bluuebunny/crossref_metadata_2025 huggingface dataset:
Participation in a Heart Failure Clinical Trial
Authors: Ezekowitz Justin , Mentz Robert J. , Westerhout Cynthia M. , Sweitzer Nancy K. , Givertz Michael M. , Piña Ileana L. , O’Connor Christopher M. , Greene Stephen J. , McMullan Ciaran , Roessig Lothar , Hernandez Adrian F. , Armstrong Paul W.
Published: August 2021

Background:

Randomized controlled trials (RCTs) often target enrollment of patients with demographics and outcomes less representative of the broader population of interest. To provide context for the VICTORIA trial (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction), we designed a registry of hospitalized patients with worsening heart failure to characterize their clinical profile, outcomes, and reasons for their nonparticipation in a RCT.

Methods:

Fifty-one RCT sites in Canada and the United States participated. Eligible patients included those with chronic heart failure, hospitalized for heart failure, and an ejection fraction <45%; no other exclusions were applied. Sites identified patients between 2017 and 2019 during the RCT enrollment period. RCT eligibility criteria were applied, and non–mutually exclusive reasons for nonenrollment were captured. Mortality at 1 year was estimated via the Meta-Analysis Global Group in Chronic Heart Failure risk score or as observed in the RCT.

Results:

Overall, 2056 patients were enrolled in the registry; 61% (n=1256) were ineligible for the RCT, 37% (n=766) were eligible but not enrolled, and 2% (n=34) were also enrolled in the RCT. Registry participants had a median age of 70, 33% were women, and 63% were White. The median risk score predicted a 20.9% 1-year mortality, higher than in the RCT (predicted 14.7% and observed 11.5%). Major reasons for ineligibility in the RCT included the use of nitrates (23%), systolic blood pressure <100 mm Hg (12%), and substance use (11%) with other exclusion criteria <10%. For eligible patients, reasons for nonparticipation in the RCT included lack of interest in participating (28%), poor compliance (25%), inability to complete follow-up (23%), too sick (20%), unable to provide consent (17%), and distance from site (15%).

Conclusions:

Patients with worsening heart failure in routine clinical practice exhibit high-risk features, and approximately one-third were eligible for an RCT but excluded. The majority of these nonparticipating patients had modifiable reasons.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02861534.
Endothelial-Mesenchymal Transition in Heart Failure With a Preserved Ejection Fraction
Authors: Valero-Muñoz María , Oh Albin , Faudoa Elizabeth , Bretón-Romero Rosa , El Adili Fatima , Bujor Andreea , Sam Flora
Published: August 2021

Background:

The management of clinical heart failure with a preserved ejection fraction (HFpEF) is often complicated by concurrent renal dysfunction, known as the cardiorenal syndrome. This, combined with the notable lack of evidence-based therapies for HFpEF, highlights the importance of examining mechanisms and targetable pathways in HFpEF with the cardiorenal syndrome.

Methods:

HFpEF was induced in mice by uninephrectomy, infusion of
d
-aldosterone (HFpEF; N=10) or saline (Sham; N=8), and given 1% NaCl drinking water for 4 weeks. Renal fibrosis and endothelial-mesenchymal transition (endo-MT) were evident once HFpEF developed. Human aortic endothelial cells were treated for 4 days with 10% serum obtained from patients with chronically stable HFpEF with the cardiorenal syndrome (N=12) and compared with serum-treated human aortic endothelial cells from control subjects (no cardiac/renal disease; N=12) to recapitulate the in vivo findings.

Results:

Kidneys from HFpEF mice demonstrated hypertrophy, interstitial fibrosis (1.9-fold increase;
P
<0.05) with increased expression of endo-MT transcripts, including pdgfrβ (platelet-derived growth factor receptor β), snail, fibronectin, fsp1 (fibroblast-specific protein 1), and vimentin by 1.7- (
P
=0.004), 1.7- (
P
=0.05), 1.8- (
P
=0.005), 2.6- (
P
=0.001), and 2.0-fold (
P
=0.001) versus Sham. Immunostaining demonstrated co-localization of CD31 and ACTA2 (actin α2) in kidney sections suggesting evidence of endo-MT. Similar to the findings in HFpEF mice, comparable endo-MT markers were also significantly elevated in human aortic endothelial cells treated with serum from patients with HFpEF compared with human aortic endothelial cells treated with serum from control subjects.

Conclusions:

These translational findings demonstrate a plausible role for endo-MT in HFpEF with cardiorenal syndrome and may have therapeutic implications in drug development for patients with HFpEF and concomitant renal dysfunction.
Association Between Excess Leisure Sedentary Time and Risk of Stroke in Young Individuals
Authors: Joundi Raed A. , Patten Scott B. , Williams Jeanne V.A. , Smith Eric E.
Published: August 2021

Background and Purpose:

The association between physical activity (PA) and lower risk of stroke is well established, but the relationship between leisure sedentary time and stroke is less well studied.

Methods:

We used 9 years of the Canadian Community Health Survey between 2000 and 2012 to create a cohort of healthy individuals without prior stroke, heart disease, or cancer. We linked to hospital records to determine subsequent hospitalization or emergency department visit for stroke until December 31, 2017. We quantified the association between self-reported leisure sedentary time (categorized as <4, 4 to <6, 6 to <8, and 8+ hours/day) and risk of stroke using Cox regression models and competing risk regression, assessing for modification by PA, age, and sex and adjusting for demographic, vascular, and social factors.

