bluuebunny/crossref_metadata_2025 huggingface dataset:
Additive kinematic formulas for flag area measures
Authors: Abardia-Evéquoz Judit , Bernig Andreas
Published: August 2021

We show the existence of additive kinematic formulas for general flag area measures, which generalizes a recent result by Wannerer. Building on previous work by the second named author, we introduce an algebraic framework to compute these formulas explicitly. This is carried out in detail in the case of the incomplete flag manifold consisting of all$$(p+1)$$(p+1)-planes containing a unit vector.
Context dependent differences in working memory related brain activity in heavy cannabis users
Authors: Kroon Emese , Kuhns Lauren , Cousijn Janna
Published: August 2021

Rationale

Compromised cognitive control in cannabis use–tempting situations is thought to play a key role in the development of cannabis use disorders. However, little is known about how exposure to cannabis cues and contexts may influence cognitive control and the underlying neural mechanisms in cannabis users.

Objectives

Working memory (WM) is an attention reliant executive function central to cognitive control. In this study, we investigated how distracting cannabis words affected WM load–dependent performance and related brain activity in near-daily cannabis users (N = 36) relative to controls (N = 33).

Methods

Brain activity was recorded during a novel N-back flanker WM task with neutral and cannabis flankers added as task-irrelevant distractors.

Results

On a behavioural level, WM performance did not differ between groups, and the presence of cannabis flankers did not affect performance. However, in cannabis users compared to controls, the presence of cannabis flankers reduced WM load–related activity in multiple regions, including the insula, thalamus, superior parietal lobe and supramarginal gyrus.

Conclusions

The group specificity of these effects suggest that cannabis users might differ from controls in the way they process cannabis-related cues and that cannabis cue exposure could interfere with other cognitive processes under cognitively demanding circumstances. Future studies should focus on the role of context in cognitive control–related processes like WM and attention to further elucidate potential cognitive impairments in heavy cannabis users and how these relate to loss of control over drug seeking itself.
Changes in Characteristics and Outcomes of Patients Undergoing Surgery for Hip Fractures Following the Initiation of Orthogeriatric Service: Temporal Trend Analysis
Authors: Fluck Ben , Yeong Keefai , Lisk Radcliffe , Watters Hazel , Robin Jonathan , Fluck David , Fry Christopher H. , Han Thang S.
Published: August 2021

The Blue Book published by the British Orthopaedic Association and British Geriatrics Society, together with the introduction of National Hip Fracture Database Audit and Best Practice Tariff, have been influential in improving hip fracture care. We examined ten-year (2009–2019) changes in hip fracture outcomes after establishing an orthogeriatric service based on these initiatives, in 1081 men and 2891 women (mean age = 83.5 ± 9.1 years). Temporal trends in the annual percentage change (APC) of outcomes were identified using the Joinpoint Regression Program v4.7.0.0. The proportions of patients operated beyond 36 h of admission fell sharply during the first two years: APC =  − 53.7% (95% CI − 68.3, − 5.2, P = 0.003), followed by a small rise thereafter: APC = 5.8% (95% CI 0.5, 11.3, P = 0.036). Hip surgery increased progressively in patients > 90 years old: APC = 3.3 (95% CI 1.0, 5.8, P = 0.011) and those with American Society of Anaesthesiologists grade ≥ 3: APC = 12.4 (95% CI 8.8, 16.1, P < 0.001). There was a significant decline in pressure ulcers amongst patients < 90 years old: APC =  − 17.9 (95% CI − 32.7, 0.0, P = 0.050) and also a significant decline in mortality amongst those > 90 years old: APC =  − 7.1 (95% CI − 12.6, − 1.3, P = 0.024). Prolonged length of stay (> 23 days) declined from 2013: APC =  − 24.6% (95% CI − 31.2, − 17.4, P < 0.001). New discharge to nursing care declined moderately over 2009–2016 (APC =  − 10.6, 95% CI − 17.2, − 2.7, P = 0.017) and sharply thereafter (APC =  − 47.5%, 95%CI − 71.7, − 2.7, P = 0.043). The rate of patients returning home was decreasing (APC =  − 2.9, 95% CI − 5.1, − 0.7, P = 0.016), whilst new discharge to rehabilitation was increasing (APC = 8.4, 95% CI 4.0, 13.0; P = 0.002). In conclusion, the establishment of an orthogeriatric service was associated with a reduction of elapsed time to hip surgery, a progressive increase in surgery carried out on high-risk adults and a decline in adverse outcomes.
Real-world applicability and impact of early rhythm control for European patients with atrial fibrillation: a report from the ESC-EHRA EORP-AF Long-Term General Registry
Authors: Proietti Marco , Vitolo Marco , Harrison Stephanie L. , Lane Deirdre A. , Fauchier Laurent , Marin Francisco , Nabauer Michael , Potpara Tatjana S. , Dan Gheorghe-Andrei , Boriani Giuseppe , Lip Gregory Y. H. ,   the ESC-EHRA EORP-AF Long-Term General Registry Investigators
Published: August 2021

Background

Use of rate/rhythm control is essential to control symptoms in patients with atrial fibrillation (AF). Recently, the EAST-AFNET 4 trial described how early rhythm control strategy was associated with a lower risk of adverse clinical outcomes.

