bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma Fatty Acid Composition Was Associated with Apelin Gene Expression in Human Adipose Tissues
Authors: Yuzbashian Emad , Asghari Golaleh , Beheshti Nilofar , Hedayati Mehdi , Zarkesh Maryam , Mirmiran Parvin , Daneshafrooz Afsoon , Khalaj Alireza
Published: October 2021

Background. Apelin is an adipokine with an intermediatory role in obesity and insulin resistance, which can be modified by dietary intake. Aims. In this study, we aimed to determine the association of the plasma fatty acid composition with apelin plasma concentration and gene expression in visceral (VAT) and subcutaneous (SAT) adipose tissues. Methods. In this cross‐sectional study, we recruited 179 patients aged 19‐75 years who were candidates for elective surgery. Through the surgery, SAT and VAT were collected to measure apelin gene expression. Anthropometric measurements, fasting blood samples, and dietary intakes were collected before surgery. Free fatty acids (FFAs) in fasting whole plasma were measured using gas chromatography with flame ionization detection. Linear regression models were used to estimate standardized β (STZ β) showing the association of individual and total FFAs with apelin gene expression after adjustment for potential confounding variables. Results. In multivariable analysis, we observed a significant positive association of total plasma free fatty acids (FFAs) (STZ β = 0.241, P = 0.006), saturated fatty acid (SFA) (STZ β = 0.336, P < 0.001), and monounsaturated fatty acid (MUFA) (STZ β = 0.313, P < 0.001) concentrations with apelin gene expression from VAT after controlling for age, sex, body mass index, homeostatic model assessment for insulin resistance (HOMA‐IR), physical activity, and energy intake. In the SFA family, there was a direct association with plasma concentration of myristic acid (STZ β = 0.372, P < 0.001), pentadecanoic acid (STZ β = 0.252, P = 0.002), and heptadecanoic acid (STZ β = 0.407, P < 0.001) with apelin mRNA expression in VAT. There was no significant association between FFAs and apelin plasma concentration and SAT mRNA levels. Conclusions. In conclusion, circulating plasma FFAs, SFA, and MUFA had a positive association with apelin gene expression in VAT. It seems that plasma fatty acid composition may regulate apelin gene expression in VAT.
The Exponential Rise of Teledentistry and Patient-Oriented Protective Measures in Southeast Asian Dental Clinics: Concerns, Benefits, and Challenges
Authors: Marya Anand , Venugopal Adith , Karobari Mohmed Isaqali , Messina Pietro , Scardina Giuseppe Alessandro , Subramanian Aravind Kumar
Published: October 2021

In the Southeast Asian region, various policies have been advocated by health regulatory bodies that entail protective measures such as face masks, gloves, maintaining distance in public areas, and more. These protective measures are aimed at helping reverse the growth rate of the coronavirus. Dentists in this region have incorporated several changes to their practices to help minimize risks of person-to-person transmission inside dental offices. This narrative review aimed to provide an in-depth overview of the current situation in the Southeast Asian region regarding the use of teledentistry during the pandemic. Teledentistry involves the transfer of patient information across remote distances for online consultation and treatment planning. A few years back, it used to be a lesser-known entity but has seen an exponential rise in its incorporation into dental practices all around the Association of Southeast Nations (ASEAN) region. Many clinics in the Southeast Asian region have started using online consultations to ensure that patients can be diagnosed or followed up during their treatment. Teledentistry is the clear answer in the coming months as it will help reduce the risk of virus transmission and help patients get access to oral healthcare and dentists to see their patients. This article reviews the current pandemic situation in the ASEAN region, the recent evidence, and the scope of teledentistry. It also provides recommendations for the future and sheds light on the different types of teledentistry and how it can be incorporated into practices by regulatory authorities in this region.
Integrative RNA-omics Discovers GNAS Alternative Splicing as a Phenotypic Driver of Splicing Factor–Mutant Neoplasms
Authors: Wheeler Emily C. , Vora Shailee , Mayer Daniel , Kotini Andriana G. , Olszewska Malgorzata , Park Samuel S. , Guccione Ernesto , Teruya-Feldstein Julie , Silverman Lewis , Sunahara Roger K. , Yeo Gene W. , Papapetrou Eirini P.
Published: October 2021

Mutations in splicing factors (SF) are the predominant class of mutations in myelodysplastic syndrome (MDS), but convergent downstream disease drivers remain elusive. To identify common direct targets of missplicing by mutant U2AF1 and SRSF2, we performed RNA sequencing and enhanced version of the cross-linking and immunoprecipitation assay in human hematopoietic stem/progenitor cells derived from isogenic induced pluripotent stem cell (iPSC) models. Integrative analyses of alternative splicing and differential binding converged on a long isoform of GNAS (GNAS-L), promoted by both mutant factors. MDS population genetics, functional and biochemical analyses support that GNAS-L is a driver of MDS and encodes a hyperactive long form of the stimulatory G protein alpha subunit, Gαs-L, that activates ERK/MAPK signaling. SF-mutant MDS cells have activated ERK signaling and consequently are sensitive to MEK inhibitors. Our findings highlight an unexpected and unifying mechanism by which SRSF2 and U2AF1 mutations drive oncogenesis with potential therapeutic implications for MDS and other SF-mutant neoplasms.

Significance:

SF mutations are disease-defining in MDS, but their critical effectors remain unknown. We discover the first direct target of convergent missplicing by mutant U2AF1 and SRSF2, a long GNAS isoform, which activates G protein and ERK/MAPK signaling, thereby driving MDS and rendering mutant cells sensitive to MEK inhibition.

