bluuebunny/crossref_metadata_2025 huggingface dataset:
Contribution of neuropsychiatric symptoms in Parkinson’s disease to different domains of caregiver burden
Authors: Chahine L. M. , Feldman R. , Althouse A. , Torsney B. , Alzyoud L. , Mantri S. , Edison B. , Albert S. , Daeschler M. , Kopil C. , Marras C.
Published: February 2021

Introduction

Caregiver burden is high among caregivers of PD patients (CPD). Neuropsychiatric symptoms are leading contributors to CPD burden, but whether different symptoms differentially impact domains of caregiver burden is not known. Our objective was to examine which neuropsychiatric symptoms and demographic factors contribute to different domains of caregiver burden in PD.

Methods

This was a cross-sectional online survey study. Participants were recruited from the Fox Insight (FI) study and were eligible if they identified themselves as a CPD. The primary outcome was the Caregiver Burden Inventory (CBI) total score and its 5 sub-domain scores. The Neuropsychiatric Inventory Questionnaire (NPI-Q) assessed caregiver-reported neuropsychiatric symptoms in the care recipient. Multivariable linear regression models were used to characterize the associations between NPI-Q symptom severity scores and CBI scores. Covariates were caregiver age, sex, education, and caregiving duration.

Results

The sample consisted of 450 CPD, mean age 65.87 (SD 10.39) years, 74% females. After adjusting for covariates, CBI total score was predicted by NPI-Q total score (β = 1.96, p < 0.001); model adjusted R2 = 39.2%. Anxiety severity had the largest effect size [standardized β (sβ) = 0.224] on the time-dependency domain, which was also associated with female sex (sβ = − 0.133) and age (sβ = 0.088). Severity of disinhibition (sβ = 0.218), agitation (sβ = 0.199), and female sex (sβ = 0.104) were associated with greater emotional burden.

Conclusion

Our findings indicate that demographic characteristics and specific neuropsychiatric symptoms contribute differentially to domains of caregiver burden. Tailored interventions to support CPD are needed.
Strategies for residual stress adjustment in bulk metal forming
Authors: Franceschi A. , Stahl J. , Kock C. , Selbmann R. , Ortmann-Ishkina S. , Jobst A. , Merklein M. , Kuhfuß B. , Bergmann M. , Behrens B.-A. , Volk W. , Groche P.
Published: February 2021

The family of bulk forming technologies comprises processes characterised by a complex three-dimensional stress and strain state. Besides shape and material properties, also residual stresses are modified during a bulk metal forming process. The state of residual stresses affects important properties, like fatigue behaviour and corrosion resistance. An adjustment of the residual stresses is possible through subsequent process steps such as heat treatments or mechanical surface modification technologies, like shot peening and deep rolling. However, these additional manufacturing steps involve supplementary costs, longer manufacturing times and harmful effects on the product quality. Therefore, an optimized strategy consists in a targeted introduction of residual stresses during the forming processes. To enable this approach, a fundamental understanding of the underlying mechanisms of residual stress generation in dependence of the forming parameters is necessary. The current state of the art is reviewed in this paper. Strategies for the manipulation of the residual stresses in different bulk forming processes are classified according to the underlying principles of process modification.
The influence of brain metastases on the central nervous system effects of methylnaltrexone: a post hoc analysis of 3 randomized, double-blind studies
Authors: Brenner Darren M. , Slatkin Neal E. , Stambler Nancy , Israel Robert J. , Coluzzi Paul H.
Published: February 2021

Purpose

Peripherally acting μ-opioid receptor antagonists such as methylnaltrexone (MNTX, Relistor®) are indicated for the treatment of opioid-induced constipation (OIC). The structural properties unique to MNTX restrict it from traversing the blood-brain barrier (BBB); however, the BBB may become more permeable in patients with brain metastases. We investigated whether the presence of brain metastases in cancer patients compromises the central effects of opioids among patients receiving MNTX for OIC.

Methods

This post hoc analysis of pooled data from 3 randomized, placebo-controlled trials included cancer patients with OIC who received MNTX or placebo. Endpoints included changes from baseline in pain scores, rescue-free laxation (RFL) within 4 or 24 h of the first dose, and treatment-emergent adverse events (TEAEs), including those potentially related to opioid withdrawal symptoms.

Results

Among 356 cancer patients in the pooled population, 47 (MNTX n = 27; placebo n = 20) had brain metastases and 309 (MNTX n = 172; placebo n = 137) did not have brain metastases. No significant differences in current pain, worst pain, or change in pain scores from baseline were observed between patients treated with MNTX or placebo. Among patients with brain metastases, a significantly greater proportion of patients who received MNTX versus placebo achieved an RFL within 4 h after the first dose (70.4% vs 15.0%, respectively, p = 0.0002). TEAEs were similar between treatment groups and were generally gastrointestinal in nature and not related to opioid withdrawal.

