bluuebunny/crossref_metadata_2025 huggingface dataset:
Arterial tortuosity syndrome causing recurrent transient ischemic attacks in young adult: a case report
Authors: Cotti Piccinelli Stefano , Premi Enrico , Bonacina Sonia , Gilberti Nicola , Vergani Veronica , Gamba Massimo , Spezi Raffaella , Delrio Ilenia , Bernier Michaël , Costa Angelo , Ravanelli Marco , Colombi Marina , Gasparotti Roberto , Padovani Alessandro , Magoni Mauro
Published: November 2021

Background

Arterial Tortuosity Syndrome (ATS) is a rare autosomal recessive disorder characterized by elongated and tortuous arteries. Although ATS showed a significant clinical and pathophysiological overlap with other syndromes involving connective tissues, only few cases of cerebrovascular events related to this syndrome have been described so far.

Case presentation

We report the case of a 33-years-old male diagnosed with ATS since childhood, that experienced three sudden episodes of expressive aphasia and right hemiparesis with spontaneous resolution. He was treated with recombinant tissue plasminogen activator (r-TPA) at a dosage of 0.9 mg/kg with a complete recovery. Brain Magnetic Resonance Imaging (MRI) showed the absence of acute ischemic lesions and the patient was diagnosed with recurrent transient ischemic attacks (TIA).

Intracranial and supra-aortic trunks Magnetic Resonance Angiography (MRA) and Angio-CT scan of the thoracic and abdominal aorta showed marked vessel tortuosity without stenosis.

To our knowledge, this is the first reported case of an ATS patient with TIA in young age that was treated with intravenous thrombolysis with recombinant plasminogen activator.

Conclusion

Our report strengthens the relationship between ATS and juvenile cerebrovascular events, suggesting that an extensive study of body vessels in order to detect potential stenoses or occlusions in these cases is needed.

The greater predisposition to cerebrovascular events in ATS could benefit from a more aggressive primary and secondary prevention therapy.
Reference values for fetal Doppler-based cardiocirculatory indices in monochorionic-diamniotic twin pregnancy
Authors: Chongsomboonsuk Thananan , Phithakwatchara Nisarat , Nawapun Katika , Viboonchart Sommai , Jaingam Suparat , Wataganara Tuangsit
Published: November 2021

Background

Placental anastomoses in monochorionic diamniotic (MCDA) twin pregnancy have a major impact on fetal circulation. This study was designed to define reference ranges of cardiac and vascular Doppler indices in MCDA twin pregnancies.

Methods

This cross-sectional study included 442 uncomplicated MCDA twin fetuses undergoing Doppler ultrasonography at 18–35 weeks of gestation. Left and right myocardial performance index (LV-MPI, RV-MPI), E/A ratio of atrioventricular valves, pulsatility indices of umbilical artery, middle cerebral artery (MCA), and ductus venosus (DV), cerebroplacental ratio, peak systolic velocity of MCA, S/a ratio of DV, and early diastolic filling time of ductus venosus (DV-E) were evaluated under standardized settings. The equation models between Doppler indices and gestational age (GA) were fitted. After adjustment for GA, the correlations between MPI and fetal heart rate (FHR), and between MPI and DV indices were analyzed.

Results

Estimated centiles of Doppler indices were derived as a function of GA, being distinct in values from those of singletons. There was no correlation between GA-adjusted MPI and FHR. DV-E was inversely related to LV-MPI.

Conclusions

MCDA twins showed significant changes in some Doppler indices throughout gestation with quantitative differences from singletons, emphasizing the importance of MC twin-specific reference values for clinical application. Further adjustment of MPI for FHR was unnecessary. DV-E is a vascular index indirectly representing fetal diastolic function.
An office-based fix-and-follow grading system assessing visual function in preverbal children
Authors: Jeon Hyeshin , Jung Jae Ho , Choi Hee-young
Published: November 2021

Background

Assessing visual function in infants is usually challenging. Fix-and-Follow is a simple and popular method for assessing early development of visual perception in infants, currently however, there is no formal reproducible method for grading the capacity of fix-and-follow. This study was to develop and validate a new fix-and-follow grading system for assessing visual function development in preverbal children.

Methods

In this cross-sectional study, the fix-and-follow grades was evaluated in 21 consecutive preverbal children. Fixation was categorised as grade 1 if there was no response to the target and grade 2 if there was a response but only for < 3 s. Grades of 3 and 4 were assigned based capacities to (1) fix on a moving target for ≥3 s, and (2) shift fixation from one target to another. If only one of these two criteria was met, grade 3 was assigned. If both were met, grade 4 was assigned. Following was evaluated using smooth pursuit movement, where grade 1 indicated no movement, grade 2 partial movement, and grade 3 complete movement. Two ophthalmologists independently applied the grading method in all patients. Then one of two examiners repeated the examinations to investigate the intra-observer agreement of the grading system.

Results

Intra-observer agreement was excellent (Kappa coefficient = 0.823) and inter-observer agreement was good (Kappa coefficient = 0.625). All patients who exhibited abnormal ocular movement had score discrepancy between a new fix-and-following grading examination.

