bluuebunny/crossref_metadata_2025 huggingface dataset:
Umgang mit COVID-19-Ausbruchssituation auf einer nicht invasiven Beatmungsstation
Authors: Schellenberg Mavi , Müller Michael M.
Published: October 2021

Patienten mit COPD haben ein erhöhtes Risiko für schwerwiegende Verläufe einer COVID-19-Erkrankung. Der Ausbruch von COVID-19 auf einer Station für nicht invasive Beatmung (NIV) zeigte darüber hinaus eine hohe Mortalität (32 %) unter COPD-Patienten mit NIV sowie Hinweise für eine verstärkte Infektionsübertragung durch die eingesetzten Therapiegeräte.

Maßnahmen zur Prophylaxe und Eindämmung von COVID-19-Infektionen im stationären Setting werden hier aufgeführt.
Herausforderung gastrointestinale Stromatumoren
Authors: Kolligs Frank T. , Reichardt Peter
Published: October 2021

Gastrointestinale Stromatumoren sind die häufigsten mesenchymalen Neoplasien des Verdauungstraktes. In lokalisierten Stadien erfolgt eine chirurgische Resektion, je nach Größe und Risikokonstellation begleitet durch eine adjuvante oder neoadjuvante Therapie. Für das metastasierte Stadium stehen heute mehrere Therapielinien zur Verfügung. Die Mutationsanalyse aus dem Tumormaterial ist für die Therapieplanung von zentraler Bedeutung.
A Flexible Approach to the Synthesis of Type II and III Lepadin Alkaloids
Authors: Chen Xiaochuan , Hu Yue , Gu He , Jia Yuanliang , Luo Guiyin
Published: October 2021

A flexible approach to both type II and III lepadin alkaloids is developed for the first time. A key Diels–Alder reaction based on a novel chiral ketolactone dienophile is employed to obtain the desirable all-cis-trisubstituted cyclohexene with excellent regio- and stereoselectivity. As the subsequent closure of the piperidine ring is devised at the N1 and C2 position via an intramolecular nucleophilic amination, the two stereochemical types of lepadin frameworks with the opposite configuration at C2 can be conveniently accessible from a common intermediate. By the approach, lepadins D, E (type II) and F (type III) are stereo­selectively synthesized from ethyl l-lactate.
Mild Biamidine-Transfer Conditions for the Synthesis of Aliphatic Biguanides
Authors: Bardovskyi Rostyslav , Fabre Marie , Ronco Cyril , Benhida Rachid
Published: October 2021

This study focuses on the development of new synthetic pathways to monosubstituted biguanides from amines. An exhaustive comparison of the conditions and reagents used for biamidine transfer was performed. New reagents were synthesized and optimized conditions for the synthesis of substituted biguanides under mild conditions were developed. Eventually, two high-yielding and straightforward protocols for the transfer of a biamidine group to various amines are proposed and their scope and limitations have been explored. These conditions include: i) a direct chromatography-free procedure and ii) an eco-friendly procedure in water compatible with bioinspired molecules. They are particularly efficient for the demanding conversion of aliphatic amines.
Base-Mediated Site-Selective Hydroamination of Alkenes
Authors: Li Ping , Lee Boon Chong , Koh Ming Joo , Zhang Xiaoxiang
Published: October 2021

We present a base-mediated hydroamination protocol, using substoichiometric amounts of a hydrosilane and potassium tert-butoxide­, that operates under mild conditions at 30 °C. Many aryl- and heteroatom-substituted olefins as well as arylamines are tolerated, affording the desired products with complete regioselectivity. Preliminary mechanistic investigations reveal a non-radical pathway for hydroamination. A sequential remote hydroamination strategy involving an initial Fe-catalysed olefin isomerisation followed by our base-mediated hydroamination was also developed to directly access β-arylamines from terminal aliphatic alkenes.
The Role of Perinatal Palliative Care in Fetal Neurology
Authors: Rent Sharla , Lemmon Monica E. , Ellestad Sarah , Bidegain Margarita
Published: October 2021

Objectives Many serious or life-threatening neurologic conditions are first diagnosed during the fetal period, often following a routine ultrasound or sonographic evaluation after an abnormal aneuploidy screen. Such conditions represent a worrisome or unexpected finding for expectant parents, making the perinatal period a critical time point to engage and empower families encountering complex neurologic clinical scenarios. This review covers the role of perinatal palliative care in these settings.

Study Design This study is a topical review

Results The prenatal identification of structural abnormalities of the brain or spinal cord, radiographic signs of hemorrhage or ischemic injury, or evidence of genetic or metabolic conditions should prompt involvement of a fetal palliative care team. The inherent prognostic uncertainty is challenging for prenatally diagnosed neurologic conditions which have difficult to predict short and long-term outcomes. While many of these conditions lead to the birth of an infant with neurodevelopmental challenges, few result in in utero demise. Palliative care beginning in the perinatal period provides an additional layer of support for families navigating complex decision-making during their pregnancy and provides continuity of care into the newborn period. Palliative care principles can help guide discussions around genetic and other diagnostic testing, fetal surgery, and birth planning. A multidisciplinary team can help support families with decision-making and through bereavement care in the setting of fetal or neonatal death.

Conclusion Early palliative care team involvement can provide a more holistic approach to counseling, facilitate planning, and ensure that a family's goals and wishes are acknowledged throughout an infant's care trajectory.

