bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Bleaching Affect the Microleakage of Class II Restoration with Bulk-Fill Composite?
Authors: Zajkani Elham , Rahbar Mahdi , Motamed Nima , Kordlou Eissa
Published: January 2022

Introduction. The use of technology in bulk-fill composites (BCs) has reduced the stresses caused by polymerization shrinkage, debonding, microleakage, or posttreatment sensitivity in them. This study was conducted to determine whether bleaching affects the microleakage of class II restoration with bulk-fill material. Materials and Methods. This laboratory study was performed on 40 normal human premolars in 4 groups (n = 20). Class II cavities were prepared in mesial and distal surfaces of the teeth with dimensions of 2 × 2 × 4 mm. Then, based on the bleaching process by 20% carbamide peroxide gel and using two types of composites, the restored cavities were randomly divided into 4 groups: (1) CC without bleaching (CC group), (2) BC without bleaching (BC group), (3) CC with bleaching (CCB group), and (4) BC with bleaching (BCB group). Then, the samples were thermocycled for 1000 cycles at a temperature range of 5–55°C, and they were immersed in 0.6% alkaline fuchsine in order to penetrate into the pigment for 24 h. After cutting, the samples were placed under a stereomicroscope (40%) to determine microleakage. The data were analyzed using one-way analysis of variance (ANOVA), and apvalue <0.05 was considered as statistically significant. Results. Microleakage was determined in the CC group0.97±0.42, BC group1.08±0.54, CCB group1.19±0.37, and BCB group0.30±0.47. There were also no significant differences in the mean microleakage between the groups. No cases with zero microleakage (no microleakage) and grade 3 of microleakage (pigment penetration into the axial wall) were observed in the samples. Also, a two-by-two comparison of significant differences between CC and BC groupsp=0.89, CC and CCB groupsp=0.45, CC and BCB groupsp=0.11, BC and CCB groupsp=0.87, BC and BCB groupsp=0.41, and CCB and BCB groupsp=0.86showed that the difference was not statistically significant. Conclusion. Results showed no difference between microleakage of BC and CC with and without bleaching, and bleaching had the same effect on microleakage of these two types of composites.
Uveal Melanoma Exosomes Induce a Prometastatic Microenvironment through Macrophage Migration Inhibitory Factor
Authors: Ambrosini Grazia , Rai Alex J. , Carvajal Richard D. , Schwartz Gary K.
Published: January 2022

Uveal melanoma is a rare melanoma subtype different from cutaneous melanoma, with high incidence of liver metastasis and poor prognosis. Cancer cell–derived extracellular vesicles have been shown to induce proinflammatory and prometastatic signaling in the tumor microenvironment and at distant sites. The characterization of uveal melanoma exosome cargo and its role in metastatic spread is essential to identify targets and intervene in the early stages of metastatic development. Our study characterizes the proteomic content of uveal melanoma exosomes and identified the presence of markers with metastatic properties. We demonstrated that uveal melanoma exosomes induce activation of cell signaling pathways and the release of cytokines and growth factors from hepatocytes. These exosome-stimulated liver cells could in turn induce migration of uveal melanoma cells, confirming that the exosomes have a functional role in the cross-talk between these two cell types. We found that the proinflammatory cytokine macrophage migration inhibitory factor (MIF) was a major player in these mechanisms and its blockade inhibited cell migration in coculture with exosome-stimulated hepatocytes and prevented the development of metastases in vivo. Targeting MIF in the early stages of metastasis may represent a novel adjuvant drug therapy to prevent metastatic spread in uveal melanoma.

Implications:

This study provides the first in vivo evidence that MIF inhibition may serve as a novel adjuvant drug therapy to prevent metastasis in uveal melanoma.
COX-2 Inhibitors Decrease Expression of PD-L1 in Colon Tumors and Increase the Influx of Type I Tumor-infiltrating Lymphocytes
Authors: Cecil Denise L. , Gad Ekram A. , Corulli Lauren R. , Drovetto Nicholas , Lubet Ronald A. , Disis Mary L.
Published: January 2022

Colon cancer is initiated under inflammatory conditions associated with upregulation of immune checkpoint proteins. We evaluated immune modulation induced by nonsteroidal anti-inflammatory agents used for colon cancer prevention. Both celecoxib and naproxen inhibited polyp growth in APC Min mice. Treatment of mice with either drug significantly decreased PD-L1 expression on polyps in a dose-dependent manner (P < 0.0001 for both). The decrease in PD-L1 was associated with an influx of CD8+ T cells into polyps (P < 0.0001, celecoxib; P = 0.048, naproxen) compared with lesions from untreated animals and correlated with disease control. Naproxen is a nonselective inhibitor of both COX-1 and COX-2, and we questioned the role of the different cyclooxygenases in PD-L1 regulation. Silencing either COX-2 or COX-1 RNA in the murine colon cancer cell line MC38, reduced PD-L1 expression by 86% in COX-2–silenced cells (P < 0.0001) while there was little effect with COX-1 siRNA compared with control. Naproxen could inhibit the growth of MC38 in vivo. Naproxen-treated mice demonstrated a significant reduction in MC38 growth as compared with control (P < 0001). Both Tbet+ CD4 and CD8 tumor-infiltrating lymphocytes (TIL) were significantly increased (P = 0.04 and P = 0.038, respectively) without a concurrent increase in GATA3+ TIL (P > 0.05). CD8+ TIL highly expressed the activation marker, CD69. Not only was PD-L1 expression decreased on tumors, but LAG3+CD8+ T cells and PD-1 and LAG3 expression on regulatory T cells was also reduced (P = 0.008 and P = 0.002, respectively). These data demonstrate COX-2 inhibitors significantly decrease PD-L1 in colonic lesions and favorably impact the phenotype of tumor-infiltrating lymphocytes to control tumor growth.

