bluuebunny/crossref_metadata_2025 huggingface dataset:
Instrumentation for automated solid phase peptide synthesis
Authors: Cammish Linda E , Kates Steven A
Published: November 2020

The concept of solid phase peptide synthesis introduced by Merrifield in 1963 involves elongating a peptide chain on a polymeric support via a two-step repetitive process: removal of the Nα-protecting group and coupling of the next incoming amino acid. A second feature of the solid phase technique is that reagents are added in large excesses which can be removed by simple filtration and washing. Since these operations occur in a single reaction vessel, the entire process is amenable to automation. Essential requirements for a fully automatic synthesizer include a set of solvent and reagent reservoirs, as well as a suitable reaction vessel to contain the solid support and enable mixing with solvents and reagents. Additionally, a system is required for selection of specific solvents and reagents with accurate measurement for delivery to and removal from the reaction vessel, and a programmer to facilitate these automatic operations is necessary. The current commercially available instruments offer a variety of features in terms of their scale (15 mg to 5 kg of resin), chemical compatibility with 9-fluorenylmethyloxycarbonyl/tert-butyl (Fmoc/tBu) and tert-butyloxycarbonyl/ benzyl (Boc/Bzl)-based methods, software (reaction monitoring and feedback control), and flexibility (additional washing and multiple activation strategies). In addition, certain instruments are better suited for the synthesis of more complex peptides such as cyclic, phosphorylated, and glycosylated sequences while others possess the ability to assemble a large number of peptide sequences. The selection of an instrument is dependent on the requirements and demands of an individual laboratory. This chapter will describe the features of the currently available systems. As the field of solid phase synthesis evolved, manufacturers designed systems based on the synergy between chemistry and engineering. A key component to an instrument is the handling of amino acids and their subsequent activation to couple to a polymeric support. The goal of an automated system is to duplicate conditions that provide stability to reactive species that might decompose. Standard protocols for automated synthesis incorporate carbodiimide, phosphonium, and aminium/uronium reagents, preformed active esters, and acid fluorides. For further details on coupling methods, see Chapter 3. A second issue related to coupling chemistry is the time required to dissolve an amino acid and store this solution.
Production of chimeras by blastocyst and morula injection of targeted ES cells
Authors: Papaioannou Virginia , Johnson Randall
Published: November 2020

The ability of mammalian embryos to incorporate foreign cells and develop as chimeras has been exploited for a variety of purposes including the elucidation of cell lineages, the investigation of cell potential, the perpetuation of mutations produced in embryonic stem (ES) cells by gene targeting, and the subsequent analysis of these mutations. The extent of contribution of the foreign cells depends on their developmental synchrony with the host embryo and their mitotic and developmental potential, which may be severely restricted if the cells bear mutations. If the goal in making chimeras is the transmission of a mutation produced by gene targeting to the next generation, the mutant ES cells must have the capacity to undergo meiosis and gametogenesis. Cells from two different mammalian embryos were first combined experimentally to produce a composite animal, dubbed a chimera, nearly four decades ago. Pairs of cleaving, pre-implantation embryos were mechanically associated in vitro until they aggregated together to make single large morulae; these in turn resulted in chimeric offspring (1). Genetic markers were used to distinguish the contributions of the two embryos in these animals. Since then, various methods for making chimeras have been explored to address different types of questions (2). In 1972 it was reported that highly asynchronous embryonic cells, which had been cultured in vitro, could contribute to chimeras upon re-introduction into pre-implantation embryos (3). Not long afterward, several groups working with teratocarcinomas, tumours derived from germ cells of the gonad, discovered that stem cells from these tumours, known as embryonal carcinoma cells, could contribute to an embryo if introduced into pre-implantation stages (4-6). It appeared that the undifferentiated stem cells of the tumour had enough features in common with early embryonic cells that they could respond to the embryonic environment, differentiating in a normal manner, even after long periods in vitro. Their embryonic potential was limited, however, and many teratocarcinoma cell lines made only meagre contributions to the developing fetus or even produced tumours in chimeras (7). Either their derivation from tumours or their extended sojourn in vitro rendered these cells so dissimilar from early embryonic cells that they rarely, if ever, had full embryonic potential.
Classical genetics and gene targeting
Authors: Bultman Scott , Magnuson Terry
Published: November 2020

