bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and Analysis of Cooling Fan to Improvise the Mass Flow Rate
Authors: Aravindkumar N , Rathish R , Vignesh S , Kesavvan K , Kirubha G , Navien Kumaar S , Praveen V
Published: May 2021

In the current era the speed and performance of the systems are the most required thing in all the industries due to development of automation in all the fields. Central Processing Unit is the heart of a system which consists of various electronics components in it, due the presence of these components and their continuous functioning the heat generated in enormous in quantity which badly affects the performance of the CPU. There are many designs of heat sink to improve the efficiency, the commonly used heat sink is cooling fans. The cooling fans are modified from the reference to the existing ones of high performing CPUs. The modified fan has been tested for its performance computationally for different conditions of speed and heats. The performance of all the conditions has been compared and with help of computational fluid dynamics software results. The best design has been opted from the results of computational work and the numerical work was carried out to find the efficiency of the newly modified fans.
Effect of thermal cycling on microstructure and hardness of carbon steel
Authors: Manjunath Yadav S , Kumar Sumit , Pancholi Vivek , Nath Sumeer K
Published: May 2021

The present investigation deals with design of thermal cycling schedule to enhance hardness of 0.26%C carbon steel using thermo-mechanical simulator Gleeble® 3800. The specimens were thermal cycled at 775°C for 3 and 7 cycles. Optical micrographs, scanning electron micrographs, X-Ray diffraction patterns of as received steel specimen as well as thermal cycled specimens were reported. The thermal cycling heat treatment causes the refinement of microstructure and is responsible for enhancement in hardness of steel specimen.
Monitoring Drought using Multispectral Remote Sensing – A Case Study
Authors: Vanajith V , Daniel Susan G , Rugma S , Dhanya M
Published: May 2021

The significance of remote sensing observations in monitoring environmental phenomena is a well-established fact. High resolution satellite images acquired using multispectral sensors contribute greatly in this aspect. In the current study, an illustration of this factor is presented using high resolution multispectral data to analyse drought conditions over Solapur, India. Here, Sentinel-2 data is utilized to estimate indices like Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI) and Vegetation condition index (VCI), which help us to infer the drought situation in the region of interest.
A Review on Smart Traffic Management System
Authors: Indhiradevi P , Saravanakumar P , Varsha R , Shahithya S , Naveen Prabhu S
Published: May 2021

Traffic congestion could be a condition in transport where it has huge crowds, slows the speed of vehicles and even it increases the vehicular lengths. Traffic congestion on city road networks has increased rapidly, since the 1950s. When the traffic demand is great then the interaction between the vehicles reduces the speed of the traffic and finally results in traffic congestion. To overcome such circumstances in present scenario, smart traffic management system can be initiated and we are in study to find a solution to make traffic free city. This system helps in monitoring the traffic signals and flow of vehicles by means of image processing with CCTV cameras. CCTV cameras help in image processing and identifying the number of vehicles passing in the road surface. It helps in abating the traffic congestion in the road and fuel consumption of the automobiles. Sensors are used for detecting the number of vehicles and speed. By coordinating the CCTV cameras and sensors the collected information can be sent to Variable Message Sign (VMS) Boards. This board displays the information regarding traffic to the road users. It helps in diverting and altering the roads at the earliest where the waiting time is reduced. Though the waiting time is reduced, fuel is consumed automatically. Therefore, reduction in the fuel consumption helps to control the air pollution. By creating the control system and detecting the problems faced in the road, traffic congestion can be reduced and provide traffic free environment. As we face rapid growth of our country’s population, smart traffic management system provides people to have smooth transportation network which would find a way to reach their destination soon and make their journey better forever.
Fiber Reinforced Sustainable Geopolymer Earth brick
Authors: Elavarasan S , Priya A K , Dhinagar R , Engels Pandi P , Gopika K , Gokulasankaran
Published: May 2021

Nowadays, the use of Earth Bricks is at this point not notable despite its enormous inclinations, especially from the biological and legitimacy viewpoints. The massive cost of materials and experienced work has held stopped various people back from working with legitimate and safe advancement procedures. Developing a sensible, safe, and viable design system has become an essential endeavor for primary modelers and experts around the globe. The construction business has consumed a gigantic proportion of typical resources and moreover been responsible for a basic energy use. Earth bricks have the most decreased exemplified energy of any design material and make structures that are unparalleled in energy capability. Later on, where the canny, long stretch energy conservation and comfort material are the objections, Earth brick is the ideal choice for energy capability and strength. The essential objective of this examination is to inspect the effects of using polypropylene fiber, Metakaolin with geopolymer fastener to settle the earth brick. The geopolymer fastener will be a mix of metakaolin and dissolvable plan. Earth Bricks will be offset with 0.25, 0.5, 0.75 and 1 % of polypropylene with geopolymer cover and it will be differentiated and Earth Bricks containing 5% of cement and Metakaolin binder.
Experimental analysis and characterization of Mechanical, Physical properties of Aluminium (Al6061) Metal Matrix composite reinforced with SiC and Al2O3using Stir casting
Authors: Ram Kumar S , Ramakrishnan S , Risvak M , Thauffeek S , Yuvaraj T
Published: May 2021