Prevention Relevance:

Nonsteroidal anti-inflammatories (NSAID) are an essential component of any combination chemoprevention of colon cancer. We show NSAID treatment reduces PD-L1 expression on intestinal tumor cells. NSAID regulation of PD-L1 is dependent on COX-2 expression. These data underscore an important immunologic mechanism of action for NSAID in colon cancer prevention.

Watch the interview with Denise Cecil, PhD, recipient of the 2024 Cancer Prevention Research Award for Outstanding Journal Article: https://vimeo.com/992981665

See related Spotlight, p. 209
CD20-Targeted Therapy Ablates De Novo Antibody Response to Vaccination but Spares Preestablished Immunity
Authors: Shree Tanaya , Shankar Vishnu , Lohmeyer Julian J.K. , Czerwinski Debra K. , Schroers-Martin Joseph G. , Rodriguez Gladys M. , Beygi Sara , Kanegai Alyssa M. , Corbelli Karen S. , Gabriel Etelka , Kurtz David M. , Khodadoust Michael S. , Gupta Neel K. , Maeda Lauren S. , Advani Ranjana H. , Alizadeh Ash A. , Levy Ronald
Published: January 2022

To obtain a deeper understanding of poor responses to COVID-19 vaccination in patients with lymphoma, we assessed blocking antibodies, total anti-spike IgG, and spike-specific memory B cells in the peripheral blood of 126 patients with lymphoma and 20 age-matched healthy controls 1 and 4 months after COVID-19 vaccination. Fifty-five percent of patients developed blocking antibodies postvaccination, compared with 100% of controls. When evaluating patients last treated from days to nearly 18 years prior to vaccination, time since last anti-CD20 was a significant independent predictor of vaccine response. None of 31 patients who had received anti-CD20 treatment within 6 months prior to vaccination developed blocking antibodies. In contrast, patients who initiated anti-CD20 treatment shortly after achieving a vaccine-induced antibody response tended to retain that response during treatment, suggesting a policy of immunizing prior to treatment whenever possible.

Significance:

In a large cohort of patients with B-cell lymphoma, time since anti-CD20 treatment was an independent predictor of neutralizing antibody response to COVID-19 vaccination. Comparing patients who received anti-CD20 treatment before or after vaccination, we demonstrate that vaccinating first can generate an antibody response that endures through anti-CD20–containing treatment.

This article is highlighted in the In This Issue feature, p. 85
Screening for Mitochondrial tRNA Mutations in 318 Patients with Dilated Cardiomyopathy
Authors: Qi Yujuan , Wu Zhenhua , Bai Yaobang , Jiao Yan , Li Peijun
Published: January 2022

Objectives: Dilated cardiomyopathy (DCM) is a complex cardiovascular disease with unknown etiology. Although nuclear genes play active roles in DCM, mitochondrial dysfunction was believed to be involved in the pathogenesis of DCM. The objective of this study was to analyze the association between mitochondrial tRNA (mt-tRNA) mutations and DCM. Materials and Methods: We performed a mutational analysis of mt-tRNA genes in a cohort of 318 patients with DCM and 200 age- and gender-matched control subjects. To further assess their pathogenicity, phylogenetic analysis and mitochondrial functions including mtDNA copy number, ATP, and ROS were analyzed. Results: Seven possible pathogenic mutations, i.e., MT-TL1 3302A>G, MT-TI 4295A>G, MT-TM 4435A>G, MT-TA 5655T>C, MT-TH 12201T>C, MT-TE 14692A>G, and MT-TT 15927G>A, were identified in the DCM group but were absent in controls. These mutations occurred at extremely conserved nucleotides of corresponding tRNAs and led to the failure in tRNAs metabolism. Moreover, a significant reduction in ATP and mtDNA copy number and a marked increase in ROS level were observed in polymononuclear leukocytes (PMNs) derived from the DCM patients carrying these mt-tRNA mutations, suggesting that these mutations may cause mitochondrial dysfunction that was responsible for DCM. Conclusions: Our data indicated that mt-tRNA mutations may be the molecular basis for DCM, which provides novel insights into the pathophysiology of DCM that manifested as mitochondrial dysfunction.
Fetal-Maternal Surgery for Spina Bifida in a HIV-Infected Mother
Authors: Elrod Julia , Ochsenbein-Kölble Nicole , Mazzone Luca , Zimmermann Roland , Berger Christoph , Speck Roberto F. , Strübing Nele , Mohr Christoph , Moehrlen Ueli , Meuli Martin
Published: January 2022

Introduction: In select cases, in utero surgery for myelomeningocele (MMC) leads to better outcomes than postnatal repair. However, maternal HIV infection constitutes a formal exclusion criterion due to the potential of vertical HIV transmission. Encouraged by a previous case of a successful fetal spina bifida repair in a Hepatitis Bs antigen-positive woman, a plan was devised allowing for fetal surgery. Case Report: In utero MMC repair was performed although the mother was HIV-infected. To minimize the risk of in utero HIV transmission, the mother was treated by highly active antiretroviral therapy throughout gestation as well as intravenous zi­dovudine administration during maternal-fetal surgery. The mother tolerated all procedures very well without any sequelae. The currently 20 month-old toddler is HIV negative and has significantly benefitted from fetal surgery. Discussion/Conclusion: This case shows that maternal HIV is not a priori a diagnosis that excludes fetal surgery. Rather, it might be a surrogate for moving towards personalized medicine and away from applying too rigorous exclusion criteria in the selection of candidates for maternal-fetal surgery.
O silêncio necessário para o recolhimento: a mulher no limiar entre ser e não-ser
Authors: Piazzolla Mariana Di Stella
Published: January 2022

