bluuebunny/crossref_metadata_2025 huggingface dataset:
Opinion: The Launch of T-levels and Digital Apps
Authors: Keegan Gillian
Published: December 2020

Minister Gillian Keegan MP introduces T Levels — a family of new qualifications that have practical digital skills and employer insight at their heart.
How Cyber Criminals Use Covid
Authors: Passeri Paolo
Published: December 2020

The advent of global pandemic has not only changed the way we work, writes Paolo Passeri, Cyber Intelligence Principal for Netskope, but means we must change the way we think about and maintain security.
Can AI Solve the Climate Crisis?
Authors: Kairinos Nikolas
Published: December 2020

Lockdown has necessitated a number of huge lifestyle changes which, coincidentally, are illustrative of the kind of sustainability-minded life adjustments some have been recommending for years, writes Nikolas Kairinos, Founder and CEO of Soffos.
Gold nanoparticle printed coverslips to facilitate fluorescence-TEM correlative microscopy
Authors: Prabhakar Neeraj , Määttänen Anni , Peltonen Jouko , Hänninen Pekka , Peurla Markus , Rosenholm Jessica M
Published: December 2020

Correlative light and electron microscopy (CLEM) allows combining the advantages of fluorescence microscopy and electron microscopy for cell imaging. Rare phenomenon expressing cells can be studied by specifically tagged fluorophores with fluorescence microscopy. Subsequently, cells can be fixed and ultra-structural details can be studied with transmission electron microscopy (TEM) at a higher resolution. However, precise landmarks are necessary to track the same cell throughout the CLEM process. In this technical report, we present a high contrast inkjet-printed gold nanoparticle patterns over commercial glass coverslip to facilitate cell tracking with correlative microscopy. High contrast and strong reflection from nano gold pattern can be used as a fixed landmark for cell identification with fluorescence microscopy. Nano gold printed letters over coverslips are visible in resin blocks, which can be further used to identify the cell of interest for performing sectioning of embedded cell blocks for TEM.
Collection efficiency and acceptance maps of electron detectors for understanding signal detection on modern scanning electron microscopy
Authors: Agemura Toshihide , Sekiguchi Takashi
Published: December 2020

Collection efficiency and acceptance maps of typical detectors in modern scanning electron microscopes (SEMs) were investigated. Secondary and backscattered electron trajectories from a specimen to through-the-lens and under-the-lens detectors placed on an electron optical axis and an Everhart–Thornley detector mounted on a specimen chamber were simulated three-dimensionally. The acceptance maps were drawn as the relationship between the energy and angle of collected electrons under different working distances. The collection efficiency considering the detector sensitivity was also estimated for the various working distances. These data indicated that the acceptance maps and collection efficiency are keys to understand the detection mechanism and image contrast for each detector in the modern SEMs. Furthermore, the working distance is the dominant parameter because electron trajectories are drastically changed with the working distance.
Transversal Hard Lefschetz Theorem on Transversely Symplectic Foliations
Authors: Álvarez López Jesús A , Jung Seoung Dal
Published: December 2020

We study the transversal hard Lefschetz theorem on a transversely symplectic foliation. This article extends the results of transversally symplectic flows (H.K. Pak, “Transversal harmonic theory for transversally symplectic flows”, J. Aust. Math. Soc. 84 (2008), 233–245) to general transversely symplectic foliations.
Go to gate: COVID-19 imported cases in Madrid and the potential role of airport transmissions
Authors: de Miguel Buckley R , Díaz-Menéndez M
Published: December 2020

Data on imported cases of COVID-19 are scarce. Recorded imported cases in Madrid, Spain represented 0.08% of the total cases from May to December 2020, as reported by the Epidemiology Service of Madrid Autonomous Community. We reflect on the potential role of airports in infection transmission, the current preventive measures to avoid travelling-related infections and discuss if there is a real need to focus on strict airport controls when community transmission is ongoing.
Altered von Willebrand Factor and ADAMTS13 Levels in Children With Cirrhosis and Extrahepatic Portal Hypertension
Authors: Islek Ali , Ilhan Derya , Ozturk Nurinnisa , Guven Burcu , Sag Elif
Published: December 2020

Background/Aim:

This study was concerned with whether vWF (von Willebrand factor) and a disintegrin and metalloprotease with a thrombospondin type 1 motif, member 13 (ADAMTS13) has altered in patients with cirrhosis and extrahepatic portal hypertension (EPH). We aimed to investigate changes to vWF and ADAMTS13 in children with cirrhosis and EPH.

Patients and Methods:

This study was conducted between January and October 2019 with both cirrhosis and EPH patients and with healthy volunteers. The von Willebrand factor antigen (vWF:Ag), von Willebrand Ristocetin cofactor (vWF:RCo), and ADAMTS13 antigen and activity were studied.

