bluuebunny/crossref_metadata_2025 huggingface dataset:
An Image Encryption Scheme based on Adaptive Bit-Plane Division
Authors: Gu Jun , Xu Feng , Zeng Tao , Lyu Xin
Published: August 2022

With the application and popularization of digital images, the security of images has been paid more and more attention. The bit-level image encryption method has become one of the commonly used methods. It has the characteristic of changing the pixel value while disturbing the position of the pixel point, but at the same time it is accompanied by a higher computational complexity. In order to improve the efficiency of the encryption algorithm, according to the characteristic that the higher 4 of the 8 bit-planes of the grayscale image contain 94.125% of the information of the entire image, the encryption structure of higher 4 bit-planes and lower 4 bit-planes is widely used. But for different images, this characteristic is not accurately applicable. In response to this problem, we design a method of adaptive bit-plane division, which uses mutual information and Jensen-Shannon divergence to measure the amount of information of bit-planes and then divides bit-planes into two parts. The results of bit-plane division are different for different images. Based on this, we propose an image encryption scheme based on adaptive bit-plane division. Compared with the traditional higher 4-bits and lower 4-bits encryption method, this scheme reduces the encryption cost and improves the encryption efficiency. Experimental results show that the proposed scheme can effectively resist the chosen plain-image attacks and has sufficient security.
Transmission Line Foreign Body Fault Detection Using Multi-Feature Fusion Based on Modified YOLOv5
Authors: Wang Qianyue , Si Gangquan , Qu Kai , Gong Jiahui , Cui Lele
Published: August 2022

The particular work environment of transmission lines makes it liable to malfunction because of the foreign bodies attached to the power equipment. However, traditional detection methods are difficult to identify the exact category of foreign bodies and ignore the relationship between a foreign body and power equipment, which is correlated to determining whether there is a fault or not. In order to detect and distinguish the foreign bodies and give fault warnings automatically in transmission line patrol with high accuracy and efficiency, we improve the original YOLOv5 object detection model and propose a novel fusion detection model using multi-scale appearance and relationship features. The proposed model is capable of transmission line foreign body category detection and fault determination. By comparing with the original YOLOv5, the proposed model shows better accuracy and achieves the strong ability to give the fault determination simultaneously, which makes it convenient for power system operators and protects the safe and stable operation of the power system.
Cloud Resource Scheduling Method based on Markov Process and the Cuckoo Search
Authors: Qi Bin , Zhang Pan , Wu Hong , Yan Miao
Published: August 2022

With the rapid development of cloud computing, the computing reliability of cloud servers has become an important research area. To improve the load balancing capability of cloud servers, an autonomous adaptive architecture cloud computing framework based on software-defined networking and network function virtualization were proposed. And a cloud resource scheduling method based on the Markov process model and cuckoo search algorithm to realize the load balancing of cloud nodes was designed. The cloud platform verified by the experiment shows that the method can effectively guarantee the service reliability of cloud computing.
Macro-mechanical properties of magnetorheological fluids based on body-centered cubic structure
Authors: Chen Song , Cai Tianwu
Published: August 2022

This paper addresses the problem that the microstructure model of magnetorheological fluid established by traditional single-chain or multi-chain dense rows is unable to accurately describe the rheological behavior and the sudden change of macroscopic mechanical properties under the action of an applied magnetic field, and analyzes the stable cluster-like structure formed by a specific volume fraction of magnetorheological fluids in a micro-narrow channel under the action of external magnetic field and extrusion pressure. This paper also establishes the equations of motion and dynamics of magnetic particles under the action of external magnetic field, analyzes the dynamic evolution of particle microstructure, performs numerical simulations of two-dimensional chaining using Matlab, and establishes a microscopic observation test bench for comparison and verification; and it establishes a model of complex cluster-like structure of magnetorheological fluids body-centered cubic, and analyzes the system energy, stability and force of the body-centered cubic structure based on the minimum system energy theory and Hertzian contact theory; and further establishes a shear yield stress model based on the body-centered cubic microstructure to analyze the macroscopic mechanical properties of magnetorheological fluids, thereby enriching the theoretical system of extrusion strengthening of magnetorheological fluids in the microscale.
Maps on the Morse boundary
Authors: Liu Qing
Published: August 2022

For a proper geodesic metric space, the Morse boundary focuses on the hyperbolic-like directions in the space. The Morse boundary is a quasi-isometry invariant. That is, a quasi-isometry between two spaces induces a homeomorphism on their Morse boundaries. In this paper, we investigate additional structures on the Morse boundary which determine the space up to a quasi-isometry. We prove that a homeomorphism between the Morse boundaries of two proper, cocompact spaces is induced by a quasi-isometry if and only if both the homeomorphism and its inverse are bihölder, or quasi-symmetric, or strongly quasi-conformal.
The Use of Mean Gray Value (MGV) as a Guide to Tension-Reducing Strategies in Body Contouring Surgery Reduces Wound-Related Morbidity
Authors: Chabot A Bert , Puyana Salomon , Lindsey John T
Published: August 2022

Background

Currently there are no known structural parameters of the integument that can be measured noninvasively which are used in the planning of body contouring surgery.

