bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Artificial Intelligence in Integrated Circuits
Authors: He Yucheng
Published: September 2021

Integrated circuit and artificial intelligence technology are inseparable. Artificial intelligence technology depends on the learning ability and computing ability of computers and other machines. In this process, integrated circuits provide hardware support for the operation of artificial intelligence algorithms. For a long time, the application research of artificial intelligence technology in the field of integrated circuit mainly focuses on circuit fault analysis and artificial intelligence chips. Especially in recent years, due to the rapid development of technology, the combination of the two has become more closely, and more scientists and researchers have invested in the interdisciplinary research of the two disciplines. In this paper, the application of artificial intelligence technology in the field of integrated circuits is explored, that is, its applications in the three aspects of chip, integrated circuit fault diagnosis and circuit design optimization is discussed, and the relationship between artificial intelligence technology and integrated circuit is reflected. Finally, it is concluded that the cross research and application of integrated circuit and artificial intelligence technology will have an important impact on the level of science and technology and the level of human social life.
Design and implementation of dynamic teaching model of diesel engine based on 3D printing technology
Authors: Chen Ping , Zhang Tao , Zhang Bin , Luo Li
Published: September 2021

In view of the shortage of models of practical installation and teaching AIDS in the teaching and training of traditional naval ship diesel engines, the 3D printing technology is integrated with the educational concept of this course, and a multi-functional diesel engine teaching AIDS model suitable for classroom teaching is designed and manufactured, and its design method and process are expounded. A set of models of diesel engine teaching AIDS are designed and manufactured by using this method and applied in classroom teaching. The teaching effect is good, the learners’ enthusiasm is stimulated, and the teaching and training quality is improved.
Research on Big Data Acquisition Bus Technology of NC Machine Tool
Authors: Li Jindong
Published: September 2021

Big data technology has strongly promoted the development of social productive forces, and commercial applications are continuously expanding in all walks of life. It also uses the power of Internet technology to provide strong technical support for the development of the entire industry. In terms of the production of CNC machine tools, due to the use of big data technology, CNC machine tools have been rapidly produced on a large scale, which has played an important role in the upgrading of the entire CNC machine tools and the improvement of quality and efficiency. This article takes the technology of big data acquisition bus for CNC machine tools as the topic, through researching and discussing its concept, meaning and related strategies, in order to effectively improve the production scale and reference.

Chinese Library Classification number : TP23 Document Identification code : A
Load Boundary Analysis of the Load-sensing Hydraulic System with Multi-way Valve and Pressure-compensated Valve
Authors: Luo Li , Yang Kun , Zhao Jianhua , Wang Yin , Song Fei
Published: September 2021

According to the analysis on the working principle of the load-sensing hydraulic system with multi-way valve and constant-difference relief pressure-compensated valve in the load-sensing circuit, it is concluded that there are two working conditions during the operation of the system, load-sensing condition and constant pressure supply condition. Without considering the effect of balance valves, the load boundaries of the forward and backward motion of two conditions were derived, as well as the whole load boundary. The selection principle of balance valves was studied and analyzed to expand the load boundaries. The above conclusions can be applied to this type of load-sensing hydraulic system with any valve-controlled cylinder structure and also provide the theoretical guidance for the design and apply of the system.
Reliability Analysis of Brake-by-wire Systems on Fault Tree
Authors: Zhang Ce , Han Yu , Lin Yier , Wang Dan
Published: September 2021

Brake-by-wire (BBW) system is the key system to ensure the safety and stability control of intelligent vehicle chassis. How to evaluate the BBW systems to meet the safety design requirements is one of the important links of system design. This article takes the BBW system as an example to illustrate the basic process of the safety assessment of intelligent vehicle. The fault tree analysis (FTA) method is used to quantitatively evaluate the failure status of the complete loss of the main brake function, and the fault tree analysis process is detailed. The results show that FTA plays an important role in guiding the design of system architecture. With the help of the importance index, we can quickly find out the weaknesses in the system architecture, when the probability of the failure state of the automobile brake-by-wire system cannot meet the ASIL requirements. Furthermore, effective countermeasures can be taken to optimize the design of the system architecture. Finally, the failure probability corresponding to the failure state of the car’s brake-by-wire system is reduced to 7×10-14.
Overheat fault analysis of drillship electric winch drive system
Authors: Kou Xinghua , Li Lili , Wang Wanli
Published: September 2021

In order to solve the problem of winch motor overheating, this paper analyzes the possible reasons of motor overheating along with the structure and principle of drillship winch. Taking the overheating fault of drillship’s driving motor as the top event, the fault tree model of the overheating problem of the driving motor is established, and the relative weak links of the winch are found out through the minimum cut set. With the result of fault tree analysis as a guide, the lifting device was inspected, the fault reason of the lifting device was found out, and the corresponding solutions were put forward. The results show that the proposed method in the paper can improve the efficiency of fault location.
Research on the Troubleshooting of “Yanmar 6EY26L” Diesel Generator
Authors: Li Tinglang
Published: September 2021

