bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical risk factors for recurrence of pelvic organ prolapse after primary native tissue prolapse repair
Authors: Bodner-Adler Barbara , Bodner Klaus , Carlin Greta , Kimberger Oliver , Marschalek Julian , Koelbl Heinz , Umek Wolfgang
Published: April 2021

Objective

To define potential risk factors for recurrence of prolapse.

Methods

This short report included all women who presented with recurrence of prolapse as well as without any recurrence signs after a vaginal approach of native tissue prolapse repair at an urogynecological center in Austria.

Results

A total of 124 recurrence cases and 64 women with no signs of recurrence after their index prolapse surgery were included. Multivariate analysis identified advanced preoperative POP‑Q stage (pelvic organ prolapse-quantification) as an independent risk factor for postoperative recurrence of prolapse (p = 0.045).

Conclusion

Initial proper preoperative counseling is of particular importance to modulate patients’ expectations after prolapse surgery.
Farm‐scale assessment of maize–pigeonpea productivity in Northern Tanzania
Authors: Mugi-Ngenga E. , Zingore S. , Bastiaans L. , Anten N. P. R. , Giller K. E.
Published: April 2021

Little is known about productivity of smallholder maize–pigeonpea intercropping systems in sub-Saharan Africa. We conducted a survey of 277 farm households in Northern Tanzania to assess socio-economic factors, field management characteristics, and their association with productivity of maize–pigeonpea intercrops. On each farm, crop assessments were focused on a field that the farmer identified as most important for food supply. Variables associated with yields were evaluated using linear regression and regression classification.
Biomass production ranged between 1.0 and 16.6 for maize, and between 0.2 and 11.9 t ha−1 for pigeonpea (at maize harvest). The corresponding grain yields ranged between 0.1 and 9.5 for maize, and between 0.1 and 2.1 t ha−1 for pigeonpea. Plant density at harvest, number of years the field had been cultivated, slope, weeding, soil fertility class, fertiliser and manure use were significantly associated with variation in maize grain yield, with interactions among the factors. Fields on flat and gentle slopes with plant density above 24,000 ha−1 had 28% extra yields when fertiliser was applied, while less than 24,000 plants ha−1 yielded 16% extra yield when manure was applied. Plant density at harvest was the key factor associated with pigeonpea yield; fields with densities above 24,000 plants ha−1 yielded an average of 1.4 t ha−1, while less than 24,000 plants ha−1 yielded 0.5 t ha−1. We conclude that performance of intercrops can be enhanced through application of organic and inorganic nutrient sources, and agronomic interventions including weeding, implementing soil conservation measures on steep slopes and optimising plant density.
On making a difference: towards a minimally non-trivial version of the identity of indiscernibles
Authors: Wörner David
Published: April 2021

The identity of indiscernibles (PII) states that indiscernible objects must be identical. Many philosophers have held that the PII turns out to be either true but trivial, or non-trivial but false, depending on how the notion of (in)discernibility is spelled out. In this paper, I propose and defend an account of this notion which aims to yield a minimally non-trivial and yet plausible version of the PII. I argue moreover that this version of the principle is immune to a number of well-known and recent objections to the PII.
Multiple Factors Influence the Accumulation of Heavy Metals (Cu, Pb, Ni, Zn) in Forest Soils in the Vicinity of Roadways
Authors: Kupka Dawid , Kania Mateusz , Pietrzykowski Marcin , Łukasik Adam , Gruba Piotr
Published: April 2021

Intensified vehicular traffic causes increased heavy metal contamination of the environment. We investigated the heavy metal chemistry of soils located under silver fir stands in the vicinity of Poland’s S7 roadway. Three sampling sites were located in fir stands in central Poland. Fieldwork included soil sampling of the organic (O) horizon and mineral (A) topsoil. We analyzed the soil pH, carbon (C) and nitrogen (N) concentration, and the HCl-extractable forms of sodium (Na) and heavy metals: copper (Cu), nickel (Ni), lead (Pb), and zinc (Zn). The stoichiometric ratios Cu:C, Ni:C, Pb:C, and Zn:C were also calculated. In all sites, a higher Na concentration was found in the 0–10 m from the forest edge. This zone was characterized by increased pH in the O horizon, increased Zn and Ni in the A horizon, and a decreased Pb in the O horizon. There was no clear pattern for the Cu concentration. The Ni:C and Zn:C ratios were correlated with pH, while Pb:C and Cu:C ratios were correlated with the clay minerals. HCl-extractable Ni and Zn concentrations in A horizon were greater near the roadway, revealing strong pH dependency. The roadway affects the geochemical background of the topsoil in the nearby fir stands. Mechanistically, we suggest that Na increases the soil pH and therefore enhances the ability of soil organic matter to bind Ni and Zn by releasing hydrogen from soil organic matter functional groups into the soil solution. A depleted Pb near the road was likely owing to the strong competition from Na.
Socializing Children
Authors: Grusec Joan E. , Davidov Maayan
Published: April 2021

Complaints are often made that recommendations about how to rear children are contradictory and, therefore, not helpful. In this Element we survey the history of theory and research relevant to childrearing in an attempt to show how apparent differences can be resolved. We suggest that socialization occurs in different domains, with each domain fostering socialization in a different way. Thus there is no all-purpose principle or mechanism of socialization but, rather, different forms of relationship between child and agent that serve a different function, involve different rules for effecting behavior change, and facilitate different outcomes. Using this framework, we survey research relevant to different domains, including the roles played by parents, siblings, and peers in the socialization process. We follow this with a discussion of how culture and biology make their contribution to an understanding of domains of socialization.
The League of Nations and the Protection of the Environment
Authors: Aloni Omer
Published: April 2021

