bluuebunny/crossref_metadata_2025 huggingface dataset:
Untangling a Web: Basic Mechanisms of the Complex Interactions Between Sleep, Circadian Rhythms, and Epilepsy
Authors: Maganti Rama K. , Jones Mathew V.
Published: February 2021

Seizures have sleep–wake and circadian patterns in various epilepsies and, in turn, disrupt sleep and circadian rhythms. The resultant sleep deprivation (SD) is an exacerbating factor for seizures that sets up a vicious cycle that can potentially lead to disease progression and even to epilepsy-related mortality. A variety of cellular or network electrophysiological changes and changes in expression of clock-controlled genes or other transcription factors underlie sleep–wake and circadian distribution of seizures, as well as the disruptions seen in both. A broad understanding of these mechanisms may help in designing better treatments to prevent SD-induced seizure exacerbation, disrupt the vicious cycle of disease progression, and reduce epilepsy-related mortality.
An efficient routing protocol for internet of medical things focusing hot spot node problem
Authors: Ahmed Ghufran , Mehmood Danish , Shahzad Khurram , Malick Rauf Ahmed Shams
Published: February 2021

The healthcare budget is increasing day-by-day as the population of the world increases. The same is the case regarding the workload of health care workers, that is, doctors and other practitioners. Under such a scenario where workload and cost are increasing drastically, there is a dire need of integrating recent technological enhancements with the said domain. Since the last decade, a lot of work is in the process considering the said integration bringing revolutionary changes. For remote monitoring, existing systems use different types of Internet of things devices that measure different health parameters. One of the major problems in such a system is to find an optimum routing approach that can resolve energy and thermal issues that are taking the limelight in the research arena. In this article, a dynamic routing technique is proposed which is keen to connect multiple in vivo/ex vivo Internet of things devices and a sink (focusing thermal and energy problem) and then forwarding data from sink to remote location for monitoring. Performance parameters are kept energy efficiency and thermal awareness and analytical results show that the proposed protocol supersedes existing approaches in said metrics.
Interval analysis-based Bi-iterative algorithm for robust TDOA-FDOA moving source localisation
Authors: Qin Ningning , Wang Chao , Shan Changxu , Yang Le
Published: February 2021

In this study, an interval extension method of a bi-iterative is proposed to determine a moving source. This method is developed by utilising the time difference of arrival and frequency difference of arrival measurements of a signals received from several receivers. Unlike the standard Gaussian noise model, the time difference of arrival - frequency difference of arrival measurements are obtained by interval enclosing, which avoids convergence and initialisation problems in the conventional Taylor-series method. Using the bi-iterative strategy, the algorithm can alternately calculate the position and velocity of the moving source in interval vector form. Simulation results indicate that the proposed scheme significantly outperforms other methods, and approaches the Cramer-Rao lower bound at a sufficiently high noise level before the threshold effect occurs. Moreover, the interval widths of the results provide the confidence degree of the estimate.
Thirty-three vascular residency programs among 13 countries joining forces to improve surgical education in times of COVID-19: A survey-based assessment
Authors: Fabiani Mario Alejandro , Gonzalez-Urquijo Mauricio , Cassagne Gabriela , Dominguez Angeles , Hinojosa-Gonzalez David Eugenio , Lozano-Balderas Gerardo , Cisneros Tinoco Miguel Ángel , Escotto Sanchez Ignacio , Esperón Percovich Alejandro , Vegas Diego Herrera , Mariné Massa Leopoldo , Mertens Renato A , Morelli Luis , Sepulveda Monsalve Gustavo , Sanchez Nicolat Nora , Perez Damian Venancio , Riambau Vicente , Vaquero Puerta Carlos , Zaefferer Patricio
Published: February 2021

Background

Academic interaction with mentors has almost become minimal due to the current pandemic of COVID-19. The objective of this study is to introduce how a group of vascular surgery residencies joined forces to improve surgical education in times of COVID-19.

Methods

On May 2020, a group of Hispanic American vascular residency programs created webinar sessions of arterial and venous clinical cases among vascular residents across Latin America and Europe. Participants were surveyed via email. Questions were about the perceived quality and utility of the webinars; answers were stratified into negative (disagree), neutral, and positive (agree).

Results

There have been 60 sessions and 118 clinical cases presented. The survey was answered by 106 participants, 82 males (78.8%) and 24 women (23.0%). Fifty-four (51.9%) were board-certified vascular surgeons, 49 (47.1%) vascular surgery residents, and 2 (1.9%) general surgery residents. Mean age of the participants was 41.5 years (range: 25–74 years). Mean years of vascular surgery practice or experience were 11.2 years (range: 0–45 years). The residency programs involved in this project were from 13 different countries. Most answers received were positive for both perceived quality and utility of the webinars.

