bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, severity and clinical manifestations of juvenile dermatomyositis among Maori and Pacific Island compared to European children
Authors: Concannon Anthony , Han Dug Yeo 
Published: June 2021

AimTo describe the incidence, demographics, diagnostic clinical manifestations and long‐term outcomes of juvenile dermatomyositis (JDM) in Maori and Pacific Island compared to European children.MethodsA chart review was conducted of children with JDM seen by the Starship Rheumatology service between 2000 and 2020. Diagnostic clinical manifestations, demographics, disease course and significant complications were collated. The incidence, clinical manifestations and severity of JDM were determined and compared between ethnic groups, in particular Maori and Pacific Island, and European children.ResultsThe overall incidence of JDM was 0.24/100 000 per year with no significant ethnic variation. Maori children were less likely to achieve a clinical response (71 vs. 100%, P = 0.08), Maori and Pacific less likely to achieve clinical remission (56 vs. 40%, P = 0.69), with Maori (71 vs. 44%, P = 0.37) and Maori and Pacific (60 vs. 44%, P = 0.69) children more likely to follow a chronic course compared to European children. Calcinosis (50 vs. 13%, P = 0.07), cutaneous vasculopathy (30 vs. 0%, P = 0.05) and interstitial lung disease (30 vs. 6%, P = 0.26) were more common in Maori and Pacific compared to European children.ConclusionThe incidence of JDM among a cohort of New Zealand children was established, with Maori and Pacific children more likely to experience a chronic continuous disease course, calcinosis, cutaneous vasculopathy and interstitial lung disease compared to European children.
Progression from sepsis to septic shock and time to treatments in preterm infants with late‐onset sepsis
Authors: Gorantiwar Sujit , de Waal Koert 
Published: June 2021

AimLate‐onset sepsis (LOS) in preterm infants can progress rapidly from minimal clinical signs and symptoms to septic shock which is associated with high mortality. The aim of this study was to describe the progression from sepsis to septic shock and evaluate our management performance with emphasis on time to treatments.MethodsThis was a retrospective observational study including preterm infants ≤32 weeks gestation with LOS and septic shock defined as the requirement of fluids and vasopressors. Physiological changes and time to first diagnostics and treatments were determined from the point of first appearance of clinical signs and symptoms of sepsis (TONSET).ResultsDuring the 10‐year observational period, 279 infants developed LOS and 25 (8.9%) progressed to septic shock. The median (interquartile range) time from TONSET to blood culture, administering antibiotics, fluid bolus and vasopressors was 8.4 (4.8–12.2), 9.2 (5.6–12.4), 14.6 (9.5–34.5) and 22.0 (14.6–44.7) h, respectively. Hypotension and raised lactate were prominent physiological changes in the progression to septic shock. Fluid bolus and vasopressors were administered when blood pressure was 20 and 41% below to what was normal before the infant became unwell. Vasopressors significantly increased blood pressure and heart rate. Mortality rate was 40% with no difference in time to treatments between survivors and non‐survivors.ConclusionClinical recognition of the onset of sepsis in preterm infants remains difficult and contributes to delay of treatment. Once recognised, early administration of antibiotics, fluid bolus and vasopressors should be prioritised.
Spatial organization, behaviour and feeding habits of red squirrels: differences between an urban park and an urban forest
Authors: Krauze‐Gryz D. , Gryz J. , Brach M. 
Published: June 2021

