bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain Network Dysfunction in Poststroke Delirium and Spatial Neglect: An fMRI Study
Authors: Boukrina Olga , Kowalczyk Mateusz , Koush Yury , Kong Yekyung , Barrett A.M.
Published: October 2021

Background and Purpose:

Delirium, an acute reduction in cognitive functioning, hinders stroke recovery and contributes to cognitive decline. Right-hemisphere stroke is linked with higher delirium incidence, likely, due to the prevalence of spatial neglect (SN), a right-brain disorder of spatial processing. This study tested if symptoms of delirium and SN after right-hemisphere stroke are associated with abnormal function of the right-dominant neural networks specialized for maintaining attention, orientation, and arousal.

Methods:

Twenty-nine participants with right-hemisphere ischemic stroke undergoing acute rehabilitation completed delirium and SN assessments and functional neuroimaging scans. Whole-brain functional connectivity of 4 right-hemisphere seed regions in the cortical-subcortical arousal and attention networks was assessed for its relationship to validated SN and delirium severity measures.

Results:

Of 29 patients, 6 (21%) met the diagnostic criteria for delirium and 16 (55%) for SN. Decreased connectivity of the right basal forebrain to brain stem and basal ganglia predicted more severe SN. Increased connectivity of the arousal and attention network regions with the parietal, frontal, and temporal structures in the unaffected hemisphere was also found in more severe delirium and SN.

Conclusions:

Delirium and SN are associated with decreased arousal network activity and an imbalance of cortico-subcortical hemispheric connectivity. Better understanding of neural correlates of poststroke delirium and SN will lead to improved neuroscience-based treatment development for these disorders.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03349411.
Internal Solitary Waves in the Andaman Sea Revealed by Long-Term Mooring Observations
Authors: Yang Yunchao , Huang Xiaodong , Zhao Wei , Zhou Chun , Huang Siwei , Zhang Zhiwei , Tian Jiwei
Published: October 2021

The complex behaviors of internal solitary waves (ISWs) in the Andaman Sea were revealed using data collected over a nearly 22-month-long observation period completed by two moorings. Emanating from the submarine ridges northwest of Sumatra Island and south of Car Nicobar, two types of ISWs, referred to as S- and C-ISWs, respectively, were identified in the measurements, and S-ISWs were generally found to be stronger than C-ISWs. The observed S- and C-ISWs frequently appeared as multiwave packets, accounting for 87% and 43% of their observed episodes, respectively. The simultaneous measurements collected by the two moorings featured evident variability along the S-ISW crests, with the average wave amplitude in the northern portion being 36% larger than that in the southern portion. The analyses of the arrival times revealed that the S-ISWs in the northern portion occurred more frequently and arrived more irregularly than those in the southern portion. Moreover, the temporal variability of ISWs drastically differed on monthly and seasonal time scales, characterized by relatively stronger S-ISWs in spring and autumn. Over the interannual time scale, the temporal variations in ISWs were generally subtle. The monthly-to-annual variations of ISWs could be mostly explained by the variability in stratification, which could be modulated by the monsoons, the winds in equatorial Indian Ocean, and the mesoscale eddies in the Andaman Sea. From careful analyses preformed based on the long-term measurements, we argued that the observed ISWs were likely generated via internal tide release mechanism and their generation processes were obviously modulated by background circulations.
The value of weather and climate information to the Tanzanian disaster risk reduction sector using non-monetary approaches
Authors: Msemo Hellen E. , Taylor Andrea L. , Birch Cathryn E. , Dougill Andrew J. , Hartley Andrew
Published: October 2021

This paper investigates the value of weather and climate information at different timescales for decision making in the Tanzanian disaster risk reduction sector using non-monetary approaches. Interviews and surveys were conducted with institutions responsible for disaster management at national, regional and district level. A range of values were identified including: 1) making informed decisions for disaster preparedness, response, recovery and restoration related activities; 2) tailoring of directives and actions based on sectoral impacts; 3) identification of hotspot areas for diseases outbreaks and surplus food production. However, while, a number of guidelines, policies, acts and regulations for disaster risk reduction exist it is not clear how well they promote the use of weather and climate information across climate sensitive sectors. Nonetheless, we find that well-structured disaster risk reduction coordination across sectors and institutions from the national to district level exists, although there is a need for further development of integrated Early Warning Systems, and a common platform to evaluate effectiveness and usefulness of weather warnings and advisories. Key challenges to address in increasing the uptake of weather warnings and advisories include language barriers, limited dissemination to rural areas, and limited awareness of forecasts. Based on the findings of this study, we recommend further quantitative evaluation of the skill of the severe weather warnings issued by the Tanzania Meteorological Authority, and an assessment of how decisions and actions are made by recipients of the warnings in the disaster risk reduction sector at different stages in the warning, response and recovery process.
Forensic Aspects of Substance Use in Older Adults
Authors: Ghadigaonkar Deepak Shantaram , Kandasamy Arun , Sivakumar Palanimuthu Thangaraju
Published: October 2021

