bluuebunny/crossref_metadata_2025 huggingface dataset:
American Enterprise Institute Roundtable: Was Milton Friedman Right about Shareholder Capitalism?*
Authors: Asness Clifford , Hubbard Glenn , Lipton Martin , Strain Michael R.
Published: April 2021

In this look back at Milton Friedman's famous essay in The New York Times 50 years ago organized by the American Enterprise Institute, three well‐known panelists discussed whether executives should continue to be guided by Friedman's oft‐cited statement that the “social responsibility of business is to increase its own profits.”

One pretext or prompt for this discussion is the Business Roundtable's recent rethinking of the corporate mission, with its emphasis on all corporate stakeholders, employees and local communities as well as shareholders. Among the panelists, Marty Lipton takes the most enthusiastic view of this alternative to shareholder primacy. Now often identified as “stakeholder capitalism,” this alternative is embraced by Lipton as part of a “New Paradigm” in which large, universal owners act more or less in concert to pressure private companies to play a greater role in protecting the environment and lifting people out of poverty.

By contrast, fund manager Cliff Asness and former Bush advisor and Columbia Business School dean Glenn Hubbard find considerable relevance and resilience in the old shareholder paradigm. Hubbard, for example, emphasizes the impossibility of maximizing long‐run value in highly competitive product and labor markets without taking care of all important stakeholders. And while sympathetic to the intent of the Business Roundtable—and the value of ensuring enough investment in corporate stakeholders—both Hubbard and Asness are troubled by the prospect of a corporate governance system trying to hold corporate managers accountable in a stakeholder‐centric world.
Value‐Added Per Share (VAPS): A Value‐Relevant Corporate Performance Metric
Authors: Rajgopal Shivaram , Rappaport Alfred
Published: April 2021

The authors introduce Value Added Per Share (VAPS) as a value‐relevant metric that is intended to complement earnings per share (EPS) in helping corporate managers and analysts understand and overcome the limitations of GAAP‐based reporting. VAPS discounts a firm's past and projected cash flows at its “cost of capital,” allowing companies to avoid the subjective accounting accrual process and other practices that often make EPS misleading.

A company's VAPS is calculated in three main steps: (1) estimate the change in the capitalized value of after‐tax operating cash flow by taking the net change (plus or minus) of the firm's operating cash flow after taxes and dividing that number by the firm's cost of capital; (2) subtract total investment expenditures; and (3) divide by the number of shares outstanding. By capitalizing the change in after‐tax operating cash flow, one finds the net change in a firm's current operations value. By subtracting investment expenditures from that change in current operations value, the analyst gets a clearer picture of the benefit to shareholders net of the funds used to create that benefit. Consistent with basic theory, VAPS is positive when a company earns a return at least equal to its cost of capital and negative otherwise.

Because of their fundamental differences, EPS and VAPS are likely to send different signals, and VAPS is expected to provide greater insight into stock price changes. The authors provide the findings of statistical tests showing the superior explanatory power of VAPS and recommend that companies publish statements of VAPS along with standard GAAP results, especially since the former can be readily calculated using the available income statement, balance sheet, and cash flow statement data.
The Pragmatic Theory of the Firm
Authors: Madden Bartley J.
Published: April 2021

Four key ideas provide the foundation for the pragmatic theory of the firm, which is expecially useful for managements and boards in developing an understanding of how companies create long‐term value for the benefit of all stakeholders.

First, and a necessary point of departure, is clarity about the purpose of the firm. Maximizing shareholder value is viewed not as the social purpose of the firm, but as a consequence of a company's effectiveness in carrying out a purpose that recognizes the benefits of success to all key corporate stakeholders.

Second, a company's knowledge‐building proficiency, in relation to that of its competitors, is viewed as the primary determinant of its long‐term performance. Nurturing and sustaining a knowledge‐building culture facilitates the discovery of obsolete assumptions and early adaptation to a changing environment.

Third, the theory avoids “compartmentalizing” a company's activities into silos by treating the firm as a holistic system. A key component of the theory that quantifies corporate performance is the life‐cycle framework in which economic returns exhibit “competitive fade” over the long term. This holistic way of thinking provides insights about intangible assets and other sources of excess shareholder returns.

Fourth, managing corporate risk should focus on identifying and removing all major obstacles to achieving the firm's purpose. Such obstacles can lead to value destruction through, for example, unethical behavior and all forms of shortsighted failure to recognize and make the most of opportunities to increase long‐run productivity and value.

This theory of the firm is pragmatic in the sense that it aims to produce insights about a company's (or business unit's) performance that can improve management's decisions, especially in allocating capital and other corporate resources. The author uses John Deere's life‐cycle track record over the past 60 years to illustrate a successful application of the theory.
Global knowledge gaps in species interaction networks data
Authors: Poisot Timothée , Bergeron Gabriel , Cazelles Kevin , Dallas Tad , Gravel Dominique , MacDonald Andrew , Mercier Benjamin , Violet Clément , Vissault Steve
Published: April 2021

