bluuebunny/crossref_metadata_2025 huggingface dataset:
High resolution measurements of the epi- and mesopelagic ocean by a profiling vehicle equipped with environmental sensors and a broadband echosounder
Authors: Grassian Benjamin D. , Roman Chris , Warren Joseph , Casagrande David
Published: May 2022

Collecting detailed surveys of the physical and biological heterogeneity in the epi and mesopelagic ocean is critical to describe the ecosystems within these vast and three-dimensional habitats. Common ocean sampling platforms (e.g., net systems, moored and shipboard sensors) are often unable to resolve marine biota at scales comparable to the variability existing in their physical environment. We have integrated a dual-frequency split-beam echosounder (Simrad EK80 with 70 and 200 kHz transducers) into the Wire Flyer profiling vehicle to achieve concurrent hydrographic and acoustic sections in environments between 0 and 1000 m. The Wire Flyer provides high-resolution repeat profiling (0–2.5 m/s vertical velocity, ∼1 km horizontal repeats) within specified water column depth bands typically spanning 300–400 m. This system can provide acoustic backscatter data at depths unavailable to shipboard surveys and can be operated in tandem with shipboard echosounders to provide overlapping acoustic coverage with concurrent hydrographic sections near the surface. The side-looking transducer orientation samples orthogonal to the vehicle's profiling survey path provide a direct measurement of horizontal heterogeneity. The collected data have proven the system’s capacity to resolve migrating layers, biological patches, and single targets in the horizontal, rising gas plumes, and scattering layer distributions tightly coupled to submesoscale environmental features.
Investigation of wavefield boundary interactions in a prototypical littoral zone
Authors: Swearingen Michelle E. , Taylor Oliver-Denzil , Costley Richard D. , Lester Alanna , Stehno Abigail , White Michael J. , Woodley Christa , Urbanczyk Aaron , McKenna Mihan
Published: May 2022

Signals in a littoral environment may be generated and received in any of the three media present: land, air, and water. Interpretation of signals that have crossed media boundaries is challenging, as the preponderance of research has treated media boundaries as lossy reflectors rather than poor transmitters. Full wavefield characterization of broadband pressure signals coupled to the land/soil, air, or water (LAW) is critical to interpreting those signals that have passed through media boundaries. However, there is only a basic understanding of how waves transform as they cross subsurface inhomogeneities and boundaries. This presentation begins with an overview of the new multi-disciplinary effort currently underway at the US Army Engineer Research and Development Center to investigate the wavefield and boundary interactions in a littoral zone environment. The experiment is designed to measure wave transmission across mixed media boundaries in a controlled, constructed, prototype littoral zone. An overview of the design and construction of the test site is provided. The preliminary experimental results are presented and discussed. [Approved for public release: distribution is unlimited.]
Real-World Financial and Clinical Impact of Diagnostic-Driven and Empirical-Treatment Strategies in High-Risk Immunocompromised Patients with Suspected Aspergillus Infection in the United Kingdom
Authors: Earnshaw Stephanie R. , McDade Cheryl , Bryan Andrew , Ines Monica , Micallef Christianne , Sung Anita , Enoch David A.
Published: May 2022

Patients at risk of invasive fungal infections (IFIs), such as
Aspergillus
spp., tend to be immunocompromised and usually take several medications which may generate many side effects. Prescribing is further complicated by comorbidities, drug interactions and challenges accessing diagnostics.
The influence of glacial isostatic adjustment on continental shelf stratigraphic correlation
Authors: King Meghan E. , Creveling Jessica R.
Published: May 2022

Glacial isostatic adjustment (GIA) imparts geographic variability in the amplitude and timing of local sea-level (LSL) change arising from glacial-interglacial oscillations relative to a global mean signal (eustasy). We modeled how GIA manifests in the stratigraphic record across four shelf-perpendicular transects moving progressively more distal to the Quaternary North American ice complex, subject to varying amounts of GIA during glacial-interglacial cycles. Along each transect, we obtained LSL histories for nine sites between 1 m and 250 m water depth from the output of a gravitationally self-consistent GIA model run from marine oxygen isotope stage (MIS) 11 to the present. We paired each site's unique LSL history with 50 identical annual sedimentation models to create a library of 400-k.y.-duration synthetic stratigraphic columns (each assuming no tectonics). Comparison of the suite of synthetic stratigraphic columns between transects for a given bathymetric depth reveals latitudinal differences in the stratigraphically determined number, magnitude, and age of glacial-interglacial cycles, as inferred from stratigraphic sequence count, apparent water-depth change, and age of preserved deglacial transgression. We conclude that, for many field locales, extraction of primary information about the number, scale, and duration of pre-Cenozoic glacial-interglacial cycles from continental shelf stratigraphic records near ice sheets demands a deconvolution of the GIA signal.
867 Prognostic accuracy of triage tools for adults with suspected COVID-19 in a pre-hospital setting: an observational cohort study
Authors: Marincowitz Carl , Sutton Laura , Stone Tony , Campbell Richard , Pilberry Richard , Thomas Benjamin , Goodacre Steve
Published: May 2022

Aims/Objectives/Background

Emergency Medical Service (EMS) and other practitioners assessing patients with suspected COVID-19 in the community must rapidly determine whether patients need treatment in hospital or can self-care. Tools to triage patient acuity have only been validated in hospital populations.

We aimed to estimate the accuracy of five risk-stratification tools recommended to predict severe illness and compare accuracy to existing clinical decision-making in a pre-hospital setting.

