bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality and environmental management systems as business tools to enhance ESG performance: a cross-regional empirical study
Authors: Ronalter Louis Maximilian , Bernardo Merce , Romaní Javier Manuel
Published: May 2022

The growing societal and political focus on sustainability at global level is pressurizing companies to enhance their environmental, social and governance (ESG) performance to satisfy respective stakeholder needs and ensure sustained business success. With a data sample of 4292 companies from Europe, East Asia and North America, this work aims to prove through a cross-regional empirical study that quality management systems (QMSs) and environmental management systems (EMSs) represent powerful business tools to achieve this enhanced ESG performance. Descriptive and cluster analyses reveal that firms with QMSs and/or EMSs accomplish statistically significant higher ESG scores than companies without such management systems (MSs). Furthermore, the results indicate that operating both types of MSs simultaneously increases performance in the environmental and social pillar even further, while the governance dimension appears to be affected mainly by the adoption of EMSs alone. To the best of the authors’ knowledge, such large-scale, cross-regional analysis of the impact of QMSs and EMSs on ESG performance is absent from the literature, thus paving the way for pioneering academic research. The study is grounded in stakeholder theory and demonstrates managers how the implementation of MSs can assist in successfully translating stakeholders’ sustainability concerns into actionable business practice. Furthermore, it allows decision-makers to gain insight into the strengths and weaknesses of QMSs and EMSs for tackling specific ESG issues and highlights the performance advantages of combining both MSs. The work also depicts policymakers how corporate sustainable performance (CSP) can be improved by fostering MSs adoption, thereby emphasizing the importance of supporting and facilitating the diffusion of these systems.
Regional Competitiveness: A Structural-Based Topic Analysis on Recent Literature
Authors: Grassia Maria Gabriella , Marino Marina , Mazza Rocco , Misuraca Michelangelo , Zavarrone Emma , Friel Martha
Published: May 2022

The concept of Regional Competitiveness (RC), in the last years, had a considerable influence on the development of strategies and policies focused on sub-national areas from an economic and social perspective. In particular, RC attracted the substantial attention of policymakers due to the possibility of evaluating and comparing different territories without any established political or conceptual framework. Conversely, scholars have long debated the meaningfulness of territorial competitiveness itself and, in case, which dimensions have to be included. This study reviewed the most recent scientific literature concerning RC with a bibliometric approach based on topic modelling. The use of a textual-based statistical approach offered an interesting insight into the RC research domain. We highlighted the topics discussed by scholars, showing the patterns emerging across years and from different publication types, and marked the differences between the vocabulary used by authors coming from EU and non-EU countries. Finally, a comparison between the RC issues coming from the literature analysis with the RC issues defined by policymakers tried to link the two standpoints followed by the institutions and the academia in a more comprehensive conceptual framework.
Digitale Gesundheitskompetenz und Wohlbefinden
Authors: Reitegger Franziska , Wright Michaela , Berger Jessica , Gasteiger-Klicpera Barbara
Published: May 2022

Hintergrund

Bisherige Befunde lassen darauf schließen, dass sich seit Beginn der Pandemie depressive und angstspezifische Symptome bei Studierenden verdoppelt haben. Digitale Gesundheitskompetenz kann hier als protektive Ressource zur Stärkung des Wohlbefindens fungieren.

Ziel

Dieser Beitrag analysiert den Zusammenhang von digitaler Gesundheitskompetenz, dem sozioökonomischen Status sowie Wohlbefinden und Zukunftsangst bei Studierenden in Österreich.

Methode

Mittels Online-Fragebogen wurden 480 Studierende österreichischer Hochschulen während der 2. Welle der Pandemie befragt. Es wurden soziodemographische Daten, Selbsteinschätzungen der Studierenden zum Wohlbefinden, zu Zukunftsängsten und zur digitalen Gesundheitskompetenz erhoben. Die Auswertung erfolgte mittels Varianz- und Regressionsanalysen.

Ergebnisse

Etwa 50 % der Studierenden berichteten über ein geringes Wohlbefinden und deutliche Zukunftsängste. In Bezug auf die digitale Gesundheitskompetenz weist die Fähigkeit zur Beurteilung der Relevanz von Informationen den größten Zusammenhang mit dem Wohlbefinden auf. Ein höherer sozioökonomischer Status korrelierte sowohl mit einem höheren Wohlbefinden als auch mit niedrigeren Zukunftsängsten.

Diskussion

Die Beurteilung der Relevanz von Informationen und die Herstellung des Bezugs zur eigenen Lebensrealität scheint ein wichtiger Faktor bei der Sicherung des Wohlbefindens zu sein. Individuelle Faktoren wie das Geschlecht oder das Studienprogramm sind für den Zusammenhang von Wohlbefinden und digitaler Gesundheitskompetenz von Relevanz.
A Systematic Mapping Study and Empirical Comparison of Data-Driven Intrusion Detection Techniques in Industrial Control Networks
Authors: Tama Bayu Adhi , Lee Soo Young , Lee Seungchul
Published: May 2022

