bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain connectivity modulation by Bayesian surprise in relation to control demand drives cognitive flexibility via control engagement
Authors: Qiao Lei , Zhang Lijie , Chen Antao
Published: April 2022

Human control is characterized by its flexibility and adaptability in response to the conditional probability in the environment. Previous studies have revealed that efficient conflict control could be attained by predicting and adapting to the changing control demand. However, it is unclear whether cognitive flexibility could also be gained by predicting and adapting to the changing control demand. The present study aimed to explore this issue by combining the model-based analyses of behavioral and neuroimaging data with a probabilistic cued task switching paradigm. We demonstrated that the Bayesian surprise (i.e. unsigned precision-weighted prediction error [PE]) negatively modulated the connections among stimulus processing brain regions and control regions/networks. The effect of Bayesian surprise modulation on these connections guided control engagement as reflected by the control PE effect on behavior, which in turn facilitated cognitive flexibility. These results bridge a gap in the literature by illustrating the neural and behavioral effect of control demand prediction (or PE) on cognitive flexibility and offer novel insights into the source of switch cost and the mechanism of cognitive flexibility.
Green spotted puffers detect a nontoxic TTX analog odor using crypt olfactory sensory neurons
Authors: Suzuki Takehisa , Nakahigashi Ryota , Adachi Masaatsu , Nishikawa Toshio , Abe Hideki
Published: April 2022

Toxic puffers accumulate their defense substance (tetrodotoxin; TTX) through the food chain. Although the previous study suggests that 5,6,11-trideoxyTTX, a nontoxic TTX analog detected simultaneously with TTX in toxic puffers or their prey, acts as an olfactory chemoattractant for grass puffers, it is unclear whether toxic puffers are commonly attracted to 5,6,11-trideoxyTTX, and which types of olfactory sensory neurons (OSNs) detect 5,6,11-trideoxyTTX. Here, we demonstrated that green spotted puffer, a phylogenetically distant species from the grass puffer, is attracted to 5,6,11-trideoxyTTX. 5,6,11-TrideoxyTTX administration made green spotted puffers stay longer at the administered site, whereas a food odor (l-Arg) made them actively swim throughout the aquarium. Attractive responses were not observed when TTX or its vehicle was administered, nor when 5,6,11-trideoxyTTX was administered to anosmic fish. Furthermore, double immunohistochemistry with activity marker and crypt OSN marker antibodies labeled oval cells with apical invagination on the olfactory epithelium surface treated with 5,6,11-trideoxyTTX. These results suggest that 5,6,11-trideoxyTTX acts as an olfactory chemoattractant detected by crypt OSNs, and attraction to 5,6,11-trideoxyTTX odor appears to be a trait shared by toxic puffers for social communication or effective toxification.
Genomic Analysis of Group B Streptococcus from Neonatal Sepsis Reveals Clonal CC17 Expansion and Virulence- and Resistance-Associated Traits After Intrapartum Antibiotic Prophylaxis
Authors: Zhou Yan , Wang Lin-Qi , Yan Qing , Lee Chien-Chung , Hsu Mei-Hua , Liao Wan-Ting , Zhang Liang , Chiu Cheng-Hsun
Published: April 2022

Background

Group B Streptococcus (GBS) is a leading cause of invasive neonatal infections. This study aimed to investigate the trend of GBS serotype and genotype change and their correlation with antimicrobial resistance before and after implementation of intrapartum antibiotic prophylaxis (IAP).

Methods

We performed serotyping, whole-genome sequencing, antimicrobial susceptibility testing, and single-nucleotide polymorphism (SNP)–based phylogenetic analysis on 238 invasive GBS isolates collected from October 1998 to February 2020 in Taiwan.

Results

There were 7 serotypes and 6 clonal complexes (CCs) among the 238 GBS isolates, and more than half of the isolates carried multiple antimicrobial resistance genes. The expansion of CC17 strains and the increase in late-onset disease occurred synchronously after the implementation of IAP. Analysis of the carriage isolates from pregnant women showed diverse serotype distribution in the IAP era. The antimicrobial susceptibility testing showed that all 238 strains were susceptible to ampicillin and penicillin, while the number of various resistance genes in GBS genomes was found increased with the expansion of CC17. Compared with reference genomes, 697 nonsynonymous SNPs in 443 protein-coding genes were CC17 specific.

Conclusions

The study revealed the expansion of GBS CC17 and the increase of late-onset disease that occurred simultaneously with the implementation of IAP. Although the susceptibility of CC17 to antimicrobial agents is not different from that of other sequence types at present, GBS with phenotypic resistance to antimicrobials may emerge in the future, given the environmental selection pressure and the continued accumulation of SNP mutations.
Cost–effectiveness of ticagrelor in patients with type 2 diabetes and coronary artery disease: a European economic evaluation of the THEMIS trial
Authors: Steg Philippe Gabriel , Bhatt Deepak L , James Stefan K , Darlington Oliver , Hoskin Louise , Simon Tabassome , Fox Kim M , Leiter Lawrence A , Mehta Shamir R , Harrington Robert A , Himmelmann Anders , Ridderstråle Wilhelm , Andersson Marielle , Bueno Héctor , De Luca Leonardo , Tank Amarjeet , Mellström Carl , McEwan Phil
Published: April 2022

Aims

To conduct a health economic evaluation of ticagrelor in patients with type 2 diabetes and coronary artery disease (CAD) from a multinational payer perspective. Cost–effectiveness and cost–utility of ticagrelor were evaluated in the overall effect of Ticagrelor on Health Outcomes in Diabetes Mellitus Patients Intervention Study (THEMIS) trial population and in the predefined patient group with prior percutaneous coronary intervention.

