bluuebunny/crossref_metadata_2025 huggingface dataset:
Guideline directed medical therapy and reduction of secondary mitral regurgitation
Authors: Spinka Georg , Bartko Philipp E. , Heitzinger Gregor , Prausmüller Suriya , Winter Max-Paul , Arfsten Henrike , Strunk Guido , Rosenhek Raphael , Kastl Stefan , Hengstenberg Christian , Pavo Noemi , Hülsmann Martin , Goliasch Georg
Published: March 2022

Background

Guideline-directed medical therapy (GDMT) is the recommended initial treatment for secondary mitral regurgitation (SMR), however, supported by only little comprehensive evidence. This study, therefore, sought to assess the effect of GDMT titration on SMR and to identify specific substance combinations able to reduce SMR severity.

Methods and results

We included 261 patients who completed two visits with an echocardiographic exam available within 1 month at each visit. After comprehensively defining GDMT titration as well as SMR reduction, logistic regression analysis was applied in order to assess the effects of overall GDMT titration and specific substance combinations on SMR severity. SMR severity improved by at least 1° in 39.3% of patients with subsequent titration of GDMT and was accompanied by reverse remodelling and clinical improvement. The effects of GDMT titration were significantly associated with SMR reduction (adj. odds ratio 2.91, 95% confidence interval 1.34–6.32, P = 0.007). Moreover, angiotensin receptor/neprilysin inhibitor (ARNi) as well as the combined dosage effects of (i) renin–angiotensin system inhibitors (RASi) and mineralocorticoid-receptor antagonists (MRA), (ii) beta-blockers (BB) and MRA, as well as (iii) RASi, BB, and MRA were all significantly associated with SMR improvement (P < 0.044 for all).

Conclusion

The present study provides comprehensive evidence for the effectiveness of contemporary GDMT to specifically improve SMR. Our data indicate that GDMT titration conveys a three-fold increased chance of reducing SMR severity. Moreover, the dosage effects of ARNi, as well as the combination of RASi and MRA, BB and MRA, and all three substances in the aggregate are able to significantly improve SMR.
Neighborhood violence and health: the mediating role of loneliness among two ethnic groups in Israel
Authors: Elran-Barak Roni , Baron-Epel Orna , Donchin Milka
Published: March 2022

Neighborhood violence is associated with poor health, but the mechanisms explaining this association are still unknown. This study seeks to examine the role of loneliness as a mediator of the association between neighborhood violence and health among two ethnic groups (Arabs and Jews) in Israel. A representative survey was conducted among adult residents (1903 Arabs and 2726 Jews) of four Israeli towns: two Arab towns, one Jewish town and one mixed town. A stratified sample of households by residential area, age and sex, was selected in each town. Mediation models were tested using Hayes’ PROCESS procedure. Traffic violations, juvenile delinquency and vandalism were reported by more than 50% of Arab residents, relative to about 25–30% of Jewish residents. Loneliness mediated the association between neighborhood violence and health, with a full serial mediation for mental health and a partial serial mediation for physical health. Findings indicate that Arab towns are characterized by severe neighborhood violence. The association between neighborhood violence and physical health was fully dependent on the mediators among both ethnic groups. Future studies should use prospective designs with objective measures of health and violence to validate our cross-sectional findings.
To what extent patents for Covid-19 mRNA vaccines are based on public research and taxpayers’ funding? A case study on the privatization of knowledge
Authors: Florio Massimo
Published: March 2022

The coronavirus disease 2019 (Covid-19) pandemic has forced us to reconsider the relationship between public and private research and development (R&D). The policy issue is whether, over the next years, governments’ only negotiating position on vaccines and biomedical technologies will be to sign one purchase contract after another and transfer value from taxpayers to investors in pharmaceutical companies. Knowledge and technologies that are crucial to Covid-19 messenger ribonucleic acid vaccine development and production were created with the R&D and financial contribution of governments. Patents filed by pharma companies do not protect the public interest arising from such earlier research. The paper offers a case study on the privatization of knowledge created in the first place by R&D in the public sector or supported by public funds and eventually being appropriated by pharmaceutical corporations. The privatization of knowledge is a more general mechanism, relevant in all industries where patents protect corporate R&D which in turn is supported by government direct or indirect subsidies.
Modes of failure of Trifecta aortic valve prosthesis
Authors: Malvindi Pietro Giorgio , Kattach Hassan , Luthra Suvitesh , Ohri Sunil
Published: March 2022

OBJECTIVES

Several concerns have been recently raised regarding the durability of Trifecta prostheses. Different mechanisms of early failure were reported. Our aim was to study in a large population the modes of failure of Trifecta valves.

METHODS

We conducted a retrospective analysis of patients who underwent surgical aortic valve replacement with a Trifecta prosthesis during the period 2010–2018. Details regarding the mode of failure and haemodynamic dysfunction were collected for patients who underwent reintervention for structural valve failure. The Kaplan–Meier method was used to calculate survival. Competing risk analysis was performed to calculate the cumulative risk of reintervention for structural valve failure.