Ecological networks are increasingly studied at large spatial scales, expanding their focus from a conceptual tool for community ecology into one that also addresses questions in biogeography and macroecology. This effort is supported by increased access to standardized information on ecological networks, in the form of openly accessible databases. Yet, there has been no systematic evaluation of the fitness for purpose of these data to explore synthesis questions at very large spatial scales. In particular, because the sampling of ecological networks is a difficult task, they are likely to not have a good representation of the diversity of Earth's bioclimatic conditions, likely to be spatially aggregated, and therefore unlikely to achieve broad representativeness. In this paper, we analyse over 1300 ecological networks in the mangal.io database, and discuss their coverage of climates, and the geographic areas in which there is a deficit of data on ecological networks. Taken together, our results suggest that while some information about the global structure of ecological networks is available, it remains fragmented over space, with further differences by types of ecological interactions. This causes great concerns both for our ability to transfer knowledge from one region to the next, but also to forecast the structural change in networks under climate change.
Insights into the Morphology of Haplozoan Parasites (Dinoflagellata) using Confocal Laser Scanning Microscopy
Authors: Angel Phil , Herranz Maria , Leander Brian S.
Published: April 2021

We describe new insights into the morphology and life history of the bizarre parasite Haplozoon axiothellae (Dinoflagellata) using light microscopy (LM), scanning electron microscopy (SEM), and confocal laser scanning microscopy (CLSM). Trophonts were isolated from the intestines of host maldanid polychaetes, Axiothella rubrocincta, collected from San Juan Island, Washington, USA. LM and SEM confirmed features previously observed, such as amphiesmal projections, mature and immature junctions between the nucleated compartments of the vermiform syncytium and visible polygonal alveoli. CLSM of adult trophonts fluorescently stained for DNA, tubulin, centrin, and plasma membrane demonstrated several new ultrastructural traits: (1) an extensive basket of parallel microtubules within the trophomere used for host attachment, (2) two physically separated MTOCs (i.e. putative pairs of basal bodies) beneath pores on the ventral side of each compartment, (3) robust mitotic and/or meiotic spindles associated with one to four nuclei in each compartment, (4) spindles with polar bodies that are disconnected from the MTOCs, (5) a centrin‐stained fibril within the trophomeres that potentially functions to retract the motile stylet, and (6) cytokinesis in the posterior‐most compartments. This study renames haplozoan compartments using the suffix “‐mere” rather than “‐cyte” (i.e. trophomere, gonomere, sporomere) to reflect their status within a single syncytium.
Bleeding after endoscopic resection between direct oral anticoagulants or warfarin: Systematic review and meta‐analysis
Authors: Zhu He , Li Fudong , Tao Ke , Liu Mingqing , Xu Hong
Published: April 2021

Background and Aim

Oral anticoagulants are risk factors for post‐endoscopic resection bleeding. We aimed to conduct a systematic review and meta‐analysis for the risks of post‐procedural bleeding (PPB) for direct oral anticoagulants (DOACs) and warfarin following endoscopic resection.

Methods

Two independent reviewers searched PubMed, Web of Science, Embase, and Cochrane Library. The Newcastle–Ottawa Scale score was used to assess the quality of the studies, the pooled odds ratio (OR) to present PPB results, and the funnel plots to assess publication bias. The Higgins I2 statistic was employed to determine the variation across studies due to heterogeneity.

Results

We reviewed 30 articles. PPB occurred in 586 patients on DOACs and 1782 on warfarin. The patients on DOACs had a significantly lower overall risk of PPB compared with those on warfarin (OR, 0.867, 95% confidence interval, 0.771–0.975; P = 0.017, I2 = 1.6%). Cumulative meta‐analysis showed that the PPB rate of DOACs has the trend to be lower than that of warfarin with publication year and sample size. For the subgroup of endoscopic submucosal dissection, the PPB of DOACs was significantly lower than that of warfarin (OR, 0.786; 95% confidence interval, 0.633–0.976; P = 0.029, I2 = 0%). No significant difference was observed between DOACs and warfarin for anticoagulant strategies, endoscopic procedures, and lesion location.

Conclusions

Compared with warfarin, DOACs have the possibility to significantly decrease the risk of PPB following endoscopic resection, especially for endoscopic submucosal dissection.
PagGRF12a interacts with PagGIF1b to regulate secondary xylem development through modulating PagXND1a expression in Populus alba × P. glandulosa
Authors: Wang Jinnan , Zhou Houjun , Zhao Yanqiu , Jiang Cheng , Li Jihong , Tang Fang , Liu Yingli , Zhao Shutang , Hu Jianjun , Song Xueqin , Lu Meng‐Zhu
Published: April 2021

Growth‐regulating factors (GRFs) are important regulators of plant development and growth, but their possible roles in xylem development in woody plants remain unclear. Here, we report that Populus alba × Papulus glandulosa PagGRF12a negatively regulates xylem development in poplar. PagGRF12a is expressed in vascular tissues. Compared to non‐transgenic control plants, transgenic poplar plants overexpressing PagGRF12a exhibited reduced xylem width and plants with repressed expression of PagGRF12a exhibited increased xylem width. Xylem NAC domain 1 (XND1) encodes a NAC domain transcription factor that regulates xylem development and transcriptional analyses revealed that PagXND1a is highly upregulated in PagGRF12a‐overexpressing plants and downregulated in PagGRF12a‐suppressed plants, indicating that PagGRF12a may regulate xylem development through PagXND1a. Transient transcriptional assays and chromatin immunoprecipitation‐polymerase chain reaction assays confirmed that PagGRF12a directly upregulates PagXND1a. In addition, PagGRF12a interacts with the GRF‐Interacting Factor (GIF) PagGIF1b, and this interaction enhances the effects of PagGRF12a on PagXND1a. Our results indicate that PagGRF12a inhibits xylem development by upregulating the expression of PagXND1a.
Personalized video consent in Blepharoplasty: A new paradigm in the preoperative consent giving process
Authors: Shome Debraj , Doshi Komal , Vadera Sapna , Kumar Vaibhav , Vyavahare Supriya S. , Kapoor Rinky
Published: April 2021

Background

Informed consent is not simply the signing of a form by the patient but more significantly, a process of an in‐depth communication between the doctor and the patient.