Results:

There were 143 180 people in our cohort and 2965 stroke events in follow-up. Median time from survey response to stroke was 5.6 years. There was a 3-way interaction between leisure sedentary time, PA, and age. The risk of stroke with 8+ hours of sedentary time was significantly elevated only among individuals <60 years of age who were in the lowest PA quartile (fully adjusted hazard ratio, 4.50 [95% CI, 1.64–12.3]). The association was significant across multiple sensitivity analyses, including adjustment for mood disorders and when accounting for the competing risk of death.

Conclusions:

Excess leisure sedentary time of 8+ hours/day is associated with increased risk of long-term stroke among individuals <60 years of age with low PA. These findings support efforts to enhance PA and reduce sedentary time in younger individuals.
Durand of St.-Pourçain on Reflex Acts and State Consciousness
Authors: Hartman Peter John
Published: August 2021

Some of my mental states are conscious and some of them are not. Sometimes I am so focused on the wine in front of me that I am unaware that I am thinking about it. But sometimes, of course, I take a reflexive step back and become aware of my thinking about the wine in front of me. What marks the difference between a conscious mental state and an unconscious one? In this article, the author focuses on Durand of St.-Pourçain’s rejection of the higher-order theory of state consciousness, according to which a mental act is conscious when there is another, suitably related, mental (reflex) act that exists at the same time with it. Durand rejects such higher-order theories on the grounds that they violate the thesis that a given mental power can have or elicit only one mental act at a given time. The author first goes over some of Durand’s general arguments for this thesis. He then turns to Durand’s application of the thesis to the issue of state consciousness and reflex acts. He closes by considering the objection that Durand’s same-order theory of state consciousness makes consciousness ubiquitous.
Black Men’s Experience of Police Harassment: A Descriptive Phenomenological Study
Authors: Townsell Ania , Vogel Eric B. , McLean Alvin
Published: August 2021

The Black community has a long, well-documented history of being disproportionately harassed by law enforcement. While psychological research has studied this phenomenon, more in-depth research on Black men’s lived-experience of police harassment is needed. This qualitative study used descriptive phenomenology to investigate Black men’s experience of being harassed by law enforcement officers. An analysis of non-structured interviews with a sample of four participants revealed several essential aspects of this experience, including: anxiety in response to the initial awareness of law enforcement’s presence, fear and confusion in response to abrupt escalation of aggression and hostility by officers, a sense of humiliation in response to degrading police tactics, anger over inability to pursue redress through the justice system, ongoing negative emotion, and a sense of having been psychologically harmed by the harassment. The implications of the findings are discussed.
A Bittersweet Memoir
Authors: Lim Anita Y. N.
Published: August 2021

I wrote this journal in March 2020 prior to the World Health Organization declaring the COVID-19 infection as a worldwide pandemic on March 11. The situation in Singapore was unfolding even as public healthcare institutions were tasked to lead the charge to contain the novel coronavirus as it was then called. This journal describes my experiences and impressions during my work in an isolation ward at the National University Hospital during this early period.

I was to be catapulted into Pandemic Team 3 in the second and third weeks of February 2020. The urgency of hospital measures to respond to the novel coronavirus meant that the general medicine consultant roster which I was on was hijacked to support the pandemic wards. I thought wryly to myself that it was a stroke of genius to commandeer the ready-made roster of senior physicians; it would have been difficult for the roster monster to solicit senior physicians to volunteer when there were still so many unknowns about this virus.

Graphic images of the dire situation in Wuhan, China, were circulating widely on social media. It was heart-wrenching to read of Dr. Li Wen Liang’s death. He had highlighted the mysterious pneumonia-causing virus. The video clip of him singing at a karaoke session that went viral underscored the tragedy of a young life cut short.

Questions raced in my mind. “Are we helpless to prevent the spread of this virus?” “Is the situation in China to be replicated here in Singapore?” This seemed incredulous, yet, might it be possible? The immediate responses that jumped up within me was “yes, it’s possible, but let’s pray not. Whatever has to be done, must be done.”
Experiments in Dealing with Epidemics in Seventeenth-Century Siam
Authors: Alberts Tara
Published: August 2021

This article uses a study of two epidemic outbreaks of smallpox in late seventeenth-century Siam to interrogate the developing “social meaning” of the disease in Thai society at the time. Through this case study the article examines the problems of translation and the limitations of our source bases for understanding premodern approaches to epidemic management. It suggests ways of reading across various sources to reconstruct how intercultural learning, exchange, and experiment among communities who suffered epidemic disease contributed to global constructions of concepts of disease.
Then and Now: A Structural Approach Analysis of Japan’s Cultural Diplomacy towards Thailand
Authors: Kittipaisalsilpa Preechaya
Published: August 2021

