bluuebunny/crossref_metadata_2025 huggingface dataset:
Physician sentiment toward artificial intelligence (AI) in colonoscopic practice: a survey of US gastroenterologists
Authors: Wadhwa Vaibhav , Alagappan Muthuraman , Gonzalez Adalberto , Gupta Kapil , Brown Jeremy R. Glissen , Cohen Jonah , Sawhney Mandeep , Pleskow Douglas , Berzin Tyler M.
Published: September 2020

Background and study aims Early studies have shown that artificial intelligence (AI) has the potential to augment the performance of gastroenterologists during endoscopy. Our aim was to determine how gastroenterologists view the potential role of AI in gastrointestinal endoscopy.

Methods In this cross-sectional study, an online survey was sent to US gastroenterologists. The survey included questions about physician level of training, experience, and practice characteristics and physician perception of AI. Descriptive statistics were used to summarize sentiment about AI. Univariate and multivariate analyses were used to assess whether background information about physicians correlated to their sentiment.

Results Surveys were emailed to 330 gastroenterologists nationwide. Between December 2018 and January 2019, 124 physicians (38 %) completed the survey. Eighty-six percent of physicians reported interest in AI-assisted colonoscopy; 84.7 % agreed that computer-assisted polyp detection (CADe) would improve their endoscopic performance. Of the respondents, 57.2 % felt comfortable using computer-aided diagnosis (CADx) to support a “diagnose and leave” strategy for hyperplastic polyps. Multivariate analysis showed that post-fellowship experience of fewer than 15 years was the most important factor in determining whether physicians were likely to believe that CADe would lead to more removed polyps (odds ratio = 5.09; P = .01). The most common concerns about implementation of AI were cost (75.2 %), operator dependence (62.8 %), and increased procedural time (60.3 %).

Conclusions Gastroenterologists have strong interest in the application of AI to colonoscopy, particularly with regard to CADe for polyp detection. The primary concerns were its cost, potential to increase procedural time, and potential to develop operator dependence. Future developments in AI should prioritize mitigation of these concerns.
The Art of Detecting Antibodies against Factor VIII
Authors: Tiede Andreas , Alberio Lorenzo
Published: September 2020

Antibodies against factor VIII (FVIII) can be detected based on their ability to neutralize the procoagulant activity of FVIII (neutralizing antibodies, inhibitors), or based on their specific binding capacity to FVIII protein. This article reviews the available assays and their clinical interpretation in patients with congenital and acquired hemophilia.
Translating Laboratory Tests into Clinical Practice: A Conceptual Framework
Authors: Nagler Michael
Published: September 2020

The use of laboratory biomarkers in clinical practice is rapidly increasing. Laboratory tests are, however, rarely evaluated adequately before implementation, and the utility of many tests is essentially unclear. An important reason for this knowledge gap is that a comprehensive and generally accepted methodological framework supporting evaluation studies is essentially lacking. Researchers, clinicians, and decision-makers are often not aware of the methodological tools available and face problems with the appraisal of a test's utility. With the present article, I aim to summarize current concepts and methodological tools and propose a framework for a phased approach that could be used in future evaluation projects. Future research will refine this suggested framework by identifying problems in current evaluation projects, specifying methodological criteria for all phases, as well as developing advanced methodological tools.
An international survey on recognition and characterization of atrophic gastritis and intestinal metaplasia
Authors: Yip Hon Chi , Uedo Noriya , Chan Shannon M. , Teoh Anthony Yuen Bun , Wong Simon Kin Hung , Chiu Philip W. , Ng Enders Kwok Wai
Published: September 2020

Background and study aims Atrophic gastritis (AG) and intestinal metaplasia (IM) are premalignant conditions of gastric cancer and endoscopic recognition and characterization may help in stratifying the gastric cancer risk for screening and surveillance. However, there is currently lack of consensus in defining the severity of AG and IM. We aimed to conduct an international survey to understand the current practice of endoscopists worldwide.

Methods An online survey was designed to collect data regarding participants’ practice in endoscopic assessment of AG & IM. A test using images was conducted to evaluate the difference in accuracy of characterization of AG & IM.

Results From July to October 2017, 249 endoscopists responded to the survey. Around 70 % of participants received some form of training on recognition of AG & IM. There was significant variety in the training received across different continents. One hundred seventy-six participants (70 %) would document the presence of both AG and IM, but the classification systems used were inconsistent between endoscopists. Overall accuracy in diagnosis of AG & IM in the image test was 84.5 % and 80.7 % respectively. The diagnostic accuracy was significantly higher among Japanese and Korean endoscopists compared to the rest of the world.

