bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal effects of growth hormone in health and in kidney disease
Authors: Haffner Dieter , Grund Andrea , Leifheit-Nestler Maren
Published: June 2021

Growth hormone (GH) and its mediator insulin-like growth factor-1 (IGF-1) have manifold effects on the kidneys. GH and IGF receptors are abundantly expressed in the kidney, including the glomerular and tubular cells. GH can act either directly on the kidneys or via circulating or paracrine-synthesized IGF-1. The GH/IGF-1 system regulates glomerular hemodynamics, renal gluconeogenesis, tubular sodium and water, phosphate, and calcium handling, as well as renal synthesis of 1,25 (OH)2 vitamin D3 and the antiaging hormone Klotho. The latter also acts as a coreceptor of the phosphaturic hormone fibroblast-growth factor 23 in the proximal tubule. Recombinant human GH (rhGH) is widely used in the treatment of short stature in children, including those with chronic kidney disease (CKD). Animal studies and observations in acromegalic patients demonstrate that GH-excess can have deleterious effects on kidney health, including glomerular hyperfiltration, renal hypertrophy, and glomerulosclerosis. In addition, elevated GH in patients with poorly controlled type 1 diabetes mellitus was thought to induce podocyte injury and thereby contribute to the development of diabetic nephropathy. This manuscript gives an overview of the physiological actions of GH/IGF-1 on the kidneys and the multiple alterations of the GH/IGF-1 system and its consequences in patients with acromegaly, CKD, nephrotic syndrome, and type 1 diabetes mellitus. Finally, the impact of short- and long-term treatment with rhGH/rhIGF-1 on kidney function in patients with kidney diseases will be discussed.
Growth in children on kidney replacement therapy: a review of data from patient registries
Authors: Bonthuis Marjolein , Harambat Jérôme , Jager Kitty J. , Vidal Enrico
Published: June 2021

Growth retardation is a major complication in children with chronic kidney disease (CKD) and on kidney replacement therapy (KRT). Conversely, better growth in childhood CKD is associated with an improvement in several hard morbidity–mortality endpoints. Data from pediatric international registries has demonstrated that improvements in the overall conservative management of CKD, the search for optimal dialysis, and advances in immunosuppression and kidney transplant techniques have led to a significant improvement of final height over time. Infancy still remains a critical period for adequate linear growth, and the loss of stature during the first years of life influences final height. Preliminary new original data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association (ESPN/ERA-EDTA) Registry confirm an association between the final height and the height attained at 2 years in children on KRT.
Relationship of irrigated wheat yield with temperature in hot environments of Sudan
Authors: Musa Abuelgasim I. I. , Tsubo Mitsuru , Ali-Babiker Imad-Eldin A. , Iizumi Toshichika , Kurosaki Yasunori , Ibaraki Yasuomi , El-Hag Faisal M. A. , Tahir Izzat S. A. , Tsujimoto Hisashi
Published: June 2021

A negative effect of increasing temperature on wheat production in the coming decades has been projected for Sudan, which is a major wheat producer in Sub-Saharan Africa. Wheat is susceptible to high temperature, so trend analysis of historical yields together with observed temperature is critical for understanding the effect of climate change. The objective of this study was to determine the association between yield of irrigated wheat in hot drylands of Sudan and temperature during the growing season (November–February). Regional-scale yield data in three major wheat-producing areas (Northern State, Gezira State, and Kassala State) in 48 crop seasons (1970/71–2017/18) were used to determine the correlation of yield with maximum (TMAX) and minimum temperatures (TMIN) at representative meteorological stations (Dongola, Wad Medani, and New Halfa, respectively). Frequencies of days with maximum temperature above 35 °C (THD) and minimum temperature above 20 °C (THN) were also used for correlation analysis. In all three areas, regression analysis detected upward trends in the growing-season temperature. The increase in temperature was particularly evident at Dongola, although no such trend has been reported previously. The yields were negatively correlated with the growing-season temperature, particularly THN in Northern State, TMAX in Gezira State, and TMIN in Kassala State. These results confirm that the recent increase in the growing-season temperature might have reduced the yield to some extent in the breadbasket of Sudan.
Fragility curves for Italian URM buildings based on a hybrid method
Authors: Sandoli A. , Lignola G. P. , Calderoni B. , Prota A.
Published: June 2021

