bluuebunny/crossref_metadata_2025 huggingface dataset:
ESC-Leitlinie Herzschrittmacher 2021 - Leadless
Pacing
Authors: Sultan Arian
Published: June 2022

Im vergangenen Jahr wurde auf dem ESC Kongress die neue Leitlinie zur
Schrittmachertherapie vorgestellt. Ein besonderes Augenmerk lag hier auf der
Indikationsempfehlung zur kabellosen Schrittmachertherapie. Aktuell sind 2
kabellose Schrittmachersysteme kommerziell erhältlich. Zum einen der asynchron
arbeitende Micra VR sowie der AV-synchron operierende Micra AV. Beide Systeme
werden kathetergestützt, in der Regel über einen rechts-femoralen Venenzugang im
rechten Ventrikel platziert. Der Micra VR wird überwiegend bei Patienten mit
intermittierender Bradykardie bei persistierendem oder permanentem
Vorhofflimmern verwendet. Mit der Einführung des Micra AV konnte das
Indikationsspektrum deutlich erweitert werden. Dieser Schrittmacher erlaubt nun
auch eine kabellose Schrittmacherimplantation bei Patienten mit erhaltener
Sinusknotenfunktion und höhergradigen AV-Blockierungen. Die aktuellen Leitlinien
haben für die Implantation eines kabellosen Schrittmachers eine
Klasse-IIa-Empfehlung, Level B lediglich für bestimmte Patientengruppen
ausgesprochen.
Herzschrittmachertherapie bei Sinusknotenerkrankung, Reflexsynkopen, seltenen Herzerkrankungen & besonderen Situationen
Authors: Wiegand Uwe
Published: June 2022

Durch die neuen ESC-Leitlinien zur Herzschrittmacher- und kardialen Resynchronisationstherapie ändert sich die Indikationsstellung nur in wenigen Bereichen. Für Patienten mit
Tachykardie-Bradykardie-Syndrom, bei denen Vorhofflimmern nicht primär mit Katheterablation behandelt werden soll, wird die Indikation zur Schrittmachertherapie erleichtert. Gleiches gilt
aber auch für Patienten mit Sinusknotenerkrankung und vermutetem Symptom-EKG-Zusammenhang, die nun im Gegensatz zu den Leitlinien von 2013 auch bei leichter Symptomatik und ohne definierte
Pausenlänge im Einzelfall einen Schrittmacher erhalten können. Bei Verdacht auf Reflexsynkopen wird analog zur Synkopenleitlinie von 2018 ein diagnostischer Algorithmus aus
Kipptischuntersuchung, Karotis-Druckversuch und – im Fall von nicht diagnostischen Ergebnissen – Implantation eines Ereignisrekorders empfohlen. Erstmals finden sich auch eigenständige
Indikationen zur Schrittmachertherapie nach Implantation von Transkatheter-Aortenklappen.
CRT „reloaded“ 2022 – die neuen Guidelines und technische Innovationen
Authors: Butter Christian , Seifert Martin , Georgi Christian
Published: June 2022

Die kardiale Resynchronisationstherapie (cardiac resynchronization therapy, CRT) stellt für Patienten mit symptomatischer Herzinsuffizienz und Linksschenkelblock eine etablierte und
erfolgreiche Therapieoption dar, wenn die konservative medikamentöse Therapie ausgeschöpft ist und alle anderen kausalen Ursachen wie Ischämie, Klappenfehler und Rhythmusstörungen behandelt
worden sind. Die aktuellen Pacing-Guidelines der ESC betonen erneut den Stellenwert der CRT als primäre interventionelle Herzinsuffizienztherapie, besonders bei Sinusrhythmus, einer LVEF
≤ 35% und typischem Linksschenkelblock ≥ 150 ms. Bei gleichzeitig bestehendem unkontrollierbarem Vorhofflimmern gewinnt die AV-Knoten-Ablation an Bedeutung. Für den nicht zu
vernachlässigenden Anteil von Herzinsuffizienzpatienten ohne klare CRT-Indikation oder mit unzureichender CRT-Response kann eine multimodale Bildgebung zusätzliche Informationen liefern.
Alternative Pacingmethoden sollten bei anatomischen Hindernissen erwogen werden. Die Wahl eines zusätzlichen Defibrillators ist auch nach der aktuellen Studienlage häufig schwierig und
bleibt individuell abzuwägen.
EMG und Neurografie – ein Update
Authors: Schulte-Mattler Wilhelm , Bischoff Christian
Published: June 2022

Elektromyografie (EMG) und Elektroneurografie (ENG) gelten als bewährte
Methoden, deren Anfänge aber schon Jahrzehnte zurückliegen. In
dieser Arbeit werden jüngere Entwicklungen beschrieben und die Rolle von
EMG und ENG in wichtigen Situationen diskutiert, nämlich bei
traumatische Nervenläsionen, Nervenkompressionssyndromen,
Polyneuropathien, Motoneuronerkrankungen, Myopathien, neuromuskulären
Transmissionsstörungen und bei muskulärer
Überaktivität.
Liebe Leserinnen und Leser
Authors: Buchner Helmut
Published: June 2022

es ist schön, Sie zum zweiten Heft in 2022 begrüßen zu
können.
Anastomose incomum entre ramos do nervo ulnar (variante anastomótica de Kaplan) – Relato de caso
Authors: Oliveira Kennedy Martinez , Benevenuto Gabriel das Chagas , de Almeida Ana Clara Ferreira , de Oliveira Daniel Gonçalves , Bueno Leonardo Braga , Teixeira Maria Fernanda Carvalho
Published: June 2022