Methods and results

A Markov model was developed to extrapolate patient outcomes over a lifetime horizon. The primary outcome was incremental cost–effectiveness ratios (ICERs), which were compared with conventional willingness-to-pay thresholds [€47 000/quality-adjusted life-year (QALY) in Sweden and €30 000/QALY in other countries].

Treatment with ticagrelor resulted in QALY gains of up to 0.045 in the overall population and 0.099 in patients with percutaneous coronary intervention (PCI). Increased costs and benefits translated to ICERs ranged between €27 894 and €42 252/QALY across Sweden, Germany, Italy, and Spain in the overall population. In patients with prior PCI, estimated ICERs improved to €18 449, €20 632, €20 233, and €13 228/QALY in Sweden, Germany, Italy, and Spain, respectively, driven by higher event rates and treatment benefit.

Conclusion

Based on THEMIS results, ticagrelor plus aspirin compared with aspirin alone may be cost–effective in some European countries in patients with T2DM and CAD and no prior myocardial infarction (MI) or stroke. Additionally, ticagrelor is likely to be cost–effective across European countries in patients with a history of PCI.
Identification of candidate genes involved in salt stress response at germination and seedling stages by QTL mapping in upland cotton
Authors: Guo Anhui , Su Ying , Nie Hushuai , Li Bin , Ma Xingkun , Hua Jinping
Published: April 2022

Salinity is a major abiotic stress at critical stages of seed germination and seedling establishment. Germination rate (GR) and field emergence rate (FER) are the key traits that determine the basic number of plants stand under field conditions. To explore molecular mechanisms in upland cotton under salt stress, a population of 177 recombinant inbred lines, and their parents were evaluated for seed germination traits (GP, germination potential; GR; FW, fresh weight; DW, dry weight; GL, germinal length) and seedling traits (FER; SH, seedling height; NL, number of main stem leaves) in 2016–2018. Based on the linkage map contained 2,859 single nucleotide polymorphism and simple sequence repeat markers, traits under salt stress (E1) and normal conditions (E2), and in the converted relative index (R-value) dataset of 3 years’ trials were used to map quantitative trait loci (QTL). A total of 3 QTL and 2 clusters were detected as salt-tolerant QTL. Three QTL (qGR-Chr4-3, qFER-Chr12-3, and qFER-Chr15-1) were detected under salt stress conditions and R-value dataset, which explained variance of phenotype 9.62–13.67%, and 4.2–4.72%, 4.75–8.96%, respectively. Two clusters (Loci-Chr4-2 and Loci-Chr5-4) harboring the QTL for 4 germination traits (GR, FER, GL, and NL) and 6 seedling traits (GR, FER, DW, FW, SH, and NL) were detected related under salt stress. A total of 691 genes were found in the candidate QTL or clusters. Among them, 4 genes (Gh_A04G1106, Gh_A05G3246, Gh_A05G3177, and Gh_A05G3266) showed expression differences between salt-sensitive and -tolerant lines under salt stress conditions, and were assigned as candidate genes in response to salt stress. The consistent salt-tolerance QTL identified in both germination and seedling stages will facilitate novel insights into effective utilization of cotton genetic resources.
Hypertension and mobile application for self-care, self-efficacy and related knowledge
Authors: Dwairej Lubna , Ahmad Muayyad
Published: April 2022

Managing hypertension is not only concerned with lowering blood pressure (BP) by using antihypertensive medications but also aims at minimizing its consequences through adopting self-care. The aim of this study was to assess the effectiveness of mobile application on self-care, BP control, self-efficacy and hypertension-related knowledge among adult patients with hypertension. A randomized design, two groups, pretest–posttest, between subjects with a 1:1 allocation ratio was used. The sample was selected from cardiology clinics has completed the study. Using a block randomization method, 57 of the participants were assigned to the intervention group receiving the educational application intervention, and 59 of them were assigned to the control group receiving usual care. The study’s findings showed that participants in the intervention group reported statistically significant higher self-care and knowledge scores than the participants in the control group after 8 weeks of receiving the study intervention. Additionally, compared with the control group participants, more participants in the intervention group demonstrated BP control. The educational application is effective in improving knowledge, self-care and BP control. The positive results indicate the value of integrating mobile applications in the care of patients with hypertension.
Quantitative Spectrophotometric Analysis of Celecoxib and Tramadol in Their Multimodal Analgesia Combination Tablets
Authors: Abdelazim Ahmed H , Ramzy Sherif , Abdel-Monem Ahmed H , Almrasy Ahmed A , Abdel-Fattah Ashraf , Shahin Mohammed
Published: April 2022

Background

Pain is a global, complex health problem that includes physical, emotional, and social components. The pain management process has many goals, including patient satisfaction, reducing clinical complications, and lowering costs. The physician describes pain medications in terms of the proven cause and classification of the severity of the pain. The combination of celecoxib and tramadol was recently approved by the Food and Drug Administration (FDA) in October 2021 for the treatment of acute pain in adults.

