bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic European Ancestry and Incident Diabetes in Black Individuals: Insights From the SPRINT Trial
Authors: Parcha Vibhu , Heindl Brittain , Kalra Rajat , Bress Adam , Rao Shreya , Pandey Ambarish , Gower Barbara , Irvin Marguerite R. , McDonald Merry-Lynn N. , Li Peng , Arora Garima , Arora Pankaj
Published: January 2022

Background:

Black individuals have high incident diabetes risk, despite having paradoxically lower triglyceride and higher HDL (high-density lipoprotein) cholesterol levels. The basis of this is poorly understood. We evaluated the participants of SPRINT (Systolic Blood Pressure Intervention Trial) to assess the association of estimated European genetic ancestry with the risk of incident diabetes in self-identified Black individuals.

Methods:

Self-identified non-Hispanic Black SPRINT participants free of diabetes at baseline were included. Black participants were stratified into tertiles (T1–T3) of European ancestry proportions estimated using 106 biallelic ancestry informative genetic markers. The multivariable-adjusted association of European ancestry proportion with indices of baseline metabolic syndrome (ie, fasting plasma glucose, triglycerides, HDL cholesterol, body mass index, and blood pressure) was assessed. Multivariable-adjusted Cox regression determined the risk of incident diabetes (fasting plasma glucose ≥126 mg/dL or self-reported diabetes treatment) across tertiles of European ancestry proportion.

Results:

Among 2466 Black SPRINT participants, a higher European ancestry proportion was independently associated with higher baseline triglyceride and lower HDL cholesterol levels (
P
<0.001 for both). European ancestry proportion was not associated with baseline fasting plasma glucose, body mass index, and blood pressure (
P
>0.05). Compared with the first tertile, those in the second (hazard ratio, 0.64 [95% CI, 0.45–0.90]) and third tertiles (hazard ratio, 0.61 [95% CI, 0.44–0.89]) of the European ancestry proportion had a lower risk of incident diabetes. A 5% point higher European ancestry was associated with a 29% lower risk of incident diabetes (hazard ratio, 0.71 [95% CI, 0.55–0.93]). There was no evidence of a differential association between the European ancestry proportion tertiles and incident diabetes between those randomized to intensive versus standard blood pressure treatment.

Conclusions:

The higher risk of incident diabetes in Black individuals may have genetic determinants in addition to adverse social factors. Further research may help understand the interplay between biological and social determinants of cardiometabolic health in Black individuals.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01206062.
Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice Patterns
Authors: Baker Anna D. , Schwamm Lee H. , Sanborn Danita Y. , Furie Karen , Stretz Christoph , Mac Grory Brian , Yaghi Shadi , Kleindorfer Dawn , Sucharew Heidi , Mackey Jason , Walsh Kyle , Flaherty Matt , Kissela Brett , Alwell Kathleen , Khoury Jane , Khatri Pooja , Adeoye Opeolu , Ferioli Simona , Woo Daniel , Martini Sharyl , De Los Rios La Rosa Felipe , Demel Stacie L. , Madsen Tracy , Star Michael , Coleman Elisheva , Slavin Sabreena , Jasne Adam , Mistry Eva A. , Haverbusch Mary , Merkler Alexander E. , Kamel Hooman , Schindler Joseph , Sansing Lauren H. , Faridi Kamil F. , Sugeng Lissa , Sheth Kevin N. , Sharma Richa
Published: January 2022

Background:

There are limited data about the epidemiology and secondary stroke prevention strategies used for patients with depressed left ventricular ejection fraction (LVEF) and sinus rhythm following an acute ischemic stroke (AIS). We sought to describe the prevalence of LVEF ≤40% and sinus rhythm among patients with AIS and antithrombotic treatment practice in a multi-center cohort from 2002 to 2018.

Methods:

This was a multi-center, retrospective cohort study comprised of patients with AIS hospitalized in the Greater Cincinnati Northern Kentucky Stroke Study and 4 academic, hospital-based cohorts in the United States. A 1-stage meta-analysis of proportions was undertaken to calculate a pooled prevalence. Univariate analyses and an adjusted multivariable logistic regression model were performed to identify demographic, clinical, and echocardiographic characteristics associated with being prescribed an anticoagulant upon AIS hospitalization discharge.

Results:

Among 14 338 patients with AIS with documented LVEF during the stroke hospitalization, the weighted pooled prevalence of LVEF ≤40% and sinus rhythm was 5.0% (95% CI, 4.1–6.0%;

I
2

, 84.4%). Of 524 patients with no cardiac thrombus and no prior indication for anticoagulant who survived postdischarge, 200 (38%) were discharged on anticoagulant, 289 (55%) were discharged on antiplatelet therapy only, and 35 (7%) on neither. There was heterogeneity by site in the proportion discharged with an anticoagulant (22% to 45%,
P
<0.0001). Cohort site and National Institutes of Health Stroke Severity scale >8 (odds ratio, 2.0 [95% CI, 1.1–3.8]) were significant, independent predictors of being discharged with an anticoagulant in an adjusted analysis.

