bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient monitoring of coefficient of variation with an application to chemical reactor process
Authors: Mahmood Tahir , Abbasi Saddam Akber
Published: November 2020

Control chart is a useful tool to monitor the performance of the industrial or production processes. Control charts are mostly adopted to detect unfavorable variations in process location (mean) and dispersion (standard deviation) parameters. In the literature, many control charts are designed for the monitoring of process variability under the assumption that the process mean is constant over time and the standard deviation is independent of the mean. However, for many real‐life processes, the standard deviation may be proportional to mean, and hence it is more appropriate to monitor the process coefficient of variation (CV). In this study, we are proposing a design structure of the Shewhart type CV control chart under neoteric ranked set sampling with an aim to improve the detection ability of the usual CV chart. A comprehensive simulation study is conducted to evaluate the performance of the proposed chart in terms of , and measures. Moreover, the comparison of chart is made with the existing competitive charts, based on simple random sampling, ranked set sampling (RSS), median RSS, and extreme RSS schemes. The results revealed that the proposed chart has better detection ability as compared to all existing competitive charts. Finally, a real‐life example is presented to illustrate the working of the newly proposed CV chart.
System for assessing the sustainability conditions of small hydro plants by fuzzy logic
Authors: Clauberg Ana Paula Coelho , de Mello Renato , Simioni Flávio José , Sehnem Simone
Published: November 2020

This work presents a system for an integrated evaluation of the implementation of small hydroelectric power plants (SHPs), based on a soft decision tree. The method generates the enterprise's sustainability index, where economic, environmental, and social aspects are considered in its interactions, with indicators measured in the field, sectoral indexes, and final index generated by fuzzy logic rule blocks. The methodology used to select the indicators and indexes followed four phases. First, a fuzzy expert system (FES) was developed in the form of a soft decision tree. Then, the array of suggested variables and weights were submitted to expert analysis using the Delphi methodology, and their assessments were collected. The third phase was the improvement of the system, taking into account the obtained considerations. In the fourth phase, the system was applied to a case study based on the installation of an SHP in the southern region of Brazil. The results obtained in the case study showed the sustainability of the enterprise. The presented method can have a significant contribution in supporting decisions regarding the licensing of hydroelectric projects.
Complexity and bias in cross‐sectional data with binary disease outcome in observational studies
Authors: Wang Mei‐Cheng , Yang Yuchen
Published: November 2020

A cross sectional population is defined as a population of living individuals at the sampling or observational time. Cross‐sectionally sampled data with binary disease outcome are commonly analyzed in observational studies for identifying how covariates correlate with disease occurrence. It is generally understood that cross‐sectional binary outcome is not as informative as longitudinally collected time‐to‐event data, but there is insufficient understanding as to whether bias can possibly exist in cross‐sectional data and how the bias is related to the population risk of interest. As the progression of a disease typically involves both time and disease status, we consider how the binary disease outcome from the cross‐sectional population is connected to birth‐illness‐death process in the target population. We argue that the distribution of cross‐sectional binary outcome is different from the risk distribution from the target population and that bias would typically arise when using cross‐sectional data to draw inference for population risk. In general, the cross‐sectional risk probability is determined jointly by the population risk probability and the ratio of duration of diseased state to the duration of disease‐free state. Through explicit formulas we conclude that bias can almost never be avoided from cross‐sectional data. We present age‐specific risk probability (ARP) and argue that models based on ARP offers a compromised but still biased approach to understand the population risk. An analysis based on Alzheimer's disease data is presented to illustrate the ARP model and possible critiques for the analysis results.
Engineering Atomic Sites via Adjacent Dual‐Metal Sub‐Nanoclusters for Efficient Oxygen Reduction Reaction and Zn‐Air Battery
Authors: Qi Defeng , Liu Yifan , Hu Min , Peng Xianyun , Qiu Yuan , Zhang Shusheng , Liu Wei , Li Hongyi , Hu Guangzhi , Zhuo Longchao , Qin Yongji , He Jia , Qi Gaocan , Sun Jiaqiang , Luo Jun , Liu Xijun
Published: November 2020

N‐coordinated transition‐metal materials are crucial alternatives to design cost‐effective, efficient, and highly durable catalysts for electrocatalytic oxygen reduction reaction. Herein, the synthesis of uniformly distributed Cu−Zn clusters on porous N‐doped carbon, which are accompanied by Cu/Zn‐Nx single sites, is demonstrated. X‐ray absorption fine structure tests reveal the co‐existence of M−N (M = Cu or Zn) and M−M bonds in the catalyst. The catalyst shows excellent oxygen reduction reaction (ORR) performance in an alkaline medium with a positive half‐wave potential of 0.884 V, a superior kinetic current density of 36.42 mA cm−2 at 0.85 V, and a Tafel slope of 45 mV dec−1, all of which are among the best‐reported results. Furthermore, when employed as an air cathode in Zn‐Air battery, it reveals a high open‐cycle potential of 1.444 V and a peak power density of 164.3 mW cm−2. Comprehensive experiments and theoretical calculations approved that the high activity of the catalyst can be attributed to the collaboration of the Cu/Zn‐N4 sites with CuZn moieties on N‐doped carbons.
Perovskite Passivation Strategies for Efficient and Stable Solar Cells
Authors: Li Cong , Li Huan , Zhu Zhinan , Cui Nuanyang , Tan Zhan'ao , Yang Rusen
Published: November 2020

