bluuebunny/crossref_metadata_2025 huggingface dataset:
A Longitudinal Examination of Developmental Covariates of Sexual Behavior Problems among Youth Referred to Child Protection Services
Authors: Chouinard-Thivierge Stéphanie , Lussier Patrick , Daignault Isabelle V.
Published: September 2021

Little is known about the development of childhood sexual behavior problems (SBP) in terms of continuity and discontinuity into adolescence. Prior studies have espoused a nondevelopmental approach focusing on the clinical profiles of these youths at the time of their referral. To address this gap, the current study proposes an examination of the developmental covariates involved in the continuity of SBP among a sample of 340 children and adolescents referred to Child Protection Services (CPS) in Quebec, Canada. Children’s CPS contacts from birth up to age 17 were inspected, allowing to recreate the life history of social and familial adversities during that period. Logistic regression models were performed and helped to identify developmental covariates of childhood-onset SBP and its persistence into adolescence. Findings suggest that children with childhood-onset SBP that persisted into adolescence have experienced various life adversities. The study findings provide some preliminary evidence of the developmental pathways of SBP.
Association of Sociodemographic Factors, Breast Cancer Fear, and Perceived Self-Efficacy With Breast Cancer Screening Behaviors Among Middle-Aged Nigerian Women
Authors: Ezema Rita Ngozi , Igbokwe Charles Chima , Iwuagwu Tochi Emmanuel , Agbaje Olaoluwa Samson , Ofuebe Justina Ifeoma , Abugu Lawretta Ijeoma , Eze Dorothy Doris , Wamanyi Yohanna
Published: September 2021

Introduction:

Breast cancer (BC) is a major public health problem among women. However, BC screening uptake is abysmally low among Nigerian women. This study evaluated the association of BC fear and perceived self-efficacy with BC screening (clinical breast exam [CBE] and mammography) among middle-aged Nigerian women.

Methods:

A community-based cross-sectional study was conducted among middle-aged women in Enugu State, southeast Nigeria. The data were collected between September 2019 and February 2020. The BC screening uptake, fear, and self-efficacy were assessed using the validated Breast Cancer Screening Questionnaire (BCSQ), Champion Breast Cancer Fear Scale (CBCFS), and Champion’s Mammography Self-Efficacy Scale (CMSES). Data were analyzed using frequencies and percentages, chi-square test, and univariate analysis of variance. Bivariate and multivariable logistic regression models were used to examine independent associations between selected sociodemographic factors, cancer fear, perceived self-efficacy, and BC screening.

Results:

The mean age of the participants was 55.3 years (SD: 5.75). More than half of the women (51%) reported having a BC screening in the past 12 months. However, only 12.5% and 16.9% reported having a CBE or mammogram in the past 12 months. The prevalence of a high, moderate, and low level of fear was 68%, 22.3%, and 9.8%, respectively. The prevalence of a high, moderate, and low self-efficacy level was 50.6%, 37.5%, and 12.0%, respectively. The multivariable logistics regression analysis showed that women aged 50-59 years and 60-64 years were 3.5 times (adjusted odds ratio [AOR] = 3.50, 95% confidence interval [CI]: 2.07-5.89, P < .0001), and 5.92 times (AOR = 5.92 95% CI: 2.63-13.35, P < .0001), respectively, more likely to perform mammogram than those aged 40-49 years. Women with a high level of self-efficacy were 2.68 times (AOR = 2.68, 95% CI: 1.15-6.26, P < .0001) more likely to use mammographic screening than those with low self-efficacy. Although not statistically significant, women with a moderate level of BC fear were 0.56 times less likely to use mammogram than women with a low level of BC fear.

Conclusion:

A low proportion of women underwent CBE or mammography. Women had a high level of BC fear and a moderate level of self-efficacy for BC screening. The findings emphasize the need for health educational and psychosocial interventions that improve self-efficacy and promote regular BC screening among middle-aged women.
Biologic Use in Pediatric Patients With Hidradenitis Suppurativa: A Systematic Review
Authors: Sachdeva Muskaan , Kim Patrick , Mufti Asfandyar , Maliyar Khalad , Sibbald Cathryn , Alavi Afsaneh
Published: September 2021

Background

There is currently at least 1 biologic (adalimumab) approved in North America for treatment of Hidradenitis Suppurativa in the pediatric population. However, no reviews or clinical trials have specifically analyzed the effectiveness and safety data of biologic use in this population. The objective of this systematic review is to identify and summarize the outcomes of biologic therapy in pediatric patients with HS.

Methods

MEDLINE and EMBASE databases were used to conduct the search on Sept 18, 2020.

