bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine learning applied to ambulatory blood pressure monitoring: a new tool to diagnose autonomic failure?
Authors: Vallelonga Fabrizio , Sobrero G. , Merola A. , Valente M. , Giudici M. , Di Stefano C. , Milazzo V. , Burrello J. , Burrello A. , Veglio F. , Romagnolo A. , Maule S.
Published: February 2022

Background

Autonomic failure (AF) complicates Parkinson’s disease (PD) in one-third of cases, resulting in complex blood pressure (BP) abnormalities. While autonomic testing represents the diagnostic gold standard for AF, accessibility to this examination remains limited to a few tertiary referral centers.

Objective

The present study sought to investigate the accuracy of a machine learning algorithm applied to 24-h ambulatory BP monitoring (ABPM) as a tool to facilitate the diagnosis of AF in patients with PD.

Methods

Consecutive PD patients naïve to vasoactive medications underwent 24 h-ABPM and autonomic testing. The diagnostic accuracy of a Linear Discriminant Analysis (LDA) model exploiting ABPM parameters was compared to autonomic testing (as per a modified version of the Composite Autonomic Symptom Score not including the sudomotor score) in the diagnosis of AF.

Results

The study population consisted of n = 80 PD patients (33% female) with a mean age of 64 ± 10 years old and disease duration of 6.2 ± 4 years. The prevalence of AF at the autonomic testing was 36%. The LDA model showed 91.3% accuracy (98.0% specificity, 79.3% sensitivity) in predicting AF, significantly higher than any of the ABPM variables considered individually (hypotensive episodes = 82%; reverse dipping = 79%; awakening hypotension = 74%).

Conclusion

LDA model based on 24-h ABPM parameters can effectively predict AF, allowing greater accessibility to an accurate and easy to administer test for AF. Potential applications range from systematic AF screening to monitoring and treating blood pressure dysregulation caused by PD and other neurodegenerative disorders.
Comparison of peripheral refraction and higher-order aberrations between orthokeratology and multifocal soft contact lens designed with highly addition
Authors: Huang Yingying , Li Xue , Ding Chenglu , Chen Yunyun , Mao Xinjie , Chen Hao , Bao Jinhua
Published: February 2022

Purpose

To compare peripheral defocus, higher-order aberrations (HOAs), and contrast visual acuity (CVA) in myopic children wearing orthokeratology (OK) lenses and multifocal soft contact lenses (MSCLs) designed with highly addition.

Methods

This is a prospective, nonrandomized, controlled study. Subjects at 8 to 13 years of age with spherical equivalent refraction from − 1.00 to − 5.00 dioptres (D) were included in the OK group (n = 30) and MSCL group (n = 23). Relative peripheral corneal defocus (RPCD) and relative peripheral refraction (RPR) were measured before and after wearing lenses. HOAs including spherical aberration (SA), coma, trefoil, and total HOAs, and high (100%) and low (10%) CVA were compared between the groups. Axial length (AL) was measured before and after wearing the lenses for 1 year.

Results

After wearing the lenses, subjects in the MSCL group had RPCD and RPR values similar to the OK group at the paracentral (within 2 mm of the cornea or 20° of the retina, all p > 0.05) but larger than the OK group at the periphery (all p < 0.05). All HOAs increased after wearing the lenses except the trefoil in the MSCL group (all p < 0.05). HOAs increased more in the OK group (all p < 0.05). The 100% and 10% CVAs were worse in the MSCL group (p = 0.02 and p = 0.004). After 1 year, AL elongation was 0.37 mm (SD = 0.16) in the MSCL group and 0.28 mm (0.16) in the OK group (p = 0.06).

Conclusion

MSCL produced larger myopic defocus at the periphery, increased less HOAs and had worse CVA than OK lens. The high addition of this MSCL did not result in better myopia control efficacy

Trial registration

Chinese Clinical Trial Registry: ChiCTR1800018564. Registered 25 September 2018; retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=31376
Early elective versus elective sigmoid resection in diverticular disease: not only timing matters—a single institutional retrospective review of 133 patients
Authors: Vaghiri Sascha , Jagalla David Mario , Prassas Dimitrios , Knoefel Wolfram Trudo , Krieg Andreas
Published: February 2022

Purpose

The optimal timing of elective surgery in patients with the colonic diverticular disease remains controversial. We aimed to analyze the timing of sigmoidectomy in patients with diverticular disease and its influence on postoperative course with respect to the classification of diverticular disease (CDD).

Methods

Patients who underwent elective laparoscopic sigmoidectomy were retrospectively enrolled and subdivided into two groups based on the time interval between the last attack and surgery: group A, early elective (≤ 6 weeks), and group B, elective (> 6 weeks). Multivariate regression models were used to identify factors which predict conversion to laparotomy, postoperative course, and length of hospital stay.

Results

A total of 133 patients (group A (n = 88), group B (n = 45)) were included. Basic demographic data did not differ between groups except for a higher rate of diabetes in group B (p = 0.009). The conversion rate was significantly higher in group A in comparison to group B (group A vs. group B: n = 23 (26.1%) vs. n = 3 (6.7%), p = 0.007). Logistic regression analysis revealed the timing of surgery and CDD stage as significant predictors for intraoperative conversion. Moreover, the postoperative course was influenced by high age as well as intraoperative conversion and length of hospital stay by conversion, preoperative CRP levels, and elective surgery.

