bluuebunny/crossref_metadata_2025 huggingface dataset:
NO2 exposure and lung function decline in a cohort of adults in Mysore, India
Authors: Nori-Sarma Amruta , Thimmulappa Rajesh , Venkataraman G V , Warren Joshua L , Berman Jesse D , Whittaker Steve D , Kulick Erin R , Wellenius Gregory A , P A Mahesh , Bell Michelle L
Published: March 2021

Increasing air pollution in low- and middle-income countries (LMICs) may be contributing to worsening respiratory health, yet to date most relevant studies have been conducted in industrialized nations. Particularly, there are few studies for India, the world’s second most populated country, and on this country’s poorest populations, who may be at the highest risk. We investigated the influence of long-term nitrogen dioxide (NO2) exposure at residential location on lung function decline over a 5-year period in a cohort of low-income adults in Mysore, Karnataka, India. In 2012–2014 and in 2017–2018, we conducted standardized interviews and performed in-home field spirometry before and after bronchodilation. We estimated annual average NO2 in 2017 based on interpolation of seasonal air pollution sampling and used linear mixed effects models with a person-specific random effect to estimate NO2 versus lung function cross-sectionally at baseline and longitudinally, adjusting for potential confounders (age at baseline, sex, smoking status, and long-term seasonality). Among healthy participants (with no COPD or asthma based on lung function tests), NO2 levels were associated with a decline in lung function pre- and post-bronchodilation (−21.7 ml [95% CI: −42.1, −1.3] for FEV1 and −22.2 ml [95% CI: −46.8, 2.3] for FVC pre-bronchodilation, −25.2 ml [95% CI: −48.4, −4.1] for FEV1 and −26.6 ml [95% CI: −51.1, −2.2] for FVC post-bronchodilation) per interquartile range (10 ppb) increase in NO2. Longitudinal impacts of air pollution on lung function were not statistically significant. Results suggest that air pollution exposure is associated with worse lung function among apparently healthy individuals among urban poor communities in India. Future studies should further characterize time-varying air pollution exposures and collect further longitudinal health data in these understudied communities.
Electro-thermo-mechanical modelling of automotive exhaust sensors
Authors: d’Apolito Luigi , Hong Hanchi
Published: March 2021

The development of automotive exhaust sensors is generally based on a time and resources consuming empirical approach. Building numerical models to study the behavior of the sensors is therefore an important key to reduce the development time and improve sensor quality. Zirconia sensor accuracy and response are dependent from temperature, so temperature is generally controlled in the desired range through a heating element. In the present study an electro-thermo-mechanical model of a heated zirconia oxygen sensor with planar structure has been provided. The numerical model has been used as a tool to study and compare different geometries of heaters. Several heater configurations have been modelled and compared in terms of: temperature rise in different points on the surface of the sensor both on the electrode side and heater side, average and maximum temperature, thermal stress and time for the sensor to be considered functional. The improved heater provided a lower peak temperature, but higher average temperature, more uniform temperature distribution, lower thermal stress and lower time than the base heater to reach the prescribed operational conditions.
Austria
Authors: Perscha Alice , Frimston Richard
Published: March 2021

The Republic of Austria is a federal republic, divided into nine states (‘Bundesländer’), which have legislative competences of their own. The judiciary is considered to be the third pillar of the Austrian constitutional system, together with legislation and administration; the doctrine of a separation of powers, judiciary, and administration (executive) means that they are separated in all instances. Austria is a civil law country; its legal system is based on Roman law.
A Panpsychist Dead End
Authors: Nagasawa Yujin
Published: March 2021

Panpsychism has received much attention in the philosophy of mind in recent years. So-called constitutive Russellian panpsychism, in particular, is considered by many the most promising panpsychist approach to the hard problem of consciousness. In this paper, however, I develop a new challenge to this approach. I argue that the three elements of constitutive Russellian panpsychism—that is, the constitutive element, the Russellian element and the panpsychist element—jointly entail a ‘cognitive dead end’. That is, even if constitutive Russellian panpsychism is true, we cannot ascertain how it might solve the hard problem of consciousness.
High-dimensional log-error-in-variable regression with applications to microbial compositional data analysis
Authors: Shi Pixu , Zhou Yuchen , Zhang Anru R
Published: March 2021

In microbiome and genomic studies, the regression of compositional data has been a crucial tool for identifying microbial taxa or genes that are associated with clinical phenotypes. To account for the variation in sequencing depth, the classic log-contrast model is often used where read counts are normalized into compositions. However, zero read counts and the randomness in covariates remain critical issues. We introduce a surprisingly simple, interpretable and efficient method for the estimation of compositional data regression through the lens of a novel high-dimensional log-error-in-variable regression model. The proposed method provides corrections on sequencing data with possible overdispersion and simultaneously avoids any subjective imputation of zero read counts. We provide theoretical justifications with matching upper and lower bounds for the estimation error. The merit of the procedure is illustrated through real data analysis and simulation studies.
Is Dengue Vaccine Protection Possible?
Authors: Halstead Scott B
Published: March 2021

