bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycoplasma pneumoniae Infection Associated with Anti-Factor H Autoantibodies in Atypical Hemolytic Uremic Syndrome
Authors: Valoti Elisabetta , Piras Rossella , Mele Caterina , Alberti Marta , Liguori Lucia , Breno Matteo , Bertulli Cristina , Bresin Elena , Donadelli Roberta
Published: April 2022

Hemolytic uremic syndrome (HUS) is a rare disease characterized by hemolytic anemia, thrombocytopenia, and renal impairment mostly triggered by strains of Shiga-like toxin-producing Escherichia coli (STEC-HUS). A rarer form of HUS, defined as atypical HUS (aHUS), is associated with genetic or acquired dysregulation of the alternative pathway of the complement system and presents a poorer prognosis than STEC-HUS. Factor H autoantibodies (anti-FHs) have been reported in aHUS in 5–11% of cases and are strongly associated with the homozygous deletion of CFHR3-CFHR1 genes. In the large majority of patients, anti-FH-associated aHUS is commonly preceded by gastrointestinal or respiratory tract infections. Here, we described the clinical case of a 3-year-old boy who was hospitalized for aHUS preceded by Mycoplasma pneumoniae (MP) infection. He resulted positive for anti-FHs and carried the homozygous deletion of CFHR3-CFHR1. Of relevance, he also showed a variant of unknown significance in the C5 gene. The patient was successfully treated with eculizumab and achieved hematological and renal remission. The anti-FH titer decreased, became negative after 6 months of mycophenolate mofetil (MMF) treatment, and remained negative for 21-month follow-up indicating that immunosuppression was effective and could prevent the reappearance of anti-FHs. We hypothesized that MP, likely through an evasion strategy of immunosurveillance based on binding of pathogen to FH, triggers anti-FH antibody generation and aHUS in a subject genetically predisposed. In conclusion, to the best of our knowledge, here, we reported the first case of anti-FH-mediated aHUS after an MP infection who benefited from eculizumab and immunosuppressive therapy based on MMF. Hence, monitoring of anti-FHs in patients with post-MP infection glomerulonephritis could be recommended, especially in those with low C3 plasma levels.
Bronchoscopic Lung Volume Reduction Coil Treatment for Severe Emphysema: A Systematic Review and Meta-Analysis of Individual Participant Data
Authors: Roodenburg Sharyn A. , Hartman Jorine E. , Deslée Gaëtan , Herth Felix J.F. , Klooster Karin , Sciurba Frank C. , Shah Pallav L. , Valipour Arschang , Zoumot Zaid , Slebos Dirk-Jan
Published: April 2022

Background: Lung volume reduction coil (LVR-coil) treatment provides a minimally invasive treatment option for severe emphysema patients which has been studied in multiple clinical trials. Objectives: The aim of the study was to assess the effect of LVR-coil treatment on pulmonary function, quality of life, and exercise capacity using individual participant data. Method: PubMed, Web of Science, and EMBASE were searched until May 17, 2021. Prospective single-arm and randomized controlled trials that evaluated the effect of LVR-coil treatment on forced expiratory volume in 1 s (FEV1), residual volume (RV), St. George Respiratory Questionnaire (SGRQ) total score, and/or 6-min walk distance (6MWD) and were registered in an official clinical trial database were eligible for inclusion. Individual patient data were requested, and a linear mixed effects model was used to calculate overall treatment effects. Results: Eight trials were included in the final analysis, representing 680 individual patients. LVR-coil treatment resulted in a significant improvement in FEV1 at 3- (0.09 L [95% confidence interval (95% CI): 0.06–0.12]) and 6-month follow-up (0.07 L [95% CI: 0.03–0.10]), a significant reduction in RV at 3- (−0.45L [95% CI: −0.62 to −0.28]), 6- (−0.33L [95% CI: −0.52 to −0.14]), and 12-month follow-up (−0.36L [95% CI: −0.64 to −0.08]), a significant reduction in SGRQ total score at 3- (−12.3 points [95% CI: −15.8 to −8.8]), 6- (−10.1 points [95% CI: −12.8 to −7.3]), and 12-month follow-up (−9.8 points [95% CI: −15.0 to −4.7]) and a significant increase in 6MWD at 3-month follow-up (38 m [95% CI: 18–58]). Conclusions: LVR-coil treatment in emphysema patients results in sustained improvements in pulmonary function and quality of life and shorter lived improvements in exercise capacity. Since the owner of this LVR-coil has decided to stop the production and newer generations LVR-coils are currently being developed, these results can act as a reference for future studies and clinical guidance.
Nonhomogenous Hyperreflectivity in the Choriocapillaris Layer on Optical Coherence Tomography Angiography Implies Early Treatment with Anti-VEGF for Central Serous Chorioretinopathy
Authors: Zhao Zhenzhen , Zhang Jingfa
Published: April 2022

