bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the effect of tool geometrical aspects on intensity of mixing and void formation in friction stir process
Authors: Malik Vinayak , Kailas Satish V
Published: July 2020

The reduction of agglomeration of particulate reinforcement in friction stir processing and elimination of joint line remnant in friction stir welding depends on stirring ability of friction stir tool. The magnitude of stirring is indicated by the intensity of material inter-mixing in tool interacted region. Present investigations analyse the influence of geometrical aspects of classical friction stir tool on the intensity of material intermixing, location of high stir regions and void formation during the steady-state phase of friction stir welding. The classical tool was chosen as its geometrical features undergo minimal wear in the harsher processing environment. Investigating material mixing using metallic inserts have their shortcomings due to different flow properties of insert/marker and parent material. Therefore, bi-colour plasticine configuration possessing primary colours was adopted to understand the level of intermixing. The hue attribute of the generated secondary colour was utilised to identify and quantify material mixing. Experimental results revealed that the pin diameter positively influenced mixing and negatively affected void formation. Shoulder size and pin taper angle aided in the closure of void with inferior mixing. The intensity of mixing enhances on selection of tools possessing a shoulder to pin diameter ratio of 2.5. Finite element simulation studies were conducted to understand the reasons for mixing under certain tooling conditions. Since material subjected to stirring is concentrated primarily on a portion of advancing side, components of shear strain, shear strain rates, shear stress and velocity were tracked for this portion of processed material during its interaction with tool pin for one complete rotation.
Optimization and evaluation of dry and minimum quantity lubricating methods on machinability of AISI 4140 using Taguchi design and ANOVA
Authors: Gürbüz Hüseyin , Emre Gönülaçar Yunus
Published: July 2020

In this work, it is aimed to study the effects of dry machining and minimum quantity lubrication application on machinability in turning AISI 4140 steel by utilizing different cutting parameters. Also, this study contains effects and optimization of cutting conditions (dry and minimum quantity lubricating), feed rate, and cutting speed on surface roughness (Ra) and main cutting forces (Fc) determined by employing the Taguchi method. At the end of experiments, it was established that compared to dry machining operations, minimum quantity lubricating significantly reduced cutting tool wear, while Fc and Ra decreased in general. Analyses of variance, regression analysis, signal-to-noise ratio, and orthogonal array were employed to analyze the effects and contributions of independent variables on dependent variables. The optimum levels of the dependent variables for reducing Fc and Ra using signal-to-noise rates were established. According to signal-to-noise ratios, minimum quantity lubricating had a more important effect on Fc and Ra than dry machining. The optimal conditions for Fc and Ra were at 0.16 mm/rev feed rate, 125 m/min cutting speed at minimum quantity lubricating. Analysis of variance results demonstrated that the feed rate is the most influential independent variable on Fc (93.976 %) and Ra (89.352 %). Validation test results exhibited that the Taguchi method and regression analysis were highly achieved methods in the optimization of independent variables for dependent variables. Taguchi optimization technique and regression analysis obtained from Fc ([Formula: see text] = 0.972 and [Formula: see text] = 0.997) and Ra ([Formula: see text] = 0.985 and [Formula: see text] = 0.996) measurements match really well with the experimental data.
Design and experimental validation of a specialized pressure-measuring rake for blended wing body aircraft’s unconventional inner flow channel
Authors: Xu Xin , Liu Dawei , Cheng Keming , Chen Dehua
Published: July 2020

The internal drag of the unconventional inner flow channel of blended wing body aircraft must be measured accurately to correct the air intake effect of the blended wing body flow-through model in wind tunnel tests. In this study, the pressure distribution of the inner flow channel under the interaction of internal and external flows was obtained through numerical simulation. A specialized pressure-measuring rake was designed based on the numerical results, and a validation test was conducted in a 2.4 m × 2.4 m transonic wind tunnel. Compared with the flow in traditional inlets/nozzles, the flow in the unconventional inner channel in the current research is asymmetric, the distortion index is higher, and the internal drag is more sensitive to flow changes. The wind tunnel test results have a good correlation with the numerical results, and the repeatability of the test results is satisfactory, indicating that the measurement accuracy and precision of the pressure-measuring rake are acceptable. The design method of the specialized rake is feasible, and it can be used to guide the measurement of complex flow in unconventional inner flow channels of blended wing body aircraft.
Form-driven design of a bending-active tensile façade system
Authors: Boulic Léa , D’Acunto Pierluigi , Bertagna Federico , Castellón Juan José
Published: July 2020

This article highlights the design potentials of a recently proposed form-driven approach for bending-active tensile structures, in which the geometry of the actively bent elements can be directly defined without the recourse to a form-finding procedure. The approach is applied to the design of a lightweight sun-shading system that can be used to protect glazed building façades, and in which actively bent beams are restrained by pre-stressing strips. Other than structural requirements, the geometry of this hybrid structure is informed by functional and environmental considerations to prevent overheating and glare inside the building.
Acceptability and correlates of HIV self-testing among university students in northern Nigeria
Authors: Iliyasu Zubairu , Kassim Radeeyah B , Iliyasu Bilkisu Z , Amole Taiwo G , Nass Nafisa S , Marryshow Salisha E , Aliyu Muktar H
Published: July 2020

