bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review andmeta‐analysis
Authors: Berberich Anne , Finitsis Stephanos , Strambo Davide , Michel Patrik , Herweh Christian , Meyer Lukas , Hanning Uta , Strbian Daniel , Abdalkader Mohamad , Nogueira Raul G. , Puetz Volker , Kaiser Daniel P. O. , Olive‐Gadea Marta , Ribo Marc , Fragata Isabel , Marto João Pedro , Romoli Michele , Ringleb Peter A. , Nguyen Thanh N. , Nagel Simon
Published: May 2022

Background and purpose

Endovascular therapy (EVT) is increasingly reported for treatment of isolated posterior cerebral artery (PCA) occlusions although its clinical benefit remains uncertain. This study‐level meta‐analysis investigated the functional outcomes and safety of EVT and best medical management (BMM) compared to BMM alone for treatment of PCA occlusion stroke.

Methods

We conducted a literature search in PubMed, Web of Science and Embase for studies in patients with isolated PCA occlusion stroke treated with EVT + BMM or BMM including intravenous thrombolysis. There were no randomized trials and all studies were retrospective. The primary outcome was modified Rankin Scale score of 0–2 at 3 months, while safety outcomes included mortality rate and incidence of symptomatic intracranial hemorrhage (sICH).

Results

Twelve studies with a total of 679 patients were included in the meta‐analysis: 338 patients with EVT + BMM and 341 patients receiving BMM alone. Good functional outcome at 3 months was achieved in 58.0% (95% confidence interval [CI] 43.83–70.95) of patients receiving EVT + BMM and 48.1% (95% CI 40.35–55.92) of patients who received BMM alone, with respective mortality rates of 12.6% (95% CI 7.30–20.93) and 12.3% (95% CI 8.64–17.33). sICH occurred in 4.2% (95% CI 2.47–7.03) of patients treated with EVT + BMM and 3.2% (95% CI 1.75–5.92) of patients treated with BMM alone. Comparative analyses were performed on studies that included both treatments and these demonstrated no significant differences.

Conclusions

Our results demonstrate that EVT represents a safe treatment for patients with isolated PCA occlusion stroke. There were no differences in clinical or safety outcomes between treatments, supporting randomization of future patients into distal vessel occlusion trials.
Simple Test for the Fitness for Purpose of Geological Reference Materials According to the Uncertainties Associated with Their Reference Values
Authors: Potts Philip J. , Webb Peter C.
Published: May 2022

A simple test is proposed for assessing whether reference material values are fit for purpose according to the uncertainties associated with these values. The approach involves comparing individual reference value uncertainties (uRM) with the corresponding target uncertainty (uH) calculated from a modified form of the Horwitz function, uH = 0.01c0.8495, where c is the mass fraction of the reference value. Providing uRM < uH/3, the uncertainty contribution from the reference value will cause an increase in the combined uncertainty no greater than 5.4% and the reference value can be considered fit for purpose in the calibration and validation of respective measurement results. In applying this methodology, it is convenient to calculate a quality factor (QF = 3uRM/uH) for each reference value, which would then be considered fit for purpose when QF < 1. Examples are shown for reference materials characterised by different methodologies (NIST certification, the IAG certification protocol, GeoReM preferred values and the GeoPT programme). Calculation of the median quality factor from all quoted reference values in individual reference materials allows an overall assessment to be made of the quality of the material and the effectiveness of the methodology used for its characterisation.
Density dependence of clutch size and offspring sex ratio in starling colonies
Authors: Rubalcaba Juan G. , Polo Vicente
Published: May 2022

Optimal life‐history theory predicts that individuals should adjust both the number and the sex of their offspring to maximize fitness in response to environmental and social factors such as breeding density. While reductions in optimal clutch size are well‐studied in birds, the evidence for sex ratio adjustments is still equivocal and, so far, we lack a thorough understanding of how these strategies interact to maximize fitness. Here, we investigate how breeding density simultaneously affects brood sex ratio and clutch size in a sexually dimorphic and polygynous bird. We tested the prediction that mothers breeding at a higher density lay smaller clutches and overproduce daughters, the sex with less variable fitness returns and that disperses further away from their natal territory. We distributed nest boxes at either a high (HD) or a low density (LD) and monitored clutch sizes and sex ratios during five years in a wild breeding colony of spotless starlings. While mothers breeding in HD nests produced more daughters than those breeding in LD nests, the density dependence of clutch size varied among years, with a tendency to lay smaller clutches in HD nests. Our results suggest that mothers consistently adjust offspring sex ratio in response to breeding density, whereas adjustments in clutch size varied in a more complex way. These results support the role of sex allocation strategies in response to density and show that further theoretical and empirical research is required to understand the interaction between clutch size and sex ratio adjustments in animals.
Oral anticoagulants and outcomes in adults ≥80 years with atrial fibrillation: A global federated health network analysis
Authors: Harrison Stephanie L. , Buckley Benjamin J. R. , Ritchie Leona A. , Proietti Riccardo , Underhill Paula , Lane Deirdre A. , Lip Gregory Y. H.
Published: May 2022

Background

The objective of this study was to determine associations between use of oral anticoagulation (OAC) and stroke and bleeding‐related outcomes for older people ≥80 years with atrial fibrillation (AF), and to determine trends over time in prescribing of OAC for this population.