A ética levinasiana assume a mulher ou o feminino como alteridade discreta. A decisão por uma leitura elegendo um dos termos pode abrir para diferentes interpretações sobre a atribuição dessa alteridade, e isso suscitou um enorme interesse por teóricas feministas pela filosofia de Levinas, sendo Simone de Beauvoir uma das precursoras da crítica ao rebaixamento da mulher como Outro, continuada, de certa forma, por Luce Irigaray. Para compreender como essas críticas implicam na constituição de uma subjetividade oferecida a Outrem, decidimos iniciar pela análise do lugar que a mulher ocupa na ética levinasiana. Discutiremos desde a perspectiva da separação entre o ser e o ente, com objetivo de constituir o que sustenta uma aceitação de uma alteridade radical, tomando primeiramente o termo mulher como alteridade silenciosa, cuja posição intermediária entre ser e não-ser torna-se a condição para o recolhimento, e por conseguinte, indispensável para a relação ética. Em seguida, apresentaremos algumas questões que orbitam em torno da noção de feminino empregada por Levinas.
Comida de refugiado como recurso identitário e de identificação
Authors: Lucena Célia Toledo
Published: January 2022

Neste artigo objetiva-se promover uma discussão teórica sobre refúgio, identidade, fronteiras étnicas, comida migratória e refletir acerca da culinária do Oriente Médio como forma de identificação e de construção/manutenção de identidades de refugiados na capital paulista. Também, iniciar discussões sobre os efeitos das diferenças culturais e as estratégias de resistência e de tradução cultural. Leva-se em conta que a cozinha e suas práticas são repletas de representações e significados e que a cultura alimentar é um marcador étnico. Os refugiados são marcados por identidades móveis, hibridismos culturais e sentimentos de pertencimento ao lugar de origem. Esse fluxo de refugiados provenientes da Síria, a partir de 2013, com a instalação de restaurantes e de venda de comida delivery, sem dúvida, estimula a ampliação dos ares multiculturais da cidade de São Paulo que é marcada por um “cosmopolitismo diaspórico”.
From Crisis Management to Realignment of Forces
Authors: Tagirova Alsu
Published: January 2022

In 1969, after a series of large-scale border clashes, the People's Republic of China (PRC) and the Soviet Union finally decided to enter negotiations to prevent a wider military confrontation. The de-escalation process that ensued gave Soviet and Chinese leaders two options: either to compromise and reach a settlement or to go back to a strategy of delay. This article shows that the choice between the two options depended on whether either state believed it could improve its relative position in a better political environment or could gain certain political advantage by immediately settling the dispute. Ultimately, both sides chose to return to a strategy of delay. The Chinese decision was influenced by the strategic configuration of U.S. “triangular” diplomacy and the hope that it would enhance the PRC's relative position. For Soviet officials, the outcome stemmed from a lack of trust in their Chinese counterparts.
“You Don't Know Khrushchev Well”
Authors: Torigian Joseph
Published: January 2022

The ouster of Nikita Khrushchev in October 1964 was a key moment in the history of elite politics in one of the most important authoritarian regimes of the twentieth century. Yet political scientists and historians have long seemed uninterested in Khrushchev's downfall, regarding it as the largely “inevitable” result of his supposedly unpopular policies. Archival sources that have recently come to light cast serious doubt on this assessment and demonstrate new ways of measuring contingency. By showing the countermeasures Khrushchev could have taken, the importance of timing, and the sense among the plotters that their move was highly risky, this article demonstrates that Khrushchev's defeat was far from preordained. The lesson of October 1964 is not that policy differences or failures lead inexorably to political defeat, but that elite politics in Marxist-Leninist regimes is inherently ambiguous, personal, and, most importantly, highly contingent.
The world’s tiniest land snails from Laos and Vietnam (Gastropoda, Pulmonata, Hypselostomatidae)
Authors: Páll-Gergely Barna , Jochum Adrienne , Vermeulen Jaap J. , Anker Katja , Hunyadi András , Örstan Aydin , Szabó Ábel , Dányi László , Schilthuizen Menno
Published: January 2022

Two new, extremely small land snail species, Angustopila coprologos Páll-Gergely, Jochum & Hunyadi n. sp. and Angustopila psammion Páll-Gergely, Vermeulen & Anker n. sp. are described from northern Vietnam and northern Laos, respectively. The former is characterized by a rough surface sculpture and bears tiny mud granules arranged in a pattern of radial lines on its shell surface. The latter species is the new global record-holder of the tiniest land snail title, with a shell width of 0.6–0.68 mm and a shell height of 0.46–0.57 mm. These measurements surpass the former records of Angustopila pallgergelyi and Acmella nana.
A new synonym of Calamus leptospadix (Arecaceae)
Authors: MEHMUD SELIM , ROY HIMU
Published: January 2022

N/A
Disepalum rawagambut (Annonaceae), a new tree species from peat swamp forest of Sumatra, Indonesia
Authors: RANDI AGUSTI , WIJEDASA LAHIRU S. , THOMAS DANIEL C.
Published: January 2022

