bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of a High-Dimensional Mathematical Model for Plant Virus Transmission with Continuous and Impulsive Roguing Control
Authors: Qiu Guangming , Tang Sanyi , He Mengqi
Published: December 2021

Roguing and replanting are the most common strategies to control plant diseases and pests. How to build the mathematical models of plant virus transmission and consider the impact of roguing and replanting strategies on plant virus eradication is of great practical significance. In the present paper, we propose the mathematical models for plant virus transmission with continuous and impulsive roguing control. For the model with continuous control strategies, the threshold values for the existences and stabilities of multiple equilibria have been given, and the effect of roguing strategies on the threshold values is also addressed. Furthermore, the model with impulsive roguing control tactics is proposed, and the existence and stability of the plant-only and disease-free periodic solutions of the model are investigated by calculating several threshold values. Moreover, when selecting the design control strategy to minimize the threshold, we systematically analyze the existence of the optimal times of roguing infected plants within a replanting cycle, which is of great significance to the design and optimization of the prevention and control strategy of plant virus transmission. Finally, numerical investigations are given to reveal the main conclusions, and the biological implications of the main results are briefly discussed in the last section.
Effect of Continuous Subcutaneous Injection of Insulin Analogues in Pregnant Women with Diabetes Mellitus Complicated with Ketoacidosis
Authors: Pan Yunfei , Wang Qi , Zhao Feimin , Shen Jiaying , Zhong Xiaojing
Published: December 2021

Objective. To investigate the clinical effect of continuous subcutaneous injection of insulin analogues in pregnant women with diabetes mellitus complicated with ketoacidosis. Methods. A total of 92 pregnant patients with diabetes mellitus complicated with ketoacidosis from June 2014 to January 2021 were selected. All patients were randomly divided into an observation group and control group according to the method of random number. The control group received intravenous infusion of insulin, and the observation group received continuous subcutaneous infusion of quick-acting insulin analogues. The clinical effects of the two groups were observed. Results. The time needed to control blood glucose <13.8 mmol/L, the amount of insulin needed to control blood glucose <13.8 mmol/L, the time needed to correct DKA, and the amount of insulin needed to correct DKA in the observation group were significantly less than those in the control group (

P
<
0.05

). Compared with the control group, the average occurrence times of hypoglycemia, the length of stay, the total amount of insulin in hospital, and the total amount of insulin used during pregnancy in the observation group were significantly less than those in the control group (

P
<
0.05

). The values of SCr, CRP, BUN, arterial blood gas pH, and adiponectin in the two groups were significantly improved as compared with those before treatment, and the improvement in the observation group was significantly better than that in the control group (

P
<
0.05

). After treatment, the fasting blood glucose, 2-hour postprandial blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin in the experimental group were significantly better than those in the routine group, and the difference was statistically significant (

P
<
0.05

). Conclusion. Continuous subcutaneous injection of insulin analogues is effective in the treatment of diabetic patients with ketoacidosis, which can effectively improve blood glucose, carbon dioxide binding capacity, and glycosylated hemoglobin and accelerate the negative conversion of urinary ketone body. It is worth popularizing to reduce the occurrence of hypoglycemia and the dose of insulin and shorten the time of hospitalization.
A Rare Complication of Fine-Needle Aspiration of Neck Structures
Authors: Qadadha Yazeed M. , Nanda Nainika , Ennis Chad , McCulloch Timothy
Published: December 2021

Fine-needle aspiration (FNA) is a generally accepted tool for safe diagnostic evaluation in the workup of lesions and masses. Aside from the commonly discussed risks of infection and minor bleeding related to skin puncture, other more serious complications have been reported sparingly. We present two cases of pneumothorax from FNA of neck structures, which have been theorized but not previously reported to our knowledge. Discussion of cases of this complication rather than solely a theoretical understanding of it will aid in diagnosis and management of this complication.
EEG Analysis with Wavelet Transform under Music Perception Stimulation
Authors: Xue Jing
Published: December 2021

In order to improve the classification accuracy and reliability of emotional state assessment and provide support and help for music therapy, this paper proposes an EEG analysis method based on wavelet transform under the stimulation of music perception. Using the data from the multichannel standard emotion database (DEAP), α, ß, and θ rhythms are extracted in frontal (F3 and F4), temporal (T7 and T8), and central (C3 and C4) channels with wavelet transform. EMD is performed on the extracted EEG rhythm to obtain intrinsic mode function (IMF) components, and then, the average energy and amplitude difference eigenvalues of IMF components of EEG rhythm waves are further extracted, that is, each rhythm wave contains three average energy characteristics and two amplitude difference eigenvalues so as to fully extract EEG feature information. Finally, emotional state evaluation is realized based on a support vector machine classifier. The results show that the correct rate between no emotion, positive emotion, and negative emotion can reach more than 90%. Among the pairwise classification problems among the four emotions selected, the classification accuracy obtained by this EEG feature extraction method is higher than that obtained by general feature extraction methods, which can reach about 70%. Changes in EEG α wave power were closely correlated with the polarity and intensity of emotion; α wave power varied significantly between “happiness and fear,” “pleasure and fear,” and “fear and sadness.” It has a good application prospect in both psychological and physiological research of emotional perception and practical application.
Ontogeny and Vulnerabilities of Drug-Tolerant Persisters in HER2+ Breast Cancer
Authors: Chang Chewei Anderson , Jen Jayu , Jiang Shaowen , Sayad Azin , Mer Arvind Singh , Brown Kevin R. , Nixon Allison M.L. , Dhabaria Avantika , Tang Kwan Ho , Venet David , Sotiriou Christos , Deng Jiehui , Wong Kwok-kin , Adams Sylvia , Meyn Peter , Heguy Adriana , Skok Jane A. , Tsirigos Aristotelis , Ueberheide Beatrix , Moffat Jason , Singh Abhyudai , Haibe-Kains Benjamin , Khodadadi-Jamayran Alireza , Neel Benjamin G.
Published: December 2021

