bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Prediction in Women With Congenital Long QT Syndrome
Authors: Goldenberg Ilan , Bos J. Martijn , Yoruk Ayhan , Chen Anita Y. , Lopes Coeli , Huang David T. , Kutyifa Valentina , Younis Arwa , Aktas Mehmet K. , Z. Rosero Spencer , McNitt Scott , Sotoodehnia Nona , Kudenchuk Peter J. , Rea Thomas D. , Arking Dan E. , Scott Christopher G. , Briske Kaylie A. , Sorensen Katrina , J. Ackerman Michael , Zareba Wojciech
Published: July 2021

Background

We aimed to provide personalized risk estimates for cardiac events (CEs) and life‐threatening events in women with either type 1 or type 2 long QT.

Methods and Results

The prognostic model was derived from the Rochester Long QT Syndrome Registry, comprising 767 women with type 1 long QT (n=404) and type 2 long QT (n=363) from age 15 through 60 years. The risk prediction model included the following variables: genotype/mutation location, QTc‐specific thresholds, history of syncope, and β‐blocker therapy. A model was developed with the end point of CEs (syncope, aborted cardiac arrest, or long QT syndrome–related sudden cardiac death), and was applied with the end point of life‐threatening events (aborted cardiac arrest, sudden cardiac death, or appropriate defibrillator shocks). External validation was performed with data from the Mayo Clinic Genetic Heart Rhythm Clinic (N=467; type 1 long QT [n=286] and type 2 long QT [n=181]). The cumulative follow‐up duration among the 767 enrolled women was 22 243 patient‐years, during which 323 patients (42%) experienced ≥1 CE. Based on genotype‐phenotype data, we identified 3 risk groups with 10‐year projected rates of CEs ranging from 15%, 29%, to 51%. The corresponding 10‐year projected rates of life‐threatening events were 2%, 5%, and 14%. C statistics for the prediction model for the 2 respective end points were 0.68 (95% CI 0.65–0.71) and 0.71 (95% CI 0.66–0.76). Corresponding C statistics for the model in the external validation Mayo Clinic cohort were 0.65 (95% CI 0.60–0.70) and 0.77 (95% CI 0.70–0.84).

Conclusions

This is the first risk prediction model that provides absolute risk estimates for CEs and life‐threatening events in women with type 1 or type 2 long QT based on personalized genotype‐phenotype data. The projected risk estimates can be used to guide female‐specific management in long QT syndrome.
Navigating Internationalism from Buenos Aires: The Centro de Arte y Comunicación
Authors: Spencer Catherine
Published: July 2021

This article maps the complex socio-political terrain negotiated by the Centro de Arte y Comunicación (CAYC) during the early 1970s from Buenos Aires. It shows how the CAYC attempted to continue the internationalising aims which the Instituto Torcuato Di Tella had pursued in the 1960s, while also providing a space for the exhibition and development of Conceptualism that engaged with political conditions in Argentina and in other countries including Brazil, Uruguay, Chile and Columbia, developing the framework of “systems art” in order to do so. The compromises necessitated by CAYC's balancing act opened the organisation, and in particular its director Jorge Glusberg, to accusations of cultural imperialism and complicity: from almost the very beginning, the CAYC project was characterised by dissensus and disagreement. The controversy generated by CAYC – documented in archives, publications and exhibition catalogues – now offers a rich historiographical resource for Latin American art, revealing how competing models of internationalism and Conceptualism were closely intertwined rather than diametrically opposed.
Climate Change and the Human Right to Water
Authors: Szwedo Piotr
Published: July 2021

‘Climate action’ and ‘Clean water and sanitation’ are two interconnected Sustainable Development Goals (6 & 13). Climate change has negative effects on all aspects of the human right to water: water’s availability, quality, accessibility, affordability and acceptability. Fulfilment of Sustainable Development Goals is measured by Indicators elaborated by different kind of organs and institutions. Indicators pertains to different factors and may lead to normative consequences. As instruments of global governance they require more transparency and participation in order to foster legitimacy and effectiveness Goals’ achievement. Reports of the Intergovernmental Panel on Climate Change (IPCC) are examples of “governance by indicators”. The main content of reports is data syntheses of various factors influencing climate evolution. However, they contain “summaries for policymakers” of unequivocally normative character based on the interpretation and generalisation of data analysis. Explanation of climatological analyses, convincing theory of probability is required in order to gain stronger civil societies’ conviction for more dynamic action.
Scaphisoma pandemum sp. nov. (Coleoptera: Staphylinidae: Scaphidiinae) from the Atlantic Forest of Southeast Brazil
Authors: GROLL ELISA VON , LOPES-ANDRADE CRISTIANO
Published: July 2021

Scaphidiinae (Coleoptera, Staphylinidae) comprises more than 1800 described species in 46 genera. With 766 described species and subspecies, Scaphisoma Leach is the most diverse genus of this subfamily and is distributed almost worldwide. A total of 38 species are recorded from the Neotropical region and only six are known from Brazil. In this paper, Scaphisoma pandemum von Groll & Lopes-Andrade, sp. nov. is described on the basis of 44 specimens collected from polyporoid fungi in two Atlantic Forest remnants in Viçosa, Minas Gerais, Southeast Brazil. We provide images of adult male and female and their dissected parts, information and photographs of host fungi and comparative notes.
Utilising a WeChat intervention to improve HIV and AIDS education among college students in China
Authors: Zha Peijia , Mahat Ganga , Qureshi Rubab , Zhao Liang , Shen Qu , Chao Ying-Yu , Liu Yang
Published: July 2021

Objective:

To evaluate a WeChat-based HIV and AIDS educational intervention to enhance knowledge, improve attitudes and reduce stigma among college students in China.