N/A
Typifications in the genus Dichanthium (Andropogoneae: Poaceae)
Authors: SHAIKH TARBEJ , GHALME RAGHUNATH , POTDAR GIRISH
Published: January 2022

Dichanthium aristatum (Poir.) C.E. Hubb, D. foulkesii (Hook.f.) S.K. Jain & Deshp., D. mccannii Blatt., D. panchganiense Blatt. & McCann and D. paranjpyeanum (Bhide) Clayton are lectotypified, the selection of lectotype is discussed.
Comprehensive Assessment and Variation Characteristics of the Drought Intensity in North China Based on EID
Authors: Zhao Haiyan , Chen XianYan , Yang JiaXi , Yao Chuang , Zhang Qiang , Mei Ping
Published: January 2022

Under the new background of climate change, it is very important to identify the characteristics of drought in North China. Based on the daily meteorological drought comprehensive index from 494 national meteorological stations in North China during 1961–2019, the drought processes and their intensity are identified by applying the “extreme” intensity–duration (EID) theory. Then, the stage variation characteristics of the drought trend, the average drought intensity, and the drought frequency are analyzed. The results show that among the five drought intensity indices the process maximum intensity demonstrates the greatest correlation coefficient with the disaster rate of drought in North China. Therefore, the process maximum intensity of drought is selected as the annual drought intensity to analyze the drought characteristics in North China. According to the climate warming trends, the study period is divided into three stages, that is, 1951–84 (stage I), 1985–97 (stage II), and 1998–2019 (stage III). The comprehensive results show that the drought intensity in North China has significant stage characteristics. In stage I, the drought shows an increasing trend in most parts of North China, but its average intensity is relatively weaker, with a lower severe drought frequency. The drought also shows an increasing trend in most parts in stage II, with a more significant increase rate than that in stage I, and the average drought intensity is the strongest and the severe drought frequency is the highest. In stage III, the drought shows a decreasing trend in some areas, and the average intensity is the weakest, with a lower severe drought frequency.

Significance Statement

In this paper, we develop a drought intensity formula, the maximum intensity of drought, based on the “extreme” intensity–duration theory. The maximum intensity of drought was then calculated and selected as an annual drought intensity to analyze the drought characteristics in North China. We found that the annual drought intensity better captured the extremity and the patterns of drought process than that obtained with single indices and comprehensive indices. The results show a decreasing trend of drought in North China after 1998.
Subsurface Warm Biases in the Tropical Atlantic and Their Attributions to the Role of Wind Forcing and Ocean Vertical Mixing
Authors: Zhang Qiushi , Zhu Yuchao , Zhang Rong-Hua
Published: January 2022

Realistic ocean subsurface simulations of thermal structure and variation are critically important to success in climate prediction and projection; currently, substantial systematic subsurface biases still exist in the state-of-the-art ocean and climate models. In this paper, subsurface biases in the tropical Atlantic Ocean (TA) are investigated by analyzing simulations from the Ocean Model Intercomparison Project (OMIP) and conducting ocean-only experiments that are based on the Parallel Ocean Program, version 2 (POP2). The subsurface biases are prominent in almost all OMIP simulations, characterized by two warm-bias patches off the equator. By conducting two groups of POP2-based ocean-only experiments, two potential origins of the biases are explored, including uncertainties in wind forcing and vertical mixing parameterization, respectively. It is illustrated that the warm bias near 10°N can be slightly reduced by modulating the prescribed wind field, and the warm biases over the entire basin are significantly reduced by reducing background diffusivity in the ocean interior in ways to match observations. By conducting a heat-budget analysis, it is found that the improved subsurface simulations are attributed to the enhanced cooling effect by constraining the vertical mixing diffusivity in terms of the observational estimate, implying that overestimation of vertical mixing is primarily responsible for the subsurface warm biases in the TA. Since the climate simulation is very sensitive to the vertical mixing parameterization, more accurate representations of ocean vertical mixing are clearly needed in ocean and climate models.

Significance Statement

The purpose of our study is to analyze the characteristics of subsurface temperature biases in the tropical Atlantic Ocean and to investigate the causes for the biases. This is important because subsurface biases greatly reduce the reliability of models in climate prediction and projection. It is found that significant subsurface warm biases arise in 100–150 m over the entire tropical Atlantic basin and the biases are mainly attributed to overestimated ocean vertical mixing. Our work highlights that subsurface ocean simulations are highly sensitive to vertical mixing parameterization, and further research is necessary for more accurate representations of ocean vertical mixing in ocean and climate modeling.
Risk Factors for Delirium and Association of Antipsychotic Use with Delirium Progression in Critically Ill Trauma Patients
Authors: Shoulders Bethany R. , Elsabagh Sarah , Tam Douglas J. , Frantz Amanda M. , Alexander Kaitlin M. , Voils Stacy A.
Published: January 2022

Background

Delirium occurs frequently in critically ill and injured patients and is associated with significant morbidity and mortality. Limited data exists on the risk factors for developing delirium in critically ill trauma patients and the effect of antipsychotic (AP) medications on delirium progression.

Objective

The objective of this study is to determine the incidence of delirium in critically ill trauma versus non-trauma surgical patients and determine if the presence of trauma was associated with intensive care unit (ICU) delirium. Secondary outcomes included identifying risk factors for delirium and determining the impact of AP medication use on delirium progression in critically ill trauma patients.

Methods

This retrospective review studies adult trauma/surgical ICU patients admitted between May 2017-July 2018 to a level I trauma and tertiary referral center. Regression modeling was used to determine the impact of AP use on delirium-free days.

