bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging technologies in brachytherapy
Authors: Song William Y , Robar James L , Morén Björn , Larsson Torbjörn , Carlsson Tedgren Åsa , Jia Xun
Published: October 2021

Brachytherapy is a mature treatment modality. The literature is abundant in terms of review articles and comprehensive books on the latest established as well as evolving clinical practices. The intent of this article is to part ways and look beyond the current state-of-the-art and review emerging technologies that are noteworthy and perhaps may drive the future innovations in the field. There are plenty of candidate topics that deserve a deeper look, of course, but with practical limits in this communicative platform, we explore four topics that perhaps is worthwhile to review in detail at this time. First, intensity modulated brachytherapy (IMBT) is reviewed. The IMBT takes advantage ofanisotropicradiation profile generated through intelligent high-density shielding designs incorporated onto sources and applicators such to achieve high quality plans. Second, emerging applications of 3D printing (i.e. additive manufacturing) in brachytherapy are reviewed. With the advent of 3D printing, interest in this technology in brachytherapy has been immense and translation swift due to their potential to tailor applicators and treatments customizable to each individual patient. This is followed by, in third, innovations in treatment planning concerning catheter placement and dwell times where new modelling approaches, solution algorithms, and technological advances are reviewed. And, fourth and lastly, applications of a new machine learning technique, called deep learning, which has the potential to improve and automate all aspects of brachytherapy workflow, are reviewed. We do not expect that all ideas and innovations reviewed in this article will ultimately reach clinic but, nonetheless, this review provides a decent glimpse of what is to come. It would be exciting to monitor as IMBT, 3D printing, novel optimization algorithms, and deep learning technologies evolve over time and translate into pilot testing and sensibly phased clinical trials, and ultimately make a difference for cancer patients. Today’s fancy is tomorrow’s reality. The future is bright for brachytherapy.
Comparison between the results of a recently-developed biological weighting function (V79-RBE10 BWF) and the in vitro clonogenic survival RBE10 of other repair-competent asynchronized normoxic mammalian cell lines and ions not used for the development of the model
Authors: Parisi Alessio , Struelens Lara , Vanhavere Filip
Published: October 2021

728 simulated microdosimetric lineal energy spectra (26 different ions between 1H and 238U, 28 energy points from 1 to 1000 MeV/n) were used in combination with a recently-developed biological weighting function (Parisi et al 2020 Phys. Med. Biol. 1361–6560) and 571 published in vitro clonogenic survival curves in order to: (1) assess prediction intervals for the in silico results by deriving an empirical indication of the experimental uncertainty from the dispersion in the in vitro hamster lung fibroblast (V79) data used for the development of the biophysical model; (2) explore the possibility of modeling the relative biological effectiveness (RBE) of the 10% clonogenic survival of asynchronized normoxic repair-competent mammalian cell lines other than the one used for the development of the model (V79); (3) investigate the predictive power of the model through a comparison between in silico results and in vitro data for 10 ions not used for the development of the model. At first, different strategies for the assessment of the in silico prediction intervals were compared. The possible sources of uncertainty responsible for the dispersion in the in vitro data were also shortly reviewed. Secondly, also because of the relevant scatter in the in vitro data, no statistically-relevant differences were found between the RBE10 of the investigated different asynchronized normoxic repair-competent mammalian cell lines. The only exception (Chinese Hamster peritoneal fibroblasts, B14FAF28), is likely due to the limited dataset (all in vitro ion data were extracted from a single publication), systematic differences in the linear energy transfer calculations for the employed very-heavy ions, and the use of reference photon survival curves extracted from a different publication. Finally, the in silico predictions for the 10 ions not used for the model development were in good agreement with the corresponding in vitro data.
Uncovering low frequency band gaps in electrically resonant metamaterials through tuned dissipation and negative impedance conversion
Authors: Callanan J , Willey C L , Chen V W , Liu J , Nouh M , Juhl A T
Published: October 2021

A new class of electromechanically coupled metamaterial is presented which relies on magnetic field interactions between the host structure and a local resonator circuit to realize novel vibration control capabilities. The metamaterial chain exhibits a highly tunable vibration band gap which can be easily placed at a desired frequency using the resonant circuit parameters, providing a robust mechanism to independently alter the band gap width, depth, and frequency of maximum attenuation. In its dissipative form, the electromechanical metamaterial is shown to exhibit electrical metadamping as a function of the local resonance circuit resistance. The impact of the damping ratio as a function of the electrical resistance is characterized in frequency and time domains, and related to the infinite system dynamics. A robust experimental realization of the system is constructed which achieves electromechanical coupling through a moving coil and magnet system. The apparatus is used to show that the band gap location and depth can be readily tuned with the circuit elements. The presented metamaterial has potential for meaningful vibroacoustic practical applications in addition to revealing fundamentally new properties of damped electrically-resonant structures.
In situ embedded PZT sensor for monitoring 3D concrete printing: application in alkali-activated fly ash-slag geopolymers
Authors: Kocherla Amarteja , Kamakshi Tippabhotla A , Subramaniam Kolluru V L
Published: October 2021

