bluuebunny/crossref_metadata_2025 huggingface dataset:
Topographic Correction of Geothermal Heat Flux in Greenland and Antarctica
Authors: Colgan William , MacGregor Joseph A. , Mankoff Kenneth D. , Haagenson Ryan , Rajaram Harihar , Martos Yasmina M. , Morlighem Mathieu , Fahnestock Mark A. , Kjeldsen Kristian K.
Published: January 2021

We present a new approach to account for the influence of subglacial topography on geothermal heat flux beneath the Greenland and Antarctic ice sheets. We first establish a simple empirical proportionality between local geothermal flux and topographic relief within a given radius, based on a synthesis of existing observations of these properties elsewhere on Earth. This analysis essentially yields a high‐pass filter that can be readily applied to existing large‐scale geothermal heat flux fields to render them consistent with known subglacial topography. This empirical approach avoids both the geometric limitations of existing analytic models and the complex boundary conditions required by numerical heat flow models, yet it also produces results that are consistent with both of those methods, for example, increased heat flux within valleys and decreased heat flux along ridges. Comparison with borehole‐derived geothermal heat flux suggests that our topographic correction is also valid for non‐ice‐covered areas of Earth and that a borehole location uncertainty of >100 m can limit the value of its inferred heat flux. Ice‐sheet‐wide application of this approach indicates that the effect of local topography upon geothermal heat flux can be as important as choice of regional geothermal heat flux field across a small portion of Antarctica (2%) and a larger portion of Greenland (13%), where subglacial topography is best resolved. We suggest that spatial variability in geothermal heat flux due to topography is most consequential in slower‐flowing portions of the ice sheets, where there is no frictional heating due to basal sliding. We conclude that studies of interactions between ice sheets and geothermal heat flux must consider the effect of subglacial topography at sub‐kilometer horizontal scales.
La regi�n agr�cola m�s importante de la India se est� desertificando
Authors: Singh Gurpreet
Published: January 2021

El cultivo de arroz consume m�s agua de la que el Punjab puede recargar. Si contin�an las tasas de riego actuales, el estado vaciar� sus reservas de agua subterr�nea dentro de 20 a�os.
Widespread myocardial dysfunction in COVID-19 patients detected by myocardial strain imaging using 2-D speckle-tracking echocardiography
Authors: Li Rui , Wang Hong , Ma Fei , Cui Guang-lin , Peng Li-yuan , Li Chen-ze , Zeng He-song , Marian Ali J. , Wang Dao-wen
Published: January 2021

COVID-19 is a multiorgan systemic inflammatory disease caused by SARS-CoV-2 virus. Patients with COVID-19 often exhibit cardiac dysfunction and myocardial injury, but imaging evidence is lacking. In the study we detected and evaluated the severity of myocardial dysfunction in COVID-19 patient population using two-dimensional speckle-tracking echocardiography (2-D STE). A total of 218 consecutive patients with confirmed diagnosis of COVID-19 who had no underlying cardiovascular diseases were enrolled and underwent transthoracic echocardiography. This study cohort included 52 (23.8%) critically ill and 166 noncritically ill patients. Global longitudinal strains (GLSs) and layer-specific longitudinal strains (LSLSs) were obtained using 2-D STE. Changes in GLS were correlated with the clinical parameters. We showed that GLS was reduced (<−21.0%) in about 83% of the patients. GLS reduction was more common in critically sick patients (98% vs. 78.3%, P < 0.001), and the mean GLS was significantly lower in the critically sick patients than those noncritical (−13.7% ± 3.4% vs. −17.4% ± 3.2%, P < 0.001). The alteration of GLS was more prominent in the subepicardium than in the subendocardium (P < 0.001). GLS was correlated to mean serum pulse oxygen saturation (SpO2, RR = 0.42, P < 0.0001), high-sensitive C-reactive protein (hsCRP, R = −0.20, P = 0.006) and inflammatory cytokines, particularly IL-6 (R = −0.21, P = 0.003). In conclusions, our results demonstrate that myocardial dysfunction is common in COVID-19 patients, particularly those who are critically sick. Changes in indices of myocardial strain were associated with indices of inflammatory markers and hypoxia, suggesting partly secondary nature of myocardial dysfunction.
A new generation needle- and adjuvant-free trivalent plague vaccine utilizing adenovirus-5 nanoparticle platform
Authors: Kilgore Paul B. , Sha Jian , Andersson Jourdan A. , Motin Vladimir L. , Chopra Ashok K.
Published: January 2021

A plague vaccine with a fusion cassette of YscF, F1, and LcrV encoding genes in an adenovirus-5 vector (rAd5-YFV) is evaluated for efficacy and immune responses in mice. Two doses of the vaccine provides 100% protection when administered intranasally against challenge with Yersinia pestis CO92 or its isogenic F1 mutant in short- or long- term immunization in pneumonic/bubonic plague models. The corresponding protection rates drop in rAd5-LcrV monovalent vaccinated mice in plague models. The rAd5-YFV vaccine induces superior humoral, mucosal and cell-mediated immunity, with clearance of the pathogen. Immunization of mice with rAd5-YFV followed by CO92 infection dampens proinflammatory cytokines and neutrophil chemoattractant production, while increasing Th1- and Th2-cytokine responses as well as macrophage/monocyte chemo-attractants when compared to the challenge control animals. This is a first study showing complete protection of mice from pneumonic/bubonic plague with a viral vector-based vaccine without the use of needles and the adjuvant.
The role of peripheral type 2 innate lymphoid cells in bronchiolitis
Authors: Tang Yong-Jun , Xie Li-Li , Zheng Xiang-Rong , Liu Chen-Tao , Wang Xia
Published: January 2021

