bluuebunny/crossref_metadata_2025 huggingface dataset:
Dekonvolution von Mischspuren nach vollständig kontinuierlichem Modell
Authors: Dika Beate , Dreßler Jan , Edelmann Jeanett , Kohl Michael
Published: December 2021

Hintergrund

Bei der Untersuchung von Mischspuren können stochastische Effekte die Beurteilung einer Spurenlegerschaft beeinträchtigen. Daher finden immer mehr softwarebasierte Lösungen Einzug in die Spurenuntersuchung, die durch Berücksichtigung biologischer Parameter eine Hilfestellung bei der Ableitung von Einzelprofilen bieten sollen. Im Rahmen der Studie wurde eine wissenschaftliche Validierung der Mischspurenanalyse-Software Genoproof® Mixture 4 (GPM4, Qualitype GmbH, Dresden, Deutschland) durchgeführt.

Material und Methoden

Die in unterschiedlichen Mischungsverhältnissen vorliegenden 2‑ und 3‑Personen-Mischspuren wurden künstlich unter Verwendung isolierter CD4+-Lymphozyten von 9 Spendenden erzeugt. Nach Erstellung der STR-Profile wurden die Mischspuren mittels GPM4 im Hinblick auf die Dekonvolution ausgewertet.

Ergebnisse

In den 2‑Personen-Mischspuren mit klarer Unterscheidung von Haupt- und Nebenkomponente wurde von der Software in der Großzahl der untersuchten STR-Systeme die richtige Genotypkonstellation (GTK) der Komponenten abgeleitet, oftmals mit einer Wichtung > 90 %. In den anteilsähnlicheren Mischspuren wurden zunehmend nichtzutreffende Allelableitungen beobachtet. Eine Abnahme der Performance in Bezug auf die Ableitung der richtigen GTK zeigten die 3‑Personen-Mischspuren. Faktoren wie Mischkomposition und Homo- und Heterozygotie in den genetischen Profilen hatten nachweislich einen Einfluss auf die Auftrennung der Mischspuren.

Diskussion

Mischspuren, die keine klare Unterscheidung von Haupt- und Nebenkomponente erlauben, stellen eine Schwierigkeit bei der Dekonvolution dar. In diesen Fällen ist eine Differenzierung der Peakhöhen detektierter Allele nur schwer möglich, da diese bei Anteilsgleichheit beider Komponenten eine komparable Intensität aufweisen. Ein deutlicher DNA-Mengen-Unterschied der Komponenten ist für die Berechnung von Vorteil.
Schwere sexualisierte Gewalt – Aufklärung eines Falls durch Kombination aus DNA- und mRNA-Analyse
Authors: Neis Maximilian , Siegel Sonja , Banaschak Sibylle , Schneider Peter M.
Published: December 2021

Mithilfe der Analyse von mRNA-Expressionsmustern durch Einsatz der PCR-Amplifikation von zellspezifischen cDNA-Transkripten und Nachweis der Amplifikate mittels Kapillarelektrophorese (CE) lässt sich die Frage klären, aus welchen Zelltypen (Blut, Speichel, Sperma, Vaginalschleimhaut, Menstrual- und Nasensekret) sich eine biologische Spur zusammensetzt. Durch Verwendung der DNA-RNA-Koextraktion kann dieses Verfahren unabhängig von der STR-Typisierung durchgeführt werden. Am Beispiel des hier dargestellten Falles, bei dem Vaginalsekret der verletzten Frau am Mittelfinger des Beschuldigten nachgewiesen wurde, wird gezeigt, dass der Einsatz dieser Methode besonders bei Fällen von sexualisierter Gewalt sinnvoll ist.
Vitale anale Tierfraßverletzung durch einen Dackel
Authors: Duval Inga , Doberentz Elke , Madea Burkhard
Published: December 2021

Hundebissverletzungen weisen bei Lebenden in der Regel eine charakteristische Morphologie auf, anhand derer sich die Entstehung gut nachvollziehen lässt. Haben Hunde Zugang zu einer Leiche, so kann es zu postmortalen Tierfraßverletzungen kommen, und das Verletzungsbild kann u. U. auf den ersten Blick auch als Fremdbeibringung durch Dritte missinterpretiert werden.

Vorgestellt wird ein seltener Fall einer Tierfraßverletzung an einer lebenden Person. Eine Mischintoxikation mit Zopiclon und Alkohol im häuslichen Umfeld führte zur Bewusstlosigkeit, die einen ausgedehnten Gewebsdefekt im Analbereich durch Bissverletzungen des eigenen Dackels ermöglichte. Außergewöhnlich ist hierbei neben der vitalen Entstehung auch die Lokalisation der Verletzung.
A variation of the prime k-tuples conjecture with applications to quantum limits
Authors: McGrath Oliver
Published: December 2021

Let $$\mathcal {H}^{*}=\{h_1,h_2,\ldots \}$$

H

∗

=

{

h
1

,

h
2

,
…
}

be an ordered set of integers. We give sufficient conditions for the existence of increasing sequences of natural numbers $$a_j$$

a
j

and $$n_k$$

n
k

such that $$n_k+h_{a_j}$$

n
k

+

h

a
j

is a sum of two squares for every $$k\ge 1$$

k
≥
1

and $$1\le j\le k.$$

1
≤
j
≤
k
.

