bluuebunny/crossref_metadata_2025 huggingface dataset:
Archaeo-Geophysical Investigation of Ife City Grand Resort Iron Smelting Site at Ile-Ife, Southwest Nigeria
Authors: Oni Ademakinwa George , Olorunfemi Martins Olusola , Ogunfolakan Benjamin Adisa , Okunubi Michael Olajide
Published: February 2022

Ile-Ife in southwestern Nigeria is rich in art and craft traditions, most especially iron smelting. The town hosts hundreds of smelting sites with little or no archaeological record. Archaeo-geophysical prospection of a suspected smelting site in Ile-Ife involved the magnetic and electrical resistivity geophysical methods and archaeological excavation with the aim to identify its buried artefacts/features and date the site. The geophysical investigations located a circular/oval-shaped dipolar magnetic anomaly that coincided with a high resistivity zone, typical of a heat-impacted furnace or a slag trench. Iron slag, tuyere, fired clay furnace fragments, and charcoal were recovered from the pits excavated at the locations of the geophysical anomalies. Smelting activity at the site, from dated charcoal, took place at some point between the 13th-15th centuries AD, a middle to late age in Africa’s history of iron smelting. This study, therefore, validated the examined site as an ancient iron smelting site and situated its place in the archaeological history of iron smelting.
Review and new species of Donaciolagria Pic, 1914 (Coleoptera: Tenebrionidae: Lagriinae), with a key, and an annotated checklist
Authors: Telnov Dmitry
Published: February 2022

Donaciolagria Pic, 1914 is a small genus of colourful Lagriinae Latreille, 1825 (Tenebrionidae Latreille, 1802) restricted to the southern Himalayas and montane systems of China, northern Indochina, as well as present in Taiwan. In the present paper the following five new species are described and illustrated, in addition to the 13 previously known valid taxa: Donaciolagria cupreoaurata sp. n. (China: Yunnan), D. evanescens sp. n. (China: Yunnan), D. mimica sp. n. (China: Hubei, Shaanxi, Sichuan), D. regia sp. n. (India: Arunachal Pradesh), and D. weigeli sp. n. (China: Yunnan). One new synonymy is proposed: Donaciolagria longipennis Pic, 1914 = D. longipennis var. jeanvoinei Pic, 1927 syn. n. A lectotype is designated for Donaciolagria longipennis var. jeanvoinei Pic, 1927. Donaciolagria basipes Pic, 1927 and D. pici Borchmann, 1936 are redescribed. A key to and a checklist of Donaciolagria species are presented, supplemented with new records and habitus images of several known species.
Shifting Identities in Modern Sindh: Bhil and Kohli Hindus of Khebar in the Shia Ismaili Muslim Community
Authors: Khwaja Mahek
Published: February 2022

Indo-Muslim history is hybrid. The Hindu Bhil and Kohli communities of Khebar, Sindh, are examples of this hybridity. Before Partition in 1947, when socio-cultural ambivalence was widespread, Bhils and Kohlis lived alongside Muslims. After Partition, the situation changed, and these communities suffered socio-economic isolation. Between 1964 and 1979, Bhils and Kohlis in Kebhar experienced three waves of da’wah (i.e., calling people to embrace Islam). In these waves, Ismaili missionaries targeted Patels (i.e., community headmen). In response, this group recognized the 49th Imam of Shia Ismaili Muslims as a manifestation of the dasa avatara from Hinduism. This article addresses what factors led to this recognition and how groups cross thresholds between Hinduism and Islam.
Taxonomic study of the leafhopper genus Agnesiella Dworakowska (Hemiptera: Cicadellidae: Typhlocybinae) from China, with descriptions of 13 new species
Authors: WANG JUNJIE , ZHANG YALIN , HUANG MIN
Published: February 2022

Thirteen new species of the leafhopper genus Agnesiella Dworakowska, Agnesiella (Agnesiella) protensa, A. (A.) recurve, A. (A.) polita, A. (Draberiella) gaura, A. (D.) longisagittata, A. (D.) eleganta, A. (D.) glabra, A. (D.) exigua, A. (D.) mitrata, A. (D.) apiculata, A. (D.) tridigitata, A. (D.) lata and A. (D.) stipitata spp. nov., are described and illustrated. A. (A.) marginata and A. (D.) irma are recorded from China for the first time. A checklist and key to the species (males) from China in Agnesiella are provided.
Rediscovering the mosquito fauna (Diptera: Culicidae) of Estonia: an annotated checklist with distribution maps and DNA evidence
Authors: KIRIK HELI , TUMMELEHT LEA , KURINA OLAVI
Published: February 2022

