bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing an Evidence-Based Military Auditory Fitness-for-Duty Standard Based on the 80-Word Modified Rhyme Test
Authors: Brungart Douglas S. , Sheffield Benjamin M. , Galloza Hector , Schurman Jaclyn R. , Russell Shoshannah , Barrett Mary E. , Witherell Krystal , Makashay Matthew J. , Heil Thomas
Published: November 2022

Objectives:

One important function of military audiology is to conduct evaluations of service members (SMs) with hearing loss to ensure they are fit for deployment in dangerous operational environments. The objective of this study was to establish evidence-based auditory fitness-for-duty criteria based on speech-in-noise performance on the 80- and 160-word clinical versions of the Modified Rhyme Test (MRT80 and MRT160).

Design:

Approximately 2400 SMs with various levels of hearing loss were recruited to complete the MRT80 in conjunction with their annual hearing conservation evaluations. These SMs were also asked to perform one or more operationally-relevant listening tasks based on audio recordings made in highly realistic military training environments. The scores on these tests were compared to determine how well a proposed cutoff criterion for the MRT80 was able to identify individuals who are hard of hearing with an exceptionally high risk of abnormally poor performance on operationally-relevant hearing tasks.

Results:

The results show that a cutoff criterion that combines the percent correct score on two lists of the MRT80 (i.e. MRT160) with information about the better-ear threshold at 2 kHz is generally able to separate listeners with hearing loss into those who are likely to perform relatively well on operational listening tests and those who are likely to perform poorly on these tasks. This is consistent with current military acquisition standards, which identify the MRT as the preferred test for evaluating speech intelligibility for radios, headsets, and other communication equipment. It is also consistent with prior studies conducted in high-fidelity military simulations which have shown a significant correlation between MRT performance and operational outcomes.

Conclusions:

The proposed selection criteria, along with the new hearing profile standards that were recently adopted by the US Army, appear to provide an effective evidence-based methodology for identifying those SMs with hearing loss who are most at risk for poor performance on hearing-critical military tasks.
A Simplified Electroencephalography Montage and Interpretation for Evaluation of Comatose Patients in the ICU
Authors: Abid Sonia , Papin Gregory , Vellieux Geoffroy , de Montmollin Etienne , Wicky Paul Henri , Patrier Juliette , Jaquet Pierre , Bouadma Lila , Rouvel-Tallec Anny , Timsit Jean-François , Sonneville Romain
Published: November 2022

OBJECTIVES:

Electroencephalography (EEG) is one of the main tools for diagnosis and prognostication of encephalopathy. Our two objectives were to assess: 1) the reliability of intensivists’ interpretations (one trained intensivist and nonexpert intensivists) on specific EEG patterns and 2) the feasibility of performing simplified EEG by a trained intensivist in ICU.

DESIGN:

Prospective, single-center study.

SETTING:

One French tertiary-care center.

PATIENTS:

Thirty-six consecutive ICU patients with encephalopathy.

INTERVENTION:

A trained intensivist (1-year specific electrophysiologic course) recorded and interpreted EEGs using a 10 monopod montage at bedside. Then, 22 nonexpert intensivists underwent a 1-hour educational session on interpretation of EEG background (activity, continuity, and reactivity) and common patterns seen in ICU. Trained and nonexpert intensivists’ interpretation of EEG recordings was evaluated and compared with an expert neurophysiologist’s interpretation (gold standard). The agreement between the two interpretations was evaluated. Second, the duration of the entire EEG procedure (specifically EEG installation) at bedside was recorded.

MEASUREMENTS AND MAIN RESULTS:

Agreements and reliability between the trained intensivist and the neurophysiologist were acceptable for minimal (agreement, 94%; Pearson coefficient, 0.60) and maximal (89%, 0.89) background frequency, burst suppression (agreement, 100%; Kappa coefficient, 1), background continuity (83%, 0.59), and reactivity to auditory stimulus (78%, 0.44). Agreements between the 22 nonexpert intensivists and the neurophysiologist were heterogeneous. As a result, 87% of the 22 nonexpert intensivists obtained an acceptable reliability for the minimum background frequency, 95% for the maximum background frequency, and 73% and 95% for burst suppression and isoelectric background identification, respectively. The median duration of the entire EEG procedure was 47 minutes (43–53 min), including 22 minutes (20–28 min) of EEG installation.

CONCLUSIONS:

Intensivists can rapidly learn background activity and identify burst-suppression and isoelectric background. However, more educational sessions are required for interpretation of other EEG patterns frequently observed in the ICU setting.
Patient-Specific Computational Modeling of Different Cannulation Strategies for Extracorporeal Membrane Oxygenation
Authors: Ahmed Yunus , Lynch Sabrina R. , Haft Jonathan W. , Moll Frans L. , van Herwaarden Joost A. , Burris Nicholas S. , Patel Himanshu J. , Figueroa C. Alberto
Published: November 2022