Our method uses a novel modification of the Maynard–Tao sieve together with a second moment estimate. As a special case of our result, we deduce a conjecture due to D. Jakobson which has several implications for quantum limits on flat tori.
Stability of some vector bundles on Hilbert schemes of points on K3 surfaces
Authors: Reede Fabian , Zhang Ziyu
Published: December 2021

LetXbe a projective K3 surfaces. In two examples where there exists a fine moduli spaceMof stable vector bundles onX, isomorphic to a Hilbert scheme of points, we prove that the universal family$${\mathcal {E}}$$Eon$$X\times M$$X×Mcan be understood as a complete flat family of stable vector bundles onMparametrized byX, which identifiesXwith a smooth connected component of some moduli space of stable sheaves onM.
Laxity measurement of internal knee rotation after primary anterior cruciate ligament rupture versus rerupture
Authors: Mayr Hermann O. , Hellbruegge Georg , Haasters Florian , Ipach Bastian , Schmal Hagen , Prall Wolf C.
Published: December 2021

Purpose

The aim of the current study was to objectify the rotational laxity after primary anterior cruciate ligament (ACL) rupture and rerupture after ACL reconstruction by instrumented measurement. It was hypothesized that knees with recurrent instability feature a higher internal rotation laxity as compared to knees with a primary rupture of the native ACL.

Study design

Cross-sectional study, Level of evidence III.

Methods

In a clinical cross-sectional study successive patients with primary ACL rupture and rerupture after ACL reconstruction were evaluated clinically and by instrumented measurement of the rotational and antero-posterior laxity with a validated instrument and the KT1000®, respectively. Clinical examination comprised IKDC 2000 forms, Lysholm Score, and Tegner Activity Scale. Power calculation and statistical analysis were performed (p value < 0.05).

Results

24 patients with primary ACL rupture and 23 patients with ACL rerupture were included. There was no significant side-to-side difference in anterior translation. A side-to side difference of internal rotational laxity ≥ 10° was found significantly more frequent in reruptures (53.6%) compared to primary ruptures (19.4%; p < 0.001). A highly significant relationship between the extent of the pivot-shift phenomenon and side-to-side difference of internal rotation laxity could be demonstrated (p < 0.001). IKDC 2000 subjective revealed significantly better scores in patients with primary ACL tear compared to patients with ACL rerupture (56.4 ± 7.8 vs. 50.8 ± 6.2; p = 0.01). Patients with primary ACL tears scored significantly better on the Tegner Activity Scale (p = 0.02). No significant differences were seen in the Lysholm Score (p = 0.78).

Conclusion

Patients with ACL rerupture feature significantly higher internal rotation laxity of the knee compared to primary ACL rupture. The extend of rotational laxity can be quantified by instrumented measurements. This can be valuable data for the indication of an anterolateral ligament reconstruction in ACL revision surgery.
The predictive and incremental validity of ADHD beyond the VRAG-R in a high-risk sample of young offenders
Authors: Gregório Hertz Priscilla , Müller Marcus , Barra Steffen , Turner Daniel , Rettenberger Martin , Retz Wolfgang
Published: December 2021

The VRAG-R is a well-established actuarial risk-assessment instrument, which was originally developed for assessing violent recidivism risk in adult male offenders. Whether or not the VRAG-R can also predict violent recidivism in young offenders is unclear so far. In the emergence of juvenile offending, attention-deficit/hyperactivity disorder (ADHD) seems to be of major importance suggesting that it could be relevant for risk assessment as well. Thus, we examined the predictive accuracy of the VRAG-R in a high-risk sample of N = 106 (M = 18.3 years, SD = 1.8) young offenders and assessed the incremental predictive validity of ADHD symptomatology beyond the VRAG-R. Within a mean follow-up time of M = 13 years (SD = 1.2), n = 65 (62.5%) young offenders recidivated with a violent offense. We found large effect sizes for the prediction of violent and general recidivism and re-incarcerations using the VRAG-R sum scores. Current ADHD symptomatology added incremental predictive validity beyond the VRAG-R sum scores concerning the prediction of general recidivism but not of violent recidivism. The results supported the use of the VRAG-R for predicting violent recidivism in young offenders. Because ADHD symptomatology improves the predictive performance of the VRAG-R regarding general recidivism, we argue that addressing ADHD symptoms more intensively in the juvenile justice system is of particular importance concerning a successful long-term risk management in adolescents and young adults.
Lipid lowering therapy in primary and secondary prevention in Austria: are LDL-C goals achieved?
Authors: Siostrzonek Peter , Brath Helmut , Zweiker Robert , Drexel Heinz , Hoelzl Robert , Hemetsberger Margit , Ray Kausik K.
Published: December 2021

Background

Cardiovascular disease (CVD) is the most frequent cause of death in Austria. The European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines recommend intensive lipid lowering therapy (LLT) in patients at high or very high CV risk. Lipid management and achievement of low-density lipoprotein cholesterol (LDL-C) goals in Austria have not recently been assessed.

Methods

Subgroup analysis for Austria of a European 18 country, cross-sectional, observational study. Patients received LLT for primary (PP) or secondary prevention (SP). Data including LLT in the preceding 12 months and most recent LDL‑C were collected during a single visit between June 2017 and November 2018. Achievement of the risk-based 2016 and 2019 ESC/EAS LDL‑C goal while receiving stabilized LLT was assessed.

