bluuebunny/crossref_metadata_2025 huggingface dataset:
Autologous semitendinosus tendon graft could function as a meniscal transplant
Authors: Rönnblad Erik , Rotzius Pierre , Eriksson Karl
Published: June 2021

Purpose

Meniscectomy results in poor knee function and increased risk for osteoarthritis. Meniscal allograft transplantation is not widely used due to costs and availability. The semitendinosus tendon (ST) has the potential to remodel and revascularize in an intraarticular environment, such as ACL reconstruction. The objective for this pilot study was to investigate whether the ST graft could function as a meniscal transplant.

Methods

The ST was doubled and sutured with running sutures and pull-out sutures in each end. Bone tunnels were used for root anchorage and the graft was sutured with allinside, inside-out and outside-in technique. The pull-out sutures were fixed over a button. Partial weight bearing was allowed with limited range of motion in a brace for the first 6 weeks. Evaluation was assessed using clinical examination, radiology and patient reported outcome.

Results

A total of seven patients have been included between January 2018 and June 2020. Six medial transplants and one lateral transplant were performed. Mean age was 29 years. Four patients had completed the 12-month follow-up. Improvements were noted for IKDC Global Score, KOOS pain subscale and Lysholm. MRI indicated that the transplant become more wedge-like with visible roots and minor protrusion.

Conclusions

Even though this is primarily a technical report the follow-up data indicate that the transplant survives and adapts in shape and capabilities to an original meniscus. There were no adverse events and the patients seem to improve in terms of pain and quality of life.
Cognitive capabilities for the CAAI in cyber-physical production systems
Authors: Strohschein Jan , Fischbach Andreas , Bunte Andreas , Faeskorn-Woyke Heide , Moriz Natalia , Bartz-Beielstein Thomas
Published: June 2021

This paper presents the cognitive module of the Cognitive Architecture for Artificial Intelligence (CAAI) in cyber-physical production systems (CPPS). The goal of this architecture is to reduce the implementation effort of artificial intelligence (AI) algorithms in CPPS. Declarative user goals and the provided algorithm-knowledge base allow the dynamic pipeline orchestration and configuration. A big data platform (BDP) instantiates the pipelines and monitors the CPPS performance for further evaluation through the cognitive module. Thus, the cognitive module is able to select feasible and robust configurations for process pipelines in varying use cases. Furthermore, it automatically adapts the models and algorithms based on model quality and resource consumption. The cognitive module also instantiates additional pipelines to evaluate algorithms from different classes on test functions. CAAI relies on well-defined interfaces to enable the integration of additional modules and reduce implementation effort. Finally, an implementation based on Docker, Kubernetes, and Kafka for the virtualization and orchestration of the individual modules and as messaging technology for module communication is used to evaluate a real-world use case.
Second-generation antipsychotic use during pregnancy and risk of congenital malformations
Authors: Ellfolk Maria , Leinonen Maarit K. , Gissler Mika , Kiuru-Kuhlefelt Sonja , Saastamoinen Leena , Malm Heli
Published: June 2021

Purpose

To study if second-generation antipsychotic (S-GA) use during the first trimester of pregnancy is associated with an increased risk of major congenital malformations (MCM).

Methods

A population-based birth cohort study using national register data extracted from the Drugs and Pregnancy database in Finland, years 1996–2017. The sampling frame included 1,273,987 pregnant women. We included singleton pregnancies ending in live or stillbirth or termination of pregnancy due to severe malformation. Pregnancies with exposure to known teratogens were excluded. Women were categorized into three groups: exposed to S-GAs (n = 3478), exposed to first-generation antipsychotics (F-GAs) (n = 1030), and unexposed (no purchases of S-GAs or F-GAs during pregnancy, n = 22,540). We excluded genetic conditions and compared the prevalence of MCMs in S-GA users to the two comparison groups using multiple logistic regression models.

Results

Use of S-GAs during early pregnancy was not associated with an increased risk of overall MCMs compared to unexposed (adjusted odds ratio, OR 0.92; 95% CI 0.72–1.19) or to F-GA users (OR 0.82; 95% CI 0.56–1.20). Of individual S-GAs, olanzapine use was associated with an increased risk of overall MCMs (OR 2.12; 95% CI 1.19–3.76), and specifically, an increased risk of musculoskeletal malformations (OR 3.71; 95% CI 1.35–10.1) when compared to unexposed, while comparisons to F-GA users did not show significant results.

Conclusions

Olanzapine use is associated with an increased risk of major congenital malformations and specifically, musculoskeletal malformations. Use during pregnancy should be restricted to situations where no safer alternatives exist.
Application of experimental data to model local fouling resistances
Authors: Schlüter Florian , Augustin Wolfgang , Scholl Stephan
Published: June 2021

