bluuebunny/crossref_metadata_2025 huggingface dataset:
Decoupling Under Scrutiny: Consistency of Managerial Talk and Action in the Age of Nonprofit Accountability
Authors: Brandtner Christof
Published: March 2021

Decoupling theory suggests inconsistencies in what nonprofits do and what they claim to do. Accountability is a potential antidote to such inconsistencies in the nonprofit sector. To test whether different features of accountability prevent decoupling, I examine the divergence in statements about managerialism among nonprofit organizations in a major U.S. metropolitan area. The analysis compares a survey of organizations to public discourse based on five-million-word website text. Professionalism and evaluation indeed prevent organizations from embellishing their discourse. However, inconsistencies between managerial practices and managerial discourse remain frequent: Organizations continue to present symbolic displays of managerialism to the general public, particularly when their missions are tangible. Furthermore, ratings generate inconsistencies by leading organizations to downplay managerial practices. This study develops an institutional understanding of managerial talk and action, shows that the problem of decoupling in the “age of accountability” is multifaceted, and has implications for the estimation of nonprofit practices using automated text analysis.
Visualization of separation and reattachment in an incident shock-induced interaction
Authors: Jiao Yun , Wang Chengpeng
Published: March 2021

An experimental study is conducted on the qualitative visualization of the flow field in separation and reattachment flows induced by an incident shock interaction by several techniques including shear-sensitive liquid crystal coating (SSLCC), oil flow, schlieren, and numerical simulation. The incident shock wave is generated by a wedge in a Mach 2.7 duct flow, where the strength of the interaction is varied from weak to moderate by changing the angle of attack α of the wedge from 8° and 10° to 12°. The stagnation pressure upstream was set to approximately 607.9 kPa. The SSLCC technique was used to visualize the surface flow characteristics and analyze the surface shear stress fields induced by the initial incident shock wave over the bottom wall and sidewall experimentally which resolution is 3500 × 200 pixels, and the numerical simulation was also performed as the supplement for a clearer understanding to the flow field. As a result, surface shear stress over the bottom wall was visualized qualitatively by SSLCC images, and flow features such as separation/reattachment and the variations of position/size of separation bubble with wedge angle were successfully distinguished. Furthermore, analysis of shear stress trend over the bottom wall by a hue value curve indicated that the relative magnitude of shear stress increased significantly downstream of the separation bubble compared with that upstream. The variation trend of shear stress was consistent with the numerical simulation results, and the error of separation position was less than 2 mm. Finally, the three-dimensional schematic of incident shock-induced interaction has been achieved by qualitative summary by multiple techniques, including SSLCC, oil flow, schlieren, and numerical simulation.
Modeling of fuel transport in pressure-fed systems with flow passage opening devices
Authors: Im Seong Ho
Published: March 2021

This study presents a numerical model of a pressure-fed system with flow passage opening devices (FPODs) designed for an air vehicle with a high degree of maneuverability. The FPOD is a mechanical device that connects two separate fuel reservoirs and functions as a valve allowing liquid fuel to flow while minimizing the movement of pressurizing gas from upstream fuel tanks into downstream fuel tanks. A reduced-order model for the fuel motion in an annular fuel tank was developed to configure the depth and inclination angle of the free fuel surface on the cross-sectional plane of an annular fuel tank under accelerating conditions during flight. Furthermore, a newly proposed model that reflects the dynamic characteristics of the FPOD is used to determine the fluid type that is transported through the device. A simulation example shows that the full numerical model captures changes of the fuel transport condition over time in a complete pressure-fed system of annular fuel tanks with FPODs subject to acceleration.
Mining, Colonial Legacies, and Neoliberalism: A Political Ecology of Health Knowledge Minerıa, legados coloniales y neoliberalismo: una ecologıa polıtica del conocimiento en salud
Authors: Brisbois Ben , Feagan Mathieu , Stime Bjorn , Paz Isaac K. , Berbés-Blázquez Marta , Gaibor Juan , Cole Donald C. , Di Ruggiero Erica , Hanson Lori , Janes Craig R. , Plamondon Katrina M. , Spiegel Jerry M. , Yassi Annalee
Published: March 2021

Scholarship on the health impacts of resource extraction displays prominent gaps and apparent corporate and neocolonial footprints that raise questions about how science is produced. We analyze production of knowledge, on the health impacts of mining, carried out in relation to the Canadian International Resources and Development Institute (CIRDI), a university-based organization with substantial extractive industry involvement and links to Canada’s mining-dominated foreign policy. We use a “political ecology of knowledge” framework to situate CIRDI in the context of neoliberal capitalism, neocolonial sustainable development discourses, and mining industry corporate social responsibility techniques. We then document the interactions of specific health disciplinary conventions and knowledges within CIRDI-related research and advocacy efforts involving a major Canadian global health organization. This analysis illustrates both accommodation and resistance to large-scale political economic structures and the need to directly confront the global North governments and sectors pushing extractive-led neoliberal development globally.