Methods/Design

An observational cohort study using linked ambulance service data for patients assessed by EMS crews in the Yorkshire and Humber region of England between 18th March 2020 and 29th June 2020 was conducted to assess performance of the PRIEST tool, NEWS2, the WHO algorithm, CRB-65 and PMEWS in patients with suspected COVID-19 infection. The primary outcome was death or need for organ support.

Abstract 867 Table 1

Triage tool diagnostic accuracy statistics (95% CI) for predicting any adverse outcome

ToolN*C-statisticThresholdProportion with scoreSensitivitySpecificityPPVNPVCRB-6574700.79
(0.78, 0.80)>00.540.89
(0.88, 0.89)0.54
(0.53, 0.54)0.29 (0.29, 0.30)0.96 (0.95, 0.96)NEWS274350.80
(0.78, 0.81)>10.750.96
(0.96, 0.96)0.30
(0.29, 0.30)0.23 (0.22, 0.23)0.97 (0.97, 0.97)PMEWS74600.81
(0.80, 0.83)>20.720.98
(0.97, 0.98)0.34
(0.33, 0.34)0.24 (0.24, 0.24)0.99 (0.98, 0.99)PRIEST74700.83
(0.82, 0.84)>40.660.97
(0.97, 0.97)0.41
(0.40, 0.41)0.26 (0.25, 0.26)0.98 (0.98, 0.99)WHO74700.64
(0.64, 0.65)>00.740.98
(0.97, 0.98)0.31
(0.30, 0.31)0.23 (0.23, 0.24)0.98
(0.98, 0.99)

*Totals rounded to nearest 5

Abstract 867 Figure 1

ROC curves showing triage tool performance for predicting any adverse outcome

Results/Conclusions

Of 7550 patients in our cohort, 17.6% (95% CI:16.8% to 18.5%) experienced the primary outcome. The NEWS2, PMEWS, PRIEST tool and WHO algorithm identified patients at risk of adverse outcomes with a high sensitivity (>0.95) and specificity ranging between 0.3 (NEWS2) and 0.41 (PRIEST tool). The high sensitivity of NEWS2 and PMEWS was achieved by using lower thresholds than previously recommended (NEWS2; 0–1 vs 2+ and PMEWS; 0–2 vs 3+).

On index (first) assessment, 65% of patients were transported to hospital and EMS decision to transfer patients achieved a sensitivity of 0.84 (95% CI 0.83 to 0.85) and specificity of 0.39 (95% CI 0.39 to 0.40) to the primary outcome. This does not account for clinical reasons not to convey patients to hospital who subsequently deteriorated.

Use of NEWS2, PMEWS, PRIEST tool and WHO algorithm could therefore potentially improve EMS triage of patients with suspected COVID-19 infection. Use of the PRIEST tool could significantly increase the sensitivity of triage without increasing the number of patients conveyed to hospital.
Initial antihypertensive agent effects on acute blood pressure after intracerebral haemorrhage
Authors: Ng Yisi , Qi Wenjing , King Nicolas Kon Kam , Christianson Thomas , Krishnamoorthy Vijay , Shah Shreyansh , Divani Afshin , Bettin Margaret , Coleman Elisheva R , Flaherty Matthew L , Walsh Kyle B , Testai Fernando D , McCauley Jacob L , Gilkerson Lee A , Langefeld Carl D , Behymer Tyler Paul , Woo Daniel , James Michael L
Published: May 2022

Introduction

Current guidelines recommend blood pressure (BP) lowering in patients after acute intracerebral haemorrhage (ICH) without guidance on initial choice of antihypertensive class. This study sought to determine if initial antihypertensive class differentially effects acute BP lowering in a large multiethnic ICH cohort.

Methods

Subjects enrolled in the Ethnic/Racial Variations in ICH study between August 2010 and August 2017 with elevated admission BP and who received labetalol, nicardipine or hydralazine monotherapy as initial antihypertensive were analysed. Primary outcomes were systolic and diastolic BP changes from baseline to first BP measurement after initial antihypertensive treatment. Secondary outcomes included haematoma expansion (HE), hospital length of stay (LOS) and modified Rankin Score (mRS) up to 12 months after ICH. Exploratory outcomes assessed effects of race/ethnicity. Linear and logistic regression analyses, adjusted for relevant covariates, were performed to determine associations of antihypertensive class with outcomes.

Results

In total, 1156 cases were used in analyses. Antihypertensive class was associated with diastolic BP change (p=0.003), but not systolic BP change (p=0.419). Initial dosing with nicardipine lowered acute diastolic BP than labetalol (least square mean difference (labetalol-nicardipine)=5.47 (2.37, 8.57), p<0.001). Initial antihypertensive class was also found to be associated with LOS (p=0.028), but not with HE (p=0.406), mortality (p=0.118), discharge disposition (p=0.083) or mRS score at discharge, 3, 6 and 12 months follow-up (p=0.262, 0.276, 0.152 and 0.36, respectively). Race/ethnicity variably affected multivariable models.

Conclusion

In this large acute ICH cohort, initial antihypertensive class was associated with acute diastolic, but not systolic, BP-lowering suggesting differential effects of antihypertensive agents.

