bluuebunny/crossref_metadata_2025 huggingface dataset:
Oxygen K-edge X-ray absorption spectra of liquids with minimization of window contamination
Authors: Vogt Linda I. , Cotelesage Julien J. H. , Titus Charles J. , Sharifi Samin , Butterfield Albert E. , Hillman Peter , Pickering Ingrid J. , George Graham N. , George Simon J.
Published: October 2021

Oxygen K-edge X-ray absorption spectroscopy is used routinely to study a range of solid materials. However, liquid samples are studied less frequently at the oxygen K-edge due to the combined challenges of high-vacuum conditions and oxygen contamination of window materials. A modular sample holder design with a twist-seal sample containment system that provides a simple method to encapsulate liquid samples under high-vacuum conditions is presented. This work shows that pure silicon nitride windows have lower oxygen contamination than both diamond- and silicon-rich nitride windows, that the levels of oxygen contamination are related to the age of the windows, and provides a protocol for minimizing the background oxygen contamination. Acid-washed 100 nm-thick silicon nitride windows were found to give good quality oxygen K-edge data on dilute liquid samples.
Mahem Entertainment Society: strategic alternatives and change management
Authors: Kar Pravat Surya , Padhmanabhan V. , Bhat Akshay , Satija Amit
Published: October 2021

Learning outcomes

Teaching objectives: to help students review entertainment service and its ecosystem; to discuss leadership anxiety during change management and organizational development; to understand organizational diagnosis while initiating change management exercise; and to compare various strategic alternatives and the implications of selecting an option.

Case overview/synopsis

This case narrates dilemma of Krishna Goenkar, a management consultant entrusted to revisit strategic orientations of Mahem Entertainment Society (MES). Mahem is a fictitious state in the west coast of India. MES had been created by the Government of Mahem as a regulatory body to promote the state as a world class destination for entertainment. Public interest guided the organization, as it was a government instituted body. Hence, Goenkar had twin challenges. Firstly, what strategic initiatives should he propose to scale up the operations in spite of the given organizational constraints? Secondly, how to scale up and diversify if required, with minimal resistance? The case would help students get familiarized with entertainment domain, service ecosystem and challenges of driving strategic change in public utilities, especially in Indian and emerging market context.

Complexity academic level

This case is suitable for graduate-level programme in marketing management.

Supplementary materials

Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 8: Marketing.
Development and validation of a prognostic nomogram for malignant esophageal fistula based on radiomics and clinical factors
Authors: Zhu Chao , Ding Jialin , Wang Songping , Qiu Qingtao , Ji Youxin , Wang Linlin
Published: October 2021

Background

The current study aimed to comprehensively analyze the clinical prognostic factors of malignant esophageal fistula (MEF). Furthermore, this study sought to establish and validate prognostic nomograms incorporating radiomics and clinical factors to predict overall survival and median survival after fistula for patients with MEF.

Methods

The records of 76 patients with MEF were retrospectively analyzed. A stepwise Cox proportional hazards regression model was employed to screen independent prognostic factors and develop clinical nomograms. Radiomic features were extracted from prefistula CT images and post fistula CT images. Least absolute shrinkage and selection operator (LASSO) regression and Cox regression algorithm was used to filter radiomic features and avoid overfitting. Radiomic signature was a linear combination of optimal features and corresponding coefficients. The joint prognostic nomograms was constructed by radiomic signatures and clinical features. All models were validated by Harrell's concordance index (C‐index), caliberation and bootstrap validation.

Results

For overall survival, age, prealbumin, KPS and interval between diagnosis of esophageal cancer and fistula were identified as independent prognostic factors and incorporated into the clinical nomogram. Age, prealbumin, serum albumin, KPS and neutrophil proportion were selected for the clinical nomogram of post fistula survival. The C‐index of overall survival nomogram was 0.719 (95% CI: 0.645–0.793) and that was 0.722 (95% CI: 0.653–0.791) in the post fistula survival nomogram. The radiomic signature developed by radiomic features of prefistula CT showed a significant correlation with both overall survival and post fistula survival. The C‐index of joint nomogarm for overall survival and post fistula survival was 0.831 (95% CI: 0.757–0.905) and 0.77 (95% CI: 0.686–0.854), respectively. The calibration curve showed the joint nomograms outperformed the clinical ones.

Conclusions

The study presents nomograms incorporating independent clinical risk factors and radiomic signature to predict the prognosis of MEF. This prognostic classification system has the potential to guide therapeutic decisions for patients with malignant esophageal fistulas.
Effects of brief substance use interventions delivered in general medical settings: a systematic review and meta‐analysis
Authors: Tanner‐Smith Emily E. , Parr Nicholas J. , Schweer‐Collins Maria , Saitz Richard
Published: October 2021

Aims

To estimate effects of brief substance use interventions delivered in general medical settings.

Methods

A systematic review and meta‐analysis of randomized trials conducted since 1990 of brief substance use interventions in patients of any age or severity level recruited in general medical settings. Primary outcomes were any measure of substance use or substance‐related consequences (indexed with Hedges’ g and risk ratios). Mixed‐effects meta‐regressions were used to estimate overall effects and predictors of effect variability. Analyses were conducted separately by brief intervention (BI) target substance: alcohol only or drugs.