Despite the growing significance of Japan’s cultural diplomacy within the landscape of international relations, the study of effective ties with Thailand has not received much attention to date. This article employs a structural approach in analysing ‘when’ and ‘how’ Japan’s cultural diplomacy has evolved vis-à-vis Thailand. The article emphasises the importance of structural factors as being relational, further complicated by different levels and degrees of influence throughout three periods: the economic-oriented period (1950s-1960s), the diplomatic adjustment period (1970s-1980s), and the social relations building period (1990s-present). The analysis reveals two layers of Japan’s foreign policy instruments—economic diplomacy and cultural diplomacy — in the structuralist narrative of Japanese diplomacy towards Thailand. While economic power has been an important instrument, this article highlights how changes in the structure of international systems have had corresponding impacts on Japan’s application of cultural diplomacy that has subsequently shaped the bilateral Japan-Thailand relationship.
A Lauterpachtian Affair: Security Exceptions as ‘Self-Judging Obligations’ in the Case Law of the International Court of Justice and Beyond
Authors: Milanov Momchil
Published: August 2021

Although Sir Hersch Lauterpacht never dealt with security exceptions during his time at the International Court of Justice (ICJ), his entire body of work formed the intellectual premise for the approach of the Court towards security exceptions and the way in which the ICJ manoeuvers in the larger debate on the relationship between law, politics and the proper discharge of the judicial function. The Lauterpachtian approach is understood as a particular attitude towards the judicial function in which the Court serves as an instrument for the protection of peace, as a guardian of the coherence and unity of the international legal system and as a driving force for the development of international law. However, in some other important elements of its reasoning, the Court seems to remain more Lauterpachtian in spirit than in letter. Despite these inconsistencies, the Court arguably exerted significant (albeit somehow uneven) influence over World Trade Organization panels and investment tribunals.
Kuril Ainu Zoonyms and Phytonyms in Pallas’s Zoographia and Flora Rossica
Authors: Alonso de la Fuente José Andrés
Published: August 2021

Close inspection of the Kuril Ainu vocabularies included in two of P.S. Pallas’s less-known publications reveal the existence of expressions which are apparently documented nowhere else. By attempting to identify their provenance, at least one new source comes into light, the general impression being, as one would rather expect, that there must be a multitude of them hidden in the travelogues and personal diaries of Russian explorers from the 18th century.
Rubi Capenses: a further contribution to the knowledge of the genus Rubus (Rosaceae) in South Africa
Authors: VAN DE BEEK ABRAHAM
Published: August 2021

This article is aimed to provide a solid base for future research in Rubus in South Africa. Even if a different classification using a broader species concept will be adopted later, this contribution should be valuable for identifying the units and naming them for convenience of all later analyses. Types of earlier published names were checked and compared with present occurrence of Rubus in the region. When needed, types where designated. Some taxa where provided with a new name or status. New taxa were described if they are taxonomically well distinguished and have a solid geographical distribution. This paper contains the following nomenclatural novelties: New taxa: Rubus ser. Apetali, R. ser. Pinnati, R. ser. Rigidi, R. ser. Scleri, R. anas, R. ×bergianus, R. cryptopetalus, R. fertilis, R. ×fultiformis, R. ×fultus, R. leptodytus, R. noli-tangere, and R. trichogynus. New status and names: R. cacoeimon and R. leptostelechus. Replacement names: R. glabrior, and R. thaumasius. New status: Rubus subsect. Afroidaei and R. subsect. Pinnatifidi. New types are designated for the following taxa: R. ser. Piletocaulon, R. ser. Tephrocaulon, R. sect. Afromontani, R. borbonicus, R. borbonicus f. pyramidalis, R. exsuccus, R. heterophyllus, R. inedulis, R. madagascarius, R. originalis, R. pappei, R. pinnatus, R. pinnatus f. glaber, R. quartinianus, and R. rigidus f. umbrosus.
A new species of Oreosaurus (Squamata: Gymnophthalmidae) from the Turimiquire Massif, northeastern Venezuela
Authors: RIVAS GILSON A. , NUNES PEDRO M. SALES , BARAN AGNIESZKA , JOWERS MICHAEL J. , SMITH ERIC N. , HERNÁNDEZ-MORALES CRISTIAN , SCHARGEL WALTER E.
Published: August 2021

We describe a new species of gymnophthalmid lizard, Oreosaurus bisbali sp. nov., from the Turimiquire Massif in northeastern Venezuela. It is one of three reptile species known to be endemic to the region and the fifth species of Oreosaurus from Venezuela. It can be distinguished from all congeners by a combination of rectangular dorsal scales at midbody, having two scales separating femoral pores medially, and lacking a nasoloreal suture. The new species is likely to be restricted in distribution to the highlands of the Turimiquire Massif, which have been significantly degraded by agriculture.
Slow Modes of Global Temperature Variability and Their Impact on Climate Sensitivity Estimates
Authors: Wills Robert C. J. , Armour Kyle C. , Battisti David S. , Proistosescu Cristian , Parsons Luke A.
Published: August 2021