Conclusions:

Nearly 5% of patients with AIS have a depressed LVEF and are in sinus rhythm. There is significant variation in the clinical practice of antithrombotic therapy prescription by site and stroke severity. Given this clinical equipoise, further study is needed to define optimal antithrombotic treatment regimens for secondary stroke prevention in this patient population.
Intraventricular Hemorrhage Expansion in the CLEAR III Trial: A Post Hoc Exploratory Analysis
Authors: Roh David J. , Asonye Ifeyinwa S. , Carvalho Poyraz Fernanda , Magid-Bernstein Jessica R. , Joiner Evan F. , Avadhani Radhika , Awad Issam , Hanley Daniel F. , Ziai Wendy C. , Murthy Santosh B.
Published: January 2022

Background:

The objective of this study was to evaluate factors associated with intraventricular hemorrhage (IVH) expansion and its association with long-term outcomes.

Methods:

We performed a post hoc analysis of the international, multi-center CLEAR III trial (Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage) which enrolled IVH patients between September 1, 2009, and January 31, 2015. The exposure was IVH expansion, defined as >1 mL increase in volume between baseline and stability computed tomography scans, before treatment randomization. We assessed factors associated with IVH expansion and secondarily assessed the relationship of IVH expansion with clinical outcomes: composite of death or major disability (modified Rankin Scale score, >3), and mortality alone at 6 months. The relationship of IVH expansion on ventriculoperitoneal shunt placement was additionally explored. Multivariable logistic regression was used for all analyses.

Results:

Of 500 IVH patients analyzed, the mean age was 59 (±11) years old, 44% were female and 135 (27%) had IVH expansion. In multivariable regression models, factors associated with IVH expansion were baseline parenchymal intracerebral hemorrhage (ICH) volume (adjusted odds ratio [OR], 1.04 per 1 mL increase [95% CI, 1.01–1.08]), presence of parenchymal hematoma expansion: >33% (adjusted OR, 6.63 [95% CI, 3.92–11.24]), time to stability head CT (adjusted OR, 0.71 per 1 hour increase [95% CI, 0.54–0.94]), and thalamic hematoma location (adjusted OR, 1.68 [95% CI, 1.01–2.79]) while additionally adjusting for age, sex, and race. In secondary analyses, IVH expansion was associated with higher odds of poor 6-month outcomes (adjusted OR, 1.84 [95% CI, 1.12–3.02]) but not mortality (OR, 1.40 [95% CI, 0.78–2.50]) after adjusting for baseline ICH volume, thalamic ICH location, age, anticoagulant use, Glasgow Coma Scale score, any withdrawal of care order, and treatment randomization arm. However, there were no relationships of IVH expansion on subsequent ventriculoperitoneal shunt placement (adjusted OR, 1.02 [95% CI, 0.58–1.80]) after adjusting for similar covariates.

Conclusions:

In a clinical trial cohort of patients with large IVH, acute hematoma characteristics, specifically larger parenchymal volume, hematoma expansion, and thalamic ICH location were associated with IVH expansion. Given that IVH expansion resulted in poor functional outcomes, exploration of treatment approaches to optimize hemostasis and prevent IVH expansion, particularly in patients with thalamic ICH, require further study.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00784134.
Word Acquisition in Neural Language Models
Authors: Chang Tyler A. , Bergen Benjamin K.
Published: January 2022

We investigate how neural language models acquire individual words during training, extracting learning curves and ages of acquisition for over 600 words on the MacArthur-Bates Communicative Development Inventory (Fenson et al., 2007). Drawing on studies of word acquisition in children, we evaluate multiple predictors for words’ ages of acquisition in LSTMs, BERT, and GPT-2. We find that the effects of concreteness, word length, and lexical class are pointedly different in children and language models, reinforcing the importance of interaction and sensorimotor experience in child language acquisition. Language models rely far more on word frequency than children, but, like children, they exhibit slower learning of words in longer utterances. Interestingly, models follow consistent patterns during training for both unidirectional and bidirectional models, and for both LSTM and Transformer architectures. Models predict based on unigram token frequencies early in training, before transitioning loosely to bigram probabilities, eventually converging on more nuanced predictions. These results shed light on the role of distributional learning mechanisms in children, while also providing insights for more human-like language acquisition in language models.
Decomposing and Recomposing Event Structure
Authors: Gantt William , Glass Lelia , White Aaron Steven
Published: January 2022

We present an event structure classification empirically derived from inferential properties annotated on sentence- and document-level Universal Decompositional Semantics (UDS) graphs. We induce this classification jointly with semantic role, entity, and event-event relation classifications using a document-level generative model structured by these graphs. To support this induction, we augment existing annotations found in the UDS1.0 dataset, which covers the entirety of the English Web Treebank, with an array of inferential properties capturing fine-grained aspects of the temporal and aspectual structure of events. The resulting dataset (available at decomp.io) is the largest annotation of event structure and (partial) event coreference to date.
The Boy Who Plugs a Dike with His Finger: UN Mediation in the Gaza-Israel Crisis, 2018–2019
Authors: Schiff Amira
Published: January 2022

This article highlights the United Nations’ potential contribution in the niche of crisis management. Drawing from the crisis-based approach’s insights on crisis mediation efficacy, and Carnevale’s conceptualization of the mediator’s various strengths as the sources of leverage in mediation, the study explores UN Special Coordinator for the Middle East Peace Process Nickolay Mladenov’s mediation during the Gaza-Israel crisis in 2018–2019. I argue that a combination of contextual and behavioral factors enabled Mladenov to influence the crisis bargaining environment and pull Israel and Hamas back from the brink. These factors included both parties’ need to avoid further escalation; the mediating skills of the UN envoy; the envoy’s reputation, which led others to perceive him as the right person for the mediation mission; the UN mediator’s use of a blend of strategies and tactics; and Mladenov’s ability to apply a range of strengths, including hard power.
Publishing in Africa
Authors: Zell Hans M.
Published: January 2022

