bluuebunny/crossref_metadata_2025 huggingface dataset:
Mucus threads from surface goblet cells clear particles from the airways
Authors: Ermund Anna , Meiss Lauren N. , Dolan Brendan , Jaudas Florian , Ewaldsson Lars , Bähr Andrea , Klymiuk Nikolai , Hansson Gunnar C.
Published: November 2021

Background

The mucociliary clearance system driven by beating cilia protects the airways from inhaled microbes and particles. Large particles are cleared by mucus bundles made in submucosal glands by parallel linear polymers of the MUC5B mucins. However, the structural organization and function of the mucus generated in surface goblet cells are poorly understood.

Methods

The origin and characteristics of different mucus structures were studied on live tissue explants from newborn wild-type (WT), cystic fibrosis transmembrane conductance regulator (CFTR) deficient (CF) piglets and weaned pig airways using video microscopy, Airyscan imaging and electron microscopy. Bronchoscopy was performed in juvenile pigs in vivo.

Results

We have identified a distinct mucus formation secreted from the surface goblet cells with a diameter less than two micrometer. This type of mucus was named mucus threads. With time mucus threads gathered into larger mucus assemblies, efficiently collecting particles. The previously observed Alcian blue stained mucus bundles were around 10 times thicker than the threads. Together the mucus bundles, mucus assemblies and mucus threads cleared the pig trachea from particles.

Conclusions

These results demonstrate that normal airway mucus is more complex and has a more variable structural organization and function than was previously understood. These observations emphasize the importance of studying young objects to understand the function of a non-compromised lung.
Nanovesicles derived from bispecific CAR-T cells targeting the spike protein of SARS-CoV-2 for treating COVID-19
Authors: Zhu Tianchuan , Xiao Yuchen , Meng Xiaojun , Tang Lantian , Li Bin , Zhao Zhaoyan , Tan Qingqin , Shan Hong , Liu Lei , Huang Xi
Published: November 2021

Background

Considering the threat of the COVID-19 pandemic, caused by SARS-CoV-2, there is an urgent need to develop effective treatments. At present, neutralizing antibodies and small-molecule drugs such as remdesivir, the most promising compound to treat this infection, have attracted considerable attention. However, some potential problems need to be concerned including viral resistance to antibody-mediated neutralization caused by selective pressure from a single antibody treatment, the unexpected antibody-dependent enhancement (ADE) effect, and the toxic effect of small-molecule drugs.

Results

Here, we constructed a type of programmed nanovesicle (NV) derived from bispecific CAR-T cells that express two single-chain fragment variables (scFv), named CR3022 and B38, to target SARS-CoV-2. Nanovesicles that express both CR3022 and B38 (CR3022/B38 NVs) have a stronger ability to neutralize Spike-pseudovirus infectivity than nanovesicles that express either CR3022 or B38 alone. Notably, the co-expression of CR3022 and B38, which target different epitopes of spike protein, could reduce the incidence of viral resistance. Moreover, the lack of Fc fragments on the surface of CR3022/B38 NVs could prevent ADE effects. Furthermore, the specific binding ability to SARS-CoV-2 spike protein and the drug loading capacity of CR3022/B38 NVs can facilitate targeted delivery of remdesiver to 293 T cells overexpressing spike protein. These results suggest that CR3022/B38 NVs have the potential ability to target antiviral drugs to the main site of viral infection, thereby enhancing the antiviral ability by inhibiting intracellular viral replication and reducing adverse drug reactions.

Conclusions

In summary, we demonstrate that nanovesicles derived from CAR-T cells targeting the spike protein of SARS-COV-2 have the ability to neutralize Spike-pseudotyped virus and target antiviral drugs. This novel therapeutic approach may help to solve the dilemma faced by neutralizing antibodies and small-molecule drugs in the treatment of COVID-19.

Graphical Abstract
Differences in ICSI utilization rates among states with insurance mandates for ART coverage
Authors: Zagadailov Pavel , Cho Kyung S. , Seifer David B.
Published: November 2021

Background

Assisted reproductive technology (ART) insurance mandates promote more selective utilization of ART clinic resources including intracytoplasmic sperm injection (ICSI). Our objective was to examine whether ICSI utilization differs by state insurance mandates for ART coverage and assess if such a difference is associated with male factor, preimplantation genetic testing (PGT), and/or live birth rates.

Methods

In this retrospective analysis of the Centers for Disease Control (CDC) data from 2018, ART clinics in ART-mandated states (n = 8, AR, CT, HI, IL, MD, MA, NJ, RI) were compared individually to one another and with non-mandated states in aggregate (n = 42) for use of ICSI, male factor, PGT, and live birth rates. ANOVA was used to evaluate differences between ART-mandated states and non-mandated states. Individual ART-mandated states were compared using Welch t-tests. Statistical significance was determined by Bonferroni Correction.

Results

There were significant differences in ICSI rates (%, mean ± SD) between MA (53.3 ± 21.3) and HI (90.7 ± 19.6), p = 0.028; IL (86.5 ± 18.7) and MA, p = 0.002; IL and MD (57.2 ± 30.8), p = 0.039; IL and NJ (62.0 ± 26.8), p = 0.007; between non-mandated states in aggregate (79.9 ± 19.9) and MA, p = 0.006, and NJ (62.0 ± 26.8), p = 0.02. Male factor rates of HI (65.8 ± 16.0) were significantly greater compared to CT (18.8 ± 8.7), IL (26.0 ± 11.9), MA (26.9 ± 6.6), MD (29.3 ± 9.9), NJ (30.6 ± 17.9), and non-mandated states in aggregate (29.7 ± 13.7), all p < 0.0001. No significant differences were reported for use of PGT and/or live birth rates across all age groups regardless of mandate status.

