bluuebunny/crossref_metadata_2025 huggingface dataset:
A Confluence of Anticolonial Pathways for Indigenous Sacred Site Protection
Authors: Ellis Rachel , Perry Denielle
Published: June 2020

The confluence of the Little Colorado and Colorado Rivers is an Indigenous socio‐ecological landscape, revolving in large part around water resources. Substantial surface and groundwater use within the Little Colorado River (LCR) basin threatens the water sources of the confluence, springs in the LCR basin, and specifically the HopiSipapuni—a sacred site of cultural emergence. To address concerns about diminished flows of sacred springs, we engaged in praxis through collaborative, reciprocal, community‐based research processes. Through the lens of anticolonial theory, we ask: Can federal policies be employed in an anticolonial pursuit of water and sacred site protection? How do Indigenous grassroots organizers envision protection and work to re‐Indigenize water management? Semi‐structured interviews with Indigenous community organizers and federal land managers were coupled with policy analysis of the National Historic Preservation Act/Traditional Cultural Properties, the ongoing LCR Adjudication, and the Treaty of Guadalupe Hidalgo. Findings point to multifaceted, complex, and contradictory themes that elucidate the continued influence of colonization on water governance and the degree to which protection solutions can be anticolonial. Criteria were generated for anticolonial protective pathways that highlight the centrality of reciprocal relationships, Indigenous Knowledges, and meaningful inclusion. While details about protection pathways for the confluence andSipapuniare many, the salient finding is that the struggle for water protection in the LCR is the struggle for protection of inherent Indigenous rights.
Walleye Ogaawag Spearing in the Portage Waterway, Michigan: Integrating Mixed Methodology for Insight on an Important Tribal Fishery
Authors: Kozich Andrew T. , Gagnon Valoree S. , Mensch Gene , Michels Sophia , Gehring Nicholas
Published: June 2020

The Portage Waterway in Michigan's Upper Peninsula supports traditional Anishnaabe walleye (or ogaawag in the Anishnaabe language) spear‐harvesting for the Keweenaw Bay Indian Community (KBIC). Through reserved Indian treaty fishing rights, KBIC is highly involved in the waterway's stewardship and annual community spear‐harvest. Tribal leadership and fisheries personnel have long documented that annual harvests are far below sustainable quotas. The objectives of this research were to 1) understand the values and concerns of KBIC tribal members on Anishnaabe walleye (ogaawag) spear‐harvesting, 2) examine water temperature patterns during the spring 2018 harvest to seek insight on how harvests may be optimized, and 3) integrate Anishinaabe gikendaasowin or traditional knowledge with science and education. We conducted an online survey in February 2018, containing 27 questions, to gain preliminary insight on KBIC's perspectives of the annual walleye (ogaawag) spear‐harvest. Nearly all respondents highly value the spear‐harvest tradition personally and on behalf of the community. Similarly, nearly all agreed that it is important for the KBIC to manage its own fishery resources, and that the Tribe's Natural Resources Department effectively does so. Respondents also expressed concerns about factors that could impact their harvests, including environmental changes and confrontations with non‐Native residents. From May 1 to May 19, 2018, we deployed 13 Onset HOBO Pro V2 temperature dataloggers across the Portage Waterway to measure spring warming patterns in locations popular for spear‐fishing. This period encompassed the entire KBIC spear‐harvest season, with dataloggers recording water temperature every two hours. Temperature data show that management of the harvest season may need revision, as embayments and sloughs where spear‐fishing largely occurs warmed significantly earlier than other parts of the waterway. As the presence of walleye (ogaawag) in shallow waters depends on temperature, some parts of the waterway should be opened for harvesting earlier. Our findings will be prepared in a formal recommendation for KBIC leadership in efforts to increase harvests for the Tribal community that rely on walleye (ogaawag) as a sacred and traditional food source.
Losartan attenuates neuroinflammation and neuropathic pain in paclitaxel‐induced peripheral neuropathy
Authors: Kalynovska Nataliia , Diallo Mickael , Sotakova‐Kasparova Dita , Palecek Jiri
Published: June 2020

Paclitaxel‐induced peripheral neuropathy (PIPN) is often associated with neuropathic pain and neuroinflammation in the central and peripheral nervous system. Antihypertensive drug losartan, an angiotensin II receptor type 1 (AT1R) blocker, was shown to have anti‐inflammatory and neuroprotective effects in disease models, predominantly via activation of peroxisome proliferator‐activated receptor gamma (PPARγ). Here, the effect of systemic losartan treatment (100 mg/kg/d) on mechanical allodynia and neuroinflammation was evaluated in rat PIPN model. The expression of pro‐inflammatory markers protein and mRNA levels in dorsal root ganglia (DRGs) and spinal cord dorsal horn (SCDH) were measured with Western blot, ELISA and qPCR 10 and 21 days after PIPN induction. Losartan treatment attenuated mechanical allodynia significantly. Paclitaxel induced overexpression of C‐C motif chemokine ligand 2 (CCL2), tumour necrosis alpha (TNFα) and interleukin‐6 (IL‐6) in DRGs, where the presence of macrophages was demonstrated. Neuroinflammatory changes in DRGs were accompanied with glial activation and pro‐nociceptive modulators production in SCDH. Losartan significantly attenuated paclitaxel‐induced neuroinflammatory changes and induced expression of pro‐resolving markers (Arginase 1 and IL‐10) indicating a possible shift in macrophage polarization. Considering the safety profile of losartan, acting also as partial PPARγ agonist, it may be considered as a novel treatment strategy for PIPN patients.
Sucker with a fat lip: The soft tissues underlying the viscoelastic grip of remora adhesion
Authors: Cohen Karly E. , Crawford Callie H. , Hernandez Luz Patricia , Beckert Michael , Nadler Jason H. , Flammang Brooke E.
Published: June 2020