This article is highlighted in the In This Issue feature, p. 587
A política e a poética do coletivo Frente Três de Fevereiro
Authors: Nogueira Pedro Caetano Eboli
Published: October 2021

O presente artigo analisa as ações anti-racismo “Monumento Horizontal” (2004), intervenção urbana realizada na cidade de São Paulo, e “Bandeiras” (2005), série de bandeiras abertas em diversas partidas de futebol. Ambas foram realizadas pelo coletivo Frente Três de Fevereiro, grupo paulistano de arte e ativismo surgido com o intuito de combater o racismo estrutural. Partindo de entrevistas realizadas com o grupo, procuramos compreender o “caráter poético” atribuído ao ativismo do coletivo, sublinhando de que modo ele emerge a contrapelo de concepções políticas baseadas na comunicação. Para tal, mobilizamos os subsídios teóricos de Jacques Rancière, amparados por autores como Jean-Luc Nancy, Silvio Almeida e Judith Butler. Assim, tomamos a “poética” como via de acesso para compreender, no âmbito das estratégias políticas do coletivo, o entrelaçamento entre a noção de dissenso e a ideia de acontecimento, tal como pensada por Jacques Rancière e Michel Foucault. Por fim, justapomos as expectativas de eficácia política, subjacentes às ações do coletivo, àquilo que Jacques Rancière chamou de “modelos de eficácia da arte” em seu regime estético.
Turnover Rates of the Low-Density Lipoprotein Receptor and PCSK9: Added Dimension to the Cholesterol Homeostasis Model
Authors: Dandan Mohamad , Han Julia , Mann Sabrina , Kim Rachael , Mohammed Hussein , Nyangau Edna , Hellerstein Marc
Published: October 2021

Objective:

We measured the turnover rates of the LDLR (low-density lipoprotein receptor) and PCSK9 (proprotein convertase subtilisin/kexin type 9) in mice by metabolic labeling with heavy water and mass spectrometry.

Approach and Results:

In liver of mice fed high-cholesterol diets, LDLR mRNA levels and synthesis rates were markedly lower with complete suppression of cholesterol synthesis and higher cholesterol content, consistent with the Brown-Goldstein model of tissue cholesterol homeostasis. We observed markedly lower PCSK9 mRNA levels and synthesis rates in liver and lower concentrations and synthesis rates in plasma. Hepatic LDLR half-life (t½) was prolonged, consistent with an effect of reduced PCSK9, and resulted in no reduction in hepatic LDLR content despite reduced mRNA levels and LDLR synthesis rates. These changes in PCSK9 synthesis complement and expand the well-established model of tissue cholesterol homeostasis in mouse liver, in that reduced synthesis and levels of PCSK9 counterbalance lower LDLR synthesis by promoting less LDLR catabolism, thereby maintaining uptake of LDL cholesterol into liver despite high intracellular cholesterol concentrations.

Conclusions:

Lower hepatic synthesis and secretion of PCSK9, an SREBP2 (sterol response element binding protein) target gene, results in longer hepatic LDLR t½ in response to cholesterol feeding in mice in the face of high intracellular cholesterol content. PCSK9 modulation opposes the canonical lowering of LDLR mRNA and synthesis by cholesterol surplus and preserves LDLR levels. The physiological and therapeutic implications of these opposing control mechanisms over liver LDLR are of interest and may reflect subservience of hepatic cholesterol homeostasis to whole body cholesterol needs.
Myocardial Infarction Is Associated With Increased Stroke Severity, In‐Hospital Mortality, and Complications: Insights From China Stroke Center Alliance Registries
Authors: Duan Hongzhou , Li Zixiao , Gu Hong‐Qiu , Zhou Qi , Tong Xu , Ma Gaoting , Wang Bo , Jia Baixue , Wang Yilong , Miao Zhongrong , Wang Yongjun , Mo Dapeng
Published: October 2021

Background

Prior studies have shown an increased risk of ischemic stroke (IS) after myocardial infarction (MI); however, there are limited studies concerning the characteristics, in‐hospital mortality, and complications of patients with IS with a medical history of MI. We hypothesized that patients with IS with a medical history of MI may experience more severe strokes and have a higher risk of in‐hospital mortality and complications than patients with IS without a medical history of MI.

Methods and Results

Consecutive in‐hospital data were extracted from the China Stroke Center Alliance database from August 2015 to July 2019. Patient characteristics, hospital tests, in‐hospital mortality, and complications were analyzed and compared in patients with IS with or without a history of MI. Of 893 429 patients with IS, we identified 81 646 (9.1%) patients with a history of MI (MI group). Compared with patients with IS without MI, MI group patients were older, had a lower prevalence of current smoking, had a higher prevalence of a relative medical history, and took more medications before admission. Compared with the group with IS without MI, the MI group had a higher National Institute of Health Stroke Scale score after onset (4.0 versus 3.0; Hodges‐Lehmann estimator, 22.5) and a higher proportion of severe strokes (National Institute of Health Stroke Scale score ≥15) (7.1% versus 4.4%; absolute standardized difference=11.6%). In the fully adjusted models, the risk of in‐hospital mortality was higher in the MI group (odds ratio [OR], 1.74; 95% CI, 1.57–1.92;
P
<0.0001). MI group patients also had a higher risk of complications, including urinary tract infection (OR, 1.28; 95% CI, 1.2–1.36;
P
<0.0001), gastrointestinal bleeding (OR, 1.29; 95% CI, 1.19–1.39;
P
<0.0001), pneumonia (OR, 1.24; 95% CI, 1.21–1.28;
P
<0.0001), depression (OR, 1.33; 95% CI, 1.24–1.42;
P
<0.0001), seizure (OR, 1.35; 95% CI, 1.22–1.49;
P
<0.0001), atrial fibrillation (OR, 1.78; 95% CI, 1.71–1.86;
P
<0.0001), and cardiac or respiratory arrest (OR, 1.98; 95% CI, 1.78–2.2;
P
<0.0001).