In tropical and subtropical countries, 4 dengue viruses (DENVs) produce mild disease and a potentially fatal vascular permeability syndrome. Unique antigenic and biological properties of DENVs contribute to vaccine development delays. Three tissue culture–based tetravalent candidate dengue vaccines have advanced to phase 3 clinical testing. Sanofi-Pasteur’s chimeric yellow fever tetravalent dengue vaccine, Dengvaxia, licensed in 19 dengue-endemic countries, Europe, and the United States, partially protects seropositives but sensitizes some seronegatives to severe hospitalized dengue. During 2 years of phase 3, Takeda’s TAK-003, a chimeric DENV 2 tetravalent vaccine, protected against DENV 2 but was less protective against other DENVs. In seronegative adults, 1 dose of a tetravalent nonstructural deletion mutant vaccine in late phase developed by the US National Institutes of Health protected seronegative humans against challenge with DENVs 2 and 3. This experience suggests nearly whole DENV genomes are required to achieve balanced and sustained protective immunity.
Method-Specific Cortisol and Dexamethasone Thresholds Increase Clinical Specificity of the Dexamethasone Suppression Test for Cushing Syndrome
Authors: Vogg Nora , Kurlbaum Max , Deutschbein Timo , Gräsl Benedict , Fassnacht Martin , Kroiss Matthias
Published: March 2021

Background

The dexamethasone suppression test (DST) is the recommended first-tier test for suspected Cushing syndrome (CS). Missed dexamethasone intake or insufficient dexamethasone serum exposure may yield false positive results. Quantification of serum dexamethasone in DST samples may therefore improve test performance.

Methods

Simultaneous quantification of dexamethasone and cortisol by liquid chromatography-tandem mass spectrometry in 400 DST serum samples (100 overt CS, 200 excluded CS, 100 adrenal incidentalomas with (possible) autonomous cortisol secretion, AI-ACS) randomly selected within the indication groups. The 2.5th percentile of dexamethasone in patients with excluded CS was considered the lower limit of normal (LLN).

Results

Serum dexamethasone varied from undetectable to 20.2 ng/mL with a median of 4.8 ng/mL (95% CI 4.5-5.1 ng/mL). Dexamethasone was undetectable in only 16 patients (4%), suggesting non-compliance. The dexamethasone LLN was 1.8 ng/mL (4.6 nmol/L). Decreased glomerular filtration rate and diabetes mellitus were associated with higher serum dexamethasone concentration, while body mass index, sex, age, nicotine, and oral contraceptives had no significant effect. By excluding the 27 samples with dexamethasone <LLN and applying the method-specific cortisol cutoff of 2.4 µg/dL (66 nmol/L) to samples with suspected CS, the clinical specificity for CS increased from 67.5% to 92.4% while preserving 100% clinical sensitivity. Among 100 AI-ACS samples (defined by immunoassay), 4 samples had dexamethasone <1.8 ng/mL and 14 samples had cortisol <2.4 µg/dL, which excluded autonomous cortisol secretion.

Conclusions

Quantification of dexamethasone and method-specific cortisol cutoffs in DST samples may reduce the false positive rate and lower the proportion of patients requiring further workup.
The environmental context of inducible HSP70 expression in Eastern Brook Trout
Authors: Nguyen Bao V , O’Donnell Brigid , Villamagna Amy M
Published: March 2021

Much research has focused on the population-level effects of climate change on Eastern Brook Trout (Salvelinus fontinalis). While some studies have considered here sub-lethal stress caused by warming waters, the role of multiple, interacting stressors remains largely unexplored. We used inducible heat shock protein 70 (HSP70) as a molecular biomarker to assess in situ response of Eastern Brook Trout in headwater streams to multiple potential stressors, including temperature. Over 7 sampling events during 2018 and 2019, we sampled 141 fish and found that HSP70 expression and 3-day mean water temperature exhibited a quadratic relationship (R2-adj = 0.68). Further analyses showed that HSP70 expression was explained by temperature, relative water level and their interaction (R2-adj = 0.75), while fish size and capture location were not factors. We observed a significant increase in HSP70 expression during periods of low relative water level with warm temperatures (~18°C) and also during high relative water level with cold temperatures (~8°C). Our results suggest that temperatures at the edges of the preferred range coupled with relative water level might act together to trigger the cellular stress response in Eastern Brook Trout and that there is greater variation in response at colder temperatures. These findings reinforce the need to consider complex, interactive stressors in influencing the health and persistence of Eastern Brook Trout populations into the future.
Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes—a multicentre, randomized controlled trial
Authors: Björksved Margitha , Arnrup Kristina , Bazargani Silvia Miranda , Lund Henrik , Magnusson Anders , Magnuson Anders , Lindsten Rune , Bazargani Farhan
Published: March 2021

Objectives

To compare treatment time, patients’ perceptions during orthodontic treatment, dental fear and side effects, between open and closed surgical exposures in patients with palatally displaced canines (PDCs).

Trial design

Multicentre, randomized controlled trial, with random 1:1 allocation of two parallel groups.