Remoras are fishes that attach to a broad range of hosts using an adhesive disc on their head that is derived from dorsal fin elements. Research on the adhesive mechanism of remoras has focused primarily on the skeletal components of the disc and their contribution to generating suction and friction. However, the soft tissues of the disc, such as the soft lip surrounding the bony disc and the muscles that control the bony lamellae, have been largely ignored. To understand the sealing mechanism of the disc, it is imperative to understand the tissue morphology and material properties of the soft lip. Here, we show that the soft lip surrounding the remora disc is comprised of discrete multilayered collagen, fat, and elastic tissues which we hypothesize to have specific roles in the viscoelastic sealing mechanism of the remora disc. The central, heavily vascularized fat and collagen layer are infiltrated by strands of elastic tissue and surrounded by crossed‐fiber collagen. A newly described jubilee muscle underneath the adhesive disc provides a mechanism for stopping venous return from the disc lip, thereby allowing it to become engorged and create a pressurized fit to the attachment substrate. Thus, the remora lip acts as a vascular hydrostat.
Saving the public from the private? Incentives and outcomes in dual practice
Authors: Kuhn Michael , Nuscheler Robert
Published: June 2020

We consider a monopoly physician offering free public treatment and, if allowed, a private treatment for which patients have to pay out of pocket. While patients differ in the propensity to benefit from private treatment it always yields better health outcomes than public treatment but is also more costly in terms of money and time. We study the physician's supply of private care and allocation of time costs across public and private patients and contrast these with the first‐best allocation. To increase the willingness‐to‐pay for private treatment the physician shifts time costs to public patients. While this turns out to be socially optimal, the resulting positive network effect leads to an over‐provision of private care if time costs are sufficiently high. A second‐best allocation arises when the health authority sets public reimbursement but has no control over private provision. Depending on the welfare weight the health authority attaches to physician profits, a ban of dual practice may improve on the second‐best allocation. Notably, a ban benefits not only public patients but also private patients with a moderate propensity to benefit from private care.
Labor market characteristics and cultural choice
Authors: Ellis Christopher , Thompson Jon C. , Wu Jiabin
Published: June 2020

We develop a model of cultural selection based on the labor market characteristics of different cultural types. Following Borjas (1994, 1995) we assume that cultural heterogeneity increases labor productivity due to skill complementarities, however following Jackson and Xing (2014) we also assume that cultural heterogeneity hampers communication. We model this as a game in which individuals from two cultural types first engage in random matching, then once matched play a coordination game. Other‐type matches are thus potentially more productive, but also less likely to coordinate. We show that these two labor market characteristics serve as important primitives in determining if a cultural minority persists. Essentially, when the productivity advantages from a cross‐cultural match sufficiently outweigh the disadvantages of coordination problems then the cultural minority will persist. If not it will be assimilated. Further, we obtain results concerning the efficient size of the cultural minority, the effects of tax and welfare programs on the size and welfare of the cultural minority, and the relationship between the intensity of social interaction and size and welfare of the cultural minority.
Survey on the role of nutrition in first‐opinion practices in Austria and Germany: An evaluation of knowledge, preferences and need for further education
Authors: Bruckner Irene , Handl Stefanie
Published: June 2020

A survey was conducted among first‐opinion practices in Germany and Austria on dog nutrition consultation, food sold in the practice, recommendations given to owners, most commonly encountered consequences of malnutrition, need for further education and feeding of own dogs. Of the 169 participants, one third was from Austria, two thirds from Germany. Most practiced in the countryside or in suburbs, were female and between 36 and 55 years old. The majority felt that nutrition has become an important topic, and that “feeding myths” were on the rise. However, only in 18% of the practices at least one staff member had further education in nutrition, while none of the participants had a national or international degree. Only half of our participants felt qualified to give nutrition advice. A nutritional assessment was not regularly performed, and the Body Condition Score was not regularly assessed, often only when health problems were obvious. If a homemade diet was requested, practitioners rather referred to a nutritionist, while 25% left it up to the owners. Most relied on traditional premium diets for their patients and also for their own dogs. Feeding myths seemed to be widespread among veterinarians, too; even Biologically Appropriate Raw Feeding and diets not complying with EU legislation were recommended. There is obvious need for further education and specialization to establish nutrition consultation as a profitable service in small animal practice.
Learning technologies: A medium for the transformation of medical education?
Authors: Grainger Rebecca , Liu Qian , Geertshuis Susan
Published: June 2020

Context

Learning technologies are ubiquitous in medical schools, implemented in anticipation of more effective, active and authentic learning and teaching. Such thinking appears to be an instance of solutionism. The evidence is that academics’ adoption of learning technologies is often limited in scale and scope and frequently fails to transform their teaching practices.

Purpose

This paper aims to provide a contextualised analysis of considerations pertinent to the adoption of learning technologies by teaching staff. We contextualise a framework for understanding adoption of learning technologies in higher education by medical education.

