bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echocardiographic and clinical predictors of cardiac amyloidosis: limitations of apical sparing
Authors: Kyrouac Douglas , Schiffer Walter , Lennep Brandon , Fergestrom Nicole , Zhang Kathleen W. , Gorcsan John , Lenihan Daniel J. , Mitchell Joshua D. 
Published: December 2021

AbstractAimsThe accuracy of an apical‐sparing strain pattern on transthoracic echocardiography (TTE) for predicting cardiac amyloidosis (CA) has varied in prior studies depending on the underlying cohort. We sought to evaluate the performance of apical sparing and other TTE strain findings to screen for CA in an unselected population and determine the frequency that patients with echocardiographic concern for CA undergo evaluation for amyloidosis in clinical practice.Methods and resultsAs strain is routinely performed at our institution on all clinical TTEs, we identified all TTEs performed from 2016 through 2019 with reported concern for CA or apical sparing. We determined the performance characteristics for echocardiographic strain findings in discriminating CA including apical sparing, the ejection fraction to global longitudinal strain ratio (EF/GLS), and the septal apical–septal basal ratio (SA/SB); other clinical predictors of confirmed CA; and predictors of patients who underwent complete evaluation for CA. CA was confirmed by endomyocardial biopsy or diagnostic cardiac imaging. A total of 547 TTEs, representing 451 patients, reported concern for CA and had adequate strain for analysis. A total of 111 patients underwent complete evaluation for amyloidosis with 100 patients undergoing complete cardiac evaluation for CA. In those 100 patients, multivariable predictors of confirmed CA were age [odds ratio (OR) 3.37 per 5 years], a visual apical‐sparing pattern (OR 10.85), and left ventricular ejection fraction (LVEF)/GLS > 4.1 (OR 35.37). CA was less likely in those with coronary artery disease (OR 0.04), hypertension (OR 0.18), and increased systolic blood pressure (OR 0.60 per 5 mm Hg increase). SA/SB [area under the curve (AUC) 0.72, 95% confidence interval (CI) 0.60–0.84] and LVEF/GLS (AUC 0.72, 95% CI 0.60–0.84) both had improved discrimination for CA compared with the apical‐sparing ratio (AUC 0.66, 95% CI 0.54–0.79). Many patients with suggestive TTE findings did not receive an evaluation for amyloidosis. Complete evaluation was more likely with Caucasian race (OR 2.1), increased septal thickness (OR 1.4), increased body mass index (OR 1.2), and if the report specifically stated ‘amyloid’ (OR 1.9). Evaluations were less likely in patients with comorbidities. While hypertension reduced the likelihood of evaluating for CA, 34% of patients with CA had hypertension (>130/80 mm Hg) at time of diagnosis.ConclusionsIn a broad population of patients undergoing TTE, apical sparing on strain imaging increased the likelihood of CA diagnosis but with modest sensitivity and specificity. GLS/EF ratio may be a more reliable tool to screen for CA. The low rate of complete evaluation in patients with concerning TTE findings indicates a strong need for practice improvement and enhanced disease awareness.
Cu–Al2O3/engine oil Williamson hybrid nanofluid flow over a stretching/shrinking Riga plate with viscous dissipation and radiation effect
Authors: Nidhi  , Kumar Lokendra 
Published: December 2021

AbstractThe current effort aims to analyze fluid flow characteristics in engine oil Williamson hybrid nanofluid flow past a Riga‐plate. The employed model is influenced by thermal radiation effect, viscous dissipation, and convective surface boundary conditions. The composed equations are distorted into dimensionless form by an appropriate similarity technique. Dual solutions (a stable and an unstable solution) to the resultant highly nonlinear coupled system are found using the shooting approach. In the restricted situation, the results attained agree with published work. The impact of the necessary controlling parameters on velocity profile, temperature profile, skin friction coefficient, and reduced Nusselt number are illustrated graphically. Numerically calculated values of skin friction coefficients in both and directions and reduced Nusselt numbers are also presented in the tabular form. The notable finding of the problem analyzed is that a sufficient amount of suction is necessary for the shrinking flow to be possible. Biot number, Eckert number, and radiation parameter do not affect boundary layer separation whereas an upsurge in width of electrodes and magnets decreases the range of the first and the second solutions, and modified Hartmann number increases it.
Effects of norepinephrine on microglial neuroinflammation and neuropathic pain
Authors: Zou He‐Lin , Li Juan , Zhou Jun‐Li , Yi Xi , Cao Song 
Published: December 2021

