bluuebunny/crossref_metadata_2025 huggingface dataset:
The ParentingWell Learning Collaborative Feasibility Study: Training Adult Mental Health Service Practitioners in a Family-Focused Practice Approach
Authors: Nicholson Joanne , English Kelly , Heyman Miriam
Published: April 2021

This study investigates the feasibility and impact of the ParentingWell Learning Collaborative (PWLC) model in supporting mental health practitioners in implementing the family-focused ParentingWell practice approach with adults with mental illness. An exploratory design and qualitative methods were employed. Practitioners (n = 29) participated in in-person orientation, training and debriefing sessions; virtual coaching sessions; and via an interactive online hub. Researchers obtained data on participant engagement and satisfaction, and participants’ reports of use, helpfulness, intention to use and impact. Participants were engaged in and highly satisfied with the PWLC. They deployed PWLC skills, tools and resources with parents. Evidence of impact was provided at the personal, practice and organizational levels. This study provides preliminary support for the feasibility and impact of the PWLC. Clear specification of a theoretically-based training model for practitioners is an essential step in adapting, implementing and testing interventions in new contexts .
The symbiotic relationship between educational robotics and computer science in formal education
Authors: El-Hamamsy Laila , Bruno Barbara , Chessel-Lazzarotto Frédérique , Chevalier Morgane , Roy Didier , Zufferey Jessica Dehler , Mondada Francesco
Published: April 2021

Educational Robotics (ER) has the potential to provide significant benefits to education, provided an increase in outreach by transitioning from the extra-curricular initiatives in which ER has thrived to formal education. As Computer Science (CS) Education is undergoing curricular reforms worldwide, the present study addresses the case of a Digital Education reform that included ER as a means to teach core CS concepts. Approximately 350 teachers from the first four grades of primary school participated in a mandatory two-year continuing professional development (CPD) program. The first year of the program was dedicated to CS and introduced teachers to CS Unplugged (CSU) and Robotics Unplugged (RU) activities. As such, we analyse the interplay between these activities and focus on teachers’ voluntary adoption of the proposed content in classrooms. This is complemented by an analysis of their perception and recommendation of ER. The findings highlight three main points. Firstly, ER benefits from the integration in the CS CPD, as this provides the necessary traction to introduce ER into teacher practices (the teachers freely devoted 2275 h to ER activities in their classrooms, over two years). Secondly, the presence of ER activities in the CS-CPD allows a higher proportion of teachers to adopt the CS content, as there are teachers that favour one type of activity over the other. Finally, the globally positive perception of ER registered in this study is relevant for two reasons: teachers were not voluntarily participating in the CPD, and results did not differ between pioneers and novices.
Addressing consistency and demand uncertainty in the Home Care planning problem
Authors: Cappanera Paola , Scutellà Maria Grazia
Published: April 2021

Optimizing Home Care Services is receiving a great attention in Operations Research. We address arrival time consistency, person-oriented consistency and demand uncertainty in Home Care, while jointly optimizing assignment, scheduling and routing decisions over a multiple-day time horizon. Consistent time schedules are very much appreciated by patients who, in this setting, are very sensitive to changes in their daily routines. Also person-oriented consistency positively impacts on service quality, guaranteeing that almost the same set of caregivers take care of a patient in the planning horizon. Demand uncertainty plays a pivotal role, too, since both the set of patients under treatment and their care plan can change over time. To the best of our knowledge, this is the first paper dealing with all these aspects in Home Care via a robust approach. We present a mathematical model to the problem, and a pattern-based algorithmic framework to solve it. The framework is derived from the model via decomposition, i.e. suitably fixing the scheduling decisions through the concept of pattern. We propose alternative policies to generate patterns, taking into account consistency and demand uncertainty; when embedding them in the general framework, alternative pattern based algorithms originate. The results of a rich computational experience show that introducing consistency and demand uncertainty in pattern generation policies is crucial to efficiently compute very good quality solutions, in terms of robustness and balancing of the caregiver workload. In addition, a comparison with a simpler model, where no kind of consistency is imposed, shows the importance of considering consistency in pursuing a valuable patient-centered perspective, with a positive effect also on the efficiency of the solution approach.
It’s Our Fault: A Global Comparison of Different Ways of Explaining Climate Change
Authors: Schnegg Michael , O’Brian Coral Iris , Sievert Inga Janina
Published: April 2021

International surveys suggest people increasingly agree the climate is changing and humans are the cause. One reading of this is that people have adopted the scientific point of view. Based on a sample of 28 ethnographic cases we argue that this conclusion might be premature. Communities merge scientific explanations with local knowledge in hybrid ways. This is possible because both discourses blame humans as the cause of the changes they observe. However, the specific factors or agents blamed differ in each case. Whereas scientists identify carbon dioxide producers in particular world regions, indigenous communities often blame themselves, since, in many lay ontologies, the weather is typically perceived as a local phenomenon, which rewards and punishes people for their actions. Thus, while survey results show approval of the scientific view, this agreement is often understood differently and leads to diverging ways of allocating meaning about humans and the weather.
Advancing HEIs’ third-mission through dynamic capabilities: the role of leadership and agreement on vision and goals
Authors: Stolze Audrey , Sailer Klaus
Published: April 2021