Conclusions

The new fix-and-follow grading scale can be applied easily in preverbal children in an office setting, and it proved reliable and reproducible.
Major heart defects: the diagnostic evaluations of first-year-olds
Authors: Pavlicek Jan , Klaskova Eva , Kapralova Sabina , Palatova Alzbeta Moravova , Piegzova Alicja , Spacek Richard , Gruszka Tomas
Published: November 2021

Background

Severe or critical congenital heart defects (CHDs) constitute one third of the heart defect cases detected only after birth. These prenatally unrecognised defects usually manifest as cyanotic or acyanotic lesions and are diagnosed postnatally at various times. The aim of the study was to identify their clinical symptoms and determine individual risk periods for CHD manifestation.

Methods

Data were assessed retrospectively based on a cohort of patients born between 2009 and 2018 in a population of 175,153 live births. Occurrence of the first symptoms of CHD was classified into: early neonatal (0–7 days), late neonatal (8–28 days), early infancy (1–6 months), or late infancy (6–12 months). The first symptom for which the child was referred to a paediatric cardiologist was defined as a symptom of CHD.

Results

There were 598 major CHDs diagnosed in the studied region, 91% of which were isolated anomalies. A concomitant genetic disorder was diagnosed in 6% of the cases, while 3% presented extracardiac pathology with a normal karyotype. In total, 47% (282/598) of all CHDs were not identified prenatally. Of these, 74% (210/282) were diagnosed as early neonates, 16% (44/282) as late neonates, and 10% (28/282) as infants. The most common symptoms leading to the diagnosis of CHD were heart murmur (51%, 145/282) and cyanosis (26%, 73/282). Diagnosis after discharge from the hospital occurred in 12% (72/598) of all major CHDs. Ventricular septal defect and coarctation of the aorta constituted the majority of delayed diagnoses.

Conclusions

In conclusion, murmur and cyanosis are the most common manifestations of prenatally undetected CHDs. Although most children with major CHDs are diagnosed as neonates, some patients are still discharged from the maternity hospital with an unidentified defect.
What social determinants outside paid work are related to development of mental health during life? An integrative review of results from the Northern Swedish Cohort
Authors: Ziaei Shirin , Hammarström Anne
Published: November 2021

Background

Despite global increase in burden of mental health conditions, longitudinal studies on factors related to development of mental health are scarce. Particularly integrated understanding of how factors at each level of ecological system interact to influence mental health of individuals during their life is missing. Both work and outside work (life beyond work) spheres are two important areas in human life which can have independent effects on mental health of individuals. In this integrative review, we aimed to synthesis findings about social determinants outside paid work that are related to development of mental health during life in a 27-year prospective Swedish Cohort study by using Bronfenbrenner’s Ecological Systems Theory.

Methods

The material for this paper consists of all mental health related papers within Northern Swedish Cohort. Papers related to outside paid work exposures of life circumstances were selected. An integrative review was conducted on 27 papers and deductive qualitative content analysis in relation to Bronfenbrenner ecological framework was performed to identify the main themes.

Results

The results of this review showed that class structures and gender order at macro-level permeated into all other levels and finally became embodied in the individuals as symptoms of mental health during life. At the “exo-level” neighbourhood disadvantage was related to mental ill-health of individuals. The importance of parental interaction with other settings, like school, for mental health of individuals was highlighted at “meso-level”. At “micro-level” poor social relationships; social and material adversities and inequality in gender relations during adult life were related to mental ill-health.

Conclusion

We found mental health of individuals to be related to both unique and common factors manifesting at different socio-ecological levels. Social structures at the macro-level namely class structures and gender order permeate all other levels and eventually become embodied in the individuals as symptoms of mental health during life. Interventions addressing gender and class related inequalities might be of importance for improving mental health of individuals during their life.
Comparative retrieval analysis of antioxidant polyethylene: bonding of vitamin-E does not reduce in-vivo surface damage
Authors: Mathis Dominic T. , Schmidli Joshua , Hirschmann Michael T. , Amsler Felix , Henckel Johann , Hothi Harry , Hart Alister
Published: November 2021

Background

With the Persona® knee system a new polyethylene formulation incorporating vitamin-E which aims to reduce oxidation and maintain wear resistance was introduced. Although in-vitro studies have demonstrated positive effects of the vitamin-E antioxidants on UHMWPE, no retrieval study has looked at polyethylene damage of this system yet. It was the aim to investigate the in-vivo performance of this new design, by comparing it with its predecessor in retrieval analysis.

Methods

15 NexGen® and 8 Persona® fixed-bearing implants from the same manufacturer (Zimmer Biomet) were retrieved from two knee revision centres. For retrieval analysis, a macroscopic analysis of polyethylene using a peer-reviewed damage grading method was used (Hood-score). The roughness of all articulating metal components was measured using a contact profilometer. The reason(s) for TKA revision were recorded. Statistical analyses (t-test) were performed to investigate differences between the two designs.