Metal matrix is defined as two or more material mixing with each other, In these constituents, one is mainly metal and the other is non-metals such as ceramics, glass and rubber etc. There is a wide scope for metal matrix composites nowadays. Among various metal matrix composites, Aluminium MMC yields good results, when compared with other MMC (metal matrix composite These reinforcements have much higher strength and wear resistance than pure aluminium. Multiple reinforcements in an aluminium metal matrix composite have a lot of potential. The use of metal matrix composites with Al6061 as parent material and infusion of reinforcements like Carbides, Oxides and Borides have resulted in materials with improved mechanical strength and usability. This paper contains the investigation of Mechanical Properties of Aluminium 6061 and Aluminium 6061 reinforced with SiC, Al2O3particles. In this, we are focusing Al MMC by undergoing various tests such as impact, hardness and tensile tests. In the present work, aluminium matrix hybrid composite of Al6061+ X wt% of Al2O3+ Y wt% of SiC (X = 2.5,5 % and Y = 5,2.5%) was successfully fabricated by stir casting method. The effect of Al2O3and SiC reinforced in the matrix were investigated through tensile test, impact test, hardness values and SEM analysis (for Morphological characteristics) and the best composition of AMMC matrix was determined.
Investigation on mechanical properties of aluminium alloy A356 by reinforcing with TiB2 & WC composites
Authors: Kaviyarasan K , Thiyagu S , Shabari V , Saileswaran R , Siva Sankaran S , Sivanesan T
Published: May 2021

In this project, Aluminium metal matrix hybrid composites are processed through stir casting methodology. A356 is reinforced with ceramic particle-like Titanium diboride (TiB2) and Tungsten carbide (WC) in varying weight percentages of 92.5% A356 and TiB2 5% WC 2.5% of Sample 1, A356 90% TiB2 5% WC 5% of Sample 2, A356 100% of Sample 3 through stir casting technique. Under the Vickers hardness test, the Sample consisting of 90% A356 + 5% TiB2+ 5% WC exhibited superior results. Under the Tensile test, the Sample of 90% A356 + 5% TiB2 + 5% WC exhibited higher tensile strength when compared with the remaining two Samples. It is because the ceramic reinforcement particulates are harder than the A356 matrix material. Then the fractured Samples were examined under SEM and fracture mechanisms were studied.
Mechanical and electrical properties of borophene and its band structure modulation via strain and electric fields: a first-principles study
Authors: Wang Xiaoyuan , Wu Rongyao , Xu Tao , Gao Yang
Published: May 2021

The basic electronic and mechanical properties of 2-Pmmn borophene and their strain and electric field-dependence are studied by the first-principles calculations. The Young’s moduli are 236 and 89 GPa in the armchair and zigzag directions, respectively, indicating that the borophene has giant mechanical anisotropy. We also find that the borophene presents anisotropic electronic properties. The borophene is electroconductive in armchair direction but has a bandgap in the zigzag direction. To modulate the band structure, we applied strain and electric fields on borophene, and find that, the resistance of borophene decreases with the increase of applied strain, while the applied electric field has almost no effect on its band structure. The enhanced conductivity of borophene upon applied strain is ascribed to the expansion of the buckled structure through the analysis of the charge density of the strained borophene.
Weld zone porosity elimination process of galvanized steel zero-gap lap joints in remote laser spiral welding
Authors: Xiong Wangtao , Zhang Peilei , Yu Zhishui , Yan Hua , Wu Di , Lu Qinghua , Tian Yingtao
Published: May 2021

The remote Laser spiral welding was utilized to zero-gap lap welding of galvanized steel. The relationship between pores in the weld zone and process parameters were investigated. The combination of high keyhole velocity and small spiral spacing was found to be essential for eliminating porosity in the weld area. As the spiral pitch decreases from 0.7 mm to 0.3 mm, the porosity decreases rapidly from approximately 20% to 0%. When the spiral spacing of 0.3 mm, the porosity reaches an acceptable quality level of less than 1%. The porosity tends to decrease as the keyhole velocity increases from 3 m min−1 to 9 m min−1. At the spiral pitch of 0.3 mm and keyhole velocity of 9 m min−1, the porosity in the weld area is almost completely suppressed. The peak shear strength of the spiral weld without porosity was 8819.8 N and the peak shear strength of the spiral weld with porosity was 5104.3 N. The tensile shear performance was increased by 72.8%. The low porosity caused by the spiral laser beam improves the tensile shear strength of the oscillating weld.
Experimental wavelength-multiplexed entanglement-based quantum cryptography
Authors: Pseiner Johannes , Achatz Lukas , Bulla Lukas , Bohmann Martin , Ursin Rupert
Published: May 2021

In state-of-the-art quantum key distribution systems, the main limiting factor in increasing the key generation rate is the timing resolution in detecting photons. Here, we present and experimentally demonstrate a strategy to overcome this limitation, also for high-loss and long-distance implementations. We exploit the intrinsic wavelength correlations of entangled photons using wavelength multiplexing to generate a quantum secure key from polarization entanglement. The presented approach can be integrated into both fiber- and satellite-based quantum-communication schemes, without any changes to most types of entanglement sources. This technique features a huge scaling potential allowing to increase the secure key rate by several orders of magnitude as compared to non-multiplexed schemes.
Automatic reading recognition system of pointer meters using WSNs with on-sensor image processing
Authors: Hou Liqun , Zhang Quanjun , Qu Huaisheng
Published: May 2021