Objectives

The aim of this study was to see if mean gray value (MGV), when taken into account preoperatively, can reduce wound-related morbidity.

Methods

This project was a prospective cohort study. Ultrasound imaging of the subcutaneous tissue was performed prospectively on patients undergoing body contouring surgery to quantify the superficial fascial system so that average MGV could be calculated over the proposed surgical sites. Patients with average to poor MGV (≤0.127) were identified preoperatively for tension-reducing procedures. Wound complication rates were compared with rates in a retrospective cohort which did not undergo preoperative imaging.

Results

There were 115 patients in each of the 2 cohorts. There were 3 exclusions due to loss of ultrasound images, leaving 112 patients available for analysis in the prospective cohort. The cohorts were similar except for a higher incidence of patients with diabetes in the retrospective group (1 vs 9, P = 0.026). The wound complication rate was significantly reduced in the prospective group (5/112, 4.4%) when compared with the retrospective group (20/115, 17%, P = 0.0062). The revision and infection rates were also significantly reduced in the prospective group (1/112, 0.9%; 3/112, 2.6%) when compared with the retrospective group (8/115, 7%, P = 0.019; 10/115 8.6%, P = 0.051).

Conclusions

MGV is a unique, patient- and area-specific structural parameter of the integument, and its measurement may be useful in reducing wound-related morbidity in body contouring surgery.

Level of Evidence: 4
Elevated expression of TAM receptor tyrosine kinase in synovial fluid and synovial tissue of rheumatoid arthritis
Authors: Zheng Li , Xu Liling , Hu Fanlei , Xue Jimeng , Bai Mingxin , Yao Ranran , Zhu Huaqun , Zhong Hua , Su Yin
Published: August 2022

To investigate the expression and roles of TAM (Tyro3/Axl/Mer) receptor tyrosine kinases (TK) in synovial fluid and synovial tissue of patients with rheumatoid arthritis (RA). The expression of TAM TKs in the synovial fluid and synovial tissues of RA and osteoarthritis (OA) patients was measured by ELISA and immunohistochemistry. The relationships between soluble TAM TKs (sTAM TKs) levels and the clinical features, laboratory parameters and disease activity were analyzed in RA. The concentrations of sTAM TK in the synovial fluids of RA patients were increased in comparison to those of OA patients. Compared with OA patients, the expression of membrane Tyro3 TK (mTyro3 TK) and mMer TK in RA patient synovial tissue were significantly increased, which may partly explain the possible mechanism of elevated levels of sTAM TK in RA patient synovial fluid. sAxl TK levels were decreased in RA patients under sulfasalazine treatment and elevated in patients under Iguratimod treatment. Furthermore, sTyro3 TK levels were positively correlated with erythrocyte sedimentation rate (ESR) and negatively correlated with white blood cells (WBCs), red blood cells (RBCs), and hemoglobin (HB) in RA patients. The levels of sMer TK were positively associated with disease duration and rheumatoid factor (RF) and negatively correlated with HB, complement 3 (C3), and C4. Taken together, TAM TKs might be involved in RA synovial tissue inflammation.
Differential roles of nucleus reuniens and perirhinal cortex in Pavlovian trace fear conditioning in rats
Authors: Jhuang Yi-Ci , Chang Chun-hui
Published: August 2022

The nucleus reuniens (RE) and the perirhinal cortex (PRC) are two major relay stations that interconnect the hippocampus (HPC) and the medial prefrontal cortex (mPFC). Previous studies have shown that both the RE and the PRC are involved in the acquisition of trace fear conditioning. However, the respective contribution of the two regions is unclear. In this study, we used pharmacological approach to compare their roles. Our data suggested that inactivation of the RE or the PRC during conditioning partially impaired, whereas inactivation of both areas totally abolished, the encoding of trace fear. We next examined whether the impaired encoding of trace fear under RE inactivation can be rescued with enhanced cholinergic tone in the PRC, and vice versa. Against our hypothesis, regardless of whether the RE was on-line or not, animals failed to encode trace fear when further engaging cholinergic activities in the PRC. Conversely, depending on PRC activation level during conditioning, further recruiting cholinergic activities in the RE led to a down-shift of fear response during retrieval. Our results revealed that the RE and the PRC were necessary for the encoding of trace fear. Moreover, there was differential importance of cholinergic modulation during the process.
Monetary policy autonomy and foreign reserves accumulation in Brazil: a compensation view
Authors: Gerioni Enzo Matono , Rolim Lilian Nogueira , Omizzolo Julia Alencar , Schiozer Nikolas Alexander van de Bilt
Published: August 2022

During the 2000s, Brazil accumulated a substantial amount of foreign reserves through foreign exchange market interventions undertaken by its Central Bank. Mainstream economics considers such interventions a restriction to monetary policy autonomy. This article analyses the relationship between monetary policy autonomy and exchange rate regimes theoretically and empirically for the Brazilian economy. We argue that the compensation principle, as a direct derivation of the endogenous money approach, is an alternative to both the trilemma and dilemma views in the mainstream perspective. Then, we provide empirical evidence in favour of the compensation principle in the Brazilian economy by verifying the exogeneity of the interest rate and estimating a vector error-correction model (VECM) that indicates that the foreign reserves do not have a long-term effect on the monetary base, while they present a significant and large effect on the repos account. In line with the compensation view, we conclude that in the 2000s, Brazil had more monetary policy autonomy than conventional approaches would have suggested.
Trapezoidal Sketch: A Sketch Structure for Frequency Estimation of Data Streams
Authors: Li Ning , Yuan Xin , Ortega Jose-Fernan Martinez , Diaz Vicente Hernandez
Published: August 2022

