bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Pain–Related Jaw Muscle Motor Load and Sensory Processing
Authors: Nickel J.C. , Gonzalez Y.M. , Wu Y. , Liu Y. , Liu H. , Iwasaki L.R.
Published: June 2022

Chronic pain associated with temporomandibular disorders (TMDs) may reflect muscle mechanoreceptor afferent barrage and dysregulated sensory processing. This observational study tested for associations between Characteristic Pain Intensity (CPI), physical symptoms (Patient Health Questionnaire–15 [PHQ-15]), and cumulative jaw muscle motor load (mV*s). In accordance with institutional review board oversight and Strengthening the Reporting of Observational Studies in Epidemiology guidelines, adult subjects gave informed consent and were identified via Diagnostic Criteria for TMD (DC-TMD) examination and research protocols. Subjects were assigned to ±Pain groups using DC-TMD criteria for myalgia. CPI scores characterized pain intensity. PHQ-15 scores were surrogate measures of dysregulated sensory processing. Laboratory tests were performed to quantify masseter and temporalis muscle activities (mV) per bite force (N) for each subject. In their natural environments, subjects recorded day- and nighttime electromyography from which cumulative jaw muscle motor loads (mV*s) were determined for activities consistent with bite forces of >1 to ≤2 and >2 to ≤5 N. Data were assessed using univariate analysis of variance, simple effects tests, K-means cluster classification, and 3-dimensional regression analyses. Of 242 individuals screened, 144 enrolled, and 125 with complete data from study protocols, there were 35 females and 15 males for +Pain and 35 females and 40 males for −Pain. Subjects produced 324 daytime and 341 nighttime recordings of average duration 6.9 ± 1.7 and 7.6 ± 1.7 h, respectively. Overall, +Pain compared to −Pain subjects had significantly higher (all P ≤ 0.002) CPI and PHQ-15 scores. Cumulative jaw muscle motor loads showed significant between-subject effects for time, diagnostic group, and sex (all P < 0.003), where motor loads tended to be higher for daytime versus nighttime, +Pain versus −Pain groups, and males versus females. Two clusters were identified, and regression relations showed associations of low-magnitude daytime masseter motor load, PHQ-15, and CPI scores for cluster 1 ( n = 105, R2 = 0.44) and cluster 2 ( n = 18, R2 = 0.80). Furthermore, these regression relations showed thresholds of motor load and PHQ-15 scores, above which there were nonlinear increases in reported pain.
Vitronectin-Derived Peptide Promotes Reparative Dentin Formation
Authors: Park C. , Song M. , Kim S.Y. , Min B.M.
Published: June 2022

Exposed dental pulp can maintain its vitality through a pulp-capping procedure with biocompatible materials, followed by reparative dentin formation. Our previous study demonstrated that a vitronectin-derived peptide (VnP-16) promotes osteoblast differentiation and concomitantly restrains osteoclast differentiation and resorptive function. In this study, we aimed to demonstrate that VnP-16 promotes odontoblast differentiation, mineralization, and reparative dentin formation in a pulp exposure model using a rat tooth. VnP-16 showed no cytotoxicity and promoted cellular behavior in human dental pulp cells, enhancing their differentiation into odontoblast-like cells and mineralization, effects that are comparable to those obtained with vitronectin. In a rat pulp exposure model, VnP-16 showed mild inflammatory responses at 2 and 4 wk or none. Mineral trioxide aggregate (MTA) demonstrated a tendency of early formation of reparative dentin at 2 wk when compared with recombinant human bone morphogenetic protein 2 (rhBMP-2) and VnP-16. However, VnP-16 induced reparative dentin formation similar to MTA and rhBMP-2 without inflammation at 4 wk. In addition, VnP-16 showed a thicker and homogeneous reparative dentin formation versus MTA and rhBMP-2. Collectively, these results suggest that VnP-16 can be a useful, direct pulp-capping agent for highly qualified reparative dentin formation by promoting cell behavior and odontoblastic differentiation of human dental pulp cells.
Neuroinflammation: A Distal Consequence of Periodontitis
Authors: Li X. , Kiprowska M. , Kansara T. , Kansara P. , Li P.
Published: June 2022

