bluuebunny/crossref_metadata_2025 huggingface dataset:
The multivariable prognostic models for severe complications after heart valve surgery
Authors: Liu Yunqi , Xiao Jiefei , Duan Xiaoying , Lu Xingwei , Gong Xin , Chen Jiantao , Xiong Mai , Yin Shengli , Guo Xiaobo , Wu Zhongkai
Published: October 2021

Background

To provide multivariable prognostic models for severe complications prediction after heart valve surgery, including low cardiac output syndrome (LCOS), acute kidney injury requiring hemodialysis (AKI-rH) and multiple organ dysfunction syndrome (MODS).

Methods

We developed multivariate logistic regression models to predict severe complications after heart valve surgery using 930 patients collected retrospectively from the first affiliated hospital of Sun Yat-Sen University from January 2014 to December 2015. The validation was conducted using a retrospective dataset of 713 patients from the same hospital from January 2016 to March 2017. We considered two kinds of prognostic models: the PRF models which were built by using the preoperative risk factors only, and the PIRF models which were built by using both of the preoperative and intraoperative risk factors. The least absolute shrinkage selector operator was used for developing the models. We assessed and compared the discriminative abilities for both of the PRF and PIRF models via the receiver operating characteristic (ROC) curve.

Results

Compared with the PRF models, the PIRF modes selected additional intraoperative factors, such as auxiliary cardiopulmonary bypass time and combined tricuspid valve replacement. Area under the ROC curves (AUCs) of PRF models for predicting LCOS, AKI-rH and MODS are 0.565 (0.466, 0.664), 0.688 (0.62, 0.757) and 0.657 (0.563, 0.751), respectively. As a comparison, the AUCs of the PIRF models for predicting LOCS, AKI-rH and MODS are 0.821 (0.747, 0.896), 0.78 (0.717, 0.843) and 0.774 (0.7, 0.847), respectively.

Conclusions

Adding the intraoperative factors can increase the predictive power of the prognostic models for severe complications prediction after heart valve surgery.
Self-management of social well-being in a cross-sectional study among community-dwelling older adults: The added value of digital participation
Authors: Scheffer Mariska MJ , Menting Juliane , Boeije Hennie R
Published: October 2021

Background

This study aimed to examine associations between self-management abilities and digital participation among community-dwelling older adults with chronic conditions in the Netherlands.

Methods

The study utilized a cross-sectional design. Community-dwelling older adults were sampled from a Dutch nationwide panel study performed in October and November of 2019. We selected all adults of 65 years and above who had one or more chronic diseases (n = 1,656). Self-management was measured by six abilities (e.g., investing in resources for long-term benefits and taking care of a variety of resources), whereas digital participation was estimated with the frequency of four social internet uses (e.g., using social network websites and calling digitally).

Results

When predicting self-management abilities from digital participation, hierarchical multiple regression analysis determined statistically significant and positive relationships, in particular for e-mailing (β = 0.21; p < .001) and meeting new people online (β = 0.07; p < .05). Correlation analyses showed that highest associations were found between internet usage and the self-management abilities ‘taking initiative’ (r = .23; p < .001) and ‘being self-efficacious’ (r = .21; p < .001). Moreover, the study confirmed that higher age (β = -0.13; p < .001) and increased severity of disability (β = -0.12; p < .01) negatively impact abilities for self-management.

Conclusions

These findings suggest that internet usage and self-management abilities are positively related in the older adult population. Further research should be undertaken to examine the links between self-management abilities and digital participation more closely.
COVID-19 hotspots through clusters analysis in France (may–October 2020): where should we track the virus to mitigate the spread?
Authors: Spaccaferri Guillaume , Calba Clémentine , Vilain Pascal , Garras Loïc , Durand Cécile , Pilorget Corinne , Atiki Nahida , Bernillon Pascale , Bosc Laëtitia , Fougère Erica , Hanon Jean-Baptiste , Henry Valérie , Huchet-Kervella Caroline , Martel Mélanie , Pontiès Valérie , Mouly Damien , Rolland du Roscoat Enguerrand , Le Vu Stéphane , Desenclos Jean-Claude , Laporte Anne ,   Regional MONIC group, Rolland Patrick
Published: October 2021

Background

In France, the lifting of the lockdown implemented to control the COVID-19 first wave in 2020 was followed by a reinforced contact-tracing (CT) strategy for the early detection of cases and transmission chains. We developed a reporting system of clusters defined as at least three COVID-19 cases, within seven days and belonging to the same community or having participated in the same gathering, whether they know each other or not. The aim of this study was to describe the typology and criticality of clusters reported between the two lockdowns in France to guide future action prioritisation.

Methods

In this study we describe the typology and criticality of COVID-19 clusters between the two lockdowns implemented in France (between May and end of October 2020). Clusters were registered in a national database named “MONIC” (MONItoring des Clusters), established in May 2020. This surveillance system identified the most affected communities in a timely manner. A level of criticality was defined for each cluster to take into consideration the risk of spreading within and outside the community of occurrence, and the health impact within the community. We compared the level of criticality according to the type of community in which the cluster occurred using Pearson’s chi-square tests.

