bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptual Content and the Unity of Perception
Authors: de Bruijn David
Published: March 2022

In recent work, Scott Soames (2010, 2013, 2015, 2019) and Peter Hanks (2011, 2013, 2015) have developed a theory of propositions on which these are constituted by complexes of intellectual acts. In this article, I adapt this type of theory to provide an account of perceptual content. After introducing terminology in section 1, I detail the approach proffered by Soames and Hanks in section 2, focusing on Hanks’s version. In section 3, I introduce a problem that these theories face, namely, how to account for the unity among the relevant intellectual acts. Section 4 provides an answer to this problem of unity, while section 5 explicates the relation to Soames and Hanks. In section 6, I extend the model to a theory of the unity of experiential consciousness. Finally, in section 7, I apply the preceding considerations to debates about the nature of perceptual representation. The upshot will be that experiential unity is not simply a phenomenal feature of consciousness, but central to an account of the role perceptual representation plays in perceptual cognition.
mHealth-Supported Interventions With Potential to Address Sedentary Behavior in Older Adults: A Scoping Review
Authors: Schepens Niemiec Stacey L. , Cariño Britney , Chatfield Amy J. , Quan Kristina
Published: March 2022

Sedentary behavior (SB) is an independent risk for negative health outcomes in older adults. Mobile health (mHealth) technology has potential to address SB in this population. This scoping review aimed to describe, synthesize, and identify gaps in literature on mHealth-supported interventions with potential to reduce sedentariness in older people. Following an iterative search of five major databases, 13 studies were included in the final review. Only three papers described SB-related factors as the primary target of intervention. mHealth-Driven components were frequently paired with nonmobile approaches and aided self-regulation of physical activity as opposed to SB. Most SB-related outcomes were not statistically significant or were inconclusive. This scoping review revealed a paucity of research applying mHealth-supported approaches to directly overcome sedentariness in older people. Protocol studies included in the review provide evidence that efforts to address this research gap continue to be made, but the need for additional high-quality research remains.
Direct measurement of nanoscale filamentary hot spots in resistive memory devices
Authors: Deshmukh Sanchit , Rojo Miguel Muñoz , Yalon Eilam , Vaziri Sam , Koroglu Cagil , Islam Raisul , Iglesias Ricardo A. , Saraswat Krishna , Pop Eric
Published: March 2022

Resistive random access memory (RRAM) is an important candidate for both digital, high-density data storage and for analog, neuromorphic computing. RRAM operation relies on the formation and rupture of nanoscale conductive filaments that carry enormous current densities and whose behavior lies at the heart of this technology. Here, we directly measure the temperature of these filaments in realistic RRAM with nanoscale resolution using scanning thermal microscopy. We use both conventional metal and ultrathin graphene electrodes, which enable the most thermally intimate measurement to date. Filaments can reach 1300°C during steady-state operation, but electrode temperatures seldom exceed 350°C because of thermal interface resistance. These results reveal the importance of thermal engineering for nanoscale RRAM toward ultradense data storage or neuromorphic operation.
Reproducible Propagation of Species-Rich Soil Bacterial Communities Suggests Robust Underlying Deterministic Principles of Community Formation
Authors: Čaušević Senka , Tackmann Janko , Sentchilo Vladimir , von Mering Christian , van der Meer Jan Roelof
Published: March 2022

There is now a great awareness of the high diversity of most environmental (“free-living”) and host-associated microbiomes, but exactly how diverse microbial communities form and maintain is still highly debated. A variety of theories have been put forward, but testing them has been problematic because most studies have been based on synthetic communities that fail to accurately mimic the natural composition (i.e., the species used are typically not found together in the same environment), the diversity (usually too low to be representative), or the environmental system itself (using designs with single carbon sources or solely mixed liquid cultures).
Clinical Performance of Nanopore Targeted Sequencing for Diagnosing Infectious Diseases
Authors: Fu Yu , Chen Qingsong , Xiong Mengyuan , Zhao Jin , Shen Shucheng , Chen Liangjun , Pan Yunbao , Li Zhiqiang , Li Yirong
Published: March 2022

Nanopore targeted sequencing (NTS) is reported to be advantageous in detection speed and range over culture in prior published reports. Investigation of the clinical performance of NTS is deficient at present.
Natural Diversity and Phylogeny of Asian Red-Cheeked Squirrels (Rodentia, Sciuridae, Dremomys) in Eastern Indochina
Authors: Balakirev A. E. , Abramov A. V. , Phuong Bui Xuan , Rozhnov V. V.
Published: March 2022

Based on new molecular data for mitochondrial (Cyt b) and nuclear (IRBP,RAG1) genes, as well as an extensive analysis of morphological material, we accessed actual species taxonomy and relationships among Asian red-cheeked squirrelsDremomysdistributed in eastern Indochina and southern China. Phylogenetic analyses demonstrated that Asian red-cheeked squirrels, which are currently attributed toD. rufigenis, are not homogenic but instead consisted of two independent species-level clades—northern and south-central. The latter clade was additionally subdivided into two highly divergent clades based onCyt bgene phylogeny. In spite of multidimensional statistics approach applied (PCA) only minor cranial differences were found between populations of study what lay a basis to treat it as cryptic species. Based on our findings, red-cheeked squirrels inhabit northern Vietnam and southern China, which are usually attributed toD. rufigenis, should be treated as distinct genetic speciesD. ornatusThomas, 1914. In ones turn, based on its peculiar external morphology we can attribute the specimens from southern and central Vietnam toD. rufigenisproper and treat them asD. rufigenisfuscusBonhote, 1907 andD. r. laomacheBonhote, 1921, respectively.
Unique presentation of Merkel cell tumour affecting the hand
Authors: Tomtschik Julia , Sweitzer Keith , Bell Derek
Published: March 2022

