposed in this research can be useful to make proactive and intelligent decisions according to student performance evaluated through the electronic system’s data. The proposed model consists of five traditional machine learning algorithms, which are further enhanced by applying four ensemble techniques: bagging, boosting, stacking, and voting. The overall F1 scores of the single models are as follows: DT (0.675), RF (0.777), GBT (0.714), NB (0.654), and KNN (0.664). The model performance has shown remarkable improvement using ensemble approaches. The stacking model by combining all five classifiers has outperformed and recorded the highest F1 score (0.8195) among other ensemble methods. The integration of the ML models has improved the prediction ratio and performed better than all other ensemble approaches. The proposed model can be useful for predicting student performance and helping educators to make informed decisions by proactively notifying the students.
Decision-Making under Group Commitment
Authors: Kalech Meir
Published: August 2021

Coordination is essential for establishing and sustaining teamwork. Agents in a team must agree on their tasks and plans, and thus, group decision-making techniques are necessary to reach agreements in teams. For instance, to agree on a joint task, the agents can provide their preferences for the alternative tasks, and the best alternative could be selected by majority. Previous works assumed that agents only provide their preferences for the alternatives. However, when selecting a joint task for teamwork, it is essential to consider not only the preferences of the agents, but also the probability of the agents being able to execute the task if it is selected. In this paper, we propose a novel model, the decIsion-MAking under Group commItmeNt modEl (IMAGINE), for computing the optimal decision for a team considering several parameters. Each agent provides: (1) the utility of each alternative for the team, (2) the associated cost for the agent by executing the alternative, and (3) the probability that the agent will be able to execute the alternative task. The IMAGINE gathers these data from the agents, as well as the requisite quorum for each alternative task, which is the minimum number of agents required to complete the task successfully. Given this information, the IMAGINE determines the optimal decision for the group. We evaluated the IMAGINE by comparing it to a baseline method that does not consider the quorum requirement. We show that the IMAGINE generally comes up with a better decision than the baseline method and that the higher the quorum, the better the decisions the IMAGINE makes are.
An Oblivious Approach to Machine Translation Quality Estimation
Authors: Elmakias Itamar , Vilenchik Dan
Published: August 2021

Machine translation (MT) is being used by millions of people daily, and therefore evaluating the quality of such systems is an important task. While human expert evaluation of MT output remains the most accurate method, it is not scalable by any means. Automatic procedures that perform the task of Machine Translation Quality Estimation (MT-QE) are typically trained on a large corpus of source–target sentence pairs, which are labeled with human judgment scores. Furthermore, the test set is typically drawn from the same distribution as the train. However, recently, interest in low-resource and unsupervised MT-QE has gained momentum. In this paper, we define and study a further restriction of the unsupervised MT-QE setting that we call oblivious MT-QE. Besides having no access no human judgment scores, the algorithm has no access to the test text’s distribution. We propose an oblivious MT-QE system based on a new notion of sentence cohesiveness that we introduce. We tested our system on standard competition datasets for various language pairs. In all cases, the performance of our system was comparable to the performance of the non-oblivious baseline system provided by the competition organizers. Our results suggest that reasonable MT-QE can be carried out even in the restrictive oblivious setting.
Frequency Domain Feature Extraction Investigation to Increase the Accuracy of an Intelligent Nondestructive System for Volume Fraction and Regime Determination of Gas-Water-Oil Three-Phase Flows
Authors: Taylan Osman , Sattari Mohammad Amir , Elhachfi Essoussi Imene , Nazemi Ehsan
Published: August 2021