This is the second instalment of a two-part article. Part 1 of this article appeared in Logos, 30 (3). Part 2 sets out a number of suggestions to strengthen the book industries in Africa, and the way forward, especially on capacity- and skills-building; training for book industry personnel; strengthening book professional associations, South–South linkages, and knowledge-sharing; encouraging international collaboration; the need for ongoing research and documentation; African books in the global marketplace; and the important but still neglected area of publishing in African indigenous languages. An Appendix provides a summary of the International Publishers Association (IPA) and Association for the Development of Education in Africa (ADEA) meetings on the African book industry, held in Nairobi in June 2019, together with links to a number of articles, reports, and press statements about the meetings.
There and back again: Oocephalus piranii is better treated as Hyptis (Hyptidinae, Lamiaceae)
Authors: SOARES ARTHUR DE SOUZA , HARLEY RAYMOND MERVYN , BARÊA PASTORE JOSÉ FLORIANO , GOMES JARDIM JOMAR
Published: January 2022

Hyptis piranii, an endemic species from campos rupestres of Minas Gerais state, Brazil, was described as a member of H. sect. Polydesmia subsect. Oocephalus. After a number of sections and subsections of Hyptis had been raised to generic rank, this species became a member of the genus Oocephalus. Recent morphological analyses showed that, actually, the species is better treated as a member of Hyptis sect. Eriosphaeria. We provide a description of Hyptis piranii, as well as comments on its morphology and a plate showing key morphological features.
Diogenes matabiru, a new species of hermit crab from Lombok Island, Indonesia (Crustacea, Decapoda, Anomura, Diogenidae)
Authors: RAHAYU DWI LISTYO , PRATIWI RIANTA
Published: January 2022

A new species of hermit crab, Diogenes matabiru, is described and illustrated on the basis of the specimens collected from mangrove environment in the eastern Lombok Island, Indonesia. This new species is related to D. pallescens Whitelegge, 1897 but differs in the shape of cheliped, telson and coloration in life. A key to the species of the genus Diogenes from Indonesia is also provided.
Tropical, Subtropical, and Extratropical Atmospheric Rivers in the Australian Region
Authors: Reid Kimberley J. , King Andrew D. , Lane Todd P. , Hudson Debra
Published: January 2022

Studies of atmospheric rivers (ARs) over Australia have, so far, only focused on northwest cloudband–type weather systems. Here we perform a comprehensive analysis of AR climatology and impacts over Australia that includes not only northwesterly systems, but easterly and extratropical ARs also. We quantify the impact of ARs on mean and extreme rainfall including assessing how the origin location of ARs can alter their precipitation outcomes. We found a strong relationship between ARs and extreme rainfall in the agriculturally significant Murray–Daring basin region. We test the hypothesis that the tropical and subtropical originating ARs we observe in Australasia differ from canonical extratropical ARs by examining the vertical structure of ARs grouped by origin location. We found that in the moisture abundant tropics and subtropics, wind speed drives the intensity of ARs, while in the extratropics, the strength of an AR is largely determined by moisture availability. Finally, we examine the modulation of AR frequency by different climate modes. We find weak (but occasionally significant) correlations between ARs frequency and El Niño–Southern Oscillation, the Indian Ocean dipole, and the southern annular mode. However, there is a stronger relationship between the phases of the Madden–Julian oscillation and tropical AR frequency, which is an avenue for potential skill in forecasting ARs on subseasonal time scales.
A Decadal Weakening in the Connection between ENSO and the Following Spring SST over the Northeast Tropical Atlantic after the Mid-1980s
Authors: Chen Wei
Published: January 2022

The north tropical Atlantic (NTA) displays significant sea surface temperature anomalies (SSTA) during the ENSO decaying spring. This study identifies a largely weakened impact of ENSO on the SSTA concentrated over the northeast tropical Atlantic (NETA) after the mid-1980s, while the impacts on the SSTA over the northwest tropical Atlantic (NWTA) are stable during the whole period. Different SST datasets can recognize this weakened connection between ENSO and the NETA SSTA, suggesting the robustness in this decadal variation. The El Niño–related teleconnections shift westward after the mid-1980s, and thus the anomalous southwesterly, leading to the positive NTA SSTA via the wind–evaporation–SST feedbacks, is restricted over the NWTA without extending eastward. As a result, the positive SSTA rises only over the NWTA but is diminished over the NETA. The regime shift in these circulation anomalies is due to the westward shift in the El Niño–induced convection and circulation anomalies from the eastern equatorial Pacific (EEP) to the central equatorial Pacific (CEP). Further analysis indicates that the intensified zonal SST gradient over the equatorial Pacific leads to a westward shift of Pacific Walker circulation after the mid-1980s. The westward shift of Walker circulation contributes to the convergent circulation anomalies over the CEP and thus results in the El Niño–induced precipitation anomalies concentrated there.