The Flying Accident of marine generator is not common. If the flying accident happens in the power grid, it will easily cause the whole ship power loss and engine damage, which will have a great influence on the safe navigation of ships. this paper analyzes and probes into the causes of the flying car accident occurred in 2019 in a round of “Yanmar 6EY26L” type diesel generator, and expounds the correct treatment measures for the flying car according to the treatment methods of the ships, finally, the daily management method of ship diesel generator, the precautions and preventive measures during diesel generator start-up are put forward in order to avoid similar accidents.
Sensitivity estimates for diffuse, point-like, and extended neutrino sources with KM3NeT/ARCA
Authors: Caiffi B. , Garcia Soto A. , Heijboer A. , Kulikovskiy V. , Muller R.S. , Sanguineti M.
Published: September 2021

The identification of cosmic objects emitting high energy neutrinos could provide new insights about the Universe and its active sources. The existence of these cosmic neutrinos has been proven by the IceCube Collaboration, but the big question of which sources these neutrinos originate from, remains unanswered. The KM3NeT detector for Astroparticle Research with Cosmics in the Abyss (ARCA), with a cubic kilometer instrumented volume, is currently being built in the Mediterranean Sea. It will excel at identifying cosmic neutrino sources due to its unprecedented angular resolution for muon neutrinos (< 0.2 degree for E > 10 TeV events). KM3NeT has a view of the sky complementary to IceCube, and is sensitive to neutrinos across a wide range of energies. In order to identify the signature of cosmic neutrino sources in the background of atmospheric neutrinos and muons, statistical methods are being developed and tested with Monte-Carlo pseudo-experiments. This contribution presents the most recent sensitivity estimates for diffuse, point-like, and extended neutrino sources with KM3NeT/ARCA.
Gender, Authorship, and Translation in Modern Arabic Literature of the Mashriq
Authors: Drumsta Emily
Published: September 2021

Among the many challenges facing Arabic literature in translation, the question of gender has historically been one of the most fraught, particularly as it presses upon Arab women writers. The persistence of Orientalist tropes such as the veil and the harem; the continual othering of the exotic and supposedly untranslatable East; the frequent lumping together of Arab, Muslim, and Middle Eastern identities; the slippage between memoir, or autobiography, and fiction; and the tendency to isolate gender issues from their political, historical, and social contexts—these are some of the many phenomena that scholars and translators have examined in the Western academy. Some issues, such as the burden of mimesis, the tendency to depoliticize the work of controversial authors, and the continual association of Arabic with the Qurʾān (and thereby with the untranslatable and the sacred), face all works of Arabic in their translation for the English-language marketplace. Other issues, such as the stereotyping of Arab women as either helpless victims, exceptional escapees, or deluded pawns of Arab patriarchy, in Mohja Kahf’s reading, affect Arab women’s writing (and literature featuring Arab women characters) with particular force. Many scholars have highlighted the division between the simplistic, flattening representations of Arab women writers offered in mainstream Western publishing and the more nuanced, literarily sensitive presentations in translated works published by small, specialist, and university presses. Pressing issues of genre are also at play: the desire among American publics for a sociological, ethnographic “glimpse behind the veil” of Middle Eastern society has created a preference for both documentary memoirs and mimetic–realist works of fiction that has drawn attention away from works of experimental prose and—most notably—from poetry. Whereas male poets such as the Palestinian Maḥmūd Darwīsh (Mahmoud Darwish) and the Syro-Lebanese Adūnīs (Adunis) have multiple discrete volumes in English translation, Arab women tend to be confined to the realm of anthologies, where one or two poems are meant to represent an entire life of variegated poetic creation, and where the emphasis on their personal identity (“Arab woman”) is highlighted above their role in a more complex literary, social, and historical world. Although several contemporary poets have managed to break from the anthology loop, early-21st-century works in translation suggest that the stereotype of the Muslim woman in need of “saving” has not yet gone away. Still, scholars and translators have also offered numerous strategies and tactics for “rewiring the circuits” that govern the representation of Arab women in the West.
Assessing Contemporary Crises: Aligning Safety Science and Security Studies
Authors: van den Berg Bibi , Prins Ruth , Kuipers Sanneke
Published: September 2021

Security and safety are key topics of concern in the globalized and interconnected world. While the terms “safety” and “security” are often used interchangeably in everyday life, in academia, security is mostly studied in the social sciences, while safety is predominantly studied in the natural sciences, engineering, and medicine. However, developments and incidents that negatively affect society increasingly contain both safety and security aspects. Therefore, an integrated perspective on security and safety is beneficial. Such a perspective studies hazardous and harmful events and phenomena in the full breadth of their complexity—including the cause of the event, the target that is harmed, and whether the harm is direct or indirect. This leads to a richer understanding of the nature of incidents and the effects they may have on individuals, collectives, societies, nation-states, and the world at large.
The Anthropology of Bureaucracy and Public Administration
Authors: Bierschenk Thomas , Olivier de Sardan Jean-Pierre
Published: September 2021

