bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal Profile of Pneumonia After Stroke
Authors: de Jonge Jeroen C. , van de Beek Diederik , Lyden Patrick , Brady Marian C. , Bath Philip M. , van der Worp H. Bart , Lees K.R. , Alexandrov A. , Berge E. , Bluhmki E. , Bornstein N. , Chen C. , Claesson L. , Davis S.M. , Donnan G. , Diener H.C. , Fisher M. , Ginsberg M. , Gregson B. , Grotta J. , Hacke W. , Hennerici M.G. , Hommel M. , Kaste M. , Marler J. , Muir K. , Venketasubramanian N. , Sacco R. , Shuaib A. , Teal P. , Wahlgren N.G. , Warach S. , Weimar C.
Published: September 2021

Background and Purpose:

The occurrence of pneumonia after stroke is associated with a higher risk of poor outcome or death. We assessed the temporal profile of pneumonia after stroke and its association with poor outcome at several time points to identify the most optimal period for testing pneumonia prevention strategies.

Methods:

We analyzed individual patient data stored in the VISTA (Virtual International Stroke Trials Archive) from randomized acute stroke trials with an inclusion window up to 24 hours after stroke onset and assessed the occurrence of pneumonia in the first 90 days after stroke. Adjusted odds ratios and hazard ratios were calculated for the association between pneumonia and poor outcome and death by means of logistic and Cox proportional hazard regression, respectively, at different times of follow-up.

Results:

Of 10 821 patients, 1017 (9.4%) had a total of 1076 pneumonias. Six hundred eighty-nine (64.0%) pneumonias occurred in the first week after stroke. The peak incidence was on the third day and the median time of onset was 4.0 days after stroke (interquartile range, 2–12). The presence of a pneumonia was associated with an increased risk of poor outcome (adjusted odds ratio, 4.8 [95% CI, 3.8–6.1]) or death (adjusted hazard ratio, 4.1 [95% CI, 3.7–4.6]). These associations were present throughout the 90 days of follow-up.

Conclusions:

Two out of 3 pneumonias in the first 3 months after stroke occur in the first week, with a peak incidence on the third day. The most optimal period to assess pneumonia prevention strategies is the first 4 days after stroke. However, pneumonia occurring later was also associated with poor functional outcome or death.
Endovascular Therapy for Stroke due to Basilar Artery Occlusion
Authors: Nguyen Thanh N. , Strbian Daniel
Published: September 2021

Basilar artery occlusion stroke is known to have poor outcome with a high rate of morbidity and mortality despite best medical therapy. Since the original report of intra-arterial therapy for basilar artery occlusion in 1983, two recent randomized trials comparing endovascular therapy versus best medical management were completed on a large scale, BASICS (Basilar Artery International Cooperation Study) and the BEST trial (Basilar Artery Occlusion Endovascular Intervention Versus Standard Medical Treatment), both of which demonstrated equivocal benefit of the two modalities. In this commentary, we comment and highlight important lessons related to basilar occlusion stroke as learned from the BASICS and BEST randomized trials.
How Choreostorming Informs Thinking in Molecular Genetics and Cancer Biology
Authors: Bargonetti Jill
Published: September 2021

The medium of interpretive dance to convey basic science is well regarded but not commonplace for college-level instruction or scientific hypothesis development. The molecular biology of cancer involves multiple polymer languages that coordinate genome information flow from DNA to RNA to proteins. The author’s course (1) uses a nonbinary art-science approach to teach the molecular biology of cancer; (2) communicates cellular processes to cancer patients in order to empower them to understand what they are experiencing; and (3) assists cancer scientists in developing hypotheses through kinesthetic and visual enactment of cellular processes. Nontrained movers and scientific thinkers together participate in choreostorming, a nonbinary process for developing, and extending, thought experiments into the movement laboratory.
Birds using artificial plants as nesting material
Authors: Hiemstra Auke-Florian , Gravendeel Barbara , Schilthuizen Menno
Published: September 2021

Here we present the first cases of birds using artificial plants as nest material. We report our findings for the common coot (Fulica atra) from Leiden, the Netherlands, in 2019. This is the first population of freshwater birds studied for its use of anthropogenic nest materials, and together with another report from the same year, the earliest case of an entire bird population with plastic in all nests. We also report the first artificial plants used as nesting material by birds, and discuss the implications of their usage as such.
Islamic Marble Objects from Afghanistan in the Bumiller Collection, Bamberg
Authors: Giunta Roberta
Published: September 2021

The Bumiller Collection in Bamberg includes a number of Afghan marble artefacts that are thought to have come from Ghazni, ancient capital of the Ghaznavids (977–1186), famous for the abundant use of this material both in the decoration of religious and civil buildings in the medieval era and in the construction of funerary monuments in medieval and post-medieval times. A comparison with the finds documented by the Italian Archaeological Mission, engaged in Afghanistan since 1956 and with a specific interest in the city of Ghazni, reveals several interesting aspects that allow us to advance hypotheses about the effective provenance and dating of the marbles in the Collection.
Where Do Those Beautiful Ladies and Wolf’s Footprints Lead Us? The Mādhyamikas on Two Cārvāka/Lokāyata Stanzas
Authors: Del Toso Krishna
Published: September 2021