Results

The mean Hood score for Persona® inserts was 109.3 and for NexGen® 115.1 without significant differences between the two designs. Results from the profilometer revealed that Persona® and NexGen® femoral implants showed an identical mean surface roughness of 0.14 μm. The Persona® tibial tray showed a significantly smoother surface (0.06 μm) compared to the NexGen® (0.2 μm; p < 0.001). Both Hood score and surface roughness were influenced by the reasons for revision (p < 0.01).

Conclusions

The bonding of the antioxidant vitamin-E to the PE chain used in the novel Persona® knee system does not reduce in-vivo surface damage compared to highly crosslinked PE without supplemented vitamin-E used in its predecessor knee system NexGen®. However, the Persona® titanium alloy tibial tray showed a significantly smoother surface in comparison to the NexGen® titanium alloy tibial tray. This study provides first retrieval findings of a novel TKA design and may help to understand how the new Persona® anatomic knee system performs in vivo.
Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
Authors: Ying Xiaoqian , Liao Limin
Published: November 2021

Objectives

To report the long-term efficacy and complications of the augmentation uretero-enterocystoplasty (AUEC), including augmentation cystoplasty with simultaneous ureteroplasty and ureteral anti-reflux implantation in a single center.

Methods

We retrospectively reviewed clinical records, video-urodynamic data, and magnetic resonance urography of 210 patients who underwent the procedure for refractory lower urinary tract dysfunction (LUTD) from 2003 to 2019. International vesicoureteral reflux (VUR) and upper urinary tract dilatation (UUTD) grading systems were applied to assess upper urinary tract function, and post-operative complications were assessed.

Results

Mean age was 28.1 years, with a mean follow-up time of 57.4 months. A total of 338 ureters were simultaneously re-implanted, and ureteroplasty was performed on all ureters. There was a significant postoperative improvement in the bladder capacity, intravesical pressure, and compliance (P < 0.05). VUR improvement rate was 97.7% and postoperative improvement of UUTD presented in 72.5% ureters. Mean serum creatinine (Scr) level was significantly improved compared to preoperative Scr values (226.0 ± 89.4 μmol/L vs. 217.5 ± 133.9 umol/L, P < 0.05). The 1.0% patients had unacceptably postoperative urinary incontinence and 85.4% preoperative megaureters were improved. Primary complications included metabolic acidosis (9.5%), vesicoureteral anastomosis stenosis (6.2%), persistent VUR (2.7%), urinary calculi (6.6%), and intestinal dysfunction requiring laparotomy (3.3%).

Conclusion

In the study, a large series of patients treated with a complex surgical procedure was reported. It is novel, as this case series represents patients with aggressive surgical correction of VUR, ureteral tortuosity and upper tract dilation at the time of AC. AUEC was shown to have a positive role in treating patients with refractory LUTD associated with hydronephrosis and ureteral dilatation, stenosis or obstruction, with or without high- or low-pressure VUR. It was effective in improving renal function and protecting the UUT function from further deterioration in most patients with renal insufficiency.
Genome-wide association study of periodontal pocketing in Finnish adults
Authors: Tegelberg Paula , Leppilahti Jussi Miikkael , Ylöstalo Atte , Tervonen Tellervo , Kettunen Johannes , Suominen Anna Liisa , Ylöstalo Pekka
Published: November 2021

Background

A genome‐wide association study is an analytical approach that investigates whether genetic variants across the whole genome contribute to disease progression. The aim of this study was to investigate genome-wide associations of periodontal condition measured as deepened periodontal pockets (≥ 4 mm) in Finnish adults.

Methods

This study was based on the data of the national Health 2000 Survey (BRIF8901) in Finland and the Northern Finland Birth Cohort 1966 Study totalling 3,245 individuals. The genotype data were analyzed using the SNPTEST v.2.4.1. The number of teeth with deepened periodontal pockets (≥ 4 mm deep) was employed as a continuous response variable in additive regression analyses performed separately for the two studies and the results were combined in a meta-analysis applying a fixed effects model.

Results

Genome-wide significant associations with the number of teeth with ≥ 4 mm deep pockets were not found at the p-level of < 5 × 10−8, while in total 17 loci reached the p-level of 5 × 10−6. Of the top hits, SNP rs4444613 in chromosome 20 showed the strongest association (p = 1.35 × 10−7).

Conclusion

No statistically significant genome-wide associations with deepened periodontal pockets were found in this study.
Making complex decisions in uncertain times: experiences of Dutch GPs as gatekeepers regarding hospital referrals during COVID-19—a qualitative study
Authors: Westerduin Dieke , Dujardin Janneke , Schuurmans Jaap , Engels Yvonne , Wichmann Anne B.
Published: November 2021

Background

General practitioners often act as gatekeeper, authorizing patients’ access to hospital care. This gatekeeping role became even more important during the current COVID-19 crisis as uncertainties regarding COVID-19 made estimating the desirability of hospital referrals (for outpatient or inpatient hospitalization) complex, both for COVID and non-COVID suspected patients. This study explored Dutch general practitioners’ experiences and ethical dilemmas faced in decision making about hospital referrals in times of the COVID-19 pandemic.