Fouling is a problem that varies in space and time, but a fouling situation is commonly quantified using the integral thermal fouling resistance based on the integral heat balance and an area-averaged heat transfer assessment. However, current modeling does not take into consideration the local differences, such as constrictions, that can affect the integral fluid dynamic behavior. This work shows experimental and analytical results of local investigations of a fouled counterflow double-pipe heat exchanger. The determined local parameters are used to calculate different local fouling resistances as part of a holistic modeling approach with the aim of modeling and linking local and integral fouling resistances as well as the thermal and the mass based approaches. Therefore, mass based parameters are utilized to recalculate the obtained local thermal fouling resistances as a way to account for the heat transfer increases caused by local surface roughness and/or local constrictions. The aim of this procedure is to explain and eliminate apparent negative fouling resistances on a local basis. The local thermal fouling resistances are determined by measuring the local temperatures and then used for quantification of the local overall heat transfer coefficients. Modeling of the local mass based fouling resistances requires knowledge of the density and thermal conductivity of the local material, as well as the local layer thickness and/or the local fouling mass. The local thermal fouling resistances are recalculated using the local friction coefficients and local flow velocities resulting from local constrictions. All experimental and theoretical approaches are merged into the model presented here for the determination of local fouling resistances.
Pelvic antropometric measurement in 3D CT for placement of two unilateral iliosacral S1 - 7.3 mm screws
Authors: Suda Arnold J. , Helm Lisa , Obertacke Udo
Published: June 2021

Purpose

Stability of the dorsal pelvic ring is important for patient mobilisation and can be restored using several surgical procedures after fracture. Placement of percutaneous iliosacral screws is a reliable and minimal-invasive technique to achieve stabilisation of the dorsal pelvic ring by placement of two screws in the first sacral vertebra. Aim of this study was to evaluate 3D CT scans regarding the anatomical possibility to place two 7.3 mm iliosacral screws for fixation of the dorsal pelvic ring.

Methods

3D CT datasets of 500 consecutive trauma patients with 1000 hemipelves of a mid-european level I trauma centre with or without pelvic injury were evaluated and measured bilaterally in this retrospective study.

Results

One thousand hemipelvic datasets of 500 patients (157 females, 343 males) with a mean age of 49.7 years (18 to 95) were included in this study. Only 16 hemipelves (1.6%, 11 in females, 5 in males) in 14 patients (2.8%, 9 females = 5.73%, 5 males = 1.5%) showed too narrow corridors so that 7.3 mm screw placement would not be possible (p = 0.001). In women, too narrow corridors occurred 3.9 times as often as in men. Only two females showed this bilaterally.

Conclusion

The evaluation of 3D CT scans of the pelvis showed the importance of planning iliosacral screw placement, especially if two 7.3 mm screws are intended to be placed in the first sacral vertebra.
Reliability and reproducibility of sciatic nerve magnetization transfer imaging and T2 relaxometry
Authors: Preisner Fabian , Behnisch Rouven , Foesleitner Olivia , Schwarz Daniel , Wehrstein Michaela , Meredig Hagen , Friedmann-Bette Birgit , Heiland Sabine , Bendszus Martin , Kronlage Moritz
Published: June 2021

Objectives

To assess the interreader and test-retest reliability of magnetization transfer imaging (MTI) and T2 relaxometry in sciatic nerve MR neurography (MRN).

Materials and methods

In this prospective study, 21 healthy volunteers were examined three times on separate days by a standardized MRN protocol at 3 Tesla, consisting of an MTI sequence, a multi-echo T2 relaxometry sequence, and a high-resolution T2-weighted sequence. Magnetization transfer ratio (MTR), T2 relaxation time, and proton spin density (PSD) of the sciatic nerve were assessed by two independent observers, and both interreader and test-retest reliability for all readout parameters were reported by intraclass correlation coefficients (ICCs) and standard error of measurement (SEM).

Results

For the sciatic nerve, overall mean ± standard deviation MTR was 26.75 ± 3.5%, T2 was 64.54 ± 8.2 ms, and PSD was 340.93 ± 78.8. ICCs ranged between 0.81 (MTR) and 0.94 (PSD) for interreader reliability and between 0.75 (MTR) and 0.94 (PSD) for test-retest reliability. SEM for interreader reliability was 1.7% for MTR, 2.67 ms for T2, and 21.3 for PSD. SEM for test-retest reliability was 1.7% for MTR, 2.66 ms for T2, and 20.1 for PSD.

Conclusions

MTI and T2 relaxometry of the sciatic nerve are reliable and reproducible. The values of measurement imprecision reported here may serve as a guide for correct interpretation of quantitative MRN biomarkers in future studies.

Key Points

• Magnetization transfer imaging (MTI) and T2 relaxometry of the sciatic nerve are reliable and reproducible.

• The imprecision that is unavoidably associated with different scans or different readers can be estimated by the here presented SEM values for the biomarkers T2, PSD, and MTR.

• These values may serve as a guide for correct interpretation of quantitative MRN biomarkers in future studies and possible clinical applications.
Development and external validation of prognostic models to predict sudden and pump-failure death in patients with HFrEF from PARADIGM-HF and ATMOSPHERE
Authors: Shen Li , Claggett Brian L. , Jhund Pardeep S. , Abraham William T. , Desai Akshay Suvas , Dickstein Kenneth , Gong Jianjian , Køber Lars V. , Lefkowitz Marty P. , Rouleau Jean L. , Shi Victor C. , Swedberg Karl , Zile Michael R. , Solomon Scott D. , McMurray John J. V.
Published: June 2021

Background

Sudden death (SD) and pump failure death (PFD) are the two leading causes of death in patients with heart failure and reduced ejection fraction (HFrEF).

Objective

Identifying patients at higher risk for mode-specific death would allow better targeting of individual patients for relevant device and other therapies.

Methods

We developed models in 7156 patients with HFrEF from the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM-HF) trial, using Fine-Gray regressions counting other deaths as competing risks. The derived models were externally validated in the Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure (ATMOSPHERE) trial.

