bluuebunny/crossref_metadata_2025 huggingface dataset:
Leydig Cell Tumor in a Patient with 46,XX Disorder of Sex Development (DSD), Ovotesticular: A Case Report and a Review of the Literature
Authors: Gretser Steffen , Welte Maria-Noemi , Roos Frederik , Köllermann Jens
Published: March 2021

Disorder of sex development (DSD) is a rare condition with atypical development of chromosomal, gonadal, or anatomical sex. It is classified in different subgroups based on the patient’s karyotype, gonadal dysgenesis, and the appearance of the internal and external genitalia. Within the subgroups, the risk for developing neoplasms varies a lot. Here, we report the case of a 41-year-old patient with disorder of sex development, showing a 46,XX karyotype with an ovotestis and the simultaneous manifestation of a Leydig cell tumor in the ovotestis. The patient initially presented with infertility, and a suspicious lesion of the left testicle was noted on MRI-Scan. Upon resection, a Leydig cell tumor and an ovotestis were diagnosed. Nongerm call tumors are rare in patients with DSD. We report a nongerm cell tumor in a patient with 46,XX DSD, ovotesticular. This shows that although 46,XX DSD, ovotesticular is known to have a low potential for germ cell neoplasia, nongerm cell tumors can develop and should be into account for the management of those patients.
Study on the Synthesis of Chabazite Zeolites via Interzeolite Conversion of Faujasites
Authors: Dang Long Van , Nguyen Thu Thi Minh , Do Dang Van , Le Son Thanh , Pham Trong Dinh , Le Anh Thi Mai
Published: March 2021

The interzeolite conversion of faujasite (FAU-type) zeolites to chabazite (CHA-type) zeolite in the presence of N,N,N-trimethyladamantammonium and N,N,N-dimethylethylcyclohexylammonium cations was investigated over a large compositional range by carefully controlling the reaction mixture compositions. Highly crystalline CHA zeolites were also obtained by the transformation of several zeolite types including EMT, LTL, LEV, RTH, and MFI frameworks. The formation of CHA zeolite from FAU zeolite precursors was substantially faster than that from zeolite L with a similar composition. High-silica CHA zeolites were also produced successfully using a mixture of TMAda with a number of less expensive organic structure-directing agents. The CHA zeolite materials have been synthesized with high crystallinity and with a Si/Al ratio ranging from 5 to 140. Our data support the importance of structural similarity between the zeolite precursors, nucleation/crystallization processes, and the zeolite product in the interzeolite conversion compared to conventional amorphous aluminosilicate gels. Our synthetic methods could be used to prepare other 8-membered ring zeolites such as AEI and AFX frameworks, potential candidates for selective catalytic reduction of NOx, light olefin production, and CO2 abatement.
Impact of Ramadan Intermittent Fasting on the Heart Rate Variability and Cardiovascular Parameters of Patients with Controlled Hypertension
Authors: Hammoud Sabah , Saad Iman , Karam Rita , Abou Jaoude Fayez , van den Bemt Bart J. F. , Kurdi Mazen
Published: March 2021

Background. Conflicting results are reported on the effect of Ramadan fasting on the cardiovascular health of patients with hypertension, a highly prevalent cardiovascular disease risk factor. This research aimed to evaluate the impact of fasting on cardiac health and heart rate variability (as a measure of cardiac stress) of hypertensive patients. Methods. Patients with controlled hypertension were followed in a prospective cohort during and after Ramadan. Lipid panel and blood glucose were measured at the end of each phase. Blood pressure and heart rate variability were monitored in the morning, afternoon, and evening of each follow-up day. Results. The study included 58 subjects (mean age: 54 ± 11.5 years, 52% male). Fasting did not affect body composition, lipid panel parameters, and blood pressure of hypertensive subjects; males only presented lower body weight and hip circumference during Ramadan. Blood glucose was significantly higher during Ramadan. Fasting significantly increased HRV during the afternoon period. Conclusions. Ramadan intermittent fasting reduces cardiac stress among hypertensive patients controlled by and adherent to hypertensive medication, without affecting their hypertensive state.
Thoracic Surgery Consultations in COVID-19 Critically Ill Patients: Beyond Conservative Approach
Authors: Aljehani Yasser , Othman Sharifah A. , Almubarak Yousif , Elbaz Ayman , Sabry Mohammed , Alreshaid Farouk , Elbawab Hatem Y. , Alghamdi Zeead M. , Alshahrani Mohammed
Published: March 2021

Introduction. Iatrogenic pneumothoracis, barotraumas, and tracheoesophageal fistulae, especially after prolonged intubation, and tracheal stenosis are all entities involving thoracic surgeons’ consultation and management. With the surge of COVID-19 cases particularly in the critical care settings, various types of complications have been observed that require intervention from thoracic surgeons. Methods and Materials. A retrospective study was conducted in an academic healthcare institute in the Eastern Province of Saudi Arabia. We included all COVID-19 cases admitted to ICU in the period between March 15, 2020, and August 15, 2020, requiring thoracic surgery consultation and management. Non-COVID-19 critical cases and iatrogenic pneumothorax were excluded. Results. Of 122 patients who were admitted to ICU with COVID-19, 18 patients (14.75%) required thoracic surgery consultation and management. We discovered a significant association between the outcomes and reintubation rates and the rate of pneumothorax occurrence. The survival analysis showed improvement in patients who had thoracostomy tube insertion as a management than the group who were treated conservatively. On the other hand, there was a significant difference between the COVID ICU group who had thoracic complication and those who did not regarding the length of hospital stay. Conclusion. Noniatrogenic pneumothorax, subcutaneous emphysema, and mediastinal emphysema are well-known thoracic entities, but their presence in the context of COVID-19 disease is a harbinger for worse prognosis and outcomes. The presence of pneumothorax may be associated with better prognosis and outcome compared to surgical and mediastinal emphysema.
Numerical Simulation of Channelization Near the Wellbore due to Seepage Erosion in Unconsolidated Sands during Fluid Injection
Authors: Sun Jin , Wu Shiguo , Deng Jingen , Li Qingping , Fan Qi , Ma Linwei , Liu Yanrui
Published: March 2021

