bluuebunny/crossref_metadata_2025 huggingface dataset:
Charge algebra in Al(A)dSn spacetimes
Authors: Fiorucci Adrien , Ruzziconi Romain
Published: May 2021

Abstract

The gravitational charge algebra of generic asymptotically locally (A)dS spacetimes is derived in n dimensions. The analysis is performed in the Starobinsky/Fefferman-Graham gauge, without assuming any further boundary condition than the minimal falloffs for conformal compactification. In particular, the boundary structure is allowed to fluctuate and plays the role of source yielding some symplectic flux at the boundary. Using the holographic renormalization procedure, the divergences are removed from the symplectic structure, which leads to finite expressions. The charges associated with boundary diffeomorphisms are generically non-vanishing, non-integrable and not conserved, while those associated with boundary Weyl rescalings are non-vanishing only in odd dimensions due to the presence of Weyl anomalies in the dual theory. The charge algebra exhibits a field-dependent 2-cocycle in odd dimensions. When the general framework is restricted to three-dimensional asymptotically AdS spacetimes with Dirichlet boundary conditions, the 2-cocycle reduces to the Brown-Henneaux central extension. The analysis is also specified to leaky boundary conditions in asymptotically locally (A)dS spacetimes that lead to the Λ-BMS asymptotic symmetry group. In the flat limit, the latter contracts into the BMS group in n dimensions.
Gauge invariant perturbation theory via homotopy transfer
Authors: Chiaffrino Christoph , Hohm Olaf , Pinto Allison F.
Published: May 2021

Abstract

We show that the perturbative expansion of general gauge theories can be expressed in terms of gauge invariant variables to all orders in perturbations. In this we generalize techniques developed in gauge invariant cosmological perturbation theory, using Bardeen variables, by interpreting the passing over to gauge invariant fields as a homotopy transfer of the strongly homotopy Lie algebras encoding the gauge theory. This is illustrated for Yang-Mills theory, gravity on flat and cosmological backgrounds and for the massless sector of closed string theory. The perturbation lemma yields an algorithmic procedure to determine the higher corrections of the gauge invariant variables and the action in terms of these.
Correction to: The PanSurg‐PREDICT Study: Endocrine Surgery During the COVID‐19 Pandemic
Authors: Van Den Heede K. , Chidambaram S. , Winter Beatty J. , Chander N. , Markar S. , Tolley N. S. , Palazzo F. F. , Kinross J. K. , Di Marco A. N. ,   the PanSurg Collaborative and the PREDICT‐Endocrine Collaborative, Beatty Jasmin Winter , Chidambaram Swathikan , Markar Sheraz , Kinross James K. , Di Marco Aimee N. , Kulshreshtha Ayush , Aseem Rabiya , Deurloo Emily K. , Quinnen Nicola C. , Cruz Nina J. M. DeLa , Yiu Andrew J. , Khan Natasha , Markiewicz Ola , Goh Ee Teng , Denning Max , Aggarwal Ravi , Mason Sam , Erridge Simon , Dryden Simon D. , Clarke Jonathan M. , Sounderajah Viknesh , Acharya Amish , Rabinowicz Simon , Yalamanchili Seema , Martin Guy , Warren Leigh , Scott Alasdair J. , Burgnon Elizabeth , Purkayastha Sanjay , Mechera Robert , Glover Anthony , Papachristos Alex , Xuan Rachel , Glover Anthony , Dhondt Bert , Azab Mohammed A. , Azzam Ahmed Y. , Balalis Dimitris , Fradelos Evangelos , Korkolis Dimitris P. , Skotsimara Antonia , Baili Efstratia , Kyros Eleandros , Felekouras Evangelos , Vagios Ilias , Karydakis Lyssandros , Mpoura Maria , Syllaios Athanasios , Davakis Spyridon , Liakakos Theodore , Charalabopoulos Alexandros , Fulop Andras , Szijarto Attila , Bhat Javeid , Parray Fazl , Aziz Gowhar , Chowdri Nisar , Wani Rauf , Shah Zameer , Andrabi Syed Muzamil , Mehraj Asif , Fowler Amy , Chaudhary Ali , Murphy Ben , van der Hoef Dayna , Ryan Eanna , O′Beirn Ellen , Marzouk Fadi , McKevitt Kevin , Nizami Kulsoom , Grewal Harleen , Hennessy Orla , Roden Yasmine , Elwahab Sami A. , Collins Christopher , Ayed Souad , Alwade Hajer , Aldaya Messedah , Magboul Nasir A. , Ali Alshahrani Mushabab , Ingwersen Ewout W. , Meijer Floor , Van Dijkum Els J. M. Nieveen , Voeten Daan M. , Gisbertz Suzanne S. , Van Berge Henegouwen Mark I. , Engelsman Anton F. , Yalcinkaya Ali , Sahin Can , Yavas Mesut , Yavuz Aydin , Gobut Huseyin , Bostanci Hasan , Sare Mustafa , Yuksel Osman , Kozan Ramazan , Altiner Saygin , Leventoglu Sezai , Kocataş Ali , Bozkurt Mehmet A. , Kara Yasin , Aybar Engin , Sari Ahmet Can , Colak Elif M. , Rooney Siobhan , Nandasena Malith , Balakrishnan Anita , De Jong Mechteld C. , Mihai Radu , Khan Shahab , Van Den Heede Klaas , Chander Nikita , Chidambaram Swathikan , Palazzo Fausto , Tolley Neil , Di Marco Aimee , Parkins Kristie , Spencer Naomi , Egan Richard J.
Published: May 2021

A correction to this paper has been published: https://doi.org/10.1007/s00268‐021‐06171‐8
Acupuncture is associated with a positive effect on odour discrimination in patients with postinfectious smell loss—a controlled prospective study
Authors: Drews Tanja , Hummel Thomas , Rochlitzer Bettina , Hauswald Bettina , Hähner Antje
Published: May 2021

Introduction

Smell disorders are common in the general population and occur e.g., after infections, trauma or idiopathically Treatment strategies for smell loss range from surgery, medication to olfactory training, depending on the pathology, but they are limited This study examined the effect of acupuncture on olfactory function.

