bluuebunny/crossref_metadata_2025 huggingface dataset:
Multinational Survey of Current Practice from Imaging to Treatment of Atherosclerotic Carotid Stenosis
Authors: Saba Luca , Mossa-Basha Mahmoud , Abbott Anne , Lanzino Giuseppe , Wardlaw Joanna M. , Hatsukami Thomas S. , Micheletti Giulio , Balestrieri Antonella , Hedin Ulf , Moody Alan R. , Wintermark Max , DeMarco J. Kevin
Published: January 2021

Background: In the last 20–30 years, there have been many advances in imaging and therapeutic strategies for symptomatic and asymptomatic individuals with carotid artery stenosis. Our aim was to examine contemporary multinational practice standards. Methods: Departmental Review Board approval for this study was obtained, and 3 authors prepared the 44 multiple choice survey questions. Endorsement was obtained by the European Society of Neuroradiology, American Society of Functional Neuroradiology, and African Academy of Neurology. A link to the online questionnaire was sent to their respective members and members of the Faculty Advocating Collaborative and Thoughtful Carotid Artery Treatments (FACTCATS). The questionnaire was open from May 16 to July 16, 2019. Results: The responses from 223 respondents from 46 countries were included in the analyses including 65.9% from academic university hospitals. Neuroradiologists/radiologists comprised 68.2% of respondents, followed by neurologists (15%) and vascular surgeons (12.9%). In symptomatic patients, half (50.4%) the respondents answered that the first exam they used to evaluate carotid bifurcation was ultrasound, followed by computed tomography angiography (CTA, 41.6%) and then magnetic resonance imaging (MRI 8%). In asymptomatic patients, the first exam used to evaluate carotid bifurcation was ultrasound in 88.8% of respondents, CTA in 7%, and MRA in 4.2%. The percent stenosis upon which carotid endarterectomy or stenting was recommended was reduced in the presence of imaging evidence of “vulnerable plaque features” by 66.7% respondents for symptomatic patients and 34.2% for asymptomatic patients with a smaller subset of respondents even offering procedural intervention to patients with <50% symptomatic or asymptomatic stenosis. Conclusions: We found heterogeneity in current practices of carotid stenosis imaging and management in this worldwide survey with many respondents including vulnerable plaque imaging into their decision analysis despite the lack of proven benefit from clinical trials. This study highlights the need for new clinical trials using vulnerable plaque imaging to select high-risk patients despite maximal medical therapy who may benefit from procedural intervention.
Long-Term Effectiveness and Safety of Childhood Growth Hormone Treatment in Noonan Syndrome
Authors: Rohrer Tilman R. , Abuzzahab Jennifer , Backeljauw Philippe , Birkegård Anna Camilla , Blair Joanne , Dahlgren Jovanna , Júlíusson Pétur Benedikt , Ostrow Vlady , Pietropoli Alberto , Polak Michel , Romano Alicia , Ross Judith , Sävendahl Lars , Miller Bradley S.
Published: January 2021

Introduction: Few data exist on long-term growth hormone (GH) treatment in patients with Noonan syndrome (NS). Objective: To evaluate the effectiveness and safety of GH treatment in NS in clinical practice. Methods: Height gain, near-adult height (NAH), and safety were assessed in 2 complementary non-interventional studies: NordiNet® IOS and ANSWER. The safety analysis included 412 patients, and the effectiveness analysis included 84 GH-treated patients (male, n = 67) with ≥4 years’ height standard deviation score (HSDS) data. HSDS was determined using national reference (NR) and NS-specific (NSS) data. Results: The mean (SD) baseline age was 8.38 (3.57) years; HSDS, −2.76 (1.03); GH dose, 41.6 (11.1) µg/kg/day. The mean (SD) HSDS increase from baseline (ΔHSDS) was 0.49 (0.37) (first year), 0.79 (0.58) (second year), and 1.01 (0.60) (third year) (NR). The mean (SD) HSDS at year 3 was −1.66 (1.00) (NR; 1.06 [1.12] [NSS]). Twenty-four patients achieved NAH. The mean (SD) NAH SDS (NR) was −1.51 (0.60) (154.90 [3.21] cm) in females and −1.79 (1.09) (165.61 [7.19] cm) in males; 70.8% (17/24) had NAH SDS ≥ −2. Adverse drug reactions and GH-unrelated serious adverse events (n = 34) were reported in 22/412 (5.3%) patients. Four neoplasms and 3 cases of scoliosis were reported; no cardiovascular adverse events occurred. Conclusions: GH-treated children with NS achieved substantial height gain during the first 3 years of follow-up. Overall, 24 patients achieved NAH, with 70.8% having NAH SDS ≥ –2. There was no evidence to support a higher prevalence of neoplasm, or cardiac or other comorbidities.
The Association between Alopecia and Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Authors: Maghfour Jalal , Olson Justin , Conic Rosalynn R.Z. , Mesinkovska Natasha Atanaskova
Published: January 2021