Older adults are at high risk of developing more severe consequences of substance use. Due to aging, they may also have multiple medical and psychiatric comorbidities as well as cognitive impairment. This may lead to forensic issues both in terms of civil and criminal matters. This article will review the forensic issues of substance use and their relevance to the older population in particular.
Risk Assessment and Post-Release Recidivism in a Sample of Juvenile Homicide Offenders
Authors: Hubbell James T. , Heide Kathleen M. , Khachatryan Norair
Published: October 2021

Given recent U.S. Supreme Court rulings regarding the constitutionality of juveniles who received mandated life sentences, questions have arisen in the field of criminology regarding how these offenders will adjust if someday released. Risk scores were calculated for 59 male juvenile homicide offenders (JHOs) based upon the eight domains in the Youth Level of Supervision/Case Management Inventory (YLS/CMI) and used to examine recidivism among the 48 JHOs who were released. Sample subjects were charged as adults for murder and attempted murder in the 1980s, convicted, and sentenced to adult prison. Chi-square analyses were used to assess the relationship between risk score category and two measures of recidivism, which were general arrests and violent offenses. Results indicated risk scores failed to predict both general and violent recidivism. Implications of the findings and directions for future research are discussed.
Rapid analysis of the effects of surface and sub-surface defects in elastohydrodynamic contacts
Authors: Hooke Chris J
Published: October 2021

Surface and sub-surface defects alter the stress distribution in the material and tend to significantly reduce the life of elastohydrodnamic (EHL) contacts. Where the defects lie well below the surface their effect may be obtained by taking the EHL pressures from standard analyses and using these to determine the stress distribution. However, defects lying closer to the surface can produce significant local displacements and alter the EHL pressures. Analysis is difficult because these displacements change as the defect passes under the conjunction and calculation tends to be extremely time consuming. This paper presents an extension to the perturbation technique used for the rapid analysis of surface roughness. This extension enables solutions for both two and three dimensional defects to be obtained rapidly. The procedure is outlined and a number of examples given.
Interpreters as Japanese War Criminals
Authors: Wilson Sandra
Published: October 2021

During the Second World War, the Japanese military recruited interpreters throughout Asia to assist in interrogating suspected insurgents and managing prison and internment camps. Many interpreters were tried for war crimes by Allied authorities after Japan's surrender. Sentences passed on those who were convicted were often higher than for other low-ranking personnel. Principally using British records, I argue that interpreters were punished because they participated in mistreatment of prisoners. Their punishments were disproportionately heavy because of their close association with the Japanese military police, and as a result of moral outrage by Western courts and Chinese populations in Southeast Asia.
Equality of Surgical Fee Schedule in Japan: A Retrospective Observational Study
Authors: Nakata Yoshinori , Watanabe Yuichi , Otake Hiroshi
Published: October 2021

The authors had previously demonstrated that the Japanese surgical fee schedule had been unequal among surgical specialties in spite of its biannual revisions. This study examined how the degree of inequality of the fee schedule changed by estimating Gini coefficients for efficiency scores computed from data envelopment analysis. All the surgeries at Teikyo University Hospital in 2013 to 2018 were candidates used for the analysis of efficiency and equality of fee schedule. Inputs were defined as (1) the number of assistants, and (2) the duration of operation. An output was defined as the surgical fee. Each surgeon’s efficiency score was calculated using data envelopment analysis. Using the medians of efficiency scores in each surgical specialty, the authors inferred Gini coefficients and their standard errors in each year and in each surgical fee schedule. The authors analyzed 16 307 surgical procedures during the study period of 2013 to 2018. There was no statistically significant difference in the Gini coefficients between the years and between the surgical fee schedules ( P > .05). It was demonstrated that the degree of inequality of the Japanese surgical fee schedule remained constant from 2013 through 2018.
Rien que des mots: Counteracting homophobic speech in European and U.S. law
Authors: Alkiviadou Natalie , Belavusau Uladzislau
Published: October 2021

Adopting a comparative perspective, this article examines legal means and practices of challenging homophobic speech in European and U.S. law. This exercise revolves around the study of major cases concerning homophobic speech from the law of the European Court of Human Rights and broader legal framework within the Council of Europe (the CoE), the Court of Justice of the European Union (EU) as well as the United States Supreme Court (along with a broader scrutiny of U.S. law in comparative perspective with European (CoE and EU law) in recent years. The article concludes that the concepts of (1) hate speech (in constitutional, administrative and criminal settings) (2) direct discrimination and (3) harassment (in labour and anti-discrimination law) will be central in the strategic litigation of LGBT organizations seeking to redress the climate of homophobia via various legal avenues in both Europe and the U.S. While in the settings of European law, all three concepts – depending on the context – can benefit victims of homophobia in their judicial redress, U.S. law offers coherent protection in its employment law framework, even though this remains in need of further strengthening.
Use of Chimney Technique Does Not Improve the Outcome of Endovascular Aneurysm Repair in Patients With a Hyperangulated and Short Proximal Aortic Neck
Authors: Özdemir-van Brunschot Denise Michelle Daniëlle , Torsello Giovanni Battista , Bernardini Giulia , Litterscheid Sarah , Torsello Giovanni Federico , Beropoulis Efthymios
Published: October 2021

Purpose:

We hypothesized that extending the proximal landing zone with the chimney technique could be beneficial in patients with a hyperangulated proximal aortic neck, defined as more > 60 degrees.