Results

A total of 7236 clusters were reported over the study period, particularly in occupational environment (25.1%, n = 1813), elderly care structures (21.9%, n = 1586), and educational establishments (15.9%, n = 1154). We show a shift over time of the most affected communities in terms of number of clusters. Clusters reported in occupational environment and the personal sphere had increased during summer while clusters reported in educational environment increased after the start of the school year. This trend mirrors change of transmission pattern overtime according to social contacts. Among all reported clusters, 43.1% had a high level of criticality with significant differences between communities (p < 0.0001). A majority of clusters had a high level of criticality in elderly care structures (82.2%), in disability care centres (56.6%), and health care facilities (51.7%).

Conclusion

These results highlight the importance of targeting public health action based on timely sustained investigations, testing capacity and targeted awareness campaigns. The emergence of new SARS-CoV-2 variants strengthen these public health recommendations and the need for rapid and prioritise vaccination campaigns.
Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren
Authors: Zhao Dantong , Zhou Zhongliang , Shen Chi , Ibrahim Sahardid , Zhao Yaxin , Cao Dan , Lai Sha
Published: October 2021

Background

Caring for grandchildren is regarded as one of the principle roles of middle- and old-aged adults, especially among rural Chinese grandparents. This study aims to examine the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren, based on the gender differences in grandparental role engagement and the theories of role strain and role enhancement.

Methods

A total of 4833 rural citizens with one or more grandchildren were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Grandchild care was measured by continuous variable (duration) and categorical variable (no care, low intensity, moderate intensity, high intensity). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). We used coarsened exact matching (CEM) to balance the covariates of caregivers and non-caregivers. Following CEM, 1975 non-caregivers and 2212 caregivers were identified (N = 4187). Multilevel linear regression was employed to examine the gender differences in depressive symptoms. We also tested for the moderating role of gender on the association between grandchild care and depressive symptoms.

Results

Grandmothers were more likely to provide grandchild care (54.42% vs 51.43%) at high intensity (61.46% vs 51.01%), with longer duration (39.24 h vs 33.15 h) than that given by grandfathers. Grandmothers suffered more from depressive symptoms than grandfathers, and such gap increased when grandparents were involved in high-intensity care. Grandmothers providing grandchild care, particularly at moderate intensity, were associated with fewer depressive symptoms (Coef. = − 0.087, 95%CI: − 0.163, − 0.010; Coef. = − 0.291, 95%CI: − 0.435, − 0.147), compared with non-caregivers. Grandmothers giving moderate intensity of grandchild care were also associated with fewer depressive symptoms (Coef. = − 0.171, 95% CI: − 0.313, − 0.029), compared with those with low-intensity care. However, such associations were not significant among grandfathers.

Conclusions

Our findings highlight the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. Grandparents should be encouraged to engage in grandchild care, but at moderate intensity. The health status of middle- and old-aged adults, particularly females, should be monitored closely. Humanistic care, preventive care and curative treatment strategies focusing on such populations should be developed and refined.
Differences in genetics and microenvironment of lung adenocarcinoma patients with or without TP53 mutation
Authors: Zeng Dejun , Hu Zhengyang , Yi Yanjun , Valeria Besskaya , Shan Guangyao , Chen Zhencong , Zhan Cheng , Lin Miao , Lin Zongwu , Wang Qun
Published: October 2021

Background

Differences in genetics and microenvironment of LUAD patients with or without TP53 mutation were analyzed to illustrate the role of TP53 mutation within the carcinogenesis of LUAD, which will provide new concepts for the treatment of LUAD.

Methods

In this study, we used genetics and clinical info from the TCGA database, including somatic mutations data, RNA-seq, miRNA-seq, and clinical data. More than one bioinformatics tools were used to analyze the unique genomic pattern of TP53-related LUAD.

Results

According to TP53 gene mutation status, we divided the LUAD patients into two groups, including 265 in the mutant group (MU) and 295 in the wild-type group (WT). 787 significant somatic mutations were detected between the groups, including mutations in titin (TTN), type 2 ryanodine receptor (RYR2) and CUB and Sushi multiple domains 3(CSMD3), which were up-regulated in the MU. However, no significant survival difference was observed. At the RNA level, we obtained 923 significantly differentially expressed genes; in the MU, α-defensin 5(DEFA5), pregnancy-specific glycoprotein 5(PSG5) and neuropeptide Y(NPY) were the most up-regulated genes, glucose-6-phosphatase (G6PC), alpha-fetoprotein (AFP) and carry gametocidal (GC) were the most down-regulated genes. GSVA analysis revealed 30 significant pathways. Compared with the WT, the expression of 12 pathways in the mutant group was up-regulated, most of which pointed to cell division. There were significant differences in tumor immune infiltrating cells, such as Macrophages M1, T cells CD4 memory activated, Mast cells resting, and Dendritic cells resting. In terms of immune genes, a total of 35 immune-related genes were screened, of which VGF (VGF nerve growth factor inducible) and PGC (peroxisome proliferator-activated receptor gamma coactivator) were the most significant up-regulated and down-regulated genes, respectively. Research on the expression pattern of immunomodulators found that 9 immune checkpoint molecules and 6 immune costimulatory molecules were considerably wholly different between the two groups.

