bluuebunny/crossref_metadata_2025 huggingface dataset:
One-Stage Implant-Retaining Revision for Simultaneous Bilateral Infected Total Knee Arthroplasty: A Report of a Rare Case
Authors: Wirries Nils , Tuecking Lars-René , Skutek Michael
Published: July 2021

There is little information on the management of simultaneous infected total knee arthroplasties in the same patient. Although general principles of management for periprosthetic joint infection apply, there might be certain aspects worth to be considered. We present a case of a 78-year-old patient, who was referred in preseptic conditions 10 years following bilateral TKA. The onset of symptoms was less than one week, proposing an acute hematogenous infection. Analysis of joint fluid revealed that both of his TKAs were infected with Streptococcus sanguinis. Diagnostic algorithms, surgical principles, and the course of the patients following bilateral revision are being described. The reasons for an implant-retaining procedure with irrigation and debridement including the exchange of the polyethylene liners are being discussed as well as possible principles of management of bilateral periprosthetic joint infections.
Can Limits to Arbitrage Explain Stock Price Idiosyncratic Volatility Premium Puzzle in China’s A-Share Market?
Authors: Chen Xiaohui , Ye Jianhua
Published: July 2021

Investigating the existence and causes of idiosyncratic volatility premium puzzle in developing stock market can enrich the research on this asset pricing puzzle. To investigate the existence and whether limits to arbitrage in China’s A-share market can explain the idiosyncratic volatility premium puzzle, this paper uses listed stocks in China’s A-share market from 2002 to 2019 as a sample. We calculate three individual measures and one comprehensive measure of limits to arbitrage based on Chinese specific regulations. After that, we conduct univariate portfolios analysis, regression analysis, and bivariate portfolios analysis to obtain evidence. We prove that idiosyncratic volatility premium puzzle exists in China’s A-share market and is robust and that limits to arbitrage in this market can partly explain this asset pricing puzzle. This paper enriches research on asset pricing anomaly and can help us evaluate the effect of China’s A-share market reform.
Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19
Authors: Wei Wei , Wu Xingyue , Jin Chaoyuan , Mu Tong , Gu Guorong , Min Min , Mu Sucheng , Han Yi
Published: July 2021

Background. The prognostic nutritional index (PNI) has been reported to significantly correlate with poor survival and postoperative complications in patients with various diseases, but its relationship with mortality in COVID-19 patients has not been addressed. Method. A multicenter retrospective study involving patients with severe COVID-19 was conducted to investigate whether malnutrition and other clinical characteristics could be used to stratify the patients based on risk. Results. A total of 395 patients were included in our study, with 236 patients in the training cohort, 59 patients in the internal validation cohort, and 100 patients in the external validation cohort. During hospitalization, 63/236 (26.69%) and 14/59 (23.73%) patients died in the training and validation cohorts, respectively. PNI had the strongest relationships with the neutrophil-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) level but was less strongly correlated with the CURB65, APACHE II, and SOFA scores. The baseline PNI score, platelet (PLT) count, LDH level, and PaO2/FiO2 (P/F) ratio were independent predictors of mortality in COVID-19 patients. A nomogram incorporating these four predictors showed good calibration and discrimination in the derivation and validation cohorts. A PNI score less than 33.405 was associated with a higher risk of mortality in severe COVID-19 patients in the Cox regression analysis. Conclusion. These findings have implications for predicting the risk of mortality in COVID-19 patients at the time of admission and provide the first direct evidence that a lower PNI is related to a worse prognosis in severe COVID-19 patients.
Inflación desbordada
Authors: García Carlos
Published: July 2021

No existe una declaración más tajante sobre el origen de la inflación que la realizada por Anna Schwartz, en el prefacio del libro The Great Contraction 1929-1933: la inflación es un fenómeno monetario y no es producto de presiones de costos. Esta definición, para los macroeconomistas es precisa porque divide sin titubeos a las dos almas contrapuestas que coexisten en nuestra profesión: la monetarista –y sus extensiones neoclásicas– del keynesianismo. Continuar leyendo...
Prevalence and Landscape of Actionable Genomic Alterations in Renal Cell Carcinoma
Authors: Attalla Kyrollis , DiNatale Renzo G. , Rappold Phillip M. , Fong Christopher J. , Sanchez-Vega Francisco , Silagy Andrew W. , Weng Stanley , Coleman Jonathan , Lee Chung-Han , Carlo Maria I. , Durack Jeremy C. , Solomon Stephen B. , Reuter Victor E. , Russo Paul , Chan Timothy A. , Motzer Robert J. , Schultz Nikolaus D. , Reznik Ed , Voss Martin H. , Hakimi A. Ari
Published: July 2021

Purpose:

We report our experience with next-generation sequencing to characterize the landscape of actionable genomic alterations in renal cell carcinoma (RCC).

Experimental Design:

A query of our institutional clinical sequencing database (MSK-IMPACT) was performed that included tumor samples from 38,468 individuals across all cancer types. Somatic variations were annotated using a precision knowledge database (OncoKB) and the available clinical data stratified by level of evidence. Alterations associated with response to immune-checkpoint blockade (ICB) were analyzed separately; these included DNA mismatch repair (MMR) gene alterations, tumor mutational burden (TMB), and microsatellite instability (MSI). Data from The Cancer Genome Atlas (TCGA) consortium as well as public data from several clinical trials in metastatic RCC were used for validation purposes. Multiregional sequencing data from the TRAcking Cancer Evolution through Therapy (TRACERx) RENAL cohort were used to assess the clonality of somatic mutations.