A hybrid seismic fragility model for territorial-scale seismic vulnerability assessment of masonry buildings is developed and presented in this paper. The method combines expert-judgment and mechanical approaches to derive typological fragility curves for Italian residential masonry building stock. The first classifies Italian masonry buildings in five different typological classes as function of age of construction, structural typology, and seismic behaviour and damaging of buildings observed following the most severe earthquakes occurred in Italy. The second, based on numerical analyses results conducted on building prototypes, provides all the parameters necessary for developing fragility functions. Peak-Ground Acceleration (PGA) at Ultimate Limit State attainable by each building’s class has been chosen as an Intensity Measure to represent fragility curves: three types of curve have been developed, each referred to mean, maximum and minimum value of PGAs defined for each building class. To represent the expected damage scenario for increasing earthquake intensities, a correlation between PGAs and Mercalli-Cancani-Sieber macroseismic intensity scale has been used and the corresponding fragility curves developed. Results show that the proposed building’s classes are representative of the Italian masonry building stock and that fragility curves are effective for predicting both seismic vulnerability and expected damage scenarios for seismic-prone areas. Finally, the fragility curves have been compared with empirical curves obtained through a macroseismic approach on Italian masonry buildings available in literature, underlining the differences between the methods.
Micro-processes of Moral Normative Engagement with CSR Tensions: The Role of Spirituality in Justification Work
Authors: Shin Hyemi , Vu Mai Chi , Burton Nicholas
Published: June 2021

Although CSR scholarship has highlighted how tensions in CSR implementation are negotiated, little is known about its normative and moral dimension at a micro-level. Drawing upon the economies of worth framework, we explore how spirituality influences the negotiation of CSR tensions at an individual level, and what types of justification work they engage in when experiencing tensions. Our analysis of semi-structured interview data from individuals who described themselves as Buddhist and were in charge of CSR implementations for their organizations shows that spirituality influences how they compromise among competing moral values by identifying two forms of justification work: compartmentalizing work and contextualizing work, which help spiritual practitioners minimize moral dissonance.
Mask then classify: multi-instance segmentation for surgical instruments
Authors: Kurmann Thomas , Márquez-Neila Pablo , Allan Max , Wolf Sebastian , Sznitman Raphael
Published: June 2021

Purpose

The detection and segmentation of surgical instruments has been a vital step for many applications in minimally invasive surgical robotics. Previously, the problem was tackled from a semantic segmentation perspective, yet these methods fail to provide good segmentation maps of instrument types and do not contain any information on the instance affiliation of each pixel. We propose to overcome this limitation by using a novel instance segmentation method which first masks instruments and then classifies them into their respective type.

Methods

We introduce a novel method for instance segmentation where a pixel-wise mask of each instance is found prior to classification. An encoder–decoder network is used to extract instrument instances, which are then separately classified using the features of the previous stages. Furthermore, we present a method to incorporate instrument priors from surgical robots.

Results

Experiments are performed on the robotic instrument segmentation dataset of the 2017 endoscopic vision challenge. We perform a fourfold cross-validation and show an improvement of over 18% to the previous state-of-the-art. Furthermore, we perform an ablation study which highlights the importance of certain design choices and observe an increase of 10% over semantic segmentation methods.

Conclusions

We have presented a novel instance segmentation method for surgical instruments which outperforms previous semantic segmentation-based methods. Our method further provides a more informative output of instance level information, while retaining a precise segmentation mask. Finally, we have shown that robotic instrument priors can be used to further increase the performance.
What matters? The role of values in transformations toward sustainability: a case study of coffee production in Burundi
Authors: Rosenberg Milda Nordbø
Published: June 2021

This paper examines the role of values in transformations toward sustainability. Values, generally defined as what people deem to matter, are increasingly gaining interest in and outside of academia. For example, sustainability aligns with specific values such as dignity, equality, safety, and harmony for people and nature. However, current approaches to values are mind-matter dualistic, and therefore failing to honor the inherently dynamic relations of socio-ecological systems. Drawing on new materialism, I explore values as part of the relations that make this world and propose to consider values as material-discursive practices. Ethnographic fieldwork was done in 2017 with coffee producers in Burundi who aimed to transform production by caring for the coffee and people that grow it. Based on interviews and participatory observation, I present how values were integral to transforming the relational aspects of coffee production. In this study, values of togetherness, care, dignity, and faith were dominant and were found to reconfigure the socio-ecological system of coffee production. I argue that values are inseparable from, and hence co-productive of, the material world that we experience and play a vital role in sustainability transformations.
Ethical Issues around Death and Withdrawal of Life Support in Neonatal Intensive Care
Authors: Pant Stuti
Published: June 2021

Amongst all the traumatic experiences in a human life, death of child is considered the most painful, and has profound and lasting impact on the life of parents. The experience is even more complex when the death occurs within a neonatal intensive care unit, particularly in situations where there have been conflicts associated with decisions regarding the redirection of life-sustaining treatments. In the absence of national guidelines and legal backing, clinicians are faced with a dilemma of whether to prolong life-sustaining therapy even in the most brain-injured infants or allow a discharge against medical advice. Societal customs, vagaries, and lack of bereavement support further complicate the experience for parents belonging to lower socio-economic classes. The present review explores the ethical dilemmas around neonatal death faced by professionals in India, and suggests some ways forward.
Reduced Firing of Nucleus Accumbens Parvalbumin Interneurons Impairs Risk Avoidance in DISC1 Transgenic Mice
Authors: Zhou Xinyi , Wu Bifeng , Liu Wenhao , Xiao Qian , He Wei , Zhou Ying , Wei Pengfei , Zhang Xu , Liu Yue , Wang Jie , He Jufang , Zhang Zhigang , Li Weidong , Wang Liping , Tu Jie
Published: June 2021