Our aim was to detect type 2 innate lymphoid cells (ILC2s)-related cytokines of infants with bronchiolitis by using Elisa, Liquidchip technology and RT-PCR and investigated its correlation with bronchiolitis. We recruited 26 infants with bronchiolitis and 20 healthy infants as control from Xiangya Hospital. Compared to the control group, the serum levels of interleukin-5 (IL-5) [41.99 (21.11) vs 25.70 (19.64)], IL-9 [27.04 (37.51) vs 8.30 (0.54)], IL-13 [184.05 (132.81) vs 121.75 (176.13)], IL-33 [83.70 (46.69) vs 11.23 (55.31)] and thymic stromal lymphopoietin (TSLP) [31.42 (5.41) vs 28.76 (2.56)] were significantly increased in infants with bronchiolitis (P < 0.05), while the level of IgE had no significant difference between the two groups [19.05 (14.15) vs 14.85 (20.2), P > 0.05]. The mRNA expression of IL-17RB (9.83 ± 0.35 vs 9.19 ± 0.58), TSLP (16.98 ± 2.12 vs 15.07 ± 2.25), retinoid acid receptor related orphan receptor α (7.18 ± 0.71 vs 5.46 ± 1.09) and trans-acting T-cell-specific transcription factor 3 (4.86 ± 0.66 vs 4.19 ± 0.90) were significantly increased in infants with bronchiolitis versus the control group (P < 0.05), while there was no statistical significance for suppression of tumorigenicity 2 (5.59 ± 0.68 vs 5.41 ± 0.87, P > 0.05). Our findings suggested that ILC2s possibly play a specific role in immunopathology of bronchiolitis.
Anaerococcus urinimassiliensis sp. nov., a new bacterium isolated from human urine
Authors: Morand Aurélie , Tall Mamadou Lamine , Kuete Yimagou Edmond , Ngom Issa Isaac , Lo Cheikh Ibrahima , Cornu Florent , Tsimaratos Michel , Lagier Jean-Christophe , Levasseur Anthony , Raoult Didier , Fournier Pierre-Edouard
Published: January 2021

To date there are thirteen species validly assigned to the genus Anaerococcus. Most of the species in this genus are anaerobic and of human origin. Anaerococcus urinimassiliensis sp. nov., strain Marseille-P2143T is member of family Peptoniphilaceae, which was isolated from the urine of a 17-year-old boy affected by autoimmune hepatitis and membranoproliferative glomerulonephritis using the culturomic approach. In the current study, a taxono-genomics method was employed to describe this new species. The strain Marseille-P2143T was gram positive cocci with translucent colonies on blood agar. Its genome was 2,189,509 bp long with a 33.5 mol% G + C content and exhibited 98.48% 16S rRNA similarity with Anaerococcus provencensis strain 9,402,080. When Anaerococcus urinomassiliensis strain Marseill-P2143T is compared with closely related species, the values ranged from 71.23% with A. hydrogenalis strain DSM 7454T (NZ_ABXA01000052.1) to 90.64% with A. provencensis strain 9402080T (NZ_HG003688.1). This strain has implemented the repertoire of known bacteria of the human urinary tract.
Improving vehicle re‐identification using CNN latent spaces: Metrics comparison and track‐to‐track extension
Authors: Roman‐Jimenez Geoffrey , Guyot Patrice , Malon Thierry , Chambon Sylvie , Charvillat Vincent , Crouzil Alain , Péninou André , Pinquier Julien , Sedes Florence , Sénac Christine
Published: January 2021

Herein, the problem of vehicle re‐identification using distance comparison of images in CNN latent spaces is addressed. First, the impact of the distance metrics, comparing performances obtained with different metrics is studied: the minimal Euclidean distance (MED), the minimal cosine distance (MCD) and the residue of the sparse coding reconstruction (RSCR). These metrics are applied using features extracted from five different CNN architectures, namely ResNet18, AlexNet, VGG16, InceptionV3 and DenseNet201. We use the specific vehicle re‐identification dataset VeRi to fine‐tune these CNNs and evaluate results. Overall, independently of the CNN used, MCD outperforms MED, commonly used in the literature. These results are confirmed on other vehicle retrieval datasets. Second, the state‐of‐the‐art image‐to‐track process (I2TP) is extended to a track‐to‐track process (T2TP). The three distance metrics are extended to measure distance between tracks, enabling T2TP. T2TP and I2TP are compared using the same CNN models. Results show that T2TP outperforms I2TP for MCD and RSCR. T2TP combining DenseNet201 and MCD‐based metrics exhibits the best performances, outperforming the state‐of‐the‐art I2TP‐based models. Finally, experiments highlight two main results: i) the impact of metric choice in vehicle re‐identification, and ii) T2TP improves the performances compared with I2TP, especially when coupled with MCD‐based metrics.
Constant absolute bandwidth tunable asymmetric order dual‐band BPF with reconfigurable bandwidth using mode control technique
Authors: Narayana Shriman , Kumar Nagendra , Singh Yatendra Kumar
Published: January 2021

Herein, a dual‐band bandpass filter with bandwidth tuning and constant bandwidth centre frequency tuning is presented, where the first and second bands are, respectively, of two and three modes. Based on λ/2 resonator modal analysis, a varactor‐ended stub is centrally loaded to a varactor‐terminated resonator to control even modes, and two varactor‐ended stubs are also loaded off‐centred symmetrically to tune, mostly, odd modes. Using these varactors, the first passband is formed by pairing the first even and odd modes while the second passband using the next pair of even and odd modes. To make the second band bandwidth also constant, the first mode of another resonator kept parallel to the first resonator has been used making the second passband of three poles. S‐matrix has been derived to analyse and coupling matrices have been synthesised to design the filter. A filter has been fabricated where the first band is tunable from 0.9 to 1.24 GHz (31.7%) with absolute bandwidth of 220 MHz while the second passband is tunable from 1.8 to 2.45 GHz (30.5%) with absolute bandwidth of 280 MHz. The first and second bands' bandwidth can be tuned from 110 to 360 MHz and from 230 to 700 MHz.
Antithrombotische Therapie nach peripherer Revaskularisation
Authors: Espinola-Klein Christine
Published: January 2021

Was ist neu?