Gene targeting has provided considerable insight into the functions of numerous genes since it was developed a decade ago (1-4). A listing of the diversity of targeted genes and breadth of mutant phenotypes characterized to date can be obtained through mouse mutation databases (http://www.bis.med. jhmi.edu/Dan/tbase.html and http://biomednet.com/cgi-bin/ mko/mkohome.pl) (5, 6). However, in order to take full advantage of this technology, classical genetic methods should be utilized to extend our knowledge of individual genes to genetic pathways. In this chapter, the significance of genetics in gene targeting and phenotype interpretation are discussed. We describe how Mendelian and quantitative genetics can be exploited to map modifier loci or generate animals carrying mutations in two or more genes. We also discuss the development and application of classical genetic approaches towards elucidating gene function such as generation of allelic series and creation of deletion complexes throughout the genome in ES cells and mice. Several genetic considerations should be taken into account during the initial stages of a gene targeting experiment. In order to maximize homologous recombination efficiency, both arms of a targeting vector should be isolated from the same strain of mice as that of the ES cells (see Chapter 1 for details). Although most ES cell lines have been isolated from 129 strains of mice, significant genetic variation exists among the different substrains, which is sometimes evident by pronounced differences in coat colour (see Chapter 4, Table 1) (7, 8). For instance, 129/Sv mice (Aw/Aw, +c-Tyr +p/+c-Tyr +p ) have a white-bellied agouti (Aw) phenotype, whereas 129/SvJ mice (Aw/Aw, Tyrc p/T yrc-ch p) have a cream colour owing to the effect of mutant tyrosinase (Tyr) and pink-eyed dilution (p) alleles which are epistatic to Aw (9). Molecular analysis of different 129 substrains using microsatellite markers has provided insight into their genetic differences and revealed that 129/SvJ is particularly divergent and actually contaminated with genomic regions of non-129 origin (7, 8). Before the significance of this heterogeneity was appreciated, many targeting vectors were constructed from 129/SvJ DNA for use in 129/Sv ES cell lines.
MCQs for Cardiology Knowledge Based Assessment
Authors: Augustine Daniel , Leeson Paul , Khavandi Ali
Published: November 2020

The first MCQ preparation book on the market for the KBA in Cardiology, MCQs for Cardiology Knowledge Based Assessment features over 260 questions exactly mirroring the format and content of the exam. 11 focused sequences of questions are followed by detailed explanatory answers, which draw in the relevant aspects of the current syllabus, refer you to further reading and provide you with the broad base of knowledge the examiners expect. Written by a team of cardiology registrars and consultants with recent experience of the exam, the format is designed to give you hands-on experience of the level and type of questions you can expect in the real thing. In addition to a huge variety of images and case scenarios forming the basis of clinical question stems, the book is accompanied by a DVD featuring dozens of video loops - ranging from coronary angiograms to echocardiography - to help you become practised at responding to a clinical stimulus in the context of a Single Best Answer question. Covering the whole scope of the syllabus and offering a truly authentic experience of the exam, MCQs for Cardiology Knowledge Based Assessment is the insider's guide to the KBA, to ensure you gain both the confidence and knowledge to pass.
The Later Prehistory of North-West Europe
Authors: Bradley Richard , Haselgrove Colin , Vander Linden Marc , Webley Leo
Published: November 2020

The Later Prehistory of North-West Europe provides a unique, up-to-date, and easily accessible synthesis of the later prehistoric archaeology of north-west Europe, transcending political and language barriers that can hinder understanding. By surveying changes in social forms, landscape organization, monument types, and ritual practices over six millennia, the volume reassesses the prehistory of north-west Europe from the late Mesolithic to the end of the pre-Roman Iron Age. It explores how far common patterns of social development are apparent across north-west Europe, and whether there were periods when local differences were emphasized instead. In relation to this, it also examines changes through time in the main axes of contact between the various regions of continental Europe, Britain, and Ireland. Key to the volume's broad scope is its focus on the vast mass of new evidence provided by recent development-led excavations. The authors collate data that has been gathered on thousands of sites across Britain, Ireland, northern France, the Low Countries, western Germany, and Denmark, using sources including unpublished 'grey literature' reports. The results challenge many aspects of previous narratives of later prehistory, allowing the volume to present a distinctively fresh perspective.
Surgical Management for Glaucoma
Authors: Kamal ElMallah Mohammed
Published: November 2020

•The most commonly performed incisional procedures for glaucoma are trabeculectomy and glaucoma tube shunts (glaucoma drainage device [GDD]). Trabeculectomy is the more prevalent surgical procedure, yet the use of GDD is increasing. Although practice patterns may change with the results of the Tube vs. Trabeculectomy Study, for most surgeons trabeculectomy remains their primary procedure. • A GDD is typically indicated when a trabeculectomy is judged likely to fail •Trabeculectomy in its current form was described by Cairns in 1968. •The basic concept is to create an alternate path for aqueous egress out of the eye into the subconjunctival space. •General anesthesia is indicated in pediatric patients as well as adults not able to cooperate during surgery.
Local anesthesia with monitored anesthesia care (MAC) is used in the vast majority of adults. Methods of local anesthesia vary based on surgeon preference as well as patient characteristics. See Table 12.2 for common routes of anesthetic administration.
A traction suture allows manipulation of the globe to provide adequate surgical exposure, which is essential for successful filtering surgery. •Superior rectus bridle suture provides good exposure but has been associated with worse outcomes, produces holes in the conjunctiva that could potentially leak, may increase conjunctival scarring, and carries a small risk of scleral perforation. •Superior corneal traction suture (Fig. 12.1A) provides good exposure but may interfere with wound closure in a fornix-based incision and carries a risk of corneal perforation. •Clinical Pearl: If a corneal perforation occurs, remove the suture and pass it in an adjacent area of cornea. Usually there is no leakage once the suture is removed. If leakage is present, the surgeon can hydrate the suture track. •Inferior corneal traction suture provides less exposure than superior sutures. There is less risk of wound superior distortion, so it may be useful for fornix-based incisions. Can be placed either at the limbus (fornix-based conjunctival flap) or in the fornix, 10 mm back from the limus (limbal-based conjunctival flap).
The Scientific Sherlock Holmes
Authors: O'Brien James
Published: November 2020