In this research, a methodology consisting of an X-ray tube, one Pyrex-glass pipe, and two NaI detectors was investigated to determine the type of flow regimes and volume fractions of gas-oil-water three-phase flows. Three prevalent flow patterns—namely annular, stratified, and homogenous—in various volume percentages—10% to 80% with the step of 10%—were simulated by MCNP-X code. After simulating all the states and collecting the signals, the Fast Fourier Transform (FFT) was used to convert the data to the frequency domain. The first and second dominant frequency amplitudes were extracted to be used as the inputs of neural networks. Three Radial Basis Function Neural Networks (RBFNN) were trained for determining the type of flow regimes and predicting gas and water volume fractions. The correct detection of all flow regimes and the determination of volume percentages with a Mean Relative Error (MRE) of less than 2.02% shows that the use of frequency characteristics in determining these important parameters can be very effective. Although X-ray radiation-based two-phase flowmeters have a lot of advantages over the radioisotope-based ones, they suffer from lower measurement accuracy. One reason might be that the X-ray multi-energy spectrum recorded in the detector has been analyzed in a simple way. It is worth mentioning that the X-ray sources generate multi-energy photons despite radioisotopes that generate single energy photons, therefore data analyzing of radioisotope sources would be easier than X-ray ones. As mentioned, one of the problems researchers have encountered is the lower measurement accuracy of the X-ray, radiation-based three-phase flowmeters. The aim of the present work is to resolve this problem by improving the precision of the X-ray, radiation-based three-phase flowmeter using artificial neural network (ANN) and feature extraction techniques.
Sparse STATIS-Dual via Elastic Net
Authors: Rodríguez-Martínez Carmen C. , Cubilla-Montilla Mitzi , Vicente-Galindo Purificación , Galindo-Villardón Purificación
Published: August 2021

Multi-set multivariate data analysis methods provide a way to analyze a series of tables together. In particular, the STATIS-dual method is applied in data tables where individuals can vary from one table to another, but the variables that are analyzed remain fixed. However, when you have a large number of variables or indicators, interpretation through traditional multiple-set methods is complex. For this reason, in this paper, a new methodology is proposed, which we have called Sparse STATIS-dual. This implements the elastic net penalty technique which seeks to retain the most important variables of the model and obtain more precise and interpretable results. As a complement to the new methodology and to materialize its application to data tables with fixed variables, a package is created in the R programming language, under the name Sparse STATIS-dual. Finally, an application to real data is presented and a comparison of results is made between the STATIS-dual and the Sparse STATIS-dual. The proposed method improves the informative capacity of the data and offers more easily interpretable solutions.
Moderating Effect of Proactivity on Firm Absorptive Capacity and Performance: Empirical Evidence from Spanish Firms
Authors: Sancho-Zamora Rafael , Peña-García Isidro , Gutiérrez-Broncano Santiago , Hernández-Perlines Felipe
Published: August 2021

The purpose of this study was to understand how proactivity can affect the relationship between absorptive capacity and organisational performance. Most previous studies have ignored the role of proactivity in this relationship and have not considered the multidimensional nature of absorptive capacity. A questionnaire was sent to 800 CEOs of Spanish companies from different sectors, procuring a response rate of 38.25%. A structural equation model was applied to test the hypothesis. This study confirms the positive effect that absorptive capacity has on business performance and the moderating role of proactivity in this relationship. Companies that develop their capacity to absorb information from the environment achieve better results. Furthermore, if they engage in proactive behaviour within their company, this relationship is stronger. Future research should include more capacities that are related to knowledge and business performance (i.e., learning capability, innovation capacity, etc.). This study contributes to the understanding of how to manage a company’s knowledge in an appropriate way. It sheds new light on how knowledge management should be conducted, emphasising not only the gathering of information but also the promotion of a proactive attitude on the part of employees to achieve the goal of better performance.
Multi-Step Inertial Regularized Methods for Hierarchical Variational Inequality Problems Involving Generalized Lipschitzian Mappings
Authors: Jiang Bingnan , Wang Yuanheng , Yao Jen-Chih
Published: August 2021

In this paper, we construct two multi-step inertial regularized methods for hierarchical inequality problems involving generalized Lipschitzian and hemicontinuous mappings in Hilbert spaces. Then we present two strong convergence theorems and some numerical experiments to show the effectiveness and feasibility of our new iterative methods.
Transcatheter Aortic Valve Implantation in Younger Patients: A New Challenge
Authors: Virgili Giacomo , Romano Salvatore Mario , Valenti Renato , Migliorini Angela , Stefàno Pierluigi , Marchionni Niccolò , Carrabba Nazario
Published: August 2021