The sketch is one of the typical and widely used data structures for estimating the frequencies of items in data streams. However, since the counter sizes in traditional rectangular sketch (r-sketch) are the same, it is hard to achieve small space usage, high capacity (i.e. the maximum frequency can be recorded) and high estimated accuracy simultaneously. Moreover, when considering the high skewness of data streams, this problem will become even worse. Consequently, we propose the trapezoidal sketch (t-sketch) in this paper. In the t-sketch, different from the r-sketch, the counter sizes in different layers are different. Therefore, the low space usage and high capacity can be achieved simultaneously in the t-sketch. Moreover, based on the basic t-sketch, we propose the space-saving t-sketch and the capacity-improvement t-sketch and analyze the properties of these two t-sketches. Finally, for improving the estimation accuracy of the t-sketch further, we propose the probabilistic-based estimation error-reducing algorithm. Compared with the CM sketch, CU sketch, C sketch and A sketch, the simulation results show that the performances on space usage, capacity and estimation accuracy are improved successfully by the space-saving t-sketch and the capacity-improvement t-sketch.
Data fusion reconstruction of spatially embedded complex networks
Authors: Sun Jie , Quevedo Fernando J , Bollt Erik M
Published: August 2022

We introduce a kernel Lasso (kLasso) approach which is a type of sparse optimization that simultaneously accounts for spatial regularity and structural sparsity to reconstruct spatially embedded complex networks from time-series data about nodal states. Through the design of a spatial kernel function motivated by real-world network features, the proposed kLasso approach exploits spatial embedding distances to penalize overabundance of spatially long-distance connections. Examples of both random geometric graphs and real-world transportation networks show that the proposed method improves significantly upon existing network reconstruction techniques that mainly concern sparsity but not spatial regularity. Our results highlight the promise of data and information fusion in the reconstruction of complex networks, by utilizing both microscopic node-level dynamics (e.g. time series data) and macroscopic network-level information (metadata or other prior information).
Uniportal robotic-assisted thoracic surgery for lung resections
Authors: Gonzalez-Rivas Diego , Bosinceanu Mugurel , Motas Natalia , Manolache Veronica
Published: August 2022

Pure uniportal robotic-assisted thoracic surgery (U-RATS) is the robotic thoracic surgery performed through a single intercostal incision, without rib spreading, using the robotic camera, robotic dissecting instruments and robotic staplers. Compared to multiport, U-RATS simplifies the management of possible intraoperative bleeding, mainly due to rapid undocking and the necessary uniportal experience of the surgeon. U-RATS offers a possible uniportal robotic surgical management of lung resections, with comfort for surgeons and quick and smooth recovery for patients.
Using systems thinking to assess the functioning of an “Age-Friendly City” governance network in Australia
Authors: Ma Tracey , de Leeuw Evelyne , Proust Katrina , Newell Barry , Clapham Kathleen , Kobel Conrad , Ivers Rebecca
Published: August 2022

Age-Friendly Cities (AFC) is a framework for promoting healthy ageing through local actions. We use systems thinking to assess potential outcomes of actions to support older people’s mobility, undertaken within an AFC commitment in Greater Sydney. Interviews with 20 informants involved in providing space, infrastructure, or services that affect how older people get around were analysed using causal loop diagrams (CLDs). Four approaches to support older people’s mobility were identified and situated to the Multiple Governance Framework: land use, open and public space, supplementary transport, and community transport. Analysis revealed potential for unwanted consequences associated with each, which can be generalised into three generic potential outcomes for other jurisdictions to consider. A recommendation from this research is for policy actors to examine feedback interactions between actions so that they can foresee a wider range of outcomes and take defensive action against those unwanted. By situating CLDs within the Multiple Governance Framework, this research not only identifies what to look for, in terms of potential outcomes, but also where to look, in terms of the level of decision-making. This research offers a new way to assess the functioning of AFC governance networks by their collective outcomes and challenges the standards for the evaluation of AFC.
Understanding common dolphin and Australasian gannet feeding associations from nutritional and ethological perspectives
Authors: Stockin Karen A , Amiot Christophe , Meynier Laureline , Purvin Cameron , Machovsky-Capuska Gabriel E
Published: August 2022