Results

The 15 included studies consisted of 26 patients, with the mean age of 15 ± 2.3 years. Females accounted for 53.8% ( n = 14/26) of cases. The mean duration of HS prior to biologic initiation was 3.5 ± 2.9 years, with the majority having Hurley Stage II. The 26 patients received 34 biologics in total: 85.3% treated with TNF alpha inhibitors (adalimumab n = 17, infliximab n = 10, etanercept n = 1, unspecified n = 1), 5.9% with IL-12/23 inhibitors (ustekinumab n = 2), 5.9% with IL-1 inhibitors (i.e., anakinra n = 2) and 2.9% received IL-23 inhibitors (i.e., guselkumab n = 1) biologics. Of the 26 patients, 23.1% ( n = 6/26) experienced complete resolution (CR), 73.1% ( n = 19/26) experienced partial resolution (PR), and 3.8% ( n = 1/26) had no resolution outcomes reported. The time to resolution of HS lesions after biologic initiation ranged from 10 days to 11.5 months (mean: 5.1 months). No adverse events were reported in the studies.

Conclusion

Although anti-TNF alpha were the most common biologics used for HS in pediatric cases, large-scale trials specific to pediatric patients with HS are needed to confirm these findings.
The rise of the post-religious right: Christianism and secularism in the French Rassemblement National
Authors: Cremer Tobias
Published: September 2021

This article investigates Western European right-wing populists’ ambiguous relationship with religion and secularism using the example of the French Rassemblement National (RN). Drawing on social cleavage theory, survey data and elite interviews with RN leaders, French mainstream politicians and Church authorities, it finds that the RN employs Catholicism and laïcité as cultural identity markers against Islam to mobilise voters around a new identity cleavage between liberal-cosmopolitans and populist-communitarians. However, instead of a rapprochement with Christian policy positions, ethics and institutions, this article finds that the RN is becoming increasingly secularist in its policies, personnel and electorate. This finding is of significant relevance for the broader populism and religion literature not only because it suggests the centrality of right-wing identity politics for populist parties, but also because it challenges traditional assumptions about the relationship between right-wing populism and religion by providing evidence that in Western Europe the former is increasingly dominated by its ‘post-religious’ wing.
Automation, wellbeing and Digital Voice Assistants: Older people and Google devices
Authors: Duque Melisa , Pink Sarah , Strengers Yolande , Martin Rex , Nicholls Larissa
Published: September 2021

Digital Voice Assistants (DVAs) like Google Home provide automated news, media and other content directly into the home. In this article, we outline how Google Home’s content delivery can support the wellbeing and independence of older people. We argue that automated media provided by DVAs enrols older people in a dialectic relationship with the automated content and feminised conversation they deliver, uniquely performed within people’s own everyday life circumstances. We demonstrate this by drawing on ethnographic insights generated during a trial of smart home technologies with older Australian households who are ‘ageing in place’ in regional New South Wales. For most participants, the trial was their first encounter with DVAs and the modes of media and content delivery including for music, news, weather, trivia, jokes, facts and images. While DVAs bring new experiences via content, communication and companionship, they are also subverted, ignored or transformed as people improvise to make them ‘fit’ within their homes and lives. These dynamics underpin how DVAs, automated content delivery and user’s interactions can support people’s sense of wellness and their independent daily practices at home.
Locked down through virtual disconnect: Navigating life by staying on/off the health QR code during COVID-19 in China
Authors: Tai Zixue , Yu Xiao , He Bai
Published: September 2021

During the COVID-19 pandemic, China has implemented the most stringent lockdown measures across major cities during moments of heightened risk of infection. This mechanism is aided by the mandated Health QR Code to surveil and contain spread of the virus. This research scrutinizes the varying degrees and forms of disconnect in the context of the Health Code mandate. Informed by extensive focus group interviews of diverse resident groups, supplemented with thematic analysis of 136 newspaper news stories covering the enforcement of the Health Code, the research results offer insight over the multiplicity of voluntary and involuntary disconnective practices at both the individual/internal and societal/external level. These findings are contextualized for their theoretical relevance towards the overall line of inquiry into information technology non-use, and the pragmatic implications of the Health Code are discussed for contact tracing app design and utility in general.
Desire for sale: Live-streaming and commercial DIY porn among Chinese gay microcelebrities
Authors: Song Lin
Published: September 2021

This paper examines a nascent network of commercial DIY gay porn production by microcelebrities in China against the background of platformization, commodification, and illiberal cultural landscapes. Informed by queer Marxist theories, the paper looks at how the career trajectories of live-streamer-turned DIY gay porn actors/producers are shaped by the intertwining forces of platform capitalism, technological affordances, and state internet governance. Reflecting on the critical potential of these DIY porn production practices, it suggests that they paradoxically showcase both a willing submission to the ever-expanding logics of capitalism and means of creative negotiation with commodification and state censorship.
Educational differences in long-term care use in Sweden during the last two years of life
Authors: Kelfve Susanne , Wastesson Jonas W. , Meinow Bettina
Published: September 2021