Aim

The written informed consent process typically involves reading a lengthy document involving the medical terms which at times lead to misinterpretation. Therefore, the current research envisages assessing the effectiveness and acceptability of the video consent tool athwart the traditional written consent procedure.

Methods

A retrospective questionnaire study was carried out with 30 patients posted for Blepharoplasty surgery between ages of 18–50 years. They were divided into two groups randomly. All the participants were given written consent. Video consent was taken additionally for group 2 subjects. All the participants received pre‐validated questionnaire. The evaluation scale used was a 5‐point Likert scale.

Results

People with video consent group were more satisfied with the consent process. It was noted that all the patients who received video consent were happier and understood the consent process better than patients with written consent only.

Conclusion

The inference drawn from our study depicts that video consent is not just easy to understand and clarifies the doubts associated with the surgery but also significantly reduces the anxiety of the patient preoperatively. Also, in other ‘quality of life’ improving cosmetic procedures including rhinoplasty, face lift surgeries, jaw surgeries, botox, fillers, lasers etc., video consenting tool can be used to a maximum benefit. It is strongly recommended to adopt the practice of taking video consent format in all forms of cosmetic procedures.
The effect of reinforcing an educational programme using telephone follow‐up on health‐related quality of life of individuals using warfarin: A randomised controlled trial
Authors: Manzato Rafaela de Oliveira , Ciol Marcia A. , Bolela Fabiana , Dessotte Carina Aparecida Marosti , Rossi Lídia Aparecida , Dantas Rosana Aparecida Spadoti
Published: April 2021

Objectives

To evaluate the effect of reinforcing an educational programme through telephone follow‐up on health‐related quality of life and anxiety and depression symptoms in individuals starting warfarin therapy.

Background

Educational interventions have improved quality of life in individuals using warfarin. Few studies have examined the addition of telephone follow‐up to enhance educational interventions.

Design

Randomised controlled trial in outpatient setting.

Methods

Hospitalised adults starting warfarin therapy who agreed to participate received an educational programme about the warfarin treatment. At discharge, they were randomised to receive either five telephone follow‐up calls (intervention) or no telephone calls (controls). Both groups were evaluated for health‐related quality of life (using Duke Anticoagulation Satisfaction Scale) and symptoms of anxiety and depression (using Hospital Anxiety and Depression Scale) at three and six months post‐discharge. Groups were compared at each time by independent‐samples t test, and over time by repeated‐measures analysis of variance, with time (three and six months), groups (intervention and control) and an interaction between time and group as factors. Level of significance was set at 0.05. The Consolidated Standards of Reporting Trials was used for reporting.

Results

Fifty‐two individuals (26 per group) completed the study. There were no statistical differences between groups in health‐related quality of life, anxiety and depression symptoms, at both times post‐discharge. Participants who received follow‐up telephone calls reported better positive psychological impact (a subscale of quality of life) than controls.

Conclusions

Reinforcing an educational programme with telephone follow‐ups did not have an overall effect on health‐related quality of life of individuals using warfarin but promoted positive psychological impact.

Relevance to clinical practice

The low cost of reinforcing educational programmes with telephone calls and the improvement in positive psychological aspects indicate that this type of intervention is still a promising intervention that could be further investigated and improved.
ENIGMA‐Sleep: Challenges, opportunities, and the road map
Authors: Tahmasian Masoud , Aleman André , Andreassen Ole A. , Arab Zahra , Baillet Marion , Benedetti Francesco , Bresser Tom , Bright Joanna , Chee Michael W.L. , Chylinski Daphne , Cheng Wei , Deantoni Michele , Dresler Martin , Eickhoff Simon B. , Eickhoff Claudia R. , Elvsåshagen Torbjørn , Feng Jianfeng , Foster‐Dingley Jessica C. , Ganjgahi Habib , Grabe Hans J. , Groenewold Nynke A. , Ho Tiffany C. , Bong Hong Seung , Houenou Josselin , Irungu Benson , Jahanshad Neda , Khazaie Habibolah , Kim Hosung , Koshmanova Ekaterina , Kocevska Desi , Kochunov Peter , Lakbila‐Kamal Oti , Leerssen Jeanne , Li Meng , Luik Annemarie I. , Muto Vincenzo , Narbutas Justinas , Nilsonne Gustav , O’Callaghan Victoria S. , Olsen Alexander , Osorio Ricardo S. , Poletti Sara , Poudel Govinda , Reesen Joyce E. , Reneman Liesbeth , Reyt Mathilde , Riemann Dieter , Rosenzweig Ivana , Rostampour Masoumeh , Saberi Amin , Schiel Julian , Schmidt Christina , Schrantee Anouk , Sciberras Emma , Silk Tim J. , Sim Kang , Smevik Hanne , Soares Jair C. , Spiegelhalder Kai , Stein Dan J. , Talwar Puneet , Tamm Sandra , Teresi Giana l. , Valk Sofie L. , Van Someren Eus , Vandewalle Gilles , Van Egroo Maxime , Völzke Henry , Walter Martin , Wassing Rick , Weber Frederik D. , Weihs Antoine , Westlye Lars Tjelta , Wright Margaret J. , Wu Mon‐Ju , Zak Nathalia , Zarei Mojtaba
Published: April 2021