Gerinnungshemmende Therapie nach peripherer Intervention In Analogie zur Koronarintervention wird nach Katheterinterventionen peripherer Gefäße meist passager eine duale Thrombozytenaggregationshemmung (TZAH) mit ASS 100 mg und Clopidogrel 75 mg durchgeführt. Größere Studien zu diesem Vorgehen fehlten bisher und die Empfehlungen der aktuellen Leitlinien haben den Charakter eines Expertenkonsens.

Gerinnungshemmende Therapie nach peripherer Bypassoperation Nach peripherer Bypassanlage empfehlen die aktuellen Leitlinien in der Regel die Monotherapie mit einem TZAH (ASS 100 mg oder Clopidogrel 75 mg). In Einzelfällen wird bei venösen Bypässen eine orale Antikoagulation oder bei Kunststoffbypässen eine duale TZAH eingesetzt. Diese Empfehlungen beruhen jedoch auf wenigen, teils kleinen Studien.

Duale gerinnungshemmende Therapie mit niedrigdosiertem Rivaroxaban und ASS Die VOYAGER-PAD-Studie ist mit 6564 Patienten die größte randomisierte Studie zur gerinnungshemmenden Therapie nach Revaskularisation. Es wurde das Konzept einer niedrigdosierten Rivaroxaban-Gabe (2-mal 2,5 mg) plus ASS 100 mg nach erfolgreicher peripherer Revaskularisation untersucht. Die Studie zeigte unter der Kombinationstherapie im Vergleich zur Therapie mit ASS 100 mg allein eine signifikant niedrigere Inzidenz des kombinierten Endpunkts aus akuter Extremitätenischämie, Amputation, Myokardinfarkt, ischämischem Schlaganfall oder Tod aus kardiovaskulärer Ursache. Getriggert wurde dieses Ergebnis primär durch die Reduktion von akuten Gefäßverschlüssen. Es kam zwar insgesamt zu mehr klinisch relevanten Blutungen unter der Kombinationstherapie, eine Erhöhung von intrazerebralen oder vital bedrohlichen Blutungen zeigte sich jedoch nicht. Wenn man Risiko und Nutzen in Bezug setzt, dann verhindert in einer Population von 10 000 Patienten die zusätzliche Gabe von Rivaroxaban 2-mal 2,5 mg pro Jahr 181 primäre Endpunkte auf Kosten von 29 relevante Blutungen.
Wie (un)gefährlich ist die einfache Fettleber?
Authors: Figge Anja , Jähnert Andreas , Canbay Ali
Published: January 2021

Was ist neu?

Was kann die nichtinvasive Diagnostik bei Steatosis hepatis leisten? Neuere, nichtinvasive bildgebende Verfahren, die den Fettgehalt und die Steifigkeit der Leber bestimmen, werden zunehmend zur Verlaufskontrolle bei Patienten mit nichtalkoholischer Fettlebererkrankung (NAFLD) eingesetzt. Dadurch kann die Leberbiopsie Patienten mit unklaren Befunden vorbehalten bleiben.

Wie entsteht die Steatosis hepatis und was bedingt die Erkrankungsprogression? Westlicher Lebensstil, Veränderungen des enteralen Mikrobioms, Kofaktoren wie Begleiterkrankungen und Medikamente sowie genetische Prädispositionen beeinflussen die Krankheitsentstehung und -progression.

Welche klinischen Verläufe sind bei Steatosis hepatis zu erwarten? Wichtigster prognostischer Faktor der NAFLD ist das Auftreten einer Leberfibrose. Jedoch finden sich zunehmend auch Komplikationen, insbesondere der primäre Leberzellkrebs bei NAFLD-Patienten, ohne dass eine nichtalkoholische Steatohepatitis (NASH) zuvor bekannt war oder eine fortgeschrittene Fibrose oder Zirrhose vorliegt. Eine Komorbidität der NAFLD mit Diabetes mellitus Typ 2 ist auch bei simpler Steatose mit einer erhöhten Sterblichkeit assoziiert.

Wechselspiel zwischen nichtalkoholischer Fettlebererkrankung und extrahepatischen Komorbiditäten Die NAFLD als hepatische Manifestation des metabolischen Syndroms ist ein unabhängiger Risikofaktor für kardiovaskuläre Komplikationen. Neben dem primären Leberzellkrebs lassen sich auch extrahepatische Neoplasien, insbesondere das kolorektale Karzinom und das Mammakarzinom, bei NAFLD-Patienten insgesamt, aber auch bei Patienten mit simpler Steatose gehäuft nachweisen. Somit sollte beim Umgang mit NAFLD-Patienten, auch bei simpler Steatose, über den „hepatologischen Tellerrand“ hinaus das Bewusstsein für die hier beschriebenen zahlreichen metabolischen, kardiovaskulären und neoplastischen Assoziationen geschärft werden. Es gilt bei dieser prävalenten Erkrankung, ganzheitliche Präventionskonzepte interdisziplinär zu prüfen und zu evaluieren. Die strukturierte Etablierung und Evaluierung spezialisierter Versorgungszentren für Patienten mit NAFLD, einschließlich der interdisziplinären Evaluation und Betreuung von Patienten mit simpler Steatose, stellen angesichts der aktuellen Datenlage und der Prävalenz eine große Herausforderung für sämtliche Akteure des Gesundheitssektors dar (Abb. 1).
Schulaktivitäten analysieren – Assessment: School AMPS
Authors: Kaelin Vera
Published: January 2021