Organic–inorganic halide perovskite photovoltaic devices have advanced rapidly in recent years, and the photoelectric conversion efficiency of perovskite solar cells (PSCs) has exceeded 25%. However, the defects from the crystallization process become nonradiation recombination centers and hinder the performance and the stability of PSCs. Defect passivation by tuning grain size and grain boundary (GB) is an effective strategy to reduce the defects on GBs and film surface. Herein, recent progress in the passivation strategy for perovskite films is summarized, including nonstoichiometric passivation, iodide vacancies filling, dimensional engineering, passivation with crosslink, physical passivation, and other passivation methods. These passivation strategies play an important role in improving the quality of perovskite films, adjusting the energy band structure, reducing the density of defect states, and suppressing the nonradiative recombination of carriers. Finally, this review puts forward the development direction of passivation strategies to further improve the performance of PSCs.
Novel OSA‐Modified Starch from Gros Michel Banana for Encapsulation of Andean Blackberry Concentrate: Production and Storage Stability
Authors: Quintero‐Castaño Victor Dumar , Vasco‐Leal José Fernando , Cuellar‐Nuñez Liceth , Luzardo‐Ocampo Ivan , Castellanos‐Galeano Francisco , Álvarez‐Barreto Cristina , Bello‐Pérez Luis Arturo , Cortés‐Rodriguez Misael
Published: November 2020

Chemically modified starches from underutilized food sources such as Colombian Musaceae can be combined with additives and proper transformation procedures, as wall materials preserving bioactive compounds. This work aims to find the best conditions for encapsulating blackberry concentrate (BBC) using octenyl succinic anhydride (OSA)‐modified starch from Gros Michel banana (GMB). Experimental designs are conducted to optimize the BBC emulsion and the spray‐drying process. The solubility is the most influenced response in the spray‐drying process. Synergistic interactions between the OSA‐modified GMB starch and maltodextrin content contribute to the desirability response. OSA‐modified GMB starch produces appropriate powders with low particle size (D10: 22.2 µm, D50: 40.7 µm) and hygroscopicity (20.87 g/100 g) while exhibiting a high yield (58.94 g/100 g), total phenolics (TP) content (≈91 mg GAE/g sample), antioxidant capacity (≈89 µg TE/g sample), and encapsulation efficiency (53.01%). The obtained powders in this work have a half‐life time (15 °C) of 3.1 months (solubility) and 51.6 months (D10). These results indicate the advantage of using OSA‐modified GMB starch to produce spray‐dried BBC powders, preserving its TP content. In conclusion, OSA‐modified starches from GMB are new materials that can be used in spray drying.
Recent Progress in Polycyclic Aromatic Hydrocarbon‐Based Organic Co‐Crystals
Authors: Hu Ben‐Lin , Zhang Qichun
Published: November 2020

Recently, the development of polycyclic aromatic hydrocarbon (PAH)‐based organic co‐crystals has attracted increasing interest due to their unique packing modes, optic‐electronic properties and various potential applications in electronic, optic‐electronic and magnetic devices. In this account, we mainly discuss the definition, classification, packing patterns, preparation methods, and applications of PAH‐based co‐crystals. Specifically, the main categories of PAH‐based organic co‐crystals, the frequent methods to prepare them, three main packing patterns, their optical and electrical properties, and their potential applications will be presented. Finally, an outlook of this field is provided.
ESL programs at U.S. community colleges: A multistate analysis of placement tests, course offerings, and course content
Authors: David Nick , Kanno Yasuko
Published: November 2020

When U.S. English learners (ELs) attend college, they are more likely to enroll in 2‐year community colleges than in 4‐year colleges. Prior research points to the tension between English as a second language (ESL) programs providing support to ELs and lengthy ESL programs acting as barriers to ELs seeking access to mainstream college coursework. Nevertheless, community college ELs and ESL programs remain understudied. The researchers investigated community college ESL placement, course sequence length, and types of ESL courses offered across the United States by examining the 2017–2018 catalogs of community colleges in nine states. Two hundred seventy‐two community college catalogs were analyzed. Findings include that 81% of colleges reported offering some ESL‐specific coursework and that ESL course sequences varied on average from 2.3 to 4.7 semesters in length across states. For most states studied, ESL courses were solely structured around skills‐based instruction. Furthermore, although general English placement information was accessible and often standardized within states, ESL placement information was rarely available and sometimes out of date. Based on these findings, the authors recommend that community college ESL programs implement valid placement procedures, award college credit for ESL coursework, and streamline student access to discipline‐specific academic and vocational content.
A novel adult plant leaf rust resistance gene Lr2K38 mapped on wheat chromosome 1AL
Authors: Sapkota Suraj , Mergoum Mohamed , Kumar Ajay , Fiedler Jason D. , Johnson Jerry , Bland Dan , Lopez Benjamin , Sutton Steve , Ghimire Bikash , Buck James , Chen Zhenbang , Harrison Stephen
Published: November 2020

