bluuebunny/crossref_metadata_2025 huggingface dataset:
Natural History of Cirrhosis: Changing Trends in Etiology Over the Years
Authors: Idilman Ramazan , Aydogan Merve , Oruncu Mehmet Berk , Kartal Aysun , Elhan Atilla Halil , Ellik Zeynep , Gumussoy Mesut , Er Ramazan , Ozercan Mubin , Duman Serkan , Toruner Murat , Cinar Kubilay , Soykan Irfan , Beyler Ali Resit , Ozkan Hasan
Published: November 2020

Background and Goals: The aims of the present study were to investigate the natural history of cirrhosis and to determine trends in the etiology of cirrhosis. Methods: Between January 2001 and January 2018, a total of 1,341 patients had been diagnosed with cirrhosis and were included. Results: A total of 898 cirrhotic patients, who were followed up for at least 6 months were included into the analysis. The median age was 54 years. The median Child-Pugh and MELD scores were 7.5 and 11, respectively. Ascites (51%) was the most common causes of decompensation. Chronic viral hepatitis was the most frequent cause of cirrhosis (58%). Hepatitis B virus (HBV) infection was the main etiology (34%), followed by hepatitis C virus (HCV) infection (18%). Among 129 patients with cryptogenic cirrhosis (CC), 60 had metabolic abnormalities. If these 60 patients with CC were considered to have nonalcoholic fatty liver disease (NAFLD)-related cirrhosis, the proportion of NAFLD-related cirrhosis increased from 1.8 to 8.0%. At admission, 74 patients (8%) had been diagnosed with hepatocellular carcinoma (HCC). A new HCC developed in 80 patients during the follow-up period. The probability of developing HCC was 3.9% at 12 months. Logistic regression analysis showed that the development of HCC was significantly associated with older age (p < 0.001), male gender (p < 0.001), viral etiology (p = 0.026), and baseline high aspartate aminotransferase level (p = 0.01). Overall, 104 cirrhotic patients died. Conclusion: HBV and HCV remain the leading causes of etiology in cirrhosis and HCC. However, NAFLD-related cirrhosis is recognized as a growing burden.
Decreased Expression of Sirt1 Contributes to Ocular Behçet’s Disease Progression via Th17 and Th22 Response
Authors: Xie Manyun , Yang Yan
Published: November 2020

Background: Previous studies have indicated that Sirtuin 1 (Sirt1) plays an important role in suppressing inflammatory responses in many diseases. However, the Sirt1 levels and role of Sirt1 in ocular Behçet’s disease (OBD) have not been fully elucidated. Objective: The objective of this study was to investigate the role of Sirt1 in the pathogenesis of OBD. Methods: Sirt1 and cytokine levels were measured using ELISA. Cell viability was determined using the Cell Counting Kit-8. The frequencies of Th17 and Th22 cells were detected using flow cytometry. Results: We found decreased expression of Sirt1 in CD4+ T cells obtained from patients with active OBD. SRT1720, an agonist of Sirt1, significantly upregulated Sirt1 expression in CD4+ T cells from patients with active OBD. Sirt1 activation by SRT1720 significantly suppressed the production of interleukin (IL)-17 and IL-22 by CD4+ T cells and inhibited the expansion of Th17 and Th22 cells. Conclusion: Our results suggest that decreased Sirt1 expression might be involved in the pathogenesis of OBD and that activation of Sirt1 might be considered a potential target for OBD.
Optical Coherence Tomography Angiography of the Macula in Patients with Primary Angle-Closure Glaucoma
Authors: Zhang Yang , Zhang Shunhua , Wu Chan , Zhang Yao , Bian Ailing , Zhou Qi , Cheng Gangwei , Li Lüe
Published: November 2020

Background: The retinal microvasculature within the macula in glaucomatous eyes is not clear. Objectives: To detect macular vessel density (MVD) changes in primary angle-closure glaucoma (PACG). Methods: Twenty-two PACG patients who had an episode of acute primary angle closure were included. Structural optical coherence tomography (OCT) scans were conducted to measure the thickness of the peripapillary retinal nerve fiber layer and macular ganglion cell complex (GCC). The MVD was measured with OCT angiography. Results: A weakened macular microvascular network that had an expanded fovea avascular zone was observed in the case group. Compared with the control group, the case group had a lower MVD (p < 0.001). Single correlation analysis revealed a significant correlation of the MVD with best-corrected visual acuity (BCVA) (r = −0.65, p = 0.001), GCC (r = 0.50, p = 0.018), and the visual field mean deviation (r = −0.54, p = 0.009) in the case group. Moreover, in the mixed-effect models, the MVD was found to be positively correlated with GCC (p = 0.017) and negatively correlated with LogMar BCVA (p < 0.001). Conclusions: After an acute angle-closure attack, the macular microvascular network is attenuated, and the MVD decreases significantly.
Chitosan level effects on fermentation profile and chemical composition of sugarcane silage
Authors: Del Valle Tiago Antonio , Antonio Giovani , Zilio Elissandra Maiara de Castro , Dias Mauro Sérgio da Silva , Gandra Jefferson Rodrigues , Castro Filipe Alexandre Boscaro de , Campana Mariana , Morais Jozivaldo Prudêncio Gomes de
Published: November 2020

