bluuebunny/crossref_metadata_2025 huggingface dataset:
Expansion of the LabBM Score
Authors: Nieder Carsten , Yobuta Rosalba , Mannsåker Bård
Published: December 2020

Objectives:

The objective of this study were to improve the 3-tiered, purely biomarker-based LabBM score, which predicts the survival of patients with brain metastases, by adding the well-established prognostic factor performance status (PS), and to define its role in comparison with the recently proposed Extracranial-Graded Prognostic Assessment score, which is based on the well-known Diagnosis-specific Graded Prognostic Assessment and 2 of the same biomarkers.

Materials and Methods:

This was a retrospective single-institution analysis of 212 patients, managed with upfront brain irradiation. Survival was stratified by LabBM and LabPS score. Each included serum hemoglobin, platelets, albumin, C-reactive protein, and lactate dehydrogenase (plus PS for the LabPS). Zero, 0.5, or 1 point was assigned and the final point sum calculated. A higher point sum indicates shorter survival.

Results:

The new LabPS score predicted overall survival very well (median: 12.1 to 0.7 mo, 1-y rate: 52% to 0%), P=0.0001. However, the group with the poorest prognosis (3 or 3.5 points) was very small (4%). Most patients with comparably short survival had a lower point sum. The LabPS score failed to outperform the recently proposed Extracranial-Graded Prognostic Assessment score.

Conclusions:

Integration of blood biomarkers should be considered when attempting to develop improved scores. Additional research is needed to improve the tools which predict short survival, because many of these patients continue to go undetected with all available scores.
Second-line Chemotherapy Prolongs Survival in Real World Patients With Advanced Biliary Tract and Gallbladder Cancers
Authors: Zaidi Adnan , Chandna Nicholas , Narasimhan Gopinath , Moser Michael , Haider Kamal , Chalchal Haji , Shaw John , Ahmed Shahid
Published: December 2020

Background:

Limited evidence is available regarding the survival benefit of second-line therapy in real world patients with advanced biliary tract and gallbladder cancer. Until very recently, there was a lack of randomized clinical trials to address this important question. In this multicenter population-based cohort study, the authors evaluated whether second-line therapy improves the survival of real world patients with advanced biliary tract and gallbladder cancer.

Methods:

Patients with biopsy-proven advanced biliary tract and gallbladder cancer who were diagnosed during the period of 2006 to 2015 and had received first-line chemotherapy were assessed. Cox proportional multivariate analysis was performed to determine the survival benefit of second-line therapy.

Results:

One hundred thirty-six eligible patients with a median age of 66 years and male:female ratio of 1:1.34 were identified. Sixty-eight percent of patients had metastatic disease. Primary tumor sites were as follows: gallbladder 31%, intrahepatic cholangiocarcinoma 36%, extrahepatic bile duct 23%, and ampullary cancer 10%. Overall, 37% of patients received second-line therapy. The median overall survival of the treatment group was 17 months (95% confidence interval [CI]: 12.5-21.5) compared with 7 months (95% CI: 5.3-8.7) in the control (P<0.0001). Patients who received combination chemotherapy had a median overall survival of 20 months (14.0-26.1) compared with 17 months (13.5-20.5) if they received single-agent second-line therapy (P=0.73). Multivariate analysis of second-line therapy, hazard ratio: 0.55 (95% CI: 0.36-0.83) and neutrophil to lymphocyte ratio >2, HR: 1.10 (1.05-1.15) showed a significant correlation with survival.

Conclusions:

This well-designed population-based retrospective cohort study suggests that second-line chemotherapy improves survival of real world patients with advanced biliary tract and gallbladder cancers and should be offered to the patients who are potential candidates for chemotherapy.
RECURRENT ACUTE RETINAL NECROSIS
Authors: Spaide Richard F. , Byun Stephanie S.
Published: December 2020

Purpose:

To describe a patient with recurrent acute retinal necrosis (ARN), her treatment, and propose a possible pathophysiologic mechanism.

Method:

Case report.

Results:

A 4-year-old girl presented elsewhere with bilateral ARN, was treated, but developed a retinal detachment in the left eye that failed vitrectomy surgery. She was referred 10 years later with recurrent ARN. The infection was difficult to get under control, but eventually responded to intravenous acyclovir and foscarnet. She was given laser photocoagulation. She was placed on oral valacyclovir prophylaxis and was disease-free for 10 years at which point she decided to go to South America on vacation and stop her valacyclovir. Within a few days she developed a recurrence of ARN and flew back for treatment. She had discrete areas of retinal necrosis, vasculitis, and the laser photocoagulation lesions seemed to be ringed by a retinal change suggestive of retinitis. She responded to antiviral treatment, but developed a retinal detachment that was successfully treated. Her visual acuity was 20/20 six years later, and she was using antiviral prophylaxis.