A anastomose de Kaplan é uma rara comunicação originalmente descrita entre os ramos superficial e dorsal do nervo ulnar, distal ao túnel ulnar e em estreita relação com o osso pisiforme. O que revela, pela sua particular localização, uma formação de alta expressividade clínico-cirúrgica. Neste trabalho, uma comunicação do tipo Kaplan, porém, ainda não relatada, é descrita a partir de um membro superior esquerdo com uma inusual conformação em alça, ou um looping, entre ramos do nervo ulnar, no osso pisiforme.
When to Suspect DRUJ's Instability in Children? Case Report of a Rare Presentation of Distal Forearm Fractures
Authors: Saugy Claire-Anne , Bregou Aline Bourgeois
Published: June 2022

Pediatric displaced distal metaphyseal ulnar fractures and distal radial buckle fractures are common. However, to the best of our knowledge, their association has never been specifically reported. Thus, classification and management of this pattern remain challenging especially in young children. Distal radioulnar joint (DRUJ)'s assessment is difficult. A Galeazzi-equivalent injury should be suspected. We report the case of a 2-year-old boy who presented the above-mentioned association of forearm fractures and compare our management with actual recommendations. We would recommend a low-suspicion threshold for DRUJ's instability in young children presenting with displaced distal metaphyseal ulnar fracture associated with distal radial buckle fracture. That suspicion should raise the necessity of appropriate treatment and follow-up.
Utility of Serum Uric Acid to High-Density Lipoprotein Ratio in Prediction of Glycemic Control
Authors: Chinnusamy Manokaran , Vishwanathan Ram Arvind , Janakiraman Sathiyanarayanan , Elayidath Roshna
Published: June 2022

Introduction India has witnessed diabetes as a growing problem and is on the verge of a diabetes mellitus (DM) epidemic. Glycemic control is the way to prevent the morbidity associated with diabetes. This study aimed to find out the utility of uric acid to the high-density lipoprotein (HDL) ratio (UHR) as a marker of diabetic control.

Methodology A hospital-based cross-sectional study was conducted among type-2 diabetic individuals who attended outpatient clinics and individuals who admitted to the inpatient wards of our hospital were enlisted. HDL cholesterol, serum uric acid, glycated hemoglobin were performed. Hemoglobin A1c (HbA1c) lower than 7% was classified as a good-controlled type-2 (DM) group and those with HbA1c between 7 and 10% were classified as uncontrolled type-2 DM group and those with HbA1c greater than 10% were classified as poorly controlled type-2 DM group. HbA1c was correlated with HDL, serum uric acid, and UHR.

Results Our study demonstrates that uric acid is inversely related to HbA1c and uric acid decreases following elevated HbA1c, and this relationship was statistically significant, whereas there was a nonsignificant inverse relationship between HDL and HbA1c and UHR with HbA1c.

Conclusion Established diabetics will have a lowering of uric acid as the diabetic control worsens and UHR could not be used as a marker of diabetic control.
Avaliação da amplitude do movimento perna-pé: Qual método de aferição é mais fidedigno?
Authors: Costa Marco Túlio , Tejerina Javier Felipe Salinas , Silva Cesar Augusto Lima da , Rêgo Itallo Epaminondas de Queiroz , Bergamasco Jordanna Maria Pereira , Marchi Neto Noé De
Published: June 2022

Objetivo Avaliar os métodos de mensuração do movimento perna-pé em tornozelos e pés normais comparando os resultados das medidas clínicas com a mensuração radiográfica e determinar qual é a amplitude do movimento perna-pé considerada normal.

Métodos O movimento perna-pé foi mensurado em 44 pacientes (60 pés) empregando um goniômetro tradicional, goniômetro digital, inclinômetro, aplicativo para smartphone, além da mensuração radiográfica (considerada padrão ouro). A dorsiflexão máxima foi alcançada pedindo ao paciente dar um passo à frente com o pé contralateral e realizar o máximo de dorsiflexão possível no tornozelo estudado sem retirar o calcanhar do solo. Já para a flexão plantar máxima, foi solicitado ao paciente para dar um passo para trás com pé contralateral e fazer o máximo de flexão plantar possível sem retirar o antepé estudado do solo.

Resultados Os valores obtidos na mensuração radiográfica foram maiores do que os obtidos com a mensuração clínica. Quando comparamos apenas os resultados da mensuração clínica, o goniômetro tradicional se mostrou impreciso. Segundo o método radiográfico, a média de amplitude do movimento perna-pé foi de 65,6 graus. Já a média da flexão plantar máxima foi de 34,9 graus, e a média da dorsiflexão máxima foi de 30,7 graus.