Conclusions

Both, timing of surgery and the disease stage, influence the conversion rates in laparoscopic sigmoidectomy for diverticular disease. Accordingly, patients with complicated acute or chronic sigmoid diverticulitis should be operated in the inflammation-free interval.
Explicit vs. implicit spatial processing in arrow vs. eye-gaze spatial congruency effects
Authors: Narganes-Pineda Cristina , Chica Ana B. , Lupiáñez Juan , Marotta Andrea
Published: February 2022

Arrows and gaze stimuli lead to opposite spatial congruency effects. While standard congruency effects are observed for arrows (faster responses for congruent conditions), responses are faster when eye-gaze stimuli are presented on the opposite side of the gazed-at location (incongruent trials), leading to a reversed congruency effect (RCE). Here, we explored the effects of implicit vs. explicit processing of arrows and eye-gaze direction. Participants were required to identify the direction (explicit task) or the colour (implicit task) of left or right looking/pointing gaze or arrows, presented to either the left or right of the fixation point. When participants responded to the direction of stimuli, standard congruency effects for arrows and RCE for eye-gaze stimuli were observed. However, when participants responded to the colour of stimuli, no congruency effects were observed. These results suggest that it is necessary to explicitly pay attention to the direction of eye-gaze and arrows for the congruency effect to occur. The same pattern of data was observed when participants responded either manually or verbally, demonstrating that manual motor components are not responsible for the results observed. These findings are not consistent with some hypotheses previously proposed to explain the RCE observed with eye-gaze stimuli and, therefore, call for an alternative plausible hypothesis.
PECARN Rule in diagnostic process of pediatric patients with minor head trauma in emergency department
Authors: Gambacorta Alessandro , Moro Marianna , Curatola Antonietta , Brancato Federica , Covino Marcello , Chiaretti Antonio , Gatto Antonio
Published: February 2022

This study aims to evaluate the efficacy of the PECARN Rule (PR) in reducing radiological investigations in children with mild traumatic head injury in comparison with current clinical practice. A retrospective study was performed in our hospital between July 2015 and June 2020. Data of all children < 18 years of age admitted to the emergency department (ED), within 24 h after a head trauma with GCS ≥ 14, were analyzed. PECARN Rule was retrospectively applied to all patients. In total, 3832 patients were enrolled, 2613 patients ≥ 2 years and 1219 < 2 years. In the group of children ≥ 2 years, 10 presented clinically important traumatic brain injury (ciTBI) and were hospitalized, 7/10 underwent neurosurgery, and 3/10 clinical observation in the pediatric ward for more than 48 h. In children < 2 years, only 3 patients presented ciTBI, 2 underwent neurosurgery and 1 hospitalized. Applying the PR, no patient with ciTBI would have been discharged without an accurate diagnosis and we would have avoided 139 CT scans in patients ≥ 2 years, and 23 in those < 2 years of age (29% less).

Conclusion: We demonstrated the safety and validity of the PR in our setting with 100% sensitivity in both age groups in identifying patients with ciTBI and theoretically in reducing performed CT scans by 29%. Therefore, in patients classified in the low-risk category, it is a duty not to expose the child to ionizing radiation.

What is Known:• CT is the gold standard to identify intracranial pathology in children with head injury but CT imaging of head-injured children expose them to higher carcinogenic risk.• PECARN Rules support doctors in identifying children with ciTBI in order to reduce exposure to ionizing radiation.

What is New:• We demonstrate the safety and validity of the PR with 100% sensitivity in both age groups in identifying patients with ciTBI.• In our setting, the application of PECARN Rule would theoretically have allowed us to reduce the CT scan by 29%.
TMB and BRAF mutation status are independent predictive factors in high-risk melanoma patients with adjuvant anti-PD-1 therapy
Authors: Eckardt Julia , Schroeder Christopher , Martus Peter , Armeanu-Ebinger Sorin , Kelemen Olga , Gschwind Axel , Bonzheim Irina , Eigentler Thomas , Amaral Teresa , Ossowski Stephan , Rieß Olaf , Flatz Lukas , Garbe Claus , Forschner Andrea
Published: February 2022

Background

High tumor mutational burden (TMB) is associated with a favorable outcome in metastatic melanoma patients treated with immune checkpoint inhibitors. However, data are limited in the adjuvant setting. As BRAF mutated patients have an alternative with targeted adjuvant therapy, it is important to identify predictive factors for relapse and recurrence-free survival (RFS) in patients receiving adjuvant anti-PD-1 antibodies.

Methods

We evaluated 165 melanoma patients who started adjuvant anti-PD-1 antibody therapy at our center between March 2018 and September 2019. The initial tumor stage was assessed at the beginning of therapy according to the 8th edition of the AJCC Cancer Staging Manual. Tumor and normal tissue of the high-risk stages IIIC/D/IV were sequenced using a 700 gene NGS panel.

Results

The tumor stages at the beginning of adjuvant anti-PD-1 therapy were as follows: N = 80 stage IIIA/B (48%), N = 85 stage IIIC/D/IV (52%). 72/165 patients (44%) suffered a relapse, 44/72 (61%) with only loco regional and 28/72 (39%) with distant metastases. Sequencing results were available from 83 to 85 patients with stage IIIC/D/IV. BRAF mutation status (HR 2.12, 95% CI 1.12–4.08; p = 0.022) and TMB (HR 7.11, 95% CI 2.19–23.11; p = 0.001) were significant and independent predictive factors for relapse-free survival (RFS).

