bluuebunny/crossref_metadata_2025 huggingface dataset:
A Two-sample Nonparametric Test for Circular Data– its Exact Distribution and Performance
Authors: Jammalamadaka S. Rao , Guerrier Stéphane , Mangalam Vasudevan
Published: February 2021

A nonparametric test labelled ‘Rao Spacing-frequencies test’ is explored and developed for testing whether two circular samples come from the same population. Its exact distribution and performance relative to comparable tests such as the Wheeler-Watson test and the Dixon test in small samples, are discussed. Although this test statistic is shown to be asymptotically normal, as one would expect, this large sample distribution does not provide satisfactory approximations for small to moderate samples. Exact critical values for small samples are obtained and tables provided here, using combinatorial techniques, and asymptotic critical regions are assessed against these. For moderate sample sizes in-between i.e. when the samples are too large making combinatorial techniques computationally prohibitive but yet asymptotic regions do not provide a good approximation, we provide a simple Monte Carlo procedure that gives very accurate critical values. As is well-known, the large number of usual rank-based tests are not applicable in the context of circular data since the values of such ranks depend on the arbitrary choice of origin and the sense of rotation used (clockwise or anti-clockwise). Tests that are invariant under the group of rotations, depend on the data through the so-called ‘spacing frequencies’, the frequencies of one sample that fall in between the spacings (or gaps) made by the other. The Wheeler-Watson, Dixon, and the proposed Rao tests are of this form and are explicitly useful for circular data, but they also have the added advantage of being valid and useful for comparing any two samples on the real line. Our study and simulations establish the ‘Rao spacing-frequencies test’ as a desirable, and indeed preferable test in a wide variety of contexts for comparing two circular samples, and as a viable competitor even for data on the real line. Computational help for implementing any of these tests, is made available online “” R package and is part of this paper.
Patterns of multimorbidity and risk of disability in community-dwelling older persons
Authors: Marengoni Alessandra , Akugizibwe Roselyne , Vetrano Davide L. , Roso-Llorach Albert , Onder Graziano , Welmer Anna-Karin , Calderón-Larrañaga Amaia
Published: February 2021

The aim was to analyze the association between specific patterns of multimorbidity and risk of disability in older persons. Data were gathered from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K); 2066 60 + year-old participants living in the community and free from disability at baseline were grouped according to their multimorbidity patterns and followed-up for six years. The association between multimorbidity patterns and disability in basic (ADL) and instrumental (IADL) activities of daily living was examined through multinomial models. Throughout the follow-up, 434 (21.0%) participants developed at least one ADL and 310 (15.0%) at least one IADL. Compared to the unspecific pattern, which included diseases not exceeding their expected prevalence in the total sample, belonging to the cardiovascular/anemia/dementia, the sensory impairment/cancer and the musculoskeletal/respiratory/gastrointestinal patterns was associated with a higher risk of developing both ADL and IADL, whereas subjects in the metabolic/sleep disorders pattern showed a higher risk of developing only IADL. Multimorbidity patterns are differentially associated with incident disability, which is important for the design of future prevention strategies aimed at delaying functional impairment in old age, and for a better healthcare resource planning.
Correction to: Some mathematical concepts of the analytic hierarchy process
Authors: Saaty Thomas L.
Published: February 2021

The article Some Mathematical Concepts of the Analytic Hierarchy Process
Correction to: Feature Selection With Neural Networks
Authors: Leray Philippe , Gallinari Patrick
Published: February 2021

The article Feature Selection With Neural Networks.
Correction to: Beyond SEM: General Latent Variable Modeling
Authors: Muthen Bengt. O.
Published: February 2021

The article Beyond SEM: General Latent Variable Modeling, written by Bengt. O. Muthen.
Profiling the Self in Mobile Online Dating Apps: a Serial Picture Analysis
Authors: Degen Johanna Lisa , Kleeberg-Niepage Andrea
Published: February 2021

Profiles in the widely used phenomenon of mobile online dating applications are characteristically reduced to condensed information mostly containing one or a few pictures. Thus, these picture(s) play a significant role for the decision-making processes and success, supposedly holding vital meaning for the subjects. While profile pictures in social media are omnipresent and some research has already focused on these pictures, especially selfies, there has been little attention with regards to the actual self-presentation when mobile online dating. In this paper, we show the results of a reconstructive serial analysis of 524 mobile online dating profile pictures investigating how subjects present themselves in the context of a mobile online dating app. This context is highly specific and characterized by continuous and dichotomous judgments by (unknown) others, unseen competition, and permanent validation of the self. Despite the conceivable multitude of possible self-presentations, our analysis led to eight clear types of self-presentation. Contemplating on subject’s good reasons for presenting the self as one of many and not as varied and unique when mobile online dating, we refer to the discourse of the private self (Gergen, The saturated self: Dilemmas of identity in contemporary life, Basic Books, New York, 1991; Rose, Governing the soul: Shaping of the private self, Free Association Books, London, 2006) and to (Holzkamp, 1983. Grundlagen der Psychologie. Frankfurt a.M.: Campus.) concept of restrictive and generalized agency in a context of socially constituted norms.
Complex Human Action Recognition Using a Hierarchical Feature Reduction and Deep Learning-Based Method
Authors: Serpush Fatemeh , Rezaei Mahdi
Published: February 2021