Objective

This paper presents the first published quantitative analytical methods for celecoxib and tramadol.

Methods

The UV absorption spectra of celecoxib and tramadol showed strong overlap. Mathematical simultaneous equation and ratio difference methods were developed to resolve the spectral overlap and quantify the drugs in the combination mixture. In the simultaneous equation method, the absorbance and absorptivity values at 252 and 217 nm were used to construct two mathematical equations that were used for the simultaneous mathematical quantification of the above drugs. The mathematical manipulation of the ratio difference based on the calculation of the differences in the amplitude values between 250 and 280 nm enabled the quantitative analysis of celecoxib, and the differences in the amplitude values between 221 and 272 nm enabled the quantitative analysis of tramadol.

Results

The proposed methods were successfully applied to the selective quantitative analysis of celecoxib and tramadol in the synthetic mixtures and in the pharmaceutical tablets without interference from the tablet additives.

Conclusions

The applied methods demonstrated good linearity in the concentration range of 1–20 µg/mL and 3–45 µg/mL for celecoxib and tramadol, respectively, with acceptable accuracy and precision. The methods were found to be sensitive with LOD values of 0.183 µg/mL and 0.626 µg/mL for celecoxib and tramadol, respectively, in simultaneous equation method and of 0.275 µg/mL and 0.772 µg/mL for celecoxib and tramadol, respectively, in ratio difference method.

Highlights

The first established simple and validated UV spectrophotometric methods were described for concurrent quantification of the celecoxib and tramadol in their recently approved pharmaceutical formulation.
Genetic Analysis of Lung Cancer and the Germline Impact on Somatic Mutation Burden
Authors: Gabriel Aurélie A G , Atkins Joshua R , Penha Ricardo C C , Smith-Byrne Karl , Gaborieau Valerie , Voegele Catherine , Abedi-Ardekani Behnoush , Milojevic Maja , Olaso Robert , Meyer Vincent , Boland Anne , Deleuze Jean François , Zaridze David , Mukeriya Anush , Swiatkowska Beata , Janout Vladimir , Schejbalová Miriam , Mates Dana , Stojšić Jelena , Ognjanovic Miodrag ,   the ILCCO consortium, Witte John S , Rashkin Sara R , Kachuri Linda , Hung Rayjean J , Kar Siddhartha , Brennan Paul , Sertier Anne-Sophie , Ferrari Anthony , Viari Alain , Johansson Mattias , Amos Christopher I , Foll Matthieu , McKay James D
Published: April 2022

Background

Germline genetic variation contributes to lung cancer (LC) susceptibility. Previous genome-wide association studies (GWAS) have implicated susceptibility loci involved in smoking behaviors and DNA repair genes, but further work is required to identify susceptibility variants.

Methods

To identify LC susceptibility loci, a family history-based genome-wide association by proxy (GWAx) of LC (48 843 European proxy LC patients, 195 387 controls) was combined with a previous LC GWAS (29 266 patients, 56 450 controls) by meta-analysis. Colocalization was used to explore candidate genes and overlap with existing traits at discovered susceptibility loci. Polygenic risk scores (PRS) were tested within an independent validation cohort (1 666 LC patients vs 6 664 controls) using variants selected from the LC susceptibility loci and a novel selection approach using published GWAS summary statistics. Finally, the effects of the LC PRS on somatic mutational burden were explored in patients whose tumor resections have been profiled by exome (n = 685) and genome sequencing (n = 61). Statistical tests were 2-sided.

Results

The GWAx–GWAS meta-analysis identified 8 novel LC loci. Colocalization implicated DNA repair genes (CHEK1), metabolic genes (CYP1A1), and smoking propensity genes (CHRNA4 and CHRNB2). PRS analysis demonstrated that these variants, as well as subgenome-wide significant variants related to expression quantitative trait loci and/or smoking propensity, assisted in LC genetic risk prediction (odds ratio = 1.37, 95% confidence interval = 1.29 to 1.45; P < .001). Patients with higher genetic PRS loads of smoking-related variants tended to have higher mutation burdens in their lung tumors.