An embedded PZT sensor is developed for in situ monitoring of 3D-printed materials formed by extrusion-based layer deposition. The PZT sensor with a two-layer protection coating is embedded in the material during the layer deposition, and continuous measurements are obtained through the post-printing period. The PZT sensor is used to detect the physio-chemical changes in the alkali-activated fly ash-slag geopolymer with time. The effect of the added weight of each layer of print is sensitively reflected in the electrical impedance (EI) measurement obtained from the PZT sensor. The changes in EI measurements obtained from the embedded PZT sensor are compared with the measurements on the material related to the changes in the rheological behavior, reaction kinetics assessed using calorimetry, and setting behavior in the material. The build-up of the internal structure within the material, which allows buildability, is assessed from the conductance signature of the embedded PZT sensor. The changes produced by the chemical reactions within the binder, which bring about irreversible changes leading to the setting of the printed structure, are also sensitively detected in the EI measurements from the embedded PZT sensor. The amplitude of conductance is sensitive to the setting of the material. The frequency changes from the recorded EI signature reflect the continuous increase in the material stiffness with time.
Sensitivity analysis and machine learning modelling for the output characteristics of rotary HTS flux pumps
Authors: Wen Zezhao , Zhang Hongye , Mueller Markus
Published: October 2021

High temperature superconducting (HTS) rotatory flux pump, or so called HTS dynamo, can output none-zero time-averaged DC voltage and charge the rest of the circuit if a closed loop has been formed. This type of flux pump is often employed together with HTS coils, where the HTS coils can potentially work in persistent current mode, and act like electromagnets with considerable magnetic field, having wide range of applications in industry. The output characteristics of HTS rotary flux pumps have been extensively explored through experiments and finite element method (FEM) simulations, yet the work on constructing statistical models as an alternative approach to capture key characteristics has not been studied and published. A 2D FEM program has been used to model the HTS rotatory flux pumps and evaluate the effects of different factors upon the output voltage through parameter sweeping and analysis of variance. Typical design considerations, including operation frequency, air gap, HTS tape width and remanent flux density have been investigated, in particular the bilateral effect of HTS tape width has been explained by looking at the averaged integration of the electric field over the tape. Based on the data obtained from various simulations, regression analysis has been conducted through a collection of machine learning methods and demonstrated that the output voltage of a rotary flux pump can be obtained promptly with satisfactory accuracy via Gaussian process regression, aiming to provide a novel approach for future research and powerful design tool for industrial applications using HTS rotary flux pump devices.
Near-optimal composition of CZTS thin film via exploration of copper and thiourea molar concentration in spray pyrolysis technique
Authors: Jeganath K , Y Raviprakash
Published: October 2021

Attaining the optimal composition of Cu2ZnSnS4 (CZTS) thin film is a pre-requisite for photovoltaic application. Herein, the near-optimal composition of spray pyrolyzed CZTS thin film has been obtained by varying copper and thiourea molar concentrations in the precursor solution. Different characterization techniques such as x-ray diffraction (XRD), UV–vis spectroscopy, Scanning electron microscopy (SEM) and Energy-dispersive x-ray spectroscopy (EDS) have been employed to determine the changes in absorber layer properties. The CZTS thin films synthesized using Cu-0.016 M exhibits higher crystallinity with the direct band gap of 1.52 eV. Apart from that, the reduction of copper molar concentration in precursor solution minimizes the segregation of surface secondary phase. The variation of thiourea molar concentration facilities the growth of CZTS and reduces the formation of secondary phases. Besides that, the optical studies revealed that the increment in thiourea molar concentration leads to a broadening of band gap from 1.52 eV to 1.61 eV. The CZTS thin films synthesized using copper and thiourea molar concentrations of 0.016 M and 0.12 M showed appropriate absorber layer properties with near-optimal Cu-poor and Zn-rich ratio i.e., Cu/(Zn+Sn) = 0.81 and Zn/Sn = 1.26.
Framing Migration
Authors: Freidenberg Judith
Published: October 2021

The physical movement of a human being from his or her place of birth to another locality, a process that occurs over time as well as space, is usually known as migration. Together with fertility and mortality, migration helps track population changes. Migration also helps capture the political mood of a country, as migrants are perceived as either as threats or welcome additions.

Anthropologists tend to think about migration from the perspective of two paradigms: immigration and mobility. For the immigration paradigm, human movement is an exceptional occurrence; for the mobility paradigm, human movement is innate to the human condition and therefore constant. Neither paradigm considers the migration experience as an interactive process that engages movers and nonmovers alike, which is the focus of a proposed third paradigm.

