bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Secondary Neoplasm Following Allogeneic Hematopoietic Stem Cell Transplant: Mixed Donor-Recipient Primitive Mesenchymal Proliferation of the Liver
Authors: Earl Brian , Yang Zi Fan , Rao Harini , Cheng Grace , Wall Donna , Ngan Bo-Yee
Published: March 2021

Post-hematopoietic stem cell transplant secondary solid neoplasms are uncommon and usually host-derived. We describe a 6-year-old female who developed a mixed donor-recipient origin mesenchymal stromal tumor-like lesion in the liver following an unrelated hematopoietic stem cell transplant complicated by severe graft-versus-host disease. This lesion arose early post-transplant in association with hepatic graft-versus-host disease. At 12 years post-transplant, the neoplasm has progressively shrunken in size and the patient remains well with no neoplasm-associated sequelae. This report characterizes a novel lesion of mixed origin post-transplant and offers unique insights into the contribution of bone marrow-derived cells to extra-medullary tissues.
The association of vitamin-D level with catheter-related-thrombosis in hemodialysis patients: A data mining model
Authors: Rahimi Zhaleh , Abdolvand Neda , Sepehri Mohammad Mehdi , Khavanin Zadeh Morteza
Published: March 2021

Purpose:

This study aims to investigate the association of different risk factors including vitamin-D level with catheter-related-thrombosis in hemodialysis patients by applying data mining techniques.

Methods:

This study used the retrospectively approach and was done based on the CRISP-DM framework. The data of 1048 hemodialysis patients of Hasheminejad Kidney Center whose first catheterization was between 2014 and 2019 was used for analysis. In this study, patients with a previous history of deep venous thrombosis, thrombophilic condition, and undergone anticoagulant therapy were excluded. The decision tree J48 in WEKA software was used for modeling. The K-fold cross-validation method was also used to evaluate the classification performance. Finally, the model was evaluated by using Confusion Matrix and F-Measure.

Results:

The approved model was accurate in 70.3% of the predictions, and it demonstrated an association between patients’ vitamin-D range and catheter-related-thrombosis.

Conclusion:

The results indicated that in hemodialysis patients without the history of cancer or high blood pressure, vitamin-D had a significant impact on catheter related thrombosis.
Port malposition in the azygos vein resulting in a veno-broncho and broncho-esophageal fistula: A case report
Authors: Frias Patrick F , Cross Chloe G , Kaufman Claire S , Quencer Keith B
Published: March 2021

We present a case of a port malposition into the azygos vein resulting in both a broncho-esophageal and veno-bronchial fistula. While complications of central venous catheter malposition into the azygos vein are well documented in literature, these unique complications have not yet been described. This case underscores how utilizing state of the art technology like intra-cavity electrocardiography rather that reliance on fluoroscopy can help eliminate catheter malposition and its potential catastrophic consequences.
The art of hinting and allusions in Sámi literature: a reading of Jovnna-Ánde Vest’s novel trilogy Árbbolaččat
Authors: Fredriksen Lill Tove
Published: March 2021

Various means for levels of hinting at things or making allusions in the interaction between people are part of traditional Sámi knowledge and communication, aesthetics and interpersonal communication. A reading of the novel trilogy Árbbolaččat ( The Heirs) (1997–2005), written by the Sámi novelist Jovnna-Ánde Vest, shows how the use of hinting and allusions is depicted as birgengoansta (coping skills), an essential art to master in the life of a small community, as a way to deliver a message in a softer tone rather than saying things directly and as a way to avoid conflicts. I especially emphasize the contextual part of the yoik tradition (the ancient Sámi chanting tradition) and how it has functioned as a social device in the Sámi community. It explains the individual’s place within the community, and what people’s worldview and life philosophy tell us about life in a small Sámi village.
Confronting the contradictions between Western and Indigenous science: a critical perspective on Two-Eyed Seeing
Authors: Broadhead Lee-Anne , Howard Sean
Published: March 2021

In the mid-2000s, the term Two-Eyed Seeing was introduced by Mi’kmaw Elder Albert Marshall to suggest the complementarity of Western and Indigenous sciences. The concept has since been adopted and applied in a diverse range of research. This article examines the latent tension in Two-Eyed Seeing between a desire to foster dialogue—in order, ideally, to generate a trans-cultural “third space” of understanding—and the denial or suppression of major contradictions between predominantly wholistic Indigenous and predominantly reductionist Eurocentric worldviews. Examples are considered of both fruitful Two-Eyed Seeing collaborations and areas where antithetical approaches cannot be combined, for reasons that a more critical application of the Two-Eyed Seeing concept could help make clear. Conversely, revisioned in this way, Two-Eyed Seeing can deepen appreciation of those areas of Western science, such as the delicate empiricism of Goethean science, authentically resonant with Indigenous approaches.
Codeswitching within prepositional phrases: Effects of switch site and directionality
Authors: Soesman Aviva , Walters Joel
Published: March 2021

Aims and Research Questions:

Codeswitching (CS) was investigated among English-Hebrew bilingual preschool children in a sentence repetition task focusing on switching at different points in prepositional phrases (PPs). We asked the extent to which sentence repetition accuracy differed (1) as a function of the switch site in the PP and (2) as a function of directionality, English-to-Hebrew versus Hebrew-to-English CS.