Conclusions

This study has expanded the number of LC susceptibility loci and provided insights into the molecular mechanisms by which these susceptibility variants contribute to LC development.
Power in the Post-Civil War Period: The Effect of Armed Conflict and Gender Quotas on Women in Political Leadership Positions
Authors: Meyer Cosima , Bolin Britt
Published: April 2022

While research has shown that civil wars often significantly increase women's representation in politics, we know little about the long-term effect on women holding political leadership positions in post-civil war countries. We develop a new theoretical approach to explain how quotas affect women's long-term representation in post-civil war governments. We observe a higher share of women in cabinets after the end of civil wars. We argue that the interaction of civil wars and gender quotas that provide a legal framework for a certain share of women in political office makes it especially likely that women can retain long-term political power. In contrast, the effect on women's leadership over time is smaller in post-civil war countries without a quota. Utilizing a novel data set of female executive-branch leaders in sub-Saharan African countries from 2001 to 2018, we empirically test whether women in post-civil war countries have managed to gain a long-term hold on the progress they made in representation. Our findings show that for cabinet positions, the interplay of gender quota and civil war explains female political leaders’ longevity in post-civil war countries. This research has implications for understanding post-civil war situations and the conditions under which women retain political power.
NASP maintains histone H3–H4 homeostasis through two distinct H3 binding modes
Authors: Bao Hongyu , Carraro Massimo , Flury Valentin , Liu Yanhong , Luo Min , Chen Liu , Groth Anja , Huang Hongda
Published: April 2022

Histone chaperones regulate all aspects of histone metabolism. NASP is a major histone chaperone for H3–H4 dimers critical for preventing histone degradation. Here, we identify two distinct histone binding modes of NASP and reveal how they cooperate to ensure histone H3–H4 supply. We determine the structures of a sNASP dimer, a complex of a sNASP dimer with two H3 α3 peptides, and the sNASP–H3–H4–ASF1b co-chaperone complex. This captures distinct functionalities of NASP and identifies two distinct binding modes involving the H3 α3 helix and the H3 αN region, respectively. Functional studies demonstrate the H3 αN-interaction represents the major binding mode of NASP in cells and shielding of the H3 αN region by NASP is essential in maintaining the H3–H4 histone soluble pool. In conclusion, our studies uncover the molecular basis of NASP as a major H3–H4 chaperone in guarding histone homeostasis.
Rethinking Literacy in Rural England, 1550–1700
Authors: Hailwood Mark
Published: April 2022

Historians have long been accustomed to viewing ordinary men and women in the early modern English countryside as illiterate. They are thought to have had neither the opportunity nor the desire to acquire reading and writing skills that were superfluous to their everyday lives. This article challenges such a view. It draws on a sample of signed legal testimonies from the rural south-west of England, and pays particular attention to the different types of mark that deponents made. These marks have conventionally been treated as indicators of illiteracy. In fact, they reveal the existence of a hierarchy of writing skills, and widespread pen competency across social class and gender. This leads to a reassessment of how and why literacy skills might have been obtained by ordinary people. What emerges is that basic forms of literacy — the ability to make meaningful shapes with a pen, and the capacity to decipher individual letters — were both easy to pick up and of considerable utility when navigating the challenges of everyday rural life. The term ‘illiterate’ fails to do justice to this resourceful rural culture. The methodology deployed here could potentially be used to challenge assumptions of illiteracy in other times and places.
‘Why Stant this Word Heere’: Text, Gloss, and Voice in Hoccleve’s ‘Remonstrance to Oldcastle’
Authors: Griffiths Jane
Published: April 2022

This article is concerned with reading in Hoccleve’s ‘Remonstrance to Oldcastle’ (c. 1415), specifically with the way in which what the poem says about reading contrasts both with other aspects of Hoccleve’s advice and with the kind of reading that is encouraged by its mise-en-page. In his attempt to counter Oldcastle’s heretical beliefs, Hoccleve twice counsels against engaged, interpretative reading: first in his praise of the orthodox family who avoid textual criticism of Scripture; second in the famous passage where he advises Oldcastle to read romance rather than the Bible. The article argues that the glossing of the poem nonetheless encourages very active engagement with Hoccleve’s own text, that such engaged reading reveals his remonstrance to be directed at Henry V as much as Oldcastle, and that the programme of supposedly innocuous reading that he suggests for Oldcastle is one of the points where this is most apparent. Paying close attention both to Hoccleve’s sources and to the form in which the text appears in MS HM 111, it demonstrates that every aspect of the text begs the question that Hoccleve encourages Oldcastle not to ask: ‘Why stant this word heere?’
Fighting Rubella without Vaccines: The Danish Exception, 1941–1987
Authors: Berg Anne Hagen
Published: April 2022

In the wake of isolating the rubella (German measles) virus in 1962, laboratories in several countries set out to develop a vaccine against the teratogenic disease. Denmark chose to eliminate congenital rubella syndrome (CRS) by abortions, a strategy that differed markedly from other countries’ vaccination strategies. Danish health authorities sought to identify women entitled to therapeutic abortion and then developed a serological test with which to diagnose the presence of rubella in these women. While initially solving the problem, the Danish strategy eventually encountered other problems. This article examines the construction of rubella and CRS as problems confronting individual women in Denmark rather than as a public health challenge. Although health authorities and policymakers subsequently tried to introduce rubella vaccinations, the initially ground-breaking technology of serology tests and the institutional development established a path that proved difficult to change.
Groundbreaking new provisions in variation of BVI trusts
Authors: McKenzie Christopher
Published: April 2022