Higher education institutions (HEIs), once considered among society’s most resilient institutions, are facing challenges due to changes in governments’ and society’s expectations of them. Within the sector, there is a global call for new models and practices, requiring HEIs to develop the management capabilities once reserved for businesses. In this sense, they will pave entrepreneurial pathways and contribute to economic, technological and societal developments in their regions, thus adding a third mission (engaging socio-economic needs and market demands) to the traditional two (education and research) and transforming themselves into more entrepreneurial institutions. Dynamic capabilities enable transformation processes by allowing the dynamic sensing and seizing of opportunities and risks and the promotion of iterative change and reconfiguration. Scholars have called on HEIs to develop such dynamic capabilities in order to transform themselves and better respond to their sector’s challenges. Nevertheless, the understanding of how dynamic capabilities might advance HEIs’ third mission is still an underexplored concept, and in this paper, we propose mechanisms that promise to transform dynamic capabilities into third mission advancement. We have developed numerous theoretically grounded hypotheses and tested them with a partial least squares structural equation model into which we funnelled data collected from key decision-makers at German HEIs. The results suggest that dynamic capabilities do indeed influence third mission advancement; however, this relationship is mediated by the role of leadership and organisational agreement on vision and goals.
Identification of Elk-vehicle incident hotspots on state route 20 in Washington State
Authors: Sevigny Jennifer , Summers Amanda , Kalisz Glen , McAllister Kelly
Published: April 2021

Context

Identifying risk zones for wildlife-vehicle incidents is essential for creating effective mitigation efforts on major road networks. Wildlife-vehicle collision data are often used to identify hotspot areas without consideration of species spatial distributions.

Objectives

Evaluating both can reveal spatiotemporal patterns that can improve mitigation success.

Methods

We summarized elk-vehicle incident (EVI) data on State Route 20 (SR 20) in Washington State between 2012 and 2019. We also collared 23 elk residing in the vicinity of SR 20 and used GPS location data to identify home ranges and road crossings. We compared EVI and elk road crossing data to identify hotspot locations on SR 20 to help inform mitigation.

Results

Our EVI and elk crossing data had a non-random distribution along a 38 km section of SR 20 associated with the 95% home ranges of 8 female elk sub-herds. We found EVI data alone were an effective indicator of elk spatial distribution and movement in relation to collision hotspots along SR 20. Our results also indicated a strong association between elk crossings and EVIs by milepost. While the spatial distribution of elk sub-herds was a good predictor of EVI risk zones, EVI frequency was not associated with an increase in elk population.

Conclusions

Classifying EVI and road crossing distributions as high risk zones is the first step preceding mitigation and protection measures to prevent elk-vehicle collisions. Specific identification of hotspots will result in more effective and successful installations of high cost mitigation efforts such as wildlife crossing structures.
The functions of repressor element 1-silencing transcription factor in models of epileptogenesis and post-ischemia
Authors: Butler-Ryan Ruth , Wood Ian C.
Published: April 2021

Epilepsy is a debilitating neurological disorder characterised by recurrent seizures for which 30% of patients are refractory to current treatments. The genetic and molecular aetiologies behind epilepsy are under investigation with the goal of developing new epilepsy medications. The transcriptional repressor REST (Repressor Element 1-Silencing Transcription factor) is a focus of interest as it is consistently upregulated in epilepsy patients and following brain insult in animal models of epilepsy and ischemia. This review analyses data from different epilepsy models and discusses the contribution of REST to epileptogenesis. We propose that in healthy brains REST acts in a protective manner to homeostatically downregulate increases in excitability, to protect against seizure through downregulation of BDNF (Brain-Derived Neurotrophic Factor) and its receptor, TrkB (Tropomyosin receptor kinase B). However, in epilepsy patients and post-seizure, REST may increase to a larger degree, which allows downregulation of the glutamate receptor subunit GluR2. This leads to AMPA glutamate receptors lacking GluR2 subunits, which have increased permeability to Ca2+, causing excitotoxicity, cell death and seizure. This concept highlights therapeutic potential of REST modulation through gene therapy in epilepsy patients.
Action unit classification for facial expression recognition using active learning and SVM
Authors: Yao Li , Wan Yan , Ni Hongjie , Xu Bugao
Published: April 2021

Automatic facial expression analysis remains challenging due to its low recognition accuracy and poor robustness. In this study, we utilized active learning and support vector machine (SVM) algorithms to classify facial action units (AU) for human facial expression recognition. Active learning was used to detect the targeted facial expression AUs, while an SVM was utilized to classify different AUs and ultimately map them to their corresponding facial expressions. Active learning reduces the number of non-support vectors in the training sample set and shortens the labeling and training times without affecting the performance of the classifier, thereby reducing the cost of labeling samples and improving the training speed. Experimental results show that the proposed algorithm can effectively suppress correlated noise and achieve higher recognition rates than principal component analysis and a human observer on seven different facial expressions.
Nonlinear dynamics of a base-isolated beam under turbulent wind flow
Authors: Di Nino Simona , Luongo Angelo
Published: April 2021