Key Points
Fatores de risco relacionados a má evolução no tratamento da infecção periprótese não convencional
Authors: Viola Dan Carai Maia , Rodrigues Neto Henrique Ribeiro , Garcia Jairo Greco , Petrilli Marcelo de Toledo , Carlesse Fabianne Altruda de Moraes Costa , Jesus-Garcia Filho Reynaldo
Published: October 2021

Objetivos O objetivo do estudo é identificar os principais fatores de risco relacionados a má evolução do tratamento da infecção periprótese.

Métodos Foram avaliados de forma retrospectiva os prontuários de 109 pacientes submetidos a cirurgias de endoprótese não convencional (primárias e revisões), no período de 01 de janeiro de 2007 a 31 de dezembro de 2018. Destes, 15 pacientes diagnosticadas com infecção periprótese foram elegíveis para a participação no estudo. As variáveis sexo, idade do diagnóstico, osso acometido, duração da cirurgia, contagem de leucócitos no pré-operatório, infecção do trato urinário no 1° ano pós-operatório e tempo decorrido entre a colocação da endoprótese e o diagnóstico da infecção foram relacionadas aos desfechos utilizando o Teste Exato de Fisher (variáveis bicategóricas) e o Teste Anova (variáveis tricategóricas). A média de tempo entre diagnóstico e desfecho foram comparadas pelo método de t-student.

Resultados Os fatores de risco avaliados não demostraram correlação estatisticamente significante com os desfechos. Os dados demonstram haver tendência de diferença entre a média de tempo do aparecimento do processo infeccioso e o desfecho final do paciente. Devido a amostra limitada, acreditamos que estudos com coortes maiores possam comprovar essa tendência.

Conclusão Identificamos que o tempo entre a cirurgia de colocação da endoprótese e o aparecimento dos sintomas de infecção tende a ter relação com o desfecho e a evolução do paciente no tratamento da infecção periprótese. Os demais fatores associados, apesar de aparentemente relacionados, também não se mostraram estatisticamente relacionados a má evolução no tratamento.
Cirurgia de Bankart artroscópica: Resultados clínicos com seguimento mínimo de 10 anos
Authors: Godinho Pedro Couto , Godinho André Couto , Rondon João Victor de Campos Gomes , Oliveira Neto Francisco Cabral de , Alves Thiago de Abreu , Godinho Glaydson Gomes
Published: October 2021

Objetivo Avaliar o desfecho funcional dos pacientes submetidos ao reparo de Bankart artroscópico no longo prazo.

Métodos Avaliação retrospectiva de 41 pacientes (45 ombros) operados entre 1996 e 2009 acompanhados por um período médio de 14,89 anos. Foram feitas análises das pontuações funcionais de University of California, Los Angeles (UCLA) e Carter-Rowe, exame físico e análises de prontuários.

Resultados O escore Carter-Rowe apresentou melhora média de 46,11 pontos, com média final de 85,89 pontos, e o UCLA apresentou melhora de 31,33 pontos. Um total de 10 pacientes (22,22%) apresentou recidiva, sendo o número de luxações pré-operatórias o fator mais correlacionado.

Conclusão Foi demonstrado que o número de luxações pré-operatórias influenciou negativamente na taxa de falha.
Mão traumatizada – Atualização no primeiro atendimento
Authors: Silva Flaviana Busignani da , Giostri Giana Silveira
Published: October 2021

A mão é o segmento mais exposto ao trauma, com grande volume de atendimento em serviços de urgência e emergência. Portanto, faz-se necessário que os médicos plantonistas tenham conhecimento primordial para a conduta eficaz frente a essas lesões. Neste artigo, revisaremos as principais afecções e orientações de condutas.
Exploration of implementation practices of Montessori education in mainland China
Authors: Chen Amber
Published: October 2021

This descriptive research work highlights the implementation practices of Montessori education in mainland China and the concerns over Montessori education’s localization in mainland China. Localization can be understood as the adaptive process Montessori education undergoes in order to fit within Chinese culture. Two hundred and ten in-service Montessori teachers and administrators in China were surveyed to discover information concerning implementation practices in the following areas: mixed-aged classrooms, whether classrooms were co-teaching, student-to-teacher ratios, and morning and afternoon work cycles. The study found that the majority of classrooms were mixed-aged, reflecting high-fidelity Montessori practices. However, it also found that classrooms are co-teaching, have lower student–teacher ratios, and shortened work cycles, reflecting a departure from high-fidelity Montessori implementation. While localization should be considered to safeguard Montessori education’s sustainability, Chinese Montessori educators should also reflect on these findings as high implementation fidelity has been linked to better student outcomes.
Droplet impacts on granular monolayers transition from horizontal spreading to corona splashing
Authors: Liebendorfer Adam
Published: October 2021

Systematic experiments demonstrate dynamics that differ from smooth surfaces and are driven by a layer of particles resisting spreading drops.
Design could improve cryogenic memory performance
Authors: Lim Alane
Published: October 2021

Nickel-ruthenium-nickel antiferromagnetic system exhibits significantly slower current decay than current technologies.
Probing the size-dependent polarizability of mesoscopic ionic clusters and their induced-dipole interactions
Authors: Nguyen Trung Dac , Jiménez-Ángeles Felipe , Olvera de la Cruz Monica
Published: October 2021