A rising communication between modern industrial control infrastructure and the external Internet worldwide has led to a critical need to secure the network from multifarious cyberattacks. An intrusion detection system (IDS) is a preventive mechanism where new sorts of hazardous threats and malicious activities could be detected before harming the industrial process’s critical infrastructure. This study reviews the cutting-edge technology of artificial intelligence in developing IDS in industrial control networks by carrying out a systematic mapping study. We included 74 foremost publications from the current literature. These chosen publications were grouped following the types of learning tasks, i.e., supervised, unsupervised, and semi-supervised. This review article helps researchers understand the present status of artificial intelligence techniques applied to IDS in industrial control networks. Other mapping categories were also covered, including year published, publication venues, dataset considered, and IDS approaches. This study reports an empirical assessment of several classification algorithms such as random forest, gradient boosting machine, extreme gradient boosting machine, deep neural network, and stacked generalization ensemble. Statistical significance tests were also used to assess the classifiers’ performance differences in multiple scenarios and datasets. This paper provides a contemporary systematic mapping study and empirical evaluation of IDS approaches in industrial control networks.
Parameter analysis for sigmoid and hyperbolic transfer functions of fuzzy cognitive maps
Authors: Koutsellis Themistoklis , Xexakis Georgios , Koasidis Konstantinos , Nikas Alexandros , Doukas Haris
Published: May 2022

Fuzzy cognitive maps (FCM) have recently gained ground in many engineering applications, mainly because they allow stakeholder engagement in reduced-form complex systems representation and modelling. They provide a pictorial form of systems, consisting of nodes (concepts) and node interconnections (weights), and perform system simulations for various input combinations. Due to their simplicity and quasi-quantitative nature, they can be easily used with and by non-experts. However, these features come with the price of ambiguity in output: recent literature indicates that changes in selected FCM parameters yield considerably different outcomes. Furthermore, it is not a priori known whether an FCM simulation would reach a fixed, unique final state (fixed point). There are cases where infinite, chaotic, or cyclic behaviour (non-convergence) hinders the inference process, and literature shows that the primary culprit lies in a parameter determining the steepness of the most common transfer functions, which determine the state vector of the system during FCM simulations. To address ambiguity in FCM outcomes, we propose a certain range for the value of this parameter, $${\uplambda }$$
λ
, which is dependent on the FCM layout, for the case of the log-sigmoid and hyperbolic tangent transfer functions. The analysis of this paper is illustrated through a novel software application, In-Cognitive, which allows non-experts to define the FCM layout via a Graphical User Interface and then perform FCM simulations given various inputs. The proposed methodology and developed software are validated against a real-world energy policy-related problem in Greece, drawn from the literature.
Geologic controls on groundwater salinity reversal in North Coles Levee Oil Field, southern San Joaquin Valley, California, USA
Authors: Flowers Michael D. , Shimabukuro David H. , Stephens Michael J. , Warden John G. , Gillespie Janice M. , Chang Will
Published: May 2022

This paper documents a reversal in the groundwater salinity depth gradient in the North Coles Levee Oil Field in the San Joaquin Valley, California. Salinity, measured in mg/L, was mapped with water quality data from groundwater and oil and gas wells and salinity estimated from oil and gas well borehole geophysical logs using Archie's equation. The resulting three-dimensional salinity volume shows groundwater salinity increasing with depth through the Tulare and San Joaquin Formations to about 50,000 mg/L at 1100 m depth, then decreasing to 10,000–31,000 mg/L in the Etchegoin Formation at 1400 m depth. The high salinity zone occurs near the base of the San Joaquin Formation in sand lenses in shales that have been interpreted as representing a mudflat environment. The groundwater and produced water geochemistry show formation waters lie on the seawater dilution line, indicating the salinity structure is largely the result of dilution or evaporation of seawater and not due to water–rock interactions. Instead, changing depositional environments linked to decreasing sea level may be responsible for variably saline water at or near the time of deposition, leading to a salinity reversal preserved in connate waters. The steepness of the salinity reversal varies laterally, possibly due to post-depositional freshwater recharge allowed by thick sands, alternatively, by a change in connate water composition due to a lateral facies change present at the time of deposition. These results illustrate geologic and paleogeographic processes that drive the vertical salinity structure of groundwater in shallow alluvial basins.
On the Ethical and Epistemological Utility of Explicable AI in Medicine
Authors: Herzog Christian
Published: May 2022

In this article, I will argue in favor of both the ethical and epistemological utility of explanations in artificial intelligence (AI)-based medical technology. I will build on the notion of “explicability” due to Floridi, which considers both the intelligibility and accountability of AI systems to be important for truly delivering AI-powered services that strengthen autonomy, beneficence, and fairness. I maintain that explicable algorithms do, in fact, strengthen these ethical principles in medicine, e.g., in terms of direct patient–physician contact, as well as on a longer-term epistemological level by facilitating scientific progress that is informed through practice. With this article, I will therefore attempt to counter arguments against demands for explicable AI in medicine that are based on a notion of “whatever heals is right.” I will elucidate my elaboration on the positive aspects of explicable AI in medicine as well as by pointing out risks of non-explicable AI.
Serum uric acid and diabetic peripheral neuropathy: a double-edged sword
Authors: Zhuang Yong , Huang Huibin , Hu Xin , Zhang Jinying , Cai Qingyan
Published: May 2022

Background and objectives

Research suggests that diabetic peripheral neuropathy (DPN) is related to high serum uric acid (SUA) level, although its correlation with low SUA level has not been reported. Here, diabetic patients with hyperuricemia were excluded, and the correlation between low SUA level and DPN was explored.

