bluuebunny/crossref_metadata_2025 huggingface dataset:
Millard-Gubler Syndrome Associated with Cerebellar Ataxia in a Patient with Isolated Paramedian Pontine Infarction – A Rarely Observed Combination with a Benign Prognosis: A Case Report
Authors: Ayele Biniyam A. , Tadesse Yonas , Guta Betesaida , Zenebe Guta
Published: April 2021

Isolated pontine infarction accounts for 7% of all ischemic strokes. Millard-Gubler syndrome is a clinical syndrome which occurs following lesions involving the ventral portion of the caudal pons, resulting in classic clinical features such as ipsilateral abducens and facial nerve palsy and contralateral hemiparesis. We report the case of a 55-year-old male patient having presented to the Yehuleshet Specialty Clinic 6 years back with sudden-onset dysarthria and appendicular ataxia of 10 days duration. He reported having right hemibody weakness and blurred vision, which have significantly improved since then. He had a history of smoking of 30 pack-years. However, he quit smoking 8 years ago. There was no history of prior stroke, transient ischemic attack, diabetes, hypertension, head trauma, or dyslipidemia. On examination, he had horizontal left gaze palsy with horizontal nystagmus suggesting left-sided 6th cranial nerve palsy. He had mild left-sided facial palsy causing dysarthric speech. Right upper limb dysmetria was observed during examination; otherwise, motor, sensory, fundus, and gait examination results were normal. He had low serum vitamin D. Brain magnetic resonance imaging examination showed a 25 × 10 mm segmental lesion in the left median pons involving the basis pontis and tegmentum section. The lesion had T2 and T1 abnormal prolongation with no diffusion restriction, suggesting a subacute pontine infarct. The patient was managed with aspirin 325 mg, atorvastatin 80 mg, physical therapy, and vitamin D supplementation, and advised on behavioral risk factors. Six years after his isolated pontine infarction, the patient is fully recovered from dysarthria, facial palsy, hemiparesis, right-sided appendicular ataxia, and horizontal nystagmus, and the follow-up brain MRI showed radiological evidence of chronic paramedian pontine perforator infarction. Millard-Gubler syndrome may present with cerebellar ataxia if the paramedian pontine infarction area slightly extends laterally, affecting the middle cerebellar peduncles. Isolated pontine infarction may have a good prognosis if diagnosed and managed early.
High-Risk Periods for Adult Traumatic Brain Injuries: A Nationwide Population-Based Study
Authors: Posti Jussi P. , Kytö Ville , Sipilä Jussi O.T. , Rautava Päivi , Luoto Teemu M.
Published: April 2021

Introduction: There is minimal existing available information on nationwide seasonal peaks in traumatic brain injuries (TBIs). This lack of information is an impediment to the effective development of prevention programs, societal policies, and hinders the resourcing of medical emergency services. Our current aim is to study nationwide population-based high-risk periods TBI over a 15-year study period in Finland. Methods: Nationwide databases were searched for all admissions with a TBI diagnosis and later for deaths of persons ≥16 years of age during 2004–2018. The search included all hospitals that provide acute TBI care in Finland. Results: The study period included 69,231 TBI-related hospital admissions (men = 62%). We found that for men, the highest rate of TBIs occurred on Saturdays, whereas women experience the highest rate of TBIs on Mondays. The highest rate of TBIs in men occurred in July, while women experienced the highest rate of TBIs in January. TBI-related hospital admissions (incidence risk ratio [IRR] 1.090, 95% CI 1.07–1.11, p < 0.0001) and mortality within 30 days after TBI (hazard ratio [HR] 1.057, 95% CI 1.001–1.116, p = 0.0455) were more common on public holidays and weekends than on weekdays. There was an increasing trend in the proportion of TBI-related hospital admissions occurring on public holidays and weekends from 2004 (31.5%) to 2018 (33.4%) (p = 0.0007). In summer months, TBI-related hospital admissions (IRR 1.10, 95% CI 1.08–1.12, p < 0.0001) and 30-day mortality (HR 1.069, 95% CI 1.010–1.131, p = 0.0211) were more common than in other months. TBIs occurred more often in younger and healthier individuals on these index days and times. In terms of specific public holidays, the TBI risk was overall higher on New Year’s Eves and Days (IRR 1.40, 95% CI 1.25–1.58, p < 0.0001) and Midsummer’s Eves and Days (IRR 1.36, 95% CI 1.20–1.54, p < 0.0001), compared to nonworking days. This finding was significant in both genders. Conclusions: TBI-related hospital admissions and mortality were more common on public holidays, weekends, and in summer months in Finland. People who sustained TBIs on these days were on average younger and healthier. The occurrence of TBIs on public holidays and weekends is increasing at an alarming rate.
Small Intestinal Neuroendocrine Neoplasm: Factors Associated with the Development of Local Tumor-Related Symptoms
Authors: Deguelte Sophie , Metoudi Alicia , Rhaiem Rami , Hoeffel Chirstine , Brixi Hedia , Cadiot Guillaume , Kianmanesh Reza
Published: April 2021