One of the most popular and widely known characters in all of fiction, Sherlock Holmes has an enduring appeal based largely on his uncanny ability to make the most remarkable deductions from the most mundane facts. The very first words that Sherlock Holmes ever says to Dr. Watson are, "How are you? You have been in Afghanistan, I perceive." Watson responds, "How on earth did you know that?" And so a crime-solving legend is born. In The Scientific Sherlock Holmes, James O'Brien provides an in-depth look at Holmes's use of science in his investigations. Indeed, one reason for Holmes's appeal is his frequent use of the scientific method and the vast scientific knowledge which he drew upon to solve mysteries. For instance, in heart of the book, the author reveals that Holmes was a pioneer of forensic science, making use of fingerprinting well before Scotland Yard itself had adopted the method. One of the more appealing aspects of the book is how the author includes real-world background on topics such as handwriting analysis, describing how it was used to capture the New York Zodiac killer and to clinch the case against the Lindbergh baby kidnapper. Sherlock Holmes was knowledgeable about several sciences, most notably chemistry. Therefore the book takes a close look at Holmes the chemist and discusses, for example, chemical poisons such as carbon monoxide, chloroform, and Prussic acid (the historical name for hydrogen cyanide). The author also debunks Isaac Asimov's famous assertion that Holmes was a blundering chemist. In addition, the book discusses mathematics, physics, biology, astronomy, meteorology, and geology, always in the context of Holmes's exploits. Sherlock Holmes continues to fascinate millions of readers and movie goers alike. The Scientific Sherlock Holmes is a must-read for the legion of fans of this most beloved of all fictional detectives.
Hurricane Climatology
Authors: Elsner James B. , Jagger Thomas H.
Published: November 2020

Hurricanes are nature's most destructive storms and they are becoming more powerful as the globe warms. Hurricane Climatology explains how to analyze and model hurricane data to better understand and predict present and future hurricane activity. It uses the open-source and now widely used R software for statistical computing to create a tutorial-style manual for independent study, review, and reference. The text is written around the code that when copied will reproduce the graphs, tables, and maps. The approach is different from other books that use R. It focuses on a single topic and explains how to make use of R to better understand the topic. The book is organized into two parts, the first of which provides material on software, statistics, and data. The second part presents methods and models used in hurricane climate research.
Organic Synthesis
Authors: Taber Douglass F.
Published: November 2020

Organic synthesis is a vibrant and rapidly evolving field; we can now cyclize amines directly onto alkenes. Like its predecessors, this reference leads readers quickly to the field's more important recent developments. Two years of Douglass F. Taber's popular weekly online column, "Organic Chemistry Highlights", as featured on the organic-chemistry.org website, are consolidated here, with cumulative indices of all four volumes in this series. Important topics that are covered range from powerful new methods for C-C bond construction to asymmetric organocatalysis and direct C-H functionalization. This go-to reference focuses on the most important recent developments in organic synthesis, and includes a succinct analysis of the significance and applicability of each new synthetic method.
Intelligent Drug Development
Authors: Tansey Michael
Published: November 2020

Clinical research is heavily regulated and involves coordination of numerous pharmaceutical-related disciplines. Each individual trial involves contractual, regulatory, and ethics approval at each site and in each country. Clinical trials have become so complex and government requirements so stringent that researchers often approach trials too cautiously, convinced that the process is bound to be insurmountably complicated and riddled with roadblocks. A step back is needed, an objective examination of the drug development process as a whole, and recommendations made for streamlining the process at all stages. With Intelligent Drug Development, Michael Tansey systematically addresses the key elements that affect the quality, timeliness, and cost-effectiveness of the drug-development process, and identifies steps that can be adjusted and made more efficient. Tansey uses his own experiences conducting clinical trials to create a guide that provides flexible, adaptable ways of implementing the necessary processes of development. Moreover, the processes described in the book are not dependent either on a particular company structure or on any specific technology; thus, Tansey's approach can be implemented at any company, regardless of size. The book includes specific examples that illustrate some of the ways in which the principles can be applied, as well as suggestions for providing a better context in which the changes can be implemented. The protocols for drug development and clinical research have grown increasingly complex in recent years, making Intelligent Drug Development a needed examination of the pharmaceutical process.
The Art of Narrative Psychiatry
Authors: Hamkins SuEllen
Published: November 2020