Introduction: Optical coherence tomography angiography (OCTA) facilitates the detection of choroidal neovascularization (CNV). This study explored the role of nonhomogenous hyperreflectivity implying putative CNV in the choriocapillaris layer on OCTA in central serous chorioretinopathy (CSCR). Methods: Thirteen eyes out of 12 patients with CSCR were examined with OCTA. The nonhomogenous hyperreflectivity was compared with the histological morphology of experimental CNV. The effect of intravitreal anti-vascular endothelial growth factor (VEGF) was evaluated by analyzing the changes in central macular thickness (CMT) and the height of subretinal fluid (SRF). Results: Comparison of the nonhomogenous hyperreflectivity on OCTA with the established CNV in two animal models strongly indicated these signals are putative CNV. During following-up, these nonhomogenous hyperreflectivity in CSCR developed into visible CNV on OCTA. Moreover, anti-VEGF treatment was effective to reduce both the SRF and CMT in CSCR with nonhomogenous hyperreflectivity or secondary CNV within 2 months. Conclusion: This study suggested that the nonhomogenous hyperreflectivity on OCTA could be served as a diagnostic biomarker for putative CNV in CSCR, implying early treatment with anti-VEGF.
Inflammatory Myofibroblastic Tumor in the Thyroid Gland: A Retrospective Case Series Study and Literature Review
Authors: Shi Ping , Zhang Lan , Shi Huijing , Wu Yanzhao
Published: April 2022

Background: The objective of this study was to investigate the clinical characteristics, diagnosis, and treatment of inflammatory myofibroblastoma tumor (IMT) in the thyroid gland. Methods: A total of 17 patients with IMT by pathology from 2010 to 2020 were included in this study. Clinical features, imaging features, treatment, and prognosis were analyzed in this retrospective study. Results: The case series comprised 5 males and 12 females, with an average age of 49.6 ± 15.36 years. The patients were divided into two cohorts: with IMT without further pathological changes and with further pathological changes of the thyroid gland (e.g., nodular goiter or autoimmune thyroid disease). No significant differences were detected in tumor size and extrathyroid extension between the two groups. Fine needle aspiration biopsy examination before the operation was performed in 2 cases, and rapid freezing pathology examination during the operation was performed in 7 cases. Ultrasound images of 5 cases with only one type of pathology, IMT, presented a high and intermediate risk of malignancy. In the other 11 cases with further pathological changes of the thyroid gland, the image could be very low risk of malignancy or benign feature. Only 2 cases showed a high risk of malignancy ultrasound features. 5/17 patients underwent preventive cervical lymph node dissection additional to thyroid surgery. None of the lymph nodes were confirmed positive by postoperative pathology. Thyroid ultrasound, computed tomography scan of the lungs, abdomen ultrasound, and thyroid function tests were routine follow-up tests. During the follow-up period of 26–141 months, 2 cases were lost, and remaining 15 cases had no recurrence or metastasis and were considered cured. Conclusion: IMT in the thyroid gland is a rare disease with a good prognosis and surgical resection is the preferred treatment.
The Impact of Multidisciplinary Weight Management on Body Weight and Body Mass Composition in Women with Breast Cancer Post-Adjuvant Chemotherapy: A Retrospective Chart Review
Authors: Nguyen Vivien , Chen Juliana , Lord Reginald , Preda Veronica
Published: April 2022

Introduction: Weight gain during chemotherapy for breast cancer is a well-documented adverse effect. The purpose of this study was to investigate how multidisciplinary weight management involving endocrinology, dietitian, and exercise physiology care, in a real-life healthy weight clinic (HWC) would impact body weight and mass composition in breast cancer women post-adjuvant chemotherapy compared to a cohort of non-cancer women who have been matched by age, ethnicity, smoking, and menopausal status. Methods: Body weight (kg), BMI (kg/m2), skeletal muscle mass (SMM %), fat mass (FM %), and waist circumference (cm) were collected at baseline of the first HWC appointment, 3 months after baseline, and 6 months after baseline. A total of 32 women were included, 11 in the breast cancer cohort and 21 in the control cohort, that matched inclusion and exclusion criteria based on a retrospective chart review from 28 July 2017 to 19 July 2021. Results: By 6 months, the breast cancer women had a mean weight change of −6.99 kg (SD = 3.87, p = 0.003, n = 11) and change in BMI by −2.72 kg/m2 (SD = 1.62, p = 0.004, n = 11). There was a change in SMM of 1.21% (SD = 0.73, p = 0.005, n = 11), a change in FM of −2.76% (SD = 1.33, p = 0.002, n = 11), and a change in waist circumference of −8.13 cm (SD = 4.21, p = 0.031, n = 3). By 6 months in the breast cancer cohort, there was a larger change in body weight in women who did not have MetS (−8.72 kg, SD = 2.41, n = 6) in comparison to women with MetS (−2.65 kg, SD = 3.75 kg, n = 3) (p = 0.045). Conclusion: Findings indicate that multidisciplinary weight management has a positive role in early-stage breast cancer survival through improving body weight and mass composition. These results can add to the development of long-term treatment plans for survivors in order to shine a light on ways to reduce risk recurrence and chronic disease mortality.
Temporal Trajectory of Systolic Blood Pressure and Outcomes in Acute Intracerebral Hemorrhage: ATACH-2 Trial Cohort
Authors: Tanaka Kanta , Koga Masatoshi , Fukuda-Doi Mayumi , Qureshi Adnan I. , Yamamoto Haruko , Miwa Kaori , Ihara Masafumi , Toyoda Kazunori ,   for the ATACH-2 Trial Investigators
Published: April 2022

Background:

To highlight the heterogeneity of acute temporal blood pressure (BP) changes in the ATACH-2 trial (Antihypertensive Treatment of Acute Cerebral Hemorrhage-2) and associations with the outcomes of intracerebral hemorrhage.