Design/Methodology:

English/first language (L1)-Hebrew/second language (L2), sequential bilingual children ( N = 65), ages 5;5–6;5, participated. Thirty-six English and 36 Hebrew stimulus sentences were matched for semantic content and syntax. English stimulus sentences contained switches to Hebrew; Hebrew stimuli contained switches to English. Six ‘switch’ conditions were examined: a single codeswitched noun (N), a determiner–noun switch (DET+N), a codeswitched preposition (P), a preposition–determiner switch (P+DET), a switch of the entire PP (P+DET+N), and a no-switch condition.

Data and Analysis:

Audio recordings were transcribed and coded. Full sentence repetition was coded as correct/incorrect. The number of errors and the proportion of CS errors were computed. A 6 × 2 repeated-measures analysis of variance examined the effects of switch site within the PP and directionality (L1-to-L2 versus L2-to-L1).

Findings/Conclusions:

Accuracy was highest for the non-switched, N, and P+DET+N conditions. Accuracy was lowest for DET+N switches in English sentences, and for P switches in Hebrew sentences, and these two conditions showed the highest proportion of CS errors. The findings show evidence for a hierarchy of processing costs and directionality differences, which are interpreted in terms of contrastive typological features, particularly definiteness marking in the two languages, English by a free morpheme, and Hebrew by a bound clitic.
Adolescents with substance abuse problems in outpatient treatment: A one-year prospective follow-up study
Authors: Anderberg Mats , Dahlberg Mikael , Wennberg Peter
Published: March 2021

Aim:

There is a lack of knowledge about how adolescents with substance abuse problems manage after taking part in treatment. It is also difficult to perform traditional follow-up studies with this group. This article presents the outcome of a prospective study of 455 adolescents who underwent outpatient treatment, based on data taken from official registers. It aims to describe and analyse indications of continued use of substance (CUS) and how various risk and protective factors predict outcomes after initiated treatment at a Maria clinic in Sweden.

Design:

The study is based on structured interviews at intake, and the data that indicated CUS were taken from several different national registers. The analyses included descriptive data and bivariate associations, logistic regressions and a CHAID analysis.

Results:

Almost two thirds of the adolescents have no indication of CUS at one-year follow-up. The ten studied risk factors independently were weak predictors of CUS and it was instead the accumulation of risk factors that were linked to a negative outcome.

Conclusion:

The majority of adolescents who start outpatient treatment for substance abuse problems return to a lesser extent in registers that may indicate a continued problem with alcohol and drugs one year later. A concentration of more than five risk factors appears to be associated with a registration. The study also provides an example of an alternative method for following up adolescents with alcohol and drug abuse problems.
The construction of meaning in alcohol addiction: A narrative study of socially excluded people’s stories about alcohol
Authors: Eriksen Line Lund , Hoeck Bente
Published: March 2021

Aim:

The aim of this study is to illuminate the experience of living with alcohol addiction from the perspective of socially excluded people outside the healthcare system. It presents the results from a qualitative study of five personal narratives from socially excluded men living with alcohol addiction in Denmark. The group is rarely heard and often underprioritised in the Danish healthcare system, contributing to the social inequality in public health. Therefore, giving them a voice will contribute important insight into the individuals’ own experiences and understandings of their situations.

Design:

Five semi-structured interviews were conducted with socially excluded people living with alcohol addiction. Positioned in a narrative methodology, the focus of the study was on the construction of meaning on a structural, performative and thematic level of the narratives of addiction, as told by the person with addiction.

Results:

Social identities as “alcoholics” were constructed across the narratives; however, there was a distinct difference between the different informants’ own positions. Some constructed meaning in their addiction by including an identity as a stereotypical “drunk” defined as a certain type of unhealthy, unkempt, low-income addict. Others distanced themselves from this identity. Furthermore, alcohol was presented with a double meaning, being associated with positive memories and relationships as well as negative consequences and bad experiences, complicating a potential wish for sobriety.

Conclusions:

The study illuminates the individual perspectives in the identity construction of socially excluded people with alcohol addiction. When relating to the characteristics of the stereotypical “drunk”, the individuals’ self-perspectives may differ from the common understanding. The constructed identities reflected the participants’ lived experience with addiction, with alcohol as an unavoidable life companion, consequently creating individual meaning in one’s addiction.
Graduating political crisis and violence in the discourse of history: The role of Spanish suffixes
Authors: Oteíza Teresa , Castro Claudia , Pinuer Claudio
Published: March 2021