Results

Delirium was more common in critically ill trauma patients versus non-trauma surgical ICU patients [54/157 (34.4%) vs 42/270 (15.6%), P < .001]. Of the 54 trauma patients with delirium, 28 (52%) received an AP medication for delirium treatment and in the multiple linear regression analysis, AP use was significantly associated with fewer delirium-free days ( P = .02).

Discussion

Higher admission sequential organ failure assessment scores and increased length of stay were significantly associated with delirium onset in critically ill trauma patients. Use of AP medications for delirium treatment in this population had a negative impact on delirium-free days.
A New Predictor of Mortality in ST-Elevation Myocardial Infarction: The Uric Acid Albumin Ratio
Authors: Kalkan Sedat , Cagan Efe Süleyman , Karagöz Ali , Zeren Gönül , Yılmaz Mehmet Fatih , Şimşek Barış , Batgerel Ulaankhuu , Özkalaycı Flora , Tanboğa İbrahim Halil , Oduncu Vecih , Karabay Can Yücel , Kırma Cevat
Published: January 2022

Several studies have shown that high uric acid (UA) and low serum albumin (SA) values increase the risk of cardiovascular disease and mortality in ST-elevation myocardial infarction (STEMI). We determined whether the uric acid/albumin ratio (UAR) is a predictor of mortality in STEMI patients. All patients who presented at our center with a diagnosis of STEMI and underwent percutaneous intervention from 2015 to 2020 were screened consecutively; 4599 patients were included. A Cox proportional hazards model was used to evaluate UAR, and adjusted predictors obtained from laboratory findings and clinical characteristics contributed to mortality. Also, a regression model was presented with a directed acyclic graph (DAG). The median age of the patients was 58 years (IQR [interquartile range]: 50–67); 3581 patients (77.9%) were male. The incidence of mortality in the entire patient group was 11.9%. Median follow-up duration of all groups was 42 months. Multivariate Cox proportional regression (model-1) analysis showed age (increase 50 to 67 years; HR [hazard ratio]: 1.34, 95% CI 1.18–1.52) and UAR (increase 1.15–1.73; HR: 1.33, 95% CI 1.16–1.52) were associated with mortality. UAR may be a prognostic factor for mortality in STEMI patients and an easily accessible parameter to identify high-risk patients.
Risk Factors for Post-Thrombotic Syndrome in Patients With a First Proximal Deep Venous Thrombosis Treated With Direct Oral Anticoagulants
Authors: Spiezia Luca , Campello Elena , Simion Chiara , Poretto Anna , Dalla Valle Fabio , Simioni Paolo
Published: January 2022

The incidence of post-thrombotic syndrome (PTS) in patients with deep vein thrombosis (DVT) treated with direct oral anticoagulants (DOACs) remains a matter of debate. Hence, our endeavor to investigate a large cohort of patients with a first episode of proximal DVT treated with DOACs to ascertain the incidence and predisposing risk factors for PTS. All consecutive patients referred to the Thrombotic and Haemorrhagic Diseases Unit of Padova University Hospital (Italy) between January 2014 and January 2018 for a first episode of proximal DVT were considered for enrollment. Participants received DOACs for a minimum period of 3 months. PTS was assessed using the Villalta score up to 36 months after DVT diagnosis. Among 769 enrolled patients (M/F 353/416, age range 26–87 years), 152 (19.8%) developed PTS and 30 (3.9%) developed severe PTS. The adjusted hazard ratio was significant for obesity (1.64, 95% CI 1.28–2.39) and DVT site (femoral and/or iliac veins vs popliteal vein) (1.23, 95% CI 1.15–3.00). The incidence of PTS is not negligible in patients with proximal DVT despite the use of DOACs. We identified obesity and iliofemoral DVT as possible risk factors for PTS. Larger prospective studies are needed to confirm our findings and optimize therapeutic strategies.
Circular Dichroism Spectral Similarity Plots to Extend Validation and Correction to All Measured Wavelengths
Authors: Meuse Curtis W.
Published: January 2022

Interlaboratory comparisons of circular dichroism (CD) spectra are useful for developing confidence in the measurements associated with optically active molecules. These measurements also help define the higher-order (secondary and tertiary) structure of biopolymers. Unfortunately, the extent of the validity of these measurements has been unclear. In this work, a method is described to extend CD validation over the entire observed wavelength range using what will be called spectral similarity plots. The method involves plotting, wavelength by wavelength, all measured spectral intensities of a sample at one concentration against the intensity values of the same material at a different concentration or pathlength. These spectral similarity plots validate the instrument in terms of spectral shape and whether the shape is shifted in intensity and/or in wavelength. This comparison tests the linearity of instrument’s signal, the balance of its left and right polarizations, its wavelengths, and its spectral intensity scales. When the process is applied to materials with accepted and archived intensity values, the method can be linked to older single-wavelength and double-wavelength calibration techniques. Further, spectral similarity testing of CD spectra from samples with different concentrations run in different labs suggests that improved interlaboratory validation of CD data is possible. Since a database of archival CD measurements is available online, spectral similarity comparisons could possibly provide the ability to compare linearity, polarization balance, wavelength, and spectral intensity between all current CD instruments. If the preliminary results published here prove robust and transferable, then comparisons of full-wavelength range spectra to archived data using spectral similarity plots should become part of the standard process to validate and calibrate the performance of CD instruments.
Effect of applying independence axiom of Axiomatic Design theory on performance of an Integrated Manufacturing Information System: a computer simulation modeling approach
Authors: Mollajan Ali , Iranmanesh Hossein , Khezri AmirHossein , Abazari Amin
Published: January 2022