This is the third and final part of a study focused on the Madhyamaka accounts of the Cārvāka/Lokāyata so-called “wolf’s footprint” stanza and tale, and “beautiful lady” stanza. In particular, this paper discusses Jayānanda’s short account of the tale and the stanzas contained in his Madhyamakāvatāraṭīkā on Candrakīrti’s Madhyamakāvatārabhāṣya. The Tibetan edition and English translation of Jayānanda’s relevant passages are also provided.
Inventaire préliminaire du lexique arabe vernaculaire/semi-vernaculaire d’Ifrīqiya recueilli dans deux sources bio-hagiographiques : les Manāqib Abī Isḥāq al-Ǧabanyānī et les Manāqib Muḥriz b. Ḫalaf (5e/11e siècle)
Authors: Meouak Mohamed
Published: September 2021

This short note presents some lexical data in vernacular/semi-vernacular Arabic collected in the following Ifriqiyan sources: Manāqib Abī Isḥāq al-Jabanyānī and Manāqib Muḥriz b. Khalaf (5th/11th century). The main idea of the study is to remind the linguist and the historian of the real interest there would be in examining the textual material in vernacular/semi-vernacular Arabic from Medieval Tunisia in order to contribute to a better knowledge of the social history of linguistic habits.
Key to Ptychopteridae (Diptera) larvae of Northern Europe, with notes on distribution and biology
Authors: WIBERG-LARSEN PETER , HANSEN SØREN BIRKHOLM , RINNE AKI , VIITANEN ESKO , KROGH PAUL HENNING
Published: September 2021

A key to larvae of Ptychopteridae (phantom crane flies) is provided for species inhabiting Northern Europe. The key encompasses seven species, including the previously undescribed larvae of Ptychoptera longicauda (Tonnoir 1919). Larval specimens examined were primarily sampled from sites in Denmark. Larvae were associated with correctly identified adults based on DNA barcode (COI) sequence. In the development of the key, a wide suite of morphological characteristics were examined and evaluated for their utility to separate species. Current distribution maps are provided for all species occurring within Northern Europe. Based on records of larvae from Denmark and Finland, notes on larval habitats are given. We also present flight periods for all species examined during this study. Finally, the status of the enigmatic species Ptychoptera obscura (Peus 1958) is briefly discussed.
When unexpected guests come to eat: two new species of Phyllolabis Osten Sacken (Diptera: Limoniidae) collected with carrion-baited traps in the centre of the Iberian Peninsula
Authors: MEDEROS JORGE , MARTÍN-VEGA DANIEL , BAZ ARTURO
Published: September 2021

Phyllolabis eiroae sp. nov. and P. martinhalli sp. nov. are described from the centre of the Iberian Peninsula. These two remarkable species were collected using carrion-baited traps, running during winter, in several localities of Madrid province (Spain). The two new species are well differentiated from the other Phyllolabis Osten Sacken species recorded from the Iberian Peninsula, P. savtshenkoi Theowald, and those from the west Palaearctic. An identification key to differentiate the three Phyllolabis species occurring in the Iberian Peninsula is provided. The first images of P. savtshenkoi, based on the holotype and a male specimen recorded from a cave located in Jaén (Spain), are also provided.
Rediscovery of Forficula iberica Steinmann, 1981 (Dermaptera: Forficulidae)
Authors: GARCÍA-PARÍS MARIO , JURADO-ANGULO PILAR , MARTÍNEZ-PÉREZ SANDRA , MICÓ ESTEFANÍA
Published: September 2021

Forficula iberica Steinmann, 1981 was described from Spain (Province of Zaragoza), but since its description it has remained an unknown taxon, usually ignored or treated as a synonym of F. auricularia Linnaeus, 1758. Field work in central Spain allowed us to collect some specimens of Dermaptera that matched the original description of F. iberica. In addition, the collection of the Museo Nacional de Ciencias Naturales (MNCN-CSIC, Spain) held some specimens assignable to F. iberica confused among other Iberian species. The main objective of this work is to validate the specific status of F. iberica, report its rediscovery in central Spain, and evaluate the diagnostic characters provided by Steinmann (1981). The original description provided by Steinmann is quite complete, and fits precisely the specimens located in the field or at the MNCN, which cannot be associated to any other species of Forficulidae. The comparison of Steinmann´s paratypes of F. iberica at the Magyar Természettudományi Múzeum (MTM, Budapest), with the specimens obtained in the field, confirms that they can be assigned to F. iberica. The shape of the tegmina of F. iberica is most similar to that of F. lesnei, but differs from that of G. pubescens (obliquely truncated posteriorly). Shape of the cerci of F. iberica is similar to that of G. pubescens and G. brignolii, but different from that of F. lesnei. The genus Guanchia Burr, 1911 was created based on the shape of tegmina (obliquely truncated), but this character is quite variable. In agreement with Vigna Taglianti (2011), we consider that a phylogenetic study of the subfamily Forficulinae is necessary to revise the generic status of the continental species of Forficula included in Guanchia by Steinmann (1993).
Mechanisms shaping wind convergence under extreme synoptic situations over the Gulf Stream region
Authors: Rousseau Victor , Sanchez-Gomez Emilia , Msadek Rym , Moine Marie-Pierre
Published: September 2021