Conclusion

Globalization and technology provide an opportunity for international education, with the goal of building well-rounded and academic vascular surgeons. This group is just the beginning of a large collaborative group among Hispanic American countries, hoping that more residency programs will join, with the aim of breaking borders in the education of vascular surgery.
Design of a robust tracking controller for a nonholonomic mobile robot based on sliding mode with adaptive gain
Authors: Azzabi Ameni , Nouri Khaled
Published: February 2021

This article propounds addressing the design of a sliding mode controller with adaptive gains for trajectory tracking of unicycle mobile robots. The dynamics of this class of robots are strong, nonlinear, and subject to external disturbance. To compensate the effect of the unknown upper bounded external disturbances, a robust sliding mode controller based on an integral adaptive law is proposed. The salient feature of the developed controller resides in taking into account that the system is MIMO and the upper bound of disturbances is not priori known. Therefore, we relied on an estimation of each perturbation separately for each subsystem. Hence, the proposed controller provides a minimum acceptable errors and bounded adaptive laws with minimum of chattering problem. To complete the goal of the trajectory tracking, we apply a kinematic controller that takes into account the nonholonomic constraint of the robot. The stability and convergence properties of the proposed tracking dynamic and kinematic controllers are analytically proved using Lyapunov stability theory. Simulation results based on a comparative study show that the proposed controllers ensure better performances in terms of good robustness against disturbances, accuracy, minimum tracking errors, boundness of the adaptive gains, and minimum chattering effects.
A pretrained proximal policy optimization algorithm with reward shaping for aircraft guidance to a moving destination in three-dimensional continuous space
Authors: Wang Zhuang , Li Hui , Wu Zhaoxin , Wu Haolin
Published: February 2021

To enhance the performance of guiding an aircraft to a moving destination in a certain direction in three-dimensional continuous space, it is essential to develop an efficient intelligent algorithm. In this article, a pretrained proximal policy optimization (PPO) with reward shaping algorithm, which does not require an accurate model, is proposed to solve the guidance problem of manned aircraft and unmanned aerial vehicles. Continuous action reward function and position reward function are presented, by which the training speed is increased and the performance of the generated trajectory is improved. Using pretrained PPO, a new agent can be trained efficiently for a new task. A reinforcement learning framework is built, in which an agent can be trained to generate a reference trajectory or a series of guidance instructions. General simulation results show that the proposed method can significantly improve the training efficiency and trajectory performance. The carrier-based aircraft approach simulation is carried out to prove the application value of the proposed approach.
Striped occipital cortex and intragyral hemorrhage: Novel magnetic resonance imaging markers for cerebral amyloid angiopathy
Authors: Koemans EA , Voigt S , Rasing I , Jolink WMT , van Harten TW , van der Grond J , van Rooden S , Schreuder FHBM , Freeze WM , van Buchem MA , van Zwet EW , van Veluw SJ , Terwindt GM , van Osch MJP , Klijn CJM , van Walderveen MAA , Wermer MJH
Published: February 2021

Background and aim

To investigate whether a striped occipital cortex and intragyral hemorrhage, two markers recently detected on ultra-high-field 7-tesla-magnetic resonance imaging in hereditary cerebral amyloid angiopathy (CAA), also occur in sporadic CAA (sCAA) or non-sCAA intracerebral hemorrhage (ICH).

Methods

We performed 7-tesla-magnetic resonance imaging in patients with probable sCAA and patients with non-sCAA-ICH. Striped occipital cortex (linear hypointense stripes perpendicular to the cortex) and intragyral hemorrhage (hemorrhage restricted to the juxtacortical white matter of one gyrus) were scored on T2*-weighted magnetic resonance imaging. We assessed the association between the markers, other CAA-magnetic resonance imaging markers and clinical features.

Results

We included 33 patients with sCAA (median age 70 years) and 29 patients with non-sCAA-ICH (median age 58 years). Striped occipital cortex was detected in one (3%) patient with severe sCAA. Five intragyral hemorrhages were found in four (12%) sCAA patients. The markers were absent in the non-sCAA-ICH group. Patients with intragyral hemorrhages had more lobar ICHs (median count 6.5 vs. 1.0), lobar microbleeds (median count >50 vs. 15), and lower median cognitive scores (Mini Mental State Exam: 20 vs. 28, Montreal Cognitive Assessment: 18 vs. 24) compared with patients with sCAA without intragyral hemorrhage. In 12 (36%) patients, sCAA diagnosis was changed to mixed-type small vessel disease due to deep bleeds previously unobserved on lower field-magnetic resonance imaging.