Objectives

The aim was to evaluate the real-world applicability and impact of an early rhythm control strategy in patients with AF.

Methods

Use of an early rhythm control strategy was assessed in a European cohort of AF patients derived from the EHRA-ESC EORP-AF General Long-Term Registry. Early rhythm control was defined as use of antiarrhythmic drugs or cardioversion/catheter ablation. The primary outcome included cardiovascular death, stroke, acute coronary syndrome, and worsening of heart failure. Quality of life and health-care resource usage were also assessed as outcomes.

Results

Among the 10,707 patients evaluated for eligibility to EAST-AFNET 4, a total of 3774 (34.0%) were included. Early rhythm control was associated with better quality of life, but with greater use of health-care resources. During follow-up, the primary outcome occurred less often in early rhythm control patients than in those with no rhythm control (13.6% vs. 18.5%, p < 0.001). In the multivariate adjusted Cox regression model, no significant difference was found between no rhythm control and early rhythm control, for the primary outcome. No difference in the primary outcome between early rhythm control and ‘no rhythm control patients’ adherent to Atrial fibrillation Better Care (ABC) pathway’ was evident (p = 0.753)

Conclusions

Use of an early rhythm control strategy was associated with a lower rate of major adverse events, but this difference was non-significant on multivariate analysis, being mediated by differences in baseline characteristics and clinical risk profile. Early rhythm control was associated with a higher use of health-care resources and risk of hospital admission, despite showing better quality of life.

Graphic abstract
Non-invasive predictors for infranodal conduction delay in patients with left bundle branch block after TAVR
Authors: Auberson Chloé , Badertscher Patrick , Madaffari Antonio , Malushi Meriton , Bourquin Luc , Spies Florian , Aeschbacher Stefanie , Fahrni Gregor , Kaiser Christoph , Jeger Raban , Osswald Stefan , Sticherling Christian , Knecht Sven , Kühne Michael
Published: August 2021

Aims

Left bundle branch block (LBBB) is the most common conduction disorder after transcatheter aortic valve replacement (TAVR) with an increased risk of atrioventricular (AV) block. The aim of the current study was to identify non-invasive predictors for infranodal conduction delay in patients with LBBB.

Methods

We analyzed consecutive patients undergoing TAVR with pre-existing or new-onset LBBB between August 2014 and August 2020. His ventricular (HV) interval measurement was performed on day 1 after TAVR. Baseline, procedural, as well as surface and intracardiac electrocardiographic parameters were included. Infranodal conduction delay was defined as HV interval > 55 ms.

Results

Of 825 patients screened after TAVR, 151 patients (82 ± 6 years, 39% male) with LBBB were included. Among these, infranodal conduction delay was observed in 25%. ΔPR (difference in PR interval after and before TAVR), PR and QRS duration after TAVR were significantly longer in the group with HV prolongation. In a multivariate analysis in patients with sinus rhythm (n = 123), ΔPR (OR per 10 ms increase: 1.52; 95%CI: 1.19–2.01;p = 0.002) was the only independent factor associated with infranodal conduction delay. A change in PR interval by 20 ms yielded a specificity of 83% and a sensitivity of 46%, with a negative predictive value of 84% and a positive predictive value of 45% to predict HV prolongation.

Conclusions

Simple analysis of surface ECG and a calculated ΔPR < 20 ms can be used as predictor for the absence of infranodal conduction delay in post-TAVR patients with LBBB.

Graphical abstract
On critical Kirchhoff problems driven by the fractional Laplacian
Authors: Appolloni Luigi , Molica Bisci Giovanni , Secchi Simone
Published: August 2021

We study a nonlocal parametric problem driven by the fractional Laplacian operator combined with a Kirchhoff-type coefficient and involving a critical nonlinearity term in the Sobolev embedding sense. Our approach is of variational and topological nature. The obtained results can be viewed as a nontrivial extension to the nonlocal setting of some recent contributions already present in the literature.
Water contents of nominally anhydrous orthopyroxenes from oceanic peridotites determined by SIMS and FTIR
Authors: Wenzel Kirsten T. , Wiedenbeck Michael , Gose Jürgen , Rocholl Alexander , Schmädicke Esther
Published: August 2021

