bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and Security: The Challenges of Bringing Them Together
Authors: Pettersen Gould Kenneth , Bieder Corinne
Published: August 2020

This chapter looks back at how safety and security have developed in hazardous technologies and activities, explaining what has become an intersection between the two in both strategies and management practices. We argue for the connection to be made between social expectations of safe and secure societies and the limits to management and technical performance. In the first part of the chapter, conceptual similarities and differences are addressed and we distinguish three scientific and contextual vantage points for addressing how safety and security are converging: the conceptual approach, the technical and methodological approach, and the management and practice approach. We then go on to show that, as professional areas, safety and security have developed in different ways and supported by quite separate scientific and technological fields. Finally, we present the organization of the book.
The Interface of Safety and Security; The Workplace
Authors: Boustras George
Published: August 2020

9/11 had a great impact on the development and occurrence of high publicity security-related incidents. One of the biggest impacts was that to public health, due to an increase in psychosocial issues. Cybersecurity incidents and processes of radicalization (either due to religious, political, or economic reasons) can have a direct result on the workplace as well as at the organizational level, which in turn can affect the worker. The aim of this chapter is to explain the main factors linking safety and security, creating a new area for workplace health and safety, that of the “interface of safety and security”.
Exploring the Interrelations Between Safety and Security: Research and Management Challenges
Authors: Bieder Corinne , Pettersen Gould Kenneth
Published: August 2020

This chapter discusses some of the research and management challenges related to the safety and security nexus. In the first part, we address the conceptual connections between safety and security and discuss how different perspectives on how they come together allows for characterizing the complexity and ambivalence of their interrelations. We then go on to identify tradeoffs between safety and security and show that these exist both in theory and practice. Managing both safety and security means tradeoffs and power relations between internal entities and professionals, but also beyond its own boundaries since some vulnerabilities escape the organization’s scope. In the final part of the chapter, we argue that addressing the interrelations between safety and security poses managerial and research challenges that call for global approaches to apprehend the multiple facets of the issue. We explain that little has been done on how the global trends of the risk society bring with them unanticipated and “hidden” effects on organizations safety and security practices and that it is here, as a macro-global oriented approach to organizational safety and security research, that the two fields of safety and security confront a shared research agenda.
The Concepts of Risk, Safety, and Security: A Fundamental Exploration and Understanding of Similarities and Differences
Authors: Blokland Peter J. , Reniers Genserik L.
Published: August 2020

When discussing the concepts of risk, safety, and security, people have an intuitive understanding of what these concepts mean and to a certain level, this understanding is universal. However, when delving into the meaning of the words and concepts in order to fully understand all their aspects, one is likely to fall into a semantic debate and ontological discussions. As such, this chapter explores the similarities and differences behind the perceptions to come to a fundamental understanding of the concepts, proposing a common semantic and ontological ground for safety and security science, introducing a definition of objectives as a central starting point in the study and management of risk, safety, and security.
Safety Versus Security in Aviation
Authors: Wipf Heinz
Published: August 2020

The two domains safety and security have traditionally been kept separated in aviation. While the first treats risks associated with aviation activities, the latter safeguards civil aviation against acts of unlawful interference. While national and international guidelines exist in addressing the installation of risk management for organizations having hazardous operations in aviation, an appropriate application of established assessment techniques, both quantitative and qualitative are crucial to both domains. For an incorrect hazard identification and the quantification of an adverse outcome may strongly affect both the level of protection and the investments required to reach it. The empirical example and data shown stem from safety risk assessments in HEMS (helicopter emergency medical service) flight operations. These flight operations use advanced instrument flight procedures in obstacle rich environments under low visibility conditions and are therefore a safety concern on the one hand. On the other hand, one analyzes security, whenever HEMS flights are operated in adverse weather conditions, having as a sole navigation source signals from a global navigation satellite constellation. A traditional safety risk assessment (Wipf in Aviation risk and safety management, Springer, p 108, 1) under these circumstances, considers only factors of human performance under technical failure conditions. A security analysis, however, should treat all forms of jamming, meaconing, and spoofing of the satellite signals and the adverse impact on the performance of the receiver to calculate a valid position. The chapter illustrates to which extent commonalities reign in both domains and where practices go separate ways.
Probing neutrino quantum decoherence at reactor experiments
Authors: de Gouvêa André , De Romeri Valentina , Ternes Christoph A.
Published: August 2020

Abstract

We explore how well reactor antineutrino experiments can constrain or measure the loss of quantum coherence in neutrino oscillations. We assume that decoherence effects are encoded in the size of the neutrino wave-packet, σ. We find that the current experiments Daya Bay and the Reactor Experiment for Neutrino Oscillation (RENO) already constrain σ > 1.0×10−4 nm and estimate that future data from the Jiangmen Underground Neutrino Observatory (JUNO) would be sensitive to σ < 2.1 × 10−3 nm. If the effects of loss of coherence are within the sensitivity of JUNO, we expect σ to be measured with good precision. The discovery of nontrivial decoherence effects in JUNO would indicate that our understanding of the coherence of neutrino sources is, at least, incomplete.
Anomalies of (0,4) SCFTs from F-theory
Authors: Couzens Christopher , het Lam Huibert , Mayer Kilian , Vandoren Stefan
Published: August 2020