Merkel cell carcinoma (MCC) is a rare and highly aggressive skin cancer which most commonly occurs on the head and neck. A limited number of cases of MCC of the hand have been reported in the English literature. We describe a case of MCC of the hand in a man in his late 60s. The lesion presented on the dorsum of the left fifth digit, with metastasis to the left axillary lymph nodes. The primary lesion grew rapidly over a span of 3 months. The patient was treated with two courses of neoadjuvant nivolumab, amputation of the digit and left axillary lymph node resection followed by radiotherapy to the left hand and left axilla. He continues to follow-up for radiotherapy treatment 3 months postoperatively.
Optimisation of postoperative X-ray acquisition for orthopaedic patients
Authors: Saggi Sandip Singh , Kuah Le Zhi Dexter , Toh Lee Chuen April , Shah Mohammad Taufik bin Mohammad , Wong Merng Koon , Bin Abd Razak Hamid Rahmatullah
Published: March 2022

Postoperative X-rays are a key part of management of orthopaedic patients. These X-rays serve to check stability of orthopaedic fixation as well as to ensure that there are no peri-implant fractures and periprosthetic fractures following surgical fixation of fractures and arthroplasty procedures, respectively. Timely accurate interpretation of postoperative X-rays are crucial in guiding weight-bearing status as well as rehabilitation. Therefore, delays in X-ray acquisition may impact initiation of postoperative rehabilitation and overall length of stay negatively. The aim of this project is to optimise acquisition of postoperative X-rays in patients undergoing implant surgery and as a result increase efficiency of deployed healthcare staff. A multidisciplinary team was formed to study the efficacy of a new workflow for patients to undergo X-rays immediately after surgery while en-route to the ward. Pretrial and in-trial delays in acquiring X-rays and total man-hours spent on transport were recorded. These processes were refined and integrated to optimise the new workflow. Compared with the old workflow, delays in obtaining X-rays were significantly reduced from the longest of 20 hours and 40 min to no delays at all. Overall man-hours spent on transport of these patients were reduced by a mean of 12 and 16 min for nurses and porters, respectively. The trial workflow has since been adopted successfully by our institution and since inception has become standard practice, allowing timely review of postoperative X-rays. This has led to increased workforce efficiency as well as timely rehabilitation and discharge of patients.
Retrograde recanalisation for vertebral artery stump syndrome: a case report
Authors: Ji Renjie , Li Bing , Xu Ziqi
Published: March 2022

Vertebral artery stump syndrome (VASS) is a rare disease associated with a posterior circulation stroke after vertebral artery origin occlusion. We have herein presented a case of VASS that was effectively treated with endovascular intervention using retrograde recanalisation and the mechanism of VASS in our patient was thought to be a thrombus formed by stagnating flow.
Conserved charges for rational electromagnetic knots
Authors: Hantzko Lukas , Kumar Kaushlendra , Costa Gabriel Picanço
Published: March 2022

We revisit a newfound construction of rational electromagnetic knots based on the conformal correspondence between Minkowski space and a finite $$S^3$$

S
3

-cylinder. We present here a more direct approach for this conformal correspondence based on Carter–Penrose transformation that avoids a detour to de Sitter space. The Maxwell equations can be analytically solved on the cylinder in terms of $$S^3$$

S
3

harmonics $$Y_{j;m,n}$$

Y

j
;
m
,
n

, which can then be transformed into Minkowski coordinates using the conformal map. The resultant “knot basis” electromagnetic field configurations have non-trivial topology in that their field lines form closed knots. We consider finite, complex linear combinations of these knot-basis solutions for a fixed spin j and compute all the 15 conserved Noether charges associated with the conformal group. We find that the scalar charges either vanish or are proportional to the energy. For the non-vanishing vector charges, we find a nice geometric structure that facilitates computation of their spherical components as well. We present analytic results for all charges for up to $$j=1$$

j
=
1

. We demonstrate possible applications of our findings through some known previous results.
Novel Ductile Enhancement in the Structural Characteristics of External Beam Column Joint with Potassium-Activated Green Concrete Technology
Authors: Rajendran Mohana
Published: March 2022