This study presents new secondary ion mass spectrometry (SIMS) reference materials (RMs) for measuring water contents in nominally anhydrous orthopyroxenes from upper mantle peridotites. The enstatitic reference orthopyroxenes from spinel peridotite xenoliths have Mg#s between 0.83 and 0.86, Al2O3 ranges between 4.02 and 5.56 wt%, and Cr2O3 ranges between 0.21 and 0.69 wt%. Based on Fourier-transform infrared spectroscopy (FTIR) characterizations, the water contents of the eleven reference orthopyroxenes vary from dry to 249 ± 6 µg/g H2O. Using these reference grains, a set of orthopyroxene samples obtained from variably altered abyssal spinel peridotites from the Atlantic and Arctic Ridges as well as from the Izu-Bonin-Mariana forearc region was analyzed by SIMS and FTIR regarding their incorporation of water. The major element composition of the sample orthopyroxenes is typical of spinel peridotites from the upper mantle, characterized by Mg#s between 0.90 and 0.92, Al2O3 between 1.66 and 5.34 wt%, and Cr2O3 between 0.62 and 0.96 wt%. Water contents as measured by SIMS range from 68 ± 7 to 261 ± 11 µg/g H2O and correlate well with Al2O3 contents (r = 0.80) and Cr#s (r. = -0.89). We also describe in detail an optimized strategy, employing both SIMS and FTIR, for quantifying structural water in highly altered samples such as abyssal peridotite. This approach first analyzes individual oriented grains by polarized FTIR, which provides an overview of alteration. Subsequently, the same grain along with others of the same sample is measured using SIMS, thereby gaining information about homogeneity at the hand sample scale, which is key for understanding the geological history of these rocks.
Offensive keyword extraction based on the attention mechanism of BERT and the eigenvector centrality using a graph representation
Authors: Sarracén Gretel Liz De la Peña , Rosso Paolo
Published: August 2021

The proliferation of harmful content on social media affects a large part of the user community. Therefore, several approaches have emerged to control this phenomenon automatically. However, this is still a quite challenging task. In this paper, we explore the offensive language as a particular case of harmful content and focus our study in the analysis of keywords in available datasets composed of offensive tweets. Thus, we aim to identify relevant words in those datasets and analyze how they can affect model learning. For keyword extraction, we propose an unsupervised hybrid approach which combines the multi-head self-attention of BERT and a reasoning on a word graph. The attention mechanism allows to capture relationships among words in a context, while a language model is learned. Then, the relationships are used to generate a graph from what we identify the most relevant words by using the eigenvector centrality. Experiments were performed by means of two mechanisms. On the one hand, we used an information retrieval system to evaluate the impact of the keywords in recovering offensive tweets from a dataset. On the other hand, we evaluated a keyword-based model for offensive language detection. Results highlight some points to consider when training models with available datasets.
Development of health monitoring method for pecan nut trees using side video data and computer vision
Authors: Nomura Ryota , Oki Kazuo
Published: August 2021

Increasing efficiency and productivity in the field of agriculture is important to provide sufficient food to the world’s increasing population. It is important to monitor crops using image processing in order to realize these increases in efficiency and productivity. In order to monitor crops with high quality and accuracy, high resolution images are needed. In this research, a crop monitoring method for pecan nut trees was developed using high-resolution video taken from the side of a vehicle. First, trees were extracted by applying an object detection model to the video data. Second, the extracted trees were divided into canopy and trunk areas. Finally, using labels made by experts and the canopy image as input, the convolutional neural network (CNN) model was trained to classify unhealthy and healthy trees. The model achieved an area under the curve for classification over 0.95. Gradient-weighted Class Activation Mapping (Grad-CAM) was also applied to the model for the purpose of evaluation, and it clarified that the model is focusing on the hollow features of the canopy when performing its classification.
Techno-economic assessment of common reed and sewage sludge co-fermentation improved by vapothermal pre-treatment
Authors: Scherzinger Marvin , Kaltschmitt Marvin
Published: August 2021

This study examines whether vapothermal pre-treatment is technically feasible and brings economic advantages for a subsequent anaerobic co-fermentation of reeds together with sewage sludge. This is illustrated by the example of remote sites located close to constructed wetlands in the Persian Gulf states. Thus, eight different biogas plant configurations with an installed electric power between 75 and 450 kW, each with and without vapothermal pre-treatment, are investigated in detail related to technical and economic figures. Within the technical assessment, suitable plant components are chosen and overall plant layouts are designed and dimensioned. Furthermore, the requirements on the substrate by means of quantity, pre-treatment and storage capacities are investigated. Based on this, an economic evaluation following the annuity method is performed in order to calculate the respective electricity production costs. The results show that the thermal energy required for vapothermal pre-treatment can be obtained completely from the residual heat of the combined heat and power unit used in each case. Additionally, the specific electricity production costs can be reduced by a vapothermal pre-treatment up to 7 % related to the systems without pre-treatment. Furthermore, a comparison shows that vapothermal pre-treatment can compete with other pre-treatment methods such as steam explosion and hydrothermal pre-treatment for plants with higher installed electric capacity. In addition, it is shown that the considered cases can compete with the production of electricity using diesel as a fuel at a fuel equivalent price of 1.00 €

Graphic abstract
From embodying tool to embodying alien limb: sensory-motor modulation of personal and extrapersonal space
Authors: Berti Anna
Published: August 2021