Resistance to targeted therapies is an important clinical problem in HER2-positive (HER2+) breast cancer. “Drug-tolerant persisters” (DTP), a subpopulation of cancer cells that survive via reversible, nongenetic mechanisms, are implicated in resistance to tyrosine kinase inhibitors (TKI) in other malignancies, but DTPs following HER2 TKI exposure have not been well characterized. We found that HER2 TKIs evoke DTPs with a luminal-like or a mesenchymal-like transcriptome. Lentiviral barcoding/single-cell RNA sequencing reveals that HER2+ breast cancer cells cycle stochastically through a “pre-DTP” state, characterized by a G0-like expression signature and enriched for diapause and/or senescence genes. Trajectory analysis/cell sorting shows that pre-DTPs preferentially yield DTPs upon HER2 TKI exposure. Cells with similar transcriptomes are present in HER2+ breast tumors and are associated with poor TKI response. Finally, biochemical experiments indicate that luminal-like DTPs survive via estrogen receptor–dependent induction of SGK3, leading to rewiring of the PI3K/AKT/mTORC1 pathway to enable AKT-independent mTORC1 activation.

Significance:

DTPs are implicated in resistance to anticancer therapies, but their ontogeny and vulnerabilities remain unclear. We find that HER2 TKI-DTPs emerge from stochastically arising primed cells (“pre-DTPs”) that engage either of two distinct transcriptional programs upon TKI exposure. Our results provide new insights into DTP ontogeny and potential therapeutic vulnerabilities.

This article is highlighted in the In This Issue feature, p. 873
Initial Experience with the Comprehensive Modified Laparoscopic Pyeloplasty Technique Based on Membrane Anatomy for Treating Ureteropelvic Junction Obstruction
Authors: Wu Guohao , Li Haomin , Zhong Peifeng , Chen Dongjiang , Zhang Zhihua , Guo Zexiong , Zhuo Yumin , Xue Lianfang , Lai Caiyong
Published: December 2021

Objective: The aim of the objective was to present our initial experience and evaluate the feasibility of the novel comprehensive modified laparoscopic pyeloplasty (CMLP) technique based on membrane anatomy. Materials and Methods: Forty-eight patients underwent CMLP from February 2016 to October 2020. CMLP involves the following: dissection of the ureter was based on the fascia or fusion fascia formed by embryonic development. The ureter was separated from the ureteral sheath, and the pelvis and ureter were incised with incomplete amputation. The first stitch was placed between the lower point of the spatulated ureter and the lowest corner of the renal pelvis to ensure correct orientation of the anastomosis; anastomosis of the renal pelvis and ureter was performed using the touchless technique. Results: All CMLPs were completed successfully without conversion. The mean overall operating time was 230.96 min. The median estimated blood loss was 50.00 (interquartile range 20.00–57.50) mL. The average postoperative hospital stay was 9.31 days. The average follow-up time was 24.73 months. No major complications occurred. In 1 case, revision laparoscopic pyeloplasty was performed, but the obstruction persisted after double J stent removal, so ultimately, the double J stent required regular replacement. Another asymptomatic patient with hydronephrosis experienced failed treatment and is still under follow-up. The overall success rate was 95.83% (46/48). The success rate in patients with recurrent ureteropelvic junction obstruction (UPJO) was 87.5% (7/8). Conclusions: CMLP is a practical and effective treatment option for UPJO with a high success rate. An advantage of CMLP is the clear surgical field.
Table Sugar as a Bridge from Emergency to Elective Perineal Proctosigmoidectomy for Incarcerated Rectal Prolapse
Authors: Kyriakos Saad Melissa , Saikaly Elias
Published: December 2021

Incarcerated rectal prolapse is a rare pathology and is considered an emergency, using table sugar can shift the emergency surgery to an elective one. If left untreated, rectal prolapse may present as an emergency, be it incarceration or strangulation. In an emergency presentation for incarcerated rectal prolapse every attempt should be taken to reduce the prolapsed rectum, if not successful, emergency surgery is indicated, with perineal approach being the first choice in elderly with multiple comorbidities.
Combined Higher Frequency Fish Consumption and Healthy Lifestyle May Lower the Triglyceride/HDL-C Ratio in Middle-Aged Japanese Males: Anti-Atherosclerotic Effect of Fish Consumption
Authors: Tani Shigemasa , Imatake Kazuhiro , Suzuki Yasuyuki , Yagi Tsukasa , Takahashi Atsuhiko , Matsumoto Naoya , Okumura Yasuo
Published: December 2021

