bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal Transmission and Outcome of Neonates Born to SARS-CoV-2-Positive Mothers: The Experience of 2 Highly Endemic Italian Regions
Authors: Capozza Manuela , Salvatore Silvia , Baldassarre Maria Elisabetta , Inting Silvia , Panza Raffaella , Fanelli Margherita , Perniciaro Simona , Morlacchi Laura , Vimercati Antonella , Agosti Massimo , Laforgia Nicola
Published: October 2021

Introduction: COVID-19 is the disease caused by the novel coronavirus SARS-CoV-2, responsible of the pandemic declared in March 2020 and still ongoing. COVID-19 affects all ages but presents less complications and fatalities in children. Neonatal infections have rarely been reported worldwide, and vertical transmission is uncertain. Methods: We conducted a prospective cohort study of all infants born to SARS-CoV-2-positive mothers admitted to 2 hospitals in South (Bari) and North (Varese) of Italy from April to December 2020. A molecular nasopharyngeal swab for SARS-CoV-2 using a reverse transcriptase polymerase chain reaction was made at birth for all enrolled newborns to evaluate vertical transmission of infection. We also evaluated postnatal transmission with a second nasopharyngeal swab made at 1 month of life and described maternal and neonatal clinical findings and short-term outcomes. Results: 176/179 (97%) newborns were SARS-CoV-2 negative at birth and 151/156 (97%) infants were still negative at 1 month of life. All newborns were asymptomatic. Seventy percent of newborns were breastfed during hospitalization. At 1 month of life, 76% of infants were breastfed. Conclusion: According to our results, vertical and perinatal infection is very rare. Breastfeeding does not increase the risk of COVID-19 and should be encouraged.
Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis
Authors: Barnes Edward L. , Hudson Joshua , Esckilsen Scott , Kochar Bharati , Kappelman Michael D. , Long Millie D. , Koruda Mark , Sandler Robert S. , Herfarth Hans H.
Published: October 2021

Background: The most common complication following ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC) is pouchitis. Our study aimed to investigate the relationship between histopathologic findings of ileitis, granuloma, or transmural inflammation on the colectomy specimen of patients with clinically and endoscopically diagnosed UC and the development of pouchitis within the first 2 years after IPAA. Methods: We performed a retrospective cohort study evaluating patients undergoing colectomy with IPAA for UC between January 1, 2004 and December 31, 2016. Bivariate analyses were conducted to evaluate the relationship between clinical factors and the development of pouchitis. We performed multivariate logistic regression to evaluate the relationship between histologic, clinical, and demographic factors at the time of colectomy and subsequent development of pouchitis. Results: Among 626 patients, pouchitis occurred in 246 (39%). Patients with primary sclerosing cholangitis were more likely to develop pouchitis (adjusted odds ratio [aOR] 2.81, 95% confidence interval [CI] 1.02–7.72), as were patients with a family history of inflammatory bowel disease (aOR 1.75, 95% CI 1.11–2.77). Histologic findings of ileitis, granuloma, or transmural inflammation were not associated with an increased odds of developing pouchitis (aOR 0.70, 95% CI 0.45–1.08). Discussion/Conclusion: Patients with ileitis, granulomas, or transmural inflammation at the time of colectomy were not at greater risk for development of pouchitis in the 2 years after IPAA. These pathological findings should not preclude IPAA for UC.
Psychosocial Distress in the Early Recovery Period after Radical Prostatectomy
Authors: Kozaris Raphael , Hanske Julian , von Landenberg Nicolas , Berg Sebastian , Roghmann Florian , Brock Marko , Noldus Joachim , Müller Guido
Published: October 2021

Purpose: This study aimed to evaluate psychosocial distress in the context of continence and oncological outcome during the early recovery period after radical prostatectomy (RP) for prostate cancer. Patients and Methods: Retrospectively collected data from 587 patients who underwent inpatient rehabilitation after RP in 2016 and 2017 were analyzed. Psychosocial distress (measured by using a Questionnaire on Stress in Cancer Patients [QSC-R10]) and continence status (urine loss on a 24-h pad test and urine volume on uroflowmetry) were evaluated at the beginning (T1) and end (T2) of a 3-week inpatient rehabilitation. Multivariate logistic regression was performed to identify predictors for high distress (QSC-R10 score ≥15). Results: The median patient age was 65 years. At the start of rehabilitation, 204 patients (34.8%) demonstrated high distress. Psychosocial distress decreased significantly (p < 0.001) from a median of 11.0 at T1 (median 16 days after surgery) to a median of 6.0 at T2 (median 37 days after surgery). Complete continence increased significantly (p < 0.001) from 39.0% at T1 to 58.9% at T2. The median urine volume increased significantly (p < 0.001) from 161 mL at T1 to 230 mL at T2. Often, distress is higher in younger patients, whereas incontinence is higher in older patients. Multivariate logistic regression analysis identified age ≤69 years (p = 0.001) and tumor stage ≥pT3 (p = 0.006) as independent predictors of high distress. Conclusions: Distress and incontinence decreased significantly during the 3 weeks of inpatient rehabilitation after RP. Patient age ≤69 years and tumor stage ≥pT3 are independent predictors of high psychosocial distress.
The Regional Specificity of Mucosa-Associated Microbiota in Patients with Distal Colorectal Cancer
Authors: Kono Yoshihiko , Inoue Ryo , Teratani Takumi , Tojo Mineyuki , Kumagai Yuko , Morishima So , Koinuma Koji , Lefor Alan Kawarai , Kitayama Joji , Sata Naohiro , Horie Hisanaga
Published: October 2021

