bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-effectiveness of cyclophosphamide and non-cyclophosphamide in the induction therapy of Malaysian lupus nephritis patients
Authors: Rosli Fatimah Z , Shaharir Syahrul S , Abdul Gafor Abdul H , Mohd Rozita , Aizuddin Azimatun N , Osman Sabrizan
Published: May 2022

Background

There is a paradigm shift in the induction therapy for proliferative lupus nephritis (LN). Apart from cyclophosphamide (CYC), mycophenolate mofetil and calcineurin inhibitors have emerged as an alternative option of treatment.

Objective

We aimed to compare the cost-effectiveness analysis (CEA) per year, adverse events and renal damage at 24 months between CYC and non-CYC agents (calcineurin inhibitors or mycophenolate) as induction treatment among proliferative lupus nephritis (LN) patients.

Methods

This was a retrospective and non-controlled study involving biopsy-proven proliferative LN patients (class III or IV with or without V) in the clinic registry from 2017 to 2019. Their medical records were reviewed to determine the date and type of induction, treatment effectiveness, adverse events and renal damage at 24 months. The total cost of treatment included capital cost (building, furniture and equipment) and recurrent cost (emolument, supply/drug, lab investigations, administrative cost and utilities). Treatment effectiveness was defined as renal remission (partial or complete) at 6 months without relapse up to 24 months. The cost-effectiveness analysis (CEA) was expressed as cost per remission per year in Malaysian Ringgit (MYR).

Results

There were a total of 95 inductions with CYC and 27 with non-CYC in 94 LN patients. There was no significant difference in the total mean cost per patient/year between CYC (MYR 18460.26 ± 6500.76) compared to non-CYC (MYR 19302.10 ± 6778.22), p = 0.569. The CEA for CYC was MYR 20,632.06 (GBP 3,538.78) while non-CYC was MYR 20,846.27 (GBP 3,575.52) and mean difference MYR 214.21 (GBP 37.44). There was significantly higher capital cost, consumables, utility, maintenance, administration ( p < 0.001) and lab investigations ( p = 0.046) in the CYC arm. There was a trend of a higher infection requiring outpatient antibiotic treatment in CYC group ( p = 0.05), but similar renal damage outcome with the non-CYC group. Conclusion: For treatment of proliferative LN, there was no significant difference in the CEA and renal damage between CYC and non-CYC induction treatment. There was a trend of a higher rate of infections in the CYC group. Hence, the decision to treat patient with CYC or MMF should be tailored to individual patients, by considering the risk of infection in a particular patient.
All of the Above: Lobbying Allied, Undecided, and Opposing Lawmakers in Committee and on the Floor
Authors: Newmark Adam , Nownes Anthony J.
Published: May 2022

This paper asks: When seeking to influence legislation in Congress, do organized interests target legislative allies, opponents, undecideds, or some combination of these? We address this question with data from a survey of 836 Washington lobbyists. Our findings point to several conclusions, including the following: (1) Organized interests almost always lobby their legislative allies, whether they support or oppose legislation, and whether the legislation is at the committee or floor stage; (2) Organized interests seldom lobby only their allies, very often targeting opponents and undecideds; (3) Organized interests lobby legislative opponents when their group opponents are relatively powerful; (4) Organized interests lobby legislative opponents and undecideds more in conflictual policy environments than they do in non-conflictual policy environments; (5) Resource competition from other groups causes organized interests to shy away from lobbying non-allied lawmakers; and (6) Coalition joining is associated with less allies-only lobbying.
Neonatal Sepsis and Associated Factors Among Neonates Admitted to Neonatal Intensive Care Unit in General Hospitals, Eastern Ethiopia 2020
Authors: Roble Abdurahman Kedir , Ayehubizu Liyew Mekonen , Olad Hafsa Mohamed
Published: May 2022

Introduction:

Globally, the major cause of neonatal mortality and morbidity is neonatal sepsis, which is defined as a clinical course marked by systemic inflammation in the presence of infection in a newborn. There are limited data concerning neonatal sepsis in eastern Ethiopia. As a result, this study aimed to determine the prevalence of neonatal sepsis and associated factors among neonates admitted to intensive care units at general hospitals in Eastern Ethiopia.

Methods:

A hospital-based cross-sectional study with retrospective document review was conducted among newborns hospitalized in neonatal intensive care units. Using simple random sampling, the charts of 356 newborns who were hospitalized between January and December 2019 were included, and data were collected using a pretested checklist. Data were entered into Epi data version 3.1 and analyzed with SPSS version 22.

Results:

The overall prevalence of neonatal sepsis was 45.8% (95% CI 40.7, 51.4). Prolonged rupture of the membrane (AOR = 2.38, 95% CI: [1.27-4.45]), vaginal delivery (AOR = 1.78, 95%, CI: [1.09, 2.96]) APGAR score <7 (AOR = 4.55, 95% CI: [2.49-8.29]), prelacteal feeding (AOR = 3.54, 95% CI: [1.68-8.23]), and mechanical ventilation (AOR = 4.97,95%CI: [2.78-8.89]) were predictors associated with neonatal sepsis.