A homogeneous continuous viscoelastic beam, describing the dynamics of a base-isolated tower, exposed to a uniformly distributed turbulent wind flow, is studied. The beam is constrained at the bottom end by a nonlinear viscoelastic device, and it is free at the top end. Aeroelastic forces are computed by the quasi-static theory. The steady component of wind is responsible for a Hopf bifurcation, and the turbulent component induces parametric excitation. The interaction between the two bifurcations is investigated. Critical and post-critical behavior is analyzed by perturbation methods. The mechanical performances of the structure are discussed to assess the effectiveness of the viscoelastic isolation system.
Side effects and the enactment of accountability: results of a comparative study in two German federal states
Authors: Thiel Corrie
Published: April 2021

The paper proposes to study side effects of accountability in education within the theoretical framework of enactment research. The potential value of this approach for the study of side effects is shown by using the example of the side effect “Dependency on Expert Judgements.” Therefore, findings from the research project “Unintended Effects of Accountability in the School System” (acronym “Nefo”) are presented. The project entailed an analysis of policy documents to describe the accountability contexts under study, as well as a survey study with 2637 participating teachers and principals to examine the distribution of side effects in the no- and low-stakes contexts of the four German federal states of Berlin, Brandenburg, Thuringia, and Rhineland-Palatinate. The findings for Berlin and Thuringia are triangulated with the results from a qualitative in-depth group-discussion substudy of the Nefo project on how teachers in Berlin and Thuringia deal with accountability measures. The analysis of policy documents reveals that in Berlin, performance results gain the status of objective data that teachers need to improve their work, while teachers in Thuringia are prompted to judge by themselves the meaning of performance results for their teaching. This suggests that “Dependency on Expert Judgements” is a larger issue in Berlin than in Thuringia. However, contrary to what would be expected, the findings of the survey study indicate that the side effect plays a greater role in Thuringia than in Berlin. To explain this counterintuitive finding, teachers’ responses to standards-based accountability in Berlin and Thuringia are delineated. The paper shows that the study of meaning-making processes, which is central to the enactment framework, must not only be ignored if one tries to understand the processes that lead to the occurrence or absence of side effects. It is also important to prevent fallacies in the interpretation of survey data.
Elicitation of antioxidant metabolites in Musa species in vitro shoot culture using sucrose, temperature and jasmonic acid
Authors: Ayoola-Oresanya Ibukun O. , Sonibare Mubo A. , Gueye Badara , Abberton Michael T. , Morlock Gertrud E.
Published: April 2021

In vitro culture is not only known for the mass propagation of medicinal plants, it can also be used to boost the accumulation of useful metabolites. This work was aimed at studying the potential of elicitation on the accumulation of antioxidant secondary metabolites in different Musa species accessions. Shoot cultures of selected six Musa spp. accessions were micropropagated on Murashige and Skoog mineral-based culture medium, supplemented with indole-3-acetic acid and 6-benzylaminopurine. Different temperatures (15, 20 and 26 °C), doses of sucrose (30–50 g/L) and jasmonic acid concentrations (JA, 50–200 µM) were used as elicitors in the culture medium. High-performance thin-layer chromatography (HPTLC) coupled with effect-directed analysis (EDA) was used to compare and characterize all the 71 Musa spp. samples from the selected accessions and to reveal compound zones with antioxidant, antidiabetic and anticholinesterase activities. All elicitation and plant tissue culture experiments increased the total phenolic content (TPC) and antioxidant activity of the selected Musa spp. accessions. Extracts from plants grown at 20 °C gave the highest TPC and antioxidant activity. Addition of JA (200 µM) and higher sucrose contents (40 g/L or 45 g/L) increased the TPC and antioxidant activity as well. Not only compounds with antioxidant, but also antidiabetic and anticholinesterase activities were detected in the elicited accessions. The system presented in this study could serve as a sustainable, consistent and reliable alternative means of bioactive metabolites supply for the production of biopharmaceuticals.
Gold nanoparticles affect the cryopreservation efficiency of in vitro-derived shoot tips of bleeding heart
Authors: Kulus Dariusz , Tymoszuk Alicja
Published: April 2021

The popularity of nanoparticles (NPs) is continuously increasing. To date, however, there has been little research on the application of NPs in plant cryopreservation, i.e. storage of tissues in liquid nitrogen (LN). The aim of this study is to analyze the effect and evaluate the usefulness of gold nanoparticles (AuNPs) in regard to cryobiology studies. In vitro-derived shoot tips ofLamprocapnos spectabilis‘Valentine’ were cryopreserved with the encapsulation-vitrification protocol. Gold nanoparticles (at 10–30 ppm concentration; 13 nm in size) were added either into the preculture medium; to the protective bead matrix during encapsulation; or to the recovery medium after rewarming of samples. The control plants were produced from cryopreserved explants non-treated with nanoparticles or treated with colloid dispersion medium without NPs. A non-LN-treated standard was also considered. The influence of AuNPs on the cryopreservation efficiency was determined by evaluating the recovery rate of explants and their morphogenic response; the membrane stability index (MSI); the concentration of pigments in shoots; and the antioxidant enzymes activity. The genetic stability of the plant material was evaluated using Start Codon Targeted Polymorphism (SCoT) markers. It was found that 10 ppm of AuNPs added into the alginate bead matrix improved the recovery level of LN-derived shoot tips (70.0%) compared to the non-NPs-treated cryopreserved control (50.5%). On the other hand, the presence of nanoparticles in the recovery medium had a deleterious effect on the survival of explants. AuNPs usually had no impact on the MSI (73.9–85.9%), except for those added into the recovery medium at the concentration of 30 ppm (decline to 55.8%). All LN-derived shoots were shorter and contained less chlorophyll and carotenoids than the untreated standard. Moreover, the application of AuNPs affected the enzymatic activity inL. spectabilis. Minor genetic variation was found in 8.6% of plants if AuNPs were added either into the preculture medium (at 10 and 20 ppm) or to the alginate matrix (at 30 ppm). In conclusion, AuNPs added at a lower concentration (10 ppm) into the protective bead matrix can significantly improve the cryopreservation efficiency inL. spectabiliswith no alternation in the DNA sequence.
Leonardo da Vinci’s “Last Supper”: a case study to evaluate the influence of visitors on the Museum preservation systems
Authors: Motta Oriana , Pironti Concetta , Ricciardi Maria , Rostagno Chiara , Bolzacchini Ezio , Ferrero Luca , Cucciniello Raffaele , Proto Antonio
Published: April 2021