The number of aortic stenosis patients in Western countries is increasing, along with better life conditions and expectancies. Presently, the volume of percutaneous transcatheter aortic valve implantations (TAVIs) is incessantly increasing, and has already overcome the surgical replacement procedure volume. According to the literature, TAVI is a feasible procedure even among low surgical risk patients, and American guidelines have extended the indications for TAVI, including shifting patient evaluations from high/low STS scores to old/young patients, a “paradigm shift” of aortic stenosis evaluation. As a result, low-risk young (<75 years-old) population management could be the next challenge in cardiology. To manage the life conditions of a 65 year old patient affected by aortic stenosis who is undergoing TAVI, one of the most crucial issue will be bioprosthesis durability and the appropriate intervention to make in cases of valve dysfunction or failure.
Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation
Authors: van Knegsel Kenneth P. , Ganse Bergita , Haefeli Pascal C. , Migliorini Filippo , Scaglioni Mario F. , van de Wall Bryan J. M. , Kim Bong-Sung , Link Björn-Christian , Beeres Frank J. P. , Nebelung Sven , Schoeneberg Carsten , Hildebrand Frank , Gueorguiev Boyko , Knobe Matthias
Published: August 2021

Background and Objectives: Wound infections provoked by alterations in microcirculation are major complications in the treatment of trochanteric femur fractures. Surgical fracture fixation on a traction table is the gold standard for treatment, but the effect on tissue microcirculation is unknown. Microcirculation could be impaired by the pull on the soft-tissue or by a release of vasoactive factors. We hypothesized that intraoperative traction impairs soft-tissue microcirculation. Materials and Methods: In 22 patients (14 women, eight men), average age 78 years (range 36–96 ± 14), with trochanteric femur fractures, non-invasive laser-Doppler spectrophotometry was used to assess oxygen saturation, hemoglobin content, and blood flow in the skin and subcutaneous tissue before and after application of traction. Measurements were recorded in nine locations around the greater trochanter at a depth of 2, 8, and 15 mm before and after fracture reduction by traction. Results: No differences were found in any depth with traction compared to without (oxygen saturation: p = 0.751, p = 0.308, and p = 0.955, haemoglobin content: p = 0.651, p = 0.928, and p = 0.926, blood flow: p = 0.829, p = 0.866, and p = 0.411). Conclusion: In this pilot study, the application of traction does not affect skin and subcutaneous microcirculation in the surgery of proximal femur fractures.
Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
Authors: Shin Dong-Geum , Shin Sang-Deock , Han Donghoon , Kang Min-Kyung , Lee Seung-Hun , Kim Jihoon , Cho Jung-Rae , Kim Kunil , Choi Seonghoon , Lee Namho
Published: August 2021

Background and Objectives: Extracorporeal membrane oxygenation (ECMO) can be helpful in patients with cardiogenic shock associated with myocardial infarction, and its early use can improve the patient survival rate. In this study, we report a mortality rate-difference analysis that examined the time and location of shock occurrence. Materials and Methods: We enrolled patients who underwent ECMO due to cardiogenic shock related to myocardial infarction and assigned them to either a pre- or post-admission shock group. The primary outcome was the 1-month mortality rate; a subgroup analysis was conducted to assess the effect of bailout ECMO. Results: Of the 113 patients enrolled, 67 (38 with pre-admission shock, 29 with post-admission shock) were analysed. Asystole was more frequently detected in the pre-admission shock group than in the post-admission group. In both groups, the commonest culprit lesion location was in the left anterior descending artery. Cardiopulmonary resuscitation was performed significantly more frequently and earlier in the pre-admission group. The 1-month mortality rate was significantly lower in the pre-admission group than in the post-admission group. Male sex and ECMO duration (≥6 days) were factors significantly related to the reduced mortality rate in the pre-admission group. In the subgroup analysis, the mortality rate was lower in patients receiving bailout ECMO than in those not receiving it; the difference was not statistically significant. Conclusions: ECMO application resulted in lower short-term mortality rate among patients with out-of-hospital cardiogenic shock onset than with in-hospital shock onset; early cardiopulmonary resuscitation and ECMO might be helpful in select patients.
Mild Head Trauma (MHT) and Antiplatelet Therapy. Reply to Lorenzati et al. Comment on “Savioli et al. Mild Head Trauma: Is Antiplatelet Therapy a Risk Factor for Hemorrhagic Complications? Medicina 2021, 57, 357”
Authors: Savioli Gabriele , Ceresa Iride Francesca , Luzzi Sabino , Giotta Lucifero Alice , Cambiè Ginevra , Manzoni Federica , Preda Lorenzo , Ricevuti Giovanni , Bressan Maria Antonietta
Published: August 2021