Soft red winter wheat (SRWW) cultivar AGS 2038 has a high level of seedling and adult plant leaf rust (LR) resistance. To map and characterize LR resistance in AGS 2038, a recombinant inbred line (RIL) population consisting of 225 lines was developed from a cross between AGS 2038 and moderately resistant line UGA 111729. The parents and RIL population were phenotyped for LR response in three field environments at Plains and Griffin, GA, in the 2017–2018 and 2018–2019 growing seasons, one greenhouse environment at the adult‐plant stage, and at seedling stage. The RIL population was genotyped with the Illumina iSelect 90K SNP marker array, and a total of 7667 polymorphic markers representing 1513 unique loci were used to construct a linkage map. Quantitative trait loci (QTL) analysis detected six QTL, QLr.ags‐1AL, QLr.ags‐2AS, QLr.ags‐2BS1, QLr.ags‐2BS2, QLr.ags‐2BS3, and QLr.ags‐2DS, for seedling and adult plant LR resistance. Of these, the major adult plant leaf rust resistance QTL, QLr.ags‐1AL, was detected on all field and greenhouse adult plant tests and explained up to 34.45% of the phenotypic variation. QLr.ags‐1AL, tightly flanked by IWB20487 and IWA4022 markers, was contributed by AGS 2038. Molecular marker analysis using a diagnostic marker linked to Lr59 showed that QLr.ags‐1AL was different from Lr59, the only known LR resistance gene on 1AL. Therefore, the QTL was temporarily designated as Lr2K38. Lr2K38‐linked marker IWB20487 was highly polymorphic among 30 SRWW lines and should be useful for selecting the Lr2K38 in wheat breeding programs.
Asymmetric price volatility transmission in remote food markets: Does it matter for domestic stabilization policies?
Authors: Araap Lagat Kiplimo
Published: November 2020

In order to design better and effective domestic policies to cope with extreme cases of food price volatility, policymakers must understand the nature of market interconnectedness, sources of domestic food price volatility, and the extent to which price volatilities are transmitted within the domestic markets. Incomplete food price volatility transmission signals price inefficiency and ineffectiveness in policy intervention in stabilizing the domestic markets. The degree of price volatility transmission can provide a broad assessment of the extent to which markets are functioning in a predictable way, and price signals are passing‐through consistently between different markets. A multivariate generalized autoregressive conditional heteroskedasticity (MGARCH) model was used to estimate the price volatility transmission within and between the major (primary) and remote (secondary) maize markets in Kenya. Mobile Vulnerability Analysis and Mapping data collected real time by the World Food Program in collaboration with the Ministry of Agriculture in Kenya and other agencies were utilized. The average monthly data series used covered the periods between January 2006 and June 2019. Results confirmed significant differentiation in volatilities between the remote and major food markets. The major markets were found to be less volatile with strong volatility transmission within the markets. In contrast, the remote markets exhibited higher volatilities but with limited volatility transmissions within the markets.
Evolving Social Dimension of the European Higher Education Area
Authors: Crosier David , Haj Cezar Mihai
Published: November 2020

The social dimension is a term coined in the early years of the Bologna Process (BP). Although mentioned in the early ministerial communiqué texts, the term itself was not clearly defined until 2007. Looking back, this could perhaps be considered an oversight. However, the more likely explanation is that the term was chosen intentionally, leaving open possibilities for national and institutional action while, at the same time, committing countries to nothing precise.
What Does It Take to Build a Social Dimension Strategy? A Cross-Country Comparative Analysis of Romania and Austria
Authors: Torotcoi Simona
Published: November 2020

Unlike other action lines of the Bologna Process, slow progress has been made towards making the social dimension an implementable policy. The social dimension had to overcome a significant start-up difficulty. It entered the Bologna Process with no clear definition, guidelines or projection of concrete policy measures. In 2015, with the adoption of the Strategy for the Development of the Social Dimension and Lifelong Learning in the EHEA to 2020, participating countries were asked to come up with concrete national plans to address the participation of underrepresented groups in higher education. This paper looks in depth at two country cases that attempted to create the necessary conditions for such strategies, Austria and Romania, and asks what are the successful conditions for building a social dimension and lifelong learning strategy in line with the Bologna requirements? The common point for these countries is that both of them attempted to build a social dimension and life-long learning strategy, however, one of the countries came up with a strategy, yet other national strategies and policies were in contradiction with what the strategy promoted, whereas in the second country no strategy was developed beside the involvement of the main stakeholders. The data for the analysis comes from interviews conducted in November 2017 with stakeholders involved in the formation of these strategies, ranging from student representatives to educational experts, and governmental representatives.
Syrian University Students in Turkish Higher Education: Immediate Vulnerabilities, Future Challenges for the European Higher Education Area
Authors: Erdoğan Armağan , Erdoğan M. Murat
Published: November 2020