Material and Methods:

We retrospectively analyzed the outcome of prospectively collected data of patients treated by endovascular aneurysm repair (EVAR) for infrarenal aortic aneurysm with a hyperangulated proximal aortic neck. In all, 104 out of 130 patients were treated without (Group A) and 24 with the chimney endovascular aortic repair (ChEVAR, Group B). Primary outcome was technical and clinical success according to the reporting standards of the Society of Vascular Surgery.

Results:

The use of the chimney technique was associated with a significantly longer operation duration (167 vs. 93 min, p < .001), longer fluoroscopy time (44 vs.30 min, p = < .001), and larger amount of contrast medium used (149 vs. 127 ml, p = .03) but did not significantly improve technical (79.2% vs. 87.7%) and clinical success (54.2% vs. 68.9%). Aneurysm-related mortality was higher in group B (8.3% vs. = 0%, p < .001). Type IA endoleak was high in both groups at completion angiography (11.3% in Group A vs. 12.5% in Group B) and at follow-up (10.4% in Group A vs. 4.5% in Group B) without significant difference between the groups.

Conclusions:

Our data did not show a benefit of the primary use of the chimney technique in patients with a hyperangulated and short neck, although more studies are required to support this conclusion. Other strategies or new technologies are required for improving EVAR results in aneurysm patients with severe angulated proximal and short neck.
When non-salient information becomes salient in conversational memory: Collaboration shapes the effects of emotion and self-production
Authors: Le Bigot Ludovic , Bangoura Cléo , Knutsen Dominique , Gil Sandrine
Published: October 2021

People’s memory of what was said and who said what during dialogue plays a central role in mutual comprehension and subsequent adaptation. This article outlines that well-established effects in conversational memory such as the self-production and the emotional effects actually depend on the nature of the interaction. We specifically focus on the impact of the collaborative nature of the interaction, comparing participants’ conversational memory in non-collaborative and collaborative interactive settings involving interactions between two people (i.e., dialogue). The findings reveal that the amplitude of these conversational memory effects depends on the collaborative vs. non-collaborative nature of the interaction. The effects are attenuated when people have the opportunity to collaborate because information that remained non-salient in the non-collaborative condition (neutral and partner-produced words) became salient in the collaborative condition to a level similar to otherwise salient information (emotional and self-produced words). We highlight the importance of these findings in the study of dialogue and conversational memory.
Understanding violent extremism: Socio-demographic, criminal and psychopathological background characteristics of detainees residing in Dutch terrorism wings
Authors: Thijssen Gaby , Masthoff Erik , Sijtsema Jelle , Bogaerts Stefan
Published: October 2021

In the past decades, Europe has been shocked repeatedly by terrorist crimes. This has led to an influx of suspects and convicts of terrorism in the prison system. The aim of this study is to provide insight into socio-demographic, psychopathological and criminal background characteristics of convicted violent extremists. Retrospective analyses were conducted on primary source data from 82 convicts in Dutch prison terrorism wings. Results showed that violent extremists are a heterogeneous group regarding socio-demographic characteristics. About 60% of the population had previously been convicted of ordinary crimes and a third suffered from a mental disorder. To gain more insight into violent extremists, additional research is needed into motivational and other risk factors. The latter is a necessary step to improve the identification, risk assessment, and effective treatment of violent extremists.
Liver abnormalities in pulmonary arterial hypertension
Authors: Nickel Nils P. , Galura Gian M. , Zuckerman Marc J. , Hakim M. Nawar , Alkhateeb Haider , Mukherjee Debabrata , Austin Eric D. , Heresi Gustavo A.
Published: October 2021

Pulmonary arterial hypertension (PAH) is a cardiopulmonary disease with high mortality. In recent years, it has been recognized that PAH is a multi‐organ system disease, involving the systemic circulation, kidneys, skeletal muscles, and the central nervous system, among others. Right heart failure produces congestive hepatopathy, a disease state that has direct consequences on liver biochemistry, histology, and systemic glucose and lipid metabolism. This article aims to summarize the consequences of congestive hepatopathy with an emphasis on liver biochemistry, histology, and PAH‐targeted therapy. Furthermore, PAH‐specific changes in glucose and lipid metabolism will be discussed.
Five days of fever and myocardial inflammation
Authors: Coleman Keli D , Benz Paul , Parikh Nirzar S , Thomas Danny G , Segar David , Block Joseph , Schultz Megan L
Published: October 2021

Multisystem inflammatory syndrome in children is an emerging pediatric illness associated with severe acute respiratory syndrome coronavirus 2 infection. The syndrome is rare, and evidence-based guidelines are lacking. This report reviews a patient who presented for medical care multiple times early in the course of his illness, thus offering near-daily documentation of symptoms and laboratory abnormalities. The patient did not have thrombocytopenia, anemia, or myocardial inflammation until the fifth day of fever. These laboratory abnormalities coincided with the onset of rash, conjunctival injection, vomiting, and diarrhea: clinical signs that could serve as indicators for when to obtain blood tests. The timing of this patient’s onset of multisystem involvement suggests that testing for multisystem inflammatory syndrome in children after only 24 h of fever, as the Centers for Disease Control and Prevention recommends, may yield false-negative results. Testing for multisystem inflammatory syndrome in children after 4 days of fever may be more reliable.
Effect of Training With the Hybrid Assistive Limb on Gait Cycle Kinematics After Total Knee Arthroplasty
Authors: Fukaya Takashi , Mutsuzaki Hirotaka , Yoshikawa Kenichi , Koseki Kazunori , Iwai Koichi
Published: October 2021