Background: In old age, many people experience a period of functional decline and require long-term care. Sweden has a universal largely tax-financed health and social care system that is used by all societal groups. However, few studies have investigated if educational groups use publicly paid long-term care equitably. The aim of this study was to explore educational differences in the use of long-term care, including both home care and institutional care, during the last two years of life in Sweden. Methods: We used linked register data on mortality and long-term care use, including all adults aged ⩾67 years who died in Sweden in November 2015 ( N=6329). We used zero-inflated negative binomial regression models to analyse the number of months with long-term care by educational level, both crude and adjusted for age at death and cohabitation status. Men and women were analysed separately. Results: People with tertiary education died more commonly without using any long-term care compared to primary educated people (28.0% vs. 18.6%; p<0.001). In the adjusted model, educational differences in the estimated number of months with long-term care disappeared among men but remained significant among women (primary educated: odds ratio=17.3 (confidence interval 16.8–17.7); tertiary educated: odds ratio=15.8 (confidence interval 14.8–16.8)). Conclusions: Older adults spend considerable time in their last two years of life with long-term care. Only minor educational differences in long-term care use remained after adjustment for cohabitation status and age at death. This suggest that Sweden’s publicly financed long-term system achieves relatively equitable use of long-term care at the end of life.
Electoral responses to the increased contestation over European integration. The European Elections of 2019 and beyond
Authors: van der Brug Wouter , Gattermann Katjana , de Vreese Claes H.
Published: September 2021

This special issue focuses on the consequences of the heightened conflict between member states and increased politicization of European affairs for electoral politics in the European Union. In this introduction we begin by outlining three important developments that fuelled the politicization: (a) the common currency; (b) the increased pushback on the EU’s open border policies; and (c) the inability of the EU to prevent democratic backsliding in some countries. We then discuss their consequences for EU elections, particularly campaigns, public opinion on Europe and voter behaviour, which are investigated against the backdrop of the 2019 European Parliament elections in the individual articles in this special issue. This introduction provides a contextual framework for these contributions and reflects upon some of its main findings.
Identification of a Signature Comprising 5 Soluble Carrier Family Genes to Predict the Recurrence of Papillary Thyroid Carcinoma
Authors: Han Rui , Sun Wei , Zhang Hao
Published: September 2021

RNA-sequencing data and relevant clinical data in The Cancer Genome Atlas for 502 samples of papillary thyroid cancer (PTC) were analyzed to determine the prognostic value of soluble carrier family genes in PTC. We analyzed soluble carrier family gene expression and function in the samples. Clustering identified 2 clusters in the data. Risk characteristics were identified using LASSO and Univariate Cox regression analysis, which divided the patients into low and high-risk groups. The expression levels of 88 soluble carrier genes were significantly different between tumors and normal tissue. The 2 PTC clusters had different clinical outcomes and distributions of gene expression. The expression levels of SFXN1, SLC12A4, SLC35A1, SLC35E1, and SLCO1C1 were markedly different between the 2 groups. The high risk and low risk groups had significant different prognoses ( P < 0.05). Significant differences were identified for disease free survival (DFS), sex and T stage between the 2 subgroups. The risk score was identified as an independent prognostic variable ( P < 0.05) and as a predictor of clinicopathological variables. In patients with PTC, solute carrier gene expression showed differential associations with clinicopathological variables. The 5 genes could be used as prognostic factors for PTC, particularly to predict PTC recurrence.
Catastrophic Antiphospholipid Syndrome Following Lower Extremity Arterial Bypass Surgery: Case Report and Evidence Review
Authors: Sorour Ahmed A. , Kirksey Levester , Keller Sarah , O’Connor Michael S. , Lyden Sean P.
Published: September 2021

Catastrophic antiphospholipid syndrome (CAPS) is a rare life threatening presentation of antiphospholipid syndrome. Surgery has been proposed as one of the triggering factors for this life threatening entity. There are no detailed published reports in the current literature describing CAPS as a complication after surgery. We report a case of a 21 year old that developed CAPS postoperatively and discuss the multidisciplinary approach for diagnosis and management.
The Voices of Black South African Men on Renal Dialysis at a Tertiary Hospital: A Phenomenological Inquiry
Authors: Mokwena Jabu , Sodi Tholene , Makgahlela Mpsanyana , Nkoana Shai
Published: September 2021

The study explored the psychosocial experiences of rural black South African men undergoing renal dialysis in a tertiary hospital. Twenty men aged between 20 and 59 years ( Meanage = 40.65 yrs; SD = 12.52) participated in the study. Participants were recruited purposefully. Data were collected over a period of 4 months through in-depth face-to-face interviews and analyzed using the Interpretative Phenomenological Analytical method. The following three key themes were extracted from the interviews: (a) the emotional pain and fear of death following a diagnosis of ESRD; (b) living on dialysis interferes with the management and handling of “manly” responsibilities and duties and, (c) dialysis as a challenging yet life-saving measure. The findings further suggest that renal dialysis has an impact on men’s sense of masculinity and has the potential to complicate the management of renal failure. The paper concludes by recommending that cultural and community factors be taken into account when considering interventions to manage the health of men living with renal conditions.
The Development and Pilot of a Technology-Based Intervention in the United States for Father’s Mental Health in the Perinatal Period
Authors: Hamil Jaime , Gier Emma , Garfield Craig F. , Tandon Darius
Published: September 2021

Paternal mental health is increasingly recognized as an important public health issue, with about 10% of men experiencing depression perinatally. Paternal depression is associated with less responsive parenting, greater parenting stress, and suboptimal child development. In response to a lack of existing interventions that directly focus on fathers’ mental health in the United States, we developed and pilot tested the Fathers and Babies (FAB) intervention for use with partners of women enrolled in home visiting (HV) programs.