Mit dem School AMPS können Ergotherapeuten erfassen, wie gut Kindergarten- und Schulkinder relevante Aktivitäten in ihrem Kindergarten- bzw. Schulalltag ausführen. Sie analysieren, wo ein Kind Schwierigkeiten hat und Unterstützung benötigt.
Würden Sie einen behinderten Kollegen einstellen? – Mitarbeiter mit Behinderungen
Authors: von Eisenhart Rothe Anna
Published: January 2021

Auch Mitarbeiter können von physischen oder psychischen Einschränkungen betroffen sein. Wie gehen wir Therapeuten dann mit unseren Angestellten und Kollegen um?
Mehr Selbstständigkeit durch einfühlsames Begleiten – Castillo Morales-Konzept
Authors: Kranz Florence
Published: January 2021

Bei der Beschäftigung mit diesem interdisziplinären Konzept spürt man schnell: Hier schwingt neben neurophysiologischem Know-how auch jede Menge „Spirit“ mit. Sicherlich auch ein Grund dafür, warum es Ergo-, Physiotherapeuten und Logopäden seit über 30 Jahren in die Castillo Morales-Fortbildungen zieht. Was aber genau macht die Faszination an diesem Konzept aus? ergopraxis hat sich das neu aufgelegte Lehrbuch näher angeschaut und mit den Mitherausgeberinnen Christiane Türk und Silvia Söhlemann gesprochen.
Stellenwert der präoperativen Computertomografie für die Prädiktion einer optimalen Zytoreduktion beim fortgeschrittenen Ovarialkarzinom
Authors: Stachs Angrit , Engel Karen , Stubert Johannes , Reimer Toralf , Gerber Bernd , Dieterich Max
Published: January 2021

Einleitung Eine optimale Zytoreduktion ist der wichtigste Prognosefaktor beim fortgeschrittenen Ovarialkarzinom. Obwohl Stadieneinteilung und Einschätzung der Operabilität durch Explorativ-Operation erfolgen, gilt die präoperative Computertomografie (CT) des Abdomens als Standard. Ziel dieser Studie ist die Überprüfung verschiedener CT-Parameter hinsichtlich der Prädiktion einer optimalen Zytoreduktion.

Patienten und Methoden In die retrospektive Studie wurden 131 Patientinnen mit zwischen 2010 bis 2014 neu diagnostiziertem Ovarialkarzinom aufgenommen. Davon wurden n = 36 im FIGO-Stadium I bis IIB aus der Studie ausgeschlossen. Von den 95 Patientinnen mit FIGO-Stadium IIC bis IV lagen bei n = 75 präoperative CT-Abdomen vor. Die CT-Scans wurden einem verblindeten Review unterzogen. Die evaluierten 11 CT-Parameter wurden mittels χ2-Test und logistischer Regressionsanalyse hinsichtlich der Endpunkte makroskopischer Tumorrest sowie Tumorrest > 1 cm überprüft. Überlebensanalysen erfolgten mittels Kaplan-Meier-Methode und Log-Rank-Test.

Ergebnisse Von 75 Patientinnen hatten 28 (37,3 %) eine vollständige Tumorresektion und 26 (34,7 %) Tumorreste ≤ 1 cm. Tumorreste > 1 cm fanden sich bei 21 Patientinnen (28 %), davon waren 5 nicht resektabel. Das Gesamtüberleben bei Tumorrest > 1 cm unterschied sich signifikant von der Gruppe mit makroskopischer Tumorfreiheit (p = 0,003) bzw. Tumorrest ≤ 1 cm (p = 0,04). Die CT-Parameter Tumorherde am Diaphragma, Mesokolon, Omentum majus, Peritoneum sowie Aszites korrelierten mit makroskopischem Tumorrest. In der multivariaten logistischen Regressionsanalyse war lediglich hinsichtlich der Prädiktion einer suboptimalen Tumorresektion (> 1 cm) der CT-Parameter intraparenchymatöse Lebermetastase statistisch signifikant (OR 8,04; 95 %-KI 1,57–42,4; p = 0,0134). Sensitivität, Spezifität, PPV und NPV betragen 37,5, 89,7, 66,7 und 72,2 %.

Schlussfolgerung Obwohl mittels CT Abdomen Risikoparameter für suboptimale Tumorreduktion identifizierbar sind, ist wegen der geringen diagnostischen Genauigkeit die chirurgische Exploration mit histologischer Diagnosesicherung unverzichtbar.
The Potential for Airborne Transmission of SARS-CoV-2 in Sport: A Cricket Case Study
Authors: England Rory , Peirce Nicholas , Wedatilake Thamindu , Torresi Joseph , Kemp Simon , Cook Malcolm , Mitchell Sean , Harland Andy
Published: January 2021

A review of risk factors affecting airborne transmission of SARS-CoV-2 was synthesised into an ‘easy-to-apply’ visual framework. Using this framework, video footage from two cricket matches were visually analysed, one pre-COVID-19 pandemic and one ‘COVID-19 aware’ game in early 2020. The number of opportunities for one participant to be exposed to biological secretions belonging to another participant was recorded as an exposure, as was the estimated severity of exposure as defined from literature. Events were rated based upon distance between subjects, relative orientation of the subjects, droplet generating activity performed (e. g., talking) and event duration. In analysis we reviewed each risk category independently and the compound effect of an exposure i. e., the product of the scores across all categories. With the application of generic, non-cricket specific, social distancing recommendations and general COVID-19 awareness, the number of exposures per 100 balls was reduced by 70%. More impressive was the decrease in the most severe compound ratings (those with two or more categories scored with the highest severity) which was 98% and the reduction in exposures with a proximity <1 m, 96%. Analysis of the factors effecting transmission risk indicated that cricket was likely to present a low risk, although this conclusion was somewhat arbitrary omitting a comparison with a non-cricketing activity.
Lumbar Erector Spinae Plane Block for Posterior–Superior Iliac Spine Bone Graft Site Pain in Patients Undergoing Occipitocervical and C1–C2 Fusion for Atlantoaxial Dislocation/Odontoid Fracture—A Case Series
Authors: Mariappan Ramamani , Gandham Edmond Jonathan , Stephenson Sam Jenkins , Cherian Noble E. , Lionel Karen Ruby
Published: January 2021

