bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with delays in revascularization in patients with chronic limb-threatening ischaemia: population-based cohort study
Authors: Birmpili P , Johal A , Li Q , Waton S , Chetter I , Boyle J R , Cromwell D
Published: January 2021

Background

Prompt revascularization in patients with chronic limb-threatening ischaemia (CLTI) is important, and recent guidance has suggested that patients should undergo revascularization within 5 days of an emergency admission to hospital. The aim of this cohort study was to identify factors associated with the ability of UK vascular services to meet this standard of care.

Methods

Data on all patients admitted non-electively with CLTI who underwent open or endovascular revascularization between 2016 and 2019 were extracted from the National Vascular Registry. The primary outcome was interval between admission and procedure, analysed as a binary variable (5 days or less, over 5 days). Multivariable Poisson regression was used to examine the relationship between time to revascularization and patient and admission characteristics.

Results

The study analysed information on 11 398 patients (5973 open, 5425 endovascular), 50.6 per of whom underwent revascularization within 5 days. The median interval between admission and intervention was 5 (i.q.r. 2–9) days. Patient factors associated with increased risk of delayed revascularization were older age, greater burden of co-morbidity, non-smoking status, presentation with infection and tissue loss, and a Fontaine score of IV. Patients admitted later in the week were less likely undergo revascularization within 5 days than those admitted on Sundays and Mondays (P < 0.001). Delays were slightly worse among patients having open compared with endovascular procedures (P = 0.005) and in hospitals with lower procedure volumes (P < 0.001).

Conclusion

Several factors were associated with delays in time to revascularization for patients with CLTI in the UK, most notably the weekday of admission, which reflects how services are organized. The results support arguments for vascular units providing revascularization to have the resources for a 7-day service.
Skipping the Dry Diagonal: spatio-temporal evolution ofCrotonsectionCleodora(Euphorbiaceae) in the Neotropics
Authors: Masa-Iranzo Irene , Sanmartín Isabel , Caruzo Maria Beatriz R , Riina Ricarda
Published: January 2021

Croton is one of the largest angiosperm genera, with > 1200 species in the tropics worldwide. The arborescent Croton section Cleodora stands out for its disjunct geographical distribution with two main centres of diversity in the Amazonian and Atlantic Forest regions, separated by the Caatinga, Cerrado and Chaco biomes (the ‘Dry Diagonal’). This disjunction is found in other Neotropical lineages and attributed to Neogene geological and climatic events. We inferred a nearly complete phylogenetic reconstruction of Croton section Cleodora based on DNA sequences of nuclear ITS and five plastid regions (rps16, trnH-psbA, trnL-F, trnT-L and ycf1). We further estimated divergence times and reconstructed ancestral ranges using Bayesian methods. Our results show that Croton section Cleodora is monophyletic with two main clades; we also confirm the phylogenetic adscription of eight Croton spp. recently described or assigned to section Cleodora based on morphology. Divergence of section Cleodora from its sister clade occurred c. 25 Mya, and diversification within this group started 20 Mya. Biogeographic analyses suggest the section originated in the Amazonian region, from where it dispersed to other forested Neotropical regions, including the Atlantic Forest. Divergence between Amazonian and Atlantic Forest taxa appears to have been triggered by the formation of the South American Dry Diagonal.
Longitudinal deterioration of white-matter integrity: heterogeneity in the ageing population
Authors: Poulakis Konstantinos , Reid Robert I , Przybelski Scott A , Knopman David S , Graff-Radford Jonathan , Lowe Val J , Mielke Michelle M , Machulda Mary M , Jack Clifford R , Petersen Ronald C , Westman Eric , Vemuri Prashanthi
Published: January 2021

Deterioration in white-matter health plays a role in cognitive ageing. Our goal was to discern heterogeneity of white-matter tract vulnerability in ageing using longitudinal imaging data (two to five imaging and cognitive assessments per participant) from a population-based sample of 553 elderly participants (age ≥60 years). We found that different clusters (healthy white matter, fast white-matter decliners and intermediate white-matter group) were heterogeneous in the spatial distribution of white-matter integrity, systemic health and cognitive trajectories. White-matter health of specific tracts (genu of corpus callosum, posterior corona radiata and anterior internal capsule) informed about cluster assignments. Not surprisingly, brain amyloidosis was not significantly different between clusters. Clusters had differential white-matter tract vulnerability to ageing (commissural fibres > association/brainstem fibres). Identification of vulnerable white-matter tracts is a valuable approach to assessing risk for cognitive decline.
Hepatic Steatosis Associated With Exposure to Elvitegravir and Raltegravir
Authors: Kirkegaard-Klitbo Ditte Marie , Thomsen Magda Teresa , Gelpi Marco , Bendtsen Flemming , Nielsen Susanne Dam , Benfield Thomas
Published: January 2021

Moderate-to-severe hepatic steatosis in people living with human immunodeficiency virus (HIV) without viral hepatitis or excessive alcohol intake was associated with cumulative exposure to stavudine, elvitegravir, and raltegravir. Prospective trials are required to establish a causal association.

