bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-Term Prediction of a Nocturnal Significant Tornado Outbreak Using a Convection-Allowing Ensemble
Authors: Galarneau Thomas J. , Wicker Louis J. , Knopfmeier Kent H. , Miller William J. S. , Skinner Patrick S. , Wilson Katie A.
Published: April 2022

A multiscale analysis of the significant nocturnal tornado outbreak in Tennessee on 2–3 March 2020 is presented. This outbreak included several significant tornadoes and resulted in the second most fatalities (25) and most injuries (309) of all nocturnal tornado events in Tennessee in 1950–2020. The two deadliest tornadoes struck Nashville (EF3 intensity) and Cookeville (EF4) resulting in 5 and 19 fatalities, respectively. The supercell responsible for the tornado outbreak initiated at 0330 UTC 3 March within a region of warm frontogenesis in western Tennessee. Throughout its life cycle, the supercell was located in a region of convective available potential energy near 1000 J kg−1 and 0–1-km storm-relative helicity over 350 m2 s−2. Retrospective 3-h forecasts from the experimental Warn-on-Forecast System (WoFS) convection-allowing ensemble initialized after the parent supercell initiated indicated a high probability, high severity scenario for tornadoes across Tennessee and into Nashville through 0700 UTC. Earlier WoFS forecasts indicated a low probability, high severity scenario owing to uncertainty in the initiation of supercells. The presence of these supercells was sensitive to the upstream thermodynamic conditions and warm frontogenesis regions that were inherited from the lateral boundary conditions. In all, this study highlights the potential of the WoFS ensemble to contribute useful probabilistic severe weather information to the short-term forecast process during a nocturnal significant tornado outbreak.
Post-industrial capitalism and trade union decline in affluent democracies
Authors: Kollmeyer Christopher
Published: April 2022

This study examines trade union decline in light of concurrent changes in the demographic and sectoral composition of labor markets. Drawing on classical sociology and contemporary scholarship on work and employment, the author theorizes that the emergence of post-industrial work settings coupled with more socially diverse workforces make labor organizing more difficult than prior research recognizes. Operating through various mechanisms, these factors are thought to hinder the development of solidarity among workers and direct employment growth toward previously unorganized parts of the economy. Using panel data on 18 countries from 1960 to 2015, these ideas are tested with regression models that capture labor market changes indicative of post-industrial capitalism—measured by changes in deindustrialization, foreign-born population, and female share of employment. The results support the theoretical argument, with counterfactual estimates suggesting that labor market changes occurring between 1960 and 2015 reduced union density by 9 to 13 points for the whole sample.
Photography and transport history: a speculative approach to a theoretical framework
Authors: Pereira Hugo Silveira
Published: April 2022

Photography has been recording different aspects of human activity since the early nineteenth century. Additional innovations since then have rendered it less expensive, less cumbersome and more accessible to users. Today, the universe of photographs is immense. In this paper, I offer a theoretical approach to the use of photography in mobility and transport history. I argue that photography is much more than a mere illustrative resource and that it can be used as a primary source that provides visual materiality to aspects of transportation in the past (subjects, objects and landscapes), which can complement information found in written sources. Moreover, I speculate that photography may have a double role: as a vehicle that transports observers to faraway locations and ideas and landscapes back to observers; and as a tool for territorial appropriation of peripheral territories by core regions.
The Macroeconomic Influence of Recent Political Conflicts in Africa: Generalized Synthetic Counterfactual Evidence
Authors: Diop Samba , Asongu Simplice A. , Tchamyou Vanessa S.
Published: April 2022

This paper measures the macroeconomic influence of recent political crisis, protest and uprisings in Africa with the generalized synthetic control method and evaluates the role played by natural resource dependence on the modulation of the nexus. We find that political crisis, protests and uprisings have a significant and negative nexus with economic growth while the nexus is positive with investment and price level. For economic growth, the deviation of the actual series from the counterfactual is negative, instantaneous, persistent and highly significant; indicating non-negligible costs of the shock. Indeed, dependence on natural resources amplifies the negative influence of political crisis, protests and uprisings on GDP. Finally, the more the treated country depends on natural resources, the more it becomes resilient to the investment losses caused by political crisis.
Paul’s Rhetorical Efforts to Establish Good Will in First Thessalonians
Authors: Berglund Carl Johan
Published: April 2022

Ancient oratory ordinarily begins with an effort of captatio benevolentiae – the rhetorical strategy of praising and lauding the audience to make them well-disposed toward the speaker, attentive and receptive to your message – especially before controversial claims or challenging demands. In First Thessalonians, such efforts are manifest not only in the introduction in ch. 1, but throughout the narration in chs. 2–3, which implies that the senders are preparing for a particularly sensitive topic. The first exhortation to appear after these efforts cease, the exhortation to sexual holiness in 1 Thess. 4.3-8, must therefore represent the primary purpose of the letter. The euphemistic language used in this request makes it difficult to understand what kind of πορνεία (‘sexual immorality’) Paul, Silvanus and Timothy are arguing against, but the most likely interpretation is that they want the Thessalonian Christians to stop using their slaves and former slaves for sexual purposes.
Climate Change, Drought, and Potential Environmental Migration Flows Under Different Policy Scenarios
Authors: Smirnov Oleg , Lahav Gallya , Orbell John , Zhang Minghua , Xiao Tingyin
Published: April 2022