The most important parameter to obtain an appropriate preservation condition of museum environments concerns the indoor air quality. The exposure of artwork and materials to gaseous and particulate pollutants introduced by visitors and either indoor or outdoor sources contributes to their decay. In this work, we evaluated the possible monitoring of the visitors’ influence using the stable carbon isotopic ratio of CO2 and the concentration of NH3 as a real-time tool. The study was done in the Refectory of Santa Maria delle Grazie (Milan, Italy) which houses one of the most important paintings of Leonardo da Vinci, the Last Supper, and had more than 400,000 visitors in 2019. The results confirmed a good correlation between the presence of tourists inside the museum and the variation of δ13C value during the visits and the closure of the museum. The variation of indoor atmospheric δ13C was influenced by the presence of visitors in the Refectory and delineates the way done from the entrance to the exit. In the same way, the concentration of NH3 was influenced by the presence of visitors and confirmed the role of this one on preservation methodology for indoor air quality in the museum. This new methodology can be used as a supplemental and non-invasive tool to help in calibrating microclimatic conditions through the ventilation rate and air filtration systems in the museum and to manage the number of visitors per turn.
Comparison of Liver Recovery After Sleeve Gastrectomy and Roux-en-Y-Gastric Bypass
Authors: Schmitz Sophia M.-T. , Kroh Andreas , Koch Alexander , Brozat Jonathan F. , Stier Christine , Neumann Ulf P. , Ulmer Tom F. , Alizai Patrick H.
Published: April 2021

Background

Nonalcoholic fatty liver disease (NAFLD) is a common condition in patients with obesity. Bariatric surgery has often been proposed as a viable treatment option, but the ideal surgical procedure remains unclear. Inconsistently, reports on postoperative deterioration of liver function put further doubt on which technique to apply. Aim of this study was to assess the impact of Roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) on the postoperative recovery of liver function.

Methods

A total of 175 patients with obesity that underwent bariatric surgery in our institution were included in this prospective cohort study. BMI, laboratory values, and liver function capacity (using LiMAx) were assessed preoperatively and at 6 and 12 months postoperatively. Generalized linear model (GLM) was performed to determine variables influencing liver function capacity after the operation.

Results

Prior to operations, 64% of patients presented with a diminished liver function capacity, as measured by LiMAx test. Liver function capacity significantly recovered after 12 months in the SG group (300 μg/kg/h preop vs. 367 μg/kg/h postop) but not in the RYGB group (306 μg/kg/h preop vs. 349 μg/kg/h). Preoperative factors impeding liver function recovery included type 2 diabetes mellitus (T2DM), weight, male sex, AST/thrombocyte ratio (APRI), and gamma-glutamyltransferase (GGT).

Conclusion

Bariatric surgery, especially sleeve gastrectomy, leads to an improvement of liver function. However, in some patients with T2DM, higher preoperative weight and male sex postoperative deterioration of liver function capacity may occur.

Graphical abstract
The influence of COVID-19 preventive measures on the air quality in Abu Dhabi (United Arab Emirates)
Authors: Teixidó Oriol , Tobías Aurelio , Massagué Jordi , Mohamed Ruqaya , Ekaabi Rashed , Hamed Hussein I. , Perry Richard , Querol Xavier , Al Hosani Shaikha
Published: April 2021

