bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct visualization of local activities of long DNA strands via image–time correlation
Authors: Kang Kyongok , Ma Yue , Sadakane Koichiro
Published: September 2021

Bacteriophages with long DNA genomes are of interest due to their diverse mutations dependent on environmental factors. By lowering the ionic strength of a hydrophobic (PPh4Cl) antagonistic salt (at 1 mM), single long T4 DNA strand fluctuations were clearly observed, while condensed states of T4 DNA globules were formed above 5–10 mM salt. These long DNA strands were treated with fluorescently labeled probes, for which photo bleaching is often unavoidable over a short time of measurement. In addition, long (few tens of $$\upmu m$$

μ
m

) length scales are required to have larger fields of view for better sampling, with shorter temporal resolutions. Thus, an optimization between length and time is crucial to obtain useful information. To facilitate the challenge of detecting large biomacromolecules, we here introduce an effective method of live image data analysis for direct visualization and quantification of local thermal fluctuations. The motions of various conformations for the motile long DNA strands were examined for the single- and multi-T4 DNA strands. We find that the unique correlation functions exhibit a relatively high-frequency oscillatory behavior superimposed on the overall slower decay of the correlation function with a splitting of amplitudes deriving from local activities of the long DNA strands. This work shows not only the usefulness of an image–time correlation for analyzing large biomacromolecules, but also provides insight into the effects of a hydrophobic antagonistic salt on active T4 bacteriophage long DNA strands, including thermal translocations in their electrostatic interactions.
An Impact Assessment of Beach Wrack and Litter on Beach Ecosystem Services to Support Coastal Management at the Baltic Sea
Authors: Robbe Esther , Woelfel Jana , Balčiūnas Arūnas , Schernewski Gerald
Published: September 2021

As accumulation zones, sandy beaches are temporal sinks for beach wrack and litter, both often seen as nuisances to tourists. Consequently, there is a need for beach management and an enhanced political interest to evaluate their ecosystem services. We applied a new online multidisciplinary assessment approach differentiating between the provision, potential, and flow at German and Lithuanian beaches (Southern Baltic Sea). We selected a set of services and assessed four beach scenarios developed accordingly to common management measures (different beach wrack and litter accumulations). We conducted comparative assessments involving 39 external experts using spread-sheets and workshops, an online survey as well as a combined data-based approach. Results indicated the relative importance of cultural (52.2%), regulating and maintenance (37.4%), and provisioning services (10.4%). Assessed impact scores showed that the removal of beach wrack is not favorable with regard to the overall ecosystem service provision. Contrarily, the removal of litter can increase the service flow significantly. When removing beach wrack, synergies between services should be used, i.e., use of biomass as material or further processing. However, trade-offs prevail between cultural services and the overall provision of beach ecosystem services (i.e., coastal protection and biodiversity). We recommend developing new and innovative beach cleaning techniques and procedures, i.e., different spatio-temporal patterns, e.g., mechanical vs. manually, daily vs. on-demand, whole beach width vs. patches. Our fast and easy-to-apply assessment approach can support decision-making processes within sustainable coastal management allowing us to show and compare the impacts of measures from a holistic ecosystem services perspective.
10-year follow-up of the Columbus knee prostheses system in a prospective multicenter study
Authors: Fuchs Andreas , Häussermann Philip , Hömig Dirk , Ochs Björn Gunnar , Klopfer Tim , Müller Christof A. , Helwig Peter , Konstantinidis Lukas
Published: September 2021

Introduction

As endpoint of a prospective multicenter 10-year documentation using the Columbus system, this evaluation carried out results of clinical scores (Knee Society Score and Oxford Knee Score), an evaluation of radiological imaging, survival rates and a collection of complication statistics.

Materials and methods

There was a multicenter prospective recruitment of consecutive patients with the indication for total knee replacement (TKR). Preoperatively and 10 years after implantation, clinical scores, range of motion and radiological imaging was performed. During this period, a detailed documentation of complications was made.

Results

A total of 210 patients were recruited in 5 centers. 140 patients were available for endpoint examination 10 years after surgery. A survival rate of 96.6% (CI 95%) for the implanted Columbus prostheses after 10 years was demonstrated. Cumulative KSS showed an improvement of 75.3 (± 38.1) points and was highly significant (p < 0.0001, t test). The average functional improvement in the Oxford score was 20.6 (± 9.5) points and was also highly significant (p < 0.0001). The ROM improved from 106.5° (± 20.5) preoperatively to 116.0° (± 11.5) (p < 0.0001, t test). There were no implant-related complications as well as no new complication documented between 5- and 10-year follow-up.

Conclusions

The endpoint analysis after an observation period of 10 years provided good clinical and radiographic results. In particular, an excellent survival rate of 96.6% after 10 years was demonstrated. The data published in this study are the first to be available in a prospective multicenter study on this system, which leads to a high level of clinical significance.
Macular, papillary and peripapillary perfusion densities measured with optical coherence tomography angiography in primary open angle glaucoma and pseudoexfoliation glaucoma
Authors: Cornelius Anna , Pilger Daniel , Riechardt Aline , Reitemeyer Emanuel , Rübsam Anne , Winterhalter Sibylle , Maier Anna-Karina B.
Published: September 2021

Purpose

To compare the blood flow situation in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG) using optical coherence tomography angiography (OCTA).

