bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimates of the mean difference in orthopaedic randomized trials: obligatory yet obscure
Authors: Raittio Lauri , Launonen Antti , Mattila Ville M. , Reito Aleksi
Published: March 2021

Background

Randomized controlled trials in orthopaedics are powered to mainly find large effect sizes. A possible discrepancy between the estimated and the real mean difference is a challenge for statistical inference based on p-values. We explored the justifications of the mean difference estimates used in power calculations. The assessment of distribution of observations in the primary outcome and the possibility of ceiling effects were also assessed.

Methods

Systematic review of the randomized controlled trials with power calculations in eight clinical orthopaedic journals published between 2016 and 2019. Trials with one continuous primary outcome and 1:1 allocation were eligible. Rationales and references for the mean difference estimate were recorded from the Methods sections. The possibility of ceiling effect was addressed by the assessment of the weighted mean and standard deviation of the primary outcome and its elaboration in the Discussion section of each RCT where available.

Results

264 trials were included in this study. Of these, 108 (41 %) trials provided some rationale or reference for the mean difference estimate. The most common rationales or references for the estimate of mean difference were minimal clinical important difference (16 %), observational studies on the same subject (8 %) and the ‘clinical relevance’ of the authors (6 %). In a third of the trials, the weighted mean plus 1 standard deviation of the primary outcome reached over the best value in the patient-reported outcome measure scale, indicating the possibility of ceiling effect in the outcome.

Conclusions

The chosen mean difference estimates in power calculations are rarely properly justified in orthopaedic trials. In general, trials with a patient-reported outcome measure as the primary outcome do not assess or report the possibility of the ceiling effect in the primary outcome or elaborate further in the Discussion section.
Questionnaire-based detection of immune-related adverse events in cancer patients treated with PD-1/PD-L1 immune checkpoint inhibitors
Authors: Griewing Luisa Maria , Schweizer Claudia , Schubert Philipp , Rutzner Sandra , Eckstein Markus , Frey Benjamin , Haderlein Marlen , Weissmann Thomas , Semrau Sabine , Gostian Antoniu-Oreste , Müller Sarina K. , Traxdorf Maximilian , Iro Heinrich , Zhou Jian-Guo , Gaipl Udo S. , Fietkau Rainer , Hecht Markus
Published: March 2021

Background

Immune checkpoint inhibitors (ICI) have become standard treatment in different tumor entities. However, safe treatment with ICI targeting the PD-1/PD-L1 axis requires early detection of immune-related adverse events (irAE). There exist different questionnaires of drug manufacturers for the detection of irAE that have not been validated so far.

Methods

The prospective non-interventional ST-ICI trial studied treatment with PD-1/PD-L1 ICI alone or combined with radiotherapy. In the current analysis, the detection rate of self-reported irAE with a patient questionnaire containing 41 different questions was compared to clinician-reported irAE.

Results

Between April 2017 and August 2019, a total of 104 patients were prospectively enrolled. NSCLC (44%) and HNSCC (42%) were the most frequent tumor entities. A total of 784 questionnaires were collected. A total of 29 irAE were reported by clinicians. The most frequent irAE was hypothyroidism (9%), followed by skin reactions (5%), hepatitis (4%), diarrhea (3%), and pneumonitis (3%). Questions that became significantly more often positive at time points of clinician-reported irAE were “weight change”, “difficulty to grip things”, “bloody or mucous stool” and “insomnia”. Self-reported organ-specific questions detected at least 50% of clinician-reported irAE of gastrointestinal, lung, endocrine, and skin irAE. It was not possible to detect hepatic irAE with the questionnaire.

Conclusion

Questionnaires can help to detect gastrointestinal, lung, endocrine, or skin irAE, but not hepatic irAE. Questions on “weight change” and “insomnia” may help to increase the detection rate of irAE, besides organ-specific questions. These results are a valuable contribution to the future development of a specific and practicable questionnaire for early self-reported detection of irAE during ICI therapy in cancer patients.

Trial registration

ClinicalTrials.gov, NCT03453892. Registered on 05 March 2018.
Severe obesity in a specialist type 2 diabetes outpatient clinic: an Australian retrospective cohort study
Authors: Thakur Arunav , Sharma Dharmesh , Gupta Bhavya , Kramadhari Nikitha , Rajagopal Rohit , Simmons David , Piya Milan Kumar
Published: March 2021

Background

Obesity is a major risk factor for the development of type 2 diabetes (T2DM) and its complications. Significant weight loss has been shown to improve glycaemia in people with T2DM and obesity. National and international guidelines recommend considering bariatric surgery for body mass index (BMI) ≥ 35 kg/m2. We assessed the proportion of people with T2DM meeting criteria for surgery, how many had been offered a bariatric/obesity service referral, and compared the characteristics of people with BMI ≥ 35 kg/m2 and BMI < 35 kg/m2.

Methods

Retrospective data were collected for all people with T2DM aged ≥18 years, attending a hospital specialist diabetes outpatient service over three calendar years, 2017–2019.