After a review of the extant literature, FAB was developed with input from HV stakeholders and infant mental health consultants. FAB was subsequently pilot tested with 30 father-mother dyads, with mixed-method data collected from a subset of intervention participants to assess intervention feasibility and acceptability and guide intervention refinement.

Five themes related to FAB content and delivery considerations emerged from the initial focus groups that were used to guide FAB development. Mixed-method data collected during the pilot study established that fathers receiving FAB reported its content appropriate and thought it was feasible to receive the intervention. Several recommendations for FAB revisions were also provided.

FAB is an innovative intervention developed for fathers from contemporary family structures that was well-received during its pilot testing. Feasibility and acceptability data suggest that fathers have favorable opinions about intervention content and delivery, while also highlighting areas for future revisions of FAB.
Forging Resilience to HIV/AIDS: Personal Strengths of Middle-aged and Older Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV/AIDS
Authors: Liboro R. , Despres J. , Ranuschio B. , Bell S. , Barnes L
Published: September 2021

HIV-positive gay, bisexual, two-spirit, and other men who have sex with men (MSM) have exhibited significant resilience to HIV/AIDS in Canada since the start of the epidemic. Since 2012, most of the research that has been conducted on resilience to HIV/AIDS has utilized quantitative methods and deficits-based approaches, with a preferential focus on the plight of young MSM. In order to address apparent gaps in research on HIV/AIDS resilience, we conducted a community-based participatory research qualitative study that utilized a strengths-based approach to examine the perspectives and lived experiences of HIV-positive, middle-aged and older MSM on their individual attributes that helped forge their HIV/AIDS resilience. We conducted 41 semistructured interviews with diverse, HIV-positive, middle-aged and older MSM from Central and Southwestern Ontario, Canada. From our thematic analysis of our interviews, we identified four themes, which represented personal strengths that fostered resilience to HIV/AIDS: (a) proactiveness, (b) perseverance, (c) having the right mindset, and (d) self-awareness with self-control. This article discusses the importance of these personal strengths to fostering HIV/AIDS resilience, and how community-based resources could potentially lessen the need to muster such personal strengths, or alternatively, cultivate them.
Intramural Sport Participation: An Examination of Participant Benefits, Service Quality, Program Satisfaction, and Student Retention
Authors: Wilson Kevin E. S. , Millar Patti
Published: September 2021

This study investigates whether the benefits of participation in, and perceived service quality of, an intramural sport program contribute to student retention and overall program satisfaction. Health and wellness outcomes, student learning outcomes, service quality, program satisfaction, and student retention in intramural programming were assessed at one Canadian university. The results reveal that participants experience physical, emotional, social and academic outcomes as a result of participation in intramural programming. The results also reveal that benefits of participation (physical health and wellness, emotional wellness, academic learning outcomes, social learning outcomes) and service quality are associated with greater student retention and program satisfaction. The results highlight the unique association between physical health and wellness benefits and student retention. The results also highlight the association between service quality, social and emotional wellness and program satisfaction among participants. Implications for practice and future research are presented.
Diameter and strength of Ethiopian pure and cross-breed sheep wool fibers
Authors: Sitotaw Dereje Berihun , Tesema Addisu Ferede , Woldemariam Adane Haile
Published: September 2021

The wool fibers fineness and strength have a remarkable role to determine the quality of yarn and the subsequent fabrics. The fineness property of the wool fibers is a crucially important fiber property for grading, classifying, selecting for particular applications such as for suit, blanket, shirt, carpet, and so on. The fineness and strength properties of four indigenous (Menz, Wollo, Farta, Tikur), three exotic (Awasi, Dorper, Corrediale), and four cross-breed (50% Dorper, 50% Awasi, 75% Awsi, Washera/Awasi) sheep wool fibers from the four main body parts (sides, neck, back, and belly) at six teeth removed age of 11 different sheep breeds have been investigated. The samples of wool fibers have been conditioned for 24 h at 20ºC ± 1ºC temperature and 65% ± 2% relative humidity. The specimen for sampling has been determined based on ASTM D2130-01. The results revealed that the fineness and strength of whole fibers taken from different parts of sample sheep varied significantly within the breed and among the breeds. The result revealed that the strength and fineness of the wool fibers have a positive correlation and Ethiopian sheep wool fiber is suitable for numerous types of classical and technical applications.
Smart cyber-physical production system enabled workpiece production in digital twin job shop
Authors: Chuang Wang , Guanghui Zhou , Junsheng Wu
Published: September 2021