The channels may be formed in the unconsolidated sands reservoir due to formation failure during high-pressure water injection or frac-packing. Based on the continuum mechanics, a mathematical model has been established to simulate the formation process of big channels in unconsolidated sands reservoir during fluid injection. The model considers the effect of reservoir heterogeneity, solid particles erosion, and deposition. The dynamic formation process of channels around the borehole and its influencing factors are analyzed by this model. The results indicate that the seepage erosion plays a very significant role in the formation of the channels during fluid injection for the unconsolidated sands with extremely low strength. The formation of the channels is closely related to the duration of fluid injection, injection pressure, reservoir heterogeneity, formation plugging, and critical fluid velocity. The long channels are more likely to form as injection time increases. Higher injection pressure will lead to higher flow rate, thus eroding the solid particles and forming big channels. The increase of the rock strength will enhance the value of critical fluid velocity, which makes it difficult for the occurrence of erosional channelization. The near-wellbore damage of the formation will decrease the flow rate, and the preferential flow channels are less likely to be induced under the same injection pressure when compared with undamaged formation. In addition, we also found that the reservoir heterogeneity is essential to the formation of preferential flow channels. The channels are especially prone to be formed in the regions with high porosity and permeability at the initial time. The study can provide a theoretical reference for the optimal design of high-pressure water injection or frac-packing operation in the unconsolidated sands reservoir.
Similarities between Tumour Immune Response and Chronic Wound Microenvironment: Influence of Mesenchymal Stromal/Stem Cells
Authors: Peta Kimberly Thando , Ambele Melvin Anyasi , Pepper Michael Sean
Published: March 2021

Tumours are characterized by a state of chronic inflammation and are regarded as wounds that never heal. Mesenchymal stromal/stem cells (MSCs) are being considered as a possible treatment option. While MSCs can regulate the immune system, migrate to sites of inflammation, and are naturally immune-privileged, there have been contradictory reports on the role of these cells in the tumour microenvironment (TME). Some studies have suggested that MSCs promote tumourigenesis while others have suggested the contrary. To better evaluate the role of MSCs in the TME, it may be helpful to understand the role of MSCs in chronic wounds. Here, we discuss the role of MSCs in chronic wounds and extrapolate this to the TME. Chronic wounds are stuck in the inflammatory phase of wound healing, while in the case of the TME, both the inflammatory and proliferative phases are exploited. MSCs in chronic wounds promote a switch in macrophage phenotype from proinflammatory (M1) to anti-inflammatory (M2), thereby suppressing T, B, and natural killer cells, consequently promoting wound healing. In the case of the TME, MSCs are reported to promote tumorigenesis by suppressing T, B, and natural killer cells in addition to dendritic cells, cytotoxic T cells, and Th1-associated cytokines, thereby promoting tumour growth. Some studies have however suggested that MSCs inhibit tumourigenesis, depending on the source of the MSCs and the specific mediators involved. Therefore, the role of MSCs in the TME appears to be complex and may result in variable outcomes. Compelling evidence to suggest that MSCs are an effective treatment option against tumour progression is lacking.
Order Fulfillment Decision under Multiwarehouse Collaborative Delivery
Authors: Shuanjun Song , Longguang Peng , Yuanyi Meng , Sheng Hu
Published: March 2021

Aiming at the high cost of multicategory orders fulfillment under multiwarehouse collaborative distribution, comprehensively considering the fulfillment costs of different orders fulfillment strategies, an order fulfillment strategy selection model is proposed. The first step of the model uses the linear programming algorithm to solve the cost of suborder merge transportation after the order is split. The second step calculates the cost of the current “greedy algorithm” of the e-commerce platform for order split fulfillment. Then, the cost of each strategy is compared and the lowest cost one is chosen. The calculation example analysis shows that the order fulfillment strategy is closely related to the delivery location of the order and the SKU category. When the delivery location is far away and SKU categories are many in the order, the merged transportation strategy of suborders after the order is split will be significantly better than the cost of separate transportation. The multiwarehouse collaborative distribution fulfillment strategy proposed in this paper can provide a decision basis for the e-commerce platform to choose which fulfillment method.
Impact‐Induced Liquefaction Mechanism of Sandy Silt at Different Saturations
Authors: Li Heng , Duan Zhao , Dong Chenxi , Zhao Fasuo , Wang Qiyao
Published: March 2021