This article offers an analysis of the Spanish derivative morphology potential for graduating attitudinal meanings regarding the expression of political crisis and of contested meanings of human rights violations in the discourse of recent Chilean History. This study is framed in the typological principles of Systemic Functional Linguistics and in the appraisal system, particularly in the sub-system of graduation. The analysis demonstrates on one hand the productive role of the suffixes -ada and -azo when graduating attitudinal meanings regarding the expression of social and political crisis in the discourse of history. These suffixes can graduate at the rank of the morpheme, word and group and also be involved in an inter-stratal tension that is functioning as an experiential grammatical metaphor that works in combination with a lexical metaphor intensifying time and events in an incongruent manner. On the other hand, the analysis shows that when dealing with traumatic and argued meanings of state terror, extreme degree suffixes -ísimo/a/s play a critical role in the intensification of qualities and in the quantification as amount and extent in a congruent manner. Spanish suffixes can graduate by sub-modification in the lower rank of a word structure instead of at the group structure contributing to the building of constellation of patterns of evoked and inscribed interpersonal meanings in the discourse.
Two dialogical theorisations of children’s encounters in more-than-human worlds involving metaphor
Authors: Lawrence Penny
Published: March 2021

This article generates two dialogical theorisations of young children’s encounters in more-than-human worlds involving metaphor. The first theorisation devises metaphor as an entry point into the dialogues of more-than-humans and includes rare attention to metaphors as multimodal intra-action. The second theorisation provides an alternative to Linell’s view that relation with non-humans would be merely a metaphorical extension of dialogue, ‘as if’ they were human. Instead, a new model recognises the potential for dialogue as a relational engagement with otherness in a more-than-human-centric approach. The theorisations underpin interpretations of a range of early childhood play episodes with protagonists: sand, paper, tissue and plastic. The materials are beyond any assumed instrumental interaction waiting to be acted upon by humans; rather, they can be in social and material worlds, meeting places, of more-than-humans intra-acting. Penny Lawrence has proposed attending to the quality of relation in dialogues. The significance of these theorisations is for more-than-human study of any encounter to take account of the potential for dialogue, and for studies of dialogue to take account of the more-than-human. In particular, the processes of blending in multimodal metaphorical co-constitutive processes offer notable insights into intra-actions within more-than-human dialogues.
Colour stability of 3D-printed resin orthodontic brackets
Authors: Haynie Allison S , English Jeryl D , Paravina Rade D , Moon Audrey , Hanigan James , Abu Al Tamn Mustafa A , Kasper F Kurtis
Published: March 2021

Objective:

To evaluate the colour stability of polymeric resins that could be used to 3D-print orthodontic brackets.

Design:

In vitro, laboratory study

Materials and Methods:

Disc-shaped specimens were fabricated via 3D printing using three resins: Dental LT; Dental SG; and Clear. Five conditions were evaluated for each resin (n = 10 per treatment per resin) to assess its corresponding effect on colour and translucency: immersion in (1) red wine, (2) coffee, (3) tea and (4) distilled water (control), and (5) exposure to accelerated aging. Colour and translucency measurements were made before and after exposure using a spectrophotometer. Mean colour differences (ΔE00) and changes in translucency parameter (ΔTP00) were calculated for each sample using the CIEDE2000 colour difference formula.

Results:

Statistically significant effects of the resin material, the treatment condition and interactions effects of material and condition were observed for ΔE00 and ΔTP00 ( P < 0.001). The most pronounced changes in colour (ΔE00) were a result of the staining effects of wine on all three resins, ranging from 14.5 ± 0.6 to 20.8 ± 1.2. Dental LT, Dental SG and Clear resins all showed changes in colour when exposed to certain staining agents. Dental SG and Clear resins exhibited changes in colour with aging, while the colour of Dental LT resin remained stable with aging.

Conclusions:

The colour changes of the resins investigated does not support their use in 3D-printed aesthetic bracket applications.
Effects of coloured lighting on pleasure and arousal in relation to cultural differences
Authors: Lee H , Lee E
Published: March 2021

This study examined the effects of lighting colour on emotional states and the effects of ethnicity on the impact of lighting colours on emotional states, based on the Mehrabian and Russell’s emotional state model measuring pleasure, arousal and dominance. It was hypothesised that there are significant differences in pleasure and arousal among six lighting colours: red, green, blue, yellow, orange and purple and that different ethnicities (i.e. Asian and Caucasian) can influence the effects of the six lighting colours on pleasure and arousal. To test the hypotheses, an experiment was conducted in a controlled lab using a colour-changing LED lighting fixture with 82 participants. The results revealed that there were significant differences in pleasure and arousal among the six lighting colours. Ethnicity had significant effects on the impact of lighting colour on pleasure but not on arousal. Blue was the most pleasant lighting colour and showed significantly higher pleasure than red and purple. Red was the least pleasant lighting colour and showed significantly lower pleasure than all other lighting colours. Asians found red and purple lighting significantly less pleasant than all other colours and tended to feel more unpleasant when exposed to red, orange and purple lighting than Caucasians.
Why Some Students Adjust Easily While Others Can Not? Stress and Adjustment to University: Personality as Moderator
Authors: Kural Ayşe I. , Özyurt Berrin
Published: March 2021