Subjects and methods

This prospective observational clinical study enrolled 525 type 2 diabetes mellitus (T2DM) patients without hyperuricemia, who were divided into the diabetes with symptomatic neuropathy (150 cases), diabetes with asymptomatic neuropathy (125 cases) and diabetes with no neuropathy (250 cases) groups.

Results

The SUA slightly decreased in subjects with asymptomatic DPN compared with those with no neuropathy and greatly decreased in subjects with symptomatic DPN compared with those without (P < 0.001). The association of the SUA with diabetic neuropathy was independent of the hyperglycemic state and other potential confounders (odds ratio 0.985 [0.981–0.988], P < 0.001). The SUA was closely correlated with the means of motor/sensory nerve amplitude and CV (all P < 0.001). The optimal cut-off point for SUA to distinguish patients with diabetic neuropathy from those without was 324 umol/L, with a sensitivity of 76.0% and a specificity of 79.2% (AUC = 0.806).

Conclusions

The low SUA level is closely associated with DPN. Future studies are warranted to clarify the relationship.
Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi-Directional Sports
Authors: Harper Damian J. , McBurnie Alistair J. , Santos Thomas Dos’ , Eriksrud Ola , Evans Martin , Cohen Daniel D. , Rhodes David , Carling Christopher , Kiely John
Published: May 2022

Rapid horizontal accelerations and decelerations are crucial events enabling the changes of velocity and direction integral to sports involving random intermittent multi-directional movements. However, relative to horizontal acceleration, there have been considerably fewer scientific investigations into the biomechanical and neuromuscular demands of horizontal deceleration and the qualities underpinning horizontal deceleration performance. Accordingly, the aims of this review article are to: (1) conduct an evidence-based review of the biomechanical demands of horizontal deceleration and (2) identify biomechanical and neuromuscular performance determinants of horizontal deceleration, with the aim of outlining relevant performance implications for random intermittent multi-directional sports. We highlight that horizontal decelerations have a unique ground reaction force profile, characterised by high-impact peak forces and loading rates. The highest magnitude of these forces occurs during the early stance phase (< 50 ms) and is shown to be up to 2.7 times greater than those seen during the first steps of a maximal horizontal acceleration. As such, inability for either limb to tolerate these forces may result in a diminished ability to brake, subsequently reducing deceleration capacity, and increasing vulnerability to excessive forces that could heighten injury risk and severity of muscle damage. Two factors are highlighted as especially important for enhancing horizontal deceleration ability: (1) braking force control and (2) braking force attenuation. Whilst various eccentric strength qualities have been reported to be important for achieving these purposes, the potential importance of concentric, isometric and reactive strength, in addition to an enhanced technical ability to apply braking force is also highlighted. Last, the review provides recommended research directions to enhance future understanding of horizontal deceleration ability.
"Strategies for Teaching the War in Ukraine" Webinar Highlights
Authors: WYER FRANK
Published: June 2022

On March 15th, 2022, APSA convened the webinar “Strategies for Teaching About Russia’s Invasion of Ukraine.”The panel brought together scholars with regional expertise on Russia and Ukraine, post-Soviet political development, international relations, global civic engagement, and political science instruction. Moderated by Michelle Allendoerfer, APSA’s Director of Teaching & Learning, the five panelists included John Ishiyama (APSA President, University of North Texas), Alison R. M. McCartney (Towson University), Yoshiko Herrera (University of Wisconsin-Madison), Paul Poast (The University of Chicago) and Olga Onuch (The University of Manchester). The aim of this event was to address the opportunities and challenges for teaching political science in the context of the ongoing war in Ukraine. Members of the panel offered insights on how political science can shed light on the origins, dynamics, and consequences of the conflict, as well as practical suggestions for how to incorporate the events in Ukraine into classroom discussions and activities. In the following, I distill some of the core ideas that emerged in the panel discussion, which I organize around three key roles instructors can play during this time. Scholars of political science can provide students with relevant and accurate information about the conflict, help students to understand the conflict through the lens of political science, and empower students to take action on behalf of those affected by the conflict.
Observations of a Strong Intraseasonal Oscillation in the MLT Region During the 2015/2016 Winter Over Mohe, China
Authors: Gong Yun , Xue Junwei , Ma Zheng , Zhang Shaodong , Zhou Qihou , Huang Chunming , Huang Kaiming , Li Guozhu
Published: May 2022

