bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular Revascularization with Stent Implantation in Patients with Acute Mesenteric Ischemia due to Acute Arterial Thrombosis: Clinical Outcome and Predictive Factors
Authors: Pedersoli Federico , Schönau Kai , Schulze-Hagen Maximilian , Keil Sebastian , Isfort Peter , Gombert Alexander , Alizai Patrick Hamid , Kuhl Christiane K. , Bruners Philipp , Zimmermann Markus
Published: April 2021

Purpose

To determine 30-day-mortality rates and identify predictors for survival in patients undergoing endovascular revascularization for acute mesenteric ischemia (AMI) due to occlusion of the celiac (CA) or superior mesenteric artery (SMA) from arterial thrombosis in the setting of atherosclerosis at the vessel origin.

Materials and Methods

A retrospective analysis on patients who underwent acute endovascular revascularization to treat AMI caused by thrombotic occlusion of the CA and/or SMA between January 2011 and December 2019 was conducted. 30-day-mortality rates were calculated. Univariate binomial logistic regression analyses (p < 0.05) were performed to assess whether the following factors were associated with 30-day mortality: sex, age, history of smoking, history of abdominal angina, signs of bowel necrosis on pre-interventional CT, one- vs. two-vessel disease, patency of the inferior mesenteric artery, outpatient or inpatient occurrence of ischemia, onset of AMI during ITU stay, elevated pre-interventional serum lactate levels, total leukocyte count, platelet/lymphocyte ratio and neutrophil/lymphocyte ratio.

Results

40 patients were included in this analysis. 30-day-mortality rate was 25/40 (62.5%). Median overall survival of patients who survived the first 30 days was 36 ± 18 months. None of the analyzed factors was statistically significantly associated with 30-day mortality.

Conclusion

Although mortality of patients with AMI due to acute arterial thrombosis remains high, almost 40% of patient who underwent emergent endovascular revascularization survived longer than one month. Since no predictors for the outcome in these patients were identified, all patients with AMI should be offered an immediate revascularization effort.
The detection of malingering in whiplash-related injuries: a targeted literature review of the available strategies
Authors: Monaro Merylin , Bertomeu Chema Baydal , Zecchinato Francesca , Fietta Valentina , Sartori Giuseppe , De Rosario Martínez Helios
Published: April 2021

Objective

The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs.

Methods

We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020.

Results

Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed.

Conclusions

Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.
Influence of rebubbling on anterior segment parameters and refractive outcomes in eyes with DMEK for Fuchs endothelial dystrophy
Authors: Agha Bishr , Forster Raimund , Kohnen Thomas , Schmack Ingo
Published: April 2021

Purpose

To evaluate the potential impact of rebubbling on the anterior segment parameters and refractive outcomes in patients with graft detachment following uneventful DMEK for Fuchs endothelial dystrophy (FED).

Methods

Retrospective institutional cohort study of comparing 34 eyes of 31 patients with rebubbling for graft detachment following Descemet membrane endothelial keratoplasty (DMEK) to 33 eyes of 28 patients with uneventful DMEK. Main outcome parameters were various corneal parameters obtained by Scheimpflug imaging, refractive outcome, corrected distance visual acuity (CDVA), and endothelial cell density (ECD).

Results

Anterior and posterior corneal astigmatism, corneal densitometry, central corneal thickness, and anterior chamber depth and volume showed no significant differences. Preoperative distribution of astigmatism axis orientations showed a high proportion of anterior corneal with-the-rule astigmatism (71%) in eyes requiring rebubbling. Mean postoperative cylinder in the rebubbling group (1.21 ± 0.85 D) was significantly higher compared to the controls (p = 0.04), while differences in spherical equivalent (SE) were insignificant (p = 0.24). Postoperative CDVA was 0.11 ± 0.11 in the control group compared to 0.21 ± 0.17 in the rebubbling group (p = 0.03). Eyes with subsequent rebubbling demonstrated a significantly higher endothelial cell loss (56% versus 37%) (p < 0.001).

Conclusion

Apart from higher cylinder values, refractive outcome and corneal parameters assessed by Scheimpflug imaging were comparable in eyes with rebubbling and controls. However, a reduced visual acuity and an increased endothelial cell loss should be taken into consideration prior to rebubbling especially in eyes with circumscribed graft detachment.
Pseudomonas aeruginosa infection in respiratory samples in children with neurodisability—to treat or not to treat?
Authors: Gregson Elizabeth , Thomas Lowri , Elphick Heather E
Published: April 2021

The objective was to investigate the prevalence of Pseudomonas aeruginosa (PA) in patients with complex neurodisability and current treatment practice in our centre in order to inform future guidelines. A retrospective case note review was undertaken at a tertiary children’s hospital. One hundred sixty-two patients (mean age 11.7 years) with a primary diagnosis of neuromuscular disease (NMD) or severe cerebral palsy (CP) and a respiratory sample sent for analysis during the study period were studied. Associations between PA in respiratory samples and diagnosis, long-term ventilation, presence of a gastrostomy or a tracheostomy, antibiotic choice, clinical deterioration and adverse events were analysed. Twenty-five (15%) had one or more PA isolate in respiratory samples. There was a significant association between PA in respiratory samples and tracheostomy (p<0.05). In 52% samples, multiple pathogens co-existed. There was no significant association between choice of antibiotic and clinical outcome but when antibiotics were changed to specific PA antibiotics during the course of the illness, all resulted in clinical improvement. Twenty-six episodes involving 8 patients with recurrent admissions involved PA organisms that were resistant to one or more antibiotics.

