bluuebunny/crossref_metadata_2025 huggingface dataset:
Improved Tricuspid Valve Function, Preload Recruitment and Ventricular Efficiency During Submaximal Exercise in Patients with Unoperated Ebstein's Anomaly: An MRI Study
Authors: Ferrari Irene , Shehu Nerejda , Nagdyman Nicole , Martinoff Stefan , Ewert Peter , Stern Heiko , Meierhofer Christian
Published: October 2021

Background

Adolescents and adults with native Ebstein's anomaly (EA) are at the benign part of the Ebstein spectrum, having survived infancy without surgery. In this population, surgical indication and timing remain objects of controversy and depend, among other factors, on exercise capacity.

Purpose

To better understand the pathophysiology of exercise adaptation in native EA.

Study Type

Retrospective.

Population

Ten patients with unoperated EA (age range 18–61 years) and 13 healthy subjects as controls.

Field Strength/Sequence

Balanced steady‐state free precession cine and phase contrast flow sequences at 1.5 T.

Assessment

We measured volumes and flows at rest and during submaximal exercise. Hemodynamic parameters including stroke volume (SV), cardiac index (CI), ejection fraction (EF), and tricuspid regurgitation (TR) were calculated.

Statistical Tests

We used nonparametric Mann–Whitney U‐test and Wilcoxon signed‐rank test. A P‐value of <0.05 was considered statistically significant.

Results

Rest CI and SV were significantly higher in controls; rest heart rate (HR) was similar in the two groups (median 71 bpm by patients and 65 bpm by controls, P = 0.448). During exercise, CI increased significantly in both groups: from 2.40 to 3.35 L/min/m2 in the patient group and from 3.60 to 4.20 L/min/m2 in controls; HR increased significantly in both groups. SV increased significantly in the patient group, whereas it remained stable in controls (P = 0.5284). Patients' median TR decreased significantly: median 42% at rest and 30% during exercise; concomitantly, left ventricular (LV) preload increased significantly (+3% indexed LV end‐diastolic volume) as did LVEF (median 59% at rest vs. 65% during exercise).

Data Conclusion

During submaximal exercise, patients with mild to moderate EA improved their cardiovascular system's total efficiency by increasing CI; this was obtained by an increase in HR and by the recruitment of volume, as shown by an increased LV end‐diastolic volume and SV, with simultaneous decrease in TR. This was different from healthy subjects in which CI increased only due to HR increase.

Level of Evidence

3

Technical Efficacy Stage

3
Prenatal diagnosis of combined methylmalonic acidemia and homocystinuria cobalamin C type using clinical exome sequencing and targeted gene analysis
Authors: Hwang Narae , Jang Ja‐Hyun , Cho Eun‐Hae , Choi Rihwa , Choi Suk‐Joo , Park Hyung‐Doo
Published: October 2021

Background

Combined methylmalonic acidemia and homocystinuria is a rare inherited disorder of intracellular cobalamin metabolism caused by biallelic variants in one of the following genes: MMACHC (cblC), MMADHC (cblD), LMBRD1 (cblF), ABCD4 (cblJ), THAP11 (cblX‐like), and ZNF143 (cblX‐like), or a hemizygous variant in HCFC1 (cblX). Prenatal diagnosis of combined methylmalonic acidemia with homocystinuria is crucial for high‐risk couples since the disorder can be life‐threatening for offspring. We would like to describe two infant deaths both of which are likely attributable to cblC despite not having a genetic confirmation, and subsequent pregnancy and prenatal genetic testing.

Methods

Parental clinical exome sequencing and targeted Sanger sequencing of MMACHC gene in amniotic fluid was performed to check the carrier status of the fetus.

Results

Parental clinical exome sequencing revealed a heterozygous pathogenic variant [NM_015506.2:c.217C>T (p.Arg73*)] in the MMACHC gene of the mother and [NM_015506.2:c.609G>A (p.Trp203*)] in the MMACHC gene of the father. Targeted Sanger sequencing of MMACHC gene in amniotic fluid revealed that the fetus carried only one nonsense variant [NM_015506.2:c.609G>A (p.Trp203*)], which was inherited from the father. The mother delivered a healthy baby and the neonate did not show any symptoms or signs of combined methylmalonic acidemia and homocystinuria after birth.

Conclusion

We present a case of prenatal diagnosis with parental exome sequencing, which successfully diagnosed the carrier status of the fetus and parents in a combined methylmalonic acidemia and homocystinuria family.
Enhancement of sorghum grain yield and nutrition: A role for arbuscular mycorrhizal fungi regardless of soil phosphorus availability
Authors: Watts‐Williams Stephanie J. , Gill Alison R. , Jewell Nathaniel , Brien Christopher J. , Berger Bettina , Tran Binh T. T. , Mace Emma , Cruickshank Alan W. , Jordan David R. , Garnett Trevor , Cavagnaro Timothy R.
Published: October 2021

Societal Impact Statement

Sorghum is an important cereal crop that provides calories and nutrients for much of the world's population, and it is often grown with low fertiliser input. Optimising the yield, nutritive content and bioavailability of sorghum grain with minimal input is of importance for human nutrition, and arbuscular mycorrhizal (AM) fungi have previously shown potential to assist in this. Across sorghum genetic diversity, AM fungi improved the yield, nutrition and zinc and iron bioavailability of grain in a low phosphorus soil. Thus, food production systems that effectively manage AM fungi may improve consumer outcomes.