Design:

Randomised controlled trial.

Setting:

Public research university in China.

Method:

A total of 111 college students were randomly assigned to either an intervention group or a control group. Participants in the intervention group received an enhanced HIV and AIDS education course delivered via WeChat for 8 weeks. Independent-samples t-tests were used to analyse changes in HIV-related knowledge, attitudes and stigma.

Results:

Findings showed that both HIV- and AIDS-related knowledge ( p < .001) and attitudes ( p < .001) significantly changed in the intervention group. The intervention group also demonstrated lower stigma scores on ‘moral judgment’ ( p < .001), ‘personal stigma’ ( p = .01), ‘perceived community stigma’ ( p < .001) and the ‘total stigma scale’ ( p < .001).

Conclusion:

Results show that college students in China may benefit from a technology-based intervention which could potentially be integrated into routine HIV education for college students.
An investigation on the tribological and mechanical properties of silicone rubber/graphite composites
Authors: Sarath PS , Reghunath Rakesh , Thomas Sabu , Haponiuk Józef T , George Soney C
Published: July 2021

In this study, tribological properties and surface characteristics of silicone rubber/graphite (QMG) composites were investigated as a function of applied load, sliding velocity (1–5 m/s) and temperature. This study discusses a novel approach to improve the tribological properties of silicone rubber (QM). Inclusion of graphite significantly reduces the friction coefficient (̴40%) and specific wear rate of QM (50%). Wear mechanism involves formation of transfer film at the interphase between composite and steel counter surface. Tribological performance of QMG composites were found to be in agreement with its morphological, mechanical and dielectric properties.
Effect of reduced graphene oxide on mechanical behavior of an epoxy adhesive in glassy and rubbery states
Authors: Khabaz-Aghdam Ata , Behjat Bashir , Marques EAS , Carbas RJC , Silva Lucas FM da , Roghani-Mamaqani H
Published: July 2021

The mechanical behavior of an adhesive, in neat state and reinforced with up to 0.5 wt% of reduced graphene oxide (RGO) was investigated here. Tests were done at temperatures between the ambient temperature and the glass transition temperature ( Tg[Formula: see text] of the adhesive. Using a metal mold, cured plates of the neat and RGO reinforced epoxy adhesive were prepared. The adhesive powder and the bulk dumbbell-shaped specimens, obtained from cured adhesive plates, were subjected to differential scanning calorimetry (DSC) and tensile tests, respectively, to obtain the Tg as well as mechanical properties of the adhesives. The results indicated that adding RGO up to 0.5 wt% increased the glass transition temperature, the modulus of elasticity, and the strength of the adhesive. It was found that the presence of RGO reduced the adhesive’s strain at the break at the ambient temperature. However, at high temperatures, near the Tg, the ultimate strain of RGO-reinforced adhesives decreased slightly when compared to the ultimate strain of the neat specimens. This explains the reduction in toughness at ambient temperature obtained by adding RGO and the increase at high temperatures. Finally, the failure morphology of the neat and RGO-reinforced adhesive specimens was investigated using microscopic imaging of the specimens’ failure cross-sections, which supported and justified the experimental observations.
Realization of electromagnetic shielding performance for polyimide-matrix composite by self-metallization
Authors: Zhang Jiayang , Ni Hongjiang , Gong Ming , Li Jun , Zhang Daijun , Chen Xiangbao
Published: July 2021

Electromagnetic shielding performance has been achieved for a polyimide (PI)-matrix composite by the strategy of self-metallization of its thermosetting PI matrix. Self-metallization of the thermosetting PI was realized by silver ion/poly(amic acid) (PAA) precursor ion exchange and thermal reduction. The factors influencing the self-metallization were investigated. The electrical conductivity and integrity for the surface of the PI were achieved by optimization of ion exchange/thermal reduction parameters. The fabricated PI-matrix composite exhibits a maximum electromagnetic interference shielding effectiveness value of 81 dB. Importantly, the electromagnetic shielding performance can be maintained even after heat condition of 300°C. Meanwhile, the surface-metallized PI composite exhibits mechanical property equivalent to the pristine composite, and an Ag/matrix interfacial strength higher than 19.6 MPa. Besides, self-metallization mechanism of the thermosetting PI was investigated.
Fourier-based Synthetic-aperture Imaging for Arbitrary Transmissions by Cross-correlation of Transmitted and Received Wave-fields
Authors: Ali Rehman
Published: July 2021