Conclusion:

In this study, the prevalence of neonatal sepsis was high, and factors associated with neonatal sepsis included prolonged rupture of membrane, mode of delivery, low APGAR score, prelacteal feeding and mechanical ventilation. As a result, maternal and neonatal care should be enhanced to lower the risk of neonatal sepsis.
Callous-Unemotional Traits and Face-Emotion Recognition as Mediators in Conduct Problems of Children With ADHD
Authors: Levy Tomer , Peskin Miriam , Kohn Yoav , Sheinhorn Sapir , Schoen Gila , Weizman Abraham , Golubchik Pavel
Published: May 2022

Background:

Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk for conduct problems (CP), as well as with callous-unemotional traits (CUt) and lower accuracy in face emotional recognition (FER). It is unclear, however, whether CUt and low accuracy in FER contribute to the risk for CP in ADHD. The present study investigated the possibility of such contribution.

Methods:

This pilot study’s participants included 31 children aged 7–17 years, diagnosed with ADHD, and treated in a psychiatric outpatient clinic. The parents rated their children on the ADHD Rating Scale, Inventory of Callous-Unemotional Traits, and the Child Behavior Checklist-Conduct Problems scale. Participants completed the Hebrew version of the children’s Reading the Mind in the Eyes Test (cRMET)—a Theory of Mind measure. A bootstrapped multiple mediator model was used, adjusting for age and gender.

Results:

ADHD symptoms were associated with CP. This association was not mediated by CUt or cRMET. CUt was associated with CP independent of ADHD symptom severity.

Conclusions:

ADHD symptoms and CUt both should be considered when assessing risk for CP and devising a treatment plan, in children with ADHD. Current results did not confirm the hypothesis that cRMET and CUt mediate between ADHD symptoms and CP. More studies employing larger samples, longitudinal design, and other emotion recognition measures are needed.
Seismic performance assessment of eccentrically braced steel frames with variable-cross-section horizontal shear links
Authors: Ma Kang , Ye Xihao , Wu Ruoyang , Yu Haifeng , Wu Yangzhou , Jiang Luzhen
Published: May 2022

Based on the principle of web weakening, two types of variable-cross-section shear links for horizontal eccentrically braced steel frames (H-EBFs) were analyzed in this study. In the first design, an I-section link (L2) was designed with a lower web and wider flange than that of an ordinary shear link (L1), and in the second design, an I-section link composed of two small I-section beams (L3) was designed. To study the seismic behavior of the two types of H-EBFs, cyclic loading tests were performed on three scaled specimens, L2 (H-EBF-L2), L3 (H-EBF-L3), and a traditional link (H-EBF-L1). The results showed that most of the inelastic actions of the three specimens were concentrated in the shear links and that the failure modes were similar. Compared with specimen H-EBF-L1, the links of specimens H-EBF-L2 and H-EBF-L3 had better deformability, and the bearing capacity of the frames also improved simultaneously; thus, the energy-dissipation mechanism of H-EBF improved. The material costs of specimens H-EBF-L2 and H-EBF-L3 were reduced to a certain extent, realizing economic benefits. Additionally, the numerical models of the three specimens were established. The modeling results were in good agreement with the test results, and it was verified that the model could accurately simulate the loading process of the tests.
Identification of the scour depth of continuous girder bridges based on model updating and improved genetic algorithm
Authors: Liao Yuchen , Wang Haochen , Hou Shitong , Feng Dongming , Wu Gang
Published: May 2022

Scour is one of the primary reasons for the collapse of bridges, as it severely reduces the stability of their piers. This study developed a model updating method based on an improved genetic algorithm (GA) to identify scour depth, combined with a parallel computing technique to accelerate the model updating procedure. The proposed GA adopted a gradient-like calculation as the mutation operation, while the population in GA was initialized based on the exponential distribution. A finite element model of a continuous girder bridge, whose soil-structure interaction was simulated by winkle beam theory, was established to give a sensitivity analysis of the scour effect. A moving mass-spring model was used to simulate the vehicle-bridge interaction, and dynamic responses under various scour damages were generated to verify the method’s performance. The results of the numerical simulation indicated that the transverse vibration modes of a continuous girder bridge were sensitive to the scour effect, and the proposed method can identify the scour depth with an error of less than 0.31 m.
Shear behavior of concrete beams reinforced with closed-type winding glass fiber-reinforced polymer stirrups
Authors: Yuan Ye , Wang Zhenyu , Wang Daiyu
Published: May 2022

Conventional pultruded fiber-reinforced polymer (FRP) rod stirrups are susceptible to premature bent corner rupture and bond slip failure of overlapping legs. This research proposed a new type FRP shear reinforcement, closed-type winding GFRP (CW-GFRP) stirrups, featuring a fully closed rectangular cross-section. CW-GFRP stirrups completely avoided slip and significantly improved the strength of bent portion of stirrups. To investigate the feasibility of using CW-GFRP stirrups as shear reinforcement, shear test of 8 concrete beams reinforced with conventional pultruded stirrups and CW-GFRP stirrups was conducted. The beams were 300 mm deep and 150 mm wide, and their shear span ratio were 2.07. The effect of the material of stirrups, the spacing of stirrups, and the width of CW-GFRP stirrups were investigated. The test results showed that pultruded stirrups exhibited bond slip failure, in contrast, CW-GFRP stirrups reinforced beams prevented this failure and showed enhanced stiffness, narrower shear crack width and 1.09–1.12 times higher shear capacity. The splitting failure typical of CW-GFRP stirrups was reported, and a smaller stirrups width is expected to avoid splitting and generate greater strain at ultimate. It can be concluded that the new type of CW-GFRP stirrups is an optimized form of FRP shear reinforcement to supersede conventional pultruded stirrups. Strut-and-tie models based on ACI 318-19 and CSA S806-14 were used to predict the shear strength and produced a safe but relatively accurate prediction.
Advancing a framework for social impact assessment of tourism research
Authors: Viana-Lora Alba , Nel-lo-Andreu Marta G , Anton-Clavé Salvador
Published: May 2022