Landslide‐induced liquefaction has received extensive attention from scholars in recent years. In the study of loess landslides in the southern Loess Plateau of Jingyang, some scholars have noted the liquefaction of the near‐saturated sandy silt layer that is caused by the impact of loess landslides on the erodible terrace. The impact‐induced liquefaction triggered by landslides is probably the reason for the long‐runout landslides on the near‐horizontal terrace. In order to reveal the mechanism of impact‐induced liquefaction, this paper investigates the development of pore pressure and the impact‐induced liquefaction of sandy silt under the influence of saturation through laboratory experiments, moisture content tests, and vane shear tests. It has been found that both the total pressure and pore water pressure undergo a transient increase and decrease at the moment of impact on the soil, which takes 40–60 ms to complete and only about 20 ms to arrive at the peak. Moreover, silty sand with a saturation of more than 80° was liquefied under the impact, and the liquefaction occurred in the shallow layer of the soil body. The shear strength of the liquefied part of the soil is reduced to 1.7∼2.8 kPa. Soils with lower saturation did not liquefy. The mechanism of the impact‐induced liquefaction can be described as follows: under impact, the water in the soil gradually fills the pores of the soil body as the pore size decreases, and when the contact between the soil particles is completely replaced by pore water, the soil body loses its shear strength and reaches a liquefied state. Soils in the liquefied state have a very high permeability coefficient, and the water inside the soil body migrates upward as the particles settle, resulting in high‐moisture content in the upper soil.
Evaluation of Guided Bone Regeneration in Critical Defects Using Bovine and Porcine Collagen Membranes: Histomorphometric and Immunohistochemical Analyses
Authors: Ramires Guilherme A. D. , Helena Julia Taino , Oliveira Júlio C. S. De , Faverani Leonardo Perez , Bassi Ana Paula F.
Published: March 2021

Guided bone regeneration (GBR) is a technique used to facilitate bone regeneration, which uses a biocompatible membrane acting as a physical barrier to prevent the adjacent connective tissue from invading the bone defect. The aim of this study was to evaluate and compare the effectiveness of bovine and porcine collagenous membranes as barriers to connective tissue invasion during the repair of critical bone defects in rat calvaria, using histological, histometric, and immunohistochemical analyses. For this study, 72 rats were divided into three groups: clot group (CG), bovine collagen group (BCG), and porcine collagen group (PCG). Analyses were performed on days 7, 15, 30, and 60. The histological results showed that the PCG exhibited bone neoformation starting from day 7, and after 30 days of repair, the surgical defect was completely filled in some animals. For the BCG, there was little bone neoformation activity in the initial periods, and from day 30 onwards, there was an increase in bone neoformation, with a greater increase on day 60. The data obtained in the histometric analysis reveal that, on day 30, the neoformed bone area did not vary greatly between the PCG and the BCG, though both varied from the CG. By day 60, the PCG presented a greater area of neoformation than the BCG. These results were corroborated by the immunohistochemistry results. In view of the results obtained, it can be concluded that all membranes studied in this research promoted GBR.
Survival Disparities in Multiple Myeloma by Health Insurance Status among US Non-Elderly Adults: A SEER-Based Comparative Analysis
Authors: Huang Congyang , Liu Hanshan , Jia Li , Lu Min , Hu Suyun
Published: March 2021

Background/Aim: The impacts of health insurance status on survival outcomes in multiple myeloma (MM) have not been addressed in depth. The present study was conducted to identify definite relationships of cancer-specific survival (CSS) and overall survival (OS) with health insurance status in MM patients. Methods: MM patients aged 18–64 years and with complete insurance records between January 1, 2007, and December 31, 2016, were identified from 18 Surveillance, Epidemiology, and End Results (SEER) Database registries. Health insurance condition was categorized as uninsured, any Medicaid, insured, and insured (no specifics). Relationships of health insurance condition with OS/CSS were identified through Kaplan-Meier, and uni-/multivariate Cox regressions using the hazard ratio and 95% confidence interval. Potential baseline confounding was adjusted using multiple propensity score (mPS). Results: Totally 17,981 patients were included, including 68.3% with private insurance and only 4.9% with uninsurance. Log-rank test uncovered significant difference between health insurance status and OS/CSS among MM patients. Patients with non-insurance or Medicaid coverage in comparison with private insurance tended to present poorer OS/CSS both in multivariate Cox regression and in mPS-adjusted model (non-insurance vs. private insurance [OS/CSS]: 1.33 [1.20–1.48]/1.13 [1.00–1.28] and 1.45 [1.25–1.69]/1.18 [1.04–1.33], respectively; Medicaid coverage vs. private insurance [OS/CSS]: 1.67 [1.56–1.78]/1.25 [1.16–1.36] and 1.76 [1.62–1.90]/1.23 [1.13–1.35], respectively). Conclusions: Our observational study of exposure-outcome associations suggests that insufficient or no insurance is moderately linked with OS among MM patients aged 18–64 years. Wide insurance coverage and health-care availability may strengthen some disparate outcomes. In the future, prospective cohort research is needed to further clarify concrete risks with insurance type, owing to the lack of definite division of insurance data in SEER.
Left Atrial Appendage Flow Velocity and Multiple Infarcts in Cryptogenic Stroke
Authors: Tokunaga Keisuke , Hashimoto Go , Mizoguchi Tadataka , Mori Kota , Shijo Masahiro , Jinnouchi Juro , Kuwashiro Takahiro , Yasaka Masahiro , Kitazono Takanari , Okada Yasushi
Published: March 2021