This study aimed to evaluate the effects of increasing levels of chitosan (CHI) on sugarcane fermentation profile and losses, chemical composition, and in situ degradation. Treatments were: 0, 1, 2, 4, and 8 g of CHI/kg of dry matter (DM). Twenty experimental silos (PVC tubing with diameter 28 cm and height 25 cm) were used. Sand (2 kg) was placed at the bottom of each silo to evaluate effluent losses, and silos were weighed 60 d after ensiling to calculate gas losses. Samples were collected from the center of the silo mass to evaluate silage chemical composition, in situ degradation, fermentation profile, and mold and yeast count. Data were analyzed as a completely randomized design, and the treatment effect was decomposed using polynomial regression. Chitosan linearly increased acetic acid and NH3-N concentration, while yeast and mold count, and ethanol concentration decreased. Intermediary levels of CHI (from 4.47 to 6.34 g/kg DM) showed the lower values of effluent, gas, and total losses. There was a quadratic effect of CHI on the content of non-fiber carbohydrates, neutral and acid detergent, and in situ DM degradation. The lowest fiber content was observed with levels between 7.01 and 7.47 g/kg DM, whereas the highest non-fiber carbohydrate content and in situ DM degradation were found with 6.30 and 7.17 g/kg DM of CHI, respectively. Chitosan linearly increased acetic acid and NH3-N concentration, whereas it linearly reduced ethanol concentration and count of yeast and mold. Thus, intermediary levels of CHI, between 4.47 and 7.47 g/kg of DM, decrease fermentation losses and improve the nutritional value of sugarcane silage.
KCNQ1
and Long QT Syndrome in 1/45 Amish
Authors: Streeten Elizabeth A. , See Vincent Y. , Jeng Linda B.J. , Maloney Kristin A. , Lynch Megan , Glazer Andrew M. , Yang Tao , Roden Dan , Pollin Toni I. , Daue Melanie , Ryan Kathleen A. , Van Hout Cristopher , Gosalia Nehal , Gonzaga-Jauregui Claudia , Economides Aris , Perry James A. , O’Connell Jeffrey , Beitelshees Amber , Palmer Kathleen , Mitchell Braxton D. , Shuldiner Alan R ,   Regeneron Genetics Center*
Published: November 2020

Background:

In population-based research exome sequencing, the path from variant discovery to return of results is not well established. Variants discovered by research exome sequencing have the potential to improve population health.

Methods:

Population-based exome sequencing and agnostic ExWAS were performed 5521 Amish individuals. Additional phenotyping and in vitro studies enabled reclassification of a
KCNQ1
variant from variant of unknown significance to pathogenic. Results were returned to participants in a community setting.

Results:

A missense variant was identified in
KCNQ1
(c.671C>T, p.T224M), a gene associated with long QT syndrome type 1, which can cause syncope and sudden cardiac death. The p.T224M variant, present in 1/45 Amish individuals is rare in the general population (1/248 566 in gnomAD) and was highly associated with QTc on electro-cardiogram (
P
=5.53E-24, β=20.2 ms/allele). Because of the potential importance of this variant to the health of the population, additional phenotyping was performed in 88 p.T224M carriers and 54 noncarriers. There was stronger clinical evidence of long QT syndrome in carriers (38.6% versus 5.5%,
P
=0.0006), greater history of syncope (32% versus 17%,
P
=0.020), and higher rate of sudden cardiac death in first degree relatives<age 30 (4.5% versus 0%,
P
=0.026). Expression of p.T224M KCNQ1 in Chinese hamster ovary cells showed near complete loss of protein function. Our clinical and functional data enabled reclassification of p.T224M from a variant of unknown significance to pathogenic. Of the 88 carriers, 93% met criteria for beta-blocker treatment and 5/88 (5.7%) were on medications that may further prolong QTc. Carriers were provided a Clinical Laboratory Improvement Amendments confirmed report, genetic counseling, and treatment recommendations. Follow-up care was coordinated with local physicians.

Conclusions:

This work provides a framework by which research exome sequencing can be rapidly translated in a culturally appropriate manner to directly benefit research participants and enable population precision health.
New Cancer Diagnosis After Bleeding in Anticoagulated Patients With Atrial Fibrillation
Authors: Raposeiras Roubín Sergio , Abu Assi Emad , Barreiro Pardal Cristina , Cespón Fernandez María , Muñoz Pousa Isabel , Cobas Paz Rafael , Parada Jose Antonio , Represa Montenegro Marta , Melendo Miu María , Blanco Prieto Sonia , Rosselló Xavier , Ibañez Borja , Íñiguez Romo Andrés
Published: November 2020

Background

Bleeding is frequent in patients with atrial fibrillation (AF) treated with oral anticoagulant therapy, and may be the first manifestation of underlying cancer. We sought to investigate to what extent bleeding represents the unmasking of an occult cancer in patients with AF treated with oral anticoagulants.