Conclusions

We identify multiple precursors that predict individual patterns of adoption, illuminating factors related to the technology, the individual staff member charged with adoption and the working environment. We offer conceptual clarity to the vexed issue of learning technology adoption and provide evidence explaining why, despite their widely promulgated potential, learning technologies do not offer an easy route to the transformation of medical education.
Generative adversarial network for road damage detection
Authors: Maeda Hiroya , Kashiyama Takehiro , Sekimoto Yoshihide , Seto Toshikazu , Omata Hiroshi
Published: June 2020

Machine learning can produce promising results when sufficient training data are available; however, infrastructure inspections typically do not provide sufficient training data for road damage. Given the differences in the environment, the type of road damage and the degree of its progress can vary from structure to structure. The use of generative models, such as a generative adversarial network (GAN) or a variational autoencoder, makes it possible to generate a pseudoimage that cannot be distinguished from a real one. Combining a progressive growing GAN along with Poisson blending artificially generates road damage images that can be used as new training data to improve the accuracy of road damage detection. The addition of a synthesized road damage image to the training data improves the F‐measure by 5% and 2% when the number of original images is small and relatively large, respectively. All of the results and the new Road Damage Dataset 2019 are publicly available (https://github.com/sekilab/RoadDamageDetector).
Quality of life and the associated factors among family caregivers of older people with dementia in Thailand
Authors: Pothiban Linchong , Srirat Chomphoonut , Wongpakaran Nahathai , Pankong Orawan
Published: June 2020

Long‐term care for older people with dementia can adversely impact a family caregiver's life. A decrease in their quality of life may compromise the quality of care they provide to older people and their own quality of life. The samples include 76 family caregivers of older people with dementia in Thailand. Six questionnaires and the EuroQoL Five Dimensions Questionnaire were used in data collection. Descriptive and inferential statistics were used in data analysis. The findings revealed that quality of life of family caregivers was at a high level. Experiences of close relationships between care dyads and perceived social support were positively related to family caregiver's quality of life, whereas perceived stress and burden were negatively related. Perceived social support and experiences of close relationships might be predictors of family caregiver's quality of life. High quality of life levels among Thai family caregivers of older people with dementia were influenced by high perceived social support and high experiences of close relationships. An intervention focusing on modifying such predicting factors may effectively help maintain quality of life of these family caregivers.
Hypercontractile esophagus resolved after radiofrequency catheter ablation for atrial fibrillation: About a case
Authors: Anon Benjamin , Aubourg Alexandre , Moussata Driffa , Babuty Dominique , Picon Laurence
Published: June 2020

The pathophysiology of jackhammer esophagus is complex and remains unclear. Radiofrequency catheter ablation is indicated for highly symptomatic and drug‐refractory atrial fibrillation. This technique can induce esophageal and nerve lesions, due to thermal injury. In this report, we describe a case of hypercontractile esophagus diagnosed by HRM (high‐resolution manometry). Esophageal symptoms and HRM normalized immediately after RFCA, and we discuss the pathophysiology of hypercontractile esophagus.
Lichens redefined as complex ecosystems
Authors: Hawksworth David L. , Grube Martin
Published: June 2020

This article is a Commentary on Mark et al. (2020), 227: 1362–1375.
A highly selective and sensitive fluorescence probe for a specific binding site on insect ryanodine receptors
Authors: Liao Min , Li Qibo , Yang Zhikun , Feng Tong , Xu Zhiyuan , Liu Qing , Liu Shangzhong
Published: June 2020

There is a significant need to study the binding of active compounds to the specific sites on insect ryanodine receptors (RyRs) that are the targets of two novel classes of diamide insecticides to which insects are becoming increasingly resistant. Here, we describe a rapid assay to study the action of potential compounds on the flubendiamide (Flu) binding site of insect RyRs that uses a fluorescence polarization assay with the fluorescence probe Flu‐R‐L that we synthesized. The IC50 of Flu for inhibiting probe binding on insect RyR was 18.82 ng/mL. The binding of 86 novel phthalic diamide derivatives on insect RyRs was studied using this newly established assay, and the compounds that exhibited high‐affinity binding in the assay also possessed in vivo insecticidal activity against Plutella xylostella. Thus, Flu‐R‐L is a highly selective and sensitive fluorescence probe for studying the binding affinity of novel compounds to the Flu binding site of insect RyRs. The assay based on Flu‐R‐L is a rapid, accurate, and sensitive method for the screening of potentially bioactive molecules that bind specifically to insect RyRs.
Vaccine Procurement Contracts for Developing Countries
Authors: Martin Paola , Gupta Diwakar , Natarajan Karthik V.
Published: June 2020