Conclusion Training regarding endoscopic recognition of AG & IM differs significantly in different parts of the world. The difference in diagnostic accuracy for these premalignant gastric conditions may also explain the discrepancy in the early cancer detection rates among different countries. A simple unified classification system may be beneficial for better stratification of cancer risks.
Manual für Methoden und Nutzung versorgungsnaher Daten zur
Wissensgenerierung
Authors: Klinkhammer-Schalke Monika , Kaiser Thomas , Apfelbacher Christian , Benz Stefan , Dreinhöfer Karsten E. , Geraedts Max , Hauptmann Michael , Hoffmann Falk , Hoffmann Wolfgang , Koller Michael , Kostuj Tanja , Kowalski Christoph , Mugele Katrin , Ortmann Olaf , Schmitt Jochen , Schünemann Holger , Veit Christof , Wesselmann Simone , Bierbaum Thomas
Published: September 2020

Für die Nutzung vorhandener Versorgungsdaten gibt es immer mehr gute
Gründe, wobei v. a. die Nutzung von Registerdaten im Fokus
steht. Das zugehörige, klar strukturierte methodische Vorgehen ist
bisher noch unzureichend zusammengeführt, aufbereitet und
transparent dargestellt. Das Deutsche Netzwerk Versorgungsforschung (DNVF)
hat deswegen eine Ad hoc Kommission zur Nutzung versorgungsnaher Daten
(RWE/RWD) ins Leben gerufen. Der vom IQWiG erstellte Rapid Report
über die wissenschaftliche Ausarbeitung von Konzepten zur
„Generierung versorgungsnaher Daten und deren Auswertung zum Zwecke
der Nutzenbewertung von Arzneimitteln nach § 35a SGB V“ ist
ein wesentlicher Schritt für die Nutzung von Registerdaten zur
Evidenzgenerierung. Das vom DNVF 2020 veröffentlichte
„Memorandum Register – Update 2019“ beschreibt
Anforderungen und methodische Grundlagen von Registern. Best Practice
Beispiele aus der Onkologie, die auf dem einheitlichen onkologischen
Basisdatensatz für die Klinische Krebsregistrierung (§ 65c
SGB V) beruhen, zeigen z. B., dass im Sinne einer
wissensgenerierenden Versorgungsforschung mithilfe von Registerdaten
Leitlinien überprüft sowie Empfehlungen für
Leitlinien und notwendige Interventionen abgeleitet werden können.
Gleichzeitig fehlen jedoch klare Qualitätsanforderungen und
strukturierte formale und inhaltliche Vorgehensweisen in den Bereichen
Datenzusammenführung, Datenprüfung und Nutzung spezifischer
Methoden je nach vorhandener Fragestellung. Die bisher uneinheitlichen
Vorgaben sollen aufgearbeitet und ein Methoden-Leitfaden zur Nutzung
versorgungsnaher Daten entwickelt und veröffentlicht werden. Das
erste Kapitel des Manuals zu Methoden versorgungsnaher Daten
erläutert Zielstellung und Struktur des Manuals. Es wird dargelegt,
warum die Verwendung des Begriffes „Versorgungsnahe Daten
(VeDa)“ zielführender ist als die Nutzung der Begriffe Real
Word Data (RWD) und Real World Evidence (RWE). Mit der Vermeidung des
Begriffes „Real World“ soll insbesondere unterstrichen
werden, dass auch qualitativ hochwertige Forschung auf Versorgungsdaten
aufsetzen kann (z. B. registerbasierte vergleichende Studien).
Impacto subespinhal do quadril: Resultados clínicos e radiográficos do tratamento artroscópico
Authors: Roos Bruno Dutra , Roos Milton Valdomiro , Camisa Júnior Antero , Lima Ezequiel Moreno Ungaretti , Fontana Mariano Feraboli , Okamoto Roger Pires
Published: September 2020

Objetivo Avaliar os resultados clínicos e radiográficos assim como as complicações relacionadas a pacientes submetidos ao tratamento artroscópico do impacto subespinhal do quadril.

Métodos Foram avaliados retrospectivamente 25 pacientes (28 quadris) submetidos ao tratamento artroscópico de impacto subespinhal entre janeiro de 2012 e junho de 2018. O seguimento médio foi de 29,5 meses, e os pacientes foram avaliados clinicamente pelo Harris hip score modificado por Byrd (MHHS), o non-arthritic hip score (NAHS), e quanto à rotação interna e flexão do quadril. Além disso, foram avaliados por exames de imagem: o ângulo center-edge (CE) acetabular, o ângulo alfa, a presença de sinal da parede posterior, o grau de artrose, a presença de ossificação heterotópica do quadril e a classificação de Hetsroni para Impacto Subespinhal.

Resultados Observou-se aumento médio pós-operatório de 26,9 pontos para o MHHS, 25,4 para o NAHS (p < 0,0001), 10,5° na rotação interna (p < 0,0024) e 7,9° para flexão do quadril (p < 0,0001). Quanto à avaliação radiográfica, observou-se redução média de 3,3° no ângulo CE e de 31,6° para o ângulo alfa (p < 0,0001). Foram classificados 18 casos (64,3%) como artrose grau 0 de Tönnis e 10 (35,7%) como Tönnis 1. Dois casos (7,1%) apresentaram ossificação grau 1 de Brooker. A maioria dos quadris (n = 15; 53,6%) foi classificada como tipo II de Hetsroni et al.

Conclusão No presente estudo, os pacientes submetidos a tratamento artroscópico de impacto subespinhal apresentaram melhora nos aspectos clínicos e nos padrões radiográficos aferidos pós-operatoriamente, com seguimento médio de 29,5 meses.
How to Design and Harvest a Propeller Flap
Authors: Pignatti Marco , Pinto Valentina , Docherty Skogh Ann-Charlott , Giorgini Federico Armando , Cipriani Riccardo , De Santis Giorgio , Hallock Geoffrey G.
Published: September 2020

Propeller flaps are local flaps based either on a subcutaneous pedicle, a single perforator, or vessels entering the flap in such a way so as to allow the flap to rotate on their axis. Depending on the kind of pedicle and the anatomical area, the preoperative investigation and the harvesting techniques may vary.