Introduction: Clinical presentations of small intestinal neuroendocrine neoplasms (SiNENs) can range from asymptomatic to life-threatening complications. Other than primary tumor(s), mesenteric mass (MM) can provide local tumor-related (LTR) symptoms. Although some expert centers propose routine primary resection to avoid complications in stage IV patients, some guidelines suggest avoiding primary tumor resection unless in the presence of symptoms. This study was aimed to identify factors associated with the presence or development of LTR symptoms. Methods: From 2012 to 2019, SiNEN patients with appropriate initial morphological imaging were included. All initial imaging was reviewed. Associations between factors and LTR symptoms were assessed by logistic regression. Results: Among 144 SiNEN patients, 66 met the inclusion criteria. Multivariate analysis identified on initial morphological imaging (i) any visible primary tumor (p < 0.01) and (ii) MM contact ≥180° with the superior mesenteric vessels (p ≤ 0.02), as independent factors associated with LTR symptoms in the whole study population as well as in the subgroup of primary resected patients. Among the 14 (21%) patients with both factors on initial cross-sectional conventional imaging, 12 (18%) were straightaway symptomatic at diagnosis and the remaining became symptomatic during the follow-up. All asymptomatic patients, without upfront surgery and without any predictive factor 16/18 (89%), stayed asymptomatic during the 2.7-year median follow-up. The absence of association between these 2 factors yielded a sensitivity of 100%, a specificity of 62%, and a negative predictive value of 100% for the occurrence of LTR symptoms. Conclusion: The presence of any visible primary tumor and/or MM superior mesenteric vessels contact ≥180° at initial cross-sectional imaging are 2 easily identifiable factors, which can help physicians for the decision-making regarding timing and type of surgery for SiNENs. Larger multicenter studies should endorse these results.
Analysis of single comments left for bioRxiv preprints till September 2019
Authors: Malički Mario , Costello Joseph , Alperin Juan Pablo , Maggio Lauren A.
Published: April 2021

While early commenting on studies is seen as one of the advantages of preprints, the type of such comments, and the people who post them, have not been systematically explored.
We analysed comments posted between 21 May 2015 and 9 September 2019 for 1983 bioRxiv preprints that received only one comment on the bioRxiv website. The comment types were classified by three coders independently, with all differences resolved by consensus.
Our analysis showed that 69% of comments were posted by non-authors (N = 1366), and 31% by the preprints’ authors themselves (N = 617). Twelve percent of non-author comments (N = 168) were full review reports traditionally found during journal review, while the rest most commonly contained praises (N = 577, 42%), suggestions (N = 399, 29%), or criticisms (N = 226, 17%). Authors’ comments most commonly contained publication status updates (N = 354, 57%), additional study information (N = 158, 26%), or solicited feedback for the preprints (N = 65, 11%).
Our results indicate that comments posted for bioRxiv preprints may have potential benefits for both the public and the scholarly community. Further research is needed to measure the direct impact of these comments on comments made by journal peer reviewers, subsequent preprint versions or journal publications.
Order of draw of blood samples affect potassium results without K-EDTA contamination during routine workflow
Authors: Ercan Şerif , Ramadan Bahri , Gerenli Ozan
Published: April 2021

A specific sequence is recommended for filling blood tubes during blood collection to prevent erroneous test results due to carryover of additives. However, requirement of this procedure is still debatable. This study was aimed to investigate the potassium ethylenediaminetetraacetic acid (K-EDTA) contamination in blood samples taken after a tube containing the additive during routine workflow. The study was also carried out to examine the effect of order of draw on potassium results, regardless of K-EDTA contamination.
In 388 outpatients, to determine the probability of K-EDTA cross-contamination, blood was drawn sequentially into a serum tube, followed by a tube containing K-EDTA, and by another serum tube. In another 405 outpatients, to evaluate the effect of order of draw blood unrelated to K-EDTA contamination, two serum tube were successively collected. Potassium was measured on Cobas 6000 c501 analyser (Roche Diagnostic GmbH, Mannheim, Germany) by indirect ion selective electrode method.
Of paired samples collected before and after a K-EDTA tube, 24% had a potassium difference of above 0.3 mmol/L. However, no EDTA contamination was detected in these samples as well as 95% confidence intervals (CI) of limits of agreement for calcium were within the allowable error limits based on reference change values. Interestingly, of blood samples drawn successively, 24% had also a difference greater than 0.3 mmol/L for potassium.
Incorrect order of draw using closed blood collection system does not cause K-EDTA contamination, even in routine workflow. However, regardless of K-EDTA contamination, order of draw has significant influence on the potassium results.
The Peach Blossom Spring’s Long History as a Sacred Site in Northern Hunan
Authors: Meulenbeld Mark
Published: April 2021

Though long seen uniquely from the perspective of the Chinese literary canon, Tao Qian’s 陶潛 (365?–427) famous “Record of the Peach Blossom Spring” (“Taohuayuan ji” 桃花源記) may find an even more fruitful disciplinary home in religious studies. The story refers itself to a grotto at Wuling 武陵 (present-day northern Hunan province), a site that has been associated with Daoist transcendents (shenxian 神仙) at least since the middle of the sixth century. A Daoist monastery on that same site, the Peach Spring Abbey (Taoyuan guan 桃源觀) or Peach Blossom Abbey (Taohua guan 桃花觀), became officially recognized in 748 and received imperial support not long after. This article studies the long history of Peach Spring as a sacred site, or, as Tao Qian referred to it in his poem, a “divine realm” (shenjie 神界).
The Clash of Security and Sovereignty in Quasi-Alliance
Authors: Ban Kil Joo
Published: April 2021

