bluuebunny/crossref_metadata_2025 huggingface dataset:
The nature of dark matter and a comprehensive solution
Authors: Giese Albrecht
Published: April 2022

Dark matter has been postulated to explain the excess of gravitation in relation to Newtonian physics in the vicinity of galaxies. At present, two theories are under discussion: the assumption that undetected heavy but weakly interacting particles exist, and a modification of Newtonian gravity (MOND). Both theories are unsatisfying because they can only explain certain cases and conflict with others. Recent extended observations have now given a spectacular indication of the nature of dark matter. These observations show an identical spatial distribution of dark matter on the one hand and photons on the other hand. In the following, we will check the possibility of the solution that photons are in fact the particles that explain the phenomenon.
A formula for the value of the gravitational constant
Authors: Guy Grantham R , Montgomery Ian G
Published: April 2022

A concise and precise formula for ‘Big G’ has been derived from an electron positron model of vacuum space (the epola model) that regards gravitation as a push force resulting from magnetic spin moments. Extended tests have revealed the significance of the peculiar velocity of the Solar System as a factor within the Fine Structure Constant, by experimentally monitored periodicity of nuclear decay rates. Correlations to gravitational field intensity, indicated by tide heights, also deny a purely random function for nuclear decay. The epola model’s definition of EM waves and their spectral characteristics had indicated possible substructure of the electron as a charged hadronic pion. This study resolves anomalies of the electron by identifying Twist in addition to Spin moments that has exposed an epola mechanism for Quantum Entanglement. When free guest particles interact with the bound particles of the lattice, binding energy density reduction induces gravitational forces and reveals the factors comprising the value of Big G, that further indicate pion sub-structure of leptons with a different fine structure.
Towards a new science for autonomous manned space exploration
Authors: Grès Stéphane
Published: April 2022

Long duration human exploration of the solar system calls for a stable contribution from different communities. of organized expertise and singular emerging know-how. The challenge of such a project appears to be technological, but designing a reliable socio-technical system for international astronaut explorers is a problem of integrating validated heterogeneous knowledge into an open interdisciplinary civilizational repository guided by humanizing value. In our paper, we will show that the human species can develop a form of collective intelligence using a paradigm that reintegrates a phenomenology of the living which is relatively different from the traditional process of scientific objectification. To support this hypothesis we will show the epistemological limits of constituted science and more particularly of modern physics. We will draw the relationship that exists between the evolution of theories in the human sciences and quantum physics while insisting on the role of culture as a catalyst for a always possible evolution of the Human being (conscious and free). Going beyond the previous science and reintegrating the living observer could allow to increase the horizon of human and technological possibilities in response to the new challenges that are emerging present on a global scale. We will focus on the need to activate natural intelligence with a methodological cycle that develops and maintains a continuous process between the subjective and objective poles of the human being in gestation. As a prerequisite, this process requires recognizing the human species qualities as well as its potential. Operationally this path requires mutual listening and shared responsibility of partners with a focused on the delegation process centered on the human being in the making in an extra-planetary perspective.
Is accretion alone enough to explain the mass spectrum of black holes?
Authors: Houlden M. A. , Barrett S. D.
Published: April 2022

The discovery in recent years by gravity wave detectors of dozens of merging binary black holes with masses much greater than one solar mass, when taken with the known population of black holes raises the possibility that it may not be possible to explain their all their origins and growth by credible accretion mechanisms. This paper offers an alternative perspective; that black holes can increase their mass by a quantum process linked to the acceleration of distant matter. Also, the idea that dark matter is predominantly composed of black holes in strongly supported. A testable equation M/M = 2H for the fractional rate of production of dark matter inside a large region of space with radius r and mass M(r), where H is the Hubble Constant, is presented. A mechanism to produce early supermassive black holes is proposed.
Einstein’s dream to unify all forces finally materializes: a revived de Broglie’s pilot-wave theory with novel solutions
Authors: Munera H A
Published: April 2022

Starting from Louis de Broglie’s pilot wave-theory, this paper unifies gravity and quantum mechanics under a single mathematical field theory for all forces in Nature. Two families of potentials coexist as mathematical solutions for the homogeneous Klein-Gordon equation which is the same homogeneous classical wave equation: (a) Neo-Laplacian local time-independent background potentials, and (b) Novel time-distance entangled Q(q) potentials which are isomorph to distance-time-velocity transformations based on any of the competing relativistic theories (Lorentz, Poincaré or Einstein), or on the pre-relativistic Galilean invariant Doppler equations. This remarkable property makes present theory compatible with all previous empirical evidence, including experiments conventionally interpreted as supporting Einstein’s special relativity. We report explicit closed solutions for potentials solving the one-dimensional and three-dimensional classical wave equations, and describe in detail how to calculate time-independent neo-Laplacian background forces and relativistically isomorph time-dependent entangled forces. The scale of the problem appears as a required parameter, thus making our theory applicable to all scales of Nature from quarks to cosmos. A usually overlooked neo-Laplacian logarithmic potential predicts the observed high values of non-Keplerian tangential speeds at the galactic scale. At the human scale, calculations relative to hurricanes and tornadoes may be facilitated by the closed form of our unified forces. A novel torsion component of gravity automatically appears from our new solutions.
The hidden physical model of kinematics under SRT’s observer-centric models
Authors: Percival J N
Published: April 2022

