bluuebunny/crossref_metadata_2025 huggingface dataset:
The legal framework for climate change on power generating policy in Indonesia
Authors: Maskun  , Napang Marthen , Susyanti Nur Sri , Achmad  , Naswar  , Ilmar A , Assidiq H
Published: April 2022

The energy sector is the second largest contributor to greenhouse gas emissions after agriculture and forestry. The issue of increasing greenhouse gas emissions resulting from the 35,000-Megawatt power plant program is undoubtedly related to Indonesia’s commitment to the 2015 Paris Agreement. The purpose of this study is to identify the legal framework of the Indonesian government’s policy towards the 35,000-Megawatt power generation program. The method used is normative legal research conducted by reviewing various power generating-related legal instruments and principles in Indonesia. The results show that constructing a power plant based on coal will affect Indonesia’s commitments in the 2015 Paris Agreement. Indonesia has not yet passed the draft Renewable Energy Law; therefore, it is necessary to harmonize some Indonesian legal instruments to deal with this issue. In connection to climate change, coal is one of the significant contributors to climate change. The National Electricity Company (PLN) and IPP power plants need to increase electricity growth by 8.6%, increasing the number of power plants to 80,538 MW from 48,000 MW. In this case, the need for coal fuel in power plants is 60%, the rest comes from new renewable energy (water, geothermal, and solar) by 5%, and the remaining 45% comes from other premier fuels (diesel and petroleum).
Electroless Ni–P–B coatings on magnesium alloy AZ91D: influence of nano Al2O3 on corrosion, wear, and hardness behaviour
Authors: Lakavat Motilal , Bhaumik Amiya , Gandi Suman , Parne Sadi Reddy
Published: April 2022

This study examines the effect of nano Al2O3 additions on the corrosion, wear, and hardness properties of an electroless Ni–P–B protective coating on AZ91D magnesium alloy. In this work, nano alumina particles with a diameter of 40–50 nm and a weight percentage of 1, 2, and 3% were used in an alkaline Ni–P–B electroless bath. The surface morphology of the nano-composite coating was studied by scanning electron microscopy (SEM) and the crystalline structure of the coating was examined by x-ray diffractometer (XRD). The inclusion of alumina nanoparticles, an electroless deposit produces a homogeneous coating on the AZ91D magnesium alloy surfaces. The experimental results show that incorporating 2 wt% alumina nanoparticles into an electroless Ni–P–B coating increases microhardness (986.4-VHN200), specific wear rate (1.2 × 10–10 Kg N−1m−1) and has the lowest average friction coefficient (0.08) when compared to other coated and uncoated samples. Electrochemical polarisation and electrochemical impedance spectroscopic (EIS) tests in 3.5 wt% NaCl solution were used to investigate the corrosion resistance of various nano Al2O3 additive Ni–P–B coatings on Mg alloy surfaces. Potentiodynamic polarisation studies show that 2 wt% of nano Al2O3 incorporation in Ni–P–B coating on magnesium substrates has good corrosion resistance, with the coating resulting in the lowest corrosion rate (icorr = 1.47 × 10–8 A cm−2) and the most positive corrosion potential (Ecorr = 0.55 V).
Low-voltage flexible organic transistors based on a water-soluble natural gate dielectric exhibiting high-performance and stability
Authors: Konwar Gargi , Saxena Pulkit , Raghuwanshi Vivek , Rahi Sachin , Tiwari Shree Prakash
Published: April 2022

The use of natural material components in organic devices increases nature friendliness and biodegradability. In this paper, water-soluble natural protein gelatin is explored as a gate dielectric for demonstration of high performance and low voltage (−3 V) operation in flexible organic field-effect transistors (OFETs). The fabricated p-channel devices showed excellent electrical characteristics of maximum field-effect mobility up to 3.0 cm2 V−1 s−1, high current on/off ratios, low subthreshold swing, and nearly zero threshold voltage due to the high-quality dielectric semiconductor interface achieved through optimized processes of fabricating flexible OFET devices. These devices exhibited very high operational stability as confirmed by various stability tests including bias-stress, repeatability, electromechanical stability, cyclic stability, and long-term ambient stability. For electromechanical stability, no significant changes in the performance were observed upon application of compressive and tensile strain due to bending. A very high environmental stability with almost unchanged electrical characteristics over 24 weeks was demonstrated. Further, circuit applicability was analyzed by switching characteristics from resistive load inverters. These results indicate gelatin as a promising biodegradable dielectric candidate for low voltage flexible OFETs.
Measuring the reliability of SDG 7: the reasons, timing, and fairness of outage distribution for household electricity access solutions
Authors: Ferrall Isa , Callaway Duncan , Kammen Daniel M
Published: April 2022