Unmitigated climate change will likely produce major problems for human populations worldwide. Although many researchers and policy-makers believe that drought may be an important “push” factor underlying migration in the future, the precise relationship between drought and migration remains unclear. This article models the potential scope of such movements for the emissions policy choices facing all nation-states today. Applying insights from climate science and computational modeling to migration research, we examine the likely surge of drought-induced migration and assess the prospects of different policy scenarios to mitigate involuntary displacement. Using an ensemble of 16 climate models in conjunction with high-resolution geospatial population data and different policy scenarios, we generate drought projections worldwide and estimate the potential for internal and international population movement due to extreme droughts through the remainder of the 21st century. Our simulations suggest that a potential for drought-induced migration increases by approximately 200 percent under the current international policy scenario (corresponding to the current Paris Agreement targets). In contrast, total migration increases by almost 500 percent, should current international cooperation fail and should unrestricted policies toward greenhouse gas emissions prevail. We argue that despite the continued growth projections of drought-induced migration in all cases, international cooperation on climate change can substantially reduce the global potential for such migration, in contrast to unilateral policy approaches to energy demands. This article highlights the importance of modeling future environmental migrations, in order to manage the pressures and unprecedented policy challenges which are expected to dramatically increase under conditions of unmitigated climate change.
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and risk of depression among older people with hypertension
Authors: van Sloten Thomas T , Souverein Patrick C , Stehouwer Coen DA , Driessen Johanna HM
Published: April 2022

Background:

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), commonly used antihypertensive drugs, may have a protective effect against depression in older individuals, but evidence in humans is limited.

Aims:

We evaluated the risk of depression, among older individuals with hypertension, comparing ACE or ARB initiators to thiazide(-like) diuretic initiators. Thiazide(-like) diuretics were used as control because these drugs are not associated with mood disorders.

Methods:

We used a propensity score-matched new user cohort design with routinely collected data from general practices in England from the Clinical Practice Research Datalink database. We matched 12,938 pairs of new users of ACEIs/ARBs and thiazide(-like) diuretics with hypertension (mean age 67.6 years; 54.7% women). Follow-up time started on the date of drug initiation and ended on the date of treatment discontinuation plus 30 days, or switch to a comparator, occurrence of a study event, death, date of patient’s transfer out of practice, or end of the study period. The primary outcome was a composite endpoint of treated depression and nonfatal and fatal self-harm.

Results/outcomes:

Compared to the thiazide(-like) diuretic group, ACEIs/ARBs use was not associated with a lower risk of the primary outcome (hazard ratio 0.96 (95% confidence interval: 0.79; 1.15)). Results did not differ according to lipophilicity, duration of use, and average daily dose, or class (ACEIs or ARBs).

Conclusions/Interpretation:

New use of ACEIs or ARBs is not associated with a lower risk of depression among individuals with hypertension.
The influence of artificial intelligence assistance on the diagnostic performance of CCTA for coronary stenosis for radiologists with different levels of experience
Authors: Han Xianjun , He Yi , Luo Nan , Zheng Dandan , Hong Min , Wang Zhenchang , Yang Zhenghan
Published: April 2022

Background

The interpretation of coronary computed tomography angiography (CCTA) stenosis may be difficult among radiologists of different experience levels. Artificial intelligence (AI) may improve the diagnostic performance.

Purpose

To investigate whether the diagnostic performance and time efficiency of radiologists with different levels of experience in interpreting CCTA images could be improved by using CCTA with AI assistance (CCTA-AI).

Material and Methods

This analysis included 200 patients with complete CCTA and invasive coronary angiography (ICA) data, using ICA results as the reference. Eighteen radiologists were divided into three levels based on experience (Levels I, II, and III), and the three levels were divided into groups without (Groups 1, 2, and 3) and with (Groups 4, 5, and 6) AI assistance, totaling six groups (to avoid reader recall bias). The average sensitivity, specificity, NPV, PPV, and AUC were reported for the six groups and CCTA-AI at the patient, vessel, and segment levels. The interpretation time in the groups with and without CCTA-AI was recorded.

Results

Compared to the corresponding group without CCTA-AI, the Level I group with CCTA-AI had improved sensitivity (75.0% vs. 83.0% on patient-based; P = 0.003). At Level III, the specificity was better with CCTA-AI. The median interpretation times for the groups with and without CCTA-AI were 413 and 615 s, respectively ( P < 0.001).