Years ago, it was demonstrated (e.g., Rizzolatti et al. in Handbook of neuropsychology, Elsevier Science, Amsterdam, 2000) that the brain does not encode the space around us in a homogeneous way, but through neural circuits that map the space relative to the distance that objects of interest have from the body. In monkeys, relatively discrete neural systems, characterized by neurons with specific neurophysiological responses, seem to be dedicated either to represent the space that can be reached by the hand (near/peripersonal space) or to the distant space (far/extrapersonal space). It was also shown that the encoding of spaces has dynamic aspects because they can be remapped by the use of tools that trigger different actions (e.g., Iriki et al. 1998). In this latter case, the effect of the tool depends on the modulation of personal space, that is the space of our body. In this paper, I will review and discuss selected research, which demonstrated that also in humans: 1 spaces are encoded in a dynamic way; 2 encoding can be modulated by the use of tool that the system comes to consider as parts of the own body; 3 body representations are not fixed, but they are fragile and subject to change to the point that we can incorporate not only the tools necessary for action, but even limbs belonging to other people. What embodiment of tools and of alien limb tell us about body representations is then briefly discussed.
Prediction of all-cause mortality from 24 month trajectories in patient-reported psychological, clinical and quality of life outcomes in uveal melanoma patients
Authors: Brown Stephen L. , Fisher Peter L. , Hope-Stone Laura , Heimann Heinrich , Hussain Rumana , Cherry M. Gemma
Published: August 2021

A number of patient-reported outcomes (PROs) predict increased mortality after primary cancer treatment. Studies, though, are sometimes affected by methodological limitations. They often use control variables that poorly predict life expectancy, examine only one or two PROs thus not controlling potential confounding by unmeasured PROs, and observe PROs at only a single point in time. To predict all-cause mortality, this study used control variables affording good estimates of life expectancy, conducted multivariate analyses of multiple PROs to identify independent predictors, and monitored PROs two years after diagnosis. We recruited a consecutive sample of 824 patients with uveal melanoma between April 2008 and December 2014. PROs were variables shown to predict mortality in previous studies; anxiety, depression, visual and ocular symptoms, visual function impairment, worry about cancer recurrence, and physical, emotional, social and functional quality of life (QoL), measured 6, 12 and 24 months after diagnosis. We conducted Cox regression analyses with a census date of December 2018. Covariates were age, gender, marital and employment status, self-reported co-morbidities, tumor diameter and thickness, treatment modality and chromosome 3 mutation status, the latter a genetic mutation strongly associated with mortality. Single predictor analyses (with covariates), showed 6-month depression and poorer functional QoL predicting mortality, as did 6–12 month increases in anxiety and 6–12 month decreases in physical and functional QoL. Multivariate analyses using all PROs showed independent prediction by 6-month depression and decreasing QoL over 6–12 months and 12–24 months. Elevated depression scores six months post-diagnosis constituted an increased mortality risk. Early intervention for depressive symptoms may reduce mortality.
Income-dependent equivalence scales: A fresh look at German micro-data
Authors: Garbuszus Jan Marvin , Ott Notburga , Pehle Sebastian , Werding Martin
Published: August 2021

Income inequality and poverty risks receive a lot of attention in public debates and current research. To make income comparable across different types of households, applying the “(modified) OECD scale” – an equivalence scale with fixed weights for each household type – has become a quasi-standard in research. Instead, we derive a base-dependent equivalence scale allowing for scale weights that vary with income, building on micro-data from Germany. Our results suggest that appropriate equivalence scales are much steeper at the lower end of the income distribution than they are for higher income levels. We illustrate our findings by applying them to data on family income differentiated by household types. It turns out that using income-dependent equivalence scales matters for applied research on income inequality, especially if one is concerned with the composition, not just the size of the population at poverty risk.
Which East Asian herbal medicines can decrease viral infections?
Authors: Kuchta Kenny , Cameron Silke , Lee Minwon , Cai Shao-Qing , Shoyama Yukihiro
Published: August 2021

Whilst Western research for the COVID-19 crisis focuses on vaccination, in East Asia traditional herbal prescriptions are studied for SARS-CoV2 therapy. In Japan, Maoto (Ephedrae herba 4 g, Armeniacae semen 4 g, Cinnamomi cortex 3 g, and Glycyrrhizae radix 2 g, JPXVII) is used based on clinical evidence for its effect on early phase influenza (also caused by RNA viruses) comparable to that of oseltamivir. The Health Ministry of Thailand has approved Andrographis paniculata (Jap. Senshinren) extracts for treatment of COVID-19. Its combination (4 g) with Maoto, Maoto-ka-senshinren, seems most promising for the treatment of viral pandemics. In China, the official guideline for COVID-19 treatment contains TCM medications with antiviral, as well as immunmodulatory and anti-inflammatory effects such as: Qing-Fei-Pai-Du-Tang (Jap. Seihai-haidokuto) contains 21 drugs; Shufeng Jiedu Jiaonang (Bupleuri radix 8 g, Forsythiae fructus 8 g, Glycyrrhizae radix 4 g, Isatidis radix 8 g, Patriniae herba 8 g, Phragmitis rhizoma 6 g, Polygoni cuspidati rhizoma 10 g, Verbenae herba 8 g); Fufang Yuxingcao Heiji (Forsythiae fructus 0.6 g, Houttuyniae herba 6 g, Isatidis radix 1.5 g, Lonicerae flos 0.6 g, Scutellariae radix 1.5 g) first gained prominence during the 2002 SARS epidemic. With no Western medicine available, the following overview discusses efficacy and mechanisms in view of viral entry and replication of different East Asian herbal remedies for COVID-19 treatment.
A SARS-CoV-2 mutant from B.1.258 lineage with ∆H69/∆V70 deletion in the Spike protein circulating in Central Europe in the fall 2020
Authors: Brejová Broňa , Boršová Kristína , Hodorová Viktória , Čabanová Viktória , Reizigová Lenka , Paul Evan D. , Čekan Pavol , Klempa Boris , Nosek Jozef , Vinař Tomáš
Published: August 2021