Methods

Semi-structured interviews with Dutch general practitioners working in the Netherlands were conducted. Participants were recruited via purposive sampling. Thematic analysis was conducted using content coding.

Results

Fifteen interviews were conducted, identifying four themes: one overarching regarding (1) COVID-19 uncertainties, and three themes about experienced ethical dilemmas: (2) the patients’ self-determination vs. the general practitioners’ paternalism, (3) the general practitioners’ duty of care vs. the general practitioners’ autonomy rights, (4) the general practitioners’ duty of care vs. adequate care provision.

Conclusions

Lack of knowledge about COVID-19, risks to infect loved ones, scarcity of hospital beds and loneliness of patients during hospital admission were central in dilemmas experienced. When developing guidelines for future crises, this should be taken into account.
Being torn by inevitable moral dilemma: experiences of ICU nurses
Authors: Asadi Neda , Royani Zahra , Maazallahi Mahbubeh , Salmani Fatemeh
Published: November 2021

Background

Ethical decision-making of nurses could affect patients’ recovery and also decrease medical costs. To make ethical decisions, ICU nurses experience complicated ethical conflicts. Considering the multi-dimensional process of ethical decision-making, the present study was conducted to describe the experiences of ICU nurses regarding ethical decision making.

Method

The present research is a qualitative study with conventional content analysis approach that was done in 2020. Fourteen ICU nurses were interviewed using a semi-structured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using Granheim and Landman approach.

Results

Being torn by inevitable moral dilemma was defined as the main category which contained the categories of conflict with professional self, feeling squeezed between self-authority and demands of others, and Surrounded by organizational limitations.

Conclusions

Results of the present study showed that moral dilemma is a situation in which the nurses are forced to choose between two options based on their equipment and facilities. In these situations, the nurses would hesitate between their internal conflicts and confusion between choosing their own benefits and patients’ benefits. To prevent ethical challenges in decision making, it is necessary to educate healthcare team about ethical dilemmas and empower the personnel for encountering ethical challenges.
Patients with stable coronary artery disease and type 2 diabetes but without prior myocardial infarction or stroke and THEMIS-like patients: real-world prevalence and risk of major outcomes from the SNDS French nationwide claims database
Authors: Blin Patrick , Darmon Patrice , Henry Patrick , Guiard Estelle , Bernard Marie-Agnès , Dureau-Pournin Caroline , Maizi Hélène , Thomas-Delecourt Florence , Lassalle Régis , Droz-Perroteau Cécile , Moore Nicholas
Published: November 2021

Aim and hypotheses

The THEMIS randomized trial compared ticagrelor plus aspirin versus placebo plus aspirin for patients with stable coronary artery disease and type 2 diabetes mellitus (CAD-T2DM), and without prior myocardial infarction (MI) or stroke. The aim of the study was to quantify the size of the CAD-T2DM population without prior MI or stroke population in a real-world setting, and more specifically populations with similar THEMIS selection criteria (THEMIS-like and THEMIS-PCI-like populations), as well as their risk of major outcomes in current practice.

Methods

A 2-year follow-up cohort study included all CAD-T2DM without MI/stroke prevalent patients on January 1st, 2014 in the SNDS French nationwide claims database. The THEMIS-like population concerned those ≥ 50 years of age with similar THEMIS inclusion and exclusion criteria. Prevalence was standardized to the European population. The cumulative incidence function was used to estimate the incidence of clinical outcomes (MI, ischemic stroke, and major bleeding according to the TIMI classification) with death as competing risk, and the Kaplan–Meier estimate for all-cause death and a composite outcome of MI, stroke and all-cause death.

Results

From a population of about 50 million adults, the prevalence of CAD-T2DM without MI/stroke, THEMIS-like and THEMIS-PCI-like populations was respectively at 6.04, 1.50 and 0.27 per 1000 adults, with a mean age of 72.7, 72.3 and 70.9 years and less comorbidities and diabetic complications for the THEMIS-like and THEMIS-PCI-like population. The 2-year cumulative incidence was respectively 1.7%, 1.3% and 1.6% for MI, 1.7%, 1.5% and 1.4% for stroke, 4.8%, 3.1% and 2.9% for major bleeding, 13.6%, 9.7% and 6.8% for all-cause death, and 16.2%, 12.0% and 9.5% for the composite outcome.

Conclusion

THEMIS-like prevalence was estimated at 1.50 per 1,000 adults, representing about a quarter of CAD-T2DM without MI/stroke patients, and 0.27 per 1000 adults for the THEMIS-PCI-like populations. In current French practice, the median age of both these populations was about 5–6 years older than in the THEMIS trial, with a 2-year incidence of major outcomes between two or four time above the ones of the placebo arm of the THEMIS trial using very close definitions. Registration No. EUPAS27402 (http://www.ENCEPP.eu).
The emergence of chloroquine-sensitive Plasmodium falciparum is influenced by selected communities in some parts of the Central Region of Ghana
Authors: Asare Kwame Kumi , Africa Justice , Mbata Jennifer , Opoku Yeboah Kwaku
Published: November 2021

Background

The return of chloroquine-sensitive Plasmodium falciparum in sub-Saharan Africa countries offers the opportunity for the reintroduction of chloroquine (CQ) either in combination with other drugs or as a single therapy for the management of malaria. This study assesses the influence of individual study sites on the selection of CQ sensitive P. falciparum markers in the Central region of Ghana.