Methods:

One thousand patients with acute intracerebral hemorrhage, who had been randomized to intensive (110–139 mm Hg) or standard (140–179 mm Hg) systolic BP (SBP) lowering with intravenous nicardipine in ATACH-2 from 2011 to 2015, were analyzed about temporal changes in hourly maximum SBP up to 24 hours after randomization using group-based trajectory modeling. Outcomes included death or disability (modified Rankin Scale score 4–6) at 3 months, neurological deterioration within 24 hours (≥2-point decrease in Glasgow Coma Scale score or ≥4-point increase in National Institutes of Health Stroke Scale score), and acute kidney injury (≥0.3 mg/dL within 48 hours or ≥1.5-fold increase in serum creatinine) within 7 days after onset.

Results:

Group-based trajectory modeling revealed 4 SBP trajectory groups: moderate SBP (from ≈190 mm Hg at hospital arrival to 150–160 mm Hg after randomization; n=298), moderate-to-low SBP (from ≈190 mm Hg to <140 mm Hg; n=395), high-to-low SBP (from >210 mm Hg to <140 mm Hg; n=134), and high SBP (from >210 mm Hg to 160–170 mm Hg; n=173). Patients with intensive treatment accounted for 11.1%, 88.6%, 85.1%, and 1.7% of each group, respectively. Compared with the moderate-to-low SBP group, the high-to-low SBP group showed increased risks of death or disability at 3 months (adjusted odds ratio, 2.29 [95% CI, 1.24–4.26]) and acute kidney injury (adjusted odds ratio, 3.50 [95% CI, 1.83–6.69]), while no increase in neurological deterioration was seen in this group (adjusted odds ratio, 0.48 [95% CI, 0.20–1.13]). The moderate SBP and high SBP groups showed no significant risk differences for such outcomes.

Conclusions:

Data-driven observation using a group-based trajectory modeling approach may be useful to clarify the relationship between antihypertensive treatment, temporal SBP changes, and outcomes in acute intracerebral hemorrhage.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01176565.
Laboratory medicine in pandemic of COVID-19
Authors: Tandara Marijan , Rubic Zana , Tandara Leida , Filipi Petra , Supe Domic Daniela , Kresic Branka , Stojanovic Stipic Sanda , Ivcic Ivo
Published: April 2022

After the outbreak in China in the year 2019, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) quickly spread around the world causing a protracted pandemic. Approximately one-third of infections appear to be asymptomatic. Symptomatic disease is characterized primarily by symptoms of respiratory tract infection of varying severity. But Coronavirus Disease 2019 (COVID-19) is much more than an acute respiratory disease because SARS-CoV-2 affects many organs inducing a vast number of symptoms such as cardiovascular, neurological, gastrointestinal, dermatological, with numerous complications. Short and long-term effects of infection, severe ones, and especially mild forms of the disease which affect a huge number of patients need to be further investigated. Laboratory medicine has a crucial role in early diagnosis of the disease, recognition of the patients who need hospital care, and close monitoring of hospitalized patients to timely identify associated clinical complications as well as follow-up of patients with long-term COVID-19.
Implanting intracranial electrodes does not affect spikes or network connectivity in nearby or connected brain regions
Authors: Conrad Erin C. , Shinohara Russell T. , Gugger James J. , Revell Andrew Y. , Das Sandhitsu , Stein Joel M. , Marsh Eric D. , Davis Kathryn A. , Litt Brian
Published: April 2022

To determine the effect of implanting electrodes on electrographic features of nearby and connected brain regions in patients with drug-resistant epilepsy, we analyzed intracranial EEG recordings from 10 patients with drug-resistant epilepsy who underwent implant revision (placement of additional electrodes) during their hospitalization. We performed automated spike detection and measured EEG functional networks. We analyzed the original electrodes that remained in place throughout the full EEG recording, and we measured the change in spike rates and network connectivity in these original electrodes in response to implanting new electrodes. There was no change in overall spike rate pre- to post-implant revision (t(9) = 0.1, p = 0.95). The peri-revision change in the distribution of spike rate and connectivity across electrodes was no greater than chance (Monte Carlo method, spikes: p = 0.40, connectivity: p = 0.42). Electrodes closer to or more functionally connected to the revision site had no greater change in spike rate or connectivity than more distant or less connected electrodes. Changes in electrographic features surrounding electrode implantation are no greater than baseline fluctuations occurring throughout the intracranial recording. These findings argue against an implant effect on spikes or network connectivity in nearby or connected brain regions.
Effects of classic psychedelic drugs on turbulent signatures in brain dynamics
Authors: Cruzat Josephine , Perl Yonatan Sanz , Escrichs Anira , Vohryzek Jakub , Timmermann Christopher , Roseman Leor , Luppi Andrea I. , Ibañez Agustin , Nutt David , Carhart-Harris Robin , Tagliazucchi Enzo , Deco Gustavo , Kringelbach Morten L.
Published: April 2022