Anthropology is a latecomer to the study of bureaucracy. Nonetheless, the anthropological study of organizations—of which bureaucracies are a subtype, as larger organizations are always bureaucratically organized—was initiated by anthropologists as early as the 1920s. Since the 2010s, the anthropology of bureaucracy has slowly consolidated into a discernible subfield of the discipline. It brings to the study of public administrations a double added value: (a) a specific concern for the informal aspects of bureaucracy, (b) the emic views of bureaucratic actors and their pragmatic contexts, based on long-term immersion in the research field, as well as (c) a non-Eurocentric, global comparative perspective. Anthropologists have focused on bureaucratic actors (“bureaucrats”), the discursive, relational, and material contexts in which they work, the public policies they are supposed to implement or to comply with, and their interactions with the outside world, in particular ordinary citizens (“clients”). A foundational theorem of the anthropological study of bureaucracies has been that you cannot understand organizations on the basis of their official structures alone: the actual workings of an organization are largely based on informal practices and practical rules; there is always a gap between organizational norms and “real” practices; large-scale organizations are heterogeneous phenomena; and conflicts, negotiations, alliances, and power relations are their core components. Thus, one of the major methodological achievements of the anthropology of bureaucracy has been to focus on the dialectics of formal organization and real practices, official regulations, and informal norms in organizations “at work.”
Manipulation in Politics
Authors: Noggle Robert
Published: September 2021

Manipulation is a means by which a person is gotten to do something that the person was not initially inclined to do. As such, it is a form of power. Distinguishing it from other forms of power, such as persuasion, coercion, and physical force, is both important and difficult. It is important because it often matters which form of power a political actor uses, and manipulation is commonly thought to be a form of power whose exercise is undesirable. It is difficult because the line between manipulation and persuasion is often obscure, and because the term manipulation can be applied to tactics that influence the target’s state of mind, and tactics that change the target’s situation. Political theorists and philosophers have offered several accounts of manipulation: Some see it as deceptive influence, some see it as covert influence, some see it as influence with covert intent, some see it as offering bad reasons, and some see it as changing the external situation. While each of these approaches gets some things right about manipulation, each faces important challenges as well.

One reason why manipulation seems undesirable is that it appears to undermine autonomy. This fact helps explain why concerns about manipulation arise in discussions of “nudges” that are meant to improve people’s decision making without coercion. Even if nudges benefit their targets, they may be undesirable on balance if they involve autonomy-undermining manipulation.

Manipulation is a useful tool for autocrats, but it poses serious problems for democracies. This is because it appears to undermine the consent on which democratic legitimacy depends. Some political theorists argue that the problems posed by manipulation can be best addressed through deliberative democracy. Others dispute this suggestion. At the level of practice, there is reason to worry that late-20th- and 21st-century developments in psychology and the social and information sciences, as well as changes to the media landscape, threaten to make manipulation more prevalent and effective.
South African Film Since Apartheid
Authors: Moyer-Duncan Cara
Published: September 2021

Following South Africa’s historical multiracial elections in 1994, a Black majority government came to power, which almost immediately identified the film industry as an important part of their effort to transform one of the most racially and economically unequal countries in the world. The government considered access to culture a basic human right and saw cinema as one way to strengthen the new democracy, by promoting national unity and contributing to economic development. In 1999, through parliamentary legislation, it created the National Film and Video Foundation (NFVF), an agency responsible for promoting the development of a national cinema. This signaled the possible start of a dynamic, socially engaged, and financially viable film industry that could enliven filmmaking within South Africa and across the African continent.

With the end of apartheid-era sanctions, South Africa re-entered the global market and the government embraced neoliberal policies. Consequently, the NFVF increasingly focused on the commercial possibilities of film. While government investments in the film industry have produced some positive results, deeply entrenched structural inequities remain an obstacle to Black filmmakers seeking access to the means of production, distribution, and exhibition. Moreover, in a country of about 55 million people in 2013, cinema was only accessible to about 10 percent of the overall population due to the cost and location of movie theatres. Despite these limitations, in the first two decades of democracy, there were notable developments in independent, popular, and documentary films. Although these categories are not fixed or static, they are a useful way of framing recent trends that offer insight into the South African film industry and the way its films represent the nation. There have also been significant changes in the realm of distribution and exhibition that have the potential to upend the traditional model of cinemagoing.
The Anthropology of Special Economic Zones (Free Ports, Export Processing Zones, Tax Havens)
Authors: Neveling Patrick
Published: September 2021