Findings

A total of 116 trials (64 439 participants) were identified; 111 (62 263 participants) provided effect size data and were included in the meta‐analysis. Drug‐targeted BIs yielded significant small improvements in multiple drug/mixed substance use (Hedges' g
) = 0.08; 95% CI = 0.002, 0.15), but after adjusting for multiple comparisons, they did not produce significant effects on cannabis use (
= 0.06; 95% CI = 0.001, 0.12), alcohol use (
= 0.08; 95% CI = −0.0003, 0.17), or consequences (
= 0.05; 95% CI = 0.01, 0.10). Drug‐targeted BIs yielded larger improvements in multiple drug/mixed substance use when delivered by a general practitioner (
= 0.19; 95% CI = 0.187, 0.193). Alcohol‐targeted BIs yielded small beneficial effects on alcohol use (
= 0.12; 95% CI 0.08, 0.16), but no evidence of an effect on consequences (
= 0.05; 95% CI = −0.04, 0.13). However, alcohol‐targeted BIs only had beneficial effects on alcohol use when delivered in general medical settings
= 0.17; 95% CI = 0.10, 0.24); the findings were inconclusive for those delivered in emergency department/trauma centers (
= 0.05; 95% CI = 0.00, 0.10).

Conclusions

When delivered in general medical settings, alcohol‐targeted brief interventions may produce small beneficial reductions in drinking (equivalent to a reduction in 1 drinking day per month). There is limited evidence regarding the effects of drug‐targeted brief interventions on drug use.
UN sustainable development goals, good governance, and corruption: The paradox of the world's poorest economies
Authors: Mombeuil Claudel , Diunugala Hemantha Premakumara
Published: October 2021

The first objective of this study is to demonstrate that the UN sustainable development goals (SDGs) remain beyond reach for the world's poorest economies by analyzing the trends in the worldwide governance indicators (WGIs), corruption perception index (CPI), the GDP per capita, and the human development index (HDI) using the case of 10 former European colonies (e.g., Burundi, Burkina Faso, Central African Republic, Guinea‐Bissau, Haiti, Madagascar, Niger, Sierra Leone, Togo, and the Democratic Republic of Congo). Second, this study compares three‐panel regression models (pooled OLS model, fixed‐effects model, and random effects model) to examine the influence of the WGIs on CPI, GDP per capita, and HDI and then derive the most appropriate model. Based on the results of these two objectives, a theoretical framework is drawn to provide specific recommendations to overcome some of the challenges to sustainable development in the selected countries.
Treatment and prognosis of patients with both cancer and impaired decision‐patient with both cancer and dementia making as a symptom of dementia
Authors: Fujii Tomomi , Wada Michiko , Hasebe Shinji , Takeuchi Kazuto , Yorozuya Toshihiro , Yakushijin Yoshihiro
Published: October 2021

Aim

In our aging society, the number of patients with both cancer and dementia has recently been increasing. One of the major clinical questions is whether patients with dementia could receive appropriate cancer treatment. The purpose of this study is to know the prognosis of patients with both cancer and impaired decision‐making as a symptom of dementia, and to discuss the proper cancer treatment of the patients with dementia.

Methods

Patients newly diagnosed with both cancer and impaired decision‐making as a symptom of dementia at Ehime University Hospital between January 2010 and December 2016 were reviewed. The data of patients with cancer were retrospectively analyzed using an electronic medical record system.

Results

In total, 9354 cases were diagnosed with cancer in the Ehime University Hospital over 7 years, and only 105 (1.1%) cases with impaired decision‐making as a symptom of dementia were recorded by medical professionals, probably due to poor attention to the cognitive functions of patients with cancer. Analysis of the cancer prognosis of these patients showed that a better prognosis was seen in patients with any therapeutic interventions than in those with no treatment for the cancer itself. However, the prognosis of patients was not significantly different between standard and non‐standard treatments.

Conclusions

This study suggests that the poor interest of medical professionals in the cognitive function of patients with cancer at the time of diagnosis of cancer and the lack of any guidelines for patients with both cancer and dementia are major problems in our aging society. Geriatr Gerontol Int 2021; 21: 1105–1110.
Characterization and production potential of carotenes in Peruvian strains of Dunaliella salina Teodoresco
Authors: Hernández Acevedo Hanna Elizabeth , Flores Ramos Leenin , Villamón Cifuentes Francisco , Ruiz Soto Anthony , Aguilar Samanamud Carla Patricia
Published: October 2021

Chlorophyte microalgae Dunaliella are halophilic flagellated cells; they can resist high salinities, producing β‐carotene to balance osmotic stress. This pigment has important antioxidant properties for biotechnology, the prevention of tissue aging, the efficiency of the immune system, and sun protection against UV‐B rays. The objective of this study was to characterize native strains of the genus Dunaliella from the Marine Institute of Peru, under the influence of stress factors for the production and concentration of β‐carotene. Different tools were used to characterize these strains through molecular analysis, optimization of parameters for carotene accumulation, growth curves, life cycle, and carotene analysis. The accumulation of this pigment was mainly due to adaptation to salt stress. The differences between Dunaliella strains according to their population growth demonstrated that they did not have the same capacity to respond to the same cultivation conditions, although most of them are from the same species. The IMP‐BG‐001 strain, from Piura, can accumulate high concentrations of β‐carotene (up to 8.64 pg/cell) and still maintain a considerable growth rate without affecting the increase in biomass under controlled conditions.
Teledermatology: How It Is Impacting the Underserved
Authors: Hadeler Edward , Prose Neil , Floyd Lauren Pontius
Published: October 2021

The rapid mobilization of telemedicine during the COVID‐19 pandemic has brought about renewed concern about the digital divide. Understanding the benefits and limitations of remote medical care is an ongoing process. Access to telemedicine appointments, as well as the experience of the virtual appointment itself, varies across demographic groups.