Conclusions

Taking the mutant group as a reference, LUAD patients in the mutant group had significant differences in somatic mutations, mRNA-seq, miRNA-seq, immune infiltration, and immunomodulators, indicating that TP53 mutation plays a crucial role in the occurrence and development of LUAD.
Factors associated with mortality in rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis
Authors: Qiu Meihua , Jiang Jing , Nian Xueyuan , Wang Yutie , Yu Pengfei , Song Jie , Zou Shenchun
Published: October 2021

Background

Interstitial lung disease (ILD) is a common and potentially life-threatening complication for rheumatoid arthritis (RA) patients. However, there is a lack of clear prognostic factors in rheumatoid arthritis-associated interstitial lung disease (RA-ILD) patients. The purpose of this study was to complete a systematic review and meta-analysis of the factors associated with mortality in RA-ILD patients.

Methods

Medline, EMBASE and the Cochrane Library were searched up to September 1, 2020. The Newcastle–Ottawa Scale (NOS) was applied to assess the methodological quality of the eligible studies. Study characteristics and magnitude of effect sizes were extracted. Then, pooled hazard ratios (HRs) with the corresponding 95% confidence intervals (CIs) and pooled risk ratios (RRs) with 95% CIs were calculated to assess the factors associated with mortality in RA-ILD.

Results

Twenty-three of 3463 articles were eligible, and ten factors associated with mortality for RA-ILD were evaluated in the meta-analysis. Older age (HRs = 1.04, 95% CI 1.03–1.05), male sex (HRs = 1.44, 95% CI 1.21–1.73), having a smoking history (HRs = 1.42, 95% CI 1.03–1.96), lower diffusing capacity of the lung for carbon monoxide (DLCO)% predicted (HRs = 0.98, 95% CI 0.97–1.00), forced vital capacity (FVC)% predicted (HRs = 0.99, 95% CI 0.98–1.00), composite physiological index (CPI) (HRs = 1.04, 95% CI 1.02–1.06), usual interstitial pneumonia (UIP) pattern on HRCT (HRs = 1.88, 95% CI 1.14–3.10 and RRs = 1.90, 95% CI 1.50–2.39), emphysema presence (HRs = 2.31, 95% CI 1.58–3.39), and acute exacerbation of ILD (HRs = 2.70, 95% CI 1.67–4.36) were associated with increased mortality in RA-ILD, whereas rheumatoid factor (RF) positive status was not associated.

Conclusions

Through this systematic review and meta-analysis, we found that older age, male sex, smoking history, higher CPI, lower DLCO% predicted, lower FVC% predicted, UIP pattern on HRCT, emphysema presence and acute exacerbation of ILD were associated with an increased risk of mortality in RA-ILD.
Lymph node metastasis pattern and significance of left gastric artery lymph node dissection in esophagectomy for esophageal cancers
Authors: Deng Xiu-Mei , Zhu Tian-Yu , Wang Guo-Jun , Gao Bu-Lang , Wang Jing-Tao , Li Rui-Xin , Zhang Yun-Fei , Ding Heng-Xuan
Published: October 2021

Purpose

To investigate the lymph node metastasis pattern and significance of dissection of the left gastric artery lymph nodes in radical en bloc esophagectomy for esophageal squamous carcinomas based on the lymphatic drainage pathway revealed by carbon nanoparticle labeling.

Materials and methods

Patients who underwent en bloc esophagectomy endoscopically were retrospectively enrolled. Carbon nanoparticles were injected in the submucosa of upper thoracic esophagus to label the relevant draining lymph nodes. The clinical data, lymph nodes dissected, surgical technique, and complications were analyzed.

Results

En bloc esophagectomy was successful in all 179 patients. Metastases to the left gastric artery lymph nodes were positive in 42 patients (23.5%) but negative in 137 (76.5%). The left gastric lymph nodes were labeled, whereas no celiac lymph nodes were labeled by carbon nanoparticles. A total of 4652 lymph nodes were resected, with 26 lymph nodes per patient. Seventy-three patients had lymph node metastasis (73/179). Seventeen patients had metastasis to the recurrent laryngeal nerve lymph nodes (9.5%). The metastasis rate of the lower thoracic esophageal cancer to the left gastric artery lymph nodes was 37.0%, significantly greater than that at the middle (15.4%) or upper (6.7%) thoracic segment. The lymph node metastasis rate was significantly (P < 0.05) increased with the length of the cancerous lesion, infiltration depth, and poor differentiation. Univariate analysis revealed that the metastasis rate to the left gastric artery lymph nodes was significantly (P < 0.05) associated with paraesophageal lymph node metastasis, para-cardial lymph metastasis, and TNM classification. Multivariate analysis indicated that cancer location (odds ratio 8.32, 95% confidence interval 2.12–32.24) was significantly (P < 0.05) associated with metastasis to the left gastric artery lymph nodes, with the cancer at the middle and lower thoracic segments significantly more than in the upper thoracic segment.