Materials and methods

One hundred and twenty patients from three different orthodontic centres were randomized into one of the two intervention arms, open or closed surgical exposure. Both techniques had mucoperiosteal flaps raised and bone removed above the PDCs. In open exposure, tissue was removed above the canine, and glass ionomer – reaching above soft tissue – was built on the crown. The canine was then left to erupt spontaneously, prior to orthodontic alignment. At closed exposure, a chain was bonded to the canine and orthodontic traction was applied under the mucosa until eruption. Orthodontic alignment of the canines was undertaken after eruption into the oral cavity, with fixed appliances in both groups. All participants were treated according to intention to treat (ITT).

Blinding

Due to the nature of this trial, only outcome assessors could be blinded to the intervention group.

Results

One hundred and seventeen patients completed the trial. All PDCs were successfully aligned. Total treatment time was equal in the two techniques, mean difference −0.1 months (95% CI −3.2 to 2.9, P = 0.93). The closed group experienced more pain and discomfort during the active orthodontic traction. Dental fear, root resorption and periodontal status did not show any clinically significant differences between the groups.

Generalizability

Results of this randomized controlled trial (RCT) can be generalized only to a similar population aged 9–16 years, if exclusion criteria are met.

Conclusion

The closed exposure group experienced more pain and discomfort mostly during active orthodontic traction. All other studied outcomes were similar between the two exposure groups.

Clinical Trial registration

ClinicalTrials.gov, ID: NCT02186548 and Researchweb.org, ID: 127201.
Left ventricular unloading and the role of ECpella
Authors: Belohlavek Jan , Hunziker Patrick , Donker Dirk W
Published: March 2021

The main reason for the emergency implantation of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is the restoration of adequate systemic perfusion, while protecting the failing heart and promoting myocardial recovery are equally important goals. Following initial haemodynamic stabilization and often the urgent revascularization of the culprit lesion, the clinical focus is then directed towards the most efficient strategy for cardioprotection. Frequent echocardiography measurements may help to estimate the degree of unwanted left ventricular (LV) overloading during VA-ECMO. Additionally, the estimation of high LV filling pressures by Doppler echocardiography or their (in-)direct measurement using a dedicated surgical left atrial pressure line and conventional pulmonary artery catheter in a wedge position or a pigtail catheter in the left ventricle can be performed. Mechanical overload of the left ventricle is the major adverse effect and an obvious mechanistic and prognostic challenge of contemporary ECMO care. Many efforts are under way to overcome this phenomenon by LV unloading, which was effectively achieved by the current combined approach using an axial decompression device, while novel technical developments and approaches are tested and urgently anticipated. The aim of this report is to introduce in depth pathophysiological background, current concepts, and future perspectives in LV unloading strategies.
Prognostic Implication of Baseline Sarcopenia for Length of Hospital Stay and Survival in Patients With Coronavirus Disease 2019
Authors: Kim Ji-Won , Yoon Jun Sik , Kim Eun Jin , Hong Hyo-Lim , Kwon Hyun Hee , Jung Chi Young , Kim Kyung Chan , Sung Yu Sub , Park Sung-Hoon , Kim Seong-Kyu , Choe Jung-Yoon
Published: March 2021

Background

The impact of sarcopenia on clinical outcomes of coronavirus disease 2019 (COVID-19) is not clearly determined yet. We aimed to investigate the association between baseline sarcopenia and clinical outcomes in patients with COVID-19.

Methods

All hospitalized adult patients with COVID-19 who had baseline chest computed tomography (CT) scans at a Korean university hospital from February 2020 to May 2020 were included. The main outcome was time from hospital admission to discharge. Death was considered as a competing risk for discharge. Baseline skeletal muscle cross-sectional area at the level of the 12th thoracic vertebra was measured from chest CT scans. The lowest quartile of skeletal muscle index (skeletal muscle cross-sectional area divided by height-squared) was defined as sarcopenia.

Results

Of 121 patients (median age, 62 years; 44 men; 29 sarcopenic), 7 patients died and 86 patients were discharged during the 60-day follow-up. Patients with sarcopenia showed a longer time to discharge (median, 55 vs 28 days; p < .001) and a higher incidence of death (17.2% vs 2.2%; p = .004) than those without sarcopenia. Baseline sarcopenia was an independent predictor of delayed hospital discharge (adjusted hazard ratio [aHR], 0.47; 95% confidence interval [95% CI], 0.23–0.96), but was not independently associated with mortality in patients with COVID-19 (aHR, 3.80; 95% CI, 0.48–30.26). The association between baseline sarcopenia and delayed hospital discharge was consistent in subgroups stratified by age, sex, comorbidities, and severity of COVID-19.

Conclusions

Baseline sarcopenia was independently associated with a prolonged hospital stay in patients with COVID-19. Sarcopenia could be a prognostic marker in COVID-19.
Recruitment and Screening Methods in Alzheimer’s Disease Research: The FIT-AD Trial
Authors: Greimel Susan , Wyman Jean F , Zhang Lin , Yu Fang
Published: March 2021

Background

Recruiting older adults with Alzheimer’s disease (AD) dementia into clinical trials is challenging requiring multiple approaches. We describe recruitment and screening processes and results from the Functional Improvement from Aerobic Training in Alzheimer’s Disease study (FIT-AD Trial), a single-site, pilot randomized controlled trial testing the effects of a 6-month aerobic exercise intervention on cognition and hippocampal volume in community-dwelling older adults with mild-to-moderate AD dementia.