An adequate knowledge of skin and subcutaneous tissue perfusion in the different areas of the body is very important to plan a propeller flap to be successful.

The surgeon should begin by finding the most suitable perforators in the area surrounding the defect using available technology. The position, size, and shape of the flap are planned about this point.

For perforator-pedicled propeller flaps, the procedure starts with an exploration from the margins of the defect or through a dedicated incision to visualize any perforators in the surroundings. The most suitable perforator is selected and isolated, the skin island is replanned, and the flap is harvested and rotated into the defect. The variations in surgical technique for other types of propellers and in specific anatomical areas are also described.

Compared with free flaps, propeller flaps have the advantage of a simpler, shorter operation, without the need for a recipient vessel for microanastomosis.

Yet, from a technical point of view, an adequate experience in dissecting perforators and the use of magnifying glasses are almost always required.
Rectovaginal Fistulas Secondary to Obstetrical Injury
Authors: Dawes Aaron J. , Jensen Christine C.
Published: September 2020

Rectovaginal fistula (RVF), defined as any abnormal connection between the rectum and the vagina, is a complex and debilitating condition. RVF can occur for a variety of reasons, but frequently develops following obstetric injury. Patients with suspected RVF require thorough evaluation, including history and physical examination, imaging, and objective evaluation of the anal sphincter complex. Prior to attempting repair, sepsis must be controlled and the tract allowed to mature over a period of 3 to 6 months. All repair techniques involve reestablishing a healthy, well-vascularized rectovaginal septum, either through reconstruction with local tissue or tissue transfer via a pedicled flap. The selection of a specific repair technique is determined by the level of the fistula tract and the status of the anal sphincter. Despite best efforts, recurrence is common and should be discussed with patients prior to repair. As the ultimate goal of RVF repair is to minimize symptoms and maximize quality of life, patients should help to direct their own care based on the risks and benefits of available treatment options.
Conversion Total Hip Arthroplasty with a Direct Anterior Approach for Failed Treatment of Acetabular Fractures
Authors: Yun Andrew G. , Qutami Marilena , Dylan Pasko Kory B.
Published: September 2020

Total hip arthroplasty (THA) is a salvage procedure after failed treatment of acetabular fractures. Technical challenges increase the risk of perioperative complications, specifically nerve palsy and dislocation. The direct anterior approach (DAA) was evaluated to mitigate these risks. Clinical and radiographic outcomes were reviewed retrospectively. Thirteen patients underwent conversion THA. Of the 13, nine had been treated with open reduction internal fixation (ORIF), one with traction, and three conservatively. When possible, retained hardware was deliberately left in place. At a mean follow-up of 4 years, there were no major complications, readmissions, revisions, or deaths. Two nonunions managed with autografting went on to union. The mean HOOS (hip disability and osteoarthritis outcome) Jr score at follow-up was 89. These data suggest that the DAA may be a reasonable alternative to the posterior approach in this high-risk population.
Partial Anomalous Pulmonary Venous Return Diagnosed by Central Catheter Misplacement
Authors: Reichert Lena , Bougioukas Ioannis , Seipelt Ralf , Huwer Hanno
Published: September 2020

Anomalous venous connections of the left lung can either affect all of the veins or only the upper lobe. They mostly drain into the innominate vein. We present the case of a patient who underwent a coronary bypass operation and was prepared with insertion of central lines including Swan-Ganz catheter through both the internal jugular veins. Blood gas analysis obtained from these catheters suggested the presence of a left-to-right shunt. CT (computed tomography) imaging confirmed a pulmonary venous anomaly with misplacement of the left-sided catheter in an abnormal pulmonary vein. Such a rare condition can be suspected by obtaining arterialized blood samples and measuring the mean pressure through central catheters.
Cisto ósseo simples do acrômio: Relato de caso
Authors: Öztürk Recep , Bulut Emin Kürşat , Ateş Ömer Faruk , Güngör Bedii Şafak
Published: September 2020

Cistos ósseos simples são raros na escápula, e, pelo que sabemos, não foram relatados no acrômio. Aqui, apresentamos uma paciente do sexo feminino, de 24 anos, submetida com sucesso ao tratamento composto por curetagem e xenoenxerto. Não foram observados achados de recidiva no acompanhamento pós-operatório de seis meses, quando a paciente apresentou amplitude total de movimento e foi capaz de realizar todas as atividades rotineiras de maneira satisfatória.
Intrathrombus Fibrin Attenuates Spatial Sorting of Phosphatidylserine Exposing Platelets during Clotting Under Flow
Authors: Trigani Kevin T. , Diamond Scott L.
Published: September 2020

Background As thrombosis proceeds, certain platelets in a clot expose phosphatidylserine (PS) on their outer membrane. These PS+ platelets subsequently sort to the perimeter of the mass via platelet contraction. It remains unclear how thrombin and fibrin may alter PS+ platelet sorting within a clot.

Objective We investigated the role of fibrin in PS+ platelet sorting.

