bluuebunny/crossref_metadata_2025 huggingface dataset:
Central Hyperthyroidism due to Thyroid-Stimulating Hormone-Secreting Pituitary Microadenoma in an Adolescent Boy: Case Report and Review of the Literature
Authors: Bao Le Hoang , Duc Nguyen Minh , Chien Phan Cong , Tra My Thieu-Thi , Thang Tran Viet , Nam Tran Quang
Published: March 2021

Thyroid-stimulating hormone- (TSH-) secreting pituitary adenoma (TSH-oma) is a rare cause of secondary hyperthyroidism and can be misdiagnosed as primary hyperthyroidism. We report a case of a 15-year-old male patient who was one of two monozygotic twins and exhibited hyperthyroidism syndrome. The laboratory results showed secondary hyperthyroidism, with increased levels of free T3 (FT3) and free T4 (FT4) and no TSH inhibition. Magnetic resonance imaging (MRI) and histopathological examination of the pituitary gland confirmed pituitary microadenoma. The patient was treated with methimazole, propranolol, and somatostatin analogs to restore euthyroidism before undergoing an endoscopic transsphenoidal resection of the pituitary tumor. After surgery, the hyperthyroidism symptoms improved, thyroid hormones normalized, and MRI of the pituitary gland showed the complete removal of the tumor with no recurrence after 2 years of follow-up.
Analysis and Prediction of CET4 Scores Based on Data Mining Algorithm
Authors: Wang Hongyan
Published: March 2021

This paper presents the concept and algorithm of data mining and focuses on the linear regression algorithm. Based on the multiple linear regression algorithm, many factors affecting CET4 are analyzed. Ideas based on data mining, collecting history data and appropriate to transform, using statistical analysis techniques to the many factors influencing the CET‐4 test were analyzed, and we have obtained the CET‐4 test result and its influencing factors. It was found that the linear regression relationship between the degrees of fit was relatively high. We further improve the algorithm and establish a partition‐weighted K‐nearest neighbor algorithm. The K‐weighted K nearest neighbor algorithm and the partition algorithm are used in the CET‐4 test score classification prediction, and the statistical method is used to study the relevant factors that affect the CET‐4 test score, and screen classification is performed to predict when the comparison verification will pass. The weight K of the input feature and the adjacent feature are weighted, although the allocation algorithm of the adjacent classification effect has not been significantly improved, but the stability classification is better than K‐nearest neighbor algorithm, its classification efficiency is greatly improved, classification time is greatly reduced, and classification efficiency is increased by 119%. In order to detect potential risk graduating students earlier, this paper proposes an appropriate and timely early warning and preschool K‐nearest neighbor algorithm classification model. Taking test scores or make‐up exams and re‐learning as input features, the classification model can effectively predict ordinary students who have not graduated.
Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study
Authors: Nalunjogi Joanitah , Mugabe Frank , Najjingo Irene , Lusiba Pastan , Olweny Francis , Mubiru Joseph , Kayongo Edward , Sekibira Rogers , Katamba Achilles , Kirenga Bruce
Published: March 2021

The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.
Some New Observations on Generalized Contractive Mappings and Related Results in b-Metric-Like Spaces
Authors: Došenović Tatjana , De La Sen Manuel , Paunović Ljiljana , Rakić Dušan , Radenović Stojan
Published: March 2021

In this paper, we consider, discuss, complement, improve, generalize, and enrich some fixed point results obtained forβ−ψ1−ψ2−contractive conditions in ordered b-metric-like spaces. By using our new approach for the proof that one Picard’s sequence isbbl−Cauchy in the context of b-metric-like spaces, we get much shorter proofs than the ones mentioned in the recent papers. Also, by the use of our method, we complement and enrich some common fixed point results forβq,ϕs,ψ−contraction mappings. Our approach in this paper generalizes and modifies several comparable results in the existing literature.
Improvement in Explicit Prediction of Water Quality Using Wavelet‐Based LSSVR and M5pRT
Authors: Bhardwaj Rashmi , Bangia Aashima
Published: March 2021

Imbalance in the pH of water reduces this precious resource as an extremely dangerous liquid for human health and plants’ growth. Change in the pH levels of the drinkable water has majorly raised concern towards diverse health issues like heart problems, infant mortality rates, pigmentation of skin, and cholera outbreaks. Therefore, it is necessary to keep a check on essential water quality components that include acidic/basic nature of water. As per the US Environmental Protection Agency (USEPA), the drinkable water should have a pH level ranging from 6.5 to 8.5. Two sample situates have been identified wherever highly reported pollutants levels were found and have been analyzed through artificial intelligence (AI) techniques. It can be observed that wavelet denoised signals fed into the least squares support vector regression (LSSVR) and M5 prime regression tree (M5pRT) predicted more accurately on the basis of the performance errors that are as follows: (a) root mean squared error (RMSE); (b) mean squared error (MSE); (c) mean absolute error (MAE). On the basis of these errors, the coefficient of determination/goodness of fit (R2) simulated for the prototypes is developed in this study. RMSE outcomes diminish on the whole on applying the training and forecasting data‐division via WLSSVR and WM5pRT as compared with fitting the normalized data through LSSVR and M5pRT. These performance measures are essential to analyze the concentration levels of pH in the river streams at the identified sites of study. Thus, the observed pattern from this study may help for future estimation of the quality of water at their sources so that it prohibits the further increase in either acidic or basic salts which prove to be lethal for the environment. Thus, these predictors would be helpful towards formulation of strategies for protection of ecosystem and human health.
Risk-Averse Pricing Decisions Related to Recyclables’ Quality in a Closed-Loop Supply Chain
Authors: Zhang Qunxiang , Huang Zuqing , Zheng Rong
Published: March 2021