AbstractRed squirrels (Sciurus vulgaris) successfully inhabit cities, utilize urban structures and adapt to alternative food sources such as supplemental anthropogenic feeding. Here, we compared two urban populations: one in a busy park and another in an urban forest. The first was expected to be highly influenced by human presence (and food delivered by park visitors), and the other was hypothesized to be unaffected by human disturbance. Our goal was to determine how they differed in terms of spatial organization, behaviour and food habits. The populations were monitored using radio‐tagging. Squirrels in the park had significantly smaller home ranges than those in the forest. In both areas, they had multi‐nuclear home ranges, but the number of nuclei in the park was lower than that in the forest. This probably reflects more homogenous food availability (i.e. supplemental feeding). Squirrels in the park spent more time on the ground throughout the year than squirrels in the forest. This was probably related to their dependence on human‐supplemented food. Park squirrels often interacted with park visitors throughout the year – this involved approaching and taking food in 60% of the interactions. Hazelnuts and walnuts (food most often supplied by humans) dominated the diet of park squirrels, whereas pine and hornbeam seeds dominated the diet of forest squirrels. Overall, the study showed how living in the park with year‐round access to supplementary food changed the spatial organization and behaviour of red squirrels compared to that of the population from the urban forest reserve.
Policy designs for interorganizational coordination: Lessons from failures in governing the mining sector in Colombia and Ecuador
Authors: Cisneros Paúl 
Published: June 2021

AbstractScholars of mining policies are beginning to understand how the most recent boom in commodity prices (2000–2014) influenced the institutional development of the mining sector in Latin America. We contribute to this literature by studying the design, dynamics, and outcomes of interorganizational coordination in Colombia and Ecuador. Our findings show that, despite their divergent policies, both countries failed to integrate the mining sector's three main policy games—formalizing artisan and small‐scale operations, increasing the number of large‐scale projects, and tackling illegal extraction. Several characteristics of the design of coordination initiatives influenced policy failure—the reliance on hierarchy mechanisms to motivate coordination, the lack of specificity of the coordination mandates, and the lack of specific resources for coordination. Contextual factors also shaped the dynamics and outcomes of coordination. The limited geographical spread of artisanal and small‐scale mining and of illegal extraction, the environmental sector's weakness, and the creation of a multilayered structure for public‐sector coordination contributed to policy effectiveness in Ecuador. On the other hand, the ample spread of artisanal and small‐scale mining and of illegal extraction, the lack of a clear coordinating structure, and the environmental sector's growing vigor contributed to sustained policy failure in Colombia.
Genomic, karyological and morphological changes of South American garlics (Ipheion) provide insights into mechanisms of speciation in the Pampean region
Authors: Sassone Agostina B. , Hojsgaard Diego H. , Giussani Liliana M. , Brassac Jonathan , Blattner Frank R. 
Published: June 2021

AbstractSpeciation proceeds through mechanisms that promote reproductive isolation and shape the extent of genetic variation in natural populations, and thus its study is essential to understand the evolutionary processes leading to increased biodiversity. Chromosomal rearrangements are known to facilitate reproductive isolation by hybrid sterility and favour speciation events. The genusIpheion(Amaryllidaceae, Allioideae) is unique as its species exhibit a remarkable karyological variability but lack population‐level genetic data. To unveil the diversification processes acting upon the formation of new lineages withinIpheionin the Pampas of South America, we combined morphology and karyology approaches with genotyping‐by‐sequencing. Our phylogenomic and population genomics results supported the taxonomic division ofIpheioninto three morphological and genetically well‐differentiated groups. The origin ofIpheion uniflorumwas traced back to its current southern distribution area in the southern Pampean region (in Argentina), from where it had expanded to the north reaching Uruguay. Our results further suggested that chromosome rearrangements and ploidy shifts had triggered speciation events, first during the origin ofI.uniflorumand later during its subsequent diversification intoI.recurvifoliumandI.tweedieanum, in both cases reinforced by extrinsic factors and biogeographical settings. The current study illustrates the analytical power of multidisciplinary approaches integrating phylo‐ and population genomics with classic analyses to reveal evolutionary processes in plants.
Cross‐scene pavement distress detection by a novel transfer learning framework
Authors: Li Yishun , Che Pengyu , Liu Chenglong , Wu Difei , Du Yuchuan 
Published: June 2021