Concerns about stigma and confidentiality limit the uptake of HIV testing and counseling (HTC) among young adults. HIV self-testing has been offered as a youth-friendly alternative to conventional HTC. We conducted a cross-sectional study to assess HTC uptake, willingness to self-test, and their predictors among university students ( n =  399) in Kano, Nigeria. Anonymous self-administered questionnaires were provided to participants. Adjusted odd ratios were generated for predictors with logistic regression models. The results showed that only 35.8% ( n =  143) of participants had previous HTC.Most respondents (70.4%, n =  281) were willing to self-test. HTC was associated with year of college (500 Level vs. 100 Level), adjusted odds ratio (AOR, [95% Confidence Interval (CI)] = 0.44 (0.19–0.97), campus residence (off- vs. on-campus, AOR = 0.45; 95%CI: 0.28–0.73), sexual activity in the past six months (AOR = 0.39; 95%CI: 0.24–0.64), willingness to self-test (AOR = 0.38; 95%CI: 0.22–0.66), and consistent condom use (AOR = 4.45; 95%CI: 1.41–14.08). Students who were older (≥ 30 vs. <20 years, AOR = 0.20; 95%CI: 0.05–0.90) and female (AOR = 0.56; 95%CI: 0.32–0.98) were less likely to be willing to self-test, whereas students who were more senior (500 Level vs. 100 Level, AOR = 5.24; 95%CI: 1.85–14.84), enrolled in clinical science programs (vs. agriculture, AOR = 4.92; 95%CI: 1.51–16.05) or belonging to “other” ethnic groups (vs. Hausa–Fulani, AOR = 2.40; 95%CI: 1.11–5.19) were more willing to self-test. Overall HTC uptake was low, but acceptability of self-testing was high. College seniority, age, ethnicity, and program of study were associated with willingness to self-test. Our findings support the feasibility of scaling up HIV self-testing among university students in Nigeria.
Factors associated with non-adherence to antiretroviral therapy among female sex workers living with HIV in Hyderabad, India
Authors: Allam Ramesh R , Takamiya Mayuko , Pant Rashmi , Gandham Sabitha , Yeldandi Vijay V , Thomas Jaya , Ekstrand Maria L , Dworkin Mark S
Published: July 2020

We determined factors associated with non-adherence (consuming <90% of monthly antiretroviral therapy) among female sex workers (FSWs). An interviewer-administered questionnaire was used in a sample of 100 South Indian FSWs living with HIV. We examined demographics, food insecurity, side effects, stigma, alcohol/substance use and self-efficacy. Non-adherence was assessed by self-report, pill-count and combined measures. Prevalence ratios and 95% confidence intervals (CIs) were calculated at p-value <0.1. Thirty-seven percent (33/90) of FSWs were non-adherent by pill-count, 29% (28/95) by self-report and 52% (51/99) by the combined measure. Seventy-six percent (76/100) of FSWs reported experience of at least one form of food insecurity in the past six months. In the regression analysis, arrest in the past year was independently associated with the combined measure of non-adherence (crude prevalence ratios 1.7, 95% CI 1.0–2.8). A successful combination adherence intervention should consider several of the socio-behavioral factors identified in this study including arrest and food insecurity.
A realist systematic review of stigma reduction interventions for HIV prevention and care continuum outcomes among men who have sex with men
Authors: Dunbar Willy , Labat Aline , Raccurt Christian , Sohler Nancy , Pape Jean William , Maulet Nathalie , Coppieters Yves
Published: July 2020

While stigma associated with human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) is well recognized, there remains relatively limited intervention data on effective stigma reduction strategies. This systematic review was conducted to highlight the mechanisms through which sexual and HIV stigma is reduced in relation to HIV prevention and care engagement. Search of PubMed and Scopus resulted in 11 tested interventions to include in our preliminary model constructed from programme frameworks and recommendations. We refined the preliminary programme theory to identify whether, why, or how mitigation strategies produce observed outcomes. Our review showed that the interventions produced stigma reduction through three groups of mechanisms: (1) Self-acceptance, leadership, and motivational activation for behaviour change from intrapersonal strategies, such as education and mobile health strategies, which intervene on internalized and anticipated stigma; (2) socialization, knowledge sharing, and social empowerment from interpersonal strategies, such as peer support and training for care providers; and (3) community introspection, self-reflection, and humanistic activation from structural strategies such as community leaders’ sensitization, which intervene on both anticipated and enacted stigma. Interventions mechanisms act complementarily and can be activated in different contexts in which MSM exposed to and infected with HIV are living.
Syphilis infection among people who use and inject drugs in Cambodia: a cross-sectional study using the respondent-driven sampling method
Authors: Yi Siyan , Prem Kiesha , Chhoun Pheak , Chann Navy , Tuot Sovannary , Mun Phalkun , Mburu Gitau
Published: July 2020