Conclusions

Patients with IS with a medical history of MI have an increased risk of severe stroke, in‐hospital mortality, and complications. Studies exploring the underlying mechanisms are needed to improve and tailor stroke treatment strategies.
Naive Experience, Religious Root Unity, and Human Identity
Authors: Skillen James W.
Published: October 2021

Resolving Dooyeweerd’s temporal/supratemporal dialectic opens the way to a deeper appreciation of naive experience and human identity as the image of God. This essay makes a case for that proposition, building on my critique of Dooyeweerd’s idea of cosmic time published previously in this journal. There I hypothesized that time—temporality—should be recognized as the first modal aspect rather than as a transaspectual common denominator of the other aspects. The religious root unity of the human community is not a supratemporal, spiritual concentration point but rather humans themselves in their generations answering to God in all that they are and do. Humans are not temporal bodies directed by imperishable souls but whole persons-in-community, subject to all the modal laws and norms (including the temporal), living by faith in the true God or in false gods throughout this age, which opens to creation’s fulfillment in the age to come.
Knowledge and the Fall in American Neo-Calvinism: Toward a Van Til–Plantinga Synthesis
Authors: Békefi Bálint
Published: October 2021

Cornelius Van Til and Alvin Plantinga represent two strands of American Protestant philosophical thought influenced by Dutch neo-Calvinism. This paper compares and synthetizes their models of knowledge in non-Christians given the noetic effects of sin and non-Christian worldview commitments. The paper argues that Van Til’s distinction between the partial realization of the antithesis in practice and its absolute nature in principle correlates with Plantinga’s insistence on prima facie–warranted common-sense beliefs and their ultimate defeasibility given certain metaphysical commitments. Van Til endorsed more radical claims than Plantinga on epistemic defeat in non-Christian worldviews, the status of the sensus divinitatis, and conceptual accuracy in knowledge of the world. Finally, an approach to the use of evidence in apologetics is developed based on the proposed synthesis. This approach seeks to make more room for evidence than is generally recognized in Van Tilianism, while remaining consistent with the founder’s principles.
Using Excavated Slips to Look at Effective Governance of the Northern Frontier during the Han Dynasty—The Lelang Commandery in Han Slips
Authors: Zhang (張德芳) Defang
Published: October 2021

By analyzing “The Record of the Increase and Decrease in the Number of Households in Lelang Commandery by County in Year Four of Chuyuan” 樂浪郡初元四年縣别户口多少[集] 簿 from Han tomb #364, located in Jeongbaekdong 정백동 (貞柏洞), Pyeongyang, this paper shows how population and territory were fundamental to the exercise of power. Complete population figures for Lelang Commandery 樂浪郡 are evidence of the existence of a governing mechanism of commanderies and counties in this region during the Western Han. Furthermore, an assortment of excavated seals in the area are symbols of different levels of official authority. The discovery of impressions on clay from seals of government officials from commandery level to county level, essentially covering every county in Lelang Commandery, indicates the effectiveness of various administrative bodies and officials of all levels in exercising their functions and powers. Wooden slips that refer to Lelang, which were excavated in the Juyan 居延 area, show that Lelang commandery and all other border commanderies were effectively governed during the Western Han down through Wang Mang to the Eastern Han.
Leplat, J., François, A. & Bousta, F. (2021) Simplicillium pech-merlensis, a new fungal species isolated of the Pech-Merle show cave. Phytotaxa 521 (2): 80–94.
Authors: LEPLAT JOHANN , FRANCOIS ALEXANDRE , BOUSTA FAISL
Published: October 2021

N/A
A striking sexually dimorphic new species of Castolus (Hemiptera: Heteroptera: Reduviidae) from Colombia, with new records from Neotropical countries and taxonomic notes on the genus
Authors: FORERO DIMITRI , MEJÍA-SOTO ANDRÉS
Published: October 2021

The New World genus Castolus Stål, 1858 (Hemiptera: Heteroptera: Reduviidae) contains 16 described species. Based on material from northern Colombia we describe Castolus rafaeli sp. nov., and key all known species. The following new synonyms are proposed: Castolus nigriventris Breddin, 1904 = C. bicolor Maldonado, 1976, syn. nov.; and C. subinermis (Stål, 1862) = C. annulatus Maldonado & Brailovsky, 1992, syn. nov. = Mucrolicter alienus Elkins, 1962, syn. nov. Because M. alienus is the type species of the currently monotypic genus Mucrolicter Elkins, 1962, the proposed synonymy results in the following generic synonym: Castolus Stål, 1858 = Mucrolicter Elkins, 1962, syn. nov. New country records are provided for two species: Castolus plagiaticollis Stål, 1858 is recorded new for Colombia; and Castolus rufomarginatus Champion, 1899 for Costa Rica, Colombia, and Ecuador. Additional localities are provided for species from Colombia and other Neotropical countries based on both specimens from entomological collections and observations from the citizen science initiative iNaturalist.
On the type species of the genus Dendarus Dejean, 1821 (Coleoptera: Tenebrionidae)
Authors: KAMIŃSKI MARCIN JAN , BOUCHARD PATRICE , LEO PIERO , IWAN DARIUSZ
Published: October 2021