Methods and Results

Using data from CardioCHUVI‐AF (Retrospective Observational Registry of Patients With Atrial Fibrillation From Vigo's Health Area), 8753 patients with AF aged ≥75 years with a diagnosis of AF between 2014 and 2017 were analyzed. Of them, 2171 (24.8%) experienced any clinically relevant bleeding, and 479 (5.5%) were diagnosed with cancer during a follow‐up of 3 years. Among 2171 patients who experienced bleeding, 198 (9.1%) were subsequently diagnosed with cancer. Patients with bleeding have a 3‐fold higher hazard of being subsequently diagnosed with new cancer compared with those without bleeding (4.7 versus 1.4 per 100 patient‐years; adjusted hazard ratio [HR], 3.2 [95% CI, 2.6–3.9]). Gastrointestinal bleeding was associated with a 13‐fold higher hazard of new gastrointestinal cancer diagnosis (HR, 13.4; 95% CI, 9.1–19.8); genitourinary bleeding was associated with an 18‐fold higher hazard of new genitourinary cancer diagnosis (HR, 18.1; 95% CI, 12.5–26.2); and bronchopulmonary bleeding was associated with a 15‐fold higher hazard of new bronchopulmonary cancer diagnosis (HR, 15.8; 95% CI, 6.0–41.3). For other bleeding (nongastrointestinal, nongenitourinary, nonbronchopulmonary), the HR for cancer was 2.3 (95% CI, 1.5–3.6).

Conclusions

In patients with AF treated with oral anticoagulant therapy, any gastrointestinal, genitourinary, or bronchopulmonary bleeding was associated with higher rates of new cancer diagnosis. These bleeding events should prompt investigation for cancers at those sites.
Linking Syriac Liturgies: Digitizing Card Collections and Handwritten Notes from the Archives of the Peshitta Institute
Authors: van Peursen Wido , Veldman Geert Jan
Published: November 2020

The Peshitta is the Syriac translation of the Bible from the second century AD. It had an enormous cultural and literary impact in the Middle East, no less than the role that, for example, the Latin Vulgate played in large parts of (Western) Europe. Up to the present, the Peshitta plays a crucial role in the various Syriac Christian communities in the Middle East and the Syriac Diaspora. A valuable resource for Peshitta studies is the collection of handwritten notes on cards and binders from the first decades of the Peshitta Project (started 1959), which were digitized in the dans “Klein Data Project” (kdp) Linking Syriac Liturgies (2018–2019). The notes relate to a wealth of information about manuscripts, liturgical traditions and calendars and various Syriac Bible translations. The kdp has made this material accessible and allows for computational research into the complex interactions between textual and structured data included in this data set, in which more than 9,000 entries containing pericopes read in liturgy are indexed according to more than 70 categories.
Acanthocereus paradoxus (Cactaceae), a new endemic species from Jalisco, Mexico

Authors: GONZÁLEZ-ZAMORA PEDRO , CARRILLO-REYES PABLO , SÁNCHEZ DANIEL
Published: November 2020

Acanthocereus paradoxus sp. nov., an endemic narrow cylindrical cactus from the state of Jalisco is described and illustrated. The species can be distinguished by its narrow cylindrical mature stems, stem epidermis dull green with some dark green margins, the presence of four central spines, and a greater number of ribs and spines in young stems. A morphological  comparison with the other cylindrical members of Acanthocereus and sympatric species of the genus is provided. Data about its habitat and the conservation status are also given.
Phaeoclavulina liliputiana sp. nov. (Gomphaceae, Gomphales) a new endemic species from Tlaxcala, Mexico

Authors: GONZÁLEZ-ÁVILA ASTRID , MARTÍNEZ-GONZÁLEZ CÉSAR RAMIRO , ESPINOSA DAVID , ESTRADA-TORRES ARTURO
Published: November 2020

Phaeoclavulina liliputiana is a new endemic species from Tlaxcala, from the conifer and oak forests at an altitude of 2700 m asl, characterized by a very small basidiome size and, subellipsoid and usually more or less lacrymoid spores of 4.3–6.2 × 2.7–3.5 µm, with rounded warted ornamentation. We proposed this new species based on evidence from morphological and molecular data. We provide macro- and microscopic descriptions including illustrations of the basidiocarp, scanning electron micrographs of the basidiospores and also discuss the taxonomic position of this new species. We undertook a molecular analysis using the atp6 and SSU mitochondrial loci and nuclear ribosomal LSU.
Hypericum alacamdaglariense (Hypericaceae), a new species from Turkey

Authors: DUMAN HAYRİ , ÇAKIR-DİNDAR ECE GÖKÇE
Published: November 2020

The new species Hypericum alacamdaglariense, which belongs to the section Triadenioides, is described and illustrated. Its habitat and ecology, distribution map and conservation status are also provided. The new species is also compared to the closely related H. pallens and H. vacciniifolium in terms of their morphological features.
Typification of Cotoneaster koidzumii (Maleae, Rosaceae) and two associated names

Authors: JOCOU ADRIEL I.
Published: November 2020

The typification of the names Cotoneaster koidzumii, Cotoneaster taitoensis, and Cotoneaster formosanus (Rosaceae) is discussed. Lectotypes are designated for C. koidzumii (Herbarium TI), C. taitoensis (TI), and C. formosanus (TAIF; isolectotypes at PE and TI).
Revision of the genus Hannia (Teleostei, Terapontidae), with description of a new species, Hannia wintoni, from the Kimberley, Western Australia
Authors: SHELLEY JAMES J. , DELAVAL AURÉLIEN , LE FEUVRE MATTHEW C. , DEMPSTER TIM , RAADIK TARMO A. , SWEARER STEPHEN E.
Published: November 2020