A strong animal survival instinct is to approach objects and situations that are of benefit and to avoid risk. In humans, a large proportion of mental disorders are accompanied by impairments in risk avoidance. One of the most important genes involved in mental disorders is disrupted-in-schizophrenia-1 (DISC1), and animal models in which this gene has some level of dysfunction show emotion-related impairments. However, it is not known whether DISC1 mouse models have an impairment in avoiding potential risks. In the present study, we used DISC1-N terminal truncation (DISC1-NTM) mice to investigate risk avoidance and found that these mice were impaired in risk avoidance on the elevated plus maze (EPM) and showed reduced social preference in a three-chamber social interaction test. Following EPM tests, c-Fos expression levels indicated that the nucleus accumbens (NAc) was associated with risk-avoidance behavior in DISC1-NTM mice. In addition, in vivo electrophysiological recordings following tamoxifen administration showed that the firing rates of fast-spiking neurons (FS) in the NAc were significantly lower in DISC1-NTM mice than in wild-type (WT) mice. In addition, in vitro patch clamp recording revealed that the frequency of action potentials stimulated by current injection was lower in parvalbumin (PV) neurons in the NAc of DISC1-NTM mice than in WT controls. The impairment of risk avoidance in DISC1-NTM mice was rescued using optogenetic tools that activated NAcPV neurons. Finally, inhibition of the activity of NAcPV neurons in PV-Cre mice mimicked the risk-avoidance impairment found in DISC1-NTM mice during tests on the elevated zero maze. Taken together, our findings confirm an impairment in risk avoidance in DISC1-NTM mice and suggest that reduced excitability of NAcPV neurons is responsible.
Personalized, Evidence-Informed Training Plans and Exercise Prescriptions for Performance, Fitness and Health
Authors: Wackerhage Henning , Schoenfeld Brad J.
Published: June 2021

A training plan, or an exercise prescription, is the point where we translate sport and exercise science into practice. As in medicine, good practice requires writing a training plan or prescribing an exercise programme based on the best current scientific evidence. A key issue, however, is that a training plan or exercise prescription is typically a mix of many interacting interventions (e.g. exercises and nutritional recommendations) that additionally change over time due to periodisation or tapering. Thus, it is virtually impossible to base a complex long-term training plan fully on scientific evidence. We, therefore, speak of evidence-informed training plans and exercise prescriptions to highlight that only some of the underlying decisions are made using an evidence-based decision approach. Another challenge is that the adaptation to a given, e.g. endurance or resistance training programme is often highly variable. Until biomarkers for trainability are identified, we must therefore continue to test athletes, clients, or patients, and monitor training variables via a training log to determine whether an individual sufficiently responds to a training intervention or else re-plan. Based on these ideas, we propose a subjective, pragmatic six-step approach that details how to write a training plan or exercise prescription that is partially based on scientific evidence. Finally, we advocate an athlete, client and patient-centered approach whereby an individual’s needs and abilities are the main consideration behind all decision-making. This implies that sometimes the most effective form of training is eschewed if the athlete, client or patient has other wishes.
Multi-criteria healthcare waste disposal location selection based on Fermatean fuzzy WASPAS method
Authors: Mishra Arunodaya Raj , Rani Pratibha
Published: June 2021

Medical services inevitably generate healthcare waste (HCW) that may become hazardous to healthcare staffs, patients, the population, and the atmosphere. In most of the developing countries, HCW disposal management has become one of the fastest-growing challenges for urban municipalities and healthcare providers. Determining the location for HCW disposal centers is a relatively complex process due to the involvement of various alternatives, criteria, and strict government guidelines about the disposal of HCW. The objective of the paper is to introduce the WASPAS (weighted aggregated sum product assessment) method with Fermatean fuzzy sets (FFSs) for the HCW disposal location selection problem. This method combines the score function, entropy measure, and classical WASPAS approach within FFSs context. Next, a combined procedure using entropy and score function is proposed to estimate the criteria weights. To do this, a novel score function with its desirable properties and some entropy measures are introduced under the FFSs context. Further, an illustrative case study of the HCW disposal location selection problem on FFSs is established, which evidences the practicality and efficacy of the developed approach. Comparative discussion and sensitivity analysis are made to monitor the permanence of the introduced framework. The final results approve that the proposed methodology can effectively handle the ambiguity and inaccuracy in the decision-making procedure of HCW disposal location selection.
Empowering Growth in Pakistan?
Authors: Siegmann Karin Astrid , Majid Hadia
Published: June 2021