Methods

Genomic DNA was extracted from an archived filter paper blood blot from Cape Coast, Elmina, Assin Fosu, and Twifo Praso using the Chelex DNA extraction method. The age metadata of the patients from whom the blood spots were taken was collected. The prevalence of CQ-sensitive markers of pfcrt K76 and pfmdr1 N86 was performed using nested PCR and RFLP. The data were analysed using Chi-square and Odd ratio.

Results

The overall prevalence of CQ-sensitive P. falciparum markers, pfcrt K76 and pfmdr1 N86 in the Central Region of Ghana were 142 out of 184 (77.17%) and 180 out of 184 (97.83%), respectively. The distribution of pfcrt K76 was assessed among the age groups per the individual study sites. 12 out of 33 (36.36%), 8 out of 33 (24.24%) and 6 out of 33 (18.18%) of pfcrt K76 CQ-sensitive marker were isolated from age 0 to 5 years, 16 to 30 years and 31 to 45 years old respectively at Cape Coast. Assin Fosu and Twifo Praso had the highest pfcrt K76 prevalence in 0–5 years, followed by 16–30 years and 6–15 years of age. The results showed that there was a significant prevalence of pfcrt K76 in all study sites; Cape Coast (χ2 = 26.48, p < 0.0001), Assin Fosu (χ2 = 37.67, p < 0.0001), Twifo Praso (χ2 = 32.25, p < 0.0001) and Elmina (χ2 = 17.88, p < 0.0001). Again, the likelihood to detect pfcrt K76 (OR (95% CI) was 7.105 (3.118–17.14), p < 0.0001 and pfmdr1 (2.028 (1.065–3.790), p < 0.001) among P. falciparum isolates from Cape Coast to be seven times and two times, respectively.

Conclusion

The study showed a significant selection and expansion of chloroquine-sensitive P. falciparum markers in all the selected study areas in the Central region. This finding has a significant implication for the future treatment, management, and control of P. falciparum malaria.
A case of Bochdalek hernia with anomalous hepatic lobe heterotopia-case report
Authors: Khan Wajiha , Safi Adnan , Ahmad Asrar , Mooghal Mehwish
Published: November 2021

Background

Bochdalek hernia is the most common type of congenital diaphragmatic hernia (CDH) resulting from postero-lateral diaphragmatic defect. Hepatic heterotopia is very rarely associated with CDH, and hepatic herniation favors the worst prognosis.

Case presentation

We present a case of a neonate diagnosed with right Bochdalek hernia (BH) with anomalous hepatic lobe heterotopia. Intra operatively, mal-rotated loops were also found to be herniating in the right hemithorax. The mal-rotated loops were reduced back into abdomen after performing Ladd’s procedure and diaphragmatic defect was repaired over the anomalous liver lobe. Baby was discharged on 7th postoperative day and follow-ups showed good recovery.

Conclusion

This case report discusses the presentation, classification, and significance of this association. Our case report is noteworthy as Bochdalek hernia is very rarely associated with anomalous hepatic lobe.
Diagnosis of adult ALCAPA with computed tomography coronary artery
Authors: Tan Yew Eng , Chia Kok King , Abdul Karim Noor Khairiah
Published: November 2021

Background

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly where the left main coronary artery arises from the pulmonary artery, instead of the coronary sinus of the ascending aorta. ALCAPA is divided into infant and adult types. Life-threatening complications such as malignant arrhythmia and sudden death could ensue in adult type of ALCAPA. Imaging is the current preferred modality for ALCAPA. It is indeed a challenge to diagnose ALCAPA due to its non-specific clinical presentation and laboratory findings. We report a case of adult type ALCAPA presented with unstable angina surprisingly surviving into adulthood with no symptoms prior to presentation, which is extremely rare.

Case presentation

A 53-year-old lady presented with sudden onset of chest pain and worsening shortness of breath. She was initially treated as unstable angina. Physical examination revealed normal heart sound. Computed tomography coronary angiography (CTCA) showed an anomalous origin of the left coronary artery from the posterior wall of the proximal pulmonary artery, compatible with ALCAPA. The anomalous left coronary artery bifurcates into left anterior descending and left circumflex arteries. Cardiothoracic surgeon planned for occlusion of ALCAPA via the pulmonary artery, owing to the fact that unfeasible rerouting in the presence of well-established collateral supply.