Pain at the autologous bone graft site from the posterior–superior iliac spine (PSIS) is severe enough to affect the postoperative ambulation. It adds to the morbidity of the surgical procedure. Inadequate pain management at the graft site not only affects the postoperative recovery but also can lead to chronic pain. We report the use of ultrasound (US)-guided lumbar erector spinae plane block (ESPB), to deliver effective analgesia for this pain. Patients who underwent occipitocervical fusion (OCF) and C1–C2 fusion using PSIS for atlantoaxial dislocation (AAD)/odontoid fracture from January to March 2020 and who received US-guided lumbar ESPB were retrospectively studied. All the necessary data were collected from the inpatient hospital, anesthesia, and the acute pain service records. A total of six patients received lumbar ESPB, of which one received a single shot injection, and the rest five had a catheter placement for postoperative analgesia. The average volume of intraoperative and postoperative bolus was 27(range: 15–30) and 21 (range: 15–30) mL of 0.2% ropivacaine, respectively. All patients achieved a unilateral sensory blockade ranging from L1 to L3 dermatomes. None of our patients had a numerical rating scale of > 4 on movement at any time point during the first 48 hours except in one, in whom only a single shot bolus was given. No complications related to ESPB were noted. All were ambulated on the second postoperative day except one. The average length of hospital stay was 6 (range: 4–10) days. US-guided lumbar ESPB provides excellent analgesia for PSIS bone graft site pain and promotes early ambulation.
Childhood-Onset Multifocal Motor Neuropathy with IgM Antibodies to Gangliosides GM1: A Case Report with Poor Outcome
Authors: Pro Stefano , Ursitti Fabiana , Pruneddu Gian Luca , Di Capua Matteo , Valeriani Massimiliano
Published: January 2021

Background Multifocal motor neuropathy (MMN) is a slowly progressive motor neuropathy characterized by asymmetric muscle weakness without sensory involvement. Typically, MMN respond completely to treatment with intravenous immunoglobulin (IVIg). MMN is even rarer in the pediatric population, where only five patients have been reported up to now.

Case Report We discuss the 3-year follow-up of a 13-year-old girl with MMN who was positive for IgM antibodies to gangliosides GM1. She was diagnosed with MMN in accordance with the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) criteria. Serological studies revealed that she tested positive for IgM antibodies to GM1. She underwent intravenous methylprednisolone followed by an oral prednisone taper, intravenous immunoglobulin (IVIg), plasma exchange followed by IVIG and prednisone and Rituximab. No improvement was referred. At the present, she shows flaccid tetraplegia, facial diplegia, and bulbar cranial nerve palsy.

Conclusion Although childhood onset MMN is rare, most patients reported in literature respond to IVIg treatment. In a few cases, however, IVIg can be ineffective. In our patient, IVIg as well as treatment with prednisolone, plasma exchange and rituximab have failed.
Simplified power law relationship in the estimation of hydraulic conductivity of unsaturated sands using electrical conductivity
Authors: Liu Ching-Yi , Hsieh Yun-Da , Chiu Yung-Chia
Published: January 2021

The unsaturated zone is a complex multiphase system, and modelling and prediction of flow and contaminant transport in this zone remain a challenge. In order to understand the mechanisms of fluid flow in unsaturated sands, an accurate and efficient approach to estimate unsaturated hydraulic conductivity (K) is essential. In this study, a power law relationship was derived from a combination of Archie’s law and van Genuchten’s model to relate bulk (apparent) electrical conductivity (ECa) with unsaturated K. The laboratory sandbox experiments were conducted first to delineate the soil water characteristic curves (SWCCs). Time domain reflectometry was used to simultaneously measure volumetric water content (θ) and ECa. Then, the experimental relationships of the effective saturation (S) and ECa and simulated S–K were combined to establish the relationship between ECa and unsaturated K. The developed power law relationships described the relative EC (ECr) and relative K (Kr) very well by just using one parameter, exponent β. When fluid EC was low, the β values for the drainage and wetting processes ranged within 2.09–2.74 and 2.50–3.79 respectively. The variations of β values of homogeneous material were smaller that of heterogeneous material and the effect of hysteresis on the ECr–Kr relationship was observed. When pore space was filled with the high-EC solution, it easily mimicked the S–Kr relationship and resulted in a smaller β value. The β value acted as a lumped factor accounting for pore tortuosity, pore connectivity, shape of pore space, and fluid EC. The power law relationship of ECr–Kr developed in this study could lead to a direct estimation of the spatial and temporal variations of unsaturated K, once the measurements of SWCC are available from estimation of saturated K and combination of time-lapse ECa measurements. Accurate and efficient estimation of unsaturated K could improve the prediction of flow in the unsaturated zone and allow a comprehensive understanding of unsaturated zone processes.
The role of humorous elements in Cádizchirigotasin creating/reinforcing a local identity
Authors: Padilla Cruz Manuel
Published: January 2021