Abstract

We study the macroscopics of 2d $$ \mathcal{N} $$
N
= (0, 4) SCFTs arising from F-theory constructions. The class of 2d SCFTs we consider live on black strings which are obtained by wrapping D3-branes on a curve in the base of a possibly singular elliptically fibered Calabi-Yau threefold. In addition, we allow the D3-branes to probe ALE or ALF spaces transversely. We compute anomaly coefficients of these SCFTs by determining Chern- Simons terms in the 3d action resulting from the reduction of 6d $$ \mathcal{N} $$
N
= (1, 0) supergravity on the compact space surrounding the black string. Essential contributions to these coefficients are from one-loop induced Chern-Simons terms arising from integrating out massive Kaluza-Klein modes.
A new test of multivariate normality by a double estimation in a characterizing PDE
Authors: Dörr Philip , Ebner Bruno , Henze Norbert
Published: August 2020

This paper deals with testing for nondegenerate normality of a d-variate random vector X based on a random sample $$X_1,\ldots ,X_n$$

X
1

,
…
,

X
n

of X. The rationale of the test is that the characteristic function $$\psi (t) = \exp (-\Vert t\Vert ^2/2)$$

ψ

(
t
)

=
exp
(
-
‖
t

‖
2

/
2
)

of the standard normal distribution in $${\mathbb {R}}^d$$

R

d

is the only solution of the partial differential equation $$\varDelta f(t) = (\Vert t\Vert ^2-d)f(t)$$

Δ
f

(
t
)

=
(
‖
t

‖
2

-
d
)
f

(
t
)

, $$t \in {\mathbb {R}}^d$$

t
∈

R

d

, subject to the condition $$f(0) = 1$$

f
(
0
)
=
1

, where $$\varDelta $$
Δ
denotes the Laplace operator. In contrast to a recent approach that bases a test for multivariate normality on the difference $$\varDelta \psi _n(t)-(\Vert t\Vert ^2-d)\psi (t)$$

Δ

ψ
n

(
t
)

-

(
‖
t
‖

2

-
d
)
ψ

(
t
)

, where $$\psi _n(t)$$

ψ
n

(
t
)

is the empirical characteristic function of suitably scaled residuals of $$X_1,\ldots ,X_n$$

X
1

,
…
,

X
n

, we consider a weighted $$L^2$$

L
2

-statistic that employs $$\varDelta \psi _n(t) -(\Vert t\Vert ^2-d)\psi _n(t)$$

Δ

ψ
n

(
t
)

-

(
‖
t
‖

2

-
d
)

ψ
n

(
t
)

. We derive asymptotic properties of the test under the null hypothesis and alternatives. The test is affine invariant and consistent against general alternatives, and it exhibits high power when compared with prominent competitors. The main difference between the procedures are theoretically driven by different covariance kernels of the Gaussian limiting processes, which has considerable effect on robustness with respect to the choice of the tuning parameter in the weight function.
Benefits of non-tidal loading applied at distinct levels in VLBI analysis
Authors: Glomsda Matthias , Bloßfeld Mathis , Seitz Manuela , Seitz Florian
Published: August 2020

In the analysis of very long baseline interferometry (VLBI) observations, many geophysical models are used for correcting the theoretical signal delay. In addition to the conventional models described by Petit and Luzum (eds) (IERS Conventions, 2010), we are applying different parts of non-tidal site loading, namely the atmospheric, oceanic, and hydrological ones. To investigate their individual contributions, these parts are considered both separately and combined to a total loading. The application of the corresponding site displacements is performed at two distinct levels of the geodetic parameter estimation process (observation and normal equation level), which turn out to give very similar results in many cases. To validate our findings internally, the site displacements are provided by two different data centres: the Earth-System-Modelling group at the Deutsches GeoForschungsZentrum in Potsdam (ESMGFZ, see Dill and Dobslaw, J Geophys Res Solid Earth, 2013. 10.1002/jgrb.50353)] and the International Mass Loading Service [IMLS, see Petrov (The international mass loading service, 2015)]. We show that considering non-tidal loading is actually useful for mitigating systematic effects in the VLBI results, like annual signals in the station height time series. If the sum of all non-tidal loading parts is considered, the WRMS of the station heights and baseline lengths is reduced in 80–90% of all cases, and the relative improvement is about $$-\,3.5$$

-

3.5

% on average. The main differences between our chosen providers originate from hydrological loading.
Comparison of phytochemical composition of Ginkgo biloba extracts using a combination of non-targeted and targeted analytical approaches
Authors: Collins Bradley J. , Kerns Season P. , Aillon Kristin , Mueller Geoffrey , Rider Cynthia V. , DeRose Eugene F. , London Robert E. , Harnly James M. , Waidyanatha Suramya
Published: August 2020