Conclusions: A larger prospective study may establish clearer criteria for guideline development. Techniques such as point-of-care testing to identify virulent strains of PA may improve patient outcomes and prevent the development of antibiotic resistance in the future.

What is Known:•Children with complex neurodisability are at increased risk of respiratory morbidity and of infection with gram-negative organisms such as Pseudomonas aeruginosa.•There are currently no guidelines to inform treatment choices in this group of vulnerable children.

What is New:•15% children in this study population had Pseudomonas aeruginosa in respiratory samples during a 12-month period, the majority of whom did not require critical care treatment. Thirteen of these children had a tracheostomy in situ and 12 did not. •In those that deteriorated clinically or developed antibiotic resistant organisms, earlier detection and targeted treatment of Pseudomonas aeruginosa may have prevented deterioration.
Dietary supplement use in ambulatory cancer patients: a survey on prevalence, motivation and attitudes
Authors: Tank Maja , Franz Kristina , Cereda Emanuele , Norman Kristina
Published: April 2021

Purpose

Patients with cancer often believe dietary supplements (DS) such as micronutrients and botanical products to be health supporting and non-toxic despite growing concerns regarding potential pharmacological interactions. Studies on the prevalence of DS use among patients with cancer are heterogeneous and mainly conducted at university-based cancer centers. This survey focused on a particular cancer patient group treated in an ambulatory setting without regular access to professional nutritional counselling.

Methods

Patients with a history of cancer or hematological malignancy were included in this survey. A self-reported questionnaire was used to evaluate the different aspects of DS use, changes in dietary habits and patients’ demographic characteristics.

Results

Almost every second patient reported using DS (47.2%). Women (56.3%), patients with an academic degree (56.0%) and non-smokers (84.8%) were more inclined to use DS. Along with magnesium (16.6%), calcium (14.3%), multivitamins (12.0%) and vitamin C (9.4%), use of herbal supplements (12.6%) was common. Women (84.8% vs. 74.9% of men, p =  < 0.001) and patients younger than 65 years (84.4% vs. 77.2% of patients > 65 y, p =  0.002) sought dietary advice more often. Support of the immune system was the main reason for DS use (26.4%) and a relevant number of patients (49.6%) reported to have changed their dietary habits following cancer diagnosis.

Conclusion

DS use is common among patients with cancer treated in an ambulatory setting. This finding should encourage oncologists to implement detailed questioning about DS use and dietary habits to prevent potential interactions and offer substantial advice.
Associations of preoperative stroke and tranexamic acid administration with convulsive seizures in valvular open-heart surgery
Authors: Hulde Nikolai , Zittermann Armin , Deutsch Marcus-André , von Dossow Vera , Gummert Jan F. , Koster Andreas
Published: April 2021

In cardiac surgery, use of the antifibrinolytic agent tranexamic acid (TXA) and acute perioperative stroke are both associated with convulsive seizures. We hypothesized that an older (preoperative) stroke increases the risk of TXA-associated seizures as well. To test this hypothesis, we retrospectively analyzed data from 16,110 patients who had undergone open-heart valvular surgery at our institution between 2009 and 2020. The dosing of TXA was moderate. Use of TXA and a history of stroke were both independently associated with convulsive seizure with an adjusted odds ratio (OR) of 2.40 (95%CI: 1.71–3.37) and 1.79 (95%CI: 1.27–2.54), respectively. Compared to patients without TXA administration, the adjusted OR of experiencing a seizure in TXA patients without a history of stroke was 2.44 (95%CI: 1.71–3.46) and in patients receiving TXA with a history of stroke 4.30 (95%CI: 2.65–6.99). However, there was no significant interaction between TXA use and preoperative stroke on convulsive seizures (P = 0.77). Compared to patients without seizure, for patients with seizure, the inverse probability-weighted ORs of in-hospital mortality and 30-day mortality were 3.58 (95%CI: 2.20–5.83) and 4.04 (95%CI: 2.34–6.98), respectively. We conclude that, in patients undergoing open-heart surgery, a history of stroke is independently associated with convulsive seizures but is not a contraindication for TXA use.
A boundary-value problem arising in the modelling of equatorial wind-drift currents
Authors: Marynets Kateryna
Published: April 2021

We investigate the boundary-value problem that models wind-induced equatorial flows, establishing the existence and uniqueness of solutions. We also discuss some special cases that were studied in recent geophysical research.
The effect of nimodipine on pulmonary function in artificially ventilated patients with aneurysmal subarachnoid hemorrhage
Authors: Lunkiewicz Justyna , Brandi Giovanna , Willms Jan , Strässle Christian , Narula Gagan , Keller Emanuela , Muroi Carl
Published: April 2021

Background

Nimodipine is routinely administered in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, the effect of nimodipine on oxygen exchange in the lungs is insufficiently explored.