Results

Of 700 people seen in the service, 291 (42%) had BMI ≥ 35 kg/m2 (the “BMI ≥ 35 group”) and met criteria for bariatric surgery, but only 54 (19%) of them were offered referral to an obesity service. The BMI ≥ 35 group was younger than those with a BMI < 35 kg/m2 (56.1 ± 14.8 vs 61.4 ± 14.6 years, p < 0.001) (mean ± SD), with similar diabetes duration (11.0 ± 9.0 vs 12.3 ± 8.9 years, p = 0.078), and there was no significant difference in initial HbA1c (75 ± 27 vs 72 ± 26 mmol/mol, p = 0.118) (9.0 ± 2.5 vs 8.7 ± 2.4%) or proportion treated with insulin (62% vs 58%). There was more GLP1 agonist use in the BMI ≥ 35 group (13% vs 7%, p = 0.003) but similar rates of SGLT2 inhibitor use (25% vs 21%, p = 0.202). The BMI ≥ 35 group received more new medication and/or dose adjustments (74% vs 66%, p = 0.016). Only 29% in the BMI ≥ 35 kg group achieved HbA1c < 53 mmol/mol (7.0%).

Conclusions

In spite of frequently meeting the criteria for bariatric surgery and not achieving glycaemic targets, people with T2DM in this specialist clinic received limited medical or surgical management of their obesity. This study suggests opportunities for improvement in care of people with T2DM at several levels including increased referrals from T2DM services to weight management/bariatric services, as well as an increased use of GLP1 agonists and SGLT2 inhibitors where appropriate. Our data support the need to prioritise obesity management in the treatment of type 2 diabetes.
Presence and activation of pro-inflammatory macrophages are associated with CRYAB expression in vitro and after peripheral nerve injury
Authors: Lim Erin-Mai F. , Hoghooghi Vahid , Hagen Kathleen M. , Kapoor Kunal , Frederick Ariana , Finlay Trisha M. , Ousman Shalina S.
Published: March 2021

Background

Inflammation constitutes both positive and negative aspects to recovery following peripheral nerve injury. Following damage to the peripheral nervous system (PNS), immune cells such as macrophages play a beneficial role in creating a supportive environment for regrowing axons by phagocytosing myelin and axonal debris. However, a prolonged inflammatory response after peripheral nerve injury has been implicated in the pathogenesis of negative symptoms like neuropathic pain. Therefore, the post-injury inflammation must be carefully controlled to prevent secondary damage while allowing for regeneration. CRYAB (also known as alphaB-crystallin/HSPB5) is a small heat shock protein that has many protective functions including an immunomodulatory role in mouse models of multiple sclerosis, spinal cord injury, and stroke. Because its expression wanes and rebounds in the early and late periods respectively after PNS damage, and CRYAB null mice with sciatic nerve crush injury display symptoms of pain, we investigated whether CRYAB is involved in the immune response following PNS injury.

Methods

Sciatic nerve crush injuries were performed in age-matchedCryabknockout (Cryab−/−) and wildtype (WT) female mice. Nerve segments distal to the injury site were processed by immunohistochemistry for macrophages and myelin while protein lysates of the nerves were analyzed for cytokines and chemokines using Luminex and enzyme-linked immunosorbent assay (ELISA). Peritoneal macrophages from the two genotypes were also cultured and polarized into pro-inflammatory or anti-inflammatory phenotypes where their supernatants were analyzed for cytokines and chemokines by ELISA and protein lysates for macrophage antigen presenting markers using western blotting.

Results

We report that (1) more pro-inflammatory CD16/32+macrophages are present in the nerves ofCryab−/−mice at days 14 and 21 after sciatic nerve crush-injury compared to WT counterparts, and (2) CRYAB has an immunosuppressive effect on cytokine secretion [interleukin (IL)-β, IL-6, IL-12p40, tumor necrosis factor (TNF)-α] from pro-inflammatory macrophages in vitro.

Conclusions

CRYAB may play a role in curbing the potentially detrimental pro-inflammatory macrophage response during the late stages of peripheral nerve regeneration.
Caveolin-1 is involved in encephalomyocarditis virus replication in BHK-21 cells
Authors: Li Qiongyi , Liu Yang , Xu Shujuan , Zhao Kexue , Ling Ying , Liu Rongxiu , Ali Amjad , Bai Jialin
Published: March 2021

Background

Encephalomyocarditis virus, member of Cardiovirus genus within Picornaviridae family, is an important pathogen that infects different domestic and wild animals. However, the molecular mechanism of its entry remains unclear. In this study, we investigated the mechanism of EMCV infectivity in relation to endocytic pathway using BHK-21 cells.

Methods

The function of numerous cellular key factors implicated in the various endocytic mechanisms were systematically explored using chemical inhibitors. Furthermore, RNA interference (RNAi) as well as the overexpression of dominant protein combined to virus infectivity assays, and confocal microscopy was used to examine EMCV infection in details.