Conclusion

CCTA-AI could assist with and improve the diagnostic performance of radiologists with different experience levels, with Level I radiologists exhibiting improved sensitivity and Level III radiologists exhibiting improved specificity. The use of CCTA-AI could shorten the training time for radiologists.
Flat and rounded contacts: Modelling the effect of a moment with application to fretting fatigue tests
Authors: Truelove James PJ , Hills David A , Blades Luke E
Published: April 2022

The problem of elastic indentation by a punch having the form of a flat front face but with edge rounding, and subject to both a normal load and moment, indenting an elastically similar half-plane is considered. Contact pressure in the neighbourhood of the edges shows a local peak, and the object of the paper is to show how different combinations of normal load and moment can give rise to the same near edge behaviour and peak pressure. The result found is very simple, and of direct practical application in fretting fatigue studies, both analytical and experimental.
Proposing Anti-LGBTQIAP Resolutions at the Municipal Level in Poland: Meeting the Social Demand or Making Use of the Available Resources?
Authors: Rafałowski Wojciech
Published: April 2022

During the eight months preceding the 2019 parliamentary election in Poland, resolutions aimed against the LGBTQIAP minority were adopted by over 60 out of 2,477 municipalities. They were proposed by a local right-wing organization called Ordo Iuris. Based on the prerequisites from the political opportunity structure approach, I test two sets of explanations as to why certain municipalities were targeted by the organization, while others were not. One set of hypotheses is associated with social demand; municipalities chosen by Ordo Iuris are expected to be more religious and supportive of the political right. The other approach assumes that the activity of the organization was determined by the resources available in the community, such as high percentage of members of the local council representing the right-wing Law and Justice party, electoral turnout, membership in religious organizations, and population density. The empirical analysis confirms the significance of resources and disproves the argument associated with social demand. The study has implications for understanding how the social movements of the radical right gain political influence in Eastern European countries. It shows that they do not serve a particular demand from the society for the worldview they represent, but they rather rely on the aid from political elites and the resources provided by them and the community to promote their agenda where they can.
Extremely urgent public procurement under Directive 2014/24/EU and the COVID-19 pandemic
Authors: Telles Pedro
Published: April 2022

The COVID-19 pandemic swept throughout the European Union swiftly and led to significant changes in how we live and operate. Some of those changes occurred in public procurement as well, with Member States struggling to react to the dissemination of the virus. The purpose of this paper is to assess what scope the EU's public procurement legal framework provides to deal with a crisis, and how the rules should be interpreted. This paper will show how the EU public procurement legal framework deals with extreme urgency situations and how it has been intentionally designed to allow Member States flexibility within very clearly defined boundaries. This means that the path to award contracts without competition on the grounds of extreme urgency is narrow due to Article 32(2)(c) of Directive 2014/24/EU 1 and the case law from the CJEU. The narrowness of this path is due to the exceptional nature of procedure and the obligation for the contracting authority to discharge the tight grounds for use in full for every contract. Therefore, this paper concludes that the view exposed by the European Commission on its guidance from April 2020 that the pandemic is a single unforeseeable event amounts to an incorrect reading on how the grounds for the use of Article 32(2)(c) operate. If such interpretation was already too broad in April 2020, it certainly is no longer in line with the transition from an unfolding crisis into a new and more permanent equilibrium.

In the context of COVID-19, particularly the need for the crisis to be unforeseeable and the extreme urgency not being attributable to the contracting authority raise significant difficulties for some contracting authorities to discharge the grounds for use of the negotiated procedure without prior notice. This is particularly the case in those situations where governments centralized pandemic-related procurement.

As such, the paper concludes that existing substantive rules for extremely urgent procurement are adequate and, albeit sufficient to respond to crisis situations, that does not entail that the wholesale use of the negotiated procedure without prior notice is necessarily legal.
When Disclosures Backfire: Aversive Source Effects for Personalization Disclosures on Less Trusted Platforms
Authors: van Ooijen Iris
Published: April 2022

Recent studies indicate that transparency about data collection practices for personalized advertising in the form of disclosures increases advertising effectiveness. This work, however, demonstrates that for advertising platforms with an untrustworthy reputation, personalization disclosures may backfire because the motives of placing such disclosures are perceived as insincere. Study 1 shows that a personalization disclosure framed as a warning that is placed alongside an advertisement by the untrustworthy platform itself decreases advertising effectiveness compared to when the personalization disclosure is placed by a more trusted third party. Notably, these effects of disclosure source decrease when the disclosure is merely framed as notification. Study 2 replicates this backfire effect for a different disclosure source and examines the underlying process. When a disclosure is placed by the untrustworthy platform itself, the effect of the disclosure backfires because the motives of placing the disclosure are perceived to be insincere, which decreases advertising effectiveness. When the disclosure source is external, the backfire effect reverses, decreasing the perceived insincerity of motives and increasing advertising effectiveness. Study 3 manipulates a fictive platform's trustworthiness and replicates the backfire effect, confirming the notion that especially for untrustworthy platforms placement of personalization disclosures by a company source decreases advertising effectiveness.
Indigenous perspectives on the biodigital convergence
Authors: Williams Keith , Brant Suzanne
Published: April 2022

