bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Diverse Range of Biologically Relevant Carbohydrate‐Containing Molecules: Twenty Years of Our Journey**
Authors: Tiwari Vinod K.
Published: May 2021

There is an increasing demand for significant amount of carbohydrate‐containing molecules owing to their complete chemical, biological, and pharmacological investigations to better understand their role in many important biological events. Clinical studies of a wide range of simple carbohydrates or their derivatives, glycohybrids, glycoconjugates, and neoglycoconjugates have been conducted worldwide for the successful treatment of various frontline diseases. Herein, a brief perspective of carbohydrate‐based molecular scaffolding and my experience during the last 20 years in the area of synthetic carbohydrate chemistry, mainly for their impact in drug discovery & development, is presented.
Zoological institutions as hotspots of gastrointestinal parasites that may affect the success of ungulate reintroduction programmes
Authors: Gonzálvez Moisés , Moreno Eulalia , Pérez‐Cutillas Pedro , Gilbert Tania , Ortiz Juana , Valera Francisco , Espeso Gerardo , Benzal Jesús , Ibáñez Belén , de Ybáñez María del Rocío Ruiz
Published: May 2021

Background: Ungulates from zoological institutions are frequently used as founders in reintroduction programmes. These animals are subject to specific parasite management as parasitic infections have previously been associated with failed Bovidae reintroductions.

Methods: Questionnaires to obtain data on how these institutions screen for seasonal parasite presence and the clinical signs they induced in threatened ungulates were sent to 65 institutions involved in European Ex situ Programmes (58.5% response rate). Temperature and relative humidity data were also obtained to categorize each zoological centre.

Results: Strongyloides spp. (52.6%), Trichuris spp. (42.1%), Trichostrongylidae family (39.4%) and Eimeria spp. (36.8%) were the most frequently reported parasites in the received questionnaires. Climatic variables did not influence parasite presence.

Conclusion: Our results suggest that artificial microenvironments created by husbandry practices and enclosure design in zoos could create hotspots for gastrointestinal parasites. To maximise the success of reintroduction projects, we recommend that the influence of microclimates on parasite burdens be evaluated.
Sevoflurane or isoflurane anaesthesia? A prospective, randomised blinded clinical trial in horses undergoing elective surgery
Authors: White Kate L. , Hird John F. R. , Taylor Polly M.
Published: May 2021

Background: Isoflurane is the only volatile anaesthetic agent licensed for equine use in the United Kingdom, but sevoflurane is also commonly used. The two agents have rarely been compared for use in clinical elective surgery.

Methods: This single centre, prospective, randomised, blinded clinical investigation recruited 101 healthy client owned horses undergoing elective surgery. Anaesthesia was standardised and horses randomly assigned to receive isoflurane (I) or sevoflurane (S) for maintenance of anaesthesia in 100% oxygen. Horses were ventilated to normocapnia and received intravenous fluid therapy and haemodynamic support with dobutamine to maintain mean arterial blood pressure above 60 mm Hg. Recovery was timed and video‐recorded to allow offline evaluation by two experienced clinicians unaware of the volatile agent used. No post‐anaesthetic sedation was administered.

Results: There was no significant difference between groups in terms of haemodynamic support required during anaesthesia nor in quality or duration of recovery. Inotropic support to maintain MAP above 60 mm Hg was required by 67 of 101 (67%) of horses. Five horses in the I group required additional ketamine or thiopentone to improve the plane of anaesthesia.

Conclusions: Haemodynamic support needed during anaesthesia as well as the duration and quality of recovery were similar with isoflurane and sevoflurane.
Arginine methylation and cytoplasmic mRNA fate: An exciting new partnership
Authors: Parbin Sabnam , Damodharan Subha , Rajyaguru Purusharth I.
Published: May 2021

Posttranslational modifications play a crucial role in regulating gene expression. Among these modifications, arginine methylation has recently attracted tremendous attention due to its role in multiple cellular functions. This review discusses the recent advances that have established arginine methylation as a major player in determining cytoplasmic messenger RNA (mRNA) fate. We specifically focus on research that implicates arginine methylation in regulating mRNA translation, decay, and RNA granule dynamics. Based on this research, we highlight a few emerging future avenues that will lead to exciting discoveries in this field.
On the magnetic Schrödinger hyperbolic equation with randomized coefficients
Authors: Lu Xiaojun
Published: May 2021

Magnetic Schrödinger type equations are important physical models in the study of quantum electrodynamics (QED). This manuscript focuses on the regularity behavior of the solution of the stochastic hyperbolic equation influenced by various types of exponentially oscillating coefficients on the principal Hamiltonian operator part. Techniques from harmonic analysis and stochastic analysis are applied to explore the upper bound of loss of regularity. Moreover, appropriate counter‐examples with periodic coefficients are constructed to show the lower bound of loss of regularity by the application of instability arguments.
The Government Responds: The Agency for Healthcare Research and Quality
Authors: Leape Lucian L.
Published: May 2021