Conclusões O método mais adequado para a avaliação da amplitude do movimento perna-pé é o radiográfico. O goniômetro tradicional se mostrou o método clínico mais impreciso. A média de amplitude do movimento perna-pé em adultos jovens e saudáveis foi de 65 graus.
Field Quantization and Hamiltonians
Authors: Mondal Partha Pratim
Published: June 2022

Understanding the particle nature of light and its consequences requires quantization of light. Quantization is a process of transforming a continuous system to a discrete system. In physical sciences, quantization is carried out for entities and quantities that are inherently discrete in nature. This refers to the graininess in the actual physical state (here, electromagnetic field) whose macroscopic ensemble manifestation (wave nature) is a large-number approximation. The microscopic grainy dynamics gives rise to delicate and tiny perturbations at the level of a single grain that sum up to produce large effects at the macroscopic level (continuous domain). Thus, quantization describes the physical state at the scale of a single grain while the continuous domain describes the average dynamics (macroscopic manifestation), which wipes out the properties of single grains. As an example, quantization of an electromagnetic field yields grainy particles called photons, the existence of which has been verified experimentally. These grains have well-defined quantized quantities such as energy. In this chapter, we discuss the grainy nature of light and its quantized quantities (energy, angular momentum, etc.) associated with the grains (photons) of light.
Quantum States of Light
Authors: Mondal Partha Pratim
Published: June 2022

It is evident from the previous chapter that certain quantities that appear continuous at the macroscopic scale does actually exist in a discrete form at the microscopic scale. So, quantization of these entities makes sense and reveals a plethora of information at such length scales. In this book, our key concern lies with the properties of light, and rightfully so, we will explore different states of the optical radiation field. We will learn that light exists in many states that makes it so unique. Experimental evidence shows that light behaves as a particle at the microscopic scale (subject to specific conditions), although it behaves like a wave at the macroscopic scale. In this chapter, we will dwell deep and discuss many characteristics related to the particle nature of light. Specifically, we will consider two important states of light, the Fock and coherent states. These states can be regarded as the most fundamental states of light that enable complex interpretation of quantum features in the radiation field.
The Multifunctionality of MandarinDiào 掉
Authors: Jing Gaowa , Liu Meichun
Published: June 2022

This paper explores the various functions ofdiàoin Mandarin Chinese as it changes from a verb to a phase marker. As a phase marker,diàoprovides a natural endpoint to a co-occurring event and indicates completion, which is a distinct function from the perfect markerle. In this shift, the meaning ofdiàoalso expands, including ‘falling down’, ‘throwing down’, ‘disappearing’, ‘removal’, ‘completion’ and ‘change of state’. The multifunctionality ofdiàois the result of grammaticalization along with semantic change and extension. Cognitive mechanisms such as metonymic and metaphoric extensions, pragmatic inferencing, analogy on Verb-Complement structures, and semantic generalization all contribute to the grammaticalization ofdiào, with further influence from contact with southern Chinese dialects. This paper further argues that the grammaticalization and semantic extension ofdiàois in accordance with the development of aspectual markers cross-linguistically, reflecting the commonality in human cognition.
TV shows, authenticity, and language learning
Authors: Al-Surmi Mansoor
Published: June 2022

One of the many resources teachers seek for authentic materials, particularly for spoken English, is TV. However, the concept of authenticity is relative, and it is sometimes hard to determine how authentic materials are. The present study uses a corpus-based analysis to assess to what extent a soap opera, compared to a sitcom, represent natural conversation on a salient set of linguistic features associated with the situational characteristics of conversation. Results showed that the soap opera seems to be closer to natural conversation, and hence more authentic, in the use of features associated with two situational characteristics out of three, namelyreal time production and interactiveness, andexpressing feelings and stance. Results could help inform the practitioners’ decisions when looking for authentic spoken materials.
Altitude differentially alters the force‐velocity relationship after 3 weeks of power‐oriented resistance training in elite judokas
Authors: Almeida Filipa , Bonitch‐Góngora Juan , Feriche Belén , Schoenfeld Brad J. , de la Fuente Blanca , Padial Paulino
Published: June 2022

This study investigated the effects of a 3‐week power‐oriented resistance training programme performed at moderate altitude on the lower‐limb maximal theoretical power and force‐velocity (F‐V) imbalance of elite judokas. Twenty‐two elite male judokas were randomly assigned to either a hypobaric hypoxia or normoxia group. Mechanical outputs from an incremental loaded countermovement jump test were assessed at sea level, before and after training, and 1 week later. Results indicated an increase in the maximal theoretical force and a reduction in the F‐V imbalance both at moderate altitude and sea level. Altitude training induced additional benefits when compared to sea level for F‐V imbalance (8.4%; CI: 0.3, 17.3%), maximal theoretical power (2.09 W·kg−1; CI: 0.13, 4.52 W·kg−1) and force (1.32 N·kg−1; CI: −0.12, 2.96 N·kg−1), jump height (3.24 cm; CI: 2.02, 4.80 cm) and optimal maximal theoretical force (1.61 N·kg−1; CI: 0.06, 3.60 N·kg−1) and velocity (0.08 m·s−1; CI: 0.00, 0.17 m·s−1) after the training period. The hypoxia group achieved their best results immediately after the training period, while the normoxia group achieved them one week later. These results suggest that a power‐oriented resistance training programme carried out at moderate altitude accelerates and improves the gains in lower‐limb muscle power, while minimizing lower‐limb imbalances. Therefore, it seems appropriate to compete immediately after the return to sea level and/or use altitude training as a tool to improve muscle power levels of athletes without tapering goals, especially in highly trained power athletes, since their window of adaptation for further power enhancement is smaller.
Contemporary hemodynamic management of acute spinal cord injuries with intravenous and enteral vasoactive agents: A narrative review
Authors: Iovine Joseph A , Villanueva Ruben D , Werth Christopher M , Hlavacek Nicole L , Rollstin Amber D , Tawil Isaac , Sarangarm Preeyaporn
Published: June 2022

Purpose

The pathophysiology and hemodynamic management of acute spinal cord injuries, including the use of intravenous and enteral vasoactive agents, are reviewed.