AbstractDeep learning has achieved promising results in pavement distress detection. However, the training model's effectiveness varies according to the data and scenarios acquired by different camera types and their installation positions. It is time consuming and labor intensive to recollect labeled data and retrain a new model every time the scene changes. In this paper, we propose a transfer learning pipeline to address this problem, which enables a distress detection model to be applied to other untrained scenarios. The framework consists of two main components: data transfer and model transfer. The former trains a generative adversarial network to transfer existing image data into a new scene style. Then, attentive CutMix and image melding are applied to insert distress annotations to synthesize the new scene's labeled data. After data expansion, the latter step transfers the feature extracted by the existing model to the detection application of the new scene through domain adaptation. The effects of varying degrees of knowledge transfer are also discussed. The proposed method is evaluated on two data sets from two different scenes with more than 40,000 images totally. This method can reduce the demand for training data by at least 25% when the model is applied in a new scene. With the same number of training images, the proposed method can improve the model accuracy by 26.55%.
Randomized controlled trial of home biofeedback therapy versus office biofeedback therapy for fecal incontinence
Authors: Xiang Xuelian , Sharma Amol , Patcharatrakul Tanisa , Yan Yun , Karunaratne Tennekoon , Parr Rachel , Ayyala Deepak Nag , Hall Patricia , Rao Satish S. C. 
Published: June 2021

AbstractBackgroundBiofeedback therapy is useful for treatment of fecal incontinence (FI), but is not widely available and labor intensive. We investigated if home biofeedback therapy (HBT) is non‐inferior to office biofeedback therapy (OBT).MethodsPatients with FI (≥1 episode/week) were randomized to HBT or OBT for 6 weeks. HBT was performed daily using novel device that provided resistance training and electrical stimulation with voice‐guided instructions. OBT consisted of six weekly sessions. Both methods involved anal strength, endurance, and coordination training. Primary outcome was change in weekly FI episodes. FI improvement was assessed with stool diaries, validated instruments (FISI, FISS, and ICIQ‐B), and anorectal manometry using intention‐to‐treat analysis.Key ResultsThirty (F/M = 26/4) FI patients (20 in HBT, 10 in OBT) participated. Weekly FI episodes decreased significantly after HBT (Δ ± 95% confidence interval: 4.7 ± 1.8, compared with baseline, p = 0.003) and OBT (3.7 ± 1.6, p = 0.0003) and HBT was non‐inferior to OBT (p = 0.2). The FISI and FISS scores improved significantly in HBT group (p < 0.02). Bowel pattern, bowel control, and quality of life (QOL) domains (ICIQ‐B) improved significantly in HBT arm (p < 0.023). Resting and maximum squeeze sphincter pressures significantly improved in both HBT and OBT groups and sustained squeeze pressure in HBT, without group differences.Conclusions & InferencesHome biofeedback therapy is non‐inferior to OBT for FI treatment. Home biofeedback is safe, effective, improves QOL, and through increased access could facilitate improved management of FI.
Contribution of adhesion proteins to Aggregatibacter actinomycetemcomitans biofilm formation
Authors: Danforth David R. , Melloni Marcella , Tristano Jake , Mintz Keith P. 
Published: June 2021

AbstractAggregatibacter actinomycetemcomitans is a Gram‐negative bacterium associated with periodontal disease and multiple disseminated extra‐oral infections. Colonization of these distinct physiological niches is contingent on the expression of specific surface proteins during the initiation of developing biofilms. In this investigation, we studied fimbriae and three well‐characterized nonfimbrial surface proteins (EmaA, Aae, and ApiA/Omp100) for their contribution to biofilm formation. Mutations of these proteins in multiple strains covering four different serotypes demonstrated variance in biofilm development that was strain dependent but independent of serotype. In a fimbriated background, only inactivation of emaA impacted biofilm mass. In contrast, inactivation of emaA and/or aae affected biofilm formation in nonfimbriated A. actinomycetemcomitans strains, whereas inactivation of apiA/omp100 had little effect on biofilm formation. When these genes were expressed individually in Escherichia coli, all transformed strains demonstrated an increase in biofilm mass compared to the parent strain. The strain expressing emaA generated the greatest mass of biofilm, whereas the strains expressing either aae or apiA/omp100 were greatly reduced and similar in mass. These data suggest a redundancy in function of these nonfimbrial adhesins, which is dependent on the genetic background of the strain investigated.
Pharmacokinetic concepts for dexmedetomidine target‐controlled infusion pumps in children
Authors: Morse James D. , Cortinez Luis Ignacio , Anderson Brian J. 
Published: June 2021