The United Nations identifies ensuring ‘access to affordable, reliable, sustainable and modern energy for all’ as one of its Sustainable Development Goals for 2030. This article focuses on the comparatively under-investigated question of reliability within the broader goal. We empirically study experienced household electricity reliability using common frameworks in key countries such as Tanzania, Kenya, and India. Datasets represent a diverse set of technologies including solar home systems (SHS), solar pico-grids, and national electricity grids. First, the prevailing reliability metrics—SAIDI and SAIFI—are measured for all datasets. Informed by critical assessments, this article then proposes a suite of new metrics that facilitate improved reliability comparisons by considering the reasons, timing, and fairness of outage distribution. Analyses using our proposed metrics reveal key policy implications for addressing energy poverty in the Global South. Acknowledging that the systems studied provide different capacity, affordability, and carbon footprints, we find that on average, SHS provided comparable hours of lighting to local grid connections, however SHS outages were less equally distributed than those from other sources. In addition, calculations of grid reliability were highly sensitive to measurement techniques and assumptions used, necessitating high resolution data for policy decisions. Finally, economically driven outages conspicuous in pre-paid SHS systems (i.e., disconnections for non-payment) composed a significant portion of experienced unreliability. These findings quantify the important contribution of demand-side affordability to experienced household reliability, thereby allowing for a comprehensive understanding of the reliability of SDG 7.
The (𝑀₊,𝑀₋)-method on compact symmetric spaces and its applications
Authors: Chen Bang-Yen
Published: April 2022

The(M+,M−)(M_{+},M_{-})-method on compact symmetric spaces was introduced by the author and Tadashi Nagano in 1978. Since then, this theory have been studied and applied to several important areas in mathematics by many authors. The main purpose of this article is to provide a comprehensive survey on the(M+,M−)(M_{+},M_{-})-method, including its applications.
Recent progress of biharmonic hypersurfaces in space forms
Authors: Fu Yu , Yang Dan , Zhan Xin
Published: April 2022

In the past two decades, biharmonic submanifolds have attracted much attention from mathematicians all over the world. In particular, concerning Chen’s conjecture and the generalized Chen’s conjecture, many meaningful results have been obtained. In this survey paper, we will restrict our attention to biharmonic hypersurfaces in the real space forms. In the first three parts, we give a short survey on some new developments on biharmonic hypersurfaces in Euclidean spaces, hyperbolic spaces and Euclidean spheres, respectively. In the last section, we outline the proof of Chen’s conjecture for hypersurfaces of

R

5

\mathbb {R}^5

[Adv. Math, 383 (2021), Paper No. 107697, 28] and point out the potential importance of the method and the key techniques used in the proof for further studies on biharmonic hypersurfaces in space forms.
A survey on natural Γ-symmetric structures on 𝑅-spaces
Authors: Quast Peter , Sakai Takashi
Published: April 2022

This is a report upon the authors’ 2020 paper on

Γ
\Gamma

-symmetric structures on

R
R

-spaces, which continues various aspects of Nagano’s work. We first briefly recall some generalizations of symmetric spaces. Next we show that certain

R
R

-spaces admit

Γ
\Gamma

-symmetric structures appearing in a natural way as a generalization of symmetric

R
R

-spaces. Moreover we describe the maximal antipodal sets of these natural

Γ
\Gamma

-symmetric structures.
Long-term mitochondrial stress induces early steps of Tau aggregation by increasing reactive oxygen species levels and affecting cellular proteostasis
Authors: Samluk Lukasz , Ostapczuk Piotr , Dziembowska Magdalena
Published: April 2022

Little is known about the defects of mitochondrial biology that play a role in the development of Alzheimer’s disease, in which Tau protein aggregates are observed in the brains of some patients. Here, we report that long-term mitochondrial stress may induce early steps of Tau protein aggregation by affecting oxidative balance and cellular proteostasis.
Effects of Social Control on Eating and Relational Behaviors in Romantic Relationships
Authors: Huelsnitz Chloe O , Rothman Alexander J , Simpson Jeffry A
Published: April 2022

Background

Prior research has shown that social control strategies can have either positive or negative effects on individuals’ health behaviors. However, no research has examined the degree to which social control attempts enacted by romantic partners are associated with individuals’ relational behaviors or whether perceptions of a partner’s motivation to engage in social control moderate links between the use of social control and either health or relational behaviors.

Purpose

This study investigated (a) the degree to which two classes of social control strategies that romantic partners can use to improve their partners’ eating behavior (autonomy-supportive and autonomy-limiting strategies) are associated with eating and relational behaviors, and (b) whether perceptions of the partner’s motivation for using social control moderate associations between its use and an individual’s eating and relational behavior.

Methods

This study had a daily diary design. One hundred and forty-seven individuals in romantic relationships completed surveys for 14 consecutive days.

Results

On days when individuals reported that their partner used autonomy-supportive social control strategies, individuals reported healthier eating and more constructive relational behaviors. There were no effects of autonomy-limiting strategies on eating or relational behavior. Perceptions of a partner’s motives did not moderate associations between reported social control and any behavioral outcomes. Moreover, there were no effects of either reported social control strategies or partner motive perceptions across time.