This paper adopts a relevance-theoretic perspective to analyse howchirigotas – one of the types of bands in Cádiz carnival – exploit a series of verbal and visual comic elements in order to create or reinforce local identity: (i) the names of the bands, (ii) their attire, (iii) gestures and (iv) the lyrics of their comical songs, which satirise, mock, criticise, ridicule, praise, flatter or censure events or states of affairs. These elements will be argued to make manifest assumptions, activate (private) mental frames or express attitudes about those events or states of affairs, which the audience discover are already manifest to, and shared by, its members. Checking that other people entertain similar assumptions about and/or have similar attitudes towards those events or states of affairs – i.e. the ‘joy of manifestness’ – will be shown to be essential for generating a feeling of in-group membership on which that of a local identity greatly depends.
Pressure-Corrected Carotid Stiffness and Young’s Modulus: Evaluation in an Outpatient Clinic Setting
Authors: van der Bruggen Myrthe , Spronck Bart , Bos Siske , Heusinkveld Maarten H G , Taddei Stefano , Ghiadoni Lorenzo , Delhaas Tammo , Bruno Rosa Maria , Reesink Koen D
Published: January 2021

Background

Conventional measures for assessing arterial stiffness are inherently pressure dependent. Whereas statistical pressure adjustment is feasible in (larger) populations, it is unsuited for the evaluation of an individual patient. Moreover, statistical “correction” for blood pressure may actually correct for: (i) the acute dependence of arterial stiffness on blood pressure at the time of measurement; and/or (ii) the remodeling effect that blood pressure (hypertension) may have on arterial stiffness, but it cannot distinguish between these processes.

METHODS

We derived—assuming a single-exponential pressure–diameter relationship—3 theoretically pressure-independent carotid stiffness measures suited for individual patient evaluation: (i) stiffness index β0, (ii) pressure-corrected carotid pulse wave velocity (cPWVcorr), and (iii) pressure-corrected Young’s modulus (Ecorr). Using linear regression analysis, we evaluated in a sample of the CATOD study cohort changes in mean arterial pressure (ΔMAP) and comparatively the changes in the novel (Δβ0, ΔcPWVcorr, and ΔEcorr) as well as conventional (ΔcPWV and ΔE) stiffness measures after a 2.9 ± 1.0-year follow-up.

RESULTS

We found no association between ΔMAP and Δβ0, ΔcPWVcorr, or ΔEcorr. In contrast, we did find a significant association between ΔMAP and conventional measures ΔcPWV and ΔE. Additional adjustments for biomechanical confounders and traditional risk factors did neither materially change these associations nor the lack thereof.

Conclusions

Our newly proposed pressure-independent carotid stiffness measures avoid the need for statistical correction. Hence, these measures (β0, cPWVcorr, and Ecorr) can be used in a clinical setting for (i) patient-specific risk assessment and (ii) investigation of potential remodeling effects of (changes in) blood pressure on intrinsic arterial stiffness.
Frequency of Headaches in Macromastia Patients and Relief After Reduction Mammoplasty
Authors: Can Bilgen
Published: January 2021

Background

Several studies have reported that neck, back, and shoulder pain can be reduced after macromastia. However, only 1 study has specifically investigated the relation between macromastia and headaches.

Objectives

This study aimed to determine the frequency of headaches in patients with macromastia by examining a sample from our clinic and to determine whether the patients experienced headache relief following breast reduction surgery.

Methods

One hundred patients, out of 456 patients who met the criteria, were contacted by telephone and administered a questionnaire. Statistical analysis was performed with SPSS version 17.0. Normal distribution of the variables was examined by histograms and Kolmogorov-Smirnov tests. Pearson’s chi-square and Fisher’s exact tests were used to compare groups. The Mann-Whitney U test was used to evaluate nonparametric variables between the patients who has 1500 grams or less breast tissue removed and the patients more than 1500 grams breast tissue removed.

Results

The incidence of headaches in patients with macromastia was found to be 29%. Among the patients with headaches, 65.52% reported relief after surgery. The relief rate for headaches was found to be associated with the amount of tissue removed.

Conclusions

The incidence of headaches increased in patients with macromastia compared with the general population, and patients reported headache relief after surgery. In addition, as the amount of tissue removal increased, the relief rate for headaches after surgery also increased. Although additional studies are essential, preoperative headaches should be evaluated in breast reduction patients, and the removal of larger amounts of breast tissue should be considered among patients who report headaches.

Level of Evidence: 4
Cohomology of Lie Groupoid Modules and the Generalized van Est Map
Authors: Lackman Joshua
Published: January 2021

The van Est map is a map from Lie groupoid cohomology (with respect to a sheaf taking values in a representation) to Lie algebroid cohomology. We generalize the van Est map to allow for more general sheaves, namely to sheaves of sections taking values in a (smooth or holomorphic) $G$-module, where $G$-modules are structures, which differentiate to representations. Many geometric structures involving Lie groupoids and stacks are classified by the cohomology of sheaves taking values in $G$-modules and not in representations, including $S^1$-groupoid extensions and equivariant gerbes. Examples of such sheaves are $\mathcal{O}^*$ and $\mathcal{O}^*(*D)\,,$ where the latter is the sheaf of invertible meromorphic functions with poles along a divisor $D\,.$ We show that there is an infinitesimal description of $G$-modules and a corresponding Lie algebroid cohomology. We then define a generalized van Est map relating these Lie groupoid and Lie algebroid cohomologies and study its kernel and image. Applications include the integration of several infinitesimal geometric structures, including Lie algebroid extensions, Lie algebroid actions on gerbes, and certain Lie $\infty $-algebroids.
An insidious case of infectious mononucleosis presenting with acute appendicitis diagnosed postoperatively: a case report
Authors: AlMudaiheem Faisal A , Alhabdan Sultan , Alhalafi Mohammed S , Alshieban Saeed
Published: January 2021