Ductility and energy dissipation capacity of the beam column joints are the two prominent characteristics which govern the stability of the entire structure constructed in the seismic prone areas. In this paper, the effect of potassium-activated geopolymer concrete in the exterior beam column joint application is investigated under low frequency cyclic loading. Numerical analysis has been done by using the finite element software Abaqus and compared with the experimental work. From the load deformation relationship, parametric studies are carried out in the aspects of ductility, stiffness degradation, energy dissipation capacity, drift ratio and cracking pattern. The use of potassium-activated geopolymer technology in the exterior beam column joint application resulted in the improved ductility, energy dissipation capacity with superior ultimate load carrying capacity of 1.05% over conventional cement reinforced concrete beam column joints with special confining reinforcement confirmed by IS 13920 due to the enormous polymerization activated by high molecular potassium ions. There is an improved energy dissipation capacity of 2.78% of potassium-based geopolymer specimen resulting in lesser number of non-structural cracks and 11.26% more deformation under 11.96% enlarged drift ratio than the conventional reinforced concrete specimen. From the observed results, it is clearly noted that the implementation of potassium-activated green polymer technology in the beam column joints possessed enhanced ductility characteristics to protect the structure susceptible to seismic environment and resulted in innovative, economical and sustainable mode of seismic-resistant building construction.
China’s Afghanistan Policy in a Post-US Era
Authors: LI Li
Published: March 2022

With Taliban’s takeover of Kabul and the United States’ complete withdrawal of forces in August 2021, dramatic changes have happened in Afghanistan. China, as the largest neighbour of Afghanistan, is expected to play a bigger role. This article examines China’s intensified bilateral and multilateral diplomacy towards Afghanistan in a post-US retreat era. It attempts to interpret the objectives of China’s engagement with the Taliban regime and identify the limits of China’s policy.
Documenting the Structure and Adaptive Reuse of Roman Amphitheatres through the CIDOC CRMba Model
Authors: Ronzino Paola , Toth Anna , Falcidieno Bianca
Published: March 2022

This article addresses an important aspect of the built heritage documentation, which concerns encoding information about a building in a formal way, making it available for reuse by the research community. Formal ontologies allow structuring and integrating information from heterogeneous sources without loss of semantic information. In the field of Cultural Heritage (CH), the CIDOC Conceptual Reference Model (CRM) ontology is well known and widely accepted as it provides definitions and a formal structure to describe the implicit and explicit concepts and relationships used in the CH documentation. One of its extensions, the CRMba model, has been specifically designed to document information on a built structure and its components. In this work, we have applied the CRMba model to the documentation of Roman architectures, in particular, Roman amphitheatres, demonstrating how the semantic model allows encoding information about the structure of the building and its evolution over time and space, stressing on the concepts of “empty spaces” and “functional spaces” defined by form, and focusing on the relationship between form and function. The aim of the work is to explore the potentiality of the model and to provide, through a series of examples supported by graphs, standard encoding procedures to be reused by scholars dealing with similar case studies.
UniTE—The Best of Both Worlds: Unifying Function-fitting and Aggregation-based Approaches to Travel Time and Travel Speed Estimation
Authors: Jepsen Tobias Skovgaard , Jensen Christian S. , Nielsen Thomas Dyhre
Published: March 2022

Travel time and speed estimation are part of many intelligent transportation applications. Existing estimation approaches rely on either function fitting or data aggregation and represent different tradeoffs between generalizability and accuracy.

Function-fitting approaches learn functions that map feature vectors of, e.g., routes to travel time or speed estimates, which enables generalization to unseen routes. However, mapping functions are imperfect and offer poor accuracy in practice. Aggregation-based approaches instead form estimates by aggregating historical data, e.g., traversal data for routes. This enables very high accuracy given sufficient data. However, they rely on simplistic heuristics when insufficient data is available, yielding poor generalizability.

We present a Unifying approach to Travel time and speed Estimation (UniTE) that combines function-fitting and aggregation-based approaches into a unified framework that aims to achieve the generalizability of function-fitting approaches and the accuracy of aggregation-based approaches when data is available. We demonstrate empirically that an instance of UniTE can improve the accuracies of travel speed and travel time estimation by 40–64% and 3–23%, respectively, compared to using only function fitting or data aggregation.
Beyond the Cane: Describing Urban Scenes to Blind People for Mobility Tasks
Authors: Hoogsteen Karst M. P. , Szpiro Sarit , Kreiman Gabriel , Peli Eli
Published: March 2022

Blind people face difficulties with independent mobility, impacting employment prospects, social inclusion, and quality of life. Given the advancements in computer vision, with more efficient and effective automated information extraction from visual scenes, it is important to determine what information is worth conveying to blind travelers, especially since people have a limited capacity to receive and process sensory information. We aimed to investigate
which
objects in a street scene are useful to describe and
how
those objects should be described. Thirteen cane-using participants, five of whom were early blind, took part in two urban walking experiments. In the first experiment, participants were asked to voice their information needs in the form of questions to the experimenter. In the second experiment, participants were asked to score scene descriptions and navigation instructions, provided by the experimenter, in terms of their usefulness. The descriptions included a variety of objects with various annotations per object. Additionally, we asked participants to rank order the objects and the different descriptions per object in terms of priority and explain why the provided information is or is not useful to them. The results reveal differences between early and late blind participants. Late blind participants requested information more frequently and prioritized information about objects’ locations. Our results illustrate how different factors, such as the level of detail, relative position, and what type of information is provided when describing an object, affected the usefulness of scene descriptions. Participants explained how they (indirectly) used information, but they were frequently unable to explain their ratings. The results distinguish between various types of travel information, underscore the importance of featuring these types at multiple levels of abstraction, and highlight gaps in current understanding of travel information needs. Elucidating the information needs of blind travelers is critical for the development of more useful assistive technologies.
Evaluating the Impact of a Mobile Gaming System on the Collaborative Learning Process in a Hospitality Business Simulator
Authors: Zhang Cevin
Published: March 2022