Even though smart instruments are popular in modern industrial processes, pointer meters without computer interfaces are still widely employed in many application areas. Automatic reading recognition of pointer meters based on computer vision provides a promising solution to input the meter readings to the existing monitoring system or IoT. However, most of the current reading recognition approaches for pointer meters are based on inconvenient wired systems or expensive inspection robots. Compared with a wired system, wireless sensor networks (WSNs) are low-cost, easy to install and relocate. To leverage these advantages of WSNs and address the limitation of its radio bandwidth, this paper proposes a novel automated meter reading system for pointer meter using WSNs with on-sensor image processing, in which meter image capturing, image preprocessing, and reading recognition are completed on WSNs end node, and then only the recognition result is transmitted through WSNs. The feasibility of the proposed method is evaluated by a set of experiments on the prototype. Experimental results indicate that the presented approach can recognize the meter reading with an error of 0.3% and significantly reduce the payload transmission data in the WSNs.
Mali: The Hot and Cold Relationship Between Military Intervention and Democratic Consolidation
Authors: Matei Florina Cristiana
Published: May 2021

Many African countries are praetorian states in which the armed forces routinely meddle with politics, and hence defy civilian supremacy over the military. Mali—a noncoastal country in West Africa, with a population of 14.5 million inhabitants—is no exception. Since gaining independence from France in 1960, Mali has been a praetorian state, as the armed forces have frequently intervened in politics. As such, Mali has experienced four successful military coups (in 1968, 1991, 2012, and 2020). These coups have been caused by an array of interconnected and often overlapping factors, including the following: state formation and the relationship between the military and state institutions; legacies of the colonial times; the dynamic political and security context in north Mali; precarious state governance; history of military intervention in politics; and ineffective international aid and assistance. Mali’s on-and-off relationship with the military intervention in politics has had both positive and negative effects to the surrounding society. If the 1968 military intervention in politics was nothing more than a replacement of an authoritarian regime with another—equally deleterious to the country and its citizens—the other three interventions clearly illustrate how coups can both facilitate and jeopardize democratic consolidation. Certainly, the 1991 coup led to democratization while the 2012 and 2020 coups arrested democratic progress. As a result, Mali’s political institutions in the early 21st century are weak, corrupt, fighting one another, and incapable of governing while the security situation is perilous, despite more than seven years of external military and regional military presence.
Effect of Delays in Concordant Antibiotic Treatment on Mortality in Patients With Hospital-Acquired Acinetobacter Species Bacteremia: Emulating a Target Randomized Trial With a 13-Year Retrospective Cohort
Authors: Lim Cherry , Mo Yin , Teparrukkul Prapit , Hongsuwan Maliwan , Day Nicholas P J , Limmathurotsakul Direk , Cooper Ben S
Published: May 2021

Delays in treating bacteremias with antibiotics to which the causative organism is susceptible are expected to adversely affect patient outcomes. Quantifying the impact of such delays to concordant treatment is important for decision-making about interventions to reduce the delays and for quantifying the burden of disease due to antimicrobial resistance. There are, however, potentially important biases to be addressed, including immortal time bias. We aimed to estimate the impact of delays in appropriate antibiotic treatment of patients with Acinetobacter species hospital-acquired bacteremia in Thailand on 30-day mortality by emulating a target trial using retrospective cohort data from Sunpasitthiprasong Hospital in 2003–2015. For each day, we defined treatment as concordant if the isolated organism was susceptible to at least 1 antibiotic given. Among 1,203 patients with Acinetobacter species hospital-acquired bacteremia, 682 had 1 or more days of delays to concordant treatment. Surprisingly, crude 30-day mortality was lower in patients with delays of ≥3 days compared with those who had 1–2 days of delays. Accounting for confounders and immortal time bias resolved this paradox. Emulating a target trial, we found that these delays were associated with an absolute increase in expected 30-day mortality of 6.6% (95% confidence interval: 0.2, 13.0), from 33.8% to 40.4%.
A combined recall and rank framework with online negative sampling for Chinese procedure terminology normalization
Authors: Liang Ming , Xue Kui , Ye Qi , Ruan Tong
Published: May 2021

Motivation

Medical terminology normalization aims to map the clinical mention to terminologies coming from a knowledge base, which plays an important role in analyzing electronic health record and many downstream tasks. In this article, we focus on Chinese procedure terminology normalization. The expressions of terminology are various and one medical mention may be linked to multiple terminologies. Existing studies based on learning to rank does not fully consider the quality of negative samples during model training and the importance of keywords in this domain-specific task.

Results

We propose a combined recall and rank framework to solve these problems. A pair-wise Bert model with deep metric learning is used to recall candidates. Previous methods either train Bert in a point-wise way or based on a multi-class classification problem, which may lead serious efficiency problems or not be effective enough. During model training, we design a novel online negative sampling algorithm to activate the pair-wise method. To deal with multi-implication scenarios, we train the task of implication number prediction together with the recall task in a multi-task learning setting, since these two tasks are highly complementary. In rank step, we propose a keywords attentive mechanism to focus on domain-specific information such as procedure sites and procedure types. Finally, a fusion block merges the results of the recall and the rank model. Detailed experimental analysis shows our proposed framework has a remarkable improvement on both performance and efficiency.