Special economic zones (SEZs) are a key manifestation of neoliberal globalization. As of 2020, more than 150 nations operated more than 5,400 zones. The combined workforce of factories and service industries in bonded warehouses, export processing zones (EPZs), free trade zones (FTZs), science parks (SPs), regional development zones (RDZs), economic corridors (ECs), and other types of SEZs exceeds one hundred million. These figures include tax havens, offshore financial centers, and free ports. Neoliberal academics and researchers from international organizations say that this has been a long time coming, as the freedom offered in the zones was integral to being human and first implemented in free ports of the Roman Empire. Critical social scientists, among them many anthropologists, have instead identified the zones as products of a 1970s rupture from Keynesian welfarism and Fordist factory regimes to neoliberal globalization and post-Fordist flexible accumulation. Since the early 21st century, scholarship in anthropology has expanded this critical stance on worker exploitation in SEZs toward a historical analysis of SEZs as pacemakers of neoliberal manufacturing globalization since the 1940s. A second strand of ethnographies uses a postmodern lens to research the zones as regimes that produce neoliberal subjectivities and graduated sovereignty.
Women and Medicine in Early America
Authors: Tannenbaum Rebecca
Published: September 2021

Women from all cultural groups in British North America—European, African, and Indigenous American—played a central role in medicine in early America. They acted as midwives, healers, and apothecaries and drew on a variety of cultural traditions in doing so, even as they shared many beliefs about the workings of the human body. Healing gave women a route to authority and autonomy within their social groups. As the 18th century opened, women healers were able to enter the expanding world of capitalist commerce. Anglo-American women parlayed their knowledge of herbal medicine into successful businesses, and even enslaved midwives were sometimes able to be paid in cash for their skills. However, as academic medicine took more of an interest in topics such as childbirth, women practitioners faced increasingly bitter competition from professionalizing male physicians.
Railroad Workers and Organized Labor
Authors: Taillon Paul Michel
Published: September 2021

Railroad workers occupy a singular place in United States history. Working in the nation’s first “big businesses,” they numbered in the hundreds of thousands, came from a wide range of ethnic and racial groups, included both men and women, and performed a wide range of often esoteric tasks. As workers in an industry that shaped the nation’s financial, technological, and political-economic development, railroaders drove the leading edge of industrialization in the 19th century and played a central role in the nation’s economy for much of the 20th. With the legends of “steel-driving” John Henry and “Cannonball” Casey Jones, railroad workers entered the national folklore as Americans pondered the benefits and costs of progress in an industrial age. Those tales highlighted the glamor and rewards, the risks and disparities, and the gender-exclusive and racially hierarchical nature of railroad work. They also offer insight into the character of railroad unionism, which, from its beginnings in the 1860s, oriented toward craft-based, male-only, white-supremacist forms of organization. Those unions remained fragmented, but they also became among the most powerful in the US labor movement, leveraging their members’ strategic location in a central infrastructural industry, especially those who operated the trains. That strategic location also ensured that any form of collective organization—and therefore potential disruption of the national economy—would lead to significant state intervention. Thus, the epic railroad labor conflict of the late 19th century generated the first federal labor relations laws in US history, which in turn set important precedents for 20th-century national labor relations policy. At the same time, the industry nurtured the first national all-Black, civil-rights-oriented unions, which played crucial roles in the 20th-century African American freedom struggle. By the mid-20th century, however, with technological change and the railroads entering a period of decline, the numbers of railroad workers diminished and with them, too, their once-powerful unions.
Women, Drugs, and Violence in Sinaloa
Authors: Carey Elaine , Figueroa Patricia
Published: September 2021

As the United States approaches the fiftieth anniversary of President Richard Nixon’s war on drugs and Mexico is going through the second decade of its war on drugs, the costs and ever-escalating violence are difficult to ignore. Despite the arrests, extraditions, and successful prosecutions of leaders of drug trafficking organizations (DTOs), the trillion dollars that have been spent in the United States and Mexico have done little to undermine the drug demand in the United States or protect Mexican citizens from increasing violence. With former Mexican president Felipe Calderon’s declaration of his own drug war, women have borne the increasing brunt of that violence. Certain women benefit from the lucrative drug trade due to their families’ involvement. Throughout the 20th century, women developed DTOs, but women have always had to fear violence from male competitors and law enforcement. Yet the majority of women who experience the drug trade experience it as users and victims. DTOs and their collaborators among the politicians and the police have acted with impunity. While legitimate actors such as police and politicians claim their support for security measures to protect women and children, these same actors have provided little empathy and support for victims. Women are both combatants in the drug trade and its collateral damage. Their experience with impunity combined with a lack of empathy for the countless victims on both sides of the border has led to a growing sense of hopeless along with growing resistance.