Based on type specimen investigation, the status of Helops tristis Rossi, 1790 as the type species of the genus Dendarus Dejean, 1821 is confirmed. Lectotypes are designated for Helops tristis and Pandarus coarcticollis Mulsant, 1854 – both are classified in Dendarus. Pandarus libanicus Desbrochers des Loges, 1881 is recognised as a junior synonym of Dendarus calcaratus Baudi di Selve, 1881. Both taxa share the same locus typicus (Mount Lebanon in Lebanon) and are morphologically distinct from the Italian Dendarus lugens (Mulsant & Rey, 1854). Finally, D. lugens is considered as a synonym of D. (Dendarus) coarcticollis.
Two new species of the genus Rhicnogryllus Chopard, 1925 from Hainan, China (Orthoptera: Trigonidiidae: Trigonidiinae)
Authors: LIU YI-JIAO , HE ZHU-QING
Published: October 2021

Rhicnogryllus Chopard, 1925 currently comprises 13 extant species from Asia, Africa, South America and the Pacific. We describe two new species, R. xuandan He sp. nov. and R. fallax He sp. nov., from Hainan Island, China. The type specimens are deposited in Museum of Biology, East China Normal University (ECNU).
Investigation of Machine Learning Using Satellite-Based Advanced Dvorak Technique Analysis Parameters to Estimate Tropical Cyclone Intensity
Authors: Olander Timothy , Wimmers Anthony , Velden Christopher , Kossin James P.
Published: October 2021

Several simple and computationally inexpensive machine learning models are explored that can use advanced Dvorak technique (ADT)-retrieved features of tropical cyclones (TCs) from satellite imagery to provide improved maximum sustained surface wind speed (MSW) estimates. ADT (version 9.0) TC analysis parameters and operational TC forecast center best track datasets from 2005 to 2016 are used to train and validate the various models over all TC basins globally and select the best among them. Two independent test sets of TC cases from 2017 to 2018 are used to evaluate the intensity estimates produced by the final selected model called the “artificial intelligence (AI)” enhanced advanced Dvorak technique (AiDT). The 2017–18 MSW results demonstrate a global RMSE of 7.7 and 8.2 kt (1 kt ≈ 0.51 m s−1), respectively. Basin-specific MSW RMSEs of 8.4, 6.8, 7.3, 8.0, and 7.5 kt were obtained with the 2017 dataset in the North Atlantic, east/central Pacific, northwest Pacific, South Pacific/south Indian, and north Indian Ocean basins, respectively, with MSW RMSE values of 8.9, 6.7, 7.1, 10.4, and 7.7 obtained with the 2018 dataset. These represent a 30% and 23% improvement over the corresponding ADT RMSE for the 2017–18 datasets, respectively, with the AiDT error reduction significant to 99% in both sets. The AiDT model represents a notable improvement over the ADT performance and also compares favorably to more computationally expensive and complex machine learning models that interrogate satellite images directly while still preserving the operational familiarity of the ADT.
Context Matters: Stress for Minority Students Who Attend Minority-Majority Universities
Authors: Huynh Ho Phi , Sifuentes Katherine A. , Lilley Malin K.
Published: October 2021

Research on college student stress has typically focused on institutions where the student population is predominately White and continuing-generation. This study explored student stress in a unique context—a public regional university where the majority of students are Latinx, first-generation (FGCS), and of low socioeconomic status (SES). Of the 355 participants in the study, 72.4% self-identified as Latinx and 59.7% were FGCS. Additionally, on a subjective scale of socioeconomic status (1 = lowest, 10 = highest), the mean response was 5.76 ( SD = 1.56). Participants (18 years old or older) who were enrolled in a first-year seminar course were recruited for this study. Through an online survey during Fall 2018, first-year students reported levels of perceived and experienced stress related to academic, economic, intrapersonal, and interpersonal concerns. Results of regression analyses indicated that most types of stress were predicted by students’ Latinx identity status and SES; FGCS status did not significantly predict stress. These findings highlight the need to explore solutions to address stress for Latinx and/or low SES students. Additionally, the study underscores the necessity of conducting research at educational institutions in which Latinx, FGC, and low SES students comprise the majority of the student body.
The Roads not Taken: Greater Emphasis Needed on “Sounds”, “Actual Listening”, and “Spoken Input”
Authors: Tsang Art
Published: October 2021

Many scholars and teachers in EFL education should agree that compared with reading and writing, listening has received much less attention. This brief article discusses important gaps existing in EFL listening and overall proficiency development. It presents the case for a greater focus on sounds and actual listening in the classroom and spoken input (SI) beyond the classroom. To facilitate the discussion, two modalities of listening, namely learning to listen and listening to learn are introduced. It is hoped that by shedding light on these substantive issues, EFL stakeholders will work towards fine-tuning listening pedagogical practices and facilitating learners' reception of more SI beyond the classroom, both of which will highly likely improve learners' listening skills, enhance their overall English proficiency, and lead to more positive EFL learning experiences.
Digital Asian Shakespeare Festival, 11th World Shakespeare Congress, Singapore, 18–24 July 2021
Authors: Olive Sarah
Published: October 2021

The 2021 Digital Asian Shakespeare Festival nested within the 11th World Shakespeare Congress in Singapore, ‘where communities of Shakespeare scholars, teachers and practitioners in over 40 countries’ gathered online. Lee Hyon-u, the Festival Director, arranged an astonishing array of Asian performances. Lee wrote of the festival as offering ‘rare opportunities for delegates to enjoy the diversity and depth of Asian Shakespeare while breaking through the barrier of the Covid pandemic’. This article argues that recent Asian Shakespeare productions included in the festival offer inspiration for those staging Shakespeare worldwide as the arts attempt to recover from the pandemic.
Introduction to the special issue: Rhetorical approaches to contemporary political studies
Authors: Hatzisavvidou Sophia , Martin James
Published: October 2021