Automated human action recognition is one of the most attractive and practical research fields in computer vision. In such systems, the human action labelling is based on the appearance and patterns of the motions in the video sequences; however, majority of the existing research and most of the conventional methodologies and classic neural networks either neglect or are not able to use temporal information for action recognition prediction in a video sequence. On the other hand, the computational cost of a proper and accurate human action recognition is high. In this paper, we address the challenges of the preprocessing phase, by an automated selection of representative frames from the input sequences. We extract the key features of the representative frame rather than the entire features. We propose a hierarchical technique using background subtraction and HOG, followed by application of a deep neural network and skeletal modelling method. The combination of a CNN and the LSTM recursive network is considered for feature selection and maintaining the previous information; and finally, a Softmax-KNN classifier is used for labelling the human activities. We name our model as “Hierarchical Feature Reduction & Deep Learning”-based action recognition method, or HFR-DL in short. To evaluate the proposed method, we use the UCF101 dataset for the benchmarking which is widely used among researchers in the action recognition research field. The dataset includes 101 complicated activities in the wild. Experimental results show a significant improvement in terms of accuracy and speed in comparison with eight state-of-the-art methods.
Observations of Density Cavities and Associated Warm Ion Flux Enhancements in the Inner Magnetosphere
Authors: Ferradas C. P. , Boardsen S. A. , Fok M.‐C. , Buzulukova N. , Reeves G. D. , Larsen B. A.
Published: February 2021

We present a statistical study of density cavities observed in the inner magnetosphere by the Van Allen Probes during four one‐month periods: February 2013, July 2013, January 2014, and June 2014. These periods were chosen to allow the survey of all magnetic local times. We find that density cavities are a recurrent feature of the density profiles of in situ measurements in the inner magnetosphere. We further investigate the correlation between the density cavities and the enhancement of fluxes of warm ions with energies of 10–100 eV. The results show that warm ion flux enhancements associated with the density cavities were observed more frequently for H+, then for He+ and the least frequently for O+. The occurrences of the associated flux enhancements were increased when considering only the cavities inside the plasmasphere. Possible mechanisms responsible for the observed warm ion flux enhancements and the role of density cavities on these ion flux enhancements are discussed.
RBSP‐ECT Combined Pitch Angle Resolved Electron Flux Data Product
Authors: Boyd A. J. , Spence H. E. , Reeves G. D. , Funsten H. O. , Skoug R. M. , Larsen B. A. , Blake J. B. , Fennell J. F. , Claudepierre S. G. , Baker D. N. , Kanekal S. G. , Jaynes A. N.
Published: February 2021

We describe a new data product combining pitch angle resolved electron flux measurements from the Radiation Belt Storm Probes (RBSP) Energetic Particle Composition and Thermal Plasma (ECT) suite on the National Aeronautics and Space Administration’s Van Allen Probes. We describe the methodology used to combine each of the data sets and produce a consistent set of pitch‐angle‐resolved spectra for the entire Van Allen Probes mission. Three‐minute‐averaged flux spectra are provided spanning energies from 15 eV up to 20 MeV. This new data product offers researchers a consistent cross calibrated data set to explore the particle dynamics of the inner magnetosphere across a wide range of energies.
On the Effects of Mesospheric and Lower Thermospheric Oxygen Chemistry on the Thermosphere and Ionosphere Semiannual Oscillation
Authors: Jones M. , Sutton E. K. , Emmert J. T. , Siskind D. E. , Drob D. P.
Published: February 2021

This study quantifies mesosphere/lower thermosphere (MLT) oxygen chemical contributions to the global thermosphere‐ionosphere (T‐I) semiannual oscillation (SAO) using a series of numerical experiments from the National Center for Atmospheric Research (NCAR) thermosphere‐ionosphere‐mesosphere‐electrodynamics general circulation model (TIME‐GCM) that isolate essential chemical processes affecting O and O2 in the MLT region. We track the vertical dynamical, diffusive, and chemical fluxes of O and O2 in and out of two control volumes between ∼80 and 130 km using a finite volume approach to the individual species continuity equation to investigate their relative importance on the global T‐I SAO. TIME‐GCM results indicate that the global T‐I SAO amplitude and phase is fairly insensitive to significant changes in odd oxygen chemical reaction rates in the MLT. While chemistry has an appreciable effect on O in the MLT region, sensitivity to changes in odd oxygen and odd hydrogen chemical rates appear to be offset by a consequent adjustment in the vertical bulk wind and eddy diffusive transport of O locally, rendering their effects inconsequential to the global T‐I SAO aloft. The implications of our findings for reproducing a self‐consistent global T‐I SAO in the NCAR thermosphere‐ionosphere‐electrodynamics general circulation model (TIE‐GCM) with a lower boundary near ∼100 km are discussed. Specifically, including latitude‐season variations in O, O2, and N2 from NRLMSIS® 2.0 at the lower boundary of the TIE‐GCM near ∼100 km improves its representation of the climatological T‐I SAO. However, reformulating the TIE‐GCM temperature lower boundary condition could further improve its ability to simulate the T‐I SAO from first‐principles.
Near Trench 3D Seismic Attenuation Offshore Northern Hikurangi Subduction Margin, North Island, New Zealand
Authors: Nakai Jenny S. , Sheehan Anne F. , Abercrombie Rachel E. , Eberhart‐Phillips Donna
Published: February 2021