Results:

Twenty-eight children with cirrhosis, 16 children with EPH, and 20 healthy controls were included in the study. vWF:Ag and vWF:RCo levels were higher in patients with cirrhosis than in healthy controls (171.65±101.67 vs. 85.86±30.58, P<0.01 and 121.62±55.83 vs. 61.52±27.03, P<0.01, respectively). vWF:Ag and vWF:RCo levels were higher in patients with EPH than in healthy controls (133.93±80.13 vs. 85.86±30.58, P<0.01 and 103.18±58.55 vs. 61.52±27.03, P=0.02, respectively). The ADAMTS13 antigen and activity levels were lower in patients with cirrhosis than in healthy controls (0.58±0.23 vs. 0.97±0.15, P<0.01 and 49.91±22.43 vs. 86.51±22.07, P=0.02, respectively). The ADAMTS13 antigen and activity levels were lower in patients with EPH than in healthy controls (0.69±0.11 vs. 0.97±0.15, P=0.03; and 68.50±13.29 vs. 86.51±22.07, P=0.02, respectively). The increase in vWF and the decrease in ADAMTS13 were more pronounced in cirrhotic patients with autoimmune hepatitis (AIH) than in non-AIH patients.

Conclusions:

While levels of vWF:Ag and vWF:RCo increased in children with cirrhosis and EPH, levels of the ADAMTS13 antigen and ADAMTS13 activity decreased. These alterations were more pronounced in patients with AIH–derived cirrhosis.
Assessment of Virtual Monoenergetic Images in Run-off Computed Tomography Angiography: A Comparison Study to Conventional Images From Spectral Detector Computed Tomography
Authors: Ren Haiyan , Zhen Yanhua , Gong Zheng , Wang Chuanzhuo , Chang Zhihui , Zheng Jiahe
Published: December 2020

Objective

The aims of this study were to evaluate image quality of virtual monoenergetic images (VMIs) compared with conventional images (CIs) from spectral detector CT (SDCT) and to explore the optimal energy level in run-off computed tomography angiography (CTA).

Methods

The data sets of 35 patients who received run-off CTA on the SDCT were collected in this retrospective study. Conventional images were generated via iterative reconstruction algorithm and VMI series from 40 to 120 keV were generated via spectral reconstruction algorithm. The objective indices including vascular attenuation, noise, signal-to-noise ratio, and contrast-to-noise ratio were compared. Two readers performed subjective evaluation using a 5-point scale.

Results

The attenuation showed higher values compared with CIs at 40 to 60 keV (P < 0.001). The noise was similar in 60- to 80-keV VMIs and significantly decreased in 90- to 120-keV VMIs (P < 0.001) in comparison with CIs. The signal-to-noise ratio and contrast-to-noise ratio were improved in 40- to 60-keV VMIs compared with CIs (P < 0.05). The score of subjective assessment was higher than that of CIs in 50- to 70-keV VMIs (P < 0.001).

Conclusions

Virtual monoenergetic images can provide improved image quality compared with CIs from SDCT in run-off CTA, and VMIs at 60 keV may be the best choice in evaluating lower extremity arteries.
Functional Limb Restoration Through Amputation: Minimizing Pain and Optimizing Function With the Use of Advanced Amputation Techniques
Authors: Souza Jason M. , Wade Sean M. , Harrington Colin J. , Potter Benjamin K.
Published: December 2020

Objective:

To demonstrate the role of advanced orthoplastic techniques in harnessing the full potential of elective amputation as a functionally restorative procedure.

Summary of Background Data:

Once considered the unfortunate consequence of failed reconstructive efforts, recent outcomes studies have prompted a re-evaluation of the role of amputation in the management of complex extremity trauma. However, even as amputation is appropriately afforded greater consideration as part of the reconstructive algorithm, reconstructive techniques that are commonly utilized in pursuit of limb salvage are rarely applied to amputation.

Methods:

The following case demonstrates the successful application of orthoplastic reconstructive techniques to achieve optimal pain and functional outcomes in a 41-year-old active duty soldier who underwent an elective transtibial amputation after prolonged, limb salvage.

Results:

The patient presented with a large osteocutaneous proximal tibial defect secondary to trauma and subsequent osteomyelitis. The patient underwent a free scapular-parascapular fasciocutaneous flap to provide soft tissue coverage and facilitate the skeletal reconstruction necessary for either continued limb salvage or amputation. Due to tibial allodynia and severely limited ankle function, the patient subsequently elected for amputation in favor of continued limb salvage. Thus, a transtibial amputation was performed concurrently with a pedicled vascularized fibula to address the proximal tibial defect. A modified agonist-antagonist myoneural interface procedure was used to maximize post-amputation function, with creation of regenerative peripheral nerve interface constructs to prophylax against neurogenic pain. After the operation, the patient achieved improved function of the extremity with the use of a prosthesis and reported substantially improved pain while remaining on active duty in a warfighting military occupational specialty.

Conclusions:

By addressing all of the reconstructive components commonly considered in limb salvage, an orthoplastic approach to amputation surgery can minimize pain and maximize the rehabilitative potential of the amputee.
Time to Cannulation after ICU Admission Increases Mortality for Patients Requiring Veno-venous ECMO for COVID-19 Associated Acute Respiratory Distress Syndrome
Authors: Raff Lauren A. , Gallaher Jared R. , Johnson Daniel , Raff Evan J. , Charles Anthony G. , Reid Trista S.
Published: December 2020

Objective:

COVID-19 can cause ARDS that is rapidly progressive, severe, and refractory to conventional therapies. ECMO can be used as a supportive therapy to improve outcomes but evidence-based guidelines have not been defined.

Summary Background Data:

Initial mortality rates associated with ECMO for ARDS in COVID-19 were high, leading some to believe that there was no role for ECMO in this viral illness. With more experience, outcomes have improved. The ideal candidate, timing of cannulation, and best postcannulation management strategy, however, has not yet been defined.