Which is needed more: sovereignty or security? The autonomy–security trade-off model sees this as a trade-off between a client and a patron. A client surrenders some measure of autonomy to a patron and, in turn, receives security. This paper explores whether the underlying logic is applicable to quasi-alliances between a state and a multinational regime, such as the United Nations Command (UNC). South Korea has maintained a quasi-alliance with the UNC since the outbreak of the Korean War in 1950. The level of trade-off between South Korea and the UNC, however, has been changing over time, particularly while being affected by the power growth of South Korea, a client, and the preference changes of the US, the most important actor of the UNC, a patron. This paper attempts to explain why South Korea is much more enthusiastic in seeking full sovereignty and more autonomy in the 2018–2019 détente era.
Bande dessinée, propagande missionnaire et masculinité
Authors: Delisle Philippe
Published: April 2021

« Chantal au Katanga », dessiné par Robert Rigot et publié en 1950 dans Âmes Vaillantes, fait écho à la propagande missionnaire et en constitue un vecteur. Ce récit présente la particularité de s’ adresser à des jeunes filles. Mais il s’ inscrit largement dans la lignée de Tintin au Congo, en présentant des missionnaires avant tout civilisateurs et masculins. La force des clichés et le fait que les auteurs soient des hommes expliquent sans doute l’ effacement des religieuses.
The Re-emergence of the Indonesian Islamic State Groups: Their Survival and Modus Operandi
Authors: Machmudi Yon
Published: April 2021

The Islamic State groups under the New Order in Indonesia were represented by various groups and factions, but they originated from the single movement called Darul Islam (DI) led by Kartosuwiryo in West Java. In 1949, Kartosuwiryo – the imam of Darul Islam – declared the establishment of the Indonesia Islamic State in the village of the Cisampah district of Tasikmalaya, West Java with the sole purpose of rejecting the policy of the Republic of Indonesia to withdraw their troops from West Java. DI itself operated in West Java and expanded its influences in South Sulawesi and Aceh. Even though the Darul Islam rebellion was already crushed totally by the state, many movements linked to DI are still apparent and have operated clandestinely. The groups currently associated with Darul Islam have been suspected of their involvements in terrorist activities in Indonesia. Even people who have joined the Islamic State of Iraq and Syria (ISIS) still have a connection with the Darul Islam’s past rebellion. This article tries to analyze the main factors that caused the re-emergence of Indonesian Islamic State group called Negara Islam Indonesia (NII) and how NII becomes the main entry toward terroristic activities.
A new Gladiolus (Iridaceae) species from East Anatolia (Turkey): Gladiolus hamzaoglui

Authors: TEKŞEN MEHTAP , DUMAN HAYRİ , SAĞIROĞLU MEHMET
Published: April 2021

Gladiolus hamzaoglui (Iridaceae) is described and illustrated as a new species from Erzincan province in Eastern Anatolia, Turkey. It resembles G. halophilus by its secund inflorescence, obovoid fruit, and winged seed, and is related to G. anatolicus based on its leaf and flower features. Also it is compared to G. illyricus because of having some leaf, flower features, and winged seed characteristics. Its distribution, habitat and ecology, etymology, conservation status and diagnostic morphological, and taxonomic features with familiar species are discussed in this paper. Additionally, pollen and seed micromorphological characteristics of G. hamzaoglui, G. halophilus, and G. anatolicus are examined and compared using LM and SEM analyses. IUCN conservation status of G. hamzaoglui is suggested as Endangered (EN) category.
Aspidistra thuongiana (Asparagaceae, Nolinoideae), a new species from the South Central Coast region of Vietnam

Authors: PHAM VAN THE , NGUYEN VAN CANH , PHAN LONG KE , TRAN THANH THI VIET , NGUYEN VAN KHUONG , NURALIEV MAXIM S. , VISLOBOKOV NIKOLAY A.
Published: April 2021

Aspidistra thuongiana is described and illustrated as a new species from the South Central Coast region of Vietnam. The new species has bright yellow flower and a slender pistil with a minute stigma. It is morphologically close to A. longipedunculata, but differs in shorter peduncle, bowl-shaped (vs. campanulate) perigone, shorter ovate (vs. oblong) erect to spreading (vs. recurved) perigone lobes and stamens inserted at the base (vs. middle) of perigone tube. Data on nuclear 5S-NTS region of the new species are provided, aimed to serve as a molecular characterization for comparison with its congeners.
Two new species of Margyricarpus (Rosaceae, Sanguisorbeae) from high-elevation grasslands in southern Brazil, and other notes on the genus Margyricarpus
Authors: FUNEZ LUÍS A. , HASSEMER GUSTAVO , PERONI NIVALDO , DRECHSLER-SANTOS ELISANDRO R.
Published: April 2021

Margyricarpus pinnatus is a poorly understood entity from natural grasslands of South America that it better considered as a species complex. In this work we contribute to the advancement of the taxonomic knowledge of this challenging species complex by describing two new species of Margyricarpus from southern Brazil. We present field photographs, illustrations, a distribution map and ecologic and conservation notes on the new species.
Utilizing a Storm-Generating Hotspot to Study Convective Cloud Transitions: The CACTI Experiment
Authors: Varble Adam C. , Nesbitt Stephen W. , Salio Paola , Hardin Joseph C. , Bharadwaj Nitin , Borque Paloma , DeMott Paul J. , Feng Zhe , Hill Thomas C. J. , Marquis James N. , Matthews Alyssa , Mei Fan , Öktem Rusen , Castro Vagner , Goldberger Lexie , Hunzinger Alexis , Barry Kevin R. , Kreidenweis Sonia M. , McFarquhar Greg M. , McMurdie Lynn A. , Pekour Mikhail , Powers Heath , Romps David M. , Saulo Celeste , Schmid Beat , Tomlinson Jason M. , van den Heever Susan C. , Zelenyuk Alla , Zhang Zhixiao , Zipser Edward J.
Published: April 2021

