bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonographic detection of enthesitis and its relation to clinical manifestations among Egyptian systemic sclerosis patients
Authors: El-Leithy Sally A. , Hammoda Rasha M. , Othman Amal I. , El-Gharbawy Nermin H.
Published: February 2022

Background

Systemic sclerosis is a complex multi-systemic autoimmune disease with a wide range of its clinical manifestations; many systemic sclerosis (SSc) patients develop musculoskeletal manifestations during their course of illness. The aim of the study is to assess the prevalence of sonographically detected entheseal alterations in a case-control study of systemic sclerosis patients and to evaluate the relationship between the presence of these alterations and the clinical systemic manifestations. Patients and controls were evaluated using B mode and power Doppler ultrasonography to detect presence of enthesitis and were scored using Madrid Sonography Enthesitis Index (MASEI).

Results

In SSc patients, the MASEI score was significantly higher than in control (P< 0.0001). Enthesitis was more prevalent among SSc patients compared to healthy controls, SSc patients with enthesitis had significantly more prevalence of diffuse subtypes (P< 0.001).SSc patients had significantly more prevalence of interstitial pulmonary fibrosis (IPF) (P< 0.001), digital ulcers (P< 0.001), pulmonary hypertension (P< 0.001), and arthralgia and arthritis (P< 0.001). Regarding nailfold capillaroscopy pattern, late pattern was significantly more prevalent among patients with enthesitis (P= 0.008). Age, ESR level, and modified Rodnan skin score were predictors for MASEI score.

Conclusions

Ultrasound features of enthesopathy were frequently presented in systemic sclerosis patients. The enthesopathy was correlated with inflammation and disease complications.
Managing Metastatic Melanoma in 2022: A Clinical Review
Authors: Switzer Benjamin , Puzanov Igor , Skitzki Joseph J. , Hamad Lamya , Ernstoff Marc S.
Published: February 2022

Cutaneous melanoma remains the most lethal of the primary cutaneous neoplasms, and although the incidence of primary melanoma continues to rise, the mortality from metastatic disease remains unchanged, in part through advances in treatment. Major developments in immunomodulatory and targeted therapies have provided robust improvements in response and survival trends that have transformed the clinical management of patients with metastatic melanoma. Additional advances in immunologic and cancer cell biology have contributed to further optimization in (1) risk stratification, (2) prognostication, (3) treatment, (4) toxicity management, and (5) surveillance approaches for patients with an advanced melanoma diagnosis. In this review, we provide a comprehensive overview of the historical and future advances regarding the translational and clinical implications of advanced melanoma and share multidisciplinary recommendations to aid clinicians in the navigation of current treatment approaches for a variety of patient cohorts.
Did the Universe experience a pressure non-crushing type cosmological singularity in the recent past?
Authors: Odintsov S. D. , Oikonomou V. K.
Published: February 2022

In the recent literature it has been shown that the H
0 tension may be eliminated if an abrupt physics transition changed the Cepheid parameters in the near past of the Universe, nearly 70–150 Myrs ago. In this letter we stress the possibility that this abrupt transition was caused by the smooth passage of our Universe through a pressure finite-time cosmological singularity. Being a non-crushing type singularity the pressure singularity can leave its imprints in the Universe, since it occurs globally and literally everywhere. We discuss how this scenario could easily be realized by F(R) gravity, with the strong energy conditions being satisfied without the need for a scalar field or specific matter fluids. We also stress the fact that the pressure singularity can affect the effective gravitational constant of F(R) gravity. Moreover, we stress the fact that pressure singularities can disrupt the trajectories of bound objects in the Universe, which is also pointed out in the literature, even in the context of general relativity. We also show numerically in a general relativistic framework that elliptic trajectories are distorted and changed to different elliptic trajectories when the Universe passes through the pressure singularity. Such a disruption of the trajectories could have tidal effects on the surface of the Earth, for example on sea waters and oceans, regarding the distortion of Moon's elliptic trajectory. Accordingly, the distortion of Earth's trajectory around the Sun could have affected climatologically the Earth 70–150 Myrs ago.
Effect of a 3-Week Treatment with GLP-1 Receptor Agonists on Vasoactive Hormones in Euvolemic Participants
Authors: Vukajlovic Tanja , Sailer Clara O , Asmar Ali , Jensen Boye L , Vogt Deborah R , Christ-Crain Mirjam , Winzeler Bettina
Published: February 2022

Context

Glucagon-like-peptide-1 receptor agonists (GLP-1 RAs) exert cardiovascular benefits by reducing plasma glucose, body weight, and blood pressure. The blood pressure–lowering effect may be mediated by angiotensin II (ANG II) suppression and consecutive natriuresis. However, the role of ANG II and other vasoactive hormones on GLP-1 RA treatment has not been clearly defined.

Objective

This work aimed to investigate the effect of a 3-week treatment with the GLP-1 RA dulaglutide on vasoactive hormones, that is, renin, ANG II, aldosterone, mid-regional proatrial natriuretic peptide (MP-proANP), and natriuresis in euvolemic participants.

Methods

Randomized, double-blinded, placebo-controlled, crossover trials were conducted at University Hospital Basel, Switzerland. A total of 54 euvolemic participants, including 20 healthy individuals and 34 patients with primary polydipsia, received a subcutaneous injection of dulaglutide (Trulicity) 1.5 mg and placebo (0.9% sodium chloride) once weekly over a 3-week treatment phase.