When the IOM report started the patient safety movement by converting the safety interest of a few into the concern of the many, those who wished to enter this emerging field had little to work with: few measures, few proven safe practices, and few standards. For the patient safety movement to blossom in the ways envisioned by the IOM, a substantial amount of foundational work would be necessary. Only the government could provide the resources that were needed to accomplish this work.
Just Do It: The Surgical Checklist
Authors: Leape Lucian L.
Published: May 2021

For the second Global Patient Safety Challenge, the WHO chose making surgery safer. My involvement was minor. One day, a year or so after the hand hygiene program started, I received a call from Pauline Kelly, my friend from the Reporting Guidelines project. The World Alliance leaders had decided to do a Patient Safety Challenge on a surgical topic. This made good sense, since surgical mishaps were well recognized as a major cause of mortality worldwide. Nearly half of all AEs discovered in the Medical Practice Study were related to a surgical operation. She asked me if I thought Atul Gawande would be willing to lead it.
It’s Not Bad People: Error in Medicine
Authors: Leape Lucian L.
Published: May 2021

“Don’t go there.” Howard Hiatt and Troy Brennan were emphatic: investigating medical error and writing about it would bring the wrath of the medical profession down on my head. But how could we not go there? How could we not go there, now that we knew from the Medical Practice Study (MPS) that 120,000 people were dying from medical errors every year? How could we not act?
Everyone Counts: Building a Culture of Respect
Authors: Leape Lucian L.
Published: May 2021

“The doctor treats me like an idiot.” “He doesn’t like people who ask questions.” “He makes me feel like I’m wasting his time.” (from a patient)
New G2-conifolds in M-theory and their field theory interpretation
Authors: Acharya B. S. , Foscolo L. , Najjar M. , Svanes E. E.
Published: May 2021

Abstract

A recent theorem of Foscolo-Haskins-Nordström [1] which constructs complete G2-holonomy orbifolds from circle bundles over Calabi-Yau cones can be utilised to construct and investigate a large class of generalisations of the M-theory flop transition. We see that in many cases a UV perturbative gauge theory appears to have an infrared dual described by a smooth G2-holonomy background in M-theory. Various physical checks of this proposal are carried out affirmatively.
New positivity bounds from full crossing symmetry
Authors: Tolley Andrew J. , Wang Zi-Yue , Zhou Shuang-Yong
Published: May 2021

Abstract

Positivity bounds are powerful tools to constrain effective field theories. Utilizing the partial wave expansion in the dispersion relation and the full crossing symmetry of the scattering amplitude, we derive several sets of generically nonlinear positivity bounds for a generic scalar effective field theory: we refer to these as the P Q, Dsu, Dstu and $$ {\overline{D}}^{\mathrm{stu}} $$

D
¯

stu

bounds. While the PQ bounds and Dsu bounds only make use of the s↔u dispersion relation, the Dstu and $$ {\overline{D}}^{\mathrm{stu}} $$

D
¯

stu

bounds are obtained by further imposing the s↔t crossing symmetry. In contradistinction to the linear positivity for scalars, these inequalities can be applied to put upper and lower bounds on Wilson coefficients, and are much more constraining as shown in the lowest orders. In particular we are able to exclude theories with soft amplitude behaviour such as weakly broken Galileon theories from admitting a standard UV completion. We also apply these bounds to chiral perturbation theory and we find these bounds are stronger than the previous bounds in constraining its Wilson coefficients.
A note on generalized invertibility and invariants of infinite matrices
Authors: Seidel Markus
Published: May 2021

The classes of band-dominated operators and the subclass of operators in the Wiener algebra $${\mathcal {W}}$$
W
are known to be inverse closed. This paper studies and extends partially known results of that type for one-sided and generalized invertibility. Furthermore, for the operators in the Wiener algebra $${\mathcal {W}}$$
W
invertibility, the Fredholm property and the Fredholm index are known to be independent of the underlying space $$l^p$$

l
p

, $$1\le p\le \infty $$

1
≤
p
≤
∞

. Here this is completed by the observation that even the kernel and a suitable direct complement of the range as well as generalized inverses of operators in $${\mathcal {W}}$$
W
are invariant w.r.t. p.
Extremal Values of the Sackin Tree Balance Index
Authors: Fischer Mareike
Published: May 2021

Tree balance plays an important role in different research areas like theoretical computer science and mathematical phylogenetics. For example, it has long been known that under the Yule model, a pure birth process, imbalanced trees are more likely than balanced ones. Also, concerning ordered search trees, more balanced ones allow for more efficient data structuring than imbalanced ones. Therefore, different methods to measure the balance of trees were introduced. The Sackin index is one of the most frequently used measures for this purpose. In many contexts, statements about the minimal and maximal values of this index have been discussed, but formal proofs have only been provided for some of them, and only in the context of ordered binary (search) trees, not for general rooted trees. Moreover, while the number of trees with maximal Sackin index as well as the number of trees with minimal Sackin index when the number of leaves is a power of 2 are relatively easy to understand, the number of trees with minimal Sackin index for all other numbers of leaves has been completely unknown. In this manuscript, we extend the findings on trees with minimal and maximal Sackin indices from the literature on ordered trees and subsequently use our results to provide formulas to explicitly calculate the numbers of such trees. We also extend previous studies by analyzing the case when the underlying trees need not be binary. Finally, we use our results to contribute both to the phylogenetic as well as the computer scientific literature using the new findings on Sackin minimal and maximal trees to derive formulas to calculate the number of both minimal and maximal phylogenetic trees as well as minimal and maximal ordered trees both in the binary and non-binary settings. All our results have been implemented in the Mathematica package SackinMinimizer, which has been made publicly available.
Does the insurance status influence in-hospital outcome? A retrospective assessment in 30,175 surgical trauma patients in Switzerland
Authors: Funke Lukas , Canal Claudio , Ziegenhain Franziska , Pape Hans-Christoph , Neuhaus Valentin
Published: May 2021