Availability and implementation

The source code will be available at https://github.com/sxthunder/CMTN upon publication.
Snapshots Quiz
Authors: Kumar M , Kumar M , Kumar Jha A , Arora A
Published: May 2021

A 55-year-old male presented with a 6 month history of multiple swellings on the right buttock and sacral region with yellowish discharge. The patient frequently walked bare foot, but denied any history trauma. Fine needle aspirate cytology showed acute dense inflammation, nuclear debris and numerous filamentous bacilli, which on staining revealed gram positive bacilli. What is the diagnosis?
Prolonged Suppression of Butyrate-Producing Bacteria Is Associated With Acute Gastrointestinal Graft-vs-Host Disease and Transplantation-Related Mortality After Allogeneic Stem Cell Transplantation
Authors: Meedt Elisabeth , Hiergeist Andreas , Gessner André , Dettmer Katja , Liebisch Gerhard , Ghimire Sakhila , Poeck Hendrik , Edinger Matthias , Wolff Daniel , Herr Wolfgang , Holler Ernst , Weber Daniela
Published: May 2021

Background

Butyrogenic bacteria play an important role in gut microbiome homeostasis and intestinal epithelial integrity. Previous studies have demonstrated an association between administration of short-chain fatty acids like butyrate and protection from acute graft-vs-host disease (GvHD) after allogeneic stem cell transplantation (ASCT).

Methods

In the current study, we examined the abundance and butyrogenic capacity of butyrate-producing bacteria in 28 healthy donors and 201 patients after ASCT. We prospectively collected serial stool samples and performed polymerase chain reaction analysis of the butyrate-producing bacterial enzyme butyryl–coenzyme A (CoA):acetate CoA-transferase (BCoAT) in fecal nucleic acid extracts.

Results

Our data demonstrate a strong and prolonged suppression of butyrogenic bacteria early in the course of ASCT. In a multivariable analysis, early use of broad-spectrum antibiotics before day 0 (day of transplantation) was identified as an independent factor associated with low BCoAT copy numbers (odds ratio, 0.370 [95% confidence interval, .175–.783]; P = .009). Diminished butyrogens correlated with other biomarkers of microbial diversity, such as low 3-indoxylsulfate levels, reduced abundance of Clostridiales and low inverse Simpson and effective Shannon indices (all P < .001). Low BCoAT copy numbers at GvHD-onset were correlated with GI-GvHD severity (P = .002) and associated with a significantly higher GvHD-associated mortality rate (P = .04). Furthermore, low BCoAT copy numbers at day 30 were associated with a significantly higher transplantation-related mortality rate (P = .02).

Conclusions

Our results are consistent with the hypothesis that alterations in the microbiome play an important role in GvHD pathogenesis and that microbial parameters such as BCoAT might serve as biomarkers to identify patients at high risk of lethal GI-GvHD.
Usefulness of physical function sub-item of SF-36 survey to predict exercise intolerance in patients with heart failure
Authors: Ueno Kensuke , Kamiya Kentaro , Hamazaki Nobuaki , Nozaki Kohei , Ichikawa Takafumi , Yamashita Masashi , Uchida Shota , Kawabata Masashi , Maekawa Emi , Yamaoka-Tojo Minako , Matsunaga Atsuhiko , Ako Junya
Published: May 2021

Background

Exercise intolerance is widely known to be a major cardinal symptom in patients with heart failure (HF), but due to the recent coronavirus disease 2019 epidemic, it is still difficult to directly measure exercise tolerance in many hospitals and facilities. The 36-Item Short-Form Health Survey physical functioning (SF-36PF) pertain to lower extremity functioning and walking. The purpose of this study was to investigate whether SF-36PF is a useful predictor of exercise intolerance and to provide its optimal cut-off value for patients with HF.

Methods and results

SF-36PF and 6-min walking distance (6MWD) were evaluated in 372 consecutive patients with HF. Exercise intolerance was defined at 6MWD cut-offs of 200, 300, and 400 m. The addition of SF-36PF to the pre-existing determinants of exercise tolerance significantly improved the area under the curve scores (0.85 vs. 0.89, P = 0.011 for 6MWD <200 m; 0.90 vs. 0.93, P = 0.001 for 6MWD <300 m; 0.88 vs. 0.90, P = 0.021 for 6MWD <400 m) for the predictive effect on exercise intolerance. The cut-off values of SF-36PF for predicting exercise intolerance defined by 6MWD <200, 300, and 400 m were 45, 50, and 70, respectively.

Conclusions

SF-36PF is a useful tool as an alternative index to predict exercise intolerance in patients with HF.
Stabbing Spines: A review of the Biomechanics and Evolution of Defensive Spines
Authors: Crofts Stephanie B , Stankowich Theodore
Published: May 2021