To control manufacturing processes, integration of flows of manufacturing information is an important starting point. In this regard, an effective Integrated Manufacturing Information System (IMIS) which is capable of monitoring, analyzing, and inspecting manufacturing processes properly is critical. Often, most of difficulties in achieving an effective IMIS stem from a poor design for the system architecture. This study particularly addresses the problem of coupling in architecture of an IMIS and its effect on the system performance. This study employs “Independence Axiom” of the Axiomatic Design (AD) theory to deal with the problem and uses “times in process” and “utilized capacities of available resources” as two important criteria for evaluating the system performance. To verify the proposed methodology, a real IMIS is addressed, its stochastic behavior is simulated in Visual SLAM and AweSim (version 3.o) software environment, and the outcomes are analyzed by using logistic regression method for each level of system decomposition. Results of the analyses indicate that fulfillment of independence axiom of AD theory can significantly enhance performance of the concerned IMIS.
The Impact of Education on Youth Employability: The Case of Selected Southeastern European Countries
Authors: Bojadjieva Daniela Mamucevska , Cvetanoska Marijana , Kozheski Kristijan , Mujčinović Alen , Gašparović Slaven
Published: January 2022

This paper focuses on the processes of school-to-work transitions in a selected group of countries from South-eastern Europe (SEE), namely: Bosnia and Herzegovina; Croatia; Montenegro; North Macedonia; Serbia; and, Slovenia. Each of these countries display the same roots of development in their educational systems: however, due to their transition and integration processes within the European Union, they implemented different concepts of reforms within their educational systems. In addition, the challenges of youth employability are a common problem for each of the selected countries, and the effectiveness of the processes of school-to-work-transition varies across the countries. By using panel data and multiple linear regression models, this paper estimates the impact of different educational levels on youth employability and changes in the rates of NEET population (aged 15–24) in the selected group of countries over the period 2009 to 2019. The results suggest that the impact of the attained level of education has an ambiguous effect on the rates of youth employment; moreover, the relationship with changes in NEET rates are statistically significant and negative in most of the selected group of countries.
Design and robustness analysis of fuzzy PID controller for automatic voltage regulator system using genetic algorithm
Authors: Dogruer Tufan , Can Mehmet Serhat
Published: January 2022

In this paper, a Fuzzy proportional–integral–derivative (Fuzzy PID) controller design is presented to improve the automatic voltage regulator (AVR) transient characteristics and increase the robustness of the AVR. Fuzzy PID controller parameters are determined by a genetic algorithm (GA)-based optimization method using a novel multi-objective function. The multi-objective function, which is important for tuning the controller parameters, obtains the optimal solution using the Integrated Time multiplied Absolute Error (ITAE) criterion and the peak value of the output response. The proposed method is tested on two AVR models with different parameters and compared with studies in the literature. It is observed that the proposed method improves the AVR transient response properties and is also robust to parameter changes.
A framework for battery internal temperature and state-of-charge estimation based on fractional-order thermoelectric model
Authors: Wang Yujie , Zhou Caijie , Zhao Guanghui , Chen Zonghai
Published: January 2022

In recent years, the rapid development of electric vehicles has raised a wave of innovation in lithium-ion batteries. The safety operation of lithium-ion batteries is one of the major bottlenecks restraining the development of the energy storage market. The temperature especially the internal temperature can significantly affect the performance and safety of the battery; therefore, this paper presented a novel framework for joint estimation of the internal temperature and state-of-charge of the battery based on a fractional-order thermoelectric model. Due to the nonlinearity, coupling, and time-varying parameters of lithium-ion batteries, a fractional-order thermoelectric model which is suitable for a wide temperature range is first established to simulate the battery’s thermodynamic and electrical properties. The parameters of the model are identified by the electrochemical impedance spectroscopy experiments and particle swarm optimization method at six different temperatures, and then the relationship between parameters and temperature is obtained. Finally, the framework for joint estimation of both the cell internal temperature and the state-of-charge is presented based on the model-based state observer. The experimental results under different operation conditions indicated that, compared with the traditional off-line prediction method, the model-based online estimation method not only shows stronger robustness under different initial conditions but also has better accuracy. Specifically, the absolute mean error of the estimation of state-of-charge and internal temperature based on the proposed method is about 0.5% and 0.3°C respectively, which is about half of that based on the off-line prediction method.
Do Corporate Site Visits Constrain Real Earnings Management?
Authors: Broadstock David C. , Chen Xiaoqi , Cheng C. S. Agnes , Huang Wenli , Ma Yujing
Published: January 2022

This study investigates the relationship between corporate site visits (CSVs) and firms’ real earnings management. Using a unique dataset of site visits to Chinese firms listed on the Shenzhen Stock Exchange from 2009 to 2016, we find that such visits are negatively associated with firms’ real earnings management. The results are robust to using alternative CSV measures, controlling for alternative communication channels, and using the propensity score matching method. In cross-sectional analyses, we find that the negative association between site visits and real earnings management is stronger for more complex firms and firms with greater information asymmetry. In addition, we find that CSVs are negatively associated with both management and corporate misconduct but not with accrual-based earnings management or restatements.
Resilience in advanced cancer caregiving. A systematic review and meta-synthesis
Authors: Opsomer Sophie , Lauwerier Emelien , De Lepeleire Jan , Pype Peter
Published: January 2022

Background:

Close relatives provide much of the care to people with cancer. As resilience can shield family caregivers from mental health problems, there has been a burgeoning interest in resilience-promoting interventions. However, the evidence necessary for the development of these interventions is scant and unsynthesized.