The British Virgin Islands (BVI) has enacted innovative new trust legislation which includes provisions conferring on the BVI court an additional power to vary BVI trusts. The legislation, which is unique but which was inspired by section 47 of Bermuda’s Trustee Act 1975, on which it builds, only applies to (a) those trusts that were created after the legislation took effect but only in circumstances in which the trust instruments of which have expressly “opted in” to the new statutory provision and (b) those trusts, whenever created, that were previously governed by laws of another jurisdiction but only when an election has been made to “opt in” to the relevant provisions of the statute on changing the governing law of the trust to BVI law. Significantly the legislation potentially enables the dispositive provisions of a trust to be varied without the consent of its beneficiaries, but important and necessary safeguards have been included in the new statutory provisions so that an application will only succeed if it is considered by the court to be “expedient in the circumstances then existing” to vary the trust in the manner contemplated and the statute sets out in it the factors to which the court must have regard when making the relevant determination. The new statutory provision makes the establishment of BVI trusts and changing the governing law of a trust to the BVI attractive in circumstances in which beneficiaries are, say for tax reasons, unable themselves to consent to the relevant changes. It also permits variations in circumstances in which beneficiaries with remote interests might otherwise block certain variations which would plainly be in the interests of those who would be regarded as the trust’s principal beneficiaries.
7Jazz and American Popular Culture
Authors: Danesi Marcel
Published: April 2022

The four books reviewed here deal with the role that jazz has played in the origins and evolution of American popular culture and society more generally. The common subtext is that jazz initiated a veritable cultural revolution, providing America with its first true musical art form, as well as igniting the slow process towards the acceptance of African Americans as artists and cultural innovators, becoming the musical voice of the Civil Rights Movement in the 1950s and 1960s. The starting point of this revolution is the 1920s, appropriately named the Jazz Age, when it dawned on the young people of the era, who had embraced jazz as their own, that it was possible for all Americans to live and interact with each other on an equal footing, no matter their race, gender, or background. Jazz was rejected at first by the mainstream, denounced as disruptive of American values; but it eventually spread throughout the nation’s urban centers, providing the impetus for the emergence of a new and powerful form of culture, open to one and all—a culture that has shaped America ever since. As the books under review emphasize, albeit from different perspectives, a once condemned music ironically came forth to form the aesthetic backbone of American musical art. Moreover, there would be no distinctive American popular culture without jazz—both a musical and a social movement that continues to exert its influence to this day in America and, indeed, the world. This article is divided into six sections: 1. Introduction; 2. The Jazz Age; 3. Jazz and the Civil Rights Movement; 4. The Words of the Artists; 5. The Current State; 6. Conclusion.
A Rapid Transition to Virtual Simulation: The Creation of Virtual Simulation Doulas
Authors: Vandewark Aurora , Westmorland Miller Carrie , Brumbaugh Ian , Haywood Zoe , Bearden A. Tucker
Published: April 2022

Following COVID-19-related closures of clinical and simulation learning sites, a Jesuit college of nursing made a two-week pivot from in-person to virtual clinical learning. In response, the simulation team reinvented their role to provide extensive support in the Jesuit pedagogical tradition. These self-titled “simulation doulas” removed all nonteaching tasks from faculty, remained available for questions and concerns, and became experts on the simulation platforms. The simulation doulas’ success in facilitating such rapid transition relied on remaining transparent in communication, anticipating needs, embracing adaptability, and conveying a spirit of empowerment to stakeholders.
Informal and Incidental Learning in the Clinical Learning Environment: Learning Through Complexity and Uncertainty During COVID-19
Authors: Papanagnou Dimitrios , Watkins Karen E. , Lundgren Henriette , Alcid Grace A. , Ziring Deborah , Marsick Victoria J.
Published: April 2022

In the time of the COVID-19 pandemic, where clinical environments are plagued by both uncertainty and complexity, the importance of the informal and social aspects of learning among health care teams cannot be exaggerated. While there have been attempts to better understand the nuances of informal learning in the clinical environment through descriptions of the tacit or hidden curriculum, incidental learning in medical education has only been partially captured in the research. Understood through concepts borrowed from the Cynefin conceptual framework for sensemaking, the early stages of the pandemic immersed clinical teams in complex and chaotic situations where there was no immediately apparent relationship between cause and effect. Health care teams had to act quickly amidst the chaos: they had to first act, make sense of, and respond with intentionality. Informal and incidental learning (IIL) emerged as a byproduct of acting with the tools and knowledge available in the moment. To integrate the informal, sometimes haphazard nature of emergence among health care teams, educators require an understanding of IIL. This understanding can help medical educators prepare health professions learners for the cognitive dissonance that accompanies uncertainty in clinical practice. The authors introduce IIL as an explanatory framework to describe how teams navigate complexity in the clinical learning environment and to better inform curricular development for health professions training that prepares learners for uncertainty. While further research in IIL is needed to illuminate tacit knowledge that makes learning explicit for all audiences in the health professions, there are opportunities to cultivate learners’ skills in formal curricula through various learning interventions to prime them for IIL when they enter complex clinical learning environments.
Mechanical Power during General Anesthesia and Postoperative Respiratory Failure: A Multicenter Retrospective Cohort Study
Authors: Santer Peter , Wachtendorf Luca J. , Suleiman Aiman , Houle Timothy T. , Fassbender Philipp , Costa Eduardo L. , Talmor Daniel , Eikermann Matthias , Baedorf-Kassis Elias , Schaefer Maximilian S.
Published: April 2022