AbstractNorepinephrine (NE) is an important neurotransmitter in the central nervous system. NE is released from locus coeruleus neurons and is involved in a variety of physiological and pathological processes. Neuroinflammation is a common manifestation of many kinds of neurological diseases. The activation of microglia directly affects the status of neuroinflammation. Several kinds of adrenergic receptors, which anchor on microglia and can be regulated by NE, affect the activation of microglia and neuroinflammation. NE influences chronic pain, anxiety, and depression by regulating the activation of microglia.
Effects of modified multimodal analgesia on postoperative pain, sedation, and prognosis of gynecological patients
Authors: Zhang Fan , Luo Man , Liu De‐Xing , Zhu Yu‐Hang , Zhu Zhao‐Qiong 
Published: December 2021

AbstractPatient‐controlled intravenous analgesia is one of the most common pain relief methods in the postoperative period, but its adverse reactions remain high. This study aimed to explore the role of improved combined analgesia methods in pain, sedation, postoperative nausea, and vomiting (PONV) in patients undergoing gynecological surgeries. This study was a prospective, randomized, double‐blind controlled study. A study population of 72 patients undergoing gynecological surgery were randomly assigned to either the TAPB + S group or the TAPB + N group. All patients in both groups underwent a transversus abdominis plane block (TAPB) after induction of anesthesia. The TAPB + S group received a continuous intravenous infusion (2 ml/h) of sufentanil (1 μg/kg) plus metoclopramide (30 mg) through 100 ml elastomeric pumps postoperatively. The TAPB + N group received a continuous intravenous infusion (2 ml/h) of nalbuphine hydrochloride (1 mg/kg) plus metoclopramide (30 mg) postoperatively. The main outcome measures were as follows: postoperative pain intensity, Ramsay sedation score (RSS) after surgery, PONV occurrence rate, and rescue analgesics. The RSS of the TAPB + S group was significantly higher than that of the TAPB + N group at 2, 4, and 6 h after the operation. However, the visual analog scale score of the TAPB + S group was much higher than that of the TAPB + N group. No significant differences were found between the two groups in terms of consumption of opioids and other narcotic drugs at 2, 4, 6, 24, and 48 h after the operation. No statistically significant differences were found with respect to PONV and other adverse events in both groups. Taken together, our data indicate that the TAPB + N program can provide better postoperative analgesia and also reduce the use of strong opioids. The more optimized scheme of perioperative analgesia still needs to be researched further.
Temporal changes in the water quality of urban tropical streams: An approach to daily variation in seasonality
Authors: Bega João Miguel Merces , Zanetoni Filho José Antônio , Albertin Liliane Lazzari , Oliveira Jefferson Nascimento de 
Published: December 2021

Abstract
Using water quality indices (WQIs) is one way to monitor watercourses for water quality. Currently, there is a lack of information about their behavior in the diurnal cycle because sampling is often carried out in the morning. Also, few articles focus on assessing the urban impact on the spatial variability of WQIs in tropical first-order streams. Such streams receive many pollutants varying in intensity according to population habits, justifying the possible diurnal variation in water quality in addition to climatic attributes. This paper aims to evaluate the fluctuations in Brazilian WQIs and their parameters (temperature, turbidity, total solids [TS], hydrogen potential, dissolved oxygen [DO], biochemical oxygen demand [BOD], total phosphorus [TP], total nitrogen [TN], and Escherichia coli) between the morning (8 AM), afternoon (2 PM), and night (7 PM) periods for an urban first-order tropical stream. Overall, the lowest DO concentrations and highest values of TS, turbidity, BOD, TP, TN, and E. coli were obtained in the morning, possibly representing population habits: the greatest generation of pollutants occurs overnight and in the early morning because there are clandestine domestic wastewater inputs into the stream, whose hourly periodicity generates a similar periodicity in the WQI of the evaluated stream. Although there was a significant variation in WQI average values between morning (15.50 ± 1.97) and afternoon (20.83 ± 5.42) only during the dry season (p &lt; 0.05), different results were common throughout the day in all months, and the water quality was often classified in distinct categories: very bad, bad, and regular. Our findings present another dimension to be considered when assessing urban water quality, leading to direct benefits to the management and use of urban waters. Integr Environ Assess Manag 2022;18:1260–1271. © 2021 SETAC
KEY POINTS
This paper presents the variations in the Brazilian water quality index (WQI) and its parameters between three periods of the day (8 AM, 2 PM, and 7 PM). The greatest generation of clandestine domestic effluents occurs overnight and in the early morning, whose hourly periodicity generates a similar periodicity in the WQI. Our findings present another dimension to be considered when assessing urban water quality, leading to direct benefits to the management and use of urban waters. All parameters are equally important for the Brazilian WQI since no parameter can replace other parameters (possible if they would have similar behavior at all periods).
Disclosure obligations of a debtor under the Singapore scheme of arrangement: Lessons from England and the US
Authors: Eu Alfino Zijian 
Published: December 2021