This cross-sectional study explored the prevalence and correlates of syphilis infection among people who use and inject drugs (PWUD/PWID) in Cambodia. Data were collected in 2017 from 1,677 PWUD/PWID living in the capital city of Phnom Penh and 11 other major provinces using the respondent-driven sampling method. The SD Bioline HIV/Syphilis Duo test was used to determine human immunodeficiency virus (HIV) and current or past syphilis infection. A multivariable logistic regression analysis was conducted to identify risk factors associated with current or past syphilis infection. The prevalence of current or past syphilis infection was 3.8% (95% confidence interval = 2.4–4.6). After adjustment, current or past syphilis infection remained positively associated with being female, living on the streets, having an average monthly income of US$100–299, having transactional sex in the past three months, and having been to a rehabilitation centre in the past 12 months. Current or past syphilis infection was negatively associated with having attained at least high school level of formal education. The findings indicate vulnerability to syphilis infection among PWUD/PWID in Cambodia, particularly among subpopulations who are more marginalized. Syphilis prevention and control programmes should be systematically integrated into HIV and sexually transmitted infection policy and services in the country.
Health care issues affecting transgender people living with HIV: an opportunity for improvement
Authors: Troya Jesús , del Romero Jorge , Ryan Pablo , Cuevas Guillermo , Matarranz Mariano , Díez Beatriz , Pardo Virginia , Torres Juan , Vera Mar
Published: July 2020

The high vulnerability of transgender (TG) persons to HIV infection and the difficulties associated with access to health services can lead to delays in the diagnosis and treatment of HIV infection, thus increasing the risk of transmission of HIV by this population. We performed a retrospective study to analyze the main characteristics of TG living with HIV infection in a hospital in Madrid, Spain and to identify issues related to lack of access to the health care system and combination antiretroviral therapy (cART). We analyzed 28 TG, of whom 22 (78.6%) were TG women. Median age was 28 years (interquartile range [IQR]: 29–45), 24 (85.7%) were Latin American (all of them without health insurance), and 12 (42.8%) were sex workers. Accessibility to the health system was more difficult for 22 (78.6%) of foreign-born TG people living with HIV, with a median delay to initiation of cART of six months (IQR: 2–24). These values were greater than those recorded for the control group comprising other people living with HIV (16.9% and one month, respectively). At the first access to health care in our hospital, CD4+ cell count and HIV viral load (VL) were worse in TG patients, with a median baseline CD4+ cell count below 350 cells/µl and a higher median HIV VL, both in naïve patients (28.6%) and in pre-treated patients whose therapy was interrupted owing to access-related issues (46.4%). These data show high vulnerability to HIV infection among TG and highlight that issues associated with access to health care can cause delays in the diagnosis and treatment of HIV infection. Based on our results, we think that the health care system should adapt to the sociodemographic, clinical, and behavioral characteristics of TG people living with HIV and develop specific, targeted preventive programs to address the vulnerability of this group.
Physician–patient interaction and medication adherence in lupus nephritis
Authors: Georgopoulou Sofia , Nel Louise , Sangle Shirish R , D’Cruz David P
Published: July 2020

Objective

The quality of physician–patient interaction can have a significant impact on medication adherence. Little is known about this relationship in patients with lupus nephritis.

Methods

A cross-sectional, quantitative study. Data collected included demographics, current medication, systemic lupus erythematosus disease activity index, medication adherence, beliefs about medicines, shared decision-making, patient–doctor depth of relationship, patient–doctor quality of relationship, interpersonal trust in a physician and illness perceptions.

Results

Ninety-eight patients with lupus nephritis completed the questionnaires. Logistic regression indicated that medication adherence was significantly predicted by (a) interpersonal trust in a physician (B = 0.85, Wald 3.94, 95% confidence interval (CI) 1.01, 5.44; P = 0.05); (b) timeline cyclical (B = –0.89, Wald 4.95, 95% CI 0.19, 0.90; P < 0.05) and beliefs about the necessity of medicines (B = 0.75, Wald 4.14, 95% CI 1.03, 4.38; P < 0.05). Mediation analysis showed that beliefs about the necessity of medicines significantly mediated the relationship between trust and medication adherence when adjusted for age (B = 0.48, 95% CI 0.06, 1.08; P < 0.01). A further mediation analysis showed that patient–doctor depth of relationship (B = 0.05, 95% CI 0.01, 0.09; P < 0.001), shared decision-making (B = 0.07, 95% CI 0.01, 0.13; P < 0.001) and patient–doctor quality of relationship (B = 0.08, 95% CI 0.01, 0.16; P < 0.001) significantly mediated the relationship between illness coherence and interpersonal trust in a physician.

Conclusion

The findings highlighted two key elements: (a) the importance of trust in relation to medication adherence; and (b) a good understanding of patients’ illness is linked to a better relationship with their doctor and greater participation in shared decision-making which is associated with increased trust. Tailored psycho-educational interventions could contribute to improving the patient–doctor relationship quality, trust and increased shared decision-making, which, in turn, might improve medication adherence in patients with lupus nephritis.
Validation of a commercial magnetic bead–based multiplex assay for 5 novel biomarkers of acute kidney injury in canine serum
Authors: Davis Jennifer , Raisis Anthea L. , Miller David W. , Rossi Gabriele
Published: July 2020