The SDGs’ commitment to inclusive growth reflects an increasing international concern with the inclusiveness of macro-economic development. Yet, although research underscores that economic growth is not gender-neutral, gender dimensions remain a footnote to these debates. This article explores the connection between growth performance and gender inequalities in the case of Pakistan. The country’s macro-economic performance has been characterised as a case of ‘growth without development’. More specifically, severe gender inequalities and women’s marginalisation in international comparison have persisted even in phases of high GDP growth. This paradoxical situation offers a fertile context for the analysis of how empowering macro-economic growth has been and can be for women. We investigate how empowering growth has been for women in Pakistan by exploring aggregate data on sectoral growth and gendered employment. Our analysis does not suggest the straightforward win–win for growth and women’s empowerment espoused in Pakistan’s national policy vision. Rather, we find that women’s employment is precarious—women are largely viewed as secondary earners engaging in distress sale of labour.
Spontaneous Eye Blinks Predict Executive Functioning in Seniors
Authors: Buitenweg Jessika I. V. , Murre Jaap M. J. , Ridderinkhof K. Richard
Published: June 2021

As the world’s population is aging rapidly, cognitive training is an extensively used approach to attempt improvement of age-related cognitive functioning. With increasing numbers of older adults required to remain in the workforce, it is important to be able to reliably predict future functional decline, as well as the individual advantages of cognitive training. Given the correlation between age-related decline and striatal dopaminergic function, we investigated whether eye blink rate (EBR), a non-invasive, indirect indicator of dopaminergic activity, could predict executive functioning (response inhibition, switching and working memory updating) as well as trainability of executive functioning in older adults. EBR was collected before and after a cognitive flexibility training, cognitive training without flexibility, or a mock training. EBR predicted working memory updating performance on two measures of updating, as well as trainability of working memory updating, whereas performance and trainability in inhibition and switching tasks could not be predicted by EBR. Our findings tentatively indicate that EBR permits prediction of working memory performance in older adults. To fully interpret the relationship with executive functioning, we suggest future research should assess both EBR and dopamine receptor availability among seniors.
In luck we trust: Capturing the diversity bonus through random selection
Authors: Liu Chengwei
Published: June 2021

Complex tasks often cannot be addressed with expertise, but instead by assembling a diverse cognitive repertoire in teams. In such cases, engaging diversity may enhance performance. Yet various behavioral and social limits often deter organizations from recognizing or integrating valuable diversity. I argue that random selection is an undervalued tool for capturing the diversity bonus because it helps address: (1) the paradox of merit, by avoiding fruitless deliberation; (2) biased reasoning, by deciding on the basis of no reason; and (3) learning traps, by discovering self-confirming false beliefs. More generally, incorporating random selection in organizational design can generate a less-is-more effect: deciding by blind luck means exercising less control over outcomes but achieving more by saving time and resources, as well as detecting and sanitizing biased reasons.
CO2 and Radon Emissions as Precursors of Seismic Activity
Authors: D’Incecco Simone , Petraki Ermioni , Priniotakis Georgios , Papoutsidakis Michail , Yannakopoulos Panayiotis , Nikolopoulos Dimitrios
Published: June 2021

This paper reports a review on the relationship between seismic activity and the emissions of CO2and radon. Direct, indirect and sampling methods are mainly employed to measure CO2flux and concentration in seismic areas. The accumulation chamber technique is the mostly used in the literature. Radon gas emission in seismic areas can be considered as a short-term pre-seismic precursor. The study and the measurement of radon gas activity prior to earthquakes can be performed through active techniques, with the use of high-precision active monitors and through passive techniques with the use of passive detectors. Several investigators report models to explain the anomalous behavior of in-earth fluid gasses prior to earthquakes. Models are described and discussed.
Application of lung microphysiological systems to COVID-19 modeling and drug discovery: a review
Authors: Sun Argus M. , Hoffman Tyler , Luu Bao Q. , Ashammakhi Nureddin , Li Song
Published: June 2021

There is a pressing need for effective therapeutics for coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The process of drug development is a costly and meticulously paced process, where progress is often hindered by the failure of initially promising leads. To aid this challenge, in vitro human microphysiological systems need to be refined and adapted for mechanistic studies and drug screening, thereby saving valuable time and resources during a pandemic crisis. The SARS-CoV-2 virus attacks the lung, an organ where the unique three-dimensional (3D) structure of its functional units is critical for proper respiratory function. The in vitro lung models essentially recapitulate the distinct tissue structure and the dynamic mechanical and biological interactions between different cell types. Current model systems include Transwell, organoid and organ-on-a-chip or microphysiological systems (MPSs). We review models that have direct relevance toward modeling the pathology of COVID-19, including the processes of inflammation, edema, coagulation, as well as lung immune function. We also consider the practical issues that may influence the design and fabrication of MPS. The role of lung MPS is addressed in the context of multi-organ models, and it is discussed how high-throughput screening and artificial intelligence can be integrated with lung MPS to accelerate drug development for COVID-19 and other infectious diseases.
A Review of Verification and Validation for Space Autonomous Systems
Authors: Cardoso Rafael C. , Kourtis Georgios , Dennis Louise A. , Dixon Clare , Farrell Marie , Fisher Michael , Webster Matt
Published: June 2021

Purpose of Review

The deployment of hardware (e.g., robots, satellites, etc.) to space is a costly and complex endeavor. It is of extreme importance that on-board systems are verified and validated through a variety of verification and validation techniques, especially in the case of autonomous systems. In this paper, we discuss a number of approaches from the literature that are relevant or directly applied to the verification and validation of systems in space, with an emphasis on autonomy.