Since 2011, millions of Syrian people have had to leave their country and seek shelter in neighbouring countries and in Europe. Forced migration or displacement creates multiple vulnerabilities while trying to settle in a new environment. Socioeconomic, cultural and psychological vulnerabilities hinder them from participating actively in society. Higher education is one of the main ways that refugees and displaced people cling to hope for a better life. Their access to and participation in higher education has been a challenging route for many reasons both for themselves and also for the higher education systems and universities in their host countries. Turkey has a unique place in regard to Syrian refugees. It hosts the largest refugee population in the world with 3.6 million Syrians and 500,000 asylum seekers from other countries, such as Iraq, Iran, Afghanistan and Pakistan. Turkey has a young population with the 5–17 age group comprising 21% of the population, but the Syrian population is much younger as its rate is 30%. Turkey is also the country with the largest student population in the European Higher Education Area. The incomparable magnitude of the situation, among others, plays a crucial role in developing new integration policies. In spite of the ongoing difficulties and challenges, the past nine years proved a success story in protection, social cohesion and integration of these newcomers. Turkey has been suffering from some challenges, such as a supply and demand imbalance in higher education. Demographic factors, shortcomings of the higher education system and the unemployment rate among university graduates have been some long-term challenges for Turkish higher education. Moreover, a common misconception in public opinion, that Syrian refugees are admitted to Turkish universities without fulfilling the requirements, adds new challenges for future policies. Both the sheer number of migrants and also the emergency of the situation during this migration flow necessitated some action to be taken in the area of higher education. In a country like Turkey, where there is high competition between students to pass the nationwide university selection exam each year, encouraging Syrian students to access higher education seems to be an area for discussion. This paper is based on the fieldwork of research conducted in the context of the Hopes-MADAD project entitled “Elite Dialogue II- Dialogue with Syrian Refugees in Turkey through Syrian Academics and Students” in 2019. The main research subject is which types of vulnerabilities Syrian university students face, and how they can integrate into society in Turkey. New approaches and definitions are needed to touch the actual needs of the refugees to be actively involved into society. Nevertheless, research on the higher education practices of vulnerable groups in general, and of Syrian students in particular, is largely missing.
Advancing Learning and Teaching in the EHEA: Innovation and Links with Research
Authors: Gaebel Michael , Zhang Thérèse , Iucu Romita
Published: November 2020

Education, a core mission of universities, is frequently depicted as being resistant towards change regarding teaching methods and forms of provision. As Hooker put it, back in 1997, “the nineteenth-century model of teaching at higher level still holds sway and teaching as not changed much since. The last 15 years have seen progressive developments in many higher education institutions, but the basic model has not altered significantly, at least not in the majority of institutions.
The Future of the Bologna Process and the European Higher Education Area: New Perspectives on a Recurring Topic
Authors: Bergan Sjur , Matei Liviu
Published: November 2020

The future of the Bologna Process and the European Higher Education Area (EHEA) have been debated for more than 20 years (Bergan and Deca 2018). From the very start, even as the implementation of this continental-wide project in higher education got underway and in parallel to historical analyses (“looking back” too) that begun slowly to emerge, the future of the EHEA has been a constant preoccupation. It is perhaps in the nature of things that while the future can be close or distant, it never quite arrives, like a textitfata morgana, so that any discussion of “the future” can in principle be endless. Or, it could be that in this case discussions about the future indicate continuing uncertainty about the substance, shape and timeline of a European area for higher education. As we are completing the second decade of the Bologna Process and, if we take a formal approach, the first decade of the EHEA, this debate nevertheless takes on added urgency and includes some new elements. We are encouraged by the fact that few if any voices have been heard advocating an end to the EHEA. We therefore disregard this option here.
A New Concept for the Future EHEA
Authors: Isaacs Ann Katherine
Published: November 2020

The Bologna Follow Up Group (BFUG) is currently charged with discussing new priorities for the future of the European Higher Education Area (EHEA) and to this end has organized national consultations as well as discussions within the BFUG itself. In addition to defining new priorities, it appears essential to strengthen the awareness of the principles underlying higher education beyond national or even macro-regional borders. To go beyond lists of priorities and principles, however important and valid in themselves, it seems useful to elaborate a convincing holistic concept or way of visualizing the desired future of higher education and the EHEA’s role in achieving it. Such a concept or vision can give direction to the continuing reform process and inspire countries and higher education institutions to work creatively together. To this end, the EHEA may need to transform itself from a loose intergovernmental framework to a more cohesive space where, supported by the necessary normative reforms, higher education institutions and their stakeholders can freely and effectively pursue their collaborative mission. The paper explores whether the goal of creating a ‘European higher education community’ by 2030 can help to give direction to this complex process and what that might entail.
Charting Academic Freedom in Europe
Authors: Matei Liviu
Published: November 2020

The paper argues that the European Higher Education Area (EHEA) is currently experiencing a crisis of academic freedom and discusses the need to chart a course out of this crisis. The paper claims that the crisis, with its two dimensions (intellectual and empiric), is specific to Europe/EHEA; it is not a global or national crisis, although there are challenges to academic freedom in all other parts of the world and also within individual national higher education systems in Europe. Efforts have been started recently to address key challenges to academic freedom in the EHEA and eventually plot a course out of this crisis. The paper outlines how a comparative and applied interdisciplinary study of these efforts helps reveal their nature and scope, identify the actors/stakeholders involved as well as those, astoundingly, absent; it also allows to discuss and assess early on the chances of success and identify challenges and gaps in these efforts. The paper concludes that charting a course for academic freedom at present in the EHEA is an intergovernmental process. Higher education institutions and academics are not part of this process.
Does Erasmus Mobility Increase Employability? Using Register Data to Investigate the Labour Market Outcomes of University Graduates
Authors: Crăciun Daniela , Orosz Kata , Proteasa Viorel
Published: November 2020