Results

After a 3-week treatment phase, dulaglutide showed no effect on plasma renin, plasma ANG II, or plasma aldosterone levels in comparison to placebo. Natriuresis remained unchanged or decreased on dulaglutide depending on the measured parameter. Dulaglutide significantly decreased plasma MR-proANP levels (treatment effect: 10.60 pmol/L; 95% CI, –14.70 to –7.90; P < .001) and systolic blood pressure (median: 3 mm Hg; 95% CI, –5 to 0; P = .036), whereas heart rate increased (median: 5 bpm; 95% CI, 3-11; P < .001).

Conclusion

In euvolemic participants, a 3-week treatment of dulaglutide reduced systolic blood pressure independently of plasma renin, ANG II, or aldosterone levels and urinary sodium excretion. The reduction in MR-proANP might be secondary to reduced arterial pulse pressure.
Headache in Pregnancy and Lactation
Authors: Rayhill Melissa
Published: February 2022

PURPOSE OF REVIEW

This article discusses the many tools available for the treatment of pregnant and postpartum patients with headache. Adequate treatment of headache is an essential part of good prenatal and postnatal care.

RECENT FINDINGS

New therapies such as the calcitonin gene-related peptide monoclonal antibodies, lasmiditan, direct calcitonin gene-related peptide antagonists, and neuromodulation devices are available for the treatment of headache. This article contextualizes these new therapies in practice as they relate to the treatment of migraine in pregnancy and lactation.

Headache is common in pregnancy, and neurologists should be prepared to care for pregnant patients with headache. Preconception counseling is an important part of providing safe care to patients of childbearing potential with headache. Identifying potentially dangerous secondary headache syndromes during pregnancy and the puerperium is also essential. The repertoire of available acute and preventive headache treatments is expanding. It is important to discuss the effectiveness and safety of these therapies in the context of individual patient circumstances during pregnancy and lactation in coordination with the patient’s obstetric team.
Neurologic Complications of Obstetric Anesthesia
Authors: Waters Janet F. R.
Published: February 2022

PURPOSE OF REVIEW

The advantages of neuraxial anesthesia over general anesthesia in the obstetric population are well established. Some neurologic conditions have the potential to lower the safety threshold for administration of neuraxial anesthesia, whereas others require special consideration before using general anesthesia. The aim of this article is to help neurologists determine when neuraxial anesthesia can be safely administered and when it is inadvisable.

RECENT FINDINGS

Neuraxial anesthesia can usually be given safely in most pregnant patients with neurologic disease. Patients with mass lesions causing increased intracranial pressure or spinal tumors at the site of neuraxial needle placement and patients on anticoagulant medication are the exceptions. Post–dural puncture headaches and obstetric nerve injuries are the most common complications of neuraxial anesthesia and resolve in most patients. Other complications, including epidural hematoma, meningitis, and epidural abscess, are rare but devastating.

This article provides a review of neurologic diseases that may affect the decision-making process for anesthesia during delivery. It discusses the neurologic complications that can occur because of obstetric anesthesia and how to recognize them and describes obstetric nerve injuries and how to distinguish these relatively benign injuries from more serious complications.
Health Care and Education Access of Transnational Children in Mexico
Authors: Amuedo-Dorantes Catalina , Juarez Laura
Published: February 2022

Between 2001 and 2018, more than 5.5 million Mexican migrants were removed from the United States or returned to Mexico with their families as immigration enforcement escalated. Learning how this transition affected their children—also referred to as “the invisibles”—is a policy-relevant topic for both the United States and Mexico. Using representative data on 7.6 million Mexican- and U.S.-born children from the 2015 Mexican Intercensal Survey, we provide evidence of the gaps in access to education and health care between these two groups and of the factors potentially responsible for the existing barriers. Relative to children born in Mexico, U.S.-born children are at a considerable disadvantage in terms of health care access, but less so in terms of education. Lack of a Mexican-issued birth certificate is among the persistent factors responsible for the gaps in services. Policies aimed at changing the approach to immigration enforcement in the United States, lessening paperwork requirements in Mexico, and easing access to documentation in both countries could improve transnational children's access to basic services, as well as their present and long-term well-being.
Live imaging of avian epiblast and anterior mesendoderm grafting reveals the complexity of cell dynamics during early brain development
Authors: Yoshihi Koya , Kato Kagayaki , Iida Hideaki , Teramoto Machiko , Kawamura Akihito , Watanabe Yusaku , Nunome Mitsuo , Nakano Mikiharu , Matsuda Yoichi , Sato Yuki , Mizuno Hidenobu , Iwasato Takuji , Ishii Yasuo , Kondoh Hisato
Published: February 2022