Spinal cord injuries are devastating neurological insults that in the acute setting lead to significant hemodynamic disturbances, including hypotension and bradycardia, that are influenced by the level of injury. High thoracic (usually defined as at or above T6) and cervical injuries often manifest with hypotension and bradycardia due to destruction of sympathetic nervous system activity and unopposed vagal stimulation to the myocardium, whereas lower thoracic injuries tend to result in hypotension alone due to venous pooling. Initial management includes maintaining euvolemia with crystalloids and maintaining or augmenting mean arterial pressure with the use of intravenous vasoactive agents to improve neurological outcomes. Choice of vasopressor should be based on patient-specific factors, particularly level of injury and presenting hemodynamics. This review includes the most recent literature on intravenous vasopressors as well as the limited evidence supporting the use of enteral vasoactive agents. Enteral vasoactive agents may be considered, when clinically appropriate, as a strategy to wean patients off of intravenous agents and facilitate transfer outside of the intensive care unit.

Conclusion

The hemodynamic management of acute spinal cord injuries often requires the use of vasoactive agents to meet mean arterial pressure goals and improve neurological outcomes. Patient-specific factors must be considered when choosing intravenous and enteral vasoactive agents.
Development of a Thin-Layer Chromatography-Enzymatic Test Combination Method for the Isolation of α-Glucosidase Inhibitors From Thymelaea hirsuta
Authors: Abid Sanae , Maciuk Alexander , Fishmeister Rodolphe , Leblais Véronique , Legssyer Abdekhaleq , Mekhfi Hassane , Ziyyat Abderrahim , Aziz Mohamed , Lekchiri Abdenbi , Bnouham Mohamed
Published: June 2022

A rapid, easy and simple method for the isolation and purification of α-glucosidase inhibitors of the ethyl acetate extract of Thymelaea hirsuta (EaTh) by a combination of thin layer chromatography (TLC) and enzymatic test has been developed. EaTh was demonstrated previously a potent α-glucosidase inhibitory effect. In this study, we developed a simple TLC-enzymatic test (TLC/EZ) combination to isolate α-glucosidase inhibitors present in EaTh.EaTh was extracted by Soxhlet from Thymelaea hirsuta (T. hirsuta). The EaTh was separated on a silica gel column and then on a TLC plate. After TLC separation, the TLC/EZ combination method was applied. α-glucosidase inhibitors were detected directly in the TLC plate using the glucose oxidase peroxidase method (GOD-POD). A good detection of active compounds was obtained in the TLC favoring the TLC/EZ method. Active compounds were then characterized using high performance liquid chromatography-mass spectrometry (HPLC–MS) analysis. The main α-glucosidase inhibitors present in EaTh have a molecular ion [M + H]+ at m/z = 543. This proposed method is suitable for a reliable isolation and purification of α-glucosidase inhibitors present in EaTh. It could be proposed as an interesting alternative of the classical method for the isolation and purification of α-glucosidase inhibitors in plant extracts.
Adiposity-associated atrial fibrillation: molecular determinants, mechanisms, and clinical significance
Authors: Gawałko Monika , Saljic Arnela , Li Na , Abu-Taha Issam , Jespersen Thomas , Linz Dominik , Nattel Stanley , Heijman Jordi , Fender Anke , Dobrev Dobromir
Published: June 2022

Obesity is an important contributing factor to the pathophysiology of atrial fibrillation (AF) and its complications by causing systemic changes, such as altered haemodynamic, increased sympathetic tone, and low-grade chronic inflammatory state. In addition, adipose tissue is a metabolically active organ that comprises various types of fat deposits with discrete composition and localization that show distinct functions. Fatty tissue differentially affects the evolution of AF, with highly secretory active visceral fat surrounding the heart generally having a more potent influence than the rather inert subcutaneous fat. A variety of proinflammatory, profibrotic, and vasoconstrictive mediators are secreted by adipose tissue, particularly originating from cardiac fat, that promote atrial remodelling and increase the susceptibility to AF. In this review, we address the role of obesity-related factors and in particular specific adipose tissue depots in driving AF risk. We discuss the distinct effects of key secreted adipokines from different adipose tissue depots and their participation in cardiac remodelling. The possible mechanistic basis and molecular determinants of adiposity-related AF are discussed, and finally, we highlight important gaps in current knowledge, areas requiring future investigation, and implications for clinical management.
Predictive factors of distal stent graft-induced new entry after frozen elephant trunk procedure for aortic dissection
Authors: Hiraoka Arudo , Iida Yasunori , Furukawa Tomokuni , Ueki Chikara , Miyake Koichi , Mieno Makiko , Okamura Homare
Published: June 2022

OBJECTIVES

The incidence rate of distal stent graft-induced new entry (d-SINE) after frozen elephant trunk technique for aortic dissection remains controversial. The aim of this study was to investigate the incidence and seek the clinical and anatomical predictive factors.

METHODS

This study is a retrospective multicentre evaluation of complications including d-SINE, aortic events and reintervention after the frozen elephant trunk procedure for aortic dissection.

RESULTS

Our cohort included a total of 177 consecutive patients who underwent the frozen elephant trunk procedure for acute and chronic aortic dissection at 5 centres in Japan from May 2014 to March 2021. The incidence rate of d-SINE was 14.1% (25/177 patients). The cumulative incidence of d-SINE was 7.1%, 12.4% and 21.4% after 12, 36 and 60 months, respectively. d-SINE was not associated with mid-term survival rate. After competing risk regression analysis, onset time >48 h (subdistribution hazard ratio, 3.80; 95% confidence interval, 1.13–12.79; P = 0.031) was detected as an independent predictor.