Internal climate variability confounds estimates of the climate response to forcing but offers an opportunity to examine the dynamics controlling Earth’s energy budget. This study analyzes the time-evolving impact of modes of low-frequency internal variability on global-mean surface temperature (GMST) and top-of-atmosphere (TOA) radiation in preindustrial control simulations from phase 6 of the Coupled Model Intercomparison Project (CMIP6). The results show that the slow modes of variability with the largest impact on decadal GMST anomalies are focused in high-latitude ocean regions, where they have a minimal impact on global TOA radiation. When these regions warm, positive shortwave cloud and sea ice–albedo feedbacks largely cancel the negative feedback of outgoing longwave radiation, resulting in a weak net radiative feedback. As a consequence of the weak net radiative feedback, less energy is required to sustain these long-lived temperature anomalies. In contrast to these weakly radiating high-latitude modes, El Niño–Southern Oscillation (ENSO) has a large impact on the global energy budget, such that it remains the dominant influence on global TOA radiation out to decadal and longer time scales, despite its primarily interannual time scale. These results show that on decadal and longer time scales, different processes control internal variability in GMST than control internal variability in global TOA radiation. The results are used to quantify the impact of low-frequency internal variability and ENSO on estimates of climate sensitivity from historical GMST and TOA-radiative-imbalance anomalies.
“Beyond Weather Regimes”: Descriptors Monitoring Atmospheric Centers of Action. A case study for Aotearoa New Zealand
Authors: Pohl Benjamin , Lorrey Andrew , Sturman Andrew , Quénol Hervé , Renwick James , Fauchereau Nicolas , Pergaud Julien
Published: August 2021

This paper introduces a set of descriptors applied to weather regimes, that allow for a detailed monitoring of the location and intensity of their atmospheric centers of action (e.g. troughs and ridges) and the gradients between them, when applicable. Descriptors are designed to document the effect of climate variability and change in modulating the character of daily weather regimes, rather than merely their occurrence statistics.

As a case study, the methodology is applied to Aotearoa New Zealand (ANZ), using ERA5 ensemble reanalysis data for the period 1979-2019. Here, we analyze teleconnections between the regimes and their descriptors, and large-scale climate variability. Results show a significant modulation of centers of action by the phase of the Southern Annular Mode, with a strong relationship identified with the latitude of atmospheric ridges. Significant associations with El Niño Southern Oscillation are also identified. Modes of large-scale variability have a stronger influence on the regimes’ intrinsic features than their occurrence. This demonstrates the usefulness of such descriptors, which help understand the relationship between mid-latitude transient perturbations and large-scale modes of climate variability.

In future research, this methodological framework will be applied to analyze (i) low-frequency changes in weather regimes under climate change, in line with the southward shift of storm tracks, and (ii) regional-scale effects on the climate of ANZ, resulting from interaction with its topography.
A Weak Temperature Gradient Framework to Quantify the Causes of Potential Intensity Variability in the Tropics
Authors: Rousseau-Rizzi Raphaël , Emanuel Kerry
Published: August 2021

Potential intensity (PI) has been shown to have a linear sensitivity to sea surface temperature (SST) of about 8 m s−1 K−1, which is close to the sensitivity of PI in simulations subject to a weak temperature gradient (WTG) approximation. This suggests that most of the PI variance is associated with local rather than global SST variations. We verify that PI perturbations are approximately linear in SST, with slopes of 1.8 ± 0.2 m s−1 K−1 in radiative–convective equilibrium (RCE) and 9.1 ± 0.9 m s−1 K−1 in WTG. To do so, we simulate the sensitivity of both RCE and WTG states in a single-column model (SCM) perturbed by changing in turn CO2 concentration, aerosol concentrations, prescribed SST, and surface winds speeds. While PI is much more sensitive to SST in WTG than in RCE simulations, the SST itself is much less sensitive to radiative forcing in WTG than in RCE because of the absence of strong atmospheric response. Using these results, we develop a linear model, based on SST and midlevel saturation MSE perturbations, to partition SST and PI perturbations between local components occurring under a WTG constraint and global components that are representative of an RCE state. This model explains up to 95% of the variability of PI in reanalysis. The SCM-derived linear model coefficients are statistically indistinguishable from coefficients from a linear fit of reanalysis PI to SST and midlevel saturation MSE in most ocean basins. Our model shows that North Atlantic PI variations are explained almost entirely by local forcings in recent decades.
Anxiety Levels of Primary Caregivers of Children With Tracheostomy During the COVID-19 Pandemic
Authors: Onay Zeynep Reyhan , Gursoy Tugba Ramasli , Eyuboglu Tugba Sismanlar , Aslan Ayse Tana , Soysal Acar Azime Sebnem , Yapar Dilek , Ilhan Mustafa Necmi
Published: August 2021

We aim to evaluate the anxiety levels of caregivers of children with tracheostomy during the COVID-19 (coronavirus disease 2019) pandemic. Caregivers of 31 children with tracheostomy and 105 healthy children (control group) were included. The State-Trait Anxiety Inventory was administered via teleconference in order to investigate how participants describe how they feel at a particular moment (State) and how they generally feel (Trait). The trait anxiety levels of caregivers of children with tracheostomy were significantly higher ( P = .02). Their state anxiety levels were similar. The state and trait anxiety levels of caregivers of children with tracheostomy correlated ( r = 0.70, P < .001). At the end of the teleconference, caregivers of children with tracheostomy experienced greater anxiety relief than controls ( P < .001). Trait anxiety scores were higher among caregivers of children with tracheostomy, but their state anxiety levels were comparable to those of controls. Caregivers with high trait anxiety also exhibited high state anxiety. Informing caregivers of children with tracheostomy about COVID-19 via teleconference can reduce their anxiety during such stressful times.
A Sense of Continuity in Mortality? Exploring Science-Oriented Finns’ Views on Afterdeath
Authors: Haimila Roosa , Muraja Elisa
Published: August 2021