Institution of extracorporeal membrane oxygenation (ECMO) results in unique blood flow characteristics to the end-organ vascular beds. We studied the interplay between cardiac-driven and extracorporeal membrane oxygenation (ECMO)-driven flow to vascular beds in different ECMO configurations using a patient-specific computational fluid dynamics (CFD) analysis. A computational ECMO model (femoral artery cannulation [FAC]) was constructed using patient-specific imaging and hemodynamic data. Following model calibration, we augmented the 3D geometrical model to represent alternative ECMO configurations (ascending aorta cannulation [AAC] and subclavian artery cannulation [SAC]). We performed CFD analyses, including a novel virtual color-dye analysis to compare global and regional blood flow and pressure characteristics as well as contributions of cardiac and ECMO-derived flow to the various vascular beds. Flow waveforms at all the aortic branch vessels were pulsatile, despite low cardiac output and predominant nonpulsatile ECMO-driven hemodynamics. Virtual color-dye analysis revealed differential contribution of cardiac and ECMO-derived flow to the end-organ vascular beds in the FAC model, while this was more evenly distributed in the AAC and SAC models. While global hemodynamics were relatively similar between various ECMO configurations, several distinct hemodynamic indices, in particular wall shear stress and oscillatory shear patterns, as well as differential contribution of ECMO-derived flow to various vascular beds, showed remarkable differences. The clinical impact of this study highlighting the relevance of CFD modeling in assessment of complex hemodynamics in ECMO warrants further evaluation.
Genetic association of toxin production in the dinoflagellate Alexandrium minutum
Authors: Mary Lou , Quere Julien , Latimier Marie , Rovillon Georges-Augustin , Hégaret Hélène , Réveillon Damien , Le Gac Mickael
Published: November 2022

Dinoflagellates of the genus Alexandrium are responsible for harmful algal blooms and produce paralytic shellfish toxins (PSTs). Their very large and complex genomes make it challenging to identify the genes responsible for toxin synthesis. A family-based genomic association study was developed to determine the inheritance of toxin production in Alexandrium minutum and identify genomic regions linked to this production. We show that the ability to produce toxins is inheritable in a Mendelian way, while the heritability of the toxin profile is more complex. We developed the first dinoflagellate genetic linkage map. Using this map, several major results were obtained: 1. A genomic region related to the ability to produce toxins was identified. 2. This region does not contain any polymorphic sxt genes, known to be involved in toxin production in cyanobacteria. 3. The sxt genes, known to be present in a single cluster in cyanobacteria, are scattered on different linkage groups in A. minutum. 4. The expression of two sxt genes not assigned to any linkage group, sxtI and sxtG, may be regulated by the genomic region related to the ability to produce toxins. Our results provide new insights into the organization of toxicity-related genes in A. minutum, suggesting a dissociated genetic mechanism for the production of the different analogues and the ability to produce toxins. However, most of the newly identified genes remain unannotated. This study therefore proposes new candidate genes to be further explored to understand how dinoflagellates synthesize their toxins.
A Cochlea-Slice Model using Floquet Boundary Conditions shows Global Tuning
Authors: Tubelli Andrew , Motallebzadeh Hamid , Guinan John J. , Puria Sunil
Published: November 2022

A common assumption about the cochlea is that the local characteristic frequency (CF) is determined by a local resonance of basilar-membrane (BM) stiffness with the mass of the organ-of-Corti (OoC) and entrained fluid. We modeled the cochlea while avoiding sucha prioriassumptions by using a finite-element model of a 20-μm-thick cross-sectional slice of the middle turn of a passive gerbil cochlea. The model had anatomically accurate structural details with physiologically appropriate material properties and interactions between the fluid spaces and solid OoC structures. The longitudinally-facing sides of the slice had a phase difference that mimicked the traveling-wave wavelength at the location of the slice by using Floquet boundary conditions. A paired volume-velocity drive was applied in the scalae at the top and bottom of the slice with the amplitudes adjusted to mimic experimental BM motion. The development of this computationally efficient model with detailed anatomical structures is a key innovation of this work. The resulting OoC motion was greatest in the transverse direction, stereocilia-tip deflections were greatest in the radial direction and longitudinal motion was small in OoC tissue but became large in the sulcus at high frequencies. If the source velocity and wavelength were held constant across frequency, the OoC motion was almost flat across frequency,i.e., the slice showed no local resonance. A model with the source velocity held constant and the wavelength varied realistically across frequency, produced a low-pass frequency response. These results indicate that tuning in the gerbil middle turn is not produced by a resonance due to local OoC mechanical properties, but rather is produced by the characteristics of the traveling wave, manifested in the driving pressure and wavelength.

STATEMENT OF SIGNIFICANCE

The sensory epithelium of hearing, the organ of Corti, is encased in the bone of the fluid-filled cochlea and is difficult to study experimentally. We provide a new method to study the cochlea: making an anatomically-detailed finite-element model of a small transverse slice of the cochlea using Floquet boundary conditions and incorporating global cochlear properties in the slice drive and the wavelength-frequency relationship. The model shows that the slice properties do not show a mechanical resonance and therefore do not produce the frequency-response tuning of the cochlea. Instead, tuning emerges from global cochlear properties carried by the traveling wave.
Uncovering the principles coordinating systems-level organelle biogenesis with cellular growth
Authors: Wang Shixing , Mukherji Shankar
Published: November 2022