Significance Statement

Previous studies have indicated a positive connection between ENSO and the succeeding spring SSTA over the north tropical Atlantic (NTA), and this connection tends to be unstable. This study identifies a decadal weakening in the connection between ENSO and the SSTA actually concentrated over the northeast part of tropical Atlantic (NETA) after the mid-1980s. Further analysis indicates that the decadal changes in the ENSO–NETA connection are due to the westward shift in the ENSO-related convection and teleconnections, resulting from the westward shift of Pacific Walker circulation, induced by the intensified zonal SST gradient over the equatorial Pacific after the mid-1980s. The result implies a decadal change in NTA SSTA structure, which may bring different climate anomalies in the surrounding area.
Interannual and Interdecadal Drivers of Meridional Migration of Western North Pacific Tropical Cyclone Lifetime Maximum Intensity Location
Authors: Zhao Haikun , Zhao Kai , Klotzbach Philip J. , Wu Liguang , Wang Chunzai
Published: January 2022

Recent studies have noted a poleward shift in tropical cyclone (TC) lifetime maximum intensity (LMI) location. Whether this observed shift is due to global warming, natural variability, or a combination of both factors remains inconclusive. The western North Pacific (WNP) has been shown in prior research to be the most robust contributor to the observed poleward LMI migration. This study explores interannual and interdecadal climate drivers of WNP LMI location from 1979 to 2018. On interannual time scales, there are more northward-moving TC tracks during El Niño years compared with La Niña years. However, there is substantially smaller variance in the latitudinal distance from TC genesis latitude to LMI latitude than the variance in the TC genesis latitude. Thus, TC genesis El Niño years tend to reach their LMI at a lower latitude given the increased likelihood that they undergo genesis at a lower latitude. On decadal or longer time scales, global warming has contributed to the recent poleward shift of LMI location by causing more northwestward-/northward-moving TC tracks, while the PDO also significantly modulates decadal variability in TC genesis latitude, thus also contributing to LMI latitude changes. Further analysis of the extended period from 1960 to 2018 suggests that the trends in TC LMI latitude and TC tracks are dominated by global warming, and the PDO phase change likely reinforces this trend during 1979–2018. These three leading modes of climate variability (e.g., ENSO, PDO, and global warming) offer a more complete picture of the meridional migration of WNP LMI location on various time scales.
Using Digital Games to Promote Equity in Career and Health Education: A Prototype of Caduceus Quest
Authors: McCammon Ellen , Law Jessica , Tyler Crystal , Arrington Mason , Jagoda Patrick , Gilliam Melissa
Published: January 2022

Black and Latinx adolescents in urban schools can derive numerous benefits from tailored career and health education. However, many factors may prevent schools and teachers from offering such programing. To address the need for career and health education, we prototyped Caduceus Quest, a theory-based, digital role-playing game designed to provide information on health and biomedical science careers and sexual health (specifically HIV) for Black and Latinx adolescents. Forty high-school-aged adolescents participated in small group sessions to playtest the prototype. Post-intervention, adolescents reported increased interest in health and biomedical science careers, as well as HIV knowledge and PrEP awareness.
Influence of the pre-vulcanization inhibitor on the properties of non-vulcanized rubber compositions for in situ vulcanized reformers applications
Authors: Dall’ Agnol Veiga Viviane , Brizuela Guerra Nayrim , da Silva Crespo Janaina , Carli Larissa Nardini
Published: January 2022

In the rubber industry, some products are commercialized in a non-vulcanized form and usually present a relatively short shelf life. Therefore, there is a great interest in increasing scorch time of these formulations without affecting other rheometric properties. This study evaluated the use of different accelerators and acceleration systems over time for the rheometric properties of non-vulcanized natural rubber compositions. Twelve compositions were prepared: six using the accelerator 2,2-dithiomercaptobenzothiazole (MBTS) and six using the accelerator N-cyclohexyl-2-benzothiazole sulfenamide (CBS). For each accelerator, three acceleration systems were formulated. The same formulations were also performed including a pre-vulcanization inhibitor (PVI). It was found that the MBTS has greater acceleration stability over 6 months and the CBS provided a longer scorch time in the first months, losing this characteristic over time. The use of PVI has increased scorch times; however, it has also increased the optimum vulcanization time. The need to use the PVI for non-vulcanized materials, which are stored at temperatures up to 45°C, was verified. It is concluded that the rheometric behavior during the shelf life of non-vulcanized compositions depends on the accelerator type, acceleration system, and the use or not of a retarding agent.
Intraoral Approach for Parapharyngeal Branchial Cleft Cysts
Authors: Yang Yun Na , Hong Yong Tae
Published: January 2022

Branchial cleft cyst (BCC) most frequently arises from the second branchial cleft and is located anterior to the sternocleidomastoid muscle at the mandibular angle. However, very rarely, this may occur in the parapharyngeal space. Interestingly, the parapharyngeal BCC is frequently misdiagnosed as a peritonsillar abscess. In this study, we reported 2 cases of parapharyngeal BCC misdiagnosed as peritonsillar abscess.
Effect of vascular amyloid on white matter disease is mediated by vascular dysfunction in cerebral amyloid angiopathy
Authors: Gokcal Elif , Horn Mitchell J , Becker J. Alex , Das Alvin S , Schwab Kristin , Biffi Alessandro , Rost Natalia , Rosand Jonathan , Viswanathan Anand , Polimeni Jonathan R , Johnson Keith A , Greenberg Steven M , Gurol M Edip
Published: January 2022