Conclusions

ICSI use varied significantly among ART-mandated states while demonstrating no differences in live birth rates. These data suggest that the prevalence of male factor and the presence of a state insurance mandate are not the only factors influencing ICSI use. It is suggested that other non-clinical factors may impact the rate of ICSI utilization in a given state.
CD226 knockout alleviates high-fat diet induced obesity by suppressing proinflammatory macrophage phenotype
Authors: Ma Jingchang , Hu Wei , Zhang Dongliang , Xie Jiangang , Duan Chujun , Liu Yitian , Wang Yuling , Xu Xuexue , Cheng Kun , Jin Boquan , Zhang Yuan , Zhuang Ran
Published: November 2021

Obesity is associated with chronic low-grade inflammation, contributing to an increasing prevalence of chronic metabolic diseases, such as insulin resistance, non-alcoholic fatty liver disease (NALFD), and steatohepatitis. Macrophages are the predominant immune cells in adipose tissues. Adipose tissue macrophages (ATMs) would switch to pro-inflammatory M1 state during obesity, causing local and systemic inflammation. However, the regulatory mechanism of ATMs has not yet been well described within this process. Using a high-fat diet (HFD)–induced mouse obesity model, we found that the costimulatory molecule CD226 was highly expressed on ATMs and knockout (KO) of CD226 alleviated obesity caused by HFD. Loss of CD226 reduced the accumulation of ATMs and hindered macrophage M1 polarization, with lower serum proinflammatory cytokine levels. Furthermore, deficiency of CD226 on ATMs decreased the phosphorylation levels of VAV1, AKT, and FOXO1 and thereby upregulated PPAR-γ. Further administration of PPAR-γ inhibitor restored M1 phenotype in CD226KO ATMs. In summary, loss of CD226 alleviates the HFD-induced obesity and systemic inflammation through inhibition of the accumulation and M1 polarization of ATMs in which PPAR-γ-dependent signaling pathway is involved, suggesting that CD226 may be identified as a potential molecular target for the clinical treatment of obesity.
Wheat in vivo RNA structure landscape reveals a prevalent role of RNA structure in modulating translational subgenome expression asymmetry
Authors: Yang Xiaofei , Yu Haopeng , Sun Wenqing , Ding Ling , Li Ji , Cheema Jitender , Ramirez-Gonzalez Ricardo , Zhao Xuebo , Martín Azahara C. , Lu Fei , Liu Bao , Uauy Cristobal , Ding Yiliang , Zhang Huakun
Published: November 2021

Background

Polyploidy, especially allopolyploidy, which entails merging divergent genomes via hybridization and whole-genome duplication (WGD), is a major route to speciation in plants. The duplication among the parental genomes (subgenomes) often leads to one subgenome becoming dominant over the other(s), resulting in subgenome asymmetry in gene content and expression. Polyploid wheats are allopolyploids with most genes present in two (tetraploid) or three (hexaploid) functional copies, which commonly show subgenome expression asymmetry. It is unknown whether a similar subgenome asymmetry exists during translation. We aim to address this key biological question and explore the major contributing factors to subgenome translation asymmetry.

Results

Here, we obtain the first tetraploid wheat translatome and reveal that subgenome expression asymmetry exists at the translational level. We further perform in vivo RNA structure profiling to obtain the wheat RNA structure landscape and find that mRNA structure has a strong impact on translation, independent of GC content. We discover a previously uncharacterized contribution of RNA structure in subgenome translation asymmetry. We identify 3564 single-nucleotide variations (SNVs) across the transcriptomes between the two tetraploid wheat subgenomes, which induce large RNA structure disparities. These SNVs are highly conserved within durum wheat cultivars but are divergent in both domesticated and wild emmer wheat.

Conclusions

We successfully determine both the translatome and in vivo RNA structurome in tetraploid wheat. We reveal that RNA structure serves as an important modulator of translational subgenome expression asymmetry in polyploids. Our work provides a new perspective for molecular breeding of major polyploid crops.
Strong thermal stratification reduces detection efficiency and range of acoustic telemetry in a large freshwater lake
Authors: Kuai Yulong , Klinard Natalie V. , Fisk Aaron T. , Johnson Timothy B. , Halfyard Edmund A. , Webber Dale M. , Smedbol Stephanie J. , Wells Mathew G.
Published: November 2021

Background

The successful use of acoustic telemetry to detect fish hinges on understanding the factors that control the acoustic range. The speed-of-sound in water is primarily a function of density, and in freshwater lakes density is primarily driven by temperature. The strong seasonal thermal stratification in the Great Lakes represent some of the steepest sound speed gradients in any aquatic system. Such speed-of-sound gradients can refract sound waves leading to greater divergence of acoustic signal, and hence more rapid attenuation. The changes in sound attenuation change the detection range of a telemetry array and hence influence the ability to monitor fish. We use 3 months of data from a sentinel array of V9 and V16 Vemco acoustic fish tags, and a record of temperature profiles to determine how changes in stratification influence acoustic range in eastern Lake Ontario.

Result

We interpret data from an acoustic telemetry array in Lake Ontario to show that changes in acoustic detection efficiency and range correlate strongly with changes in sound speed gradients due to thermal stratification. The steepest sound speed gradients of 10.38 m s−1/m crossing the thermocline occurred in late summer, which caused the sound speed difference between the top and bottom of the water column to be greater than 60 m/s. V9 tags transmitting across the thermocline could have their acoustic range reduced from > 650 m to 350 m, while the more powerful V16 tags had their range reduced from > 650 m to 450 m. In contrast we found that when the acoustic source and receiver were both transmitting below thermocline there was no change in range, even as the strength of sound speed gradient varied.