This paper assumes the reader is intimately familiar with Special Relativity’s (SRT’s) model and equations. The paper summarizes the empirical data in terms of the two main categories of interpretations of SRT currently taught in college/universities, physics texts and discussed in physics journals. Inconsistencies between the data on proper time accumulation rates and SRT are discussed. All the standard rebuttals to claims of flaws or limitations in SRT associated with one set of empirical data are ruled out by other sets of empirical data. The paper focuses on proper time data as proper time is absolute and observer independent, in contrast to the observer-centric SRT spacetime views, AND any absolute effects are cumulative and, hence, especially well-suited for revealing the absolute physical reality that underlies the relativistic view.
CMB as thermal radiation from cosmic dust grains in equilibrium with the redshifted starlight
Authors: Trinchera Alessandro
Published: April 2022

This paper suggests that the cosmic microwave background radiation (CMB) arises from thermalized cosmic dust grains both in the interstellar medium (ISM) and in the intergalactic medium (IGM) in electron density zones equal to 0.5 el/m3. Otherwise, the thermalization is characterized by higher temperatures in the observed range 15-27 K. Considering that a black body spectrum requires an absorber/re-emitter to take place, starting from the radiative transfer equation, the calculation method applied determines the diameter of the targets in equilibrium with the redshifted starlight necessary to produce a thermal radiation at 2.725 K. The calculated value of the diameter can only correspond to cosmic dust grains in nature with their specific mass density and to nothing else. It is fully consistent with the observed size range of extra-terrestrial cosmic dust within 10-1000 μm. Furthermore, the carbon composition of the grains is capable to describe a black body behaviour as well as the metal composition is in a position to feature the polarization CMB map under the influence of galactic magnetic fields. The results of this inquiry are valid for any observer in the Cosmos.
Quantizing dynamics
Authors: Kanda A , Prunescu M , Wong R
Published: April 2022

In theoretical physics, quantization means reducing a continuum structure to discrete structure. This process was widely used in the development of quantum mechanics since Planck’s convention of the discretization of the energy of electromagnetic (EM) wavese=nhfas a solution to the crisis of the blackbody radiation. When combined with Einstein’s relativistic particle energy equatione=mc2it became a most fundamental process of the 20th century theoretical physics. Planck was reluctant to consider his energy quantae=nhfas a physical particle. His concern was forgotten in the process of development of quantum mechanics, which was Einstein’s relativity theory dynamics combined with Planck’s wave-particle duality. This framework was later extended by Dirac into the quantization of the entire EM field theory of Maxwell in which the EM fields, which are mathematically a continuous structure, themselves were quantized in terms of Einstein’s special theory of relativity dynamics using Fourier expansions. As it appears that the mathematical error of using wave numbers, which form a real continuum, as indexes of the Fourier expansion for the discretization of waves went unnoticed, this quantization of electrodynamics, called quantum electrodynamics (QED), became a model for further quantizing continuum based physical theories. This error was thus passed down to all of the successors of QED. The theory of quantum gravity is yet another attempt to quantize a major force field theory of gravitational forces. Here as well the issue of the difference between the continuum and the discrete was overlooked.
The Energy probability distribution of quantum levels of a particle imprisoned in a three dimensional box
Authors: Yarman T , Akkus B , Arik M , Marchal C , Cokcoskun S , Kholmetskii A , Yarman O , Zaim N , Altintas A A , Özaydin F
Published: April 2022

This work was trigerred by the earlier achivements of Yarman et al, aiming to bridge themordynamics and quantum mechanics, whence, Planck constant came to replace Boltzmann constant, and “average quantum level number” came to replace “temperature”. This evoked that the classical Maxwell energy probability distribution p(E) with respect to energy E of gas molecules might be taken care of, by the “energy probability distribution of the quantum levels” of a particle imprisoned in a given volume, assuming that in the case we have many particles, following Pauli exclusion principle, no pair of particles can sit at the same level. Thereby, the energy probability distribution of the quantum levels of a particle imprisoned in three dimensions, will be the subject of this essay. Such an outlook becomes interesting from several angles: i) It looks indeed very much like a classical Maxwellian distribution. ii) In the case we have as many free particles in the box as the number of levels depicted by the number of quantum levels in between the predetermined lower bound energy level and the upperbound energy level, all the while assuming that the Pauli principle holds, the distribution we disclose becomes the energy probability distribution of the ensemble of particles imprisoned in the given box. iii) It can even be guessed that, if elastic collisions between the free particles were allowed, and still assuming quantization and the Pauli principle, the outcome we disclose should be about the same as that of the energy probability distribution, molecules in a room would display in equilibrium. iv) The quantized energy being proportional to the sum of three squared integers associated with respectively, each of the spatial dimensions; the property we reveal certainly becomes remarkable from the point of view of mathematics of integer numbers. All the more, we further disclose that, to the probability distribution outlook remains the same, be this qualitatively for higher dimensions than 3.
Climate Change Impacts on Agriculture and Water Resource Management in the North China Plain
Authors: Lin Yanwei , Li Guangyu
Published: April 2022