Conclusion

BRAF mutation status and TMB were independent predictive factors for RFS. Patients with BRAF V600E/K mutation and TMB high had the best outcome. A classification based on BRAF mutation status and TMB is proposed to predict RFS in melanoma patients with adjuvant anti-PD-1 therapy.
Leaf-chewing herbivores affect preference and performance of a specialist root herbivore
Authors: Karssemeijer Peter N. , Winzen Laura , van Loon Joop J. A. , Dicke Marcel
Published: February 2022

Plants interact with a diversity of phytophagous insects above- and belowground. By inducing plant defence, one insect herbivore species can antagonize or facilitate other herbivore species feeding on the same plant, even when they are separated in space and time. Through systemic plant-mediated interactions, leaf-chewing herbivores may affect the preference and performance of root-feeding herbivores. We studied how six different leaf-chewing herbivore species ofBrassica oleraceaplants affected oviposition preference and larval performance of the root-feeding specialistDelia radicum. We expected that femaleD. radicumflies would oviposit where larval performance was highest, in accordance with the preference–performance hypothesis. We also assessed how the different leaf-chewing herbivore species affected defence-related gene expression in leaves and primary roots ofB. oleracea, both before and after infestation with the root herbivore. Our results show that leaf-chewing herbivores can negatively affect the performance of root-feedingD. radicumlarvae, although the effects were relatively weak. Surprisingly, we found that adultD. radicumfemales show a strong preference to oviposit on plants infested with a leaf-chewing herbivore. Defence-related genes in primary roots ofB. oleraceaplants were affected by the leaf-chewing herbivores, but these changes were largely overridden upon local induction byD. radicum. Infestation by leaf herbivores makes plants more attractive for oviposition byD. radicumfemales, while decreasing larval performance. Therefore, our findings challenge the preference–performance hypothesis in situations where other herbivore species are present.
The contribution of landscape features, climate and topography in shaping taxonomical and functional diversity of avian communities in a heterogeneous Alpine region
Authors: Anderle Matteo , Paniccia Chiara , Brambilla Mattia , Hilpold Andreas , Volani Stefania , Tasser Erich , Seeber Julia , Tappeiner Ulrike
Published: February 2022

Understanding the effects of landscape composition and configuration, climate, and topography on bird diversity is necessary to identify distribution drivers, potential impacts of land use changes, and future conservation strategies. We surveyed bird communities in a study area located in the Central Alps (Autonomous Province of South Tyrol, northeast Italy), by means of point counts and investigated taxonomic and functional diversity at two spatial scales along gradients of land use/land cover (LULC) intensity and elevation. We also explored how environmental variables influence bird traits and red-list categories. Models combining drivers of different types were highly supported, pointing towards synergetic effects of different types of environmental variables on bird communities. The model containing only LULC compositional variables was the most supported one among the single-group models: LULC composition plays a crucial role in shaping local biodiversity and hence bird communities, even across broad landscape gradients. Particularly relevant were wetlands, open habitats, agricultural mosaics made up of small habitat patches and settlements, ecotonal and structural elements in agricultural settings, and continuous forests. To conserve bird diversity in the Alps, planning and management practices promoting and maintaining small fields, structural elements, and a mosaic of different LULC types should be supported, while preserving continuous forests at the same time. Additionally, pastures, extensively used meadows, and wetlands are key to conservation. These strategies might mitigate the impacts of global change on bird diversity in the Alps and in other European mountain areas.
Comparison of health-care utilization and expenditures for minimally invasive vs. open colectomy for benign disease
Authors: Diaz Sarah E. , Lee Yongjin F. , Bastawrous Amir L. , Shih I.-Fan , Lee Shih-Hao , Li Yanli , Cleary Robert K.
Published: February 2022

Background

Adoption of minimally invasive approaches continues to increase, and there is a need to reassess outcomes and cost. We aimed to compare open versus minimally invasive colectomy short- and long-term health-care utilization and payer/patient expenditures for benign disease.

Methods

This is a retrospective analysis of IBM® MarketScan® Database patients who underwent left or right colectomy for benign disease between 2013 and 2018. Outcomes included total health-care expenditures, resource utilization, and direct workdays lost up to 365 days following colectomy. The open surgical approach (OS) was compared to minimally invasive colectomy (MIS) with subgroup analysis of laparoscopic (LS) and robotic (RS) approaches using inverse probability of treatment weighting.

Results

Of 10,439 patients, 2531 (24.3%) had open, 6826 (65.4%) had laparoscopic, and 1082 (10.3%) had robotic colectomy. MIS patients had shorter length of stay (LOS; mean difference, − 1.71, p < 0.001) and lower average total expenditures (mean difference, − $2378, p < 0.001) compared with open patients during the index hospitalization. At 1 year, MIS patients had lower readmission rates, and fewer mean emergency and outpatient department visits than open patients, translating into additional savings of $5759 and 2.22 fewer days missed from work for health-care visits over the 365-day post-discharge period. Within MIS, RS patients had shorter LOS (mean difference, − 0.60, p < 0.001) and lower conversion-to-open rates (odds ratio, 0.31 p < 0.001) during the index hospitalization, and lower hospital outpatient visits (mean difference, − 0.31, p = 0.001) at 365 days than LS.