Background: Fish consumption may be associated with a low risk of coronary artery disease. We aimed to investigate whether higher fish consumption results in improved lifestyle behaviors and thus lower triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio – a predictor of atherosclerotic cardiovascular disease (ASCVD). Methods and Results: This cross-sectional study included 2,947 middle-aged Japanese males with no history of ASCVD or lipid-modifying therapy, who presented at the Health Planning Center of Nihon University Hospital between April 2018 and March 2019. We performed an analysis of variance using fish consumption as a categorical variable (0–2 days, 3–4 days, or 5–7 days per week). The serum TG/HDL-C ratio in the 5–7 days fish consumption group was significantly lower than those in the 0–2 and 3–4 days fish consumption groups (p < 0.0001 and p < 0.01, respectively). Multiple regression stepwise analysis revealed that weekly fish consumption negatively and independently determined the TG/HDL-C ratio (β = −0.061, p = 0.001). As fish consumption increased, the proportion of subjects with smoking habits decreased (p = 0.014), those engaging in aerobic exercises and aggressive daily physical activity increased (p < 0.0001 for both), and those with alcohol habit increased (p < 0.0001). In addition, we developed the risk stratification for ASCVD by combining the serum HDL-C level and the serum TG/HDL-C ratio with fish consumption. Conclusion: Increased frequency of fish consumption and improved lifestyle behaviors due to daily fish intake may work additively to lower the serum TG/HDL-C ratio. These associations may explain why high fish consumption is associated with a lower risk of ASCVD. Our findings may help physicians and nutritionists in treating patients with heart diseases and metabolic conditions by recommending a high fish diet in middle-aged Japanese males.
Níveis de compreensão leitora em um livro didático de Língua Portuguesa: uma análise sobre perguntas de leitura
Authors: Brito Raíssa Martins , Carvalho Maria Angélica Freire de
Published: December 2021

A monitoração da compreensão textual por meio de perguntas é uma das estratégias mais empregadas nos livros didáticos de Língua Portuguesa (LDP). É comum o predomínio de perguntas exigindo do aluno operacionalizações voltadas à extração de informações textuais. Nesta pesquisa, observamos a natureza das perguntas ao texto nas seções de um LDP aprovado pelo PNLD no triênio de 2017-2019 (6º ano). Realizamos o estudo a partir da descrição do roteiro de perguntas de duas seções do livro, identificando os tipos de perguntas, os níveis de compreensão e as competências leitoras mais solicitadas. Metodologicamente, trata-se de uma pesquisa de natureza qualitativa com abordagem descritivo-interpretativa das perguntas das seções de compreensão. A fundamentação teórica seguiu os pressupostos da Linguística Textual, considerando estudos relacionados ao texto e à atividade de compreensão. Os resultados mostram perguntas destacando níveis de compreensão literal e inferencial e rara condução crítica por meio da integração do contexto extralinguístico.
Nanofluorescence Probes to Detect miR-192/Integrin Alpha 1 and Their Correlations with Retinoblastoma
Authors: Gao Yu , Zhang Hongjun , Zhao Shaofei , He Daotong , Gu Cao
Published: December 2021

We developed a novel nanostructure DNA probe for the in situ detection of ITGA1 and miR-192 in retinoblastoma (RB) and to study the correlation between ITGA1 and miR-192 expression and RB development. ITGA1 and miR-192 nanostructure DNA probes were carried
by silica particles and coated by dioleoyl-trimethy-lammonium-propane, which enhances their organizational compatibility and infiltration capacity. This probe has stable physicochemical properties and high specificity and sensitivity to detect ITGA1 and miR-192 in situ both in
RB cell lines and RB tissues. Using ITGA1 and miR-192 nanostructure DNA probes in RB tissue and cell lines, we found that the expression of ITAG1 drastically increased, but to the contrary, miR-192 was not expressed. After transfection, ITGA1 and miR-192 were overexpressed
or silenced in RB116 cells, and we found that ITGA1 could effectively increase the activity and invasion of this RB cell line and reduce its apoptosis level, while miR-192 antagonized this tumor-promoting effect. Therefore, miR-192 can be used as an early biomarker of RB, and ITGA1
may be a new prognostic marker and therapeutic target for the treatment of RB.
The Leading Mode and Factors for Coherent Variations among the Subsystems of Tropical Asian Summer Monsoon Onset
Authors: Hu Peng , Chen Wen , Chen Shangfeng , Liu Yuyun , Wang Lin , Huang Ruping
Published: December 2021

Previous studies on the Asian summer monsoon (ASM) onset mainly focused on each monsoon subsystem. Mainly based on the monthly mean rainfall and low-level winds in May, this study investigated the dominant onset mode from the perspective of the entire tropical ASM region, which reveals the coherent features among the regional-scale onsets. The results of multivariate empirical orthogonal function (MV-EOF) analysis indicate that the MV-EOF1 presents reduced rainfall and anomalous low-level easterly winds at 850 hPa over the tropical ASM region in May during its positive phase. The corresponding principal component (PC1) is highly correlated with the local monsoon onset dates over the Arabian Sea, the Bay of Bengal, the Indo-China Peninsula, and the South China Sea, where the mean monsoon onsets occur in May. The only exception is the Indian subcontinent, where the mean monsoon onsets occur in June. The results indicate that the leading mode captures the synchronized variation of monsoon onset over most Asian monsoon subsystems, which exhibits remarkable interannual and interdecadal changes. The factors that modulate the coherent variation of the tropical ASM onset are further examined. The simultaneously delayed ASM onset tends to occur during the easterly phase of the 30–80-day oscillation, the decaying phase of El Niño, and the positive phase of Pacific decadal oscillation (PDO). The 30–80-day oscillation serves as a background condition for the synchronized delayed or advanced ASM onset. El Niño–related sea surface temperature anomalies modulate the tropical ASM onset mode by modulating the tropical Walker circulation and inducing an atmospheric Rossby wave response. The PDO affects the tropical ASM onset mode mainly via the equatorial Rossby wave response and the extratropical Rossby wave train.
Context Information Can Increase Revenue in Online Display Advertising Auctions: Evidence from a Policy Change
Authors: Ada Sıla , Abou Nabout Nadia , Feit Elea McDonnell
Published: December 2021