This article introduces the special issue on Rhetorical Approaches to Contemporary Political Studies. It underscores the importance of innovations in political speech as a key to the continuing attraction of scholars to rhetorical methods. This is particularly relevant at a moment of crisis and disruption in established democracies when the parameters of acceptable discourse have been brought into question by forms of ‘post-truth’ politics. Although controversial, such efforts affirm the value of rhetorical analysis as a mode of political enquiry. The article then sketches the arguments of the contributions to the issue.
Reading is a multidimensional construct at child-L2-English-literacy onset, but comprises fewer dimensions over time: Evidence from multidimensional IRT analysis
Authors: Min Shangchao , Bishop Kyoungwon , Gary Cook Howard
Published: October 2021

This study explored the interplay between content knowledge and reading ability in a large-scale multistage adaptive English for academic purposes (EAP) reading assessment at a range of ability levels across 1–12 graders. The datasets for this study were item-level responses to the reading tests of ACCESS for ELLs Online 2.0. A sample of 10,000 test takers were each time randomly drawn from the test-taking population at five grade clusters without manipulation on proficiency levels, and then with manipulation on proficiency levels. The results indicated that although the bi-factor multidimensional item response theory (MIRT) model fit the data significantly better than the unidimensional two-parameter logistic (2PL) model for Grade 1, no clear evidence can be found regarding the dimensionality of the test for Grades 2–12. However, content knowledge was consistently found to contribute substantially to test performance for low-ability-level test takers across all grade clusters. The findings indicate that EAP reading ability is a multidimensional construct in the onset of EAP reading ability development, but the presence of multidimensionality decreases as proficiency level and grade level increase. This study provides insights into the developmental pattern of the interplay between language and content in EAP reading contexts.
Modelling differential geomorphic effectiveness in neighbouring upland catchments: implications for sediment and flood risk management in a wetter world
Authors: Milan David J
Published: October 2021

In July 2007 an intense summer storm resulted in significant activation of the sediment system in the Thinhope Burn, UK. Catchment- and reach-scale morphodynamic modelling is used to investigate the geomorphic work undertaken by Thinhope Burn; comparing this with the more subdued responses shown by its neighbours. Total sediment efflux for Thinhope Burn over the 10 yr period 1998-2007 was 18, 801 m3 four times that of the larger Knar Burn catchment and fifty-four times that of the smaller Glendue Burn catchment. For a discharge of 60 m3s-1, equivalent to the July 2007 Thinhope flood, sediment efflux was 575 m3, 76 m3, and 67 m3 for Thinhope, Glendue and Knar Burns respectively. It is clear that Thinhope Burn undertook significantly more geomorphic work compared to its neighbours. Analysis of the population of shear stress for reach-scale simulations on Thinhope Burn highlighted that the final three simulations (flood peaks of 60, 90, 236 m3s-1) all produced very similar distributions, with no marked increase in the modal shear stress (∼250 Nm-2). This possibly suggests that flows >60 m3s-1 are not able to exert significantly greater energy on the channel boundary, indicating that flows in the region of 60 m3s-1 attain ‘peak’ geomorphic work. It is argued that factors such as strength resistance of the key sediment sources (e.g. paleoberms perched on terraces), structural resistance to flood waves imposed by valley form resistance, location sensitivity and transmission resistance, may all offer explanations for increased geomorphic effectiveness compared with its neighbours. With the expectation of greater rainfall totals in the winter and more extreme summer events in upland areas of the UK, it is clear that attention needs to focus upon the implications of this upon the morphological stability of these areas not least to aid future sustainable flood risk management.
Clinical outcomes of severe COVID-19 patients receiving early VV-ECMO and the impact of pre-ECMO ventilator use
Authors: Kunavarapu Chandra , Yeramaneni Samrat , Melo Jairo , Sterling Rachel K , Huskey Lindsey C , Sears Lindsay , Burch Charles , Rodriguez Steve M , Habib Phillip J , Triana Fernando , DellaVolpe Jeffrey
Published: October 2021

Acute respiratory distress syndrome (ARDS) in COVID-19 patients is associated with poor clinical outcomes and high mortality rates, despite the use of mechanical ventilation. Veno-Venous Extracorporeal membrane Oxygenation (VV-ECMO) in these patients is a viable salvage therapy. We describe clinical outcomes and survival rates in 52 COVID-19 patients with ARDS treated with early VV-ECMO at a large, high-volume center ECMO program. Outcomes included arterial blood gases, respiratory parameters, inflammatory markers, adverse events, and survival rates. Patients’ mean age was 47.8 ± 12.1 years, 33% were female, and 75% were Hispanic. At the end of study period, 56% ( n = 29) of the patients survived and were discharged and 44% ( n = 23) of the patients expired. Survival rate was 75.0% (9 out of 12) in patients placed on ECMO prior to mechanical ventilation. Longer duration on mechanical ventilation prior to ECMO intervention was associated with a 31% (aOR = 1.31, 95% CI, 1.00–1.70) increased odds of mortality after adjusting for age, gender, BMI, number of comorbid conditions, and post-ECMO ventilator days. Early and effective ECMO intervention in critical ill COVID-19 patients might be a valuable strategy in critical care settings to increase their odds of survival.
Outcome management of Fournier’s gangrene cases at tertiary hospital: 7 Years experience
Authors: Wirjopranoto Soetojo , Azmi Yufi Aulia
Published: October 2021

Objective:

This study aims to describe the condition of Fournier’s gangrene in Dr. Soetomo General Hospital from January 2014 to December 2020.