Mesoscopic clusters composed of oppositely charged particles are ubiquitous in synthetic and biological soft materials. The effective interaction between these clusters is influenced by their polarizability, that is, the ability of their constituent charges to re-arrange in response to an external electrical field. Here, using coarse-grained simulations, we show that the polarizability of electrically neutral ionic clusters decreases as the number of constituent charges increases and/or their Coulombic interaction strength increases for various ion valencies, ion densities, and degrees of cluster boundary hardness. For clusters of random ionomers and their counterions, their polarizability is shown to depend on the number of polymer chains. The variation of the cluster polarizability with the cluster size indicates that throughout the assembly, the induced-dipole interactions between the clusters may be reduced substantially as they acquire more charges while maintaining zero net charge. Under certain conditions, the induced-dipole interactions may become repulsive, as inferred from our simulations with a polarizable solvent. As a result, the dipole-induced related interactions can serve as a counterbalancing force that contributes to the self-limiting aggregation of charge-containing assemblies.
Performance comparison of a 9-kW magnetically shielded Hall thruster operating on xenon and krypton
Authors: Su L. L. , Jorns B. A.
Published: October 2021

The performance of a 9-kW class magnetically shielded Hall thruster operating on xenon and krypton propellants is experimentally characterized. Thrust and efficiency measurements performed at discharge powers ranging from 4.5 to 9 kW indicate that the anode efficiency of krypton is 9%–18% lower than that of xenon. This difference is comparable to previous measurements reported for unshielded Hall thrusters, although it is found that unlike in previous studies, the efficiency ratio widens with increasing discharge voltage. Far-field probes are employed to measure the contributions to anode efficiency at conditions of 4.5 and 6  kW. These results indicate that mass utilization has the largest impact on the difference in performance between xenon and krypton. Assuming this mass utilization remains the dominant driver at higher voltages, it is proposed that the higher electron temperature of shielded thrusters along channel centerline coupled with the nonlinearity of the ionization cross section may explain why the efficiency gap widens with increasing voltage for shielded thrusters. The results are discussed in the context of optimizing magnetically shielded Hall thrusters for improved performance on krypton propellant.
Supercurrent transmission through Ni/Ru/Ni synthetic antiferromagnets
Authors: Mishra Swapna Sindhu , Loloee Reza , Birge Norman O.
Published: October 2021

Josephson junctions containing ferromagnetic materials are generating interest for use in superconducting electronics and cryogenic memory. Optimizing the performance of such junctions is an ongoing effort, requiring exploration of a broad range of magnetic systems. Here, we study supercurrent transmission through Ni/Ru/Ni synthetic antiferromagnets with the idea that their magnetic properties may be superior to those of isolated Ni layers. We find that the decay of the supercurrent as a function of Ni thickness is very slow with a decay length of 7.5 ± 0.8 nm. We also characterize the magnetic properties of the synthetic antiferromagnets as a function of Ni and Ru thicknesses.
Roughness-induced critical phenomenon analogy for turbulent friction factor explained by a co-spectral budget model
Authors: Li Shuolin , Katul Gabriel
Published: October 2021

Drawing on an analogy to critical phenomena, it was shown that the Nikuradse turbulent friction factor (ft) measurements in pipes of radius R and wall roughness r can be collapsed onto a one-dimensional curve expressed as a conveyance law ftRe1/4=go(χ), where Re is the bulk Reynolds number and χ=Re3/4(r/R). The implicit function go(.) was conjectured based on matching two asymptotic limits of ft. However, the connection between go(.) and the phenomenon it proclaims to represent—turbulent eddies—remains lacking. Using models for the wall-normal velocity spectrum and return-to-isotropy for pressure–strain effects to close a co-spectral density budget, a derivation of go(.) is offered. The proposed method explicitly derives the solution for the conveyance law and provides a physical interpretation of χ as a dimensionless length scale reflecting the competition between the viscous sublayer thickness and characteristic height of roughness elements. Applications of the proposed method to other published measurements spanning roughness and Reynolds numbers beyond the original Nikuradse range are further discussed.
Recent trends in pirfenidone and nintedanib use for idiopathic pulmonary fibrosis in Australia
Authors: Cox Ingrid A. , de Graaff Barbara , Corte Tamera J. , Glaspole Ian , Chambers Daniel C. , Moodley Yuben , Teoh Alan , Walters E. Haydn , Palmer Andrew J.
Published: October 2021