Periodontitis, a chronic, inflammatory disease, induces systemic inflammation and contributes to the development of neurodegenerative diseases. The precise etiology of the most common neurodegenerative disorders, such as sporadic Alzheimer’s, Parkinson’s diseases and multiple sclerosis (AD, PD, and MS, respectively), remains to be revealed. Chronic neuroinflammation is a well-recognized component of these disorders, and evidence suggests that systemic inflammation is a possible stimulus for neuroinflammation development. Systemic inflammation can lead to deleterious consequences on the brain if the inflammation is sufficiently severe or if the brain shows vulnerabilities due to genetic predisposition, aging, or neurodegenerative diseases. It has been proposed that periodontal disease can initiate or contribute to the AD pathogenesis through multiple pathways, including key periodontal pathogens. Dysbiotic oral bacteria can release bacterial products into the bloodstream and eventually cross the brain-blood barrier; these bacteria can also cause alterations to gut microbiota that enhance inflammation and potentially affect brain function via the gut–brain axis. The trigeminal nerve has been suggested as another route for connecting oral bacterial products to the brain. PD and MS are often preceded by gastrointestinal symptoms or aberrant gut microbiome composition, and alterations in the enteric nervous system accompany the disease. Clinical evidence has suggested that patients with periodontitis are at a higher risk of developing PD and MS. This nexus among the brain, periodontal disease, and systemic inflammation heralds new ways in which microglial cells, the main innate immune cells, and astrocytes, the crucial regulators of innate and adaptive immune responses in the brain, contribute to brain pathology. Currently, the lack of understanding of the pathogenesis of neurodegeneration is hindering treatment development. However, we may prevent this pathogenesis by tackling one of its possible contributors (periodontitis) for systemic inflammation through simple preventive oral hygiene measures.
The Role of Normative Age-Graded Transitions and Human Agency in Patterns and Variations of Financial Exploitation of Older Adults
Authors: Brancale Julie , Blomberg Thomas G.
Published: June 2022

Objectives: Drawing from normative age-graded transitions and human agency, this study provides a theoretical and empirical exploration of the patterns and variations of financial exploitation of older adults. Methods: The study employs qualitative methods with data collected from focus groups and interviews with residents of a large retirement community. Results: Normative age-graded transitions—such as retirement, residency relocations, changes in social support networks, medical events, death or incapacitation of a spouse, grief, declines in brain and physical health and cognition—lead to assessments of older adults’ sense of self-efficacy regarding their abilities to deal with everyday tasks, challenges, and decisions. If these assessments result in lowered self-efficacy, that reaches a threshold, cognitive transformations can occur, producing an increased vulnerability for financial exploitation. For those whose assessments of self-efficacy remained stable, financial exploitation was avoided. Conclusions: The role of normative age-graded transitions and general assessments of self-efficacy, thresholds, and cognitive transformations provides a promising theoretical approach for explaining patterns and variations of financial exploitation of older adults. These findings, if confirmed with more representative samples, can help validate the role of normative age-graded transitions and human agency in explaining why some, but not other, older adults fall victim to financial exploitation.
Are They Created Equal? A Relative Weights Analysis of the Contributions of Job Demands and Resources to Well-Being and Turnover Intention
Authors: Hoare Corey , Vandenberghe Christian
Published: June 2022

Building upon the Job Demands-Resources (JD-R) model (Demerouti et al., 2001) and the extensive research on employee turnover intention and well-being, we examined various demands and resources in relation to these outcomes. This study examined the differential relationship between job demands, and personal and job resources, and two organizational outcomes: turnover intention and emotional exhaustion. The job demands were role overload, role conflict, role ambiguity, and work-life balance. The job resources were resilience, servant leadership, relatedness, autonomy, job opportunities, pay satisfaction, and person-organization fit. An online questionnaire was administered to full-time employees via Qualtrics panel ( N = 364). Job demands were positively related to emotional exhaustion, and personal and job resources were negatively related to turnover intention. Using relative weights analysis, demands and resources were found to account for different amounts of variance in the outcome variables. This study informs our understanding of and contributes to the advancement of the JD-R model to encompass various job demands and personal and job resources and their differential relationship to emotional exhaustion and turnover intention.
Education and discipling in a performance-based or rote learning context
Authors: Bird Christine Heather , Dale Moyra
Published: June 2022