Conclusion:

Recurrent ARN can respond to aggressive treatment. Chorioretinal scars, such as from photocoagulation, may be potential sites of viral invasion during recurrences. Antiviral prophylaxis may be indicated for at-risk patients.
Adverse reactions to radiopharmaceuticals: liver radiopharmaceuticals
Authors: Battal Humeyra , Ozer Asuman Yekta
Published: December 2020

Radiopharmaceuticals are radioactive compounds used in nuclear medicine, consisting of a radioactive moiety and a pharmaceutical part. Radiopharmaceuticals are used for diagnosis (predominantly) and therapy (to a lesser extent). Adverse drug reactions are undesirable, unexpected, often harmful drug responses that occur when the drug is administered in therapeutic doses. Adverse reactions are more minor and rare because radiopharmaceuticals contain small amounts of pharmaceuticals and are administered to the patient in small doses. The main cause of the rare adverse reactions to radiopharmaceuticals is not the radiation itself, but the pharmaceutical part. Examples of adverse reactions frequently encountered in radiopharmaceuticals include nausea, dyspnea, bronchospasm, decreased blood pressure, itching, flushing, hives, chills, cough, bradycardia, muscle cramps, dizziness, fever, infection, shock, and other allergic reactions. 99mTc-iminodiacetic acid derivatives, 99mTc-sulfur colloid, 99mTc-albumin colloid, and 67Ga-gallium citrate compounds are frequently used as liver imaging agents. Adverse reactions seen in liver radiopharmaceuticals are generally nausea, vomiting, erythema, flushing, widespread rash, itching, urticaria, respiratory events, and fever. There are rare reported cases of death. Due to the widespread use of radiopharmaceuticals today, it has become important in adverse reactions. Reporting of adverse events is important, since alerting healthcare professionals to these problems, assessing the magnitude of the problems, improving diagnostic accuracy, determination of treatment methods of adverse reactions will help minimize negative effects. For this reason, it is of great importance to identify and appropriately report the adverse effects seen. It is very important for countries to have the necessary pharmacovigilance systems to report and evaluate these effects.
Presentation of Borderline Personality Disorder Symptoms in Adulthood
Authors: Wojciechowski Thomas
Published: December 2020

Past research has linked the development of borderline personality disorder to earlier exposure to violence. However, the causal link by which this relationship exists has not yet been fully identified. The present study sought to examine how exposure to violence predicted heterogeneity in the development of depressive systems and results in the arousal of borderline personality disorder symptoms in adulthood. The Pathways to Desistance data were used in the analyses. This data set consisted of the responses of 1354 juvenile offenders followed across 7 years. Group-based trajectory modeling was used to identify latent trajectories of depressive symptoms. Ordinary least squares regression was used to model covariate effects on borderline personality disorder symptoms in adulthood. Results indicated that a three-group depression trajectory model best fit the data. Direct victimization early in life was associated with increased borderline personality disorder symptoms in adulthood. When trajectory group assignment was accounted for in the model, the relationship between direct victimization and borderline personality disorder symptoms was attenuated by around 30%. Implications are discussed.
Internship assessment in professional program accreditation: a 10-year study
Authors: Bender Diane
Published: December 2020

Purpose

Professional program assessment is necessary in an accreditation process, in order to ensure educational quality and public accountability. One avenue of assessment is through an internship. The challenge is to determine how evidence from this indirect learning experience can aid in accreditation. The purpose of this paper is to describe the use of internship supervisor evaluation feedback within the accreditation process for a professional interior design degree program.

Design/methodology/approach

In this study, internship assessment was provided by feedback from intern supervisors. Ten years of supervisor feedback were analyzed using descriptive statistics and a content analysis of supervisor comments.

Findings

Two hundred forty-seven internship supervisor evaluation documents were analyzed. Overall, supervisors positively evaluated the performance of the intern as Good to Excellent. A majority of supervisors (91%) provided comments that were positive yet vague, as most could not differentiate between the intern and the intern's performance.

Practical implications

This study links experiential learning to its evidence that can be used in an accreditation process. The challenges for educators in developing an assessment tool useful for accreditation evidence and to be shared by multiple program degree stakeholders are also described.

Originality/value

Research on internships usually focuses on the student's viewpoint. This study is original in that it examines the use of internship supervisor's evidence in program accreditation.
Assessing the 2010–2018 financial crisis in Greece, Portugal, Ireland, Spain, and Cyprus
Authors: Hausken Kjell , Welburn Jonathan W.
Published: December 2020

Purpose

The article develops a model to interpret the 2010–2018 financial crisis in Greece, Portugal, Ireland, Spain and Cyprus, and the loan programs from the IL (International Lender; i.e. the European Union, the European Commission, and the International Monetary Fund).

Design/methodology/approach

For each country, an isoelastic utility with constant relative risk aversion is assumed. For the IL a Cobb Douglas utility is assumed with consumption, the GDP (Gross Domestic Product) to debt ratio, and market stability as inputs, accounting for time discounting. This article applies two methods to assess the empirics. The first method considers the IL's strategy as a whole over the 2010–2018 period. The second method assumes that the IL maximizes its utility in one period to determine its optimal loan, accounting for the empirics in that period, and the debt in the previous period.