Importance: The link between autoimmune gut disorders and different types of hair loss conditions has been recently investigated with an increased interest. With acknowledgement of the connection between immune dysregulation and the gut microbiome, this pathway is now becoming recognized as playing an important role in hair growth. The inflammatory cascade that results from the disruption of gut integrity such as seen in inflammatory bowel diseases (IBD) has been associated with certain types of alopecia. Objective: The aim of this work was to evaluate the association between alopecia and IBD. Evidence Review: A primary literature search was conducted using the PubMed, Embase, and Web of Science databases to identify articles on co-occurring alopecia and IBD from 1967 to 2020. A total of 79 studies were included in the review. A one-way proportional meta-analysis was performed on 19 of the studies to generate the pooled prevalence of alopecia and IBD. Finding: The pooled prevalence of non-scarring alopecia among IBD patients was 1.12% (k = 7, I2 = 98.6%, 95% CI 3.1–39.9); the prevalence of IBD among scarring and non-scarring alopecia was 1.99% (k = 12; I2 = 99%, 95% CI 6.2–34). The prevalence of non-scarring alopecia areata (AA) among IBD was compared to the prevalence of AA in the general population (0.63 vs. 0.1%; p < 0.0001). Similarly, the prevalence of IBD among the scarring and non-scarring alopecia groups was compared to the prevalence of IBD in the general population (1.99 vs. 0.396%; p = 0.0004). Conclusion: IBD and alopecia, particularly AA, appear to be strongly associated. Dermatology patients with alopecia may benefit from screening for IBD.
Ascitic Fluid Cytokines in Chronic Liver Disease: A Possible Prognostic Tool
Authors: Atta Shimaa , Kamel Manal , Mansour Wafaa , Hussein Taghreed , Maher Kesmat , Elrefaiy Mohamed A.
Published: January 2021

Introduction: Malignant ascites results from imbalance between protein in the peritoneal cavity and absorption of fluids via the lymphatic system. More than 20 interleukins (ILs) are known to play an important role in the protection against tumors. Materials and Methods: Ascitic fluid IL-1B, IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ levels were assessed in 45 patients with liver cirrhosis and ascites as judged by histopathological and ultrasonographic findings. They were divided into 2 groups according to presence of hepatic focal lesions. Ten patients with focal hepatic lesions were randomly selected and subjected to analysis of serum levels of IL-2 and IL-10. Results: Ascitic fluid IL-4, IL-6 and IL-10 levels were found to be significantly higher in patients with hepatocellular carcinoma (HCC) than patients with cirrhosis. TNF-α, and IFN-γ were also found to be higher in HCC than patients with cirrhosis but with no significance. On the other hand, there was no significant difference in levels of IL-1B and IL-2 between the 2 groups. Ascitic fluid IL-2 and IL-10 levels were found to be higher in ascitic fluid than in serum of the same patients. Conclusion: Ascitic fluid levels of IL-4, IL-6 and IL-10 are higher in HCC patients than patients with cirrhosis alone. Levels of ascitic fluid IL-2 and IL-10 proved to be a better prognostic tool than their levels in sera of the same patients. To conclude, patients with cirrhosis may be subjected to scheduled examination of ascitic fluid cytokines to predict transformation into HCC.
ПОРІВНЯННЯ ПОКАЗНИКІВ ОРГАНІЗАЦІЙНОЇ РОБОТИ ПРИВАТНОГО ТА КОМУНАЛЬНОГО НЕКОМЕРЦІЙНОГО КОНСУЛЬТАТИВНО-ДІАГНОСТИЧНИХ ЦЕНТРІВ
Authors: Bob A. O. , Chukur O. O. , Baloglanova I. V.
Published: January 2021

Проведено порівняльний аналіз організації вторинної амбулаторної допомоги дорослому населенню м. Миколаєва у комунальному та приватному консультативно-діагностичних центрах. Соціологічне дослідження дозволило стверджувати, що існує необхідність нової оптимізованої моделі надання медичної допомоги для населення великого міста з використанням форм і моделей державно-приват­ного партнерства.
ПРОФЕСІЙНЕ ВИГОРАННЯ СЕРЕД МЕДИЧНИХ ПРАЦІВНИКІВ: ПСИХОЛОГІЧНІ АСПЕКТИ
Authors: Kavetska N. A. , Andreychyn S. M. , Yarema N. Z.
Published: January 2021

У статті показано особливості професійного вигорання у медичних працівників. У літературі ця проблема вивчена недостатньо, є мало даних про вивчення придатності людей до медичних професій з точки зору їх психологічних особливостей, тим більше мало рекомендацій щодо адаптації до професійної діяльності. Досить детально індивідуальні психологічні особливості людей досліджено в рамках теорії К. Юнга, який перший стверджував, що мислення і поведінка людини безпосередньо залежать від структури її психіки. У подальшому його вчення розвинули послідовники, які виділили 16 психологічних типів за спільністю процесів сприйняття і обробки інформації, мислення, поведінки. Психотип – це інтегральне поняття, яке визначає психологічні особливості взаємодії індивіда з навколишнім середовищем. В основі юнгівських психотипів лягли такі властивості вищої нервової діяльності, як темперамент, швидкість процесів збудження і гальмування, у структурі психотипів взята за основу модель психіки З. Фрейда (свідоме і підсвідоме).

Ми зробили спробу розподілити основні професійні компетентності лікаря й медсестри за юнгівськими функціями, такими, як: інтуїція, сенсорика, логіка, етика. Встановлено, що у професійній діяльності медичних працівників несуть навантаження усі юнгівські функції. З точки зору вищенаведеної теорії, слід припустити, що саме тривале навантаження на слабкі функції в практичній діяльності медичного працівника веде до швидкого їх виснаження.