Results

A total of 293 patients were enrolled from 8 Austrian sites, of which 200 (PP = 104, SP = 96) received stabilized LLT at the LDL‑C measurement date. Overall, 58% (71% PP, 43% SP) and 38% (52% PP, 23% SP) achieved the risk-based 2016 and 2019 goals, respectively. Most patients received moderate-intensity statin monotherapy (46%), while 34% used high-intensity statin monotherapy. Combination therapy of moderate/high-intensity statin with ezetimibe (12%), or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors with statin ± ezetimibe (1%), was used infrequently.

Conclusion

The current Austrian routine lipid management using mainly moderate-intensity or high-intensity statin monotherapy is insufficient to attain ESC/EAS guideline goals, in particular the more stringent 2019 recommendations, a situation comparable to other participating European countries. In addition to switching to and optimizing doses of high-intensity statins, a combination with ezetimibe or PCSK9 inhibitors will be needed in many cases.
Exercise reduces systemic immune inflammation index (SII) in childhood cancer patients
Authors: Winker Matteo , Stössel Sandra , Neu Marie Astrid , Lehmann Nadine , El Malki Khalifa , Paret Claudia , Joisten Niklas , Bloch Wilhelm , Zimmer Philipp , Faber Jörg
Published: December 2021

While exercise and physical activity have been suggested to reduce mortality and symptoms in cancer, knowledge on these associations in patients with childhood cancer (CCPs) is sparse. Anti-inflammatory properties of exercise might mediate these beneficial effects. We investigated the influence of exercise on the inflammation markers neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic-immune-inflammation index (SII) and associations to patient-reported-outcomes in CCPs in a randomized-controlled trial. Results show associations between inflammation markers and patient-reported outcomes. Compared to the control group, SII was significantly reduced following exercise (p=0.036). Anti-inflammatory effects of exercise are also present in CCPs and may underlie exercise-induced benefits on symptoms. Clinical Trial Registration Number: NCT02612025
Virtual Reality Biofeedback in Health: A Scoping Review
Authors: Lüddecke Robin , Felnhofer Anna
Published: December 2021

Over the past decades, virtual reality (VR) has found its way into biofeedback (BF) therapy programs. Using VR promises to overcome challenges encountered in traditional BF such as low treatment motivation, low attentional focus and the difficulty of transferring learnt abilities to everyday life. Yet, a comprehensive research synthesis is still missing. Hence, this scoping review aims to provide an overview over empirical studies on VR based BF regarding key outcomes, included samples, used soft- and hardware, BF parameters, mode of application and potential limitations. We systematically searched Medline, PsycINFO, Scopus, CINAHL, Google Scholar and Open Grey for empirical research. Eighteen articles met the inclusion criteria. Samples mostly consisted of healthy (44.4%) and/or adult (77.7%) participants. Outcomes were mainly anxiety (44.4%), stress (44.4%) or pain reduction (11.1%), which were reduced by the VR-BF interventions at least as much as by classical BF. Participants in VR-BF interventions showed higher motivation and involvement as well as a better user experience. Heart rate or heart rate variability were the most frequently used BF parameters (50.0%), and most VR-BF interventions (72.2%) employed a natural environment (e.g., island). Currently, there is no clear evidence that VR-BF is more effective than traditional BF. Yet, results indicate that VR-BF may have advantages regarding motivation, user experience, involvement and attentional focus. Further research is needed to assess the specific impact of VR and gamification. Also, testing a broader range of clinical and younger samples would allow more far-reaching conclusions.
Associations Between Traumatic Stress, Brain Volumes and Post-traumatic Stress Disorder Symptoms in Children: Data from the ABCD Study
Authors: Bustamante Daniel , Amstadter Ananda B. , Pritikin Joshua N. , Brick Timothy R. , Neale Michael C.
Published: December 2021

Reduced volumes in brain regions of interest (ROIs), primarily from adult samples, are associated with posttraumatic stress disorder (PTSD). We extended this work to children using data from the Adolescent Brain Cognitive Development (ABCD) Study® (N = 11,848; Mage = 9.92). Structural equation modeling and an elastic-net (EN) machine-learning approach were used to identify potential effects of traumatic events (TEs) on PTSD symptoms (PTSDsx) directly, and indirectly via the volumes 300 subcortical and cortical ROIs. We then estimated the genetic and environmental variation in the phenotypes. TEs were directly associated with PTSDsx (r = 0.92) in children, but their indirect effects (r < 0.0004)—via the volumes of EN-identified subcortical and cortical ROIs—were negligible at this age. Additive genetic factors explained a modest proportion of the variance in TEs (23.4%) and PTSDsx (21.3%), and accounted for most of the variance of EN-identified volumes of four of the five subcortical (52.4–61.8%) three of the nine cortical ROIs (46.4–53.3%) and cerebral white matter in the left hemisphere (57.4%). Environmental factors explained most of the variance in TEs (C = 61.6%, E = 15.1%), PTSDsx (residual-C = 18.4%, residual-E = 21.8%), right lateral ventricle (C = 15.2%, E = 43.1%) and six of the nine EN-identified cortical ROIs (C = 4.0–13.6%, E = 56.7–74.8%). There is negligible evidence that the volumes of brain ROIs are associated with the indirect effects of TEs on PTSDsx at this age. Overall, environmental factors accounted for more of the variation in TEs and PTSDsx. Whereas additive genetic factors accounted for most of the variability in the volumes of a minority of cortical and in most of subcortical ROIs.
Relationships between chemical composition, antioxidant activity and genetic analysis with ISSR markers in flower buds of caper plants (Capparis spinosa L.) of two subspecies spinosa and rupestris of Spanish cultivars
Authors: Grimalt Mar , García-Martínez Santiago , Carbonell Pedro , Hernández Francisca , Legua Pilar , Almansa María S. , Amorós Asunción
Published: December 2021