Investigations into Fourier beamforming for medical ultrasound imaging have largely been limited to plane-wave and single-element transmissions. The main aim of this work is to generalize Fourier beamforming to enable synthetic aperture imaging with arbitrary transmit sequences. When applied to focused transmit beams, the proposed approach yields a full-waveform-based alternative to virtual-source synthetic aperture, which has implications for both coherence imaging and sound speed estimation. When compared to virtual-source synthetic aperture and retrospective encoding for conventional ultrasound sequences (REFoCUS), the proposed imaging technique shows an 8.6 and 3.8 dB improvement in contrast over virtual source synthetic aperture and REFoCUS, respectively, and a 55% improvement in point target resolution over virtual source synthetic aperture. The proposed image reconstruction technique also demonstrates general imaging improvements in vivo, while avoiding limitations seen in prior techniques.
Characterization of Urothelial Inclusions in Male Wistar Han Rats Treated Orally With the Novel α2A-Adrenoceptor Agonist Tasipimidine
Authors: Lensen Joost F. M. , Hyttilä-Hopponen Minja , Karlsson Stefan , Kuosmanen Tarja , Lehtimäki Jyrki , Leino Tiina
Published: July 2021

Intracellular inclusions were observed in urinary bladder epithelium of male Wistar rats, following oral treatment with high doses of the α2A-adrenoceptor agonist tasipimidine for 28 days. No cell death or inflammation was associated with the brightly eosinophilic inclusions. Electron microscopy (EM) studies showed that the inclusions represented intact or fragmented red blood cells (RBC) resulting from erythrophagocytosis, further supported by the presence of iron in urothelial cells. In addition, scattered iron-positive macrophages were observed in the submucosa and muscle layer, indicating microvascular leakage, as no major hemorrhage was evident. Despite the presence of inclusions, the urothelium showed normal uroplakin III distribution, normal cell turnover, and an absence of α-2u-globulin. It is, therefore, concluded that the inclusions were not associated with urothelial damage or increased renewal of the epithelium. This finding shows also that urothelial cells have the capability to phagocytize and break down RBCs originating from submucosal microvascular leakage. Similar changes were not observed in tasipimidine-treated beagle dogs (28 days), suggesting these findings were rat specific. The leakage of RBCs into the urothelium is suggested to be a consequence of exaggerated pharmacology leading to vasoconstriction of submucosal blood vessels in combination with transient increased bladder distension and pressure.
Teaching methods that foster self-efficacy belief: Perceptions of collegiate musicians from the United States
Authors: Lewis Megan , Weight Erianne , Hendricks Karin
Published: July 2021

Self-efficacy belief is a strong predictor of successful performance. Developmental differences in the acquisition of self-beliefs have been attributed to myriad individual and contextual factors, including teacher influence. The aim of this mixed-method study was to examine collegiate music students’ perceptions of teaching methods that strengthened or weakened music performance belief. A questionnaire was sent to music students enrolled in their third or fourth years of highly competitive collegiate music programs in the United States ( N = 83). Analysis of variance revealed that students who reported studying with a teacher who “influenced them to become greater than they imagined possible” indicated significantly higher music performance self-efficacy beliefs than those who had not. Participants most frequently mentioned belief-enhancing methods associated with verbal/social persuasion (e.g., demonstrated belief in student potential, encouragement, high expectations, accountability, and personalized, logical instruction). Reported mastery experience methods were frequently coupled with verbal/social persuasion and encompassed a collaborative approach to selecting repertoire, tools for self-analysis and practice maximization, opportunities and encouragement to perform often, and goal setting. Over one in three participants conveyed studying with a teacher who “influenced them to become a weaker performer,” highlighting the need to educate music teachers in belief-enhancing pedagogical practices.
Neoliberalism with Scandinavian characteristics: The slow formation of neoliberal common sense in Denmark
Authors: Stahl Rune Møller
Published: July 2021

This article describes the ascension of neoliberal economic ideas in the macroeconomic establishment in Denmark. Based on a systematic analysis of documents from the Danish government and the Economic Council from the 1970s to the early 2000s, the article traces the development of the economic ideas and policy instrument that dominate the analytical process of the Danish macroeconomic establishment. The article applies a Gramscian-inspired framework to track the gradual and uneven process under which neoliberal economic ideas became common sense in the Danish context. This framework challenges some of the assumptions of the ideational focus of much constructivist literature, and offers an alternative analysis focused on the legitimating role of economic ideas. As much of the ideational change took place after policy adaptions to international economic developments, the Danish case provides little support for the theory of the causal power of ideas. Rather, it seems as though economic models and ideas are imported as ‘after the fact’ legitimations of changes in policy.
Effect of structural design parameters on nonlinear dynamic characteristics of the gear transmission
Authors: Ouyang Tiancheng , Yang Rui , Shen Yudong , Chen Jingxian , Chen Nan
Published: July 2021