In the history of how the law has dealt with environmental issues over the last century or so, the 1920s and 30s and the key role of the League of Nations in particular remain underexplored by scholars. By delving into the League's archives, Omer Aloni uncovers the story of how the interwar world expressed similar concerns to those of our own time in relation to nature, environmental challenges and human development, and reveals a missing link in understanding the roots of our ecological crisis. Charting the environmental regime of the League, he sheds new light on its role as a centre of surprising environmental dilemmas, initiatives, and solutions. Through a number of fascinating case studies, the hidden interests, perceptions, motivations, hopes, agendas and concerns of the League are revealed for the first time. Combining legal thought, historical archival research and environmental studies, a fascinating period in legal-environmental history is brought to life.
Whole-Child Development, Learning, and Thriving
Authors: Cantor Pamela , Lerner Richard M. , Pittman Karen J. , Chase Paul A. , Gomperts Nora
Published: April 2021

We discuss whole-child development, learning, and thriving through a dynamic systems theory lens that focuses on the United States and includes an analysis of historical challenges in the American public education system, including inequitable resources, opportunities, and outcomes. To transform US education systems, developmental and learning scientists, educators, policymakers, parents, and communities must apply the knowledge they have today to 1. challenge the assumptions and goals that drove the design of the current US education system, 2. articulate a revised, comprehensive definition of whole-child development, learning, and thriving that accepts rather than simplifies how human beings develop, 3. create a profound paradigm shift in how the purpose of education is described in the context of social, cultural, and political forces, including the impacts of race, privilege, and bias and 4. describe a new dynamic 'language' for measurement of both the academic competencies and the full set of 21st century skills.
Ignoring Implementation: Defects in Canada’s “Rape Shield” Policy Cycle
Authors: McNabb Danielle , Baker Dennis
Published: April 2021

This article employs a “policy cycle” framework to explore Bill C-51, legislation which contains Canada’s latest amendments to the “rape shield.” Through an in-depth evaluation of earlier rape shield reforms, as well as a content analysis of the legislative proceedings of Bill C-51, this paper reveals that, while the impetus for introducing rape shield legislation is to protect the equality and privacy rights of sexual assault complainants, the legislative process of these “policy cycles” focuses disproportionately on remedying due process concerns and less on the problems that arise in judicial implementation of the provisions. We situate this finding within the larger trend towards the “judicialization of politics,” and trace some of the institutional and structural obstacles that impede Parliamentarians from more effectively legislating to improve sexual assault trials for complainants.
Correction in Active Cases Data of COVID-19 for the US States by Analytical Study
Authors: Solanki Ravi , Varshney Anubhav , Gourishetty Raveesh , Minase Saniya , Sivadas Namitha , Mahajan Ashutosh
Published: April 2021

The total coronavirus disease (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have reached 139 million worldwide and nearing 3 million deaths on April 16, 2021. The availability of accurate data is crucial as it makes it possible to analyze correctly the infection trends and make better forecasts. The reported recovered cases for many US states are surprisingly low. This could be due to difficulties in keeping track of recoveries, which resulted in higher numbers for the reported active cases than the actual numbers on the ground. In this work, based on the typical range of recovery rate for COVID-19, we estimate the active data from the total cases and death cases and bring out a correction for the data for all the US states reported on Worldometer.
“THIS MAN IS MY WIFE”: THE SAME-SEX MARRIAGE PROHIBITION ACT OF 2014 IN NIGERIA
Authors: Oladosu-Uthman Habibat
Published: April 2021

The increased visibility of same-sex relationships and the call for same-sex marriages have been particular challenges to the traditional marriage system in Africa in the contemporary period. While some critics have argued, erroneously, that same-sex relationships were completely unknown to the African continent until the advent of Western modernity, others have suggested that the practices speak to a greater malaise confronting African societies. Nigeria is not an exception in this case. In light of these trends, this article examines the Same-Sex Marriage Prohibition Act, which was promulgated by the Nigerian government in 2014 and has since led to infractions upon the human rights of citizens in same-sex relationships. The article examines these developments around same-sex relationships in the context of wider social and economic challenges to the traditional marriage institution in Nigeria.
Inflammatory neuropsychiatric disorders and COVID-19 neuroinflammation
Authors: Tang Siu Wa , Helmeste Daiga , Leonard Brian
Published: April 2021

Neuropsychiatric sequalae to coronavirus disease 2019 (COVID-19) infection are beginning to emerge, like previous Spanish influenza and severe acute respiratory syndrome episodes. Streptococcal infection in paediatric patients causing obsessive compulsive disorder (PANDAS) is another recent example of an infection-based psychiatric disorder. Inflammation associated with neuropsychiatric disorders has been previously reported but there is no standard clinical management approach established. Part of the reason is that it is unclear what factors determine the specific neuronal vulnerability and the efficacy of anti-inflammatory treatment in neuroinflammation. The emerging COVID-19 data suggested that in the acute stage, widespread neuronal damage appears to be the result of abnormal and overactive immune responses and cytokine storm is associated with poor prognosis. It is still too early to know if there are long-term-specific neuronal or brain regional damages associated with COVID-19, resulting in distinct neuropsychiatric disorders. In several major psychiatric disorders where neuroinflammation is present, patients with abnormal inflammatory markers may also experience less than favourable response or treatment resistance when standard treatment is used alone. Evidence regarding the benefits of co-administered anti-inflammatory agents such as COX-2 inhibitor is encouraging in selected patients though may not benefit others. Disease-modifying therapies are increasingly being applied to neuropsychiatric diseases characterised by abnormal or hyperreactive immune responses. Adjunct anti-inflammatory treatment may benefit selected patients and is definitely an important component of clinical management in the presence of neuroinflammation.
Apples before the fall: Does shape stability coincide with maturity?
Authors: Christodoulou Maria D. , Culham Alastair
Published: April 2021