Background: To validate the hypothesis that cryptogenic stroke with multiple infarcts included embolic stroke due to left atrial appendage (LAA) dysfunction, the present retrospective observational study was aimed to clarify the association between LAA flow velocity (LAA-FV) and multiple infarcts in patients with cryptogenic stroke. Methods: From consecutive patients with cryptogenic stroke admitted to our hospital within 7 days after onset, patients without brain magnetic resonance imaging (MRI) on admission or without transesophageal echocardiography (TEE) during acute hospitalization were excluded, and the remaining patients were enrolled. Multiplicity of fresh infarcts was assessed using diffusion-weighted images from brain MRI. LAA-FV was defined as LAA peak emptying flow velocity on TEE. Results: Of 786 enrolled patients, 522 patients (66%) had a single infarct, and the remaining 264 patients (34%) had multiple infarcts. The percentage of multiple infarcts decreased with increasing quartiles of LAA-FV (p for trend <0.001). The adjusted odds ratio for multiple infarcts decreased with increasing quartiles of LAA-FV (adjusted odds ratio in the fourth quartile, 0.39; 95% confidence interval, 0.25–0.60; compared with the first quartile). LAA-FV as a continuous variable was negatively associated with multiple infarcts (adjusted odds ratio per 10 cm/s, 0.87; 95% confidence interval, 0.81–0.92). Conclusions: Reduced LAA-FV on TEE was associated with multiple infarcts in patients with cryptogenic stroke. The present findings indicate that cryptogenic stroke with multiple infarcts includes embolic stroke due to LAA dysfunction.
Does the Acoustic Voice Quality Index (AVQI) Correlate with Perceived Creak and Strain in Normophonic Young Adult Finnish Females?
Authors: Laukkanen Anne-Maria , Rantala Leena
Published: March 2021

Background: The Acoustic Voice Quality Index (AVQI) is a correlate of dysphonia. It has been found to differentiate between dysphonic and normophonic speakers and to indicate the effects of voice therapy. This study investigates how the AVQI reacts towards creak and strain, which are common in normophonic speakers. Methods: The material was obtained from an earlier study on 104 Finnish female university students (mean age 24.3 years, SD 6.3 years) with no known pathology of voice or hearing and a perceptually normal voice (G = 0 in GRBAS), who were recorded while reading aloud a standard text and sustaining the vowel [a:]. Perceptual analysis for the amount of creak and strain was carried out by 2 expert listeners. In this study, the AVQI v03.01 was analyzed and correlated with perceptual evaluations. Samples with low and high amounts of creak and strain were compared with t tests. Results: On average, the AVQI was below the threshold value of dysphonia in the Finnish population. The AVQI (ρ = 0.35, p = 0.000) and its subparameters, smoothed cepstral peak prominence (CPPS; ρ = –0.35, p = 0.000) and harmonics-to-noise ratio (HNR; ρ = –0.30, p = 0.002) showed low but significant correlations with creak. Strain had low but significant correlations with spectral Slope (ρ = 0.38, p = 0.000) and Tilt (ρ = –0.40, p = 0.009). The AVQI was lower (better) in samples that were evaluated as having a high amount of strain, but the difference was not significant. Only CPPS differentiated significantly between low and high amounts of creak. Conclusion: The AVQI does not seem to differentiate between high and low amounts of creak and strain in normophonic speakers.
Turban Tumor Syndrome: In Search of a Gold Standard – A Case Report
Authors: Bargiel Jakub , Wyszyńska-Pawelec Grażyna , Gontarz Michał , Gąsiorowski Krzysztof , Marecik Tomasz , Szczurowski Paweł , Zapała Jan
Published: March 2021

Turban tumor syndrome (TTS) is a rare condition characterized by predisposition to developing multiple adnexal tumors. It is the rare autosomal dominant genodermatosis that is associated with the mutation of the CYLD suppressor gene. We herein report rare TTS in an adult who suffered from numerous episodic ulcerations of the scalp tumors and frequent bleeding following a minor trauma. The plain radiograms of the skull excluded bone marrow infiltration, and no regional lymphadenopathy was noted. The patient underwent total scalp excision and split skin grafting under general anesthesia in a single-stage operation. Recovery was uneventful. No recurrence was observed during the 2-year follow-up. Due to a high recurrence rate and risk of neoplastic transformation, surgery should be considered as the gold standard.
Illusions, Delusions, and Your Backwards Bayesian Brain: A Biased Visual Perspective
Authors: Born Richard T. , Bencomo Gianluca M.
Published: March 2021

The retinal image is insufficient for determining what is “out there,” because many different real-world geometries could produce any given retinal image. Thus, the visual system must infer which external cause is most likely, given both the sensory data and prior knowledge that is either innate or learned via interactions with the environment. We will describe a general framework of “hierarchical Bayesian inference” that we and others have used to explore the role of cortico-cortical feedback in the visual system, and we will further argue that this approach to “seeing” makes our visual systems prone to perceptual errors in a variety of different ways. In this deliberately provocative and biased perspective, we argue that the neuromodulator, dopamine, may be a crucial link between neural circuits performing Bayesian inference and the perceptual idiosyncrasies of people with schizophrenia.
Measuring Semantic Similarity in Grids Using Ontology
Authors: Bagherifard Karamollah , Nilashi Mehrbakhsh
Published: March 2021