Background

Mechanical power during ventilation estimates the energy delivered to the respiratory system through integrating inspiratory pressures, tidal volume, and respiratory rate into a single value. It has been linked to lung injury and mortality in the acute respiratory distress syndrome, but little evidence exists regarding whether the concept relates to lung injury in patients with healthy lungs. This study hypothesized that higher mechanical power is associated with greater postoperative respiratory failure requiring reintubation in patients undergoing general anesthesia.

Methods

In this multicenter, retrospective study, 230,767 elective, noncardiac adult surgical out- and inpatients undergoing general anesthesia between 2008 and 2018 at two academic hospital networks in Boston, Massachusetts, were included. The risk-adjusted association between the median intraoperative mechanical power, calculated from median values of tidal volume (Vt), respiratory rate (RR), positive end-expiratory pressure (PEEP), plateau pressure (Pplat), and peak inspiratory pressure (Ppeak), using the following formula: mechanical power (J/min) = 0.098 × RR × Vt × (PEEP + ½[Pplat – PEEP] + [Ppeak − Pplat]), and postoperative respiratory failure requiring reintubation within 7 days, was assessed.

Results

The median intraoperative mechanical power was 6.63 (interquartile range, 4.62 to 9.11) J/min. Postoperative respiratory failure occurred in 2,024 (0.9%) patients. The median (interquartile range) intraoperative mechanical power was higher in patients with postoperative respiratory failure than in patients without (7.67 [5.64 to 10.11] vs. 6.62 [4.62 to 9.10] J/min; P < 0.001). In adjusted analyses, a higher mechanical power was associated with greater odds of postoperative respiratory failure (adjusted odds ratio, 1.31 per 5 J/min increase; 95% CI, 1.21 to 1.42; P < 0.001). The association between mechanical power and postoperative respiratory failure was robust to additional adjustment for known drivers of ventilator-induced lung injury, including tidal volume, driving pressure, and respiratory rate, and driven by the dynamic elastic component (adjusted odds ratio, 1.35 per 5 J/min; 95% CI, 1.05 to 1.73; P = 0.02).

Conclusions

Higher mechanical power during ventilation is statistically associated with a greater risk of postoperative respiratory failure requiring reintubation.

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Impact of a Hybrid-Virtual Teaching Model on the Physical Examination Skills of Fourth-Year Medical Students
Authors: Zeldin Evan R. , Charles Stephen C. , Tumin Dmitry , Lawson Luan , Faulk Clinton , Norbury John W.
Published: April 2022

A required fourth-year advanced core Neurology-PM&R clerkship was adapted to hybrid format (2 week remote; 2 week in-person) during the COVID-19 pandemic. With teaching of the neurological physical examination being shifted to the remote component, we sought to determine whether this negatively affected student performance on an Objective Structured Clinical Examination (OSCE), particularly the physical exam component. Mean pandemic-era total OSCE scores (n = 79; 85.1 ± 7.3) were similar to pre-pandemic era (n = 137; 83.5 ± 6.0; p = 0.082). Pandemic-era physical exam scores were slightly higher than pre-pandemic (86.9 ± 6.5 vs. 84.9 ± 6.6). Despite conversion of the clerkship to a hybrid curriculum, the performance of the students on the OSCE and the physical exam were unchanged. Reasons for this lack of change may include the constructiveness and integration of the case-based virtual demonstrations combined with in-person learning or the flexibility of the virtual course to allow students more time to prepare for the OSCE and the physical exam. Our findings demonstrate that a hybrid-virtual model can be used to teach foundational skills such as the basics of the physical examination, while allowing faculty to address higher order skills such as integration of clinical data with medical knowledge.
Galeazzi Fracture-Dislocation
Authors: Ramponi Denise R.
Published: April 2022

A Galeazzi fracture-dislocation is defined as a distal radius fracture with disruption of the distal radioulnar joint (DRUJ). The typical mechanism of injury is a forceful axial load with forearm torsion, which is often seen in a fall on the out stretched hand (FOOSH). The diagnosis is made with radiographs of the distal forearm and the wrist. The diagnosis can often be missed because ligament disruption of the distal radioulnar joint (DRUJ) can be overlooked. Treatment in children is usually nonsurgical with closed reduction and long arm cast. Adult treatment is usually open reduction and internal fixation. Complications can result in disability and include malunion, limited range of motion of the forearm, chronic pain, DRUJ instability, and osteoarthritis.
Contrasting effects of human settlement on the interaction among sympatric apex carnivores
Authors: Penjor Ugyen , Astaras Christos , Cushman Samuel A. , Kaszta Żaneta , Macdonald David W.
Published: April 2022