Methods

A retrospective cohort study was conducted. People aged ≥80 years with AF receiving (1) no OAC; (2) warfarin; or (3) a non‐vitamin‐K antagonist oral anticoagulant (NOAC) between 2011 and 2019 were included. Propensity score matching was used to balance cohorts (no OAC, warfarin or a NOAC) on characteristics including age, sex, ethnicity, and co‐morbidities. Cox proportional hazard models were used to derive hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

The proportion of people aged ≥80 years receiving any OAC increased from 32.4% (n = 27,647) in 2011 to 43.6% (n = 110,412) in 2019. After propensity score matching, n = 169,067 individuals were included in the cohorts receiving no OAC or a NOAC. Compared to no OAC, participants receiving a NOAC had a lower risk of incident dementia (hazHR 0.68, 95% CI 0.65–0.71), all‐cause mortality (HR 0.49, 95% CI 0.48–0.50), first‐time ischaemic stroke (HR 0.87, 95% CI 0.83–0.91), and a higher risk of major bleeding (HR 1.08, 95% CI 1.05–1.11). Compared to participants receiving warfarin, participants receiving a NOAC had a lower risk of dementia (HR 0.90, 95% CI: 0.86–0.93), all‐cause mortality (HR 0.74, 95% CI: 0.72–0.76), ischaemic stroke (HR 0.86, 95% CI: 0.82–0.90) and major bleeding (HR 0.88, 95% CI: 0.85–0.90). Similar results were observed when only including people with additional bleeding risk factors.

Conclusions

The proportion of people aged ≥80 years receiving OAC has increased since the introduction of NOACs, but remains low. Use of a NOAC was associated with improved outcomes compared to warfarin, and compared to no OAC, except for a small but statistically significant higher risk of major bleeding.
Structural basis for histone H3 recognition by NASP in Arabidopsis
Authors: Liu Yanhong , Chen Liu , Wang Na , Wu Baixing , Bao Hongyu , Huang Hongda
Published: May 2022

The structural basis for histone recognition by the histone chaperone nuclear autoantigenic sperm protein (NASP) remains largely unclear. Here, we showed that Arabidopsis thaliana AtNASP is a monomer and displays robust nucleosome assembly activity in vitro. Examining the structure of AtNASP complexed with a histone H3 α3 peptide revealed a binding mode that is conserved in human NASP. AtNASP recognizes the H3 N‐terminal region distinct from human NASP. Moreover, AtNASP forms a co‐chaperone complex with ANTI‐SILENCING FUNCTION 1 (ASF1) by binding to the H3 N‐terminal region. Therefore, we deciphered the structure of AtNASP and the basis of the AtNASP–H3 interaction.
High school policies about sexual harassment: What's on the books and what students think
Authors: Brown Christia Spears , Biefeld Sharla D. , Bulin Jenna
Published: May 2022

Sexual harassment (SH) in schools is unwanted and unwelcome behavior of a sexual nature that, when severe, offensive, and pervasive, creates a hostile environment that is prohibited under Title IX of the Education Amendments of 1972. In the current mixed methods study, using analyses of school policies and reports, and student survey and qualitative data, we examined (a) whether public high schools’ policies about SH were in compliance with Title IX guidance, (b) whether SH policies were related to alumni's knowledge and attitudes about their schools’ SH policies, and (c) whether SH policies were related to alumni's experiences with and reporting of SH. Results indicated that, of the 172 school districts within one state, only one‐fourth of the school districts had SH policies in which SH was clearly defined and in which there were noted consequences for perpetrating SH. Despite students experiencing SH, very few students ever reported SH to an adult at school. However, of the small number of students who reported SH to an adult at school, 87.5% went to a school with an explicit SH policy. Many students stated that they did not report SH because they did not trust adults to handle it fairly or effectively.
Falsely “high” serum cobalamin level in subacute combined degeneration of spinal cord secondary to pernicious anemia masquerading as myelodysplastic syndrome
Authors: Yong Kar Ying , Yap Eng Soo , Goh Yihui , Tan Loon Ying , Choong Clarice Shi Hui , Ng Kay Wei Ping
Published: May 2022

Cobalamin deficiency causes clinical manifestations ranging from anemia to neuropsychiatric presentations. We present a patient initially treated as myelodysplastic syndrome (MDS), who was later diagnosed to have pernicious anemia. He presented with pancytopenia, and bone marrow aspirate was suggestive of MDS. Serum cobalamin was high. Six months later, he developed progressive lower limb weakness. Magnetic resonance imaging (MRI) of the spine showed a hyperintense signal in the lateral aspects of the cord at C6 to T10 suggestive of subacute combined degeneration of the spinal cord. Homocysteine, methylmalonic acid, and anti‐intrinsic factor levels were found to be high, confirming the diagnosis of cobalamin deficiency secondary to pernicious anemia. His pancytopenia and weakness improved markedly after 5 months of parenteral cobalamin injection. This case highlights that cobalamin deficiency can mimic MDS, and second‐line assays are important in a patient with a high clinical suspicion of cobalamin deficiency despite normal serum cobalamin level.
Paediatric kidney transplantation: Towards a framework for pretransplant urological evaluation
Authors: Evans‐Barns Hannah , Mushtaq Imran , Michell Ian , Kausman Joshua , Webb Nathalie , Taghavi Kiarash
Published: May 2022