Prey detection and subsequent capture is considered a major hypothesis to explain feeding associations between common dolphins and Australasian gannets. However, a current lack of insight on nutritional strategies with respect to foraging behaviours of both species has until now, prevented any detailed understanding of this conspecific relationship. Here we combine stomach content analysis (SCA), nutritional composition of prey, a multidimensional nutritional niche framework (MNNF) and videography to provide a holistic dietary, nutritional, and behavioural assessment of the feeding association between dolphins and gannets in the Hauraki Gulf, New Zealand. Dolphins consumed ten prey species, including grey mullet (Mugil cephalus) as the most representative by wet mass (33.4%). Gannets preyed upon six species, with pilchards (Sardinops pilchardus) contributing most of the diet by wet mass (32.4%) to their diet. Both predators jointly preyed upon pilchard, jack mackerel (Trachurus spp.), arrow squid (genus Nototodarus), and anchovy (Engraulis australis). Accordingly, the MNNF revealed a moderate overlap in the prey composition niche (0.42) and realized nutritional niche (0.52) between dolphins and gannets. This suggests that both predators coexist in a similar nutritional space, while simultaneously reducing interspecific competition and maximizing the success of both encountering and exploiting patchily distributed prey. Behavioural analysis further indicated that dolphin and gannets feeding associations are likely to be mutually beneficial, with a carouselling foraging strategy and larger pod sizes of dolphins, influencing the diving altitude of gannets. Our approach provides a new, more holistic understanding of this iconic foraging relationship, which until now has been poorly understood.
Association of summer temperatures and acute kidney injury in South Korea: a case-crossover study
Authors: Ahn Joonho , Bae Sanghyuk , Chung Byung Ha , Myong Jun-Pyo , Park Min Young , Lim Youn-Hee , Kang Mo-Yeol
Published: August 2022

Background

Due to climate change, days with high temperatures are becoming more frequent. Although the effect of high temperature on the kidneys has been reported in research from Central and South America, Oceania, North America and Europe, evidence from Asia is still lacking. This study aimed to examine the association between short-term exposure to high temperatures and acute kidney injury (AKI) in a nationwide study in South Korea.

Methods

We used representative sampling data from the 2002–2015 National Health Insurance Service–National Sample Cohort in South Korea to link the daily mean temperatures and AKI cases that occurred in the summer. We used a bidirectional case-crossover study design with 0–7 lag days before the emergency room visit for AKI. In addition, we stratified the data into six income levels to identify the susceptible population.

Results

A total of 1706 participants were included in this study. The odds ratio (OR) per 1°C increase at 0 lag days was 1.051, and the ORs per 1°C increase at a lag of 2 days were both 1.076. The association between exposure to high temperatures and AKI was slightly greater in the low-income group (OR = 1.088; 95% CI: 1.049–1.128) than in the high-income group (OR = 1.065; 95% CI: 1.026–1.105).

Conclusions

In our study, a relationship between exposure to high temperatures and AKI was observed. Precautions should be taken at elevated temperatures to minimize the risk of negative health effects.
Where is Conflict Research? Western Bias in the Literature on Armed Violence
Authors: Phillips Brian J , Greene Kevin T
Published: August 2022

Which countries are likely to be subjects of research in the study of armed conflict? Evidence from other fields suggests that research often focuses disproportionately on the West, but it is unclear to what extent this is true in conflict studies. We suggest that a baseline explanation of research focus is each country’s conflict experience, and we present two additional hypotheses: Western bias and research feasibility. Empirically, we count countries in the abstracts of five prominent conflict or security journals, 1990–2015. We also manually count single-country case studies. Western countries, measured by U.N. voting or geographic location, appear more than non-Western countries, even after considering conflict, wealth, and other factors. There is less support for the research feasibility argument, measured by each country’s official languages and democracy. We find French- and Spanish-language countries less likely to appear in the literature. We conclude with a discussion of under-studied countries and offer related suggestions.
What is a supercoiling-sensitive gene? Insights from topoisomerase I inhibition in the Gram-negative bacterium Dickeya dadantii
Authors: Pineau Maïwenn , Martis B. Shiny , Forquet Raphaël , Baude Jessica , Villard Camille , Grand Lucie , Popowycz Florence , Soulère Laurent , Hommais Florence , Nasser William , Reverchon Sylvie , Meyer Sam
Published: August 2022

DNA supercoiling is an essential mechanism of bacterial chromosome compaction, whose level is mainly regulated by topoisomerase I and DNA gyrase. Inhibiting either of these enzymes with antibiotics leads to global supercoiling modifications and subsequent changes in global gene expression. In previous studies, genes responding to DNA relaxation induced by DNA gyrase inhibition were categorised as ‘supercoiling-sensitive’. Here, we studied the opposite variation of DNA supercoiling in the phytopathogen Dickeya dadantii using the non-marketed antibiotic seconeolitsine. We showed that the drug is active against topoisomerase I from this species, and analysed the first transcriptomic response of a Gram-negative bacterium to topoisomerase I inhibition. We find that the responding genes essentially differ from those observed after DNA relaxation, and further depend on the growth phase. We characterised these genes at the functional level, and also detected distinct patterns in terms of expression level, spatial and orientational organisation along the chromosome. Altogether, these results highlight that the supercoiling-sensitivity is a complex feature, which depends on the action of specific topoisomerases, on the physiological conditions, and on their genomic context. Based on previous in vitro expression data of several promoters, we propose a qualitative model of SC-dependent regulation that accounts for many of the contrasting transcriptomic features observed after DNA gyrase or topoisomerase I inhibition.
The Impact of Smoking Status and Smoking-Related Comorbidities on Coronavirus Disease 2019 Patient Outcomes: A Causal Mediation Analysis
Authors: Le Guen Claire L , Muir Kelsey C , Simons Melanie , Coffman Donna L , Soans Rohit S
Published: August 2022

Introduction

Smoking history is a known risk factor for significant chronic diseases as well as pulmonary infections; however, the impact of smoking status on coronavirus disease 2019 (COVID-19) outcomes has not been conclusively characterized. This study aims to evaluate the association of smoking status on COVID-19 outcomes, and to explore the mechanism by which smoking and smoking-related comorbidities relate to COVID-19 outcomes.