Telemedicine has promise in dermatology. However, if it continues to expand beyond the pandemic, federal changes may be necessary to improve access to remote care for all patients moving forward. This involves creating mandates for increased broadband access, deploying digital health tools and portals usable by underserved populations, and increasing access to interpreters. Information technology personnel may also become necessary members of the clinical care team. Parity between video and phone visit reimbursement for providers is also necessary.
Classifying Component Function in Product Assemblies With Graph Neural Networks
Authors: Ferrero Vincenzo , DuPont Bryony , Hassani Kaveh , Grandi Daniele
Published: October 2021

Function is defined as the ensemble of tasks that enable the product to complete the designed purpose. Functional tools, such as functional modeling, offer decision guidance in the early phase of product design, where explicit design decisions are yet to be made. Function-based design data is often sparse and grounded in individual interpretation. As such, function-based design tools can benefit from automatic function classification to increase data fidelity and provide function representation models that enable function-based intelligent design agents. Function-based design data is commonly stored in manually generated design repositories. These design repositories are a collection of expert knowledge and interpretations of function in product design bounded by function-flow and component taxonomies. In this work, we represent a structured taxonomy-based design repository as assembly-flow graphs, then leverage a graph neural network (GNN) model to perform automatic function classification. We support automated function classification by learning from repository data to establish the ground truth of component function assignment. Experimental results show that our GNN model achieves a micro-average F1-score of 0.617 for tier 1 (broad), 0.624 for tier 2, and 0.415 for tier 3 (specific) functions. Given the imbalance of data features and the subjectivity in the definition of product function, the results are encouraging. Our efforts in this paper can be a starting point for more sophisticated applications in knowledge-based CAD systems and Design-for-X consideration in function-based design.
Investigation on Optimal Electric Energy Storage Capacity to Maximize Self-Consumption of Photovoltaic System
Authors: Lee Ruda , Lee Hyomun , Kim Dongsu , Yoon Jongho
Published: October 2021

Battery systems are critical factors in the effective use of renewable energy systems because the self-production of electricity by renewables for self-consumption has become profitable for building applications. This study investigates the appropriate capacity of the battery energy storage system (BESS) installed in all-electric zero-energy powerhouses (AEZEPHs). The AEZEPH used for this study is a highly energy-efficient house. Its criteria indicate that all the electrical energy within the home is covered based on the generated electricity from onsite renewable energy systems, including that the annual net site energy use is almost equal to zero. The experiment for measured data of electricity consumed and generated in the buildings is conducted for a year (i.e., January through December 2014). Based on the measured data, patterns of the electricity consumed by the AEZEPH and generated by an onsite renewable energy system (i.e., photovoltaic (PV) system) and BESS's appropriate capacity are then analyzed and evaluated using the electric energy storage (EES) analysis tool, named Poly-sun. This study indicates that self-consumption can be increased up to 66% when the ESS system is installed and used during operating hours of the PV system. The amount of received electricity during the week tends to be reduced by about two times.
A Method to Resolve Simulation of Discontinuous Flow Field: A Valve Example From Full Closing to Re-Closure
Authors: Li Qingye , Li Kunpeng , Zong Chaoyong , Zheng Fengjie , Song Xueguan
Published: October 2021

In transient computational fluid dynamics (CFD) simulations, the continuity of the flow field is an essential prerequisite. However, continuous flows can be separated under certain conditions, such as the process from valve opening to reclosure. The current method often leaves a narrow gap to estimate the full closing status, which will introduce a deviation. To address this issue, a full closing numerical simulation method (FCNSM) is developed to solve the problem of simulation between discontinuous flow field (DFF) and continuous flow field (CFF). The matrix laboratory (matlab) program has been used to communicate fluent as a server session to call the files fluent and automatically execute text-based user interface (TUI) commands. The radial basis function (RBF) is used to construct the relationship between the variables of the flow field and the coordinates of mesh nodes, which can achieve the data transmission from a DFF to a CFF. Automatic stopping of transient calculations is achieved by passing variables among matlab program, scheme language, and user-defined functions (UDF) when a physical quantity reaches a set value. Based on this method, a transient simulation with a dynamic mesh of a 2-D model regarding a pressure relief valve (PRV) is performed to simulate the process of the valve from full closing to reclosure, the flow characteristics through the PRV are obtained using this method. This study makes it possible to use FCNSM for understanding dynamic characteristics from DFF to CFF.
Previously Unrecognized Source of Error in the Change in Maximum Total Point Motion to Determine Continuous Migration of Unstable Tibial Baseplates
Authors: Niesen Abigail E. , Hull Maury L.
Published: October 2021