The biodigital convergence describes the intersection, and in some cases merging, of biological and digital technologies. Biodigital technologies include mRNA vaccines used to treat COVID-19, digitally controlled surveillance insects, microorganisms genetically engineered to produce medicinal compounds, and more. While significant scholarship has been paid to the ethical dimensions of biodigital technologies from a Western standpoint, little attention has focused on Indigenous views on the biodigital convergence. In this article, we explore the biodigital convergence from a Haudenosaunee perspective and suggest that insights from Indigenous philosophical traditions—specifically regarding relationality and territory—may be necessary for humanity to adapt to the profound and existential changes implicit in the biodigital convergence.
In the wake of the ironworks - entrepreneurship and the spatial connections to empowerment and emancipation
Authors: Roos Annie , Gaddefors Johan
Published: April 2022

In this article, we explore connections between entrepreneurship, gender, empowerment and emancipation. Through the lens of entrepreneurship, we investigate the spatial aspects of these interlinked processes and illustrate emancipation through oppressive gender structures. This spatial lens allows us to see how emancipation changes in practice over time, with empowerment being one of these practices. Through ethnographic longitudinal fieldwork that studies an ironworks turned into a tourist garden, we highlight the collective reproduction of established oppressive structures. Our findings prioritise a spatial understanding of how entrepreneurship connects to empowerment and emancipation.
Consumer sovereignty and the Greek economic crisis: (Dis)continuity of consumer sovereignty repertoires
Authors: Lallas Dimitris
Published: April 2022

In this paper, I attempt to reformulate the (consumer) action and discourse, as these arise from the discourse of visitors at the biggest shopping mall in Athens. The qualitative data are derived from 20 semi-structured interviews conducted with visitors at The Mall Athens. The cultural-consumer repertoires of the participants, that is, their understanding, evaluation, and justification schemes of their consumer practices and desires, are analyzed from a constructionist point of view. The context of the ten-year-long Greek economic crisis is a promising field for the investigation of the concept, meaning, experience, and performance of consumer sovereignty. Hence, the very concept of consumer sovereignty is empirically “tested,” including its different conceptualizations and performances. In particular, two repertoires of consumer sovereignty arise, namely, the power of free hedonistic choice and the morose rational prudence, while the crisis critically mediates and raises issues of (dis)continuity for these two repertoires.
“Don’t bully! We are all different”: Pedagogical potential of early critical literacy with bullying-themes
Authors: Wee Su-Jeong , Kim So Jung , Kim Jinhee
Published: April 2022

In spite of the increased attention that has been given to early critical literacy practices, there remains a limited amount of scholarship dedicated to exploring how critical literacy may be implemented in early childhood classrooms to prevent bullying. As such, the purpose of this article is to examine the pedagogical potential of early critical literacy with bullying-themes, for educating young children on anti-bullying. Using a qualitative study approach, this study was conducted in a classroom of twenty 5-year-old children in a metropolitan city in South Korea. The central focus of this study was dedicated to examining how children’s understanding of bullying toward their peers of different racial/ethnic backgrounds and special needs change through a series of critical literacy activities, including reading, discussion, and follow-up role-playing and writing activities. Findings suggest that critical literacy activities on bullying have the potential to aid in creating anti-bullying environments in which young children critically examine bullying issues from multiple perspectives and actively generate their own understanding of bullying.
Examining Cyberstalking Perpetration and Victimization: A Scoping Review
Authors: Wilson Chanelle , Sheridan Lorraine , Garratt-Reed David
Published: April 2022

In recent years the body of literature on cyberstalking has expanded rapidly. The present work aimed to summarize the current state of the literature on cyberstalking perpetration and victimization in a scoping review. Forty-one quantitative and qualitative studies that examined variables relating to cyberstalking victimization and perpetration were collated. Following the methodology of Arksey and O’Malley (2005), an in-depth thematic analysis of the articles was undertaken. Prevalence of victimization and perpetration rates were compared and key themes synthesized. Despite examining similar young adult populations, the prevalence of victimization was found to range considerably from 0.7% (Reyns & Engelbrecht, 2010) to 85.2% (Strawhun et al., 2013) across studies. Themes were divided into two overarching classifications, factors relating to victimization and factors relating to perpetration. Deviant peer association, low self-control, previous harassment experiences and personality traits were some of the factors most frequently examined in relation to perpetration; whilst online exposure, online disclosure and guardianship were some of the factors most frequently examined in relation to victimization. Within these themes, deviant peer association and low self-control were found to consistently correlate with an increase in both cyberstalking victimization and perpetration. Guardianship and confidence online demonstrated inconsistent results. This review has summarized what is currently known and has been validated within cyberstalking research pertaining to victimization and perpetration, and has identified gaps and potential areas of future development.
Involving a Significant Other in Treatment of Patients With PTSD Symptoms: A Systematic Review of Treatment Interventions
Authors: Meuleman Eline , Sloover Mèlanie , van Ee Elisa
Published: April 2022