Research has demonstrated consistently that personality and perceived stress, independently, are essential factors for university adjustment among university freshmen; however, little is known about the associations between personality, perceived stress, and adjustment together. Our primary goal was to explore the predictive utility of perceived stress for explaining university adjustment among university freshmen ( N = 290). We also tested the moderating role of personality traits and this research was embedded within a Big Five model of personality including the sixth trait for Turkish context, ‘Negative Valence’. Results addressed that only conscientiousness and negative valence moderated the perceived stress and adjustment association. Students high on negative valence and/or conscientiousness tended to experience the detrimental effect of perceived stress on university adjustment more due to their personality. These results suggested that personality might be an important factor to include in adjustment fostering interventions for freshmen at universities.
Bad Timing for Epileptic Networks: Role of Temporal Dynamics in Seizures and Cognitive Deficits
Authors: Lenck-Santini Pierre-Pascal
Published: March 2021

The precise coordination of neuronal activity is critical for optimal brain function. When such coordination fails, this can lead to dire consequences. In this review, I will present evidence that in epilepsy, failed coordination leads not only to seizures but also to alterations of the rhythmical patterns observed in the electroencephalogram and cognitive deficits. Restoring the dynamic coordination of epileptic networks could therefore both improve seizures and cognitive outcomes.
The role of orthographic cues to stress in Italian visual word recognition
Authors: Colombo Lucia , Sulpizio Simone
Published: March 2021

In this study, stress diacritics were used to investigate the processing of stress information in lexical decision. We ran two experiments in Italian, a language in which stress position is not predictable by rule and only final stress—that is, the less common pattern—is orthographically marked with a diacritic. In Experiment 1, a lexical decision task, two factors were manipulated: the stress pattern of words—antepenultimate (nondominant) and penultimate (dominant)—and the presence/absence of the diacritics, signalling the stress position. Participants were faster to categorise stimuli as words when they bear dominant than nondominant stress. However, the advantage disappeared when the diacritic was used. In Experiment 2, a same-different verification task was used in which participants had to decide if a referent word and a target were same (carota-CAROTA, /ka’rɔta/; tavolo-TAVOLO, /’tavolo/) or different. We compared two conditions requiring a “different” response, in which referent and target with dominant and nondominant stress were congruent (caròta-CAROTA; tàvolo-TAVOLO) or incongruent (càrota-CAROTA; tavòlo-TAVOLO) with the word’s stress. For words with dominant stress, “different” responses were faster in the incongruent condition than the congruent condition. This congruency effect was not observed for words with nondominant stress pattern. Overall, the data suggest that stress information is based on lexical phonology, and the stress dominance effect has a lexical base in word recognition.
Time-dependent shift of the relationship between systolic blood pressure and clinical outcome in acute lacunar stroke
Authors: Shin Dong W , Gorelick Philip B , Bae Hee-Joon ,   the Clinical Research Collaboration for Stroke in Korea (CRCS-K) Investigators
Published: March 2021

Background and aims

This study explores the relationship between systolic blood pressure during the acute period of stroke and poor functional outcome in patients with lacunar stroke, emphasizing a possible time-dependent nature of the relationship.

Methods

Based on multicenter stroke registry data, patients with acute lacunar stroke were identified, and systolic blood pressure levels at eight time points (1, 2, 4, 8, 16, 24, 48, and 72 h) after stroke onset were extracted at the 15 participating centers in South Korea. Poor functional outcome was defined as a three-month modified Rankin Scale score of 2–6. Non-linear restricted cubic spline and linear models were used for assessing the relationship at each time point.

Results

A total of 97,349 systolic blood pressure measurements of 3,042 patients were analyzed. At 1 h and 4 h after stroke onset, the relationship between systolic blood pressure and poor outcome showed a non-linear association. The nadir was 155 mmHg at 1 h and 124 mmHg at 4 h. After this time period, a higher systolic blood pressure was associated with a poorer outcome. This linear relationship weakened over time after 12 h (coefficient values of the adjusted linear models: 0.0081 at 8 h, 0.0105 at 12 h, 0.0102 at 24 h, 0.0082 at 48 h, 0.0054 at 72 h).

Conclusions

Based on our cohort of large number of lacunar stroke patients, our findings suggest that systolic blood pressure levels may follow a time-dependent course in relation to prediction of outcome at three months. The findings may be valuable for hypothesis generation in association with clinical trial development for blood pressure control in acute stroke patients.
Influence of time to endovascular stroke treatment on outcomes in the early versus extended window paradigms
Authors: Nogueira Raul G , Jovin Tudor G , Haussen Diogo C , Gupta Rishi , Jadhav Ashutov , Budzik Ronald F , Baxter Blaise , Krajina Antonin , Bonafe Alain , Malek Ali , Narata Ana Paula , Shields Ryan , Zhang Yanchang , Morgan Patricia , Bartolini Bruno , English Joey , Mohammaden Mahmoud , Frankel Michael R , Liebeskind David S , Veznedaroglu Erol ,   for the Trevo Registry and DAWN Trial Investigators
Published: March 2021

Background

The effect of time from stroke onset to thrombectomy in the extended time window remains poorly characterized.

Aim

We aimed to analyze the relationship between time to treatment and clinical outcomes in the early versus extended time windows.