RESULTS

The overall population comprises 1228 patients (1084 TF model and 144 TFGT model). Forty-four patients—mean patients’ age at the time of the first implant 69 (standard deviation: 12) years and 61% female—underwent reintervention for structural valve failure after a median time of 63 [44–74] months. The cumulative incidence of reintervention for structural valve failure was 0.16% (SE 0.11%), 1.77% (SE 0.38%) and 5.11% (SE 0.98%) at 1, 5 and 9 years, respectively. In 24/44 patients (55%), a leaflet tear with dehiscence at the commissure level was found intraoperatively or described by imaging assessment. The cumulative incidence of reintervention for failure due to leaflet(s) tear was 0.16% (SE 0.11%), 1.08% (SE 0.29%) and 3.03% (SE 0.88%) at 1, 5 and 9 years, respectively.

CONCLUSIONS

Leaflet(s) tear with dehiscence along the stent post was the main mode of early failure, up to 5 years, after Trifecta valves’ implantation.
Identification of epigenetic genes for predicting prognosis and immunotherapy response of ovarian cancer
Authors: Shen Wenbin , Jiang Wei , Ye Shuang , Sun Min , Yang Huijuan , Shan Boer
Published: March 2022

Background

Epigenetic factors play a critical role in tumour development and progression. The aim of this study was to construct and validate a robust epigenetic gene set-based signature for predicting prognosis of ovarian cancer.

Methods

By using LASSO Cox regression model, we screened out the most useful prognostic epigenetic factors and a prognostic signature was developed based on them. Survival receiver operating characteristic was used to test the prognostic accuracy of signature in training and validation sets. The associations between the risk scores and immune cell infiltration, tumour purity, immune checkpoint inhibitor genes expression were also assessed in ovarian cancer .

Results

A total of 26 epigenetic factors were identified to develop the prognostic signature. In the training set, the prognosis of high-risk patients was strikingly poorer than that of low-risk patients (hazard ratio: 2.11, 95% confidence interval: 1.65–2.72, P < 0.001). Similar results were further observed in the internal validation set (hazard ratio: 1.69, 95% confidence interval: 1.07–2.63, P = 0.020) and external validation set (hazard ratio:1.95, 95% confidence interval: 1.41–2.69; P < 0.001). Survival receiver operating characteristic at 5 year showed the epigenetic signature (area under the curve = 0.700) performed better than other clinical features in predicting prognosis. Distinct difference in immune activation related pathways, immune cells infiltration, tumour purity reflected by immune and stromal score and immune checkpoint inhibitor genes gene expression was observed between high- and low-risk samples.

Conclusions

This study constructed an epigenetic signature that was capable of predicting postoperative outcomes and may also serve as potential biomarker for immunotherapy responses for ovarian cancer.
Correlative volume-imaging using combined array tomography and FIB-SEM tomography with beam deceleration for 3D architecture visualization in tissue
Authors: Hirashima Shingo , Ohta Keisuke , Rikimaru-Nishi Yukiko , Togo Akinobu , Funatsu Takashi , Tsuneyoshi Risa , Shima Yuichi , Nakamura Kei-ichiro
Published: March 2022

Focused ion beamed (FIB) SEM has a higher spatial resolution than other volume-imaging methods owing to the use of ion beams. However, in this method, it is challenging to analyse entire biological structures buried deep in the resin block. We developed a novel volume-imaging method by combining array tomography and FIB-SEM tomography and investigated the chondrocyte ultrastructure. Our method imparts certainty in determining the analysis area such that cracks or areas with poor staining within the block are avoided. The chondrocyte surface showed fine dendritic processes that were thinner than ultrathin sections. Upon combination with immunostaining, this method holds promise for analysing mesoscopic architectures.
Foreign Interference and Social Media Networks: A Relational Approach to Studying Contemporary Russian Disinformation
Authors: Lemke Tobias , Habegger Michael W
Published: March 2022

The use of disinformation to disrupt the domestic politics of other states has become a staple of contemporary global politics. How these campaigns operate at a microlevel of individual users and network communities, however, remains undertheorized. In this article, we develop a theoretical framework to analyze how states leverage existing social media networks strategically for that purpose. Drawing from social network theory, we argue that the spread of disinformation in the digital age is best understood by examining how actors achieve and maintain access to the existing social media networks via a process of cultural keying—mimicking the cultural cues of the target network to camouflage their intentions and attract followers. While this activity is usually limited in scale and scope, it may be amplified to seize on critical domestic and international events. To demonstrate these arguments, we examine the Twitter behavior of the Kremlin-linked news outlets RT and Sputnik during and after the 2017 French presidential election. We first analyze their presence and salience in a network of accounts interested in French politics. We then use structural topic modeling to identify thematic overlap between the outlets and our panel of users. Our analysis suggests that Kremlin-linked outlets are indeed active in local networks and repeatedly key on salient themes such as Islamophobia and Euroscepticism to blend in.
Barbaloin attenuates pulmonary fibrosis through TGF-β1/Smads/p38 pathway
Authors: Zhang Gong , Bai Rong , Huang Jianlin , Gao Yafeng , Yun Xiuli , Haji Akber Aisa
Published: March 2022

Objectives

Barbaloin is one of the main bioactive ingredients extracted from Aloe vera, which has the property of protecting the lung from LPS-induced acute injury; however, the anti-pulmonary fibrosis effect of barbaloin is still unknown. Herein, we present novel data showing the anti-pulmonary fibrosis effect of barbaloin and revealing the possible molecular mechanism.