Conclusion

Focal disruptions of the BBB caused by brain metastases did not appear to alter central nervous system penetrance of MNTX.
Applying MDD in the content management system domain
Authors: Priefer Dennis , Rost Wolf , Strüber Daniel , Taentzer Gabriele , Kneisel Peter
Published: February 2021

Content management systems (CMSs) such as Joomla and WordPress dominate today’s web. Enabled by standardized extensions, administrators can build powerful web applications for diverse customer demands. However, developing CMS extensions requires sophisticated technical knowledge, and the complex code structure of an extension gives rise to errors during typical development and migration scenarios. Model-driven development (MDD) seems to be a promising paradigm to address these challenges; however, it has not found adoption in the CMS domain yet. Systematic evidence of the benefit of applying MDD in this domain could facilitate its adoption; however, an empirical investigation of this benefit is currently lacking. In this paper, we present a mixed-method empirical investigation of applying MDD in the CMS domain, based on an interview suite, a controlled experiment, a field experiment, and case studies. During the experiments, we used JooMDD, an MDD infrastructure instantiation for CMS extensions. This infrastructure, which is also presented in this work, consists of a DSL with model editors, code generators, and reverse engineering facilities. We consider three scenarios of developing new (both independent and dependent) CMS extensions and of migrating existing ones to a new major platform version. The experienced developers in our interviews acknowledge the relevance of these scenarios and report on experiences that render them suitable candidates for a successful application of MDD. We found a particularly high relevance of the migration scenario. Our experiments largely confirm the potentials and limits of MDD as identified for other domains. In particular, we found a productivity increase up to factor 11.7 and a quality increase up to factor 2.4 during the development of CMS extensions. Furthermore, our observations highlight the importance of good tooling that seamlessly integrates with already used tool environments and processes.
Side effects of topical atropine 0.05% compared to 0.01% for myopia control in German school children: a pilot study
Authors: Joachimsen Lutz , Farassat Navid , Bleul Tim , Böhringer Daniel , Lagrèze Wolf A. , Reich Michael
Published: February 2021

Purpose

Based on findings of the Asian low-concentration atropine for myopia progression study, a concentration of 0.05% has been proposed as a good compromise between safety and efficacy for myopia control. However, no data on side effects have been published so far in Caucasian children receiving this dose.

Methods

Prior to commencement of bilateral atropine treatment with 0.05% atropine, 19 myopic children aged 5 to 15 years were treated in only one eye at bedtime leaving the other eye as a control. Pupil size, accommodation amplitude and near visual acuity were measured at 10:00 a.m. the next day and compared to the untreated contralateral control eye. The results were then compared to a cohort of 18 children whose treatment with 0.01% atropine commenced in a similar fashion.

Results

Twelve children (63%) reported visual impairment or reading difficulties. Anisocoria was 2.9 ± 1.1 mm. In comparison, 0.01% atropine led to a significantly less anisocoria of 0.8 ± 0.7 mm (p < 0.0001). Accommodation was decreased by − 4.2 ± 3.8 D in 0.05% atropine treated eyes, whereas 0.01% atropine induced hypoaccommodation of − 0.05 ± 2.5 D (p < 0.01). Near visual acuity was not significantly reduced in eyes treated with 0.05% atropine compared to 0.01% atropine (p = 0.26).

Conclusion

Compared to 0.01%, our data indicate stronger more relevant side effects of 0.05% topical atropine in young Caucasian children with progressive myopia as recently reported in Asian children, potentially compromising acceptance and compliance.
Reasoning with Ambiguity
Authors: Wurm Christian
Published: February 2021

We treat the problem of reasoning with ambiguous propositions. Even though ambiguity is obviously problematic for reasoning, it is no less obvious that ambiguous propositions entail other propositions (both ambiguous and unambiguous), and are entailed by other propositions. This article gives a formal analysis of the underlying mechanisms, both from an algebraic and a logical point of view. The main result can be summarized as follows: sound (and complete) reasoning with ambiguity requires a distinction between equivalence on the one and congruence on the other side: the fact that$$\alpha $$αentails$$\beta $$βdoesnotimply$$\beta $$βcan be substituted for$$\alpha $$αin all contexts preserving truth. Without this distinction, we will always run into paradoxical results. We present the (cut-free) sequent calculus$$\mathsf {AL}^{\textit{cf}}$$ALcf, which we conjecture implements sound and complete propositional reasoning with ambiguity, and provide it with a language-theoretic semantics, where letters represent unambiguous meanings and concatenation represents ambiguity.
Fundamental material property trends in the La0.8-xNdxCa0.2FeO3-δ series: crystal structure and thermal expansion
Authors: Berger Christian , Bucher Edith , Lammer Judith , Nader Christina , Sitte Werner
Published: February 2021

Compounds from the series La0.8-xNdxCa0.2FeO3-δ (0.1 ≤ x ≤ 0.7) were synthesised by a sol–gel route. X-ray diffraction and Rietveld analysis showed that materials with 0 ≤ x ≤ 0.6 crystallize as single-phase orthorhombic perovskites. The smaller ionic radius of Nd3+ compared to La3+ leads to a decrease in unit cell volume with increasing x. Elemental mapping by high-resolution scanning transmission electron microscopy with energy-dispersive X-ray spectroscopy confirms the homogeneous distribution of the A-site elements (La, Nd and Ca) in the perovskite (ABO3) lattice. The thermal expansion behaviour of La0.8-xNdxCa0.2FeO3-δ (0 ≤ x ≤ 0.6) was characterized by dilatometry at 30 ≤ T/°C ≤ 1000 and 1 × 10–3 ≤ pO2/bar ≤ 1. The thermal expansion coefficients of La0.8-xNdxCa0.2FeO3-δ, which were determined in regions I (40–530 °C) and II (530–990 °C), respectively, are almost independent of the Nd concentration in the range of (0 ≤ x ≤ 0.6) and increase slightly with decreasing pO2. The transition from orthorhombic to trigonal modification, which is observed for La0.8Ca0.2FeO3-δ at approx. 740 °C, is suppressed for all Nd-substituted compounds with x ≥ 0.1.
Ways of Seeing Christ the Judge: The Iconography of Christ III and its Visual Context
Authors: Jones Natalie
Published: February 2021

