bluuebunny/crossref_metadata_2025 huggingface dataset:
Bedarfsanalyse zur Curriculumsentwicklung für die anästhesiologische Kreißsaalversorgung – eine deutschlandweite Umfrage
Authors: Flentje Markus , Eismann Hendrik , Schwill Simon , Forstner Daniel , Kranke Peter
Published: July 2022

Hintergrund

Die anästhesiologische Tätigkeit in der Kreißsaalumgebung impliziert die Besonderheiten der 200 %-Letalität, die beschreibt, dass Notfallsituationen Mutter und Kind betreffen können. Ein Umstand, der die Notwendigkeit einer besonderen Sorgfalt in der Mitarbeiterausbildung und -auswahl eindrücklich unterstreicht. Gleichwohl existiert derzeit keine detaillierte Beschreibung der notwendigen Kompetenzen in dieser Arbeitsumgebung. Die vorliegende Studie soll die Ausbildungssituation in der anästhesiologischen Weiterbildung beschreiben und im Hinblick auf die Notwendigkeit eines Curriculums analysieren.

Methodik

In einer multizentrischen Beobachtungsstudie wurden Ärzt:innen in Weiterbildung (AiW) und ausbildende Fachärzt:innen (FÄ) nach Methoden der Einarbeitung, Feedbackgabe, übernommenen Tätigkeiten und Bedarf eines Curriculums befragt. Teilnehmende wurden über die Mitgliedsdatenbank der DGAI angeschrieben und konnten onlinebasiert den 11 Items umfassenden Fragebogen beantworten.

Ergebnisse

Insgesamt wurden 495 Fragebogen (FÄ 329;166 AiW) abgeschlossen. Fachärzt:innen und AiW machen unterschiedliche Angaben zur Durchführung von Abschlussgesprächen (59,6 % vs. 10 %) und der Unterstützung durch ein Curriculum (76,3 % vs. 15,7 %). Unabhängig vom Weiterbildungsjahr werden von AiW Kaiserschnitte unter Supervisionsstufe „Rufweite“ durchgeführt. Die Periduralanästhesie (PDA) ist während der Einarbeitung die am seltensten durchgeführte Maßnahme. Beide Gruppen schätzen den Nutzen bzw. den Wert einer Beschreibung von Lernzielen und der Verfügbarkeit eines Curriculums als hoch ein.

Schlussfolgerung

Die Unterstützung der Einarbeitung wird von FÄ und AiW teilweise unterschiedlich beantwortet. Einzelne seltene durchgeführte Maßnahmen, wie die PDA, bedürfen künftig einer gesonderten Aufmerksamkeit. Die Beschreibung von Lernzielen und die Curriculumsentwicklung werden ausdrücklich gewünscht.
XIGA: An eXtended IsoGeometric analysis approach for multi-material problems
Authors: Noël L. , Schmidt M. , Doble K. , Evans J. A. , Maute K.
Published: July 2022

Multi-material problems often exhibit complex geometries along with physical responses presenting large spatial gradients or discontinuities.
In these cases, providing high-quality body-fitted finite element analysis meshes and obtaining accurate solutions remain challenging. Immersed boundary techniques provide elegant solutions for such problems. Enrichment methods alleviate the need for generating conforming analysis grids by capturing discontinuities within mesh elements. Additionally, increased accuracy of physical responses and geometry description can be achieved with higher-order approximation bases. In particular, using B-splines has become popular with the development of IsoGeometric Analysis. In this work, an eXtended IsoGeometric Analysis (XIGA) approach is proposed for multi-material problems. The computational domain geometry is described implicitly by level set functions. A novel generalized Heaviside enrichment strategy is employed to accommodate an arbitrary number of materials without artificially stiffening the physical response. Higher-order B-spline functions are used for both geometry representation and analysis. Boundary and interface conditions are enforced weakly via Nitsche’s method, and a new face-oriented ghost stabilization methodology is used to mitigate numerical instabilities arising from small material integration subdomains. Two- and three-dimensional heat transfer and elasticity problems are solved to validate the approach. Numerical studies provide insight into the ability to handle multiple materials considering sharp-edged and curved interfaces, as well as the impact of higher-order bases and stabilization on the solution accuracy and conditioning.
Gait, falls, cognitive function, and health-related quality of life after shunt-treated idiopathic normal pressure hydrocephalus—a single-center study
Authors: Hallqvist Caroline , Grönstedt Helena , Arvidsson Lisa
Published: July 2022

Background

Normal pressure hydrocephalus (NPH) is a neurological disorder, characterized by gait- and balance disturbance, cognitive deterioration, and urinary incontinence, combined with ventricular enlargement. Gait ability, falls, cognitive status, and health-related quality of life pre and post surgery have not previously been studied at Karolinska University Hospital.

Methods

One hundred and eighteen patients with iNPH that underwent shunt surgery at Karolinska University Hospital during the years from 2016 to 2018 were included. Results of walking tests, test for cognitive function, and self-estimated health-related quality of life, before and 3 months after surgery, were collected retrospectively as a single-center study.

Results

Walking ability, cognitive function, and health-related quality of life significantly increased 3 months after shunt surgery. A positive significant correlation was seen between a higher self-estimated quality of life and walking ability.