Ad exchanges, where real-time auctions for display ad impressions take place, have historically emphasized user targeting, and advertisers sometimes did not know on which sites their ads would appear; in other words, they had no ad context. More recently, some ad exchanges have been encouraging publishers to provide context information to ad buyers that would allow them to adjust their bids for ads at specific sites. This article explores the empirical effect of a change in context information provided by a private European ad exchange. Analyzing this as a quasi-experiment using difference in differences, the authors find that average revenue per impression rose when the exchange provided subdomain information to ad buyers. Thus, ad context information is important to ad buyers, and they will act on it. Revenue per impression rises for nearly all sites, which is what auction theory predicts will happen when rational buyers with heterogeneous preferences are given more information. Exceptions are sites with thin markets prior to the policy change; consistent with theory, these sites do not show a rise in prices. This study adds evidence that ad exchanges with reputable publishers, particularly smaller volume, high-quality sites, should provide ad buyers with context information, which can be done at almost no cost.
Understanding EFL Instructor Identity Changes During Online Teaching in the COVID-19 Pandemic: A Case Study in China
Authors: Yuan Kaihao , Liu Shuwen
Published: December 2021

The outbreak of COVID-19 witnesses a sudden surge of fully online classes globally. Scholarly attention has promptly shifted to explore the personal experiences and perceived challenges of students and teachers. For English as a Foreign Language (EFL) instructors around the world, many are required to teach online for the first time, yet studies on their teacher identity development in online teaching contexts remain limited. To address this gap, the researchers conducted a case study of three EFL instructors in a Chinese university within an online semester to understand how their online teacher identities developed and shifted. The concepts of ‘imagined and practiced identity’ and social representation theory have been adopted as the conceptual framework. The findings revealed the trajectories of three online EFL instructors as their imagined identities evolved and renegotiated into their practiced ones based on individual and contextual factors. The findings reveal a lack of rule-based identities from the participants and highlight the need for pedagogical and psychological support for EFL teachers when they transition to an online context. Recommendations are made accordingly.
Development and Validation of a Prognostic Model to Predict Hearing Recovery for Patients With Chronic Otitis Media
Authors: Xie Fengyang , Zhen Xiaoyue , Zhu Haiyuan , Kou Yan , Li Changle , Guo Ling , Shi Li , Han Jie , Zhou Xuanchen
Published: December 2021

Objective

To explore the factors affecting postoperative hearing recovery in chronic otitis media (COM) patients, establish a clinical prediction model for hearing recovery, and verify the accuracy of the model.

Methods

Data of patients with COM who were admitted to our hospital between January 1, 2012 and September 30, 2020 were retrospectively analyzed. We collected data on relevant clinicopathological characteristics of patients. The patients were randomly divided into the development cohort and validation cohorts. A postoperative air-bone gap (ABG) ≤20 dB was defined as successful hearing recovery. Univariate and multivariable logistic regression analyses were used to investigate the association of several prognostic factors with hearing recovery. These factors were then used to establish a nomogram. The model was subjected to bootstrap internal validation and performance evaluation in terms of discrimination, calibration, and clinical validity.

Results

This study included 2146 patients with COM: the development cohort comprised 1610 patients (mean [standard deviation; SD] age, 44.1 [14.7] years; 733 men [45.5%]) and the validation cohort included 536 patients (mean [SD] age, 42.9 [14.4] years; 234 men [43.7%]). Multivariable logistic regression analysis showed that age, duration of onset, styles of surgery (tympanoplasty, canal wall up-CWU, or canal wall down-CWD), ossicular prosthesis, granulation or calcified blocks around the ossicular chain, ossicular chain integrity, duration of drilling, eustachian tube dysfunction, mixed hearing loss, semicircular canal fistula, and second surgery were associated with hearing recovery. A nomogram based on these variables was constructed. The area under the curve was 0.797 (95% confidence interval [CI], 0.778–0.812) in the development cohort and 0.798 (95% CI, 0.7605–0.8355) in the validation cohort.