Introduction

Reportedly, wearable robots, such as the hybrid assistive limb (HAL), are effective in the functional recovery of various locomotor disabilities, including disrupted walking, restricted range of motion, and muscle weakness. However, the effect of walking exercises with a HAL on the kinematic and kinetic variables of lower limb joint function is not yet fully understood. Therefore, the purpose of this study was to elucidate the effect of HAL on the kinematic and kinetic variables of lower limb function in patients 5 weeks after total knee arthroplasty (TKA).

Materials and Methods

Nine patients (ten knees) in the HAL training group and nine patients (nine knees) in the control group underwent TKA. HAL training was initiated 1–5 weeks after TKA, and general rehabilitation was performed in the control group. Gait analysis was performed on each patient using a motion analysis system at 5 weeks after TKA. We compared the effects of the joint angles of the walking cycle between groups, and investigated the effect of the walking cycle’s joint angles on step length.

Results

In the HAL group, the odds ratio of hip extension was as large as 1.741, while that of knee swing was as large as 1.501. These 2 variables were significant between the 2 groups. Knee swing and varus significantly affected step length.

Conclusions

Our results suggest that training by wearing HAL after TKA increased the mobility of the knee and hip joints during early postoperative walking, and that walking ability was improved by increasing the step length.
Anticoagulation targeting membrane-bound anionic phospholipids improves outcomes of traumatic brain injury in mice
Authors: Dong Xinlong , Liu Wei , Shen Yu , Houck Katie , Yang Mengchen , Zhou Yuan , Zhao Zilong , Wu Xiaoping , Blevins Teri , Koehne Amanda L. , Wun Tze-Chein , Fu Xiaoyun , Li Min , Zhang Jianning , Dong Jing-fei
Published: October 2021

Severe traumatic brain injury (TBI) often causes an acute systemic hypercoagulable state that rapidly develops into consumptive coagulopathy. We have recently demonstrated that TBI-induced coagulopathy (TBI-IC) is initiated and disseminated by brain-derived extracellular vesicles (BDEVs) and propagated by extracellular vesicles (EVs) from endothelial cells and platelets. Here, we present results from a study designed to test the hypothesis that anticoagulation targeting anionic phospholipid-expressing EVs prevents TBI-IC and improves the outcomes of mice subjected to severe TBI. We evaluated the effects of a fusion protein (ANV-6L15) for improving the outcomes of TBI in mouse models combined with in vitro experiments. ANV-6L15 combines the phosphatidylserine (PS)-binding annexin V (ANV) with a peptide anticoagulant modified to preferentially target extrinsic coagulation. We found that ANV-6L15 reduced intracranial hematoma by 70.2%, improved neurological function, and reduced death by 56.8% in mice subjected to fluid percussion injury at 1.9 atm. It protected the TBI mice by preventing vascular leakage, tissue edema, and the TBI-induced hypercoagulable state. We further showed that the extrinsic tenase complex was formed on the surfaces of circulating EVs, with the highest level found on BDEVs. The phospholipidomic analysis detected the highest levels of PS on BDEVs, as compared with EVs from endothelial cells and platelets (79.1, 15.2, and 3.5 nM/mg of protein, respectively). These findings demonstrate that TBI-IC results from a trauma-induced hypercoagulable state and may be treated by anticoagulation targeting on the anionic phospholipid-expressing membrane of EVs from the brain and other cells.
Association of blood trihalomethane concentrations with asthma in US adolescents: nationally representative cross-sectional study
Authors: Sun Yang , Xia Peng-Fei , Xie Jing , Mustieles Vicente , Zhang Yu , Wang Yi-Xin , Messerlian Carmen
Published: October 2021

Background

Population studies show that the use of swimming pools is associated with the risk of asthma and allergic diseases among children. Our objective was to explore the associations between blood trihalomethane (THM) concentrations and asthma among US adolescents, and assess to what extent the association is modified by active tobacco smoke exposure.

Methods

We included 2359 adolescents aged 12–19 years with measured blood concentrations of chloroform (trichloromethane (TCM)), bromodichloromethane (BDCM), dibromochloromethane (DBCM) and bromoform (tribromomethane (TBM)) from the National Health and Nutrition Examination Survey 2005–2012. Logistic regression models were fitted to assess the odds ratios for the association of blood THM concentrations (three or four categories) with the risk of self-reported current and ever (lifetime) asthma.

Results

Blood DBCM concentrations were associated with a higher risk of ever asthma among all adolescents (OR 1.54 (95% CI 1.07–2.21), comparing the extreme exposure categories). The relationship was stronger among adolescents exposed to tobacco smoke (OR 3.96 (95% CI 1.89–8.30), comparing the extreme exposure categories). We also found positive relationships between blood brominated THM concentrations (sum of BDCM, DBCM and TBM) and risk of ever asthma and between blood DBCM and brominated THM concentrations and risk of current asthma among adolescents with tobacco smoke exposure. The relative excess risk of ever asthma due to the interaction between high blood DBCM and brominated THM concentrations and tobacco smoke exposure was 1.87 (95% CI 0.30–3.43) and 0.78 (95% CI 0.07–1.49), respectively.