This article examines the iconographic programme of the Last Judgement scene depicted inChrist III. A notable feature of the poem’s detailed visual programme is the way in which it provides the audience with a single, panoramic vision that encompasses the divergent perspectives of the blessed and the damned. It is on account of this dual perspective that the poem, through its precise use of language and imagery, presents the audience with a bifocal vision of Christ as King of Kings and Judge of the World, in keeping with the words of Revelation 19:16. A detailed analysis of the poem’s imagery, however, suggests that its portrait of Christ as Judge is not only informed by scripture and exegetical sources, but is also indebted to contemporary visual imagery, particularly the depiction of Christ asMajestas Domini, or Christ in Majesty. As a result, and by approaching the poem’s imagery from an iconological perspective, it is argued that the poet ofChrist IIIhad a detailed knowledge of contemporary Christological motifs. Furthermore, a careful analysis of the language used to describe the Judgement scene, and particularly the depiction of Christ as Judge, suggests that the poet intentionally seeks to evoke a range of specific visual images in the mind of his audience in order to amplify the poem’s instructive and penitential aims.
Disentangling the corporate entrepreneurship construct: conceptualizing through co-words
Authors: Castriotta Manuel , Loi Michela , Marku Elona , Moi Ludovica
Published: February 2021

This study defines the conceptual structure of corporate entrepreneurship (CE) by looking at the terms scholars have used over the last 26 years of research. With the use of a co-word analysis, five distinctive dimensions of CE and the evolution of related key terms are identified: sustained regeneration, competitive advantage, external entrepreneurship, organizational rejuvenation, and domain redefinition. Over time scholars’ attention has shifted from strategy to entrepreneurship by highlighting the relevance of the terms ‘intrapreneurship’ and ‘entrepreneurial orientation’. Surprisingly, concepts related to strategic entrepreneurship and strategic renewal are less relevant than expected. Besides laying the ground for a shared conceptualization of CE, this study highlights how bibliomeitrics can contribute to decreasing conceptual ambiguity in emergent research fields, such as entrepreneurship. Implications for managers on how to strategically create and develop CE within different organizational settings are also discussed.
Precious Metal Distributions Between Copper Matte and Slag at High $$ P_{{{\text{SO}}_{ 2} }} $$ in WEEE Reprocessing
Authors: Chen Min , Avarmaa Katri , Klemettinen Lassi , O’Brien Hugh , Shi Junjie , Taskinen Pekka , Lindberg Daniel , Jokilaakso Ari
Published: February 2021

The distributions of precious metals (gold, silver, platinum, and palladium) between copper matte and silica-saturated FeO
x
-SiO2/FeO
x
-SiO2-Al2O3/FeO
x
-SiO2-Al2O3-CaO slags were investigated at 1300 °C and

$$ P_{{{\text{SO}}_{ 2} }} $$

P

SO
2

= 0.5 atm. The experiments were carried out in silica crucibles under flowing CO-CO2-SO2-Ar gas atmosphere. The concentrations of precious metals in matte and slag were analyzed by Electron Probe X-ray Microanalysis and Laser Ablation-High-Resolution Inductively Coupled Plasma-Mass Spectrometry, respectively. The precious metal concentrations in matte and slag, as well as the distribution coefficients of precious metals between matte and slag, were displayed as a function of matte grade. The present results obtained at

$$ P_{{{\text{SO}}_{ 2} }} $$

P

SO
2

of 0.5 atm were compared with previous results at

$$ P_{{{\text{SO}}_{ 2} }} $$

P

SO
2

of 0.1 atm for revealing the effects of

$$ P_{{{\text{SO}}_{ 2} }} $$

P

SO
2

and selected slag modifiers (CaO and Al2O3) on precious metal distributions at copper matte smelting conditions. The present results also contribute experimental thermodynamic data of precious metal distributions in pyrometallurgical reprocessing of electronic waste via copper smelting processes.
Correction to: Study on Ultimate Compressive Strength of Aluminium-Alloy Plates and Stiffened Panels
Authors: Liu Bin , Doan Van Tuyen , Garbatov Y. , Wu Weiguo , Soares C. Guedes
Published: February 2021

A Correction to this paper has been published: 10.1007/s11804-021-00194-2
Single-Cell RNA Sequencing of the Adult Mammalian Heart—State-of-the-Art and Future Perspectives
Authors: Gladka Monika M.
Published: February 2021

Purpose of the Review

Cardiovascular disease remains the leading cause of death worldwide, resulting in cardiac dysfunction and, subsequently, heart failure (HF). Single-cell RNA sequencing (scRNA-seq) is a rapidly developing tool for studying the transcriptional heterogeneity in both healthy and diseased hearts. Wide applications of techniques like scRNA-seq could significantly contribute to uncovering the molecular mechanisms involved in the onset and progression to HF and contribute to the development of new, improved therapies. This review discusses several studies that successfully applied scRNA-seq to the mouse and human heart using various methods of tissue processing and downstream analysis.

Recent Findings

The application of scRNA-seq in the cardiovascular field is continuously expanding, providing new detailed insights into cardiac pathophysiology.