Grid computing is a new and broad research area that aims to share resources available in many computers in the network. Web services have necessary capabilities to achieve this goal and due to this, usually grid service is called a Web service. Measuring the similarity of services is an important and valuable task that is used particularly in some cases such as replacing a service with another service or combination of services and applications. In this paper, a semantic model based on OWL ontology language for services is presented and with regard to this, the similarity measure is provided .Finally, a mathematical model for solving two given problems is proposed.
Factors that Influence the Android Apps Permissions
Authors: Awang Abu Bakar Normi Sham , Mahmud Iqram
Published: March 2021

The Android Market is the official (and primary) storefor Android applications. The Market provides users with average user ratings, user reviews, descriptions, screenshots,and permissions to help them select applications. Generally, prior to installation of the apps, users need to agree on the permissions requested by the apps, they are not given any other option. Essentially, users may not aware on some security issues that may arise from the permissions. Some apps request the right to manipulate sensitive data, such as GPS location, photos, calendar, contact, email and files. In this paper, we explain the sources of sensitive data, what the malicious apps can do to the data, and apply the empirical software engineering analysis to find the factors that could potentially influence the permissions in Android apps. In addition, we also highlight top ten most implemented permissions in Android apps and also analyse the permissions for the apps categories in Android.
International Journal for Research and Development in Engineering
Authors: Nadkarni Tushar
Published: March 2021

Search Engines are tremendous force multipliers for end hosts trying to discover content on the Web. As the amount of content online grows, so does dependence on web crawlers to discover relevant content. The motive is to develop an efficient Web Crawler that will give results more relevant to search keyword and faster, which will support Semantics extraction, multithreading and distributed computing.
Computer Users Perceptions of Indonesian Online Bussines Webpage Based on Human Computer Interface
Authors: Sudarma Made
Published: March 2021

Nowadays, in this era of information technology personal computer is common usage in office and home purposes. Most of personal computer software applications use US-English for its user interface and not all countries use the computer instruction using the language of the country concerned. In general, the problems caused by conditions like this one is creates a semantic gap. Indonesian is also experiencing these problems which there are still many Indonesian people that cannot understand in computer English instructions. This gap may increase intensifies globalization. However, the semantic gap also creates end users market opportunity for Indonesian computer application with appropriate terminology. With proper terminology, making computer software applications will target of non-advanced users.

This paper researches on the potentials of an Indonesian online bussines web browser. A mocked-up clone of Mozilla Firefox 18.1 was made for the purpose of collecting questionnaire result from respondents. The respondents were computer course students which meet the criterions of non-advanced users. The test that was done states that simple straightforward translations should be adequate for most cases, although a standardization of terminologies is still required.
Nitriary Model Towards Study of Flip-Flop Gates in Internet
Authors: Fernando Erick , Touriano Derist
Published: March 2021

Scholars agree that embedded configurations are an interesting new topic in the field of artificial intelligence, and scholars concur. In fact, few experts would disagree with the development of Smalltalk, which embodies the extensive principles of e-voting technology. We used atomic epistemologies to demonstrate that model checking and digital-to-analog converters are rarely incompatible. In this paper, we disprove not only that simulated annealing can be made cooperative, cooperative, and omniscient, but that the same is true for link-level acknowledgements. the main contribution of our work is that we used cooperative communication to confirm that SCSI disks and agents are regularly incompatible. Continuing with this rationale, to fix this issue for checksums, we presented an analysis of active networks.
The Identification of Balinese Scripts’ Characters in Papyrus Based on Semantic Feature and K Nearest Neighbor
Authors: Sudarma Made , Surya Darma I Wayan Agus
Published: March 2021

Papyrus script is a cultural heritage in Bali. As we know, that the papyrus is a cultural matter which is rich in valuable cultural values. Issues or problems encountered today is that the papyrus are not well maintained. Thus, many papyrus becomes damaged because it is not stored properly. Papyrus script was written using Balinese script’s characters which having different features compared with Latin’s characters. Balinese script can be recognized with feature extraction owned by each Balinese script. KNN is a classification algorithm based on nearest neighborhood. KNN can be used to classify Balinese script’s features so that the test Balinese script’s features which having nearest neighborhood value with the trained Balinese script’s features will be recognized as the same Balinese script
Spiritual Maturity and the Appropriate Age for a Bishop in Auxentius of Durostorum
Authors: Tone Hiroshi
Published: March 2021

Epistula de Wulfila episcopo by Auxentius of Durostorum reported that Ulfila became a bishop when he was thirty years old. This report was dramatized in order to emphasize Ulfila’s sanctity. This study will examine the symbolic meaning of thirty years old, and explain how it is a deep-rooted and continual idea in the arrangement of clerical offices. As a result, I contend that the symbolism of “thirty years old” was the appropriate age for someone to lead the community. This idea came from Numbers 4:2–3 and could be also found in the Judaic tradition. One could argue that this idea on spiritual leadership prevailed, was accepted and was later the basis of the clerical offices.
The List of Aristotelian Types of Motion and Its Extension in De duabus in Christo voluntatibus of John Damascene
Authors: Tölpt Tauri
Published: March 2021