Conclusion

Changes in thermal stratification occur routinely in the Great Lakes, on timescales between months and days. The acoustic range can be reduced by as much as 50% compared to unstratified conditions when fish move across the thermocline. We recommend that researchers consider the influences of thermal stratification to acoustic telemetry when configuring receiver position.
Radiology reporting in oncology—oncologists’ perspective
Authors: Spînu-Popa Elisabeta Valeria , Cioni Dania , Neri Emanuele
Published: November 2021

Background

Structured reporting and standardized criteria are increasingly recognized as means of improving both radiological and clinical practice by allowing for better content and clarity. Our aim was to examine oncologists’ opinions and expectations concerning the radiologist’s report to identify general needs in daily practice and ways to improve interdisciplinary communication.

Methods

A 19-question survey was sent to 230 oncologists from three different countries (France, Romania, Switzerland) identified on the online web pages of different hospitals and private clinics. The survey was sent by electronic mail with an online survey program (Google Forms®). All recipients were informed of the purpose of the study. The data were collected by the online survey program and analysed through filtering the results and cross-tabulation.

Results

A total of 52 responses were received (response rate of 22.6%). The majority of the respondents (46/52, 88%) preferred the structured report, which follows a predefined template. Most of the respondents (40/52, 77%) used RECIST 1.1 or iRECIST in tumour assessment. Nearly half of the oncologists (21/52, 40%) measured 1–3 cases per week. On a 10-point Likert scale, 34/52 (65%) oncologists rated their overall level of satisfaction with radiologists’ service between 7 and 10. In contrast, 12/52 (19%) oncologists rated the radiologists’ service between 1 and 4. Moreover, 42/52 (80%) oncologists acknowledged that reports created by a radiologist with a subspecialty in oncologic imaging were superior to those created by a general radiologist.

Conclusion

Structured reports in oncologic patients and the use of RECIST criteria are preferred by oncologists in their daily clinical practice, which signals the need for radiologists also to implement such reports to facilitate communication.

Furthermore, most of the oncologists we interviewed recognized the added value provided by radiologists specializing in oncologic imaging. Because this subspecialty is present in only a few countries, generally in large clinics, further training might become a challenge; nevertheless, intensive efforts should be made to enhance expertise in cancer imaging.
Medical Outcomes of Oncology Inpatients With and Without Chaplain Spiritual Care Visit: The Yale New Haven Hospital Experience
Authors: Chow Ronald , Tenenbaum Leah , Balboni Tracy A. , Prsic Elizabeth Horn
Published: November 2021

PURPOSE:

Although there exists some literature on the psychosocial elements of health between patients with and without spiritual care, less information is available on hospital health outcomes. Hence, we aimed to describe and compare health care utilization and outcomes among medical oncology patients who received and did not receive spiritual care consultation during inpatient admission.

METHODS:

We conducted a retrospective chart review of medical oncology patients admitted to Yale New Haven Hospital between January 1, 2018, and December 31, 2020, to compare hospital outcomes between patients with and without spiritual care.

RESULTS:

Thirty-one thousand six hundred twenty-three patients were included, of whom 11,053 (35%) received a chaplain spiritual care visit and had a spiritual care note. Patients who received spiritual care were older and sicker. Readmission rates within 30 days were greater in the spiritual care group (OR = 1.07; P = .018). In addition, patients receiving spiritual care were at greater odds of increased length of stay (β = 4.92; P < .0001), intensive care unit admission (OR = 2.98; P < .0001), hospital death (OR = 1.46; P < .0001), and emergency department visit within 30 days of discharge (OR = 1.17; P < .0001).

CONCLUSION:

Patients who were older and sicker had greater spiritual care utilization than their younger and healthier counterparts. Spiritual care assessment of existential distress, complex grief, and faith-based support may be positively associated not only with patient care and quality of life but also with health care utilization and outcomes.
Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California
Authors: Burman Abigail , Haeder Simon F.
Published: November 2021

Context: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes.

Methods: We evaluated accuracy and timely access data obtained from the California Department of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California.

Findings: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed other markets with regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments.

Conclusions: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.
Authoritarian Regime Legitimacy and Health Care Provision: Survey Evidence from Contemporary China
Authors: Duckett Jane , Munro Neil
Published: November 2021

Context: Over the last two decades a growing body of research has shown that authoritarian regimes are trying to increase their legitimacy by providing public goods. But there has so far been very little research on whether or not these regimes are successful.

Methods: This article analyzes data from a 2012–2013 nationally representative survey in China to examine whether health care provision bolsters the Communist regime's legitimacy. Using multivariate ordinal logistic regression, we test whether having public health insurance and being satisfied with the health care system are associated with separate measures of the People's Republic of China's regime legitimacy: support for “our form of government” (which we call “system support”) and political trust.

Findings: Having public health insurance is positively associated with trust in the Chinese central government. Health care system satisfaction is positively associated with system support and trust in local government.