The chapter sets out to answer a question that has long been on the mind of policy-makers, university leaders, scholars and students: does international student credit mobility have a positive impact on graduate employability? Traditionally, this question has been answered using survey data where internationally mobile students self-report their employment situation at a certain point after graduation. According to these studies, international student mobility positively affects the labour market outcomes of students. For instance, the European Commission reports that: (1) students who completed an Erasmus mobility program are half as likely to face long-term unemployment; (2) the unemployment rate of Erasmus students is 23% lower five years after graduation (European Commission 2014). While these studies provide important insights about the benefits associated with the cross-border credit mobility of students, the results can be plagued by self-selection bias in reporting post-mobility employment outcomes. In order to avoid the problems associated with survey data, in this chapter we offer an analysis based on register data from university records and employment records, using as a case study the West University of Timisoara, a leading comprehensive university in Romania. Using register data offers the possibility to study population-level data and compare the employment outcomes of mobile and non-mobile students. The chapter analyses the impact of credit mobility on insertion in the labour market, income levels and occupational prestige. While the research question that the chapter is trying to answer is important, the main message of the chapter is broader: ministries and higher education institutions should release data for research purposes. Register data is readily available and helps researchers make efficient use of resources. In turn, this can encourage evidence-based policymaking.
ABECTO: An ABox Evaluation and Comparison Tool for Ontologies
Authors: Keil Jan Martin
Published: November 2020

Correctness and completeness of ontologies on the schema and the instance level are important quality criteria in their selection for an application. Due to the general lack of gold standard data sources, the determination of these criteria, especially on the instance level, is challenging. The direct comparison of candidate data sources enables the approximation of these criteria. We introduce ABECTO, an ABox evaluation and comparison tool for ontologies. ABECTO provides a framework for the comparison of different semantic data sources in the same domain on the instance level.
A healthy lifestyle mitigates the risk of heart disease related to type 2 diabetes: a prospective nested case–control study in a nationwide Swedish twin cohort
Authors: Yang Rongrong , Xu Hui , Pedersen Nancy L. , Li Xuerui , Yu Jing , Bao Cuiping , Qi Xiuying , Xu Weili
Published: November 2020

Aims/hypothesis

We aimed to examine the association between type 2 diabetes and major subtypes of heart disease, to assess the role of genetic and early-life familial environmental factors in this association and to explore whether and to what extent a healthy lifestyle mitigates the risk of heart disease related to type 2 diabetes.

Methods

In this prospective nested case–control study based on the Swedish Twin Registry, 41,463 twin individuals who were aged ≥40 and heart disease-free were followed up for 16 years (from 1998 to 2014) to detect incident heart disease. Type 2 diabetes was ascertained from self-report, the National Patient Registry and glucose-lowering medication use. Heart disease diagnosis (including coronary heart disease, cardiac arrhythmias and heart failure) and onset age were identified from the National Patient Registry. Healthy lifestyle-related factors consisted of being a non-smoker, no/mild alcohol consumption, regular physical activity and being non-overweight. Participants were divided into three groups according to the number of lifestyle-related factors: (1) unfavourable (participants who had no or only one healthy lifestyle factor); (2) intermediate (any two or three); and (3) favourable (four). Generalised estimating equation models for unmatched case–control design and conditional logistic regression for co-twin control design were used in data analyses.

Results

Of all participants, 2304 (5.5%) had type 2 diabetes at baseline. During the observation period, 9262 (22.3%) had any incident heart disease. In unmatched case–control analyses and co-twin control analyses, the multi-adjusted OR and 95% CI of heart disease related to type 2 diabetes was 4.36 (3.95, 4.81) and 4.89 (3.88, 6.16), respectively. The difference in ORs from unmatched case–control analyses vs co-twin control analyses was statistically significant (OR 1.57; 95% CI 1.42, 1.73; p < 0.001). In stratified analyses by type 2 diabetes, compared with an unfavourable lifestyle, an intermediate lifestyle or a favourable lifestyle was associated with a significant 32% (OR 0.68; 95% CI 0.49, 0.93) or 56% (OR 0.44; 95% CI 0.30, 0.63) decrease in heart disease risk among patients with type 2 diabetes, respectively. There were significant additive and multiplicative interactions between lifestyle and type 2 diabetes on heart disease.

Conclusions/interpretation

Type 2 diabetes is associated with more than fourfold increased risk of heart disease. The association still remains statistically significant, even after fully controlling for genetic and early-life familial environmental factors. However, greater adherence to a healthy lifestyle may significantly mitigate the risk of heart disease related to type 2 diabetes.
Predictive indicators for revisional surgery in nasal reconstruction after Mohs surgery
Authors: Andrew Tom W. , Garioch Jennifer J. , Lovat Penny E. , Moncrieff Marc D.
Published: November 2020

Background

Reconstruction of nasal lesions is complex due to the topography, mobile free margins and borders of anatomical subunits. Reconstructive challenges can lead to multiple revisional surgeries to achieve the final aesthetic result. This study aimed to evaluate risk factors and predictors of revisional surgery in patients undergoing reconstruction after Mohs micrographic surgery for nasal tumours.