Conclusion

Romantic partners’ perceived use of autonomy-supportive—but not autonomy-limiting—social control has benefits for individuals’ health behaviors without incurring notable costs to their romantic relationship.
Coalitions among Plaintiffs’ Attorneys in Securities Class Actions
Authors: Choi Stephen J , Erickson Jessica , Pritchard Adam C
Published: April 2022

This article examines contests among plaintiffs’ law firms to become lead counsel in securities fraud class actions. We study lead counsel appointments in all federal securities class actions from 2005 to 2016. Although the typical class action has several lead plaintiff motions, many of these motions will either withdraw or combine before the judge chooses the lead plaintiff and lead counsel. We find that law firms’ decisions to combine correspond primarily with the existence of relationships between law firms rather than case characteristics. When motions combine, the number of selected lead counsel typically increases. We also find that the correspondence of prior relationships between law firms on decisions to withdraw or combine does not increase with our proxies for the importance of synergies between law firms.
Fingerprints of climatic changes through the late Cenozoic in southern Asian flora: Magnolia section Michelia (Magnoliaceae)
Authors: Zhao Nan , Park Suhyeon , Zhang Yu-Qu , Nie Ze-Long , Ge Xue-Jun , Kim Sangtae , Yan Hai-Fei
Published: April 2022

Background and Aims

Ongoing global warming is a challenge for humankind. A series of drastic climatic changes have been proven to have occurred throughout the Cenozoic based on a variety of geological evidence, which helps to better understand our planet’s future climate. Notably, extant biomes have recorded drastic environmental shifts. The climate in southern Asia, which hosts high biodiversity, is deeply impacted by the Asian monsoon. The origins and evolutionary dynamics of biomes occurring between the tropics and sub-tropics in southern Asia have probably been deeply impacted by climatic changes; however, these aspects remain poorly studied. We tested whether the evolutionary dynamics of the above biomes have recorded the drastic, late Cenozoic environmental shifts, by focusing on Magnolia section Michelia of the family Magnoliaceae.

Methods

We established a fine time-calibrated phylogeny of M. section Michelia based on complete plastid genomes and inferred its ancestral ranges. Finally, we estimated the evolutionary dynamics of this section through time, determining its diversification rate and the dispersal events that occurred between tropical and sub-tropical areas.

Key Results

The tropical origin of M. section Michelia was dated to the late Oligocene; however, the diversification of its core group (i.e. M. section Michelia subsection Michelia) has occurred mainly from the late Miocene onward. Two key evolutionary shifts (dated approx. 8 and approx. 3 million years ago, respectively) were identified, each of them probably in response to drastic climatic changes.

Conclusion

Here, we inferred the underlying evolutionary dynamics of biomes in southern Asia, which probably reflect late Cenozoic climatic changes. The occurrence of modern Asian monsoons was probably fundamental for the origin of M. section Michelia; moreover, the occurrence of asymmetric dispersal events between the tropics and sub-tropics hint at an adaptation strategy of M. section Michelia to global cooling, in agreement with the tropical conservatism hypothesis.
The Effect of a Novel Platysma Hammock Flap During Extended Deep Plane Facelift on the Signs of Aging in the Neck
Authors: Jacono Andrew A , Alemi A Sean , Harmon Jeffrey Joseph , Ahmedli Nigar
Published: April 2022

Background

Aging changes in the neck, including platysma banding (PB), skin laxity (SL), and submandibular gland visibility (SGV), have a high degree of recurrence after rhytidectomy.

Objectives

The authors sought to assess the long-term improvement in PB, SL, and SGV with addition of aplatysmal hammock flap to the extended deep-plane facelift and assess patient satisfaction.

Methods

This was a prospective study of 123 consecutive patients undergoing extended deep-plane facelift incorporating platysma hammock flap with or without midline platysmaplasty. Standard 2-dimensional patient photographs were employed to assess PB, SL, and SGV preoperative and >12 months postoperative. A 1-year postoperative patient satisfaction survey was conducted.

Results

The platysmal hammock flap without midline platysmaplasty cohort had a significant (P < 0.01) reduction in mean preoperative PB, SL, and SGV scores from 1.03, 1.88, and 1.21 to 0.06, 0.03, and 0.15 at 21 months. The platysmal hammock flap with midline platysmaplasty cohort had a significant (P < 0.01) reduction in preoperative PB, SL, and SGV scores from 1.81, 2.43, and 1.81 to 0.10, 0.15, and 0.48 at 18 months. The platysmal hammock flap with and without midline platysmaplasty cohorts had 96.2% and 88.9% satisfaction, respectively.

Conclusions

Extended deep-plane facelift with a platysmal hammock flap achieves long-term, sustained improvements in PB, SL, and SGV; is well-tolerated; and results in substantial patient satisfaction.

Level of Evidence: 4
Patient-level costs of staged unilateral versus immediate bilateral symmetrization mammoplasty in breast-conserving surgery
Authors: Grant Yasmin , Thiruchelvam Paul T. R. , Kovacevic Lana , Mossialos Elias , Al-Mufti Ragheed , Hogben Katy , Hadjiminas Dimitri J. , Leff Daniel R.
Published: April 2022

Background

Following therapeutic mammoplasty (TM), the contralateral breast may require a later balancing procedure to optimize shape and symmetry. The alternative is to offer patients simultaneous TM with immediate contralateral symmetrization via a dual-surgeon approach, with the goal of reducing costs and minimizing the number of subsequent hospital appointments in an era of COVID-19 surges. The aim of this cost–consequence analysis is to characterize the cost–benefit of immediate bilateral symmetrization dual-operator mammoplasty versus staged unilateral single operator for breast cancer surgery.