Narrative psychiatry empowers patients to shape their lives through story. Rather than focusing only on finding the source of the problem, in this collaborative clinical approach psychiatrists also help patients diagnose and develop their sources of strength. By encouraging the patient to explore their personal narrative through questioning and story-telling, the clinician helps the patient participate in and discover the ways in which they construct meaning, how they view themselves, what their values are, and who it is exactly that they want to be. These revelations in turn inform clinical decision-making about what it is that ails them, how they'd like to treat it, and what recovery might look like. The Art of Narrative Psychiatry is the first comprehensive description of narrative psychiatry in action. Engaging and accessible, it demonstrates how to help patients cultivate their personal sources of strength and meaning as resources for recovery. Illustrated with vivid case reports and in-depth accounts of therapeutic conversations, the book offers psychiatrists and psychotherapists detailed guidance in the theory and practice of this collaborative approach. Drawing inspiration from narrative therapy, post-modern philosophy, humanistic medicine, and social justice movements - and replete with ways to more fully manifest the intentions of the mental health recovery model - this engaging new book shows how to draw on the standard psychiatric toolbox while also maintaining focus on the patient's vision of the world and illuminating their skills and strengths. Written by a pioneer in the field, The Art of Narrative Psychiatry describes a breadth of nuanced, powerful narrative practices, including externalizing problems, listening for what is absent but implicit, facilitating re-authoring conversations, fostering communities of support, and creating therapeutic documents. The Art of Narrative Psychiatry addresses mental health challenges that range from mild to severe, including anxiety, depression, despair, anorexia/bulimia, perfectionism, OCD, trauma, psychosis, and loss. True to form, the author narrates her own experience throughout, sharing her internal thoughts and decision-making processes as she listens to patients. The Art of Narrative Psychiatry is necessary reading for any professional seeking to empower their patients and become a better, more compassionate clinician.
Gay (White) Male Speech and the E(race)sure of Identity
Authors: Cornelius Brianna R.
Published: November 2020

Although a notable body of work has emerged describing gay male speech (GMS), its overlap with African American language (AAL) remains comparatively understudied. This chapter explores the assumption of whiteness that has informed research on gay identity and precluded intersectional considerations in sociolinguistic research. Examining the importance of racial identity, particularly Blackness, to the construction of gay identity in the United States, the chapter investigates the treatment of GMS as white by default, with the voices of gay men of color considered additive. The desire vs. identity debate in language and sexuality studies contributed to an understanding of gay identity as community-based practice, thereby laying a necessary framework for the study of GMS. However, this framework led to a virtually exclusive focus on white men’s language use. Although efforts to bring a community-based understanding to gay identity have been groundbreaking, the lack of consideration of intersectionality has erased contributions to GMS from racially based language varieties, such as AAL.
Neoliberal Pleasure: Intimate Talk about Female Sexual Experience
Authors: Couper Shannon
Published: November 2020

Sociolinguists have investigated the language of sexual violence and consent at length, but sexual pleasure remains largely overlooked. Sexual pleasure has often been forgotten in the battle against rape culture, but this discussion centers it. First, relevant concepts from the sociolinguistic scholarship are positioned alongside queer feminist conceptions of sexual pleasure. The discussion then turns to New Zealand case studies of conversations in intimate friendships about sexual pleasure to demonstrate how navigating conflicting discourses transforms sexual pleasure into a neoliberal project. A critical response is offered in a consideration of pleasure activism and how further sociolinguistic attention can harness the political power of pleasure. Sexual pleasure is a significant contributor to advancing sexual liberation, and sociolinguistic efforts to understand these complexities are important. Without paying attention to how sexual experiences are made sense of in intimate conversations, there is a risk of ensnaring pleasure in traps of faux empowerment discourse and neoliberal constraints.
“Enjoy It, Destroy It?” 40 Years of Punk Rock Scholarship
Authors: Wright Lucy
Published: November 2020

This chapter reviews (English-language) punk scholarship since the origins of the music and the subculture in the mid-1970s, from Britain, the United States, and more broadly. It draws on over 150 sources. The aim of the chapter is to identify and articulate pertinent themes from across the spectrum of punk scholarship, and to explore ways in which punk rock has—to date—been conceived and conceptualized. It organizes the material into six categories: punk beginnings, politics, identities, materialities, spaces, and legacies.
The General Impact of Context on Aesthetic Experience
Authors: Pelowski Matthew , Specker Eva
Published: November 2020