Conclusion

Certain patterns exist in lymph node metastasis of esophageal cancer, and in radical esophagectomy of esophageal cancers, dissection of the left gastric artery lymph nodes is necessary to prevent possible residual or metastasis of esophageal squamous carcinomas based on the lymphatic drainage pathway of esophageal carcinomas demonstrated by carbon nanoparticle labeling.
Recent advances in immunoassays and biosensors for mycotoxins detection in feedstuffs and foods
Authors: Li Runxian , Wen Yang , Wang Fenglai , He Pingli
Published: October 2021

Mycotoxins are secondary metabolites produced by fungus. Many mycotoxin species are highly toxic and are frequently found in cereals and feedstuffs. So, powerful detection methods are vital and effective ways to prevent feed contamination. Traditional detection methods can no longer meet the needs of massive, real-time, simple, and fast mycotoxin monitoring. Rapid detection methods based on advanced material and sensor technology are the future trend. In this review, we highlight recent progress of mycotoxin rapid detection strategies in feedstuffs and foods, especially for simultaneous multiplex mycotoxin determination. Immunoassays, biosensors, and the prominent roles of nanomaterials are introduced. The principles of different types of recognition and signal transduction are explained, and the merits and pitfalls of these methods are compared. Furthermore, limitations and challenges of existing rapid sensing strategies and perspectives of future research are discussed.
Seismic microzonation of a region with complex surficial geology based on different site classification approaches
Authors: Salsabili Mohammad , Saeidi Ali , Rouleau Alain , Nastev Miroslav
Published: October 2021

A seismic microzonation study was conducted to refine the seismic hazard model for the city of Saguenay, Canada. The Quaternary geology underlying Saguenay shows complex glacial and post-glacial stratigraphy with a number of buried valleys filled with fluvioglacial and glaciomarine sediments. High impedance contrast between rock formations and surficial sediments is prone to seismic amplification. To evaluate their applicability, advantages and limitations in capturing the geological specificity of the study area, four site classification methods were applied: the current National Building Code of Canada (NBCC) and Eurocode 8, both mainly based on the average shear-wave velocity for the surficial sediments (VS,avg) and for the top 30 m (VS,30); a method based on the fundamental site period (T0); and a hybrid method based on the combination of VS,30, T0 and VS,avg. The study specifically aimed to evaluate the importance of the site classification parameters on the resulting microzonation maps. VS,30 is capable to present the geological and geotechnical site conditions, however, the results may be further improved by considering Vs,avg in shallow and T0 in thick layers of soil sediments as secondary parameters. The T0 method gives also satisfactory results with T0 showing a better correlation to Vs,30 than to Vs,avg. The versatile hybrid method may be challenging to apply in certain cases with its nine different site categories and parameters.
Person authentication based on eye-closed and visual stimulation using EEG signals
Authors: Yap Hui Yen , Choo Yun-Huoy , Mohd Yusoh Zeratul Izzah , Khoh Wee How
Published: October 2021

The study of Electroencephalogram (EEG)-based biometric has gained the attention of researchers due to the neurons’ unique electrical activity representation of an individual. However, the practical application of EEG-based biometrics is not currently widespread and there are some challenges to its implementation. Nowadays, the evaluation of a biometric system is user driven. Usability is one of the concerning issues that determine the success of the system. The basic elements of the usability of a biometric system are effectiveness, efficiency and user satisfaction. Apart from the mandatory consideration of the biometric system’s performance, users also need an easy-to-use and easy-to-learn authentication system. Thus, to satisfy these user requirements, this paper proposes a reasonable acquisition period and employs a consumer-grade EEG device to authenticate an individual to identify the performances of two acquisition protocols: eyes-closed (EC) and visual stimulation. A self-collected database of eight subjects was utilized in the analysis. The recording process was divided into two sessions, which were the morning and afternoon sessions. In each session, the subject was requested to perform two different tasks: EC and visual stimulation. The pairwise correlation of the preprocessed EEG signals of each electrode channel was determined and a feature vector was formed. Support vector machine (SVM) was then used for classification purposes. In the performance analysis, promising results were obtained, where EC protocol achieved an accuracy performance of 83.70–96.42% while visual stimulation protocol attained an accuracy performance of 87.64–99.06%. These results have demonstrated the feasibility and reliability of our acquisition protocols with consumer-grade EEG devices.
What has the COVID-19 pandemic taught us about conducting patient and public involvement remotely? Insights from a series of digital meeting observations
Authors: Lampa Elin , Sonnentheil Björn , Tökés Antónia , Warner Georgina
Published: October 2021

Background

During the COVID-19 pandemic many work tasks are being done remotely through digital meetings, including PPI in research. Yet, some PPI activities have been paused or cancelled altogether during the pandemic. In this commentary, we share our insights from observing digital meetings with researchers and public contributors, representing vulnerable groups. Additionally, we discuss how remote PPI activities can be understood and improved.