The role of the urologist in paediatric kidney transplantation has evolved alongside advances in management for the various causes of end‐stage kidney disease. Improvements in antenatal intervention and postnatal care have seen children with increasingly complex urological anomalies survive until transplant. Once solely responsible for the oversight of a child's surgical care, the paediatric urologist now works within a multidisciplinary transplant team, alongside transplant surgeons, paediatric nephrologists, transplant coordinators, psychologists, social workers, and transitional care specialists. We sought to identify available pretransplant evaluation frameworks to guide urological preparation and decision‐making. Drawing from available evidence and reflecting on multi‐institutional experience, we propose a streamlined approach to urologic assessment, which recognises that optimal transplant outcomes in this heterogenous cohort require lower urinary tract dysfunction to be carefully defined preoperatively.
Waitlist and posttransplant outcomes of critically ill infants awaiting heart transplantation managed without ventricular assist device support
Authors: Frandsen Erik L. , Banker Katherine A. , Mazor Robert L. , McMullan D. Michael , Law Yuk M. , Kemna Mariska S. , Albers Erin L. , Hong Borah J. , Friedland‐Little Joshua M.
Published: May 2022

Background

Infants listed for heart transplant are at high risk for waitlist mortality. While waitlist mortality for children has decreased in the current era of increased ventricular assist device use, outcomes for small infants supported by ventricular assist device remain suboptimal. We evaluated morbidity and survival in critically ill infants listed for heart transplant and managed without ventricular assist device support.

Methods

Critically ill infants (requiring ≥1 inotrope and mechanical ventilation or ≥2 inotropes without mechanical ventilation) listed between 2008 and 2019 were included. During the study period, infants were managed primarily medically. Mechanical circulatory support, specifically extracorporeal membrane oxygenation, was utilized as “rescue therapy” for decompensating patients.

Results

Thirty‐two infants were listed 1A, 66% with congenital heart disease. Median age and weight at listing were 2.2 months and 4.4 kg, with 69% weighing <5 kg. At listing, 97% were mechanically ventilated, 41% on ≥2 inotropes, and 25% under neuromuscular blockade. Five patients were supported by ECMO after listing. A favorable outcome (transplant or recovery) was observed in 84%. One‐year posttransplant survival was 92%. Infection was the most common waitlist complication occurring in 75%. Stroke was rare, occurring in one patient who was supported on ECMO. Renal function improved from listing to transplant, death, or recovery (eGFR 70 vs 87 ml/min/1.73m2, p = .001).

Conclusion

A strategy incorporating a high threshold for mechanical circulatory support and acceptance of prolonged mechanical ventilation and neuromuscular blockade can achieve good survival and morbidity outcomes for critically ill infants listed for heart transplant.
Fertile ground, complex matter: Plurality of farmers’ attitudes towards green waste application as sustainable soil management
Authors: Happel Maaike , Orsi Francesco , Hartmann Thomas , Bakker Martha
Published: May 2022

The adoption of sustainable soil management practices such as the use of green waste from road‐side management and nature reserves is thwarted in practice by hesitance on the side of farmers. To foster the use of these practices, it is crucial to understand farmers’ decision perspectives and attitudes towards them. Using Q‐methodology, the perspectives of 12 dairy and arable farmers in The Netherlands were analysed. It was studied which barriers farmers perceive for green waste application (GWA), and whether perceptions of barriers are related to particular rationalities on the position of farmers within society. In Q‐sorts and semistructured interviews, farmers ranked their degree of agreement on 41 statements about GWA, nutrient policy information, general beliefs on soil and farm management and circular agriculture, inspired by a cultural theory framework. Six decision perspectives were identified, globally agreeing on the benefits of GWA but challenged by rapidly changing regulations regarding nutrient management. Plurality in decision perspectives captured the need for trusted information, alongside differing views on responsibility and views on sustainable agriculture. Combining Q‐methodology with cultural theory confirmed the need to include various notions of trust, power and responsibility in understanding complex decision‐making perspectives within more sustainable soil management practices.
Meta‐synthesis of family communication patterns during post‐stroke vascular aphasia: Evidence to guide practice
Authors: Ramazanu Sheena , Chisale Master R. O. , Baby Priya , Wu Vivien Xi , Mbakaya Balwani C.
Published: May 2022

Background

Previous studies have predominantly focused on the needs of persons with aphasia (PWA), after a stroke diagnosis. However, aphasia is found to cause communication challenges in persons with stroke and their family caregivers as a unit. Evidence is inconclusive about the communication patterns of both persons with aphasia and their family caregivers after a stroke. Studies have not been synthesized on facilitators and barriers of communication patterns between PWA and family caregivers after a stroke.

Aims

A meta‐synthesis of qualitative evidence was conducted to explore family communication patterns after post‐stroke vascular aphasia.

Methods

An electronic literature search of PubMed, CINAHL, Cochrane Library, PsyINFO, and Scopus was performed from January to March 2021. The methods of qualitative meta‐synthesis were underpinned by Sandelowski and Barosso's guidelines. Data analysis was facilitated by Braun and Clarke thematic analysis, using NVivo 11 software.

Results

A total of twenty studies were included for meta‐synthesis. Three themes with corresponding subthemes were identified: (1) changes in family communication patterns (subthemes: adapting to the changes in PWA after a stroke, striving toward communication recovery); (2) facilitators of family communication patterns (subthemes: supportive communication techniques, hope of recovery, time to re‐adjust, and community engagement [recreational activities]); and (3) barriers of communication (subthemes: emotional turmoil and daunting tasks of rehabilitation).