In recent years, several Global Health Organizations (GHOs) have experimented with market‐based procurement contracts to encourage pharmaceutical companies to bring late‐stage vaccines to developing‐country markets. Pharmaceutical companies often find such markets financially unattractive because the opportunity cost of capacity commitment is high, developing countries have limited ability to pay, and demand is uncertain. A contract design recently implemented by one GHO offers the manufacturer a per‐dose sales subsidy, which is paid by the GHO, on top of the base price paid by developing countries. The subsidy is required because the base price is not enough, by itself, to induce the manufacturer to commit capacity for developing‐country markets. A natural question that arises in this context is whether, within a fixed budget, alternate contract designs lead to higher capacity commitment. This study proposes and analyzes three contract designs that include the current practice and two alternatives inspired by contracts studied in the operations management literature. It also considers two types of budget constraints that may arise in practice and quantifies the impact of each type of budget constraint on the manufacturer’s capacity commitment. We show that the best contract design depends on the size of the budget, and that GHOs can increase capacity commitment (over the contract design used in practice) by choosing the budget‐appropriate contract design and optimal parameters for the chosen design.
First/Last Teacher: Recasting Soviet Legacies in Contemporary Kyrgyz Cinema
Authors: MONASTIREVA‐ANSDELL ELENA
Published: June 2020

Renowned Soviet‐Kyrgyz writer Chingiz Atimatov's 1962 novella The First Teacher has staying power in contemporary Kyrgyzstan figuring prominently–and positively–in Kyrgyz culture and cinema of the last decade. This seems to be a postcolonial paradox as Aitmatov's classic has traditionally been read as a socialist‐realist narrative welcoming the arrival of the forcefully imposed Soviet power to Kyrgyzstan in 1924. My fresh reading of Aitmatov's Soviet‐era classic as more ambiguous than originally thought and its subsequent reinterpretations in recent Kyrgyz cinema corroborates David Chione Moore's seminal argument about the reality of post‐colonialism in the post‐Soviet space while also revealing the productive tension between the two conflicting views of the Soviet experiment as non‐colonial or “simply differently configured” colonial. Even though Aitmatov privileges Soviet culture over “backward” Kyrgyz ways and wages a socialist realist struggle between the old and the new in The First Teacher, this early narrative crafted during the Thaw builds in a lot of ambiguity about the Soviet project in Kyrgyzstan. I argue that the novella's pronounced Thaw idealism and its revision of the Stalinist myth of the ideologically driven positive hero, combined with the young writer's subtly articulated Kyrgyz values that exist alongside and often in tension with his distinct Soviet persona, all allow for a more flexible interpretation and negotiation of a hybrid, ambivalent, and multivalent post‐Soviet Kyrgyz culture and nationhood in contemporary Kyrgyz cinema.
Varieties of liberalism: A comparative analysis of family policy and poverty outcomes across the 50 United States
Authors: Daiger von Gleichen Rosa , Parolin Zachary
Published: June 2020

The United States is generally recognised as an exemplar of liberal policy regime types. However, given evidence of state‐level divergence in social policy, this article investigates to what extent such variation is present and relevant in state‐level family policy. To this end, we pose a primary and secondary research question. Our primary question is whether varieties of liberalism exist across the 50 states in the United States. Our secondary question is whether these varieties of liberalism correspond to variety in social indicators of families' economic well‐being. To answer our primary question, we first construct a family policy index that scores the relative generosity and coverage of state‐administered social programmes that contribute to the (de)commodification and (de)familialisation of households with children. We then perform a cluster analysis to group states by shared decommodifying and defamilialising features. To answer our secondary question, we investigate how our family‐policy clusters are associated with social indicators of families' financial security. Our findings suggest that varieties of liberalism do, indeed, exist within the United States. With the exception of Vermont, which stands out with respect to its comparatively generous family policies, we classify states into two groups: those with ‘soft’ liberal family policy in states featuring relatively generous and accessible policies and ‘hard’ liberal family policy in states achieving little of either. We find that these differences help explain state‐level heterogeneity in levels of economic security among households with children, particularly single‐mother households.
Third time’s a charm? Mobilization of autologous peripheral blood stem cells in patients with two previous failed mobilizations with plerixafor
Authors: Zhuang Lefan , Boriboonnangkul Pudpong , Wang Shirong , Yuan Shan
Published: June 2020

BACKGROUND

Patients who respond inadequately to plerixafor salvage during autologous peripheral blood stem cell (PBSC) collection are frequently remobilized with plerixafor to collect additional stem cells. However, in patients who fail remobilization, it is unclear whether additional mobilization efforts with plerixafor are useful.

STUDY DESIGN AND METHODS

We retrospectively examined the PBSC collections of 15 consecutive patients with lymphoma and multiple myeloma who underwent three mobilizations with plerixafor.

RESULTS

Of the 821 patients who underwent autologous stem cell collections, 15 patients were mobilized three times with plerixafor (1.8%), which enabled 11 (73.3%) patients to reach 2.0 × 106 CD34+ cells/kg or greater. Among patients who eventually collected successfully the median yields from the three collection attempts were 0.46, 0.76, and 1.54 × 106 CD34+ cells/kg, respectively. Among those who collected less than 2.0 × 106 CD34+ cells/kg cumulatively, the median yields were 0.14, 0.33, and 0.22 × 106 CD34+ cells/kg from the three collection attempts. The combined collection yields from the first two mobilization attempts were significantly lower (p = 0.003; range, 0.09‐0.73 vs. 0.63‐1.84; median, 0.51 vs. 1.36) in those who failed collection.