Trial registration number

NCT01202864.
Simulations of isotropic turbulent flows using lattice Boltzmann method with different forcing functions
Authors: Kareem Waleed Abdel , Asker Zafer M.
Published: May 2022

Three different forcing functions are used with the lattice Boltzmann method (LBM) to simulate the forced isotropic turbulence in periodic boxes at different resolutions ranging from [Formula: see text] to [Formula: see text] grid points using the D3Q19 model. The aims of this study are to examine the effect of using different forcing functions on the LBM stability; to track the development of the turbulent fields at several resolutions, to investigate the effect of the weak compressibility due to change of fluid density on the flow simulations, and to identify the effective force type. The injection is performed through adding the force randomly to the collision term. The three forcing methods depend on sine and cosine as functions of the wave numbers and space. The forcing amplitude values of [Formula: see text] and the relaxation time [Formula: see text] are fixed in all cases. The single relaxation time model is found stable at such values of the forcing amplitude and the relaxation time. However, the development of the turbulent data at the different resolutions needs about 10000 time-steps to reach the required statistical state including clear visualizations of fine scale vortices. Many simulations have been tested using different values of the relaxation time [Formula: see text] and the development of the turbulent fields is found faster with fewer time-steps but the stability of the LBM is broken at some resolutions (not necessary the higher resolution). The statistical features of all fields, such as the Taylor and the Kolmogorov micro-scales, the Taylor Reynolds number, the flatness and the skewness, are calculated and compared with the previous efforts. The worm-like vortices are visualized at all cases and it is found that more fine vortices can be extracted as the resolution increases. The energy spectrum has a reasonable Kolmogorov power law at the resolutions of [Formula: see text] and [Formula: see text], respectively. Results show that the third forcing method that uses a cosine disturbance function has the best statistical features and the finest visualized vortical structures especially at higher resolutions. Extensive discussions about the density field and its evolution with time at different forcing functions, comparison to Navier–Stokes solutions and the time development of the energy spectra for all cases are also carried out.
Online Monitoring of Ecoenvironmental Pollution Data in Internet Environment
Authors: Han Bo
Published: May 2022

In view of the problems of poor air quality and serious soil pollution in the current ecological environment, an online monitoring of ecological environment pollution data in the Internet environment is proposed. The concentration of pollution sources that may appear in the atmospheric environment is analyzed through the analysis coefficient of ecological environment pollutants, and the specific grade data corresponding to the air quality index is determined. Observation and mapping are carried out for the area to be monitored, and then, the monitoring points are determined, the monitoring equipment is arranged, and the soil profile of the area is sampled in the monitoring area. The self-organizing neural network model is used to conduct spatial cluster analysis on the pollution of ecological environment pollution areas, evaluate the sensitivity of soil pollution, and build a land ecological pollution monitoring information model. Based on the Internet of Things technology and the comprehensive use of GPS, sensors, and other technologies and equipment, the framework of monitoring technology is constructed, and the online monitoring of ecological environment pollution data is completed. The experimental results show that the proposed method has high data accuracy in different locations and different seasons, which is consistent with the actual situation; because of the maturity of the Internet of Things technology, compared with the literature method, the method in this paper can provide a cost-effective data foundation, which is more cost-effective, and save time and energy.
Orientin Enhances Colistin-Mediated Bacterial Lethality through Oxidative Stress Involvement
Authors: Khumbulani Madonsela , Alayande Kazeem Adekunle , Sabiu Saheed
Published: May 2022

Bacterial resistance to colistin has prompted the search for alternative strategies to enhance antibacterial potential. Combination therapy remains one of the viable strategies in antibacterial therapy and has been proven to be effective in reducing the risk of resistance. In this study, the potential of orientin for enhancing the antibacterial activity of colistin was assessed against Klebsiella pneumoniae and Pseudomonas aeruginosa in vitro. The involvement of oxidative stress in such enhancement was also assessed. The minimum inhibitory concentrations (MICs) of colistin and orientin were 16 μg/mL and 64 μg/mL against K. pneumoniae and 64 μg/mL and 256 μg/mL against P. aeruginosa respectively. For the combination therapy, orientin potentiates the antibacterial effect of colistin with a friction inhibitory concentration index (FICI) of 0.37 and 0.31 against K. pneumoniae and P. aeruginosa, respectively. This observation suggests a synergistic interaction, with the MIC of colistin being reduced by 3- and 4-fold in the presence of orientin against K. pneumoniae and P. aeruginosa, respectively. Additionally, treatment with the combination of colistin and orientin induced oxidative stress against both organisms through increased cellular levels of superoxide anion radicals with concomitant increase in NAD+/NADH and ADP/ATP ratios. These findings suggest that orientin enhanced colistin in the killing of the test bacteria and the cotreatment of colistin and orientin induced oxidative stress, through reactive oxygen species generation, which consequently facilitated bacterial lethality without causing drug-drug interactions. Although, the data presented in this study has supported the capability of orientin for strengthening antibacterial activity of colistin toward the fight against drug-resistant Gram-negative bacteria, studies focusing on the exact target and mechanism of action of orientin are underway.
Gas Expansion Three Days after Pars Plana Vitrectomy with Sulfur Hexafluoride 20% Tamponade following Carbon Monoxide Toxicity and Oxygen Therapy
Authors: Abrishami Mojtaba , Shariati Mehrdad Motamed , Bolouki Ali , Zamani Ghodsieh
Published: May 2022