Results

NYHA class and NT-proBNP were independent predictors for both modes of death. The SD model additionally included male sex, Asian or Black race, prior CABG or PCI, cancer history, MI history, treatment with LCZ696 vs. enalapril, QRS duration and ECG left ventricular hypertrophy. While LVEF, ischemic etiology, systolic blood pressure, HF duration, ECG bundle branch block, and serum albumin, chloride and creatinine were included in the PFD model. Model discrimination was good for SD and excellent for PFD with Harrell’s C of 0.67 and 0.78 after correction for optimism, respectively. The observed and predicted incidences were similar in each quartile of risk scores at 3 years in each model. The performance of both models remained robust in ATMOSPHERE.

Conclusion

We developed and validated models which separately predict SD and PFD in patients with HFrEF. These models may help clinicians and patients consider therapies targeted at these modes of death.

Trial registration number

PARADIGM-HF: ClinicalTrials.gov NCT01035255, ATMOSPHERE: ClinicalTrials.gov NCT00853658.

Graphics abstract
The role of the femoral component orientation on dislocations in THA: a systematic review
Authors: van Erp Joost H. J. , Snijders Thom E. , Weinans Harrie , Castelein René M. , Schlösser Tom P. C. , de Gast Arthur
Published: June 2021

Introduction

Dislocation remains a major complication in total hip arthroplasty (THA), in which femoral component orientation is considered a key parameter. New imaging modalities and definitions on femoral component orientation have been introduced, describing orientation in different planes. This study aims to systematically review the relevance of the different orientation parameters on implant stability.

Methods

A systematic review was performed according to the PRISMA guidelines to identify articles in the PubMed and EMBASE databases that study the relation between any femoral component orientation parameters and implant stability in primary THA.

Results

After screening for inclusion and exclusion criteria and quality assessment, nine articles were included. Definitions to describe the femoral component orientation and methodologies to assess its relevance for implant stability differed greatly, with lack of consensus. Seven retrospective case–control studies reported on the relevance of the transversal plane orientation: Low femoral- or low combined femoral and acetabular anteversion was statistical significantly related with more posterior dislocations, and high femoral- or combined femoral and acetabular anteversion with anterior dislocations in two studies. There were insufficient data on sagittal and coronal component orientation in relation to implant stability.

Conclusion

Because of incomparable definitions, limited quality and heterogeneity in methodology of the included studies, there is only weak evidence that the degree of transverse component version is related with implant stability in primary THA. Recommendations about the optimal orientation of the femoral component in all three anatomical planes cannot be provided. Future studies should uniformly define the three-dimensional orientation of the femoral component and systematically describe implant stability.
Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation
Authors: Müller-Graff Franz-Tassilo , Ilgen Lukas , Schendzielorz Philipp , Voelker Johannes , Taeger Johannes , Kurz Anja , Hagen Rudolf , Neun Tilmann , Rak Kristen
Published: June 2021

Purpose

For further improvements in cochlear implantation, the measurement of the cochlear duct length (CDL) and the determination of the electrode contact position (ECP) are increasingly in the focus of clinical research. Usually, these items were investigated by multislice computed tomography (MSCT). The determination of ECP was only possible by research programs so far. Flat-panel volume computed tomography (fpVCT) and its secondary reconstructions (fpVCTSECO) allow for high spatial resolution for the visualization of the temporal bone structures. Using a newly developed surgical planning software that enables the evaluation of CDL and the determination of postoperative ECP, this study aimed to investigate the combination of fpVCT and otological planning software to improve the implementation of an anatomically based cochlear implantation.

Methods

Cochlear measurements were performed utilizing surgical planning software in imaging data (MSCT, fpVCT and fpVCTSECO) of patients with and without implanted electrodes.

Results

Measurement of the CDL by the use of an otological planning software was highly reliable using fpVCTSECO with a lower variance between the respective measurements compared to MSCT. The determination of the inter-electrode-distance (IED) between the ECP was improved in fpVCTSECO compared to MSCT.

Conclusion

The combination of fpVCTSECO and otological planning software permits a simplified and more reliable analysis of the cochlea in the pre- and postoperative setting. The combination of both systems will enable further progress in the development of an anatomically based cochlear implantation.
Chronobiology of transient global amnesia
Authors: Hoyer Carolin , Higashida Kyoko , Fabbian Fabio , De Giorgi Alfredo , Sandikci Vesile , Ebert Anne , Platten Michael , Okazaki Shuhei , Manfredini Roberto , Szabo Kristina
Published: June 2021

Introduction

The etiology of transient global amnesia (TGA) is still a matter of debate. Based, among others, on the observation of a close temporal relation between certain events and subsequent TGA episodes, recent proposals discuss the relevance of stress-associated processes impacting on hippocampal functioning. Circadian, infra- and ultradian rhythmicity has been found to play a relevant role in the multifactorial pathomechanisms of various disorders but has not been thoroughly studied in TGA.

Methods

Data of patients with a final diagnosis of TGA were collected in Mannheim, Germany (06/1999–01/2018, n = 404), and in the Kansai district, Japan (04/2006–03/2018, n = 261). Chronological patterns of TGA occurrence were determined.