Introduction

There has been growing evidence in trauma literature that differences in insurance status lead to inequality in treatment and outcome. Most studies comparing uninsured to insured patients were done in the USA. We sought to gain further insights into differences in the outcomes of trauma patients in a healthcare system with mandatory public health coverage by comparing publicly versus privately insured patients.

Methods

We used a prospective national quality assessment database from the Arbeitsgemeinschaft für Qualitätssicherung in der Chirurgie (AQC). More than 80 surgical departments in Switzerland are part of this quality program. We included all patients in the AQC database with any S- or T-code diagnosis according to the International Classification of Diseases ICD-10 (any injuries) who were treated during the 11-year period of 2004–2014. Missing insurance status information was an exclusion criterion. In total, 30,175 patients were included for analysis. The primary outcome was in-hospital mortality. Secondary outcomes included overall and intra- and postoperative complications. Bi- and multivariate analyses were performed, adjusted for insurance status, age, sex, American Society of Anesthesiologists (ASA) physical status category, type of injury, and surgeon’s level of experience.

Results

In total, 76.8% (n = 23,196) of the patients were publicly insured. Patients with public insurance were significantly younger (p < 0.001), more often male (p < 0.001), and in better general health according to the ASA physical status category (p < 0.001). Length of pre- and postoperative stay and the number of operations per case were similar in the two groups. Patients with public insurance had a lower mortality rate (1.3% vs. 1.9%, p < 0.001), but after adjusting for confounders, insurance status was not a predictor of mortality. Overall complication rates were significantly higher for publicly insured patients (8.4% vs. 6.2%, p < 0.001), and after adjusting for confounders, insurance status was identified as an independent risk factor for overall complications (p < 0.001).

Conclusion

Differences exist with respect to patient and procedural characteristics: publicly insured patients were younger, more often male, and scored better on ASA physical status. Insurance status seems not to be a predictor for fatal outcome after trauma, although it is associated with complications.
Thermodynamic Implementations of Quantum Processes
Authors: Faist Philippe , Berta Mario , Brandao Fernando G. S. L.
Published: May 2021

Recent understanding of the thermodynamics of small-scale systems have enabled the characterization of the thermodynamic requirements of implementing quantum processes for fixed input states. Here, we extend these results to construct optimal universal implementations of a given process, that is, implementations that are accurate for any possible input state even after many independent and identically distributed (i.i.d.) repetitions of the process. We find that the optimal work cost rate of such an implementation is given by the thermodynamic capacity of the process, which is a single-letter and additive quantity defined as the maximal difference in relative entropy to the thermal state between the input and the output of the channel. Beyond being a thermodynamic analogue of the reverse Shannon theorem for quantum channels, our results introduce a new notion of quantum typicality and present a thermodynamic application of convex-split methods.
Infrahepatic Inferior Vena Cava Clamping does not Increase the Risk of Pulmonary Embolism Following Hepatic Resection
Authors: Birgin Emrullah , Mehrabi Arianeb , Sturm Dorothée , Reißfelder Christoph , Weitz Jürgen , Rahbari Nuh N.
Published: May 2021

Background

Infrahepatic inferior vena cava (IVC) clamping reduces central venous pressure. However, controversies remain regarding its impact on postoperative complications, particularly, the incidence of postoperative pulmonary embolism (PE). The aim of the study was to determine the impact of IVC clamping on the incidence of PE in patients undergoing hepatectomy.

Methods

A pooled analysis of five prospective trials on patients who underwent hepatic resection over a period of 10 years was performed. Patients with infrahepatic IVC clamping were compared to patients without infrahepatic IVC clamping. Outcomes were studied by univariate and multivariate analyses.

Results

Of 505 included patients, 141 patients had IVC clamping and 364 patients served as control group. The rate of postoperative PE was comparable between groups (3% vs. 3%;P = 0.762), as were postoperative morbidity (P = 0.932), bile leakage (P = 0.272), posthepatectomy hemorrhage (P = 0.095), and posthepatectomy liver failure (P = 0.605), respectively. No clinicopathological and intraoperative risk factors were found to predict the onset of PE. Subgroup analyses of patients with major hepatectomy and vascular resections confirmed no adverse perioperative outcomes to be associated with IVC clamping.