Fruit shape is the result of the interaction between genetic, epigenetic, environmental factors and stochastic processes. As a core biological descriptor both for taxonomy and horticulture, the point at which shape stability is reached becomes paramount in apple cultivar identification, and authentication in commerce. Twelve apple cultivars were sampled at regular intervals from anthesis to harvest over two growing seasons. Linear and geometric morphometrics were analysed to establish if and when shape stabilised and whether fruit asymmetry influenced this. Shape stability was detected in seven cultivars, four asymmetric and three symmetric. The remaining five did not stabilise. Shape stability, as defined here, is cultivar-dependent, and when it occurs, it is late in the growing season. Geometric morphometrics detected stability more readily than linear, especially in symmetric cultivars. Key shape features are important in apple marketing, giving the distinctness and apparent uniformity between cultivars expected at point of sale.
Attach importance of the bootstrapttest against Student'sttest in clinical epidemiology: a demonstrative comparison using COVID-19 as an example
Authors: Zhao Shi , Yang Zuyao , Musa Salihu S. , Ran Jinjun , Chong Marc K. C. , Javanbakht Mohammad , He Daihai , Wang Maggie H.
Published: April 2021

Student'sttest is valid for statistical inference under the normality assumption or asymptotically. By contrast, although the bootstrapttest was proposed in 1993, it is seldom adopted in medical research. We aim to demonstrate that the bootstrapttest outperforms Student'sttest under normality in data. Using random data samples from normal distributions, we evaluated the testing performance, in terms of true-positive rate (TPR) and false-positive rate and diagnostic abilities, in terms of the area under the curve (AUC), of the bootstrapttest and Student'sttest. We explore the AUC of both tests with varying sample size and coefficient of variation. We compare the testing outcomes using the COVID-19 serial interval (SI) data in Shenzhen and Hong Kong, China, for demonstration. With fixed TPR, the bootstrapttest maintained the equivalent accuracy in TPR, but significantly improved the true-negative rate from the Student'sttest. With varying TPR, the diagnostic ability of bootstrapttest outperformed or equivalently performed as Student'sttest in terms of the AUC. The equivalent performances are possible but rarely occur in practice. We find that the bootstrapttest outperforms by successfully detecting the difference in COVID-19 SI, which is defined as the time interval between consecutive transmission generations, due to sex and non-pharmaceutical interventions against the Student'sttest. We demonstrated that the bootstrapttest outperforms Student'sttest, and it is recommended to replace Student'sttest in medical data analysis regardless of sample size.
A scoping review of research on policies to address child undernutrition in the Millennium Development Goals era
Authors: Pike Vanessa , Bradley Beverly , Rappaport Aviva I , Zlotkin Stanley , Perumal Nandita
Published: April 2021

Objective:

The breadth of research on the impact of nutrition-specific policies to address child undernutrition is not well documented. This review maps the evidence base and identifies gaps on such policies.

Design:

We systematically searched Medline, Embase, PAIS Index for public policy, Scopus and Web of Science databases to identify eligible studies. Key study characteristics, including research design, type of policy, time span of policy before impact assessment, child age at outcome assessment and types of outcomes assessed, were abstracted in duplicate.

Setting:

Low-, middle- and high-income countries.

Participants:

Studies were eligible for inclusion if they aimed to assess the impact of population-level nutrition-specific policies on undernutrition among children under 10 years of age.

Results:

Of the 5646 abstracts screened, eighty-three studies were included. A range of policies to address child undernutrition were evaluated; the majority were related to micronutrient fortification. Most studies were observational, reported on mandatory regional or sub-national polices, were conducted in high-income countries and evaluated policies within 1 year of implementation. A narrow set of health outcomes were evaluated, most commonly iodine deficiency disorders and neural tube defects.

Conclusions:

Nutrition policies were commonly associated with improved child nutritional status and health. However, this evidence is primarily based on limited settings and on a limited number of outcomes. Further research is needed to assess the longer-term impact of a broader range of nutrition policies on child health, particularly in low- and middle-income countries.
Matrices of ‘Love and Theft’: Joan Baez Imitates Bob Dylan
Authors: HADDON MIMI
Published: April 2021

This article uses Joan Baez's impersonations of Bob Dylan from the mid-1960s to the beginning of the twenty-first century as performances where multiple fields of complementary discourse converge. The article is organized in three parts. The first part addresses the musical details of Baez's acts of mimicry and their uncanny ability to summon Dylan's predecessors. The second considers mimicry in the context of identity, specifically race and asymmetrical power relations in the history of American popular music. The third and final section analyses her imitations in the context of gender and reproductive labour, focusing on the way various media have shaped her persona and her relationship to Dylan. The article engages critical theoretical work informed by psychoanalysis, post-colonial theory, and Marxist feminism.
FSS-based triplate antenna design concept for wireless devices
Authors: Kotrashetti Ashwini , Lande B. K , Poddar Ajay
Published: April 2021