An ethnographic study in Nepal explores traditional cultural patterns of teaching and learning and asks how these patterns are also evident in teaching and discipling in the Nepali church. Pedagogical practices are analyzed to demonstrate the use of a performance-based model based on rote learning. It includes the interpretive context, modeling and observation, practice, performance, and evaluation. We conclude with a discussion of the implications for education or discipleship, including reviewing the place of questions, mistakes, “cheating,” and introducing innovations.
Application of Sampling Variance of Item Response Theory Parameter Estimates in Detecting Outliers in Common Item Equating
Authors: Liu Chunyan , Jurich Daniel
Published: June 2022

In common item equating, the existence of item outliers may impact the accuracy of equating results and bring significant ramifications to the validity of test score interpretations. Therefore, common item equating should involve a screening process to flag outlying items and exclude them from the common item set before equating is conducted. The current simulation study demonstrated that the sampling variance associated with the item response theory (IRT) item parameter estimates can help detect outliers in the common items under the 2-PL and 3-PL IRT models. The results showed the proposed sampling variance statistic ( SV) outperformed the traditional displacement method with cutoff values of 0.3 and 0.5 along a variety of evaluation criteria. Based on the favorable results, item outlier detection statistics based on estimated sampling variability warrant further consideration in both research and practice.
Incubating Future Scholars in the Humanities: A Case Study of an Honors Program at Peking University
Authors: Shen Yuting
Published: June 2022

The Humanities have an enduring role in improving society and people’s well-being, yet there is a very limited discussion of how to foster talents in the Humanities. This case study scrutinized how an honors program in the Humanities can enhance the academic potential of gifted undergraduates at an elite university in China. The results indicate that such an honors program can provide academic training and support and cultural influence beyond academic enhancement, thus incubating future scholars in the Humanities. While there are some implementation issues to consider—courses, supervision, various types of academic support, disciplinary culture, and academic traditions—all have takeaways for other institutions interested in maximizing the academic potential of gifted undergraduates in the Humanities. As a result, this study expands our understanding of Humanities education and education for gifted undergraduates in non-Western countries.
How the Senior Community Service Employment Program Influences Participant Well-Being: A Participatory Research Approach With Program Recommendations
Authors: Halvorsen Cal J. , Werner Kelsey , McColloch Elizabeth , Yulikova Olga
Published: June 2022

The federal Senior Community Service Employment Program (SCSEP) provides on-the-job training to people 55 years and older with incomes at or below 125% of the federal poverty level with multiple barriers to employment. This study examined the processes by which SCSEP may influence participant financial, physical, and mental well-being. We engaged 15 SCSEP participants and case managers over four virtual and one telephone session using a participatory research method called community-based system dynamics. Activities included identifying key problem trends, variable elicitation, developing a causal map, and identifying changes to the system to increase participant well-being. Respondents identified how individual, organizational, and program and policy factors relate to participant well-being (e.g., SCSEP participation reduces social isolation, which increases desire to participate) and suggested program and policy recommendations to strengthen SCSEP (e.g., benchmarks of success should include health and well-being outcomes). These findings highlight the benefits and potential of this long-running program.
Diasporas and Collective Remittances: From State-Driven to Unofficial Forms of Diaspora Engagement
Authors: Galstyan Nare , Ambrosini Maurizio
Published: June 2022