CONCLUSIONS

Awareness that there is a relatively higher incidence of d-SINE after frozen elephant trunk procedures is important. Non-hyper-acute phase was detected as an independent risk factor. Pre-emptive endovascular repair may be appropriate to protect new entry in high-risk patients.
Global prevalence of resistance to macrolides inMycoplasma pneumoniae: a systematic review and meta-analysis
Authors: Wang Guotuan , Wu Peng , Tang Rui , Zhang Weidong
Published: June 2022

Objectives

To determine the prevalence of resistance to macrolides in Mycoplasma pneumoniae worldwide.

Methods

Prior to 12 December 2020, PubMed, Web of Science, Scopus and Embase databases were searched for epidemiological studies of M. pneumoniae resistance. Two reviewers independently extracted data from included studies. The extracted data include sampling population, total sampling number, the number of resistant strains and the molecular subtype of resistant strains. The estimate of resistance prevalence was calculated using the random-effects model.

Results

A total of 17 873 strains were obtained from five continents and reported in 98 investigations between 2000 and 2020, with 8836 strains characterized as macrolide resistant. In summary, macrolide-resistant M. pneumoniae was most common in Asia (63% [95% CI 56, 69]). In Europe, North America, South America and Oceania, the prevalence was 3% [2, 7], 8.6% [6, 11], 0% and 3.3%, respectively. Over the last 20 years, the prevalence of macrolide-resistant M. pneumoniae has remained high in China (81% [73, 87]), with a significant increasing trend in South Korea (4% [1, 9] to 78% [49, 93], P < 0.0001). Furthermore, a point mutation at 2063 from A to G was mostly related to M. pneumoniae macrolide resistance. In terms of clinical outcomes, longer cough (mean difference [MD]: 2.93 [0.26, 5.60]) and febrile days (MD: 1.52 [1.12, 1.92]), and prolonged hospital stays (MD: 0.76 [0.05, 1.46]) might be induced by macrolide-resistant M. pneumoniae pneumonia.

Conclusions

The incidence of macrolide-resistant M. pneumoniae varies globally, with eastern Asia having a greater degree of resistance. However, attention is also required in other areas, and antibiotic alternatives should be considered for treatment in high-prevalence countries.
How can natural language processing help model informed drug development?: a review
Authors: Bhatnagar Roopal , Sardar Sakshi , Beheshti Maedeh , Podichetty Jagdeep T
Published: June 2022

Objective

To summarize applications of natural language processing (NLP) in model informed drug development (MIDD) and identify potential areas of improvement.

Materials and Methods

Publications found on PubMed and Google Scholar, websites and GitHub repositories for NLP libraries and models. Publications describing applications of NLP in MIDD were reviewed. The applications were stratified into 3 stages: drug discovery, clinical trials, and pharmacovigilance. Key NLP functionalities used for these applications were assessed. Programming libraries and open-source resources for the implementation of NLP functionalities in MIDD were identified.

Results

NLP has been utilized to aid various processes in drug development lifecycle such as gene-disease mapping, biomarker discovery, patient-trial matching, adverse drug events detection, etc. These applications commonly use NLP functionalities of named entity recognition, word embeddings, entity resolution, assertion status detection, relation extraction, and topic modeling. The current state-of-the-art for implementing these functionalities in MIDD applications are transformer models that utilize transfer learning for enhanced performance. Various libraries in python, R, and Java like huggingface, sparkNLP, and KoRpus as well as open-source platforms such as DisGeNet, DeepEnroll, and Transmol have enabled convenient implementation of NLP models to MIDD applications.

Discussion

Challenges such as reproducibility, explainability, fairness, limited data, limited language-support, and security need to be overcome to ensure wider adoption of NLP in MIDD landscape. There are opportunities to improve the performance of existing models and expand the use of NLP in newer areas of MIDD.

Conclusions

This review provides an overview of the potential and pitfalls of current NLP approaches in MIDD.
Scattering of light in thin magnetized envelopes
Authors: Silant’ev N A , Alekseeva G A , Ananjevskaja Yu K
Published: June 2022

We consider optically thin spherical stellar envelopes with dipole magnetic field. The source of magnetic dipole field is assumed a star with radius Rs and magnetic moment $\boldsymbol{ M}$. We also assume that a star emits the non-polarized radiation. The general formulas for the Stokes parameters of single scattered radiation are given for both small and large parameters $x=\omega _B/\omega =0.93\times 10^{-8}\lambda (\mu \rm{m})\, \mathit{ B}(\rm{G})$. The particular calculations are related with circular polarization of scattered radiation on the condition x ≪ 1 for the following electron number densities: Ne(r) = N0(Rs/r)n with n = 0, 1, and 2. It is shown that observed circular polarization is $p_\mathit{ V}\simeq 31\, x(R_\mathrm{ s})\, N_0\sigma _\mathrm{ T} R_\mathrm{ s}\, \cos \vartheta _\mathrm{ m}\, (1-\eta ^{n+2})/(n+2){{\ \rm per\ cent}}$, where σT is the Thomson cross-section, parameter x(Rs) corresponds to that at the star surface, and ϑm is the angle between the magnetic dipole $\boldsymbol{M}$ and the direction to a telescope. The value η = Rs/R0, where R0 is the radius of envelope.
Machine learning to identify ICL and BCG in simulated galaxy clusters
Authors: Marini I , Borgani S , Saro A , Murante G , Granato G L , Ragone-Figueroa C , Taffoni G
Published: June 2022