Methods

In vivo experiment, oral administration of barbaloin was investigated through paraquat-induced pulmonary fibrosis in mice. In vitro experiment, epithelial-mesenchymal transition (EMT) process and TGF-β1 pathway were investigated in A549 cells for exploring the anti-fibrosis molecular mechanism of barbaloin.

Key findings

Results showed that barbaloin could improve pulmonary fibrosis through improving physiological routine indexes and histopathological lesions of mice in a dose-dependent manner. Hydroxyproline, collagen I, N-cadherin and α-SMA levels were significantly suppressed. Besides, pro-inflammatory cytokines were also improved. In vitro experiment, barbaloin could inhibit the process of EMT through repressing α-SMA, collagen I and N-cadherin and increasing E-cadherin. In addition, barbaloin could repress the expression of p-Smad2/3 and then suppress the process of EMT through intervening TGF-β1-induced canonical pathway. Moreover, MMP-2 and MMP-9 were also inhibited by barbaloin via repressing phosphorylation of p38 through TGF-β1-induced non-canonical axis.

Conclusions

Our findings reveal the anti-pulmonary fibrosis effect of barbaloin in vivo and in vitro for the first time. These results indicate that barbaloin may be a promising clinical candidate drug against pulmonary fibrosis.
Molecular basis of differential adventitious rooting competence in poplar genotypes
Authors: Ranjan Alok , Perrone Irene , Alallaq Sanaria , Singh Rajesh , Rigal Adeline , Brunoni Federica , Chitarra Walter , Guinet Frederic , Kohler Annegret , Martin Francis , Street Nathaniel R , Bhalerao Rishikesh , Legué Valérie , Bellini Catherine
Published: March 2022

Recalcitrant adventitious root (AR) development is a major hurdle in propagating commercially important woody plants. Although significant progress has been made to identify genes involved in subsequent steps of AR development, the molecular basis of differences in apparent recalcitrance to form AR between easy-to-root and difficult-to-root genotypes remains unknown. To address this, we generated cambium tissue-specific transcriptomic data from stem cuttings of hybrid aspen, T89 (difficult-to-root) and hybrid poplar OP42 (easy-to-root), and used transgenic approaches to verify the role of several transcription factors in the control of adventitious rooting. Increased peroxidase activity was positively correlated with better rooting. We found differentially expressed genes encoding reactive oxygen species scavenging proteins to be enriched in OP42 compared with T89. A greater number of differentially expressed transcription factors in cambium cells of OP42 compared with T89 was revealed by a more intense transcriptional reprograming in the former. PtMYC2, a potential negative regulator, was less expressed in OP42 compared with T89. Using transgenic approaches, we demonstrated that PttARF17.1 and PttMYC2.1 negatively regulate adventitious rooting. Our results provide insights into the molecular basis of genotypic differences in AR and implicate differential expression of the master regulator MYC2 as a critical player in this process.
Automating public announcement logic with relativized common knowledge as a fragment of HOL in LogiKEy
Authors: Benzmüller Christoph , Reiche Sebastian
Published: March 2022

A shallow semantical embedding for public announcement logic (PAL) with relativized common knowledge is presented. This embedding enables the first-time automation of this logic with off-the-shelf theorem provers for classical higher-order logic. It is demonstrated (i) how meta-theoretical studies can be automated this way and (ii) how non-trivial reasoning in the target logic (PAL), required for instance to obtain a convincing encoding and automation of the wise men puzzle, can be realized. Key to the presented semantical embedding is that evaluation domains are modelled explicitly and treated as an additional parameter in the encodings of the constituents of the embedded target logic; in previous related works, e.g. on the embedding of normal modal logics, evaluation domains were implicitly shared between meta-logic and target logic. The work presented in this article constitutes an important addition to the pluralist LogiKEy knowledge engineering methodology, which enables experimentation with logics and their combinations, with general and domain knowledge, and with concrete use cases—all at the same time.
Future-proofing
Authors: Simone Carla , Wagner Ina , Müller Claudia , Weibert Anne , Wulf Volker
Published: March 2022

Sustainability is crucial for the future of our societies. From a computing perspective, the challenge is to design IT artifacts that contribute to improving people’s work and everyday lives in a sustainable way, thereby also contributing to social and ecological sustainability. The book documents the experiences of several leading research groups in Europe, North America, and South Africa, describing their efforts to achieve sustainable design results, the difficulties that barred the way, and the strategies they adopted to achieve the goal of sustainability. The analysis of this rich empirical material aids consideration of how to more systematically address and possibly overcome impediments to achieve a design result that is sustainable in practice. It points to the importance of considering the socio-technical nature of innovation, focusing on the relationship between ownership, appropriation, and learning early on in a project, and not only striving for technological flexibility but also taking care of issues of maintenance repair in designing computer support. The book discusses the changes that would be necessary to make the main stakeholders in IT design more open to creating environments for sustainable innovation. The examples discussed in this book and their analysis can inspire researchers, institutions, managers, IT professionals, and educators to promote the goal of sustainable design and increase the overall awareness of its strategic relevance.
Controls on the Emplacement Style of Coherent Kimberlites in the Lac de Gras Field, Canada
Authors: Tovey Madeline , Giuliani Andrea , Phillips David , Nowicki Tom , Pearson D Graham , Fedortchouk Yana , Russell James K
Published: March 2022