This article aims to advance the methodology for assessing the social impact of tourism research. An evaluation framework was designed to measure social impact in three stages—ex-ante, in-itinere and ex-post—and the ex-post evaluation was applied to a tourism research project, the POLITUR project, to test its validity. The collected information originated from interviews and documentary material. The analysis was structured according to six main areas—communication and promotion, policies and regulation, economic benefit, new technological resources, environment and social improvements—and four dimensions—temporal, applied, geographical and sustainability. The results are followed by a discussion of the domains and dimensions of the social impact assessment of tourism research. The need for further improvement in methods for measuring the social impact of tourism research and the importance of research that generates social impact are highlighted.
The law of reciprocity holds (more or less) for circadian-effective lighting
Authors: Rea MS
Published: May 2022

Delivering effective lighting in buildings to support circadian entrainment of the occupants is of growing interest and importance to lighting specifiers. Circadian-effective lighting is not simply about how much light to provide; it also depends upon how long that light is provided. Recent research suggests that the amount of light and the duration of light exposure are reciprocally related for entrainment in the morning hours (i.e. 08:00–12:00). This opens up a number of design options heretofore unaddressed by lighting specifiers.
E-Govemment and Public Affairs Education
Authors: Jennings Edward T.
Published: May 2022

This article examines three fundamental questions with respect to the place of e-government in graduate education for cancers in public service. First, where does e-govemment fit in the curriculum of graduate programs in public policy and administration? Second, might we expect the answer to this question to vary depending on the institutional home and type of public affaire degree? Third, should we expect programs to offer a required course on e-government or should we aim to integrate material on e-govemment throughout the curriculum? These questions are approached through standards developed for public affairs education in the United States. hut they are examined in the context of international variations in governance, technology, and education.

The article first traces the development of e-government across the globe, summarizing important issues and considerations that governments must answer as they pursue e-government initiatives. It then reviews standards that have been developed for public affairs education in the United States and turns to the question of how in incorporate e-government in the curricalum.

E-government involves much more than technological and information management questions. Thus, it has implications for the entire public affairs curriculum. It is unlikely that a single course can successfully covers technical, managerial, and policy dimensions of e-government. For must programs, it will be more productive to explore e-government across a range of courses in the existing curriculum. The approach that is taken is likely to be affected by institutional setting, resources, and faculty competencies. It is also likely to be shaped by the broader social, economic, and political environments in which programs operate. Although the stage of e-government development in the country is likely to make a difference, although we can also hope that our training will also shape e-government's development.
A Study of Healthcare Reform in China in Light of the USA and Canadian Systems
Authors: Chen Greg
Published: May 2022

This article describes and examines the newly implemented basic medical insurance system for urban employees in China. The insurance system was built on two distinct concepts, individual providence and social insurance, and was characterized by national government mandates, local government administration, and employer/employee contributions. The study found that the Chinese basic medical insurance program for urban employees was implemented in all major urban areas. About 130 million people were covered under the scheme as of May 2005. The program benefits are limited with relatively low ceilings on reimbursable expenses and high cost sharing from the insured. The procedure for reimbursement is complicated and time consuming. China can learn from the U.S. and Canadian systems in both financing and providing healthcare. The U.S. system arguably supplies the best medical services in terms of quality and accessibility for those who are insured and those who can pay out of pocket. But the huge costs may not work well with China at present. The Canadian system, which is relatively effective, efficient, and equitable, although not as accessible, may fit China better. The study also suggests that the U.S. employer-based healthcare insurance system requires a major overhaul. It puts U.S. companies at a disadvantaged position in the increasingly competitive global marketplace.
Promotion for Performance? The working incentive of Chinese provincial environmental agency heads in pollution reduction
Authors: Liu Lei , Li Mingyue , Chu May
Published: May 2022

Promotion is argued to be the primary working incentive for Chinese officials. Different from previous studies that focus on the provincial governors and party secretaries, this paper makes the first attempt to examine whether the career turnover of China's provincial environmental agency heads (PEAHs) is affected by the environmental performance within their jurisdictions. The results show that the performance in reducing nationally targeted pollutants—i.e., sulfur dioxide (SO2) and chemical oxygen demand (COD)—is not necessarily correlated with political turnover, which only depends on political factors such as the age when assuming office, tenure of the office, and if they are local people. Therefore, a lack of promotion incentive is found among China's PEAHs in local environmental management. Their working incentive is straightforward top-down control, making them merely the implementers of economy-dominated local public policy. A more robust and transparent performance management system, to connect the provincial environmental performance with the PEAH's political career, is supposed to be beneficial for China's environmental management.
Patterns of Infra-Popliteal Arterial Disease
Authors: Del Valle William , Wedderman Dave
Published: May 2022

Introduction

The growth of the diabetic population and the increased prevalence of peripheral arterial disease (PAD) below the knee has created an increased demand for duplex ultrasound (DUS) evaluation of the infra-popliteal arteries. The purpose of this study is to show how DUS can be used to identify the patterns of infra-popliteal arterial occlusive disease.