Conclusion

Whereas a striped occipital cortex is rare in sCAA, 12% of patients with sCAA have intragyral hemorrhages. Intragyral hemorrhages seem to be related to advanced disease and their absence in patients with non-sCAA-ICH could suggest specificity for CAA.
Evolving extreme events caused by climate change: A tail based Bayesian approach for extreme event risk analysis
Authors: Arif Mohammad , Khan Faisal , Ahmed Salim , Imtiaz Syed
Published: February 2021

Natural hazards are of significant concern for engineering development in the offshore environment. Climate change phenomena are making these concerns even greater. The frequency and extent of natural hazards are undesirably evolving over time; so risk estimation for such events require special consideration. In most cases the existing extreme models (based on the extreme value theory) are unable to capture the changing frequency and extremeness of natural hazards. To capture the evolving frequency and extremeness of natural hazards and their effects on offshore process operations, an advanced probabilistic approach is proposed in this paper. The approach considers a heavy right tail probability model. The model parameter is estimated through the Bayesian inference. Hill and the SmooHill estimators are used to evaluate the lowest and highest exponent of the probability model. The application of the approach is demonstrated through extreme iceberg risk analysis for the Jeanne d’Arc basin. This study shows climate change or global warming is causing to appear a significant number of icebergs every year in the study area. Offshore structures are often designed to withstand the impact of 1 MT icebergs weight; however, the study observes large icebergs (10 MT weight) are sighted in recent years (14% of the total number of cited icebergs for the period of 2002–2017). As a result, the design philosophy needs to be revised. The proposed risk-based approach provides a robust design criterion for offshore structures.
The benefits of reading for pleasure
Authors: du Sautoy Timothy
Published: February 2021

What are you reading for pleasure at the moment? Many of us may confess to not having the time or inclination to read for pleasure. Indeed, we have enough to read in the form of journals, textbooks and clinical documents in our day-to-day work, as well as in our continuing professional development. So you are not alone if you struggle to answer this question. This article aims to demonstrate that the benefits of reading for pleasure may be more far reaching, more applicable to general practice, and more applicable to our patients, than you might expect.
Network Pharmacology Integrated Molecular Docking Reveals the Anti-COVID-19 Mechanism of Yinma Jiedu Granules
Authors: Yuan ZiXin , Zeng Can , Yu Bing , Zhang Ying , Wang TianShun , Wu XingPan , Yang Yan-fang , Wu He-zhen
Published: February 2021

To investigate the mechanism of action of components of Yinma Jiedu granules in the treatment of coronavirus disease 2019 (COVID-19) using network pharmacology and molecular docking. The main chemical components of Yinma Jiedu granules were collected in the literature and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database. Using the SwissTargetPrediction database, the targets of the active component were identified and further correlated to the targets of COVID-19 through the GeneCards database. The overlapping targets of Yinma Jiedu granules components and COVID-19 were identified as the research target. Using the Database for Annotation, Visualization and Integrated Discovery database to carry out the target gene function Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway annotation and Cytoscape 3.6.1 software was used to construct a “component-target-pathway” network. The protein-protein interaction network was built using Search Tool for the Retrieval of Interacting Genes/Proteins database. Using Discovery Studio 2016 Client software to study the virtual docking of key protein and active components. One hundred active components were screened from the Yinma Jiedu Granules that involved 67 targets, including mitogen-activated protein kinase 3 (MAPK3), epidermal growth factor receptor, tumor necrosis factor, tumor protein 53, and MAPK1. These targets affected 109 signaling pathways including hypoxia-inducible factor-1, apoptosis, and Toll-like receptor signaling pathways. Molecular docking results showed that the screened active components have a strong binding ability to the key targets. In this study, through network pharmacology and molecular docking, we justified the multicomponent, multitarget, and multipathways of Yinma Jiedu Granules in the treatment of COVID-19.
Epidemiology of Patients with Dance-Related Injuries Presenting to Emergency Departments in the United States, 2014-2018
Authors: Honrado Joshua , Bay R. Curt , Lam Kenneth C.
Published: February 2021

Background:

Updated rates and patterns associated with patients with dance-related injuries reporting to US emergency departments (EDs) is needed.

Hypothesis:

Between the years 2014 and 2018, there will be an observed rise of patients with dance-related injuries seen within US EDs.

Study Design:

Retrospective analysis.

Level of Evidence:

Level 4.

Methods:

Utilizing the National Electronic Injury Surveillance System (NEISS) database, data were abstracted for all structured dance-related injuries for all people who presented to a NEISS participating hospital from January 1, 2014, to December 31, 2018. Data were abstracted on age, sex, race, disposition, location on the body where the injury happened, and free text box regarding the mechanism and nature of the injury. Each patient case was associated with a weight to provide national incidence rate (per 100,000) estimates. Descriptive statistics were used to summarize counts, percentages, and rates across patient cases.

Results:

Between years 2014 and 2018, 4152 patients reported to the NEISS EDs with a dance-related injury. Most injuries occurred in female patients (83.3%; n = 3459) and among those who were 10 to 18 years old (76.2%; n = 3164). The most common injuries were ankle sprain/strain (12.7%; n = 527) and knee sprain/strain (10.4%; n = 431). Almost all patients were treated and released (97.1%; n = 4033). These data yielded population-weighted estimates of 125,618 injuries for the study period, with an increasing trend over time (19.2% increase over 5 years). Incidence rates were over 4 times higher for female (12.4) than for male patients (3.0) and highest in the 10- to 18-year-old age group (incidence rate = 46.4).