Purpose. To report an unusual case of gas expansion following oxygen therapy in a patient with sulfur hexafluoride (SF6) 20% tamponade after pars plana vitrectomy. Case Report. A 40-year-old man came to the clinic with severe ocular pain and redness and also vision decrease in his left eye three days after uncomplicated 23-gauge pars plana vitrectomy, internal limiting membrane peeling combined with phacoemulsification, and using 20% SF6 injection as a tamponade agent due to significant cataract and a full-thickness macular hole. In ophthalmic examinations of his left eye, high intraocular pressure (approximately 70 mmHg), a flat anterior chamber, and a gas-filled vitreous cavity were found. The patient had been hospitalized the day before due to carbon monoxide poisoning and had undergone oxygen therapy with a pure 100% mask for three hours. Conclusion. It seems that oxygen therapy or carbon monoxide poisoning increases the volume of gas in the patient’s vitreous cavity and the nonexpansile percentage of SF6 expands.
Sports Action Recognition and Analysis Relying on Inertial Sensors
Authors: Liu Yutong , Zhou Zunliang , Qian Xiaolong , Chen Jiaming
Published: May 2022

The process of sports action recognition involves not only the change of motion speed but also the change of motion attitude, so it is necessary to carry out coordinate system transformation and attitude behavior recognition in combination with the actual situation, and inertial sensors play an important role in this process. Moreover, this paper combines inertial sensors to construct a sports action recognition and analysis system. In addition, based on the STA/LTA-AIC vibration wave picking method, an improved STA/LTA-AIC method based on wavelet packet decomposition is proposed to automatically identify the first arrival of vibration waves. Through the experimental research, it can be seen that the sports action recognition system based on an inertial sensor proposed in this paper has a good performance in sports action feature recognition.
The Efficacy of Pulsed Electromagnetic Fields on Pain, Stiffness, and Physical Function in Osteoarthritis: A Systematic Review and Meta-Analysis
Authors: Tong Jie , Chen Zhengyu , Sun Guanghua , Zhou Jun , Zeng Ye , Zhong Peirui , Deng Chengyuan , Chen Xiaocui , Liu Liu , Wang Shiyong , Chen Jiaqian , Liao Ying
Published: May 2022

Background. Although there are many pharmacological interventions for adults with osteoarthritis (OA) who do not meet the indications for surgery, side effects and adverse effects cannot be ignored. Physical interventions are known for their effectiveness and safety, and pulsed electromagnetic fields (PEMFs) have already been applied to skeletal diseases such as osteoporosis. Objective. In this systematic review and meta-analysis, we aimed to assess the efficacy of PEMF on the major symptoms of patients with OA compared with efficacy of other interventions. Methods. Randomized controlled trials (RCTs) investigating OA patients treated with PEMF and with pain, stiffness, and physical function impairment since 2009 were included. The Visual Analog Scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were used for assessment. All extracted data were analyzed using RevMan V.5.3. Results. Eleven RCTs consisting of 614 patients were enrolled in this meta-analysis, of which 10 trials comprised knee OA and one comprised hand OA. Compared with the control groups, the PEMF treatment yielded a more favorable output. PEMF alleviated pain (standardized mean differences [SMD] = 0.71, 95% confidence interval [CI]: 0.08–1.34, p = 0.03), improved stiffness (SMD = 1.34, 95% CI: 0.45–2.23,

p
=
0.003

), and restored physical function (SMD = 1.52, 95% CI: 0.49–2.55,

p
=
0.004

). Conclusions. PEMF therapy ameliorates OA symptoms such as pain, stiffness, and physical function in patients compared to other conservative treatments. There is an urgent need to search for different types of OA in multiple locations.
The Cell Type–Specific 5hmC Landscape and Dynamics of Healthy Human Hematopoiesis and TET2-Mutant Preleukemia
Authors: Nakauchi Yusuke , Azizi Armon , Thomas Daniel , Corces M. Ryan , Reinisch Andreas , Sharma Rajiv , Cruz Hernandez David , Köhnke Thomas , Karigane Daiki , Fan Amy , Martinez-Krams Daniel , Stafford Melissa , Kaur Satinder , Dutta Ritika , Phan Paul , Ediriwickrema Asiri , McCarthy Erin , Ning Yuhong , Phillips Tierney , Ellison Christopher K. , Guler Gulfem D. , Bergamaschi Anna , Ku Chin-Jen , Levy Samuel , Majeti Ravindra
Published: May 2022

The conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) is a key step in DNA demethylation that is mediated by ten–eleven translocation (TET) enzymes, which require ascorbate/vitamin C. Here, we report the 5hmC landscape of normal hematopoiesis and identify cell type–specific 5hmC profiles associated with active transcription and chromatin accessibility of key hematopoietic regulators. We utilized CRISPR/Cas9 to model TET2 loss-of-function mutations in primary human hematopoietic stem and progenitor cells (HSPC). Disrupted cells exhibited increased colonies in serial replating, defective erythroid/megakaryocytic differentiation, and in vivo competitive advantage and myeloid skewing coupled with reduction of 5hmC at erythroid-associated gene loci. Azacitidine and ascorbate restored 5hmC abundance and slowed or reverted the expansion of TET2-mutant clones in vivo. These results demonstrate the key role of 5hmC in normal hematopoiesis and TET2-mutant phenotypes and raise the possibility of utilizing these agents to further our understanding of preleukemia and clonal hematopoiesis.

Significance:

We show that 5-hydroxymethylation profiles are cell type–specific and associated with transcriptional abundance and chromatin accessibility across human hematopoiesis. TET2 loss caused aberrant growth and differentiation phenotypes and disrupted 5hmC and transcriptional landscapes. Treatment of TET2 KO HSPCs with ascorbate or azacitidine reverted 5hmC profiles and restored aberrant phenotypes.