The Cloud, Aerosol, and Complex Terrain Interactions (CACTI) field campaign was designed to improve understanding of orographic cloud life cycles in relation to surrounding atmospheric thermodynamic, flow, and aerosol conditions. The deployment to the Sierras de Córdoba range in north-central Argentina was chosen because of very frequent cumulus congestus, deep convection initiation, and mesoscale convective organization uniquely observable from a fixed site. The C-band Scanning Atmospheric Radiation Measurement (ARM) Precipitation Radar was deployed for the first time with over 50 ARM Mobile Facility atmospheric state, surface, aerosol, radiation, cloud, and precipitation instruments between October 2018 and April 2019. An intensive observing period (IOP) coincident with the RELAMPAGO field campaign was held between 1 November and 15 December during which 22 flights were performed by the ARM Gulfstream-1 aircraft. A multitude of atmospheric processes and cloud conditions were observed over the 7-month campaign, including numerous orographic cumulus and stratocumulus events; new particle formation and growth producing high aerosol concentrations; drizzle formation in fog and shallow liquid clouds; very low aerosol conditions following wet deposition in heavy rainfall; initiation of ice in congestus clouds across a range of temperatures; extreme deep convection reaching 21-km altitudes; and organization of intense, hail-containing supercells and mesoscale convective systems. These comprehensive datasets include many of the first ever collected in this region and provide new opportunities to study orographic cloud evolution and interactions with meteorological conditions, aerosols, surface conditions, and radiation in mountainous terrain.
Direct Influence of Solar Spectral Irradiance on the High-Latitude Surface Climate
Authors: Jing Xianwen , Huang Xianglei , Chen Xiuhong , Wu Dong L. , Pilewskie Peter , Coddington Odele , Richard Erik
Published: April 2021

Not only total solar irradiance (TSI) but also spectral solar irradiance (SSI) matter for our climate. Different surfaces can have different reflectivity for the visible (VIS) and near-infrared (NIR). The recent NASA Total and Spectral Solar Irradiance Sensor (TSIS-1) mission has provided more accurate SSI observations than before. The TSI observed by TSIS-1 differs from the counterpart used by climate models by no more than 1 W m−2. However, the SSI difference in a given VIS (e.g., 0.44–0.63 μm) and NIR (e.g., 0.78–1.24 μm) band can be as large as 4 W m−2 with opposite signs. Using the NCAR CESM2, we study to what extent such different VIS and NIR SSI partitions can affect the simulated climate. Two sets of simulations with identical TSI are carried out, one with SSI partitioning as observed by the TSIS-1 mission and the other with what has been used in the current climate models. Due to different VIS-NIR spectral reflectance contrasts between icy (or snowy) surfaces and open water, the simulation with more SSI in the VIS has less solar absorption by the high-latitude surfaces, ending up with colder polar surface temperature and larger sea ice coverage. The difference is more prominent over the Antarctic than over the Arctic. Our results suggest that, even for the identical TSI, the surface albedo feedback can be triggered by different SSI partition between the VIS and NIR. The results underscore the importance of continuously monitoring SSI and the use of correct SSI in climate simulations.
Sea Surface Temperature Intercomparison in the Framework of the Copernicus Climate Change Service (C3S)
Authors: Yang Chunxue , Leonelli Francesca Elisa , Marullo Salvatore , Artale Vincenzo , Beggs Helen , Nardelli Bruno Buongiorno , Chin Toshio M. , De Toma Vincenzo , Good Simon , Huang Boyin , Merchant Christopher J. , Sakurai Toshiyuki , Santoleri Rosalia , Vazquez-Cuervo Jorge , Zhang Huai-Min , Pisano Andrea
Published: April 2021

A joint effort between the Copernicus Climate Change Service (C3S) and the Group for High Resolution Sea Surface Temperature (GHRSST) has been dedicated to an intercomparison study of eight global gap-free sea surface temperature (SST) products to assess their accurate representation of the SST relevant to climate analysis. In general, all SST products show consistent spatial patterns and temporal variability during the overlapping time period (2003–18). The main differences between each product are located in the western boundary current and Antarctic Circumpolar Current regions. Linear trends display consistent SST spatial patterns among all products and exhibit a strong warming trend from 2012 to 2018 with the Pacific Ocean basin as the main contributor. The SST discrepancy between all SST products is very small compared to the significant warming trend. Spatial power spectral density shows that the interpolation into 1° spatial resolution has negligible impacts on our results. The global mean SST time series reveals larger differences among all SST products during the early period of the satellite era (1982–2002) when there were fewer observations, indicating that the observation frequency is the main constraint of the SST climatology. The maturity matrix scores, which present the maturity of each product in terms of documentation, storage, and dissemination but not the scientific quality, demonstrate that ESA-CCI and OSTIA SST are well documented for users’ convenience. Improvements could be made for MGDSST and BoM SST. Finally, we have recommended that these SST products can be used for fundamental climate applications and climate studies (e.g., El Niño).
Evaluation of the snow cover in the Soil, Vegetation, and Snow (SVS) land surface model
Authors: Leonardini Gonzalo , Anctil François , Vionnet Vincent , Abrahamowicz Maria , Nadeau Daniel F. , Fortin Vincent
Published: April 2021