Simulation-based pedagogy is fully considered when designing collaborative learning processes. However, particularly for training managerial skills in hospitality industries, limited work has been performed on analysing the impact of business simulations in the direction of a mobile gaming system. This paper presents a tablet gaming setup for a hospitality business simulator representing tourist flow characteristics, resource management, and the interaction of actors based on a competition relationship among hotel chain operators involved in the hospitality industry. The mobile gaming system was tested in game-based learning exercises, as in distance and classroom learning case studies, following identically parameterised scenarios. First, survey scores were collected using the self-report Learning Experience and Outcomes Questionnaire to evaluate ubiquitous human mobile-web interaction. Second, lag sequential analysis was employed to examine learning effects. Finally, a regression analysis was carried out to understand whether mobile gaming behaviours were likely to predict hotel performance as the outcome of the collaborative learning process. A total of 90 graduate students participated in game-based learning sessions in the autumn and spring semesters of 2020 and 2021, respectively. For the self-efficacy section, there were no significant differences in the scores. Sixty percent of the scored items in the classroom learning case study outperformed those in distance learning. Face-to-face participation enables more interaction between participants and mobile devices. The regression analysis delivered a △R2 of 0.43 (

F

4,31

 = 7.56,

P
<
0.001

) for the classroom learning case study and 0.49 (

F

4,47

 = 13.19,

P
<
0.001

) for the distance learning case study. The significant correlation between changes in hotel performance and learning behaviours could be attributed to the collaborative learning process. A business simulator powered by a well-designed mobile gaming system could be used to improve hospitality management.
Urinary BA Indices as Prognostic Biomarkers for Complications Associated with Liver Diseases
Authors: Li Wenkuan , Alamoudi Jawaher Abdullah , Gautam Nagsen , Kumar Devendra , Olivera Macro , Gwon Yeongjin , Mukgerjee Sandeep , Alnouti Yazen
Published: March 2022

Hepatobiliary diseases and their complications cause the accumulation of toxic bile acids (BA) in the liver, blood, and other tissues, which may exacerbate the underlying condition and lead to unfavorable prognosis. To develop and validate prognostic biomarkers for the prediction of complications of cholestatic liver disease based on urinary BA indices, liquid chromatography-tandem mass spectrometry was used to analyze urine samples from 257 patients with cholestatic liver diseases during a 7-year follow-up period. The urinary BA profile and non-BA parameters were monitored, and logistic regression models were used to predict the prognosis of hepatobiliary disease-related complications. Urinary BA indices were applied to quantify the composition, metabolism, hydrophilicity, and toxicity of the BA profile. We have developed and validated the bile-acid liver disease complication (BALDC) model based on BA indices using logistic regression model, to predict the prognosis of cholestatic liver disease complications including ascites. The mixed BA and non-BA model was the most accurate and provided higher area under the receiver operating characteristic (ROC) and smaller akaike information criterion (AIC) values compared to both non-BA and MELD (models for end stage liver disease) models. Therefore, the mixed BA and non-BA model could be used to predict the development of ascites in patients diagnosed with liver disease at early stages of intervention. This will help physicians to make a better decision when treating hepatobiliary disease-related ascites.
INI-1-Deficient Sinonasal Carcinoma: Case Report with Emphasis on Differential Diagnosis
Authors: Alsayed Anwaar M. , Aljufairi Eman A. , Alshammari Amjad O. , Alsindi Khalid A. , Sabra Omar A.
Published: March 2022

SMARCB1-deficient sinonasal carcinoma is a newly described entity, with less than 100 reported cases. It is characterized by basaloid or rhabdoid morphology and is diagnosed by complete loss of nuclear SMARCB1 (INI-1). The morphologic appearance, specific immunophenotypic markers, and unique molecular make-up distinguish this entity from other various malignant neoplasms. We present a case of a 55-year-old male that presented with a large progressing palatine mass. Magnetic resonance imaging showed a heterogeneous mass involving the left maxillary space. The initial biopsy was diagnosed as undifferentiated carcinoma. Resection was performed, and immunohistochemical studies revealed a complete loss of INI-1, refining the diagnosis to SMARCB1-deficient sinonasal carcinoma. Diagnosis of SMARCB1-deficient sinonasal carcinoma should be considered in all undifferentiated sinonasal carcinomas. Immunohistochemistry or molecular studies are mandatory to confirm the diagnosis and exclude other morphologically similar entities.
Detection of BRAF V600E in Fine-Needle Aspiration Samples of Thyroid Nodules by Droplet Digital PCR
Authors: Lu Sang-Yu , Chen Ying-Chao , Feng Jia-Lin , Zhou Qin-Yi , Chen Jing , Zhu Chen-Fang , Guo Miao-Miao , Zhang Man-Man , Zhang Qian-Yue , Lu Meng , Yang Liu , Wu Jing , Zhao Shuang-Xia , Song Huai-Dong , Ye Xiao-Ping
Published: March 2022