Отже, застосування типологічного підходу, що ґрунтується на теорії Юнга, дало б можливість як конкретизувати підходи до набуття професійних компетентностей медичними працівниками з урахуванням їх індивідуальних особливостей, так і окреслити заходи профілактики розвитку професійного вигорання.
ОСОБЛИВОСТІ ФУНКЦІОНУВАННЯ СИСТЕМИ ВНУТРІШНЬОГО ЗАБЕЗПЕЧЕННЯ ЯКОСТІ ВИЩОЇ ОСВІТИ В ТЕРНОПІЛЬСЬКОМУ НАЦІОНАЛЬНОМУ МЕДИЧНОМУ УНІВЕРСИТЕТІ ІМЕНІ І. Я. ГОРБАЧЕВСЬКОГО МОЗ УКРАЇНИ
Authors: Korda M. M. , Chornomydz A. V. , Shulhai A. H. , Mashtalir A. I.
Published: January 2021

Сьогодні в Тернопільському національному медичному університеті імені І. Я. Горбачевського Міністерства охорони здоров’я України функціонує 5-рівнева система внутрішнього забезпечення якості вищої освіти, яка побудована на основі «Стандартів і рекомендацій щодо забезпечення якості в Європейському просторі вищої освіти» із залученням у систему всіх учасників освітнього процесу та розподілом функцій між різними структурними одиницями системи (децентралізація функцій). У статті описано, як функціонує кожен рівень системи та як взаємопов’язані всі структурні елементи системи внутрішнього забезпечення якості вищої освіти в університеті.

Описана система внутрішнього забезпечення якості вищої освіти Тернопільського національного медичного університету імені І. Я. Горбачевського МОЗ України є досить функціональною та дієвою, що дозволяє охопити всіх учасників освітнього процесу під єдиною парадигмою забезпечення якості освіти.
ВИКОРИСТАННЯ ІНТЕРАКТИВНИХ МЕТОДІВ ВИКЛАДАННЯ ТА РОЗВИТОК ДИСТАНЦІЙНОЇ ОСВІТИ ЛІКАРІВ У ТЕРНОПІЛЬСЬКОМУ НАЦІОНАЛЬНОМУ МЕДИЧНОМУ УНІВЕРСИТЕТІ ІМЕНІ І. Я. ГОРБАЧЕВСЬКОГО МОЗ УКРАЇНИ В УМОВАХ КАРАНТИНУ
Authors: Posolenyk L. Ya. , Vydoinyk O. Ya.
Published: January 2021

У статті висвітлено досвід використання освітніх платформ навчання Moodle та Microsoft Teams для проведення практичного онлайн-заняття й оцінено ефективність інтерактивної інноваційної технології «круглий стіл» у формуванні професійних та комунікативних компетентностей у майбутніх медичних працівників у ТНМУ імені І. Я. Горбачевського МОЗ України.

Дистанційне навчання у ТНМУ імені І. Я. Горбачевського МОЗ України через освітню дистанційну платформу Microsoft Teams на сьогодні є складовою освітнього процесу й забезпечує навчання у найбільш зручному місці та часі, надає доступ до електронних баз знань. Інтерактивна технологія навчання – це така організація навчального процесу, за якої неможлива неучасть студента в колективному взаємодоповнювальному, заснованому на взаємодії всіх його учасників процесі навчання, зокрема й під час вимушеного, внаслідок карантину. При цьому такі форма і засоби навчання вимагають від викладача вдосконалення викладання як за змістом, так і за його формою й оволодіння сучасними засобами та методами навчання і, водночас, забезпечують виконання навчального навантаження.

Ефективне поєднання інтерактивних методів навчання та систем електронних освітніх платформ протягом дистанційного навчання дозволяє забезпечити максимальне здобуття студентом практичних знань й умінь, розвинути його комунікативні компетентності, забезпечує високий рівень клінічного мислення, полегшить поєднання теоретичних знань з практичною діяльністю після закінчення карантинних обмежень і може бути рекомендованим для широкого впровадження в навчальний процес у закладах вищої освіти та безперервного професійного розвитку лікарів через запровадження доступних слухачам освітніх платформ із широким використанням наявних WEB-ресурсів.
Seeing Double(s)
Authors: D’Alconzo Nicolò
Published: January 2021

This article considers the Lucianic Erôtes a receptor of Greek novels and focusses on Chariton’s Callirhoe as hypotext. It argues that Chariton’s construction of Callirhoe as a double of Aphrodite, and the plot that this predicament generates, are central to the presentation of the statue of Aphrodite in the Erôtes. This is revealed by consistent verbal echoes and by the re-enactment of memorable scenes in the novel. The Erôtes emerges as an important document for the early reception of Greek novels, and its author as an attentive reader of them.
Understanding of Growth Mechanism and Structure of Multilayer Thin Films via Layer-by-Layer Hydrogen Bonded Assembly from Polymer Brushes-Grafted Surface
Authors: Wei Hua , Zhang Hua , Zhou Yang , Wang Zongbao , Wang Rong , Chen Jing
Published: January 2021

This study demonstrated the feasibility of polymer brushes-modified plate substrate as template to construct multilayer thin films via layer-by-layer hydrogen bonded assembly. The anchored chains via controlled surface-initiated atom transfer radical polymerization (SI-ATRP). The anchored
poly(4-vinylpyridine) brushes functions as a multivalent H-acceptor to regulate the following hydrogen bonded assembly with H-donors to construct multilayer thin films via layer-by-layer deposition technique. The growth mechanism and film natures of multilayer films mediated by hydrogen bonded
assembly from a polymer brushes-grafted surface were fully investigated.
Seasonal Variation of the Westerly Jet over Asia in the Last Glacial Maximum: Role of the Tibetan Plateau Heating
Authors: Lei Jing , Shi Zhengguo , Xie Xiaoning , Sha Yingying , Li Xinzhou , Liu Xiaodong , An Zhisheng
Published: January 2021