The domains of research, practice, and policy reflect these framing paradigms, alone or in combination. By working on the interstices between these domains, anthropology could contribute to a transdisciplinary field of migration studies.
Neoliberalism
Authors: Toft Jessica
Published: October 2021

Neoliberalism is an international, transdisciplinary, and interdisciplinary concept with political, economic, and social dimensions. Neoliberalism is a governing rationality based on market logic that protects free markets by reducing business regulations, restricting citizen and resident welfare state protections, and increasing welfare state discipline. This entails three dimensions: First, neoliberalism consists of economic governing principles to benefit free markets both globally and domestically to the advantage of corporations and economic elites. Second, this includes concurrent state governing principles to limit welfare state protections and impose disciplinary governance so service users will be individually responsible and take up precarious work. A third component is neoliberal governmentality—the ways neoliberalism shapes society’s members through the state to govern themselves as compliant market actors. Neoliberalism is at its core a political reasoning, organizing society around principles of market rationality, from governance structure to social institutions to individual behavior in which individuals should behave as responsible and accountable market actors. Among its central tenets are that individuals should behave as independent responsible market actors; the social welfare state should be downsized and delegated to lower levels of government; and public welfare should be privatized, marketized, and commodified. While neoliberal policy design sets public provision parameters, its signature tool is to govern through state public administration. New public managerialism is a common example, as is managerialism more generally; they both borrow business management principles and apply them to the management of all aspects of social services. Because of its prescriptive nature, there is concern that neoliberalism dictates practice, threatening professional authority of social workers and challenging the implicit trust the public puts in professions. Writ large, there are concerns about democracy itself as neoliberalism works against the will of the people and collective responses to social problems. Resistance to neoliberalism is growing and early examples are provided.
Predictive Analytics and Big Data
Authors: Cariceo Oscar E. , Nair Murali , Bokhari Wahaj
Published: October 2021

Predictive analytics is a set of techniques and an advanced methodological and research approach that seeks to reach conclusions about the future, rather than explanations of specific issues or phenomena. The fast growth in popularity and application of data science to different businesses and activities, such as human services and nonprofit management, are related to the emergence and consolidation of big data. In terms of digital networking, the availability of data produced by individuals every day is enormous. Tools and techniques such as machine learning, deep learning, visualization, time series analysis, networking analysis, natural language processing, and text mining may help support evidence-based practice for social workers. Predictive analytics and big data offer an opportunity to enhance innovative social change and people’s well-being.
Apt, Nana
Authors: Sottie Cynthia Akorfa
Published: October 2021

Nana Araba Apt (1942–2017) was a renowned gerontologist, researcher, author, advocate, and a pioneer in social work education in Ghana. She was a professor of Sociology and Social Work and the founder and Director of the Center for Social Policy Studies at the University of Ghana. She was the founder of Help Age Ghana, the first aging advocacy organization of its kind in Ghana, and a founding member and president of the African Gerontological Society. Her lifelong passions began with her concerns for street children. She founded the College for Ama, a charitable foundation that runs yearly summer camps for rural girls to challenge them to understand the value of education and delay marriage. Her life and work impacted social work education and the welfare of the underprivileged in developing countries.
Phylogeography of Iris loczyi (Iridaceae) in Qinghai–Tibet Plateau revealed by chloroplast DNA and microsatellite markers
Authors: Zhang Guoli , Han Yan , Wang Huan , Wang Ziyang , Xiao Hongxing , Sun Mingzhou
Published: October 2021

Quaternary climate oscillations and complex topography have tremendous effects on current distribution and genetic structure of species, and hence the Qinghai–Tibet Plateau (QTP), the largest plateau in the world, has become a hotspot for many phylogeographic studies. However, little is known about the phylogeographic pattern of herbaceous plants in QTP. Here, we investigate the genetic diversity, population structure and historical dynamics of Iris loczyi, using five chloroplast DNA (cpDNA) fragments and seven microsatellite markers. A total of 15 populations, and 149 individuals were sampled throughout the QTP. High genetic diversity was detected both in cpDNA (Hd = 0.820) and SSR (Ho = 0.689, He = 0.699). Ten cpDNA haplotypes and 163 alleles were identified. AMOVA and clustering analyses revealed obvious differentiation between regions. The Nst, Gst and Mantel test showed significant phylogeographic structure of I. loczyi. The neutrality test and mismatch distribution analyses indicated that I. loczyi could not have undergone a historical population expansion, but population XS from the Qilian Mountain area could have experienced a local expansion. Bottleneck analyses indicated that I. loczyi had not experienced bottleneck recently. Based on cpDNA and SSR results, the Qilian Mountain area was inferred as a potential glacial refuge, and the southern Tibet valley was considered as a ‘microrefugia’ for I. loczyi. These findings provided new insights into the location of glacial refuges for the species distributed in QTP, and supplemented more plant species data for the response of QTP species to the Quaternary climate.
Social Workers as Local Politicians in Israel
Authors: Binder Noa , Weiss-Gal Idit
Published: October 2021