Methods

The study explored nimodipine medication in artificially ventilated patients with aSAH. The data collection period was divided into nimodipine-dependent (ND) and nimodipine-independent (NID) periods. Values for arterial partial pressure of oxygen (PaO2) and fraction of inspired oxygen (FiO2) were collected and compared between the periods. Patients were divided in those with lung injury (LI), defined as median Horowitz index (PaO2/FiO2) ≤40 kPa (≤300 mmHg), and without and in those with lower respiratory tract infection (LRTI) and without.

Results

A total of 53 out of 150 patients were artificially ventilated, and in 29 patients, the Horowitz index could be compared between ND and NID periods. A linear mixed model showed that during ND period the Horowitz index was 2.3 kPa (95% CI, 1.0–3.5 kPa, P<0.001) lower when compared to NID period. The model suggested that in the presence of LI, ND period is associated with a decrease of the index by 2.8 kPa (95% CI, 1.2–4.3 kPa, P<0.001). The decrease was more pronounced with LRTI than without: 3.4 kPa (95% CI, 0.8–6.1 kPa) vs. 2.1 kPa (95% CI, 0.7–3.4 kPa), P=0.011 and P=0.002, respectively.

Conclusions

In patients with LI or LRTI in the context of aSAH, pulmonary function may worsen with nimodipine treatment. The drop of 2 to 3 kPa of the Horowitz index in patients with no lung pathology may not outweigh the benefits of nimodipine. However, in individuals with concomitant lung injury, the effect may be clinically relevant.
Seismically induced changes in groundwater levels and temperatures following the ML5.8 (ML5.1) Gyeongju earthquake in South Korea
Authors: Lee Soo-Hyoung , Lee Jae Min , Moon Sang-Ho , Ha Kyoochul , Kim Yongcheol , Jeong Dan Bi , Kim Yongje
Published: April 2021

Hydrogeological responses to earthquakes such as changes in groundwater level, temperature, and chemistry, have been observed for several decades. This study examines behavior associated with ML5.8 and ML5.1 earthquakes that occurred on 12 September 2016 near Gyeongju, a city located on the southeast coast of the Korean peninsula. The ML5.8 event stands as the largest recorded earthquake in South Korea since the advent of modern recording systems. There was considerable damage associated with the earthquakes and many aftershocks. Records from monitoring wells located about 135 km west of the epicenter displayed various patterns of change in both water level and temperature. There were transient-type, step-like-type (up and down), and persistent-type (rise and fall) changes in water levels. The water temperature changes were of transient, shift-change, and tendency-change types. Transient changes in the groundwater level and temperature were particularly well developed in monitoring wells installed along a major boundary fault that bisected the study area. These changes were interpreted as representing an aquifer system deformed by seismic waves. The various patterns in groundwater level and temperature, therefore, suggested that seismic waves impacted the fractured units through the reactivation of fractures, joints, and microcracks, which resulted from a pulse in fluid pressure. This study points to the value of long-term monitoring efforts, which in this case were able to provide detailed information needed to manage the groundwater resources in areas potentially affected by further earthquakes.
A rare triad of morning glory disc anomaly, moyamoya vasculopathy, and transsphenoidal cephalocele: pathophysiological considerations and surgical management
Authors: Pavanello Marco , Fiaschi Pietro , Accogli Andrea , Severino Mariasavina , Tortora Domenico , Piatelli Gianluca , Capra Valeria
Published: April 2021

Morning glory disc anomaly is a congenital abnormality of the optic disc and peripapillary retina reported as an isolated condition or associated with various anomalies, including basal encephaloceles and moyamoya vasculopathy. However, the co-occurrence of these three entities is extremely rare and the pathogenesis is still poorly understood. Moreover, data on the surgical management and long-term follow-up of the intracranial anomalies are scarce. Here, we describe the case of a 11-year-old boy with morning glory disc anomaly, transsphenoidal cephalocele, and moyamoya vasculopathy, who underwent bilateral indirect revascularization with encephalo-duro-myo-arterio-pericranio-synangiosis at the age of 2 years, and endoscopic repair of the transsphenoidal cephalocele at the age of 6 years. A rare missense variant (c.1081T>C,p.Tyr361His) was found in OFD1, a gene responsible for a X-linked ciliopathy, the oral-facial-digital syndrome type 1 (OFD1; OMIM 311200). This case expands the complex phenotype of OFD1 syndrome and suggests a possible involvement of OFD1 gene and Shh pathway in the pathogenesis of these anomalies.
Cohesive Growth in Europe: A Tale of Two Peripheries
Authors: Dauderstädt Michael
Published: April 2021

Over the last two decades, income disparities between EU member states tended to decline, particularly before the financial crisis. While Central and Eastern Europe caught up with the EU average, Southern Europe fell behind after 2009. Catch-up growth in both peripheries relied on nominal convergence (real appreciation) and foreign capital. Further growth can and should be fostered by an economic policy that does not neglect domestic demand, stabilises capital markets and invests in research, education, health and intangibles.
Bullying and Victimization in Native and Immigrant Very-Low-Income Adolescents in Italy: Disentangling the Roles of Peer Acceptance and Friendship
Authors: Bianchi Dora , Cavicchiolo Elisa , Manganelli Sara , Lucidi Fabio , Girelli Laura , Cozzolino Mauro , Galli Federica , Alivernini Fabio
Published: April 2021

Background

Very-low-income students are a population at a high risk of perpetrating and suffering bullying at school, and at the same time the peer group at school is often one of the few sources of support for these minors.