Findings

For the first method, when the output elasticity in the IL's Cobb Douglas utility is high favoring consumption, the IL prefers offering a higher loan than its actual loan. Otherwise the IL prefers to offer no loan. The output elasticity at which the IL prefers to offer a loan is lowest for Greece, second lowest for Cyprus, third lowest for Portugal, and highest for Ireland and Spain. A high loan to Greece over a larger range of the output elasticity for Greece's consumption is supported by Greece being prioritized through the loan program. For the second method, the IL prefers to offer no loan to Greece which is too burdened with debt. Thus, the first method seems preferable, considering the entire duration of the crisis holistically.

Originality/value

The article offers a novel perspective of how to assess debt crises, enabling the IL to weigh various factors such as consumption, GDP, loan offered, and each country's debt to credit markets.
What shapes Muslim business operators’ attitudes towards value-added tax? Evidence from the United Arab Emirates
Authors: Kasim Mohd Ariff , Mohd Hanafi Siti Rosmaini , Mohd Suki Norazah
Published: December 2020

Purpose

This study aims to examine what factors shape Muslim business operators’ attitudes towards pre- and post-value-added tax (VAT) implementation in the United Arab Emirates (UAE).

Design/methodology/approach

A longitudinal approach is employed to collect data from a total of 200 respondents, during both the pre-VAT implementation period and the post-VAT implementation period. A partial least squares structural equation modelling approach was performed to analyse the research.

Findings

Empirical findings revealed that challenges in implementing the VAT system were the primary predictors of Muslim business operators’ attitudes regarding the pre-VAT implementation period in the UAE because they were aware that the penalties associated with non-compliance would outweigh the costs incurred in preparing for the VAT. During the post-VAT implementation period, awareness was the strongest influence on Muslim business operators’ attitude because there are no income taxes imposed on businesses and individuals in the UAE.

Practical implications

The introduction of VAT in the UAE ignited great controversy on the part of Muslim business operators, who viewed the new tax system as a significant challenge or risk to their careers, especially when they realised that they would have to play a significant role in tax collection. VAT registration should be required for all businesses regardless of size since they are going to be the tax agents for the government. Indeed, the government should finalize policies and procedures on the penalties for non-compliance since such legalities could greatly contribute towards the acceptance of VAT.

Originality/value

Challenges prompted Muslim business operators to become more knowledgeable about VAT, whereas also developing a greater awareness and sense of preparedness regarding the implications of the system on their businesses. This discovery has advanced the theoretical understanding of the topic and its managerial implications.
Gap assessment and comparison of the quality of services between central libraries of the University of Tehran and Allameh Tabataba'i University
Authors: Jabbari Leila , Jalali Dizaji Ali , Malekolkalami Mila
Published: December 2020

Purpose

The purpose of this study is to measure the gap and compare the quality of services provided by the Central Library of the University of Tehran and Allameh Tabataba'i University and identify the components of service that need improvement in these libraries.

Design/methodology/approach

In this study, a descriptive survey method is used for data collection. The study sample contains 205 people selected out of 31,000 members of Tehran University and 100 people out of 15,000 members at Allameh Tabataba'i University. The LibQual tool is used to measure different levels of users' perceptions of library service quality.

Findings

Based on the findings of the study, the level of service received at the University of Tehran was higher than the minimum expected level, and at Allameh Tabataba'i University, the level of service received was lower than the minimum level of expected, which indicates users' satisfaction at this index at the University of Tehran and users' dissatisfaction at Allameh Tabataba'i University. In the index of information control and library as a place in Tehran University, the level of service received was higher than the minimum level and in Allameh Tabataba'i University, the level of service received was lower than the minimum level, which indicates the satisfaction of users in this index at the University of Tehran and users' dissatisfaction at Allameh Tabataba'i University.

Practical implications

Service quality, or quality of service, is the measurement and comparison of the size of service provided with users' expectations. The following principles illustrate the dimensions of service quality: Quality of service is much more difficult to measure than the quality of goods. The quality of service is based on users' expectations. Quality of service varies in status, meaning that the quality of a service is measured against the customer's initial expectations of that service (Parasuraman et al., 1985).

Originality/value

Being the first performance evaluation, community synchronization, economic justification, user satisfaction and customer orientation are the values of the present study.
Aid for trade and inflation: Exploring the trade openness, export product diversification and foreign direct investment channels
Authors: Gnangnon Sèna Kimm
Published: December 2020

Drivers of inflation have been extensively investigated in the literature. However, little attention has been paid to the effect of official development assistance flows, let alone the part of this aid allocated to the trade sector (the so‐called Aid for Trade [AfT] flows) on inflation in the recipient‐countries. This paper explores the effect of AfT flows on inflation in recipient‐countries, using a set of 126 countries over the period 1995–2015, and the two‐step system generalised methods of moments technique. Results have shown that AfT flows contribute to reducing inflation, with the magnitude of this negative effect being higher than that of NonAfT flows (that is, other development aid flows than AfT flows). Interestingly, AfT flows tend to exert a higher negative effect on inflation in countries that enjoy a greater export product diversification, higher FDI inflows, greater trade policy liberalisation and trade openness. These findings show that a scale up of AfT flows (ideally not at the expense of NonAfT flows) by donor‐countries can contribute to greater macroeconomic stability, including through lower inflation rates in recipient‐countries.
Development and functional evaluation of pedotransfer functions for soil hydraulic properties for the Zambezi River Basin
Authors: Kalumba Mulenga , Bamps Brecht , Nyambe Imasiku , Dondeyne Stefaan , Van Orshoven Jos
Published: December 2020