Conclusions

ALCAPA is a rare and life-threatening condition in adults which may lead to myocardial infarction and sudden death in untreated cases. CTCA is one of the preferred modern imaging modality in ALCAPA owing to its superior ability for direct visualization of the anomaly. Hence, early identification and surgical intervention of the anomaly are paramount to reduce the morbidity and mortality.
Reimagining the Introductory Math Curriculum for Life Sciences Students
Authors: O’Leary Erin Sanders , Sayson Hannah Whang , Shapiro Casey , Garfinkel Alan , Conley William J. , Levis-Fitzgerald Marc , Eagan M. Kevin , Van Valkenburgh Blaire
Published: November 2021

Description of an innovative new math curriculum for life science students and a study examining its cognitive and noncognitive impacts, including improved academic performance in math, higher grade outcomes in subsequent science courses, and increased interest in quantitative concepts and skills relevant to 21st-century biology.
Domestic abuse and mental health: the amplified risks created during the pandemic
Authors: Hisham Idura N. , Sin Jacqueline , Rouf Khadj , Taggart Danny , Townsend Giles , Sweeney Angela
Published: November 2021

No recent pandemic has had such a severe socioeconomic impact as COVID-19. Significant economic uncertainty and social restrictions have led to increased levels of stress for many. There has been increased social isolation, financial stress and alcohol intake, all of which can increase domestic abuse and other forms of household abuse. Increases in abuse in the home found in other public health emergencies and economic recessions can be seen now – reported UK domestic abuse rates have increased since the start of COVID-19. This article focuses on how COVID-19 and its anticipated aftermath exacerbate the risk factors for domestic abuse in the general population and discusses clinical implications for mental health practitioners in the UK. It aims to provide a point of learning based on previous disease outbreaks and recessions, with a focus on specific factors, such as unemployment and alcohol misuse, and how these contribute to increasing incidence and severity of abuse – and more importantly, how mental health professionals can mitigate these for patients, 1 in 3 of whom are estimated to have already experienced abuse before the COVID-19 pandemic.
M Equilibrium: A Theory of Beliefs and Choices in Games
Authors: Goeree Jacob K. , Louis Philippos
Published: November 2021

We introduce a set-valued solution concept, M equilibrium, to capture empirical regularities from over half a century of game theory experiments. We show M equilibrium serves as a meta theory for various models that hitherto were considered unrelated. M equilibrium is empirically robust and, despite being set-valued, falsifiable. Results from a series of experiments that compare M equilibrium to leading behavioral game theory models demonstrate its virtues in predicting observed choices and stated beliefs. Data from experimental games with a unique pure-strategy Nash equilibrium and multiple M equilibria exhibit coordination problems that could not be anticipated through the lens of existing models. (JEL C72, C90, D83)
Do Women Respond Less to Performance Pay? Building Evidence from Multiple Experiments
Authors: Bandiera Oriana , Fischer Greg , Prat Andrea , Ytsma Erina
Published: November 2021

Existing empirical work raises the hypothesis that performance pay—whatever its output gains—may widen the gender earnings gap because women may respond less to incentives. We evaluate this possibility by aggregating evidence from existing experiments on performance incentives with male and female subjects. Using a Bayesian hierarchical model, we estimate both the average effect and heterogeneity across studies. We find that the gender response difference is close to zero and heterogeneity across studies is small, while performance pay increases output by 0.36 standard deviations on average. The data thus support agency theory for men and women alike. (JEL C11, C90, J16, J31, J33)
Optimal Targeted Lockdowns in a Multigroup SIR Model
Authors: Acemoglu Daron , Chernozhukov Victor , Werning Iván , Whinston Michael D.
Published: November 2021

We study targeted lockdowns in a multigroup SIR model where infection, hospitalization, and fatality rates vary between groups—in particular between the “young,” the “middle-aged,” and the “old.” Our model enables a tractable quantitative analysis of optimal policy. For baseline parameter values for the COVID-19 pandemic applied to the US, we find that optimal policies differentially targeting risk/age groups significantly outperform optimal uniform policies and most of the gains can be realized by having stricter protective measures such as lockdowns on the more vulnerable, old group. Intuitively, a strict and long lockdown for the old both reduces infections and enables less strict lockdowns for the lower-risk groups. (JEL H51, I12, I18, J13, J14)
Symptom burden of people with progressive ataxia, and its wider impact on their friends and relatives: a cross-sectional study
Authors: Lowit Anja , Greenfield Julie , Cutting Emily , Wallis Ruby , Hadjivassiliou Marios
Published: November 2021

Background: Progressive ataxias are complex disorders that result in a wide variety of symptoms. Whilst we currently have a relatively good understanding of the symptom patterns associated with the various types of ataxia, and how these diseases progress over time, their impact on the person with ataxia is less well understood. In addition, little is known about how carers, friends and families are affected by them. This paper aims to provide preliminary information on the presence and impact of medical symptoms and day-to-day challenges on people with ataxia and their friends and relatives.

Method: Data were extracted from a survey by Ataxia UK for their members. The views of 366 people with ataxia and 52 friends and relatives are reported. Data were analysed for the entire groups, as well as for the three most common ataxia types represented in the sample, Friedreich’s ataxia, inherited ataxia (excluding Friedreich’s ataxia), and cerebellar ataxia of unknown cause.

Results: The survey confirmed the symptom patterns described in previous research, but further showed that the impact of these symptoms can vary across ataxia populations. Similar findings were observed for day-to-day challenges. Friends and relatives experienced similar challenges to people with ataxia, indicating that support provided has to consider those supporting people with ataxia as well as the patient. Respondents also highlighted limitations in terms of accessing support services, and not all services were able to cater fully to their specific needs.