Conclusions

This study demonstrated the various clinical factors correlated with hearing recovery in patients with COM. The nomogram developed with these data could provide personalized risk estimates of hearing recovery to enhance preoperative counseling and help to set realistic expectations in patients.
Interpersonal Consequences of Deceptive Expressions of Sadness
Authors: Gunderson Christopher A. , Baker Alysha , Pence Alona D. , ten Brinke Leanne
Published: December 2021

Emotional expressions evoke predictable responses from observers; displays of sadness are commonly met with sympathy and help from others. Accordingly, people may be motivated to feign emotions to elicit a desired response. In the absence of suspicion, we predicted that emotional and behavioral responses to genuine (vs. deceptive) expressers would be guided by empirically valid cues of sadness authenticity. Consistent with this hypothesis, untrained observers (total N = 1,300) reported less sympathy and offered less help to deceptive (vs. genuine) expressers of sadness. This effect was replicated using both posed, low-stakes, laboratory-created stimuli, and spontaneous, real, high-stakes emotional appeals to the public. Furthermore, lens models suggest that sympathy reactions were guided by difficult-to-fake facial actions associated with sadness. Results suggest that naive observers use empirically valid cues to deception to coordinate social interactions, providing novel evidence that people are sensitive to subtle cues to deception.
Social capital or non-human sources? A cross-context study on information source selection of migrant farmer workers
Authors: Wang Fang
Published: December 2021

Insufficient examination of social factors obscures the reason why non-human information sources are under-utilised by social groups with lower information literacy. This study explores the mechanism of information source selection (ISS) of Chinese migrant farmer workers (MFWs) in different industries by conducting a cross-context analysis. After iterative analyses of multiple cases, a theoretical model of information source selection within an individual’s information world is constructed. It explains why MFWs make more use of social capitals than non-human information sources in information seeking. Besides, the information needs are examined form both the needed information and the need itself. A classification of social capital as human information source is created and the roles that social capitals and non-human information sources play in ISS are identified. This study provides novel theoretical insights into the ‘old’ issue of ISS, and thus has practical implications for public information service providers and MFW-related policy makers.
Characterising users’ task completion process in learning-related tasks:A search pace model
Authors: Liu Chang , Song Xiaoxuan , Hansen Preben
Published: December 2021

This study investigated users’ searching, reading and writing interactions and their activity transitions during task completion process when users were collecting information for learning-related search tasks. Task completion process was defined as the process users started to search till the time when they have collected enough information to accomplish the search tasks. The data analysis was conducted from a new process perspective through synthesising macro- and micro-process levels. Four evenly distributed stages were divided according to the total task completion time in each search session. Our results demonstrated that users generally experienced three sub-processes during task completion process: exploration, accumulation and composition/reporting. Exploration sub-process is basically the first quarter of the total task completion time, during which users often issue more queries and visit more search engine result pages (SERPs) to collect information, and the dominant activity transition is switching between searching and reading; accumulation sub-process is mainly the second and third quarters of the total task completion time, during which they visit more unique content pages, have more revisits per content page, and they switch between reading and writing activities frequently; the last stage is composition/reporting sub-process, which is dominated by writing, and users often switch between writing and reading, and between writing and searching. Based on these findings, we propose a search pace model to describe how users proceed from the beginning to the end of task completion process in these three sub-processes. The methodology applied has been proved to be effective to examine users’ interaction behaviours from the process perspective on both the micro- and macro-levels. The findings of this article help us understand how users proceed their dynamic searching, reading and writing behaviours for learning-related tasks, and also have implications for the design of search systems that support learning-related tasks.
Social capital and individual motivations for information sharing: A theory of reasoned action perspective
Authors: Al-Husseini Sawasn J
Published: December 2021

Based on the theory of reasoned action, this study examined the impact of social capital and individual motivations on information sharing in the context of higher education. The research conducted an online survey of 277 academic technicians in five academic institutions in public university in Iraq. The model was developed using the structural equation modelling technique with AMOS v.27 and conditional hypotheses were tested. The findings suggest that social connection, trust, reciprocity, shared language, vision and a positive attitude towards assisting others influence technicians’ willingness to share information. It is also shown that attitude and subjective norms significantly affect information-sharing intentions. The results provide insights into understanding the social capital processes and individual motivations that contribute to information sharing among academic technicians in developing countries, particularly Iraq. Therefore, lab managers can implement practical plans to support these factors.
Tuberculoma – a great mimicker: can diffusion tensor imaging and tractography help?
Authors: Khan Beenish , Dixit Rashmi , Prakash Anjali , Aggarwal Sunita
Published: December 2021

Background

Central nervous system (CNS) tuberculomas often mimic tumors on conventional imaging, differentiation of which may not be possible without invasive tissue sampling. Diffusion tensor imaging (DTI), owing to its unrivalled property of characterizing molecular diffusion, may help in better lesion characterization and tractography may help understand the pattern of white matter involvement by tuberculomas.

Purpose

To estimate qualitative and quantitative diffusion tensor changes in brain tuberculomas and to evaluate patterns of white matter involvement using 3D tractography.

Material and Methods

Thirty patients with brain tuberculomas were evaluated on a 3-T magnetic resonance scanner. Diffusion tensor images were acquired along 20 non-colinear encoding directions with two b-values (b = 0, b = 1000). Regions of interest (ROIs) were drawn on quantitative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps in the center of the tuberculoma and perilesional area. Similar ROIs were placed in contralateral hemispheres for comparison. Tractography maps were also generated.