Psychedelic drugs show promise as safe and effective treatments for neuropsychiatric disorders, yet their mechanisms of action are not fully understood. A fundamental hypothesis is that psychedelics work by dose-dependently changing the functional hierarchy of brain dynamics, but it is unclear whether different psychedelics act similarly. Here, we investigated the changes in the brain’s functional hierarchy associated with two different psychedelics (LSD and psilocybin). Using a novel turbulence framework, we were able to determine the vorticity, that is, the local level of synchronization, that allowed us to extend the standard global time-based measure of metastability to become a local-based measure of both space and time. This framework produced detailed signatures of turbulence-based hierarchical change for each psychedelic drug, revealing consistent and discriminate effects on a higher level network, that is, the default mode network. Overall, our findings directly support a prior hypothesis that psychedelics modulate (i.e., “compress”) the functional hierarchy and provide a quantification of these changes for two different psychedelics. Implications for therapeutic applications of psychedelics are discussed.
Czech Grammar Error Correction with a Large and Diverse Corpus
Authors: Náplava Jakub , Straka Milan , Straková Jana , Rosen Alexandr
Published: April 2022

We introduce a large and diverse Czech corpus annotated for grammatical error correction (GEC) with the aim to contribute to the still scarce data resources in this domain for languages other than English. The Grammar Error Correction Corpus for Czech (GECCC) offers a variety of four domains, covering error distributions ranging from high error density essays written by non-native speakers, to website texts, where errors are expected to be much less common. We compare several Czech GEC systems, including several Transformer-based ones, setting a strong baseline to future research. Finally, we meta-evaluate common GEC metrics against human judgments on our data. We make the new Czech GEC corpus publicly available under the CC BY-SA 4.0 license at http://hdl.handle.net/11234/1-4639.
Trauma-Informed Theology or Theologically Informed Trauma?
Authors: Wendel Alex R.
Published: April 2022

In this article I first provide an overview of the ways in which trauma impacts people’s understandings and experiences of God, then survey two works of “trauma-informed theology” to demonstrate how these approaches to theology can lead to diminished views of God and turn theology into anthropology, and, finally, propose an approach to trauma and theology that maintains a theocentric theological method that affirms the subjective experiences of traumatized individuals while not advancing diminished understandings of God. It is the triune God revealed in Scripture that wipes away the tears of trauma survivors and this God alone who comforts and heals humanity.
Divine Simplicity, God’s Freedom, and the Supposed Problem of Modal Collapse
Authors: Pedersen Daniel J. , Lilley Christopher
Published: April 2022

Proponents of the modal collapse argument claim that divine simplicity, traditionally conceived, contradicts other Christian commitments about divine freedom and grace by ultimately rendering all God’s acts, including creation and redemption, absolutely necessary. If true, the argument goes, theologians must abandon either God’s simplicity or God’s freedom. The aim of this dilemma is to force the abandonment of simplicity. However, we argue that the modal collapse argument is insufficient to generate this dilemma apart from additional premises—and that these tacit premises are the true locus of dispute.
The Dawn of the Experimental Study of Time Perception: Höring (1864) and Mach (1865)
Authors: Wearden John H.
Published: April 2022

This article discusses the contents of two of the earliest publications about the experimental psychology of time, those from Höring (1864) and Mach (1865). Höring’s thesis, conducted under Vierordt’s supervision, involved the discrimination of the relative rates of successive periods of beats of a metronome. In general, timing sensitivity decreased as the beats slowed, thus violating Weber’s Law of constant sensitivity for time. Mach (1865) conducted a range of experiments, using metronomes, pendulums, and different sorts of apparatus of his own design. He, likewise, found violations of Weber’s Law, with the Weber fraction following a U-shaped function of duration, with a minimum (of around 5%) at 500 or 600 ms. Mach also conducted research on the smallest temporal intervals that could be distinguished, following an earlier suggestion by Czermak, and reported that the smallest values were obtained with the auditory sense. Mach’s article also discussed the perception of rhythms, and the possibility that different animal species show different sensitivity to time. Some modern work on Weber’s Law and timing is briefly discussed at the end of the article.
3. Design and Reflection on the Metric of Common Dynamics
Authors: Garza-Vázquez Oscar , Ramírez Viviana
Published: April 2022

This chapter relies on the theoretical knowledge provided in previous chapters to present the metric and indicators proposed to capture the quality of the dynamic of the common good at the municipal level. The chapter reflects on the processes, challenges and lessons of translating the theoretical framework into a practical instrument of measurement in order to guide policy efforts. Oscar Garza-Vázquez and Viviana Ramirez begin by discussing the importance of developing a metric to operationalise a common good approach and how it may contribute to development practice. They argue that this metric adds insights to development practice by making visible and tangible two factors that have been neglected in traditional measures of development: (a) the socio-structural aspect of development and (b) the relational dynamic processes underlying social changes. Then, they present and discuss each of the dimensions and indicators used to bring to life the matrix of the common good’s dynamic presented in Chapter 2. Finally, they conclude by pointing out future challenges if the metric is to be used to guide policy and decision-making at the local level.
6. Governance, Commoning and the Unequal Terms of Recognition
Authors: De Herdt Tom , Samnick Denis Augustin
Published: April 2022