Industry 4.0 describes the future production of workpiece in job shop as: the workpiece is a smart one; it knows the details of how to manufacture itself; and it can communicate with manufacturing environment to support its own machining processes. This means that the production of workpiece places more emphasis on the smart realization of the process level in Industry 4.0. However, how to implement the production scenario based on existing technologies has not yet been well studied. On account of this, this article aims to study how to use existing technologies in job shop such as digital twins, Internet of Things (IoT), Cyber-physical Production System (CPPS), etc., to realize the workpiece-driven process-level production. The process-level production of a workpiece is divided into three stages according to the different manufacturing resources involved. On this basis, the production of the workpiece in digital twin job shop is divided into process level, operation level, and IoT/sensor level. Firstly, the manufacturing requirements at process level are generated according to production planning and process sheet. And these requirements are written into RFID tag of the workpiece. The workpiece dynamically interacts with different workstations via RFID reader/antenna in order to complete the manufacturing requirements. Secondly, based on the tag data, the interaction model of operation level, and IoT/sensor level CPPSs is given. Thirdly, at IoT/sensor level, the RFID devices are treated as a CPPS to track the manufacturing resources. And different smart sensors are used as independent sensor CPPSs to monitor the running status of machine tool. The RFID and sensor CPPSs are triggered by operation level CPPSs. Finally, a digital twin job shop is taken as an example to illustrate the feasibility of the proposed models and methods.
Experimental study of the mechanical properties of steel fiber stainless-steel reinforced concrete (SFSRC) beams under low velocity impact conditions
Authors: Zhou Xiwu , Zhang Wen , Wang Xiangyu
Published: September 2021

In the present study, based on the previous impact resistance test study results regarding stainless steel reinforced concrete beams, six steel fiber stainless-steel reinforced concrete (SFSRC) beams were subjected to drop-hammer impact tests using an advanced ultra-high heavy multi-function drop hammer impact test system. The goal was to further investigate the mechanical properties of SFSRC beams under impact load conditions. The influencing effects of the steel fiber content and impact velocity levels on the impact resistance mechanical properties of SFSRC beams were analyzed. A digital image correlation method (DIC) was used to analyze the full-field strain and displacement values of the specimens. The results revealed that the steel fibers had significantly enhanced the overall energy dissipation and crack resistance capacities of the specimens, and also improved the brittleness of the stainless steel reinforced concrete beams. In addition, the addition of steel fibers effectively inhibited the local damages of the beam-hammer contact areas. In this study’s experiments, the impact resistance of the beams was observed to be the highest when the fiber content was 2.0%. The internal force formula of the local response stage of the beams showed that the shearing effects had significant impacts on the overall failure modes of the specimens. It was found that with the increases in impact velocity, the failure mode of the SFSRC beams transitioned from bending failure to shear failure, and then to a punching shear failure mode. The DIC results indicated that the addition of steel fiber improved the bonding performances between the concrete matrixes, along with inhibiting the crack development rates through the bond force between the fiber and the concrete.
Isolation effects of vehicle-induced vibration tested by integral floating method
Authors: Li Hao , Yang Weiguo , Liu Pei , Zou Xiaoguang , Wang Meng
Published: September 2021

A set of integral floating vibration isolation methods was developed in this study to remedy the lack of effective measures for over-track buildings. The effect of vibration isolation pads was investigated experimentally; the resulting field measurements were used to determine the time-frequency dynamic responses of vehicle-induced vibration and isolation effects. The characteristics of the vibration source appear to significantly affect the frequency domain distribution of vibration inside the building. When no vibration isolation measures are taken, the internal vibration of the cultural center exceeds the limit. BSW vibration isolation pads R480, R550, and R800 are effective in the frequency range of 16–80 Hz. The vibration isolation level in the Z direction is between 5.6 and 7.3 dB. After floating vibration isolation treatment, the maximum Z vibration level of the cultural center is 56.4 dB in daytime hours and 52.9 dB at night, which satisfies the relevant standard. The proposed method is shown to effectively hinder the structural vibration caused by subways on surrounding buildings.
Modeling of rolling force of ultra-heavy plate accounting for gradient temperature
Authors: Zhang Shun Hu , Che Li Zhi
Published: September 2021

In this paper, the nonlinear specific plastic power of the Mises criterion is integrated analytically to establish the rolling force model of gradient temperature rolling for an ultra-heavy plate by a new method called the root vector decomposition method. Firstly, the sinusoidal velocity field is proposed in terms of the characteristics of metal flow during ultra-heavy plate rolling, which satisfies the kinematically admissible condition. Meanwhile, the characteristics of the temperature distribution along the thickness direction of the plate during the gradient temperature rolling is described mathematically. Based on the velocity field and the temperature distribution expression, the rolling energy functional is obtained by using the root vector decomposition method, and the analytical solution of rolling force is derived according to the variational principle. Through comparison and verification, the rolling force model solved by the root vector decomposition method in this paper is in good agreement with the measured one, and the maximum error of the rolling force is just 10.21%.
A lifetime optimization method of new energy storage module based on new artificial fish swarm algorithm
Authors: Zhi Pengfei , Qi Yongshuang , Wang Weiran , Qiu Haiyang , Zhu Wanlu , Yang Ye
Published: September 2021