Objective

This two-wave study is aimed to disambiguate the two different roles of peer acceptance and friendship on bullying and victimization in very-low-income adolescents, exploring the possible differential role of immigrant background.

Method

An online survey was administered to 249 early to late adolescents living below the poverty threshold (Mage = 12.76;SDage = 2.34; 41.8% girls; 19.3% immigrants). A multivariate regression model with multi-group analyses was applied.

Results

Our results indicated that peer friendship was a protective factor against bullying as well as victimization, whilst peer acceptance was not protective. Only for natives (but not for immigrants), a high level of peer acceptance was a risk factor for bullying, and low school achievement was a risk factor for victimization. The persistence of victimization over time was significantly stronger for immigrants than for natives.

Conclusions

The study provides new insights for the unique protective role of classmates’ friendship in natives and immigrants, while acceptance appeared to be less relevant. Research and applied implications are discussed.
An Investigation of the Contested Qualified Health Claims for Green Tea and Cancer
Authors: Berhaupt-Glickstein A. , Hallman W. K.
Published: April 2021

There have been seven qualified health claims (QHCs) in the marketplace about the relationship between the consumption of green tea and the reduced risk of breast and/or prostate cancers that were written by three stakeholders (the U.S. Food and Drug Administration (FDA), Fleminger, Inc. (tea company), and the Federal Court). This paper evaluates assertions about the effects of these claims on consumers, which were contested in a federal lawsuit. Using a 2 × 7 experimental design, 1,335 Americans 55 years and older were randomized to view one QHC about green tea and cancer, or an identical QHC about a novel diet-disease relationship; yukichi fruit juice and gastrocoridalis. The results show that differing stakeholder descriptions of the same evidence significantly affected consumer perceptions. For example, QHCs written by Fleminger, Inc. were rated as providing greater evidence for the green tea-cancer claim. An FDA summary statement implied mandatory (vs. voluntary) labelling and greater effectiveness, and qualitative descriptions suggested that greater evidence existed for the claims (vs. quantitative descriptions). Greater evidence was also inferred for familiar claims (green tea and cancer).
Factors influencing students’ satisfaction with continuous use of learning management systems during the COVID-19 pandemic: An empirical study
Authors: Alzahrani Latifa , Seth Kavita Panwar
Published: April 2021

COVID-19 has impacted educational processes in most countries: some educational institutions have closed, while others, particularly in higher education, have converted to online learning systems, due to the advantages offered by information technologies. This study analyzes the critical factors influencing students’ satisfaction with their continuing use of online learning management systems in higher education during the COVID-19 pandemic. Through the integration of social cognitive theory, expectation confirmation theory, and DeLone and McLean’s IS success model, a survey was conducted of 181 UK students who engaged with learning management systems. It was found that, during the pandemic, service quality did not influence students’ satisfaction, although both information quality and self-efficacy had significant impacts on satisfaction. In addition, the results revealed that neither self-efficacy nor satisfaction impacted personal outcome expectations, although prior experience and social influence did. The findings have practical implications for education developers, policymakers, and practitioners seeking to develop effective strategies for and improve the use of learning management systems during the pandemic.
Heritage event as tourist attraction: the case of Dymarki Swietokrzyskie, Poland
Authors: Cudny Waldemar , Jolliffe Lee , Guz Anna
Published: April 2021

While previous research has focused on heritage visitor attractions few studies have examined visitation to and experience of ancient industrial sites as geographical tourist spaces. This article profiles visitation to Dymarki Swietokrzyskie, a heritage reenactment of past events and ancient industrial traditions of iron smelting held in the Polish town of Nowa Slupia. Visitor survey analysis showed visitors perceive the event is a significant tourist attraction. It attracts tourists, is an element of the local heritage industry and contributes to the development of tourism services as part of the heritage tourism sector. The event in Nowa Slupia forms a tourist attraction based on heritage used for creating a contemporary heritage event, evoking specific tourist behaviors and therefore bringing economic profits. Creating the heritage tourism experience here was possible due to the influence of the mix of the elements in a heritage tourism behavioral model consisting of: politics, conservation, authenticity, impact management and interpretation. Examination of the event confirmed the validity of this framework for the analysis of heritage site visitation as well as providing practical insights for both site managers and future researchers.
The Impacts of Incentives for International Publications on Research Cultures in Chinese Humanities and Social Sciences
Authors: Xu Xin , Oancea Alis , Rose Heath
Published: April 2021