To grasp the polycentric governance of a nexus of common goods, in Chapter 6 Tom de Herdt and Denis Augustin Samnick focus on reflexive governance and the rule-setting processes that control commoning practice. There is a multiplicity here that is unavoidable, with each common good having its own dynamic and its own rule setting. However, based on the results of Ultimatum Game experiments, they suggest that recognition and ‘cognitive empathy’ appear as key aspects of a governance of commons within a set of institutions. Yet, following Sandel’s civic approach and the notion of commoning, they shift from the question of which entitlements governance should secure to the question of how citizens secure entitlements and who participates in these processes. They identify voice and accountability mechanisms as key features of an indicator of nexus governance.
11. Assessing the Nexus of the Common Good
Authors: Tallabs Valente , Nebel Mathias
Published: April 2022

In this case study, Valente Tallabs and Mathias Nebel apply the matrix of common good dynamics to the municipality of Atlixco, in the State of Puebla (Mexico). The chapter identifies and aggregates quantitative data to build each of the five key drivers of the matrix. It then proceeds to diagnose the dynamics of the nexus in Atlixco in terms of a simple ‘traffic light’ for each of the dimensions of the matrix. The case study highlights the possibility of framing the socio-political analysis of a municipality in terms of a common good dynamic, highlighting some deep structural deficiencies, as well as strengths, of the municipality.
12. Assessing the Transformative Impact of Love-Based Microsocial Communities
Authors: Beretta Simona
Published: April 2022

This chapter summarises Simona Berretta’s research on micro-social relations, discussing how they can contribute to our understanding of the nexus of common goods. Do transformative micro-social relations also generate a dynamic of the common good, and how? What can we learn about the inner dynamics of the common good at the macro level, by looking at the micro-dynamics of personalised relations of care involving vulnerable people? The author studies a faith-based rehab community in Italy and the GRIPP program for prisoners in the US. She shows that the common good matrix may help us understand the building blocks of sociality, or the creation of a common root which is a shared humanity, that is, a shared practice of our humanity.
Improving Estimates of U.S. Tornado Frequency by Accounting for Unreported and Underrated Tornadoes
Authors: Potvin Corey K. , Broyles Chris , Skinner Patrick S. , Brooks Harold E.
Published: April 2022

Many tornadoes are unreported because of lack of observers or are underrated in intensity, width, or track length because of lack of damage indicators. These reporting biases substantially degrade estimates of tornado frequency and thereby undermine important endeavors such as studies of climate impacts on tornadoes and cost–benefit analyses of tornado damage mitigation. Building on previous studies, we use a Bayesian hierarchical modeling framework to estimate and correct for tornado reporting biases over the central United States during 1975–2018. The reporting biases are treated as a univariate function of population density. We assess how these biases vary with tornado intensity, width, and track length and over the analysis period. We find that the frequencies of tornadoes of all kinds, but especially stronger or wider tornadoes, have been substantially underestimated. Most strikingly, the Bayesian model estimates that there have been approximately 3 times as many tornadoes capable of (E)F2+ damage as have been recorded as (E)F2+ [(E)F indicates a rating on the (enhanced) Fujita scale]. The model estimates that total tornado frequency changed little over the analysis period. Statistically significant trends in frequency are found for tornadoes within certain ranges of intensity, pathlength, and width, but it is unclear what proportion of these trends arise from changes in damage survey practices. Simple analyses of the tornado database corroborate many of the inferences from the Bayesian model.

Significance Statement

Prior studies have shown that the probabilities of a tornado being reported and of its intensity, track length, and width being accurately estimated are strongly correlated with the local population density. We have developed a sophisticated statistical model that accounts for these population-dependent tornado reporting biases to improve estimates of tornado frequency in the central United States. The bias-corrected tornado frequency estimates differ markedly from the official tornado climatology and have important implications for tornado risk assessment, damage mitigation, and studies of climate change impacts on tornado activity.
Well-Mixed Boundary Layer–Top Entrainment Instability: Hydrodynamic Analysis
Authors: Yano Jun-Ichi
Published: April 2022

The present study shows by a linear hydrodynamic stability analysis that an unstable mixed-layer deep circulation can be generated in the dry convective well-mixed layer by the entrainment from the top. The newly identified instability arises under the two competing processes induced by the top entrainment: the destabilization by generating thermal perturbations and the damping by mechanical mixing. The former and the latter, respectively, dominate over the other in the limits of large and small scales. As a result, the instability is realized at the horizontal scales larger than the order of the mixed-layer depth (ca. 1 km), and the time scale for the growth is about 1 day. This study has been motivated from a question of whether the cloud-top entrainment instability (CTEI) can induce a transition of the stratocumulus-topped well-mixed boundary layer into trade cumulus. The present study intends to extend the previous studies based on the local parcel analyses to a full analysis based on the hydrodynamics. Unfortunately, being based on a dry formulation, the present result does not apply directly to the CTEI problem. Especially, the evaporative cooling is totally neglected. Nevertheless, the present result can still be applied to moist systems, to some extent, by redefining certain terms in the formulation.
A Linear Theory of Wind Farm Efficiency and Interaction
Authors: Smith Ronald B.
Published: April 2022