Neuroimaging and genetics studies have advanced our understanding of the neurobiology of sleep and its disorders. However, individual studies usually have limitations to identifying consistent and reproducible effects, including modest sample sizes, heterogeneous clinical characteristics and varied methodologies. These issues call for a large‐scale multi‐centre effort in sleep research, in order to increase the number of samples, and harmonize the methods of data collection, preprocessing and analysis using pre‐registered well‐established protocols. The Enhancing NeuroImaging Genetics through Meta‐Analysis (ENIGMA) consortium provides a powerful collaborative framework for combining datasets across individual sites. Recently, we have launched the ENIGMA‐Sleep working group with the collaboration of several institutes from 15 countries to perform large‐scale worldwide neuroimaging and genetics studies for better understanding the neurobiology of impaired sleep quality in population‐based healthy individuals, the neural consequences of sleep deprivation, pathophysiology of sleep disorders, as well as neural correlates of sleep disturbances across various neuropsychiatric disorders. In this introductory review, we describe the details of our currently available datasets and our ongoing projects in the ENIGMA‐Sleep group, and discuss both the potential challenges and opportunities of a collaborative initiative in sleep medicine.
Reaching trans women in San Francisco for efforts to eliminate hepatitis C
Authors: Hernandez Christopher J. , Trujillo Dillon , Turner Caitlin M. , Sicro Sofia , Meza Joaquin , Bella Mackie , Daza Emperatriz , Torres Francisco , McFarland Willi , Wilson Erin C.
Published: April 2021

Hepatitis C infections continue to rise among marginalized communities, including among transgender people. Efforts to eliminate hepatitis C from San Francisco require successful identification of active HCV infections among transgender women and subsequent treatment of infection. This secondary analysis of the National HIV Behavioral Surveillance Transgender Women (NHBS‐Trans) Study aims to identify areas of improvement in the hepatitis C care cascade and associated barriers that preclude successful treatment. One hundred and eighty (89.6%) trans women reported being previously screened for HCV, 47 (26.1%) reported being diagnosed with HCV, twenty‐eight of the 47 (59.6%) who reported HCV diagnosis also reported that they received HCV treatment, with and 24 of the 28 (85.7%) reported completing their treatment. Overall, we detected HCV antibodies among 23.9% of participants and detected HCV RNA among 6.0%. This suggests that despite improvements in screening for HCV, active cases may not be successfully treated. Efforts to reduce barriers to HCV care should be prioritized, with heightened consideration for trans‐specific needs.
Inhibition of hepatitis E virus replication by zinc‐finger antiviral Protein synergizes with IFN‐β
Authors: Yu Wenhai , Ji Hanbin , Long Feiyan , Chen Shuangfeng , He Qiuxia , Xia Yueping , Cong Chao , Yang Chenchen , Wei Daqiao , Huang Fen
Published: April 2021

Hepatitis E virus (HEV) infection is the most common cause of acute viral hepatitis worldwide. However, host–HEV interactions have yet to be fully understood. Zinc‐finger antiviral protein (ZAP) is a novel interferon (IFN)‐stimulated gene product that inhibits a variety of viruses in synergy with IFN‐β. To evaluate the role of ZAP in HEV infection, its expressions in HEV‐infected patients and in cell cultures were measured. We report a significant inhibition of ZAP expression in patients with HEV genotype four acute infection. The expression of ZAP in the HEV life cycle was monitored in cultures of HEV‐infected cells. Results indicated that the ZAP level decreased significantly after HEV infection. ZAP over‐expression inhibited HEV replication, whereas its knockdown by RNA interference significantly increased HEV RNA. These suggest that ZAP serves as an antiviral in HEV infection. Moreover, silencing ZAP decreased IFN regulatory factor 3 (IRF3) phosphorylation in HEV‐infected cells treated with poly(I:C), indicating that ZAP synergizes with IFN‐β. In conclusion, ZAP is an important anti‐HEV host factor and in synergy with IFN‐β, inhibits HEV replication.
Diagnostic accuracy of fibrosis tests in children with non‐alcoholic fatty liver disease: A systematic review
Authors: Draijer Laura G. , van Oosterhout Janneke P. M. , Vali Yasaman , Zwetsloot Sabrina , van der Lee Johanna H. , van Etten‐Jamaludin Faridi S. , Chegary Malika , Benninga Marc A. , Koot Bart G. P.
Published: April 2021

Background & Aims

Non‐alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in children. Even at young age, it can progress to liver fibrosis. Given the drawbacks of liver biopsy, there is a need for non‐invasive methods to accurately stage liver fibrosis in this age group. In this systematic review, we evaluate the diagnostic accuracy of non‐invasive methods for staging liver fibrosis in children with NAFLD.