We postulated that vascular dysfunction mediates the relationship between amyloid load and white matter hyperintensities (WMH) in cerebral amyloid angiopathy (CAA). Thirty-eight cognitively healthy patients with CAA (mean age 70 ± 7.1) were evaluated. WMH was quantified and expressed as percent of total intracranial volume (pWMH) using structural MRI. Mean global cortical Distribution Volume Ratio representing Pittsburgh Compound B (PiB) uptake (PiB-DVR) was calculated from PET scans. Time-to-peak [TTP] of blood oxygen level-dependent response to visual stimulation was used as an fMRI measure of vascular dysfunction. Higher PiB-DVR correlated with prolonged TTP (r = 0.373, p = 0.021) and higher pWMH (r = 0.337, p = 0.039). Prolonged TTP also correlated with higher pWMH (r = 0.485, p = 0.002). In a multivariate linear regression model, TTP remained independently associated with pWMH (p = 0.006) while PiB-DVR did not (p = 0.225). In a bootstrapping model, TTP had a significant indirect effect (ab = 0.97, 95% CI: 0.137–2.461), supporting that the association between PiB-DVR and pWMH is mediated by TTP response. There was no longer a direct effect independent of the hypothesized pathway. Our study suggests that the effect of vascular amyloid load on white matter disease is mediated by vascular dysfunction in CAA. Amyloid lowering strategies might prevent pathophysiological processes leading to vascular dysfunction, therefore limiting ischemic brain injury.
Impact of COVID-19 on healthcare waste generation: Correlations and trends from a tertiary hospital of a developed country
Authors: Garlasco Jacopo , Canepari Alessandro , Giacobone Gilda , Funicelli Gemma , Kozel Daniela , Bernini Luciano , Cotroneo Alida
Published: January 2022

The SARS-CoV-2 (COVID-19) coronavirus pandemic has represented an emergency not only from a clinical point of view, but also for the environment due to the largely increased waste disposal. This study aimed at estimating, in the context of current trends, the increase in healthcare waste (HW) generation during the outbreak, based on data from a tertiary hospital. From the purveying office statements of ‘SS Antonio e Biagio e Cesare Arrigo’ Hospital of Alessandria (Italy), monthly HW generation data from January 2015 to March 2021 were retrospectively retrieved. Trends and COVID’s impact were evaluated by Interrupted Time Series (ITS) design with linear regression models. Locally Weighted Scatterplot Smoothing was used to model the relation between infectious HW generation and proportion of COVID-related bed days. HW generation rose from 35.9 ± 3.8 tonnes month−1 (2.4 ± 0.2 kg per patient-day, kg PD−1) in 2015–2019, to 46.3 ± 6.0 tonnes month−1 (3.3 ± 0.7 kg PD−1) during the outbreak. The increasing trend was not appreciably modified as for its slope (p = 0.363), while a significant level change was found between baseline and outbreak (+ 0.72 kg PD−1, p < 0.001). The proportion of COVID-related bed days non-linearly affected the infectious HW generated per patient-day, with steeper increases for proportions above 20%. The study showed a significant rise in HW generation in 2020–2021, reasonably due to the COVID outbreak; in addition, the generally increasing trend was not affected. Therefore, urgent measures are needed to conciliate safety requirements with HW generation issues.
Using abrasive flow finishing process to reduce noise and vibrations of cylindrical and conical gears
Authors: Rana Vivek , Petare Anand , Kumar Jain Neelesh , Parey Anand
Published: January 2022

This paper reports on reduction of noise and vibrations of cylindrical and conical gears through simultaneous reduction in their microgeometry errors, functional parameters, and surface roughness by finishing them with abrasive flow finishing (AFF) process. Previously identified optimum values of AFF medium viscosity and finishing time were used during AFF of the chosen gears. Noise and vibrations characteristics of the unfinished gears and the AFF finished gears were studied by varying motor speed and applied load at four levels each. An indigenously developed test rig was used for spur and straight bevel gears whereas drivetrain diagnostic simulator was used for helical gears. Indigenously developed dual flank roll tester was used to evaluate functional parameters of the unfinished and the best finished gears by AFF process. It was found that AFF process simultaneously reduced microgeometry errors, functional parameters, maximum and average values of surface roughness of spur, helical, and straight bevel gears. It reduced noise and vibration by 5.2 dBA and 5.3 m/s2 for spur gears, by 3.4 dBA and 7.5 m/s2 for helical gears, and by 4.6 dBA and 4 m/s2 for straight bevel gears. This study proves that AFF is an easy-to-operate and effective process for reducing noise and vibrations of cylindrical and conical gears through simultaneous reduction in their microgeometry errors, functional parameters, and surface roughness values. Outcome of this work will be helpful for various manufactures and users of different types of gears.
Feedback control of limit cycle oscillations and transonic buzz, using the nonlinear transonic small disturbance aerodynamics
Authors: Kwon Jae R , Vepa Ranjan
Published: January 2022