Results:

Of the 753 individuals with RCC identified in the MSK-IMPACT cohort, 115 showed evidence of targetable alterations, which represented a prevalence of 15.3% [95% confidence interval (CI), 12.7%–17.8%). When stratified by levels of evidence, the alterations identified corresponded to levels 2 (11.3%), 3A (5.2%), and 3B (83.5%). A low prevalence was recapitulated in the TCGA cohort at 9.1% (95% CI, 6.9%–11.2%). Copy-number variations predominated in papillary RCC tumors, largely due to amplifications in the MET gene. Notably, higher rates of actionability were found in individuals with metastatic disease (stage IV) compared with those with localized disease (OR, 2.50; 95% CI, 1.16–6.16; Fisher's P = 0.01). On the other hand, the prevalence of alterations associated with response to ICB therapy was found to be approximately 5% in both the MSK-IMPACT and TCGA cohorts and no associations with disease stage were identified (OR, 1.35; 95% CI, 0.46–5.40; P = 0.8). Finally, multiregional sequencing revealed that the vast majority of actionable mutations occurred later during tumor evolution and were only present subclonally in RCC tumors.

Conclusions:

RCC harbors a low prevalence of clinically actionable alterations compared with other tumors and the evidence supporting their clinical use is limited. These aberrations were found to be more common in advanced disease and seem to occur later during tumor evolution. Our study provides new insights on the role of targeted therapies for RCC and highlights the need for additional research to improve treatment selection using genomic profiling.
A High-Throughput Mechanical Activator for Cartilage Engineering Enables Rapid Screening of in vitro Response of Tissue Models to Physiological and Supra-Physiological Loads
Authors: Capuana Elisa , Marino Davide , Di Gesù Roberto , La Carrubba Vincenzo , Brucato Valerio , Tuan Rocky S. , Gottardi Riccardo
Published: July 2021

Articular cartilage is crucially influenced by loading during development, health, and disease. However, our knowledge of the mechanical conditions that promote engineered cartilage maturation or tissue repair is still incomplete. Current in vitro models that allow precise control of the local mechanical environment have been dramatically limited by very low throughput, usually just a few specimens per experiment. To overcome this constraint, we have developed a new device for the high throughput compressive loading of tissue constructs: the High Throughput Mechanical Activator for Cartilage Engineering (HiT-MACE), which allows the mechanoactivation of 6 times more samples than current technologies. With HiT-MACE we were able to apply cyclic loads in the physiological (e.g., equivalent to walking and normal daily activity) and supra-physiological range (e.g., injurious impacts or extensive overloading) to up to 24 samples in one single run. In this report, we compared the early response of cartilage to physiological and supra-physiological mechanical loading to the response to IL-1β exposure, a common but rudimentary in vitro model of cartilage osteoarthritis. Physiological loading rapidly upregulated gene expression of anabolic markers along the TGF-β1 pathway. Notably, TGF-β1 or serum was not included in the medium. Supra-physiological loading caused a mild catabolic response while IL-1β exposure drove a rapid anabolic shift. This aligns well with recent findings suggesting that overloading is a more realistic and biomimetic model of cartilage degeneration. Taken together, these findings showed that the application of HiT-MACE allowed the use of larger number of samples to generate higher volume of data to effectively explore cartilage mechanobiology, which will enable the design of more effective repair and rehabilitation strategies for degenerative cartilage pathologies.
Interventions to Support Informal Caregivers of People with Chronic Obstructive Pulmonary Disease: A Systematic Literature Review
Authors: Marques Alda , Cruz Joana , Brooks Dina
Published: July 2021

Background: Chronic obstructive pulmonary disease (COPD) imposes tremendous challenges for both patients and informal caregivers. Caregivers are key players in the management of COPD. Recently, COVID-19 further increased reliance on informal caregivers who urgently need specific support. This systematic literature review aimed to systematically describe the content and explore the effects of interventions to support informal caregivers of people with COPD. Methods: A mixed-methods systematic review was conducted. PubMed, Scopus, Web of Science, and EBSCO were searched. Studies implementing interventions supporting informal caregivers of people with COPD were included. Data were extracted and analysed in outcome domains and categories using framework analysis. Results: Twenty (14 quantitative, 4 mixed-methods, and 2 qualitative) studies were included. Informal caregivers were mainly female (86%). Caregiving context was poorly/never described. Interventions included patient-caregiver dyads and never caregivers only. Informal caregivers were invited to participate if available. Interventions were delivered across all COPD phases (acute/stable/advanced) and settings (inpatient/outpatient/home), with a wide range of total length, frequency, and duration of sessions. All included education about the disease and its management. Discharge/action plans (n = 12); adherence to therapy and healthy lifestyles (n = 9); and family concerns and psychosocial issues (n = 7) were also commonly addressed. Only 9 (45%) studies reported caregiver-related outcomes, and overall positive effects were observed in 7/9 outcome domains, using a high variety of qualitative and qualitative methods. Often categories were addressed but not assessed. Conclusion: Interventions have a narrow scope (i.e., education) and have not been specifically designed to support informal caregivers. Current evidence showed positive effects, but high methodological heterogeneity exists. Future studies need to explore caregiver-tailored, taking into consideration gender differences; multicomponent; and flexibly administered interventions to effectively support COPD caregivers.
Portable High-Flow Nasal Oxygen during Walking in Patients with Severe Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial
Authors: Carlucci Annalisa , Rossi Veronica , Cirio Serena , Piran Manuela , Bettinelli Giuditta , Fusar Poli Barbara , Malovini Alberto , Ceriana Piero , Ambrosino Nicolino
Published: July 2021

