bluuebunny/crossref_metadata_2025 huggingface dataset:
Deterrence by Punishment or Denial? The eFP Case
Authors: Noll Jörg , Bojang Osman , Rietjens Sebastiaan
Published: December 2020

In 2017 NATO initiated Enhanced Forward Presence (eFP) in the Baltics to deter Russia. While most studies analyse eFP from the perspective of NATO or the troop contributing countries, this chapter addresses the question how the host nations, i.e. in this contribution Estonia, Latvia and Lithuania, perceive the deterrence strategy underlying eFP as well as their own strategies. In doing this, the chapter emphasizes how strategic culture influences the Baltic countries’ behaviour towards deterrence. We found that in Estonia perspectives on eFP were ambiguous. While official documents reflect the official NATO narrative based on deterrence by punishment other sources stress the illusion, expectation or aspiration of deterrence by denial. In Lithuania, documents, officials and experts emphasize deterrence by denial as opposed to deterrence by punishment. Latvia considers the strategy behind eFP as deterrence by punishment. The strategic cultures, the history and threat perceptions of the Baltic states explain these differences to a large extent. In particular the presence of Russophone minorities in Estonia and Latvia, lead to some reluctance in fully embracing NATO’s strategy, while at the same time both countries prepare to counter Russia’s threat with their allies.
The Essence of Cross-Domain Deterrence
Authors: Sweijs Tim , Zilincik Samuel
Published: December 2020

Both deterrence theory and deterrence practice are evolving to address contemporary strategic challenges. In the military domain, states progressively integrate and synchronise military operations. Outside of it, they exploit grey zone strategies that combine different instruments of influence across multiple domains. These developments are now giving birth to a new wave of thinking about cross domain deterrence (CDD), what it precisely entails, and what favouring conditions are necessary for it to be effective. This chapter situates CDD in the context of today’s challenges, and identifies the prerequisites for these favouring conditions based on a review of a rather diverse body of literature. It finds that one strand of that literature predominantly focuses on practical and technical prerequisites in order for CDD to be effective, leaving the framework of traditional deterrence theory intact. It also finds a second strand that holds that the nature of today’s challenges requires more than mere innovation in application. The ideas about deterrence proposed by this second strand are expanding on common understandings of deterrence to the extent that deterrence is no longer only about fear nor about convincing opponents to refrain from certain behaviour. The conclusion summarises the findings and elaborates their implications for theory and practice.
Molecular insights into symbiosis—mapping sterols in a marine flatworm-algae-system using high spatial resolution MALDI-2-MS imaging with ion mobility separation
Authors: Bien Tanja , Hambleton Elizabeth A. , Dreisewerd Klaus , Soltwisch Jens
Published: December 2020

Waminoa sp. acoel flatworms hosting Symbiodiniaceae and the related Amphidinium dinoflagellate algae are an interesting model system for symbiosis in marine environments. While the host provides a microhabitat and safety, the algae power the system by photosynthesis and supply the worm with nutrients. Among these nutrients are sterols, including cholesterol and numerous phytosterols. While it is widely accepted that these compounds are produced by the symbiotic dinoflagellates, their transfer to and fate within the sterol-auxotrophic Waminoa worm host as well as their role in its metabolism are unknown. Here we used matrix-assisted laser desorption ionization (MALDI) mass spectrometry imaging combined with laser-induced post-ionization and trapped ion mobility spectrometry (MALDI-2-TIMS-MSI) to map the spatial distribution of over 30 different sterol species in sections of the symbiotic system. The use of laser post-ionization crucially increased ion yields and allowed the recording of images with a pixel size of 5 μm. Trapped ion mobility spectrometry (TIMS) helped with the tentative assignment of over 30 sterol species. Correlation with anatomical features of the worm, revealed by host-derived phospholipid signals, and the location of the dinoflagellates, revealed by chlorophyll a signal, disclosed peculiar differences in the distribution of different sterol species (e.g. of cholesterol versus stigmasterol) within the receiving host. These findings point to sterol species-specific roles in the metabolism of Waminoa beyond a mere source of energy. They also underline the value of the MALDI-2-TIMS-MSI method to future research in the spatially resolved analysis of sterols.
Echinocandins: structural diversity, biosynthesis, and development of antimycotics
Authors: Hüttel Wolfgang
Published: December 2020

Echinocandins are a clinically important class of non-ribosomal antifungal lipopeptides produced by filamentous fungi. Due to their complex structure, which is characterized by numerous hydroxylated non-proteinogenic amino acids, echinocandin antifungal agents are manufactured semisynthetically. The development of optimized echinocandin structures is therefore closely connected to their biosynthesis. Enormous efforts in industrial research and development including fermentation, classical mutagenesis, isotope labeling, and chemical synthesis eventually led to the development of the active ingredients caspofungin, micafungin, and anidulafungin, which are now used as first-line treatments against invasive mycosis. In the last years, echinocandin biosynthetic gene clusters have been identified, which allowed for the elucidation but also engineering of echinocandin biosynthesis on the molecular level. After a short description of the history of echinocandin research, this review provides an overview of the current knowledge of echinocandin biosynthesis with a special focus of the diverse structural elements, their biosynthetic background, and structure−activity relationships.

Key points

• Complex and highly oxidized lipopeptides produced by fungi.

• Crucial in the design of drugs: side chain, solubility, and hydrolytic stability.