In the Lac de Gras (LDG) kimberlite field, Northwest Territories, Canada, coherent kimberlites (CKs) occur as tabular dykes, pipe-shaped diatremes, and irregular bodies without well-defined geometries. Combining the morphology of CK bodies with the occurrence of fragmented olivine microcrysts allows distinction of four CK types at LDG: (1) dykes with no broken olivine; (2) CK without well-defined but probable sheet geometry and no broken olivine; (3) pipe-filling CK (pfCK) with abundant broken olivine and (4) pfCK with no broken olivine. These features suggest an intrusive origin for type 1 and, probably, type 2 CK; a high-energy extrusive emplacement for CK type 3 and a low-energy intrusive or extrusive emplacement for the CK type 4. Here, we compare petrographic and whole-rock, olivine and spinel compositional data for high-energy extrusive pfCK, low-energy pfCK and intrusive CK units to understand the factors controlling their variable emplacement styles. Extrusive CK contain more abundant groundmass phlogopite and monticellite, lower carbonate/silicate mineral abundance ratios and significantly lower dolomite and pleonaste-spinel abundances compared to intrusive CK. This indicates greater CO2 loss and higher H2O/CO2 in the melt phase for the extrusive CK during emplacement. Lower incompatible element concentrations in the extrusive CKs and different chromite Ti# and olivine rim Mg# indicate derivation from distinct primitive melt compositions. The extrusive CK feature higher ɛNdi and marginally higher ɛHfi compositions than the intrusive CK, pointing to derivation from distinct sources. These findings strongly imply that distinct primary melt compositions were largely responsible for the differences in emplacement styles of CK at LDG. Low-energy pfCKs have similar olivine rim Mg#, chromite Ti# and, hence, primitive melt compositions to the high-energy extrusive CK samples. Their marginally different emplacement styles may depend on local factors, such as changing stress regimes, or slightly different volatile concentrations. Both types of pfCK might reflect the waning stages of volcanic sequences resulting from the eruption of a segregated magma column that started with pipe excavation and the explosive emplacement of gas-rich magma (volcaniclastic kimberlite), followed by the less energetic emplacement of melt-rich magma (pfCK). This hypothesis underscores different primary melt compositions for dyke vs pipe-forming (and filling) kimberlites and hence a fundamental primary melt control on the explosivity of kimberlites.
Local Integration: A Durable Solution in need of Restoration?
Authors: Hovil Lucy , Maple Nicholas
Published: March 2022

Local integration has long been seen as the “forgotten” durable solution to refugee displacement1 evidenced by the reluctance of governments across the world to accord refugees a new citizenship. This article goes further. It argues that local integration as a durable solution has not been merely forgotten, but deliberately avoided at a national, regional and international level. As a result, its veracity as a realistic durable solution for the majority of refugees is now in question.

The article examines ways in which states seek to evade local integration. It begins by investigating the multiple tactics used by wealthier governments to elude responsibility both at a national level and through the influence they exert over global refugee responses. It then explores how countries hosting the greatest numbers of refugees, with a specific focus on Africa, have allowed significant numbers of refugees into their territory but have then maintained a short-term approach that has, in practice, blocked local integration as a durable solution. We argue that a mix of global, national, and local processes and forces have effectively conspired to diminish local integration as a durable solution to the point that it has all but vanished from the political arena. The implications for refugee populations of these processes and forces – talked of collectively as the politics of evasion – are profound.

While refugees continue to find ways to negotiate their own access to communities and labour markets, this is often done against national, regional, and international policies rather than with them. Ultimately, by highlighting its value as a durable solution, while showing that there is almost uniform acceptance by states and international organisations working on protection concerns that it is no longer politically viable, this article hopes to restart an urgent conversation about the value of local integration and how it can be reinvigorated.
LGBTQ+ Worker Protections: Implications for Academic Medicine Today and in the Future
Authors: Sánchez Nelson F. , Kennedy Lydia , Spigner Sabina T. , Hartman A. Wesley , Sánchez John P. , Callahan Edward J.
Published: March 2022

The Supreme Court’s 2020 ruling prohibiting workplace discrimination based on sexual orientation or gender identity (Bostock v Clayton County) offers new legal protections for LGBTQ+ employees and allies and new opportunities for academic medicine to advance LGBTQ+ inclusion at their institutions. In this perspective piece, the authors examine the history of LGBTQ+ community recognition, tolerance, protections, and ongoing inclusion and the advocacy efforts led by LGBTQ+ patients, community activists, and medical colleagues. They also examine the current limitations of the court’s ruling and recommend future actions to advance workplace and health equity. While recent advancements in equality have not erased chronic barriers to inclusion and advancement, they can pave the way for leaders in research, education, and clinical care to shape national health guidelines and policies that impact the health of all Americans.
Early Restrictive Fluid Strategy Impairs the Diaphragm Force in Lambs with Acute Respiratory Distress Syndrome
Authors: Ijland Marloes M. , Ingelse Saranke A. , van Loon Lex M. , van Erp Merijn , Kusters Benno , Ottenheijm Coen A. C. , Kox Matthijs , van der Hoeven Johannes G. , Heunks Leo M. A. , Lemson Joris
Published: March 2022

Background

The effect of fluid management strategies in critical illness–associated diaphragm weakness are unknown. This study hypothesized that a liberal fluid strategy induces diaphragm muscle fiber edema, leading to reduction in diaphragmatic force generation in the early phase of experimental pediatric acute respiratory distress syndrome in lambs.