Conclusion

MIS colectomy is associated with lower mean health-care expenditures and less resource utilization compared to the open approach for benign disease at index operation and 365-days post-discharge. Health-care expenditures for LS and RS are similar but shorter mean LOS and lower conversion-to-open surgery rates were observed at index operation for the RS approach.
Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for undifferentiated-type early gastric cancer meeting the expanded criteria: a systematic review and meta-analysis
Authors: Yang Hyo-Joon , Kim Jie-Hyun , Kim Na Won , Choi Il Ju
Published: February 2022

Background

There have been concerns over the long-term outcomes of endoscopic submucosal dissection (ESD) for undifferentiated-type early gastric cancer (UD EGC). We aimed to compare the long-term outcomes of ESD and surgery for patients with UD EGC.

Methods

We searched PubMed, Embase, and Cochrane Library databases through March 2021 to identify studies that compared the long-term outcomes of ESD and surgery for UD EGC meeting expanded criteria for curative resection. The risk of bias was assessed with the Cochrane tool for non-randomized studies. The risk ratio (RR) was estimated using a fixed-effect model.

Results

Overall, 1863 patients from five retrospective cohort studies, including 908 patients with propensity score matching (PSM), were eligible for meta-analysis. ESD was associated with inferior overall survival (OS) compared to surgery in the overall cohort (RR 2.11; 95% CI 1.26–3.55) but not in the PSM cohort (RR 1.18; 95% CI 0.60–2.32). In the PSM cohort, ESD had a lower disease-free survival (DFS) (RR 2.49; 95% CI 1.42–4.35) and higher recurrence (RR 12.61; 95% CI 3.43–46.37), gastric recurrence (RR 11.25; 95% CI 3.06–41.40), and extragastric recurrence (RR 4.23; 95% CI 0.47–37.93). Recurrence outcomes were similar between the overall and PSM cohorts. Disease-specific survival was not significantly different between the two groups in both the overall and PSM cohorts.

Conclusion

Although OS after curative ESD for UD EGC was not different from that after surgery in the PSM cohort, DFS and recurrence were inferior after ESD. Limitations included a lack of randomized trials. Further prospective studies comparing the long-term outcomes of ESD and surgery for UD EGC are needed (PROSPERO CRD 42021237097).
Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial
Authors: Yang Funa , Li Lijuan , Mi Yanzhi , Zou Limin , Chu Xiaofei , Sun Aiying , Sun Haibo , Liu Xianben , Xu Xiaoxia
Published: February 2022

Background

Perioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Limited reports, however, have focused on quantitative, detailed early activity plans for patients receiving minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in the recovery of bowel and physical functions for patients undergoing MIE.

Methods

In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2019 to February 2020 were selected and randomly assigned to an intervention group (IG) or a control group (CG). The participants in the IG received medical care based on the t-ECRP strategy during perioperative period, and participants in the CG received routine care. The recovery of bowel and physical functions, readiness for hospital discharge (RHD), and postoperative hospital stay were evaluated on the day of discharge.

Results

Two hundred and fifteen cases with esophageal cancer (EC) were enrolled and randomized to the IG (n = 107) or CG (n = 108). The mean age was 62.58 years (SD 9.07) and 71.16% were male. For EC, 53.49% were mid-location cancers and 79.07% were classified as pathological stage II and III cancers. There were no significant differences between the two groups in terms of demographic and clinical characteristics and baseline physical functions. Participants in the IG group presented significantly shorter lengths of time to first flatus (P < 0.001), first postoperative bowel movement (P = 0.024), and for up and go test (P < 0.001), and lower scores of frailty (P < 0.001). The analysis also showed that participants in the IG had higher scores of RHD and shorter lengths of postoperative stay than in the CG (P < 0.05).

Conclusions

The t-ECRP appears to improve bowel and physical function recovery, ameliorate RHD, and shorten postoperative hospital stay for patients undergoing MIE. Clinicians should consider prescribing quantitative, detailed, and individualized early activity plans for these patients.

Trial registration

ClinicalTrials.gov (Identifier: NCT01998230)
Amendment of the Japanese consensus guidelines for autoimmune pancreatitis, 2020
Authors: Okazaki Kazuichi , Kawa Shigeyuki , Kamisawa Terumi , Ikeura Tsukasa , Itoi Takao , Ito Tetsuhide , Inui Kazuo , Irisawa Atsushi , Uchida Kazushige , Ohara Hirotaka , Kubota Kensuke , Kodama Yuzo , Shimizu Kyoko , Tonozuka Ryosuke , Nakazawa Takahiro , Nishino Takayoshi , Notohara Kenji , Fujinaga Yasunari , Masamune Atsushi , Yamamoto Hiroshi , Watanabe Takayuki , Nishiyama Toshimasa , Kawano Mitsuhiro , Shiratori Keiko , Shimosegawa Tooru , Takeyama Yoshifumi ,   Members of the Research Committee for IgG4-related Disease supported by the Ministry of Health, Labour, Welfare of Japan, Japan Pancreas Society
Published: February 2022