We image seismic attenuation near the Hikurangi trench offshore New Zealand, using ocean bottom and land‐based seismometers, revealing high attenuation above a recurring shallow slow‐slip event and within the subducting Hikurangi Plateau. The Hikurangi subduction margin east of the North Island, New Zealand is the site of frequent shallow slow slip events. Overpressured fluids are hypothesized to lead to slow slip at shallow depths close to the oceanic trench. Seismic attenuation, energy loss of seismic waves, can be used to detect high temperatures, melt, the presence of fluids, and fractures. We use local earthquake P‐ and S‐waves from 180 earthquakes to invert for t*, and subsequently invert for Qp and Qs, offshore the North Island directly above the area of slow slip. We image Qp and Qs to ∼25 km depth, increasing resolution of previously identified coastal low Q (100–300), and finding a new region of even higher attenuation (Qp and Qs < 50–100) directly above the shallow slow slip event of 2014–2015, beneath the offshore seismic array. This highest attenuation is downdip of a subducting seamount, and is spatially correlated with a high seismic reflectivity zone and Vp/Vs > 1.85, all of which provide evidence for the presence of fluids. The Qp and Qs is low at the trench (<50–100) and in the subducting plate (100–200), suggesting that seismic wave scattering due to faults, fractures, and the inherent heterogeneous composition of the Hikurangi Plateau, a large igneous province, plays a role in seismic attenuation.
Vorticity Recirculation and Asymmetric Generation at a Small Headland With Broadband Currents
Authors: Kovatch Michael , Feddersen Falk , Grimes Derek J. , MacMahan Jamie H.
Published: February 2021

Fixed acoustic Doppler current profiler (ADCP) velocity measurements are used to investigate headland vorticity generation and recirculation in ∼20 m depth around the small (∼1 km) central California headland Pt. Sal. To reduce vorticity estimation noise, velocities are reconstructed from the first two Empirical Orthogonal Function modes representing ≈73% of the variance. Using fixed ADCPs, depth‐averaged vorticity is estimated west and south of Pt. Sal. Only one west‐location vorticity component is estimated, leading to negative vorticity bias for northward flow. The south location vorticity is consistent with estimates from parallel vessel transects on one day. The observed depth‐averaged flow V was primarily along‐bathymetric contours and varied ±0.2 ms−1 across subtidal and tidal frequency bands. The depth‐averaged normalized vorticity varied ±8 across all frequency bands. Vorticity distributions are skewed with opposite sign at west and south locations, and is more likely at the west location. At both locations, depth‐averaged vorticity and velocity are inversely related, with relationship asymmetric with sign of V, indicating headland and farther upstream vorticity generation. Binned‐mean depends on both V and its time‐derivative, and indicates vorticity recirculation across the headland. The ∼2 h vorticity adjustment timescale and the associated short excursion distances indicate vorticity generation between south and west locations. Potential vorticity changes across the headland are different for positive and negative V indicating headland asymmetric vorticity generation. Pt. Sal occupies a nondimensional parameter space that is unique relative to other well studied headlands.
Four Types of Baroclinic Instability Waves in the Global Oceans and the Implications for the Vertical Structure of Mesoscale Eddies
Authors: Feng Ling , Liu Chuanyu , Köhl Armin , Stammer Detlef , Wang Fan
Published: February 2021

Linear stability analysis is re‐conducted to fully understand the geostrophic distribution of the different types of baroclinic instability (BCI) in the global oceans, their correspondence to the different vertical structures of the observed mesoscale eddies, and the properties and formation mechanisms of the instability waves. Four principal vertical types of BCI are identified, which are found to exhibit large‐scale patterns in the global ocean. The surface‐ and bottom‐intensified type (called the Eady type hereafter) is mainly located in the Antarctic Circumpolar Current (ACC) region, locations of the bottom‐intensified type (Charney_b type) are scattered around the Eady type, the surface‐intensified type (Charney_s type) primarily occurs in the subtropics (10°–35°), and the interior‐intensified type (Phillips type) occurs primarily between 5° and 20° in both hemispheres. More specifically, both geostrophic locations and the depths of the maximum perturbation velocities of the Phillips type BCIs match those of observed subsurface eddies. Moreover, the BCI waves show regions of uniform propagation properties: eastward in the ACC and the mid‐latitudes (25°–45°), and westward in the low latitudes (30°S–30°N) of both hemispheres and in the high latitudes of the Northern Hemisphere (>50°N). These waves resemble normal mode Rossby waves in structure (i.e., first baroclinic, second baroclinic, and topographic Rossby waves), but their propagation speeds are found to be Doppler shifted by the mean flows relevant for the corresponding BCI type. Propagating signals with the same dispersion relationships as the BCI waves are captured with numerical ocean general circulation models.
The Role of Climate and Lake Size in Regulating the Ice Phenology of Boreal Lakes
Authors: Higgins S. N. , Desjardins C. M. , Drouin H. , Hrenchuk L. E. , van der Sanden J. J.
Published: February 2021

We quantified the relationships between seasonal air temperatures and ice phenology for a 0.54 km2 boreal lake in Northwestern Ontario, Canada using a 50‐year time series (1970–2019). Significant temporal trends in the duration of ice cover (−4.0 days decade−1) occurred over the study period and both ice‐on and ice‐off dates were highly predictable from seasonal air temperatures. While temporal trends in ice‐off dates were not significant, ice‐on dates trended later by 2.2 days decade−1, and both ice‐off dates and the duration of ice‐cover became increasingly variable over the study period. For three consecutive winter seasons, we also evaluated regional variations of ice‐phenology and snow and ice‐thickness from 9 to 30 boreal lakes across a lake size gradient (0.02–26 km2) using ground based and satellite observations. Regional variation of ice‐on dates (30–45 days), ice‐off dates (10–21 days), and total duration of ice‐cover (22–38 days) between lakes displayed significant nonlinear relationships to lake size across all years. Regional variation of ice‐off dates was structured according to lake size, and appeared driven by relationships between lake size, snow thickness, and ice thickness. Multiple linear regression and generalized additive modeling approaches to predict ice‐on and ice‐off dates at the regional scale by integrating the effects of air temperature and lake size had similar performance, explaining >90% of the variance of observed.
A binary mixed polymer brush coating with adjusted hydrophobic property to control protein adsorption
Authors: Chen Chaoshi , Atif Muhammad , He Kang , Zhang Miao , Chen Lijuan , Wang Yanmei
Published: February 2021

Binary mixed polymer brushes based on PGMA-b-PNIPAM-b-PSt and PMOXA-r-GMA were used as thermoresponsive coating to control protein adsorption.
Restricted binding of a model protein on C3N4nanosheets suggests an adequate biocompatibility of the nanomaterial
Authors: Gu Zonglin , Perez-Aguilar Jose Manuel , Shao Qiwen
Published: February 2021

The fixed binding pattern of protein adsorption to C3N4plays a major role in the nanomaterial biocompatibility, which results from the inherent porous surface structure.
Reliable intermittent extended dissipative control for uncertain fuzzy flexible spacecraft systems with Bernoulli stochastic distribution
Authors: Ding Kui , Zhu Quanxin
Published: February 2021

This paper addresses the problem of uncertain fuzzy intermittent extended dissipative control to stabilize the flexible spacecraft (FS). However, to the systems with actuator random failures, input saturation and Bernoulli stochastic distribution by utilizing a novel switching Lyapunov function method. Compared with the existing common Lyapuonv function, the proposed approach is convenient for us to exploit more information of switching interval. Especially, the condition that control length and control period must be a certain proportion in the previous works of intermittent control strategy is removed in this work, which promotes the obtained criterion to be less conservative. Numerical simulations are finally given to demonstrate the validity and superiority of the theoretical results.
Performance‐enhanced iterative learning control using a model‐free disturbance observer
Authors: Li Min , Yan Tingjian , Mao Caohui , Wen Long , Zhang Xinxin , Huang Tao
Published: February 2021

This paper proposes a novel performance‐enhanced iterative learning control (ILC) scheme using a model‐free disturbance observer (DOB) to achieve high performance for precision motion systems that encounter non‐repetitive disturbances. As is well known, the performance of the standard ILC (SILC) is severely degraded by the non‐repetitive disturbances. By introducing DOB into SILC, this paper improves the robustness of the ILC system against non‐repetitive disturbances. In the proposed enhanced ILC (EILC), SILC aims at learning the feedforward signals for a specific reference, while DOB is to compensate for external disturbances. Little or no plant model knowledge is required for SILC. To maintain this advantage after introducing DOB, a model‐free design method for DOB is proposed to release the need for the plant model. Based only on a specific reference and the corresponding feedforward signals learned by SILC, the filter of DOB is optimized via an instrumental‐variable estimate method. Numerical simulation is performed to illustrate the effectiveness and enhanced performance of the proposed control approach.
The robust multi‐innovation estimation algorithm for Hammerstein non‐linear systems with non‐Gaussian noise
Authors: Wang Xuehai , Ding Feng
Published: February 2021

The characteristic of the external noise has significant influences on system modelling and identification, and the assumption that the noise follows the Gaussian distribution may be invalid due to realistic reasons. This paper discusses the identification issue of Hammerstein non‐linear systems with non‐Gaussian noise and presents a robust gradient algorithm. The algorithm is derived based on the logarithmic cost function of continuous mixed ‐norm of prediction errors, which takes into account each ‐norm of errors for . The gain at each recursive step adapts to the data quality so that the algorithm has good robustness to non‐Gaussian noise. To improve the estimation accuracy, a robust multi‐innovation gradient algorithm is proposed by using the multi‐innovation identification theory. Two examples are provided to exhibit the validity of the proposed algorithms.
Optimal mean‐square consensus for heterogeneous multi‐agent system with probabilistic time delay
Authors: Sun Fenglan , Li Hao , Zhu Wei , Kurths Jürgen
Published: February 2021

This paper studies the mean‐square consensus for heterogeneous multi‐agent systems with probabilistic time delay. Each agent in the system has an objective function and only knows its own objective function. Control protocols for the system both over the fixed and the switched weighted‐balanced topologies are designed. The consensus state of agents' position can make the sum of objective functions minimum. By adopting probability statistics, stochastic process, matrix theory and some stability method, sufficient conditions for the consensus protocol are given. Several simulations are presented to illustrate the potential correctness of the results.
Distributed static output feedback control for interconnected systems in finite‐frequency domain
Authors: Chen Xuefeng , Xu Huiling , Wang Hui
Published: February 2021

This paper aims at designing a distributed static output feedback (DSOF) controller for the interconnected system in finite‐frequency domain. Motivated by the fact that the signal transmitting process is usually affected by surrounding environments, the interconnection communication between subsystems are assumed to be non‐ideal. By introducing some dilated multipliers into the extended condition that guarantees the well‐posedness, stability and finite‐frequency performance of non‐ideally interconnected systems, a new equivalent condition is derived, which is more effective for parameterizing the DSOF controller. A two‐stage approach is then developed for constructing a DSOF controller: design an initial distributed full information (DFI) controller first and then derive a desired DSOF from the DFI controller. Moreover, two iterative linear matrix inequality based algorithms are proposed to improve the solvability of the DFI controller and DSOF controller design problems. Finally, an example is given to show the effectiveness of the proposed two‐stage DSOF controller design method.
A non‐linear adaptive excitation control scheme for feedback linearized synchronous generations in multimachine power systems
Authors: Roy Tushar Kanti , Mahmud Md. Apel , Shen Weixiang , Oo Amanullah Maung Than
Published: February 2021

A new adaptive scheme is proposed in this paper to design excitation controllers for feedback linearized models of synchronous generators in multimachine power systems in order to ensure the stability during large disturbances. The proposed scheme uses speed deviations of synchronous generators, readily available measured physical properties of multimachine power systems, to make all generators within a power network as partially linearized as well as to provide more damping. An adaptive scheme is then used to estimate all unknown parameters which appear in the partial feedback linearizing excitation controllers in order to avoid parameter sensitivities of existing feedback linearization techniques. The overall stability of multimachine power systems is ensured through the excitation control and parameter adaptation laws. The Lyapunov stability theory is used to theoretically analyse the stability of multimachine power systems with the proposed scheme. Simulation studies are presented to evaluate the performance of the proposed excitation control scheme for two different test systems by different operating conditions including short‐circuit faults on key locations along with variations in parameters for a large duration. Furthermore, comparative results are presented to highlight the superiority of the proposed adaptive partial feedback linearizing excitation control scheme over an existing partial feedback linearizing excitation controllers.
Contact resonance frequencies and their harmonics in scanning probe microscopy
Authors: Murillo‐Bracamontes Eduardo A. , Gervacio‐Arciniega Juan J. , Cruz‐Valeriano Edgar , Enríquez‐Flores Christian I. , Palomino‐Ovando Martha A. , Yañez‐Limón José M. , Siqueiros Jesús M. , Cruz M. Paz
Published: February 2021

Local characterizations of electric, magnetic, mechanical, electrochemical, and structural properties of materials by scanning probe microscopy (SPM) can be carried out by sensing variations of the contact cantilever's resonance frequencies, resulting in diverse microscopy techniques such as piezoresponse force microscopy (PFM), atomic force acoustic microscopy (AFAM) and piezomagnetic force microscopy (PmFM), to name a few. In this work, we provide a simple setup to determine such frequencies, together with the dynamic response of the SPM cantilever and its harmonics. The setup is less expensive when compared to the commercial versions and allows a better control of the in‐and‐out PFM. It is based on the use of the internal AC source of a lock‐in amplifier controlled by software developed in LabVIEW. In order to illustrate the utility of the contact resonance frequencies in the SPM, resonance‐PFM, PFM non‐linearities, discrimination of ferroelectric from non‐ferroelectric responses and PmFM measurements, and determination of the modulus of elasticity by AFAM are conducted.
Der geriatrische Traumapatient
Authors: Schütze Konrad , Gebhard Florian , Richter Peter H.
Published: February 2021

Die prähospitale, stationäre und poststationäre Versorgung von immer mehr hochbetagten Patienten mit typischen alterstraumatologischen Frakturen stellt eine Herausforderung für Rettungsdienst, Krankenhäuser und Krankenkassen dar. Diese Herausforderungen in der Behandlung der alterstraumatologischen „Big Five“ soll im Fokus dieses Artikels stehen.
Die vier Schockformen – Teil 4: distributiver Schock
Authors: Jacko Tobias , Wunderl Martin , Tharmaratnam Gayathiri , Schebler Karoline , Hossfeld Björn , Gässler Holger
Published: February 2021

Der distributive Schock ist die häufigste Art von Schock. Er wird verursacht durch eine relative Hypovolämie, die durch eine pathologische Umverteilung des intravaskulären Blutvolumens bedingt ist. Ein Grund dafür ist ein Verlust des Gefäßtonus mit Volumenverschiebung im Gefäßsystem. Ein weiterer Grund ist eine erhöhte Gefäßpermeabilität mit Volumenverschiebung in das Interstitium, auch Kapillarleck oder Capillary Leak genannt. Der distributive Schock wird in 3 Subtypen unterteilt: anaphylaktischer/anaphylaktoider, septischer und neurogener Schock.
Coarctation of the Aorta as a Rare Indirect Cause of Aneurysmal Subarachnoid Hemorrhage in the Adolescent: A Case Report and Review of the Literature
Authors: Veldeman Michael , Höllig Anke , Clusmann Hans , Schubert Gerrit Alexander
Published: February 2021

Aneurysmal subarachnoid hemorrhage (SAH) is rare in teenagers. We present the case of a 19-year-old woman with an aneurysmal SAH and four anterior circulation aneurysms. Due to the urgency of operative treatment, no initial conventional cerebral angiography was performed. The CT angiography depicted the aortic arch incompletely. The coarctation was discovered on day 5 after ictus in a cerebral angiography for vasospasm surveillance. We believe that in young SAH patients without an explainable predilection for aneurysm formation, imaging of the aortic arch during the initial CT angiography, not to miss a coarctation of the aorta, is highly recommended.
Positron Emission Tomography in Segmentectomy for cT1N0M0 Nonsmall Cell Lung Cancer
Authors: Nomori Hiroaki , Machida Yoichi , Yamazaki Ikuo , Honma Koichi , Otsuki Ayumu , Cong Yue , Sugimura Hiroshi , Oyama Yu
Published: February 2021

Background This study was aimed to examine the significance of fluorodeoxyglucose positron emission tomography in predicting prognosis after segmentectomy in lung cancer.

Methods This was a retrospective cohort study, including 227 patients with cT1N0M0 nonsmall cell lung cancer who underwent positron emission tomography followed by segmentectomy between 2012 and 2019. Significance of tumor histology, T-stage, tumor size, and standardized uptake value on positron emission tomography in relation to recurrence-free survival were examined using Cox's proportional hazard analysis. Median follow-up period was 56 months (range: 1–95 months).

Results Tumor stages were Tis in 25 patients, T1mi/T1a in 51, T1b in 98, and T1c in 53. Twenty-six patients (11%) experienced recurrences, including local (n = 8) and distant (n = 18). Multivariate analysis showed that the significant variables for recurrence-free survival were T-stage and standardized uptake value (p = 0.002 and 0.015, respectively), whereas tumor histology and tumor size were not significant (p = 0.28 and 0.44, respectively). When tumor size was divided into ≤2 cm and >2 cm for analysis, it was not significant again (p = 0.49), whereas standardized uptake value remained significant (p = 0.008). While standardized uptake value of tumors with recurrences was significantly higher than those without (4.9–2.8 and 2.6–2.5, respectively, p < 0.001), there was no significant difference between local and distant recurrences (p = 0.32). Cut-off value of standardized uptake value for recurrences was 3.2. Five-year recurrence-free survival rates in tumors with standardized uptake value <3.2 and ≥3.2 were 86 and 65%, respectively (p < 0.001).

Conclusion Positron emission tomography could predict the prognosis after segmentectomy better than tumor size.
Adverse Drug Reactions with First-Line and Second-Line Drugs in Treatment of Tuberculosis
Authors: Prasad Rajendra , Singh Abhijeet , Gupta Nikhil
Published: February 2021

Drug-susceptible tuberculosis (DS-TB) requires treatment with first-line drugs (FLDs) whereas drug-resistant TB (DR-TB) are treated with combination of second-line drugs (SLDs) and fewer FLDs. Adverse drug reactions (ADRs) to these drugs are quite evident as they are being used for longer duration. The overall prevalence of ADRs with FLDs and SLDs are estimated to vary from 8.0 to 85 and 69 to 96%, respectively. Most ADRs are observed in the intensive phase as compared to continuation phase. Major concerns exist regarding treatment of DR-TB patients, especially with SLDs having lower efficacy more toxicity and high cost as compared to FLDs. A variety of ADRs may be produced by anti-TB drugs ranging from mild or minor to severe or major like gastrointestinal toxicity (nausea/vomiting, diarrhoea, and hepatotoxicity), ototoxicity, neurotoxicity (peripheral neuropathy and seizures), nephrotoxicity, cutaneous toxicity, and cardiotoxicity. Most of ADRs are minor and can be managed without discontinuation of treatment. Few ADRs' can be major causing life-threatening experience leading to either modification or discontinuation of regimen and even mortality. A careful monitoring of ADRs during the treatment with anti-TB drugs and early recognition and appropriate management of these ADRs might improve adherence leading to favorable outcome.
Variable Genotype–Phenotype Correlation of Pompe's Disease Caused by a c.2015 G > A (p.Arg672Gln) Mutation in the GAA Gene
Authors: Tokatly Latzer Itay , Sagi Liora , Bali Deeksha Sarihyan , Rehder Catherine , Orbach Rotem , Fattal-Valevski Aviva
Published: February 2021

Pompe's disease occurs due to an autosomal recessive trait resulting from numerous distinctive mutations in the GAA gene. It manifests as a broad spectrum of clinical phenotypes with progressive weakness that impairs motor and respiratory functions being common for all its forms. Cardiac hypertrophy is a prominent feature of its classic infantile form. To date, the pathogenic variant c.2015G > A (p.Arg672Gln) in exon 14 of the GAA gene has been described in 10 children of different ethnic groups, with variable phenotypic presentations. This work describes three children from two unrelated families of Arab ethnicity who presented with infantile-onset Pompe's disease as a result of a c.2015G > A (p.Arg672Gln) mutation. The clinical course of the children we report was more severe than previous reports. This further emphasizes the lack of a strict genotype–phenotype correlation in regard to the unique c.2015G > A (p.R672Q) mutation that causes Pompe's disease. This information contributes to the knowledge of the phenotypic expression of the specific mutation c.2015G > A (p.Arg672Gln) that causes Pompe's disease.
The outcome of 41 Late-Diagnosed Turkish GA-1 Patients: A Candidate for the Turkish NBS
Authors: Kılavuz Sebile , Bulut Derya , Kor Deniz , Şeker-Yılmaz Berna , Özcan Neslihan , Incecik Faruk , Onan Bilen , Ceylaner Gülay , Önenli-Mungan Neslihan
Published: February 2021

Background Glutaric aciduria type 1(GA-1) is an inherited cerebral organic aciduria. Untreated patients with GA-1 have a risk of acute encephalopathic crises during the first 6 years of life. In so far as GA-1 desperately does not exist in Turkish newborn screening (NBS) program, most patients in our study were late-diagnosed.

Method This study included 41 patients diagnosed with acylcarnitine profile, urinary organic acids, mutation analyses in the symptomatic period. We presented with clinical, neuroradiological, and molecular data of our 41 patients.

Results The mean age at diagnosis was 14.8 ± 13.9 (15 days to 72 months) and, high blood glutaconic acid, glutarylcarnitine and urinary glutaric acid (GA) levels in 41 patients were revealed. Seventeen different mutations in the glutaryl-CoA dehydrogenase gene were identified, five of which were novel. The patients, most of whom were late-diagnosed, had a poor neurological outcome. Treatment strategies made a little improvement in dystonia and the frequency of encephalopathic attacks.

Conclusion All GA-1 patients in our study were severely affected since they were late-diagnosed, while others show that GA-1 is a treatable metabolic disorder if it is diagnosed with NBS. This study provides an essential perspective of the severe impact on GA-1 patients unless it is diagnosed with NBS. We immediately advocate GA-1 to be included in the Turkish NBS.
Meningiomas of the Planum Sphenoidale and Tuberculum Sella
Authors: Echalier Elizabeth L. , Subramanian Prem S.
Published: February 2021

Patients with meningiomas of the planum sphenoidale and tuberculum sella often present with insidious vision loss in one or both eyes as the only sign or symptom of their disease, although other sensory, oculomotor, and even endocrine abnormalities may be seen in a minority of cases. Incidentally discovered tumors also are common, as patients may undergo neuroimaging for unrelated symptoms or events. Depending on the size and orientation of the tumor, central vision loss from optic nerve compression may be a later sign, and loss of peripheral vision in one or both eyes may not be recognized until it has progressed to areas closer to fixation. A thorough neuroophthalmologic assessment including visual field testing will help to define the extent of optic pathway involvement. Both fundus examination and optical coherence tomography of the retinal nerve fiber layer and macular ganglion cell complex will aid in determining prognosis after treatment of the tumor. Orbital surgery rarely is indicated as primary therapy for meningiomas in this location, and surgical resection or debulking is usually pursued before consideration is given to radiation therapy. Because of the long-term risk of residual tumor growth or recurrence, neuroophthalmic surveillance along with serial neuroimaging is required for years after tumor resection and/or radiation therapy.
Late-Onset Narcolepsy: A Case Report with Brief Review of the Literature
Authors: Jacob Jeny , Venkataram Rajesh , Baikunje Nandakishore , Soori Rashmi
Published: February 2021

Narcolepsy, a sleep disorder, has its onset in childhood and early adulthood but rarely in older adults. This case report focuses on a man in his late fifties who was noticed to have excessive daytime sleepiness during his stay in our hospital for an unrelated medical ailment. He was further evaluated with overnight polysomnography and next day multiple sleep latency test which confirmed the diagnosis of narcolepsy.
Epilepsy in Nicolaides–Baraitser Syndrome: Review of Literature and Report of 25 Patients Focusing on Treatment Aspects
Authors: Hofmeister Benedikt , von Stülpnagel Celina , Betzler Cornelia , Mari Francesca , Renieri Alessandra , Baldassarri Margherita , Haberlandt Edda , Jansen Katrien , Schilling Stefan , Weber Peter , Ahlbory Katja , Tang Shan , Berweck Steffen , Kluger Gerhard
Published: February 2021

Nicolaides–Baraitser syndrome (NCBRS), caused by a mutation in the SMARCA2 gene, which goes along with intellectual disability, congenital malformations, especially of face and limbs, and often difficult-to-treat epilepsy, is surveyed focusing on epilepsy and its treatment. Patients were recruited via “Network Therapy of Rare Epilepsies (NETRE)” and an international NCBRS parent support group. Inclusion criterion is NCBRS-defining SMARCA2 mutation. Clinical findings including epilepsy classification, anticonvulsive treatment, electroencephalogram (EEG) findings, and neurodevelopmental outcome were collected with an electronic questionnaire. Inclusion of 25 NCBRS patients with epilepsy in 23 of 25. Overall, 85% of the participants (17/20) reported generalized seizures, the semiology varied widely. EEG showed generalized epileptogenic abnormalities in 53% (9/17), cranial magnetic resonance imaging (cMRI) was mainly inconspicuous. The five most frequently used anticonvulsive drugs were valproic acid (VPA [12/20]), levetiracetam (LEV [12/20]), phenobarbital (PB [8/20]), topiramate (TPM [5/20]), and carbamazepine (CBZ [5/20]). LEV (9/12), PB (6/8), TPM (4/5), and VPA (9/12) reduced the seizures' frequency in more than 50%. Temporary freedom of seizures (>6 months) was reached with LEV (4/12), PB (3/8), TPM (1/5, only combined with PB and nitrazepam [NZP]), and VPA (4/12). Seizures aggravation was observed under lamotrigine (LTG [2/4]), LEV (1/12), PB (1/8), and VPA (1/12). Ketogenic diet (KD) and vagal nerve stimulation (VNS) reduced seizures' frequency in one of two each. This first worldwide retrospective analysis of anticonvulsive therapy in NCBRS helps to treat epilepsy in NCBRS that mostly shows only initial response to anticonvulsive therapy, especially with LEV and VPA, but very rarely shows complete freedom of seizures in this, rather genetic than structural epilepsy.
Genetic Factors in Nonsyndromic Orofacial Clefts
Authors: Khan Mahamad Irfanulla , CS Prashanth , Srinath Narasimha Murthy
Published: February 2021

Orofacial clefts (OFCs) are the most common congenital birth defects in humans and immediately recognized at birth. The etiology remains complex and poorly understood and seems to result from multiple genetic and environmental factors along with gene–environment interactions. It can be classified into syndromic (30%) and nonsyndromic (70%) clefts. Nonsyndromic OFCs include clefts without any additional physical or cognitive deficits. Recently, various genetic approaches, such as genome-wide association studies (GWAS), candidate gene association studies, and linkage analysis, have identified multiple genes involved in the etiology of OFCs.

This article provides an insight into the multiple genes involved in the etiology of OFCs. Identification of specific genetic causes of clefts helps in a better understanding of the molecular pathogenesis of OFC. In the near future, it helps to provide a more accurate diagnosis, genetic counseling, personalized medicine for better clinical care, and prevention of OFCs.
Functional Assessment of Coronary Artery Lesions—Old and New Kids on the Block
Authors: Patel Prashant , Rao Ravi , Sethi Prabhdeep , Mukherjee Ashis , Varadarajan Padmini , Pai Ramdas G.
Published: February 2021

Angiography is inaccurate in assessing functional significance of coronary lesions, and often stenoses deemed severe on angiographic assessment do not restrict coronary blood flow at rest or with maximal dilatation. Angiography-guided revascularization has not shown improvement in hard clinical outcomes in stable ischemic heart disease (SIHD). Most current guidelines for SIHD recommend invasive functional assessment of lesions to guide revascularization if prior evidence of ischemia is not available. There has been several recent advances and development of novel methods in this arena. Various contemporary clinical trials have been undertaken for validation of these indices. Here we review the physiological basis, tools, techniques, and evidence base for various invasive (resting as well as hyperemic) and noninvasive methods for functional assessment of coronary lesions. Left main stenosis, bifurcation lesions, serial stenosis, and acute coronary syndrome each causes unique disequilibrium that may affect measurements and require special considerations for accurate functional assessment.
Predictive Value of Body Mass Index in Minimally Invasive Mitral Valve Surgery
Authors: Minol Jan-Philipp , Dimitrova Vanessa , Petrov Georgi , Langner Robert , Boeken Udo , Lichtenberg Artur , Akhyari Payam
Published: February 2021

Background With this study we aimed to analyze if the separate consideration of body mass index (BMI) could provide any superior predictive values compared with the established risk scores in isolated minimally invasive mitral valve surgery (MIMVS). This might facilitate future therapeutic decision-making, e.g., regarding the question surgery versus transcatheter mitral valve repair (TMVr).

Methods We assessed the relevance of BMI in non-underweight patients who underwent isolated MIMVS. The risk predictive potential of BMI for mortality and several postoperative adverse events was assessed in 429 consecutive patients. This predictive potential was compared with that of European System for Cardiac Outcome Risk Evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons score (STS score) using a comparative receiver operating characteristic curve analysis.

Results BMI was a significant numeric predictor of wound healing disorders (p = 0.001) and proved to be significantly superior in case of this postoperative adverse event compared with the EuroSCORE II (p = 0.040) and STS score (p = 0.015). Except for this, the predictive potential of BMI was significantly inferior compared with that of the EuroSCORE II and STS score for several end points, including 30-day (p = 0.029 and p = 0.006) and 1-year (p = 0.012 and p = 0.001) mortality.

Conclusion Therefore, we suggest that, in the course of decision-making regarding the right treatment modality for non-underweight patients with isolated mitral valve regurgitation, the sole factor of BMI should not be given a predominant weight.
Therapeutic Options for Left Main, Left Main Equivalent, and Three-Vessel Disease
Authors: Glazier James J. , Ramos-Parra Bayoan , Kaki Amir
Published: February 2021

Patients with left main, left main equivalent, and three-vessel coronary artery disease (CAD) represent an overlapping spectrum of patients with advanced CAD that is associated with an adverse prognosis. Guideline-directed medical therapy is a necessary but often insufficient treatment option, as such patients frequently need mechanical revascularization by either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). In patients with advanced CAD presenting with acute myocardial infarction, PCI, of course, is the preferred treatment option. For stable patients with advanced CAD, CABG surgery remains the standard of care. However, observations from the SYNergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) trial suggest that PCI may be a useful alternative in patients with three-vessel disease with a low SYNTAX score as well as in patients with left main disease and a low or intermediate SYNTAX score. In the subset of patients with diabetes mellitus, the Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease trial unequivocally demonstrated the superiority of CABG surgery in improving outcomes. The findings of the recently published Everolimus-Eluting Stent System versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization and Nordic–Baltic–British Left Main Revascularization study trials point to a favorable role for PCI in certain low-to-moderate risk patients with left main stem disease.
Optical Coherence Tomography of the Coronary Arteries
Authors: Roland Robert , Veselka Josef
Published: February 2021

Intravascular imaging, particularly optical coherence tomography, has brought significant improvement in diagnostic and therapeutical approaches to coronary artery disease and has offered superior high-resolution visualization of coronary arteries. The ability to obtain images of intramural and transmural coronary structures allows the study of the process of atherosclerosis, effect of therapies, mechanism of acute coronary syndrome and stent failure, and performance of new devices and enables the interventional cardiologist to optimize the effect of percutaneous coronary intervention. In this review, we provide the summary of the latest published data on clinical use of optical coherence tomography as well as practical algorithm for optical coherence tomography-guided percutaneous coronary intervention for daily interventional practice.