Background: High-flow nasal oxygen (HFNO) improves exercise capacity, oxygen saturation, and symptoms in patients with chronic obstructive pulmonary disease (COPD). Due to the need of electricity supply, HFNO has not been applied during free ambulation. Objective: We evaluated whether HFNO delivered during walking by a battery-supplied portable device was more effective than usual portable oxygen in improving exercise capacity in patients with COPD and severe exercise limitation. The effects on 6-min walking tests (6MWTs) were the primary outcome. Methods: After a baseline 6MWT, 20 stable patients requiring an oxygen inspiratory fraction (FiO2) <0.60 during exercise, randomly underwent 2 6MWT carrying a rollator, under either HFNO with a portable device (HFNO test) or oxygen supplementation by a Venturi mask (Control) at isoFiO2. Walked distance, perceived dyspnea, pulse oximetry, and inspiratory capacity at end of the tests as well as patients’ comfort were compared between the tests. Results: As compared to baseline, walked distance improved significantly more in HFNO than in the control test (by 61.1 ± 37.8 and 39.7 ± 43.8 m, respectively, p = 0.01). There were no significant differences between the tests in dyspnea, peripheral oxygen saturation, or inspiratory capacity, but HFNO test was appreciated as more comfortable. Conclusion: In patients with COPD and severe exercise limitation, HFNO delivered by a battery-supplied portable device was more effective in improving walking distance than usual oxygen supplementation.
Performance of Prediction Models for Contrast-Induced Acute Kidney Injury after Transcutaneous Aortic Valve Replacement
Authors: Rosa Vitor E.E. , Campos Carlos M. , Bacelar Antonio , Abizaid Alexandre A.C. , Mangione José A. , Lemos Pedro A. , Esteves Vinicius , Caramori Paulo , Sampaio Roney O. , Tarasoutchi Flávio , Mehran Roxana , Brito Jr Fabio S.
Published: July 2021

Background: Acute kidney injury (AKI) has shown to adversely affect outcomes in patients undergoing transcutaneous aortic valve replacement (TAVR), and its correct risk estimation may interfere in procedural planning and strategies. The aim of the study was to test and compare 6 scores in predicting AKI after TAVR. Methods: We tested 6 scores (the contrast material limit score, volume-to-creatinine clearance ratio, ACEF, CR4EATME3AD3, Mehran model A, and Mehran model B) in a total of 559 consecutive patients included in the Brazilian TAVR registry. Results: All scores had a poor accuracy and calibration to predict the occurrence of AKI grade 1 or 2. All scores improved the accuracy of AKI risk prediction when stratified for AKI grade 2/3 and AKI grade 3 for all scores. The CR4EATME3AD3 was the best predictor of AKI stage 2/3 (AUC: 0.62; OR: 1.12; 95% CI 1.01–1.26; p = 0.04) and AKI stage 3 (AUC: 0.64; OR: 1.16; 95% CI 1.02–1.32; p = 0.02). Mehran models A and B were both good models for AKI stage 3 (AUC: 0.63; OR: 1.10; 95% CI 1.01–1.22; p = 0.05; and AUC: 0.62; OR: 1.10; 95% CI 1.00–1.21; p = 0.05, respectively). Conclusions: None of the current models demonstrated validity in detecting AKI when its lower grades were evaluated. CR4EATME3AD3 was the best score in predicting moderate to severe AKI after TAVR. These findings suggest that contrast-induced AKI may not be the only factor related to kidney injury after TAVR.
Tongue and Lip Comparisons between Healthy and Nondysphagic Poststroke Individuals
Authors: Galek Kristine , Bice Ed M. , Marquez Giselle
Published: July 2021