Conclusion:

Patients with dance-related injuries reporting to EDs increased over a 5-year period from 2014 to 2018. The majority of dancers in the study were female patients, between the ages of 10 and 18 years, nearly half of the patients reported to the ED with a sprain/strain, and almost all patients were treated and released.

Clinical Relevance:

An increase in access to proper injury prevention medical services and education should be provided to female dancers between the ages of 10 and 18 years.

Strength of Recommendation Taxonomy:

B.
How to select patients requiring coronary revascularisation using coronary physiology
Authors: Modi Bhavik , Perera Divaka
Published: February 2021

The coronary angiogram is an indicator of flow limiting coronary artery disease but coronary physiology at the time of angiography is vital in assessing the true functional significance of coronary artery disease. With advances in guidewire technology and the greater use of physiology within the catheter laboratory, there is now a slow evolution of physiological indices in being able to reliably assess the functional significance of individual lesions and also the adequacy of revascularization in a growing range of clinical scenarios. As co-registration of physiology with the angiogram and intravascular imaging will become easier, we will find ourselves increasingly in an era of ‘Precision PCI’.
The Impact of Monetary Policy Shocks on Corporate Dynamic Investment Activity With Financial Heterogeneity
Authors: Aktar Mahbuba , Abedin Mohammad Zoynul , Gupta Anupam Das
Published: February 2021

This article assesses the differential reactions of firms’ investment to monetary policy shocks based on various financial heterogeneity measures, such as leverage and cash holdings. It applies U.S. public firms’ panel data from the sample period 1990Q1 to 2007Q4 and high-frequency event-study approach. Low-leverage and high cash holding firms react more to monetary policy shocks explaining the different investment activities. For the high-leverage and low cash holding firms, the two monetary policy shock variable interactions are statistically insignificant. However, they are statistically significant for the low-leverage and high cash holding firms. During a contractionary monetary policy period, higher cash holding firms improve investment efficiency. This article strengthens the literature of corporate investment behavior which can assist advance and optimize macrocontrol policies.
The Effect of Teachers’ Union Contracts on School District Efficiency: Longitudinal Evidence From California
Authors: Marianno Bradley D. , Bruno Paul , Strunk Kathrine O.
Published: February 2021

While the effect of teachers’ unions on school districts continues to be debated, the research literature provides few definitive conclusions to guide these discussions. In this article, we examine the relationship between teachers’ union contracts and school district efficiency. We define efficiency as the ratio of short-run productivity (student performance on standardized exams) to expenditures. We estimate a series of school district fixed effect models using measures of district collective bargaining agreement (CBA) restrictiveness tied to longitudinal outcomes. We find that CBA restrictiveness is positively associated with expenditures on students, instruction, instruction support services, and teacher and administrator salaries over time. We find no significant relationship between CBA restrictiveness and student achievement. Finally, we find a negative relationship between CBA restrictiveness and district efficiency. Given the small magnitude of our effect sizes, we conclude that weakening union rights may not produce large gains in efficiency and may come at substantial political costs.
Effects of a Public Awareness Campaign on Time to and Way of Hospital Admission After Stroke
Authors: Heuschmann Peter U. , Zweynert Sarah , Sobesky Jan , Nolte Christian H. , Audebert Heinrich J. , Hantke Christiane , Koennecke Hans-Christian , Kalic Marianne , Berger Klaus , Endres Matthias
Published: February 2021

Public education campaigns are recommended to increase awareness for stroke. The effect of a public advertising and education campaign in an urban region in Germany was assessed and compared with a control region. We hypothesized that such a campaign would increase the number of patients being admitted by emergency medical services (EMS). A multimedia campaign and targeted education of health care professionals and the public was employed in Berlin during six consecutive months to disseminate knowledge about stroke symptoms and appropriate actions to take. Data on time to hospital admission and details on transport were retrieved from registries for the episode before, during, and after the campaign. To test the effect of the campaign, it was compared with another urban region in Germany (Ruhr-Area), where no campaign had been conducted. Between January 2010 and February 2011, 9,166 patients with stroke or transient ischemic attack (TIA) were documented in Berlin and 9,994 in the Ruhr-Area. In both regions, following the campaign period, patients were more often admitted to hospital within the first 2 hr after onset (Berlin: odds ratio [OR] = 1.16, 95% confidence interval [CI] = [1.02, 1.32]; Ruhr-Area: OR = 1.18, 95% CI = [1.05, 1.34]). Patients were more likely being admitted via EMS after the campaign (Berlin: OR = 1.71, 95% CI = [1.50, 1.94]; Ruhr-Area: OR = 1.34, 95% CI = [1.17, 1.53]). The results suggest that an increased uptake of EMS triggered shorter time to hospital admission. A reduction in delay to hospitalization and an increased uptake of EMS were observed over the study period for both regions. No effect of the campaign was identified.
Working Capital Management and SMEs Profitability in Emerging Economies: The Ghanaian Case
Authors: Braimah Abudu , Mu Yinping , Quaye Isaac , Ibrahim Alhassan Abubakar
Published: February 2021