Main body

As part of a PPI evaluation project, live observations were conducted by two trained observers, using a semi‐structured observation protocol developed to objectively assess aspects of group dynamics in PPI research meetings with public contributors with experience of seeking refuge and parents facing economic hardship. This project’s data collection is ongoing and the insights in this commentary is based on the observers’ discussion. We discuss these insights through the lens of the Media Richness Theory, stating that the choice of media we communicate through should be guided by what kind of information we want to communicate to each other. The more complex the information is, the richer the media tool needs to be. For example, information in a text message is more easily misinterpreted than information given in person. This is because meeting in person gives us more information, for example through body language and tone of voice. Based on our experiences from observing digital research meetings, we give suggestions on how to improve digital meetings with public contributors. A few key points are: actively choosing which media to use; being prepared to guide contributors to the chosen media in a way that is suitable for them; and the increased importance of the person chairing the meeting to actively include all participants.

Conclusions

We reach the conclusion that digital meetings with public contributors is possible, but that researchers need to make a commitment and actively work to solve practical issues. Finally, the format and structure of digital meetings should be co-created together with public contributors.
Diagnostic retinal biopsy in the management of secondary non-CNS vitreoretinal lymphoma masquerading as viral retinitis: a case report
Authors: Rali Aditya , Xu Lucy T. , Craven Caroline , Cohen Jonathon B. , Yeh Steven , Grossniklaus Hans E. , O’Keefe Ghazala D.
Published: October 2021

Background

Intraocular lymphoma accounts for fewer than 1% of intraocular tumors. When the posterior segment is involved, it can be further classified as vitreoretinal or choroidal lymphoma. Vitreoretinal lymphoma (VRL) can rarely masquerade as an infectious retinitis making diagnosis and management challenging.

Results

A 73-year-old woman with a history of non-central nervous system (CNS) involving diffuse large B-cell lymphoma (DLBCL) was referred for worsening blurry vision—visual acuity of count figures at 2 ft—in her right eye for 8 months. Dilated fundus examination of the right eye was significant for retinal whitening and dot-blot hemorrhages, which was concerning for a viral retinitis and guided initial management. Secondary intraocular lymphoma was also considered. The retinal disease continued to progress despite intravitreal and systemic antiviral therapy, and a diagnostic vitrectomy was inconclusive. A retinal biopsy was then performed, which showed DLBCL, confirming a diagnosis of secondary VRL. Three subsequent treatments with intravitreal methotrexate led to regression of the VRL.

Conclusions

Our case highlights the utility of a retinal biopsy after an inconclusive diagnostic vitrectomy in a challenging scenario of VRL to establish a diagnosis and initiate successful treatment. A multidisciplinary team of providers was essential for diagnosis, comprehensive workup, medical and surgical management of the patient.
Post-COVID depression among a sample of Egyptian patients and its associated factors
Authors: Ezzelregal Hieba Gamal , Hassan Azza Mohammed , Mohamed Rehab Serag , Ahmed Noha Othman
Published: October 2021

Background

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities. Nowadays, we are in COVID-19 pandemic. From practice after COVID-19 illness resolves, some of the recovering patients return back smoothly to their pre-illness life. Others experience different mood changes. Anxiety and depression are the most common. Those patients with improving general health, radiology, and oxygenation have different somatic complaints such as sensation of dyspnoea. Psychological support and psychiatric evaluation can help them to overcome this situation and get rid of dyspnoea sensation. This work aimed to evaluate the relation between COVID-19 survivors and depression and to how extent this could affect functional status of the study participants.

Results

This work recruited 102 adult patients as a sample of Egyptians who were positive PCR for SARS-COV2, turned negative and free of symptoms for 1 month or more which include physicians, nurses, employees, and literate health care workers of Ain Shams University hospitals attending chest outpatient clinic for follow-up. The majority were 47.1% in age group (35–55 years), sixty two (60.8%) participants were females, 74.5% had high education, and 24.5% were smokers. The most frequent symptom reported by study participants as the most annoying COVID-19 symptom was fever (32.4%). Beck depression inventory score showed that 59 (57.8%) participants had no depression, 24 (23.5%) had mild depression, 16 (15.7%) had moderate depression, and only 3 (2.9%) participants had severe depression. Logistic regression analysis was done to measure effect of steroid use and grade of dyspnoea on development of moderate or severe post-COVID depression and showed that higher grades of dyspnoea were associated with higher probability of development of moderate or severe post-COVID depression (p value < 0.05).