Background/Aims: Recent studies have demonstrated that the populations of several microbes are significantly increased in fecal samples from patients with colorectal cancer (CRC), suggesting their involvement in the development of CRC. The aim of this study was to identify microbes which are increased in distal CRCs and to identify the specific location of microbes increased in mucosal tissue around the tumor. Methods: Tissue specimens were collected from surgical resections of 28 distal CRCs. Five samples were collected from each specimen (location A: tumor, B: adjacent normal mucosa, C: normal mucosa 1 cm proximal to the tumor, D: normal mucosa 3 cm proximally, and E: normal mucosa 6 cm proximally). The microbiota in the sample were analyzed using 16S rRNA gene amplicon sequencing and the relative abundance (RA) of microbiota compared among the 5 locations. Results: At the genus level, the RA of Fusobacterium and Streptococcus at location A was the highest among the 5 locations, significantly different from that in location E. The dominant species of each genus was Fusobacterium nucleatum and Streptococcus anginosus. The RAs of these species gradually decreased from locations B to E with a statistically significant difference in F. nucleatum. The genus Peptostreptococcus also showed a similar trend, and the RA of Peptostreptococcus stomatis in location A was significantly associated with depth of tumor invasion and tumor size. Conclusion: Although the clinical relevance is not clear yet, these results suggest that F. nucleatum, S. anginosus, and P. stomatis can spread to the adjacent normal tissues and may change the surrounding microenvironment to support the progression of CRC.
Erweiterte Formen der roboterassistierten Lungenresektion
Authors: Scheinerman Joshua A. , Jiang Jeffrey , Chang Stephanie H. , Geraci Travis C. , Cerfolio Robert J.
Published: October 2021

Während der Lungenkrebs weiterhin die häufigste krebsbedingte Todesursache in den USA darstellt, bildet die Chirurgie in kurativer Intention weiterhin eine tragende Säule der Therapie. Seit mehr als einem Jahrzehnt kommen dabei im Rahmen der Lungenresektion bei nicht kleinzelligem Bronchialkarzinom (NSCLC) auch roboterassistierte Systeme zum Einsatz. Zu lokal begrenzteren Formen der Resektion wie z.B. Keilresektionen oder Lobektomien liegen umfangreiche Daten vor, die eine Reduktion der Krankenhausverweildauer und der postoperativen Schmerzen ebenso belegen wie verbesserte Raten der Lymphknotendissektion und des Auftretens von Komplikationen. Das roboterassistierte Vorgehen bietet eine Vielzahl technischer Vorzüge, z.B. bessere Optik, natürliche Handbewegungen für den Operateur bei der Steuerung der Instrumente sowie präzise Identifizierung der Gewebeebenen und entsprechend ergonomischer und sicherere Dissektion. Aufgrund dieser Vorteile wächst auch das Anwendungsspektrum für roboterassistierte Resektionen. In der vorliegenden Übersichtsarbeit werten wir die vorliegenden Daten zu erweiterten Formen der roboterassistierten Lungenresektion aus, insbesondere die Resektion nach Induktionstherapie, Manschetten-Lobektomie und Pneumonekto­mie. Darüber hinaus werden die Indikationen für diese komplexeren Resektionen betrachtet und die Daten und Outcomes aus der Erfahrung anderer Einrichtungen mit diesen Eingriffen wiedergegeben. Abschließend beschreiben wir die Strategie und Sichtweisen in unserer eigenen Einrichtung im Hinblick auf die genannten drei Formen der erweiterten Lungenresektion. Während die Anwendbarkeit und die Sicherheit der roboterassistierten Chirurgie bei diesen komplexen Lungenresektion noch Gegenstand kontroverser Debatten sind, hoffen wir durch Darstellung der vorliegenden Evidenz und Evaluierung der Wirksamkeit und Sicherheit für NSCLC-Patienten zur Klärung beizutragen.
Differentiating Gastrointestinal Stromal Tumors from Leiomyomas Using a Neural Network Trained on Endoscopic Ultrasonography Images
Authors: Seven Gulseren , Silahtaroglu Gokhan , Seven Ozden Ozluk , Senturk Hakan
Published: October 2021

Background: Endoscopic ultrasonography (EUS) is crucial to diagnose and evaluate gastrointestinal mesenchymal tumors (GIMTs). However, EUS-guided biopsy does not always differentiate gastrointestinal stromal tumors (GISTs) from leiomyomas. We evaluated the ability of a convolutional neural network (CNN) to differentiate GISTs from leiomyomas using EUS images. The conventional EUS features of GISTs were also compared with leiomyomas. Patients and Methods: Patients who underwent EUS for evaluation of upper GIMTs between 2010 and 2020 were retrospectively reviewed, and 145 patients (73 women and 72 men; mean age 54.8 ± 13.5 years) with GISTs (n = 109) or leiomyomas (n = 36), confirmed by immunohistochemistry, were included. A total of 978 images collected from 100 patients were used to train and test the CNN system, and 384 images from 45 patients were used for validation. EUS images were also evaluated by an EUS expert for comparison with the CNN system. Results: The sensitivity, specificity, and accuracy of the CNN system for diagnosis of GIST were 92.0%, 64.3%, and 86.98% for the validation dataset, respectively. In contrast, the sensitivity, specificity, and accuracy of the EUS expert interpretations were 60.5%, 74.3%, and 63.0%, respectively. Concerning EUS features, only higher echogenicity was an independent and significant factor for differentiating GISTs from leiomyomas (p < 0.05). Conclusions: The CNN system could diagnose GIMTs with higher accuracy than an EUS expert and could be helpful in differentiating GISTs from leiomyomas. A higher echogenicity may also aid in differentiation.
Perspectivas decoloniais para um design pluriversal
Authors: Montuori Bruna Ferreira , Nicoletti Viviane Mattos
Published: October 2021