Recent Findings

Despite advances in individual verification and validation techniques, there is still a lack of approaches that aim to combine different forms of verification in order to obtain system-wide verification of modular autonomous systems.

This systematic review of the literature includes the current advances in the latest approaches using formal methods for static verification (model checking and theorem proving) and runtime verification, the progress achieved so far in the verification of machine learning, an overview of the landscape in software testing, and the importance of performing compositional verification in modular systems. In particular, we focus on reporting the use of these techniques for the verification and validation of systems in space with an emphasis on autonomy, as well as more general techniques (such as in the aeronautical domain) that have been shown to have potential value in the verification and validation of autonomous systems in space.
Grid cyber security: secure by design, continuous threat monitoring, effective incident response and board oversight
Authors: Geach Dale
Published: June 2021

Grids are possibly the highest expression of engineering serving society. From the aqueducts created in the sixth century BCE to the modern era birth of gas utilities in the 1820s, followed by electricity generation and distribution grids in the 1880s and the computer information-sharing age kicking off in the 1960s, we have been creating distribution infrastructure.

Grids are possibly the highest expression of engineering serving society. We have lots of infrastructure, spanning generations of engineering and technology, still in service.

This presents a problem as there are many who see these grids as vulnerable and high-value targets. Dale Geach of Siemens UK examines where the weaknesses lie and how they have already been exploited. As grid operators seek the huge benefits of modernising grid operations, it's important that they adopt a secure-by-design network with continuous threat detection and watertight response plans.
International Law and the Politics of History
Authors: Orford Anne
Published: June 2021

As the future of international law has become a growing site of struggle within and between powerful states, debates over the history of international law have become increasingly heated. International Law and the Politics of History explores the ideological, political, and material stakes of apparently technical disputes over how the legal past should be studied and understood. Drawing on a deep knowledge of the history, theory, and practice of international law, Anne Orford argues that there can be no impartial accounts of international law's past and its relation to empire and capitalism. Rather than looking to history in a doomed attempt to find a new ground for formalist interpretations of what past legal texts really mean or what international regimes are really for, she urges lawyers and historians to embrace the creative role they play in making rather than finding the meaning of international law.
Kings as Judges
Authors: Boucoyannis Deborah
Published: June 2021

How did representative institutions become the central organs of governance in Western Europe? What enabled this distinctive form of political organization and collective action that has proved so durable and influential? The answer has typically been sought either in the realm of ideas, in the Western tradition of individual rights, or in material change, especially the complex interaction of war, taxes, and economic growth. Common to these strands is the belief that representation resulted from weak ruling powers needing to concede rights to powerful social groups. Boucoyannis argues instead that representative institutions were a product of state strength, specifically the capacity to deliver justice across social groups. Enduring and inclusive representative parliaments formed when rulers could exercise power over the most powerful actors in the land and compel them to serve and, especially, to tax them. The language of rights deemed distinctive to the West emerged in response to more effectively imposed collective obligations, especially on those with most power.
Judicialization of the Sea: Bargaining in the Shadow of UNCLOS
Authors: Mitchell Sara McLaughlin , Owsiak Andrew P.
Published: June 2021

Based on a comprehensive empirical analysis of maritime disputes during the twentieth century, this Article argues that international courts cast a shadow that markedly changes bargaining by potential litigating states. In particular, the filing of optional declarations under Article 287 of UNCLOS increases states’ use of non-binding methods of dispute settlement, and the Article theorizes that this occurs because the declarations credibly threaten court involvement and provide more information about likely litigation outcomes. The Article's central finding is that states that file Article 287 declarations have fewer maritime claims, more peaceful negotiations, and less need for judicial dispute settlement.
A Sensibilist Explanation of Imaginative Resistance
Authors: Franzén Nils
Published: June 2021

This article discusses why it is the case that we refuse to accept strange evaluative claims as being true in fictions, even though we are happy to go along with other types of absurdities in such contexts. For instance, we would refuse to accept the following statement as true, even in the context of a fiction: (i) In killing her baby, Giselda did the right thing; after all, it was a girl.