Despite previous intensive investigations on epiblast cell migration in avian embryos during primitive streak development before stage (st.) 4, this migration at later stages of brain development has remained uninvestigated. By live imaging of epiblast cells sparsely labeled with green fluorescence protein, we investigated anterior epiblast cell migration to form individual brain portions. Anterior epiblast cells from a broad area migrated collectively towards the head axis during st. 5-7 at a rate of 70-110 µm/h, changing directions from diagonal to parallel and forming the brain portions and abutting head ectoderm. This analysis revised the previously published head portion precursor map in anterior epiblasts at st. 4/5. Grafting outside the brain precursor region of mCherry-expressing nodes producing anterior mesendoderm (AME) or isolated AME tissues elicited new cell migration towards ectopic AME tissues. These locally convergent cells developed into secondary brains with portions that depended on the ectopic AME position in the anterior epiblast. Thus, anterior epiblast cells are bipotent for brain/head ectoderm development with given brain portion specificities. A brain portion potential map is proposed, also accounting for previous observations.
Ezrin knockdown reduces procaterol-stimulated ciliary beating without morphological changes in mouse airway cilia
Authors: Kawaguchi Kotoku , Nakayama Shogo , Saito Daichi , Kogiso Haruka , Yasuoka Kasane , Marunaka Yoshinori , Nakahari Takashi , Asano Shinji
Published: February 2022

Mucociliary clearance, which is conducted by beating cilia cooperating with the surface mucous layer, is a major host defense mechanism of the airway epithelium. Ezrin, a crosslinker between membrane proteins and the actin cytoskeleton, is located in microvilli and around the basal bodies in airway ciliary cells. It is also likely that ezrin plays an important role in apical localization of β2 adrenergic receptor (β2AR) in airway ciliary cells. Here, we studied the physiological roles of ezrin by using trachea and airway epithelial cells prepared from ezrin-knockdown (Vil2kd/kd) mice. The trachea and airway ciliary cells of Vil2kd/kd mice presented a normal morphology and basal body orientation, suggesting that ezrin is not directly involved in development and planar cell polarity of cilia. Procaterol stimulates ciliary beating (frequency and amplitude) via β2AR in the airway ciliary cells. In the Vil2kd/kd mice, airway ciliary beating stimulated with procaterol was partly inhibited due to the impairment of cell surface expression of β2AR. These results suggest that ezrin regulates the beating of airway ciliary cells by promoting the apical surface localization of β2AR.

This article has an associated First Person interview with the first author of the paper.
Political Distortions, State Capture, and Economic Development in Africa
Authors: Canen Nathan , Wantchekon Leonard
Published: February 2022

This article studies the role of political distortions in driving economic growth and development in Africa. We first discuss how existing theories based on long-run structural factors (e.g., pre-colonial and colonial institutions, or ethnic diversity) may not capture new data patterns in the region, including changes to political regimes, growth patterns, and their variation across regions with similar historical experiences. We then argue that a framework focused on political distortions (i.e., how political incentives impact resource allocation and economic outcomes) may have multiple benefits: it encapsulates many distortions observed in practice, including patronage, variations in contract enforcement and the role of political connections in firm outcomes; it unifies results in Africa and elsewhere; and it leaves a wide scope for policy analysis. We conclude by overviewing reforms that may curb such distortions, including changes to campaign financing rules, bureaucratic reform, free trade agreements, and technology.
Young Adults and Labor Markets in Africa
Authors: Bandiera Oriana , Elsayed Ahmed , Smurra Andrea , Zipfel Céline
Published: February 2022

Every year, millions of young adults join the labor market in Africa. This paper harmonizes surveys and censuses from 68 low- and middle-income countries to compare their job prospects to those of their counterparts in other low-income regions. We show that employment rates are similar at similar levels of development but that young adults in Africa are less likely to have a salaried job, especially when the size of their cohort is large. Building on existing evidence on the impacts of interventions targeting both the demand and supply sides of the labor market, we discuss policy priorities for boosting the growth of salaried job creation in the region.
Impact of an ultra-low dose unenhanced planning scan on CT coronary angiography scan length and effective radiation dose
Authors: Duerden Laura , O’Brien Helen , Doshi Susan , Charters Pia , King Laurence , Hudson Benjamin. J , Rodrigues Jonathan Carl Luis
Published: February 2022

Objective

Imaged scan length (z-axis coverage) is a simple parameter that can reduce CT dose without compromising image quality. In CT coronary angiography (CTCA), z-axis coverage may be planned using non-contrast calcium score scan (CaCS) to identify the relevant coronary anatomy. However, standardised Agatston CaCS is acquired at 120 kV which adds a relatively high contribution to total study dose and CaCS is no longer routinely recommended in UK guidelines. We evaluate an ultra-low dose unenhanced planning scan on CTCA scan length and effective radiation dose.

Methods:

An ultra-low dose tin filter (Sn-filter) planning scan (100 kVp, maximum iterative reconstruction) was performed and used to plan the z-axis coverage on 48 consecutive CTCAs (62% men, 62 ± 13 years) compared with 47 CTCA planned using a localiser alone (46% men, 59 ± 12 years) between May and June 2019. Excess scanning beyond the ideal scan length was calculated for both groups. Estimations of radiation dose were also compared between the two groups.

Results:

Addition of an ultra-low dose unenhanced planning scan to CTCA protocol was associated with reduction in overscanning with no impact on image quality. There was no significant difference in total study effective dose with the addition of the planning scan, which had an average dose–length product of 3 mGy.cm. (total study dose: Protocol A 2.1 mSv vs Protocol B 2.2 mSv, p = 0.92).

Conclusion:

An ultra-low dose unenhanced planning scan facilitates optimal scan length for the diagnostic CTCA, reducing overscanning and preventing incomplete cardiac imaging with no significant dose penalty or impact on image quality.

