bluuebunny/crossref_metadata_2025 huggingface dataset:
Bayesian Statistical Methods in Psychology
Authors: Depaoli Sarah
Published: February 2021

The use of Bayesian statistics within psychology is on the rise, and this trajectory will likely continue to accelerate in the coming years. There are many different reasons why a researcher may want to implement Bayesian methodology. First, there are cases where models are too “complex” for traditional (frequentist) methods to handle. Second, Bayesian methods are sometimes preferred if only small samples are available, since the use of priors can improve estimation accuracy with minimal data. Third, the researcher may prefer to include background information in the estimation process, and this can be done via the priors. Finally, Bayesian methods produce results that are rich with detail and can be more informative about the population parameters. Specifically, information surrounding the entire posterior distribution is provided through Bayesian estimation, as opposed to a point estimate obtained through traditional (frequentist) methods. All of these reasons make Bayesian methods attractive to the psychological sciences. This bibliography begins with a section on General Overviews, which presents works that provide general introductions to Bayesian methods. A subsection within this overview section covers Papers Introducing Bayesian Methods to Subfields in Psychology, and a second subsection includes Resources for Particular Model Types Popular in Psychological Research. Next, some of the more comprehensive Bayesian Textbooks are presented, and this is followed by a treatment of the Philosophy that underlies Bayesian statistics. The next section is Markov Chain Monte Carlo and Samplers. One of the most common tools for Bayesian estimation is the Markov chain Monte Carlo (MCMC) algorithm. MCMC is used to construct chains through samplers, and these chains represent draws from the posterior. A subsection on Convergence is included here to highlight the importance of assessing Markov chain convergence. This is followed by a section on Prior Distributions, which includes subsections on Expert Elicitation of Priors and the Data-Prior Conflict. A section on Software Resources is presented, which covers some of the main software programs implementing Bayesian statistical modeling. Finally, a section on Model Assessment and Fit is presented. Each of these sections and subsections were selected to highlight an understanding of Bayesian statistics, the role it plays in psychology, and proper implementation.
Visualizations
Authors: Çöltekin Arzu , Griffin Amy , Robinson Anthony
Published: February 2021

Visualizations (i.e., thinking in images internally in the human mind) or externally expressing a concept via graphical means—such as documenting an observation in a hand-drawn or digital visuospatial sketch, or creating a visual output from data—have always been an integral part of scientific inquiry and communication. One might argue that the ‘graphy’ part of ‘geography’ refers to visually and spatially (i.e., visuospatially) documenting the world. For the vast majority of people, a significant part of human experience is shaped by sight, and the human visual system occupies a large chunk of human cognitive processing capacity. Given that, one can speculate that comprehension and communication through visuospatial means could be ‘second nature’ to people. There is ample evidence to support this line of thinking: As opposed to written words or a large list of numbers, visualizations allow us to see patterns and anomalies quickly, sometimes even at a glance. However, the power of visualizations depends on a number of factors including the details of their design, the abilities and background of the human viewing them, and the context in which a visualization is used. This power must also be critically viewed from an ethics perspective. These three factors are elaborated under various subsections. However, first, a fundamental question needs to be asked: Is visualization a product or a process? The word visualization is commonly used as a noun for a visual product (e.g., a map or a plot is a visualization). However, both mental and external visualizations are processes, and the term ‘visualization’ as it was introduced into scientific discourse refers to a process. The process aspect is important to remember, because this is viewed as a key factor that distinguishes using visualizations to explain what is already known versus exploring the unknown. With the latter activity, visualizing things becomes a part of the scientific inquiry as an active tool that helps build hypotheses and thus facilitate thinking and reasoning, in addition to explaining what is already known. Whether the goal is to explain or to explore, the design and use of visualizations needs to be intentional and not arbitrary. To create and read visualizations intentionally, a certain level of visual literacy built on design, technology, and knowledge of human visuospatial cognition is necessary. This manuscript identifies scholarly resources to help all scientists and aspiring scientists, especially those in spatial sciences, to build, refresh their knowledge of, and learn or teach about visualizations.
Measurement of Terrestrial Snow
Authors: Kinar Nicholas J. , Pomeroy John W.
Published: February 2021

