bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of data-driven and physics-based gas turbine fault recognition approaches
Authors: Pérez-Ruiz Juan Luis , Loboda Igor , González-Castillo Iván , Pineda-Molina Víctor Manuel , Rendón-Cortés Karen Anaid , Miró-Zárate Luis Angel
Published: January 2021

The present paper compares the fault recognition capabilities of two gas turbine diagnostic approaches: data-driven and physics-based (a.k.a. gas path analysis, GPA). The comparison takes into consideration two differences between the approaches, the type of diagnostic space and diagnostic decision rule. To that end, two stages are proposed. In the first one, a data-driven approach with an artificial neural network (ANN) that recognizes faults in the space of measurement deviations is compared with a hybrid GPA approach that employs the same type of ANN to recognize faults in the space of estimated fault parameter. Different case studies for both anomaly detection and fault identification are proposed to evaluate the diagnostic spaces. They are formed by varying the classification, type of diagnostic analysis, and deviation noise scheme. In the second stage, the original GPA is reconstructed replacing the ANN with a tolerance-based rule to make diagnostic decisions. Here, two aspects are under analysis: the comparison of GPA classification rules and whole approaches. The results reveal that for simple classifications both spaces are equally accurate for anomaly detection and fault identification. However, for complex scenarios, the data-driven approach provides on average slightly better results for fault identification. The use of a hybrid GPA with ANN for a full classification instead of an original GPA with tolerance-based rule causes an increase of 12.49% in recognition accuracy for fault identification and up to 54.39% for anomaly detection. As for the whole approach comparison, the application of a data-driven approach instead of the original GPA can lead to an improvement of 12.14% and 53.26% in recognition accuracy for fault identification and anomaly detection, respectively.
Construction and analysis for dys-regulated lncRNAs and mRNAs in LPS-induced porcine PBMCs
Authors: Zhang Jing , Xu Xin , Chen Hongbo , Kang Ping , Zhu Huiling , Ren Hongyan , Liu Yulan
Published: January 2021

Long non-coding RNAs (lncRNAs) are emerging as key regulators in inflammation. However, their functions and profiles in LPS-induced inflammation in pigs are largely unknown. In this study, we profiled global lncRNA and mRNA expression changes in PBMCs treated with LPS using the lncRNA-seq technique. In total 43 differentially expressed (DE) lncRNAs and 1082 DE mRNAs were identified in porcine PBMCs after LPS stimulation. Functional enrichment analysis on DE mRNAs indicated these genes were involved in inflammation-related signaling pathways, including cytokine–cytokine receptor interaction, TNF-α, NF-κB, Jak-STAT and TLR signaling pathways. In addition, co-expression network and function analysis identified the potential lncRNAs related to inflammatory response and immune response. The expressions of eight lncRNAs (ENSSSCT00000045208, ENSSSCT00000051636, ENSSSCT00000049770, ENSSSCT00000050966, ENSSSCT00000047491, ENSSSCT00000049750, ENSSSCT00000054262 and ENSSSCT00000044651) were validated in the LPS-treated PBMCs by quantitative real-time PCR (qRT-PCR). In LPS-challenged piglets, we identified that expression of three lncRNAs (ENSSSCT00000051636, ENSSSCT00000049770, and ENSSSCT00000047491) was significantly up-regulated in liver, spleen and jejunum tissues after LPS challenge, which indicated that these lncRNAs might be important regulators for inflammation. This study provides the first lncRNA and mRNA transcriptomic landscape of LPS-mediated changes in porcine PBMCs, which might provide potential insights into lncRNAs involved in regulating inflammation in pigs.
Food autonomy: decolonial perspectives for Indigenous health and buen vivir
Authors: Calderón Farfán Juan Camilo , Dussán Chaux Juan David , Arias Torres Dolly
Published: January 2021

Introduction:

Indigenous peoples’ food systems have weakened as a result of pressures exerted by agro-commercial policies and chains, which has led to the dependency and deterioration of their ways of life. It is in this context that the construction of perspectives on food autonomy positions itself as a potential and strategic field of social decolonial mobilization for indigenous peoples’ health and buen vivir.

Objective:

The aim of this study was to analyze the meanings of food autonomy from the perspectives of a Nasa Indigenous community in Colombia.

Method:

This was a qualitative study, involving 38 Indigenous people belonging to the Nasa Huila Indigenous community, aged between 18 and 73, with different occupations. The information was obtained by means of discussion groups and processed through content analysis. The project had the consent and ethical endorsement of the indigenous community.

Results:

According to the study group, food autonomy is related to the Nasa identity, today weakened by territorial conditions, proximity to non-indigenous populations and the external influence of institutional food programs. Food autonomy develops by means of practices aimed at the production, distribution, preparation and consumption of healthy, chemical-free, homegrown food products from the family level, for self-consumption and in resistance to dependence on external commercial chains.