Results

Significant circadian rhythmicity of TGA occurrence with bimodal peaks (mid-morning, late afternoon) was found for the entire population (p = 0.002) and for either sub-cohort (Mannheim: p = 0.003, Kansai: p = 0.007). This finding was confirmed for either sex (women: p = 0.004, men: p = 0.004) and different age groups (< 65 years: p = 0.0009, ≥ 65 years: p = 0.003). There was no variation according to day of the week, month or season, but the proportion of patients with a weekday episode was significantly higher in the Mannheim cohort (p = 0.002).

Discussion

We identified a robust circadian rhythm in TGA occurrence which remarkably applied to either of the two study sites located on different continents and which was independent of sex and age. In light of abundant evidence of circadian rhythmicity of both, components of the human stress response system and memory, chronobiological analyses may provide an opportunity to further uncover the mechanisms underlying TGA.
Frequency and phenotype of thalamic aphasia
Authors: Rangus Ida , Fritsch Merve , Endres Matthias , Udke Birgit , Nolte Christian H.
Published: June 2021

Background

Aphasia is a recognized presenting symptom of thalamic lesions. Little is known regarding its frequency and phenotype. We examined the frequency of thalamic aphasia following Isolated Acute unilateral ischemic Lesions in the Thalamus (IALT) with respect to lesion location. Furthermore, we characterized thalamic aphasia according to affected language domains and severity.

Methods

Fifty-two patients with IALT were analyzed [44% female, median age: 73 years (IQR: 60–79)]. Lesion location was determined using 3-Tesla magnetic resonance imaging and categorized as anterior, posterior, paramedian or inferolateral. Standardized language assessment was performed using the validated Aphasia checklist (ACL) directly after symptom onset. Aphasia was defined as an ACL sum score of < 135 (range: 0–148).

Results

Of 52 patients, 23 (44%) fulfilled the ACL diagnostic criteria for aphasia, including nearly all lesion locations and both sides. The average ACL sum score was 132 ± 11 (range: 98–147). Aphasia was characterized by deficits within domains of complex understanding of speech and verbal fluency. Patients with left anterior IALT were most severely affected, having significantly lower ACL scores than all other patients (117 ± 13 vs. 135 ± 8; p < 0.001). In particular, aphasia in patients with left anterior IALT was characterized by significantly worse performance in the rating of verbal communication, verbal fluency, and naming (all p ≤ 0.001).

Conclusion

Aphasia occurs in almost half of patients with focal thalamic lesions. Thalamic aphasia is not confined to one predefined thalamic lesion location, but language deficits are particularly pronounced in patients with left anterior IALT presenting with a distinct pattern.
C-Planarity Testing of Embedded Clustered Graphs with Bounded Dual Carving-Width
Authors: Da Lozzo Giordano , Eppstein David , Goodrich Michael T. , Gupta Siddharth
Published: June 2021

For a clustered graph, i.e, a graph whose vertex set is recursively partitioned into clusters, the C-Planarity Testing problem asks whether it is possible to find a planar embedding of the graph and a representation of each cluster as a region homeomorphic to a closed disk such that (1) the subgraph induced by each cluster is drawn in the interior of the corresponding disk, (2) each edge intersects any disk at most once, and (3) the nesting between clusters is reflected by the representation, i.e., child clusters are properly contained in their parent cluster. The computational complexity of this problem, whose study has been central to the theory of graph visualization since its introduction in 1995 [Feng, Cohen, and Eades, Planarity for clustered graphs, ESA’95], has only been recently settled [Fulek and Tóth, Atomic Embeddability, Clustered Planarity, and Thickenability, to appear at SODA’20]. Before such a breakthrough, the complexity question was still unsolved even when the graph has a prescribed planar embedding, i.e, for embedded clustered graphs. We show that the C-Planarity Testing problem admits a single-exponential single-parameter FPT (resp., XP) algorithm for embedded flat (resp., non-flat) clustered graphs, when parameterized by the carving-width of the dual graph of the input. These are the first FPT and XP algorithms for this long-standing open problem with respect to a single notable graph-width parameter. Moreover, the polynomial dependency of our FPT algorithm is smaller than the one of the algorithm by Fulek and Tóth. In particular, our algorithm runs in quadratic time for flat instances of bounded treewidth and bounded face size. To further strengthen the relevance of this result, we show that an algorithm with running time O(r(n)) for flat instances whose underlying graph has pathwidth 1 would result in an algorithm with running time O(r(n)) for flat instances and with running time $$O(r(n^2) + n^2)$$

O
(
r

(

n
2

)

+

n
2

)

for general, possibly non-flat, instances.
The impact of EAES Fellowship Programme: a five-year review and evaluation
Authors: Tsai Alice , Soltes Marek , Lesko Dusan , Adamina Michel , Andrejevic Pedrag , Bjelovic Milos , Campbell Kenneth , Coleman Mark , de Manzini Nicoló , Delibegovic Samir , Majewski Wlodzimierz , Malanowska Ewelina , Martinek Lubomir , Sedman Peter , Lázár György , Tsalis Konstantinos , Popa Dorin
Published: June 2021

Background

The European Association of Endoscopic Surgery (EAES) fellowship programme was established in 2014, allowing nine surgeons annually to obtain experience and skills in minimally invasive surgery (MIS) from specialist centres across the Europe and United States. It aligns with the strategic focus of EAES Education and Training Committee on enabling Learning Mobility opportunities. To assess the impact of the programme, a survey was conducted aiming to evaluate the experience and impact of the programme and receive feedback for improvements.