In the face of a growing human footprint, understanding interactions among threatened large carnivores is fundamental to effectively mitigating anthropogenic threats and managing species. Using data from a large-scale camera trap survey, we investigated the effects of environmental and anthropogenic variables on the interspecific interaction of a carnivore guild comprising of tiger, leopard and dhole in Bhutan. We demonstrate the complex effects of human settlement density on large carnivore interactions. Specifically, we demonstrate that leopard–dhole co-occupancy probability was higher in areas with higher human settlement density. The opposite was true for tiger–leopard co-occupancy probability, but it was positively affected by large prey (gaur) abundance. These findings suggest that multi-carnivore communities across land-use gradients are spatially structured and mediated also by human presence and/or the availability of natural prey. Our findings show that space-use patterns are driven by a combination of the behavioural mechanism of each species and its interactions with competing species. The duality of the effect of settlement density on species interactions suggests that the benefits of exploiting anthropogenic environments are a trade-off between ecological opportunity (food subsidies or easy prey) and the risk of escalating conflict with humans.
Seroprevalence of Helicobacter pylori among dyspeptic patients in northern Lebanon: a 6-year retrospective study in two tertiary hospitals
Authors: Ismail Mohamad Bachar , Osman Marwan , Bou Raad Elie , Achkar Marcel , Hamze Monzer
Published: April 2022

Helicobacter pylori

causes chronic gastritis and plays a significant role in duodenal/gastric ulcer disease and gastric cancer. Its prevalence varies among different populations and geographical areas. Here, in a hospital-based retrospective study, we investigated the seroprevalence of

H. pylori

infection in northern Lebanon. We examined the records of 4000 consecutive dyspeptic patients attending 2 tertiary care centres in the North (Tripoli) and Akkar (Halba) governorates. Seropositivity for

H. pylori

was determined using enzyme immunoassays investigating specific anti-

H. pylori

IgG antibodies. The association of infection with the available patients’ demographic characteristics was also evaluated. The mean age of our study population was 36.9±16.6 years. With 2486 female and 1514 male subjects, the overall female/male ratio was 1.64. In total,

H. pylori

seropositivity was detected in 1367/4000 (34.2 %) tested individuals. The multivariate logistic regression analysis showed that

H. pylori

infection is less prevalent in female than in male examined patients [adjusted odds ratio (OR): 0.84; 95 % confidence interval (CI): 0.73–0.96; P<0.013]. Seroprevalence gradually increased with age – from 14.6 % in patients below 18 years to 42.9 % in those above 49 years – and was significantly higher among Akkar patients compared to those from the North governorate: 49.6 versus 28.7 %, respectively (P<0.001). Overall, a third of symptomatic patients in northern Lebanon are infected with

H. pylori

. However, the prevalence of infection was markedly different in close geographical zones in this region. Additional screening studies using different screening methods are needed in the future to determine the accurate prevalence of this bacterium and its clinical implications to establish efficient national intervention strategies.
Uropathogenic Escherichia coli can cause cystitis at extremely low inocula in a pig model
Authors: Stærk Kristian , Andersen Morten Østergaard , Andersen Thomas Emil
Published: April 2022

Urinary tract infection (UTI) is one of the most common bacterial infections worldwide. Experimental models that accurately reflect the high susceptibility to UTI in humans have, however, been lacking. This situation has limited detailed research into the early bladder colonization by uropathogens and the early innate defence mechanisms elicited to prevent this. We recently presented a model of urinary tract infection in pigs, animals that are naturally susceptible to UTI and have greater similarity to the physiology and anatomy of the human urinary tract than traditional rodent UTI models. In the current study, we used the pig model to investigate the minimal infectious inoculum of uropathogenic

Escherichia coli

, the most common cause of urinary tract infection. We show that in this animal a few individual bacteria that come into contact with the urothelium can give rise to fulminant cystitis, indicating the high infectious potential of uropathogenic

E. coli

.
Towards extreme learning machine framework for lane detection on unmanned mobile robot
Authors: Dai Yingpeng , Li Jiehao , Wang Junzheng , Li Jing , Liu Xu
Published: April 2022

Purpose

This paper aims to focus on lane detection of unmanned mobile robots. For the mobile robot, it is undesirable to spend lots of time detecting the lane. So quickly detecting the lane in a complex environment such as poor illumination and shadows becomes a challenge.

Design/methodology/approach

A new learning framework based on an integration of extreme learning machine (ELM) and an inception structure named multiscale ELM is proposed, making full use of the advantages that ELM has faster convergence and convolutional neural network could extract local features in different scales. The proposed architecture is divided into two main components: self-taught feature extraction by ELM with the convolution layer and bottom-up information classification based on the feature constraint. To overcome the disadvantages of poor performance under complex conditions such as shadows and illumination, this paper mainly solves four problems: local features learning: replaced the fully connected layer, the convolutional layer is used to extract local features; feature extraction in different scales: the integration of ELM and inception structure improves the parameters learning speed, but it also achieves spatial interactivity in different scales; and the validity of the training database: a method how to find a training data set is proposed.