The systematics of the genus Hannia Vari 1978, endemic to freshwater habitats of remote north-western Australia, is revised in light of recent collections in the region and a molecular study of the group that identified an undescribed candidate species. A new freshwater fish species (Hannia wintoni sp. nov) is described based on analysis of multiple nuclear genetic markers (53 allozyme loci), mitochondrial DNA sequence data (601 bp cytochrome b) and morphology (examination of a suite of 66 morphometric and meristic characters). Head profile, postorbital length, maximum length, preopercular spines and pectoral-fin rays are characters that best distinguish H. wintoni sp. nov from its only congener, H. greewayi. While the existing description of H. greenwayi is robust and accurate, we present a number of additional characters that enhance to the original description, based on type and fresh material. Information on the known distribution, habitats and conservation status of the two species is summarised. The new species is a narrow-range endemic.
A novel species Spinonema gracilispiculum sp. n. (Nematoda: Desmodoridae) from the oxygen minimum zone of Eastern Arabian Sea margin
Authors: JACOB JINI , RAYAROTH ANILKUMAR PADINJARE , USEPH ABDUL JALEEL KOOVAPURATH , PHILIP ROSAMMA , DAMODARAN RAYAROTH
Published: November 2020

A new species of marine free living nematode Spinonema gracilispiculum sp. n. is described from the oxygen minimum zone of the eastern Arabian Sea (216m) margin. This new nematode species was found exclusively in the station with sandy texture and dissolved oxygen level 0.35 ml/l and are represented by only few individuals from a single location, despite analysing 288 core samples from an extensive survey along the eastern Arabian Sea OMZ region covering from 06°57′19″N to 21°30′639″N. Spinonema gracilispiculum sp. n. differs from other known species of the genus in the body length, position of the dorsal spine, contour and span of lateral alae, size and shape of spicules, number of pre cloacal setae and sexual dimorphism in presence of dorsal spine and amphideal fovea shape. This is the first record of the genus Spinonema from the Indian Ocean. A pictorial and dichotomous keys to the species of Spinonema are also provided, supplemented with comparative morphometric details of all valid species based on published information.
Portraying Humans as Machines to Promote Health: Unintended Risks, Mechanisms, and Solutions
Authors: Weihrauch Andrea , Huang Szu-Chi
Published: November 2020

To fight obesity and educate consumers on how the human body functions, health education and marketing materials often highlight the importance of adopting a cognitive approach to food. One strategy employed to promote this approach is to portray humans as machines. Five studies (and three replication and follow-up studies) using different human-as-machine stimuli (internal body composition, face, appearance, and physical movement) revealed divergent effects of human-as-machine representations. While these stimuli promoted healthier choices among consumers who were high in eating self-efficacy, they backfired among consumers who were low in eating self-efficacy (measured in Studies 1 and 3–5; manipulated in Study 2). This reversal happened because portraying humans as machines activated consumers’ expectation of adopting a cognitive, machine-like approach to food (Studies 3 and 4)—an expectation that was too difficult to meet for those with low (vs. high) eating self-efficacy. We tested a solution to accompany human-as-machine stimuli in the field (Study 5): we externally enhanced how easy and doable it was for consumers low in eating self-efficacy to adopt a cognitive approach to food, which effectively attenuated the backfire effect on their lunch choices at a cafeteria.
The usability of ventilator maintenance user interface: A comparative evaluation of user task performance, workload, and user experience
Authors: Jiang Mingyin , Sun Dongjie , Li Qiang , Wang Daoxiong
Published: November 2020

Poor usability designed of ventilator user interface can easily lead to human error. In this study, we evaluated the usability design of ventilator maintenance user interface and identified problems related to the usability of user interface that could easily cause human error. Sixteen respiratory therapists participated in this usability study. The usability of the ventilator maintenance user interface was evaluated by participants’ task performance (task completion time, task error rate), physiological workload (eye-fixation duration) and perceived workload (NASA-TLX), and user experience (questionnaire). For task performance, task completion time and task error rate showed significant differences. For task completion time, significant difference was found when conducting ventilator self-test ( p < 0.001), replace the breathing circuit ( p = 0.047), and check battery status ( p = 0.005). For task error rate, the three ventilators showed significant difference ( p = 0.012), and the Serov I showed a significantly higher task error rate than the Boaray 5000D ( p = 0.031). For workload, the Serov I was associated with higher physiological and perceived workloads than other ventilators ( p < 0.05). For user experience, the Boaray 5000D received better scores among the ventilators in terms of ease to maintain, friendly to maintain, and willingness to use ( p < 0.05, respectively). Our study adds available literature for usability evaluation of ventilator maintenance user interface. The results indicate that the maintenance user interface of the Boaray 5000D performed better than the other two tested ventilators. Moreover, the study results also proved that eye-fixation duration can be a reliable tool for evaluating the usability of ventilator user interface.
Fostering human–robot cooperative architectures for search and rescue missions in urban fires
Authors: Couceiro Micael S , Portugal David , Rocha Rui P , Araújo André
Published: November 2020