Aims and Methods

Patients admitted with SARS-CoV-2 infection from November 2020 through January 2021 were included in this study. Causal mediation models investigating the associations between smoking status and the outcomes of mortality, intensive care unit (ICU) admission, advanced respiratory support, mechanical ventilation, ICU length of stay, and hospital length of stay, through mediation via smoking-related comorbidities, were examined.

Results

Active smokers did not experience worse COVID-19 outcomes once hospitalized. Former smokers had a higher odds of mortality (total effect OR 1.59, 95% CI 1.07 to 2.38, p = .01; indirect effect OR 1.45, 95% CI 1.09 to 1.93, p < .001), and advanced respiratory support (total effect OR 1.31, 95% CI 1.04 to 1.67, p = .02; indirect effect OR 1.26, 95% CI 1.03 to 1.54, p = .02), which were mediated by smoking-related comorbidities. While there was a nonsignificant increase in the total effect for mechanical ventilation, smoking-related comorbidities were significant mediators for their increased need (total effect OR 1.40, 95% CI 0.92 to 2.14, p = .13; indirect effect OR 1.47, 95% CI 1.10 to 1.87, p < .001).

Conclusions

Although active smokers did not experience worse COVID-19 outcomes compared to never smokers, these results should be interpreted with caution. Compared to never smokers, former smokers had greater odds of mortality, advanced respiratory support, and mechanical ventilation which was significantly mediated through smoking-related comorbidities.

Implications

Previous studies have linked smoking status with worse COVID-19 outcomes, and have inferred that smoking-related comorbidities may play a role in these findings. This causal mediation analysis provides statistical evidence supporting this hypothesis, clarifying the risk that smoking-related comorbidities impart on COVID-19 outcomes in those with a smoking history.
Generating an oilseed rape mutant with non-abscising floral organs using CRISPR/Cas9 technology
Authors: Wu Jian , Liu Huimin , Ren Sichao , Li Panpan , Li Xue , Lin Li , Sun Qinfu , Zhang Long , Lin Chen , Wang Youping
Published: August 2022

Oilseed rape plants with abscission-defective ﬂoral organs acquired through genome editing show less susceptibility to Sclerotinia sclerotiorum infection and longer ﬂowering-period for flower tourism.
Fictions that Purport to Tell the Truth
Authors: Marsili Neri
Published: August 2022

Can fictions make genuine assertions about the actual world? Proponents of the ‘Assertion View’ answer the question affirmatively: they hold that authors can assert, by means of explicit statements that are part of the work of fiction, that something is actually the case in the real world. The ‘Nonassertion’ View firmly denies this possibility. In this paper, I defend a nuanced version of the Nonassertion View. I argue that even if fictions cannot assert, they can indirectly communicate that what is recounted as fictional is actually true. I show that this view is supported by independent linguistic data, and that it is able to defuse the objections that are typically raised against the Nonassertion View. I conclude by showing that this position has some interesting implications for testimonial cognitivism about fiction.
Therapeutics in rheumatology and the kidney
Authors: Harty Tommy , O’Shaughnessy Michelle , Harney Sinead
Published: August 2022

The field of rheumatology has advanced significantly in recent years to provide rheumatologists with an extensive array of medications to combat rheumatic joint conditions. In contrast to an older era, when NSAIDs and other nephrotoxic agents were the mainstay of treatment, modern DMARDs vary considerably in their nephrotoxic potential and their use is not always precluded in populations with pre-existing chronic kidney disease (CKD). This review will explore in detail the safety and efficacy profiles of medications used to treat rheumatologic disease, specifically in the setting of CKD. Specifically, we discuss both traditional agents used, i.e. NSAIDs, CSs and conventional synthetic DMARDs, as well as novel biologic DMARDs and targeted synthetic DMARDs. Anti-gout prescribing in CKD is also reviewed. We aim to provide practical guidance to rheumatologists, nephrologists and general physicians when prescribing these medications in the setting of CKD.
The managerial contradictions of extroverted financialization: the rise and fall of Deutsche Bank
Authors: Beck Mareike
Published: August 2022