Conclusions

Exposure to THMs is associated with a higher risk of asthma in adolescents, particularly among those exposed to tobacco smoke.
Guide sheathversusnon-guide sheath method for endobronchial ultrasound-guided biopsy of peripheral pulmonary lesions: a multicentre randomised trial
Authors: Oki Masahide , Saka Hideo , Imabayashi Tatsuya , Himeji Daisuke , Nishii Yoichi , Nakashima Harunori , Minami Daisuke , Okachi Shotaro , Mizumori Yasuyuki , Ando Masahiko
Published: October 2021

Background

Guide sheaths (GSs) have been widely used during radial probe endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB) of peripheral pulmonary lesions. However, it remains unknown whether a GS enhances the diagnostic yield. We compared the diagnostic yields of small peripheral pulmonary lesions between rEBUS-TBB with and without a GS.

Methods

In eight institutions, patients with peripheral pulmonary lesions ≤30 mm in diameter were enrolled and randomised to undergo rEBUS-TBB with a GS (GS group) or without a GS (non-GS group) using a 4.0-mm thin bronchoscope, virtual bronchoscopic navigation and fluoroscopy. The primary end-point was the diagnostic yield of the histology specimens.

Results

A total of 605 patients were enrolled; ultimately, data on 596 (300 in the GS group and 296 in the non-GS group) with peripheral pulmonary lesions having a longest median diameter of 19.6 mm were analysed. The diagnostic yield of histological specimens from the GS group was significantly higher than that from the non-GS group (55.3%versus46.6%; p=0.033). Interactions were evident between the diagnostic yields, procedures, lobar locations (upper lobeversusother regions; p=0.003) and lesion texture (solidversuspart-solid nodules; p=0.072).

Conclusions

The diagnostic yield for small peripheral pulmonary lesions afforded by rEBUS-TBB using a GS was higher than that without a GS.
Nestin promotes pulmonary fibrosisviafacilitating recycling of TGF-β receptor I
Authors: Wang Jiancheng , Lai Xiaofan , Yao Senyu , Chen Hainan , Cai Jianye , Luo Yulong , Wang Yi , Qiu Yuan , Huang Yinong , Wei Xiaoyue , Wang Boyan , Lu Qiying , Guan Yuanjun , Wang Tao , Li Shiyue , Xiang Andy Peng
Published: October 2021

Background

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease that is characterised by aberrant proliferation of activated myofibroblasts and pathological remodelling of the extracellular matrix. Previous studies have revealed that the intermediate filament protein nestin plays key roles in tissue regeneration and wound healing in different organs. Whether nestin plays a critical role in the pathogenesis of IPF needs to be clarified.

Methods

Nestin expression in lung tissues from bleomycin-treated mice and IPF patients was determined. Transfection with nestin short hairpin RNA vectorsin vitrothat regulated transcription growth factor (TGF)-β/Smad signalling was conducted. Biotinylation assays to observe plasma membrane TβRI, TβRI endocytosis and TβRI recycling after nestin knockdown were performed. Adeno-associated virus serotype (AAV)6-mediated nestin knockdown was assessedin vivo.

Results

We found that nestin expression was increased in a murine pulmonary fibrosis model and IPF patients, and that the upregulated protein primarily localised in lung α-smooth muscle actin-positive myofibroblasts. Mechanistically, we determined that nestin knockdown inhibited TGF-β signalling by suppressing recycling of TβRI to the cell surface and that Rab11 was required for the ability of nestin to promote TβRI recycling.In vivo, we found that intratracheal administration of AAV6-mediated nestin knockdown significantly alleviated pulmonary fibrosis in multiple experimental mice models.

Conclusion

Our findings reveal a pro-fibrotic function of nestin partially through facilitating Rab11-dependent recycling of TβRI and shed new light on pulmonary fibrosis treatment.
COPD mortality and exacerbations in the placebo group of clinical trials over two decades: a systematic review and meta-regression
Authors: Andreas Stefan , Röver Christian , Heinz Judith , Taube Christian , Friede Tim
Published: October 2021

A decreasing trend in exacerbation rates has been observed in COPD. Because mortality is linked to exacerbations, it is of interest to investigate whether a similar time trend is also present in mortality rates.

We performed a systematic review of placebo groups in published randomised controlled trials. Mortality rate was modelled based on a Poisson distribution for the event counts. Adding information on mortality as well as on newly published studies on a previous database, we performed a meta-regression.

Among the 56 included studies representing 14 166 patients, an annual decrease in mortality rates of 6.1% (−0.6%, 12.6%) (p=0.073) was observed. Consistent results were obtained in subgroups as well as when adjusting for potential confounders. The correlation between exacerbation rate and mortality rate was positive but weak as well as insignificant.