Urban fires are probably the most frequent catastrophic incidents in urban areas, requiring a prompt response due to life endangerment in highly populated zones and the high risk of fire propagation to buildings and parked cars in the vicinity. Robot assistance has been identified as a valuable resource for such urban search and rescue (USAR) scenarios by taking advantage of robots’ expendability. However, it is still unclear or not quantified how advantageous such human–robot cooperation can be to the final outcome of firefighting operations and other USAR missions. This article reports research in this context by modeling key features of a firefighting mission in response to an urban fire in a large basement garage. Besides building a behavioral model of human firefighting teams based on interviews with a Portuguese Fire Department, and assessing their performance under different circumstances, this work studies the addition of robotic teams in cooperation with human firefighters to overcome communication issues and improve situation awareness. The results obtained highlight the importance of such human–robot partnership for a more effective response to an urban fire and mitigation of life endangerment of first responders and victims.
Do We Get What We Pay For? Examining the Relationship Between Payments and Clinical Outcomes in High-Volume Elective Surgery in a Commercially-Insured Population
Authors: Arenchild Madison , Offodile Anaeze C. , Revere Lee
Published: November 2020

Studies evaluating the cost and quality of healthcare services have produced inconsistent results. We seek to determine if higher paid hospitals have higher quality outcomes compared to those receiving lower payments, after accounting for clinical and market level factors. Using inpatient commercial claims from the IBM® MarketScan® Research Databases, we used an ordinal logistic regression to analyze the association between hospital median payments for elective hip and knee procedures and 3 quality outcomes: prolonged length of stay, complication rate, and 30-day readmission rate. Patient-level and market factor covariates were appropriately adjusted. Hospital-level payments were found to be not significantly correlated with hospital quality of care. This research suggests that higher payments cannot predict higher quality outcomes. This finding has implications for provider-payer negotiations, value-based insurance designs, strategies to increase high-value care provision, and consumer choices in an increasingly consumer-oriented healthcare landscape.
Transparency in Local Governments: Patterns and Practices of Twenty-first Century
Authors: Krah Redeemer Dornudo Yao , Mertens Gerard
Published: November 2020

The study is a systematic literature review that assembles scientific knowledge in local government transparency in the twenty-first Century. The study finds a remarkable growth in research on local government transparency in the first nineteen years, particularly in Europe and North America. Social, economic, political and institutional factors are found to account for this trend. In vogue among local governments is the use of information technology to enhance transparency. The pressure to become transparent largely comes from the passage of Freedom of Information Laws and open data initiatives of governments.
Targeted Molecular Therapies in Allergy and Rhinology
Authors: Damask Cecelia C. , Ryan Matthew W. , Casale Thomas B. , Castro Mario , Franzese Christine B. , Lee Stella E. , Levy Joshua M. , Lin Sandra Y. , Lio Peter A. , Peters Anju T. , Platt Michael P. , White Andrew A.
Published: November 2020

Biologic agents, monoclonal antibodies that target highly‐specific molecular pathways of inflammation, are becoming integrated into care pathways for multiple disorders that are relevant in otolaryngology and allergy. These conditions share common inflammatory mechanisms of so‐called Type 2 inflammation with dysregulation of immunoglobulin E production and eosinophil and mast cell degranulation leading to tissue damage. Biologic agents are now available for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, eosinophilic granulomatosis with polyangiitis (EGPA), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU). This paper summarizes the diagnosis and management of these conditions and critically reviews the clinical trial data that has led to regulatory approval of biologic agents for these conditions.
Afterlives: Testimonies of Irish Catholic Mothers on Infant Death and the Fate of the Unbaptized
Authors: Kennedy Liam
Published: November 2020

Older Irish Catholics remember a metaphysical space or place called Limbo. This was the destination of unbaptized infants. They could never enter Heaven because the stain of original sin had not been removed. In addition, they were denied burial in consecrated ground. Fear of such eventualities drove parents to baptize as soon as possible. Nor was this a purely Irish phenomenon. In emergency cases, even baptism in utero was permitted in some parts of Catholic Europe. The centerpiece of this study is the testimonies of Irish mothers and their remembrances of the perils of Limbo, the disposal of infant corpses (in cillíní), and “churching.” Why belief in Limbo has become almost extinct in recent decades is explored, drawing on both demand and supply side explanations. More generally, considerations of Limbo, the unbaptized, and the afterlife give rise to challenging questions as to secularization and even the definition of childhood.
Rapid Jetlag Resetting of Behavioral, Physiological, and Molecular Rhythms in Proestrous Female Mice
Authors: Pilorz Violetta , Kolms Beke , Oster Henrik
Published: November 2020