Synopsis

Spines are ubiquitous in both plants and animals, and while most spines were likely originally used for defense, over time many have been modified in a variety of ways. Here we take an integrative approach to review the form, function, and evolution of spines as a defensive strategy in order to make new connections between physical mechanisms and functional behavior. While this review focuses on spines in mammals, we reference and draw ideas from the literature on spines in other taxa, including plants. We begin by exploring the biomechanics of defensive spines, their varied functions, and nondefensive modifications. We pay particular attention to the mechanics involved in passive puncture and the ways organisms have overcome limitations associated with the low energy input. We then focus on the ecological, physiological, and behavioral factors that promote the evolution of spiny defenses, including predator- and habitat-mediated hypotheses. While there is considerable evidence to support both, studies have generally found that (1) defensive spines are usually effective against one class of attacker (e.g., larger predators) but ineffective against or even facilitate predation by others and (2) species that are more visible or exposed to predators are under much stronger selection to evolve defensive spines or some other robust defense. What type of defensive morphology that evolves, however, is less predictable and probably strongly dependent on both the dominant source of predation and the habitat structure of the organism (e.g., arboreal, terrestrial, and fossorial). We then explore traits that often are correlated with defensive spines and armor, potentially forming armor syndromes, suites of traits that evolve together with body armor in a correlated fashion. In mammals, these include aposematic warning coloration, locomotion style, diet, metabolic rate, and relative brain size. Finally, we encourage integration of mechanistic, behavioral, and evolutionary studies of defensive spines and suggest future avenues of research in the biomechanics, evolution, and behavior of spines and spiny organisms.
Validation of neonatal and paediatric antimicrobial stewardship treatment algorithms in rapid diagnostic-detected bacteraemia
Authors: Kruger Howard Amy , Parbuoni Kristine A , Claeys Kimberly , Biggs Jessica M , Seung Hyunuk , Johnson Kristie , Campbell James , Morgan Jill A
Published: May 2021

Objectives

Blood culture rapid diagnostic testing (RDT) aids in early organism identification and resistance gene detection. This information allows quicker transition to tailored antimicrobial therapy, improved patient outcomes and prevention of antimicrobial resistance. An antimicrobial treatment algorithm based on RDT results and local antibiograms can serve as a valuable clinical decision-support tool. This study assessed the proportion of appropriate antibiotic therapy recommendations using a novel paediatric RDT-guided treatment algorithm compared with standard care (SC) in paediatric bacteraemia.

Methods

This was a retrospective, observational study of admitted paediatric patients who received antibiotics for RDT-confirmed bacteraemia. Appropriateness of SC was compared with algorithm-recommended treatment. Antimicrobial appropriateness was defined as in vitro susceptibility to the organism identified through traditional microbiology. Clinical appropriateness took into consideration the ability to tailor therapy within 12 h of RDT results. Appropriateness was evaluated by two blinded, independent reviewers.

Key findings

Eighty-six blood cultures were included with 15 unique Gram-positive and Gram-negative species or genus identified. Comparative antimicrobial appropriateness of SC and algorithm-recommended treatment was 94.2% (81/86) and 100% (86/86), respectively (P = 0.06). Clinical assessment determined 39.5% (34/86) of SC patients were on appropriate therapy within 12 h of RDT result. Algorithm-recommended therapy was clinically appropriate in 97.7% (84/86) of patients (P < 0.001). There was a median time savings of 42.7 h (IQR 40.6, 49.4) for the patients able to be de-escalated as compared with waiting on final sensitivities.

Conclusions

Algorithm-guided treatment may allow most patients to be de-escalated to organism-tailored therapy earlier in their therapeutic course.
Observer analysis and design for nonlinear bounded Lipschitz systems
Authors: Alexandridis Antonio T , Papageorgiou Panos C
Published: May 2021

The design of dynamic observers for nonlinear Lipschitz systems has considered great attention in past decades. Instead of applying the standard strictly explicit designs or LMI-based heuristic solutions, in this paper, an efficient systematic method is deployed by considering the existence of some arbitrary bounds on the nonlinear Lipschitz terms. The method enables to relax the observer design from the conventional restrictions and it is easily solved analytically without needing the solution of LMIs. As proven in the paper by a detailed and rigorous analysis, its main advantage is that it guarantees global asymptotic stability and ensures the observer response with desired decay characteristics satisfying simultaneously the Lyapunov equation.
Additive Processes on the Unit Circle and Loewner Chains
Authors: Hasebe Takahiro , Hotta Ikkei
Published: May 2021

This paper defines the notion of generators for a class of decreasing radial Loewner chains that are only continuous with respect to time. For this purpose, “Loewner’s integral equation”, which generalizes Loewner’s differential equation, is defined and analyzed. The definition of generators is motivated by the Lévy–Khintchine representation for additive processes on the unit circle. Actually, we can and do introduce a homeomorphism between the above class of Loewner chains and the set of the distributions of increments of additive processes equipped with suitable topologies. On the other hand, from the viewpoint of non-commutative probability theory, the above generators also induce bijections with some other objects: in particular, monotone convolution hemigroups and free convolution hemigroups. Finally, the generators of Loewner chains constructed from free convolution hemigroups via subordination are computed.
Perspectives on Remote Glucose Monitoring in Youth With Type 1 Diabetes
Authors: Fremont Ettya R , Miller Victoria A
Published: May 2021

Objective

Continuous glucose monitoring (CGM) has become increasingly popular among youth with type 1 diabetes (T1D). Used with CGM, remote monitoring (RM) gives caregivers real-time access to patients’ glucose values. Whereas RM may safeguard against hypo- and hyperglycemic events, little is known about how older children and adolescents, who are striving for independence, and their parents view the RM aspect of CGM. The goal of this study was to describe and explore parent and youth perceptions of RM.

Methods

Youth with T1D and their parents participated separately in semi-structured interviews 2 months after starting CGM. Questions focused on decisions to use and experiences with RM.