Female mosquitoes (Diptera: Culicidae) affect their hosts in numerous negative ways and are crucial to the spread of vector-borne pathogens. It is, therefore, important to have a detailed overview of regional mosquitoes, to be able to detect changes in species diversity and identify possible health threats. The aim of this study was to update the checklist of the mosquito fauna of Estonia for the first time since 1957. For this purpose, 24,344 adult mosquitoes (94% females) were collected in Estonia from 2008 to 2020 using various trapping methods. Specimens were primarily identified by morphological characteristics, but DNA barcoding based on the partial cytochrome c oxidase subunit 1 gene (COI) was also used. Species were included in the checklist based on historical records as well as new collections, while also considering reports from neighboring countries. Species records are supplemented with voucher specimens, distribution maps and DNA evidence. The updated checklist includes 34 species, 27 of which were confirmed with recently collected material. All in all, Aedes communis (de Geer, 1776) proved to be the most common mosquito in Estonia, accounting for 30.1% of the specimens collected. This is noteworthy, as this species has been implicated in the transmission of multiple disease agents present in the area. New evidence revealed the presence of Ae. hexodontus Dyar, 1916, Ae. sticticus (Meigen, 1838), Anopheles messeae Falleroni, 1926 and Culiseta bergrothi (Edwards, 1921) in Estonia.
Redescription of the rare, deep-sea hyperiidean amphipod Megalanceoloides remipes (K.H. Barnard, 1932) (Crustacea: Amphipoda: Hyperiidea), including the first description of males
Authors: ZEIDLER WOLFGANG
Published: February 2022

Megalanceoloides remipes is a rare deep-sea species known from very few specimens. Until recently (Zeidler 2019) it was known only from the type, an incomplete female, and one other specimen, probably a juvenile female (Vinogradov 1964). Another specimen, an ovigerous female, described by Gasca & Haddock (2016) and compared to the previous two, was later considered to be a new species, M. aequanime Gasca, 2017 (Gasca & Browne 2017). More recently, Williams & Bunkley-Williams (2019) proposed another new species, M. gascae, for the specimen described by Vinogradov (1964). Thus, a redescription of M. remipes is still required, especially in light of the two new species proposed by these authors. The recent discovery of several specimens of M. remipes, including both sexes, in the USNM (Zeidler 2019) has now made it possible to provide a detailed redescription of the species, together with the first description of males, enabling a better comparison with M. aequanime and M. gascae.
The milliped family Striariidae Bollman, 1893. V. Stegostriaria dulcidormus, n. gen., n. sp., Kentrostriaria ohara, n. gen., n. sp., and the convergent evolution of exaggerated metazonital crests (Diplopoda, Chordeumatida, Striarioidea)
Authors: SHEAR WILLIAM A. , MAREK PAUL E.
Published: February 2022

Two new genera and species, Stegostriaria dulcidormus (Trisariinae) and Kentrostriaria ohara (Striariinae), are described from Oregon and Idaho, respectively. The new species are distinct from any other striariids, and indeed from any other chordeumatidan millipedes, in having the second dorsal crests greatly enlarged, giving them a fanciful resemblance to stegosaurid dinosaurs. In spite of this similarity, the two species are so distinct they cannot be accommodated in the same genus or the same subfamily. The exaggerated metazonital crests are therefore attributed to convergent evolution. We present a key to the genera of the family Striariidae.
Effects of Mg Doping on Double Channel Layer Atmospheric Pressure-Plasma Enhanced Chemical Vapor Deposition Fabricated Amorphous InGaZnO Thin Film Transistors
Authors: Wu Chien-Hung , Liu Po-Tsun , Chung Wen-Chun , Chang Kow-Ming , Lien Der-Hsien , Liu Cheng
Published: February 2022

Amorphous IGZO (a-IGZO) has been proved to be a suitable material for the channel layer in a thin film transistor, showing high mobility even in low temperature fabrication, device electrical characteristic exceeds a-Si or other metal oxide semiconductor materials. In this work, bottom
gate top TFT is fabricated. With Atmosphere Pressure-PECVD (AP-PECVD), a-IGZO is deposited as device channel layer. A double channel layer is tested with Mg doping added in the bottom layer. This work focus on how the Mg doping concentration in the bottom layer affects device electrical characteristic.
The result for best device characteristics is 5% Mg doping, showing highest mobility, lowest threshold voltage, and nearly 108 in Ion/Ioff. A suitable doping concentration can lower interface defect density and affect grain size, which both leads to a better
device characteristics. However, device characteristics show sign of degradation with excess doping concentration.
Characterization of the Influence of Heat Compression on Bamboo Cell Walls by Nanoindentation
Authors: Yuan Tiancheng , Huang Yaqian , Wang Xinzhou , Liu Hongzheng , Zhang Aiwen , Wang Qiuyi , Zhao Yihan , Han He , Weng Fujin , Li Yanjun
Published: February 2022

Heat compression refers to a modification method that can be adopted to enhance the mechanical and physical properties of bamboo materials. In this paper, the focus was placed on investigating the micromorphology, cellulose crystallinity, chemical composition, and nano-scale mechanical
properties of treated bamboo cell walls. The results demonstrated that the heat compression process induced a reduction in the cell lumen of the bamboo cell wall. Besides, the hemicellulose and cellulose content decreased; while the lignin content increased. Moreover, the oven density of bamboo
samples increased due to the heat compression process. The elastic modulus and hardness increased from 13.9 MPa and 0.55 MPa to 17.3 MPa and 0.88 MPa, respectively. Further, the creep ratio in the treated group decreased compared with the control one.
Manipulating Electron-Spin Polarization via a δ-Potential in an Embedded Magnetic-Electric-Barrier Microstructure
Authors: Yang Shuai-Quan , Lu Mao-Wang , Guo Qing-Meng , Qin Ying-Jie , Xie Shi-Shi
Published: February 2022