CONCLUSIONS

The majority (73.3%) of patients who underwent three mobilization attempts were eventually able to collect enough cells to permit autologous transplantation. Extremely low peripheral blood CD34+ count after the first dose of plerixafor and collection yields during the first two attempts were associated with a poor collection yield on the third attempt. The risks and benefits of a third mobilization should be weighed to facilitate judicious use of resources.
Design, Analysis, Comparison, and Experimental Validation of Insulated Metal Substrates for High-Power Wide-Bandgap Power Modules
Authors: Gurpinar Emre , Ozpineci Burak , Chowdhury Shajjad
Published: June 2020

Direct bonded copper (DBC) substrates used in power modules have limited heat spreading and manufacturing capability due to ceramic properties and manufacturing technology. The ceramic and copper bonding is also subject to high mechanical stress due to coefficient of thermal expansion mismatch between the copper and the ceramic. For wide-bandgap (WBG) devices, it is of interest exploring new substrate technologies that can overcome some of the challenges of direct bonded copper substrates. In this technical paper, the design, analysis, and comparison of insulated metal substrates (IMSs) for high-power wide-bandgap semiconductor-based power modules are discussed. This paper starts with technical description and discussion of state-of-the-art DBC substrates with different ceramic insulators such as aluminum nitride (AlN), Al2O3, and Si3N4. Next, an introduction of IMSs and their material properties, and a design approach for SiC (silicon carbide) metal-oxide-semiconductor field-effect transistor (MOSFET)-based power modules for high-power applications is provided. The influence of dielectric thickness on the power handling capability of the substrate are also discussed. The designed IMS and DBC substrates were characterized in terms of steady-state and transient thermal performance using finite element simulation. Finally, the performance of the IMS and DBC are validated in an experimental setup under different loading and cooling temperature conditions. The simulation and experimental results showed that the IMS can provide high steady-state thermal performance for high-power modules based on SiC MOSFETs. Furthermore, the IMS provided enhanced transient thermal performance, which provided a reduced junction temperature when the module is operated at low fundamental output frequencies in traction drive systems.
Drop Generation in Cross-Flow of Liquid Rotating in Rigid Body Motion
Authors: Zhang Haipeng , Ryu Sangjin
Published: June 2020

Various methods have been developed to generate monodisperse drops of a dispersed phase (DP) liquid in an immiscible continuous phase (CP) liquid, which include the membrane emulsification method and the microfluidic drop generation. This study proposes an easy-to-adopt drop generation method using cross-flow: a DP liquid is injected through a stationary vertical syringe needle into a CP liquid rotating in rigid body motion. The developed method was tested and characterized using de-ionized water as the DP liquid and mineral oil as the CP liquid. Drops were generated mainly either in the dripping mode or the jetting mode, and the former resulted in higher monodispersity. Smaller drops were generated when a thinner syringe needle was used, the average flow speed of the DP liquid through the needle was decreased, or the linear flow speed of the CP liquid at the needle location was increased. Especially, the power–law relationship was observed between the drop diameter and the flow speeds, and the dripping-to-jetting transition (DJT) was observed when the Weber number of the DP liquid was about 5.
Cadmium selenide by XPS
Authors: Ospina Rogelio , Rincón-Ortiz Sergio A. , Rodriguez-Pereira Jhonatan
Published: June 2020

Cadmium selenide was analyzed using x-ray photoelectron spectroscopy. The specimen is a powder purchased from Chemsavers. The sample was fixed to a stainless-steel sample holder with copper 3MTM double-sided adhesive tape. Survey spectra, Cd 3d, Se 3d, O 1s, Cd 3p, Cd MNN, Se LMM, Se 3p, C 1s, and Cd 4d core level along with the valence band spectra were recorded. Results point out a stoichiometry of 0.95 on surface.
One-dimensional simulation of Couette–Poiseuille flow with variable cross section for the full range of gas rarefaction
Authors: Jünemann Timo , Brümmer Andreas
Published: June 2020

Clearance mass flows are a major loss mechanism in dry running rotatory positive displacement vacuum pumps. Therefore, a detailed knowledge of the clearance mass flow is crucial to calculate the operation of those pumps. The small clearance heights and the large pressure range of such pumps require a wide range of gas rarefaction parameters to be taken into account. The flow in the clearance can be described as a combined Couette–Poiseuille flow with variable cross section. This is typically done by solving the Stokes equation, but especially at high gas rarefaction parameters, the inertia cannot be neglected any more, which can lead to choking of the flow. A one-dimensional approach for the compressible fluid flow was provided by Shapiro. It is shown that this approach can be carried over for the rarefied gas flow. The problem is solved in bounds for the constant total temperature and compared to experimental investigations by varying the pressure ratio and the circumferential speed of the clearance boundary in a wide range of gas rarefaction parameters.
Acoustic and photographic monitoring of coastal maritime traffic: Influence on the soundscape
Authors: Magnier Caroline , Gervaise Cédric
Published: June 2020

Due to the absence of Automatic Identification System data (used by 3.7% of the Calvi bay fleet), the acoustic monitoring of coastal environments presents difficulties. A specific visual monitoring protocol has been set up on a photographic observatory using the wide-angle camera GoPro®. The detection and localization of boats were carried by two image processing algorithms and allowed the creation of a map of maritime traffic for a surface of 3.48 km2. The ocean noise is described through two different scales (the individual scale and the global scale) which are linked to the traffic information. The Sound Pressure Level characterizes the individual sources and correlates with the distance of the nearest ship, whereas the Ambient Noise Level characterizes the background without individual sources and correlates with the number of boats present. A high spatial and seasonal variability due to coastal maritime traffic is observed in the broadband [100 Hz–30 kHz]. Closest to the traffic, the acoustic is punctuated by diel patterns of biological sounds and the use patterns of the boaters. In spite of an important diurnal flotilla (more than 550 boats per day), the nocturnal activity of fish remains an important element on the soundscape (average and median levels higher during the night).
Passive geoacoustic inversion in the Mid-Atlantic Bight in the presence of strong water column variability
Authors: Tan Tsu Wei , Godin Oleg A. , Katsnelson Boris G. , Yarina Marina
Published: June 2020