Keyword: drug-trafficking
Samba Schools
Authors: Sandroni Carlos , Barros Felipe
Published: September 2021

Samba schools are musical and recreational associations linked to carnival, created in Rio de Janeiro between 1928 and 1932 approximately. The first competitive samba school parade was held during the 1932 carnival, and since then they have held annually, always during carnival. Samba schools were also created in São Paulo later in the 1930s and gradually spread throughout Brazil, expanding internationally from the 1970s onwards. Since the end of the 1950s, the samba school parade has been recognized as the principal event in the Rio de Janeiro carnival. It is characterized as a performance involving music, dance, costume, and artwork. In the 1930s, each school sang up to three different sambas: the rule of just a single samba per parade was established later. Instrumental accompaniment is produced by the bateria, a set of membranophones and idiophones, which is perhaps the most the most characteristic element of a samba school. In addition, a small group of guitars and cavaquinho (a type of ukulele) provide the harmonic base for the singing. A group of judges mark the competition: points are organized by theme, music, dance, and outstanding features. The parade has gone through numerous transformations over the years. One such was the growing importance of the enredo, the central theme or story guiding the parade as a whole. In the 1950s, the composition of the sambas for the parade came to be driven by the need to present each aspect of the enredo in the music and lyrics, which led to the creation of a new type of samba, the samba-enredo. At time, the sambas performed in the parades were not very different from the sambas released on records and sung in different contexts in festivities. In the 1960s, the coordination of all aspects of the parade, with the aim of showing the enredo in the best manner possible, led to the emergence of a new role, the carnavalesco, who is charged with choosing the theme and designing and planning everything related to the parade’s visual and scenic dimensions.

Increasing public interest in the samba schools was accompanied by the growth of the parade itself, implying ever greater costs, connections, and conflicts with the public authorities and with different private economic agents, including in some cases illegal economic activities, such as gambling. The importance of the parade of the samba schools for the city of Rio de Janeiro was expressed in the construction in 1983–1984 of a new and immense urban structure, known as the Sambódromo. Designed to shelter the parades without disturbing urban circulation, as had happened until then in the mounting and dismantling of stands, the Sambódromo is used throughout the year. Its open spaces host various festive events in the city, while the closed ones are used for activities linked to public education.
CRISPR/Cas9-mediated disruption of the PYRROLIDINE KETIDE SYNTHASE gene reduces the accumulation of tropane alkaloids in Atropa belladonna hairy roots
Authors: Hasebe Fumihito , Yuba Honoka , Hashimoto Takashi , Saito Kazuki , Funa Nobutaka , Shoji Tsubasa
Published: September 2021

Tropane alkaloids, including clinically important hyoscyamine and scopolamine, are produced in the roots of medicinal plant species, such as Atropa belladonna, from the Solanaceae family. Recent molecular and genomic approaches have advanced our understanding of the metabolic enzymes involved in tropane alkaloid biosynthesis. A noncanonical type III polyketide synthase, pyrrolidine ketide synthase (PYKS) catalyzes a two-step decarboxylative reaction, which involves imine–ketide condensation indispensable to tropane skeleton construction. In this study, we generated pyks mutant A. belladonna hairy roots via CRISPR/Cas9-mediated genome editing and analyzed the metabolic consequences of the loss of PYKS activity on tropane alkaloids, providing insights into a crucial role of the scaffold-forming reaction in the biosynthetic pathway.
Clinical validation and evaluation of a novel six-lead handheld electrocardiogram recorder compared to the 12-lead electrocardiogram in unselected cardiology patients (EVALECG Cardio)
Authors: Azram Mohammad , Ahmed Noura , Leese Lucy , Brigham Matthew , Bowes Robert , Wheatcroft Stephen B , Ngantcha Marcus , Stegemann Berthold , Crowther George , Tayebjee Muzahir H
Published: September 2021

Aims

Handheld electrocardiogram (ECG) monitors are increasingly used by both healthcare workers and patients to diagnose cardiac arrhythmias. There is a lack of studies validating the use of handheld devices against the standard 12-lead ECG. The Kardia 6L is a novel handheld ECG monitor which can produce a 6-lead ECG. In this study, we compare the 6L ECG against the 12-lead ECG.

Methods and results

A prospective study consisting of unselected cardiac inpatients and outpatients at Leeds Teaching Hospital NHS Trust. All participants had a 12- and 6-lead ECGs. All ECG parameters were analysed by using a standard method template for consistency between independent observers. Electrocardiograms from the recorders were compared by the following statistical methods: linear regression, Bland–Altman, receiver operator curve, and kappa analysis. There were 1015 patients recruited. The mean differences between recorders were small for PR, QRS, cardiac axis, with receiver operator analysis area under the curve (AUC) of >80%. Mean differences for QT and QTc (between recorders) were also small, with AUCs for QT leads of >75% and AUCs for QTc leads of >60%. Key findings from Bland–Altman analysis demonstrate overall an acceptable agreement with few outliers instances (<6%, Bland–Altman analysis).

Conclusion

Several parameters recorded by the Kardia 6L (QT interval in all six leads, rhythm detection, PR interval, QRS duration, and cardiac axis) perform closely to the gold standard 12-lead ECG. However, that consistency weakens for left ventricular hypertrophy, QRS amplitudes (Lead I and AVL), and ischaemic changes.
Male–female differences in acute thoracic aortic dissection: a systematic review and meta-analysis
Authors: Meccanici Frederike , Gökalp Arjen L , Thijssen Carlijn G E , Mokhles Mostafa M , Bekkers Jos A , van Kimmenade Roland , Verhagen Hence J , Roos-Hesselink Jolien W , Takkenberg Johanna J M
Published: September 2021

OBJECTIVES

This study aims to systematically review published literature on male–female differences in presentation, management and outcomes in patients diagnosed with acute thoracic aortic dissection (AD).