Conclusions

Patients with suspected iNPH treated with shunt surgery at Karolinska University Hospital improved their walking ability and cognitive functioning 3 months after shunt surgery. A positive significant correlation was seen between a higher self-estimated quality of life and walking ability but not with increased cognitive function. We then concluded that the selection of patients for shunting maintained a high standard.
Stressors Increase the Impacts of Coastal Macrofauna Biodiversity Loss on Ecosystem Multifunctionality
Authors: Gammal Johanna , Hewitt Judi , Gladstone-Gallagher Rebecca , Thrush Simon , Douglas Emily , Lohrer Andrew , Pilditch Conrad
Published: July 2022

There is substantial evidence that biodiversity underpins ecosystem functioning, but it is unclear how these relationships change with multiple stressors in complex real-world settings. Coastal zones are affected by numerous stressors (for example, sediment input and nutrient runoff from land) and the cumulative effects of these stressors may result in pronounced and unexpected changes in the functioning of ecosystems. To investigate the cumulative effects of turbidity and elevated nutrients on coastal biodiversity-ecosystem functioning relationships, we performed a large-scale field experiment manipulating in situ sediment porewater ammonium concentrations and measured multiple ecosystem functions related to carbon fixation and mineralisation in 15 estuaries with varying levels of turbidity. The results indicated that the benthic macrofauna diversity (species richness, abundance, and functional richness) declined with increased porewater ammonium concentrations and there were clear thresholds in light levels at the seafloor in relation to the biodiversity-ecosystem function relationships. Multifunctionality indices (an integrated index of all measured functions) in moderately turbid and turbid estuaries (daily mean seafloor PAR < 420 µmol m−2 s−1) decreased with the loss of macrofauna biodiversity. Functioning in low-turbidity estuaries (daily mean PAR > 420 µmol m−2 s−1) however remained relatively constant, suggesting that they were more resilient against the nutrient-induced biodiversity loss. Our results demonstrate that ecosystems already stressed by stressors that alter functional performance (turbidity) may be more prone to loss of overall functioning if biodiversity is reduced by another stressor (nutrient enrichment), highlighting the potential snowballing effects of cumulative change.
A new price index for multi-period and multilateral comparisons
Authors: Faliva Mario , Nava Consuelo Rubina , Zoia Maria Grazia
Published: July 2022

Within the stochastic approach, this paper establishes a closed-form solution to the price index problem for an arbitrary number of periods or countries. The index’s reference basket merges the intersections of all couples of baskets in all periods/countries and provides an effective commodity coverage. Under spherical regression errors, the index satisfies the Geary–Khamis equation system and, as such, offers a general and compact representation of the latter as well as the inferential framework as a dowry. Furthermore, by relaxing sphericalness in favor of a more realistic assumption of commodity-dependent variances, a broader result is achieved. The solution to the price index problem thus obtained encompasses the Geary–Khamis formulation and sows the seeds to further advances.
Assessing Engagement of Adolescents and Young Adults (AYA) in HIV Research: A Multi-method Analysis of a Crowdsourcing Open Call and Typology of AYA Engagement in Sub-Saharan Africa
Authors: Tahlil Kadija M. , Rachal Laura , Gbajabiamila Titi , Nwaozuru Ucheoma , Obiezu-Umeh Chisom , Hlatshwako Takhona , Tembo Mandikudza , Willis Nicola , Nyagog Carine Oum , Vorkoper Susan , Sturke Rachel , Rosenberg Nora E. , Ojo Victor , Moses Isaac , Ahmed Nadia , Beima-Sofie Kristin , Roberts Sarah T. , Kateera Brenda , Namisoke-Magongo Eleanor , Mbizvo Michael T. , Iwelunmor Juliet , Ezechi Oliver , Tucker Joseph D.
Published: July 2022

Engagement of adolescents and young adults (AYA) in HIV research is increasing in many settings. We organized a crowdsourcing open call to solicit examples of how AYA have been engaged in HIV research in Africa and to develop an engagement typology. We formed a steering committee, promoted the open call, organized judging and recognized finalists. We used a multi-methods approach to identify emerging themes and measure engagement. We received 95 entries from individuals in 15 countries; 74 met the eligibility criteria. More than three-quarters of entries were from AYA (55/74, 74%). Four themes characterized AYA engagement: (1) AYA were co-creators in the HIV research process. (2) AYA were involved in community-level capacity building. (3) AYA were co-leaders in minor risk research. (4) AYA used digital methods to enhance engagement. Our open call identified diverse methods of AYA engagement, which can enhance strategies used to reach AYA in African HIV studies.
How Adolescent Mothers Interpret and Prioritize Evidence About Perinatal Child Protection Involvement: Participatory Contextualization of Published Evidence
Authors: Dion Anna , Nakajima Amy , McGee Amy , Andersson Neil
Published: July 2022