Increased understanding of cardiac pathophysiology on the single-cell level will contribute to the development of novel, more effective therapeutic strategies. Here, we summarise the possible application of scRNA-seq to the adult mammalian heart.
Not all homeowners are alike: a segmentation model based on a quantitative analysis of Dutch adopters of residential photovoltaics
Authors: Broers Wendy , Vasseur Veronique , Kemp René , Abujidi Nurhan , Vroon Zeger
Published: February 2021

The implementation of residential photovoltaics must increase more rapidly to combat climate change and its impacts. This challenge is addressed in this study by introducing a segmentation model in order to develop a theoretical and empirical foundation for understanding the heterogeneity of potential adopters. Data were collected by means of a survey among Dutch adopters (n = 1395) and the data is analysed with statistical descriptive analyses and nonparametric tests. The five segmentation groups are divided by the homeowners’ educational background or profession (technical, financial-economic or other) and level of environmental concern. The results demonstrate that the groups are substantial in size and that there are significant differences between these groups on personal characteristics such as homeowners’ level of environmental concern and the level of influence of their social network on their decision to adopt. In addition, significant differences are found between the groups on the perceived characteristics of the residential photovoltaics such as perceived complexity and aesthetics, and the amount of previous practice with other energy measures in their home. Accordingly, these insights can be used by policymakers and the public and private sectors to promote residential photovoltaics more effectively by targeting the segmentation groups more adequately. The different groups will be drawn to different aspects and therefore, a broader pallet of benefits must be presented; a mix of different communication channels must be used; objective and non-technical assistance in the decision-making must be offered; and different kind of products must be provided.
Checkpoint inhibitor induced hepatitis and the relation with liver metastasis and outcome in advanced melanoma patients
Authors: Biewenga Maaike , van der Kooij Monique K. , Wouters Michel W. J. M. , Aarts Maureen J. B. , van den Berkmortel Franchette W. P. J. , de Groot Jan Willem B. , Boers-Sonderen Marye J. , Hospers Geke A. P. , Piersma Djura , van Rijn Rozemarijn S. , Suijkerbuijk Karijn P. M. , ten Tije Albert J. , van der Veldt Astrid A. M. , Vreugdenhil Gerard , Haanen John B. A. G. , van der Eertwegh Alfons J. M. , van Hoek Bart , Kapiteijn Ellen
Published: February 2021

Background

Checkpoint inhibitor-induced hepatitis is an immune-related adverse event of programmed cell death protein 1 (PD-1) inhibition, cytotoxic T-lymphocyte associated 4 (CTLA-4) inhibition or the combination of both. Aim of this study was to assess whether checkpoint inhibitor-induced hepatitis is related to liver metastasis and outcome in a real-world nationwide cohort.

Methods

Data from the prospective nationwide Dutch Melanoma Treatment Registry (DMTR) was used to analyze incidence, risk factors of checkpoint inhibitor-induced grade 3–4 hepatitis and outcome.

Results

2561 advanced cutaneous melanoma patients received 3111 treatments with checkpoint inhibitors between May 2012 and January 2019. Severe hepatitis occurred in 30/1620 (1.8%) patients treated with PD-1 inhibitors, in 29/1105 (2.6%) patients treated with ipilimumab and in 80/386 (20.7%) patients treated with combination therapy. Patients with hepatitis had a similar prevalence of liver metastasis compared to patients without hepatitis (32% vs. 27%; p = 0.58 for PD-1 inhibitors; 42% vs. 29%; p = 0.16 for ipilimumab; 38% vs. 43%; p = 0.50 for combination therapy). There was no difference in median progression free and overall survival between patients with and without hepatitis (6.0 months vs. 5.4 months progression-free survival; p = 0.61; 17.0 vs. 16.2 months overall survival; p = 0.44).

Conclusion

Incidence of hepatitis in a real-world cohort is 1.8% for PD-1 inhibitor, 2.6% for ipilimumab and 20.7% for combination therapy. Checkpoint inhibitor-induced hepatitis had no relation with liver metastasis and had no negative effect on the outcome.
On Finite Energy Solutions of 4-harmonic and ES-4-harmonic Maps
Authors: Branding Volker
Published: February 2021

4-harmonic and ES-4-harmonic maps are two generalizations of the well-studied harmonic map equation which are both given by a nonlinear elliptic partial differential equation of order eight. Due to the large number of derivatives it is very difficult to find any difference in the qualitative behavior of these two variational problems. In this article we prove that finite energy solutions of both 4-harmonic and ES-4-harmonic maps from Euclidean space must be trivial. However, the energy that we require to be finite is different for 4-harmonic and ES-4-harmonic maps pointing out a first difference between these two variational problems.
Translational Science for Climate Services: Mapping and Understanding Users’ Climate Service Needs in CSSP China
Authors: Opitz-Stapleton Sarah , Street Roger , Ye Qian , Han Jiarui , Hewitt Chris D.
Published: February 2021

The Climate Science for Service Partnership China (CSSP China) is a joint program between China and the United Kingdom to build the basis for climate services to support the weather and climate resilient economic development and welfare in China. Work Package 5 (WP5) provides the translational science on identification of: different users and providers, and their mandates; factors contributing to communication gaps and capacities between various users and providers; and mechanisms to work through such issues to develop and/or evolve a range of climate services. Key findings to emerge include that users from different sectors have varying capacities, requirements, and needs for information in their decision contexts, with a current strong preference for weather information. Separating climate and weather services when engaging users is often not constructive. Furthermore, there is a need to move to a service delivery model that is more user-driven and science informed; having sound climate science is not enough to develop services that are credible, salient, reliable, or timely for diverse user groups. Greater investment in building the capacity of the research community supporting and providing climate services to conduct translational sciences and develop regular user engagement processes is much needed. Such a move would help support the China Meteorological Administration’s (CMA) ongoing efforts to improve climate services. It would also assist in potentially linking a broader group of “super” users who currently act as providers and purveyors of climate services because they find the existing offerings are not relevant to their needs or cannot access CMA’s services.
Von Gallup zu Big Data. Rekonstruktion und Neujustierung der Debatte über Meinungsforschung und Demokratie
Authors: Dormal Michel
Published: February 2021

