bluuebunny/crossref_metadata_2025 huggingface dataset:
Transport in Tanzania
Authors: Streit Katie Valliere
Published: January 2021

Tanzanian men and women have embraced, adapted, and innovated various transportation technologies over the centuries as part of their survival and wealth accumulation strategies. During the precolonial era, dhows and porterage caravans helped to draw mainland Tanzania and Zanzibar into ever-widening trade networks with Central-East Africa, the western Indian Ocean, and the capitalist world economy during the 19th century. The onset of colonialism brought attempts by German and British administrations to replace these “traditional” forms of mobility with “modern” railways, steamships, and motor vehicles. Europeans expected to use these tools to conquer and subordinate African populations according to the demands of the colonial economy. Europeans also perceived these technologies as material manifestations of their alleged intellectual and moral superiority. Colonial administrations, however, continually lacked the necessary resources to construct and maintain new transportation infrastructure amid challenging climates and terrain. Dhows and porters successfully competed with railways, motor vehicles, and steamships throughout the colonial era and remained integral components of the colonial economy. As new transportation systems gradually became integrated into Tanzania’s physical and socioeconomic landscape, ordinary Tanzanians utilized the technologies of mobility to pursue their self-interests. Throughout the process of building transportation infrastructure and using automobiles, dhows, railways, and airplanes, ordinary Tanzanians created identities that challenged discriminatory racial and gender social orders constructed by colonial governments and the Tanzanian nation-state.
Libya: Modern Political History
Authors: Mundy Jacob
Published: January 2021

The modern Libyan state began to take shape within the Ottoman Empire from the mid-16th century onward. Libya’s path to independent statehood was violently interrupted in 1911 with the onset of an Italian conquest. Rome’s efforts to annex Libya through settler colonialism and ethnic cleansing were in turn disrupted by World War II. The United Nations (UN) helped to guide Libya to independence under the Sanusi monarchy in 1951, albeit in close collaboration with the United Kingdom and the United States. The Sanusi monarchy, founded in the eastern region of Cyrenaica in the late 19th century, faced substantial difficulties in its efforts to transform an incredibly vast, thinly populated, socially diverse, and seemingly resource-poor country into a modern nation state. Though the extraction and exportation of oil from the 1960s onward help to alleviate some of the financial constraints on the government, the increasing centralization of power within the monarchy eventually led to a military coup in 1969. Libya’s new regime, under the leadership of Mu‘ammar Al-Gaddafi, would eventually pursue a radical program involving centralized economic planning funded through oil sales, a baroque system of popular consultation, a terrifying array of “revolutionary” security institutions, military aggression in Chad, and confrontations with North Atlantic powers directly and indirectly. Though the Gaddafi regime was able to survive an array of domestic and international challenges for over four decades, a mass armed uprising in 2011, which precipitated a merciless civil war and foreign military intervention, led to its downfall. Subsequent international assistance and successive transitional authorities, however, were unable to address the spiral of insecurity that consumed Libya from 2012 onwards. A second civil war erupted in 2014, one fed not only by competing domestic visions for the future of Libya, but also by the competing ambitions of other states in the region.
An Introduction to Bootstrap Theory in Time Series Econometrics
Authors: Cavaliere Giuseppe , Nielsen Heino Bohn , Rahbek Anders
Published: January 2021

While often simple to implement in practice, application of the bootstrap in econometric modeling of economic and financial time series requires establishing validity of the bootstrap. Establishing bootstrap asymptotic validity relies on verifying often nonstandard regularity conditions. In particular, bootstrap versions of classic convergence in probability and distribution, and hence of laws of large numbers and central limit theorems, are critical ingredients. Crucially, these depend on the type of bootstrap applied (e.g., wild or independently and identically distributed (i.i.d.) bootstrap) and on the underlying econometric model and data. Regularity conditions and their implications for possible improvements in terms of (empirical) size and power for bootstrap-based testing differ from standard asymptotic testing, which can be illustrated by simulations.
Integrated Assessment Models for Climate Change
Authors: Bosetti Valentina
Published: January 2021

To guide climate change policymaking, we need to understand how technologies and behaviors should be transformed to avoid dangerous levels of global warming and what the implications of failing to bring forward such transformation might be. Integrated assessment models (IAMs) are computational tools developed by engineers, earth and natural scientists, and economists to provide projections of interconnected human and natural systems under various conditions.

These models help researchers to understand possible implications of climate inaction. They evaluate the effects of national and international policies on global emissions and devise optimal emissions trajectories in line with long-term temperature targets and their implications for infrastructure, investment, and behavior. This research highlights the deep interconnection between climate policies and other sustainable development objectives.

Evolving and focusing on one or more of these key policy questions, the large family of IAMs includes a wide array of tools that incorporate multiple dimensions and advances from a range of scientific fields.
Brazilian Space Law
Authors: de O. Bittencourt Neto Olavo , Freire e Almeida Daniel
Published: January 2021

The article provides an overview of the Brazilian legal framework for space-related activities, highlighting the main legal instruments and their most relevant provisions. Domestic regulatory initiatives are appraised and contextualized through the review of specific provisions and legal instruments. The Brazilian space program’s normative structure is acknowledged, considering national space policy and applicable legislation.