Conclusions

Infrahepatic IVC clamping does not increase the incidence of postoperative PE.
Variation in arterial input function in a large multicenter computed tomography perfusion study
Authors: Peerlings Daan , Bennink Edwin , Dankbaar Jan W. , Velthuis Birgitta K. , de Jong Hugo W. A. M. ,   On behalf of the DUtch acute STroke (DUST) study investigators, Majoie C. B. , Roos Y. B. , Duijm L. E. , Keizer K. , van der Lugt A. , Dippel D. W. , Droogh - de Greeve K. E. , Bienfait H. P. , van Walderveen M. A. , Wermer M. J. , Lycklama à Nijeholt G. J. , Boiten J. , Duyndam D. , Kwa V. I. , Meijer F. J. , van Dijk E. J. , Kesselring F. O. , Hofmeijer J. , Vos J. A. , Schonewille W. J. , van Rooij W. J. , de Kort P. L. , Pleiter C. C. , Bakker S. L. , Bot J. , Visser M. C. , Velthuis B. K. , van der Schaaf I. C. , Dankbaar J. W. , Mali W. P. , van Seeters T. , Horsch A. D. , Niesten J. M. , Biessels G. J. , Kappelle L. J. , Luitse M. J. , van der Graaf Y.
Published: May 2021

Objectives

To report the variation in computed tomography perfusion (CTP) arterial input function (AIF) in a multicenter stroke study and to assess the impact this has on CTP results.

Methods

CTP datasets from 14 different centers were included from the DUtch acute STroke (DUST) study. The AIF was taken as a direct measure to characterize contrast bolus injection. Statistical analysis was applied to evaluate differences in amplitude, area under the curve (AUC), bolus arrival time (BAT), and time to peak (TTP). To assess the clinical relevance of differences in AIF, CTP acquisitions were simulated with a realistic anthropomorphic digital phantom. Perfusion parameters were extracted by CTP analysis using commercial software (IntelliSpace Portal (ISP), version 10.1) as well as an in-house method based on block-circulant singular value decomposition (bSVD).

Results

A total of 1422 CTP datasets were included, ranging from 6 to 322 included patients per center. The measured values of the parameters used to characterize the AIF differed significantly with approximate interquartile ranges of 200–750 HU for the amplitude, 2500–10,000 HU·s for the AUC, 0–17 s for the BAT, and 10–26 s for the TTP. Mean infarct volumes of the phantom were significantly different between centers for both methods of perfusion analysis.

Conclusions

Although guidelines for the acquisition protocol are often provided for centers participating in a multicenter study, contrast medium injection protocols still vary. The resulting volumetric differences in infarct core and penumbra may impact clinical decision making in stroke diagnosis.

Key Points

• The contrast medium injection protocol may be different between stroke centers participating in a harmonized multicenter study.

• The contrast medium injection protocol influences the results of X-ray computed tomography perfusion imaging.

• The contrast medium injection protocol can impact stroke diagnosis and patient selection for treatment.
Novel loci and Mapuche genetic ancestry are associated with pubertal growth traits in Chilean boys
Authors: Vicuña Lucas , Norambuena Tomás , Miranda José Patricio , Pereira Ana , Mericq Veronica , Ongaro Linda , Montinaro Francesco , Santos José L. , Eyheramendy Susana
Published: May 2021

Puberty is a complex developmental process that varies considerably among individuals and populations. Genetic factors explain a large proportion of the variability of several pubertal traits. Recent genome-wide association studies (GWAS) have identified hundreds of variants involved in traits that result from body growth, like adult height. However, they do not capture many genetic loci involved in growth changes over distinct growth phases. Further, such GWAS have been mostly performed in Europeans, but it is unknown how these findings relate to other continental populations. In this study, we analyzed the genetic basis of three pubertal traits; namely, peak height velocity (PV), age at PV (APV) and height at APV (HAPV). We analyzed a cohort of 904 admixed Chilean children and adolescents with European and Mapuche Native American ancestries. Height was measured on roughly a $$6-$$

6
-

month basis from childhood to adolescence between 2006 and 2019. We predict that, in average, HAPV is 4.3 cm higher in European than in Mapuche adolescents (P = 0.042), and APV is 0.73 years later in European compared with Mapuche adolescents (P = 0.023). Further, by performing a GWAS on 774, 433 single-nucleotide polymorphisms, we identified a genetic signal harboring 3 linked variants significantly associated with PV in boys (P$$< 5 \times 10^{-8}$$

<
5
×

10

-
8

). This signal has never been associated with growth-related traits.
Cephalometric analyses for cleft patients: a statistical approach to compare the variables of Delaire’s craniofacial analysis to Bergen analysis
Authors: Doberschütz Philine Henriette , Schwahn Christian , Krey Karl-Friedrich
Published: May 2021

Objectives

Cephalometric analyses using lateral craniofacial radiographs are common diagnostic procedures for evaluating skeletal patterns. However, in patients with pronounced abnormalities like cleft lip and palate, standard cephalometric analyses and landmarks may not be suitable. This study aims to clarify whether the inclusion of landmarks less compromised by the cleft defect or located outside the cleft area results in a different cephalometric assessment of the viscerocranium. Delaire’s whole-skull analysis and Bergen analysis were examined for similarities and underlying common observations.