Resumen

La investigación sobre los impactos en la salud de la extracción de recursos naturales delata brechas importantes y huellas corporativas y neocoloniales, que plantean dudas acerca de cómo se produce la ciencia. Analizamos la producción de conocimiento sobre los impactos en la salud de la minería en relación con el Instituto Canadiense de Desarrollo y Recursos Internacionales (CIRDI, siglas en inglés), una organización universitaria que cuenta con participación sustancial de la industria extractiva y tiene vínculos con la política exterior de Canadá, la cual es dominada por intereses mineros. Utilizamos un marco de "ecología política del conocimiento" para situar a CIRDI en el contexto del capitalismo neoliberal, los discursos neocoloniales de desarrollo sostenible y las técnicas de responsabilidad social corporativa de la industria minera. Luego, documentamos las interacciones entre los conocimientos y convenciones disciplinarias de salud dentro de los esfuerzos de investigación y promoción relacionados con CIRDI que involucran a una importante organización canadiense de salud global. Este análisis muestra tanto la complacencia como la resistencia a las estructuras políticas económicas a gran escala, y la necesidad de confrontar directamente a los gobiernos y sectores del Norte global que manejan el desarrollo neoliberal impulsado por la extracción a nivel mundial.
Understanding Social Insurance: Risk and Value Pluralism in the Early British Welfare State
Authors: Friedman Rachel Z.
Published: March 2021

This article seeks to make two contributions to the understanding of social insurance, a central policy tool of the modern welfare state. Focusing on Britain, it locates an important strand of theoretical support for early social insurance programs in antecedent developments in mathematical probability and statistics. While by no means the only source of support for social insurance, it argues that these philosophical developments were among the preconditions for the emergence of welfare policies. In addition, understanding the influence of these developments on British public discourse and policy sheds light on the normative principles that have undergirded the welfare state since its inception. Specifically, it suggests that the best model, or normative reconstruction, of social insurance in this context is a value-pluralist one, which pursues efficiency and equality or solidarity, grounded in group-based perceptions of risk.
Rapid, Responsive, and Relevant?: A Systematic Review of Rapid Evaluations in Health Care
Authors: Vindrola-Padros Cecilia , Brage Eugenia , Johnson Ginger A.
Published: March 2021

Changing health-care climates mean evaluators need to provide findings within shorter time frames, but challenges remain in the creation of rapid research designs capable of delivering quality data to inform decision-making processes. We conducted a review of articles to grapple with these challenges and explore the ways in which rapid evaluations have been used in health care. We found different labels being used to define rapid evaluations and identified a trend in the design of evaluations, where evaluators are moving away from short studies to longer evaluations with multiple feedback loops or cyclical stages. Evaluators are using strategies to speed up evaluations: conducting data collection and analysis in parallel, eliminating the use of transcripts, and utilizing larger evaluation teams to share the workload. Questions persist in relation to the suitability of rapid evaluation designs, the trustworthiness of the data, and the degree to which evaluation findings are used to make changes in practice.
Enabling critical performativity: The role of institutional context and critical performative work
Authors: Leca Bernard , Barin Cruz Luciano
Published: March 2021

Critical performativity has become a promising notion for critical scholars who want to have concrete impact on society. Although the number of studies contributing to this literature has significantly increased in recent years, most of them are still restricted to theoretical debates. Rarely are those who have analyzed empirical cases and explored the institutional context that strengthen or limit the chances of critical projects to be successfully performed in practice. In this article we draw on the case of Popular Cooperative Incubators in Brazil to address this blind spot in current literature on critical performativity. We particularly focus on the institutional context for critical projects to be performative and on how actors shape the institutional context. We develop the notion of “critical performative work” to better show how the combination of institutional theory and critical management studies can help advance critical performativity. We offer both new theoretical contributions and practical suggestions for critical theory to have a larger impact in practice.
Negotiation between modernity and local culture in moviegoing practice: A case study of a traditional movie theater in Guangzhou Metropolis
Authors: Lin Geng , Wu Hao , Xie Xiaoru , Fan Yang Fiona , Lv Zuyi
Published: March 2021

As a medium for delivering modernity, movie theaters have faithfully recorded the dialogue between modernity and local daily lives. In contrast to modern movie theaters, traditional cinemas are distinguished by their long history, through which they reflect the changing connotations and social construction of modernity over time. Based on detailed analysis of the historical and social characteristics of Nanguan cinema, a 100-year-old movie theater in Guangzhou, China, we reach the following two conclusions: first, shaped by local traditional culture, the practice of moviegoing localizes modernity with a distinctive grassroots feature that enlivens everyday lives; second, moviegoing at traditional theaters in modern metropolitan areas has further enriched the connotations of modernity by providing a nostalgic experience for audiences.
Fire hazard assessment with indoor spaces for evacuation route selection in building fire scenarios
Authors: Song Yiquan , Niu Lei , Liu Pengfei , Li Yi
Published: March 2021