Sorghum is a C4 cereal crop that is an important source of calories and nutrition across the world, predominantly cultivated and consumed in low‐ and middle‐income countries. Sorghum can be highly colonised by arbuscular mycorrhizal (AM) fungi, and the plant‐fungal association can lead to improvements in biomass and nutrient uptake. High‐throughput phenotyping allows us to non‐destructively interrogate the ‘hidden’ effects of AM fungi on sorghum growth and phenology.

Eight genetically diverse sorghum genotypes were grown in a soil amended with 2 or 20 mg P kg−1 and inoculated with an AM fungal culture of Rhizophagus irregularis. High‐throughput phenotyping uncovered the ‘hidden’ effects of AM fungi on growth and phenology, while grain biomass, nutrition, Zn and Fe bioavailability and root AM colonisation was determined after destructive harvest.

Sorghum plants colonised by AM fungi generally performed better than non‐AM control plants, with greater yield, harvest indices, and grain P, Zn and Fe contents. During the early growth stages, AM colonisation led to temporary growth depressions. There were also AM fungal and P fertilisation effects on sorghum time‐of‐flowering. The sorghum genotype with the highest AM colonisation could barely produce grain when non‐inoculated.

The two genotypes that failed to mature had very low AM colonisation. Generally, the genetically diverse sorghum genotypes were highly responsive to AM colonisation and produced more grain of greater nutritive quality when colonised, without adverse consequences for micronutrient bioavailability.
NADH Regeneration Promoted by Solar Light Using Gold Nanoparticles/Layered Double Hydroxides as Novel Photocatalytic Nanoplatforms
Authors: Grosu Elena‐Florentina , Girardon Jean‐Sébastien , Carja Gabriela , Froidevaux Renato
Published: October 2021

Nicotinamide adenine dinucleotide NAD(P)H is a prolific cofactor in oxidoreductases biochemistry, but its high cost and the stoichiometric amounts motivates significant research for establishing efficient solutions for regenerating NAD(P)H from NAD(P)+. This study presents nanoparticles of gold/layered double hydroxides (AuNPs/LDH) as nanoplatforms with highly efficient photocatalytic response for solar‐light promoted NADH regeneration. The novel photocatalysts are obtained via self‐assembling of ZnAlLDH and AuNPs by using the manifestation of the “structural memory” of the anionic clay in gold salt solution. The chemical composition, structural, optical and nanotextural features of AuNPs/LDH have been assessed by transmission electron microscopy (TEM), energy dispersive X‐Ray Spectroscopy (EDX), powder X‐ray diffraction (XRD), and UV‐Vis Spectroscopy (UV‐Vis). It was found that, at pH 8 and in the presence of flavin mononucleotide (FMN) as a mediator and using water as an electron donor, the regeneration the NADH under solar light is defined by a rate of 20.5 μM/h. Furthermore, the regenerated NADH cofactor is tested in presence of Horseradish Peroxidase (HRP) enzyme to promote the hydrogen peroxide reduction.
Odd entanglement entropy and logarithmic negativity for thermofield double states
Authors: Ghasemi Mostafa , Naseh Ali , Pirmoradian Reza
Published: October 2021

Abstract

We investigate the time evolution of odd entanglement entropy (OEE) and logarithmic negativity (LN) for the thermofield double (TFD) states in free scalar quantum field theories using the covariance matrix approach. To have mixed states, we choose non-complementary subsystems, either adjacent or disjoint intervals on each side of the TFD. We find that the time evolution pattern of OEE is a linear growth followed by saturation. On a circular lattice, for longer times the finite size effect demonstrates itself as oscillatory behavior. In the limit of vanishing mass, for a subsystem containing a single degree of freedom on each side of the TFD, we analytically find the effect of zero-mode on the time evolution of OEE which leads to logarithmic growth in the intermediate times. Moreover, for adjacent intervals we find that the LN is zero for times t < β/2 (half of the inverse temperature) and after that, it begins to grow linearly. For disjoint intervals at fixed temperature, the vanishing of LN is observed for times t < d/2 (half of the distance between intervals). We also find a similar delay to see linear growth of ∆S = SOEE− SEE. All these results show that the dynamics of these measures are consistent with the quasi-particle picture, of course apart from the logarithmic growth.
Learning and generalising object extraction skill for contact-rich disassembly tasks: an introductory study
Authors: Serrano-Muñoz Antonio , Arana-Arexolaleiba Nestor , Chrysostomou Dimitrios , Bøgh Simon
Published: October 2021

Remanufacturing automation must be designed to be flexible and robust enough to overcome the uncertainties, conditions of the products, and complexities in the planning and operation of the processes. Machine learning methods, in particular reinforcement learning, are presented as techniques to learn, improve, and generalise the automation of many robotic manipulation tasks (most of them related to grasping, picking, or assembly). However, not much has been exploited in remanufacturing, in particular in disassembly tasks. This work presents the state of the art of contact-rich disassembly using reinforcement learning algorithms and a study about the generalisation of object extraction skills when applied to contact-rich disassembly tasks. The generalisation capabilities of two state-of-the-art reinforcement learning agents (trained in simulation) are tested and evaluated in simulation, and real world while perform a disassembly task. Results show that at least one of the agents can generalise the contact-rich extraction skill. Besides, this work identifies key concepts and gaps for the reinforcement learning algorithms’ research and application on disassembly tasks.
Genetic and epigenetic characterization of posterior pituitary tumors
Authors: Schmid Simone , Solomon David A. , Perez Eilis , Thieme Anne , Kleinschmidt-DeMasters Bette K. , Giannini Caterina , Reinhardt Annekathrin , Asa Sylvia L. , Mete Ozgur , Stichel Damian , Siewert Christin , Dittmayer Carsten , Hasselblatt Martin , Paulus Werner , Nagel Christoph , Harter Patrick N. , Schittenhelm Jens , Honegger Jürgen , Rushing Elisabeth , Coras Roland , Pfister Stefan M. , Buslei Rolf , Koch Arend , Perry Arie , Jones David T. W. , von Deimling Andreas , Capper David , Lopes M. Beatriz
Published: October 2021