Methods

Ten recruitment strategies and a 4-step screening process were used to ensure a homogenous sample and exercise safety. The initial target sample was 90 participants over 48 months which was increased to 96 to allow those in the screening process to enroll if qualified. A tertiary analysis of recruitment and screening rates, recruitment yields and costs, and demographic characteristics of participants was conducted.

Results

During the 48-month recruiting period, 396 potential participants responded to recruitment efforts, 301 individuals were reached and 103 were tentatively qualified. Of these, 67 (69.8%) participants completed the optional magnetic resonance imaging and 7 were excluded due to abnormal magnetic resonance imaging findings. As a result, we enrolled 96 participants with a 2.92 screen ratio, 2.14 recruitment rate, and 31.9% recruitment yield. Referrals (28.1%) and Alzheimer’s Association events/services (21.9%) yielded over 49% of the enrolled participants. Total recruitment cost was $38 246 or $398 per randomized participant.

Conclusions

A multiprong approach involving extensive community outreach was essential in recruiting older adults with AD dementia into a single-site trial. For every randomized participant, 3 individuals needed to be screened. Referrals were the most cost-effective recruitment strategy.

Clinical Trials Registration Number: NCT0194550
Dental chews positively shift the oral microbiota of adult dogs
Authors: Oba Patrícia M , Carroll Meredith Q , Alexander Celeste , Somrak Amy J , Keating Stephanie C J , Sage Adrianna M , Swanson Kelly S
Published: March 2021

Microbiota plays a prominent role in periodontal disease, but the canine oral microbiota and how dental chews may affect these populations have been poorly studied. We aimed to determine the differences in oral microbiota of adult dogs consuming dental chews compared with control dogs consuming only a diet. Twelve adult female beagle dogs (mean age = 5.31 ± 1.08 yr) were used in a replicated 4 × 4 Latin square design consisting of 28-d periods. Treatments (n = 12/group) included: diet only (CT); diet + Bones & Chews Dental Treats (BC; Chewy, Inc., Dania Beach, FL); diet + Dr. Lyon’s Grain-Free Dental Treats (DL; Dr. Lyon’s, LLC, Dania Beach, FL); and diet + Greenies Dental Treats (GR; Mars Petcare US, Franklin, TN). Each day, one chew was provided 4 h after mealtime. On day 27, breath samples were analyzed for total volatile sulfur compound concentrations using a Halimeter. On day 0 of each period, teeth were cleaned by a veterinary dentist blinded to treatments. Teeth were scored for plaque, calculus, and gingivitis by the same veterinary dentist on day 28 of each period. After scoring, salivary (SAL), subgingival (SUB), and supragingival (SUP) samples were collected for microbiota analysis using Illumina MiSeq. All data were analyzed using SAS (version 9.4) using the Mixed Models procedure, with P < 0.05 considered significant. All dogs consuming chews had lower calculus coverage and thickness, pocket depth and bleeding, plaque thickness, and halitosis compared with CT. In all sites of collection, CT dogs had a higher relative abundance of one or more potentially pathogenic bacteria (Porphyromonas, Anaerovorax, Desulfomicrobium, Tannerella, and Treponema) and lower relative abundance of one or more genera associated with oral health (Neisseria, Corynebacterium, Capnocytophaga, Actinomyces, Lautropia, Bergeyella, and Moraxella) than those fed chews. DL reduced Porphyromonas in SUP and SUB samples. DL and GR reduced Treponema in SUP samples. DL increased Corynebacterium in all sites of collection. BC increased Corynebacterium in SAL samples. DL and GR increased Neisseria in SAL samples. DL increased Actinomyces in the SUB sample. GR increased Actinomyces in SAL samples. Our results suggest that the dental chews tested in this study may aid in reducing periodontal disease risk in dogs by beneficially shifting the microbiota inhabiting plaque and saliva of a dog’s oral cavity. These shifts occurred over a short period of time and were correlated with improved oral health scores.
Insecticidal Effect of Phosphine on Eggs of the Khapra Beetle (Coleoptera: Dermestidae)
Authors: Lampiri Evagelia , Athanassiou Christos G
Published: March 2021

