bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ordering and inequalities for mixtures on risk aggregation
Authors: Chen Yuyu , Liu Peng , Liu Yang , Wang Ruodu 
Published: June 2021

AbstractAggregation sets, which represent model uncertainty due to unknown dependence, are an important object in the study of robust risk aggregation. In this paper, we investigate ordering relations between two aggregation sets for which the sets of marginals are related by two simple operations: distribution mixtures and quantile mixtures. Intuitively, these operations “homogenize” marginal distributions by making them similar. As a general conclusion from our results, more “homogeneous” marginals lead to a larger aggregation set, and thus more severe model uncertainty, although the situation for quantile mixtures is much more complicated than that for distribution mixtures. We proceed to study inequalities on the worst‐case values of risk measures in risk aggregation, which represent conservative calculation of regulatory capital. Among other results, we obtain an order relation on VaR under quantile mixture for marginal distributions with monotone densities. Numerical results are presented to visualize the theoretical results and further inspire some conjectures. Finally, we provide applications on portfolio diversification under dependence uncertainty and merging p‐values in multiple hypothesis testing, and discuss the connection of our results to joint mixability.
Protecting pegged currency markets from speculative investors
Authors: Neuman Eyal , Schied Alexander 
Published: June 2021

AbstractWe consider a stochastic game between a trader and a central bank in a target zone market with a lower currency peg. This currency peg is maintained by the central bank through the generation of permanent price impact, thereby aggregating an ever‐increasing risky position in foreign reserves. We describe this situation mathematically by means of two coupled singular control problems, where the common singularity arises from a local time along a random curve. Our first result identifies a certain local time as that central bank strategy for which this risk position is minimized. We then consider the worst‐case situation the central bank may face by identifying that strategy of the strategic investor that maximizes the expected inventory of the central bank under a cost criterion, thus establishing a Stackelberg equilibrium in our model.
Role of optical coherence tomography in determining specific diagnostic pattern of retinal nerve fiber layer involvement in various central nervous system demyelinating diseases: An observational study
Authors: Khandelwal Dinesh , Dadarwal Kishor , Hiremath Ashwini , Mathur Vaibhav 
Published: June 2021

AbstractAimsTo assess retinal nerve fiber layer thickness by optical coherence tomography (OCT) in various central nervous system demyelinating diseases.Methods and MaterialA total of 40 patients were selected. There were 8 patients of multiple sclerosis, 12 patients of neuromyelitis optica spectrum disorders (NMOSD), 9 patients of optic neuritis, and 11 patients of longitudinally extensive transverse myelitis (LETM). The fast retinal nerve fiber layer (RNFL) thickness protocol was used to compute the overall average RNFL thickness for each eye. Average RNFL thickness for 360° around the optic disk, for the superior, nasal, inferior, and temporal quadrants around the optic disk as well as in the twelve 30° segments (with 3 o'clock position as nasal) were recorded.ResultsAverage RNFL thicknesses were lower in NMOSD group. Superior, inferior, and temporal quadrants are the preferentially affected while 8 o'clock position RNFL was the thinnest. MS involved 8 o'clock position and temporal quadrant. Of 9 o'clock position and temporal quadrant were the thinnest in LETM. In idiopathic optic neuritis, lowest RNFL value was recorded in the nasal quadrant. In 3 o'clock position, maximum thinning was noted in idiopathic ON. At 9 o'clock position, maximum thinning was seen in LETM patients.ConclusionsMost o'clock positions and superior, inferior, and temporal quadrants were affected in NMOSD. MS mainly involved 8 o’clock position and temporal quadrant. LETM preferentially affected 9 o’clock position and the temporal quadrant. Hence, observing the pattern of RNFL thinning with OCT in CNS demyelinating diseases can intimate the etiological cause. However, larger studies are needed further to confirm the same.
Overview on domestication, breeding, genetic gain and improvement of tuber quality traits of potato using fast forwarding technique (GWAS): A review
Authors: Naeem Muhammad , Demirel Ufuk , Yousaf Muhammad Farhan , Caliskan Sevgi , Caliskan Mehmet Emin 
Published: June 2021