This article is highlighted in the In This Issue feature, p. 265
Delineation of Cancer Service Areas Anchored by Major Cancer Centers in the United States
Authors: Wang Changzhen , Wang Fahui , Onega Tracy
Published: May 2022

Defining a reliable geographic unit pertaining to cancer care is essential in its assessment, planning, and management. This study aims to delineate and characterize the cancer service areas (CSA) accounting for the presence of major cancer centers in the United States. We used the Medicare enrollment and claims from January 1, 2014 to September 30, 2015 to build a spatial network from patients with cancer to cancer care facilities that provided inpatient and outpatient care of cancer-directed surgery, chemotherapy, and radiation. After excluding those without clinical care or outside of the United States, we identified 94 NCI-designated and other academic cancer centers from the members of the Association of American Cancer Institutes. By explicitly incorporating existing specialized cancer referral centers, we refined the spatially constrained Leiden method that accounted for spatial adjacency and other constraints to delineate coherent CSAs within which the service volumes were maximal but minimal between them. The derived 110 CSAs had a high mean localization index (LI; 0.83) with a narrow variability (SD = 0.10). The variation of LI across the CSAs was positively associated with population, median household income, and area size, and negatively with travel time. Averagely, patients traveled less and were more likely to receive cancer care within the CSAs anchored by cancer centers than their counterparts without cancer centers. We concluded that CSAs are effective in capturing the local cancer care markets in the United States. They can be used as reliable units for studying cancer care and informing more evidence-based policy.

Significance:

Using the most refined network community detection method, we can delineate CSAs in a more robust, systematic, and empirical manner that incorporates existing specialized cancer referral centers. The CSAs can be used as a reliable unit for studying cancer care and informing more evidence-based policy in the United States. The cross-walk tabulation of ZIP code areas, CSAs, and related programs for CSAs delineation are disseminated for public access.
Delirium Item Bank: Utilization to Evaluate and Create Delirium Instruments
Authors: Helfand Benjamin K.I. , Tommet Douglas , Detroyer Elke , Milisen Koen , Adamis Dimitrios , Metzger Eran D. , Marcantonio Edward R. , Boudreaux Edwin D. , Inouye Sharon K. , Jones Richard N. ,   For the BASIL study group
Published: May 2022

Introduction: The large number of heterogeneous instruments in active use for identification of delirium prevents direct comparison of studies and the ability to combine results. In a recent systematic review we performed, we recommended four commonly used and well-validated instruments and subsequently harmonized them using advanced psychometric methods to develop an item bank, the Delirium Item Bank (DEL-IB). The goal of the present study was to find optimal cut-points on four existing instruments and to demonstrate use of the DEL-IB to create new instruments. Methods: We used a secondary analysis and simulation study based on data from three previous studies of hospitalized older adults (age 65+ years) in the USA, Ireland, and Belgium. The combined dataset included 600 participants, contributing 1,623 delirium assessments, and an overall incidence of delirium of about 22%. The measurements included the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria for delirium, Confusion Assessment Method (long form and short form), Delirium Observation Screening Scale, Delirium Rating Scale-Revised-98 (total and severity scores), and Memorial Delirium Assessment Scale (MDAS). Results: We identified different cut-points for each existing instrument to optimize sensitivity or specificity, and compared instrument performance at each cut-point to the author-defined cut-point. For instance, the cut-point on the MDAS that maximizes both sensitivity and specificity was at a sum score of 6 yielding 89% sensitivity and 79% specificity. We then created four new example instruments (two short forms and two long forms) and evaluated their performance characteristics. In the first example short form instrument, the cut-point that maximizes sensitivity and specificity was at a sum score of 3 yielding 90% sensitivity, 81% specificity, 30% positive predictive value, and 99% negative predictive value. Discussion/Conclusion: We used the DEL-IB to better understand the psychometric performance of widely used delirium identification instruments and scorings, and also demonstrated its use to create new instruments. Ultimately, we hope that the DEL-IB might be used to create optimized delirium identification instruments and to spur the development of a unified approach to identify delirium.
The Effect of Cerebellar Repetitive Transcranial Magnetic Stimulation on Dysphagia due to Posterior Circulation Stroke, a Randomized Controlled Trial Protocol
Authors: Chen Qingfa , Huang Huayao , Chen Guangliang , Chen Jianhua , Fang Fangshuang , Lei Hanhan , Zhang Yixian , Lin Jilan , Chen Xiuyun , Liu Nan , Li Jing , Chen Ronghua , Du Houwei
Published: May 2022

Introduction: Cerebellum might be active during the task of swallowing. Little is known whether cerebellar repetitive transcranial magnetic stimulation (rTMS) could improve post-stroke dysphagia (PSD) due to occlusion in the posterior circulation. This paper describes the rationale and design of a randomized controlled trial that aims to determine the effect of cerebellar rTMS on dysphagia due to posterior circulation stroke. Methods and Analysis: Thirty patients with PSD due to occlusion in the posterior circulation will be randomly divided to receive real (n = 20) or sham (n = 10) cerebellar rTMS. Patients in the real rTMS group will receive 250 pulses rTMS at a low intensity with 10 Hz frequency for 10 days (five consecutive days per week). The severity of dysphagia will be assessed with videofluoroscopic swallowing study (VFSS) using the Rosenbek penetration aspiration scale (PAS), the pharyngeal constriction ratio (PCR), and the dysphagia outcome and severity scale (DOSS) before and immediately after the last session and then again after 1 and 3 months. The functional magnetic resonance imaging (fMRI) will be assessed before and after the last session and then again after 1 month and 3 months. The primary outcome is the improvement of swallowing function determined by PAS, PCR, and DOSS. The secondary outcomes include changes in brain connectivity network detected using fMRI. Discussion: This study will determine whether cerebellar rTMS improves dysphagia due to posterior circulation stroke in Chinese patients. Our findings will contribute to a new approach for swallowing function recovery after posterior circulation stroke.
Fotografia e sagrados afro-brasileiros: modulações da diferença em Pierre Verger e seus contemporâneos
Authors: Pereira Edilson
Published: May 2022