Infectious mononucleosis (IM) is a syndrome caused by the Epstein-Barr virus. IM typically presents with fever, pharyngitis and lymphadenopathy. Rarely, it can cause acute appendicitis. We report the case of a 19-year-old female presenting with a chief complaint of colicky, non-radiating abdominal pain for 2 days. Abdominal examination revealed rebound tenderness in right iliac fossa tenderness and splenomegaly. The diagnosis of acute appendicitis was confirmed by computed tomography. She underwent laparoscopic appendectomy and mesenteric lymph node biopsy. She was later diagnosed with IM based on laboratory findings and histopathology results. She received a course of intravenous acyclovir and was discharged. This shows that IM may present with acute appendicitis as the initial presentation and may not be accompanied by any other significant symptoms of IM.
The University of Virginia’s Institute of Law, Psychiatry, and Public Policy
Authors: Bonnie Richard J. , Murrie Daniel C. , Zelle Heather
Published: January 2021

This chapter describes the collaboration between the Institute of Law, Psychiatry, and Public Policy at the University of Virginia and the Department of Behavioral Health and Developmental Services in the Commonwealth. It is the longest running of the collaborations described in this book, having been in operation for nearly 50 years, and it involves activities in the areas of consultation on policy development, forensic training (including fellowships and other specialized training), public and professional education in mental health law, and the operation of a forensic assessment clinic. It serves as a national model, and many of the current leaders in mental health law and forensic psychiatry and psychology have received or provided training as part of this collaboration.
Establishing a Forensic Training Clinic
Authors: Conroy Mary Alice
Published: January 2021

The collaboration described in this chapter differs somewhat from that in other chapters. A university in Texas—Sam Houston State University—established a forensic training clinic staffed by doctoral trainees in clinical psychology and supervised by faculty members. This clinic offered services to courts in the region, primarily involving the evaluation of individuals involved in the criminal justice system on issues such as competence to stand trial, sentencing for individuals committing sexual offenses, mental state at the time of the offense, and others. This yielded valuable specialized training opportunities for graduate students, strong evaluations at a reasonable rate for courts, and an opportunity to generate funding for the university and the training program. The “collaboration,” therefore, was between the university and the court system rather than a state department of mental health; however many of the developmental and operational considerations were comparable to those described in other chapters.
Collaboration Between Universities and Public Behavioral Health Organizations
Authors: Heilbrun Kirk , Giallella Christy , Wright H. Jean , DeMatteo David , Griffin Patricia , Locklair Benjamin , Ayers David , Desai Alisha , Pietruszka Victoria
Published: January 2021

This book’s major purpose is to offer detailed information about successful collaborations between universities and public behavioral health organizations in criminal justice contexts. This final chapter distills the descriptions of collaborative projects offered in the previous nine contributed chapters into a series of “lessons learned” toward building, operating, and sustaining a successful collaboration. The lessons are offered in particular areas: planning, working together, training, consultation, financial considerations, personnel, and research. This volume, including the nine specific exemplary projects and the final “lessons learned” chapter, has implications for comparable collaborations between universities and public behavioral health organizations in a criminal justice context.
Peers as Culturally Relevant Change Agents
Authors: Collins Tai A. , Scott Meagan N. , Villarreal Julia N. , Endres Bryn E.
Published: January 2021

As the United States’ school-age population has become increasingly diverse, it is critical that the curricula, instruction, assessments, and interventions in schools are culturally relevant, reflecting the values and lived experiences of children and families. In this chapter, we posit that peer-mediated interventions are viable strategies that can be used to improve the cultural relevance of interventions in schools. After reviewing culturally relevant school-based service delivery, we offer four reasons supporting the use of peers as culturally relevant change agents: (a) communal orientation, (b) preference for racial/ethnic match, (c) overcoming cultural mismatches in schools, and (d) near peer modeling.
Peer Management Interventions
Authors: Helbig Kate A. , Dart Evan H.
Published: January 2021

Peer management interventions include strategies in which a student interventionist is trained to prompt, reinforce, and/or provide feedback on other students’ nonacademic behaviors (e.g., providing tokens for appropriate hand-raising, providing praise for joining ongoing groups on the playground). This chapter describes the variety of behaviors that have been addressed using peer management intervention. This chapter also discusses recommendations for implementing peer management interventions in schools, including considerations of diversity and equity within peer management interventions. Sample scripts and intervention materials are included.
Peer-Mediated Pivotal Response Training
Authors: McCoy Dacia M. , Ritter Chelsea , Murphy J. Meredith
Published: January 2021

Peer-mediated Pivotal Response Training (PM-PRT) is a behavioral approach that incorporates instruction and practice opportunities on pivotal and socially significant skills (e.g., communication, playing with peers) for individuals diagnosed with developmental disorders in their everyday routines and environments. This chapter provides an overview of key components to successfully utilize the PM-PRT intervention with children in a variety of settings. The intervention includes a peer interventionist who may use selected strategies with a target student such as gaining attention, modeling, turn-taking, encouraging conversation, choice in tasks, and reinforcement of attempts during a play session. For example, the intervention may be implemented during recess and can be tailored to an individual’s target behaviors. The flexibility of PM-PRT allows it to be an effective and efficient intervention that promotes generalization across peers and settings.
School-Wide Positive Behavioral Interventions and Supports
Authors: McIntosh Kent , Kittelman Angus
Published: January 2021

School-Wide Positive Behavioral Interventions and Supports (SWPBIS) refers to a systematic framework for service delivery in schools whereby evidence-based interventions are implemented within systems to ensure safe and equitable schools for all students. This chapter covers the SWPBIS model with particular attention to the potential of peers to be utilized in reducing the disproportionate discipline practices seen with various populations. This chapter includes practical recommendations for implementing SWPBIS and considerations of diversity and equity.
Anxiety and Other Distressing Symptoms
Authors: Markowitz John C.
Published: January 2021