In summary, analysis of randomised controlled trials in COPD patients showed a decrease in mortality in the placebo arms over the last two decades. This effect is comparable to the previously observed decrease in annual exacerbation rate. Albeit insignificant, our results suggest that care is needed in the design of new trials or when comparing results from trials published many years apart.
Methodological dualism considered as a heuristic paradigm for clinical psychiatry
Authors: Pernu Tuomas K.
Published: October 2021

Debates on dualism continue to plague psychiatry. I suggest that these debates are based on false dichotomies. According to metaphysical physicalism, reality is ultimately physical. Although this view excludes the idea of entities distinct from physical reality, it does not compel us to favour neural over psychological interventions. According to methodological dualism, both physical and mental interventions on the world can be deemed effective, and both perspectives can therefore be thought to be equally ‘real’.
Neuromuscular Disorders in the Intensive Care Unit
Authors: Birch Torrey Boland
Published: October 2021

PURPOSE OF REVIEW

This article discusses the pathophysiology, presentation, diagnosis, treatment, and prognosis of common neuromuscular disorders seen in the intensive care unit, including Guillain-Barré syndrome, myasthenia gravis, and intensive care unit–acquired weakness.

RECENT FINDINGS

Guillain-Barré syndrome can have an excellent prognosis if patients are diagnosed early, appropriately treated, and monitored for complications, including respiratory failure and dysautonomia. Intensive care unit–acquired weakness increases overall mortality in patients who are critically ill, and distinguishing between critical illness myopathy and critical illness polyneuropathy may have important prognostic implications.

Neuromuscular disorders are not rare in the intensive care unit setting, and precise identification and treatment of these conditions can greatly impact long-term outcomes.
Seizures, Status Epilepticus, and Continuous EEG in the Intensive Care Unit
Authors: Rosenthal Eric S.
Published: October 2021

PURPOSE OF REVIEW

This article discusses the evolving definitions of seizures and status epilepticus in the critical care environment and the role of critical care EEG in both diagnosing seizure activity and serving as a predictive biomarker of clinical trajectory.

RECENT FINDINGS

Initial screening EEG has been validated as a tool to predict which patients are at risk of future seizures. However, accepted definitions of seizures and nonconvulsive status epilepticus encourage a treatment trial when the diagnosis on EEG is indeterminate because of periodic or rhythmic patterns or uncertain clinical correlation. Similarly, recent data have demonstrated the diagnostic utility of intracranial EEG in increasing the yield of seizure detection. EEG has additionally been validated as a diagnostic biomarker of covert consciousness, a predictive biomarker of cerebral ischemia and impending neurologic deterioration, and a prognostic biomarker of coma recovery and status epilepticus resolution. A recent randomized trial concluded that patients allocated to continuous EEG had no difference in mortality than those undergoing intermittent EEG but could not demonstrate whether this lack of difference was because of studying heterogeneous conditions, examining a monitoring tool rather than a therapeutic approach, or examining an outcome measure (mortality) perhaps more strongly associated with early withdrawal of life-sustaining therapy than to a sustained response to pharmacotherapy.

Seizures and status epilepticus are events of synchronous hypermetabolic activity that are either discrete and intermittent or, alternatively, continuous. Seizures and status epilepticus represent the far end of a continuum of ictal-interictal patterns that include lateralized rhythmic delta activity and periodic discharges, which not only predict future seizures but may be further classified as status epilepticus on the basis of intracranial EEG monitoring or a diagnostic trial of antiseizure medication therapy. In particularly challenging cases, neuroimaging or multimodality neuromonitoring may be a useful adjunct documenting metabolic crisis. Specialized uses of EEG as a prognostic biomarker have emerged in traumatic brain injury for predicting language function and covert consciousness, cardiac arrest for predicting coma recovery, and subarachnoid hemorrhage for predicting neurologic deterioration due to delayed cerebral ischemia.
Toll signalling promotes blastema cell proliferation during cricket leg regeneration via insect macrophages
Authors: Bando Tetsuya , Okumura Misa , Bando Yuki , Hagiwara Marou , Hamada Yoshimasa , Ishimaru Yoshiyasu , Mito Taro , Kawaguchi Eri , Inoue Takeshi , Agata Kiyokazu , Noji Sumihare , Ohuchi Hideyo
Published: October 2021

Hemimetabolous insects, such as the two-spotted cricket Gryllus bimaculatus, can recover lost tissues, in contrast to the limited regenerative abilities of human tissues. Following cricket leg amputation, the wound surface is covered by the wound epidermis, and plasmatocytes, which are insect macrophages, accumulate in the wound region. Here, we studied the function of Toll-related molecules identified by comparative RNA sequencing during leg regeneration. Of the 11 Toll genes in the Gryllus genome, expression of Toll2-1, Toll2-2 and Toll2-5 was upregulated during regeneration. RNA interference (RNAi) of Toll, Toll2-1, Toll2-2, Toll2-3 or Toll2-4 produced regeneration defects in more than 50% of crickets. RNAi of Toll2-2 led to a decrease in the ratio of S- and M-phase cells, reduced expression of JAK/STAT signalling genes, and reduced accumulation of plasmatocytes in the blastema. Depletion of plasmatocytes in crickets using clodronate also produced regeneration defects, as well as fewer proliferating cells in the regenerating legs. Plasmatocyte depletion also downregulated the expression of Toll and JAK/STAT signalling genes in the regenerating legs. These results suggest that Spz-Toll-related signalling in plasmatocytes promotes leg regeneration through blastema cell proliferation by regulating the Upd-JAK/STAT signalling pathway.
Imaging characteristics of pathologically proven adrenal adenomas with myelolipomatous degeneration: correlation with clinical and pathologic features
Authors: Guccione Jeffrey , Soliman Moataz , Zhang Miao , Habra Mouhammed Amir , Collins Katrina , Zhao Jianping , Elsayes Khaled M
Published: October 2021

Objectives

Adrenal adenoma with myelolipomatous degeneration (AMD) is a rarely reported and often overlooked entity. The aim of this study is to improve understanding of these lesions by characterizing the imaging findings with pathologic and clinical correlation.