The calculation of time-varying meshing stiffness caused by the alternate contacting of the gear tooth is an essential prerequisite to obtain real and effective nonlinear dynamic characteristics of the transmission system, so that the significance of which cannot be overemphasized. Accordingly, this work proposes an improved method to get meshing stiffness with taking fillet-foundation and gear rim deflection into consideration. Compared to the traditional potential energy method, the proposed method has more superior accuracy and performance, and its effectiveness has been further verified by the finite element analytical model. After that, an ideal eight degree of freedoms (DOFs) dynamic model of one stage mass-spring-damper involute spur gear, including lateral and torsional motions, is established to study the dynamic characteristics. Due to the complexity of the gear system operating conditions, we also investigate the influence of various parameters including hub bore radius, transmitting load, and rotation speed on dynamic features, especially in heavy-load and high-speed conditions. From the results, it can be concluded that these parameters will play a prominent role in the spur gear pair dynamic behaviors, providing a certain guidance for gear design.
Hearing Outcomes in Stickler Syndrome: Variation Due to COL2A1 and COL11A1
Authors: Bath Fadlullah , Swanson Dan , Zavala Hanan , Chinnadurai Siva , Roby Brianne B.
Published: July 2021

Objectives:

Stickler syndrome (SS) is a heterogeneous inherited connective tissue disorder, often due to a mutation in COL2A1 or COL11A1. Mutations in these genes cause collagen abnormalities affecting ocular, auditory, orofacial, and skeletal systems, including hearing loss, micrognathia, and cleft palate. Understanding the variability of hearing phenotypes based on genetic mutation has a significant impact on treatment and long-term care.

Design:

A retrospective chart review of pediatric patients with a confirmed diagnosis of SS between January 2003 and December 2018 at a tertiary pediatric hospital was performed. Patients were excluded if they did not have genetic evaluation, craniofacial/ear, nose, and throat evaluation, and/or audiologic testing. Charts were reviewed for the following information: age, race, sex, SS diagnosis, genetic variant of SS, and audiological testing data.

Results:

There were 29 confirmed patients with SS who met criteria, 16 with type I ( COL2A1) and 13 with type II ( COL11A1). Of the 13 patients with type II, 12 (92%) demonstrated hearing loss, ranging in severity from mild to severe. In type I, 25% of patients had mild or resolved hearing loss.

Conclusion:

Results suggest that patients with type II SS are more likely to have congenital hearing loss than type I. Data also suggest that the COL11A1 mutation shows consistently more severe hearing loss than the COL2A1 mutation.
Utilizing a Growth Mindset and the Tadros Theory of Change to Increase Children’s Well-Being
Authors: Harris Allissa , Tadros Eman
Published: July 2021

Mindsets play huge roles in individuals’ goals, attitudes, relationships, motivation, and potential. A growth mindset is the desired mindset to have; it is very positive, learning focused, and encouraging. The academic benefits for students with growth mindsets include earning better grades, more motivation, and scoring higher on national standardized tests than students with fixed mindsets. Many studies have been conducted to determine the effects mindsets have on humans, specifically in terms of academics and overall well-being; however, there needs to be a stronger connection from research to practice to directly apply this mindset. The Tadros Theory of Change is integrated with a growth mindset to better conceptualize family strengths and structure as well as to empower and encourage growth and change. This article offers clinical implications for practice for both counselors and families and provides future research directions.
Tools for Evaluating the Implementation of Complex Education Interventions
Authors: Kainz Kirsten , Metz Allison , Yazejian Noreen
Published: July 2021

Large-scale education interventions aimed at diminishing disparities and generating equitable learning outcomes are often complex, involving multiple components and intended impacts. Evaluating implementation of complex interventions is challenging because of the interactive and emergent nature of intervention components. Methods that build from systems science have proven useful for addressing evaluation challenges in the complex intervention space. Complexity science shares some terminology with systems science, but the primary aims and methods of complexity science are different from those of systems science. In this paper we describe some of the language and ideas used in complexity science. We offer a set of priorities for evaluation of complex interventions based on language and ideas used in complexity science and methodologies aligned with the priorities.
Fluorescent in situ hybridization (FISH): A useful diagnostic tool for childhood conjunctival melanoma
Authors: María Moral Raquel , Monteagudo Carlos , Muriel Javier , Moreno Lucía , María Peiró Ana
Published: July 2021

Introduction:

Conjunctival melanoma is extremely rare in children and has low rates of resolution. Definitive histopathological diagnosis based exclusively on microscopic findings is sometimes difficult. Thus, early diagnosis and adequate treatment are essential to improve clinical outcomes.

Clinical case:

We present the first case in which the fluorescent in situ hybridization (FISH) diagnostic technique was applied to a 10-year-old boy initially suspected of having amelanotic nevi in his right eye. Based on the 65% of tumor cells with 11q13 (CCND1) copy number gain and 33% with 6p25 (RREB1) gain as measured by the FISH analysis, and on supporting histopathological findings, the diagnosis of conjunctival melanoma could be made. Following a larger re-excision, adjuvant therapy with Mitomycin C (MMC), cryotherapy and an amniotic membrane graft, the patient has remained disease-free during 9 years of long-term follow-up.