Background: The lips and tongue play a substantial role in efficient clearance of food from the mouth and pharynx into the esophagus. No study has compared oral pressures between healthy individuals and poststoke individuals who report functional swallow abilities. Aim: The current study aimed to investigate the presence of differences in oral pressures between healthy individuals and poststroke individuals who report functional swallowing abilities. Design: This is a controlled matched pair study. Population: Eighteen control participants (CG) and 18 nondysphagic poststroke participants (NDSG) were enrolled into this study. Methods: The Iowa Oral Performance Instrument (IOPI) was used to measure and compare tongue strength, endurance, and functional lingual and labial pressures between sex and age-matched pairs. Results: Six paired, two-tailed t tests revealed that tongue and lip pressures were different between the 2 groups. Maximum anterior tongue pressures and posterior tongue pressures were also different, i.e., t(17) = –2.89 (p = 0.010) and t(17) = –2.85 (p = 0.011), with the CG presenting higher pressures. Right lip pressures were significantly lower in the NDSG compared to the CG, i.e., t(17) = 2.45 (p = 0.0001). Left lip pressures were significantly lower in the NDSG compared to the CG, i.e., t(17) = –5.43 (p = 0.0001). Tongue endurance, i.e., t(17) = 0.092 (p = 0.928) and saliva swallow pressures, i.e., t(17) = –0.490 (p = 0.63) were not different. Conclusion: Although poststroke participants reported functional swallowing abilities, there were differences in tongue and lip pressures but not in endurance or saliva swallow pressures. Clinical Rehabilitation Impact: Poststroke individuals without complaints of dysphagia who are not assessed may experience subclinical dysphagia that could negatively impact their nutrition and quality of life.
Maternal Heart Failure
Authors: Bright Rachel A. , Lima Fabio V. , Avila Cecilia , Butler Javed , Stergiopoulos Kathleen
Published: July 2021

Heart failure (HF) remains the most common major cardiovascular complication arising in pregnancy and the postpartum period. Mothers who develop HF have been shown to experience an increased risk of death as well as a variety of adverse cardiac and obstetric outcomes. Recent studies have demonstrated that the risk to neonates is significant, with increased risks in perinatal morbidity and mortality, low Apgar scores, and prolonged neonatal intensive care unit stays. Information on the causal factors of HF can be used to predict risk and understand timing of onset, mortality, and morbidity. A variety of modifiable, nonmodifiable, and obstetric risk factors as well as comorbidities are known to increase a patient's likelihood of developing HF, and there are additional elements that are known to portend a poorer prognosis beyond the HF diagnosis. Multidisciplinary cardio‐obstetric teams are becoming more prominent, and their existence will both benefit patients through direct care and increased awareness and educate clinicians and trainees on this patient population. Detection, access to care, insurance barriers to extended postpartum follow‐up, and timely patient counseling are all areas where care for these women can be improved. Further data on maternal and fetal outcomes are necessary, with the formation of State Maternal Perinatal Quality Collaboratives paving the way for such advances.
VIEWS OF THE PRE-HOSPITAL HEALTHWORKERS IN THE TRANSFER OF COVID-19 PATIENTS TO THE HOSPITAL AND MANAGEMENT A QUALITATIVE STUDY
Authors: YILMAZ Sarper
Published: July 2021

The main purpose of this study is to make an assessment based on the opinions of pre-hospital HCWs, who provide the first care to patients during the pandemic and who work in patient transport or within the pre-hospital emergency medical services (PEMS) system. A case study was conducted with qualitative research methods from the literature. While analyzing the experiences through the eyes of the HCWs, it was witnessed that they had gained experiencial knowledge from previous epidemics and that although they had been tested very hard professionally, they never stopped fighting the pandemic. It was observed that not only society but more specifically HCWs had to deal with enormous risks due to the insufficient awareness of COVID-19. Though they experienced a great sense of professional satisfaction and gained experience, they were tested by the difficult conditions of the pandemic, both professionally and personally. The main defense system for societies against the COVID-19 pandemic—in which prevention methods, treatments, and vaccines are continously discussed and high levels of worldwide uncertainty prevails—are HCWs; therefore, the events they experience throughout this unique period in time should be recorded in history.
Reconciling Seemingly Contradictory Results from the Oregon Health Insurance Experiment and the Massachusetts Health Reform
Authors: Kowalski Amanda E.
Published: July 2021

A headline result from the Oregon Health Insurance Experiment is that emergency room (ER) utilization increased. A seemingly contradictory result from the Massachusetts health reform is that ER utilization decreased. I reconcile both results by identifying treatment effect heterogeneity within the Oregon experiment and extrapolating it to Massachusetts. Even though Oregon compliers increased their ER utilization, they were adversely selected relative to Oregon never takers, who would have decreased their ER utilization. Massachusetts expanded coverage from a higher level to healthier compliers. Therefore, Massachusetts compliers are comparable to a subset of Oregon never takers, which can reconcile the results.
Miscellaneous of new species in Epidendrum (Orchidaceae) from southwestern Ecuador
Authors: ROMERO BOSCO JAVIER ZAMBRANO , HÁGSATER ERIC , SOLANO RODOLFO
Published: July 2021

Epidendrum amoanum, E. × inauditum, E. laciniatum, E. leptopetalum, E. marioi, E. oroense, E. viridi-ochraceum, and E. viridium are described and illustrated based on specimens collected in southwestern Ecuador. Information concerning distribution, habitat, and phenology are provided for each taxon. The new orchid taxa are members of Diothonea, Incomptum, Nocturnum, Schistochilum, and Spathiger groups.
Mycena yuezhuoi sp. nov. (Mycenaceae, Agaricales), a purple species from the peninsula areas of China
Authors: LIU ZEWEI , NA QIN , CHENG XIANHAO , WU XIAOMING , GE YUPENG
Published: July 2021