Pregnant and parenting adolescents are more likely than adults to live with economic and social vulnerability, contributing to a higher risk of poorer maternal and newborn health outcomes. These same factors contribute to higher rates of postpartum child protection investigations among adolescents. This study describes an innovative approach to contextualize evidence on factors contributing to perinatal child protection involvement in the perspectives of pregnant and parenting adolescents. Using Weight of Evidence, an evidence-based participatory procedure, we conducted a conventional literature review and used fuzzy cognitive maps to contextualize evidence in the experiences of young mothers exposed to child protection investigations. Published evidence was contextualized through semi-structured mapping interviews with ten pregnant and parenting youth and subsequently shared with three child protection workers specialized in pre- and post-natal risk assessment. We developed and consolidated explanatory accounts describing how factors contribute to child protection involvement in the perinatal period among adolescent parents. We collaboratively designed and prioritized interventions strategies together with six adolescent parents. Young women highlighted mental health consequences of child protection involvement, including a reluctance to disclose their own health and social needs, challenges to their identity and self-confidence as parents, and social isolation. Women prioritized reducing the stigma they experience in accessing services, strengthening supportive relationships and greater understanding of their rights in child protection investigations as actionable intervention areas. Inputs of young women and service providers precipitated a reconceptualization of risk and identified how to support greater agency and self-determination among young parents experiencing child protection investigations.
The Effects of International Trade on Structural Convergence and CO2 Emissions
Authors: Hübler Michael , Bukin Eduard , Xi Yuting
Published: July 2022

This article introduces a new econometric model that includes an innovative measure of intersectoral structural change. This model describes the structural convergence (or divergence) of sector share patterns across countries (from the North-South or global perspective) influenced by international trade. The econometric analysis applies panel data estimators with different types of fixed effects to the 2013 and 2016 releases of the World Input-Output Database, covering the periods 1995–2009 and 2000–2014. The results show that international trade mostly promotes structural convergence, which is enhanced by sectoral capital intensities. It seems, however, that in this millennium, structural divergence, also fostered by international trade, occurred in terms of the CO$$_2$$

2

intensity of production.
Letting the body find its way: skills, expertise, and Bodily Reflection
Authors: FOULTIER Anna Petronella
Published: July 2022

What forms of consciousness can the subject have of her body in action? This is a recurrent issue in contemporary research on skilled movement and expertise, and according to a widespread view, the body makes itself inconspicuous in performance in favour of the object or goal that the activity is directed to. However, this attitude to consciousness in bodily performance seems unsatisfying for an understanding of skilled action, and the work of several researchers can be seen as responding to this view: Montero, Legrand, Ravn and others in the philosophy of expertise and of dance have developed various notions of consciousness and cognition to account for the mindful processes at play in performance.

Two related questions can be distinguished here: (1) Is there an inherent conflict between skilled action and at least more than marginal awareness of that action, or is it possible – and even desirable – to reflect on our own performance without considerably impeding on it? (2) What forms of consciousness pertaining to the body in action must we distinguish in order to answer the first question?

This paper gives an overview of this discussion, focusing on the second issue, although the first will come into play in so far as it is linked with the latter question. Drawing on Merleau-Ponty’s analyses of bodily reflection and on dancers’ descriptions, I show that there is, in phenomenological terms, a bodily level of reflection: a fully conscious and exploratory activity that is led by the skilled body, and that is explicitly aimed at by many performers.
Proof-of-concept of polymetallic phyto-extraction of base metal mine tailings from Queensland, Australia
Authors: Nkrumah Philip Nti , Corzo Remigio Amelia , van der Ent Antony
Published: July 2022

Purpose

The increasing volumes of mine tailings that are being generated globally because of the rise in metal demand, whilst ore-grades continue to decline, call for novel sustainable management options. Phytoextraction using hyperaccumulator plant species may be one of such strategies to deal with these large volumes of contaminated materials. However, base metals (such as zinc, lead, copper) mine tailings are inherently polymetallic that necessitate targeting multiple metal(loid)s simultaneously for effective phytoextraction. The aim of this study was to conduct a proof-of-concept experiment for polymetallic phytoextraction of base metal mine tailings.

Methods

Selected hyperaccumulator plants (Noccaea caerulescens targeting zinc, Biscutella laevigata and Silene latifolia targeting thallium, Phytolacca octandra targeting manganese, Pityrogramma calomelanos targeting arsenic) were grown in monocultures and mixed cultures for 12 weeks on tailings from the zinc-lead-copper Dugald River and Mt Isa Mines, Queensland, Australia.

Results

Noccaea caerulescens accumulated zinc and manganese (up to ~ 1 wt% and ~ 1.4 wt%, respectively) with zinc-manganese co-localization at the leaf apex and margins. The monocultured B. laevigata exhibited severe toxicity symptoms, which were alleviated when co-cultured with N. caerulescens. Trichomes were important storage sites for zinc and manganese in B. laevigata. Silene latifolia accumulated higher thallium than B. laevigata, whilst P. octandra promoted thallium accumulation in S. latifolia.

Conclusions

This proof-of-concept test of polymetallic phytoextraction provides a real-life demonstration of this innovative technology which could be adapted to further experiments at base metal mines around the world.
Textile Dye Removal by Acacia dealbata Link. Pollen Adsorption Combined with UV-A/NTA/Fenton Process
Authors: Teixeira Ana R. , Jorge Nuno , Fernandes José R. , Lucas Marco S. , Peres José A.
Published: July 2022