Methods

We searched MEDLINE, Embase, Web of Science and the Cochrane Library, for studies that evaluated the performance of a blood‐based biomarker, prediction score or imaging technique in staging liver fibrosis in children with NAFLD, using liver biopsy as the reference standard.

Results

Twenty studies with a total of 1787 NAFLD subjects were included, which evaluated three prediction scores, five simple biomarkers, two combined biomarkers and six imaging techniques. Most studies lacked validation. Substantial heterogeneity of studies and limited available study data precluded a meta‐analysis of the few fibrosis tests evaluated in more than one study. The most consistent accuracy data were found for transient elastography by FibroScan®, ELF test and ultrasound elastography, with an area under the receiver operating characteristics curve varying between 0.92 and 1.00 for detecting significant fibrosis.

Conclusion

Due to the lack of validation, the accuracy and clinical utility of non‐invasive fibrosis tests in children with NAFLD remains uncertain. As studies have solely been performed in tertiary care settings, accuracy data cannot directly be translated to screening populations.
Environmental specialization and cryptic genetic divergence in two massive coral species from the Florida Keys Reef Tract
Authors: Rippe John P. , Dixon Groves , Fuller Zachary L. , Liao Yi , Matz Mikhail
Published: April 2021

Broadcast‐spawning coral species have wide geographical ranges spanning strong environmental gradients, but it is unclear how much spatially varying selection these gradients actually impose. Strong divergent selection might present a considerable barrier for demographic exchange between disparate reef habitats. We investigated whether the cross‐shelf gradient is associated with spatially varying selection in two common coral species, Montastraea cavernosa and Siderastrea siderea, in the Florida Keys. To this end, we generated a de novo genome assembly for M. cavernosa and used 2bRAD to genotype 20 juveniles and 20 adults of both species from each of the three reef zones to identify signatures of selection occurring within a single generation. Unexpectedly, each species was found to be composed of four genetically distinct lineages, with gene flow between them still ongoing but highly reduced in 13.0%–54.7% of the genome. Each species includes two sympatric lineages that are only found in the deep (20 m) habitat, while the other lineages are found almost exclusively on the shallower reefs (3–10 m). The two “shallow” lineages of M. cavernosa are also specialized for either nearshore or offshore: comparison between adult and juvenile cohorts indicates that cross‐shelf migrants are more than twice as likely to die before reaching adulthood than local recruits. S. siderea and M. cavernosa are among the most ecologically successful species on the Florida Keys Reef Tract, and this work offers important insight into the genomic background of divergent selection and environmental specialization that may in part explain their resilience and broad environmental range.
The discursive transformation of grief throughout history
Authors: Gravesen Janni Dahlgaard , Birkelund Regner
Published: April 2021

In recent decades, the phenomenon of grief, when you lose a loved one, has been the subject of exploration and discussion among researchers. Because of this, prolonged grief is now recognized as a possible mental disorder as the latest version of the diagnosis manual; ‘International Classification of Diseases’ (ICD‐11) being published in 2018 is featuring a new diagnosis called ‘prolonged grief disorder’. The commencement of this new disorder indicates a shift in the way grief is being articulated why the notion of rupture from the French philosopher Michel Foucault is applied as a philosophical approach in this paper. A Foucault‐inspired discourse analysis has been prepared and by considering the issue historically and tracing how the concept of grief has been articulated in different time periods throughout history, the aim is to map out the discursive transformation that has taken place and to gain insight into how the societal context has supported and enabled this transformation. This paper takes a historical look back from the 1800s to present and identifies when changes can be observed in the way grief is being articulated. These changes or ruptures are identified in the work of Søren Aabye Kierkegaard, Sigmund Freud and Margaret Stroebe & Henk Schut who all must be assumed to have contributed significantly to how grief is perceived in various historical time periods. The discourse analysis identifies how prominent thinkers have articulated grief in each period and how today's perception of grief, as a possible mental disorder, both relates to these prominent thinkers but also reflects dominant societal values and ideologies.
Neural correlates of nonjudgmental perception induced through meditation
Authors: Katyal Sucharit , Goldin Philippe
Published: April 2021

Ambiguous sensory stimuli provide insight into the dynamics of the human mind. When viewing substantially different images in the two eyes (i.e., binocular rivalry (BR)), perception spontaneously fluctuates between the two images along with patch‐like mixtures of the two, with limited ability to control such fluctuations. Previous studies have shown that long‐term meditation training can enable a more stable perception by reducing such fluctuations. Using electroencephalography, we investigated the neural bases of perceptual stabilization in long‐term meditators (LTMs) and age‐matched meditation‐naive control participants. We measured BR alternations before and after participants practiced meditation. We expected that perceptual stabilization through meditation could occur via one of two neurocognitive mechanisms: (1) a more engaged/effortful attention reflected by increased long‐range phase synchronization between early visual sensory and higher‐level brain regions, or (2) a disengaged/nonevaluative form of attention reflected by decreased phase synchronization. We found that compared with control participants, LTMs were in a significantly longer mixed perceptual state following concentrative meditation practice. The increase in mixed percepts across individuals was strongly correlated with reduced parietal–occipital gamma‐band (30–50 Hz) phase synchrony. These findings suggest that concentrative meditation enables a nonevaluative perceptual stance supported by reduced communication between hierarchical visual brain regions.
Gestational diabetes and childhood asthma in a racially diverse US pregnancy cohort
Authors: Adgent Margaret A. , Gebretsadik Tebeb , Reedus Jada , Graves Cornelia , Garrison Etoi , Bush Nicole , Davis Robert , LeWinn Kaja Z. , Tylavsky Frances , Carroll Kecia N.
Published: April 2021

Background

Childhood asthma is a common chronic disease that likely has prenatal origins. Gestational diabetes alters maternal physiology and may influence fetal risk for childhood‐onset disease. However, the association between gestational diabetes and child asthma is not well characterized.