In a closed-loop supply chain, uncertainty of recyclables’ quality is a major factor of supply chain members’ decision-making. Because of this uncertainty, manufacturers must pay varying manufacturing costs for remanufacturing recyclables. Our study assumed that manufacturers are risk-averse towards uncertainty in manufacturing costs and constructed a retailer recycling model and a third-party recycling model to investigate pricing decisions in a decentralized closed-loop supply chain under uncertainty about recyclables’ quality. Our findings can be summarized as follows: (1) the higher the degree of consumer preference for remanufactured products, the higher the wholesale and retail prices of remanufactured products and the higher the recycling price of used products; (2) the two recycling models showed a U-shaped relationship between supply chain revenue and the degree of consumer preference for remanufactured products, and this supply chain revenue is related to the consumer preference coefficient; (3) there is a U-shaped relationship between the retailer’s expected revenue and the degree of consumer preference for remanufactured products in the R mode and an M-shaped relationship between them in the 3P mode; (4) in both recycling modes, the manufacturer’s risk aversion is inversely proportional to supply chain revenue, and supply chain revenue in the R mode is higher than that in the 3P mode; and (5) the higher the uncertainty of recyclables’ quality, the lower the recycling price of used products and the lower the manufacturer’s enthusiasm for recycling or for used products.
A Diagnostic Dilemma of Antiglutamic Acid Decarboxylase 65 (Anti-GAD 65) and Mycoplasma Pneumoniae Antibodies in a Girl Presenting with Acute-Onset Obsessive-Compulsive Disorder
Authors: Freeman Cecilia G. , Langeveldt Antanoid J. , Miller Robyn R.
Published: March 2021

Acute-onset obsessive-compulsive disorder can be challenging, especially when triggered by an underlying disease process. Clinicians often turn to Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), but it is important to consider a broad differential in these patients. We present a case of a 9-year-old girl with acute-onset obsessive-compulsive behavior likely triggered by a post-infectious phenomenon that ultimately resolved following treatment with plasmapheresis.
Therapeutic Inhibition of Cathepsin S Reduces Inflammation and Mucus Plugging in Adult βENaC-Tg Mice
Authors: Brown Ryan , Small Donna M. , Doherty Declan F. , Holsinger Leslie , Booth Robert , Williams Richard , Ingram Rebecca J. , Elborn J. Stuart , Mall Marcus A. , Taggart Clifford C. , Weldon Sinéad
Published: March 2021

Background. Elevated levels of the cysteine protease cathepsin S (CatS) are associated with chronic mucoobstructive lung diseases such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). We have previously demonstrated that prophylactic treatment with a CatS inhibitor from birth reduces inflammation, mucus plugging, and lung tissue damage in juvenile β-epithelial Na+ channel-overexpressing transgenic (βENaC-Tg) mice with chronic inflammatory mucoobstructive lung disease. In this study, we build upon this work to examine the effects of therapeutic intervention with a CatS inhibitor in adult βENaC-Tg mice with established disease. Methods. βENaC-Tg mice and wild-type (WT) littermates were treated with a CatS inhibitor from 4 to 6 weeks of age, and CatS-/-βENaC-Tg mice were analysed at 6 weeks of age. Bronchoalveolar lavage (BAL) fluid inflammatory cell counts were quantified, and lung tissue destruction and mucus obstruction were analysed histologically. Results. At 6 weeks of age, βENaC-Tg mice developed significant airway inflammation, lung tissue damage, and mucus plugging when compared to WT mice. CatS-/-βENaC-Tg mice and βENaC-Tg mice receiving inhibitor had significantly reduced airway mononuclear and polymorphonuclear (PMN) cell counts as well as mucus plugging. However, in contrast to CatS-/-βENaC-Tg mice, therapeutic inhibition of CatS in βENaC-Tg mice had no effect on established emphysema-like lung tissue damage. Conclusions. These results suggest that while early CatS targeting may be required to prevent the onset and progression of lung tissue damage, therapeutic CatS targeting effectively inhibited airway inflammation and mucus obstruction. These results indicate the important role CatS may play in the pathogenesis and progression of mucoobstructive lung disease.
Increased Levels of ER Stress and Apoptosis in a Sheep Model for Pulmonary Fibrosis Are Alleviated by In Vivo Blockade of the KCa3.1 Ion Channel
Authors: Perera Udari E. , Organ Louise , Dewage Sasika N. V. , Derseh Habtamu B. , Stent Andrew , Snibson Kenneth J.
Published: March 2021