Methods

This was a prospective cohort study from April 2, 2008 to February 26, 2019. The study population included all consecutive patients who underwent Mohs micrographic surgery for nasal skin cancer. Resection and reconstruction of nasal skin cancer was performed by the Mohs team.

Results

A total of 988 cases met our study inclusion criteria with 64 (6.5%) cases requiring unplanned surgical revision. Revision rates were highest in the ala (9.0%, p < 0.05) and complex anatomical subunits (16.7%, p < 0.0001). In contrast, revision rates for dorsum lesions were lowest (1.8%, p < 0.001). In terms of reconstructive modalities, local flaps resulted in significantly higher rates of revision when compared to grafts (relative risk, 2.37; 95% CI, 1.15–5.0; p < 0.01). In terms of histological diagnosis, squamous cell carcinoma had significantly higher revision rates when compared to basal cell carcinoma (p < 0.05).

Conclusions

To our knowledge, this is the first study to report the risk factors and predictors of revision surgery in patients undergoing MMS for nasal tumours. This study highlights that the reconstructive modality utilised affects the functional and cosmetic outcome of MMS. We note that ala complex subunit lesions, squamous cell carcinoma and flap reconstruction were associated with an increased risk of revision after Mohs reconstruction of nasal lesions.

Level of evidence: Level III, risk/prognostic; therapeutic study.

Trial registration number

(Ref: PLA-19-20_A03) 04/02/2020.
The Diversity of Nitrogen-Cycling Microbial Genes in a Waste Stabilization Pond Reveals Changes over Space and Time that Is Uncoupled to Changing Nitrogen Chemistry
Authors: Rose A. , Padovan A. , Christian K. , van de Kamp J. , Kaestli M. , Tsoukalis S. , Bodrossy L. , Gibb K.
Published: November 2020

Nitrogen removal is an important process for wastewater ponds prior to effluent release. Bacteria and archaea can drive nitrogen removal if they possess the genes required to metabolize nitrogen. In the tropical savanna of northern Australia, we identified the previously unresolved microbial communities responsible for nitrogen cycling in a multi-pond wastewater stabilization system by measuring genomic DNA and cDNA for the following:nifH(nitrogen fixation);nosZ(denitrification);hzsA(anammox); archaealAamoAand bacterialBamoA(ammonia oxidation);nxrB(nitrite oxidation); andnrfA(dissimilatory NO3reduction to NH3). By collecting 160 DNA and 40 cDNA wastewater samples and measuring nitrogen (N)-cycling genes using a functional gene array, we found that genes from all steps of the N cycle were present and, except fornxrB, were also expressed. As expected, N-cycling communities showed daily, seasonal, and yearly shifts. However, contrary to our prediction, probes from most functional groups, excludingnosZandAamoA, were different between ponds. Further, different genes that perform the same N-cycling role sometimes had different trends over space and time, resulting in only weak correlations between the different functional communities. Although N-cycling communities were correlated with wastewater nitrogen levels and physico-chemistry, the relationship was not strong enough to reliably predict the presence or diversity of N-cycling microbes. The complex and dynamic response of these genes to other functional groups and the changing physico-chemical environment provides insight into why altering wastewater pond conditions can result an abundance of some gene variants while others are lost.
Preventable Morbidity and Mortality Among Non‐trauma Emergency Surgery Patients: The Role of Personal Performance and System Flaws in Adverse Events
Authors: Velmahos Constantine S. , Kokoroskos Nikolaos , Tarabanis Constantine , Kaafarani Haytham M. , Gupta Sanjay , Paranjape Charudutt N.
Published: November 2020

Background

Preventable morbidity and mortality among emergency surgery patients is not adequately analyzed. We aim to describe and classify preventable complications and deaths in this population.

Methods

The medical records and quality control documents of patients with emergency, non‐trauma, surgical disease admitted between September 1, 2006, and August 31, 2018, and recorded to have a preventable or potentially preventable morbidity and mortality were reviewed. The primary outcome was a classification of the complications and deaths by a panel of experts, as attributable to issues of personal performance or system deficiencies.

Results

One hundred and fifty patients were identified (127 complications and 23 deaths). The most commonly encountered preventable complications were surgical‐site infection (17%), bleeding (13%), injury to adjacent structures (12%), and anastomotic leak (8%). The majority of complications seemed to stem from personal performance (97%), due to either technical or judgment issues, and only 3% were linked with system flaws, either in the form of communication or inadequate protocols. Alcohol use disorder and duration of operation were different between patients with preventable adverse events related to technical issues and patients related to judgment issues; furthermore, more patients who experienced judgment issues died during hospital stay (p <0.05).