Results

Analysis of 43 parents and 41 youth (13.79 years ± 2.82) interviews revealed four themes, with 10 subthemes. Seven subthemes emerged in parent and youth interviews, and three emerged exclusively in parent interviews. The overarching themes included the impact of RM on (1) peace-of-mind, (2) parental anxiety, (3) communication; and addressed (4) technological limitations that prevented some from using RM. Regardless of youth age, youth and parents found comfort in parental knowledge of glucose values and parental abilities to assist youth (e.g., giving reminders to eat). Whereas RM could lead to conflicts due to excessive communication (e.g., texting), conflicts could be resolved through iterative parent-youth conversations.

Conclusion

RM may facilitate youth independence by providing a way for them to stay connected to their support system while acquiring developmentally appropriate skills. However, families should have iterative discussions about boundaries to mitigate parental over-involvement.
Disparities in Incidence and Severity of Shigella Infections Among Children—Foodborne Diseases Active Surveillance Network (FoodNet), 2009-2018
Authors: Gharpure Radhika , Marsh Zachary A , Tack Danielle M , Collier Sarah A , Strysko Jonathan , Ray Logan , Payne Daniel C , Garcia-Williams Amanda G
Published: May 2021

Background

Shigella infections are an important cause of diarrhea in young children and can result in severe complications. Disparities in Shigella infections are well documented among US adults. Our objective was to characterize disparities in incidence and severity of Shigella infections among US children.

Methods

We analyzed laboratory-diagnosed Shigella infections reported to FoodNet, an active, population-based surveillance system in 10 US sites, among children during 2009-2018. We calculated the incidence rate stratified by sex, age, race/ethnicity, Shigella species, and disease severity. Criteria for severe classification were hospitalization, bacteremia, or death. The odds of severe infection were calculated using logistic regression.

Results

During 2009-2018, 10 537 Shigella infections were reported in children and 1472 (14.0%) were severe. The incidence rate was 9.5 infections per 100 000 child-years and the incidence rate of severe infections was 1.3 per 100 000 child-years. Incidence was highest among children aged 1-4 years (19.5) and lowest among children aged 13-17 years (2.3); however, children aged 13-17 years had the greatest proportion of severe infections (21.2%). Incidence was highest among Black (16.2 total; 2.3 severe), Hispanic (13.1 total; 2.3 severe), and American Indian/Alaska Native (15.2 total; 2.5 severe) children. Infections caused by non-sonnei species had higher odds of severity than infections caused by Shigella sonnei (adjusted odds ratio 2.58; 95% confidence interval 2.12-3.14).

Conclusions

The incidence and severity of Shigella infections among US children vary by age, race/ethnicity, and Shigella species, warranting investigation of unique risk factors among pediatric subpopulations.
Tremarctos ornatus(Carnivora: Ursidae)
Authors: Vela-Vargas I Mauricio , Jorgenson Jeffrey P , González-Maya José F , Koprowski John L
Published: May 2021

Tremarctos ornatus (F.G. Cuvier, 1825) is a tremarctine bear commonly known as the Andean bear. It is a medium-sized bear with black to dark red-brown pelage with dense, long, coarse fur; creamy white marks occur on the chin, neck, and chest, and often white to creamy marks occur on the face, around the muzzle, and eyes. It is distributed in the tropical Andes of Venezuela, Colombia, Ecuador, Perú, Bolivia, and northern Argentina in South America. T. ornatus is catalogued as “Vulnerable” (VU) by the International Union for Conservation of Nature and Natural Resources and is included in CITES Appendix I. Main threats include habitat loss and fragmentation, illegal killing, human–bear conflicts, and most likely climate change.
An international multicenter matched cohort analysis of incidental meningioma progression during active surveillance or after stereotactic radiosurgery: the IMPASSE study
Authors: Sheehan Jason , Pikis Stylianos , Islim Abdurrahman I , Chen Ching-Jen , Bunevicius Adomas , Peker Selcuk , Samanci Yavuz , Nabeel Ahmed M , Reda Wael A , Tawadros Sameh R , El-Shehaby Amr M N , Abdelkarim Khaled , Emad Reem M , Delabar Violaine , Mathieu David , Lee Cheng-Chia , Yang Huai-Che , Liscak Roman , Hanuska Jaromir , Alvarez Roberto Martinez , Patel Dev , Kondziolka Douglas , Moreno Nuria Martinez , Tripathi Manjul , Speckter Herwin , Albert Camilo , Bowden Greg N , Benveniste Ronald J , Lunsford Lawrence Dade , Jenkinson Michael D
Published: May 2021

Background

The optimal management of patients with incidental meningiomas remains unclear. The aim of this study was to characterize the radiologic and neurological outcomes of expectant and stereotactic radiosurgery (SRS) management of asymptomatic meningioma patients.

Methods

Using data from 14 centers across 10 countries, the study compares SRS outcomes to active surveillance of asymptomatic meningiomas. Local tumor control of asymptomatic meningiomas and development of new neurological deficits attributable to the tumor were evaluated in the SRS and conservatively managed groups.