This article offers a sensibilist diagnosis of this puzzle, inspired by an observation first made by David Hume. According to sensibilism, the way we feel about things settles their evaluative properties. Thus, when confronted with a fictional scenario where the configuration of non-evaluative facts and properties is relevantly similar to the actual world, we refuse to go along with evaluative properties being instantiated according to a different pattern. It is the attitudes we hold in the actual world that fix the extension of evaluative terms, even in nonactual worlds. When engaging with a fiction, we (to some extent) leave our beliefs about what the world is like behind, while taking our emotional attitudes with us into the fiction.

To substantiate this diagnosis, this paper outlines a sensibilist semantics for evaluative terms based on recent discussion regarding predicates of personal taste, and explains how, together with standard assumptions about the nature of fictional discourse, it makes the relevant predictions with respect to engagement with fictions.
Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020
Authors: Gladstone David J. , Lindsay M. Patrice , Douketis James , Smith Eric E. , Dowlatshahi Dar , Wein Theodore , Bourgoin Aline , Cox Jafna , Falconer John B. , Graham Brett R. , Labrie Marilyn , McDonald Lena , Mandzia Jennifer , Ngui Daniel , Pageau Paul , Rodgerson Amanda , Semchuk William , Tebbutt Tammy , Tuchak Carmen , van Gaal Stephen , Villaluna Karina , Foley Norine , Coutts Shelagh , Mountain Anita , Gubitz Gord , Udell Jacob A , McGuff Rebecca , Heran Manraj K.S. , Lavoie Pascale , Poppe Alexandre Y. ,   the Canadian Stroke Consortium
Published: June 2021

The 2020 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for the Secondary Prevention of Stroke includes current evidence-based recommendations and expert opinions intended for use by clinicians across a broad range of settings. They provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations address triage, diagnostic testing, lifestyle behaviors, vaping, hypertension, hyperlipidemia, diabetes, atrial fibrillation, other cardiac conditions, antiplatelet and anticoagulant therapies, and carotid and vertebral artery disease. This update of the previous 2017 guideline contains several new or revised recommendations. Recommendations regarding triage and initial assessment of acute transient ischemic attack (TIA) and minor stroke have been simplified, and selected aspects of the etiological stroke workup are revised. Updated treatment recommendations based on new evidence have been made for dual antiplatelet therapy for TIA and minor stroke; anticoagulant therapy for atrial fibrillation; embolic strokes of undetermined source; low-density lipoprotein lowering; hypertriglyceridemia; diabetes treatment; and patent foramen ovale management. A new section has been added to provide practical guidance regarding temporary interruption of antithrombotic therapy for surgical procedures. Cancer-associated ischemic stroke is addressed. A section on virtual care delivery of secondary stroke prevention services in included to highlight a shifting paradigm of care delivery made more urgent by the global pandemic. In addition, where appropriate, sex differences as they pertain to treatments have been addressed. The CSBPR include supporting materials such as implementation resources to facilitate the adoption of evidence into practice and performance measures to enable monitoring of uptake and effectiveness of recommendations.
Collective Religious Freedom as Associational Action: How Sociological Concepts Can Help Make Sense of the Jurisprudence
Authors: Swiffen Amy
Published: June 2021

Religious freedom is protected by section 2(a) of theCanadian Charter of Rights and Freedoms.Historically, the right has been understood in individual terms, though the courts have acknowledged a collective dimension to religion as expressed in a community of believers. Yet, the precise meaning of collective religious freedom has not been fully fleshed out. The current case law only encompasses a limited range of forms of collective religious expression and does not articulate a coherent theory as to why some collective 2(a) claims succeed while others fail. This paper draws on concepts from interpretive sociology to help clarify the existing jurisprudence and reveal a tension that is otherwise invisible over the status of volition/voluntariness in the collective religious freedom framework. Addressing this tension can help rationalize the Court’s jurisprudence and give resources to critics looking to change how the law encompasses collective religious experience.
An experimental study measuring human annotator categorization agreement on commonsense sentences
Authors: Santos Henrique , Kejriwal Mayank , Mulvehill Alice M. , Forbush Gretchen , McGuinness Deborah L.
Published: June 2021

Developing agents capable of commonsense reasoning is an important goal in Artificial Intelligence (AI) research. Because commonsense is broadly defined, a computational theory that can formally categorize the various kinds of commonsense knowledge is critical for enabling fundamental research in this area. In a recent book, Gordon and Hobbs described such a categorization, argued to be reasonably complete. However, the theory’s reliability has not been independently evaluated through human annotator judgments. This paper describes such an experimental study, whereby annotations were elicited across a subset of eight foundational categories proposed in the original Gordon-Hobbs theory. We avoid bias by eliciting annotations on 200 sentences from a commonsense benchmark dataset independently developed by an external organization. The results show that, while humans agree on relatively concrete categories like time and space, they disagree on more abstract concepts. The implications of these findings are briefly discussed.
Carbonate shelf development and early Paleozoic benthic diversity in Baltica: a hierarchical diversity partitioning approach using brachiopod data
Authors: Penny Amelia M. , Hints Olle , Kröger Björn
Published: June 2021