Conclusion:

Food autonomy positions itself as a community and political strategy that integrates the strengthening of family gardens, the adaptation of a food program menu, education and governance towards the development of autonomous processes from a decolonial perspective, for the promotion of health and buen vivir.
A revision of bird skin preparation aimed at improving the scientific value of ornithological collections
Authors: Carrillo-Ortiz José , Guallar Santi , Martínez-Vargas Jessica , Quesada Javier
Published: January 2021

The methods used to preserve bird skins in museums have a potentially crucial impact on the feasibility and use of these specimens as a source of biological knowledge, although this subject is rarely broached. Study skins of birds are usually prepared with folded wings and straight legs to facilitate storage in the collection; yet, this method can hamper the measurement and examination of certain important features such as wing-feather moult. To make consultation easier for ornithologists, alternative preparation methods such as the splitting of wings and tarsi from the rest of the animal have been proposed by curators. Our aim was to study whether or not preparing bird specimens with spread limbs makes consultation simpler. First, we used two different methods to prepare two specimens each of two common European passerine species: (1) ‘traditional’ (folded wings and straight tarsi) and (2) ‘spread’ (limbs spread on one side of the body). Then, we asked 22 experienced ornithologists to identify moult limits and take three biometric measurements (wing chord, length of the third primary feather and tarsus length) from all four specimens. Subsequently, we asked which preparation method they preferred for obtaining data. The ‘spread’ preparation was preferred for moult, third primary feather length and tarsus length, whilst the ‘traditional’ preparation was preferred for wing chord. Data obtained from the folded and spread preparations were very highly repeatable within each method but only moderately to highly repeatable between methods. One of the handicaps with the ‘spread’ preparation is the increase in storage space required, a factor that should be taken into account before it is employed. Nevertheless, this specimen preparation technique can greatly facilitate consultation and therefore improve the scientific value of ornithological collections.
A theoretical framework to improve the construct for chronic pain disorders using fibromyalgia as an example
Authors: Kumbhare Dinesh , Tesio Luigi
Published: January 2021

Fibromyalgia (FM) is a frequent, complex condition of chronic musculoskeletal pain with no evidence for biological correlates. For this reason, despite many efforts from the medical community, its construct still appears ill defined. Promising candidate biomarkers are critically reviewed. A research agenda is proposed for developing a clearer construct of FM. The ideal theoretical framework is one of overcoming the illness–disease dichotomy and considering reciprocal interactions between biology and behaviour. This approach may foster research in other fields of pain medicine and of medicine in general.
Effect of Dehydrothermal Treatment on the Mechanical Properties and Biocompatibility of Plaster of Paris–CaCO3 Hydrogel Loaded With Cinnamaldehyde for Biomedical Purposes
Authors: Dewi Anne Handrini , Yulianto Dedy Kusuma , Siswomihardjo Widowati , Rochmadi Rochmadi , Ana Ika Dewi
Published: January 2021

CaCO3 hydrogel incorporation into Plaster of Paris (POP) formulations decreased the resorption rate of the POP after implantation in the body. Although an inflammatory process is required as part of wound healing, the accumulation and activation of inflammatory cells in the POP–hydrogel CaCO3 implant area needs to be controlled. Therefore, cinnamaldehyde, as an anti-inflammatory agent with a unique α, β-unsaturated aldehyde, was incorporated into the CaCO3 hydrogel. During the incorporation, both the lipophilic and hydrophilic sides of the cinnamaldehyde molecule can influence the physical and mechanical properties of the CaCO3 hydrogel, in which mechanical properties of a tissue engineering scaffold are important to fine tune cellular activity during implantation. On the other hand, as a 3-dimensional polymeric structure, crosslinking is needed for the CaCO3 hydrogel to stabilize and increase its molecular weight for better mechanical strength, and more resistance to heat, wear, and solvent attack. For that purpose, dehydrothermal treatment (DHT) was applied to the crosslink hydrogel system as a favorable crosslinking method to avoid the use of a chemical agent. In this study, 3 groups of hydrogels of CaCO3, namely DHT crosslinked, loaded with cinnamaldehyde, and loaded with cinnamaldehyde followed by DHT crosslinking were developed before being combined with POP in 50 wt%. To evaluate the effect of DHT to the final POP-cinnamaldehyde-loaded CaCO3 hydrogel properties and biocompatibility, scanning electron microscopy, contact angle, surface roughness, hardness, diametral tensile strength, and in vivo biocompatibility studies were conducted. It was observed that cinnamaldehyde with DHT treatment improved the POP–hydrogel CaCO3 properties and had good biocompatibility. Thus, POP-cinnamaldehyde-loaded CaCO3 hydrogel can be a promising bone substitute containing an anti-inflammatory agent.
Changes in perceptions of media bias
Authors: Goidel Kirby , Davis Nicholas T. , Goidel Spencer
Published: January 2021

In this paper, we utilize a module from the Cooperative Congressional Election Study to explore how individual perceptions of media bias changed over the course of the 2016 presidential campaign. While previous literature has documented the role of partisan affiliation in perceptions of bias, we know considerably less about how these perceptions change during a presidential election. Consistent with existing theories of attitude change, perceptions of bias polarize with strong Democrats moving toward believing the media were biased against Hillary Clinton (and in favor of Donald Trump) and independent-leaning Republicans moving toward believing the media were biased against Donald Trump. At the end of the 2016 election, more individuals believed the media were biased against their side. These effects were moderated by how much attention individuals paid to the campaign.
The algorithm audit: Scoring the algorithms that score us
Authors: Brown Shea , Davidovic Jovana , Hasan Ali
Published: January 2021