Este artigo tem como objetivo refletir sobre as diferentes nuances que o design brasileiro pode tomar diante de narrativas decoloniais, que rompem com ideais universais por outros baseados no pluriverso (ESCOBAR 2016). Buscamos aqui compreender o posicionamento hegemônico do campo a fim de questionar seu lugar dominante à luz de teorias que elucidam a colonialidade do poder (QUIJANO, 2000). Por meio de duas abordagens de pensamento – o fronteiriço, que teoriza a partir das fronteiras epistêmicas, e outro interseccional, que olha a partir dos vazios nos encontros de categorias de raça, gênero, classe e trabalho – levantamos reflexões teóricas e práticas que orientam praticantes para uma atitude alinhada ao pensamento decolonial. O artigo divide-se em três partes: (1) as relações entre modernidade e colonialidade aplicadas ao contexto brasileiro; (2) o design brasileiro sob as lentes de pensamentos interseccional e fronteiriço; e (3) reflexões teóricas e práticas para a construção de uma perspectiva decolonial para um design pluriversal. Com base nesses pontos, endereçamos caminhos alternativos ao design brasileiro, que tem como base práticas emancipatórias que orientam para a autonomia e a liberdade das subjetividades.
Myeloid Mineralocorticoid Receptor Transcriptionally Regulates P-Selectin Glycoprotein Ligand-1 and Promotes Monocyte Trafficking and Atherosclerosis
Authors: Man Joshua J. , Lu Qing , Moss M. Elizabeth , Carvajal Brigett , Baur Wendy , Garza Amanda E. , Freeman Roy , Anastasiou Marina , Ngwenyama Njabulo , Adler Gail K. , Alcaide Pilar , Jaffe Iris Z.
Published: October 2021

Objective:

MR (mineralocorticoid receptor) activation associates with increased risk of cardiovascular ischemia while MR inhibition reduces cardiovascular-related mortality and plaque inflammation in mouse atherosclerosis. MR in myeloid cells (My-MR) promotes inflammatory cell infiltration into injured tissues and atherosclerotic plaque inflammation by unclear mechanisms. Here, we examined the role of My-MR in leukocyte trafficking and the impact of sex.

Approach and Results:

We confirm in vivo that My-MR deletion (My-MR-KO) in ApoE-KO mice decreased plaque size. Flow cytometry revealed fewer plaque macrophages with My-MR-KO. By intravital microscopy, My-MR-KO significantly attenuated monocyte slow-rolling and adhesion to mesenteric vessels and decreased peritoneal infiltration of myeloid cells in response to inflammatory stimuli in male but not female mice. My-MR-KO mice had significantly less PSGL1 (P-selectin glycoprotein ligand 1) mRNA in peritoneal macrophages and surface PSGL1 protein on circulating monocytes in males. In vitro, MR activation with aldosterone significantly increased PSGL1 mRNA only in monocytes from MR-intact males. Similarly, aldosterone induced, and MR antagonist spironolactone inhibited, PSGL1 expression in human U937 monocytes. Mechanistically, aldosterone stimulated MR binding to a predicted MR response element in intron-1 of the PSGL1 gene by ChIP-qPCR. Reporter assays demonstrated that this PSGL1 MR response element is necessary and sufficient for aldosterone-activated, MR-dependent transcriptional activity.

Conclusions:

These data identify PSGL1 as a My-MR target gene that drives leukocyte trafficking to enhance atherosclerotic plaque inflammation. These novel and sexually dimorphic findings provide insight into increased ischemia risk with MR activation, cardiovascular protection in women, and the role of MR in atherosclerosis and tissue inflammation.

Graphic Abstract:

A graphic abstract is available for this article.
Abstract 13432: Pulmonary Artery Pressure-Guided Therapy in Patients With Heart Failure Using the CardioMEMS Device and HF Readmissions: Analysis of the National Readmissions Database
Authors: Ruiz Ernesto A , Malik Aaqib , Polydoros Kampaktsis , Briasoulis Alexandros
Published: October 2021

Introduction:
Pulmonary artery pressure (PAP)-guided therapy in patients with heart failure (HF) using the CardioMEMS device (CMM), an implantable PAP sensor, has shown to reduce hospitalizations in prior studies.

Hypothesis:
We sought to evaluate the clinical benefit of the CMM device in regard to readmission rates using the National Readmission Database (NRD).

Methods:
We queried the NRD to identify patients who underwent CMM implantation (CPT code 33289) between years 2014 to 2018 and studied their HF readmissions. We compared CMM patients and their readmissions with a matched cohort of patients with HF without CMM. Multivariate Cox regression analysis was performed to adjust for other predictors of readmissions.

Results:
Prior to matching we identified 3,965,188 weighted HF patients without CMM and 1528 patients with CMM. After propensity score matching for several patient and hospital related characteristics, the cohort consisted of 1528 patients with CMM and 1528 with HF without CMM. Before matching CMM patients were younger, more frequently males, with higher rates of prior myocardial infarction and chronic kidney disease. Readmission rates at 30-days were 17.6% vs. 21% for patients with vs. without CMM respectively and remained statistically significant after matching (17.5% vs. 22.7%, p=0.01). The rates of 90-day (29.1% vs 36.5%, p=0.002) and 180-day (40.1% vs. 46.6%, p=0.03) readmissions were lower in the CMM group (Figure). In multivariable regression models, CMM was associated with lower risk of readmissions (HR, 0.78, 95% CI 0.64-0.94, p=0.01).