Among the hallmark properties of the eukaryotic cell is its organization into specialized biochemical compartments known as organelles. Understanding how organelle biogenesis at systems-scale is coordinated with cellular growth rate and size is a major goal of quantitative cell biology. Here we map out the correlation structure of systems-level organelle biogenesis with cellular growth using “rainbow yeast”, a strain ofSaccharomyces cerevisiaethat expresses fluorescent labels for 6 major organelles. By carrying out hyperspectral imaging of thousands of single rainbow yeast cells, we decomposed the systems-level organelle biogenesis program into specific modes that characterize the response to changes in nutrient availability. Upon chemical biological dissection of this response, our results suggest that systems-level organelle biogenesis represents the sum of distinct organelle modes excited by growth rate and cell size separately. The flexibility afforded by this regulatory architecture may underlie how eukaryotic cells leverage compartmentalization to independently tune cell sizes and growth rates and satisfy potentially incompatible environmental and developmental constraints.
Molecular Mechanism for Bacterial Degradation of Plant Hormone Auxin
Authors: Ma Yongjian , Li Xuzichao , Wang Feng , Zhang Lingling , Che Xing , Yu Dehao , Liu Xiang , Li Zhuang , Sun Huabing , Yu Guimei , Zhang Heng
Published: November 2022

Plant-associated bacteria play important regulatory roles in modulating plant hormone auxin levels, affecting the growth and yields of crops. A conserved auxin-degradation (adg) operon was recently identified in theVariovoraxgenomes, which is responsible for root growth inhibition (RGI) reversion, promoting rhizosphere colonization and root growth. However, the molecular mechanism underlying auxin degradation byVariovoraxremains unclear. Here, we systematically screenedVariovoraxadg operon products and identified two proteins, AdgB and AdgI, that directly associate with auxin indole-3-acetic acid (IAA). Further biochemical and structural studies revealed that AdgB is a highly IAA-specific ABC transporter solute binding protein, likely involved in IAA uptake. AdgI interacts with AdgH to form a functional Rieske non-heme dioxygenase, which works in concert with a FMN-type reductase encoded by geneadgJto transform IAA into the biologically inactive 2-oxindole-3-acetic acid (oxIAA), representing a new bacterial pathway for IAA inactivation/degradation. Importantly, incorporation of a minimum set ofadgH/I/Jgenes could enable IAA degradation byE. coli, suggesting a promising strategy for repurposing the adg operon for IAA regulation. Together, our study identifies the key components and underlying mechanisms involved in IAA transformation byVariovoraxand brings new insights into the bacterial turnover of plant hormones, which would provide the basis for potential applications in rhizosphere optimization and ecological agriculture.
Is ultrasound imaging effective in teaching anatomy in undergraduate medicine? A systematic review protocol
Authors: Powell Eloise , Hammond Lucy , Marlowe Frederick
Published: November 2022

Anatomy knowledge is a foundation of learning medicine and is traditionally taught to students using cadaveric dissection. In the last few decades, a variety of adjuncts to teaching anatomy have been developed including plastic models, plastinated human specimens, living anatomy (surface) and radiological images to aid learning. Portable ultrasound (US) has become a useful learning tool that is safe and non-invasive allowing for visualisation of organs and associated structures. The role of ultrasound has been widely discussed in the literature with some institutions integrating it into the medical curriculum.

This protocol describes a planned study that aims to evaluate the effectiveness of ultrasound in teaching anatomy to medical students by systematically reviewing the existing literature available in the public domain. Data gathered by these studies can be extracted and analysed to provide evidence of the effectiveness of ultrasound in medical education. The outcome will potentially support medical educators in integrating ultrasound aided learning into the curriculum with the aim of improving students understanding of anatomy. A secondary outcome may be basic understanding and competency in ultrasound.
Human FcγRIIIa activation on splenic macrophages drives the in vivo pathogenesis of dengue disease
Authors: Yamin Rachel , Kao Kevin S. , MacDonald Margaret R. , Cantaert Tineke , Rice Charles M. , Ravetch Jeffrey V. , Bournazos Stylianos
Published: November 2022

Although dengue virus (DENV) infection typically causes asymptomatic disease, DENV-infected patients can experience severe complications. A risk factor for symptomatic disease is pre-existing anti-DENV IgG antibodies. Cellular assays suggested that these antibodies can enhance viral infection of Fcγ receptor (FcγR)-expressing myeloid cells. Recent studies, however, revealed more complex interactions between anti-DENV antibodies and specific FcγRs by demonstrating that modulation of the IgG Fc glycan correlates with disease severity. To investigate thein vivomechanisms of antibody-mediated dengue pathogenesis, we developed a mouse model for dengue disease that recapitulates the unique complexity of human FcγRs. Our studies reveal that thein vivopathogenic activity of anti-DENV IgG antibodies is exclusively mediated through engagement of FcγRIIIa expressed on splenic macrophages, resulting in inflammatory sequelae and mortality. These findings highlight the importance of IgG-FcγRIIIa interactions in dengue disease, with important implications in the design of safer vaccination approaches and effective therapeutic strategies.
Parental perception of distance learning and homeschooling during COVID-19 pandemic: an empirical analysis in Sri Lanka
Authors: Priyashantha A.K. Hasith , Pratheesh N. , Pretheeba P.
Published: November 2022

Purpose

Many countries around the world were compelled to adhere to rigorous practices of school closures due to the spread of the novel coronavirus (COVID-19). During the lockdown period, distance teaching and learning have become the only form to keep students on track. Reports have revealed that during this period, parents and students have strived hard to cope up with the learning method, which is new to the school education system in Sri Lanka. Against this background, this study explored the perceptions of parents in distance learning and homeschooling of their children during the COVID-19 pandemic in Sri Lanka. In addition, this study also attempted to assess the success of such educational practices in the country during the pandemic.