Clinical Trials Registration. NCT02382822.
Evaluation of Vaccine Safety After the First Public Sector Introduction of Typhoid Conjugate Vaccine—Navi Mumbai, India, 2018
Authors: Longley Ashley T , Date Kashmira , Luby Stephen P , Bhatnagar Pankaj , Bentsi-Enchill Adwoa D , Goyal Vineet , Shimpi Rahul , Katkar Arun , Yewale Vijay , Jayaprasad Niniya , Horng Lily , Kunwar Abhishek , Harvey Pauline , Haldar Pradeep , Dutta Shanta , Gidudu Jane F
Published: January 2021

Background

In December 2017, the World Health Organization (WHO) prequalified the first typhoid conjugate vaccine (TCV; Typbar-TCV). While no safety concerns were identified in pre- and postlicensure studies, WHO’s Global Advisory Committee on Vaccine Safety recommended robust safety evaluation with large-scale TCV introductions. During July–August 2018, the Navi Mumbai Municipal Corporation (NMMC) launched the world’s first public sector TCV introduction. Per administrative reports, 113 420 children 9 months–14 years old received TCV.

Methods

We evaluated adverse events following immunization (AEFIs) using passive and active surveillance via (1) reports from the passive NMMC AEFI surveillance system, (2) telephone interviews with 5% of caregivers of vaccine recipients 48 hours and 7 days postvaccination, and (3) chart abstraction for adverse events of special interest (AESIs) among patients admitted to 5 hospitals using the Brighton Collaboration criteria followed by ascertainment of vaccination status.

Results

We identified 222/113 420 (0.2%) vaccine recipients with AEFIs through the NMMC AEFI surveillance system: 211 (0.19%) experienced minor AEFIs, 2 (0.002%) severe, and 9 serious (0.008%). At 48 hours postvaccination, 1852/5605 (33%) caregivers reported ≥1 AEFI, including injection site pain (n = 1452, 26%), swelling (n = 419, 7.5%), and fever (n = 416, 7.4%). Of the 4728 interviews completed at 7 days postvaccination, the most reported AEFIs included fever (n = 200, 4%), pain (n = 52, 1%), and headache (n = 42, 1%). Among 525 hospitalized children diagnosed with an AESI, 60 were vaccinated; no AESIs were causally associated with TCV.

Conclusions

No unexpected safety signals were identified with TCV introduction. This provides further reassurance for the large-scale use of Typbar-TCV among children 9 months–14 years old.
Digging Into the Channels of Bunching: Evidence from the Uruguayan Income Tax
Authors: Bergolo Marcelo , Burdin Gabriel , De Rosa Mauricio , Giaccobasso Matias , Leites Martin
Published: January 2021

Based on detailed administrative tax records, we implement a bunching design to explore how individual taxpayers respond to personal income taxation in Uruguay. We estimate a very modest elasticity of taxable income at the first kink point (0.06) driven by a combination of gross labour income and deduction responses. Taxpayers use personal deductions more intensively close to the kink point and underreport income to the tax authority. Our results suggest that the efficiency costs of taxation are not necessarily large in contexts characterised by limited deduction opportunities. Policy efforts should be directed at broadening the tax base and improving enforcement capacity.
Summary: international consensus statement on nomenclature and classification of the congenital bicuspid aortic valve and its aortopathy, for clinical, surgical, interventional and research purposes
Authors: Michelena Hector I , Della Corte Alessandro , Evangelista Arturo , Maleszewski Joseph J , Edwards William D , Roman Mary J , Devereux Richard B , Fernández Borja , Asch Federico M , Barker Alex J , Sierra-Galan Lilia M , De Kerchove Laurent , Fernandes Susan M , Fedak Paul W M , Girdauskas Evaldas , Delgado Victoria , Abbara Suhny , Lansac Emmanuel , Prakash Siddharth K , Bissell Malenka M , Popescu Bogdan A , Hope Michael D , Sitges Marta , Thourani Vinod H , Pibarot Phillippe , Chandrasekaran Krishnaswamy , Lancellotti Patrizio , Borger Michael A , Forrest John K , Webb John , Milewicz Dianna M , Makkar Raj , Leon Martin B , Sanders Stephen P , Markl Michael , Ferrari Victor A , Roberts William C , Song Jae-Kwan , Blanke Philipp , White Charles S , Siu Samuel , Svensson Lars G , Braverman Alan C , Bavaria Joseph , Sundt Thoralf M , Khoury Gebrine El , De Paulis Ruggero , Enriquez-Sarano Maurice , Bax Jeroen J , Otto Catherine M , Schäfers Hans-Joachim
Published: January 2021

This International evidence-based nomenclature and classification consensus on the congenital bicuspid aortic valve and its aortopathy recognizes 3 types of bicuspid aortic valve: 1. Fused type, with 3 phenotypes: right-left cusp fusion, right-non cusp fusion and left-non cusp fusion; 2. 2-sinus type with 2 phenotypes: Latero-lateral and antero-posterior; and 3. Partial-fusion or forme fruste. This consensus recognizes 3 bicuspid-aortopathy types: 1. Ascending phenotype; root phenotype; and 3. extended phenotypes.
Validation of risk scores for ischaemic stroke in atrial fibrillation across the spectrum of kidney function
Authors: de Jong Ype , Fu Edouard L , van Diepen Merel , Trevisan Marco , Szummer Karolina , Dekker Friedo W , Carrero Juan J , Ocak Gurbey
Published: January 2021

Aims 

The increasing prevalence of ischaemic stroke (IS) can partly be explained by the likewise growing number of patients with chronic kidney disease (CKD). Risk scores have been developed to identify high-risk patients, allowing for personalized anticoagulation therapy. However, predictive performance in CKD is unclear. The aim of this study is to validate six commonly used risk scores for IS in atrial fibrillation (AF) patients across the spectrum of kidney function.