Ginkgo biloba extract (GbE) is a dietary supplement derived from an ethanolic extract of Ginkgo biloba leaves. Unfinished bulk GbE is used to make finished products that are sold as dietary supplements. The variable, complex composition of GbE makes it difficult to obtain consistent toxicological assessments of potential risk. The National Toxicology Program (NTP) observed hepatotoxicity in its rodent studies of a commercially available, unfinished GbE product, but the application of these results to the broader GbE supplement market is unclear. Here, we use a combination of non-targeted and targeted chromatographic and spectrophotometric methods to obtain profiles of 24 commercially available finished GbE products and unfinished standardized and unstandardized extracts with and without hydrolysis, then used principal component analysis to group unfinished products according to their similarity to each other and to National Institute of Standards and Technology (NIST) standard reference materials (SRM), and the finished products. Unfinished products were grouped into those that were characteristic and uncharacteristic of standardized GbE. Our work demonstrates that different analytical approaches produced similar classifications of characteristic and uncharacteristic products in unhydrolyzed samples, but the distinctions largely disappeared once the samples were hydrolyzed. Using our approach, the NTP GbE was most similar to two unfinished GbE products classified as characteristic, finished products, and the NIST GbE SRM. We propose that a simple analysis for the presence, absence, or amounts of compounds unique to GbE in unhydrolyzed samples could be sufficient to determine a sample’s authenticity.

Graphical abstract
Effects of modular ion-funnel technology onto analysis of breath VOCs by means of real-time mass spectrometry
Authors: Pugliese Giovanni , Piel Felix , Trefz Phillip , Sulzer Philipp , Schubert Jochen K. , Miekisch Wolfram
Published: August 2020

Proton transfer reaction time-of-flight mass spectrometry (PTR-ToF-MS) is a powerful tool for real-time monitoring of trace concentrations of volatile organic compounds (VOCs). The sensitivity of PTR-ToF-MS also depends on the ability to effectively focus and transmit ions from the relatively high-pressure drift tube (DT) to the low-pressure mass analyzer. In the present study, a modular ion-funnel (IF) is placed adjacent to the DT of a PTR-ToF-MS instrument to improve the ion-focusing. IF consists of a series of electrodes with gradually decreasing orifice diameters. Radio frequency (RF) voltage and direct current (DC) electric field are then applied to the electrodes to get the ions focused. We investigated the effect of the RF voltage and DC field on the sensitivity of a pattern of VOCs including hydrocarbons, alcohols, aldehydes, ketones, and aromatic compounds. In a proof-of-concept study, the instrument operating both as normal DT (DC-mode) and at optimal IF conditions (RF-mode) was applied for the breath analysis of 21 healthy human subjects. For the range of investigated VOCs, an improvement of one order of magnitude in sensitivity was observed in RF-mode compared with DC-mode. Limits of detection could be improved by a factor of 2–4 in RF-mode compared with DC-mode. Operating the instrument in RF-mode allowed the detection of more compounds in the exhaled air compared with DC-mode. Incorporation of the IF considerably improved the performance of PTR-ToF-MS allowing the real-time monitoring of a larger number of potential breath biomarkers.
Molecular approach for insect detection in feed and food: the case of Gryllodes sigillatus
Authors: Daniso Enrico , Tulli Francesca , Cardinaletti Gloriana , Cerri Roberto , Tibaldi Emilio
Published: August 2020

The production of insects on an industrial scale has attracted the attention of the research and agricultural industry as novel protein sources. To detect the presence of Gryllodes sigillatus (GS) in feed and food, a real-time PCR method based on the mitochondrial cytochrome b (CYB) gene is proposed by this study. Forty DNA samples of animal and plant origin were used to confirm the specificity of the qPCR system. The detection method’s performance was evaluated on different processed GS matrices including native GS (UnGS) and different commercial products: crunchy roasted samples (RoGS), insect meal mixtures (ACGS) and energetic snacks containing GS (GSS). Data on sequencing were aligned with the reference gene to confirm the PCR products. The regression curve (y = −3.394 x + 42.521; R2 = 0.994, d.f. 14) between Ct values and Log DNA concentrations of Gryllodes sigillatus resulted in an efficiency of 96.4%. The severity of the technological processing treatments and the matrix structure affected the intensity of the PCR signal with the same amount of insect DNA as observed by different y-intercepts of the three-regression lines for RoGS, ACGS, and GSS. The real-time PCR method resulted in robust and sensitive outcomes able to detect low amounts of GS DNA (5 g/100 g) in a complex matrix, making it suitable for detecting the presence or absence of labeled Gryllodes sigillatus material both in feed and food.
$$\lambda $$-Semidirect products of inverse monoids are weakly Schreier extensions
Authors: Faul Peter F.
Published: August 2020

A split extension of monoids with kernel $$k :N \rightarrow G$$

k
:
N
→
G

, cokernel $$e :G \rightarrow H$$

e
:
G
→
H

and splitting $$s :H \rightarrow G$$

s
:
H
→
G

is weakly Schreier if each element $$g \in G$$

g
∈
G

can be written $$g = k(n)se(g)$$

g
=
k
(
n
)
s
e
(
g
)

for some $$n \in N$$

n
∈
N

. The characterization of weakly Schreier extensions allows them to be viewed as something akin to a weak semidirect product. The motivating examples of such extensions are the Artin glueings of topological spaces and, of course, the Schreier extensions of monoids which they generalise. In this paper we show that the $$\lambda $$
λ
-semidirect products of inverse monoids are also examples of weakly Schreier extensions. The characterization of weakly Schreier extensions sheds some light on the structure of $$\lambda $$
λ
-semidirect products. The set of weakly Schreier extensions between two monoids comes equipped with a natural poset structure, which induces an order on the set of $$\lambda $$
λ
-semidirect products between two inverse monoids. We show that Artin glueings are in fact $$\lambda $$
λ
-semidirect products and inspired by this identify a class of Artin-like $$\lambda $$
λ
-semidirect products. We show that joins exist for this special class of $$\lambda $$
λ
-semidirect product in the aforementioned order.
Automatic identification of atypical clinical fMRI results
Authors: Jansma J. Martijn , Rutten Geert-Jan , Ramsey Lenny E. , Snijders T. J. , Bizzi Alberto , Rosengarth Katharina , Dodoo-Schittko Frank , Hattingen Elke , de la Peña Mar Jiménez , von Campe Gord , Jehna Margit , Ramsey Nick F.
Published: August 2020