Material and methods:

This study used a retrospective analytic design, by taking data through medical records at Dr. Soetomo General Hospital from January 2014 to December 2020. This study used total sampling with recorded data: age, gender, length of stay, outcome, location, comorbidities, causes, management, culture results, and Fournier’s gangrene severity index (FGSI) score.

Result:

Of the 135 subjects collected, it was found that 55.56% were individuals over 50 years of age. About 91.11% were male patients, with some sites being in the scrotum 50.37%. Only 25.19% of patients had no comorbids, while the rest had a history of CKD, hypertension, diabetes, or a combination of these diseases. Bacterial cultures obtained were mostly caused by the Enterobacteriaceae bacteria group (32.59%). Of the subjects we studied who experienced mortality, it was found that all were from the group with FGSI >9.

Conclusion:

From the results of our descriptive study, at a glance, it appears that there is a tendency for the incidence of Fournier’s gangrene in the elderly and individuals with comorbidities. And the mortality rate increases with a high FGSI value. So that FGSI could be used as a predictor of mortality in patients with FG.
HCBS Service Spending and Nursing Home Placement for Patients With Alzheimer’s Disease and Related Dementias: Does Race Matter?
Authors: Yan Di , Wang Sijiu , Temkin-Greener Helena , Cai Shubing
Published: October 2021

Objectives: We examined the extent to which home and community-based services (HCBS) spending affected the likelihood of nursing home (NH) placement among black and white HCBS users with Alzheimer’s disease and related dementias (ADRD). Methods: The study population included new HCBS users with ADRD between 2010 and 2013 ( N = 1,046,200). Results: We found that a one hundred dollar increase in monthly HCBS spending was associated with a 0.3 percentage points decrease in the NH placement rate among Whites, but a 0.3 percentage points increase in the NH placement rate among Blacks. The overall NH placement rate was 68.2% and 56.7% for Whites and Blacks, respectively. Discussion: A higher HCBS spending was associated with a decreased likelihood of NH placements for Whites but not for Blacks. It is important to understand how states’ HCBS expansion efforts influence Blacks and Whites with ADRD so that resources can be tailored to communities with different race-mix.
Sociodemographic and Geographic Factors Associated With Non-Obstetrical Ultrasound Imaging Utilization: A Population-Based Study
Authors: Adams Scott J. , Yao Shenzhen , Mondal Prosanta , Lim Hyun , Mendez Ivar , Babyn Paul
Published: October 2021

Objective:

Ultrasound is one of the most commonly used imaging modalities, though some populations face barriers in accessing ultrasound services, potentially resulting in disparities in utilization. The objective of this study was to assess the association between sociodemographic and geographic factors and non-obstetrical ultrasound utilization in the province of Saskatchewan, Canada.

Methods:

All non-obstetrical ultrasound exams performed from 2014 to 2018 in Saskatchewan, Canada were retrospectively identified from province-wide databases. Univariate and multivariate Poisson regression analyses were performed to assess the association between ultrasound utilization and sex, age, First Nations status, Charlson Comorbidity Index, urban vs. rural residence, geographic remoteness, and neighborhood income.

Results:

A total of 1,324,846 individuals (5,857,044 person-years) were included in the analysis. Female sex (adjusted incidence rate ratio [aIRR], 2.20; 95% confidence interval [CI], 2.19-2.22), age (aIRR, 4.97; 95% CI, 4.90-5.05 for ≥57 years vs. <11 years), comorbidities (aIRR, 4.36 for Charlson Comorbidity Index >10 vs. 0; 95% CI, 3.78-5.03), and higher neighborhood income (aIRR, 1.04; 95% CI, 1.02-1.05 for highest vs. lowest quintile) were associated with higher rates of ultrasound utilization. Individuals who were status First Nations (aIRR, 0.91; 95% CI, 0.90-0.92) or resided in geographically remote areas (aIRR, 0.87 for most vs. least remote; 95% CI, 0.83-0.91) had lower rates of ultrasound utilization. Individuals who lived in a rural area also had lower rates of ultrasound utilization (aIRR, 0.93; 95% CI, 0.92-0.94).

Conclusion:

Substantial disparities exist in non-obstetrical ultrasound utilization among individuals in low-income neighborhoods, status First Nations individuals, and individuals in rural and remote communities.
Cutting force, Vibration, and Temperature in Drilling on a Thermoplastic Material of PEEK
Authors: Chang Dar-Yuan , Lin Chien-Hung , Wu Xing-Yao , Yang Chun-Chun , Chou Shan-Chao
Published: October 2021

Polyetheretherketone (PEEK) is one of the semi-crystalline thermoplastic polymers with excellent machinability and chemical stability applied to precise structural plates and electronic components. This study installed multiple sensors to analyze the machining characteristics in the PEEK drilling. According to the time domain signals, the effects of spindle speed and feed rate on the machining characteristics of cutting force and vibration were investigated. In addition, an infrared thermography was installed to record the temperature variation within the drilling area. The experimental hole was 2-mm diameter with a 4.5-mm depth. Experimental results showed that the effect of the feed rate on thrust force is greater than the spindle speed; drilling by a low-level spindle speed with a low-level feed rate can obtain the smallest cutting force and acceleration amplitude in the spindle axis; the temperature within the drilling area is inverse to the feed rate and a high-level feed rate is helpful for forming regular curl chips. When adequate airflow was applied during the drilling operation, the hole’s shrinkage ratio and roundness can be decreased. The data presented in this paper provide valuable references for realizing the drilling of the thermoplastic—PEEK.
Evaluations of the sum-score-based and item response theory-based tests of group mean differences under various simulation conditions
Authors: Wang Mian , Reeve Bryce B.
Published: October 2021