Using meteor radar measurements at Mohe (MH, 53.5°N, 122.3°E) and the reanalysis data from 2011 to 2020, the characteristics of intraseasonal oscillations (ISOs) in the mesosphere and lower thermosphere (MLT) region over MH are investigated for the first time. The radar observation shows a prominent ISO with periods of 40–60 days in the zonal wind during the 2015/2016 winter. The observed ISO is the strongest in the oscillation period of 30–60 days during nearly a decade of observation. The ISO amplitude reaches a maximum of 16 m/s at 90 km. The vertical structure indicates that intraseasonal variabilities in the lower mesosphere contribute to the ISO in the MLT region. By bandpassing the zonal wind obtained from the reanalysis data along 122.5°E at 52 km in the Northern Hemisphere with cutoff periods of 40 and 60 days, we show that ISOs in the tropical and mid‐latitude mesosphere are related to each other. Our results also indicate that the tropical mesospheric ISO and the tropospheric Madden‐Julian Oscillations (MJO) are highly correlated. Our analysis suggests that the MJO in the equatorial troposphere may contribute to the enhancement of the ISO in the MLT region over MH. Additionally, a very strong El Niño during the 2015/2016 winter was accompanied by the positive Indian Ocean Dipole, which confines the active MJO in phases 2‒4 for a long time. This may be the reason that in the oscillation period of 30–60 days, the ISO observed at MH is the strongest during almost a decade of observation.
A Role for the Ocean in the Winter Sea Ice Distribution North of Svalbard
Authors: Herbaut Christophe , Houssais Marie‐Noëlle , Blaizot Anne‐Cécile , Molines Jean‐Marc
Published: May 2022

The ocean is suggested to play a major role in the ongoing winter decay of the sea ice cover in the western Eurasian Basin. Using a high‐resolution sea ice‐ocean model, we investigate the processes influencing the ice‐ocean interactions in winter in the waters north of Svalbard, with a particular focus on those contributing to sea ice melt events of large amplitude. These short term events, lasting 5–10 days, are associated with locally large melt rates mostly found along the pathway of the Atlantic Water. The sum of all these events over the simulation period is found to contribute 40% of the total winter melt. Episodes of strong surface winds, occasionally associated with enhanced velocity shear at the mixed layer base, can trigger enhanced entrainment of Atlantic Water through the relatively shallow upper thermocline in the Atlantic Water boundary current, leading to substantial ocean heat transfer to the sea ice. In some cases, strengthening of the boundary current also contributes to fueling the heat transfer to the ice. Another type of large melt event, not linked to increased ocean vertical heat flux but due to ice being advected over warm surface waters, is also identified, sometimes associated with episodes of ice close‐up. Sea ice budget calculations show that, overall, large melt events contribute significantly to the eastward retreat of the winter marginal ice zone on the upper slope east of Svalbard while episodes of northward advection of ice largely dominate the ice edge retreat over the shelf north of Svalbard.
Wide Versus Narrow Back‐Arc Rifting: Control of Subduction Velocity and Convective Back‐Arc Thinning
Authors: Erdős Zoltán , Huismans Ritske S. , Faccenna Claudio
Published: May 2022

Back‐arc basins such as the ones behind the island‐arcs of the Western Pacific Ocean or the ones in the Mediterranean Sea are ubiquitous structures of the Earth. They are extensional basins forming in the overriding plate behind subduction zones and similarly to continental rifts, they can exhibit different structural styles from narrow, localized rifting to wide‐rift extension. While these different structural styles have been long recognized, the factors controlling the style of extension in these basins have not been explored properly. We use thermo‐mechanical models to investigate how the relative rates of progressive build‐up of slab‐pull force and of convective thinning and thermal weakening of the overriding plate control the style of back‐arc rifting. Following subduction‐initiation, a high subducting plate velocity results in rapid build‐up of the slab‐pull force. The relatively low rate of convectively thinning and associated moderate weakening of the overriding plate require slab‐pull to build up to close to its maximum value to overcome the high back‐arc integrated strength resulting in a narrow back‐arc rift. In turn a low subducting plate velocity in comparison with the timescale of convective thinning of the overriding plate allows for significant back‐arc weakening before the slab‐pull force becomes large enough to drive back‐arc extension. In this case, the back‐arc exhibits a wide rifting style as extension occurs at significantly reduced overriding plate integrated strength. Our model results provide an explanation why some subduction zones exhibit wide, distributed extension in the overriding plate such as for instance observed in the Pannonian basin.
Climate Leads to Reversed Latitudinal Changes in Chinese Flood Peak Timing
Authors: Yang Yixin , Yang Long , Chen Xiaodong , Wang Qiang , Tian Fuqiang
Published: May 2022

Changes in river floods under a changing climate are of worldwide concerns, but relevant knowledge is limited especially over the East Asia monsoon region. Here we examine changes in flood peak timing based on the most comprehensive flood data set to date across China during 1961–2017. The temporal shifts of Chinese flood peak timing range from −19.0 days earlier to +14.0 days later per decade. Earlier flood occurrences are mainly observed in northern China, with delayed flood occurrences in the south. The spatial pattern of reversed latitudinal changes in flood timing leads to growing spatial extents of concurrent river floods over China. Soil moisture plays an important role in modulating such changes, despite precipitation determines the climatological mean dates of flood occurrences. Our results highlight a strong climate signal on the changes in flood timing over China, and call for coordinated efforts in alleviating expanding flood hazards related to the changes in flood timing.
Aotearoa New Zealand's 21st‐Century Wildfire Climate
Authors: Melia N. , Dean S. , Pearce H. G. , Harrington L. , Frame D. J. , Strand T.
Published: May 2022