North China Plain (NCP) is a main agricultural production region in China, dominated by a summer maize-winter wheat double cropping system. However, the grain yield highly depends on groundwater extraction to fulfil the irrigation demand. Additionally, the warming and drying tendency under climate change will further challenge water resource availability and agricultural productivity. This study applied modelled regional precipitation and temperature within the East Asia domain from the Coordinated Regional Climate Downscaling Experiment to derive climate change indicators and quantify future water resource utilisation. Results show a 30% increase in water irrigation demand (IWD) for growing maize in Jiangsu Province and a slight decrease in central Shandong Province. While for wheat, IWD decreases by 3-24% over the NCP except for northern Hebei Province and northern Shandong Province. Therefore, we suggest reducing agricultural fields for summer maize in southern NCP and winter wheat in northern NCP, and intensifying cultivation in central Shandong Province. Mann-Kendall statistics indicate an indistinct trend for IWD but a significant increase in crop evapotranspiration (ETc) during 2021-2050, highlighting the necessity to cope with rising ETc and apply varieties with high stress-tolerance to release irrigating water intensity under future climate change.
Multiple Linear Regression Model of Environmental Variables, Predictors of Global Solar Radiation in the Area of East Lima, Peru
Authors: Soria Juan J , Poma Orlando , Sumire David A , Rojas Joel Hugo Fernandez , Chipa Sulamita Marinela Ramos
Published: April 2022

Multiple regression models are very relevant to predict values using predictor variables. The objective of this study was to predict the global solar radiation in the year 2019 in the area of East Lima, Peru. Three continuous quantitative predictor variables were analyzed: temperature, humidity, wind speed and the response variable was global solar radiation, resulting in a model with excellent significance p<0.001 that shows the prediction is effective. The multiple linear regression method was used, finding an average global radiation of 175 W/m2 and predictor variables with average temperature of 19.2 °C, humidity 23.9% and wind speed 1.77 m/s, with the highest temperature in summer recorded at 24.6°C, the highest humidity of 51.2% in autumn, the highest wind speed in summer at 2.63 m/s and the highest maximum global solar radiation in spring with 183 W/m2.
Possibility for Production of Biogas from Manure in Bulgaria
Authors: Ganev Ivaylo , Velichkova Rositsa , Gieva Elitsa , Filipov Kalin , Dimitrov Lubomir
Published: April 2022

The permanent consumption increasing of energy, foods, techniques and other goods and serviced worldwide leads to the intensifier of their production and to the constant market expansion. In turn, the processes taking place in some of these productions are responsible for the deterioration of the quality of the environment. Over the last decade, science and industry have followed the environmental policies and one of the developing approaches is being the use of by-products as raw materials for new production. The waste to energy technologies meets the requirements both of sustainable managing of wastes and energy production by sources with zero carbon footprint. Typical for this technological approach is its local application and in this study is performed an overview analysis of the possibilities for utilization of livestock manures in systems for production of biogas in Bulgaria. Based on the statistical data for number, and type of farm animals in the country for 2020, their localization, and the potential for gas production of their manure, the calculations were made. The obtained results are presented by regional division and it was estimated that total 1142 installation with 500 kWh capacity could be realized in the investigated farms plants. The obtained results are promising and they are prerequisite for further technological and economic investigations of this waste to energy technology
Sustainable Cities, Rescue of Original Construction Methods and Use of Technology. A literary Review
Authors: Vicuña Susana Moya
Published: April 2022

The concept of sustainability and even more so applied to the city is quite broad, however in general we could say that they are those whose planning and growth considers current challenges, but also understands and recognizes those next to appear, such as the upsurge of climate change, the growth and migration of the human population in and towards cities, based on which it designs a model based on economic and social development, thinking about the importance of people and their needs. In recent years, several sustainable cities have appeared that are proposed as a model, many of these cities have not only looked to the future with new technologies that offer us efficient systems, but have also looked to the past and have found vernacular architecture of their environments, practical solutions of a passive nature, however, although these model cities can serve as an example and even as a hotbed for the development of techniques and technologies that lead us to a sustainable city, they are not models that can be adapted in an intact way in any territory, but must be reinterpreted to achieve optimal functioning among different conditions of another territory.
Influence of adiabatic response of passing energetic ions on high-frequency fishbone
Authors: KONG Haozhe , WANG Feng , SUN Jizhong
Published: April 2022