During a study of Mycena s.l. in eastern China, a distinct species, Mycena yuezhuoi, was collected on the Jiaodong Peninsula. Mycena yuezhuoi has the following characteristics: a purple pileus, emarginate and white lamellae, elongated pip-shaped to cylindrical basidiospores, and cheilocystidia that are smooth or occasionally have an apical protrusion. The discovery of M. yuezhuoi provides new material for the study of Mycena sect. Calodontes, especially the M. pura complex. Although M. yuezhuoi closely resembles M. pura regarding macroscopic characteristics, it forms a monophyletic clade in phylogenetic trees that is distinct from clades in the M. pura complex. Moreover, the molecular phylogeny obtained from a combined analysis of multiple gene regions (ITS+RPB1+tEF1) supports the results of the morphological identification. We propose Mycena yuezhuoi as a new species based on morphological observations and phylogenetic analyses and provide line drawings, photos, descriptions, and comparisons with allied species.
Review of the species of Pediobius (Hymenoptera, Eulophidae) having extreme dorsal setation and description of a new species from East Africa
Authors: GUMOVSKY ALEX
Published: July 2021

The Afrotropical species of the genus Pediobius (Hymenoptera, Eulophidae) characterized by extreme setation on the dorsal mesosoma are reviewed and grouped into a newly proposed setigerus group. This group is characterized by the broad attachment of the third funicular and first claval segments, so that the funicle is functionally 2-segmented with a 3-segmented clava. Four species are recognized for the group: P. setigerus Kerrich (from Ghana, Ivory Coast, Republic of Guinea, the Democratic Republic of the Congo, Uganda), P. multisetis Bouček (from Ivory Coast), P. sp. indet. aff. multisetis (from Uganda), and P. erinaceus Gumovsky sp. n. (from Uganda). This last species is associated with a leaf miner, and is easily recognizable in having numerous strong bristles on the lateral areas of the mesoscutum, along the notauli, and anterior margin of the mesoscutum, a smooth mesoscutellum with only one pair of thin setae, and the pronotal collar with only 6 thin setae. By contrast, in P. setigerus and P. multisetis the mesoscutellum is sculptured and bears a row of about 20 strong bristles on each side, and the pronotal collar also bears about 20 strong bristles. The differences between P. setigerus and P. multisetis, as well as issues on their biology and type material, are discussed.
Description of the second- and third-instar larvae of Hydrovatus crassulus Sharp, 1882 (Coleoptera: Dytiscidae: Hydrovatini)
Authors: MICHAT MARIANO C.
Published: July 2021

The second- and third-instar larvae of the diving-beetle species Hydrovatus crassulus Sharp, 1882 are described and illustrated, including detailed morphometric and chaetotaxic analyses of the cephalic capsule, head appendages, legs, last abdominal segment and urogomphi. Larvae of this species lack the parietal pore PAo, the premental seta LA3 and the urogomphal seta UR8, and have the sensillum MN2 shaped as a short hair-like seta and the ventral surface of the abdominal segments II–V sclerotized. All these characteristics are shared with the other species of Hydrovatus Motschulsky, 1853 known in detail (H. caraibus Sharp, 1882) and therefore are considered diagnostic for the genus. Hydrovatus crassulus also characterizes by the presence of a small galea, which reinforces the hypothesis that this structure is part of the ancestral condition of Hydrovatus. Larvae of H. crassulus differ from those of H. caraibus in having a smaller size, a smaller ratio U/LAS, and a larger ratio U1/U2, and also in the presence (in most cases) of a secondary seta on the anteroventral surface of femur.
Impacts of Multi-Timescale Circulations on Meridional Moisture Transport
Authors: Liu Qiao , Li Tim , Zhou Weican
Published: July 2021

Relative impacts of the climatological annual mean, the climatological annual variation, the synoptic, the intra-seasonal and the inter-annual flows on meridional moisture transport were investigated based on reanalysis data. Due to an in-phase relationship between the poleward wind and specific humidity, the synoptic and intra-seasonal motions contribute about 50% and 30% of the maximum zonal and annual mean poleward moisture transport in the middle latitudes, respectively. The preferred latitudinal location (40°N or S) of the maximum zonal mean moisture transport by the synoptic motion is attributed to the combined effect of the maximum wind variability poleward of 40°N or S in association with atmospheric baroclinic instability and the maximum moisture variability equatorward of 40°N or S in association with the anomalous advection of the mean moisture. While the MJO and ENSO have a small contribution to the long-term mean transport, they may strongly affect regional moisture transport through interaction with the mean moisture and through the modulation to higher-frequency modes. A statistical relationship between tropical cyclone (TC) moisture and intensity was constructed based on a large number of high-resolution Weather Research and Forecasting (WRF) model simulations, and the so-derived relationship was further applied to estimate TC moisture transport. It is found that TC transport accounts for about 30% (53%) of the climatological seasonal mean total moisture transport over key northern (southern) hemispheric TC track regions in the northern (southern) hemispheric TC season.
Tropical and subtropical forcing of future southern hemisphere stationary wave changes
Authors: Patterson Matthew , Woollings Tim , Bracegirdle Thomas J.
Published: July 2021