Empirical Green's functions are obtained for 31 paths in a highly dynamic coastal ocean by cross-correlation of ambient and shipping noise recorded in the Shallow Water 2006 experiment on a horizontal line array and a single hydrophone about 3600 m from the array. Using time warping, group speeds of three low-order normal modes are passively measured in the 10–110 Hz frequency band and inverted for geoacoustic parameters of the seabed. It is demonstrated that, despite very strong sound speed variations caused by nonlinear internal waves, noise interferometry can be successfully used to acoustically characterize the seafloor on a continental shelf.
Acceptance and Feasibility of Seated Elliptical Pedaling to Replace Sedentary Behavior in Older Adults
Authors: Lerma Nicholas L. , Cho Chi C. , Swartz Ann M. , Maeda Hotaka , Cho Young , Strath Scott J.
Published: June 2020

The purpose of this study was to explore the feasibility and acceptability of a seated pedaling device to reduce sedentary behavior (SB) in the homes of older adults. Methods: Each participant (N = 20) was outfitted with an activity monitor and seated pedaling device in the home for 7 days and randomly assigned to one of four light-intensity pedaling groups (15, 30, 45, and 60 min/day). Results: There was 100% adherence in all groups and significant group differences in the minutes pedaled per day (p < .001), with no significant difference in the total pedaling days completed (p = .241). The 15-, 30-, 45-, and 60-min groups experienced a 4.0%, 5.4%, 10.6%, and 11.3% reduction in SB on the days pedaled, respectively. Conclusion: Clinically relevant reductions in SB time were achievable in this 1-week trial. Long-term adherence and the impact of replacing SB with seated light activities on geriatric-relevant health outcomes should be investigated.
Patterns of Herpes Simplex Virus 1 Infection in Neural Progenitor Cells
Authors: Zheng Wenxiao , Klammer Alissa M. , Naciri Jennifer N. , Yeung Jason , Demers Matthew , Milosevic Jadranka , Kinchington Paul R. , Bloom David C. , Nimgaonkar Vishwajit L. , D’Aiuto Leonardo
Published: June 2020

This study employed human induced pluripotent stem cells (hiPSCs) to model the interaction of HSV-1 with NPCs, which reside in the neurogenic niches of the CNS and play a fundamental role in adult neurogenesis. Herein, we provide evidence that in NPCs infected at an MOI as low as 0.001, HSV-1 can establish a latent state, suggesting that (i) a variant of classical HSV-1 latency can be established during earlier stages of neuronal differentiation and (ii) neurogenic niches in the brain may constitute additional sites of viral reactivation. Lytic HSV-1 infections impaired NPC migration, which represents a critical step in neurogenesis. A difference in susceptibility to HSV-1 infection between two-dimensional (2D) and three-dimensional (3D) NPC cultures was observed, highlighting the potential value of 3D cultures for modeling host-pathogen interactions. Together, our results are relevant in light of observations relating HSV-1 infection to postencephalitic cognitive dysfunction.
The Basic Leucine Zipper Transcription Factor PlBZP32 Associated with the Oxidative Stress Response Is Critical for Pathogenicity of the Lychee Downy Blight Oomycete Peronophythora litchii
Authors: Kong Guanghui , Chen Yubin , Deng Yizhen , Feng Dinan , Jiang Liqun , Wan Lang , Li Minhui , Jiang Zide , Xi Pinggen
Published: June 2020

In this study, we utilized the RNAi technique to investigate the functions of PlBZP32, which possesses a basic leucine zipper (bZIP)-PAS structure, and provided insights into the contributions of bZIP transcription factors to oxidative stress, the production of sporangia, the germination of cysts, and the pathogenicity of
Peronophythora litchii
. This study also revealed the role of PlBZP32 in regulating the enzymatic activities of extracellular peroxidases and laccases in the plant-pathogenic oomycete.
Transition from the lithospheric to asthenospheric mantle-derived magmatism in the Early Jurassic along eastern Bangong–Nujiang Suture, Tibet: Evidence for continental arc extension induced by slab rollback
Authors: Xu Wang-Chun , Zhang Hong-Fei , Chen Li-Ran , Luo Bi-Ji , Guo Liang , Guo Jing-Liang
Published: June 2020