Results

Mean FA in the center and perilesional area of tuberculomas were 0.098 ± 0.041 and 0.311 ± 0.135, respectively. ADC values in corresponding regions were 0.920 ± 0.272 ×10−3 mm2/s and 1.157 ± 0.277 ×10−3 mm2/s. These values were significantly different compared to contralateral similar brain parenchyma. Tractography revealed interruption of white fibers in the center with deviation of fibers at the periphery in the majority of tuberculomas with none showing infiltration of white matter described in tumors.

Conclusion

Significant qualitative as well as quantitative DTI changes were seen in tuberculoma and perilesional areas compared to contralateral hemisphere with tractography showing a pattern different from that described in tumors. These findings may help to differentiate tuberculomas from infiltrating tumors.
Gaps in the continuum of care among people living with HIV in Afghanistan
Authors: Harooni Mohammad Zubair , Atarud Abdul Alim , Ehsan Ehsanullah , Alokozai Ajmal , McFarland Willi , Mirzazadeh Ali
Published: December 2021

Background

Afghanistan adopted a “test and treat” strategy for all people living with HIV (PLWH) in 2016. In this study, we presented demographic and clinical characteristics of all people diagnosed between 2013 and 2019 and evaluated progress towards 90-90-90 UNAIDS targets and identified program gaps among PLWH in Afghanistan diagnosed in 2018.

Methods

We used clinical, behavioral, and demographic data from national HIV surveillance for 1394 patients diagnosed from 2013 through 2019. We also tracked 184 patients diagnosed with HIV in 2018 over 15 months to assess their enrollment in care, antiretroviral therapy (ART) initiation, retention on ART, and viral suppression.

Results

Of 1394 patients diagnosed from 2013 through 2019, 76.0% were male, 73.7% were older than 24 years, and 33.4% acquired HIV through heterosexual sex. Of the 184 patients diagnosed in 2018, 94.6% were enrolled in care, 88.6% received ART, 84.2% were retained on ART for at least 12 months, and 33.7% received a viral load test. Of those with a viral load test, 74.2% were virally suppressed. Patients who were 35–44 years old (52.0%, p-value .001), acquired HIV through unsafe injection (62.5%, p-value .413), were co-infected with hepatitis C virus (HCV) (60.0%, p-value .449), and with CD4 > 500 at diagnosis (64.7%, p-value .294) were less likely to be virally suppressed 12 months after diagnosis.

Conclusion

Nearly 95% of people diagnosed with HIV in Afghanistan in 2018 were linked to care and nearly 90% were on ART. Viral testing and viral suppression remain low with notable disparities for middle-aged patients, and possibly for those who injected drugs. Addressing barriers to HIV programs in Afghanistan, particularly for people who inject drugs (PWID), are urgently needed to reach the 90-90-90 global targets. Surveillance data on the number of people with undiagnosed HIV is needed to assess the first 90 target.
Franz Tappeiner (1816–1902): The physician who became headhunter. Portrait of a leading figure in 19th Century anthropology
Authors: Brigo Francesco , Martini Mariano
Published: December 2021

Franz Tappeiner (1816, Laas – 1902, Merano) was an Austrian physician and anthropologist. He studied at the universities of Prague, Padua and Vienna and in 1846 he moved to Merano. Tappeiner investigated the transmission of pulmonary tuberculosis in animal models and he dealt with public health. As an anatomist, he performed thousands of craniometrics measurements, creating a huge skull collection later donated to the Natural History Museum in Vienna. In 1878, Tappeiner turned to archeology and palaeoanthropology, with the aim of clarifying the origins of the Alpine population of Tyroleans. He was also active as a botanist.
Revisiting Leadership Communication: A Need for Conversation
Authors: Rizvi Irfan A , Popli Sapna
Published: December 2021

Effective communication is critical for leaders to influence and create an impact within and outside organizations. Despite this, questions are raised regarding the efficacy & effectiveness of organizational leaders in conducting meaningful communication & conversations with their teams. Often, organizations are unsure of the specific leadership communication attributes and their outcomes at the individual, team and organizational levels. The primary objective of this study is to evaluate the impact of leaders’ communication on the feelings and thoughts of subordinates and to identify attributes for a possible measure of ‘effective leadership communication’. On the basis of ‘communicative leadership’ theorization by Johansson et al. (2014) , primary data was collected from employees’ across organizations. The study reveals gaps in the leader’s communication competence and suggests a need for more meaningful conversation with subordinates. The study proposes a tool for leadership communication assessment comprising two factors: transforming thoughts and transforming individuals.
Book review: Juned Shaikh, Outcaste Bombay: City Making and the Politics of the Poor
Authors: Devi Rama
Published: December 2021

Juned Shaikh, Outcaste Bombay: City Making and the Politics of the Poor. Orient BlackSwan, 2021, xii + 227 pp., ₹995.
Government Expenditure on Drinking Water and Sanitation in Uttar Pradesh, India: An Empirical Analysis of Its Trend and Composition
Authors: Shukla Rashmi
Published: December 2021

Government expenditure on water supply and sanitation (WSS) aims to improve both the quality of life and health conditions. Using budget analyses, this article highlights the trend and composition of WSS expenditure in Uttar Pradesh covering the period 1990–1991 to 2018–2019. The article also presents political regime wise trend of WSS expenditure and finds that political regime affects WSS expenditure. Regression analysis reveals that net state domestic product is negatively related to WSS expenditure. This is not a good sign for the state where unsafe drinking water, sanitation and hygienic condition is the fourth leading risk responsible for disease burden, and the current status of water, sanitation and hygiene (WASH) condition is quite low. The overall budget for WSS in Uttar Pradesh is grossly inadequate, irresponsive and out of sync with the development reality. There is an acute need of government intervention with higher budgetary allocations for the overall development of water and sanitation facilities in Uttar Pradesh.
Corporal punishment in New South Wales: A call for repeal of section 61AA
Authors: Greeff Laetitia-Ann
Published: December 2021