Interest is growing in measurement of novel biomarkers for the diagnosis of acute kidney injury. Multiplex assays may provide a rapid and cost-effective way of measurement; however, sparse information is published regarding their use in dogs. We aimed to validate a commercial magnetic bead–based assay for 5 biomarkers: clusterin (Clus), cystatin C (CysC), kidney injury molecule 1 (KIM-1), monocyte chemoattractant protein 1 (MCP-1), and neutrophil gelatinase–associated lipocalin (NGAL). Intra- and inter-assay imprecision, linearity under dilution (LUD), spike recovery (S-R), and hemoglobin interference were evaluated using serum from healthy and diseased dogs. Additionally, the effect of sample type (serum vs. plasma) was investigated. All values for Clus and MCP-1 were outside the assay’s measurable range. Intra- and inter-assay precision were acceptable for NGAL (CVs 8.8% and 13.2%, respectively). Regression analysis of LUD and S-R indicated good linearity for CysC and NGAL. Hemolysis did not affect measurement of any biomarker. Measured concentrations of CysC ( p = 0.018) and NGAL ( p = 0.015) were significantly lower in sodium citrate plasma compared to serum. We conclude that this magnetic bead–based assay is precise and accurate for NGAL measurement in canine serum. Inappropriate standards for MCP-1 and Clus, and poor accuracy for KIM-1 measurement, suggest that this assay cannot reliably quantify those biomarkers in canine blood. Measurements of CysC in canine blood using this assay must be interpreted with caution given inter-assay imprecision.
Topical aloe vera for the treatment of cetuximab-related acneiform rash in colorectal cancer: A case report
Authors: Gürbüz Mustafa , Akkuş Erman , Utkan Güngör
Published: July 2020

Introduction

Colorectal cancer is one of the most common cancers in the world. Cetuximab is an epidermal growth factor receptor (EGFR) inhibitor which provides survival benefit when combined with chemotherapy in RAS wild type metastatic colorectal cancer. Cutaneous toxicities associated with cetuximab have a significant impact on patient quality of life, treatment continuation and healthcare resource utilization.

Case report

A 60-year-old male patient presented with fatigue, weight loss and abdominal pain. Two closely located malignant polypoid lesions were detected in the sigmoid colon, and pathological examination revealed colonic adenocarcinoma. Management and outcome: Thorax, abdominal and pelvic computed tomography showed metastases. FOLFOX chemotherapy and cetuximab were started. The patient developed acneiform rash firstly in his face, although prophylactic vitamin K1 0.1% containing cream was given. He was given mild potency topical corticosteroid and doxycycline. The lesions progressed to his front and back body. He did not want to use topical vitamin K1 cream, topical steroid and doxycycline tablets. Instead, he wanted to use aloe vera extract which he produced from the leaves of the plant. Patient’s lesions were regressed significantly.

Discussion

The most common and earliest skin toxicity is acneiform rash which affects 60 to 80% of the patients. In this case, cetuximab-related severe acneiform rash was effectively treated by topical aloe vera. Topical aloe vera may be used in the management of cetuximab-related cutaneous toxicities without any side effect.
The COVID-19 Epidemic and the Prison System in Italy
Authors: Cingolani Mariano , Caraceni Lina , Cannovo Nunzia , Fedeli Piergiorgio
Published: July 2020

The Italian Ministry of Justice and that of Health have established two strategies to limit the spread of COVID-19 in prisons: progressive isolation from the external world and adoption of practices to identify possible cases and to treat infected subjects. After the announcement of regulations revolts erupted in numerous Italian prisons. The motivations and effects of these strategy are discussed critically into the search for a balance between the right to health and other rights of prisoners in Italian prisons with the problem of an occupancy level of 121.75%.
Evaluation of inner retinal dimples and internal limiting membrane flap configuration after temporal inverted ILM flap technique
Authors: Avci Remzi , Mavi Yildiz Aysegul , Yilmaz Sami
Published: July 2020

Purpose:

To quantitatively evaluate structural changes associated with inner retinal dimples (IRDs) and qualitatively classify the internal limiting membrane (ILM) flap configuration after temporal inverted ILM flap technique using spectral domain optical coherence tomography (SD-OCT).

Methods:

Twenty-three eyes of 23 patients with successfully closed idiopathic, large (>400 μm) macular hole were enrolled. Patients were treated with pars plana vitrectomy followed by temporal inverted ILM flap technique. A complete ophthalmologic examination including cross sectional and en face OCT in addition to multicolor blue reflectance imaging of confocal scanning laser ophthalmoscopy (cSLO) was performed preoperatively and at postoperative month-12. The location, number, depth, and width of the IRDs were analyzed using blue reflectance images of multicolor cSLO and en face OCT. The ILM flap is also classified as smooth, wrinkled, and folded with en face OCT.

Results:

The mean number of IRDs visualized on en face OCT ( n = 23.08 ± 22.05) was statistically significantly higher compared with multicolor cSLO blue reflectance module (5.91 ± 10.58; p < 0.001). The mean depth of IRDs measured on en face OCT was 8.08 ± 3.1 μm (3–14 μm) which referred to the nerve fiber layer. The final visual acuity was associated with neither ILM flap configuration ( p = 0.408), nor number of the IRDs on en face OCT ( p = 0.112).

Conclusion:

En face OCT is a novel imaging modality that offers improved visualization and accuracy in identifying the features of the IRDs and the ILM flap. Additionally, it provides clear visualization of the vitreoretinal interface to distinguish whether ILM was peeled or not in the initial surgery.
Smoking and Unemployment: A Photo Elicitation Project
Authors: Michalek Anne K , Wong Samantha L , Brown-Johnson Cati G , Prochaska Judith J
Published: July 2020

Introduction:

Research has documented higher smoking prevalence with unemployment and greater difficulty with gaining re-employment for those who smoke. Using photo elicitation methods, we sought to gain a deeper understanding of the connection between job-seeking and tobacco use.