Materials/methods

Based on the cephalometric evaluation of 217 patients with different types of non-syndromal cleft formation, Delaire and Bergen analysis were compared using three statistical methods: correlation analysis, factor analysis, and cluster analysis. Reproducibility was assessed by Bland–Altman plots, intraclass correlation coefficients, mean absolute differences, and coefficients of variability.

Results

Although Delaire analysis and Bergen analysis are based on different concepts and landmarks, a majority of corresponding variables was found. Certain aspects of craniofacial base relation and craniospinal articulation are only assessed by Delaire analysis. All but one variable showed very good reproducibility.

Conclusions

The inclusion of landmarks less compromised by or located outside the cleft area does not result in variables that provide a different assessment of the viscerocranial area.

Clinical Relevance

The findings contradict the concept of invalidity of landmarks compromised by the cleft defect or located within the affected cleft area. Within the scope of its viscerocranial field of view, Bergen analysis appears to be on a par with Delaire analysis in the diagnosis of cleft patients.
Associating Ethos with Objects: Reasoning from Character of Public Figures to Actions in the World
Authors: Budzynska Katarzyna , Koszowy Marcin , Pereira-Fariña Martín
Published: May 2021

Ethotic arguments, such as arguments from expert opinion and ad hominem arguments, play an important role in communication practice. In this paper, we argue that there is another type of reasoning from ethos, in which people argue about actions in the world. These subspecies of ethotic arguments are very common in public debates: societies are involved in heated disputes about what should be done with monuments of historical figures such as Stalin or Colston: Should we demolish the building they funded? Should we revere their statues? Should the street named after them be renamed?; and the general public vividly argue about what should be done with the legacy of producers, directors and actors in debates of the #MeToo movement: Should their new movies be distributed? Should their scenes be deleted from motion pictures? Should their stars from the Hollywood Walk of Fame be removed? Many arguments in these debates boil down to the character of the public figures: He was a slave trader!—But he is a part of our history; He harassed a young girl!—But he is an important actor. The reasoning step here is legitimised by the association between a person and an extra-linguistic object: the association between a historical figure and their statue or between an actor and their movie. The nature of this association is explained in the paper using Peirce’s theory of signs. We propose to extend an existing approach to patterns of reasoning from ethos that will help us to shed new light on ethotic argumentation and open an avenue for a systematic account of these unexplored argument forms.
Pulmonary inflammation following intratracheal instillation of cellulose nanofibrils in rats: comparison with multi-walled carbon nanotubes
Authors: Fujita Katsuhide , Obara Sawae , Maru Junko , Endoh Shigehisa
Published: May 2021

Safety assessment of cellulose nanofibrils (CNFs) is required to accelerate the utilization of these materials in industrial applications. The present study aimed to characterize the effects on rat pulmonary inflammation over a period of 90 days following intratracheal instillation of three types of CNFs or multi-walled carbon nanotubes (MWCNTs) at doses of 0.5, 1.0, or 2.0 mg/kg. The pulmonary inflammatory responses induced by phosphorylated CNFs (CNF1), 2,2,6,6-tetramethylpiperidine-1-oxyl radical (TEMPO)-oxidized CNFs (CNF2), CNFs produced via mechanical defibrillation (CNF3), and MWCNTs were investigated using bronchoalveolar lavage fluid analysis, histopathological findings, and comprehensive gene expression profiling of rat lungs. CNF1 and CNF2 with approximately equal diameter (7.0–8.0 nm) and length (0.8–1.0 µm) distributions induced inflammation after dosing, which was attenuated 90 days post-instillation. CNF3 of relatively greater thickness (21.2 nm) and longer length (1.7 μm) deposited around the terminal bronchioles were observed after instillation. Acute inflammatory responses in the alveoli induced by CNF3 were mild compared with those induced by other materials and attenuated 90 days post-instillation. MWCNTs induced severe pulmonary inflammatory responses that continued during the test period. The inflammation failed to resolve within 90 days post-instillation. A hierarchical cluster analysis revealed comparable gene expression profiles for CNF1, CNF2, and CNF3, whereas profiles of MWCNTs were different from those of other test substances. This study suggests that pulmonary inflammation is associated with the diameter and length distributions of CNFs and that the pulmonary inflammation caused by CNFs is mild compared with that caused by MWCNTs.

Graphic abstract
The conundrums of formal and informal meritocracy: dealing with gender segregation in the academy
Authors: Powell Stina , Arora-Jonsson Seema
Published: May 2021

Despite the academy’s commitment to the idea of meritocratic and fair principles in recruitments, promotions, student admissions and progress, gender segregation and gender inequalities continue to trouble universities worldwide. Through case-studies of two education programs at a Swedish university, we investigate how processes of formal merit, both formal (required for admission such as high grades) and what we identify as informal merit (needing to act in particular ways once admitted) work to obviate or reproduce gender-segregation. We analyze how everyday gendering processes in the classroom play a central role in what gets constructed as merit. Changing notions of merit during the period of study can hamper possibilities for ending gender segregation in HE or open up for ways to circumvent it. We show that a complex and ongoing construction of informal merit can restrain students from minority groups (in relation to gender, but also ethnic background, socioeconomic position, or sexuality) to enter, and importantly, remain in the program. At the same time, new ways of addressing the subject itself provides potential openings. We argue that in order to achieve gender balance at universities, it is urgent to understand how informal and formal merit interplay once students have joined the university and importantly also when they have made the leap and broken with gender segregated education choices.
Human actions were responsible for both initiation and termination of varve preservation in Lake Vesijärvi, southern Finland
Authors: Salminen Sarianna , Tammelin Mira , Jilbert Tom , Fukumoto Yu , Saarni Saija
Published: May 2021