Methods and results 

Overall, 36 004 subjects with newly diagnosed AF from SCREAM (Stockholm CREAtinine Measurements), a healthcare utilization cohort of Stockholm residents, were included. Predictive performance of the AFI, CHADS2, Modified CHADS2, CHA2DS2-VASc, ATRIA, and GARFIELD-AF risk scores was evaluated across three strata of kidney function: normal kidney function [estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2], mild CKD (eGFR 30–60 mL/min/1.73 m2), and advanced CKD (eGFR <30 mL/min/1.73 m2). Predictive performance was assessed by discrimination and calibration. During 1.9 years, 3069 (8.5%) patients suffered an IS. Discrimination was dependent on eGFR: the median c-statistic in normal eGFR was 0.75 (range 0.68–0.78), but decreased to 0.68 (0.58–0.73) and 0.68 (0.55–0.74) for mild and advanced CKD, respectively. Calibration was reasonable and largely independent of eGFR. The Modified CHADS2 score showed good performance across kidney function strata, both for discrimination [c-statistic: 0.78 (95% confidence interval 0.77–0.79), 0.73 (0.71–0.74) and 0.74 (0.69–0.79), respectively] and calibration.

Conclusion 

In the most clinically relevant stages of CKD, predictive performance of the majority of risk scores was poor, increasing the risk of misclassification and thus of over- or undertreatment. The Modified CHADS2 score performed good and consistently across all kidney function strata, and should therefore be preferred for risk estimation in AF patients.
Can centre-based childcare buffer against the negative effects of family adversity on child socio-emotional wellbeing?
Authors: Parkes Alison , Green Michael , Pearce Anna
Published: January 2021

Background

Different configurations of family adversity affect children’s socio-emotional development differently; however, we lack knowledge of moderators amenable to policy intervention. This study explored whether early childhood centre-based childcare moderated the impact of family adversity configurations on socio-emotional development.

Methods

Data were from the Growing Up in Scotland first birth cohort, born 2004–05. Latent class analysis of 19 early childhood family adversity indicators identified four classes: ‘Low Risk’ (68%), ‘Poor Maternal Health’ (16.5%), ‘Economic Hardship’ (10.0%) and ‘Multiple Adversities’ (5.5%). Latent growth models of externalizing and internalizing symptom trajectories (age 46–152 months, n = 3561) by family adversity controlled for confounding. Moderation by centre-based childcare use was examined through stratification.

Results

Compared to ‘Low Risk’, high-risk classes had more externalizing and internalizing symptoms and internalizing symptoms increased at a faster rate, with ‘Multiple Adversities’ faring worst. The effects of ‘Economic Hardship’ on change in externalizing symptoms over time varied by childcare (P = 0.035): relative to the Low Risk group, symptoms increased (+0.04 points/year) among those not using childcare, and decreased (–0.09 points/year) among those who did. The effect of ‘Multiple Adversities’ on internalizing symptoms also varied (P = 0.034): +0.12 without centre-based childcare; +0.33 with centre-based childcare (patterns were similar for externalizing symptoms but with wide confidence intervals). No moderation was found by ‘Poor Maternal Health’.

Conclusions

Centre-based childcare may alleviate disadvantages in socio-emotional wellbeing for children experiencing mainly economic hardship, but may exacerbate them for those experiencing multiple adversities. A better understanding of how early years’ services can support families with complex needs is required.
Air Power, NGOs, and Collateral Killings
Authors: Allen Susan H , Bell Sam R , Martinez Machain Carla
Published: January 2021

Air strikes have become an essential tool in major powers’ military arsenals. Yet, despite the precise technology that air power represents, its use can also result in unintended killings. In this paper, we explore how air strikes affect civilian killings as collateral damage by third party interveners. In particular, we argue that this effect is conditioned by the presence of non-governmental civil society actors on the ground. We thus explore how air strikes affect civilian killings by government actors involved in conflicts and how civil society can diminish harm against civilian actors during aerial bombing campaigns. Our results suggest that air strikes may cause deaths through collateral killings. Yet, when air strikes occur in countries where human rights organizations are active, these civilian deaths may be mitigated.
Robust modeling of additive and nonadditive variation with intuitive inclusion of expert knowledge
Authors: Hem Ingeborg Gullikstad , Selle Maria Lie , Gorjanc Gregor , Fuglstad Geir-Arne , Riebler Andrea
Published: January 2021