SARS-CoV-2 mutants carrying the ∆H69/∆V70 deletion in the amino-terminal domain of the Spike protein emerged independently in at least six lineages of the virus (namely, B.1.1.7, B.1.1.298, B.1.160, B.1.177, B.1.258, B.1.375). We analyzed SARS-CoV-2 samples collected from various regions of Slovakia between November and December 2020 that were presumed to contain B.1.1.7 variant due to drop-out of the Spike gene target in an RT-qPCR test caused by this deletion. Sequencing of these samples revealed that although in some cases the samples were indeed confirmed as B.1.1.7, a substantial fraction of samples contained another ∆H69/∆V70 carrying mutant belonging to the lineage B.1.258, which has been circulating in Central Europe since August 2020, long before the import of B.1.1.7. Phylogenetic analysis shows that the early sublineage of B.1.258 acquired the N439K substitution in the receptor-binding domain (RBD) of the Spike protein and, later on, also the deletion ∆H69/∆V70 in the Spike N-terminal domain (NTD). This variant was particularly common in several European countries including the Czech Republic and Slovakia but has been quickly replaced by B.1.1.7 early in 2021.
Obesity paradox in joint replacement for osteoarthritis — truth or paradox?
Authors: Kunutsor Setor K. , Whitehouse Michael R. , Blom Ashley W.
Published: August 2021

Obesity is associated with an increased risk of cardiovascular disease (CVD) and other adverse health outcomes. In patients with pre-existing heart failure or coronary heart disease, obese individuals have a more favourable prognosis compared to individuals who are of normal weight. This paradoxical relationship between obesity and CVD has been termed the ‘obesity paradox’. This phenomenon has also been observed in patients with other cardiovascular conditions and diseases of the respiratory and renal systems. Taking into consideration the well-established relationship between osteoarthritis (OA) and CVD, emerging evidence shows that overweight and obese individuals undergoing total hip or knee replacement for OA have lower mortality risk compared with normal weight individuals, suggesting an obesity paradox. Factors proposed to explain the obesity paradox include the role of cardiorespiratory fitness (“fat but fit”), the increased amount of lean mass in obese people, additional adipose tissue serving as a metabolic reserve, biases such as reverse causation and confounding by smoking, and the co-existence of older age and specific comorbidities such as CVD. A wealth of evidence suggests that higher levels of fitness are accompanied by prolonged life expectancy across all levels of adiposity and that the increased mortality risk attributed to obesity can be attenuated with increased fitness. For patients about to have joint replacement, improving fitness levels through physical activities or exercises that are attractive and feasible, should be a priority if intentional weight loss is unlikely to be achieved.
Exploring students’ learning experience in online education: analysis and improvement proposals based on the case of a Spanish open learning university
Authors: Rivera-Vargas Pablo , Anderson Terry , Cano Cristina Alonso
Published: August 2021

Not surprisingly, the number of online universities continues to expand—especially in Covid-19 times. These institutions all offer “online education” with diverse institutional, technological, and pedagogical processes. However, a fundamental element has to do with the experience of the students, and how they adapt to the educational model of the online university in which they are studying. In this article, we present the main results of the case-study developed in one of the most historical and relevant virtual universities in an international context. We have explored and analysed the process of adaptation to the educational model by the student body, and their perceptions of their interactions with the pedagogical, institutional, and technological elements designed to support their learning. Qualitative and quantitative methods are used to gather and analyse the data. From 1715 students who participated in the survey and the perceptions of 30 students individually interviewed, the results show positive evaluations regarding the integration and adoption of technological competencies, and also, that the online education generally serves as a responsive model to the emergent needs of the learner. However, the results also show that students have important concerns regarding the pedagogical and institutional support provided.
Preoperative measurement of the hiatal surface with MDCT: impact on surgical planning
Authors: Rengo Marco , Boru Cristian E. , Badia Stefano , Iossa Angelo , Bellini Davide , Picchia Simona , Panvini Nicola , Carbone Iacopo , Silecchia Gianfranco , Laghi Andrea
Published: August 2021

Objective

To evaluate the accuracy and reproducibility of hiatal surface area (HSA) measurement on dedicated multidetector computed tomography (MDCT) acquisition, in patients, previously subjected to laparoscopic sleeve gastrectomy (LSG), and affected by gastroesophageal reflux disease (GERD). Intraoperative HSA measurement was considered the reference standard.