Methods We used an 8-channel microfluidic assay of clotting over collagen (±tissue factor) at 100 s−1 initial wall shear rate. Temporal PS+ platelet sorting was measured using a Pearson's correlation coefficient between the annexin V distribution in a clot at 9 versus 15 minutes. Spatial PS+ platelet sorting was measured using an autocorrelation metric of the final annexin V distribution.

Results By 6 minutes, PS+ platelets were distributed throughout the platelet deposits and became highly spatially sorted by 15 minutes when thrombin and fibrin were blocked with Phe-Pro-Arg-chloromethylketone (PPACK). Fibrin polymerization (no PPACK) attenuated temporal and spatial PS sorting and clot contraction. With Gly-Pro-Arg-Pro (GPRP) added to block fibrin polymerization, PS sorting was prominent as was clot contraction. Exogenously added tissue plasminogen activator drove fibrinolysis that in turn promoted clot contraction and PS sorting, albeit to a lesser degree than the PPACK or GPRP conditions. Clots lacking fibrin displayed 3.6 times greater contraction than clots with fibrin.

Conclusion PS sorting correlated with clot contraction, as previously reported. However, fibrin inversely correlated with both percent contraction and PS sorting. Fibrin attenuated clot contraction and PS sorting relative to clots without fibrin.
Evaluation of Efficacy of Coenzyme Q10 as an Adjunct to Nonsurgical Periodontal Therapy and Its Effect on Crevicular Superoxide Dismutase in Patients with Chronic Periodontitis
Authors: Pranam Swagat , Palwankar Pooja , Pandey Ruchi , Goyal Anjana
Published: September 2020

Objectives To assess the efficacy of coenzyme Q10 (CoQ10) as an adjunct to nonsurgical periodontal therapy and its effect on superoxide dismutase (SOD) in gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP).

Materials and Methods A total of 16 patients aged between 30 and 50 years having mild to moderate CP of both sexes having pocket depth of 5 to 7 mm in four nonadjacent interproximal sites were selected. The sites were randomized and divided into treatment and control groups. CoQ10 and a placebo gel were administered in the treatment and control sites, respectively, at baseline after scaling and root planing (SRP). GCF was collected using microcapillary method at baseline and 3 months and was assessed for SOD using enzyme-linked immunosorbent assay reader at 450 nm wavelength. Probing pocket depth, gingival index, and plaque index were assessed at baseline, 1 month, and 3 months, respectively.

Statistical analysis For each assessment point, data were statistically analyzed using Student’s t-test and paired t-test. Level of significance was set at p < 0.05.

Results On intergroup comparison, there was no statistically significant difference between the clinical parameters of both the groups at all the time intervals (p > 0.05), but there was a significant increase in the level of SOD in the test group (p > 0.05) compared with the control group at 3 months.

Conclusions Adjunctive use of CoQ10 with SRP can boost the antioxidant concentration, but it is not superior to SRP in the treatment of CP.
Adult Learning Principles and Peer Delivery Improve Satisfaction of Electronic Medical Record Onboarding Education
Authors: Lawrence Joanna , Tanny Sharman Tan , Heaton Victoria , Andrew Lauren
Published: September 2020

Objectives Given the importance of onboarding education in ensuring the safety and efficiency of medical users in the electronic medical record (EMR), we re-designed our EMR curriculum to incorporate adult learning principles, informed and delivered by peers. We aimed to evaluate the impact of these changes based on their satisfaction with the training.

Methods A single site pre- and post-observational study measured satisfaction scores (four questions) from junior doctors attending EMR onboarding education in 2018 (pre-implementation) compared with 2019 (post-implementation). An additional four questions were asked in the post-implementation survey. All questions employed a Likert scale (1–5) with an opportunity for free-text. Raw data were used to calculate averages, standard deviations and the student t-test was used to compare the two cohorts where applicable.

Results There were a total of 98 respondents in 2018 (pre-implementation) and 119 in 2019 (post-implementation). Satisfaction increased from 3.8/5 to 4.5/5 (p < 0.0001) following implementation of a peer-delivered curriculum in line with adult learning practices. The highest-rated factors were being taught by other doctors (4.9/5) and doctors having the appropriate knowledge to deliver training (4.9/5). Ninety-two percent of junior doctors were motivated to engage in further EMR education and 90% felt classroom support was adequate.

Conclusion EMR onboarding education for medical users is a critical ingredient to organizational safety and efficiency. An improvement in satisfaction ratings by junior doctors was demonstrated after significant re-design of the curriculum was informed and delivered by peers, in line with adult learning principles.
Feasibility of a Tertiary Hospital Antimicrobial Stewardship Ward Round Using an Electronic Prescribing System—A Pilot Study
Authors: Hamilton Niall L. , Gardiner Sharon J. , Chuah Qian Yi , Chin Paul K.L. , Dalton Simon C. , Metcalf Sarah C. L.
Published: September 2020

Objectives The aim was to conduct a pilot study to determine staff resource requirements for an antimicrobial stewardship (AMS) ward round informed by electronic prescriptions, and the number of restricted antimicrobial prescriptions that would prompt a ward round recommendation.

Methods Prescription data on 26 restricted antimicrobial agents (which have specific prescribing criteria defined by the national drug funding agency) were extracted from the electronic prescribing and administration system (MedChart). A language query was used for specific antimicrobial names on Mondays, Wednesdays, and Fridays over 4 weeks. Prescriptions that had ceased or had an appropriate indication documented were excluded. The remaining prescriptions were evaluated in the ward round upon clinical record review with theoretical AMS recommendations made and time requirements recorded. The ward rounds were performed by two clinical staff, a doctor and pharmacist.