Incentives for improving research productivity at universities prevail in global academia. However, the rationale, methodology, and impact of such incentives and consequent evaluation regimes are in need of scrutinization. This paper explores the influences of financial and career-related publishing incentive schemes on research cultures. It draws on an analysis of 75 interviews with academics, senior university administrators, and journal editors from China, a country that has seen widespread reliance on international publication counts in research evaluation and reward systems. The study focuses on humanities and social sciences (HSS) as disciplinary sites, which embody distinct characteristics and have experienced the introduction of incentive schemes in China since the early 2000s. Findings reveal tensions between internationalization and indigenization, quality and quantity, integrity and instrumentalism, equity and inequity in Chinese academia. In particular, we argue that a blanket incentive scheme could reinforce a managerial culture in higher education, encourage performative objectification of academics, and jeopardize their agency. We thereby challenge ‘one-size-fits-all’ policymaking, and suggest instead that institutions should have the opportunity to adopt an ethical and ‘human-oriented’ approach when developing their research incentives and evaluation mechanisms.
A ride through the epigenetic landscape: aging reversal by reprogramming
Authors: de Lima Camillo Lucas Paulo , Quinlan Robert B. A.
Published: April 2021

Aging has become one of the fastest-growing research topics in biology. However, exactly how the aging process occurs remains unknown. Epigenetics plays a significant role, and several epigenetic interventions can modulate lifespan. This review will explore the interplay between epigenetics and aging, and how epigenetic reprogramming can be harnessed for age reversal. In vivo partial reprogramming holds great promise as a possible therapy, but several limitations remain. Rejuvenation by reprogramming is a young but rapidly expanding subfield in the biology of aging.
Clinical and economic burden of nonalcoholic steatohepatitis in Saudi Arabia, United Arab Emirates and Kuwait
Authors: Sanai Faisal M. , Al Khathlan Abdullah , Al Fadhli Ahmad , Jazzar Ahmad S. , Hashim Al Moutaz , Mansour Eid , Abaalkhail Faisal , Hasan Fuad , Al Mudaiheem Hajer , Al Quraishi Huda , Bottomley Juliana , Alswat Khalid A. , Al Ghamdi Mohammed , Farghaly Mohamed , Fathy Motaz , Awad Nancy , Mohamed Omneya , Kozma Sam , Al-Hamoudi Waleed , Al-jedai Ahmed
Published: April 2021

Background and aims

The Middle East (ME) has a high prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), driven by obesity and type-2 diabetes mellitus (T2DM). Studies in Saudi Arabia (KSA) and United Arab Emirates (UAE) predict an escalating impact of NAFLD/NASH, particularly advanced fibrosis due to NASH (AF-NASH), increasing cases of cirrhosis, liver cancer and death. The scale of this burden in other ME countries is unknown with no reports of NAFLD/NASH healthcare resource utilization (HCRU) or costs. We estimated the clinical and economic burden of NAFLD/NASH in KSA, UAE and Kuwait.

Methods

Markov models populated with country-specific obesity and T2DM prevalence data estimated numbers and progression of NAFLD/NASH patients from 2018 to 2030. Model inputs, assumptions and outputs were collected from literature, national statistics, and expert consensus.

Results

Over 13 years, the KSA model estimated cases increasing as follows: patients with fibrosis F0–3 doubled to 2.5 m, compensated and decompensated cirrhosis and hepatocellular carcinoma trebled to 212,000; liver failure or transplant patients increased four-fold to 4,086 and liver-related death escalated from < 10,000 to > 200,000. Similar trends occurred in UAE and Kuwait. Discounted lifetime costs of NASH standard-care increased totaling USD40.41 bn, 1.59 bn and 6.36 bn in KSA, UAE (Emiratis only) and Kuwait, respectively. NASH-related costs in 2019 comprised, respectively, 5.83%, 5.80% and 7.66% of national healthcare spending.

Conclusions

NASH, especially AF-NASH, should be considered a higher priority in ME Public Health policy. Our analyses should inform health policy makers to mitigate the enormity of this escalating regional burden.
Functional Role of Cerebellar Gamma Frequency in Motor Sequences Learning: a tACS Study
Authors: Giustiniani A. , Tarantino V. , Bracco M. , Bonaventura R. E. , Oliveri M.
Published: April 2021

Although the role of the cerebellum in motor sequences learning is widely established, the specific function of its gamma oscillatory activity still remains unclear. In the present study, gamma (50 Hz)—or delta (1 Hz)—transcranial alternating current stimulation (tACS) was applied to the right cerebellar cortex while participants performed an implicit serial reaction time task (SRTT) with their right hand. The task required the execution of motor sequences simultaneously with the presentation of a series of visual stimuli. The same sequence was repeated across multiple task blocks (from blocks 2 to 5 and from blocks 7 to 8), whereas in other blocks, new/pseudorandom sequences were reproduced (blocks 1 and 6). Task performance was examined before and during tACS. To test possible after-effects of cerebellar tACS on the contralateral primary motor cortex (M1), corticospinal excitability was assessed by examining the amplitude of motor potentials (MEP) evoked by single-pulse transcranial magnetic stimulation (TMS). Compared with delta stimulation, gamma-tACS applied during the SRTT impaired participants’ performance in blocks where the same motor sequence was repeated but not in blocks where the new pseudorandom sequences were presented. Noteworthy, the later assessed corticospinal excitability was not affected. These results suggest that cerebellar gamma oscillations mediate the implicit acquisition of motor sequences but do not affect task execution itself. Overall, this study provides evidence of a specific role of cerebellar gamma oscillatory activity in implicit motor learning.
How the loss of forest fauna undermines the achievement of the SDGs
Authors: Krause Torsten , Tilker Andrew
Published: April 2021