In response to the latest knowledge and the amendment of the Japanese diagnostic criteria for autoimmune pancreatitis (AIP) in 2018, the Japanese consensus guidelines for managing AIP in 2013 were required to be revised. Three committees [the professional committee for developing clinical questions (CQs) and statements by Japanese specialists; the expert panelist committee for rating statements by the modified Delphi method; and the evaluating committee of moderators] were organized. Twenty specialists in AIP extracted the specific clinical statements from a total of 5218 articles (1963–2019) from a search in PubMed and the Cochrane Library. The professional committee made 14, 9, 5, and 11 CQs and statements for the current concept and diagnosis, extra-pancreatic lesions, differential diagnosis, and treatment, respectively. The expert panelists regarded the statements as valid after a two-round modified Delphi approach with individually rating these clinical statements, in which a clinical statement receiving a median score greater than 7 on a 9-point scale from the panel was regarded as valid. After evaluation by the moderators, the amendment of the Japanese consensus guidelines for AIP has been proposed in 2020.
Synthesis of N4-acetylated 3-methylcytidine phosphoramidites for RNA solid-phase synthesis
Authors: Moreno Sarah , Flemmich Laurin , Micura Ronald
Published: February 2022

The growing interest in 3-methylcytidine (m3C) originates from the recent discoveries of m3C modified tRNAs in humans as well as its intensively debated occurrence in mRNA. Moreover, m3C formation can be catalyzed by RNA without the assistance of proteins as has been demonstrated for a naturally occurring riboswitch fold using the methylated form of its cognate ligand as cofactor. Additionally, new RNA sequencing methods have been developed to detect this modification in transcriptome-wide manner. For all these reasons, an increasing demand for synthetic m3C containing oligoribonucleotides is emerging. Their chemical synthesis relies on RNA solid-phase synthesis using phosphoramidite building blocks. Here, we describe a facile synthetic path towards N4-acetylated 2′-O-TBDMS- and 2′-O-TOM m3C phosphoramidites to provide an optimal toolbox for solid-phase synthesis of m3C containing RNA.

Graphical abstract
Longitudinal effects of emotion awareness and regulation on mental health symptoms in adolescents with and without hearing loss
Authors: Eichengreen Adva , Broekhof Evelien , Tsou Yung-Ting , Rieffe Carolien
Published: February 2022

Emotion awareness (EA) and regulation (ER) are each known to associate with mental health symptoms, yet there is a paucity of longitudinal studies examining them jointly during adolescence. Furthermore, little is known about these skills and their relations in deaf and hard-of-hearing (DHH) adolescents, who are at risk for reduced emotion socialization and for more mental health symptoms. This longitudinal study examined the development and unique contributions of EA (emotion differentiation, emotion communication and bodily unawareness) and ER (approach, avoidance and worry/rumination) to internalizing and externalizing symptoms in adolescents with and without hearing loss. Using self- and parent's reports, we assessed 307 adolescents (age 9–15) three times over 18-month period. We found stability over time in development of EA and avoidance ER, increase in approach ER and decrease in worry/rumination. High levels and increases over time in two aspects of EA, emotion differentiation and communication, and in approach and avoidance ER were related to decreases in depressive symptoms. An increase in approach ER was also related to a decrease in anxiety symptoms. Yet, low levels or decreases in worry/rumination were related to decreased levels of depressive, anxiety and externalizing symptoms. Hearing loss did not moderate any of the variables or relations tested. Preliminary tests suggested heterogeneity within the DHH group according to educational placement, language abilities and parental education level. Overall, findings pointed at unique contributions of EA and ER to mental health development, suggesting that DHH adolescents, especially in mainstream schools, do not differ from their hearing peers in their emotion awareness and regulation.
Stakeholders’ perceptions of factors influencing climate change risk in a Central America hotspot
Authors: Feliciano Diana , Sobenes Alejandra
Published: February 2022

To identify adaptation priorities, countries aim to systematically assess their climate change risks, consistent with international agreements. National-scale risk assessment usually follows an expert-led procedure that aims to establish traction with existing policy processes. This may underrepresent important local or regional contexts, including where there are divergent socio-cultural factors or value systems that influence risk perception. These differences in interpretation are explored in detail for Guatemala, located in a climate change risk “hotspot” region, based upon semi-structured interviews with a wide range of stakeholders. Perceptions of factors affecting climate change risk are assessed between different types of stakeholders. Adaptive capacity and risk governance are considered, including the role of international aid to reduce climate change risk in developing countries. Non-profit, inter-municipal organisations of two or more municipalities, namedmancomunidades, are potentially a useful structure to build adaptive capacity through reflexive risk assessment.
Fluoroless left atrial access for radiofrequency and cryoballoon ablations using a novel radiofrequency transseptal wire
Authors: Demo Hany , Aranda Carla , Razminia Mansour
Published: February 2022

Purpose

Conventional catheter ablation for atrial fibrillation requires fluoroscopy, which has inherent risks of radiation exposure to patients and medical staff. Optimization of fluoroscopy parameters and use of three-dimensional electroanatomic mapping (EAM) and intracardiac echocardiography (ICE) have helped to reduce radiation exposure; however, despite growing evidence, there are still concerns about safety and added procedure time associated with fluoroless procedures, particularly in left-sided ablations, due to the potential risk of complications. Herein, we report our initial experience using a radiofrequency (RF) wire for completely fluoroless radiofrequency ablation (RFA) and cryoballoon ablation (CBA).