This study empirically examines the impact of working capital management (WCM) on the profitability of Small and Medium Scale Enterprises (SMEs) in the context of a developing economy, Ghana. We analyzed data on 366 SMEs over a 10-year period, spanning 2007 to 2016. Generalized method of moment (GMM) estimation was employed. The results reveal a positive relationship between trade payable period and profitability. The inventory conversion period and cash conversion cycle show a negative association with profitability. The results show an inverted U-shaped relationship between trade receivables collection period and corporate profitability, an indication of an optimal trade receivables collection period that maximizes profitability. Further check suggests a deviation from the optimal trade receivables collection period significantly and negatively affects corporate profitability. The study reveals the need for firms to ensure efficient management of working capital to maximize profitability.
Components of Emotion Regulation Flexibility: Linking Latent Profiles to Depressive and Anxious Symptoms
Authors: Chen Shuquan , Bonanno George A.
Published: February 2021

Emotion regulation flexibility has been conceptualized as a multicomponent construct that consists of context sensitivity, repertoire, and feedback responsiveness. Although individuals with greater abilities in each component show better psychological adjustment, the patterns of these components remain unknown. In two cross-sectional MTurk studies ( Ns = 200 and 802), we identified four or five predominant latent profiles: high-flexibility regulators (HFR), medium-flexibility regulators (MFR), context-insensitive regulators (CIR), feedback-irresponsive regulators (FIR), and low-repertoire regulators (LRR; Study 2 only). Inflexible regulators (CIR, FIR, and LRR) exhibited greater depressive and anxious symptoms than MFR and then HFR. Although inflexible regulators did not differ from each other on depressive symptoms, CIR showed more anxious symptoms than FIR and LRR. These findings support the importance of all three flexibility components with a highlight on context sensitivity and, moreover, suggest one potential way in which future studies can integrate various flexibility components.
Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review
Authors: Scheyerer Max J. , Spiegl Ulrich J. A. , Grueninger Sebastian , Hartmann Frank , Katscher Sebastian , Osterhoff Georg , Perl Mario , Pumberger Matthias , Schmeiser Gregor , Ullrich Bernhard W. , Schnake Klaus J.
Published: February 2021

Study Design:

Systematic review.

Objectives:

Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure.

Methods:

We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm.

Results:

After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated.

Conclusion:

In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.
Urban Neoliberal Debt Peonage: Prisoner Reentry, Work, and the New Jim Crow
Authors: Prior Francis B.
Published: February 2021

In this study, I analyze the experiences of people leaving prison and jail, using the concept of urban neoliberal debt peonage. I define urban neoliberal debt peonage as the push of race-class subjugated (RCS) formerly incarcerated people into the low-wage labor market. I argue that urban neoliberal debt peonage is a social process of economic extraction from and racial control of RCS groups structured by state bureaucracies and corporate employers. I provide evidence for this argument using participant observation and interview methods in a large northeastern U.S. city at an employment-oriented prisoner reentry organization that I call “Afterward.” People came to Afterward seeking employment, but were forwarded to work that was often unstable and unable to support subsistence living. Unstable low-wage work did not alter people’s social and economic situations enough to preclude them from engaging in income-producing criminal activity that comes with the risk of reincarceration. Meanwhile, the criminal justice system extracted money from the formerly incarcerated via debt collection, and corporate employers benefited from neoliberal policies that give them tax breaks for hiring Afterward clients. While not identical, the social process of urban neoliberal debt peonage echoes that of post–Civil War debt peonage and convict leasing.
Examining the Educational and Employment Outcomes of Reverse Credit Transfer
Authors: S. Giani Matt , Taylor Jason L. , Kauppila Sheena
Published: February 2021

Reverse credit transfer (RCT) is an emerging policy designed to award associate’s degrees to students who transfer from 2-year to 4-year colleges after transfer. The purpose of this study is to estimate the impact of RCT degree receipt on students’ university and labor outcomes using data from Texas, where the legislature passed RCT policy in 2011. We find that posttransfer associate’s degree recipients are significantly more likely to persist and attain in universities compared to their peers who were eligible for RCT but did not receive the degree, and these benefits are often larger for students from populations historically marginalized from higher education. However, these estimates are suggestive given the potential of self-selection biasing the estimates upward, and the results are sensitive to moderate bias from unobserved variables. We find limited evidence of additional benefit of these associate’s degrees, which are largely academic and transfer-oriented degrees, on labor outcomes.
Family Perceptions of a Cooking and Nutrition Program for Low-Income Children and Adolescents
Authors: Saxe-Custack Amy , Goldsworthy Mallory , Lofton Heather Claire , Hanna-Attisha Mona , Nweke Onyinye
Published: February 2021