The decolourization of an aqueous solution of the textile dye Acid Red 88 (AR88) and the control of the invasive plant species Acacia dealbata Link. (ADL) were addressed in this work. The aims of the study were (1) characterization of the ADL pollen, (2) application of the pollen powder in adsorption processes, (3) selection of the best operational conditions for nitriloacetic acid (NTA)-UV-A-Fenton process and (4) assess the efficiency of the combined treatment adsorption and NTA-UV-A-Fenton in AR88 decolourization. In a first step, ADL pollen was used as a AR88 bioadsorbent. Fourier-transform infrared spectroscopy (FTIR) analysis were performed and revealed the presence of proteins, fatty acids, carbohydrates and lignin in the pollen. Afterwards, trough scanning electron microscopy (SEM), it was possible to verify that ADL pollen has several empty spaces that can be used for dye adsorption. Biosorption results showed higher adsorption of AR88 with application of pH 3.0 and [pollen] = 3.0 g/L with 18.8 mg/g of dye adsorbed. The best fitting was observed with Langmuir, SIPS and Jovanovic isotherms (0.993, 0.996 and 0.994, respectively). To complement the biosorption, a UV-A-Fenton process was applied, and results showed a higher AR88 removal with (NTA) addition. Higher irradiance power favored the oxidation process with high Ф photodegradation value and low Electric Energy per Order ($$E_{\text{EO}}$$

E
EO

) and Specific Applied Energy ($$E_{\text{SAE}}$$

E
SAE

). The combination of biosorption with NTA-UV-A-Fenton was the most efficient system with an AR88 decolourization of 98.5% and a total organic carbon (TOC) removal of 83.5%.

Graphical Abstract
Regularized Variational Estimation for Exploratory Item Factor Analysis
Authors: Cho April E. , Xiao Jiaying , Wang Chun , Xu Gongjun
Published: July 2022

Item factor analysis (IFA), also known as Multidimensional Item Response Theory (MIRT), is a general framework for specifying the functional relationship between respondents’ multiple latent traits and their responses to assessment items. The key element in MIRT is the relationship between the items and the latent traits, so-called item factor loading structure. The correct specification of this loading structure is crucial for accurate calibration of item parameters and recovery of individual latent traits. This paper proposes a regularized Gaussian Variational Expectation Maximization (GVEM) algorithm to efficiently infer item factor loading structure directly from data. The main idea is to impose an adaptive <mml:math xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mnf="http://cambridge.org/core/manifest" xmlns:cup="http://contentservices.cambridge.org" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:m="http://cambridge.org/core/metadata" xmlns:core="http://cambridge.org/core" xmlns:c="http://cambridge.org/core/content">L1\documentclass[12pt]{minimal}
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\begin{document}$$L_1$$\end{document}-type penalty to the variational lower bound of the likelihood to shrink certain loadings to 0. This new algorithm takes advantage of the computational efficiency of GVEM algorithm and is suitable for high-dimensional MIRT applications. Simulation studies show that the proposed method accurately recovers the loading structure and is computationally efficient. The new method is also illustrated using the National Education Longitudinal Study of 1988 (NELS:88) mathematics and science assessment data.
“Image to patient” equal-resolution surface registration supported by a surface scanner: analysis of algorithm efficiency for computer-aided surgery
Authors: Świątek-Najwer Ewelina , Majak Marcin , Popek Michał , Żuk Magdalena
Published: July 2022

Purpose

The “image to patient” registration procedure is crucial for the accuracy of surgical instrument tracking relative to the medical image while computer-aided surgery. The main aim of this work was to create an equal-resolution surface registration algorithm (ERSR) and analyze its efficiency.

Methods

The ERSR algorithm provides two datasets with equal, high resolution and approximately corresponding points. The registered sets are obtained by projection of a user-designed rectangle(s)-shaped uniform clouds of points on DICOM and surface scanner datasets. The tests of the algorithm were performed on a phantom with titanium microscrews. We analyzed the influence of DICOM resolution on the effect of the ERSR algorithm and compared the ERSR to standard paired-points landmark transform registration. The methods of analysis were Target Registration Error, distance maps, and their histogram evaluation.

Results

The mean TRE in case of ERSR equaled 0.8 ± 0.3 mm (resolution A), 0.8 ± 0.5 mm (resolution B), and 1.0 ± 0.7 mm (resolution C). The mean values were at least 0.4 mm lower than in the case of landmark transform registration. The distance maps between the model achieved from the scanner and the CT-based model were analyzed by histogram. The frequency of the first bin in a histogram of the distance map for ERSR was about 0.6 for all three resolutions of DICOM dataset and three times higher than in the case of landmark transform registration. The results were statistically analyzed using the Wilcoxon signed-rank test (alpha = 0.05).

Conclusion

The tests proved a statistically significant higher efficiency of equal resolution surface registration related to the landmark transform algorithm. It was proven that the lower resolution of the CT DICOM dataset did not degrade the efficiency of the ERSR algorithm. We observed a significantly lower response to decreased resolution than in the case of paired-points landmark transform registration.
HIV Testing Uptake According to Opt-In, Opt-Out or Risk-Based Testing Approaches: a Systematic Review and Meta-Analysis
Authors: Soh Qi Rui , Oh Leon Y. J. , Chow Eric P. F. , Johnson Cheryl C. , Jamil Muhammad S. , Ong Jason J.
Published: July 2022

Purpose of Review

Improving HIV testing uptake is essential to ending the HIV pandemic. HIV testing approaches can be opt-in, opt-out or risk-based. This systematic review examines and compares the uptake of HIV testing in opt-in, opt-out and risk-based testing approaches.

Recent Findings

There remain missed opportunities for HIV testing in a variety of settings using different approaches: opt-in (a person actively accepts to be tested for HIV), opt-out (a person is informed that HIV testing is routine/standard of care, and they actively decline if they do not wish to be tested for HIV) or risk-based (using risk-based screening tools to focus testing on certain individuals or sub-populations at greater risk of HIV). It is not clear how the approach could impact HIV test uptake when adjusted for other factors (e.g. rapid testing, country-income level, test setting and population tested).