Results

The results indicated that the EMCV entry into BHK-21 cells depends on caveolin, dynamin, and actin but not clathrin nor macropinocytosis pathways. The effects of overexpression and knockdown of caveolin-1, one components of the caveolae, was examined on EMCV infection. The results showed that EMCV infection was positive correlation with caveolin-1 expression. Confocal microscopy analysis and internalization assay showed that caveolin-1 is required at the early stage of EMCV infection.

Conclusions

Caveolin-1, dynamin, and actin-dependent endocytosis pathways are necessary for EMCV infection in vitro.
Relationship between patellofemoral finite helical axis and femoral trans-epicondylar axis using a static magnetic resonance-based methodology
Authors: Yu Zhenguo , Cai Hong , Yang Bin , Yao Jie , Zhang Ke , Tian Hua , Liu Zhongjun
Published: March 2021

Background

To manage patellofemoral joint disorders, a complete understanding of the in vivo patellofemoral kinematics is critical. However, as one of the parameters of joint kinematics, the location and orientation of the patellofemoral finite helical axis (FHA) remains unclear. The purpose of this study is to quantify the location and orientation of the patellar FHA, both in vivo and non-invasively at various flexion angles, and evaluate the relationship of the FHA and the trans-epicondylar axis (TEA).

Methods

The magnetic resonance (MR) images of 18 unilateral knees were collected at full extension, 30°, 60°, 90°, and maximum angle of knee flexion. Three-dimensional models of the knee joint at different flexion angles were created using the MR images, and then used to calculate the patellar tracking and FHA with a spline interpolation algorithm. By using a coordinate system based on the TEA, the FHA tracking was quantified. Six parameters concerning the location and orientation of the patellar FHA were analysed.

Results

The average patellar FHA drew an L-shaped tracking on the midsagittal plane moving from the posteroinferior to the anterosuperior side of the TEA with knee flexion. Before 90° flexion, the patellar rotational radius decreased slightly, with an average value of 5.65 ± 1.09 cm. During 20° to 90° knee flexion, the average angle between the patellar FHA and the TEA was approximately 10° and that between the FHA and the coronal plane was maintained at about 0°, while that between the FHA and the level plane fluctuated between − 10° and 10°.

Conclusions

This study quantitatively reported the continuous location and direction of the patellar FHA during knee flexion. The patellar FHA was close to but not coincident with the femoral TEA both in location and orientation, and the patellar rotational radius decreased slightly with knee flexion. These findings could provide a clear direction for further studies on the difference in patellofemoral FHA among various types of patellofemoral disorders, and provide a foundation for the application of FHA in surgical evaluation, preoperative planning and prosthesis design, thereby assisting in the diagnosis and treatment of patellofemoral disorders.
Biomechanics of artificial pedicle fixation in a 3D-printed prosthesis after total en bloc spondylectomy: a finite element analysis
Authors: Wang Xiaodong , Xu Hanpeng , Han Ye , Wu Jincheng , Song Yang , Jiang Yuanyuan , Wang Jianzhong , Miao Jun
Published: March 2021

Background

This study compared the biomechanics of artificial pedicle fixation in spine reconstruction with a 3-dimensional (3D)-printed prosthesis after total en bloc spondylectomy (TES) by finite element analysis.

Methods

A thoracolumbar (T10–L2) finite element model was developed and validated. Two models of T12 TES were established in combination with different fixation methods: Model A consisted of long-segment posterior fixation (T10/11, L1/2) + 3D-printed prosthesis; and Model B consisted of Model A + two artificial pedicle fixation screws. The models were evaluated with an applied of 7.5 N·m and axial force of 200 N. We recorded and analyzed the following: (1) stiffness of the two fixation systems, (2) hardware stress in the two fixation systems, and (3) stress on the endplate adjacent to the 3D-printed prosthesis.

Results

The fixation strength of Model B was enhanced by the screws in the artificial pedicle, which was mainly manifested as an improvement in rotational stability. The stress transmission of the artificial pedicle fixation screws reduced the stress on the posterior rods and endplate adjacent to the 3D-printed prosthesis in all directions of motion, especially in rotation.

Conclusions

After TES, the posterior long-segment fixation combined with the anterior 3D printed prosthesis could maintain postoperative spinal stability, but adding artificial pedicle fixation increased the stability of the fixation system and reduced the risk of prosthesis subsidence and instrumentation failure.
Role of glioblastoma stem cells in cancer therapeutic resistance: a perspective on antineoplastic agents from natural sources and chemical derivatives
Authors: Alves Ana Laura V. , Gomes Izabela N. F. , Carloni Adriana C. , Rosa Marcela N. , da Silva Luciane S. , Evangelista Adriane F. , Reis Rui Manuel , Silva Viviane Aline O.
Published: March 2021