Idiopathic pulmonary fibrosis (IPF) is a fatal interstitial lung disease, characterized by progressive damage to the lung tissues. Apoptosis and endoplasmic reticulum stress (ER stress) in type II alveolar epithelial cells (AECs) and lung macrophages have been linked with the development of IPF. Therefore, apoptosis- and ER stress-targeted therapies have drawn attention as potential avenues for treatment of IPF. The calcium-activated potassium ion channel KCa3.1 has been proposed as a potential therapeutic target for fibrotic diseases including IPF. While KCa3.1 is expressed in AECs and macrophages, its influence on ER stress and apoptosis during the disease process is unclear. We utilized a novel sheep model of pulmonary fibrosis to demonstrate that apoptosis and ER stress occur in type II AECs and macrophages in sheep with bleomycin-induced lung fibrosis. Apoptosis in type II AEC and macrophages was identified using the TUNEL method of tagging fragmented nuclear DNA, while ER stress was characterized by increased expression of GRP-78 ER chaperone proteins. We demonstrated that apoptosis and ER stress in type II AECs and macrophages increased significantly 2 weeks after the final bleomycin infusion and remained high for up to 7 weeks post-bleomycin injury. Senicapoc treatment significantly reduced the rates of ER stress in type II AECs and macrophages that were resident in bleomycin-infused lung segments. There were also significant reductions in the rates of apoptosis of type II AECs and macrophages in the lung segments of senicapoc-treated sheep. In vivo blockade of the KCa3.1 ion channel alleviates the ER stress and apoptosis in type II AECs and macrophages, and this effect potentially contributes to the anti-fibrotic effects of senicapoc.
Simulation Analysis of Magnetic Gradient Full-Tensor Measurement System
Authors: Xu Lei , Zhang Ning , Fang Liqing , Chen Huadong , Lin Pengfei , Lin Chunsheng
Published: March 2021

The magnetic gradient full-tensor measurement system is diverse, and the magnetometer array structure is complex. Aimed at the problem, seven magnetic gradient full-tensor measurement system models are studied in detail. The full-tensor measurement theories of the tensor measurement arrays are analyzed. Under the same baseline distance, the magnetic dipole model is used to simulate the measurement system. Based on different measurement systems, the paper quantitatively compares and analyzes the error of the structure. A more optimized magnetic gradient full-tensor measurement system is suggested. The simulation results show that the measurement accuracy of the planar measurement system is slightly higher than that of the stereo measurement system. Among them, the cross-shaped and square measurement systems have relatively smaller structural errors and higher measurement accuracy.
Numerical Investigation on the Ground Response of a Gob‐Side Entry in an Extra‐Thick Coal Seam
Authors: Zang C.W. , Zhang G.C. , Tao G.Z. , Zhu H.M. , Li Y. , Zuo H.
Published: March 2021

This study was aimed at the large deformation phenomenon of rock mass surrounding the gob‐side entry driven in a 20 m extra‐thick coal seam. Taking tailgate 8211 as the engineering background, a numerical investigation was employed to analyze the deformation law of the gob‐side entry. The study results are as follows. (1) Because the immediate roof was composed of weak coal mass with a thickness of 17 m, the roof coal mass was vulnerable to fail with the effect of overlying strata pressure; thus, a visual subsidence of roof coal mass with a maximum convergence of 800 mm was observed in the field. (2) The bearing capacity of the coal pillar was significantly less than that of the panel rib, resulting in the pillar failing more easily under the ground pressure and then generating large‐scale squeezing deformation. (3) The roof and panel rib were in a state of shear failure with a failure depth of about 5 m. The coal pillar was entirely in a state of plastic failure. (4) A support scheme including an asymmetric anchor beam truss, roof angle anchor cable, and anchor cable combination structure was proposed. The field work confirmed that this support scheme could efficiently control the deformation and failure of the rock mass surrounding the gob‐side entry. This study provides the theoretical basis and technical support for the control of rocks surrounding the gob‐side entry in similar conditions.
Assessment of Educational Quality and Associated Factors: The Case of Arba Minch College of Health Sciences in 2017, South Ethiopia
Authors: Gilano Girma , Hailegebreal Samuel
Published: March 2021

Introduction. Over the decades, improving the quality of education has been pronounced frequently in many studies. It became a political argument in different media across the globe and the theme of courtesy among scientists. The concern about education is not something you ignore or consider later, so the attempts to improve are increasing with the quality matter going longer and continuing to date. Thus, the primary aim of this work was to assess the quality of education and its associated factors for the future improvement in the study site. Methods. An institution-based cross-sectional study was conducted in Arba Minch College of Health Sciences (AMCHS) students and staff from all departments. Ethical clearance was received and verbal consent was secured beforehand. After processing, data was entered into Epi Info and then transferred and analyzed in SPSS 25.0. Result and Discussion. The overall quality of education in the college was 2.87 ± 1.12. Administrative services, reading places, and resources took a larger share of poor quality. Accessibility, friendliness of staffs to each other and students, availability of clear guideline of conduct, presence of effective, accurate, and promotive services, high standard administrative buildings, availability of standard catering service, availability of standard laboratories, communication, and exchanges with similar level colleges in the region, weekly time table, weekly load, distance, etc. and some sociodemographic factors were associated with poor quality of education. Thus, the college inquired to welcome the aforementioned shortcomings improvement and to provide enough solutions.
End Point Estimate of Littlewood-Paley Operator Associated to the Generalized Schrödinger Operator
Authors: Chen Yanping , Tao Wenyu
Published: March 2021