The human-driven loss of biodiversity has numerous ecological, social, and economic impacts at the local and global levels, threatening important ecological functions and jeopardizing human well-being. In this perspective, we present an overview of how tropical defaunation—defined as the disappearance of fauna as a result of anthropogenic drivers such as hunting and habitat alteration in tropical forest ecosystems—is interlinked with four selected Sustainable Development Goals (SDGs). We discuss tropical defaunation related to nutrition and zero hunger (SDG 2), good health and well-being (SDG 3), climate action (SDG 13), and life on land (SDG 15). We propose a range of options on how to study defaunation in future research and how to address the ongoing tropical defaunation crisis, including but not limited to recent insights from policy, conservation management, and development practice.
In harm’s way: Non-migration decisions of people at risk of slow-onset coastal hazards in Bangladesh
Authors: Mallick Bishawjit , Rogers Kimberly G. , Sultana Zakia
Published: April 2021

Non-migration is an adaptive strategy that has received little attention in environmental migration studies. We explore the leveraging factors of non-migration decisions of communities at risk in coastal Bangladesh, where exposure to both rapid- and slow-onset natural disasters is high. We apply the Protection Motivation Theory (PMT) to empirical data and assess how threat perception and coping appraisal influences migration decisions in farming communities suffering from salinization of cropland. This study consists of data collected through quantitative household surveys (n = 200) and semi-structured interviews from four villages in southwest coastal Bangladesh. Results indicate that most respondents are unwilling to migrate, despite better economic conditions and reduced environmental risk in other locations. Land ownership, social connectedness, and household economic strength are the strongest predictors of non-migration decisions. This study is the first to use the PMT to understand migration-related behaviour and the findings are relevant for policy planning in vulnerable regions where exposure to climate-related risks is high but populations are choosing to remain in place.
Improved image denoising via RAISR with fewer filters
Authors: Zin Theingi , Nakahara Yusuke , Yamaguchi Takuro , Ikehara Masaaki
Published: April 2021

In recent years, accurate Gaussian noise removal has attracted considerable attention for mobile applications, as in smart phones. Accurate conventional denoising methods have the potential ability to improve denoising performance with no additional time. Therefore, we propose a rapid post-processing method for Gaussian noise removal in this paper. Block matching and 3D filtering and weighted nuclear norm minimization are utilized to suppress noise. Although these nonlocal image denoising methods have quantitatively high performance, some fine image details are lacking due to the loss of high frequency information. To tackle this problem, an improvement to the pioneering RAISR approach (rapid and accurate image super-resolution), is applied to rapidly post-process the denoised image. It gives performance comparable to state-of-the-art super-resolution techniques at low computational cost, preserving important image structures well. Our modification is to reduce the hash classes for the patches extracted from the denoised image and the pixels from the ground truth to 18 filters by two improvements: geometric conversion and reduction of the strength classes. In addition, following RAISR, the census transform is exploited by blending the image processed by noise removal methods with the filtered one to achieve artifact-free results. Experimental results demonstrate that higher quality and more pleasant visual results can be achieved than by other methods, efficiently and with low memory requirements.
Dexamethasone Restores the Repressive Effect of Tumor Necrosis Factor-α on Follicular Growth and E2 Secretion During the In Vitro Culture of Preantral Follicles
Authors: Wu Que , Zhuang Tingwei , Li Zhiling
Published: April 2021

As a proinflammatory cytokine, tumor necrosis factor-α (TNF-α) is central to the female reproductive tract and affects various phases of follicular development and uterine cycles. High levels of TNF-α play a vital role in the pathogenesis of polycystic ovary syndrome (PCOS) in patients. Clinicians know that dexamethasone can inhibit the induction of androgen by suppressing the adrenal glands which improves the status of the endocrine system in PCOS patients. We hypothesize that dexamethasone has much more functionality and can exert a therapeutic effect by antagonizing TNF-α. We added TNF-α to the follicular culture medium to simulate the high TNF-α levels observed in the endocrine environment of PCOS patients. Dexamethasone was added to the medium to determine if it could counteract the inhibitory effect of TNF-α on follicular growth and 17β-estradiol (E2) secretion. Follicular diameter, E2 concentration, follicle survival, antral-like cavity formation, and ovulation were measured to assess the effects of dexamethasone. In our work, TNF-α inhibited in vitro follicular growth and E2 secretion in a dose-dependent manner. Based on the results of the present research, we concluded that the addition of dexamethasone partially counteracts the repressive effect of TNF-α on follicle growth and E2 secretion during in vitro culture of the preantral follicles of mice. Thus, the findings in this paper suggest that dexamethasone may act as a therapy by counteracting the effects of TNF-α in PCOS patients. These results provide a new foundation for exploring the treatment of PCOS patients with dexamethasone.
Cognitive Robots and the Conscious Mind: A Review of the Global Workspace Theory
Authors: Signa Alessandro , Chella Antonio , Gentile Manuel
Published: April 2021