Linking Evidence to Action

Although persons with aphasia and family caregivers are striving to achieve normalcy in communication, they are often challenged by communication deficits and protective family behaviors. Therefore, to establish effective communication, it is of paramount importance for nursing professionals to educate PWAs and their caregivers on facilitators and barriers of family communication patterns. Technology‐based family communication facilitation and support groups for PWA and their family caregivers are recommended to promote family communication. The review was registered with PROSPERO (CRD42021235519).
Desafios e possibilidades para a inserção de farmacêuticos na Estratégia Saúde da Família no município de Vitória da Conquista, Brasil
Authors: Oliveira Coqueiro Fabrício , Maia dos Santos Adriano , Baier Krepsky Patricia
Published: May 2022

Esta pesquisa tem como objetivo compreender como o farmacêutico pode contribuir para o fortalecimento da Estratégia de Saúde da Família, por meio de um estudo qualitativo. Foram realizadas três sessões de grupo focal, duas com atores que atuavam em equipes de unidades básicas de saúde e outro composto de atores da assistência farmacêutica. A análise de conteúdo temática resultou em quatro categorias: 1) falta de esclarecimento de dúvidas sobre medicamentos para a equipe de Saúde da Família e usuários; 2) incipiente interação do farmacêutico com a equipe; 3) necessidade de enfrentamento da medicamentalização da sociedade e 4) estrutura inadequada das farmácias nas unidades básicas de saúde. Houve demanda por profissionais mais preparados para ações integradas às equipes de Saúde da Família. Ações possíveis são discutidas.
Fin de vida en pacientes con cáncer no curable. Percepciones de los pacientes sobre el sistema de salud
Authors: De Vries Esther , Medina-Rico Mauricio , Osorio Clavijo Katalina , Rodríguez Nicole Alejandra , Vicuña Jiménez Víctor Manuel , Leal Fabián , Calvache José Andrés , Moreno Socorro
Published: May 2022

Objetivo: Identificar y analizar experiencias y opiniones que pacientes oncológicos sin opción curativa tienen respecto al sistema de salud en torno a sus cuidados paliativos y deseos de final de vida. Métodos: Estudio cualitativo con perspectiva crítico-constructivista. Se realizaron 22 entrevistas en profundidad a pacientes entre 28 y 78 años con algunos de los cánceres más frecuentes (mama, cuello uterino, colon, estómago, entre otros, con una expectativa de vida entre seis y doce meses) atendidos en el Hospital Universitario San José de Popayán, el Hospital Universitario San Ignacio y el Instituto Nacional de Cancerología en Bogotá. Resultados: Se identificaron dos categorías de experiencias y deseos de los pacientes: una acerca de la atención e información que desean recibir por parte del personal de salud y otra relacionada con el sistema de salud, que incluye problemas administrativos con las EPS, la importancia de brindar continuidad en la atención médica, la oportunidad en la entrega de medicamentos y la asignación de citas, y la infraestructura hospitalaria direccionada hacia la Institución donde desean ser atendidos.  Conclusiones: Los resultados de este estudio contribuyen al entendimiento de las experiencias que los pacientes con cáncer no curable han tenido con el sistema de salud. Es necesario educar al personal de salud sobre la necesidad de indagar y discutir los deseos de sus pacientes para ofrecer ayuda pertinente que optimice su calidad de vida. Se debe mejorar la infraestructura de los centros de cuidados paliativos y urgencias, el agendamiento de citas y la entrega oportuna de medicamentos.
Gerentes de Atenção Básica à Saúde
Authors: Bairros da Silva Luciano , Oliveira Sousa Marcos Henrique , Tôrres Oliveira Elaine Cristina , Iñiguez-Rueda Lupicinio
Published: May 2022

Se objetivó caracterizar el perfil de los gerentes de Unidades Básicas de Salud (UBS), que detenían de equipos de la Estrategia Salud de la Familia, en la capital Maceió, Alagoas, Brasil. Se trata de un estudio descriptivo transversal, realizado con 31 gestores de UBS, ubicadas en ocho Distritos Administrativos de Salud. Se reunieron datos sociodemográficos de: sexo, edad, tipo de vínculo laboral, área de capacitación, experiencias en funciones de gestión y tiempo de ejercicio de la función directiva. La información se presentó por medio de medida absolutas y relativas. Se identificó que los gestores son en su mayoría del sexo femenino (67,74%), con edad de los 30 a los 39 años (35,48%), con título universitario en las áreas de ciencias sociales aplicadas (67,74%), con contrato laboral en puesto comisionado (93,55%), con experiencia en función de dirección no sanitaria (38,71%) y con menos de un año en el puesto (29,03%). Se identificó que la gestión municipal cumple la recomendación de la Política Nacional de Atención Primaria de que toda UBS disponga de un gerente y que la mayoría de los profesionales presentan los requisitos mínimos para desempeñar la función. Sin embargo, se verificó elevado número de gerentes con contracto de empleo inestables e inseguros y desempeñando la gerencia sin experiencia en el área de la salud. Se considera necesaria la definición inmediata de criterios específicos para la selección y el grado de profesionalidad, así como la elección por contratos de trabajo que garanticen los derechos de los trabajadores y una mayor estabilidad en la función para estos profesionales.
Rotor Stability Effects of Tilting Pad Journal Bearings With Assembled Clearance Asymmetry
Authors: Urbiola-Soto Leonardo , Pennacchi Paolo
Published: May 2022