Knowledge about social workers (SWs) who run for political office is rare. This study sought to examine the conditions and factors that led SWs in Israel to enter the formal world of politics and to run for elected office at the local level. Twenty SWs who ran for, or held, local political offices were interviewed employing semi-structured interviews. The analysis was based on content analysis and yielded that most ran for councillor positions while three ran for mayor. Eleven SWs were elected at least once. They all possessed personal resources, such as political, communication and leadership competencies. They also displayed psychological involvement in politics, which developed through early political socialisation, social work education and experience in community activities. This was coupled with a sense that political office is an important vehicle to create change in the community to which they felt obligated and committed. Their desire to affect change became a realistic option following direct recruitment by political or community figures who knew them from their prior community activities. Support from their families and social networks enabled them to overcome dilemmas concerning their capacity to run for office.
Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines in Allogeneic Hematopoietic Stem Cell Transplant Recipients: Immunogenicity and Reactogenicity
Authors: Sherman Amy C , Desjardins Michaël , Cheng Chi An , Bausk Bruce , Izaguirre Natalie , Zhou Guohai , Krauss Jonathan , Tolan Nicole , Walt David R , Soiffer Robert , Ho Vincent T , Issa Nicolas C , Baden Lindsey R
Published: October 2021

The severe acute respiratory syndrome coronavirus 2 messenger RNA vaccine–induced humoral response and reactogenicity profile are described in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Findings showed that 75.0% (by Simoa assay) or 80.0% (by Roche assay) of the HSCT cohort had a positive antibody response on series completion, compared with 100% in the healthy cohort.
The Removal of Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Other Microbial Bioaerosols by Air Filtration on Coronavirus Disease 2019 (COVID-19) Surge Units
Authors: Conway Morris Andrew , Sharrocks Katherine , Bousfield Rachel , Kermack Leanne , Maes Mailis , Higginson Ellen , Forrest Sally , Pereira-Dias Joana , Cormie Claire , Old Tim , Brooks Sophie , Hamed Islam , Koenig Alicia , Turner Andrew , White Paul , Floto R Andres , Dougan Gordon , Gkrania-Klotsas Effrossyni , Gouliouris Theodore , Baker Stephen , Navapurkar Vilas
Published: October 2021

Airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in a coronavirus disease 19 (COVID-19) ward before activation of HEPA-air filtration but not during filter operation; SARS-CoV-2 was again detected following filter deactivation. Airborne SARS-CoV-2 was infrequently detected in a COVID-19 intensive care unit. Bioaerosol was also effectively filtered.
Loss of myeloid Bmal1 exacerbates hypertensive vascular remodelling through interaction with STAT6 in mice
Authors: Huo Mingyu , Cao Xiaoyun , Zhang Hongsong , Lau Chi Wai , Hong Huiling , Chen Francis M , Huang Yu , Chawla Ajay , Tian Xiao Yu
Published: October 2021

Aims

In addition to its involvement of inflammatory responses, limited information is available on the phenotype and behaviour of vascular macrophages during hypertensive vascular remodelling. Here, we aim at studying the contribution of BMAL1 to the pro-fibrotic macrophage phenotype in the vasculature during hypertension, which leads to enhanced vascular remodelling and promoted blood pressure increase.

Methods and results

Wild type Bmal1f/f and myeloid cell selective Bmal1 knockout Bmal1f/f; LysMCre/+ mice were infused with AngII for 4 weeks to induce hypertension. AngII-induced blood pressure increase, vascular media thickness and vascular dysfunction were enhanced in Bmal1f/f; LysMCre/+ mice, accompanied with a pro-fibrotic M2 phenotype of the vascular macrophages. Bmal1f/f; LysMCre/+ mice also have more up-regulations of MMP9 and MMP13 expression in the vascular wall, accompanied by enhanced collagen deposition after AngII infusion. Loss of Bmal1 in bone marrow-derived macrophages enhanced STAT6 activation induced by IL4, and the subsequent MMP13 up-regulation and activity. In macrophages, loss of Bmal1 enhanced the phosphorylation and nuclear translocation of STAT6 triggered by IL4, through possibly a direct interaction between BMAL1 and STAT6. To further determine whether IL4-induced signalling in macrophage contributes to enhanced vascular remodelling in hypertensive mice, we showed that deletion of myeloid IL4Rα in Il4raf/f; LysMCre/+ mice attenuated blood pressure increase and hypertensive vascular remodelling after AngII infusion.