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The Management between Comorbidities and Pain Level with Physical Activity in Individuals with Hip Osteoarthritis with Surgical Indication: A Cross-Sectional Study
Authors: Santiago Michael Silveira , Aidar Felipe J. , dos Santos Moraes Talita Leite , de Farias Neto Jader Pereira , Vieira Filho Mário Costa , de Vasconcelos Diego Protásio , Leite Victor Siqueira , Doria Felipe Meireles , Sobral Porto Erick , Albuquerque Madruga Reuthemann Esequias Teixeira Tenório , de Azevedo David Edson Ramos , Barreto Adonai Pinheiro , Gomes Marcel Vieira , de Almeida-Neto Paulo Francisco , de Araújo Tinôco Cabral Breno Guilherme , da Silva Júnior Walderi Monteiro
Published: August 2021

Background and Objectives: The degenerative pathology of the hip joint appears in young age groups, related to fem-oroacetabular impingement, and in advanced age, due to other inflammatory causes, with greater potential for severity in the presence of comorbidities. Objectives: To evaluate the participation of the main causes of osteoarthritis in relation to physical activities, s Body Mass Index (BMI) and television time (TV). Materials and Methods: 54 patients with surgical indication treated at an orthopedic referral university hospital were stratified into groups (Impact: I, Osteonecrosis/rheumatic: II, Infectious/traumatic: III), and the influence of comorbidities on physical activity performance, relative to BMI and TV time. Results: It was observed that the impact group was the most frequent (51.8%), with 79.6% under the age of 60 years. This group followed the general mean (p < 0.05), using the variables of comorbidity and the level of physical activity. Pain intensity, TV time, BMI showed no correlation with physical activity. Conclusion: Morphostructural changes (group I) represented the most frequent etiological group, and severe pain was common in almost the entire sample. Unlike BMI, comorbidity showed a significant relationship with the level of physical activity.
COVID-19 Pneumonia in Vaccinated Population: A Six Clinical and Radiological Case Series
Authors: Brogna Barbara , Bignardi Elio , Brogna Claudia , Capasso Chiara , Gagliardi Giuliano , Martino Alberigo , Musto Lanfranco Aquilino
Published: August 2021

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its related disease (COVID-19) continue to represent a challenge for humans. To date, vaccination programs have represented an opportunity to navigate the pandemic. However, the advent of new genetic COVID-19 variants has increased more attention representing a worrying threat not only for not vaccinated but also for vaccinated people as virus infections have been shown also in the last ones. Herein, we report different clinical cases and radiological findings of COVID-19 pneumonia in six fully vaccinated patients. Two patients had a history of Rituximab therapy for follicular lymphoma and with persistent positivity for SARS-CoV-2 on nasopharyngeal/oropharyngeal (NP/OP) swabs and with moderate pneumonia on the chest computed tomography (CT). One patient who resulted to be positive to delta variant 8 days after the second vaccination dose, died shortly after. Two patients were hospitalized due to the worsening of fever and dyspnea in presence of mild pneumonia on CT. In one patient mild pneumonia was found on the chest-CT performed after a lipothymic episode associated with chest pain and positive NP/OP swab tested for SARS-CoV-2. These data suggested that in fully vaccinated people, caution should be preserved, and the use of masks and social distancing should be continued in all closed environments. However, further clinical trials should be done to better understand how various factors can influence vaccine immunogenicity as the presence of virus mutations, age factors, and the presence of an immunocompromised state.
Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws
Authors: Sermon An , Hofmann-Fliri Ladina , Zderic Ivan , Agarwal Yash , Scherrer Simon , Weber André , Altmann Martin , Knobe Matthias , Windolf Markus , Gueorguiev Boyko
Published: August 2021