Air-sea interaction processes over the Gulf Stream have received particular attention over the last decade. It has been shown that sea surface temperature (SST) gradients over the Gulf Stream can alter the near surface wind divergence through changes in the marine atmospheric boundary layer (MABL). Two mechanisms have been proposed to explain the response: the Vertical Mixing Mechanism (VMM) and the Pressure Adjustment Mechanism (PAM). However, their respective contribution is still under debate. It has been argued that the synoptic perturbations over the Gulf Stream can provide more insight on the MABL response to SST fronts. We analyze the VMM and PAM under different atmospheric conditions obtained from a classification method based on the deciles of the statistical distribution of winter turbulent heat fluxes over the Gulf Stream. Lowest deciles are associated with weak air-sea interactions and anticyclonic atmospheric circulation over the Gulf Stream, whereas highest deciles are related to strong air-sea interactions and a cyclonic circulation. Our analysis includes the low and high-resolution versions of the ARPEGEv6 atmospheric model forced by observed SST, and the recently released ERA5 global reanalysis. We find that the occurrence of anticyclonic and cyclonic perturbations associated with different anomalous wind regimes can locally modulate the activation of the VMM and the PAM. In particular, the PAM is predominant in anticyclonic conditions, whereas both mechanisms are equally present in most of the cyclonic conditions. Our results highlight the role of the atmospheric circulation and associated anomalous winds in the location, strength and occurrence of both mechanisms.
The inherent uncertainty of precipitation variability, trends, and extremes due to internal variability, with implications for Western US water resources
Authors: McKinnon Karen A. , Deser Clara
Published: September 2021

The approximately century-long instrumental record of precipitation over land reflects a single sampling of internal variability. Thus, the spatiotemporal evolution of the observations is only one realization of `what could have occurred' given the same climate system and boundary conditions, but different initial conditions. While climate models can be used to produce initial-condition large ensembles that explicitly sample different sequences of internal variability, an analogous approach is not possible for the real world. Here, we explore the use of a statistical model for monthly precipitation to generate synthetic ensembles based on a single record. When tested within the context of the NCAR Community Earth System Model version 1 Large Ensemble (CESM1-LE), we find that the synthetic ensemble can closely reproduce the spatiotemporal statistics of variability and trends in winter precipitation over the extended contiguous United States, and that it is difficult to infer the climate change signal in a single record given the magnitude of the variability. We additionally create a synthetic ensemble based on the Global Precipitation Climatology Centre (GPCC) dataset, termed the GPCC-synth-LE; comparison of the GPCC-synth-LE with the CESM1-based ensembles reveals differences in the spatial structures and magnitudes of variability, highlighting the advantages of an observationally-based ensemble. We finally use the GPCC-synth-LE to analyze three water resource metrics in the Upper Colorado River Basin: frequency of dry, wet, and whiplash years. Thirty-one year ‘climatologies’ in the GPCC-synth-LE can differ by over 20% in these key water resource metrics due to sampling of internal variability, and individual ensemble members in the GPCC-synth-LE can exhibit large near-monotonic trends over the course of the last century due to sampling of variability alone.
The efficacy of seasonal terrestrial water storage forecasts for predicting vegetation activity over Africa
Authors: Cook Benjamin I , Slinski Kimberly , Peters-Lidard Christa , McNally Amy , Arsenault Kristi , Hazra Abheera
Published: September 2021

Terrestrial water storage (TWS) provides important information on terrestrial hydroclimate and may have value for seasonal forecasting because of its strong persistence. We use the NASA Hydrological Forecast and Analysis System (NHyFAS) to investigate TWS forecast skill over Africa and assess its value for predicting vegetation activity from satellite estimates of leaf area index (LAI). Forecast skill is high over East and Southern Africa, extending up to 3–6 months in some cases, with more modest skill over West Africa. Highest skill generally occurs during the dry season or beginning of the wet season when TWS anomalies from the previous wet season are most likely to carry forward in time. In East Africa, this occurs prior to and during the transition into the spring “Long Rains” from January–March, while in Southern Africa this period of highest skill starts at the beginning of the dry season in April and extends through to the start of the wet season in October. TWS is highly and positively correlated with LAI, and a logistic regression model shows high cross-validation skill in predicting above or below normal LAI using TWS. Combining the LAI regression model with the NHyFAS forecasts, 1-month lead LAI predictions have high accuracy over East and Southern Africa, with reduced but significant skill at 3-month leads over smaller sub-regions. This highlights the potential value of TWS as an additional source of information for seasonal forecasts over Africa, with direct applications to some of the most vulnerable agricultural regions on the continent.
Clinical Factors Contributing to Anastomotic Leak After Mid-to-High Colorectal Anastomosis
Authors: Ghuman Amandeep , Ganga Ramarao , Parisi Severino Natalia , Krizzuk Dimitri , Li Qiong Zhen , Wexner Steven D. , Da Silva Giovanna
Published: September 2021

Background

Low colorectal anastomoses carry a high anastomotic leak (AL) rate (up to 20%) and thus are commonly diverted. Much less is known about mid-to-high colorectal anastomosis, which carries a leak rate of 2-4%. The objective of this study was to determine our AL rate after mid-to-high colorectal anastomosis and associated risk factors.