This article advances understandings of collective remittances practices by elaborating on the case of the Armenian diaspora in the Netherlands. It argues that the collection, management, and distribution of collective remittances are crucial aspects of how diasporic immigrant groups function. Hence, collective remittances represent a lens through which to analyze a diaspora's internal life, gender differences and tensions, relations with the origin state or homeland, and connections to other relevant institutions. Furthermore, the article brings three new insights to diaspora studies. First, it demonstrates how practices connected to the collection and sending of collective remittances reflect the internal dynamics of diasporic migrations and diaspora-homeland relations. Second, the article unpacks the concept of collective remittances itself, classifying it into three categories: collective remittances initiated from above, with a state-driven character; collective remittances organized by transnational non-state institutions, such as religious institutions and pan-diasporic organizations; and collective remittances initiated from below, organized by migrants and local networks of diaspora members. Third, this article highlights women's roles in organizing alternative forms of collective remittances, from external to official channels. The qualitative examination of collective remittances presented here supplies a new vision of collective remittances in which informal and hidden aspects, gender roles, forms of reciprocation, and creation and circulation of trust are highlighted.
Developing a Scale to Investigate the Dissatisfaction with the Face and Body
Authors: Ayase Izumi , Mori Masaki , Kato Takaaki
Published: June 2022

The purpose of this study was to develop a psychometric scale to measure dissatisfaction with one’s face. In Study 1, 1,002 people aged 17–42 years using a 7-point Likert scale for a draft scale. Exploratory factor analysis revealed that the scale consisted of 27 items and a 3-factor structure (Avoidance, Fear, and Obsessive thinking), named Face Dissatisfaction Scale (FDS). Study 2 examined sex differences in dissatisfaction with the face and body. The results showed that females were more dissatisfied with faces than males; however, there was no sex difference in body dissatisfaction. Males were more dissatisfied with bodies than faces; however, there was no difference in females. We found that face dissatisfaction was positively associated with dysmorphic concerns and obsessive-compulsive tendencies. Moreover, the FDS showed high goodness-of-fit, reliability, and validity. The study suggests that FDS is a useful psychometric tool to seek unsatisfied people with their faces.
Long non-coding RNA growth arrest specific 5 regulates the T helper 17/regulatory T balance by targeting miR-23a in myasthenia gravis
Authors: Xu Yingying , Ouyang Yiqun
Published: June 2022

Objective

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder. Recent studies report that long non-coding RNAs (lncRNAs) play vital roles in the pathogenesis of various diseases. This study explored the molecular mechanism of lncRNA growth arrest specific 5 (GAS5) in regulating the T helper 17 (Th17)/regulatory T (Treg) cell balance in MG.

Methods

GAS5 and miR-23a expression levels were detected by quantitative reverse transcription polymerase chain reaction. Flow cytometry was performed to examine the proportion of Th17 and Treg cells in CD4+ T cells from MG patients. The interaction between GAS5 and miR-23a was verified by luciferase reporter and RNA immunoprecipitation assays. Levels of Th17 and Treg-related proteins were examined using western blots and enzyme-linked immunosorbent assays.

Results

GAS5 expression levels were significantly decreased in the CD4+ T cells of MG patients, and GAS5 overexpression restrained Th17 differentiation in CD4+ T cells. Moreover, miR-23a was confirmed as a downstream target of GAS5 and negatively regulated by GAS5 through a direct interaction. Further exploration showed that GAS5 can inhibit Th17 differentiation by downregulating miR-23a.

Conclusion

Collectively, our results indicate that GAS5 can regulate the Th17/Treg balance by targeting miR-23a expression, providing a scientific basis for clinical therapeutic development for MG.
Automated peritoneal dialysis as a cost-effective urgent-start dialysis option for ESRD patients: A prospective cohort study
Authors: Jin Haijiao , Lu Renhua , Lv Shifan , Wang Ling , Mou Shan , Zhang Minfang , Wang Qin , Pang Huihua , Yan Hao , Li Zhenyuan , Che Miaoling , Shen Jianxiao , Yan Jiayi , Gu Aiping , Zhang Haifen , Liu Qian , Fang Nina , Jin Yan , Ni Zhaohui
Published: June 2022

Background

Several studies have reported the feasibility of urgent-start peritoneal dialysis (PD) as an alternative to hemodialysis (HD) using a central venous catheter (CVC). However, the cost-effectiveness of automated peritoneal dialysis (APD) as an urgent-start dialysis modality has not been directly evaluated, especially in China.