Snow on the land surface is an important component of the hydrological cycle in cold regions and acts as a hydrologic reservoir with a residence time that introduces a delay before ablation when runoff from snowmelt enters rivers, streams, and aquifers. Mass and energy fluxes between the snowpack and the atmosphere affect climate, temperature, and biogeochemical cycles in cold regions. Snow is a thermal insulator and the presence or absence of snow influences soil temperatures and soil water content that affect the growth of plants and agricultural crops. Snowpack chemistry is indicative of atmospheric pollutants and ions present in snowmelt runoff affect water quality and biological processes. Changes in the snowpack due to mass and energy fluxes associated with heat transport modify snow particle size, snow structure, and density, influencing albedo, permeability, air and water transport through snow, the rate of snowmelt, and mechanical properties. In some regions, snowmelt is a source of water for hydroelectric power generation, agricultural production, and human consumption. Accumulation of snow in complex terrain and snowpack metamorphic processes contribute to avalanche activity that redistributes snow between different areas but also influences biogeography and creates human hazards in regions where the spatial distribution of snow is important for winter recreation and skiing activities. Wind is also responsible for redistribution of snow and affects the spatial distribution of snowcover. Measurement of snow quantifies the spatial distribution of snowpack properties and provides inputs for mathematical models used for prediction and forecasting of flooding, drought, runoff, climate change, and avalanche activity for assessment of water resources and regional hazards. Snowpack measurements also provide insight into hydrological processes related to snow in a temporal and geographic context, allowing for a better scientific understanding of these processes and providing a means for the development of more accurate mathematical models. This bibliography provides an overview of how terrestrial snow properties and processes are measured. Papers were selected for this bibliography based on pedagogical value and an emphasis on important research conducted during the last thirty years for an up-to-date overview, although earlier papers and monographs are also included that had an influence on snow hydrology in a historical context.
Geography and Empire
Authors: Sarmento João
Published: February 2021

Geography has engaged in the study of empire since its early days as an academic discipline. Few disciplines have such a clear complicity with this political formation, that feeds on territorial growth through military power, and that limits political sovereignty in the peripheries. In fact, a temporal correspondence exists between the birth of modern geography and the emergence of a new phase of capitalist imperialism during the 1870s. Viewed as the queen of the imperial sciences over a century ago, geographies of empire have changed throughout time, reflecting the modifications in the discipline and the transformation in the nature of empires. During the late 19th and early 20th centuries, and under environmental determinism, geographical knowledge produced by the likes of Frederich Ratzel or Alfred Mackinder lent scientific credibility to ideologies of imperialism while, at the same time, they legitimized the scientific claims of geography as an academic discipline. Climatic and acclimatization studies and prerogatives were pivotal to construct moralistic considerations of both people and places. During the first half of the 20th century, geographies of empire were dominated, in part, by the regional tradition of French geographic inquiry, which cultivated a regional, zonal approach, while work with a focus on empire had a global and zonal tropicality architecture. Quantitative and neopositivist geography approaches in the second half of the 20th century had a less marked influence. Since the late 1980s, a concern for “empire” has returned to geography, and various subdisciplines have focused on the imperial genealogy of the discipline, the links between geography and empire, and the consequences of those links. A more critical engagement with the history of geography has provided contextual histories of global spatial practice and discourse over the past two centuries. The reconsideration of imperialism in view of postcolonial theory, tackling “historical amnesia,” has also promoted a new wave of studies. In a broad way we can be tempted today to make a division between geographical research, which participated in imperial development and maintenance, and geographical research “after Empire,” which aims to study and understand the past and present spatialities of empire.
Food Industry
Authors: Abarca Meredith , Lopez Joshua
Published: February 2021

Food’s complex roles in Latinas/os’ lives are such that we simultaneously need to explore the dynamics caused by the food industry as well as those created by people’s foodscapes. The social and health sciences have for a long time researched how the three pillars of the food industry, production, distribution, and consumption, impact the Latina/o “body.” What these studies often show is how the economics and politics governing the mechanism of the food industry negatively affects Latinas/os’ lives in terms of labor conditions and consumer habits. More recently, the humanities—particularly history, literary studies, philosophy—have placed the focus on people’s foodscapes. This refers to the places and spaces where people gather, prepare, share, speak about, and eat food. It includes stories of food’s significance at the personal, familial, cultural, and historical level. Foodscapes encapsulate how and why people create and perform food narratives that define and redefine their sense of identity. Studying food narratives of how Latinas/os gather and share information meaningful to them, shifts the focus from “bodies” that keep the food industry in operation to people who embody food’s material and symbolic realities.
Artemisia Gentileschi
Authors: ffolliott Sheila
Published: February 2021

In the expanding scholarship on Artemisia Gentileschi (b. 1593–d. c. 1654), accounts of her accomplishments and success have long tangled with considerations of her gender and biography. Most early modern women artists had artist fathers and acquired the requisite skills at home. In a Roman art world permeated with Caravaggism, Orazio Gentileschi, widowed when Artemisia was twelve, taught his daughter. In 1610, aged seventeen, she signed and dated a poignant narrative featuring a prominent female nude, Susanna and the Elders (Pommersfelden, Schloss Weissenstein). This accomplished work, to which Orazio may have contributed, presaged what would become her trademark: dramatic narratives featuring female protagonists, some nude. The next year her father’s associate, Agostino Tassi—who claimed that Orazio had him teach Artemisia perspective—deflowered her and, with expectations of marriage, their intimacy continued. In 17th-century Roman law, rape of a virgin was not a crime of violence, but an offense against family honor. Tassi was already married so Orazio initiated prosecution. After a trial in 1612, he was sentenced and Artemisia married Pierantonio Stiattesi. As Sofonisba Anguissola’s father had praised her to potential patrons, so Orazio promoted his daughter’s talent, writing Christine of Lorraine, dowager Grand Duchess of Tuscany that nineteen-year-old Artemisia “had no peer.” Her honor recovered—essential to any future career—Artemisia and her husband moved to Florence, where she developed into an independent painter. She created her best-known work, the startlingly graphic Judith Decapitating Holofernes (Florence: Uffizi); forged patronage connections; and gained membership in the Florentine Academy. She bore five children, only one of whom survived childhood, and maintained a workshop, even while a single mother, using credit to purchase supplies and hire helpers. New evidence, including personal letters revealing her powers of verbal expression, has further illuminated her Roman and Florentine periods, and greatly expanded our knowledge of her professional maturation in Venice, London, and especially Naples, where she spent twenty years. She offered paintings and wrote letters to potential clients, sometimes asserting her artistic authority. Spanish, Italian, and English royalty; nobility; and connoisseurs commissioned and collected her work. Artemisia cleared a series of gender-based hurdles. Although women’s artistic ability was thought to suit them for less mentally taxing genres like still life or portraiture, Artemisia achieved professional success in narrative painting. She was the first woman to achieve a stature fully commensurate with her male counterparts. Her story of surviving rape and the public exposure of the trial, alongside scholars’ assertions that her paintings articulate a protofeminist viewpoint, have made her a modern feminist icon.
Precedent and the Rule of Law
Authors: Lewis Sebastian
Published: February 2021