Adiabatic response effects on high-frequency fishbone instability driven by passing energetic ions are studied. With finite orbit width effects, the adiabatic contribution

δ

W

hf

is derived analytically for purely passing energetic ions. By approximating the adiabatic contribution to the first order of the reverse aspect ratio

ε
,

we derive one of its analytic expressions, which is expected to be more accurate than that in a previous work (Graves J P 2004 Phys. Rev. Lett.
92 185003). For high-frequency fishbone instability, nonadiabatic response is usually dominant over adiabatic response, but under certain circumstances the latter plays an important role, comparable to the former. With a more generalized distribution function by introducing Gaussian-type factors representing their pitch and radial dependences and using a slowing-down equilibrium distribution for the energy of energetic ions, numerical analysis indicates that the adiabatic contribution is conducive to stabilization of the mode and causes a decrease in mode frequency. In addition, we find that the adiabatic contribution has a weak stabilizing effect on the fishbone instability when the finite orbit width effect is taken into account. We further analyze the dependence of the adiabatic contribution on the characteristic parameters of the distribution function. When the neutral beam has either a larger deviation from the plasma axis or a larger radial profile, the adiabatic contribution has a more evident effect on the fishbone instability. When the neutral beam has a relatively small critical energy, the adiabatic contribution has a greater effect on the mode instability.
Impact of Technological Developments on Infectious Disease Epidemiology: Lessons From the First 100 Years of the American Journal of Epidemiology
Authors: Foxman Betsy , Mehta Shruti
Published: April 2022

Technological developments in laboratory and epidemiologic methods, combined with increasing computing power, have synergistically increased our understanding of the epidemiology of infectious disease. Using historical examples from the first 100 years of the American Journal of Epidemiology, we illustrate how these developments provided the foundation for the rapid detection of the agent causing coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from its transmission efficiency and modalities, risk factors, and natural history to the evaluation of new vaccines and treatments to control its spread and impact. Comparisons with timelines for elucidation of the epidemiology, natural history, and control of other infectious diseases, including viral hepatitis, humbly remind us of how much past discoveries have paved the way for more rapid discovery of and response to new pathogens. We close with some comments on a potential future role of the Journal in infectious disease epidemiology.
Development and implementation of strategic frameworks for polypharmacy management in healthcare organisations: a scoping review
Authors: Al Bulushi S , McIntosh T , Grant A , Stewart D , Cunningham S
Published: April 2022

Introduction

‘Polypharmacy management’ (PM) guidelines exist (1) but there are challenges to implementation and WHO recommends theory-based organisational change strategies to address this (2).

Aim

To identify current evidence base around the development and implementation of strategic frameworks for polypharmacy management in healthcare organisations.

Methods

The Arksey and O’Malley framework and the PRISMA Scoping Reviews extension were used. Databases (Medline, IPA, CINAHL and Business Source Complete) were searched to December 2020. After title and abstract screening full text articles were reviewed. Search, data extraction and eligibility criteria were defined (table). Included studies were charted to collate extracted information and a descriptive narrative approach to data synthesis was taken. All steps involved independent checks by two team members with disagreement mediation by a third.

Results

Initially 702 records were identified after removal of duplicates, 632 of these were excluded after screening leaving 70 papers. A further 63 of these 70 papers were excluded after full text review. The seven papers remaining met the eligibility criteria fully and showed: despite wide availability of polypharmacy guidelines in the West, particularly the UK and European Union, there is limited evidence on the strategic development and implementation of PM frameworks. The main characteristics of strategic approaches used included: Kotter’s eight step process for organisational change, theoretical domains framework to identify individual behavioural determinants, and a community-based medication management intervention. Reported barriers were: lack of data to create a sense of urgency, lack of a national plan for implementation, monitoring and evaluation, poor coordination of care, lack of time for staff, unclear allocation of tasks and responsibilities and lack of training. Organisational level facilitators included: government funding streams and strict regulatory environment, national emphasis on quality and presence of contextual evidence.

Conclusion

Despite PM guidance this review shows limited evidence on development of theory based strategic frameworks for organisational change. Evidence was from Western contexts only. A strength of this work is that it searched internationally but was limited by exclusion of grey literature. Further work is required on theory based strategic organisational change in PM particularly in contexts out with the Western world.

References

(1) Mair A, Fernandez-Llimos F, Alonso A, Harrison C, Hurding S, Kempen T, Kinnear M, Michael N, McIntosh J, Wilson M, the SIMPATHY Consortium. Polypharmacy Management by 2030: a patient safety challenge. 2nd edition. Coimbra: SIMPATHY Consortium; 2017.