Advances in knowledge:

An ultra-low dose CTCA planning is feasible and effective at optimising scan length.
Medical student Interest in expanded transgender gynecologic education
Authors: Wright Danielle , Campedelli Alexandra
Published: February 2022

Background: The purpose of this study was to use survey data to better understand medical students’ comfort in taking care of transgender patients and to determine whether this is an area that needs to be expanded upon in their curriculum.

Methods: Eight pre-clerkship medical students participated in a virtual two-week course about gynecologic transgender care which included a mix of self-paced learning combined with two days of interactive faculty-led sessions. Students were asked to complete a pre and post course survey evaluating their comfort in caring for transgender individuals. 

Results: Students’ knowledge about the gynecologic needs of transgender individuals significantly improved after taking the course with the average student rating before and after the course being 2.38 ± 0.74 (p<0.05) and 4.25 ± 0.46 (p<0.05), respectively. In addition, 100% of students “agreed” or “strongly agreed” that this course built their confidence in taking care of transgender patients in the clinical setting.

Conclusions: This study highlights a potential gap in medical education while also emphasizing that knowledge on this special population can enhance physician confidence when caring for transgender individuals.
Spatio-temporal distribution of antimalarial drug resistant gene mutations in a Plasmodium falciparum parasite population from Kilifi, Kenya: A 25-year retrospective study
Authors: Omedo Irene , Bartilol Brian , Kimani Domtila , Gonçalves Sónia , Drury Eleanor , Rono Martin K. , Abdi Abdirahman I. , Almagro-Garcia Jacob , Amato Roberto , Pearson Richard D. , Ochola-Oyier Lynette Isabella , Kwiatkowski Dominic , Bejon Philip
Published: February 2022

Background: Antimalarial drug resistance is a major obstacle to sustainable malaria control. Here we use amplicon sequencing to describe molecular markers of drug resistance in Plasmodium falciparum parasites from Kilifi county in the coastal region of Kenya over a 25-year period.

Methods: We performed P. falciparum amplicon sequencing on 1162 malaria-infected blood samples collected between 1994 and 2018 to identify markers of antimalarial drug resistance in the Pfcrt, Pfdhfr, Pfdhps, Pfmdr1, Pfexo, Pfkelch13, plasmepsin 2/3, Pfarps10, Pffd, and Pfmdr2 genes. We further interrogated parasite population structure using a genetic barcode of 101 drug resistance-unrelated single nucleotide polymorphisms (SNPs) distributed across the genomes of 1245 P. falciparum parasites.

Results: Two major changes occurred in the parasite population over the 25 years studied. In 1994, approximately 75% of parasites carried the marker of chloroquine resistance, CVIET. This increased to 100% in 1999 and then declined steadily, reaching 6.7% in 2018. Conversely, the quintuple mutation form of sulfadoxine-pyrimethamine resistance increased from 16.7% in 1994 to 83.6% in 2018. Several non-synonymous mutations were identified in the Kelch13 gene, although none of them are currently associated with artemisinin resistance. We observed a temporal increase in the Pfmdr1 NFD haplotype associated with lumefantrine resistance, but observed no evidence of piperaquine resistance. SNPs in other parts of the genome showed no significant temporal changes despite the marked changes in drug resistance loci over this period.

Conclusions: We identified substantial changes in molecular markers of P. falciparum drug resistance over 25 years in coastal Kenya, but no associated changes in the parasite population structure.
The genome sequence of the grey top shell, Steromphala cineraria (Linnaeus, 1758)
Authors: Adkins Patrick , Mrowicki Robert , Harley Joanna , Mieszkowska Nova ,   Marine Biological Association Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: February 2022

We present a genome assembly from an individual Steromphala cineraria (the grey topshell; Mollusca; Gastropoda; Trochida; Trochidae). The genome sequence is 1,270 megabases in span. The majority of the assembly (99.23%) is scaffolded into 18 chromosomal pseudomolecules.
Postawy proinnowacyjne nauczycieli – elementy teorii i badań
Authors: Kamińska Małgorzata
Published: February 2022

W artykule przedstawiono pedeutologiczny aspekt innowacyjności w edukacji. Na początku nawiązano do dokumentów strategicznych UE oraz zapi- sów dotyczących działań na rzecz podnoszenia poziomu innowacyjności w edukacji. Następnie omówiono cechy charakteryzujące postawę proinnowacyjną człowieka w kontekście takich pojęć jak kreatywność i innowacyjność. Wskazano na czynniki warunkujące postawę proinnowacyjną. W głównej części artykułu skupiono się na różnych płaszczyznach działalności innowacyjnej nauczycieli i ich stosunku do twór- czości i kreatywności. Zwrócono uwagę na postawy nauczycieli wobec zachowań twórczych uczniów. Ważnym elementem jest próba diagnozy czynników kształtujących innowacyjność nauczycieli – w ujęciu systemowym i osobowym. W analizie wykorzystano wybrane wyniki dotychczasowych badań.
Rola bodźca podczas retrospekcji z perspektywy tłumaczy symultanicznych
Authors: Gumul Ewa
Published: February 2022