Methods

Proximal anterior circulation occlusion patients from a multicentric prospective registry were categorized into early (≤6 h) or extended (>6–24 h) treatment window. Patients with baseline National Institutes of Health Stroke Scale (NIHSS) ≥ 10 and intracranial internal carotid artery or middle cerebral artery-M1-segment occlusion and pre-morbid modified Rankin scale (mRS) 0–1 (“DAWN-like” cohort) served as the population for the primary analysis. The relationship between time to treatment and 90-day mRS, analyzed in ordinal (mRS shift) and dichotomized (good outcome, mRS 0–2) fashion, was compared within and across the extended and early windows.

Results

A total of 1603 out of 2008 patients qualified. Despite longer time to treatment (9[7–13.9] vs. 3.4[2.5–4.3] h, p < 0.001), extended-window patients ( n = 257) had similar rates of symptomatic intracranial hemorrhage (sICH; 0.8% vs. 1.7%, p = 0.293) and 90-day-mortality (10.5% vs. 9.6%, p = 0.714) with only slightly lower rates of 90-day good outcomes (50.4% vs. 57.6%, p = 0.047) versus early-window patients ( n = 709). Time to treatment was associated with 90-day disability in both ordinal (adjusted odd ratio (aOR), ≥ 1-point mRS shift: 0.75; 95%CI [0.66–0.86], p < 0.001) and dichotomized (aOR, mRS 0–2: 0.73; 95%CI [0.62–0.86], p < 0.001) analyses in the early- but not in the extended-window (aOR, mRS shift: 0.96; 95%CI [0.90–1.02], p = 0.15; aOR, mRS0–2: 0.97; 95%CI [0.90–1.04], p = 0.41). Early-window patients had significantly lower 90-day functional disability (aOR, mRS shift: 1.533; 95%CI [1.138–2.065], p = 0.005) and a trend towards higher rates of good outcomes (aOR, mRS 0–2: 1.391; 95%CI [0.972–1.990], p = 0.071).

Conclusions

The impact of time to thrombectomy on outcomes appears to be time dependent with a steep influence in the early followed by a less significant plateau in the extended window. However, every effort should be made to shorten treatment times regardless of ischemia duration.
Age-related changes in the performance of bowlers in Test match cricket
Authors: Thorley Jack
Published: March 2021

Data from elite professional sports players provide a valuable source of information on human performance and ageing. Functional declines in performance have been investigated across a wide range of sporting disciplines that vary in their need for physical strength, endurance, cognitive ability and motor skills, but researchers do not always consider other sources of heterogeneity that can exist between individuals. Using information on all male bowlers to have played Test match cricket since the early 1970s, this study separated age-dependent variation in bowling performance at the population-level into within-individual and between-individual (age-class) changes. There was little evidence for senescence in bowling performance as measured via economy rate or wicket-taking ability, irrespective of the style of the bowler (fast or slow). Instead, analyses detected strong between-individual contributions to bowling performance as higher quality bowlers were able to compete at the elite level for longer, and were therefore over-represented in older age classes: how they accomplish this alongside the physical demands of Test cricket remains unresolved. Bowlers also experienced a deterioration in the last year of their Test careers. Lastly, multivariate models identified a negative correlation between slow bowlers in their economy rate and their wicket-taking ability, suggesting that in general, the most economical slow bowlers in the modern era of Test match cricket have also taken wickets at the fastest rate. The same is not true for fast bowlers, which is perhaps partly because bowling at high speed compromises accuracy and thus increases scoring opportunities for batters.
Expanding indications for endovascular thrombectomy-how to leave no patient behind
Authors: Sporns Peter B. , Fiehler Jens , Ospel Johanna , Safouris Apostolos , Hanning Uta , Fischer Urs , Goyal Mayank , McTaggart Ryan , Brehm Alex , Psychogios Marios
Published: March 2021

Endovascular thrombectomy (EVT) has become standard of care for large vessel occlusion strokes but current guidelines exclude a large proportion of patients from this highly effective treatment. This review therefore focuses on expanding indications for EVT in several borderline indications such as patients in the extended time window, patients with extensive signs of infarction on admission imaging, elderly patients and patients with pre-existing deficits. It also discusses the current knowledge on intravenous thrombolysis as an adjunct to EVT and EVT as primary therapy for distal vessel occlusions, for tandem occlusions, for basilar artery occlusions and in pediatric patients. We provide clear recommendations based on current guidelines and further literature.
From “Greater Europe” to “Greater Eurasia”: Status concerns and the evolution of Russia’s approach to alignment and regional integration
Authors: Krickovic Andrej , Pellicciari Igor
Published: March 2021

Russia’s approach to alignment and regional integration has evolved dramatically—from a focus on the West and disinterest and neglect of regional integration in the 1990s, to vigorous efforts to reintegrate the post-Soviet space under Russian leadership in the period between 2009 and 2014, to forming a “Greater Eurasia” that transcends the post-Soviet space and includes China and other non-Western powers (such as Turkey, India, and Iran) today. Status concerns are key to understanding this evolution in policy and vision as a declining Russia struggles to avoid losing great power status. Russia initially eschewed its relationships with post-Soviet states in favor of integration with Europe and the West, which seemed to offer greater status gains. When Russia failed to find a place in the Western liberal order and “Greater Europe” commensurate with its status aspirations, it shifted its attention to regional integration of the post-Soviet space, believing this would make Russia, in the words of President Putin, “one of the poles in a future multipolar world.” However, integrating the post-Soviet space proved to be an arduous task (that failed miserably in Ukraine) and did not yield the status gains Russia hoped for. The scope of Eurasian integration has now shifted to the formation of a “Greater Eurasia,” as Russia looks to gain status through its association with more dynamic rising and emerging powers.
Rapid Point-of-Care Test for Determination of C-Peptide Levels
Authors: Rao Paturi V. , Bean Eric , Nair-Schaef Dhanalakshmi , Chen Siting , Kazmierczak Steven C. , Roberts Charles T. , Nagalla Srinivasa R.
Published: March 2021