We investigate the role of gravity waves (GW), farm shape, and wind direction on the efficiency and interaction of wind farms using a two-layer linearized dynamical model with Rayleigh friction. Five integrated diagnostic quantities are used: total wind deficit, the first moment of vorticity, turbine work, disturbance kinetic energy, and vertical energy flux. The work done on the atmosphere by turbine drag is balanced by dissipation of disturbance kinetic energy. A new definition of wind farm efficiency is proposed based on “turbine work.” While GWs do not change the total wind deficit or the vorticity pattern, they alter the spatial pattern of wind deficit and typically make a wind farm less efficient. GWs slow the winds upwind and reduce the wake influence on nearby downstream wind farms. GWs also propagate part of the disturbance energy upward into the upper atmosphere. We applied these ideas to the proposed 45 km × 15 km wind energy areas off the coast of New England. The proximity of these farms allows GWs to play a significant role in farm interaction, especially in winter with northwesterly winds. The governing equations are solved directly and by using fast Fourier transforms (FFT). The computational speed of the linear FFT model suggests its future use in optimizing the design and day-by-day operation of these and other wind farms.

Significance Statement

When a wind farm is generating electricity, the drag of the wind turbines slows the regional winds. As wind farms grow larger and more closely spaced, this wind reduction will limit the efficiency of wind farms and their economic return. In this paper we analyze an idealized mathematical model of the atmospheric response to wind farm drag including nonlocal gravity wave effects. We propose a new definition of farm efficiency based on the atmospheric disturbance that a farm creates. We also propose a fast Fourier transform (FFT) method for carrying out these estimates.
Ensemble Sensitivity of Precipitation Type to Initial Conditions for a Major Freezing Rain Event in Montreal
Authors: Tootill Daniel , Kirshbaum Daniel J.
Published: April 2022

The predictability of precipitation type in a January 2017 winter storm over the northeastern United States and southeastern Canada is examined using a convective-scale initial-condition ensemble with the Weather Research and Forecasting (WRF) Model. Real-time forecasts of the event by Environment and Climate Change Canada predicted 15–25 cm of snow accumulation in Montreal, Quebec, Canada. However, the initial 4 h of the event had 5–8 mm of freezing rain instead, followed by 7 cm of snow. While the total liquid-equivalent precipitation was consistent with the forecast, the unexpected freezing rain caused significant disruption in the Montreal region. The fraction of freezing precipitation (freezing rain and/or ice pellets) over the initial 4 h in Montreal varied greatly across the ensemble, with some members producing nearly all snow and others producing nearly all freezing precipitation. In members with larger fractions of freezing precipitation (as opposed to snow), the cyclone’s midlevel trough was displaced slightly to the northwest, and its downstream (eastern) edge was narrower, the latter of which was traced back to model initialization. These differences increased the midlevel southerly flow into southern Quebec, which both enhanced the horizontal warm advection and decreased the vertical cold advection leading up to the event. The consequent midlevel warming over Montreal in these members produced an above-zero layer that melted falling precipitation, leading to freezing upon contact with the ground. This case study highlights the value of convective-scale ensembles for identifying mechanisms by which initial synoptic-scale uncertainties lead to high-impact localized errors in precipitation type.
How Frequently Does Rapid Intensification Occur after Rapid Contraction of the Radius of Maximum Wind in Tropical Cyclones over the North Atlantic and Eastern North Pacific?
Authors: Li Yuanlong , Wang Yuqing , Tan Zhe-Min
Published: April 2022

The phenomenon that rapid contraction (RC) of the radius of maximum wind (RMW) could precede rapid intensification (RI) in tropical cyclones (TCs) has been found in several previous studies, but it is still unclear how frequently and to what extent RC precedes RI in rapidly intensifying and contracting TCs in observations. In this study, the statistical relationship between RMW RC and TC RI is examined based on the extended best track dataset for the North Atlantic and eastern North Pacific during 1999–2019. Results show that for more than ∼65% of available TCs, the time of the peak contraction rate precedes the time of the peak intensification rate, on average, by ∼10–15 h. With the quantitatively defined RC and RI, results show that ∼50% TCs with RC experience RI, and TCs with larger intensity and smaller RMW and embedded in more favorable environmental conditions tend to experience RI more readily following an RC. Among those TCs with RC and RI, more than ∼65% involve the onset of RC preceding the onset of RI, on average, by ∼15–25 h. The preceding time tends to be longer with lower TC intensity and larger RMW and shows weak correlations with environmental conditions. The qualitative results are insensitive to the time interval for the calculation of intensification/contraction rates and the definition of RI. The results from this study can improve our understanding of TC structure and intensity changes.
Effects of Trauma Center Consolidation on Pediatric Trauma at an Appalachian Pediatric Hospital
Authors: Heard Matthew A. , Billington Alicia R. , Whitmire Morgan H. , Collins Hannah W. , Burns J. Bracken
Published: April 2022