Let

L
=
−
Δ
+
μ

be the generalized Schrödinger operator on

ℝ

d

,
d
≥
3
,

where

μ
≠
0

is a nonnegative Radon measure satisfying certain scale-invariant Kato conditions and doubling conditions. In this work, we give a new

BMO

space associated to the generalized Schrödinger operator

L
,
BM

O

θ
,
L

, which is bigger than the

BMO

spaces related to the classical Schrödinger operators

A

=

−

Δ

+

V

, with

V

a potential satisfying a reverse Hölder inequality introduced by Dziubański et al. in 2005. Besides, the boundedness of the Littlewood-Paley operators associated to

L

in

BM

O

θ
,
L

also be proved.
A Novel Cluster‐Based Wireless Sensor Network Reliability Model Using the Expectation Maximization Algorithm
Authors: Yang Jianfeng , Chen Jing , Huo Yujia , Liu Yanyu
Published: March 2021

Wireless sensor networks (WSNs) have been used widely across various industries and business fields that require the coverage of large geographical regions that are difficult for humans to reach. It is therefore important to be able to model, assess, and predict the reliability of WSNs. Masked data is a type of missing data used to represent system failure when the exact cause of the failure is unknown. This paper proposed a novel additive reliability model for a cluster‐based WSN system using general masked data and uses the expectation maximization (EM) algorithm to solve the problem of the maximum likelihood estimation (MLE). Moreover, the proposed model assumes that a WSN comprises several clusters, and the failure processes of these clusters are independent. The probability characteristics of the system are determined according to the topology of the WSN system to evaluate the system reliability. Finally, the proposed model is demonstrated to be powerful for estimating WSN system reliability using a simulated dataset.
Clinical and Radiological Presentations of Various Pulmonary Infections in Hospitalized Diabetes Mellitus Patients: A Prospective, Hospital-Based, Comparative, Case Series Study
Authors: Vishwakarma Pravesh , Usman Kauser , Garg Rajiv , Bajpai Jyoti , Sethi Rishi , Pradhan Akshyaya
Published: March 2021

Background. Diabetes mellitus is associated with increased rate of respiratory tract infections. The objective was to compare demographic, clinical, serum biochemical, and typical and atypical radiological profiles among hospitalized diabetics and nondiabetics with lower respiratory tract infection. Material and Methods. A prospective, hospital-based, consecutive, comparative observational study of 12-month study duration was conducted. Patients aged 13–90 years diagnosed with lower respiratory tract infection with or without diagnosed diabetes mellitus participated in the study. Demographic, clinical, serum biochemistry, and radiological profiles of diabetics (

n
=
44

) and nondiabetics (

n
=
53

) were compared. Results. Diabetics were older than nondiabetics at presentation (

p
<
0.0001

). Difference in mean random blood sugar (RBS) (

p
<
0.001

), fasting blood sugar (FBS) (

p
<
0.001

), and postprandial blood sugar (PPBS) (

p
<
0.0001

) was significant between diabetics and nondiabetics. Nondiabetics more frequently presented with fever (

p
=
0.0032

), chest pain (

p
=
0.0002

), and hemoptysis (

p
=
0.01

) as compared to diabetics. Diabetics more frequently presented with extreme temperatures (hypothermia or hyperpyrexia) (

p
=
0.022

), lower serum sodium levels (

p
=
0.047

), and lower partial arterial pressure (

p
<
0.001

) than nondiabetics. The mean pneumonia patient outcomes research team (PORT) risk score was higher in diabetics (

124.84
±
41.31

) compared to nondiabetics (

77.85
±
39.77

) (

p
<
0.001

). Diabetics more commonly displayed bilateral lesions with multilobe or lower lobe involvement, the most common type of lesion being exudative. Conclusion. Diabetic patients usually had severe pulmonary infection and poor prognosis as suggested by higher mean PORT risk score. They also more frequently presented with bilateral lesions with multilobe or lower lobe involvement as evidenced by radiography as compared to nondiabetic patients.
Determination of Potential Therapeutic Targets and Prognostic Markers of Ovarian Cancer by Bioinformatics Analysis
Authors: Zhang Jing , Huang Shouguo , Quan Lini , Meng Qiu , Wang Haiyan , Wang Jie , Chen Jin
Published: March 2021