Methods

Sixty patients with smell loss following infections of the upper respiratory tract were included in this investigation Half of the study group were randomly assigned to verum acupuncture and the other half to sham acupuncture Olfaction was measured by means of the “Sniffin’ Sticks” test battery (odour threshold, discrimination and identification).

Results

Compared to sham acupuncture, verum was associated with an improvement of smell function as measured by the TDI score (p = 0.039) The improvement was largely determined by improvement in odour discrimination, and was significantly better in patients with a shorter duration of the disorder.

Conclusion

The present results suggest that acupuncture is an effective supplementary treatment option for patients with olfactory loss.
Simultaneous right-sided nephrectomy with orthotopic liver and kidney transplantation—An alternative method for patients with autosomal dominant polycystic liver and kidney disease
Authors: Felgendreff Philipp , Tautenhahn Hans-Michael , Lux Sascha , Dondorf Felix , Aschenbach René , Rauchfuss Falk , Settmacher Utz
Published: May 2021

Purpose

In patients suffering from autosomal dominant polycystic liver and kidney disease (ADPLKD), combined organ transplantation often poses a technical challenge due to the large volume of both organs. To simplify the transplantation procedure by improving the exposure of anatomical structures, we introduce a novel surgical technique of orthotopic liver and kidney transplantation.

Methods

The modified simultaneous liver and kidney transplantation technique via a right-sided L-incision included three steps: (1) right-sided nephrectomy in the recipient followed by (2) orthotopic liver transplantation in cava replacement technique and (3) the orthotopic kidney transplantation with arterial reconstruction to the right common iliac artery.

Results

In total, seven patients with ADPLKD were transplanted by using the modified transplantation technique. The mean operation time was 342.43 min (±68.77). Postoperative patients were treated for 6.28 days (±2.50) in the intensive care unit and were discharged from the surgical ward approximately 28 days (±5.66) after the operation with normal graft function. Complications associated with the use of the modified technique, such as bleeding, anastomotic stenosis, biloma, or urinoma, did not occur.

Conclusion

Modified simultaneous liver and kidney transplantation is a safe alternative for patients with ADPLKD. By combining right-sided nephrectomy and orthotopic graft transplantation, the approach optimizes the exposure of anatomical structures and simplifies the transplantation procedure. Additionally, the modified transplantation technique does not require a particular organ explantation procedure and can be applied for all liver and kidney grafts.
Cerebrospinal fluid α synuclein concentrations in patients with positive AD biomarkers and extrapyramidal symptoms
Authors: Winkel Izabela , Ermann Natalia , Żelwetro Agnieszka , Sambor Bożydar , Mroczko Barbara , Kornhuber Johannes , Paradowski Bogusław , Lewczuk Piotr
Published: May 2021

Extrapyramidal symptoms (EP) are not uncommon in Alzheimer’s Disease (AD); when present, they negatively influence the course of the disorder. A large proportion of AD patients shows concomitant Lewy bodies’ pathology post mortem. Total α Synuclein (αSyn) concentrations are frequently increased in the cerebrospinal fluid (CSF) of AD patients, but are decreased in Parkinson’s Disease (PD) and Dementia with Lewy Bodies (DLB). αSyn CSF concentrations in AD patients with EP (EP+) have not been reported so far. αSyn and the four Neurochemical Dementia Diagnostics (NDD) CSF biomarkers, (Aβ1-42, Aβ42/40, Tau, and pTau181), interpreted according to the Erlangen Score algorithm, were measured in patients with positive NDD results and presence of extrapyramidal symptoms (NDD + / EP+; n = 26), in patients with positive NDD results and absence of extrapyramidal symptoms (NDD+ / EP−; n = 54), and in subjects with negative NDD results (NDD−; n = 34). Compared to the NDD− controls (379.8 ± 125.2 pg/mL), NDD+ patients showed, on average, highly significantly increased CSF αSyn (519 ± 141.3 pg/mL, p < 0.01), but without differences between NDD+ / EP+ and NDD+ / EP− subgroups (p = 0. 38). Moderate but highly significant association was observed between concentrations of αSyn and Tau (r = 0.47, p < 0.01) and pTau181 (r = 0.65, p < 0.01). Adjusted for diagnoses, age, and sex, subjects with more advanced neurodegeneration on neuroimaging showed significantly lower αSyn concentrations (p < 0.02). In the setting AD versus controls, the area under the receiver operating characteristic (ROC) curve was 0.804 [0.712; 0.896] with the sensitivity and the specificity of 0.863 and 0.618, respectively. αSyn in AD patients does not differentiate between subjects with- and without EP. Its increased average concentration reflects probably neurodegenerative process, and is not specific for any pathophysiologic mechanisms. Further studies are necessary to explain the role of CSF αSyn as a potential biomarker.
Pilot testing an intervention to educate and promote nutritious choices at food pantries
Authors: McKee Sarah L. , Gurganus Eminet Abebe , Atoloye Abiodun T. , Xu Ran , Martin Katie , Schwartz Marlene B.
Published: May 2021

Aim

This study aimed to assess the impact of the Supporting Wellness at Pantries (SWAP) system on client food selections at a food pantry.