The preventive and cautionary measures taken by the UAE and Abu Dhabi governments to reduce the spread of the coronavirus disease (COVID-19) and promote social distancing have led to a reduction of mobility and a modification of economic and social activities. This paper provides statistical analysis of the air quality data monitored by the Environment Agency – Abu Dhabi (EAD) during the first 10 months of 2020, comparing the different stages of the preventive measures. Ground monitoring data is compared with satellite images and mobility indicators. The study shows a drastic decrease during lockdown in the concentration of the gaseous pollutants analysed (NO2, SO2, CO, and C6H6) that aligns with the results reported in other international cities and metropolitan areas. However, particulate matter (PM10 and PM2.5) averaged concentrations followed a markedly different trend from the gaseous pollutants, indicating a larger influence from natural events (sand and dust storms) and other anthropogenic sources. The ozone (O3) levels increased during the lockdown, showing the complexity of O3 formation. The end of lockdown led to an increase of the mobility and the air pollution; however, air pollutant concentrations remained in lower levels than during the same period of 2019. The results in this study show the large impact of human activities on the quality of air and present an opportunity for policymakers and decision-makers to design stimulus packages to overcome the economic slow-down, with strategies to accelerate the transition to resilient, low-emission economies and societies more connected to the nature that protect human health and the environment.
Prasugrel switching from clopidogrel after percutaneous coronary intervention for acute coronary syndrome in Taiwanese patients: an analysis of safety and efficacy
Authors: Liu Ping-Yen , Su Cheng-Huang , Kuo Feng-Yu , Lee Wen-Lieng , Wang Yi-Chih , Lin Wei-Shiang , Chu Pao-Hsien , Lu Tse-Min , Lo Ping-Han , Lee Cheng-Han , Lan Wei-Ren , Huang Chien-Lung , Tsukiyama Shuji , Yang Wei-Chen , Cheng Li-Chung , Rafael Virginia , Nikolajsen Christian , Yin Wei-Hsian
Published: April 2021

The recommended maintenance dose of prasugrel for East Asian populations (i.e., Japanese and Taiwanese) is 3.75 mg as part of dual antiplatelet therapy (DAPT) for the prevention of recurrent ischemia and stent thrombosis in acute coronary syndrome (ACS). This modified dosage regimen has been established in studies conducted in Japan; however, the efficacy and safety of switching from clopidogrel to prasugrel DAPT among Taiwanese patients remain to be explored. In this phase IV, multicenter, single-arm, open-label study, we evaluated the 4-week pharmacodynamic response, and the 48-week safety outcomes of prasugrel 3.75 mg after a switch from clopidogrel in Taiwanese ACS patients. A total of 203 prasugrel-naïve ACS patients (over 90% male) who had received post-PCI clopidogrel DAPT for at least 2 weeks were enrolled from ten medical centers in Taiwan and subsequently switched to prasugrel 3.75 mg DAPT. Four weeks after the switch, P2Y12 reaction unit (PRU) values were significantly decreased in the total cohort (mean − 18.2 ± 48.1; 95% confidence interval − 24.9 to − 11.5,p < 0.001), and there was an overall consistent antiplatelet response in the treated subjects. The proportion of patients with high on-treatment platelet reactivity (HPR; PRU > 208) dropped from 23.5 to 10% (p < 0.001). Female sex was associated with a greater PRU reduction with prasugrel, whereas HPR at baseline, age ≥ 65 years, and body mass index ≥ 25 best predicted HPR at Week 4. Throughout the 48-week treatment with prasugrel, the incidences of MACE (1.0%) and TIMI major bleeding (2.0%) were rather low, accompanying an acceptable safety profile of TIMI minor (6.4%) and non-major, non-minor clinically relevant bleeding (3.0%). Overall, switching to the maintenance dose of prasugrel (3.75 mg) was observed to be effective and well tolerated among post-PCI ACS patients in Taiwan. Clinical Trial Registration Number: NCT03672097.
Computational evaluation of laparoscopic sleeve gastrectomy
Authors: Toniolo Ilaria , Fontanella Chiara Giulia , Gagner Michel , Stefanini Cesare , Foletto Mirto , Carniel Emanuele Luigi
Published: April 2021

LSG is one of the most performed bariatric procedures worldwide. It is a safe and effective operation with a low complication rate. Unsatisfactory weight loss/regain may occur, suggesting that the operation design could be improved. A bioengineering approach might significantly help in avoiding the most common complications. Computational models of the sleeved stomach after LSG were developed according to bougie size (range 27–54 Fr). The endoluminal pressure and the basal volume were computed at different intragastric pressures. At an inner pressure of 22.5 mmHg, the basal volume of the 54 Fr configuration was approximately 6 times greater than that of the 27 Fr configuration (57.92 ml vs 9.70 ml). Moreover, the elongation distribution of the gastric wall was assessed to quantify the effect on mechanoreceptors impacting satiety by differencing regions and layers. An increasing trend in elongation strain with increasing bougie size was observed in all cases. The most stressed region and layer were the antrum (approximately 25% higher stress than that in the corpus at 37.5 mmHg) and mucosa layer (approximately 7% higher stress than that in the muscularis layer at 22.5 mmHg), respectively. In addition, the pressure–volume behaviors were reported. Computational models and bioengineering methods can help to quantitatively identify some critical aspects of the “design” of bariatric operations to plan interventions, and predict and increase the success rate. Moreover, computational tools can support the development of innovative bariatric procedures, potentially skipping invasive approaches.
Impact of thrombus aspiration in frail STEMI patients
Authors: Mone Pasquale , Gambardella Jessica , Pansini Antonella , Rizzo Mario , Mauro Ciro , Minicucci Fabio , Santulli Gaetano
Published: April 2021

Background

Despite primary percutaneous coronary intervention (PPCI) is generally considered the best therapy in older frail adults with ST-segment elevation myocardial infarction (STEMI), the incidence of re-hospitalization for cardiovascular diseases remains significant in these patients.

Aims

We hypothesized that thrombus aspiration (TA) before PPCI could be a useful treatment for reducing mortality and rehospitalizations in frail patients undergoing PPCI for STEMI.