The demand for new energy will continue to expand as the environment changes and fossil energy decreases. However, the instability of new energy has slowed down the development of new energy. The joint use of new energy and energy storage modules effectively solves the shortcomings of new energy. The article proposed a lifetime optimization method of new energy storage module based on new artificial fish swarm algorithm. Firstly the life model based on the battery capacity [Formula: see text], charging current [Formula: see text], and discharge current [Formula: see text] is built. Secondly, the deep learning method is used to improve the step length and speed change of artificial fish-school algorithm. Finally, the simulation platform detects the optimized parameters [Formula: see text]. The simulation results show that optimized parameters can help extend the life of the energy storage module.
Design of a seed implantation robot with counterbalance and soft tissue stabilization mechanism for prostate cancer brachytherapy
Authors: Buyun Wang , Yi Liang , Dezhang Xu , Yongde Zhang , Yong Xu
Published: September 2021

This article focuses on the topic of the structural design of surgical radioactive surgery robot for prostate cancer. To improve the weight-to-payload ratio of surgery robot end-effector, the energy consumption and stability of robot joint drive and reducing the displacement and deformation of needle insertion in soft tissue. This article discusses the new static torque balancing method and multi-needle insertion soft tissue stabilization mechanisms that may be used in previously articulated seed implantation robots. Compared with the existing balancing system schemes, we adopt the idea of mutual conversion of gravitational potential energy and elastic potential energy and establish a static balancing model. With preloaded displacement parameter of the spring α, the variable gravity torque balance of robot arm can be achieved. Torque and equivalent gravity balancing distribution with the spring balance system and the quantitative evaluation experiment were performed, and experiment results provide evidence that these spring balance devices can basically compensate the gravity torque of the robot arm. In addition, we used nonlinear spring–damper model to establish multi-needles insertion soft tissue force model. Then, a variable multi-needle insertion soft tissue stabilization device is designed with six working modes. The innovative design of this device is the use of the first four needles that are introduced simultaneously on either side of the midline. Initially completed displacement simulation of different numbers of needle insertion prostate tissue, experiment results indicate that multi-needle puncture mechanism could reduce prostate displacement in the y- or z-direction. By this method, the prostate may be fixed, thus this mechanism maybe reduces rotation of the prostate and enabling subsequent needles to be inserted accurately.
Principals’ perceptions of school autonomy and educational leadership
Authors: Niesche Richard , Eacott Scott , Keddie Amanda , Gobby Brad , MacDonald Katrina , Wilkinson Jane , Blackmore Jill
Published: September 2021

This paper examines principals’ perceptions of school autonomy and leadership as part of a 3-year research project looking at the implications of school autonomy on social justice across four states of Australia (Victoria, New South Wales, Western Australia and Queensland). Drawing on interviews with principals and representatives from principal stakeholder organisations in these four state jurisdictions, the paper identifies a number of key issues for school principals and the implications for understandings and practices of educational leadership. These include varied understandings of autonomy, practices of leadership and implications for health, workload and well-being. The paper argues that while principals have mixed perceptions of school autonomy policies, there has been a narrowing of leadership experiences by principals in the form of managerialism and compliance. Furthermore, principals continue to experience high levels of workload, and some principals, depending on career stage and experience level, feel better able to work within and sometimes against these policies in their schools and communities. These practices are sometimes felt to be despite the system and not due to school autonomy policies themselves. The implication of these findings is that principals are inequitably able to respond to and implement school autonomy policies, an issue often glossed over in educational leadership research.
Benefit of second-line therapy for advanced esophageal squamous cell carcinoma: a tri-center propensity score analysis
Authors: Müller Moritz , Posch Florian , Kiem Dominik , Barth Dominik , Horvath Lena , Stotz Michael , Schaberl-Moser Renate , Pichler Martin , Greil Richard , Jost Philipp J. , Seeber Andreas , Amann Arno , Schlick Konstantin , Gerger Armin , Riedl Jakob M.
Published: September 2021

Background:

The level of evidence for palliative second-line therapy in advanced esophageal squamous cell carcinoma (aESCC) is limited. This is the first study that reports efficacy data comparing second-line therapy + active symptom control (ASC) versus ASC alone in aESCC.

Methods:

We conducted a tri-center retrospective cohort study ( n = 166) including patients with aESCC who had experienced disease progression on palliative first-line therapy. A propensity score model using inverse probability of treatment weighting (IPTW) was implemented for comparative efficacy analysis of overall survival (OS) in patients with second-line + ASC ( n = 92, 55%) versus ASC alone ( n = 74, 45%).