• Genetic methods for engineering biosynthesis have recently become available.
Intra-tumoural lipid composition and lymphovascular invasion in breast cancer via non-invasive magnetic resonance spectroscopy
Authors: Cheung Sai Man , Husain Ehab , Mallikourti Vasiliki , Masannat Yazan , Heys Steven , He Jiabao
Published: December 2020

Objectives

Despite improved survival due to new treatments, the 10-year survival rate in patients with breast cancer is approximately 75%. Lymphovascular invasion (LVI), a prognostic marker independent from histological grade and stage, can only be fully determined at final histological examination. Lipid composition is deregulated in tumour via de novo lipogenesis, with alteration in lipogenic genes in LVI. We hypothesise alteration in lipid composition derived from novel non-invasive spectroscopy method is associated with LVI positivity.

Methods

Thirty female patients (age 39–78) with invasive ductal carcinoma were enrolled, with 13 LVI negative and 17 LVI positive. Saturated, monounsaturated, polyunsaturated fatty acids and triglycerides (SFA, MUFA, PUFA and TRG) were quantified from ex vivo breast tumours freshly excised from patients on a 3 T clinical MRI scanner, and proliferative activity marker Ki-67 and serotonin derived histologically.

Results

There were significantly lower MUFA (p = 0.0189) in LVI positive (median: 0.37, interquartile range (IQR): 0.25–0.64) than negative (0.63, 0.49–0.96). There were significantly lower TRG (p = 0.0226) in LVI positive (1.32, 0.95–2.43) than negative (2.5, 1.92–4.15). There was no significant difference in SFA (p = 0.6009) or PUFA (p = 0.1641). There was no significant correlation between lipid composition against Ki-67 or serotonin, apart from a borderline negative correlation between PUFA and serotonin (r = - 0.3616, p = 0.0496).

Conclusion

Lipid composition might provide a biomarker to study lymphovascular invasion in breast cancer.

Key Points

• Monounsaturated fatty acids in lymphovascular invasion (LVI) positive invasive breast carcinoma were significantly lower than that in LVI negative.

• Triglycerides in LVI positive invasive breast carcinoma were significantly lower than that in LVI negative.

• Lipid composition from MR spectroscopy reflects the rate of de novo lipogenesis and provides a potential biomarker independent from histological grade and stage.
Adhärenz bei der Anti-VEGF-Therapie – Überlegungen und praktische Empfehlungen
Authors: Lommatzsch Albrecht , Eter Nicole , Ehlken Christoph , Lanzl Ines , Kaymak Hakan , Schuster Alexander K. , Ziemssen Focke
Published: December 2020

Hintergrund

Zahlreiche Studien haben eine mangelnde Therapieadhärenz als wichtigen Faktor identifiziert, der einer notwendigen Anzahl von Anti-VEGF-Behandlungen und somit einem besseren funktionellen Ergebnis entgegensteht.

Fragestellung

Der Beitrag diskutiert konkrete Maßnahmen, die das Risiko einer zu späten oder zu seltenen intravitrealen operativen Medikamenteneingabe (IVOM) im Sinne einer Unterbehandlung verringern.

Material und Methode

Im Rahmen einer Expertenrunde wurden relevante Parameter der Therapieadhärenz und Variablen identifiziert. Sinnvolle Abläufe strukturiert und organisatorischen Bereichen zugeordnet.

Ergebnisse

Die Zusammenstellung identifizierter Einflussfaktoren und sinnvoller Maßnahmen (Organisation, Transport, Kommunikation, Motivation) ermöglicht es Behandlern, die eigene Umsetzung der IVOM-Therapie in unterschiedlichen Bereichen zu optimieren. Regelmäßige Monitoring-Maßnahmen können den Umfang von Therapiepausen und -abbrüchen identifizieren. Für konkrete Kennzahlen (IVOM pro Zeitintervall, längstes Pausenintervall, Mindestabdeckung pro Zeit, Verzögerungen) wurde eine Auswirkung auf die Entwicklung der Sehfunktion nachgewiesen. Organisatorische Maßnahmen, die Schulung von Team und Zuweisern, die redundante und iterative Informationsweitergabe an Patienten haben sich in der Erfahrung von Experten bewährt. Die feste Integration dieser Prozesse in bestehende Strukturen wird durch die Arbeit mit Checklisten erleichtert.

Schlussfolgerungen

Eine Optimierung der Abläufe ist oft möglich, um die Adhärenz und somit die funktionellen Ergebnisse zu verbessern. Bisher fehlen jedoch noch interventionelle Studien, wie Adhärenz und Persistenz im deutschen Behandlungssetting erhöht werden.
The summer 2019 basaltic Vulcanian eruptions (paroxysms) of Stromboli
Authors: Giordano G. , De Astis G.
Published: December 2020