In this paper, a systematic method to suppress transonic buzz with feedback is presented. A trailing edge control surface in the form of part-span flap was used only to modify and control the unsteady aerodynamic loading on the wing. The flap rotation was used to provide feedback, which consisted of a weighted linear combination of the amplitudes of the principal modes of the structure, referred to as the control law. A linear, optimal feedback control law, that is synthesized systematically based on pseudo-spectral time domain analysis, may be used in principle, to assess its capacity to actively suppress the buzz in the transonic flow domain by using a servo-controlled control surface to modify the unsteady, nonlinear aerodynamic loads on the wing. Thus, it is essential that a set of feasible control laws are first constructed. In this paper, this is done by applying the doublet-lattice method. Restrictions, such as near-zero structural damping in the flap mode, were imposed on the aeroelastic model to facilitate the occurrence of transonic buzz. The feasible set of control laws were then assessed using the nonlinear transonic small disturbance theory and an optimum control is selected to suppress the buzz. The essential differences of the behaviour of the closed-loop system in nonlinear transonic flow, when compared to the applications of linear optimal control in linear potential flow, are presented and discussed.
Prevalence and risk factors of trastuzumab induced cardiotoxicity in Tunisian HER2-positive breast cancer patients
Authors: Toukabri Imen , Ben Said Azza , Hamdi Adel , Aloulou Aziza , Ben Ayed Wiem , Cherif Ines , Limayem Imen
Published: January 2022

Introduction

Cardiotoxicity is the most important side effect of Trastuzumab treatment. The purpose of this study is to evaluate the prevalence of Trastuzumab induced cardiotoxicity and to analyze risk factors associated with this side effect.

Materials and Methods

A retrospective institutional study was carried out from June 2018 to December 2018 at the department of Medical Oncology of Salah Azaiz institute, Tunis, Tunisia. Demographic, clinical characteristics (menopausal status, breast cancer stage, anthracyclines exposure, comorbidities presence…) and left ventricular ejection function (LVEF) measurements, were collected from patient records.

Results

Twenty-three women (20%) had Trastuzumab induced cardiotoxicity.65.2% (N = 15) experienced a decrease in LVEF more than 10% with a decrease below normal value and 34.8% (N = 8) experienced a decrease in LVEF more than 20%. Obesity is a risk factor for the occurrence of Trastuzumab induced cardiotoxicity (adjusted odds ratio (OR) = 2.919 (95% confidence interval (CI) [1.0411–8.186]; p = 0.042).

Conclusion

Our study highlighted that obesity is associated with a high risk of cardiotoxicity in women treated with Trastuzumab. Therefore, close monitoring of cardiac function is recommended especially for obese women during Trastuzumab administering.
Psychological resilience is an independent correlate of health-related quality of life in middle-aged and older adults with HIV in the Deep South
Authors: Hopkins Cierra N , Lee Cheryl A , Lambert Crystal Chapman , Vance David E , Haase Shakaye R , Delgadillo Jeremy D , Fazeli Pariya L
Published: January 2022

Older people living with HIV (PLWH) are at risk for poorer health-related quality of life (HRQoL). Psychological resilience may protect HRQoL in this population. The sample included 174 predominately African American PLWH (age 40–73). Results indicated associations between resilience, socioeconomic status, cognitive performance, instrumental activities of daily living, personality, and depressive symptoms. HIV factors (e.g. viral load, duration of HIV) were not associated with resilience. Adjusting for confounders, resilience was associated with mental HRQoL. Understanding factors associated with resilience among older PLWH and the translation of resilience to HRQoL may inform interventions to improve well-being among individuals aging with HIV.
Talking the Talk of Social Mobility: The Political Performance of a Misguided Agenda
Authors: Ingram Nicola , Gamsu Sol
Published: January 2022

Since 2010, the language of social mobility has been increasingly utilised by UK politicians from across the political spectrum to denote a commitment to ‘fair access’ to opportunity in both education and the professions. Within this policy discourse, the default understanding of inequality is premised on a narrow notion of access to elite education and employment positions, where a deeper understanding of the politics of social reproduction and inequality, or any meaningful emphasis on redistribution, is absent. The social mobility agenda is axiomatically an equality of opportunity agenda where the focus is on ‘levelling up’ those who are considered to be falling behind. Its focus on opportunity to the detriment of outcome thus rules out considerations of structural solutions to inequalities. In this article, we unpack the discourses of social mobility that are prevalent in recent UK government papers and political talk, with a specific focus on the Social Mobility Commission (SMC) in order to consider how these shape policy approaches to education and labour market participation. We argue that the presiding ‘race to the top’ mentality undermines the very equality that the social mobility agenda claims to be seeking to achieve, and in doing so we implicate the SMC in purveying contradictory understandings of mobility that compound and conceal existing inequalities. Through a focus on graduate employment, we problematise the role of higher education in the promotion of social mobility. We consider the role of employers participating in the Social Mobility Employer Index and expose the contradictions between the performance of social mobility and the reality of corporate practices that entrench social inequalities. Our work underscores the need for a new political conversation about social mobility and a redirection of attendant education and employment policy to focus on dismantling rather than reinforcing social hierarchies.
Glitch, the Post-digital Aesthetic of Failure and Twenty-First-Century Media
Authors: Kemper Jakko
Published: January 2022