AbstractThe Singapore scheme of arrangement has received considerable attention from the international community in recent years due to the Chapter 11‐inspired reforms enacted in 2017. However, an overlooked, and perhaps underdeveloped, aspect of the Singapore scheme has been the disclosure obligations of the debtor throughout the scheme process. This article seeks to provide a critical evaluation of the disclosure framework under the Singapore scheme and, drawing on features of the English scheme and Chapter 11 in the US, to identify potential avenues for reform. Three, in particular, are highlighted. The first relates to a lack of formal requirements in Singapore prescribing the form and duration of notice which a debtor is required to give to its creditors of its application for leave to convene the creditor's meeting. The second concerns the uncertainty surrounding the precise types of information to be included in the explanatory statement which is circulated to the creditors. This is a particularly important issue given that Singapore schemes often feature retail investors who would generally be reliant on the explanatory statement to make an informed decision. Third, given the significant reforms enacted to the Singapore scheme, namely the availability of a broader moratorium and rescue financing provisions, there is a heightened need for more comprehensive financial disclosures at an earlier stage in the scheme process even before the debtor applies for leave to convene the creditors' meeting.
Nanobioglass enhanced polyurethane/collagen conduit in sciatic nerve regeneration
Authors: Nasab Somayeh Tofighi , Roodbari Nasim Hayati , Goodarzi Vahabodin , Khonakdar Hossein Ali , Nourani Mohammad Reza 
Published: December 2021

AbstractThe main purpose of neural tissue engineering and regenerative medicine is the development of biological substitutions to preserve, improve, and regenerate the damaged functions of tissues and organs. Three novel conduits, including polyurethane (PU), polyurethane/collagen (PU/C), and polyurethane/collagen/nano‐bio glass (PU/C/NBG), were fabricated by the electrospinning technique. After confirming the suitability of conduits in the in‐vitro environment, conduits were surgically sutured in a 10‐mm gap in the sciatic nerve of a rat to evaluate their role in sciatic nerve reconstruction. After 4, 8, and 12 weeks of surgery, nerve regeneration was assessed by the hot plate test, sciatic functional index, electromyography, histology, and immunohistochemistry against S100, NF200, and CD31 antibodies. The results of various examinations revealed that the PU/C/NBG conduit is significantly more suitable than PU and PU/C conduits in terms of nerve regeneration. However, all three groups of conduits had the potential to be used for nerve regeneration. Overall, this study discovered that the PU/C/NBG conduit is a biocompatible neural conduit, which is a favorable candidate for peripheral nerve regeneration and axonal growth.
Malnutrition on admission increases the in‐hospital mortality and length of stay in elder adults with acute ischemic stroke
Authors: Hao Ruixiao , Qi Xuemei , Xia Xiaoshuang , Wang Lin , Li Xin 
Published: December 2021