Conclusions

Our results suggested a tonic effect of BMAL1 deletion on hypertensive vascular remodelling. BMAL1 might inhibit IL4-STAT6 signalling in macrophages through the interaction with STAT6 to reduce STAT6 activation and target gene transcription, especially MMP9 and MMP13, contributing to vascular remodelling.
Intron distribution and emerging role of alternative splicing in fungi
Authors: Muzafar Suraya , Sharma Ravi Datta , Chauhan Neeraj , Prasad Rajendra
Published: October 2021

Spliceosomal introns are noncoding sequences that are spliced from pre-mRNA. They are ubiquitous in eukaryotic genomes, although the average number of introns per gene varies considerably between different eukaryotic species. Fungi are diverse in terms of intron numbers ranging from 4% to 99% genes with introns. Alternative splicing is one of the most common modes of posttranscriptional regulation in eukaryotes, giving rise to multiple transcripts from a single pre-mRNA and is widespread in metazoans and drives extensive proteome diversity. Earlier, alternative splicing was considered to be rare in fungi, but recently, increasing numbers of studies have revealed that alternative splicing is also widespread in fungi and has been implicated in the regulation of fungal growth and development, protein localization and the improvement of survivability, likely underlying their unique capacity to adapt to changing environmental conditions. However, the role of alternative splicing in pathogenicity and development of drug resistance is only recently gaining attention. In this review, we describe the intronic landscape in fungi. We also present in detail the newly discovered functions of alternative splicing in various cellular processes and outline areas particularly in pathogenesis and clinical drug resistance for future studies that could lead to the development of much needed new therapeutics.
3-D seismic velocity structure of the Kumaun–Garhwal (Central) Himalaya: insight into the Main Himalayan Thrust and earthquake occurrence
Authors: Gupta Sandeep , Mahesh P , Kanna Nagaraju , Sivaram K , Paul Ajay
Published: October 2021

Objective assessment of seismic hazard and understanding of the Himalayan arc's tectonics requires detailed information on the crustal structure and geometry of the underthrusting Indian Plate beneath the Himalaya. Here, we present high-resolution 3-D P-wave velocity (Vp) and P-to-S-wave velocity ratio (Vp/Vs) images of the Kumaun–Garhwal Himalaya, a proposed potential region for the future great earthquake. We generate these images by inverting arrival times of 515 local earthquakes recorded by 41 broad-band stations during November 2006–June 2008. The tomographic images show a heterogeneous structure in the upper-mid crust. These images, along with available geophysical and geological information, indicate the presence of quartz-rich felsic rocks in the uppermost crust and the occurrence of saline-rich aqueous fluid/partial melt in the upper-mid crust. We propose that the Main Himalayan Thrust (MHT), having a flat-ramp-flat geometry, lies at the base of these fluid zones. The small- and moderate-to-strong-magnitude earthquakes are mainly confined to the fluid-rich zones along the MHT and quartz-rich rocks in the upper crust. Such an interpretation implies that the earthquake occurrence in the Kumaun–Garhwal Himalaya is largely controlled by the geometry of the MHT and crustal lithology.
P-wave scattering by randomly distributed aligned cracks in fractal media
Authors: Ma Rupeng , Ba Jing , Carcione José M , Lebedev Maxim
Published: October 2021

Seismic wave scattering dispersion and attenuation can be significant in cracked reservoirs. Many scattering models have been proposed, and the fractal (self-similar) features of the medium need to be further incorporated and analysed. We solve the P-wave scattering caused by fluid-saturated aligned cracks of finite thickness embedded in fractal media. The model is based on crack displacement discontinuities by using the Foldy approximation and representation theorem. The frequency dependence of velocity and attenuation are analysed as a function of the incidence angle and the crack and fluid properties. The results show that the crack density, thickness and radius can have a significant influence on the wave properties, as well as the fluid bulk modulus and saturation. The model requires three parameters to describe self-similar cracked media, and can be relevant in seismology, oil exploration and non-destructive testing of materials.
Notes on a compressible extended Burgers model of rheology
Authors: Ivins Erik R , Caron Lambert , Adhikari Surendra , Larour Eric
Published: October 2021

Constitutive theory for viscoelasticity has broad application to solid mantle or ice deformations driven by tides, surface mass variations, and post-seismic flow. Geophysical models using higher order viscoelasticity can better accommodate geodetic observations than lower-order theory, typically provided by tensor versions of Maxwell, 4-parameter Burgers or standard linear (Zener) rheology. We derive, for the first time, a mathematical description of a compressible version of the extended Burgers material (EBM) model paradigm which has a distribution function of relaxation spectra. The latter model is often used for parametrizing high temperature background transient responses in the rock physics and mechanics laboratory setting and have demonstrated application to low frequency seismic wave attenuation. A new generalization of this practical anelastic model is presented and applied to the glacial isostatic adjustment momentum equations, thus providing useful guidance for generating initial-value boundary problem-solving software for quite general coding strategies. The solutions for the vertical motion response to a suddenly imposed surface load reveal a short-term transience of substantial amplitude.
Assessing the impact of clinical coordination interventions on the continuity of care for patients with chronic conditions: participatory action research in five Latin American countries
Authors: Espinel-Flores Verónica , Vargas Ingrid , Eguiguren Pamela , Mogollón-Pérez Amparo-Susana , Ferreira de Medeiros Mendes Marina , López-Vázquez Julieta , Bertolotto Fernando , Vázquez María Luisa
Published: October 2021