(2) World Health Organization. Medication safety in polypharmacy: technical report. Geneva: World Health Organization; 2019.
War Myths and the Normalization of PTSD and Military Suicide: The Military Suicide Equation
Authors: MacKenzie Megan , Wegner Nicole
Published: April 2022

Military suicide is an increasing concern for Western militaries. In this article, using a qualitative media analysis, we introduce the military suicide equation as a metanarrative and analytic tool for understanding discourse on military suicides. This metanarrative—overseas service + post-traumatic stress disorder (PTSD) = suicide—positions military suicide as the consequences of PTSD acquired during overseas military deployment and positions increased military funding as the simplistic solution to what is often described as a military suicide “epidemic.” The military suicide equation operates to both normalize evidence of widespread mental health issues within militaries and sustain support for military institutions and war deployments by directing public attention to the “problem-solution” cycle identified in the equation. We assess the political consequences of this simplistic representation, namely the reproduction of preexisting myths about the “unknowability” of war, civilian responsibilities to “Support the Troops,” and the exceptional nature of military service and combat deployment.
Political and International Affairs Simulations and College Students’ Civic Development
Authors: Siegel-Stechler Kelly , Gee Gretchen
Published: April 2022

Political science professors frequently use simulations to try to enhance student learning. Beyond their use in experiential learning, prior research suggests that simulations may also improve student civic outcomes and promote political interest and engagement outside of the classroom. This study estimates the impact of political science simulations by examining students’ attitudes and behaviors before and after taking part in a simulation. We study whether participation in classroom and Model United Nations simulations leads to increases in student civic engagement, political efficacy, and appreciation of diverse viewpoints among college students using a comparison group difference-in-difference design. We find significant positive impacts of simulations on measures of civic engagement, which suggests that students who participate in simulations may take immediate and concrete steps to be more involved in social and political groups.
Latin American New Constitutionalism
Authors: Couso Javier
Published: April 2022

The notion of a ‘new Latin American constitutionalism’ (or ‘neo-constitutionalism’) is equivocal. This because it alludes to two radically different constitutional schools of thought that, in the last couple of decades, entered the academic and political scene of the region, transforming part of the constitutional culture and practice of the countries where they have been most influential. The first and most significant school called ‘Latin America’s progressive neo-constitutionalism’, came out of the liberal tradition, as a rejection of the legal formalism and positivism that characterized much of Latin American constitutionalism in the nineteenth and twentieth centuries. The second one, which can be called ‘Latin America’s radical neo-constitutionalism’ combines Marxist and post-Marxist critiques of liberal legalism with the radical-democratic tradition which, since the times of the enlightenment, has associated constitutionalism with the sovereign power of the people.
Freedom of Expression and Populist Politics
Authors: Ugarte Ramiro Álvarez
Published: April 2022

This chapter seeks to describe the normative underpinnings of the freedom of expression debate, which engulfed Latin America in the last few years, especially around the push, led by some countries, to reform the Inter-American Human Rights System. Based on this analysis, the chapter argues for a conflicting relationship between populist politics and freedom of expression. With the dust settled over the Inter-American reform process, the analysis seems timely and relevant given the decline of left-wing populism in the region and the rise of right-wing populism worldwide.
A View From (South) Africa
Authors: Dugard Jackie
Published: April 2022

This chapter presents a South African’s view of constitutional jurisprudence in Latin America. Writing as an English-speaker from a South African and largely social rights perspective, the constitutional jurisprudence of Latin America stands out for two key, linked reasons. First is the recognition and implementation by the courts of the right of direct access to the highest court. Second is the robust way the courts have advanced individual remedies to social rights, particularly the right to health. The chapter sets out the ways in which, from this (South) African’s perspective, the constitutionalism from particularly Costa Rica, Brazil and Colombia stands out, focusing on direct access to the highest court and the adjudication of social rights.
Defining Physiological Decompensation: An Expert Consensus and Retrospective Outcome Validation
Authors: Mitchell Oscar J. L. , Dewan Maya , Wolfe Heather A. , Roberts Karsten J. , Neefe Stacie , Lighthall Geoffrey , Sands Nathaniel A. , Weissman Gary , Ginestra Jennifer , Shashaty Michael G. S. , Schweickert William D. , Abella Benjamin S.
Published: April 2022

OBJECTIVES:

Physiological decompensation of hospitalized patients is common and is associated with substantial morbidity and mortality. Research surrounding patient decompensation has been hampered by the absence of a robust definition of decompensation and lack of standardized clinical criteria with which to identify patients who have decompensated. We aimed to: 1) develop a consensus definition of physiological decompensation and 2) to develop clinical criteria to identify patients who have decompensated.

DESIGN:

We utilized a three-phase, modified electronic Delphi (eDelphi) process, followed by a discussion round to generate consensus on the definition of physiological decompensation and on criteria to identify decompensation. We then validated the criteria using a retrospective cohort study of adult patients admitted to the Hospital of the University of Pennsylvania.

SETTING:

Quaternary academic medical center.