This chapter discusses the general impact of context on the aesthetic experience. It is designed to anticipate the other chapters’ discussions of context’s specific areas—the social, the physical or institutional, information and framing, museums, background or personality-related features. Here, the authors offer a more general consideration discussing key aspects such as: What even is context? How can it best be thought about? What are the key issues that might be considered? And, especially, how can it be generally integrated into present knowledge of models of aesthetic processing experience? Beginning with the interest in context throughout the history of aesthetics, the chapter builds a presentation of empirical approaches and especially theory, focusing on context’s main layers and points of influence. It then discusses how key context issues might be considered in models of aesthetic processing, with the goal of providing a framework for better approaching context aspects in this book and in one’s own future studies. This is also interspersed with what the authors consider to be some of the more intriguing studies in order to spur readers’ thinking about the potential for studying context. The chapter concludes with some major issues, some candidates for future consideration, and suggestions for further reading and education.
Public Administration
Authors: Spanou Calliope
Published: November 2020

The chapter examines the legacies of Greek public administration and the drivers of modernization, from democratization in the 1980s, to Europeanization in the 1990s and the economic crisis starting in 2010. It describes public administration as a quasi-Weberian bureaucracy that is characterized by three interrelated deficits: legitimacy, efficiency, and institutionalization. These capture its most important weaknesses. Politicization which has been the most debated aspect, is seen as a form of symbiosis between politics and administration that tends to sideline efficiency and modernization requirements. The ‘low reform capacity’, which is usually attributed to its Napoleonic origins, contrasts vividly with the profusion of administrative reforms and the constant presence of the issue on the domestic political agenda. Administrative modernization progressed in the 1990s as part of Europeanization, though the then dominant new public management ideas have generally been resisted in favour of a neo-Weberian reform mix. However, critical deficiencies were exposed with the outbreak of the economic crisis in 2010. Subsequently, administrative reform became an extensive chapter of the three fiscal and macro-economic adjustment programmes. External pressure induced reform activity, but results appear uneven, depending on the reform area. Despite improvements, intrinsic and contextual factors linked to fiscal consolidation and the adjustment programmes’ conditionality account for the absence of radical transformation in the modus operandi of the political-administrative system.
The Politics of Europeanization
Authors: Featherstone Kevin , Papadimitriou Dimitris
Published: November 2020

‘Europe’, ‘Europeans’, and ‘Europeanness’ have been crucial themes in the history of modern Greece, from the creation of the new state in 1832 to the sovereign debt crisis of 2010. As elsewhere, these notions have served as référentiels in questions of national identity, progress, capability, legitimation and strategic interest. In the Greek case, the European dimension to these questions has been felt acutely. This chapter considers Greece’s political development in the context of its membership of the European Union, assessing the extent to which the latter has prompted domestic reform. A general theme that emerges from the scholarly literature in this area is of Greece’s uneven adaptation across different sectors, a feature that provokes interesting research contrasts, but also challenges of interpretation. To understand how EU pressures for adaptation have been received domestically, the chapter opens with a discussion of the changing images and meanings of ‘Europe’ in Greece. This is followed by an assessment of the range and significance of the domestic adaptation of policies and regulations to EU legislation, as established by existing academic studies and policy papers. We note the current state of knowledge of Europeanization impacts on Greece, the implications of the findings, and pointers for future research. The unevenness of adaptation is an essential lens for analysis.
Anaphora Resolution
Authors: Mitkov Ruslan
Published: November 2020

This chapter provides a theoretical background of anaphora and introduces the varieties of this pervasive linguistic phenomenon. Next, it defines the task of anaphora resolution and introduces it as a three-stage process: identification of anaphors, location of the candidates for antecedents, and the resolution algorithm. After that, the chapter outlines a selection of influential and extensively cited anaphora resolution algorithms and proceeds to discuss issues related to the evaluation of anaphora resolution algorithms. Recent deep learning work on anaphora and coreference resolution is briefly presented as well. Finally, the chapter explains why anaphora resolution is important for various NLP applications.
TOWARDS NATIONAL DIAGNOSTIC REFERENCE LEVELS FOR MAMMOGRAPHY IN SERBIA
Authors: Rafajlovic S , Ciraj-Bjelac O , Bozovic P
Published: November 2020