We theoretically explore how to manipulate electron-spin polarization by a δ-potential in an embedded magnetic-electric-barrier microstructure (EMEBM), which can be fabricated experimentally by patterning a ferromagnetic (FM) stripe and a Schottky-metal (SM) stripe on top
and bottom of GaAs/AlxGa1_xAs heterostructure, respectively. Due to spin-orbit coupling (SOC) an appreciable electron-spin polarization effect still remains, even through a δ-potential is contained. Besides, electron-spin polarization
ratio can be controlled by δ-potential, which may result in a structurally-manipulable electron-spin filter for spintronics device applications.
Memristive Hopfield Neural Network for Reasoning with Incomplete Information and Its Circuit Implementation
Authors: Sun Junwei , Han Juntao , Han Gaoyong , Wang Yanfeng , Liu Peng
Published: February 2022

Memristor-based neural networks have been extensively studied, but reasoning as an important topic of artificial intelligence is rarely implemented directly by circuit. Reasoning, as an important part of artificial intelligence, is an open and challenging problem to be solved. In this
paper, memristive hopfield neural network is designed to realize reasoning. The designed circuit consists of four modules, namely a signal processing module, an iterator module, a signal input module and a signal output module. The signal processing module performs iterative operations under
the control of the iterator module, so that the output signals of memristive hopfield neural network can converge to the final states. Reasoning is one of the basic forms of thinking, and is the process of drawing result from one or several given conditions. A guessing game for athletes is
completed by the designed circuit which can reason the name of the athlete from incomplete information. The simulation results verify the feasibility of the circuit for reasoning.
Preparation of Nano Cadmium Sulfide and Its Influence on Glomerular Mesangial Cell Apoptosis and NF-κB Expression of Renal Calculus Mice
Authors: Li Xingbin , Yi Qiuyang , Yao Chao , Liang Cheng , Li Maoshen , Chen Yifu , Mao Min , Lei Yin
Published: February 2022

The study was intended to investigate the influence of nano cadmium sulfide (nCdS) in glomerular mesangial cell (GMC) apoptosis and nuclear factor-kappa B (NF-κB) expression of renal calculus mice. The cadmium acetate and thioacetamide were used to prepare nCdS, which was
then characterized by X-ray diffractometer and high-resolution transmission electron microscope for the crystal form, morphology, and particle size. 20 SPF male mice selected as research subjects which were randomly divided into experimental group and control group. Regarding the establishment
of renal calculus mouse model, the mice in the experimental group were kept with ordinary feed together with stone attractant (made of ethylene glycol and ammonium chloride), and the mice in the control group were kept with ordinary feed together with tap water. Further, the tetrazolium salt
colorimetric method was used to detect the cytotoxicity of nCdS, with Western blot adopted to detect the expression levels of apoptosis-related protein of Bcl-2 and Bax in the two groups of mice, and immunohistochemical staining method applied to detect the expression level of NF-κB
in two groups of mice. The results showed that the renal calculus mouse model was successfully established. The prepared nCdS demonstrated a good dispersion property with a regular round shape and uniform particle size distribution between 2.34~10.52 nm. When the concentration of nCdS increased,
the survival rate of the GMC decreased, with a notable difference noted (P < 0.05). In contrast with the control group, the expression level of Bcl-2 in the GMC of the experimental group decreased, and that of Bax increased, with the difference found to be notable (P <0.05).
The expression of NF-κB in the GMC of experimental group was obviously higher versus that of the control group, and the difference was notable (P <0.05). In conclusions, the nCdS exhibits cytotoxic effects on the GMC in renal calculus mice by promoting the apoptosis
of GMC and the NF-κB expression in renal calculus mice.
Dense Uniformed Joints Between Molybdenum Disilicides and Stainless Steel Powders and Their Welding Behavior
Authors: Liu W. , Zhang C. , Yan X. , Mei B. Z. , Huang X. D. , Wang P. C. , Teng Y. Y. , Lin L. , Lei S. Y.
Published: February 2022

The dense uniformed joints between molybdenum disilicides (MoSi2) and stainless steel powders were prepared using the spark plasma sintering (SPS) technique with nine graded materials and their welding behavior was investigated. The results showed that such joints can be
achieved using graded interlayers because the coefficient of thermal expansion (CTE) of each interlayer closely matched over a wide temperature range. Furthermore, the compatibility between the graded interlayers prevented MoSi2 with low toughness from the occurrence of microcracks
resulted from the residual stresses formed during cooling of the joint. Moreover, the 9-layer joint with a thickness of 1.0 mm for each layer exhibited the minimum residual stress if the compositional exponent was 0.8.
From the Welfare State to the Welfare Society: A Shift in Paradigm
Authors: Gupta Asha
Published: February 2022

Covid-19 and its aftermath brought home the lesson that in future we just cannot rely on welfare state to deal with sudden outbreaks or natural calamities. We would have to empower individuals in the era of digitalisation for quick support and social solidarity. We are living in a world today where profound socio-economic, political and cultural changes are taking place due to rapid technological changes and globalisation. The 2008 fiscal crisis made it clear that the new liberal philosophy is no longer valid in early 21st century. Unless and until there is solidarity at the societal level, the woes of modern men and women cannot be mitigated effectively. This study seeks to explore the possibility of a shift in paradigm from the welfare state to the welfare society in order to deal with some of the challenges faced by the welfare states in the 21st century. It concludes by highlighting the urgent need for associating participatory society and various stakeholders in the enterprise of welfare in future. The methodology adopted is analytical, comparative and empirical.
Meaning in Life and Coping With Everyday Stressors
Authors: Ward Sarah , Womick Jake , Titova Liudmila , King Laura
Published: February 2022