Conclusion

As predicted, COVID-19 survivors presented a high prevalence of psychiatric sequelae. Age, sex, and education level were important association factors. Higher educational level was associated with higher score of depression due to increased awareness of the current pandemic issue. Steroids’ use was proposed as a cause of depression since the majority of moderate or severe depression group were on steroids. Higher grades of dyspnoea were associated with higher probability of development of moderate or severe post-COVID depression. It is suggested that COVID-19 survivors should be assessed, to properly diagnose and treat any psychiatric conditions, to reduce the disease burden.
Efficient 2D acoustic wave finite-difference numerical simulation in strongly heterogeneous media using the adaptive mesh refinement technique
Authors: Zhang Chunli , Zhang Wei
Published: October 2021

The finite-difference method (FDM) is one of the most popular numerical methods to simulate seismic wave propagation in complex velocity models. If a uniform grid is applied in FDM for heterogeneous models, the grid spacing is determined by the global minimum velocity to suppress dispersion and dissipation errors in the numerical scheme, resulting in spatial oversampling in higher velocity zones. Then, the small grid spacing dictates a small time step due to the stability condition of explicit numerical schemes. The spatial oversampling and reduced time step will cause unnecessarily inefficient use of memory and computational resources in simulations for strongly heterogeneous media. To overcome this problem, we have used the adaptive mesh refinement (AMR) technique in the FDM to flexibly adjust the grid spacing following velocity variations. AMR is rarely used in acoustic wave simulations with the FDM due to the increased complexity of implementation, including its data management, grid generation, and computational load balancing on high-performance computing platforms. We implement AMR for 2D acoustic wave simulation in strongly heterogeneous media based on the patch approach with FDM. The AMR grid can be automatically generated for given velocity models. To simplify the implementation, we use a well-developed AMR framework, AMReX, to carry out the complex grid management. Numerical tests determine the stability, accuracy level, and efficiency of the AMR scheme. The computation time is approximately proportional to the number of grid points, and the overhead due to the wavefield exchange and data structure is small.
Management of Cerebral Edema, Brain Compression, and Intracranial Pressure
Authors: Liotta Eric M.
Published: October 2021

PURPOSE OF REVIEW

This article reviews the pathophysiology and management of cerebral edema, brain compression, and elevated intracranial pressure (ICP). It also provides a brief introduction to the concept of the glymphatic system and select cellular contributors to cerebral edema.

RECENT FINDINGS

Cerebral edema and brain compression should be treated in a tiered approach after the patient demonstrates a symptomatic indication to start treatment. All patients with acute brain injury should be treated with standard measures to optimize intracranial compliance and minimize risk of ICP elevation. When ICP monitors are used, therapies should target maintaining ICP at 22 mm Hg or less. Evidence exists that serial clinical examination and neuroimaging may be a reasonable alternative to ICP monitoring; however, clinical trials in progress may demonstrate advantages to advanced monitoring techniques. Early decompressive craniectomy and hypothermia are not neuroprotective in traumatic brain injury and should be reserved for situations refractory to initial medical interventions. Medical therapies that acutely lower plasma osmolality may lead to neurologic deterioration from osmotic cerebral edema, and patients with acute brain injury and renal or liver failure are at elevated risk.

A tiered approach to the management of cerebral edema and brain compression can reduce secondary brain injury when implemented according to core physiologic principles. However, our knowledge of the pathophysiology of acute brain injury is incomplete, and the conceptual framework underlying decades of clinical management may need to be revised in response to currently evolving discoveries regarding the pathophysiology of acute brain injury.
Acute Neurologic Manifestations of Respiratory Viruses
Authors: Pizzi Michael A.
Published: October 2021

PURPOSE OF REVIEW

Understanding the pathophysiology of COVID-19 and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus that causes the disease has demonstrated the complexity of acute respiratory viruses that can cause neurologic manifestations. This article describes the most common respiratory viruses that have neurologic manifestations, with a focus on SARS-CoV-2 and COVID-19.

RECENT FINDINGS

In vitro and in vivo studies have better elucidated the neurotropism of various respiratory viruses. Understanding host cell receptors that mediate viral binding and entry not only demonstrates how viruses enter host cells but also provides possible mechanisms for therapeutic interventions. Elucidation of SARS-CoV-2 binding and fusion with host cells expressing the angiotensin-converting enzyme 2 (ACE2) receptor may also provide greater insights into its systemic and neurologic sequelae. Respiratory virus neurotropism and collateral injury due to concurrent inflammatory cascades result in various neurologic pathologies, including Guillain-Barré syndrome, encephalopathy, encephalitis, ischemic stroke, intracerebral hemorrhage, and seizures.

Numerous respiratory viruses can infect the cells of the peripheral and central nervous systems, elicit inflammatory cascades, and directly and indirectly cause various neurologic manifestations. Patients with neurologic manifestations from respiratory viruses are often critically ill and require mechanical ventilation. Neurologists and neurointensivists should be familiar with the common neurologic manifestations of respiratory viruses and the unique and still-evolving sequelae associated with COVID-19.
Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome as Syndromes of Cerebrovascular Dysregulation
Authors: Singhal Aneesh B.
Published: October 2021

PURPOSE OF REVIEW

This article describes the causes, clinical and imaging features, management, and prognosis of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS), in which the underlying pathophysiology is related to reversible dysregulation of the cerebral vasculature.