The transition of the geochemical signature in mafic rocks along the eastern Bangong–Nujiang suture in Tibet contains important information about geodynamic processes in the upper mantle. This study recognized two episodes of Early Jurassic gabbros from the Kaqiong terrane, a microblock within the Bangong–Nujiang suture zone. Early gabbros (ca. 197–191 Ma) appear as lenses in the basement complex and were overprinted by amphibolite/granulite-facies metamorphism at ca. 180 Ma. Later undeformed hornblende gabbros (ca. 177–175 Ma) occur as dikes intruding into the basement complex. The early metagabbros are characterized by arc-like geochemical features and enriched Nd-Hf isotopic compositions (whole rock ∑Nd(t) = –0.7 to +0.3; zircon ∑Hf(t) = –5.7 to –2.2), which suggests formation by partial melting of an enriched lithospheric mantle source. In contrast, the later hornblende gabbros have depleted Nd-Hf isotopic compositions (whole rock ∑Nd(t) = +6.1 to +7.1; zircon ∑Hf(t) = +10.7 to +16.8) and normal mid–oceanic–ridge basalt (N–MORB)-type rare earth element (REE) features. They also show variable enrichments of fluid mobile elements (e.g., Rb, U, Pb), indicative of the input of slab-derived fluids in their mantle source. Thus, the hornblende gabbros were most likely originated from the asthenospheric mantle metasomatized by subducted oceanic slab-derived fluids. The transition in geochemical and isotopic compositions of these mantle-derived magmas reveals a long-lasting lithosphere extension and thinning along the southern margin of the Qiangtang terrane in the Early Jurassic. Combined with geological observations, we propose that this transition has resulted from the southward rollback of the subducting Bangong–Nujiang Tethyan oceanic slab. The slab rollback could have initiated the overriding plate extension and the asthenosphere upwelling. Wider implications of this study are that an onset of slab rollback could be an important trigger for the transition of magmatic geochemistry in subduction zones.
Efficacy and safety of flash glucose monitoring in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis
Authors: Castellana Marco , Parisi Claudia , Di Molfetta Sergio , Di Gioia Ludovico , Natalicchio Annalisa , Perrini Sebastio , Cignarelli Angelo , Laviola Luigi , Giorgino Francesco
Published: June 2020

Introduction

Flash glucose monitoring (FGM) is a factory-calibrated sensor-based technology for the measurement of interstitial glucose. We performed a systematic review and meta-analysis to assess its efficacy and safety in patients with type 1 and type 2 diabetes.

Research design and methods

PubMed, CENTRAL, Scopus and Web of Science were searched in July 2019. Twelve studies with a follow-up longer than 8 weeks, evaluating 2173 patients on prandial insulin, multiple daily insulin injections or continuous subcutaneous insulin infusion were included. The following data were extracted: HbA1c, time in range, time above 180 mg/dL, time below 70 mg/dL, frequency of hypoglycemic events, number of self-monitoring of blood glucose (SMBG) measurements, total daily insulin dose, patient-reported outcomes, adverse events, and discontinuation rate. A comparison with SMBG was conducted.

Results

FGM use was associated with a reduction in HbA1c (−0.26% (−3 mmol/mol); p=0.002) from baseline to the last available follow-up, which correlated with HbA1c levels at baseline (−0.4% (−4 mmol/mol) for each 1.0% (11 mmol/mol) of HbA1c above 7.2% (55 mmol/mol)). Also, a decrease in time below 70 mg/dL was found (−0.60 hours/day; p=0.04). Favorable findings in patient-reported outcomes and no device-related serious adverse events were reported. When compared with SMBG, FGM was characterized by no statistically different change in HbA1c (p=0.09), with lower number of SMBG measurements per day (−3.76 n/day; p<0.001) and risk of discontinuation (relative risk=0.42; p=0.001). A limited number of studies, with a heterogeneous design and usually with a short-term follow-up and without specific training, were found.

Conclusions

The present review provides evidence for the use of FGM as an effective strategy for the management of diabetes.
Regular strength training and baseline fitness in overweight infantry members of Slovenian Armed Forces
Authors: Vodičar Miha , Kovčan B , Pori P , Vodičar J , Šimenko J , Karpljuk D , Marković G , Hadžić V
Published: June 2020

Introduction

The prevalence of overweight subjects in military cohorts increases despite the obligatory army physical fitness test (APFT) requirements and the negative consequences of possible test failure due to the increased body mass index (BMI). Studies that have examined the association of BMI with baseline fitness in the military are showing conflicting evidence. The primary aim of the study is to examine BMI effects on baseline fitness that was measured by APFT and additional functional performance tests (FT) (vertical countermovement jump with and without load, loaded prone plank, single-leg hamstring bridge test and pull-ups). Our secondary goal is to explore if regular strength training modifies the BMI effect on baseline fitness.

Methods

A cross-sectional study on a sample of 118 male infantry soldiers that have performed APFT and FT was carried out. Body mass and body height measurements were used to calculate BMI, and to categorise participants into BMI ranks. Two independent categorical variables (BMI rank and strength training) were used to evaluate their influence on dependent variables of physical performance acquired from APFT and FT.

Results

A significantly large size effect of BMI rank (F=1.69, p=0.037; effect size (ES)=0.15) and regular strength training (F=2.66, p=0.006; ES=0.21) on physical performance was found. It was shown that strength training had a medium ES on push-up and pull-up performance, as well as on the overall APFT score and loaded plank.

Conclusions

The importance of regular strength training and normal BMI for better overall baseline fitness in infantry members was highlighted. Most importantly, it was shown that performance is not affected in overweight soldiers who are performing regular strength training in addition to their daily physical training.