We searched four databases for studies reporting on HIV test uptake. In total, 18,238 records were screened, and 150 studies were included in the review. Most studies described an opt-in approach (87 estimates), followed by opt-out (76) and risk-based (19). Opt-out testing was associated with 64.3% test uptake (I2 = 99.9%), opt-in testing with 59.8% (I2 = 99.9%) and risk-based testing with 54.4% (I2 = 99.9%). When adjusted for settings that offered rapid testing, country income level, setting and population tested, opt-out testing had a significantly higher uptake (+ 12% (95% confidence intervals: 3–21), p = 0.007) than opt-in testing. We also found that emergency department patients and hospital outpatients had significantly lower HIV test uptake than other populations.
Long-Term Sequelae of COVID-19 in Experimental Mice
Authors: Paidas Michael J. , Cosio Daniela S. , Ali Saad , Kenyon Norma Sue , Jayakumar Arumugam R.
Published: July 2022

We recently reported acute COVID-19 symptoms, clinical status, weight loss, multi-organ pathological changes, and animal death in a murine hepatitis virus-1 (MHV-1) coronavirus mouse model of COVID-19, which were similar to that observed in humans with COVID-19. We further examined long-term (12 months post-infection) sequelae of COVID-19 in these mice. Congested blood vessels, perivascular cavitation, pericellular halos, vacuolation of neuropils, pyknotic nuclei, acute eosinophilic necrosis, necrotic neurons with fragmented nuclei, and vacuolation were observed in the brain cortex 12 months post-MHV-1 infection. These changes were associated with increased reactive astrocytes and microglia, hyperphosphorylated TDP-43 and tau, and a decrease in synaptic protein synaptophysin-1, suggesting the possible long-term impact of SARS-CoV-2 infection on defective neuronal integrity. The lungs showed severe inflammation, bronchiolar airway wall thickening due to fibrotic remodeling, bronchioles with increased numbers of goblet cells in the epithelial lining, and bronchiole walls with increased numbers of inflammatory cells. Hearts showed severe interstitial edema, vascular congestion and dilation, nucleated red blood cells (RBCs), RBCs infiltrating between degenerative myocardial fibers, inflammatory cells and apoptotic bodies and acute myocyte necrosis, hypertrophy, and fibrosis. Long-term changes in the liver and kidney were less severe than those observed in the acute phase. Noteworthy, the treatment of infected mice with a small molecule synthetic peptide which prevents the binding of spike protein to its respective receptors significantly attenuated disease progression, as well as the pathological changes observed post-long-term infection. Collectively, these findings suggest that COVID-19 may result in long-term, irreversible changes predominantly in the brain, lung, and heart.
TOP2B Is Required to Maintain the Adrenergic Neural Phenotype and for ATRA-Induced Differentiation of SH-SY5Y Neuroblastoma Cells
Authors: Khazeem Mushtaq M. , Casement John W. , Schlossmacher George , Kenneth Niall S. , Sumbung Nielda K. , Chan Janice Yuen Tung , McGow Jade F. , Cowell Ian G. , Austin Caroline A.
Published: July 2022

The neuroblastoma cell line SH-SY5Y is widely used to study retinoic acid (RA)-induced gene expression and differentiation and as a tool to study neurodegenerative disorders. SH-SY5Y cells predominantly exhibit adrenergic neuronal properties, but they can also exist in an epigenetically interconvertible alternative state with more mesenchymal characteristics; as a result, these cells can be used to study gene regulation circuitry controlling neuroblastoma phenotype. Using a combination of pharmacological inhibition and targeted gene inactivation, we have probed the requirement for DNA topoisomerase IIB (TOP2B) in RA-induced gene expression and differentiation and in the balance between adrenergic neuronal versus mesenchymal transcription programmes. We found that expression of many, but not all genes that are rapidly induced by ATRA in SH-SY5Y cells was significantly reduced in the TOP2B null cells; these genes include BCL2, CYP26A1, CRABP2, and NTRK2. Comparing gene expression profiles in wild-type versus TOP2B null cells, we found that long genes and genes expressed at a high level in WT SH-SY5Y cells were disproportionately dependent on TOP2B. Notably, TOP2B null SH-SY5Y cells upregulated mesenchymal markers vimentin (VIM) and fibronectin (FN1) and components of the NOTCH signalling pathway. Enrichment analysis and comparison with the transcription profiles of other neuroblastoma-derived cell lines supported the conclusion that TOP2B is required to fully maintain the adrenergic neural-like transcriptional signature of SH-SY5Y cells and to suppress the alternative mesenchymal epithelial-like epigenetic state.
Identifying the Needs of Primary Care Providers Caring for Breast and Colon Cancer Survivors in the Safety-Net: a Qualitative Study
Authors: Dixit Niharika , Rodriguez Gladys , Sarkar Urmimala , Burke Nancy , Trejo Evelin , Devore Denise Joanna , Couey Paul , Nápoles Anna María
Published: July 2022