Methods:

We conducted a retrospective review from April 1 to July 31, 2020 of the first 25 patients with COVID-19 associated ARDS placed on V-V ECMO at our institution. We analyzed the differences between survivors to hospital discharge and those who died. Modified Poisson regression was used to model adjusted risk factors for mortality.

Results:

Forty-four patients (11/25) survived to hospital discharge. Survivors were significantly younger (40.5 years vs 53.1 years; P < 0.001) with no differences between cohorts in mean body mass index, diabetes, or PaO2:-FiO2 at cannulation. Survivors had shorter duration from symptom onset to cannulation (12.5 days vs 19.9 days, P = 0.028) and shorter duration of intensive care unit (ICU) length of stay before cannulation (5.6 days vs 11.7 days, P = 0.045). Each day from ICU admission to cannulation increased the adjusted risk of death by 4% and each year increase in age increased the adjusted risk 6%.

Conclusions:

ECMO has a role in severe, refractory ARDS associated with COVID-19. Increasing age and time from ICU admission were risk factors for mortality and should be considered in patient selection. Further studies are needed to define best practices for V-V ECMO use in COVID-19.
Validation of the Al-based Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) Calculator in Patients 65 Years and Older
Authors: Maurer Lydia R. , Chetlur Prahan , Zhuo Daisy , El Hechi Majed , Velmahos George C. , Dunn Jack , Bertsimas Dimitris , Kaafarani Haytham M.A.
Published: December 2020

Objective:

We sought to assess the performance of the Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) tool in elderly emergency surgery (ES) patients.

Summary Background Data:

The POTTER tool was derived using a novel Artificial Intelligence (AI)-methodology called optimal classification trees and validated for prediction of ES outcomes. POTTER outperforms all existent risk-prediction models and is available as an interactive smartphone application. Predicting outcomes in elderly patients has been historically challenging and POTTER has not yet been tested in this population.

Methods:

All patients ≥65 years who underwent ES in the ACS-NSQIP 2017 database were included. POTTER’s performance for 30-day mortality and 18 postoperative complications (eg, respiratory or renal failure) was assessed using c-statistic methodology, with planned sub-analyses for patients 65 to 74, 75 to 84, and 85+ years.

Results:

A total of 29,366 patients were included, with mean age 77, 55.8% females, and 62% who underwent emergency general surgery. POTTER predicted mortality accurately in all patients over 65 (c-statistic 0.80). Its best performance was in patients 65 to 74 years (c-statistic 0.84), and its worst in patients ≥85 years (c-statistic 0.71). POTTER had the best discrimination for predicting septic shock (c-statistic 0.90), respiratory failure requiring mechanical ventilation for ≥48 hours (c-statistic 0.86), and acute renal failure (c-statistic 0.85).

Conclusions:

POTTER is a novel, interpretable, and highly accurate predictor of in-hospital mortality in elderly ES patients up to age 85 years. POTTER could prove useful for bedside counseling and for benchmarking of ES care.
Ultrasensitivity and bistability in covalent modification cycles with positive autoregulation
Authors: Jeynes-Smith C. , Araujo R. P.
Published: December 2020

Switch-like behaviours in biochemical networks are of fundamental significance in biological signal processing, and exist as two distinct types: ultra-sensitivity and bistability. Here we propose two new models of a reversible covalent-modification cycle with positive autoregulation (PAR) - a motif structure that is thought to be capable of both ultrasensitivity and bistability in different parameter regimes. These new models appeal to a modelling framework that we callcomplex complete, which accounts fully for the molecular complexities of the underlying signalling mechanisms. Each of the two new models encodes a specific molecular mechanism for PAR. We demonstrate that the modelling simplifications for PAR models that have been used in previous work, which rely on a Michaelian approximation for the enzyme-mediated reactions, are unable to accurately recapitulate the qualitative signalling responses supported by our ‘full’ complex-complete models. Strikingly, we show that the parameter regimes in which ultrasensitivity and bistability obtain in the complex-complete framework contradict the predictions made by the Michaelian simplification. Our results highlight the critical importance of accurately representing the molecular details of biochemical signalling mechanisms, and strongly suggest that the Michaelian approximation may be inadequate for predictive models of enzyme-mediated chemical reactions with added regulations.
Anatomical variations and evolution: re‐evaluating their importance for surgeons
Authors: Saniotis Arthur , Henneberg Maciej
Published: December 2020

For several decades, anatomists and biological anthropologists have made an intensive study in anatomical variations in ancestral and living humans. While many anatomical variants do not require clinical attention, some may present diagnostic problems or augur adverse symptoms. It is only in the last few decades that a plausible argument has been made that anatomical changes in human individuals and lineages demonstrate ongoing microevolution. Since the mid‐19th century, there has been a reduction in differential mortality. Increased variation of heritable traits is a consequential outcome of relaxation of natural selection. Consequently, this has contributed to various anatomical variations in musculo‐skeletal anatomy, vascular anatomy as well as congenital disorders such as spina bifida occulta. The authors argue that surgeons and anatomists should improve their knowledge of evolution and its continuing influence on human morphology. Simply repeating the old mantra that anatomical variations are important because knowledge of them minimizes surgical complications, albeit important, is inadequate.
The importance of intraspecific trait variability in promoting functional niche dimensionality
Authors: He Dong , Biswas Shehkar R. , Xu Ming‐Shan , Yang Tong‐Hui , You Wen‐Hui , Yan En‐Rong
Published: December 2020