Celem niniejszego artykułu jest zbadanie, w jaki sposób studenci tłumaczenia postrzegają rolę bodźca stymulującego w badaniu z wykorzystaniem metody protokołów retrospektywnych. Opisywane w artykule badania ankietowe są częścią badania eksperymentalnego mającego na celu porównanie wpływu dwóch rodzajów bodźca (transkrypcji tekstu wyjściowego i nagrania tekstu docelowego) na informacyjność werbalizacji, ich obfitość oraz dokładność. Ankieta dotyczyła stopnia trudności przypominania, czynników ułatwiających retrospekcję, przydatności użytego i potencjalnego bodźca oraz stopnia zniekształcenia danych pamięciowych przez bodziec.
Przekład naukowy a obrazowanie: badania wstępne nad subiektywnymi aspektami znaczenia w prozie naukowej z wykorzystaniem kilku tłumaczeń tego samego tekstu źródłowego
Authors: Wiraszka Łukasz
Published: February 2022

Artykuł przedstawia badania wstępne nad subiektywnymi aspektami znaczenia w przekładzie tekstu naukowego z wykorzystaniem materiału składającego się z jednego tekstu źródłowego w języku angielskim oraz jego pięciu polskich przekładów. Wyniki analizy semantycznej w kategoriach wymiarów obrazowania Ronalda Langackera – narzędzia stworzonego na potrzeby opisu subiektywnych aspektów znaczenia językowego, lecz dotychczas stosowanego głównie do badania semantycznych „detali” w przekładzie literatury pięknej – pokazują, że sposób widzenia określonych treści przez autora ulega w przekładzie naukowym różnym wypaczeniom. Wobec niezaprzeczalnej roli przekładu w rozwoju nauki oraz istotnej funkcji subiektywnych elementów tekstu naukowego można sformułować tezę, że koncepcja ekwiwalencji na poziomie obrazowania (Tabakowska 2001) ma uzasadnione zastosowanie również w przekładzie tekstu  naukowego.
LA CAZA DE LIEBRES CON GALGOS EN ANDALUCÍA: DESDE EL CONFLICTO A LA PATRIMONIALIZACIÓN.
Authors: P. Gamuz Helena , Palenzuela Chamorro Pablo
Published: February 2022

La caza de liebres con galgos en Andalucía es una modalidad de caza menor sin armas de fuego que posee un fuerte arraigo en la región. El colectivo de galgueros y galgueras andaluces, que en la actualidad se aproxima a los seis millares de participantes, entiende que sus prácticas se encuentran en situación de vulnerabilidad debido, principalmente, pero entre otros, a las críticas y discursos que se desprenden desde otros sectores de la población que cuestionan y denuncian la utilización y el trato que aquellos ofrecen a los animales involucrados en esta modalidad cinegética. Este conflicto percibido ha sido uno de los motivos por los cuales se ha promovido la elaboración de un informe técnico para el registro de la actividad en el Atlas del Patrimonio Inmaterial de Andalucía. El mismo entrañaría el reconocimiento, que no la declaración o catalogación con efectos jurídico-administrativos, de la actividad como patrimonio cultural inmaterial y vivo en este territorio. Este artículo presenta, a partir de los resultados extraídos del trabajo 8 de campo llevado a cabo para la elaboración de dicho informe, los principales valores etnológicos detectados para la caza de liebres con galgos en Andalucía. A partir de ello, el texto reflexiona sobre cómo el conflicto puede convertirse en catalizador de procesos de patrimonialización, al tiempo que del mismo surgen ciertas problemáticas de índole ético y moral con las actividades y prácticas que se quieren proteger y en las que se utilizan animales.
Uncovering Characteristic Response Paths of a Population
Authors: Song Yicheng , Sahoo Nachiketa , Srinivasan Shuba , Dellarocas Chrysanthos
Published: February 2022

We propose an approach for uncovering characteristic response paths of a population from an individual-level multivariate time series data set. The approach is based on a model that accommodates a set of arbitrary distributions for endogenous variables and interstep intervals and variables. The model enables reliable estimation of individual-level parameters by uncovering and statistically pooling clusters of similar individuals. We show that using such a model one can distribute the response of an outcome variable to an impulse over all possible preceding activity sequences. When a few such sequences explain most of the response, they describe the population’s characteristic response paths from the impulse to the outcome. We apply the proposed approach to a customer touchpoint data set from a large multichannel specialty retailer. This application uncovers six customer segments, each with unique characteristic paths to purchase. These paths provide insights into the behavior of customers and the optimal over-time communication strategy for different customer segments.

Summary of Contribution: Uncovering users’ paths through physical and virtual spaces has been of considerable interest in the computing and operations research domain. The existing research suggests a demand for visualizing the primary paths of agents through geographic, online, and activity spaces. Thus far, most of the research have developed approaches that are unique to specific domains providing insight into the domain in the process. There is a need for a general statistically robust approach that can be applied to a broad range of domains to uncover variable sequences that lead to outcomes of interest. We propose a computational approach to uncover characteristic response paths of a population from an individual-level multivariate time series data set. The approach is based on a statistical model that accommodates arbitrary and mixed set of distributions for the endogenous variables, accommodates intersession intervals and variables, and reliably estimates individuals’ parameters through statistical pooling by uncovering clusters of similar members. These features make the proposed model suitable for a large variety of real-world datasets. We show that using such a model one can extract characteristic paths over possible activity sequences starting from an impulse leading up to a target variable of interest.
Managerial Regret and Inventory Pricing
Authors: Li Meng , Liu Yan
Published: February 2022

In this paper, we study a regretful seller’s problem of selling a fixed number of goods over a finite and known time horizon. The seller engages in counterfactual thinking to compare her selected price with other forgone alternatives. If a forgone alternative (ex post) generates a better outcome than the selected one, then the seller experiences regret. We characterize the pricing decision of a regretful seller and find that, although regret leads the seller to set a price that is lower than that set by an unbiased seller, the regretful seller employs decision policies whose structure is similar to those of the unbiased seller: the price decreases with the remaining inventory and increases with the time-to-go. Interestingly, we find that the seller who has a greater number of goods does not necessarily receive greater revenue.