Objective

To investigate the association between gestational diabetes and wheeze/asthma at approximately 4 years of age in a racially diverse US cohort.

Methods

We studied mother‐child dyads enrolled prenatally in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study. Gestational diabetes was determined by medical chart review. At approximately 4 years of age, we assessed child respiratory outcomes including parent report of physician‐diagnosed asthma (ever), current wheeze (symptoms within the past 12 months), and current asthma (physician diagnosis and/or medication or symptoms within the past 12 months). We used the modified Poisson regression to assess associations between gestational diabetes and child respiratory outcomes, adjusting for maternal age, race, prenatal smoking, pre‐pregnancy body mass index, parity, asthma history, socioeconomic status, and infant sex.

Results

Among 1107 women, 66% were African American/Black. Six percent (n = 62) had gestational diabetes documented during pregnancy. Gestational diabetes was associated with increased risk of physician‐diagnosed asthma (adjusted risk ratio (RR) [95% Confidence Interval]: 2.13 [1.35, 3.38]; prevalence: 14%), current wheeze (RR: 1.85 [1.23, 2.78]; prevalence: 19%), and current asthma (RR: 2.01 [1.30, 3.10]; prevalence: 16%).

Conclusions

Gestational diabetes was associated with increased risk of asthma and wheeze outcomes. Additional studies are needed to elucidate modifiable pathways underlying this association.
Comparison of levetiracetam versus phenytoin/fosphenytoin for busulfan seizure prophylaxis at a pediatric institution
Authors: Hughes Kaitlynn , Garrity Lisa , Nelson Adam S. , Lane Adam , Teusink‐Cross Ashley
Published: April 2021

Introduction

Busulfan is a chemotherapy agent used in hematopoietic stem cell transplant (HSCT) conditioning regimens. Busulfan is associated with tonic‐clonic seizures in ~10% of patients if administered without seizure prophylaxis. Historically, phenytoin was the most commonly utilized seizure prophylaxis agent; however, phenytoin is associated with CYP450 drug interactions and potentially increases the clearance of busulfan. Levetiracetam is being used more recently for busulfan seizure prophylaxis and is not associated with drug‐drug interactions; however, data supporting use in pediatric patients are limited. The primary objective is to determine whether there is any difference in seizure rates or safety profile between phenytoin and levetiracetam when used for seizure prophylaxis.

Methods

We conducted a retrospective chart review including patients who received busulfan between 2010 and 2019 were identified. The data were evaluated to compare the incidence of busulfan‐induced seizures in HSCT patients receiving either phenytoin or levetiracetam and to determine the impact of drug‐drug interactions on treatment outcomes/adverse events.

Results

A total of 342 patients were included with a median age of six years. Overall, five patients within the phenytoin group (n = 126) (4%) and zero patients in the levetiracetam group (n = 216) experienced a seizure (P = .007). There were no differences in liver enzyme elevations, recurrence rates of primary disease, and veno‐occlusive disease.

Conclusion

Levetiracetam is effective at preventing seizures associated with busulfan administration with no clinically significant adverse effects when compared to phenytoin.
Chronic obstructive pulmonary disease exacerbation fundamentals: Diagnosis, treatment, prevention and disease impact
Authors: MacLeod Mairi , Papi Alberto , Contoli Marco , Beghé Bianca , Celli Bartolome R. , Wedzicha Jadwiga A. , Fabbri Leonardo M.
Published: April 2021

In chronic obstructive pulmonary disease (COPD), exacerbations (ECOPD), characterized by an acute deterioration in respiratory symptoms, are fundamental events impacting negatively upon disease progression, comorbidities, wellbeing and mortality. ECOPD also represent the largest component of the socioeconomic burden of COPD. ECOPDs are currently defined as acute worsening of respiratory symptoms that require additional therapy. Definitions that require worsening of dyspnoea and sputum volume/purulence assume that acute infections, especially respiratory viral infections, and/or exposure to pollutants are the main cause of ECOPD. But other factors may contribute to ECOPD, such as the exacerbation of other respiratory diseases and non‐respiratory diseases (e.g., heart failure, thromboembolism). The complexity of worsening dyspnoea has suggested a need to improve the definition of ECOPD using objective measurements such as blood counts and C‐reactive protein to improve accuracy of diagnosis and a personalized approach to management. There are three time points when we can intervene to improve outcomes: acutely, to attenuate the length and severity of an established exacerbation; in the aftermath, to prevent early recurrence and readmission, which are common, and in the long‐term, establishing preventative measures that reduce the risk of future events. Acute management includes interventions such as corticosteroids or antibiotics and measures to support the respiratory system, including non‐invasive ventilation (NIV). Current therapies are broad and better understanding of clinical phenotypes and biomarkers may help to establish a more tailored approach, for example in relation to antibiotic prescription. Other unmet needs include effective treatment for viruses, which commonly cause exacerbations. Preventing early recurrence and readmission to hospital is important and the benefits of interventions such as antibiotics or anti‐inflammatories in this period are not established. Domiciliary NIV in those patients who are persistently hypercapnic following discharge and pulmonary rehabilitation can have a positive impact. For long‐term prevention, inhaled therapy is key. Dual bronchodilators reduce exacerbation frequency but in patients with continuing exacerbations, triple therapy should be considered, especially if blood eosinophils are elevated. Other options include phosphodiesterase inhibitors and macrolide antibiotics. ECOPD are a key component of the assessment of COPD severity and future outcomes (quality of life, hospitalisations, health care resource utilization, mortality) and are a central component in pharmacological management decisions. Targeted therapies directed towards specific pathways of inflammation are being explored in exacerbation prevention, and this is a promising avenue for future research.
Acupuncture as a tool to reduce nausea in terminally ill patients
Authors: Brøndum Lotte , Markfoged Birte , Finderup Jeanette
Published: April 2021