Background and Objectives: Hip fractures constitute the most debilitating complication of osteoporosis with steadily increasing incidences in the aging population. Their intramedullary nailing can be challenging because of poor anchorage in the osteoporotic femoral head. Cement augmentation of Proximal Femoral Nail Antirotation (PFNA) blades demonstrated promising results by enhancing cut-out resistance in proximal femoral fractures. The aim of this study was to assess the impact of augmentation on the fixation strength of TFN-ADVANCEDTM Proximal Femoral Nailing System (TFNA) blades and screws within the femoral head and compare its effect when they are implanted in centre or anteroposterior off-centre position. Materials and Methods: Eight groups were formed out of 96 polyurethane low-density foam specimens simulating isolated femoral heads with poor bone quality. The specimens in each group were implanted with either non-augmented or cement-augmented TFNA blades or screws in centre or anteroposterior off-centre positions, 7 mm anterior or posterior. Mechanical testing was performed under progressively increasing cyclic loading until failure, in setup simulating an unstable pertrochanteric fracture with a lack of posteromedial support and load sharing at the fracture gap. Varus-valgus and head rotation angles were monitored. A varus collapse of 5° or 10° head rotation was defined as a clinically relevant failure. Results: Failure load (N) for specimens with augmented TFNA head elements (screw/blade centre: 3799 ± 326/3228 ± 478; screw/blade off-centre: 2680 ± 182/2591 ± 244) was significantly higher compared with respective non-augmented specimens (screw/blade centre: 1593 ± 120/1489 ± 41; screw/blade off-centre: 515 ± 73/1018 ± 48), p < 0.001. For both non-augmented and augmented specimens failure load in the centre position was significantly higher compared with the respective off-centre positions, regardless of the head element type, p < 0.001. Augmented off-centre TFNA head elements had significantly higher failure load compared with non-augmented centrally placed implants, p < 0.001. Conclusions: Cement augmentation clearly enhances the fixation stability of TFNA blades and screws. Non-augmented blades outperformed screws in the anteroposterior off-centre position. Positioning of TFNA blades in the femoral head is more forgiving than TFNA screws in terms of failure load.
Subtyping Hyperchloremia among Hospitalized Patients by Machine Learning Consensus Clustering
Authors: Thongprayoon Charat , Nissaisorakarn Voravech , Pattharanitima Pattharawin , Mao Michael A. , Kattah Andrea G. , Keddis Mira T. , Dumancas Carissa Y. , Vallabhajosyula Saraschandra , Petnak Tananchai , Erickson Stephen B. , Dillon John J. , Garovic Vesna D. , Kashani Kianoush B. , Cheungpasitporn Wisit
Published: August 2021