In radiostereometric analysis (RSA), continuous migration denoted as ΔMTPM is the difference between maximum total point motion (MTPM) at 2 years relative to time zero and MTPM at 1 year relative to time zero. Continuous migration has been used to diagnose tibial baseplates as stable versus unstable when compared to a specified stability limit (i.e., value of ΔMTPM). If the same point experiences MTPM at 2 years and at 1 year (usually the case for marker-based RSA), then an implicit assumption is that the migration path between 2 years and 1 year is the same as the path between 1 year and time zero. This article uses vector analysis to demonstrate a source of error in ΔMTPM not previously recognized and estimates the magnitude of error based on the interplay of independent variables which affect the error. The two independent variables which affect the error are the angle between the two migration vectors (i.e., MTPM between time zero and 2 years and MTPM between time zero and 1 year) and the difference in magnitude of the two vectors. The relative error increased in an absolute sense as the angle between the vectors increased and decreased for larger differences in the magnitudes of the two vectors. For magnitude ratios ranging from 1.25 to 2, relative errors ranged from –21% to –3% at 10 deg and from –78% to –42% at 60 deg, respectively. Knowledge of these errors highlights a limitation in the use of ΔMTPM not previously recognized.
Experimental Study of the Endwall Heat Transfer of a Transonic Nozzle Guide Vane With Upstream Jet Purge Cooling Part 1—Effect of Density Ratio
Authors: Mao Shuo , Sibold Ridge , Ng Wing F. , Li Zhigang , Bai Bo , Xu Hongzhou , Fox Michael
Published: October 2021

Nozzle guide vane (NGV) platforms often use complex cooling schemes to mitigate the ever-increasing thermal loads on endwall. Understanding the effect of advanced cooling schemes amid the highly complex three-dimensional secondary flow is vital to engine efficiency and durability. This study analyzes, experimentally and numerically, and describes the effect of coolant to mainstream blowing ratio, momentum ratio, and density ratio (DR) for a typical axisymmetric converging nozzle guide vane platform with an upstream doublet staggered, steep-injection, cylindrical hole purge cooling scheme. Nominal flow conditions were engine-representative and as follows: Maexit = 0.85, Reexit,Cax = 1.5 × 106 and an inlet large-scale freestream turbulence intensity of 16%. Two blowing ratios were investigated, each corresponding to the design condition and its upper extrema at M = 2.5 and 3.5, respectively. For each blowing ratio, the coolant to mainstream density ratio was varied between DR = 1.2, representing typical experimental neglect of coolant density, and DR = 1.95, representative of typical engine conditions. The results show that with a fixed coolant-to-mainstream blowing ratio, the density ratio plays a vital role in the coolant-mainstream mixing and the interaction between coolant and horseshoe vortex (HSV) near the vane leading edge. A higher density ratio leads to a better coolant coverage immediately downstream of the cooling holes but exposes the in-passage endwall near the pressure side. It also causes the in-passage coolant coverage to decay at a higher rate in the flow direction. From the results gathered, both density ratio and blowing ratio should be considered for accurate testing, analysis, and prediction of purge jet cooling scheme performance.
Leisure-Time Physical Activity and Glycemic Control Independently Predicts Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus
Authors: Bhati Pooja , Hussain M. Ejaz
Published: October 2021

Background: Though cardiac autonomic neuropathy (CAN) is a common complication of type 2 diabetes mellitus (T2DM); still, there is lack of clarity on pathophysiological correlates for its onset and progression. Therefore, the purpose of this study was to investigate the predictive ability of lifestyle and cardiometabolic risk factors for CAN in T2DM patients. Methods: A total of 105 Indian T2DM patients were recruited in the present study. Cardiometabolic risk factors, such as glycemic control, lipids, resting heart rate, systolic and diastolic blood pressure, and lifestyle risk parameters, such as physical activity levels and sleep quality were assessed. Standard cardiovascular autonomic reflex tests were performed for diagnosing CAN by Ewing’s criteria. Results: Leisure-time physical activity and glycosylated hemoglobin were significant independent predictors of CAN in T2DM. Leisure-time physical activity and glycosylated hemoglobin predicted the occurrence of CAN at cutoff values ≤4.68 metabolic equivalent-hours per week (P = .007) and >7.5% (P = .002), respectively. Conclusions: The T2DM patients should be encouraged to engage in leisure-time physical activity of at least 4.68 metabolic equivalent-hours per week (equivalent to 1.2 h of walk or 0.6 h of jog per week) and therapeutic strategies for controlling hyperglycemia in T2DM should aim to reduce glycosylated hemoglobin below 7.5% to reduce CAN occurrence.
Metabolism, Excretion, and Mass Balance of [
14
C]-Rezafungin in Animals and Humans
Authors: Ong Voon , Wills Sarah , Watson Deborah , Sandison Taylor , Flanagan Shawn
Published: October 2021

Rezafungin is a novel echinocandin being developed for treatment of candidemia and invasive candidiasis and for prevention of invasive fungal disease caused by Candida,
Aspergillus
, and
Pneumocystis
spp. in recipients of blood and marrow transplantation. Studies using [

14

C]-radiolabeled rezafungin were conducted in rats, monkeys, and humans to characterize the mass balance, excretion, and pharmacokinetics of [

14

C]-rezafungin and to evaluate relative amounts of rezafungin metabolites compared with parent drug.
Evaluation of a Capped Dosing Telavancin Regimen Compared to Standard Dosing at a Large Community Teaching Hospital
Authors: Diggs Fernando J. , Edwards Jonathan D. , Garza Kimberly B. , Hassoun Ali A. M. , Durham Spencer H.
Published: October 2021