Glioblastoma (GBM) is the highest-grade form of glioma, as well as one of the most aggressive types of cancer, exhibiting rapid cellular growth and highly invasive behavior. Despite significant advances in diagnosis and therapy in recent decades, the outcomes for high-grade gliomas (WHO grades III-IV) remain unfavorable, with a median overall survival time of 15–18 months. The concept of cancer stem cells (CSCs) has emerged and provided new insight into GBM resistance and management. CSCs can self-renew and initiate tumor growth and are also responsible for tumor cell heterogeneity and the induction of systemic immunosuppression. The idea that GBM resistance could be dependent on innate differences in the sensitivity of clonogenic glial stem cells (GSCs) to chemotherapeutic drugs/radiation prompted the scientific community to rethink the understanding of GBM growth and therapies directed at eliminating these cells or modulating their stemness. This review aims to describe major intrinsic and extrinsic mechanisms that mediate chemoradioresistant GSCs and therapies based on antineoplastic agents from natural sources, derivatives, and synthetics used alone or in synergistic combination with conventional treatment. We will also address ongoing clinical trials focused on these promising targets. Although the development of effective therapy for GBM remains a major challenge in molecular oncology, GSC knowledge can offer new directions for a promising future.
NRF2 is required for structural and metabolic maturation of human induced pluripotent stem cell-derived ardiomyocytes
Authors: Zhang Xinyuan , Ye Liang , Xu Hao , Zhou Qin , Tan Bin , Yi Qin , Yan Liang , Xie Min , Zhang Yin , Tian Jie , Zhu Jing
Published: March 2021

Background

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) hold great promise for regenerative medicine and in drugs screening. Despite displaying key cardiomyocyte phenotypic characteristics, they more closely resemble fetal/neonatal cardiomyocytes and are still immature; these cells mainly rely on glucose as a substrate for metabolic energy, while mature cardiomyocytes mainly employ oxidative phosphorylation of fatty acids. Studies showed that the alteration of metabolism pattern from glycolysis to oxidative phosphorylation improve the maturity of hiPSC-CMs. As a transcription factor, accumulating evidences showed the important role of NRF2 in the regulation of energy metabolism, which directly regulates the expression of mitochondrial respiratory complexes. Therefore, we hypothesized that NRF2 is involved in the maturation of hiPSC-CMs.

Methods

The morphological and functional changes related to mitochondria and cell maturation were analyzed by knock-down and activation of NRF2.

Results

The results showed that the inhibition of NRF2 led to the retardation of cell maturation. The activation of NRF2 leads to a more mature hiPSC-CMs phenotype, as indicated by the increase of cardiac maturation markers, sarcomere length, calcium transient dynamics, the number and fusion events of mitochondria, and mitochondrial respiration. Bioinformatics analysis showed that in addition to metabolism-related genes, NRF2 also activates the expression of myocardial ion channels.

Conclusions

These findings indicated that NRF2 plays an important role in the maturation of hiPSC-CMs. The present work provides greater insights into the molecular regulation of hiPSC-CMs metabolism and theoretical basis in drug screening, disease modeling, and alternative treatment.
Advances in intranasal application of stem cells in the treatment of central nervous system diseases
Authors: Zhang Yu-Ting , He Kai-Jie , Zhang Jin-Bao , Ma Quan-Hong , Wang Fen , Liu Chun-Feng
Published: March 2021

Stem cells are characterized by their self-renewal and multipotency and have great potential in the therapy of various disorders. However, the blood–brain barrier (BBB) limits the application of stem cells in the therapy of neurological disorders, especially in a noninvasive way. It has been shown that small molecular substances, macromolecular proteins, and even stem cells can bypass the BBB and reach the brain parenchyma following intranasal administration. Here, we review the possible brain-entry routes of transnasal treatment, the cell types, and diseases involved in intranasal stem cell therapy, and discuss its advantages and disadvantages in the treatment of central nervous system diseases, to provide a reference for the application of intranasal stem cell therapy.
Power equipment fault information acquisition system based on Internet of things
Authors: Wang Ruilian , Li Minghai
Published: March 2021

With the advent of the Internet of things era, power equipment is gradually connected to the network, and its intelligent fault detection function provides greater help for the power industry. The purpose of this study is to design the power equipment fault information acquisition system of the Internet of things. This research is based on the equipment fault information collection system of the Internet of things and mainly studies the fault information collection method based on the Internet of things technology. Equipment fault data are generally time series data. In the analysis of equipment failure, the data before and after fault and before and after fault are analyzed. The abnormal state of equipment is associated with the data before and after the fault. Therefore, by analyzing the characteristics of the fault data and the equipment before and after the fault, a bidirectional recurrent neural network model based on LSTM is constructed. The method designed in this paper can not only improve the efficiency and speed of collection, but also can compare and collect fault information. The overall operation state of the power unit is improved accurately. The research results show that the company's low-voltage user acquisition success rate has reached more than 99%. With the increase of time, the fault information collection efficiency can approach 99%. It shows that the function of this research system is better, the economic loss of the company is reduced, and the management is optimized.
A cut finite element method for spatially resolved energy metabolism models in complex neuro-cell morphologies with minimal remeshing
Authors: Farina Sofia , Claus Susanne , Hale Jack S. , Skupin Alexander , Bordas Stéphane P. A.
Published: March 2021