Water retention and saturated hydraulic conductivity are soil properties that are key determinants in crop growth and hydrological modelling. They are commonly estimated from basic soil characteristics such as bulk density, organic carbon content and texture by means of pedotransfer functions (PTFs). In order to assess and compare the inherent performance and the functional applicability in the Zambezi River Basin (ZRB) of the widely used Saxton & Rawls PTFs and a set of newly developed PTFs, we compiled measurements of water retention at pF0.0, 1.0, 2.0, 2.8, 3.4 and 4.2 and of saturated hydraulic conductivity (Ksat) on 631 soil samples throughout the ZRB. A total of 329 of the samples were related to 55 soil profiles available in the Africa Soil Profile database, whereas our own field campaign carried out in a 2,426‐km2 subbasin of the ZRB provided the remaining 302 samples related to 119 soil profiles. Apart from evaluating the Saxton & Rawls PTFs, we developed multiple linear regression (MLR) PTFs, and PTFs derived by three machine learning (ML) models: artificial neural network (ANN), random forest (RF) and support vector machine (SVM). All PTFs were first evaluated based on a comparison of the estimated and measured property values by means of R2, mean absolute error (MAE) and root mean squared error (RMSE). For the ensemble of MLR‐PTF and ML‐PTFs, the R2 of the six water content variables and the Ksat ranged from 0.55 to 0.85, whereas for the Saxton & Rawls PTFs the range was between 0.10 and 0.50. Secondly, all PTFs were subjected to a functional evaluation using the Food and Agriculture Organization (FAO) AquaCrop crop growth model. Dry season irrigation requirements for maize as computed by AquaCrop with measured versus estimated soil hydraulic properties revealed that ANN‐PTFs provide AquaCrop outputs that come closest to AquaCrop outputs generated with measured soil hydraulic properties. This study shows the importance of performing functional evaluation of pedotransfer functions before their widespread application.

Highlights

Developed machine learning and multiple linear regression pedotransfer functions (PTFs).

The Saxton & Rawls PTFs are not recommended for use in the Zambezi River Basin.

PTFs were functionally evaluated through use of estimated soil hydraulic properties in AquaCrop.

More accurate PTFs have better functional performance, although differences are small.
Troubling Territories: Discomfort in Co‐Construction
Authors: Gregory Peter , March Claire
Published: December 2020

The Valuing Voices project (funded by Paul Hamlyn Foundation) offered an opportunity to reconsider the territorial boundaries of learning in the arts by a group of teachers, artists, pupils and university lecturers. This article will consider the importance of the troubling or discomfort exposed within the processes of learning over the life of the project (before it was paused due to the 2020 CO‐VID 19 pandemic). There is considerable interest in defining zones of discomfort as a means of understanding the importance of resilience and determination in learning. Much of this stems from the work of Vygotsky, who described zones of proximal development. His work has subsequently been applied to learning activities in general and his particular interest in learning in art has been overlooked. Paul Hamlyn Foundation recognised the challenges of developing effective teachers of art and wanted to provoke some alternative opportunities by funding a number of projects across the UK. Valuing Voices was one of these which grew from an existing alliance of schools (catering for a range of additional needs), a number of artists (visual, sound and movement) who had previously only worked in mainstream educational settings and university staff specialising in art education. An earlier project had facilitated some dialogue within their traditional roles, but Valuing Voices set out to explore something more challenging as everyone involved became part of a co‐construction team. Much is written about the processes of collaboration, teamwork, communities of practice and related models of multiple learners operating together. This article sets out the additional lessons learned by all Valuing Voices participants occupying the zone of learning originally described by Vygotsky, where there was no ‘knowledgeable other’ to enable and further the learning process and all must deal with feelings of inadequacies and immense uncertainties. This was produced in recognition that little literature has been published on the process of co‐construction itself. The structure adopted here sets out the issues, the development of the two‐year project and the emotional and cognitive aspects explored along the way.
Personality‐dependent inter‐ and intraspecific foraging competition in the invasive round goby, Neogobius melanostomus
Authors: Ericsson Philip , Persson Anders , Behrens Jane W. , Brodin Tomas , Hirsch Philipp Emanuel , Sundelin Anna , van Deurs Mikael , von Friesen Lisa W. , Nilsson P. Anders
Published: December 2020