A gradual adaptation to a shifted light-dark (LD) cycle is a key element of the circadian clock system and believed to be controlled by the central circadian pacemaker, the suprachiasmatic nucleus (SCN). Endocrine factors have a strong influence on the regulation of the circadian clock network and alter acute photic responses of the SCN clock. In females, endocrine function depends on the stage of the ovarian cycle. So far, however, little is known about the effect of the estrous cycle on behavioral and molecular responses to shifts in the LD rhythm. Based on this, we investigated whether estrous state affects the kinetics of phase shift during jetlag in behavior, physiology, and molecular clock rhythms in the SCN and in peripheral tissues. Female mice exposed to an advanced LD phase at proestrous or metestrous showed different phase-shift kinetics, with proestrous females displaying accelerated adaptation in behavior and physiology. Constant darkness release experiments suggest that these fast phase shifts do not reflect resetting of the SCN pacemaker. Explant experiments on SCN, adrenal gland, and uterus confirmed this finding with proestrous females showing significantly faster clock phase shifts in peripheral tissues compared with the SCN. Together, these findings provide strong evidence for an accelerated adaptation of proestrous compared with metestrous females to new LD conditions that is accompanied by rapid behavioral, physiological, and molecular rhythm resetting. Not only do these findings open up a new avenue to understand the effect of estrous cycle on the clock network under changing environmental conditions but also imply a greater susceptibility in proestrous females.
Canadian Association of Radiologists White Paper on De-Identification of Medical Imaging: Part 1, General Principles
Authors: Parker William , Jaremko Jacob L. , Cicero Mark , Azar Marleine , El-Emam Khaled , Gray Bruce G. , Hurrell Casey , Lavoie-Cardinal Flavie , Desjardins Benoit , Lum Andrea , Sheremeta Lori , Lee Emil , Reinhold Caroline , Tang An , Bromwich Rebecca
Published: November 2020

The application of big data, radiomics, machine learning, and artificial intelligence (AI) algorithms in radiology requires access to large data sets containing personal health information. Because machine learning projects often require collaboration between different sites or data transfer to a third party, precautions are required to safeguard patient privacy. Safety measures are required to prevent inadvertent access to and transfer of identifiable information. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI Ethical and Legal standing committee with the mandate to guide the medical imaging community in terms of best practices in data management, access to health care data, de-identification, and accountability practices. Part 1 of this article will inform CAR members on principles of de-identification, pseudonymization, encryption, direct and indirect identifiers, k-anonymization, risks of reidentification, implementations, data set release models, and validation of AI algorithms, with a view to developing appropriate standards to safeguard patient information effectively.
The Network Structure of Trauma Symptoms of Abuse-exposed Children and Adolescents in South Africa
Authors: Makhubela Malose
Published: November 2020

Network theory promises new ways for conceptualizing, methods for investigating, and state-of-the-art lines of research that will improve our knowledge of mental health in high-risk children and adolescents. This study constructed a symptom network to examine associations between a wide range of trauma symptoms in a sample of children and adolescents ( N = 270; Mage = 12.55 yrs, SD = 1.19; 67% = Female) who experienced different forms of abuse (i.e., sexual, physical, emotional and neglect). Symptom-pairs regularized partial correlations, with the Extended Bayesian Information Criterion Graphical Least Absolute Shrinkage and Selection Operator (EBICglasso), were computed to estimate the network structure and centrality measures of the TSCC-SF items. Results show sadness, dissociative amnesia, and sexual arousal to be the most central symptoms in the network, while suicidality was found to be the shortest pathway across all other symptoms (domains). By providing clinicians with specific symptoms to target in interventions, the network framework has the potential to guide and enhance the effectiveness of psychological therapies in high-risk populations.
The Relationship Between Perceived Social Support and PTSD Symptoms After Exposure to Physical Assault: An 8 Years Longitudinal Study
Authors: Johansen Venke A. , Milde Anne Marita , Nilsen Roy Miodini , Breivik Kyrre , Nordanger Dag Øystein , Stormark Kjell Morten , Weisæth Lars
Published: November 2020

Consequences of nondomestic violence are known to be multifaceted with high rates of emotional and psychological problems in addition to physical injuries, and victims report many trauma related symptoms. This study explore if perceived social support (PSS) (Social Provisions Scale [SPS]) and post-traumatic stress disorder (PTSD) symptoms (Impact of Event Scale [IES-22]) are interrelated among adult victims at four assessment points up until eight years after the exposure to physical assault; soon after the event (T1), three months after T1 (T2), one year after T1 (T3), and eight years after T1 (T4). One hundred and forty-three subjects participated at T1, 94 at T2, 73 at T3, and 47 accepted a follow-up at T4. At T1, 138 of 143 completed the questionnaires within 16 weeks after the incident. PTSD symptoms were highly correlated across time ( p < .001); PSS were significantly correlated only between T1 and T2 ( p < .001), T1 and T3 ( p < .05), and between T2 and T3 ( p < .05). Cross-lagged analyses showed an inverse relationship between prior PSS and later PTSD symptoms across all time points ( ps < .05); not proved between prior PTSD symptoms and later PSS ( ps > .1). PSS at T1 was an independent predictor of PSS one year and eight years after the incident. We conclude that higher perception of social support protects against the development of PTSD symptoms; diminished perception of social support increases the risk of developing PTSD symptoms. These findings suggest that PSS after experiencing a violent assault should be considered as an important factor in natural recovery in the long run, as well as essential alongside psychiatric treatment. Establishing psychosocial interventions for victims of physical violence in the acute phase may prevent prolonged trauma reactions.
Activating Community Resilience: The Emergence of COVID-19 Funds Across the United States
Authors: Paarlberg Laurie E. , LePere-Schloop Megan , Walk Marlene , Ai Jin , Ming Yue
Published: November 2020