Methods

We conducted a study comparing PPCI alone vs TA + PPCI in frail STEMI patients. We examined a cohort of consecutive frail patients aged ≥ 65 years with first STEMI treated with PPCI between February 2008 and July 2015 at the Department of Cardiology of the “Cardarelli” Hospital in Naples, Italy.

Results

The study was completed by 389 patients (PPCI: 195, TA + PPCI: 194). At 1-month follow-up, the rate of death from any cause was 7.0% in patients treated with PPCI alone vs 3.0% in patients treated with TA + PPCI (p 0.036), whereas death from cardiovascular causes was 6.0% in the PPCI group vs 3.0% in the TA + PPCI group (p 0.028). Equally important, the rate of re-hospitalization due to heart failure was 7.5% in the PPCI group vs 4.0% in TA + PPCI group (p 0.025) and the rate of re-hospitalization due to acute coronary syndrome was 10.0% in the PPCI group vs 4.5% in the TA + PPCI group (p 0.016).

Conclusion

These results indicate the importance of TA in the treatment of STEMI in a group of high-risk patients such as elderly with frailty.
Status and challenges of integrated watershed management practices after-project phased-out in Eastern Tigray, Ethiopia
Authors: Gebregergs Tirhas , Teka Kassa , Taye Gebeyehu , Gidey Eskinder , Dikinya Oagile
Published: April 2021

Land degradation in the form of soil erosion is one of the major causes for declining ecosystem functions in the northern highlands of Ethiopia including the Eastern Tigray. Hence, different integrated watershed management practices were introduced in the last few years to avert the problem. Currently, most of these practices are phased out. However, the status and challenges of these practices after phase-out are not well documented and required scientific research. On-field measurement from nine sample plots having a size of each 50 m*50 m at 200 m interval was conducted to assess the status and challenges of these practices. Results of the assessment showed that physical soil and water conservation structures were deteriorated by 47–64% after IWM project phased out. The key problems were lack of periodic maintenance, and limited support by biological conservation measures. The study results suggest that Watershed technologies are highly challenged after project phase-out. Hence, integration among the community, government and non-governmental organizations are needed to sustainably manage these resources.
Big data for sustainable agri‐food supply chains: a review and future research perspectives
Authors: Rejeb Abderahman , Rejeb Karim , Zailani Suhaiza
Published: April 2021

Research on agri-food supply chains (AFSCs) has attracted significant attention in recent years due to the challenges associated with sustainably feeding the global population. The purpose of this study is to review the potentials of big data for sustainable AFSCs. One hundred twenty-eight (128) journal articles were selected to identify how big data can contribute to the sustainable development of AFSCs. As part of our focus, a framework was developed based on the conceptualization of AFSCs in the extant literature to analyse big data research in the context of AFSCs and to provide insights into the potentials of the technology for agri-food businesses. The findings of the review indicate that there is a noticeable growth in the number of studies addressing the applications of big data for AFSCs. The potentials of big data for AFSC sustainability were synthesized in a summary framework, highlighting the primary resources and activities that are ready for improvement with big data. These include soil, water, crop and plant management, animal management, waste management and traceability management. The challenges of big data integration in AFSCs, the study’s implications, contributions, and the future research directions are highlighted in detail.
Blockchain research in healthcare: a bibliometric review and current research trends
Authors: Rejeb Abderahman , Treiblmaier Horst , Rejeb Karim , Zailani Suhaiza
Published: April 2021

The literature on blockchain-enabled use cases has grown exponentially over recent years. Yet, studies are missing that apply bibliometrics and visualization techniques to unravel the dynamics and current discussions pertaining to the nexus of blockchain technology (BCT) and the healthcare field. To close this knowledge gap, we examine the knowledge base and research hotspots of BCT research in the field of healthcare. We carry out a series of bibliometric analyses on the extant literature, including the scholarly production, developmental pattern of the annual total number of authors, and identification of productive academic institutions, countries, and leading authors. Additionally, we conduct a keyword co-occurrence analysis and identify the major research hotspots and trends for the future. The findings of this research are valuable for scholars and practitioners who seek to better understand the development status, dynamics, and trends pertaining to BCT in healthcare.
New trenching results along the İznik segment of the central strand of the North Anatolian Fault (Turkey): an integration with preexisting data
Authors: Civico R. , Smedile A. , Pantosti D. , Cinti F. R. , De Martini P. M. , Pucci S. , Çakır Z. , Şentürk S.
Published: April 2021

This paper provides a new contribution to the construction of the complex and fragmentary mosaic of the Late Holocene earthquakes history of the İznik segment of the central strand of the North Anatolian Fault (CNAF) in Turkey. The CNAF clearly displays lower dextral slip rates with respect to the northern strand however, surface rupturing and large damaging earthquakes (M > 7) occurred in the past, leaving clear signatures in the built and natural environments. The association of these historical events to specific earthquake sources (e.g., Gemlik, İznik, or Geyve fault segments) is still a matter of debate. We excavated two trenches across the İznik fault trace near Mustafali, a village about 10 km WSW of İznik where the morphological fault scarp was visible although modified by agricultural activities. Radiocarbon and TL dating on samples collected from the trenches show that the displaced deposits are very recent and span the past 2 millennia at most. Evidence for four surface faulting events was found in the Mustafali trenches. The integration of these results with historical data and previous paleoseismological data yields an updated Late Holocene history of surface-rupturing earthquakes along the İznik Fault in 1855, 740 (715), 362, and 121 CE. Evidence for the large M7 + historical earthquake dated 1419 CE generally attributed to this fault, was not found at any trench site along the İznik fault nor in the subaqueous record. This unfit between paleoseismological, stratigraphic, and historical data highlights one more time the urge for extensive paleoseismological trenching and offshore campaigns because of the high potential to solve the uncertainties on the seismogenic history (age, earthquake location, extent of the rupture and size) of this portion of NAFZ and especially on the attribution of historical earthquakes to the causative fault.
Bedside pressure-pain threshold algometry to measure abdominal tenderness in childhood appendicitis: A retrospective cohort study
Authors: Postuma Ray , Vajcner Glen , Postuma Ronald B. , Keijzer Richard
Published: April 2021