Purpose of Review

The theory of consciousness is a subject that has kept scholars and researchers challenged for centuries. Even today it is not possible to define what consciousness is. This has led to the theorization of different models of consciousness. Starting from Baars’ Global Workspace Theory, this paper examines the models of cognitive architectures that are inspired by it and that can represent a reference point in the field of robot consciousness.

Recent Findings

Global Workspace Theory has recently been ranked as the most promising theory in its field. However, this is not reflected in the mathematical models of cognitive architectures inspired by it: they are few, and most of them are a decade old, which is too long compared to the speed at which artificial intelligence techniques are improving. Indeed, recent publications propose simple mathematical models that are well designed for computer implementation.

In this paper, we introduce an overview of consciousness and robot consciousness, with some interesting insights from the literature. Then we focus on Baars’ Global Workspace Theory, presenting it briefly. Finally, we report on the most interesting and promising models of cognitive architectures that implement it, describing their peculiarities.
Worse for girls?: Gender differences in discrimination as a predictor of suicidality among Latinx youth
Authors: Vargas Sylvanna M. , Calderon Vanessa , Beam Christopher R. , Cespedes‐Knadle Yolanda , Huey Stanley J.
Published: April 2021

Introduction

Gender and ethnic differences exist in suicidal ideation, plan, and attempt among adolescents in the U.S. However, limited research has used theoretically‐informed approaches to integrate how cultural and classic risk factors together account for suicide‐related pathways among vulnerable populations. Informed by the interpersonal theory of suicide, the present cross‐sectional study examined gender differences in the association between a cultural (i.e., discrimination) and classic (i.e., depressive symptomatology) risk factor, and suicidality among youth of Latin American heritage.

Methods

A total of 390 Latinx adolescents (ages 13–18; 50% female) attending a high school in Southern California, U.S.A. completed a series of questionnaires that included measures of depressive symptoms, suicidality (including ideation, past attempts, and likelihood of future behavior), perceived discrimination, and demographics.

Results

We found that discrimination was associated with increased suicidality among Latinx adolescents. The discrimination‐suicidality association was stronger for girls versus boys, such that girls who experienced greater discrimination demonstrated the highest levels of suicidality. Although depression was also significantly associated with suicidality, the discrimination x gender interaction was found above and beyond the main effect of depressive symptomatology and covariates. Additional analyses revealed significant gender and moderation effects only for suicidal ideation and not for attempts.

Conclusions

These findings indicate that the relationship between discrimination and suicidality (particularly ideation) is more pronounced for Latinx girls than boys. This study also highlights the importance of drawing on theory‐driven and culturally informed work that incorporates classic and cultural correlates of suicidality among diverse subpopulations.
Virtual Play and the Victorian Novel
Authors: Gao Timothy
Published: April 2021

Pondering the town he had invented in his novels, Anthony Trollope had 'so realised the place, and the people, and the facts' of Barset that 'the pavement of the city ways are familiar to my footsteps'. After his novels end, William Thackeray wonders where his characters now live, and misses their conversation. How can we understand the novel as a form of artificial reality? Timothy Gao proposes a history of virtual realities, stemming from the imaginary worlds created by novelists like Trollope, Thackeray, Charlotte Bronte, and Charles Dickens. Departing from established historical or didactic understandings of Victorian fiction, Virtual Play and the Victorian Novel recovers the period's fascination with imagined places, people, and facts. This text provides a short history of virtual experiences in literature, four studies of major novelists, and an innovative approach for scholars and students to interpret realist fictions and fictional realities from before the digital age. This title is also available as Open Access on Cambridge Core.
Rollout of COVID-19 Vaccination in India: A SWOT Analysis
Authors: Sharma Priyanka , Pardeshi Geeta
Published: April 2021

Objective:

This study aimed to identify the strengths, weaknesses, opportunities, and threats (SWOT) in the rollout of the COVID-19 vaccination campaign in India.

Methods:

The internal and external attributes affecting the vaccination rollout identifed by reviewing the scientific literature, government guidelines, and press statements, along with media reports, were categorized into the SWOT matrix.

Results:

The existing immunization program, indigenous vaccine production, setting up of the National Expert Group on Vaccine Administration for COVID-19, updated guidelines, and training followed by dry runs were identified as strengths. The weaknesses identified in the program were knowledge gap about vaccines, apprehensions, lack of temperature loggers and vaccine vial monitors, space contraints in health care set up, demand supply gap, and digital divide. The experience of conducting the general elections, intersectoral coordination forged during the pandemic response, Information Technology platform, and vaccine eagerness present opportunities to strengthen the program. The emergence of virus variants, commercial interests, laxity in COVID-19 appropriate behavior, and receding wave of the pandemic can pose significant threats to the implementation of the vaccination campaign.