Subject and methods

In a pre–post comparison study design, a client-choice food pantry implemented SWAP by reorganizing its inventory to promote healthy options. Each product was ranked as “choose often” (green), “sometimes” (yellow), or “rarely” (red) based on saturated fat, sodium, and sugar. Signage was added to indicate each item’s SWAP rank and healthier foods were placed at eye level. Client food baskets were assessed at time 1 (n = 121) and time 2 (n = 101). The proportions of green and red foods selected were compared using regression analyses.

Results

The regression analyses showed that the proportion of green foods selected by clients increased by 11% (p < 0.001) and the proportion of red foods selected decreased by 7% (p < 0.001) after SWAP was implemented (n = 222).

Conclusions

SWAP has the potential to positively shift client choices among the items available in a food pantry setting. SWAP is one component of a suite of changes to the charitable food system that have the potential to alleviate food insecurity, improve diet quality, and assist clients in managing diet-related diseases.
Nonlinear modelling of the seismic response of masonry structures: Calibration strategies
Authors: D’Altri Antonio Maria , Cannizzaro Francesco , Petracca Massimo , Talledo Diego Alejandro
Published: May 2021

In this paper, a simple and practitioners-friendly calibration strategy to consistently link target panel-scale mechanical properties (that can be found in national standards) to model material-scale mechanical properties is presented. Simple masonry panel geometries, with various boundary conditions, are utilized to test numerical models and calibrate their mechanical properties. The calibration is successfully conducted through five different numerical models (most of them available in commercial software packages) suitable for nonlinear modelling of masonry structures, using nonlinear static analyses. Firstly, the panel stiffness calibration is performed, focusing the attention to the shear stiffness. Secondly, the panel strength calibration is conducted for several axial load ratios by attempts using as reference the target panel strength deduced by well-known analytical strength criteria. The results in terms of panel strength for the five different models show that this calibration strategy appears effective in obtaining model properties coherent with Italian National Standard and Eurocode. Open issues remain for the calibration of the post-peak response of masonry panels, which still appears highly conventional in the standards.
Development of a thermal model for irreversible electroporation: an approach to estimate and optimize the IRE protocols
Authors: Wardhana Girindra , Almeida João Pedro , Abayazid Momen , Fütterer Jurgen J.
Published: May 2021

Purpose

Irreversible electroporation (IRE) is an emerging technique that has drawn attention in the field of cancer treatment. IRE uses non-thermal electric pulses to induce death of cancerous cells. However, recent studies have shown that the application of this technique may result in heating of the tissue. There is still room for improving its efficiency and defining better treatment protocols. This study investigates the optimal IRE protocols that avoiding the thermal damage during the IRE treatment.

Methods

Electrode and pulse parameter are investigated. Finite element models are created to evaluate the ablation area and the temperature changes in the tissue. The model is validated experimentally in bovine liver tissue, while the parameters were optimized using response surface method (RSM).

Results

From analysis of variance, the parameter of electrode distance and input voltage has significant effect to the temperature rise in the IRE treatment of bovine liver (P = 0.020 and P = 0.003 respectively). Meanwhile, only the input voltage significantly affects the ablation area (P < 0.001). The optimal result from RSM showed that for maximum ablation area 250.82mm2 with no thermal damage, the IRE protocol consisted of an active electrode length of 10 mm, a distance between electrodes of 10 mm, and the delivery of 50 pulses of 41.21 µs and 3000 V.

Conclusions

The approach presented in this study allows the optimization of the IRE protocols. An optimal IRE protocol that maximizes the ablation area was successfully calculated which can be applied with no risk of thermal damage to the tissue.
An Investigation into the Correlation of Small Punch and Uniaxial Creep Data for Waspaloy
Authors: Williams T. , Evans M. , Harrison W.
Published: May 2021

Within the aerospace sector, the understanding and prediction of creep strains for materials used in high-temperature applications, such as Nickel-based super alloys, is imperative. Small punch testing offers the potential for understanding creep behavior using much less material than conventional uniaxial testing but in contrast to uniaxial creep tests, the stress in small punch creep (SPC) tests is multiaxial. SPC testing can be a valuable tool for validating models of creep deformation, but the key to unlocking its full capability is through the accurate correlation of the creep material properties measured through both techniques. As such, the focus of this paper is to correlate the creep behavior of Waspaloy obtained through conventional uniaxial testing to that obtained via small punch creep testing. Recently, and for low chrome steels, this has been achieved through use of the k
sp method, but there are good reasons for believing this technique will not work so well for Nickel-based super alloys. This paper shows this to be the case for Waspaloy and proposes some alternative methods of correlation based on combining the Monkman–Grant relation and the Wilshire equations for both uniaxial and small punch creep. It was found that this latter approach enabled the accurate conversion of SPC minimum displacement rates to equivalent uniaxial minimum creep rates which, when combined with the Wilshire equations, enabled SPC test loads to be converted into equivalent uniaxial stresses (and visa versa) with levels of accuracy that were significantly reduced when compared to using the k
sp method. Further, the random error associated with these conversions were dramatically increased.
A new inferential approach for response-adaptive clinical trials: the variance-stabilized bootstrap
Authors: Baldi Antognini Alessandro , Novelli Marco , Zagoraiou Maroussa
Published: May 2021