Telavancin, a lipoglycopeptide antibiotic, is traditionally dosed at 10 mg/kg based on total body weight but is associated with toxicities that limit its use. This study supports the use of a capped dosing regimen of 750 mg in obese patients, which is associated with equal efficacy and fewer adverse effects compared to traditional dosing.
Secondary Analysis of a Systematic Review: Are Antifungal Noninferiority Trials at Risk of Eroding Effectiveness Because of Biocreep?
Authors: Komorowski Adam S. , Bai Anthony D. , Cvetkovic Anna , Mourad Omar , Lo Carson K. L. , Li Xena X. , Mokashi Vaibhav , Findlater Aidan , Duncan D. Brody , Fuller Charlotte , Leto Daniela L. , Yamamura Deborah , Mertz Dominik
Published: October 2021

Non-inferiority randomized controlled trial (RCT) effectiveness may erode when results favor the active control over time, and when a decreasingly effective control arm is used in serial trials. We analyzed 32 antifungal noninferiority RCTs (NI-RCTs) for these scenarios in this secondary analysis of a systematic review.
The Conserved Serine Transporter SdaC Moonlights To Enable Self Recognition
Authors: Chittor Achala , Gibbs Karine A.
Published: October 2021

Bacteria can receive secret messages from kin during migration. For
Proteus mirabilis
, these messages are necessary for virulence in multispecies infections.
Antenatal Bartter syndrome: a new compound heterozygous mutation in exon 2 of KCNJ1 gene
Authors: Mani Srinivasan , Nair Jayasree , Handa Deepali
Published: October 2021

A 30+6/7-week infant was born by vaginal delivery to a 21-year-old primigravida with pregnancy complicated by polyhydramnios. The infant developed polyuria and significant weight loss in the first 2 weeks of life despite appropriate fluid management. He developed hyponatraemia, hypochloraemia, transient hyperkalaemia and prerenal azotaemia with metabolic acidosis. On further evaluation, he had elevated plasma renin and aldosterone levels. Bartter syndrome was considered in the differential diagnosis. Bartter syndrome gene panel revealed a rare compound heterozygous mutation in exon 2 of the KCNJ1 gene (Lys186Glu/Thr71Met), suggesting antenatal Bartter syndrome (type 2). The infant developed late-onset hypokalaemia and metabolic alkalosis by week 4 of life. He regained birth weight by week 3 of life but failed to thrive (10–20 g/kg/day) despite high caloric intake (140 kcal/kg/day). His electrolyte abnormalities gradually improved, and he was discharged home without the need for electrolyte supplements or medications.
Identification of novel missense mutation in a patient with an asymptomatic para-aortic paraganglioma
Authors: Daghlas Salah , Gundluru Rajani , Nada Ayman , Khan Uzma
Published: October 2021

A 31-year-old Caucasian woman underwent a standard workup as a potential kidney transplant donor. Kidney donor protocol CT showed a left para-aortic hypervascular mass suspicious for a paraganglioma. Biochemical workup revealed elevated urinary catecholamines, supporting this suspicion. The patient underwent surgical resection with histopathological evaluation that confirmed the diagnosis. Endocrine evaluation 2 years later revealed a family history of a cousin with a history of pheochromocytoma as a teenager. A genetic panel identified a missense mutation in succinate dehydrogenase C (c.202T>C; p.Ser68Pro), which was described as a variant of unknown significance. In silico analysis suggested that it may be a deleterious mutation. We concluded that this mutation may be pathogenic, considering these supporting pieces of evidence and her early-onset paraganglioma. This report highlights the importance of genetic screening in patients with paragangliomas/pheochromocytomas, since many cases are familial. Additionally, it underscores the importance of evaluating and documenting cases of variants of unknown significance.
Gonadotropin-releasing hormone agonist versus expectant management for treating multiple leiomyomas after myomectomy: the study protocol for a multicentre, prospective, randomised controlled clinical trial
Authors: Wei Jia , Ma Xiangyi , Wang Wenwen , Zhang Minli , Yu Zhiying , Zhang Wei , Hong Li , Li Zhiying , Li Lin , Du Xin , Feng Yun , Guo Ruixia , Zhang Chunlian , Yue Qingfen , Wang Wuliang , Wang Shixuan
Published: October 2021

Introduction

Leiomyoma recurrence is a major concern for long-term myomectomy management, especially for multiple leiomyomas. Gonadotropin-releasing hormone agonist (GnRHa) is one of the most effective medications to reduce the volume of fibroids and the uterus. However, its role in preventing recurrence after conservative surgery remains unclear. At present, there is no randomised clinical trial determining the efficacy of GnRHa treatment for preventing multiple leiomyomas recurrence after myomectomy.

Methods and analysis

We are conducting a phase IV randomised controlled trial in women aged 18–45 undergoing myomectomy for multiple leiomyomas. After surgery, women whose pathological result confirms multiple leiomyomas are randomised in a 1:1 ratio into an observation or GnRHa group. The primary outcome is the recurrence of either clinical symptoms or fibroids on imaging. Patients will be assessed for adverse events during the follow-up.