AbstractTuber quality is the subject of great interest among the processing industry and consumers worldwide. Being a polygenic trait, its enhancement requires a systematic understanding of their genetic complexity. Molecular genetics offered valuable solutions to the challenging endeavours of slow genetic gains in conventional potato breeding. With the advent of linkage maps, molecular markers and availability of next‐generation sequencing (NGS) platforms, the plant breeding programmes worldwide have achieved faster genetic gain due to marker‐assisted selection (MAS). Linkage mapping detects QTLs in biparental population; alternatively, genomic and phenotypic differences can be identified by extensive genotyping and phenotyping of a germplasm panel depicting natural biological diversity to reveal QTLs, in other words, marker‐trait associations. Due to advancements in the fields of genome sequencing and bioinformatics, researchers have preferred to use the genome‐wide association mapping (GWAS) method for detecting QTLs due to its higher resolution. In potato, GWAS identified causative allele(s)/loci and provides reliable platform for the development of diagnostic SNP markers by employing Infinium SolCAP SNP array. Later, KASP validation markers can be developed to be used as selection markers in order to bred improved cultivars. The current review focuses on recently used approaches for genetic analyses (linkage mapping or association mapping) regarding potato tuber quality traits, provides comprehensive knowledge about breeding, genetic gain, basic genetic and statistical GWAS concepts and subsequently highlights the genetic discoveries using GWAS and KASP markers.
Multiple in vivo Effects of Cadmium on Photosynthetic Electron Transport in Pea Plants
Authors: Todorenko Daria , Volgusheva Alena , Timofeev Nyurgun , Kovalenko Ilya , Matorin Dmitry , Antal Taras 
Published: June 2021

AbstractThe inhibitory effects of cadmium (CdSO4) on the primary photosynthetic processes were studied in vivo in Pisum sativum by using Multi‐function Plant Efficiency Analyser (M‐PEA‐2). Photosynthetic parameters related to photosystem (PS) II, PS I and intersystem electron carriers were calculated from the light‐induced kinetics of prompt chlorophyll a fluorescence (OJIP transient), delayed chlorophyll a fluorescence (DF), and 820 nm modulated reflection (MR). Low‐dose exposure to cadmium (20 μm CdSO4 for 48 h) reduced probability of electron transfer from plastoquinones to the terminal electron acceptors of PSI (δRo) accompanied by a decrease in the rate of P700+ and PC reduction (Vred) and the magnitude of the I2 step on the DF kinetics. Electron transport through PSI remained unaltered. The obtained results allowed us to propose existence of the potential site of inhibition of photosynthetic electron flow by cadmium between PSII and PSI. We propose to use parameters δRo, Vred, and I2/I1 as sensitive indicators of an early contamination by heavy metals.
Project-Based Teaching of a Manufacturing Class During the COVID-19 Pandemic
Authors: Masato Davide , Johnston Stephen 
Published: June 2021

Abstract
The plastics engineering program at the University of Massachusetts Lowell has taught mold design and engineering to undergraduate students for over 60 years. In 2020, the unexpected arrival of the COVID-19 pandemic in March forced the instructors to revisit the class program and objectives. Similar to other academic courses, the class became virtual. This meant redesigning an intensive hands-on manufacturing class into one that could be taught and taken from our home offices while maintaining academic rigor and continuing to meet critical student learning objectives. The timing of the pandemic meant that students, who were completing tooling split designs and starting computer numerical control programming, could not move forward with machining, assembly, and molding. Instead, their projects became virtual learning experiences. This paper provides the analysis and discussion of how new ideas in teaching were implemented to virtually introduce engineering students to the world of plastic manufacturing. The students' work was carried out on plastic part designs of their choice, some of which included thin walls (&lt;2 mm) and microscale features (∼800 μm) typical of a micro-injection molding process.
Surgery and COVID-19: a rapid scoping review of the impact of the first wave of COVID-19 on surgical services
Authors: O'Rielly Connor , Ng-Kamstra Joshua , Kania-Richmond Ania , Dort Joseph , White Jonathan , Robert Jill , Brindle Mary , Sauro Khara 
Published: June 2021