The westerly jet (WJ) is an important component of atmospheric circulation, which is characterized by prominent seasonal variations in intensity and position. However, the response of the WJ over Asia during the Last Glacial Maximum (LGM) is still not clear. Using general circulation model experiments, the seasonal behaviors of the WJ over central Asia and Japan are analyzed in this paper. The results show that, compared to the present day (PD), the WJ presents a complicated response during the LGM, both in intensity and position. Over central Asia, it becomes weaker in both summer and winter. But over Japan, it is enhanced in summer but becomes diminished in winter. In terms of position, the WJ over central Asia shifts southward in both summer and winter, whereas the WJ over Japan moves southward in summer but does not change obviously relative to PD in winter. Such WJ changes are well explained by meridional temperature gradients in high troposphere, which is closely linked to seasonal thermal anomalies over the Tibetan Plateau (TP). Despite cooler LGM conditions, the anomalous warming center over the TP becomes stronger in summer. Derived from the heat budget equation, the stronger heating center is mainly caused by the weaker adiabatic cooling generated from ascending motion over the area south of the TP. In winter, the cooling over the TP is also strengthened, mostly owing to the subsidence-induced weaker adiabatic heating. Due to the importance of the WJ, the potential role of TP thermal effects should be a focus when explaining the East Asian climate change during the LGM.
Efficiency of Time Series Homogenization: Method Comparison with 12 Monthly Temperature Test Datasets
Authors: Domonkos Peter , Guijarro José A. , Venema Victor , Brunet Manola , Sigró Javier
Published: January 2021

The aim of time series homogenization is to remove nonclimatic effects, such as changes in station location, instrumentation, observation practices, and so on, from observed data. Statistical homogenization usually reduces the nonclimatic effects but does not remove them completely. In the Spanish “MULTITEST” project, the efficiencies of automatic homogenization methods were tested on large benchmark datasets of a wide range of statistical properties. In this study, test results for nine versions, based on five homogenization methods—the adapted Caussinus-Mestre algorithm for the homogenization of networks of climatic time series (ACMANT), “Climatol,” multiple analysis of series for homogenization (MASH), the pairwise homogenization algorithm (PHA), and “RHtests”—are presented and evaluated. The tests were executed with 12 synthetic/surrogate monthly temperature test datasets containing 100–500 networks with 5–40 time series in each. Residual centered root-mean-square errors and residual trend biases were calculated both for individual station series and for network mean series. The results show that a larger fraction of the nonclimatic biases can be removed from station series than from network-mean series. The largest error reduction is found for the long-term linear trends of individual time series in datasets with a high signal-to-noise ratio (SNR), where the mean residual error is only 14%–36% of the raw data error. When the SNR is low, most of the results still indicate error reductions, although with smaller ratios than for large SNR. In general, ACMANT gave the most accurate homogenization results. In the accuracy of individual time series ACMANT is closely followed by Climatol, and for the accurate calculation of mean climatic trends over large geographical regions both PHA and ACMANT are recommended.
Enhanced Tropical Eastern Indian Ocean Rainfall Breaks Down the Tropical Easterly Jet–Indian Rainfall Relationship
Authors: Huang Sihua , Wang Bin , Wen Zhiping , Chen Zesheng
Published: January 2021

Previous studies found a tight connection between the tropical easterly jet (TEJ) and Indian summer monsoon rainfall (ISMR). Here we show that the TEJ–ISMR relationship is nonstationary and breaks down from 1994 to 2003 (epoch P2), in contrast to the significant positive correlation during epochs P1 (1979–93) and P3 (2004–16). The breakdown of the TEJ–ISMR relationship concurs with the increased rainfall variability over the tropical eastern Indian Ocean (TEIO). The enhanced TEIO rainfall anomalies excite a significant lower-level cyclonic circulation that reduces the ISMR and meanwhile strengthen the upper-level divergence and excite a pair of upper-level anticyclones to the west of the TEIO as Rossby wave responses, both accelerating the TEJ. Thus, the TEIO rainfall plays a more important role than the ISMR in TEJ variability during P2, causing the breakdown of the TEJ–ISMR relationship. In contrast, a relatively weak amplitude of the TEIO rainfall during P1 and P3 was unable to change the positive TEJ–ISMR relationship. The changes in the TEIO rainfall variability are mainly attributed to the increased SST variability over the tropical southeastern Indian Ocean, but their cause remains elusive.
Climate Change Observations of Indigenous Communities in the Indian Himalaya
Authors: Negi Vikram S. , Thakur Shinny , Dhyani Rupesh , Bhatt Indra D. , Rawal Ranbeer S.
Published: January 2021