Results In 12 days, 622 prescriptions were extracted. Of these, 66 were evaluated in ward rounds, with 67% (44/66) being for ciprofloxacin or piperacillin-tazobactam. Theoretical AMS recommendations were made in 61% (40/66) of cases, 45% (18/40) being to use a narrower spectrum agent, 30% (12/40) to consult the Infectious Diseases Service, and 23% (9/40) to stop antimicrobial therapy. Data extraction took an analyst approximately 15 minutes, screening by a doctor approximately 20 minutes, and ward rounds approximately 41 minutes per day.

Conclusion Our approach required, in total, approximately 100 clinical staff minutes per day to screen approximately 50 prescriptions and identify and evaluate approximately four prescriptions and showed clinical value. Resource planning should also consider Infectious Diseases and/or Microbiology (physician and service) involvement, and audit capability.
Endocrinology and Covid-19: A Multifaceted Interaction
Authors: Priya Gagan , Grewal Emmy , Maisnam Indira
Published: September 2020

Women with diabetes, obesity and other endocrine or metabolic disorders form a distinct vulnerable group, who are at increased risk during the COVID-19 pandemic, either due to increased risk of severe infection or due to challenges in healthcare delivery during the pandemic.

Diabetes is a major risk factor for increased morbidity and mortality from COVID-19. Optimal cardiometabolic control and preventive measures to reduce risk of infection are needed in people afflicted with diabetes. Women with diabetes are at greater risk as they have limited access to diabetes care facilities even outside the time frame of a pandemic and this gender gap in care is likely to widen during the pandemic. Moreover, the care of pregnant women with pre-existing diabetes or gestational diabetes mellitus (GDM) also cannot be compromised. While alternate screening strategies for GDM such as the use of fasting plasma glucose and glycosylated hemoglobin are being considered, telemedicine services can offer a platform for remote monitoring and delivery of optimal diabetes care to pregnant women.

Telemedicine services can also be used for delivery of long-term care for other endocrine disorders. Elective surgery or evaluation of endocrine disorders that are not immediately life-threatening can be deferred till appropriate safety precautions can be taken. At the same time, there is a need ensure that care of endocrinopathies such as diabetes, obesity, thyroid disorders and osteoporosis, all of which affect women more severely, is not compromised during the pandemic.

Many endocrine organs, including pancreas, thyroid, testis, ovary, adrenals and pituitary, express the angiotensin-converting enzyme 2 (ACE2) that is the receptor for SARS-CoV-2 virus. Since ACE2 expression is different in men and women, there is a need to evaluate the impact of the virus on endocrine system and assess whether this is gender-specific.
Multidisciplinary Approach to Malignant Biliary Obstruction
Authors: Kim Derek Taeyoung , Rahman Uzma , Tenney Robert W. , Roa Oleandro A. Cercio , Rastogi Pawan , Cynamon Jacob , Golowa Yosef
Published: September 2020

Treatment of malignant biliary obstruction (MBO) requires the coordination of multiple specialties, including oncologists, surgeons, gastroenterologists, and interventional radiologists. If the tumor is resectable, surgical candidates can usually proceed to surgery without preoperative biliary drainage. For patients who undergo biliary drainage, endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) combined with biliary stenting are techniques with comparable technical success and mortality, each with distinct advantages and risks. Advances in endoscopic ultrasound allow drainage in patients with challenging anatomy. There are a multitude of devices used for biliary decompression. Self-expanding metal stents (SEMS), with longer patency rates, are in most instances preferred over plastic stents for MBO, especially in patients with life expectancy more than 3 to 4 months. Advantages of covered SEMS versus uncovered SEMS remain controversial as covered stents can prevent tumor ingrowth but at the expense of potential increase in stent migrations. Extra-anatomic biliary drainage using lumen-apposing metal stents is an emerging technique which shows promise when conventional ERCP fails. It is imperative to understand these techniques when tailoring a treatment strategy. The goal of this article is to discuss a multidisciplinary approach for MBO to promote comprehensive care using case examples to highlight essential principles.
Interactive Effects of a Combination of the HDAC3 and HDAC9 Genes with Diabetes Mellitus on the Risk of Ischemic Stroke
Authors: Chiou Hung-Yi , Bai Chyi-Huey , Lien Li-Ming , Hu Chaur-Jong , Jeng Jiann-Shing , Tang Sung-Chun , Lin Huey-Juan , Hsieh Yi-Chen
Published: September 2020

Background and Aim Previous studies indicated that the HDAC3 and HDAC9 genes play critical roles in atherosclerosis and ischemic stroke (IS). The purpose of this study was to investigate the association of combined single-nucleotide polymorphisms in the HDAC3 and HDAC9 genes with the susceptibility to IS.

Methods A case–control study was conducted including 863 IS patients and 863 age- and gender-matched healthy participants. A polygenic score was developed to estimate the contribution of a combination of the HDAC3 and HDAC9 genes to the risk of IS. The interactive effects of traditional risk factors of stroke and the polygenic score on the risk of IS were explored. Additionally, the association between the polygenic score and the progression of atherosclerosis, a potential risk factor of IS, was examined in our healthy controls.