Methods:

We performed infra-popliteal duplex ultrasound scans on 100 consecutive patients (199 limbs) with suspected PAD. Peak systolic velocity (PSV) was obtained from the anterior tibial artery (ATA) and posterior tibial artery (PTA) at the distal, mid, and proximal calf levels. The acceleration time (AT) was measured in the distal ATA and PTA segments.

Results:

The PTA was the infra-popliteal artery that was most often totally occluded (21% of limbs). Segmental PTA occlusions occurred predominantly in the proximal and distal segments. The ATA was totally occluded in 8% of limbs, with segmental occlusions located predominantly in the mid segment. We also confirmed that proximal PAD prolongs distal infra-popliteal artery AT and reduces distal PSV.

Conclusion:

These data add to our understanding of the patterns of infra-popliteal arterial disease and should be of interest to sonographers who perform DUS of the lower extremity arteries.
How Much Information Do Icelandic Men Receive on Pros and Cons of Prostate-Specific Antigen Testing Prior to Undergoing Testing?
Authors: Eiriksdottir Valgerdur Kristin , Baldursdottir Birna , Fridriksson Jon Orn , Valdimarsdottir Heiddis B.
Published: May 2022

Prostate-specific antigen (PSA) testing for asymptomatic men is neither encouraged nor discouraged in most countries; however, shared decision-making is emphasized prior to PSA testing. The objective of this study was to examine to what extent Icelandic men receive information about the pros and cons of PSA testing. Furthermore, to explore if patient–provider communication about pros and cons of PSA testing has improved in the last decade during which time more emphasis has been placed on shared decision-making. All Icelandic men diagnosed with prostate cancer in the years 2015 to 2020 were invited to participate, and a total of 471 out of 1002 men participated (response rate 47.0%). Participants’ age ranged from 51 to 95 years ( M = 71.9, SD = 7.3). Only half of the men received information about the pros and cons of PSA testing, a third did not receive any information prior to testing and, alarmingly, 22.2% of the men did not even know that they were being tested. A majority of the participants lacked knowledge about the testing with half of the men reporting that they had no knowledge about pros and cons of PSA testing prior to testing. The findings have major public health relevance as they indicate that information provided prior to PSA testing continue to be deficient and that there is a pressing need for interventions that educate men about the benefits and limitations of PSA testing before men undergo medical procedures that can seriously affect their quality of life.
Five-year evaluation of a low-cost quality assurance protocol for clinical ultrasound transducers
Authors: Hyldgaard Niels , Bolander Malvang Lise , Brix Lau
Published: May 2022

Objective:

To implement, execute and evaluate a quality assurance test protocol for clinical ultrasound transducers that is software-based, user-independent, inexpensive, easily repeatable, and does not require tissue phantoms.

Methods:

The test protocol is based on in-air reverberation images. The software test tool generates uniformity- and reverberation profiles to monitor system sensitivities and signal uniformities that provide a sensitive analysis of transducer status. Whenever a transducer was suspected to be damaged validating tests were conducted using the Sonora FirstCall test system. A total of 21 transducers from five ultrasound scanner systems were included in the study. Tests were performed every other month for a total of 5 years.

Results:

Each transducer was tested on average 11.7 times. Testing a transducer required a total of 2.75 hours annually. The ultrasound quality assurance test protocol detected an average annual fail rate of 10.7%. The test protocol provides a reliable approach for monitoring transducer lens status of clinically used ultrasound transducers.

Conclusion:

The ultrasound quality assurance test protocol may potentially find deviations in diagnostic quality before being noticed by the clinicians. Thus, the ultrasound quality assurance test protocol holds the ability to reduce the risk of undiscovered image quality degradation hereby minimizing the danger of diagnostic errors.
The influence of tactical formation on physical and technical match performance in male soccer: A systematic review
Authors: Forcher Leon , Forcher Leander , Wäsche Hagen , Jekauc Darko , Woll Alexander , Altmann Stefan
Published: May 2022

The number of investigations that specifically address the influence of formation on soccer performance has increased in recent years. Since there is no overview that summarizes these effects, this systematic review aims to synthesize the available literature on the effects of tactical formation on physical and technical match performance. According to the PRISMA 2020 guidelines, a systematic search was performed (Databases: PubMed and Web of Science). Studies were included, if they reported any physical (e.g., sprinting distance) or technical (e.g., number of passes) match performance parameters and compared at least two different formations. The study outcomes were synthesized descriptively. The effect of formation on physical performance was investigated in ten studies while three studies investigated the effect on technical performance (11 studies included). The studies revealed that formation has an effect on the physical and technical match performance of soccer players both in a team and at a positional level. On a team level, smaller differences were observed for formations that are similar in the number of players in each playing position (i.e., 4-5-1, 4-2-3-1). Furthermore, physical match performance was higher in formations with three defenders (e.g., 3-5-2) in comparison to formations with four defenders (e.g., 4-4-2). On a positional level, all positions were affected in a similar way by formation. Therefore, formation affects the physical and technical match performance of soccer players and if the playing position is also considered, the results become even more meaningful. The studies were very heterogeneous regarding their methodology (i.e., parameters, sample size). The findings can help coaches to design their training programs and to prepare the players for a specific positional role depending on the tactical formation.
Automatic semantic knowledge extraction from electronic forms
Authors: Wu Haolin , French Tim , Liu Wei , Hodkiewicz Melinda
Published: May 2022