Corporal punishment is lawful in the home in all Australian states and territories. In early 2021, the Tasmanian Commissioner for Children and Young People called for a repeal of s 50 of the Criminal Code Act 1924 (Tas) which permits the use of corporal punishment in the home, noting that society had moved on from the regular canings of the early 20th century when the law was passed. This article supports the call to abolish the defence of reasonable chastisement (lawful correction in NSW) by repealing s 61AA of the Crimes Act 1900 (NSW) so that children can have the same protections from physical violence as adults.
Effect of Marital Status on the Survival of Patients With Adenocarcinoma of the Esophagogastric Junction: A Population-Based, Propensity-Matched Study
Authors: Wang Sihan , Chen Liubo , Chen Dongdong , Chao Jian , Shao Yangliu , Tang Kejun , Chen Wenteng
Published: December 2021

Background

Marital status has been reported as an independent prognostic factor in various types of malignancies. However, the association between marital status and outcomes of patients with adenocarcinoma of the esophagogastric junction (AEG) has not been fully explored. To this end, we aimed to investigate the effect of marital status on survival of AGE patients.

Methods

The Surveillance Epidemiology and End Results (SEER) database (2010–2015) was used to extract eligible patients with Siewert type II AEG. Meanwhile, propensity score matching was performed to match 1576 unmarried patients with 1576 married patients. Kaplan–Meier method with log-rank test was used to plot survival curves, univariate and multivariate Cox regression analyses were adopted to investigate the association of marital status with overall survival (OS) and cancer-specific survival (CSS) in AEG patients before and after matching.

Results

Multivariate analysis in the unmatched cohort revealed that marital status was an independent prognostic factor in patients with Siewert type II AEG. Unmarried patients had poorer OS (hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.12–1.29, P < .001) and poorer CSS (HR: 1.19, 95% CI: 1.10–1.29, P < .001) than married patients before matching. Additionally, widowed patients had the poorest OS (HR: 1.26, 95% CI: 1.11–1.44, P < .001) and CSS (HR: 1.29, 95% CI: 1.12–1.48, P < .001) compared with married patients. Furthermore, unmarried status remained as an independent prognostic for both OS (HR: 1.20, 95% CI: 1.10–1.31, P < .001) and CSS (HR: 1.18, 95% CI: 1.08–1.30, P < .001) in 1:1 propensity score-matched analysis. Subgroup analysis further revealed that OS and CSS rates were significantly higher in married patients than unmarried ones in most subgroups stratified by different variables.

Conclusions

This population-based study identified that marital status was an independent prognostic indicator for AEG patients. Married AEG patients had better prognosis than their unmarried counterparts.
Diagnostic Accuracy of D-Dimers for Predicting Pulmonary Embolism in COVID-19-Patients
Authors: Laouan Brem Falmata , Asmae Boudouh , Amane Yassine , Bouazzaoui Mohammed-Amine , Chaymae Miri , Rasras Hammam , Nasri Siham , Abda Naima , Skiker Imane , Kouismi Hatim , Zakaria Bazid , Ismaili Nabila , El Ouafi Noha
Published: December 2021

Importance

Proinflammatory and hypercoagulable states with marked elevation seen in D-Dimer levels have been accurately described in patients infected by the SARS- Cov2 even without pulmonary embolism (PE).

Objectives

To compare D-dimers values in patients infected by the novel Coronavirus 2019 (COVID-19) with and without PE and to establish an optimal D-dimer cut-off to predict the occurrence of PE, which guides pulmonary computed tomography angiography (CTPA) indication.

Methods

We retrospectively enrolled all COVID-19-patients admitted between October first and November 22th, 2020, at the University Hospital Center of Mohammed VI, Oujda (Morocco), suspected to have PE and underwent a CTPA. Demographic characteristics and blood test results were compared between PE-positive and PE-negative. The receiver operating characteristics (ROC) curve was constructed to establish an optimal D-Dimer cut-off to predict the occurrence of PE.

Results

The study population consisted of 84 confirmed COVID-19-patients. The mean age was 64.93 years (SD 14.19). PE was diagnosed on CTPA in 31 (36.9%) patients. Clinical symptoms and in-hospital outcomes were similar in both groups except that more men had PE ( p = .025). The median value of D-dimers in the group of patients with PE was significantly higher (14 680[IQR 33620-3450]ng/mL compared to the group of patients without PE 2980[IQR 6870-1600]ng/mL [P < .001]. A D-dimer at 2600 ng/mL was the optimal cut-off for predicting PE with a sensitivity of 90.3%, and AUC was .773[CI 95%, .667 −.876).