We propose a novel Bayesian approach that robustifies genomic modeling by leveraging expert knowledge (EK) through prior distributions. The central component is the hierarchical decomposition of phenotypic variation into additive and nonadditive genetic variation, which leads to an intuitive model parameterization that can be visualized as a tree. The edges of the tree represent ratios of variances, for example broad-sense heritability, which are quantities for which EK is natural to exist. Penalized complexity priors are defined for all edges of the tree in a bottom-up procedure that respects the model structure and incorporates EK through all levels. We investigate models with different sources of variation and compare the performance of different priors implementing varying amounts of EK in the context of plant breeding. A simulation study shows that the proposed priors implementing EK improve the robustness of genomic modeling and the selection of the genetically best individuals in a breeding program. We observe this improvement in both variety selection on genetic values and parent selection on additive values; the variety selection benefited the most. In a real case study, EK increases phenotype prediction accuracy for cases in which the standard maximum likelihood approach did not find optimal estimates for the variance components. Finally, we discuss the importance of EK priors for genomic modeling and breeding, and point to future research areas of easy-to-use and parsimonious priors in genomic modeling.
Natural genetic variation inDrosophila melanogasterreveals genes associated withCoxiella burnetiiinfection
Authors: Guzman Rosa M , Howard Zachary P , Liu Ziying , Oliveira Ryan D , Massa Alisha T , Omsland Anders , White Stephen N , Goodman Alan G
Published: January 2021

The gram-negative bacterium Coxiella burnetii is the causative agent of Query (Q) fever in humans and coxiellosis in livestock. Host genetics are associated with C. burnetii pathogenesis both in humans and animals; however, it remains unknown if specific genes are associated with severity of infection. We employed the Drosophila Genetics Reference Panel to perform a genome-wide association study to identify host genetic variants that affect host survival to C. burnetii infection. The genome-wide association study identified 64 unique variants (P < 10−5) associated with 25 candidate genes. We examined the role each candidate gene contributes to host survival during C. burnetii infection using flies carrying a null mutation or RNAi knockdown of each candidate. We validated 15 of the 25 candidate genes using at least one method. This is the first report establishing involvement of many of these genes or their homologs with C. burnetii susceptibility in any system. Among the validated genes, FER and tara play roles in the JAK/STAT, JNK, and decapentaplegic/TGF-β signaling pathways which are components of known innate immune responses to C. burnetii infection. CG42673 and DIP-ε play roles in bacterial infection and synaptic signaling but have no previous association with C. burnetii pathogenesis. Furthermore, since the mammalian ortholog of CG13404 (PLGRKT) is an important regulator of macrophage function, CG13404 could play a role in host susceptibility to C. burnetii through hemocyte regulation. These insights provide a foundation for further investigation regarding the genetics of C. burnetii susceptibility across a wide variety of hosts.
New regulators ofDrosophilaeye development identified from temporal transcriptome changes
Authors: Quiquand Manon , Rimesso Gerard , Qiao Nan , Suo Shengbao , Zhao Chunyu , Slattery Matthew , White Kevin P , Han Jackie J , Baker Nicholas E
Published: January 2021

In the last larval instar, uncommitted progenitor cells in the Drosophila eye primordium start to adopt individual retinal cell fates, arrest their growth and proliferation, and initiate terminal differentiation into photoreceptor neurons and other retinal cell types. To explore the regulation of these processes, we have performed mRNA-Seq studies of the larval eye and antennal primordial at multiple developmental stages. A total of 10,893 fly genes were expressed during these stages and could be adaptively clustered into gene groups, some of whose expression increases or decreases in parallel with the cessation of proliferation and onset of differentiation. Using in situ hybridization of a sample of 98 genes to verify spatial and temporal expression patterns, we estimate that 534 genes or more are transcriptionally upregulated during retinal differentiation, and 1367 or more downregulated as progenitor cells differentiate. Each group of co-expressed genes is enriched for regulatory motifs recognized by co-expressed transcription factors, suggesting that they represent coherent transcriptional regulatory programs. Using available mutant strains, we describe novel roles for the transcription factors SoxNeuro (SoxN), H6-like homeobox (Hmx), CG10253, without children (woc), Structure specific recognition protein (Ssrp), and multisex combs (mxc).
Estimating divergence times from DNA sequences
Authors: Sjödin Per , McKenna James , Jakobsson Mattias
Published: January 2021

The patterns of genetic variation within and among individuals and populations can be used to make inferences about the evolutionary forces that generated those patterns. Numerous population genetic approaches have been developed in order to infer evolutionary history. Here, we present the “Two-Two (TT)” and the “Two-Two-outgroup (TTo)” methods; two closely related approaches for estimating divergence time based in coalescent theory. They rely on sequence data from two haploid genomes (or a single diploid individual) from each of two populations. Under a simple population-divergence model, we derive the probabilities of the possible sample configurations. These probabilities form a set of equations that can be solved to obtain estimates of the model parameters, including population split times, directly from the sequence data. This transparent and computationally efficient approach to infer population divergence time makes it possible to estimate time scaled in generations (assuming a mutation rate), and not as a compound parameter of genetic drift. Using simulations under a range of demographic scenarios, we show that the method is relatively robust to migration and that the TTo method can alleviate biases that can appear from drastic ancestral population size changes. We illustrate the utility of the approaches with some examples, including estimating split times for pairs of human populations as well as providing further evidence for the complex relationship among Neandertals and Denisovans and their ancestors.
Automated and customizable quantitative image analysis of wholeCaenorhabditis elegansgermlines
Authors: Toraason Erik , Adler Victoria L , Kurhanewicz Nicole A , DiNardo Acadia , Saunders Adam M , Cahoon Cori K , Libuda Diana E
Published: January 2021