Electronic tabular forms are an intuitive way for organisations to collect, present and store structured information for human readers. Forms use features such as fonts, colours and cell positioning to help readers navigate and find information. Millions of forms, typically in Portable Document Format (PDF), are generated by businesses as part of routine operations. Unlike human readers, machines are not able to directly ‘understand’ the implicit cues contained in the fonts, colours and use of boxes without explicit processing. In this paper, a supervised computer vision model is proposed to decompose the PDF form document into nested microtables. The cells within these microtables are then processed using a customisable rule bank for meaningful table content and semantic relationship extraction. The process is demonstrated on an industry dataset of 37 maintenance procedure documents containing 373 pages and 1016 unique microtables. A web application EMU (Extracting Machine Understandable Semantics from Forms) demonstrates how data captured in tables with different dimensions in procedural forms can be automatically extracted and stored in JavaScript Object Notation (JSON). Identifying and extracting nested tables is a critical fundamental step for future applications to support machine-automated search and extraction of data at scale for both maintenance and other procedural documentation.
Look and ye shall hear: Selective auditory attention modulates the audiovisual correspondence effect
Authors: Janyan Armina , Shtyrov Yury , Andriushchenko Ekaterina , Blinova Ekaterina , Shcherbakova Olga
Published: May 2022

One of the unresolved questions in multisensory research is that of automaticity of consistent associations between sensory features from different modalities (e.g. high visual locations associated with high sound pitch). We addressed this issue by examining a possible role of selective attention in the audiovisual correspondence effect. We orthogonally manipulated loudness and pitch, directing participants’ attention to the auditory modality only and using pitch and loudness identification tasks. Visual stimuli in high, low or central spatial locations appeared simultaneously with the sounds. If the correspondence effect is automatic, it should not be affected by task changes. The results, however, demonstrated a cross-modal pitch-verticality correspondence effect only when participants’ attention was directed to pitch, but not to loudness identification task; moreover, the effect was present only in the upper location. The findings underscore the involvement of selective attention in cross-modal associations and support a top-down account of audiovisual correspondence effects.
Seizure control and its associated factors among epileptic patients at Neurology Clinic, University of Gondar hospital, Northwest Ethiopia
Authors: Zena Dawit , Tadesse Abilo , Bekele Nebiyu , Yaregal Samson , Sualih Nuria , Worku Edilawit
Published: May 2022

Background:

Epilepsy is characterized by two or more unprovoked recurrent seizures, which often respond to available antiseizure medications. However, seizure control among epileptic patients in the developing world is low. Factors determining seizure control among epileptic patients were not evidently explored in the study setting.

Objectives:

This study aimed to determine the magnitude of uncontrolled seizures and associated factors among epileptic patients at the University of Gondar hospital.

Methods:

This cross-sectional study was conducted at the University of Gondar hospital, Northwest Ethiopia. A convenience sampling method was used to recruit study subjects. Controlled seizure was defined as seizure freedom for the past 1 year. Logistic regression analysis was used to identify factors associated with seizure control. A p-value < 0.05 was used to declare a significant association.

Results:

A total of 320 study subjects were included in the study. The mean (±SD) age of patients was 27.5 ± 7.6 years. More than half (182/320, 57%) of epileptic patients had uncontrolled seizures. Five or more pretreatment seizure episodes (adjusted odds ratio = 3.98, 95% confidence interval: 1.81–8.75, p = 0.001), less than 2 years on anti-seizure medications (adjusted odds ratio = 8.64, 95% confidence interval: 3.27–22.85, p < 0.001), taking 2 or more ASMs (adjusted odds ratio = 2.48, 95% confidence interval: 1.23–5.02, p = 0.011), poor adherence to ASMs (adjusted odds ratio = 9.37, 95% confidence interval: 4.04–21.75, p < 0.001), and living at a single trip distance from hospital equaled 1 h or more (adjusted odds ratio = 4.20, 95% confidence interval: 2.11–8.41, p < 0.001) were significantly associated with uncontrolled seizures.