Conventional multiband antennas suffer from strong interactions among different operating frequencies, complex configurations, low bandwidth, and reduced efficiencies. A design concept for a multibeam multiband antenna in wireless devices is proposed in this paper. The design concept provides a promising approach to augment transmission and reception. The principle of design involves a primary radiating element embedded in a triplate conformation which excites a passive array of multiple frequency secondary radiators, forming a frequency selective structure in triplate (FSST). The higher order mode behavior of the parent antenna characterizes the design of FSST placed in its nearfield. The mathematical modeling and analysis of the design methodology is also presented. As proof of concept, the proposed design methodology is validated with simulations and experiments at four unlicensed communication bands and the results are compared.
A Threshold Sea‐Surface Temperature at 14°C for Phytoplankton Nonlinear Responses to Ocean Warming
Authors: Feng Jianfeng , Stige Leif Chr , Hessen Dag Olav , Zuo Zhiling , Zhu Lin , Stenseth Nils Chr
Published: April 2021

Marine phytoplankton play a central role in supporting life in the oceans and profoundly affect global biogeochemical cycles. Previous studies have revealed positive effects of sea‐surface temperature (SST) on phytoplankton in terms of chlorophyll a concentrations (Chla) in high latitude oceans, while negative effects prevail in tropical and midlatitude oceans as well as under stratified summer conditions at higher latitudes. Based on a global analysis of 20 years of ocean Chla and SST data, we first investigated how interannual variability in SST is associated with Chla for each month of the season for every ocean province. We then quantified how the SST‐Chla relationships varied with the long‐term average (baseline) SST. We found significant season‐dependent SST effects on Chla in most ocean provinces. The signs and magnitudes of these effects were consistently associated with the baseline SST, with a shift from positive to negative effects of SST on Chla around 14°C. Based on field observations and literature data, we also estimated the interaction between nitrate limitation and temperature on the SST‐Chla relationship. Our findings suggest that the ocean warming effects on Chla depend consistently on the baseline temperature, both with regard to seasonal effects within regions and regional effects between high and low latitude provinces. Our analysis further suggests that the monthly 14°C isotherms can be used as a first approximation to separate areas and seasons where warming has opposite signed effects.
Contrasting Growth Response of Jack Pine and Trembling Aspen to Climate Warming in Quebec Mixedwoods Forests of Eastern Canada Since the Early Twentieth Century
Authors: Boakye Emmanuel A. , Bergeron Yves , Girardin Martin P. , Drobyshev Igor
Published: April 2021

Forest monitoring studies show contrasting trends in tree growth rates since the mid‐twentieth century. However, due to their focus on annual and decadal dynamics, they provide limited insight into the effects of long‐term climatic variability on tree growth. Here, we relied on a large tree‐ring dataset (∼2,700 trees) of two common North American shade‐intolerant tree species, trembling aspen (Populus tremuloides Michx.) and jack pine (Pinus banksiana Lambert), to assess their lifespan‐long growth dynamics in the mixedwood forests of Québec. We also determined how the environmental conditions of the stands influenced tree growth. We observed a significant increase in the radial growth rate of trembling aspen during the study period, while the jack pine decline was not significant. Over the whole study region, the trees growing in sites with lower competition, and those at the lower sections of the terrain slope experienced more of the positive effects of temperature on growth rates. Our study suggests that the tree growth response to climate warming may be species‐specific and will vary across the boreal mixedwoods.
FTA: A Feature Tracking Empirical Model of Auroral Precipitation
Authors: Wu Chen , Ridley Aaron J. , DeJong Anna D. , Paxton Larry J.
Published: April 2021

The Feature Tracking of Aurora (FTA) model was constructed using 1.5 years of Polar Ultraviolet Imager data and is based on tracking a cumulative energy grid in 96 magnetic local time (MLT) sectors. The equatorward boundary, poleward boundary, and 19 cumulative energy bins are tracked with the energy flux and the latitudinal position. With AE increasing, the equatorward boundary moves to lower latitudes everywhere, while the poleward boundary moves poleward in the 2300–0300 MLT region and equatorward in other MLT sectors. This results in the aurora getting wider on the nightside and becoming narrower on the dayside. The peak intensity of the aurora in each MLT sector is almost linearly related to AE, with the global peak moving from pre‐midnight to post‐midnight as geomagnetic activity increases. Ratios between the Lyman‐Birge‐Hopfield‐long and ‐short models allow the average energy to be calculated. Predictions from the FTA and two other auroral models were compared to the measurements by the Defense Meteorological Satellite Program Special Sensor Ultraviolet Spectrographic Imagers (SSUSI) on March 17, 2013. Among the three models, the FTA model specified the most confined patterns with the highest energy flux, agreeing with the spatial and temporal evolution of SSUSI measurements better and predicted auroral power (AP) better during higher activity levels (SSUSI AP > 20 GW). The Fuller‐Rowell and Evans (1987) and FTA models specified very similar average energy compared with SSUSI measurements, doing slightly better by ∼1 keV than the OVATION Prime model.
Genome sequence analysis of deep sea Aspergillus sydowii BOBA1 and effect of high pressure on biodegradation of spent engine oil
Authors: Ganesh Kumar A. , Manisha D. , Sujitha K. , Magesh Peter D. , Kirubagaran R. , Dharani G.
Published: April 2021