Arranged in a spatial-temporal gradient for germ cell development, the adult germline of Caenorhabditis elegans is an excellent system for understanding the generation, differentiation, function, and maintenance of germ cells. Imaging whole C. elegans germlines along the distal-proximal axis enables powerful cytological analyses of germ cell nuclei as they progress from the pre-meiotic tip through all the stages of meiotic prophase I. To enable high-content image analysis of whole C. elegans gonads, we developed a custom algorithm and pipelines to function with image processing software that enables: (1) quantification of cytological features at single nucleus resolution from immunofluorescence images; and (2) assessment of these individual nuclei based on their position within the germline. We show the capability of our quantitative image analysis approach by analyzing multiple cytological features of meiotic nuclei in whole C. elegans germlines. First, we quantify double-strand DNA breaks (DSBs) per nucleus by analyzing DNA-associated foci of the recombinase RAD-51 at single-nucleus resolution in the context of whole germline progression. Second, we quantify the DSBs that are licensed for crossover repair by analyzing foci of MSH-5 and COSA-1 when they associate with the synaptonemal complex during meiotic prophase progression. Finally, we quantify P-granule composition across the whole germline by analyzing the colocalization of PGL-1 and ZNFX-1 foci. Our image analysis pipeline is an adaptable and useful method for researchers spanning multiple fields using the C. elegans germline as a model system.
Features of Daily Social Interactions That Discriminate Between Older Adults With and Without Mild Cognitive Impairment
Authors: Zhaoyang Ruixue , Sliwinski Martin J , Martire Lynn M , Katz Mindy J , Scott Stacey B
Published: January 2021

Objectives

Detecting subtle behavioral changes in everyday life as early signs of cognitive decline and impairment is important for effective early intervention against Alzheimer’s disease. This study examined whether features of daily social interactions captured by ecological momentary assessments could serve as more sensitive behavioral markers to distinguish older adults with mild cognitive impairment (MCI) from those without MCI, as compared to conventional global measures of social relationships.

Method

Participants were 311 community-dwelling older adults (aged 70–90 years) who reported their social interactions and socializing activities 5 times daily for 14 consecutive days using smartphones.

Results

Compared to those with normal cognitive function, older adults classified as MCI reported less frequent total and positive social interactions and less frequent in-person socializing activities on a daily basis. Older adults with and without MCI, however, did not show differences in most features of social relationships assessed by conventional global measures.

Discussion

These results suggest that certain features of daily social interactions (quality and quantity) could serve as sensitive and ecologically valid behavioral markers to facilitate the detection of MCI.
Compatibility of the Intellectual Property Regime, the Convention on Biological Diversity and the Nagoya Protocol
Authors: Roca Santiago
Published: January 2021

For nearly two decades, there has seemingly been no way to make intellectual property norms compatible with the implementation of the Convention on Biological Diversity (CBD) and the Nagoya Protocol (NP). This conflict makes these two international agreements inoperative and difficult to apply.

This study analyzes the main disagreements between the regulations of the CBD and NP on the one hand and intellectual property norms on the other. It briefly reviews the character and the dominant perspectives of both regulations and identifies concepts and interpretations that, if applied correctly, could make them compatible. To this end, the approach of this paper is to separate the problem of conservation and sustainability in biodiversity from the problem of the lack of intrinsic, potential or use value attributed to genetic resources and traditional knowledge. It also redeems the notion of patents as an instrument to reestablish fair competition and solve the market failure of unfair imitation, rather than its deployment as a strategic asset to generate extraordinary, monopolistic profits. At the same time, the article evaluates the assumed preponderance of innovation and conservation goals in comparison to other rights and public interests. The study analyzes the eleven most important connections between the rules that regulate the access to and use and distribution of benefits deriving from biodiversity and those that protect intellectual property. It concludes that most international impasses in which intellectual property is pitted against the CBD and the NP find a solution through the new approach proposed above. Finally, the article briefly provides solutions to each of the eleven issues examined.
Genocide and the ‘clean-fighting Turk’ in First World War Britain and Ireland
Authors: Steel Daniel
Published: January 2021

British and Irish attitudes towards their Turkish enemy during the First World War have rarely been explored. Unlike the German ‘Hun’, Turks were praised as ‘clean fighters’, despite overwhelming evidence of the Armenian Genocide. Using largely unexamined press material, this article attributes the ‘clean-fighting Turk’s’ longevity to the sanctity of soldier testimony, where it originated, and the preoccupation with Germany. Both Turkish chivalry, which highlighted German ‘barbarity’ by contrast, and Germano-centric interpretations of the Armenian Genocide offered hitherto unrecognized validation of the United Kingdom’s ‘just war’ in Europe. The First World War was truly global, but Germany dominated the public imagination.
Thermal conductivity estimation of nanofluids with TiO2 nanoparticles by employing artificial neural networks
Authors: Komeili Birjandi Ali , Irandoost Shahrestani Misagh , Maleki Akbar , Habibi Ali , Pourfayaz Fathollah
Published: January 2021