Previous studies have called for the inclusion of social support in the treatment of PTSD. The current review identifies interventions for adults with PTSD symptoms, which include a significant other as a source of social support. 11 articles focusing on eight interventions were found, including a total of 495 participants who had experienced trauma. These interventions were divided according to level of involvement of the significant other in treatment. Significant others were either passively or actively involved in the treatment. Preliminary results show that interventions actively involving a significant other in the treatment of the patient with posttraumatic stress symptoms were most effective in reducing PTSD symptoms. The current review provides recommendations for future research and suggests that significant others should be actively involved in the treatment of PTSD symptoms.
Management of giant adrenal pseudocyst in pregnancy – A unique approach and review of literature
Authors: Khan Tazeen , Sabu Brinda , Ranganayaki Vidyalekshmy , Rafeekha P , Thomas Renu
Published: April 2022

Pseudocysts of the adrenal gland are rare and in the majority of cases are non- functioning. They become symptomatic only when they are complicated by hormonal excess, rupture, haemorrhage or infection. Described here is a 26-year-old woman who developed an acute abdomen at 28 weeks of gestation due to a left adrenal haemorrhagic pseudocyst. A conservative approach was adopted, which was followed by elective term caesarean delivery with surgical intervention at the same time. The described case is unique in terms of strategizing timing and mode of management and thus minimizing the risk of prematurity and maternal morbidity associated with interval surgery.
Rethinking anti-money laundering supervision: The Single Supervisory Mechanism - a model for a European anti-money laundering supervisor?
Authors: Schlarb Dominik D
Published: April 2022

Whereas the prudential supervision of credit and other financial institutions has been a core policy concern of the EU legislator in the aftermath of the 2008 Financial Crisis, the supervision of private sector entities within the European Anti-Money Laundering framework has been subject to less attention. However, on 20 July 2021, the European Commission intervened and published legislative proposals for two regulations and one directive, meant to boost the European response to the phenomenon of Money Laundering. This contribution – after having pointed out the shortcomings of the current legislative framework – pursues a twofold objective: first, offering an in-depth analysis of whether the Single Supervisory Mechanism, set up within the banking union for the purposes of prudential supervision, might be a useful precedent of Europeanisation to build up upon in matters of Anti-Money Laundering supervision, and second, commenting the possible approaches to be taken when setting up an EU level Anti-Money Laundering supervisor. The systemic cross-border importance of AML – beyond the euro area – warrants the establishment of a new EU agency specialised on AML, invested with more supervisory powers than EBA, ESMA and EIOPA and taking over the direct supervision of high-risk obliged entities, while indirectly supervising the remaining entities. It is argued furthermore that such institutional reform should necessarily be accompanied by the establishment of a Single Rulebook, which enjoys direct applicability across the EU.
Experience and Management of the Adverse Effects of Analgesics After Surgery: A Pediatric Patient Perspective
Authors: Li Mandy M. J. , Larche Cynthia L. , Vickers Kelsey , Vigouroux Marie , Ingelmo Pablo M. , Hovey Richard , Ferland Catherine E.
Published: April 2022

After surgery, the adverse effects (AEs) of analgesics are common and critical factors influencing the postoperative experience of pediatric patients. Inadequate management of AEs has been found to prolong hospital stay, increase readmission rates and decrease satisfaction with care. The aim of this qualitative descriptive study was to better understand the AEs of analgesics from the perspective of adolescent patients with idiopathic scoliosis after spinal surgery. A total of 7 patients participated in the study. Semistructured interviews were conducted at discharge and 1 week after discharge. Transcribed data were analyzed using qualitative content analysis and themes were identified. Overall, participants most frequently reported gastrointestinal and cognitive AEs, with constipation being the most persistent and bothersome. The pediatric participants used a combination of 3 strategies to mitigate analgesic AEs, namely pharmacologic, nonpharmacologic, and reduction of analgesic intake. Participants demonstrated a lack of understanding of AEs and involvement in their own care. Future studies should be conducted to evaluate the efficacy of nonpharmacological strategies in managing analgesic AEs for pediatric patients after surgery.
Prevalence, risk factors, and long-term outcomes of cerebral ischemia in hospitalized COVID-19 patients – study rationale and protocol of the CORONIS study: A multicentre prospective cohort study
Authors: van Lith Theresa J , Sluis Wouter M , Wijers Naomi T , Meijer Frederick JA , Kamphuis-van Ulzen Karin , de Bresser Jeroen , Dankbaar Jan Willem , van den Heuvel Frederik MA , Antoni M Louisa , Mulders-Manders Catharina M , de Mast Quirijn , van de Veerdonk Frank L , Klok Frederikus A , Tuladhar Anil M , Cannegieter Suzanne C , Wermer Marieke JH , van der Worp H Bart , Huisman Menno V , de Leeuw Frank-Erik
Published: April 2022