Ethics and dissemination

The study was approved by the Medical Ethics Committee of the Tongji Hospital Affiliated with the Tongji Medical College of Huazhong University of Science and Technology (TJ-IRB20180311) according to the submitted study protocol (V.1.0, 10 November 2017) and informed consent (V.1.0, 10 November 2017). The results will be presented at domestic and international conferences and published in peer-reviewed journals.

Trial registration number

ChiCTR-IPR-17012992.
Comparison of strategies for adherence to venous thromboembolism prophylaxis in high-risk surgical patients: a before and after intervention study
Authors: da Silva Leopoldo Muniz , Lima Helidea de Oliveira , Ferrer Ricardo , Ho Anthony M-H , Silveira Saullo Queiroz , Abib Arthur de Campos Vieira , Bellicieri Fernando Nardy , Camire Daenis , Mittermayer Otto , Botelho Karen Kato , Pla Gil Andre Mortari , Mizubuti Glenio B
Published: October 2021

Background

Venous thromboembolism (VTE) is a major cause of perioperative morbimortality. Despite significant efforts to advance evidence-based practice, prevention rates remain inadequate in many centres.

Objective

To evaluate the effectiveness of different strategies aimed at improving adherence to adequate VTE prophylaxis in surgical patients at high risk of VTE.

Method

Before and after intervention study conducted at a tertiary hospital. Adherence to adequate VTE prophylaxis was compared according to three strategies consecutively implemented from January 2019 to December 2020. A dedicated hospitalist physician alone (strategy A) or in conjunction with a nurse (strategy B) overlooked the postoperative period to ensure adherence and correct inadequacies. Finally, a multidisciplinary team approach (strategy C) focused on promoting adequate VTE prophylaxis across multiple stages of care—from the operating room (ie, preoperative team-based checklist) to collaboration with clinical pharmacists in the postoperative period—was implemented.

Results

We analysed 2074 surgical patients: 783 from January to June 2019 (strategy A), 669 from July 2019 to May 2020 (strategy B), and 622 from June to December 2020 (strategy C). VTE prophylaxis adherence rates for strategies (A), (B) and (C) were (median (25th–75th percentile)) 43.29% (31.82–51.69), 50% (42.57–55.80) and 92.31% (91.38–93.51), respectively (p<0.001; C>A=B). There was a significant reduction in non-compliance on all analysed criteria (risk stratification (A (25.5%), B (22%), C (6%)), medical documentation (A (68%), B (55.2%) C (9%)) and medical prescription (A (51.85%), B (48%), C (6.10%)) after implementation of strategy C (p<0.05). Additionally, a significant increase in compliance with adequate dosage, dosing interval and scheduling of the prophylactic regimen was observed.

Conclusion

Perioperative VTE prophylaxis strategies that relied exclusively on physicians and/or nurses were associated with suboptimal execution and prevention. A multidisciplinary team-based approach that covers multiple stages of patient care significantly increased adherence to adequate VTE prophylaxis in surgical patients at high risk of developing perioperative VTE.
The Pathophysiology of Primary Blast Injury and its implications for treatment. Part II: The Auditory Structures and Abdomen
Authors: Cripps N P J , Glover M A , Guy R J
Published: October 2021

The authors have previously considered the mechanisms by which primary blast injury affects the respiratory and cardiovascular systems and what deductions may be made about management of the resulting injuries. This article considers the somatic effects of primary blast on abdominal and auditory structures. These injuries are usually of less immediate cocern but require accurate management in order to avoid late mortality and morbidity and to return the casualty to full function.

Recognition of likely injury patterns is vital to the instigation of correct management. The tympanic membrane, for instance, is easily damaged by blast and such an injury may be complicated by ossicular disruption, perilymph fistula or forceful distribution of squamous epithelium around air filled spaces with potential to form cholesteatoma.

Abdominal organs can be severely disrupted by primary blast. The treatment of such injuries is not dissimilar to that of any other cause of abdominal trauma. The most challenging aspect is the identification of intestinal intramural haemorrhage and discrimination between those lesions destined for perforation or for spontaneous recovery.

In this article the range and mechanism of injury are described for each system, drawing on experience from other modes of injury closely related to blast, followed by suggestions for their management established from literature reviews and experimental work undertaken by the authors during periods of full time research.
Calonectria vigiensis sp. nov. (Hypocreales, Nectriaceae) associated with dieback and sudden-death symptoms of Theobroma cacao from Mérida state, Venezuela
Authors: Mohali Sari R. , Stewart Jane E.
Published: October 2021

Calonectria vigiensis sp. nov. (Hypocreales, Nectriaceae) is a newly described species associated with cacao (Theobroma cacao L.) in Mérida state, Venezuela. This new species was identified using morphological methods as well as DNA sequencing and multigene phylogenetic analyses. Based on phylogenetic analyses of a combined dataset including translation elongation factor 1-α (tef1), calmodulin (cmdA), and β-tubulin (btub) genes across closely related species within Calonectria, a new species was identified as Ca. vigiensis within the Calonectria naviculata species complex, but it was determined to be well-separated from genetically close species such as Calonectria multilateralis L. Lombard & Crous, Calonectria multinaviculata R.F. Alfenas, L. Lombard & Crous, and Calonectria naviculata Crous & M.J. Wingf. This work reports 1 previously undescribed fungal species (Ca. vigiensis) that is associated with dieback and sudden-death symptoms in T. cacao plantations in Mérida state, Venezuela.
Free data at spacelike $${\mathscr {I}}$$ and characterization of Kerr-de Sitter in all dimensions
Authors: Mars Marc , Peón-Nieto Carlos
Published: October 2021