Trogoderma granarium Everts (Coleoptera: Dermestidae) is one of the most important quarantine pests of stored grains. Control of this insect species can be achieved through a gaseous insecticide, phosphine. Many studies focus on the effect of phosphine on different developmental stages of insects, with most of them highlighting eggs as the most tolerant stage. Our data showed that 2-d-old eggs of T. granarium are more susceptible than 1-d-old eggs. Faster hatching was observed in eggs exposed to phosphine for 2 d compared to controls and the result was more pronounced for 1-d-old than 2-d-old eggs. In contrast to the 2-d exposure, hatching rates of eggs exposed to 4 and 6 d were notably reduced, while there was a delay in egg hatching compared to controls. Moreover, larval development from untreated eggs was faster than the larvae from treated eggs, regardless of the exposure time. These dissimilar patters in larval growth may suggest certain delayed effects of phosphine fumigation. The results of the present work can be further utilized for the development of phosphine-based quarantine and pre-shipment treatments for the control of T. granarium.
The Role of Mobile Technology in Documenting International Crimes
Authors: Gabriele Chiara , Matheson Kelly , Llorente Raquel Vazquez
Published: March 2021

This article reflects on the landmark use of photo and video evidence in the Affaire Castro et Kizito. In 2018, a mobile military court in Kalehe, South Kivu, in the Democratic Republic of Congo (DRC) tried two members of the Forces Démocratiques de Libération du Rwanda (FDLR) for crimes against humanity and war crimes. This case broke new ground not only in the DRC, but also globally. For the first time, a court of law admitted digital photography that had been captured with the eyeWitness app, a ready-for-court technology developed to streamline the documentation of international crimes. The authors of this article are legal advisers who were involved in the case and write from their own experience to illustrate how photo and video evidence can strengthen cases and advance justice for the gravest crimes.
Modified Glasgow Prognostic Score is predictive of prognosis for non-small cell lung cancer patients treated with stereotactic body radiation therapy: a retrospective study
Authors: Chen Zhe , Nonaka Hotaka , Onishi Hiroshi , Nakatani Eiji , Sato Yoko , Funayama Satoshi , Watanabe Hiroaki , Komiyama Takafumi , Kuriyama Kengo , Marino Kan , Aoki Shinichi , Araya Masayuki , Tominaga Licht , Saito Ryo , Maehata Yoshiyasu , Oguri Mitsuhiko , Saito Masahide
Published: March 2021

We aimed to assess the predictive value of the modified Glasgow prognostic score (mGPS) in patients with non-small cell lung cancer (NSCLC) who underwent stereotactic body radiation therapy (SBRT). We retrospectively reviewed the records of 207 patients, with a median age of 79 years. The pretreatment mGPS was calculated and categorized as high (mGPS = 1–2) or low (mGPS = 0). The median follow-up duration was 40.7 months. The five-year overall survival (OS), progression-free survival (PFS) and time to progression (TTP) rates were 44.3%, 36% and 54.4%, respectively. Multivariate analysis revealed that mGPS was independently predictive of OS (hazard ratio [HR] 1.67; 95% confidence interval 1.14–2.44: P = 0.009), PFS (HR 1.58; 1.10–2.28: P = 0.014) and TTP (HR 1.66; 1.03–2.68: P = 0.039). Patients who had high mGPS showed significantly worse OS (33.3 vs 64.5 months, P = 0.003) and worse PFS (23.8 vs 39 months, P = 0.008) than those who had low mGPS. The data showed a trend that patients with high mGPS suffered earlier progression compared to those with low mGPS (54.3 vs 88.1 months, P = 0.149). We confirmed that mGPS is independently predictive of prognosis in NSCLC patients treated with SBRT.
Technical Note: validation of a material assignment method for a retrospective study of carbon-ion radiotherapy using Monte Carlo simulation
Authors: Chang Weishan , Koba Yusuke , Furuta Takuya , Yonai Shunsuke , Hashimoto Shintaro , Matsumoto Shinnosuke , Sato Tatsuhiko
Published: March 2021

We propose a two-step method to converse human tissue materials from patient computed tomography (CT) images, which is required in dose reconstructions for a retrospective study of carbon-ion radiotherapy (CIRT) using Monte Carlo (MC) simulation. The first step was to assign the standard tissues of the International Commission on Radiological Protection reference phantoms according to the CT-number. The second step was to determine the mass density of each material based on the relationship between CT-number and stopping power ratio (Hounsfield unit [HU]-SPR) registered in treatment planning system (TPS). Direct implementation of the well-calibrated HU-SPR curve allows the reproduction of previous clinical treatments recorded in TPS without uncertainty due to a mismatch of the CT scanner or scanning conditions, whereas MC simulation with realistic human tissue materials can fulfill the out-of-field dose, which was missing in the record. To validate our proposed method, depth-dose distributions in the homogenous and heterogeneous phantoms irradiated by a 400 MeV/u carbon beam with an 8 cm spread-out Bragg peak (SOBP) were computed by the MC simulation in combination with the proposed methods and compared with those of TPS. Good agreement of the depth-dose distributions between the TPS and MC simulation (within a 1% discrepancy in range) was obtained for different materials. In contrast, fluence distributions of secondary particles revealed the necessity of MC simulation using realistic human tissue. The proposed material assignment method will be used for a retrospective study using previous clinical data of CIRT at the National Institute of Radiological Sciences (NIRS).
Handling inconsistency in partially preordered ontologies: the Elect method
Authors: Belabbes Sihem , Benferhat Salem , Chomicki Jan
Published: March 2021