Background. BRAF exon 15 p.V600E (BRAF V600E) mutation has been established as an important molecular marker for papillary thyroid carcinoma diagnosis by ultrasound-guided fine-needle aspiration biopsy (FNAB). Sanger sequencing is the gold standard for detecting BRAF V600E mutations but fails to identify low-frequency mutations. However, droplet digital PCR (ddPCR) is a popular new method for detecting low-frequency mutations. Here, we compare the efficiency of droplet digital PCR (ddPCR) and Sanger sequencing for detection of the BRAF V600E mutation in thyroid fine-needle aspiration (FNA) samples. Methods. Thyroid fine-needle aspiration samples from 278 patients with 310 thyroid nodules were collected. Sanger sequencing and ddPCR were conducted to detect the BRAF V600E mutation. Results. The BRAF V600E mutation was found in 94 nodules (30.32%) by ddPCR and 40 nodules (12.90%) by Sanger sequencing in 310 FNA samples. A total of 119 nodules were confirmed PTC by postsurgical pathology. Among which the BRAF mutation was found in 80 (67.23%) nodules by ddPCR and 31 (26.05%) by Sanger sequencing. All nodules carrying the mutation detected by Sanger sequencing (SS+) were verified by ddPCR (ddPCR+). Also, all nodules with no mutation detected by ddPCR were interpreted as wild-type by Sanger sequencing (SS−). In addition. Almost all SS+/ddPCR + nodules (95.00%; 38/40) and SS−/ddPCR + nodules (100.00%; 54/54) displayed a BRAF mutation rate of >5% and <15%, respectively, indicating easy misdetection by Sanger sequencing when the mutation rate is between 5 and 15%. Conclusion. ddPCR has higher sensitivity than Sanger sequencing and we propose ddPCR as a supplement to Sanger sequencing in molecular testing of BRAF using FNAB samples.
DNA Repair Protein HELQ and XAB2 as Chemoresponse and Prognosis Biomarkers in Ascites Tumor Cells of High-Grade Serous Ovarian Cancer
Authors: Zhu Fang , Yang Siyu , Lei Ming , He Qiongqiong , Wu Lisha , Zhang Yu
Published: March 2022

Nucleotide excision repair (NER) is an important mediator for responsiveness of platinum-based chemotherapy. Our study is aimed at investigating the NER-related genes expression in ascites tumor cells and its application in the prediction of chemoresponse in high-grade serous ovarian cancer (HGSC) patients. The relationship between 16 NER-related genes and the prognosis of ovarian cancer was analyzed in the TCGA database. NER-related genes including HELQ and XAB2 expressions were determined via immunocytochemistry in ascites cell samples from 92 ovarian cancer patients prior to primary cytoreduction surgery. Kaplan-Meier analysis and Cox model were used to investigate the association between NER-related gene expression and prognosis/chemotherapeutic response. Predicting models were constructed using a training cohort of 60 patients and validated in a validation cohort of 32 patients. We found that high expression of HELQ and XAB2 in the training cohort was associated with poor prognosis (for HELQ,

P
=
0.001

,

HR
=
2.83

, 95% CI: 1.46-5.49; for XAB2,

P
=
0.008

,

HR
=
2.38

, 95% CI: 1.23-4.63) and platinum resistance (for HELQ,

P
<
0.001

; for XAB2,

P
=
0.006

). In the validation cohort, the combination of HELQ and XAB2 (

AUC
=
0.863

) showed the highest AUC. The expression levels of HELQ (RR 5.7, 95% CI 1.7-19.2) and XAB2 (RR 3.2, 95% CI 0.9-10.8) in ascites tumor cells were positively correlated to the risk of platinum resistance. In summary, we revealed that the expression levels of HELQ and XAB2 are candidate predictors for primary chemotherapy responsiveness and prognosis in HGSC. Ascites cytology is applicable as a promising method for chemosensitivity prediction in HGSC.
Artery of Percheron Infarction: A Case Report of Bilateral Thalamic Stroke Presenting with Acute Encephalopathy
Authors: Donohoe Charles , Nia Nooshin Kiani , Carey Patricia , Vemulapalli Vamsi
Published: March 2022

The artery of Percheron (AOP) is a relatively rare anatomic variant in which a solitary arterial trunk branches from the proximal segment of the posterior cerebral artery and provides arterial supply to the paramedian region of the thalami bilaterally and often to the rostral part of the midbrain. Occlusion of the artery of Percheron results in bilateral paramedian thalamic infarcts with and without midbrain involvement. Recognition of this condition as an acute stroke may be challenging due to various nonlocalized clinical presentations, given the wide range of neurological functions subserved by the thalamus. Prompt neuroimaging, preferably with magnetic resonance imaging (MRI), in conjunction with familiarity with this relatively rare vascular variation can facilitate initiation of appropriate time contingent thrombolytic treatment and improved long-term prognosis. We present a case of a 56-year-old African American female with a bilateral thalamic infarct secondary to the artery of Percheron thromboembolism. This patient presented unresponsive without focal neurologic findings but with an initial Glasgow Coma Score (GCS) of 7, and subsequent computed tomographic (CT) head revealed bilateral thalamic hypodensities. Confirmatory MRI exhibited bilateral subacute thalamic infarcts, which were thought to be embolic with the source from the left ventricular thrombus as the patient had at least three distinct clots. Unfortunately, the patient’s mental status did not improve significantly, and she was discharged to a nursing facility for extended care. AOP infarction may be missed on vascular imaging utilizing CT, MRI, and even catheter angiography. Clinical recognition that the AOP is one of the only single artery occlusions that can affect bilateral structures and frequently present solely as altered mental status without focal neurologic deficits is crucial to the diagnosis.
Complete AV Block in Vaccinated COVID-19 Patient
Authors: Lee Kevin , Rahimi Osman , Gupta Neelesh , Ahsan Chowdhury
Published: March 2022