AbstractPharmacokinetic parameter estimates are used in mathematical equations (pharmacokinetic models) to describe concentration changes with time in a population and are specific to that population. Simulation using these models and their parameter estimates can enrich understanding of drug behavior and serve as a basis for study design. Pharmacokinetic concepts are presented pertaining to future designs of dexmedetomidine target‐controlled infusion pumps in children. This manuscript provides the pediatric anesthesiologist with an understanding of the nuances that should be considered when using target‐controlled infusion pumps; how the central volume may differ between populations, how clearance changes with age, and the impact of adverse effects on dose. In addition, the ideal loading dose and rate of delivery to achieve target concentration without adverse cardiovascular effects are reviewed, and finally, dose considerations for obese children, based on contact‐sensitive half‐time, are introduced. An understanding of context‐sensitive half‐time changes with age enables anesthetic practitioners to better estimate duration of effect after cessation of dexmedetomidine infusion. Use of these known pharmacokinetic parameters and covariate information for the pediatric patient could readily be incorporated into commercial target‐controlled infusion pumps to allow effective and safe open‐loop administration of dexmedetomidine in children.
Homophonic Reports and Gradual Communication
Authors: Picazo Claudia 
Published: June 2021

AbstractPragmatic modulation makes contextual information necessary for interpretation. This poses a problem for homophonic reports and inter‐contextual communication in general: of co‐situated interlocutors, we can expect some common ground, but non‐co‐situated interpreters lack access to the context of utterance. Here I argue that we can nonetheless share modulated contents via homophonic reports. First, occasion‐unspecific information is often sufficient for the recovery of modulated content. Second, interpreters can recover what is said with different degrees of accuracy. Homophonic reports and inter‐contextual communication are often successful because the reporting context does not demand full accuracy.
Driven to Extremes: Donald Trump's Extraordinary Impact on the 2020 Elections
Authors: Jacobson Gary C. 
Published: June 2021

AbstractReactions to the divisive person and presidency of Donald Trump dominated voting decisions in the 2020 elections, which consequently set new records for electoral continuity, party loyalty, nationalization, polarization, and presidential influence on the down‐ballot vote choices, to the point where local factors such as incumbency, candidate quality, and campaign spending barely registered in the congressional election results. Evaluations of Trump’s leadership in the national crises besetting the United States in 2020 were assimilated almost entirely into existing attitudes toward the president, limiting the impact of these events. The Democrats achieved unified control of the government, but by the narrowest of margins, and the political configuration that had emerged from Trump’s election in 2016 remained largely intact. Republicans’ responses to Trump’s seditious efforts to nullify Biden’s victory promise to extend his influence through the 2022 elections and beyond.
Market structure and bank conduct in Lesotho
Authors: Moshoeshoe Ramaele , Thokoa Katleho 
Published: June 2021

AbstractLesotho's banking industry is highly concentrated and is perceived to be uncompetitive. However, high market concentration does not necessarily imply a lack of competition in the market. Until now, there is no evidence supporting the view that the industry is uncompetitive. Therefore, this paper uses monthly bank‐level data from 2013:10 to 2019:5, and employs the Panzar‐Rosse H‐statistic and the Boone indicator to examine competition in Lesotho's banking industry. We find that the industry acts as a ‘monopoly’ or a ‘perfectly colluding oligopoly’. We, therefore, argue that policy makers should set up the long anticipated antitrust agency to oversee conduct in this industry, and all other industries to improve societal welfare.
Determiners and the Development of Grammatical Nominalization in Nivaĉle*
Authors: Otero Manuel A. , Payne Doris L. , Vidal Alejandra 
Published: June 2021