Objectives Idiopathic pulmonary fibrosis (IPF) is one of the most common forms of interstitial lung disease presenting in people aged ≥50 years. There is currently no cure for IPF, but two medications (pirfenidone and nintedanib) have been shown to slow the functional decline of the lungs. In 2017, these two medications were listed on the Pharmaceutical Benefits Scheme (PBS) for subsidisation in Australia. This study evaluated local trends in the use of these two medications. Methods Prescription data for this analysis were obtained from the PBS Item Reports for the period May 2017–May 2020. Population data were extracted from the Australian Bureau of Statistics data cubes. A descriptive approach was used to conduct and report the analysis to illustrate trends in the use of these two medications and associated costs. Results There were 44 010 prescriptions processed for the treatment for IPF in the 3-year period. Nintedanib use was higher than pirfenidone use, accounting for 54% of prescriptions. New South Wales accounted for 35% of the total prescriptions but, when standardised against population size, the Australian Capital Territory accounted for the highest proportion of prescriptions (24%). Prescriptions for nintedanib and pirfenidone were associated with a total cost of A$131 377 951 over the period 2017–20. Conclusion This study provides initial information on prescription rates, practices and expenditure for pirfenidone and nintedanib. In addition, we provide some insight into possible pharmacological and epidemiological trends based on jurisdictional differences. Together, the results from this study provide a platform for future research given the dearth of information on IPF in Australia. What is known about the topic? Data regarding trends in the utilisation of antifibrotics for the treatment of IPF in Australia are currently limited. What does this paper add? This study demonstrated that nintedanib use was slightly higher than pirfenidone use, and that there were variations in jurisdictional prescribing practices. The highest number of prescriptions and costs were attributable to New South Wales but, when standardised against population size, the Australian Capital Territory had the highest number of prescriptions and costs. What are the implications for practitioners? This study provides some insights into the use of pirfenidone and nintedanib, as well as pharmacoepidemiological trends, in Australia, which is useful for economic evaluation and modelling future health expenditure.
Phosphorylation and Pin1 binding to the LIC1 subunit selectively regulate mitotic dynein functions
Authors: Kumari Amrita , Kumar Chandan , Pergu Rajaiah , Kumar Megha , Mahale Sagar P. , Wasnik Neeraj , Mylavarapu Sivaram V.S.
Published: October 2021

The dynein motor performs multiple functions in mitosis by engaging with a wide cargo spectrum. One way to regulate dynein’s cargo-binding selectivity is through the C-terminal domain (CTD) of its light intermediate chain 1 subunit (LIC1), which binds directly with cargo adaptors. Here we show that mitotic phosphorylation of LIC1-CTD at its three cdk1 sites is required for proper mitotic progression, for dynein loading onto prometaphase kinetochores, and for spindle assembly checkpoint inactivation in human cells. Mitotic LIC1-CTD phosphorylation also engages the prolyl isomerase Pin1 predominantly to Hook2-dynein-Nde1-Lis1 complexes, but not to dynein-spindly-dynactin complexes. LIC1-CTD dephosphorylation abrogates dynein-Pin1 binding, promotes prophase centrosome–nuclear envelope detachment, and impairs metaphase chromosome congression and mitotic Golgi fragmentation, without affecting interphase membrane transport. Phosphomutation of a conserved LIC1-CTD SP site in zebrafish leads to early developmental defects. Our work reveals that LIC1-CTD phosphorylation differentially regulates distinct mitotic dynein pools and suggests the evolutionary conservation of this phosphoregulation.
A novel method for diagnosing bearing transfer faults based on a maximum mean discrepancies guided domain-adversarial mechanism
Authors: Jia Meixia , Wang Jinrui , Zhang Zongzhen , Han Baokun , Shi Zhaoting , Guo Lei , Zhao Weitao
Published: October 2021

Transfer learning has been successfully applied in fault diagnosis to solve the difficulty in constructing network models due to the lack of labeled data in practical engineering. The current transfer learning models mainly use the adaptive method to obtain the similarity between source and target domains, but the obtained similarity is incomplete. Inspired by the domain-adversarial mechanism, a novel method called ‘distance guided domain-adversarial network’ (DGDAN) is proposed in this study. DGDAN includes two modules: domain-adversarial network and maximum mean discrepancies (MMD) guided domain adaptation. In this method, a stacked autoencoder (SAE) is used as the feature extractor of the domain-adversarial network to learn domain invariant features, and MMD is used to measure the non-parametric distance of different metric spaces to improve domain alignment. Reduction of the distance of the bottleneck layer of the feature extractor is employed to improve the feature extraction capability of the network. Experimental results show that the classification accuracy rate of DGDAN is more than 98%, and DGDAN has superior robustness and generalization ability.
Application of a whale optimized variational mode decomposition method based on envelope sample entropy in the fault diagnosis of rotating machinery
Authors: Lu N , Zhou T X , Wei J F , Yuan W L , Li R Q , Li M L
Published: October 2021

In recent years, the variational mode decomposition (VMD) method has been introduced for rotating machinery fault diagnosis. However, the results largely depend on its parameters. When an optimization algorithm is employed to optimize these parameters, the fitness function is critical. In this paper, a new fitness function, envelope sample entropy, is constructed. Based on this, a whale optimized VMD method is proposed for rotating machinery fault diagnosis. First, the vibration signals were decomposed by the optimized VMD method to obtain a series of intrinsic mode functions (IMFs), from which the IMFs containing the main information were selected. Then, features were extracted from the selected IMFs and their dimensions were reduced using the local tangent space alignment method. Finally, support vector machine was adopted for fault identification. Compared with related methods, the experiment results show that the proposed method obtains a higher fault recognition accuracy.
Lithography-free synthesis of periodic, vertically-aligned, multi-walled carbon nanotube arrays
Authors: Chen Ruiting , Xue Yafei , Xu Xinyue , Yang Hui , Qiu Tengfei , Shui Lingling , Wang Xin , Zhou Guofu , Giersig Michael , Pidot Sacha , Hutchison James A , Akinoglu Eser Metin
Published: October 2021