Nowadays, Machine Learning techniques offer fast and efficient solutions for classification problems that would require intensive computational resources via traditional methods. We examine the use of a supervised Random Forest to classify stars in simulated galaxy clusters after subtracting the member galaxies. These dynamically different components are interpreted as the individual properties of the stars in the Brightest Cluster Galaxy (BCG) and IntraCluster Light (ICL). We employ matched stellar catalogues (built from the different dynamical properties of BCG and ICL) of 29 simulated clusters from the DIANOGA set to train and test the classifier. The input features are cluster mass, normalized particle cluster-centric distance, and rest-frame velocity. The model is found to correctly identify most of the stars, while the larger errors are exhibited at the BCG outskirts, where the differences between the physical properties of the two components are less obvious. We investigate the robustness of the classifier to numerical resolution, redshift dependence (up to z = 1), and included astrophysical models. We claim that our classifier provides consistent results in simulations for z < 1, at different resolution levels and with significantly different subgrid models. The phase-space structure is examined to assess whether the general properties of the stellar components are recovered: (i) the transition radius between BCG-dominated and ICL-dominated region is identified at 0.04 R200; (ii) the BCG outskirts (>0.1 R200) is significantly affected by uncertainties in the classification process. In conclusion, this work suggests the importance of employing Machine Learning to speed up a computationally expensive classification in simulations.
Biodegradable iron oxide nanoparticles for intraoperative parathyroid gland imaging in thyroidectomy
Authors: Zheng Weihui , Liu Chun , Jin Jiaoyue , Sun Wei , Zhao Jianqiang , Zhao Ming , Yao Shili , Zhu Bing , Chen Fan , Shang Jinbiao , Wang Kejing , Guo Peng , Qin Jiangjiang , Cheng Xiangdong
Published: June 2022

Parathyroid gland (PG) injury is the most common complication of thyroidectomy owing to the lack of approaches for surgeons to effectively distinguish PGs from surrounding thyroid glands (TGs) in the operation room. Herein, we report the development of biodegradable iron oxide nanoparticles (IONPs) as a promising contrast agent candidate for intraoperative PG visualization. We elucidated that locally administrated dark-colored IONPs readily diffuse in TGs but cannot infiltrate tissue-dense PGs, yielding a distinguishable contrast enhancement between PGs and TGs by naked eye observation. We performed unbiased and quantitative in vivo screenings to optimize particle size and concentration of IONPs for PG/TG contrast enhancement. Moreover, in vivo applications of IONPs via the local administration route demonstrate no adverse toxicities and can be biodegraded in the thyroid microenvironment within 3 months. To our knowledge, these promising findings provide the first in vivo evidence that IONPs can serve as a safe, biodegradable, and effective contrast agent candidate for improving PG visualization in thyroidectomy.
Predictable Effects of Visual Salience in Experimental Decisions and Games
Authors: Li Xiaomin , Camerer Colin F
Published: June 2022

Bottom-up stimulus-driven visual salience is largely automatic, effortless, and independent of a person’s “top-down” perceptual goals; it depends only on features of a visual stimulus. Algorithms have been carefully trained to predict stimulus-driven salience values for each pixel in any image. The economic question we address is whether these salience values help explain economic decisions. Our first experimental analysis shows that when people pick between sets of fruits that have artificially induced value, predicted salience (which is uncorrelated with value by design) leads to mistakes. Our second analysis uses evidence from games in which choices are locations in images. When players are trying to cooperatively match locations, predicted salience is highly correlated with the success of matching (r = .57). In competitive hider-seeker location games, players choose salient locations more often than predicted by the unique Nash equilibrium. This tendency creates a disequilibrium “seeker’s advantage” (seekers win more often than predicted in equilibrium). The result can be explained by level-k models in which predicted stimulus-driven salience influences level-0 choices and thereby influences overall perceptions, beliefs, and choices of higher-level players. The third analysis shows that there is an effect of visual salience in matrix games, but it is small and statistically weak. Applications to behavioral IO, price and tax salience, nudges and design, and visually influenced beliefs are suggested.
The Association Between Neighborhood Poverty and Hippocampal Volume Among Individuals at Clinical High-Risk for Psychosis: The Moderating Role of Social Engagement
Authors: Ku Benson S , Aberizk Katrina , Addington Jean , Bearden Carrie E , Cadenhead Kristin S , Cannon Tyrone D , Carrión Ricardo E , Compton Michael T , Cornblatt Barbara A , Druss Benjamin G , Mathalon Daniel H , Perkins Diana O , Tsuang Ming T , Woods Scott W , Walker Elaine F
Published: June 2022