Brazil regulates national space activities through a myriad of regulations and edicts, forming a broad—although fragmented—body of rules. Considered an emerging space power, Brazil has a long-standing and ambitious space program, involving artificial satellites, launch centers, and the eventual development of a national launch vehicle. However, a domestic, general space law, as required by the Federal Constitution of 1988, still awaits to be enacted. The latest developments at the Brazilian Space Agency indicate that it might not be too long for such a federal law to materialize.

The importance of a national space law for the implementation of international obligations as well as to ensure legal certainty for governmental and non-governmental national space activities is increasingly realized by space-faring nations. The Brazilian space legal framework represents a relevant case study toward the identification of appropriate legal mechanisms for the regulation of national space activities, taking into account international principles and local perspectives.
Chelyabinsk Meteorite
Authors: Popova Olga
Published: January 2021

The asteroid impact near the Russian city of Chelyabinsk on February 15, 2013, was the largest airburst on Earth since the 1908 Tunguska event, causing a natural disaster in an area with a population exceeding 1 million. On clear morning at 9:20 a.m. local time, an asteroid about 19 m in size entered the Earth atmosphere near southern Ural Mountains (Russia) and, with its bright illumination, attracted the attention of hundreds of thousands of people. Dust trail in the atmosphere after the bolide was tens of kilometers long and was visible for several hours. Thousands of different size meteorites were found in the areas south-southwest of Chelyabinsk.

A powerful airburst, which was formed due to meteoroid energy deposition, shattered thousands of windows and doors in Chelyabinsk and wide surroundings, with flying glass injuring many residents.

The entrance and destruction of the 500-kt Chelyabinsk asteroid produced a number of observable effects, including light and thermal radiation; acoustic, infrasound, blast, and seismic waves; and release of interplanetary substance. This unexpected and unusual event is the most well-documented bolide airburst, and it attracted worldwide attention. The airburst was observed globally by multiple instruments. Analyses of the observational data allowed determination of the size of the body that caused the superbolide, its velocity, its trajectory, its behavior in the atmosphere, the strength of the blast wave, and other characteristics. The entry of the 19-m-diameter Chelyabinsk asteroid provides a unique opportunity to calibrate the different approaches used to model meteoroid entry and to calculate the damaging effects.

The recovered meteorite material was characterized as brecciated LL5 ordinary chondrite, in which three different lithologies can be distinguished (light-colored, dark-colored, and impact-melt). The structure and properties of meteorites demonstrate that before encountering Earth, the Chelyabinsk asteroid had experienced a very complex history involving at least a few impacts with other bodies and thermal metamorphism.

The Chelyabinsk airburst of February 15, 2013, was exceptional because of the large kinetic energy of the impacting body and the damaging airburst that was generated. Before the event, decameter-sized objects were considered to be safe. With the Chelyabinsk event, it is possible, for the first time, to link the damage from an impact event to a well-determined impact energy in order to assess the future hazards of asteroids to lives and property.
Gender, Sexuality, and Identity in 20th-Century Costa Rica
Authors: Alvarenga Patricia
Published: January 2021

Proposals challenging male authority gained strength in Costa Rica during the 20th century and, especially at the turn of the 21st century, and questioned naturalized sexual and gender identities. The effects of these discursivities are varied. The experience of feminists, of middle-class women outside these discursivities, and of women of the subaltern classes demonstrate the plurality of meanings attributed to gender relations as filtered through subjective experience. The introduction of alternative identity proposals destabilizes the established parameters of sexual and gender identities, but, at the same time, produces new conservative discursivities that limit the potential for change. Two feminist movements, one that reached its peak in the 1920s and a second that arose in the final decades of the 20th century, brought about substantive changes in female identities, revealing the power relations that underlie the discursive representation of patriarchal power as eternal and immutable. An assessment of contemporary feminism based on the experiences of its protagonists shows the movement’s significant gains as well as the challenges and weaknesses it has faced over its history, the most important of which may be how to reach beyond the sphere of well-educated, heterosexual, middle-class women. In conclusion, public discourses that have politicized gender and sexuality in Costa Rica are creatively constituted in the social world, according to what changes appear attainable at different moments of history. Carved out by actors committed to change, these discourses have achieved substantive transformations in institutional structures and subjectivities. However, present experience shows clearly that every affirmation of identity is precarious, and that the gains achieved require the ongoing, active engagement of civil society.
Gaceta de Guatemala in the Colonial Period
Authors: Poupeney Hart Catherine
Published: January 2021