Pituicytoma (PITUI), granular cell tumor (GCT), and spindle cell oncocytoma (SCO) are rare tumors of the posterior pituitary. Histologically, they may be challenging to distinguish and have been proposed to represent a histological spectrum of a single entity. We performed targeted next-generation sequencing, DNA methylation profiling, and copy number analysis on 47 tumors (14 PITUI; 12 GCT; 21 SCO) to investigate molecular features and explore possibilities of clinically meaningful tumor subclassification. We detected two main epigenomic subgroups by unsupervised clustering of DNA methylation data, though the overall methylation differences were subtle. The largest group (n = 23) contained most PITUIs and a subset of SCOs and was enriched for pathogenic mutations within genes in the MAPK/PI3K pathways (12/17 [71%] of sequenced tumors:FGFR1(3),HRAS(3),BRAF(2),NF1(2),CBL(1),MAP2K2(1),PTEN(1)) and two with accompanyingTERTpromoter mutation. The second group (n = 16) contained most GCTs and a subset of SCOs, all of which mostly lacked identifiable genetic drivers. Outcome analysis demonstrated that the presence of chromosomal imbalances was significantly associated with reduced progression-free survival especially within the combined PITUI and SCO group (p = 0.031). In summary, we observed only subtle DNA methylation differences between posterior pituitary tumors, indicating that these tumors may be best classified as subtypes of a single entity. Nevertheless, our data indicate differences in mutation patterns and clinical outcome. For a clinically meaningful subclassification, we propose a combined histo-molecular approach into three subtypes: one subtype is defined by granular cell histology, scarcity of identifiable oncogenic mutations, and favorable outcome. The other two subtypes have either SCO or PITUI histology but are segregated by chromosomal copy number profile into a favorable group (no copy number changes) and a less favorable group (copy number imbalances present). Both of the latter groups have recurrent MAPK/PI3K genetic alterations that represent potential therapeutic targets.
Absenteeism and associated labour costs according to depressive symptom severity in the German general population: why preventive strategies matter
Authors: Eßl-Maurer Roland , Flamm Maria , Hösl Katharina , Osterbrink Jürgen , van der Zee-Neuen Antje
Published: October 2021

Purpose

Depression is a highly prevalent mental health condition with substantial individual, societal and economic consequences. This study focussed on the association of depressive symptom severity with absenteeism duration and employer labour costs.

Methods

Using cross-sectional data from the German Health Update 2014/2015, multivariable zero-inflated Poisson regression (ZIP) models explored the association of depressive symptom severity (8-item depression patient health questionnaire—PHQ-8), with absenteeism weeks during 12 months in men and women working full- or part-time. The predicted sick leave weeks were multiplied by mean average labour costs.

Results

The sample consisted of 12,405 persons with an average sick leave of 1.89 weeks (SD 4.26). Fifty-four % were women and 57% were between 40 and 59 years of age. In men and women, mild, moderate, moderately severe and severe depressive symptoms were associated with a significant factor increase in sick leave weeks compared to persons with no or minimal symptoms. Labour costs increased with increasing symptom severity from € 1468.22 for men with no or minimal depressive symptoms to € 7190.25 for men with severe depressive symptoms and from € 1045.82 to € 4306.30 in women, respectively.

Conclusion

The present results indicate that increasing depressive symptom severity is associated with increasing absenteeism and employer costs. They emphasize the need for implementation, realignment or extension of professional work-site health promotion programmes aiming at the improvement and maintenance of employee health and the reduction of labour costs associated with depression-related sick leave.
Regional accents modulate perspective in geographical space
Authors: García-Marco Enrique , Branca Itatí , Castillo Dolores , León Inmaculada , Beltrán David , de Vega Manuel
Published: October 2021

In this study, participants listened to first-person statements that mentioned a character who was approaching a geographical location close to (Tenerife, Canary Islands) or distant from the participant (Madrid, Spanish peninsula), pronounced with either the participants' local or a distal regional accent. Participants more often judged approaching statements as coherent when they refer to a close place pronounced with local accent or refer to a distant place with distal accent, rather than when they refer to a close place with distal accent or to a distant place with local accent. These results strongly suggest that the local accent induces listeners to keep their own geographical perspective, whereas the distal accent determines shifting to another’s perspective. In sum, a subtle paralinguistic cue, the speaker’s regional accent, modulates the participants’ geographic perspective when they listen to identical first-person sentences with approaching deictic verbs.
Flächensparen in der Planung von Logistikimmobilien
Authors: Kotzold Dennis , Hüer Lucas , Griese Kai-Michael , Franz Martin
Published: October 2021