Conclusion:

The dose of a preferred anti-seizure medication should be optimized before combinations of anti-seizure medications are used. Adherence to anti-seizure medications should be reinforced for better seizure control. Epilepsy care should be integrated into primary health care services in the catchment region.
Stay Woke: An Analysis of How Referees Evaluate the In-Game Communication of a Historically Black College and University that Competes in a Predominantly White Institution Conference
Authors: Dix Andrew
Published: May 2022

The purpose of this investigation was to examine the personal fouls that were called against a historically black college and university (HBCU) that athletically participates in a conference which is comprised of predominantly white institutions (PWIs). The study introduction provided an overview of Tennessee State University (TSU) as it relates to their involvement in the Ohio Valley Conference (OVC). The cultural approach to organizations served as the communication-centric theoretical frame while the previous literature on referee bias was reviewed. The criterion of personal fouls per game (PFPG) was examined . Z-score analyses revealed that referees called more PFPG against the HBCU of TSU in men’s college basketball relative to the number of PFPG that were called against the PWI conference teams in the OVC. A similar effect was observed in women’s college basketball. Theoretical implications for the cultural approach to organizations were noted in the study discussion as were practical implications for TSU and other HBCUs.
Radiological Definitions of Sagittal Plane Segmental Instability in the Degenerative Lumbar Spine – A Systematic Review
Authors: Elmose Signe F. , Andersen Gustav O. , Carreon Leah Yacat , Sigmundsson Freyr G. , Andersen Mikkel O.
Published: May 2022

Study Design

Systematic Review.

Objective

To collect and group definitions of segmental instability, reported in surgical studies of patients with lumbar spinal stenosis (LSS) and/or lumbar degenerative spondylolisthesis (LDS). To report the frequencies of these definitions. To report on imaging measurement thresholds for instability in patients and compare these to those reported in biomechanical studies and studies of spine healthy individuals.To report on studies that include a reliability study.

Methods

This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies eligible for inclusion were clinical and biomechanical studies on adult patients with LDS and/or LSS who underwent surgical treatment and had data on diagnostic imaging. A systematic literature search was conducted in relevant literature databases. Full text screening inclusion criteria was definition of segmental instability or any synonym. Two reviewers independently screened articles in a two-step process. Data synthesis presented by tabulate form and narrative synthesis.

Results

We included 118 studies for data extraction, 69% were surgical studies with decompression or fusion as interventions, 31% non-interventional studies. Grouping the definitions of segmental instability according similarities showed that 24% defined instability by dynamic sagittal translation, 26% dynamic translation and dynamic angulation, 8% used a narrative definition. Comparison showed that non-interventional studies with a healthy population more often had a narrative definition.

Conclusion

Despite a reputation of non-consensus, segmental instability in the degenerative lumbar spine can radiologically be defined as > 3 mm dynamic sagittal translation.
Safety, Efficacy, and Cost-Effectiveness of Simultaneous Bilateral Arthroscopic Bankart Repair for Bilateral Shoulder Instability
Authors: Yildirim Kerem , Pehlivanoglu Tuna , Tandogan Reha N. , Beyzadeoglu Tahsin
Published: May 2022

Background:

Bilateral shoulder instability and Bankart lesions are not rare and frequently require surgical treatment. Bilateral instability may be treated with either a single-stage, simultaneous bilateral Bankart repair or 2-stage surgery.

Purpose/Hypothesis:

To compare simultaneous bilateral arthroscopic Bankart repair to 2-stage repair in terms of clinical outcomes and hospitalization costs. It was hypothesized that simultaneous repair would provide clinical outcomes similar to those of 2-stage Bankart repair while yielding lower hospitalization costs.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent simultaneous bilateral arthroscopic Bankart repair (group 1) were matched by age, sex, and injury type to control patients who had unilateral Bankart repair (group 2). All patients were operated on by the same surgeon in the same institution between 2007 and 2017 and had a minimum follow-up duration of 24 months. Patients with inflammatory arthritis, metabolic/malignant disease, previous shoulder surgery, a glenoid bone loss ≥25%, or off-track Hill-Sachs lesion were excluded. The 2 groups were compared in terms of pre- and postoperative Western Ontario Shoulder Instability Index (WOSI) scores, hospitalization costs, complications, and recurrent instability. The hospitalization cost of group 2 was multiplied by 2 to create a projection of the estimated cost of 2 sequential unilateral Bankart repairs.

Results:

The study population comprised 48 patients (38 men [79.17%] and 10 women [20.83%]; mean age, 25.5 years at surgery and 22.75 years at first dislocation). Group 1 included 32 shoulders in 16 patients, while group 2 consisted of 32 shoulders in 32 patients. The mean hospitalization cost (in 2020 US dollars) was $26,010 ± $1455 for group 1 and $33,591 ± $1574 for group 2 ( P < .001). Both groups had improved WOSI scores after surgery and achieved similar scores at the latest follow-up. There was 1 redislocation in each group (3.13%). No surgery- or anesthesia-related/medical complications were recorded in either group.

Conclusion:

For bilateral shoulder instability, clinical outcomes of simultaneous bilateral arthroscopic Bankart repair were similar to those of 2-stage repair; however, lower hospitalization costs were seen after simultaneous bilateral repair compared with 2-stage surgery.
The multifaceted role of platelets in mediating brain function
Authors: Burnouf Thierry , Walker Tara L.
Published: May 2022

Platelets, the small, anucleate blood cells that originate from megakaryocytes in the bone marrow, are typically associated with coagulation. However, it is now apparent that platelets are more multifaceted than originally thought, with their function extending beyond their traditional role in hemostasis to acting as important mediators of brain function. In this review, we outline the broad repertoire of platelet function in the central nervous system, focusing on the similarities between platelets and neurons. We also summarize the role that platelets play in the pathophysiology of various neurological diseases, with a particular focus on neuroinflammation and neurodegeneration. Finally, we highlight the exciting prospect of harnessing the unique features of the platelet proteome and extracellular vesicles, which are rich in neurotrophic, antioxidative, and antiinflammatory factors, for the development of novel neuroprotective and neuroregenerative interventions to treat various neurodegenerative and traumatic pathologies.
The clinical and laboratory diagnosis of vaccine-induced immune thrombotic thrombocytopenia
Authors: Bissola Anna-Lise , Daka Mercy , Arnold Donald M. , Smith James W. , Moore Jane C. , Clare Rumi , Ivetic Nikola , Kelton John G. , Nazy Ishac
Published: May 2022