Gaceta de Guatemala is the name of a newspaper spanning four series and published in Central America before the region’s independence from Spain. As one of the first newspapers to appear in Spanish America on a periodical basis, the initial series (1729–1731) was inspired by its Mexican counterpart (Gaceta de México) and thus it adopted a strong local and chronological focus. The title resurfaced at the end of the 18th century thanks to the printer and bookseller Ignacio Beteta who would assure its continuity until 1816. The paper appeared as a mainly news-oriented publication (1793–1796), only to be reshaped and energized by a small group of enlightened men close to the university and the local government (1797–1807). In an effort to galvanize society along the lines of the reforms promoted by the Bourbon regime, and to engage in a dialogue with readers beyond the borders of the capital city of Guatemala, they relied on a vast array of sources (authorized and censored) and on a journalistic model associated with the British Spectator: it allowed them to explore different genres and a wide variety of topics, while also allowing the paper to fulfill its role as an official and practical news channel. The closure of the Economic Society which had been the initial motor for the third series, and the failure to attract or retain strong contributors led slowly to the journal’s social irrelevance. It was resurrected a year after ceasing publication, to address the political turmoil caused by the Napoleonic invasion of the Peninsula and to curb this event’s repercussions overseas. These circumstances warranted a mainly news-oriented format, which prevailed in the following years. The official character of the paper was confirmed in 1812 when it appeared as the Gaceta del Gobierno de Guatemala, a name with which it finally ended publication (1808–1816).
The Cocoa Trade in New Spain in the 18th Century
Authors: Valle Pavón Guillermina del
Published: January 2021

In New Spain, cocoa was a staple food whose high demand at the beginning of the 17th century meant that cocoa beans were imported from Guatemala, Venezuela, and Guayaquil. The viceroyalty of New Spain became the largest world buyer of cocoa because it paid for the product with silver, which was the principal means of exchange at the time. The cocoa trade was monopolized by a small, powerful group of the Consulado (merchants’ guild) of Mexico City who contracted it, redistributed it to the rest of the viceroyalty, and shipped it to Spain. However, the Spanish Crown’s prohibitionist trade policy hindered the expansion of the cocoa trade to meet the demand in New Spain. As Spain intermittently suspended sailing between the viceroyalties of Mexico and Peru, the supply of Guayaquil cocoa was limited to shippers who could obtain special licenses and those who smuggled it. When the monarchy required extraordinary funds to finance its wars in Europe, it granted permits to move Ecuadorian cocoa through the Pacific routes. However, it preferred the supply of cocoa from Caracas for geostrategic reasons, a factor that was used by Caracas shippers to raise prices.

Mexican merchants preferred to import Ecuadorian cocoa because of its higher profitability. Trade in cocoa from this source was based on a confluence of complex kinship, community, and friendship networks. Finally, in 1789, the Guayaquil cocoa trade was authorized without restrictions, which significantly reduced the demand for Caracas cocoa. In addition, cocoa from Tabasco, Guatemala, and Maracaibo was traded in New Spain. The relationship between the Crown and the commercial elite of Mexico was characterized by a policy of continual ongoing negotiations. The cocoa trade was privileged in exchange for merchants’ contributions over and above regular fiscal payments.
Reverse longitudinal stent deformation during percutaneous intervention via the retrograde approach to a chronic total occlusion of the right coronary artery: a case report
Authors: Cosgrove Claudia , Marciniak Marciej , Spratt James C
Published: January 2021

Background

Longitudinal stent deformation (LSD) is an uncommon but recognized mechanical complication of coronary stent implantation, usually occurring at the proximal stent edge due to compression by guide catheter or catheter extensions. Retrograde techniques for chronic total occlusion (CTO) percutaneous coronary intervention expose the distal stent edge to potential interaction with retrograde equipment under a tensioned system.

Case summary

We describe a case of distal stent edge LSD, occurring during a retrograde approach to a right coronary artery CTO via septal collateral channels. While removing the externalized wire, interaction with the retrograde microcatheter caused compression of the distal end of the newly implanted stents.

Discussion

This unusual complication highlights the reduced longitudinal strength of newer generation stent platforms and the risks of interaction between retrograde equipment and stents on an externalized wire.
Case report: Concomitant MitraClip implantation for severe mitral regurgitation and plug closure of endocarditis induced fistula between aortic root and left atrium after transcatheter aortic valve implantation
Authors: Ren Ben , de Jaegere Peter P T , van Mieghem Nicolas N M
Published: January 2021

Background

Infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) occurs in up to 1.5% of patients within the first year. The development of an aorto-atrial fistula (AAF) is a rare but problematic complication of IE, which can be confirmed with transoesophageal echocardiography (TOE). We present an exceptional case of occluding an aorto-left atrial fistula only diagnosed with intraprocedural TOE during a subsequent procedure of MitraClip implantation.