Reductions in hippocampal volume (HV) have been associated with both prolonged exposure to stress and psychotic illness. This study sought to determine whether higher levels of neighborhood poverty would be associated with reduced HV among individuals at clinical high-risk for psychosis (CHR-P), and whether social engagement would moderate this association. This cross-sectional study included a sample of participants (N  =  174, age-range = 12–33 years, 35.1% female) recruited for the second phase of the North American Prodrome Longitudinal Study. Generalized linear mixed models tested the association between neighborhood poverty and bilateral HV, as well as the moderating role of social engagement on this association. Higher levels of neighborhood poverty were associated with reduced left (β  =  −0.180, P  =  .016) and right HV (β  =  −0.185, P  =  .016). Social engagement significantly moderated the relation between neighborhood poverty and bilateral HV. In participants with lower levels of social engagement (n  =  77), neighborhood poverty was associated with reduced left (β  =  −0.266, P  =  .006) and right HV (β = −0.316, P  = .002). Among participants with higher levels of social engagement (n = 97), neighborhood poverty was not significantly associated with left (β  =  −0.010, P  =  .932) or right HV (β  =  0.087, P  =  .473). In this study, social engagement moderated the inverse relation between neighborhood poverty and HV. These findings demonstrate the importance of including broader environmental influences and indices of social engagement when conceptualizing adversity and potential interventions for individuals at CHR-P.
The Tumorigenic Potential of Human Pluripotent Stem Cells
Authors: Lezmi Elyad , Benvenisty Nissim
Published: June 2022

Human pluripotent stem cells (hPSCs) are currently evaluated for clinical applications due to their proliferation and differentiation capacities, raising the need to both assess and enhance, the safety of hPSC-based treatments. Distinct molecular features contribute to the tumorigenicity of hPSCs, manifested in the formation of teratoma tumors upon transplantation in vivo. Prolonged in vitro culturing of hPSCs can enhance selection for specific genetic aberrations, either at the chromosome or gene level. Some of these aberrations are tightly linked to human tumor pathology and increase the tumorigenic aggressiveness of the abnormal cells. In this perspective, we describe major tumor-associated risk factors entailed in hPSC-based therapy, and present precautionary and safety measures relevant for the development and application of such therapies.
Application of an Existing Syndromic Surveillance System to Quantify Possible Cases of Opioid-associated Amnestic Syndrome in Massachusetts
Authors: Barash Jed A. , Ergas Rosa , Parikh Megha , Klevens R. Monina , DeMaria Alfred
Published: June 2022

Objectives

In recent years, an opioid-associated amnestic syndrome (OAS) was identified in Massachusetts through elicited reporting by health care providers (traditional surveillance, TS). Whether OAS occurs more frequently and with a wider spatiotemporal distribution in Massachusetts remains unclear. We compared the frequency and spatiotemporal characteristics of emergency department (ED) visits for possible OAS (pOAS) using a pre-existing syndromic surveillance system (SyS) with OAS cases captured through TS.

Methods

SyS was queried for Massachusetts ED visits in 15- to 55- year-olds with a chief complaint text and discharge codes for memory loss in association with codes for opioid use (pOAS). SyS data were extracted for 2016–2020, whereas TS was conducted for 2012–2018. Cases identified by SyS and TS were stratified by demographic and spatiotemporal variables.

Results

TS ascertained 22 reported cases of OAS (18 males) between 2012 and 2018, ranging from 0 to 5 annually. No identified OAS patients presented between January and March or in western Massachusetts. Between 2016 and 2020, SyS identified 82 ED visits (49 males) with pOAS, ranging from 13 to 22 per year. Over the 5-year period, at least 2 ED visits for pOAS occurred during each month of the year (24 total during January, February, or March) and at least 1 visit occurred in each county except 2, with the second largest number (11) in Berkshire County (at the western border of Massachusetts), where no cases were ascertained through TS.

Conclusions

Although OAS is a relatively rare condition, use of SyS in Massachusetts suggests a broader and more frequent spatiotemporal distribution than previously indicated from TS.
Right-to-Left Shunts Occur During Cardiopulmonary Resuscitation: Echocardiographic Observations
Authors: Jung Woo Jin , Cha Kyoung-Chul , Roh Young-Il , Bae Kyung Soo , Kwon Tae Hyun , Han Jae Hun , Hwang Sung Oh
Published: June 2022

OBJECTIVES:

A significant proportion of the population has a patent foramen ovale (PFO). The intracardiac pressure during cardiopulmonary resuscitation (CPR) may differ from that of normal circulation, which may result in a right-to-left shunt in the presence of a PFO. In this study, transesophageal echocardiography (TEE) was conducted to evaluate whether CPR carried out in patients after cardiac arrest causes right-to-left shunt.

DESIGN:

A retrospective observational study.

SETTING:

One academic medical center from January 2017 to April 2020.

PATIENTS:

Patients older than 20 years who suffered from nontraumatic out-of-hospital cardiac arrest (OHCA) and underwent intra-arrest TEE.

MEASUREMENT AND MAIN RESULTS:

Patients who had microbubbles resulting from fluid injection in the right atrium, as indicated on TEE imaging, were included in the analysis. The presence of right-to-left shunt was defined as the appearance of microbubbles in the systemic circulation, including the left atrium, left ventricle, or aorta. A total of 97 patients were included in the final analysis. A right-to-left shunt was observed in 21 patients (21.6%), and no shunt was found in 76 patients (78.4%). The degree of the right-to-left shunt, determined by the number of microbubbles, was mild in 11 patients (52.4%), moderate in eight (38.0%), and severe in two (9.6%). Multivariate analysis showed that no factors were associated with the presence of right-to-left shunt during CPR.