A safe and effective evacuation route is important for reducing casualties during building fires, and this topic has been a long-term focus of emergency management. Indoor space is a space within one or multiple buildings consisting of architectural components and is the basis of indoor route analyses. Based on indoor space, an indoor network model is designed that considers fire protection design, spatial matching between fire information and the indoor space, and the passability of the indoor space during a fire. Then, an evacuation route selection algorithm that considers hazard and time is proposed. The key features of the route selection algorithm, which include assessing the fire hazards, evacuation time in each indoor space and parallel computing in the route selection algorithm, are subsequently presented. Finally, taking a gymnasium as an example, case modelling and fire information integration are performed to investigate two fire scenarios and the optimal evacuation routes over time are identified in each scenario.
Variations in the mechanical properties of bionanocomposites by water absorption
Authors: Rana SS , Gupta MK
Published: March 2021

The present study aims to investigate the water absorption property and its effect on the mechanical properties (i.e. tensile, flexural, and impact) of bionanocomposites. The epoxy-based bionanocomposites were prepared by reinforcing the epoxy with 1, 2, 3, 4, and 5 wt% of nanocellulose using in situ polymerization method. The maximum water uptake by bionanocomposites was measured; however, the water absorption behavior was not found in accordance with Fickian’s diffusion model. In the present study, very low water absorption in the range of 0.17–0.34% was offered by bionanocomposites. The results obtained from the present experimental study suggested that there were a maximum degradation of 14.96% in tensile strength, 26.44% in flexural strength, and 55.66% in impact strength for bionanocomposites reinforced with 5 wt% of nanocellulose by water uptake.
Magnetic resonance lymphangiography in group 1 paediatric pulmonary arterial hypertension
Authors: Juaneda Ernesto , Catalfamo Danilo , Fregapani Juan P. , Peirone Alejandro , Juaneda Ignacio , Kreutzer Cristian , Lucino Sergio
Published: March 2021

Pulmonary hypertension could have thoracic lymphatic abnormalities caused by right ventricular failure. Since there is no description of such abnormalities, the purpose of this study was to investigate them with magnetic resonance. Prospective review magnetic resonance T2‐weighted lymphangiography was performed between January 2017 and October 2019 through quantitative thoracic duct diameter, diameter index and qualitative lymphatic abnormalities types: 1 – little or none abnormalities, 2 – abnormalities in supraclavicular region, 3 – abnormalities extending into the mediastinum and 4 – abnormalities extending into the lung. Five patients with group 1 pulmonary arterial hypertension participated in this study. The mean age was 12.44 ± 4.92 years, three male and two female. The quantitative analysis yielded the following results: mean thoracic duct diameter of 2.92 ± 0.16 mm and thoracic duct index 2.28 ± 1.03 mm/m2. Qualitative lymphangiography abnormalities were type 1 in three patients, type 2 in one, all with low‐risk determinants, and type 3 in one with high‐risk determinants and right ventricular failure. Magnetic resonance T2‐weighted lymphangiography in group 1 paediatric pulmonary arterial hypertension allowed for the identification of the thoracic duct, which was used to perform both quantitative and qualitative analysis of thoracic lymphatic abnormalities, in particular when increased high‐risk determinants and right ventricular failure were present. These features represent an extracardiac finding useful to understand systemic venous congestion impact on lymphatic system.
Imaging Characteristics and Surgical Outcomes in Patients With Intraspinal Solitary Fibrous Tumor/Hemangiopericytoma: A Retrospective Cohort Study
Authors: Okubo Toshiki , Nagoshi Narihito , Tsuji Osahiko , Tachibana Atsuko , Kono Hitoshi , Suzuki Satoshi , Okada Eijiro , Fujita Nobuyuki , Yagi Mitsuru , Matsumoto Morio , Nakamura Masaya , Watanabe Kota
Published: March 2021

Study Design:

Retrospective cohort study.

Objectives:

Intraspinal solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) is often misdiagnosed preoperatively as schwannoma or meningioma because its imaging characteristics are not well understood. As postoperative prognosis differs among the 3 lesions, predicting the probability of SFT/HPC preoperatively is essential. Thus, this study investigates the imaging characteristics of SFT/HPC compared with those of schwannoma or meningioma and evaluates surgical outcomes.

Methods:

The preoperative imaging findings, tumor resection extent, recurrence and regrowth rates, and neurological improvement were compared between 10 patients with SFT/HPC and 42 patients with schwannoma or 40 patients with meningioma.

Results:

Most patients with SFT/HPC showed isointensity on both T1- and T2-weighted images compared with patients with schwannoma ( P = 0.011 and 0.029, respectively) and no significant difference compared with patients with meningioma ( P = 0.575 and 0.845, respectively). Almost all patients with SFT/HPC showed highly uniformizing enhancement patterns, similar to those with meningioma ( P = 0.496). Compared with meningioma, SFT/HPC lacked the dural tail sign and intratumoral calcification and exhibited irregular shape. Of the 5 patients who underwent partial resection, 60% exhibited tumor recurrence and regrowth following surgery.