Background. Coronavirus 2019 (COVID-19) was initially identified approximately in December 2019 at Wuhan, China, as patients presented with vague prodromal and respiratory symptoms. With the developing investigation of its clinical manifestation, cardiac symptoms have been widely reported including acute coronary syndromes, myocarditis, arrhythmias, heart failure, and cardiac arrest. Case Summary. An 84 year-old male with history of coronary artery disease, hypertension, and hyperlipidemia presented to an outside urgent care with prodromal symptoms. The patient had received the second Pfizer vaccine three months prior. This presentation, he was found to be COVID-19 positive as well as bradycardic with a complete AV block. He was transferred to a tertiary center for further evaluation and management. However, after transfer, the patient refused further invasive cardiac interventions and after medical therapy was discharged home in complete AV block. Discussion. We report a novel case of a Pfizer-vaccinated patient whose initial presenting symptoms of COVID-19 included a complete AV block as well as the challenges and difficulties in approaching such patients. Although this patient’s etiology of his complete AV block may result from multiple factors, given the acuity in setting of concurrent COVID-19 infections, top differentials include viral myocarditis, COVID-19-induced Takotsubo cardiomyopathy complicated by a complete AV-block, or a direct conduction pathway infection. Management of patients should focus on a multidisciplinary approach, and prevention is critical via vaccination.
Multiple Brain Metastases in a Patient with ROS1 Fusion-Positive Lung Adenocarcinoma as a Disease Flare due to Crizotinib Cessation Caused by Disseminated Aseptic Inflammation from Crizotinib-Associated Renal Cysts: A Case Report
Authors: Amano Yosuke , Kage Hidenori , Tanaka Goh , Sato Yusuke , Tanaka Mariko , Nagase Takahide
Published: March 2022

Rapid tumor growth after cessation of molecularly targeted drugs, called “disease flare,” may occur and affect the prognosis of lung cancer. However, this phenomenon has never been reported in ROS proto-oncogene 1 (ROS1) fusion-positive lung adenocarcinoma. Herein, we report a disease flare in a patient with ROS1 fusion-positive lung adenocarcinoma. A 60-year-old female was diagnosed with stage IVA ROS1 fusion-positive lung adenocarcinoma via bronchoscopy. Although crizotinib, an ROS1 tyrosine kinase inhibitor, achieved a partial response, a mass lesion appeared in the patient’s right kidney 12 months after starting crizotinib, which was diagnosed pathologically as crizotinib-associated renal cysts (CARCs). Given that readministration of crizotinib repeatedly induced CARC-like aseptic inflammation that appeared to be disseminated around surgical site, crizotinib treatment had to be abandoned. Around 25 days after crizotinib cessation, she was referred to the emergency department with a convulsive seizure and hemiparesis due to new, rapidly growing brain metastases. Whole-brain irradiation and administration of another ROS1 tyrosine kinase inhibitor, entrectinib, markedly ameliorated the metastases and improved hemiparesis. This has been the first report of a disease flare after crizotinib cessation due to CARCs in a patient with ROS1 fusion-positive lung adenocarcinoma. Attention should be paid to disease flare, especially in the brain, when molecularly targeted medication is stopped due to adverse events in ROS1 fusion-positive lung adenocarcinoma. Switching to drugs that penetrate the blood-brain barrier could overcome disease flare in the brain.
Exploring the issues and concerns in the implementation of customs trade facilitation initiatives in Central Luzon, Philippines
Authors: Mangohig Joyce Ann V.
Published: March 2022

towards liberalization of trade and promoting importation and exportation business. This qualitative study sought to identify the emerging issues and concerns surrounding the implementation of the customs trade facilitation initiatives on exportation and importation in Central Luzon, Philippines. The participants of this study were 300 exporters, importers, and processors of the Port of Limay (Bataan), Port of Subic (Olongapo), and Port of Clark (Pampanga). A written interview guide was used in data collection. Findings showed varied concerns in the customs trade facilitation activities encountered by the participants in the different ports of Central Luzon. Major problems include the issues on processing time, website system, absence of signatories, delayed processes, trade ruling changes, and the absence of the paperless transactions. The preliminary data obtained from this qualitative research may be a baseline for the continuous improvement of the customs trade facilitation activities in the region. A quantitative instrument may likewise be developed based on the merging themes culled from this study to validate this qualitative inquiry's results further. The current study also contributes to the shortage of literature in the Philippines regarding customs trade facilitation initiatives.
Major Determinants That Perform a Predominant Role Globally in the Furtherance of SMEs; ARDL and Bound Testing Approach
Authors: Khan Ruby
Published: March 2022

Purpose- Our study aims to empirically examine the influence of different economic indicators such as the global GDP growth rate and the global GDP per capita growth rate on the number of small and medium businesses (SMEs) around the world. In this article, we explored the challenges that SMEs face worldwide during the establishment process and various governments provide policies and regulations that promote and secure SME growth and development.