John Damascene’s use of philosophical logic in his theological treatises has remained a somewhat unclear subject. We know that John compiled purely logical and philosophical works, such as the Institutio Elementaris and the Dialectica. But it is not clear how much, if at all, John’s purely philosophical projects contributed to his later theological work. In order to illuminate the issue, I shall take under investigation the Damascene’s implementation of the Aristotelian types of motion that are clearly found both in John’s philosophic and in his theological works. One of his theological works in which the Aristotelian types of motion are used in tandem with the intelligible motion is the De duabus in Christo voluntatibus. Taking this Christological work as a starting point, this article aims to shed light on the potential sources behind the Damascene’s use of the different types of motion and the significance thereof for his arguments against Monothelitism and Monoenergism.
Rus’/Russia and the Mongols: Some Remarks on the Historical Meaning and the Present Debate of the Mongol-Tatar yoke
Authors: Pubblici Lorenzo
Published: March 2021

The Mongol conquests and the following dominations have long been the subject of historical reevaluation by the scientific community. The spread and progressive specialization of Mongolian studies of the latest decades have also affected the westernmost of the four khanates resulted from the division of the Empire: the ulus Jochi, better known as Golden Horde. Russia’s territorial vastity, its proximity to Western Europe, and its multicultural characters have all attracted the historians’ attention to the Mongol era. By retracing the crucial historiographical passages, from nineteenth-century studies to the present day, this article aims to provide a broad and updated perspective of how the scientific debate has developed internationally and its relationship with the macro-levels of the Russian society today: from politics to public opinion.
Turkish Constitutionalism in Millî Mücadele
Authors: Petrucciano Francesco
Published: March 2021

The Teşkilât-ı Esasiye Kānūnu of 1921 is an interesting snapshot of the state-building process of the Turkish State during the Millî Mücadele. In this transitional period, the Ankara Meclis puts in the Chart all the expectations for the new State, drawing a system strongly based on Parliamentarism. While denying the Imperial authority, it voluntarily defers the definition of the form of the State, paving the way to a new idea of sovereignty. The fundamental Chart constitutes the instrument the Meclis uses to inject new fundamental concepts in the Turkish legal system, while overcoming the concept of osmanlıcılık. A courageous attempt to introduce in Turkey some of the most advanced ideas of public law at that time, it represents the evolution and the end of the second Constitutional Era. This work aims to demonstrate how this Chart and the following reforms represent the base of much of what Turkey was for almost a century.
New records of fleas and ticks in armadillos (Xenarthra: Chlamyphoridae)
from the Espinal and Monte ecoregions of La Pampa province, Argentina
Authors: EZQUIAGA MARÍA CECILIA , SOIBELZON ESTEBAN
Published: March 2021

La Pampa province is divided into two clearly distinguishable fractions: a small northeastern humid sector corresponding to the Pampas ecoregion and a drier western sector, represented by the Monte de Llanuras y Mesetas (termed Monte region in this paper) and Espinal ecoregions (sensu Brown et al. 2006). These three ecoregions are visibly distinguishable from an edaphological and phytogeographic point of view, while the mammalian fauna composition is homogeneous. The study area was located in the central part of the province, comprising the Monte and Espinal ecoregions (Fig. 1). In that area three species of armadillos are recorded (Soibelzon et al. 2015). Two of these (Zaedyus pichiy Desmarest, 1804 and Chaetophractus villosus Desmarest, 1804) (Xenarthra: Chlamyphoridae) are the most common and widely distributed armadillos both in the province and in the country, while the third species, Chlamyphorus truncatus Harlan, 1825, has a more restricted distribution and is one of the most cryptic and least known armadillos in the country. For this reason, in our fieldwork ectoparasites were obtained only from the first two species mentioned.
Three new species of Lamprigera Motschulsky (Coleoptera, Lampyridae) from China, with notes on known species
Authors: DONG ZHIWEI , YIU VOR , LIU GUICHUN , HE JINWU , ZHAO RUOPING , PENG YANQIONG , LI XUEYAN
Published: March 2021

Lamprigera is found only in those countries from the Himalaya–Karakoran –Tibet region to SE Asia where 17 species have been previously recorded. These 17 include four species from China. In this work, combined molecular data (COI) and morphological traits identified eight species in our collections. Among these, we found three Chinese species (Lamprigera alticola Dong & Li, sp. nov., Lamprigera luquanensis Dong & Li, sp. nov. and Lamprigera magnapronotum Dong & Li, sp. nov.) that are new to science, bringing the total number of species of Lamprigera to 20 (17+3), and four other known species that are herein newly recorded for the first time in China. These four new records, the three new species, and the four previously known records bring the total number of Chinese species to 11. The morphological traits, especially the male genitalia and pronotum, are described for all eight species. We conclude that male genitalia and pronotum are the most important diagnostic traits for separating species of Lamprigera, and this is confirmed by COI data.
A new giant species of the millipede genus Prionopetalum Attems, 1909 from Mt. Kilimanjaro, Tanzania (Diplopoda, Spirostreptida, Odontopygidae)
Authors: ROSENMEJER TRINE , ENGHOFF HENRIK
Published: March 2021

A new large species of the millipede genus Prionopetalum Attems, 1909, P. nessiae sp. nov. from Mt. Kilimanjaro, Tanzania, is described, with SEM imaging and illustrations of relevant taxonomic characters, and mapped. Comments on the significance of sternum 9 in descriptions of Odontopygidae, and on the intrageneric differences in Prionopetalum, are included.
Enhanced Abyssal Mixing in the Equatorial Pacific Associated with Non-Traditional Effects
Authors: Delorme Bertrand L. , Thomas Leif N. , Marchesiello Patrick , Gula Jonathan , Roullet Guillaume , Molemaker M. Jeroen
Published: March 2021