Courts may reason using precedents in various ways, but not all of them satisfy the rule of law. This article provides two ways that are compatible with this ideal and one which is not. In doing so, the article aims to explain the practice of following precedent in law and to offer criteria for evaluating its value. Two claims are defended. First, courts always have a reason to decide precedent-governed disputes by following precedent. This reason is a minimum requirement of the rule of law, and in some cases this reason may be reinforced in the form of an obligation. Secondly, depending on whether courts have a reason or an obligation to follow precedent, two modes of precedential reasoning may be identified. The article explains them in detail. The modes, together with the considerations that are reasons in favour of them or against them, provide a valuable philosophical foundation of precedent-following in law.
Suzaku detection of solar wind charge exchange emission from a variety of highly ionized ions in an interplanetary coronal mass ejection
Authors: Asakura Kazunori , Matsumoto Hironori , Okazaki Koki , Yoneyama Tomokage , Noda Hirofumi , Hayashida Kiyoshi , Tsunemi Hiroshi , Nakajima Hiroshi , Katsuda Satoru , Ishi Daiki , Ezoe Yuichiro
Published: February 2021

X-ray emission generated through solar-wind charge exchange (SWCX) is known to contaminate X-ray observation data, the amount of which is often significant or even dominant, particularly in the soft X-ray band, when the main target consists of comparatively weak diffuse sources, depending on the space weather during the observation. In particular, SWCX events caused by interplanetary coronal mass ejections (ICMEs) tend to be spectrally rich and to provide critical information about the metal abundance in the ICME plasma. We analyzed the SN1006 background data observed with Suzaku on 2005 September 11 shortly after an X6-class solar flare, signatures of which were separately detected together with an associated ICME. We found that the data include emission lines from a variety of highly ionized ions generated through SWCX. The relative abundances of the detected ions were found to be consistent with those in past ICME-driven SWCX events. Thus, we conclude that this event was ICME driven. In addition, we detected a sulfur xvi line for the first time as one from an SWCX emission, which suggests that it is the most spectrally rich SWCX event ever observed. We suggest that observations of ICME-driven SWCX events can provide a unique probe to study the population of highly ionized ions in the plasma, which is difficult to measure in currently available in situ observations.
Association between intake of sweetened beverages with all-cause and cause-specific mortality: a systematic review and meta-analysis
Authors: Li Hongyi , Liang Huoyan , Yang Han , Zhang Xiaojuan , Ding Xianfei , Zhang Ruifang , Mao Yimin , Liu Zhangsuo , Kan Quancheng , Sun Tongwen
Published: February 2021

Background

Conclusions remain controversial between the consumption of sugar and artificially sweetened beverages (SSBs and ASBs) and mortality.

Methods

We systematically searched the PubMed, Embase, Cochrane Library and Web of Science databases from their inception date to 1st January 2020, prospective cohort studies researching the mortality risk and SSBs or ASBs consumption were included. Random effects meta-analyses and dose–response analyses were performed to measure the association. Subgroup analyses and sensitivity analyses were further performed to explore the source of heterogeneity. Publication bias was assessed by Funnel plots and Egger’s regression test.

Results

Across all 15 cohorts, 1211 470 participants were included. High SSB consumption was associated with a higher risk of all-cause mortality (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.06–1.19, P < 0.001; and cardiovascular disease [CVD] mortality [HR 1.20, 95% CI, 1.05–1.38, P < 0.001]), and high ASBs consumption showed similar result (HR 1.12, 95% CI, 1.04–1.21, P = 0.001 for all-cause mortality and HR 1.23, 95% CI, 1.00–1.50, P = 0.049 for CVD mortality), both showed a linear dose–response relationship.