Methods

A survey using a 5-point Likert scale was used to evaluate clinical, education and research experience. The impact on acquisition of new technical skills, change in clinical practice and ongoing collaboration with the host institute was assessed. The fellows selected between 2014 and 2018 were included. Ratings were analysed in percentage; thematic analysis was applied to the free-text feedbacks using qualitative analysis.

Results

All the fellows had good access to observing in operating theatres and 70.6% were able to assist. 91.2% participated in educational activities and 23.5% were able to contribute through teaching. 44.1% participated in research activities and 41.2% became an author/co-author of a publication from the host. 97.1% of fellows stated that their operative competency had increased, 94.3% gained new surgical skills and 85.7% was able to introduce new techniques in their hospitals. 74.29% agreed that the clinical experience led to a change in their practices. The most commonly suggested improvements were setting realistic target in clinical and research areas, increasing fellowship duration, and maximising theatre assisting opportunities. Nevertheless, 100% of fellows would recommend the fellowship to their peers.

Conclusion

EAES fellowship programme has shown a positive impact on acquiring and adopting new MIS techniques. To further refine the programme, an individualised approach should be adopted to set achievable learning objectives in clinical skills, education and research.
Differentiating PSP from MSA using MR planimetric measurements: a systematic review and meta-analysis
Authors: Heim Beatrice , Krismer Florian , Seppi Klaus
Published: June 2021

Differential diagnosis of parkinsonian syndromes is considered one of the most challenging in neurology. Quantitative MR planimetric measurements were reported to discriminate between progressive supranuclear palsy (PSP) and non-PSP-parkinsonism. Several studies have used midbrain to pons ratio (M/P) and the Magnetic Resonance Parkinsonism Index (MRPI) in distinguishing PSP patients from those with Parkinson's disease. The current meta-analysis aimed to compare the performance of these measures in discriminating PSP from multiple system atrophy (MSA). A systematic MEDLINE review identified 59 out of 2984 studies allowing a calculation of sensitivity and specificity using the MRPI or M/P. Meta-analyses of results were carried out using random effects modelling. To assess study quality and risk of bias, the QUADAS-2 tool was used. Eight studies were suitable for analysis. The meta‐analysis showed a pooled sensitivity and specificity for the MRPI of PSP versus MSA of 79.2% (95% CI 72.7–84.4%) and 91.2% (95% CI 79.5–96.5%), and 84.1% (95% CI 77.2–89.2%) and 89.2% (95% CI 81.8–93.8%), respectively, for the M/P. The QUADAS-2 toolbox revealed a high risk of bias regarding the methodological quality of patient selection and index test, as all patients were seen in a specialized outpatient department without avoiding case control design and no predefined threshold was given regarding MRPI or M/P cut-offs. Planimetric brainstem measurements, in special the MRPI and M/P, yield high diagnostic accuracy for the discrimination of PSP from MSA. However, there is an urgent need for well-designed, prospective validation studies to ameliorate the concerns regarding the risk of bias.
The association between treated psychiatric and neurodevelopmental disorders and out-of-home care among Finnish children born in 1997
Authors: Kääriälä Antti , Gyllenberg David , Sund Reijo , Pekkarinen Elina , Keski-Säntti Markus , Ristikari Tiina , Heino Tarja , Sourander Andre
Published: June 2021

Comprehensive overviews of the use of psychiatric services among children and adolescents placed in out-of-home care (OHC) by child welfare authorities are scarce. We examine specialized service use for psychiatric and neurodevelopmental disorders among children and adolescents in a total population involving children in OHC. We used the longitudinal administrative data of a complete Finnish birth cohort 1997 (N = 57,174). We estimated risk ratios (RRs) for a range of diagnosed psychiatric and neurodevelopmental disorders among children in OHC. We also estimated RRs for OHC among those with diagnosed disorders. We used descriptive methods to explore the timing of first entry into OHC relative to the first diagnosis. Among children in OHC, 61.9% were diagnosed with any psychiatric or neurodevelopmental disorder, compared with 18.0% among those never in OHC (RR: 3.7; 95% CI 3.6–3.8). The most common diagnosed disorders among children in OHC were depression and anxiety disorders, neurodevelopmental disorders, and oppositional defiant disorder/conduct disorder (ODD/CD). Among all children with any diagnosis, 18.1% experienced OHC, compared with 2.5% among those without a diagnosis (RR: 7.4; 95% CI 6.9–7.9). Of those diagnosed with self-harm and suicidality, ODD/CD, substance-related disorders, and psychotic and bipolar disorders, 43.5–61.2% experienced OHC. Of the children in OHC receiving psychiatric services, half were diagnosed before first placement in OHC. The majority of children with experience in OHC were diagnosed with psychiatric or neurodevelopmental disorders. They comprised a significant proportion of individuals treated for severe and complex psychiatric disorders and self-harm.
Association analysis of juvenile idiopathic arthritis genetic susceptibility factors in Estonian patients
Authors: Nikopensius Tiit , Niibo Priit , Haller Toomas , Jagomägi Triin , Voog-Oras Ülle , Tõnisson Neeme , Metspalu Andres , Saag Mare , Pruunsild Chris
Published: June 2021

Background

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition of childhood. Genetic association studies have revealed several JIA susceptibility loci with the strongest effect size observed in the human leukocyte antigen (HLA) region. Genome-wide association studies have augmented the number of JIA-associated loci, particularly for non-HLA genes. The aim of this study was to identify new associations at non-HLA loci predisposing to the risk of JIA development in Estonian patients.