CONCLUSIONS:

Right-to-left shunts can be appreciated during CPR in patients who experience OHCA. Further studies are needed to verify its clinical significance.
Accident Simulation Study for Nuclear Power Plants Impacting Louisiana: Differences in 2017 vs. 1992 Protective Action Guidelines
Authors: McMahon Michael D. , Chancellor Jeffery C.
Published: June 2022

Louisiana has aligned its radiological emergency program with the 2017 US Environmental Protection Agency Protective Action Guides Manual but has added a child thyroid dose evacuation threshold in lieu of distributing potassium iodide to the public. The nuclear power plants will continue to align with the 1992 manual for the foreseeable future, which could lead to possible accident scenarios in which state recommendations would differ from those of the utility. The objective of this study is to predict what accident and weather conditions will lead to a differing set of recommendations. This study performs a representative set of simulations of potential nuclear power plant accidents using a combination of the RASCAL software package, provided by the Nuclear Regulatory Commission, and a Software system used by Entergy combining an older RASCAL dose modeling methodology with plant-specific input. Four preliminary results of this study are presented: a spent fuel fire where differences in whole body dose lead to very different evacuations, a loss of coolant accident in which the child thyroid dose is the determining factor, a core melt accident using stack monitors to locate the evacuation threshold point, and a spiked coolant accident that could lead to an evacuation order before the plant declares a General Emergency. Weather plays as great a role as accident conditions in determining whether the evacuation recommendations differ. The completed results of this study can provide guidance to states as they evaluate the transition to the 2017 guidelines.
Effects of a Meaning-Centered Spiritual Care Training Program for Hospice Palliative Care Teams in South Korea
Authors: Kang Kyung-Ah , Kim Shin-Jeong , Kim Do-Bong , Koh Su-Jin , Park Myung-Hee , Yoon Soo-Jin
Published: June 2022

Background

Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent.

Objective

The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT).

Methods

This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions’ preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ2 test, 1-way analysis of variance, and repeated-measures analysis of variance.

Results

There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency (P = .002) and spiritual care therapeutics (P = .038), whereas no significant difference was found for compassion fatigue (P = .716).

Conclusion

The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training.

Implications for Practice

The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.
Exploring the Experience of Living with and Managing Presbyopia
Authors: Stokes Jonathan , Shirneshan Elaheh , Graham Christina A. , Paulich Maggie , Johnson Nathan
Published: June 2022

SIGNIFICANCE

Presbyopia typically occurs around 40 years of age and affects approximately one-quarter of the global population. Up to October 2021, there were no approved pharmacotherapies for presbyopia, and common treatments, such as glasses, can have disadvantages for individuals' health-related quality of life.

PURPOSE

This study aimed to document the experience of living with and managing presbyopia, identify perspectives on treatment options, and determine whether there is an unmet need in the treatment landscape.

METHODS

Coded transcripts of concept elicitation (CE; n = 20) and cognitive debriefing (n = 20) interviews with presbyopic individuals, originally conducted for development of patient-reported outcome instruments, were reanalyzed to identify salient concepts describing participants' experiences with presbyopia treatments. Qualitative ranking exercises assessed participants' preferences for a potential pharmacotherapy vs. existing treatments.

RESULTS

Because most concepts were identified with the CE interviews, data reflect CE findings unless otherwise noted. Average age across CE/cognitive debriefing interviews was 49.4 years; a vast majority of participants used glasses for presbyopia treatment. Four themes related to treatment with glasses were identified with the interviews: inconvenience during daily activities, negative physical sensations around the eyes/head, limitations, and undesirable impacts on daily life (e.g., psychosocial). Most commonly, participants reported inconveniences related to forgetting glasses and psychosocial impacts (e.g., feeling/looking older). Strained/tired eyes and limited ability to see at varying distances were also reported. Among participants with near-vision glasses who provided data, two-thirds expressed interest in alternative treatments. In addition, almost three-quarters of the participants ranked hypothetical eye drops as their first or second preferred option, vs. reading glasses, contact lenses, magnifying glasses, and surgery.

CONCLUSIONS

This study explored the experience of living with and managing presbyopia and identified limitations and negative impacts of current treatments. Pharmacological development (e.g., eye drops) may fulfill an unmet need in the presbyopia treatment landscape.
Mortality in Cases of Acute Alcohol Intoxication in Children
Authors: Plis Semyon S. , Veselkina Olesya V. , Klevno Vladimir A. , Vlassov Vasiliy V.
Published: June 2022

Background

Russia suffers from high alcohol-related mortality. Most forensic autopsies in Russia include blood alcohol tests, but a systematic analysis of these data has never been conducted for children's deaths.

Methods

We performed an analysis of juvenile mortality using autopsy reports from the Moscow Region Bureau of Forensic Medical Examination from January 1, 2009, to December 31, 2018.

Results

Despite a decrease in incidence (R
s = −0.661), the number of cases of alcohol intoxication in minors was still high. The mean age of children in our study was 14.77 years (95% confidence interval [CI], 14.31–15.23). Death was predominantly among boys (72%) and those with higher blood alcohol concentrations (mean difference [MD], 0.295; 95% CIMD, 0.012–0.58). The number of cases of unnatural death increased with age (R
s = 0.746, P = 0.001). Accidents were the most predominant cause of death, followed by suicide, homicide, and natural causes. Fatal alcohol intoxication was observed at an average blood alcohol concentration of 3.58 g/L (95% CI, 1.46–5.7), without any specific signs on autopsy. Even a strong smell of alcohol is an unreliable sign in the clinic.

Conclusion

A systematic study of alcohol in forensic autopsy shows that the number of children who die with alcohol intoxication is high. Teenagers are the predominant age group experiencing alcohol intoxication. In our opinion, an alcohol blood test should be performed in all suspicious cases, especially in teenagers.