Methods

A single center retrospective cohort study of patients undergoing left colonic resections with mid-to-high colorectal anastomosis (≥7 cm from the anal verge) from January 2008 to October 2017 was utilized. Main outcome, AL, defined as clinical suspicion supported by radiological or intraoperative findings, was calculated and risk factors assessed using multivariable logistic regression analysis.

Results

977 patients were included; 487 (49.9%) were male, with a mean age of 59.8 (+/−12.1) years. Mean BMI was 27.5 (+/−5.5) kg/m2. Diverticular disease (67.5%), malignancy (17.4%), and inflammatory bowel disease (2.2%) were the main indications for resection. Mean length of stay was 6.7 (+/−4.5) days. 455 (46.8%) colonic resections were performed by laparoscopy, 283 (29.1%) by hand assisted surgery, 219 (22.5%) by laparotomy, and 16 (1.6%) by robotics. Majority of patients had complete donuts (99.6%) and a negative air leak test (97.7%). 149 patients (15.3%) underwent construction of a diverting stoma. The overall AL rate was 2.1% (n = 20). Increased BMI (>30 kg/m2), P = .02, was an independent risk factor for AL and a trend observed for positive air leak tests ( P = .05), with other factors failing to achieve statistical significance.

Conclusions

Patients with mid-to-high colorectal anastomosis have a 2% AL risk. Increased BMI was a risk factor for AL.
COVID-19 Hard Lockdown in South Africa: Lessons for Climate Stakeholders Pursuing the Thirteenth Sustainable Development Goal
Authors: Ebhuoma Eromose E.
Published: September 2021

As a result of South Africa recording its first COVID-19 index case in March 2020, the country imposed one of the strictest lockdowns globally. The lockdown unearthed vital lessons that climate practitioners both in South Africa – the largest emitter of greenhouse gases on the African continent – and globally can draw from to facilitate the achievement of the thirteenth Sustainable Development Goal (SDG 13). Drawing on secondary data analysis of media reports regarding South Africa’s strategy to tackle the ongoing COVID-19 pandemic, with particular emphasis on the hard lockdown, three themes emerged. These were rephrased to align appropriately with the discourse on climate change (CC). These include changing the distant framing narrative of CC, prioritizing green growth and utilizing credible messengers. Each theme is discussed critically in terms of how it will aid climate policy developers and practitioners in facilitating the attainment of SDG 13.
Predict the exercise behavior intention of the older adults in Taipei City to promote exercise behavior
Authors: Huang Wei Yang , Wu Cheng-En
Published: September 2021

The purpose of this study employed the theory of planned behavior as a research framework to analyze the explanatory power of exercise attitude, subjective norms, and perceived behavioral control on exercise intention among older adults and to obtain insight on exercise behavior among older adults. The study used Ajzen's theory of planning behavior as a basis to compile the “Exercise Behavior Intention Questionnaire of the Older Adults.” Results showed that there were significant differences were detected in the exercise intentions of older adults with different subjective norms and perceived behavioral control. This indicated that older adults of greater age have a greater need for companionship from family members and stronger subjective norms. In addition, exercise attitude, subjective norms, and perceived behavioral control explained the variance in exercise intention among older adults, verifying the positive explanatory power of these variables on exercise intention in older adults. The study concluded that the theory of planned behavior, improving older adults’ exercise attitude alone was insufficient for increasing their exercise behavior intention. In particular, older adults of greater age had greater needs for social support from the main groups, and they required encouragement to enhance their self-efficacy and confidence.
Screening of hemophagocytic lymphohistiocytosis in children with severe sepsis in pediatric intensive care
Authors: El-Sayed Zeinab A , El-Owaidy Rasha H , Khamis Mohammed A , Rezk Ahmed R
Published: September 2021

Background:

We sought to screen for clinical and laboratory features of hemophagocytic lymphohistiocytosis among pediatric patients with severe sepsis.

Methods:

We conducted a retrospective study that analyzed the clinical and laboratory data of 70 pediatric patients who died of severe sepsis. Medical records were revised for the presence of fever, splenomegaly, pancytopenia, hyperferritinemia, hypertriglyceridemia, and hypofibrinogenemia. Soluble CD25 was measured in stored samples.

Results:

Patients’ ages ranged between 0.5 and 11 years with median (interquartile range) 2 (1–5). All patients had fever (≥38.5 °C) and pancytopenia, 58 (82.9%) hepatosplenomegaly, 36 (51.4%) lymphadenopathy, 37 (52.9%) had ferritin >500 ng/ml, 20 (28.6%) had fibrinogen <1.5 mg/ml, 14 (20%) had fasting triglycerides >264 mg/dl while 5 (7.1%) had soluble CD25 >2400 U/ml. Twenty-five (35.7%) patients fulfilled at least 5/6 of the hemophagocytic lymphohistiocytosis-2004 diagnostic criteria. Multivariate backward binary logistic regression analysis revealed lymphadenopathy as an independent predictor for hemophagocytic lymphohistiocytosis criteria fulfilment with odds ratio of 23.9. Fibrinogen had the best performance in discriminating hemophagocytic lymphohistiocytosis fulfilling from non-fulfilling groups (cut-off value: <1.8 mg/ml), followed by ferritin/erythrocyte sedimentation rate ratio (cut-off value: >17).