Conclusions:

Complete en bloc surgical resection should be attempted in patients with intraspinal SFT/HPC to prevent postoperative recurrence or regrowth. As this tumor is often preoperatively misdiagnosed, we recommend that the imaging findings exhibited in this study should be used to positively suspect SFT/HPC. This will enhance patient outcomes by enabling more appropriate preoperative surgical planning.
Emerging Issues in Fiscal Sustainability in India: A Study of Central Government Finances, 1979–1980 to 2018–2019
Authors: Rath Anita , Sachan Arpit
Published: March 2021

The objective of the article is to examine the fiscal sustainability of the Indian central government’s finances in the era of rule-based fiscal policy. Asymmetric budgetary adjustment process and revenue–expenditure nexus are also analysed in this article by employing threshold autoregressive models/momentum threshold autoregressive models. Findings of the article reveal emerging issues in fiscal sustainability in India. The central government’s expenditure as a share of gross domestic product (GDP) has been falling continuously, leaving little room for further pruning. The current scenario of negative growth in central government’s revenue as a share of GDP, if not reversed, can become the Achilles heel of government finances in India.

JEL Classification: E62, H600, H500, C32
“Those People Motivate and Inspire Me to Take My Treatment.” Peer Support for Adolescents Living With HIV in Cape Town, South Africa
Authors: Rencken Camerin A. , Harrison Abigail D. , Mtukushe Bulelwa , Bergam Scarlett , Pather Ariana , Sher Rebecca , Davidson Bianca J. , Carrihill Michelle , Matiwane Mluleki , Kuo Caroline , Galárraga Omar , Hoare Jacqueline
Published: March 2021

Adherence to antiretroviral therapy (ART) and psychosocial support to manage stigma and disclosure is essential for adolescents living with HIV (ALHIV). Peer support groups can help ALHIV and their families live successfully with HIV. This qualitative study aimed to examine adolescent and caregiver perspectives on peer support groups. Three themes emerged: (1) peer support encouraged adherence to ART, (2) serostatus disclosure outside the family was perceived as difficult, and (3) the peer support group fostered fundamental and meaningful peer relationships for ALHIV. Caregivers felt peer support groups increased self-acceptance and adherence for ALHIV across 3 domains: (1) as motivation for families and adolescents, (2) to increase adolescent independence and maturity, and (3) to help adolescents accept their HIV status and live successfully with HIV. These data highlight the importance of psychosocial support groups for ALHIV and caregivers, illustrating the benefits of a safe space with trusted relationships and open communication.
When the “Blank Slate” Is a White One: White Institutional Isomorphism in the Birth of National Public Radio
Authors: Garbes Laura
Published: March 2021

A burgeoning literature at the intersection of the sociology of race and organizations explores the organization’s role in (re)producing racial inequalities. The present article builds from this growing literature in its analysis of the formation of National Public Radio (NPR), to better understand how organizational actors translate racialized practices into new organizations at their foundation, even when they seek greater racial inclusivity. I coin a new analytical concept, white institutional isomorphism, to analyze how organizations that embrace a mission of diversity may end up reproducing racially exclusionary practices. White institutional isomorphic pressures are racialized norms that shape the standards and practices adopted across organizations within a given field. Using organizational meeting minutes, external reports, oral histories, and founder memoirs, I show that early implementation of station membership criteria, hiring practices, and programming priorities, while considered race-neutral decisions by the founders that shared a white habitus, inhibited the inclusion of nonwhite voices into NPR’s workforce, station membership, and programming.
Stable and Reversible Photoluminescence from GaN Nanowires in Solution Tuning by Ionic Concentration
Authors: Nguyen Anh Thi , Ho Ya-Wen , Yu Wei-Cheng , Zan Hsiao-Wen , Meng Hsin-Fei , Chou Yi-Chia
Published: March 2021

We report response of photoluminescence (PL) from GaN nanowires without protection in solutions. The distinct response is not only toward pH but toward ionic concentration under same pH. The nanowires appear to be highly stable under aqueous solution with high ionic concentration and low pH value down to 1. We show that the PL has a reversible interaction with various types of acidic and salt solutions. The quantum states of nanowires are exposed to the external environment and have a direct physical interaction which depends on the anions of the acids. As the ionic concentration increases, the PL intensity goes up or down depending on the chemical species. The response results from a competition of change in surface band bending and charge transfer to redox level in solution. That of GaN films is reported for comparison as the effect of surface band bending can be neglected so that there are only slight variations in PL intensity for GaN films. Additionally, such physical interaction does not impact on the PL peaks in acids and salts, whereas there is a red shift on PL when the nanowires are in basic solution, say NH4OH, due to chemical etching occurred on the nanowires.
Carbon footprinting of universities worldwide: Part I—objective comparison by standardized metrics
Authors: Helmers Eckard , Chang Chia Chien , Dauwels Justin
Published: March 2021

Background

Universities, as innovation drivers in science and technology worldwide, should be leading the Great Transformation towards a carbon–neutral society and many have indeed picked up the challenge. However, only a small number of universities worldwide are collecting and publishing their carbon footprints, and some of them have defined zero emission targets. Unfortunately, there is limited consistency between the reported carbon footprints (CFs) because of different analysis methods, different impact measures, and different target definitions by the respective universities.