This paper discusses disadvantages and limitations of the available inferential approaches in sequential clinical trials for treatment comparisons managed via response-adaptive randomization. Then, we propose an inferential methodology for response-adaptive designs which, by exploiting a variance stabilizing transformation into a bootstrap framework, is able to overcome the above-mentioned drawbacks, regardless of the chosen allocation procedure as well as the desired target. We derive the theoretical properties of the suggested proposal, showing its superiority with respect to likelihood, randomization and design-based inferential approaches. Several illustrative examples and simulation studies are provided in order to confirm the relevance of our results.
Library for universal virtual reality experiments (luVRe): A standardized immersive 3D/360° picture and video database for VR based research
Authors: Schöne Benjamin , Kisker Joanna , Sylvester Rebecca Sophia , Radtke Elise Leila , Gruber Thomas
Published: May 2021

Virtual reality is a promising tool for experimental psychology, enhancing the ecological validity of psychological science. The advantage of VR is that it enables researchers to study emotional and cognitive processes under realistic conditions while maintaining strict experimental control. To make it easier for scientists to get into the world of VR research and to improve the comparability of scientific results, we have created and validated a standardized set of 3D/360° videos and photos. Study 1 investigated the electrophysiological differences between motivational and emotional reactions exhibited under immersive VR and conventional 2D conditions. The obtained frontal alpha asymmetries show diverge patterns between the two conditions giving rise to further speculations that associated psychological processes exhibit more natural functional properties under immersive conditions. The feeling of being at the center of a realistic VR environment creates a sense of self-relevance. In VR, motivational tendencies and emotional reactions are related to objects or persons within the vicinity of the participant and not to the stimuli presented on a screen. Study 2, investigating the memory performance for VR videos as opposed to a conventional 2D screen presentation, provides evidence that memory formed under immersive conditions created more profound memory traces. This so-called memory superiority effect for the VR conditions might again result from the feeling of being in a scene, thus facilitating the formation of autobiographical memory. The implementation of VR experiments using the database is straightforward as it does neither require much technical equipment nor a high level of VR expertise.
Robotic versus laparoscopic gastrectomy for gastric cancer: an umbrella review of systematic reviews and meta-analyses
Authors: Marano Luigi , Fusario Daniele , Savelli Vinno , Marrelli Daniele , Roviello Franco
Published: May 2021

An umbrella review was performed to summarize literature data and to investigate benefits and harm of robotic gastrectomy (RG) compared to laparoscopic (LG) approach. To overcome the intrinsic limitations of laparoscopy, the robotic approach is claimed to facilitate lymph-node dissection and complex reconstruction after gastrectomy, to assure oncologic safety also in advanced gastric cancer. A literature search was conducted in PubMed, Cochrane and Embase databases for all meta-analyses published up to December 2019. The search strategy was previously published in a protocol. We selected fourteen meta-analyses comparing outcomes between LG and RG with curative intent in patients with diagnosis of resectable gastric cancer. We highlight that RG has a longer operation time, inferior blood loss, reduction in hospital stay and a more rapid recovery of bowel function. In meta-analyses with statistical significance the number of nodes removed in RG is higher than LG and the distal margin of resection is higher. There is no difference in terms of total complication rate, mortality, morbidity, anastomotic leakage, anastomotic stenosis, intestinal obstruction and in conversion rate to open technique. The safety and efficacy of robotic gastrectomy are not clearly supported by strong evidence, suggesting that the outcomes reported for each surgical technique need to be interpreted with caution, in particular for the meta-analyses in which the heterogeneity is large. Certainly, robotic gastrectomy is associated with shorter time to oral intake, lesser intraoperative bleeding and longer operation time with an acceptable level of evidence. On the other hand, the data regarding other outcomes are insufficient as well as non-significant, from an evidence point of view, to draw any robust conclusion.
Future-Founding Poetry
Authors: Pöhlmann Sascha
Published: May 2021

Although issues of futurity have become more and more central to literary and cultural studies in recent years, especially in environmental criticism, no scholarly work has yet addressed the topic of beginnings in American poetry in sufficient scope or detail or with adequate theoretical background. This book is a study of how beginnings are made in American poetry. It borrows Walt Whitman's term "future-founding" to establish a theory of poetic beginnings that asks how poetry relates to notions of the future and how it imagines, constructs, and influences this future in the present. Furthermore, it seeks to change the way literary scholars think about futurity with regard to American poetry: they most often conceive of it in terms of newness alone, yet a deeper theorization of beginningsmust open up new ways of understanding the complexities of this relation. With chapters on Whitman, William Carlos Williams, Langston Hughes, Muriel Rukeyser, Allen Ginsberg, and future-founding poetry after 9/11, this book explains how American poetry makes its beginnings, with what means and to which political and aesthetic ends, and how it addresses fundamental questions about the nature of futurity itself. Sascha Pöhlmann is Associate Professor of American Literary History at Lüdwig-Maximilians-University, Munich.
Exploring the emotional burdens and impact of medical negligence litigation on the plaintiff and medical practitioner: insights from Ireland
Authors: Tumelty Mary-Elizabeth
Published: May 2021

Arguments for reform of the dynamic of medical negligence litigation in Ireland frequently centre on temporal and financial concerns. However, as the field of law and psychology has continued to grow, a body of international literature has emerged which recognises that litigation can have a destructive emotional impact on its participants, particularly in the context of medical negligence disputes.