Background. Flint Kids Cook, a nutrition and culinary program for children and adolescents, was created in October 2017 to address health concerns among youth and families in a low-income, urban community. In this study, researchers examined family experiences with the 6-week, chef-led program, which was taught in a farmers’ market kitchen. Methods. At the conclusion of each session, researchers used an open-ended focus group format to assess program experiences, perceived impact on youth self-efficacy for cooking and healthy eating, and caregiver support. This qualitative study was guided by thematic analysis. Results. Between November 2017 and December 2018, 72 caregivers (n = 38) and students (n = 34) participated in separate focus groups. Caregivers were primarily female (74%) and African American (71%). Most students were African American (76%) and half were female. Recurrent themes included food acceptance, dietary modifications, confidence in the kitchen, and program design. Caregivers and students agreed that location and design of the program alongside facilitation by an experienced chef were important factors for program success. Conclusions. This study demonstrated that a chef-led healthy cooking program for youth was effective in improving perceived food acceptance, dietary habits, and confidence in the kitchen. The program could be modeled in similar communities to address diet and health of children and adolescents.
Antenatal Steroid Utilization in Ethiopia
Authors: Metaferia Gesit , Abayneh Mahlet , Aynalem Sara , Demisse Abayneh G. , Demtse Asrat G. , Eshetu Beza , Mekasha Amha , Worku Bogale , Nigussie Assaye K. , McClure Elizabeth M. , Goldenberg Robert L. , Muhe Lulu M.
Published: February 2021

Background. Administration of antenatal corticosteroids to pregnant mothers is one of the most effective interventions to decrease preterm neonatal mortality. In this study we assessed antenatal steroid utilization by the mother and its effect on preterm babies. Method. Two years prospective, multicenter, observational study was conducted in selected hospitals of Ethiopia. Significance of the study outcomes was tested by chi-square and binary logistic regression. Result. Out of 4919 participants, 1575 preterm babies whose gestational ages were below 35 weeks were included in the study. Use of antenatal dexamethasone was 37.5% among study participants. The risk of early onset neonatal sepsis 235 (40.4%) was higher in preterm babies whose mother took antenatal dexamethasone ( P-value .002) than those who did not. Conclusion. Antenatal dexamethasone use in our study was comparable with other low and middle-income countries. Risk of early onset neonatal sepsis was higher among infants whose mother took antenatal dexamethasone.
Emergency Department Presentations by Children in Remote Australia: A Population-based Study
Authors: Dossetor Philippa Jane , Fitzpatrick Emily F. M. , Glass Kathryn , Douglas Kirsty , Watkins Rochelle , Oscar June , Carter Maureen , Harley David , Jeffery Heather E. , Elliott Elizabeth Jane , Martiniuk Alexandra L. C.
Published: February 2021

Background. Aboriginal leaders invited us to examine the frequency and reasons for emergency department (ED) presentations by children in remote Western Australia, where Prenatal Alcohol Exposure (PAE) is common. Methods. ED presentations (2007-11 inclusive) were examined for all children born in the Fitzroy Valley in 2002-03. Results. ED data for 127/134 (94.7%) children (95% Aboriginal) showed 1058 presentations over 5-years. Most (81%) had at least 1 presentation (median 9.0, range 1-50). Common presentations included: screening/follow-up/social reasons (16.0%), injury (15.1%), diseases of the ear (14.9%), skin (13.8%), respiratory tract (13.4%), and infectious and parasitic diseases (9.8%). PAE and higher presentations rates were associated. Commonly associated socio-economic factors were household over-crowding, financial and food insecurity. Conclusion. Children in very remote Fitzroy Crossing communities have high rates of preventable ED presentations, especially those with PAE. Support for culturally appropriate preventative programs and improved access to primary health services need to be provided in remote Australia.
Do Video Games Predict an Early Advanced Capacity to Learn Interventional Radiology Skills?
Authors: Busch Caleb , Fehr Austin , Rohr Aaron , Custe Brandon , Collins Zachary
Published: February 2021

Purpose:

To elucidate the relationship between video game (VG) play and interventional radiology (IR) technical skills in medical students.

Materials and Methods:

Twenty medical students recruited at our institution’s IR symposium completed a survey to ascertain demographics and prior VG experience, then participated in a 3-part trial of skills assessing IR and VG skill and visuospatial aptitude (VSA). IR skill was evaluated via an endovascular simulation task, VG skill by performance on three separate VGs, and VSA using the Cube Comparison test. Regression analysis was tested the strength of relationship between IR skill and VG experience, VG skill, and VSA, respectively, and participants were stratified by IR skill to top and bottom halves for survey-response comparison.

Results:

There was no correlation between either VG skill or visuospatial aptitude and IR skill (r = −0.22, p = 0.35; and r = 0.14, p = 0.57). Greater number of years playing VGs correlated with superior IR skill (Spearman’s rho=-0.45, p<0.05). Students who selected IR as their specialty of interest had extensive VG experience, playing for > 15 years (n = 4, 80%), at least 10 hours per week at their peak (n = 3, 60%), and reported being either “skilled” or “highly skilled” at VGs (n = 3, 60%).