Methods

In the largest series to date, we report 11 nodules in 11 patients confirmed with a pathologic diagnosis of AMD. The available cross-sectional imaging and histopathologic features were reviewed by two radiologists and two pathologists, respectively. Clinical and laboratory data for each patient were obtained from the electronic medical records, when available.

Results

All 11 patients had a CT prior to resection or biopsy of the adrenal nodule, with five having received an adrenal mass protocol study. An MRI was available in three patients. The median size of the nodules on imaging was 4.5 cm (range 2.8–8.7) and all but one had macroscopic fat. The largest focus of macroscopic fat had a median size of 0.7 cm (range 0.2–1.6) and on average was 14.4% the size of the tumor, using greatest dimensions. Four (36.4%) patients had a diagnosis of Cushing syndrome prior to nodule resection.

Conclusions

Not all adrenal nodules with macroscopic fat on imaging are pure myelolipomas. An AMD should be considered, especially if the foci of fat are small and other features of an adenoma are present. Some may also be associated with Cushing syndrome.

Advances in knowledge:

Myelolipomatous degeneration within an adrenal adenoma has only rarely been previously reported with very few reports emphasizing the imaging features. There may be an association with cortisol hypersecretion and improved recognition of this entity could lead to changes in clinical management.
The radiologic roadmap for treatment of an acute appendicitis patient who tested positive for coronavirus disease 19
Authors: Arik Şeref Barbaros , Gunaydin Elif , Bİlgiç Celal İsmail , Güvenç İnanç
Published: October 2021

Objective:

In this study, we aimed to emphasize the role of radiological imaging in determining the treatment of a patient, who tested positive for COVID-19 and diagnosed with acute appendicitis during the pandemic.

Methods:

A 31-year-old patient presented to the emergency department due to abdominal pain. Ultrasound examination, thoracic and pelvic CT scan were performed.

Results:

Non-complicated appendicitis can be treated conservatively with antibiotics. Treatment can be maintained by starting with IV antibiotics and bridging therapy with oral antibiotics.

Conclusion:

This studysummarize how radiological follow-up can be used to decide on the suitability of the patient for appropriate medical treatment as an alternative to surgery in a patient, whose gold standard treatment is emergency surgical intervention, which is frequently encountered in the emergency department during the COVID-19 pandemic. Healthcare workers need to be protected to ensure the continuity of the health system. On the other hand, patients requiring emergency healthcare should also be provided with appropriate treatment. Healthcare professionals should choose the most appropriate treatment method, protecting themselves and their patients as much as possible.
The HES-code and the data protection during COVID-19 pandemic in Turkey
Authors: Cangil Sabah Mine
Published: October 2021

Mobile applications are a beneficial tool to fight the coronavirus. With the mobile tracing applications, it became easier to cut the chain of transmission of the virus and reduce the number of daily cases. Many countries developed their applications and made them available to their citizens. While using these applications, it is necessary to protect the fundamental rights and freedoms of the individual. This frequent processing of individuals' health data has created legal problems regarding the protection of personal data. The purpose of this paper is to present a study on the Turkish Covid-19 tracing application “Hayat Eve Sığar-HES” and the legal issues behind the application.
Slavery as national trauma in Richard Ford’s “everything could be worse”.
Authors: Peinado Abarrio Rubén
Published: October 2021

This article explores slavery as a national trauma in Richard Ford’s 2014 novella “Everything Could Be Worse.” First, slavery is conceptualized as trauma, emphasizing its role in the formation of contemporary Black identity in the United States. The categories of ‘postmemory’ (Marianne Hirsch), ‘phantom’ and ‘crypt’ (Nicolas Abraham and Maria Torok) are presented, as they facilitate the study of multigenerational oppression and the transmission of trauma. Then, a brief discussion of the race question in Ford’s fiction and nonfiction contextualizes the analysis of the novella. In “Everything Could Be Worse,” which resembles a ghost story as well as a session of psychoanalysis, the intergenerational effects of trauma affect the descendants of both victims and perpetrators of slavery. Finally, it is concluded that, despite certain shortcomings, Ford’s approach to racial difference is becoming increasingly sophisticated. Este artículo explora la esclavitud como trauma nacional en “Everything Could Be Worse” (2014), de Richard Ford. En primer lugar, se lleva a cabo la conceptualización de la esclavitud como trauma, prestando atención a su papel en la formación de la identidad negra estadounidense contemporánea. Las categorías de ‘posmemoria’ (Marianne Hirsch), ‘fantasma’ y ‘cripta’ (Nicolas Abraham y Maria Torok) se presentan para facilitar el estudio de la opresión multigeneracional y la trasmisión del trauma. A continuación, una breve discusión de la cuestión racial en la ficción y no ficción de Ford contextualiza el análisis de “Everything Could Be Worse.” En esta novela corta, los efectos del trauma intergeneracional se perciben en los descendientes tanto de las víctimas como de los perpetradores de la esclavitud. Por último, se concluye que, a pesar de ciertas limitaciones, resulta evidente la creciente sofisticación con la que Ford trata la diferencia racial.
Una puerta a la ocupación prerromana de A Coruña: El yacimiento de Príncipe 17.
Authors: Nión-Álvarez Samuel , Castro González Mª Guadalupe , Rivas Nódar Marco Antonio
Published: October 2021