In recent years, the ethical impact of AI has been increasingly scrutinized, with public scandals emerging over biased outcomes, lack of transparency, and the misuse of data. This has led to a growing mistrust of AI and increased calls for mandated ethical audits of algorithms. Current proposals for ethical assessment of algorithms are either too high level to be put into practice without further guidance, or they focus on very specific and technical notions of fairness or transparency that do not consider multiple stakeholders or the broader social context. In this article, we present an auditing framework to guide the ethical assessment of an algorithm. The audit instrument itself is comprised of three elements: a list of possible interests of stakeholders affected by the algorithm, an assessment of metrics that describe key ethically salient features of the algorithm, and a relevancy matrix that connects the assessed metrics to stakeholder interests. The proposed audit instrument yields an ethical evaluation of an algorithm that could be used by regulators and others interested in doing due diligence, while paying careful attention to the complex societal context within which the algorithm is deployed.
Development of alternating, ipsilateral Horner syndrome and Pourfour du Petit syndrome associated with oesophagostomy tube placement in a cat
Authors: Lee Liu Yi , Horikawa Taemi
Published: January 2021

Case summary

A 12-year-old spayed female domestic shorthair cat was presented to a referral hospital for chronic intermittent hyporexia and weight loss. An abdominal ultrasound was performed, which revealed a mid-jejunal mass and mesenteric lymphadenomegaly. Surgical resection and placement of an oesophagostomy tube (O-tube) was performed. Upon recovery the cat exhibited signs of Horner syndrome, which resolved over the span of 2 weeks. Subsequently, the cat developed signs of unilateral Pourfour du Petit syndrome in the left eye at day 20 and unilateral Horner syndrome at day 25 ipsilateral to the O-tube insertion site. The O-tube was removed 32 days postoperatively, and Horner syndrome resolved 24 h later. Follow-up examination 15 months later did not show any recurrence of ocular signs.

Relevance and novel information

To our knowledge, this represents the first report of alternating ipsilateral Horner and Pourfour du Petit syndrome in a single patient that underwent placement of an O-tube. Neurological complications after O-tube placement are uncommon, with only a single previously published report of a cat developing Horner syndrome after O-tube placement. Veterinarians should consider potential ocular and neurological complications after O-tube placement and monitor for such signs postoperatively.
Cross-Cultural Comparisons of the Cute and Related Concepts in Japan, the United States, and Israel
Authors: Nittono Hiroshi , Lieber-Milo Shiri , Dale Joshua P.
Published: January 2021

An online survey was conducted to clarify the connotative meanings of the cute and the attitudes toward cuteness in three countries: Japan ( n = 1,000), the United States ( n = 718), and Israel ( n = 437). The results show a remarkable resemblance in respondents’ conceptions of the cute ( kawaii in Japanese and hamud in Hebrew) across countries. Except for slight cultural differences, the following common tendencies were found: (a) Cuteness is highly appreciated and believed to induce positive affective responses, (b) women tend to find things cute more frequently and strongly than men do, (c) animal babies are thought to be cuter than human babies, and (d) infants are found to be cuter when people get older, while older people generally show less positive attitudes toward cuteness. This study provides some evidence that the concept of cuteness and the feelings connected to its perception are universal.
Prevalence of Goiter Among School-Aged Children in Ethiopia: Update of Systematic Review and Meta-analysis
Authors: Tekalegn Yohannes , Bekele Kebebe , Sahiledengle Biniyam , Woldeyohannes Demelash
Published: January 2021

Background

Iodine deficiency is a major public health concern throughout the world. Goiter is the most visible sign of iodine deficiency. In Ethiopia, a study finding regarding the prevalence of goiter among school-age children is inconsistent and highly variable.

Objectives

To estimate the pooled prevalence of goiter among school-age children in Ethiopia.

Methods

Three international databases (MEDLINE/Pub-Med, Google Scholar and Science Direct) were systematically searched. Besides, the reference sections of identified articles were searched to increase the chance of detecting missed articles in gray literature. STATA Version 14 statistical software was used to conduct a meta-analysis. The pooled prevalence with a 95% confidence interval was displayed using the forest plot. A random-effect meta-analysis model was used to compute the pooled prevalence, and The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies.

Results

A total of 14 studies fulfilled the inclusion criteria and included in this systematic review and Meta-analysis, with a total sample size of 26,282. The finding of this systematic review revealed that the pooled prevalence of goiter among school-age children was 42.9% (95% CI: 38.8–46.9). The highest prevalence of goiter (46.7%) was observed in Oromia region and the lowest (26.3%) was observed in Benishangul-Gumuz region.

Conclusions

This review finding revealed that more than two in five of the school children in Ethiopia suffer from iodine deficiency disorder as manifested by the goiter rate.
National Picture of the Self-Determination Characteristics of Secondary School English Learners With Disabilities
Authors: Newman Lynn A. , Garcia Elisa B. , Trainor Audrey A. , Chong Melanie
Published: January 2021

We examined the self-determination of English learners with disabilities in secondary school, based on a secondary analysis of the National Longitudinal Transition Study 2012 (NLTS 2012). Self-determination characteristics of English learners with disabilities differed significantly from those of other students with disabilities, and of English learner students and students who are not English learners in the general population, including their being less likely to act autonomously or report empowerment-related or self-realization-related behaviors. Multivariate analyses identified several student and family characteristics associated with variations in aspects of self-determination, including age, gender, and postsecondary expectations. Implications for practice and research are discussed, including the importance of considering these factors when selecting, implementing, and evaluating self-determination interventions for English learners with disabilities.
Association Between Deep Posterior Cervical Paraspinal Muscle Morphology and Clinical Features in Patients With Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Doi Toru , Ohtomo Nozomu , Oguchi Fumihiko , Tozawa Keiichiro , Nakarai Hiroyuki , Nakajima Koji , Sakamoto Ryuji , Okamoto Naoki , Nakamoto Hideki , Kato So , Taniguchi Yuki , Matsubayashi Yoshitaka , Oka Hiroyuki , Matsudaira Ko , Tanaka Sakae , Oshima Yasushi
Published: January 2021

Study Design:

A retrospective observational study.