Methods

We prospectively enrolled patients with end-stage renal disease (ESRD) who required urgent-start dialysis at a single center from March 2019 to November 2020. Patients were grouped according to their urgent-start dialysis modality (APD and HD). Urgent-start dialysis conducted until 14 days after PD catheter insertion. Then, PD was maintained. Each patient was followed until July 2021 or death or loss to follow-up. The primary outcome was the incidence of short-term dialysis-related complications. The secondary outcome was the cost and duration of the initial hospitalization. Technique survival, peritonitis-free or bacteriamia-free survival and patient survival were also compared.

Results

Sixty-eight patients were included in the study, of whom 36 (52.9%) patients were in APD group. Mean follow-up duration was 20.1 months. Compared with the HD group, the APD group had significantly fewer short-term dialysis-related complications. The cost of initial hospitalization was also significantly lower in APD patients. There was no significant difference between APD and HD patients with respect to duration of the initial hospitalization, technique survival rate, peritonitis-free or bacteriemia-free survival rate, and patient survival rate.

Conclusion

Among ESRD patients with an urgent need for dialysis, APD as urgent-start dialysis modality, compared with HD using a CVC, resulted in fewer short-term dialysis-related complications and lower cost.
Evaluation of anticoagulation with bivalirudin for heparin-induced thrombocytopenia during extracorporeal membrane oxygenation
Authors: Hanna Dylan J , Torbic Heather , Militello Mike , Strnad Kyle , Krishnan Sudhir , Hohlfelder Ben
Published: June 2022

Introduction:

Unfractionated heparin is the most commonly utilized anticoagulant in extracorporeal membrane oxygenation (ECMO) due to clinician familiarity, ease of reversal, and low cost compared to alternative agents. However, heparin’s anticoagulant effect can be unpredictable and its use accompanies a risk of heparin induced thrombocytopenia (HIT). Successful use of bivalirudin as an alternative to heparin in non-HIT ECMO patients has previously been described. However, there is a paucity of data regarding its utilization in patients with confirmed HIT on ECMO.

Methods:

This single-center retrospective chart review at Cleveland Clinic Main Campus included 12 ECMO patients who were managed with bivalirudin for a new diagnosis of HIT. Descriptive statistical analyses were performed utilizing median with interquartile range and number with percent as appropriate.

Results:

Of the 12 patients included, median ECMO duration was 328.5 (218.8–502.1) h and venoarterial ECMO was the most common configuration. No patients experienced the primary outcome of in-circuit thrombosis while on bivalirudin. One patient developed a deep vein thrombosis 22.5 h after switching from heparin to bivalirudin. Major bleeding occurred during bivalirudin therapy in 8 (66.7%) patients.

Conclusions:

Overall, our study results suggest that bivalirudin is effective for the management of HIT and did not show evidence of in-circuit thrombosis. A high incidence of major bleeding was observed with bivalirudin use within this study. Clinicians should view bivalirudin as an acceptable agent for the treatment of HIT in the ECMO population, but must consider bleeding risk given the lack of effective reversal agents.
Minimally invasive aortic valve replacement with an expandable bioprosthesis after LVAD implantation as redo surgery
Authors: Öztürk Mahmut , Risteski Petar , Doss Mirko , Popov Aron-Frederik
Published: June 2022

Left Ventricular Assist Device (LVAD) is currently implanted not only as a bridge to transplant or recovery but also as destination therapy. One factor, affecting the device performance and treatment adequacy negatively is the development of aortic valve insufficiency (AI) after the implantation. Herein, we introduce a minimally invasive partial sternotomy aortic valve replacement with an expandable bio-prosthesis in a 74-year-old LVAD patient with severe AI.
A mini-review of the physical recycling methods for plastic parts in end-of-life vehicles
Authors: Martinez Sanz Vicent , Morales Serrano Adrian , Schlummer Martin
Published: June 2022