This paper was accepted by Manel Baucells, behavioral economics and decision analysis.
Design of Incentive Programs for Optimal Medication Adherence in the Presence of Observable Consumption
Authors: Suen Sze-chuan , Negoescu Diana , Goh Joel
Published: February 2022

Designing Incentives to Promote Treatment Adherence

Premature cessation of antibiotic therapy is common and can severely compromise health outcomes, potentially leading to worsening health, disease transmission, and antibiotic resistance. In “Design of Incentive Programs for Optimal Medication Adherence in the Presence of Observable Consumption,” Sze-chuan Suen, Diana Negoescu, and Joel Goh investigate the problem of designing a schedule of incentive payments to induce socially optimal treatment adherence levels in settings in which treatment adherence can be observed but patient preferences for treatment adherence are heterogeneous and unobservable to a health provider. The novel elements of this problem stem from its institutional features: there is a single incentive schedule applied to all patients, incentive payments must be increasing in patients’ adherence, and patients cannot be a priori prohibited from any given levels of adherence. The authors develop models to design optimal incentives incorporating these features and conduct a numerical study of the tuberculosis epidemic in India.
Continuous Assortment Optimization with Logit Choice Probabilities and Incomplete Information
Authors: Peeters Yannik , den Boer Arnoud V. , Mandjes Michel
Published: February 2022

This paper considers a novel formulation of the classical assortment optimization problem with multinomial logit demand and unknown model parameters. The novelty lies in the fact that the set of products is not finite but a continuum, motivated by the desire to understand the problem characteristics for many products, as well as by applications where products are characterized by a continuous quality variable. For settings with and without capacity constraints, the authors design data-driven decision policies and prove upper and lower bounds on the regret, which imply that these policies are asymptotically optimal.
Technical Note—On Matrix Exponential Differentiation with Application to Weighted Sum Distributions
Authors: Das Milan Kumar , Tsai Henghsiu , Kyriakou Ioannis , Fusai Gianluca
Published: February 2022

On Modeling the Probability Distribution of Stochastic Sums

In the “Technical Note—On Matrix Exponential Differentiation with Application to Weighted Sum Distributions,” Das, Tsai, Kyriakou, and Fusai propose an efficient methodology for approximating the unknown probability distribution of a weighted stochastic sum or time integral. Resulting from earlier contributions based on continuous-time Markov chain approximations of one-dimensional Markov processes is the Laplace transform of the unknown distribution available in exponential matrix form. In this paper, the authors develop a bona fide Pearson curve-fitting approach to this distribution based on the moments, which they recover from the derivatives of the Laplace transform. Motivated by the computational hurdles toward this, they derive computationally efficient closed-form expressions for the derivatives of the matrix exponential. They then apply to pricing average-based options.
Delay-Join the Shortest Queue Routing for a Parallel Queueing System with Removable Servers
Authors: Badian-Pessot Pamela , Down Douglas G. , Lewis Mark E.
Published: February 2022

We introduce a new class of policies called “delay-join the shortest queue (delay-JSQ)” for use in parallel processing networks with removable servers. When jobs arrive to the system while all servers are on, jobs should be routed to the shortest queue. However, when servers are off, they take a random time to turn back on, which we allow to occur only when the number of jobs in each of the nonempty queues exceeds a fixed threshold. This new class of policies balances the load among all servers that are currently on and balances the capacity by keeping servers off until they are needed. A detailed numerical study shows that at moderate loads (where server farms and increasingly manufacturing facilities operate), delay-JSQ outperforms JSQ by up to 80%. In addition, it does so without precise knowledge of the input parameters and even when the input process is nonstationary.
Meeting the challenge of insulin resistance in general practice
Authors: Winter George
Published: February 2022

As evidence around the role of insulin resistance in many long term conditions continues to grow, George Winter looks at what we know so far
Acute supralevator abscess: the little we know
Authors: Zinicola R , Cracco N , Rossi G , Giuffrida M , Giacometti M , Nicholls RJ
Published: February 2022

Introduction

Acute supralevator abscess (SLA) is an uncommon and complicated form of anorectal sepsis. Its correct management is crucial to avoid complex iatrogenic fistula formation. A comprehensive review of the literature was conducted to determine the incidence of SLA and the surgical outcome with particular reference to the direction of drainage.

Methods

A search of Medline, PubMed and the Cochrane Library was performed to identify all studies reporting surgical drainage of SLA.