Objective:

To clarify the association of the paraspinal muscle area and composition with clinical features in patients with cervical ossification of the posterior longitudinal ligament (OPLL).

Methods:

Consecutive patients with cervical OPLL who underwent cervical magnetic resonance imaging (MRI) before surgery were reviewed. The cross-sectional area (CSA) and fatty infiltration ratio (FI%) of deep posterior cervical paraspinal muscles (multifidus [MF] and semispinalis cervicis [SCer]) were examined. We assessed the association of paraspinal muscle measurements with the clinical characteristics and clinical outcomes, such as Neck Disability Index (NDI) score. Moreover, we divided the patients into 2 groups according to the extent of the ossified lesion (segmental and localized [OPLL-SL] and continuous and mixed [OPLL-CM] groups) and compared these variables between the 2 groups.

Results:

49 patients with cervical OPLL were enrolled in this study. The FI% of the paraspinal muscles was significantly associated with the number of vertebrae ( ρ = 0.283, p = 0.049) or maximum occupancy ratio of OPLL ( ρ = 0.397, p = 0.005). The comparative study results indicated that the NDI score was significantly worse (OPLL-SL, 22.9 ± 13.7 vs. OPLL-CM, 34.4 ± 13.7) and FI% of SCer higher (OPLL-SL, 9.1 ± 1.7% vs. OPLL-CM, 11.1 ± 3.7%) in the OPLL-CM group than those in the OPLL-SL group.

Conclusions:

Our results suggest that OPLL severity may be associated with fatty infiltration of deep posterior cervical paraspinal muscles, which could affect neck disability in patients with cervical OPLL.
Postoperative MRI Visualization of the Cervical Spine Following Cervical Disc Arthroplasty: A Prospective Single-Center Comparison of a Titanium and Cobalt-Chromium Prosthesis
Authors: Byvaltsev Vadim A. , Kalinin Andrei A. , Aliyev Marat A. , Riew K. Daniel
Published: January 2021

Study Design:

Prospective non-randomized single-center cohort study.

Objectives:

To analyze the quality of postoperative magnetic resonance imaging of 2 structurally different cervical disc arthroplasty devices at the index and adjacent levels.

Methods:

A non-randomized, comparative, prospective, single-center study included 40 patients (23 men and 17 women) aged 32 (26-40) years. Two study groups were utilized: in the first (n = 20), a titanium prosthesis was used; in the second (n = 20), a cobalt-chromium implant was used. Evaluation of MRI studies before and after surgery was performed using sagittal and axial T2 weighted images by 2 specialists who were blinded to the prosthesis that was used. To determine the quality of an MRI image, the classification of Jarvik 2000, the radiological and orthopedic scales for assessing artifacts were used.

Results:

There was good-to-excellent inter-observer agreement for all of the MR parameters used for the titanium and satisfactory-to-good for the cobalt chromium group. The analysis of the quality of postoperative imaging using the Jarvik 2000 scale showed a statistically significant deterioration in MR images in the cobalt chromium group ( P < 0.001), compared to the titanium ( P = 0.091). Following a single-level total arthroplasty, the titanium group had better MRI images according to radiological and orthopedic scales ( P < 0.001).

Conclusion:

Titanium cervical disc arthroplasty devices result in superior postoperative MR imaging, as compared to cobalt chromium prostheses, as the latter significantly reduces image quality due to the pronounced ferromagnetic effect.
Patellofemoral Dislocation Recurrence After a First Episode: A Case-Control Study
Authors: Martinez-Cano Juan Pablo , Chica Julián , Martinez-Arboleda Juan José , Rincón-Escobar Erika , Zamudio-Castilla Laura , Renjifo Martin , Martinez-Rondanelli Alfredo
Published: January 2021

Background:

Lateral patellar dislocation can become a recurrent problem after the first episode. Identifying those patients who are at increased risk of redislocation is important for the treatment decision-making process.

Purpose:

To identify clinical and radiologic risk factors for recurrence of patellar dislocation after a first episode.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

The study included patients with lateral patellar dislocation and a 1-year minimum follow-up who were seen between 2011 and 2018. Patients aged 10 to 65 years were included. Patient characteristics, physical examination (patellar apprehension, J sign), and radiographs were reviewed. The Caton-Deschamps and Insall-Salvati ratios were used to evaluate patella alta. High-grade trochlear dysplasia was defined as Dejour types B, C, and D.