The objective of this work is to investigate the possibility to set a national diagnostic reference levels (nDRLs) for diagnostic and screening mammography in Serbia based on local practice and available resources. This study included all types of mammography systems that are currently used in Serbia, namely screen-film mammography (SFM), computed radiography (CR) and full-field digital mammography (FFDM). The nDRLs are provided in terms of mean glandular dose (MGD) for different breast thicknesses simulated by polymethyl methacrylate (PMMA) phantom. For each breast thickness, MGD was calculated for the X-ray tube output, using clinically used exposure parameters. DRLs were chosen as the 75th percentile of MGD distribution for 20-, 40-, 45-, 60- and 70-mm phantom thicknesses. For SFM units proposed nDRL values are 0.7, 2.1, 2.7, 4.6 and 6.8 mGy; for CR units proposed nDRL values are 0.7, 1.8, 2.4, 4.5 and 5.6 mGy; and corresponding values for FFDM units are 0.8, 1.7, 2, 2. and 3.2 mGy for 20-, 40-, 45-, 60- and 70-mm PMMA thickness, respectively.
Management of Patients With Graves Orbitopathy Using Endonasal Endoscopic Techniques
Authors: Gras-Cabrerizo Juan R. , Rodríguez-Álvarez Fernando , Gomez-Anson Beatriz , Cubero-Marcos José María , Martel-Martin Maria , Granell-Moreno Esther , Lopez-Vilas Montserrat , Montserrat-Gili Joan Ramon , Massegur-Solench Humbert
Published: November 2020

Objective:

The aim of the authors’ study is to show their surgical results in orbital decompression using different endonasal endoscopic techniques. These approaches are according to the degree of proptosis and the presence or not of sight threatening.

Methods:

The authors performed 31 orbital decompressions on 20 Graves orbitopathy patients. Average age at surgery was 52 years. There were 5 males and 15 females. Five patients were diagnosed as having severe or for sight-threatening Graves orbitopathy. These included 3 men and 2 women having an average age of 54 years old. Minimum postsurgical follow-up was 12 months in all patients.

Results:

Orbital decompression was performed in 15 patients for proptosis and in 5 patients for urgent sight threat. Thirteen orbits showed mild proptosis and 18 orbits presented moderate proptosis. In patients without sight threatening reduction of proptosis had a mean value of 2.8 mm as determined by exophtalmometry, being 3.3 mm when measured on magnetic resonance imaging. The mean millimeter in mild proptosis was between 1.5 and 1.7 and between 3.4 and 4.2 in moderate proptosis. In patients having sight threat mean visual acuity after surgery improved from 0.6 to 0.9.

Only 1 patient without diplopia preoperative developed diplopia after surgery (17%). In 55% of patients strabismus and/or eyelid surgery were required.

In postoperative follow-up, 2 patients developed a mucocele and 1 patient developed corneal erosion.

Conclusion:

The authors recommend the preservation of the periorbital sling and the anterior ethmoido-maxillary angle in patients with mild-moderate exophthalmos and without threatened vision. In case of sight threatening the authors resected the most periorbita as much as possible.

Evidence-based medicine Level V.
Delays, masks, the elderly, and schools: first COVID-19 wave in the Czech Republic
Authors: Smyčka Jan , Levínský René , Hromádková Eva , Šoltés Michal , Šlerka Josef , Tuček Vít , Trnka Jan , Šmíd Martin , Zajíček Milan , Diviák Tomáš , Neruda Roman , Vidnerová Petra , Berec Luděk
Published: November 2020

Running across the globe for more than a year, the COVID-19 pandemic keeps demonstrating its strength. Despite a lot of understanding, uncertainty regarding the efficiency of interventions still persists. We developed an age-structured epidemic model parameterized with sociological data for the Czech Republic and found that (1) delaying the spring 2020 lockdown by four days produced twice as many confirmed cases by the end of the lockdown period, (2) personal protective measures such as face masks appear more effective than just a reduction of social contacts, (3) only sheltering the elderly is by no means effective, and (4) leaving schools open is a risky strategy. Despite the onset of vaccination, an evidence-based choice and timing of non-pharmaceutical interventions still remains the most important weapon against the COVID-19 pandemic.

One sentence summary

We address several issues regarding COVID-19 interventions that still elicit controversy and pursue ignorance
Evaluating the Efficacy of Tocilizumab in Moderate to Severe COVID-19 with Progressive Illness despite Steroids: Identifying the Optimal Timing of its Administration in C3G study
Authors: Madan Surabhi , Rana Manish , Gajjar Rohan , Shah Nitesh , Thakkar Vipul , Shah Bhagyesh , Dabhi Pradip , Patel Minesh , Shah Hardik , Chovatiya Rashmi , Soni Maulik , Bapat Nirav , Patel Amit
Published: November 2020

Background

High mortality has been described in coronavirus disease 2019 (COVID-19) with cytokine release syndrome (CRS). Tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist may be associated with improved outcomes in such patients; however, the subgroups of patients who benefit the most need to be identified.

Objective

To analyze the efficacy and optimal timing of administration of TCZ in moderate to severe COVID-19 with features of CRS, where the response to steroids was poor.

Methods

This is a retrospective study of 125 patients admitted between May 5 to July 31, 2020, in a tertiary care hospital in western India, with moderate to severe COVID-19 who were treated with TCZ along with steroids. The primary outcomes were the need for mechanical ventilation (MV) or death, and secondary outcomes were a decrease in oxygen requirement and inflammatory markers; the incidence of secondary infections, and renal or hepatic dysfunction. Kaplan Meier survival analysis and log rank test were used for evaluating primary outcomes. Secondary outcomes were analyzed using the Wilcoxon Signed-Rank test.