PATIENTS:

Adult patients admitted to the Hospital of the University of Pennsylvania who had triggered a rapid response team (RRT) response between January 1, 2019, and December 31, 2020.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Sixty-nine experts participated in the eDelphi. Participation was high across the three survey rounds (first round: 93%, second round: 94%, and third round: 98%). The expert panel arrived at a consensus definition of physiological decompensation, “An acute worsening of a patient’s clinical status that poses a substantial increase to an individual’s short-term risk of death or serious harm.” Consensus was also reached on criteria for physiological decompensation. Invasive mechanical ventilation, severe hypoxemia, and use of vasopressor or inotrope medication were bundled as criteria for our novel decompensation metric: the adult inpatient decompensation event (AIDE). Patients who met greater than one AIDE criteria within 24 hours of an RRT call had increased adjusted odds of 7-day mortality (adjusted odds ratio [aOR], 4.1 [95% CI, 2.5–6.7]) and intensive care unit transfer (aOR, 20.6 [95% CI, 14.2–30.0]).

CONCLUSIONS:

Through the eDelphi process, we have reached a consensus definition of physiological decompensation and proposed clinical criteria with which to identify patients who have decompensated using data easily available from the electronic medical record, the AIDE criteria.
Invasive Fusobacterium Infections in Children: A Retrospective Multicenter Study
Authors: Hirschhorn Adi , Averbuch Diana , Michaan Nadav , Adler Amos , Grisaru-Soen Galia
Published: April 2022

Background:

The past decade has witnessed a rise in Fusobacterium infections. This study aimed to describe the epidemiology, clinical and demographic characteristics and outcomes associated with Fusobacterium infections in hospitalized children in central Israel.

Methods:

We retrospectively analyzed the medical records of children <18 years old who had been admitted with a diagnosis of invasive Fusobacterium infection (IFI) between January 2010 and April 2020. Clinical, laboratory and microbiologic data were retrieved. IFI diagnosis was based upon microbiological identification in any specimen by culture or by 16S ribosomal RNA polymerase chain reaction.

Results:

Fifty-one children (26 boys) with a median age of 3 years (range, 5–16 years) were included. Hospitalizations for IFI increased from 19 of 100,000 admissions between 2010 and 2015 to 50 of 100,000 between 2016 and 2020, representing a 2.5-fold increase. Most of the infections were from an otogenic source (n = 28, 55%) followed by an oropharyngeal/respiratory source (n = 21, 41%). The most common complications were subperiosteal and epidural abscesses (41% and 37%, respectively). Thrombosis was diagnosed in 11 children, 10 of whom had sinus vein thrombosis. All had an otogenic source. Children with otogenic compared with all other infection sources were significantly younger (median age of 1.9 vs. 3 years; P < 0.001). Forty-seven children (92%) underwent a surgical intervention. All patients survived, one with neurologic sequelae.

Conclusions:

The admissions for IFI in children increased 2.5-fold during the last decade. The most common source is otogenic, especially among younger children, and it is associated with high complication rates. Current management, including combinations of antibiotics and surgical interventions, leads to favorable outcome.
Differences in Bacterial Colonization and Mucosal Responses Between High and Low SES Children in Indonesia
Authors: van Dorst Marloes M.A.R. , Azimi Shohreh , Wahyuni Sitti , Amaruddin Aldian I. , Sartono Erliyani , Wammes Linda J. , Yazdanbakhsh Maria , Jochems Simon P.
Published: April 2022

Background:

Increased nasopharyngeal carriage of pathogenic bacteria is found in low socioeconomic status (SES) settings. How SES affects local immune responses, important for controlling colonization, is currently unknown.

Objective:

Examining bacterial colonization and cytokine response in the nasal mucosa of children from high and low SES.

Methods:

Nasosorption samples were collected in October 2019 from 48 high SES and 50 low SES schoolchildren, in a cross-sectional study in Makassar, Indonesia. Twenty-five cytokines were measured in nasal fluid. Quantitative polymerase chain reaction was performed to determine carriage and density of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Staphylococcus aureus. Data were analyzed using multivariate regression.

Results:

H. influenzae and S. pneumoniae densities were increased in low SES settings compared to the high SES settings (P = 0.006, P = 0.026), with 6 and 67 times higher median densities, respectively. Densities of H. influenzae and S. pneumoniae were positively associated with levels of IL-1beta and IL-6. After correcting for bacterial density, IL-6 levels were higher in colonized children from high SES than low SES for H. influenzae and S. pneumoniae (both P = 0.039).