AbstractNivaĉle, a Mataco‐Mataguayan language of the South American Chaco, exhibits right branching syntax often involving determiners. The determiners express visibility, proximity, existence, have temporal implications, and mark abstract referents and nominalized clauses. This paper proposes that headless relative clauses arose by using determiners in grammatical nominalization via an amalgam source construction, while a certain complement clause structure may have arisen by using a determiner as a cataphoric pronoun before a co‐referent clause. As background for the historical argument, we first introduce the determiners and predicating versus referring expressions. We then discuss the role of the determiners in grammatical nominalization to create headless relatives, and then the complement clause structure headed by ka=. Employing comparative Mataguayan data, we propose historical scenarios that may have yielded the two constructions.
Towards a dynamic photosynthesis model to guide yield improvement in C4 crops
Authors: Wang Yu , Chan Kher Xing , Long Stephen P. 
Published: June 2021

SummaryThe most productive C4 food and biofuel crops, such as Saccharum officinarum (sugarcane), Sorghum bicolor (sorghum) and Zea mays (maize), all use NADP‐ME‐type C4 photosynthesis. Despite high productivities, these crops fall well short of the theoretical maximum solar conversion efficiency of 6%. Understanding the basis of these inefficiencies is key for bioengineering and breeding strategies to increase the sustainable productivity of these major C4 crops. Photosynthesis is studied predominantly at steady state in saturating light. In field stands of these crops light is continually changing, and often with rapid fluctuations. Although light may change in a second, the adjustment of photosynthesis may take many minutes, leading to inefficiencies. We measured the rates of CO2 uptake and stomatal conductance of maize, sorghum and sugarcane under fluctuating light regimes. The gas exchange results were combined with a new dynamic photosynthesis model to infer the limiting factors under non‐steady‐state conditions. The dynamic photosynthesis model was developed from an existing C4 metabolic model for maize and extended to include: (i) post‐translational regulation of key photosynthetic enzymes and their temperature responses; (ii) dynamic stomatal conductance; and (iii) leaf energy balance. Testing the model outputs against measured rates of leaf CO2 uptake and stomatal conductance in the three C4 crops indicated that Rubisco activase, the pyruvate phosphate dikinase regulatory protein and stomatal conductance are the major limitations to the efficiency of NADP‐ME‐type C4 photosynthesis during dark‐to‐high light transitions. We propose that the level of influence of these limiting factors make them targets for bioengineering the improved photosynthetic efficiency of these key crops.
Whole truths but half the blood: Addressing the gap between the evidence and practice of pre‐hospital and in‐hospital blood product use for trauma resuscitation
Authors: Hashmi Zain G. , Chehab Mohamad , Nathens Avery B. , Joseph Bellal , Bank Eric A. , Jansen Jan O. , Holcomb John B. 
Published: June 2021

AbstractBackgroundIn recent years, several studies have demonstrated the efficacy of using pre‐hospital blood product and in‐hospital whole blood for trauma resuscitation. While some observations suggest an encouraging uptake of this evidence by emergency medical service (EMS) agencies and trauma centers, a nationwide characterization of blood product utilization for bleeding trauma patients remains unknown. The objective of this study is to determine nationwide estimates of pre‐hospital blood product and in‐hospital whole blood utilization for trauma resuscitation.Study Design and MethodsAll adult trauma patients reported to the National Emergency Medical Services Information System (NEMSIS) dataset 2019 were included. Proportions of patients who received any pre‐hospital blood product were calculated. The American College of Surgeons (ACS) Trauma Quality Programs (TQP) databases 2015–2017 and first quarter of 2020 were used to calculate the proportion of ACS‐verified trauma centers that transfused whole blood.ResultsAmong a total of 3,058,804 pre‐hospital trauma patients, only 313 (0.01%) received any blood transfusion; 208 (0.21%) patients with systolic blood pressure (SBP) ≤90 mmHg and 121 (0.67%) patients with SBP ≤90 mmHg and heart rate ≥120 beats per minute received any blood product. The proportion of ACS‐verified trauma centers transfusing whole blood increased from 16.7% (45/269) in 2015 to 24.5% (123/502) in first quarter of 2020.DiscussionDespite strong evidence and recommendations, pre‐hospital utilization of blood products for trauma resuscitation remains low. Additionally, while the overall in‐hospital whole blood use also remains low, its use has increased at ACS‐verified trauma centers over the past 5 years.