Case summary

A 79-year-old symptomatic male patient with multiple comorbidities was referred due to severe mitral regurgitation (MR). He has had prior TAVI which was complicated with streptococcal IE for which he had received prolonged antibacterial therapy. Transthoracic echocardiography (TTE) revealed severe MR. The patient was accepted for a MitraClip procedure by the heart team. Intra-procedural TOE revealed also a significant continuous shunt through an AAF which was likely caused by the endocarditis. The strategy was therefore defined as to occlude the fistula with an Amplatzer Vascular Plug II 12 mm. The plug was released in the fistula leaving an insignificant residual shunt. After the transseptal puncture one MitraClip XTR was implanted, reducing the MR to mild. After the procedure, the patient’s general clinical condition improved without signs of haemolysis. The pre-discharge TTE confirmed trace residual shunt, mild residual MR and mild paravalvular leakage.

Discussion

Our case illustrates a complex transcatheter structural heart intervention with improvised procedural strategies based on the intra-procedural TOE findings. We conclude that the pre-procedural TOE needs to be comprehensive rather than exclusive, particularly in the context of bioprosthesis-related endocarditis.
A novel exergy-based assessment on a multi-production plant of power, heat and hydrogen: integration of solid oxide fuel cell, solid oxide electrolyzer cell and Rankine steam cycle
Authors: Sadeghzadeh Milad , Mehrpooya Mehdi , Ansarinasab Hojat
Published: January 2021

Title

Multi-production plant is an idea highlighting cost- and energy-saving purposes. However, just integrating different sub-systems is not desired and the output and performance based on evaluation criteria must be assessed. In this study, an integrated energy conversion system composed of solid oxide fuel cell (SOFC), solid oxide electrolyzer cell (SOEC) and Rankine steam cycle is proposed to develop a multi-production system of power, heat and hydrogen to alleviate energy dissipation and to preserve the environment by utilizing and extracting the most possible products from the available energy source. With this regard, natural gas and water are used to drive the SOEC and the Rankine steam cycle, respectively. The required heat and power demand of the electrolyzer are designed to be provided by the fuel cell and the Rankine cycle. The feasibility of the designed integrated system is evaluated through comprehensive exergy-based analysis. The technical performance of the system is evaluated through exergy assessment and it is obtained that the SOFC and the SOEC can achieve to the high exergy efficiency of 84.8% and 63.7%, respectively. The designed system provides 1.79 kg/h of hydrogen at 125 kPa. In addition, the effective designed variables on the performance of the designed integrated system are monitored to optimize the system’s performance in terms of technical efficiency, cost-effectivity and environmental considerations. This assessment shows that 59.4 kW of the available exergy is destructed in the combustion chamber. Besides, the techno-economic analysis and exergoenvironmental assessment demonstrate the selected compressors should be re-designed to improve the cost-effectivity and decline the negative environmental impact of the designed integrated energy conversion system. In addition, it is calculated that the SOEC has the highest total cost and also the highest negative impact on the environment compared to other designed units in the proposed integrated energy conversion system.
Spring foraging movements of an urban population of grey-headed flying foxes (Pteropus poliocephalus)
Authors: Boardman Wayne S J , Roshier David , Reardon Terry , Burbidge Kathryn , McKeown Adam , Westcott David A , Caraguel Charles G B , Prowse Thomas A A
Published: January 2021

Flying foxes provide ecologically and economically important ecosystem services but extensive clearing and modification of habitat and drought combined with the planting of commercial and non-commercial trees across various landscapes, has meant flying foxes in Australia are increasingly seeking foraging resources in new areas. In 2011, grey-headed flying foxes formed a camp in Adelaide, South Australia, outside their previously recorded range. We used global positioning system telemetry to study the movements and foraging behaviour of this species in Adelaide in spring (September to November) 2015. High-frequency location data were used to determine the foraging range and the most frequently visited foraging sites used by each bat which were ground-truthed to identify forage plants. A total of 7239 valid locations were collected over 170 nights from four collars. Despite being a highly mobile species, the mean core foraging range estimate was only 7.30 km2 (range 3.3–11.2 km2). Maximum foraging distance from the camp in the Botanic Park was 9.5 km but most foraging occurred within a 4-km radius. The most common foraging sites occurred within the residential area of Adelaide and included introduced forage plant species, Lemon-scented gum (Corymbia citriodora) and Port Jackson fig (Ficus rubiginosa). Other observed movement activities included dipping behaviour on inland and marine waters and travel across flight paths around Adelaide airport. Our findings suggest that urban habitats in Adelaide provide sufficient foraging resources for grey-headed flying foxes to use these areas exclusively, at least in spring. This creates substantial opportunities for bats to interact with humans and their infrastructure.
Thinking outside the park: recommendations for camera trapping mammal communities in the urban matrix
Authors: Herrera Daniel J , Moore Sophie M , Flockhart D T Tyler , McShea William J , Cove Michael V
Published: January 2021