Case discussion:

Every ophthalmologist should remember to consider and not forget the possibility of using FISH analyses during the differential diagnosis of any suspicious conjunctival lesions. Genetic techniques, such as FISH, have led to great advances in the classification of ambiguous lesions. Evidence-based guidelines for diagnosing conjunctival melanoma in the pediatric population are needed to determine the most appropriate strategy for this age group.
Autonomous underwater vehicle challenge: design and construction of a medium-sized, AI-enabled low-cost prototype
Authors: Paraschos Dimitrios , Papadakis Nikolaos K.
Published: July 2021

The design of an autonomous underwater vehicle (AUV) with physical dimensions of 1100 mm × 700 mm × 330 mm, and weight of 55 kg, is introduced herein. This paper describes the design, materials, hydrodynamics, and system architecture of an AUV prototype named Synoris, developed as a low-cost and medium-scale testbed platform. Synoris moves via six brushless motors, can reach up to 200 m depth, has an autonomy estimated around 6 hours and a modular design for multiple payload options. Stability control, autonomous movement, obstacle avoidance temperature/pressure sensing, and video/image capturing are simultaneously performed by exploiting a set of onboard computers that are described briefly in Section 4. The whole platform is built on top of the open source software called ROS (robotic operating system) that provides a flexible framework for writing robot software by providing services such as low-level device control, message parsing, data fusion, and system integration. Synoris is ideal for underwater applications and missions, involving machine learning and computer vision features. AUV development in general meets high-cost solutions due to the complexity and harshness of the operational environment. Even the most cost-effective solutions demand plentiful resources. This paper describes the entire process of development and how a relatively low-cost approach can provide a reliable AUV for many underwater applications, involving AI and machine-learning capabilities.
Relative Clinical Outcomes Comparing Manual and Robotic-Assisted Total Knee Arthroplasty at Minimum 1-Year Follow-up
Authors: Mitchell Joseph , Wang Jesse , Bukowski Brett , Greiner Justin , Wolford Brianna , Oyer Mark , Illgen Richard L.
Published: July 2021

Background: Total knee arthroplasty (TKA) demonstrates excellent durability using jig-based manual techniques (manual TKA [mTKA]), but significant rates of dissatisfaction remain. Modifications of mTKA techniques and TKA implant designs to improve outcomes have had minimal success. Studies comparing relative outcomes of mTKA and robotic-assisted TKA (raTKA) are limited. Purpose: This study sought to compare outcomes of mTKA and raTKA in patients at a single institution. Methods: We retrospectively reviewed all primary TKAs performed by 1 surgeon from 2015 to 2017. In all, 139 consecutive mTKAs (2015–2016) and 148 consecutive raTKAs (2016–2017) were included. No cases were excluded. Patient demographics, complications, readmission rates, and clinical and patient-reported outcomes were compared at a minimum of 1-year follow-up. A post hoc student t test and Pearson χ2 test were used for continuous and categorical data. Results: We found that mTKA patients compared with raTKA patients required significantly longer length of stay (LOS) (1.73 vs 1.18 days, respectively), greater morphine milligram equivalents consumption (89.6 vs 65.2, respectively), and increased physical therapy (PT) visits (13.0 vs 11.0, respectively) with increased 30-day readmission rates (4.3 vs 0.7%, respectively) that approached significance. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement and the University of California at Los Angeles activity score did not differ significantly comparing raTKA with mTKA patients at 1 year. There were no differences in complication rates. Conclusion: Significant early clinical benefits were noted with raTKA, including lower opioid requirements, shorter LOS, and fewer PT visits when compared with mTKA. A reduction in 30-day readmission rates was noted with raTKA that was not significant. Excellent clinical results with similar patient-reported outcomes were noted in both groups at 1-year follow-up. Further prospective investigations at longer follow-up intervals comparing these techniques are warranted.
Femicide and Feminicide in Mexico: Patterns and Trends in Indigenous and Non-Indigenous Regions
Authors: Frías Sonia M.
Published: July 2021

The killing of women in Mexico has attracted both national and international attention. Many of these homicides are regarded as feminicides, which are defined as the misogynistic killing of women for reasons of gender rooted in ideological and structural gender inequalities. This study examines changes and continuities in female homicides and femicides from 2001 to 2017 in indigenous and non-indigenous municipalities. Female homicides have increased at a higher rate than femicides, but the latter has increased at a higher rate in indigenous municipalities than in non-indigenous municipalities. This is associated with an increase in gender equality in a context of conflict and structural discrimination against indigenous peoples. Implications for future research and public interventions are discussed.
What type of democracy do Chileans want?
Authors: Singh Shane P. , Williams Neil S.
Published: July 2021

Chile is undergoing perhaps the most dramatic reformation of any contemporary democracy and will adopt a wholly new constitution in the coming two years. Against this backdrop, in this Research Note we investigate which democratic features Chileans prefer. To so do, we field a conjoint experiment with a large quota sample of Chileans. Results reveal that Chileans have several distinct preferences over democratic features that are currently subject to change. We also find that these preferences are largely indistinguishable within demographic subgroups. We conclude with a discussion of the implications of our findings in light of Chile’s ongoing processes of democratic reform and lessons for other democracies.
Submitral Aneurysm Presenting as Pulsating Epigastric Mass—Diagnostic and Surgical Considerations
Authors: Ramaswamy Rajesh Kumar , Chandresekaran Ramyashri , Chandrasekhar Anitha , Gnanasekaran Pradeep , Subramaniam Ganapathy , Komarakshi Balakrishnan
Published: July 2021