Stationary wave changes play a significant role in the regional climate change response in Southern Hemisphere (SH) winter. In particular, almost all CMIP5 models feature a substantial strengthening of the westerlies to the south of Australia and enhancement of the subtropical jet over the eastern Pacific in winter. In this study we investigate the mechanisms behind these changes, finding that the stationary wave response can largely be explained via reductions in the magnitude of the upper level Rossby wave source over the tropical / subtropical East Pacific. The Rossby wave source changes in this region are robust across the model ensemble and are strongly correlated with changes to low latitude circulation patterns, in particular, the projected southward migration of the Hadley cell and weakening of the Walker circulation. To confirm our mechanism of future changes, we employ a series of barotropic model experiments in which the barotropic model is given a background state identical to a particular CMIP5 model and an anomalous Rossby wave source is imposed. This simple approach is able to capture the primary features of the ensemble mean change, including the cyclonic anomaly south of Australia, and is also able to capture many of the inter-model differences. These findings will help to advance our understanding of the mechanisms underpinning SH extratropical circulation changes under climate change.
Discrimination experienced by Aboriginal and Torres Strait Islander males in Australia: Associations with suicidal thoughts and depressive symptoms
Authors: Haregu Tilahun , Jorm Anthony F , Paradies Yin , Leckning Bernard , Young Jesse T , Armstrong Gregory
Published: July 2021

Introduction:

Globally, Indigenous populations have higher rates of suicidal behavior and psychological distress compared to non-Indigenous populations. Indigenous populations also report high rates of exposure to discrimination, which could potentially contribute to poor mental health outcomes. The objectives of this paper were to estimate the prevalence of discrimination among Aboriginal and Torres Strait Islander males in Australia and to examine the role of discrimination in the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms.

Methods:

We used cross-sectional data on 13,697 males aged 18–55 years from the Australian Longitudinal Study on Male Health. We undertook a Poisson regression with robust standard error analyses to examine Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination in the past 2 years as correlates of recent suicidal ideation. We used zero-inflated negative binomial regression to assess Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination as correlates of recent depressive symptoms.

Results:

Aboriginal and Torres Strait Islander males have a twofold higher prevalence of self-perceived discrimination (39.2% vs 19.3%, p < 0.001), suicidal ideation (21.8% vs 9.4%, p < 0.001) and moderate or worse depressive symptoms (24.0% vs 12.2%, p < 0.001) as compared to their non-Indigenous counterparts. After adjusting for sociodemographics and substance use, Aboriginal and Torres Strait Islander status was significantly associated with suicidal thoughts (odds ratio = 1.49, p = 0.019) and depressive symptoms (prevalence rate ratio = 1.19, p = 0.018). About 15.3% and 28.7% of the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms, respectively, was explained by discrimination.

Conclusion:

Our analyses add to evidence that discrimination is a contributor to mental health disparities between Aboriginal and Torres Strait Islander and non-Indigenous populations in Australia. Reducing discrimination ought to be considered as part of strategies to improve the social and emotional well-being of Aboriginal and Torres Strait Islander people.
Perception towards E-learning and COVID-19 on the mental health status of university students in Malaysia
Authors: Moy Foong Ming , Ng Yit Han
Published: July 2021

The COVID-19 pandemic has disrupted the lives of all including university students. With the preventive measures to reduce the transmission of COVID-19, all face-to-face teaching and learning are converted to e-learning. The COVID-19 pandemic and the implementation of e-learning may influence these students’ mental conditions. This study aimed to determine the association of factors with mental health status (depression, anxiety and stress) among university students in Malaysia. Study participants were tertiary education students from both the private and public universities in Malaysia. Participants were recruited via university emails and social media. The survey was administered via the online REDCap platform, from April to June 2020, during the movement control order period in the country. The questionnaire captured data on socio-demographic characteristics, academic information, implementation of e-learning, perception towards e-learning and COVID-19; as well as DASS 21 to screen for depression, anxiety and stress. The levels of stress, anxiety and depression were 56.5% (95% CI: 50.7%, 62.1%), 51.3% (95% CI: 45.6%, 57.0%) and 29.4% (95% CI: 24.3%, 34.8%) respectively. Most participants had good perception towards e-learning but negative perception on COVID-19. From the multivariate analysis, participants with positive perception on COVID-19 were protective towards stress (aOR: 0.96; 95% CI: 0.92, 0.99), anxiety (aOR: 0.94, 95% CI: 0.90, 0.98) and depression (aOR: 0.95; 95% CI: 0.91, 0.99). Older students were 14% (aOR: 0.86, 95% CI: 0.79, 0.94) and 11% (aOR: 0.89: 95% CI: 0.80, 0.99) less likely for anxiety and depression, respectively. Students originated from the Malay ethnicity had higher odds (aOR: 1.93; 95% CI: 1.05, 3.56) for depression. These findings demonstrated that the mental status of university students was greatly affected during the COVID-19 pandemic. Timely and credible information should be disseminated to alleviate their negative perception towards COVID-19.
Patterns of Paternal Involvement of Korean Fathers: A Person-Centered Approach
Authors: Ko Kwangman , Kang Youngjin , Choi Jieun
Published: July 2021