Conclusions:
The CardioMEMS device was associated with reduced HF rehospitalization rates in a nationally representative cohort of HF patients
SMC-Derived Hyaluronan Modulates Vascular SMC Phenotype in Murine Atherosclerosis
Authors: Hartmann Felicia , Gorski Daniel J. , Newman Alexandra A.C. , Homann Susanne , Petz Anne , Owsiany Katherine M. , Serbulea Vlad , Zhou Yu-Qing , Deaton Rebecca A. , Bendeck Michelle , Owens Gary K. , Fischer Jens W.
Published: October 2021

Rationale:

Plaque instability remains poorly understood and new therapeutic approaches to reduce plaque rupture and subsequent clinical events are of great interest. Recent studies revealed an important role of phenotypic switching of smooth muscle cells (SMC) in controlling plaque stability, including ECM (extracellular matrix) deposition.

Objective:

The aim of this study was to elucidate the role of hyaluronan derived from SMC–hyaluronan synthase 3 (
Has3
), in phenotypic switching and plaque stability in an animal model of atherosclerosis.

Methods and Results:

A mouse line with SMC-specific deletion of
Has3
and simultaneous SMC-lineage tracing (
e
YFP [enhanced yellow fluorescent protein]) on an
Apoe
−/−
background was used. Lineage tracing of SMC with
e
YFP revealed that SMC-specific deletion of
Has3
significantly increased the number of LGALS3
+
(galectin-3) transition state SMC and decreased ACTA2
+
(alpha-smooth muscle actin) SMC. Notably, SMC-
Has3
deletion led to significantly increased collagen deposition and maturation within the fibrous cap and the whole lesion, as evidenced by picrosirius red staining and LC-PolScope analysis. Single-cell RNA sequencing of brachiocephalic artery lesions demonstrated that the loss of SMC-
Has3
enhanced the transition of SMC to a
Lgals3
+
, ECM-producing phenotype with elevated acute-phase response gene expression. Experiments using cultured murine aortic SMC revealed that blocking CD44 (cluster of differentiation-44), an important hyaluronan binding receptor, recapitulated the enhanced acute-phase response, and synthesis of fibrous ECM.

Conclusions:

These studies provide evidence that the deletion of SMC-
Has3
results in an ECM-producing transition state SMC phenotype (characterized by LGALS3
+
expression), likely via reduced CD44 signaling, resulting in increased collagen formation and maturation, an index consistent with increased plaque stability.
Period Prevalence of Rheumatic Heart Disease and the Need for a Centralized Patient Registry in American Samoa, 2016 to 2018
Authors: Woodruff Rebecca C. , Eliapo‐Unutoa Ipuniuesea , Chiou Howard , Gayapa Maria , Noonan Sara , Podila Pradeep S. B. , Rayle Victoria , Sanchez Guillermo , Tulafono Ray , Van Beneden Chris A. , Ritchey Matthew
Published: October 2021

Background

Rheumatic heart disease (RHD) is a severe, chronic complication of acute rheumatic fever, triggered by group A streptococcal pharyngitis. Centralized patient registries are recommended for RHD prevention and control, but none exists in American Samoa. Using existing RHD tracking systems, we estimated RHD period prevalence and the proportion of people with RHD documented in the electronic health record.

Methods and Results

RHD cases were identified from a centralized electronic health record system, which retrieved clinical encounters with RHD
International Classification of Diseases, Tenth Revision, Clinical Modification
(
ICD‐10‐CM
) codes, clinical problem lists referencing RHD, and antibiotic prophylaxis administration records; 3 RHD patient tracking spreadsheets; and an all‐cause mortality database. RHD cases had ≥1 clinical encounter with RHD
ICD‐10‐CM
codes, a diagnostic echocardiogram, or RHD as a cause of death, or were included in RHD patient tracking spreadsheets. Period prevalence per 1000 population among children aged <18 years and adults aged ≥18 years from 2016 to 2018 and the proportion of people with RHD with ≥1 clinical encounter with an RHD
ICD‐10‐CM
code were estimated. From 2016 to 2018, RHD was documented in 327 people (57.2%: children aged <18 years). Overall RHD period prevalence was 6.3 cases per 1000 and varied by age (10.0 pediatric cases and 4.3 adult cases per 1000). Only 67% of people with RHD had ≥1 clinical encounter with an RHD
ICD‐10‐CM
code.

Conclusions

RHD remains a serious public health problem in American Samoa, and the existing electronic health record does not include all cases. A centralized patient registry could improve tracking people with RHD to ensure they receive necessary care.
Prognostic Importance of Pulmonary Arterial Capacitance in Acute Decompensated Heart Failure With Preserved Ejection Fraction
Authors: Nakagawa Akito , Yasumura Yoshio , Yoshida Chikako , Okumura Takahiro , Tateishi Jun , Yoshida Junichi , Abe Haruhiko , Tamaki Shunsuke , Yano Masamichi , Hayashi Takaharu , Nakagawa Yusuke , Yamada Takahisa , Dohi Tomoharu , Nakatani Daisaku , Hikoso Shungo , Sakata Yasushi ,   Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators
Published: October 2021

Background

Although the prognostic importance of pulmonary arterial capacitance (PAC; stroke volume/pulmonary arterial pulse pressure) has been elucidated in heart failure with reduced ejection fraction, whether its significance in patients suffering from heart failure with preserved ejection fraction is not known. We aimed to examine the association of PAC with outcomes in inpatients with heart failure with preserved ejection fraction.