METHODS

A systematic literature search was conducted for studies published between 1 January 1999 and 19 October 2020 investigating mortality and morbidity in adult patients diagnosed with AD. Patient and treatment characteristics were compared with odds ratios (ORs) and standardized mean differences and a meta-analysis using a random-effects model was performed for early mortality. Overall survival and reoperation were visualized by pooled Kaplan–Meier curves.

RESULTS

Nine studies investigating type A dissections (AD-A), 1 investigating type B dissections (AD-B) and 3 investigating both AD-A and AD-B were included encompassing 18 659 patients. Males were younger in both AD-A (P < 0.001) and AD-B (P < 0.001), and in AD-A patients males had more distally extended dissections [OR 0.57, 95% confidence interval (CI) 0.46–0.70; P < 0.001]. Longer operation times were observed for males in AD-A (standardized mean difference 0.29, 95% CI 0.17–0.41; P < 0.001) while male patients were less often treated conservatively in AD-B (OR 0.65, 95% CI 0.58–0.72; P < 0.001). The pooled early mortality risk ratio for males versus females was 0.94 (95% CI 0.84–1.06, P = 0.308) in AD-A and 0.92 (95% CI 0.83–1.03, P = 0.143) in AD-B. Pooled overall mortality in AD-A showed no male–female difference, whereas male patients had more reinterventions during follow-up.

CONCLUSIONS

This systematic review shows male–female differences in AD patient and treatment characteristics, comparable early and overall mortality and inconsistent outcome reporting. As published literature is scarce and heterogeneous, large prospective studies with standardized reporting of male–female characteristics and outcomes are clearly warranted. Improved knowledge of male–female differences in AD will help shape optimal individualized care for both males and females.

Clinical registration number

PROSPERO, ID number: CRD42020155926.
Epidemiology of Occupational Electrical Injuries
Authors: Salehi Seyed Hamid , Sadat Azad Yasaman , Bagheri Tooran , Ghadimi Tayyeb , Rahbar Arya , Ehyaei Parvin , Momeni Mahnoush
Published: September 2021

Electrical injuries are an uncommon but very destructive type of burn, with serious complications and disabilities for the victims. This study was conducted due to the importance of understanding the epidemiology of electrical accidents in planning to prevent their occurrence. This is a retrospective cross-sectional study that was performed on patients with electrical burns referred to Shahid Motahari Educational and Medical Center from 2017 to 2018. Patients’ information was entered in the researcher-made information registration form, including demographic and accident-related information. In this study, most of the accidents occurred in the workplace with high-voltage electricity. Contact with overhead cables and wires was the most common cause of injury. Excision and graft surgeries were the most common type of surgery. The variables of sex, age, length of hospital stay, and type of job had a significant relationship with the type of voltage (P < .05). The difference between the ratio of men to women and the length of hospitalization in the group of injured with high-voltage electricity was greater and most of these patients were construction workers. The variables of sex, nationality, length of hospital stay, and cause of the accident had a significant relationship with the type of job (P < .05). Construction workers are the main group at risk of electrical damage in Iran. Therefore, it is recommended to conduct more extensive studies in the field of recognizing and implementing practical methods of preventing electrical injuries, especially in high-risk work environments.
Molecular Alterations in Meningioangiomatosis Causing Epilepsy
Authors: Dono Antonio , Pothiawala Azim Z , Lewis Cole T , Bhattacharjee Meenakshi B , Ballester Leomar Y , Tandon Nitin
Published: September 2021

Meningioangiomatosis (MA) is a rare process at the intersection of cerebral developmental and neoplastic disorders that often results in epilepsy. We evaluated molecular alterations in MA to characterize its biology and pathogenesis. We searched a comprehensive institutional database for patients with MA treated between 2004 and 2019. Demographic, clinical, surgical, and radiographical data were collected. MA and associated meningioma tissues were evaluated using a next-generation sequencing assay interrogating 1425 cancer-related genes. We studied 5 cases: 3 with MA and 2 with MA associated with a meningioma. Of the MAs associated with a meningioma, 1 had deletions in the NF2 gene in both the MA and the meningioma components, whereas the other had an NF2 deletion in only the MA component. Additional mutations were identified in the MA components, suggesting that MA arises from the meningioma rather than the meningioma resulting from a transformation of the MA. The 3 cases of pure MA showed variants of unknown significance with no alterations in known oncogenic drivers. Our findings provide a starting point to a better understanding of the pathogenesis of this rare lesion. Our study indicates that MA-meningiomas have a neoplastic nature that differs from the hamartomatous/developmental nature of pure MA.
Tick-borne encephalitis (TBE) in Switzerland: does the prolongation of vaccine booster intervals result in an increased risk of breakthroughs?
Authors: Schmidt Axel J , Altpeter Ekkehardt , Graf Simone , Steffen Robert
Published: September 2021

Background

In 2006, the Swiss Federal Office of Public Health (FOPH) decided recommending a prolongation of vaccine booster intervals after the third dose for the prevention of tick-borne encephalitis (TBE) from 3 to 10 years.