Aim

To investigate if acupuncture reduces nausea and vomiting in terminally ill patients.

Design

A comparative effectiveness research design was used to generate evidence‐based knowledge close to practice for the use of clinicians. The sample size was calculated to 136 patients randomised into an intervention and a control group, respectively. Nausea and vomiting were measured using the EORTC QLQ‐c15‐PAL (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire, core 15, Palliation).

Location

The trial was conducted among terminally ill patients admitted to three in‐bed hospices in Demark.

Participants

Terminally ill patients suffering from nausea and/or vomiting; 95% of patients had cancer.

Intervention

The intervention group received acupuncture in addition to usual care for three days. We used the acupuncture spots: Pericardium‐6, Stomach‐36, Liver‐3 and Yin Tang. The control group received usual care only.

Results

In total, 136 patients were randomised, 24 patients withdrew resulting in a total sample of 112 patients: 52 patients in the intervention group and 60 patients in the control group. In the intervention group, 75% of the patients experienced a reduction of their nausea score after the intervention compared to 55% in the control group. The statistical difference was p = 0.028. In the intervention group, 52% of the patients did not experience nausea at all after the intervention compared to 30% in the control group. In the intervention group, 31% of the patients were still vomiting after the intervention compared to 34% in the control group; no statistically significant difference was found.

Conclusion

Acupuncture reduced the experience of nausea among terminally ill patients but did not reduce vomiting. Thus, acupuncture is recommended to reduce nausea among terminally ill patients.
Detecting initial aragonite and calcite variations in limestone–marl alternations
Authors: Nohl Theresa , Steinbauer Manuel J. , Sinnesael Matthias , Jarochowska Emilia
Published: April 2021

Limestone–marl alternations are commonly used for high‐resolution cyclostratigraphic studies and palaeoenvironmental reconstructions, but diagenetic studies indicate that not all limestone–marl alternations reflect genuine differences in the initial sediment composition driven by environmental changes. Differences in the ratios of diagenetically inert trace elements between limestones and marls indicate changes affecting the terrigenous fraction of the precursor sediment. Contrarily, limestone–marl alternations without these differences can be the product of: (i) variations in CaCO3 input (aragonite, calcite); (ii) distortion of the latter by diagenetic CaCO3 redistribution; or (iii) diagenetic CaCO3 redistribution in a homogeneous precursor sediment. The aim of this study is to provide a method to differentiate these cases and to identify variations in the proportion of calcite and aragonite in the precursor sediment composition. The model of differential diagenesis assumes that the concentration of diagenetically inert elements is inversely proportional to the amount of redistributed CaCO3. Consequently, the difference between ratios of diagenetically inert elements from two adjacent beds is a measure for CaCO3 redistribution. This is quantifiable by the vector length between ratios from two adjacent beds. The approach is illustrated here by evaluation of a case study from the Silurian of Gotland, Sweden. Trace elements were compared according to their solubility during diagenesis. All elements bound to clay minerals or calcite show similar patterns of vector length, while vector length of elements which fit into the aragonite lattice, and are diagenetically mobile, differ. The vector length approach provides a tool to test the diagenetic origin of limestone–marl alternations, to identify initial variations in CaCO3 input and to test a limestone–marl alternation’s suitability for cyclostratigraphic analyses.
Multi-Objective Surrogate-Assisted Stochastic Optimization for Engine Calibration
Authors: Pal Anuj , Wang Yan , Zhu Ling , Zhu Guoming G.
Published: April 2021