Methods:

Unemployed daily smokers (18 men, 1 woman) were recruited from the San Francisco Employment Development Department (EDD) and provided disposable cameras with 27 exposures and a list of 20 photo prompts related to job-seeking and tobacco. Study staff reviewed the photos with the participants and audio-recorded their narratives. The photos and narratives were coded for themes.

Results:

Of 363 photos, the most frequent photo imagery related to transportation (n = 56, 15.4%), work or education (n = 39, 10.7%), and littered cigarettes (n = 39, 10.7%). Narrated themes centered on motivators to quit smoking (255 mentions from 15 participants); people, places, and things associated with smoking (248 mentions, 16 participants); and motivators to secure work (157 mentions, 13 participants). The intersection of smoking and unemployment received 92 mentions from 11 participants, with 60 mentions (8 participants) identifying smoking as a barrier to re-employment.

Conclusions:

Both motivators to quit and associated smoking cues were salient in the environments of job-seeking smokers. Struggles with quitting and perceptions that smoking is harming re-employment success suggest the potential for offering tobacco treatment in EDD settings. With permission, the photos and themes have been incorporated into a tobacco treatment intervention for job-seeking smokers.
Geeks vs grandees: A transnational comparison of dress codes in American and British federal technology agencies
Authors: Schulte Stephanie
Published: July 2020

This comparative transnational history informed by discourse analysis examines the US and UK news coverage of two new ‘federal startups’ created in the early 2010s: The United States Digital Service and Government Digital Service. These agencies were designed to renovate federal infrastructures and institutions by integrating technologies and technologists into the federal government. Early coverage of these agencies in both countries focused on the integration of casual dress norms common in technology industries into federal offices dominated by suits. In the United States, those norms were embraced, often with amusement. But in the United Kingdom, they were met with hostility. This article explains why dress code was a focus in both countries and why it was covered differently in each. Ultimately, this study argues workplace attire is emblematic of the differing ways in which industry and government partnerships function in these countries. Dress code norm differences offer a window into how nationally specific cultural values remained about technology and government in each country. Ultimately, these findings suggest the extent to which values prioritized by technology industries became those prioritized by the US government, and the extent to which the United Kingdom retained separation between those arenas.
‘Learning her culture and growing up strong’: Aboriginal and/or Torres Strait Islander fathers, children and the sharing of culture
Authors: Prehn Jacob , Guerzoni Michael Andre , Peacock Huw
Published: July 2020

Indigenous fathers play a central role in the lives of Indigenous children growing up strong. For Australia’s Indigenous people, growing strong includes the possession of heightened levels of health, education and cultural knowledge. This article focuses on Indigenous fathers and how they understand the importance of sharing cultural activities with their children. We argue that the sharing of Indigenous cultural practices, and the subsequent telling of this narrative, are key enablers for Indigenous fathers to assist their families to flourish. We analyse qualitative data from the Longitudinal Study of Indigenous Children to explore what components/aspects of Indigenous culture fathers perceive will assist children to strongly mature, how culture is transmitted, and what barriers fathers face in this process. Results show that according to participants, learning about culture, family and identity are components to helping children prosper, with collecting food the most common activity used to achieve this end.
Experimental investigations on P22/P91 dissimilar shielded metal arc welds for power plant applications
Authors: Mahajan Sumit , Chhibber Rahul
Published: July 2020

This article deals with the development of shielded metal arc welding electrodes for P22/P91 welds. A comparison has also been drawn with commercially available electrodes. P22 low alloy steel matching electrodes developed in the laboratory using a mixture design approach was employed to fabricate the dissimilar weld. Experimentations were performed to evaluate the microstructure and mechanical properties of microhardness, tensile strength, and impact energy of the welds. The impact strength was found to improve by 19% for a laboratory developed electrode made welds as compared to the commercial electrodes. The weld chemistry investigations indicate that the weld fabricated with laboratory-developed electrodes have a higher amount of chromium and molybdenum. These elements are known to enhance the corrosion resistance of joint, thereby imparting enhanced structural integrity in high temperature operating conditions. The electrodes designed and developed in this work are found to enhance the properties of P22/P91 joint much better as compared to that with the commercial electrodes.
Renin–angiotensin system inhibitor use and colorectal cancer risk and mortality: A dose–response meta analysis
Authors: Chen Xia , Yi Chang-hong , Ya Kuang-guan
Published: July 2020

Objective:

This study was undertaken to determine whether use of the renin–angiotensin system (RAS) inhibitors would increase colorectal cancer morbidity and mortality.

Methods:

Databases were electronically searched to collect data of RAS use and colorectal cancer morbidity and mortality from inception to October 2018. Stata 12.0 software was used to perform a meta-analysis.