Stromboli is an active, open conduit mafic volcano, whose persistent mild Strombolian activity is occasionally punctuated by much stronger explosions, known as paroxysms. During summer 2019, the volcano unexpectedly produced one such paroxysm on July 3, followed by intense explosive and intermittent effusive activity culminating in a second paroxysm on August 28. Visual observations and the analysis of the fall deposits associated with the two paroxysms allowed us to reconstruct ballistic exit velocities of up to 160 m s−1. Plume heights of ~ 8.4 km and 6.4 km estimated for the two events correspond to mass eruption rates of 1.1 × 106 kg s−1 and 3.6 × 105 kg s−1, respectively. This is certainly an underestimate as directional pyroclastic flows into which mass was partitioned immediately formed, triggering small tsunamis at the sea entrance. The mass of ballistic spatters and blocks erupted during the July 3 event formed a continuous cover at the summit of the volcano, with a mass calculated at ~ 1.4 × 108 kg. The distribution of fall deposits of both the July 3 and August 28 events suggests that pyroclasts characterized by terminal fall velocities < 10–20 m s−1 remained fully suspended within the convective region of the plume and did not fall at distances closer than ca 1700 m to the vent. Based on the impulsive, blast-like phenomenology of paroxysms as well as the deposit distribution and type, paroxysms are classified as basaltic Vulcanian in style. The evolution of the summer 2019 eruptive events was not properly captured within the framework of the alert level system which is focused on tsunamigenic processes, and this is discussed so as to provide elements for the implementation of the reference scenarios and an upgrade of the system to take into account such events. In particular we find that, although still largely unpredictable, at least at operational time scales, and not necessarily tsunamigenic, Vulcanian eruptions and the subsequent evolution of the eruptive phenomena should be considered for the alert level system. This serves as a warning to the implementation of alert systems where the unexpected needs to be taken into account, even at systems that are believed to be relatively “predictable” as is the case at many persistently active, open vent mafic systems.
Perceptions on the management of varices and on the use of albumin in patients with cirrhosis among GI specialists in Austria
Authors: Pfisterer Nikolaus , Schmidbauer Caroline , Riedl Florian , Maieron Andreas , Stadlbauer Vanessa , Hennlich Barbara , Schwarzer Remy , Puespoek Andreas , Bucsics Theresa , Effenberger Maria , Bota Simona , Gschwantler Michael , Peck-Radosavljevic Markus , Mandorfer Mattias , Madl Christian , Trauner Michael , Reiberger Thomas
Published: December 2020

Background

Portal hypertension (PH) causes severe complications in patients with liver cirrhosis, such as variceal bleeding and ascites; however, data on the knowledge and perceptions on guideline recommendations for the management of varices and the use of albumin is scarce.

Methods

We designed two structured surveys on (i) the management of varices and (ii) the use of albumin for Austrian physicians of specialized Gastro-Intestinal (GI) centers. The interviewed physicians were confronted spontaneously and provided ad hoc responses to the questionnaire.

Results

In total, 158 surveys were completed. Interestingly, many specialists (30%) would recommend a follow-up gastroscopy after 1 year in patients with compensated cirrhosis without varices (i.e., overtreatment). For small varices, 81.5% would use non-selective beta blockers (NSBB) for primary prophylaxis (PP). For PP in patients with large varices, endoscopic band ligation (EBL) plus NSBB was preferred by 51.4% (i.e., overtreatment). Knowledge on the indication criteria for early TIPS (transjugular intrahepatic portosystemic shunt) was reported by 54.3%, but only 20% could report these criteria correctly. The majority (87.1%) correctly indicated a preference to use NSBB and EBL for secondary prophylaxis (SP).

The majority of participating gastroenterologists reported no restrictions on the use of albumin (89.8%) in their hospitals. Of the interviewed specialists, 63.6% would use albumin in patients with SBP; however, only 11.4% would use the doses recommended by guidelines. The majority of specialists indicated using albumin at the recommended doses for hepatorenal syndrome (HRS-AKI, 86.4%) and for large volume paracentesis (LVP, 73.3%). The individual responses regarding albumin use for infections/sepsis, hyponatremia, renal impairment, and encephalopathy were heterogeneous.

Conclusion

The reported management of PH and varices is mostly adherent to guidelines, but endoscopic surveillance in patients without varices is too intense and EBL is overused in the setting of PP. Knowledge on the correct use of early TIPS must be improved among Austrian specialists. Albumin use is widely unrestricted in Austria; however, albumin is often underdosed in established indications.
Long-term (> 10 years) clinical outcomes of instrumented posterolateral fusion for spondylolisthesis
Authors: Lehr A. M. , Delawi D. , van Susante J. L. C. , Verschoor N. , Wolterbeek N. , Oner F. C. , Kruyt M. C.
Published: December 2020

Purpose

Despite the rapid increase in instrumented spinal fusions for a variety of indications, most studies focus on short-term fusion rates. Long-term clinical outcomes are still scarce and inconclusive. This study investigated clinical outcomes > 10 years after single-level instrumented posterolateral spinal fusion for lumbar degenerative or isthmic spondylolisthesis with neurological symptoms.

Methods

Cross-sectional long-term follow-up among the Dutch participants of an international multicenter randomized controlled trial comparing osteogenic protein-1 with autograft. Clinical outcomes were assessed using the Oswestry Disability Index (ODI), EQ-5D-3L and visual analogue scale (VAS) for leg and back pain, as well as questions on satisfaction with treatment and additional surgery.

Results

The follow-up rate was 73% (41 patients). At mean 11.8 (range 10.1–13.7) years after surgery, a non-significant deterioration of clinical outcomes compared to 1-year follow-up was observed. The mean ODI was 20 ± 19, mean EQ-5D-3L index score 0.784 ± 0.251 and mean VAS for leg and back pain, respectively, 34 ± 33 and 31 ± 28. Multiple regression showed that diagnosis (degenerative vs. isthmic spondylolisthesis), graft type (OP-1 vs. autograft) and 1-year fusion status (fusion vs. no fusion) were not predictive for the ODI at long-term follow-up (p = 0.389). Satisfaction with treatment was excellent and over 70% of the patients reported lasting improvement in back and/or leg pain. No revision surgeries for non-union were reported.