Design/methodology/approach

A quantitative research approach was used, and data were collected using a structured questionnaire. The questionnaires were distributed via Google Forms to a sample of 587 respondents through snowball sampling across Sri Lanka.

Findings

According to the collected data, about 52% of participants positively responded to the current distance learning practices adopted in school education. Meanwhile, about 57% of parents were negatively concerned about current practices. The respondents had negative concerns about the new role of teaching at home, difficulties in balancing work-from-home activities, too many distractions and unfamiliarity with the teaching methods and the subjects. Further with regard to depression, the majority of respondents have moderate depression which could be led to not favouring or being active in teaching. Accounting overall fact, the success of distance learning and homeschooling was higher with parents who have a good educational and socioeconomic background. The impact of these education systems appears to be long-lasting and may contribute to rising disparities.

Research limitations/implications

This study will help to pay close attention to the constraints and implications of distance learning activities, along with homeschooling and its adaptation in the future as a matter of urgency.

Originality/value

Several studies described obstacles encountered by students and academics in the higher education sector. However, this study helps to understand the existing difficulties experienced by parents/guardians with homeschooling and the introduction of distance education via the virtual platform in the primary and secondary education system in Sri Lanka. The findings highlighted the importance of developing sufficient information technology infrastructure facilities throughout the nation before hosting such virtual teaching and learning across Sri Lanka.
Use of chatbots for customer service in MSMEs
Authors: Cordero Jorge , Barba-Guaman Luis , Guamán Franco
Published: November 2022

Purpose

This research work aims to arise from developing new communication channels for customer service in micro, small and medium enterprises (MSMEs), such as chatbots. In particular, the results of the usability testing of three chatbots implemented in MSMEs are presented.

Design/methodology/approach

The methodology employed includes participants, chatbot development platform, research methodology, software development methodology and usability test to contextualize the study's results.

Findings

Based on the results obtained from the System Usability Scale (SUS) and considering the accuracy of the chatbot's responses, it is concluded that the level of satisfaction in using chatbots is high; therefore, if the chatbot is well integrated with the communication systems/channels of the MSMEs, the client receives an excellent, fast and efficient service.

Originality/value

The paper analyzes chatbots for customer service and presents the usability testing results of three chatbots implemented in MSMEs.
Advertising and pricing of online direct selling considering network externalities
Authors: Shen Liang , Fan Runjie , Wang Yuyan , Li Hua , Tang Rongyun
Published: November 2022

Purpose

Considering the network externalities of online selling, this paper builds three different online direct selling models: manufacturer direct selling (MN model), network platform direct selling (NN model) and retailer direct selling (RN model). The optimal advertising and pricing decision and corporate profits under each selling model are investigated.

Design/methodology/approach

Combining the characteristics of online direct selling, this paper formulates direct selling models that are dominated by different companies as Stackelberg game models. Numerical analyses are carried out, along with the comparison of the equilibrium solutions for each model.

Findings

The authors' research shows that increasing network externalities is conducive to the development of enterprises. The network platform's profit is the lowest in the RN model and the highest in the NN one. The comparison of manufacturers' profits between the MN model and the NN model primarily depends on consumers' sensitivities for sales price and advertising promotion level. The manufacturer does not benefit from the RN model due to the lowest efficiency.

Originality/value

Coupled with three different online direct selling models and detailed analyses of the optimal solutions, this study has enriched the theoretical foundation of online direct selling. Moreover, this study extends the research of network externalities to the field of e-commerce, revealing the network externalities' influence on the decision-making of the e-supply chain.
Investigating older women with an abnormal cervical screening test: Is anxiety an issue?
Authors: Cruickshank Margaret
Published: November 2022

Linked article: This is a mini commentary on Gustafson et al., pp. 192–200 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.17299
Ankylosing spondylitis with Kikuchi–Fujimoto disease: A case report with literature review
Authors: Li Man , Hsu Jhe‐Yuan , Xie Yong‐Xin , Wu Yong‐Lan , Wei James Cheng‐Chung
Published: November 2022

We present the case of a patient diagnosed with ankylosing spondylitis (AS) along with Kikuchi–Fujimoto disease (KFD), possibly triggered by infection or autoimmunity. Both AS and KFD involved a similar immune pathway. Hence, clinicians should consider the possibility of KFD when lymphadenopathy is observed, especially in patients with infection or underlying autoimmune diseases.
Acceptability and feasibility of telehealth outpatient video‐link consultations: A national cross‐sectional survey of surgeons prior to the COVID‐19 pandemic
Authors: Mackenzie Lisa , Noble Natasha , Proietto Anthony , Jones Julia , Norton Grace , Palazzi Kerrin
Published: November 2022

Objective

This study explored use and perceived barriers to the use of post‐operative video‐link telehealth among a sample of Australian surgeons shortly before the COVID‐19 pandemic.