Results Subjects with a higher polygenic score had an increased risk of IS (odds ratio: 1.83; 95% confidence interval: 1.38–2.43) after adjusting for covariates compared with individuals with a lower polygenic score. An interactive effect of diabetes mellitus and the polygenic score on the risk of IS was observed. A significant positive correlation between the polygenic score and a change in the plaque score (standardized β = 0.42, p = 0.0235) in healthy controls with diabetes mellitus was found.

Conclusion Our results suggested that the combination of the HDAC3 and HDAC9 genes with a history of diabetes mellitus could exacerbate the deterioration of atherosclerosis, thereby increasing the risk of IS. Further studies are warranted to explore our results in other populations.
Covid-19: implications for insurer risk management and the insurability of pandemic risk
Authors: Richter Andreas , Wilson Thomas C.
Published: September 2020

This paper analyzes the insurability of pandemic risk and outlines how underwriting policies and scenario analysis are used to build resilience upfront and plan contingency actions for crisis scenarios. It then summarizes the unique “lessons learned” from the Covid-19 crisis by baselining actual developments against a reasonable, pre-Covid-19 pandemic scenario based on the 2002 SARS epidemic and 1918 Spanish influenza pandemic. Actual developments support the pre-Covid-19 hypothesis that financial market developments dominate claims losses due to the demographics of pandemics and other factors. However, Covid-19 “surprised” relative to the pre-Covid-19 scenario in terms of its impact on the real economy as well as on the property and casualty segment as business interruption property triggers and exclusions are challenged, something that may adversely impact the insurability of pandemics as well as the perception of the industry for some time to come. The unique lessons of Covid-19 reinforce the need for resilience upfront in solvency and liquidity, the need to improve business interruption wordings and re-underwrite the book, and the recognition that business interruption caused by pandemics may not be an insurable risk due to its large accumulation potential and the threat of external moral hazard. These insurability limitations lead to a discussion about the structure and financing of protection against the impact of future pandemics.
Automated portfolio rebalancing: Automatic erosion of investment performance?
Authors: Horn Matthias , Oehler Andreas
Published: September 2020

Robo-advisers enable investors to establish an automated rebalancing strategy for a portfolio usually consisting of stocks and bonds. Since households’ portfolios additionally include further frequently tradable assets like real estate funds, articles of great value and cash(-equivalents), we analyze whether households would benefit from a service that automatically rebalances a portfolio which additionally includes the latter assets. In contrast to previous studies, this paper relies on real-world household portfolios, which are derived from the German central bank’s (Deutsche Bundesbank) Panel on Household Finances (PHF)-Survey. We compute the portfolio performance increase/decrease that households would have achieved by employing rebalancing strategies instead of a buy-and-hold strategy in the period from September 2010 to July 2015 and analyze whether subsamples of households with certain sociodemographic and socioeconomic characteristics would have benefited more from portfolio rebalancing than other household subsamples. The empirical analysis shows that the analyzed German households would not have benefited from an automated rebalancing service and that no subgroup of households would have significantly outperformed another subgroup in the presence of rebalancing strategies.
Asymmetric semiconductor nanostructures for particle manipulation
Authors: Maser Jaykob , Rovey Joshua
Published: September 2020

We explore how material selection affects the electromagnetic response of closely positioned asymmetric nanostructures. COMSOL Multiphysics is used to model the system, and the materials studied include gold (Au), gallium arsenide (GaAs), indium tin oxide (ITO), and aluminum zinc oxide (AZO). All materials produce average electric field magnitudes on the order of 10 MV/m. We conclude that the ITO and AZO nanostructures produce the most uniform electric field response over the entire domain of incident wavelengths and that GaAs is least thermally stable in a vacuum environment due to its low heat conductivity.
Researchers watch protein unfolding in real-time with X-ray solution scattering
Authors: Gasparini Allison
Published: September 2020

Researchers were able to observe the structural dynamic changes of the protein apomyoglobin in solution during folding using X-ray solution scattering.
Simultaneously probing the absorption of two different materials in a tri-layer system
Authors: Gasparini Allison
Published: September 2020

Measurements of absorption at the M-edge of iron and nickel with absolute timing provide greater insight into ultrafast magnetization in related materials.
The numerical solution of fourth order nonlinear singularly perturbed boundary value problems via 10-point subdivision scheme based numerical algorithm
Authors: Ejaz Syeda Tehmina , Baleanu Dumitru , Mustafa Ghulam , Malik Safia , Chu Yu-Ming
Published: September 2020

The subdivision scheme is used to illustrate smooth curves and surfaces. It is an algorithmic technique which takes a coarse polygon as an input and produces a refined polygon as an output. In this paper, a 10-point interpolating subdivision scheme is used to develop a numerical algorithm for the solution of fourth order nonlinear singularly perturbed boundary value problems (NSPBVPs). The studies of convergence and approximation order of the numerical algorithm are also presented. The solution of NSPBVPs is presented to see the efficiency of the algorithm.
Substrate counts: Quantitative effects of surface roughness on fingering pattern and rim shape of an impacting drop
Authors: Shen Jiaxing , Wang Xishi
Published: September 2020