ObjectivesTo understand how surgical services have been reorganised during and following public health emergencies, particularly the first wave of the COVID-19 pandemic, and the consequences for patients, healthcare providers and healthcare systems.DesignA rapid scoping review.SettingWe searched the MEDLINE, Embase and grey literature sources for documents and press releases from governments and surgical organisations or associations.ParticipantsStudies examining surgical service delivery during public health emergencies including COVID-19, and the impact on patients, providers and healthcare systems were included.Primary and secondary outcome measuresPrimary outcomes were strategies implemented for the reorganisation of surgical services. Secondary were the impacts of reorganisation and resuming surgical services, such as: adverse events (including morbidity and mortality), primary care and emergency department visits, length of hospital and ICU stay, and changes to surgical waitlists.ResultsOne hundred and thirty-two studies were included in this review; 111 described reorganisation of surgical services, 55 described the consequences of reorganising surgical services; and 6 reported actions taken to rebuild surgical capacity in public health emergencies. Reorganisations of surgical services were grouped under six domains: case selection/triage, personal protective equipment (PPE) regulations and practice, workforce composition and deployment, outpatient and inpatient patient care, resident and fellow education, and the hospital or clinical environment. Service reorganisations led to large reductions in non-urgent surgical volumes, increases in surgical wait times and impacted medical training (ie, reduced case involvement) and patient outcomes (eg, increases in pain). Strategies for rebuilding surgical capacity were scarce but focused on the availability of staff, PPE and patient readiness for surgery as key factors to consider before resuming services.ConclusionsReorganisation of surgical services in response to public health emergencies appears to be context dependent and has far-reaching consequences that must be better understood in order to optimise future health system responses to public health emergencies.
Managing violence against healthcare personnel in the emergency settings of Pakistan: a mixed methods study
Authors: Khan Muhammad Naseem , Khan Ikram , Ul-Haq Zia , Khan Mirwais , Baddia Faryal , Ahmad Fayaz , Khan Salman 
Published: June 2021

ObjectivesThe primary objective of this study was to evaluate the effectiveness of a half-day training on de-escalation of violence against healthcare personnel regarding prevention and management of violence incidents versus a similar tertiary-level hospital with no such training. Secondary objectives were to compare the overall satisfaction, burnout, fear of violence and confidence in coping with patients’ aggression of the healthcare personnel in the two hospitals.DesignMixed method design, with a comparative cross-sectional (quantitative) and focus group discussions (qualitative) components.SettingEmergency departments of the two tertiary care hospitals in district Peshawar over 6 months starting from May 2018.ParticipantsHealthcare personnel in the emergency departments of the two hospitals (trained vs untrained).Outcome measuresViolence exposure (experienced/witnessed) assessed through a previously validated tool in the past 5 months. Burnout, confidence in coping with patient aggression and overall job satisfaction were also assessed through validated tools. The qualitative component explored the perceptions of healthcare personnel regarding the management of violence and the importance of training on de-escalation of violence through focus group discussions in the two hospitals.ResultsThe demographic characteristics of the healthcare personnel within the two hospitals were quite similar. The de-escalation training did not lead to a reduction in the incidences of violence; however, confidence in coping with patient aggression and the overall satisfaction were significantly improved in the intervention hospital. The de-escalation training was lauded by the respondents as led to an improvement in communication skills, and the healthcare personnel suggested for scale-up to all the cadres and hospitals.ConclusionThe study found significant improvements in the confidence of healthcare personnel in coping with patient aggression, along with better job satisfaction and less burnout in the intervention hospital following the de-escalation training.
Risk factors for severity on admission and the disease progression during hospitalisation in a large cohort of patients with COVID-19 in Japan
Authors: Terada Mari , Ohtsu Hiroshi , Saito Sho , Hayakawa Kayoko , Tsuzuki Shinya , Asai Yusuke , Matsunaga Nobuaki , Kutsuna Satoshi , Sugiura Wataru , Ohmagari Norio 
Published: June 2021