Conclusions

High consumption of both ASBs and SSBs showed significant associations with a higher risk of CVD mortality and all-cause mortality. This information may provide ideas for decreasing the global burden of diseases by reducing sweetened beverage intake.
Distributing Points On The Torus Via Modular Inverses
Authors: Humphries Peter
Published: February 2021

We study various statistics regarding the distribution of the points $$ \left\{\left(\frac{d}{q},\frac{\overline{d}}{q}\right) \in \mathbb{T}^2 : d \in (\mathbb{Z}/q\mathbb{Z})^{\times}\right\} $$ as q tends to infinity. Due to non-trivial bounds for Kloosterman sums, it is known that these points equidistribute on the torus. We prove refinements of this result, including bounds for the discrepancy, small-scale equidistribution, bounds for the covering exponent associated with these points, sparse equidistribution, and mixing.
Prenatal Kynurenine Elevation Elicits Sex-Dependent Changes in Sleep and Arousal During Adulthood: Implications for Psychotic Disorders
Authors: Rentschler Katherine M , Baratta Annalisa M , Ditty Audrey L , Wagner Nathan T J , Wright Courtney J , Milosavljevic Snezana , Mong Jessica A , Pocivavsek Ana
Published: February 2021

Dysregulation of the kynurenine pathway (KP) of tryptophan catabolism has been implicated in psychotic disorders, including schizophrenia and bipolar disorder. Kynurenic acid (KYNA) is a KP metabolite synthesized by kynurenine aminotransferases (KATs) from its biological precursor kynurenine and acts as an endogenous antagonist of N-methyl-D-aspartate and α7-nicotinic acetylcholine receptors. Elevated KYNA levels found in postmortem brain tissue and cerebrospinal fluid of patients are hypothesized to play a key role in the etiology of cognitive symptoms observed in psychotic disorders. Sleep plays an important role in memory consolidation, and sleep disturbances are common among patients. Yet, little is known about the effect of altered KP metabolism on sleep–wake behavior. We presently utilized a well-established experimental paradigm of embryonic kynurenine (EKyn) exposure wherein pregnant dams are fed a diet laced with kynurenine the last week of gestation and hypothesized disrupted sleep–wake behavior in adult offspring. We examined sleep behavior in adult male and female offspring using electroencephalogram and electromyogram telemetry and determined sex differences in sleep and arousal in EKyn offspring. EKyn males displayed reduced rapid eye movement sleep, while female EKyn offspring were hyperaroused compared to controls. We determined that EKyn males maintain elevated brain KYNA levels, while KYNA levels were unchanged in EKyn females, yet the activity levels of KAT I and KAT II were reduced. Our findings indicate that elevated prenatal kynurenine exposure elicits sex-specific changes in sleep–wake behavior, arousal, and KP metabolism.
Ursolic acid disturbs ROS homeostasis and regulates survival-associated gene expression to induce apoptosis in intestinal cancer cells
Authors: Rawat Laxminarayan , Nayak Vijayashree
Published: February 2021

Ursolic acid is a natural compound possessing several therapeutic properties including anticancer potential. In present study, cytotoxic and antimetastatic properties of ursolic acid were investigated in intestinal cancer cell lines INT-407 and HCT-116. The cells growth and number were decreased in a dose- and time-dependent manner in both the cell lines. It also increases reactive oxygen species levels in the cells in order to induce apoptosis. Ursolic acid was found to be a significant inhibitor of cancer cells migration and gene expression of migration markers FN1, CDH2, CTNNB1 and TWIST was also downregulated. Ursolic acid treatment downregulated the gene expression of survival factors BCL-2, SURVIVIN, NFKB and SP1, while upregulated the growth-restricting genes BAX, P21 and P53. These results indicate that ursolic acid has anticancer and antimetastatic properties against intestinal cancer. These properties could be beneficial in cancer treatment and could be used as complementary medicine.
Low-cost chamber design for simultaneous CO2 and O2 flux measurements between tree stems and the atmosphere
Authors: Helm Juliane , Hartmann Henrik , Göbel Martin , Hilman Boaz , Herrera Ramírez David , Muhr Jan
Published: February 2021

Tree stem CO2 efflux is an important component of ecosystem carbon fluxes and has been the focus of many studies. While CO2 efflux can easily be measured, a growing number of studies have shown that it is not identical with actual in situ respiration. Complementing measurements of CO2 flux with simultaneous measurements of O2 flux provides an additional proxy for respiration, and the combination of both fluxes can potentially help getting closer to actual measures of respiratory fluxes. To date, however, the technical challenge to measure relatively small changes in O2 concentration against its high atmospheric background has prevented routine O2 measurements in field applications. Here, we present a new and low-cost field-tested device for autonomous real-time and quasi-continuous long-term measurements of stem respiration by combining CO2 (NDIR-based) and O2 (quenching-based) sensors in a tree stem chamber. Our device operates as a cyclic-closed system and measures changes in both CO2 and O2 concentration within the chamber over time. The device is battery powered with a >1-week power independence, and data acquisition is conveniently achieved by an internal logger. Results from both field and laboratory tests document that our sensors provide reproducible measurements of CO2 and O2 exchange fluxes under varying environmental conditions.
Pelecanimimus(Theropoda: Ornithomimosauria) postcranial anatomy and the evolution of the specialized manus in Ornithomimosaurs and sternum in maniraptoriforms
Authors: Cuesta Elena , Vidal Daniel , Ortega Francisco , Shibata Masateru , Sanz José L
Published: February 2021