The influence of lake restoration efforts on lake bottom-water conditions and varve preservation is not well known. We studied varved sediments deposited during the last 80 years along a water-depth transect in the Enonsaari Deep, a deep-water area of the southernmost Enonselkä Basin, Lake Vesijärvi, southern Finland. For the last few decades, the Enonselkä Basin has been subject to ongoing restoration efforts. Varve, elemental, and diatom analyses were undertaken to explore how these actions and other human activities affected varve preservation in the Enonsaari Deep. In contrast to most varved Finnish lakes, whose water columns have a natural tendency to stratify, and possess varve records that span thousands of years, varve formation and preservation in Lake Vesijärvi was triggered by relatively recent anthropogenic stressors. The multi-core varve analysis revealed that sediment in the Enonsaari Deep was initially non-varved, but became fully varved in the late 1930s, a time of increasing anthropogenic influence on the lake. The largest spatial extent of varves occurred in the 1970s, which was followed by a period of less distinguishable varves, which coincided with diversion of sewage from the lake. Varve preservation weakened during subsequent decades and was terminated completely by lake aeration in the 2010s. Despite improvements in water quality, hypolimnetic oxygen depletion and varve preservation persisted beyond the reduction in sewage loading, initial aeration, and biomanipulation. These restoration efforts, however, along with other human actions such as harbor construction and dredging, did influence varve characteristics. Varves were also influenced by diatom responses to anthropogenic forcing, because diatoms form a substantial part of the varve structure. Of all the restoration efforts, a second episode of aeration seems to have had the single most dramatic impact on profundal conditions in the basin, resulting in replacement of a sediment accumulation zone by a transport or erosional zone in the Enonsaari Deep. We conclude that human activities in a lake and its catchment can alter lake hypolimnetic conditions, leading to shifts in lake bottom dynamics and changes in varve preservation.
Consensus among preference rankings: a new weighted correlation coefficient for linear and weak orderings
Authors: Plaia Antonella , Buscemi Simona , Sciandra Mariangela
Published: May 2021

Preference data are a particular type of ranking data where some subjects (voters, judges,...) express their preferences over a set of alternatives (items). In most real life cases, some items receive the same preference by a judge, thus giving rise to a ranking with ties. An important issue involving rankings concerns the aggregation of the preferences into a “consensus”. The purpose of this paper is to investigate the consensus between rankings with ties, taking into account the importance of swapping elements belonging to the top (or to the bottom) of the ordering (position weights). By combining the structure of$$\tau _x$$τxproposed by Emond and Mason (J Multi-Criteria Decis Anal 11(1):17–28, 2002) with the class of weighted Kemeny-Snell distances, a position weighted rank correlation coefficient is proposed for comparing rankings with ties. The one-to-one correspondence between the weighted distance and the rank correlation coefficient is proved, analytically speaking, using both equal and decreasing weights.
Challenges and opportunities in improving left ventricular remodelling and clinical outcome following surgical and trans-catheter aortic valve replacement
Authors: Jin Xu Yu , Petrou Mario , Hu Jiang Ting , Nicol Ed D. , Pepper John R.
Published: May 2021

Over the last half century, surgical aortic valve replacement (SAVR) has evolved to offer a durable and efficient valve haemodynamically, with low procedural complications that allows favourable remodelling of left ventricular (LV) structure and function. The latter has become more challenging among elderly patients, particularly following trans-catheter aortic valve implantation (TAVI). Precise understanding of myocardial adaptation to pressure and volume overloading and its responses to valve surgery requires comprehensive assessments from aortic valve energy loss, valvular-vascular impedance to myocardial activation, force-velocity relationship, and myocardial strain. LV hypertrophy and myocardial fibrosis remains as the structural and morphological focus in this endeavour. Early intervention in asymptomatic aortic stenosis or regurgitation along with individualised management of hypertension and atrial fibrillation is likely to improve patient outcome. Physiological pacing via the His-Purkinje system for conduction abnormalities, further reduction in para-valvular aortic regurgitation along with therapy of angiotensin receptor blockade will improve patient outcome by facilitating hypertrophy regression, LV coordinate contraction, and global vascular function. TAVI leaflet thromboses require anticoagulation while impaired access to coronary ostia risks future TAVI-in-TAVI or coronary interventions. Until comparable long-term durability and the resolution of TAVI related complications become available, SAVR remains the first choice for lower risk younger patients.
Restoring chemo-sensitivity to temozolomide via targeted inhibition of poly (ADP-ribose) polymerase-1 by naringin in glioblastoma
Authors: Rao Vanishree , Cheruku Sri Pragnya , Manandhar Suman , Vibhavari R. J. A. , Nandakumar Krishnadas , Rao C. Mallikarjuna , Ravichandiran V. , Kumar Nitesh
Published: May 2021