Logistikunternehmen haben es bei der Suche nach neuen Standorten zunehmend schwerer, da geeignete Standorte immer knapper werden und ihnen wachsende Widerstände entgegenstehen: Umweltverbände und Anwohner*innen kritisieren Luftverschmutzung, Flächenverbrauch, Beeinträchtigungen des Landschaftsbilds und Zunahme des Verkehrslärms; die Lokalpolitik bevorzugt häufig Unternehmen mit höheren Gewerbesteueraufkommen und mehr (hochqualifizierten) Arbeitsplätzen. Der Druck auf die Logistikbranche, nachhaltigere Konzepte der Flächennutzung zu entwickeln und umzusetzen steigt. Zielsetzung des Artikels ist es, Ansätze aufzuzeigen, wie die Flächennutzung in der Logistik optimiert werden kann. Ein wichtiges Lösungsfeld ist auf Basis des Logistikmodells von Pfohl (2010) vor allem in den Bereichen der Flächenplanung zu verorten. Als Grundlage des Artikels wurde eine systematische Literaturrecherche durchgeführt. Die Ergebnisse zeigen Möglichkeiten auf, wie Unternehmen und Kommunen durch eine frühzeitige Planung zur Optimierung von Flächennutzung für logistische Prozesse beitragen können. Die sorgfältige Planung eines Lagers und die damit einhergehende Nutzung von effizienten Lagersystemen, verringern die benötigte Fläche und sorgen für verbesserte Prozesse im Bereich der Lager- und Umschlagslogistik. Auch lassen sich ggf. neue Lagerflächen vermeiden, wenn die bereits genutzten Flächen optimiert werden.
Reproducibility of MRI-based white matter tract estimation using multi-fiber probabilistic tractography: effect of user-defined parameters and regions
Authors: Brumer Irène , De Vita Enrico , Ashmore Jonathan , Jarosz Jozef , Borri Marco
Published: October 2021

Objective

There is a pressing need to assess user-dependent reproducibility of multi-fibre probabilistic tractography in order to encourage clinical implementation of these advanced and relevant approaches. The goal of this study was to evaluate both intrinsic and inter-user reproducibility of corticospinal tract estimation.

Materials and methods

Six clinical datasets including motor functional and diffusion MRI were used. Three users performed an independent tractography analysis following identical instructions. Dice indices were calculated to quantify the reproducibility of seed region, fMRI-based end region, and streamline maps.

Results

The inter-user reproducibility ranged 41–93%, 29–94%, and 50–92%, for seed regions, end regions, and streamline maps, respectively. Differences in streamline maps correlated with differences in seed and end regions. Good inter-user agreement in seed and end regions, yielded inter-user reproducibility close to the intrinsic reproducibility (92–97%) and in most cases higher than 80%.

Discussion

Uncertainties related to user-dependent decisions and the probabilistic nature of the analysis should be considered when interpreting probabilistic tractography data. The standardization of the methods used to define seed and end regions is a necessary step to improve the accuracy and robustness of multi-fiber probabilistic tractography in a clinical setting. Clinical users should choose a feasible compromise between reproducibility and analysis duration.
Increased grazing drives homogenisation but reduced grazing increases turnover in upland habitat mosaics
Authors: Pakeman Robin J. , Fielding Debbie A.
Published: October 2021

Many ecosystems are grazed by livestock or large, wild herbivores and exist as mosaics of different vegetation communities. Changing grazing could have an impact on heterogeneity as well as on composition. A long-term, large-scale grazing experiment that maintained existing low-intensity sheep grazing, tripled it, removed it and partially substituted sheep grazing by cattle grazing was set up on a mosaic of upland vegetation types. The impact of changing grazing regimes was assessed in terms of changes in temporal and spatial species and functional beta diversity. Removal of grazing had the highest impact on species replacement, whilst increased grazing was closest to maintaining the original species complement. Wet heath and Molina mire had the lowest turnover, but wet heath showed the highest changes in unidirectional abundance as it contained species capable of increasing in abundance in response to changing grazing intensity. Agrostis-Festuca and Nardus grasslands displayed the highest level of balanced species replacement reflecting their more dynamic vegetation. In functional terms, there was no clear separation of communities based on their grazing preference, all were relatively resistant to change but Nardus grassland was the most resistant to the removal of grazing. The increased offtake associated with increased grazing led to a degree of homogenisation as grazing tolerant species associated with preferred communities increased in the unpreferred ones. Decisions about grazing management of the uplands involve many trade-offs, and this study identified potential trade-offs between stability and homogenisation to add to existing ones on the biodiversity of different groups of species and on ecosystem services.
Clinical, echocardiographic and hemodynamic predictors of right heart failure after LVAD placement
Authors: Stricagnoli M. , Sciaccaluga C. , Mandoli G. E. , Rizzo L. , Sisti N. , Aboumarie H. S. , Benfari G. , Maritan L. , Tsioulpas C. , Bernazzali S. , Maccherini M. , Natali B. M. , Focardi M. , D’Ascenzi F. , Lisi M. , Valente S. , Mondillo S. , Cameli M.
Published: October 2021