O artigo revisita a obra de Pierre Verger para analisar as condições de formação do seu olhar, acompanhando-o desde a França até o Brasil, o Benin e a Nigéria. Com apoio na literatura especializada, analiso os usos sociais da fotografia e abordo quatro modulações da alteridade expressas pela fotografia de Verger e de seus contemporâneos: indo da tipificação científica-moderna; passando pelo objeto de interesse etnográfico/antropológico; seguindo pelo englobamento da perspectiva religiosa e ritual; até o tratamento estereotipado do candomblé pelo mercado editorial. Considero, enfim, a contribuição de Verger para a transformação da cultura visual associada aos cultos afro no país.
Text Messages to Improve Medication Adherence and Secondary Prevention After Acute Coronary Syndrome: The TEXTMEDS Randomized Clinical Trial
Authors: Chow Clara K. , Klimis Harry , Thiagalingam Aravinda , Redfern Julie , Hillis Graham S. , Brieger David , Atherton John , Bhindi Ravinay , Chew Derek P. , Collins Nicholas , Andrew Fitzpatrick Michael , Juergens Craig , Kangaharan Nadarajah , Maiorana Andrew , McGrady Michele , Poulter Rohan , Shetty Pratap , Waites Jonathon , Hamilton Craig Christian , Thompson Peter , Stepien Sandrine , Von Huben Amy , Rodgers Anthony ,   on behalf of the TEXTMEDS Investigators*
Published: May 2022

Background:

TEXTMEDS (Text Messages to Improve Medication Adherence and Secondary Prevention After Acute Coronary Syndrome) examined the effects of text message–delivered cardiac education and support on medication adherence after an acute coronary syndrome.

Methods:

TEXTMEDS was a single-blind, multicenter, randomized controlled trial of patients after acute coronary syndrome. The control group received usual care (secondary prevention as determined by the treating clinician); the intervention group also received multiple motivational and supportive weekly text messages on medications and healthy lifestyle with the opportunity for 2-way communication (text or telephone). The primary end point of self-reported medication adherence was the percentage of patients who were adherent, defined as >80% adherence to each of up to 5 indicated cardioprotective medications, at both 6 and 12 months.

Results:

A total of 1424 patients (mean age, 58 years [SD, 11]; 79% male) were randomized from 18 Australian public teaching hospitals. There was no significant difference in the primary end point of self-reported medication adherence between the intervention and control groups (relative risk, 0.93 [95% CI, 0.84–1.03];
P
=0.15). There was no difference between intervention and control groups at 12 months in adherence to individual medications (aspirin, 96% vs 96%; β-blocker, 84% vs 84%; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, 77% vs 80%; statin, 95% vs 95%; second antiplatelet, 84% vs 84% [all
P
>0.05]), systolic blood pressure (130 vs 129 mm Hg;
P
=0.26), low-density lipoprotein cholesterol (2.0 vs 1.9 mmol/L;
P
=0.34), smoking (
P
=0.59), or exercising regularly (71% vs 68%;
P
=0.52). There were small differences in lifestyle risk factors in favor of intervention on body mass index <25 kg/m
2
(21% vs 18%;
P
=0.01), eating ≥5 servings per day of vegetables (9% vs 5%;
P
=0.03), and eating ≥2 servings per day of fruit (44% vs 39%;
P
=0.01).

Conclusions:

A text message–based program had no effect on medical adherence but small effects on lifestyle risk factors.

Registration:

URL:
https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364448
; Unique identifier: ANZCTR ACTRN12613000793718.
Differences in Performance on Quality Measures for Thrombectomy‐Capable Stroke Centers Compared With Comprehensive Stroke Centers in 2019 to 2020
Authors: Baker David W. , Schmaltz Stephen , Kolbusz Karen , Messé Steven R. , Jauch Edward C. , Schwamm Lee H.
Published: May 2022

Background

Thrombectomy‐Capable Stroke Center (TSC) certification was created to improve timely access to mechanical thrombectomy (MT), where travel to a Comprehensive Stroke Center (CSC) would entail prolonged transport time. No study has evaluated the quality of MT and stroke care at TSCs compared with CSCs.

Methods

We compared performance for 3 MT measures for all TSCs and CSCs certified by The Joint Commission in 2019 and 2020: (1) time from arrival to skin puncture, (2) the percentage of patients who achieved Thrombolysis in Cerebral Infarction ≥2B perfusion, and (3) the proportion of patients with symptomatic hemorrhagic transformation following MT. Wilcoxon ranked‐sum tests and signed‐rank tests were used to compare TSCs and CSCs within years and changes in performance from 2019 to 2020.