C-peptide is co-secreted with insulin and is not subject to hepatic clearance and thus reflects functional β-cell mass. Assessment of C-peptide levels can identify individuals at risk for or with type 1 diabetes with residual β-cell function in whom β cell-sparing interventions can be evaluated, and can aid in distinguishing type 2 diabetes from Latent Autoimmune Diabetes in Adults and late-onset type 1 diabetes. To facilitate C-peptide testing, we describe a quantitative point-of-care C-peptide test. C-peptide levels as low as 0.2 ng/ml were measurable in a fingerstick sample, and the test was accurate over a range of 0.17 to 12.0 ng/ml. This test exhibited a correlation of r = 0.98 with a high-sensitivity commercial ELISA assay and a correlation of r = 0.90 between matched serum and fingerstick samples.
The smoking-dyslipidaemia dyad: A potent synergistic risk for atherosclerotic coronary artery disease
Authors: Prakash Vineet , Jaker Sams , Burgan Amjad , Jacques Adam , Fluck David , Sharma Pankaj , Fry Christopher H , Han Thang S
Published: March 2021

Background

Smoking and dyslipidaemia are known individual risk factors of coronary artery disease (CAD). The present study examined the combined risk of smoking and dyslipidaemia on coronary atherosclerosis.

Methods

Coronary artery calcium (CAC), measured by cardiac CT, was used to assess the extent of CAD, which was related to smoking and dyslipidaemia using logistic regression, adjusted for age, sex, hypertension, BMI and family history of ischaemic heart disease.

Results

Seventy-one patients (46 men, 25 women: median age of 53.7yrs; IQR = 47.0–59.5) were recruited. The mean log10 CAC score in never-smokers without dyslipidaemia (reference group) was 0.37 (SD = 0.73), while the value in those with a history of smoking was 0.44 ± 0.48 (mean difference: 0.07, 95%CI:–0.67 to 0.81, p = 0.844), dyslipidaemia was 1.07 ± 1.08 (mean difference: 0.71, 95%CI: 0.24 to 1.17, p = 0.003), and both risk factors was 1.82 ± 0.64 (mean difference: 1.45, 95%CI:0.88 to 2.02, p < 0.001). For individuals in the reference group, the proportions with none, one and multiple vessel disease were 80.6%, 16.1% and 3.2%; for those with a history of smoking or with dyslipidaemia were 50.0%, 25.0% and 25.0%; and for those with both risk factors were 8.3%, 25.0% and 66.7%. Patients with a history of both risk factors had greater adjusted risks of having one- vessel disease - OR = 14.3 (95%CI = 2.1–98.2) or multiple vessel disease: OR = 51.8 (95%CI = 4.2–609.6).

Conclusions

Smoking and dyslipidaemia together are associated with high coronary artery calcification and CAD, independent of other major risk factors.
Remote certification of out-of-hospital deaths in a Canadian Province: An 8-year experience of a novel practice
Authors: Tanguay Alain , Lebon Johann , Hébert Denise
Published: March 2021

Introduction:

Certification of out-of-hospital deaths is challenging as physicians are often unavailable at the scene. In these situations, emergency medical services will generally transport the decedent to the nearest hospital. In 2011, a remote death certification program was implemented in the province of Québec, Canada. The program was managed through an online medical control center and enabled death certification by a remote physician. We sought to evaluate the implementation and feasibility of the remote death certification program and to describe the challenges we experienced.

Methods:

We retrospectively reviewed all remote death certification requests received at the online medical control center between 2011 and 2019. Data were collected from the online medical control center database and records. Feasibility was determined by evaluating the remote death certification rate.

Results:

Overall, 84.1% of remote death certification requests were realized, producing a total of 9776 death certificates. Male decedents accounted for 61.5% of remote death certification requests and were more likely than females to undergo a coroner’s investigation for cause of death (36.3% vs 20.8%, p = 0.017). Urban/mixed regions had higher rates of achieved remote death certifications (mean 87.3% vs 76.9%, p = 0.033) and putrefied bodies (mean 3.8% vs 2.2%, p = 0.137) compared to rural regions. Among unrealized remote death certification requests, the most common reason was failure of relatives to designate a funeral home (36.8%).