A thorough understanding of brain metabolism is essential to tackle neurodegenerative diseases. Astrocytes are glial cells which play an important metabolic role by supplying neurons with energy. In addition, astrocytes provide scaffolding and homeostatic functions to neighboring neurons and contribute to the blood–brain barrier. Recent investigations indicate that the complex morphology of astrocytes impacts upon their function and in particular the efficiency with which these cells metabolize nutrients and provide neurons with energy, but a systematic understanding is still elusive. Modelling and simulation represent an effective framework to address this challenge and to deepen our understanding of brain energy metabolism. This requires solving a set of metabolic partial differential equations on complex domains and remains a challenge. In this paper, we propose, test and verify a simple numerical method to solve a simplified model of metabolic pathways in astrocytes. The method can deal with arbitrarily complex cell morphologies and enables the rapid and simple modification of the model equations by users also without a deep knowledge in the numerical methods involved. The results obtained with the new method (CutFEM) are as accurate as the finite element method (FEM) whilst CutFEM disentangles the cell morphology from its discretisation, enabling us to deal with arbitrarily complex morphologies in two and three dimensions.
A survey of dimension reduction and classification methods for RNA-Seq data on malaria vector
Authors: Arowolo Micheal Olaolu , Adebiyi Marion Olubunmi , Aremu Charity , Adebiyi Ayodele A.
Published: March 2021

Recently unique spans of genetic data are produced by researchers, there is a trend in genetic exploration using machine learning integrated analysis and virtual combination of adaptive data into the solution of classification problems. Detection of ailments and infections at early stage is of key concern and a huge challenge for researchers in the field of machine learning classification and bioinformatics. Considerate genes contributing to diseases are of huge dispute to a lot of researchers. This study reviews various works on Dimensionality reduction techniques for reducing sets of features that groups data effectively with less computational processing time and classification methods that contributes to the advances of RNA-Sequencing approach.
Feasibility and acceptability of an online mindfulness-based group intervention for adults with tic disorders
Authors: Reese Hannah E. , Brown W. Alan , Summers Berta J. , Shin Jin , Wheeler Grace , Wilhelm Sabine
Published: March 2021

Background

Preliminary research suggests that a mindfulness-based treatment approach may be beneficial for adults with tic disorders. In the present study, we report on the feasibility, acceptability, safety, and symptomatic effect of a novel online mindfulness-based group intervention for adults with Tourette syndrome or persistent tic disorder. Data from this study will directly inform the conduct of a funded randomized controlled trial comparing the efficacy of this intervention to another active psychological intervention.

Methods

One cohort of adults with Tourette syndrome participated in an 8-week online mindfulness-based group intervention. Measures of feasibility, acceptability, and safety were administered throughout and at posttreatment. Self-reported measures of mindfulness and clinician-rated measures of tic severity and impairment were administered at baseline and posttreatment.

Results

Data on refusal, dropout rate, attendance, participant satisfaction, and safety suggest that this is a feasible and acceptable intervention. However, participant adherence to home practice was lower than anticipated. Mindfulness, tic severity, and tic-related impairment only modestly improved from baseline to posttreatment. Qualitative analysis of participant feedback revealed aspects of the intervention that were most helpful and also areas for improvement.

Conclusions

Data suggest that although this is a feasible and acceptable intervention, it should be modified to enhance participant adherence, more successfully engage the target mechanism, and optimize outcomes.

Trial registration

Clinicaltrials.gov registration #NCT03525626. Registered on 24 April 2018
Location probability learning in 3-dimensional virtual search environments
Authors: Sisk Caitlin A. , Interrante Victoria , Jiang Yuhong V.
Published: March 2021

When a visual search target frequently appears in one target-rich region of space, participants learn to search there first, resulting in faster reaction time when the target appears there than when it appears elsewhere. Most research on this location probability learning (LPL) effect uses 2-dimensional (2D) search environments that are distinct from real-world search contexts, and the few studies on LPL in 3-dimensional (3D) contexts include complex visual cues or foraging tasks and therefore may not tap into the same habit-like learning mechanism as 2D LPL. The present study aimed to establish a baseline evaluation of LPL in controlled 3D search environments using virtual reality. The use of a virtual 3D search environment allowed us to compare LPL for information within a participant’s initial field of view to LPL for information behind participants, outside of the initial field of view. Participants searched for a letter T on the ground among letter Ls in a large virtual space that was devoid of complex visual cues or landmarks. The T appeared in one target-rich quadrant of the floor space on half of the trials during the training phase. The target-rich quadrant appeared in front of half of the participants and behind the other half. LPL was considerably greater in the former condition than in the latter. This reveals an important constraint on LPL in real-world environments and indicates that consistent search patterns and consistent egocentric spatial coding are essential for this form of visual statistical learning in 3D environments.
The illusion of absence: how a common feature of magic shows can explain a class of road accidents
Authors: Ekroll Vebjørn , Svalebjørg Mats , Pirrone Angelo , Böhm Gisela , Jentschke Sebastian , van Lier Rob , Wagemans Johan , Høye Alena
Published: March 2021