Results

The median time from arrival to skin puncture was 75.8 minutes for CSCs compared with 106.1 minutes for TSCs in 2019 (
P
<0.001) and 74.8 minutes for CSCs compared with 91.7 minutes for TSCs in 2020 (
P
<0.001). For TSCs, the median time was 11.2 minutes lower in 2020 compared with 2019 (
P
<0.005). There were no differences in the median proportion of patients who had

Thrombolysis

in

Cerebral

Infarction

≥

${\text{Thrombolysis in Cerebral Infarction}} \ge $

2b perfusion achieved for CSCs compared with TSCs in 2019 (85.2% versus 84.3%, respectively;
P
=0.87) or 2020 (86.9% versus 88.6%, respectively;
P
=0.73). Rates of symptomatic hemorrhagic complications were similar.

Conclusions

Times from arrival to skin puncture were longer at TSCs compared with CSCs, although this difference narrowed significantly in 2020. This improvement and the similar rates of successful MT and complications at TSCs and CSCs support current recommendations to transport patients with suspected large‐vessel occlusion to a TSC if a CSC is >30 minutes longer transport time. However, routing decisions for suspected large‐vessel occlusion must be made at a local level based on the performance data for TSCs and CSCs.
Hypothesis Test and Confidence Analysis With Wasserstein Distance on General Dimension
Authors: Imaizumi Masaaki , Ota Hirofumi , Hamaguchi Takuo
Published: May 2022

We develop a general framework for statistical inference with the 1-Wasserstein distance. Recently, the Wasserstein distance has attracted considerable attention and has been widely applied to various machine learning tasks because of its excellent properties. However, hypothesis tests and a confidence analysis for it have not been established in a general multivariate setting. This is because the limit distribution of the empirical distribution with the Wasserstein distance is unavailable without strong restriction. To address this problem, in this study, we develop a novel nonasymptotic gaussian approximation for the empirical 1-Wasserstein distance. Using the approximation method, we develop a hypothesis test and confidence analysis for the empirical 1-Wasserstein distance. We also provide a theoretical guarantee and an efficient algorithm for the proposed approximation. Our experiments validate its performance numerically.
Protective Behaviors for COVID-19 Were Associated With Fewer Psychological Impacts on Nurses: A Cross-Sectional Study in Taiwan
Authors: Yen Chia-Chi , Chan Min-Ho , Lin Wei-Chun , Yeh Shu-Chuan Jennifer
Published: May 2022

Objective: The COVID-19 pandemic has increased psychological distress among common people and has caused health care providers, such as nurses, to experience tremendous stress. Methods: This prospective cross-sectional study assessed the psychological impacts on nurses in a community hospital in Taiwan, including major depressive disorder (MDD), posttraumatic stress (PTS), and pessimism. According to transactional theory, coping strategies and personal factors have psychological impacts. We hypothesized that behavioral responses to COVID-19 (problem-focused coping) are more effective in reducing psychological impacts than emotional responses to COVID-19 (emotion-focused coping). Independent variables were the use of behavioral and emotional coping strategies for COVID-19 and 3 personal factors, namely sleep disturbance, physical component summary (PCS-12), and mental component summary (MCS-12) of the 12-Item Short Form Health Survey (SF-12) obtained from the Medical Outcomes Study. Dependent variables comprised 3 psychological impacts, namely MDD, PTS, and pessimism. Results: We determined that behavioral coping strategies had significant negative effects on PTS and pessimism; however, emotional coping strategies had significantly positive effects on PTS and pessimism. Sleep disturbance was significantly associated with increased MDD and pessimism. PCS-12 had a significant negative effect on PTS, whereas MCS-12 was not significantly associated with any of the 3 psychological impacts. Conclusions: Nurses who adopted protective behavior against COVID-19, such as washing hands, wearing masks, avoiding touching eyes, and mouth, and avoiding personal contact, were associated with less posttraumatic stress and pessimism. Healthcare providers should consider strategies for improving preventive behaviors to help ease their worries and fears concerning COVID-19.
Population risk profile analysis of acute uncomplicated type B aortic dissection patients undergoing thoracic endovascular aortic repair
Authors: Al-Tawil Mohammed , Geragotellis Alexander , Jubouri Matti , Tan Sven ZCP , Mohammed Idhrees , Williams Ian , Bashir Mohamad
Published: May 2022

Background

Uncomplicated type B aortic dissection (unTBAD) comprises the estimated majority of type B aortic dissection (TBAD), presenting without any of the complications associated with complicated TBAD (coTBAD). Although first-line treatment for coTBAD is thoracic endovascular aortic repair (TEVAR), and despite the fact that TEVAR has proven its safety and effectiveness in the treatment of unTBAD, unTBAD is still being predominantly managed conservatively with medical therapy, with a small proportion of patients being offered TEVAR.

Aims

The main scope of this review is to highlight the evidence in the literature of the demographic characteristics and associated co-morbidities of unTBAD patients undergoing TEVAR in order to produce a risk stratification system to achieve favourable outcomes.

Methods

A comprehensive literature search was conducted using multiple electronic databases including PubMed, Ovid, Scopus, and EMBASE.

Results

Multiple demographic characteristics and associated co-morbidities of unTBAD patients affecting TEVAR outcomes were identified, assessed, and investigated, including age, gender, race, genetics, medical conditions, such as hypertension and diabetes, and lifestyle factors such as smoking. Most factors were associated with increased risks of mortality and morbidity, while others, such as race, were identified as being protective against those when it comes to TEVAR.