Methods

During 2019–2020, a survey was mailed to RACS or RANZCOG Fellows.

Design

Cross‐sectional survey.

Setting and Participants

A total of 907 surgeons practising in Australia completed the survey.

Main Outcome Measures

The study‐specific survey assessed telehealth use in the last 3 months and the perceived barriers and enablers to the use of post‐operative teleconsultations, across the domains: quality of care; convenience and efficiency; legal/regulatory issues; financial issues and technological issues.

Results

Twenty‐five percent of eligible surgeons returned the survey, with n = 763 pre‐pandemic responses included in analyses. Approximately one‐quarter (26%) of surgeons had used telehealth post‐operatively with patients in the last 3 months. The most frequently endorsed barriers to use related to quality of care: ‘I cannot undertake a patient examination’ and ‘I cannot provide the same level of care as during an in‐person consultation’; and convenience and efficiency: ‘Teleconsultations are more difficult to arrange’. Surgeons who had recently used telehealth were less likely to endorse most barriers. Younger age, awareness of Medicare telehealth reimbursement and working in neurosurgery, urology, paediatric surgery and plastic and reconstructive surgery (compared to general surgery) were associated with recent telehealth use by surgeons.

Conclusions

Some surgeons' perceived barriers to telehealth pre‐COVID may be overcome by COVID‐19‐related telehealth uptake and familiarisation. However, many barriers will need to be addressed to ensure that telehealth adoption is sustained beyond the pandemic.
In response to ‘The Two of Us project: An exploration of the relationships of people with intellectual disability in different social contexts’ (Jack Kelly and Seren Wagstaff)
Authors: Townson Louise , Chapman Rohhss
Published: November 2022

We are Lou Townson and Rohhss Chapman and we have a long history of working together and being friends. Together we are responding to our selected British Journal of Learning Disabilities article, The ‘Two of Us’ project.
Compounds from diverse natural origin against triple‐negative breast cancer: A comprehensive review
Authors: Thilagavathi Ramasamy , Priyankha Sridhar , Kannan Manivel , Prakash Muthuramalingam , Selvam Chelliah
Published: November 2022

Triple‐negative breast cancer (TNBC) is caused due to the lack of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor 2 (HER2) expression. Triple‐negative breast cancer is the most aggressive heterogeneous disease that is capable of producing different clones and mutations. Tumorigenesis in TNBC is caused due to the mutation or overexpression of tumor suppressor genes. It is also associated with mutations in the BRCA gene which is linked to hereditary breast cancer. In addition, PARP proteins and checkpoint proteins also play a crucial function in causing TNBC. Many cell signaling pathways are dysregulated in TNBC. Even though chemotherapy and immunotherapy are good options for TNBC treatment, the response rates are still low in general. Many phytochemicals that are derived from natural compounds have shown very good inhibitions for TNBC. Natural compounds have the great advantage of being less toxic, having lesser side effects, and being easily available. The secondary metabolites such as alkaloids, terpenoids, steroids, and flavonoids in natural products make them promising inhibitors of TNBC. Their compositions also offer vital insights into inhibitory action, which could lead to new cancer‐fighting strategies. This review can help in understanding how naturally occurring substances and medicinal herbs decrease specific tumors and pave the way for the development of novel and extremely efficient antitumor therapies.
Clinical characteristics and treatment outcomes of secondary ocular adnexal lymphoma
Authors: Yang Yu , Jin Xuelian , Wang Yujiao , Ma Ruixin , He Weimin
Published: November 2022

Background

To describe the clinical characteristics and treatment outcomes of secondary ocular adnexal lymphoma (OAL), and emphasise the impact of timely biopsy and systemic evaluation on the diagnosis and treatment.

Methods

The data of patients with secondary OAL in our hospital from January 2010 to June 2021 were retrospectively reviewed.

Results

A total of 54 patients (30 men and 24 women) were included in the study. The mean age at presentation was 60 years (median 62 years; range 37–83 years). The main symptoms included ocular mass (74%), periorbital swelling (43%), and proptosis (39%). The main histopathological types were mucosa‐associated lymphoid tissue lymphoma (30%), diffuse large B‐cell lymphoma (28%), and natural killer/T‐cell lymphoma (18%). In particular, three patients exhibited different pathological types of ocular lymphoma compared to previously diagnosed systemic lymphoma. The most common site of ocular and systemic involvement was the orbit (85%) and lymph nodes (56%), respectively, and 25 (46%) patients had occult extraocular lesions. Additionally, the 5‐year overall survival rate of the entire cohort was 56%, and significant differences were observed between the three main pathological types and stages of the disease (all p < 0.001).