Results:

The most frequent second-line regimens used were docetaxel (36%) and paclitaxel (18%). In unadjusted primary endpoint analysis, second-line + ASC was associated with significantly longer OS compared with ASC alone [hazard ratio (HR) = 0.49, 95% confidence interval (CI): 0.35–0.69, p < 0.0001]. However, patients in the second-line + ASC group were characterized by more favorable baseline features including a better Eastern Cooperative Oncology Group (ECOG) performance status, a longer first-line treatment duration and lower C-reactive protein levels. After rigorous adjusting for baseline confounders by re-weighting the data with the IPTW the favorable association between second-line and longer OS weakened but prevailed. The median OS was 6.1 months in the second-line + ASC group and 3.2 months in the ASC group, respectively (IPTW-adjusted HR = 0.40, 95% CI: 0.24–0.69, p = 0.001). Importantly, the benefit of second-line was consistent across several clinical subgroups, including patients with ECOG performance status ⩾1 and age ⩾65 years. The most common grade 3 or 4 adverse events associated with palliative second-line therapy were hematological toxicities.

Conclusion:

This real-world study supports the concept that systemic second-line therapy prolongs survival in patients with aESCC.
Diagnosis and management of lung involvement in systemic lupus erythematosus and Sjögren’s syndrome: a literature review
Authors: Depascale Roberto , Del Frate Giulia , Gasparotto Michela , Manfrè Valeria , Gatto Mariele , Iaccarino Luca , Quartuccio Luca , De Vita Salvatore , Doria Andrea
Published: September 2021

Lung involvement in systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome (pSS) has extensively been outlined with a multiplicity of different manifestations. In SLE, the most frequent finding is pleural effusion, while in pSS, airway disease and parenchymal disorders prevail. In both cases, there is an increased risk of pre-capillary and post-capillary pulmonary arterial hypertension (PAH) and pulmonary venous thromboembolism (VTE). The risk of VTE is in part due to an increased thrombophilic status secondary to systemic inflammation or to the well-established association with antiphospholipid antibody syndrome (APS). The lung can also be the site of an organ-specific complication due to the aberrant pathologic immune-hyperactivation as occurs in the development of lymphoma or amyloidosis in pSS. Respiratory infections are a major issue to be addressed when approaching the differential diagnosis, and their exclusion is required to safely start an immunosuppressive therapy. Treatment strategy is mainly based on glucocorticoids (GCs) and immunosuppressants, with a variable response according to the primary pathologic process. Anticoagulation is recommended in case of VTE and multi-targeted treatment regimens including different drugs are the mainstay for PAH management. Antibiotics and respiratory physiotherapy can be considered relevant complement therapeutic measures. In this article, we reviewed lung manifestations in SLE and pSS with the aim to provide a comprehensive overview of their diagnosis and management to physicians taking care of patients with connective tissue diseases.
China in Latin America Then and Now: A Systemic Constructivist Analysis of China’s Foreign Policy
Authors: Chen Chien-Kai
Published: September 2021

Examining China’s policy towards Latin America from 1949 to the present day, this article uncovers a puzzle about China in Latin America: while the guiding doctrine of China’s policy towards the region has never changed (i.e. “South–South Cooperation” on the basis of the “Five Principles of Peaceful Coexistence”), there is a difference in terms of its policy goal between then and now (i.e. a very revisionist and politically focused goal until the late 1970s as compared to a less revisionist and economically focused one today). Based on the theory of systemic constructivism, this article demonstrates that the change of the interactions between China and other countries in our world (from isolation and confrontation to engagement and interdependence) has changed China’s perception about the nature of the international system, as well as its identity and interests in the system, which in turn has changed its policy goal towards Latin America and the “Global South” in general.
Effects of Aerobic Exercise on Systemic Insulin Degludec Concentrations in People with Type 1 Diabetes
Authors: Herzig David , Groessl Michael , Álvarez-Martínez Mario , Reverter-Branchat Gemma , Nakas Christos T , Kosinski Christophe , Stettler Christoph , Bally Lia
Published: September 2021

Background:

There is conflicting evidence on the effect of exercise on systemic insulin concentrations in adults with type 1 diabetes.

Methods:

This prospective single-arm study examined the effect of exercise on systemic insulin degludec (IDeg) concentrations. The study involved 15 male adults with type 1 diabetes (age 30.7 ± 8.0 years, HbA1c 6.9 ± 0.7%) on stable IDeg regimen. Blood samples were collected every 15 minutes at rest, during 60 minutes of cycling (66% VO2max) and until 90 minutes after exercise termination. IDeg concentrations were quantified using high-resolution mass-spectrometry and analyzed applying generalized estimation equations.

Results:

Compared to baseline, systemic IDeg increased during exercise over time ( P < .001), with the highest concentrations observed toward the end of the 60-minute exercise (17.9% and 17.6% above baseline after 45 minutes and 60 minutes, respectively). IDeg levels remained elevated until the end of the experiment (14% above baseline at 90 minutes after exercise termination, P < .001).

Conclusions:

A single bout of aerobic exercise increases systemic IDeg exposure in adults on a stable basal IDeg regimen. This finding may have important implications for future hypoglycemia mitigation strategies around physical exercise in IDeg-treated patients.
Cone-beam CT angiography to assess the microvascular anatomy of intracranial arterial dissections
Authors: Diana Francesco , Raz Eytan , Biraschi Francesco , Romano Daniele G , Toccaceli Giada , Shapiro Maksim , Peschillo Simone
Published: September 2021

Background

Intracranial artery dissection is a rare and generally under-recognized cause of ischaemic stroke or subarachnoid haemorrhage.