Conclusions: Health care provision may bolster the legitimacy of authoritarian regimes, with the clearest evidence showing that concrete benefits may translate into trust in the central government. Further research is needed to understand the relationship between trends in health care provision and legitimacy over time and in other types of authoritarian regime.
Team-Specific Human Capital and Team Performance: Evidence from Doctors
Authors: Chen Yiqun
Published: November 2021

This paper studies whether team members’ past collaboration creates team-specific human capital and influences current team performance. Using administrative Medicare claims for two heart procedures, I find that shared work experience between the doctor who performs the procedure (“proceduralist”) and the doctors who provide care to the patient during the hospital stay for the procedure (“physicians”) reduces patient mortality rates. A one standard deviation increase in proceduralist-physician shared work experience leads to a 10–14 percent reduction in patient 30-day mortality. Patient medical resource use also declines with shared work experience, even as survival improves. (JEL I10, J24, M12, M54)
Product Innovation, Product Diversification, and Firm Growth: Evidence from Japan’s Early Industrialization
Authors: Braguinsky Serguey , Ohyama Atsushi , Okazaki Tetsuji , Syverson Chad
Published: November 2021

We explore how firms grow by adding products. We leverage detailed data from Japan’s cotton spinning industry at the turn of the last century to do so. This setting allows us to fully characterize the type of differentiation (vertical or horizontal) of new product introductions as well as whether the product is within or outside of the firm’s prior technological capabilities. We find that trying to introduce innovative products beyond the firm’s previous technologically feasible set, even if such trials fail, is a key to firm growth. Indeed, it mostly facilitates growth through the firm’s later success in horizontal product diversification. In long-term outcomes, the right tail of the firm size distribution becomes dominated by firms that first moved into technologically challenging products and then later applied their newly acquired technical competence to horizontal expansion of their product portfolios. Two mechanisms through which this knowledge transfer occurs are greater production system flexibility and higher product appeal to downstream buyers. (JEL D22, L11,L67, N65, N85, O31, O33)
The Tax Elasticity of Capital Gains and Revenue-Maximizing Rates
Authors: Agersnap Ole , Zidar Owen
Published: November 2021

This paper uses a direct-projections approach to estimate the effect of capital gains taxation on realizations at the state level and then develops a framework for determining revenue-maximizing rates at the federal level. We find that the elasticity of revenues with respect to the tax rate over a 10-year period is −0.5 to −0.3, indicating that capital gains tax cuts do not pay for themselves and that a 5 percentage point rate increase would yield $18 to $30 billion in annual federal tax revenue. Our long-run estimates yield revenue-maximizing capital gains tax rates of 38 to 47 percent. (JEL E62, H25, H71)
Cheating with Models
Authors: Eliaz Kfir , Spiegler Ran , Weiss Yair
Published: November 2021

Beliefs and decisions are often based on confronting models with data. What is the largest “fake” correlation that a misspecified model can generate, even when it passes an elementary misspecification test? We study an “analyst” who fits a model, represented by a directed acyclic graph, to an objective (multivariate) Gaussian distribution. We characterize the maximal estimated pairwise correlation for generic Gaussian objective distributions, subject to the constraint that the estimated model preserves the marginal distribution of any individual variable. As the number of model variables grows, the estimated correlation can become arbitrarily close to one regardless of the objective correlation. (JEL D83, C13, C46, C51)
Teenage Driving, Mortality, and Risky Behaviors
Authors: Huh Jason , Reif Julian
Published: November 2021

We investigate the effect of teenage driving on mortality and risky behaviors in the United States using a regression discontinuity design. We estimate that total mortality rises by 5.84 deaths per 100,000 (15 percent) at the minimum legal driving age cutoff, driven by an increase in motor vehicle fatalities of 4.92 deaths per 100,000 (44 percent). We also find that poisoning deaths, which are caused primarily by drug overdoses, rise by 0.31 deaths per 100,000 (29 percent) at the cutoff and that this effect is concentrated among females. Our findings show that teenage driving contributes to sex differences in risky drug use behaviors. (JEL I12, J13, J16, R41)
Study and development of algorithms for managing and optimizing wireless resources in environments of multiple technologies
Authors: Χούνος Κωνσταντίνος
Published: November 2021