Both inter‐ and intraspecific trait variation are critical to species distribution along environmental gradients, but our understanding of these patterns predominantly relies upon species‐level trait means and variances. Trait integration, defined as how strongly multiple traits covary with one another, is a key indicator of the dimensionality of functional space for accommodating biodiversity in communities. As trait covariance can differ dramatically at the interspecific versus intraspecific levels, how intraspecific trait variability alters the strength of trait integration and eventually modulates biodiversity along environmental gradients has been rarely tested. Here, we measured nine functional traits (leaf area, specific leaf area, leaf and stem dry‐matter content, leaf nitrogen and phosphorus contents, specific stem length, Huber value and maximum height) paired with site‐specific soil fertility for 70 woody communities in subtropical Chinese forests. All species‐by‐site combinations were sampled to ensure a sufficient representation of intraspecific trait variation across sites. Community‐level trait integration was quantified from the variance of eigenvalues of the trait correlation matrix. The direct and/or indirect effects of soil fertility and trait integration on species richness and trait diversity were assessed through path analyses. Trait integration quantified from both inter‐ and intraspecific variances was on average 21.7% weaker than that from only interspecific variance, indicating a crucial role of intraspecific trait variability in promoting niche dimensionality. Whether accounting for intraspecific variation or not, less fertile sites had stronger trait integration, which in turn depressed both taxonomic and functional diversity, supporting the assumption that higher environmental stress demands stronger tradeoffs among multiple functions in viable strategies. Importantly, the negative association between trait integration and species richness became stronger when accounting for intraspecific variation, suggesting that species distribution and occurrence can be a consequence of intraspecific trait variability. This study highlights the importance of intraspecific trait variability in understanding functional tradeoffs underlying biodiversity patterns.
Life‐history dimensions indicate non‐random assembly processes in tropical island tree communities
Authors: Schrader Julian , Craven Dylan , Sattler Cornelia , Cámara‐Leret Rodrigo , Moeljono Soetjipto , Kreft Holger
Published: December 2020

Community assembly processes on islands are often non‐random. The mechanisms behind non‐random assembly, however, are generally difficult to disentangle. Functional diversity in combination with a null model approach that accounts for differences in species richness among islands can be used to test for non‐random assembly processes, but has been applied rarely to island communities. By linking functional diversity of trees on islands with a null model approach, we bridge this gap and test for the role of stochastic versus non‐random trait‐mediated assembly processes in shaping communities by studying functional diversity–area relationships. We measured 11 plant functional traits linked to species dispersal and resource acquisition strategies of 57 tree species on 40 tropical islands. We grouped traits into four life‐history dimensions representing 1) dispersal ability, 2) growth strategy, 3) light acquisition and 4) nutrient acquisition. To test for non‐random assembly processes, we used null models that account for differences in species richness among the islands. Our results reveal contrasting responses of the four life‐history dimensions to island area. The dispersal and the growth strategy dimensions were underdispersed on smaller islands, whereas the light acquisition dimension was overdispersed. The nutrient acquisition dimension did not deviate from null expectations. With increasing island area, shifts in the strength of non‐random assembly processes increased the diversity of dispersal and acquisition strategies in island communities. Our results suggest that smaller islands may be more difficult to colonize and provide more limited niche space compared to larger islands, whose tree communities are likely determined by stochastic processes and higher niche diversity. Our null model approach highlights that analyzing the functional diversity of different life‐history dimensions provides a powerful framework to unravel community assembly processes on islands. These complex, non‐random assembly processes are masked by measures of functional diversity that do not account for differences in species richness between islands.
Changes in seed predation along a 2300‐m elevational gradient on a tropical mountain in Myanmar: a standardized test with 32 non‐native plant species
Authors: Thein Myo Min , Wu La‐Mei , Corlett Richard T. , Quan Rui‐Chang , Wang Bo
Published: December 2020

It has been hypothesized that biotic interactions are stronger towards lower latitudes and elevations. However, results vary among interaction systems and experimental protocols. Our goal was to examine the validity of this prediction by using a standardized method to investigate seed–animal interaction. We assessed removal by animals for 40 960 seeds belonging to 32 non‐native tree species along an elevation gradient from 600 m to 2910 m on Mount Victoria (Nat Ma Taung), western Myanmar. We analyzed the elevational trends of seed removal at both individual seed level (probability of depot encounter, proportion of seeds removed after encounter and total proportion of seeds removed) and community level (Shannon diversity and species evenness indices). The dry and wet seasons had opposite relationships between seed removal and elevation, i.e. hump‐shaped in the dry season and U‐shaped in the wet season. Individual plant species displayed almost all possible patterns: U‐shaped and hump‐shaped, monotonic decrease and increase, and elevation‐independent patterns. As a consequence of the hump‐shaped seed removal pattern with elevation in the dry season, the diversity and evenness of surviving seeds showed U‐shaped patterns. Our study shows that elevational trends in seed–animal interactions do not follow a constant rule, but differ between seasons and among species, suggesting that a one‐off survey with few species might give misleading information on overall macroecological patterns. Future studies of trends in biotic interactions along gradients should bear this in mind.
Increase in humidity widens heat tolerance range of tropical Ceratosolen fig wasps
Authors: Gigante Earl Terrenz , Lim Emmanuel Justin , Crisostomo Kei Gabrielle , Cornejo Patricia , Rodriguez Lillian Jennifer
Published: December 2020

1. Fig wasps are the obligate mutualistic pollinators of fig trees, which are important components of tropical forests. The stability of these species interactions, in the face of environmental changes, relies heavily on the thermal tolerance of these wasps.