Results

Among 1081 patients admitted during the study period, 125 were administered TCZ (median age, 56 [95% CI 54 - 60] years; 100 [80%] male). The commonest symptoms were fever (96%), cough (64%), and dyspnea (48.8%). 78.4% patients had comorbidities (hypertension 51.2%, diabetes 43.2%, obesity 25.6% and chronic cardiac disease 13.6%). Of 117 patients who were treated with TCZ before requiring MV, 18.8% progressed to MV. Overall, 25% of the patients needed MV support. 65.3% of patients were discharged by day 14 after TCZ administration. Mortality was nil, 16.2%, 50%, and 62.5% in patients who received TCZ on room air, low flow oxygen, high flow nasal cannula (HFNC) and bilevel positive airway pressure (BiPAP), and MV respectively; overall 24.8% of patients died. Survival analysis showed no difference in outcome with respect to age and gender, while progression to MV showed a statistically significant reduction for the event death (90.9% of patients who progressed to MV died as compared to 6.3% who did not; log rank test with p < 0.0001). No adverse events were noticed.

Conclusion

Mortality was least in patients of COVID-19 with CRS who received TCZ while on low flow oxygen. When administered in the early hypoxemic phase, TCZ is associated with reduced mortality and decreased need for mechanical ventilation.
Balancing quarantine and self-distancing measures in adaptive epidemic networks
Authors: Horstmeyer Leonhard , Kuehn Christian , Thurner Stefan
Published: November 2020

We study the relative importance of two key control measures for epidemic spreading: endogenous social self-distancing and exogenous imposed quarantine. We use the framework of adaptive networks, moment-closure, and ordinary differential equations (ODEs) to introduce several novel models based upon susceptible-infected-recovered (SIR) dynamics. First, we compare computationally expensive, adaptive network simulations with their corresponding computationally highly efficient ODE equivalents and find excellent agreement. Second, we discover that there exists a relatively simple critical curve in parameter space for the epidemic threshold, which strongly suggests that there is a mutual compensation effect between the two mitigation strategies: as long as social distancing and quarantine measures are both sufficiently strong, large outbreaks are prevented. Third, we study the total number of infected and the maximum peak during large outbreaks using a combination of analytical estimates and numerical simulations. Also for large outbreaks we find a similar compensation effect as for the epidemic threshold. This suggests that if there is little incentive for social distancing within a population, drastic quarantining is required, and vice versa. Both pure scenarios are unrealistic in practice. Our models show that only a combination of measures is likely to succeed to control epidemic spreading. Fourth, we analytically compute an upper bound for the total number of infected on adaptive networks, using integral estimates in combination with the moment-closure approximation on the level of an observable. This is a methodological innovation. Our method allows us to elegantly and quickly check and cross-validate various conjectures about the relevance of different network control measures. In this sense it becomes possible to adapt models rapidly to new epidemic challenges such as the recent COVID-19 pandemic.
Systematic comparative analysis of Mendelian randomization methods for inferring causal genes of complex phenotypes and the application to psychiatric diseases
Authors: Jiang Lin , Yi Guorong , Li Xiangyi , Xue Chao , Li Mulin Jun , Huang Hailiang , Li Miaoxin
Published: November 2020

Isolating causal genes from enormous genome-wide association signals of complex phenotypes remains an open and challenging question. SMR (Summary-based Mendelian Randomization) is a widely used Mendelian randomization (MR) method for inferring causal genes by using a single expression quantitative trait locus (eQTL). In the present study, we explored more powerful MR methods based on multiple eQTLs. Among six representative multiple instrumental variable (IVs) based MR methods, original used in the epidemiological field, not all MR methods worked for the causal gene estimation. But we found the maximum-likelihood based MR method and weighted median-based MR method were preferable to the other four MR methods in terms of valid type 1 errors, acceptable statistical powers and robustness to linkage disequilibrium (LD) in eQTLs. Both of the MR methods were also much more powerful than the SMR. We recalibrated key parameters of the two MR methods in practices and developed a multiple IVs based MR analysis framework for causal gene estimation, named MACG and available at http://pmglab.top/kggsee. In the applications, MACG not only rediscovered many known causal genes of the schizophrenia and bipolar disorder, but also reported plenty of promising candidate causal genes. In conclusion, this study provided a powerful tool and encouraging exemplars of mining potential causal genes from huge amounts of GWAS signals with eQTLs.
Preventing extinctions post-2020 requires recovery actions and transformative change
Authors: Bolam Friederike C. , Ahumada Jorge , Akçakaya H. Reşit , Brooks Thomas M. , Elliott Wendy , Hoban Sean , Mair Louise , Mallon David , McGowan Philip J.K. , Raimondo Domitilla , Rodríguez Jon Paul , Roe Dilys , Seddon Mary B. , Shen Xiaoli , Stuart Simon N. , Watson James E.M. , Butchart Stuart H.M.
Published: November 2020