A deep-sea fungus Aspergillus sydowii BOBA1 isolated from marine sediment at a depth of 3000 m was capable of degrading spent engine (SE) oil. The response of immobilized fungi towards degradation at elevated pressure was studied in customized high pressure reactors without any deviation in simulating in situ deep-sea conditions. The growth rate of A. sydowii BOBA1 in 0.1 MPa was significantly different from the growth at 10 MPa pressure. The degradation percentage reached 71.2 and 82.5% at atmospheric and high pressure conditions, respectively, within a retention period of 21 days. The complete genome sequence of BOBA1 consists of 38,795,664 bp in size, comprises 2582 scaffolds with predicted total coding genes of 18,932. A total of 16,247 genes were assigned with known functions and many families found to have a potential role in PAHs and xenobiotic compound metabolism. Functional genes controlling the pathways of hydrocarbon and xenobiotics compound degrading enzymes such as dioxygenase, decarboxylase, hydrolase, reductase and peroxidase were identified. The spectroscopic and genomic analysis revealed the presence of combined catechol, gentisate and phthalic acid degradation pathway. These results of degradation and genomic studies evidenced that this deep-sea fungus could be employed to develop an eco-friendly mycoremediation technology to combat the oil polluted marine environment. This study expands our knowledge on piezophilic fungi and offer insight into possibilities about the fate of SE oil in deep-sea.
Multitask fMRI and machine learning approach improve prediction of differential brain activity pattern in patients with insomnia disorder
Authors: Lee Mi Hyun , Kim Nambeom , Yoo Jaeeun , Kim Hang-Keun , Son Young-Don , Kim Young-Bo , Oh Seong Min , Kim Soohyun , Lee Hayoung , Jeon Jeong Eun , Lee Yu Jin
Published: April 2021

We investigated the differential spatial covariance pattern of blood oxygen level-dependent (BOLD) responses to single-task and multitask functional magnetic resonance imaging (fMRI) between patients with psychophysiological insomnia (PI) and healthy controls (HCs), and evaluated features generated by principal component analysis (PCA) for discrimination of PI from HC, compared to features generated from BOLD responses to single-task fMRI using machine learning methods. In 19 patients with PI and 21 HCs, the mean beta value for each region of interest (ROIbval) was calculated with three contrast images (i.e., sleep-related picture, sleep-related sound, and Stroop stimuli). We performed discrimination analysis and compared with features generated from BOLD responses to single-task fMRI. We applied support vector machine analysis with a least absolute shrinkage and selection operator to evaluate five performance metrics: accuracy, recall, precision, specificity, and F2. Principal component features showed the best classification performance in all aspects of metrics compared to BOLD response to single-task fMRI. Bilateral inferior frontal gyrus (orbital), right calcarine cortex, right lingual gyrus, left inferior occipital gyrus, and left inferior temporal gyrus were identified as the most salient areas by feature selection. Our approach showed better performance in discriminating patients with PI from HCs, compared to single-task fMRI.
Higher CD4/CD8 ratio of pleural effusion predicts better survival for lung cancer patients receiving immune checkpoint inhibitors
Authors: Lee Po-Hsin , Yang Tsung-Ying , Chen Kun-Chieh , Huang Yen-Hsiang , Tseng Jeng-Sen , Hsu Kuo-Hsuan , Wu Yu-Chen , Liu Ko-Jiunn , Chang Gee-Chen
Published: April 2021

Pleural effusion is a rare immune-related adverse event for lung cancer patients receiving immune checkpoint inhibitors (ICIs). We enrolled 281 lung cancer patients treated with ICIs and 17 were analyzed. We categorized the formation of pleural effusion into 3 patterns: type 1, rapid and massive; type 2, slow and indolent; and type 3, with disease progression. CD4/CD8 ratio of 1.93 was selected as the cutoff threshold to predict survival. Most patients of types 1 and 2 effusions possessed pleural effusion with CD4/CD8 ratios ≥ 1.93. The median OS time in type 1, 2, and 3 patients were not reached, 24.8, and 2.6 months, respectively. The median PFS time in type 1, 2, and 3 patients were 35.5, 30.2, and 1.4 months, respectively. The median OS for the group with pleural effusion CD4/CD8 ≥ 1.93 and < 1.93 were not reached and 2.6 months. The median PFS of those with pleural effusion CD4/CD8 ≥ 1.93 and < 1.93 were 18.4 and 1.2 months. In conclusion, patients with type 1 and 2 effusion patterns had better survival than those with type 3. Type 1 might be interpreted as pseudoprogression of malignant pleural effusion. CD4/CD8 ratio ≥ 1.93 in pleural effusion is a good predicting factor for PFS.
Measuring Stakeholder Perceptions: A Review of Social Validity Reporting in ASHA Journals
Authors: Olszewski Arnold , Rae Kirsty
Published: April 2021

Purpose

Intervention research in speech-language pathology is growing; however, there remains a gap between research and clinical practice. To promote evidence-based practice, stakeholder input may be solicited during the development and evaluation of treatments. One method of evaluating stakeholder input is by subjectively measuring social validity. Social validity probes end users' satisfaction and acceptability of a treatment.

Method

This review article explores the type and frequency of subjective social validity measures reported in speech-language pathology treatment literature published in
American Journal of Speech-Language Pathology; Journal of Speech, Language, and Hearing Research;
and
Language, Speech, and Hearing Services in Schools
from January 2017 through April 2019. In total, 93 treatment studies were included and coded descriptively.