Findings

A total of 19 studies were identified, including 563 patients. The only two prospective studies reported an incidence of SLA of 10% and 3% in 68 and 100 patients, respectively, with anorectal sepsis. In 17 retrospective studies, the incidence ranged from 0% to 28%. Magnetic resonance imaging (MRI) was performed routinely in only one study. The surgical anatomical classification of the abscess was described in six studies diagnosed at surgery. The direction of surgical drainage whether ‘inwards’ (into the lumen) or ‘outwards’ (into the ischioanal fossa) was stated in only six studies. In two of these, the direction of drainage was contradictory to the recommendation made by Parks et al. Recurrent sepsis was reported in eight studies and ranged from 0% to 53%.

Conclusions

Detailed and prospective data on acute SLA are lacking. Its real incidence is unclear and it is not possible to analyse surgical outcomes conclusively according to different direction of drainage. The routine use of MRI in complicated anorectal sepsis would specify the surgical anatomy of SLA before any drainage is carried out.
The palliative management of non-islet cell tumour hypoglycaemia with glucocorticoids and somatostatin analogues in an unresectable hepatocellular carcinoma
Authors: North AS , Thakkar RG , James RA , Hammond JS
Published: February 2022

Non-islet cell tumour hypoglycaemia (NICTH) results from paraneoplastic insulin-like growth factor-II (IGF-II) secretion and its potent insulin-like effect. It causes recurrent, often severe, hypoglycaemic episodes, which is detrimental to quality of life. There is limited evidence regarding best supportive care in unresectable tumours. A 76-year-old woman presented with hypoglycaemic collapse. A new diagnosis of unresectable hepatocellular carcinoma (HCC) was made. The IGF-II:IGF-I ratio was 11.0, which confirmed NICTH. The octreoscan showed avid disease. The main problem was symptomatic nocturnal hypoglycaemia. Curative treatment options were not possible in this case and treatment focused on preventing symptomatic hypoglycaemia. Inpatient treatment was with high carbohydrate nasogastric (NG) feeds, prednisolone and somatostatin analogue (octreotide) infusion. Once stabilised, the patient was discharged with NG feeds, prednisolone and a long-acting somatostatin analogue (sandostatin). The patient received successful end-of-life care with her family as per her wishes, without requiring readmission. The treatments were well-tolerated and effective in preventing symptomatic hypoglycaemic episodes. The combination of high carbohydrate NG feed with prednisolone and somatostatin analogues was effective in preventing symptomatic hypoglycaemia. Somatostatin analogues had a useful steroid sparing role. Larger case series are warranted to clarify the management of NICTH patients with placebo-controlled studies to determine the role of somatostatin analogues.
Pollination of Brassica campestris (Cruciferae) by Andrena savignyi (Andrenidae: Hymenoptera): Female vs. Male Pollination
Authors: Akram Waseem , Sajjad Asif
Published: February 2022

Female and male solitary bees usually differ in their behavioral and morphological attributes and consequently in their pollination effectiveness. The current study was carried out at the research farm of The Islamia University of Bahawalpur, Pakistan, to compare the foraging behavior and pollination efficiency of female and male Andrena savignyi Spinola, 1838 on Brassica campestris. The impact of different environmental factors (temperature, relative humidity, light intensity and wind speed) on foraging behavior was also studied. Andrena savignyi was the most abundant floral visitor of B. campestris and comprised 52.17% of the floral visitors. Female individuals fed on both nectar and pollen while male fed on nectar. Visitation frequency, visitation rate, pollen harvest and pollen deposition of females were significantly higher than that of males because of their larger size and more dry weight. The maximum abundance of females was recorded at 12:00 pm followed by a sharp decline until 4:00 pm whereas males attained their maximum abundance at 2:00 pm. The female pollinated flowers resulted in greater pod weight, pod length, number of seeds per pod, seed weight per pod and germination percentage than the males. Our results suggest that females of A. savignyi deliver better pollination of B. campestris than males in terms of its reproductivesuccess and germination percentage. Future studies should emphasis on exploring the biology and ecology of A. savignyi with special focus of its artificial nesting.
Axial motion estimation and correction for simultaneous multi-plane two-photon calcium imaging
Authors: Flores-Valle Andres , Seelig Johannes D.
Published: February 2022

Two-photon imaging in behaving animals is typically accompanied by
brain motion. For functional imaging experiments, for example with
genetically encoded calcium indicators, such brain motion induces
changes in fluorescence intensity. These motion-related intensity
changes or motion artifacts can typically not be separated from neural
activity-induced signals. While lateral motion, within the focal
plane, can be corrected by computationally aligning images, axial
motion, out of the focal plane, cannot easily be corrected. Here, we
developed an algorithm for axial motion correction for non-ratiometric
calcium indicators taking advantage of simultaneous multi-plane
imaging. Using temporally multiplexed beams, recording simultaneously
from at least two focal planes at different z
positions, and recording a z-stack for each beam as a
calibration step, the algorithm separates motion-related and neural
activity-induced changes in fluorescence intensity. The algorithm is
based on a maximum likelihood optimisation approach; it assumes (as a
first order approximation) that no distortions of the sample occurs
during axial motion and that neural activity increases uniformly along
the optical axis in each region of interest. The developed motion
correction approach allows axial motion estimation and correction at
high frame rates for isolated structures in the imaging volume
in vivo, such as sparse expression patterns in the
fruit fly brain.
Real-time OCT image denoising using a self-fusion neural network
Authors: Rico-Jimenez Jose J. , Hu Dewei , Tang Eric M. , Oguz Ipek , Tao Yuankai K.
Published: February 2022