Methods

In this prospective study a total of 26 POAG and 23 PXG eyes were included. All patients underwent a complete ophthalmological examination including standard automated perimetry, stereoscopic photographs of the optic disc, peripapillary retinal nerve fibre layer analysis and examination of vascular parameters of the optic nerve head (ONH), the peripapillary region and macula using OCTA. In addition to the vascular parameters recorded by the device, the vascular images were graphically evaluated using Image J. All recorded vascular parameters were compared between both groups and correlated to structural and functional parameters.

Results

The mean superficial perifoveal plexus perfusion density (PD) was significantly lower in PXG eyes than compared to POAG eyes using OCTA (32.57% ± 3.57% vs. 34.92% ± 2.11%, p = 0.007). The mean PD parameters for the superficial peripapillary plexus (40.98% ± 3.04% vs. 42.09% ± 2.29%, p = 0.152) as well as the size of the foveal avascular zone (FAZ) (0.23 mm2 ± 0.1 mm2 vs. 0.23 mm2 ± 0.09 mm2) did not differ between both groups. Additional graphic evaluation using Image J showed no significant difference for superficial perifoveal plexus PD (32.97% ± 1.11% vs. 33.35% ± 0.95%, p = 0.194) and peripapillary plexus PD (46.65% ± 0.83% vs. 46.95% ± 0.5%, p = 0.127) between the groups. Retinal nerve fibre layer (RNFL) thickness correlated significantly with peripapillary plexus PD for both OCTA data and Image J data (p < 0.001, p = 0.032).

Conclusion

The severity of the glaucoma seems to be crucial for peripapillary and macular perfusion densities, and not the form of glaucoma. An additional graphic evaluation is a possible step that could be implemented to improve the comparability of OCTA scans and to optimize the possibility of quantitative perfusion analysis in the case of deviating quality criteria.
Predictors for thromboembolism in patients with cholangiocarcinoma
Authors: Pfrepper Christian , Knödler Maren , Schorling Ruth Maria , Seehofer Daniel , Petros Sirak , Lordick Florian
Published: September 2021

Background

Patients with cancer are at increased risk of thromboembolic events contributing significantly to cancer-related morbidity and mortality. Because cholangiocarcinoma is a rare type of cancer, the incidence of thromboembolism in this patient population is not well defined.

Methods

Patients with cholangiocarcinoma treated at the University Cancer Center Leipzig between January 2014 and December 2018 were analyzed retrospectively regarding the incidence of arterial and venous thromboembolism.

Results

A total of 133 newly and consecutively diagnosed patients were included, of whom 22% had stage IV disease. Thromboembolism was diagnosed in 39 (29.3%), with 48% of the events occurring between 60 days prior and 30 days after the initial diagnosis. Arterial thrombosis accounted for 19% and portal venous thrombosis for 33% of the events, while the rest of events occurred in the non-portal venous system. In multivariable analysis, an ONKOTEV score ≥ 2 was the only independent predictor for thromboembolism. Serum CA 19-9 was available in 87 patients (65.4%). In this subgroup, CA 19-9 above the median of 97.7 U/ml and vascular or lymphatic compression were independent predictors for thromboembolism in the first year and CA 19-9 alone remained a significant predictor over the whole observation period. An ONKOTEV score ≥ 2 and increasing age were predictors of survival.

Conclusions

A very high thromboembolic risk was observed in cholangiocarcinoma, comparable to the risk situation in pancreatic and gastric cancer. The ONKOTEV score and serum CA 19-9 are independent predictors of thromboembolic events. Prospective validation of our observations in this patient population is warranted.
Surface-based nocturnal air temperature inversions in southern Poland and their influence on PM10 and PM2.5 concentrations in Upper Silesia
Authors: Niedźwiedź Tadeusz , Łupikasza Ewa Bożena , Małarzewski Łukasz , Budzik Tomasz
Published: September 2021

The frequency, strength and seasonal variations of surface-based temperature inversions (SBTIs) in Upper Silesia (Southern Poland) were examined using data from January 2001 to September 2020. Based on the air temperatures recorded at the meteorological station of the Institute of Earth Sciences in Sosnowiec (263 m a.s.l.) at heights of 2 m and 88 m above the ground, the vertical temperature gradient of the 100-m layer (γSos100 m) was determined. A lapse rate of γSos100 m > 0.5 K was defined as a temperature inversion. The measurements for 00 UTC (midnight) and 12 UTC (midday) were compared with data from the upper air station in Wrocław (116 m a.s.l.) located in the Lower Silesia Lowland, approximately 170 km NW of Sosnowiec. Based on soundings from Wrocław, in addition to the temperature gradient in the lower 100-m layer of air (γWrc100), three other characteristics of SBTIs were calculated: inversion depth (ID) or thickness in metres, inversion strength (ΔTi) in K and vertical temperature gradients across the whole SBTI layer γi in K 100 m−1. On an annual basis, the frequency of nighttime SBTIs (γ > 0.5 K 100 m−1) ranged from 47% in Sosnowiec to almost 59% in Wrocław. At both stations, the fewest SBTIs occurred in winter (23–38%) and the most in summer (64–75%). Moreover, they were more frequent in spring (52–61%) than in autumn (49–59%). The SBTI frequency was very low during the midday hours, amounting to 0.6–0.7% days a year, and it increased to 1–2% only in winter. Annually, the depth of 81% of inversions ranged between 50 and 300 m, varying seasonally from almost 67% in winter to 87% in summer. The presented research shows that SBTIs in winter were among the main factors contributing to a high concentration of particulate matter pollutants in the ground-level atmosphere. During nights with temperature inversions, the annual mean PM10 concentration reached 125% of the mean value, ranging from 114% in summer to 189% in winter.
Lifestyle factors in patients with rheumatoid arthritis—a cross-sectional study on two Scandinavian cohorts
Authors: Karstensen Julie Katrine , Primdahl Jette , Andersson Maria L. E. , Christensen Jeanette Reffstrup , Bremander Ann
Published: September 2021