Methods

A retrospective analysis was conducted on ablation procedures for various cardiac arrhythmias performed non-fluoroscopically at two centers using the VersaCross RF wire transseptal system under EAM and ICE guidance.

Results

A total of 72 and 54 patients underwent RFA and CBA, respectively, successfully without any procedural complications. Transseptal access time for RFA was 14.5 ± 6.6 min from procedure start (including sheath and catheter placements ± right-sided ablation) or 2.8 ± 1.0 min from RF wire insertion into the femoral introducer. Transseptal access time for CBA was 19.2 ± 11.7 min from procedure start (including sheath and catheter placements ± right-sided ablation) or 3.5 ± 1.6 min from RF wire insertion into the femoral introducer. Average procedure time was 104.4 ± 38.0 min for RFA and 91.1 ± 22.1 min for CBA.

Conclusions

A RF wire can be used to achieve completely fluoroless transseptal puncture safely and effectively while improving procedural efficiency in both RFA and CBA.
Substituting Silver for Tellurium in Selenium–Tellurium Thin Films for Improving the Optical Characteristics
Authors: Abd-Elnaiem Alaa M. , Abdelraheem A. M. , Abdel-Rahim M. A. , Moustafa Samar
Published: February 2022

The effect of Ag content on the linear and nonlinear optical characteristics of thermal evaporated Se90−xTe10Agx thin films, 100 nm thick, (where x = 0, 2, 4, 6, and 8 at.%) has been examined. The optical measurements were reviewed in the wavelength range of 390–2500 nm based on the transmittance and reflectance data, and the amorphous state of the as-prepared thin film was confirmed by X-ray diffraction. The absorption coefficient, extinction coefficient, bandgap, optical density, optical conductivity, dissipation factor, and other optical properties were examined and discussed. For all of the samples, the extinction coefficient of Se90−xTe10Agx declines as the wavelength and Ag concentration rise, whereas the absorption coefficient increases linearly with incident photon energy. Furthermore, the optical bandgap and the width of localized states alter in the exact opposite direction, which is consistent with previously reported findings. The decrease in the optical band gap as Ag concentration increases could be attributable to an increase in the amount of disorder in the materials and the density of defect states. Other critical optoelectronic characteristics are also determined, and they are found to be influenced by the Ag ratio and photon wavelength. These materials may be ideal for optical memory applications due to their high absorption coefficient and compositional dependence of absorption.
Oil crystallization properties as an index for monitoring early stage curing of oil-based paints: DSC analysis on linseed oil systems
Authors: Pizzimenti Silvia , Saitta Francesca , Signorelli Marco , Tinè Maria Rosaria , Bonaduce Ilaria , Duce Celia , Fessas Dimitrios
Published: February 2022

In this work, we propose to follow the crystallization capability of oils in oil-based paints, during curing, as an indirect index of the matrix status in the early stages of paint film formation that usually are indicative and crucial to understand the process evolution. To proof the concept, the oil crystallization properties were investigated through DSC measurements on samples of both unpigmented linseed oil and two model paints, composed by lead white + linseed oil (LWLO) and ultramarine blue + linseed oil (UBLO), at different ageing time at room and oxygen-limiting conditions. The results indicate that the curing process strongly affects the oil’s ability of forming crystals in the paint layers, and the proposed experimental approach is rather suitable and sensitive enough to discriminate differences between the action of pigments and environmental conditions. On the other hand, despite the simplicity and the potentiality, this approach is limited at the early stages of paint curing offering an index of the overall matrix status and therefore must be intended as a complementary method that has to be integrated with other approaches if the aim is to explore in detail the chemical and physical aspects of the curing process.
Anti-kindling effect of Ginkgo biloba leaf extract and L-carnitine in the pentylenetetrazol model of epilepsy
Authors: Essawy Amina E. , El-Sayed Soad Ahmed , Tousson Ehab , Abd El-gawad Horeya S. , Alhasani Reem Hasaballah , Abd Elkader Heba-Tallah Abd Elrahim
Published: February 2022

Epilepsy is one of the most common serious brain disorders, affecting about 1% of the population all over the world.Ginkgo bilobaextract (GbE) and L-carnitine (LC) reportedly possess the antioxidative activity and neuroprotective potential. In this report, we investigated the possible protective and therapeutic effects of GbE and LC against pentylenetetrazol (PTZ)-induced epileptic seizures in rat hippocampus and hypothalamus. Adult male albino rats were equally divided into eight groups: control, GbE (100 mg/kg), LC (300 mg/kg), PTZ (40 mg/kg), protective groups (GbE + PTZ and LC + PTZ), and therapeutic groups (PTZ + GbE and PTZ + LC). The oxidative stress, antioxidant, and neurochemical parameters, viz., malondialdehyde (MDA), nitric oxide (NO), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), acetylcholine esterase (AchE), dopamine (DA), norepinephrine (NE), and serotonin (5-HT), in the hippocampal and hypothalamic regions have been evaluated. PTZ injection leads to an increase in the seizure score, the levels of MDA and NO, and to a decrease in the activity of GSH, SOD, CAT, and GPx. Besides, monoamine neurotransmitters, DA, NE, and 5-HT, were depleted in PTZ-kindled rats. Furthermore, PTZ administration caused a significant elevation in the activity of AchE. Hippocampal and hypothalamic sections from PTZ-treated animals were characterized by severe histopathological alterations and, intensely, increased the ezrin immunolabeled astrocytes. Pre- and post-treatment of PTZ rats with GbE and LC suppressed the kindling acquisition process and remarkably alleviated all the aforementioned PTZ-induced effects. GbE and LC have potent protective and therapeutic effects against PTZ-induced kindling seizures via the amelioration of oxidative/antioxidative imbalance, neuromodulatory, and antiepileptic actions.
Adolescents’ Continuum and Categorical Beliefs, Help-seeking Intentions, and Stigma Towards People Experiencing Depression or Schizophrenia
Authors: Fernandez Dominic K. , Deane Frank P. , Vella Stewart A.
Published: February 2022