2. This study determined the upper thermal limits of three tropical Ceratosolen fig wasp species. Humidity levels and collection season were varied to determine the effect of water availability on heat tolerance.

3. Wasps were placed in incubators to simulate different temperature regimes (30–45 °C) with varying humidity conditions. Wasp populations from either the dry or wet seasons were tested. Upper lethal temperature was determined by recording wasp survival.

4. All factors (temperature, humidity, season, wasp species, and their interactions) significantly affected wasp longevity. Exposure to high temperatures resulted in a significant decrease in wasp longevity: longest at 30 °C and the ratio decreased rapidly at 40 and 45 °C. An increase in temperature from 30 to 35 °C caused at least a two‐fold reduction in wasp lifespan. More surprisingly, humid conditions allowed survival for two to six times longer than non‐humid conditions in high temperatures (40–45 °C). Wasps obtained during the wet season also survived longer than those from the dry season. Increased water availability (i.e. during wet season and with high humidity conditions) thus increased wasp upper thermal limits.

5. Relative humidity was a strong limiting factor in the heat tolerance of tropical wasps. Persistence of insect species that are narrowly‐distributed will depend on the presence of intact, high‐humidity habitats.
Features of oral squamous cell carcinoma in ex vivo fluorescence confocal microscopy
Authors: Shavlokhova Veronika , Flechtenmacher Christa , Sandhu Sameena , Vollmer Michael , Hoffmann Jürgen , Engel Michael , Ristow Oliver , Freudlsperger Christian
Published: December 2020

Background

Real‐time microscopic imaging of freshly excised oral squamous cell carcinomas (OSCCs) would be potentially supportive in rapid recognition of oral malignancy and an optimal and time‐saving management of patients' surgical treatment.

Objectives

The aim of this study was to examine oral squamous cell cancer tissue in regards to the commonly known and well‐described histomorphologic criteria for the diagnosis of OSCC in ex vivo confocal fluorescent microscopy and to analyze its correlation with grade of differentiation and level of invasiveness.

Methods

Ex vivo confocal laser scanning microscopy (CLSM) images of 38 OSCCs were evaluated immediately after excision for presence or absence of various cytological and architectural features based on the histopathological background. Next, these features were compared to the grade of differentiation as elaborated via gold standard histologic examination.

Results

Of 38 invasive OSCCs, 14 were well differentiated, while three moderately and 19 were poorly differentiated. The presence of the commonly known cytologic and histopathologic criteria for the diagnosis of oral squamous cell carcinoma such as the destruction of the basal cell membrane, cellular and nuclear pleomorphism, anisocytosis, intraepithelial keratinization, nuclear hyperchromasia, atypical mitotic figures as well as the presence of necrosis, and mixed inflammation could be observed in ex vivo fluorescence confocal microscopy (FCM). In ex vivo fluorescence confocal microscopy pictures, cellular pleomorphism and anisocytosis were observed more often in poorly differentiated OSCCs. Intraepithelial keratinization was associated with well differentiated and moderately differentiated OSCCs.

Conclusion

The results demonstrate the high potential of ex vivo fluorescence confocal microscopy in fresh tissue for rapid real‐time diagnosis of OSCC.
Nomograms predicting the outcomes of endoscopic treatments for pediatric upper urinary tract calculi
Authors: Zhang Yu , Li Jun , Zhang Dong , Jiao Jian Wei , Tian Ye
Published: December 2020

Objectives

To demonstrate the efficacy and safety of mini‐percutaneous nephrolithotomy, micro‐percutaneous nephrolithotomy, and flexible ureteroscopy for pediatric upper urinary tract calculi and to develop nomograms predicting surgical outcomes.

Methods

A prospectively managed database containing children who were diagnosed with upper urinary tract calculi and treated with mini‐percutaneous nephrolithotomy, micro‐percutaneous nephrolithotomy, and flexible ureteroscopy between June 2014 and April 2019 was analysed. Patient demographics, intraoperative data, stone characteristics, stone‐free rate, and complication rate were analysed and compared. Nomograms predicting the postoperative stone‐free rate and complication rate were established based on predictors, and internal validation was performed. Calibration curves and decision curves were generated to assess the predictive efficacy and clinical benefit.