Introduction

The risk for cardiovascular diseases and other comorbidities increases with the number of unhealthy lifestyle factors in the general population. However, information on the combined number of unhealthy lifestyle factors in people with rheumatoid arthritis (RA) is scarce.

Objectives

To study lifestyle factors and the association between disease impact and two or more unhealthy lifestyle factors in two Scandinavian cohorts with RA.

Methods

We analysed data from two cohorts, Danish (n = 566; mean age 61.82 (SD 11.13) years; 72% women) and Swedish (n = 955; mean age 66.38 (SD 12.90) years; 73% women). Lifestyle factors (tobacco use, BMI, alcohol consumption and physical activity) were dichotomised as healthy vs. unhealthy (range 0–4 unhealthy factors). The association between disease impact and two or more unhealthy lifestyle factors was analysed using logistic regression.

Results

Sixty-six percent of Danish and 47% of Swedish respondents reported two or more unhealthy lifestyle factors, most commonly, being overweight/obese and physical inactivity. For Danish participants, two or more unhealthy lifestyle factors were associated with (OR and 95% CI) male gender (1.86; 1.21–2.85), cardiovascular diseases (1.90; 1.28–2.82) and disease duration (0.97; 0.95–0.99). Corresponding findings for the Swedish cohort were male gender (1.42; 1.07–1.89), pain (1.10; 1.04–1.15), fatigue (1.09; 1.04–1.15), physical functioning (1.64; 1.28–2.10) and quality of life (0.35; 0.20–0.60).

Conclusion

Many patients, most often male, in both cohorts had two or more unhealthy lifestyle factors. The number of unhealthy lifestyle factors indicates a multifaceted relationship with disease impact.

Key Points• This article contributes with new information concerning the proportion of patients with RA who have one or more unhealthy lifestyle factors.• Every second patient in the two included cohorts reported two or more unhealthy lifestyle factors.• Two or more unhealthy lifestyle factors were more common in men than in women but were not necessarily associated with measures of disease impact.• In order to adhere to a healthier lifestyle, a large proportion of the patients need to change more than one lifestyle habit, which entails a challenge for both the patients and the health professionals.
To what extent are pollutant emission intensified by international tourist arrivals? Starling evidence from G7 Countries
Authors: Gyamfi Bright Akwasi , Bein Murad A. , Adedoyin Festus Fatai , Bekun Festus Victor
Published: September 2021

A large volume of environmental science and pollution research has focused on the contributions of various forms of energy consumption to emissions. However, little attention is given to the impact of human activities such as tourism. Hence, this study investigates the impact of tourist arrivals, energy use, and economic growth on CO2 emissions in the G7 countries for the period 1995–2018. The study employed the use of dynamic panel estimations, namely dynamic ordinary least square, fully modified ordinary least squares and panel pooled mean group-autoregressive distributed lag model (PMG-ARDL) estimation techniques to establish long-run and short-run relationships between the study variable of interest, while the Dumitrescu Hurlin non-causality test was used to test for causality direction among the variables outlined. Empirical findings from the regression revealed that economic growth, tourism and energy use are strong drivers of emission levels in the G7 bloc, while the causality analysis revealed that there is unidirectional causality from CO2 to energy use, CO2 to economic growth (GDP) and GDP to tourist arrivals. These outcomes imply that tourism, energy use and economic growth have no direct effect on emissions, but rather emissions predict economic growth and energy use. Furthermore, tourist arrivals predict energy use; economic growth predicts tourism. Overall based on the study of empirical outcomes, we suggest that to achieve more significant results in reducing emissions, governments of the G7 countries should continue to emphasize green tourism as well as increase the share of renewable energy in their regional energy mix. More policy direction was outlined in the concluding section of this study.
Maternal Mid-Gestation Cytokine Dysregulation in Mothers of Children with Autism Spectrum Disorder
Authors: Casey S. , Carter M. , Looney A. M. , Livingstone V. , Moloney G. , O’Keeffe G. W. , Taylor R. S. , Kenny L. C. , McCarthy F. P. , McCowan L. M. E. , Thompson J. M. D. , Murray D. M. ,   the SCOPE Consortium
Published: September 2021