Methods

Nineteen mechanically ventilated female lambs (2 to 6 weeks old) with experimental pediatric acute respiratory distress syndrome were randomized to either a strict restrictive fluid strategy with norepinephrine or a liberal fluid strategy. The fluid strategies were maintained throughout a 6-h period of mechanical ventilation. Transdiaphragmatic pressure was measured under different levels of positive end-expiratory pressure (between 5 and 20 cm H2O). Furthermore, diaphragmatic microcirculation, histology, inflammation, and oxidative stress were studied.

Results

Transdiaphragmatic pressures decreased more in the restrictive group (–9.6 cm H2O [95% CI, –14.4 to –4.8]) compared to the liberal group (–0.8 cm H2O [95% CI, –5.8 to 4.3]) during the application of 5 cm H2O positive end-expiratory pressure (P = 0.016) and during the application of 10 cm H2O positive end-expiratory pressure (–10.3 cm H2O [95% CI, –15.2 to –5.4] vs. –2.8 cm H2O [95% CI, –8.0 to 2.3]; P = 0.041). In addition, diaphragmatic microvessel density was decreased in the restrictive group compared to the liberal group (34.0 crossings [25th to 75th percentile, 22.0 to 42.0] vs. 46.0 [25th to 75th percentile, 43.5 to 54.0]; P = 0.015). The application of positive end-expiratory pressure itself decreased the diaphragmatic force generation in a dose-related way; increasing positive end-expiratory pressure from 5 to 20 cm H2O reduced transdiaphragmatic pressures with 27.3% (17.3 cm H2O [95% CI, 14.0 to 20.5] at positive end-expiratory pressure 5 cm H2O vs. 12.6 cm H2O [95% CI, 9.2 to 15.9] at positive end-expiratory pressure 20 cm H2O; P < 0.0001). The diaphragmatic histology, markers for inflammation, and oxidative stress were similar between the groups.

Conclusions

Early fluid restriction decreases the force-generating capacity of the diaphragm and diaphragmatic microcirculation in the acute phase of pediatric acute respiratory distress syndrome. In addition, the application of positive end-expiratory pressure decreases the force-generating capacity of the diaphragm in a dose-related way. These observations provide new insights into the mechanisms of critical illness–associated diaphragm weakness.

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TUG-10: A Modification of the Timed Up and Go Test for Aerobic Assessment in Older Adults
Authors: Hergott Colleen G. , Bolgla Lori A. , Waller Jennifer L. , Dowling Aaron , Ezzell Kennedy , Graves Corley , Peed William
Published: March 2022

Purpose:

Cardiorespiratory fitness tests are important for older adults to determine baseline cardiovascular fitness and appropriate aerobic exercise intensity. The Timed Up and Go (TUG) is a test that can be modified to challenge the aerobic system by performing 10 continuous repetitions (TUG-10). The TUG-10 advantages include less space and time requirements and incorporation of functional tasks with balance challenges. The purpose of this study was to relate the performance and physiologic responses of the TUG-10 to other common aerobic capacity tests.

Methods:

Fourteen independent community-dwelling adults performed the 6-minute-walk test (6MWT), 2-minute-step test (2MST), and TUG-10. Heart rate (HR), diastolic and systolic blood pressure, and rate of perceived exertion (RPE) were recorded before and after each test. Bland–Altman plots were used to determine the agreement between test performances. Repeated measures mixed models compared differences in the physiologic changes between the tests.

Results:

Participants had a clinically greater increase in the adjusted mean change in HR during the 2MST (22.5 bpm) than the 6MWT (17.0 bpm) and TUG-10 (12.3 bpm). Diastolic blood pressure response was similar across all 3 tests with no significant change. Systolic blood pressure increased less during the 6MWT (15.4 mm Hg) compared with the 2MST (33.3 mm Hg) and TUG-10 (28.7 mm Hg). Participants reported a higher RPE during the 2MST (7.9) than the 6MWT (6.1) and TUG-10 (5.2). The Bland–Altman plots indicated that participants' performance on the 3 tests was comparable.

Conclusions:

The TUG-10, 6MWT, and 2MST demonstrated comparable performances and clinically similar physiologic changes. Heart rate and RPE changes were greater during the 2MST than the other tests, suggesting that the 2MST was more demanding. Findings support the TUG-10 as a potential functional outcome measure to estimate cardiorespiratory fitness. Moreover, the TUG-10 required minimal space and time and may facilitate the gap in aerobic testing in physical therapy practice.
Strategies for Prevention or Treatment of Tobacco and Cannabis Use Disorder
Authors: DeJong Katherine N. , Choby Beth , Valent Amy M.
Published: March 2022

Tobacco and cannabis use in pregnancy are associated with increased adverse perinatal and long-term offspring outcomes. Products for both have evolved with various forms available on the market, challenging accurate counseling of risks and quantification of tobacco and cannabis usage during the perinatal period. Health care providers are recommended to screen for any type of use, provide consistent messaging of harms of tobacco and cannabis use in pregnancy, and offer individualized interventions. The journey to cessation can be complicated by barriers and triggers, lack of social supports, and mental health challenges that should be addressed to prevent relapse and withdrawals.
The Role of Intraocular Pressure and Systemic Hypertension in the Progression of Glaucomatous Damage to the Macula
Authors: Chang Angela Y. , Tsamis Emmanouil , Blumberg Dana M. , Al-Aswad Lama A. , Cioffi George A. , Hood Donald C. , Liebmann Jeffrey M. , De Moraes C.G.
Published: March 2022

Précis:

Macular structural and functional parameters were better correlated with pressure-dependent glaucomatous damage than conventional parameters. Self-reported systemic hypertension (HTN) was not associated with structural or functional progression in this cohort.

Purpose:

The aim was to examine the relationships between intraocular pressure (IOP), systemic HTN, and glaucoma progression using structural testing with optical coherence tomography (OCT) and functional testing with visual field (VF).

Patients and Methods:

A total of 191 eyes of 119 patients enrolled in a prospective, longitudinal study (Structural and Functional Progression of Glaucomatous Damage to the Macula study) with a diagnosis of glaucoma were analyzed. Patients were tested with 10-2 and 24-2 VF and spectral-domain OCT obtained at 4 to 6 month intervals. IOP from each visit was collected. Self-reported diagnoses of HTN were reported in 72 eyes (37%) in the patients included. Linear mixed effects regression was used to test the relationship between summary statistics from VF and OCT and HTN diagnosis. The goodness-of-fit of relationships was assessed with Bayesian information criterion.

Results:

Mean follow-up IOP was most associated with the following OCT parameters: global macula ganglion cell layer (GCL), inferior macula GCL, mean macular vulnerability zone GCL, and mean less vulnerable zone macula GCL, and with the following VF parameters: 10-2 PSD and 10-2 MD. There was no significant difference in rates of progression between HTN and non-HTN patients for any OCT or VF parameter. Models with the best goodness-of-fit for the relationship between HTN and progression were the same as those observed for IOP.

Conclusion:

Macular structural and functional parameters are more sensitive to IOP in terms of glaucomatous progression when compared with more conventional parameters. While HTN was not significantly associated with progression using any parameter, macular structural and functional parameters had a better goodness-of-fit to model progression and may be useful as endpoints.
Do Personal Nurse-Initiated Medication Boxes Work in Prison? A Cross-Sectional Study Involving Incarcerated Persons and Prison Officers in a Swiss Prison
Authors: Pralong Dominique , Tran Nguyen Toan , Mary Gérard , Renaud Audrey , Meach Francesco , Wolff Hans
Published: March 2022

Introduction

Daily in-hand medication dispensing in prisons and jails is resource intensive, disempowering, and nonconfidential. This research aimed to assess a nurse-initiated, low-frequency medication dispensing system using personal lockable boxes.

Methods

A cross-sectional study was carried out in a Swiss prison involving 47 box users and 19 custodial officers.

Findings

Box users agreed or strongly agreed about the perceived advantages of the box system, including user-friendliness, lower theft risk, and increased dignity, confidentiality, compliance, and autonomy to self-manage medication. Officers, who must accompany nurses during dispensing rounds, concurred that medication boxes were more time-efficient and improved role differentiation between custodial and clinical staff. Patients and officers were overall satisfied with the system and would recommend scaling it up in other facilities.

Discussion

This study suggests that medication boxes are feasible, acceptable, easy to use, and secure. Boxes could promote patients' autonomy, protect confidentiality, and allow nurses to dedicate more time to individual visits and health promotion and prevention activities.
Effect of Tongue-Pressure Resistance Training in Poststroke Dysphagia Patients With Oral Motor Dysfunction
Authors: Wang Tingwei , Tai Jiahui , Hu Ruiping , Fan Shunjuan , Li Haozheng , Zhu Yulian , Wu Yi , Wu Junfa
Published: March 2022

Objectives

The aims of the study were to investigate the effect of tongue-pressure resistance training in poststroke dysphagia patients with oral motor dysfunction and to examine the therapeutic value of tongue-pressure resistance training in the oral and pharyngeal phases.

Design

Patients were divided into an experimental and a control group. Both groups received 30 mins of traditional swallowing rehabilitation treatment every day for 4 wks. In addition, the experimental group received tongue-pressure resistance training for an extra 20 mins/d. Maximum tongue pressure and fiberoptic endoscopic examination of swallowing were assessed before and after treatments.

Results

Compared with the control group, the experimental group showed significant improvement in Functional Communication Measure for swallowing, Oral Motor Function Scale, maximum tongue pressure, Murray Secretion Scale, Rosenbek Penetration–Aspiration Scale, and food residue in pyriform sinuses (P < 0.05). There was no significant difference in food residue in epiglottic vallecula between both groups (P > 0.05).

Conclusions

This study demonstrated that tongue-pressure resistance training is an effective approach to improve the overall swallowing function in patients with oral motor dysfunction. The improvement of oral motor function could facilitate the recovery of pharyngeal motor function. Tongue-pressure resistance training seems to have more clearance of residue in piriform sinus than epiglottic vallecula.
Scalable deep learning algorithm to compute percent pulmonary contusion among patients with rib fractures
Authors: Choi Jeff , Mavrommati Katherine , Li Nancy Yanzhe , Patil Advait , Chen Karen , Hindin David I. , Forrester Joseph D.
Published: March 2022

BACKGROUND

Pulmonary contusion exists along a spectrum of severity, yet is commonly binarily classified as present or absent. We aimed to develop a deep learning algorithm to automate percent pulmonary contusion computation and exemplify how transfer learning could facilitate large-scale validation. We hypothesized that our deep learning algorithm could automate percent pulmonary contusion computation and that greater percent contusion would be associated with higher odds of adverse inpatient outcomes among patients with rib fractures.

METHODS

We evaluated admission-day chest computed tomography scans of adults 18 years or older admitted to our institution with multiple rib fractures and pulmonary contusions (2010–2020). We adapted a pretrained convolutional neural network that segments three-dimensional lung volumes and segmented contused lung parenchyma, pulmonary blood vessels, and computed percent pulmonary contusion. Exploratory analysis evaluated associations between percent pulmonary contusion (quartiles) and odds of mechanical ventilation, mortality, and prolonged hospital length of stay using multivariable logistic regression. Sensitivity analysis included pulmonary blood vessel volumes during percent contusion computation.

RESULTS

A total of 332 patients met inclusion criteria (median, 5 rib fractures), among whom 28% underwent mechanical ventilation and 6% died. The study population's median (interquartile range) percent pulmonary contusion was 4% (2%–8%). Compared to the lowest quartile of percent pulmonary contusion, each increasing quartile was associated with higher adjusted odds of undergoing mechanical ventilation (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.1–2.1) and prolonged hospitalization (OR, 1.6; 95% CI, 1.1–2.2), but not with mortality (OR, 1.1; 95% CI, 0.6–2.0). Findings were similar on sensitivity analysis.

CONCLUSION

We developed a scalable deep learning algorithm to automate percent pulmonary contusion calculating using chest computed tomography scans of adults admitted with rib fractures. Open code sharing and collaborative research are needed to validate our algorithm and exploratory analysis at a large scale. Transfer learning can help harness the full potential of big data and high-performing algorithms to bring precision medicine to the bedside.

LEVEL OF EVIDENCE

Prognostic and epidemiological, Level III.
Grigory Isaakovich Barenblatt. 10 July 1927—22 June 2018
Authors: Chorin Alexandre J. , Bažant Zdeněk P.
Published: March 2022

Grigory Barenblatt devoted his scientific life to the analysis of difficult and important problems in mechanics: turbulence, including turbulence in the oceans and the atmosphere and in polymeric fluids, fracture, fatigue and damage accumulation in solids, flow in porous media, and combustion. He made use of sophisticated and innovative mathematical tools that he himself developed with his collaborators: in particular, similarity, scaling methods and intermediate asymptotics. During the years up to the dissolution of the USSR, he held senior positions in the Institute of Petroleum, the Institute for Problems in Mechanics and the Institute of Oceanology, all institutes of the USSR Academy of Sciences, and the Department of Plasticity at the Institute of Mechanics, Lomonosov Moscow State University. In 1992 he was appointed the first G. I. Taylor Professor of Fluid Mechanics at the Department of Applied Mathematics and Theoretical Physics, University of Cambridge, and then in 1996, he was appointed Professor in Residence, Department of Mathematics, University of California at Berkeley. His work has garnered many prestigious awards and world-wide recognition.
John Charlton Polkinghorne KBE. 16 October 1930—9 March 2021
Authors: Taylor J. C. , Wilkinson D. A.
Published: March 2022

John Polkinghorne made many contributions to theoretical elementary particle physics. Between 1959 and 1979 he led the theoretical physics group in the Department of Applied Mathematics and Theoretical Physics in Cambridge University. He discovered important features of the analytic properties of the scattering matrix, culminating in the jointly authored book,
The analytic S-matrix
, which has become widely influential. He also worked on scattering at high energies and developed a covariant formulation of Feynman's (Richard Feynman ForMemRS) parton model (partons being later identified as quarks and gluons). In 1979, he resigned from his professorship of Mathematical Physics and commenced training as an Anglican priest. While serving in a number of appointments within the Church of England and then within Cambridge University he became one of the most influential figures in the growing academic field of science and religion, publishing both popular and academic texts and lecturing on an international stage.
Source-sink behavioural dynamics limit institutional evolution in a group-structured society
Authors: Hébert-Dufresne Laurent , Waring Timothy M. , St-Onge Guillaume , Niles Meredith T. , Kati Corlew Laura , Dube Matthew P. , Miller Stephanie J. , Gotelli Nicholas J. , McGill Brian J.
Published: March 2022