Results:

A total of 16 publications involving 2,847,597 participants were included. RAS inhibitor use was related to colorectal cancer risk (relative risk (RR): 0.86; 95% confidence interval (CI): 0.78–0.93) and mortality (RR: 0.80; 95% CI: 0.66–0.98) decrement. Subgroup analysis showed angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) (RR: 0.82; 95% CI: 0.69-0.96) or ARB (RR: 0.86; 95% CI: 0.73–0.98) or ACEI (RR: 0.81; 95% CI: 0.70–0.92) were related to colorectal cancer risk decrement. Furthermore, RAS inhibitor use was related to colorectal cancer risk decrement in Caucasians (RR: 0.88; 95% CI: 0.80–0.96) and Asians (RR: 0.72; 95% CI: 0.61–0.85). Additionally, dose–response showed that per one year duration of RAS inhibitor use incremental increase was related to 6% colorectal cancer risk decrement (RR: 0.94; 95% CI: 0.90–0.97).

Conclusion:

According to the evidence, RAS inhibitor use was associated with colorectal cancer risk and mortality decrement.
Comparative Effectiveness of Cheonwangbosimdan (Tian Wang Bu Xin Dan) Versus Cognitive-Behavioral Therapy for Insomnia in Cancer Patients: A Randomized, Controlled, Open-Label, Parallel-Group, Pilot Trial
Authors: Moon Sun-Young , Jerng Ui Min , Kwon O-Jin , Jung So-Young , Lee Jee Young , Yoon Seong Woo , Shin Won-Chul , Byun Jung-Ick , Lee Jun-Hwan
Published: July 2020

Cancer patients have a 2 times higher prevalence of insomnia than healthy populations and cancer-related insomnia has received minimal attention while insomnia can aggravate the rehabilitation of cancer patients. Cheonwangbosimdan is a Korean herbal medicine generally used to relieve sleep deprivation, however, few studies presented the effects of Cheonwangbosimdan on cancer-related insomnia. The purpose of study is to examine the feasibility of Cheonwangbosimdan treatments for cancer patients. Twenty-two participants were allocated into a Cheonwangbosimdan or cognitive-behavioral therapy for insomnia (CBT-I) control group by equal number. The intervention group took Cheonwangbosimdan liquid once in a day and attend visits once a week for 4 weeks. The CBT-I group underwent individualized behavioral therapy 4 times in 4 weeks. The primary outcome is changes in the Insomnia Severity Index (ISI) from baseline to the end of the trial. Responses to the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Zung Self-Rating Anxiety Scale (SAS), Brief Fatigue Inventory (BFI), Euroqol-5 Dimensions-5 Levels (EQ-5D-5L), and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) were secondary outcomes used to evaluate the quality of sleep. Outcomes were measured at a follow-up visit (visit 5) in the fifth week of the trial. There is no difference between 2 groups, but both groups showed tendency to alleviate cancer insomnia symptoms. SAS-K showed significant difference between the 2 groups (P < .001), as treatment group score was highly lowered than control group score. The study can contribute to more attentive care for insomnia in cancer patients.
Network Dysfunction in Comorbid Psychiatric Illnesses and Epilepsy
Authors: Colmers Phillip L. W. , Maguire Jamie
Published: July 2020

The episodic nature of both epilepsy and psychiatric illnesses suggests that the brain switches between healthy and pathological states. The most obvious example of transitions between network states related to epilepsy is the manifestation of ictal events. In addition to seizures, there are more subtle changes in network communication within and between brain regions, which we propose may contribute to psychiatric illnesses associated with the epilepsies. This review will highlight evidence supporting aberrant network activity associated with epilepsy and the contribution to cognitive impairments and comorbid psychiatric illnesses. Further, we discuss potential mechanisms mediating the network dysfunction associated with comorbidities in epilepsy, including interneuron loss and hypothalamic–pituitary–adrenal axis dysfunction. Conceptually, it is necessary to think beyond ictal activity to appreciate the breadth of network dysfunction contributing to the spectrum of symptoms associated with epilepsy, including psychiatric comorbidities.
William Cheselden (1688-1752): 18th-Century Pioneer of Lateral Lithotomy and Iridectomy
Authors: Michaleas Spyros N. , Tsoucalas Gregory , Tekiner Halil , Karamanou Marianna
Published: July 2020

William Cheselden (1688-1752) was a British surgeon and anatomist who was famous for his rapid and skilful techniques. He emphasized learning through dissection and introduced lateral lithotomy as an effective approach for the removal of bladder stones. Medical practitioners throughout Europe adopted his techniques. Cheselden also has been credited with the first known case of full recovery from blindness using iridectomy. Moreover, a milestone in his career was his indirect instigation for the separation of surgeons from barbers. He is considered the founder of modern British surgery.
Epidemiology of Male Sexual Dysfunction in Asian and European Regions: A Systematic Review
Authors: Irfan Muhammad , Hussain Nik Hazlina Nik , Noor Norhayati Mohd. , Mohamed Mahaneem , Sidi Hatta , Ismail Shaiful Bahari
Published: July 2020