This paper presents component and system-level analyses to understand the stiffness, damping, and rotor stability effects of tilting pad journal bearings (TPJB) with assembled clearance variation across pads. This variation results from a normal manufacturing process of the bearing components, i.e., shaft, bearing shell, pad radius, and pad thickness, whose machining tolerances add in a closed-loop producing a different assembled clearance per pad. The results are compared to the standard analysis practice of uniformly setting all pads assembled clearance to its maximum and minimum stack-up values to find the worst case for stability. The component-level analysis follows a rigid rotor approach. While in the system-level analysis, a full rotor-bearings-seals model of a lightweight, high-speed centrifugal compressor is employed. A four-pad TPJB with a load between pads (LBP) configuration is considered. Large differences in stiffness and log dec are encountered, while almost negligible differences are found in damping. Also, some interesting observations related to rotor-bearing planar mode shapes are reported when the bearing pads have dissimilar assembled clearances. These modes disappear once the labyrinth seal force coefficients are incorporated into the full model.
Stability of Allowable Flaw Angles for High Toughness Ductile Pipes Subjected to Bending Stress in the ASME Code Section XI
Authors: Hasegawa Kunio , Strnadel Bohumír , Li Yinsheng , Lacroix Valéry
Published: May 2022

Allowable stresses for pipes with circumferential flaws are provided by the ASME Code Section XI. The stresses for the high toughness pipes are determined by fully plastic collapse stresses and safety factors. The plastic collapse stresses are estimated by limit load criteria, which are also provided by the ASME Code Section XI. When applied stresses of the pipes at the flaw locations are less than the allowable stresses, the flaws are acceptable for the end-of-evaluation period. The allowable stresses are categorized for various service-level conditions of the plant operation. When pipe walls are thin, part-through flaws can easily develop into through-wall flaws, and the likelihood of coolant leakage is high. The ASME Code Section XI provides final allowable flaw angles of through-wall flaws that are a limit on the length of part-through wall flaws for thin-walled pipes. The final allowable angles are currently applied to pipes in order to maintain structural tolerance if the part-through flaws become through-wall flaws. To ensure that this stability is not compromised, plastic collapse stresses for through-wall flaws are combined with the allowable stresses. However, the final allowable angles of through-wall flaws are not identified for thin-walled pipes. This paper compares plastic collapse stresses of through-wall flaws and allowable stresses of part-through flaws for pipes. The comparison of these stresses is used to derive the final allowable angles of through-wall flaws. The angles can be expressed either in the form of exact solutions or as conventional options that are appropriate for various service-level conditions.
Non-Conservatism of ASME BPVC Section III Division 5 Isochronous Stress–Strain Curves for 316H Stainless Steel at Low Stresses
Authors: Petkov Markian , Young George A. , Juan Pierre-Alexandre
Published: May 2022

Future Gen IV high-temperature reactors are expected to operate above 450 °C where creep effects are significant in safety-related structures, e.g., reactor vessels. The ASME Boiler and Pressure Vessel Code (BPVC) Section III Division 5 provides the rules and methodologies for design of such high-temperature components. Of high relevance to the designer are the isochronous stress–strain curves (ISSCs) part of the rules for deformation limits in the code. The ISSCs are an important method to estimate accumulated inelastic strains at a given stress and duration at elevated temperatures. In this study, the ISSCs for 316H stainless steel in the current edition of the ASME BPVC Section III Division 5 have been reevaluated between 593 °C and 750 °C by adopting a physics-informed minimum creep rate model to reconstruct them. It is demonstrated that the current ASME Section III Division 5 minimum creep rate model underpredicts creep rates compared to experimental data at low stresses (e.g., 650 °C, <40 MPa). By employing a physics-informed minimum creep rate model which captures both diffusive- and dislocation glide/climb-controlled creep regimes, this deficiency is addressed. The ASME ISSCs for 316H stainless steel are then reconstructed by adopting this modified minimum creep rate model. It was found that the ASME ISSCs could underestimate total accumulated strains at ∼σ/σy <0.65 for durations t >1000 h by >10 times which could give rise to non-conservatism in inelastic strain. Experimental data at various temperatures confirm the findings. Potential approaches to address this non-conservatism in inelastic strain and the implications to design are discussed.
Very low frequency three-dimensional beamforming for a miniaturized aperture acoustic vector sensor array
Authors: Guo Junyuan , Li Liangwen , Piao Shengchun , Gong Lijia , Zhang Minghui
Published: May 2022

In this Letter, a three-dimensional beamforming method is proposed for a miniaturized aperture acoustic vector sensor (AVS) array. This method extracts the multipole modes using the AVS array, and then synthesizes the desired beam pattern according to the relation between multipole modes and spherical harmonics. Compared to the spherical harmonics decomposition of the sound field method, the proposed method achieves comparable array gain with higher white noise gain when the distance of adjacent elements d and the wavelength λ satisfy 0.01≤d/λ≤0.2. Experimental results also demonstrate the effectiveness of the proposed three-dimensional beamforming method at very low frequency.
Atmospheric turbulence effects on shaped and unshaped sonic boom signatures
Authors: Stout Trevor A. , Sparrow Victor W.
Published: May 2022