The Soil, Vegetation, and Snow (SVS) land surface model was recently developed at Environment and Climate Change Canada (ECCC) for operational numerical weather prediction and hydrological forecasting. This study examined the performance of the snow scheme in the SVS model over multiple years at ten well-instrumented sites from the Earth System Model-Snow Model Intercomparison Project (ESM-SnowMIP), which covers alpine, maritime and taiga climates. The SVS snow scheme is a simple single-layer snowpack scheme that uses the force-restore method. Stand-alone, point-scale verification tests showed that the model is able to realistically reproduce the main characteristics of the snow cover at these sites, namely snow water equivalent, density, snow depth, surface temperature, and albedo. SVS accurately simulated snow water equivalent, density and snow depth at open sites, but exhibited lower performance for subcanopy snowpacks (forested sites). The lower performance was attributed mainly to the limitations of the compaction scheme and the absence of a snow interception scheme. At open sites, the SVS snow surface temperatures were well represented but exhibited a cold bias, which was due to poor representation at night. SVS produced a reasonably accurate representation of snow albedo, but there was a tendency to overestimate late winter albedo. Sensitivity tests suggested improvements associated with the snow melting formulation in SVS.
In Situ Underwater Average Flow Velocity Estimation Using a Low-cost Video Velocimeter
Authors: Lertvilai Pichaya , Roberts Paul L.D. , Jaffe Jules S.
Published: April 2021

The development of a low-cost Video Velocimeter (VIV) to estimate underwater bulk flow velocity is described. The instrument utilizes a simplified particle image correlation technique to reconstruct an average flow velocity vector from video recordings of ambient particles. The VIV uses a single camera with a set of mirrors that splits the view into two stereoscopic views, allowing estimation of the flow velocity vector. The VIV was validated in a controlled flume using ambient seawater, and subsequently field tested together with an acoustic Doppler velocimeter with both mounted close to the coastal seafloor. When used in non-turbulent flow, the instrument can estimate mean flow velocity parallel to the front face of the instrument with root-mean-squared errors of the main flow within 10% of the ±20 cm/s measurement range when compared to an ADV. The predominant feature of the VIV is that it is a cost-effective method to estimate flow velocity in complex benthic habitats where velocity parallel to the sea floor is of interest.
Rafael Correa’s Decade in Power (2007–2017): Citizens’ Revolution, Sumak Kawsay, and Neo-Extractivism in Ecuador
Authors: Goeury Hugo
Published: April 2021

In 2006, Rafael Correa was elected president of Ecuador on the promise that his Citizens’ Revolution would represent “a change of era” for the country, notably through the writing of a new constitution. The indigenous concept of sumak kawsay/buen vivir, which represents, among other things, a new development paradigm based on the decommodification of nature, became the guiding principle of this new constitution. While the failed Yasuní-ITT initiative represented an innovative attempt to translate buen vivir into policies, Correa’s reliance on neo-extractivism and the repression of indigenous communities deviated dramatically from the transformative path offered by sumak kawsay. The tensions between the sumak kawsay approach enshrined in the 2008 Constitution and the policies implemented by Correa can be explained, at least partly, by the Citizens’ Revolution’s anticorporatism and the “delegative democratic regime” Correa put into place.

En 2006, Rafael Correa fue elegido presidente de Ecuador con la promesa de que su Revolución Ciudadana representaría “un cambio de era” para el país, en particular a través de la redacción de una nueva constitución. El concepto indígena de sumak kawsay/buen vivir, que representa, entre otras cosas, un nuevo paradigma de desarrollo basado en la desmercantilización de la naturaleza, se convirtió en el principio rector de dicha Constitución. Si bien la fallida iniciativa Yasuní-ITT fue un intento innovador de traducir el buen vivir en políticas, la dependencia de Correa del neoextractivismo y la represión de las comunidades indígenas se desvió dramáticamente del camino transformador ofrecido por sumak kawsay. Las tensiones entre el enfoque sumak kawsay consagrado en la Constitución de 2008 y las políticas implementadas por Correa pueden explicarse, al menos en parte, a partir del anticorporativismo de la Revolución Ciudadana y el régimen de democracia delegativa establecido por Correa.
Factors Affecting Dilation Interval in Patients With Granulomatosis With Polyangiitis‐Associated Subglottic and Glottic Stenosis
Authors: Chen Lena W. , Lina Ioan , Motz Kevin , Berges Alexandra J. , Ospino Rafael , Seo Philip , Hillel Alexander T.
Published: April 2021

Objective

Subglottic stenosis (SGS) is a known complication of granulomatosis with polyangiitis (GPA). We investigated the impact of medical and surgical interventions on the surgical dilation interval and characterized patients with glottic involvement.

Study Design

A retrospective chart review of patients with GPA‐associated SGS was performed from 2010 to 2019.

Setting

Tertiary academic medical center.

Methods

The impact of medical and surgical interventions on dilation interval was assessed. The prevalence of glottic involvement was assessed, and clinical characteristics and outcomes were compared with patients without glottic involvement.

Results

A total of 39 patients with GPA‐associated SGS were analyzed. Dilation intervals in patients receiving leflunomide (n = 4; median, 484 days; 95% CI, 405‐1099) were greater than in those not receiving leflunomide (median, 155 days; 95% CI, 48‐305; P =. 033). The surgical technique used did not affect dilation interval. Patients with glottic involvement (n = 13) had a greater incidence of dysphonia (13/13 vs 15/26 [58%], P =. 007) and a shorter dilation interval with involvement (median, 91 days; interquartile range, 70‐277) versus without involvement (median, 377 days; interquartile range, 175‐1148; hazard ratio, 3.38; 95% CI, 2.26‐5.05; P <. 001). Of 13 patients, 8 (62%) did not have glottic involvement on first presentation.