Results

Of the 93 treatment studies included in this review, 20 reported subjective measures of social validity. The most common method of measurement was questionnaires (
n
= 19), followed by interviews (
n
= 5), and direct observation (
n
= 1).

Conclusions

Only 21.5% of reviewed speech-language pathology treatment articles from American Speech-Language-Hearing Association journals reported measures of social validity, although it is a crucial component of implementation of evidence-based practice. We urge researchers and journal editors to include social validity measures in treatment literature as we promote the uptake of evidence-based practices and the involvement of stakeholders during the development of evidence-based practices. We also encourage the development of social validity measures that can be validated on individuals with communication disorders.
Waste management strategy and development in Ajman, UAE
Authors: Al-Dabbagh Riadh
Published: April 2021

Population growth, social and industrial activities have increased significantly, resulting in an increase in the quantities of wastes in UAE in specific the Emirate of Ajman. Most of the waste is still not thoroughly treated and ends up in municipal landfills, where organic waste generates many gases such as methane, a potent greenhouse gas. Currently, little of the waste is burned, and the rate of municipal waste recycling has been rapidly rising. Waste management in the Ajman is coordinated through local authorities. For this purpose the UAE has set Key Performance Indicators (KPIs) to measure its performance against its targets of 2021. To support the national efforts, Ajman is continuously seeking to adopt vital initiatives and projects that are positively affecting all aspects of life. Waste issues are handled through recycling and converting waste to energy and resources, new technologies and improved waste separation and collection systems. Ajman Municipality and Planning Department has initiated plans and efforts in waste management, including converting waste to energy, treating wastewater, and controlling the movement of hazardous waste. The programs are implemented with the aim to reduce the adverse per capita environmental impact of the city, including by paying particular attention to air quality and all types of waste. The paper presents an overview of the waste situation and the management practices according to the Municipality's plans and strategies. It is concluded that Ajman still lacks an infrastructure for organic waste recycling for residents. This organic waste is a significant contributor to methane emissions from landfills. Challenges are to be solved, such as the lack of adequate waste sorting and recycling facilities in the Emirate and weak community culture to adopt waste sorting. Many practices started to be implemented by the Municipality, for instance, creating an incinerator used to treat non-chemical medical waste generated from hospitals & clinics. As a result, Ajman has witnessed a reduction in the quantity of waste dumped in the landfill.
Rôle des accélérateurs de particules dans la lutte contre le SARS-CoV-2
Authors: Bayat Sam , Delerue Nicolas
Published: April 2021

À travers le monde, les équipes sanitaires ont été en première ligne pour lutter contre la propagation du virus SARS-CoV-2, responsable de la pandémie de Covid-19. Au-delà du traitement de l’urgence médicale, des recherches sont nécessaires pour mieux comprendre comment inhiber les mécanismes d’action du virus.

On peut, entre autres, imager par diffraction la structure de ses protéines grâce au rayonnement X synchrotron ou à des flux de neutrons, ou étudier les lésions qui se forment dans les poumons.
Comment les bactéries explorent les surfaces…
Authors: Peruani Fernando
Published: April 2021

Comment une bactérie peut-elle explorer le mieux possible l’espace autour d’elle, en particulier quand elle est au voisinage d’une paroi ? La bactérie et les physiciens semblent d’accord sur la solution : un subtil compromis entre avancer, tourner et adhérer par intermittence.

Piégées par les interactions hydrodynamiques, les bactéries arrivent à se déplacer sur des surfaces en s’y collant transitoirement.
Häufigkeit und Strahlenexposition nuklearmedizinischer Untersuchungen in Deutschland
Authors: Borowski Markus , Pirl Lukas , Happel Christian , Hellwig Dirk , Mix Michael , Wiggermann Philipp
Published: April 2021

Neun Jahre nach der letzten bundesweiten Erhebung von Daten zur Häufigkeit und Strahlenexposition nuklearmedizinischer Untersuchungen wurde in 71 Einrichtungen erneut ein umfangreicher Datensatz für die Jahre 2016 und 2017 zusammengetragen und analysiert. Die Auswertung basierte auf möglichst vollständigen Daten sämtlicher Untersuchungen des Erhebungszeitraums. Erstmalig wurden ebenfalls Daten zu computertomografischen (CT)-Untersuchungen im Rahmen der Hybridbildgebung erfasst. Die relative Häufigkeit untersuchter Organbereiche hat sich im Vergleich zur Vorgängerstudie relevant geändert. Die relative Häufigkeit von Schilddrüsen- und Skelettuntersuchungen ist deutlich rückläufig. Der Anteil der PET-Bildgebung hat sich mehr als verdoppelt. Die anhand applizierter Aktivitäten berechnete effektive Dosis sank im Mittel um mehr als 25 %, was jedoch vornehmlich auf Änderungen in den Dosiskoeffizienten zurückzuführen ist. Bei Untersuchungen, für die diagnostische Referenzwerte (DRW) existieren, sind Konvergenzen applizierter Aktivitäten zu diesen Werten erkennbar. Bei anderen Untersuchungen ist die Verteilung der in Einrichtungen im Mittel applizierten Aktivitäten teilweise recht heterogen. Die Höhe der Dosis der CT-Untersuchungen, die im Rahmen der Hybridbildgebung durchgeführt werden, unterscheidet sich relevant zwischen einzelnen Einrichtungen. Darüber hinaus besteht eine deutliche Überlappung der Verteilungen der Dosiswerte bei diagnostischen CT-Untersuchungen und solchen, die nach Aussage der Anwender ausschließlich zur Schwächungskorrektur und anatomischen Koregistrierung durchgeführt wurden.
Seltene Erkrankungen des vestibulären Labyrinths: von Zebras, Chamäleons und Wölfen im Schafspelz
Authors: Dlugaiczyk Julia
Published: April 2021