RECENT FINDINGS

PRES and RCVS are descriptive terms, each bringing together conditions with similar clinical-imaging manifestations. Headache, visual symptoms, seizures, and confusion occur in both syndromes. RCVS is usually heralded by recurrent thunderclap headaches, whereas encephalopathy and seizures are typical in PRES. In PRES, brain imaging shows reversible vasogenic edema that is typically symmetric and located in subcortical regions (mostly posterior predominant). In RCVS, brain imaging is often normal; cerebral angiography shows segmental vasoconstriction-vasodilatation affecting the circle of Willis arteries and their branches. Aside from shared clinical features, significant imaging overlap exists. Both PRES and RCVS can be complicated by ischemic and hemorrhagic brain lesions; angiographic abnormalities frequently occur in PRES and vasogenic edematous lesions in RCVS. Common triggers (eg, eclampsia, vasoconstrictive and chemotherapeutic agents) have been identified. Abnormal cerebrovascular tone and endothelial dysfunction may explain both syndromes. Management of these syndromes includes the removal of identified triggers, symptomatic treatment of headache or seizures, and moderate blood pressure control. Both syndromes are self-limited, with clinical recovery occurring within days to weeks. Long-term deficits and mortality are uncommon.

PRES and RCVS have been well characterized and acknowledged to have significant overlap. Advances in our understanding of pathophysiology and risk factors for poor outcome are expected to optimize the management of these not uncommon syndromes.
After Sexology
Authors: Lubin Joan , Vaccaro Jeanne
Published: October 2021

Is sexology over? What does one do with its history, at once a seemingly remote relic and a persistent logic of biopolitics today? “Sexology and Its Afterlives” begins from the premise that the history of sexology lives in the infrastructures of the present. Locating the afterlives of sexology in material and aesthetic form, this introduction to the special issue engages the largely unmarked detritus of a disaggregated sexological project, whose components have found renewed life in the biopolitical apparatus. The contributors to this issue identify not only familiar sites of sexological persistence (the sex-segregated public toilet) but also less immediately obvious ones (the Moynihan report, redlining, the army base) as executing the unfinished business of the sexological project. This breadth of sexological diffusion makes its analysis a necessarily interdisciplinary prospect, and the contributors call on disability studies, trans studies, Black studies, women-of-color feminism, visual culture, and the history of sexuality, generating emergent concepts, including crip-of-color critique (Kim), binary-abolitionist praxis (Stryker), a “trans-mad” aesthetic (Crawford), and a shift toward expressivity as a framework (Musser). Across the issue, newly imagined sites of collective politics come into view as a payoff for working through the stalled-out imaginaries of sexological binarisms.
Queering the Moment of Hypospadias “Repair”
Authors: Griffiths David Andrew
Published: October 2021

Heteronormativity structures biomedical justifications for continuing surgical interventions on infants’ genitals that are cosmetic and medically unnecessary. It would seem, then, that queer theory is uniquely suited to challenge this continuing practice. This article takes up the question of what queer theory can do for intersex, with particular focus on queer temporality. I consider the example of “hypospadias repair,” a surgical intervention justified by invoking restrictive norms of what the penis should look like and be able to do at some point in the future. In contrast, intersex activists invoke post-medical futures, structured by norms of consent and bodily integrity. While queer approaches to temporality might challenge the notion of intervening surgically on an infant for the sake of the future adult the child will become, might this queer critique also disrupt the ability of activist individuals and organizations to invoke other narratives of the future, including ones where adults have not had irreversible surgeries as infants? I will ask whether queer theories of temporality and futurity can challenge medical practices that compromise consent and bodily integrity. Can queer theory question surgery as a queer moment and help us to conceptualize all bodily differences within a more expansive frame, without reinstating heteronormative narratives of futurity?
Making Cardiopulmonary Exercise Testing Interpretable for Clinicians
Authors: Andonian Brian J. , Hardy Nicolas , Bendelac Alon , Polys Nicholas , Kraus William E.
Published: October 2021

Cardiopulmonary exercise testing (CPET) is a dynamic clinical tool for determining the cause for a person's exercise limitation. CPET provides clinicians with fundamental knowledge of the coupling of external to internal respiration (oxygen and carbon dioxide) during exercise. Subtle perturbations in CPET parameters can differentiate exercise responses among individual patients and disease states. However, perhaps because of the challenges in interpretation given the amount and complexity of data obtained, CPET is underused. In this article, we review fundamental concepts in CPET data interpretation and visualization. We also discuss future directions for how to best use CPET results to guide clinical care. Finally, we share a novel three-dimensional graphical platform for CPET data that simplifies conceptualization of organ system-specific (cardiac, pulmonary, and skeletal muscle) exercise limitations. Our goal is to make CPET testing more accessible to the general medical provider and make the test of greater use in the medical toolbox.
Along the Italian route of End-of-life: the latest judicial evolution on assisted suicide
Authors: Andreani Teresa
Published: October 2021