We focus on the problem of handling inconsistency in lightweight ontologies. We assume that the terminological knowledge base (TBox) is specified in DL-Lite and that the set of assertional facts (ABox) is partially preordered and may be inconsistent with respect to the TBox. One of the main contributions of this paper is the provision of an efficient and safe method, called Elect, to restore the consistency of the ABox with respect to the TBox. In the case where the assertional base is flat (i.e. no priorities are associated with the ABox) or totally preordered, we show that our method collapses with the well-known intersection ABox repair semantics and the non-defeated semantics, respectively. The semantic justification of the Elect method is obtained by first viewing a partially preordered ABox as a family of totally preordered ABoxes and then applying non-defeated inference to each of the totally preordered ABoxes. We introduce the notion of elected assertions which allows us to provide an equivalent characterization of the Elect method without explicitly generating all the totally preordered ABoxes. We show that computing the set of elected assertions is done in polynomial time with respect to the size of the ABox. The second part of the paper discusses how to go beyond the Elect method. In particular, we discuss to what extent the Elect method can be generalized to description logics that are more expressive than DL-Lite.
Preventing Hospital Infections
Authors: Meddings Jennifer , Chopra Vineet , Saint Sanjay
Published: March 2021

This book provides a detailed, step-by-step description of a model quality improvement intervention for hospitals, pinpointing the obstacles and showing how to surmount them. This second edition has been carefully updated, with new material describing some technical aspects of infection prevention, new tools for use by front-line providers, and results of recent large collaborative infection prevention studies. In easy-to-read, user-friendly language, it explains why clinicians neglect or actively oppose quality changes—from physicians who distrust change, to nurses who want to protect their turf, to infection preventionists who avoid the wards. The book also sheds light on how and why hospitals embark on quality improvements, the role of the hospital’s leadership cadre, the selection and training of the project team, and how to sustain quality gains long term. The intervention framework described in the book focuses on the prevention of hospital-associated infections—in particular, catheter-associated urinary tract infection (CAUTI)—but it is directly applicable to a variety of other hospital issues, such as falls, pressure sores, and Clostridioides difficile infection (CDI). In fact, the book includes a chapter applying this framework to a CDI prevention initiative. In addition, for hospitals having trouble with staff adherence to a quality initiative, we provide three infection-specific questionnaires (for CAUTI, CLABSI, and CDI) to help pinpoint individual problems, and provide a link to a website offering advice tailored to their specific circumstances.
Psychologically Immobilized and Functionally Paralyzed
Authors: Doleys Daniel M. , Doleys Nicholas D.
Published: March 2021

The role of conditioning in the development and maintenance of fear and avoidance is well-researched and well-established. Learning theory and conditioning principals form the basis of various behavioral therapies. Indeed, even the process of nociception is susceptible to conditioning. Pharmacological therapy is not likely to be effective and may, in fact, be detrimental to the patient. There are a variety of behavioral strategies that can be implemented in a primary care setting as well as in a pain clinician. Utilizing the expertise of a behavioral therapist may be ideal, but most interested clinicians can acquire a basic understanding of the principle and techniques. There are a variety of educational materials suitable for patient use that can be incorporated into treatment. Functional restoration should be considered as a primary outcome, perhaps even more so, than a reduction of subjective pain rating.
The Unseen Reality
Authors: Doleys Daniel M. , Doleys Nicholas D.
Published: March 2021

It is not uncommon to encounter a patient who is convinced of a somatic cause for their pain. However, in the case of delusional parasitosis, the patient demonstrates an unshakable conviction of some type of infestation. This can lead various form self-mutilation intended to extract the parasite. They will search for evidence in the excrement. They can seem quite convincing. In some instance, this belief can result in very obsessive cleaning rituals, which may include children. Patients are unconvinced by other explanations and resist psychiatric intervention. However, this, oftentimes, is the only hope for effective management. It is important to not discount the patient; the problem is real to them. Attempts should be made, without reinforcing their delusion, to gain their trust so they will agree to appropriate consultations.
Psychogenic Pain: A Useful Concept?
Authors: Doleys Daniel M. , Doleys Nicholas D.
Published: March 2021

The term “psychogenic” pain was use liberally during the 20th century. It has been applied in a number of different ways. First, to describe pain originating from psychological/psychiatric (ie, mental) processes. Second, as a way of declaring that, although there may be physical abnormalities, the degree of pain experienced is dictated by psychological states. Finally, to imply that psychological factors co-mingle with physical factors in the experience of pain, especially chronic pain. By its very nature, “psychogenic” implies of separation of mind and body. Most often it has been used as a diagnosis of exclusion—we cannot find the real (ie, medical/physical) cause, so it must be psychological, all but impugning the validity of the patient’s report. In the midst of modern technology and research, and the prevailing philosophical approach to pain (chronic), the term “psychogenic” has exhausted its research, clinical, and practical utility. This chapter provides supporting evidence for this conclusion and research data highlighting the complex and dynamic nature of pain (chronic).
Psychological/Behavioral Therapies
Authors: Doleys Daniel M. , Doleys Nicholas D.
Published: March 2021