Background:

COVID-19 is often complicated by thrombo-embolic events including ischemic stroke. The underlying mechanisms of COVID-19-associated ischemic stroke, the incidence and risk factors of silent cerebral ischemia, and the long-term functional outcome in these patients are currently unknown.

Patients and methods:

CORONavirus and Ischemic Stroke (CORONIS) is a multicentre prospective cohort study investigating the prevalence, risk factors and long-term incidence of (silent) cerebral ischemia, and the long-term functional outcome among patients with COVID-19. We aim to include 200 adult patients hospitalized with COVID-19 without symptomatic ischemic stroke to investigate the prevalence of silent cerebral ischemia compared with 60 (matched) controls with MRI. In addition, we will identify potential risk factors and/or causes of cerebral ischemia in COVID-19 patients with ( n = 70) or without symptomatic stroke ( n = 200) by means of blood sampling, cardiac workup and brain MRI. We will measure functional outcome and cognitive function after 3 and 12 months with standardized questionnaires in all patients with COVID-19. Finally, the long-term incidence of (new) silent cerebral ischemia in patients with COVID-19 will be assessed with follow up MRI ( n = 120).

The CORONIS study is designed to add further insight into the prevalence, long-term incidence and risk factors of cerebral ischemia, and the long-term functional outcome in hospitalized adult patients with COVID-19.
Progressive chronic kidney function decline as a clinical presentation of immune checkpoint inhibitor-associated nephrotoxicity
Authors: Wang Qiyu , Dougan Michael , Zhang M. Lisa , Sise Meghan E.
Published: April 2022

Background:

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. However, ICIs can be limited by inflammatory toxicities referred to as immune related-adverse events (irAEs). Clinical presentation of acute kidney injury (AKI) with corresponding pathological features of acute interstitial nephritis (AIN) is the most common manifestation of kidney irAE.

Case discussion:

A 74-year-old man with invasive squamous cell carcinoma (SCC) and chronic kidney disease (CKD) developed progressive kidney function decline after initiating treatment with cemiplimab (a programmed death protein 1 inhibitor). Because of the outstanding treatment response, and the fact that the patient had no other irAEs, cemiplimab was continued with close monitoring of kidney function. Over the course of 2 years, his creatinine increased from 2.1 to 3.1 mg/dL. Two years into treatment, he presented to the clinic with nausea, vomiting and diarrhea. He was hospitalized and underwent endoscopic examination that led to the diagnosis ICI-associated enterocolitis. After initiation of high dose glucocorticoids, his serum creatinine rapidly improved to his pre-ICI baseline.

Conclusion:

ICI-associated nephrotoxicity should be considered as a possible cause of rapidly progressive CKD; clinicians must keep a high suspicion for irAEs even in patients who have been receiving ICIs for over 1 year.
RGMQL: scalable and interoperable computing of heterogeneous omics big data and metadata in R/Bioconductor
Authors: Pallotta Simone , Cascianelli Silvia , Masseroli Marco
Published: April 2022

Background

Heterogeneous omics data, increasingly collected through high-throughput technologies, can contain hidden answers to very important and still unsolved biomedical questions. Their integration and processing are crucial mostly for tertiary analysis of Next Generation Sequencing data, although suitable big data strategies still address mainly primary and secondary analysis. Hence, there is a pressing need for algorithms specifically designed to explore big omics datasets, capable of ensuring scalability and interoperability, possibly relying on high-performance computing infrastructures.

Results

We propose RGMQL, a R/Bioconductor package conceived to provide a set of specialized functions to extract, combine, process and compare omics datasets and their metadata from different and differently localized sources. RGMQL is built over the GenoMetric Query Language (GMQL) data management and computational engine, and can leverage its open curated repository as well as its cloud-based resources, with the possibility of outsourcing computational tasks to GMQL remote services. Furthermore, it overcomes the limits of the GMQL declarative syntax, by guaranteeing a procedural approach in dealing with omics data within the R/Bioconductor environment. But mostly, it provides full interoperability with other packages of the R/Bioconductor framework and extensibility over the most used genomic data structures and processing functions.