Wildfire is a highly variable natural phenomenon, yet despite this, climate change is already making wildfire conditions measurably worse around the world; however, detailed knowledge about Aotearoa New Zealand's wildfire climate is currently limited. This study blends weather observations with regional climate model projections to assess Aotearoa New Zealand's 21st‐century wildfire climate. We find that in the 21st‐century, the emergence of a new—more severe wildfire climate will occur. Detailed analysis of observed and simulated wildfire weather finds that “very‐extreme” wildfire weather conditions matching the levels observed in Australia's 2019/2020 “Black Summer” bushfires are possible in regions formerly unaffected. While the extent of emergence is dependent on future emissions, the frequency of very‐extreme conditions for the areas affected can occur at any time and is independent of projected 21st‐century climate changes. Our findings have significant implications for many rural fire authorities, forest managers and investors, and climate mitigation and afforestation programs.
Chemerin is secreted by the chicken oviduct, accumulates in egg albumen and could promote embryo development
Authors: Estienne Anthony , Brossaud Adeline , Ramé Christelle , Bernardi Ophélie , Reverchon Maxime , Rat Christophe , Delaveau Joël , Chambellon Emilie , Helloin Emmanuelle , Froment Pascal , Dupont Joëlle
Published: May 2022

Understanding of the distribution of chemerin and its receptors, Chemokine-like Receptor 1 (CMKLR1), G Protein-coupled Receptor 1 (GPR1) and Chemokine (C–C motif) receptor-like 2 (CCRL2), in the egg and the embryonic annexes is currently lacking, and their role during embryogenesis remains unknown. By immunoblot using monoclonal anti-chicken antibodies and Enzyme Linked Immunosorbent Assays (ELISA), we found that chemerin is expressed 10 times higher in albumen eggs than in blood plasma, and it is also abundant in the perivitelline membrane but undetectable in yolk. Chicken chemerin can inhibit bacterial growth. By Reverse Transcription—quantitative Polymerisation Chain Reaction (RT-qPCR), western-blot, and immunofluorescence, we show that chemerin is locally produced by the oviduct magnum that participates in albumen formation. Using cultures of magnum explants, we demonstrate that progesterone (P4) and oestradiol (E2) treatment increases chemerin secretion into cultured media and expression in magnum. Chemerin and its three receptors are present in amniotic and Chorio Allantoic Membranes (CAM). Only CMKLR1 expression decreased from embryonic day (ED) 7 to ED11 and remained low until ED18. Chemerin concentrations strongly increased in amniotic fluid at D14 when egg albumen crossed the amniotic membrane. In ovo injections of neutralising chemerin and CMKLR1 antibodies (0.01, 0.1 and 1 µg) increased embryo mortality, which occurred mainly at ED12-13, in a dose-dependent manner. Chemerin treatment increased primary CAM viability. Finally, chemerin and CMKLR1 inhibition within the CAM led to a decrease in blood vessel development and associated angiogenic gene expression. Our results show an important function of the chemerin system during embryo development in chickens, suggesting the potential use of this adipokine as a predictive marker for egg fertility or hatchability.
Anisotropic, ultrastrong and light-transmission film designed on wheat straw
Authors: Cui Boyu , Xie Hao , Sun Hao , Ji Tong , Li Shuang , Jia Xue , Wang Weihong
Published: May 2022

The highly oriented structure of wheat straw is preserved and made into a high-performance film that is expected to be used in sustainable products.
Flexible management and decarbonisation of rural networks using multi‐functional battery control
Authors: McGarry Connor , Galloway Stuart , Hunter Lewis
Published: May 2022

To support the electrification of heat and transport, distribution network operators are looking to adopt network management solutions which can exploit local flexibility to advance their decarbonisation efforts in line with the evolving management requirements of the network. This paper develops a multi‐functional battery control strategy that integrates constraint management with carbon‐intensity linked control dispatch – carbon control – to support decarbonisation of rural distribution networks in Scotland by displacing last resort backup diesel generation and facilitating low carbon network balancing in the drive towards self‐sustaining local distribution networks. The interplay between the different functionalities is considered to understand the challenges, and opportunities, of adopting multi‐functional battery storage as an alternative management solution based on an operational distribution network in Scotland. Case studies are presented which consider network constraints at different times of day and year for various generation, demand and carbon intensity profiles to support this investigation. The findings of this work provide for the near‐term, realisation of self‐sustaining carbon‐neutral local distribution networks that are in keeping with both the operational objectives of incumbent network operators, smart local energy systems and also low carbon policy objectives.
Application of a Machine Learning–Based Decision Support Tool to Improve an Injury Surveillance System Workflow
Authors: Catchpoole Jesani , Nanda Gaurav , Vallmuur Kirsten , Nand Goshad , Lehto Mark
Published: May 2022

Background Emergency department (ED)-based injury surveillance systems across many countries face resourcing challenges related to manual validation and coding of data.

Objective This study describes the evaluation of a machine learning (ML)-based decision support tool (DST) to assist injury surveillance departments in the validation, coding, and use of their data, comparing outcomes in coding time, and accuracy pre- and postimplementations.

Methods Manually coded injury surveillance data have been used to develop, train, and iteratively refine a ML-based classifier to enable semiautomated coding of injury narrative data. This paper describes a trial implementation of the ML-based DST in the Queensland Injury Surveillance Unit (QISU) workflow using a major pediatric hospital's ED data comparing outcomes in coding time and pre- and postimplementation accuracies.