Rim perturbations during the spreading of an impacting water drop are studied to provide quantitative insight into the effects of the substrate surface on the drop spreading process. Water drop impingement experiments on different surfaces confirm that undulations over the spreading rim are affected by surface characteristics. We have obtained a new relation to predict the number of fingers at the maximum spreading, providing a quantitative proof for substrate effects on evolution of the frontal shape. The valid range of the Weber number for this relation is 130–397. Moreover, we suggest a dimensionless “abnormality degree” for estimating the deformation of the rim shape due to instabilities and subsequent undulations. This parameter is quantitatively studied. Through a curve-fitting approach, we show that it can be expressed as a polynomial of three variables, namely, the Weber number and two roughness parameters. This study reveals the role of the solid surface in drop impingement and provides a comprehensive view of this process. The range of average surface roughness in this study is varied between 0.016 μm and 5.894 μm, and the characteristic slope ranges from 0.49 × 10−3 to 53.39 × 10−3.
Density of states and particle statistics
Authors: Levi A. F. J.
Published: September 2020

The calculation of the density of states and the occupation of states are key to understanding electron transport and electron scattering in semiconductor devices. Analytic and numerical methods to calculate the electron density of states are described for homogeneous lattices with periodic boundary conditions. The special case of surface states is also introduced because of its relevance to nano-scale electronic devices. Some of the properties of isospectral supersymmetric and PT-symmetric states are also described. Following this, the optimal design of the density of states is considered by introducing the concept of an objective and cost function. A key idea is that breaking crystal symmetry enables access to a vast number of different densities of states and hence potentially different device function. The chapter concludes by considering the statistics of particle state occupation. The effect that the Pauli exclusion principle for identical indistinguishable half-integer-spin particles has on the occupation of Fermi-particle states in small and large systems is described. An efficient way to numerically calculate the chemical potential of an electron gas in thermal equilibrium with a Fermi–Dirac distribution is given. The Bose–Einstein distribution for indistinguishable integer-spin particle state occupation in thermal equilibrium is also introduced.
Electron Transmission
Authors: Levi A. F. J.
Published: September 2020

The propagation matrix method is developed as an efficient way to solve the Schrödinger equation describing electron transmission in the presence of a one-dimensional piecewise-constant potential that occurs in layered single-crystal semiconductor heterostructure devices. Resonant electron tunneling through two rectangular potential energy barriers and a resonant electron tunneling threshold through three barriers are described. The existence of a resonance lifetime is used to explain key aspects of these electron transmission phenomena. Inelastic electron tunneling through a tunnel barrier is introduced by first considering the incoherent case and its application to inelastic electron tunneling spectroscopy. The propagation matrix method is then applied to the exact calculation of coherent elastic and inelastic electron transmission through piecewise-constant potentials in the presence of a localized phonon. The concept of quantum feedback driven by unitarity is introduced, and transient inelastic scattering effects, including the creation of localized transient states, are described.
Optimal heterostructure device design
Authors: Levi A. F. J.
Published: September 2020

The optimal design of a semiconductor heterostructure diode is developed by first creating an efficient forward physical model of electron transport using the Landauer approach in the depletion approximation. Calculation of the room-temperature current–voltage characteristic of a GaAs/AlGaAs heterostructure tunnel diode is then used as a worked example. Following this, formal aspects of optimal design methodology are introduced. The definitions of objective function, simulated function, cost function, and distance measure are given. Because of the importance of efficiently finding derivatives of the cost function with respect to the design parameters, the adjoint method is described. The chapter concludes by showing the non-intuitive optimal semiconductor heterostructure conduction band potential energy profile design of a tunnel diode device that gives a linear current–voltage characteristic.
Electron–Phonon Scattering in Semiconductors
Authors: Levi A. F. J.
Published: September 2020

This chapter describes the calculation of electron scattering rates from quantized lattice vibrations. The focus is on electron interaction with longitudinal polar-optic phonons because that dominates in semiconductors such as GaAs. The polarizability and relative permittivity due to longitudinal polar-optic phonons is found and a dielectric loss function is defined. The Fröhlich interaction is introduced and the golden rule is used to find an analytic expression for the scattering rate and mean-free-path of an electron with motion in the parabolic conduction band of a semiconductor maintained at finite temperature. Then, within linear dielectric response, the same result is obtained by integrating the loss function subject to kinematic constraints. This last step, a parabola of integration over the dielectric loss function, can be applied to the more general case of calculating non-equilibrium electron scattering rates in doped semiconductors.
Climate change effects on pasture-based dairy systems in south-eastern Australia
Authors: Pembleton K. G. , Cullen B. R. , Rawnsley R. P. , Ramilan T.
Published: September 2020