Results

Forty‐three children underwent mini‐percutaneous nephrolithotomy on 56 sides in 47 operations, 30 children underwent micro‐percutaneous nephrolithotomy on 30 sides in 30 operations, and 275 children underwent flexible ureteroscopy on 320 sides in 288 operations. The stone‐free rates were 88.5% (282/320) for flexible ureteroscopy, 89.3% (50/56) for mini‐percutaneous nephrolithotomy, and 90.0% (27/30) for micro‐percutaneous nephrolithotomy (P = 0.94). And the complication rates were 19.8% (57/288), 36.2% (17/47), and 33.3% (10/30), respectively (P = 0.02). Nomograms based on stone characteristics, operation duration, and the physical condition of the child were shown to have good discrimination and calibration. The area under the curve of the models was 81% for stone‐free rate and 73% for complication rate. The calibration curves showed that the nomogram might underestimate the probability of stone‐free rate when the threshold was below 82% and might overestimate the risk of complication rate when the threshold was over 25%. The decision curves demonstrated that the Capital Medical University nomograms improved clinical risk prediction against threshold probabilities of stone‐free rate ≤20% and complication rate ≤10%.

Conclusions

Both the percutaneous nephrolithotomy and flexible ureteroscopy procedures could have acceptable stone‐free rates when treating pediatric stones. The Capital Medical University nomograms performed well in helping to predict stone‐free and complication rates.
Identifying standards for postseason advancement: a case of the National Basketball Association
Authors: Chen Shih‐Pin , Liao Chi‐Nan
Published: December 2020

This paper identifies a standard for postseason advancement and predicts whether a team will advance when criteria are known but requirements are undetermined. A frontier function for advancing teams is constructed based on their past statistics of influential performance factors. The difference between a team's performance and the frontier function indicates whether a team will advance. The importance of each performance factor and team efficiency (TE) after a certain number of regular‐season games is identified. The ratio of a team's actual winning percentage to its highest winning percentage indicates the in‐season TE. Data from advancing teams in the National Basketball Association (NBA) over 11 years are collected. The difference between the Eastern Conference and the Western Conference and the changes in NBA playing styles are analyzed. The results predict whether stakeholders’ teams will advance and provide managers and coaches a metric to measure the optimal performance and direction of improvement.
Predictors and short‐term outcomes of post‐stroke fatigue in initial phase of transition from hospital to home: A prospective observational study
Authors: Su Ya , Asamoto Mitsuko , Yuki Michiko , Saito Masaru , Hasebe Naoko , Hirayama Kengo , Otsuki Mika , Iino Chieko
Published: December 2020

Aim

To analyse the interactions of associated factors with post stroke fatigue (PSF) after discharge home and determine the predictors of PSF and their impact on stroke survivors.

Design

A prospective observational study.

Methods

A total of 94 patients with acute stroke were recruited between May 2019 ‐July 2020. The main outcomes were fatigue, depression, insomnia, sarcopenia, and health‐related quality of life (HRQOL) and were assessed at admission and 1 month after discharge. Fatigue was measured using the Fatigue Assessment Scale. Depression and Insomnia were assessed using the Hospital Anxiety and Depression Scale‐Depression and Insomnia Severity Index, respectively. Sarcopenia was measured using the SARC‐F questionnaire, and HRQOL was assessed using the Short Form‐8.

Results

Acute phase PSF was an independent predictor of PSF after discharge home. Moreover the path analysis revealed that this effect is mediated through both the direct effect of acute‐phase PSF on PSF after discharge home and through the indirect effect of interaction with pre‐stroke SARC‐F, acute phase depression, and acute phase insomnia, which remains a separate predictor of acute‐phase PSF. In total, 17% of the survivors had persistent PSF. Persistent PSF was significantly associated with depression, insomnia, sarcopenia, and a lower quality of life scores.

Conclusions

Post‐stroke fatigue may occur in the acute phase and persists after discharge, it will not only affect later depression, insomnia, and quality of life, but also sarcopenia.

Impact

Acute phase PSF was found to be an independent predictor of PSF after discharge home. In addition, the interaction with pre‐stroke SARC‐F, acute phase depression and insomnia had an indirect connection with PSF after discharge home, which remains a separate predictor of acute‐phase PSF. Thus, early assessment and management of mental status, sleep problems, and sarcopenia during hospitalization might be an important step in post‐stroke rehabilitation and home transition.
Risk stratification in asymptomatic patients with Brugada syndrome: Utility of multiple risk factor combination rather than programmed electrical stimulation
Authors: Shinohara Tetsuji , Takagi Masahiko , Kamakura Tsukasa , Sekiguchi Yukio , Yokoyama Yasuhiro , Aihara Naohiko , Hiraoka Masayasu , Aonuma Kazutaka ,   for the Japan Idiopathic Ventricular Fibrillation Study (J‐IVFS) Investigators
Published: December 2020

Background

The prognostic value of programmed electrical stimulation (PES) in Brugada syndrome (BrS) remains controversial. Asymptomatic BrS patients generally have a better prognosis than those with symptoms. The purpose of this study was to evaluate the value of nonaggressive PES with up to two extra stimuli and predict clinical factors for risk stratification in asymptomatic BrS patients.

Methods

The study enrolled 193 consecutive asymptomatic BrS patients with type 1 ECG (mean age: 50 ± 13 years, 180 males) who underwent PES using a nonaggressive uniform protocol. Cardiac events (CEs: sudden cardiac death or ventricular tachyarrhythmia) during the follow‐up period were examined.