Inclining mortality with a constant plummet in the survival rates associated with glioblastoma still stands as an inveterate predicament. The only promising therapy with temozolomide (TMZ) is now side-lined due to escalated resistance mediated by Poly (ADP-ribose) Polymerase-1 (PARP-1). In the light of this, the very study was designed to evaluate the potential of an active phyto component named naringin, in inhibiting PARP-1, using in silico and in vitro methods. Under in silico settings, inhibitor bound crystal structure of PARP-1, i.e., 4UND was retrieved and molecular docking studies were performed against naringin using Schrodinger software. In vitro cytotoxicity and apoptotic detection assay were performed using C6 glioma cells. Docking studies revealed high affinity and low binding energy at the inhibition site with good stability. An increase in cytotoxicity to C6 cells was observed with TMZ and naringin combination when compared to TMZ alone. Isobologram plot confirmed the synergistic effect of the drug combination. A significant increase in the number of apoptotic cells with combination drugs, as evaluated by acridine orange and ethidium bromide staining reassured the reversal of resistance. In conclusion, chemosensitivity to TMZ was restored by successful inhibition of PARP-1 using naringin and the drug combination was hence proven effective in reversing TMZ resistance.
The application of an environmental performance framework for climate adaptation innovations on two nature-based adaptations
Authors: van Loon-Steensma Jantsje M. , Goldsworthy Christopher
Published: May 2021

In this paper, we introduce and test a framework to qualitatively assess the environmental impact of climate adaptation innovations with the ambition to facilitate the implementation of these adaptations. The framework was designed to enable continuous environmentally conscious benchmarking based on three environmental performance indicators: sustainable design, environmental impact and ecological impact. It was pilot tested by uninvolved experts and key-persons for two large-scale nature-based flood adaptation innovations in the Netherlands and discussed with environmental assessment professionals. Our findings indicate how the inclusion of our framework helps to identify important knowledge gaps regarding environmental co-benefits and trade-offs, and can be beneficial to both those developing the innovation and the local authorities charged with assessing the suitability of innovations. We conclude by noting how the incorporation of environmental impact assessment from the design stage of adaptations could supplement existing environmental assessment regulations pre-empting concerns rather than reacting to them.
Efficacy and efficiency of fracture liaison services to reduce the risk of recurrent osteoporotic fractures
Authors: Javaid M. K.
Published: May 2021

Background

Acting to prevent the next fracture after a sentinel fracture is support by the evidence base and brings benefits for patients, clinicians and healthcare systems. However, more patients after a fragility fracture remain untreated and vulnerable to future potentially life-changing fractures. Fracture liaison services (FLS) are models of care that can close this care gap.

Methods

A narrative review of the key evidence for the efficacy and effectiveness of FLS was performed

Results

There are few randomised control trials of FLSs and none with fracture as the primary outcome. Several observational studies have also demonstrated reductions in fracture, but most were limited by potential bias. Several studies have highlighted that not every FLS is automatically effective.

Conclusion

Further research should focus on implementing effective FLS using published standards and only then exploring impacts on patient outcomes such as refracture rates.
Allergen Immunotherapy in Pediatric Respiratory Allergy
Authors: Doroudchi Ali , Imam Kamran , Garcia Lloret Maria Ines
Published: May 2021

Purpose of Review

Atopic diseases such as asthma and allergic rhinitis are highly prevalent in children. Common triggers include tree and grass pollens, house dust mites, molds, and animal dander. These diseases are most often treated symptomatically; however, many patients show partial or poor response and require long-term medication use. Allergen immunotherapy (AIT) stands as the only treatment modality that can alter the underlying disease process and potentially offer a cure. In this review article, we discuss the merits of AIT with particular emphasis on its efficacy and safety in pediatric patients. We also discuss the challenges for AIT implementation and present an overview of current research that aims at improving its applicability for the treatment of allergic diseases.

Recent Findings

Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are both safe and efficacious treatment options in children with allergic rhinitis and allergic asthma. Additionally, AIT has efficacy in preventing the development of asthma in children. Although there are clear advantages with AIT, there are challenges to overcome to optimize treatment. Solutions include improved diagnostics with pre-treatment biomarkers and molecular multiplex assays, biomarkers for prediction of response (e.g., basophil activation markers), improved allergen immunogenicity with the use of recombinant AIT, adjuvants, and allergoids, and lastly improved safety with the concurrent use of omalizumab.

AIT has shown safety and efficacy in major clinical trials for the treatment of allergic rhinitis and allergic asthma in children. AIT provides a curative treatment option for atopic disorders and should be considered in children with allergic rhinitis and allergic asthma. There are many continued advances being made in the field of allergy to further improve the safety and efficacy profile and shorten the duration of AIT treatment.
Prognostic parameter differences in breast cancer patients between luminal A and luminal B types after application of the new classification according to Ki67 score
Authors: Mohammed Ayad Ahmad
Published: May 2021

ABSTRACT

Background:

The conventional histological classification of breast cancer doesn't provide sufficient information about the biological characteristics and treatment prediction for breast cancer subtypes. Luminal breast cancer has been classified recently according to the expression of ki67 which has a great impact of the biological activity of the tumor.

