bluuebunny/crossref_metadata_2025 huggingface dataset:
Bedside Evaluation of Early VAS/NRS Based Protocols for Intravenous Morphine in the Emergency Department: Reasons for Poor Follow-Up and Targeted Practices
Authors: Lvovschi Virginie Eve , Hermann Karl , Lapostolle Frédéric , Joly Luc-Marie , Tavolacci Marie-Pierre
Published: November 2021

Intravenous (IV) morphine protocols based on patient-reported scores, immediately at triage, are recommended for severe pain in Emergency Departments. However, a low follow-up is observed. Scarce data are available regarding bedside organization and pain etiologies to explain this phenomenon. The objective was the real-time observation of motivations and operational barriers leading to morphine avoidance. In a single French hospital, 164 adults with severe pain at triage were included in a cross-sectional study of the prevalence of IV morphine titration; caregivers were interviewed by real-time questionnaires on “real” reasons for protocol avoidance or failure. IV morphine prevalence was 6.1%, prescription avoidance was mainly linked to “Pain reassessment” (61.0%) and/or “alternative treatment prioritization” (49.3%). To further evaluate the organizational impact on prescription decisions, a parallel assessment of “simulated” prescription conditions was simultaneously performed for 98/164 patients; there were 18 titration decisions (18.3%). Treatment prioritization was a decision driver in the same proportion, while non-eligibility for morphine was more frequently cited (40.6% p = 0.001), with higher concerns about pain etiologies. Anticipation of organizational constraints cannot be excluded. In conclusion, IV morphine prescription is rarely based on first pain scores. Triage assessment is used for screening by bedside physicians, who prefer targeted practices to automatic protocols.
BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies
Authors: Tiribelli Mario , Michelutti Angela , Cavallin Margherita , Di Giusto Sara , Simeone Erica , Fanin Renato , Damiani Daniela
Published: November 2021

BCL-2 overexpression has been associated with resistance to chemotherapy and reduced survival in acute myeloid leukemia (AML), but few data are available in elderly patients, a subset accounting for majority of AML cases and with dismal prognosis. We retrospectively analyzed 113 AML patients aged ≥65 years treated with 3 + 7 chemotherapy (n = 51) or hypomethylating agents (HMAs) (n = 62), evaluating the role of BCL-2 expression on complete remission (CR) and overall survival (OS). BCL-2 was expressed in 81 patients (72%), more frequently in those with unfavorable cytogenetic-molecular risk. CR was achieved in 34.5% cases, without differences according to BCL-2 expression or induction therapy. In the whole population 1-year OS was 39%, similar in BCL-2+ and BCL-2- cases. In BCL-2 positive patients OS was superior with HMAs (56% vs. 25% with 3 + 7; p = 0.02), while no advantage for HMA was found in BCL-2 negative cases (36% vs. 27% for 3 + 7). Therapy with HMAs was the only factor associated with longer OS in BCL-2+ AML by multivariable analysis. Use of HMAs, possibly in combination with BCL-2 inhibitors, appears to be particularly appealing in BCL2+ AML, where it is associated with superior survival.
Treatment Options for Elderly/Unfit Patients with Chronic Lymphocytic Leukemia in the Era of Targeted Drugs: A Comprehensive Review
Authors: Fresa Alberto , Autore Francesco , Galli Eugenio , Tomasso Annamaria , Stirparo Luca , Innocenti Idanna , Laurenti Luca
Published: November 2021

Chronic lymphocytic leukemia (CLL) incidence increases with age reaching 37.9/100,000 in patients over 85 years. Although there is no standardized geriatric tool specifically validated for CLL, a correct framing of the fitness status is of critical importance to individualize treatment strategies. Based on the evidence available to date, frontline chemoimmunotherapy has an increasingly narrowing application, being eligible for candidacy only in elderly fit patients without or with minimal geriatric syndromes. On the other hand, treatment with BCR inhibitors, monotherapy, or in combination with anti-CD20 antibodies (e.g., obinutuzumab), must be preferred both for frontline and relapsed CLL not only in unfit patients, but also in fit patients with unmutated IGHV or harboring del(17p) and/or TP53 mutations/deletions. Second-generation inhibitors (e.g., acalabrutinib, zanubrutinib, pirtobrutinib) are novel compounds that, due to their better safety profile and different specificity, will help physicians overcome some of the safety issues and treatment resistances. In the era of targeted therapies, treatment decisions in elderly and/or unfit patients with CLL must be a balance between efficacy and safety, carefully evaluating comorbidities and geriatric syndromes to ensure the best approach to improve both quality of life and life expectancy.
Ultrasound Assessment in Cardiogenic Shock Weaning: A Review of the State of the Art
Authors: Muñoz-Rodríguez Rebeca , García-González Martín Jesús , Jorge-Pérez Pablo , Martín-Cabeza Marta M. , Izquierdo-Gómez Maria Manuela , Marí-López Belén , Duque-González María Amelia , Barragán-Acea Antonio , Lacalzada-Almeida Juan
Published: November 2021