Background and Objectives: Despite the association between hyperchloremia and adverse outcomes, mortality risks among patients with hyperchloremia have not consistently been observed among all studies with different patient populations with hyperchloremia. The objective of this study was to characterize hyperchloremic patients at hospital admission into clusters using an unsupervised machine learning approach and to evaluate the mortality risk among these distinct clusters. Materials and Methods: We performed consensus cluster analysis based on demographic information, principal diagnoses, comorbidities, and laboratory data among 11,394 hospitalized adult patients with admission serum chloride of >108 mEq/L. We calculated the standardized mean difference of each variable to identify each cluster’s key features. We assessed the association of each hyperchloremia cluster with hospital and one-year mortality. Results: There were three distinct clusters of patients with admission hyperchloremia: 3237 (28%), 4059 (36%), and 4098 (36%) patients in clusters 1 through 3, respectively. Cluster 1 was characterized by higher serum chloride but lower serum sodium, bicarbonate, hemoglobin, and albumin. Cluster 2 was characterized by younger age, lower comorbidity score, lower serum chloride, and higher estimated glomerular filtration (eGFR), hemoglobin, and albumin. Cluster 3 was characterized by older age, higher comorbidity score, higher serum sodium, potassium, and lower eGFR. Compared with cluster 2, odds ratios for hospital mortality were 3.60 (95% CI 2.33–5.56) for cluster 1, and 4.83 (95% CI 3.21–7.28) for cluster 3, whereas hazard ratios for one-year mortality were 4.49 (95% CI 3.53–5.70) for cluster 1 and 6.96 (95% CI 5.56–8.72) for cluster 3. Conclusions: Our cluster analysis identified three clinically distinct phenotypes with differing mortality risks in hospitalized patients with admission hyperchloremia.
Successful Treatment of Catastrophic Antiphospholipid Syndrome Using Rituximab: Case Report and Review of the Literature
Authors: Stanescu Cristina , Andronesi Andreea Gabriella , Jurcut Ciprian , Gherghiceanu Mihaela , Vornicu Alexandra , Burcea Florentina Andreea , Andronesi Toader Danut , Lupusoru Gabriela Elena , Iliuta Luminita , Sorohan Bogdan Marian , Obrisca Bogdan , Ismail Gener
Published: August 2021

Background: Kidney involvement is a frequent complication of systemic lupus erythematosus (SLE) and kidney biopsy is essential in differentiating lupus nephritis (LN) from thrombotic microangiopathy (TMA) secondary to antiphospholipid autoantibodies (aPL). Association between antiphospholipid syndrome (APS) and acquired hemophilia due to inhibitors was very rarely described in SLE patients. Case presentation: We present the case of a 61-year-old male diagnosed with SLE who acquired deficiency of clotting factor VIII due to circulating inhibitors, admitted for acute kidney injury (AKI), microangiopathic hemolytic anemia, thrombocytopenia, and diplopia. Kidney biopsy showed TMA due to APS, but no signs of LN. Head computed tomography identified low dense areas in the white matter, suggesting small blood vessels’ involvement. A diagnosis of probable catastrophic antiphospholipid syndrome (CAPS) was established and treatment with low molecular weight heparin, intravenous methylprednisolone, plasmapheresis, and rituximab was initiated, followed by resolution of AKI, diplopia, and TMA with complete depletion of CD19+B-lymphocytes (CD19+B-Ly) after one month. We further review the current knowledge regarding pathogenesis and management of CAPS in SLE patients. Conclusions: Targeted therapy was possible after kidney biopsy, improving renal and general prognosis. CD19+B-Ly repopulation preceded biological relapse, so monitoring of CD19+B-Ly may serve as a tool to predict relapses and guide rituximab therapy.
Dissecting the Molecular Features of Systemic Light Chain (AL) Amyloidosis: Contributions from Proteomics
Authors: Rognoni Paola , Mazzini Giulia , Caminito Serena , Palladini Giovanni , Lavatelli Francesca
Published: August 2021