As the number of cancer survivors continues to increase and given the shortage of oncology clinicians in safety net health care settings, primary care providers (PCPs) in these settings will increasingly provide cancer survivorship care. In order to ensure equitable care for low-income and underserved breast and colon cancer survivors, it is essential to understand the safety-net PCPs’ perspective. We conducted semi-structured, in-depth qualitative interviews with 11 PCPs working in a safety-net health care system to identify their needs in caring for cancer survivors. Interviews were audio-recorded and professionally transcribed. Two coders independently coded the interviews and conducted regular meetings until we reached consensus on the results. Analysis was based in grounded theory and performed using the constant comparative method. Thematic analysis identified six themes as follows: (1) Cancer survivorship care can be integrated with the whole person and chronic disease care management that occurs in primary care; (2) PCPs’ perceptions regarding patients’ survivorship care needs and their confidence in meeting those needs; (3) preference for a shared care model; (4) coordination of care; (5) PCPs’ need for survivorship care education and training; and (6) unique issues involved in the care of older cancer survivors. PCPs in the safety-net believe that providing comprehensive survivorship care requires coordination of care through the cancer continuum. Tools like checklists, electronic health records-based communication, and convenient electronic consultations with cancer specialists would enhance the quality of survivorship care. Respondents advocate the inclusion of survivorship care education in medical education. The continuity of care with PCPs means that they play a particularly important role in the care of older cancer survivors.
Required and desired: breakthroughs for future-proofing mineral and metal extraction
Authors: Clausen Elisabeth , Sörensen Aarti
Published: July 2022

The global industrial mining sector is, like other sectors, undergoing an unprecedented transformation pushed by global sustainability and climate challenges. The need to increase productivity and efficiency of mineral extraction along with increasing pressure from a wide range of stakeholders to decarbonise the industry and make mining practices more sustainable, accountable, and socially acceptable are driving the adoption of automation and digitalisation technologies as well as the electrification of equipment and the implementation of more sustainable energy solutions for the industry. Automation and digitalisation are changing the way minerals and metals are extracted and provide important tools for designing and implementing the mine of the future: a digitally integrated, autonomous mine where no humans need to be put in harm’s way and in which the connected systems are able to reduce the ever-increasing complexity to such an extent that improved decision-making can be realised in real time. Mining as an industry still has a way to go to reach the potential of automation and digitalisation on the one hand, and alternative drive systems and sustainable power generation on the other. This paper will give an overview of empirically derived leading technologies underlying the current transformation and will place them in the context of the data-information-value-chain that can provide a more systematic approach to describe the various technologies and, in particular, their interrelationships. This can support a better understanding of assessing the overall technological maturity of an operation, especially with respect to their evolution from automation of equipment towards autonomous systems. There is no reason to doubt that, from a technology perspective, the digitally connected, autonomous, and carbon-free mine have the potential to become a reality. Breakthrough effects can be expected to come not from any single technology but rather from successfully developing, implementing, and integrating the full suite of (available) automation and digitalisation technologies across entire mining operations and moving towards digitally integrated, autonomous systems considering the process and its interrelations holistically (Clausen et al. 2020b). However, in order to get there, mining companies need to consider not only the technological aspects of this transformation. For successfully responding to the changing landscape of stakeholder expectations and future-proofing the industry requires, the authors argue that mining companies need to adopt a mind-set of the human-centred climate smart mine (Clausen and Sörensen 2021). In addition, mining companies need to reconsider their role in the economic, social, and environmental ecosystem they are embedded in so they can break through traditions that keep them from successfully positioning themselves as builders of social value.
Factors Influencing Substrate Oxidation During Submaximal Cycling: A Modelling Analysis
Authors: Rothschild Jeffrey A. , Kilding Andrew E. , Stewart Tom , Plews Daniel J.
Published: July 2022

Background

Multiple factors influence substrate oxidation during exercise including exercise duration and intensity, sex, and dietary intake before and during exercise. However, the relative influence and interaction between these factors is unclear.

Objectives

Our aim was to investigate factors influencing the respiratory exchange ratio (RER) during continuous exercise and formulate multivariable regression models to determine which factors best explain RER during exercise, as well as their relative influence.

Methods

Data were extracted from 434 studies reporting RER during continuous cycling exercise. General linear mixed-effect models were used to determine relationships between RER and factors purported to influence RER (e.g., exercise duration and intensity, muscle glycogen, dietary intake, age, and sex), and to examine which factors influenced RER, with standardized coefficients used to assess their relative influence.

Results

The RER decreases with exercise duration, dietary fat intake, age, VO2max, and percentage of type I muscle fibers, and increases with dietary carbohydrate intake, exercise intensity, male sex, and carbohydrate intake before and during exercise. The modelling could explain up to 59% of the variation in RER, and a model using exclusively easily modified factors (exercise duration and intensity, and dietary intake before and during exercise) could only explain 36% of the variation in RER. Variables with the largest effect on RER were sex, dietary intake, and exercise duration. Among the diet-related factors, daily fat and carbohydrate intake have a larger influence than carbohydrate ingestion during exercise.

Conclusion

Variability in RER during exercise cannot be fully accounted for by models incorporating a range of participant, diet, exercise, and physiological characteristics. To better understand what influences substrate oxidation during exercise further research is required on older subjects and females, and on other factors that could explain additional variability in RER.
SCL-90 empirical factors predict post-surgery weight loss in bariatric patients over longer time periods
Authors: Albert Umberto , Bonavigo Tommaso , Moro Oriana , De Caro Elide Francesca , Palmisano Silvia , Pascolo-Fabrici Elisabetta , Sandri Federico , de Manzini Nicolò , Di Blas Lisa
Published: July 2022

Purpose

This longitudinal study examined how pre-intervention psychological health helps predict bariatric surgery (BS) success as percentage of expected body mass index loss (%EBMIL) over shorter to longer periods.