Submitral aneurysm (SMA) is a rare anomaly that typically occurs adjacent to the posterior leaflet of the mitral valve. We report the case of a ten-year-old female child presenting with SMA with anteroinferior extension, differing from the more typical posterior and lateral extension. Successful surgical management is described.
Minimally Invasive Tubular Lumbar Discectomy Versus Conventional Open Lumbar Discectomy: An Observational Study From the Canadian Spine Outcomes and Research Network
Authors: Evaniew Nathan , Bogle Andrew , Soroceanu Alex , Jacobs W. Bradley , Cho Roger , Fisher Charles G. , Rampersaud Y. Raja , Weber Michael H. , Finkelstein Joel A. , Attabib Najmedden , Kelly Adrienne , Stratton Alexandra , Bailey Christopher S , Paquet Jerome , Johnson Michael , Manson Neil A. , Hall Hamilton , McIntosh Greg , Thomas Kenneth C.
Published: July 2021

Study Design:

Retrospective cohort study.

Objective:

We evaluated the effectiveness of minimally invasive (MIS) tubular discectomy in comparison to conventional open surgery among patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN).

Methods:

We performed an observational analysis of data that was prospectively collected. We implemented Minimum Clinically Important Differences (MCIDs), and we adjusted for potential confounders with multiple logistic regression. Adverse events were collected according to the Spinal Adverse Events Severity (SAVES) protocol.

Results:

Three hundred thirty-nine (62%) patients underwent MIS tubular discectomy and 211 (38%) underwent conventional open discectomy. There were no significant differences between groups for improvement of leg pain and disability, but the MIS technique was associated with reduced odds of achieving the MCID for back pain (OR 0.66, 95% CI 0.44 to 0.99, P < 0.05). We identified statistically significant differences in favor of MIS for each of operating time (MIS mean (SD) 72.2 minutes (30.0) vs open 93.5 (40.9)), estimated blood loss (MIS 37.9 mL (36.7) vs open 76.8 (71.4)), length of stay in hospital (MIS 73% same-day discharge vs open 40%), rates of incidental durotomy (MIS 4% vs open 8%), and wound-related complications (MIS 3% vs open 9%); but not for overall rates of reoperation.

Conclusions:

Open and MIS techniques yielded similar improvements of leg pain and disability at up to 12 months of follow-up, but MIS patients were less likely to experience improvement of associated back pain. Small differences favored MIS for operating time, blood loss, and adverse events but may have limited clinical importance.
Using Educational Institutional Archives to Unsettle and Rectify Racial Pasts
Authors: Goss Devon R.
Published: July 2021

This article offers a pedagogical response to the growing demand that institutions of higher education must contend with their racial pasts. Drawing upon concepts from the literature on collective memory, students work with institutional archives that showcase localized examples of racial injustice. Students are then asked to imagine potential options for the collective redress of these institutional racial pasts. This activity provides a chance for students to consider how racial histories are preserved and told, and to suggest solutions for changing that story. Moreover, through engaging in this activity, students are encouraged to see their campus environments within the context of contemporary understandings of institutional racism.
Policies, Laws and Schemes Supporting Foster Care and Adoption in South Asia
Authors: Saxena Ratna , Bhardwaj Bhavyaa
Published: July 2021

Families are the natural environment for children to grow. Children have the right to be cared for by their parents; parents have a responsibility to provide for their children’s upbringing and development. States have the responsibility to provide special protection and assistance to millions of children in South Asia who no longer have families, who have become separated from their families, or whose families represent a serious danger to their health or development. There is a spectrum of services available to children whose parents no longer provide adequate care, known as Out of Home Care or Alternate Care.

There are growing concerns about the situation of children outside parental care and the provision of suitable alternatives in South Asia. These children often find themselves at a high risk of violence, exploitation, abuse and neglect, and their well-being is often insufficiently monitored. An inadequate care environment can impair a child’s emotional and social development, and leave children extremely vulnerable to abuse and exploitation, including sexual abuse and physical violence.

Across the South Asian region, the combined impacts of widespread poverty, prolonged armed conflict, frequent natural disasters and the spread of COVID-19 is exerting extreme pressure on families and communities, as well as on the limited social services available to support them.

The present article aims to study the various policies, laws & schemes supporting two forms of alternate care, namely, foster care & adoption in South Asia, identify the gaps in the implementation and make certain recommendations.
Sensor-based fall risk assessment in older adults with or without cognitive impairment: a systematic review
Authors: Bezold Jelena , Krell-Roesch Janina , Eckert Tobias , Jekauc Darko , Woll Alexander
Published: July 2021

Background

Higher age and cognitive impairment are associated with a higher risk of falling. Wearable sensor technology may be useful in objectively assessing motor fall risk factors to improve physical exercise interventions for fall prevention. This systematic review aims at providing an updated overview of the current research on wearable sensors for fall risk assessment in older adults with or without cognitive impairment. Therefore, we addressed two specific research questions: 1) Can wearable sensors provide accurate data on motor performance that may be used to assess risk of falling, e.g., by distinguishing between faller and non-faller in a sample of older adults with or without cognitive impairment?; and 2) Which practical recommendations can be given for the application of sensor-based fall risk assessment in individuals with CI? A systematic literature search (July 2019, update July 2020) was conducted using PubMed, Scopus and Web of Science databases. Community-based studies or studies conducted in a geriatric setting that examine fall risk factors in older adults (aged ≥60 years) with or without cognitive impairment were included. Predefined inclusion criteria yielded 16 cross-sectional, 10 prospective and 2 studies with a mixed design.