Results

Comprehensive CF data of 20 universities from around the globe were collected and analysed. Essential factors contributing to the university CF were identified. For the first time, CF data from universities were not only compared. The CF data were also evaluated, partly corrected, and augmented by missing contributions, to improve the consistency and comparability. The CF performance of each university in the respective year is thus homogenized, and measured by means of two metrics: CO2e emissions per capita and per m2 of constructed area. Both metrics vary by one order of magnitude across the different universities in this study. However, we identified ten universities reaching a per capita carbon footprint of lower than or close to 1.0 Mt (metric tons) CO2e/person and year (normalized by the number of people associated with the university), independent from the university’s size. In addition to the aforementioned two metrics, we suggested a new metric expressing the economic efficiency in terms of the CF per $ expenditures and year. We next aggregated the results for all three impact measures, arriving at an overall carbon performance for the respective universities, which we found to be independent of geographical latitude. Instead the per capita measure correlates with the national per capita CFs, and it reaches on average 23% of the national impacts per capita. The three top performing universities are located in Switzerland, Chile, and Germany.

Conclusion

The usual reporting of CO2 emissions is categorized into Scopes 1–3 following the GHG Protocol Corporate Accounting Standard which makes comparison across universities challenging. In this study, we attempted to standardize the CF metrics, allowing us to objectively compare the CF at several universities. From this study, we observed that, almost 30 years after the Earth Summit in Rio de Janeiro (1992), the results are still limited. Only one zero emission university was identified, and hence, the transformation should speed up globally.
QTL mapping of root traits in wheat under different phosphorus levels using hydroponic culture
Authors: Yang Mengjiao , Wang Cairong , Hassan Muhammad Adeel , Li Faji , Xia Xianchun , Shi Shubing , Xiao Yonggui , He Zhonghu
Published: March 2021

Background

Phosphorus (P) is an important in ensuring plant morphogenesis and grain quality, therefore an efficient root system is crucial for P-uptake. Identification of useful loci for root morphological and P uptake related traits at seedling stage is important for wheat breeding. The aims of this study were to evaluate phenotypic diversity of Yangmai 16/Zhongmai 895 derived doubled haploid (DH) population for root system architecture (RSA) and biomass related traits (BRT) in different P treatments at seedling stage using hydroponic culture, and to identify QTL using 660 K SNP array based high-density genetic map.

Results

All traits showed significant variations among the DH lines with high heritabilities (0.76 to 0.91) and high correlations (r = 0.59 to 0.98) among all traits. Inclusive composite interval mapping (ICIM) identified 34 QTL with 4.64–20.41% of the phenotypic variances individually, and the log of odds (LOD) values ranging from 2.59 to 10.43. Seven QTL clusters (C1 to C7) were mapped on chromosomes 3DL, 4BS, 4DS, 6BL, 7AS, 7AL and 7BL, cluster C5 on chromosome 7AS (AX-109955164 - AX-109445593) with pleiotropic effect played key role in modulating root length (RL), root tips number (RTN) and root surface area (ROSA) under low P condition, with the favorable allele from Zhongmai 895.

Conclusions

This study carried out an imaging pipeline-based rapid phenotyping of RSA and BRT traits in hydroponic culture. It is an efficient approach for screening of large populations under different nutrient conditions. Four QTL on chromosomes 6BL (2) and 7AL (2) identified in low P treatment showed positive additive effects contributed by Zhongmai 895, indicating that Zhongmai 895 could be used as parent for P-deficient breeding. The most stable QTL QRRS.caas-4DS for ratio of root to shoot dry weight (RRS) harbored the stable genetic region with high phenotypic effect, and QTL clusters on 7A might be used for speedy selection of genotypes for P-uptake. SNPs closely linked to QTLs and clusters could be used to improve nutrient-use efficiency.
Cognitive status of patients judged fit for discharge from the post-anaesthesia care unit after general anaesthesia: a randomized comparison between desflurane and propofol
Authors: Robert Cyrille , Soulier Anne , Sciard Didier , Dufour Guillaume , Alberti Corinne , Boizeau Priscilla , Beaussier Marc
Published: March 2021

Background

The Aldrete’s score is used to determine when a patient can safely leave the Post-Anaesthesia Care Unit (PACU) and be transferred to the surgical ward. The Aldrete score is based on the evaluation of vital signs and consciousness. Cognitive functions according to the anaesthetic strategy at the time the patient is judged fit for discharge from the PACU (Aldrete’s score ≥ 9) have not been previously studied. The aim of this trial was to assess the cognitive status of inpatients emerging either from desflurane or propofol anaesthesia, at the time of PACU discharge (Aldrete score ≥ 9).

Methods

Sixty adult patients scheduled for hip or knee arthroplasty under general anaesthesia were randomly allocated to receive either desflurane or propofol anaesthesia. Patients were evaluated the day before surgery using Digit Symbol Substitution Test (DSST), Stroop Color Test and Verbal Learning Test. After surgery, the Aldrete score was checked every 5 min until reaching a score ≥ 9. At this time, the same battery of cognitive tests was applied. Each test was evaluated separately. Cognitive status was reported using a combined Z score pooling together the results of all 3 cognitive tests.

Results

Among the 3 tests, only DSST was significantly reduced at Aldrete Score ≥ 9 in the Desflurane group. Combined Z-scores at Aldrete Score ≥ 9 were (in medians [interquartils]): − 0.2 [− 1.2;+ 0.6] and − 0.4 [− 1.1;+ 0.4] for desflurane and propofol groups respectively (P = 0.62). Cognitive dysfunction at Aldrete score ≥ 9 was observed in 3 patients in the Propofol group and in 2 patients in the Desflurane group) (P = 0.93).