Conclusion:

There is a significant clinical and laboratory overlap between hemophagocytic lymphohistiocytosis and severe sepsis, making the syndromes difficult to distinguish. The use of current hemophagocytic lymphohistiocytosis-2004 diagnostic criteria should be applied cautiously in those patients.
Modeling and simulation of the dynamic behavior of the macaw palm fruit-rachilla system
Authors: Pereira Mariana Ribeiro , Santos Fábio Lúcio , Velloso Nara Silveira , Villar Flora Maria de Melo , Rodrigues Mateus Resende
Published: September 2021

The macaw palm ( Acrocomia aculeata) is a palm tree native to tropical forests that stand out due to its great potential for oil production. This study was developed with the objective of constructing a high-fidelity model of the macaw palm fruit-rachilla system for the purpose of simulating its dynamic behavior when subjected to mechanical vibrations. The finite element method was used to determine the natural frequencies and modes of vibration of the system. The three-dimensional models of the fruit-rachilla systems were elaborated using CAD3D Fusion 360 software. The modal properties of the fruit-rachilla systems were obtained based on the models developed by varying the elasticity modulus values of the system. The parameters of greatest influence in the estimation of natural frequencies are the elasticity modulus, especially that of the fruit-rachilla joint, and the specific mass. The models that take into account the three-dimensional strains along the rachilla are the least sensitive to variations in the mechanical properties (elasticity modulus and specific mass) and are shown to be more representative of the actual physical system.
Metamodel-based formalization of DEVS atomic models
Authors: Blas María Julia , Gonnet Silvio
Published: September 2021

The Discrete-Event System Specification (DEVS) formalism is a modeling formalism based on systems theory that provides a general methodology for hierarchical construction of reusable models in a modular way. When concrete DEVS models are developed using programming languages, it is difficult to ensure they conform to their formal model. Hence, building an implementation of formal models in a way that ensures DEVS formalism correctness is not easy. In this paper, we improve the interplay of abstraction (i.e., formal specification) and concreteness (i.e., programming code implementation) in advancing the theory and practice of DEVS using a specific-designed metamodel. The main contribution is a novel conceptualization of classic DEVS with ports founded on existing approaches but that also includes new improved elements related to the definition of atomic models. That is, our metamodel includes all the concepts and relationships needed to define the formal specification of DEVS atomic models. This allows us to define instances of our conceptualization that comply with the DEVS formal specification. To instantiate our metamodel, we propose a computer-aided environment that has been developed using the Eclipse Modeling Project. As an example, we show how our metamodel can be used to define the classic “switch” model. As a conclusion, we discuss how the final metamodel can be used to support interoperability with DEVS simulation tools.
Separatists, state subjectivity, and fundamental ontological (in)security in international relations
Authors: Grzybowski Janis
Published: September 2021

Ontological security studies (OSS) in International Relations (IR) emphasize the role of identity, anxiety, and a sense of self in world politics. Yet suggesting that states act in certain ways because of ‘who they are’ also assumes that they are in fact states. In this article, I problematize the presupposition of state subjects in the context of separatist conflicts in which claims to statehood compete and overlap. Where unrecognized de facto states are pitted against their unyielding parent states, the two threaten each other’s very state personhood, thereby presenting a more radical challenge to their existence than traditional ‘physical’ and ‘ontological’ security threats. Separatist conflicts thus reveal a widely overlooked dimension of fundamental ontological security, provided by the constitution and recognition of states as such. Moreover, because of the exclusiveness of state subjects in the modern international order, any third parties attempting to resolve such conflicts inevitably face a meta-security dilemma whereby reassuring one side by confirming its claim to statehood simultaneously renders the other side radically insecure. Thus, rather than regarding particular state subjects as merely the starting point of quests for ontological security in international relations, they should also be understood as already their result.
Performance comparison of estimation-based control schemes for hybrid systems
Authors: Mottaiyandi Elenchezhiyan , Vellayikot Shijoh , Kaliappan Vijayakumar
Published: September 2021

In this paper, the authors have proposed an estimation-based control scheme. Artificial neural network and unscented Kalman filter are used for state estimation and inverse dynamics controller is implemented that utilizes the estimation of unmeasured state variables. The benchmark example taken for the analysis and implementation is nonlinear autonomous three-tank hybrid system and non-autonomous switched mode non-isothermal continuous stirred tank reactor, which are subjected to state and measurement noise. The performance comparison of both proposed estimation-based control scheme has been carried out and results are presented. Further, the proposed scheme is validated with three-tank hybrid system experimental setup.
How do 3-year-olds use relevance inferencing to interpret indirect speech?
Authors: Abbot-Smith Kirsten , Schulze Cornelia , Anagnostopoulou Nefeli , Zajączkowska Maria , Matthews Danielle
Published: September 2021