Mountains are important global sites for monitoring biological and socioecological responses to climate change, and the Himalaya has some of the world’s most rapid and visible signs of climate change. The increased frequency and severity of climate anomalies in the region are expected to significantly affect livelihoods of indigenous communities in the region. This study documents the perceptions of indigenous communities of climate change in the western Himalaya of India. The study highlights the power of knowledge and understanding available to indigenous people as they observe and respond to climate change impacts. We conducted a field-based study in 14 villages that represent diverse socioecological features along an altitudinal range of 1000–3800 m MSL in the western Himalaya. Among the sampled population, most of the respondents (>95%) agreed that climate is changing. However, people residing at low- and high-altitude villages differ significantly in their perception, with more people at high altitudes believing in an overall warming trend. Instrumental temperature and rainfall from nearby meteorological stations also supported the perception of local inhabitants. The climate change perceptions in the region were largely determined by sociodemographic variables such as age, gender, and income as well as altitude. A logistic regression, which exhibited significant association of sociodemographic characteristics with climate change perceptions, further supported these findings. The study concluded that the climate change observations of local communities can be usefully utilized to develop adaptation strategies and mitigation planning in the Himalayan region.
Evaluation of Clinical Outcomes After Revascularization in Patients With Chronic Limb-Threatening Ischemia: Results From a Prospective National Cohort Study (RIVALUTANDO)
Authors: de Donato Gianmarco , Benedetto Filippo , Stilo Francesco , Chiesa Roberto , Palombo Domenico , Pasqui Edoardo , Panzano Claudia , Pulli Raffaele , Novali Claudio , Silingardi Roberto , Grego Francesco , Palasciano Giancarlo , Setacci Carlo ,   RIVALUTANDO Collaborators
Published: January 2021

We evaluated the outcomes of revascularization in patients with chronic limb-threatening ischemia (CLTI) treated in real-world settings. This is a prospective multicenter cohort study with 12-month follow-up enrolling patients (n = 287) with CLTI undergoing open, endovascular, or hybrid lower extremity revascularization. The primary end point was amputation-free survival (AFS) at 12 months. Cox proportional analysis was used to determine independent predictors of amputation and restenosis. At 30 days, major adverse cardiovascular and major adverse limb events (MALE) rates were 3.1% and 2.1%, respectively. At 1 year, the overall survival rate was 88.8%, the AFS was 86.6%, and the primary patency was 70.5%. Freedom from MALE was 62.5%. After multivariate analysis, smoking (hazard ratio [HR] = 2.2, P = 0.04), renal failure (HR = 2.3, P = 0.03), Rutherford class (≥5) (HR = 3.2, P = 0.01), and below-the-knee disease (HR = 2.0, P = 0.05) were significant predictors of amputation; iloprost infusion (>10 vials) (HR = 0.64, P = 0.05) was a significant protective factor. Cilostazol administration (HR = 0.77, P = 0.05) was a significant protective factor for restenosis. Results from this prospective multicenter registry offer a consistent overview of clinical outcomes of CLTI patients at 1 year when adequately revascularized. Medical treatment, including statins, cilostazol and iloprost, were associated with improved 1-year freedom from restenosis and amputation.
Extraction method of composite fault features of gear transmission system based on demodulation of NMD and Teager energy operators
Authors: Wang Jingyue , Liu Yuefu , Wang Haotian , E Jiaqiang
Published: January 2021

In order to effectively identify and extract the composite fault characteristics of the gear transmission system, a composite fault diagnosis method combining nonlinear mode decomposition (NMD) and Teager energy operator demodulation is proposed. Because the envelope demodulation of Hilbert transform has the disadvantages of large amount of calculation and end effect, it uses Teager energy operator to solve the problem of large amount of calculation, and NMD solves the problem that the fault signal features is not easy to extract under the mode aliasing. First, the NMD method is used to decompose the fault simulation signal, and the nonlinear modal component with practical physical significance is obtained. Secondly, the Teager energy operator demodulation is carried out for the nonlinear modal components, and the demodulation results are analyzed to verify the feasibility of the method. Then, the method is applied to the composite fault diagnosis of gear pitting wear in gear transmission system, and the characteristic frequency obtained from the test data is compared with the calculated characteristic frequency. The comparative analysis shows that the method can separate the fault characteristic frequencies of large and small gears. The comparative analysis with EMD and EEMD methods in simulation signal analysis and experimental research shows that this method is superior.
Optimization and selection of Galileo triple-frequency carrier linear combination
Authors: Wang Jun , Dong Xurong , Fu Wei , Yan Di , Shi Zengkai
Published: January 2021

The triple-frequency linear combination with a low noise, a long wavelength, and a weak ionosphere is beneficial to effectively eliminate or weaken the common errors, advance the reliability of cycle slip detection and repair, and speed up the convergence time of fixed ambiguity. By establishing the Galileo triple-frequency carrier linear combination model, three types of linear combinations are derived: Geometry-free (GF) combinations, minimum noise (MN) combinations, and ionosphere-free (IF) combinations. The geometric relationships of these linear combinations are displayed in the form of image. The results indicate that the angle formed by the IF combinations and the MN combinations is between 75.02° and 86.01°, which also illustrates that it is more difficult to meet the carrier phase combinations with a low noise and a weak ionosphere. Moreover, to guarantee the integer cycle characteristics of ambiguity, the combination coefficient must be an integer. Galileo triple-frequency linear combination is solved utilizing the extremum method. To sum up, the sum of the coefficients of the extra wide lane (EWL) combinations and wide lane (WL) combinations is zero, and the sum of the coefficients of the narrow lane (NL) combinations is one. (0, 1, −1) is the optimal triple-frequency linear combination in Galileo. Three independent linear combinations are selected separately from the EWL, WL, and NL to jointly solve the integer ambiguity. Further, it creates a prerequisite for high-precision and real-time kinematic positioning.
Uncertain Choices: The Heterogeneous Multinomial Logit Model
Authors: Tutz Gerhard
Published: January 2021