With the increase in hospital consolidation over the past decade, multiple studies have been performed evaluating patient outcomes after consolidation. To date, there have not been studies performed to assess outcomes in pediatric trauma patients. The goal was to assess pediatric patient outcomes in a children’s hospital after consolidation of two Level 1 Trauma centers in a rural Appalachian health system. A retrospective analysis of data from the Trauma Registry between October 2015 - September 2020 was performed. The variables included in analysis were age, injury severity score (ISS), hospital days, intensive care unit days, ventilator days, mortality, discharge disposition, consults, and hospital visit cost. Despite increased ISS, there was no difference in in-patient outcomes. However, these patients were more likely to require orthopedic evaluation and further outpatient care after discharge, suggesting more severely injured patients were evaluated by the trauma service post consolidation.
Co-opting Business Models at the Base of the Pyramid (BOP): Microentrepreneurs and Multinational Enterprises in Ghana
Authors: Decker Stephanie , Obeng Dankwah George
Published: April 2022

In African countries such as Ghana, microentrepreneurs make formal economy goods and services available to base of the pyramid (BOP) consumers. Multinational enterprises (MNEs) co-opt BOP business models when they enter the BOP market. We conducted a case study of six MNEs and 36 microentrepreneurs in three key sectors. In two sectors (fast-moving consumer goods and telecommunications), reverse bridging enables MNEs to capture value from BOP business models, which has a negative impact on both the financial and social capital of microentrepreneurs. In the third sector (finance), microentrepreneurs are buffered from the negative effects of co-optation through a process of integrating, which enhances their social capital but reduces their financial capital. Our research contributes to the BOP literature, first by demonstrating that financial and social capital are intertwined at the BOP level, and second by analyzing how the negative effects of co-optation can be cushioned by enhancing microentrepreneurs’ social capital.
Performance of Coefficient Alpha and Its Alternatives: Effects of Different Types of Non-Normality
Authors: Xiao Leifeng , Hau Kit-Tai
Published: April 2022

We examined the performance of coefficient alpha and its potential competitors (ordinal alpha, omega total, Revelle’s omega total [omega RT], omega hierarchical [omega h], greatest lower bound [GLB], and coefficient H) with continuous and discrete data having different types of non-normality. Results showed the estimation bias was acceptable for continuous data with varying degrees of non-normality when the scales were strong (high loadings). This bias, however, became quite large with moderate strength scales and increased with increasing non-normality. For Likert-type scales, other than omega h, most indices were acceptable with non-normal data having at least four points, and more points were better. For different exponential distributed data, omega RT and GLB were robust, whereas the bias of other indices for binomial-beta distribution was generally large. An examination of an authentic large-scale international survey suggested that its items were at worst moderately non-normal; hence, non-normality was not a big concern. We recommend (a) the demand for continuous and normally distributed data for alpha may not be necessary for less severely non-normal data; (b) for severely non-normal data, we should have at least four scale points, and more points are better; and (c) there is no single golden standard for all data types, other issues such as scale loading, model structure, or scale length are also important.
Walking back to happiness: The resurgence of latent callings in later life
Authors: Sturges Jane , Bailey Catherine
Published: April 2022

Working in a domain to which one feels called has been heralded as a source of deep meaning and fulfilment, but not everyone is able to pursue their calling through paid employment. Current thinking positions such abandoned occupational callings as a source of regret, stress and disappointment but, by focusing on the perspectives of those still in mid-career, extant research has overlooked the potential for a calling to re-emerge in late adulthood. Drawing on life history narratives from retired individuals who felt called to music at an early age but did not pursue a musical career, we contribute to the corpus of work on unanswered callings by proposing the construct of latent callings to explain how callings may be held in the individual’s identity set primed to re-emerge, and reveal the mutable calling identity scripts that re-awaken the potential to live out a calling later in life. Our research shows how latent callings may be resumed via accommodation, deferred and emergent pathways and highlights the potential for a previously unanswered calling to become a source of social connection, deep happiness and enjoyment late in life.
Discontinuation of Health Interventions Among Brazilian Older Adults During the Covid-19 Pandemic: REMOBILIZE Study
Authors: Coelho de Amorim Juleimar Soares , Ornellas Giulianna , Lloyd-Sherlock Peter , Pereira Daniele Sirineu , da Silva Alexandre , Duim Etienne , Lima Camila Astolphi , Perracini Monica Rodrigues
Published: April 2022

The objective of this study was to analyze changes in access to health interventions during the pandemic among Brazilian older adults and to investigate the factors associated with social and health inequalities. We conducted an online survey with Brazilian adults aged 60  +  years between May and June 2020. A multidimensional questionnaire was used to investigate access to health interventions during the pandemic and associated factors. Of 1482 participants, 56.5% reported health care before the pandemic, and 36.4% discontinued it during the pandemic. The discontinuation rate was 64.4% (95% CI 61.1-67.6). Participants with higher educational level (nine or more years of education: OR 0.34; 95% CI 0.17-0.70) and higher income (eight or more times the minimum wage: OR 0.54; 95% CI 0.36-0.81) were associated with less probability of discontinuation. Presenting multimorbidity (OR: 1.42; 95% CI 1.06-1.90) and polypharmacy (OR: 0.61; 95% CI 0.46-0.81) were associated with discontinuity in health interventions. Our study showed that structural health inequities in access to health care shaped the rates of discontinuation in health care interventions during the COVID-19 pandemic. Strategic actions should be set up to actively monitor socially vulnerable older adults and strengthen community-based services to mitigate the discontinuation of health care interventions.
Oral Health in the Population Assessment of Tobacco and Health Study
Authors: Chaffee B.W. , Lauten K. , Sharma E. , Everard C.D. , Duffy K. , Park-Lee E. , Taylor E. , Tolliver E. , Watkins-Bryant T. , Iafolla T. , Compton W.M. , Kimmel H.L. , Hyland A. , Silveira M.L.
Published: April 2022