The use of patient-reported outcomes measures is gaining popularity in clinical trials for comparing patient groups. Such comparisons typically focus on the differences in group means and are carried out using either a traditional sum-score-based approach or item response theory (IRT)-based approaches. Several simulation studies have evaluated different group mean comparison approaches in the past, but the performance of these approaches remained unknown under certain uninvestigated conditions (e.g. under the impact of differential item functioning (DIF)). By incorporating some of the uninvestigated simulation features, the current study examines Type I error, statistical power, and effect size estimation accuracy associated with group mean comparisons using simple sum scores, IRT model likelihood ratio tests, and IRT expected-a-posteriori scores. Manipulated features include sample size per group, number of items, number of response categories, strength of discrimination parameters, location of thresholds, impact of DIF, and presence of missing data. Results are summarized and visualized using decision trees.
Peter Richard Barton BDS MBBS MA MDS FDSRCS MRCS LRCP (1921–2010) oral and maxillofacial surgeon and artist
Authors: Gelbier Stanley
Published: October 2021

Peter Barton enjoyed a rare achievement: distinction in science and the arts. He was an oral and maxillofacial surgeon, a painter, musician and philosopher, with a sharp intellect and questioning mind. A true polymath.
The Profitability of Volatility Trading on Exchange-traded Dollar-rupee Options: Evidence of a Volatility Risk Premium?
Authors: Bhat Aparna
Published: October 2021

This article examines the profitability of short volatility strategies in the exchange-traded USDINR options market. Returns from delta-hedged short positions in straddles, strangles and individual call and put options are examined across different trading horizons and volatility regimes. The study finds that short volatility strategies yield significant mean and median returns regardless of the trading horizon and option moneyness before considering transaction costs. This is suggestive of a volatility risk premium priced in USDINR options. However, the returns are found to be insignificant and even negative after accounting for trading costs such as bid-ask spreads and brokerage. The study concludes that although USDINR options appear to be overpriced because of the volatility risk premium, short option strategies can be profitably exploited only by market makers and institutional investors facing low spreads and funding costs. The findings are suggestive of an informationally efficient market.
Assessment of Progressive Collapsing Foot Deformity Using Semiautomated 3D Measurements Derived From Weightbearing CT Scans
Authors: Krähenbühl Nicola , Kvarda Peter , Susdorf Roman , Burssens Arne , Ruiz Roxa , Barg Alexej , Hintermann Beat
Published: October 2021

Background:

In progressive collapsing foot deformity (PCFD), hind- and midfoot deformities can be hard to characterize based on weightbearing plain radiography. Semiautomated 3-dimensional (3D) measurements derived from weightbearing computed tomography (WBCT) scans may provide a more accurate deformity assessment. In the present study, automated 3D measurements based on WBCT were used to compare hindfoot alignment of healthy individuals to patients with PCFD.

Methods:

The WBCT scans of 20 patients treated at our institution with either a flexible (N = 10) or rigid (N = 10) PCFD were compared with the WBCT scans of a control group of 30 healthy individuals. Using semiautomated image analysis software, from each set of 3D voxel images, we measured the talar tilt (TT), hindfoot moment arm (HMA), talocalcaneal angle (TCA; axial/lateral), talonavicular coverage (TNC), and talocalcaneal overlap (TCO). The presence of medial facet subluxation as well as sinus tarsi/subfibular impingement was additionally assessed.

Results:

With the exception of the TCA (axial/lateral), the analyzed measurements differed between healthy individuals and patients with PCFD. The TCA axial correlated with the TNC in patients with PCFD. An increased TCO combined with sinus tarsi impingement raised the probability of predicting a deformity as rigid.

Conclusion:

Using 3D measurements, in this relatively small cohort of patients, we identified relevant variables associated with a clinical presentation of flexible or rigid PCFD. An increased TCO combined with sinus tarsi impingement raised the probability of predicting a deformity as rigid. Such WBCT-based markers possibly can help the surgeon in decision-making regarding the appropriate surgical strategy (eg, osteotomies vs realignment arthrodesis). However, prospective studies are necessary to confirm the utility of the proposed parameters in the treatment of PCFD.

Level of Evidence:

Level III, case-control study.
Fecal CEA Has an Advantage in the Diagnosis of Colorectal Cancer at Early Stage
Authors: Li Linfang , Xing Shan , Wu Miantao , Ao Yufeng , Zheng Xin , Cai Rongzeng , Han Runkun , Li Jingcong , Li Xiaohui , Zeng Qiuyao
Published: October 2021

Purpose

Serum carcinoembryonic antigen (SCEA) level is often measured in patients with CRC but suffers from poor sensitivity and specificity as a diagnostic biomarker. CEA is more abundant in stool than in serum, but it has not been widely studied. This study aimed to elucidate the efficacy of fecal CEA (FCEA) as a potential non-invasive biomarker for early diagnosis of CRC.

Materials and Methods

We retrospectively analyzed the determination of FCEA and SCEA levels by electrochemiluminescence. We evaluated the diagnostic accuracy of FCEA and SCEA levels in early-stage CRC patients and healthy controls using ROC curve.