Results The study found a 10% reduction in manual coding time after the DST was introduced. The Kappa statistics analysis in both DST-assisted and -unassisted data shows increase in accuracy across three data fields, that is, injury intent (85.4% unassisted vs. 94.5% assisted), external cause (88.8% unassisted vs. 91.8% assisted), and injury factor (89.3% unassisted vs. 92.9% assisted). The classifier was also used to produce a timely report monitoring injury patterns during the novel coronavirus disease 2019 (COVID-19) pandemic. Hence, it has the potential for near real-time surveillance of emerging hazards to inform public health responses.

Conclusion The integration of the DST into the injury surveillance workflow shows benefits as it facilitates timely reporting and acts as a DST in the manual coding process.
Deep Brain Stimulation for Morbid Obesity: An Underutilized Neuromodulatory Treatment for Severely Obese Patients?
Authors: Stapińska-Syniec Angelika , Kupryjaniuk Anna , Sobstyl Michał
Published: May 2022

Background Morbid obesity (MO) has been steadily increasing in the last few years. Pharmacotherapy and bariatric surgeries remain the main treatment modalities for MO, although in the long-term they may lose their effectiveness. Other treatment approaches are urgently needed and deep brain stimulation (DBS) is a promising therapy. Disturbed energy homeostasis caused by intake of highly palatable and caloric foods may induce hedonic eating. The brain nuclei responsible for energy homeostasis and hedonia are the hypothalamic nuclei and nucleus accumbens. These brain structures constitute the stereotactic targets approached with DBS to treat MO.

Material and Methods We have performed a literature search of all available clinical applications of DBS for MO in humans. We were able to identify three case series reports and additional six case reports involving 16 patients. The selected stereotactic targets included lateral hypothalamus in eight patients, ventromedial hypothalamus in two patients, and nucleus accumbens in six patients.

Results In general, the safety profile of DBS in refractory MO patients was good. Clinical improvement regarding the mean body mass index could be observed in obese patients.

Conclusions MO is a demanding condition. Since in some cases standardized treatment is ineffective, new therapies should be implemented. DBS is a promising therapy that might be used in patients suffering from MO, however, more studies incorporating more individuals and with a longer follow-up are needed to obtain more reliable results concerning its effectiveness and safety profile.
Acute Cholecystitis: An Emerging Complication in Spinal Cord Injury Patients in the United States
Authors: Gartenberg Ariella , Nessim Adam , Cho Woojin
Published: May 2022

Background Spinal cord injury (SCI) is a significant medical condition associated with various secondary complications, including cholelithiasis. Cholelithiasis can cause biliary duct obstruction and result in acute cholecystitis. The development of acute cholecystitis in SCI patients has been well studied in the Taiwanese population, showing an increased risk of acute cholecystitis in patients with SCI. The development of cholecystitis has not been well studied in the United States.

Materials and Methods A retrospective review was performed on 3,939 propensity score-matched patients aged 18 to 85 years who had SCI/surgery from 2000 to 2019. Patients were divided based on the development of postoperative complications, specifically cholecystitis with cholecystectomy.

Results SCI consisted of quadriplegia (42%), paraplegia (53%), unspecified lesion of cervical spinal cord (3%), and thoracic spinal cord (2%). All groups were comparable regarding age, gender, body mass index, smoking status, and Charlson comorbidity Index. The incidence of acute cholecystitis with subsequent cholecystectomy among patients with SCI was 43.0 per 10,000 person-years (95% confidence interval: 41.51–44.49). Median follow-up was 36 months. The development of cholecystitis was comparable among females (54.5%) and males (45.5%), and among African Americans (52.5%) and Caucasians (47.5%).

Conclusion There is an association between SCI and development of acute cholecystitis among U.S. patients. As SCI patients do not present with the classic signs of biliary colic, risk assessment for the development of acute cholecystitis will guide patient management and allow neurosurgeons to weigh the risks and benefits of prophylactic treatment for gallbladder complications.
Pharmacovigilance in Homoeopathy—Need of the Hour: A Narrative Review
Authors: Singh Priya
Published: May 2022

Background Homoeopathy is the newest art and science of healing. Like conventional medicine, pharmacovigilance is an important aspect of homoeopathy. There is a paucity of knowledge and ignorance among the practitioners. The necessity is to create awareness and encourage the homoeopathic professionals regarding drug safety surveillance, documentation and reporting of adverse events.

Methods A web-based online search from databases, journals, bibliographic resources regarding the practice of pharmacovigilance in homoeopathy was done. Articles and publications till January 2021 along with literature from homoeopathic books were analysed.

Results Data on adverse drug reactions (ADRs) and events in homoeopathy have been collected and reported in European countries. In India, of late these terminologies are being acknowledged among a group of homoeopathic practitioners only. Still, a dearth of cognizance on the subject exists and little reporting is done. People usually do not relate such adverse reactions to the use of homoeopathic medicines. For scrutinising the same, the Ministry of AYUSH, Govt. of India, has taken an initiative for Pharmacovigilance of Ayurveda, Siddha, Unani & Homoeopathy systems of medicine for reporting and taking measures against ADR and objectionable advertisements. The probable risk factors and ways to prevent ADR and benefits of pharmacovigilance in homoeopathic practice could be deduced.