Genetic diversity and variability between populations is essential for the long-term survival of plant species as well as their adaptation to different habitats. The Capparis spinosa L. has two subspecies in Spain, spinosa with stipules thorny and rupestris without them. In Spain, the subspecies used for its cultivation is spinosa, which is difficult to manipulate due to its stipules thorny. The capers, unripe fruits and tender shoots are used as food. The caper plant is a rich source of phenolic compounds, due to that many flavonoids have been found in different parts of caper plant and in high quantities, which indicates that it is a good source of functional compounds both as food and for nutraceutical applications. There are no published works on the differences in biochemical and functional compounds of both subspecies, so in this work 32 varieties have been genetically analyzed to know their subspecies. Afterwards, various biochemical and functional parameters have been analyzed to find out if they present differences between both subspecies. From the results of the biochemical and functional parameters studied, there are no difference between the spinosa and rupestis subspecies, in all the parameters studied, except chlorophylls. There was more difference between the results of the subspecies spinosa among them, than with the subspecies rupestris. For all this, it can be concluded that the rupestris subspecies that does not present stipules thorniness can be cultivated, instead of the spinosa subspecies that does present them, without losing functional or nutritional characteristics of the caper buds.
Brain–computer interfaces for human gait restoration
Authors: Nenadic Zoran
Published: December 2021

In this review article, we present more than a decade of our work on the development of brain–computer interface (BCI) systems for the restoration of walking following neurological injuries such as spinal cord injury (SCI) or stroke. Most of this work has been in the domain of non-invasive electroencephalogram-based BCIs, including interfacing our system with a virtual reality environment and physical prostheses. Real-time online tests are presented to demonstrate the ability of able-bodied subjects as well as those with SCI to purposefully operate our BCI system. Extensions of this work are also presented and include the development of a portable low-cost BCI suitable for at-home use, our ongoing efforts to develop a fully implantable BCI for the restoration of walking and leg sensation after SCI, and our novel BCI-based therapy for stroke rehabilitation.
When the Evidence Is Incorrect: an Exploration of What Happens When Interviewers Unwittingly Present Inaccurate Information in Interviews with Suspects
Authors: Beek Martijn van , Bull Ray , Chen Melissa
Published: December 2021

Skillfully presenting evidence/information to suspects is one of the few interviewing techniques that increases the likelihood of guilty suspects providing information or making a confession, without making innocent ones do so as well. It is important that this evidence/information is correct, since deliberately disclosing incorrect evidence poses some risks. Also, in real-life interviews, police interviewers may unwittingly disclose incorrect evidence, for example when a witness was mistaken and provided the police with incorrect information. The present study examined the behavior of fifty police interviewers in interviews with “suspects” of a scripted crime: what is their response when the interviewees try to explain to them that some of the evidence/information just disclosed by them is incorrect? Eleven interviewers responded adaptively (by actively picking up on this new information), 35 responded in a neutral way and four responded maladaptively (by discrediting the interviewee’s claim). Experience and a full interview training had a significant negative relationship with adaptiveness. These results indicate that, when preparing and conducting interviews with suspects, greater awareness is needed of the possibility that some of the evidence/information that is to be disclosed could be incorrect, and therefore it is crucial that suspects’ responses which suggest such may be the case are taken into account.
White paper on peanut allergy: treatment pathway
Authors: Klimek Ludger , Lange Lars , Blum Lea Alexandra , Klimek Felix , Nemat Katja , Reese Imke , Blumchen Katharina
Published: December 2021

Background

Peanuts are a member of the legume family (botanical family Leguminosae) and peanut allergies are the most common cause of food anaphylaxis in many countries. The prevalence of peanut allergy is increasing.

Methods

Experts from Germany and Austria performed a standardized literature search and published their consensus recommendations in a White Paper on Peanut Allergy, which this care pathway is based upon, thus, providing a comprehensive diagnosis and treatment algorithm.

Results

The most important diagnostic key elements include a detailed clinical medical history, evidence of peanut-specific sensitization by means of skin prick testing and/or in vitro determination of the peanut (extract)-specific IgE and/or the molecular component diagnostics (most important Ara h 2-specific IgE, sometimes also Ara h1-, 3-, 6-, 8- and 9-specific IgE) as well as the gold standard, the double-blind, placebo-controlled food challenge. The diagnostic algorithms were created for the following constellations: Suspected primary peanut allergy with a clear history of systemic immediate-type reaction, suspected primary peanut allergy with questionable symptoms, suspected secondary (possibly pollen-associated) peanut allergy with a history of solely oropharyngeal symptoms and incidental finding of sensitization and no peanut ingestion so far.