Conclusion

This study showed favourable clinical outcomes > 10 years after instrumented posterolateral spinal fusion and supports spondylolisthesis with neurological symptoms as indication for fusion surgery.
Differentiating influenza from COVID-19 in patients presenting with suspected sepsis
Authors: D’Onofrio Valentino , Van Steenkiste Eveline , Meersman Agnes , Waumans Luc , Cartuyvels Reinoud , Van Halem Karlijn , Messiaen Peter , Gyssens Inge C.
Published: December 2020

There is a need for a quick assessment of severely ill patients presenting to the hospital. The objectives of this study were to identify clinical, laboratory and imaging parameters that could differentiate between influenza and COVID-19 and to assess the frequency and impact of early bacterial co-infection. A prospective observational cohort study was performed between February 2019 and April 2020. A retrospective cohort was studied early in the COVID-19 pandemic. Patients suspected of sepsis with PCR-confirmed influenza or SARS-CoV-2 were included. A multivariable logistic regression model was built to differentiate COVID-19 from influenza. In total, 103 patients tested positive for influenza and 110 patients for SARS-CoV-2, respectively. Hypertension (OR 6.550), both unilateral (OR 4.764) and bilateral (OR 7.916), chest X-ray abnormalities, lower temperature (OR 0.535), lower absolute leukocyte count (OR 0.857), lower AST levels (OR 0.946), higher LDH (OR 1.008), higher ALT (OR 1.044) and higher ferritin (OR 1.001) were predictive of COVID-19. Early bacterial co-infection was more frequent in patients with influenza (10.7% vs. 2.7%). Empiric antibiotic usage was high (76.7% vs. 84.5%). Several factors determined at presentation to the hospital can differentiate between influenza and COVID-19. In the future, this could help in triage, diagnosis and early management. Clinicaltrial.gov Identifier: NCT03841162
Development of a data-driven model for spatial and temporal shallow landslide probability of occurrence at catchment scale
Authors: Bordoni M. , Vivaldi V. , Lucchelli L. , Ciabatta L. , Brocca L. , Galve J. P. , Meisina C.
Published: December 2020

A combined method was developed to forecast the spatial and the temporal probability of occurrence of rainfall-induced shallow landslides over large areas. The method also allowed to estimate the dynamic change of this probability during a rainfall event. The model, developed through a data-driven approach basing on Multivariate Adaptive Regression Splines technique, was based on a joint probability between the spatial probability of occurrence (susceptibility) and the temporal one. The former was estimated on the basis of geological, geomorphological, and hydrological predictors. The latter was assessed considering short-term cumulative rainfall, antecedent rainfall, soil hydrological conditions, expressed as soil saturation degree, and bedrock geology. The predictive capability of the methodology was tested for past triggering events of shallow landslides occurred in representative catchments of Oltrepò Pavese, in northern Italian Apennines. The method provided excellently to outstanding performance for both the really unstable hillslopes (area under ROC curve until 0.92, true positives until 98.8%, true negatives higher than 80%) and the identification of the triggering time (area under ROC curve of 0.98, true positives of 96.2%, true negatives of 94.6%). The developed methodology allowed us to obtain feasible results using satellite-based rainfall products and data acquired by field rain gauges. Advantages and weak points of the method, in comparison also with traditional approaches for the forecast of shallow landslides, were also provided.
In vivo comparison of braided (Accero) and laser-cut intracranial stents (Acclino, Credo): evaluation of vessel responses at subacute and mid-term follow-up in a rabbit model
Authors: Mühl-Benninghaus Ruben , Tomori Toshiki , Krajewski Stefanie , Dietrich Philipp , Simgen Andreas , Yilmaz Umut , Brochhausen Christoph , Kießling Mara , Reith Wolfgang , Cattaneo Giorgio
Published: December 2020

This study aimed to investigate in vivo two stent technologies, with particular emphasis on thrombogenicity and inflammatory vessel remodeling processes. The micro-stents tested in this study were developed for intracranial aneurysm treatment. In our study twelve, New Zealand white rabbits were divided into two groups: 18 laser-cut stents (LCS) and 18 braided stents (BS) were impanated without admiration of antiplatelet medication. Three stents were implanted into each animal in the common carotid artery, subclavian artery, and abdominal aorta. Digital subtraction angiography was performed before and after stent implantation and at follow-up for the visualization of occurring In-stent thromboembolism or stenosis. The Stents were explanted for histopathological examination at two different timepoints, after 3 and 28 days. Angiographically neither in-stent thrombosis nor stenosis for both groups was seen. There was a progressive increase in the vessel diameter, which was more pronounced for BS than for LCS. We detected a higher number of thrombi adherent to the foreign material on day 3 for BS. On day 3, the neointima was absent, whereas the complete formation observed was on day 28. There was no significant difference between both groups regarding the thickness of the neointima. The in vivo model of our study enabled the evaluation of blood and vessel reactions for two different stent technologies. Differences in vessel dimension and tissue around the stents were observed on day 28. Histological analysis on day 3 enabled the assessment of thrombotic reactions, representing an important complementary result in long-term studies.
States in the decomposition of verbal predicates
Authors: Spathas Giorgos , Michelioudakis Dimitris
Published: December 2020