Although fragmentation in the provision of services is considered an obstacle to effective health care, there is scant evidence on the impact of interventions to improve care coordination between primary care and secondary care in terms of continuity of care—i.e. from the patient perspective—particularly in Latin America (LA). Within the framework of the Equity-LA II project, interventions to improve coordination across care levels were implemented in five Latin American countries (Brazil, Chile, Colombia, Mexico and Uruguay) through a participatory action research (PAR) process. This paper analyses the impact of these PAR interventions on the cross-level continuity of care of chronic patients in public healthcare networks. A quasi-experimental study was performed with measurements based on two surveys of a sample of patients with chronic conditions (392 per network; 800 per country). Both the baseline (2015) and evaluation (2017) surveys were conducted using the CCAENA questionnaire. In each country, two comparable public healthcare networks were selected, one intervention and one control. Outcomes were cross-level continuity of information and clinical management continuity. Descriptive analyses were conducted, and Poisson regression models with robust variance were fitted to estimate changes. With differences between countries, the results showed improvements in cross-level continuity of clinical information (transfer of clinical information) and clinical management continuity (care coherence). These results are consistent with those of previous studies on the effectiveness of the interventions implemented in each country in improving care coordination in Brazil, Chile and Colombia. Differences between countries are probably related to particular contextual factors and events that occurred during the implementation process. This supports the notion that certain context and process factors are needed to improve continuity of care. The results provide evidence that, although the interventions were designed to enhance care coordination and aimed at health professionals, patients report improvements in continuity of care.
Life skill education at the time of COVID-19: perceptions and strategies of Italian expert school educators
Authors: Velasco V , Cominelli S , Scattola P , Celata C
Published: October 2021

The coronavirus disease 2019 (COVID-19) pandemic has had a huge effect on adolescents’ health and learning. Health promotion strategies should be valued, and life skill education is a potential approach in this direction. This study aimed to investigate the implementation of an evidence-based life skill education programme during the COVID-19 pandemic in the Lombardy Region (Italy) by collecting opinions about the programme’s usefulness and feasibility and identifying the strategies for implementing it through distance teaching. The study involved 63 middle school expert teachers, principals or coordinators in life skill education. An online questionnaire with closed- and open-ended questions was used. A qualitative content analysis was carried out using N-Vivo Answers software. The participants recognized the high value of life skill education at the time of COVID-19, but they showed reticence regarding its feasibility. Positive effects of the programme on both health and learning outcomes were reported. The obstacles were related to interpersonal aspects, student involvement, methods, organization and planning. Many strategies were suggested related to the teaching method, the curriculum organization and the adaptation needs. These strategies can be used to implement active and cooperative learning at a distance to reinforce students’ life skills to cope with the crisis and promote their health.
Infective aortitis after self-expanding transcatheter valve implantation: a case report of a new reality for cardiac surgeons
Authors: Máximo José , Pissarra Diana , Marinho Benjamim , Pinho Paulo
Published: October 2021

A 62-year-old female patient was admitted to hospital care due to an ischaemic stroke and fever of unknown origin, 6 months after a transfemoral aortic valve implantation for symptomatic aortic stenosis. Further study resulted in the diagnosis of infective aortitis, and clinical course deemed prosthesis explantation necessary. In this case report, we describe the technique used to explant the partially endothelized aortic valve and review the alternatives found in literature for safe prosthesis removal.
Longitudinal Immune Profiling of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Solid Organ Transplant Recipient
Authors: Klein Jonathan , Brito Anderson F , Trubin Paul , Lu Peiwen , Wong Patrick , Alpert Tara , Peña-Hernández Mario A , Haynes Winston , Kamath Kathy , Liu Feimei , Vogels Chantal B F , Fauver Joseph R , Lucas Carolina , Oh Jieun , Mao Tianyang , Silva Julio , Wyllie Anne L , Muenker M Catherine , Casanovas-Massana Arnau , Moore Adam J , Petrone Mary E , Kalinich Chaney C , Dela Cruz Charles , Farhadian Shelli , Ring Aaron , Shon John , Ko Albert I , Grubaugh Nathan D , Israelow Benjamin , Iwasaki Akiko , Azar Marwan M ,   for the Yale Implementing Medical and Public Health Action Against Coronavirus in Connecticut (IMPACT) Research Team
Published: October 2021

Background

The underlying immunologic deficiencies enabling severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection are currently unknown. We describe deep longitudinal immune profiling of a transplant recipient hospitalized twice for coronavirus disease 2019 (COVID-19).

Methods

A 66-year-old male renal transplant recipient was hospitalized with COVID-19 March 2020 then readmitted to the hospital with COVID-19 233 days after initial diagnosis. Virologic and immunologic investigations were performed on samples from the primary and secondary infections.

Results

Whole viral genome sequencing and phylogenetic analysis revealed that viruses causing both infections were caused by distinct genetic lineages without evidence of immune escape mutations. Longitudinal comparison of cellular and humoral responses during primary SARS-CoV-2 infection revealed that this patient responded to the primary infection with low neutralization titer anti–SARS-CoV-2 antibodies that were likely present at the time of reinfection.