Results:

A total of 130 patients (139 knees) with primary lateral patellar dislocation were included. Recurrent dislocation was seen in 83 knees (59.71%). Stepwise logistic regression analysis demonstrated that Caton-Deschamps ratio ≥1.15 (OR, 2.39; 95% CI, 1.09-5.22; P = .029), age <21 years (OR, 2.53; 95% CI, 1.11-5.77; P = .027), and high-grade trochlear dysplasia (OR, 4.17; 95% CI, 1.90-9.17; P < .001) were significantly associated with patellar redislocation. Based on the presence of these factors, the probability of dislocation after a first lateral patellar dislocation was 31.2% with no factors present, 36.6% with any 1 factor present, 71.7% with any 2 factors present, and 86.2% if all 3 conditions were present.

Conclusion:

The results of this study indicated that patella alta, high-grade trochlear dysplasia, and age <21 years were independent risk factors for patellar redislocation after a first episode, with an additive effect when they were present together. This may help to guide the type of treatment for these patients.
Respiratory Modalities in Preventing Reintubation in a Pediatric Intensive Care Unit
Authors: Al-Hadidi Ameer , Lapkus Morta , Karabon Patrick , Akay Begum , Khandhar Paras
Published: January 2021

Post-extubation respiratory failure requiring reintubation in a Pediatric Intensive Care Unit (PICU) results in significant morbidity. Data in the pediatric population comparing various therapeutic respiratory modalities for avoiding reintubation is lacking. Our objective was to compare therapeutic respiratory modalities following extubation from mechanical ventilation. About 491 children admitted to a single-center PICU requiring mechanical ventilation from January 2010 through December 2017 were retrospectively reviewed. Therapeutic respiratory support assisted in avoiding reintubation in the majority of patients initially extubated to room air or nasal cannula with high-flow nasal cannula (80%) or noninvasive positive pressure ventilation (100%). Patients requiring therapeutic respiratory support had longer PICU LOS (10.92 vs 6.91 days, P-value = .0357) and hospital LOS (16.43 vs 10.20 days, P-value = .0250). Therapeutic respiratory support following extubation can assist in avoiding reintubation. Those who required therapeutic respiratory support experienced a significantly longer PICU and hospital LOS. Further prospective clinical trials are warranted.
Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly
Authors: Shih Ya-Chen Tina , Xu Ying , Lowenstein Lisa M. , Volk Robert J.
Published: January 2021

Introduction. The Centers for Medicare & Medicaid Services requires a written order of shared decision making (SDM) visit in its coverage policy for low-dose computed tomography (LDCT) for lung cancer screening (LCS). With screening eligibility starting at age 55, private insurance plans will likely adopt this coverage policy. This study examined the implementation of SDM in the context of LCS among the privately insured. Methods. We constructed two study cohorts from MarketScan Commercial Claims and Encounters database 2016-2017: a LDCT cohort who received LDCT for LCS and an SDM cohort who had an LCS-related SDM visit. For the LDCT cohort, we examined the trend and factors associated with the receipt of SDM within 3 months prior to LDCT. For the SDM cohort, we studied the trend and factors associated with LDCT within 3 months after an SDM visit. Results. For privately insured adults aged <64, 93% (19,681/21,084) of the LDCT cohort did not have a billing claim indicating SDM, although the uptake of SDM increased from 3.1% in 1Q2016 to 8.2% in 4Q2017 ( P < 0.0001). For the SDM cohort, 46% (948/2048) did not have a claim for an LDCT for lung cancer screening in the 3 months after the SDM visit; this percentage increased from 29.5% in 1Q2016 to 61.8% in 3Q2017 ( P < 0.0001). Limitations. Findings cannot be generalized to other nonelderly adults without private insurance. Additionally, the rate of SDM identified from claims may be underreported. Conclusions. We found a growing but low uptake of SDM among privately insured individuals who underwent LDCT. The higher rate of LDCT in the SDM cohort than the rate reported in national studies emphasized the importance of patient awareness.
Covid-19 has made clear why all physicians need to know about the business of healthcare
Authors: Myers Christopher G , Mayo Anna T , Kachalia Allen , Polsky Daniel , Sutcliffe Kathleen M
Published: January 2021

Amid longstanding recognition that healthcare challenges are often managerial, not just clinical, many have called for greater attention to developing physicians’ business management abilities. However, the Covid-19 pandemic has amplified the urgency of building physicians’ business knowledge and skills—from understanding health economics and finances to managing dynamics of collaborative leadership and change—in order to respond to pandemic-induced business challenges that threaten healthcare organizations. Unfortunately, existing efforts to develop these critical skills among physicians remain limited, focusing primarily on early-career physicians-in-training or later-career physicians in formal leadership positions. These efforts leave a wide swath of frontline physician leaders “in the middle” without systematic resources for developing their business management abilities. We advocate for several key changes to professional practices and policies to help bring business of health knowledge and skills to the foreground for all physicians, both in the pandemic and beyond.
The 2018 update of the US National Seismic Hazard Model: Where, why, and how much probabilistic ground motion maps changed
Authors: Petersen Mark D , Shumway Allison M , Powers Peter M , Mueller Charles S , Moschetti Morgan P , Frankel Arthur D , Rezaeian Sanaz , McNamara Daniel E , Luco Nicolas , Boyd Oliver S , Rukstales Kenneth S , Jaiswal Kishor S , Thompson Eric M , Hoover Susan M , Clayton Brandon S , Field Edward H , Zeng Yuehua
Published: January 2021