Results

Overall, sensor-based data was mainly collected during walking tests in a lab setting. The main sensor location was the lower back to provide wearing comfort and avoid disturbance of participants. The most accurate fall risk classification model included data from sit-to-walk and walk-to-sit transitions collected over three days of daily life (mean accuracy = 88.0%). Nine out of 28 included studies revealed information about sensor use in older adults with possible cognitive impairment, but classification models performed slightly worse than those for older adults without cognitive impairment (mean accuracy = 79.0%).

Conclusion

Fall risk assessment using wearable sensors is feasible in older adults regardless of their cognitive status. Accuracy may vary depending on sensor location, sensor attachment and type of assessment chosen for the recording of sensor data. More research on the use of sensors for objective fall risk assessment in older adults is needed, particularly in older adults with cognitive impairment.

Trial registration

This systematic review is registered in PROSPERO (CRD42020171118).
Dual species dynamic transcripts reveal the interaction mechanisms between Chrysanthemum morifolium and Alternaria alternata
Authors: Liu Lina , Chen Fadi , Chen Sumei , Fang Weimin , Liu Ye , Guan Zhiyong
Published: July 2021

Background

Chrysanthemum (Chrysanthemum morifolium) black spot disease caused by Alternaria alternata is one of the plant’s most destructive diseases. Dual RNA-seq was performed to simultaneously assess their transcriptomes to analyze the potential interaction mechanism between the two species, i.e., host and pathogen.

Results

C. morifolium and A. alternata were subjected to dual RNA-seq at 1, 12, and 24 h after inoculation, and differential expression genes (DEGs) in both species were identified. This analysis confirmed 153,532 DEGs in chrysanthemum and 14,932 DEGs in A. alternata, which were involved in plant-fungal interactions and phytohormone signaling. Fungal DEGs such as toxin synthesis related enzyme and cell wall degrading enzyme genes played important roles during chrysanthemum infection. Moreover, a series of key genes highly correlated with the early, middle, or late infection stage were identified, together with the regulatory network of key genes annotated in the Plant Resistance Genes database (PRGdb) or Pathogen-Host Interactions database (PHI-base). Highly correlated genes were identified at the late infection stage, expanding our understanding of the interplay between C. morifolium and A. alternata. Additionally, six DEGs each from chrysanthemum and A. alternata were selected for quantitative real-time PCR (qRT-PCR) assays to validate the RNA-seq output.

Conclusions

Collectively, data obtained in this study enriches the resources available for research into the interactions that exist between chrysanthemum and A. alternata, thereby providing a theoretical basis for the development of new chrysanthemum cultivars with resistance to pathogen.
A machine learning approach for accurate and real-time DNA sequence identification
Authors: Wang Yiren , Alangari Mashari , Hihath Joshua , Das Arindam K. , Anantram M. P.
Published: July 2021

Background

The all-electronic Single Molecule Break Junction (SMBJ) method is an emerging alternative to traditional polymerase chain reaction (PCR) techniques for genetic sequencing and identification. Existing work indicates that the current spectra recorded from SMBJ experimentations contain unique signatures to identify known sequences from a dataset. However, the spectra are typically extremely noisy due to the stochastic and complex interactions between the substrate, sample, environment, and the measuring system, necessitating hundreds or thousands of experimentations to obtain reliable and accurate results.

Results

This article presents a DNA sequence identification system based on the current spectra of ten short strand sequences, including a pair that differs by a single mismatch. By employing a gradient boosted tree classifier model trained on conductance histograms, we demonstrate that extremely high accuracy, ranging from approximately 96 % for molecules differing by a single mismatch to 99.5 % otherwise, is possible. Further, such accuracy metrics are achievable in near real-time with just twenty or thirty SMBJ measurements instead of hundreds or thousands. We also demonstrate that a tandem classifier architecture, where the first stage is a multiclass classifier and the second stage is a binary classifier, can be employed to boost the single mismatched pair’s identification accuracy to 99.5 %.

Conclusions

A monolithic classifier, or more generally, a multistage classifier with model specific parameters that depend on experimental current spectra can be used to successfully identify DNA strands.
Transmitted drug resistance to Tenofovir/Emtricitabine among persons with newly diagnosed HIV infection in Shenyang city, Northeast China from 2016 to 2018
Authors: Wang Zhen , Zhao Bin , An Minghui , Song Wei , Dong Xue , Li Xin , Wang Lu , Wang Lin , Tian Wen , Ding Haibo , Han Xiaoxu
Published: July 2021

Background

To assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as pre-exposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China.