Until now, the growth of periodic vertically aligned multi-walled carbon nanotube (VA-MWCNT) arrays was dependent on at least one lithography step during fabrication. Here, we demonstrate a lithography-free fabrication method to grow hexagonal arrays of self-standing VA-MWCNTs with tunable pitch and MWCNT size. The MWCNTs are synthesized by plasma enhanced chemical vapor deposition (PECVD) from Ni catalyst particles. Template guided dewetting of a thin Ni film on a hexagonally close-packed silica particle monolayer provides periodically distributed Ni catalyst particles as seeds for the growth of the periodic MWCNT arrays. The diameter of the silica particles directly controls the pitch of the periodic VA-MWCNT arrays from 600 nm to as small as 160 nm. The diameter and length of the individual MWCNTs can also be readily adjusted and are a function of the Ni particle size and PECVD time. This unique method of lithography-free growth of periodic VA-MWCNT arrays can be utilized for the fabrication of large-scale biomimetic materials.
Laser nanoprinting of floating three-dimensional plasmonic color in pH-responsive hydrogel
Authors: Li Wanyi , Zeng Xianzhi , Dong Yajing , Feng Ziwei , Wen Hongjing , Chen Qin , Wen Long , Song Shichao , Li Xiangping , Cao Yaoyu
Published: October 2021

Recent demonstrations of metasurfaces present their great potential to implement flat and multifunctional optical elements, which are accomplished with the designs of planar optics and micro-/nano- fabrications. Integrating metasurfaces in three dimensions has manifested drastically increasing advantages in manipulating light fields by extending design freedom. However, fabricating three-dimensional metasurfaces remain a tough challenge due to the lack of stereo printing protocols. Herein, we demonstrate laser nanoprinting of floated silver nanoparticle array in transparent hydrogel films for 3D metasurface to achieve color patterning. It is found that spatially resolved nanoparticles can be produced through laser induced photoreduction of silver ions and robustly anchored to the gel backbones by a focused femtosecond laser beam within a pH-responsive smart hydrogel matrix. With the aid of expansion properties of the pH-responsive hydrogel, repetitive coloration of the patterned plasmonic nanoparticle array over a wide spectrum range is achieved via reversible regulation of nanoparticle spacing from 550 to 350 nm and vice versa. This approach allows broadband 3D color-regulation in nanoscale for applications in active spectral filtering, information encryption, security tagging and biological colorimetric sensing, etc.
Polarization-enhanced cell walls etching of anodic titanium oxide
Authors: Sapoletova Nina A , Kushnir Sergey E , Napolskii Kirill S
Published: October 2021

Anodic titanium oxide (ATO) photonic crystals (PhCs) are promising for photonics, photocatalysis, and solar cells. A refractive index modulation in ATO PhCs is caused by the modulation of porosity and, thus, the pore diameter should be controlled precisely. The ATO cell walls etching in electrolyte solution during anodizing increases the porosity of the PhC structure and shifts the photonic band gap (PBG) position to shorter wavelengths. Until now, the ATO cell walls etching in organic based electrolytes has been associated solely with the chemical dissolution of ATO in fluoride-containing solutions. Here, a significant enhancement of cell walls etching is observed when electric current flows under anodic polarization. This effect leads to the blue shift of the PBG position with the number of periods of ATO PhC structure. Therefore, it is essential for the synthesis of ATO PhCs with a precise PBG position.
Adaptive proton therapy
Authors: Paganetti Harald , Botas Pablo , Sharp Gregory C , Winey Brian
Published: October 2021

Radiation therapy treatments are typically planned based on a single image set, assuming that the patient’s anatomy and its position relative to the delivery system remains constant during the course of treatment. Similarly, the prescription dose assumes constant biological dose-response over the treatment course. However, variations can and do occur on multiple time scales. For treatment sites with significant intra-fractional motion, geometric changes happen over seconds or minutes, while biological considerations change over days or weeks. At an intermediate timescale, geometric changes occur between daily treatment fractions. Adaptive radiation therapy is applied to consider changes in patient anatomy during the course of fractionated treatment delivery. While traditionally adaptation has been done off-line with replanning based on new CT images, online treatment adaptation based on on-board imaging has gained momentum in recent years due to advanced imaging techniques combined with treatment delivery systems. Adaptation is particularly important in proton therapy where small changes in patient anatomy can lead to significant dose perturbations due to the dose conformality and finite range of proton beams. This review summarizes the current state-of-the-art of on-line adaptive proton therapy and identifies areas requiring further research.
Rice yield stability compared to major food crops in West Africa
Authors: Duvallet Mathilde , Dumas Patrice , Makowski David , Boé Julien , del Villar Patricio Mendez , Ben-Ari Tamara
Published: October 2021

West Africa is one of the regions the most concerned with structural food and nutrition security. Consequently, agricultural development pathways and scenarios are under high scientific and political scrutiny in this region. Rice, as a rapidly growing staple plays a key role in the West African diet representing close to 40% of the total volume of cereal consumed in the region. In the context of the 2008 food price crisis several West African countries have since proclaimed rice self-sufficiency as a target. Here, we show that rice yields tend to be, on average over the entire region, less stable (by a range of 15%–30%) than that of alternative crops, possibly substitutable in diets. The regions where yields of alternative crops are more stable than those of rice correspond to the main climatic regions where these crops are grown: sorghum, millet in the Sahelian and Sudanian regions and tubers in the Guinean region. Rice yields are significantly less stable for 33% of the comparisons considered and are significantly more stable than any alternative crop for 15% of the comparisons in few areas without clear longitudinal patterns. Models accounting for climate variability explain up to 17% of the variance of the data and reveal that yield variability differences between rice and alternative crops tends to widen in the areas where the monsoon precipitation is more variable between-years. The highest levels of variability of rice yields compared to alternative crops are recorded in regions where the monsoon varies strongly between years. Our analysis advocates for an explicit account of yield stability in West African rice expansion scenarios and supply strategies.
Effect of plasma treatment on the seed germination and seedling growth of radish (Raphanus sativus)
Authors: GURAGAIN Rajesh Prakash , BANIYA Hom Bahadur , DHUNGANA Santosh , CHHETRI Ganesh Kuwar , SEDHAI Binita , BASNET Niroj , SHAKYA Aavash , PANDEY Bishnu Prasad , PRADHAN Suman Prakash , JOSHI Ujjwal Man , SUBEDI Deepak Prasad
Published: October 2021