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but serious adverse syndrome occurring 5 to 30 days after adenoviral vector COVID-19 vaccination. Therefore, a practical evaluation of clinical assessments and laboratory testing for VITT is needed to prevent significant adverse outcomes as the global use of adenoviral vector vaccines continues. We received the clinical information and blood samples of 156 patients in Canada with a suspected diagnosis of VITT between April and July 2021. The performance characteristics of various diagnostic laboratory tests were evaluated against the platelet factor 4 (PF4)-14C-serotonin release assay (SRA) including a commercial anti-PF4/heparin immunoglobulin G (IgG)/IgA/IgM enzyme immunoassay (EIA, PF4 Enhanced; Immucor), in-house IgG-specific anti-PF4 and anti-PF4/heparin-EIAs, the standard SRA, and the PF4/heparin-SRA. Of those, 43 (27.6%) had serologically confirmed VITT-positive based on a positive PF4-SRA result and 113 (72.4%) were VITT-negative. The commercial anti-PF4/heparin EIA, the in-house anti-PF4-EIA, and anti-PF4/heparin-EIA were positive for all 43 VITT-confirmed samples (100% sensitivity) with a few false-positive results (mean specificity, 95.6%). These immunoassays had specificities of 95.6% (95% confidence interval [CI], 90.0-98.6), 96.5% (95% CI, 91.2-99.0), and 97.4% (95% CI, 92.4-99.5), respectively. Functional tests, including the standard SRA and PF4/heparin-SRA, had high specificities (100%), but poor sensitivities for VITT (16.7% [95% CI, 7.0-31.4]; and 46.2% [95% CI, 26.6-66.6], respectively). These findings suggest EIA assays that can directly detect antibodies to PF4 or PF4/heparin have excellent performance characteristics and may be useful as a diagnostic test if the F4-SRA is unavailable.
Lower-leg injury and knee arthroscopy have distinct effects on coagulation
Authors: Touw Carolina E. , Nemeth Banne , Rondon Araci M. R. , van Adrichem Raymond A. , Lisman Ton , Versteeg Henri H. , Schipper Inger B. , Nelissen Rob G. H. H. , Bos Mettine H. A. , Cannegieter Suzanne C.
Published: May 2022

It is unknown how lower-leg injury and knee arthroscopy, both associated with venous thromboembolism (VTE), affect coagulation. To study the effect of (1) lower-leg trauma and (2) knee arthroscopy on coagulation, plasma samples of the Prevention of Thrombosis following CAST immobilization (POT-CAST, #NCT01542762) and Prevention of Thrombosis following Knee Arthroscopy (POT-KAST, #NCT01542723) trials were used, which were collected shortly after lower-leg trauma and before/after (<4 hours) knee arthroscopy. For aim 1, 1204 lower-leg injury patients were compared with preoperative samples of 1001 controls. Mean differences/ratios (if ln-retransformed because of skewedness) were adjusted for sex, age, body mass index, comorbidity, malignancy, and oral contraceptives using linear regression. For aim 2, perioperative mean changes of 715 arthroscopy patients were calculated. Plasma levels of fibrinogen, factor (F)VIII, FIX, FXI, von Willebrand Factor (VWF), and D-dimer were measured in all individuals. Parameters of underlying mechanisms (tissue factor, interleukin-6 [IL-6], myeloperoxidase DNA, cell-free DNA) were measured in random subsets. In lower-leg injury patients, coagulation parameter levels increased, especially FVIII, VWF, and D-dimer, that is, adjusted mean differences: FVIII 26.8% (95% confidence interval [CI], 23.7-29.9), FIX 13.8% (95% CI, 11.9-15.6), FXI 5.1% (95% CI, 3.3-7.0), VWF 29.8% (95% CI, 26.0-33.6), fibrinogen 32.5 mg/dL (95% CI, 25.8-39.2), and D-dimer (mean ratio) 3.3 (95% CI, 3.1-3.6). Remaining parameters were unchanged, except for increased IL-6 levels. After arthroscopy, all parameters decreased. Lower-leg trauma is associated with increased procoagulant factor levels in contrast to knee arthroscopy. This suggests that, in both situations, different pathways are involved in development of VTE.
Cost-effectiveness and gain-sharing scenarios for purchasing a blockchain-based application in the maritime supply chain
Authors: Carlan Valentin , Sys Christa , Vanelslander Thierry
Published: May 2022