Conclusion Homoeopathy is a widely followed system of medicine that is quite popular among the common people. The need of knowledge and promotion of suspected ADR reporting should be emphasised to increase the credibility of homoeopathy among the scientific community. Also, the profession should refrain from misleading and objectionable advertisements in print and electronic media.
Endoscopic Endonasal Resection of a Cavernous Malformation of the Third Ventricle: Case Report and Literature Review
Authors: Bin Abdulqader Sarah , Alzhrani Gmaan
Published: May 2022

Background Suprasellar and third ventricle cavernous malformations (CMs) are uncommon. Conventional approaches such as interhemispheric and translamina terminalis approaches are often used to resect these lesions. Here we demonstrate the use of the endoscopic endonasal approach for a third ventricle CM.

Case description A 31-year-old man presented with progressive symptoms of headache and visual disturbance as well as short-term memory deficit over a 6-month period. Neurologic examination revealed bitemporal hemianopsia. Radiologic images showed a suprasellar lesion extending into the third ventricle as well as obstructive hydrocephalus. The patient was operated on using an endoscopic endonasal approach and histopathology revealed a diagnosis of CM. Transient diabetes insipidus and adrenal insufficiency were reported postoperatively.

Conclusion This report demonstrates safe resection of a third ventricle CM via the endonasal route.
Minimally Invasive Aortic Valve Replacement in Contemporary Practice: Clinical and Hemodynamic Performance from a Prospective Multicenter Trial
Authors: Velders Bart J.J. , Vriesendorp Michiel D. , Reardon Michael J. , Rao Vivek , Lange Rüdiger , Patel Himanshu J. , Gearhart Elizabeth , Sabik Joseph F. , Klautz Robert J.M.
Published: May 2022

Background The advent of transcatheter aortic valve replacement (AVR) has led to an increased emphasis on reducing the invasiveness of surgical procedures. The aim of this study was to evaluate clinical outcomes and hemodynamic performance achieved with minimally invasive aortic valve replacement (MI-AVR) as compared with conventional AVR.

Methods Patients who underwent surgical AVR with the Avalus bioprosthesis, as part of a prospective multicenter non-randomized trial, were included in this analysis. Surgical approach was left to the discretion of the surgeons. Patient characteristics and clinical outcomes were compared between MI-AVR and conventional AVR groups in the entire cohort (n = 1077) and in an isolated AVR subcohort (n = 528). Propensity score adjustment was performed to estimate the effect of MI-AVR on adverse events.

Results Patients treated with MI-AVR were younger, had lower STS scores, and underwent concomitant procedures less often. Valve size implanted was comparable between the groups. MI-AVR was associated with longer procedural times in the isolated AVR subcohort. Postprocedural hemodynamic performance was comparable. There were no significant differences between MI-AVR and conventional AVR in early and 3-year all-cause mortality, thromboembolism, reintervention, or a composite of those endpoints within either the entire cohort or the isolated AVR subcohort. After propensity score adjustment, there remained no association between MI-AVR and the composite endpoint (hazard ratio: 0.86, 95% confidence interval: 0.47–1.55, p = 0.61).

Conclusion Three-year outcomes after MI-AVR with the Avalus bioprosthetic valve were comparable to conventional AVR. These results provide important insights into the overall ability to reduce the invasiveness of AVR without compromising outcomes.
A Rare Case of Multicentric Primary Pulmonary Artery Sarcoma: Eliminating the Masquerade with Multimodality Imaging
Authors: Kaushik Kavya S. , Karnavat Chandresh , Kakkar Ritu , Desai Shrinivas
Published: May 2022

A 68-year-old male presented with a short history of exertional dyspnea and a provisional diagnosis of pulmonary thromboembolism was made. However, chest radiograph and further investigations in the form of computed tomography pulmonary angiogram, magnetic resonance imaging of thorax, and whole body fluorodeoxyglucose (FDG) positron emission tomography-computed tomography revealed a large mass arising from the distal left pulmonary artery extending into adjacent lung and another lesion near the root of the main pulmonary artery, both of which showed post-contrast enhancement and intense FDG uptake. Tissue sampling by transthoracic computed tomography-guided biopsy and immunohistochemistry confirmed the diagnosis of pulmonary artery angiosarcoma. Here, we present such a case of very rare occurrence which, in view of multicentricity and substantial extension into adjacent lung, is the first of its kind to be reported, to the best of our knowledge.
Transmitral Septal Myectomy and Mitral Valve Surgery via Right Mini-Thoracotomy
Authors: El-Sayed Ahmad Ali , Salamate Saad , Giammarino Sabrina , Ciobanu Veceslav , Bakhtiary Farhad
Published: May 2022

Background Transmitral myectomy for symptomatic hypertrophic obstructive cardiomyopathy is possible with existence of substantial mitral valve disease. We present herein our experience of minimally invasive transmitral septal myectomy combined with mitral valve surgery through right anterior mini-thoracotomy in the past 4 years at our institution.