Cardiogenic shock (CS) is associated with a high in-hospital mortality despite the achieved advances in diagnosis and management. Invasive mechanical ventilation and circulatory support constitute the highest step in cardiogenic shock therapy. Once established, taking the decision of weaning from such support is challenging. Intensive care unit (ICU) bedside echocardiography provides noninvasive, immediate, and low-cost monitoring of hemodynamic parameters such as cardiac output, filling pressure, structural disease, congestion status, and device functioning. Supplemented by an ultrasound of the lung and diaphragm, it is able to provide valuable information about signs suggesting a weaning failure. The aim of this article was to review the state of the art taking into account current evidence and knowledge on ICU bedside ultrasound for the evaluation of weaning from mechanical ventilation and circulatory support in cardiogenic shock.
The Impact of Neurocognitive Functioning on the Course of Posttraumatic Stress Symptoms following Civilian Traumatic Brain Injury
Authors: Van Praag Dominique L. G. , Van Den Eede Filip , Wouters Kristien , Wilson Lindsay , Maas Andrew I. R. ,   The CENTER-TBI Investigators and Participants
Published: November 2021

Background: One out of seven individuals who have suffered a traumatic brain injury (TBI) develops a posttraumatic stress disorder (PTSD), which is often associated with neurocognitive impairment. The present study explores the impact of neurocognitive functioning after mild, moderate, and severe TBI on the course of PTSD symptoms. Methods: The data of 671 adults admitted to hospital for a TBI was drawn from the Collaborative European Neurotrauma Effectiveness Research (CENTER-TBI) study. After six- and 12-months post-injury, participants completed the PTSD Checklist-5 (PCL-5), from which change scores were calculated. At six months, participants also completed a neurocognitive assessment including the Rey Auditory Verbal Learning Test, the Trail Making Test, and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Linear regressions were performed to identify associations between cognitive functioning and PCL-5 change scores. Results: Overall, mean PCL-5 change scores showed no clear change (−0.20 ± 9.88), but 87 improved and 80 deteriorated by a change score of 10 or more. CANTAB Rapid Visual Information Processing scores were significantly associated with PCL-5 change scores. Conclusions: Strong sustained attention was associated with improvement in PTSD symptoms. Assessing cognitive performance may help identify individuals at risk of developing (persisting) PTSD post-TBI and offer opportunities for informing treatment strategies.
Impact of Wedge Effect on Outcomes of Intertrochanteric Fractures Treated with Intramedullary Proximal Femoral Nail
Authors: Yen Shen-Ho , Lu Cheng-Chang , Ho Cheng-Jung , Huang Hsuan-Ti , Tu Hung-Pin , Chang Je-Ken , Chen Chung-Hwan , Lin Sung-Yen
Published: November 2021

The purpose of this study is to investigate the risk factors for wedge effect and its relevance between blade cut-out in patients with intertrochanteric fractures (ITF) treated with proximal femoral nail antirotation II (PFNA-II). A total of 113 patients with ITF treated with PFNA-II between 2012 and 2016 were retrospectively analyzed. Radiographic variables including preoperative fracture pattern, fracture classification, lateral wall fracture, and postoperative neck–shaft angle (NSA), femoral offset (FO), blade cut-out, and Parker’s ratio were measured for analysis. An average of 4.16° of varus malalignment in NSA and 5.5 mm of femoral shaft lateralization in FO was found post-operatively. The presence of lateral wall fracture was significantly related to post-operative varus change of NSA (p < 0.05). After at least one year of follow up, the blade cut-out rate was 2.65% (3/113), and Parker’s ratio was significantly higher in patients with blade cut-out (p = 0.0118). This study concluded that patients with ITF-present preoperative lateral wall fracture and postoperative higher Parker’s ratio in AP radiography showed higher incidence of wedge effect that might increase risk of blade cut out.
Comparative Analysis of Corneal Parameters in Swept-Source Imaging between DMEK and UT-DSAEK Eyes
Authors: Machalińska Anna , Kuligowska Agnieszka , Kowalska Bogna , Safranow Krzysztof
Published: November 2021

Background: The need to provide a comparative analysis of corneal parameter changes compared to their preoperative values between Descemet membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) patients. Methods: The study included 24 eyes after UT-DSAEK and 24 eyes after DMEK. Visual acuity, endothelial cell count (ECC), central corneal thickness (CCT), mean keratometry (MK), mean astigmatism (MA), astigmatism asymmetry (AA) and higher-order aberrations (HOAs) were assessed at baseline and 1, 3, 6 and 12 months after the surgery. Results: From the 3rd month post operation, ECC was higher in the DMEK eyes than in the UT-DSAEK eyes (p = 0.01). In a bivariate analysis that was adjusted for age, DMEK was associated with a smaller decrease in posterior MK at the 1-month (β = −0.49, p = 0.002), 3-month (β = −0.50, p < 0.001), 6-month (β = −0.58, p < 0.001) and 12-month (β = −0.49, p < 0.001) follow-up visits. There were no significant differences in changes in anterior or combined surface MK throughout the observation period. Accordingly, no significant differences in changes in MA, AA or HOAs compared to the baseline values were identified between the eyes after DMEK and UT-DSAEK at any follow-up time point. Conclusions: UT-DSAEK seemed to be an easier and safer technique than DMEK while maintaining similar outcomes regarding irregular astigmatism and total keratometry values.
Renal Recovery after the Implementation of an Electronic Alert and Biomarker-Guided Kidney-Protection Strategy following Major Surgery
Authors: Halmy Laszlo , Riedel Joshua , Zeman Florian , Tege Birgit , Linder Volker , Gnewuch Carsten , Graf Bernhard M. , Schlitt Hans J. , Bergler Tobias , Göcze Ivan
Published: November 2021