Method

A prospective single-centre observational study was conducted at an academic teaching centre for breast cancer surgery in the UK. Pseudonymized data for clinicopathological variables and procedural care information, including the type of initial breast-conserving surgery and subsequent reoperation(s), were extracted from the electronic patient record. Financial data were retrieved using the Patient-Level Information and Costing Systems.

Results

Between April 2014 and March 2020, 232 women received either immediate bilateral (n = 44), staged unilateral (n = 57) for breast cancer, or unilateral mammoplasty alone (n = 131). The median (interquartile range (i.q.r.)) additional cost of unilateral mammoplasty with staged versus immediate bilateral mammoplasty was €5500 (€4330 to €6570) per patient (P < 0.001), which represents a total supplementary financial burden of €313 462 to the study institution. There was no significant difference between groups in age, Charlson comorbidity index, operating minutes, time to adjuvant radiotherapy in months, or duration of hospital stay.

Conclusion

Synchronous dual-surgeon immediate bilateral TM can deliver safe immediate symmetrization and is financially beneficial, without delay to receipt of adjuvant therapy, or additional postoperative morbidity.
How (Not) to Purchase Novel Goods and Services: Specific Performance Versus at-will Contracts
Authors: Schmitz Patrick W
Published: April 2022

A buyer wants to purchase an innovative good from a seller. Both parties are risk-neutral, and payments from the buyer to the seller must be non-negative. After the contract is signed, the seller privately observes a signal which may be informative about the seller’s costs. We compare two contracting regimes. In the case of specific performance, the courts enforce the contractually specified trade level. In the case of at-will contracting, the seller is free to walk away from the contract after observing the signal. The optimal regime from an economic efficiency point-of-view depends on the informativeness of the signal.
A Nearly Neutral Model of Molecular Signatures of Natural Selection after Change in Population Size
Authors: Müller Rebekka , Kaj Ingemar , Mugal Carina F.
Published: April 2022

The nearly neutral theory is a common framework to describe natural selection at the molecular level. This theory emphasizes the importance of slightly deleterious mutations by recognizing their ability to segregate and eventually get fixed due to genetic drift in spite of the presence of purifying selection. As genetic drift is stronger in smaller than in larger populations, a correlation between population size and molecular measures of natural selection is expected within the nearly neutral theory. However, this hypothesis was originally formulated under equilibrium conditions. As most natural populations are not in equilibrium, testing the relationship empirically may lead to confounded outcomes. Demographic nonequilibria, for instance following a change in population size, are common scenarios that are expected to push the selection–drift relationship off equilibrium. By explicitly modeling the effects of a change in population size on allele frequency trajectories in the Poisson random field framework, we obtain analytical solutions of the nonstationary allele frequency spectrum. This enables us to derive exact results of measures of natural selection and effective population size in a demographic nonequilibrium. The study of their time-dependent relationship reveals a substantial deviation from the equilibrium selection–drift balance after a change in population size. Moreover, we show that the deviation is sensitive to the combination of different measures. These results therefore constitute relevant tools for empirical studies to choose suitable measures for investigating the selection–drift relationship in natural populations. Additionally, our new modeling approach extends existing population genetics theory and can serve as foundation for methodological developments.
Complete Sequence of a 641-kb Insertion of Mitochondrial DNA in the Arabidopsis thaliana Nuclear Genome
Authors: Fields Peter D. , Waneka Gus , Naish Matthew , Schatz Michael C. , Henderson Ian R. , Sloan Daniel B.
Published: April 2022

Intracellular transfers of mitochondrial DNA continue to shape nuclear genomes. Chromosome 2 of the model plant Arabidopsis thaliana contains one of the largest known nuclear insertions of mitochondrial DNA (numts). Estimated at over 600 kb in size, this numt is larger than the entire Arabidopsis mitochondrial genome. The primary Arabidopsis nuclear reference genome contains less than half of the numt because of its structural complexity and repetitiveness. Recent data sets generated with improved long-read sequencing technologies (PacBio HiFi) provide an opportunity to finally determine the accurate sequence and structure of this numt. We performed a de novo assembly using sequencing data from recent initiatives to span the Arabidopsis centromeres, producing a gap-free sequence of the Chromosome 2 numt, which is 641 kb in length and has 99.933% nucleotide sequence identity with the actual mitochondrial genome. The numt assembly is consistent with the repetitive structure previously predicted from fiber-based fluorescent in situ hybridization. Nanopore sequencing data indicate that the numt has high levels of cytosine methylation, helping to explain its biased spectrum of nucleotide sequence divergence and supporting previous inferences that it is transcriptionally inactive. The original numt insertion appears to have involved multiple mitochondrial DNA copies with alternative structures that subsequently underwent an additional duplication event within the nuclear genome. This work provides insights into numt evolution, addresses one of the last unresolved regions of the Arabidopsis reference genome, and represents a resource for distinguishing between highly similar numt and mitochondrial sequences in studies of transcription, epigenetic modifications, and de novo mutations.
Characteristics, relationships and precision of direct acoustic-to-seismic coupling measurements from local explosions
Authors: Anthony Robert E , Watzak Joshua , Ringler Adam T , Wilson David C
Published: April 2022