Tobacco use is a well-established risk factor for multiple adverse oral conditions. Few nationally representative oral health data sets encompass the current diversity of tobacco and nicotine products. This investigation examines the validity of oral health measures in the Population Assessment of Tobacco and Health (PATH) Study to assess relationships between tobacco use and oral health. Cross-sectional data from PATH Study wave 4 ( N = 33,643 US adults, collected 2016–2018) were used to obtain estimates for 6 self-reported oral conditions (e.g., bone loss around teeth, tooth extractions) and compared with analogous estimates from the National Health and Nutrition Examination Survey (NHANES) cycle 2017–2018 ( N = 5,856). Within the PATH Study, associations were calculated between tobacco use status and lifetime and past 12-mo experience of adverse oral conditions using survey-weighted multivariable logistic regression. Nationally representative estimates of oral conditions between the PATH Study and NHANES were similar (e.g., ever-experience of bone loss around teeth: PATH Study 15.2%, 95% CI, 14.4%–15.9%; NHANES 16.6%, 95% CI, 14.9%–18.4%). In the PATH Study, combustible tobacco smoking was consistently associated with lifetime and past 12-mo experience of adverse oral health (e.g., exclusive cigarette smoking vs. never tobacco use, adjusted odds ratio [AOR] for loose teeth in past 12 mo: 2.02; 95% CI, 1.52–2.69). Exclusive smokeless tobacco use was associated with greater odds of loose teeth (AOR, 1.93; 95% CI, 1.15–3.26) and lifetime precancerous lesions (AOR, 3.85; 95% CI, 1.73–8.57). Use of other noncigarette products (e.g., pipes) was inconsistently associated with oral health outcomes. PATH Study oral health measures closely align with self-reported measures from NHANES and are internally concurrent. Observed associations with tobacco use and the ability to examine emerging tobacco products support application of PATH Study data in dental research, particularly to examine potential oral health effects of novel tobacco products and longitudinal changes in tobacco use behaviors.
CGRP and Shh Mediate the Dental Pulp Cell Response to Neuron Stimulation
Authors: Moore E.R. , Michot B. , Erdogan O. , Ba A. , Gibbs J.L. , Yang Y.
Published: April 2022

Dental pain is a persistent, detrimental public health issue that requires a better understanding of the mechanisms of tooth pain and inflammation in order to develop more effective treatments. Calcitonin gene-related peptide (CGRP) and dental pulp cells are promising candidates for mediating tooth pain and generating reparative dental tissues, respectively, but their behavior in the context of pulpitis remains elusive. The mouse incisor requires Sonic hedgehog (Shh) secreted from sensory nerves to continuously regenerate. However, it is unknown whether sensory nerves also regulate the comparatively nonregenerative mouse molar through CGRP and Shh. This is an important knowledge gap to fill since mouse incisors differ biologically from human teeth, while mouse and human molars are similar. In this work, we identified that molar pulp cells express CGRP receptor and Gli1, a Hedgehog (Hh) signaling protein found to label a dental stem cell population in the mouse incisor. We also observed in a mouse molar injury model that Hh signaling was activated and Shh expression was upregulated in vivo. We then determined in vitro that Shh and CGRP regulate differentiation of primary mouse molar and incisor pulp cells and a human dental pulp stem cell line. Furthermore, conditioned media from stimulated sensory neurons induced Hh signaling activation and inflammatory gene expression in primary molar pulp cells, which was abolished by inhibition of either Shh or CGRP. Our results suggest that CGRP and Shh signaling may promote an inflammatory response after injury in the molar and that activated sensory nerves secrete CGRP and Shh to regulate molar pulp cell expansion and differentiation into odontoblast-like cells for dentin repair. Thus, CGRP/Shh signaling should be considered for new strategies that seek to manage pain or dentin regeneration in the molar.
Food for thought: Transport within the food supply chain
Authors: Spain Thomas , Turner David A.
Published: April 2022

Recently Hayden and Zunino Singh wrote in the Journal of Transport History of the greater need to study food movement. Whilst accepting their general premise, we argue that they downplay the fact that the evolution of logistics and supply chains has received sparse attention in the historical literature. Using case studies of the domestic British milk trade (1919–c.1945) and international quail trade ( c.1850–1914), we demonstrate how a concept originating in the study of modern supply chains – supply chain governance – can be illuminating. As a conceptual framework, this can facilitate the identification of key agents, institutions and goods movements within supply chains, and the nature of the relationships between them, whilst illuminating how change and development is shaped by regulation, economic cycles, consumer demand, and, of course, transport. The concept's application therefore presents a robust way to better understand the movement of goods in history.