Amyloidoses are characterized by aggregation of proteins into highly ordered amyloid fibrils, which deposit in the extracellular space of tissues, leading to organ dysfunction. In AL (amyloid light chain) amyloidosis, the most common form in Western countries, the amyloidogenic precursor is a misfolding-prone immunoglobulin light chain (LC), which, in the systemic form, is produced in excess by a plasma cell clone and transported to target organs though blood. Due to the primary role that proteins play in the pathogenesis of amyloidoses, mass spectrometry (MS)-based proteomic studies have gained an established position in the clinical management and research of these diseases. In AL amyloidosis, in particular, proteomics has provided important contributions for characterizing the precursor light chain, the composition of the amyloid deposits and the mechanisms of proteotoxicity in target organ cells and experimental models of disease. This review will provide an overview of the major achievements of proteomic studies in AL amyloidosis, with a presentation of the most recent acquisitions and a critical discussion of open issues and ongoing trends.
Efficacy of Whole-Blood Del Nido Cardioplegia Compared with Diluted Del Nido Cardioplegia in Coronary Artery Bypass Grafting: A Retrospective Monocentric Analysis of Pakistan
Authors: Haider Adnan , Khwaja Irfan Azmatullah , Khan Ammar Hameed , Yousaf Muhammad Shahbaz , Zaneb Hafsa , Qureshi Abdul Basit , Rehman Habib
Published: August 2021

Background and Objectives: Cardioplegia is one of the most significant components used to protect the myocardium during cardiac surgery. There is a paucity of evidence regarding the utilization of whole-blood Del Nido cardioplegia (WB-DNC) on clinical outcomes in coronary artery bypass grafting (CABG). The purpose of this retrospective cross-sectional study is to compare the effectiveness of diluted (blood to crystalloid; 1:4) Del Nido cardioplegia (DNC) with WB-DNC in patients who underwent elective CABG in a tertiary care hospital in Lahore-Pakistan. Materials and Methods: This was a retrospective descriptive study conducted at the Department of Cardiovascular Surgery, King Edward Medical University, Lahore. The medical database of all consecutive patients admitted from January 2018 to March 2020 and who fulfilled the inclusion criteria were reviewed. Results: Out of 471 patients admitted during the study period, 450 underwent various elective cardiac surgeries. Out of 450, 321 patients (71.33%) were operated on for CABG. Only 234/321 (72.89%) CABG patients fulfilled our inclusion criteria; 120 (51.28%) patients received WB-DNC, while 114 (48.71%) patients were administered with DNC. The former group presented with better clinical outcomes compared with the latter in terms of lesser requirements of inotropic support, low degree of hemodilution, shorter in-hospital stay, improved renal function, and cost-effectiveness. Peak values of serum Troponin-T (Trop-T), creatine kinase-myocardial band (CK-MB) release, and activated clotting time (ACT) were also lower in the WB-DNC group compared with the DNC group. Conclusions: The WB-DNC conferred better myocardial protection, improved early clinical outcomes, and also proved to be economical for patients undergoing elective CABG compared with classical crystalloid cardioplegia solution.
Artificial Intelligence, Machine Learning and Deep Learning in Ion Channel Bioinformatics
Authors: Ashrafuzzaman Md.
Published: August 2021

Ion channels are linked to important cellular processes. For more than half a century, we have been learning various structural and functional aspects of ion channels using biological, physiological, biochemical, and biophysical principles and techniques. In recent days, bioinformaticians and biophysicists having the necessary expertise and interests in computer science techniques including versatile algorithms have started covering a multitude of physiological aspects including especially evolution, mutations, and genomics of functional channels and channel subunits. In these focused research areas, the use of artificial intelligence (AI), machine learning (ML), and deep learning (DL) algorithms and associated models have been found very popular. With the help of available articles and information, this review provide an introduction to this novel research trend. Ion channel understanding is usually made considering the structural and functional perspectives, gating mechanisms, transport properties, channel protein mutations, etc. Focused research on ion channels and related findings over many decades accumulated huge data which may be utilized in a specialized scientific manner to fast conclude pinpointed aspects of channels. AI, ML, and DL techniques and models may appear as helping tools. This review aims at explaining the ways we may use the bioinformatics techniques and thus draw a few lines across the avenue to let the ion channel features appear clearer.
IL-17C and IL-17RE Promote Wound Closure in a Staphylococcus aureus-Based Murine Wound Infection Model
Authors: Pätzold Linda , Stark Alexandra , Ritzmann Felix , Meier Carola , Tschernig Thomas , Reichrath Jörg , Bals Robert , Bischoff Markus , Beisswenger Christoph
Published: August 2021