Conclusion

No difference was observed in cognitive status at Aldrete score ≥ 9 between desflurane and propofol anaesthesia. Although approximately 10% of patients still had cognitive dysfunctions, an Aldrete score ≥ 9 was associated with satisfactory cognitive function recovery in the majority of the patients after lower limb arthroplasty surgery under general anaesthesia.

Trial registration

Clinical Trials identifier NTC02036736.
Waist circumference prediction for epidemiological research using gradient boosted trees
Authors: Zhou Weihong , Eckler Spencer , Barszczyk Andrew , Waese-Perlman Alex , Wang Yingjie , Gu Xiaoping , Feng Zhong-Ping , Peng Yuzhu , Lee Kang
Published: March 2021

Background

Waist circumference is becoming recognized as a useful predictor of health risks in clinical research. However, clinical datasets tend to lack this measurement and self-reported values tend to be inaccurate. Predicting waist circumference from standard physical features could be a viable method for generating this information when it is missing or mitigating the impact of inaccurate self-reports. This study determined the degree to which the XGBoost advanced machine learning algorithm could build models that predict waist circumference from height, weight, calculated Body Mass Index, age, race/ethnicity and sex, whether they perform better than current models based on linear regression, and the relative importance of each feature in this prediction.

Methods

We trained tree-based models (via XGBoost gradient boosting) and linear models (via regression) to predict waist circumference from height, weight, Body Mass Index, age, race/ethnicity and sex (n = 60,740 participants). We created 10 iterations of each model, each using 90% of the dataset for training and the remaining 10% for testing performance (this group was different for each iteration). We calculated model performance and feature importance as an average across 10 iterations. We then externally validated the ensembled version of the top model.

Results

The XGBoost model predicted waist circumference with a mean bias ± standard deviation of 0.0 ± 0.04 cm and a root mean squared error of 4.7 ± 0.05 cm, with performance varying slightly by sex and race/ethnicity. The XGBoost model showed varying degrees of improvement over linear regression models. The top 3 predictors were Body Mass Index, weight and race (Asian). External validation found that on average this model overestimated waist circumference by 4.65 cm in the United Kingdom population (mainly due to overprediction in females) and underestimated waist circumference by 1.7 cm in the Chinese population. The respective root mean squared errors were 7.7 cm and 7.1 cm.

Conclusions

XGBoost-based models accurately predict waist circumference from standard physical features. Waist circumference prediction using this approach would be valuable for epidemiological research and beyond.
Primary care physician volume and quality of care for older adults with dementia: a retrospective cohort study
Authors: Lane Natasha E. , Ling Vicki , Glazier Richard H. , Stukel Thérèse A.
Published: March 2021

Background

Some jurisdictions restrict primary care physicians’ daily patient volume to safeguard quality of care for complex patients. Our objective was to determine whether people with dementia receive lower-quality care if their primary care physician sees many patients daily.

Methods

Population-based retrospective cohort study using health administrative data from 100,256 community-living adults with dementia aged 66 years or older, and the 8,368 primary care physicians who cared for them in Ontario, Canada. Multivariable Poisson GEE regression models tested whether physicians’ daily patient volume was associated with the adjusted likelihood of people with dementia receiving vaccinations, prescriptions for cholinesterase inhibitors, benzodiazepines, and antipsychotics from their primary care physician.

Results

People with dementia whose primary care physicians saw ≥ 30 patients daily were 32% (95% CI: 23% to 41%, p < 0.0001) and 25% (95% CI: 17% to 33%, p < 0.0001) more likely to be prescribed benzodiazepines and antipsychotic medications, respectively, than patients of primary care physicians who saw < 20 patients daily. Patients were 3% (95% CI: 0.4% to 6%, p = 0.02) less likely to receive influenza vaccination and 8% (95% CI: 4% to 13%, p = 0.0001) more likely to be prescribed cholinesterase inhibitors if their primary care physician saw ≥ 30 versus < 20 patients daily.

Conclusions

People with dementia were more likely to receive both potentially harmful and potentially beneficial medications, and slightly less likely to be vaccinated by high-volume primary care physicians.
Secondary gliosarcoma: the clinicopathological features and the development of a patient-derived xenograft model of gliosarcoma
Authors: Kiang Karrie Mei-Yee , Chan Andrian A. , Leung Gilberto Ka-Kit
Published: March 2021

Background

Gliosarcoma (GSM) is a distinct and aggressive variant of glioblastoma multiforme (GBM) with worse prognosis and few treatment options. It is often managed with the same treatment modalities with temozolomide (TMZ) as in GBM. However, the therapeutic benefits on GSM from such treatment regimen is largely unknown. Patient-derived xenograft (PDX) models have been used widely to model tumor progression, and subsequently to validate biomarkers and inform potential therapeutic regimens. Here, we report for the first time the successful development of a PDX model of secondary GSM.