In this article, a modeling strategy is proposed that accounts for heterogeneity in nominal responses that is typically ignored when using common multinomial logit models. Heterogeneity can arise from unobserved variance heterogeneity, but it may also represent uncertainty in choosing from alternatives or, more generally, result from varying coefficients determined by effect modifiers. It is demonstrated that the bias in parameter estimation in multinomial logit models can be substantial if heterogeneity is present but ignored. The modeling strategy avoids biased estimates and allows researchers to investigate which variables determine uncertainty in choice behavior. Several applications demonstrate the usefulness of the model.
Inspiration and Exasperation: The Challenges of Inhaled Biologics
Authors: Hall Peter , Vahle John L. , Colman Karyn
Published: January 2021

The delivery of biotherapeutic molecules (antibodies, proteins, peptides) and nucleic acids via the respiratory route has presented challenges for regulatory approval, due in part to a lack of understanding of the expected pathology, mechanisms of toxicity, and immunogenicity induced by the inhalation route. Although the first inhaled biotherapeutic was approved some time ago (Dornase Alfa, Pulmozyme; Genetech, 1993), no other inhaled biotherapeutics have been marketed for the treatment of human disease other than the inhaled insulins (Exubera; Pfizer, 2006 and Afrezza; Mannkind Corporation, 2014). As a result, scientific knowledge within the toxicologic pathology community is fragmented with precious little publicly available data. Therefore, one of the aims of this special edition was to generate a collection of manuscripts that pathologists and toxicologists could refer in order to understand the pathology, mechanisms of toxicity, immunogenicity, and challenges associated with the development of inhaled biotherapeutics.
Neo-Despotism as Anti-Despotism
Authors: Diken Bülent
Published: January 2021

I treat despotism as a virtual concept. Thus it is necessary to expose its actualizations even when it appears as its opposite, refusing to recognize itself as despotism. I define despotism initially as arbitrary rule, in terms of a monstrous transgression of the law. But since the monster is grounded in its very formlessness, it cannot be demonstrated. However, one can always try to de-monstrate it through disagreements. In doing this, I deal with despotism not as a solipsistic undertaking but as part of a constellation that always already contains two other elements: economy and voluntary servitude. I give three different – ancient, early modern and late modern – accounts of this nexus, demonstrating how despotism continuously takes on new appearances. I conclude, in a counter-classical prism, how the classical nexus has evolved in modernity while the focus gradually shifted towards another triangulation: neo-despotism, use and dissent.
State Early Learning and Development Standards: A Unified Curriculum Framework for All Young Children
Authors: Bruder Mary Beth , Ferreira Kelly E.
Published: January 2021

Early learning and development standards (ELDS) describe the knowledge, skills, and dispositions young children should demonstrate before kindergarten. This article describes a review of state ELDS for children from birth to 5 years of age to determine if they included information and guidance about the learning needs of young children with developmental delays. A national search of ELDS located 79 documents that represented 53 U.S. states and territories. The review of the documents revealed that a majority of state ELDS had references to young children with developmental delays (89%), but statements and guidance describing specific accommodations for this population were not prevalent. Only two states had supplemental documents addressing the learning needs of young children with developmental delays to facilitate their inclusion in state ELDS. Implications of these findings and recommendations to facilitate the use of ELDS with all young children in inclusive early childhood programs and classrooms are discussed.
Influence of Rail Transit on Development Patterns in the Mountain Mega-Region with a Surprise and Implications for Rail Transit and Land-Use Planning
Authors: Nelson Arthur C. , Hibberd Robert
Published: January 2021

Between 2020 and 2050, all states comprising the Mountain Mega-Region (MMR—Arizona, Colorado, Nevada, New Mexico, and Utah) will be among the top 10 fastest growing U.S. states. They also have among the nation’s largest shares of land area in federal, state, public, and tribal land ownership. This has led to concentrations of populations in their metropolitan areas. Indeed, in 2020, the metropolitan areas of more than one million residents—Albuquerque, Las Vegas, Phoenix, Salt Lake City, and Tucson—comprise more than 70% of their states’ populations. With rapid growth combined with land constraints, many of these metropolitan areas are using rail transit systems to help meet transportation needs while also influencing development patterns in intended ways. If they are effective, these rail transit systems will: (a) create commercial real estate rent premiums; (b) attract jobs; and (c) attract households to areas near rail stations. We report the effectiveness of MMR rail transit systems in each of these respects. We also present a surprise: Contrary to conventional wisdom, it is households with children that locate closest to rail stations than single persons and childless households. We reason that improved planning is needed to meet the market demand for development throughout the half-mile circle around transit stations in the MMR’s metropolitan areas. If this can be done, all development in these MMR metropolitan areas may occur near rail transit stations.
Complications and Sequelae in Patients With Congenital Microcephaly Associated With Zika Virus Infection: Two-Year Follow-Up
Authors: Gouvea Luane A. , Martins Marlos , Vivacqua Daniela , Rosseto Julia , Lima Giulia , Frota Ana Cristina , Abreu Thalita , Araujo Alexandra , Hofer Cristina Barroso
Published: January 2021

Background:

We aim to describe the long term follow-up of a cohort of children exposed in utero to the Zika virus.

Methods:

Descriptive study of a cohort of microcephalic children due to Zika virus. Logistic regression was used to evaluate variables associated with worse prognosis epilepsy.