We study the free data in the Fefferman–Graham expansion of asymptotically Einstein$$(n+1)$$(n+1)-dimensional metrics with non-zero cosmological constant. We analyze the relation between the electric part of the rescaled Weyl tensor at$${\mathscr {I}}$$I,D, and the free data at$${\mathscr {I}}$$I, namely a certain traceless and transverse part of then-th order coefficient of the expansion$$\mathring{g}_{(n)}$$g˚(n). In the case$$\Lambda <0$$Λ<0and Lorentzian signature, it was known [23] that conformal flatness at$${\mathscr {I}}$$Iis sufficient forDand$$\mathring{g}_{(n)}$$g˚(n)to agree up to a universal constant. We recover and extend this result to general signature and any sign of non-zero$$\Lambda $$Λ. We then explore whether conformal flatness of$${\mathscr {I}}$$Iis also neceesary and link this to the validity of long-standing open conjecture that no non-trivial purely magnetic$$\Lambda $$Λ-vacuum spacetimes exist. In the case of$${\mathscr {I}}$$Inon-conformally flat we determine a quantity constructed from an auxiliary metric which can be used to retrieve$$\mathring{g}_{(n)}$$g˚(n)from the (now singular) electric part of the Weyl tensor. We then concentrate in the$$\Lambda >0$$Λ>0case where the Cauchy problem at$${\mathscr {I}}$$Iof the Einstein vacuum field equations is known to be well-posed when the data at$${\mathscr {I}}$$Iare analytic or when the spacetime has even dimension. We establish a necessary and sufficient condition for analytic data at$${\mathscr {I}}$$Ito generate spacetimes with symmetries in all dimensions. These results are used to find a geometric characterization of the Kerr-de Sitter metrics in all dimensions in terms of its geometric data at null infinity.
The Influence of Message Direction on Attribute Benefit and Purchase Intention Applied to the Logical Design of an AI Chatbot
Authors: Chen Cheng-Chung , Chen Ying
Published: October 2021

This study aims to explore the influence of various possible combinations of consumer attribute benefits and the message direction provided by merchants on the final purchase intention of consumers. A two-factor experimental design was used to collect data from Generation Z consumers. Four experimental combination scenarios were designed based on consumer attribute benefits (hedonic or utilitarian) and message direction (positive or negative messages). A total of 160 valid samples were obtained, and the influence of variable-final purchase intention was analyzed. The results showed that the combination of product attributes and message direction has a significant impact on purchase intention and that hedonic products should be recommended to process-benefit consumers through positive messages. However, chatbots should choose utilitarian products and negative messages to effectively improve consumers’ purchase intention and willingness. In practical application, by finding out the best correspondence method of message transmission and providing the AI chatbot with a reference for the logical construction of content transmission, the communication efficiency between merchants and consumers can be enhanced, and the scientific and technological service capability of merchants can be improved.
A Reference Point Selection and Direction Guidance-Based Algorithm for Large-Scale Multi-Objective Optimization
Authors: Wu Xiangjuan , Wang Yuping , Tian Shuai , Wang Ziqing
Published: October 2021

Designing efficient algorithms for the large-scale multi-objective problems (LSMOPs) is a very challenging problem currently. To tackle LSMOPs, we first design a new reference points selection strategy to enhance the diversity of algorithms and avoid the algorithm falling into local minima. The strategy selects not only a part of nondominated solutions with the largest crowding distance, but also a part of relatively uniformly distributed solutions as the reference points. In this way, much better diversity and convergence can be obtained. Second, we propose a direction-guided offspring generation strategy, where a type of potential directions is designed to generate the promising solutions which can balance the convergence and diversity of the obtained solutions and improve the effectiveness of the algorithm significantly. Based on the two proposed strategies, we propose a new effective algorithm for LSMOPs. Numerical experiments are executed on two widely used large-scale multi-objective benchmark problem sets with 200, 500 and 1000 decision variables and a comparison with five state-of-the-art algorithms is made. The experimental results show that our proposed algorithm is effective and can obtain significantly better solutions than the compared algorithms.
Theoretical analysis on the Rényi holographic dark energy in the Finsler–Randers cosmology
Authors: Lou Han , Li Jinyang , Yang Weiqiang , Feng Wenyu , Liu Wenzhong , Zhang Qian , Zhang Nan , Qi Yannan , Wu Yabo
Published: October 2021

In this work, we study the cosmological consequences of Rényi holographic dark energy model in the framework of the Finsler–Randers cosmology in which the Hubble horizon is considered as the IR cutoff. In this setup, we derive the evolution equation for the Rényi holographic dark energy density parameter, the equation of state (EoS) parameter and deceleration parameter. Our study shows that this model can describe the current accelerating universe in both noninteracting and interacting scenarios, and also a transition occurs from the deceleration phase to the accelerated phase at the late-time. Moreover, we discuss the statefinder diagnosis of this model, meanwhile, plot the curves of r and s versus redshift z and the evolutionary trajectories of [Formula: see text]. We find that statefinder can not only break the degeneracy of different coupling parameter values in this model, but also effectively distinguish the difference between the Rényi holographic dark energy model and the [Formula: see text]CDM model. In addition, we find that the statefinder pair [Formula: see text] performs better than [Formula: see text] and [Formula: see text] in this model.
HARD TURNING PERFORMANCE EVALUATION USING CVD AND PVD COATED CARBIDE TOOLS: A COMPARATIVE STUDY
Authors: MALLICK RAJASHREE , KUMAR RAMANUJ , PANDA AMLANA , SAHOO ASHOK KUMAR
Published: October 2021