The epithelial cytokine interleukin-17C (IL-17C) mediates inflammation through the interleukin 17 receptor E (IL-17RE). Prior studies showed a detrimental role of IL-17C in the pathogenesis of immune-mediated skin diseases (e.g., psoriasis). Here, we examined the role of IL-17C/IL-17RE in wound closure in a Staphylococcus aureus wound infection model. We demonstrate that wound closure is significantly delayed in IL-17RE (Il-17re−/−)- and 17C (Il-17c−/−)-deficient mice. There was no significant difference between WT, Il-17re−/−, and Il-17c−/− mice in the absence of infection. Deficiency for IL-17RE and IL-17C did not significantly affect the elimination of bacteria. IL-17C expression was increased in the epidermis of human S. aureus-infected skin. Our results indicate that the IL-17C/IL-17RE axis contributes to the closure of infected wounds but does not contribute to the elimination of S. aureus.
Biodiversity of Phages Infecting the Dairy Bacterium Streptococcus thermophilus
Authors: Hanemaaijer Laurens , Kelleher Philip , Neve Horst , Franz Charles , de Waal Paul , van Peij Noël , van Sinderen Douwe , Mahony Jennifer
Published: August 2021

Streptococcus thermophilus-infecting phages represent a major problem in the dairy fermentation industry, particularly in relation to thermophilic production systems. Consequently, numerous studies have been performed relating to the biodiversity of such phages in global dairy operations. In the current review, we provide an overview of the genetic and morphological diversity of these phages and highlight the source and extent of genetic mosaicism among phages infecting this species through comparative proteome analysis of the replication and morphogenesis modules of representative phages. The phylogeny of selected phage-encoded receptor binding proteins (RBPs) was assessed, indicating that in certain cases RBP-encoding genes have been acquired separately to the morphogenesis modules, thus highlighting the adaptability of these phages. This review further highlights the significant advances that have been made in defining emergent genetically diverse groups of these phages, while it additionally summarizes remaining knowledge gaps in this research area.
Adherent-Invasive and Non-Invasive Escherichia coli Isolates Differ in Their Effects on Caenorhabditis elegans’ Lifespan
Authors: de Sousa Figueiredo Maria Beatriz , Pradel Elizabeth , George Fanny , Mahieux Séverine , Houcke Isabelle , Pottier Muriel , Fradin Chantal , Neut Christel , Daniel Catherine , Bongiovanni Antonino , Foligné Benoît , Titécat Marie
Published: August 2021

The adherent-invasive Escherichia coli (AIEC) pathotype has been implicated in the pathogenesis of inflammatory bowel diseases in general and in Crohn’s disease (CD) in particular. AIEC strains are primarily characterized by their ability to adhere to and invade intestinal epithelial cells. However, the genetic and phenotypic features of AIEC isolates vary greatly as a function of the strain’s clonality, host factors, and the gut microenvironment. It is thus essential to identify the determinants of AIEC pathogenicity and understand their role in intestinal epithelial barrier dysfunction and inflammation. We reasoned that soil nematode Caenorhabditis elegans (a simple but powerful model of host-bacterium interactions) could be used to study the virulence of AIEC vs. non- AIEC E. coli strains. Indeed, we found that the colonization of C. elegans (strain N2) by E. coli impacted survival in a strain-specific manner. Moreover, the AIEC strains’ ability to invade cells in vitro was linked to the median lifespan in C. elegans (strain PX627). However, neither the E. coli intrinsic invasiveness (i.e., the fact for an individual strain to be characterized as invasive or not) nor AIEC’s virulence levels (i.e., the intensity of invasion, established in % from the infectious inoculum) in intestinal epithelial cells was correlated with C. elegans’ lifespan in the killing assay. Nevertheless, AIEC longevity of C. elegans might be a relevant model for screening anti-adhesion drugs and anti-invasive probiotics.