Results

During a mean follow‐up of 101 ± 48 months, seven asymptomatic patients (3.6%) had a CE. The incidence of CEs was not different between patients with and without inducible ventricular tachyarrhythmia by PES (p = .51). The clinical significance of risk factor combinations, including spontaneous type 1 ECG, family history of sudden cardiac death, QRS duration in lead V2, and presence of J wave, was evaluated. Using the Kaplan–Meier method according to the number of risk factors, the prevalence of CE in patients with three or four risk factors was determined to be significantly higher than in those with one risk factor (p = .02 and p = .004, respectively).

Conclusions

The present study suggests that inducibility of ventricular tachyarrhythmia does not predict future CEs in asymptomatic BrS patients. Combination analysis of the other four clinical risk parameters may be effective for risk assessment.
Anatomical insights into posterior wall isolation in patients with atrial fibrillation: A hypothesis to protect the esophagus
Authors: Lu Xiaofeng , Peng Shi , Wu Xiaoyu , Zhou Genqing , Wei Yong , Cai Lidong , Xu Juan , Ding Yu , Chen Songwen , Liu Shaowen
Published: December 2020

Introduction

Left atrial posterior wall (LAPW) isolation may be performed as an additional atrial fibrillation (AF) ablation strategy based on pulmonary vein isolation. A modified posterior‐inferior line (MPL) was proposed for reducing esophageal injury. The aim of this study was to evaluate the anatomical characteristics of the MPL, compared with the conventional posterior line (CPL).

Methods and Results

Multidetector computed tomography was performed in 102 consecutive AF patients (male/female = 60/42) preoperative, and the parameters were evaluated as follows: the distance from MPL and CPL to the esophagus, fat pad presence and thickness in the course of MPL and CPL, and the esophageal route below CPL. The average distance from the MPL to the esophagus was longer than from CPL to the esophagus (3.7 ± 1.5 vs. 1.7 ± 0.4 mm, p < .001). Proportion of fat pad was higher in the course of MPL than CPL. The myocardium tissue and fat pad under MPL was thicker than under CPL (2.9 ± 1.1 vs. 1.6 ± 0.3 mm, p < .001; 1.4 ± 0.6 vs. 0.9 ± 0.2 mm, p < .001), respectively. In patients whose esophagus was unconfined in a triangular space at the left inferior pulmonary vein level, the average distance from MPL to esophagus was longer than the confined patients (4.0 ± 1.7 vs. 3.2 ± 1.0 mm, p = .001).

Conclusion

The MPL was far away from the esophagus with thicker myocardium tissue and more fat pad than the CPL; thus, MPL could serve as a favorable alternative in linear ablation for LAPW isolation.
Evaluation of a novel monoclonal antibody‐based enzyme immunoassay for detection of Histoplasma antigen in urine of dogs
Authors: Clark Kristen , Hanzlicek Andrew S.
Published: December 2020

Background

Commercially available, noninvasive testing options for histoplasmosis are limited outside of the United States.

Objectives

To describe the diagnostic performance of a novel Histoplasma antigen enzyme immunoassay (IM EIA) for the diagnosis of histoplasmosis in dogs.

Animals

Twenty dogs with histoplasmosis, 79 dogs without histoplasmosis, and 11 unclassified dogs providing 202 urine samples.

Methods

This a prospective study using stored urine samples. Samples were analyzed with the IM EIA and with the commercially available Histoplasma antigen EIA (MV EIA). Dogs were classified based on final proven diagnosis and performance of the IM EIA was described and compared with the MiraVista enzyme immunoassay (MV EIA).

Results

The diagnostic sensitivity (DSe), specificity (DSp), and accuracy (DAc) of the IM EIA were 70% (51%‐89%), 99% (97%‐100%), and 93% (81%‐100%), respectively. The DSe, DSp, and DAc for the MV EIA were 95% (85%‐100%), 99% (97%‐100%), and 98% (95%‐100%), respectively. The area under the receiver operator characteristic curve was significantly smaller for IM EIA (0.87) as compared with MV EIA (0.97, P = .03). This was primarily due to 6 false negative IM EIA results, 4 from dogs with disease localized to the gastrointestinal tract. The MV EIA was positive in 5/6 of these dogs.

Conclusions and Clinical Importance

The IM EIA might be useful for the diagnosis of disseminated histoplasmosis in dogs, but clinical usefulness will be limited in dogs with histoplasmosis localized to the GI tract.
Evaluation of 3 refractometers to determine transfer of passive immunity in neonatal beef calves
Authors: Gamsjäger Lisa , Elsohaby Ibrahim , Pearson Jennifer M. , Levy Michel , Pajor Edmond A. , Windeyer M. Claire
Published: December 2020

Background

Refractometry is used to assess transfer of passive immunity (TPI), but studies evaluating different refractometers and appropriate thresholds for recommended target immunoglobulin G (IgG) concentrations for beef calves are limited.

Objectives

To evaluate test performance of digital (DSTP) and optical (OSTP) serum total protein (STP) refractometers and a digital Brix (DBRIX) refractometer for assessment of passive immunity in beef calves.

Animals

A total of 398 beef calves from 6 herds, 1 to 7 days of age.

Methods

Serum IgG concentration was estimated by DSTP, OSTP, and DBRIX, and measured by radial immunodiffusion (RID). Correlation coefficients (r) among results were calculated. Optimal STP and Brix thresholds for identification of IgG <10, <16, and <24 g/L were determined using interval likelihood ratios. Refractometer performance and agreement were assessed using areas under the curve (AUC), diagnostic test characteristics, Cohen's kappa (κ), and Bland‐Altman analysis.