Autism spectrum disorder (ASD) is a developmental disorder characterised by deficits in social interactions and communication, with stereotypical and repetitive behaviours. Recent evidence suggests that maternal immune dysregulation may predispose offspring to ASD. Independent samples t-tests revealed downregulation of IL-17A concentrations in cases, when compared to controls, at both 15 weeks (p = 0.02), and 20 weeks (p = 0.02), which persisted at 20 weeks following adjustment for confounding variables. This adds to the growing body of evidence that maternal immune regulation may play a role in foetal neurodevelopment.
Microstructure–property relation and machine learning prediction of hole expansion capacity of high-strength steels
Authors: Li Wei , Vittorietti Martina , Jongbloed Geurt , Sietsma Jilt
Published: September 2021

The relationship between microstructure features and mechanical properties plays an important role in the design of materials and improvement of properties. Hole expansion capacity plays a fundamental role in defining the formability of metal sheets. Due to the complexity of the experimental procedure of testing hole expansion capacity, where many influencing factors contribute to the resulting values, the relationship between microstructure features and hole expansion capacity and the complexity of this relation is not yet fully understood. In the present study, an experimental dataset containing the phase constituents of 55 microstructures as well as corresponding properties, such as hole expansion capacity and yield strength, is collected from the literature. Statistical analysis of these data is conducted with the focus on hole expansion capacity in relation to individual phases, combinations of phases and number of phases. In addition, different machine learning methods contribute to the prediction of hole expansion capacity based on both phase fractions and chemical content. Deep learning gives the best prediction accuracy of hole expansion capacity based on phase fractions and chemical composition. Meanwhile, the influence of different microstructure features on hole expansion capacity is revealed.

Graphical abstract
Performance optimization of RSOA based mm-wave radio-over-fibre access network
Authors: Udvary Eszter
Published: September 2021

In this paper, a Reflective Semiconductor Optical Amplifier based, Radio-over-Fibre access network configuration has been proposed to feed future millimeter-wave radio systems. The system architecture combines several approaches to overcome the challenges of millimeter-wave signal transmission. Reflective semiconductor optical amplifier modulator realizes a colorless and relatively cost-effective Remote Antenna Unit. The same optical carrier is used for both downlink and uplink. Optical single-sideband modulation is used at the downlink, which is robust against chromatic dispersion, but the complex realization of this modulation format is not possible at the Remote Antenna Unit. Optical intermediate frequency transmission is applied at the uplink direction, and the required local oscillator signal originates from the central station. The critical element is the reflective optical amplifier, as it compensates for the optical loss and works as an external intensity modulator. The operation of the reflective optical amplifier is modeled by multisection rate and wave equation-based description. The amplification and modulation behaviors of an available reflective optical amplifier are also measured. The experimental work validated the colorless operation and the quality of the modulation versus bias current and input optical power. Finally, system simulation was realized. The uplink and downlink power budgets were balanced, and optimal values for the optical coupling rate and RSOA bias current have been selected.
Quantum k-community detection: algorithm proposals and cross-architectural evaluation
Authors: Gemeinhardt Felix G. , Wille Robert , Wimmer Manuel
Published: September 2021

Emerging quantum technologies represent a promising alternative for solving hard combinatorial problems in the post-Moore’s law era. For practical purposes, however, the current number of qubits limits the direct applicability to larger real-world instances in the near-term future. Therefore, a promising strategy to overcome this issue is represented by hybrid quantum classical algorithms which leverage classical as well as quantum devices. One prominent example of a hard computational problem is the community detection problem: a partition of a graph into distinct communities such that the ratio between intra-community and inter-community connectivity is maximized. In this paper, we explore the current potential of quantum annealing and gate-based quantum technologies to solve the community detection problem for an arbitrary number of communities. For this purpose, existing algorithms are (re-)implemented and new hybrid algorithms, that can be run on gate-model devices, are proposed. Their performance on standardized benchmark graphs has been evaluated and compared to the one of a state-of-the-art classical heuristic algorithm. Although no quantum speed-up has been achieved, the existing quantum annealing-based methods as well as the novel hybrid algorithms for gate-based quantum computers yield modularity values, which are similar to those of the classical heuristic. However, the modular architecture of the used algorithms allows for fast utilization of more powerful quantum technologies once they become available.Reproducibility:Our code and data are publicly available (Github in Quantum Modularization.https://github.com/jku-win se/quantum_modularization2021).
Conductivity measurement of ionic liquids confined in the nanopores of metal–organic frameworks: a case study for [BMIM][TFSI] in HKUST-1
Authors: Zhang Zejun , Li Chun , Chandresh Abhinav , Heinke Lars
Published: September 2021

Nanoporous materials like metal–organic frameworks (MOFs) attract considerable attention as porous host for electrolytes like ionic liquids (ILs). The conductivity and mobility of the ions in the pores are among the key properties and their experimental quantification is of paramount importance. Here, three different approaches for the quantification of the ion conductivity of IL@MOF via electrochemical impedance spectroscopy (EIS) are compared: the material in the form of IL-impregnated MOF powders pressed into pellets between two planar electrodes, MOF films grown on substrates with deposited electrodes loaded with IL by impregnation, and the IL-loaded MOF films where excess IL is removed. Contact-angle measurements and EIS data show that the excess IL on the outer MOF surface of the film or pellet results in apparent conductivities, larger than the intrinsic conductivity of the IL@MOF. Removing the excess IL enables the experimental quantification of the intrinsic IL@MOF conductivity.