Atmospheric turbulence is known to randomly distort the “N-wave” sonic boom signature emitted by conventional, unshaped supersonic aircraft. To predict the effect of turbulence on the signature from shaped aircraft, a numerical model has been developed based on the nonlinear Khokhlov–Zabolotskaya–Kuznetzov (KZK) propagation equation coupled with an approximate atmospheric turbulence model. The effects of turbulence on an archetypal N-wave and a shaped signature are compared via a series of numerical experiments propagating the signatures through multiple random realizations of turbulence in varying atmospheric and propagation conditions. The simulated results generally show that the variance of the Stevens Mark VII perceived level metric related to loudness is decreased by boom shaping and that the shocks in the shaped signature are less distorted than for the N-wave. Additionally, the probabilities of high-level and high-amplitude signatures are decreased for the shaped signature. Thus, the model predicts that boom shaping results in a signature with more consistent loudness and amplitude after propagation through turbulence.
What Recess Policy? Assessing Arizona Schools’ Adherence to Senate Bill 1083
Authors: Griffo Janelle , Nam Kahyun , van der Mars Hans , Kulinna Pamela , Ross Allison
Published: May 2022

Children’s health is affected by physical activity (PA) opportunities throughout the school day. Schools are a central venue for children meeting physical activity recommendations, and multiple areas, such as recess, have been established to protect against childhood obesity and overweight. Senate Bill 1083 is a law that addresses recess policies in Arizona that calls for students in Grades K–5 receive at least two recess periods per day. The purposes of this study were to explore Arizona charter and public elementary (K–5) school’s adherence to Senate Bill 1083 as well as investigate the barriers, if any, to implementing recess. A modified version of the School Physical Activity Policy Assessment survey was administered to members of the Arizona Health and Physical Education organization. Findings from the survey show that Arizona schools are not providing the recommended number of recess periods per day, and there are multiple barriers to recess implementation. Further investigations and bill modifications are needed.
The deubiquitinase USP8 targets ESCRT-III to promote incomplete cell division
Authors: Mathieu Juliette , Michel-Hissier Pascale , Boucherit Virginie , Huynh Jean-René
Published: May 2022

In many vertebrate and invertebrate organisms, gametes develop within groups of interconnected cells called germline cysts formed by several rounds of incomplete divisions. We found that loss of the deubiquitinase USP8 gene in
Drosophila
can transform incomplete divisions of germline cells into complete divisions. Conversely, overexpression of USP8 in germline stem cells is sufficient for the reverse transformation from complete to incomplete cytokinesis. The ESCRT-III proteins CHMP2B and Shrub/CHMP4 are targets of USP8 deubiquitinating activity. In
Usp8
mutant sister cells, ectopic recruitment of ESCRT proteins at intercellular bridges causes cysts to break apart. A Shrub/CHMP4 variant that cannot be ubiquitinated does not localize at abscission bridges and cannot complete abscission. Our results uncover ubiquitination of ESCRT-III as a major switch between two types of cell division.
Fate mapping of neural stem cell niches reveals distinct origins of human cortical astrocytes
Authors: Allen Denise E. , Donohue Kevin C. , Cadwell Cathryn R. , Shin David , Keefe Matthew G. , Sohal Vikaas S. , Nowakowski Tomasz J.
Published: May 2022

Progenitors of the developing human neocortex reside in the ventricular and outer subventricular zones (VZ and OSVZ, respectively). However, whether cells derived from these niches have similar developmental fates is unknown. By performing fate mapping in primary human tissue, we demonstrate that astrocytes derived from these niches populate anatomically distinct layers. Cortical plate astrocytes emerge from VZ progenitors and proliferate locally, while putative white matter astrocytes are morphologically heterogeneous and emerge from both VZ and OSVZ progenitors. Furthermore, via single-cell sequencing of morphologically defined astrocyte subtypes using Patch-seq, we identify molecular distinctions between VZ-derived cortical plate astrocytes and OSVZ-derived white matter astrocytes that persist into adulthood. Together, our study highlights a complex role for cell lineage in the diversification of human neocortical astrocytes.
Effective Interferon Lambda Treatment Regimen To Control Lethal MERS-CoV Infection in Mice
Authors: Dijkman Ronald , Verma Abhishek Kumar , Selvaraj Muneeswaran , Ghimire Roshan , Gad Hans Henrik , Hartmann Rune , More Sunil , Perlman Stanley , Thiel Volker , Channappanavar Rudragouda
Published: May 2022

Effective antiviral agents are urgently required to prevent and treat individuals infected with SARS-CoV-2 and other emerging viral infections. The COVID-19 pandemic has catapulted our efforts to identify, develop, and evaluate several antiviral agents.
The 2009 Pandemic H1N1 Hemagglutinin Stalk Remained Antigenically Stable after Circulating in Humans for a Decade
Authors: Christensen Shannon R. , Martin Emily T. , Petrie Joshua G. , Monto Arnold S. , Hensley Scott E.
Published: May 2022

In 2009, a new pandemic H1N1 (pH1N1) virus began circulating in humans. Many individuals mounted hemagglutinin (HA) stalk-focused antibody responses upon infection with the 2009 pH1N1 strain, since the HA stalk of this virus was relatively conserved with other seasonal H1N1 strains.
Dual-Role of Cholesterol‐25‐Hydroxylase in Regulating Hepatitis B Virus Infection and Replication
Authors: Wei Qi , Song Hongxiao , Gao Yanli , Xu Fengchao , Xiao Qingfei , Wang Fei , Lei Bingxin , Niu Junqi , Gao Pujun , Ma Haichun , Tan Guangyun
Published: May 2022