Endorsement of science might entail a belief in “secular death”, in which an individual faces annihilation as the bodily functions cease. In this article, we examine what science-oriented individuals think happens to humans after death. Does endorsement of science entail views on human annihilation or do people also express continuity beliefs? The open-ended responses of 387 Finns were analysed. The respondents were recruited online via organisations that promote science and research. The results suggest that while science-oriented Finns mainly endorsed annihilation and secular death, some also expressed (mostly nonreligious) views on continuation, e.g., in social bonds and nature. Secular forms of continuity were more likely mentioned by unbelievers, while theist respondents relied primarily on afterlife beliefs.
Action network: a probabilistic graphical model for social simulation
Authors: Zakaria Nordin
Published: August 2021

Agent-based social simulations are typically described in imperative form. While this facilitates implementation as computer programs, it makes implicit the different assumptions made, both about the functional form and the causal ordering involved. As a solution to the problem, a probabilistic graphical model, Action Network (AN), is proposed in this paper for social simulation. Simulation variables are represented by nodes, and causal links by edges. An Action Table is associated with each node, describing incremental probabilistic actions to be performed in response to fuzzy parental states. AN offers a graphical causal model that captures the dynamics of a social process. Details of the formalism are presented along with illustrative examples. Software that implements the formalism is available at http://actionnetwork.epizy.com .
Ultrasound-guided autologous blood patch – A novel modality for broncho-pleural-cutaneous fistula closure
Authors: Varghese Ashin , Baby Jacob , Ray Brijesh
Published: August 2021

We present a 36-year-old immuno-compromised male with non-resolving pneumonia, who developed a broncho-pleuro-cutaneous fistula following a thoracoscopic biopsy, which was successfully managed with an ultrasound-guided blood patch placed over the bronchial defect. We discuss the mechanism by which this is presumed to close a fistula, thus justifying it as a cost effective and minimally invasive modality of treatment.
Neighborhood Social Cohesion and Mobility Limitations Among Community-dwelling Older Americans: The Mediating Roles of Depressive Symptoms and Mastery
Authors: Wang Fei , Qin Weidi , Yu Jiao
Published: August 2021

Neighborhood environment plays an important role in late-life health; yet, the social aspect of neighborhood environment and its impact on mobility limitations have rarely been examined. This nonexperimental, cross-sectional study examines the relationship between neighborhood social cohesion and mobility limitations and the potential mediators (i.e., depressive symptoms, mastery) of this relationship. A total of 8,317 Americans aged 65 years and older were selected from the Health and Retirement Study. Using ordinary least squares regressions, this study shows that neighborhood social cohesion was negatively associated with mobility limitations ( B  =  −0.04, p < .01). A Sobel test of mediation indicated that this relationship was significantly mediated by depressive symptoms ( z  =  −9.10, p < .001) and mastery ( z  =  −8.86, p < .001). Findings suggest that neighborhood cohesion can reduce mobility limitations through mitigating depressive symptoms and increasing mastery. Future research should disentangle the temporal ordering of the mediators.
No evidence of an association between parental mind-mindedness at 9 months and language development at either 9 or 25 months in Swedish infants
Authors: Nyberg Sandra , Rudner Mary , Mattila Peter , Heimann Mikael
Published: August 2021

Mind-mindedness (MM), the parent’s propensity to treat their young child as an individual with a mind of their own, has repeatedly been found to be positively associated with subsequent child development outcomes. In the current Swedish study, the first aim was to investigate the main features of MM in this cultural context and the second aim was to investigate its association with early child language development. Sixty-three parent-child dyads participated. MM was assessed by videotaped laboratory-based parent-child dyad free-play sessions. Language development was assessed using the parent questionnaire Swedish Early Communicative Development Inventory (SECDI), a Swedish adaptation of the internationally used MacArthur-Bates Communicative Development Inventories (MB-CDI). The ratio between Appropriate MM and Non-attuned MM was 4:1 and there was no statistically significant correlation between these two variables. There were no statistically significant correlations between Total MM or Appropriate MM and language ability ratings at either 9 or 25 months. This may be due to methodological issues concerning elicitation of MM in a Swedish context. We emphasize the importance of further theoretical and empirical studies of cross-cultural validation of MM.
Factors Associated With Hearing Outcomes After Stapedotomy in Taiwanese Patients With Clinical Otosclerosis
Authors: Chen Pei-Hsin , Lin Kai-Nan , Lin Hsiu-Yin , Yu Rui-Bin , Liu Pi-Yun , Shih Wan-Ting , Chen Jeng-Wen
Published: August 2021

Objective:

To examine the clinical factors associated with the effectiveness of stapedotomy in improving hearing sensitivity in Taiwanese patients with otosclerosis.