Conclusion

Among emergency surgery patients, who suffer preventable complications and deaths, issues related to personal performance are more frequent than system flaws. Whereas the effort to improve systems should be unwavering, the emphasis on the surgeon's personal responsibility to avoid preventable complications should not be derailed.
Clinical utility of circulating tumor-associated cells to predict and monitor chemo-response in solid tumors
Authors: Crook Timothy , Gaya Andrew , Page Raymond , Limaye Sewanti , Ranade Anantbhushan , Bhatt Amit , Patil Sanket , Kumar Prashant , Patil Darshana , Akolkar Dadasaheb
Published: November 2020

Purpose

Selection of cytotoxic chemotherapy agents (CCA) based on pre-treatment evaluation of drug sensitivities is a desirable but unmet goal for personalized anticancer treatment strategies. Prior attempts to correlate in vitro Chemo-Response Profiles (CRP) of tumor explants or Circulating Tumor Cells (CTCs) with clinical outcomes have been largely unsuccessful.

Methods

We present results from a large cohort (n = 5090, three Arms) of patients with various solid organ tumors, where CRP of Circulating Tumor-Associated Cells (C-TACs) was determined against cancer-specific CCA panels to generate a database of 56,466 unique CRP.

Results

In Arm 1 (n = 230), 93.7% concordance was observed between CRP of C-TACs and concurrently obtained Tumor tissue Derived Cells (TDCs). In arm 2 (n = 2201, pretreated), resistance of C-TACs to ≥ 1 CCA was observed in 79% of cases. In a blinded subset analysis of 143 pretreated patients with radiologically ascertained disease progression, CRP of C-TACs was 87% concordant with in vivo treatment failure. In Arm 3 (n = 2734, therapy naïve), innate resistance of C-TACs to ≥ 1 CCA was observed in 61% of cases. In a blinded subset analysis of 77 therapy naïve patients, in vitro chemo-sensitivity of C-TACs was concordant with radiologically ascertained treatment response to first line CCA in 97% of cases.

Conclusion

To our knowledge, this is the first expansive and in-depth study demonstrating that real-time CRP of C-TACs is a viable approach for non-invasive assessment of response to CCA in solid organ cancers.
On the recirculating flow of three-dimensional asymmetric bluff bodies
Authors: Legeai Antoine , Cadot Olivier
Published: November 2020

The paper investigates the role of geometrical asymmetric modifications of a rectangular flat-backed body on the properties of the recirculating flow at a Reynolds number $$Re=1.8\times 10^5$$

R
e
=
1.8
×

10
5

. The reference model has two reflectional symmetries denoted $$s_y$$

s
y

and $$s_z$$

s
z

in both spanwise directions. The flow is subjected to the static instability that leads to two mirrored wake states breaking the symmetry $$s_y$$

s
y

. Two families of geometrical variation of the fore-body and after-body are studied, each breaking one of the reflectional symmetries of the reference model. Geometrical modifications that preserve $$s_y$$

s
y

evidence possibilities of bistable dynamics suppression although the static instability persists. Geometrical modifications that do not preserve $$s_y$$

s
y

produces a large unbalance of both wake states in accordance to recent observations on real cars (Bonnavion et al. in J Wind Eng Ind Aerodyn 184:77–89, 2019). Results offer perspectives for potential drag reduction induced by appropriate coupling of bluff body geometry and wake state selection.

Graphic abstract
Incidence of Horner syndrome associated with neuroblastic disease
Authors: Kuchalska Katarzyna , Barełkowska Monika , Derwich Katarzyna , Jończyk-Potoczna Katarzyna , Gotz-Więckowska Anna
Published: November 2020

Purpose

Horner syndrome (HS) manifests in unilateral ptosis, miosis, enophthalmos, and anhedonia. It is most commonly caused by trauma or surgical procedures, but can also occur in pediatric patients as a result of tumors, especially neuroblastoma (NBL). The objective of this study was to analyze the incidence of HS in patients diagnosed with NBL.

Methods

A retrospective analysis of data collected at the Department of Pediatric Oncology, Hematology, and Transplantology from 2004 to 2019 was performed. The study group included 119 patients younger than 18 years old, with 62 girls and 57 boys. All of them were diagnosed with a neuroblastic tumor.

Results

Among the 119 patients, eight children (6.72%) were diagnosed with HS associated with NBL. Three of these patients presented to the clinic with HS, whereas HS developed after the surgical procedure to remove the tumor in four patients. The adrenal gland was the most frequent localization of the tumor. However, HS occurred more frequently in patients with mediastinum tumors. As a presenting symptom, HS occurred in 2 of 11 cases (18.18%) with mediastinum localization. All of the patients with HS were younger than 2 years old.

Conclusion

Investigation of the cause of isolated HS is crucial because it can be the first symptom of NBL. However, the surgical procedure itself increases the risk of HS as a complication of NBL treatment.
Parental occupational exposure and congenital heart diseases in a Hungarian case–control study
Authors: Fazekas-Pongor Vince , Fekete Mónika , Csáky-Szunyogh Melinda , Cseh Károly , Pénzes Melinda
Published: November 2020

Purpose

Our study aimed to explore the effect of parental occupational exposure to endocrine disrupting chemicals (EDCs) on the development of congenital heart diseases (CHDs) in the offspring, and to compare job-exposure matrix (JEM)-assessed and self-reported occupational exposures with each other.