Given roles and expectations of father involvement in South Korea are in transition from traditional breadwinner to an involved caregiver to children, it is plausible that Korean fathers show diverse involvement behaviors in the contexts of work, family, and parenting. Using a person-centered approach, we explored if there were groupings of Korean fathers who could be identified from their involvement with their children. We also examined if those subgroup memberships were related to various factors in work, family, and parenting domains. With a sample of 212 married working fathers and the 12 items of involvement behaviors, we found four heterogeneous subgroups of people: low-involved, accessibility-focused, involved-but-less-accessible, and highly involved fathers. Significant differences among the four profiles were also found regarding various factors such as job stress, work and family conflict, work schedule, maternal employment, parenting satisfaction, and perceived level of involvement. Suggestions for future research, practitioners, and policymakers were discussed.
Targeting reactive nitroxidative species in preclinical models of migraine
Authors: Akerman Simon , Salvemini Daniela , Romero-Reyes Marcela
Published: July 2021

Background

Reactive nitroxidative species, such as nitric oxide but particularly peroxynitrite, have been strongly implicated in pain mechanisms. Targeting peroxynitrite is anti-nociceptive in pain models, but little is known about its role in migraine mechanisms. Given the need to validate novel targets for migraine headache, our objective was to study the potential of reactive nitroxidative species, particularly peroxynitrite, as novel targets for drug discovery and their role in migraine mechanisms.

Methods

We recorded neuronal activity in rats with extracellular electrodes and examined the effects of targeting nitric oxide or peroxynitrite on ongoing and cranial-evoked firing rates of central trigeminocervical neurons. We injected calcitonin gene-related peptide (which produces migraine-like headache in migraineurs) and characterized neuronal responses to cranial stimulation and on behavioral responses to nociceptive periorbital stimulation and determined the effects of targeting reactive nitroxidative species on the mediated changes.

Results

L-NAME (nitric oxide synthase inhibitor) and Fe(III)5,10,15,20-tetrakis(4-sulfonatophenyl)porphyrinato chloride (FeTPPS; peroxynitrite decomposition catalyst) inhibited ongoing and dural-evoked responses of trigeminocervical neurons, without affecting normal facial-cutaneous responses. Calcitonin gene-related peptide caused activation and sensitization of dural-responsive trigeminovascular neurons with hypersensitivity to intracranial and extracranial stimulation, and reduction of periorbital withdrawal thresholds. Only the peroxynitrite decomposition catalyst prevented these neuronal and behavioral nociceptive responses.

Discussion

The data support that calcitonin gene-related peptide mediates the underlying neurobiological mechanisms related to the development of migraine-like headache. They also confirm the role of nitric oxide and implicate peroxynitrite production along the trigeminovascular migraine pathway in these mechanisms. The data also support peroxynitrite as a novel and potentially effective target for migraine treatment. The current drug development focus on peroxynitrite decomposition catalysts for chronic pain disorders should therefore extend to migraine.
Surrounding Vehicles’ Contribution to Car-Following Models: Deep-Learning-Based Analysis
Authors: Vasebi Saeed , Hayeri Yeganeh M. , Jin Peter J.
Published: July 2021

Relatively recent increased computational power and extensive traffic data availability have provided a unique opportunity to re-investigate drivers’ car-following (CF) behavior. Classic CF models assume drivers’ behavior is only influenced by their preceding vehicle. Recent studies have indicated that considering surrounding vehicles’ information (e.g., multiple preceding vehicles) could affect CF models’ performance. An in-depth investigation of surrounding vehicles’ contribution to CF modeling performance has not been reported in the literature. This study uses a deep-learning model with long short-term memory (LSTM) to investigate to what extent considering surrounding vehicles could improve CF models’ performance. This investigation helps to select the right inputs for traffic flow modeling. Five CF models are compared in this study (i.e., classic, multi-anticipative, adjacent-lanes, following-vehicle, and all-surrounding-vehicles CF models). Performance of the CF models is compared in relation to accuracy, stability, and smoothness of traffic flow. The CF models are trained, validated, and tested by a large publicly available dataset. The average mean square errors (MSEs) for the classic, multi-anticipative, adjacent-lanes, following-vehicle, and all-surrounding-vehicles CF models are 1.58 × 10−3, 1.54 × 10−3, 1.56 × 10−3, 1.61 × 10−3, and 1.73 × 10−3, respectively. However, the results show insignificant performance differences between the classic CF model and multi-anticipative model or adjacent-lanes model in relation to accuracy, stability, or smoothness. The following-vehicle CF model shows similar performance to the multi-anticipative model. The all-surrounding-vehicles CF model has underperformed all the other models.
Binary search tree-based explicit MPC controller design with Kalman filter for vehicular adaptive cruise system
Authors: Feng Shilin , Zhao Youqun , Deng Huifan , Wang Qiuwei
Published: July 2021