Results

In the unmatched cohorts, 727 meningioma patients underwent SRS and were followed for a mean of 57.2 months. In the conservatively managed cohort, 388 patients were followed for a mean of 43.5 months. Tumor control was 99.0% of SRS and 64.2% of conservatively managed patients (P < .001; OR 56.860 [95% CI 26.253-123.150]). New neurological deficits were 2.5% in the SRS and 2.8% of conservatively managed patients (P = .764; OR 0.890 [95% CI 0.416-1.904]). After 1:1 propensity matching for patient age, tumor volume, location, and imaging follow-up, tumor control in the SRS and conservatively managed cohorts was 99.4% and 62.1%, respectively (P < .001; OR 94.461 [95% CI 23.082-386.568]). In matched cohorts, new neurological deficits were noted in 2.3% of SRS-treated and 3.2% of conservatively managed patients (P = .475; OR 0.700 [95% CI 0.263-1.863]).

Conclusions

SRS affords superior radiologic tumor control compared to active surveillance without increasing the risk of neurological deficits in asymptomatic meningioma patients. While SRS and active surveillance are reasonable options, SRS appears to alter the natural history of asymptomatic meningiomas including tumor progression in the majority of patients treated.
Certified B Corporations and Benefit Corporations
Authors: Gehman Joel , Thapa Urusha , Cao Ke
Published: May 2021

Since the mid-2010s, Certified B Corporations and Benefit Corporations, both commonly referred to as B Corps, have emerged as a global phenomenon. These organizational forms are adopted by for-profit businesses. Whereas Certified B Corporations have been accredited for their environmental, social, and governance (ESG) practices, Benefit Corporations are a new legal form, currently available in forty states, the District of Columbia, and Puerto Rico in the United States as well as in British Columbia (Canada), Colombia, Ecuador, France, Italy, and Peru. These innovations were promulgated by B Lab, a US-based nonprofit organization. Founded in 2006 in the suburbs of Philadelphia, Pennsylvania, B Lab has sought to institutionalize business as a force for good. To date, certification is available to any business worldwide, and approximately eight thousand companies in ninety-three countries were certified as of January 2024. Prominent Certified B Corporations include Ben & Jerry’s, Coursera, Danone North America, Patagonia, and TOMS. Examples of Benefit Corporations include Allbirds, data.world, Kickstarter, and Plum Organics. Overall, the B Corp movement’s radical aspiration to redefine business has garnered substantial attention from policymakers, media, businesses, nongovernmental organizations (NGOs), and academics. This article provides an overview of burgeoning scholarly work—ranging from general references and cutting-edge theoretical work to empirical research evidence and key pedagogical resources. A core focus is on enumerating the variety of theoretical perspectives and central research themes in extant work, including interdisciplinary publications. We close by discussing exemplary teaching materials and introducing other resources, such as the B Academics research community, a chronology of key thematic research events, and data sets available to researchers. Overall, the bibliography, first published in 2021, serves as a living repository of B Corp scholarship, past and emerging, for a broad range of veteran and nascent B Corp academics across multiple disciplines.
The phosphorylated pathway of serine biosynthesis links plant growth with nitrogen metabolism
Authors: Zimmermann Sandra E , Benstein Ruben M , Flores-Tornero María , Blau Samira , Anoman Armand D , Rosa-Téllez Sara , Gerlich Silke C , Salem Mohamed A , Alseekh Saleh , Kopriva Stanislav , Wewer Vera , Flügge Ulf-Ingo , Jacoby Richard P , Fernie Alisdair R , Giavalisco Patrick , Ros Roc , Krueger Stephan
Published: May 2021

Because it is the precursor for various essential cellular components, the amino acid serine is indispensable for every living organism. In plants, serine is synthesized by two major pathways: photorespiration and the phosphorylated pathway of serine biosynthesis (PPSB). However, the importance of these pathways in providing serine for plant development is not fully understood. In this study, we examine the relative contributions of photorespiration and PPSB to providing serine for growth and metabolism in the C3 model plant Arabidopsis thaliana. Our analyses of cell proliferation and elongation reveal that PPSB-derived serine is indispensable for plant growth and its loss cannot be compensated by photorespiratory serine biosynthesis. Using isotope labeling, we show that PPSB-deficiency impairs the synthesis of proteins and purine nucleotides in plants. Furthermore, deficiency in PPSB-mediated serine biosynthesis leads to a strong accumulation of metabolites related to nitrogen metabolism. This result corroborates 15N-isotope labeling in which we observed an increased enrichment in labeled amino acids in PPSB-deficient plants. Expression studies indicate that elevated ammonium uptake and higher glutamine synthetase/glutamine oxoglutarate aminotransferase (GS/GOGAT) activity causes this phenotype. Metabolic analyses further show that elevated nitrogen assimilation and reduced amino acid turnover into proteins and nucleotides are the most likely driving forces for changes in respiratory metabolism and amino acid catabolism in PPSB-deficient plants. Accordingly, we conclude that even though photorespiration generates high amounts of serine in plants, PPSB-derived serine is more important for plant growth and its deficiency triggers the induction of nitrogen assimilation, most likely as an amino acid starvation response.
The State of American Federalism, 2020–2021: Deepening Partisanship amid Tumultuous Times
Authors: Konisky David M , Nolette Paul
Published: May 2021