Methods

Live-born infants born in 2007–2008 were selected from the population-based Hungarian Case–Control Surveillance of Congenital Abnormalities Study. 577 cases with any CHDs were compared to 1731 matched controls. Parental periconceptional occupational exposure to EDCs was assessed by a JEM and by questionnaire-based self-reporting of parents. Multivariate conditional logistic regression analyses were conducted to explore associations between parental occupational exposure to EDCs and the entire spectrum of CHDs and by CHD subtypes in the offspring. Kappa statistics were also performed to determine the consistency among JEM-assessed and self-reported occupational exposure of parents.

Results

JEM-assessed paternal exposure to polychlorinated organic substances, phthalates, biphenolic compounds, and solvents were significantly associated with the entire spectrum of CHDs. Ventricular septal defects were significantly associated with paternal self-reported exposure to pesticides, while atrial septal defects were significantly associated to paternal JEM-assessed phthalate exposure. Paternal solvent exposure was significantly associated with atrial septal defects and right ventricle outflow tract obstructions. JEM-assessed and self-reported exposures to pesticides, heavy metals, and solvents exhibited poor agreement for mothers and slight agreement for fathers.

Conclusion

Even though parental occupational exposure to EDCs seems to have a minor impact on the occurrence of CHDs, the results of biological and environmental monitoring should be taken into consideration as well.
Associations of sustained smoking and smoking cessation with work-related outcomes: a longitudinal analysis
Authors: Troelstra Sigrid A. , Boot Cécile R. L. , Harting Janneke , Geuskens Goedele A. , Kunst Anton E. , van der Beek Allard J.
Published: November 2020

Purpose

The aim of this study was to assess the association between sustained smoking and quitting with work-related outcomes among older workers.

Methods

We categorized a sample of older employees into non-smokers, sustained smokers and quitters. Multivariable regression models were used to test longitudinal associations of sustained smoking and smoking cessation with sickness absence, productivity loss and work ability.

Results

We included 3612 non-smokers, 673 sustained smokers and 246 quitters. Comparing sustained smokers to non-smokers, we found higher (but not statistically significant) sickness absence for sustained smokers [1.01, 95% confidence interval (CI) − 0.16–2.17]. We did not find differences in productivity loss (OR 0.82, 95% CI 0.60–1.13) and work ability (0.05, 95% CI −0.05–0.15). For employees with a relatively high physical health at baseline, comparing quitters to sustained smokers, we found higher (but not statistically significant) productivity loss for quitters (OR 2.23, 95% CI 0.94–5.31), and no difference in sickness absence (0.10, 95% CI − 2.67–2.87), and work ability (− 0.10, 95% CI −  0.36–0.16). For employees with a relatively low physical health at baseline, comparing quitters to sustained smokers, we found a statistically significant lower work ability (− 0.31, 95% CI − 0.57–0.05), and no difference in sickness absence (2.53, 95% CI − 1.29–6.34) and productivity loss (OR 1.26, 95% CI 0.66–2.39).

Conclusions

We found no evidence that sustained smokers have less favorable work-related outcomes than non-smokers or that quitters have more favorable work-related outcomes than sustained smokers. The benefits of smoking cessation for employers might take a longer time to develop.
Inability to accumulate Ni in a genus of hyperaccumulators: the paradox of Odontarrhena sibirica (Brassicaceae)
Authors: Bettarini Isabella , Colzi Ilaria , Gonnelli Cristina , Pazzagli Luigia , Reeves Roger D. , Selvi Federico
Published: November 2020

Main conclusion

Odontarrhenais a highly diverse genus of Ni-hyperaccumulators. Here, we demonstrate substantial inability to accumulate Ni in the facultative serpentinophyteO. sibirica, which seems a unique case among the numerous species of the genus that grow on ultramafic soils.

Odontarrhenais the most diverse genus of Ni-accumulating plants in W Eurasia, with most taxa growing obligatorily or facultatively on ultramafic soils. A notable exception may beO. sibirica, a facultative serpentinophyte from the E Mediterranean and W Asia in which accumulation ability is still enigmatic. We addressed this issue using observational and experimental methods. Atomic Absorption Analysis of 33 herbarium specimens and plant and soil samples from seven ultramafic and non-ultramafic sites in Greece revealed shoot Ni values always much lower than 1000 µg g−1, non-significant differences between plants from the two soil types and no relationship with soil pH. Only two Turkish specimens from waste mines had shoot Ni concentration > 1000 µg g−1. The reasons for this deviating result remain obscure, but may be associated with inherent peculiarities of the local populations. When cultivated together with congeneric Ni-accumulating species on the same natural ultramafic soil, onlyO. sibiricawas unable to accumulate the metal. Although plant growth was stimulated in hydroponics at relatively low NiSO4levels (50–150 µM), as typical for hyperaccumulators, Ni-accumulation occurred only at higher concentrations which had a toxic effect. This peculiar combination of Ni-response traits could be the result of a partial evolutionary loss of ability with respect to all other Ni-accumulating congeneric species. For this,O. sibiricacould represent a unique model system for further studies on the evolutionary dynamics, physiological mechanisms and genetic control of metal accumulation and homeostasis.