Λόγω των ριζικών αλλαγών στην καθημερινότητα μας, μια απότομη αύξηση της παγκόσμιας ασύρματης συνδεσιμότητας έχει παρατηρηθεί τα τελευταία χρόνια. Επομένως, τα παραδοσιακά δίκτυα μεγάλης εμβέλειας (macro-cells) είναι πλέον ανεπαρκή να εξυπηρετήσουν αποτελεσματικά τις απαιτήσεις των χρηστών τους. Αυτό οδήγησε στην παράλληλη ανάπτυξη μικρότερων και πυκνότερων ετερογενών κυψελών (Heterogeneous networks), η οποία προτείνεται ευρέως στο πλαίσιο των δικτύων 5ης γενιάς (5G). Επιπρόσθετα, εκεί εμφανίζονται οι έννοιες του «softwarization» και «cloudification», επιτρέποντας έτσι την εκμετάλλευση όλων των διαθέσιμων δικτυακών πόρων (radio resources) με ενιαίο τρόπο. Εκ πρώτης όψεως, τα παραπάνω φαντάζουν ιδανική λύση για το φαινόμενο έλλειψης πόρων (capacity crunch). Παρόλα αυτά, αρκετή προσοχή πρέπει να δοθεί, καθώς η πλειοψηφία των πυκνά τοποθετημένων ετερογενών κυψελών (ultra-dense HetNets) στα δίκτυα 5G περιέχει τεχνολογίες και πρότυπα που χρησιμοποιούν τις ίδιες περιορισμένες ζώνες συχνοτήτων. Εκτός αυτού, ελάχιστος έως καθόλου συντονισμός υπάρχει μεταξύ αυτών των προτύπων στα επίπεδα προτεραιότητας μεταδόσεων και συνύπαρξης. Επομένως, μεγάλη ποσότητα απρόβλεπτων παρεμβολών δημιουργείται, γεγονός που οδηγεί σε αμφισβητήσιμη απόδοση σε αυτά τα περιβάλλοντα. Τέλος, αφενός μεν ο χειρισμός των ασύρματων δικτυακών πόρων ως υπηρεσία (radio as a service) μπορεί να οδηγήσει σε πιο αποτελεσματική χρήση πόρων και σε σύγκριση με την στατική κατανομή φάσματος. Αφετέρου, αυτό αυξάνει κατά πολύ την πολυπλοκότητα όσον αφορά την ενορχήστρωση του δικτύου.Για να αντιμετωπιστεί αποτελεσματικά η έλλειψη φάσματος, απαιτείται προσεκτικός δικτυακός σχεδιασμός και ευέλικτη διαχείριση πόρων. Στόχος αυτής της διδακτορικής διατριβής είναι η ανάπτυξη και παρουσίαση νέων μοντέλων και μηχανισμών, τα οποία βελτιώνουν την αξιοποίηση των πόρων σε σύγχρονα ασύρματα συστήματα πολλαπλών προτύπων. Αρχικά, η παρούσα διατριβή, ασχολείται με τον εντοπισμό και την αποφυγή παρεμβολών στα ευρέως διαδεδομένα συστήματα IEEE 802.11 (Wi-Fi). Δεδομένου ότι το πρότυπο Wi-Fi κατέχει σημαντικό ρόλο στα δίκτυα 5G, η διατριβή αυτή παρουσιάζει αναλυτικά πως η ορθή φασματική ανάλυση μπορεί να ενισχύσει την απόδοση του δικτύου κάτω από σχήματα επιλογής σταθμού βάσης, επιλογής καναλιών και πρόβλεψης παρεμβολών στο μέλλον. Επιπρόσθετα, η διατριβή αυτή εστιάζει και στην δυναμική μίσθωση και τιμολόγηση των ασυρμάτων πόρων δικτύωσης σε περιβάλλοντα 5G. Για τον λόγο αυτό, δημιουργούνται τα προσχέδια για μια οντότητα που έχει ως σκοπό την δυναμική τιμολόγηση του διαθέσιμου φάσματος. Τέλος, αξίζει να σημειωθεί, ότι όλα τα μοντέλα και οι μηχανισμοί που αναπτύχθηκαν στο πλαίσιο αυτής της διατριβής έχουν αξιολογηθεί πειραματικά σε πραγματικές ασύρματες υποδομές (wireless testbeds).
Ο διάλογος μεταξύ εθνικού δικαστή και Δικαστηρίου της Ευρωπαϊκής Ένωσης στην προστασία των θεμελιωδών δικαιωμάτων
Authors: Σαφούρης Γεώργιος
Published: November 2021

Το Δικαστήριο της Ευρωπαϊκής Ένωσης, που εδρεύει στο Λουξεμβούργο, είναι περισσότερο συνδεδεμένο, στη συνείδηση του νομικού κόσμου, με την επίλυση τεχνικών ζητημάτων της εσωτερικής αγοράς της ΕΕ. Παραγνωρίζεται, έτσι, η σπουδαία δικαιοδοτική του λειτουργία στην προστασία των ανθρωπίνων δικαιωμάτων, καθώς και η σημαντική λειτουργία που μπορεί να επιτελέσει ο μηχανισμός της προδικαστικής παραπομπής στο ΔΕΕ, σε εθνικές υποθέσεις προσβολής θεμελιωδών δικαιωμάτων. Η παρούσα διατριβή αποσκοπεί σε αυτόν ακριβώς το στόχο: να φωτίσει τις δυνατότητες προστασίας των θεμελιωδών δικαιωμάτων, τις οποίες προσφέρει ο μηχανισμός της προδικαστικής παραπομπής στο ΔΕΕ, το δεύτερο αυτό «δικαστήριο ανθρωπίνων δικαιωμάτων», μετά την ΕΔΔΑ.
Case Report: Poor oral hygiene leading to an emergency condition: A case report of Ludwig’s angina
Authors: Pant Prashant , Shrestha Oshan , Budhathoki Pawan , Devkota Nebula , Kumar Giri Prabin , Shrestha Dhan Bahadur
Published: December 2021

Ludwig’s angina (LA) is a rapidly spreading and potentially life-threatening infection having an odontogenic infection as the most common source. It involves the floor of the mouth and neck. Modernization in medical care has made this entity rare and of low mortality at the present but it is still feared as a lethal entity due to rapidly progressive airway obstruction that follows. Here we report a case of a 15-year-old male who suffered from LA. Presenting symptoms and findings of the examination helped in the clinical diagnosis. Immediate intubation, use of broad-spectrum antibiotics, and treatment of complications aided the patient’s recovery. LA should be considered for differential diagnosis in the case of neck swelling especially in those having a history of poor oral hygiene and recent dental procedures. Management of LA and its complications should always involve doctors from multiple disciplines.
Integration of Waste Assessment Model and Lean Automation to Improve Process Cycle Efficiency in the Automotive Industry
Authors: Setiawan Setiawan , Setiawan Indra , Jaqin Choesnul , Prabowo Herry Agung , Purba Humiras Hardi
Published: December 2021