Methods:

In this retrospective study, we reviewed the medical records of 31 patients (36 ears) with otosclerosis undergoing stapedotomy performed by a single surgeon. Preoperative and postoperative hearing results were analyzed to identify factors associated with hearing outcomes after stapedotomy in the Taiwanese population with clinical otosclerosis.

Results:

Compared with preoperative pure tone averages (PTAs), stapedotomy significantly improved postoperative air conduction (AC) thresholds ( P < .0001), bone conduction (BC) thresholds ( P = .025), and air-bone gaps (ABGs; P < .0001). Postoperative closure of ABGs less than 10 or 20 dB was achieved in 16 (44.4%) and 33 (91.7%) of 36 surgical ears. Improvement in postoperative AC thresholds and ABGs and the size of preoperative ABGs were significantly correlated (r = .650, P < .001 and r = .745, P < .001, respectively). Gender-stratified analysis indicated a stronger correlation between improvement in postoperative AC thresholds and preoperative ABGs in male patients than in female patients (r = .893, P < .001 and r = .476, P = .014, respectively), and in postoperative and preoperative ABGs (r = .933, P < .001 and r = .626, P < .001, respectively). With the more stringent criteria for surgical success, factors including age (≤50 years), type (conductive, BC ≤25 dB), and degree (PTA ≤55 dB) of preoperative hearing loss led to more favorable outcomes.

Conclusions:

We reported evidence supporting a potential gender difference on hearing outcomes after stapedotomy in Taiwanese patients with otosclerosis. Age, type, and degree of preoperative hearing loss may affect the surgical success rate.
Dysuria therapeutic agents as an independent prognostic factor for the primary recurrence of non-muscle invasive bladder cancer: a propensity score matching study
Authors: Kato Yoichiro , Ikarashi Daiki , Kikuchi Daichi , Takayama Misato , Kanzaki Seiko , Ito Akito , Tamura Daichi , Matsuura Tomohiko , Maekawa Shigekatsu , Kato Renpei , Kanehira Mitsugu , Takata Ryo , Sugimura Jun , Obara Wataru
Published: August 2021

Objective

To investigate if the use of therapeutic agents for dysuria is a risk factor for the primary recurrence of non-muscle invasive bladder cancer (NMIBC).

Methods

First, patients with NMIBC were divided into two groups: the non-recurrence group and the recurrence group. Patient characteristics were compared between both groups. The risk factors of recurrence that were statistically different between the two groups were identified by multivariate analysis. Second, we divided the patients into risk and non-risk groups, and differences in the recurrence-free survival (RFS) between the two groups were analyzed before and after propensity score matching (PSM).

Results

A total of 162 patients were included, with 84 patients in the non-recurrence group and 78 patients in the recurrence group. In the multivariate analysis, the intake of dysuria agents and bacillus Calmette–Guérin (BCG) therapy were independent factors. The RFS results in terms of the intake of dysuria agents were statistically significant before and after PSM analysis, but no factors were significantly different between the BCG and non-BCG groups after PSM.

Conclusions

Therapeutic agents for dysuria might be at an independent risk factor for NMIBC recurrence. This trial is registered with the UMIN Clinical Trials Registry under the number UMIN000036097 ( https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno = R000041122 ).
Doubtful use of placebo following placebo in recent controlled trials of lasmiditan and ubrogepant for the treatment of migraine attacks
Authors: Tfelt-Hansen Peer , Jørgensen Karsten , Diener Hans-Christoph
Published: August 2021

Purpose

In four large controlled trials with lasmiditan and ubrogepant placebo was administered in the first step to demonstrate an effect on migraine attack. In the same trials the investigators also asked the question: is a second dose of the drug effective in non-responders to the first dose? In this phase patients who received placebo in the first phase of the trial again after 2 hours received another dose of placebo.

Conclusion

To be ethical, clinical research requires balancing rigorous science with the protection of human subjects; and it is, in our view, questionable whether placebo was used with “scientific rigor” in the second step of these trials, and this design is not recommended.
Activation of the trigeminal system as a likely target of SARS-CoV-2 may contribute to anosmia in COVID-19
Authors: Messlinger Karl , Neuhuber Winfried , May Arne
Published: August 2021

Clinical publications show consistently that headache is a common symptom in the coronavirus disease of 2019 (COVID-19). Several studies specifically investigated headache symptomatology and associated features in patients with COVID-19. The headache is frequently debilitating with manifold characters including migraine-like characteristics. Studies suggested that COVID-19 patients with headache vs. those without headache are more likely to have anosmia. We present a pathophysiological hypothesis which may explain this phenomenon, discuss current hypotheses about how the coronavirus SARS-CoV-2 enters the central nervous system and suggest that activation of the trigeminal nerve may contribute to both headache and anosmia in COVID-19.
CGRP-dependent signalling pathways involved in mouse models of GTN- cilostazol- and levcromakalim-induced migraine
Authors: Christensen Sarah L , Rasmussen Rikke H , Ernstsen Charlotte , La Cour Sanne , David Arthur , Chaker Jade , Haanes Kristian A , Christensen Søren T , Olesen Jes , Kristensen David M
Published: August 2021

Background

Knowledge of exact signalling events during migraine attacks is lacking. Various substances are known to trigger migraine attacks in patients and calcitonin gene-related peptide antagonising drugs are effective against migraine pain. Here, we investigated the signalling pathways involved in three different mouse models of provoked migraine and relate them to calcitonin gene-related peptide and other migraine-relevant targets.