Background: The facilitation of early recovery of acute kidney injury (AKI) is an important step to improve outcome, particularly because of the limited therapeutic interventions currently available for AKI. The combination of an electronic alert and biomarker-guided kidney-protection strategy implemented in the routine care may have an impact on the incidence of early complete reversal of AKI after major non-cardiac surgery. Methods: We studied 294 patients in two cohorts before (n = 151) and after protocol implementation (n = 143). Data collection required 6 months for each cohort. The kidney-protection protocol included an electronic alert to detect patients who were eligible for urinary biomarker [TIMP2 × IGFBP7]-guided kidney-protection intervention. Intervention was stratified according to three levels of immediate AKI risk: low, moderate, and high. After intervention, postoperative changes in the glomerular filtration rate (eGFR) were identified with a tracking software that included an alert for nephrology consultation if the eGFR had declined by >25% from the preoperative reference value. Primary outcome was early AKI recovery, i.e., the complete reversal of any AKI stage to absence of AKI within the first 7 postoperative days. Results: Protocol implementation significantly increased the recovery of AKI (36/46, 78% compared to control 27/48, 56%, (p = 0.025)) and reduced the length of the ICU stay (p < 0.001). There was no significant difference in the overall incidence of all AKI and moderate and severe AKI in the first 7 postoperative days: 46/143 (32%) and 12/151 (8%) in the protocol implementation group compared to 48/151 (32%) and 18/151 (12%) in the historical control group. Patients with AKI reversal within the first 7 postoperative days had lower in-hospital mortality than patients without AKI reversal. Conclusions: Implementing a combined electronic alert and biomarker-guided kidney-protection strategy in routine care improved early recovery of AKI after major surgery.
Projections of Primary and Revision Shoulder Arthroplasty until 2040: Facing a Massive Rise in Fracture-Related Procedures
Authors: Klug Alexander , Herrmann Eva , Fischer Sebastian , Hoffmann Reinhard , Gramlich Yves
Published: November 2021

Although the demand for shoulder arthroplasties has reached its highest number worldwide, there remains a lack of epidemiologic data regarding recent and future trends. In this study, data for all shoulder arthroplasties (hemiarthroplasty, reverse/anatomic shoulder arthroplasty) from the nationwide inpatient statistics of Germany (2010–2019) and population forecasts until 2040 were gathered. A Poisson and a negative binomial approach using monotone B-splines were modeled for all types of prostheses to project the annual number and incidence of primary and revision arthroplasty. Additionally, trends in main indicators were also gathered and expected changes were calculated. Overall, the number of primary shoulder replacements is set to increase significantly by 2040, reaching at least 37,000 (95% CI 32,000–44,000) procedures per year. This trend is mainly attributable to an about 10-fold increased use of fracture-related reverse shoulder arthroplasty in patients over 80 years of age, although the number of procedures in younger patients will also rise substantially. In contrast, hemiarthroplasties will significantly decrease. The number of revision procedures is projected to increase subsequently, although the revision burden is forecast to decline. Using these country-specific projection approaches, a massive increase of primary and revision shoulder arthroplasties is expected by 2040, mainly due to a rising number of fracture-related procedures. These growth rates are substantially higher than those from hip or knee arthroplasty. As these trends are similar in most Western countries, this draws attention to the international issue, of: if healthcare systems will be able to allocate human and financial resources adequately, and if future research and fracture-prevention programs may help to temper this rising burden in the upcoming decades.
Cone-Beam Breast Computed Tomography: Time for a New Paradigm in Breast Imaging
Authors: O'Connell Avice M. , Marini Thomas J. , Kawakyu-O'Connor Daniel T.
Published: November 2021

It is time to reconsider how we image the breast. Although the breast is a 3D structure, we have traditionally used 2D mammography to perform screening and diagnostic imaging. Mammography has been continuously modified and improved, most recently with tomosynthesis and contrast mammography, but it is still using modifications of compression 2D mammography. It is time to consider 3D imaging for this 3D structure. Cone-beam breast computed tomography (CBBCT) is a revolutionary modality that will assist in overcoming the limitations of current imaging for dense breast tissue and overlapping structures. It also allows easy administration of contrast material for functional imaging. With a radiation dose on par with diagnostic mammography, rapid 10 s acquisition, no breast compression, and true high-resolution isotropic imaging, CBBCT has the potential to usher in a new era in breast imaging. These advantages could translate into lower morbidity and mortality from breast cancer.
Updates on the Latest Surgical Approach of the Aortic Stenosis
Authors: Geicu Lucian , Busuttil Olivier , D’Ostrevy Nicolas , Pernot Mathieu , Benali Walid , Labrousse Louis , Modine Thomas
Published: November 2021