This study is to study the expression of CXCRs in ovarian cancer tissues and their value in prognosis. The expressions of CXCR1‐CXCR7 mRNA between ovarian tumor tissues and normal tissues and in different pathological types of ovarian tumor tissues were compared by ONCOMINE online tool. The relationship between the expression of CXCRs and clinical pathological staging was studied by GEPIA. Kaplan‐Meier plotter online tool was used to analyze prognosis. Finally, GO and KEGG analyses and protein interaction network analysis were performed for CXCRs by the DAVID software to predict their function, and cBioPortal was used to identify the key functional genes. The expression of CXCR3/4/7 mRNA in ovarian cancer tissues was higher than that in normal ovarian tissues, and the expression of CXCR4 was the highest (fold change = 306.413, P < 0.05). The expression of CXCR1/2/3/4/7 mRNA in different pathological types of ovarian tumors was significantly different (P < 0.05). Only CXCR5 expression level was associated with tumor staging. Survival analysis showed that high CXCR7 mRNA expression and low CXCR5/6 expression were associated with the shortening of overall survival. High CXCR4/7 expression and low CXCR5/6 expression were associated with the shortening of progression‐free survival. High CXCR2/4 expression and low CXCR5/6 expression were closely related to the shortening of postprogressing survival. Protein interaction network analysis showed that GNB1, PTK2, MAPK1, PIK3CA, GNB4, GNA11, KNG1, and ARNT proteins were closely related to the CXC receptor family. CXCR3/4/7 are potential therapeutic targets, and CXCR2/4/5/6/7 are new markers for the prognosis of ovarian cancer.
A High-Order Iterative Scheme for a Nonlinear Pseudoparabolic Equation and Numerical Results
Authors: Nhan Nguyen Huu , Dung Tran Trinh Manh , Thanh Le Thi Mai , Ngoc Le Thi Phuong , Long Nguyen Thanh
Published: March 2021

In this paper, by applying the Faedo-Galerkin approximation method and using basic concepts of nonlinear analysis, we study the initial-boundary value problem for a nonlinear pseudoparabolic equation with Robin–Dirichlet conditions. It consists of two main parts. Part 1 is devoted to proof of the unique existence of a weak solution by establishing an approximate sequence

u

m

based on a

N

-order iterative scheme in case of

f
∈

C

N

0,1

×

0
,

T

∗

×
ℝ

N
≥
2

, or a single-iterative scheme in case of

f
∈

C

1

Ω
¯

×

0
,

T

∗

×
ℝ

. In Part 2, we begin with the construction of a difference scheme to approximate

u

m

of the

N

-order iterative scheme, with

N
=
2

. Next, we present numerical results in detail to show that the convergence rate of the 2-order iterative scheme is faster than that of the single-iterative scheme.
On the Controllability of Discrete-Time Leader-Follower Multiagent Systems with Two-Time-Scale and Heterogeneous Features
Authors: Gu Mengqi , Jiang Guo-Ping
Published: March 2021

This paper investigates the controllability of discrete-time leader-follower multiagent systems (MASs) with two-time-scale and heterogeneous features, motivated by the fact that many real systems are operating in discrete-time. In this study, singularly perturbed difference systems are used to model the two-time-scale heterogeneous discrete-time MASs. To avoid the ill-posedness problem caused by the singular perturbation parameter when using the classical control theory to study the model, the singular perturbation method was first applied to decompose the system into two subsystems with slow-time-scale and fast-time-scale feature. Then, from the perspective of algebra and graph theory, several easier-to-use controllability criteria for the related MASs are proposed. Finally, the effectiveness of the main results is verified by simulation.
Segmental Cardiac Radiation Dose Determines Magnitude of Regional Cardiac Dysfunction
Authors: Trivedi Siddharth J. , Tang Simon , Byth Karen , Stefani Luke , Lo Queenie , Otton James , Jameson Michael , Tran David , Batumalai Vikneswary , Holloway Lois , Delaney Geoff P. , Koh Eng‐Siew , Thomas Liza
Published: March 2021

Background

Subclinical left ventricular dysfunction detected by 2‐dimensional global longitudinal strain post breast radiotherapy has been described in patients with breast cancer. We hypothesized that left ventricular dysfunction postradiotherapy may be site specific, based on differential segmental radiotherapy dose received.

Methods and Results

Transthoracic echocardiograms were performed at baseline, 6 weeks, and 12 months postradiotherapy on 61 chemotherapy‐naïve women with left‐sided breast cancer undergoing tangential breast radiotherapy. Radiation received within basal, mid, and apical regions for the 6 left ventricular walls was quantified from the radiotherapy treatment planning system. Anterior, anteroseptal, and anterolateral walls received the highest radiation doses, while inferolateral and inferior walls received the lowest. There was a progressive increase in the radiation dose received from basal to apical regions. At 6 weeks, the most significant percentage deterioration in strain was seen in the apical region, with greatest reductions in the anterior wall followed by the anteroseptal and anterolateral walls, with a similar pattern persisting at 12 months. There was a within‐patient dose–response association between the segment‐specific percentage deterioration in strain at 6 weeks and 12 months and the radiation dose received.

Conclusions

Radiotherapy for left‐sided breast cancer causes differential segmental dysfunction, with myocardial segments that receive the highest radiation dose demonstrating greatest strain impairment. Percentage deterioration in strain observed 6 weeks postradiotherapy persisted at 12 months and demonstrated a dose–response relationship with radiotherapy dose received. Radiotherapy‐induced subclinical cardiac dysfunction is of importance because it could be additive to chemotherapy‐related cardiotoxicity in patients with breast cancer. Long‐term outcomes in patients with asymptomatic strain reduction require further investigation.
The First Workers’ Government in History: Karl Marx’s Addenda to Lissagaray’s History of the Commune of 1871
Authors: Gaido Daniel
Published: March 2021