Conclusion: This study begins to provide information that can be used in further research to explore the needs of people with ataxia and their carers, friends, and relatives. Such research will support treatment trial design, ensuring patients’ needs are considered, help to tailor support services to their needs, and ensure health care professionals have the necessary skills to fully address them.
Soluble FMS-Like Tyrosine Kinase-1: Role in placenta accreta spectrum disorder
Authors: Lumbanraja Sarma , Yaznil M Rizki , Siahaan Andre M , Berry Eka Parda Bancin
Published: November 2021

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sfltsFlt-1 has a role in the development of placenta accreta.

Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Mann-Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI).

Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. -Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03).

Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.
Augmented reality emotion recognition for autism spectrum disorder children
Authors: Neo Han Foon , Teo Chuan Chin , Yeo Quan Fong
Published: November 2021

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder that affects brain development. The prevalence of ASD is one in 68 children. Low social motivation is the main cause in developing social communication skills deficiency. As a result, it is becoming difficult for them to express themselves, to be able to manage social interactions, and they lack the ability to comfort others and even share their own feelings. This study aimed to design a mobile application based on augmented reality (AR) focusing on social interactions and communication aspect for children with ASD. The scope is in emotion recognition, which makes use of emotional icons to help them improve their social skills, more specifically on helping them to recognize various emotions. The emotions are represented by emojis inspired by Dr. Paul Ekman who has created the basic six emotions, namely happiness, sadness, disgust, fear, surprise, and angry. Additional emotions such as confound face, winking with tongue, cold sweat, blowing kiss, flushed, sleepy, disappointed, and winking are included. AR is able to gage the children’s attention when they view the animated emojis. The application enables the children with ASD to be more willing in recognizing different emotional expressions and improve their social skills by expressing their own feelings. The scope of the study is limited to emotion recognition. It is developed based on literature reviews without guidance of any certified ASD specialist. AR is an interactive technology that places digital information in our physical world in real time, providing precise registration in all three dimensions. Existing literature proved that the traditional face-to-face teaching methods have failed to increase the interest and ability of ASD children because the teacher has full control in the classroom. This study adds value to the existing works to incorporate AR as additional intervention in treating ASD children.
STYLISTIC ANALYSIS OF ENGLISH NEWS REPORT ON PUBLIC HEALTH EMERGENCY FROM THE LEVEL OF SYNTAX
Authors: ZHANG YUNRUI
Published: November 2021

Abstract. COVID-19, which has spread rapidly and enveloped most of the world from the year 2020, is a global public health crisis the likes of which we have not seen in a century. Today, COVID-19 still remains to be brought under full control at the global level. Since the epidemic outbreak, various mass media report the COVID-19 timely and clearly, among which newspaper is a common and major one to report the epidemic situation. Randomly taking plenty of examples on COVID-19 from China Daily, this paper made a stylistic analysis on English news report of public health emergency from the level of syntax. Through analysing, the writer hopes that it can enlarges the research scope of news report, and deepens the people’s recognition on English news report of public health emergency.
CONSTRUCTION OF THE TEACHING SYSTEM OF “CLASS, CERTIFICATE, POST AND ABILITY INTEGRATION”—TAKE SOFTWARE APPLICATION COURSES AS AN EXAMPLE
Authors: YIN FANGFANG
Published: November 2021

Abstract. In the process of vocational education improvement, “the integration of class, certificate, post and ability” teaching system reform and practice have been discussed, for the three software application courses of computer-aided design (CAD), building information modeling (BIM) and Glodon engineering quantity software (GQI). The analysis and positioning of “classes, certificates, posts, skills”, “classes and posts docking” to formulate teaching plans, “course certificate integration” setting teaching content, curriculum teaching method design, assessment and evaluation, the above five aspects were analyzed for the corresponding curriculum teaching reform and the study. Practice has proved that the effect has been good: the numbers of students applying for the vocational skill level certificate and the application rate both have increased, and the passing rate has grown up significantly, which has risen from 78% to 98%.
LOW-COST FIELD PROGRAMMABLE GATE ARRAY ACCELERATES DEEP Q-LEARNING
Authors: WANG JINGHUI , ZHAO YUANCHAO
Published: November 2021

Abstract. Due to recent advances in digital technologies, deep reinforcement learning has emerged, and has demonstrated its ability and effectiveness in solving complex learning problems not possible before. In particular, convolution neural networks (CNNs) have been demonstrated their effectiveness in reinforcement learning. However, they require intensive CPU operations and memory bandwidth that make general CPUs fail to achieve desired performance levels. In this paper, we used some low-cost field programming gates array (FPGA) designed a parallel Deep Qlearning accelerator to solve this problem. And the system has high efficient and flexibility.
A VISUALIZATION ANALYSIS OF HOTSPOTS AND TRENDS OF INTERNATIONAL ENTREPRENEURSHIP RESEARCH
Authors: YI RUI , HUANG QIU , ZHANG YUEZHOU
Published: November 2021