Conclusions

After established diagnosis the standard of care is counseling to avoid peanut contact and prescription of emergency medications (oral antihistamines, oral steroids, inhaled β2-agonists, injectable intramuscular epinephrine) as needed. Instruction on the use of these emergency medications should be provided. A preparation for oral immunotherapy (OIT) for 4 to 17 years old peanut allergic children/ adolescents has been recently approved by the regulatory authorities. OIT for peanut allergy shows high efficacy and an acceptable safety profile, improves quality of life, and health economic aspects. Thus it offers a therapeutic option for peanut allergic children and adolescents.
Coalescence of black hole–neutron star binaries
Authors: Kyutoku Koutarou , Shibata Masaru , Taniguchi Keisuke
Published: December 2021

We review the current status of general relativistic studies for coalescences of black hole–neutron star binaries. First, high-precision computations of black hole–neutron star binaries in quasiequilibrium circular orbits are summarized, focusing on the quasiequilibrium sequences and the mass-shedding limit. Next, the current status of numerical-relativity simulations for the merger of black hole–neutron star binaries is described. We summarize our understanding for the merger process, tidal disruption and its criterion, properties of the merger remnant and ejected material, gravitational waveforms, and gravitational-wave spectra. We also discuss expected electromagnetic counterparts to black hole–neutron star coalescences.
Blockchain for Trade: When Code Needs Law
Authors: Ganne Emmanuelle
Published: December 2021

In spite of decades of efforts to digitalize trade, it remains labor- and paper-intensive. Shipping a container from Mombasa to Rotterdam generates a pile of paper that is twenty-five cm. high. Around thirty actors and more than one hundred people are involved throughout the journey, with the number of interactions exceeding two hundred. The unique characteristics of blockchain make it a promising technology to remove the multiple frictions and inefficiencies that plague international trade today and that have been put into sharp focus during the COVID-19 pandemic. The potential is significant, but technology on its own can do little. Trade digitalization cannot happen in a legal and regulatory vacuum. While law and regulation are often seen as constraints or means to counter unintended consequences of technological developments, they also play a key enabling role. International legal instruments already provide useful guidance in some areas, but gaps remain to be filled and more proactive action is needed across the globe to transpose existing legal instruments into national legislation. International organizations have a key role to play to help coordinate action on these two fronts.
Challenges and Approaches to Regulating Decentralized Finance
Authors: Salami Iwa
Published: December 2021

Decentralized finance (DeFi) is an ecosystem of financial applications that are built on top of blockchain networks. DeFi aims to create an open-source, permissionless, and transparent financial system that operates without any central authority. Instead, a smart contract—which is a self-executing contract with the terms of the agreement between transacting parties written into lines of code—replaces financial institutions in the transaction. As a result, DeFi is available to everyone with reliable access to electricity and Internet connectivity. It also serves as a form of non-custodial finance since users maintain full control of their assets and transact through smart contract programs that facilitate peer-to-peer interactions. While DeFi presents huge opportunities, it also poses significant risks to traditional finance ecosystems, including the use of stablecoins and the absence of a know-your-customer framework. This essay argues that for DeFi to secure credibility, it needs to be adequately regulated in a way that aligns with how the technology works.
FURTHER CONSIDERATIONS FOR THE AUTHENTICATION OF THE PEKING UNIVERSITY CANG JIE PIAN: WITH BRIEF DIGRESSION ON THE SO-CALLED “HAN BOARD” WITNESS
Authors: Foster Christopher J.
Published: December 2021

Over the past few years, additional evidence has surfaced that supplements my prior authentication of the Peking University Han strips, and in particular the *Cang Jie pian 蒼頡篇 manuscript from this collection. The present article surveys this fresh evidence, including confirmation of spiraling verso lines on the archaeologically excavated Shuihudi 睡虎地 Han strips, as well as further textual parallels, both with a previously unidentified Cang Jie pian strip from Niya 尼雅, and also with newly published content from the Shuiquanzi 水泉子 *Cang Jie pian. The article also critically examines in greater detail the methodology previously employed to authenticate the Peking University Han strips. Limitations are acknowledged, both in regard to supporting negative appraisals, and in the determination of “novelty” for manuscript features. To demonstrate these issues, the article analyzes a conflict between the Peking University and Shuiquanzi Cang Jie pian manuscripts and introduces the publication of the so-called “Han board” *Cang Jie pian witness largely unknown to the field before.
The Democratic Cost of Consecutive Re-election and Presidential Term-Limit Evasion in Latin America
Authors: Kouba Karel , Pumr Jan
Published: December 2021