This paper proposes a new diagnostic for the detection of stative sub-events in the decomposition of verbal predicates. The diagnostic is based on a certain type of presupposition triggered by additive operators like Greekke‘also’, which we call Stative Presuppositions. It is argued that the generation of such Stative Presuppositions requires the existence of a syntactically accessible constituent that denotes a predicate of states that additive operators can take scope over. We investigate the distribution of Stative Presuppositions and observe that not all verbs that support inferences to a result state give rise to them. Based on this distribution we argue for a non-uniform analysis of result verbs; whereas some verbs require an event-decompositional analysis, others are better captured by scalar- and incrementality-based analyses. We cast our analysis in the framework of Distributed Morphology and propose to explain non-uniformity based on how different types of verbal roots interact with verbal functional material. Moreover, treating roots as the locus of encyclopedic information explains lexical variation in the generation of Stative Presuppositions within sub-classes of result verbs. We strengthen our conclusions by considering and rejecting alternative syntactic and semantic mechanisms for generating Stative Presuppositions. We conclude that the availability of Stative Presuppositions with additive operators is currently the most reliable diagnostic for the detection of syntactically accessible result states in verbal decomposition.
The Child’s Right to a Voice
Authors: Archard David , Uniacke Suzanne
Published: December 2020

This article provides a philosophical analysis of a putative right of the child to have their expressed views considered in matters that affect them. Article 12 of the United Nations Convention on the Rights of the Child 1989 is an influential and interesting statement of that right. The article shows that the child’s ‘right to a voice’ is complex. Its complexity lies in the problem of contrasting an adult’s normative power of choice with a child’s weighted views, in the various senses in which we might consider the child’s views, and in the questions of how to weight those views and how their weighting makes a practical difference in coming to a decision. In so doing we criticise other accounts that simply regard a child’s views as having consultative value. We also make better sense of how we might weight a child’s views. The philosophical issues addressed in the article carry implications for how we might understand Article 12 that are not satisfactorily identified and addressed in the voluminous literature on Article 12 within childhood studies. These issues also have implications for how we might understand the distinction between adults and children in respect of powers of personal choice. We conclude by emphasising the importance and value of the right that Article 12 seeks to formally identify.
Aggregate Public-Private Remuneration Patterns in South Africa
Authors: Wörgötter Andreas , Nomdebevana Sihle
Published: December 2020

This paper investigates the public-private remuneration patterns in South Africa with time-series methods for the first time since the introduction of an inflation-targeting framework in 2000. Co-integration tests and analysis confirm that there is a stable, long-run relationship between nominal and real remuneration in the public and private sector. The adjustment to the deviations from this long-run relationship is strong and significant for public-sector remuneration, while private-sector wages neither respond to deviations from the long-run relationship nor lagged changes in public-sector remuneration. The causal direction from private- to public-sector remuneration does not change if real earnings are calculated with the gross domestic product deflator. This is confirmed by simple Granger-causality tests.
Comparison between the 10- and the 30-s-long Wingate Anaerobic Test in summer Paralympic athletes with a lower limb impairment
Authors: Cavedon Valentina , Rosponi A. , Alviti F. , De Angelis M. , Guerra E. , Rodio A. , Di Giacinto B. , Milanese C. , Bernardi M.
Published: December 2020

Background

The 30-s-long Wingate Anaerobic Test (WAnT_30s) has some limitations in high-level athletes. A shorter version might be helpful for both clinical applications and performance assessment. The comparison between the traditional WAnT_30s and a shorter version has never been carried out yet in Paralympic athletes.

Aim

To assess if a 10-s-long Wingate Anaerobic Test (WAnT_10s) could be used to accurately assess and predict the anaerobic components of physical fitness as an alternative to the traditional WAnT_30s in male Paralympic athletes.

Methods

Forty-four trained male Paralympic Athletes grouped by severity of locomotor impairment completed the WAnT_30s and the WAnT_10s with an arm cranking ergometer. Differences between mean and peak power achieved throughout both WAnTs were analysed using a mixed-design analysis of variance and predictivity was assessed by stepwise linear regression analysis.

Results

In the whole sample, peak power values were similar (P > 0.005) in the two tests and the WAnT_10s mean power was significantly higher than that in the WAnT_30s (P < 0.005). Finally, the mean power measured during WAnT_30s showed high level of predictability from mean power measured during WAnT_10s and the Functional class (adjustedR2 = 0.906;P < 0.001).