The Ordovician–Silurian (~485–419 Ma) was a time of considerable evolutionary upheaval, encompassing both great evolutionary diversification and one of the first major mass extinctions. The Ordovician diversification coincided with global climatic cooling and paleocontinental collision, the ecological impacts of which were mediated by region-specific processes including substrate changes, biotic invasions, and tectonic movements. From the Sandbian–Katian (~453 Ma) onward, an extensive carbonate shelf developed in the eastern Baltic paleobasin in response to a tectonic shift to tropical latitudes and an increase in the abundance of calcareous macroorganisms. We quantify the contributions of environmental differentiation and temporal turnover to regional diversity through the Ordovician and Silurian, using brachiopod occurrences from the more shallow-water facies belts of the eastern Baltic paleobasin, an epicontinental sea on the Baltica paleocontinent. The results are consistent with carbonate shelf development as a driver of Ordovician regional diversification, both by enhancing broadscale differentiation between shallow- and deep-marine environments and by generating heterogeneous carbonate environments that allowed increasing numbers of brachiopod genera to coexist. However, temporal turnover also contributed significantly to apparent regional diversity, particularly in the Middle–Late Ordovician.
The sensitivity of Neotoma to climate change and biodiversity loss over the late Quaternary
Authors: Tomé Catalina P. , Lyons S. Kathleen , Newsome Seth D. , Smith Felisa A.
Published: June 2021

The late Quaternary in North America was marked by highly variable climate and considerable biodiversity loss including a megafaunal extinction event at the terminal Pleistocene. Here, we focus on changes in body size and diet in Neotoma (woodrats) in response to these ecological perturbations using the fossil record from the Edwards Plateau (Texas) across the past 20,000 years. Body mass was estimated using measurements of fossil teeth and diet was quantified using stable isotope analysis of carbon and nitrogen from fossil bone collagen. Prior to ca. 7000 cal yr BP, maximum mass was positively correlated to precipitation and negatively correlated to temperature. Independently, mass was negatively correlated to community composition, becoming more similar to modern over time. Neotoma diet in the Pleistocene was primarily sourced from C3 plants, but became progressively more reliant on C4 (and potentially CAM) plants through the Holocene. Decreasing population mass and higher C4/CAM consumption was associated with a transition from a mesic to xeric landscape. Our results suggest that Neotoma responded to climatic variability during the terminal Pleistocene through changes in body size, while changes in resource availability during the Holocene likely led to shifts in the relative abundance of different Neotoma species in the community.
Gospel of Gold: Unearthing Religious Spaces in the Nineteenth-Century American West
Authors: Keegan Brennan
Published: June 2021

Like much of the American West, a history of material conquest and natural resource extraction has precluded sustained study of Montana's religious past. This article uses the case of gold miners in the southwestern corner of the Territory of Montana from 1862 to 1889 to argue for the value of place-based studies of American religious experience. Rather than serving as a restrictive lens, place-based studies reveal religion in process. In Montana gold mining communities, religion was produced and reproduced through the labors of daily life, intricately tied to the limits and possibilities of place, never static or complete. Protestant missionaries adopted alternative tools of evangelism to fit the particularities of place. Those who succeeded found that the “get-saved-quick” approach of revivals appealed to the “get-rich-quick” lifestyle of mining communities. Dominated by male miners, defined by physical toil for uncertain reward, and subject to national economic trends, gold rush communities reveal how religion shifts and transforms in relation to labor, gender relations, and the natural world. Situated at the nexus of mineral extraction and missionary adaptation and appropriation, this article reflects on the ways in which religion in the United States develops across borders and through practical engagement with regional landscapes.
What the blogosphere has to say about adult tonsillectomy
Authors: O'Byrne L M , Salem M , Fenton J E
Published: June 2021

Objectives

Tonsillectomy has generated extensive comment on the internet, but this content has not been examined in a scientific manner. This study aimed to determine what the blogosphere has to say about adult tonsillectomy and to report whether this information can be used to improve post-surgical care.

Methods

The internet was searched to find personal blogs relating to tonsillectomy. A retrospective review of data collected on these blogs was carried out and the blogs were conceptually analysed by the authors.

Results

Fifty blogs were included. Seventy per cent of patients had read blogs prior to their procedure. The average pain score where available was 7.2. Complications occurred in 10 per cent of patients. Only 1 patient (2 per cent) regretted having a tonsillectomy.