The effect on the germination and seedling growth of radish (Raphanus sativus) seeds were examined employing a dielectric barrier discharge (DBD) at atmospheric pressure and room temperature for various treatment time. DBD plasma using argon gas of flow rate 2 l m−1 was employed in this study. Radish seeds were treated with DBD plasma for 1–5 min, respectively. Germination characteristics, seedling growth parameters, the contact angle of the seed coat, water uptake capacity, mass loss, the temperature of the seeds, chlorophyll, and carotenoid contents of the seedlings were measured before and after the DBD plasma treatments. Plasma treatment of radish seeds significantly increased germination-related characters, including germination percentage, fresh and dry weight, vigor index, and total carotenoids contents. However, the cumulative production rate was found to be decreased. Results from the experiment indicate an acceleration in the water uptake of the radish seeds and make the seed surface hydrophilic by plasma treatment. Scanning electron microscopy analysis showed that etching effects on the seed coat occurred after the argon plasma treatments, which affected the wettability of the radish seed. The experimental findings showed that seeds being treated by DBD plasma for 2 and 3 min had a positive effect on the germination and seedling growth of radish.
Optimization of follow-up in patients with papillary thyroid cancer who show no evidence of disease 9–12 months after treatment
Authors: Nordell Fabian , Hallal Ghadir , Asp Pernilla , Almquist Martin
Published: October 2021

Background

Papillary thyroid cancer (PTC) has an excellent prognosis, and recurrence is rare in patients with no evidence of disease (NED) after initial treatment. Despite this, several guidelines recommend long and costly follow-up, with limited evidence of improved patient outcomes. This study aims to examine the value of follow-up in patients with NED after treatment for PTC, by determining the rate of recurrence, recurrence-associated morbidity, and death, and whether any recurrence was diagnosed through the follow-up programme.

Methods

Patients operated for PTC at Lund University Hospital between January 2004 and December 2016 were eligible. Patients with T1a N0/NX were excluded as well as patients with any other thyroid malignancy. Data were collected retrospectively by searching the patients’ medical records. NED was defined as thyroglobulin less than 1 ng/ml, thyroglobulin antibodies less than 20 kIU/l, and negative imaging. Biochemical recurrence was defined as thyroglobulin greater than 1 ng/ml, and/or thyroglobulin antibodies greater than 20 kIU/l. Structural recurrence was defined as a strong suspicion of recurrence on imaging and/or histological proof of recurrence.

Results

Out of a cohort of 187 patients, there were 90 patients with NED who were followed for a median of 6.3 years. Three patients had biochemical recurrence; none of them had symptoms, nor were they treated for their recurrence. Three had structural recurrence; all were above 75 years old and only one was diagnosed through the follow-up programme. No patient died of PTC; five patients died during the follow-up.

Conclusion

Follow-up as it is designed today cannot identify recurrences accurately and seems to be of questionable benefit in younger patients with NED after treatment for PTC.
A Randomized Trial of Point-of-Care Early Infant Human Immunodeficiency Virus (HIV) Diagnosis in Zambia
Authors: Chibwesha Carla J , Mollan Katie R , Ford Catherine E , Shibemba Aaron , Saha Pooja T , Lusaka Mildred , Mbewe Felistas , Allmon Andrew G , Lungu Rose , Spiegel Hans M L , Mweni Emmanuel , Mwape Humphrey , Kankasa Chipepo , Chi Benjamin H , Stringer Jeffrey S A
Published: October 2021

Background

Point-of-care (POC) early infant diagnosis (EID) provides same-day results and the potential for immediate initiation of antiretroviral therapy (ART).

Methods

We conducted a pragmatic trial at 6 public clinics in Zambia. HIV-exposed infants were individually randomized to either (1) POC EID (onsite testing with the Alere q HIV-1/2 Detect) or (2) enhanced standard of care (SOC) EID (off-site testing at a public laboratory). Infants with HIV were referred for ART and followed for 12 months. Our primary outcome was defined as alive, in care, and virally suppressed at 12 months.

Results

Between March 2016 and November 2018, we randomized 4000 HIV-exposed infants to POC (n=1989) or SOC (n=2011). All but 2 infants in the POC group received same-day results, while the median time to result in the SOC group was 27 (interquartile range: 22–30) days. Eighty-one (2%; 95% confidence interval [CI]: 1.6–2.5%) infants were diagnosed with HIV. Although ART initiation was high, there were 15 (19%) deaths, 15 (19%) follow-up losses, and 31 (38%) virologic failures. By 12 months, only 20 of 81 (25%; 95% CI: 15–34%) infants with HIV were alive, in care, and virally suppressed: 13 (30%; 16–43%) infants in the POC group vs 7 (19%; 6–32%) in the SOC group (RR: 1.56; .7–3.50).