Acoustic energy originating from explosions, sonic booms, bolides and thunderclaps have been recorded on seismometers since the 1950s. Direct pressure loading from the passing acoustic wave has been modelled and consistently observed to produce ground deformations of the near surface that have retrograde elliptical particle motions. In the past decade, increased deployments of colocated seismometers and infrasound sensors have driven efforts to use the transfer function between direct acoustic-to-seismic coupling to infer near-surface material properties including seismic velocity structure and elastic moduli. In this study, we use a small aperture (≈600 m) array of broadband seismometers installed in different manners and depths in both granite and sedimentary overburden to understand the fundamental nature and repeatability of seismic excitation from 1 to 15 Hz using horizontally propagating acoustic waves generated by 97 local (2–10 km) explosions. In agreement with modelling, we find that the ground motions induced by acoustic-to-seismic coupling attenuate rapidly with depth. We confirm the modelled relation between acoustic and ground motion amplitudes, but show that within one acoustic wavelength, the uncertainty in the transfer coefficient between seismic and acoustic energy at a given seismic station increases linearly with separation distance between the seismic and acoustic sensor. We attribute this observation to the rapid decorrelation of the infrasonic wavefield across small spatial scales and recommend colocating seismic and infrasound sensors for use in studies seeking to invert for near-surface material properties. Additionally, contrary to acoustic-to-seismic coupling theory and prior observations, we find that seismometers emplaced in granite do not record retrograde elliptical particle motions in response to direct pressure loading. We rule out seismometer tilt effects as a likely source of this observations and suggest that existing models of acoustic-to-seismic excitation may be too simplistic for seismometers placed in high rigidity materials.
Practicing functional nasal surgery in the non-urban setting: experience from a single center
Authors: Tham Tristan , Saleem Matthew I , Hawthorne McKenna , Georgolios Alexandros
Published: April 2022

Nasal airway obstruction is a prevalent chief complaint in the contemporary facial plastic surgery practice. Studies report an asymmetric distribution of plastic surgeons across the United States with a disproportionately high concentration of surgeons practicing in urban areas. The lack of elective specialist care creates unique challenges for these patients who may need to travel and dedicate time to reach a nasal surgery expert. We conducted a retrospective chart review to report our experience from practicing functional nasal surgery in such a non-urban setting in the United States. A total of 103 patients underwent functional nasal surgery (FNS) between May 2015 and August 2021 including septoplasty, inferior turbinate reduction, septorhinoplasty and nasal valve procedures. We present the epidemiological characteristics, surgical techniques used and postoperative complications and illuminate the unique characteristics of practicing FNS in the non-urban setting.
Five-Year PTSD Symptom Remission in Two Patients Following Treatment With Rivastigmine
Authors: Rudzki Stephan , Praet Stephan
Published: April 2022

Introduction

The beneficial effect of rivastigmine, an acetylcholinesterase inhibitor (AChEi), which increases levels of acetylcholine (ACh), was first reported in 2013. This paper replicates those findings and reports sustained symptom remission.

Methods and Materials

The high-frequency (HF) component of heart rate variability (HRV) is a measure of cholinergic withdrawal and was measured using a Zephyr Bioharness HR monitor, pre- and post-commencement of treatment. Data analysis was performed using Kubios HRV software. PTSD symptom severity was assessed using the Post-Traumatic Checklist—Civilian (PCL-C).

Results

Low HF HRV was observed in both patients before rivastigmine treatment and reductions in PCL-C scores paralleled increases in HF HRV values. Follow-up revealed low HF HRV values in both patients despite PCL-C scores indicating remission. Sympathetic nervous system hyperactivity was observed in one patient, just before a suicide attempt. Following rivastigmine treatment, the patient had no further suicidal ideation or attempts. Another patient reported worsening of her PTSD symptoms in the peri-menstrual period, which was abolished by rivastigmine. She also experienced symptom relapse following prolonged infections.

Conclusion

Low HF HRV has been reported in PTSD patients, but findings have been inconsistent. Cholinergic withdrawal could explain the disturbances in sleep, learning, and memory seen in PTSD patients. The relapse of symptoms following prolonged infection implicates the immune system as a possible initiator of the disorder. ACh and estrogen have anti-inflammatory properties, supporting a possible role of inflammation in initiating PTSD. The effect of rivastigmine treatment should be tested in properly controlled clinical trials.
Physical Tests to Predict Combat Task Performance Among Brazilian Air Force Infantry Cadets
Authors: Botta Willian C , Franchini Emerson , Gabriel-Costa Daniele , Campos Fábio A D
Published: April 2022

Introduction

The Brazilian Air Force (BAF) personnel must be prepared to perform their professional activities under the worst conditions. This preparation goes beyond habits of practicing physical activity, since it is necessary to perform specific physical tasks, referred to as “combat tasks” (CTs). This study aimed to investigate a combination of specific physical tests (SPTs) for predicting physical performance on simulated tasks (STs) that mimicked the performance of CTs.