Design/methodology/approach- This study presents a combination of time-series statistical analysis and analysis of literature gathered from published sources. A statistical analysis of the number of small and medium-sized businesses around the world is presented in the paper in relation to global GDP (current US dollars), global GDP growth rates (annual percent), and global GDP per capita (annual percent).

Findings- Two determinants, Global GDP Growth rate and Global GDP Per Capita growth rate, are found as significant regressors. In addition, the number of SMEs worldwide during the previous year had a significant impact on the current year.

Research limitations- limited availability of government sources of data are the biggest hindrance. In this study we relied on the statistics published by STATISTA, knowing that it’s a private company that maintains business statistics.

Practical implications- SMEs have a significant impact on the economy that cannot be ignored. The government of some countries has commissioned a network of technology centers, tool rooms, and extension centers in collaboration with the private sector and foreign governments. These measures are a collective effort to support SMEs, preserve millions of jobs, and encourage domestic investments which will ultimately sustain the country's economic growth. 

Originality/value- In comparison with reviewed literature, this study focuses more on the regressors and regressands using statistical tools and the variables of interest.
Relações entre o uso de anfetaminas e sintomas psicóticos: uma revisão sistemática
Authors: Mesquita Vinícius Henrique , Rambaldi Raquel Henriques , Proença Raquel Lautenschlager Santana
Published: March 2022

Anfetaminas são substâncias com ações no sistema nervoso central e periférico com potencial de causar dano intenso e de desencadear sintomas psicóticos (delírios, alucinações). Esta revisão procurou identificar trabalhos com informações essenciais para a compreensão das relações entre o uso dessas substâncias por indivíduos e o desenvolvimento de quadros psicóticos, tanto transitórios, ocorridos apenas durante o uso, quanto persistentes durante e após o período de abstinência, ou evoluindo para transtornos primários, como a esquizofrenia. Através de busca em dois bancos de dados foi possível selecionar as referências que supriram os objetivos. Diversas pesquisas buscaram desvendar os mecanismos de ação dessas drogas, e as bases neurológicas, bioquímicas, fisiológicas e moleculares dos transtornos psicóticos, procurando evidências das ligações entre as três situações citadas anteriormente, e similaridades significativas entre os quadros foram identificadas, incluindo em exames de neuroimagem e análises de quadros clínicos, além de comprovações estatísticas. Contudo, futuros estudos são necessários para esclarecer alguns aspectos desse tema e melhorar classificação etiológica, clínica e diagnóstica, além do manejo desses pacientes.
Relato de caso: avaliação do risco de suicídio no transtorno depressivo maior grave com sintomas psicóticos
Authors: Barbosa Gabriela Fukuyama , Picarelli Cristiane Cacossi
Published: March 2022

Para além de sua sintomatologia clássica, o Transtorno Depressivo Maior (TDM) pode cursar com episódios únicos ou recorrentes de quadros psicóticos, marcados pela presença de delírios e alucinações cujos conteúdos associam-se frequentemente a ideias negativas e depressivas de morte, ruína, culpa e punição merecida. Esta condição está fortemente conectada a alto risco suicida, motivo pelo qual deve-se diagnosticar e intervir de maneira positiva o mais precocemente possível, a fim de que a vida, o sentido e a qualidade de viver do indivíduo possam ser restaurados e preservados. O caso relatado refere-se a uma paciente com diagnóstico atual de TDM grave e recorrente com sintomas psicóticos e alta intencionalidade suicida. Apresenta o humor constantemente deprimido, choro fácil e frequente, hipobulia, distúrbios do sono e sentimentos de menos-valia. Ademais, seu quadro cursa com sonhos e sensações estranhas relacionados a entidades malignas, assim como com alucinações visuais persistentes e delírios religiosos de pecado, culpa exagerada e punição divina. Frente à resistência dos sintomas ao tratamento farmacológico inicial, foram discutidas outras possibilidades de abordagem, conduta e diagnósticos diferenciais paralelamente à avaliação constante do risco de suicídio.
Rising to a New Challenge: A Protocol for Case-Study Research on Transboundary Climate Risk
Authors: Harris Katy , Lager Frida , Jansen Marta K. , Benzie Magnus
Published: March 2022

Recent research has highlighted that adaptation tends to focus exclusively on the local and direct impacts of climate change and misses the crucial dimension of transboundary climate risk, which all countries are likely to face, irrespective of their level of development. This paper aims to improve the coverage of transboundary climate risk in case-study research for adaptation. It proposes a protocol to help researchers identify how their case studies can incorporate an analysis of transboundary climate risk, thereby supporting more holistic, effective, and just approaches to adaptation. Existing climate risk assessment frameworks and supporting guidelines have significant strengths but also various challenges when applied to the novel context of transboundary climate risk. This is illustrated with reference to the impact chain framework. Its opportunities pertain to both its flexible form and systems-first focus while its constraints include an analytic emphasis on linear cause–effect relationships (that bely the complexity and uncertainty of systemic risk) and its limited applicability to fragmented governance landscapes (in the absence of an effective consideration of risk ownership). After critically examining the suitability of the impact chain framework, a new protocol is introduced, which builds on principles for managing complex risk and frameworks for assessing risk ownership. The protocol is designed to enable case-study researchers to better identify, assess, and appraise transboundary climate risks, as well as enquire into appropriate risk owners and adaptation options across scales. The paper argues for more innovation in adaptation research to better reflect the complexity and interdependency that characterize today’s world.