The 2018 US Geological Survey National Seismic Hazard Model (NSHM) incorporates new data and updated science to improve the underlying earthquake and ground motion forecasts for the conterminous United States. The NSHM considers many new data and component input models: (1) new earthquakes between 2013 and 2017 and updated earthquake magnitudes for some earlier earthquakes; (2) two updated smoothed seismicity models to forecast earthquake rates; (3) two suites of new central and eastern US (CEUS) ground motion models (GMMs) to translate ground shaking for various earthquake sizes and source-to-site distances considered in the model; (4) two CEUS GMMs for aleatory variability; (5) two CEUS site-effect models that modify ground shaking based on alternative shallow site conditions; (6) more advanced western US (WUS) lithologic and structural information to assess basin site effects for selected urban regions; and (7) a more comprehensive range of outputs (22 periods and 8 site classes) than in previous versions of the NSHMs. Each of these new datasets and models produces changes in the probabilistic ground shaking levels that are spatially and statistically analyzed. Recent earthquakes or changes to some older earthquake magnitudes and locations mostly result in probabilistic ground shaking levels that are similar to previous models, but local changes can reach up to +80% and −60% compared to the 2014 model. Newly developed CEUS models for GMMs, aleatory variability, and site effects cause overall changes up to ±64%. The addition of the WUS basin amplifications causes changes of up to +60% at longer periods for sites overlying deep soft soils. Across the conterminous United States, the hazard changes in the model are mainly caused by new GMMs in the CEUS, by sedimentary basin effects for long periods (≥1 s) in the WUS, and by seismicity changes for short (0.2 s) and long (1 s) periods for both areas.
Clinical phenotype, fibrinogen supplementation, and health-related quality of life in patients with afibrinogenemia
Authors: Casini Alessandro , von Mackensen Sylvia , Santoro Cristina , Djambas Khayat Claudia , Belhani Meriem , Ross Cecil , Dorgalaleh Akbar , Naz Arshi , Ünal Ekrem , Abdelwahab Magy , Lozeron Elise Dupuis , Trillot Nathalie , Susen Sophie , Peyvandi Flora , de Moerloose Philippe
Published: January 2021

Due to the low prevalence of afibrinogenemia, epidemiologic data on afibrinogenemia are limited, and no data are available on health-related quality of life (HRQoL). We conducted a cross-sectional international study to characterize the clinical features, the fibrinogen supplementation modalities, and their impact on HRQoL in patients with afibrinogenemia. A total of 204 patients (119 adults and 85 children) from 25 countries were included. The bleeding phenotype was severe: 68 (33.3%) patients having at least one bleed per month and 48 (23%) a history of cerebral bleeding. About 35% (n = 72) of patients were treated with fibrinogen concentrates or cryoprecipitates as prophylaxis, 18.1% (n = 37) received ≥1 injection per week, and 16.6% (n = 34) were on home treatment. A thrombotic event was reported in venous and/or arterial territories by 37 (18.1%) patients. Thrombosis occurred even in young patients, and recurrence was frequent (7.4%). The total HRQoL was lower in children than in adults. Discomfort linked to treatment and limitations to sports and leisure were the main concerns. Women and children were particularly affected in family relationships. In multivariate analyses, younger age, residence in Asia or Africa, and a previous thrombotic event were statistically correlated with a worse HRQoL. In summary, our study underlines the severe bleeding and thrombotic phenotype and their impact on HRQoL in afibrinogenemia. The optimal strategy for fibrinogen supplementation needs to be determined. This trial was registered at www.clinicaltrials.gov as #NCT03484065.
Conservative management of COVID-19 associated hypoxaemia
Authors: Voshaar Thomas , Stais Patrick , Köhler Dieter , Dellweg Dominic
Published: January 2021

Background

Invasive mechanical ventilation of hypoxaemic coronavirus disease 2019 (COVID-19) patients is associated with mortality rates of >50%. We evaluated clinical outcome data of two hospitals that agreed on a predefined protocol for restrictive use of invasive ventilation where the decision to intubate was based on the clinical presentation and oxygen content rather than on the degree of hypoxaemia.

Method

Data analysis was carried out of patients with positive PCR-testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typical history, and symptoms and pulmonary infiltrates who exhibited oxygen saturation values of <93%.

Results

We identified 78 patients who met the inclusion criteria. The oxygen saturation nadir was 84.4±6.5% for the whole group. 53 patients (68%) received nasal oxygen (group 1), 17 patients (22%) were treated with nasal high-flow continuous positive airway pressure (CPAP), noninvasive ventilation or a combination thereof (group 2), and eight patients (10%) were intubated (group 3). The Horovitz index was 216±8 for group 1, 157±13 for group 2 and 106±15 for group 3. Oxygen content was 14.5±2.5, 13.4±1.9 and 11.6±2.6 mL O2·dL−1for the three respective groups. Overall mortality was 7.7%; the mortality of intubated patients was 50%. Overall, 93% of patients could be discharged on room air.