Aim:

To create an overall picture of evidence on resilience in cancer caregiving by a theory-driven meta-synthesis.

Design:

In this systematically constructed review a thematic synthesis approach has been applied. The original findings were coded and structured deductively according to the theoretical framework. Consequently, the codes were organized inductively into themes and subthemes.

Data sources:

Through September 2019, five electronic databases were searched for qualitative studies on resilience in cancer caregiving. The search was extended by a supplementary hand search. Seventeen studies met the eligibility criteria.

Results:

The elements of resilience, as described in the pre-defined theoretical framework of Bonanno, are reflected in the lived experiences of family caregivers. The resilience process starts with the diagnosis of advanced cancer and may result in mental wellbeing, benefit finding, and personal growth. The process is influenced by context elements such as individual history, sociocultural background, caregiver characteristics, and the behavior of the supportive network. A repertoire of coping strategies that caregivers use throughout the caregiving process moderates the resilience process.

Conclusion:

This review and theoretical synthesis reveal key elements of resilience in the process of cancer caregiving, including influencing factors and outcomes. Implications and avenues for further research are discussed.
Venous cerebral blood flow quantification and cognition in patients with sickle cell anemia
Authors: Stotesbury Hanne , Hales Patrick W , Koelbel Melanie , Hood Anna M , Kawadler Jamie M , Saunders Dawn E , Sahota Sati , Rees David C , Wilkey Olu , Layton Mark , Pelidis Maria , Inusa Baba PD , Howard Jo , Chakravorty Subarna , Clark Chris A , Kirkham Fenella J
Published: January 2022

Prior studies have described high venous signal qualitatively using arterial spin labelling (ASL) in patients with sickle cell anemia (SCA), consistent with arteriovenous shunting. We aimed to quantify the effect and explored cross-sectional associations with arterial oxygen content (CaO2), disease-modifying treatments, silent cerebral infarction (SCI), and cognitive performance. 94 patients with SCA and 42 controls underwent cognitive assessment and MRI with single- and multi- inflow time (TI) ASL sequences. Cerebral blood flow (CBF) and bolus arrival time (BAT) were examined across gray and white matter and high-signal regions of the sagittal sinus. Across gray and white matter, increases in CBF and reductions in BAT were observed in association with reduced CaO2 in patients, irrespective of sequence. Across high-signal sagittal sinus regions, CBF was also increased in association with reduced CaO2 using both sequences. However, BAT was increased rather than reduced in patients across these regions, with no association with CaO2. Using the multiTI sequence in patients, increases in CBF across white matter and high-signal sagittal sinus regions were associated with poorer cognitive performance. These novel findings highlight the utility of multiTI ASL in illuminating, and identifying objectively quantifiable and functionally significant markers of, regional hemodynamic stress in patients with SCA.
Can routine MRI spine T1 sequences be used for prediction of decreased bone density?
Authors: Kale Hrishikesh , Yadav Saksham
Published: January 2022

Background

Bone marrow signal is ideally evaluated with magnetic resonance imaging (MRI) due to its high tissue contrast. While advanced MRI quantitative methods can be used for estimating bone density, there are no readily available parameters on routine clinical MRI sequences of the lumbar spine.

Purpose

To evaluate whether T1 signal intensity (SI) ratio of lumbar vertebral body (VB)/cerebrospinal fluid (CSF) may predict decreased bone density.

Material and Methods

A retrospective study was conducted. After use of inclusion/exclusion criteria, 36 patients who had an MRI scan of the lumbar spine and a DEXA scan performed as a part of annual health visit were selected. T1 SI of the lumbar vertebral bodies and adjacent CSF were recorded. Ratio of T1 SI of L1–L4 (VB)/CSF was calculated. The corresponding bone-density values on DEXA scan measured as g/cm2 were obtained. Pearson's r correlation statistic was used to determine the correlation between these variables.

Results

T1 VB/T1 CSF SI ratio was between 1.308 and 2.927 (mean = 2.028). Mean T1 SI value of vertebral bodies (L1–L4) was 264.9 and mean CSF SI value was 131.9. Bone density in g/cm2 was between 0.851 and 1.398 (mean = 1.081). Pearson correlation coefficient was r = −0.619 ( P=0.0001), which shows a negative moderate correlation between the T1 VB/T1 CSF SI ratio and bone density.

Conclusion

A high T1 VB/T1 CSF SI ratio on routine MRI sequences may indicate decreased bone density. This ratio may be of substantial benefit in unsuspected osteoporosis/osteopenia on routine MRI lumbar spine imaging.
Clinical prediction rule for bacteremia with pyelonephritis and hospitalization judgment: chi-square automatic interaction detector (CHAID) decision tree analysis model
Authors: Fukui Sayato , Inui Akihiro , Saita Mizue , Kobayashi Daiki , Naito Toshio
Published: January 2022

Objective

This study was performed to identify predictive factors for bacteremia among patients with pyelonephritis using a chi-square automatic interaction detector (CHAID) decision tree analysis model.

Methods

This retrospective cross-sectional survey was performed at Juntendo University Nerima Hospital, Tokyo, Japan and included all patients with pyelonephritis from whom blood cultures were taken. At the time of blood culture sample collection, clinical information was extracted from the patients’ medical charts, including vital signs, symptoms, laboratory data, and culture results. Factors potentially predictive of bacteremia among patients with pyelonephritis were analyzed using Student’s t-test or the chi-square test and the CHAID decision tree analysis model.