Purpose

Functional MRI is not routinely used for neurosurgical planning despite potential important advantages, due to difficulty of determining quality. We introduce a novel method for objective evaluation of fMRI scan quality, based on activation maps. A template matching analysis (TMA) is presented and tested on data from two clinical fMRI protocols, performed by healthy controls in seven clinical centers. Preliminary clinical utility is tested with data from low-grade glioma patients.

Methods

Data were collected from 42 healthy subjects from seven centers, with standardized finger tapping (FT) and verb generation (VG) tasks. Copies of these “typical” data were deliberately analyzed incorrectly to assess feasibility of identifying them as “atypical.” Analyses of the VG task administered to 32 tumor patients assessed sensitivity of the TMA method to anatomical abnormalities.

Results

TMA identified all atypical activity maps for both tasks, at the cost of incorrectly classifying 3.6 (VG)–6.5% (FT) of typical maps as atypical. For patients, the average TMA was significantly higher than atypical healthy scans, despite localized anatomical abnormalities caused by a tumor.

Conclusion

This study supports feasibility of TMA for objective identification of atypical activation patterns for motor and verb generation fMRI protocols. TMA can facilitate the use and evaluation of clinical fMRI in hospital settings that have limited access to fMRI experts. In a clinical setting, this method could be applied to automatically flag fMRI scans showing atypical activation patterns for further investigation to determine whether atypicality is caused by poor scan data quality or abnormal functional topography.
Optimization of nitric oxide donors for investigating biofilm dispersal response in Pseudomonas aeruginosa clinical isolates
Authors: Cai Yu-ming , Webb Jeremy S.
Published: August 2020

Pseudomonas aeruginosa biofilms contribute heavily to chronic lung infection in cystic fibrosis patients, leading to morbidity and mortality. Nitric oxide (NO) has been shown to disperse P. aeruginosa biofilms in vitro, ex vivo and in clinical trials as a promising anti-biofilm agent. Traditional NO donors such as sodium nitroprusside (SNP) have been extensively employed in different studies. However, the dosage of SNP in different studies was not consistent, ranging from 500 nM to 500 μM. SNP is light sensitive and produces cyanide, which may lead to data misinterpretation and inaccurate predictions of dispersal responses in clinical settings. New NO donors and NO delivery methods have therefore been explored. Here we assessed 7 NO donors using P. aeruginosa PAO1 and determined that SNP and Spermine NONOate (S150) successfully reduced > 60% biomass within 24 and 2 h, respectively. While neither dosage posed toxicity towards bacterial cells, chemiluminescence assays showed that SNP only released NO upon light exposure in M9 media and S150 delivered much higher performance spontaneously. S150 was then tested on 13 different cystic fibrosis P. aeruginosa (CF-PA) isolates; most CF-PA biofilms were significantly dispersed by 250 μM S150. Our work therefore discovered a commercially available NO donor S150, which disperses CF-PA biofilms efficiently within a short period of time and without releasing cyanide, as an alternative of SNP in clinical trials in the future.

Key points

• S150 performs the best in dispersing P. aeruginosa biofilms among 7 NO donors.

• SNP only releases NO in the presence of light, while S150 releases NO spontaneously.

• S150 successfully disperses biofilms formed by P. aeruginosa cystic fibrosis clinical isolates.
Cooperating, congenital neutropenia–associated Csf3r and Runx1 mutations activate pro-inflammatory signaling and inhibit myeloid differentiation of mouse HSPCs
Authors: Ritter Malte , Klimiankou Maksim , Klimenkova Olga , Schambach Axel , Hoffmann Dirk , Schmidt Amy , Kanz Lothar , Link Daniel C. , Welte Karl , Skokowa Julia
Published: August 2020

Patients with the pre-leukemia bone marrow failure syndrome called severe congenital neutropenia (CN) have an approximately 15% risk of developing acute myeloid leukemia (AML; called here CN/AML). Most CN/AML patients co-acquireCSF3RandRUNX1mutations, which play cooperative roles in the development of AML. To establish an in vitro model of leukemogenesis, we utilized bone marrow lin−cells from transgenic C57BL/6-d715Csf3rmice expressing a CN patient–mimicking truncatedCSF3Rmutation. We transduced these cells with vectors encodingRUNX1wild type (WT) orRUNX1mutant proteins carrying the R139G or R174L mutations. Cells transduced with theseRUNX1mutants showed diminished in vitro myeloid differentiation and elevated replating capacity, compared with those expressing WTRUNX1. mRNA expression analysis showed that cells transduced with theRUNX1mutants exhibited hyperactivation of inflammatory signaling and innate immunity pathways, including IL-6, TLR, NF-kappaB, IFN, and TREM1 signaling. These data suggest that the expression of mutatedRUNX1in aCSF3R-mutated background may activate the pro-inflammatory cell state and inhibit myeloid differentiation.
Coronary computed tomography angiography (CCTA): effect of bolus-tracking ROI positioning on image quality
Authors: Nebelung Heiner , Brauer Thomas , Seppelt Danilo , Hoffmann Ralf-Thorsten , Platzek Ivan
Published: August 2020

Objectives

The aim of the study was to evaluate the effect of bolus-tracking ROI positioning on coronary computed tomography angiography (CCTA) image quality.