In Marxist circles it is common to refer to Karl Marx’s The Civil War in France for a theoretical analysis of the historical significance of the Paris Commune, and to Prosper-Olivier Lissagaray’s History of the Commune of 1871 for a description of the facts surrounding the insurrection of the Paris workers and its repression by the National Assembly led by Adolphe Thiers. What is less well-known is that Marx himself oversaw the German translation of Lissagaray’s book and made numerous additions to it. In this article we describe Marx’s addenda to Lissagaray’s work, showing how they contribute to concretising his analysis of the Paris Commune and how they relate to the split in the International Working Men’s Association between Marxists and anarchists that took place after the Commune’s defeat. We also show how Marx’s additions to the German version of Lissagaray’s book were linked to his involvement with the recently created Socialist Workers’ Party of Germany and to his criticism of the programme it had adopted at the congress celebrated in the city of Gotha.
Class, Assets and Work in Rentier Capitalism
Authors: Christophers Brett
Published: March 2021

‘Rentier capitalism’ is the term increasingly used to describe economies dominated by rentiers, rents, and rent-generating assets. A growing body of scholarship considers how the ownership of such assets by individuals and households is reshaping patterns of class and inequality and accordingly requires the reconceptualisation of the latter phenomena. The significance of company-owned assets and corporate rents for class, inequality and their conceptualisation has not been considered, however. This article offers an exploratory investigation along these lines, highlighting the importance of employees’ working relationship to company-owned, rent-generating assets for their class position. The article further reflects on how developments in this regard might be approached from the perspective of Marx’s writing on value, labour and class, and the challenges that those developments potentially pose to Marxian concepts.
Laparoscopic-Assisted Relocation of the Umbilicus With Umbilicoplasty in Complex Abdominal Wall Reconstruction
Authors: Halsey Jordan N. , Ayyala Haripriya S. , Eid Sebastian R. , Ciminello Frank S.
Published: March 2021

Patients with complex abdominal wall pathology often present with significant distortion of their umbilicus. Ventral and umbilical hernias often create widening or protrusion of the umbilicus, while obesity and laxity of the skin and subcutaneous tissue of the abdominal wall further exacerbates the deformity. The primary goal of hernia repair is always reduction of the hernia with a tension-free repair; however, an important secondary goal is esthetic improvement of the abdominal wall. Often, in patients with complex hernia defects involving the umbilicus, there is discussion of not salvaging the umbilicus altogether. Although this certainly remains an option for many patients, we present a technique that would not only allow for hernia reduction under direct laparoscopic visualization but also an improved esthetic to the umbilicus.
The role of rurality on factors associated with major depressive episode screening among Brazilian adults in a national household survey
Authors: Souza Maximiliano Loiola Ponte de , Caranha Nathalia Paz , Herkrath Fernando José
Published: March 2021

Background:

Worldwide, depression is one of the leading causes of disability, contributing significantly to the global burden of disease. The aim of this study was to evaluate in Brazil the effect of living in rural or urban areas on the prevalence of major depressive episode (MDE), as well as the differences among associated factors in both contexts.

Methods:

Data from 60,202 adult residents from a household-based cross-sectional survey conducted in Brazil were analyzed. The prevalence of MDE, evaluated using PHQ-9, as well as the prevalence ratios between the categories of the independent variables were estimated. Multiple hierarchical Poisson regression analyses based on a theoretical model were reproduced for both rural and urban areas.

Results:

Residents of rural areas showed lower MDE prevalence (3.3% [95% CI: 2.9–3.9] vs. 4.2% [95% CI: 3.9–4.6], p < .05) and the effect of rurality remained even adjusted by potential confounders (PR = 0.8 [95% CI: 0.7–0.9]). Better education, social network, and access to health services were protective factors for both rural and urban areas, while previous diagnosis of depression, chronic diseases, and obesity were risk factors. Living in the northern region, being indigenous, presenting higher income and number of goods were protective factors only in rural areas. In urban areas, being younger and having an occupation were protective factors, whereas female sex and having some disability were risk factors.

Conclusions:

Rural and urban areas differ not only in the prevalence of depression, but also in the way in which different factors influence its occurrence.
Peace, love, and justice: A participatory phenomenological study of psychosocial well-being in Afghanistan
Authors: Bragin Martha , Akesson Bree , Ahmady Mariam , Akbari Sediqa , Ayubi Bezhan , Faqiri Raihana , Faiq Zekrullah , Oriya Spozhmay , Zaffari Rohina , Rasooli Mohammad Hadi , Azizi Basir Ahmad , Barakzai Fareshteh , Haidary Yasamin , Jawadi Sediqa , Wolfson Hannah , Ahmadi Sayed Jafar , Karimi Basir Ahmad , Sediqi Sataruddin
Published: March 2021

While there have been many studies that elucidate the extent of human suffering in Afghanistan, there has been no formal study of what it means to be psychologically and socially well. This article reports on a participatory phenomenological study conducted in Afghanistan designed to better understand psychosocial well-being. Collecting data from 440 Afghan participants in 56 focus group discussions, the research specifically elaborated and operationalized definitions of psychosocial well-being that were relevant to the Afghan context. This study adds critical value around definitions of what it means to be psychosocially well in Afghanistan and other conflict-affected countries.
In Silico Modeling of Hyposalivation and Biofilm Dysbiosis in Root Caries
Authors: Head D. , Marsh P.D. , Devine D.A. , Tenuta L.M.A.
Published: March 2021