Methods

Fifty-two candidates for laparoscopic hiatal hernia repair were prospectively included in the study. MDCT images were acquired during swallowing of oral iodinated contrast media and during strain. Measurements were performed by nine readers divided into three groups according to their experience. Results were compared with intraoperative measurements by means of Spearman correlation coefficient. Reproducibility was evaluated with intra- and interreader agreement by means of weighted Cohen’s kappa and intraclass correlation coefficient (ICC).

Results

Significant differences between MDCT and intraoperative HSA measurements were observed for swallowing imaging for less experienced readers (p = 0.037, 0.025, 0.028 and 0.019). No other statistically significant differences were observed (p > 0.05). The correlation between HSA measured intraoperatively and on MDCT was higher for strain imaging compared to swallowing (r = 0.94—0.92 vs 0.94—0.89). The overall reproducibility of MDCT HSA measurement was excellent (ICC of 0.95; 95% CI 0,8993 to 0,9840) independently of reader’s experience

Conclusion

HSA can be accurately measured on MDCT images. This method is reproducible and minimally influenced by reader experience. The preoperative measurement of HSA has potential advantages for surgeons in terms of correct approach to hiatal defects in obese patient.
Bone Mineral Density Trends During the First Year After Laparoscopic Sleeve Gastrectomy—a Cohort Study on 241 Patients
Authors: Malinici Elisabeta , Sirbu Anca , Popa Miruna , Andrei Marian , Ioacara Sorin , Copaescu Catalin , Fica Simona
Published: August 2021

Purpose

Laparoscopic sleeve gastrectomy (LSG) is an effective weight loss procedure, but detrimental effects on bone health have been described. We aimed to assess the dynamics of regional and total bone mineral density (BMD) in a cohort of patients undergoing LSG and to capture gender differences in terms of evolution.

Materials and Methods

We conducted a retrospective study on 241 patients who underwent LSG to determine the regional and total BMD changes at 6 and 12 months after the intervention.

Results

One hundred ten males and 140 females (97 pre-, 43 postmenopausal) were included. Mean baseline body mass index (BMI) was 44.16 ± 6.11 kg/m2 in males and 41.60 ± 5.54 kg/m2 in females, reaching 28.62 ± 4.26 kg/m2 and 27.39 ± 4.2 kg/m2, respectively, at 12 months. BMD showed a continuous decline, with significant loss from 6 months postoperatively. There was a positive correlation between BMD and BMI decline at 12 months (r = 0.134, p < 0.05). Total BMD loss at 12 months was significantly greater in males than premenopausal females, independent of BMI variation and age. During the first 6 months, men lost significantly more bone mass than premenopausal and postmenopausal women (BMD variation was 2.62%, 0.27%, 1.58%, respectively). The second period (6–12 months) was similar in all three groups, revealing a further steady (~ 1.4%) BMD decline.

Conclusions

Our results are consistent with previous findings that LSG negatively impacts BMD, stressing the importance of bone health-oriented measures in postoperative care. Moreover, the impact that seems more significant in males warrants future exploration, as it might change clinical practice.

Graphical abstract
Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy
Authors: Okdahl Tina , Brock Christina
Published: August 2021

Purpose of Review

To discuss and provide evidence-based data on dietary supplements as part of treating diabetic neuropathy

Recent Findings

Few randomized controlled trials are available, but some have shown beneficial efficacy of various dietary supplements on objective primary endpoints including nerve conduction velocities and axon potentials as well as subjective patient-reported outcomes.

No medical cure for diabetic neuropathy exists, and prevention is therefore crucial. Tight glucose control slows the progression of nerve damage in diabetes, but an unmet clinical need for effective interventions is warranted. Consequently, a growing number of patients turn to dietary supplements proposed to possess neuroprotective properties. However, the postulated effects are often not evidence-based as they have not been tested scientifically. Taken together, this review will focus on dietary supplements investigated in clinical trials for their potential capabilities in targeting the molecular mechanisms involved in the underlying pathogenesis of diabetic neuropathy.
Efficacy of Ketogenic Diets on Type 2 Diabetes: a Systematic Review
Authors: Tinguely Delphine , Gross Justine , Kosinski Christophe
Published: August 2021

Purpose of Review

To assess the pleiotropic effects of ketogenic diets (KD) on glucose control, changes in medication, and weight loss in individuals with type 2 diabetes, and to evaluate its practical feasibility

Recent Findings

KD results in improved HbA1c already after 3 weeks, and the effect seems to persist for at least 1 year. This is associated with a reduction in glucose-lowering medications. The weight loss observed after a short time period seems to be maintained with a long-term diet. Adequate support (supportive psychological counseling, enhancing positive affectivity, reinforcing mindful eating) is necessary to achieve a benefit and to assure adherence.