Results

In total, 198 patients (60 (30.3%) men, 138 (69.7%) women; mean age, 74.69 ± 15.27 years) were included in this study, of whom 92 (46.4%) had positive blood culture results. The CHAID decision tree analysis revealed that patients with a white blood cell count of >21,000/μL had a very high risk (89.5%) of developing bacteremia. Patients with a white blood cell count of ≤21,000/μL plus chills plus an aspartate aminotransferase concentration of >19 IU/L constituted the high-risk group (69.0%).

Conclusion

The present results are extremely useful for predicting the results of bacteremia among patients with pyelonephritis.
Time to switch angiotensin-converting enzyme inhibitors/angiotensin receptor blockers to sacubitril/valsartan in patients with cancer therapy-related cardiac dysfunction
Authors: Xi Qianlan , Chen Zijun , Li Tingming , Wang Liya
Published: January 2022

Advances in cancer therapy have resulted in more cancer therapy-related cardiac dysfunction (CTRCD), which is the main cause of death in older female survivors of breast cancer. Traditionally, guideline-recommended medications for heart failure, such as beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs), are commonly used to prevent or attenuate CTRCD. However, sometimes their effectiveness is not satisfactory. Recently, the drug combination of sacubitril plus valsartan has been proven to be more beneficial for heart failure with reduced ejection fraction in the long term compared with an ACEI/ARB alone. However, there is a lack of evidence of the efficacy and safety of this drug combination in CTRCD. We report a case of worsening CTRCD, despite treatment with traditional medications, in which the patient improved after changing perindopril to sacubitril/valsartan. The patient’s heart function greatly improved after changing this ACEI to sacubitril/valsartan. Changing an ACEI/ARB to sacubitril/valsartan in patients with worsening chemotherapy-induced heart failure is appropriate. Further studies with a high level of evidence are required to assess the efficacy and safety of sacubitril/valsartan for CTRCD.
Gastric adenocarcinoma with germ cell tumor components: a rare case report
Authors: Han Xu , Wang Shu , He Hongyu , Sun Yao , Li Jiannan
Published: January 2022

Germ cell tumors (GCTs) often occur in male testes and female ovaries. Extragonadal GCTs account for approximately 2% to 5% of all GCTs and mainly occur in the mediastinum, retroperitoneum, and pineal gland. In this study, we reported a rare case of gastric adenocarcinoma with GCT components. The patient’s serum α-fetoprotein (AFP) level was higher than normal. Abdominal computed tomography (CT) showed a 10-cm × 10-cm tumor between the spleen and the bottom of the stomach. Gastric endoscopy indicated an ulcerative lesion extending from the bottom of the stomach to the antrum. Tissue biopsy identified the tumor as an adenocarcinoma. The patient underwent abdominal tumor resection, subtotal gastrectomy, D2 lymphadenectomy, and splenectomy. Postoperative histopathology showed that the tumor was a moderately to poorly differentiated adenocarcinoma. Immunohistochemistry analysis revealed positive staining for AFP, glypican-3, and placental alkaline phosphatase. Gastric adenocarcinoma with GCT components is particularly uncommon and rarely reported. Elevated serum AFP and/or β-human chorionic gonadotropin levels, abdominal CT, histopathology, and immunohistochemistry may help diagnose GCTs. Radical surgery resection is the primary treatment method for GCTs. Adjuvant chemotherapy and radiotherapy are effective for advanced GCTs.
Anthracycline, taxane, and trastuzumab-based neoadjuvant chemotherapy in HER2-positive early breast cancer: phase II trial
Authors: Conte Benedetta , Montemurro Filippo , Levaggi Alessia , Blondeaux Eva , Molinelli Chiara , Cardinali Barbara , Poggio Francesca , Buzzatti Giulia , Bighin Claudia , Lambertini Matteo , Del Mastro Lucia
Published: January 2022

Objective:

Neoadjuvant chemotherapy has become the preferred treatment in HER2-positive early breast cancer. Several trials investigated the neoadjuvant efficacy of dual HER2 blockade with anthracycline-free chemotherapy, whereas few data are available on single-agent trastuzumab and anthracycline-based regimens, which represent the standard of care in the adjuvant setting. This phase II, single-arm trial assessed anthracycline-based chemotherapy and trastuzumab as neoadjuvant treatment for high-risk HER2-positive breast cancer.

Methods:

Forty-three patients with stage II–III HER2-positive breast cancer were treated with 4 courses of neoadjuvant 5-fluorouracil 600 mg/m2, epirubicin 90 mg/m2, cyclophosphamide 600 mg/m2 (FEC ×4) every 21 days, followed by 12 courses of weekly paclitaxel 80 mg/m2 and trastuzumab 2 mg/Kg IV (loading dose 4 mg/kg).

Results:

Pathologic complete response (pCR) was observed in 22 (51%) of 43 patients. After a median follow-up of 6 years, the 5-year disease-free survival and overall survival were 85.8% (95% confidence interval 75.9%–97%) and 89.6% (80.4%–99.8%), respectively. A temporary decrease in left ventricular ejection fraction was observed in two patients. No cardiac death or congestive heart failure occurred. One patient died due to febrile neutropenia.

Conclusions:

FEC ×4 followed by paclitaxel and trastuzumab was associated with high pCR rates and favorable long-term outcomes. However, this regimen was associated with relevant hematologic toxicity.