The purpose of the present note is to draw attention to the potential role of a recently discovered visual illusion in creating traffic accidents. The illusion consists in a compelling and immediate experience that the space behind an occluding object in the foreground is empty. Although the illusion refers to a region of space, which is invisible due to occlusion (a blind spot), there is evidence to suggest that it is nevertheless driven by visual mechanisms and that it can be just as deceptive and powerful as ordinary visual illusions. We suggest that this novel illusion can make situations involving blind spots in a road user's field of view even more dangerous than one would expect based on the lack of visibility by itself. This could be because it erroneously makes the road user feel that (s)he has actually seen everything there is to see, and thus has verified that the blind spot is empty. This hypothesis requires further testing before definitive conclusions can be drawn, but we wish to make researchers and authorities involved in the analysis of traffic accidents and on-the-spot crash investigations aware of its potential role in order to encourage registration of relevant data and facilitate further research.
Nano-imprinted subwavelength gratings as polarizing beamsplitters
Authors: Wüster Julian , Bourgin Yannick , Feßer Patrick , Behrens Arne , Sinzinger Stefan
Published: March 2021

Polarizing beamsplitters have numerous applications in optical systems, such as systems for freeform surface metrology. They are classically manufactured from birefringent materials or with stacks of dielectric coatings. We present a binary subwavelength-structured form-birefringent diffraction grating, which acts as a polarizing beamsplitter for a wide range of incidence angles −30∘…+30∘. We refine the general design method for such hybrid gratings. We furthermore demonstrate the manufacturing steps with Soft-UV-Nanoimprint-Lithography, as well as the experimental verification, that the structure reliably acts as a polarizing beamsplitter. The experimental results show a contrast in efficiency for TE- and TM-polarization of up to 1:18 in the first order, and 34:1 in the zeroth order. The grating potentially enables us to realize integrated compact optical measurement systems, such as common-path interferometers.
Transarterial embolization with N-butyl 2-cyanoacrylate for the treatment of recurrent secondary post-tonsillectomy hemorrhage
Authors: Awad Ahmad Sayed , Nassef Amr A. , Mashhour Shady Nabil
Published: March 2021

Background

Postoperative hemorrhage is a potential complication of tonsillectomy, and early diagnosis and adequate management are mandatory to prevent hemorrhagic shock. The aim of this study was to assess the safety and efficacy of transcatheter embolization of recurrent post-tonsillectomy hemorrhage by using N-butyl 2-cyanoacrylate.

Results

We performed a retrospective analysis of the medical records, imaging findings, technical details, and clinical outcome of eight patients with delayed post-tonsillectomy hemorrhage who underwent endovascular embolization. All patients were followed up; technical and clinical successes of treatment were evaluated. All patients had arterial pseudoaneurysm as a source of bleeding. The injured artery was facial artery in four patients, lingual artery in three patients, and linguofacial trunk in one patient. All lesions were treated by endovascular embolization using NBCA glue. All patients were successfully embolized with no clinical complications. In one patient with pseudoaneurysm at the ostium of the facial artery, after filling the pseudoaneurysm with glue, inadvertently proximal reflux into the adjacent part of the external carotid artery (ECA) occurred leading to its occlusion with no related immediate or delayed complication.

Conclusion

Endovascular embolization is an effective and almost safe procedure in the management of recurrent post-tonsillectomy bleeding. In such cases, we can use NBCA glue with certain precautions as an effective appropriate embolizing agent.
Collaborative chronic care model implementation within outpatient behavioral health care teams: qualitative results from a multisite trial using implementation facilitation
Authors: Sullivan Jennifer L. , Kim Bo , Miller Christopher J. , Elwy A. Rani , Drummond Karen L. , Connolly Samantha L. , Riendeau Rachel P. , Bauer Mark S.
Published: March 2021

Background

This paper reports on a qualitative evaluation of a hybrid type II stepped-wedge, cluster randomized trial using implementation facilitation to implement team-based care in the form of the collaborative chronic care model (CCM) in interdisciplinary outpatient mental health teams. The objective of this analysis is to compare the alignment of sites’ clinical processes with the CCM elements at baseline (time 1) and after 12 months of implementation facilitation (time 2) from the perspective of providers.

Methods

We conducted semi-structured interviews to assess the extent to which six CCM elements were in place: work role redesign, patient self-management support, provider decision support, clinical information systems, linkages to community resources, and organizational/leadership support. Interviews were transcribed and a priori CCM elements were coded using a directed content analysis approach at times 1 and 2. We sought consensus on, and compared, the extent to which each CCM element was in place at times 1 and 2.

Results

We conducted 27 and 31 telephone interviews at times 1 and 2, respectively, with outpatient mental health providers at nine participating sites. At time 1 and time 2, three CCM elements were most frequently present across the sites: work role redesign, patient self-management support, and provider decision support. The CCM elements with increased implementation from time 1 to time 2 were work role redesign, patient self-management support, and clinical information systems. For two CCM elements, linkages to community resources and organizational/leadership support, some sites had increased implementation at time 2 compared to time 1, while others had reductions. For the provider decision support element, we saw little change in the extent of its implementation.