Although the use of plastic components is increasing in the automotive industry, yet the recovery rates of these materials in end-of-life vehicle (ELV) is lower compared to metals. One of the main problems of ELV plastic waste is poor separation and sorting. Large car plastic parts consist of fibre-reinforced plastics, whereas other components end up in the automotive shredder residue (ASR), featuring a very heterogeneous mix of light materials that contains mostly non-metallic materials such as textiles, plastics, cartridges and wood. Generally, ASR was disposed in landfill or diverted to thermal treatments, such as pyrolysis or gasification, for energy recovery. Currently, the recovery of raw materials from various waste streams plays a key role in new European strategy for plastics in a circular economy. The approach of physical recycling methods described in this mini-review helps to maintain the value of polymer materials in the value chain allowing the reuse in the original or similar application.
Continuous antimicrobial mechanism of dispersible hydroxyapatite nanoparticles doped with zinc ions for percutaneous device coatings
Authors: Oshita Mari , Umeda Koji , Kataoka Minami , Azuma Yoshinao , Furuzono Tsutomu
Published: June 2022

Percutaneous devices—indwelling catheters—related infections are serious clinical incidents. It is accordingly necessary to develop anti-infective coating materials suitable for the devices for long-term effectiveness. In our research group, highly dispersible and crystalline hydroxyapatite (HAp) nanoparticles doped with metallic or halogen ions possessing antibacterial activities have been developed. In this study, antibacterial, dispersible, and crystalline zinc (Zn)-doped hydroxyapatite [Zn(15)-HAp] nanoparticles substituted with 13.5% Zn content [Zn/(Zn + Ca) × 100] were prepared by a wet chemical method using an anti-sintering agent through calcination. Antibacterial activities of Zn(15)-HAp nanoparticles were evaluated using Escherichia coli ( E. coli) and Staphylococcus aureus. The survival rates of the bacteria on Zn(15)-HAp nanoparticles were significantly lower than that on normal HAp (nHAp) coated surfaces, while no influences were observed on proliferation of L929 cells. Even after soaking Zn(15)-HAp nanoparticles in PBS for 2 weeks, the antibacterial activities against E. coli were maintained at a similar level to a 20 min soaking. The bacterial death was related to not only ion-exchange phenomenon between Zn and magnesium ions but also accumulation of reactive oxygen species (ROS) in the cells. Allergic-like reactions—anaphylactoid reactions—might not readily occur with Zn(15)-HAp nanoparticles because the amounts of histamine released from HMC-1 cells co-cultured with nanoparticles were not significantly different to that of nHAp, but were statistically much lower than that of chlorhexidine.
Statin-Associated Autoimmune Myopathy: Review of the Literature
Authors: Barrons Robert
Published: June 2022

Objective: Statin-associated autoimmune myopathy (SAAM) is a rare adverse event characterized by progressive muscle symptoms despite discontinuation, requiring immunosuppressive therapy for remission. The objective of this review was to characterize SAAM, for timely detection, while examining the literature for effective treatment considerations. Methods: PubMed search was conducted from 2010 to 2020 was for relevant case series and studies of at least 8 patients displaying muscle discomfort or weakness, anti-HMGCR antibodies, exposure to statins, and biopsies consistent with SAAM. Results: Three case series and 3 case cohort studies identified 199 patients with SAAM. Exhibiting a mean age of 63.74 years, patients were more likely Caucasian (81%) and female (1.2X), and required a mean duration of 4.75 years before symptomatic. The presentation involved proximal muscle weakness (94%), myalgias (37%) and dysphagia (23%), accompanied by a mean creatinine kinase of 6383 IU/L. Most patients (57%) required 2 or more immunosuppressive (IMS) agents to achieve 62% remission. After 2 years of treatment, 15% of patients without remission reported symptomatic improvement, while another 12% were refractory to treatment. Conclusion: Delayed onset of SAAM greater than 4 years from statin initiation may create a low index of suspicion. However, progression of symptoms beyond 2 months from statin discontinuation and positive anti-HMGCR antibodies requires immunosuppressive agents. Data and expert opinion support use of at least two IMS medications upon diagnosis for a minimum of 2 years. Therapy success depends on timely recognition and initiation of IMS combinations to achieve earlier remission and symptomatic improvement.
Dynamic responses of electromechanical transmission system based on a nonlinear hybrid model
Authors: Wang Zhen , Liu Hui , Xiang Changle , Zhang Wei , Zhan Zhaobin , Yan Pengfei
Published: June 2022