Conclusion

A D-dimer cut-off value of 2600 ng/mL is a significant predictor of PE in COVID-19-patients with a sensitivity of 90.3%.
Public Perceptions of Current COVID-19 Vaccinations. Results of a Pilot Survey
Authors: Kantarcioglu Bulent , Patel Krishan , Lewis Joseph , Iqbal Omer , Siddiqui Fakiha , Jabeen Nusrat , Laddu Atul R. , Carter Charles A. , Fareed Jawed
Published: December 2021

Introduction

We conducted a cross-sectional survey as a part of an educational program in collaboration with the Global Thrombosis Forum (GTF), an affiliate of North American Thrombosis Forum (NATF), and Loyola University about public perceptions of COVID-19 and COVID-19 vaccinations in the US. In this study, we are reporting the results of this survey.

Materials and Methods

The survey, in the form of a questionnaire, has been developed by GTF and faculty members. A prepared questionnaire was sent to the members of the Georgia and Illinois communities.

Results

In our current study, the COVID-19 vaccine willingness rate was 94.5% and vaccination rate was 90.9%. In multivariate analysis believing to have enough information about the safety and efficacy of COVID-19 vaccines (OR: 3.730, 95% CI: 1.199–11.603, p: 0.023) and gender (OR: 0.123, 95% CI: 0.016–0.967, p: 0.046) were significant predictors for vaccine willingness. Previous COVID-19 infection (OR: 0.215, 95% CI: 0.061–0.758, p: 0.017), moderate and severe effects of COVID-19 pandemic on participant's life (OR: 4.631, 95% CI 1.681–12.760, p: 0.003) and believing to have enough information about the safety and efficacy of COVID-19 vaccines (OR: 4.119, 95% CI: 1.508–11.253, p: 0.006) were significant predictors for final vaccination status.

Conclusion

In conclusion, currently vaccination remains one of the most effective tools in the fight against the COVID-19 pandemic. The vaccine hesitancy is a complex phenomenon that is driven by individuals' perceptions of safety, and efficiency of the vaccines. We must continue to educate the public and communities that vaccines are safe, that they are effective and that they are still required even after a COVID-19 infection.
Improving Prediction of Long-Term Care Utilization Through Patient-Reported Measures: Cross-Sectional Analysis of High-Need U.S. Veterans Affairs Patients
Authors: Jacobs Josephine C. , Maciejewski Matthew L. , Wagner Todd H. , Van Houtven Courtney H. , Lo Jeanie , Greene Liberty , Zulman Donna M.
Published: December 2021

This article examines the relative merit of augmenting an electronic health record (EHR)-derived predictive model of institutional long-term care (LTC) use with patient-reported measures not commonly found in EHRs. We used survey and administrative data from 3,478 high-risk Veterans aged ≥65 in the U.S. Department of Veterans Affairs, comparing a model based on a Veterans Health Administration (VA) geriatrics dashboard, a model with additional EHR-derived variables, and a model that added survey-based measures (i.e., activities of daily living [ADL] limitations, social support, and finances). Model performance was assessed via Akaike information criteria, C-statistics, sensitivity, and specificity. Age, a dementia diagnosis, Nosos risk score, social support, and ADL limitations were consistent predictors of institutional LTC use. Survey-based variables significantly improved model performance. Although demographic and clinical characteristics found in many EHRs are predictive of institutional LTC, patient-reported function and partnership status improve identification of patients who may benefit from home- and community-based services.
Pandemic, Therapy, and a Meditation on How: A Creative-Relational Inquiry
Authors: Wyatt Jonathan
Published: December 2021

“A creative-relational inquiry,” writes Dan Harris, “might be so small as to be imperceptible to the human eye . . . [b]ut it might also simultaneously be so big that whole universes exist within, between, and through it.” In this brief article, I take up Harris’ claim, writing into questions of scope and pace at this pandemic time, like how the small and the slow of an Edinburgh lockdown flutters into writing, poetic and therapeutic life, while around, within and beyond there is the multiplicity of the small, vast and fast of a virus. The text mutates with one small word, “how.”
Assessment of adverse events among cervical cancer patients at Kenyatta National Hospital
Authors: Kibaara Muthoni , Degu Amsalu
Published: December 2021

Introduction

Due to their cytotoxic nature, anticancer drugs and radiotherapy have the potential to cause toxic adverse events. As a result, they can increase the risk of morbidity and mortality. However, there was a lack of data among cervical cancer patients in our setting. Hence, this study was aimed to assess the prevalence of adverse events among cervical cancer patients at Kenyatta National Hospital.

Methods

A cross-sectional study design was employed among a consecutive sample of 151 adult cervical cancer patients. The data were collected by reviewing the medical records and interviewing the patients. The data were entered and analyzed using SPSS 27.0 software. The results were presented with frequency tables and graphs.

Results

A total of 214 adverse events (prevalence of 100%) were identified from 151 patients. The most common adverse events identified were ulcerated sores (52.8%), dysuria (7.5%), thrombocytopenia (5.6%), and loss of appetite (5.6%). The majority of the patients (80.8%) who had adverse events were on radiotherapy. As per the Naranjo causality assessment scale, the predominant (80.1%) proportion of the adverse event was a probable adverse event with a total score of 5–8. Besides, 15.9% of the adverse events had a possible causality. The present study also reported that 61.6% of patients with a probable adverse event were treated with radiotherapy.

Conclusion

The prevalence of adverse events among cervical patients was high in our setting. The predominant proportion of the adverse event was a probable adverse event and most of them were treated with radiotherapy.