Applying nanofluids in energy-related technologies and thermal mediums can lead to remarkable enhancement in their efficiency and performance due to their modified thermophysical properties. Among thermophysical properties, thermal conductivity (TC) performs principal role in heat transfer ability of nanofluids. Artificial neural networks (ANNs) have shown promising performance in modeling nanofluids’ TC. In this article, two types of ANNs are used for estimating TC of nanofluids with TiO2 nanoparticles. In this regard, effective factors including particle size, temperature, volume fraction of solid particles and TC of the base fluids are applied at the input of the model. Based on the comparison between the estimated data and the corresponding actual ones, it is concluded that employing multi-layer perceptron (MLP) is superior compared with group method of data handling (GMDH). In the optimal conditions of the networks, the R-squared value of the models based on both MLP and GMDH was 0.999. Moreover, average absolute relative deviations of the mentioned models were around 0.23% and 0.32%, respectively.
A Littlewood-Type Theorem for Random Bergman Functions
Authors: Cheng Guozheng , Fang Xiang , Liu Chao
Published: January 2021

Let $f(z)=\sum _{n=0}^{\infty }a_n z^n$ be a formal power series with complex coefficients. Let $({\mathcal{R}} f)(z)= \sum _{n=0}^{\infty }\pm a_n z^n$ be the randomization of $f$ by choosing independently a random sign for each coefficient. Let $H^p({\mathbb{D}})$ and $L^p_a({\mathbb{D}})$  $(p>0)$ denote the Hardy space and the Bergman space, respectively, over the unit disk in the complex plane. In 1930, Littlewood proved that if $f \in H^2({\mathbb{D}})$, then ${\mathcal{R}} f \in H^p({\mathbb{D}})$ for any $p \in (0, \infty )$ almost surely, and if $f \notin H^2({\mathbb{D}})$, then ${\mathcal{R}} f \notin H^p({\mathbb{D}})$ for any $p \in (0, \infty )$ almost surely. In this paper, we obtain a characterization of the pairs $(p, q) \in (0, \infty )^2$ such that ${\mathcal{R}} f$ is almost surely in $L^q_a({\mathbb{D}})$ whenever $f \in L^p_a({\mathbb{D}})$, including counterexamples to show the optimality of the embedding. In contrast to Littlewood’s theorem, random Bergman functions exhibit no improvement of regularity for any $p>0$, but the loss of regularity for $p<2$ is not as drastic as the Hardy case; there is indeed a nontrivial boundary curve given by $\frac{1}{q}-\frac{2}{p}+\frac{1}{2}=0$. Several other results about random Bergman functions are established along the way. The technical difficulties, especially when $p<1$, are different from the Hardy space and we devise a different route of proof. The Dirichlet space follows as a corollary. An improvement of the original Littlewood theorem is obtained.
Balancing value and burden: the Centers for Medicare & Medicaid Services electronic Clinical Quality Measure (eCQM) Strategy Project
Authors: Schreiber Michelle , Krauss Deborah , Blake Bridget , Boone Edna , Almonte Rose
Published: January 2021

Healthcare is undergoing a digital transformation, and the Centers for Medicare & Medicaid Services (CMS) aims to help providers navigate the clinical quality improvement landscape. In December 2017, CMS launched the Electronic Clinical Quality Measure (eCQM) Strategy Project. This article consists of 2 parts. The first part describes stakeholder outreach aimed to identify burdens and recommendations related to eCQM implementation and reporting. The second part describes how these burdens were addressed by CMS and how to engage in the digital transformation journey.

Six themes emerged from the stakeholder feedback: Alignment, Value, Development Process, Implementation and Reporting Processes; EHR certification process; and Communication, Education, and Outreach. CMS and its partners addressed over 100 recommendations to improve the eCQM development, implementation, and reporting experience by creating implementation strategies. This included the development of new tools, such as the Measure Collaboration (MC) Workspace and ongoing testing of Fast Healthcare Interoperability Resources (FHIR)-based standards for quality measurement.

CMS is sharing this summary of the eCQM Strategy Project to reflect CMS’ interest in stakeholder engagement and burden reduction, increase awareness of available resources, and encourage continued engagement throughout this digital transformation in quality reporting.
Developing a Validated HPLC Method for Quantification of Ceftazidime Employing Analytical Quality by Design and Monte Carlo Simulations
Authors: Kaur Ranjot , Saini Sumant , Patel Asha , Sharma Teenu , Kaur Ripandeep , Katare O. P , Singh Bhupinder
Published: January 2021

Background

Ceftazidime, a third-generation cephalosporin, is widely used in the treatment of lung infections, often given as “off-label” nebulization. There is a need to develop a sensitive and robust analytical method to compute aerodynamic properties of ceftazidime following nebulization.

Objective

The current study entails development of a simple, accurate, and sensitive HPLC method for ceftazidime estimation, employing the principles of analytical quality-by-design (AQbD) and Monte Carlo simulations.

Method

Selection of critical material attributes (CMAs) affecting method performance was accomplished by factor screening exercises. Subsequently, the influential CMAs, i.e., mobile phase ratio and flow rate, were systemically optimized using a face-centered cubic design for the chosen critical analytical attributes (CAAs). The factor relationship(s) between CMAs and CAAs was explored employing a 3 D-response surface and 2 D-contour plots, followed by numerical as well as graphical optimization, for establishing the optimal chromatographic conditions. The obtained method operable design region was validated by Monte Carlo simulations for defect rate analysis.