Methods

Demographic and epidemiological information of all newly diagnosed HIV-1 infected residents in Shenyang city from 2016 to 2018 were anonymously collected from the local HIV epidemic database. HIV-1 pol sequences were amplified from RNA in cryopreserved plasma samples and sequenced directly. Viral subtypes were inferred with phylogenetic analysis and drug resistance mutations (DRMs) were determined according to the Stanford HIVdb algorithm. Recent HIV infection was determined with HIV Limiting Antigen avidity electro immunoassay.

Results

A total of 2176 sequences (92.4%, 2176/2354) were obtained; 70.9% (1536/2167) were CRF01_AE, followed by CRF07_BC (18.0%, 391/2167), subtype B (4.7%, 102/2167), other subtypes (2.6%, 56/2167), and unique recombinant forms (3.8%, 82/2167). The prevalence of TDR was 4.9% (107/2167), among which, only 0.6% (13/2167) was resistance to TDF/FTC. Most of these subjects had CRF01_AE strains (76.9%, 10/13), were unmarried (76.9%, 10/13), infected through homosexual contact (92.3%, 12/13), and over 30 years old (median age: 33). The TDF/FTC DRMs included K65R (8/13), M184I/V (5/13), and Y115F (2/13). Recent HIV infection accounted for only 23.1% (3/13). Most cases were sporadic in the phylogenetic tree, except two CRF01_AE sequences with K65R (Bootstrap value: 99%).

Conclusions

The prevalence of TDR to TDF/FTC is low among newly diagnosed HIV-infected cases in Shenyang, suggesting that TDR may have little impact on the protective effect of the ongoing CROPrEP project in Shenyang city.
Outpatient parenteral antimicrobial therapy (OPAT) for aortic vascular graft infection; a five-year retrospective evaluation
Authors: Allen Niamh , Adam Mohamed , O’Regan Grace , Seery Aoife , McNally Cora , McConkey Samuel , Brown Aisling , de Barra Eoghan
Published: July 2021

Objectives

An estimated 1% of endovascular aneurysm repair (EVAR) devices become infected, carrying a high mortality rate. Surgical explantation is recommended and prognosis is guarded. This retrospective cohort analysis focuses on the role of outpatient parenteral antimicrobial therapy (OPAT) in the management of aortic vascular graft infections following EVAR.

Methods

Patients who received OPAT for aortic graft infections (AGI) following EVAR from 2014 to 2018 inclusive were identified using the OPAT database. Clinical, microbiological and radiological data were collected. Survivors were followed up for a median of 36 months (range 25–60) after first presentation with infection. Outcomes were assessed.

Results

Eleven cases with 20 OPAT episodes were identified: 10/11 male, median age 76 (IQR 71–81). Median time to presentation was 7 months (range 0–81 months) after EVAR. OPAT lead to a 55% reduction in length of hospital stay. One patient had graft explantation; four others had temporising measures. Eight of 11 were alive a median of 36 months after presentation with infection, having had a median of 2 re-treatments on OPAT (range 1–3). Seven of the eight survivors were on continuous suppressive oral antimicrobials; three were also intermittently on intravenous antibiotics for flares of infection. Patient/ infection outcomes were cure (1/11), improved (7/11), failure (3/11).

Conclusion

AGI following EVAR usually presents in the first year after graft deployment. OPAT has an important peri-operative role in patients suitable for curative surgery. OPAT followed by oral suppressive antimicrobial therapy can be a feasible long-term treatment for non-curative management of AGI. Survival in our cohort was longer than expected, and OPAT was feasible despite the complexity of these infections. OPAT can avoid multiple and lengthy hospital admissions and maximise time at home and quality of life in this cohort with life-limiting infection.
Caffeine-induced hypokalemia: a case report
Authors: Han Min Jee , Kim Su-Hyun , Shin Jung-ho , Hwang Jin Ho
Published: July 2021

Background

With an increase in the global popularity of coffee, caffeine is one of the most consumed ingredients of modern times. However, the consumption of massive amounts of caffeine can lead to severe hypokalemia.

Case presentation

A 29-year-old man without a specific past medical history was admitted to our hospital with recurrent episodes of sudden and severe lower-extremity weakness. Laboratory tests revealed low serum potassium concentration (2.6–2.9 mmol/L) and low urine osmolality (100–130 mOsm/kgH2O) in three such prior episodes. Urinary potassium/urinary creatinine ratio was 12 and 16 mmol/gCr, respectively. The patient was not under medication with laxatives, diuretics, or herbal remedies. Through an in-depth interview, we found that the patient consumed large amounts of caffeine-containing beverages daily, which included > 15 cups of coffee, soda, and various kinds of tea. After the cessation of coffee intake and concomitant intravenous potassium replacement, the symptoms rapidly resolved, and the serum potassium level normalized.

Conclusions

An increased intracellular shift of potassium and increased loss of potassium in urine due to the diuretic action have been suggested to be the causes of caffeine-induced hypokalemia. In cases of recurring hypokalemia of unknown cause, high caffeine intake should be considered.