Conclusions:

In our study, though limited by power, number of years playing VGs correlated positively with IR skills in medical students. Prior VG experience may predict an early advanced capacity to learn IR skills and an interest in the specialty.
Cerebrovascular disease in patients with cognitive impairment: A white paper from the ESO dementia committee – A practical point of view with suggestions for the management of cerebrovascular diseases in memory clinics
Authors: Verdelho Ana , Biessels Geert Jan , Chabriat Hugues , Charidimou Andreas , Duering Marco , Godefroy Olivier , Pantoni Leonardo , Pavlovic Aleksandra , Wardlaw Joanna
Published: February 2021

Purpose

Practical suggestions on clinical decisions about vascular disease management in patients with cognitive impairment are proposed.

Methods

The document was produced by the Dementia Committee of the European Stroke Organisation (ESO) based on the evidence from the literature where available and on the clinical experience of the Committee members. This paper was endorsed by the ESO.

Findings

Vascular risk factors and cerebrovascular disease are frequent in patients with cognitive impairment. While acute stroke treatment has evolved substantially in last decades, evidence of management of cerebrovascular pathology beyond stroke in patients with cognitive impairment and dementia is quite limited. Additionally, trials to test some daily-life clinical decisions are likely to be complex, difficult to undertake and take many years to provide sufficient evidence to produce recommendations. This document was conceived to provide some suggestions until data from field trials are available. It was conceived for the use of clinicians from memory clinics or involved specifically in cognitive disorders, addressing practical aspects on diagnostic tools, vascular risk management and suggestions on some therapeutic options.

Discussion and conclusions

The authors did not aim to do an exhaustive or systematic review or to cover all current evidence. The document approach in a very practical way frequent issues concerning cerebrovascular disease in patients with known cognitive impairment.
Public transport availability inequalities and transport poverty risk across England
Authors: Sun Yeran , Thakuriah Piyushimita (Vonu)
Published: February 2021

The general transit feed specification is becoming a popular data format for the publication of public transport schedules, making possible the collection of a nation-wide public transport schedule dataset, which enables monitoring of transit supply at an up-to-date and more precise level across a country than previously possible. In this paper, we use general transit feed specification data to measure local-scale public transport availability across England based on service frequency and spatial proximity to public transport stops/stations. Moreover, to demonstrate the usefulness of public transport availability measures, we examine inequalities of public transport provision and identify areas at risk of transport poverty across England. Furthermore, we estimate population (number of households) who are likely to suffer from transport poverty, accounting for public transport availability, time-based job accessibility by public transport or walking, household income and car ownership levels. Based on the criteria, we have used to identify public transport risk, we find that investment in the development of public transport services should prioritise West Midlands, East of England, South East and South West as those regions have more households who are likely to suffer from transport poverty. This paper contributes by (1) defining more comprehensive transit availability measures than existing measures at a variety of geography levels and (2) integrating fours aspects (i.e. public transport availability, job accessibility by public transport or walking, household income and car availability) to analyse transport poverty comprehensively.
COVID-19 and hematopoietic stem cell transplantation and immune effector cell therapy: a US cancer center experience
Authors: Maurer Katie , Saucier Anna , Kim Haesook T. , Acharya Utkarsh , Mo Clifton C. , Porter Julie , Albert Cindy , Cutler Corey , Antin Joseph H. , Koreth John , Gooptu Mahasweta , Romee Rizwan , Wu Catherine J. , Soiffer Robert J. , Nikiforow Sarah , Jacobson Caron , Ho Vincent T.
Published: February 2021

The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), identified in late 2019 as the causative agent of COVID-19, was declared a pandemic by the World Health Organization on 11 March 2020. Widespread community transmission in the United States triggered a nationwide shutdown, raising major challenges for administration of hematopoietic stem cell transplant (HSCT) and chimeric antigen receptor (CAR)-T cell therapies, leading many centers to delay or cancel operations. We sought to assess the impact of the COVID-19 pandemic on operations and clinical outcomes for HSCT and CAR-T cellular therapies at the Dana-Farber Cancer Institute by reviewing administration and outcomes in 127 cell therapy patients treated during the initial COVID-19 surge: 62 adult allogeneic HSCT (allo-HSCT), 38 autologous HSCT (auto-HSCT), and 27 CAR-T patients. Outcomes were compared with 66 allo-HSCT, 43 auto-HSCT, and 33 CAR-T patients treated prior to the pandemic. A second control cohort was evaluated for HSCT groups to reflect seasonal variation in infections. Although there were changes in donor selection and screening as well as cryopreservation patterns of donor products, no differences were observed across groups in 100-day overall survival, progression-free survival, rates of non–COVID-19 infections, including hospital length of stay, neutrophil engraftment, graft failure, acute graft-versus-host disease in allo-HSCT patients, or cytokine release syndrome and neurotoxicity in CAR-T patients. No HSCT patients contracted COVID-19 between days 0 and 100. One CAR-T patient contracted COVID-19 at day +51 and died of the disease. Altogether, our data indicate that cellular therapies can be safely administered throughout the ongoing COVID-19 pandemic with appropriate safeguards.
Phenomic profiling of a novel sibling species within the Scedosporium complex in Thailand
Authors: Kitisin T. , Ampawong S. , Muangkaew W. , Sukphopetch P.
Published: February 2021

Background

Scedosporium species are a group of pathogenic fungi, which can be found worldwide around high human-impacted areas. Infections of Scedosporium have been reported in several immunocompromised and immunocompetent patients with a high mortality rate. Recently, we have isolated and identified several Scedosporium strains during an environmental survey in Thailand.