Conclusions

The development of neutralizing antibodies and humoral memory responses in this patient failed to confer protection against reinfection, suggesting that they were below a neutralizing titer threshold or that additional factors may be required for efficient prevention of SARS-CoV-2 reinfection. Development of poorly neutralizing antibodies may have been due to profound and relatively specific reduction in naive CD4 T-cell pools. Seropositivity alone may not be a perfect correlate of protection in immunocompromised patients.
In vitro analysis of the replicative capacity and phenotypic susceptibility to integrase inhibitors of HIV-2 mutants with integrase insertions
Authors: Le Hingrat Quentin , Collin Gilles , Damond Florence , Peytavin Gilles , Lebourgeois Samuel , Ghosn Jade , Bachelard Antoine , Ferré Valentine Marie , Matheron Sophie , Descamps Diane , Charpentier Charlotte
Published: October 2021

Background

HIV-2 resistance to integrase strand-transfer inhibitors (INSTIs) is characterized by two main pathways: (i) mutations at codons 143, 148 and155; and (ii) amino acid insertion after integrase codon 231 (231ins).

Objectives

To complete INSTI resistance data on HIV-2 by determining the viral replicative capacity and INSTI phenotypic susceptibility of integrase mutants obtained through site-directed mutagenesis.

Methods

Site-directed mutants (SDMs) were constructed and viral stocks produced. Viral replicative capacity was assessed by measuring HIV-2 viral load at days 3, 7 and 14. In vitro phenotypic susceptibility was measured using the ANRS PBMC assay.

Results

Viruses bearing 231ins did not present impaired replicative capacity, except the 231ins GIRGK mutant. A 231ins GK SDM was resistant to raltegravir and cabotegravir, but remained susceptible to dolutegravir and bictegravir. SDMs harbouring a 5 amino acid insertion (GYKGK or SREGK) were both resistant to all INSTIs. The SDM with T97A+N155H, with or without E92Q, was resistant to all INSTIs, except bictegravir.

Conclusions

These first data on the newly described resistance pathway 231ins, using site-directed mutagenesis, showed no measurable impact on viral fitness and confirmed the decreased susceptibility to a first-generation INSTI (raltegravir) and cabotegravir. Resistance to second-generation INSTIs (dolutegravir and bictegravir) occurred for mutants with a 5 amino acid 231ins.
Development and validation of a prediction model for actionable aspects of frailty in the text of clinicians’ encounter notes
Authors: Martin Jacob A , Crane-Droesch Andrew , Lapite Folasade C , Puhl Joseph C , Kmiec Tyler E , Silvestri Jasmine A , Ungar Lyle H , Kinosian Bruce P , Himes Blanca E , Hubbard Rebecca A , Diamond Joshua M , Ahya Vivek , Sims Michael W , Halpern Scott D , Weissman Gary E
Published: October 2021

Objective

Frailty is a prevalent risk factor for adverse outcomes among patients with chronic lung disease. However, identifying frail patients who may benefit from interventions is challenging using standard data sources. We therefore sought to identify phrases in clinical notes in the electronic health record (EHR) that describe actionable frailty syndromes.

Materials and Methods

We used an active learning strategy to select notes from the EHR and annotated each sentence for 4 actionable aspects of frailty: respiratory impairment, musculoskeletal problems, fall risk, and nutritional deficiencies. We compared the performance of regression, tree-based, and neural network models to predict the labels for each sentence. We evaluated performance with the scaled Brier score (SBS), where 1 is perfect and 0 is uninformative, and the positive predictive value (PPV).

Results

We manually annotated 155 952 sentences from 326 patients. Elastic net regression had the best performance across all 4 frailty aspects (SBS 0.52, 95% confidence interval [CI] 0.49–0.54) followed by random forests (SBS 0.49, 95% CI 0.47–0.51), and multi-task neural networks (SBS 0.39, 95% CI 0.37–0.42). For the elastic net model, the PPV for identifying the presence of respiratory impairment was 54.8% (95% CI 53.3%–56.6%) at a sensitivity of 80%.

Discussion

Classification models using EHR notes can effectively identify actionable aspects of frailty among patients living with chronic lung disease. Regression performed better than random forest and neural network models.