Results:

We followed 28 children (15 females), with a median follow-up of 24 months (IQR = 12-28). During the follow-up, 1 infant died. The median head circumference at birth was 29 cm (IQR = 27-31). All presented a global developmental delay. The most frequent central nervous system abnormalities were on cortical development in 22 participants; dysgenesis of corpus callosum in 13; ventriculomegaly in 25; and calcifications in 24. A total of 9 presented ocular abnormalities, 4 auditory impairment. During follow-up, 12 presented with sleep disorders, 10 with irritability, and 23 with epilepsy (2 with generalized tonic-clonic, 3 with generalized tonic-clonic and spasms, 12 with spasms, 3 tonic and spasms, and 3 motor focal and spasms). The median age at the begin of the epilepsy was 4 months (IQR = 2-10), the median number of drugs used to control the epilepsy was 2 (IQR = 2-3). Maternal illicit drug use during pregnancy was associated with worse prognosis epilepsy (Lennox-Gastaut syndrome, West syndrome, or status epilepticus). A total of 19 presented with dysphagia, 10 children required gastrostomy.

Conclusion:

Children with microcephaly due to Zika virus presented with several complications during follow-up, as epilepsy, spastic diplegia, and global developmental delay.
Robust steering assistance control for tracking large-curvature path considering uncertainties of driver’s steering behavior
Authors: Wang Jinxiang , Fang Zhenwu , Dai Mengmeng , Yin Guodong , Xia Jingjing , Li Pu
Published: January 2021

A human-machine shared steering control is presented in this paper for tracking large-curvature path, considering uncertainties of driver’s steering characteristics. A driver-vehicle-road (DVR) model is proposed in which uncertain characteristic parameters are defined to describe the human driver’s steering behaviors in tracking large-curvature path. Then the radial basis function neural network (RBF) is used to estimate parameters of different drivers’ characteristics and to obtain the boundaries of these parameters. Parameter uncertainties of the driver’s steering characteristics and time-varying vehicle speed of the DVR model are handled with the Takagi-Sugeno (T-S) fuzzy logic. And these parameter uncertainties are considered in the design of the shared steering controller. Then based on the DVR model, a T-S fuzzy full-order dynamic compensator with D-pole assignment is designed to assist driver’s steering for tracking path with large curvature. Simulation results show that the proposed controller can provide individual levels of steering assistance in path following according to driver’s proficiency, and can improve driving comfort significantly.
Micromechanical modeling of architected piezoelectric foam with simplified boundary conditions for hydrophone applications
Authors: Khan Kamran A , Alarafati Hamad K , Khan Muhammad Ali
Published: January 2021

Architected piezoelectric materials with controlled porosity are of interest for applications such as hydrophones, miniature accelerometers, vibratory sensors, and contact microphones. Current analytical modeling approach cannot be readily applied to design architected periodic piezoelectric foams with tunable properties while exhibiting elastic anisotropy and piezoelectric activity. This study presents micromechanical-finite element (FE) models to characterize the electromechanical properties of architected piezoelectric foams. The microstructure with zero-dimension (3-0 foam, spherical porosity) and one-dimensional (3-1 foam, cylindrical porosity) connectivity were considered to analyze the effect of porosity connectivity on the performance of piezoelectric foam. 3D FE models of the 3-0 and 3-1 foams were developed and using the intrinsic symmetry of porous structures simplified mixed boundary conditions (MBCs) equivalent to periodic boundary conditions (PBC) were proposed. The proposed approach is simple and eliminates the need of tedious mesh generation process on opposite boundary faces on the micromechanical model of porous microstructures with PBCs. The results obtained from the proposed micromechanics-FE models were compared with those obtained by means of the analytical models based on micromechanics theories, and FE models with PBCs reported in the literature for both 3-0 and 3-1 type foams. An excellent agreement was observed. The computed effective elastic, piezoelectric and dielectric properties and corresponding figure of merit (FOM) revealed that piezoelectric foams with 3-0 connectivity exhibit enhanced hydrostatic FOM as compared to piezoelectric foams with 3-1 connectivity. It is concluded that spherical porosity is more suitable to hydrophone applications.
COVID-19 among immigrants in Norway, notified infections, related hospitalizations and associated mortality: A register-based study
Authors: Indseth Thor , Grøsland Mari , Arnesen Trude , Skyrud Katrine , Kløvstad Hilde , Lamprini Veneti , Telle Kjetil , Kjøllesdal Marte
Published: January 2021

Aim: Research concerning COVID-19 among immigrants is limited. We present epidemiological data for all notified cases of COVID-19 among the 17 largest immigrant groups in Norway, and related hospitalizations and mortality. Methods: We used data on all notified COVID-19 cases in Norway up to 18 October 2020, and associated hospitalizations and mortality, from the emergency preparedness register (including Norwegian Surveillance System for Communicable Diseases) set up by The Norwegian Institute of Public Health to handle the pandemic. We report numbers and rates per 100,000 people for notified COVID-19 cases, and related hospitalizations and mortality in the 17 largest immigrant groups in Norway, crude and with age adjustment. Results: The notification, hospitalization and mortality rates per 100,000 were 251, 21 and five, respectively, for non-immigrants; 567, 62 and four among immigrants; 408, 27 and two, respectively, for immigrants from Europe, North-America and Oceania; and 773, 106 and six, respectively for immigrants from Africa, Asia and South America. The notification rate was highest among immigrants from Somalia (2057), Pakistan (1868) and Iraq (1616). Differences between immigrants and non-immigrants increased when adjusting for age, especially for mortality. Immigrants had a high number of hospitalizations relative to notified cases compared to non-immigrants. Although the overall COVID-19 notification rate was higher in Oslo than outside of Oslo, the notification rate among immigrants compared to non-immigrants was not higher in Oslo than outside. Conclusions: We observed a higher COVID-19 notification rate in immigrants compared to non-immigrants and much higher hospitalization rate, with major differences between different immigrant groups. Somali-, Pakistani- and Iraqi-born immigrants had especially high rates.
Built Environment and Self-Rated Health: Comparing Young, Middle-Aged, and Older People in Chengdu, China
Authors: Lyu Yingying , Forsyth Ann , Worthington Steven
Published: January 2021

Objectives:

This article explores how the building-scale built environment is associated with self-rated health, examining differences in this association among younger, middle-aged, and older age groups. Features examined included building type, building condition, and sidewalk presence in front of dwellings.