Trial registration number

NCT03415464
Improving asthma care with Asthma-COPD Afterhours Respiratory Nurse at Emergency (A-CARE)
Authors: Chew Si Yuan , Leow Jenneth Yue Ling , Chan Adrian Kok Wai , Chan Jing Jing , Tan Kenneth Boon Kiat , Aman Butta , Tan Donna , Koh Mariko Siyue
Published: June 2020

Background

Emergency departments (ED) are important providers of asthma care, particularly after-hours. We identified gaps for quality improvement such as suboptimal adherence rates to three key recommendations from the Global Initiative for Asthma (GINA) guidelines for discharge management asthma guidelines. These were: the prescription of oral and inhaled corticosteroids (OCS and ICS) and issuance of outpatient follow-up for patients discharged from the ED.

Aim

To achieve an adherence rate of 80% to GINA guidelines for ED discharge management by providing after-hours asthma counselling services.

Methods

We implemented Asthma-COPD Afterhours Respiratory Nurse at Emergency (A-CARE) according to the Plan-Do-Study-Act (PDSA) framework to provide after-hours asthma counselling and clinical decision support to ED physicians three nights a week. Data on adherence rates to the GINA guidelines were collected and analysed on a run chart.

Results

After 17 months’ follow-up, a sustained improvement was observed in patients reviewed by A-CARE in the median adherence rates to OCS prescription (58% vs 86%), ICS initiation (27% vs 67%) and issuance of follow-up (69% vs 92%), respectively. The overall impact was, however, limited by a suboptimal referral rate to A-CARE (16%) in a clinical audit of all ED patients with asthma. Nonetheless, in this audit, attendance rates for patients referred to our respiratory department for follow-up were higher in those receiving asthma counselling compared with those who did not (41.7% vs 15.9%, p=0.0388).

Conclusion

Sustained improvements in the adherence rates to guidelines were achieved for patients reviewed by A-CARE but were limited in overall impact due to suboptimal referral rate. We plan to improve the quality of asthma care by implementing further PDSA cycles to increase the referral rates to A-CARE.
Abstracts from international emergency medicine journals
Authors: Production EMJ
Published: June 2020

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.
Innovating at pace during crisis—military lessons for the COVID environment
Authors: Hodgetts Brigadier Tim
Published: June 2020

The challenges of innovating at pace in recent conflicts has encouraged military medical lessons to be codified into an integrated model of innovation, with generic application for the wider healthcare sector and the COVID environment specifically. This ‘Toolset for innovation and change’ emphasises the need to first understand and frame the problem using external (STEEPLE) and internal (TEPID COIL) factor analysis. The conditions that support exemplar innovation adoption by an organisation are described (ADOPTER—Agile, Decisive, Outcome focused, Politically aware, Tolerant of Risk, Empowered and Rewarded) as are the conditions that are necessary for successful innovation translation to another organisation (TRANSL8—Transformational leadership, Relevance, Adaptability/Acceptability, Networks, Simplicity, Life enhancing change, 8-steps of complex change). The obstructions to innovation, or ‘innovation constipation’, are highlighted and remembered as B-OWELS. The toolset was first developed by the author in 2015 from sustained experience of innovation at pace and has been successfully applied to messy problems requiring complex change in both the military and civilian healthcare sectors.
Local anesthesia versus general anesthesia during endovascular therapy for acute stroke: a propensity score analysis
Authors: Pop Raoul , Severac François , Happi Ngankou Emmanuel , Harsan Oana , Martin Ioan , Mihoc Dan , Manisor Monica , Simu Mihaela , Chibbaro Salvatore , Wolff Valérie , Gheoca Roxana , Meyer Alain , Pottecher Julien , Audibert Gérard , Derelle Anne-Laure , Tonnelet Romain , Liao Liang , Zhu François , Bracard Serge , Anxionnat René , Richard Sébastien , Beaujeux Rémy , Gory Benjamin
Published: June 2020

Background

To date, the choice of optimal anesthetic management during endovascular therapy (EVT) of acute ischemic stroke patients remains subject to debate. We aimed to compare functional outcomes and complication rates of EVT according to the first-line anesthetic management in two comprehensive stroke centers: local anesthesia (LA) versus general anesthesia (GA).

Methods

Retrospective analysis of prospectively collected databases, identifying all consecutive EVT for strokes in the anterior circulation performed between January 1, 2018 and December 31, 2018 in two EVT-capable stroke centers. One center performed EVT under LA in the first intention, while the other center systematically used GA. Using propensity score analysis, the two groups underwent 1:1 matching, then procedural metrics, complications, and clinical outcomes were compared. Good outcome was defined as 90 days modified Rankin Scale (mRS) ≤2, and successful recanalization as modified Thrombolysis In Cerebral Ischemia (mTICI) 2b-3.

Results

During the study period, 219 patients were treated in the LA center and 142 in the GA center. Using the propensity score, 97 patients from each center were matched 1:1 according to the baseline characteristics. Local anesthesia was associated with a significantly lower proportion of good outcome (36.1% vs 52.0%, OR 0.53, 95% CI 0.33 to 0.87; p=0.039), lower rate of successful recanalization (70.1% vs 95.8%, OR 0.13, 95% CI 0.04 to 0.39; p<0.001), and more procedural complications (14.4% vs 3.0%, OR 3.44, 95% CI 1.09 to 14.28; p=0.018). There were no significant differences in 90-day mortality or symptomatic hemorrhagic transformation rates.

Conclusions

In this study, systematic use of GA for stroke EVT was associated with better clinical outcomes, higher recanalization rates, and fewer procedural complications compared with patients treated under LA as the primary anesthetic approach.