Urbanization is increasing globally, fragmenting habitats and prompting human–wildlife conflict. Urban wildlife research is concurrently expanding, but sampling methods are often biased towards large and intact habitats in public green spaces, neglecting the far more abundant, but degraded, habitats in the urban matrix. Here, we introduce the Five P’s of Urban Ecology—Partnerships, Planning, Placements, Public participation and Processing—as a path to overcoming the logistical barriers often associated with camera-trapping in the urban matrix. Though the Five P’s can be applied to a variety of urban sampling methods, we showcase the camera-trapping efforts of the DC Cat Count project in Washington, DC, as a case study. We compared occupancy models for eight urban mammal species using broad categorizations of land cover and local land use to determine drivers of mammal occurrence within the urban matrix as compared with urban habitat patches. Many native species maintained a strong association with large, semi-natural green spaces, but occupancy was not limited to these locations, and in some cases, the use of private yards and the built environment were not notably different. Furthermore, some species exhibited higher occupancy probabilities in developed areas over green spaces. Though seemingly intuitive, we offer advice on how to greatly reduce habitat-biased sampling methods in urban wildlife research and illustrate the importance of doing so to ensure accurate results that support the formation of effective urban planning and policy.
The relations between age, face mask perceptions and face mask wearing
Authors: Howard Matt C
Published: January 2021

Popular press outlets have proposed that older individuals are less likely to wear face masks despite health benefits of doing so during the COVID-19 pandemic. The current article investigates this notion in four separate studies, and we also assess the mediating effect of face mask perceptions between age and face mask wearing using the eight-dimension Face Masks Perceptions Scale (FMPS). The sample-size weighted average correlation between age and face mask wearing was −.07 (95%C.I.[−.14, .001], Z-value = −1.928, P = .054, n = 824), indicating that older individuals are slightly less likely to wear face masks compared to younger individuals. Age did not have significant relations with any face mask perceptions, and the mediating effect of face mask perceptions was not robust or consistent. This indicates that the relation between age and face mask wearing is not explained by face mask perceptions, and researchers must turn to other explanatory mechanisms to understand this relation. We propose possible avenues, such as dual-system theories, to further investigate this research question as well as others associated with face mask perceptions, face mask wearing and the COVID-19 pandemic.
Dk Gravitational Instantons as Superpositions of Atiyah–Hitchin and Taub–NUT Geometries
Authors: Schroers B J , Singer M A
Published: January 2021

We obtain Dk ALF gravitational instantons by a gluing construction which captures, in a precise and explicit fashion, their interpretation as nonlinear superpositions of the moduli space of centred SU(2) monopoles, equipped with the Atiyah–Hitchin metric, and k copies of the Taub–NUT manifold. The construction proceeds from a finite set of points in euclidean space, reflection symmetric about the origin, and depends on an adiabatic parameter which is incorporated into the geometry as a fifth dimension. Using a formulation in terms of hyperKähler triples on manifolds with boundaries, we show that the constituent Atiyah–Hitchin and Taub–NUT geometries arise as boundary components of the five-dimensional geometry as the adiabatic parameter is taken to zero.
Prone Position Ventilation in Neurologically Ill Patients: A Systematic Review and Proposed Protocol
Authors: Wright James M. , Gerges Christina , Shammassian Berje , Labak Collin M. , Herring Eric Z. , Miller Benjamin , Alkhachroum Ayham , Kottapally Mohan , Huang Wright Christina , Rodgers Richard B. , Sedney Cara , Ngwenya Laura B. , Stippler Martina , Sieg Emily , Babu Maya A. , Hoffer Alan , Hejal Rana
Published: January 2021

OBJECTIVES:

Prone positioning has been shown to be a beneficial adjunctive supportive measure for patients who develop acute respiratory distress syndrome. Studies have excluded patients with reduced intracranial compliance, whereby patients with concomitant neurologic diagnoses and acute respiratory distress syndrome have no defined treatment algorithm or recommendations for management. In this study, we aim to determine the safety and feasibility of prone positioning in the neurologically ill patients.

DESIGN AND SETTING:

A systematic review of the literature, performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses 2009 guidelines, yielded 10 articles for analysis. Using consensus from these articles, in combination with review of multi-institutional proning protocols for patients with nonneurologic conditions, a proning protocol for patients with intracranial pathology and concomitant acute respiratory distress syndrome was developed.

MEASUREMENTS AND MAIN RESULTS:

Among 10 studies included in the final analysis, we found that prone positioning is safe and feasible in the neurologically ill patients with acute respiratory distress syndrome. Increased intracranial pressure and compromised cerebral perfusion pressure may occur with prone positioning. We propose a prone positioning protocol for the neurologically ill patients who require frequent neurologic examinations and intracranial monitoring.

CONCLUSIONS:

Although elevations in intracranial pressure and reductions in cerebral perfusion pressure do occur during proning, they may not occur to a degree that would warrant exclusion of prone ventilation as a treatment modality for patients with acute respiratory distress syndrome and concomitant neurologic diagnoses. In cases where intracranial pressure, cerebral perfusion pressure, and brain tissue oxygenation can be monitored, prone position ventilation should be considered a safe and viable therapy.
Awareness With Paralysis in Mechanically Ventilated Patients in the Emergency Department and ICU: A Systematic Review and Meta-Analysis*
Authors: Pappal Ryan D. , Roberts Brian W. , Winkler Winston , Yaegar Lauren H. , Stephens Robert J. , Fuller Brian M.
Published: January 2021

OBJECTIVE:

Awareness with paralysis is a devastating complication for mechanically ventilated patients and can carry long-term psychologic sequelae. Hundreds of thousands of patients require mechanical ventilation in the emergency department and ICU annually, yet awareness has only been rigorously examined in the operating room (incidence ~0.1%). This report collates the global literature regarding the incidence of awareness with paralysis outside of the operating room.