Conclusion

Permissive hypoxaemia where decisions for the level of respiratory therapy were based on the clinical presentation and oxygen content resulted in low intubation rates, low overall mortality and a low number of patients who require oxygen after discharge.
Prognostic value of clinically important deterioration in COPD: IMPACT trial analysis
Authors: Han MeiLan K. , Criner Gerard J. , Dransfield Mark T. , Halpin David M.G. , Jones Christine E. , Kilbride Sally , Lange Peter , Lettis Sally , Lipson David A. , Lomas David A. , Martin Neil , Martinez Fernando J. , Wise Robert A. , Naya Ian P. , Singh Dave
Published: January 2021

Introduction

Clinically important deterioration (CID) is a multicomponent measure for assessing disease worsening in chronic obstructive pulmonary disease (COPD). This analysis investigated the prognostic value of a CID event on future clinical outcomes and the effect of single-inhaler tripleversusdual therapy on reducing CID risk in patients in the IMPACT trial.

Methods

IMPACT was a phase III, double-blind, 52-week, multicentre trial. Patients with symptomatic COPD and at least one moderate/severe exacerbation in the prior year were randomised 2:2:1 to fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 µg, FF/VI 100/25 µg or UMEC/VI 62.5/25 µg. CID at the time-point of interest was defined as a moderate/severe exacerbation, ≥100 mL decrease in trough forced expiratory volume in 1 s or deterioration in health status (increase of ≥4.0 units in St George's Respiratory Questionnaire total score or increase of ≥2.0 units in COPD Assessment Test score) from baseline. A treatment-independentpost hocprognostic analysis compared clinical outcomes up to week 52 in patients with/without a CID by week 28. A prospective analysis evaluated time to first CID with each treatment.

Results

Patients with a CID by week 28 had significantly increased exacerbation rates after week 28, smaller improvements in lung function and health status at week 52 (all p<0.001), and increased risk of all-cause mortality after week 28versuspatients who were CID-free. FF/UMEC/VI significantly reduced CID riskversusdual therapies (all p<0.001).

Conclusions

Prevention of short-term disease worsening was associated with better long-term clinical outcomes. FF/UMEC/VI reduced CID riskversusdual therapies; this effect may improve long-term prognosis in this population.
Evaluation of a multicomponent grading system for obstructive sleep apnoea: the Baveno classification
Authors: Randerath Winfried J. , Herkenrath Simon , Treml Marcel , Grote Ludger , Hedner Jan , Bonsignore Maria Rosaria , Pépin Jean Louis , Ryan Silke , Schiza Sophia , Verbraecken Johan , McNicholas Walter T. , Pataka Athanasia , Sliwinski Pawel , Basoglu Özen K.
Published: January 2021

New findings on pathophysiology, epidemiology, and outcome have raised concerns on the relevance of the apnoea–hypopnoea index (AHI) in the classification of obstructive sleep apnoea (OSA) severity. Recently, a multicomponent grading system decision integrating symptomatology and comorbidities (Baveno classification), was proposed to characterise OSA and to guide therapeutic decisions. We evaluated whether this system reflects the OSA population, whether it translates into differences in outcomes, and whether the addition of AHI improves the scheme. A total of 14 499 OSA patients from the European Sleep Apnoea Database cohort were analysed. The groups were homogeneously distributed and were found to clearly stratify the population with respect to baseline parameters. Differences in sleepiness and blood pressure between the groups were analysed in a subgroup of patients after 24–36 months of treatment. Group A (minor symptoms and comorbidities) did not demonstrate any effect of treatment on outcome. However, groups B (severe symptoms, minor comorbidities), C (minor symptoms, severe comorbidities) and D (severe symptoms and comorbidities) were associated with improvement in either or both parameters with treatment. The AHI is an essential prerequisite of the diagnosis; however, adding the AHI did not improve the classification. Rather, it was inferior with respect to guiding the treatment decision. Thus, the Baveno classification allows a better stratification of the OSA population and may provide a better guidance for therapeutic decisions in OSA.
Effects of Annealing on Electrochemical Properties of Solvothermally Synthesized Cu2SnS3 Anode Nanomaterials
Authors: Peng Xiaoli , Wen Chong , Zhang Qian , Min Hang , Xiang Yong , Hu Xiaoran , Zhang Xiaokun
Published: January 2021

Cu2SnS3, as a modified material for high-capacity tin-based anodes, has great potential for lithium-ion battery applications. The solvothermal method is simple, convenient, cost-effective, and easy to scale up, and has thus been widely used for the preparation of nanocrystals. In this work, Cu2SnS3 nanoparticles were prepared by the solvothermal method. The effects of high-temperature annealing on the morphology, crystal structure, and electrochemical performance of a Cu2SnS3 nano-anode were studied. The experimental results indicate that high-temperature annealing improves the electrochemical performance of Cu2SnS3, resulting in higher initial coulombic efficiency and improved cycling and rate characteristics compared with those of the as-prepared sample.
Analysis of Rice Transcriptome Reveals the LncRNA/CircRNA Regulation in Tissue Development
Authors: Zhou Run , Sanz-Jimenez Pablo , Zhu Xi-Tong , Feng Jia-Wu , Shao Lin , Song Jia-Ming , Chen Ling-Ling
Published: January 2021

Background

Long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs) can play important roles in many biological processes. However, no study of the influence of epigenetics factors or the 3D structure of the genome in their regulation is available in plants.