This study examines the impact of boldness on foraging competition of the highly invasive round goby Neogobius melanostomus Pallas 1815. Individual risk tolerance, or boldness, was measured as the time to resume movement after a simulated predation strike. Fish that resumed movement faster were categorized as “bold,” fish that took more time to resume movement were categorized as “shy” and those that fell in between these two categories were determined to have “intermediate” boldness. Competitive impacts of boldness in N. melanostomus were determined in a laboratory foraging experiment in which interspecific (juvenile Atlantic cod Gadus morhua Linnaeus 1758) and intraspecific (intermediate N. melanostomus) individuals were exposed to either bold or shy N. melanostomus competitors. G. morhua consumed fewer prey when competing with bold N. melanostomus than when competing with shy N. melanostomus, whereas intermediately bold N. melanostomus foraging was not affected by competitor boldness. Bold and shy N. melanostomus consumed similar amounts of prey, and the number of interactions between paired fish did not vary depending on the personality of N. melanostomus individuals. Therefore, intraspecific foraging competition was not found to be personality dependent. This study provides evidence that individual differences in boldness can mediate competitive interactions in N. melanostomus; nonetheless, results also show that competition is also governed by other mechanisms that require further study.
Recumbent folding in the Upper Cretaceous Eaux‐Chaudes massif: A Helvetic‐type nappe in the Pyrenees?
Authors: Caldera Norbert , Teixell Antonio , Griera Albert , Labaume Pierre , Lahfid Abdeltif
Published: December 2020

We describe a singular structure in Upper Cretaceous rocks of the Eaux‐Chaudes massif of the western Pyrenees, consisting of a kilometre‐scale fold nappe with a sheared overturned limb. High ductile strain attests a deformation style rarely reported for the alpine Pyrenees, and peak temperature in Upper Cretaceous carbonates is estimated by Raman spectroscopy of carbonaceous material palaeothermometry in the lower greenschist facies (>300°C). The normal fold limb retains the original sedimentary textures, while the overturned limb shows calcite crystal‐plastic deformation and dynamic recrystallization, with crystallographic preferred orientation. The observed ductility and metamorphic temperature bear similarities with the lower Helvetic nappes of the Alps, suggesting deep burial and/or possibly high geothermal gradient in this part of the Pyrenees.
Cryopreservation of buffy coat derived platelets: Paired in vitro characterization using uncontrolled versus controlled freezing rate protocols
Authors: Tynngård Nahreen , Bell Alice , Gryfelt Gunilla , Cvetkovic Stefan , Wikman Agneta , Uhlin Michael , Sandgren Per
Published: December 2020

Background

Cryopreserved platelets show a reduced recovery and viability after freezing and thawing including several ultrastructural and phenotypic deteriorations compared with liquid‐stored platelets. It is suggested that using Controlled‐Rate Freezing (CRF) can reduce variability and optimize the functionality profile for cells. The objective of the study is to compare cellular, metabolic, phenotypic and functional effects on platelets after cryopreservation using different freezing rate protocols.

Study Design and Methods

To evaluate the possible effects of different freezing rate protocols a two‐experimental study comparing diverse combinations was tested with a pool and split design. Uncontrolled freezing of platelets in materials with different thermal conductivity (metal vs cardboard) was evaluated in experiment 1. Experiment 2 evaluated uncontrolled vs a controlled‐rate freezing protocol in metal boxes. All variables were assessed pre and post cryopreservation.

Results

Directly after thawing, no major differences in platelet recovery, LDH, ATP, Δψ, CD62P, CD42b, platelet endothelial cell adhesion molecule and sCD40L were seen between units frozen with different thermal conductivity for temperature. In contrast, we observed signs of increased activation after freezing using the CRF protocol, reflected by increased cell surface expression of CD62P, PAC‐1 binding and increased concentration of LDH. Agonist induced expression of a conformational epitope on the GPIIb/IIIa complex and contribution to blood coagulation in an experimental rotational thromboelastometry setup were not statistically different between the groups.

Conclusion

The use of a uncontrolled freezing rate protocol is feasible, creating a platelet product comparable to using a controlled rate freezing equipment during cryopreservation of platelets.
Classification and Comparison of Mechanical Design of Powered Ankle–Foot Prostheses for Transtibial Amputees Developed in the 21st Century: A Systematic Review
Authors: Liu Jingjing , Abu Osman Noor Azuan , Al Kouzbary Mouaz , Al Kouzbary Hamza , Abd Razak Nasrul Anuar , Shasmin Hanie Nadia , Arifin Nooranida
Published: December 2020

A systematic review of the mechanical design of powered ankle–foot prostheses developed from 2000 to 2019 was conducted through database and manual searches. A total of ten English and two Chinese databases were searched using the same keywords. Moreover, information on commercialized prostheses was collected through a manual search. A total of 8729 publications were obtained from the database search, and 83 supplementary publications and 49 online product introductions were accumulated through the manual search. A total of 91 powered ankle–foot prostheses were extracted from 159 publications and online information after exclusion. The mechanical design characteristics of the prostheses were described briefly and compared after they were categorized into 11 subclassifications. This review revealed that a considerable number of powered ankle–foot prostheses were developed in the last 20 years. The development of such prostheses was characterized by alternative modes, that is, from pneumatic or hydraulic drivers to motorized drivers and from rigid transmissions to elastic actuators. This review contributes to the comprehensive understanding of current designs, which can benefit the combination of the advantages of and redundancy avoidance in future powered ankle–foot prostheses.
Material Properties of the Medial Elbow During Passive Valgus and Self-Initiated Varus Torques
Authors: Diefenbach Brian J. , Kulas Anthony S. , Curran Christopher J. , Rider Patrick M.
Published: December 2020