Methods

Tissue obtained from a tumor resection revealed a secondary GSM arising from GBM. The clinical, radiological, and histopathological records of the patient were retrospectively reviewed. Samples obtained from surgery were cultured ex vivo and/or implanted subcutaneously in immunocompromised mice. Histopathological features between the primary GBM, secondary GSM, and GSM PDX are compared.

Results

In explant culture, the cells displayed a spindle-shaped morphology under phase contrast microscopy, consistent with the sarcomatous component. GSM samples were subcutaneously engrafted into immunocompromised mice after single-cell suspension. Xenografts of serial passages showed enhanced growth rate with increased in vivo passage. We did not observe any histopathological differences between the secondary GSM and its serial in vivo passages of PDX tumors.

Conclusions

Our PDX model for GSM retained the histopathological characteristics of the engrafted tumor from the patient. It may provide valuable information to facilitate molecular and histopathological modelling of GSM and be of significant implication in future research to establish precise cancer medicine for this highly malignant tumor.
Giant congenital nodular melanoma in a newborn: a case report and literature review
Authors: Zhou Jun , Lv Meng-xing , Duan Ling , Xie Yu-cheng , A Zhi-xiang , Wu Hong-fang , Gao Yan
Published: March 2021

Background

Malignant melanoma (MM) arises predominantly after adolescence and is uncommon in children. Congenital MM in newborns is even rarer with a dearth of published literature; as a consequence, there is no uniform standard for the pathogenesis and treatment for neonatal malignant melanoma. Herein we report a case of giant congenital nodular MM in a newborn, including its clinical, imaging, pathological and molecular pathological features. This case is the largest giant congenital primary nodular malignant melanoma in utero in neonates currently reported in China.

Case presentation

A female neonatal patient was found to have a 2.97 cm× 1.82 cm×1.50 cm mass with a clear boundary at the right acromion in color Doppler ultrasound examination at 24 weeks of gestation. The mass increased to 3.0 cm×5.0 cm×9.0 cm at birth, and local ulceration was seen. MRI demonstrated that the mass was located on the right shoulder and underarm in a lobulated appearance, and surrounded the right scapula which was deformed. Clinical stage:IV(AJCC 8th Edition (2017)). α-Fetoprofein (AFP) by hematological examination: 1210ng/ml, NSE: 21.28ng/ml, LDH: 842U/L. The patient underwent surgical resection of the tumor, and was pathologically diagnosed as neonatal congenital malignant melanoma; immunohistochemistry (IHC): S-100 (+), HMB45 (+), Melan A (+), and Tyrosinase (+). Molecular pathological examination for BRAF V600E showed no mutations (Quantitative Real-time PCR, qPCR); And so were NRAS, C-kit (exons 9,11,13,14,17,18), and TERT (promoter locus, C228T and C250T) (Sanger sequencing). Non-surgical therapies were not carried out after the surgical resection of the tumor. After 6 months of follow-up, the child developed normally, and color Doppler ultrasound showed no obvious tumor growth or abnormality in the original tumor site.

Conclusions

It is extremely rare to see giant congenital primary nodular MM in utero in neonates. The pathogenesis, treatment and prognosis of congenital MM need further research. The diagnosis mainly depends on histopathology and immunohistochemistry, and it needs to be differentiated from malignant lymphoma and primitive neuroectodermal tumor. The current treatment strategy for MM relies on the surgical excision of the mass. Research directed at molecular detection for genetic mutations would contribute to targeted therapy and better prognosis.
Is the contralateral lesser trochanter a reliable reference for planning of total hip arthroplasty – a 3-dimensional analysis
Authors: Hasler Julian , Hoch Armando , Fürnstahl Philipp , Ackermann Jakob , Zingg Patrick O. , Vlachopoulos Lazaros
Published: March 2021

Background

Preoperative templating in total hip arthroplasty (THA) is mandatory to achieve appropriate offset and leg length equality. However, templating methods using the contralateral hip might be susceptible to errors resulting from side-differences in the femoral morphology. The distance of the lesser trochanter to the femoral head center (LTFHD) is a frequently used reference parameter for preoperative planning and intraoperative validation during THA. However, currently no three-dimensional (3D) analysis of side differences of the LTFHD exists.

Methods

Using Computer tomography (CT)-based surface models from 100 paired femora (50 cadavers), side-to-side asymmetry of the LTFHD, femoral length, femoral head diameter (FHD) and femoral antetorsion were analyzed. Univariate linear regression models were established to evaluate potential associations between sides regarding LTFHD and FHD as well as a correlation of these parameters with each other.

Results

Statistically significant side-differences were found for the LTFHD (p = 0.02) and FHD (p = 0.03) with a mean absolute side-difference of 1.6 ± 1.4mm (range 0.1–5.5mm) and 0.4mm ± 0.6mm (range 0–3mm), respectively. The ratio between the LTFHD and FHD was consistent with an average value of 1.16 ± 0.08 and reliable between sides with a correlation coefficient (r) of 0.72 (p < 0.01).