Root caries progression is aggravated by hyposalivation, which can accelerate the conversion of a dental biofilm from having a symbiotic microbial relationship with the host (predominance of nonaciduric species) to a dysbiotic one (dominated by aciduric species). Using a mathematical model previously employed to investigate factors associated with biofilm dysbiosis, we systematically explored the deleterious effect of hyposalivation on the composition of the biofilm and the risk of root dentin demineralization. By varying the clearance half-times of sugar (i.e., readily fermented dietary carbohydrates), we simulated hyposalivation and investigated its effect on 1) the time that the biofilm pH spends below the minimum for dentin or enamel demineralization and 2) the conversion of the biofilm from a symbiotic to dysbiotic composition. The effect of increasing sugar clearance half-times on the time that the biofilm pH is below the threshold for demineralization was more pronounced for dentin than for enamel (e.g., increasing the clearance half-time from 2 to 6 min doubled the time that the biofilm pH was below the threshold for dentin demineralization). The effect on biofilm composition assessed at 50 d showed that the conversion from a symbiotic to a dysbiotic biofilm happened around a frequency of 6 sugar intakes per day when the clearance half-time was 2 min but only 3 sugar intakes per day when the clearance half-time was 6 min. Taken together, the results confirm the profound effect that prolonged sugar clearance has on the dynamics of dental biofilm composition and the subsequent risk of root caries. This in silico model should be applied to study how interventions that alter salivary clearance rates or modify biofilm pH can affect clinical conditions such as root caries.
EpsR Negatively Regulates Streptococcus mutans Exopolysaccharide Synthesis
Authors: Chen J. , Zhang A. , Xiang Z. , Lu M. , Huang P. , Gong T. , Pan Y. , Lin Y. , Zhou X. , Li Y.
Published: March 2021

Streptococcus mutans is considered the primary etiological agent of human dental caries. Glucosyltransferases (Gtfs) from S. mutans play important roles in the formation of biofilm matrix and the development of cariogenic oral biofilm. Therefore, Gtfs are considered an important target to prevent the development of dental caries. However, the role of transcription factors in regulating gtf expression is not yet clear. Here, we identify a MarR (multiple antibiotic resistance regulator) family transcription factor named EpsR (exopolysaccharide synthesis regulator), which negatively regulates gtfB expression and exopolysaccharide (EPS) production in S. mutans. The epsR in-frame deletion strain grew slowly, aggregated more easily in the presence of dextran, and displayed different colony morphology and biofilm structure. Notably, epsR deletion resulted in altered 3-dimensional biofilm architecture, increased water-insoluble EPS production, and upregulated GtfB protein content and activity. In addition, global gene expression profiling revealed differences in the expression levels of 69 genes in which gtfB was markedly upregulated. The conserved DNA motif for EpsR binding was determined by electrophoretic mobility shift assay and DNase I footprinting assays. Moreover, analysis of β-galactosidase activity suggested that EpsR acted as a repressor and inhibited gtfB expression. Taken together, our findings indicate that EpsR is an important transcription factor that regulates gtfB expression and EPS production in S. mutans. These results add new aspects to the complexity of regulating the expression of genes involved in the cariogenicity of S. mutans, which might lead to novel strategies to prevent the formation of cariogenic biofilm that may favor diseases.
TiO2 Nanonetwork on Rough Ti Enhanced Osteogenesis In Vitro and In Vivo
Authors: Yang W.E. , Huang H.H.
Published: March 2021

The objective in this study was to enhance osteogenic responses (in vitro and in vivo) to roughened titanium (Ti) dental implants through the formation of superhydrophilic TiO2 nanonetwork surface structure. Sandblasting and acid etching (SLA) was used to roughen the Ti surface. An electrochemical anodization process was then used to form a superhydrophilic TiO2 nanonetwork on the SLA Ti surfaces. The pore size of the nanonetwork structure ranged from a few nanometers to more than 100 nm, which is on the same scale as many biological species. Human bone marrow mesenchymal stem cells were used as an in vitro test model. The TiO2 nanonetwork structure was shown to have a significantly positive effect on hydrophilicity, protein adsorption, cell adhesion, cell migration, cell mineralization, and the gene and protein expression of osteogenic markers. The osseointegration of an anodized SLA screw-type Ti dental implant was investigated in vivo via implantation in the femur of New Zealand white rabbits for durations of 4 or 12 wk. The presence of a superhydrophilic surface TiO2 nanonetwork was shown to significantly enhance the bone-to-implant contact of the roughened SLA screw-type Ti dental implants. Overall, the proposed superhydrophilic TiO2 nanonetwork structure on the roughened SLA Ti surface proved highly effective in enhancing osteogenic responses in vitro and in vivo.
School Music and the Transition to College
Authors: Elpus Kenneth
Published: March 2021