Methods

In this retrospective monocentric study, all patients had undergone CCTA by step-and-shoot mode to rule out coronary artery disease within a cohort at intermediate risk. Two groups were formed, depending on ROI positioning (left atrium (LA) or ascending aorta (AA)). Each group contained 96 patients. To select pairs of patients, propensity score matching was used. Image quality with regard to coronary arteries as well as pulmonary arteries was evaluated using quantitative and qualitative scores.

Results

In terms of the coronary arteries, there was no significant difference between both groups using quantitative (SNR AA 14.92 vs. 15.46; p = 0.619 | SNR LM 19.80 vs. 20.30; p = 0.661 | SNR RCA 24.34 vs. 24.30; p = 0.767) or qualitative scores (4.25 vs. 4.29; p = 0.672), respectively. With regard to pulmonary arteries, we found significantly higher quantitative (SNR RPA 8.70 vs. 5.89; p < 0.001 | SNR LPA 9.06 vs. 6.25; p < 0.001) and qualitative scores (3.97 vs. 2.24; p < 0.001) for ROI positioning in the LA than for ROI positioning in the AA.

Conclusions

ROI positioning in the LA or the AA results in comparable image quality of CT coronary arteriography, while positioning in the LA leads to significantly higher image quality of the pulmonary arteries. These results support ROI positioning in the LA, which also facilitates triple-rule-out CT scanning.

Key Points

• ROI positioning in the left atrium or the ascending aorta leads to comparable image quality of the coronary arteries.

• ROI positioning in the left atrium results in significantly higher image quality of the pulmonary arteries.

• ROI positioning in the left atrium is feasible to perform triple-rule-out CTA.
Egg consumption and cardiovascular risk: a dose–response meta-analysis of prospective cohort studies
Authors: Godos Justyna , Micek Agnieszka , Brzostek Tomasz , Toledo Estefania , Iacoviello Licia , Astrup Arne , Franco Oscar H. , Galvano Fabio , Martinez-Gonzalez Miguel A. , Grosso Giuseppe
Published: August 2020

Purpose

Cardiovascular disease (CVD) is a leading cause of mortality globally and is strongly influenced by dietary risk factors. The aim was to assess the association between egg consumption and risk of CVD risk/mortality, including coronary heart disease (CHD), stroke, and heart failure.

Methods

MEDLINE, Embase, and Web of Science databases were searched through April 2020 for prospective studies. Two independent reviewers screened and extracted the data through standardized methods. Size effects were calculated as summary relative risks (SRRs) in a dose–response fashion through random-effects meta-analyses.

Results

Thirty-nine studies including nearly 2 million individuals and 85,053 CHD, 25,103 stroke, 7536 heart failure, and 147,124 CVD cases were included. The summary analysis including 17 datasets from 14 studies conducted on CVD (incidence and/or mortality) showed that intake of up to six eggs per week is inversely associated with CVD events, when compared to no consumption [for four eggs per week, SRR = 0.95 (95% CI: 0.90; 1.00)]; a decreased risk of CVD incidence was observed for consumption of up to one egg per day [SRR = 0.94 (95% CI: 0.89; 0.99)]. The summary analysis for CHD incidence/mortality including 24 datasets from 16 studies showed a decreased risk up to two eggs per week [(SRR = 0.96 (95% CI: 0.91; 1.00)]. No associations were retrieved with risk of stroke. The summary analysis for heart failure risk including six datasets from four studies showed that intake of one egg per day was associated with increased risk raising for higher intakes compared to no consumption [for 1 egg per day, SRR = 1.15 (95% CI:1.02; 1.30)]. After considering GRADE criteria for strength of the evidence, it was rated low for all outcomes but stroke, for which it was moderate (yet referring to no risk).

Conclusion

There is no conclusive evidence on the role of egg in CVD risk, despite the fact that higher quality studies are warranted to obtain stronger evidence for a possible protection of CVD associated with moderate weekly egg consumption compared to no intake; equally, future studies may strengthen the evidence for increased heart failure risk associated with high regular egg consumption.
Management of critical-sized bone defects in the treatment of fracture-related infection: a systematic review and pooled analysis
Authors: Bezstarosti H. , Metsemakers W. J. , van Lieshout E. M. M. , Voskamp L. W. , Kortram K. , McNally M. A. , Marais L. C. , Verhofstad M. H. J.
Published: August 2020

Purpose

This systematic review determined the reported treatment strategies, their individual success rates, and other outcome parameters in the management of critical-sized bone defects in fracture-related infection (FRI) patients between 1990 and 2018.