Conclusion:

Increased densities of H. influenzae and S. pneumoniae were observed in low SES children, whereas IL-6 levels associated with colonization were reduced in these children, indicating that immune responses to bacterial colonization were altered by SES.
The Forensic Psychiatric Network of Observation and Documentation: At the Intersection of Review Board Hearings and Nursing Practice
Authors: Domingue Jean-Laurent , Jacob Jean-Daniel , Perron Amélie , Foth Thomas , Pariseau-Legault Pierre
Published: April 2022

Forensic psychiatric nursing is a specialty at the junction of two well-researched intersecting systems with two mandates: criminal justice and health care. Nurses' involvement at one of the systems' points of juncture, review board (RB) hearings, has largely been left unexplored. At RB hearings, a panel of legal and healthcare professionals determines if persons unfit to stand trial (UST) or not criminally responsible on account of mental disorder (NCR) represent significant threats to the safety of the public and orders conditions aimed at keeping the community safe. The aim of this article is to present the results of a critical ethnography that explored how psychiatric and public safety discourses construct the identity of persons UST or NCR during RB hearings as well as nurses' contribution to such identity construction. The main finding is that the forensic psychiatric structure leverages nursing interventions and documentation as evidence of deviancy, so that persons UST or NCR can be objectified and produced as dangerous. Structures sustaining the forensic psychiatric system inscribe nursing care within a disciplinary scheme, rendering the care-and-custody dichotomy insufficient to explain the complex processes at play in forensic psychiatry. These findings have implications for the practice of nurses working in forensic psychiatric settings and for that of other nurses who practice on the medicolegal borderland.
Nonfatal Strangulation
Authors: Hartlaub Tami , Castro Brandi , Frey Michelle
Published: April 2022

Nonfatal strangulation is a relatively newly recognized mechanism of injury that may not be taken seriously because of lack of physical injuries that many times accompany it. This comparison case series supports the importance of considering not only visually detected injuries but also symptoms the patient may be experiencing when determining diagnostics necessary to guide a treatment plan. A visually detectable injury is dependent on multiple factors. Bruises may occur with minimal pressure but may not be visible immediately after assault. Contrary to this, extensive bruising of the neck is not an accurate indicator of damage to underlying structures. The authors' experiences in these two cases signify the necessity of a comprehensive assessment utilizing both physical symptoms and assessments as the basis for determining nonfatal strangulation treatment plans.
Integrative treatment of herbal medicine with western medicine on coronary artery lesions in children with Kawasaki disease
Authors: Choi Jungyoon , Chang Seokjoo , Kim Eunjin , Min Sang Yeon
Published: April 2022

Background:

Kawasaki disease (KD) is a major cause of coronary artery lesions (CALs) in children. Approximately 10% to 20% of children treated with intravenous immunoglobulin are intravenous immunoglobulin-resistant. This study evaluated the efficacy and safety of adding herbal medicine to conventional western medicines versus conventional western medicines alone for CALs in children with KD.

Methods:

This study searched 9 electronic databases until August 31, 2021. The inclusion criteria were the randomized controlled trials (RCTs) that assessed the CALs in children with KD and compared integrative treatment with conventional western treatments. Two authors searched independently for RCTs, including eligible articles that fulfilled the inclusion criteria, extracted data, and assessed the methodological quality using the Cochrane risk of bias tool. Meta-analysis was conducted using Cochrane Collaboration's Review Manager 5.4 software. The effect size was presented as the risk ratio (RR), and the fixed-effect models were used to pool the results.

Results:

The finally selected 12 studies included a total of 1030 KD patients. According to a meta-analysis, the integrative treatment showed better results than the conventional treatment in the CAL prevalence rate (RR = 2.00; 95% confidence interval [CI], 1.49–2.71; P < .00001), CAL recovery rate (RR = 1.27; 95% CI, 1.05–1.54; P = .02), and total effective rate (RR = 1.17; 95% CI, 1.11–1.23; P < .00001). Only 2 studies referred to the safety of the treatment. The asymmetrical funnel plot of the CAL prevalence rate indicated the possibility of potential publication bias.

Conclusions:

This review found the integrative treatment to be more effective in reducing the CAL prevalence rate and increasing the CAL recovery rate and total effective rate in KD patients than conventional western treatment. However, additional well-designed RCTs will be needed further to compensate restrictions of insufficient trials on safety, methodological quality, and publication bias.
Rheumatoid arthritis in a patient with compound heterozygous variants in the COL11A2 gene and progressive hearing loss
Authors: Tsuchida Yumi , Nagafuchi Yasuo , Uehara Tomoko , Suzuki Hisato , Yamada Mamiko , Kono Masanori , Hatano Hiroaki , Shoda Hirofumi , Fujio Keishi , Kosaki Kenjiro
Published: April 2022

Rationale:

Collagen type XI alpha 2 chain is a component of type XI collagen and is expressed in various tissues including articular cartilage and tectorial membrane of the cochlea. Variants in the COL11A2 gene, which encodes collagen type XI alpha 2 chain, has been reported to cause hearing loss and has been associated with osteoarthritis and ossification of the posterior longitudinal ligament of the spine. Despite the importance of type XI collagen in the joints, association of rheumatoid arthritis (RA) with COL11A2 has not been reported.