Results

We describe the isolate, TMMI-012, possibly a new species isolated from soils in the Chatuchak public park, Bangkok, Thailand. TMMI-012 is phylogenetically related to the Scedosporium genus and is a sibling to S. boydii but shows distinct morphological and pathological characteristics. It is fast growing and highly resistant to antifungal drugs and abiotic stresses. Pathological studies of in vitro and in vivo models confirm its high virulence and pathogenicity.

Conclusion

TMMI-012 is considered a putative novel Scedosporium species. The high antifungal resistance of TMMI-012 compared with its sibling, Scedosporium species is likely related to its clinical impact on human health.
Clinical characteristics and outcomes of critically ill COVID-19 patients in Tokyo: a single-center observational study from the first wave
Authors: Banno Aya , Hifumi Toru , Okamoto Hiroshi , Masaki Minori , Seki Koichiro , Isokawa Shutaro , Otani Norio , Hayashi Kuniyoshi , Ishimatsu Shinichi
Published: February 2021

Background

Many studies have been published about critically ill coronavirus disease 2019 (COVID-19) during the early phases of the pandemic but the characteristic or survival of critically ill Japanese patients have not yet been investigated. We sought to investigate the characteristics, inflammatory laboratory finding trends, and outcomes among critically ill Japanese patients who were admitted to the intensive care unit (ICU) with the first wave of COVID-19.

Methods

A retrospective observational study was performed in a single institution in the center of Tokyo. Laboratory-confirmed COVID-19 patients admitted to the ICU from March 19 to April 30, 2020 were included. Trends for significant inflammatory laboratory findings were analyzed. In-hospital death, days of mechanical ventilation or oxygen supplementation, days of ICU or hospital stay were followed until May 26, 2020.

Results

Twenty-four patients were included. Median age was 57.5 years, and 79% were male. The neutrophil-to-lymphocyte ratio was elevated to a median of 10.1 on admission and peaked on Day 10 of illness. Seventeen patients were intubated on Day 11 of illness and received mechanical ventilation. One patient underwent extracorporeal membrane oxygenation. The majority (88%) received systemic steroids, including 16 patients who received high dose methylprednisolone (500–1000 mg). Favipiravir was used in 38% of patients. Two patients, including 1 who refused intensive care, died. Eighteen patients were discharged. Median length of ICU and hospital stay for all patients was 6 and 22 days, respectively. Median length of ventilator dependency was 7 days. Four patients underwent a tracheostomy and received prolonged ventilation for more than 21 days. One patient receiving mechanical ventilation died. All survivors discontinued ventilator use.

Conclusions

Mortality was remarkably low in our single institutional study. Three survivors received mechanical ventilation for more than 3 weeks. Trends of clinically significant laboratory markers reflected the clinical course of COVID-19.
Role of nicergoline in corneal wound healing in diabetic rats
Authors: Portela Amanda Lemos Barros Martins , Moreno Rafael Neves , Ribeiro Maria Helena Madruga Lima , de Andrade Fernanda Miguel , Alves Yale Viana , Alves Mônica , Lira Rodrigo Pessoa Cavalcanti
Published: February 2021

Background

To investigate the effect of nicergoline on the rate of complete corneal ulcer reepithelialization (CCUR) in diabetic rats with diabetic keratopathy.

Methods

Forty-eight streptozotocin-induced diabetic rats were randomly divided into two groups. The experimental group (n = 24) received nicergoline (10 mg.kg− 1.day− 1), while the control group (n = 24) received a placebo. A corneal epithelial defect was induced using a corneal diamond burr, and defect area was compared at time points of 0, 12, 24, 48 and 72 h after the injury using image analysis software. The probability of CCUR within 72 h was assessed using the Kaplan–Meier survival analysis log-rank test.

Results

When compared, 4 of the 24 rats (17%) in the placebo group and 12 of the 24 rats (50%) in the nicergoline group were found to have CCUR within 72 h (log-rank = 0.027). Cox regression analysis found no effect of the covariates blood glucose (P = 0.601) or weight (P = 0.322) on the corneal reepithelialization (survival) curve.

Conclusions

Nicergoline increased wound healing rates relative to placebo and may therefore be investigated as a treatment option in diabetic keratopathy.