Conclusion

Although GPA is classically thought to affect the subglottis, it also involves the glottis in a subset of patients. These patients have greater complaints of dysphonia and require more frequent surgery. Systemic therapy may increase dilation intervals. In this preliminary study, patients taking leflunomide demonstrated an improvement, highlighting the need for further study of immunosuppression regimens in the treatment of GPA‐associated SGS.
Crizotinib for c-MET–amplified advanced NSCLC: a single-center experience
Authors: Tacar Seher Yildiz , Yilmaz Mesut , Oz Buge , Tural Deniz
Published: April 2021

Introduction:

Lung cancer is the most common cause of cancer-related death in the world. Changes in the treatment of metastatic lung cancer in recent years have made targetable mutations gain importance. MET alteration is one of these driver mutations and crizotinib is a tyrosine kinase inhibitor used in therapy.

Methods:

In our study, data of patients with c-MET amplification who received crizotinib treatment between July 2017 and November 2020 in the Medical Oncology Clinic of Bakırköy Dr. Sadi Konuk Training and Research Hospital were retrospectively analyzed. c-MET scanning was performed by the fluorescent in situ hybridization method by using Cytotest MET/CCP7 probe kit by evaluating 100 tumor cells and the threshold value for positivity was accepted as above 20%.

Results:

Eight of 28 patients who received crizotinib treatment had c-MET amplification. Seven of these patients were male and one was female. Progression-free survival and overall survival in these eight patients were 9.4 and 10.9 months, respectively, and objective response rate was 50%. Grade 4 nausea was observed in only one patient; there was no grade 4–5 toxicity and no patient discontinued the drug due to toxicity.

Conclusion:

Crizotinib is an effective treatment option other than cytotoxic chemotherapy in the limited number of patients with MET amplification in the stage 4 lung adenocarcinoma subgroup. It is important to investigate this amplification, which can be detected especially in smoking patients in the appropriate patient group, and to use appropriate tyrosine kinase inhibitors in treatment.
“I'm Just Like, You Know What, It’s Now or Never”: Exploring How Women of Color Experiencing Severe Abuse and Homicide Risk Journey Toward Formal Help-Seeking
Authors: Harper Shannon B.
Published: April 2021

Women in the United States are more likely to be killed by an intimate partner than anyone else, and prior, severe domestic violence (DV) is typically involved in such intimate partner homicides (IPH). Black women experience disproportionately high rates of DV and IPHs, severe injury, and abuse with weapons. Distinct patterns of escalating DV are associated with impending risk of re-victimization and lethal violence. One of the most common predictors associated with formal DV help-seeking is severity of physical violence. The current study uses semi-structured interviews with 11 severe abuse survivors to answer the following research questions: (1) How do women experiencing severe abuse make sense of DV resources across the course of their abusive relationships? (2) How do women experiencing severe abuse make sense of services when fear of death/homicide risk is present? Approximately 91% of the sample is comprised of women of color (WOC) survivors. Results demonstrate that WOC survivors navigated complex journeys toward formal DV help-seeking that involved resisting help-seeking when the abuse still felt manageable; delaying help-seeking to protect themselves from escalating violence; and hastening help-seeking when breaking points were reached and the risk of death felt tangible. DV resources took on a different meaning in participants’ lives as abuse became more severe across the abuse lifecourse, and in relation to life circumstances and patterns of abuse, and personal perceptions of homicide risk. WOC participants also often experienced multiple structural barriers to formal help-seeking and waited until the violence was severe and/or life-threatening to make first contact, which highlights the necessity of immediate risk assessment with responsive service offerings that address the link between DV and poverty, as well as regular follow-up and ongoing support.
Exposure to Campus Messages about Dating and Sexual Violence: A Latent Class Analysis
Authors: O'Connor Julia , Hoxmeier Jill , McMahon Sarah , Cusano Julia , Wilson Courtney
Published: April 2021

This study investigates college students’ exposure to messages about campus dating and sexual violence (DSV) to discover classes of students based on the message source. Latent class analysis was performed with data assessing 5,284 students’ exposure to 16 different sources of information regarding DSV, from having a professor discuss these topics to participating in related campus events. Several variables were included in the analysis to understand students’ class membership in relation to pertinent student demographic factors. The best model indicated that there are five classes of students based on their exposure to messages, with some subgroups of students having high exposure to various sources of messages about DSV while others have low exposure. Still other subgroups are primarily exposed to messages through nonactive or noninstitutional sources of information. Subgroups of students, based on their exposure to DSV messaging, also differ regarding demographic makeup. The implications from these results include the need to tailor DSV programming on campus to subgroups of students based on their varying baseline levels of message exposure. As students are exposed to messaging through differing sources, including passive and noninstitutional, institutions can use this information when designing outreach efforts to better fit with the needs of various subgroups of students.
Developing and testing a new quantitative near infrared spectroscopy online tracking measuring system for soil detection during automatic dishwashing
Authors: Richter Johannes , Kessler Arnd , Weber Thomas , Heißler Heinz , Gerstenlauer Michaela , Wüst Matthias , Stamminger Rainer
Published: April 2021