Pelecanimimus polyodon was discovered in 1993 in the Spanish Barremian fossil site of Las Hoyas, being the first ornithomimosaur described from Europe. So far, there has been no detailed description of the holotype of Pelecanimimus, which is composed of the anterior-half of an articulated skeleton. Here we report a new, detailed, revised and more accurate osteological description of its postcranial skeleton, comparing this new data to information about Ornithomimosauria from the last three decades. This osteological and phylogenetic analysis of Pelecanimimus shows several ornithomimosaur synapomorphies and a unique combination of characters that emend its original diagnosis. Pelecanimimus diverged early in Ornithomimosauria and reveals an enlargement trend of the manus, shared with derived ornithomimosaurians, due to a long metacarpal I and elongated distal phalanges. This evolutionary novelty, and other synapomorphies, has led to the definition of a new clade, Macrocheiriformes, including Pelecanimimus and more derived ornithomimosaurs. Pelecanimimus has the only ossified sternal plates among ornithomimosaurs and the first evidence of uncinate processes in a non-maniraptoran theropod, indicating a convergent appearance of these structures in Coelurosauria. The character combination in an early-diverging ornithomimosaur like Pelecanimimus found in this analysis provides a key step in the evolution of the manus and pectoral girdle in Ornithomimosauria.
Effects of clinicopathological factors on prognosis of young patients with resected breast cancer
Authors: Li Wen , Deng Yunfu , Wu Qiang , Chen Wenjie , Liu Zhengkun , Wang Ting , Ai Cheng , Chen Fang , Wang Zhu , Ma Guangzhi , Zhou Qinghua
Published: February 2021

This study aims to analyze the relationship between clinicopathological characteristics and survival in young patients (≤35 years old) with resected breast cancer.

A total of 173 cases were included in this study. The clinicopathological factors potentially associated with prognosis were evaluated. Furthermore, we categorized patients into different groups to evaluate the prognosis according to hormone receptor status or important risk factors.

Younger age (≤30 years) was an independent predictor for poor disease-free survival (DFS) and overall survival (OS). Besides, PR negative status, tumor grade, and advanced lymph nodes postsurgery were independent prognostic factors of DFS, while PR negative status and advanced lymph nodes postsurgery were independent prognostic factors of OS. For hormone receptor-positive patients, people with ER+ or PR+ and HER2−/+ showed poorer prognosis than the other 2 levels. Risk factor grouping based on the ER, PR, HER2, Ki-67 status, tumor grade, and lymph nodes postsurgery showed that patients in highest score group received the poorest prognosis. Grading system based on the hormone status or the risk factor grouping may offer a useful approach to assess which subgroups of young breast cancer present poorer prognosis.
Multicenter, randomized, double-blind, controlled trial of transcutaneous electrical nerve stimulation for pancreatic cancer related pain
Authors: He Lihua , Tan Keping , Lin Xianming , Yi Hui , Wang Xueliang , Zhang Jiangsong , Lin Jietao , Lin Lizhu
Published: February 2021

Background:

Up to 80% of patients with pancreatic cancer experience abdominal and back pain. Although pharmacologic medications provide some relief, many report inadequate analgesia and adverse effects. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive physical modality and had been widely applied for pain relieving, yet no study has investigated the effectiveness of TENS for pain in pancreatic cancer.

Methods:

Eligible patients were randomly assigned in a 1:1 ratio to TENS group or control group. The primary outcome was percentage change of numerous rating scale (NRS) after treatment. Secondary outcomes included percentage change of analgesic medication consumption and effect on constipation and poor appetite.

Results:

One hundred seventy-one patients were recruited (84 to control group and 87 to TENS group). NRS in TENS group has been largely decreased 77.9% right after treatment and 27.1% in 2 hours, before applying any analgesic medication, while that in control group was slightly downregulated right after treatment but gave a trend to increase at 1, 2, and 3 hours. When comparing both groups, pain was significantly well controlled without analgesic medication supplement in TENS group at 0 hour (difference in mean percent change in NRS = 50.0 [95% CI, 50–51.4], P < .01) and 3 hours (difference in mean percent change in NRS = 134.0 [95% CI, 130.0–142.7], P < .01) after treatment, and this analgesic effect last to 3 weeks after treatment cycle (difference in mean percent change in NRS = 22.5 [95% CI, 17.6–27.3], P < .01) without increase of analgesic medication consumption.

Conclusions:

TENS reduces pain without increase analgesic medication consumption in patients with pancreatic cancer pain. It provides an alternative therapy for pain in pancreatic cancer.