ABSTRACT

Introduction:

Abdominal wall tenderness and its localization are key diagnostic features of appendicitis. However, abdominal wall tenderness assessment is subjective, and its utility in the diagnostic discrimination of appendicitis is limited. The objective of this study is to assess whether measuring abdominal tenderness using algometry can improve the clinical assessment of children with suspected appendicitis.

Methods:

Using a spring-gauge, pocket-size algometer, similar to a tire gauge, we measured abdominal wall pressure-pain thresholds and tenderness localization ratios in children with suspected appendicitis referred to one pediatric general surgeon. We correlated the results with the final diagnosis, standard diagnostic scores, and abdominal ultrasound.

Results:

Of 557 children with suspected appendicitis, 421 (76%) had algometry measurements of whom 239 (57%) underwent appendectomy. Appendicitis was confirmed in 216 (90%); appendicitis prevalence 51%. Pressure-pain thresholds were significantly lower and tenderness localization ratios higher in appendicitis. The difference was greatest with perforation: maximum AUC 0.884 overall, in males AUC 0.935. During observation, pressure-pain thresholds decreased while tenderness localization ratio increased in appendicitis patients, signaling increasing tenderness and more precise localization for appendicitis. The reverse was observed for non-appendicitis patients. Localization ratios were superior to the two standard diagnostic appendicitis scores (Algometry AUC = 0.844; Alvarado AUC = 0.790, pediatric appendicitis score AUC = 0.760) and white blood cell count alone (AUC = 0.728). Algometry results yielded positive and negative predictive values up to 100%.

Conclusion:

Bedside measurements of abdominal wall tenderness outperformed individual clinical and laboratory parameters and appendicitis diagnostic scores in identifying acute appendicitis. If validated and given its ease, algometry has the potential for incorporation into clinical practice, documentation, and as a quantifiable tenderness measure for use in clinical research.

Highlights
The prevalence and influencing factors of anaemia among pre-pregnant women in mainland China: a large population-based, cross-sectional study
Authors: Zhao Jun , Zhu Xiaoyue , Dai Qiaoyun , Hong Xiang , Zhang Hongguang , Huang Kaiping , Wang Yuanyuan , Yang Xueying , Zhang Yue , Peng Zuoqi , Zhang Ya , Xuan Yan , Wang Qiaomei , Shen Haiping , Zhang Yiping , Yan Donghai , Wang Bei , Ma Xu
Published: April 2021

Anaemia is a global public health problem affecting women worldwide, and reproductive-age women are at increased risk. We conducted a population-based cross-sectional study analysing the prevalence of overall anaemia and anaemia according to severity in Chinese pre-pregnant women to update current knowledge on anaemia epidemiology. Based on the National Free Preconception Check-up Projects supported by the Chinese government, 5 679 782 women participating in this project in 2017 were included in the present study. The cyanmethemoglobin method was applied to assess Hb concentrations. Univariate and multivariate logistic regressions were applied for associated factors. The prevalence of anaemia among Chinese pre-pregnant women was 21·64 % (mild: 14·10 %, moderate: 7·17 % and severe : 0·37 %). The prevalence of overall and severe anaemia was the highest in Tibet and the lowest in Beijing among thirty-one provinces. Women’s age, region, ethnic origin, educational level, occupation and pregnancy history were all correlated with anaemia. Women with B blood type (adjusted OR (aOR) = 0·89), higher BMI (overweight: aOR = 0·84; obesity: aOR = 0·70) and alcohol consumption (aOR = 0·69) were less likely to have anaemia, while those with rhesus negative blood type (aOR = 1·10), history of anaemia (aOR = 2·60), older age at menarche (aOR = 1·19), heavy menstrual blood loss (aOR = 1·39), longer menstrual period (aOR = 1·09) and shorter menstrual cycle (aOR = 1·08) were more likely to suffer from anaemia. Meat or egg eaters were not significantly associated with severe anaemia. Anaemia is of moderate public health significance among Chinese pre-pregnant women. Interventions should be considered to prevent anaemia to the greatest extent possible to avoid potential harm in this population.
Coherent Pathways for Subduction From the Surface Mixed Layer at Ocean Fronts
Authors: Freilich Mara , Mahadevan Amala
Published: April 2021