AbstractPurposeMalnutrition, as determined by the Controlling Nutritional Status (CONUT), has an effect on the 3‐month and long‐term prognosis of stroke patients. The association between malnutrition and in‐hospital mortality has not been well established. We aimed to investigate the relationship between the CONUT score on admission and in‐hospital mortality and length of stay (LOS) in elderly patients with acute ischemic stroke (AIS).MethodsThis study analyzed controls and patients with AIS. Malnutrition was determined using the CONUT score. A CONUT score of 5–12 was defined as undernutrition status. Based on the CONUT scores, the patients were divided into the low CONUT (0–4) and high CONUT (5–12) groups.ResultsIn total, 1079 participants were recruited, comprising 288 controls and 791 AIS patients. Among the 791 patients, 64 (8.1%) had malnutrition and 63 (7.9%) had an in‐hospital death. Compared to the controls, the AIS patients presented higher CONUT scores, higher proportion of in‐hospital mortality (8.0%), and longer length of stay. Malnutrition was independently associated with in‐hospital mortality in the AIS patients (adjusted odds ratio: 3.77, 95% confidence interval [CI]: 1.55–9.15; p = 0.003). The general linear models showed an association between the CONUT score and LOS (β = 0.574, 95% CI: 0.208–0.934; p = 0.002). Furthermore, the effect of the interaction between infection and nutrition status on in‐hospital mortality showed borderline statistical significance (p = 0.06).ConclusionsMalnutrition estimated by the CONUT score on admission can be a predictor of in‐hospital mortality and increased LOS in elderly AIS patients.
How the rise of testosterone therapy in men was inspired by lizard research with David Crews
Authors: Morgentaler Abraham 
Published: December 2021

AbstractA chance encounter in 1975 with David Crews in Harvard Square led to 3 years of research in his lab, investigating the role of testosterone (T) in male sexual behavior of the lizard, Anolis carolinensis. In 1988 when I began my practice as a urologist and specialist in men's health, my research experience with lizards led me to offer testosterone therapy (TTh) to men suffering with symptoms of testosterone deficiency, despite the universal belief that TTh caused prostate cancer (PCa). My investigation of this topic over 30+ years has led to revolutionary changes in the diagnosis and treatment of men with testosterone deficiency and our understanding of the biology of testosterone and PCa. Today, it is routine for men successfully treated for PCa to receive TTh, a remarkable fact given that standard treatment for men with advanced PCa has been androgen deprivation for the last 80 years. Our research showed low T was not protective for PCa; TTh did not appear to worsen PCa for various cancer stages; and provided the theoretical framework for understanding why androgen deprivation shrinks PCa tumors, yet TTh appears to not cause PCa growth under most conditions. This is based on the Saturation Model, which recognizes there is a finite ability of androgens to stimulate PCa growth, which becomes maximal at low T concentrations. David Crews was an outstanding mentor—the lessons I learned from him inspired a lifetime of work, which in turn led to improved quality of life for millions of men.
Evaluation of optical 3D scanning system for radiotherapy use
Authors: Crowe Scott , Luscombe Jenna , Maxwell Sarah , Simpson‐Page Emily , Poroa Tania , Wilks Rachael , Li Weizheng , Cleland Susannah , Chan Philip , Lin Charles , Kairn Tanya 
Published: December 2021

AbstractIntroductionOptical three‐dimensional scanning devices can produce geometrically accurate, high‐resolution models of patients suitable for clinical use. This article describes the use of a metrology‐grade structured light scanner for the design and production of radiotherapy medical devices and synthetic water‐equivalent computer tomography images.MethodsFollowing commissioning of the device by scanning objects of known properties, 173 scans were performed on 26 volunteers, with observations of subjects and operators collected.ResultsThe fit of devices produced using these scans was assessed, and a workflow for the design of complex devices using a treatment planning system was identified.ConclusionsRecommendations are provided on the use of the device within a radiation oncology department.
Modeling and forecasting the total number of cases and deaths due to pandemic
Authors: Khan Nasrullah , Arshad Asma , Azam Muhammad , Al‐marshadi Ali Hussein , Aslam Muhammad 
Published: December 2021