DATA SOURCES:

We searched OvidMedline, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, conference proceedings, and reference lists.

STUDY SELECTION:

Randomized or nonrandomized studies (except single case studies) reporting on awareness with paralysis in the emergency department or ICU were eligible.

DATA EXTRACTION:

Two independent reviewers screened abstracts for eligibility.

DATA SYNTHESIS:

The search identified 4,454 potentially eligible studies. Seven studies (n = 941 patients) were included for analysis. A random effects meta-analysis of proportions along with multiple subgroup analyses was performed. Significant between-study heterogeneity in reporting of awareness with paralysis was noted, and the quality of the evidence was low. Analyses stratified by: 1) good-quality studies and 2) use of the modified Brice questionnaire to detect awareness revealed estimates of 3.4% (95% CI, 0–10.2%) and 1.9% (95% CI, 1.0–3.0%), respectively.

CONCLUSIONS:

The incidence of awareness with paralysis in mechanically ventilated patients in the emergency department and ICU, as evaluated in a small number of qualifying studies from this comprehensive systematic review, appears much higher than that reported from the operating room. Given the clinical and statistical heterogeneity, caution is warranted in the interpretation of these findings. Further high-quality studies are needed to both define the true incidence and to target the prevention of awareness with paralysis in this vulnerable patient cohort.
Iatrogenic Arsenism Characterized by Palmoplantar Hyperkeratosis and Diffused Skin Cancers for Over Decades
Authors: Tian Cui-cui , Hu Feng-Qiu , Lu Sha , Tan Guo-Zhen , Wang Liangchun
Published: January 2021

Chronic arsenism usually occurs after a long-term unawareness of arsenic exposure from environment, occupation, food, and water. We here reported 3 cases with diffused arsenic keratosis and skin cancers derived from long-term arsenic medication ingestion. In these cases, hyperkeratotic skin lesions were initially found on palms and soles, slowly progressed to every part of the skin and lasted maximally for over 30 years. Skin cancers were diagnosed and removed intermittently within decades, but with no malignancies in other organs. Oral retinoids combing with topical 5- fluorouracil and photodynamic treatment yielded a desirable outcome.
Amelioration of motor and nonmotor symptoms in cortical cerebellar atrophy and multiple system atrophy-cerebellar type by inpatient rehabilitation: a retrospective study
Authors: Sonoda Yuma , Yamanaka Yuya , Sawano Shinichiro , Komada Ryo , Kugo Masato , Kitamura Akihiro , Ogawa Nobuhiro , Yamakawa Isamu , Kim Hyoh , Sanada Mitsuru , Imai Shinji , Urushitani Makoto
Published: January 2021

Sporadic spinocerebellar degenerative diseases such as multiple system atrophy (cerebellar type) and cortical cerebellar atrophy typically present with cerebellar ataxia. Multiple system atrophy is characterized by ataxia, with parkinsonism, dysautonomia and neuropsychiatric symptoms, resulting in reduced quality of life. Effects of physical rehabilitation focused on motor symptoms with ataxia in nonmultiple system atrophy patients have been reported; however, without addressing concomitant nonmotor symptoms. Here, we examined the motor, nonmotor and quality of life effects of inpatient physical rehabilitation in 15 multiple systems atrophy and nine cortical cerebellar atrophy patients without dementia. Rehabilitation involved a 4-week hospitalization with physical, occupational and speech therapy. The following assessments were conducted at admission and discharge: the scale for the assessment and rating of ataxia for ataxia; Montreal cognitive assessment for cognition, hospital anxiety and depression scale for emotion and medical outcomes study short-form for health-related quality of life. Data were analyzed for statistical significance (P < 0.05) using the Wilcoxon signed-rank test. In patients with multiple system atrophy, rehabilitation significantly improved ataxia, cognition with mild cognitive impairment (73.3%) and health-related quality of life; however, patients with depression (86.7%) showed no improvement in emotional health and quality of life. Similar effects on motor and nonmotor symptoms were observed in patients with cortical cerebellar atrophy. This suggests that inpatient rehabilitation could not only improve motor and nonmotor functions, but also the quality of life in patients with spinocerebellar degenerative disease.
Functional recovery of working-age patients with traumatic brain injury stratified in 30-day periods since head trauma to rehabilitation admission
Authors: García-Rudolph Alejandro , García-Molina Alberto
Published: January 2021