Significance Statement

This work aims to demonstrate why the transboundary nature of climate risk requires a distinct analytical approach and proposes a seven-step guide that aims to facilitate the exploration of transboundary climate risk through case-study-based research for adaptation. Domestic climate risks continue to dominate the field of climate change research, translating into a significant blind spot in adaptation planning and action. Without the provision of practical guidance—to equip researchers with approaches and tools specifically designed to analyze the transboundary and systemic nature of climate risk—adaptation action will fail to offer sufficient protection against the full range of risks climate change presents. This article begins to address this void and ultimately—through greater recognition and understanding of transboundary climate risk—promote approaches to adaptation that are reflective of the interdependency of our world today and our shared and common future.
Identification and validation of a prognostic model for melanoma patients with 9 ferroptosis-related gene signature
Authors: Chen Yuxuan , Guo Linlin , Zhou Zijie , An Ran , Wang Jiecong
Published: March 2022

Background

Melanoma is a highly heterogeneous and
aggressive cutaneous malignancy. Ferroptosis, a new pathway of cell death
depending on the intracellar iron, has been shown to be significantly
associated with apoptosis of a number of tumors, including melanoma.
Nevertheless, the relationship between ferroptosis-related genes (FRGs) and the
melanoma patients’ prognosis needs to be explored.

Methods

Download expression profiles of FRGs and
clinical data from The Cancer Genome Atlas (TCGA) database. 70% data were
randomly selected from the TCGA database and utilized the univariate Cox
analysis and the least absolute shrinkage and selection operator (LASSO)
regression model to create a prognostic model, and the remaining 30% was used
to validate the predictive power of the model. In addition, GSE65904 and
GSE22153 date sets as the verification cohort to testify the predictive ability
of the signature.

Results

We identified nine FRGs relating with melanoma
patients’ overall survival (OS) and established a prognostic model based on
their expression. During the research, patients were divided into group of
high-risk and low-risk according to the results of LASSO regression analysis.
Survival time was significantly longer in the low-risk group than that of in the
high-risk group (P < 0.001). Enrichment analysis of different risk groups
demonstrated that the reasons for the difference were related to immune-related
pathways, and the degree of immune cell infiltration in the low-risk group was
significantly higher than that in the high-risk group.

Conclusions

The FRG prognostic model we established can
predict the prognosis of melanoma patients and may further guide subsequent
treatment.
Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda
Authors: Byamukama Onesmus , Migisha Richard , Kalyebara Paul Kato , Tibaijuka Leevan , Lugobe Henry Mark , Ngonzi Joseph , Ahabwe Onesmus Magezi , Garcia Kenia Raquel Martinez , Mugyenyi Godfrey R. , Boatin Adeline Adwoa , Muhumuza Joy , Ssalongo Wasswa G. M. , Kayondo Musa , Kanyesigye Hamson
Published: March 2022

Background

Women with previous cesarean deliveries, have a heightened risk of poor maternal and perinatal outcomes, associated with short interbirth intervals. We determined the prevalence of short interbirth interval, and associated factors, among women with antecedent cesarean deliveries who delivered at Mbarara Regional Referral Hospital (MRRH), in southwestern Uganda.

Methods

We conducted a cross-sectional study on the postnatal ward of MRRH from November 2020 to February 2021. We enrolled women who had antecedent cesarean deliveries through consecutive sampling. We obtained participants’ socio-demographic and obstetric characteristics through interviewer-administered structured questionnaires. We defined short interbirth interval as an interval between two successive births of < 33 months. Modified Poisson regression was used to identify factors associated with short interbirth intervals.

Results

Of 440 participants enrolled, most had used postpartum family planning (PPFP) prior to the current pregnancy (67.5%), and most of the pregnancies (57.2%) were planned. The mean age of the participants was 27.6 ± 5.0 years. Of the 440 women, 147 had a short interbirth interval, for a prevalence of 33% (95%CI: 29–38%). In multivariable analysis, non-use of PPFP (adjusted prevalence ratio [aPR] = 2.24; 95%CI: 1.57–3.20, P < 0.001), delivery of a still birth at an antecedent delivery (aPR = 3.95; 95%CI: 1.43–10.9, P = 0.008), unplanned pregnancy (aPR = 3.59; 95%CI: 2.35–5.49, P < 0.001), and young maternal age (aPR = 0.25 for < 20 years vs 20–34 years; 95%CI: 0.10–0.64, P = 0.004), were the factors significantly associated with short interbirth interval.

Conclusion

One out of every three womenwith antecedent caesarean delivery had a short interbirth interval. Short interbirth intervals were more common among women with history of still births, those who did not use postpartum family planning methods, and those whose pregnancies were unplanned, compared to their counterparts. Young mothers (< 20 years) were less likely to have short interbirth intervals compared to those who were 20 years or older. Efforts should be made to strengthen and scale up child-spacing programs targeting women with previous cesarean deliveries, given the high frequency of short interbirth intervals in this study population.