Methods

A systematic literature search on treatment and outcome of critical-sized bone defects in FRI was performed. Treatment strategies identified were, autologous cancellous grafts, autologous cancellous grafts combined with local antibiotics, the induced membrane technique, vascularized grafts, Ilizarov bone transport, and bone transport combined with local antibiotics. Outcomes were bone healing and infection eradication after primary surgical protocol and recurrence of FRI and amputations at the end of study period.

Results

Fifty studies were included, describing 1530 patients, the tibia was affected in 82%. Mean age was 40 years (range 6–80), with predominantly male subjects (79%). Mean duration of infection was 17 months (range 1–624) and mean follow-up 51 months (range 6–126). After initial protocolized treatment, FRI was cured in 83% (95% CI 79–87) of all cases, increasing to 94% (95% CI 92–96) at the end of each individual study. Recurrence of infection was seen in 8% (95% CI 6–11) and amputation in 3% (95% CI 2–3). Final outcomes overlapped across treatment strategies.

Conclusion

Results should be interpreted with caution due to the retrospective and observational design of most studies, the lack of clear classification systems, incomplete data reports, potential underreporting of adverse outcomes, and heterogeneity in patient series. A consensus on classification, treatment protocols, and outcome is needed to improve reliability of future studies.
Introducing multiple-choice questions to promote learning for medical students: effect on exam performance in obstetrics and gynecology
Authors: Jud Sebastian M. , Cupisti Susanne , Frobenius Wolfgang , Winkler Andrea , Schultheis Franziska , Antoniadis Sophia , Beckmann Matthias W. , Heindl Felix
Published: August 2020

Purpose

Testing is required in medical education. The large number of exams that students face requires effective learning strategies. Various methods of improving knowledge retention and recall have been discussed, two of the most widely evaluated of which are test-enhanced learning and pause procedures. This study investigated the effect of voluntary multiple-choice questions on students’ performance.

Methods

In a prospective study from April 2013 to March 2015, 721 students were randomly assigned to receive supplementary online material only (control group) or additional multiple-choice questions (investigative group) accompanying lectures. Their performance in the final exam was evaluated.

Results

A total of 675 students were ultimately included, with 299 randomly assigned to the investigative group and 376 to the control group. Students in the investigative group scored significantly better in relation to grades and points (2.11 vs. 2.49; 33 vs 31.31; p < 0.05). The effect declined over time.

Conclusion

This is the first study of the use of voluntary multiple-choice questions to improve medical students’ performance. The results support test-enhanced learning and the feasibility of implementing multiple-choice questions in lectures.
Simulation of the effect of mucociliary clearance on the bronchial distribution of inhaled radon progenies and related cellular damage using a new deposition and clearance model for the lung
Authors: Farkas Árpád
Published: August 2020

Most of the current dosimetry models of inhaled short-lived radon decay products assume uniform activity distributions along the bronchial airways. In reality, however, both deposition and clearance patterns of inhaled radon progenies are highly inhomogeneous. Consequently, a new deposition-clearance model has been developed that accounts for such inhomogeneities and applied together with biophysical models of cell death and cell transformation. The scope of this study was to apply this model which is based on computational fluid and particle dynamics methods, in an effort to reveal the effect of mucociliary clearance on the bronchial distribution of deposited radon progenies. Furthermore, the influence of mucociliary clearance on the spatial distribution of biological damage due to alpha-decay of the deposited radon progenies was also studied. The results obtained demonstrate that both deposition and clearance of inhaled radon progenies are highly non-uniform within a human airway bifurcation unit. Due to the topology of the carinal ridge, a slow clearance zone emerged in this region, which is the location where most of the radio-aerosols deposit. In spite of the slow mucus movement in this zone, the initial degree of inhomogeneity of the activity due to the nonuniform deposition decreased by a factor of about 3 by considering the effect of mucociliary clearance. In the peak of the airway bifurcation, the computed cell death and cell transformation probabilities were lower when considering deposition and clearance simultaneously, compared to the case when only deposition was considered. However, cellular damage remained clustered.
Impact of pre-stroke dependency on outcome after endovascular therapy in acute ischemic stroke
Authors: Oesch Lisa , Arnold Marcel , Bernasconi Corrado , Kaesmacher Johannes , Fischer Urs , Mosimann Pascal J. , Jung Simon , Meinel Thomas , Goeldlin Martina , Heldner Mirjam , Volbers Bastian , Gralla Jan , Sarikaya Hakan
Published: August 2020

Background and purpose

Current demographic changes indicate that more people will be care-dependent due to increasing life expectancy. Little is known about impact of preexisting dependency on stroke outcome after endovascular treatment (EVT).

Methods

We compared prospectively collected baseline and outcome data of previously dependent vs. independent stroke patients (prestroke modified Rankin Scale score of 3–5 vs. 0–2) treated with EVT. Outcome measures were favorable 3-month outcome (mRS ≤ 3 for previously dependent and mRS ≤ 2 for independent patients, respectively), death and symptomatic intracranial hemorrhage (sICH).