The sole use of medically (somatic)-based therapies when treating a patient is rarely sufficient to address the complex nature of chronic pain. The risk of iatrogenic dependence, and compromising adverse events, encourages the use of a more comprehensive and patient-involved process. There are a number of psychologically based therapies applicable to the treatment of chronic pain. The most researched and commonly used are the behavioral-based therapies. They range from simple to complex and from brief to prolonged. While it may be preferable to have these treatments applied by a trained behavioral specialist with a background in chronic pain, many can be adapted for use in the primary care setting. Furthermore, a variety of cell phone apps, self-help books, and YouTube presentations are available for patient and family use.
Coronary artery spasm and microvascular angina
Authors: Ong Peter , Sechtem Udo
Published: March 2021

Ischaemic heart disease comprises a variety of coronary abnormalities, ranging from obstructive atherosclerotic stenoses to functional coronary vasomotor disorders. The latter comprise coronary spasm, as well as coronary microvascular dysfunction. Importantly, structural and functional abnormalities can coexist in a given patient, making it sometimes difficult to determine the underlying cause of angina. Thus, diagnostic algorithms should not only consider the evaluation of atherosclerotic epicardial disease, but also look for the presence of functional coronary disorders. This holds especially true for patients in whom obstructive coronary disease has been excluded, as many of these patients are labelled as having ‘non-cardiac chest pain’. Such an approach may enable the treating physician to adjust the pharmacological therapy more appropriately, in order to improve symptoms and prognosis. Often drug classes such as calcium channel blockers and nitrates are beneficial in these patients. This chapter gives an overview on the current pharmacological management of patients with coronary artery spasm and those suffering from microvascular angina.
A Narrative Review on the Role of Staphylococcus aureus Bacteriuria in S. aureus Bacteremia
Authors: Schuler Franziska , Barth Peter J , Niemann Silke , Schaumburg Frieder
Published: March 2021

Staphylococcus aureus bacteriuria (SABU) can occur in patients with S. aureus bacteremia (SAB). However, little is known on the (molecular) pathomechanisms of the renal passage of S. aureus. This review discusses the epidemiology and pathogenesis of SABU in patients with SAB and identifies knowledge gaps. The literature search was restricted to the English language. The prevalence of SABU in patients with SAB is 7.8%–39% depending on the study design. The main risk factor for SABU is urinary tract catheterization. SABU in SAB patients is associated with increased mortality. Given present evidence, hematogenous seeding—as seen in animal models—and the development of micro-abscesses best describe the translocation of S. aureus from blood to urine. Virulence factors that might be involved are adhesion factors, sortase A, and coagulase, among others. Other potential routes of bacterial translocation (eg, transcytosis, paracytosis, translocation via “Trojan horses”) were identified as knowledge gaps.
Alteration of economic situation
Authors: Gundt Miriam
Published: March 2021

The applicant shall inform the Court promptly of any alteration in his economic situation.
Article 286 TFEU
Authors: Flynn Leo
Published: March 2021

Article 247 EC The Members of the Court of Auditors shall be chosen from among persons who belong or have belonged in their respective States to external audit bodies or who are especially qualified for this office. Their independence must be beyond doubt.
An International Perspective
Authors: Eckes Christina , Wessel Ramses A.
Published: March 2021

The European Union’s ability to conduct its own foreign policy is not contested as a matter of principle. The Union is for instance the only non-state actor that participates in certain international functional regimes on equal footing with states. At the same time, the Union’s ability to conduct its own foreign policy remains under constant pressure, both from the outside and from the inside. This pressure is created by states, which use both external and internal legal narratives to try to rein in the at least at times quasi-sovereign external posture of the EU. Under international law the narrative goes that only states are vested with ‘original rights’ and hence are ‘primary subjects’ of international law. Even though other international actors accept that the Union takes at times a state-like position, ‘the EU is, under international law, precluded by its very nature from being considered a State’ and classified as an international organization. In that capacity, the Union remains seen as exercising delegated rights and at least partially as penetrable in that behind the organization there are still the Member States as the ultimate point of reference. These pressures have from the outset led to the idea that the EU
Introduction To Strict Product Liability
Authors: Fairgrieve Duncan , Goldberg Richard
Published: March 2021

The adoption of the strict liability scheme for defective products by the European Union Product Liability Directive, and its subsequent transposition through Pt 1 of the Consumer Protection Act 1987, changed the basis on which actions for compensation for damage caused by defective products had been brought for over fifty years. In essence, the change was from a system which required proof of negligence to one in which liability was dependent on proving that a defective product had caused damage. While we shall see that many academics and commentators had originally assumed a critical view of the strict liability regime, considering that in practice liability would be no wider than under negligence, it is now clearly established that, in respect of products supplied on or after 1 March 1988, strict liability under the 1987 Act is the primary cause of action in product liability litigation in the United Kingdom. In many Member States, the effects of the new regime have been very significant indeed.
Provisions Covering General Product Safety
Authors: Fairgrieve Duncan , Goldberg Richard
Published: March 2021