This article draws upon concepts of community resilience to explore the antecedents of community philanthropic organizations’ response to COVID-19. Although the pandemic is a global threat, responses have been local. We test a model of community resilience activation in the context of the emergence of local COVID-19 funds. We find that a philanthropic organization’s capacity to act in a crisis and respond to the needs of the community depends on the stock of community capitals and organizational capacity. The importance of economic, cultural, and political factors in predicting the emergence of a fund raises important questions about disparities in resilience along class and race lines and the role of political ideology in shaping perceptions of crises. Our research contributes to our understanding of community philanthropic organizations’ capacity to activate community resources during a crisis.
Informal Practices in the Making of Professionals: The Case of Engineers in Soviet and Post-Soviet Azerbaijan
Authors: Ergun Ayça , Sayfutdinova Leyla
Published: November 2020

This study expands the understanding of the role of informality in post-socialist professions by examining the use of informal practices by an under-researched professional group of engineers in Azerbaijan. We use in-depth interviews with engineers educated in Soviet and post-Soviet periods to trace changes and continuities in the use of informal practices in their education and work. The study found that although many practices inherited from the Soviet period (e.g. bribery in higher education and nepotism in employment) have undermined professional standards, others, such as reliance on interpersonal professional networks and reputations, have helped to transmit professional knowledge and preserve professional values. We argue that informality has a dual impact on the engineering profession in Azerbaijan: some informal practices undermine professionalism while others help to sustain it.
Analysis on the driver’s upper and lower neck injury in the three stages of the frontal collision
Authors: Hong Liang , Liu Gang
Published: November 2020

According to the driver’s moving posture in the frontal collision, the movement process of the driver could be divided into the three stages. At present, the researchers mainly focused on the neck injuries in the first stage of the driver movement, seldom involve the neck injuries in the second and third stage of the driver movement. The aim of this study is to investigate the neck injuries in the three stages comprehensively to expand the protective scope of the neck. Firstly, the simulation model of the driver restraint system was developed and validated. Secondly, parametric studies were conducted to investigate the influences of the design parameters of the driver restraint system on the occurrence times and the variation trends of the upper and lower neck injuries. Finally, the driver restraint system design parameters were optimized globally using the whole injury criterion of the neck WICN. The results indicate that the driver restraint system should be designed with the moderate vent leakage coefficient, inflator mass-flow rate and fabric permeability coefficient of airbag, and the smaller recliner rotational stiffness of seatback for reducing the neck injuries. After optimization, the peak anterior shear force of lower neck F3 reduces by 27.2%, the peak extension bending moment of upper and lower neck Mupper, Mlower decline by 22.4% and 22.2% respectively, WICN decreases by 15.2%, and the other neck injury values also show a declining trend. At the moment, both the peak anterior shear force of lower neck F3 and the peak extension bending moment of lower neck Mlower appear in the second stage, the peak extension bending moment of upper neck Mupper appears in the third stage, the other neck injury values appear in the first stage.
Electric torque assist and supercharging of a downsized gasoline engine in a 48V mild hybrid powertrain
Authors: Xia Feihong , Griefnow Philip , Tidau Florian , Jakoby Moritz , Klein Serge , Andert Jakob
Published: November 2020

48V systems enable not only mild hybrid functionalities such as recuperation or torque assist by a belt-driven starter generator (BSG), but also electrification of accessories and the engine boosting system. To maximize the powertrain efficiency, a proper layout of the electrified system and an optimized distribution of the electric power during transient operation is essential. In this study, a vehicle co-simulation of a conventional powertrain with a downsized turbocharged gasoline engine is extended by a 48V system with an electric compressor (eC) and a BSG. The control functions of the eC and BSG are based on a state-of-the-art vehicle application and calibrated for transient operating conditions. The engine model, which is built using a one-dimensional crank angle resolved approach in GT-POWER, has been validated with measurement data and is used to predict the interaction between the eC and the engine air path. The investigations using the simulation platform show that the 48V eC and the BSG can significantly improve the fuel effïciency if the electric energy consumption is initially neglected. However, when considering the electric energy consumption within the vehicle co-simulation, efficient operation is particularly depending on driver torque demand, the battery state-of-charge and charging effïciency. Hence, intelligent operating strategies are necessary to take advantage of the better torque response and improve fuel consumption at the same time.
Risk Evaluation Model of Wind Energy Investment Projects Using Modified Fuzzy Group Decision-making and Monte Carlo Simulation
Authors: Erfani Abdolmajid , Tavakolan Mehdi
Published: November 2020

The recent increasing trend of investments in wind energy projects to support sustainable development requires an appropriate risk evaluation model to ensure the success of these projects. Early studies focus on opinion and discussion from subject matter experts. However, the expertise level in the subject is varied, and evaluation without considering expert competency can cause biased results. On the other hand, most of the project cost estimation models do not consider uncertainty in all cash flow parameters. In response, this article proposes a model that evaluates risks in wind energy investment projects by considering the knowledge and background of experts. Then, an integrated model of risk evaluation and cost estimation is developed. The model consists of three main stages: risk identification based on a systematic literature review (SLR); risk analysis phase 1 based on a modified fuzzy group decision-making; and risk analysis phase 2 based on a Monte Carlo simulation method. The main advantages of the proposed model are: (a) providing a comprehensive risk identification in wind energy investment projects; (b) using a modified fuzzy model to improve the risk assessment process by considering the expert competency in wind energy projects; and (c) establishing an integrated model to evaluate the cash flow of the investment. A wind farm in the Middle East is selected as the case study to examine the usability and practicality of the proposed model. The results show that the most important risks are ‘change in regulation and policy’, ‘dependency on the international market for importing raw materials’ and ‘market competitiveness’. On the other hand, the financial assessment under uncertainty shows that the profitability of the investment can be varied, and it emphasises the importance of an appropriate risk management process to guarantee the success of the investment.
Buccal Hydromorphone Syrup for Managing Dyspnea in Idiopathic Pulmonary Fibrosis
Authors: Fong Shannon , Richman-Eisenstat Janice , Kalluri Meena
Published: November 2020