Graphical abstract

The ionic conduction of ionic liquid (IL) confined in nanoporous metal–organic framework (MOF) is explored via impedance spectroscopy, where the material is either in the form of pellets pressed from powder or in the form of thin films grown on suitable substrates. The different methods show substantially different results, attributed to excess IL on the external surface, and a method for recording the intrinsic IL@MOF conductivity is presented.
Microstructure and Corrosion Properties of AlCrFeCoNi High-Entropy Alloy Coatings Prepared by HVAF and HVOF
Authors: Löbel Martin , Lindner Thomas , Mehner Thomas , Rymer Lisa-Marie , Björklund Stefan , Joshi Shrikant , Lampke Thomas
Published: September 2021

High-entropy alloys (HEAs) represent an innovative development approach for new alloy systems. These materials have been found to yield promising properties, such as high strength in combination with sufficient ductility as well as high wear and corrosion resistance. Especially for alloys with a body-centered cubic (bcc) structure, advantageous surface properties have been revealed. However, typical HEA systems contain high contents of expensive or scarce elements. Consequently, applying them as coatings where their use is limited to the surface represents an exciting pathway enabling economical exploitation of their superior properties. Nevertheless, processing conditions strongly influence the resulting microstructure and phase formation, which in turn has a considerable effect on the functional properties of HEAs. In the presented study, microstructural differences between high-velocity oxygen fuel (HVOF) and high-velocity air fuel (HVAF) sprayed coatings of the alloy AlCrFeCoNi are investigated. A metastable bcc structure is formed in both coating processes. Precipitation reactions are suppressed by the rapid solidification during atomization and by the relatively low thermal input during spraying. The coating resistance to corrosive media was investigated in detail, and an improved passivation behavior was observed in the HVAF coatings.
Structured pain-free exercise progressively improves ankle-brachial index and walking ability in patients with claudication and compressible arteries: an observational study
Authors: Manfredini Fabio , Traina Luca , Gasbarro Vincenzo , Straudi Sofia , Caruso Lorenzo , Fabbian Fabio , Zamboni Paolo , Manfredini Roberto , Lamberti Nicola
Published: September 2021

In patients with peripheral artery disease (PAD), supervised exercise at near-moderate pain improves walking ability but not ankle-brachial index (ABI) values. In a retrospective observational study, we determined vascular and functional effects of a 6-month structured pain-free exercise program in patients with claudication and compressible vessels. Four-hundred and fifty-nine consecutive patients were studied. Segmental limb pressures were measured and ABI calculated during circa-monthly hospital visits. The 6-min (6MWD) and the pain-free walking distance (PFWD) during the 6-min walking test were determined. Two daily 8-min sessions of slow–moderate in-home walking at increasing metronome-paced speed were prescribed. After excluding patients with unmeasurable ABI or incompletion of the program, 239 patients were studied. Safe and satisfactory (88%) execution of the prescribed training sessions was reported. During the visits, bilateral ABI improved (+ 0.07; p < 0.001) as well as the segmental pressures in the more impaired limb, with changes already significant after 5 weeks of slow walking. Both systolic and diastolic blood pressure decreased overtime (F = 46.52; p < 0.001; F = 5.52; p < 0.001, respectively). 6MWD and PFWD improved (41[0‒73]m p < 0.001 and 107[42‒190]m p < 0.001, respectively) with associated decrease of walking heart rate (F = 15.91; p < 0.001) and Physiological Cost Index (F = 235.93; p < 0.001). The variations of most parameters at different visits correlated to the training load calculated. In a regression model, the PFWD variations directly correlated with rate sessions completed, training load and ABI change and inversely with the baseline value (R2 = 0.27; p < 0.001). In the PAD population studied, moderate pain-free exercise improved ABI with associated progressive functional and cardiovascular changes occurring regardless of subjects characteristics.
Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention
Authors: Kunneman Marleen , Branda Megan E. , Ridgeway Jennifer L. , Tiedje Kristina , May Carl R. , Linzer Mark , Inselman Jonathan , Buffington Angela L. H. , Coffey Jordan , Boehm Deborah , Deming James , Dick Sara , van Houten Holly , LeBlanc Annie , Liesinger Juliette , Lima Janet , Nordeen Joanne , Pencille Laurie , Poplau Sara , Reed Steven , Vannelli Anna , Yost Kathleen J. , Ziegenfuss Jeanette Y. , Smith Steven A. , Montori Victor M. , Shah Nilay D.
Published: September 2021

Purpose

To determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making.

Methods

In this mixed methods multicenter cluster randomized trial, we included patients with type 2 diabetes mellitus and their primary care clinicians. We compared usual care with or without a within-encounter SDM conversation aid. We assessed participant-reported decisions made and quality of SDM (knowledge, satisfaction, and decisional conflict), clinical outcomes, adherence, and observer-based patient involvement in decision-making (OPTION12-scale). We used semi-structured interviews with patients to understand their perspectives.