This paper contributes to the discourse on law-caused harms through a critical exploration of the emotional burdens of medical negligence litigation from the perspective of both the plaintiff and medical practitioner, with reference to the findings of an empirical study (interviews with barristers, patient support groups, and medical professional bodies) and the literature. Whilst the temporal and financial efficiency of medical negligence litigation is important, if litigation can cause emotional harm, this should be considered a serious, undesirable effect of the traditional adversarial process, and may have broader implications for reform in this area.
Training in endoscopic ear surgery using the papaya petiole
Authors: Narendrakumar V
Published: May 2021

Background

Endoscopic ear surgery is a game changer in the field of otology. Training in endoscopic skills is essential for ENT residents, and is especially important during the coronavirus disease 2019 lockdown period. In such difficult times, ENT residents and surgeons can undergo hands-on training using a papaya petiole, even within their homes.

Objective

Endoscopic ear surgery training can be carried out using a papaya petiole, enabling the practice of grommet insertion, tympanomeatal flap elevation and foreign body removal from the external auditory canal. This model does not need any laboratory setup.

Results and conclusion

The hollow structure of the papaya petiole model is very similar to that of the external auditory canal, making training in endoscopic ear surgery easy. Use of the model helps a beginner to train in endoscopic handling and microsurgical instrumentation, and improves depth perception. In addition, it does not require high-end facilities to store equipment or undertake the training at any given point in time.
The provision of ENT teaching in the undergraduate medical curriculum: a review and recommendations
Authors: Patel B , Saeed S R , Smith S
Published: May 2021

Objective

The existing provision of ENT teaching in the undergraduate curriculum is deemed inadequate by medical students, general practitioners and ENT surgeons alike. This study aims to explore the perceptions of a variety of stakeholders on how undergraduate ENT provision can be optimised.

Methods

This study involved semi-structured interviews with seven participants (two medical students, two general practitioners, two ENT surgeons and a curriculum developer). Inductive thematic analysis was used to identify key themes that emerged from the interviews.

Results

The four emergent themes were evaluation of current ENT provision, barriers to learning and teaching, alternate means of delivery of ENT education, and professional identity development. A number of barriers to learning and teaching in the clinical environment were identified including student-related, teacher-related and environmental factors.

Conclusion

The existing ENT provision should be re-considered to help students achieve a basic level of competence in managing common ENT conditions. This can be achieved by ENT teaching in additional contexts including general practice, e-learning and simulation workshops.
Informant-based screening tools for dementia: an overview of systematic reviews
Authors: Taylor-Rowan Martin , Nafisi Sara , Owen Rhiannon , Duffy Robyn , Patel Amit , Burton Jennifer K. , Quinn Terence J.
Published: May 2021

Background

Informant-based questionnaires may have utility for cognitive impairment or dementia screening. Reviews describing the accuracy of respective questionnaires are available, but their focus on individual questionnaires precludes comparisons across tools. We conducted an overview of systematic reviews to assess the comparative accuracy of informant questionnaires and identify areas where evidence is lacking.

Methods

We searched six databases to identify systematic reviews describing diagnostic test accuracy of informant questionnaires for cognitive impairment or dementia. We pooled sensitivity and specificity data for each questionnaire and used network approaches to compare accuracy estimates across the differing tests. We used grading of recommendations, assessment, development and evaluation (GRADE) to evaluate the overall certainty of evidence. Finally, we created an evidence ‘heat-map’, describing the availability of accurate data for individual tests in different populations and settings.

Results

We identified 25 reviews, consisting of 93 studies and 13 informant questionnaires. Pooled analysis (37 studies; 11 052 participants) ranked the eight-item interview to ascertain dementia (AD8) highest for sensitivity [90%; 95% credible intervals (CrI) = 82–95; ‘best-test’ probability = 36]; while the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was most specific (81%; 95% CrI = 66–90; ‘best-test’ probability = 29%). GRADE-based evaluation of evidence suggested certainty was ‘low’ overall. Our heat-map indicated that only AD8 and IQCODE have been extensively evaluated and most studies have been in the secondary care settings.

Conclusions

AD8 and IQCODE appear to be valid questionnaires for cognitive impairment or dementia assessment. Other available informant-based cognitive screening questionnaires lack evidence to justify their use at present. Evidence on the accuracy of available tools in primary care settings and with specific populations is required.
Pre-conceptual counselling in cardiology patients: still work to do and still missed opportunities. A comparison between 2015 and 2019 in women with cardiac disease attending combined obstetric cardiology clinics. Should the European Guidelines change anything?
Authors: Kasargod Prabhakar Chethan R. , Pamment Daisy , Thompson Peter J. , Chong Hsu , Thorne Sara A. , Fox Caroline , Morris Katie , Hudsmith Lucy H.
Published: May 2021

Women with underlying cardiac conditions have an increased risk of adverse pregnancy outcomes. Counselling reproductive age women with heart disease is important to assist them in deciding whether to pursue pregnancy, to ensure their best cardiovascular status prior to pregnancy, and that they understand the risks of pregnancy for them and baby. This also provides an opportunity to explore management strategies to reduce risks. For this growing cohort of women, there is a great need for pre-conceptual counselling.