Deutsche Bank was once an acclaimed US-style investment bank but is now struggling. The rise of US finance is often explained as an outcome of financial liberalization that motivated other banks to abandon their traditional industrial support to chase profit opportunities within global securities markets. This story, however, underestimates how the transition to US-led financialization was deeply entangled with managerial struggles and the contradictions of adopting US financial innovations from a peripheral position. By contrast, I use the concept of extroverted financialization to portray Deutsche Bank’s transformation as an outcome of its attempts to integrate new funding practices connected to US money markets, called liability management. I argue that this process generated a difficult-to-manage business model and, ultimately, Deutsche’s decline. Because of these extroverted strategies, the bank is now caught between opposing logics of banking, within neither of which it can regain its previous powerful position.
A Generic Pharmacokinetic Model for Quantifying Mother-to-Offspring Transfer of Lipophilic Persistent Environmental Chemicals
Authors: Kapraun Dustin F , Zurlinden Todd J , Verner Marc-André , Chiang Catheryne , Dzierlenga Michael W , Carlson Laura M , Schlosser Paul M , Lehmann Geniece M
Published: August 2022

Lipophilic persistent environmental chemicals (LPECs) can accumulate in a woman’s body and transfer to her developing child across the placenta and via breast milk. To assess health risks associated with developmental exposures to LPECs, we developed a pharmacokinetic (PK) model that quantifies mother-to-offspring transfer of LPECs during pregnancy and lactation and facilitates internal dosimetry calculations for offspring. We parameterized the model for mice, rats, and humans using time-varying functions for body mass and milk consumption rates. The only required substance-specific parameter is the elimination half-life of the LPEC in the animal species of interest. We used the model to estimate whole-body concentrations in mothers and offspring following maternal exposures to hexachlorobenzene (HCB) and 2,2′,4,4′,5,5′-hexachlorobiphenyl (PCB 153) and compared these with measured concentrations from animal studies. We also compared estimated concentrations for humans to those generated using a previously published human LPEC PK model. Finally, we compared human equivalent doses (HEDs) calculated using our model and an allometric scaling method. Estimated and observed whole-body concentrations of HCB and PCB 153 in offspring followed similar trends and differed by less than 60%. Simulations of human exposure yielded concentration estimates comparable to those generated using the previously published model, with concentrations in offspring differing by less than 12%. HEDs calculated using our PK model were about 2 orders of magnitude lower than those generated using allometric scaling. Our PK model can be used to calculate internal dose metrics for offspring and corresponding HEDs and thus informs assessment of developmental toxicity risks associated with LPECs.
Minimally Invasive Method in Treatment of Idiopathic Congenital Vertical Talus: Recurrence is Uncommon
Authors: Cummings Jason L. , Hosseinzadeh Pooya
Published: August 2022

Background:

Historically, treatment for congenital vertical talus (CVT) has included open reduction of the talonavicular joint and extensive soft tissue release. In 2006, a new minimally invasive method consisting of serial manipulation and casting followed by percutaneous fixation of the talonavicular joint and percutaneous Achilles tenotomy was introduced. Although the early results of this new technique are promising, more research is needed to verify that the talonavicular correction is maintained with time.

Methods:

We conducted a retrospective chart review of all patients with idiopathic CVT who underwent minimally invasive correction by a single surgeon at a tertiary care institution. Radiographic evaluation of the preoperative, immediate postoperative, 1 year postoperative and latest follow-up appointments were performed. Complications and clinical outcomes were recorded. Radiographic recurrence of the deformity was defined as lateral talar axis-first metatarsal base angle >30 degrees. Statistical analysis was performed on the maintenance of radiographic correction and factors associated with recurrence.

Results:

Forty seven feet in 35 patients were included in the study with average follow-up of 45 months. The average preoperative lateral talar axis-first metatarsal base angle was 74±18 compared with 12±8 after initial surgical intervention. In addition, radiographic correction of all other measured angles was achieved in every child following the initial surgery. Radiographic recurrence of talonavicular deformity was seen in 4 feet (9%). No cases of recurrence required a second corrective surgery during the follow-up period. There was a significant association between patient age at the time of treatment and recurrence of talonavicular deformity with patients older than 12 months being more likely to experience recurrence (P=0.041).

Conclusions:

In this large series, we found that correction of talonavicular deformity can be achieved and maintained in a large majority of children with idiopathic CVT who undergo treatment with this minimally invasive technique and recurrences are uncommon. Treatment with this technique should be initiated as soon as a diagnosis of CVT is confirmed and the patient is medically stable to decrease the likelihood of experiencing recurrence of talonavicular deformity.

Level of Evidence:

Level III.
The Efficacy of Albumin Dialysis in the Treatment of Severe Cholestatic Drug-Induced Liver Injury
Authors: Narayanan Mechu , Vora Ravi S. , Flynn Mary M. , Subramanian Ram M.
Published: August 2022

INTRODUCTION:

Drug-induced liver injury (DILI) is a significant cause of acute liver injury and can present as cholestatic injury with or without associated hepatitis. Although most patients with DILI recover with supportive care, some can develop severe refractory cholestasis that impairs recovery of hepatic function, with subsequent progression to acute or chronic liver failure. Current pharmacotherapy and extracorporeal therapies such as hemodialysis have limited benefit. Albumin dialysis is an emerging strategy in the extracorporeal treatment of intoxications caused by protein bound drugs and can be used for the removal of albumin bound bilirubin and bile acids.