Methods

Adult candidates for BS (N = 334, 67.4% females) completed the Symptoms Checklist 90 (SCL-90) questionnaire; on average, 11 months occurred between the pre-surgery psychological evaluations and the bariatric intervention. We explored the factor structure of the SCL-90 items and inspected how SCL-90 empirical factors compared with SCL-90 scales and general indices predicted %EBMIL at 3–6-month, 1-year, and 2-year follow-up occasions, adjusting for gender, pre-intervention use of antidepressants and actual and ideal BMIs.

Results

Factor analysis combined the 90 items into 8 factors, which partially replicated the expected item structure. The SCL-90 empirical factors (but not the SCL-90 scales and indices) contributed to predict BS success. In fact, the Relational Distress factor directly protected from weight regain at 1-year follow-up, indirectly via 1-year %EBMIL at the 2-year follow-up, when it further strengthened the impact of the empirical factor of Generalized Anxiety on the 2-year BS outcome. The results also evidenced a cascade effect of the pre-surgery actual BMI across time as well as unique and direct effects of pre-surgery use of antidepressants and perceived ideal BMI on the 2-year outcome.

Conclusions

SCL-90 empirical factor scores for obese patients are more efficient in anticipating BS success compared with original scale scores. They reveal that relational distress and anxiety are risk factors for postoperative weight loss, in addition to pre-intervention actual BMI, antidepressant therapy, and perceived ideal BMI.

Level of evidence

III, well-designed cohort.
Sirolimus as a second-line treatment for Graves’ orbitopathy
Authors: Lanzolla G. , Maglionico M. N. , Comi S. , Menconi F. , Piaggi P. , Posarelli C. , Figus M. , Marcocci C. , Marinò M.
Published: July 2022

Objectives

A beneficial effect of sirolimus in Graves’ orbitopathy (GO) was reported, suggesting a possible use in clinical practice. We conducted an observational, single-centre, no-profit, clinical study to investigate the efficacy of sirolimus as a second-line treatment for moderate-to-severe, active GO compared with methylprednisolone.

Methods

Data from consecutive patients given sirolimus (2 mg orally on first day, followed by 0.5 mg/day for 12 weeks) or methylprednisolone [500 mg iv/weekly (6 weeks), 250 mg/weekly (6 weeks)] as a second-line treatment were collected and compared. Primary objective: overall GO outcome at 24 weeks, based on a composite evaluation. Secondary objectives at 24 weeks: (1) improvement in quality of life, evaluated using a specific uestionnaire (GO-QoL); (2) reduction in proptosis; (3) reduction in the clinical activity score (CAS); (4) improvement of eye ductions; and (5) reduction in eyelid aperture.

Results

Data from 30 patients (15 per group) treated between January 15, 2020, and June 15, 2021, were analysed. Proportion of GO responders (primary outcome) at 24 weeks was significantly greater in sirolimus group compared with methylprednisolone group (86.6% vs 26.6%; OR: 17.8; 95% CI from 2.7 to 116.8;P = 0.0026). GO-quality of life (GO-QoL) score was greater in sirolimus group. Proportion of proptosis responders was greater in sirolimus group, as well as proportion of clinical activity score (CAS) responders. No serious adverse events were observed, with no differences between groups.

Conclusions

Sirolimus seems to be an effective second-line treatment for GO. Further randomized clinical trials are needed to confirm our observations.
La terapia chirurgica nelle forme di iperparatiroidismo primario familiare
Authors: Rossi Leonardo , Ambrosini Carlo Enrico , Frustaci Gianluca , De Napoli Luigi , Materazzi Gabriele
Published: July 2022

Sommario

L’iperparatiroidismo primario si manifesta in forma familiare nel 5% dei casi. L’età di insorgenza e la presentazione clinica di queste forme familiari sono variabili in base alla mutazione genica che sottende la sindrome. Il trattamento chirurgico delle forme familiari di iperparatiroidismo primario differisce in base alla specifica sindrome e rappresenta una sfida chirurgica per l’intrinseco rischio di recidiva/persistenza. Inoltre, l’ottimale strategia chirurgica è spesso dibattuta per la necessità di bilanciare un efficace trattamento con il rischio di complicanze, in particolare l’ipoparatiroidismo definitivo e la paralisi del nervo laringeo ricorrente. Il trattamento chirurgico rimane il trattamento di scelta per tutte le forme familiari di iperparatiroidismo primario riportate nella presente rassegna.
Collaboration and Communication between Hobby Metal Detectorists and Archaeologists in Norway
Authors: Axelsen Irmelin
Published: July 2022

In this article, the ways in which hobby metal detectorists searching for protected objects in the ploughsoil and archaeologists in Norway have collaborated and communicated throughout the public history of metal detecting in the country is outlined and problematized. Due to the opinions of individual archaeologists working in key positions and the autonomy of the country's local and regional management institutions, there are huge variations in both attitudes and practices toward metal detecting and its practitioners. In some areas, metal detectorists are allowed to search more or less freely, whereas in others, entire fields are protected after a few finds, making continued detecting without formal approval from the authorities illegal. Because of this, and the extreme difference in the activity level of individual detectorists, the number of recorded detecting finds varies immensely across county and regional borders. I suggest that channels for collaboration and communication be formalized and that a national and therefore uniform public reporting system be realized—given that it is, for the time being, largely up to individual archaeologists whether some of the country's most active citizen scientists are equally treated by the archaeological heritage management system in Norway.
New lower bounds for van der Waerden numbers
Authors: Green Ben
Published: July 2022