Recent theoretical work has shown that, when the so-called non-traditional effects are taken into account, the reflection of Equatorially Trapped Waves (ETWs) off the seafloor generates strong vertical shear that results in bottom-intensified mixing at the inertial latitude of the ETW via a mechanism of critical reflection. It has been estimated that this process could play an important role in driving diapycnal upwelling in the Abyssal Meridional Overturning Circulation (AMOC). However, these results were derived under an idealized configuration with a monochromatic ETW propagating through a flat ocean at rest. To test the theory in a flow that is more representative of the ocean, we contrast a set of realistic numerical simulations of the Eastern Equatorial Pacific run using either the hydrostatic or quasi-hydrostatic approximation, the latter of which accounts for non-traditional effects. The simulations are nested into a Pacific-wide hydrostatic parent solution forced with climatological data and realistic bathymetry, resulting in an ETW field and a deep circulation consistent with observations. Using these simulations, we observe enhanced abyssal mixing in the quasi-hydrostatic run, even over smooth topography, that is absent in the hydrostatic run. The mixing is associated with inertial shear that has spatio-temporal properties consistent with the critical reflection mechanism. The enhanced mixing results in a weakening of the abyssal stratification and drives diapycnal upwelling in our simulation, in agreement with the predictions from the idealized simulations. The diapycnal upwelling is on the order of O(10) Sv and thus could play an important role in closing the AMOC.
Use of Predictive Modeling to Tailor Molecular Testing Utilization for Thyroid Nodules
Authors: Ahmed Sadia T. , Fernandes Stevyn , Gao Qi , Ow Thomas J. , Smith Richard V. , Schiff Bradley A. , Mehta Vikas
Published: March 2021

Objective

Various risk stratification systems for cytologically indeterminate thyroid nodules are available. However, malignancy risk assessment data, such as ultrasound features, are not always used when the decision is to order molecular testing or not. Our aim was to investigate the utility of molecular testing after incorporating an algorithm with ultrasound‐based risk of malignancy (ROM) estimation.

Study Design

Diagnostic/prognostic study.

Setting

Single‐institution urban tertiary care center.

Methods

We performed a single‐institution retrospective chart review of all thyroid nodules that had undergone molecular testing. A web‐based Malignancy Risk Estimation System for Thyroid Nodules was utilized with ultrasound findings to stratify malignancy risk according to the Korean Thyroid Imaging Reporting and Data System (TI‐RADS), French TI‐RADS, American Association of Clinical Endocrinology guideline, and American Thyroid Association guideline. A novel algorithm for utilizing molecular testing at our institution was developed with the Korean TI‐RADS and with recommendations from the American Thyroid Association and National Comprehensive Cancer Network.

Results

The Korean TI‐RADS performed best in our population (area under the curve = 0.83). A positive molecular test result had a positive association with a higher ROM according to all 4 models (P <. 05). Use of our algorithm prior to molecular testing would have prevented 38% of benign/low‐ROM negative nodules (n = 28) from being tested.

Conclusion

In patients with indeterminate thyroid nodules, an algorithm built on pre‐ and posttest probability to guide molecular testing might reduce unnecessary testing of benign and low‐risk nodules.
Thyroid Eye Disease, Teprotumumab, and Hearing Loss: An Evolving Role for Otolaryngologists
Authors: Chern Alexander , Dagi Glass Lora R. , Gudis David A.
Published: March 2021

Teprotumumab is a human monoclonal antibody and IGF‐1R (insulin‐like growth factor 1 receptor) inhibitor approved for treatment of thyroid eye disease in adults. Recent clinical trials have demonstrated side effects, notably hearing loss, in the treatment cohort as compared with the placebo cohort. These unexpected otologic side effects may be understood through a mechanistic understanding of IGF‐1 (insulin‐like growth factor 1). As otolaryngologists who historically play a significant role in the multidisciplinary treatment of thyroid disease and its associated complications, we should be aware of and monitor the otologic side effects of teprotumumab. Clinicians who prescribe teprotumumab should strongly consider monitoring patients’ hearing with an audiologist and otolaryngologist.
Management of Pulmonary Hypertension in Term Infants—A Review
Authors: Kumaran Uthaya , Shenoi Arvind
Published: March 2021

Abstract

Pulmonary hypertension (PH) in the term newborn is associated with roughly one-fifth higher mortality and morbidity. The diagnosis of PH is confirmed by echocardiogram based on established criteria, including assessment of cardiac function, size of the shunts, and presence of hypovolemia. The elementary steps in the management of PH are supportive measures followed by oxygenation, ventilation including possibly high frequency ventilation; lung recruitment and surfactant therapy. Ventilation strategies are based on the etiology of persistent pulmonary hypertension of the newborn (PPHN)-like lung parenchymal disease, or hypoplasia. Oxygenation index (OI) or oxygen saturation index (OSI) are the parameters used for monitoring the disease progression and treatment. Surfactant is given if OI >5 in PPHN due to underlying lung disease, and pulmonary vasodilators such as sildenafil are contemplated if OI <15 and inhaled nitric oxide (iNO) if OI >15. If iNO and sildenafil fail, the options available are milrinone, bosentan, adenosine, and prostaglandins. Extra corporeal membrane oxygenation is the final option available with OI >40. A structured algorithmic approach for the management of PH in term infants is discussed in this review. Novel therapies targeting specific pathways in the pulmonary vasculature are under investigation.
Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users
Authors: Tackett Alayna P , Wallace Samantha W , Smith Caitlin E , Turner Elise , Fedele David A , Stepanov Irina , Lechner William V , Hale Jessica J , Wagener Theodore L
Published: March 2021

Objective:

This study examined caregiver perception of harm and child secondhand exposure to nicotine in a sample of e-cigarette-exclusive, cigarette-exclusive, and non-tobacco/nicotine users (non-users).