Meaning in life (MIL) has been proposed to improve coping and resilience. Yet MIL’s association with coping has primarily been investigated in the context of extreme stressors and trauma, often using varied measures of MIL. Is MIL associated with varied coping strategies, coping self-efficacy, and distress in relation to commonly experienced, everyday challenges? Using diverse methodological designs, five studies (total N = 1,646) investigated the association between MIL and coping strategies/appraisals pertaining to varied challenging, stressful events. Across recalled (Studies 1 and 2), anticipated (Study 3), and experienced stressors (Studies 3–5), MIL was consistently associated with positive reinterpretation, proactive planning, coping self-efficacy, and stress. MIL was inconsistently related to threat/emotion-coping.
Cyberspace-based urban networks: Visualising and exploring China's intercity interaction from a new perspective
Authors: Zhang Zuo , Wang Zhe
Published: February 2022

The rapid urbanisation of China has increased public awareness of rising housing prices, particularly in large and medium-sized cities. The popularisation of the Internet in China has driven a shift in the public's attention to housing prices, moving from geographic space to cyberspace. Based on web search engine data using geotag, this paper attempts to create a better visualisation of the shift in the public's attention to housing prices from the perspectives of geographic space and cyberspace. Intercity interaction is also analysed in the context of cyberspace-based urban networks, through hybrid featured graphics. Specifically, data regarding public attention to housing prices are gathered (via queries data through Baidu Index) in 363 Chinese cities. The data are divided into a local city housing price attention index and an offsite city housing price attention index. Second, public attention flows are presented using origin-destination flows maps, chord diagrams and violin diagrams. These hybrid feature graphics show the interrelationship between cities and the complexity of public attention flows. This information will help us to reveal intercity interaction and the cyberspace-based urban network structure in China.
User Engagement With Mood-Related Content on the National Cancer Institute Smokefree.Gov Initiative Cessation Resources
Authors: Budenz Alexandra , Wiseman Kara P. , Keefe Brian , Prutzman Yvonne
Published: February 2022

Aims

This study aimed to examine engagement with mood-related content on the Smokefree.gov Initiative’s smoking cessation resources.

Methods

Smokefree.gov website analytics (July 2018–July 2019) were analyzed for user interactions with mood content on informational webpages and interactive self-assessment tools (mood quizzes, smoking quit plans). We also examined mood feature engagement (texting or pressing a command button for mood support) among text program and app users (July 2018–July 2019).

Results

Mood webpage views comprised 1.5% of all Smokefree.gov webpage views. Depression quizzes represented 82.9% of quiz completions, and stress quizzes represented 0.4% of quiz completions. Stress, anxiety, and low mood were the most reported smoking triggers on quit plans. Approximately 7,000 text program users and 3,000 app users sought real-time mood support.

Conclusions

Given the importance of mood management in the smoking cessation process these findings demonstrate promising opportunities to increase the reach of mood support resources.
Re-visiting the Armey Curve Hypothesis: An Empirical Evidence from India
Authors: Jain Neha , Sinha Niharika
Published: February 2022

The present study aims to examine the relationship between government size and economic growth in India for the period from 1961 to 2018. Additionally, as a novel contribution, the current study also attempts to examine the existence of Armey curve and estimate the threshold level of government size in India. The empirical estimation uses time series analysis and employs quadratic ordinary least squares (OLS) function and autoregressive distributed lag (ARDL) bound testing approach to co-integration to examine the association between the variables. The result of the study confirms a long-run significant positive impact of government size on economic growth. The present study also finds the existence of Armey curve and supports the Armey curve hypothesis in India. There exists a positive impact of government size till the threshold level, and beyond the threshold level, the coefficient of economic growth tends to decrease. The estimated optimal government size is 11.89% for India; this shows that, currently, the government spends less than the optimum amount. It implies that India operates somewhere on the positive slope of the Armey curve, and there is a scope for the government to expand its size further. However, the findings of the study also suggest that a large size of the government can be harmful for the efficiency of economic growth; thus, adjusting the government at its optimum is crucial to the economy.

JEL Classifications: B23, C01, C87, H11, H50, O47
European Stroke Organisation – European Society for Minimally Invasive Neurological Therapy expedited recommendation on indication for intravenous thrombolysis before mechanical thrombectomy in patients with acute ischaemic stroke and anterior circulation large vessel occlusion
Authors: Turc Guillaume , Tsivgoulis Georgios , Audebert Heinrich J. , Boogaarts Hieronymus , Bhogal Pervinder , De Marchis Gian Marco , Fonseca Ana Catarina , Khatri Pooja , Mazighi Mikaël , Pérez de la Ossa Natalia , Schellinger Peter D. , Strbian Daniel , Toni Danilo , White Philip , Whiteley William , Zini Andrea , van Zwam Wim , Fiehler Jens
Published: February 2022