Over the last twenty years, we marked significant progresses in the field of tissue engineering and the development of new aortic valve structural and delivery systems. These continuous iterations on the field, have completely changed the surgical indications and approaches for AVR. Nowadays, therapeutic decisions are endorsed by international guidelines; however, new technical advances need a new integrated approach. The clinical scenarios issued from the interaction between the Guidelines and the newest approaches and technologies are regularly on debate by the Heart Team. We will present some of our most encountered situations and the pattern of our therapeutic decisions. To easily navigate through Guidelines and clinical scenarios, we reported in this review a simplified and easy to use Clinical decision-making algorithm that may be a valuable tool in our daily practice.
A Novel Method of Temporomandibular Joint Hypermobility Diagnosis Based on Signal Analysis
Authors: Grochala Justyna , Grochala Dominik , Kajor Marcin , Iwaniec Joanna , Loster Jolanta E. , Iwaniec Marek
Published: November 2021

Despite the temporomandibular joint (TMJ) being a well-known anatomical structure its diagnosis may become difficult because physiological sounds accompanying joint movement can falsely indicate pathological symptoms. One example of such a situation is temporomandibular joint hypermobility (TMJH), which still requires comprehensive study. The commonly used official research diagnostic criteria for temporomandibular disorders (RDC/TMD) does not support the recognition of TMJH. Therefore, in this paper the authors propose a novel diagnostic method of TMJH based on the digital time–frequency analysis of sounds generated by TMJ. Forty-seven volunteers were diagnosed using the RDC/TMD questionnaire and auscultated with the Littmann 3200 electronic stethoscope on both sides of the head simultaneously. Recorded TMJ sounds were transferred to the computer via Bluetooth® for numerical analysis. The representation of the signals in the time–frequency domain was computed with the use of the Python Numpy and Matplotlib libraries and short-time Fourier transform. The research reveals characteristic time–frequency features in acoustic signals which can be used to detect TMJH. It is also proved that TMJH is a rare disorder; however, its prevalence at the level of around 4% is still significant.
Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans
Authors: Roehl Anna Bettina , Hein Marc , Kroencke Johanna , Kork Felix , Koch Alexander , Andert Anne , Becker Michael , Schmöe Jonas , Reinartz Sebastian Daniel
Published: November 2021

Background: The goal of cardiac evaluation of patients awaiting orthotopic liver transplantation (OLT) is to identify the patients at risk for cardiovascular events (CVEs) in the peri- and postoperative periods by opportunistic evaluation of coronary artery calcium (CAC) in non-gated abdominal computed tomographs (CT). Methods: We hypothesized that in patients with OLT, a combination of Lee’s revised cardiac index (RCRI) and CAC scoring would improve diagnostic accuracy and prognostic impact compared to non-invasive cardiac testing. Therefore, we retrospectively evaluated 169 patients and compared prediction of CVEs by both methods. Results: Standard workup identified 22 patients with a high risk for CVEs during the transplant period, leading to coronary interventions. Eighteen patients had a CVE after transplant and a CAC score > 0. The combination of CAC and RCRI ≥ 2 had better negative (NPV) and positive predictive values (PPV) for CVEs (NPV 95.7%, PPV 81.6%) than standard non-invasive stress tests (NPV 92.0%, PPV 54.5%). Conclusion: The cutoff value of CAC > 0 by non-gated CTs combined with RCRI ≥ 2 is highly sensitive for identifying patients at risk for CVEs in the OLT population.
Anticipating and Adapting to the Future Impacts of Climate Change on the Health, Security and Welfare of Low Elevation Coastal Zone (LECZ) Communities in Southeastern USA
Authors: Allen Thomas , Behr Joshua , Bukvic Anamaria , Calder Ryan S. D. , Caruson Kiki , Connor Charles , D’Elia Christopher , Dismukes David , Ersing Robin , Franklin Rima , Goldstein Jesse , Goodall Jonathon , Hemmerling Scott , Irish Jennifer , Lazarus Steven , Loftis Derek , Luther Mark , McCallister Leigh , McGlathery Karen , Mitchell Molly , Moore William , Nichols Charles Reid , Nunez Karinna , Reidenbach Matthew , Shortridge Julie , Weisberg Robert , Weiss Robert , Wright Lynn Donelson , Xia Meng , Xu Kehui , Young Donald , Zarillo Gary , Zinnert Julie C.
Published: November 2021

Low elevation coastal zones (LECZ) are extensive throughout the southeastern United States. LECZ communities are threatened by inundation from sea level rise, storm surge, wetland degradation, land subsidence, and hydrological flooding. Communication among scientists, stakeholders, policy makers and minority and poor residents must improve. We must predict processes spanning the ecological, physical, social, and health sciences. Communities need to address linkages of (1) human and socioeconomic vulnerabilities; (2) public health and safety; (3) economic concerns; (4) land loss; (5) wetland threats; and (6) coastal inundation. Essential capabilities must include a network to assemble and distribute data and model code to assess risk and its causes, support adaptive management, and improve the resiliency of communities. Better communication of information and understanding among residents and officials is essential. Here we review recent background literature on these matters and offer recommendations for integrating natural and social sciences. We advocate for a cyber-network of scientists, modelers, engineers, educators, and stakeholders from academia, federal state and local agencies, non-governmental organizations, residents, and the private sector. Our vision is to enhance future resilience of LECZ communities by offering approaches to mitigate hazards to human health, safety and welfare and reduce impacts to coastal residents and industries.
The Use of Geoinformatics in Coastal Atmospheric Transport Phenomena: The Athens Experiment
Authors: Nitis Theodoros , Moussiopoulos Nicolas
Published: November 2021