Clinical Trial Registration:

This study was registered at ClinicalTrials.gov, identifier NCT03331055.
Clinical characteristics of 2,459 severe or critically ill COVID-19 patients
Authors: Zhong Zhimei , Li Hongyuan , Zhu Jieyun , Ji Pan , Li Bocheng , Pang Jielong , Zhang Jianfeng , Liang Xiangdong
Published: February 2021

Our study aims to summarize the clinical characteristics of patients with severe or critically ill coronavirus disease 2019 (COVID-19).

Five databases were electronically searched to collect studies describing clinical characteristics of severe or critically ill COVID-19 patients and published between January 1, 2020 and April 12, 2020. Three reviewers independently collected the literature, extracted the required data, and assessed the risk of publication bias of the included studies before including the studies in the meta-analysis.

A total of 40 studies involving 2459 patients with severe or critically ill COVID-19 patients were included. Meta-analysis showed that a greater proportion of severe or critically COVID-19 patients were male (62.3%), and the 2 main clinical symptoms were fever (87.4%) and cough (66.3%). Other common clinical symptoms included dyspnea (45.3%), chest tightness (37.4%), fatigue (36.6%), and expectoration (31.9%). Minor symptoms included myalgia (19.5%), dizziness (11.5%), headache (11.4%), diarrhea (11.2%), pharyngalgia (11.0%), nausea, and vomiting (5.9%). Most patients showed elevated levels of C-reactive protein (83.5%) and D-dimer (73.3%), lymphopenia (70.3%), and normal leukocyte counts (56.9%). Other findings included abnormal levels of liver function (39.8%), elevated procalcitonin (36.6%), leukocytosis (21.7%), thrombocytopenia (19.0%), and leucopenia (18.2%). Most patients showed acute respiratory distress syndrome (60.8%). Other complications included acute cardiac injury (37.1%), shock (32.0%), and acute kidney injury (22.0%).

The most common symptoms of severe or critically ill COVID-19 patients were fever and cough. Most patients showed lymphopenia, elevated levels of C-reactive protein and D-dimer. A large percentage of patients progress to ARDS, acute cardiac injury, acute kidney injury and shock were also common.
Prevalence and clinical characteristics of hospitalized children with community-acquired Mycoplasma pneumoniae pneumonia during 2017/2018, Chengde, China
Authors: Su Meng , Wang Qian , Li Dan , Wang Ling-Ling , Wang Chun-Yang , Wang Jiang-Li , Zhang Qing , Du Luan-Ying , Liu Jian-Ying , Xie Guang-Cheng
Published: February 2021

Community acquired-pneumonia (CAP) has varying causative pathogens and clinical characteristics. This study investigated the prevalence of Mycoplasma pneumoniae (M pneumoniae) and evaluated the clinical characteristics in infected hospitalized children by disease severity.

From throat swabs of hospitalized children (5 months to 14 years) with CAP collected between November 2017 and May 2018, M pneumoniae and other CAP pathogens were identified using polymerase chain reaction (PCR). Differences in clinical and laboratory test data were compared between severe and mild case groups.

Of 333 hospitalized children enrolled, 221/333 (66.4%) tested positive for M pneumoniae and 24/221 (10.9%) patients were (n = 9, aged <5 years vs n = 15, ≥5 years) single infection by PCR, however, only 170/333 (51.1%) patients were presented with M pneumoniae IgM-positive. M pneumoniae detection rate by PCR was higher than by immunoglobulin (IgM) serology. In 123/221 (55.7%) M pneumoniae infected patients, coinfection with bacterial pathogens (n = 61, <5 years vs n = 62, ≥5 years) occurred. Children (aged 3–8 years) had most M pneumoniae infection. Severe M pneumoniae pneumonia (MPP) in children occurred mostly in older age (7 [interquartile ranges {IQR}, 6–8] years; P < .0001), with longer cough days (14 [IQR, 10–19.5] days; P = .002) and hospitalization duration (9.5 [IQR, 7–12.3] days; P < .0001), lower lymphocyte ratio (24.1, [IQR, 20.0–31.1] %; P = .001), higher neutrophils ratio (66.0, [IQR, 60.2–70.3]%; P < .0001), and serum C-reactive protein (CRP) level (3.8, [IQR, 1.3–10.9] mg/L; P = .027).

M pneumoniae is the most commonly detected pathogen in CAP. High coinfection prevalence increases diagnosis difficulty by clinically nonspecific characteristics. M pneumoniae detection by PCR with IgM may improve precise and reliable diagnosis of community-acquired MPP.
Care maps are an effective tool for optimizing quality of care of infectious diseases in a resource-constrained short-stay ambulatory care setting
Authors: Washirasaksiri Chaiwat , Phisalprapa Pochamana , Chaisathaphol Thanet , Auesomwang Chonticha , Sitasuwan Tullaya , Tinmanee Rungsima , Kositamongkol Chayanis , Sutee Rungsinee , Chouriyagune Charoen , Srivanichakorn Weerachai
Published: February 2021

Care maps (CMs), which are innovative, comprehensive, educational, and simple medical tools, were developed for 6 common diseases, including heart failure, stroke, hyperglycemia, urinary tract infection, dengue infection, and upper gastrointestinal bleeding, were implemented in a short-stay ambulatory ward. This study aimed to investigate the effectiveness of and level of clinician satisfaction with CMs in an ambulatory care setting.