If a child asks a friend to play football and the friend replies, ‘I have a cough’, the requesting child must make a ‘relevance inference’ to determine the communicative intent. Relevance inferencing is a key component of pragmatics, that is, the ability to integrate social context into language interpretation and use. We tested which cognitive skills relate to relevance inferencing. In addition, we asked whether children’s lab-based pragmatic performance relates to children’s parent-assessed pragmatic language skills. We tested 3.5- to 4-year-old speakers of British English (Study 1: N = 40, Study 2: N = 32). Children were presented with video-recorded vignettes ending with an utterance requiring a relevance inference, for which children made a forced choice. Study 1 measured children’s Theory of Mind, their sentence comprehension and their real-world knowledge and found that only real-world knowledge retained significance in a regression analysis with children’s relevance inferencing as the outcome variable. Study 2 then manipulated children’s world-knowledge through priming but found this did not improve children’s performance on the relevance inferencing task. Study 2 did, however, reveal a significant correlation between children’s relevance inferencing and a measure of morpho-syntactic production. In both studies parents rated their children’s pragmatic language usage in daily life, which was found to relate to performance in our lab-based relevance inferencing task. This set of studies is the first to empirically demonstrate that lab-based measures of relevance inferencing are reflective of children’s pragmatic abilities ‘in the wild’. There was no clear association between relevance inferencing and Theory of Mind. There was mixed evidence for the role of formal language, which should be further investigated. Finally, real-world knowledge was indeed associated with relevance inferencing but future experimental work is required to test causal relations.
Frailty Index as a Predictor of Readmission in Patients With Head and Neck Cancer
Authors: Voora Rohith S. , Qian Alexander S. , Kotha Nikhil V. , Qiao Edmund M. , Meineke Minhthy , Murphy James D. , Orosco Ryan K.
Published: September 2021

Objective

To evaluate the predictive utility of the Hospital Frailty Risk Score (HFRS), a stratification tool based on the ICD‐10 (International Classification of Disease, Tenth Revision), and other risk factors for 30‐day readmissions and mortality in a nationally representative cohort.

Study Design

Retrospective database review.

Setting

Nationwide Readmissions Database (2017).

Methods

Patients with head and neck cancer who underwent major surgical procedures were identified from the 2017 Nationwide Readmissions Database, representing 116 medical centers nationwide. Bivariate and multivariable logistic regression methods were used to identify factors associated with unplanned 30‐day readmission, 30‐day readmission mortality, and increased length of hospital stay.

Results

A total of 14,420 patients underwent major head and neck cancer surgery. Unplanned readmission occurred in 11% of patients. The most common reasons for unplanned readmission were procedural complications (26.5%), sepsis (7.3%), and respiratory failure (3.9%). Elevated frailty index (HFRS ≥5) was identified in 22% of patients. Frailty was associated with higher 30‐day readmission rates (18.0% vs 9.5%, P <. 01), which held on multivariate modeling (odds ratio [OR], 1.59 [95% CI, 1.37‐1.85]). Frail patients spent more days in the hospital (8.2 vs 6.8, P =. 02) and incurred more charges across hospital stays ($275,000 vs $188,000, P <. 01). Patients >75 years old (OR, 1.26 [1.03‐1.55]) and patients with electrolyte abnormalities (OR, 1.25 [1.07‐1.46] were significantly more likely to be readmitted.

Conclusion

In this head and neck cancer surgical population, HFRS significantly predicted unplanned readmission. HFRS is a potential risk stratification tool and should be compared with other methods and explored in other cancer populations. Beyond the challenge of identifying at‐risk patients, future work should explore potential interventions aimed at mitigating readmission.
Congenital Cytomegalovirus Targeted Screening Implementation and Outcomes: A Retrospective Chart Review
Authors: Ronner Evette A. , Glovsky Cheryl K. , Herrmann Barbara S. , Woythaler Melissa A. , Pasternack Mark S. , Cohen Michael S.
Published: September 2021

Objective

To assess the effectiveness and outcomes of a targeted cytomegalovirus (CMV) testing protocol.

Study Design

Retrospective chart review.

Setting

Tertiary care institution.

Methods

Targeted screening for CMV in children who did not pass the newborn hearing screening (NHS) was introduced in July 2015 for the level 2 and 3 nurseries at our hospital. In January 2016, this policy was extended to include all nurseries. Retrospective chart review was performed for all newborns who did not pass their NHS between 2013 and 2020. CMV testing rates and related outcomes were compared before and after rollout.

Results

A total of 891 charts were reviewed for infants who did not pass their NHS: 530 (60%) had CMV testing, of which 8 (1.5%) tested positive. Three cases were detected prior to and 5 occurred after initiation of targeted screening. Six CMV+ infants demonstrated hearing loss on confirmatory auditory brainstem response, all of whom began treatment with oral valganciclovir. Hearing remained stable in 3 patients, progressed in 2, and improved in 1. The rate of CMV testing in children who did not pass their NHS increased from 14% to 88% after full implementation of targeted screening (P <. 001). The average age at initial infectious disease consultation was significantly younger for infants born after targeted screening (P <. 001).