Methods:

Cigarette-exclusive (n = 19), e-cigarette-exclusive (n = 12), and non-users (n = 20) and their children (N = 51, Mage = 10.47) completed self-report questionnaires about perceptions of harm, child secondhand exposure, and provided urine to assess child nicotine exposure (cotinine). ANOVAs examined differences between caregiver use status on tobacco harm perceptions and child cotinine levels. Independent samples t-test compared differences in caregiver-reported child secondhand exposure in the home and car.

Results:

All 3 caregiver groups rated cigarettes as highly harmful ( P = .14), but e-cigarette users rated all 3 types of e-cigarette products (Cartridge-based: P < .001; Tank: P < .001; Box Mod: P < .001) as less harmful than cigarette users and non-users. Caregivers from the e-cigarette user group reported greater child secondhand exposure than caregivers using cigarettes (past 7-day in-home exposure ( P = .03); past 7-day exposure in-home + in-car exposure ( P = .02); in-home exposure by caregivers and other people exposure ( P = .02)). Children from the cigarette user group had significantly higher levels of cotinine ( M = 16.6, SD = 21.7) compared to children from the Non-User group ( M = .43, SD = .95; P = .001), but no significant difference when compared to children from the E-Cigarette User group ( M = 6.5, SD = 13.5).

Discussion:

In this sample, caregivers who used e-cigarettes perceived them as less harmful, reported using them more frequently at home and in the car, even when their children were present, compared to cigarette users. As a result, children appear to be exposed to nicotine at levels similar to children living with cigarette users. Future caregiver prevention and intervention efforts should target education around the potential harms of secondhand e-cigarette aerosol to children.
‘Have you ever traded sex for money or drugs?’ Health care providers’ perspectives on sex trafficking risk assessments in clinics
Authors: Gerassi Lara , Pederson Anna
Published: March 2021

Objective

The United States’ Institute of Medicine recommends that health care providers be aware of sex trafficking (ST) indicators and conduct risk assessments to identify people at risk. However, the challenges among those who conduct such assessments remain largely understudied. The aim of this study was to understand the perceived barriers to ST risk assessment among health care providers in a large health care organization.

Methods

This study used a collective case study approach in five sites of a large health care organization that serves high-risk populations in a Midwestern state. Twenty-three in-depth, semi-structured interviews were conducted with health care staff (e.g. medical assistants, nurse practitioners). Two research team members conducted independent deductive coding (e.g. knowledge of ST), and inductive coding to analyse emerging themes (e.g. responses to ST risk or commercial sex disclosures, provider role ambiguity).

Results

Although staff routinely screened by asking ‘Have you ever traded sex for money or drugs?’, participants primarily described avoiding further discussions of ST with adult patients because they (1) aimed to be non-judgmental, (2) viewed following up as someone else’s job, and/or (3) lacked confidence to address ST concerns themselves, particularly when differentiating sex work from ST. Differences all emerged based on clinical context (e.g. urban location).

Conclusions

There may be missed opportunities to assess patients for ST risk and use harm-reduction strategies or safety plan to address patients’ needs. Implications for practice, policy, and future research are discussed.
The Mechanism of Jian-Gan-Xiao-Zhi Decoction in Insulin Resistant Adipocytes and Its Component Analysis
Authors: Fang Fang , Wen Wei-Bo , Xie Xue-Hua , Yang Ling , Zhang Xu , Zhao Jie
Published: March 2021

Background: Jian-Gan-Xiao-Zhi decoction (JGXZ) is a traditional Chinese medicine formula to treat patients with non-alcoholic fatty liver disease (NAFLD). The study aimed to analyze the mechanism of JGXZ in adipocytes and detect the main components of the drug in rat serum. Methods: 3T3-L1 preadipocytes were used to establish an insulin resistant (IR) adipocyte model. Lipid accumulation in adipocytes was detected by oil red O staining. After JGXZ treatment, glucose consumption, total cholesterol (TC), and triglyceride (TG) were analyzed using the corresponding kits. ROS levels were measured by flow cytometry. In addition, Western blot was used to assess LKB1/AMPK and JNK/IRS/PI3k/AKT expressions. The main components of JGXZ in rat serum samples were detected by LC-MS/MS using a Phenomenex Luna C18 column, a mobile phase of methanol and 0.1% formic acid solution, and ESI detection. Results: JGXZ significantly decreased glucose levels and adipogenesis, accompanied by decreased IR ( P < 0.01). Besides, JGXZ markedly affected ROS, LKB1/AMPK, and JNK/IRS/PI3k/AKT levels ( P < 0.01). R1, Rg1, paeoniflorin, Rb1, astragaloside IV, and tanshinone could be significantly quantified. Conclusions: JGXZ decreased glucose and lipid synthesis, possibly via the ROS/AMPK/JNK pathway. R1, Rg1, paeoniflorin, Rb1, astragaloside IV, and tanshinone in JGXZ could play major roles in treating NAFLD, which could assist in the study of the mechanism of JGXZ in treating NAFLD.