The enzymatic product of CH25H, 25-hydroxycholesterol (25HC), has been previously shown to play a critical role in the blockage of the cell-virus fusion in response to viral infection. However, our study indicates a dual role of CH25H in regulating HBV. We find the CH25H-mediated inhibition of HBV replication is independent on its enzyme activity and CH25H binds to HBx and inhibits HBx nucleus translocation. We are interested to find out 25HC promotes HBV infection.
Draft Genome Sequence of Vibrio mediterranei Strain CyArs1
Authors: Boaventura João , Caetano Tânia , Mendo Sónia , Cleary Daniel F. R. , Gomes Newton C. M. , Oliveira Vanessa
Published: May 2022

Here, we report on the draft genome sequence of
Vibrio mediterranei
strain CyArs1, isolated from the marine sponge
Cinachyrella
sp. Genome annotation revealed multiple genomic features, including eukaryotic-like repeat protein- and multidrug resistance-encoding genes, potentially involved in symbiotic relationships with the sponge host.
Runoff of Russian Rivers under Current and Projected Climate Change: a Review 2. Climate Change Impact on the Water Regime of Russian Rivers in the XXI Century
Authors: Gelfan A. N. , Gusev E. M. , Kalugin A. S. , Krylenko I. N. , Motovilov Yu. G. , Nasonova O. N. , Millionshchikova T. D. , Frolova N. L.
Published: May 2022

The present overview is the second part of the article “Runoff of Russian Rivers Under Current and Projected Climate Change: A Review,” which focuses on modern assessment of possible changes in the runoff characteristics of Russian rivers in the XXI century under projected global climate change. The article considers two assessment groups: based on (1) climate models and (2) hydrological models, using data of climate model simulations. The review mainly presents works that have been published over the last 7−8 years, since the release of the previous IPCC Assessment Report and the National Assessment Report of Roshydromet. It is noted that, in recent years, there has been a shift regarding the methodology of assessment of hydrological consequences of projected climate change—from simulations based on climate models to simulations based on regional hydrological models that allow one to simulate characteristics of the water regime of rivers over a historical period more accurately and to assess their possible changes in the future with lower uncertainty than climate models.
Vaccine-induced immune thrombocytopaenia and thrombosis (VITT) after COVID-19 vaccination
Authors: Ribeiro Maria Inês , Pimenta Inês , Conde Inês , Gonzalez Filipe André
Published: May 2022

COVID-19 represents a global health emergency, causing significant morbidity and mortality. Multiple vaccines have been distributed worldwide to control the spread of this pandemic. Several reports of thrombosis and thrombocytopaenia have been described after vaccination. These have been termed vaccine-induced immune thrombocytopaenia and thrombosis (VITT). We report a fatal case of VITT after receiving the first dose of Ad26.COV2.S vaccine. A man in his 30s developed thrombocytopaenia, massive haemoperitoneum due to spleen rupture and extensive portal and femoral vein thrombosis. The patient rapidly developed multiple organ failure and died. We attributed this condition to the vaccine due to the temporal relationship, presence of thrombosis and thrombocytopaenia, high levels of platelet factor 4 antibodies and exclusion of other diagnoses. Healthcare providers should be aware of such rare but fatal complications of COVID-19 immunisation, as early diagnosis of VITT may improve prognosis by allowing timely appropriate treatment.
Gastric tuberculosis presenting as a large gastric ulcer
Authors: Elterefi Alanood Eisameldin , Uwaydah Ahmad Kanaan , Helal Gamal Rashed , Hassan Nidal M M
Published: May 2022

While gastrointestinal (GI) tuberculosis (TB) accounts for 1%–3% of all TB cases worldwide, TB of the stomach is extremely rare and accounts for 1%–2% of all GI TB. Little is known about this entity, and most data are obtained from case reports. We report a case of a woman in her 60s who presented with a 2-week history of generalised weakness, fatigue and shivering, with severe loss of appetite on background history of dyspepsia and significant weight loss for the preceding 2 years. Upper endoscopy revealed a large gastric ulcer. Biopsy and histopathology revealed caseating granulomas with numerous acid-fast bacilli detected with Ziehl-Neelsen stain. She was diagnosed with gastric TB. Subsequently, she was also diagnosed with pulmonary, adrenal and colonic involvement.
Longus colli tendinitis: acute neck pain with retropharyngeal swelling
Authors: Lim Wan Qi , Ho Eu Chin
Published: May 2022

Longus colli tendinitis (LCT) has been described in several case reports, and is likely underdiagnosed due to its non-specific symptoms and self-limiting nature. It usually presents as acute neck pain with retropharyngeal swelling seen on nasoendoscopy and imaging studies. This may lead to unnecessary invasive interventions if physicians are unaware of the disease course. We discuss a case of LCT in a young woman who was treated at our institution, with recommendations on how to identify and treat such cases accurately without overtreatment.
Gingival enlargement improvement following medication change from amlodipine to benidipine and periodontal therapy
Authors: Kamei Hidehiko , Furui Maria , Matsubara Tatsuaki , Inagaki Koji
Published: May 2022