Conclusion

Targeted screening is a feasible and effective method to identify CMV+ infants early in life. Implementation of a targeted screening program for CMV in children who do not pass the NHS resulted in significantly higher rates of CMV testing and earlier referral to infectious disease.
Identifying older adults with frailty approaching end-of-life: A systematic review
Authors: Hall Alex , Boulton Elisabeth , Kunonga Patience , Spiers Gemma , Beyer Fiona , Bower Peter , Craig Dawn , Todd Chris , Hanratty Barbara
Published: September 2021

Background:

People with frailty may have specific needs for end-of-life care, but there is no consensus on how to identify these people in a timely way, or whether they will benefit from intervention.

Aim:

To synthesise evidence on identification of older people with frailty approaching end-of-life, and whether associated intervention improves outcomes.

Design:

Systematic review (PROSPERO: CRD42020462624).

Data sources:

Six databases were searched, with no date restrictions, for articles reporting prognostic or intervention studies. Key inclusion criteria were adults aged 65 and over, identified as frail via an established measure. End-of-life was defined as the final 12 months. Key exclusion criteria were proxy definitions of frailty, or studies involving people with cancer, even if also frail.

Results:

Three articles met the inclusion criteria. Strongest evidence came from one study in English primary care, which showed distinct trajectories in electronic Frailty Index scores in the last 12 months of life, associated with increased risk of death. We found no studies evaluating established clinical tools (e.g. Gold Standards Framework) with existing frail populations. We found no intervention studies; the literature on advance care planning with people with frailty has relied on proxy definitions of frailty.

Conclusion:

Clear implications for policy and practice are hindered by the lack of studies using an established approach to assessing frailty. Future end-of-life research needs to use explicit approaches to the measurement and reporting of frailty, and address the evidence gap on interventions. A focus on models of care that incorporate a palliative approach is essential.
Forging connections: The role of ‘boundary spanners’ in globalising clusters and shaping cluster evolution
Authors: Wu Di
Published: September 2021

Synthesising the endogenous-centred evolutionary economic geography perspective, and the globally oriented ‘global pipelines’ and global production networks frameworks, this article develops the ‘boundary spanner’ concept to propose a theoretical framework to illustrate how resourceful actors, as boundary spanners, globalise clusters and in turn drive cluster evolution. This framework comprises four interrelated cluster boundary-spanning functions, namely, discursive construction, innovation promotion, production coordination and market reach. This article aims to advance the cluster literature by unpacking how clusters’ global connections are constructed and maintained, conceptualising the multidimensional role of the agency of boundary spanners and demonstrating boundary spanners’ contributions to cluster evolution.
Equal channel angular pressing of wire-formed Al6063 by PU rubber-assisted procedure
Authors: Ebrahimi Mahmoud , Attarilar Shokouh , Özkavak Hatice-Varol , Gode Ceren
Published: September 2021

Expanding suitable severe plastic deformation processes seems essential to design lightweight wire-formed materials for emerging demands. In this regard, 6063 aluminum alloy in the form of wire was processed successfully by polyurethane rubber assisted-equal channel angular pressing up to 16 passes by route BC. It was found that significant improvement of hardness and strength is achieved at the initial passes due to the increment of material’s dislocations density which leads to the crystallite size decrease and lattice microstrain increase. Also, subsequent passes improve the mechanical properties with a gentle rate due to the saturation of dislocation strengthening. The fractography analysis indicated that the ductile fracture mode of the annealed aluminum decreases by imposing the ECAP process. It is related to the formation of cleavage and rive patterns and the reduction in the number and size of the dimples compared to the initial condition. Eventually, X-ray diffraction findings showed that by adding pass numbers, the isotropy degree of the aluminum sample enhances because of the lowest diffraction scattering.
Retrograde endoureterotomy as a treatment option for impacted calculus in the ureterointestinal junction
Authors: Panach-Navarrete Jorge , Negueroles-García María , Martínez-Jabaloyas José María
Published: September 2021

Introduction:

In patients with a history of radical cystectomy and with intestinal diversion, urolithiasis in the upper urinary tract is a frequent event.

Material and methods:

We describe for the first time a case of retrograde endoureterotomy used to treat a calculus proximal to the ureterointestinal junction.

Results:

This technique is of interest when antegrade access is not possible. In our example, after passing the guidewire percutaneously, and externalize it through the stoma, the left meatus was reached with a resectoscope inserted through the ileal duct. After the use of a balloon to prevent migration of the calculus, a retrograde endoureterotomy was performed with a Collins knife and the stone removed. The patient’s progress was satisfactory.