Six randomized controlled clinical trials have assessed whether mechanical thrombectomy (MT) alone is non-inferior to intravenous thrombolysis (IVT) plus MT within 4.5 hours of symptom onset in patients with anterior circulation large vessel occlusion (LVO) ischaemic stroke and no contraindication to IVT. An expedited recommendation process was initiated by the European Stroke Organisation (ESO) and conducted with the European Society of Minimally Invasive Neurological Therapy (ESMINT) according to ESO standard operating procedure based on the GRADE system. We identified two relevant Population, Intervention, Comparator, Outcome (PICO) questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence and wrote evidence-based recommendations. Expert opinion was provided if insufficient evidence was available to provide recommendations based on the GRADE approach. For stroke patients with anterior circulation LVO directly admitted to a MT-capable centre (‘mothership’) within 4.5 hours of symptom onset and eligible for both treatments, we recommend IVT plus MT over MT alone (moderate evidence, strong recommendation). MT should not prevent the initiation of IVT, nor should IVT delay MT. In stroke patients with anterior circulation LVO admitted to a centre without MT facilities and eligible for IVT ≤4.5 hrs and MT, we recommend IVT followed by rapid transfer to a MT capable-centre (‘drip-and-ship’) in preference to omitting IVT (low evidence, strong recommendation). Expert consensus statements on ischaemic stroke on awakening from sleep are also provided. Patients with anterior circulation LVO stroke should receive IVT in addition to MT if they have no contraindications to either treatment.
Repeated dose budesonide/formoterol compared to salbutamol in adult asthma: a randomised crossover trial
Authors: Kearns Nethmi , Bruce Pepa , Williams Mathew , Doppen Marjan , Black Melissa , Weatherall Mark , Beasley Richard
Published: February 2022

Background

Our objective was to determine the comparative bronchodilator, systemic β2-agonist, cardiovascular and adverse effects of salbutamol 200 µg and budesonide/formoterol 200/6 µg when taken repeatedly in stable asthma.

Methods

This open-label, crossover, single-centre, controlled trial randomised adults with asthma to different orders of two treatment regimens: salbutamol 200 µgviametered-dose inhaler at 0, 30, 60 and 90 min, then salbutamol 2.5 mgvianebuliser at 120, 140, 160 and 420 min; or budesonide/formoterol 200/6 µg one actuationviaTurbuhaler at 0, 30, 60 and 90 min, then two actuations at 120, 140, 160 and 420 min. The primary outcome measure was forced expiratory volume in 1 s (FEV1) after 180 min. Secondary outcomes included repeat measures of FEV1, serum potassium, heart rate and adverse events

Results

Of 39 patients randomised, two withdrew due to adverse events (QTCFprolongation and T-wave abnormalities) after the first intervention with salbutamol. The mean±sdchange from baseline FEV1180 min after randomisation for salbutamol and budesonide/formoterol regimens was 0.71±0.46 L (n=38) and 0.58±0.45 L (n=37), respectively, with a mean±sdpaired difference of −0.10±0.40 L (n=37) and a model-based estimated difference of −0.12 (95% CI −0.25–0.02) L (p=0.088). In the main secondary analysis, salbutamol resulted in significantly greater FEV1from 30 to 240 min, but lesser FEV1at 360 and 420 min. Salbutamol resulted in a significantly lower serum potassium, and a higher heart rate and number of adverse events.

Conclusions

The comparative bronchodilator responses of repeated administration of salbutamol 200 µg and budesonide/formoterol 200/6 µg differed depending on the time of measurement. Salbutamol caused greater systemic β2-agonist and cardiovascular effects and more adverse events.
The experiences of people with type 2 diabetes in communicating with general practitioners in China – a primary care focus group study
Authors: Yao Mi , Zhang Dong-ying , Fan Jie-ting , Lin Kai , Haroon Shamil , Jackson Dawn , Li Hai , Chen Wei , Cheng Kar Keung , Lehman Richard
Published: February 2022

Background

With the implementation of health care reforms in China, primary care is on a journey to provide care for most patients with type 2 diabetes. While Chinese general practitioners (GPs) have described challenges in communication with diabetes patients in their daily practice, little is known about patients’ experiences in communicating with their GPs.

Methods

Five focus groups (of 4–5 participants each) were used to explore views from patients with type 2 diabetes. Purposive sampling was used to recruit a spread of participants from general practices in Guangzhou city, China. Focus groups were audio-recorded, transcribed, and thematically analyzed using the Framework Method.

Results

Ten males and 12 female patients from five general practices participated in focus group discussions, with a mean age of 57.3 years and 7.3 years of diabetes duration. Five main themes emerged: patients’ understanding about diabetes, diabetes medication, communication with GPs, physician-patient relationships, and healthcare systems and context. Patients generally searched for information on the internet, but they weren’t always sure if it was trustworthy. Several communication needs were described by diabetes patients, such as explanation of blood glucose monitoring, medication information support, communication in the risk of diabetes complications and cardiovascular disease, and language barriers. Communication was frequently brief and not tailored to their concerns, and some described being scolded or panicked by GPs. Participants acknowledged the pressures within the health system, such as short consultation times, an incoherent GP-hospital interface and high demand.

Conclusions

Key issues from the patients’ perspective for the development of primary care based management of diabetes in China were identified. People with type 2 diabetes require more access to trustworthy diabetes information and wish for better channels of communication with their GPs. Strategies may be required to improve GPs’ communication skills with their patients that also consider the context of the wider health system environment in China.
Inflammatory cloacogenic polyps in children: diagnostic yield of rectal retroflexion during colonoscopy
Authors: Kim You Ie , Joo Jung Yeon , Yang Hye Ran
Published: February 2022

Background and aims

Inflammatory cloacogenic polyps (ICPs) are inflammatory lesions occurring around the anal transitional zone. These are rare in the pediatric population, and most reported cases are found in adults. Therefore, this study aimed to evaluate the usefulness of rectal retroflexion (RR) during colonoscopy in detecting ICPs in children.