In this introductory article for the 2020–2021 Annual Review of American Federalism, we review notable developments in U.S. politics and policy during the last year, with an emphasis on their intersections with and consequences for federalism. We focus in particular on the 2020 elections and the COVID pandemic, along with policy developments in the areas of criminal justice and police reform, health care, environment, immigration, and equality and religious liberty. The events of the past year, especially those related to the pandemic and the fallout of the presidential election, led to a resurgence of public interest in federalism and a focus on the importance of government decision-making of state and local governments. Events during the last year have not only reinforced partisan polarization but have also deepened the existing divide of Americans along partisan lines and perhaps in new ways. Partisan differences have increasingly become cultural differences, so that political and policy differences have saturated American culture in notable ways.
Opioid use disorder and COVID-19
Authors: Mitchell Michaela , Shee Kameron , Champlin Kelly , Essary Alison C. , Evans Matthew
Published: May 2021

Preliminary data suggest that opioid-related overdose deaths have increased subsequent to COVID-19. Despite national support for expanding the role of physician assistants (PAs) and NPs in serving patients with opioid use disorder, these clinicians are held to complex and stringent regulatory barriers. COVID-19 triggered significant changes from regulatory and federal agencies, yet disparate policies and regulations persist between physicians and PAs and NPs. The dual epidemics of COVID-19 and opioid use disorder highlight the inadequate infrastructure required to support patients, communities, and clinicians, and may serve as the catalyst for eliminating barriers to care.
Juvenile Batten disease
Authors: Niederer Kathryn
Published: May 2021

This article describes the 6-year journey to diagnosis of twin girls with varying presentations of the same rare disease. Batten disease is a neurodegenerative disease caused by an autosomal recessive genetic mutation. In patients with juvenile Batten disease, the most common initial symptom is vision loss, and initial testing early in the disease process typically fails to find any indication of this fatal disease.
Increased Glucocorticoid Receptor Alpha Expression and Signaling in Critically Ill Coronavirus Disease 2019 Patients*
Authors: Vassiliou Alice G. , Athanasiou Nikolaos , Keskinidou Chrysi , Jahaj Edison , Tsipilis Stamatios , Zacharis Alexandros , Botoula Efthimia , Diamantopoulos Aristidis , Ilias Ioannis , Vassiliadi Dimitra A. , Tsagarakis Stylianos , Kotanidou Anastasia , Dimopoulou Ioanna
Published: May 2021

OBJECTIVES:

Critical illness is characterized by increased serum cortisol concentrations and bioavailability resulting from the activation of the hypothalamic-pituitary-adrenal axis, which constitutes an essential part of the stress response. The actions of glucocorticoids are mediated by a ubiquitous intracellular receptor protein, the glucocorticoid receptor. So far, data on coronavirus disease 2019 and glucocorticoid receptor alpha expression are lacking.

DESIGN:

Prospective observational study.

SETTING:

One academic multidisciplinary ICU.

SUBJECTS:

Twenty-six adult coronavirus disease 2019 patients; 33 adult noncoronavirus disease 2019 patients, matched for age, sex, and disease severity, constituted the control group. All patients were steroid-free.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Glucocorticoid receptor alpha, glucocorticoid-inducible leucine zipper expression, and serum cortisol were measured on ICU admission. In coronavirus disease 2019 patients, glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper messenger RNA expression were upregulated (4.7-fold, p < 0.01 and 14-fold, p < 0.0001, respectively), and cortisol was higher (20.3 vs 14.3 μg/dL, p < 0.01) compared with the control group.

CONCLUSIONS:

ICU coronavirus disease 2019 patients showed upregulated glucocorticoid receptor alpha and glucocorticoid-inducible leucine zipper expression, along with cortisol levels, compared with ICU noncoronavirus disease 2019 patients. Thus, on ICU admission, critical coronavirus disease 2019 appears to be associated with hypercortisolemia, and increased synthesis of glucocorticoid receptor alpha and induced proteins.
Adherence to Child Attention-Deficit/Hyperactivity Disorder Treatment Guidelines in Medical Homes—Results from a National Survey
Authors: AlRasheed Rashed M. , Martin-Herz Susanne P. , Glidden David V. , Okumura Megumi J.
Published: May 2021

Objective:

Having primary care delivered through a medical home is believed to improve mental health care delivery to children. Children with attention-deficit/hyperactivity disorder (ADHD) are commonly treated in pediatric practices, yet little is known about ADHD treatment patterns in medical homes. Our objective was to assess for treatment variation depending on parent-perceived medical home (PPMH) status. We hypothesized that having a PPMH would be associated with receiving ADHD treatments recommended by clinical guidelines.

Methods:

We used the 2016 National Survey of Children's Health—a nationally representative cross-sectional survey of children in the United States. Analyses included an unweighted sample of 4,252, representing 5.4 million children aged 3 to 17 years with parent-reported ADHD. Child characteristics were analyzed using descriptive statistics. Associations between ADHD treatment types and PPMH status were assessed using a multinomial logistic regression, adjusting for child characteristics.

Results:

Having a PPMH was associated with increased prevalence odds of children's receipt of medications alone for ADHD (vs no treatment). The prevalence odds of receiving behavioral treatment alone (vs medications alone) for ADHD decreased by 43% when children had a PPMH (95% confidence interval, 0.38–0.85, p = 0.01). PPMH status was not associated with a statistically significant difference in prevalence odds of receiving combination treatment (vs medications alone) for pediatric ADHD.

Conclusion:

Having a PPMH was associated with children's receipt of ADHD medications alone, but not behavioral treatments. Our findings suggest that medical homes may need further improvement to ensure that children with ADHD receive treatments as recommended by clinical guidelines.