Ausgangspunkt des Beitrags ist die Feststellung, dass im Zuge aktueller Debatten über Big Data, wie sie etwa der Skandal rund um Cambridge Analytica und Facebook provozierte, eine Reihe von weiterhin unbeantworteten Fragen wieder auftauchen, die bereits in der älteren Kontroverse rund um das Verhältnis von Demoskopie und Demokratie verhandelt wurden. Auf diese Kontroverse wird daher entlang der vier Punkte Aufklärung, Gleichheit, Teilhabe und gutes Regieren ein neuer Blick geworfen. Im Ergebnis wird ein demoskopischer und ein konfigurativer Modus der Verdopplung von Gesellschaft idealtypisch unterschieden. Beide haben an einer modernen Entwicklung teil, in der von Einheit auf Pluralität umgestellt wird. Im Sinne eines demokratietheoretischen Pluralismus wird versucht, Minimalbedingungen einer komplexen Balance zu benennen und mögliche Herausforderungen derselben durch neue Technologien herauszuarbeiten. Diese zugleich offene und auf einer gewissen Abstraktionshöhe angesiedelte Perspektive vermag nicht nur, die Kontinuität in der Diskontinuität und die Herausforderungen durch Big-Data-gestützte Formen der Demoskopie neu zu beschreiben, sondern eignet sich auch als Heuristik für konkrete Problemfelder.
Review and Development of Electric Motor Systems and Electric Powertrains for New Energy Vehicles
Authors: Cai William , Wu Xiaogang , Zhou Minghao , Liang Yafei , Wang Yujin
Published: February 2021

This paper presents a review on the recent research and technical progress of electric motor systems and electric powertrains for new energy vehicles. Through the analysis and comparison of direct current motor, induction motor, and synchronous motor, it is found that permanent magnet synchronous motor has better overall performance; by comparison with converters with Si-based IGBTs, it is found converters with SiC MOSFETs show significantly higher efficiency and increase driving mileage per charge. In addition, the pros and cons of different control strategies and algorithms are demonstrated. Next, by comparing series, parallel, and power split hybrid powertrains, the series–parallel compound hybrid powertrains are found to provide better fuel economy. Different electric powertrains, hybrid powertrains, and range-extended electric systems are also detailed, and their advantages and disadvantages are described. Finally, the technology roadmap over the next 15 years is proposed regarding traction motor, power electronic converter and electric powertrain as well as the key materials and components at each time frame.
Weight loss monitoring reduces the occurrence of neonatal hypernatremic dehydration in breastfeeding neonates
Authors: Zia Muhammad TK. , Golombek Sergio , Nitkowski-Keever Sabrina , Paudel Umesh
Published: February 2021

Background:

Excessive weight loss enhances the incidence of neonatal hypernatremic dehydration (NHD). We compared the effect of a new breastfeeding policy against an old breastfeeding policy on neonatal weight change and the incidence of NHD.

Methods:

This was a QA project between two sets of breastfeeding (BF) protocols for exclusively BF newborns. Under our old BF policy, a number of neonates had a significant loss of weight after birth and were admitted to the NICU due to NHD. We implemented a new BF policy that was used when a newborn loses>5% of previously recorded weight within a 24-h interval. Two groups were compared: the preintervention group (old BF policy) and postintervention group (new BF policy). Additionally, characteristics of newborns admitted to NICU were separately compared with the subgroup of pre- and post intervention dehydration groups.

Results:

Preintervention = 1320 and postintervention = 1450. Neonates with weight loss of > 5% within the first 24-h time interval were higher in the postintervention group (19.7%) as compared to the pre-intervention group (10.2%) (P < .05). However, the number of infants diagnosed to have NHD was lower in the postintervention group (0.68%) than in the preintervention group (1.66%), (P < .03). Neonatal characteristics were comparable between subgroups of dehydration.

Conclusion:

An intervention at ≥ 5% neonatal weight loss markedly reduces the incidence of NHD- associated NICU admissions.
Guidelines for Patient-Centered Opioid Prescribing and Optimal FDA-Compliant Disposal of Excess Pills after Inpatient Operation: Prospective Clinical Trial
Authors: Porter Eleah D. , Bessen Sarah Y. , Molloy Ilda B. , Kelly Julia L. , Ramkumar Niveditta , Phillips Joseph D. , Loehrer Andrew P. , Wilson Matthew Z. , Hasson Rian M. , Ivatury Srinivas J. , Henkin Jessica R. , Barth Richard J.
Published: February 2021

BACKGROUND:

To optimize responsible opioid prescribing after inpatient operation, we implemented a clinical trial with the following objectives: prospectively validate patient-centered opioid prescription guidelines and increase the FDA-compliant disposal rate of leftover opioid pills to higher than currently reported rates of 20% to 30%.