Patient concerns:

The patient is a 60-year-old female, born to Japanese parents of no known consanguinity. She had progressive hearing loss since childhood. Her father also had progressive hearing loss before middle age. She developed joint pain in the knees and the hips in her forties. When she was 56, she developed polyarthritis. Rheumatoid factor and anti-CCP antibodies were positive.

Diagnoses:

She was diagnosed with osteoarthritis and RA. Whole exome analysis detected 2 rare variants, c.4201C>T, p.(Arg1401Trp) and c4265C>T, p.(Pro1422Leu), in the COL11A2 gene (NM_080680.2). Whole genome analysis with a long insert size confirmed 2 variants that are in trans.

Interventions and outcomes:

She received a cochlear implant, which improved her hearing. She was treated with methotrexate, golimumab, tocilizumab, and upadacitinib with partial responses for her RA.

Lessons:

We herein report a patient with RA with compound heterozygous variants in the COL11A2 gene. Autoantibodies against type XI collagen are detected in the sera of patients with RA, suggesting the possibility that type XI collagen may be involved in the pathogenesis of RA as an autoantigen. The hearing loss and osteoarthritis in this patient may be due to the compound heterozygous variants in the COL11A2 gene, and the conformational changes induced by the variants may have changed the immunogenicity of type XI collagen, leading to the development of RA.
Are COVID-19 mRNA vaccine side effects severe enough to cause missed work? Cross-sectional study of health care-associated workers
Authors: Cohen David A. , Greenberg Patricia , Formanowski Brielle , Parikh Payal D.
Published: April 2022

The Coronavirus Disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome-coronavirus-2, has claimed 5,587,549 lives worldwide as of January 20, 2022. Fortunately, large-scale vaccination can mitigate the impact of COVID-19 by making the disease milder and less common. Although 75.2% of the United States population has received at least 1 dose of a COVID-19 vaccines thus far, concerns regarding vaccine side effects have contributed to vaccine hesitancy. Furthermore, nearly 50% of adults in the United States are concerned not only about side effects, but about their downstream impact, including missed work.

The goal of this cross-sectional study was to investigate the effect of messenger RNA vaccine adverse effects on the propensity to miss work among employees associated with a single, large academic health center.

Using Qualtrics, all employees, including faculty, staff, and trainees, of 5 large departments were surveyed to determine whether they received the COVID-19 vaccine and which type, and any symptoms they experienced after receipt of either vaccine dose. We hypothesized that vaccine recipients would be more likely to miss work or feel sick enough to miss work following the second dose.

Thirty-seven percent of respondents experienced events severe enough that they needed to miss work from either of the doses, with the majority (27.8%) related to the second dose. These findings are consistent with and expand on the results from the phase 3 trials for Pfizer-BionTech and Moderna, which showed that vaccine side effects were more common after the second dose than after the first dose. Our statistically significant finding was more common among Asians, women, trainees/house staff, and nonphysician clinical employees.

With an increasing number of individuals taking the vaccine, employers will need to account for the impact of adverse effects on their employees’ ability to work. These findings will further help organizations better plan for staffing as vaccinations increase to mitigate the spread of COVID-19.
Effect of intrarenal renin-angiotensin-aldosterone system on renal function in patients after cardiac surgery
Authors: Niu Peiyuan , Ren Xuejing , Wu Meihao , Wan Shengfeng , Zheng Yan , Jiao Xiaojing , Yan Lei , Cao Huixia , Yang Leiyi , Shao Fengmin
Published: April 2022

The aim of the study was to investigate the influence of intrarenal RAS on the decrease of renal function in patients undergoing cardiac surgery with cardiopulmonary bypass. This observational study investigated the activation of intrarenal RAS in 24 patients with AKI after cardiac surgery with cardiopulmonary bypass. The activation of intrarenal RAS was determined by urinary angiotensinogen (uAGT), which was measured at 12 hours before surgery, 0 and12 hours after surgery. The results were compared with those of 21 patients without AKI after cardiac surgery with cardiopulmonary bypass. Clinical and laboratory data were collected. Compared with baseline, all patients with cardiac surgery had activation of intrarenal RAS at 0 and 12 hours after surgery. The activation of intrarenal RAS was found significantly higher at both 0 and 12 hours after surgery in AKI group versus non AKI group (6.18 ± 1.93 ng/mL vs 3.49 ± 1.71 ng/mL, 16.38 ± 7.50 ng/mL vs 6.04 ± 2.59 ng/mL, respectively). There was a positive correlation between the activation of RAS at 0 hour after surgery and the decrease of renal function at 48 hours after surgery (r = 0.654, P = .001). These findings suggest that uAGT might be a suitable biomarker for prediction of the occurrence and severity of AKI after cardiac surgery. Inhibition of intrarenal RAS activation might be one the path of future treatment for this type of disease.