Male sexual dysfunctions (MSDs) often remain undiagnosed and untreated in Asia compared to Europe due to conservative cultural and religious beliefs, socioeconomic conditions, and lack of awareness. There is a tendency for the use of traditional medicines and noncompliance with and reduced access to modern healthcare. The present systematic review compared the incidence and factors of MSD in European and Asian populations. English language population/community-based original articles on MSDs published in MEDLINE from 2008 to 2018 were retrieved. A total of 5392 studies were retrieved, of which 50 (25 Asian and 25 European) were finally included in this review. The prevalence of erectile dysfunction (ED) (0%–95.0% vs. 0.9%–88.8%), low satisfaction (3.2%–37.6% vs. 4.1%–28.3%), and hypoactive sexual desire disorder (HSDD) (0.7%–81.4 vs. 0%–65.5%) was higher in Asian than in European men, whereas the prevalence of anorgasmia (0.4% vs. 3%–65%) was lower in Asian than in European men. Age was an independent positive factor of MSD. In European men over 60 years old, the prevalence of premature ejaculation (PE) decreased. The prevalence of MSD was higher in questionnaires than in interviews. The significant factors were age, single status, low socioeconomic status, poor general health, less physical activity, cardiovascular diseases, diabetes, obesity, lower urinary tract symptoms, prostatitis, anxiety, depression and alcohol, tobacco, and drug use. The prevalence of MSD differed slightly in Asian and European men. There is a need to conduct large studies on the various Asian populations for the effective management of MSD.
Fuzzy Neural Network PID–based constant deceleration compensation device for the brakes of mining hoists
Authors: Ma Chi , Tian Suzhi , Xiao Xinming , Jiang Yuqiang
Published: July 2020

In comparison with constant torque brakes, constant deceleration brakes are more advantageous for the safety of mining hoists, but complete set of such products manufactured by big companies are not what ordinary mining enterprises can afford. As an alternative solution, this article develops a constant deceleration compensation device, which adds the function of constant deceleration brake onto the original brakes. Control strategy based on Fuzzy Neural Network PID is investigated and simulated with the combination of AMEsim and Simulink. An actual device is built and tested in real industrial field. The application illustrates the feasibility of this constant deceleration compensation device, which can achieve constant decelerations within a very short time. This device will prevent dangerous decelerations from happening to hoists at a much lower cost, and greatly improve the safety and reliability of mining hoists.
Towards a healthy school climate: The mediating effect of transformational leadership on cultural intelligence and organisational health
Authors: Velarde Joseph M , Ghani Muhammad Faizal , Adams Donnie , Cheah Jun-Hwa
Published: July 2020

In the ever-changing 21st-century landscape characterised by emerging global and technical trends, the search for relevant leaders in school systems relies on the premises of building a conducive, adaptive and inclusive learning environment. Thus, this article aims to examine the mediating effect of transformational leadership attributes of school leaders on their cultural intelligence and the organisational health of secondary schools in Kuala Lumpur. Using a quantitative design, a survey questionnaire was administered to 476 school leaders in Kuala Lumpur. The results from the survey were analysed using PLS-SEM technique with SmartPLS software, which established the direct effects of cultural intelligence on transformational leadership and organisational health. In addition, transformational leadership was determined to have a direct effect on organisational health. The evaluation of the structural model revealed that transformational leadership has a mediating effect on cultural intelligence of school leaders and organisational health of secondary schools. Aside from advancing the theoretical understanding of school leadership, the results of this article present reflection points for current and aspiring school leaders, opportunities for inclusion of cultural understanding in school leadership programs, and provisions in policies in organisational development in multicultural schools.
Ten Years of Sports Health: Authorship Characteristics and Levels of Evidence
Authors: Judy Ryan P. , Talentino Spencer , Bedi Asheesh , Lesniak Bryson P.
Published: July 2020

Context:

Sports Health: A Multidisciplinary Approach, now 10 years into production, has been ranked a top-25 journal in sport sciences and has tripled its impact throughout its existence.

Objective:

To evaluate authorship trends and levels of evidence (LOE) of articles published in Sports Health from 2009 to 2018. The secondary aim was to analyze funding sources and internationalization throughout the journal’s tenure.

Data Sources:

All clinical studies published in Sports Health between the years 2009 and 2018 were examined.

Study Selection:

All publications from the provided years were electronically reviewed by 2 reviewers and evaluated for inclusion criteria. Editorials, society news, memorials, letters to the editor, and corrigenda were excluded.

Study Design:

Systematic review.

Level of Evidence:

Level 5.

Data Extraction:

Articles were examined for number of authors, presence of female authorship, funding, country of origin, international collaboration, academic degree or certification of first and senior authors, and LOE. Clinical articles were assigned LOE based on guidelines from the University of Oxford’s Centre for Evidence-Based Medicine.

Results:

A total of 654 articles were examined. The percentage of high-LOE studies increased throughout the study period. The percentage of publications with female authors also increased throughout the study period. The mean number of authors per article increased from 3.2 to 4.6 over the 10-year period ( P < 0.05). The percentage of publications with international collaboration stayed consistent, while the number of countries per year increased during the study period. Overall, institutions from 23 countries have published in Sports Health since its inception to the time of this study.