Conclusion:

Our 8-year experience with the remote death certification program demonstrates that despite facing numerous challenges, this process is feasible and offers a valuable option to manage out-of-hospital deaths. The remote death certification program is spreading in the remaining regions of Québec. Future studies will aim to quantify how much time this process saves for emergency medical services in each region of the province.
Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia
Authors: Agazhe Mequanint , Eshetu Daniel , Arsicha Admasu , Hamato Assefa , Petros Assefa , Dabaro Desalegn , Yohanis Nigussie , Getahun Bekalu , Hirigo Agete Tadewos
Published: March 2021

Introduction:

In the current days, stroke has become one of the common reasons for admission in many health care setups and becoming an alarming public health problem in Ethiopia. Hence, this study aimed to assess the incidence and associated factors of stroke among patients admitted to the medical wards in Yirgalem hospital.

Methods:

An institution-based retrospective cross-sectional study design was carried out from 01 January 2017, to 30 December 2019. Admitted adult patients’ medical charts were used to collect all required information using structured checklists. Data were analyzed using statistical package for social sciences (SPSS) version 20 software, and a p value < 0.05 was accepted as statistically significant.

Result:

From a total of 3016 admitted patients, the incidence of stroke was 3.15% (n = 95). Of the 95 stroke cases, 58.9% were males and 69.5% of them were urban dwellers. 62.1% (59/95) of the stroke patients had an ischemic stroke, whereas 37.9% (36/95) had a hemorrhagic stroke. Patients with age ⩾ 65 years, smokers, hypertension, and type-II diabetes had significantly higher ischemic stroke when compared to patients with hemorrhagic stroke (62.7% vs 30.5%, p = 0.008), (49.1% vs 11.1%, p ⩽ 0.0001), and (71.2%vs 13.9%, p < 0.0001), respectively. While patients with hypertension had a significantly higher rate of hemorrhagic stroke when compared to patients with ischemic stroke (88.9% vs 61%, p = 0.003).

Conclusion:

The majority of stroke patients had cardiovascular problems and hypertension. More than 44% and 34.7% of them had a history of alcoholism and smoking. Therefore, proper management of hypertension, lifestyle modification, early screening and management of strok risks and avoiding risk-full personal behaviors like smoking and alcoholism are important tools to limit or prevent stroke-related morbidity and mortality.
Bacterial uropathogens and susceptibility testing among patients diagnosed with urinary tract infections at Hiwot Fana Specialized University Hospital, Eastern Ethiopia
Authors: Tesfa Tewodros , Baye Yohannes , Sisay Mekonnen , Amare Firehiwot , Gashaw Tigist
Published: March 2021

Background:

Urinary tract infection is a common infection posing a significant healthcare burden globally. Currently, it is becoming hard to manage due to the drug resistance of uropathogens. This study aimed to evaluate the rate of culture positivity and the susceptibility pattern of isolates among clinically diagnosed patients with urinary tract infection.

Methods:

An institution-based cross-sectional study was conducted on patients clinically diagnosed with urinary tract infections and received a drug prescription at Hiwot Fana Specialized University Hospital from August 2018 to June 2019. A clean-catch mid-stream urine specimen was collected and bacterial identification and susceptibility test were performed using standard microbiological methods. Data were entered into EpiInfo 7 and exported to STATA 15 for analysis. Data were analyzed using descriptive analysis and bi-variate and multivariate regression analyses and presented with graphs, frequency, and tables.

Results:

A total of 687 urine samples were collected from patients with clinically diagnosed urinary tract infections. The mean age was 31 years and 56.62% were female. 28.38% of the participants had a culture-positive result, of which 86.15% had monomicrobial infections. Inpatients (AOR = 3.8, 95% CI = (1.8–7.9)) and hypertensive patients (AOR = 2.1, 95% CI = (1.1–4.4)) had higher odds of culture-positive results. Staphylococcus species (35.3%), E. coli (25.34%), Pseudomonas species (6.8%), and other Enterobacterales are isolated. Most isolates showed resistance to more than one drug, and amikacin, gentamicin, and nitrofurantoin showed relatively higher activity against isolates.

Conclusion:

About one-third of the clinically diagnosed patients with urinary tract infection were culture-positive with many types of bacterial uropathogens. Inpatients and hypertensive patients had a higher risk of developing bacterial infections. Bacterial isolates showed different percentages of susceptibility to the tested antibiotics.
Intra-arterial infusion of autologous bone marrow mononuclear cells combined with intravenous injection of cerebrolysin in the treatment of middle cerebral artery ischemic stroke: Case report
Authors: Le Vien C , Nguyen Ngoc H , Le Song H
Published: March 2021

We present a patient with severe middle cerebral artery occlusion who received an intra-arterial infusion of autologous bone marrow stem cells combined with Cerebrolysin IV. The patient was evaluated before and after treatment using the National Institutes of Health Stroke Scale, the Medical Research Council Muscle Scale, Modified Brunnstrom Classification, Barthel Index and modified Rankin Scale. After the therapy, the patient showed good outcome with functional as well as neurological improvements especially in terms of functional motor recovery without any side effects. Further controlled studies are needed to find possible side effects and establish net efficacy.
Complications following local anaesthetic transperineal prostate biopsies without antibiotic prophylaxis: An institution’s experience
Authors: John Joseph B , MacCormick Angus , MacDonagh Ruaraidh , Speakman Mark J , Vennam Ramesh , Burns-Cox Nicholas
Published: March 2021

Objectives:

This study aimed to describe a UK institution’s experience with local anaesthetic (LA) transperineal (TP) prostate biopsies (PB), and to report 30-day complications following LATPPB, including a large cohort that did not receive antibiotic prophylaxis.