Conclusion

The WAnT_10s is accurate to assess peak power, is definitively appropriate to evaluate the alactic anaerobic metabolism and seems able to predict the mean power as traditionally evaluated through a WAnT_30s in male Paralympic Athletes. Thus, it can be used to assess the anaerobic components of physical fitness in this athletic population.
Community structure in the World Trade Network based on communicability distances
Authors: Bartesaghi Paolo , Clemente Gian Paolo , Grassi Rosanna
Published: December 2020

In this paper, we investigate the mesoscale structure of the World Trade Network. In this framework, a specific role is assumed by short- and long-range interactions, and hence by any suitably defined network-based distance between countries. Therefore, we identify clusters through a new procedure that exploits Estrada communicability distance and the vibrational communicability distance, which turn out to be particularly suitable for catching the inner structure of the economic network. The proposed methodology aims at finding the distance threshold that maximizes a specific quality function defined for general metric spaces. Main advantages regard the computational efficiency of the procedure as well as the possibility to inspect intercluster and intracluster properties of the resulting communities. The numerical analysis highlights peculiar relationships between countries and provides a rich set of information that can hardly be achieved within alternative clustering approaches.
Resilience, Hope, and Subjective Happiness Among the Turkish Population: Fear of COVID-19 as a Mediator
Authors: Satici Seydi Ahmet , Kayis Ahmet Rifat , Satici Begum , Griffiths Mark D. , Can Gurhan
Published: December 2020

Psychology deals with not only mental disorders but also psychological strengths within individuals. Psychological strengths will play an important role in struggling with the global novel coronavirus 2019 (COVID-19) pandemic. The present study tested a model concerning the relationship between resilience, hope, and subjective happiness using structural equation modeling to identify the mediating role of fear of COVID-19. A cross-sectional survey was conducted among a convenience sample of 971 Turkish individuals (aged 18 to 74 years) from 75 of 81 cities in Turkey. The survey included the Subjective Happiness Scale, Fear of COVID-19 Scale, Brief Resilience Scale, and the Dispositional Hope Scale, and data were analyzed using structural equation modeling (SEM). The SEM demonstrated an association between resilience–hope and subjective happiness was mediated by fear of COVID-19 (CMIN/df = 2.664, CFI = 0.994, NFI = 0.984, TLI = 0.984, GFI = 0.994, RMSEA = 0.044, SRMR = 0.024, AIC = 81.334, ECVI = 0.084). Resilience had a direct effect and an indirect effect on subjective happiness via fear of COVID-19. Hope also had a direct effect and an indirect effect on subjective happiness via fear of COVID-19. Consequently, in the fight against COVID-19, individuals who are resistant to stress and have a belief that they can find a way to cope can help prevent the fear of COVID-19 and so enhance good mental health.
Derivation of a Clinical Risk Score to Predict 14-Day Occurrence of Hypoxia, ICU Admission, and Death Among Patients with Coronavirus Disease 2019
Authors: Levine David M. , Lipsitz Stuart R. , Co Zoe , Song Wenyu , Dykes Patricia C. , Samal Lipika
Published: December 2020

Background

Uncertainty surrounding COVID-19 regarding rapid progression to acute respiratory distress syndrome and unusual clinical characteristics make discharge from a monitored setting challenging. A clinical risk score to predict 14-day occurrence of hypoxia, ICU admission, and death is unavailable.

Objective

Derive and validate a risk score to predict suitability for discharge from a monitored setting among an early cohort of patients with COVID-19.

Design

Model derivation and validation in a retrospective cohort. We built a manual forward stepwise logistic regression model to identify variables associated with suitability for discharge and assigned points to each variable. Event-free patients were included after at least 14 days of follow-up.

Participants

All adult patients with a COVID-19 diagnosis between March 1, 2020, and April 12, 2020, in 10 hospitals in Massachusetts, USA.

Main Measures

Fourteen-day composite predicting hypoxia, ICU admission, and death. We calculated a risk score for each patient as a predictor of suitability for discharge evaluated by area under the curve.

Key Results

Of 2059 patients with COVID-19, 1326 met inclusion. The 1014-patient training cohort had a mean age of 58 years, was 56% female, and 65% had at least one comorbidity. A total of 255 (25%) patients were suitable for discharge. Variables associated with suitability for discharge were age, oxygen saturation, and albumin level, yielding a risk score between 0 and 55. At a cut point of 30, the score had a sensitivity of 83% and specificity of 82%. The respective c-statistic for the derivation and validation cohorts were 0.8939 (95% CI, 0.8687 to 0.9192) and 0.8685 (95% CI, 0.8095 to 0.9275). The score performed similarly for inpatients and emergency department patients.

Conclusions

A 3-item risk score for patients with COVID-19 consisting of age, oxygen saturation, and an acute phase reactant (albumin) using point of care data predicts suitability for discharge and may optimize scarce resources.
Liquid Air Energy Storage for Decentralized Micro Energy Networks with Combined Cooling, Heating, Hot Water and Power Supply
Authors: She Xiaohui , Zhang Tongtong , Peng Xiaodong , Wang Li , Tong Lige , Luo Yimo , Zhang Xiaosong , Ding Yulong
Published: December 2020

Liquid air energy storage (LAES) has been regarded as a large-scale electrical storage technology. In this paper, we first investigate the performance of the current LAES (termed as a baseline LAES) over a far wider range of charging pressure (1 to 21 MPa). Our analyses show that the baseline LAES could achieve an electrical round trip efficiency (eRTE) above 60% at a high charging pressure of 19 MPa. The baseline LAES, however, produces a large amount of excess heat particularly at low charging pressures with the maximum occurred at ∼1 MPa. Hence, the performance of the baseline LAES, especially at low charging pressures, is underestimated by only considering electrical energy in all the previous research. The performance of the baseline LAES with excess heat is then evaluated which gives a high eRTE even at lower charging pressures; the local maximum of 62% is achieved at ∼4 MPa. As a result of the above, a hybrid LAES system is proposed to provide cooling, heating, hot water and power. To evaluate the performance of the hybrid LAES system, three performance indicators are considered: nominal-electrical round trip efficiency (neRTE), primary energy savings and avoided carbon dioxide emissions. Our results show that the hybrid LAES can achieve a high neRTE between 52% and 76%, with the maximum at ∼5 MPa. For a given size of hybrid LAES (1 MW×8 h), the primary energy savings and avoided carbon dioxide emissions are up to 12.1 MWh and 2.3 ton, respectively. These new findings suggest, for the first time, that small-scale LAES systems could be best operated at lower charging pressures and the technologies have a great potential for applications in local decentralized micro energy networks.
1H, 13C, and 15N backbone chemical shift assignments of the C-terminal dimerization domain of SARS-CoV-2 nucleocapsid protein
Authors: Korn Sophie M. , Lambertz Roderick , Fürtig Boris , Hengesbach Martin , Löhr Frank , Richter Christian , Schwalbe Harald , Weigand Julia E. , Wöhnert Jens , Schlundt Andreas
Published: December 2020