Optical coherence tomography (OCT) has become the gold standard for ophthalmic diagnostic imaging. However, clinical OCT image-quality is highly variable and limited visualization can introduce errors in the quantitative analysis of anatomic and pathologic features-of-interest. Frame-averaging is a standard method for improving image-quality, however, frame-averaging in the presence of bulk-motion can degrade lateral resolution and prolongs total acquisition time. We recently introduced a method called self-fusion, which reduces speckle noise and enhances OCT signal-to-noise ratio (SNR) by using similarity between from adjacent frames and is more robust to motion-artifacts than frame-averaging. However, since self-fusion is based on deformable registration, it is computationally expensive. In this study a convolutional neural network was implemented to offset the computational overhead of self-fusion and perform OCT denoising in real-time. The self-fusion network was pretrained to fuse 3 frames to achieve near video-rate frame-rates. Our results showed a clear gain in peak SNR in the self-fused images over both the raw and frame-averaged OCT B-scans. This approach delivers a fast and robust OCT denoising alternative to frame-averaging without the need for repeated image acquisition. Real-time self-fusion image enhancement will enable improved localization of OCT field-of-view relative to features-of-interest and improved sensitivity for anatomic features of disease.
Polarized spectroscopy and SESAM mode-locking of Tm,Ho:CALGO
Authors: Wang Yicheng , Loiko Pavel , Zhao Yongguang , Pan Zhongben , Chen Weidong , Mero Mark , Xu Xiaodong , Xu Jun , Mateos Xavier , Major Arkady , Guina Mircea , Petrov Valentin , Griebner Uwe
Published: February 2022

A Tm,Ho:CALGO laser passively mode-locked by a GaSb-based SESAM generated pulses as short as 52 fs at a central wavelength of 2015 nm with a broad spectral bandwidth of 82 nm (full width at half maximum) owing to the combined gain profiles of both dopants for σ-polarized light. The average output power reached 376 mW at a repetition rate of 85.65 MHz. In the continuous-wave regime, the laser was power scaled up to 1.01 W at 2080.6 nm with a slope efficiency of 32.0%, a laser threshold of 155 mW and π-polarized emission. Polarized spectroscopic properties of Ho3+ ions in singly doped and codoped CALGO crystals were revisited to explain the observed laser performance.
Inverse design of gradient-index volume multimode converters
Authors: Barré Nicolas , Jesacher Alexander
Published: February 2022

Graded-index optical elements are capable of shaping light precisely and in very specific ways. While classical freeform optics uses only a two-dimensional domain such as the surface of a lens, recent technological advances in laser manufacturing offer promising prospects for the realization of arbitrary three-dimensional graded-index volumes, i.e. transparent dielectric substrates with voxel-wise modified refractive index distributions. Such elements would be able to perform complex light transformations on compact scales. Here we present an algorithmic approach for computing 3D graded-index devices, which utilizes numerical beam propagation and error reduction based on gradient descent. We present solutions for millimeter-sized elements addressing important tasks in photonics: a mode sorter, a photonic lantern and a multimode intensity beam shaper. We further discuss suitable cost functions for all designs to be used in the algorithm. The 3D graded-index designs are spatially smooth and require a relatively small refractive index range in the order of 10−2, which is within the reach of direct laser writing manufacturing processes such as two-photon polymerization.
Decomposing socio-economic inequality in catastrophic out-of-pocket health expenditures in Malawi
Authors: Mulaga Atupele N. , Kamndaya Mphatso S. , Masangwi Salule J.
Published: February 2022

Reducing health inequalities and inequities is one of the key goals that health systems aspire to achieve as it ensures improvement in health outcomes among all population groups. Addressing the factors contributing to inequality in catastrophic health expenditures is important to reducing inequality in the burden of health expenditures. However, there are limited studies to explain the factors contributing to inequalities in catastrophic health expenditures. The study aimed to measure and decompose socio-economic inequality in catastrophic health into its determinants. Data for the analysis come from the fourth integrated household survey. Data for 12447 households in Malawi were collected from April 2016 to April 2017 by the National Statistical Office. The secondary analysis was conducted from June 2021 to October 2021. Catastrophic health expenditure was estimated as a proportion of households whose out-of-pocket health expenditures as a ratio of non-food consumption expenditures exceeds 40% threshold level. We estimated the magnitude of socio-economic inequality using the Erreygers corrected concentration index and used decomposition analysis to assess the contribution of inequality in each determinant of catastrophic health expenditure to the overall socio-economic inequality. The magnitude of the Erreygers corrected concentration index of catastrophic health expenditure (CI = 0.004) is small and positive which indicates that inequality is concentrated among the better-off. Inequality in catastrophic health expenditure is largely due to inequalities in rural residency (127%), socio-economic status (-40%), household size (14%), presence of a child under five years old (10%) and region of the household (10%). The findings indicate that socio-economic inequality in catastrophic health expenditures is concentrated among the better-off in Malawi. The results imply that policies that aim to reduce inequalities in catastrophic health expenditures should simultaneously address urban-rural and income inequalities.