Near infrared (NIR) measurements have been used for several years to examine the processes taking place in the dishwasher during dishwashing. It is possible to differentiate between the soil components butterfat, oatmeal and egg-yolk and to determine their concentration in the dishwashing liquor quantitatively. Consequently, time-consuming dishwashing tests can be avoided by weighing the dishes. However, this method is also based on a small number of NIR measurements which are carried out intrusively during the dishwashing process, i.e. outside the dishwasher. These few NIR measurements make it difficult to investigate the dynamics of a dishwashing process. In this study, the development, testing and usage of a new online tracking measuring system is presented. The latter was used to perform 38 dishwashing processes, each containing 51 NIR spectra, to develop a calibration model using the partial least squares regression method with cross-validation. This new online tracking measuring system, based on the calibration, can determine the concentrations of three different soil components in the dishwashing liquor during automatic dishwashing. By recording the 51 spectra, it is possible to display a tracking curve for each soil component, i.e. the concentration courses of the dishwashing process over time. This results in a significantly better time resolution and it was possible to investigate the first dynamic part of the tracking curve, i.e. the beginning of the dishwashing process. This could lead to the opportunity to change the state of the dishwasher depending on the concentrations detected in the first step and, secondly, to a more environmentally friendly and cost-reducing dishwashing process.
Standing out from the crowd: Both cue numerosity and social information affect attention in multi-agent contexts
Authors: Capozzi Francesca , Bayliss Andrew P , Ristic Jelena
Published: April 2021

Groups of people offer abundant opportunities for social interactions. We used a two-phase task to investigate how social cue numerosity and social information about an individual affected attentional allocation in such multi-agent settings. The learning phase was a standard gaze-cuing procedure in which a stimulus face could be either uninformative or informative about the upcoming target. The test phase was a group-cuing procedure in which the stimulus faces from the learning phase were presented in groups of three. The target could either be cued by the group minority (i.e., one face) or majority (i.e., two faces) or by uninformative or informative stimulus faces. Results showed an effect of cue numerosity, whereby responses were faster to targets cued by the group majority than the group minority. However, responses to targets cued by informative identities included in the group minority were as fast as responses to targets cued by the group majority. Thus, previously learned social information about an individual was able to offset the general enhancement of cue numerosity, revealing a complex interplay between cue numerosity and social information in guiding attention in multi-agent settings.
Asymptomatic Medial Elbow Ultrasound Abnormality in Youth Baseball Players Is an Independent Risk Factor for Elbow Injury: A Prospective Cohort Study
Authors: Shitara Hitoshi , Tajika Tsuyoshi , Kuboi Takuro , Ichinose Tsuyoshi , Sasaki Tsuyoshi , Hamano Noritaka , Endo Fumitaka , Kamiyama Masataka , Miyamoto Ryosuke , Kakase Kurumi , Yamamoto Atsushi , Kobayashi Tsutomu , Takagishi Kenji , Chikuda Hirotaka
Published: April 2021

Background:

Youth baseball players who experience elbow pain during the season frequently exhibit radiographic elbow abnormalities. However, it is unknown whether asymptomatic elbow abnormalities are risk factors for in-season elbow injuries.

Purpose:

To determine whether the preseason presence of asymptomatic medial epicondyle apophysitis is a risk factor for in-season elbow injuries in youth baseball players.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Youth baseball players (N = 210; age range, 7-12 years) with no pain or history of injury in their throwing arms underwent preseason evaluations that included shoulder and elbow range of motion measurements, shoulder muscle strength testing, and ultrasound elbow scans with a multifrequency 13-MHz linear array transducer. Over 1 year of play, the players and their parents maintained daily elbow pain diaries. Elbow injuries were defined as medial elbow symptoms that prevented ball throwing for ≥8 days.

Results:

The preseason ultrasound evaluation revealed medial epicondyle apophysitis in 59 players. In the year following, elbow injuries occurred in 17 (28.8%) players with preseason medial epicondyle apophysitis and 18 (11.9%) players without apophysitis. Independent predictors of elbow injuries were preseason medial epicondyle apophysitis (odds ratio [OR], 2.488; 95% confidence interval [CI], 1.152-5.376; P = .02) and deficits of abduction (ABD) and external rotation of the dominant shoulder (OR, 0.963; 95% CI, 0.936-0.992; P = .012).

Conclusion:

Asymptomatic medial epicondyle apophysitis and ABD and external rotation deficits in the dominant shoulder were risk factors for elbow injuries in 7- to 12-year-old youth baseball players. These findings may aid in the design of programs to prevent elbow injuries in this population.
Stroke 20 20: Implementation goals for intravenous thrombolysis
Authors: Mikulik Robert , Bar Michal , Cernik David , Herzig Roman , Jura Rene , Jurak Lubomir , Neumann Jiri , Sanak Daniel , Ostry Svatopluk , Sevcik Petr , Skoda Ondrej , Skoloudik David , Vaclavik Daniel , Tomek Ales
Published: April 2021

Introduction

Knowledge of the implementation gap would facilitate the use of intravenous thrombolysis in stroke, which is still low in many countries. The study was conducted to identify national implementation targets for the utilisation and logistics of intravenous thrombolysis.

Material and Method

Multicomponent interventions by stakeholders in health care to optimise prehospital and hospital management with the goal of fast and accessible intravenous thrombolysis for every candidate. Implementation results were documented from prospectively collected cases in all 45 stroke centres nationally. The thrombolytic rate was calculated from the total number of all ischemic strokes in the population of the Czech Republic since 2004.