Objectives

The aim of this study was to analyse the efficacy of cone-beam computed tomography angiography (CBCT-A) to detect arterial ultrastructural alterations in intracranial artery dissection.

Method

This is an observational and retrospective case series.

Results

Between January 2018 and November 2020, four patients were admitted with an acute ischaemic stroke due to intracranial dissection studied with CBCT-A. In all cases, the CBCT-A documented vascular ultrastructural alterations related with the intracranial dissection.

Conclusions

CBCT-A is an intraprocedural diagnostic technique that is useful for the diagnosis of intracranial dissections.
Engineering of fully humanized and vascularized 3D bone marrow niches sustaining undifferentiated human cord blood hematopoietic stem and progenitor cells
Authors: Born Gordian , Nikolova Marina , Scherberich Arnaud , Treutlein Barbara , García-García Andrés , Martin Ivan
Published: September 2021

Hematopoietic stem and progenitor cells (HSPCs) are frequently located around the bone marrow (BM) vasculature. These so-called perivascular niches regulate HSC function both in health and disease, but they have been poorly studied in humans due to the scarcity of models integrating complete human vascular structures. Herein, we propose the stromal vascular fraction (SVF) derived from human adipose tissue as a cell source to vascularize 3D osteoblastic BM niches engineered in perfusion bioreactors. We show that SVF cells form self-assembled capillary structures, composed by endothelial and perivascular cells, that add to the osteogenic matrix secreted by BM mesenchymal stromal cells in these engineered niches. In comparison to avascular osteoblastic niches, vascularized BM niches better maintain immunophenotypically-defined cord blood (CB) HSCs without affecting cell proliferation. In contrast, HSPCs cultured in vascularized BM niches showed increased CFU-granulocyte-erythrocyte-monocyte-megakaryocyte (CFU-GEMM) numbers. The vascularization also contributed to better preserve osteogenic gene expression in the niche, demonstrating that niche vascularization has an influence on both hematopoietic and stromal compartments. In summary, we have engineered a fully humanized and vascularized 3D BM tissue to model native human endosteal perivascular niches and revealed functional implications of this vascularization in sustaining undifferentiated CB HSPCs. This system provides a unique modular platform to explore hemato-vascular interactions in human healthy/pathological hematopoiesis.
Efficacy of 0.4 mg tamsulosin monotherapy in patients with moderate-to-severe lower urinary tract symptoms
Authors: Kang Tae Wook , Jung Jae Hung , Kim Dong Wook , Lee Kwang Ho , Chung Hyun Chul
Published: September 2021

Purpose:

To evaluate efficacy of 0.4 mg tamsulosin monotherapy in patients with benign prostatic hyperplasia with moderate-to-severe International Prostate Symptom Score.

Material and methods:

From May 2015 to May 2017, 102 patients were analyzed, retrospectively. The patients were classified into three groups according to the combination of medication (tamsulosin 0.4 mg vs tamsulosin 0.4 mg + solifenacin 5 mg vs tamsulosin 0.4 mg + mirabegron 50 mg). Baseline characteristics (e.g. age, body weight, height, and underlying medical disease) were collected. International Prostate Symptom Score, prostate specific antigen, prostate volume, peak urinary flow rate (Qmax), voided volume, and post-voided volume before after treatment were evaluated.

Results:

We classified and analyzed the patients into three groups depending on the medication. And there were no significant differences between all parameters among the groups. Voided volume at 3 months after treatment in each group was 170.54 ± 125.83, 121.55 ± 46.19, and 274.63 ± 132.30 ( p = 0.019). Differences of voiding symptom score and difference of post-voided volume among the groups before after treatment was 5.00 ± 5.42, 1.92 ± 3.92, and 0.11 ± 5.11 and 8.37 ± 34.32, 0.78 ± 14.86, −33.63 ± 28.58 ( p = 0.037, p = 0.007).

Conclusion:

We think tamsulosin monotherapy will be feasible as a first-line therapy for the patients with benign prostatic hyperplasia who has struggled with moderate-to-severe lower urinary tract symptoms.
Reverse wedge osteotomy for Madelung’s deformity in a high school student: A case report
Authors: Tajika Tsuyoshi , Kuboi Takuro , Endo Fumitaka , Hatori Yuhei , Chikuda Hirotaka
Published: September 2021

Madelung deformity is a congenital disorder with the malformation of anterior ulnar bowing of radius and a dorsally protruding ulnar head caused by premature growth disturbance at the medial volar aspect of the distal radius. This report describes a bilateral idiopathic Madelung deformity in a 17-year-old woman treated successfully using reverse wedge osteotomy of the distal radius in a symptomatic left wrist. Reverse wedge osteotomy can orient the radial joint surface while correcting the whole radius length by reversely putting the wedge bone removed from the distal metaphysis of radius, the base of which is cut from the surplus of the radial and dorsal cortical bone in the hypotrophic portion. We corrected the palmar subluxation of the carpus, restored her good function, and relieved her wrist pain.