Purpose: This study aims to improve Process Cycle Efficiency (PCE) by reducing waste in the assembly production line. This research is a case study conducted in a four-wheel vehicle manufacturing company to create a Lean production system.
Methodology/Approach: This study uses the Waste Assessment Model (WAM) and Lean Automation integration methods carried out by 5 expert judgements in the selected four-wheeled vehicle industry.
Findings: Based on the WAM method, this study found the biggest waste on the assembly line, namely transportation with a percentage of 20.44%. Improvements made with Lean Automation can increase the value of PCE from 56.76% to 63.62%.
Research Limitation/Implication: This research is limited to one model, namely Multi Purpose Vehicle (MPV). This research provides benefits for companies related to waste reduction. For similar companies, this research can be input for manufacturing practitioners in improving manufacturing performance to compete in the global market. This Lean production can reduce manpower which has an impact on saving production costs.
Originality/Value of paper: This paper provides added value related to the application of Lean terminology which aims to improve industrial automation-based manufacturing companies.
Functional IT Complementarity and Hospital Performance in the United States: A Longitudinal Investigation
Authors: Mishra Abhay Nath , Tao Youyou , Keil Mark , Oh Jeong-ha (Cath)
Published: November 2021

For healthcare practitioners and policymakers, one of the most challenging problems is understanding how to implement health information technology (HIT) applications in a way that yields the most positive impacts on quality and cost of care. We identify four clinical HIT functions which we label as order entry and management (OEM), decision support (DS), electronic clinical documentation (ECD), and results viewing (RV). We view OEM and DS as primary clinical functions and ECD and RV as support clinical functions. Our results show that no single combination of applications uniformly improves clinical and experiential quality and reduces cost for all hospitals. Thus, managers must assess which HIT interactions improve which performance metric under which conditions. Our results suggest that synergies can be realized when these systems are implemented simultaneously. Additionally, synergies can occur when support HIT is implemented before primary HIT and irrespective of the order in which primary HITs are implemented. Practitioners should also be aware that the synergistic effects of HITs and their impact on cost and quality are different for chronic and acute diseases. Our key message to top managers is to prioritize different combinations of HIT contingent on the performance variables they are targeting for their hospitals but also to realize that technology may not impact all outcomes.
Waging War from Remote Cubicles: How Workers Cope with Technologies That Disrupt the Meaning and Morality of Their Work
Authors: Rauch Madeleine , Ansari Shahzad (Shaz)
Published: November 2021

Technologies are known to alter social structures in the workplace, reconfigure roles and relationships, and disrupt status hierarchies. However, less attention has been given to how an emerging technology disrupts the meaning and moral values that tether people to their work and render it meaningful. To understand how workers respond to such an emerging technology, we undertook an inductive, qualitative study of military personnel working in unmanned aerial vehicles, or drone operations, for the U.S. Air Force. We draw on multiple data sources, including personal diaries kept by personnel involved in drone operations. We identified three characteristics of drone technology: remote-split operations, remote piloting of unmanned vehicles, and interaction through iconic representations. Our analysis suggests that drone technology has revolutionized warfare by (1) creating distanciated intimacy, (2) dissolving traditional spatio-temporal boundaries between work and personal life, and (3) redefining the legal and moral parameters of work. Drone program workers identified with these changes to their working environment in contradictory ways, which evoked emotional ambivalence about right and wrong. However, their organization gave them little help in alleviating their conflicting feelings. We illuminate how workers cope with such ambivalence when a technology transforms the meaning and morality of their work. We extend theory by showing that workers’ responses to a changed working environment as a result of a remote technology are not just based on how the technology changes workers’ tasks, roles, and status but also on how it affects their moral values.
A Discrete Simulation-Based Optimization Algorithm for the Design of Highly Responsive Last-Mile Distribution Networks
Authors: Snoeck André , Winkenbach Matthias
Published: November 2021

Online and omnichannel retailers are proposing increasingly tight delivery deadlines, moving toward instant on-demand delivery. To operate last-mile distribution systems with such tight delivery deadlines efficiently, defining the right strategic distribution network design is of paramount importance. However, this problem exceeds the complexity of the strategic design of traditional last-mile distribution networks for two main reasons: (1) the reduced time available for order handling and delivery and (2) the absence of a delivery cut-off time that clearly separates order collection and delivery periods. This renders state-of-the-art last-mile distribution network design models inappropriate, as they assume periodic order fulfillment based on a delivery cutoff. In this study, we propose a metamodel simulation-based optimization (SO) approach to strategically design last-mile distribution networks with tight delivery deadlines. Our methodology integrates an in-depth simulator with traditional optimization techniques by extending a traditional black-box SO algorithm with an analytical model that captures the underlying structure of the decision problem. Based on a numerical study inspired by the efforts of a global fashion company to introduce on-demand distribution with tight delivery deadlines in Manhattan, we show that our approach outperforms contemporary SO approaches as well as deterministic and stochastic programming methods. In particular, our method systematically yields network designs with superior expected cost performance. Furthermore, it converges to good solutions with a lower computational budget and is more consistent in finding high-quality solutions. We show how congestion effects in the processing of orders at facilities negatively impact the network performance through late delivery of orders and reduced potential for consolidation. In addition, we show that the sensitivity of the optimal network design to congestion effects in order processing at the facilities increases as delivery deadlines become increasingly tight.
Concurrent and Overlapping Surgery: Perspectives from Surgeons on Spinal Posterior Instrumented Fusion for Adolescent Idiopathic Scoliosis
Authors: Allahabadi Sachin , Wu Hao-Hua , Allahabadi Sameer , Woolridge Tiana , Kohn Michael A. , Diab Mohammad
Published: November 2021

Purpose

The purpose of this study was to determine perspectives of surgeons regarding simultaneous surgery in patients undergoing posterior spine instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS).

Methods

A survey was administered to orthopaedic trainees and faculty regarding simultaneous surgery for primary PSIF for AIS. A five-point Likert scale (1: ‘Strongly Disagree’ to 5: ‘Strongly Agree’) was used to assess agreement with statements about simultaneous surgery. We divided simultaneous surgery into concurrent, when critical portions of operations occur at the same time, and overlapping, when noncritical portions occur at the same time.