Shear wave elastography imaging of the ulnar collateral ligament (UCL) is used to help understand changes in material properties of the ligament. Ensuring that the wrist flexors are relaxed is essential as muscle contractions can alter the alignment of the medial elbow. The purpose of this study was to determine how the structural and material properties of the medial elbow respond to various elbow torques. The medial elbows of 20 healthy adults, free from upper extremity disorders, were imaged in 3 of the following torque conditions: (1) neutral relaxed, (2) passive valgus, and (3) active varus. Structural properties (ulnohumeral gap and UCL length) using B-mode and material properties (UCL and flexor muscle stiffness) using shear wave were measured. Passive valgus torque opened the ulnohumeral gap (P < .001), and increased UCL (P < .001) and wrist flexor stiffness (P = .001), compared with the neutral condition. Under an active varus contraction, the gap returned back to the neutral position, but UCL (P < .008) and wrist flexor stiffness (P < .004) remained elevated compared with neutral, meaning low-intensity torques can influence structural and material properties of the medial elbow. Therefore, effort should be taken to minimize muscle activation during imaging in order to accurately measure medial elbow properties.
Modulating the Gut Microbiota of Humans by Dietary Intervention with Plant Glycans
Authors: Tannock Gerald W.
Published: December 2020

The human colon contains a community of microbial species, mostly bacteria, which is often referred to as the gut microbiota. The community is considered essential to human well-being by conferring additional energy-harvesting capacity, niche exclusion of pathogens, and molecular signaling activities that are integrated into human physiological processes.
Long-lived seamount subduction in ancient orogens: Evidence from the Paleozoic South Tianshan
Authors: Wan Bo , Wang Xinshui , Liu Xijun , Cai Keda , Xiao Wenjiao , Mitchell Ross N.
Published: December 2020

Along the present-day circum-Pacific subduction girdle, seamount subduction is known to have significant effects on subduction dynamics including on seismicity and arc magmatism. Because seamount subduction should have occurred throughout much of Earth history, its effects on orogenesis in the overriding plate should be identifiable in ancient orogens. In this study, we investigate the Paleozoic South Tianshan orogen of Central Asia, for which abundant evidence of seamount subduction exists, further bolstered by the continuation of a long-lived plume-induced large igneous province on the subsequently accreted Tarim craton. We find that semi-continuous seamount subduction from ca. 400 to 330 Ma temporarily shut down arc magmatism, and once the seamounts were completely subducted, then arc magmatism resumed and eclogites were quickly exhumed. If such an orogenic fingerprint of seamount subduction can be identified in ancient orogens, a much more complete picture of plume-subduction interaction and its influence on both crustal and mantle processes can be developed.
Realistic GUT Yukawa couplings from a random clockwork model
Authors: von Gersdorff Gero
Published: December 2020

We present realistic models of flavor in SU(5) and SO(10) grand unified theories (GUTs). The models are renormalizable and do not require any exotic representations in order to accommodate the necessary GUT breaking effects in the Yukawa couplings. They are based on a simple clockwork Lagrangian whose structure is enforced with just two (one) vectorlike U(1) symmetries in the case of SU(5) and SO(10) respectively. The inter-generational hierarchies arise spontaneously from products of matrices with order one random entries.
Rank Estimation for Mean Residual Life Transformation Model
Authors: Chen Xiaoping
Published: December 2020

This paper proposes a new and important class of mean residual life regression model, which is called the mean residual life transformation model.  The link function is assumed to be unknown and increasing in its second argument, but it is permitted to be not differentiable. The mean residual life transformation model encompasses the proportional mean residual life model, the additive mean residual life model, and so on. Under maximum rank correlation estimation, we present the estimation procedures, whose asymptotic and finite sample properties are established. The consistent variance can be estimated by a resampling method via perturbing the

U

-statistics objective function repeatedly which avoids the usual sandwich choice. Monte Carlo simulations reveal good finite sample performance and the estimators are illustrated with the Oscar data set.
Interval Observer Design for One Class of Uncertain Linear Strictly Metzlerian Time-Delay Systems
Authors: Krokavec Dušan , Filasová Anna
Published: December 2020

The paper is concerned with design requirements when the problem of nonnegative state estimation for one class of uncertain linear Metzlerian time-delay systems with constant delays is tackled, while system states take nonnegative values whenever the initial conditions are nonnegative, the upper and lower system matrix bounds are strictly Metzler matrices, and the upper and lower output matrix bounds are nonnegative matrices. By defining positive definite diagonal matrix variables and introducing an associate structure of linear matrix inequalities, the design conditions are proven, guaranteeing if they are feasible, the resulting observer gain matrix is positive and the reflected observer system matrices are strictly Metzler and Hurwitz. A numerical example illustrates the solvability of the proposed design conditions.
A Novel Consumer Purchase Behavior Recognition Method Using Ensemble Learning Algorithm
Authors: Wang Peng , Xu Zhengliang
Published: December 2020