Results

We enrolled 350 patients and 99 clinicians from 20 practices and interviewed 26 patients. Use of the conversation aid increased post-encounter patient knowledge (correct answers, 52% vs. 45%, p = 0.02) and clinician involvement of patients (Mean between-arm difference in OPTION12, 7.3 (95% CI 3, 12); p = 0.003). There were no between-arm differences in treatment choice, patient or clinician satisfaction, encounter length, medication adherence, or glycemic control. Qualitative analyses highlighted differences in how clinicians involved patients in decision making, with intervention patients noting how clinicians guided them through conversations using factors important to them.

Conclusions

Using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence or improved diabetes control in patients with type 2 diabetes. Future interventions may need to focus specifically on patients with signs of poor treatment fit.

Clinical trial registration

ClinicalTrial.gov: NCT01502891.
Longitudinal effects of family and school context on the development on emergent literacy skills in preschoolers
Authors: Incognito Oriana , Pinto Giuliana
Published: September 2021

The negative influence of economic and socio-cultural disadvantages on students’ literacy performance has been widely documented. However, the ability of schooling to counterbalance the predictive effect exerted by inequality in the family context has been less investigated. This study aims to longitudinally investigate the relative weight of the child’s family context, i.e., parents’ occupation and education levels; home literacy; and the school context, in terms of didactical intervention, on emergent literacy skills. A total of 193 children in the last year of preschool participated in the longitudinal research. Each child was administered socio-economic measures (parental education [PE] and home literacy [HL] levels) and, at the beginning and end of the school year, tasks to assess his or her emergent literacy skills (phonological awareness and textual and notational skills). General linear model analyses were carried out. The results of the initial assessment showed that PE level was a powerful predictor of performance that was associated with significantly lower performance in children from disadvantaged backgrounds in all the tested skills. After a year of schooling, all participants benefitted from the teaching received, with significantly increased performance in phonological awareness, notational skills and textual competence. In addition, by comparing the scores of the three groups at the end of the school year, we verified that teaching exerted varying degrees of influence depending on the student group and tested ability.
Forest Loss is Accelerating Along the US Gulf Coast
Authors: McCarthy Matthew J. , Dimmitt Benjamin , DiGeronimo Sebastian , Muller-Karger Frank E.
Published: September 2021

Sea-level rise is impacting the longest undeveloped stretch of coastline in the contiguous United States: The Florida Big Bend. Due to its low elevation and a higher-than-global-average local rate of sea-level rise, the region is losing coastal forest to encroaching marsh at an unprecedented rate. Previous research found a rate of forest-to-marsh conversion of up to 1.2 km2 year−1 during the nineteenth and twentieth centuries, but these studies evaluated small-scale changes, suffered from data gaps, or are substantially outdated. We replicated and updated these studies with Landsat satellite imagery covering the entire Big Bend region from 2003 to 2016 and corroborated results with in situ landscape photography and high-resolution aerial imagery. Our analysis of satellite and aerial images from 2003 to 2016 indicates a rate of approximately 10 km2 year−1 representing an increase of over 800%. Areas previously found to be unaffected by the decline are now in rapid retreat.
Facies, magnetic susceptibility and timing of the Late Devonian Frasnian/Famennian boundary interval (Xom Nha Formation, Central Vietnam)
Authors: Ta Hoa Phuong , Königshof Peter , Ellwood Brooks B. , Nguyen Thang C. , Luu Phuong Lan T. , Doan Dinh Hung , Munkhjargal Ariuntogos
Published: September 2021

Upper Devonian carbonates deposited through the Frasnian/Famennian (F/F) stage boundary in the Xom Nha Formation, Central Vietnam, were studied. The section is mainly composed of fossiliferous, brecciated, and laminated limestone beds, while shale beds occur in a subordinate number. Microfacies generally suggests a hemipelagic setting on an outer shelf environment with low sedimentation rates. A sediment accumulation rate of 0.217 cm/kyrs for this section is calculated. The Xom Nha section does not exhibit characteristic black shales or black limestones through the F/F boundary, but instead shows a similar lithology in comparison to other F/F sections in Southeast Asia. The carbonates yielded abundant conodonts, which represent mainly cosmopolitan species but the section differs from most sections in Europe in showing relatively high numbers of Palmatolepis linguiformis species. Deposition through the F/F boundary interval reported here for the Xom Nha section appears to have occurred during a ~1.2 Ma, and shows well-defined climate cyclicity.
Discoloration and mineralization of a textile azo dye using a hybrid UV/O3/SBR process
Authors: Mahdizadeh Hakimeh , Dadban Shahamat Yousef , Rodríguez-Couto Susana
Published: September 2021

Most synthetic dyes are toxic and hardly biodegradable compounds that enter the environment mainly through the discharged of non-treated textile industry effluents. The present study investigated the removal of the textile monoazo dye Reactive Red 198 (RR-198) from aqueous solutions using the ultraviolet light and ozonation alone and in combination (i.e., UV/O3) followed by a Sequencing Batch Reactor (SBR). The pH (5 ≤ pH ≤ 9) and dye initial concentration (50–300 mg/L) parameters were optimized in the ozonation process at reaction time of 0–60 min. Then, TOC removal and dye discoloration percentage was compared with the O3, UV and O3/UV processes. In order to compare the performance of the SBR in dye discoloration of RR-198 and TOC removal, four types of effluent, including Raw dye, O3-pretreated dye, UV-treated dye and UV/O3-pretreated dye were separately treated in the SBR system. In the ozonation process, by increasing the pH and reducing the initial dye concentration increased the discoloration percentage. The highest dye discoloration percentage and TOC removal obtained in the hybrid UV/O3/SBR process. Combining biological systems and Advanced Oxidation Processes is an appropriate option for the decomposition of resistant pollutants and increasing the biodegradability of these compounds and is applicable in the water and wastewater industry.
Preschool children’s mathematical arguments in play-based activities
Authors: Nergård Beate
Published: September 2021