Methods Between March 2017 and October 2020, 14 patients with hypertrophic obstructive cardiomyopathy and mitral valve disease required minimally invasive transmitral septal myectomy combined with mitral valve reconstruction or replacement at our institution. Mean age of patients was 54.2 ± 11.4 and 42.9% (n = 6) were female. Twelve patients (85.1%) were in New York Heart Association class III to IV and 6 patients (42.9%) presented with persistent atrial fibrillation. Clinical data were prospectively entered into our institutional database.

Results Cardiopulmonary bypass time accounted for 140.2 ± 32.6 minutes and the myocardial ischemic time was 78.5 ± 12.4 minutes. Thirty-day mortality and overall mortality were zero. Peak ventricular outflow gradient decreased from 75.2 ± 12.7 to 9.4 ± 2.3 mm Hg (p < 0.0001). Simultaneously, mitral valve reconstruction and replacement were performed in 11 (78.6%) and 3 (21.4%) patients, respectively. No systolic anterior motion was seen in patients with mitral valve repair. No conversion to full sternotomy and/or rethoracotomy was noted. During a mean follow-up period of 24 ± 13 months, no patient required reoperation, no recurrence mitral regurgitation, and left ventricular outflow tract obstruction.

Conclusion Transmitral septal myectomy combined with mitral valve surgery through right anterior mini-thoracotomy can be performed safely with excellent surgical outcomes.
Gross Total Resection of a Ruptured Micro-arteriovenous Malformation within the Cerebellar Peduncle: A Case Report and Qualitative Review of the Literature
Authors: Iqbal M. Omar , Lariccia Nicholas , Markosian Christopher , Christie Catherine , Tomycz Luke D.
Published: May 2022

Deep-seated micro-arteriovenous malformations (micro-AVMs) may pose a challenge for complete yet safe resection. We propose the strategic placement of two to three microaneurysm clips throughout the hemorrhage cavity to successfully localize the micro-AVM nidus via digital subtraction angiography (DSA). We successfully demonstrate this novel method in a 15-year-old adolescent boy with cerebellar intraparenchymal hemorrhage who underwent hematoma evacuation and expansile duraplasty. He was found to have a 1-cm nidus of a micro-AVM with early venous drainage located in the right middle cerebellar peduncle. Five days later, we proceeded to resect the micro-AVM; however, a clear nidus or bleeding source was unable to be localized intraoperatively despite the use of stereotactic neuronavigation. In turn, we placed two mini-aneurysm clips superiorly and inferiorly within the hematoma cavity, which led to successful localization via DSA and complete resection. No surgical complications occurred. The patient completely recovered from right-sided weakness and dysarthria 6 to 12 months postoperatively. Our technique allows for the rapid localization and complete resection of micro-AVM nidi when stereotactic neuronavigation is inadequate.
Prone Positioning and Neuromuscular Blocking Agents as Adjunctive Therapies in Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome
Authors: Guérin Claude , Cour Martin , Argaud Laurent
Published: May 2022

Neuromuscular blocking agents (NMBAs) and prone position (PP) are two major adjunctive therapies that can improve outcome in moderate-to-severe acute respiratory distress syndrome. NMBA should be used once lung-protective mechanical ventilation has been set, for 48 hours or less and as a continuous intravenous infusion. PP should be used as early as possible for long sessions; in COVID-19 its use has exploded. In nonintubated patients, PP might reduce the rate of intubation but not mortality. The goal of this article is to perform a narrative review on the pathophysiological rationale, the clinical effects, and the clinical use and recommendations of both NMBA and PP.
A Prevalence Study of Canine Humeral Condylar Fractures Over a Ten-Year Period at an Academic Teaching Hospital
Authors: Schettler Michael , Cassel Nicky , Elliot Ross C. , Fosgate Geoffrey T. , Schettler Keleigh , Biller David
Published: May 2022

Objective The aim of this study was to investigate the prevalence, breed predisposition and fracture conformation of humeral condylar fractures (HCF) over a 10-year period. Results were compared with published studies emanating from the United Kingdom exploring effect of breed on HCF.

Methods Data for all canine admissions to the Veterinary Teaching Hospital at Kansas State University were extracted for the period January 2010 to October 2020. Humeral fractures were recorded and further subclassified as medial, lateral and ‘T’/‘Y’ condylar fractures. The associations between HCF and subtypes with breed were assessed using univariate logistic regression with a comparison group. Multivariable logistic regression was used to evaluate the effect of breed while accounting for dog age, sex and neuter status.

Results Of the 44,952 canine patients seen during the study period, period prevalence (95% confidence interval [CI] for HCF was 0.26% [0.22, 0.31]). After adjustment for age and neuter status, French Bulldogs were 49 times more likely to be diagnosed with a HCF compared with the comparison breed group (odds ratio [OR], 49.0; 95% CI, 26.9–89.3). After adjustment for age and neuter status, Cocker Spaniels (OR, 42.8; 95% CI, 16.8–108.6), Boston Terriers (OR, 22.9; 95% CI, 11.0–47.9) and Brittany Spaniels (OR, 21.5; 95% CI, 7.3–63.1) had the next highest increase in HCF compared with the comparison group.

Conclusion Based on a study population from the United States, French Bulldogs were 49 times more likely to be diagnosed with a HCF compared with the comparison breed group.