Results

The 72 respondents (78.3% of 92 surveyed) disagreed with concurrent surgery for ‘one of my patients’ (response mean 1.76 (sd 1.03)) but were more accepting of overlapping surgery (mean 3.94 (sd 0.99); p < 0.0001). The rating difference between concurrent and overlapping surgery was smaller for paediatric and spine surgeons (-1.25) than for residents or those who did not identify a subspecialty (-2.17; p = 0.0246) or other subspecialty surgeons (-2.57; p = 0.0026). Respondents were more likely to agree with explicit informed consent for concurrent surgery compared with overlapping (mean 4.32 (sd 0.91) versus 3.44 (sd 1.14); p < 0.001).

Conclusion

Orthopaedic surgeons disagreed with concurrent but were more accepting of overlapping surgery and anaesthesia for PSIF for AIS. Respondents were in greater agreement that patients should be explicitly informed of concurrence than of overlap. The surgical community's evidence and position regarding simultaneous surgery, in particular overlapping, must be more effectively presented to the public in order to bridge the gap in perspectives.

Level of Evidence

IV
3D ultrasound reconstruction of sonographic callus
Authors: Nicholson Jamie A. , Oliver William M. , MacGillivray Tom J. , Robinson C. Michael , Simpson A. Hamish R. W.
Published: December 2021

Aims

The aim of this study was to establish a reliable method for producing 3D reconstruction of sonographic callus.

Methods

A cohort of ten closed tibial shaft fractures managed with intramedullary nailing underwent ultrasound scanning at two, six, and 12 weeks post-surgery. Ultrasound capture was performed using infrared tracking technology to map each image to a 3D lattice. Using echo intensity, semi-automated mapping was performed to produce an anatomical 3D representation of the fracture site. Two reviewers independently performed 3D reconstructions and kappa coefficient was used to determine agreement. A further validation study was undertaken with ten reviewers to estimate the clinical application of this imaging technique using the intraclass correlation coefficient (ICC).

Results

Nine of the ten patients achieved union at six months. At six weeks, seven patients had bridging callus of ≥ one cortex on the 3D reconstruction and when present all achieved union. Compared to six-week radiographs, no bridging callus was present in any patient. Of the three patients lacking sonographic bridging callus, one went onto a nonunion (77.8% sensitive and 100% specific to predict union). At 12 weeks, nine patients had bridging callus at ≥ one cortex on 3D reconstruction (100%-sensitive and 100%-specific to predict union). Presence of sonographic bridging callus on 3D reconstruction demonstrated excellent reviewer agreement on ICC at 0.87 (95% confidence interval 0.74 to 0.96).

Conclusion

3D fracture reconstruction can be created using multiple ultrasound images in order to evaluate the presence of bridging callus. This imaging modality has the potential to enhance the usability and accuracy of identification of early fracture healing. Cite this article: Bone Joint Res 2021;10(12):759–766.
Taxonomic Partition Suggests a High Degree of Coevolution Between Termites and Their Termitophiles
Authors: Eloi Igor , Pires-Silva Carlos M. , Zilberman Bruno
Published: November 2021

Termites have a tight interaction with their social parasitic Corotocini beetles. This association is thought to be mainly host-specific, despite some host-switch events. By analyzing the taxonomic partition between species and genera of Corotocini, we propose the hypothesis that the main driver of the diversity of these termitophiles is coevolution.
Nesting Biology of the Solitary Ground-Nesting Bee Diadasina riparia (Apidae: Emphorini)
Authors: Martins Herbeson Ovidio de Jesus , Amorim Junior Gilson Paiva , Sabino William Oliveira , Ferreira Vinina Silva
Published: November 2021

We described the nesting behavior and ecology of Diadasina riparia, from an urban dry forest fragment. The nests of D. riparia were shallow with circular entrance, closed by a mud plug, from which a straight vertical tunnel ending in one or more brood cells. Most females need one day for construction and provisioning the nest. The natural enemies were flies of Anthrax genus, the cleptoparasitic bees Leiopodus trochantericus, and Mutillidae wasp. The feature about the life history, nest architecture, materials used, pollen provisions behavior and associated organisms of this species allow the comparison with other emphorines species.
تأثير الحبس المنزلي على الأطفال الفلسطينيين في القدس // The Effect of House Arrest on Palestinian Children in Jerusalem
Authors: ناهدة العرجا
Published: November 2021

هدفت هذه الدراسة إلى الكشف عن الآثار النفسية والاجتماعية والتعليمية الناتجة عن الحبس المنزلي على الأطفال الفلسطينيين في مدينة القدس. واستخدمت الباحثة عينة قصبية عشوائية مكونة من
(١٠) عائلات من القدس لديهم طغل محبوس منزليأ وا عتمدت منهج تحليل المضمون عبر إجراء مقابلات مع هذه العائلات في هذه الدراسة. وأظهرت النتائج أن أغلبية الأطفال اعتقلتهم شرطة الاحتلال من
البيت، وأنهم تعرضوا الى عدة اعتقالات قد تصل ثلاث عشرة مرة. كما تبين أن أغلب أطغال الحبس المنزلي يعانون من أبعاد نفسية تمثلت بالخوف والقلق واليأس والتوتر والعصبية، الا ان قلة منهم
لم يكونوا خائفين بمقدار خوف الأم أثناء عملية الاعتقال. وأجمع معظم الأمهات والآباء على أن أطفالهم تعرضوا لأشكال متعددة من التعنيب الجسدي والنفسي في سجون الاحتلال الإسرائيلي بالإضافة
إلى ذلك فإن نصف الأطفال أعطاهم المحتل دواء للتبول اللاؤرادي وللأعصاب، بالرغم من أن أغلبية الأطفال لم يتم وضعهم في عزل انفرادي أثناء الاعتقال. وتبين انه تم حبس هؤلاء الاطغال منزليا
في منزلهم باستثناء طغل واحد في بيت جدته، مما ادى الى تتضاعف الضفط النفسي لدى الأطفال بعد الاعتقال والحبس المنزلي كما وادى الى صعوبة في النوم.