Methods

In vivo mouse models of glyceryl trinitrate-, cilostazol- and levcromakalim-induced migraine were applied utilising tactile sensitivity to von Frey filaments as measuring readout. Signalling pathways involved in the three models were dissected by use of specific knockout mice and chemical inhibitors. In vivo results were supported by ex vivo wire myograph experiments measuring arterial dilatory responses and ex vivo calcitonin gene-related peptide release from trigeminal ganglion and trigeminal nucleus caudalis from mice.

Results

Glyceryl trinitrate-induced hypersensitivity was dependent on both prostaglandins and transient receptor potential cation channel, subfamily A, member 1, whereas cilostazol- and levcromakalim-induced hypersensitivity were independent of both. All three migraine triggers activated calcitonin gene-related peptide signalling, as both receptor antagonism and antibody neutralisation of calcitonin gene-related peptide were effective inhibitors of hypersensitivity in all three models. Stimulation of trigeminal ganglia and brain stem tissue samples with cilostazol and levcromakalim did not result in release of calcitonin gene-related peptide, and vasodilation following levcromakalim stimulation was independent of CGRP receptor antagonism.

Conclusion

The mouse models of glyceryl trinitrate-, cilostazol- and levcromakalim- induced migraine all involve calcitonin gene-related peptide signalling in a complex interplay between different cell/tissue types. These models are useful in the study of migraine mechanisms.
Evaluation of sustainable e-waste collection method for urban and rural region of India
Authors: Singh Shailender , Dasgupta Mani Sankar , Routroy Srikanta
Published: August 2021

Electronic waste is one of the most challenging waste streams to manage. It has become a significant concern in developing countries due to the ever-increasing volume of generation coupled with deficient growth in collection and processing infrastructure. For the various stakeholders, it is of paramount importance to adopt a robust and sustainable collection method for hazard mitigation. The prevalent e-waste collection methods are categorized under four major heads, namely take-back, retail store, door-to-door and curbside collection. The e-waste collection problems are analysed from various perspective, based on literature that cited developing country-specific survey and data that includes India. Economic sustainability and potential risk are included as attributes in the evaluation scheme. We attempt to establish a decision-making model. Discussion with the field experts and decision-makers (DMs) provided the weights for various attributes and sub-attributes. A fuzzy linguistic scale is used to take care of ambiguity in DMs’ opinion. Fuzzy- Analytical Hierarchy Process (FAHP) is used to determine the importance of various attributes and sub-attributes, while Fuzzy-VlseKriterijumska Optimizacija I Kompromisno Resenje (FVIKOR) is used to determine the rank of the alternatives. Based on the analysis, ‘take-back collection’ and ‘retail store based collection’ are found the most suitable options for urban and rural regions respectively. The attributes, social awareness and economical sustainability are found to have the highest significance in both cases. Implementation of a collection method is an expensive activity, and the proposed Fuzzy-Multi Attribute Decision Making attempts to capture various attributes and their complex interplay to arrive at a decision on optimum e-waste collection option(s) in a specific locality.
Best practice for bio-waste collection as a prerequisite for high-quality compost
Authors: Friege Henning , Eger Yasmin
Published: August 2021

Due to its high content of humic substances, compost from bio-waste improves the structure and fertility of soils serving also as a sink for CO2. But compost is also contaminated with numerous compounds, for example, plastics, glass particles, etc., mostly due to incorrect sorting by the waste producer, that is, households. The contamination even increases when covering areas of a high population density as is also evident from experience in Germany with a steadily increasing proportion of bio-waste. Only compost with high quality and minimum contamination is an acceptable fertilizer. A structured interview of experts investigated which measures or combinations of measures are best suitable to reduce the rate of misplaced materials in the organic waste. Only responsible persons were interviewed whose municipalities extensively collect separately bio-waste since years and have a low rate of unwanted materials. The questions focus on the identification of the misplacements according to their kind and quantity, the respective collection system, the regional statutes and their enforcement as well as the kind and extent of public awareness measures. The respective necessary measures are being discussed. This systemic approach can be transferred to other regions that intend to collect large quantities of bio-waste separately.
A robust fuzzy multi-objective programming model to design a sustainable hospital waste management network considering resiliency and uncertainty: A case study
Authors: Negarandeh Rana , Tajdin Ali
Published: August 2021

With the increase in the number of patients and activity of hospitals, the issue of hospital waste management (HWM) is becoming more and more challenging and worrying. In addition to financial losses, there will be irreparable damage to the ecosystem and environment which will create many problems for people (because the job of some people in the area is livestock and agriculture and they have a lot to do with their surroundings). It also doubles the need to pay attention to the issue of sustainable development (simultaneous attention to social, economic and environmental dimensions) in waste management. Moreover, the climatic and geographical conditions and lack of proper waste management in this area lead to major problems. Therefore, in this research, by developing a novel multi-objective mixed integer linear programming model, HWM is addressed in the hospitals of Sari, Iran. The aim is to design an HWM network considering sustainability, resiliency and uncertainty. In order to deal with uncertainty, a robust fuzzy programming approach is employed, and then an improved goal programming technique and Lp-metric method is proposed to solve the model. It was revealed that goal programming outperforms the Lp-metric method in terms of all objectives. Furthermore, the obtained results demonstrate the applicability and efficiency of the proposed methodology to design an efficient sustainable HWM network.
Provision of extended producer responsibility system for products packaging: A case study of Iran
Authors: Jalalipour Haniyeh , Ahmadi Masoud , Jaafarzadeh Neematollah , Morscheck Gert , Narra Satyanarayana , Nelles Michael
Published: August 2021