STUDY DESIGN:

We prospectively enrolled 229 patients admitted for 48 hours or longer after elective general, colorectal, urologic, gynecologic, or thoracic operation. At discharge, patients received a prescription for both nonopioid analgesics and opioids based on their opioid usage the day before discharge: if 0 oral morphine milligram equivalents (MME) were used, then five 5-mg oxycodone pill-equivalents were prescribed; if 1 to 29 MME were used, then fifteen 5-mg oxycodone pill-equivalents were prescribed; if 30 or more MME were used, then thirty 5-mg oxycodone pill-equivalents were prescribed. We considered patients' opioid pain medication needs to be satisfied if no opioid refills were obtained. To improve FDA-compliant disposal of leftover pills, we implemented patient education, convenient drop-box, reminder phone call, and questionnaire.

RESULTS:

Our opioid guideline satisfied 93% (213 of 229) of patients. Satisfaction was significantly higher in lower opioid usage groups (p = 0.001): 99% (99 of 100) in the 0 MME group, 90% (91 of 101) in the 1 to 29 MME group, and 82% (23 of 28) in the 30 or more MME group. Overall, 95% (217 of 229) of patients used nonopioid analgesics. Sixty percent (138 of 229) had leftover pills; 83% (114 of 138) disposed of them using an FDA-compliant method and 51% (58 of 114) used the convenient drop-box. Of 2,604 prescribed pills, only 187 (7%) were kept by patients.

CONCLUSIONS:

This clinical trial prospectively validated a patient-centered opioid discharge prescription guideline that satisfied 93% of patients. FDA-compliant disposal of excess pills was achieved in 83% of patients with easily actionable interventions.
ICD-11 Paraphilic Disorders: A South African Analysis of Its Utility in the Medico-Legal Context
Authors: Artz Lillian , Swanepoel Magdaleen , Nagdee Mohammed , Combrinck Helene , Kaliski Sean , Stein Dan J. , Butterworth J.
Published: February 2021

Background

In an effort to improve the clinical utility of the ICD-10, the WHO Working Group on the Classification of Sexual Disorders and Sexual Health recommended a new classification of Paraphilic Disorders in the ICD-11 to replace the ICD-10 section on Disorders of Sexual Preference. The proposed classification may have different implications for different countries. AIM: To examine South African national laws and policies, within which Paraphilic Disorders are encountered, and to assess the implications of the new classification.

Method

A South African working group - representing experts within the disciplines of criminal law, psychiatry, psychology, public health, and criminology - reviewed: (i) national laws affected by reclassification, (ii) current practices in the psycho-legal assessment of sexual offenders, (iii) the implications of the reclassification for assessment and decision-making in forensic practice and other health settings, (iv) specific implications of the reclassification for diagnosis, and (v) implications of the reclassification as it relates to the demographic and sociocultural context of South Africa.

Outcomes

As a rule, South African courts do not accept the existence of a Paraphilic Disorder on its own to be sufficient grounds to absolve any defendant from criminal responsibility though defence. Nevertheless, a diagnosis such as coercive sexual sadism disorder runs the risk of medicalization of criminal behavior with inappropriate use to mitigate sentences.

Clinical Implications

The ICD-11 approach is clinically useful in emphasizing that a broad range of sexual behavior fall under the rubric of healthy sexual behavior, but also that compulsive sexual behavior can be pathological.

Strengths and Limitations

This analysis was conducted by an interdisciplinary expert group, aligning international forensic mental health and national legal constructs in a low-middle income country (LMIC). The analysis is limited by its reliance on expert opinion rather than empirical data.

CONCLUSIONS

It is recommended that the ICD-11 includes a cautionary statement for forensic use, highlighting the fact that the mere inclusion of a diagnosis in the ICD-11 does not necessarily have forensic relevance.
Principles of Integrated Marketing Communications
Authors: Ang Lawrence
Published: February 2021

Marketing in the digital age poses major challenges for traditional and established practices of communication. To help readers meet these challenges Principles of Integrated Marketing Communications: An Evidence-based Approach provides a comprehensive foundation to the principles and practices of integrated marketing communications (IMC). It examines a variety of traditional and digital channels used by professionals to create wide-reaching and effective campaigns that are adapted for the aims of their organisations. This edition has been thoroughly revised and each chapter includes: case studies of significant and award-winning campaigns from both Australian and international brands that illustrate the application of explored concepts; discussion and case study questions that enable readers to critically evaluate concepts and campaigns; a managerial application section that illustrates how concepts can be applied effectively in a real situation; a 'further thinking' section that expands knowledge of advanced concepts and challenges readers to think more broadly about IMC.
Manuel II Palaiologos (1350–1425)
Authors: Çelik Siren
Published: February 2021

Few Byzantine emperors had a life as rich and as turbulent as Manuel II Palaiologos. A fascinating figure at the crossroads of Byzantine, Western European and Ottoman history, he endured political turmoil, witnessed no less than three sieges by the Ottomans and travelled as far as France and England. He was a prolific writer, producing a vast corpus of literary, theological and philosophical works. Yet, despite his talent, Manuel has largely been ignored as an author. This biography constructs an in-depth picture of him of as a ruler, author and personality, as well as providing insight into his world and times. It offers the first analysis of the emperor's complete oeuvre, focusing on his literary style, self-representation philosophical/theological thought. By focusing not only on political events, but also on the personality, personal life and literary output of Manuel, this biography paints a new portrait of a multifaceted emperor.
Access to Endovascular Thrombectomy for Stroke in Rural Versus Urban Regions
Authors: Yan Yi , Hu Kai , Alcock Susan , Ghrooda Esseddeeg , Trivedi Anurag , McEachern James , Kaderali Zul , Shankar Jai
Published: February 2021

Purpose:

Endovascular thrombectomy (EVT) significantly improves outcomes for acute ischemic stroke patients with large vessel occlusion (LVO) who present in a time sensitive manner. Prolonged EVT access times may reduce benefits for eligible patients. We evaluated the efficiency of EVT services including EVT rates, onset-to-CTA time and onset-to-groin puncture time in our province.