Abstract. Based on the international entrepreneurship documents and data of Web of Science, this paper applies Citespace scientific visualization tool and bibliometric method as well as knowledge mapping analysis method to have visualization analysis of the English documents related to international entrepreneurship from 1989 to 2019. In this paper, we organized the distribution of countries, institutions and authors as well as the keywords clustering of the documents about international entrepreneurship in recent thirty years, and summarized the research stages and the hot-spots and trends of future research in this field, providing reference and orientation for the future research and specific practices in the international entrepreneurship field.
NCENTIVE EFFECT OF PAY GAP IN TOP MANAGEMENT TEAM UNDER DIFFERENT PROMOTION OPPORTUNITIES
Authors: LU HAIFAN
Published: November 2021

Abstract. This paper makes a research on the effect of pay gap in top management team on company performance under different promotion opportunities of managers by using panel data of Chinese A share listed firms during 2015-2019. The results show that when managers have less opportunities to be promoted, the pay gap in top management team is lager. But lager pay gap will not always improve performance.
MODELING AND SIMULATION FOR MILITARY SUPPLY CHAIN RISK EVOLUTION BASED ON INFORMATION ENTROPY
Authors: CHEN YUANWEN , JIANG YU , ZHANG JICAI
Published: November 2021

Abstract. Military supply chain risk is an important index in measuring the reliability of military logistics equipment support. It has the characteristics of dynamic development, and how to conduct profound research on the development and evolution process has important practical significance. On the basis of defining system elements, this paper firstly constructed a system dynamics model of risk evolution by using risk evolution system flow diagram of military supply chain, then determined the relevant model parameters through the method of information entropy. Finally, by using the simulation method, this paper studied the impact of impulse mutation, risk tolerance and risk response ability on the risk evolution process. The results show that improving the ability of risk tolerance and risk response plays an important role in effectively controlling of military supply chain risk.
APPLICATIONS OF TWO IMPORTANT THEOREMS OF FRACTIONAL CALCULUS
Authors: YU CHII-HUEI
Published: November 2021

Abstract. In this article, we study the fundamental theorem of fractional calculus and integration by parts for fractional calculus, regarding the Jumarie type of modified Riemann-Liouville fractional derivatives. On the other hand, some examples are proposed to illustrate the applications of these two important theorems.
Mitigating Gig and Remote Worker Misconduct: Evidence from a Real Effort Experiment
Authors: Burbano Vanessa C. , Chiles Bennett
Published: November 2021

Employee misconduct is costly to organizations and has the potential to be even more common in gig and remote work contexts, in which workers are physically distant from their employers. There is, thus, a need for scholars to better understand what employers can do to mitigate misconduct in these nontraditional work environments, particularly as the prevalence of such work environments is increasing. We combine an agency perspective with a behavioral relationship-based perspective to consider two avenues through which gig employers can potentially mitigate misconduct: (1) through the communication of organizational values and (2) through the credible threat of monitoring. We implement a real effort experiment in a gig work context that enables us to cleanly observe misconduct. Consistent with our theory, we present causal evidence that communication of organizational values, both externally facing in the form of social/environmental responsibility and internally facing in the form of an employee ethics code, decreases misconduct. This effect, however, is largely negated when workers are informed that they are being monitored. We provide suggestive evidence that this crowding out is due to a decrease in perceived trust that results from the threat of monitoring. Our results have important theoretical implications for research on employee misconduct and shed light on the trade-offs associated with various potential policy solutions.
Learning by Connecting: How Rule Networks Evolve Through Discovery of Relevance
Authors: Schulz Martin , Zhu Kejia
Published: November 2021

Learning-by-connecting, the formation of connections between lessons, is a fairly common phenomenon, but how does it evolve? We argue that learning-by-connecting unfolds as the relevance of lessons to other lessons is gradually discovered over time. The process of “relevance discovery” unfolds through a dynamic interplay between lessons and their context that provides opportunities to discover the relevance of lessons to other lessons. We develop a theoretical model in which the availability of these opportunities and their sorting in time drive the formation of connections. We explore and test our model in the context of organizational rules that we conceptualize, following rule-based learning theories, as repositories of lessons learned. Our empirical context is the formation of citation ties between clinical practice guidelines (CPGs), a type of organizational rules in healthcare, in a Canadian regional healthcare organization. We find that citation tie formation intensifies when opportunities to discover relevance become available. We also find that learning-by-connecting creates rule networks in which the formation of new ties slows down due to the sorting of opportunities in time. Our findings support our assumption that learning-by-connecting is shaped by relevance discovery. Our study extends models of rule-based learning and contributes to discussions on the formation of connections in contexts of dispersed learning and knowledge.
Are you experiencing gender bias?
Authors: Hancock Dave
Published: November 2021

A new book by Mary Ann Sieghart looks at the gender bias inherent in society and what the evidence says about why and how it exists. Dave Hancock reports
Understanding new records management guidance
Authors: Simsek Ceylan
Published: November 2021

NHSX, the body responsible for NHS technology, digital and data, has released new guidance on record management. Ceylan Simsek, Case Manager at Medical Protection, explains the key points