Methods

We performed genome-wide association analyses in an entire JIA case–control sample (All-JIA) and in a case–control sample for oligoarticular JIA, the most prevalent JIA subtype. The entire cohort was genotyped using the Illumina HumanOmniExpress BeadChip arrays. After imputation, 16,583,468 variants were analyzed in 263 cases and 6956 controls.

Results

We demonstrated nominal evidence of association for 12 novel non-HLA loci not previously implicated in JIA predisposition. We replicated known JIA associations in CLEC16A and VCTN1 regions in the oligoarticular JIA sample. The strongest associations in the All-JIA analysis were identified at PRKG1 (P = 2,54 × 10−6), LTBP1 (P = 9,45 × 10−6), and ELMO1 (P = 1,05 × 10−5). In the oligoarticular JIA analysis, the strongest associations were identified at NFIA (P = 5,05 × 10−6), LTBP1 (P = 9,95 × 10−6), MX1 (P = 1,65 × 10−5), and CD200R1 (P = 2,59 × 10−5).

Conclusion

This study increases the number of known JIA risk loci and provides additional evidence for the existence of overlapping genetic risk loci between JIA and other autoimmune diseases, particularly rheumatoid arthritis. The reported loci are involved in molecular pathways of immunological relevance and likely represent genomic regions that confer susceptibility to JIA in Estonian patients.

Key Points• Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease with heterogeneous presentation and genetic predisposition.• Present genome-wide association study for Estonian JIA patients is first of its kind in Northern and Northeastern Europe.• The results of the present study increase the knowledge about JIA risk loci replicating some previously described associations, so adding weight to their relevance and describing novel loci.• The study provides additional evidence for the existence of overlapping genetic risk loci between JIA and other autoimmune diseases, particularly rheumatoid arthritis.
A Multilevel Approach to Understanding the Determinants of Maternal Harsh Parenting: the Importance of Maternal Age and Perceived Partner Support
Authors: Farley Laura , Oliver Bonamy R. , Pike Alison
Published: June 2021

Determinants of parenting are most often considered using one child per family within a cross-sectional design. In 182 families, the current study included two siblings and sought to predict maternal harsh parenting measured prospectively when each child was age 2 years from child gender, infant temperament, maternal age, maternal educational attainment, maternal depression and anxiety and maternal perceptions of partner support. Multilevel modeling was used to examine between- and within-family variance simultaneously. Mothers reported levels of harsh parenting that were similar towards both children (intraclass correlation = 0.69). Thus, the majority of variance in maternal perceptions of their harsh parenting resided between rather than within families and was accounted for in part by maternal age and maternal perceptions of partner support. Results are discussed in relation to family-wide determinants of harsh parenting, previous literature pertaining to parenting siblings and the potential avenues for future research and practice.
Lower human defensin 5 in elderly people compared to middle-aged is associated with differences in the intestinal microbiota composition: the DOSANCO Health Study
Authors: Shimizu Yu , Nakamura Kiminori , Kikuchi Mani , Ukawa Shigekazu , Nakamura Koshi , Okada Emiko , Imae Akihiro , Nakagawa Takafumi , Yamamura Ryodai , Tamakoshi Akiko , Ayabe Tokiyoshi
Published: June 2021

Recently, aging is considered a risk factor for various diseases. Although changes in the intestinal microbiota along with aging are thought to associate with the increased disease risk, mechanisms that cause age-related transition of the intestinal microbiota remain unknown. This study aims to clarify relationships between the amount of human defensin 5 (HD5), a Paneth cell α-defensin, which is known to regulate the intestinal microbiota, and age-related differences of the intestinal microbiota composition. Fecal samples from 196 healthy Japanese (35 to 81 years old) were collected and measured HD5 concentration. HD5 concentration in the elderly group (age > 70 years old) was significantly lower than the middle-aged group (age ≤ 70 years old). Furthermore, individual age was negatively correlated with HD5 concentration (r =  − 0.307, p < 0.001). In β-diversity, the intestinal microbiota of the elderly showed a significantly different composition compared to the middle-aged. At the genus level, relative abundance of Collinsella, Alistipes, Peptococcaceae; unassigned, Lactobacillus, Lactococcus, Weissella, Christensenellaceae R-7 group, Megasphaera, and [Eubacterium] eligens group was significantly higher, and Lachnospiraceae; unassigned, Blautia, Anaerostipes, Fusicatenibacter, Dorea, and Faecalibacterium was significantly lower in the elderly compared to the middle-aged. In addition, HD5 concentration was negatively correlated with Alistipes, Peptococcaceae; unassigned, and Christensenellaceae R-7 group and positively correlated with Lachnospiraceae; unassigned and Dorea. These results provide novel insights into the immunosenescence of enteric innate immunity, indicating low HD5 is suggested to contribute to the age-related differences in the intestinal microbiota and may relate to increased risk of diseases in elderly people.
Conventional displays of structures in data compared with interactive projection-based clustering (IPBC)
Authors: Thrun Michael C. , Pape Felix , Ultsch Alfred
Published: June 2021