Increases in temperature, along with possible decreases in rainfall, will influence the production of forage on Australian dairy farms. A biophysical simulation study was undertaken to compare the performance of perennial pastures and annual forage cropping systems under a historical scenario and two possible future climate scenarios for three key dairy locations of south-eastern Australia. Pastures and forage-cropping systems were simulated with the biophysical models DairyMod and APSIM, respectively, for a location with a heavy reliance on irrigation (Dookie, Victoria), a location with a partial reliance on irrigation (Elliott, Tasmania), and a dryland location (Terang, Victoria). The historical climate scenario (baseline scenario) had no augmentation to climate data and an atmospheric CO2 concentration of 380 ppm, whereas the two future climate scenarios had either a 1°C increase in temperatures (with an atmospheric CO2 concentration of 435 ppm) and a concurrent 10% decrease in rainfall, or a 2°C increase in temperatures (with an atmospheric CO2 concentration of 535 ppm) and a concurrent 20% decrease in rainfall. At Dookie, mean annual dry matter yields of the forage-cropping options and the pasture systems increased under both future climate scenarios but more irrigation was required. At Terang, the yield of forage-cropping systems increased whereas the yield of the pasture systems decreased under the future climate scenarios. At Elliott, yields of irrigated pastures and cropping systems increased but there was minimal or a negative impact on yields of dryland pastures and cropping systems under the future climate scenarios. At all three locations, forage production increased in the colder months of the year with a decrease in production during the warmer months. This study indicates that double-cropping and irrigated-pasture systems at all three locations appear resilient to projected changes in climate; however, for irrigated systems this assumes a reliable supply of irrigation water. The systems implications of how a shift in the seasonality of forage supply within these options impacts on the farm system as a whole warrants further investigation.
Wearing one for the team: views and attitudes to face covering in New Zealand/Aotearoa during COVID-19 Alert Level 4 lockdown
Authors: Gray Lesley , MacDonald Carol , Tassell-Matamua Natasha , Stanley James , Kvalsvig Amanda , Zhang Jane , Murton Samantha , Wiles Siouxsie , Puloka Viliami , Becker Julia , Johnston David , Baker Michael G.
Published: September 2020

ABSTRACT
INTRODUCTIONMass masking is emerging as a key non-pharmaceutical intervention for reducing community spread of COVID-19. However, although hand washing, social distancing and bubble living have been widely adopted by the ‘team of 5 million’, mass masking has not been socialised to the general population.
AIMTo identify factors associated with face masking in New Zealand during COVID-19 Alert Level 4 lockdown to inform strategies to socialise and support mass masking.
METHODSA quantitative online survey conducted in New Zealand during April 2020 invited residents aged ≥18 years to complete a questionnaire. Questions about face masking were included in the survey. The sample was drawn from a commissioned research panel survey, with boosted sampling for Māori and Pacific participants. Responses were weighted to reflect the New Zealand population for all analyses.
RESULTSA total of 1015 individuals participated. Self-reported beliefs were strongly related to behaviours, with respondents viewing face masking measures as ‘somewhat’ or ‘very’ effective in preventing them from contracting COVID-19 more likely to report having worn a face mask than respondents who viewed them as ‘not at all’ effective. The strongest barriers to face mask use included beliefs that there was a mask shortage and that the needs of others were greater than their own.
DISCUSSIONHighlighting the efficacy of and dispelling myths about the relative efficacy of mask types and socialising people to the purpose of mass masking will contribute to community protective actions of mask wearing in the New Zealand response to COVID-19.
Accelerated reproduction is not an adaptive response to early-life adversity in wild baboons
Authors: Weibel Chelsea J. , Tung Jenny , Alberts Susan C. , Archie Elizabeth A.
Published: September 2020

Significance

If an individual can anticipate an early death, should they also “live fast”? Fast reproduction is often proposed to be an adaptive response to harsh conditions in early life because early adversity predicts shorter lifespans. Individuals who speed up reproduction after experiencing early adversity might therefore have higher fitness than those who do not. Here, we use extensive data on wild female baboons to test if fast reproduction offers fitness advantages to females who experience nutritional and psychosocial sources of early adversity. Contrary to several influential hypotheses, females who experienced early adversity did not improve their fitness if they sped up reproduction. Our results raise doubts that accelerated reproduction is an adaptive response to early adversity in long-lived, slow-reproducing species.
Children’s narrative interactions
Authors: Quasthoff Uta , Stude Juliane
Published: September 2020

This contribution traces which aspects of narrative acquisition have been emphasized in 30 years of Narrative Inquiry. It then uses this synopsis as a starting-point to present a theoretical and empirical framework which can be characterized by some of the aspects that have attracted less attention in the journal so far. The summary of this consistent interactive approach and some of the results of about 40 years of respective research, based on different corpora, should support the idea that taking up these aspects is worthwhile. Investigating a broad range of age-groups and comparing a variety of contexts, including peer-interaction and classrooms, as well as different genres such as conversational narratives of personal experience and fantasy stories, with a perspective on inter-individual differences, not only expand our knowledge about narrative acquisition, but lead to a new coherent resource-based explication of central concepts such as narration, competence and acquisition.
The impact of post-editing and machine translation on creativity and reading experience
Authors: Guerberof-Arenas Ana , Toral Antonio
Published: September 2020

This article presents the results of a study involving the translation of a fictional story from English into Catalan in three modalities: machine-translated (MT), post-edited (MTPE) and translated without aid (HT). Each translation was analysed to evaluate its creativity. Subsequently, a cohort of 88 Catalan participants read the story in a randomly assigned modality and completed a survey. The results show that HT presented a higher creativity score if compared to MTPE and MT. HT also ranked higher in narrative engagement, and translation reception, while MTPE ranked marginally higher in enjoyment. HT and MTPE show no statistically significant differences in any category, whereas MT does in all variables tested. We conclude that creativity is highest when professional translators intervene in the process, especially when working without any aid. We hypothesize that creativity in translation could be the factor that enhances reading engagement and the reception of translated literary texts.