Coastal environment, an area where abrupt changes occur between land and sea, significantly affects the quality of life of a high portion of the Earth’s population. Therefore, the wide range of phenomena observed in coastal areas need to be assessed reliably regarding both data sets and methods applied. In particular, the study of coastal atmospheric transport phenomena which affect a variety of activities in coastal areas, using modeling techniques, demand accurate estimations of a range of meteorological and climatological variables related to the planetary boundary layer. However, the accuracy of such estimations is not obvious. Geoinformatics is able to fill this gap and provide the framework for the design, processing and implementation of accurate geo-databases. This paper aims to highlight the role of geoinformatics in the context of coastal meteorology and climatology. More precisely, it aims to reveal the effect on the performance of a Mesoscale Meteorological Model when a new scheme regarding the input surface parameters is developed using satellite data and application of Geographical Information Systems. The development of the proposed scheme is described and evaluated using the coastal Metropolitan Area of Athens, Greece as a case study. The results indicate a general improvement in the model performance based on the statistical evaluations of three meteorological parameters (temperature, wind speed and wind direction) using four appropriate indicators. The best performance was observed for temperature, then for wind direction and finally for wind speed. The necessity of the proposed new scheme is further discussed.
A Coordination System between Decision Making and Controlling for Autonomous Collision Avoidance of Large Intelligent Ships
Authors: Zhou Zhengyu , Zhang Yingjun , Wang Shaobo
Published: November 2021

Large ships are typically with large inertia and longtime delay in motion, in prevailing collision avoidance methods, their maneuverability is generally neglected, there could be a dangerous situation if the system fails to control the ship course as ordered in a timely manner. This paper proposes a coordination system which consists of two algorithms for avoiding risk and then returning to scheduled waypoint. The avoiding risk algorithm are based on VO (velocity obstacle) method, the returning algorithm is derived from LOS (light of sight) guidance. For better performance, the ship model for simulation is a nonlinear Norrbin Model, with the controller improved by CGSA (closed loop gain shaping algorithm) method from traditional PID control, COLREGS (Convention on the International Regulations for Preventing Collisions at Sea) constrains are considered. To test the effectiveness of the proposed system, a series of complex scenarios including Imazu problem are applied.
Invasive Fungal Infections Complicating COVID-19: A Narrative Review
Authors: Casalini Giacomo , Giacomelli Andrea , Ridolfo Annalisa , Gervasoni Cristina , Antinori Spinello
Published: November 2021

Invasive fungal infections (IFIs) can complicate the clinical course of COVID-19 and are associated with a significant increase in mortality, especially in critically ill patients admitted to an intensive care unit (ICU). This narrative review concerns 4099 cases of IFIs in 58,784 COVID-19 patients involved in 168 studies. COVID-19-associated invasive pulmonary aspergillosis (CAPA) is a diagnostic challenge because its non-specific clinical/imaging features and the fact that the proposed clinically diagnostic algorithms do not really apply to COVID-19 patients. Forty-seven observational studies and 41 case reports have described a total of 478 CAPA cases that were mainly diagnosed on the basis of cultured respiratory specimens and/or biomarkers/molecular biology, usually without histopathological confirmation. Candidemia is a widely described secondary infection in critically ill patients undergoing prolonged hospitalisation, and the case reports and observational studies of 401 cases indicate high crude mortality rates of 56.1% and 74.8%, respectively. COVID-19 patients are often characterised by the presence of known risk factors for candidemia such as in-dwelling vascular catheters, mechanical ventilation, and broad-spectrum antibiotics. We also describe 3185 cases of mucormycosis (including 1549 cases of rhino-orbital mucormycosis (48.6%)), for which the main risk factor is a history of poorly controlled diabetes mellitus (>76%). Its diagnosis involves a histopathological examination of tissue biopsies, and its treatment requires anti-fungal therapy combined with aggressive surgical resection/debridement, but crude mortality rates are again high: 50.8% in case reports and 16% in observational studies. The presence of other secondary IFIs usually diagnosed in severely immunocompromised patients show that SARS-CoV-2 is capable of stunning the host immune system: 20 cases of Pneumocystis jirovecii pneumonia, 5 cases of cryptococcosis, 4 cases of histoplasmosis, 1 case of coccidioides infection, 1 case of pulmonary infection due to Fusarium spp., and 1 case of pulmonary infection due to Scedosporium.
Fungi Associated with Postharvest Diseases of Sweet Potato Storage Roots and In Vitro Antagonistic Assay of Trichoderma harzianum against the Diseases
Authors: Paul Narayan Chandra , Park Soyoon , Liu Haifeng , Lee Ju Gyeong , Han Gui Hwan , Kim Hyunsook , Sang Hyunkyu
Published: November 2021