Results

Thrombolytic rates of 1.3 (95%CI 1.1 to 1.4), 5.4 (95%CI 5.1 to 5.7), 13.6 (95%CI 13.1 to 14.0), 23.3 (95%CI 22.8 to 23.9), and 23.5% (95%CI 23.0 to 24.1%) were achieved in 2005, 2009, 2014, 2017, and 2018, respectively. National median door-to-needle times were 60–70 minutes before 2012 and then decreased progressively every year to 25 minutes (IQR 17 to 36) in 2018. In 2018, 33% of both university and non-university hospitals achieved median door-to-needle time ≤20 minutes. In 2018, door-to-needle times ≤20, ≤45, and ≤60 minutes were achieved in 39, 85, and 93% of patients.

Discussion

Thrombolysis can be provided to ≥ 20% of all ischemic strokes nationwide and it is realistic to achieve median door-to-needle time 20 minutes.

Conclusion

Stroke 20–20 could serve as national implementation target for intravenous thrombolysis and country specific implementation policies should be applied to achieve such target.
Impact of visceral obesity on operative outcomes of laparoscopic nephrectomy: comparison between visceral fat area and body mass index
Authors: Yoshino Tateki , Oshima Shota , Sugitani Tomoyuki , Kobayashi Yusuke , Kawakami Kazuo , Kodama Koji , Onuma Hideyuki , Yasumoto Hiroaki , Shiina Hiroaki , Hasegawa Yasuhisa
Published: April 2021

Background

Obesity has been considered as a risk factor influencing operative difficulty. It was reported that body mass index (BMI; kg/m2) did not always properly reflect the degree of a patient’s visceral fat. The purpose of this study is to retrospectively investigate the association of operative outcomes and obesity indices including visceral fat area (VFA; cm2) and BMI in retroperitoneoscopic nephrectomy (RN).

Methods

We retrospectively reviewed consecutive 96 RN procedures performed from September 2016 to June 2020. We divided patients into BMI obese group (BMI ≥ 25, n = 25) and BMI normal group (BMI < 25, n = 71), VFA obese group (VFA ≥ 100, n = 54) and VFA normal group (VFA < 100, n = 42). Patient characteristics, operative and postoperative outcomes were compared between the two groups for each index of obesity.

Results

In two groups divided by BMI, the only specimen weight was significantly greater in the obese group (320 vs. 460 g, p < 0.001), whereas VFA obese group had longer insufflation time (165 vs. 182 min, p = 0.028), greater estimated blood loss (34 vs. 88 ml, p = 0.003) and greater specimen weight (255 vs. 437 g, p < 0.001) than VFA normal group. In a logistic regression analysis, high VFA value was a significant predictor for greater specimen weight and high VFA value and large size of renal tumor were significant predictors for greater blood loss. By contrast, BMI was not a significant predictor. Furthermore, in the case of non-obese patients (BMI < 25), VFA obese group had significantly longer insufflation time, greater estimated blood loss and greater specimen weight than normal group.

Conclusions

The present data suggest that VFA is a more useful parameter than BMI for predicting the operative difficulty associated with obesity, and VFA has a higher use value in non-obese patients (BMI < 25) than in obese patients (BMI ≥ 25).
Molecular epidemiology of Staphylococcus aureus in African children from rural and urban communities with atopic dermatitis
Authors: Ndhlovu Gillian O. N. , Abotsi Regina E. , Shittu Adebayo O. , Abdulgader Shima M. , Jamrozy Dorota , Dupont Christopher L. , Mankahla Avumile , Nicol Mark P. , Hlela Carol , Levin Michael E. , Lunjani Nonhlanhla , Dube Felix S.
Published: April 2021

Background

Staphylococcus aureus has been associated with the exacerbation and severity of atopic dermatitis (AD). Studies have not investigated the colonisation dynamics of S. aureus lineages in African toddlers with AD. We determined the prevalence and population structure of S. aureus in toddlers with and without AD from rural and urban South African settings.

Methods

We conducted a study of AD-affected and non-atopic AmaXhosa toddlers from rural Umtata and urban Cape Town, South Africa. S. aureus was screened from skin and nasal specimens using established microbiological methods and clonal lineages were determined by spa typing. Logistic regression analyses were employed to assess risk factors associated with S. aureus colonisation.

Results

S. aureus colonisation was higher in cases compared to controls independent of geographic location (54% vs. 13%, p < 0.001 and 70% vs. 35%, p = 0.005 in Umtata [rural] and Cape Town [urban], respectively). Severe AD was associated with higher colonisation compared with moderate AD (86% vs. 52%, p = 0.015) among urban cases. Having AD was associated with colonisation in both rural (odds ratio [OR] 7.54, 95% CI 2.92–19.47) and urban (OR 4.2, 95% CI 1.57–11.2) toddlers. In rural toddlers, living in an electrified house that uses gas (OR 4.08, 95% CI 1.59–10.44) or utilises kerosene and paraffin (OR 2.88, 95% CI 1.22–6.77) for heating and cooking were associated with increased S. aureus colonisation. However, exposure to farm animals (OR 0.3, 95% CI 0.11–0.83) as well as living in a house that uses wood and coal (OR 0.14, 95% CI 0.04–0.49) or outdoor fire (OR 0.31, 95% CI 0.13–0.73) were protective. Spa types t174 and t1476, and t272 and t1476 were dominant among urban and rural cases, respectively, but no main spa type was observed among controls, independent of geographic location. In urban cases, spa type t002 and t442 isolates were only identified in severe AD, t174 was more frequent in moderate AD, and t1476 in severe AD.

Conclusion

The strain genotype of S. aureus differed by AD phenotypes and rural-urban settings. Continued surveillance of colonising S. aureus lineages is key in understanding alterations in skin microbial composition associated with AD pathogenesis and exacerbation.