اشارت نتائج الدراسة إلى أن للحبس المنزلي أبعادا تعليمية سلبية ادت الى تراجع في الدراسة عند نصف الأحلفال والى رفض العودة إلى المدرسة عند بعضهم. وبالنسبة للأبعاد٠ الاجتماعية تبين وجود
تفير ملحوظ في حياتهم الاجتماعية، إذ اشارت النتائج الى أن أكثر من نصف أطغال العينة لا يفضلون الذهاب لزيارة الأهل، كمأ أصبحت علاقننهم بأصدقائهم أضعف بعد تجربة الاعتقال؛ واشارت
النتائج الى ان نصف أطغال العينة يفضلون الذهاب إلى النادي وآخرون يفضلون البقاء في البيت وممارسة هواية معينة. ومن أهم التوصيات التي خرجت بها الدراسة توفير البرامج الإرشادية التي تقدم
للاطفال المحبوسين منزليأ عبر جلسات الإرشاد الجمعي والأنشطة الجماعية التي تهدف إلى خفض ما يواجهونه من مشكلات نفسية كالعدوانية والانطواء والخوف والقلق.
Low concentration Phloxine B staining for high chemical contrast, nonlinear microscope mosaic imaging of skin alterations in pseudoxanthoma elasticum
Authors: Fésűs L. , Plázár D. , Kolonics A. , Martin L. , Wikonkál N. , Medvecz M. , Szipőcs R.
Published: November 2021

Pseudoxanthoma elasticum (PXE) is an autosomal recessive metabolic disorder characterized by ectopic mineralization of soft connective tissue. Histopathology findings include fragmented, mineralized elastic fibers and calcium deposits in the mid-dermis. Nonlinear microscopy (NLM) can be used for visualization of these histopathological alterations of the mid-dermis in PXE-affected skin sections. Upon introducing a normalized 3D color vector representation of emission spectra of three of the main tissue components (collagen, elastin and calcification) we found that due to their broad, overlapping emission spectra, spectral separation of emission from elastin and calcification is practically impossible in fresh-frozen or unstained, deparaffinized PXE sections. However, we found that the application of a low concentration Phloxine B staining after the deparaffinization process creates an imaging contrast for these two tissue components, which enables spectral decomposition of their fluorescence images. The obtained concentration maps for calcium deposits can be well suited for the determination of illness severity by quantitative analysis.
Phase sensitivity enhancement for the SU(1,1) interferometer using photon level operations
Authors: Xin Jun
Published: November 2021

We propose to employ photon level operations (PLOs) to enhance the phase sensitivity of the SU(1,1) interferometer (SUI). Two types of PLOs are considered, including photon subtraction scheme (PSS) and photon addition scheme (PAS). By performing either PSS or PAS on the two arms inside the SUI, we demonstrate that the phase sensitivity of the SUI can be enhanced. More interestingly, we find that both PSS and PAS are able to increase the robustness of the SUI against the internal loss of the interferometer, which is one of the main imperfect factors that limit the performance of the SUI.
Terahertz perfect absorber based on flexible active switching of ultra-broadband and ultra-narrowband
Authors: Zheng Zhipeng , Zheng Ying , Luo Yao , Yi Zao , Zhang JianGuo , Liu Li , Song Qianjv , Wu Pinghui , Yu Yang , Zhang Jianfa
Published: November 2021

Metamaterial perfect absorbers in the terahertz band are attracting more and more attention. Pure narrowband absorbers as well as broadband absorbers have been proposed one after another in recent years. However, absorbers that can achieve both narrow-band absorption and broadband absorption have hardly been reported. To meet more practical needs, we propose a terahertz metamaterial perfect absorber that combines ultra-broadband and narrowband based on the phase transition properties of vanadium dioxide (VO2). Its main structure consists of a metal ring and four VO2 discs, and the absorber can be flexibly switched between ultra-broadband and narrowband absorption by adjusting the ambient temperature. The resonator consisting of metal rings and VO2 discs are mainly responsible for the formation of absorption peaks. A detailed explanation is given by means of magnetic resonance theory and the impedance matching principle. Compared to recent reports, our design offers a significant improvement in absorption rate and bandwidth and is also flexible in terms of tuning. Moreover, as the phase transition temperature of VO2 is only slightly higher than room temperature, there are almost no limitations for experimental and practical applications. Therefore, our design will have significant applications in modulation, sensing, energy harvesting, switching devices, etc.
Topological states in the super-SSH model
Authors: Zhang Yiqi , Ren Boquan , Li Yongdong , Ye Fangwei
Published: November 2021

The topological edge state distributes along the edge of a topological insulator which has advantages in prohibiting radiation and reflection in the evolution dynamics because of the topological protection property. The Su-Schrieffer-Heeger (SSH) model provides the simplest lattice configuration that supports topological edge states. Here, we investigate the properties of an extended SSH model – super-SSH model – with three sites in a unit cell for one-dimensional case and nine sites in a unit cell for two-dimensional case. Theoretical analysis and numerical simulation demonstrate that topological edge states and topological defect states are supported in the super-SSH model. This work extends the form of SSH model and may serve as a novel platform for developing photonic techniques based on topological phase transition.