Conclusions

Secondary OAL is a rare disease with a poor prognosis. That the disease is associated with a more aggressive pathological type is well established, indolent lymphoma is not uncommon. Furthermore, OAL and previously diagnosed systemic lymphoma may be pathologically distinct in some patients. Therefore, we recommend a prompt excision biopsy and a thorough systemic evaluation of patients with suspected OAL.
Sparse neural network regression with variable selection
Authors: Shin Jae‐Kyung , Bak Kwan‐Young , Koo Ja‐Yong
Published: November 2022

This paper reports on our study of a sparse neural network regression method based on a single hidden layer architecture and sparsity‐inducing penalties. To determine the size of network in a data‐adaptive way, we adopt the lasso and group lasso penalty functions to simultaneously induce sparsity at node and predictor levels. We also devise several techniques to improve performance of the neural network regression estimator. We adopt a B‐spline activation function with a compact support to identify local trends of data. In addition, we develop an algorithm based on node addition process, in which additional nodes come into the network as a complexity parameter decreases. At each value of the complexity parameter, the algorithm initializes the additional nodes along the direction that best captures the unexplained functional relationship between the response and predictors. The optimization step is conducted based on an efficient coordinate descent algorithm. Numerical studies based on simulated and real datasets illustrate that the combination of the aforementioned devices significantly improves the performance of the neural network estimator.
“War Begins in the Minds of Men”: Luther's theological anthropology and anti‐muslim polemics
Authors: Kohli Candace L.
Published: November 2022

The Turk is a looming figure in Martin Luther's theological imagination, emerging again and again as a rhetorical tool and historical reality in his thought and work. Yet, Luther's treatment of the Turks has received relatively little attention despite continuities in his polemical project with the Jews. In the 1540s, Luther outlined a systematic theological interrogation of Muslims’ humanity and applied his own Christian theological anthropology to determine that, on the basis of belief in the Koran, Muslims do not fit the criteria to be human persons. This article examines this claim to identify ways theology and cultural bias worked in tandem to reinforce this nefarious commitment in Luther's thought.
Adult mixed phenotype acute leukemia (MPAL): B/myeloid MPALisoMPO is distinct from other MPAL subtypes
Authors: Weinberg Olga K. , Dennis Jake , Zia Hamid , Chen Pu , Chu Andrew , Koduru Prasad , Luu Hung S. , Fuda Franklin , Chen Weina
Published: November 2022

Introduction

Myeloperoxidase (MPO) is considered a specific marker of myeloid/non‐monocytic lineage in the diagnosis of mixed phenotype acute leukemia (MPAL). However, the clinical significance of isolated dim MPO expression in otherwise typical B lymphoblastic leukemia (B‐ALL; referred to as B/myeloid MPALisoMPO) in adult patients is unknown.

Methods

We compared flow cytometric immunophenotype and clinicopathological findings among cases of B/myeloid MPALisoMPO (n = 13), other MPAL subtypes (n = 10, B/myeloid and T/myeloid MPAL), B‐ALL (n = 64), and acute myeloid leukemia (AML, n = 58), using the 2016 WHO classification. For MPAL cases, MPO was reported as the percent of MPO positive blasts and its intensity (dim or moderate/strong). The pattern of heterogenous antigen expression (inversely coordinated expression between myeloid and lymphoid markers and cell size) was assessed.

Results

Cases of B/myeloid MPALisoMPO showed a fairly homogenous single B‐lineage blast population with dim MPO expression whereas cases of other MPAL subtypes displayed heterogeneous antigen expression and moderate/strong MPO expression. The percent of MPO positive blasts in these two groups was similar. Expressions of CD15, CD117, and monocytic markers were more common in other MPAL than in B/myeloid MPALisoMPO. B/myeloid MPALisoMPO patients had similar overall and leukemia free survivals as B‐ALL patients and better than other MPAL patients.

Conclusion

This is the first study to investigate the clinical significance of adult B/myeloid MPALisoMPO using the 2016 WHO classification. Our results suggest that B/myeloid MPALisoMPO clinically behaves more similarly to B‐ALL than to other MPAL subtypes, supporting the 2016 WHO classification to segregate this entity from other MPAL subtypes.
Hypertension in the older person: is age just a number?
Authors: Karayiannis Christopher C.
Published: November 2022

Older patients with hypertension are at a higher risk of cardiovascular events compared to younger adults but are also more vulnerable to the adverse effects of blood pressure (BP) lowering. Frailty is an important predictor of vulnerability to such adverse events, and age alone may not best reflect underlying risk. Therefore, an individualised approach to management of hypertension in the older person is required. Such an approach requires knowledge of frailty, the physiology of hypertension and ageing and a contextual understanding of best evidence. Management needs to be holistic and take account of the older person's care needs, wishes and priorities. This review describes physiological considerations and current guidelines and best practices regarding BP lowering in older people and highlights areas with paucity of evidence. A proposed and testable approach to managing hypertension in the older person (≥70 years) is discussed.
Cannula provoked upper extremity superficial vein thrombophlebitis: are we overtreating?
Authors: Yuen Hiu L. A. , Fang Wendy , Tran Huyen , Chunilal Sanjeev D.
Published: November 2022