A nonlinear hybrid model of electromechanical transmission system is proposed by combining finite element method and lumped parameter method, in which the flexible shaft model is established by using three-dimension nonlinear beam element based on the absolute node coordinate formulation and the gear mesh model is calculated by using nonlinear time-varying lumped parameter model. In the hybrid model, the coupling between the nonlinear deformation of shafts and excitation of gears is considered. The generalized- α implicit time stepping algorithm is used to study the dynamic responses of system. Then, comparisons and analyses are made of the dynamic responses of system between the hybrid model and previous lumped parameter model. Finally, the effects of flexibility of shafts, the geometrical parameters of shaft, the mounting position of the gear on the shaft and the operation conditions on the dynamic responses of system are analyzed. The results show that the presented nonlinear hybrid model is valid and effective in predicting the dynamic behavior of electromechanical transmission system. The gear meshing force is increased by 14.3% and new coupling frequencies are observed due to the effect of the shaft flexibility. Moreover, since the shaft radius of 0.05 m is the critical value for the accurate calculation of the proposed nonlinear hybrid model, the nonlinearity caused by the shaft vibration cannot be ignored. When the gear is installed at the midpoint of the shaft, the maximum von Mises stress of the shaft of 1.8 × 107 Pa is achieved and located at the connected point on the shaft. This study plays an important role in the field of electromechanical transmission design.
Changes in the vegetation and water cycle of the Ecuadorian páramo during the last 5000 years
Authors: Ledru Marie-Pierre , Aquino-Alfonso Olga , Finsinger Walter , Samaniego Pablo , Hidalgo Silvana
Published: June 2022

We analyzed changes in the long-term vegetation cover and in fire activity over the past 5000 years in the Ecuadorian páramo using a sediment core from Papallacta (Ecuador). The chronology is constrained by three tephra layers and 32 AMS 14C ages, and 168 samples yielded a high-resolution record of environmental changes. We estimated the upslope wind convectivity as the ratio between pollen transported from the Andean cloud forest and Poaceae pollen to distinguish changes in atmospheric moisture from changes in soil moisture. The record showed that the two sources of moisture, either from year-round adiabatic cloud dripping linked to SASM activity or to ENSO variability at decadal-scale, influenced vegetation-cover changes. Between 5000 and 2450 cal yr BP, both soil moisture and biomass burning were higher than after 2450 cal yr BP. The shift between the two states matches the zonal increase in summer insolation that drove the ITCZ to its southernmost position. Our results underline resilience to volcanic activity, the importance of the upslope convective dripping with the lowest convective index observed at ~4500 cal yr BP, the anomalous last century with the highest convective activity and the driest soil conditions recorded in the last 5000 years, the recent increase in fire activity and the link between soil moisture and the position of the ITCZ.
Tensile properties and fracture behavior of carbon nanotube-sheets/carbon fibers epoxy-impregnated bundle composites
Authors: Naito Kimiyoshi , Nagai Chiemi , Shirasu Keiichi , Shimamura Yoshinobu , Inoue Yoku
Published: June 2022

An interesting technique for modifying carbon fiber-reinforced polymer matrix composites is through hybridization with carbon nanotubes (CNTs). Carbon nanotubes sheets/carbon fibers offer potential benefits of nanoscale reinforcement to the well-established fibrous composites by creating multiscale hybrid micro-nano composites. In this study, the tensile properties of high tensile strength polyacrylonitrile (PAN)- and high modulus pitch-based carbon fiber-reinforced polymer matrix composites incorporating CNT sheets (CNT-sh/CFs/Ep-H: CNT sheets/carbon fibers/epoxy hybrid composites) were investigated. To fabricate CNT sheets, CNT was vertically grown on a quartz glass plate by chemical vapor deposition. A solid-state drawing and winding technique was applied to transform the vertically aligned CNT array into horizontally aligned CNT sheets. The tensile modulus of the CNT-sh/CFs/Ep-H was higher than that of the composite in the as-received state (CFs/Ep: carbon fibers/epoxy bundle composite). The tensile strength of the CNT-sh/PAN-based CF/Ep-H was lower than that of the PAN-based CF/Ep, whereas the tensile strength of the CNT-sh/pitch-based CF/Ep-H was higher than that of the pitch-based CF/Ep.
Barriers and Facilitators of Adherence to Oral Nutritional Supplements Among People Living With Cancer: A Systematic Review
Authors: Wang Qiu-Chen , Yuan Hua , Chen Zhi-Ming , Wang Jia , Xue Hui , Zhang Xiu-Ying
Published: June 2022