Conclusion

It is important for otolaryngologists to stay in tune with the blogosphere as this unregulated and easily accessible source of information is both friend and foe but will ultimately help in pre-operative counselling and post-operative management.
Efficacy of therapist-delivered transdiagnostic CBT for patients with persistent physical symptoms in secondary care: a randomised controlled trial
Authors: Chalder Trudie , Patel Meenal , Hotopf Matthew , Moss-Morris Rona , Ashworth Mark , Watts Katie , David Anthony S. , McCrone Paul , Husain Mujtaba , Garrood Toby , James Kirsty , Landau Sabine
Published: June 2021

Background

Medically unexplained symptoms otherwise referred to as persistent physical symptoms (PPS) are debilitating to patients. As many specific PPS syndromes share common behavioural, cognitive, and affective influences, transdiagnostic treatments might be effective for this patient group. We evaluated the clinical efficacy and cost-effectiveness of a therapist-delivered, transdiagnostic cognitive behavioural intervention (TDT-CBT) plus (+) standard medical care (SMC) v. SMC alone for the treatment of patients with PPS in secondary medical care.

Methods

A two-arm randomised controlled trial, with measurements taken at baseline and at 9, 20, 40- and 52-weeks post randomisation. The primary outcome measure was the Work and Social Adjustment Scale (WSAS) at 52 weeks. Secondary outcomes included mood (PHQ-9 and GAD-7), symptom severity (PHQ-15), global measure of change (CGI), and the Persistent Physical Symptoms Questionnaire (PPSQ).

Results

We randomised 324 patients and 74% were followed up at 52 weeks. The difference between groups was not statistically significant for the primary outcome (WSAS at 52 weeks: estimated difference −1.48 points, 95% confidence interval from −3.44 to 0.48, p = 0.139). However, the results indicated that some secondary outcomes had a treatment effect in favour of TDT-CBT + SMC with three outcomes showing a statistically significant difference between groups. These were WSAS at 20 weeks (p = 0.016) at the end of treatment and the PHQ-15 (p = 0.013) and CGI at 52 weeks (p = 0.011).

Conclusion

We have preliminary evidence that TDT-CBT + SMC may be helpful for people with a range of PPS. However, further study is required to maximise or maintain effects seen at end of treatment.
Parental suicide attempts and offspring's risk of attempting or dying by suicide: does the timing of a parental suicide attempt matter?
Authors: Ortin-Peralta Ana , Keski-Säntti Markus , Gissler Mika , Veijola Juha , Sourander Andre , Duarte Cristiane S.
Published: June 2021

Background

Studies on the transmission of suicide risk have focused on parental history of suicide attempts (SAs), overlooking when the attempt happened. This study examined how the offspring's risk of attempting or dying by suicide varied by the timing of a first parental SA and the sex of the parent who attempted suicide.

Methods

Participants were 59 469 members of the 1987 Finnish Birth Cohort. The Finnish Hospital Discharge and Cause of Death Registers were the sources for parental and offspring SAs and offspring suicide. Timing of parental SA was coded as before (pre-pregnancy and pregnancy) and after the child's birth [infant/toddler years (0–2 years), childhood (3–11 years), adolescence (12–17 years), and young adulthood (18–26 years)].

Results

In the multivariate models, having a parent who attempted suicide increased the offspring's risk of attempting suicide (odds ratio (OR) = 1.77, 95% confidence interval (CI) 1.39–2.25), but not of dying by suicide. Compared to unexposed offspring, those exposed after child's birth were at higher risk of attempting suicide (OR = 1.90, 95% CI 1.46–2.47), specifically when the parent attempted during offspring's childhood, adolescence, and young adulthood. A first maternal SA increased offspring's risk of attempting suicide regardless of the timing.

Conclusions

The impact of a parental SA on offspring's risk of attempting suicide differed depending on the timing and sex of the parent who attempted suicide, suggesting that the transmission of suicide risk may occur through genetic as well as environmental factors. Our findings call for an intergenerational approach in suicide risk assessment.
HOW TO REPORT AND MONITOR THE PERFORMANCE OF WAITING LIST MANAGEMENT
Authors: Torkki Markus , Linna Miika , Seitsalo Seppo , Paavolainen Pekka
Published: June 2021

Objectives: Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management.

Methods: There were 1,774 waiting list patients for hallux valgus or varicose vein surgery or sterilization. The waiting time distributions of patients receiving surgery and of patients still waiting for an operation are presented in column charts. The charts are compared with two model charts. One model chart presents a high queue discipline (first in—first out) and another a poor queue discipline (random) queue.

Results: There were significant differences in waiting list management across hospitals and patient categories. Examples of a poor queue discipline were found in queues for hallux valgus and varicose vein operations.

Conclusions: A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.
A Practical-Prophetic-Pastoral Exemplar: An Extended Homily on the Ministry and Writings of Percy Dearmer
Authors: Percy Martyn
Published: June 2021

An extended homily or meditation that focuses on some aspects of the life and work of Percy Dearmer. Dearmer, in his pastoral attentiveness, irenic prophetic action, and practical Christianity, sought to continue a distinctive English Anglican tradition of faithfully fulfilling his vocation through a richly incarnational ministry.