A powerful legal tool in evolving solid waste management (SWM) systems is extended producer responsibility (EPR). It is a mechanism that shifts the responsibility of a product to manufacturers/importers at the ‘end-of-life’ stage. Yet, implementation of the EPR concept has faced difficulties in developing countries. In Iran, as one such country, the principle of EPR system was issued in executive regulation of SWM in 2005, however, so far, it has been limited to a voluntary scheme. The problem merits further investigation. Therefore, this study aims to shed light on the obstacles in the path of developing EPR system for product packaging. The research examines the current SWM systems in four functional classified frameworks: legal, institutional, financial and technical. The strengths, weaknesses, opportunities and threats of the system are elaborated through semi-structured interviews with a senior executive in the Ministry of Interior (MoI). Then, viable methods to increase resource efficiency and sustainable waste treatment are suggested. The change in the financing mechanism in the Budget Law 2020 forces the manufacturers/importers of products containing recyclable components to pay the revenue from one in 1000 products to MoI for developing recycling facilities and incinerators through partnerships with the private sector. This new strategy would promote proper management of product packaging, create more jobs and a market for international cooperation. However, poor source-separation of wet/dry waste, informal sector activities, exclusive focus on the economic aspect of waste management, lack of expertise and public awareness campaigns are the barriers in this regard.
Residential Care Development in California: History and Policy
Authors: Frochen Stephen , Ailshire Jennifer , Pynoos Jon
Published: August 2021

This literature review provides a framework for understanding the development of residential care in California, including state licensing, federal funding, and state and local planning policies for the development of facilities. It discusses the history, planning, and licensing of residential care as a home and community-based service in California. It examines the historic and innovative federal programs supporting assisted living in public or affordable housing, the public equivalent of residential care. Finally, it describes how the California housing crisis has prompted a new and sweeping set of state and local planning policies encouraging its development.
Revitalizing HIV Prevention Programs: Recommendations From Those Most Impacted by HIV in the Deep South
Authors: Williams Michelle S. , Poteat Tonia , Bender Melverta , Ugwu Precious , Burns Paul A.
Published: August 2021

Purpose:

The incidence of new HIV infections is disproportionately high among Black men who have sex with men (BMSM) in Mississippi. Community-based organizations received funding through the ACCELERATE! initiative to implement interventions aimed at increasing BMSM’s access to HIV prevention, treatment and care interventions.

Approach:

We conducted a mixed methods evaluation of the ACCELERATE! initiative to assess its impact. We also explored factors that act as barriers to and facilitators of BMSM’s engagement in HIV prevention interventions.

Setting:

Interviews were conducted between July 2018 and February 2020.

Participants:

Thirty-six BMSM and 13 non-grantee key informants who worked in the field of HIV in Mississippi participated.

Method:

The qualitative data from the interview transcripts was analyzed using an iterative, inductive coding process.

Results:

We identified 10 key recommendations that were most common across all participants and that were aligned with UNAIDS Global AIDS Strategy strategic priorities. Several recommendations address the reduction of HIV- and LGBT-stigma. Two of the most common recommendations were to increase representation of the target population in health promotion program leadership and to include HIV with other Black health issues in community-based health education programs rather than singling it out. Another recommendation called for programs aimed at addressing underlying factors associated with HIV-risk behaviors, such as mental illness.

Conclusion:

Our results indicate that HIV education interventions in the Deep South need to be revitalized to enhance their reach and effectiveness.
Cutting performance evaluation of boron-doped and undoped diamond coatings in drilling of CFRP laminates
Authors: Soldatov Alexander , Okada Akira , Ogawa Hitoshi
Published: August 2021

This study investigated the effect of boron-doped and undoped diamond coatings on the cutting performance of cobalt cemented tungsten carbide (WC-Co) drills when drilling CFRP. Three types of diamond coating, as boron-doped microcrystalline (B-MCD), boron-doped nanocrystalline (B-NCD), and undoped nanocrystalline (NCD), were deposited on specially designed for drilling of CFRP one-shot drills by the hot filament chemical vapor deposition (HFCVD) method. The coating characteristics, such as surface morphology, roughness, carbon structure, and interfacial adhesion, were investigated. Then cutting tests were carried out, and the tool’s flank wear, thrust force, and torque were evaluated. For comparison of cutting performance, non-coated WC-Co drills were used in the tests as well. Furthermore, drilled holes were inspected in terms of peel-up and push-out delamination. According to the results, the B-MCD coated drill presented advantages in tool life, and quality of drilled holes over the NCD and B-NCD coated drills. Also, the results confirmed the adhesion enhanced effect of diamond coating to WC-Co substrate through boron doping of the layer.