ObjectivesTo investigate the risk factors contributing to severity on admission. Additionally, risk factors of worst severity and fatality were studied. Moreover, factors were compared based on three points: early severity, worst severity and fatality.DesignAn observational cohort study using data entered in a Japan nationwide COVID-19 inpatient registry, COVIREGI-JP.SettingAs of 28 September 2020, 10480 cases from 802 facilities have been registered. Participating facilities cover a wide range of hospitals where patients with COVID-19 are admitted in Japan.ParticipantsParticipants who had a positive test result on any applicable SARS-CoV-2 diagnostic tests were admitted to participating healthcare facilities. A total of 3829 cases were identified from 16 January to 31 May 2020, of which 3376 cases were included in this study.Primary and secondary outcome measuresPrimary outcome was severe or nonsevere on admission, determined by the requirement of mechanical ventilation or oxygen therapy, SpO2 or respiratory rate. Secondary outcome was the worst severity during hospitalisation, judged by the requirement of oxygen and/orinvasive mechanical ventilation/extracorporeal membrane oxygenation.ResultsRisk factors for severity on admission were older age, men, cardiovascular disease, chronic respiratory disease, diabetes, obesity and hypertension. Cerebrovascular disease, liver disease, renal disease or dialysis, solid tumour and hyperlipidaemia did not influence severity on admission; however, it influenced worst severity. Fatality rates for obesity, hypertension and hyperlipidaemia were relatively lower.ConclusionsThis study segregated the comorbidities influencing severity and death. It is possible that risk factors for severity on admission, worst severity and fatality are not consistent and may be propelled by different factors. Specifically, while hypertension, hyperlipidaemia and obesity had major effect on worst severity, their impact was mild on fatality in the Japanese population. Some studies contradict our results; therefore, detailed analyses, considering in-hospital treatments, are needed for validation.Trial registration numberUMIN000039873. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045453
Incidence, origins and avoidable harm of missed opportunities in diagnosis: longitudinal patient record review in 21 English general practices
Authors: Cheraghi-Sohi Sudeh , Holland Fiona , Singh Hardeep , Danczak Avril , Esmail Aneez , Morris Rebecca Lauren , Small Nicola , Williams Richard , de Wet Carl , Campbell Stephen M , Reeves David 
Published: June 2021

BackgroundDiagnostic error is a global patient safety priority.ObjectivesTo estimate the incidence, origins and avoidable harm of diagnostic errors in English general practice. Diagnostic errors were defined as missed opportunities to make a correct or timely diagnosis based on the evidence available (missed diagnostic opportunities, MDOs).MethodRetrospective medical record reviews identified MDOs in 21 general practices. In each practice, two trained general practitioner reviewers independently conducted case note reviews on 100 randomly selected adult consultations performed during 2013–2014. Consultations where either reviewer identified an MDO were jointly reviewed.ResultsAcross 2057 unique consultations, reviewers agreed that an MDO was possible, likely or certain in 89 cases or 4.3% (95% CI 3.6% to 5.2%) of reviewed consultations. Inter-reviewer agreement was higher than most comparable studies (Fleiss’ kappa=0.63). Sixty-four MDOs (72%) had two or more contributing process breakdowns. Breakdowns involved problems in the patient–practitioner encounter such as history taking, examination or ordering tests (main or secondary factor in 61 (68%) cases), performance and interpretation of diagnostic tests (31; 35%) and follow-up and tracking of diagnostic information (43; 48%). 37% of MDOs were rated as resulting in moderate to severe avoidable patient harm.ConclusionsAlthough MDOs occurred in fewer than 5% of the investigated consultations, the high numbers of primary care contacts nationally suggest that several million patients are potentially at risk of avoidable harm from MDOs each year. Causes of MDOs were frequently multifactorial, suggesting the need for development and evaluation of multipronged interventions, along with policy changes to support them.
Symptom prevalence and severity in palliative cancer medicine
Authors: Webber Kath , Davies Andrew Neil , Leach Charlotte , Waghorn Melanie 
Published: June 2021