A surrogate-assisted optimization approach is an attractive way to reduce the total computational budget for obtaining optimal solutions. This makes it special for its application to practical optimization problems requiring a large number of expensive evaluations. Unfortunately, all practical applications are affected by measurement noises, and not much work has been done to address the issue of handling stochastic problems with multiple objectives and constraints. This work tries to bridge the gap by demonstrating three different frameworks for performing surrogate-assisted optimization on multi-objective constrained problems with stochastic measurements. To make the algorithms applicable to real-world problems, heteroscedastic (nonuniform) noise is considered for all frameworks. The proposed algorithms are first validated on several multi-objective numerical problems (unconstrained and constrained) to verify their effectiveness and then applied to the diesel engine calibration problem, which is expensive to perform and has measurement noises. A gt-suite model is used to perform the engine calibration study. Three control parameters, namely, variable geometry turbocharger (VGT) vane position, exhaust-gas-recirculating (EGR) valve position, and the start of injection (SOI), are calibrated to obtain the tradeoff between engine fuel efficiency performance (brake specific fuel consumption (BSFC)) and NOx emissions within the constrained design space. The results show that all three proposed extensions can handle the problems well with different measurement noise levels at a reduced evaluation budget. For the engine calibration problem, a good approximation of the optimal region is observed with more than 80% reduction in the evaluation budget for all the proposed methodologies.
Optimized Economic Operation of Microgrid: Combined Cooling and Heating Power and Hybrid Energy Storage Systems
Authors: Abdalla Ahmad N. , Nazir Muhammad Shahzad , Tiezhu Zhu , Bajaj Mohit , Sanjeevikumar P. , Yao Liu
Published: April 2021

With the rapid development of clean energy, the combined cooling and heating power (CCHP) and hybrid energy storage system (HESS) have become matured significantly. However, further optimizing the configuration of the energy supply system and adjusting the output of distributed micro-sources and energy storage units are still attractive issues. This paper focuses on the two-stage optimization strategy of the microgrid system, including CCHP and HESS. The details of the operating characteristics and mathematical models of distributed micro-sources in the system are presented. The energy storage architecture is used for mathematical modeling, and the optimization model is analyzed from the two perspectives of energy supply and demand, which explores the feasibility of improving the economic operation of the micro-energy system. The two-stage optimization model in which the first stage is to determine the optimal installation capacity of various equipment and the second stage determines the optimal operation plan of the system by obtaining the system’s capacity configuration. The simulation results show that the CCHP system can reduce the operation cost by 4.61% and 6.48% for winter and summer, respectively, also reduce fuel cost consumption by 3.01% and 3.68% for winter and summer, respectively.
Design Equations for Mixed-Mode Fracture of Dental Ceramic–Cement Interfaces Using the Brazil-Nut-Sandwich Test
Authors: Manan David Tamim , Kim Jeongho , de Melo Renata Marques , Zhang Yu
Published: April 2021

Dental interfaces are subject to mixed-mode loading. This study provides practical guidance for determining interfacial fracture toughness of dental ceramic systems. We address interfacial fracture of a composite resin cement sandwiched between two dental ceramic materials. Emphasis is placed on sandwich disc specimens with cracks originating from elliptical-shaped flaws near the center, for which analytical fracture mechanics methods fail to predict. The interaction integral method is used to provide accurate finite element solutions for cracks with elliptical-shaped flaws in a Brazil-nut-sandwich specimen. The developed model was first validated with existing experimental data and then used to evaluate the three most widely used dental ceramic systems: polycrystalline ceramics (zirconia), glass-ceramics (lithium disilicate), and feldspathic ceramics (porcelain). Contrary to disc specimens with ideal cracks, those with cracks emanating from elliptical-shaped flaws do not exhibit a monotonic increase in interfacial toughness. Also, interfacial fracture toughness is seen to have a direct relationship with the aspect ratio of elliptical-shaped flaws and an inverse relationship with the modulus ratio of the constituents. The presence of an elliptical-shaped flaw significantly changes the interfacial fracture behavior of sandwich structures. Semi-empirical design equations are provided for fracture toughness and stress intensity factors for interfacial cracks. The developed design equations provide practical guidance for determining interfacial fracture toughness of selected dental ceramic material systems. Those equations take into account four critical factors: size of the elliptical flaw, modulus ratio of constituent materials, loading angle, and applied load.
X-Ray Characterization of Real Fuel Sprays for Gasoline Direct Injection
Authors: Sforzo Brandon A. , Tekawade Aniket , Kastengren Alan L. , Fezzaa Kamel , Ilavsky Jan , Powell Christopher F. , Pei Yuanjiang , Zhang Anqi , Levy Robert
Published: April 2021

The effects of fuel blend properties on spray and injector performance has been investigated in a side-mount injector for gasoline direct injection (GDI) using two certification fuel blends: Euro 5 and Euro 6. Several X-ray diagnostic techniques were conducted to characterize the injector and spray morphology. Detailed internal geometry of the GDI injector was resolved to 1.8 μm, through the use of hard X-ray tomography. The geometry characterization of this six-hole GDI, side mount injector, quantifies relevant hole and counterbore dimensions and reveals the intricate details within the flow passages, including surface roughness and micron-sized features. Internal valve motion was measured with a temporal resolution of 20 μs and a spatial resolution of 2.0 μs, for three injection pressures and several injector energizing strategies. The needle motion for both fuels exhibits similar lift profiles for common energizing commands. A combination of X-ray radiography and ultra-small-angle X-ray scattering (USAXS) was used to characterize the fuel mass distribution and the droplet sizing, respectively. Tomographic spray radiography revealed the near-nozzle distribution of fuel mass for each of the fuels and the asymmetry produced by the angled nozzles. Under evaporative conditions, the two fuels show minor differences in peak fuel mass distribution during steady injection, though both exhibit fluctuations in injection during the early, transient phase. USAXS measurements of the path-specific surface area of the spray indicated lower peak values for the more evaporative conditions in the near nozzle region.