Methods

To ascertain whether this amendment resulted in an increased rate of vaccine breakthroughs, we conducted a retrospective analysis of surveillance data collected 2000–19 by mandatory reporting to the Swiss FOPH. Fractions of breakthroughs [with 95% confidence intervals (CIs)]—0–3 years vs >3–10 years after the third vaccination dose—were compared across time periods and age groups.

Results

Among 3205 notified TBE cases, known vaccination status was reported in 2562 (79.9%), including 103 patients with ≥3 vaccine doses (4.0%). Among those, there were 39 patients who had received the last dose within 3 years and 48 patients in the >3–10 years group. During the 2010–19 period in which the new booster strategy was implemented there were 23 and 38 breakthroughs, respectively, and the annual breakthrough rate was 7.7 (95% CI 5.0–11.7) cases during the first 3 years after the last dose, and 5.4 (95% CI 3.9–7.5) cases in following 7 years. We observed no significant trend of TBE breakthroughs with increasing age. Increasing numbers of TBE and of vaccine breakthroughs over time have been associated with spreading endemicity and higher vaccination coverage in Switzerland.

Conclusions

There is no indication that extended booster intervals resulted in an increased rate of breakthroughs, but there was a marked public health benefit with respect to increased acceptability of TBE immunization in the general population.
Clinical Management of Hospitalized Coronavirus Disease 2019 Patients in the United States
Authors: Mozaffari Essy , Chandak Aastha , Zhang Zhiji , Liang Shuting , Gayle Julie , Thrun Mark , Gottlieb Robert L , Kuritzkes Daniel R , Sax Paul E , Wohl David A , Casciano Roman , Hodgkins Paul , Haubrich Richard
Published: September 2021

Background

The objective of this study was to characterize hospitalized coronavirus disease 2019 (COVID-19) patients and describe their real-world treatment patterns and outcomes over time.

Methods

Adult patients hospitalized on May 1, 2020–December 31, 2020 with a discharge diagnosis of COVID-19 were identified from the Premier Healthcare Database. Patient and hospital characteristics, treatments, baseline severity based on oxygen support, length of stay (LOS), intensive care unit (ICU) utilization, and mortality were examined.

Results

The study included 295657 patients (847 hospitals), with median age of 66 (interquartile range, 54–77) years. Among each set of demographic comparators, the majority were male, white, and over 65. Approximately 85% had no supplemental oxygen charges (NSOc) or low-flow oxygen (LFO) at baseline, whereas 75% received no more than NSOc or LFO as maximal oxygen support at any time during hospitalization. Remdesivir (RDV) and corticosteroid treatment utilization increased over time. By December, 50% were receiving RDV and 80% were receiving corticosteroids. A higher proportion initiated COVID-19 treatments within 2 days of hospitalization in December versus May (RDV, 87% vs 40%; corticosteroids, 93% vs 62%; convalescent plasma, 68% vs 26%). There was a shift toward initiating RDV in patients on NSOc or LFO (68.0% [May] vs 83.1% [December]). Median LOS decreased over time. Overall mortality was 13.5% and it was highest for severe patients (invasive mechanical ventilation/extracorporeal membrane oxygenation [IMV/ECMO], 53.7%; high-flow oxygen/noninvasive ventilation [HFO/NIV], 32.2%; LFO, 11.7%; NSOc, 7.3%). The ICU use decreased, whereas mortality decreased for NSOc and LFO.

Conclusions

Clinical management of COVID-19 is rapidly evolving. This large observational study found that use of evidence-based treatments increased from May to December 2020, whereas improvement in outcomes occurred over this time-period.
Broad Resistance to Post-Harvest Fruit Rot in USVL Watermelon Germplasm Lines to Isolates of Phytophthora capsici Across the United States
Authors: Kousik Chandrasekar S. , Ikerd Jennifer L. , Wechter W. Patrick , Branham Sandra , Turechek William
Published: September 2021