Right ventricular failure (RVF) after left ventricular assist device (LVAD) implant is associated with increasing morbidity and mortality. The aim of this study was to identify the best predictors of RVF post LVAD-implant among biochemical, haemodynamic and echocardiographic parameters. From 2009 to 2019, 38 patients who underwent LVAD implantation at our centre were prospectively enrolled. Preoperative clinical, laboratory, echocardiographic and haemodynamic parameters were reported. Overall, eight patients (21%) developed RVF over time, which revealed to be strongly related to overall mortality. Pulmonary artery pulsatility index (PAPi) resulted to be the most significant right heart catheterization index in discriminating RVF vs no RVF patients [(1.32 ± 0.26 vs. 3.95 ± 3.39 respectively) p = 0.0036]. Regarding transthoracic echocardiography, RVF was associated with reduced free wall right ventricular longitudinal strain (fw-RVLS) (− 7.9 ± 1.29 vs. − 16.14 ± 5.83) (p < 0.009), which was superior to other echocardiographic determinants of RVF. Among laboratory values, N-terminal pro-brain natriuretic peptide (NT-proBNP) was strongly increased in RVF patients [(10,496.13 pg/ml ± 5272.96 pg/ml vs. 2865, 5 pg/ml ± 2595.61 pg/ml) p = 0.006]. PAPi, NT-proBNP and fwRVLS were the best pre-operative predictors of RVF, a post-LVAD implant complication which was confirmed to have a great impact on survival. In particular, fwRVLS has been proven to be the strongest independent predictor.
Contemporary Judeo–Spanish Poetry for Young Readers
Authors: August-Zarębska Agnieszka
Published: October 2021

This article presents contemporary Judeo-Spanish poetry for children in the context of the postvernacular mode (when the language is not used any more in everyday communication) of the language. It discusses the poetry collections of three authors who have published Judeo-Spanish poems in the twenty-first century: Ada Gattegno-Saltiel, Avner Perez, and Sarah Aroeste, as well as the project Yeladino, which is an anthology of Judeo-Spanish translations of Hebrew poems. It analyses the books and projects in terms of their subject matter, language, and poetic devices, as well as the relation of some of them with music, theatre-music performance, and educational activities. The paper raises the question of audience of this poetry, allowing for the fact that nowadays there are no children learning Judeo-Spanish as their first language, and that the language itself is considered severely endangered. The paper states the presence of the dual address in these books, i.e. to children and adults, both on the level of implied and real audience.
Concurrent and Prospective Associations Between Social Anxiety and Responses to Stress in Adolescence
Authors: Blöte Anke W. , Miers Anne C. , Westenberg P. Michiel
Published: October 2021

Several studies have investigated the relationship between adolescents’ responses to stress and general anxiety and depression, but only few studies addressed the relationship between responses to stress and social anxiety. The current three-wave longitudinal study, that covered a period of 5 years with a time interval of on average two years between waves, examined concurrent as well as prospective relations between adolescents’ self-reported stress responses, including coping responses, and self-perceived social anxiety. Both the predictive power of social anxiety for different stress responses and, reversely, of stress responses for social anxiety were evaluated. Participants were 331 youth (170 boys) aged 9 to 17 years old at Wave 1. Self-report questionnaires were used to measure social anxiety, responses to social stress, and depressive symptoms. Results showed significant concurrent relations between social anxiety and maladaptive stress responses. Moreover, the study yielded evidence for social anxiety predicting stress responses across time as well as stress responses predicting social anxiety, although evidence for the former link is stronger. The findings suggest that a relative lack of adaptive stress responses may heighten social anxiety and social anxiety in turn may trigger maladaptive as well as adaptive responses to social problems. The relevance of these findings for social anxiety prevention and intervention purposes are discussed.
“To Normalize is to Impose a Requirement on an Existence.” Why Health Professionals Should Think Twice Before Using the Term “Normal” With Patients
Authors: Rost Michael
Published: October 2021

The term “normal” is culturally ubiquitous and conceptually vague. Interestingly, it appears to be a descriptive-normative-hybrid which, unnoticedly, bridges the gap between the descriptive and the normative. People’s beliefs about normality are descriptive and prescriptive and depend on both an average and an ideal. Besides, the term has generally garnered popularity in medicine. However, if medicine heavily relies on the normal, then it should point out how it relates to the concept of health or to statistics, and what, after all, normal means. Most importantly, the normativity of the normal needs to be addressed. Since the apparently neutral label “normal” can exclude, stigmatize, and marginalize people who are defined in contrast to it as abnormal, health professionals should think twice before using the term with patients. The present critical perspective advocates against using the term “normal,” as long as no understanding of a person’s individual normality has been attained. It advocates for the right to autonomously determine one’s own normality. For health professionals I do not see worthwhile benefits of subscribing to the concept of (non-individual and normatively loaded) “normality” and imposing it on their patients. But I do see many risks.
ASCO 2021—selection of personal highlights in early stage non-small cell lung cancer
Authors: Absenger Gudrun , Pircher Andreas
Published: October 2021

This article intends to summarize personal non-small cell lung cancer (NSCLC) highlights of the virtual ASCO 2021 meeting. Immunotherapy is now a mainstay of advanced stage NSCLC treatment and there are several ongoing studies investigating the role of immunotherapy in early stage NSCLC. At ASCO 2021 the first data on atezolizumab in the adjuvant setting were presented and give a positive signal that immunotherapy will also become an option for patient in early stage NSCLC. Furthermore, overall survival (OS) updates of two studies investigating the effects of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in the adjuvant setting of EGFR-mutated NSCLC patients were presented. In conclusion ASCO 2021 provided the lung cancer community with inspiring new data especial in early stages and challenges the community with integration of these data into our daily clinical routine.
Gemäßigt konstruktivistische Prozessmerkmale fächerübergreifenden Unterrichts im Fächerverbund Sport und Biologie
Authors: Kramer Niklas , Wegner Claas
Published: October 2021