Conclusion:

Female authorship in Sports Health surpasses industry standards, and the percentage of high-LOE studies remains remarkably high. Sports Health has stayed true to its multidisciplinary scope, as evidenced by the authors’ varying degrees and numerous countries that publish in the journal.
Covid-19 and labour law in France
Authors: Sachs Tatiana
Published: July 2020

The French government has mobilised various instruments to deal with the consequences of the pandemic. The main one is partial unemployment, which for the time being has made it possible to limit the rise of unemployment. However, as the period of return-to-work has begun, the question arises as to the distribution of efforts between the State, employers and employees. In any case, this crisis has undoubtedly enhanced the status of the State, which is no longer seen merely as a regulator but as a planner.
Ash and Garcia on bump stocks
Authors: Harman Graham
Published: July 2020

This commentary is a response to James Ash’s ‘Flat Ontology and Geography’, one of the first serious efforts to make use of the philosophy of Tristan Garcia for social science purposes. After reviewing some key distinctions between different kinds of flat ontology, I suggest that both Ash and Garcia make a step forward while failing to strike the desired balance between interconnected networks and autonomous units.
Connexin 43 plays a role in proliferation and migration of pulmonary arterial fibroblasts in response to hypoxia
Authors: McNair Andrew J. , Wilson Kathryn S. , Martin Patricia E. , Welsh David J. , Dempsie Yvonne
Published: July 2020

Pulmonary hypertension (PH) is a disease associated with vasoconstriction and remodelling of the pulmonary vasculature. Pulmonary artery fibroblasts (PAFs) play an important role in hypoxic‐induced remodelling. Connexin 43 (Cx43) is involved in cellular communication and regulation of the pulmonary vasculature. Using both in vitro and in vivo models of PH, the aims of this study were to (i) investigate the role of Cx43 in hypoxic‐induced proliferation and migration of rat PAFs (rPAFs) and rat pulmonary artery smooth muscle cells (rPASMCs) and (ii) determine whether Cx43 expression is dysregulated in the rat sugen5416/hypoxic model of PH. The role of Cx43 in hypoxic‐induced proliferation and migration was investigated using Gap27 (a pharmacological inhibitor of Cx43) or genetic knockdown of Cx43 using siRNA. Cx43 protein expression was increased by hypoxia in rPAFs but not rPASMCs. Hypoxic exposure, in the presence of serum, resulted in an increase in proliferation of rPAFs but not rPASMCs. Hypoxic exposure caused migration of rPAFs but not rPASMCs. Phosphorylation of p38 mitogen‐activated protein kinase (MAPK) and ERK1/2 were increased by hypoxia in rPAFs. The effects of hypoxia on proliferation, migration and MAPK phosphorylation in rPAFs were attenuated in the presence of Gap27 or Cx43 siRNA. Cx43 protein expression was increased in sugen5416/hypoxic rat lung; this increased expression was not observed in sugen5416/hypoxic rats treated with the MAPK pathway inhibitor GS‐444217. In conclusion, Cx43 is involved in the proliferation and migration of rPAFs in response to hypoxia via the MAPK signalling pathway.
Cardiac tamponade: an educational review
Authors: Imazio Massimo , De Ferrari Gaetano Maria
Published: July 2020

Cardiac tamponade is a pericardial syndrome characterised by an impairment of the diastolic filling of the ventricles causing reduction of cardiac output, usually producing signs and symptoms of cardiac arrest, if untreated. The main causes of cardiac tamponade include percutaneous cardiac interventions, malignacies, infectious/inflammatory causes, mechanical complications of myocardial infarction and aortic dissection. The diagnosis of cardiac tamponade is a clinical diagnosis based on a suggestive history and clinical presentation with worsening dyspnoea, distended jugular veins, muffled heart sounds and pulsus paradoxus, and should be confirmed by echocardiography. Cardiac tamponade is a life-threatening syndrome that requires urgent treatment by pericardiocentesis. Pericardiocentesis is an interventional technique to drain pericardial fluid by a percutaneous route. The standard technique for pericardiocentesis is guided by echocardiography or fluoroscopy under local anaesthesia. Pericardiocentesis should be performed by experienced operators and carries a variable risk of complications, mainly cardiac chamber puncture, arrhythmias (ventricular arrhythmias suggest puncture of the ventricle), coronary artery puncture or haemothorax, pneumothorax, pneumopericardium and hepatic injury. The prognosis of cardiac tamponade is essentially related to aetiology. Cardiac tamponade in patients with cancer and metastatic involvement of the pericardium has a bad short-term prognosis because it is a sign of advanced cancer, on the contrary, patients with cardiac tamponade and a final diagnosis of idiopathic pericarditis generally have a good long-term prognosis.
Metabolic endoscopy: Today’s science—tomorrow’s treatment
Authors: Hadefi Alia , Arvanitakis Marianna , Huberty Vincent , Devière Jacques
Published: July 2020

Obesity, type 2 diabetes mellitus (T2DM) and nonalcoholic steatohepatitis are increasing pandemic metabolic disorders. Lifestyle intervention (LSI) is the cornerstone treatment for these but is successful as standard care alone in only a few patients, given the modest weight loss at mid and long term. Conversely, bariatric surgery is the only proven effective treatment for these metabolic disorders, albeit offered only in a small percentage of cases because of its invasiveness and cost.

The so‐called endoscopic bariatric and metabolic therapies (EBMTs) include new, less‐invasive technologies such as intragastric balloons, aspiration therapy, endoscopic sleeve gastroplasty, diversion devices, and duodenal mucosal resurfacing, currently at various stages of development. EBMTs, as an add‐on to LSI, might represent an effective treatment filling the gap between medical and surgical management, taking into account, however, that obesity and its associated comorbidities constitute a chronic disease that needs lifelong therapy. In this review we describe the current scientific evidence surrounding EBMTs as well as future opportunities for such treatments in managing obesity and metabolic disorders.