Findings

Experimental results on various data sets reveal that the proposed algorithm effectively improves performance under complex conditions. In the actual environment, experimental results tested by the robot platform named BIT-NAZA show that the proposed algorithm achieves better performance and reliability.

Originality/value

This research can provide a theoretical and engineering basis for lane detection on unmanned robots.
Numerical procedure for the simulation of an electro-thermal anti-icing system
Authors: Carozza Antonio , Petrosino Francesco , Mingione Giuseppe
Published: April 2022

Purpose

This study aims to couple two codes, one able to perform icing simulations and another one capable to simulate the performance of an electrothermal anti-icing system in an integrated fashion.

Design/methodology/approach

The classical tool chain of icing simulation (aerodynamics, water catch and impact, mass and energy surface balance) is coupled to the thermal analysis through the surface substrate and the ice thickness. In the present approach, the ice protection simulation is not decoupled from the ice accretion simulation, but a single computational workflow is considered.

Findings

A fast approach to simulate advanced anti-icing systems is found in this study.

Originality/value

This study shows the validation of present procedure against literature data, both experimental and numerical.
The impact of the adoption of international accounting and auditing standards on corruption perception
Authors: Kurniawati Elisabeth Penti , Achjari Didi
Published: April 2022

Purpose

This study aims to investigate the impact of the adoption of international accounting and auditing standards on corruption perception. In addition, this study examines the strength of auditing and reporting standards (SARS) that mediate the relationship.

Design/methodology/approach

Agency theory and bonding theory were applied in this paper to investigate the impact of the adoption of international accounting and auditing standards on corruption perception. Data from 130 countries during three years were collected from Transparency International, Worldwide Governance Indicators, International Federation of Accountants, World Economic Forum, World Bank, Freedom House and World Justice Project. Hypotheses were tested using partial least squares structural equation modeling.

Findings

The results show a positive impact of the adoption of international accounting and auditing standards on corruption perception, directly and indirectly, through the SARS.

Practical implications

The results provide an insight into corruption eradication strategy through the adoption of international accounting and auditing standards and strengthen the auditing and reporting standards.

Originality/value

This study is distinctive, as no study has yet examined the impact of the adoption of international accounting standards construct, which contains International Financial Reporting Standards and International Standards on Auditing, on the corruption perception. The corruption perception construct is developed by combining the corruption perception index and the control of corruption indicators.
COVID-19 full vaccination and blockchain size: empirical evidence from the cryptocurrency market
Authors: Havidz Shinta Amalina Hazrati , Tiffani Tiffani , Calvilus Ingrid Claudia , Angelita Zefanya
Published: April 2022

Purpose

This paper aims to analyse COVID-19 indices and blockchain features on Bitcoin and Ethereum returns, respectively. The authors focus on the most used and owned cryptocurrencies that cover Europe, the US and Asian countries.

Design/methodology/approach

An autoregressive distributed lag panel (pooled mean group and mean group) is utilized, and a robustness check is incorporated by using a Random Effect Model and Generalized Method of Moments (GMM).

Findings

Four new findings were discovered, including (1) the vaccine confidence index (VCI) pushes economic recovery and increased demand for the Bitcoin market, but the opposite result was interestingly observed from Ethereum; (2) the blockchain features were revealed to be essential to Bitcoin, while they were irrelevant to Ethereum for short-run country-specific results; (3) the hash rate and network difficulty moved inversely during the pandemic; and (4) the government played a significant role in taking action during uncertain times and regarding cryptocurrency policies.

Research limitations/implications

VCI is constructed by the most used vaccine type in our sample countries (i.e. Pfizer), as the data for a specific classification by each type is still unavailable.

Practical implications

Providing an evenly distributed vaccination program primary vaccination series against COVID-19 to the citizens is an essential duty of the government. Bitcoin policymakers and investors should watch the COVID-19 vaccine distributions closely as it will affect its return. Ethereum is emphasized to keep developing its smart contract which appeared to outplay other blockchain features. Cryptocurrency investors should be wise in their investment decisions by analysing the news thoroughly.

Social implications

This research emphasizes that the success in the roll-out of COVID-19 vaccination requires citizens' willingness to participate and their trust in the vaccine's efficacy. Such self-awareness and self-discipline in society can ultimately empower individuals and stabilise the economy. Nevertheless, the implementation of health protocols is still highly required to prevent the spread of new variants of COVID-19.

Originality/value

This is the first study that attempts to construct a VCI which denotes the confidence derived from the administration of full-dose COVID-19 vaccines (an initial vaccine and a second vaccine). The authors further find the impact on cryptocurrency returns. Next, blockchain size is utilized as a new determinant of cryptocurrencies.