Sweet potato is the 11th most important food crop in the world and an excellent source of nutrition. Postharvest diseases were monitored in sweet potato storage roots collected from the local markets in Korea during 2021. Several diseases including Fusarium surface and root rot, charcoal rot, dry rot, and soft rot were observed in the postharvest sweet potatoes. A total of 68 fungal isolates were obtained from the diseased samples, and the isolates were grouped into 8 different fungal colony types. Based on multilocus phylogeny and morphological analysis of 17 representative isolates, the isolates were identified as Fusarium oxysporum, F. ipomoeae, F. solani, Penicillium citrinum, P. rotoruae, Aspergillus wentii, Mucor variicolumellatus (Mu. circinelloides species complex), and Macrophomina phaseolina. F. oxysporum was the predominant pathogen as this is the most common pathogen of sweet potato storage roots causing the surface rot disease, and M. phaseolina caused the most severe disease among the pathogens. Dual culture antagonistic assays were evaluated using Trichoderma harzianum strains CMML20–26 and CMML20–27. The results revealed that the two strains showed strong antifungal activity in different ranges against all tested pathogens. This study provides an understanding of diverse postharvest diseases in sweet potatoes and suggests potential biocontrol agents to manage the diseases. In addition, this is the first report of sweet potato storage root rot diseases caused by A. wentii, and P. rotoruae worldwide.
Unusual Inflammatory Tinea Infections: Majocchi’s Granuloma and Deep/Systemic Dermatophytosis
Authors: Castellanos Jade , Guillén-Flórez Andrea , Valencia-Herrera Adriana , Toledo-Bahena Mirna , Ramírez-Cortés Erika , Toussaint-Caire Sonia , Mena-Cedillos Carlos , Salazar-García Marcela , Bonifaz Alexandro
Published: November 2021

Purpose of review. Inflammatory tinea is an uncommon group of dermatophyte entities that predominantly cause fungal infection of the skin and hair. This review intends to present all of the available evidence regarding its epidemiology, etiopathogenesis, clinical features, and diagnostic methods as well as treatments recommended for various inflammatory tinea infections. This article provides a review of Majocchi’s granuloma and dermatophytic or Hadida’s disease. Recent findings. The new phylogenetic classification of dermatophytes includes nine genera, and those that affect humans are Trichophyton, Microsporum, Epidermophyton, and Nannizzia. Furthermore, molecular advancements have revealed impaired antifungal immune responses caused by inflammatory tinea, which are detailed in this article. Summary. The common denominator in these pathologies is the presence of impaired immune responses and, consequently, an impaired inflammatory response by the host. It is necessary to be familiar with these immunological characteristics in order to use the appropriate diagnostic methods and to provide adequate treatment.
Fungal Enzymes as Catalytic Tools for Polyethylene Terephthalate (PET) Degradation
Authors: Ahmaditabatabaei Seyedehazita , Kyazze Godfrey , Iqbal Hafiz M. N. , Keshavarz Tajalli
Published: November 2021

The ubiquitous persistence of plastic waste in diverse forms and different environmental matrices is one of the main challenges that modern societies are facing at present. The exponential utilization and recalcitrance of synthetic plastics, including polyethylene terephthalate (PET), results in their extensive accumulation, which is a significant threat to the ecosystem. The growing amount of plastic waste ending up in landfills and oceans is alarming due to its possible adverse effects on biota. Thus, there is an urgent need to mitigate plastic waste to tackle the environmental crisis of plastic pollution. With regards to PET, there is a plethora of literature on the transportation route, ingestion, environmental fate, amount, and the adverse ecological and human health effects. Several studies have described the deployment of various microbial enzymes with much focus on bacterial-enzyme mediated removal and remediation of PET. However, there is a lack of consolidated studies on the exploitation of fungal enzymes for PET degradation. Herein, an effort has been made to cover this literature gap by spotlighting the fungi and their unique enzymes, e.g., esterases, lipases, and cutinases. These fungal enzymes have emerged as candidates for the development of biocatalytic PET degradation processes. The first half of this review is focused on fungal biocatalysts involved in the degradation of PET. The latter half explains three main aspects: (1) catalytic mechanism of PET hydrolysis in the presence of cutinases as a model fungal enzyme, (2) limitations hindering enzymatic PET biodegradation, and (3) strategies for enhancement of enzymatic PET biodegradation.
Pharmacogenomic Testing and Patient Perception Inform Pain Pharmacotherapy
Authors: Loh Feng-Hua , Azzi Brigitte , Weingarten Alexander , Loewy Zvi G.
Published: November 2021