Results

The optimized HPLC conditions for estimating ceftazidime were acetonitrile to acetic acid solution (75:25) as mobile phase at a flow rate of 0.7 mL/min, leading to Rt of 4.5 min and peak tailing ≤2. Validation studies, as per International Conference on Harmonization Q2(R1) guidance, demonstrated high sensitivity, accuracy, and efficiency of the developed analytical method with an LOD of 0.075 and LOQ of 0.227 µg/mL. Application of this chromatographic method was extrapolated for determining aerodynamic performance by nebulizing ceftazidime at a flow rate of 15 L/min using a next-generation impactor. The study indicated superior performance, sensitivity, and specificity of the developed analytical system for quantifying ceftazidime.

Conclusions

Application of an AQbD approach, coupled with Monte Carlo simulations, aided in developing a robust HPLC method for estimationof ceftazidime per se and on various stages of impactor.

Highlights

(i) QbD-enabled development of robust RP-HPLC method for ceftazidime quantification, (ii) Analytical method optimization employing Risk Assessment and Design of Experiments, (iii) Design space verification and defect rate analysis using Monte Carlo simulations, (iv) Chromatographic method validation as per ICH Q2 R1 guidelines and (v) Quantitative estimation of ceftazidime on various stages of impactor
An Atmospheric Plasma Jet Induces Expression of Wound Healing Genes in Progressive Burn Wounds in a Comb Burn Rat Model: A Pilot Study
Authors: Lee Yoonje , Ricky Sanjaya , Lim Tae Ho , Kim Hongjung , Lee Eui Jung , Song Yeongtak , Lee Sunmi , Jang Yongwoo
Published: January 2021

Burn-related injuries are devastating injuries with a high mortality rate that affect people of all ages worldwide. We assessed the effectiveness of plasma jet treatment in altering the expression of genes involved in wound healing in a prospective longitudinal observational animal study. Six male Sprague–Dawley rats weighing 350 g were used, and burn wounds were made by applying a preheated brass comb (100°C) to the back of the rats, resulting in four full-thickness burn wounds separated by three interspaces. A total of 18 burn wounds were induced on three rats. One side of the burn, on each rat received plasma treatment (plasma group), while the other side did not (control group). The interspaces were subjected to the plasma jet for 2 minutes per day until 7 days post-wounding. Plasma treatment significantly decreased the expression of proinflammatory cytokines. Furthermore, an increase in the expression of anti-inflammatory cytokines was observed in the plasma group. We showed that plasma jet treatment could improve burn wound healing by altering the expression of genes involved in the development of wound healing.
A Systematic Review of Quality Improvement Interventions in Burn Care
Authors: Rogers Alan D , Wallace David L , Cartotto Robert
Published: January 2021

Quality improvement interventions (QIIs) are intended to improve the care of patients. Unlike most traditional clinical research, these endeavors emphasize the sustainable implementation of scientific evidence rather than the establishment of evidence. Our purpose was to conduct a systematic review of QII publications in the field of burn care. A systematic review was conducted utilizing electronic databases (MEDLINE, Embase, and Cochrane Library) of all studies relating to “quality improvement” in burn care published until March 31, 2020. Studies were excluded if no baseline data were reported, or if no intervention was applied and tested. Studies were scored using a novel 10-point evaluation system for QII. We evaluated 414 studies involving “quality improvement” in burn care. Only 82 studies contained a QII while 332 studies were categorized as traditional research. Several traditional research studies made claims to be QIIs, but few met the criteria. Of the 82 QII references, only 20 (24%) were accessible as full-text manuscripts, the remainder were published as abstracts only. The mean score was 7.95 for full-text studies (range 6–10) and 7.4 for abstract-only studies (range 5.5–9.5). Despite the importance of quality improvement (QI) in burn care, very few studies have been published that employ true QI methodology, and many QII studies never advance beyond publication as abstracts in conference proceedings. Based on this systematic review, we propose guidelines to improve the quality of QII submissions.
The Burden of Adverse Childhood Experiences in Children and Those of Their Parents in a Burn Population
Authors: Ong Jia Ern , Fassel Mikenzy , Scieszinski Laura , Hosseini Sameen , Galet Colette , Oral Resmiye , Wibbenmeyer Lucy
Published: January 2021

The aim of this study was to determine the prevalence, type, and associations of parental and child adverse childhood experiences (ACEs) in children presenting with burn injuries. Parents of burned children completed an ACE-18 survey, including questions on parent and child ACEs, needs, and resiliency. Demographics, burn injury, hospital course, and follow-up data were collected. Family needs and burn outcomes of children with and without ACEs’ exposure (no ACE vs one to two ACEs vs three or more ACEs) were analyzed. P <.05 was considered significant. Seventy-five children were enrolled—58.7% were male, 69.3% white. The average age was 6.0 ± 5.2 years. The average total burn surface area was 4.4 ± 5.7% (0.1–27%). Parent ACE exposure correlated with child ACE exposure (r = .57; P = .001) and this intensified by increasing child age (P = .004). Child ACE exposure showed a graded response to family needs, including food and housing insecurity and childcare needs. Stress and psychosocial distress of the parents was significantly associated with their children’s ACE burden. The ACE burden of parents of burned children can affect the ACE load of their children. Burned children with more ACEs tend to have significantly more needs and more family distress. Awareness of past trauma can help identify a vulnerable population to ensure successful burn recovery.
Expert Consensus on Clinical Practice of Burn Units in Shanghai During the COVID-19 Epidemic
Authors: Ma Bing , Fan Xiaoming , Kong Weishi , Xiao Shichu , Zhu Shihui , Yao Min , Liu Yan , Zhu Weiping , Wang Jie , Zeng Yong , Zhao Yede , Su Bo , Xu Shun , Dong Zhaoyang , Gu Haifeng , Li Wei , Jiang Yu , Gu Danping , Xia Zhaofan
Published: January 2021