Methods

A total of 1837 colonoscopies were performed in 1278 children between September 2003 and August 2020 at the Seoul National University Bundang Hospital. The laboratory test results and colonoscopic and histopathological findings were retrospectively reviewed. ICP was detected using the RR and was diagnosed based on the histologic findings of the polyp.

Results

A total of 69 patients were diagnosed with juvenile polyps (n = 62) or ICP (n = 7), with the latter being detected through RR. All children with ICP were diagnosed from 2013 onwards when RR during colonoscopy came to be routinely performed in our medical center. The patients with ICP were older at diagnosis and more associated with a family history of colorectal polyps than JP. Stool occult blood and the polyps’ endoscopic characteristics, such as number, location, volume, and shape, significantly varied between the two groups. Additionally, there was a statistically significant difference in the polypectomy method. During the long-term follow-up, there was no recurrence of ICP.

Conclusions

Due to their location at the anorectal junction, ICPs may be overlooked during colonoscopy, leading to misdiagnosis. Therefore, a retroflexion view during colonoscopy may help detect ICPs in pediatric patients, especially those presenting with hematochezia.
Immunovirological discordance among female sex workers who start antiretroviral therapy in Burkina Faso
Authors: Bazié Wilfried Wenceslas , Somé Diane Yirgnur , Traoré Isidore Tiandiogo , Sanon Anselme , Konaté Issouf , Tassembedo Souleymane , Taofiki Ajani Ousmane , Kania Dramane , Ouédraogo Abdoulaye , Vuylsteke Bea , Gilbert Caroline , Meda Nicolas , Ouédraogo Abdoul Salam , Nagot Nicolas
Published: February 2022

Background

In people living with HIV/AIDS (PLWHA), initiation of antiretroviral therapy (ART) leads to sustained effective suppression of viral replication and increasing CD4 + T cell count. However, a fraction of ART-treated patients still fail to reach adequate CD4 + T cell number despite a suppressed viral load (VL), and this phenomenon is defined as immunovirological discordance (IVD). In Africa, several studies have reported immunovirological outcomes of antiretroviral therapy, but little is known about IVD occurrence in Female sex workers (FSW). This study aimed to assess the prevalence of IVD and associated factors among a cohort of HIV infected FSW in Burkina Faso.

Methods

We conducted a cohort study from December 2003 to October 2016. Immunovirological discordance was defined as CD4 + T cell gain < 100 cells/µL despite a suppressed VL (VL < 1000 copies/mL) 12 months after ART initiation. The CD4 + T cells were counted using BD FACSCount™ System and point of care Pima™ CD4 + Analyzer. HIV-1 RNA was quantified by real-time polymerase-chain-reaction assay with the use of the ABI 7000 system. We conducted a logistic regression to identify factors associated with discordant responses.

Results

Among the 123 HIV-1 infected FSW having at least 12 months follow-up on ART, 105 (85.4%) achieved HIV-1 RNA suppression. Among the latter 25 gained less than 100 CD4 + T cells within 12 months follow-up. The IVD rate was 23.8% (95%CI 16.04%–33.11%). After adjustment for age, WHO clinical stage and ART regimen including nucleoside/nucleotide reverse transcriptase inhibitors, only baseline CD4 + T cell count between 200 to 350 cells/µL (adjusted OR: 4.15; 95%CI 1.13–15.22) and 350 to 500 cells/µL (adjusted OR: 17.50; 95%CI 2.68–114.31) remain significantly associated with IVD occurrence.

Conclusions

Immunovirological discordance response was common in FSW with proportions close to those observed in the general population. A diagnosis and personalized follow-up of patients who do not achieve full immune reconstitution would make it possible to avoid complications in terms of morbidity and mortality.
Uncovering potential genes in colorectal cancer based on integrated and DNA methylation analysis in the gene expression omnibus database
Authors: Wang Guanglin , Wang Feifei , Meng Zesong , Wang Na , Zhou Chaoxi , Zhang Juan , Zhao Lianmei , Wang Guiying , Shan Baoen
Published: February 2022

Background

Colorectal cancer (CRC) is major cancer-related death. The aim of this study was to identify differentially expressed and differentially methylated genes, contributing to explore the molecular mechanism of CRC.

Methods

Firstly, the data of gene transcriptome and genome-wide DNA methylation expression were downloaded from the Gene Expression Omnibus database. Secondly, functional analysis of differentially expressed and differentially methylated genes was performed, followed by protein-protein interaction (PPI) analysis. Thirdly, the Cancer Genome Atlas (TCGA) dataset and in vitro experiment was used to validate the expression of selected differentially expressed and differentially methylated genes. Finally, diagnosis and prognosis analysis of selected differentially expressed and differentially methylated genes was performed.

Results

Up to 1958 differentially expressed (1025 up-regulated and 993 down-regulated) genes and 858 differentially methylated (800 hypermethylated and 58 hypomethylated) genes were identified. Interestingly, some genes, such as GFRA2 and MDFI, were differentially expressed-methylated genes. Purine metabolism (involved IMPDH1), cell adhesion molecules and PI3K-Akt signaling pathway were significantly enriched signaling pathways. GFRA2, FOXQ1, CDH3, CLDN1, SCGN, BEST4, CXCL12, CA7, SHMT2, TRIP13, MDFI and IMPDH1 had a diagnostic value for CRC. In addition, BEST4, SHMT2 and TRIP13 were significantly associated with patients’ survival.