Materials and Methods

Thirty infantry cadets from the BAF took part in anthropometric assessments, 11 SPTs, and 3 STs, during 7 testing days. Bivariate Pearson’s correlation was used to determine linear relationships between SPT and ST results, and multiple linear regression models were used to identify test batteries that significantly predicted performance on STs. The level of significance was set at 5%. The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the BAF (protocol code 15796819.4.0000.5250, date of approval September 25, 2019).

Results

The greatest predictive power was obtained by the test battery that consisted of sprint–drag–carry, leg tucks, and handgrip strength (R2 = 0.56, P < .01). Conversely, the test battery comprised of push-ups, sit-ups, and 12-minute run (which represents the conventional physical test of the BAF), which presented the lowest predictive power (R2 = 0.14, P < .05).

Conclusions

In conclusion, this study identified a test battery for predicting performance on the following STs: foot march, casualty drag, and move under direct fire. This finding represents the first step to improve the reliability of the BAF physical assessments, focusing on combat readiness levels.
Natural history of Behçet’s disease focusing on remission of oral ulcers
Authors: Tomizuka Takafumi , Kikuchi Hirotoshi , Okubo Mai , Asako Kurumi , Miyata Satoshi , Kono Hajime
Published: April 2022

Objectives

To describe the long-term clinical course of each manifestation of Behçet’s disease (BD) and clarify factors involved in oral ulcer (OU) remission using clinical information of BD patients.

Methods

We retrospectively studied 155 BD patients visiting our hospital (1989–2020). We defined remission criteria for each manifestation and examined long-term clinical changes. Classification and regression trees and multivariable analyses were performed to investigate OU prognostic factors; hazard ratios were used to assign scores to prognostic factors deemed significant [OU prognosis score (OuP score)]. Risk stratification was examined by dividing the OuP scores into four stages.

Results

OUs appeared earliest, with the slowest decline in prevalence observed post-BD diagnosis. OU presence was the most common factor inhibiting complete remission. Young age at OU onset, never smoker, presence of genital ulcers, positive pathergy test, no usage of tumour necrosis factor inhibitors or of immunosuppressants, and long-term non-treatment or symptomatic treatment for OUs were poor OU prognostic factors. Based on multivariable analysis, the area under the curve of the OuP score to predict OU prognosis was 0.678.

Conclusions

Remission criteria for each symptom clarified that OU had the greatest impact on complete BD remission. Faster OU remission was associated with earlier OU therapeutic intervention other than symptomatic treatment.
Cost-effectiveness analyses of biologic and targeted synthetic disease-modifying anti-rheumatic diseases in patients with rheumatoid arthritis: Three approaches with a cohort simulation and real-world data
Authors: Kuwana Masataka , Tamura Naoto , Yasuda Shinsuke , Fujio Keishi , Shoji Ayako , Yamaguchi Hiroko , Iwasaki Katsuhiko , Makishima Misako , Kawata Yuichi , Yamashita Katsuhisa , Igarashi Ataru
Published: April 2022

Objective

To assess the cost-effectiveness of biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in rheumatoid arthritis.

Methods

We conducted three analyses: a lifetime analysis with a cohort model (Study A) and two short-term analyses (Studies B and C). Study A evaluated the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained from costs of standard treatments. Study B evaluated yearly costs per person achieving American College of Rheumatology (ACR) response (ACR20, ACR50, and ACR70), and Study C evaluated costs per person achieving previously defined claims-based effectiveness (equivalent to 28-joint Disease Activity Score ≤ 3.2). The proportion of ACR responders to the drugs of interest were determined by mixed treatment comparisons. Studies B and C estimated costs using a claims database.

Results

In Study A, ICERs of all b/tsDMARDs were lower than 5.0 million Japanese yen (JPY) per QALY. In Study B, yearly costs per person with ACR50 response were lower for subcutaneous tocilizumab (TCZ-SC; 1.9 million JPY) and SC abatacept (2.3 million JPY). In Study C, costs per person were lower for TCZ-SC (1.3 million JPY) and intravenous TCZ (1.6 million JPY) and effectiveness rates were higher for intravenous TCZ (45.3%) and infliximab (43.0%).

Conclusion

The b/tsDMARDs with lower prices showed higher cost-effectiveness.
Progression to Critical Illness and Death in Patients With Breakthrough Hospitalizations
Authors: Suleyman Geehan , Fadel Raef , Alsaadi Ayman , Sueng Luis Ng , Ghandour Ali , Alkhatib Ahmad , Singh Tarandeep , Parsons Austin , Miller Joseph , Ramesh Mayur , Brar Indira , Alangaden George
Published: April 2022

Background

Characterization of disease progression and outcomes after coronavirus disease 2019 (COVID-19)–related hospitalization in vaccinated compared with unvaccinated individuals is limited.

Methods

This was a retrospective case–control study of symptomatic vaccinated (cases) and unvaccinated (controls) participants hospitalized for COVID-19 between December 30, 2020, and September 30, 2021, in Southeast Michigan. Hospitalized adult patients with lab-confirmed COVID-19 were identified through daily census report. Breakthrough infection was defined as detection of severe acute respiratory syndrome coronavirus 2 ≥14 days after completion of the primary vaccination series. The association between prior vaccination and critical COVID-19 illness (composite of intensive care unit [ICU] admission, invasive mechanical ventilation [IMV], 28-day mortality) was examined.