Cannula provoked upper extremity superficial vein thrombophlebitis (UESVT) is common. Retrospective audit of 93 consecutive patients, 51% male, median age 57 years (range 20–91), with symptomatic UESVT revealed varied management including symptomatic management (37%), prophylactic (37%) and higher dose anticoagulation (27%). There was 2% (95% confidence interval (CI) 0–7.6) thrombus extension and 1% (95% CI 0–5.9) major bleeding, both limited to cancer. We argue anticoagulation is unnecessary in most UESVT patients.
Overlooked species diversity in the hyper‐arid Sahara Desert unveiled by dryland‐adapted lizards
Authors: Liz André Vicente , Rödder Dennis , Gonçalves Duarte Vasconcelos , Velo‐Antón Guillermo , Tarroso Pedro , Geniez Philippe , Crochet Pierre‐André , Carvalho Silvia B. , Brito José Carlos
Published: November 2022

Aim

Hyper‐arid sandy and rocky fields rank among the least biologically diverse habitats of the desert biome, yet knowledge of local biodiversity patterns is also extremely poor. In the Sahara Desert, palaeoclimate oscillations affected the extent of hyper‐arid habitats, but it is unclear how these dynamics determined the evolution and distribution of local specialists. Herein, we assessed cryptic diversity, diversification patterns and spatial connectivity within a Sahara‐widespread group of dryland‐adapted lizards.

Location

Sahara‐Sahel ecoregions.

Taxon

Acanthodactylus scutellatus species group.

Methods

Inter‐ and intraspecific phylogenetic structure, divergence times, spatial genetic patterns and cryptic diversity were assessed using nuclear and mitochondrial loci. The effects of topography and land cover on phylogeographic structure and diversity were tested with generalized linear models. Interspecific hybridization was evaluated using 11 microsatellites across the group's major sympatry zone, predicted based on ecological niche models.

Results

Species of Acanthodactylus scutellatus group exhibit Late Miocene origins, followed by extensive intraspecific divergence throughout the Pliocene. The northern Sahara worked as a major diversification hotspot, harbouring a patchwork of small‐ranged, divergent lineages. These lineages are parapatric or sympatric and present concordant nuclear and mitochondrial differentiation, suggesting species status. Genetic connectivity increases in southern latitudes, with wide‐ranging lineages spanning from the Red Sea to the Atlantic coast. Within these potential corridors, mountain outskirts and sand fields in the Sahara interior seemingly acted as origins for recent population expansions. Genetic diversity and connectivity are favoured by terrain roughness and soft‐sand cover respectively. Three species inhabit the Atlantic Sahara sympatry zone without evidence of gene flow.

Main conclusions

Overlooked species‐level diversity within a major specialist group of Sahara drylands exposes the recurrent knowledge shortfalls present in hyper‐arid desert environments. Humidity and sandy habitat shifts triggered potential successions of population isolation and re‐connectivity, which favoured cladogenesis in northern desert regions and population expansions across southern east–west corridors.
Beyond Big Five trait domains: Stability and change in personality facets across midlife and old age
Authors: Brandt Naemi D. , Drewelies Johanna , Willis Sherry L. , Schaie K. Warner , Ram Nilam , Gerstorf Denis , Wagner Jenny
Published: November 2022

Objective

Accumulated evidence indicates both stable and malleable parts of inter‐individual differences in the broad Big Five domains. Less is known, however, about stability and change at the more diversified facet level. With the current study, we fill this gap by investigating personality stability and change across midlife and old age.

Method

We apply local structural equation measurement models and second‐order growth curve models to four waves of data obtained with the full NEO Personality Inventory (NEO‐PI‐R) collected over 11 years from 1667 adults (Mage = 62.69 years, SDage = 15.62, 55% female) who participated in the Seattle Longitudinal Study.

Results

Measurement invariance analyses indicated that the psychometric properties of the NEO‐PI‐R facets are comparable across time and age. Results revealed substantial rank‐order stabilities across all facets, yet the exact pattern varied strongly between facets of the same trait and across traits. Mean‐level change of facets from midlife to old age largely mirrored the mean‐level change observed for the broader traits.

Conclusion

We discuss conceptual implications and argue that in the face of overall stability across midlife and old age, changes in the rank‐ordering of people reveals a much more complex and diverse pattern of development than analyses at the trait level suggest.
Bruxism in awake dogs as a clinical sign of forebrain disease: 4 cases
Authors: Liatis Theofanis , Madden Megan , Marioni‐Henry Katia
Published: November 2022

Background

Bruxism is a repetitive masticatory muscle activity characterized by clenching or grinding of the teeth, or by bracing or thrusting of the mandible, or both.

Objectives

To investigate whether bruxism in awake dogs could be associated with brain lesions.

Animals

Four dogs with episodic bruxism in the awake state.

Methods

Observational retrospective single‐center case series. Inclusion criteria were dogs examined between 2010 and 2021 with episodic bruxism as a presenting complaint or observed during the examination or hospitalization, complete medical records and magnetic resonance imaging or computed tomography of the brain. Bruxism during epileptic seizures as oroalimentary automatism was an exclusion criterion.

Results

Four dogs met the inclusion criteria. Two dogs had bruxism while awake as a presenting complaint, whereas in the remaining 2 it was a clinical finding. All dogs had neuroanatomical localization consistent with a forebrain lesion, with diencephalic involvement in 3/4. The diagnostic evaluation was consistent with neoplasia (n = 2) and meningoencephalitis of unknown origin (n = 2), in 1 case accompanied by corpus callosum abnormality affecting the forebrain, in 3 dogs advanced imaging findings were suggestive of increased intracranial pressure. All dogs were euthanized.