Sportunterricht wird in vielen konzeptionell-reflektorischen Arbeiten als ein ergiebiger Partner für fächerübergreifende Unterrichtsmaßnahmen gesehen. Ein solch mehrperspektivisch orientierter Sportunterricht bietet im Hinblick auf den sportpädagogischen Diskurs eine Möglichkeit, kognitive Aktivität im Schulsport zu implementieren und die Relevanz des Faches zu erhöhen. Dennoch zeigt sich ein Evaluationsdefizit eines solchen Unterrichts. Die vorliegende Studie wirkt diesem Defizit entgegen und setzt sich zunächst mit strukturellen Merkmalen eines fächerübergreifenden Unterrichts auseinander. Da sowohl das Konstrukt der kognitiven Aktivierung als auch der fächerübergreifende Unterricht eine Nähe zum Konstruktivismus offenbaren, soll in der vorliegenden Studie untersucht werden, inwiefern sich ein fächerübergreifender Unterricht in den konstruktivistischen Prozessmerkmalen (situativ, aktiv, konstruktiv) vom Fachunterricht unterscheidet. Dafür nahmen insgesamtN = 75 Schüler*innen (15,2 Jahre) aus vier Kursen des Sekundarbereichs an einer fächerübergreifenden Unterrichtseinheit im Fächerverbund Sport und Biologie teil. Zur Evaluation der konstruktivistischen Prozessmerkmale wurde der Kurzfragebogen nach Basten et al. eingesetzt, der für den fächerübergreifenden Unterricht sowie für den Sport- und Biologieunterricht bewertet wurde. Messwiederholte Varianzanalysen zeigten signifikante Unterschiede zwischen den fächerübergreifenden Unterrichtseinheiten und dem Biologieunterricht in allen drei Subskalen. Der Sportunterricht unterschied sich lediglich in der Subskala „situativ“ von den Unterrichtseinheiten. Der Einfluss des subjektiven Vorwissens auf die Bewertung der fächerübergreifenden Unterrichtseinheiten konnte nur für die Subskala „konstruktiv“ festgestellt werden. Schüler*innen mit viel Vorwissen bewerteten diese im fächerübergreifenden Zusammenhang signifikant höher. Die Studie stützt damit die bereits theoretisch angenommene höhere Ausprägung der prozessbezogenen Merkmale des gemäßigten Konstruktivismus in fächerübergreifenden Unterrichtseinheiten im Vergleich zum Biologieunterricht. Zudem wird die Sonderstellung des Faches Sport deutlich, die in weiteren Studien untersucht werden sollte.
Urban Stormwater Modeling with Local Inertial Approximation Form of Shallow Water Equations: A Comparative Study
Authors: Wang Weiqi , Chen Wenjie , Huang Guoru
Published: October 2021

This study focused on the performance and limitations of the local inertial approximation form model (LIM) of the shallow water equations (SWEs) when applied in urban flood modeling. A numerical scheme of the LIM equations was created using finite volume method with a first-order spatiotemporal Roe Riemann solver. A simplified urban stormwater model (SUSM) considering surface and underground dual drainage system was constructed based on LIM and the US Environmental Protection Agency Storm Water Management Model. Moreover, a complete urban stormwater model (USM) based on the SWEs with the same solution algorithm was used as the evaluation benchmark. Numerical results of the SUSM and USM in a highly urbanized area under four rainfall return periods were analyzed and compared. The results reveal that the performance of the SUSM is highly consistent with that of the USM but with an improvement in computational efficiency of approximately 140%. In terms of the accuracy of the model, the SUSM slightly underestimates the water depth and velocity and is less accurate when dealing with supercritical flow in urban stormwater flood modeling. Overall, the SUSM can produce comparable results to USM with higher computational efficiency, which provides a simplified and alternative method for urban flood modeling.
Association of ATG5 gene polymorphism with Parkinson’s disease in a Han Chinese population
Authors: Han Jing , Feng Ganghua , Wu Jibao , Zhang Yi , Long Zhipeng , Yao Xiaoxi
Published: October 2021

Purpose

There is growing evidence that autophagy-related gene 5 (ATG5) is involved in neural development, neuronal differentiation, and neurodegenerative diseases. The purpose of this study was to investigate the association between ATG5 gene single-nucleotide polymorphisms (SNPs) and Parkinson’s disease (PD) in the Han population.

Methods

A case–control study was conducted in 120 PD patients and 100 healthy volunteers. MassArray platform was used to analyze polymorphisms in three different regions of ATG5 gene (rs510432, rs573775 and rs17587319). In the included subjects, 50 PD patients and 50 healthy volunteers were selected, and the plasma ATG5 concentration was detected by enzyme-linked immunosorbent assay (ELISA). The allele and genotype frequencies of SNPs were assessed using the SHEsis program.

Results

We found a significant correlation between rs17587319 and PD, and the subcomponent showed a high correlation between rs17587319 with cognitive impairment and age at onset in PD patients. At the same time, the total plasma ATG5 level of PD patients and the plasma ATG5 expression level of early-onset Parkinson’s disease (EOPD) patients were significantly higher than the control group, while there was no significant difference of ATG5 expression between late-onset Parkinson’s disease (LOPD) patients and the control group.

Conclusion

These findings suggest that genetic variations in the ATG5 gene and low levels of the ATG5 protein are associated with susceptibility to PD and with cognitive impairment in PD patients. ATG5 could be a potential biomarker to assess the severity and prognosis of PD.
Role of Transcranial Doppler in Cardiac Surgery Patients
Authors: Gupta Pranav , Steiner Luzius A.
Published: October 2021

Purpose of Review

This review discusses applications of transcranial Doppler (TCD) in cardiac surgery, its efficacy in preventing adverse events such as postoperative cognitive decline and stroke, and its impact on clinical outcomes in these patients.