The current outbreak of the highly infectious COVID-19 respiratory disease is caused by the novel coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). To fight the pandemic, the search for promising viral drug targets has become a cross-border common goal of the international biomedical research community. Within the international Covid19-NMR consortium, scientists support drug development against SARS-CoV-2 by providing publicly available NMR data on viral proteins and RNAs. The coronavirus nucleocapsid protein (N protein) is an RNA-binding protein involved in viral transcription and replication. Its primary function is the packaging of the viral RNA genome. The highly conserved architecture of the coronavirus N protein consists of an N-terminal RNA-binding domain (NTD), followed by an intrinsically disordered Serine/Arginine (SR)-rich linker and a C-terminal dimerization domain (CTD). Besides its involvement in oligomerization, the CTD of the N protein (N-CTD) is also able to bind to nucleic acids by itself, independent of the NTD. Here, we report the near-complete NMR backbone chemical shift assignments of the SARS-CoV-2 N-CTD to provide the basis for downstream applications, in particular site-resolved drug binding studies.
Pharmacokinetic considerations in geriatric cancer patients
Authors: Hohenegger Martin
Published: December 2020

Pharmacological anticancer therapy in elderly people has to account for pharmacokinetic aspects in view of age-related changes in organ function and disease-related alterations. Age-related changes in organ function might still be physiological and have to be discriminated from concomitant diseases and their pharmacotherapy. Although efficacy is retained with pharmacological anticancer therapies in elderly patients, plasma drug concentrations and the incidence of adverse reactions often increase. Thus, altered organ function in elderly will be reviewed with respect to clinically relevant outcomes. Furthermore, possible consequences of therapeutic drug monitoring will be discussed focusing on novel targeted therapies with small molecules. Examples of therapeutic drug monitoring during targeted therapies may represent an easy tool to overcome the individual pharmacokinetic situation of elderly cancer patients and may contribute to enhanced safety, when implemented in clinical routine.
High-intensity exercise programs in people with dementia — a systematic review and meta-analysis
Authors: Russ J. , Weyh C. , Pilat C.
Published: December 2020

Dementia is a syndrome characterized by a progressive deterioration of cognitive and physical functions. The aim of this systematic review was to investigate the effects of high-intensity exercise training (HIT) programs on cognitive and mental health, physical performance, activities of daily living (ADLs) and quality of life (QoL) in people with dementia. A systematic literature search for randomized controlled trials was performed until July 2019. We calculated mean difference (MD) or standardized MD (SMD) and the 95% confidence interval (CI), and assessed heterogeneity using I2 statistic. Nine studies from three large-scale research projects which were based on the high-intensity functional exercise (HIFE) program incorporating strength, balance and mobility exercises of the lower limbs, including 456 participants (85.5 ± 7.0 years), were considered. There was an overall good study quality (mean PEDro score = 7.6 ± 0.7). Compared to seated control activities, strength and balance HIT resulted in statistically significant but small positive effects on balance performance (MD = 2.31, 95% CI = 0.44–4.17, p = 0.02; I2 = 73%) and on the abilities to independently perform ADLs (SMD = 0.28, 95% CI = 0.12–0.44, p = 0.0006; I2 = 0%). No differences were found in cognitive function, depressive symptoms and QoL. The qualitative analyses yielded sporadic beneficial results (mobility, psychological well-being and apathetic behaviour) in favour of HIT. There is only limited evidence for an intensity-related dose–response relationship. Further well-designed studies are needed to identify the best exercise type for different types and stages of dementia.
GliMR: Cross-Border Collaborations to Promote Advanced MRI Biomarkers for Glioma
Authors: Clement Patricia , Booth Thomas , Borovečki Fran , Emblem Kyrre E. , Figueiredo Patrícia , Hirschler Lydiane , Jančálek Radim , Keil Vera C. , Maumet Camille , Özsunar Yelda , Pernet Cyril , Petr Jan , Pinto Joana , Smits Marion , Warnert Esther A. H.
Published: December 2020

Purpose

There is an annual incidence of 50,000 glioma cases in Europe. The optimal treatment strategy is highly personalised, depending on tumour type, grade, spatial localization, and the degree of tissue infiltration. In research settings, advanced magnetic resonance imaging (MRI) has shown great promise as a tool to inform personalised treatment decisions. However, the use of advanced MRI in clinical practice remains scarce due to the downstream effects of siloed glioma imaging research with limited representation of MRI specialists in established consortia; and the associated lack of available tools and expertise in clinical settings. These shortcomings delay the translation of scientific breakthroughs into novel treatment strategy. As a response we have developed the network “Glioma MR Imaging 2.0” (GliMR) which we present in this article.