Methods and Results

We prospectively studied 705 patients (median age, 83 years; 55% women) registered in PURSUIT‐HFpEF (Prospective Multicenter Observational Study of Patients With Heart Failure With Preserved Ejection Fraction). We investigated the association of echocardiographic PAC at discharge with the primary end point of all‐cause death or heart failure rehospitalization with a mean follow‐up of 384 days. We further tested the acceptability of the prognostic significance of PAC in a subgroup of patients (167/705 patients; median age, 81 years; 53% women) in whom PAC was assessed by right heart catheterization. The median echocardiographic PAC was 2.52 mL/mm Hg, with a quartile range of 1.78 to 3.32 mL/mm Hg. Univariable and multivariable Cox regression testing revealed that echocardiographic PAC was associated with the primary end point (unadjusted hazard ratio, 0.82; 95% CI, 0.72–0.92;
P
=0.001; adjusted hazard ratio, 0.86; 95% CI, 0.74–0.99;
P
=0.035, respectively). Univariable Cox regression testing revealed that PAC assessed by right heart catheterization (median calculated PAC, 2.82 mL/mm Hg) was also associated with the primary end point (unadjusted HR, 0.70; 95% CI, 0.52–0.91;
P
=0.005).

Conclusions

A prospective cohort study revealed that impaired PAC diagnosed with both echocardiography and right heart catheterization was associated with adverse outcomes in inpatients with heart failure with preserved ejection fraction.

Registration

URL: https://upload.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000024414. Unique identifier: UMIN000021831.
Impact of nationwide COVID-19 lockdown on workload and injury patterns of major trauma cases in a regional trauma centre in Singapore
Authors: Kang Min Li , Lim Woan Wui , Lee Daniel Jin Keat , Goo Jerry Tiong Thye
Published: October 2021

Introduction:

Singapore instituted lockdown measures from 7 February 2020 to 1 June 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

A retrospective analysis of cases from the national trauma registry was carried out comparing the lockdown period (from 7 February 2020 to 1 June 2020) to the pre-lockdown period (from 7 February 2019 to 1 June 2019). Data extracted included the volume of Tier 1 (injury severity score [ISS] >15) and Tier 2 (ISS 9–15) cases and epidemiology. Subgroup analysis was performed for Tier 1 patient outcomes.

Results:

Trauma volume decreased by 19.5%, with a 32% drop in Tier 1 cases. Road traffic and workplace accidents decreased by 50% (P < 0.01), while interpersonal violence showed an increase of 37.5% (P = 0.34). There was an 18.1% decrease in usage of trauma workflows (P = 0.01), with an increase in time to intervention for Tier 1 patients from 88 to 124 min (P = 0.22). Discharge to community facilities decreased from 31.4% to 17.1% (P < 0.05). There was no increase in inpatient mortality, length of stay in critical care or length of stay overall.

Conclusion:

There was an overall decrease in major trauma cases during the lockdown period, particularly road traffic accidents and worksite injuries, and a relative increase in interpersonal violence. Redeployment of manpower and hospital resources may have contributed to decreased usage of trauma workflows and community facilities. In the event of further lockdowns, it is necessary to plan for trauma coverage and maintain the use of workflows to facilitate early intervention.
Improving children’s cooperativeness during magnetic resonance imaging using interactive educational animated videos: a prospective, randomised, non-inferiority trial
Authors: Utama Evelyn Gabriela , Saffari Seyed Ehsan , Tang Phua Hwee
Published: October 2021

Introduction:

A previous prospective, randomised controlled trial showed that animated videos shown to children before magnetic resonance imaging (MRI) scan reduced the proportion of children needing repeated MRI sequences and improved confidence of the children staying still for at least 30 min. Children preferred the interactive video. We hypothesised that the interactive video is non-inferior to showing two videos (regular and interactive) in improving children’s cooperativeness during MRI scans.

Methods:

In this Institutional Review Board-approved prospective, randomised, non-inferiority trial, 558 children aged 3–20 years scheduled for elective MRI scan from June 2017 to March 2019 were randomised into the interactive video only group and combined (regular and interactive) videos group. Children were shown the videos before their scan. Repeated MRI sequences, general anaesthesia (GA) requirement and improvement in confidence of staying still for at least 30 min were assessed.

Results:

In the interactive video group (n = 277), 86 (31.0%) children needed repeated MRI sequences, two (0.7%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 22.1% after the video. In the combined videos group (n = 281), 102 (36.3%) children needed repeated MRI sequences, six (2.1%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 23.2% after the videos; the results were not significantly different between the two groups.

Conclusion:

The interactive video group demonstrated non-inferiority to the combined videos group.
Governance by Perpetual Conflict: How Early Colonial Political Practices Undermine Democracy in Post-Civil War Sri Lanka
Authors: Perera Binendri
Published: October 2021

The 1978 Constitution of Sri Lanka established a semi-presidential system within the country with constitutional provisions for a powerful executive presidency. Three decades later, practices of the presidents in the post-war period show commonalities with the Sinhala monarchy that prevailed in early colonial Sri Lanka. To substantiate this argument, this paper focuses on four kings from the Sithavaka and Kandyan kingdoms who reigned in Sri Lanka during the Portuguese colonization and the early years of Dutch colonization, i.e. from 1521 to 1687. These kings governed by feeding off perpetual conflict, using such as a political tool to retain their dictatorial authority and political relevance. Despite being formally constrained by the 1978 Constitution, presidents in the post-war period engage in a similar form of governance. However, this local conceptualization of the executive as a monarch clashes with the substantive democratic rationality of the office of president, which requires constitutional and political checks that apply beyond elections. Due to this clash between governance by perpetual conflict, which gains legitimacy from and has been instituted since Sri Lanka’s early colonial past, and democratic governance, the establishment of democratic constitutional norms within the country has been unstable.
A Sociological Analysis of the Performance and Subjective Well-being of Elite Sports Players in China
Authors: Fung Sai-fu , Huang Qian , Zhang Xiaoli
Published: October 2021

We were inspired by the market transition theory to investigate the relationship between elite sports players’ performance, subjective well-being and demographic characteristics with the lens of Weberian concept of instrumental rationality (zweckrational). This cross-sectional study was recruited 144 (Mage = 18.96, sd = 3.129) professional athletes in gymnastics, combat sports (including boxing, taekwondo, weightlifting, judo and wrestling), soccer, swimming and wushu (Chinese martial arts), in a government-operated sports institution in China. A hierarchical regression analysis was implemented to observe the relationship between the following variables, the subjective well-being, instrumental factors and other demographic factors, including gender, age, educational level, number of years on professional team and injury record. The results show that the bonus incentive system is the most important predictor of the athletes’ performance. We argue that under the context of China’s market transition, the lens of instrumental rationality can shed light on how the means-end calculations of elite athletes affect their sports performance.
Varieties of Clientelism in Comparative Democracies: Power, State Formation and Citizenship in the Philippines, Bosnia and Herzegovina
Authors: Calimbahin Cleo Anne A.
Published: October 2021

Clientelism in comparative democracies have evolved through time within informal and formal institutions. Using the book by Brkovic, that follows the tradition of challenging the unidimensional view of clientelism in Bosnia and Herzegovina, this essay provides the Philippine case as contrast and comparison. The article examines how both countries’ experience can open new avenues for us to understand the durability of clientelism and its relationship with formal and informal institutions. Brokovic’s agency and personhood within clientelistic relationships accounts for the endurance of this practice in democratic societies that experienced transition. Clientelism persists in part due to the reliability of personal relations over the ability of public institutions to deliver. This review article will probe clientelism, as it manifests in the politics of the Philippines and its democratic institutions. Among the multiple types of clientelistic relationship in the Philippines, some emphasize the role of machine politics, corruption, and coercion. Brković’s book provides a new lens of analysis by looking at clientelism through personhood and agency as power. The contribution of the book on the discourse of clientelism can deepen the understanding of Philippine politics because it encourages an analysis that looks at the exercise of democracy through personhood, agency, and informal institutions. It invites us to view clientelism not just through corruption and violence. By combining the analysis that utilizes formal and informal institutions, personhood and structuralist, this essay explains why some countries that have transitioned into democracies remain ambiguous states and explain the persistence of clientelism.
Variations in bacterial decay between cell types and between cell wall regions in waterlogged archaeological wood excavated in the intertidal zone
Authors: Cha Mi Young , Lee Kwang Ho , Kim Jong Sik , Kim Yoon Soo
Published: October 2021

The bacterial decay of waterlogged archeological wood (WAW, hard pine spp.) taken from Daebudo shipwreck No. 2, which was buried in the intertidal zone in the mid-west coast (Yellow sea) of South Korea approximately 800 years ago, was investigated. The maximum moisture content of the outer parts (approx. 3 cm of depth) of WAW was approximately 4.2 times higher than that of undegraded reference pine wood. ATR-FTIR and solid-state 13C-NMR analysis indicated a relative increase of the lignin concentration in WAW caused by the degradation of cellulose and hemicelluloses across the board studied (31-cm-wide and 14.5-cm-thick board). Micromorphological studies also revealed that bacterial degradation was progressed to a depth of 15 cm (vertically 7.3 cm) from the surface, which is the innermost part of the board. Erosion bacteria (EB) were identified as the main degraders of WAW. Degradation by tunneling bacteria (TB) was occasionally detected. Decay resistance to bacterial attacks in WAW varied between cell types and between cell wall regions. Axial tracheids showed less resistance than ray tracheids, ray parenchyma cells, and axial intercellular canal cells, including strand tracheids, subsidiary parenchyma cells, and epithelial cells. Decay resistance was higher in ray tracheids and strand tracheids than in ray parenchyma cells and subsidiary parenchyma-/epithelial cells, respectively. Bordered- and cross-field pit membranes and the initial pit borders showed higher decay resistance than the tracheid cell walls. Overall, the S2 layer of the axial tracheids showed the weakest resistance to bacterial attacks.
Dooyeweerd’s Problematic Idea of Cosmic Time
Authors: Skillen James W.
Published: October 2021

Herman Dooyeweerd (1953, 28) writes that “the idea of cosmic time constitutes the basis of the philosophical theory of reality in [A New Critique of Theoretical Thought].” My aim is to present and defend the hypothesis that Dooyeweerd’s idea of time is, in part, mistaken at its foundation. His idea of a cosmic temporal coherence of diverse modal aspects arose from the absolutization of a concept of temporal universality that he adopted uncritically as the transcendental basic Idea of cosmic time. My immanent-critical assessment leads to the hypothesis that temporality should be recognized as the first modal aspect, which, for Dooyeweerd, has been lost to view. Recovering both the sphere sovereignty of the temporal aspect and the equal universality of all aspects opens the way to a resolution of Dooyeweerd’s temporal/supratemporal dialectic and to a new perspective on naive experience and the meaning of humans as God’s image.
Prioritizing Humane Minimum-Stress Methods in Swine Facility & Protocol Design
Authors: Panepinto Linda M.
Published: October 2021