Conclusion:

The study identified factors that can aid designing effective measures and countermeasures for the COVID-19 vaccination rollout. This SWOT analysis is relevant to low- and middle-income countries planning to implement the COVID-19 vaccination in the near future.
Evaluation of cycle threshold values at deisolation
Authors: Mowrer Clayton T. , Creager Hannah , Cawcutt Kelly , Birge Justin , Lyden Elizabeth , Van Schooneveld Trevor C. , Rupp Mark E. , Hewlett Angela
Published: April 2021

The decision to discontinue isolation in hospitalized patients with persistently positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) molecular testing is nuanced. Improvement in clinical status should be evaluated with expert consultation when considering whether discontinuation of isolation is appropriate. The cycle threshold value may serve as a useful adjunct to this decision-making process.
Impact of cascade reporting of antimicrobial susceptibility on fluoroquinolone and meropenem consumption at a Veterans’ Affairs medical center
Authors: Vissichelli Nicole C. , Orndahl Christine M. , Cecil Jane A. , Hill Emily M. , Hitchcock Matthew M. , Sabo Roy T. , Stevens Michael P. , Tassone Dan , Vaughan Leroy B. , Markley J. Daniel
Published: April 2021

Objective:

To determine whether cascade reporting is associated with a change in meropenem and fluoroquinolone consumption.

Design:

A quasi-experimental study was conducted using an interrupted time series to compare antimicrobial consumption before and after the implementation of cascade reporting.

Setting:

A 399-bed, tertiary-care, Veterans’ Affairs medical center.

Participants:

Antimicrobial consumption data across 8 inpatient units were extracted from the Center for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) antimicrobial use (AU) module from April 2017 through March 2019, reported as antimicrobial days of therapy (DOT) per 1,000 days present (DP).

Intervention:

Cascade reporting is a strategy of reporting antimicrobial susceptibility test results in which secondary agents are only reported if an organism is resistant to primary, narrow-spectrum agents. A multidisciplinary team developed cascade reporting algorithms for gram-negative bacteria based on local antibiogram and infectious diseases practice guidelines, aimed at restricting the use of fluoroquinolones and carbapenems. The algorithms were implemented in March 2018.

Results:

Following the implementation of cascade reporting, mean monthly meropenem (P =.005) and piperacillin/tazobactam (P = .002) consumption decreased and cefepime consumption increased (P < .001). Ciprofloxacin consumption decreased by 2.16 DOT per 1,000 DP per month (SE, 0.25; P < .001). Clostridioides difficile rates did not significantly change.

Conclusion:

Ciprofloxacin consumption significantly decreased after the implementation of cascade reporting. Mean meropenem consumption decreased after cascade reporting was implemented, but we observed no significant change in the slope of consumption. cascade reporting may be a useful strategy to optimize antimicrobial prescribing.
A randomized controlled trial of Lactobacillus rhamnosus GG on antimicrobial-resistant organism colonization
Authors: Rauseo Adriana M. , Hink Tiffany , Reske Kimberly A. , Seiler Sondra M. , Bommarito Kerry M. , Fraser Victoria J. , Burnham Carey-Ann D. , Dubberke Erik R. ,   for the CDC Prevention Epicenter Program
Published: April 2021

Objective:

Alteration of the colonic microbiota following antimicrobial exposure allows colonization by antimicrobial-resistant organisms (AROs). Ingestion of a probiotic, such as Lactobacillus rhamnosus GG (LGG), could prevent colonization or infection with AROs by promoting healthy colonic microbiota. The purpose of this trial was to determine the effect of LGG administration on ARO colonization in hospitalized patients receiving antibiotics.

Design:

Prospective, double-blinded, randomized controlled trial of LGG versus placebo among patients receiving broad-spectrum antibiotics.

Setting:

Tertiary care center.

Patients:

In total, 88 inpatients receiving broad-spectrum antibiotics were enrolled.

Intervention:

Patients were randomized to receive 1 capsule containing 1×1010 cells of LGG twice daily (n = 44) or placebo (n = 44), stratified by ward type. Stool or rectal-swab specimens were collected for culture at enrollment, during admission, and at discharge. Using selective media, specimens were cultured for Clostridioides difficile, vancomycin-resistant Enterococcus spp (VRE), and antibiotic-resistant gram-negative bacteria. The primary outcome was any ARO acquisition. Secondary outcomes included loss of any ARO if colonized at enrollment, and acquisition or loss of individual ARO.

Results:

ARO colonization prevalence at study enrollment was similar (LGG 39% vs placebo 39%). We detected no difference in any ARO acquisition (LGG 30% vs placebo 33%; OR,1.19; 95% CI, 0.38–3.75) nor for any individual ARO acquisition. There was no difference in the loss of any ARO (LGG 18% vs placebo 24%; OR, 1.44; 95% CI, 0.27–7.68) nor for any individual ARO.

Conclusion:

LGG administration neither prevented acquisition of ARO nor accelerated loss of ARO colonization.