Recent Findings

TCD alone and in combination with other neuromonitoring modalities has attracted attention as a potential monitoring tool in cardiac surgery patients. TCD allows not only the detection of microemboli and measurement of cerebral blood flow velocity in cerebral arteries but also the assessment of cerebral autoregulation.

Neuromonitoring is critically important in cardiac surgery as surgical and anesthetic interventions as well as several other factors may increase the risk of cerebral embolization (gaseous and particulate) and cerebral perfusion anomalies, which may lead to adverse neurological events. As an experimental tool, TCD has revealed a possible association of poor neurological outcome with intraoperative cerebral emboli and impaired cerebral perfusion. However, to date, there is no evidence that routine use of transcranial Doppler can improve neurological outcome after cardiac surgery.
Different glomerular filtration rate estimating formula for prescribing DOACs in oldest patients: appropriate dosage and bleeding risk. Post hoc analysis of a prospective cohort
Authors: Calsolaro Valeria , Okoye Chukwuma , Rogani Sara , Calabrese Alessia Maria , Dell’Agnello Umberto , Antognoli Rachele , Guarino Daniela , Monzani Fabio
Published: October 2021

Background

Direct oral anticoagulants (DOACs) pharmacokinetics depends on estimated glomerular filtration rate (eGFR), whose estimation is crucial for optimal risk/benefit balance.

Aims

To assess the concordance among different eGFR formulas and the potential impact on DOACs prescription appropriateness and bleeding risk in oldest hospitalized patients.

Methods

Post hoc analysis of a single-centre prospective cohort study. eGFR was calculated by creatinine-based (MDRD, CKD-EPICr, BIS1) and creatinine–cystatin-C-based (CKD-EPIComb and BIS2) formulas. Patients were stratified according to eGFR [severely depressed (SD) 15–29; moderately depressed (MD) 30–49; preserved/mildly depressed (PMD): ≥ 50 ml/min/1.73 m2]. Concordance between the different equations was assessed by Cohen’s kappa coefficient.

Results

Among AF patients, 841 (59.2% women, mean age 85.9 ± 6.5 years) received DOACs. By CKD-EPICr equation, 135 patients were allocated in the SD, 255 in the MD and 451 in the PMD group. The concordance was excellent only between BIS 2 and CKD-EPIComb and MDRD and CKD-EPICr, while was worse (from good to poor) between the other formulas. Indeed, by adding cystatin-C almost over 1/3 of the patients were reallocated to a worse eGFR class. Bleeding prevalence increased by 2–3% in patients with discordant eGFR between formulas, reallocated to a worse chronic kidney disease (CKD) stage, although without reaching statistical significance. CKD-EPIComb resulted the best predictor of bleeding events (AUROC 0.71, p = 0.03).

Discussion

This study highlights the variability in CKD staging according to different eGFR formulas, potentially determining inappropriate DOACs dosing. Although the cystatin-C derived CKDEPIComb equation is the most accurate for stratifying patients, BIS1 may represent a reliable alternative.
„Heroismus als Weg zur Transzendenz“. Metadiskursive Religionsbezüge und apokalyptische Diskurspraxis der Neuen Rechten
Authors: Schilk Felix
Published: October 2021

In der Rechtsextremismusforschung wird die Instrumentalisierung von Religionen zu Zwecken politischer Agitation ausführlich untersucht. Der Beitrag differenziert diese Perspektive, indem er nach der Form und Funktion religiöser Deutungsmuster in rechten Krisennarrativen fragt.

In einem theoretischen Teil werden in einer wissenssoziologischen Perspektive zunächst strukturelle Gemeinsamkeiten von Konservatismus, Rechtspopulismus und der Neuen Rechten sowie Ähnlichkeiten von rechten Krisennarrativen und apokalyptischen Texten hervorgehoben. In zwei empirischen Analyseschritten werden dann (I) anhand von Quellen aus dem Umfeld der Neuen Rechten zwei metadiskursive Bezüge auf Religionskonzepte systematisiert und (II) durch die exemplarische Analyse populärer rechter Narrative die Struktur und Funktion von apokalyptischen Deutungsmustern skizziert.

Esoterische Religionsbezüge rekurrieren auf die traditionalistische Philosophie und betonen den immanenten Gehalt einerphilosophia perennis. Im Rahmen exoterischer Religionsbezüge werden vor allem die sozialintegrativen Aspekte der Religion als Institution hervorgehoben. In metapolitischen Krisennarrativen werden beide Bezüge in Form von apokalyptischen Deutungsmustern aufbereitet, wobei der Figur desKatechoneine wichtige Rolle zukommt. Dabei wird deutlich, dass die Neue Rechte apokalyptische Deutungsmuster tradiert, weil sie zur Legitimation und Durchsetzung ihrer politischen Hegemonieambitionen auf permanente Krisennarrationen angewiesen ist.