Despite theoretical arguments suggesting the strong effects of presidential term limits and re-election on democracy, there is surprisingly little empirical evidence to evaluate them. We test both the effect on democracy of the existence of a consecutive re-election rule and of reforms introducing it for incumbent presidents. Using evidence from Latin American countries between 1945 and 2018, we test their relationship to both vertical and horizontal accountability. A synthetic control method is employed to account for the effect of term-limit reforms, and time-series cross-section models for modelling the association with the re-election rule. Both vertical and horizontal accountability as well as the quality of democracy are eroded by term-limit evasion reforms in most countries and strengthened in none between 1990 and 2018. Allowing presidents to run for re-election – relative to term-limited ones – is consistently associated with weak democratic outcomes.
Outbreak of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in hospitalized hemodialysis patients: An epidemiologic and genomic investigation
Authors: Marvil Charles E. , Babiker Ahmed , Preston Aaron , Webster Andrew S. , Guarner Jeannette , Love Kari , Ghonim Elham , Rebolledo Paulina A. , Wang Yun F. , Arthur Robert A. , Johnston H. Richard , Waggoner Jesse J. , Piantadosi Anne , Jacob Jesse T.
Published: December 2021

We performed an epidemiological investigation and genome sequencing of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to define the source and scope of an outbreak in a cluster of hospitalized patients. Lack of appropriate respiratory hygiene led to SARS-CoV-2 transmission to patients and healthcare workers during a single hemodialysis session, highlighting the importance of infection prevention precautions.
Experimental study of the flows in a non-axisymmetric ellipsoid under precession
Authors: Burmann Fabian , Noir Jérõme
Published: December 2021

Precession driven flows are of great interest for both, industrial and geophysical applications. While cylindrical, spherical and spheroidal geometries have been investigated in great detail, the numerically and theoretically more challenging case of a non-axisymmetric cavity has received less attention. We report experimental results on the flows in a precessing triaxial ellipsoid, with a focus on the base flow of uniform vorticity, which we show to be in good agreement with existing theoretical models. As predicted, the uniform vorticity component exhibits two branches of solutions leading to a hysteresis cycle as a function of the Poincaré number. The first branch is observed at low forcing and characterized by large amplitude of the total fluid rotation and a moderate tilt angle of the fluid rotation axis. In contrast, the second branch displays only a moderate fluid rotation and a large tilt angle of the fluid rotation axis, which tends to align with the precession axis. In addition, we observe the occurrence of parametric instabilities early in the first branch, which saturate in the second branch, where we observe the same order of the kinetic energy in the base flow and instabilities.
Explorative gradient method for active drag reduction of the fluidic pinball and slanted Ahmed body
Authors: Li Yiqing , Cui Wenshi , Jia Qing , Li Qiliang , Yang Zhigang , Morzyński Marek , Noack Bernd R.
Published: December 2021

We address a challenge of active flow control: the optimization of many actuation parameters guaranteeing fast convergence and avoiding suboptimal local minima. This challenge is addressed by a new optimizer, called the explorative gradient method (EGM). EGM alternatively performs one exploitive downhill simplex step and an explorative Latin hypercube sampling iteration. Thus, the convergence rate of a gradient based method is guaranteed while, at the same time, better minima are explored. For an analytical multi-modal test function, EGM is shown to significantly outperform the downhill simplex method, the random restart simplex, Latin hypercube sampling, Monte Carlo sampling and the genetic algorithm. EGM is applied to minimize the net drag power of the two-dimensional fluidic pinball benchmark with three cylinder rotations as actuation parameters. The net drag power is reduced by 29 % employing direct numerical simulations at a Reynolds number of

$100$

based on the cylinder diameter. This optimal actuation leads to 52 % drag reduction employing Coanda forcing for boat tailing and partial stabilization of vortex shedding. The price is an actuation energy corresponding to 23 % of the unforced parasitic drag power. EGM is also used to minimize drag of the

$35^\circ$

slanted Ahmed body employing distributed steady blowing with 10 inputs. 17 % drag reduction are achieved using Reynolds-averaged Navier–Stokes simulations at the Reynolds number

$Re_H=1.9 \times 10^5$

based on the height of the Ahmed body. The wake is controlled with seven local jet-slot actuators at all trailing edges. Symmetric operation corresponds to five independent actuator groups at top, middle, bottom, top sides and bottom sides. Each slot actuator produces a uniform jet with the velocity and angle as free parameters, yielding 10 actuation parameters as free inputs. The optimal actuation emulates boat tailing by inward-directed blowing with velocities which are comparable to the oncoming velocity. We expect that EGM will be employed as efficient optimizer in many future active flow control plants as alternative or augmentation to pure gradient search or explorative methods.
Labor Migration and Climate Change Adaptation
Authors: DRAPER JAMIE
Published: December 2021

Social scientific evidence suggests that labor migration can increase resilience to climate change. For that reason, some have recently advocated using labor migration policy as a tool for climate adaptation. This paper engages with the normative question of whether, and under what conditions, states may permissibly use labor migration policy as a tool for climate adaptation. I argue that states may use labor migration policy as a tool for climate adaptation and may even have a duty to do so, subject to two moral constraints. First, states must also provide acceptable alternative options for adaptation so that the vulnerable are not forced to sacrifice their morally important interests in being able to remain where they are. Second, states may not impose restrictive terms on labor migrants to make accepting greater numbers less costly for themselves because doing so unfairly shifts the costs of adaptation onto the most vulnerable.
The Creative Advance Must Be Defended: Miscegenation, Metaphysics, and Race War in Jan Smuts’s Vision of the League of Nations
Authors: KRIPP JACOB
Published: December 2021