Despite the documented decrease in HbA1, a definitive causal effect of KD remains to be proven. KD should be performed under strict medical supervision. Future research should clarify how compliance can be maximized and how ketosis can be optimally monitored.
Thyroid testing paradigm switch from thyrotropin to thyroid hormones—Future directions and opportunities in clinical medicine and research
Authors: Fitzgerald Stephen P. , Bean Nigel G. , Hennessey James V. , Falhammar Henrik
Published: August 2021

Purpose

Recently published papers have demonstrated that particularly in untreated individuals, clinical parameters more often associate with thyroid hormone, particularly free thyroxine (FT4), levels than with thyrotropin (TSH) levels. Clinical and research assessments of the thyroid state of peripheral tissues would therefore be more precise if they were based on FT4 levels rather than on TSH levels. In this paper we describe implications of, and opportunities provided by, this discovery.

Conclusions

The FT4 level may be the best single test of thyroid function. The addition of free triiodothyronine (FT3) and TSH levels would further enhance test sensitivity and distinguish primary from secondary thyroid dysfunction respectively. There are opportunities to reconsider testing algorithms. Additional potential thyroidology research subjects include the peripheral differences between circulating FT4 and FT3 action, and outcomes in patients on thyroid replacement therapy in terms of thyroid hormone levels. Previously performed negative studies of therapy for subclinical thyroid dysfunction could be repeated using thyroid hormone levels rather than TSH levels for subject selection and the monitoring of treatment. Studies of outcomes in older individuals with treatment of high normal FT4 levels, and pregnant women with borderline high or low FT4 levels would appear to be the most likely to show positive results. There are fresh indications to critically re-analyse the physiological rationale for the current preference for TSH levels in the assessment of the thyroid state of the peripheral tissues. There may be opportunities to apply these research principles to analogous parameters in other endocrine systems.
“Masato de Yuca” and “Chicha de Siete Semillas” Two Traditional Vegetable Fermented Beverages from Peru as Source for the Isolation of Potential Probiotic Bacteria
Authors: Rebaza-Cardenas Teresa D. , Silva-Cajaleón Kenneth , Sabater Carlos , Delgado Susana , Montes-Villanueva Nilda D. , Ruas-Madiedo Patricia
Published: August 2021

In this work, two Peruvian beverages “Masato de Yuca,” typical of the Amazonian communities made from cassava (Manihot esculenta), and “Chicha de Siete Semillas,” made from different cereal, pseudo-cereal, and legume flours, were explored for the isolation of lactic acid bacteria after obtaining the permission of local authorities following Nagoya protocol. From an initial number of 33 isolates, 16 strains with different RAPD- and REP-PCR genetic profiles were obtained. In Chicha, all strains were Lactiplantibacillus plantarum (formerly Lactobacillus plantarum), whereas in Masato, in addition to this species, Limosilactobacillus fermentum (formerly Lactobacillus fermentum), Pediococcus acidilactici, and Weissella confusa were also identified. Correlation analysis carried out with their carbohydrate fermentation patterns and enzymatic profiles allowed a clustering of the lactobacilli separated from the other genera. Finally, the 16 strains were submitted to a static in vitro digestion (INFOGEST model) that simulated the gastrointestinal transit. Besides, their ability to adhere to the human epithelial intestinal cell line HT29 was also determined. Following both procedures, the best probiotic candidate was Lac. plantarum Ch13, a robust strain able to better face the challenging conditions of the gastrointestinal tract and showing higher adhesion ability to the intestinal epithelium in comparison with the commercial probiotic strain 299v. In order to characterize its benefit for human health, this Ch13 strain will be deeply studied in further works.
Correction to: Two-scale coupling for preconditioned Hamiltonian Monte Carlo in infinite dimensions
Authors: Bou-Rabee Nawaf , Eberle Andreas
Published: August 2021

A Correction to this paper has been published: 10.1007/s40072-020-00175-6
Surgical aortic valve replacement in elderly patients: effects on physical performance, cognitive function and health-related quality of life
Authors: De Rui Marina , Tarzia Vincenzo , Mazzochin Mattia , Bertocco Anna , Ceolin Chiara , Trevisan Caterina , Tessari Chiara , Cavalli Chiara , Piperata Antonio , Coin Alessandra , Gerosa Gino , Sergi Giuseppe
Published: August 2021

Background

Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention.

Aims

To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term.

Methods

This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant’s clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests.

Results

Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4.

Conclusions

Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample.
Pedagogical Strategies for the Enhancement of Medical Education
Authors: Azzam Mohammad B. , Easteal Ronald A.
Published: August 2021

Clearly, memory and learning are essential to medical education. To make memory and learning more robust and long-term, educators should turn to the advances in neuroscience and cognitive science to direct their efforts. This paper describes the memory pathways and stages with emphasis leading to long-term memory storage. Particular stress is placed on this storage as a construct known as schema. Leading from this background, several pedagogical strategies are described: cognitive load, dual encoding, spiral syllabus, bridging and chunking, sleep consolidation, and retrieval practice.
The Technological Condition of Human Evolution: Lithic Studies as Basic Science
Authors: Hussain Shumon Tobias , Soressi Marie
Published: August 2021