A retrospective chart review study comparing the quality of care between before and after CM implementation was conducted. The medical records of patients who were admitted to a short-stay ambulatory ward in a tertiary referral center were reviewed. Demographic data, severity of disease, quality of care, length of stay (LOS), admission cost, and CM user satisfaction were collected and recorded.

The medical records of 1116 patients were evaluated. Of those, 589 and 527 patients were from before (non-CM group) and after CM (CM group) implementation, respectively. There were no significant differences between groups for age, gender, or disease-specific severity the median (interquartile range) total and essential quality scores were significantly higher in the CM group than in the non-CM group [total quality score 85.3 (75.0–92.9) vs 61.1 (50.0–75.0); P < .001, and essential quality scores 90.0 (75.0–100.0) vs 60.0 (40.6–80.0); P < .0001, respectively]. All aspects of quality of care were significantly improved between before and after CM implementation. Overall median LOS was significantly decreased from 3.8 (2.5–5.7) to 3.0 (2.0–4.9) days, but there was no significant decrease for admission cost. However, CMs were able to significantly reduce both LOS and admission cost in the infectious disease-related subgroup. Most CM users reported satisfaction with CMs.

CMs were shown to be an effective tool for improving the quality of care in patients with ambulatory infectious diseases. In that patient subgroup, LOS and admission cost were both significantly reduced compared to pre-CM implementation.
TurboHawk plaque rotation system for treatment of arteriosclerosis occlusion in lower extremities
Authors: Yuan Zhao , Yang Bo , Wang Jian , An Huan-song , Xu Hai
Published: February 2021

This pilot study retrospectively assessed the feasible efficacy of TurboHawk plaque rotation system (THPRS) for treatment of arteriosclerosis occlusion in lower extremities (AOLE).

A total of 36 eligible patients with AOLE were included in this pilot retrospective study. We divided all those patients into a treatment group and a control group, each group 18 patients. All patients in both groups administered conventional therapy. Additionally, all patients in the treatment group received THPRS, while all patients in the control group received percutaneous transluminal angioplasty (PTA) and percutaneous transluminal stenting (PTS). All outcomes were evaluated and analyzed at 3-month after surgery.

At 3-month postsurgery, there were not significant statistical differences in clinical manifestations (intermittent claudication, P = .49; resting pain, P = .28), ankle brachial index change (P = .07), 6-minute walk distance (P = .43), and complications between 2 groups.

This pilot study did not show better outcome improvement of THPRS for patients with AOLE. We cautiously draw the present conclusion, because it suffers from several major restrictions. Thus, further studies with larger sample size and longer term follow-up are still needed to warrant the current conclusion.
Endplate injury as a risk factor for cage retropulsion following transforaminal lumbar interbody fusion
Authors: Zhou Zhi-Jie , Xia Ping , Zhao Feng-Dong , Fang Xiang-Qian , Fan Shun-Wu , Zhang Jian-Feng
Published: February 2021

Although transforaminal lumbar interbody fusion (TLIF) is a widely accepted procedure, major complications such as cage retropulsion (CR) can cause poor clinical outcomes. Endplate injury (EI) was recently identified as a risk factor for CR, present in most levels developing CR. However, most EIs occurred in non-CR levels, and the features of EIs in CR levels remain unknown.

The aim of this study was to identify risk factors for CR following TLIF; in particular, to investigate the relationship between EIs and CR, and to explore the features of EIs in CR.

Between October 2010 and December 2016, 1052 patients with various degenerative lumbar spinal diseases underwent bilateral instrumented TLIF. Their medical records, radiological factors, and surgical factors were reviewed and factors affecting the incidence of CR were analyzed.

Twenty-one patients developed CR. Nine had back pain or leg pain, of which six required revision surgery. A pear-shaped disc, posterior cage positioning and EI were significantly correlated with CR (P < .001, P = .001, and P < .001, respectively). Computed tomography (CT) scans revealed the characteristics of EIs in levels with and without CR. The majority of CR levels with EIs exhibited apparent compression damage in the posterior part of cranial endplate on the decompressed side (17/18), accompanied by caudal EIs isolated in the central portion. However, in the control group, the cranial EIs involving the posterior part was only found in four of the total 148 levels (P < .001). Most of the injuries were confined to the central portion of the cranial or caudal endplate or both endplates (35 in 148 levels, 23.6%). Additionally, beyond cage breaching into the cortical endplate on lateral radiographs, a characteristic appearance of coronal cage misalignment was found on AP radiographs in CR levels with EIs.

A pear-shaped disc, posterior cage positioning and EI were identified as risk factors for CR. EI involving the posterior epiphyseal rim had influence on the development of CR. Targeted protection of the posterior margin of adjacent endplates, careful evaluation of intraoperative radiographs, and timely remedial measures may help to reduce the risks of CR.
A case report of congenital idiopathic hypogonadotropic hypogonadism caused by novel mutation of GNRHR gene
Authors: Wang Liping , Lin Weisheng , Li Xiaohong , Zhang Lijuan , Wang Kai , Cui Xiaoli , Tang Shanmei , Fang Guangguang , Tan Yan , Wang Xuelai , Chen Chuan , Yang Chuanchun , Tang Huiru
Published: February 2021

Rationale:

This study aimed to investigate the genetic mutation characteristics of congenital idiopathic hypogonadotropic hypogonadism (IHH) through the clinical features and genetic analysis of 2 patients with IHH in 1 pedigree.