Materials and methods:

Three areas were defined: zone I- urban region, zone II-areas within 1 h drive distance from the Comprehensive Stroke Center (CSC); and zone III-areas more than 1hr drive distance from the CSC. In this retrospective cohort study, EVT rate, onset-to-groin puncture time and onset-to-CTA time were compared among the three groups using Krustal–Wallis and Wilcoxon tests.

Results:

The EVT rate per 100,000 inhabitants for urban zone I was 8.6 as compared to 5.1 in zone II, and 7.5 in zone III. Compared to zone I (114 min; 95% CI (96, 132); n = 128), mean onset-to-CTA time was 19 min longer in zone II (133 min; 95% CI (77, 189); n = 23; p = 0.0459) and 103 min longer in zone III (217 min, 95% CI (162, 272); n = 44; p < 0.0001). Compared to zone I (209 min, 95% CI (181, 238)), mean onset-to-groin puncture time was 22 min longer in zone II (231 min, 95% CI (174, 288); p = 0.046) but 163 min longer in zone III (372 min, 95% CI (312, 432); p < 0.0001).

Conclusion:

EVT access in rural areas is considerably reduced with significantly longer onset-to-groin puncture times and onset-to-CTA times when compared to our urban area. This may help in modifying the patient transfer policy for EVT referral.
Converging Luminosity in Column‐Sprite Filaments
Authors: Gomez Kuri Z. , Soula S. , Neubert T. , Mlynarczyk J. , Köhn C.
Published: February 2021

Sprites are electrical discharges in the mesosphere powered by the quasi‐electrostatic field following a cloud‐to‐ground lightning stroke. They are luminous structures with tendrils formed by a space charge wave with high electric fields that ionizes the atmosphere, excites optical emissions and leaves a trail of enhanced densities of electrons, and negative and positive ions. The duration of the luminous streamers in sprites is usually ∼1–10 ms. In this study, we present observations of sprite streamer filaments where the upper and lower ends continue to glow for more than 80 ms while the two ends slowly converge and fade. Simultaneous magnetic observations suggest that the field in the mesosphere is maintained at a high value by the long‐lasting continuing current of the causative stroke. We propose that the observation is a signature of currents in the filaments fed by electrons detached from negative ions at the lower origin.
Negative Pressure Perturbations Associated With Tornado‐Scale Vortices in the Tropical Cyclone Boundary Layer
Authors: Feng Yecheng , Wu Liguang , Liu Qingyuan , Zhou Weican
Published: February 2021

Dangerous turbulences were observed in the eyewall of category 5 Hurricane Hugo (1989) and the surface pressure associated with the turbulence was 8 hPa lower than the mean pressure in the eye. In this study, it is demonstrated that small scale, negative pressure perturbations in the tropical cyclone eyewall are associated with the tornado‐scale vortex (TSV) simulated with the large‐eddy simulation technique in a semi‐idealized numerical experiment. The negative pressure perturbation associated with TSVs is nonhydrostatic, dynamically resulting from the shearing effect. As a result, the negative pressure perturbation is linearly correlated with the vertical component of relative vorticity and maximum wind perturbation. Since the TSV is prevalent near the inner edge of the tropical cyclone eyewall, it is suggested that caution should be taken to estimate the central pressure of tropical cyclones with the extremely low pressure observed in the eyewall.
Variable In Situ Stress Orientations Across the Northern Hikurangi Subduction Margin
Authors: McNamara D. D. , Behboudi E. , Wallace L. , Saffer D. , Cook A. E. , Fagereng A. , Paganoni M. , Wu Hung‐Yu , Kim G. , Lee H. , Savage H. M. , Barnes P. , Pecher I. , LeVay L. J. , Petronotis K. E.
Published: February 2021

We constrain orientations of the horizontal stress field from borehole image data in a transect across the Hikurangi Subduction Margin. This region experiences NW‐SE convergence and is the site of recurrent slow slip events. The direction of the horizontal maximum stress is E‐W at an active splay thrust fault near the subduction margin trench. This trend changes to NNW‐SSE in a forearc trench slope basin on the offshore accretionary wedge, and to NE‐SW in the onshore forearc. Multiple, tectonic, and geological processes, either individually or in concert, may explain this variability. The observed offshore to onshore stress rotation may reflect a change from dominantly compressional tectonics at the deformation front, to a strike‐slip and/or extensional tectonic regime closer to the Taupo Volcanic Zone, further inland. In addition, the offshore stress may be affected by topography and/or stress rotation around subducting seamounts, and/or temporal stress changes during the slow slip cycle.
Halogen Bearing Amphiboles, Aqueous Fluids, and Melts in Subduction Zones: Insights on Halogen Cycle From Electrical Conductivity
Authors: Manthilake G. , Koga K. T. , Peng Y. , Mookherjee M.
Published: February 2021