This paper aims to understand how everyday life is affected by new technological conditions through an inquiry into glitch, a concept that signifies moments of faulty interference in the regular operation of a technology and that is often labeled a ghost in the machine. By drawing on two concepts from cultural studies – spectrality and post-digital culture – it demonstrates how the imperfection-oriented aesthetic of glitch is today complicated by the technological tendency to bypass human awareness. By developing this argument through a reading of German electronic music group Oval’s influential glitch-based record 94diskont (1995), the paper shows how glitch’s signification of mediation, fragility and technological complexity has been modulated in recent years. This analysis is augmented through a consideration of Mark B.N. Hansen’s concept of ‘twenty-first-century media’, which takes as highly significant the tendency of contemporary media to operate beyond the thresholds of human cognition and perception. The paper suggests that, as a result of these new medial forms, the subversive potential of glitch-based artworks is impacted severely, but also that glitch’s status of ghost in the machine offers valuable resources for thinking through the media experiences afforded by 21st-century media. This paper thereby points to new potential modes of critique, and expands existing cultural debates about aesthetics, technology, and the constitution of everyday life.
Lunatocapitate and Triquetrohamate Arthrodeses for Degenerative Arthritis of the Wrist: A Midterm Follow-Up
Authors: Schindelar Lili E. , Wang Mark L. , Bednar John M. , Miller Andrew J.
Published: January 2022

Background:

Degenerative arthritis of the wrist is a common condition often treated with 4 corner arthrodesis (FCA) or a partial wrist fusion. A number of limited intercarpal arthrodeses have been proposed for treatment of this condition. One technique, described by Wang and Bednar in 2012, involves fusion of the lunatocapitate and triquetrohamate joints. This study presents midterm follow-up of outcomes following this 2 column arthrodesis.

Methods:

From 2000 to present, patients who underwent lunatocapitate and triquetrohamate arthrodesis were evaluated. The original cohort from the 2012 study was reviewed, as well as any additional patients who since underwent this procedure. Only patients who had greater than 5 years of follow-up data were included. Outcomes included demographics, wrist range of motion, grip strength, complications, and radiographic evidence of union.

Results:

Twenty-one cases were included in the final analysis. Mean follow-up was 8.75 years. Wrist extension and flexion were 58% and 90% of the unaffected side, respectively. Grip strength was 92% of the unaffected side. Osseous union was achieved in 95.2% of cases. Two cases underwent revision surgery, one for nonunion and one following a fall.

Conclusions:

Lunatocapitate and triquetrohamate arthrodesis offers a treatment for wrist arthritis that yields good clinical outcomes, low nonunion rates, and no conversions to total wrist arthrodesis, as shown by 5-year follow-up data. Limited intercarpal arthrodesis is an alternative to FCA, with the advantage of a smaller surgical footprint and simpler technique, while still providing excellent mid- to long-term outcomes.
Prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada
Authors: Carter Allison , Gormley Becky , Muchenje Marvelous , Zhu Denise , Patterson Sophie , Kestler Mary , Hankins Catherine , Logie Carmen H , Brotto Lori A , Tharao Wangari , Lee Melanie , Li Jenny , Ding Erin , de Pokomandy Alexandra , Loutfy Mona , Kaida Angela
Published: January 2022

Objectives:

We assessed the prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada.

Methods:

We analyzed cross-sectional survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (2017–2018). Self-identified women living with HIV were asked about sexual concerns post-HIV diagnosis and associated distress (none, mild, moderate, severe). Five areas of concern were assessed, including difficulties related to sexual self-esteem, sexual function, relationships, and emotional and behavioral aspects of sex. Logistic regression analyses identified correlates of reporting any sexual concerns and severe distress about these concerns.

Results:

Of 906 participants (median age 48, Q1–Q3 = 41–55), 596 (65.8%) reported sexual concerns post-HIV diagnosis. We found a high prevalence of concerns related to relationships (43.3%), sexual self-esteem (49.4%), and emotional aspects of sex (45.4%), relative to sexual functioning (38.4%) and behavioral aspects (33.7%). Of those with sexual concerns, 36.7% reported severe distress. Reports of severe distress were the highest for relationship difficulties (32.5%), relative to other areas of concern (21.4%–22.8%). In adjusted analyses, women reporting sexual dissatisfaction and high HIV-related stigma had significantly higher odds of reporting sexual concerns. Conversely, those reporting higher resilience, better mental health, African, Caribbean, and Black identity, and sex as somewhat unimportant, not at all important, or neutral to their lives had lower adjusted odds. Factors associated with severe distress about sexual concerns included older age, body dissatisfaction, sexual dissatisfaction, and high HIV-related stigma, while better mental health and getting support from someone living with HIV were protective. While 84.4% of women had discussed with a provider how viral load impacts transmission risk, only 40.6% had conversations about sexual wellbeing.

Conclusion:

More attention to women’s sexual wellbeing within social and relational contexts is critical to ensure the sexual rights of women living with HIV are upheld.
Management of Patients with Poor Prognosis First Permanent Molars Beyond ‘Ideal’ Timing
Authors: Warrilow Laura , McDonald Sheridan
Published: January 2022

The management of compromised first permanent molars is a common clinical conundrum in paediatric dentistry. Extensive guidance exists which supports the timed extraction of severely affected molars presenting at 8–10 years to allow favourable eruption of unaffected second permanent molars. However, treatment planning becomes more of a challenge when this window of opportunity is missed. In these situations, we are left with a tooth of guarded long-term prognosis in a patient where access and cooperation can be challenging. Delays to routine care as a result of the COVID-19 pandemic are likely to make this a more common clinical presentation so this article aims to discuss management options for these patients.
A ‘real-world’ standard for radical prostatectomy: Analysis of the British Association of Urological Surgeons Complex Operations Reports, 2016–2018
Authors: John Joseph B , Pascoe John , Fowler Sarah , Walton Thomas , Johnson Mark , Aning Jonathan , Challacombe Benjamin , Bufacchi Rory , Dickinson Andrew J , McGrath John S
Published: January 2022

Objective:

To produce comprehensive and detailed benchmarking data allowing surgeons and patients to compare practice against, by using all recorded radical prostatectomies across a 3-year period in England.