Results

In the current analysis, we identified a total of 15,122 lncRNAs and 7902 circRNAs in three tissues (root, leaf and panicle) in the rice varieties Minghui 63, Zhenshan 97 and their hybrid Shanyou 63. More than 73% of these lncRNAs and parental genes of circRNAs (P-circRNAs) are shared among Oryza sativa with high expression specificity. We found that, compared with protein-coding genes, the loci of these lncRNAs have higher methylation levels and the loci of circRNAs tend to locate in the middle of genes with high CG and CHG methylation. Meanwhile, the activated lncRNAs and P-circRNAs are mainly transcribed from demethylated regions containing CHH methylation. In addition, ~ 53% lncRNAs and ~ 15% P-circRNAs are associated with transposable elements (TEs), especially miniature inverted-repeat transposable elements and RC/Helitron. We didn’t find correlation between the expression of lncRNAs and histone modifications; however, we found that the binding strength and interaction of RNAPII significantly affects lncRNA expression. Interestingly, P-circRNAs tend to combine active histone modifications. Finally, we found that lncRNAs and circRNAs acting as competing-endogenous RNAs have the potential to regulate the expression of genes, such as osa-156 l-5p (related to yield) and osa-miR444a-3p (related to N/P metabolism) confirmed through dual-luciferase reporter assays, with important roles in the growth and development of rice, laying a foundation for future rice breeding analyses.

Conclusions

In conclusion, our study comprehensively analyzed the important regulatory roles of lncRNA/circRNA in the tissue development of Indica rice from multiple perspectives.
Identification and characterization of the LRR repeats in plant LRR-RLKs
Authors: Chen Tianshu
Published: January 2021

Background

Leucine-rich-repeat receptor-like kinases (LRR-RLKs) play central roles in sensing various signals to regulate plant development and environmental responses. The extracellular domains (ECDs) of plant LRR-RLKs contain LRR motifs, consisting of highly conserved residues and variable residues, and are responsible for ligand perception as a receptor or co-receptor. However, there are few comprehensive studies on the ECDs of LRR-RLKs due to the difficulty in effectively identifying the divergent LRR repeats.

Results

In the current study, an efficient LRR motif prediction program, the “Phyto-LRR prediction” program, was developed based on the position-specific scoring matrix algorithm (PSSM) with some optimizations. This program was trained by 16-residue plant-specific LRR-highly conserved segments (HCS) from LRR-RLKs of 17 represented land plant species and a database containing more than 55,000 predicted LRRs based on this program was constructed. Both the prediction tool and database are freely available athttp://phytolrr.com/for website usage and athttp://github.com/phytolrrfor local usage. The LRR-RLKs were classified into 18 subgroups (SGs) according to the maximum-likelihood phylogenetic analysis of kinase domains (KDs) of the sequences. Based on the database and the SGs, the characteristics of the LRR motifs in the ECDs of the LRR-RLKs were examined, such as the arrangement of the LRRs, the solvent accessibility, the variable residues, and the N-glycosylation sites, revealing a comprehensive profile of the plant LRR-RLK ectodomains.

Conclusion

The “Phyto-LRR prediction” program is effective in predicting the LRR segments in plant LRR-RLKs, which, together with the database, will facilitate the exploration of plant LRR-RLKs functions. Based on the database, comprehensive sequential characteristics of the plant LRR-RLK ectodomains were profiled and analyzed.
Patterns of introgression vary within an avian hybrid zone
Authors: Maxwell Logan M. , Walsh Jennifer , Olsen Brian J. , Kovach Adrienne I.
Published: January 2021

Background

Exploring hybrid zone dynamics at different spatial scales allows for better understanding of local factors that influence hybrid zone structure. In this study, we tested hypotheses about drivers of introgression at two spatial scales within the Saltmarsh Sparrow (Ammospiza caudacuta) and Nelson’s Sparrow (A. nelsoni) hybrid zone. Specifically, we evaluated the influence of neutral demographic processes (relative species abundance), natural selection (exogenous environmental factors and genetic incompatibilities), and sexual selection (assortative mating) in this mosaic hybrid zone. By intensively sampling adults (n = 218) and chicks (n = 326) at two geographically proximate locations in the center of the hybrid zone, we determined patterns of introgression on a fine scale across sites of differing habitat. We made broadscale comparisons of patterns from the center with those of prior studies in the southern edge of the hybrid zone.

Results

A panel of fixed SNPs (135) identified from ddRAD sequencing was used to calculate a hybrid index and determine genotypic composition/admixture level of the populations. Another panel of polymorphic SNPs (589) was used to assign paternity and reconstruct mating pairs to test for sexual selection. On a broad-scale, patterns of introgression were not explained by random mating within marshes. We found high rates of back-crossing and similarly low rates of recent-generation (F1/F2) hybrids in the center and south of the zone. Offspring genotypic proportions did not meet those expected from random mating within the parental genotypic distribution. Additionally, we observed half as many F1/F2 hybrid female adults than nestlings, while respective male groups showed no difference, in support of Haldane’s Rule. The observed proportion of interspecific mating was lower than expected when accounting for mate availability, indicating assortative mating was limiting widespread hybridization. On a fine spatial scale, we found variation in the relative influence of neutral and selective forces between inland and coastal habitats, with the smaller, inland marsh influenced primarily by neutral demographic processes, and the expansive, coastal marsh experiencing higher selective pressures in the form of natural (exogenous and endogenous) and sexual selection.

Conclusions

Multiple drivers of introgression, including neutral and selective pressures (exogenous, endogenous, and sexual selection), are structuring this hybrid zone, and their relative influence is site and context-dependent.