Conclusions and Clinical Importance

Our results suggest that the presence of bruxism in the awake state associated with other neurological deficits might indicate a forebrain lesion.
Determination of the umbilicus position in Japanese children
Authors: Saeki Isamu , Kurihara Sho , Kojima Masato , Takahashi Shinya , Hiyama Eiso
Published: November 2022

Background

Although there have been many reports concerning the normal position of the umbilicus, the measurements were performed from the surface of the body in all cases. We examined computed tomography (CT) images to determine the accurate position of the umbilicus in children.

Methods

We retrospectively examined the CT data of 120 Japanese children (60 boys, 60 girls). The angle between both iliac crests to the umbilicus (IU angle), the angle between both anterior superior iliac spines and the umbilicus (AU angle), and the ratio of the length from the xiphoid process to the umbilicus and length from the umbilicus to the pubic symphysis were measured.

Results

The mean AU angle was 33.7° ± 5.1°, showing the least data variations. A significant difference was noted in the AU angle between boys and girls (32.7° ± 4.6° and 34.6° ± 5.4° respectively; p = 0.04). When we defined the position of the umbilicus as an AU angle of 33° in boys and 35° in girls, 115 children (95.8%) fell within ±10°.

Conclusions

The AU angle is the preferable predictor of the umbilicus position in children.
Impact of psychosocial factors on medication level variability index and outcomes in pediatric liver transplant recipients
Authors: Sakhuja Shruti , Himes Ryan , Carreker Colleen , Guffey Danielle , Beer Stacey , Amin Mansi , Hiremath Girish , Mysore Krupa
Published: November 2022

Background

Caregivers play an important role in maintaining a functioning graft after pediatric liver transplantation. Therefore, the psychosocial factors of both patients and caregivers can have a critical impact on transplant outcomes. Appropriate assessment and recognition of these factors pre‐transplantation may allow transplant teams to better define the needs of pediatric organ recipients and develop specific countermeasures, which may then contribute toward improving transplant outcomes.

Methods

We studied 136 pediatric LT recipients followed at Texas Children's Hospital. Licensed social workers conducted comprehensive pre‐transplant assessments on each patient, consisting of 22 psychosocial variables that were thought to impact adherence, which were reviewed during our study period. Non‐adherence was determined using the MLVI for up to 4 years after transplantation. Biopsy‐confirmed rejection episodes were assessed in the first 3 years after liver transplantation.

Results

Factors significantly associated with non‐adherence (defined as MLVI >2) included parental age and parental education level at assessment, type of insurance, and household income. The number of ACR episodes trended higher in patients with non‐adherence, and these patients had a higher number of moderate to severe rejection episodes but this trend was not statistically significant.

Conclusions

Psychosocial characteristics such as parental age, education level, insurance, and household income may contribute significantly to suboptimal adherence to medications after transplantation. Identification of these psychosocial factors and early intervention is essential to the success and equitable care of our pediatric LT recipients.
GOD AND A WORLD OF NATURAL EVIL: THEOLOGY AND SCIENCE IN HARD CONVERSATION
Authors: Southgate Christopher
Published: November 2022

This is the text of the 2022 Boyle Lecture. After some acknowledgements, it introduces the theological problem of the suffering of nonhuman creatures in the natural world as described by evolutionary science. It sets aside the neo‐Cartesian objection that this suffering should not be considered real. The lecture then considers, and initially rejects, theodicies based on some form of fall event. An account is offered based on the premise that Darwinian evolution was the only way God could have given rise to a biological world containing the sorts of values we observe. Although this remains the preferred basis for an evolutionary theodicy, consideration is finally given to the extent to which certain phenomena, such as parasitism, cancers, and viral infections, might be thought to exhibit a resistance to the divine will. The tentative suggestion is made that this resistance might derive from temptation by spiritual powers, thus incorporating into an overall only‐way account an element of angelic fallenness.
Hydroelastic Analysis of Hard Chine Sections Entering Water—Observations for Use in Preliminary Design Stage
Authors: Tavakoli Sasan , Babanin Alexander V. , Hirdaris Spyros
Published: November 2022

Wing-in ground effect (WIG) vehicles and planing hulls are exposed to unsteady, high magnitude hydrodynamic forces as their bow enters water. The resulting forces can lead to structural damage and uncomfortable riding conditions. This paper aims to provide deeper understanding on the influence of structural flexibility throughout the water entry process of a hard-chine section. A finite volume method (FVM) based flexible fluid-structure interaction (FFSI) model is used to solve multi-physics. Quantitative comparisons are made between experimental and computational data. Simulations demonstrate that structural responses can attenuate the pressure acting on the body of hard-chine sections impinging water with deadrise angles of 10deg, 20deg, and 30deg. However, they cannot affect that of a section with deadrise angle of 45deg since its pressure distribution pattern is different. It is shown that the impact speed has an important role in hydroelastic response while the sectional Young's modulus affects impact pressures and resulting equivalent stresses. The former increases under the increase of Young's modulus. The latter may increase when the impact speed is low and decreases when the impact speed is high. It is concluded that the results presented may be useful for preliminary design.