The present study examines the structure and mathematical content of children’s mathematical arguments as part of communication in play-based activities. It shows how Nordin and Boistrup’s (The Journal of Mathematical Behavior 51:15–27, 2018) framework for identifying and reconstructing mathematical arguments, which includes Toulmin’s model of argumentation, the notion of anchoring (Lithner, Educational Studies in Mathematics 67:255–276, 2008) and a multimodal approach, can be used to identify and explore preschool children’s mathematical arguments. Two different types of argument that occurred during play-based activities were identified: partial arguments and full arguments. The findings reveal the extensive use of multimodal interactions in all parts of the children’s mathematical arguments. Moreover, the findings point to the crucial role of adults as dialogue collaborators in the argumentation that emerges in the play-based activities.
A severe case of Israeli spotted fever with pleural effusion in Italy
Authors: Guccione Cristoforo , Colomba Claudia , Rubino Raffaella , Bonura Celestino , Anastasia Antonio , Agrenzano Stefano , Caputo Valentina , Giammanco Giovanni Maurizio , Cascio Antonio
Published: September 2021

Background

The most common Italian rickettsiosis is Mediterranean Spotted Fever (MSF). MSF is commonly associated with a symptom triad consisting of fever, cutaneous rash, and inoculation eschar. The rash is usually maculopapular but, especially in severe presentations, may be petechial. Other typical findings are arthromyalgia and headache. Herein, we describe for the first time an unusual case of Israeli spotted fever (ISF) associated with interstitial pneumonia and pleural effusion in which R. conorii subsp. israelensis was identified by molecular methods in the blood, as well as in the pleural fluid.

Case presentation

A 72-year-old male presented with a 10-day history of remittent fever. On admission, the patient’s general condition appeared poor with confusion and drowsiness; the first assessment revealed a temperature of 38.7°, blood pressure of 110/70 mmHg, a blood oxygen saturation level of 80% with rapid, frequent, and superficial breathing using accessory muscles (28 breaths per minute), and an arrhythmia with a heart rate of 90 beats per minute. qSOFA score was 3/3. Chest CT revealed ground-glass pneumonia with massive pleural effusion. Petechial exanthema was present diffusely, including on the palms and soles, and a very little eschar surrounded by a violaceous halo was noted on the dorsum of the right foot. Awaiting the results of blood cultures, broad-spectrum antibiotic therapy with meropenem 1 g q8h, ciprofloxacin 400 mg q12h, and doxycycline 100 mg q12h was initiated. Doxycycline was included in the therapy because of the presence of petechial rash and fever, making us consider a diagnosis of rickettsiosis. This suspicion was confirmed by the positivity of polymerase chain reaction on whole blood for R. conorii subsp. israelensis. Thoracentesis was performed to improve alveolar ventilation. R. conorii subsp. israelensis was again identified in the pleural fluid by PCR technique. On day 4 the clinical condition worsened. Blood exams showed values suggestive of secondary hemophagocytic lymphohistiocytosis; 4 out of 8 diagnostic criteria were present and empirical treatment with prednisone was started resulting in a gradual improvement in general condition.

Conclusions

Israeli spotted fever may be a severe disease. A high index of suspicion is required to promptly start life-saving therapy. Pleural effusion and interstitial pneumonia may be part of the clinical picture of severe rickettsial disease and should not lead the physician away from this diagnosis.
Projected Drought Conditions over Southern Slope of the Central Himalaya Using CMIP6 Models
Authors: Sharma Shankar , Hamal Kalpana , Khadka Nitesh , Ali Munawar , Subedi Madan , Hussain Gulfam , Ehsan Muhammad Azhar , Saeed Sajjad , Dawadi Binod
Published: September 2021

Nepal is located on the southern slope of the Central Himalayas and has experienced frequent droughts in the past. In this study, we used an ensemble of 13 biased corrected models from the Coupled Model Intercomparison Project Phase 6 (CMIP6) to assess the future drought conditions over Nepal under three shared socioeconomic pathways (SSP126, SSP245, and SSP585) using the Standardized Precipitation Evapotranspiration Index (SPEI) at annual timescale. The monthly correlation between observed and CMIP6-simulated historical SPEI is 0.23 (p < 0.01), which indicates the CMIP6 model ensemble can simulate the drought characteristics over Nepal. In the future period (2020–2100), the duration and severity of droughts are projected to increase with higher emission scenarios, especially for SSP585. Our results indicate enhanced drought intensity under SSP126, whereas, under SSP245, the drought frequency will be slightly higher. The drought frequency is projected to increase in the early future (2020–2060), decreasing in the late future (2061–2100) under all SSP scenarios. The results further indicate more prolonged and severe droughts in the early future under SSP585 as compared to SSP126 and SSP245. The findings of the present study can help drought mitigation as well as long-term adaptation strategies over Nepal.
Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study
Authors: Lampalzer Ute , Tozdan Safiye , von Franqué Fritjof , Briken Peer
Published: September 2021

Introduction

Studies on characteristics of self-referred men with sexual interest in minors (SIM) and treatment approaches in this group of patients are still relatively rare.