Conclusion

Despite the favourable results yielded by TEVAR in unTBAD, there remains a grey area concerning its management. Thus, it is important to incorporate the demographics and co-morbidities of unTBAD patients’ when into clinical judgement when assessing indications for TEVAR intervention to ensure optimum results can be achieved.
A brief overview of properties and reactions of diisocyanates
Authors: Spence Mark W , Plehiers Patrick M
Published: May 2022

By way of introduction to the special issue on d iisocyanates and their corresponding diamines, this brief overview presents, for the most commonly used diisocyanate monomers, a selection of physical-chemical properties that are relevant to exposure in the workplace and in the general environment, as well as a concise overview of diisocyanate reactions and some of their toxicological implications.
Interindividual age differences in personality structure
Authors: Beck Emorie D , Condon David , Jackson Josh
Published: May 2022

Most investigations in the structure of personality traits do not adequately address age; instead, they presuppose a constant structure across the lifespan. Further, few studies look at the structure of personality traits a-theoretically, often neglecting to examine the relationship among indicators within a trait (convergence) and across traits (divergence). Using a network approach, the present study examines (1) age differences in divergence and convergence, (2) the similarity between the Big Five and network structures, and (3) the consistency of network structure across age groups in a large, cross-sectional sample. Results indicate that convergence shows early gains in adolescence with few differences across the lifespan, while divergence mostly weakens across adulthood. The result of these age-related differences is that Big Five indicators only parallel the Big Five structure among young but not older adults. The structure of young adults tends to be quite similar while the network structures of older adults appear to greatly differ from one another. These results suggest that older adults have a different structure of personality than younger adults and suggest that future research should not assume consistency in personality structure across the lifespan.
The (in)equality dynamic of childcare-related policy development in post-Yugoslav countries
Authors: Dobrotić Ivana
Published: May 2022

This article explores the (in)equality dynamic of childcare-related policy reforms in post-Yugoslav countries to expose ‘silent’ cleavages embedded in parenting leaves and early childhood education and care policies design that may challenge or reinforce parental (in)equalities in employment and care opportunities. It is guided by the principles and (sub-)questions of intersectionality-based policy analysis to determine who benefits and/or is excluded from the policy goals and allocation of childcare-related resources. All former Yugoslav republics initially relied on gendered and selective childcare-related policy design, empowering only a fraction of working mothers. In the last three decades only Slovenia equalized the potential of childcare-related policy allowing various parents to more easily engage in care and employment. The other post-Yugoslav countries that were more exposed to the post-1990 societal re-traditionalization and cost-containment measures mostly exacerbated the existing or created new layers of inequalities and (dis)advantages intersecting along gender, class, ethnical and spatial lines. While enacting more socially inclusive leaves, they also amplified the systematic exclusion of some parents from access to childcare-related rights and the opportunity to work and care. Parents, particularly mothers in precarious employment, ethnic minorities and ‘new’ migrants, as well as those living in less developed areas, were the most affected by the (absence of) reforms.
Cephalometric Soft Tissue Morphology of Adults With Unoperated Submucous Cleft Palate
Authors: Cao Congcong , Xu Xue , Yin Heng , Zheng Qian , Xu Chao , Shi Bing
Published: May 2022

The aim of this study was to compare craniofacial soft tissue characteristics between subjects with unrepaired submucous cleft palate (SMCP) and noncleft individuals.

This retrospective cross-sectional study was performed on 27 subjects with unrepaired SMCP (13 male and 14 female subjects; mean age, 21.77 ± 4.09 years) and 30 noncleft controls (14 male and 16 female subjects; mean age, 22.67 ± 4.28 years). The predictor variable was cleft deformity. The outcome variable was cephalometric soft tissue measurements. Other study variables were gender and age. Independent samples t test and Mann-Whitney U test were used for intergroup comparison. P value was set at .05.

Significant differences were observed in the facial profile angle, total facial profile angle, soft tissue A-N-B angle, nasal base prominence, upper lip length, lower lip protrusion, and the ratio of upper lip length to mentolabial height between subjects with unoperated SMCP and noncleft controls.

The primary deformity of the cleft palate leads to unsatisfactory facial soft tissue morphology, especially in the middle facial region.
A promising cognitive screener in multiple sclerosis: The NIH toolbox cognition battery concords with gold standard neuropsychological measures
Authors: Manglani Heena R , Fisher Megan E , Duraney Elizabeth Jean , Nicholas Jacqueline A , Prakash Ruchika Shaurya
Published: May 2022

Background:

Routine cognitive screening is a priority in MS clinical care. The National Institutes of Health Toolbox (NIHTB) Cognition Battery is a 30-min instrument validated in neurological populations excluding MS.

Objectives:

To assess construct validity of NIHTB tests and compare classification of cognitive impairment with gold-standard tests. To evaluate relationships between fluid cognition and clinical measures.

Methods:

Eighty-seven individuals, aged 30–59 years, completed the NIHTB, Minimal Assessment of Cognitive Function in MS (MACFIMS), Wechsler Adult Intelligence Scale-IV subtests, and measures of disease severity, depression, and fatigue.

Results:

The NIHTB showed adequate convergent validity for processing speed, working memory, and episodic memory. Although fluid cognition scores from the NIHTB and MACFIMS classified a similar proportion of participants as cognitively impaired, the two batteries differed in which individuals were classified as impaired versus preserved. NIHTB fluid cognition was inversely correlated with disease severity but not related to depression or fatigue.

Conclusions:

The NIHTB concords with gold-standard measures, and classifies cognitive impairment at similar rates to the MACFIMS. Adjusted NIHTB fluid cognition was negatively associated with disease severity suggesting clinical utility. Psychometric validation of the NIHTB in clinical practice will elucidate its promise as a cognitive screener in MS.