Results

Two hundred ten (39%) fully vaccinated and 325 (61%) unvaccinated patients were evaluated. Compared with controls, cases were older, had more comorbidities (4 [3–7] vs 2 [1–4]; P < .001), and were more likely to be immunocompromised. Cases had less severe symptoms compared with controls (2 [1–2] vs 2 [2–3]; P < .001) and were less likely to progress to critical COVID-19 illness (33.3% vs 45.5%; P < .001); 28-day mortality was significantly lower in cases (11.0% vs 24.9%; P < .001). Symptom severity (odds ratio [OR], 2.59; 95% CI, 1.61–4.16; P < .001) and modified Sequential Organ Failure Assessment score on presentation (OR, 1.74; 95% CI, 1.48–2.06; P < .001) were independently associated with development of critical COVID-19 illness. Prior vaccination (OR, 0.528; 95% CI, 0.307–0.910; P = .020) was protective.

Conclusions

COVID-19-vaccinated patients were less likely to develop critical COVID-19 illness and more likely to survive. Disease severity at presentation was a predictor of adverse outcomes regardless of vaccination status.
Association ofCD274(PD-L1) Copy Number Changes with Immune Checkpoint Inhibitor Clinical Benefit in Non-Squamous Non-Small Cell Lung Cancer
Authors: Murugesan Karthikeyan , Jin Dexter X , Comment Leah A , Fabrizio David , Hegde Priti S , Elvin Julia A , Alexander Brian , Levy Mia A , Frampton Garrett M , Montesion Meagan , Roychowdhury Sameek , Kurzrock Razelle , Ross Jeffrey S , Albacker Lee A , Huang Richard S P
Published: April 2022

Background

We sought to characterize response to immune checkpoint inhibitor (ICI) in non-squamous non-small cell lung cancer (NSCLC) across various CD274 copy number gain and loss thresholds and identify an optimal cutoff.

Materials and Methods

A de-identified nationwide (US) real-world clinico-genomic database was leveraged to study 621 non-squamous NSCLC patients treated with ICI. All patients received second-line ICI monotherapy and underwent comprehensive genomic profiling as part of routine clinical care. Overall survival (OS) from start of ICI, for CD274 copy number gain and loss cohorts across varying copy number thresholds, were assessed.

Results

Among the 621 patients, patients with a CD274 CN greater than or equal to specimen ploidy +2 (N = 29) had a significantly higher median (m) OS when compared with the rest of the cohort (N = 592; 16.1 [8.9-37.3] vs 8.6 [7.1-10.9] months, hazard ratio (HR) = 0.6 [0.4-1.0], P-value = .05). Patients with a CD274 copy number less than specimen ploidy (N = 299) trended toward a lower mOS when compared to the rest of the cohort (N = 322; 7.5 [5.9-11.3] vs 9.6 [7.9-12.8] months, HR = 0.9 [0.7-1.1], P-value = .3).

Conclusion

This work shows that CD274 copy number gains at varying thresholds predict different response to ICI blockade in non-squamous NSCLC. Considering these data, prospective clinical trials should further validate these findings, specifically in the context of PD-L1 IHC test results.
Nutritional recommendations for patients undergoing prolonged glucocorticoid therapy
Authors: Esteves Gabriel P , Mazzolani Bruna Caruso , Smaira Fabiana Infante , Mendes Elizabeth Silva , de Oliveira Gabriela Guimarães , Roschel Hamilton , Gualano Bruno , Pereira Rosa Maria R , Dolan Eimear
Published: April 2022

Glucocorticoid (GC) therapy is a common treatment used in rheumatic and autoimmune diseases, owing to its anti-inflammatory and immunosuppressive effects. However, GC therapy can also induce a number of adverse effects, including muscle and bone loss, hypertension, metabolic perturbations and increased visceral adiposity. We review available evidence in this area and provide nutritional recommendations that might ameliorate these adverse effects. Briefly, optimizing calcium, vitamin D, sodium and protein intake and increasing consumption of unprocessed and minimally processed foods, while decreasing the consumption of ultra-processed foods, might counteract some of the specific challenges faced by these patients. Importantly, we identify a dearth of empirical data on how nutritional intervention might impact health-related outcomes in this population. Further research is required to investigate the clinical and therapeutic efficacy of these theory-based recommendations.
When FinTech Competes for Payment Flows
Authors: Parlour Christine A , Rajan Uday , Zhu Haoxiang
Published: April 2022

We study the impact of FinTech competition in payment services when a monopolist bank uses payment data to learn about consumers’ credit quality. Competition from FinTech payment providers disrupts this information spillover. The bank’s price for payment services and its loan offers are affected. FinTech competition promotes financial inclusion, may hurt consumers with a strong bank preference, and has an ambiguous effect on the loan market. Both FinTech data sales and consumer data portability increase bank lending, but the effects on consumer welfare are ambiguous. Under mild conditions, consumer welfare is higher under data sales than with data portability.
Trends in risk factor control in patients with gout: data from the National Health and Nutrition Examination Survey, 2007–2018
Authors: Li Likang , Tian Junzhang , Wang Ruoting , Adachi Jonathan D , Chen Bo , Qu Hongying , Li Guowei
Published: April 2022

Objectives

To explore trends in risk factor control (hypertension, diabetes mellitus, hyperlipidaemia) in patients with gout and medication use among those whose risk factor control targets were not achieved.