This retrospective comparative audit assessed new referrals and pre-conceptual counselling of women attending a joint obstetric–cardiology clinic at a tertiary maternity centre in a 12-month period of 2015–2016 compared with 2018–2019. This reflected the timing of the introduction of a multidisciplinary meeting prior to clinics and assessed the impact on referrals with the introduction of the European Society of Cardiology guidelines.

Data were reviewed from 56 and 67 patients in respective audit periods. Patient’s risk was stratified using modified World Health Organization classification.

Less than 50% of women with pre-existing cardiac conditions had received pre-conceptual counselling, although half of them had risks clearly documented. The majority of patients had a recent electrocardiograph and echocardiogram performed prior to counselling, and there was a modest improvement in the number of appropriate functional tests performed between time points. One-third of patients in both cohorts were taking cardiac medications during pregnancy.

There was a significant increase in the number of pregnant women with cardiac disease and in complexity according to modified World Health Organization risk classification. While there have been improvements, it is clear that further work to improve availability and documentation of pre-pregnancy counselling is needed.
Prehospital Decompression of Pneumothorax: A Systematic Review of Recent Evidence
Authors: Robitaille-Fortin Maxime , Norman Sharon , Archer Thomas , Mercier Eric
Published: May 2021

Introduction:

Pneumothorax remains an important cause of preventable trauma death. The aim of this systematic review is to synthesize the recent evidence on the efficacy, patient outcomes, and adverse events of different chest decompression approaches relevant to the out-of-hospital setting.

Methods:

A comprehensive literature search was performed using five databases (from January 1, 2014 through June 15, 2020). To be considered eligible, studies required to report original data on decompression of suspected or proven traumatic pneumothorax and be considered relevant to the prehospital context. They also required to be conducted mostly on an adult population (expected more than ≥80% of the population ≥16 years old) of patients. Needle chest decompression (NCD), finger thoracostomy (FT), and tube thoracostomy were considered. No meta-analysis was performed. Level of evidence was assigned using the Harbour and Miller system.

Results:

A total of 1,420 citations were obtained by the search strategy, of which 20 studies were included. Overall, the level of evidence was low. Eleven studies reported on the efficacy and patient outcomes following chest decompression. The most studied technique was NCD (n = 7), followed by FT (n = 5). Definitions of a successful chest decompression were heterogeneous. Subjective improvement following NCD ranged between 18% and 86% (n = 6). Successful FT was reported for between 9.7% and 32.0% of interventions following a traumatic cardiac arrest. Adverse events were infrequently reported. Nine studies presented only on anatomical measures with predicted failure and success. The mean anterior chest wall thickness (CWT) was larger than the lateral CWT in all studies except one. The predicted success rate of NCD ranged between 90% and 100% when using needle >7cm (n = 7) both for the lateral and anterior approaches. The reported risk of iatrogenic injuries was higher for the lateral approach, mostly on the left side because of the proximity with the heart.

Conclusions:

Based on observational studies with a low level of evidence, prehospital NCD should be performed using a needle >7cm length with either a lateral or anterior approach. While FT is an interesting diagnostic and therapeutic approach, evidence on the success rates and complications is limited. High-quality studies are required to determine the optimal chest decompression approach applicable in the out-of-hospital setting.
Haplotype analysis ofSaltolQTL region in diverse landraces, wild rice and introgression lines of rice (Oryza sativaL.)
Authors: Manohara K. K. , Morajkar Shaiesh , Shanbhag Yogini , Phadte Pratham , Singh Nagendra Kumar
Published: May 2021

Salt stress is a major abiotic stress affecting the productivity of rice crop worldwide. This study screened a set of 71 rice genotypes collected from coastal parts of Goa and Karnataka states in India for seedling stage salinity tolerance to identify genotypes alternative to standard salt-tolerant donors Pokkali, FL478, etc. Phenotyping for seedling stage tolerance was carried out under micro plots at an induced salinity of 12 dS/m. For haplotyping, 14SaltolQTL linked simple sequence repeat (SSR) markers on chromosome 1 were utilized. On the basis of the response to salt stress, 10 genotypes were found tolerant, 16 moderately tolerant, 29 sensitive and 15 as highly sensitive. Among the SSR markers, marker RM10871 was the most polymorphic with a polymorphic information content of 0.90, exhibiting 14 different alleles followed by RM10793 (0.84) and RM3412 (0.80) with 8 and 7 alleles, respectively. These markers also exhibited high values for the effective number of alleles (Ne) and gene diversity (I). The haplotype analysis revealed that the allelic constitution of theSaltolregion of 10 tolerant genotypes from our study varied in comparison to the reference tolerant check FL478. Further, the haplotype of three tolerant genotypes, namely, Goa Dhan 2, Panvel 1 and Goa wild rice (GWR) 005 appears to be completely different from the FL478 haplotype indicating tolerance in these genotypes is controlled by genomic region other thanSaltol.These three genotypes with probable novel regions for seedling stage salt tolerance can be considered for enhancing salinity tolerance of rice cultivars.
Must International Legal Pedagogy Remain Eurocentric?
Authors: AL ATTAR Mohsen
Published: May 2021

Mainstream international law is Eurocentric. Throughout the past half millennia, no territory beyond Europe was safe from jus gentium's striking capability to legitimize the intrusion of European civilizational precepts. Beginning with the Americas but quickly shifting to Africa and Asia, each continent was a battleground for the penetration of a provincial knowledge system. In this paper, I explore the implications of Eurocentrism for international legal pedagogy. While textbook authors now pay homage to other civilizations, their effusions are ornamental only. Instead of supporting epistemological equivalency, they centre European international law throughout their works, exorcising the brutalities of European history that generated the law in question. After setting out the dilemma, I outline three approaches towards transforming international legal pedagogy that capitalize on the decolonization movement. Each method builds on the premise that, without epistemic diversity, legal pedagogy will continue to rationalize European international law's predatory impulse.
Wer bekommt Nierensteine?
Authors: Mohebbi Nilufar
Published: May 2021