The main purpose of this book is to provide a detailed statement of the principles governing the civil liability of manufacturers and others for damage or loss caused by defective products. In this final chapter we refer briefly to some of the main sources which seek to regulate product safety through the use of the criminal law. Of course, many types of products are covered by specific legislation. For example, the sale of food for human consumption and medicines fall into this category. The details fall outside the scope of this work.
When the Worlds of Preferences Collide: Determinants of MP’s Attitudes on the Italian Questione Romana 1861–1870
Authors: Casiraghi Matteo C M , Curini Luigi
Published: March 2021

The relationship between original and induced preferences in affecting political actions has been a recurrent topic in the literature. Less attention has been devoted to investigating the interaction between these two preferences, and possible neutralising/reinforcing effects. We explore this dynamic on a crucial issue in XIX century Italy, the ‘Questione Romana’, employing a quantitative analysis on an original corpus of legislative speeches (1861–1870). The absence of strong parties allows investigating the relationship between MPs’ original preferences and that induced by their voters’ linkage. Moreover, as politicians and voters were part of the same elite, we can check how their paths of political socialisation shape this relationship, leading to aligned or colliding preferences.
Supersymmetric quantum field theory with exotic symmetry in 3+1 dimensions and fermionic fracton phases
Authors: Yamaguchi Satoshi
Published: March 2021

We propose a supersymmetric quantum field theory with exotic symmetry related to fracton phases. We use superfield formalism and write down the action of a supersymmetric version of the $\varphi$ theory in $3+1$ dimensions. It contains a large number of ground states due to the fermionic higher pole subsystem symmetry. Its residual entropy is proportional to the area instead of the volume. This theory has a self-duality similar to that of the $\varphi$ theory. We also write down the action of a supersymmetric version of a tensor gauge theory, and discuss Bogomol’nyi–Prasad–Sommerfield (BPS) fractons.
Physical Therapist Interventions for Infants With Nonsynostotic Positional Head Deformities: A Systematic Review
Authors: Cabrera-Martos Irene , Ortigosa-Gómez Salvador Jesús , López-López Laura , Ortiz-Rubio Araceli , Torres-Sánchez Irene , Granados-Santiago María , Valenza Marie Carmen
Published: March 2021

Objective

This study sought to examine the methodological quality and summarize the evidence from clinical trials that examined the effectiveness of physical therapist interventions in the management of nonsynostotic positional head deformities in infants.

Methods

The following electronic databases were searched: PubMed/MEDLINE, ScienceDirect, CINAHL, Scopus, PEDro, and Web of Science. Two different authors conducted the searches and completed the data extraction. Randomized and non-randomized clinical trials were included. The risk of bias was assessed using the Downs and Black Scale and the Cochrane Collaboration’s tool.

Results

Six articles were finally included. The main features of interventions included education to parents about positioning, manual therapy, and motor stimulation. The small sample sizes were not adequately powered and methodological quality showed a high risk of bias, mainly from a lack of blinding and limited external validity.

Conclusion

There are indicators that suggest that physical therapist interventions may be useful for infants with nonsynostotic head deformities at improving cranial asymmetries and motor development. However, the validity of such conclusion is limited because most trials included had a high risk of bias. More rigorous research on physical therapy, including randomized controlled trials with larger sample sizes, is required in this area.

Impact

The high prevalence and incidence of nonsynostotic positional head deformities in infants calls for the development of effective interventions. Physical therapists have a promising role in the improvement of cranial asymmetry and motor development. The most reported interventions involved educating parents about positioning and manual therapy. Some studies show that changes obtained after physical therapist intervention were comparable with those obtained after helmet therapy.

Lay Summary

Early referral to physical therapy may help to prevent or reduce the severity of nonsynostotic positional head deformities. Education about positioning is important to prevent and improve the asymmetry of the baby’s head when there is nonsynostotic positional head deformity. Physical therapist interventions can improve motor development in infants with nonsynostotic positional head deformity who have motor delays.
Celebrating holy week practices at home during the COVID-19 pandemic in the Philippines
Authors: Gozum Ivan Efreaim A , Nucum John Lu Allan M , Noriega Patrick Joseph D
Published: March 2021

A recent correspondence suggested that taking home ashes and launching digital Lenten ashes filters are non-traditional yet creative ways for the Catholic Church to perform the ritual practice in celebrating Ash Wednesday. These creative practices are deemed as necessary so that the Catholic community can celebrate the liturgical celebration while ensuring public health. With this, we propose in this paper practices that can be done during the holy week so that the spread of the coronavirus will be mitigated.
Science and religion for COVID-19 vaccine promotion
Authors: Galang Joseph Renus F
Published: March 2021

A recent correspondence published in this journal proposed a multi-sectoral approach on the coronavirus disease 2019 (COVID-19) vaccination hesitancy, whereas another proposed that religious leaders play a role in gaining the public’s trust in COVID-19 vaccine. This article raises awareness that though religious leaders play a huge role in promoting the COVID-19 vaccine, they are still bound by the findings of science. What this article, therefore, proposes is the collaboration of science and religion in COVID-19 vaccine promotion.