The housing, care and handling of animals in a laboratory/research setting presents a wide variety of challenges to researchers, veterinarians and animal care staff. With that in mind, there are certain fundamental components of both facility design and procedural techniques which should always be considered. Some of the initial considerations should be the potential value of the research being proposed along with ethical aspects of the protocol design. The selected species should be appropriate for the study and essential needs of that species addressed with regard to their 24/7 environment. In addition, the equipment and expertise needed to humanely conduct restraint and other procedures should be available. At times, the goals of the science are moved ahead of the basic well-being of the subjects being studied. This can be problematic, especially for animals that are maintained long term. This review of facilities, animal care enrichment strategies and methodologies for swine will highlight some of the more effective and practical approaches to minimizing stress and enhancing the value of the research conducted.
A new species of climbing Chamaedorea (Arecaceae) from Chiapas, Mexico
Authors: PÉREZ-FARRERA MIGUEL ANGEL , GUTIÉRREZ-ORTEGA JOSÉ SAID , HODEL DONALD R. , VILLAR-MORALES DIEGO , SANTOS-HERNÁNDEZ NANCY GABRIELA , MARTÍNEZ-CAMILO RUBÉN
Published: October 2021

Chamaedorea tacanensis (Arecaceae), a new species from the Tacaná Volcano Biosphere Reserve, Chiapas, Mexico, is described based on morphological and phylogenetic data. It is morphologically similar to C. elatior, the only other climbing species in the genus. However, C. tacanensis is distinguished by having linear pinnae (lanceolate in C. elatior), petioles emerging glaucous (glabrous in C. elatior), and longer rachises, blades and peduncles than C. elatior. Also, C. tacanensis has pinnate-leaved seedlings and juveniles, whereas they are simple or bifid in C. elatior. The two taxa form separate monophyletic groups. Geographically, C. tacanensis is found in tropical montane cloud forests of the Pacific slope whereas C. elatior mostly occurs in lowland tropical forests of the Atlantic slope. Chamaedorea tacanensis has been recorded in only three localities: two in the Tacaná Volcano Biosphere Reserve, Mexico, and one in San Marcos, Guatemala. Further floristic studies in surrounding areas might better clarify the geographic distribution range of this species.
Ditiola haasii (Basidiomycota, Dacrymycetaceae)—taxonomy and ecology of a rare species from Central Europe
Authors: ZAMORA JUAN CARLOS , HOLEC JAN
Published: October 2021

Ditiola haasii, a largely unknown member of the Dacrymycetes described from Germany, is documented in detail based on two specimens collected on Picea abies wood in the Boubínský prales virgin forest, Czech Republic. The work represents the first complete taxonomic/ecological investigation of the species since its original description. The morphology of the newly studied samples is evaluated to gain a better knowledge of intraspecific variation, and a phylogenetic analysis based on nrLSU data is provided to further confirm our identification and show the phylogenetic position of D. haasii within the Dacrymycetes. A comparison with similar species and those with which it has been confused is made and ecological details are provided based on our collections. Colour photographs of basidiomata and micromorphological characters are published. Ditiola haasii is currently documented by just six records worldwide, all of them from Central Europe.
Bulbophyllum xuansonii (Orchidaceae), a new miniature orchid from northern Vietnam and new national record of B. gracilipes
Authors: NGUYEN DINH HIEP , AVERYANOV LEONID V. , DANG VAN SON , PHAM PHUOC DIEN , MAISAK TATIANA , BUI VAN HUONG , DANG MINH QUAN , TRUONG BA VUONG
Published: October 2021

Bulbophyllum xuansonii belonging to section Brachystachyae, discovered in Ninh Binh and Son La provinces is described here as a new species for science. This species is similar to B. xylophyllum and B. gracilipes but can be easily distinguished by the smaller habit and shape of tepals and stelidia. Additionally, B. gracilipes found in Lam Dong Province is reported as the species newly recorded for the flora of Vietnam. The paper provides analytical photos and data on phenology, ecology, and distribution of studied species. Morphological characters of the new species and similar species are shortly discussed. The key for identification of species of B. sect. Brachystachyae in Vietnam is also included.
Three new genera of large marsh beetles (Coleoptera: Scirtidae) from Valdivian temperate rain forests of southern South America
Authors: RUTA RAFAŁ
Published: October 2021

The present paper fills a gap in the knowledge of the largest marsh beetles in the Neotropics. Argelodes gen. nov., Solierodes gen. nov. and Mucronotus gen. nov. are described from Southern South America. Argelodes and Solierodes are monotypic, contain Argelodes magnificus sp. nov. and Solierodes rousseli (Solier, 1849) comb. nov., while Mucronotus contains five species: Mucronotus velutinus (Solier, 1849) comb. nov., M. schwabei (Pic, 1938) comb. nov., and three newly described ones—M. enigmaticus sp. nov., M. patagonicus sp. nov., and M. valdivianus sp. nov. Affinities of newly described genera with Australian taxa are briefly discussed. Pronotal modifications in marsh beetles are illustrated and discussed.
Ten new species of marine bryozoans (Gymnolaemata: Cheilostomatida) from Brazil
Authors: ALMEIDA ANA C.S. , LARRÉ IGOR R.N.M. , VIEIRA LEANDRO M.
Published: October 2021