Results

Among 1247 patients, 84 (6.7%) were dependent before stroke. They were older (81 vs. 72 years of age), more often female (61.9% vs. 46%), had a higher stroke severity at baseline (NIHSS 18 vs. 15 points), more often history of previous stroke (32.9% vs. 9.1%) and more vascular risk factors than independent patients. Favorable outcome and mortality were to the disadvantage of independent patients (26.2% vs. 44.4% and 46.4% vs. 25.5%, respectively), whereas sICH was comparable in both cohorts (4.9% vs. 5%). However, preexisting dependency was not associated with clinical outcome and mortality after adjusting for outcome predictors (OR 1.076, 95% CI 0.612–1.891; p = 0.799 and OR 1.267, 95% CI 0.758–2.119; p = 0.367, respectively).

Conclusion

Our study underscores the need for careful selection of care-dependent stroke patients when considering EVT, given a less favorable outcome observed in this cohort. Nonetheless, EVT should not systematically be withheld in patients with preexisting disability, since prior dependency does not significantly influence outcome.
Vascular risk factors, white matter lesions and cognitive impairment in Parkinson’s disease: the PACOS longitudinal study
Authors: Nicoletti Alessandra , Luca Antonina , Baschi Roberta , Cicero Calogero Edoardo , Mostile Giovanni , Davì Marco , La Bianca Giuseppe , Restivo Vincenzo , Zappia Mario , Monastero Roberto
Published: August 2020

Background

Vascular risk factors (VRFs) may be associated with cognitive decline in early Parkinson’s disease (PD) but results are inconclusive. The identification of modifiable risk factors is relevant for prevention and treatment.

Methods

Parkinson’s disease (PD) patients of the PACOS cohort who underwent a baseline and follow-up neuropsychological evaluation were enrolled in the study. PD with Mild Cognitive Impairment (MCI) and dementia (PDD) were diagnosed according to the MDS criteria. A Baseline 1.5 T brain MRI was used to calculate the white matter lesions (WMLs) burden using the Wahlund visual scale. Laboratory data, presence of hypertension, diabetes and use of anti-hypertensive drugs were collected and the Framingham Risk (FR) score was calculated. VRFs predicting PD-MCI and PDD were evaluated using Cox proportional hazard regression model.

Results

Out of 139 enrolled patients, 84 (60.4%) were classified as normal cognition (NC) and 55 (39.6%) as MCI at baseline. At follow-up 28 (33.3%) PD-NC developed MCI and 4 (4.8%) PDD (follow-up time 23.5 ± 10.3 months). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD. At multivariate analysis among PD-NC a systolic blood pressure (SBP) > 140 mmHg was the stronger predictor of MCI (adjHR 4.04; 95% CI 1.41–11.3) while the presence of MCI at baseline (adj HR 7.55; 95% CI 1.76–32.3) and a severe WMLs burden (adj HR 2.80; 95% CI 0.86–9.04) were the strongest predictors of PDD, even if this latter association has a trend towards significance.

Conclusion

Hypertension represents the most important modifiable risk factor for PD-MCI in the PACOS cohort, increasing the risk of about four times.
Random Geometric Complexes and Graphs on Riemannian Manifolds in the Thermodynamic Limit
Authors: Lerario Antonio , Mulas Raffaella
Published: August 2020

We investigate some topological properties of random geometric complexes and random geometric graphs on Riemannian manifolds in the thermodynamic limit. In particular, for random geometric complexes we prove that the normalized counting measure of connected components, counted according to isotopy type, converges in probability to a deterministic measure. More generally, we also prove similar convergence results for the counting measure of types of components of eachk-skeleton of a random geometric complex. As a consequence, in the case of the 1-skeleton (i.e., for random geometric graphs) we show that the empirical spectral measure associated to the normalized Laplace operator converges to a deterministic measure.
Financial toxicity and employment status in cancer survivors. A systematic literature review
Authors: Mols Floortje , Tomalin Bianca , Pearce Alison , Kaambwa Billingsley , Koczwara Bogda
Published: August 2020

Background

Financial toxicity has traditionally been attributed to the rising costs of cancer care. As ability to work impacts one’s financial situation, limited employment and reduced income may also contribute to financial toxicity. We examined evidence of the association between financial toxicity and employment status in cancer survivors.

Methods

A systematic literature review was performed via PubMed, Web of Science, CINAHL, and PsycINFO with search terms including “Cancer,” “Financial toxicity,” and “Employment” on September 25, 2019.

Results

Thirty-one papers met eligibility criteria. Thirteen studies were rated as having high quality, 16 as adequate, and two as low. Being actively treated for cancer had serious negative consequences on employment and medical expenditures. Unemployment, changed or reduced employment, lost days at work, poor work ability, and changes to employment were associated with a higher risk of financial toxicity. Patients who were younger, non-white, unmarried, of low education, living with dependents, residing in non-metropolitan service areas, with lower income, and of low socioeconomic status were more at risk of financial toxicity. Other variables associated with financial toxicity included having a mortgage/personal loan, higher out of pocket costs and household bills, limited health insurance, more severely ill, on active treatment, and lower functioning or quality of life.