Conclusions

The identified altered genes may be involved in tumorigenesis of CRC. In addition, BEST4, SHMT2 and TRIP13 may be considered as diagnosis and prognostic biomarkers for CRC patients.
Physical (in)activity, and its predictors, among Brazilian adolescents: a multilevel analysis
Authors: Gomes Thayse Natacha , Thuany Mabliny , dos Santos Fernanda Karina , Rosemann Thomas , Knechtle Beat
Published: February 2022

Background

Physical activity is a multifactorial trait, determined by both individual and environmental characteristics, it seems relevant to understand the determinants related to youth guidelines accomplishment. The present study aimed to verify the differences between the Brazilian federative units regarding to the prevalence of youth physical activity guidelines accomplishment and to investigate the determinants related to the inter-individual differences in this accomplishment.

Methods

Sample comes from the 2015 Brazilian National School Health Survey (PeNSE), comprising 99,570 adolescents (51,527 girls, 13-17y), enrolled in 3039 schools. Adolescents reported the time they spend in moderate-to-vigorous physical activity daily, and they were categorized as active or inactive, if the guidelines were achieved, or not, respectively, and multilevel statistical analyses were used, including both child and school-level variables. Multilevel Binomial model was computed in the SuperMix software.

Results

The majority of the adolescents did not comply with the physical activity guidelines daily, where Bahian children complied the least, while those from Amazonas, Tocantins, and Mato Grosso do Sul complied the most. Boys (OR: 2.305; 95%CI: 2.277-2.334), older adolescents (OR: 1.044; 95%CI: 1.036-1.051), and those who spent more time in active travelling to/from school (OR: 1.001; 95%CI: 1.001-1.001) complied more the physical activity guidelines. At the school level, adolescents from larger schools (OR: 0.957; 95%CI: 0.928-0.986) tended to comply less with the guidelines.

Conclusion

Significant differences between Brazilian federative units in youth daily physical activity guidelines compliance were observed, highlighting the role of individual but also environmental constraints in the Brazilian adolescents’ engagement in physical activity.
The economic and health burden of stroke among younger adults in Australia from a societal perspective
Authors: Tan Elise , Gao Lan , Collier Janice M. , Ellery Fiona , Dewey Helen M. , Bernhardt Julie ,   The AVERT Trial Collaboration Group, Moodie Marj
Published: February 2022

Background

To estimate the short term (5 years) and long term (30 years) economic burden of stroke among younger adults (18–64 years), and to calculate the loss of health-related quality of life in these individuals, in Australia.

Methods

A Markov microsimulation model was built to simulate incidence of stroke among younger adults in Australia. Younger adults with stroke commenced in the model via health states defined by the modified Rankin Scale at 12 months from the AVERT study (A Very Early Rehabilitation Trial), and transitioned through these health states. Costs in Australian dollars (AUD) were measured from a societal perspective for a 2018 reference year and categorised into medical, non-medical and indirect costs. Probabilistic sensitivity analyses were performed to test the robustness around the cost of illness estimates. The loss of health-related quality of life due to stroke among younger adults was calculated by determining the difference in estimated quality-adjusted life years (QALYs) between the stroke population and the general population. This was determined by multiplying the predicted remaining life years for the modelled stroke cohort and the age-matched general population, by their corresponding age-dependent utilities.

Results

The economic burden of stroke among younger adults was estimated to be AUD2.0 billion over 5 years, corresponding to a mean of $149,180 per stroke patient. Over 30 years, the economic impact was AUD3.4 billion, equating to a mean of $249,780 per case. Probabilistic sensitivity analyses revealed a mean cost per patient of $153,410 in the short term, and a mean cost per patient of $273,496 in the long term. Compared to the age-matched general population, younger adults with stroke experienced a loss of 4.58 life years and 9.21 QALYs.

Conclusions

The results of our study suggests high economic and health burden of stroke among younger adults and highlights the need for preventive interventions targeting this age group.

Trial registration

ACTRN12606000185561, retrospectively registered.
Cases of intervention refusal encountered by public health nurses in Japan and characteristics of their support– qualitative analysis of described mother-child and elderly cases
Authors: Okamoto Reiko , Kiya Misaki , Koide Keiko , Tanaka Miho , Kageyama Masako
Published: February 2022

Background

The purpose of this study is to clarify the actual situation of the cases and the characteristics of support, focusing on mothers and their children, and elderly persons among the cases of intervention refusal encountered by public health nurses (PHNs) in Japan.

Methods

The data were descriptions of intervention refusal cases that were freely described by PHNs working for prefectural and municipal governments in questionnaire surveys nationwide. The characteristics of the cases and the support were categorized according to the situation of the case, and the number of descriptions was summarized and interpreted.

Results

The results revealed that interventions involving mothers and children were refused in most of by mother or parents. The refusals were related to child abuse, parental mental illness, obsessiveness, and complex backgrounds. The actual status of intervention refusal in elderly persons, interventions are frequently refused by elderly persons themselves in the case of self-neglect and by family members living with the elderly in the case of abuse. The refusals were related to mental disorders or dementia and living alone. In both cases, PHNs provided support in collaboration with multi-disciplinary and multi-agencies, and attempts were made to alleviate the situation of refusal to intervene, from detecting cases through contact during home visits and in other settings, and by coordinating with appropriate team members as required.