With the prosperous development of e-commerce platforms, consumer returns often occur. The issue of returns has become a stumbling block to the profitability of e-commerce companies. To protect consumers’ purchase rights, the Chinese government has introduced a 7-day unreasonable return policy. In order to use the return policy to attract consumers to buy, various e-commerce platforms have created a more relaxed and convenient return environment for consumers. On the one hand, the introduction of the return policy has increased customer trust in e-commerce platforms and stimulated purchase demand. On the other hand, the return behavior also increases the cost of the e-commerce platform. With the upgrading of consumption, customers pay more attention to personalized experience. In addition to considering price when purchasing online, the quality of services provided by e-commerce platforms will also directly affect customers’ purchasing decisions and return behavior. Therefore, under the personalized return policy of the e-commerce platform, whether consumers will make another purchase is worth studying. In order to achieve this goal, an ensemble learning method (AdaBoost-FSVM) based on fuzzy support vector machine (FSVM) is applied to predict the purchase intention of consumers. First, the grid search method is used to optimize the modeling parameters of the FSVM base classifier. Second, the AdaBoost-FSVM ensemble prediction model is constructed by using multiple base classifiers. In order to evaluate the performance of the prediction models used, logistic regression (LR), support vector machine (SVM), FSVM, random forest (RF), and XGBoost were used to construct prediction models for purchasing behavior. The experimental results demonstrate that the method used in this study has a more accurate prediction effect than the comparison algorithms. The predictive model used in this study can be used in the recommendation system of shopping websites and can also be used to guide e-commerce companies to customize various preferential policies and services, so as to quickly and accurately stimulate the purchase intention of more potential consumers.
Dynamic Neighborhood-Based Particle Swarm Optimization for Multimodal Problems
Authors: Zhang Xu-Tao , Xu Biao , Zhang Wei , Zhang Jun , Ji Xin-fang
Published: December 2020

Various black-box optimization problems in real world can be classified as multimodal optimization problems. Neighborhood information plays an important role in improving the performance of an evolutionary algorithm when dealing with such problems. In view of this, we propose a particle swarm optimization algorithm based on dynamic neighborhood to solve the multimodal optimization problem. In this paper, a dynamic ε-neighborhood selection mechanism is first defined to balance the exploration and exploitation of the algorithm. Then, based on the information provided by the neighborhoods, four different particle position updating strategies are designed to further support the algorithm’s exploration and exploitation of the search space. Finally, the proposed algorithm is compared with 7 state-of-the-art multimodal algorithms on 8 benchmark instances. The experimental results reveal that the proposed algorithm is superior to the compared ones and is an effective method to tackle multimodal optimization problems.
Systemic Lupus Erythematosus Presenting as Acute Lupus Pneumonitis during Pregnancy
Authors: Marte Furment Marlene , Sharma Suyansh , Pabolu Sangeetha
Published: December 2020

Introduction. This is a case of new-onset systemic lupus erythematosus (SLE) manifesting as acute pneumonitis during pregnancy. No prior reports have documented pneumonitis as the presenting manifestation of SLE in pregnant women. Case Presentation. A 23-year-old pregnant female presented with high-grade fever, cough, arthralgias, and respiratory failure. Infectious workup was negative. She was positive for ANA, anti-dsDNA, anti-SSA, hypocomplementemia, and pulmonary infiltrates, supporting the diagnosis of SLE and pneumonitis. The patient received methylprednisolone achieving adequate clinical and serological response. Conclusion. When SLE patients present with fever, cough, and respiratory failure, pulmonary infiltrates should raise the suspicion of pneumonitis in the absence of infection and hemorrhage. Even though acute lupus pneumonitis (ALP) is rare and seen only in 2% of SLE patients, a high index of suspicion aids in prompt diagnosis of this life-threatening condition. Also, positive anti-SSA antibodies may be associated with lupus pneumonitis.
Modifiable determinants for the success or failure of inter-physician collaboration in group practices in Germany - a qualitative study
Authors: Weinmayr Lisa-Marie , Zwierlein Ruben , Steinhäuser Jost
Published: December 2020

Background

A growing demand for physicians exists worldwide. Due to political changes, economic incentives and new workplace expectations a trend from single-handed practices to group practices has been noticed in many countries over the last years. In view of this background, our study aimed to identify determinants for success or failure of inter-physician collaboration in order to positively influence future collaboration in anticipation of the important role group practices may play in future health care delivery.

Methods

We chose a qualitative study design, using semi-structured phone interviews to collect data from physicians and non-physician consultants with experience in inter-physician collaboration that were analysed using content analysis. Eleven physicians with experience in collaborative working and fourteen non-physician consultants specializing in advice to health care professionals participated.