Clustering is an important task in knowledge discovery with the goal to identify structures of similar data points in a dataset. Here, the focus lies on methods that use a human-in-the-loop, i.e., incorporate user decisions into the clustering process through 2D and 3D displays of the structures in the data. Some of these interactive approaches fall into the category of visual analytics and emphasize the power of such displays to identify the structures interactively in various types of datasets or to verify the results of clustering algorithms. This work presents a new method called interactive projection-based clustering (IPBC). IPBC is an open-source and parameter-free method using a human-in-the-loop for an interactive 2.5D display and identification of structures in data based on the user’s choice of a dimensionality reduction method. The IPBC approach is systematically compared with accessible visual analytics methods for the display and identification of cluster structures using twelve clustering benchmark datasets and one additional natural dataset. Qualitative comparison of 2D, 2.5D and 3D displays of structures and empirical evaluation of the identified cluster structures show that IPBC outperforms comparable methods. Additionally, IPBC assists in identifying structures previously unknown to domain experts in an application.
WomBot: an exploratory robot for monitoring wombat burrows
Authors: Ross Robert , Carver Scott , Browne Elizabeth , Thai Ba Son
Published: June 2021

In this study we evaluate the design and efficacy of Wombot, an exploratory robot used to study environmental conditions within wombat burrows. Our purpose-built robot traverses through the difficult terrain present in wombat burrows whilst facilitating placement and retrieval of environmental data loggers. Our preliminary results suggest that the environmental conditions present within the burrows would result in a long mite survival time which shows significant risk for spreading infestations throughout a wombat population.

Article Highlights

Wombats live in difficult to observe burrows and suffer from mange cased by Sarcoptes scabiei.

A teleoperated robot was designed to traverse the difficult terrain within burrows whilst placing and retrieving environmental loggers.

Cool and humid environmental conditions within burrows suggest a relatively long mite survival time of 16–18 days
Où sont les freins à l’emploi?
Authors: Bouchet Célia
Published: June 2021

La sous-représentation en emploi des personnes handicapées est documentée. En revanche, les restrictions pour accéder à un travail rémunéré sont peu connues dans leurs déclinaisons par types de déficience, et difficiles à isoler des sorties d’emploi liées aux déficiences d’origine professionnelle. À l’aide de l’Enquête Emploi 2011 et de son module ad hoc, cet article dégage des facteurs et processus contribuant à l’inactivité, au chômage, ou à leur coprésence, pour des personnes de 15-64 ans vivant en ménages en France métropolitaine et ayant une déficience survenue avant la fin de leur formation initiale. Selon les types et degrés de déficience, des mécanismes handicapants plurifactoriels surviennent à des stades divers, dessinant trois configurations d’absence d’emploi: inactivité pour les personnes avec une déficience cognitive (forte ou modérée) ou une déficience psychique modérée, chômage pour les personnes avec une déficience visuelle forte ou une déficience motrice modérée, et coexistence des deux pour les personnes avec une déficience motrice forte ou une déficience psychique forte. Par ailleurs, les reconnaissances administratives de handicap ont des effets nuancés (selon les droits associés) et les rendements des diplômes sont hétérogènes selon les sous-groupes.
Engaging faculty in a workshop intervention on overcoming the influence of implicit bias
Authors: Carnes Molly , Sheridan Jennifer , Fine Eve , Lee You-Geon , Filut Amarette , Topp Sharon
Published: June 2021

Introduction:

To study the effectiveness of any educational intervention for faculty requires first that they attend the training. Using attendance as a measure of faculty engagement, this study examined factors associated with the percentage of faculty in divisions of departments of medicine who attended a workshop as part of a multisite study.

Methods:

Between October 2018 and March 2020, 1675 of 4767 faculty in 120 divisions of 14 departments of medicine attended a 3-hour in-person workshop as part of the Bias Reduction in Internal Medicine (BRIM) initiative. This paper describes the workshop development and study design. The number of faculty per division ranged from 5 to 296. Attendance rates varied from 2.7% to 90.1%. Taking a quality improvement approach, the study team brainstormed factors potentially related to variations in workshop attendance, constructed several division- and institution-level variables, and assessed the significance of factors on workshop attendance with hierarchical linear models.

Results:

The following were positively associated with workshop attendance rate: the division head attended the workshop, the BRIM principal investigator gave Medical Grand Rounds, and the percentage of local workshop presenters who completed training. Workshop attendance rates fell when departments identified more than five on-site study leaders.

Conclusions:

Factors associated with higher workshop attendance may have increased the perceived status and value of attending the workshop, leading faculty to choose the workshop over other competing demands. For future investigators studying educational interventions that require participation of faculty in clinical departments at multiple sites, this work offers several valuable lessons.
POWER SERIES PROOFS FOR LOCAL STABILITIES OF KÄHLER AND BALANCED STRUCTURES WITH MILD -LEMMA
Authors: RAO SHENG , WAN XUEYUAN , ZHAO QUANTING
Published: June 2021

By use of a natural map introduced recently by the first and third authors from the space of pure-type complex differential forms on a complex manifold to the corresponding one on the small differentiable deformation of this manifold, we will give a power series proof for Kodaira–Spencer’s local stability theorem of Kähler structures. We also obtain two new local stability theorems, one of balanced structures on an n-dimensional balanced manifold with the
$(n-1,n)$
th mild
$\partial \overline {\partial }$
-lemma by power series method and the other one on p-Kähler structures with the deformation invariance of
$(p,p)$
-Bott–Chern numbers.
ACQUIRING L2 PRONOUN INTERPRETATION BIASES
Authors: Contemori Carla , Mossman Sabrina , Ramos Alba K.
Published: June 2021