Background:

Understanding how the relationships between built environments and health vary across age groups helps to build a healthy environment for all. However, most studies have concentrated on the neighborhood or indoor environment, rather than whole buildings, and few have compared age groups.

Methods:

This study analyzed survey data from 1,019 adults living in 40 neighborhoods in Chengdu, China, recruited through a clustered random sampling approach. It used a Bayesian logistic mixed-effects model with interaction terms between age-group indicators and other variables.

Results:

Significant differences exist in the relationships of self-rated health with some environmental and other indicators among age groups. For older people, living in multi-floor buildings, having a household smoker, and undertaking fewer hours of weekly exercise were associated with lower odds of reporting good, very good, or excellent health. These relationships were not identified among middle-aged and younger people. More education was associated with higher odds of reporting better health among older and middle-aged groups.

Conclusions:

Older people experience more health-related challenges compared to middle-aged and younger people. However, among the examined built environment factors, building type was the only significant factor related to self-rated health among older people. To promote health among older people, this study recommends adding elevators in the multi-floor buildings.
Total Ankle Arthroplasty Survivorship, Complication, and Revision Rates in Patients Younger Than 55 Years
Authors: Consul Devon W. , Chu Anson , Langan Travis M. , Hyer Christopher F. , Berlet Gregory
Published: January 2021

Total ankle replacement has become a viable alternative to ankle arthrodesis in the surgical management of advanced ankle arthritis. Total ankle replacement has generally been reserved for patients who are older and for those who will have a lower demand on the replacement. The purpose of the current study is to review patient outcomes, complications, and implant survival in patients younger than 55 years who underwent total ankle replacement at a single institution. A single-center chart and radiographic review was performed of consecutive patients who underwent total ankle replacement for treatment of end-stage ankle arthritis. All surgeries were performed by 1 of 5 fellowship-trained foot and ankle surgeons at a single institution. A total of 51 patients met inclusion criteria with a mean follow-up of 31.2 months (SD = 16.2). Implant survival was 94%, There were 7 major complications (13%) requiring an unplanned return to the operating room and 8 minor complications (15%) that resolved with conservative care. The results of this study show that total ankle replacement is a viable treatment option for patients younger than 55 years.

Levels of Evidence: A retrospective case series
Heart Transplantation for Pediatric and Congenital Cardiac Disease: A Comparison of Two Eras over 23 Years and 188 Transplants at a Single Institution
Authors: Tuite Genevieve C. , Quintessenza James A. , Asante-Korang Alfred , Ghazarian Sharon R. , Wisotzkey Bethany L. , Shah Shawn , Stapleton Gary E. , Decker Jamie A. , Herbert Carrie E. , Kartha Vyas , Alexander Plato , Carapellucci Jennifer , Krasnopero Diane , Hanson Jade , Goldenberg Neil A. , Do Nhue L. , Mavroudis Constantine , Karl Tom R. , Boucek Robert J. , Kutty Shelby , Vricella Luca A. , van Gelder Hugh M. , Jacobs Jeffrey P.
Published: January 2021

Background:

To assess changes in patterns of practice and outcomes over time, we reviewed all patients who underwent heart transplantation (HTx) at our institution and compared two consecutive eras with significantly different immunosuppressive protocols (cohort 1 [80 HTx, June 1995-June 2006]; cohort 2 [108 HTx, July 2006-September 2018]).

Methods:

Retrospective study of 180 patients undergoing 188 HTx (June 1995-September 2018; 176 first time HTx, 10 second HTx, and 2 third HTx). In 2006, we commenced pre-HTx desensitization for highly sensitized patients and started using tacrolimus as our primary postoperative immunosuppressive agent. The primary outcome was mortality. Survival was modeled by the Kaplan-Meier method. Univariable and multivariable Cox proportional hazard models were created to identify prognostic factors for survival.

Results:

Our 188 HTx included 18 neonates, 85 infants, 83 children, and 2 adults (>18 years). Median age was 260.0 days (range: 5 days-23.8 years). Median weight was 7.5 kg (range: 2.2-113 kg). Patients in cohort 1 were less likely to have been immunosensitized preoperatively (12.5% vs 28.7%, P = .017). Nevertheless, Kaplan-Meier analysis suggested superior survival in cohort 2 ( P = .0045). Patients in cohort 2 were more likely to be alive one year, five years, and ten years after HTx. Multivariable analysis identified the earlier era (hazard ratio [HR] [95% confidence interval] for recent era = 0.32 [0.14-0.73]), transplantation after prior Norwood operation (HR = 4.44 [1.46-13.46]), and number of prior cardiac operations (HR = 1.33 [1.03-1.71]) as risk factors for mortality.

Conclusions:

Our analysis of 23 years of pediatric and congenital HTx reveals superior survival in the most recent 12-year era, despite the higher proportion of patients with elevated panel reactive antibody in the most recent era. This improvement was temporally associated with changes in our immunosuppressive strategy.