In the last three decades, the dilemma of End-of-Life is one of the most disputed bio-juridical questions Italy is confronting with. By raising highly sensitive ethical, legal and political dilemmas, it has deeply divided the Italian society, the scientific community and the political arena. In the context of a raging controversy, the Italian Parliament has opted for silence. Thus, an evolutive, judicial route has marked the legal frame in response to numerous, concrete demands of recognition of the freedom of self-determination and value of dignity in the final phase of life. In this review article, an overview of the judicial evolution of the complex mosaic of end-of-life issues will be firstly offered through three cases, pillars on which the latest judicial evolution on assisted suicide lays its foundations. Secondly, the issue of assisted suicide will be singularly addressed through the examination of the Cappato case which has outlined the path for the historical ruling of the Italian Constitutional Court, no'242 of 2019 on the constitutional illegitimacy of the crime of assistance to suicide under article 580 of the Italian Criminal Code. Precisely, the Court has pointed out several, concurrent requirements in presence of which an active conduct directly connected with suicide is not criminally relevant: the autonomous and free formation of the individual will, the irreversible nature of the disease, the ongoing practice of a life-saving treatment, the intolerability of the physical or psychological sufferings and the mental capacity to self-determination. Among the numerous, emerging, interpretative questions, the latest Trentini case, in which the requirement of life-saving treatment has been interpreted as inclusive of pharmacological therapy and of every material, sanitary life-saving assistance, will be further evaluated. Conclusively, a cross section of the fragile interplay between the legislative power and the judiciary power will be depicted in reference to the main open interpretative questions related to the enforcement of the constitutional ruling and a portrait of the upcoming scenerios, as the existing legislative drafts and the prepositive referendum question, will be concisely examined.
A closer look at the forgotten bones of the Dolmen of Pedras Grandes (Odivelas, Portugal). (Examining old human remains 7).
Authors: Silva Ana Maria , Sousa Ana Catarina , Scarre Chris
Published: October 2021

The Dolmen of Pedras Grandes (Odivelas, Lisboa, Portugal) was discovered and excavated at the end of the 19th century by Carlos Ribeiro. In 2004, this monument was re-excavated by Rui Boaventura and a complete study was conducted. The Dolmen of Pedras Grandes presents a polygonal chamber and a very short passage and may have had a short period of burial activity in the 4thmillennium as indicated by the radiocarbon dates and the “archaic” artefacts. The relative and absolute dating enable us to assign this monument to the initial phase of megalithic funerary monumentality in south-central Portugal. Moreover, the recovery of human skeletal material offers an opportunity to obtain data on the biological profile and the health status of the human community who buried their dead in this megalithic tomb. In this paper are present new radiocarbon dates and isotopic analyses obtained from human bone samples from this tomb and also a complete anthropological study of the human skeletal material recovered in this monument. At least 13 individuals are represented in the skeletal assemblage, including 8 adults (> 16 years) and 5 non-adults, although this is certainly an underestimate due to the poor preservation of the bone assemblage. Young children, under the age of three years, are missing. A small number of pathologies were observed, including cranial trauma, degenerative joint disease and oral pathologies. The high frequency of stress indicators, more specifically linear enamel hypoplasia, is a notable feature of this assemblage. The new data are discussed in the context of the problem of the origin of megalithic monumentality in Central and Southern Portugal
A Graph-Based Ant Algorithm for the Winner Determination Problem in Combinatorial Auctions
Authors: Ray Abhishek , Ventresca Mario , Kannan Karthik
Published: October 2021

Iterative combinatorial auctions are known to resolve bidder preference elicitation problems. However, winner determination is a known key bottleneck that has prevented widespread adoption of such auctions, and adding a time-bound to winner determination further complicates the mechanism. As a result, heuristic-based methods have enjoyed an increase in applicability. We add to the growing body of work in heuristic-based winner determination by proposing an ant colony metaheuristic–based anytime algorithm that produces optimal or near-optimal winner determination results within specified time. Our proposed algorithm resolves the speed versus accuracy problem and displays superior performance compared with 20 past state-of-the-art heuristics and two exact algorithms, for 94 open test auction instances that display a wide variety in bid-bundle composition. Furthermore, we contribute to the literature in two predominant ways: first, we represent the winner determination problem as one of finding the maximum weighted path on a directed cyclic graph; second, we improve upon existing ant colony heuristic–based exploration methods by implementing randomized pheromone updating and randomized graph pruning. Finally, to aid auction designers, we implement the anytime property of the algorithm, which allows auctioneers to stop the algorithm and return a valid solution to the winner determination problem even if it is interrupted before computation ends.