Watermelon is an important cucurbit vegetable crop grown in most of the United States. Phytophthora fruit rot of watermelon caused by Phytophthora capsici has been a major factor, limiting production for the past 15 years in the southeastern United States. The U.S. Department of Agriculture, Agricultural Research Service released five Phytophthora fruit rot-resistant germplasm lines for use in breeding programs. These lines were developed by phenotyping using a local isolate of P. capsici from South Carolina. The present study was undertaken to determine if these resistant lines had broad resistance to diverse P. capsici isolates collected from different states and crops. Five resistant germplasm lines (USVL020-PFR, USVL203-PFR, USVL782-PFR, USVL489-PFR, and USVL531-MDR) and two susceptible cultivars, Sugar Baby and Mickey Lee, used as checks were grown in a field in 2014 and 2015 to produce fruit for evaluation. Mature fruit were harvested and placed in a walk-in growth chamber and inoculated with 20 different P. capsici isolates. The chamber was maintained at 26 ± 2°C and high relative humidity (>95%) using a humidifier. All five resistant germplasm lines were significantly more resistant than the two susceptible checks to all 20 P. capsici isolates. Among the five resistant germplasm lines, USVL020-PFR, USVL782-PFR, and USVL531-MDR had broad resistance. Some P. capsici isolates induced minor lesions and rot on USVL489-PFR compared with the other resistant lines. Variation in virulence and genetic diversity among the 20 P. capsici isolates was also observed. The five watermelon germplasm lines will be useful for developing commercial watermelon cultivars with broad resistance to P. capsici.
New Drugs 2021, Part 2
Authors: Hussar Daniel A.
Published: September 2021

The second of a two-part series, this article describes eight recently approved drugs, including the first drug approved for the treatment of SARS-CoV-2, a first-in-class HIV attachment inhibitor, and a new intravenous injection indicated for the treatment of acute pain in adults for whom other treatments are ineffective.
Characterizing Substance Use Disorders Among Transgender Adults Receiving Care at a Large Urban Safety Net Hospital
Authors: Braun Hannan M. , Jones Emily K. , Walley Alexander Y. , Siegel Jennifer , Streed Carl G.
Published: September 2021

Objectives

In the midst of the opioid crisis, increasing attention has been given to assessing and addressing substance use disorders (SUDs) among transgender and gender diverse (TGD) populations. As electronic health records begin to more uniformly collect gender identity data, clinicians and public health professionals are better able to examine the prevalence of SUDs and the receipt of SUD treatment services in these populations.

Methods

We utilized cross-sectional electronic health records data from January 2005 to December 2019 from a large safety-net hospital in Massachusetts. A cohort of TGD patients was identified using self-reported gender identity data as well as diagnostic and procedures codes associated with receipt of gender-affirming care (n = 2000). We calculated odds of SUD diagnosis and receipt of medications for SUD among TGD patients.

Results

Among a cohort of 2000 TGD patients, 8.8% had a SUD diagnosis. SUD diagnoses were more common among older, Black, and transmasculine patients, as well as those holding public health insurance. SUD diagnoses were less likely among those reporting college-level education. Of those with an opioid use disorder (OUD), 46% were prescribed an FDA-approved medication for OUD.

Conclusions

SUD diagnoses among TGD patients were associated with demographic, socioeconomic, and gender-related factors. We found a modestly lower prevalence of non-tobacco SUD among our cohort of TGD patients than the national average of 7.4%. Despite a relatively better receipt of prescription treatment services than the national average, the low rate of treatment overall represents a missed opportunity to address SUDs in these vulnerable populations.
Impact of Cost Information on Parental Decision Making: A Randomized Clinical Trial Evaluating Cast Versus Splint Selection for Pediatric Distal Radius Buckle Fractures
Authors: Lawrence J. Todd R. , MacAlpine Elle M. , Buczek Matthew J. , Horn B. David , Williams Brendan A. , Manning Kassidy , Shah Apurva S.
Published: September 2021

Background:

Price transparency purports to help patients make high-value health care decisions, however, there is little data to support this. The pediatric distal radius buckle fracture (DRBF) has 2 equally efficacious but not equally priced treatment options (cast and splint), serving as an excellent potential model for studying price transparency. This study uses the DRBF model to assess the impact of up-front cost information on a family’s treatment decisions when presented with clinically equivalent treatment options for a low-risk injury.

Methods:

Participants age 4 to 14 presenting with an acute DRBF to a hospital-based pediatric orthopaedic clinic were recruited for this randomized controlled trial. Participants were randomized into cost-informed or cost-blind cohorts. All families received standardized information about the injury and treatment options. Cost-informed families received additional cost information. Both groups were allowed to freely choose a treatment. Families were surveyed regarding their decision factors. Cost-blinded families were subsequently presented with the cost information and could change their decision. Independent samples t tests and χ2 tests were utilized to evaluate differences.

Results:

A total of 127 patients were enrolled (53% cost-informed, 47% cost-blind). The 2 groups did not significantly differ in demographics. Immobilization selection did not differ between groups, with 48% of the cost-informed families selecting the more expensive option (casting), compared with 47% of the cost-blind families. Cost was the least influential factor in the decision-making process according to participant survey, influencing only 9% of families. Only one family changed their decision after receiving cost information, from a splint to a cast.

Conclusion:

Families appear to be cost-insensitive when making medical treatment decisions for low-risk injuries for their child. Price transparency alone may not help families arrive at a decision to pursue high-value treatment in low-risk orthopaedic injuries.

Level of Evidence:

Level I.