Maritime supply chain (MarSC) stakeholders interact with third parties (e.g. freight forwarders, 3PLs, financial institutes, custom authorities) to facilitate the cargo flow and exchange of information, documents, or financials. Hence, MarSC stakeholders are increasingly interested in innovative technological solutions that vouch for the authenticity and/or the ownership of digital assets without the control of a central third party. Extended research is carried out to prove how applications based on the distributed ledger technology or blockchain address these requirements, yet limited research investigates their purchasing process and economic implications. This paper uses the phytosanitary certificate in an international supply chain flow as a case study where interaction between multiple stakeholders is fundamental and analyses the purchase scenarios of a blockchain-based tool. To do so, it uses a theoretical model that identifies and quantifies the costs and benefits incurred by MarSC stakeholders, formulates gain-sharing scenarios and presents the results of a sensitivity analysis to show the dependence between the data-use and the potential economic gains it generates. The results show that freight forwarders could share economic benefits with shippers or consignees to anticipate purchasing a blockchain-based tool.
Identification and expression analysis of the CqSnRK2 gene family and a functional study of the CqSnRK2.12 gene in quinoa (Chenopodium quinoa Willd.)
Authors: Xiao-lin Zhu , Bao-qiang Wang , Xiao-hong Wei
Published: May 2022

Background

Sucrose non-fermenting 1 (SNF1)-associated protein kinase 2 (SnRK2) proteins belong to a relatively small family of plant-specific serine/threonine (Ser/Thr) protein kinases. SnRK2s participate in the abscisic acid (ABA) signaling pathway and play important roles in many biotic and abiotic stresses. At present, no SnRK2 gene has been reported in quinoa, and the recently published genome for this species provides an opportunity to identify and characterize the SnRK2 gene family.

Results

We identified 13 SnRK2 genes in the C. quinoa genome by bioinformatics analysis. Based on their phylogenetic relationships, these genes were divided into three subfamilies, similar to the situation in other plant species. Gene duplication analysis showed that there were seven pairs of homologous genes in the CqSnRK2 family, and that purifying selection played an important role in the evolution of SnRK2 genes. Gene structure analysis showed that the first exon in the SnRK2 family genes has the same length as the last exon, and that CqSnRK2 genes in the same subfamily have similar gene structures. Sequence analysis showed that the N-terminal region contains three highly conserved motifs. In addition, many kinds of cis-elements were identified in the promoter region of CqSnRK2, including those for hormone responses, stress responses, and tissue-specific expression. Transcription data analysis and qRT-PCR results showed that CqSnRK2 has different expression patterns in roots, stems, and leaves, and responded to biotic and abiotic stresses such as low temperature, salt, drought, and abscisic acid (ABA). In addition, we found that the protein encoded by CqSnRK2.12 was localized to the cytoplasm and nucleus, and there was no self-activation. The results of CqSnRK2.12 overexpression showed that transgenic Arabidopsis thaliana lines had increased drought tolerance compared to the controls.

Conclusion

The results of our study provide references for further studies on the evolution, function, and expression of the SnRK2 gene family in quinoa.
An in-depth bioinformatic analysis of the novel recombinant lumpy skin disease virus strains: from unique patterns to established lineage
Authors: Krotova Alena , Byadovskaya Olga , Shumilova Irina , van Schalkwyk Antoinette , Sprygin Alexander
Published: May 2022

Background

Since the first description of lumpy skin disease virus (LSDV) in Africa in the 1920’s, it has brazenly spread beyond Africa into the Middle East, Europe and most recently Asia. In 2017 the first atypical LSDV recombinant strain was reported in Russia, composed of both a live-attenuated Neethling vaccine strain and Kenyan vaccine strain. An increase in LSDV research enabled a public release of numerous full genome sequences of unique recombinant LSDV strains from Kazakhstan, Russia, China and Vietnam. Prior to the recombinant strain first described in China in 2019, every new recombinant strain was genetically unique and each of these recombinants clustered in a monophyletic lineage. In this work, we provide the complete genome sequences of two novel recombinant strains of LSDV from Russia and attempt to gain more insight into genomic composition of all the recombinant strains currently available. This analysis will provide new insight into the global molecular epidemiology of LSDV.

Results

By sequencing and analyzing two novel recombinant strains Khabarovsk/2020 and Tomsk/2020, this study investigates the differences and similarities of all five the available recombinant LSDV lineages from different countries based on the SNPs inherited from the aforementioned parental strains. A total of seven recombinant strains: LSDV/Russia/Saratov/2017, LSDV/Russia/Udmurtya/2019, LSDV/KZ-Kostanay/Kazakhstan/2018, LSDV/Russia/Tyumen/2019, LSDV/GD01/China/2020 Khabarovsk/2020 and Tomsk/2020 were examined. It was observed that strains isolated prior to 2020 were composed of unique combinations of open reading frames, whilst from 2020 onwards all circulating strains in Russia and South-Eastern Asia belonged to a single lineage radiating out in the region. The first representative of this lineage is LSDV/GD01/China/2020. Interestingly, the other four unique recombinant strains as well as the newly established lineage, exhibit consistent patterns of targeted selection pointing to regions constantly selected for during the recombination-driven processes.

Conclusion

This study highlights the inexplicable emergence of novel recombinant strains to be unique introductions of sibling viruses, with the most recent recombinant lineage establishing as the dominant strain across the south eastern Asian countries as evidenced by full genome sequence data. Overall, these findings indicate that LSDVs are subjected to accelerated evolutionary changes due to recombination in the face of homologous live attenuated vaccines as well as the slow genetic drift commonly observed in capripoxviruses curculatign in the field with hardly any genetic changes over decades.