Methods

We used the data from National Health and Nutrition Examination Survey (NHANES) between 2007–2008 and 2017–2018 for analyses. The study samples were weighted so that they could be representative of the non-institutionalized US population. We conducted a cross-sectional analysis to assess trends in risk factor control and medication use, and employed logistic regression analyses to explore patient characteristics associated with risk factor control.

Results

The prevalence of participants in whom blood pressure control target was achieved decreased from 64.6% in 2007–2008 to 55.3% in 2017–2018 (P-value for trend = 0.03). The percentage of participants whose glycaemic, lipid or all three risk factor control targets were achieved remained stable temporally (P > 0.05). Some patient characteristics were significantly related to risk factor control, including age 45–64, age ≥65, Asian Americans, non-Hispanic Blacks, higher family income, and being overweight and obese. A trend towards increased use of glucose-lowering medication was found (from 71.0% in 2007–2008 to 94.7% in 2017–2018, P < 0.01), while the prevalence of taking blood pressure-lowering and lipid-lowering medications remained stable (P > 0.05).

Conclusion

Based on NHANES data, a significant trend towards decreased blood pressure control was observed in patients with gout, while glycaemic and lipid control levelled off. These findings emphasize that more endeavours are needed to improve management of cardiovascular risk factors in patients with gout.
New Dental Warning for Buprenorphine
Authors: Aschenbrenner Diane S.
Published: April 2022

The labeling for transmucosal buprenorphine products will now include a warning that the drug may cause serious dental problems such as tooth decay, cavities, oral infections, and tooth loss.

Nurses and NPs should complete an oral history and assessment prior to patients beginning treatment. Patients should be informed of these potential adverse effects and encouraged to receive regular dental care.
Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19
Authors: Pagador Florida , Barone Melanie , Manoukian Mana , Xu Wenrui , Kim Linda
Published: April 2022

Background:

Prolonged exposure to work-related stress can lead to nurse burnout, potentiating clinical and medication errors and low-quality patient care. Holistic approaches (such as mindfulness training, “zen rooms,” and massage chairs, among others) have been shown to reduce nurses' anxiety, stress, and burnout.

Purpose:

To evaluate the use of “serenity lounges” (dedicated rooms where nurses can take workday breaks for the purposes of relaxation and rejuvenation) and massage chairs on nurses' anxiety, stress, and burnout.

Methods:

This quality improvement project analyzed 67 paired responses to surveys filled out by nurses before and after their use of serenity lounges at a medical center in Los Angeles between November 2020 and May 2021. Following successful implementation of a serenity lounge on a pilot unit, this project was expanded to a total of 10 units, including COVID-19 cohort units. As part of this expansion, massage chairs were added to 10 serenity lounges, along with items such as wipes, gloves, and shoe covers to enable nurses to adhere to infection control protocols.

Results:

Analysis of the 67 paired responses to pre- and post-lounge-use surveys revealed a significant reduction in feelings of emotional exhaustion, burnout, frustration, being worn out, stress, and anxiety after use of the serenity lounge. Improvements in feelings of emotional exhaustion, being worn out, and being anxious were also noted after using the massage chair for at least 10 to 20 minutes.

Conclusions:

These results highlight the importance of providing a holistic approach, including a serene space, massage equipment, and other amenities, to help nurses reduce feelings of anxiety, stress, and burnout, particularly during challenging times such as the COVID-19 pandemic.
Fewer Postsurgical ICU Admissions in Hospitals with Better Nurse Work Environments
Authors: Rosenberg Karen
Published: April 2022

According to this study:

Patients in hospitals that have better nurse work environments are less likely to be admitted to an ICU after surgery and to die compared with patients in hospitals that have poorer nurse work environments.
Increase in Type 1 Diabetes Incidence in Children During COVID-19
Authors: Rosenberg Karen
Published: April 2022

According to this study:

There was an increase in the incidence of new-onset type 1 diabetes in children during the COVID-19 pandemic.

More children had diabetic ketoacidosis at the time of diagnosis.
Du ration of Anticoagulant Therapy for Pediatric Venous Thromboembolism
Authors: Rosenberg Karen
Published: April 2022

According to this study:

Among patients younger than 21 years of age who have provoked venous thromboembolism, anticoagulant therapy for six weeks compared with three months met noninferiority criteria based on the trade-off between recurrent venous thromboembolism risk and bleeding risk.
Recognizing and Acting on Mentation Concerns
Authors: Mack Laurin , Zonsius Mary C. , Newman Michelle , Emery-Tiburcio Erin E.
Published: April 2022

This article is the fourth in a series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive.

The articles in this series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by The John A. Hartford Foundation, are also provided. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Information for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.