Die wissenssoziologische Perspektive macht eine ambivalente Struktur neurechter Texte sichtbar und kann Anschluss- und Transformationsmöglichkeiten von rechten Narrativen und Diskursen erklären. Der Beitrag basiert auf einer diskursanalytischen Untersuchung neurechter Publikationen.
Revisiting the relationship between farm mechanization and labour requirement in India
Authors: Rajkhowa Pallavi , Kubik Zaneta
Published: October 2021

In many developing and emerging economies, better employment opportunities in the non-farm sector have increased rural wages due to labour shortages during the peak agricultural season. Increasing wages often cause a substitution of labour for mechanical power, but extensive use of labour-saving technologies may cause labour displacement and have serious equity concerns. Using the household and individual fixed effect estimation approach, this paper analyses the relationship between different types of farm machines and labour requirements in India. The results suggest that a unit increase in the level of farm mechanization increases the demand for hired labour by 12%. Moreover, we find that the level of farm mechanization has a positive effect on women’s participation in farm work, while it decreases the probability of children participating in agriculture-related work. Disaggregated analysis based on types of farm machinery suggests that water-lifting equipment, draft power and tractors increase the probability of male household members working on their farms, while all types of farm machines, except tractors, have a positive effect on female farm labour participation. We also find that the effect of farm mechanization on the demand for hired labour decreases as the size of the farm increases.
Online-to-offline advertisements as field experiments
Authors: Matsui Akira , Moriwaki Daisuke
Published: October 2021

Online advertisements have become one of today’s most widely used tools for enhancing businesses partly because of their compatibility with A/B testing. A/B testing allows sellers to find effective advertisement strategie,s such as ad creatives or segmentations. Even though several studies propose a technique to maximize the effect of an advertisement, there is insufficient comprehension of the customers’ offline shopping behavior invited by the online advertisements. Herein, we study the difference in offline behavior between customers who received online advertisements and regular customers (i.e., the customers visits the target shop voluntary), and the duration of this difference. We analyze approximately three thousand users’ offline behavior with their 23.5 million location records through 31 A/B testings. We first demonstrate the externality that customers with advertisements traverse larger areas than those without advertisements, and this spatial difference lasts several days after their shopping day. We then find a long-run effect of this externality of advertising that a certain portion of the customers invited to the offline shops revisit these shops. Finally, based on this revisit effect findings, we utilize a causal machine learning model to propose a marketing strategy to maximize the revisit ratio. Our results suggest that advertisements draw customers who have different behavior traits from regular customers. This study demonstrates that a simple analysis may underrate the effects of advertisements on businesses, and an analysis considering externality can attract potentially valuable customers.
Covid-19 as an opportunity to teach epistemic insight: findings from exploratory workshops on Covid-19 and science with students aged 15–17 in England
Authors: Billingsley Berry , Heyes Joshua M. , Nassaji Mehdi
Published: October 2021

The contributions of science and scientists to combatting Covid-19 have been at the forefront of media attention throughout 2020 and early 2021, exposing the public to the processes of science in an unprecedented manner. The pandemic has highlighted the necessity of scientists working collaboratively with other disciplines in informing thinking about a complex, evolving real-world problem. This draws attention to recent efforts, both in the UK and internationally, towards curriculum reform integrating epistemic insight (knowledge about knowledge, including about what disciplines are and how they interact), with significant implications for the teaching of science in schools. We present findings from two exploratory workshops with 15–17-year-old students in England on the role of science during the pandemic. We found that the workshops provided space for students to begin to develop epistemic insight regarding how science informs decision-making in dialogue with other disciplines. We make recommendations proposing pedagogical approaches using live, complex, real-world problems to address issues around understandings of the nature of science, misinformation, trust and participation in science.
Forest Governance: Hydra or Chloris?
Authors: Arts Bas
Published: October 2021

Many forest-related problems are considered relevant today. One might think of deforestation, illegal logging and biodiversity loss. Yet, many governance initiatives have been initiated to work on their solutions. This Element takes stock of these issues and initiatives by analysing different forest governance modes, shifts and norms, and by studying five cases (forest sector governance, forest legality, forest certification, forest conservation, participatory forest management). Special focus is on performance: are the many forest governance initiatives able to change established practices of forest decline (Chloris worldview) or are they doomed to fail (Hydra worldview)? The answer will be both, depending on geographies and local conditions. The analyses are guided by discursive institutionalism and philosophical pragmatism. This title is also available as Open Access on Cambridge Core.
Introducing Morphology
Authors: Lieber Rochelle
Published: October 2021

A lively introduction to morphology, this textbook is intended for undergraduates with relatively little background in linguistics. It shows students how to find and analyze morphological data and presents them with basic concepts and terminology concerning the mental lexicon, inflection, derivation, morphological typology, productivity, and the interfaces between morphology and syntax on the one hand and phonology on the other. By the end of the text students are ready to understand morphological theory and how to support or refute theoretical proposals. Providing data from a wide variety of languages, the text includes hands-on activities designed to encourage students to gather and analyse their own data. The third edition has been thoroughly updated with new examples and exercises. Chapter 2 now includes an updated detailed introduction to using linguistic corpora, and there is a new final chapter covering several current theoretical frameworks.
Energy versus safety: unilateral action, voter welfare, and executive accountability
Authors: Noble Benjamin S.
Published: October 2021

Does increasing executive power necessarily decrease accountability? To answer this question, I develop a two-period signaling model comparing voter welfare in two separation-of-powers settings. In one, the executive works with a median legislator to change policy; in the other, the executive chooses between legislation or unilateral action. Both politicians may have preferences that diverge from the voter's, yet I find that increasing executive power may increase accountability and welfare, even in some cases when the legislator is more likely to share the voter's preferences than the executive. Unilateral power allows a congruent executive to overcome gridlock, implement the voter's preferred policy, and reveal information about the politicians’ types—which can outweigh the risks of a divergent executive wielding power for partisan ends.