This study explored the transition from secondary to postsecondary education among a national sample of students who had or had not studied music in high school. Using evidence from the High School Longitudinal Study of 2009, a nationally representative longitudinal study of 21,440 American high school students who were ninth graders in the 2009–2010 school year, music and nonmusic students were compared for college admission outcomes. Specifically, music and nonmusic students were compared in terms of participation in the college admission process, the selectivity of colleges applied to and attended, scholarship and grant receipt, and election of either an arts or STEM (science, technology, engineering, mathematics) major. Comparisons controlled for the well-documented preexisting differences among those students who do and do not elect high school music study. Results showed that music and nonmusic students dropped out of high school, applied to college, attended college, received college scholarships and grants, and majored in STEM fields at statistically similar rates. However, music students were considerably more likely to major in a visual or performing arts field than nonmusic students. These results suggest that school music study does not disadvantage students in the transition to college even when compared with peers who elected additional “academic” subjects in lieu of music.
‘It Feels Like Life Is Narrowing’: Aspirational Lifestyles and Ambivalent Futures among Norwegian ‘Top Girls’
Authors: Vaadal Kristine , Ravn Signe
Published: March 2021

Analyses of young feminine identities have often focused on consumption, career and intimate life as separate spheres. In this article, we bring these together to nuance the concept of the ‘top girl’. Drawing on a qualitative study of young Norwegian ‘top girls’’ alcohol consumption and lifestyles we explore how ‘appropriate’ feminine identities are configured in the present and in the future. We analyse how the egalitarian context shapes the contours of the ‘top girl’ and find that ‘progressive’ values are central to our participants’ present lifestyles. However, these progressive lifestyles are expected to collide with the ‘square’ lives the participants see awaiting them as middle-class adult women and mothers. We argue that as the participants grow older, the range of legitimate, middle-class femininities is narrowing. Further, we suggest that in an egalitarian context such as the Norwegian context the ‘top girl’ lacks an attractive, adult equivalent.
The Relationship Between Self-Compassion, Childhood Maltreatment and Attachment Orientation In High-Risk Adolescents
Authors: Quinlan Heather Mary , Hadden Kellie Lynn , Storey David Paul
Published: March 2021

The purpose of the current study was to explore whether selfcompassion predicted psychological distress over and above childhood maltreatment and attachment orientation in high-risk youths. Fifty-one youths (31 males, 20 females) aged 17 to 24, recruited from a community non-profit organization in St. John’s, Newfoundland and Labrador, Canada, were administered validated measures of childhood maltreatment, attachment orientation, self-compassion, and psychological distress. Results indicated that self-compassion was inversely associated with childhood maltreatment, attachment anxiety, attachment avoidance, and psychological distress. However, results did not support the hypothesis that self-compassion was a significant predictor of psychological distress over and above attachment anxiety and childhood maltreatment in high-risk youths. Our results indicated that self-compassion is not well developed in street-involved youths and may be a vital intervention target to heal negative internalized views of the self, while maintaining vigilance to threats inherent in the street environment.
Feasibility of a Nurse Coached Walking Intervention for Informal Dementia Caregivers
Authors: Flanagan Jane , Post Kathryn , Hill Rebecca , DiPalazzo John
Published: March 2021

This study’s purpose was to determine the feasibility of a nurse coached walking intervention for informal caregivers of persons with dementia. Participants were randomly assigned to a nurse coached intervention or a control group. Five male and 27 female caregivers ( n = 32) participated. Measures included steps, walked well-being, and perceived stress. For steps walked, each group experienced a statistical difference ( p = .01 control; p = .02 intervention) and large effect size (0.90). Neither group had a statistical difference in well-being ( p = .38 control; p = .08 intervention) or perceived stress ( p = .56 control; p = .18 intervention). The intervention group achieved a large effect size in well-being (1.38) and moderate effect size in perceived stress (0.51). A 0.94 pedometer adherence, self-reported user ease with technology and 100% retention rate support feasibility. Many participants described feelings of loneliness and grief, but reported the pedometer motivated them to walk.
A comparative study of four diffusion-weighted imaging models in the diagnosis of cervical cancer
Authors: Song Jiao , Lu Yi , Wang Xue , Peng Wenwen , Lin Wenxiao , Hou Zujun , Yan Zhihan
Published: March 2021

Background

Most commonly used diffusion-weighted imaging (DWI) models include intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), stretched exponential model (SEM), and mono-exponential model (MEM). Previous studies of the four models were inconsistent on which model was more effective in distinguishing cervical cancer from normal cervical tissue.

Purpose

To assess the performance of four DWI models in characterizing cervical cancer and normal cervical tissue.

Material and Methods

Forty-seven women with suspected cervical carcinoma underwent DWI using eight b-values before treatment. Imaging parameters, calculated using IVIM, SEM, DKI, and MEM, were compared between cervical cancer and normal cervical tissue. The diagnostic performance of the models was evaluated using independent t-test, Mann–Whitney U test, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression analysis.

Results

All parameters except pseudo-diffusion coefficient (D*) differed significantly between cervical cancer and normal cervical tissue ( P < 0.001). Through logistic regression analysis, all combined models showed a significant improvement in area under the ROC curve (AUC) compared to individual DWI parameters. The model with combined IVIM parameters had a larger AUC value compared to those of other combined models ( P < 0.05).

Conclusion

All four DWI models are useful for differentiating cervical cancer from normal cervical tissue and IVIM may be the optimal model.