We show that there is a red-blue colouring of$[N]$with no blue 3-term arithmetic progression and no red arithmetic progression of length$e^{C(\log N)^{3/4}(\log \log N)^{1/4}}$. Consequently, the two-colour van der Waerden number$w(3,k)$is bounded below by$k^{b(k)}$, where$b(k) = c \big ( \frac {\log k}{\log \log k} \big )^{1/3}$. Previously it had been speculated, supported by data, that$w(3,k) = O(k^2)$.
Comparing the activity of novel antibiotic agents against carbapenem-resistant Enterobacterales clinical isolates
Authors: Tamma Pranita D. , Bergman Yehudit , Jacobs Emily B. , Lee Jae Hyoung , Lewis Shawna , Cosgrove Sara E. , Simner Patricia J. ,   for the Centers for Disease Control and Prevention Epicenters Program
Published: July 2022

Objective:

We compared the activity of 8 novel β-lactam and tetracycline-derivative antibiotics against a cohort of clinical carbapenem-resistant Enterobacterales (CRE) isolates and investigated the incremental susceptibility benefit of the addition of an aminoglycoside, fluoroquinolone, or polymyxin to the β-lactam agents to assist with empiric antibiotic decision making.

Methods:

A collection of consecutive CRE clinical isolates from unique patients at 3 US hospitals (2016–2021) was assembled. Broth microdilution was performed to obtain antimicrobial susceptibility testing results. Mechanisms of carbapenem resistance were investigated through short-read and long-read whole-genome sequencing.

Results:

Of the 603 CRE isolates, 276 (46%) were carbapenemase producing and 327 (54%) were non–carbapenemase producing, respectively. The organisms most frequently identified were Klebsiella pneumoniae (38%), Enterobacter cloacae complex (26%), and Escherichia coli (16%). We obtained the following percent susceptibility to novel β-lactam agents: ceftazidime-avibactam (95%), meropenem-vaborbactam (92%), imipenem-relebactam (84%), and cefiderocol (92%). Aminoglycosides and the polymyxins provided greater incremental coverage as second agents, compared to fluoroquinolones. Amikacin and plazomicin exhibited the greatest additive value. Ceftazidime-avibactam, meropenem-vaborbactam, and cefiderocol were active against 94% of the 220 KPC-producing isolates. Cefiderocol was active against 83% of the 29 NDM-producing isolates. Ceftazidime-avibactam had 100% activity against the 9 OXA-48-like–producing isolates. Tigecycline had the highest activity compared to other tetracyclines against KPC, NDM, or OXA-48-like–producing isolates.

Conclusion:

Selection among novel agents requires a nuanced understanding of the molecular epidemiology of CRE. This work provides insights into the comparative activity of novel agents and the additive value of a second antibiotic for empiric antibiotic decision making.
Antibiotic stewardship to reduce inappropriate antibiotic prescribing in integrated academic health-system urgent care clinics
Authors: Patel Dharmesh , Ng Teresa , Madani Lubna S. , Persell Stephen D. , Greg Mark , Roemer Phillip E. , Oberoi Sonali K. , Linder Jeffrey A.
Published: July 2022

Objective:

To develop and implement antibiotic stewardship activities in urgent care targeting non–antibiotic-appropriate acute respiratory tract infections (ARIs) that also reduces overall antibiotic prescribing and maintains patient satisfaction.

Patients and setting:

Patients and clinicians at the urgent care clinics of an integrated academic health system.

Intervention and methods:

The stewardship activities started in fiscal 2020 and included measure development, comparative feedback, and clinician and patient education. We measured antibiotic prescribing in fiscal years 2019, 2020, and 2021 for the stewardship targets, potential diagnosis-shifting visits, and overall. We also collected patient satisfaction data for ARI visits.

Results:

From FY19 to FY21, 576,609 patients made 1,358,816 visits to 17 urgent care clinics, including 105,781 visits for which stewardship measures were applied and 149,691 visits for which diagnosis shifting measures were applied. The antibiotic prescribing rate decreased for stewardship-measure visits from 34% in FY19 to 12% in FY21 (absolute change, −22%; 95% confidence interval [CI], −23% to −22%). The antibiotic prescribing rate decreased for diagnosis-shifting visits from 63% to 35% (−28%; 95% CI, −28% to −27%), and the antibiotic prescribing rate decreased overall from 30% to 10% (−20%; 95% CI, −20% to −20%). The patient satisfaction rate increased from 83% in FY19 to 89% in FY20 and FY21. There was no significant association between antibiotic prescribing rates of individual clinicians and ARI visit patient satisfaction.

Conclusions:

Although it was affected by the COVID-19 pandemic, an ambulatory antimicrobial stewardship program that focused on improving non–antibiotic-appropriate ARI prescribing was associated with decreased prescribing for (1) the stewardship target, (2) a diagnosis shifting measure, and (3) overall antibiotic prescribing. Patient satisfaction at ARI visits increased over time and was not associated with clinicians’ antibiotic prescribing rates.