The present study investigated the relationships between continuum and categorical beliefs, stigma, and help-seeking in response to vignettes depicting depression and schizophrenia. Participants were 193 adolescents aged 13-18 years. Results showed no relationships between continuum beliefs and stigma or help-seeking intentions for the depression vignette when controlling for other predictors. Stronger categorical beliefs were associated with greater social distance, and endorsement of dangerousness, avoidance, and fear. For the schizophrenia vignette, higher continuum beliefs predicted lower prognostic pessimism, social distance, and stigmatising attitudes. Surprisingly, continuum beliefs predicted greater intentions to not seek help. Categorical beliefs were associated with greater prognostic pessimism, social distance, and stigmatising attitudes. Future research is needed to explore the effect of continuum belief interventions on adolescent mental health stigma.
Soziale Lage, Muster in der Präventionsnutzung und kindliche Entwicklung – eine Clusteranalyse im Rahmen der Schuleingangsuntersuchung
Authors: Götz Simon , Kreffter Katharina , Weyers Simone
Published: February 2022

Hintergrund

Kinder aus Familien in benachteiligten sozialen Lagen nutzen Präventionsangebote seltener und haben häufiger Defizite in der Entwicklung als sozial besser gestellte Kinder. Vernetzte Unterstützung und Beratung in Form von Präventionsketten sollen dem entgegenwirken. Deren individuellen Nutzungsmuster sind bislang kaum untersucht.

Fragestellung

Die Studie untersucht, ob sich Muster der Präventionsnutzung beobachten lassen und ob diese mit der sozialen Lage und der kindlichen Entwicklung verknüpft sind.

Material und Methoden

Dies wurde anhand von Befragungsdaten zur Präventionsnutzung analysiert, die in der Schuleingangsuntersuchung bei 6480 Kindern erhoben wurden. Mit einer hierarchischen Clusteranalyse wurden zunächst Cluster ähnlicher Präventionsnutzung identifiziert. Mit Poisson-Regressionsanalysen („rate ratios“, 95 %-Konfidenzintervall) wurden Zusammenhänge zwischen den Clustern und ausgewählten Merkmalen der sozialen Lage sowie der Häufigkeit auffälliger Befunde (altersgemäße Entwicklung, Gewicht, Aufmerksamkeit, Körperkoordination, Verhalten) untersucht.

Ergebnisse

Es wurden drei Muster identifiziert: eines mit starker Nutzung (aktives Cluster), eines mit geringer Nutzung (passives Cluster) und eine Mischform mit Teilnahme an einer Kindergartenuntersuchung (KU) und mittlerer Präventionsnutzung (KU-Cluster). Das KU-Cluster hat den höchsten, das aktive Cluster den geringsten Anteil von Kindern in einer benachteiligten sozialen Lage. Im KU-Cluster und im passiven Cluster zeigen sich häufiger auffällige Befunde als im aktiven Cluster.

Schlussfolgerung

Im KU-Cluster zeigt sich eine höhere Nutzung von Präventionsangeboten als man im Hinblick auf die soziale Lage der Kinder erwarten würde. In kommunalen Präventionsketten könnte die KU daher eine Lotsenfunktion erfüllen.
Policy Feedback and Government Responsiveness in a Comparative Perspective
Authors: Busemeyer Marius R.
Published: February 2022

This paper focuses on the transferability of policy feedback and responsiveness theories. These theories have enjoyed a great deal of scholarly interest in the past years and are widely applied in different country contexts. However, this theory transfer tends to be more focused on the empirical challenges while neglecting the fact that it also involves normative implications about representative democracy. These implications, I argue, are strongly influenced by the real-world example of the United States, where the theories were originally developed. More specifically, I contend that bringing in theoretical approaches that are more influenced by European experiences such as neocorporatism and party difference theory affects the depiction of the role of interest groups and party government in policy feedback and responsiveness theories. I conclude by highlighting the contours of an empirical research agenda that might further elaborate on these issues.
Transforming environmental governance: critical action intellectuals and their praxis in the field
Authors: Ojha Hemant , Nightingale Andrea J. , Gonda Noémi , Muok Benard Oula , Eriksen Siri , Khatri Dil , Paudel Dinesh
Published: February 2022