Results

Education in entrepreneurial skills as well as implementation of good practice management in preparation for collaboration are crucial modifiable facilitators for successful inter-physician collaboration. Furthermore, open communication and realistic insight into the mode of acquaintance, moral concept and degree of specialisation of the colleagues involved play major roles for the success of inter-physician collaboration in group practices.

Conclusions

There are several underlying themes beyond clinical expertise concerning success or failure of group practices. To influence future collaboration positively, it is important to focus on management and communication skills as well as to address basic understanding of economics.
Oral rehydration therapies in Senegal, Mali, and Sierra Leone: a spatial analysis of changes over time and implications for policy
Authors: Wiens Kirsten E. , Schaeffer Lauren E. , Sow Samba O. , Ndoye Babacar , Cain Carrie Jo , Baumann Mathew M. , Johnson Kimberly B. , Lindstedt Paulina A. , Blacker Brigette F. , Bhutta Zulfiqar A. , Cormier Natalie M. , Daoud Farah , Earl Lucas , Farag Tamer , Khalil Ibrahim A. , Kinyoki Damaris K. , Larson Heidi J. , LeGrand Kate E. , Cook Aubrey J. , Malta Deborah C. , Månsson Johan C. , Mayala Benjamin K. , Mokdad Ali H. , Ogbuanu Ikechukwu U. , Sankoh Osman , Sartorius Benn , Topor-Madry Roman , Troeger Christopher E. , Welgan Catherine A. , Werdecker Andrea , Hay Simon I. , Reiner Robert C.
Published: December 2020

Background

Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes.

Methods

We used a Bayesian geostatistical model and data from household surveys to map the percentage of children with diarrhea that received (1) any ORS, (2) only RHF, or (3) no oral rehydration treatment between 2000 and 2018. This approach allowed examination of whether RHF was replaced with ORS before and after interventions, policies, and external events that may have impacted healthcare access.

Results

We found that RHF was replaced with ORS in most Sierra Leone districts, except those most impacted by the Ebola outbreak. In addition, RHF was replaced in northern but not in southern Mali, and RHF was not replaced anywhere in Senegal. In Senegal, there was no statistical evidence that a national policy promoting ORS use was associated with increases in coverage. In Sierra Leone, ORS coverage increased following a national policy change that abolished health costs for children.

Conclusions

Children in parts of Mali and Senegal have been left behind during ORS scale-up. Improved messaging on effective diarrhea treatment and/or increased ORS access such as through reducing treatment costs may be needed to prevent child deaths in these areas.
Does paracetamol improve quality of life, discomfort, pain and neuropsychiatric symptoms in persons with advanced dementia living in long-term care facilities? A randomised double-blind placebo-controlled crossover (Q-PID) trial
Authors: van Dam Paulien H. , Achterberg Wilco P. , Husebo Bettina S. , Caljouw Monique A. A.
Published: December 2020

Background

The objectives of this study are to determine the effects of regularly scheduled administration of paracetamol (acetaminophen) on quality of life (QoL), discomfort, pain and neuropsychiatric symptoms of persons with dementia living in long-term care facilities (LTCFs).

Methods

A multicentre randomised double-blind placebo-controlled crossover trial for 13 weeks (January 2018 to June 2019) in 17 LTCFs across the west of the Netherlands. Inclusion criteria were age ≥ 65 years, (advanced) dementia and a moderate to low QoL, independent of the presence of pain (QUALIDEM ≤ 70). Exclusion criteria were the use of regular pain treatment, allergies to the study medication, severe liver disease, use of > 4 units of alcohol/day, weight < 50 kg and/or concomitant use of flucloxacillin. Participants received study medication (paracetamol/placebo) in two periods of 6 weeks each (1 week in between as a wash-out period). Randomisation decided in which order participants received paracetamol and placebo. Primary outcomes included QoL (QUALIDEM) and discomfort (DS-DAT), secondary outcomes included pain (MOBID-2) and neuropsychiatric symptoms (NPI-NH).

Results

Ninety-five LTCF residents (mean age 83.9 years [SD 7.6], 57.9% females) were included. Repeated linear mixed models showed no difference in mean differences of QUALIDEM (paracetamol +1.3 [95% CI -1.0–3.5], placebo +1.5 [95% CI -0.7–3.8]), DS-DAT (paracetamol -0.1 [95% CI -1.4–1.2], placebo 0.6 [95 CI -0.7–1.8]), MOBID-2 (paracetamol 0.0 [95% CI -0.5–0.5], placebo -0.2 [95% CI -0.7–0.3]) and NPI-NH (paracetamol +1.5 [95% CI -2.3–5.4], placebo -2.1 [95% CI -6.0–1.7]) in favour of either paracetamol or placebo.

Conclusions

Compared to placebo, paracetamol showed no positive effect on QoL, discomfort, pain and neuropsychiatric symptoms in persons with advanced dementia with low QoL. It is important to find out more specifically which individual persons with advanced dementia could benefit from pain treatment with paracetamol, and for clinicians to acknowledge that a good assessment, monitoring and multidomain approach is vital for improving QoL in this vulnerable group.

Trial registration

Netherlands Trial Register NTR6766. Trial registration date: 20 October 2017