This paper argues that the idea of global peace in early twentieth-century liberal international order was sutured together by the threat of race war. This understanding of racial peace was institutionalized in the League of Nations mandate system through its philosophical architect: Jan Smuts. I argue that the League figured in Smuts’s thought as the culmination of the creative advance of the universe: white internationalist unification and settler colonialism was the cosmological destiny of humanity that enabled a racial peace. In Smuts’s imaginary, the twin prospect of race war and miscegenation serves as the dark underside that both necessitates and threatens to undo this project. By reframing the problem of race war through his metaphysics, Smuts resolves the challenge posed by race war by institutionalizing indirect rule and segregation as a project of pacification that ensured that settlement and the creative advance of the cosmos could proceed.
Implications of new technologies for future food supply systems
Authors: Asseng S. , Palm C. A. , Anderson J. L. , Fresco L. , Sanchez P. A. , Asche F. , Garlock T. M. , Fanzo J. , Smith M. D. , Knapp G. , Jarvis A. , Adesogan A. , Capua I. , Hoogenboom G. , Despommier D. D. , Conti L. , Garrett K. A.
Published: December 2021

The combination of advances in knowledge, technology, changes in consumer preference and low cost of manufacturing is accelerating the next technology revolution in crop, livestock and fish production systems. This will have major implications for how, where and by whom food will be produced in the future. This next technology revolution could benefit the producer through substantial improvements in resource use and profitability, but also the environment through reduced externalities. The consumer will ultimately benefit through more nutritious, safe and affordable food diversity, which in turn will also contribute to the acceleration of the next technology. It will create new opportunities in achieving progress towards many of the Sustainable Development Goals, but it will require early recognition of trends and impact, public research and policy guidance to avoid negative trade-offs. Unfortunately, the quantitative predictability of future impacts will remain low and uncertain, while new chocks with unexpected consequences will continue to interrupt current and future outcomes. However, there is a continuing need for improving the predictability of shocks to future food systems especially for ex-ante assessment for policy and planning.
What are the Barriers to Taxing Wealth? The Case of a Wealth Tax Proposal in the UK
Authors: PRABHAKAR RAJIV
Published: December 2021

Over the past decade there have been repeated calls for the greater taxation of wealth. These calls have had little impact on policy. There has been a global trend to reduce or abolish taxes on wealth. The contrast suggests that it may be better now to explore how taxes on wealth may be made a reality rather than designing new tax proposals. What are the barriers to tax wealth? This paper addresses this by conducting a case study of a high profile plan for introducing a one-off wealth tax in the UK. It identifies a tyranny of the status quo, framing and the policy process as key barriers to tax reform. It uses thematic analysis to study how the plans for a one-off wealth tax were discussed in the media and the UK Parliament. This paper argues that there were important shortfalls in both the way the case for a wealth tax was framed as well as the engagement with the policy process. It claims that a stronger framing would have discussed wealth inequality in greater depth and there was a need for a less equivocal case to Parliamentarians.
OP123 The Use Of Surrogate Outcomes In National Institute For Health And Care Excellence (NICE) Highly Specialised Technology Evaluations: A Review Of Published Guidance
Authors: Guo Yelan , Bregman Caroline , Elliott Nicole
Published: December 2021

Introduction

The use of surrogate outcomes in health technology assessment (HTA) is increasing and methods for validating surrogate relationships have been published. However, these may not be fully applicable to ultra-rare diseases due to challenges such as scarcity of evidence and heterogenous populations. This study reviews and summarizes the use of surrogate outcomes and committee's considerations in the evaluations within the National Institute for Health and Care Excellence's (NICE) Highly Specialised Technology (HST) programme, which was established in 2013 in response to the challenges associated with the assessment of ultra-rare diseases.

Methods

All HST evaluation documents published before November 2020 were reviewed. Data extracted included surrogate outcomes used, rationales, the committee's considerations on the validity and generalizability of the surrogate relationships, related uncertainties, and other factors considered in decision-making.

Results

Seven out of the eighteen published HST topics used surrogate outcomes. The rationale for most of the surrogate relationships focused on biological plausibility. Common concerns raised by the committee included the generalizability of the surrogate relationship to the condition of interest, the lack of validation, and inability to prove or quantify the magnitude of benefits associated with the surrogate relationships. In some topics, other aspects of the evidence and clinical/patient expert's opinions were also considered by the committee.

Conclusions

The use of surrogate outcomes is common in NICE HST evaluations and the challenges in supporting surrogate relationships with more than biological plausibility are recognized. However, our review indicates that, the committee considers more than just biological plausibility and will take into account other related factors.
OP130 Economic Evaluation Of High-Cost Drugs For Relapsing-Remitting Multiple Sclerosis In Thailand
Authors: Khuntha Sarayuth , Budtarad Nuttakarn , Kingkaew Pritaporn , Hadnorntun Phorntida , Leelahavarong Pattara
Published: December 2021

Introduction

Drugs for relapsing-remitting multiple sclerosis (RRMS) are costly and not included in the National List of Essential Medicines of Thailand yet. This study aims to conduct an economic evaluation of high-cost drugs for RRMS.