Methods

GliMR aims to build a pan-European and multidisciplinary network of experts and accelerate the use of advanced MRI in glioma beyond the current “state-of-the-art” in glioma imaging. The Action Glioma MR Imaging 2.0 (GliMR) was granted funding by the European Cooperation in Science and Technology (COST) in June 2019.

Results

GliMR’s first grant period ran from September 2019 to April 2020, during which several meetings were held and projects were initiated, such as reviewing the current knowledge on advanced MRI; developing a General Data Protection Regulation (GDPR) compliant consent form; and setting up the website.

Conclusion

The Action overcomes the pre-existing limitations of glioma research and is funded until September 2023. New members will be accepted during its entire duration.
Inheritance of some flag leaf and yield characteristics by half-diallel analysis in rice crops (Oryza Sativa L.)
Authors: Bassuony Nessreen N. , Zsembeli József
Published: December 2020

This study was conducted during 2018 and 2019 at the Rice Research and Training Centre farm, Sakha, Kafr el Sheikh, Egypt. Six genotypes of rice, Sakha 101, Giza 178, Irat 170, Wab-56-104, IR65500-127 and IR69853 were half-diallel crossed to estimate the combining ability effect as well as sink and yield potential in rice. Sink capacity (number of spikelets/panicle and 1000-grain weight), source leaf (flag leaf length, flag leaf width and flag leaf area), source-sink association (number of spikelets/panicle to flag leaf area ratio) and traits of yield components (filled grains number/panicle and panicle number) plant and grain yield/plant) were analysed. The results indicated that both general and specific combining ability were highly significant for all the studied characteristics. IR65500-127, Giza 178, and Sakha 101 were identified as good parents, so these parents were suggested for a further recombinant breeding programme. The cross of 3 × 5 was found to be superior for flag leaf width and grain yield, while the cross of 1 × 4 was found to be superior for flag leaf length, flag leaf length/width ratio, chlorophyll content and number of panicles/plant. Advancing these crosses and effected selections in segregating generation would be helpful to develop high yielding varieties. The genetic parameter showed a dominant deviation in one direction was controlled for all characters except flag leaf length. The analysis of the regression line showed that the over-dominance played an important role in the inheritance of gene action for grain yield/plant.
A case report on mediastinal fixation to save physiology of mediastinum in a lung cancer patient
Authors: Marzban-Rad Saeid , Sattari Parastesh , Marzban-Rad Maryam , Azimi Ghasem
Published: December 2020

ABSTRACT

Introduction:

The mediastinal space is confined from the top to the thorax inlet, at the bottom with the diaphragm.

Presentation of case:

A female with a right lung tumor with a history of chemotherapy, intubation, mediastinal fixation was performed on the affected side due to inadequate lung expansion, treatment-resistant fistula and intolerance of surgery to the pulmonary fistula. By fixing the mediastinal space on the affected side, right pleural space was drained.

Conclusion:

It is recommended that patients undergoing surgery for chronic empyema due to immunodeficiency and refractory infections, who do not tolerate surgery due to chronic pleural effusion and cavitation due to loculated Empyema develop thoracic surgery, fixation and continued treatment should be performed.
Evaluation of causes of brain CT scan in patients with minor trauma
Authors: Zahabi Saleh Salehi , Rafiei Hooman , Torabi Faranak , Salehi Amir , Rezaei Bareza
Published: December 2020

ABSTRACT

Background:

Computerized tomography (CT) scan is one of the widely used imaging modalities for the diagnosis of anomalies and diseases. Nonetheless, increased exposure to the radiations is one of its overlooked side effects.

Objective:

The aim of this study was to determine the causes of cerebral CT scan in patients with minor trauma.

Method:

In this cross-sectional study, 550 patients with minor head trauma referred to (XXX) were evaluated. The data are collected and completed using a questionnaire comprising of variables such as age, sex, type of trauma, trauma severity, CT scan results, associated symptoms based on NEXUS II, CCHR and NOC criteria and underlying diseases. The data were analyzed using statistical tests and SPSS software version 22.

Result:

The mean age of patients was 32.5 years and 62% of patients were male. 67% of the patients visited the hospital on their own. The cause of the trauma in 29% patients was car accident, 19% fall from height and 16.5% conflict. Scalp lesions were seen in 30.5%, hematomas in 4.9%, dizziness in 8.9%, history of comorbidities in 5.8%, episode of vomiting less than 2 in 7.3%, episode of vomiting more than 2 times in 1.1%, headache with score ≥7 in 5.8%, headache with score ≤7 in 23.1%, postoperative forgetfulness in 0.2%, raccoon eyes in 0.2% and nose bleeding in 1.5%. Findings of CT scan were abnormal in 0.2% of patients. The patient's condition declared cleared in 94.5% cleared and 5.5% referred to a neurosurgery. Statistically, CT scan had significant role in predicting the patient's neurosurgery counseling status (P < 0.05).

Conclusion:

The majority of patients with minor head trauma had normal brain CT scan and was discharged without the need for neurosurgery counseling. Therefore, it seems necessary to reduce brain CT scans without indication to reduce the radiation dose among patients with minor head trauma.

Highlights: