bluuebunny/crossref_metadata_2025 huggingface dataset:
Contrasting Ocean–Atmosphere Dynamics Mediate Flood Hazard across the Mississippi River Basin
Authors: Muñoz Samuel E. , Hamilton Brynnydd , Parazin B.
Published: November 2022

The Mississippi River basin drains nearly one-half of the contiguous United States, and its rivers serve as economic corridors that facilitate trade and transportation. Flooding remains a perennial hazard on the major tributaries of the Mississippi River basin, and reducing the economic and humanitarian consequences of these events depends on improving their seasonal predictability. Here, we use climate reanalysis and river gauge data to document the evolution of floods on the Missouri and Ohio Rivers—the two largest tributaries of the Mississippi River—and how they are influenced by major modes of climate variability centered in the Pacific and Atlantic Oceans. We show that the largest floods on these tributaries are preceded by the advection and convergence of moisture from the Gulf of Mexico following distinct atmospheric mechanisms, where Missouri River floods are associated with heavy spring and summer precipitation events delivered by the Great Plains low-level jet, whereas Ohio River floods are associated with frontal precipitation events in winter when the North Atlantic subtropical high is anomalously strong. Further, we demonstrate that the El Niño–Southern Oscillation can serve as a precursor for floods on these rivers by mediating antecedent soil moisture, with Missouri River floods often preceded by a warm eastern tropical Pacific (El Niño) and Ohio River floods often preceded by a cool eastern tropical Pacific (La Niña) in the months leading up peak discharge. We also use recent floods in 2019 and 2021 to demonstrate how linking flood hazard to sea surface temperature anomalies holds potential to improve seasonal predictability of hydrologic extremes on these rivers.
Study of the Decadal Predictability of Mediterranean Sea Surface Temperature Based on Observations
Authors: Yan Xiaoqin , Tang Youmin , Yang Dejian
Published: November 2022

Sea surface temperature (SST) changes in the Mediterranean Sea have profound impacts on both the Mediterranean regions and remote areas. Previous studies show that the Mediterranean SST has significant decadal variability that is comparable with the Atlantic multidecadal variability (AMV). However, few studies have discussed the characteristics and sources of the decadal predictability of Mediterranean SST based on observations. Here for the first time we use observational datasets to reveal that the decadal predictability of Mediterranean SST is contributed by both external forcings and internal variability for both annual and seasonal means, except that the decadal predictability of the winter mean SST in the eastern Mediterranean is mostly contributed by only internal variability. Besides, the persistence of the Mediterranean SST is quite significant even in contrast with that in the subpolar North Atlantic, which is widely regarded to have the most predictable surface temperature on the decadal time scale. After the impacts of external forcings are removed, the average prediction time of internally generated Mediterranean SST variations is more than 10 years and closely associated with the multidecadal variability of the Mediterranean SST that is closely related to the accumulated North Atlantic Oscillation forcing.

Significance Statement

Decadal prediction of sea surface temperature (SST) in the Mediterranean Sea is very important due to its profound climate impacts. Understanding the spatial/seasonal characteristics and sources of the decadal predictability of the Mediterranean SST are crucial for skillful decadal prediction of the Mediterranean SST and related variations. This study for the first time shows that the decadal predictability of the Mediterranean SST is quite significant even in comparison with the AMV. The decadal predictability of the Mediterranean SST is both region and season dependent. The internally generated decadal predictability of the Mediterranean SST is most probably related to the local ocean dynamics.
Short-Term Ensemble Streamflow Prediction Using Spatially Shifted QPF Informed by Displacement Errors
Authors: Hugeback Kyle K. , Franz Kristie J. , Gallus William A.
Published: November 2022

Errors associated with the location of precipitation in QPFs present challenges when used for hydrologic prediction, particularly in small watersheds. This work builds on a past study that systematically shifted QPFs prior to inputting them into a hydrologic model to generate streamflow ensembles. In the original study, which used static, predetermined shifting distances, flood detection improved, but false alarms increased due to large ensemble spread. The present research tests a more informed approach by randomly selecting shift directions and distances based on the distribution of displacement errors from a sample of QPFs. Precipitation forecasts were taken from the High-Resolution Rapid Refresh Ensemble (HRRRE), and streamflow predictions were generated using the Weather Research and Forecasting hydrological modeling system, version 5.1.1, in a National Water Model 2.0 configuration. A 63-member streamflow ensemble was generated using the 9 original HRRRE and 54 shifted HRRRE members. Two ensemble updating schemes were tested in which ensemble member weights were adjusted using precipitation location and QPF displacement present at convective initiation. The ensembles using QPF shifted based on climatological spatial errors showed higher probabilistic forecasting skill, while having comparable dichotomous forecasting skill to the original HRRRE ensemble. Other methods of selecting nine ensemble members from the full 63-member suite did not show significant improvement. Flood peak timing showed frequent errors, with average timing errors around five hours early. Larger watersheds tended to have better skill metric scores than smaller basins, with increased skill added by the shifting of QPF.
Attribution of the Subsurface Temperature Change in the Southern Hemisphere
Authors: Chen Jia-Jia , Cheng Xuhua
Published: November 2022

The Southern Hemisphere temperature has experienced obvious changes with great spatial differences over the past several decades. Most regions show extreme warming, especially those located at 35°–55°S. In contrast, subsurface cooling exists between 15° and 35°S in the Indian and Pacific basins. The subsurface temperature and salinity change can be divided into spiciness change and heave components. The results show the warming due to isopycnal movement being largely offset by significant spiciness cooling at middepth. Surface warming and subduction into the interior ocean account for subsurface spiciness cooling near 45°S, while surface freshening and penetration along isopycnals are more important to the subsurface spiciness cooling farther north. The isobaric temperature change is associated with pure warming and pure heaving, and the subsurface cooling observed in the Indian and Pacific subtropics is predominantly attributed to pure heaving. This study provides a quantitative estimate of the relative contribution of surface temperature, salinity change, and circulation adjustment in subsurface temperature change, highlighting the importance of circulation change in producing subsurface cooling. Further research is needed to understand why different processes dominate in different ocean sections.

Significance Statement

While the global ocean is warming, the subsurface temperature change exhibits a significant regional disparity. This paper attempts to explain the deep-reaching warming at 35°–55°S and cooling at 15°–35°S based on three historical observation datasets. We find that the cooling mostly occurs between 400 and 1000 m in the south Indian and Pacific subtropics (15°–35°S), which is attributed to pure heaving, indicating the importance of circulation change in these regions. The midlatitude warming (35°–55°S) is mainly caused by the pure warming process, which is related to heat uptake at the subpolar surface and northward and downward heat transport. The spiciness cooling near 45°S is mainly driven by the subduction of the surface warming signal while the freshening process has a stronger impact on spiciness cooling farther north.
Resistance welding of carbon fibre reinforced PEKK by means of CNT webs
Authors: Russello M , Catalanotti G , Hawkins SC , Falzon BG
Published: November 2022

Single lap shear specimens were manufactured using resistance welding of carbon fibre reinforced substrates by means of CNT web-based heating elements. Heating elements were manufactured by embedding the CNT web layers between layers of PEKK/glass fibre and connecting them to copper electrodes. An experimental campaign explored their electrothermal behaviour influencing the welding process. Single lap shear specimens were then welded at a pressure of 0.05 MPa and different levels of power and duration. An optimum bond was obtained with a specific power of 80–90 kW/m2 and a time of 150 s, achieving a shear strength of 30 MPa. Post-mortem analysis revealed that fracture propagated within the substrates. This work represents a further step in the integration of CNT web-based heating elements in an industrial welding process.
How to treat type 1b endoleakage-extension, fEVAR, bEVAR, or open repair
Authors: Khouqeer Ahmed F , Etheridge Ginger M , Coselli Joseph S , Orozco-Sevilla Vicente
Published: November 2022

Thoracic endovascular aneurysm repair has been well described in the literature as a treatment for a wide range of thoracic aortic pathologies. As with any intervention, there remains a risk of an unfavorable outcome, including endoleak, a term used to describe unexpected blood flow between the stent-graft and the wall of the excluded aneurysm. Endoleaks cause pressurized enlargement of the aneurysmal sac and may lead to catastrophic outcomes such as rupture and death. Type 1b endoleak represents a distal landing zone that is compromised by retrograde blood flow. Moreover, there is a lack of data on type 1b endoleaks and its management options. With the increase in emerging endovascular techniques and technologies, endoleaks are more frequent. However, the management of endoleaks is not standardized among different centers. The purpose of this article is to provide an overview of type 1b endoleaks after thoracic endovascular aneurysm repair, current management options, and our experience.
Multidisciplinary treatment of giant presacral solitary fibrous tumour: a case report and literature review
Authors: Fang Hanjun , Wei Zhiming , Lai Jieqing , Li Ruoyu , Lan Yun , Yi Chunzhi , Chen Zhenqiu , Fang Bin
Published: November 2022

Solitary fibrous tumours (SFTs) usually occur at the pleura. Extrapleural sites, particularly giant extrapleural solitary fibromas, are more rarely observed in the clinic, and the clinical diagnosis and treatment of this disease is a focus of attention. Herein, the case of a 43-year-old male patient with giant presacral SFT successfully treated by open surgery, and with a final diagnosis confirmed by postoperative pathology and immunohistochemistry, is reported. The patient was followed-up regularly during 5 years after surgery, with no obvious surgical complications, and no tumour recurrence noted on pelvic magnetic resonance imaging. This case provides clinical information that may help in the diagnosis and treatment of complex SFT.
Quantifying state-led gentrification in London: Using linked consumer and administrative records to trace displacement from council estates
Authors: Reades Jonathan , Lees Loretta , Hubbard Phil , Lansley Guy
Published: November 2022

Over the past 20 years, increasing land values, a rising population and inward investment from overseas have combined to encourage the demolition and redevelopment of many large council-owned estates across London. While it is now widely speculated that this is causing gentrification and displacement, the extent to which it has forced low-income households to move away from their local community remains to a large degree conjectural and specific to those estates that have undergone special scrutiny. Given the lack of spatially disaggregated migration data that allows us to study patterns of dispersal from individual estates, in this article, we report on an attempt to use consumer-derived data (LCRs) to infer relocations at a high spatial resolution. The evidence presented suggests that around 85% of those displaced remain in London, with most remaining in borough, albeit there is evidence of an increasing number of moves out of London to the South-East and East of England.
Optimal transfer orbit design of spacecraft with finite thrust based on Legendre pseudospectral method
Authors: Tu Lianghui , Wang Yuhao , Yan Chao , Yang Yang
Published: November 2022

This article explores the application of the Legendre pseudospectral method to spacecraft orbital transfer with finite thrust optimization problem. Firstly, the model of the orbital transfer optimization control problem was established, while equations of motion were simplified based on some hypotheses. The performance was optimized to minimize the cumulative fuel consumption. The control variable was the thrust attack angle, and terminal state variable constraints included path angle, altitude, and velocity constraints. Then, the optimal control problem was transformed into a nonlinear programming problem (NLP) using the Legendre pseudospectral method. The dynamic optimization problem was transformed into a static parameter optimization problem. The state variables and control variables were selected as the optimal parameters at all collocation nodes. Lastly, the parameter optimization problem was solved using the SNOPT (Sparse Nonlinear Optimizer) software package. The SNOPT software package shows high convergence for a nonlinear programming problem. During the simulation, it was noted that the Legendre pseudospectral method is not sensitive to orbital transfer initial conditions. It was also observed that the optimal solutions of the orbital transfer optimization problem are fairly good in robustness. Therefore, the Legendre pseudospectral method is a viable approach to the spacecraft orbital transfer with a finite thrust optimization problem. The orbit optimization method proposed in this paper can also provide reference and guidance for solving other interplanetary orbital transfer optimization problems.
Achieving Calm: A Study on the Health Care Experiences of People With Lived Experience of Homelessness in Central Texas
Authors: Christian Nicholaus , McFall Curk , Suarez Joel , Ulack Chris , Wagen Brooke , Williams Whitney , Teisberg Elizabeth
Published: November 2022

The experiences of care of people with lived experience of homelessness are rarely embraced to change care delivery. We conducted qualitative group and one-on-one interviews utilizing experience group methodology with 27 people with lived experience of homelessness currently housed in one permanent housing community in central Texas. We analyzed data using an inductive thematic approach to identify shared obstacles and barriers to receiving health care. We then analyzed findings with the capability, comfort, and calm value framework to identify health outcomes that matter most to study participants. Poor access to care, discontinuities in care, distrust in providers, and confusing terminology were identified as the biggest barriers to health. The overwhelming majority of experiences reflected poor health outcomes of calm, the outcome of a health care experience that adds ease to one’s life rather than logistical and administrative chaos. We propose three practical approaches to achieve calm for this population as follows: systems-level embracement of compassionate care, integration of relationship-based care navigation into all levels of care, and building efficient transportation into care design. We conclude that designing health care that works in the lives of people with lived experience of homelessness is critical to address the gaps in care that fuel the health disparity these individuals face compared to people without this lived experience.
K-Means segmentation of tourism accommodation based on the active use of websites: Its application to an emerging destination (extremadura, Spain)
Authors: Sánchez-Rivero Marcelino , Rodríguez-Rangel María Cristina , Ricci-Risquete Alejandro
Published: November 2022

The management, maintenance and positioning of a website as a tool for information, promotion and marketing are necessary requirements for the regulated tourist accommodation of today. However, modern websites must go much further as they must also take into account the demands and needs of the 3.0 tourist Websites must therefore be operational (direct bookings, fast loading, adapted to mobile devices, …), informative (before, during and after the trip) and interactive (comments, evaluation of the experience, …). The aim of this study is to analyse the state of development of websites of tourist accommodation at a destination, the Spanish region of Extremadura, which aims to keep up with this technological revolution. To this end, a questionnaire was used to find out the characteristics of the websites (if they exist) of the entire population of “regulated” tourist accommodation in the region (1748 establishments). Based on the items included in this questionnaire and working exclusively with the subpopulation of accommodation with a website, three dimensions of evaluation of these websites were constructed: operability, informative capacity, and interaction. These three dimensions were used as segmentation variables to define a total of four clearly different groups or clusters of websites. The results obtained, using a k-means algorithm, confirm that tourist accommodation establishments in Extremadura have a lot of work to do if they are to increase the usefulness of their websites.
Visual communication and mental health
Authors: Bennett Jill
Published: November 2022

This article conceptualizes the field of ‘visual communication and mental health’, prioritizing the question of how visual imagery is experienced. Taking as its starting point the challenge of overcoming stigma and the limitations of visual clichés of depression and mental illness, the author argues for a dynamic, relational model of communications, foregrounding lived experience. To illuminate the psychosocial impacts and potential benefits of creative engagement with visual media, she draws on understandings of symbolic communication, derived in particular from the work of DW Winnicott and the British Independent tradition of psychoanalysis. The imagery discussed includes stock and campaign imagery, conceptual/expressive artwork and a virtual reality (VR) production that extends an innovative approach to mental health literacy by First Nations artists.
Seismic media: art and geological co-creation in Ōtautahi Christchurch, Aotearoa New Zealand
Authors: Joyce Zita , Ballard Susan
Published: November 2022

In September 2010 the city of Ōtautahi Christchurch, New Zealand was rocked by the first of a sequence of 16,000 earthquakes. This essay considers art and creative practices that have responded to the experience of living in the earthquake-damaged city. In an environment transformed by seismicity, we argue that artists became co-creators with the planet, using its instability as a medium of art making, an active agent and long-term collaborator in creative practice. Those practices mediate the experience of seismicity, communicating the overwhelming energy of a faultline rupture in artworks that employ sound, touch, image, memory and emotion. We use the term seismic media to describe an expansive field encompassing the unstable earth as medium, the practice of mediating seismicity, and the media texts and objects that attempt to express it. In this essay we employ the concept of seismic media to discuss artworks created within the city of Ōtautahi Christchurch as it undergoes an extended period of rebuilding. We identify artists’ relationships with the material geology of a city with a focus on new geographical and aesthetic understandings. Seismic media enables people to work through the experiences of earthquakes and their long aftermath, while remembering the city as it was and imagining the city that could be.
Self-Prioritization Reconsidered: Scrutinizing Three Claims
Authors: Golubickis Marius , Macrae C. Neil
Published: November 2022

Such is the power of self-relevance, it has been argued that even arbitrary stimuli (e.g., shapes, lines, colors) with no prior personal connection are privileged during information processing following their association with the self (i.e., self-prioritization). This prioritization effect, moreover, is deemed to be stimulus driven (i.e., automatic), grounded in perception, and supported by specialized processing operations. Here, however, we scrutinize these claims and challenge this viewpoint. Although self-relevance unquestionably influences information processing, we contend that, at least at present, there is limited evidence to suggest that the prioritization of arbitrary self-related stimuli is compulsory, penetrates perception, and is underpinned by activity in a dedicated neural network. Rather, self-prioritization appears to be a task-dependent product of ordinary cognitive processes.
Reasons to Remain Critical About the Literature on Habits: A Commentary on Wood et al. (2022)
Authors: De Houwer Jan , Buabang Eike K. , Boddez Yannick , Köster Massimo , Moors Agnes
Published: November 2022

Wood et al. (2022) reviewed arguments in support of the idea that much of human behavior is habitual. In this commentary, we first point at ambiguities in the way Wood et al. referred to habits. This allows us to clarify the question that lies at the core of the debate on habits: To what extent is habitual behavior mediated by stimulus–response associations or by goal representations? We then argue that Wood et al. dismissed goal-directed explanations of habitual behavior too easily. Finally, we point out that Wood et al.’s reanalysis of our data is misleading in that a more fine-grained analysis supports rather than questions goal-directed accounts.
Forging Partnerships: Preparing School Leaders in Complex Environments
Authors: Peña Isela , Rincones Rodolfo , Canaba Karina Chantal
Published: November 2022

This study examines how two autonomous organizations collaborate toward preparing school principals. Studies exploring the early phases of partnership creation are missing from the current literature. As universities continue to partner with school districts to prepare principals, understanding the early development process is important. This study focuses on the beginnings of a university school district partnership using Gajda’s five principles of collaboration and Kezar’s Stage Model for Collaboration. Findings suggest that while the collaboration successfully enrolled students, challenges in the collaboration’s initial phase impede a smooth transition from partnership planning to implementation.
A Critical Genre Analysis of Covert Advertising Through Short-Videos in Douyin: The Chinese Version of Tik-Tok
Authors: Li Dongmei , Chow Ung T’chiang , Cheong Cecilia Yin Mei
Published: November 2022

Short-video social media is becoming a major advertising tool in the digital age. Covert advertising is increasingly used as a major strategy to effectively promote a product. This study aims to explore the genre of covert short-video advertisements launched in Douyin—the Chinese version of TikTok. It integrates Bhatia’s critical genre analysis approach with Kress and van Leeuwen’s Multimodal Discourse Analysis approach as the conceptual framework. The researchers selected 100 covert short-video advertisements in Douyin for analysis. The findings demonstrate how this genre is manipulated to exploit consumerism, to shape consumer culture and to drive business growth through rhetorical moves, interdiscursivity and exploitation of multimodal resources. This study not only gives insight into the less explored deceptive new media genre but also contributes to recognition of covert short-video advertising and methods in analyzing genres in the age of “new media.”
Where to invest in cycle parking: A portfolio management approach to spatial transport planning
Authors: Ito Yuhei , Morgan Malcolm , Lovelace Robin
Published: November 2022

A lack of cycle parking is a known barrier to promoting the uptake of cycling in urban areas. Unlike cars that can be parked on the roadside with little additional infrastructure, bikes usually require dedicated parking facilities. The existing research and guidance on where cycle parking should be provided primarily focuses on key destinations such as train stations or schools. Thus, there is a gap in knowledge about the amount of general-purpose cycle parking required and how it should be distributed across a city. This paper presents a novel method for analysing and prioritising the spatial distribution of cycle parking. The method draws on established portfolio management techniques but applies them in a spatial context. Using the case study of London, we demonstrate that it is possible to identify areas that have a deficit of cycle parking as well as locations that have the most significant potential for increasing cycling uptake by providing additional cycle parking.
Comparative Analysis of Hallux Valgus Surgical Techniques: A Systematic Review
Authors: Amin Atish , Ali Shahrukh R. , Patel Mayurkumar S. , Nsekpong Tyler B. , Beasley Brian J. , Panchbhavi Vinod K. , Jupiter Daniel
Published: November 2022

Category:

Bunion; Midfoot/Forefoot

Introduction/Purpose:

Hallux valgus is a foot deformity where the distal portion of the hallux deviates laterally, forming a bunion. Here we review three surgical techniques for correction of the deformity: lapidus arthrodesis (LA), minimally invasive surgery (MIS), or proximal chevron osteotomy (PCO). The purpose of this study was to compare the hallux valgus angle (HVA) and intermetatarsal angle (IMA) for radiologic outcomes, and the American Orthopaedic Foot & Ankle Society Score (AOFAS) score for quality of life outcomes, between treatment groups.

Methods:

We performed a literature search, with strict inclusion and exclusion criteria, for identifying pertinent references. After review, and resolution of any disagreements by consensus among 5 raters, a total of 42 studies were included in this analysis.

Results:

The mean HVA difference (postoperative to preoperative) was 23.68 for PCO and 21.40 for LA. The mean IMA difference was 9.53 for PCO and 8.12 for LA. The mean of postoperative HVA was calculated to be11.81 for MIS and 9.13 for LA. The mean of postoperative IMA was calculated to be 8.39 for MIS and 6.60 for LA. The postoperative AOFAS mean was 86.00 for MIS and 86.46 for LA. No studies directly compared surgical methods; the results that follow describe each technique summarized separately.

Conclusion:

We discovered that HVA and IMA difference means were higher in PCO vs LA, with a larger difference signifying better radiologic correction. HVA and IMA postoperative means were lower in LA vs MIS. A smaller postoperative angle signifies more physiologic correction. Postoperative AOFAS means were similar in MIS vs LA. Further research should be done to evaluate an ideal procedure and explore better techniques for hallux valgus correction.
Clinical Outcomes of Fifth Metatarsal Fractures using Jones Fracture-Specific Screw vs Intramedullary Fixation
Authors: Anastasio Albert T. , Chopra Aman , Fletcher Amanda N. , Sharma Akhil , Parekh Selene G.
Published: November 2022

Category:

Midfoot/Forefoot

Introduction/Purpose:

Fractures of the proximal fifth metatarsal (Jones fractures) are common foot injuries in both athlete and nonathlete populations, given repetitive loading of the lateral column during gait. Intramedullary screw fixation is the current most common surgical management for Jones fractures, but high rates of nonunion and refracture as well as hardware prominence are reported with existing implant options for this fracture pattern. The Jones bolt is a novel surgical treatment for Jones fractures which aims for more anatomic fixation of this injury. The purpose of this study was to compare the Jones bolt to intramedullary screw fixation with regard to complication rates and patient reported outcomes.

Methods:

A retrospective single-surgeon case series was approved by our institutional review board. A sample of both athletes as well as nonathletes with proximal fifth metatarsal fractures treated with either intramedullary screw fixation or the Jones bolt was collected. Demographic data, patient reported outcomes, and complication rates were analyzed.

Results:

Patients reported significant improvements in both visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society (AOFAS) scores following operative fixation of Jones fractures (Table 1). The average VAS score improved from 5.4+-2.6 preoperatively to 1.4+-1.7 postoperatively (p<0.0001). The average AOFAS score improved from 59.0+-13.2 preoperatively to 186.0+-11.2 postoperatively (p<0.0001). There was no difference in final postoperative VAS (1.4 vs. 1.4; p=0.9702) or AOFAS (87.7 vs 85.7; p=0.4262) or overall change of VAS (3.8 vs. 3.5; p=0.8219) or AOFAS (20.5 vs. 25.0; p=0.6613) for Jones bolt versus all other types of fixation.

Conclusion:

The Jones bolt is a novel treatment for proximal fifth metatarsal fractures, with noninferior outcome scores and complication rates when compared with intramedullary screw fixation. Long-term follow-up and larger sample sizes are indicated to assess for superiority of the Jones bolt.
DNase treatment for atelectasis in infants with severe respiratory syncytial virus bronchiolitis
Authors: Merkus P.J.F.M. , de Hoog M. , van Gent R. , de Jongste J.C.
Published: November 2022

Respiratory insufficiency due to respiratory syncytial virus (RSV) bronchiolitis is partly due to the abundance of thickened mucus and the inability to clear it from the airways. Mucus in RSV bronchiolitis contains necrotic inflammatory and epithelial cells. The viscoelastic properties of purulent airway secretions are largely due to the presence of highly polymerized deoxyribonucleic acid (DNA). Recombinant human deoxyribonuclease (rhDNase) is known to liquefy such mucus in patients with cystic fibrosis, whereas case reports described a beneficial effect in other respiratory disorders. The authors hypothesized that rhDNase would diminish atelectasis and mucus plugging in infants with severe RSV bronchiolitis.

Two infants with RSV bronchiolitis with massive unilateral atelectasis in whom mechanical ventilation was imminent due to exhaustion, and three mechanically ventilated infants (two neonates, one with bronchopulmonary dysplasia) with RSV bronchiolitis with pneumonia received treatment with 2.5 mg nebulized rhDNase twice daily.

Following administration of nebulized recombinant human deoxyribonuclease, clinical and radiological parameters improved quickly. Mechanical ventilation could be avoided in two infants while in three infants on artificial ventilation, clinical recovery started following the first dose of the drug. A therapeutic trial of recombinant human deoxyribonuclease may be an option in the treatment for atelectasis in severe or complicated respiratory syncytial virus bronchiolitis in infancy.
Nasal epithelial cell culture fluorescence recovery after photobleaching predicts cystic fibrosis therapeutic response
Authors: Corcoran Timothy E. , Bertrand Carol A. , Myerburg Michael M. , Weiner Daniel J. , Frizzell Sheila A. , Li Anna , Agostini Brittani , Parker Robert S. , Shapiro Monica E. , Muthukrishnan Ashok , Hages Nicholas D. , Mulhern Brian P. , Pilewski Joseph M.
Published: November 2022

Background

Human nasal epithelial (HNE) cells can be sampled noninvasively and cultured to provide a model of the airway epithelium that reflects cystic fibrosis (CF) pathophysiology. We hypothesised thatin vitromeasures of HNE cell physiology would correlate directly within vivomeasures of lung physiology and therapeutic response, providing a framework for using HNE cells for therapeutic development and precision medicine.

Methods

We sampled nasal cells from participants with CF (CF group, n=26), healthy controls (HC group, n=14) and single CF transmembrane conductance regulator (CFTR) mutation carrier parents of the CF group (CR group, n=16). Participants underwent lung physiology and sweat chloride testing, and nuclear imaging-based measurement of mucociliary clearance (MCC) and small-molecule absorption (ABS). CF participants completed a second imaging day that included hypertonic saline (HS) inhalation to assess therapeutic response in terms of MCC. HNE measurements included Ussing chamber electrophysiology, small-molecule and liquid absorption rates, and particle diffusion rates through the HNE airway surface liquid (ASL) measured using fluorescence recovery after photobleaching (FRAP).

Results

Long FRAP diffusion times were associated with increased MCC response to HS in CF. This implies a strong relationship between inherent factors affecting ASL mucin concentration and therapeutic response to a hydrating therapy. MCC decreased with age in the CR group, which had a larger range of ages than the other two groups. Likely this indicates a general age-related effect that may be accentuated in this group. Measures of lung ABS correlated with sweat chloride in both the HC and CF groups, indicating that CFTR function drives this measure of paracellular small-molecule probe absorption.

Conclusions

Our results demonstrate the utility of HNE cultures for assessing therapeutic response for hydrating therapies.In vitromeasurements of FRAP were particularly useful for predicting response and for characterising important properties of ASL mucus that were ultimately reflected in lung physiology.
Short-term cognitive loading deteriorates breathing pattern and gas exchange in adult patients with congenital central hypoventilation syndrome
Authors: Taytard Jessica , Niérat Marie-Cécile , Gand Camille , Lavault Sophie , Morélot-Panzini Capucine , Patout Maxime , Serresse Laure , Wattiez Nicolas , Bodineau Laurence , Straus Christian , Similowski Thomas
Published: November 2022

Question

HumanPHOX2Bmutations result in life-threatening sleep-related hypoventilation (congenital central hypoventilation syndrome, CCHS). Most patients retain ventilatory activity when awake through a respiratory-related cortical network. We hypothesised that this need to mobilise cortical resources to breathe would lead to breathing-cognition interferences during cognitive loading.

Patients and methods

Seven adult CCHS patients (five women; median age 21) performed standard neuropsychological tests (paced auditory serial addition test – calculation capacity, working memory, sustained and divided attention; trail making test – visuospatial exploration capacity, cognitive processing speed, attentional flexibility; Corsi block-tapping test – visuospatial memory, short-term memory, working memory) during unassisted breathing and under ventilatory support. Ventilatory variables and transcutaneous haemoglobin oxygen saturation were recorded. Cortical connectivity changes between unassisted breathing and ventilatory support were assessed using electroencephalographic recordings (EEG).

Results

Baseline performances were lower than expected in individuals of this age. During unassisted breathing, cognitive loading coincided with increased breathing variability, and decreases in oxygen saturation inversely correlated with an increasing number of apnoeic cycles per minute (rho −0.46, 95% CI −0.76 to −0.06, p=0.01). During ventilatory support, cognitive tasks did not disrupt breathing pattern and were not associated with decreased oxygen saturation. Ventilatory support was associated with changes in EEG cortical connectivity but not with improved test performances.

Conclusions

Acute cognitive loads induce oxygen desaturation in adult CCHS patients during unassisted breathing, but not under ventilatory support. This justifies considering the use of ventilatory support during mental tasks in CCHS patients to avoid repeated episodes of hypoxia.
On the Paramagnetic-Like Susceptibility Peaks at Zero Magnetic Field in $$\hbox{WSe}_{2-x}\hbox{Te}_{x}$$ Single Crystals
Authors: Huang Shiu-Ming , Wang Pin-Cing , Hung Kuo-Yi , Cheng Fu-En , Li Chang-Yu , Chou Mitch
Published: November 2022

A weakly temperature-dependent paramagnetic-like susceptibility peak at zero magnetic field is observed in $$\hbox{WSe}_{2-x}\hbox{Te}_{x}$$

WSe

2
-
x

Te
x

with only marginal amount of ferromagnetic impurities. The ferromagnetic hysteresis loop and the magnetic moment splitting between zero-field-cooled and field-cooled processes indicate ferromagnetism in the samples. The paramagnetic-like susceptibility peak height is proportional to the remanent magnetic moment of hysteresis loops. High-resolution transmission electron microscope image supports that the observed ferromagnetic feature originates from lattice distortion. These results imply that the weakly temperature-dependent paramagnetic-like susceptibility peak originates from weak lattice distortion and/or superparamagnetism.
De novo genome assembly and analysis of Zalaria sp. Him3, a novel fructooligosaccharides producing yeast
Authors: Yoshikawa Jun , Matsutani Minenosuke , Maeda Mayumi , Kashiwagi Yutaka , Maehashi Kenji
Published: November 2022

Background

Zalaria sp. Him3 was reported as a novel fructooligosaccharides (FOS) producing yeast. However, Zalaria spp. have not been widely known and have been erroneously classified as a different black yeast, Aureobasidium pullulans. In this study, de novo genome assembly and analysis of Zalaria sp. Him3 was demonstrated to confirm the existence of a potential enzyme that facilitates FOS production and to compare with the genome of A. pullulans.

Results

The genome of Zalaria sp. Him3 was analyzed; the total read bases and total number of reads were 6.38 Gbp and 42,452,134 reads, respectively. The assembled genome sequence was calculated to be 22.38 Mbp, with 207 contigs, N50 of 885,387, L50 of 10, GC content of 53.8%, and 7,496 genes. g2419, g3120, and g3700 among the predicted genes were annotated as cellulase, xylanase, and β-fructofuranosidase (FFase), respectively. When the read sequences were mapped to A. pullulans EXF-150 genome as a reference, a small amount of reads (3.89%) corresponded to the reference genome. Phylogenetic tree analysis, which was based on the conserved sequence set consisting of 2,362 orthologs in the genome, indicated genetic differences between Zalaria sp. Him3 and Aureobasidium spp.

Conclusion

The differences between Zalaria and Aureobasidium spp. were evident at the genome level. g3700 identified in the Zalaria sp. Him3 likely does not encode a highly transfructosyl FFase because the motif sequences were unlike those in other FFases involved in FOS production. Therefore, strain Him3 may produce another FFase. Furthermore, several genes with promising functions were identified and might elicit further interest in Zalaria yeast.
A proposed methodology for uncertainty extraction and verification in priority setting partnerships with the James Lind Alliance: an example from the Common Conditions Affecting the Hand and Wrist Priority Setting Partnership
Authors: Grindlay D. J. C. , Davis T. R. C. , Kennedy D. , Larson D. , Furniss D. , Cowan K. , Giddins G. , Jain A. , Trickett R. W. , Karantana A.
Published: November 2022

Background

To report our recommended methodology for extracting and then confirming research uncertainties – areas where research has failed to answer a research question – derived from previously published literature during a broad scope Priority Setting Partnership (PSP) with the James Lind Alliance (JLA).

Methods

This process was completed in the UK as part of the PSP for “Common Conditions Affecting the Hand and Wrist”, comprising of health professionals, patients and carers and reports the data (uncertainty) extraction phase of this. The PSP followed the robust methodology dictated by the JLA and sought to identify knowledge gaps, termed “uncertainties” by the JLA. Published Cochrane Systematic Reviews, Guidelines and Protocols, NICE (National Institute for Health and Care Excellence) Guidelines, and SIGN (Scottish Intercollegiate Guidelines Network) Guidelines were screened for documented “uncertainties”. A robust method of screening, internally verifying and then checking uncertainties was adopted. This included independent screening and data extraction by multiple researchers and use of a PRISMA flowchart, alongside steering group consensus processes.

Selection of research uncertainties was guided by the scope of the Common Conditions Affecting the Hand and Wrist PSP which focused on “common” hand conditions routinely treated by hand specialists, including hand surgeons and hand therapists limited to identifying questions concerning the results of intervention, and not the basic science or epidemiology behind disease.

Results

Of the 2358 records identified (after removal of duplicates) which entered the screening process, 186 records were presented to the PSP steering group for eligibility assessment; 79 were deemed within scope and included for the purpose of research uncertainty extraction (45 full Cochrane Reviews, 18 Cochrane Review protocols, 16 Guidelines). These yielded 89 research uncertainties, which were compared to the stakeholder survey, and added to the longlist where necessary; before derived uncertainties were checked against non-Cochrane published systematic reviews.

Conclusions

In carrying out this work, beyond reporting on output of the Common Conditions Affecting the Hand and Wrist PSP, we detail the methodology and processes we hope can inform and facilitate the work of future PSPs and other evidence reviews, especially those with a broader scope beyond a single disease or condition.
Health care providers’ knowledge of clinical protocols for postpartum hemorrhage care in Kenya: a cross-sectional study
Authors: Henry Junita , Clarke-Deelder Emma , Han Dan , Miller Nora , Opondo Kennedy , Oguttu Monica , Burke Thomas , Cohen Jessica L. , McConnell Margaret
Published: November 2022

Background

Postpartum hemorrhage (PPH) remains the leading cause of maternal death worldwide despite its often-preventable nature. Understanding health care providers’ knowledge of clinical protocols is imperative for improving quality of care and reducing mortality. This is especially pertinent in referral and teaching hospitals that train nursing and medical students and interns in addition to managing emergency and referral cases.

Methods

This study aimed to (1) measure health care providers’ knowledge of clinical protocols for risk assessment, prevention, and management of PPH in 3 referral hospitals in Kenya and (2) examine factors associated with providers’ knowledge. We developed a knowledge assessment tool based on past studies and clinical guidelines from the World Health Organization and the Kenyan Ministry of Health. We conducted in-person surveys with health care providers in three high-volume maternity facilities in Nairobi and western Kenya from October 2018-February 2019. We measured gaps in knowledge using a summative index and examined factors associated with knowledge (such as age, gender, qualification, experience, in-service training attendance, and a self-reported measure of peer-closeness) using linear regression.

Results

We interviewed 172 providers including consultants, medical officers, clinical officers, nurse-midwives, and students. Overall, knowledge was lowest for prevention-related protocols (an average of 0.71 out of 1.00; 95% CI 0.69–0.73) and highest for assessment-related protocols (0.81; 95% CI 0.79–0.83). Average knowledge scores did not differ significantly between qualified providers and students. Finally, we found that being a qualified nurse, having a specialization, being female, having a bachelor's degree and self-reported closer relationships with colleagues were statistically significantly associated with higher knowledge scores.

Conclusion

We found gaps in knowledge of PPH care clinical protocols in Kenya. There is a clear need for innovations in clinical training to ensure that providers in teaching referral hospitals are prepared to prevent, assess, and manage PPH. It is possible that training interventions focused on learning by doing and teamwork may be beneficial.
Factors associated with Women’s timing of first antenatal care visit during their last pregnancy: evidence from 2016 Uganda demographic health survey
Authors: Towongo Moses Festo , Ngome Enock , Navaneetham Kannan , Letamo Gobopamang
Published: November 2022

Background

Utilization of antenatal care services (ANC) during pregnancy has been recognized as a major public health intervention to abate maternal morbidity and mortality. Uganda has experienced high levels of maternal morbidity and mortality over the past two decades. This could be partly attributed to the lower proportion of women who initiated their first antenatal care visit during the first trimester of their gestation period. This study aimed at investigating the factors associated with timing of first ANC visit by women in Uganda.

Method

This study used secondary data from the 2016 Uganda Demographic and Health Survey (UDHS). The study population comprises of women aged 15–49 who reported to have given their last birth during the five years preceding the 2016 UDHS survey. The outcome variable for this study was the timing of first ANC visit. Univariate, bivariate, and multilevel binary logistic regression analysis was used to determine the factors associated with the utilization of timing of first ANC visit.

Results

Findings show that only 30% [95%CI; 0.28–0.31] of women utilized ANC during the first trimester. Women of higher parity (4+) were less likely to utilize ANC in the first trimester compared to the lower parity (1) (AOR, 0.74, CI; 0.60–0.92). Women who reside in communities with good access to health facility were more likely to utilize ANC during the first trimester as compared to women residing in communities inaccessible to health facility (AOR, 1.36, CI; 1.04–1.77). Women who reside in less diverse ethnic communities were less likely to utilize ANC in the first trimester compared to their counterparts (AOR, 0.15, CI; 0.11–0.22).

Conclusion

This study demonstrated that contextual factors are important predictors of utilization of ANC during the first trimester apart from individual, factors. It is thus important for maternal health programme interventions to consider both individual and contextual factors when encouraging women to utilize ANC services during the first trimester.