Social change in any society entails changes in both behaviours and institutions. We model a group-structured society in which the transmission of individual behaviour occurs in parallel with the selection of group-level institutions. We consider a cooperative behaviour that generates collective benefits for groups but does not spread between individuals on its own. Groups exhibit institutions that increase the diffusion of the behaviour within the group, but also incur a group cost. Groups adopt institutions in proportion to their fitness. Finally, the behaviour may also spread globally. We find that behaviour and institutions can be mutually reinforcing. But the model also generates behavioural source-sink dynamics when behaviour generated in institutionalized groups spreads to non-institutionalized groups and boosts their fitness. Consequently, the global diffusion of group-beneficial behaviour creates a pattern of institutional free-riding that limits the evolution of group-beneficial institutions. Our model suggests that, in a group-structured society, large-scale beneficial social change can be best achieved when the relevant behaviour and institutions remain correlated.
Synthetic diversity in the preparation of metallic uranium
Authors: Jang Harry , Louis-Jean James , Childs Bradley , Holliday Kiel , Reilly Dallas , Athon Matthew , Czerwinski Kenneth , Hatchett David , Poineau Frederic
Published: March 2022

Uranium metal is associated with several aspects of nuclear technology; it is used as fuel for research and power reactors, targets for medical isotope productions, explosive for nuclear weapons and precursors in synthetic chemistry. The study of uranium metal at the laboratory scale presents the opportunity to evaluate metallic nuclear fuels, develop new methods for metallic spent fuel reprocessing and advance the science relevant to nuclear forensics and medical isotope production. Since its first isolation in 1841, from the reaction of uranium chloride and potassium metal, uranium metal has been prepared by solid-state reactions and in solution by electrochemical, chemical and radiochemical methods. The present review summarizes the methods outlined above and describes the chemistry associated with each preparation.
Comparing optimization criteria in antibiotic allocation protocols
Authors: Jamieson-Lane Alastair , Friedrich Alexander , Blasius Bernd
Published: March 2022

Clinicians prescribing antibiotics in a hospital context follow one of several possible ‘treatment protocols’—heuristic rules designed to balance the immediate needs of patients against the long-term threat posed by the evolution of antibiotic resistance and multi-resistant bacteria. Several criteria have been proposed for assessing these protocols; unfortunately, these criteria frequently conflict with one another, each providing a different recommendation as to which treatment protocol is best. Here, we review and compare these optimization criteria. We are able to demonstrate that criteria focused primarily on slowing evolution of resistance are directly antagonistic to patient health both in the short and long term. We provide a new optimization criteria of our own, intended to more meaningfully balance the needs of the future and present. Asymptotic methods allow us to evaluate this criteria and provide insights not readily available through the numerical methods used previously in the literature. When cycling antibiotics, we find an antibiotic switching time which proves close to optimal across a wide range of modelling assumptions.
Asymptotic stability of quasi-periodic orbits
Authors: Breunung Thomas
Published: March 2022

Stability is one of the most fundamental properties of solutions to differential equations and, for example, can explain the presence of harmful vibrations. While the stability type of fixed points and periodic orbits can be assessed with standard tools, no general and reliable method allows to conclude about the stability of quasi-periodic orbits. Here, we overcome this limitation and develop a novel and universal method to rigorously assess the asymptotic stability of quasi-periodic solutions to differential equations. Furthermore, we develop an automated algorithm for such stability investigations and demonstrate its applicability on two explicit mechanical examples.
Positive and negative effects of land abandonment on butterfly communities revealed by a hierarchical sampling design across climatic regions
Authors: Sugimoto Naoki , Fukasawa Keita , Asahara Akio , Kasada Minoru , Matsuba Misako , Miyashita Tadashi
Published: March 2022

Land abandonment may decrease biodiversity but also provides an opportunity for rewilding. It is therefore necessary to identify areas that may benefit from traditional land management practices and those that may benefit from a lack of human intervention. In this study, we conducted comparative field surveys of butterfly occurrence in abandoned and inhabited settlements in 18 regions of diverse climatic zones in Japan to test the hypotheses that species-specific responses to land abandonment correlate with climatic niches and habitat preferences. Hierarchical models that unified species occurrence and habitat preferences revealed that negative responses to land abandonment were associated with species that have cold climatic niches and use open habitats, suggesting that species negatively impacted by land abandonment will decline more due to future climate warming. Maps representing species gains and losses due to land abandonment, which were created from the model estimates, showed similar geographical patterns, but some areas exhibited high species losses relative to gains. Our hierarchical modelling approach was useful for scaling up local-scale effects of land abandonment to a macro-scale assessment, which is crucial to developing spatial conservation strategies in the era of depopulation.
Competition among small individuals hinders adaptive radiation despite ecological opportunity
Authors: ten Brink Hanna , Seehausen Ole
Published: March 2022

Ontogenetic diet shifts, where individuals change their resource use during development, are the rule rather than the exception in the animal world. Here, we aim to understand how such changes in diet during development affect the conditions for an adaptive radiation in the presence of ecological opportunity. We use a size-structured consumer–resource model and the adaptive dynamics approach to study the ecological conditions for speciation. We assume that small individuals all feed on a shared resource. Large individuals, on the other hand, have access to multiple food sources on which they can specialize. We find that competition among small individuals can hinder an adaptive radiation to unfold, despite plenty of ecological opportunity for large individuals. When small individuals experience strong competition for food, they grow slowly and only a few individuals are recruited to the larger size classes. Hence, competition for food among large individuals is weak and there is therefore no disruptive selection. In addition, initial conditions determine if an adaptive radiation occurs or not. A consumer population initially dominated by small individuals will not radiate. On the other hand, a population initially dominated by large individuals may undergo adaptive radiation and diversify into multiple species.