Aim

The aim of this exploratory pilot study was to investigate hypersexuality and impulsivity as 2 dynamic risk factors that could possibly change during treatment in self-referred men with SIM.

Methods

Data were collected at the “Kein Täter Werden (means: not become an offender)” network site in Hamburg. Using self-report questionnaires, the extent of hypersexuality and impulsivity was analyzed with the samples’ pretreatment data via descriptive statistics and compared with nonclinical samples of other studies. The relation between hypersexuality and impulsivity was analyzed via Spearman's correlation coefficient with pretreatment data (N = 77). Intragroup analysis compared hypersexuality and impulsivity from pre- and posttreatment (n = 29).

Main Outcome Measures

Hypersexual Behavior Inventory and Barratt Impulsiveness Scale Version 11.

Results

The degree of generalized impulsivity in the SIM group was comparable to that in nonclinical samples while the degree of hypersexuality was considerably higher than in nonclinical samples. Sixty-four percent of the participants were in the range of clinically relevant hypersexuality. Impulsivity and hypersexuality were weakly positively correlated with each other. During treatment hypersexuality significantly decreased while impulsivity did not differ significantly between before beginning treatment and after (partial) completion.

Conclusion

Hypersexuality, but not impulsivity, was pronounced in the group of self-referred men with SIM and should be targeted in treatment. In order to improve treatment outcome regarding risk reduction in self-referred men with SIM, a focus on treatment approaches that were developed to treat hypersexuality can be expected to be effective while focusing on generalized impulsivity may be less relevant.
G-spot: Fact or Fiction?: A Systematic Review
Authors: Vieira-Baptista Pedro , Lima-Silva Joana , Preti Mario , Xavier Joana , Vendeira Pedro , Stockdale Colleen K.
Published: September 2021

Introduction

The G-spot, a putative erogenous area in the anterior vaginal wall, is a widely accepted concept in the mainstream media, but controversial in medical literature.

Aim

Review of the scientific data concerning the existence, location, and size of the G-spot.

Methods

Search on Pubmed, Pubmed Central, Cochrane, clinicaltrials.gov and Google Scholar from inception to November 2020 of studies on G-spot's existence, location and nature. Surveys, clinical, physiological, imaging, histological and anatomic studies were included.

Main Outcome Measure

Existence, location, and nature of the G-spot.

Results

In total, 31 eligible studies were identified: 6 surveys, 5 clinical, 1 neurophysiological, 9 imaging, 8 histological/anatomical, and 2 combined clinical and histological. Most women (62.9%) reported having a G-spot and it was identified in most clinical studies (55.4% of women); in 2 studies it was not identified in any women. Imaging studies had contradictory results in terms of its existence and nature. Some showed a descending of the anterior vaginal wall, that led to the concept of clitourethrovaginal complex. In anatomic studies, one author could systematically identify the G-spot, while another group did not find it. Studies on innervation of the vaginal walls did not systematically identify an area with richer innervation.

Conclusion

The different studies did systematically agree on the existence of the G-spot. Among the studies in which it was considered to exist, there was no agreement on its location, size, or nature. The existence of this structure remains unproved.

Vieira-Baptista P, Lima-Silva J, Preti M, et al. G-spot: Fact or Fiction?: A Systematic Review. Sex Med 2021;9:100435.
For King and Country
Authors: Jones Heather
Published: September 2021

This is a ground-breaking history of the British monarchy in the First World War and of the social and cultural functions of monarchism in the British war effort. Heather Jones examines how the conflict changed British cultural attitudes to the monarchy, arguing that the conflict ultimately helped to consolidate the crown's sacralised status. She looks at how the monarchy engaged with war recruitment, bereavement, gender norms, as well as at its political and military powers and its relationship with Ireland and the empire. She considers the role that monarchism played in military culture and examines royal visits to the front, as well as the monarchy's role in home front morale and in interwar war commemoration. Her findings suggest that the rise of republicanism in wartime Britain has been overestimated and that war commemoration was central to the monarchy's revered interwar status up to the abdication crisis.
Introduction to the Biogeochemistry of Soils
Authors: Amundson Ronald
Published: September 2021

The first process-based textbook on how soils form and function in biogeochemical cycles, offering a self-contained and integrated overview of the field as it now stands for advanced undergraduate and graduate students in soil science, environmental science, and the wider Earth sciences. The jargon-free approach quickly familiarises students with the field's theoretical foundations before moving on to analyse chemical and other numerical data, building the necessary skills to develop questions and strategies for original research by the end of a single semester course. The field-based framework equips students with the essential tools for accessing and interpreting the vast USDA soil dataset, allowing them to establish a working knowledge of the most important modern developments in soil research. Complete with numerous end-of-chapter questions, figures and examples, students will find this textbook a multidisciplinary toolkit invaluable to their future careers.