Conclusions

Sites increased the extent of implementation on several CCM elements. The most progress was made in the CCM elements where sites had CCM-aligned processes in place at time 1. Teams made progress on elements they could more easily control, such as work role redesign. Our results suggest that maximizing the benefits of CCM-based outpatient mental health care may require targeting resources and training toward specific CCM elements—especially in the use of clinical information systems and linking with community resources.

Trial registration

Clinical Trials NCT02543840.
Social Networks and Stratagems of Nineteenth-Century Coast Salish Leaders
Authors: Ritchie Morgan , Miller Bruce Granville
Published: March 2021

During the socially transformative mid-nineteenth century in the Salish Sea region of the Northwest Coast, a number of influential leaders emerged within Indigenous tribal groups. They played a significant role in reshaping the social geography of the region, blending emergent religious, commercial, and military bases for authority with more conventional Coast Salish strategies of patronage and generosity. The authors examine the lives and social connections of three Coast Salish leaders to illustrate how they were able to establish and maintain social networks across the region for their advantage and for the advantage of followers who had gravitated to them from surrounding shattered communities.
Khipu Transcription Typologies: A Corpus-Based Study of theTextos Andinos
Authors: Medrano Manuel
Published: March 2021

Despite ongoing efforts to compile both Andean khipus and their written colonial references, initiatives in this domain have emphasized the benefits of aggregation vis-à-vis preservation and diffusion, largely forgoing opportunities to analyze khipu data in aggregate. This article introduces multivariate statistical analysis to colonial khipu texts, enlisting the aid of a heretofore little-studied source: the Textos Andinos, a compilation of sixteenth-century Spanish transcriptions of Indigenous khipu “readings.” The largest syntactically annotated corpus of khipu transcriptions to date is compiled. Textual interpretation informs an exegetical typology of “paper khipus”—a division of the texts into distinguishable categories. The initial typology is expanded using the outcome of its statistical evaluation. Pre- versus postconquest content and the incorporation of currency emerge as the primary distinguishing attributes of khipu transcriptions. The expanded typology in turn enables the assessment of previous hypotheses in the study of paper khipus, responding to criticisms of their generalizability; suggestions of a diminishment in khipu complexity following the Spanish conquest are revisited and corroborated to this effect. A corpus-based study of khipu transcriptions offers a promising inroad to negotiating the highly mediated conditions of their original creation while expanding the study of khipus in the early colonial Andes. The aggregative methodology is proposed to ethnohistorians as an additional strategy for complementing and enriching historical interpretation.
The Impact of Grandparental Death on the Fertility of Adult Children
Authors: Okun Barbara S. , Stecklov Guy
Published: March 2021

The increasingly central role of vertical family kinship in Western societies underscores the potential value of intergenerational linkages that tie grandparents to the fertility of their adult children. Recent research has examined the changing demography of grandparenthood and the roles fulfilled by living grandparents, but the complex implications of grandparental death—a key feature of intergenerational linkages over the life course—have drawn less attention. In this article, we explore whether and how childbearing of adult women is affected by the death of grandparents—their own parent(s) or their spouse's parent(s). We develop a novel conceptual framework that presents the pathways of influence and considers the overall impact of grandparental death on childbearing of adult children. We then estimate fixed-effects models to identify causal relationships between grandparental death and childbearing, using linked micro-level census and population register data from Israel for the period 1986–2014. We find that grandparental death leads to a reduction of approximately 5 percentage points in the five-year probability of childbirth. The effects of grandparental death are negative across all parities examined and are broadly similar across grandparent's gender and kinship relation. Additional effects are identified, including how the impact of grandparental death varies with time since the previous birth as well as residential proximity prior to death. We explain how our findings regarding the effect of grandparental death offer insight into the role of living grandparents. Our results suggest that policy-makers concerned with low fertility should explore mechanisms that reinforce potential sources of support from grandparents.
A genomic exploration of the early evolution of extant cats and their sabre-toothed relatives
Authors: Westbury Michael V , Barnett Ross , Sandoval-Velasco Marcela , Gower Graham , Vieira Filipe Garrett , de Manuel Marc , Hansen Anders J , Yamaguchi Nobuyuki , Werdelin Lars , Marques-Bonet Tomas , Gilbert M Thomas P , Lorenzen Eline D
Published: March 2021

Background: The evolutionary relationships of Felidae during their Early–Middle Miocene radiation is contentious. Although the early common ancestors have been subsumed under the grade-group Pseudaelurus, this group is thought to be paraphyletic, including the early ancestors of both modern cats and extinct sabretooths.

Methods: Here, we sequenced a draft nuclear genome of Smilodon populator, dated to 13,182 ± 90 cal BP, making this the oldest palaeogenome from South America to date, a region known to be problematic for ancient DNA preservation. We analysed this genome, together with genomes from other extinct and extant cats to investigate their phylogenetic relationships.

Results: We confirm a deep divergence (~20.65 Ma) within sabre-toothed cats. Through the analysis of both simulated and empirical data, we show a lack of gene flow between Smilodon and contemporary Felidae.