Conclusion

Cancer negatively affects employment, and these changes are significant contributors to financial toxicity. Researchers, healthcare professionals, and patients themselves should all cooperate to tackle these complex issues.
Respiratory characteristics and related intraoperative ventilatory management for patients with COVID-19 pneumonia
Authors: Aoyama Hiroko , Uchida Kanji
Published: August 2020

A substantial proportion of patients with coronavirus disease 19 (COVID-19) develop severe respiratory failure. Although the exact pathophysiology of severe COVID-19 pneumonia remains unknown and the characteristics of these patients are heterogeneous, the acute respiratory failure often fulfills criteria for acute respiratory distress syndrome (ARDS) and the clinical characteristics are also consistent with what is previously known about ARDS. Cohort studies also report distinctively high association between perioperative COVID-19 and postoperative mortality. In this special article, we review several publications on the pathophysiology of COVID-19, and discuss intraoperative ventilatory management for patients with COVID-19 based on the respiratory characteristics of COVID-19 pneumonia in light of the ongoing controversy of clinical phenotypes.
Characterization of two newly isolated Staphylococcus aureus bacteriophages from Japan belonging to the genus Silviavirus
Authors: Kitamura Naoya , Sasabe Eri , Matsuzaki Shigenobu , Daibata Masanori , Yamamoto Tetsuya
Published: August 2020

Two Staphylococcus aureus bacteriophages, KSAP7 and KSAP11, were isolated from sewage and characterized. Based on morphology and DNA sequences, they were assigned to the genus Silviavirus, subfamily Twortvirinae, family Herelleviridae, whose members are hypothesized to be suitable for bacteriophage therapy. The KSAP7 and KSAP11 genomes were 137,950 and 138,307 bp in size, respectively. Although their DNA sequences were almost identical, evidence of site-specific DNA rearrangements was found in two regions. Changes in the number of PIEPEK amino acid sequence repeats encoded by orf10 and the insertion/deletion of a 541-bp sequence that includes a possible tail-related gene were identified.
Parental positive regard and expressed emotion—prediction of developing attention deficit, oppositional and callous unemotional problems between preschool and school age
Authors: Pauli-Pott Ursula , Bauer Lotte , Becker Katja , Mann Christopher , Müller Viola , Schloß Susan
Published: August 2020

Parental expressed emotion and positive reinforcement are assumed to affect the development of oppositional and callous-unemotional behaviors in children at risk of attention deficit hyperactivity disorder (ADHD). As longitudinal research on this issue is scarce, we analyzed the respective links between preschool and school age. 138 five-year-old (m = 58.2, s = 6.2 months) children (59% boys) with elevated ADHD symptoms (according to screening) were assessed at the ages of five and eight years. At 5 years, maternal expressed emotion (using the Five Minute Speech Sample) and positive regard of child (using a standardized at-home observation procedure) were assessed. At 5 and 8 years, symptoms of ADHD, oppositional defiant disorder (ODD), and callous-unemotional (CU) behaviors were measured using a multi-informant approach. Multiple linear regression analyses revealed that positive regard specifically predicted a decrease in ODD symptoms between preschool and school age. The expression of high negative emotion specifically predicted an increase in CU behaviors. The development of ADHD symptoms was not predicted by parenting. Knowledge on these specific links can help to elaborate diagnostic and counseling processes in preschoolers with high ADHD symptoms. Underlying mechanisms and the role of neurocognitive deficits of the preschool child should be further analyzed.
The interplay between mothers’ and children behavioral and psychological factors during COVID-19: an Italian study
Authors: Di Giorgio Elisa , Di Riso Daniela , Mioni Giovanna , Cellini Nicola
Published: August 2020

Italy has been the first nation outside of Asia to face the COVID-19 outbreak. To limit viral transmission of infection, by March 10th, 2020, the Italian Government has ordered a national lockdown, which established home confinement, home (smart) working, and temporary closure of non-essential businesses and schools. The present study investigated how these restrictive measures impacted mothers and their pre-school children’s behavioral habits (i.e., sleep timing and quality, subjective time experience) and psychological well-being (i.e., emotion regulation, self-regulation capacity). An online survey was administered to 245 mothers with pre-school children (from 2 to 5 years). Mothers were asked to fill the survey thinking both on their habits, behaviors, and emotions and on those of their children during the quarantine, and retrospectively, before the national lockdown (i.e., in late February). A general worsening of sleep quality and distortion of time experience in both mothers and children, as well as increasing emotional symptoms and self-regulation difficulties in children, was observed. Moreover, even when the interplay between the behavioral and psychological factors was investigated, the factor that seems to mostly impact both mothers' and children's psychological well-being was their sleep quality. Overall, central institutions urgently need to implementing special programs for families, including not only psychological support to sustain families with working parents and ameliorating children's management.
How Does Collaborative Reflection Unfold in Online Communities? An Analysis of Two Data Sets
Authors: Prilla Michael , Blunk Oliver , Chounta Irene-Angelica
Published: August 2020

People can learn a lot through (collaborative) reflection at work: In organizations, staff debate experiences and due to issues every day, thus reflecting together and learning from each other. While this is desirable, it is often hindered by differences in time and space. Online discussions in community-like systems may provide a means to overcome this issue and enable staff to share experiences and learn from them. In this paper, we study two different data sets from two software systems to support online collaborative reflection in order to analyze what possible factors influence the occurrence of aspects of reflection in online discussions, like experiences, suggestions and learning. Our results include findings that partially approve existing models of (collaborative) reflection, but also others that add to or even challenge these models. Overall, we found that collaborative reflection may take different paths towards learning. From this we derive that facilitation mechanisms need to take up these paths, and that facilitation may be successful in different ways than anticipated from existing literature. We describe possible facilitation mechanisms and discuss their implementation.