Stopping human-induced extinctions will require strong policy commitments that comprehensively address threats to species. In 2021, a new Global Biodiversity Framework will be agreed by the Convention on Biological Diversity. Here we investigate how the suggested targets could contribute to reducing threats to threatened vertebrates, invertebrates, and plants, and assess the importance of a proposed target to implement recovery actions for threatened species. We find that whilst many of the targets benefit species, extinction risk for over one third of threatened species would not be reduced sufficiently without a target on recovery actions, includingex situconservation, reintroductions and other species-specific interventions. A median of 41 threatened species per country require such actions, and they are found in most countries of the world. To prevent future extinctions, policy commitments must include recovery actions for the most threatened species in addition to broader transformative change.
Does psychological climate affect task and contextual performance through affective commitment? Evidence from public sector companies
Authors: Uraon Ram Shankar , Gupta Manish
Published: November 2020

Purpose

This paper has two main purposes. One purpose is to examine the mediating role of affective commitment in the relationship between psychological climate and contextual and task performance. Another purpose is to conceptualize and measure the psychological climate.

Design/methodology/approach

Data were analyzed using a sample of 514 employees working in 12 public sector companies in India. Partial least squares (PLS) technique was used to test the proposed research framework.

Findings

The results of this study revealed that affective commitment has a mediating role in the relationship between psychological climate and contextual performance as well as between psychological climate task performance.

Research limitations/implications

The findings of this study augment the theory of psychological climate by suggesting that individuals perceiving high a psychological climate are likely to have the high affective commitment that ultimately leads to higher performance.

Practical implications

Public sector companies are encouraged to provide a favorable psychological climate that can emotionally commit the employees to perform well.

Originality/value

This study is one of its kinds to overcome the limitations of the earlier studies such as in examining the effect of higher-order psychological climate on task and contextual performances.
Different student achievement profiles in a learning study about integers: are the students included?
Authors: Lövström Anna , Malmqvist Johan , Olteanu Constanta
Published: November 2020

Purpose

The aim of this study is to investigate achievement profiles in mathematics when integers are taught in a learning study in grade three (to children 8–9 years old) and to explore to what extent students with such profiles participate in inclusive teaching and learning practices.

Design/methodology/approach

Data from a previous learning study are re-analysed, supported by a framework that enables the investigation of inclusive practices. In the present study, inclusion and achievement are viewed as interrelated, meaning that student achievement must be incorporated in the definition of inclusion. The analysis is based on documentation of a video-recorded lesson and on identical tests conducted before and after the lesson.

Findings

The general framing of the learning study indicates an inclusive practice, while pre- and post-test achievement together with data from the lesson reveal a mixed picture concerning student achievement and inclusion. The analysis of the pre- and post-test results for the 16 students in the class indicates considerable diversity in student achievement, resulting in four achievement profiles. The main conclusion is that some students gained from participating in the learning study lesson while others did not. The extensive analysis of four students' participation, one for each profile, shows that differences in student achievement are related to the extent to which students participate in inclusive teaching and learning practices.

Originality/value

While previous research on learning studies has mainly considered average student achievement, this study focuses on individual variation in achievement and the reasons for it, a matter largely neglected in previous learning study research.
Effect of internal competitive work environment on working smart and emotional exhaustion: the moderating role of time management
Authors: Kalra Ashish , Agnihotri Raj , Talwar Sunali , Rostami Amin , Dwivedi Prabhat K.
Published: November 2020

Purpose

Although the role of the internal competitive work environment is important, it remains understudied in a business-to-business (B2B) selling context. Grounded in job-demands resources theory, this study aims to investigate the relationships between internal competitive work environment, working smart, emotional exhaustion and sales performance.

Design/methodology/approach

Data were gathered from 147 salespeople working for a financial service firm. Sales performance ratings were reported by supervisors. Hypotheses were tested using structural equation modeling.

Findings

This study finds dual effects of the internal competitive work environment on salesperson’s job outcomes. Although such an environment improves working smart behaviors, which increases sales performance, it also increases emotional exhaustion, which reduces sales performance.

Research limitations/implications

This study extends job-demands resources theory by proposing internal competitive work environment as a challenge demand and extends the theory by proposing that a salesperson’s time management skills as a personal resource that may reduce such environment’s deleterious effects.

Practical implications

Sales managers should consider the complex nature of increasing competition within the organization and assess the ability of their workforce to effectively manage their time. Training programs that develop time management skills should also be promoted.

Originality/value

To the best of the authors’ knowledge, this study is among the first to consider the multifaceted effects of the internal competitive work environment in a B2B sales context. By focusing on the duality of the work environment, this study provides a greater understanding of the influences of organizational factors on sales performance.