We stratified 213 patients with traumatic brain injury according to their time to rehabilitation admission in three groups (0–30 days, 31–60 and 61–90) in order to (1) compare total Functional Independence Measure efficiency and effectiveness between groups; (2) analyze time to admission as predictor of TFIM at discharge. After adjusting for age, Glasgow Coma Scale (GCS), Disability Rating Scale (DRS) and sex, 0–30 had the highest TFIM efficiency compared with 31–60 (P < 0.001) and 61–90 (P < 0.001), 31–60 was quasi-significantly (P = 0.051) higher than 61–90. After adjusting for age, GCS, DRS and sex, 0–30 had the highest TFIM mean effectiveness when compared with 31–60 (P = 0.004) and 61–90 (P < 0.001). Thirty-one to 60 was significantly higher (P = 0.041) than 61–90. Almost half of the variance was explained by regression models containing time to admission as predictor of TFIM at discharge. Time to admission was key to obtain significant differences in TFIM efficiency, effectiveness and in predicting TFIM at discharge.
Dermal Regeneration Templates in Maxillo-Facial District: A Multipurpose Aid
Authors: Spallaccia Fabrizio , Benedetti Simone , Massarelli Mauro , Paparo Francesco , Rivaroli Andrea , Vellone Valentino
Published: January 2021

Since 1980s, the use of dermal regeneration templates (DRT) for reconstructive purposes has been described in Literature.1 The authors present their experience of 13 patients treated with integra dermal regeneration template and a single-stage surgery for different indications like oncologic reconstruction, trauma injuries, and preprosthetic surgery in the maxillo-facial district.

The authors retrospectively reviewed a total of 13 patients treated with DRT at Maxillo-Facial Department of S. Maria Hospital in Terni.

Inclusion criteria included the presence of a defect nonapproachable primarily or by secondary intention with an easy locoregional flap reconstruction, a complete clinical record, and a minimum 6 months follow-up.

A total of 12 patients underwent surgical reconstruction with DRT at the S. Maria Hospital from June 2018 to February 2020.

During follow-up, all patients in which intraoral reconstruction was performed showed first signs of re-mucosization and neovascularization after 10 days.

Only in 1 patient (8%) a seroma underneath the silicon sheet was observed. Afterward, the patient healed correctly with no other complications.

Dermal regeneration template represents an option that should be considered in the head and neck district reconstruction, especially for intraoral defects where, thanks to its long-term functional results and limited alternatives, should represent a relevant choice.
Vibrio agarilyticus sp. nov., an agar-digesting marine bacterium isolated from coastal seawater in Daya Bay (Guangdong, China)
Authors: Wang Xiaolei , Guo Feng , Tian Peng , Yu Shuangen , Xue Chun-Xu , Wang Wei , Xiao Jiaguang , Niu Wentao
Published: January 2021

A Gram-strain-negative, facultatively anaerobic, motile, rod-shaped and flagellated marine bacterium, designated SM6T, was isolated from surface seawater collected in Daya Bay (Guangdong, China). Phylogenetic analysis based on 16S rRNA gene sequences, multilocus sequence analysis, phylogenomic analysis of single-copy gene families and whole genome data showed that strain SM6T belonged to the genus

Vibrio

. The closest phylogenetic relatives of SM6T were

Vibrio plantisponsor

MSSRF60T (97.38 % 16S rRNA gene sequence pairwise similarity),

Vibrio variabilis

R-40492T (97.27 %),

Vibrio aestuarianus

ATCC 35048T (97.21 %) and

Vibrio sagamiensis

LC2-047T (97.3 %). Growth of strain SM6T occurred at 10–45 °C (optimum 30 °C), at pH 6.0–9.0 (optimum 6.0) and in the presence of 0–10 % (w/v) NaCl (optimum 3–8 %). The predominant fatty acids (>10 %) were summed feature 3 (C16 : 1
ω7c or/and C16 : 1
ω6c), C16 : 0 and summed feature 8 (C18 : 1
ω7c or/and C18 : 1
ω6c). The DNA G+C content of the assembled genomic sequences was 47.37 % for strain SM6T. Average nucleotide identity values between SM6T and its reference species were lower than the threshold for species delineation (95–96 %); in silico DNA–DNA hybridization further showed that the strains shared less than 70 % similarity. On the basis of evidence from the present polyphasic study, strain SM6T is considered to represent a novel species of the genus

Vibrio

, for which the name Vibrio agarilyticus sp. nov. is proposed. The type strain is SM6T (=KCTC 82076T=MCCC 1K04327 T).
Extending influenza surveillance to detect non-influenza respiratory viruses of public health relevance: analysis of surveillance data, 2015-2019, Belgium
Authors: Subissi Lorenzo , Bossuyt Nathalie , Reynders Marijke , Gérard Michèle , Dauby Nicolas , Lacor Patrick , Daelemans Siel , Lissoir Bénédicte , Holemans Xavier , Magerman Koen , Jouck Door , Bourgeois Marc , Delaere Bénédicte , Quoilin Sophie , Van Gucht Steven , Thomas Isabelle , Barbezange Cyril
Published: January 2021

BACKGROUND

Seasonal influenza-like illness (ILI) affects millions of people yearly. Severe acute respiratory infections (SARI), mainly caused by influenza, are a leading cause of hospitalisation and mortality. Increasing evidence indicates that non-influenza respiratory viruses (NIRVs) also contribute to the burden of SARI. In Belgium, SARI surveillance by a network of sentinel hospitals is ongoing since 2011.