Zusammenfassung. Trotz zunehmender Fortschritte in der Medizin sind die Prävalenz und Inzidenz von Nierensteinen in den letzten Jahren kontinuierlich angestiegen. Nierensteine sind mit einem hohen Rezidivrisiko, einer hohen Morbidität inklusive Entwicklung einer chronischen Niereninsuffizienz und Dialysepflichtigkeit sowie einem erhöhten kardiovaskulären Risiko assoziiert. Daher ist das Erkennen von Risikofaktoren und insbesondere Hochrisikopatienten für das Management von Nierensteinpatienten essenziell. Die Risikofaktoren für Nierensteinbildung sind vielfältig und bestehen unter anderem aus allgemeinen Faktoren (junges Manifestationsalter, familiäre Disposition), genetische oder erworbene Erkrankungen mit Risiko für Steinbildung, Medikamente etc. In diesem Rahmen wurden auch verschiedene Prädiktions-Scores für die Abschätzung des Rezidivrisikos entwickelt. Für den Nutzen des Einsatzes dieser Tools ist jedoch noch nicht genügend Evidenz vorhanden.
Neuropsychologische Schätzdefizite bei rechtsfrontaler und rechtstemporaler Epilepsie
Authors: Schwarz Michael , Benkowitsch Edith , Schneider Katrin , Walther Katrin , Hamer Hajo
Published: May 2021

Zusammenfassung. Hintergrund: Nach dem bisherigen Forschungsstand sind neuropsychologische Beeinträchtigungen der Schätzfunktion vor allem bei rechtshemisphärischen Läsionen zu erwarten. Ziele: Es wurde die Fähigkeit des Schätzens bei Epilepsiepatient_innen und einer gesunden Kontrollgruppe untersucht. Je nach Läsionsort wurden sechs Gruppen (rechtsfrontal, linksfrontal, rechtstemporal-mesial, rechtstemporal-neokortikal, linkstemporal-mesial, linkstemporal-neokortikal) einbezogen. Methoden: Mit 176 Personen, 109 Patient_innen und 67 Kontrollpersonen, wurde der Test zum kognitiven Schätzen durchgeführt. Fragestellung: Es wurde erwartet, dass speziell Patient_innen mit rechtshemisphärischen Läsionen Defizite im Schätzen aufweisen. Ergebnisse: Patient_innen mit rechtsfrontalen und rechtstemporalen mesialen Läsionen wiesen signifikant schlechtere Schätzleistungen gegenüber Patient_innen mit linkshemisphärischen Läsionen und der Kontrollgruppe auf. Fazit: Die Ergebnisse sprechen für die vorherrschende Beteiligung der rechten Hemisphäre an der Fähigkeit des kognitiven Schätzens.
Simulation ermöglicht soziale und interaktive Lernprozesse
Authors: Lang Markus , Pfeilstecher Manuel
Published: May 2021

Was ist zu diesem Thema bekannt?

Über die Anwendung von Simulationstraining in der psychiatrischen Pflegeausbildung wird im deutschsprachigen Raum kaum publiziert.

Wie wird eine neue Perspektive eingebracht?

Simulationstraining ermöglicht für die psychiatrische Pflegeausbildung soziale und interaktive Lernprozesse sowie das Sichtbarmachen von möglichen Krankheitsverläufen.

Was sind die Auswirkungen für die Praxis?

Studierende erleben in der Simulation realitätsnahe Situationen und erfahren dadurch bereits in der Ausbildung die eigene Reaktion auf mitunter sehr herausfordernde psychiatrische Pflegesituationen.
Assessment of FY‐2G Atmospheric Motion Vector Data and Assimilating Impacts on Typhoon Forecasts
Authors: Liang Jiahao , Chen Keyi , Xian Zhipeng
Published: May 2021

Atmospheric motion vectors (AMVs) have produced positive impacts on global weather forecasts, but few studies have evaluated the impacts of AMV data from the Fengyun (FY) geostationary satellite series, especially from FY‐2G and FY‐4, on typhoon forecasts in a regional model. In this study, the qualities of FY‐2G and Himawari‐8 AMV data are comparatively evaluated with several preprocesses (e.g., height assignment, quality control, channel merging, thinning, and observation error assignment) employed, and a super typhoon (Typhoon Hato, which occurred in 2017) is selected to assess the forecasting performances with the AMV data assimilated in the Weather Research and Forecasting data assimilation (WRFDA) system. The results show that the AMV data from Himawari‐8 are better overall than those from FY‐2G, with smaller RMSEs and biases for full wind speeds, and the preprocesses improve the qualities of these two geostationary satellite AMV data sets, as they both depict the same general atmospheric circulations. On the other hand, assimilation of AMV data improves the forecasts of environmental fields, resulting in the simulated track and intensity being closer to the observations. Generally, assimilating FY‐2G AMV data has comparably positive impacts with Himawari‐8 AMVs, and the AMV data retrieved from multiple channels provide even better forecasts. Experiments involving another typhoon case are also performed to further provide evidence that the derived AMV data from the Fengyun geostationary satellite series have value in the operational applications.
Platycodin D, a natural component of Platycodon grandiflorum, prevents both lysosome- and TMPRSS2-driven SARS-CoV-2 infection by hindering membrane fusion
Authors: Kim Tai Young , Jeon Sangeun , Jang Youngho , Gotina Lizaveta , Won Joungha , Ju Yeon Ha , Kim Sunpil , Jang Minwoo Wendy , Won Woojin , Park Mingu Gordon , Pae Ae Nim , Han Sunkyu , Kim Seungtaek , Lee C. Justin
Published: May 2021