Learners of a nonnull subject language (e.g., English) whose first language (L1) is a null subject language (e.g., Spanish) can show some optionality in the interpretation of overt subject pronouns in the second language (L2). By exposing L2 learners to nativelike interpretations of pronouns in discourse, we aim at understanding how exposure can promote implicit learning of pronoun comprehension biases in a L2. A sentence comprehension task was used with intermediate-proficiency English L2 speakers (L1 Spanish) that included a pretest, an exposure phase using the priming technique, an immediate posttest, and a delayed posttest administered 6–10 days later. English learners showed a significant increase in nativelike pronoun interpretations both in the immediate posttest and in the delayed posttest, in comparison to the pretest. The results show that exposure through priming can be effective in changing L2 participants’ interpretations and that effects of exposure are persistent and may aid in the successful acquisition of pronoun resolution biases.
First glaciological investigations at Ridge B, central East Antarctica
Authors: Ekaykin Alexey A. , Bolshunov Alexey V. , Lipenkov Vladimir Ya. , Scheinert Mirko , Eberlein Lutz , Brovkov Evgeniy , Popov Sergey V. , Turkeev Alexey V.
Published: June 2021

The region of Ridge B in central East Antarctica is one of the last unexplored parts of the continent and, at the same time, ranks among the most promising places to search for Earth's oldest ice. In January 2020, we carried out the first scientific traverse from Russia's Vostok Station to the topographical dome of Ridge B (Dome B, 3807 m above sea level, 79.02°S, 93.69°E). The glaciological programme included continuous snow-radar profiling and geodetic positioning along the traverse's route, installation of snow stakes, measurements of snow density, collection of samples for stable water isotope and chemical analyses and drilling of a 20 m firn core. The first results of the traverse show that the surface mass balance at Dome B (2.28 g cm−2 year−1) is among the lowest in Antarctica. The firn temperature below the layer of annual variations is −58.1 ± 0.2°C. A very low value of heavy water stable isotope content (-58.2‰ for oxygen-18) was discovered at a distance of 170 km from Vostok Station. This work is the first step towards a comprehensive reconnaissance study of the Ridge B area aimed at locating the best site for future deep drilling for the oldest Antarctic ice.
The gut microbiota as a therapeutic target for obesity: a scoping review
Authors: Santos-Paulo Stephanie , Costello Samuel P. , Forster Samuel C. , Travis Simon P. , Bryant Robert V.
Published: June 2021

There is mounting evidence that microbiome composition is intimately and dynamically connected with host energy balance and metabolism. The gut microbiome is emerging as a novel target for counteracting the chronically positive energy balance in obesity, a disease of pandemic scale which contributes to >70 % of premature deaths. This scoping review explores the potential for therapeutic modulation of gut microbiota as a means of prevention and/or treatment of obesity and obesity-associated metabolic disorders. The evidence base for interventional approaches which have been shown to affect the composition and function of the intestinal microbiome is summarised, including dietary strategies, oral probiotic treatment, faecal microbiota transplantation and bariatric surgery. Evidence in this field is still largely derived from preclinical rodent models, but interventional studies in obese populations have demonstrated metabolic improvements effected by microbiome-modulating treatments such as faecal microbiota transplantation, as well as drawing attention to the unappreciated role of microbiome modulation in well-established anti-obesity interventions, such as dietary change or bariatric surgery. The complex relationship between microbiome composition and host metabolism will take time to unravel, but microbiome modulation is likely to provide a novel strategy in the limited armamentarium of effective treatments for obesity.
Heart rate variability moderates the effects of COVID-19-related stress and family adversity on emotional problems in adolescents: Testing models of differential susceptibility and diathesis stress
Authors: Miller Jonas G. , Chahal Rajpreet , Kirshenbaum Jaclyn S. , Ho Tiffany C. , Gifuni Anthony J. , Gotlib Ian H.
Published: June 2021

The COVID-19 pandemic is a unique period of stress, uncertainty, and adversity that will have significant implications for adolescent mental health. Nevertheless, stress and adversity related to COVID-19 may be more consequential for some adolescents’ mental health than for others. We examined whether heart rate variability (HRV) indicated differential susceptibility to mental health difficulties associated with COVID-19 stress and COVID-19 family adversity. Approximately 4 years prior to the pandemic, we assessed resting HRV and HRV reactivity to a well-validated stress paradigm in 87 adolescents. During the pandemic, these adolescents (ages 13–19) reported on their health-related stress and concerns about COVID-19, family adversity related to COVID-19, and their recent emotional problems. The association between COVID-19 stress and emotional problems was significantly stronger for adolescents who previously exhibited higher resting HRV or higher HRV reactivity. For adolescents who exhibited lower resting HRV or HRV augmentation, COVID-19 stress was not associated with emotional problems. Conversely, lower resting HRV indicated vulnerability to the effect of COVID-19 family adversity on emotional problems. Different patterns of parasympathetic functioning may reflect differential susceptibility to the effects of COVID-19 stress versus vulnerability to the effects of COVID-19 family adversity on mental health during the pandemic.