AIM

Here, we report the results of using in-house multiplex PCRs for the detection of a flexible panel of viruses in respiratory ILI and SARI samples and the estimated incidence rates of SARI associated to each virus.

METHODS

ILI was defined as an infection with onset of fever and cough or dyspnoea. SARI was defined as an infection requiring hospitalization with onset of fever and cough or dyspnoea within the previous 10 days. Samples were collected during four winter seasons and tested by multiplex RT-qPCRs for influenza virus and NIRVs. Using catchment population estimates, incidence rates of SARI associated to each virus were calculated.

RESULTS

One third of the SARI cases were positive for NIRVs, reaching 49.4% among children under fifteen. In children under five, incidence rates of NIRV-associated SARI were double that of influenza (103.4 versus 57.6 per 100000 person-months), with NIRV co-infections, respiratory syncytial viruses, human metapneumoviruses and picornaviruses contributing the most (33.1, 13.6, 15.8 and 18.2 per 100000 person-months, respectively).

CONCLUSION

Early testing for NIRVs could be beneficial to clinical management of SARI patients, especially in children under five, for whom the burden of NIRV-associated disease exceeds that of influenza.
Type 2 Diabetes Modifies Skeletal Muscle Gene Expression Response to Gastric Bypass Surgery
Authors: Barberio Matthew D. , Dohm G. Lynis , Pories Walter J. , Gadaleta Natalie A. , Houmard Joseph A. , Nadler Evan P. , Hubal Monica J.
Published: January 2021

Roux-en-Y gastric bypass (RYGB) is an effective treatment for type 2 diabetes mellitus (T2DM) which can result in remission of clinical symptoms, yet mechanisms for improved skeletal muscle health are poorly understood. We sought to define the impact of existing T2DM on RYGB-induced muscle transcriptome changes.

Methods

Vastus lateralis biopsy transcriptomes were generated pre- and 1-yr post-RYGB in black adult females with (T2D; n = 5, age=51±6 yr, BMI=53.0±5.8 kg/m2) and without (CON; n = 7,43±6 yr,51.0±9.2 kg/m2) T2DM. Insulin, glucose, and HOMA-IR were measured in blood at the same time points. ANCOVA detected differentially expressed genes (p< 0.01, Fold change<|1.2|), which were used to identify enriched biological pathways.

Results

Pre-RYGB, 95 probes were downregulated with T2D including subunits of mitochondrial complex I. Post-RYGB, the T2D group had normalized gene expression when compared to their non-diabetic counterparts with only 3 probes remaining significantly different. In the T2D, we identified 52 probes upregulated from pre- to post-RYGB, including NDFUB7 and NDFUA1.

Conclusion

Black females with T2DM show extensive down regulation of genes across aerobic metabolism pathways prior to RYGB, which resolves 1 year post-RYGB and is related to improvements in clinical markers. These data support efficacy of RYGB for improving skeletal muscle health, especially in patients with T2DM.
Exploring support needs of people living with diabetes during the coronavirus COVID-19 pandemic: insights from a UK survey.
Authors: Sauchelli Sarah , Bradley Julia , England Clare , Searle Aidan , Whitmarsh Alex
Published: January 2021

Background
The coronavirus COVID-19 pandemic has radically compromised healthcare for people living with chronic conditions such as diabetes. Government-imposed restrictions to contain the spread of the virus has forced people to suddenly adjust their lifestyle. This study aimed to capture the impact of the pandemic on people living with diabetes and the views of these individuals on ways in which the information, advice and support they are receiving could be improved.

Research design and methods
An online anonymous survey was distributed across the UK during the first lockdown and initial easing. The survey comprised questions about confidence in diabetes self-management, resources used to obtain information, advice and support, and opinions on how these could be improved. Open-ended captured subjective experiences.

Results
The survey was completed by 773 adults living with diabetes (69.2% type 1, 28.5% type 2). There was notable variability in the impact of the pandemic on confidence in self-management, with confidence having deteriorated most commonly in the ability to take care of own mental wellbeing (37.0% respondents) and improved most commonly in maintaining a healthy weight (21.1% respondents). 41.2% of respondents living alone reported not receiving any outside support. The quality of information, advice and support received from the healthcare team was rated poorly by 37.2%. Respondents sought greater communication and tailored advice from their care team, clear and consistent information from the government and news channels, and improved understanding of diabetes and its challenges from their personal networks and employers.

Conclusion
Adjusting to the COVID-19 pandemic has strained the mental health and wellbeing of people living with diabetes. Diabetes care teams must receive assistance to support these individuals without risking further inequalities in access to healthcare. Equipping personal networks and employers with knowledge on diabetes and skills to support self-management may reduce the burden on the NHS.