The use of calcium channel blockers (CCBs) is associated with gingival enlargement, which adversely affects oral function, hygiene and aesthetics. Although CCB-induced gingival enlargement is a known adverse effect, it is rarely or never caused by some CCBs. In this paper, we report the case of a late 80’s female patient with hypertension who experienced amlodipine-induced gingival enlargement. The patient’s antihypertensive medication was changed from amlodipine to another CCB of the same class, benidipine, which has not been reported to cause gingival enlargement. The patient also received periodontal therapy. A significant improvement in gingival enlargement was noted, and blood pressure control was maintained. This case indicates that it might be beneficial for patients with hypertension presenting CCB-induced gingival enlargement to switch from the CCB that caused gingival enlargement to another CCB with little to no risk.
One in two people admitted to hospital with covid-19 develop complications and may need support
Authors: Saul Helen , Gursul Deniz , Cassidy Samantha , Harrison Ewen
Published: May 2022

The study

Drake TM, Riad AM, Fairfield CJ, et al. Characterisation of in-hospital complications associated with covid-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study. Lancet 2021;398:10296.

To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/one-in-two-people-hospitalised-with-covid-19-develop-complications-may-need-support/
Estimating the threshold of health workforce densities towards universal health coverage in Africa
Authors: Ahmat Adam , Asamani James Avoka , Abdou Illou Mourtala Mahaman , Millogo Jean Jacques Salvador , Okoroafor Sunny C , Nabyonga-Orem Juliet , Karamagi Humphrey Cyprian , Nyoni Jennifer
Published: May 2022

Background

There have been past efforts to develop benchmarks for health workforce (HWF) needs across countries which have been helpful for advocacy and planning. Still, they have neither been country-specific nor disaggregated by cadre—primarily due to data inadequacies. This paper presents an analysis to estimate a threshold of 13 cadres of HWF density to support the progressive realisation of universal health coverage (UHC).

Method

Using UHC service coverage as the outcome measure, a two-level structural equation model was specified and analysed in STATA V.16. In the first level of structural equations, health expenditure per capita—one of the cross-cutting inputs for UHC, was used to explain the critical inputs for service delivery/coverage. In the second level of the model, the critical inputs for service delivery were used to explain the UHC Service Coverage Index (UHC SCI), in which the contribution of the HWF was ‘partial out’.

Results

The analysis found that a unit increase in the HWF density per 10 000 population is positively associated with statistically significant improvements in the UHC SCI of countries (β=0.127, p<0.001). Similarly, a positive and statistically significant association was established between diagnostic readiness and the UHC SCI (β=0.243, p=0.015). Essential medicines readiness was positively correlated but not statistically significant (β=0.053, p=0.658). Controlling for other variables, a density of 134.23 per 10 000 population across 13 HWF categories is necessary to attain at least 70% UHC SCI.

Conclusion

Consistent with current knowledge, the HWF is a significant predictor of the UHC SCI. Attaining at least 70% of the UHC SCI requires about 134.23 health workers (a mix of 13 cadres) per 10 000 population.
Health workforce policy and plan implementation in the context of universal health coverage in the Africa Region
Authors: Ahmat Adam , Okoroafor Sunny C , Asamani James Avoka , Dovlo Delanyo , Millogo Jean Jacques Salvador , Abdou Illou Mourtala Mahaman , Nyoni Jennifer
Published: May 2022

Several countries in Africa have developed human resources for health (HRH) policies and strategies to synergise efforts in setting priorities, directions and means to address the major challenges around leadership and governance, production, recruitment, management, motivation and retention and coordination. In this paper, we present information on the availability, quality and implementation of national HRH policies and strategic plans in the WHO Africa Region. Information was obtained using a questionnaire completed by the head of HRH departments in the Ministries of Health of 47 countries in the WHO Africa Region. Of the 47 countries in the Region, 57% (27 countries) had HRH policies and 11% (5 countries) were in the process of developing one. Thirty-two countries (68%) had national strategic plans for HRH with 12 (26%) being in the process of developing a strategic plan, and 28 countries reporting the implementation of their strategic plans. On the quality of the policies and strategic plans, 28 countries (88%) linked their plans to the national development plan, 30 countries (94%) informed their policy and plan using the national health policy and strategic plans. Evidence-based HRH policies and plans guide the actions of actors in strengthening health systems. Countries need to invest in developing quality HRH policies and plans through an intersectoral approach and based on contextual evidence. This is vital in ensuring that equitably distributed, well-regulated and motivated HRH are available to deliver people-centred health services to the population.
Global health education in high-income countries: confronting coloniality and power asymmetry
Authors: Sayegh Hoda , Harden Christina , Khan Hijab , Pai Madhukar , Eichbaum Quentin G , Ibingira Charles , Goba Gelila
Published: May 2022

Contemporary global health education is overwhelmingly skewed towards high-income countries (HICs). HIC-based global health curricula largely ignore colonial origins of global health to the detriment of all stakeholders, including trainees and affected community members of low- and middle-income countries. Using the Consortium of Universities for Global Health’sGlobal Health Education Competencies Tool-Kit, we analyse the current structure and content of global health curricula in HICs. We identify two major areas in global health education that demand attention: (1) the use of a competency-based education framework and (2) the shortcomings of curricular content. We propose actionable changes that challenge current power asymmetries in global health education.