This omnibus chapter covers anxiety disorders and other psychiatric disorders that may arise or be aggravated by the pandemic. Some anxiety is of course warranted in the midst of a crisis of ongoing risk and uncertainty; therapist and patient must try to separate appropriate from symptomatic anxiety. The chapter includes a discussion of prior IPT research for these disorders, appropriate IPT adaptations, and extended, detailed case examples illustrating the application of IPT to panic disorder, generalized anxiety disorder, and social anxiety disorder. It also addresses how the pandemic may trigger or exacerbate other diagnoses for which IPT has shown benefit.
The Effects of Transcranial Direct Current Stimulation Combined with Aerobic Exercise on Pain Thresholds and Electroencephalography in Healthy Adults
Authors: Sato Gosuke , Osumi Michihiro , Nobusako Satoshi , Morioka Shu
Published: January 2021

Objectives

We examined whether transcranial direct current stimulation (tDCS) combined with aerobic exercise (AE) modulated the pressure pain threshold (PPT) and peak alpha frequency (PAF) measured via resting electroencephalography.

Design

Single-blind experimental study with a cross-over design.

Setting

Neuro Rehabilitation Research Center, Kio University.

Subjects

Ten healthy controls participated in this study.

Methods

Three types of sessions––(i) tDCS, (ii) Sham tDCS/AE, and (iii) tDCS/AE––were tested in this investigation. Anodal stimulation (2 mA, 20 minutes) was applied over the left primary motor cortex. Each session was 20 minutes long. We used the PPT and short-form Profile of Mood States-Brief, as well as PAF measured via resting-electroencephalography, to investigate the effects of tDCS and AE. Heart rate and scores on the Borg scale were used to confirm exercise intensity. PAF was calculated in four regions of interest: frontal, central, parietal, and occipital areas.

Results

The change ratio of PPT increased during each session. The maximum change ratio of PPT were tDCS: 40.7%, Sham tDCS/AE: 51.5%, and tDCS/AE: 83.4%. change ratio of PPT was earlier and higher in the tDCS/AE trials compared with the other sessions. Negative mood was improved after session completion. Significant differences in PAF were found in the occipital area in the Sham tDCS/AE and tDCS/AE sessions.

Conclusions

The combined tDCS and AE intervention induced significant changes in PPT in a single session, with a PAF that was earlier and higher than those produced during the Sham tDCS/AE and tDCS sessions.
Belief Movement, Uncertainty Reduction, and Rational Updating
Authors: Augenblick Ned , Rabin Matthew
Published: January 2021

When a Bayesian learns new information and changes her beliefs, she must on average become concomitantly more certain about the state of the world. Consequently, it is rare for a Bayesian to frequently shift beliefs substantially while remaining relatively uncertain, or, conversely, become very confident with relatively little belief movement. We formalize this intuition by developing specific measures of movement and uncertainty reduction given a Bayesian’s changing beliefs over time, showing that these measures are equal in expectation and creating consequent statistical tests for Bayesianess. We then show connections between these two core concepts and four common psychological biases, suggesting that the test might be particularly good at detecting these biases. We provide support for this conclusion by simulating the performance of our test and other martingale tests. Finally, we apply our test to data sets of individual, algorithmic, and market beliefs.
A Multicenter, Open-Label, Randomized Controlled Trial of a Conservative Fluid Management Strategy Compared With Usual Care in Participants After Cardiac Surgery: The Fluids After Bypass Study*
Authors: Parke Rachael L. , Gilder Eileen , Gillham Michael J. , Walker Laurence J. C. , Bailey Michael J. , McGuinness Shay P.
Published: January 2021

OBJECTIVES:

There is little evidence to guide fluid administration to patients admitted to the ICU following cardiac surgery. This study aimed to determine if a protocolized strategy known to reduce fluid administration when compared with usual care reduced ICU length of stay following cardiac surgery.

DESIGN:

Prospective, multicenter, parallel-group, randomized clinical trial.

SETTING:

Five cardiac surgical centers in New Zealand conducted from November 2016 to December 2018 with final follow-up completed in July 2019.

PATIENTS:

Seven-hundred fifteen patients undergoing cardiac surgery; 358 intervention and 357 usual care.

INTERVENTIONS:

Randomization to protocol-guided strategy utilizing stroke volume variation to guide administration of bolus fluid or usual care fluid administration until desedation or up to 24 hours. Primary outcome was length of stay in ICU. Organ dysfunction, mortality, process of care measures, patient-reported quality of life, and disability-free survival were collected up to day 180.

MEASUREMENTS AND MAIN RESULTS:

Overall 666 of 715 (93.1%) received at least one fluid bolus. Patients in the intervention group received less bolus fluid (median [interquartile range], 1,000 mL [250–2,000 mL] vs 1,500 mL [500–2,500 mL]; p < 0.0001) and had a lower overall fluid balance (median [interquartile range], 319 mL [–284 to 1,274 mL] vs 673 mL [38–1,641 mL]; p < 0.0001) in the intervention period. There was no difference in ICU length of stay between the two groups (27.9 hr [21.8–53.5 hr] vs 25.6 hr [21.9–64.6 hr]; p = 0.95). There were no differences seen in development of organ dysfunction, quality of life, or disability-free survival at any time points. Hospital mortality was higher in the intervention group (4% vs 1.4%; p = 0.04).

CONCLUSIONS:

A protocol-guided strategy utilizing stroke volume variation to guide administration of bolus fluid when compared with usual care until desedation or up to 24 hours reduced the amount of fluid administered but did not reduce the length of stay in ICU.