Patient concerns:

A 23-year-old girl presented with primary amenorrhea, sparse pubic hair, lack of breast development, and delayed sexual development.

Diagnoses:

Combined with the clinical characteristics, auxiliary examinations, and molecular genetic analysis, the patient was diagnosed as IHH.

Interventions:

Whole exome and Sanger sequencing were performed to validate the mutation in family members.

Outcomes:

A novel homozygous missense mutation c.521A > G (p.Q174R) in the GNRHR gene was identified in the 2 affected sisters. Familial segregation showed that the homozygous variant was inherited from their parents respectively and the eldest sister was the carrier without correlative symptom.

Lessons:

We reported a novel GNRHR mutation in a pedigree with congenital idiopathic hypogonadotropic hypogonadism. Glutamine at amino acid position 174 was highly conserved among various species. The molecular structure of GNRHR protein showed that p.Q174R mutation brought in a new stable hydrogen bond between position 174 and 215, may impede conformational mobility of the TMD4 and TMD5. It suggests that the missense mutation c.521A > G related to congenital idiopathic hypogonadotropic hypogonadism was probably a causative factor for both sisters. Through high-throughput sequencing and experimental verification, we had basically determined the patient's pathogenic mutation and inheritance, which could better guide doctors for treatment.
The effect of oral low molecular weight liquid hyaluronic acid combination with glucosamine and chondroitin on knee osteoarthritis patients with mild knee pain
Authors: Wang Shyu-Jye , Wang Ya-Hui , Huang Liang-Chen
Published: February 2021

Background:

The popularity of dietary supplements for knee osteoarthritis (OA) management is on the rise; however, their effects are still debated.

Methods:

This study aimed to investigate the effect of an oral low molecular weight liquid hyaluronic acid supplement in the treatment of knee OA patients with mild knee pain (visual analogue scale [VAS] ≤ 3) in Taiwan population. This was a randomized, double-blind, placebo-controlled study. Forty-seven subjects were enrolled and randomly allocated to either the A+HA or the placebo groups. The subjects were required to drink a bottle contained 20 mL of A+HA or placebo daily throughout an 8-week study period. The efficacy was assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 36-item Short Form Survey (SF-36).

Results:

At Week 8, significant reductions from baseline in the WOMAC pain (–2.6 ± 1.68, P < .0001), stiffness (–1.2 ± 1.50, P = .007), physical function (–5.8 ± 4.39, P < .0001), and total (–9.4 ± 5.82, P < .0001) scores were observed in the A+HA group but not in the placebo group. Significant differences in the mean change of WOMAC scores from baseline at Week 8 between groups were detected (P < .01). At Week 8, the A+HA group also showed significant improvements in SF-36 physical functioning (2.7 ± 3.10, P = .001) and bodily pain (0.7 ± 1.50, P < .05) domains. Although the A+HA group had a higher increase in the SF-36 total score than the placebo group but the difference was not statistically significant (2.1 ± 12.75 vs 0.3 ± 19.66, P = .12).

Conclusions:

Oral administration of low molecular weight liquid HA appeared to be effective for knee OA patients with mild knee pain (VAS ≤ 3) in the relief of knee OA symptoms, particularly in pain and physical function.

Clinical Trial Registration: NCT04352322.
Repetitive syncope caused by a rare massive sporadic malignant peripheral nerve sheath tumor involving carotid arteries
Authors: Wang Tiehao , Wang Jiarong , Zhao Jichun , Yuan Ding , Yao Wenqing
Published: February 2021

Rationale:

Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas arising from peripheral nerves. MPNSTs are uncommon in the head and neck, and various clinical manifestation often make the diagnosis challenging.

Patient concerns:

A 67-year-old female was referred for evaluation of repetitive syncope with a massive mass in the neck. Preoperative evaluation revealed potential neuroendocrine activity of the mass and enhanced computed tomography showed carotid artery was involved.

Diagnosis:

According to the preoperative imaging, intraoperative finding and postoperative pathological examination, the diagnosis of left neck MPNST involving left carotid arteries was made.

Interventions:

Volume expansion therapy with phenoxybenzamine started one week before surgery. Complete surgical resection of the mass was performed and pathological analysis suggested the diagnosis of MPNST. The postoperative radiotherapy was not given due to her poor nutrition.

Outcomes:

This patient recovered well after surgery and no sign of recurrence was noted at 2-year follow-up.

Lessons:

Though the involvement of carotid artery with neuroendocrine activity is rare in sporadic MPNST, preoperative scanning of blood and urine catecholamine is crucial for intraoperative hemodynamic stability, especially when carotid artery is involved.