Patients and methods:

The British Association of Urological Surgeons (BAUS) manages the radical prostatectomy (RP) Complex Operations Database. Surgical departments upload data which they can review and amend before lockdown and data cleansing. Analysis of 2016–2018 data held on the BAUS Complex Operations Database was performed for 21,973 patients undergoing RP in England, producing procedure-specific benchmarking data. General linear models were used to assess differences in patient selection between different operative modalities. Analysis involved assessment of case selection, operative decisions and outcomes, case volume and pathological outcomes.

Results:

Using national Hospital Episode Statistics, the BAUS RP dataset was estimated 91% complete. Median age was 65 and 96% were American Society of Anesthesiologists (ASA) Grades 1–2. Over 80% had RP performed in a high-volume centre (>100 annual RPs) and 88% had Gleason grade group (GGG) ⩾2 disease on biopsy. Robotic-assisted RP (RARP), laparoscopic RP (LRP) and open RP (ORP) were performed in 85%, 7.2% and 7.7% of cases, respectively. Patient and disease characteristics differed across surgical modalities. Transfusion rates were 0.14% in RARP, 0.38% in LRP and 1.8% in ORP. Increased positive surgical margin (PSM) rates were observed with increasing prostate-specific antigen (PSA), GGG and T-stage, with comparable PSM rates across surgical modalities. Lymph node dissection was performed more commonly in high-risk cases (cT3, PSA > 20, GGG ⩾ 4). Pathological upstaging was common. Median length of stay was 1, 2 and 3 days for RARP, LRP and ORP, respectively. ORP had Clavien–Dindo complications ⩾3 and unplanned hospital readmissions.

Conclusion:

This analysis has enabled the first set of UK national RP standards to be produced allowing procedure, patient and disease-specific national, centre and individual comparisons. The present degree of service centralisation, operative modalities, and specific aspects of surgical practice can be observed.

Level of evidence:

2b
Youth sport parents’ familiarity and perceptions of concussion legislation
Authors: Kim Sungwon , Connaughton Daniel P. , Spengler John O.
Published: January 2022

Objectives

In an effort to reduce the negative health consequences often associated with concussions among young athletes, all U.S. states and the District of Columbia enacted youth concussion legislation between 2009 and 2014. This study explored youth sport parents’ (1) familiarity with their state's concussion legislation, and (2) perceptions about the need for additional legislative provisions not currently found in such laws.

Methods

Cross-sectional online survey data were obtained from parents ( n = 430) of youth sport athletes from 22 U.S states.

Results

Primary findings suggest that 67% of parents were moderately to extremely familiar with the removal from play requirement; 69.9% were moderately to extremely familiar with mandatory concussion training for coaches; and 75.1% were moderately to extremely familiar with the medical clearance requirement for athletes to return to play. In regard to perceptions, approximately half (50.2%) believed it is essential to mandate parent/guardian notification when a child suffers a potential concussion; and 42.8% believed it is essential to include a penalty/sanction for violating the statute. Based on the results of a multivariable logistic regression model, a significantly greater familiarity of concussion legislation was found among parents who were White/Caucasian, had advanced degrees, had higher household incomes, or were urban residents.

Conclusions

Our findings suggest that most youth sport parents have a sound understanding of concussion legislation and believe that the laws should be revised to improve best practices in preventing and managing concussions. Parents who face socio-cultural and economic barriers can benefit most from having access to credible information about their state's concussion law.
Safety and Efficacy of Indomethacin for Reducing Chest Tube Duration After Coronary Artery Bypass Grafting Surgery
Authors: Gibson Caitlin M. , Hall Brenton , Kwon Hyanggi Irene , Davis Sondra , Bradford Darien , Howard Meredith L.
Published: January 2022

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) contain a boxed warning for use in coronary artery bypass graft (CABG) surgery due to increased risk of thrombotic events, but recent research has challenged the assumption that these risks are a class effect. One anecdotal indication for NSAIDs in CABG is reducing chest tube output. Objective: The primary objective of this retrospective study was to determine whether indomethacin was associated with reduced duration of chest tube insertion after CABG surgery, defined as total chest tube duration in controls versus duration of chest tube insertion after the first dose of indomethacin in the treatment group. Secondary objectives were comparisons of daily reductions in chest tube output volume, length of stay, and safety between groups. Methods: In this retrospective, single-center case-control review, adult patients who received indomethacin after CABG were matched 1:1 to control patients based on age, sex, concomitant valve surgery, and, when possible, diabetes status. Results: Thirty-two patients were included. The mean age was 56 years and 75% were men. The primary outcome measure was 94 hours among control patients and 82.8 hours among indomethacin patients ( P = 0.041). Insignificant mean reductions in daily chest tube output were observed prior to and after indomethacin initiation (38.7 vs 87.7 mL/day, P > 0.05). Conclusion: In this small, single-center study, indomethacin appeared safe and possibly effective for reducing chest tube duration after CABG surgery. Future large, prospective, randomized studies should be conducted to confirm the results.