Conclusions

RGMQL is able to combine the query expressiveness and computational efficiency of GMQL with a complete processing flow in the R environment, being a fully integrated extension of the R/Bioconductor framework. Here we provide three fully reproducible example use cases of biological relevance that are particularly explanatory of its flexibility of use and interoperability with other R/Bioconductor packages. They show how RGMQL can easily scale up from local to parallel and cloud computing while it combines and analyzes heterogeneous omics data from local or remote datasets, both public and private, in a completely transparent way to the user.
A cautionary signal from the Red Sea on the impact of increased dust activity on marine microbiota
Authors: Behzad Hayedeh , Ohyanagi Hajime , Alharbi Badr , Ibarra Martin , Alarawi Mohammed , Saito Yoshimoto , Duarte Carlos M. , Bajic Vladimir , Mineta Katsuhiko , Gojobori Takashi
Published: April 2022

Background

Global climate change together with growing desertification is leading to increased dust emissions to the atmosphere, drawing attention to possible impacts on marine ecosystems receiving dust deposition. Since microorganisms play important roles in maintaining marine homeostasis through nutrient cycling and carbon flow, detrimental changes in the composition of marine microbiota in response to increased dust input could negatively impact marine health, particularly so in seas located within the Global Dust Belt. Due to its strategic location between two deserts and unique characteristics, the Red Sea provides an attractive semi-enclosed “megacosm” to examine the impacts of large dust deposition on the vastly diverse microbiota in its exceptionally warm oligotrophic waters.

Results

We used culture-independent metagenomic approaches to assess temporal changes in the Red Sea microbiota in response to two severe sandstorms, one originated in the Nubian Desert in the summer 2016 and a second one originated in the Libyan Desert in the spring 2017. Despite differences in sandstorm origin and meteorological conditions, both sandstorms shifted bacterial and Archaeal groups in a similar mode. In particular, the relative abundance of autotrophic bacteria declined while those of heterotrophic bacteria, particularly Bacteroidetes, and Archaea increased. The changes peaked within six days from the start of sandstorms, and the community recovered the original assemblage within one month.

Conclusion

Our results suggest that increased dust emission with expanding desertification could lead to undesirable impacts in ocean function, enhancing heterotrophic processes while reducing autotrophic ones, thereby affecting the marine food web in seas receiving dust deposition.
Elevated plasma Ninjurin-1 levels in atrial fibrillation is associated with atrial remodeling and thromboembolic risk
Authors: Fang Chen , Jiao Kaicheng , Zuo Kun , Yang Xinchun
Published: April 2022

Background

Nerve injury-induced protein 1 (Ninj1) is elevated in various inflammatory diseases. The soluble form of Ninj1 yield by matrix metalloproteinase cleavage is a secreted protein and inhibits cell adhesion and inflammation. However, the role of plasma Ninj1 in atrial fibrillation (AF) has not been reported. The present study aimed to investigate the correlation between plasma Ninj1 levels and AF.

Methods

A total of 96 AF patients [age 66.00 (60.00, 72.00) years, male 56 (58.33%)] and 51 controls without AF [age 65.00 (55.00, 68.00) years, male 21 (41.18%)] were enrolled in this study. Plasma Ninj1 concentrations were detected using enzyme-linked immunosorbent assay. Also, the clinical characteristics, left atrial volume index (LAVI), CHA2DS2-VASc score, and HAS-BLED score were evaluated.

Results

Plasma Ninj1 levels were significantly higher in patients with AF than in controls (P < 0.001). Plasma Ninj1 levels were positively correlated with LAVI (P = 0.019) and CHA2DS2-VASc score (P = 0.024). Logistic regression analysis confirmed that the Ninj1 plasma levels were associated with AF (P = 0.009). The receiver operating characteristic analysis showed that plasma Ninj1 had a predictive value for AF (P < 0.001).

Conclusions

Plasma Ninj1 levels were elevated in patients with AF, associated with left atrial enlargement and thromboembolic risk in AF.
Recommendations made by patients, caregivers, providers, and decision-makers to improve transitions in care for older adults with hip fracture: a qualitative study in Ontario, Canada
Authors: Cadel Lauren , Kuluski Kerry , Everall Amanda C. , Guilcher Sara J. T.
Published: April 2022

Background

Older adults frequently experience fall-related injuries, including hip fractures. Following a hip fracture, patients receive care across a number of settings and from multiple different providers. Transitions between providers and across settings have been noted as a vulnerable time, with potentially negative impacts. Currently, there is limited research on how to improve experiences with transitions in care following a hip fracture for older adults from the perspectives of those with lived experienced. The purpose of this study was to explore service recommendations made by patients, caregivers, healthcare providers, and decision-makers for improving transitions in care for older adults with hip fracture.

Methods

This descriptive qualitative study was part of a larger longitudinal qualitative multiple case study. Participants included older adults with hip fracture, caregivers supporting an individual with hip fracture, healthcare providers, and decision-makers. In-depth, semi-structured interviews were conducted with all participants, with patients and caregivers having the opportunity to participate in follow-up interviews as they transitioned out of hospital. All interviews were audio-recorded, transcribed verbatim, and analyzed thematically.