CASES SERIES:

We describe the efficacy of albumin dialysis with the molecular adsorbent recirculating system (MARS) in the successful treatment of five patients with severe cholestatic DILI that was refractory to standard medical therapy. All patients had a sustained improvement in serum bilirubin levels after completing MARS therapy, with a complete resolution of their liver injury.

DISCUSSION:

Our case series demonstrates that albumin dialysis could provide an important treatment strategy in the setting of severe refractory cholestatic DILI and be considered as a novel therapeutic option in specific cases of drug hepatotoxicity in which the causative agent has high protein binding characteristics.
Mechanisms for blood pressure reduction following isometric exercise training: a systematic review and meta-analysis
Authors: Edwards Jamie J. , Wiles Jonathan , O’Driscoll Jamie
Published: August 2022

Objective:

Isometric exercise training (IET) is established as an effective antihypertensive intervention. Despite this, the physiological mechanisms driving blood pressure (BP) reductions following IET are not well understood. Therefore, we aimed to perform the first meta-analysis of the mechanistic changes measured following IET.

Methods:

PubMed, Cochrane library and SPORTDiscus were systematically searched for randomized controlled trials published between January 2000 and December 2021 reporting the effects of IET on resting BP and at least one secondary mechanistic parameter following a short-term intervention (2–12 weeks).

Results:

Eighteen studies with a pooled sample size of 628 participants were included in the final analysis. IET produced significant reductions in resting systolic and diastolic BP of 9.35 mmHg (95% confidence interval [CI] = −7.80 to −10.89, P < 0.001) and 4.30 mmHg (CI = −3.01 to −5.60, P < 0.001), respectively. Mechanistically, IET produced a statistically significant reduction in resting heart rate (mean difference [MD]: −1.55 bpm, CI = −0.14 to −2.96, P = 0.031) and a significant increase in stroke volume (MD: 6.35 ml, CI = 0.35 to 12.60, P = 0.038), with no significant change in cardiac output. Conversely, total peripheral resistance (TPR) significantly decreased following IET (MD: −100.38 dyne s−1 cm5, CI = −14.16 to −186.61, P = 0.023), with significant improvements in the low frequency to high frequency heart rate variability ratio (MD: −0.41, CI = −0.09 to −0.73, P = 0.013) and baroreceptor reflex sensitivity (MD: 7.43 ms/mmHg, P < 0.001).

Conclusion:

This work demonstrates that a reduction in TPR, potentially mediated through enhanced autonomic vasomotor control, is primarily responsible for BP reductions following IET. Furthermore, this novel analysis suggests wall squat interventions to be the most effective IET mode, with clinically relevant differences in BP reductions compared to handgrip and leg extension IET; although future direct comparative research is required.
Effects of Repealing the ACA Individual Mandate Penalty on Insurance Coverage and Marketplace Enrollment
Authors: Oyeka Onyinye I , Lyu Wei , Wehby George L.
Published: August 2022

Background:

Congress eliminated the individual mandate penalty of the Affordable Care Act (ACA) effective January 1, 2019.

Objective:

To examine the effects of repealing the ACA mandate penalty on private health insurance coverage and marketplace enrollment by leveraging state-based mandates in Massachusetts and New Jersey.

Research Design:

We employ synthetic control and difference-in-differences methods to compare insurance and enrollment changes separately in Massachusetts and New Jersey, which had insurance mandates effective in 2019, to other states without such mandates.

Subjects:

Adults aged 18–64 years with income of 150–300% and above 300% of the Federal Poverty Level who participated in the 2016–2019 American Community Survey (ACS) and adults aged 18–64 enrolled in insurance marketplaces based on state-level data from the 2016–2021 Marketplace Open Enrollment Period Public Use Files (MOEP-PUF).

Measures:

Any insurance, individually purchased coverage, and employer-sponsored coverage from the ACS and marketplace enrollment from the MOEP-PUF.

Results:

Changes in any coverage, individually purchased coverage, and employer-sponsored coverage rates are relatively small (generally in the range of 1–2 percentage points) and statistically nonsignificant in both Massachusetts and New Jersey compared with states without mandates. Furthermore, there is no discernable difference by eligibility for marketplace subsidies based on income level in the ACS data. Similarly, estimates for changes in marketplace enrollment are also small overall and statistically nonsignificant.

Conclusion:

Private insurance coverage rates and marketplace enrollment for adults 18–64 do not appear to have changed thus far owing to the 2019 repeal of the ACA individual mandate penalty.
How did Veterans’ Reliance on Veterans Health Administration Outpatient Care Change After Expansion of the Veterans Community Care Program?
Authors: Sterling Ryan A. , Liu Chuan-Fen , Hebert Paul L. , Fortney John C. , Swankoski Kaylyn E. , Katon Jodie G. , Wong Edwin S.
Published: August 2022

Background:

The Veterans Community Care Program (VCCP) aims to address access constraints in the Veterans Health Administration (VA) by reimbursing care from non-VA community providers. Little existing research explores how veterans’ choice of VA versus VCCP providers has evolved as a significant VCCP expansion in 2014 as part of the Veterans Access, Choice, and Accountability Act.

Objectives:

We examined changes in reliance on VA for primary care (PC), mental health (MH), and specialty care (SC) among VCCP-eligible veterans.