Methods

The Markov model was used to estimate lifetime costs and quality-adjusted life years (QALYs) gained. The treatment options include Interferon beta-1a (IFN) and Teriflunomide (TERI) (first-line), Fingolimod (FIN) and Natalizumab (NATA) (second-line), and Alemtuzumab (ALEM) (third-line) compared with usual care. The effectiveness of drugs was retrieved by network meta-analysis. The probability of health state transition was obtained from primary data. Treatment-related costs were derived from the national database. Other costs and utilities were obtained from the study in Thai RRMS patients.

Results

The lowest lifetime costs option was usual care (THB2 million) (USD65,808), while the highest QALY gained option was IFN-NATA-ALEM (8.6 QALY gained). All treatment options were not cost-effective compared with usual care at the threshold of THB160,000 (USD5,300) per QALY gained. However, the option of IFN-NATA-ALEM yielded the lowest incremental cost-effectiveness ratio (ICER), which was THB4.4 million (USD144,778) per QALY gained.

Conclusions

High-cost drugs were not cost-effective; nonetheless, the IFN-NATA-ALEM option could increase QALY gained with the lowest additional budget. The government should negotiate the price of IFN to decrease by eighty percent.
OP244 Tools And Experiences To Facilitate Effective Patient Participation In Health Technology Assessment
Authors: Toledo-chávarri Ana , Remón Lucia Prieto , Ibargoyen Nora , Linde Máximo Molina , Pego Yolanda Triñanes , Reviriego Eva , Iglesias Asun Gutierrez , García Vanesa Ramos , López-Argumedo Marta , Álvarez-Pérez Yolanda
Published: December 2021

Introduction

In 2017, a Patient Involvement Interest Group (PIIG) was created in the Spanish Network for Health Technology Assessment of the National Health System (RedETS) to facilitate and promote Patient Involvement (PI) in Health Technology Assessment (HTA). The PIIG proposed a decisional flowchart to guide researchers’ in decisions regarding PI methods in HTA. The flowchart proposed a combination of direct involvement and incorporation of patient-based evidence depending on the scope and the aims of the assessment.

This work aims to present the flowchart and the results of the evaluation of the latest experiences in PI in HTA in RedETS (2018–2020), including direct-involvement and patient-based evidence.

Methods

A survey was sent to the HTA researchers who implemented PI initiatives in RedETS assessments. The survey asked to describe their experiences, lessons learned, challenges and added value regarding the use of direct-involvement, systematic reviews (SR) and primary studies. A descriptive analysis was performed and the results were discussed in an online PIIG workshop.

Results

Thirty-two assessments included direct PI, twenty-one SR synthesized qualitative and quantitative studies about patient experiences, values and preferences and eight included primary studies, mainly of qualitative design. Recruitment and the lack of methodological resources were the main barriers both for direct PI and primary studies. Relevance of the included studies was the main barrier for SR. Added value was found in all PI methods. Direct-involvement had an impact on the project plan and PICO definition, outcomes relevance, information about the health condition and treatments. SR contributed with relevant patient-based evidence, deeper assessment of patient experiences, values and preferences and implementation factors. Primary studies developed new or contextualized knowledge directly applicable to decision-making.

Conclusions

The PI flowchart has served to facilitate the incorporation of patient input in HTA reports. The different approaches implemented have allowed to provide relevant and well-grounded data in each report to inform decision-making in patient-centered healthcare provision, but it is necessary that specific training and resources are provided to enable adequate and timely implementation.
OP277 Rapid Development Of An Evaluation Framework: Capturing The Impact Of COVID-19 Activities By A Health Technology Assessment Body
Authors: Elston Lauren , Hughes Sophie , Myles Susan
Published: December 2021

Introduction

Health Technology Wales (HTW) is committed to evaluating the impact of our work. In March 2020, HTW directed efforts to support Welsh Government and health and social care providers in response to the COVID-19 pandemic. We adapted the HTW evaluation framework to specifically capture the impact of our additional COVID-19 work. Here we analyze data collected since the framework was implemented.

Methods

Both formal and informal feedback was analyzed. Formal feedback was obtained through the HTW Impact Questionnaire, which was developed to support more formalized data capture for all HTW workstreams and to facilitate feedback from all stakeholder groups. It was piloted with a targeted list of individuals and responses were received for COVID-19 work. Informal feedback included feedback received via email or through word of mouth.

Results

HTW COVID-19 products to date include Topic Exploration Reports, rapid evidence summaries and an Evidence Appraisal Report (EAR) on COVID-19 diagnostic tests (molecular and antibody tests). Stakeholders were positive about these outputs, describing them as valuable and informative. Reported impacts included informing policy and decision making, reducing duplication of efforts and helping to target development. The EAR received national and international focus, leading to HTW involvement in the European Network for Health Technology Assessment (EUnetHTA) COVID-19 reviews. Survey participants who gave feedback on COVID-19 activities included two members of Health Technology Assessment organizations, a health board representative and an industry representative; all agreed that HTW's COVID-19 work was useful, that the methods were reliable and robust and that HTW is responsive. All participants also felt that HTW's COVID-19 work had a positive impact in the wider health and social care context.

Conclusions

HTW was able to respond rapidly to the COVID-19 pandemic and adapt current evaluation practices to capture the impact of COVID-19 work. We will continue to evaluate our COVID-19 activities. Future work will involve following up on the developing impact of our COVID-19 work and expanding our methods for data capture, for example conducting stakeholder interviews.