Conclusions

POC EID eliminated diagnostic delays and accelerated ART initiation but did not translate into definitive improvement in 12-month outcomes. In settings where centralized EID is well functioning, POC EID is unlikely to improve pediatric HIV outcomes.

Clinical Trials Registration

This trial is registered at https://clinicaltrials.gov (NCT02682810).
Disease Progression in Patients With Nontuberculous Mycobacterial Lung Disease of Nodular Bronchiectatic (NB) Pattern: The Roles of Cavitary NB and Soluble Programmed Death Protein-1
Authors: Pan Sheng Wei , Su Wei Juin , Chan Yu Jiun , Ho Mei Lin , Feng Jia Yih , Shu Chin Chung , Wang Jann Yuan , Wang Hao Chien , Yu Chong Jen , Chen Yuh Min
Published: October 2021

Background

In patients with nodular bronchiectatic (NB) nontuberculous mycobacterial lung disease (NTM-LD), risk factors for disease progression have not been clearly investigated. The roles of cavitary NB and soluble programmed death protein-1 (sPD-1), an immune-related biomarker, in the disease course of NB NTM-LD remain unknown.

Methods

Patients with NB NTM-LD were enrolled from 2 medical centers in 2014–2020. We identified cavitary NB, measured sPD-1 levels, and analyzed factors associated with cavitary NB and predictors for disease progression of NB NTM-LD.

Results

Of 120 cases of NB NTM-LD, 87 (72.5%) were caused by Mycobacterium avium complex. sPD-1 levels were lower in 13 (10.8%) patients with cavitary NB than in noncavitary patients (P = .020). Over 1.41 ± 1.43 years of follow-up, 12 (92.3%) patients in the cavitary and 66 (61.7%) in the noncavitary group developed disease progression (P = .032). In multivariable analysis, body mass index (BMI [kg/m2]; adjusted hazard ratio [aHR], .895 [95% confidence interval, .811–.988]), sputum smear grade (aHR, 1.247 [1.014–1.534]), cavitary NB (aHR, 2.008 [1.052–3.834]), and sPD-1 (per 10-pg/mL increase; aHR, .889 [.816–.967]) were predictive for disease progression. Notably, sPD-1 showed a dose-dependent association with disease progression (sPD-1 ≤23.5 pg/mL; aHR, 3.306 [1.664–6.567]; sPD-1: 23.6–53.7 pg/mL; aHR, 2.496 [1.390–4.483]) compared with the reference (sPD-1 >53.7 pg/mL).

Conclusions

Patients with NB NTM-LD and low sPD-1, low BMI, high smear grade, and cavitary NB were at high risk for disease progression. sPD-1 was low in patients with cavitary NB phenotype and dose-responsively associated with disease progression.
Wars of Choice: Leaders, Rebellion Legacy, and Domestic Unrest
Authors: Su Ruolin
Published: October 2021

Existing studies suggest that leaders that have earlier been participants in rebellions have a higher propensity for international conflict than leaders with no such experience. This paper examines whether prior involvement in rebellions will induce leaders to initiate international conflicts during domestic strife. I propose a preference modification approach and argue that rebel leaders’ policy choices during domestic unrest are a product of their pre-existing preferences and contextual factors. Specifically, I claim that the greater preference for conflict abroad during domestic unrest that former rebel leaders display than do their fellow leaders is contingent on the severity level of domestic problems. When facing serious internal unrest, rebel leaders are less likely than their non-rebel counterparts to engage in international conflicts due to the effect that critical domestic strife will have on the former’s perceptions and thus their policy preferences. Intense domestic strife predisposes rebel leaders to engage in both international conflict and domestic measures, which to some extent neutralises their original policy preference of international conflict as the sole policy response. By contrast, non-rebel leaders perceive more efficacy in international conflict during severe domestic unrest and are more likely to initiate an international dispute in that case. Statistical analyses of the international militarised dispute initiations of leaders under domestic strife from 1875 to 2000 reveal strong support for these arguments.
Interpretable, not black-box, artificial intelligence should be used for embryo selection
Authors: Afnan Michael Anis Mihdi , Liu Yanhe , Conitzer Vincent , Rudin Cynthia , Mishra Abhishek , Savulescu Julian , Afnan Masoud
Published: October 2021

Artificial intelligence (AI) techniques are starting to be used in IVF, in particular for selecting which embryos to transfer to the woman. AI has the potential to process complex data sets, to be better at identifying subtle but important patterns, and to be more objective than humans when evaluating embryos. However, a current review of the literature shows much work is still needed before AI can be ethically implemented for this purpose. No randomized controlled trials (RCTs) have been published, and the efficacy studies which exist demonstrate that algorithms can broadly differentiate well between ‘good-’ and ‘poor-’ quality embryos but not necessarily between embryos of similar quality, which is the actual clinical need. Almost universally, the AI models were opaque (‘black-box’) in that at least some part of the process was uninterpretable. This gives rise to a number of epistemic and ethical concerns, including problems with trust, the possibility of using algorithms that generalize poorly to different populations, adverse economic implications for IVF clinics, potential misrepresentation of patient values, broader societal implications, a responsibility gap in the case of poor selection choices and introduction of a more paternalistic decision-making process. Use of interpretable models, which are constrained so that a human can easily understand and explain them, could overcome these concerns. The contribution of AI to IVF is potentially significant, but we recommend that AI models used in this field should be interpretable, and rigorously evaluated with RCTs before implementation. We also recommend long-term follow-up of children born after AI for embryo selection, regulatory oversight for implementation, and public availability of data and code to enable research teams to independently reproduce and validate existing models.
Was this career shaped by people or by chance?
Authors: Field John G
Published: October 2021