This study emphasizes the comparative cutting performance evaluation of CVD- and PVD-coated carbide inserts in hard turning of AISI D2 steel. The cutting factors, namely cutting speed (100[Formula: see text]m/min), tool feed rate (0.08[Formula: see text]mm/rev), and depth of cut 0.2[Formula: see text]mm, have been fixed for the entire study. The comparative study is based on the analysis of the obtained test results of flank wear, tool life, auxiliary flank wear, surface roughness, and surface texture. Both tools are catastrophically failed when tool wear reached limiting flank wear ([Formula: see text][Formula: see text]mm) criteria. SEM and EDS analysis of both the tools (at their end of tool life) are carried. Diffusion followed by adhesion is found to be the prime mechanism at the end of tool life. Based on limiting flank wear criteria, the tool life of CVD and PVD tools was estimated as 65 and 57[Formula: see text]min, respectively, i.e. the tool life of the CVD tool is 14% longer than that of the PVD tool. Considering the limiting criteria of surface roughness ([Formula: see text]m), the tool life of the CVD tool was estimated as 63[Formula: see text]min while for the PVD tool, it was found as 54[Formula: see text]min i.e. about 14.3% higher tool life was found for the CVD tool relative to the PVD tool. The auxiliary flank wear was observed to be lower for the CVD tool relative to the PVD tool. Surface roughness for both the tools increased with cutting time and the relatively larger rough surface was obtained with the PVD tool. The machining cost of one pass of the CVD tool is 2.5% less than that of the PVD tool. However, for mass production, the CVD tool is more efficient than the PVD tool for machining hard D2 steel ([Formula: see text] HRC).
Active Queue Management in RED Considering Critical Point on Target Queue
Authors: Singha Soamdeep , Jana Biswapati , Mandal Niranjan Kumar
Published: October 2021

The basic philosophy behind RED is to prevent congestion. When the average queue length exceeds the minimum threshold, packets are randomly dropped, or the explicit congestion notification bit is marked. Since network requirements differ significantly, it is not an optimal approach to establish RED parameters with constant value. There is a new algorithm we are proposing called Critical Point on Target Queue (AQM-RED-CPTQ), provide greater congestion management over the network while also preserving the value of RED. To overcome the problem in RED without changing queue weight parameter, we have proposed few models to control the congestion by introducing range parameter with probability and control mechanism which will belong between minimum and maximum threshold. The current queue size is controlled together with average queue size. A new range variable has been introduced to improve the performance of priority queue of existing RED based algorithm which improves the overall performance of networks. For each packet, minimum and maximum threshold has been updated and dropped with probability (Pa) for a special condition. Instead of multiplicative increase and decrease the maximum probability, the scheme uses additive-increase and multiplicative-decrease. Once the AVG queue length is close to the minimum threshold value, our approach automatically sets queue parameter according to queue conditions and handles queuing delay and improve throughput. The simulated results proof that our approaches are better than RED in terms of throughput, end to end delay, packet delivery ratio and goodput.
Quality by Design Approach to Formulate Empagliflozin-Loaded Chitosan Nanoparticles: In Vitro, In Vivo and Pharmacokinetic Evaluation of Anti-Diabetic Drugs
Authors: Khan Tahira , Nabi Bushra , Rehman Saleha , Akhtar Mohd. , Ali Javed , Najmi Abul Kalam
Published: October 2021

Present research focuses on formulating the empagliflozin (EMPA) loaded chitosan nanoparticles (CS Nps) using quality by design approach to overcome its innate adverse effects and enhance therapeutic prospects. Box- Behnken design (BBD) suggested quadratic model for fabricating EMPA Nps, by ionic gelation method, showing significant effect of independent variables on responses. The particle size and polydispersity index (PDI) for formulated EMPA loaded CS Nps was 152.4 ± 0.84 nm and 0.245 ± 0.005, respectively. The % entrapment efficiency and loading capacity of EMPA Nps was 83.8 ± 0.002% and 42.9 ± 0.03 %. Surface morphology of Nps using TEM, DSC and FTIR spectra of pure drug and formulated Nps were studied for further characterization. In vitro release of EMPA CS Nps showed better release profile than pure EMPA solution when compared in 2 different buffers namely; Phosphate buffer pH 7.4 (85.19 ± 4.22 %) and HCl buffer pH 1.2 (86.68 ± 7.33%). Permeability coefficient enhanced by 6.2-fold in case of EMPA CS Nps attributing to increase in intestinal uptake owing to small particle size. The study of pharmacokinetic parameters showed increase in plasma concentration and elimination half -life of EMPA Nps when compared to EMPA suggesting better distribution of drug inside the systemic circulation. The stability study conducted for 90 days showed no variations in the physical stability of Nps. The application of quality by design approach for EMPA loaded CS NPs showed improved permeation, drug release and better pharmacokinetic profile proposing CS as a promising carrier of EMPA for the better efficacy, leading to prospective clinical fate.