Conclusions: Given that some species traditionally assigned to Pseudaelurus originated in the Early Miocene ~20 Ma, this indicates that some species of Pseudaelurus may be younger than the lineages they purportedly gave rise to, further supporting the hypothesis that Pseudaelurus was paraphyletic.
The future of public health policymaking after COVID-19: a qualitative systematic review of lessons from Health in All Policies
Authors: Cairney Paul , St Denny Emily , Mitchell Heather
Published: March 2021

Background: ‘Health in All Policies’ (HIAP) describes the pursuit of health equity. It has five main elements: treat health as a human right; identify evidence of the ‘social determinants’ of health inequalities, recognise that most powers to affect health are not held by health departments, promote intersectoral policymaking and collaboration inside and outside of government, and generate political will. Studies describe its potential but bemoan a major implementation gap. Some HIAP scholars learn from policymaking research how to understand this gap, but the use of policy theories is patchy. In that context, our guiding research question is:How does HIAP research use policy theory to understand policymaking?It allows us to zoom-out to survey the field and zoom-in to identify: the assumed and actual causes of policy change, and transferable lessons to HIAP scholars and advocates.

Methods: Our qualitative systematic review (two phases, 2018 and 2020) identified 4972 HIAP articles. Of these, 113 journal articles (research and commentary) provide a non-trivial reference to policymaking (at least one reference to a policymaking concept). We use the 113 articles to produce a general HIAP narrative and explore how the relatively theory-informed articles enhance it.

Results: Most articles focus on policy analysis (identifying policy problems and solutions) rather than policy theory (explaining policymaking dynamics). They report a disappointing gap between HIAP expectations and policy outcomes. Theory-informed articles contribute to a HIAP playbook to close that gap or a programme theory to design and evaluate HIAP in new ways.  

Conclusions: Few HIAP articles use policy theories for their intended purpose. Policy theories provide lessons to aid critical reflection on power, political dilemmas, and policymaking context. HIAP scholars seek more instrumental lessons, potentially at the cost of effective advocacy and research.
Naïve, unenculturated chimpanzees fail to make and use flaked stone tools
Authors: Bandini Elisa , Motes-Rodrigo Alba , Archer William , Minchin Tanya , Axelsen Helene , Hernandez-Aguilar Raquel Adriana , McPherron Shannon P. , Tennie Claudio
Published: March 2021

Background: Despite substantial research on early hominin lithic technologies, the learning mechanisms underlying flake manufacture and use are contested. To draw phylogenetic inferences on the potential cognitive processes underlying the acquisition of both of these abilities in early hominins, we investigated if and how one of our closest living relatives, chimpanzees (Pan troglodytes), could learn to make and use flakes.

Methods: Across several experimental conditions, we tested unenculturated, naïve chimpanzees from two independent populations (n=11) for their abilities to spontaneously make and use their own flakes as well as to use pre-made flakes made by a human experimenter.

Results: Despite the fact that the chimpanzees demonstrated an understanding of the requirements of the task and that subjects were sufficiently motivated and had ample opportunities to develop these behaviours, none of the chimpanzees tested, made or used flakes in any of the experimental conditions.

Conclusions: These results differ from all previous ape flaking experiments, which found flake manufacture and use in bonobos and one orangutan. However, these earlier studies tested human-enculturated apes and provided the test subjects with flake making and using demonstrations. The contrast between these earlier positive findings and our negative findings (despite using a much larger sample size) suggests that human enculturation and/or human demonstrations may be necessary for chimpanzees to acquire these abilities. The data obtained in this study are consistent with the hypothesis that flake manufacture and use might have evolved in the hominin lineage after the split betweenHomoandPan7 million years ago, a scenario further supported by the initial lack of flaked stone tools in the archaeological record after this split. We discuss possible evolutionary scenarios for flake manufacture and use in both non-hominin and hominin lineages.
Academic promotion and leadership: ‘moving the needle’ for the enhancement of gender equality in Tunisian higher education institutional members of the RMEI network following the TARGET framework
Authors: Chouari Monia , Ghiss Moncef , Zabaniotou Anastasia
Published: March 2021

Although job opportunities, recruitment criteria, health insurance and social welfare are equally available regardless of sex, academic promotion at higher education institutions has so far been a challenging issue for women more than men. Even though there are not legislative policies or political strategies proscribing gender discrimination, the under-representation of women in high profile positions is thought-provoking as it was found by this study on collecting segregating data at the Faculty of Arts and Human Sciences of Sousse (FAHSS) and to a lesser degree at the National Engineering School of Sousse (ENISO). Given insufficient research in the area under investigation, and despite the shortage of data needed for examination, this study makes use of and analyses the available data collected from Sousse University. Built upon the findings, this paper sets forth to examine impediments as challenges to progress which are encountered by women. Despite the belief that gender parity has been acquired, it is still a challenge to progress to endorse the culture of gender equality at higher education institutions. The study entails the activities of the gender equality committee created at Sousse University in 2018 with the support of the Mediterranean Network of Engineering Schools (RMEI) and under the framework of the EU TARGET project entitled ‘Taking a reflexive approach to gender equality at Institutional transformation’.