Conclusion:

Endoscopic management of calculi in patients with intestinal diversion can be performed with different approaches. We recommend retrograde endoureterotomy as a feasible treatment option for the removal of impacted calculi at the ureterointestinal junction.
The Mental Health Effects of Student Activism: Persisting Despite Psychological Costs
Authors: Conner Jerusha O. , Crawford Emily , Galioto Megan
Published: September 2021

As student activism continues to roil campuses, concerns have arisen about the mental health costs associated with activist-oriented civic engagement. Drawing on in-depth interviews with 42 self-identifying student activists from across the United States, this study examines how activists describe the impact of their activism on their mental health. While just under one third of the respondents perceived a positive effect, 60% of the respondents noted adverse consequences to their psychological well-being. Nevertheless, these respondents remained committed to continuing their activism. Four factors surfaced in activists’ reflections on their mental health, which, while not responsible for positive mental health outcomes, did help offset the stress, exhaustion, and guilt associated with activism. These four factors included social capital or connection to others, a sense of purpose, effecting change, and self-care and collective care. Respondents credited these factors with helping them to sustain the emotionally and physically difficult work of activism. Implications for higher education policy and practice are discussed.
Learning From Youth: Using Positive Outcomes to Evaluate Summer Youth Employment Programs
Authors: Greene Jordan , Seefeldt Kristin
Published: September 2021

Summer Youth Employment Programs (SYEPs) help connect youth to opportunities for career exploration, skill development, and mentorship. Despite heightened investment in SYEPs, research regarding positive impacts is limited. Most of the common SYEP evaluation strategies are rooted in deficit thinking and focus on outcomes such as reducing violent crime, risk behaviors, gaps in unemployment, and increasing educational attainment. Despite recent shifts toward approaches that acknowledge structural oppression in adolescent research more broadly, evaluations of SYEPs often perpetuate a discourse of deficiency about marginalized communities by emphasizing disparities without acknowledging the systemic forces that create them. In this article, we utilize the Five Cs of Positive Youth Development to present an alternative set of outcomes identified from focus groups and surveys with youth ages 16 to 24 who participated in SummerWorks, a 10-week SYEP located in Washtenaw County, Michigan. Specifically, we find that SYEPs may help youth make the transition to adulthood, build community and increase their social capital, and access knowledge, resources, and opportunities. Through this approach, we hope to expand the literature on the impacts of SYEPs and encourage antiracist evaluation strategies that build on these findings and challenge deficit thinking.
Business or Pleasure? A Comparison of Migrant and Non-Migrant Uber Drivers in Australia
Authors: James Holtum Peter , Irannezhad Elnaz , Marston Greg , Mahadevan Renuka
Published: September 2021

Despite evidence of sub-standard working conditions and low rates of pay, drivers working on the Uber platform report varying levels of job-satisfaction. In order to better understand driver experience most research conducted to date differentiates driver experience by driver investment (time) on the platform. While this approach offers insight into driver motivations, it obfuscates key socio-political aspects of the globalised labour market; namely the precarity of many migrant workers. We present findings from a mixed methods study into migrant and non-migrant drivers on the Uber platform in Queensland, Australia. Specifically, our data illustrates key differences between migrants and non-migrants’ motivations to drive, their dependency on the platform, and their sense of autonomy and agency. Our findings suggest that migrant drivers experience greater levels of job insecurity, specifically around factors of job tenure, agency, and personal safety.
Who Are You? The Study of Personality in Patients With Anterograde Amnesia
Authors: Garland McKenna M. , Vaidya Jatin G. , Tranel Daniel , Watson David , Feinstein Justin S.
Published: September 2021

Little is known about the role of declarative memory in the ongoing perception of one’s personality. Seven individuals who developed a rare and severe type of anterograde amnesia following damage to their medial temporal lobes were identified from our neurological patient registry. We examined the stability of their personality ratings on the Big Five Inventory over five retest periods and assessed the accuracy of their ratings via analyses of self–caregiver agreement. The patients portrayed a stable sense of self over the course of 1 year. However, their self-ratings differed from those provided by the caregivers. Intriguingly, these discrepancies diminished when caregivers retrospectively rated the patients’ personalities prior to their brain injury, suggesting that patients’ perceptions of themselves were stuck in the past. We interpret our findings to indicate that the ability to form new declarative memories is not required for maintaining a stable sense of self but may be important for updating one’s sense of self over time.
Correlation-based joint feature screening for semi-competing risks outcomes with application to breast cancer data
Authors: Peng Mengjiao , Xiang Liming
Published: September 2021

Ultrahigh-dimensional gene features are often collected in modern cancer studies in which the number of gene features [Formula: see text] is extremely larger than sample size [Formula: see text]. While gene expression patterns have been shown to be related to patients’ survival in microarray-based gene expression studies, one has to deal with the challenges of ultrahigh-dimensional genetic predictors for survival predicting and genetic understanding of the disease in precision medicine. The problem becomes more complicated when two types of survival endpoints, distant metastasis-free survival and overall survival, are of interest in the study and outcome data can be subject to semi-competing risks due to the fact that distant metastasis-free survival is possibly censored by overall survival but not vice versa. Our focus in this paper is to extract important features, which have great impacts on both distant metastasis-free survival and overall survival jointly, from massive gene expression data in the semi-competing risks setting. We propose a model-free screening method based on the ranking of the correlation between gene features and the joint survival function of two endpoints. The method accounts for the relationship between two endpoints in a simply defined utility measure that is easy to understand and calculate. We show its favorable theoretical properties such as the sure screening and ranking consistency, and evaluate its finite sample performance through extensive simulation studies. Finally, an application to classifying breast cancer data clearly demonstrates the utility of the proposed method in practice.