Despite a recent increase in the number of taxonomic studies on the bryozoan fauna of northeastern Brazil, new discoveries and re-examination of museum specimens allow the continued recognition of new taxa. Here, we describe ten new cheilostome species from the northeastern continental shelf of Brazil based on different museum collections. The new species are: Thalamoporella tupinamba n. sp., Turbicellepora papula n. sp., Plesiocleidochasma brasiliensis n. sp., Plesiocleidochasma infundibulum n. sp., Rhynchozoon turgidum n. sp., Cribrilaria brasiliensis n. sp., Hippoporina titan n. sp., Crepidacantha fasciata n. sp., Crepidacantha browni n. sp., and Hippopodina inarmata n. sp. Some specimens previously reported from northeastern Brazil are here reassigned to the newly described taxa, and two new combinations, Cribrilaria caraguata (Winston & Vieira, 2013) n. comb. and Cribrilaria tuba (Winston & Vieira, 2013) n. comb., are proposed.
The Effects on Electric Field and Hydrostatic Pressure on the Doped Properties in a Strained (In,Ga)N-GaN Coupled Quantum Wells
Authors: Li Xin-Nan , Wang Guang-Xin , Duan Xiu-Zhi
Published: October 2021

A variational approach is utilized to investigated the electron-impurity interaction in zinc-blende (In,Ga)N-GaN strained coupled quantum wells. The donor imputrity states are studied in consideration of the effects of hydrostatic pressure and external electric field. Our results indicate that the binding energy visibly depends on hydrostatic pressure, strain of coupled quantum wells, and applied electric field. The binding energy demonstrates a peak value with the reduction of the left-well width, and which displays a minimum value with the increment of the middle-barrier width. A decreasing behavior on the binding energy is also demonstrated when the right-well width enhances. Also the binding energy augments constantly with the increasing hydrostatic pressure. Besides, the dependency of the binding energy on variation of impurity position has been analyzed detailedly.
On the diurnal cycle of rainfall and convection over Lake Victoria and its catchment. Part 2: Meteorological factors in the diurnal and seasonal cycles
Authors: Nicholson Sharon E. , Hartman Adam T. , Klotter Douglas A.
Published: October 2021

The purpose of this article is to determine the meteorological factors controlling the lake-effect rains over Lake Victoria. Winds, divergence, vertical motion, specific humidity, Convective Available Potential Energy (CAPE), and Convective Inhibition (CIN) were examined. The local wind regime and associated divergence/convergence are the major factors determining the diurnal cycle of rainfall over the lake and catchment. The major contrast between over-lake rainfall in the wet- and dry-season months is the vertical profile of omega. This appears to be a result of seasonal contrasts in CAPE, CIN, and specific humidity, parameters that play a critical role in vertical motion and convective development.
The Value of Abdominal and Pelvic CT Scan in Trauma Patients With Low Injury Severity Score and High Glasgow Coma Scale
Authors: Wasfie Tarik , Rivera Daniel , Naisan Mursal , Zaremba Shelby , Depuydt Mikayla , Read Sydney , Hella Jennifer , Barber Kimberly , Yapchai Raquel , Shapiro Brian
Published: October 2021

Introduction

Computed tomography scans became the mainstay of emergency department (ED) evaluation of trauma patients including those with a high Glasgow Coma Scale (GCS) and a low Injury Severity Score (ISS). We elected to find the value of abdominal and pelvic CT in patients with negative physical examination and Focused Assessment of Sonography for Trauma (FAST) on arrival to the ED.

Methods

This study is a retrospective analysis of 901 consecutive patients from 2017 to 2019 who presented to the ED with level 2 and 3 activation criteria. Each patient received a physical examination, CT abdomen and pelvis, and FAST exam. Data were collected on external factor including GCS, ISS, age, sex, comorbidities, anticoagulation use, and surgical intervention. The patients were divided into 2 groups, Group A and B. Group A consisted of patients with a negative physical exam, FAST, and CT result. Group B included patients with a negative physical exam and FAST exam with positive CT findings. Statistical analysis was done using a Student’s t-test and chi-square test for significance value of P < .05. Institutional Review Board approval was obtained for this study.

Results

A total of 901 patients were analyzed which included 489 (54.3%) male and 412 (45.7%) female with a mean age of 56.2 (SD = 22.62) years. Out of the 901 patients, 461 patients received a physical, FAST, and CT exam. Group A consisted of 442 (95.9%) patients and Group B had 19 (4.1%) patients. Both groups were similar in GCS and ISS scoring with no significance difference in age, sex, comorbidities, and anticoagulation use. There was a significant difference in the ICU and hospital mean length of stay when CT scan was positive [2 (SD = 4.23) days vs. .6 (SD = 1.33) days with P < .0001 and 4.57 (SD ± 4.17) days vs. 2.5 (SD = 2.00) days with P < .0001, respectively]. The CT findings of the 19 patients in group B consisted of 6 incidentalomas, 5 vertebral compression fractures, 4 pelvic bone fractures, 1 minor liver contusion, 1 non-specific bowel thickening, 1 non-displaced rib fracture, and 1 case of small amount of free fluid in the pelvis. None of the CT findings required surgical intervention.

Conclusion

Computed tomography of the abdomen and pelvis in trauma patients with high GCS and low ISS with initial negative physical and FAST examination did not provide additional critical information.
Trauma Informed Strategies for Human Trafficking Education in Urban Schools: An Attachment Theory Perspective
Authors: Albert Lumina S.
Published: October 2021

It is being increasingly recognized that providing human trafficking education (HTE) in schools is an effective prevention tool. Yet, the strategies that may be utilized in delivering these programs have not been fully established. The purpose of this paper is two fold. First, the paper discusses the importance of providing human trafficking education in schools, with a particular emphasis on urban schools. Second, the paper utilizes an attachment theory perspective to suggest strategies for trauma informed human trafficking education in schools. This work draws upon recent research in trauma-informed education and practice, and uses an attachment theory perspective to discuss ways to incorporate well-researched strategies and tools into potential curricula for human trafficking education. In the absence of trauma informed strategies incorporated into school education, the effectiveness of anti-trafficking initiatives may be highly compromised.