ObjectivesTo establish symptom prevalence and associated distress in a large cohort of UK patients with cancer referred to a palliative care team.MethodsThis is a secondary analysis of two large data sets of patients with advanced cancer. Each patient had completed the Memorial Symptom Assessment Scale-Short Form to assess 32 symptoms and related distress. Data frequencies were conducted in Excel.Results1507 patients were recruited. The most common symptoms were lack of energy (89%), pain (83%), feeling drowsy (77%) and dry mouth (70%). 67% of patients had psychological symptoms, with 31% of all patients having significant psychological distress.ConclusionsSymptom burden is significant in palliative patients with cancer. Structured symptom assessment with access to relevant supportive services is recommended.
Pulmonary Function and Respiratory Muscle Strength in Patients with Multiple Sclerosis
Authors: Westerdahl Elisabeth , Gunnarsson Martin , Wittrin Anna , Nilsagård Ylva 
Published: June 2021

Background. In patients with multiple sclerosis (MS), there is a decline in muscle strength and physical capacity due to demyelination and axonal loss in the central nervous system. In patients with advanced MS or in a later stage of the disease, also respiratory impairment may occur. The degree of pulmonary dysfunction in the earlier stages of MS has not been thoroughly described. Therefore, the primary aims of this study are to describe pulmonary function and respiratory muscle strength in patients with a moderate disease course and to identify associations between respiratory muscle strength and functional capacity. Methods. A sample of 48 patients with a diagnosis of MS and mean age

56
±
11

years was studied using a descriptive cross-sectional design. The patients had a disease duration of

24
±
11

years and a median Expanded Disability Status Scale (EDSS) score of 4.5 (interquartile range 4.0-6.5). Pulmonary function assessed by spirometry, respiratory muscle strength, peak cough flow and peripheral oxygen saturation, subjective breathing and coughing ability, and physical capacity measured using the 6MWT were evaluated. Results. The patients had normal pulmonary function with no significant abnormalities in dynamic spirometry (vital capacity

103
±
16
%

predicted, forced expiratory volume in 1 second

95
±
15
%

predicted). Peak expiratory flow rate

89
±
17
%

predicted was in the lower limit of normal. Respiratory muscle strength, determined by maximal inspiratory (MIP) and expiratory (MEP) static pressures, was normal but with large differences between individuals. MIP ranged from 26 to 143 cmH2O (

98
±
31
%

predicted); the MEP values ranged from 43 to 166 cmH2O (

104
±
29
%

predicted), with two patients having values below the lower limit of normal. Significant positive associations between MIP as well as MEP were found in several pulmonary function variables. A significant negative association was found between EDSS score and MEP (

r
=
−
0.312

,

p
=
0.031

). Mean peak cough flow was

389
±
70

L/min, which is comparable with the values reported for healthy adults. The patients did not experience a severely decreased ability to take deep breaths or cough. There was a moderate correlation between MEP and physical capacity, as assessed by the 6MWT (

r
=
0.399

,

p
=
0.010

) and between peak expiratory flow (PEF) and the 6MWT (

r
=
0.311

,

p
=
0.048

). Conclusion. Respiratory muscle strength, pulmonary function assessed by spirometry, and peak cough flow were normal in patients with mild to moderate MS; however, there were large individual differences demonstrating low respiratory muscle strength in some patients. Significant associations between MEP and functional capacity and between MEP and disease severity were found, indicating that patients with impaired respiratory muscle strength have lower functional capacity and more severe disease.