The recent elaboration and rapid expansion of aDNA, paleoproteomics, and related fields have propelled a profound “biomolecular turn” in archaeology and fundamentally changed the topology of archaeological knowledge production. Such a transformation of the archaeological research landscape is not without consequence for long-standing research practices in the field, such as lithic analysis. This special issue derives from the session Old Stones, New Eyes? organized by the authors at the UISPP World Congress in Paris in 2018, which aimed to explore the future of lithic studies. An underlying theme of our session was the felt need to respond to the increasing marginalization of lithic research in terms of its capacity to (1) contribute to the grand narratives of early human evolution and (2) better articulate the role and significance of lithic studies in interdisciplinary human origins research. In this editorial, we briefly outline some of the questions and challenges raised by the biomolecular turn and advocate for a more self-conscious and reflexive stance among lithic experts. We argue that lithic studies fulfill all necessary requirements to act as a basic science for human origins research and that its role and status depends less on technological advances, such as, e.g., improved computing facilities, novel analytical software, or automated shape capture technologies, than on continuous work on the conceptual and methodological foundations of inquiry. We finally draw attention to the unique capability of lithic studies to shed light on the human technological condition and illustrate this potential by introducing and briefly discussing the papers included in this issue.
Metagenomic insights into the effects of submerged plants on functional potential of microbial communities in wetland sediments
Authors: Wang Binhao , Zheng Xiafei , Zhang Hangjun , Yu Xiaoli , Lian Yingli , Yang Xueqin , Yu Huang , Hu Ruiwen , He Zhili , Xiao Fanshu , Yan Qingyun
Published: August 2021

Submerged plants in wetlands play important roles as ecosystem engineers to improve self-purification and promote elemental cycling. However, their effects on the functional capacity of microbial communities in wetland sediments remain poorly understood. Here, we provide detailed metagenomic insights into the biogeochemical potential of microbial communities in wetland sediments with and without submerged plants (i.e.,Vallisneria natans). A large number of functional genes involved in carbon (C), nitrogen (N) and sulfur (S) cycling were detected in the wetland sediments. However, most functional genes showed higher abundance in sediments with submerged plants than in those without plants. Based on the comparison of annotated functional genes in the N and S cycling databases (i.e., NCycDB and SCycDB), we found that genes involved in nitrogen fixation (e.g.,nifD/H/K/W), assimilatory nitrate reduction (e.g.,nasAandnirA), denitrification (e.g.,nirK/SandnosZ), assimilatory sulfate reduction (e.g.,cysD/H/J/N/Qandsir), and sulfur oxidation (e.g.,glpE, soeA, sqrandsseA) were significantly higher (correctedp < 0.05) in vegetated vs. unvegetated sediments. This could be mainly driven by environmental factors including total phosphorus, total nitrogen, and C:N ratio. The binning of metagenomes further revealed that some archaeal taxa could have the potential of methane metabolism including hydrogenotrophic, acetoclastic, and methylotrophic methanogenesis, which are crucial to the wetland methane budget and carbon cycling. This study opens a new avenue for linking submerged plants with microbial functions, and has further implications for understanding global carbon, nitrogen and sulfur cycling in wetland ecosystems.
Historical Benchmarks for Quality Tolerance Limits Parameters in Clinical Trials
Authors: Makowski Marcin , Bhagat Ruma , Chevalier Soazig , Gilbert Steven A. , Görtz Dagmar R. , Kozińska Marta , Nadolny Patrick , Suprin Melissa , Turri Sabine
Published: August 2021

Background

In 2016, the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use updated its efficacy guideline for good clinical practice and introduced quality tolerance limits (QTLs) as a quality control in clinical trials. Previously, TransCelerate proposed a framework for QTL implementation and parameters. Historical data can be important in helping to determine QTL thresholds in new clinical trials.

Methods

This article presents results of historical data analyses for the previously proposed parameters based on data from 294 clinical trials from seven TransCelerate member companies. The differences across therapeutic areas were assessed by comparing Alzheimer’s disease (AD) and oncology trials using a separate dataset provided by Medidata.

Results

TransCelerate member companies provided historical data on 11 QTL parameters with data sufficient for analysis for parameters. The distribution of values was similar for most parameters with a relatively small number of outlying trials with high parameter values. Medidata provided values for three parameters in a total of 45 AD and oncology trials with no obvious differences between the therapeutic areas.

Conclusion

Historical parameter values can provide helpful benchmark information for quality control activities in future trials.
Counting closed geodesics in a compact rank-one locally CAT(0) space
Authors: RICKS RUSSELL
Published: August 2021

Let X be a compact, geodesically complete, locally CAT(0) space such that the universal cover admits a rank-one axis. Assume X is not homothetic to a metric graph with integer edge lengths. Let
$P_t$
be the number of parallel classes of oriented closed geodesics of length at most t; then
$\lim \nolimits _{t \to \infty } P_t / ({e^{ht}}/{ht}) = 1$
, where h is the entropy of the geodesic flow on the space
$GX$
of parametrized unit-speed geodesics in X.