The adaptive cruise control (ACC) system has received significant attention due to traffic safety improvement, traffic throughput increment, and energy conservation. Model Predictive Control (MPC) has been successfully applied in the control of multi-objective vehicular ACC. However, as a state-feedback policy, MPC requires full state measurement. Meanwhile, the real-time performance of MPC is intractable. This paper proposes to estimate the state value and disturbance value with an extended state Kalman filter to deal with measurement uncertainty. The Kalman filter is based on an augmented state-space model which takes the disturbance term as a new state. To improve real-time performance, this paper suggests employing an explicit MPC (EMPC) based on binary search tree to move the online computational burden of MPC to offline computation by multi-parametric quadratic programming (MPQP). An improved algorithm to solve the MPQP problem offline is proposed, which is initialized discarding the requirement of parameters range, while previous methods need. In the simulated measurement process, the extended state Kalman filter can effectively reduce noise and accurately estimate the value of state and disturbance in the car-following model. Simulations in different scenarios are performed to test the effectiveness of the proposed ACC controller. Results show that the proposed EMPC for the ACC system can improve the real-time performance of the MPC with little loss of performance. On average, the EMPC via binary search is 95.8 times faster than the MPC with the same parameters as EMPC for the studied ACC system. And it has better overall performance compared with the ACC with collision avoidance (CA-ACC) method.
Bowel ultrasound enhances predictive value based on clinical indicators: a scoring system for moderate-to-severe endoscopic activities in patients with ulcerative colitis
Authors: Zhang Mengmeng , Zhang Huimin , Zhu Qingli , Bai Xiaoyin , Zhou Qingyang , Ruan Gechong , Li Wenbo , Ma Li , Xiao Mengsu , Yang Hong , Qian Jiaming
Published: July 2021

Background and Aim:

The aim was to assess non-invasive factors among clinical features, laboratory, and bowel ultrasound (BUS) characteristics and to develop a scoring system to predict endoscopic activities for ulcerative colitis (UC) patients.

Methods:

We performed a retrospective study collecting UC patients between January 2015 to September 2020. Logistic regression was performed to predict moderate-to-severe endoscopic activities, defined as endoscopic Mayo score ⩾2. Model performance was described with discrimination and calibration ability and validated by internal and external methods.

Results:

A total of 103 and 29 patients were enrolled in the modeling and validation groups, respectively. Stool frequency ⩾5 times/day, hematochezia, erythrocyte sedimentation rate (ESR), and colonic wall flow in BUS were included into two predictive models for endoscopic activities, both with good discrimination ability [Area under curve (AUC) 0.879 and 0.882, p  < 0.001] and a sensitivity of 76.7% and specificity of 92.3%, which showed an adequate calibration ability by using the Hosmer–Lemeshow test ( p = 0.14 and 0.07). The external validation displayed consistent results with the above mentioned. Nomograms were also established for these models.

Conclusion:

We developed predictive models for endoscopic disease activities by using noninvasive factors based on stool frequency, hematochezia, ESR, and colonic wall blood flow in BUS. These models performed well in the internal and external validation.
ARTHROSCOPIC TREATMENT OF POSTERIOR ANKLE IMPINGEMENT IN PEDIATRIC ATHLETES AND ITS OUTCOMES - A PROSPECTIVE STUDY
Authors: Kushare Indranil , Ghanta Ramesh , Allahabadi Sachin , Kastan Kristen , Stone Tracie , Gomez Jorge , McKay Scott
Published: July 2021

Background:

Posterior ankle impingement (PAI) is a known cause of posterior ankle pain in athletes performing repetitive plantarflexion motions, such as in soccer. Even though it is well-described in adults, literature on PAI in pediatric patients is scarce.

Purpose:

The purpose was to describe prospective outcomes after arthroscopic management of posterior ankle impingement in pediatric and adolescent patients.

Methods:

An IRB-approved prospective study was performed at a tertiary children’s hospital from 2016-2020. Patients <18 years of age who were diagnosed with posterior ankle impingement and underwent posterior ankle arthroscopy with minimum 3-month post-operative follow-up were included. Data collected included pre-operative demographics and sporting activities, clinical and radiologic findings. Visual Analogue Scale (VAS) scores, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were collected at the initial and follow-up visits.

Results:

A total of 50 patients (65 ankles; 28 females), were included with mean age 13.3 years. Football and soccer were the most commonly implicated sports. All patients underwent initial conservative management including relative rest, immobilization and/or physical therapy for an average period of 44 weeks. The indication for surgery was failure of conservative management to improve symptoms. All patients underwent posterior ankle arthroscopy with arthroscopic confirmation of impingement pathology followed by debridement. The pathology was predominantly bony (Os trigonum, Stieda process) in 54%, and predominantly soft tissue (low flexor hallucis longus belly, ganglion cyst in the ankle, hypertrophied posterior ankle ligaments) in 46%. All 50 patients (100%) returned to sports at an average 8.5 ± 4.1 weeks. 51 ankles had radiographs done at 1 years post-operatively which did not show recurrence or any new osseous abnormalities. At mean follow up of 26 months, there was a statistically significant improvement in VAS scores (7.0 to 0.53, p<0.05) and AOFAS scores (63.9 to 95.6, p<0.05) from pre- to post-operative final follow-up. Complications included numbness over lateral part of the heel (sural nerve distribution) in 1 patient.

Conclusion:

The first prospective study on pediatric PAI demonstrates that arthroscopic treatment, after failed conservative management, allowed patients to return to prior level of activity and sports, and resulted in improved pain relief and higher functional parameters. Complications associated with this procedure were minimal.