In frontal zones, water masses that are tens of kilometers in extent with origins in the mixed layer can be identified in the pycnocline for days to months. Here, we explore the pathways and mechanisms of subduction, the process by which water from the surface mixed layer makes its way into the pycnocline, using a submesoscale‐resolving numerical model of a mesoscale front. By identifying Lagrangian trajectories of water parcels that exit the mixed layer, we study the evolution of dynamical properties from a statistical standpoint. Velocity‐ and buoyancy‐gradients increase as water parcels experience both mesoscale (geostrophic) and submesoscale (ageostrophic) frontogenesis and subduct beneath the mixed layer into the stratified pycnocline along isopycnals that outcrop in the mixed layer. Subduction is transient and occurs in coherent regions along the front, the spatial and temporal scales of which influence the scales of the subducted water masses in the pycnocline. An examination of specific subduction events reveals a range of submesoscale features that support subduction. Contrary to the forced submesoscale processes that sequester low potential vorticity (PV) anomalies in the interior, we find that PV can be elevated in subducting water masses. The rate of subduction is of similar magnitude to previous studies (∼100 m/year), but the Lagrangian evolution of properties on water parcels and pathways that are unraveled in this study emphasize the role of submesoscale dynamics coupled with mesoscale frontogenesis.
Impact of Intraseasonal Waves on Angolan Warm and Cold Events
Authors: Imbol Koungue Rodrigue Anicet , Brandt Peter
Published: April 2021

The intraseasonal variability of the tropical eastern boundary upwelling region in the Atlantic Ocean is investigated using multiyear mooring and satellite data. Pronounced oscillations of alongshore velocity and sea level off Angola at periods of about 90 and 120 days are observed. Similar spectral peaks are detected along the equator suggesting an equatorial forcing via equatorial and coastally trapped waves. Equatorial variability at 90 days is enhanced only in the eastern Atlantic likely forced by local zonal wind fluctuations. Variability at 120 days is generally stronger and linked to a second equatorial basin mode covering the whole equatorial basin. Besides forcing of the 120‐day variability by equatorial zonal winds, additional forcing of the resonant basin mode likely originates in the central and western tropical North Atlantic. The coastally trapped waves generated at the eastern boundary by the impinging equatorial Kelvin waves that are detected through their variations in sea level anomaly are associated with corresponding sea surface temperature anomalies delayed by about 14 days. Off Angola, those intraseasonal waves interfere with major coastal warm and cold events that occur every few years by either enhancing them as for the Benguela Niño in 1995 or damping them as for the warm event in 2001.
How Nitrogen and Phosphorus Availability Change Water Use Efficiency in a Mediterranean Savanna Ecosystem
Authors: El‐Madany Tarek S. , Reichstein Markus , Carrara Arnaud , Martín M. Pilar , Moreno Gerardo , Gonzalez‐Cascon Rosario , Peñuelas Josep , Ellsworth David S. , Burchard‐Levine Vicente , Hammer Tiana W. , Knauer Jürgen , Kolle Olaf , Luo Yunpeng , Pacheco‐Labrador Javier , Nelson Jacob A. , Perez‐Priego Oscar , Rolo Victor , Wutzler Thomas , Migliavacca Mirco
Published: April 2021

Nutrient availability, especially of nitrogen (N) and phosphorus (P), is of major importance for every organism and at a larger scale for ecosystem functioning and productivity. Changes in nutrient availability and potential stoichiometric imbalance due to anthropogenic nitrogen deposition might lead to nutrient deficiency or alter ecosystem functioning in various ways. In this study, we present 6 years (2014–2020) of flux‐, plant‐, and remote sensing data from a large‐scale nutrient manipulation experiment conducted in a Mediterranean savanna‐type ecosystem with an emphasis on the effects of N and P treatments on ecosystem‐scale water‐use efficiency (WUE) and related mechanisms. Two plots were fertilized with N (NT, 16.9 Ha) and N + P (NPT, 21.5 Ha), and a third unfertilized plot served as a control (CT). Fertilization had a strong impact on leaf nutrient stoichiometry only within the herbaceous layer with increased leaf N in both fertilized treatments and increased leaf P in NPT. Following fertilization, WUE in NT and NPT increased during the peak of growing season. While gross primary productivity similarly increased in NT and NPT, transpiration and surface conductance increased more in NT than in NPT. The results show that the NPT plot with higher nutrient availability, but more balanced N:P leaf stoichiometry had the highest WUE. On average, higher N availability resulted in a 40% increased leaf area index (LAI) in both fertilized treatments in the spring. Increased LAI reduced aerodynamic conductance and thus evaporation at both fertilized plots in the spring. Despite reduced evaporation, annual evapotranspiration increased by 10% (48.6 ± 28.3 kg H2O m−2), in the NT plot, while NPT remained similar to CT (−1%, −6.7 ± 12.2 kgH2O m−2). Potential causes for increased transpiration at NT could be increased root biomass and thus higher water uptake or rhizosphere priming to increase P‐mobilization through microbes. The annual net ecosystem exchange shifted from a carbon source in CT (75.0 ± 20.6 gC m−2) to carbon‐neutral in both fertilized treatments [−7.0 ± 18.5 gC m−2 (NT) 0.4 ± 22.6 gC m−2 (NPT)]. Our results show, that the N:P stoichiometric imbalance, resulting from N addition (without P), increases the WUE less than the addition of N + P, due to the strong increase in transpiration at NT, which indicates the importance of a balanced N and P content for WUE.