Patients and methods:

A prospective database of 313 consecutive patients undergoing LATPPB was maintained, describing patient and disease characteristics, and complications. From September 2019 to January 2020, antibiotic prophylaxis was given before LATPPB ( n=149). Following a change to routine care, from January 2020 to July 2020, prophylactic antibiotics were not given before LATPPB ( n=164). A comparative analysis was performed to determine complication rates following antibiotic prophylaxis discontinuation using electronic hospital and primary care records.

Results:

Patient and disease characteristics were comparable in antibiotic and non-antibiotic cohorts, and representative of PB and prostate cancer cohorts described in the urological literature. The infection-related complication rate was 0.32% across all patients, and 0% for those not receiving antibiotic prophylaxis. The overall complication rate was 0.64%, and 0.61% for those not receiving antibiotic prophylaxis. There were no severe (Clavien–Dindo 3–5) complications. The unplanned hospital admission rate was 0.64%.

Conclusion:

The complication rate after LATPPB was low, with no infection-related complications in patients who did not receive antibiotic prophylaxis. This provides further evidence supporting the discontinuation of routine prophylactic antibiotics before TPPB. Level of evidence: Level 2b.
Isoimperatorin exerts anti-inflammatory activity by targeting the LPS-TLR4/MD-2-NF-κB pathway
Authors: Chen Guirong , Liu Yunong , Xu Yubin , Zhang Mingbo , Guo Song , Zhang Gang
Published: March 2021

Isoimperatorin (QHS) is a phytoconstituent found in the methanolic extracts obtained from the roots of Angelica dahurica, which contains anti-inflammatory, anti-bacterial, analgesic, anti-tumor, and vasodilatory activities. QHS possesses potent antagonistic activity against lipopolysaccharide (LPS)-induced inflammation; however, the mechanism of action remains unclear. In this study, we investigated the anti-inflammatory effect of QHS and explored the underlying mechanisms. The QHS was purchased from Jiangsu Yongjian Pharmaceutical Co., Ltd. (Jiangsu, China). We performed MTT assay, real-time PCR, ELISA, and western blotting experiments to assess the anti-inflammatory activity and the possible mechanism of QHS in vitro. Molecular docking was performed to study the binding of QHS and myeloid differentiation protein-2 (MD-2) and elucidate the possible anti-inflammatory mechanism. QHS had no significant effect on cell viability. Moreover, pre-treatment with QHS significantly decreased the release of inflammatory cytokines and mediators including NO, TNF-α, IL-6, and IL-1β. In addition, real-time PCR showed that QHS decreased the mRNA expressions of iNOS, COX-2 TNF-α, IL-6, and IL-1β. Western blotting indicated that QHS could inhibit the expression of the proteins associated with the LPS-TLR4/MD-2-NF-κB signaling pathway. Lastly, molecular docking revealed a possible binding mechanism between QHS and MD-2. QHS exhibited anti-inflammatory activity when combined with MD-2, regulating the LPS-TLR4/MD-2-NF-κB signaling pathway, and inhibiting the release and expression of inflammatory cytokines and mediators. Furthermore, QHS can be used as a potential TLR4 antagonist, which blocks MD-2 binding, for treating inflammatory responses induced by LPS.
Angular similarity in test parameters
Authors: Chakrabartty Satyendra Nath
Published: March 2021

Through N-dimensional person space, the article gives measures of test parameters and item statistics, including difficulty/discriminating value of test, correlations between a pair of items, and item-total correlations with binary items using angular similarity between two vectors. Relationships between difficulty value and discriminating value of items and test were derived, including relationship between test reliability and test discriminating value. Reliability of a test as per theoretical definition in terms of length of score vectors of two parallel subtests and angle between such vectors was derived. The method was extended to find reliability of a battery of tests. Reliability and discriminating value of a Likert-type item and scale was found in terms of angular similarity without involving assumptions of continuous nature or linearity or normality for the observed variables, or the underlying variable being measured. The proposed methods also avoid test of unidimensionality or assumption of normality or bivariate normality associated with the polychoric correlations. Thus, the proposed methods are in fact nonparametric and considered as improvement over the existing ones. Reliability as a measure of association of two vectors and discrimination as a measure of distance between the vectors are likely to show a negative relationship.
On the role of global change science in sustainable development: Reflecting on Ye Duzheng’s contributions
Authors: Lu Jianhua
Published: March 2021

Ye Duzheng was a world-renowned climate scientist and a pioneer of global change science in China and across the world. This paper revisits his ideas on linking global change science to sustainable development and his understanding of orderly human activities, along with his activities in leading research on global change science beginning in the early 1980s. Ye’s work has clearly shown that literacy in global change science and Earth system science and the interaction between the social and natural sciences and between policymakers and stakeholders at different levels are essential to sustainable development.