Patients and methods:

A total of 300 patients with breast cancer who underwent modified radical mastectomy were investigated. Patients were divided into 2 groups: Luminal A (101 patients) and B (199 patients) according to the new classification based on hormone receptor and Ki67 expressions and the prognostic parameters were investigated.

Results:

The mean age was 48.81 years with a mean BMI of 30.7, the age showed no significant correlation (P value 0.996), but it was significant with BMI (P value 0.045). Lobular breast cancer was commoner in luminal type-A (13.9%) comparing to type-B patients (5%) with a significant correlation with the histopathological type (P value 0.006). Most patients presented with clinical stage IIB, IIA, and IIIA respectively. The tumor size, axillary LN status, clinical stage, and recurrence or metastasis showed no statistical significance (P values 0.9, 0.078, 0.584, and 0.943) respectively, 66.3% of luminal type-A patients had intermediate grade and no tumor necrosis (72.5%), while 55.3% of luminal type-B patients had high grade and tumor necrosis (61.8%), the correlation was significant for tumor grade and necrosis (P values 0.000) for each parameter. Luminal type-B had higher breast cancer fatality rate compared to type-A (11.2% vs. 2%) with a significant correlation with survival status and duration of survival (P values 0.003 & 0.025) respectively.

Conclusion:

Luminal type-A cancer is less common than type-B but has better survival and duration of survival than type-B. Ki67 biomarker affects tumor aggressiveness and invasiveness. More genetic analysis is required to detect the molecular diversity of both types.

Highlights
Hunger, Appetite and the Politics of the Renaissance Stage
Authors: Williamson Matt
Published: May 2021

Hunger and appetite permeate Renaissance theatre, with servants, soldiers, courtiers and misers all defined with striking regularity through their relation to food. Demonstrating the profound ongoing relevance of Marxist literary theory, Hunger, Appetite and the Politics of the Renaissance Stage highlights the decisive role of these drives in the complex politics of early modern drama. Plenty and excess were thematically inseparable from scarcity and want for contemporary audiences, such that hunger and appetite together acquired a unique significance as both subject and medium of political debate. Focusing critical attention on the relationship between cultural texts and the material base of society, Matthew Williamson reveals the close connections between how these drives were represented and the underlying socioeconomic changes of the period. At the same time, he shows how hunger and appetite provided the theatres with a means of conceptualising these changes and interrogating the forces that motivated them.
Biomedical Measurement Systems and Data Science
Authors: Insana Michael
Published: May 2021

Discover the fundamental principles of biomedical measurement design and performance evaluation with this hands-on guide. Whether you develop measurement instruments or use them in novel ways, this practical text will prepare you to be an effective generator and consumer of biomedical data. Designed for both classroom instruction and self-study, it explains how information is encoded into recorded data and can be extracted and displayed in an accessible manner. Describes and integrates experimental design, performance assessment, classification, and system modelling. Combines mathematical concepts with computational models, providing the tools needed to answer advanced biomedical questions. Includes MATLAB® scripts throughout to help readers model all types of biomedical systems, and contains numerous homework problems, with a solutions manual available online. This is an essential text for advanced undergraduate and graduate students in bioengineering, electrical and computer engineering, computer science, medical physics, and anyone preparing for a career in biomedical sciences and engineering.
Using a Logic Model to Enable and Evaluate Long-Term Outcomes of a Mass Casualty Training Program: A Single Center Case Study
Authors: Dadario Nicholas B , Bellido Simon , Restivo Andrew , Kulkarni Miriam , Singh Maninder , Yoon Andrew , Shapiro Jared , Quintero Frank , Tagami Tianna , Yang Christina J , Jafri Farrukh N
Published: May 2021

Purpose:

Global health disasters are on the rise and can occur at any time with little advance warning, necessitating preparation. The authors created a comprehensive evidence-based Emergency Preparedness Training Program focused on long-term retention and sustained learner engagement.

Method:

A prospective observational study was conducted of a simulation-based mass casualty event training program designed using an outcomes-based logic model. A total of 25 frontline healthcare workers from multiple hospital sites in the New York metropolitan area participated in an 8-hour immersive workshop. Data was collected from assessments, and surveys provided to participants 3 weeks prior to the workshop, immediately following the workshop, and 3 months after completion of the workshop.

Results:

The mean percentage of total knowledge scores improved across pre-workshop, post-workshop and retention (3 months post-workshop) assessments (53.2% vs. 64.8% vs. 67.6%, P < 0.05). Average comfort scores in the core MCI competencies increased across pre-workshop, post-workshop and retention self-assessments (P < 0.01). Of the participants assessed at 3 months retention (n = 14, 56%), 50.0% (n = 7) assisted in updating their hospital’s emergency operations plan and 50.0% (n = 7) pursued further self-directed learning in disaster preparedness medicine.

Conclusions:

The use of the logic model provided a transparent framework for the design, implementation, and evaluation of a competency-based EPT program at a single academic center.