(1) Background: Chronic pain is one of the most common reasons for individuals to seek medications. Historically, opioids have been the mainstay of chronic pain management. However, in some patient populations, opioids fail to demonstrate therapeutic efficacy, whereas in other populations, opioids may cause toxic effects, even at lower doses. Response to pain medication is affected by many factors, including an individual’s genetic variations. Pharmacogenomic testing has been designed to help achieve optimal treatment outcomes. This study aimed at assessing the impact of CYP2D6 pharmacogenomic testing on physicians’ choice in prescribing chronic pain medications and patient pain control. (2) Methods: This retrospective study reviewed 107 patient charts from a single site pain management center. All 107 patients received pharmacogenomic testing. The outcomes of interest were confirmation that the optimal pain medication is being administered or a change in the chronic pain medication is warranted as a result of the pharmacogenomic testing. The main independent variable was the pharmacogenomic test result. Other independent variables included patient gender, race, and comorbidities. The retrospective study was reviewed and approved by the Touro College and University System IRB, HSIRB1653E. (3) Results: Patients self-reported pain intensity on a scale of 1–10 before and after pharmacogenomic testing. Then, 100% of patients in the retrospective study were tested for their pain pharmacogenomic profile. Of the 107 patients participating in the study, more than 50% had their medications altered as a result of the pharmacogenomic testing. The percentage of patients with intense pain were decreased post-pharmacogenomic testing (5.6%) as compared to pre-pharmacogenomic testing (10.5%). Patients with intense, moderate, and mild pain categories were more likely to receive changes in pain medications. In contrast, patients with severe pain were less likely to receive a change in pain medication. Hispanic ethnicity was associated with a statistically significantly decrease in a pain scale category. Illegal drug abuse was associated with a decrease in pain scale category. Change in medication dose was associated with a decrease in pain scale category. (4) Conclusion: In this retrospective study, implementation of pharmacogenomic testing demonstrated significant benefits to patients with intense pain undergoing treatment.
Whose Policy Uncertainty Matters in the Trade between Korea and the U.S.?
Authors: Bahmani-Oskooee Mohsen , Baek Jungho
Published: November 2021

Since the introduction of the news-based policy uncertainty measure, a few studies have looked at its impact on trade flows by using panel models and aggregate trade data. In this paper we consider the short-run and long-run response of 61 2-digit U.S. exporting industries to Korea and 49 2-digit Korean exporting industries to the U.S. to policy uncertainty measures of the U.S. and Korea. We find that both measures have short-run effects on exports of almost one-third of industries in either direction. In the long run, however, while nine U.S. exporting industries (with a trade share of 9%) are negatively affected by the Korean uncertainty measure, only five industries (with 6% export share) are affected by the U.S. uncertainty measure. As for the Korean exporting industries, we find that three industries with a 31% export share are affected positively by the Korean uncertainty measure and six industries with a 7% export share are affected positively by the U.S. uncertainty measure.
Expectations Concordance and Stock Market Volatility: Knightian Uncertainty in the Year of the Pandemic
Authors: Frydman Roman , Mangee Nicholas
Published: November 2021

This study introduces a novel index based on expectations concordance for explaining stock-price volatility when novel events that are each somewhat unique cause unforeseeable change and Knightian uncertainty in the process driving outcomes. Expectations concordance measures the degree to which KU events are associated with directionally similar expectations of future returns. Narrative analytics of daily news reports allow for the assessment of bullish versus bearish views in the stock market. Increases in expectations concordance across all KU events results in reinforcing effects and an increase in stock market volatility. Lower expectations concordance produces a stabilizing effect wherein the offsetting views reduce market volatility. The empirical findings hold for ex post and ex ante measures of volatility and for OLS and GARCH estimates.
Effects of the Invasive Tree Species Ailanthus altissima on the Floral Diversity and Soil Properties in the Pannonian Region
Authors: Demeter András , Saláta Dénes , Tormáné Kovács Eszter , Szirmai Orsolya , Trenyik Petra , Meinhardt Sarolta , Rusvai Katalin , Verbényiné Neumann Krisztina , Schermann Balázs , Szegleti Zsófia , Czóbel Szilárd
Published: November 2021

Tree-of-heaven (Ailanthus altissima) is one of the most dangerous and widespread invasive woody plant species in Europe. Despite the fact that A. altissima is in the focus of an increasing number of research projects, the impact of its mass spread on native vegetation, its diversity, and changes in soil quality are still incomplete. The current study addresses the effects of this invasive species on plant diversity and soil parameters simultaneously. The main objective of our research is to determine the impact of cover and mass of A. altissima on the diversity of each forest layer; the examined soil parameters and on other selected environmental variables. For botanical and pedological investigations we selected nine A. altissima-dominated sites in Central Europe, in the Pannonian Biogeographical Region. Based on our results, it can be stated that fully grown A. altissima-dominated stands can displace other taxa by their shading and allelopathy, thereby reducing canopy layer diversity. The increase in the species richness of the shrub layer had a positive correlation with the diversity of the floor layer and also with the humus and ammonia content of the soil. As the diversity of shrub layer and floor layer positively correlated with many soil parameters, the diverse vegetation of these layers can represent a potential opportunity for the regeneration of areas infected with A. altissima.
You Win Some, You Lose Some: Compensating the Loss of Green Space in Cities Considering Heterogeneous Population Characteristics
Authors: Nordström Jonas , Hammarlund Cecilia
Published: November 2021

The increased urbanization and human population growth of the recent decades have resulted in the loss of urban green spaces. One policy used to prevent the loss of urban green space is ecological compensation. Ecological compensation is the final step in the mitigation hierarchy; compensation measures should thus be a last resort after all opportunities to implement the earlier steps of the hierarchy have been exhausted. Ecological compensation should balance the ecological damage, aiming for a “no net loss” of biodiversity and ecosystem services. In this study, we develop a simple model that can be used as tool to study the welfare effects of applying ecological compensation when green space is at risk of being exploited, both at an aggregate level for society and for different groups of individuals. Our focus is on urban green space and the value of the ecosystem service—recreation—that urban green space provides. In a case study, we show how the model can be used in the planning process to evaluate the welfare effects of compensation measures at various sites within the city. The results from the case study indicate that factors such as population density and proximity to green space have a large impact on aggregate welfare from green space and on net welfare when different compensation sites are compared against each other.
Preferences in Farmland Eco-Compensation Methods: A Case Study of Wuhan, China
Authors: Yang Xin , Zhou Xiaohe , Cao Shuwen , Zhang Anlu
Published: November 2021