Research Design:

We linked VA administrative data with VCCP claims to retrospectively examine utilization during calendar years 2016–2018.

Subjects:

1.78 million veterans enrolled in VA before 2013 and VCCP-eligible in 2016 due to limited VA capacity or travel hardship.

Measures:

We measured reliance as the proportion of total annual outpatient (VA+VCCP) visits occurring in VA for PC, MH, and SC.

Results:

Of the 26.1 million total outpatient visits identified, 45.6% were for MH, 29.9% for PC, and 24.4% for SC. Over the 3 years, 83.2% of veterans used any VA services, 23.8% used any VCCP services, and 20.0% were dual VA-VCCP users. Modest but statistically significant declines in reliance were observed from 2016–2018 for PC (94.5%–92.2%), and MH (97.8%–96.9%), and a more significant decline was observed for SC (88.5%–79.8%).

Conclusions:

Veterans who have the option of selecting between VA or VCCP providers continued using VA for most of their outpatient care in the initial years after the 2014 VCCP expansion.
The value of 68Ga-PSMA-11 PET/CT in patients with prostate cancer and inconclusive standard imaging at primary staging
Authors: Nalliah Surenth , Zacho Helle D.
Published: August 2022

Objective

The current standard imaging recommended for primary staging of intermediate- and high-risk prostate cancer (PCa) consists of bone scintigraphy (BS) and computed tomography (CT). Some patients will have equivocal lesions or divergent findings on BS and CT, leading to inconclusive disease staging. Our aim was to investigate the value of 68Ga-PSMA-11 PET/CT in PCa with inconclusive disease stage based on standard imaging.

Methods

We made a single-center study of patients with newly diagnosed PCa who underwent a 68Ga-PSMA-11 PET/CT due to equivocal findings or discrepancies between BS and CT from 1 January 2017 to 31 December 2020. The value of 68Ga-PSMA-11 PET/CT was evaluated for each location of equivocal findings (regional lymphnode, nonregional lymphnodes, bones and other metastases) and on a patient level.

Results

Seventy-six patients were included in the study (62 patients with 72 equivocal lesions, 14 with discrepancy between BS and CT). Equivocal lesions were predominately in the bones (61%, 44/72), or in the regional lymph nodes (17%, 12/72). 68Ga-PSMA-11 PET/CT provided a conclusive diagnosis in 90% (65/72) of the equivocal lesions. All patients with discrepancies between BS and CT had definite answers after 68Ga-PSMA-11 PET/CT. 68Ga-PSMA-11 PET/CT also uncovered 32 additional sites of metastasis in 25 patients not visible by standard imaging.

Conclusion

68Ga-PSMA-11 PET/CT provides a definite disease stage in more than 90% of newly diagnosed patients with inconclusive standard imaging. Furthermore, it revealed additional sites of metastasis in 25 patients not detected by standard imaging.
Antibody-mediated rejection: prevention, monitoring and treatment dilemmas
Authors: Rodriguez-Ramirez Sonia , Al Jurdi Ayman , Konvalinka Ana , Riella Leonardo V.
Published: August 2022

Purpose of review

Antibody-mediated rejection (AMR) has emerged as the leading cause of late graft loss in kidney transplant recipients. Donor-specific antibodies are an independent risk factor for AMR and graft loss. However, not all donor-specific antibodies are pathogenic. AMR treatment is heterogeneous due to the lack of robust trials to support clinical decisions. This review provides an overview and comments on practical but relevant dilemmas physicians experience in managing kidney transplant recipients with AMR.

Recent findings

Active AMR with donor-specific antibodies may be treated with plasmapheresis, intravenous immunoglobulin and corticosteroids with additional therapies considered on a case-by-case basis. On the contrary, no treatment has been shown to be effective against chronic active AMR. Various biomarkers and prediction models to assess the individual risk of graft failure and response to rejection treatment show promise.

The ability to personalize management for a given kidney transplant recipient and identify treatments that will improve their long-term outcome remains a critical unmet need. Earlier identification of AMR with noninvasive biomarkers and prediction models to assess the individual risk of graft failure should be considered. Enrolling patients with AMR in clinical trials to assess novel therapeutic agents is highly encouraged.
A Patient With Large Cavernous Hemangioma in the Cavernous Sinus Straddling the Saddle With Bilateral Optic Nerve Compression
Authors: Ye Tang , Chen Baodong , Wu Tao , Ma Yuqiang
Published: August 2022

Background:

This report describes the removal of a giant cavernous hemangioma while protecting the blood vessels and nerves to the greatest degree of safety, relieving the intracranial space, and relieving the symptoms of the patient.

Methods:

Large cavernous hemangioma crossing into the cavernous sinus in a saddle surgery procedure was retrospectively analyzed, summarizing many cross-regional giant cavernous hemangioma treatments.

Results:

The patient underwent non-en bloc resection of the tumor with rapid removal. The internal carotid artery and adjacent nerves were safely preserved.

Conclusion:

Large cavernous hemangiomas spanning from the cavernous sinus to the area of the butterfly saddle require complete evaluation, and appropriate surgical entry should be selected. With the surgeon having rich surgical experience, the operation can protect the patient’s neurological function.