Conclusions

It is suggested that PHNs need to acquire practical skills depending on the characteristics of the case to cope with critical situations throughout the process of engagement.
SCOPE: safer care for older persons (in residential) environments—a pilot study to enhance care aide-led quality improvement in nursing homes
Authors: Doupe Malcolm , Brunkert Thekla , Wagg Adrian , Ginsburg Liane , Norton Peter , Berta Whitney , Knopp-Sihota Jennifer , Estabrooks Carole
Published: February 2022

Background

Nursing home residents require daily support. While care aides provide most of this support they are rarely empowered to lead quality improvement (QI) initiatives. Researchers have shown that care aide-led teams can successfully participate in a QI intervention called Safer Care for Older Persons in Residential Care Environments (SCOPE). In preparation for a large-scale study, we conducted a 1-year pilot to evaluate how well coaching strategies helped teams to enact this intervention. Secondarily, we measured if improvements in team cohesion and communication, and resident quality of care, occurred.

Methods

This study was conducted using a prospective single-arm study design, on 7 nursing homes in Winnipeg Manitoba belonging to the Translating Research in Elder Care research program. One QI team was selected per site, led by care aides who partnered with other front-line staff. Each team received facilitated coaching to enact SCOPE during three learning sessions, and additional support from quality advisors between these sessions. Researchers developed a rubric to evaluate how well teams enacted their interventions (i.e., created actionable aim statements, implemented interventions using plan-do-study-act cycles, and used measurement to guide decision-making). Team cohesion and communication were measured using surveys, and changes in unit-level quality indicators were measured using Resident Assessment Instrument-Minimum Data Set data.

Results

Most teams successfully enacted their interventions. Five of 7 teams created adequate-to-excellent aim statements. While 6 of 7 teams successfully implemented plan-do-study-act cycles, only 2 reported spreading their change ideas to other residents and staff on their unit. Three of 7 teams explicitly stated how measurement was used to guide intervention decisions. Teams scored high in cohesion and communication at baseline, and hence improved minimally. Indicators of resident quality care improved in 4 nursing home units; teams at 3 of these sites were scored as ‘excellent’ in two or more enactment areas, versus 1 of the 3 remaining teams.

Conclusions

Our coaching strategies helped most care aide-led teams to enact SCOPE. Coaching modifications are needed to help teams more effectively use measurement. Refinements to our evaluation rubric are also recommended.
Using ELECTRE-TRI and FlowSort methods in a stock portfolio selection context
Authors: Emamat Mir Seyed Mohammad Mohsen , Mota Caroline Maria de Miranda , Mehregan Mohammad Reza , Sadeghi Moghadam Mohammad Reza , Nemery Philippe
Published: February 2022

In recent years, multi-criteria sorting problems have become an interesting topic for researchers working on multi-criteria decision-making. ELimination and Choice Expressing REality (ELECTRE)-TRI and FlowSort are well-known approaches suggested for such a classification. The current study aimed to implement ELECTRE-TRI and FlowSort methods in the stock portfolio selection (SPS) as one of the most popular and important decision-making subjects and compare the outcomes of each method to understand how these methods perform in SPS problems. In this study, the best–worst method was applied to determine the weights of criteria. Four approaches for ELECTRE-TRI and 15 approaches for FlowSort were considered. Finally, 19 different approaches were considered to select stocks from a large pool of stocks. Results indicated that the model parameter should be properly defined to minimize inconsistencies and improve the power of the model.
Venogenic erectile dysfunction: diagnosis on computed tomography cavernosography and endovascular treatment using an anterograde access via deep dorsal penile vein
Authors: Hoppe Hanno , Diehm Nicolas
Published: February 2022

Background

The underlying etiologies of erectile dysfunction may be manifold. Among them, vasculogenic etiologies are of increasing relevance and are not strictly limited to the elderly population. According to recent study, venogenic erectile dysfunction appears to be even more relevant than arteriogenic erectile dysfunction. Venogenic erectile dysfunction due to venous leakage causes insufficient penile blood retention. Proper diagnosis of venous leakage should include both color Doppler flow analysis and computed tomography cavernosography for adequate patient selection and treatment planning. Besides surgical ligation of penile draining veins, endovascular treatment methods may demonstrate more promising results. Especially endovascular embolization of venous leakage using an anterograde access via deep dorsal penile veins appears to be more beneficial for patients’ clinical outcome and awareness of this technique should be raised among endovascular interventionalists.

Case presentation

A 47-year-old man was diagnosed with venogenic erectile dysfunction due to venous leakage on color Doppler flow analysis and computed tomography cavernosography. He did not respond to PDE-5-inhibitors. This patient demonstrated major venous leakage of paired deep dorsal penile veins via periprostatic veins and internal pudendal veins draining into both iliohypogastric veins. This patient’s venous leak was treated with endovascular embolization using an anterograde access via deep dorsal penile veins.

Conclusion

This patient’s erectile dysfunction due to venous leakage, based on findings in color Doppler flow analysis and computed tomography cavernosography, was embolized using an anterograde access via deep dorsal penile veins as a minimally-invasive endovascular treatment option.