An ongoing pandemic of coronavirus disease 2019 (COVID-19) is now the greatest threat to global public health. Herbal medicines and their derived natural products have drawn much attention in the treatment of COVID-19, but the detailed mechanisms by which natural products inhibit SARS-CoV-2 have not been elucidated. Here, we show that platycodin D (PD), a triterpenoid saponin abundant in Platycodon grandiflorum (PG), a dietary and medicinal herb commonly used in East Asia, effectively blocks the two main SARS-CoV-2 infection routes via lysosome- and transmembrane protease serine 2 (TMPRSS2)-driven entry. Mechanistically, PD prevents host entry of SARS-CoV-2 by redistributing membrane cholesterol to prevent membrane fusion, which can be reinstated by treatment with a PD-encapsulating agent. Furthermore, the inhibitory effects of PD are recapitulated by the pharmacological inhibition or gene silencing of NPC1, which is mutated in patients with Niemann–Pick type C (NPC) displaying disrupted membrane cholesterol distribution. Finally, readily available local foods or herbal medicines containing PG root show similar inhibitory effects against SARS-CoV-2 infection. Our study proposes that PD is a potent natural product for preventing or treating COVID-19 and that briefly disrupting the distribution of membrane cholesterol is a potential novel therapeutic strategy for SARS-CoV-2 infection.
miR-19b enhances osteogenic differentiation of mesenchymal stem cells and promotes fracture healing through the WWP1/Smurf2-mediated KLF5/β-catenin signaling pathway
Authors: Huang Yan , Xu Yongqiang , Feng Siyin , He Pan , Sheng Bing , Ni Jiangdong
Published: May 2021

Bone marrow mesenchymal stem cell (BMSC)-derived exosomes have been found to enhance fracture healing. In addition, microRNAs contributing to the healing of various bone fractures have attracted widespread attention in recent years, but knowledge of the mechanisms by which they act is still very limited. In this study, we clarified the function of altered microRNA-19b (miR-19b) expression in BMSCs in fracture healing. We modulated miR-19b expression via mimics/inhibitors in BMSCs and via agomirs in mice to explore the effects of these changes on osteogenic factors, bone cell mineralization and the healing status of modeled fractures. Through gain- and loss-of function assays, the binding affinity between miR-19b and WWP1/Smurf2 was identified and characterized to explain the underlying mechanism involving the KLF5/β-catenin signaling pathway. miR-19b promoted the differentiation of human BMSCs into osteoblasts by targeting WWP1 and Smurf2. Overexpression of WWP1 or Smurf2 degraded the target protein KLF5 in BMSCs through ubiquitination to inhibit fracture healing. KLF5 knockdown delayed fracture healing by modulating the Wnt/β-catenin signaling pathway. Furthermore, miR-19b enhanced fracture healing via the KLF5/β-catenin signaling pathway by targeting WWP1 or Smurf2. Moreover, miR-19b was found to be enriched in BMSC-derived exosomes, and treatment with exosomes promoted fracture healing in vivo. Collectively, these results indicate that mesenchymal stem cell-derived exosomal miR-19b represses the expression of WWP1 or Smurf2 and elevates KLF5 expression through the Wnt/β-catenin signaling pathway, thereby facilitating fracture healing.
Invasive mechanical ventilation at 36 weeks post-menstrual age, adverse outcomes with a comparison of recent definitions of bronchopulmonary dysplasia
Authors: Guaman Milenka Cuevas , Pishevar Nikou , Abman Steven H. , Keszler Martin , Truog William E. , Panitch Howard , Nelin Leif D.
Published: May 2021

Objectives

To determine whether the need for invasive mechanical ventilation (iMV) at 36 weeks PMA in patients with severe bronchopulmonary dysplasia (sBPD) identifies those patients at highest risk for tracheostomy or gastrostomy, and to compare sBPD with recent definitions of BPD.

Study design

Observational study from Jan 2015 to Sept 2019 using data from the BPD Collaborative Registry.

Results

Five hundred and sixty-four patients with sBPD of whom 24% were on iMV at 36 weeks PMA. Those on iMV had significantly (p < 0.0001) increased risk for tracheostomy or gastrostomy. The overall mortality rate was 3% and the risk for mortality was substantially greater in those on iMV than in those on noninvasive support at 36 weeks PMA (RR 13.8, 95% CI 4.3–44.5, p < 0.0001). When applying the NICHD definition (2016) 44% had Grade III BPD. When applying the NRN definition, 6% had Grade 1 BPD, 70% had Grade 2 BPD, and 24% had Grade 3 BPD.

Conclusions

Patients with sBPD who were on iMV at 36 weeks had a significantly greater risk of inhospital mortality and survivors had a significantly greater risk of undergoing tracheostomy and/or gastrostomy. The use of type 2 sBPD or Grade 3 BPD would enhance the ability to target future studies to those infants with sBPD at the highest risk of adverse long-term outcomes.