This paper discusses the people and events that influenced my career and the lessons I learnt along the way. In this essay I attempt to pass these lessons on to others. Born and growing up in Cape Town, from my earliest recollections at the age of four I have wanted to be associated with fish and the sea. My first mentor was the Professor of Zoology at the University of Cape Town, who gave me the opportunity to go to sea on the University research ship, and later to join the International Indian Ocean Expedition where I met others who influenced me. Then a postdoctoral fellowship in Nova Scotia led me to meet Ken Mann, a SCOR working group, and a series of wonderful colleagues and friends. The contribution of each of these to my development is discussed, along with the lessons learned. The friends I have made on my journey in marine science and my academic family of former students have enriched my life enormously and if I had my life again, I would have it no other way.
Organizational capacity for patient and family engagement in hospital planning and improvement: interviews with patient/family advisors, managers and clinicians
Authors: Anderson Natalie N , Baker G Ross , Moody Lesley , Scane Kerseri , Urquhart Robin , Wodchis Walter P , Gagliardi Anna R
Published: October 2021

Background

Patient and family engagement (PE) in healthcare planning and improvement achieves beneficial outcomes and is widely advocated, but a lack of resources is a critical barrier. Little prior research studied how organizations support engagement specifically in hospitals.

Objective

We explored what constitutes hospital capacity for engagement.

Methods

We conducted descriptive qualitative interviews and complied with criteria for rigour and reporting in qualitative research. We interviewed patient/family advisors, engagement managers, clinicians and executives at hospitals with high engagement activity, asking them to describe essential resources or processes. We used content analysis and constant comparison to identify themes and corresponding quotes and interpreted findings by mapping themes to two existing frameworks of PE capacity not specific to hospitals.

Results

We interviewed 40 patient/family advisors, patient engagement managers, clinicians and corporate executives from nine hospitals (two < 100 beds, four 100 + beds, three teaching). Four over-arching themes about capacity considered essential included resources, training, organizational commitment and staff support. Views were similar across participant and hospital groups. Resources included funding and people dedicated to PE and technology to enable communication and collaboration. Training encompassed initial orientation and project-specific training for patient/family advisors and orientation for new staff and training for existing staff on how to engage with patient/family advisors. Organizational commitment included endorsement from the CEO and Board, commitment from staff and continuous evaluation and improvement. Staff support included words and actions that conveyed value for the role and input of patient/family advisors. The blended, non-hospital-specific framework captured all themes. Hospitals of all types varied in the availability of funding dedicated to PE. In particular, reimbursement of expenses and compensation for time and contributions were not provided to patient/family advisors. In addition to skilled engagement managers, the role of clinician or staff champions was viewed as essential.

Conclusion

The findings build on prior research that largely focused on PE in individual clinical care or research or in primary care planning and improvement. The findings closely aligned with existing frameworks of organizational capacity for PE not specific to hospital settings, which suggests that hospitals could use the blended framework to plan, evaluate and improve their PE programs. Further research is needed to yield greater insight into how to promote and enable compensation for patient/family advisors and the role of clinician or staff champions in supporting PE.
Anti-Nuclear Antibody Quantitation: Calibration and Harmonization Adjustment via Population Interrogation
Authors: Wener Mark H , Fink Susan L , Morishima Chihiro , Chaudhary Anu , Hutchinson Kathleen
Published: October 2021

Background

The 2019 classification criteria for systemic lupus erythematosus (SLE) includes an initial criterion requiring the presence of an antinuclear antibody (ANA), positive at a titer of at least 1:80 on HEp-2 cells, or equivalent. However, results of ANA tests performed on HEp-2 cells vary when tested in different laboratories. Calibration of ANA assays by achieving a common specificity in healthy control populations offers the possibility of achieving harmonization via population interrogation, but the expected specificity in a healthy control population is not known.

Methods

The studies used to determine the use of ANAs performed by immunofluorescence microscopy on HEp-2 cells as the entry criterion for classification of SLE were reanalyzed by a meta-analysis to determine the expected frequency of positive ANAs in healthy control populations at serum dilutions of 1:40 and 1:80.

Results

Our meta-analysis demonstrated that the expected specificity in a healthy control population of ANA performed using serum diluted 1:80 is 91.3% (CI 86.1–94.7%). The expected specificity of ANA performed at 1:40 serum dilution is 79.2% (CI 72.3–84.8%).

Conclusion

One approach to achieving harmonization of ANA assays from different laboratories with each other and with expected performance would involve adjusting assays so that about 10% of a healthy control population has a positive ANA when tested at 1:80 dilution, and about 20% of the healthy control population has a positive ANA when tested at 1:40 dilution. This pragmatic approach to calibration and harmonization adjustment via population interrogation offers an opportunity for individual laboratories to be aligned with each other and with ANA performance expected for consistent categorization of patients with SLE.