Amphiboles are hydrous minerals that are formed in the oceanic crust via hydrothermal alteration. The partial substitution of halogens for OH− makes amphibole one of the principal hosts of Cl and F in the subducting slab. In this study, we investigated the electrical conductivity of a suite of halogen bearing amphibole minerals at 1.5 GPa up to 1,400 K. The discontinuous electrical behavior indicates dehydration of amphibole at ∼915 K. This is followed by dehydration induced hydrous melting at temperatures above 1,070 K. We find that the released aqueous fluids have an electrical conductivity of ∼0.1 S/m. This high electrical conductivity is likely to explain anomalously high electrical conductivity observed in certain subduction zone settings. This high electrical conductivity of an order of magnitude greater than the electrical conductivity of pure aqueous fluids at similar conditions is likely due to the partitioning of the F and Cl into the aqueous fluids. We also noted that subsequent to the dehydration, secondary phases form due to the breakdown of the primary halogen bearing amphibole. Chemical analyses of these secondary phases indicate that they are repositories of F and Cl. Hence, we infer that upon dehydration of the primary halogen bearing amphibole, first the F and Cl are partitioned into the aqueous fluids and then the halogens are partitioned back to the secondary mineral phases. These secondary minerals are likely to transport the halogen to the deep Earth and may in part explain the halogen concentration observed in ocean island basalt.
Potential Impacts of Supersonic Aircraft Emissions on Ozone and Resulting Forcing on Climate: An Update on Historical Analysis
Authors: Zhang Jun , Wuebbles Donald , Kinnison Douglas , Baughcum Steven L.
Published: February 2021

Commercial aircraft flying at supersonic speeds in the lower stratosphere are being discussed once again after a hiatus of almost 20 years. Potential environmental effects from fleets of such aircraft need to be understood for their possible impacts on stratospheric ozone; levels of stratospheric ozone determine the amount of biologically harmful ultraviolet radiation from the Sun reaching the Earth's surface. Changes in the distribution and concentrations of ozone also have implications on climate. This study evaluates the potential impact on stratospheric ozone and on climate forcing from different levels of nitrogen oxides (NOx) and water vapor (H2O) emissions from supersonic transport. Toward establishing a baseline relative to prior studies, we also compare these new analyses with results from the 1999 aviation assessments, using the same aviation emissions. Despite the understanding of atmospheric processes used in studying chemistry‐climate interactions have been greatly enhanced over the last 20 years, this study finds that, for the baseline scenario, the resulting effects on stratospheric ozone are similar to those from many of the models in the prior assessment, although with a stronger ozone sensitivity to NOx emissions. We show that the resulting ozone effects largely depend on the NOx and H2O emission levels and the net changes in stratospheric ozone are determined by the chemical interactions between different ozone production and depletion cycles. We also calculate the radiative forcing impact for the resulting changes in the distributions of ozone and H2O, and confirm that stratospheric H2O emissions are an important factor in potential climate impacts from supersonic aircraft emissions.
The Spatial and Temporal Distribution of Nighttime Ozone and Sulfur Dioxide in the Venus Mesosphere as Deduced From SPICAV UV Stellar Occultations
Authors: Evdokimova D. , Belyaev D. , Montmessin F. , Korablev O. , Bertaux J.‐L. , Verdier L. , Lefèvre F. , Marcq E.
Published: February 2021

The nighttime ozone and sulfur dioxide distributions were analyzed using the entire Spectroscopy for the Investigation of the Characteristics of the Atmosphere of Venus (SPICAV) UV/Venus Express stellar occultation data set. After the discovery of an ozone layer at 100 km in the mesosphere reported by Montmessin, Bertaux, et al. (2011, https://doi.org/10.1016/j.icarus.2011.08.010), 132 other detections were made during the entire 8 years long observing period of the SPICAV UV instrument. In the rare detections, the peak abundances of O3 accumulating in the mesosphere are observed with densities from 107 to 108 molecules⋅cm−3 at 85–110 km. The ozone layer is estimated to vary from 1 to 30 ppbv at 85–95 km while at 95–105 km the volume mixing ratio is expected within an interval from 6 to 120 ppbv. Below 93 km, a puzzling decrease of mixing ratio is observed towards midnight at 30°N. Our work also provides an improved sequel to the analysis of the sulfur dioxide survey previously made in the upper mesosphere by Belyaev, Evdokimova, et al. (2017, https://doi.org/10.1016/j.icarus.2017.05.002). On average, the SO2 content is found to remain constant throughout the vertical profile at a value of around 135 ± 21 ppbv between 85 and 100 km. Rapid and large variations prevent to conclude firmly on any time or space pattern of SO2.
A Shorter, Sharper Rainy Season Amplifies California Wildfire Risk
Authors: Swain Daniel L.
Published: February 2021

California has experienced increasingly severe autumn wildfires over the past several decades, which have exacted a rising human and environmental toll. Recent fire and climate science research has demonstrated a clear link between worsening California wildfires and climate change, mainly though the vegetation‐drying effect of rising temperatures and shifting precipitation seasonality. New work by Luković et al. (2021) explores observed changes in California's autumn precipitation in greater detail, finding that the rainy season has indeed become progressively delayed and that the “sharpness” of California precipitation seasonality has increased. These precipitation shifts have important implications for the region's ecology and wildfire risk, as they increase the degree of temporal overlap between extremely dry vegetation conditions and fire‐promoting downslope winds in late autumn. Both of these observed shifts are consistent with climate model projections for the region's future, suggesting that recent trends may offer an early preview of larger changes to come.