Results

A total of 47 participants took part in 65 interviews. We identified three main categories of recommendations: (1) hospital-based recommendations; (2) community-based recommendations; and (3) cross-sectoral based recommendations. Hospital-based recommendations focused on treating patients and families with respect, improving the consistency, frequency, and comprehensiveness of communication between hospital providers and between providers and families, and increasing staffing levels. Community-based recommendations included the early identification of at-risk individuals and providing preventative and educational programs. Cross-sectoral based recommendations were grounded in enhanced system navigation through communication and care navigators, particularly within primary and community care settings.

Conclusions

Our findings highlighted the central role primary care can play in providing targeted, integrated services for older adults with hip fracture. The recommendations outlined have the potential to improve experiences with care transitions for older adults with hip fracture, and thus, addressing and acting on them should be a priority.
Evaluating the clinical impact of routine whole genome sequencing in tuberculosis treatment decisions and the issue of isoniazid mono-resistance
Authors: Park Mirae , Lalvani Ajit , Satta Giovanni , Kon Onn Min
Published: April 2022

Background

The UK has implemented routine use of whole genome sequencing (WGS) in TB diagnostics. The WHO recommends addition of a fluoroquinolone for isoniazid mono-resistance, so early detection may be of use. The aim of this study was to describe the clinical utility and impact of WGS on treatment decisions for TB in a low incidence high resource clinical setting. The clinical turnaround time (TAT) for WGS was analysed in comparison to TB PCR using Xpert MTB/RIF (Cepheid, Sunnyvale, CA) results where available and subsequent phenotypic drug susceptibility testing (DST) when required.

Methods

This was a retrospective analysis of TB cases from January 2018 to March 2019 in London. Susceptibility and TAT by WGS, phenotypic DST, TB PCR using Xpert MTB/RIF were correlated to drug changes in order to describe the utility of WGS on treatment decisions on isoniazid mono-resistance in a low incidence high resource setting.

Results

189 TB cases were identified; median age 44 years (IQR 28–60), m:f ratio 112:77, 7 with HIV and 6 with previous TB. 80/189 cases had a positive culture and WGS result. 50/80 were fully sensitive to 1st line treatment on WGS, and the rest required additional DST. 20/80 cases required drug changes; 12 were defined by WGS: 8 cases had isoniazid mono-resistance, 2 had MDR-TB, 1 had isoniazid and pyrazinamide resistance and 1 had ethambutol resistance. The median TAT for positive culture was 16 days (IQR 12.5–20.5); for WGS was 35 days (IQR 29.5–38.75) and for subsequent DST was 86 days (IQR 69.5–96.75), resulting in non-WHO regimens for a median of 50.5 days (IQR 28.0–65.0). 9/12 has TB PCRs (Xpert MTB/RIF), with a median TAT of 1 day.

Conclusion

WGS clearly has a substantial role in our routine UK clinical settings with faster turnaround times in comparison to phenotypic DST. However, the majority of treatment changes defined by WGS were related to isoniazid resistance and given the 1 month TAT for WGS, it would be preferable to identify isoniazid resistance more quickly. Therefore if resources allow, diagnostic pathways should be optimised by parallel use of WGS and new molecular tests to rapidly identify isoniazid resistance in addition to rifampicin resistance and to minimise delays in starting WHO isoniazid resistance treatment.
The effect of a full-time infection control nursing service in the prevention of multidrug-resistant organism in the orthopedic ward
Authors: Yang Yun , Tang Ting-ting , Lin Ji , Gan Chun-lan , Huang Wen-zhi , Fang Yue
Published: April 2022

Background

Our aim was to evaluate the effect of setting up a full-time infection control nursing service on reducing the prevalence of multidrug-resistant organism (MDRO) in the orthopedic ward.

Methods

From January 2015 to March 2019, routine prevention and control measures were taken for patients infected/colonized with MDRO in this ward, which was set as the pre-intervention period. The intervention period was from April 2019 to June 2021. The study was designed to evaluate whether the establishment of a full-time infection control nursing service could reduce the positive density of MDRO in the hospital by using an interrupted time-series model of a quasi experimental study.

Results

There were 11,759 patients during pre-intervention period and 8142 patients during intervention period. The total number of MDRO isolated before intervention was 177, of which 145 were obtained in hospital and 32 were brought in from outside hospital. The total number of MDRO isolated after intervention was 47, of which 29 were obtained in hospital and 18 were brought in from outside hospital. Before intervention, the positive density of MDRO in the orthopedic ward showed an increasing trend (β1 = 0.02, P = 0.003). After intervention, the positive density of MDRO showed a downward trend (β3 = − 0.05, P = 0.018).

Conclusions

The establishment of the full-time infection control nursing service in the orthopedic ward can effectively reduce the nosocomial prevalence of MDRO.