In response to coronavirus disease 2019 (COVID-19), the Shanghai Burn Clinical Quality Control Center organized experts to formulate and implement a set of rapid, simple, and effective prevention and control measures, and there have not been any cases of health care professionals or inpatients in burn units suspected or confirmed with COVID-19. This article elaborates on the specific measures in burn units in response to the epidemic, including the implementation of standardized procedures, remote consultations, strengthened follow-up, exchange of experience, and popular science, among others. We share experience from Shanghai to benefit related disciplines in other countries and regions.
The Impact of COVID-19 on Adult Burn Management in the United Kingdom: A Regional Center Experience
Authors: Varma Parvathi , Kazzazi Diana , Anwar Mohammad Umair , Muthayya Preetha
Published: January 2021

In this study, we aim to quantify the impact of COVID-19 on burns provision at an adult regional burn center. Two cohorts of patients were identified for comparison: one during the beginning of the COVID-19 lockdown in April 2020 and a comparator cohort in April 2019. There was a 30% decrease in the incidence of adult burns in 2020. The mean total body surface area (TBSA) was 1.8% and 4.3% in 2019 and 2020, respectively. Scald injuries were the commonest mechanism of burns in both cohorts. Depth of burns was deeper in 2019, with 17.6% of patients presenting with deep burns, compared with 9.6% in 2020. Eight percent of patients in 2019 required theater compared with zero patients in 2020. A similar percentage of patients were admitted in both cohorts. In 2019, admitted patients had an average inpatient stay of 0.57 days per TBSA. In 2020, the average stay per TBSA in all patients was 0.6 days and 1.5 days in survivors. In the lockdown period, 54% of patients were followed up by telemedicine. This difficult period has taught us how important a functioning healthcare system is and how we can be better prepared in the future.
Pseudomonal Meningoencephalitis With Ventriculitis Secondary to Bacteremia in a Burn Patient: A Novel Case
Authors: Segal Nicolas , Polcz Valerie E , McKean Jordan A , Kariyawasam Vidhu , Carson Joshua S , Fahy Brenda G
Published: January 2021

Burn patients with large burn surface area involvement are at increased risk of infection due to the presence of large wounds, multiple surgeries, prolonged intensive care unit admission, and immunosuppression. Pseudomonas aeruginosa is the most commonly isolated organism in this population. Even with frequent infections in the burn population, meningitis and encephalitis are rare, and ventriculitis is exceptional. We report the case of a 66-year-old woman who developed P. aeruginosa bacteremia during her hospital course, causing secondary meningoencephalitis with ventriculitis. She was admitted for partial- and full-thickness burns affecting the neck, chest, abdomen, upper medial arms, and bilateral anteromedial thighs for an estimated 20% total body surface area burn. She met sepsis criteria and broad-spectrum antimicrobial coverage was initiated. Magnetic resonance imaging of the brain, performed for altered mental status, revealed meningitis and ventriculitis. Cerebrospinal fluid analysis demonstrated findings consistent with bacterial meningitis, with cultures positive for P. aeruginosa. Serial neuroimaging with computerized tomography revealed new areas of ischemia concerning for septic emboli. In the presence of altered mental status and fever of unknown origin, workup should remain broad. Even in the presence of another source, it is important to keep an open mind for the rarer intracerebral infection as it requires different management, including urgent evaluation of antibiotic selection and dosing to ensure central nervous system penetration, and neurosurgical evaluation.
Mitigating the Transmission of COVID-19 with the Appropriate Usage of Personal Protective Protocols and Equipment in Breast Imaging and Intervention
Authors: Moseley Tanya W , Conners Amy L , He Hongying , Barth Jean E , Lightfoote Johnson B , Parikh Jay R , Whitman Gary J
Published: January 2021

The integration of personal protective equipment (PPE) and procedures into breast imaging and intervention practices will mitigate the risk of transmission of COVID-19 during the pandemic. Although supply chain shortages have improved, understanding the proper use of PPE and protocols to mitigate overconsumption are important to ensure efficacious utilization of PPE. Protocols and best practices are reviewed, and guidelines and resource materials are referenced in order to support breast imaging healthcare professionals.
Displaying plaster casts, staging Romanization
Authors: Iannantuono Ketty
Published: January 2021

In 1911, on the occasion of the fiftieth anniversary of the unification of Italy, a grand exhibition of Roman antiquities was hosted at the Baths of Diocletian in Rome. Rodolfo Lanciani, main agent behind the organization of this Mostra Archeologica, opted for exhibiting mainly reproductions of ancient monuments from the far-flung regions that once formed the Roman Empire. The aim was to reconstruct a coherent image of ancient Roman culture, directed towards the celebration of both the glorious Roman Empire and the expanding Italian one. By examining the selection of material exhibited and its display, this paper will analyse how early twentieth-century visions of the Roman past and the Italian present were reflected in the Mostra Archeologica. This analysis sheds light on the impact of these ideas and the nationalistic biases they introduced into the formulation of modern notions of Roman provincial art and archaeology.