Context:

Dyspnea is a highly distressing symptom that characterizes idiopathic pulmonary fibrosis (IPF), a common idiopathic interstitial lung disease (ILD) with a high symptom burden, poor quality of life, and early mortality. Though opioids are mentioned in guidelines for dyspnea management, guidance on how and when to initiate opioids is lacking. Different pharmacologic strategies are needed to address different types of dyspnea (baseline, incident, and crisis). Due to a longer onset of action, the oral route (swallowed) may be less effective for prevention of incident dyspnea or for rapid relief of crisis dyspnea, prompting the use of alternative drug delivery strategies for self-management. We inadvertently discovered the efficacy of buccal administration of low dose, low volume hydromorphone oral syrup for dyspnea management in ILD, which has not been previously reported in the literature.

Case Series:

We describe our approach to dyspnea assessment and management in IPF, including use of the Multidimensional Dyspnea Scale (MDDS), a novel instrument yet to be validated that we developed to better identify and categorize dyspnea into the types experienced by a patient with IPF over the course of a day. We then describe how buccal hydromorphone oral syrup is initiated and titrated for dyspnea management in 3 patients at different points in their disease trajectory.

Conclusion:

Buccal hydromorphone oral syrup is effective for dyspnea management across the spectrum of IPF. When integrated into a patient-centered algorithm for symptom assessment and management, it allows for rapid and easy self-management of dyspnea by patients and their caregivers.
An Exploratory Study to Assess School Principals’ Knowledge of Child Welfare Policies
Authors: McCabe Jeffrey
Published: November 2020

Because schools are a customary location to conduct child abuse and neglect investigative interviews, this study examines survey results from 109 principals in Tennessee to determine if the Title I status of a school or years of experience as a principal predict awareness of DCS interview policies and an ability to accurately interpret policies related to school-based interviews. A statistically significant relationship was found between the Title I status of a school and principals’ awareness of interview policies. Not all school principals in Tennessee were aware of or could accurately interpret policies for conducting interviews. This study identified principals being more aware of school district issued policies than state-issued policies, and that including the DCS policy as part of school-district policy may increase awareness.
Studying Heterogeneity in the Subsistence Consumer Market: A Context-Sensitive Approach
Authors: Janda Sergej von , Shainesh G. , Hillebrand Christina Maria
Published: November 2020

This multimethod study develops a context-sensitive approach to subsistence consumer segmentation as advocated in the international market segmentation literature. Building on the theory of consumption values, the authors conduct multisited rapid ethnography research to collect primary data from urban subsistence consumers in South Africa and India who were presented with a simulated product choice situation. The authors convert the data into quantifiable segmentation variables for further analysis. This approach is particularly useful in subsistence consumer markets that are characterized by a dearth of quantifiable consumer data. The study reveals four distinct subsegments—Family-Oriented Workers, Low-Skilled Price-Sensitives, Young Performers, and Conscious Conservatives—that differ significantly in education level, number of children, age, consumption values, and purchase behavior. A detailed discussion of the context-sensitive segmentation approach applied in this study enables scholars and practitioners to deploy and adapt it to different environments and requirements.
Lessons Learned: Using the Caprini Risk Assessment Model to Provide Safe and Efficacious Thromboprophylaxis Following Hip and Knee Arthroplasty
Authors: Krauss Eugene S. , Cronin MaryAnne , Dengler Nancy , Simonson Barry G. , Enker Paul , Segal Ayal
Published: November 2020

Two of the more common potential complications after arthroplasty are venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolus (PE), and excess bleeding. Appropriate chemoprophylaxis choices are essential to prevent some of these adverse events and from exacerbating others. Risk stratification to prescribe safe and effective medications in the prevention of postoperative VTE has shown benefit in this regard. The Department of Orthopaedic Surgery at Syosset Hospital/Northwell Health, which performs over 1200 arthroplasties annually, has validated and is using the 2013 version of the Caprini Risk Assessment Model (RAM) to stratify each patient for risk of postoperative VTE. This tool results in a culling of information, past and present, personal and familial, that provides a truly thorough evaluation of the patient’s risk for postoperative VTE. The Caprini score then guides the medication choices for thromboprophylaxis. The Caprini score is only valuable if the data is properly collected, and we have learned numerous lessons after applying it for 18 months. Risk stratification requires practice and experience to achieve expertise in perioperative patient evaluation. Having access to pertinent patient information, while gaining proficiency in completing the Caprini RAM, is vital to its efficacy. Ongoing, real time analyses of patient outcomes, with subsequent change in process, is key to improving patient care.