Die Differenzialdiagnose von Erkrankungen des vestibulären Labyrinths stellt eine grosse Herausforderung dar, da sich hinter dem sehr häufigen Leitsymptom «Schwindel» viele verschiedene und v. a. seltene Erkrankungen verbergen können. Der vorliegende Beitrag gibt einen Überblick über die für den HNO-Arzt wichtigen seltenen Erkrankungen des vestibulären Labyrinths ausgehend von ihrer klinischen Präsentation als akutes (AVS), episodisches (EVS) oder chronisches vestibuläres Syndrom (CVS). Der Schwerpunkt liegt dabei auf den EVS, sortiert nach ihrer Dauer und dem Vorhandensein von Triggern (Sekunden, ohne Trigger: Vestibularisparoxysmie, Tumarkin-Krise; Sekunden, lärm- und druckinduziert: Syndrome des «dritten Fensters»; Sekunden bis Minuten, positionsabhängig: seltene Varianten und Differenzialdiagnosen des benignen paroxysmalen Lagerungsschwindels; Stunden bis Tage, spontan: intralabyrinthäre Schwannome, Tumoren des endolymphatischen Sacks, Autoimmunerkrankungen des Innenohres). Des Weiteren werden seltene Differenzialdiagnosen eines AVS (Neuritis vestibularis inf., Otolithenfunktionsstörungen, vaskuläre Ursachen, akute bilaterale Vestibulopathie) und eines CVS (bilaterale Vestibulopathie) erläutert. Dabei werden insbesondere die entscheidenden diagnostischen Massnahmen für die Identifikation der einzelnen Krankheitsbilder und die Warnzeichen für potentiell gefährliche Ursachen (z. B. Labyrinthinfarkt/-blutung) dargelegt. Somit dient dieser Beitrag dem HNO-Arzt in Klinik und Praxis als eine Art «Vademecum» für die zügige Identifikation und zeitnahe Therapie seltener Erkrankungen des Gleichgewichtsorgans.
Seltene Erkrankungen und Hals-Nasen-Ohren-Heilkunde, Kopf und
Halschirurgie
Authors: Plontke Stefan K.
Published: April 2021

Seltene Erkrankungen stellen betroffene Patienten, ihre Angehörigen,
Ärzte, Pflegekräfte und Therapeuten oft vor besondere
Herausforderungen. Ihre Seltenheit erschwert aus medizinischen und
ökonomischen Gründen häufig die Forschung und die
medizinische Versorgung. Viele typische Krankheiten im HNO-Fachgebiet
zählen definitionsgemäß allein aufgrund ihrer
Prävalenz zu den seltenen Erkrankungen. Die Einleitung der richtigen
Schritte zum Management dieser Patienten setzt Kenntnisse über die
Diagnostik, über bestehende Ressourcen wie Zentren, Netzwerke und
Register, die Besonderheiten in der Arzt-Patienten-Beziehung, die Nachsorge
einschließlich der Kommunikation mit den betreuenden
Hausärzten und die Rolle von Selbsthilfegruppen voraus. Von
besonderem Interesse für die Universitätsmedizin und die
wissenschaftliche Fachgesellschaft sind die Besonderheiten im Bereich der
Forschung einschließlich der europäischen Vernetzung und
Forschungsförderung, des Informationsmanagements, der
Öffentlichkeitsarbeit, der Aus-, Fort- und Weiterbildung, Aspekte
der Finanzierung sowie regulatorische Aspekte, wie Orphan Drugs und
klinische Studien bei kleinen Populationen.
Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis
Authors: Tavakoly Rahele , Hadi Amir , Rafie Nahid , Talaei Behrouz , Marx Wolfgang , Arab Arman
Published: April 2021

The possible effect of probiotic interventions on immunological markers in athletes is inconclusive. Therefore, to synthesize and quantitatively analyze the existing evidence on this topic, systematic literature searches of online databases PubMed, Scopus, Cochrane Library, and ISI Web of Sciences was carried out up to February 2021 to find all randomized controlled trials (RCTs) concerning the immunological effects of probiotics in athletes. In the random-effects model, weighted mean difference (WMD) and 95% confidence interval (CI) explained the net effect. The authors assessed the likelihood of publication bias via Egger’s and Begg’s statistics. A total of 13 RCTs (836 participants) were retrieved. Probiotic consumption reduced lymphocyte T cytotoxic count significantly (WMD=−0.08 cells×109/L; 95% CI: −0.15 to −0.01; p=0.022) with evidence of moderate heterogeneity (I
2=59.1%, p=0.044) and monocyte count when intervention duration was ≤ 4 weeks (WMD=−0.08 cells×109/L; 95% CI: −0.16 to −0.001; I
2=0.0%). Furthermore, leukocyte count was significantly elevated (WMD=0.48 cells×109/L; 95% CI: 0.02 to 0.93; I
2=0.0%) when multi-strain probiotics were used. Probiotic supplements may improve immunological markers, including lymphocyte T cytotoxic, monocyte, and leukocyte in athletes. Further randomized controlled trials using diverse strains of probiotics and consistent outcome measures are necessary to allow for evidence-based recommendations.
Homeopathic Treatment of a Lower Leg Edema—A Case Report
Authors: Pannek Jürgen , Pannek-Rademacher Susanne
Published: April 2021

Background Homeopathy is frequently and successfully used in daily clinical practice, so there is a need for well-documented case reports that illustrate its effectiveness. For this reason, we present a case in which homeopathy was used to treat an ankle and lower leg for spontaneous acute swelling and redness.