La siguiente publicación tiene por objeto realizar una revisión de Príncipe 17 (A Coruña), solar excavado en el año 2007. A pesar de haber pasado desapercibido en su momento y de no contar con una estratigrafía particularmente esclarecedora, este yacimiento ofrece resultados transcendentales para la comprensión de las primeras fases de ocupación de la península de A Coruña. Se trata del primer contexto arqueológico publicado que parece determinar la existencia de una fase de ocupación anterior a la conquista de Roma dentro del ámbito de la ciudad vieja coruñesa. Esta afirmación supone tener que replantear las interpretaciones realizadas hasta el momento, y permite explorar nuevas hipótesis acerca de la evolución histórica de la ciudad herculina. En este sentido, se realizará una revisión del estado de la investigación en lo relativo a los orígenes del asentamiento romano de Brigantium, que nos permitirá entender cuáles son las posturas planteadas y qué nuevas vías de interpretación podemos explorar. Con estas perspectivas, se planteará un estudio material del yacimiento con dos objetivos bien definidos: por un lado, definir y situar su registro arqueológico en su tiempo y en su espacio; por el otro, explorar sus implicaciones dentro de los procesos sociales e históricos del enclave.
Olisipo (Lisbon, Portugal) and its place in the Roman trade.
Authors: Simões Filipe Victor Manuel
Published: October 2021

Although usually considered the most important city of Lusitania - after Augusta Emerita - and the main maritime harbour of the whole Atlantic peninsular façade, there remains a generalized absence of studies that highlight the role that Olisipo played in the most western of the Roman provinces’ economy and commercial relations. This work aims to address that absence, by focusing on the research on Olisipo, located at the Tagus estuary, during the period encompassing the Republic and the Principate, and based on the study of amphorae. The dataset resulting from the analysis of the amphorae from Lisbon discloses the existence of a vast network of commercial relations with the diverse areas of the Mediterranean throughout all of the considered chronology, thus revealing a cosmopolitan city, with an active and central role in the complex commercial exchanges of the West of Iberian Peninsula with the rest of the Roman Empire. These results underline Olisipo’s importance as a trading post in the Atlantic coast during the Roman period, a role that has been recognized long ago, allowing to draw in a more accurate way how the city’s economic history was shaped.
Delayed Use of the Recombinant Human IL-1 Receptor Antagonist Anakinra in Five COVID-19 Patients with Pulmonary Fibrosis and Persistent Hypoxaemia: A Preliminary Report
Authors: Nan Daniel , Abraira-Meriel Cristina , de la Roz-Fernandez Sandra , Maestre-Orozco Tamara , Hernandez Jose Luis , Fernandez-Ayala Marta
Published: October 2021

Coronavirus disease 2019 (COVID-19) is currently a major public health problem. The development of pulmonary fibrosis secondary to acute respiratory distress syndrome (ARDS) is one of the expected sequelae. In this case series, we describe five instances of the use of anakinra in late-phase COVID-19 pneumonia in hospitalized patients with pulmonary fibrosis and refractory respiratory failure fulfilling ARDS criteria. The study demonstrates that anakinra has promising efficacy and safety in late-phase COVID-19 infection in patients with ARDS and refractory hypoxaemia, and suggests its potential application as antifibrotic therapy in these patients.
Em torno - ruínas de uma cidade em eterna reconstrução
Authors: Sá Alexandre , Racy João Paulo Alvaro
Published: October 2021

Esse artigo pretende investigar as transformações atravessadas pela cidade do Rio de Janeiro durante processo de reforma urbanística preparatória para os Jogos Olímpicos (2016) e a Copa do Mundo (2014), estabelecendo possíveis relações de aproximação e distanciamento com a Reforma Pereira Passos, realizada entre 1902 e 1906. Destruições intencionais que  erigiram novos monumentos, consideravelmente questionáveis.
Mitodologia em Arte: afeto catalisador na criação cênico-pedagógica de Yriadobá
Authors: Lyra Luciana Rocha , Rolin Adriana
Published: October 2021

Este artigo é composto por duas epístolas sobre a criação da performance Yriadobá, parte da pesquisa de mestrado, defendida em 2019, na linha Arte, pensamento e performatividade (PPGArtes-UERJ). Urdido em escrita performativa, o texto debate o aspecto curativo da arte, acostando-se do conceito afeto catalisador, de Nise da Silveira.