Results

Refractometer results were highly correlated with RID (r = 0.82‐0.91) and with each other (r = 0.91‐0.95), and overall test performance was excellent (AUC = 0.93‐0.99). The STP concentrations of ≤5.1, ≤5.1, and ≤5.7 g/dL and Brix percentages of ≤7.9%, ≤8.3%, and ≤8.7% indicated IgG concentrations <10, <16, and <24 g/L, respectively. Agreement of refractometers with RID was variable (κ = 0.46‐0.80) and among refractometers was substantial (κ = 0.62‐0.89).

Conclusions and Clinical Importance

All refractometers showed good utility as monitoring tools for assessment of TPI in beef calves.
Participatory Research in Mesoamerica and Data Protection in Europe (and Elsewhere)
Authors: Cant Alanna
Published: December 2020

This essay examines the tensions between participatory ethnographic research methods and newly emerging legal regimes of data protection and privacy. Drawing on the example of recent grant‐funded research in Mexico, the essay charts how the European Union's General Data Protection Regulation impedes the practices and ethos of participatory research in significant ways. In particular, new legal requirements about data collection, access and storage, and “the right to be forgotten,” effectively preclude integrating community members into research planning or data collection. As countries around the world move toward more robust and comprehensive data protection and privacy laws, the issues raised in this essay are likely to become more pressing in many different research contexts in the future. [Mexico, data protection, participatory research, privacy laws].
“Beyond an acronym, STEM is…”: Perceptions of STEM
Authors: Navy Shannon L. , Kaya Fatma , Boone Brian , Brewster Christine , Calvelage Kelly , Ferdous Tanzimul , Hood Ebony , Sass Laura , Zimmerman Maggie
Published: December 2020

Although STEM is at the forefront of many educational initiatives, little is known about various professionals’ perceptions of STEM. This mixed‐methods study surveyed 164 preservice teachers, inservice teachers, administrators, informal educators, and STEM professionals. Quantitative and qualitative questions on the survey elicited participants’ perceptions of STEM, STEM support, and STEM careers. Quantitative analysis revealed that profession influenced understandings of STEM, importance of STEM, support for STEM, and perceptions of STEM career opportunities. Qualitative analysis provided rich explanations for the differences in perceptions among professions. This study suggests that science teacher educators need to ensure preservice teachers have understandings of STEM and STEM careers, K‐16 educators need to emphasize the current importance of STEM, and administrators and policymakers need to align visions of STEM with curriculum and pacing guides so teachers feel supported in their STEM endeavors.
Measuring rural access for SDG 9.1.1
Authors: Workman Robin , McPherson Kevin
Published: December 2020

The Rural Access Index is a measure of access developed by the World Bank and has been incorporated into the Sustainable Development Goals (SDGs) as indicator 9.1.1. This measures the proportion of the rural population living within 2 km of an all‐season road, using GIS layers and relying on three data sources: population, road network location and condition. Open GIS data are used for population and road location, but there are challenges to define the all‐season status of roads. Every country measures road condition differently and against different parameters, which makes consistency of the all‐season status between countries difficult. This article reports on research to refine the GIS methodology for assessing SDG 9.1.1 to make it more sustainable, repeatable and consistent by using geospatial data and tools, based on trials in four countries—Ghana, Malawi, Myanmar and Nepal—which were selected for their diversity of environment and data.
Biogenesis of large dense core vesicles in mouse chromaffin cells
Authors: Dembla Ekta , Becherer Ute
Published: December 2020

Large dense core vesicle (LDCVs) biogenesis in neuroendocrine cells involves: (a) production of cargo peptides processed in the Golgi; (b) fission of cargo loaded LDCVs undergoing maturation steps; (c) movement of these LDCVs to the plasma membrane. These steps have been resolved over several decades in PC12 cells and in bovine chromaffin cells. More recently, the molecular machinery involved in LDCV biogenesis has been examined using genetically modified mice, generating contradictory results. To address these contradictions, we have used NPY‐mCherry electroporation combined with immunolabeling and super‐resolution structured illumination microscopy. We show that LDCVs separate from an intermediate Golgi compartment, mature in its proximity for about 1 hour and then travel to the plasma membrane. The exocytotic machinery composed of vSNAREs and synaptotagmin1, which originate from either de novo synthesis or recycling, is most likely acquired via fusion with precursor vesicles during maturation. Finally, recycling of LDCV membrane protein is achieved in less than 2 hours. With this comprehensive scheme of LDCV biogenesis we have established a framework for future studies in mouse chromaffin cells.
Export as shelter from domestic corruption: Theory and evidence from developing countries
Authors: Liu Yu , Zhou Mohan , Lin Faqin , Gu Lihua
Published: December 2020

When corruption becomes a significant barrier to develop domestic business, do firms resort to exporting as a solution? In other words, is there a ‘shelter effect’ of exporting? We build a simple model to analyse the effects of corruption on firms’ domestic versus foreign market sales. The model predicts that when corruption increases the cost of domestic sales, large firms increase exports relative to domestic sales, whereas small firms do the opposite. Using data from the World Bank Enterprise Surveys, we provide supportive evidence to these predictions. We also find the ‘shelter effect’ to be weaker for politically connected firms.