Case Report A 54-year-old man presented with recurrence of a swollen left ankle and lower leg, which had previously been treated by conventional medicine. After case taking, a homeopathic treatment with Apis mellifica 200c led to a fast improvement. The patient was free of symptoms within 24 hours and has remained so for 3 years.

Conclusion Homeopathic treatment with Apis mellifica led to a fast and long-lasting improvement of an acute ankle swelling and reddening that had recurred after conventional medical therapy of similar symptoms.
Comparison of Bleeding Risk Scores in Elderly Patients Receiving Extended Anticoagulation with Vitamin K Antagonists for Venous Thromboembolism
Authors: Frei Andrea N. , Stalder Odile , Limacher Andreas , Méan Marie , Baumgartner Christine , Rodondi Nicolas , Aujesky Drahomir
Published: April 2021

Background In elderly patients with venous thromboembolism (VTE), the decision to extend anticoagulation beyond 3 months must be weighed against the bleeding risk. We compared the predictive performance of 10 clinical bleeding scores (VTE-BLEED, Seiler, Kuijer, Kearon, RIETE, ACCP, OBRI, HEMORR2HAGES, HAS-BLED, ATRIA) in elderly patients receiving extended anticoagulation for VTE.

Methods In a multicenter Swiss cohort study, we analyzed 743 patients aged ≥65 years who received extended treatment with vitamin K antagonists after VTE. The outcomes were the time to a first major and clinically relevant bleeding. For each score, we classified patients into two bleeding risk categories (low/moderate vs. high). We calculated likelihood ratios and the area under the receiver operating characteristic (ROC) curve for each score.

Results Over a median anticoagulation duration of 10.1 months, 45 patients (6.1%) had a first major and 127 (17.1%) a clinically relevant bleeding. The positive likelihood ratios for predicting major bleeding ranged from 0.69 (OBRI) to 2.56 (Seiler) and from 1.07 (ACCP) to 2.36 (Seiler) for clinically relevant bleeding. The areas under the ROC curves were poor to fair and varied between 0.47 (OBRI) and 0.70 (Seiler) for major and between 0.52 (OBRI) and 0.67 (HEMORR2HAGES) for clinically relevant bleeding.

Conclusion The predictive performance of most clinical bleeding risk scores does not appear to be sufficiently high to identify elderly patients with VTE who are at high risk of bleeding and who may therefore not be suitable candidates for extended anticoagulation.
Microparticles: An Alternative Explanation to the Behavior of Vascular Antiphospholipid Syndrome
Authors: Álvarez Daniel , Rúa Carolina , Cadavid J Ángela P.
Published: April 2021

Antiphospholipid syndrome is an autoimmune disease characterized by the persistent presence of antiphospholipid antibodies, along with occurrence of vascular thrombosis and pregnancy morbidity. The variety of antiphospholipid antibodies and their related mechanisms, as well as the behavior of disease in wide groups of patients, have led some authors to propose a differentiation of this syndrome into two independent entities: vascular and obstetric antiphospholipid syndrome. Thus, previous studies have discussed whether specific autoantibodies may be responsible for this differentiation or, in contrast, how the same antibodies are able to generate two different clinical presentations. This discussion is yet to be settled. The capability of serum IgG from patients with vascular thrombosis to trigger the biogenesis of endothelial cell-derived microparticles in vitro is one of the previously discussed differences between the clinical entities of antiphospholipid syndrome. These vesicles constitute a prothrombotic mechanism as they can directly lead to clot activation in murine models and recalcified human plasma. Nevertheless, other indirect mechanisms by which microparticles can spread a procoagulant phenotype could be critical to understanding their role in antiphospholipid syndrome. For this reason, questions regarding the cargo of microparticles, and the signaling pathways involved in their biogenesis, are of interest in attempting to explain the behavior of this autoimmune disease.
Krankenhauszukunftsgesetz: Wenn für den Digitalisierungsschub das Personal fehlt
Authors: Brodbeck Marc-Stefan
Published: April 2021

Im Gesundheitswesen bietet der Einsatz moderner IT-Lösungen enorme Chancen. Gerade dieser Sektor hinkt allerdings beim Digitalisierungsgrad im Branchenvergleich noch hinterher. Abhilfe soll das neue Krankenhauszukunftsgesetz schaffen. Ein Flaschenhals bleibt dabei jedoch nach wie vor: Wie gewinnen Krankenhäuser die dafür erforderlichen technikaffinen Führungskräfte und IT-Spezialisten?
Krankenhauswäsche: Nachhaltige Textilien
Authors: Lang Michael
Published: April 2021

Der Deutsche Textilreinigungs-Verband setzt sich dafür ein, auch in der Pandemie verstärkt textile Mehrwegprodukte zu nutzen und den Einsatz von Einwegtextilien wie etwa OP-Kittel zu reduzieren.Stephan Richtzenhain, Geschäftsführer des Textildienstleisters Sitex, erklärt die Hintergründe.