Conclusions

The LTFHD is a reliable reference parameter for preoperative templating and intraoperative validation during THA with a high correlation between sides (r = 0.93,p < 0.01). However, 8 % of the investigated specimens revealed a LTFHD of more than 4mm, which should be anticipated during THA to avoid unsatisfiable results.
A method for interoperable knowledge-based data quality assessment
Authors: Tute Erik , Scheffner Irina , Marschollek Michael
Published: March 2021

Background

Assessing the quality of healthcare data is a complex task including the selection of suitable measurement methods (MM) and adequately assessing their results.

Objectives

To present an interoperable data quality (DQ) assessment method that formalizes MMs based on standardized data definitions and intends to support collaborative governance of DQ-assessment knowledge, e.g. which MMs to apply and how to assess their results in different situations.

Methods

We describe and explain central concepts of our method using the example of its first real world application in a study on predictive biomarkers for rejection and other injuries of kidney transplants. We applied our open source tool—openCQA—that implements our method utilizing the openEHR specifications. Means to support collaborative governance of DQ-assessment knowledge are the version-control system git and openEHR clinical information models.

Results

Applying the method on the study’s dataset showed satisfactory practicability of the described concepts and produced useful results for DQ-assessment.

Conclusions

The main contribution of our work is to provide applicable concepts and a tested exemplary open source implementation for interoperable and knowledge-based DQ-assessment in healthcare that considers the need for flexible task and domain specific requirements.
Divergent CPEB prion-like domains reveal different assembly mechanisms for a generic amyloid-like fold
Authors: Hervás Rubén , del Carmen Fernández-Ramírez María , Galera-Prat Albert , Suzuki Mari , Nagai Yoshitaka , Bruix Marta , Menéndez Margarita , Laurents Douglas V. , Carrión-Vázquez Mariano
Published: March 2021

Background

Amyloids are ordered, insoluble protein aggregates, characterized by a cross-β sheet quaternary structure in which molecules in a β-strand conformation are stacked along the filament axis via intermolecular interactions. While amyloids are typically associated with pathological conditions, functional amyloids have also been identified and are present in a wide variety of organisms ranging from bacteria to humans. The cytoplasmic polyadenylation element-binding (CPEB) prion-like protein is an mRNA-binding translation regulator, whose neuronal isoforms undergo activity-dependent aggregation, a process that has emerged as a plausible biochemical substrate for memory maintenance. CPEB aggregation is driven by prion-like domains (PLD) that are divergent in sequence across species, and it remains unknown whether such divergent PLDs follow a similar aggregating assembly pathway. Here, we describe the amyloid-like features of the neuronalAplysiaCPEB (ApCPEB) PLD and compare them to those of theDrosophilaortholog, Orb2 PLD.

Results

Using in vitro single-molecule and bulk biophysical methods, we find transient oligomers and mature amyloid-like filaments that suggest similarities in the late stages of the assembly pathway for both ApCPEB and Orb2 PLDs. However, while prior to aggregation the Orb2 PLD monomer remains mainly as a random coil in solution, ApCPEB PLD adopts a diversity of conformations comprising α-helical structures that evolve to coiled-coil species, indicating structural differences at the beginning of their amyloid assembly pathways.

Conclusion

Our results indicate that divergent PLDs of CPEB proteins from different species retain the ability to form a generic amyloid-like fold through different assembly mechanisms.
BG-flow, a new flow cytometry tool for G-quadruplex quantification in fixed cells
Authors: De Magis Alessio , Kastl Melanie , Brossart Peter , Heine Annkristin , Paeschke Katrin
Published: March 2021

Background

Nucleic acids can fold into non-canonical secondary structures named G-quadruplexes (G4s), which consist of guanine-rich sequences stacked into guanine tetrads stabilized by Hoogsteen hydrogen bonding, π-π interactions, and monovalent cations. G4 structure formation and properties are well established in vitro, but potential in vivo functions remain controversial. G4s are evolutionarily enriched at distinct, functional genomic loci, and both genetic and molecular findings indicate that G4s are involved in multiple aspects of cellular homeostasis. In order to gain a deeper understanding of the function of G4 structures and the trigger signals for their formation, robust biochemical methods are needed to detect and quantify G4 structures in living cells. Currently available methods mostly rely on fluorescence microscopy or deep sequencing of immunoprecipitated DNA or RNA using G4-specific antibodies. These methods provide a clear picture of the cellular or genomic localization of G4 structures but are very time-consuming. Here, we assembled a novel protocol that uses the G4-specific antibody BG4 to quantify G4 structures by flow cytometry (BG-flow).

Results

We describe and validate a flow cytometry-based protocol for quantifying G4 levels by using the G4-specific antibody BG4 to label standard cultured cells (Hela and THP-1) as well as primary cells obtained from human blood (peripheral blood mononuclear cells (PBMCs)). We additionally determined changes in G4 levels during the cell cycle in immortalized MCF-7 cells, and validated changes previously observed in G4 levels by treating mouse macrophages with the G4-stabilizing agent pyridostatin (PDS).

Conclusion

We provide mechanistic proof that BG-flow is working in different kinds of cells ranging from mouse to humans. We propose that BG-flow can be combined with additional antibodies for cell surface markers to determine G4 structures in subpopulations of cells, which will be beneficial to address the relevance and consequences of G4 structures in mixed cell populations. This will support ongoing research that discusses G4 structures as a novel diagnostic tool.