Over the past decade, widespread concern has emerged over how environmental governance can be transformed to avoid impending catastrophes such as climate change, biodiversity loss, and livelihood insecurity. A variety of approaches have emerged, focusing on either politics, technological breakthrough, social movements, or macro-economic processes as the main drivers of change. In contrast, this paper presents theoretical insights about how systemic change in environmental governance can be triggered by critical and intellectually grounded social actors in specific contexts of environment and development. Conceptualising such actors as critical action intellectuals (CAI), we analyze how CAI emerge in specific socio-environmental contexts and contribute to systemic change in governance. CAI trigger transformative change by shifting policy discourse, generating alternative evidence, and challenging dominant policy assumptions, whilst aiming to empower marginalized groups. While CAI do not work in a vacuum, nor are the sole force in transformation, we nevertheless show that the praxis of CAI within fields of environmental governance has the potential to trigger transformation. We illustrate this through three cases of natural resource governance in Nepal, Nicaragua and Guatemala, and Kenya, where the authors themselves have engaged as CAI. We contribute to theorising the ‘how’ of transformation by showing the ways CAI praxis reshape fields of governance and catalyze transformation, distinct from, and at times complementary to, other dominant drivers such as social movements, macroeconomic processes or technological breakthroughs.
Numerical investigation of the clinched joint loadings considering the initial pre-strain in the joining area
Authors: Martin Sven , Bielak Christian R. , Bobbert Mathias , Tröster Thomas , Meschut Gerson
Published: February 2022

The components of a body in white consist of many individual thin-walled sheet metal parts, which usually are manufactured in deep-drawing processes. In general, the conditions in a deep-drawing process change due to changing tribology conditions, varying degrees of spring back, or scattering material properties in the sheet blanks, which affects the resulting pre-strain. Mechanical joining processes, especially clinching, are influenced by these process-related pre-strains. The final geometric shape of a clinched joint is affected to a significant level by the prior material deformation when joining with constant process parameters. That leads to a change in the stiffness and force transmission in the clinched joint due to the different geometric dimensions, such as interlock, neck thickness and bottom thickness, which directly affect the load bearing capacity. Here, the influence of the pre-straining in the deep drawing process on the force distribution in clinch points in an automotive assembly is investigated by finite-element models numerically. In further studies, the results are implemented in an optimization tool for designing clinched components. The methodology starts with a pre-straining of metal sheets. This step is followed by 2D rotationally symmetric forming simulations of the joining process. The resulting mesh of each forming simulation is rotated and 3D models are obtained. The clinched joint solid model with pre-strains is used further to determine the joint stiffnesses. With the simulation of the same test set-up with an equivalent point-connector model, the equivalent stiffness for each pre-strain combination is determined. Simulations are performed on a clinched component to assess the influence of pre-strain and sheet thinning on the clinched joint loadings by using the equivalent stiffnesses. The investigations clearly show that for the selected component, the loadings at the clinch points are dependent on the sheet thinning and the stiffnesses due to pre-strain. The magnitude of the influence varies depending on the quantity considered. For example, the shear force is more sensitive to the joint stiffness than to the sheet thinning.
Optimal pricing for electricity retailers based on data-driven consumers’ price-response
Authors: Pérez-Santalla Román , Carrión Miguel , Ruiz Carlos
Published: February 2022

In the present work, we tackle the problem of finding the optimal price tariff to be set by a risk-averse electric retailer participating in the pool and whose customers are price sensitive. We assume that the retailer has access to a sufficiently large smart-meter dataset from which it can statistically characterize the relationship between the tariff price and the demand load of its clients. Three different models are analyzed to predict the aggregated load as a function of the electricity prices and other parameters, as humidity or temperature. More specifically, we train linear regression (predictive) models to forecast the resulting demand load as a function of the retail price. Then, we will insert this model in a quadratic optimization problem which evaluates the optimal price to be offered. This optimization problem accounts for different sources of uncertainty including consumer’s response, pool prices and renewable source availability, and relies on a stochastic and risk-averse formulation. In particular, one important contribution of this work is to base the scenario generation and reduction procedure on the statistical properties of the resulting predictive model. This allows us to properly quantify (data-driven) not only the expected value but the level of uncertainty associated with the main problem parameters. Moreover, we consider both standard forward-based contracts and the recently introduced power purchase agreement contracts as risk-hedging tools for the retailer. The results are promising as profits are found for the retailer with highly competitive prices and some possible improvements are shown if richer datasets could be available in the future. A realistic case study and multiple sensitivity analyses have been performed to characterize the risk-aversion behavior of the retailer considering price-sensitive consumers. It has been assumed that the energy procurement of the retailer can be satisfied from the pool and different types of contracts. The obtained results reveal that the risk-aversion degree of the retailer strongly influences contracting decisions, whereas the price sensitiveness of consumers has a higher impact on the selling price offered.
A mesh morphing computational method for geometry optimization of assembled mechanical systems with flexible components
Authors: Calì Michele , Ambu Rita
Published: February 2022

In this paper an interactive computational methodology was developed assuming that shape and size optimization of flexible components can significantly improve energy absorption or storage ability in assembled systems with flexible components (AS-FC). A radial basis functions mesh morphing formulation in non-linear numerical finite element analysis, including contact problems and flow interaction, was adopted as optimal design method to optimize shape and size design parameters in AS-FC. Flexible components were assembled in finite element environment according to functional ISO-ASME tolerances specification; non-linear structural analysis with flow interaction analysis was performed. The results of the study showed that the proposed method allows to optimize the shape and size of the flexible components in AS-FC maximizing the system's ability to absorb or store energy. The potentiality of the method and its forecasting capability were discussed for the case study of an automotive crash shock in which the specific energy absorption was increased by over 40%. The case studied refers to a simple flexible component geometry, but the method could be extended to systems with more complex geometries.