Conclusions

NLP-based models offer promising support to population health management programs that seek to identify and refer community-dwelling patients with frailty for evidence-based interventions.
Post-war Violence against Human Rights Defenders and State Protection in Colombia
Authors: Wesche Philipp
Published: October 2021

In transitions from armed conflict, human rights defenders play an important role: in many cases, they are the local protagonists of the peace process. At the same time, they are at high risk of becoming victims of post-war violence. This article explores how states can protect defenders from such violence by presenting a case study of the Colombian transition, which has been characterized by high rates of homicides of defenders and threats against their physical integrity. Based on qualitative interviews with experts involved in protection, the article argues that violence against defenders may evolve into a systemic problem in post-conflict settings. In such contexts, protection must go beyond providing individual security measures to defenders at risk. Instead, it should follow a collective approach that emphasizes the security of communities and organizations, strengthens their capacities and relations with the state, and strives to dismantle the armed groups responsible for attacking defenders.
Acres for the Affluent: An Interactive Model of Nonprofit Resources and Demand Heterogeneity
Authors: Zuhlke Samantha
Published: October 2021

According to the theory of government failure, nonprofit organizations emerge when governments fail to provide goods or services to a public with heterogeneous demands. This study approaches this fundamental theory of the nonprofit sector from a pluralist political viewpoint, marrying the theory of government failure to resource-driven nonprofit arguments via updated modeling and measurement strategies. This article proposes a new, conditional demand heterogeneity hypothesis, wherein the effect of demand heterogeneity on the nonprofit sector increases in the presence of increasing resources: nonprofit service delivery is most likely when those experiencing government failure have access to resources. This article is the first to test supply and demand nonprofit arguments in tandem using an interactive modeling specification and the first to operationalize demand heterogeneity using policy-based measures. I employ a finite distributed lag model with an interactive term in a time series, cross-sectional analysis of public and nonprofit land conservation in the United States. I find that nonprofit land conservation increases when citizens express greater environmental concern but only in the presence of increasing disposable income. Examining nonprofit theory within the context of land conservation provides a comparable measure of government and nonprofit service provision, controls for the nature of the good provided by these institutions, and allows for a policy-driven measure of demand heterogeneity, improving upon previous studies’ employment of diversity-based proxy measures. The results advance our understanding of how to test and measure demand heterogeneity nonprofit arguments and suggest that access to resources conditions which interests find expression in nonprofit organizations.
Urban citizenship for all? Exploring the limits of an agenda in São Paulo’s squats
Authors: Zacca Thomaz Diana
Published: October 2021

Scholarly analyses often interpret the urban struggles of both marginalised citizens and marginalised migrants through the single frame of urban citizenship. Urban citizenship, in this literature, is generally understood as an agenda that seeks to achieve the full political belonging of all those who inhabit the city. This article questions two assumptions running through much of this scholarship. The first is the assumption that struggles for urban citizenship necessarily promote the full belonging of all city dwellers. I argue that this understanding does not adequately take into account the social hierarchies existing within citizenship. The second is the assumption that all marginalised city dwellers (including migrants) will claim for their political belonging to the city. These limitations in the urban citizenship agenda are explored in the divergent aspirations and claims-making of both Brazilians and international migrants living together in squats in central São Paulo, Brazil. I show how militant Brazilian squatters pursuing their full urban citizenship bring about progressive change while also unintentionally reinscribing social hierarchies within citizenship. I also show how migrant squatters are not clearly compelled by the prospect of full belonging in São Paulo, but instead often aspire to better futures elsewhere. In sum, I argue that analyses of urban struggles located at the intersection of migration and residential segregation should not assume that the urban citizenship agenda will be either universally inclusive or universally desirable in a given city.
Variable star classification across the Galactic bulge and disc with the VISTA Variables in the Vía Láctea survey
Authors: Molnar Thomas A , Sanders Jason L , Smith Leigh C , Belokurov Vasily , Lucas Philip , Minniti Dante
Published: October 2021

We present VIVACE, the VIrac VAriable Classification Ensemble, a catalogue of variable stars extracted from an automated classification pipeline for the Vista Variables in the Vía Láctea (VVV) infrared survey of the Galactic bar/bulge and southern disc. Our procedure utilises a two-stage hierarchical classifier to first isolate likely variable sources using simple variability summary statistics and training sets of non-variable sources from the Gaia early third data release, and then classify candidate variables using more detailed light curve statistics and training labels primarily from OGLE and VSX. The methodology is applied to point-spread-function photometry for ∼490 million light curves from the VIRAC v2 astrometric and photometric catalogue resulting in a catalogue of ∼1.4 million likely variable stars, of which ∼39, 000 are high-confidence (classification probability >0.9) RR Lyrae ab stars, ∼8000 RR Lyrae c/d stars, ∼187, 000 detached/semi-detached eclipsing binaries, ∼18, 000 contact eclipsing binaries, ∼1400 classical Cepheid variables and ∼2200 Type II Cepheid variables. Comparison with OGLE-4 suggests a completeness of around 90  per cent for RRab and ≲ 60 per cent for RRc/d, and a misclassification rate for known RR Lyrae stars of around 1 per cent for the high confidence sample. We close with two science demonstrations of our new VIVACE catalogue: first, a brief investigation of the spatial and kinematic properties of the RR Lyrae stars within the disc/bulge, demonstrating the spatial elongation of bar-bulge RR Lyrae stars is in the same sense as the more metal-rich red giant population whilst having a slower rotation rate of ∼40 km s−1kpc−1; and secondly, an investigation of the Gaia EDR3 parallax zeropoint using contact eclipsing binaries across the Galactic disc plane and bulge.