Results

A total of 298 people were included: 115 patients with CRC, 35 patients with adenomatous polyp (APC), 46 patients with non-gastrointestinal cancer (NGC), and 102 healthy controls (HC). The FCEA concentrations in CRC and APC patients were significantly higher than that of NGC and HC, and this is different from SCEA expression in APC and NGC. As a diagnostic biomarker of CRC, FCEA had significantly larger AUC compared with SCEA (.802 vs .735, P  < .001). For identifying early-stage colorectal cancer, FCEA showed better diagnostic efficacy (AUC: .831) than SCEA (AUC: .750), and the combination of the 2 biomarkers was even higher (AUC: .896). The sensitivity of FCEA was higher than that of SCEA (78.7% vs 29.8%). When SCEA was negative, 80.3% of CRC and 54.6% of APC cases could be identified by FCEA.

Conclusion

Compared with SCEA, FCEA has more advantages in the diagnosis of the early stage of colorectal cancer and adenomatous polyps.
Reimaging Public-Private Partnership Model as Hybrid: South Africa Viewpoint
Authors: Sinkala Alinaswe , Ochieng Edward , Ominde Diana , Zuofa Tarila , Badi Sulafa
Published: October 2021

As significant increases in the financing of infrastructure and other resources will still be required to bridge the current infrastructure gap experienced globally, alternatives to the standard PPP infrastructure project delivery models are constantly appraised in several nations. This research examined the viability of reframing Public Private Partnership (PPP) frameworks as hybrid PPP alliances (HPPPA), which would enhance current PPP practices and enable practitioners in South Africa to deliver PPP infrastructure projects more efficiently. The research adopted a two-pronged qualitative data collection approach, utilizing semi-structured interviews as well as case studies to obtain empirical evidence that was compared to secondary data on how PPP practices in South Africa can be enhanced. The research established that while the South African PPP legislations was adjudged as being suitable, the delivery framework was found to be highly costly and comprised of long approval processes.
Psychosocial indicators of primary congenital glaucoma and filtering surgeries impacts on children and family’s quality of life
Authors: Silva Andrea Oliveira da , Rolim-de-Moura Christiane , Botelho Nara Lúcia Poli , Gracitelli Carolina PB , Ferraz Nívea Nunes
Published: October 2021

Purpose:

To identify psychosocial indicators and evaluate the filtering surgeries impacts on quality of life (QOL) of children with primary congenital glaucoma (PCG) and their family.

Methods:

Parents of children with bilateral PCG who underwent filtering surgery were included. Data were collected through: (a) psychological inquiry to determine psychosocial indicators; (b) Children’s Visual Function Questionnaire (CVFQ). The associations between the CVFQ scores and visual acuity, intraocular pressure, optic disk cupping, horizontal corneal diameter, axial length, number of surgeries, and hypotensive eye drops were investigated. The statistical significance level was considered as p ⩽ 0.05.

Results:

The mean age of the nine mothers interviewed and their children (six boys and three girls) was 29 ± 5 years and 35 ± 18 months, respectively. The psychosocial indicators determined were: emotional impact of the diagnosis, disease knowledge, mother and family’s feelings on facing the surgical treatment, surgical result comprehension, treatment adherence, child's emotional and behavioral reactions, social support, and future expectations. In CVFQ analysis, QOL score was strongly associated with visual acuity ( r = −0.79; p = 0.01). Besides the treatment score was correlated to intraocular pressure ( r = −0.68; p < 0.05), optic disk cupping ( r = −0.85; p = 0.03), and corneal diameter ( r = −0.69; p = 0.02). Correlations were not found for number of surgeries and eye drops.

Conclusions:

This study confirmed the PCG surgical treatment impact on QOL and determined psychosocial indicators which may favor the suitable actions in psychological treatment and follow-up of the children and families.
Should we care about the ocular surface in the anophthalmic patient?
Authors: Volpe Giulio , De Piano Maria , Mazzone Giacomilde , Micera Alessandra , Bonini Stefano , Modugno Alessandra Claudia
Published: October 2021

Purpose:

To assess clinical and biomolecular changes of the conjunctival epithelium in anophthalmic patients wearing an ocular prosthesis.

Methods:

Thirty-five unilateral anophthalmic patients were enrolled. Patients with blepharitis, lid abnormalities, and topical/systemic medication affecting the ocular surface were excluded. Symptom Assessment in Dry Eye (SANDE) questionnaire and tear function test (Schirmer Test Type I) were recorded. Conjunctival inflammation and meibomian gland dysfunction (MGD) were graded in the anophthalmic side and fellow eye. Impression cytology sampling of the upper, lower tarsal, and posterior/bulbar conjunctiva from the anophthalmic socket were collected and compared to healthy controls.

Results:

Patients had significantly higher SANDE ( p < 0.001), Schirmer I test ( p = 0.004), conjunctival inflammation ( p < 0.001), and MGD scores ( p < 0.001) on the anophthalmic side compared to the fellow eye. Mucin 5AC, inflammatory markers (MMP-9, ICAM-1) expression ( p < 0.001), and response to oxidative stress (NRF2-KEAP1 signaling pathway) ( p < 0.05) were significantly upregulated in the posterior conjunctival surface in the anophthalmic socket.

Conclusions:

Anophthalmic patients complained of more pronounced dry eye symptoms and presented more significant signs of inflammation and MGD on the anophthalmic side. The bulbar conjunctiva, behind the prosthesis, showed more significant hyperexpression of mucins, markers of inflammation, and increased response to oxidative stress compared to the tarsal conjunctiva. Patients wearing ocular prosthesis had signs of inflammation resembling dry eye disease.