AbstractThe COVID‐19 pandemic has appeared as the predominant disease of the 21st century at the end of 2019 and was a drastic start with thousands of casualties and the COVID‐19 victims in 2020. Due to the drastic effect, COVID‐19 scientists are trying to work on pandemic diseases and Governments are interested in the development of methodologies that will minimize the losses and speed up the process of cure by providing vaccines and treatment for such pandemics. The development of a new vaccine for any pandemic requires long in vitro and in vivo trials to use. Thus the strategies require understanding how the pandemic is spreading in terms of affected cases and casualties occurring from this disease, here we developed a forecasting model that can predict the no of cases and deaths due to pandemic and that can help the researcher, government, and other stakeholders to devise their strategies so that the damages can be minimized. This model can also be used for the judicial distribution of resources as it provides the estimates of the number of casualties and number of deaths with high accuracy, Government and policymakers on the basis of forecasted value can plan in a better way. The model efficiency is discussed on the basis of the available dataset of John Hopkins University repository in the period when the disease was first reported in the six countries till the mid of May 2020, the model was developed on the basis of this data, and then it is tested by forecasting the no of deaths and cases for next 7 days, where the proposed strategy provided excellent forecasting. The forecast models are developed for six countries including Pakistan, India, Afghanistan, Iran, Italy, and China using polynomial regression of degrees 3–5. But the models are analyzed up to the 6th‐degree and the suitable models are selected based on higher adjusted R‐square (R2) and lower root‐mean‐square error and the mean absolute percentage error (MAPE). The values of R2 are greater than 99% for all countries other than China whereas for China this R2 was 97%. The high values of R2 and Low value of MAPE statistics increase the validity of proposed models to forecast the total no cases and total no of deaths in all countries. Iran, Italy, and Afghanistan also show a mild decreasing trend but the number of cases is far higher than the decrease percentage. Although India is expected to have a consistent result, more or less it depicts some other biasing factors which should be figured out in separate research.
Articular contact motion at the knee during daily activities
Authors: Thomeer Lucas T. , Guan Shanyuanye , Gray Hans A. , Pandy Marcus G. 
Published: December 2021

AbstractWe combined mobile biplane X‐ray imaging and magnetic resonance imaging to measure the regions of articular cartilage contact and cartilage thickness at the tibiofemoral and patellofemoral joints during six functional activities: standing, level walking, downhill walking, stair ascent, stair descent, and open‐chain (non‐weight‐bearing) knee flexion. The contact centers traced similar paths on the medial and lateral femoral condyles, femoral trochlea, and patellar facet in all activities while their locations on the tibial plateau were more varied. The translations of the contact centers on the femur and patella were tightly coupled to the tibiofemoral flexion angle in all activities (r2 > 0.95) whereas those on the tibia were only moderately related to the flexion angle (r2 > 0.62). The regions of contacting cartilage were significantly thicker than the regions of non‐contacting cartilage on the patella, femoral trochlea, and the medial and lateral tibial plateaus in all activities (p < 0.001). There were no significant differences in thickness between contacting and non‐contacting cartilage on the medial and lateral femoral condyles in all activities, except open‐chain knee flexion. Our results provide partial support for the proposition that cartilage thickness is adapted to joint load and do not exclude the possibility that other factors, such as joint congruence, also play a role in regulating the structure and organization of healthy cartilage. The data obtained in this study may serve as a guide when evaluating articular contact motion in osteoarthritic and reconstructed knees.
The Cardiac Caval Index: Improving Noninvasive Assessment of Cardiac Preload
Authors: Ermini Leonardo , Seddone Stefano , Policastro Piero , Mesin Luca , Pasquero Paolo , Roatta Silvestro 
Published: December 2021

ObjectivesInferior vena cava (IVC) pulsatility quantified by the Caval Index (CI) is characterized by poor reliability, also due to the irregular magnitude of spontaneous respiratory activity generating the major pulsatile component. The aim of this study was to test whether the IVC cardiac oscillatory component could provide a more stable index (Cardiac CI‐CCI) compared to CI or respiratory CI (RCI).MethodsNine healthy volunteers underwent long‐term monitoring in supine position of IVC, followed by 3 minutes passive leg raising (PLR). CI, RCI, and CCI were extracted from video recordings by automated edge‐tracking and CCI was averaged over each respiratory cycle (aCCI). Cardiac output (CO), mean arterial pressure (MAP) and heart rate (HR) were also recorded during baseline (1 minutes prior to PLR) and PLR (first minute).ResultsIn response to PLR, all IVC indices decreased (P < .01), CO increased by 4 ± 4% (P = .055) while HR and MAP did not vary. The Coefficient of Variation (CoV) of aCCI (13 ± 5%) was lower than that of CI (17 ± 5%, P < .01), RCI (26 ± 7%, P < .001) and CCI (25 ± 7%, P < .001). The mutual correlations in time of the indices were 0.81 (CI‐RCI), 0.49 (CI‐aCCI) and 0.2 (RCI‐aCCI).ConclusionsLong‐term IVC monitoring by automated edge‐tracking allowed us to evidence that 1) respiratory and averaged cardiac pulsatility components are uncorrelated and thus carry different information and 2) the new index aCCI, exhibiting the lowest CoV while maintaining good sensitivity to blood volume changes, may overcome the poor reliability of CI and RCI.