Successful farmland eco-compensation projects need to reflect the heterogeneous preferences both from suppliers and beneficiaries. This paper tries to answer this question by investigating both citizen and farmer preferences for different farmland eco-compensation methods in Wuhan, China, and explore some of the socio-demographic characteristics that contribute to their preferences. Based on the data of 288 citizens and 331 farmers, the multinomial logit model was employed to analyze their preferences for the four farmland eco-compensation methods (monetary compensation, in-kind compensation, technology compensation and policy compensation), respectively. The results show that: (1) Monetary compensation is the most welcomed farmland eco-compensation method among both citizens and farmers. (2) Despite farmers and citizens both putting a high value on monetary compensation methods, citizens are more likely to provide compensation methods that can help farmers improve their living standards in a sustainable method (in-kind compensation, technology compensation and policy compensation). Farmers are less likely to choose the in-kind compensation method. (3) The preference for farmland eco-compensation systems of farmers and citizens are influenced by different socio-demographic characteristics. The results can help the government to design more aimed farmland eco-compensation methods for farmers with different socio-demographic characteristics.
Integrated Evaluations of Resource and Environment Carrying Capacity of the Huaihe River Ecological and Economic Belt in China
Authors: Hsu Wei-Ling , Shen Xijuan , Xu Haiying , Zhang Chunmei , Liu Hsin-Lung , Shiau Yan-Chyuan
Published: November 2021

The evaluations of resource and environment carrying capacity and territorial development suitability, also referred to as “double evaluations”, have been taken by China as an important direction in territorial space planning. Based on the evaluation of resource and environment carrying capacity, the double evaluations can contribute to protecting ecological safety and territorial safety and promoting regional sustainable development. The focus of this study was to integratedly evaluate the resource and environment carrying capacity of the Huaihe River Ecological and Economic Belt. First, the overall weights of the factors at the dimension level and the index level in the established integration evaluation system were calculated with the fuzzy analytical hierarchy process (FAHP) method; and then, using the linear weighted function, the overall resource and environment carrying capacities of 25 cities in the belt were calculated. On that basis, the resource and environment carrying capacity evaluation model was established. Through model analysis, this study comprehensively investigated the resource and environment carrying capacity of the Huaihe River Eco-economic Belt and provided a foundation for the future territorial space planning and layout of the Huaihe River Eco-economic Belt.
Understanding Public Attention towards the Beautiful Village Initiative in China and Exploring the Influencing Factors: An Empirical Analysis Based on the Baidu Index
Authors: Ji Qin , Yang Jianping , He Qingshan , Chen Hongju , Wang Xiran , Tang Fan , Ge Qiuling , Wang Yanxia , Ding Feng
Published: November 2021

The implementation of China’s Beautiful Village Initiative was an extraordinary achievement and aroused extensive public attention. However, existing research mostly focuses on the construction and seldom on public attention towards the Beautiful Village Initiative. For this reason, this paper investigated the spatiotemporal characteristics of public attention based on the Baidu index using time-constrained clustering and the spatial autocorrelation test. Our results showed that the evolutionary process can be divided into three stages: very little national attention (2011–2012), injection of a strong impetus (2013–2015), and rooted in the people’s minds (2016–2020). Spatially, provincial public attention demonstrated obvious spatial differentiation and stable spatial autocorrelation, with Low–Low clusters in Northwest China and High–High Clusters in East, Central, and North China. Spatial econometric models were further utilized to quantify the effects of socioeconomic factors on public attention. The results of the SEM model proved the existence of spatial spillover effects and indicated that the urbanization rate, population density, education level, and network popularity rate all positively affected public attention. The relationship between Beautiful Village construction and public attention was uncoordinated and, in most provinces, advances in public attention were ahead of the construction level. Our findings contribute to the understanding of public attention towards the Beautiful Village Initiative, and policy suggestions we proposed would be applied to increasing public awareness and participation.
An Analysis of an Area’s Vulnerability to the Emergence of Land-Use Conflicts
Authors: Cieślak Iwona , Biłozor Andrzej
Published: November 2021

The optimization of space is the priority goal of spatial planning. Spatial planning policies have numerous objectives, including the prevention of land-use conflicts. Conflicts arise whenever two entities have contradictory expectations regarding the surrounding space. In the process of spatial development, humans impart new characteristics to space, which, under specific circumstances, can give rise to land-use conflict. The elements of space that are particularly vulnerable to conflict include boundary points, property boundaries, density of development, or the shared use of infrastructure. The main aim of this study was to develop a procedure for evaluating the risk of land-use conflict based on the characteristic attributes of space. The proposed procedure for assessing the accumulation of conflict-generating traits in space was developed with the use of databases, GIS tools, and statistical data processing methods.