This study aims to synthesize the barriers and facilitators of oral nutritional supplement adherence in people with cancer and assess levels of adherence. Databases including Embase, PubMed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journal Database, were used to search articles before January 4, 2021. Eighteen studies with 1,267 participants met the inclusion criteria. All studies reported rates of adherence, ranging from 6.0% to 96.9%. Gastrointestinal intolerances and disliked tastes were considered common barriers to cancer patients’ adherence, whereas the ONS management strategy was considered the most crucial facilitator of adherence. Health professionals can improve adherence through regular monitoring and guidance and incentive strategies, and paying attention to the management and prevention of adverse reactions when prescribing nutritional products.
Simplification and Multidimensional Adaptation of the Stratification Tool for Pharmaceutical Care in People Living With HIV
Authors: Morillo-Verdugo Ramón , Aguilar Pérez Tamara , Gimeno-Gracia Mercedes , Rodríguez-González Carmen , Robustillo-Cortes María de las Aguas , Robustillo-Cortes María de las Aguas , Uranga Aitziber Illaro , López Alicia Lázaro , Crespo Angels Andreu , Alarcón Aránzazu Linares , Vega Beatriz Proy , García Belén López , Solanes Carlos Seguí , Rodríguez-González Carmen , Guisado Carolina Aguilar , García Elena Cárdaba , Cuadrado Emilio Molina , Boquet Emilio Monte , Lecha Encarna Abad , Escrig Esther Vicente , Orfila Gabriel Mercadal , Aznárez Herminia Navarro , López Inmaculada Nacle , Orbis Irene Cañamares , Anciano Jara Gallardo , Arrate Javier Casas , Ferrández Javier Sánchez-Rubio , López Joaquín Ignacio Serrano , Pedrosa José Alberto Peña , González Jose Sebastián Roldan , Lisón Luis Carlos Fernández , Framinan Luis Margusino , Valín Luis Ortega , Martin Maite , Vélez Manuel , Crespo María Ángeles Andreu , Maria Maria Carmen Rosado , Coronel María García , Fernández Maria Jose Huertas , Gimeno-Gracia Mercedes , García Mercedes Manzano , Peña Noelia Garrido , Atorrasagasti Oihana Mora , Fenollera Patricia Sanmartin , Ruíz Pilar Díaz , Elcano Ramón San Miguel , Molina Raquel Fresquet , del Águila Vera Áreas , Rebollo-Gómez Dr Elena , Marfil Dr Vanessa
Published: June 2022

Background

People living with human immunodeficiency virus (HIV) require specific pharmaceutical care (PC). Although the 2017 Capacity-Motivation-Opportunity (CMO) PC model allows a multidisciplinary approach that focuses on patient needs, it is too complex and presents room for improvement.

Objective

The aim of this study is to simplify and adapt the previous 2017 PC tool through a multidimensional approach to improve HIV patient care, to prove the validity of the model in real-life patients.

Methods

The new PC tool was generated by keeping some of the variables of the 2017 document and conducting a literature search. Content validity was determined by a 2-round Delphi methodology with an expert panel of 42 pharmacists. Consensus for the first and second rounds was defined as ≥70% agreement. The tool generated was validated in 407 real-life patients.

Results

Thirty-seven experts completed the first round of the Delphi survey and 36 the second. No consensus was reached for 3 variables, any of the frequency options and 4 interventions, while the experts agreed not to include 1 intervention in round 1. Consensus to include them was found for all but 1 variable and 1 intervention in round 2. The final tool obtained to select and stratify HIV-positive patients was composed of 9 dimensions divided into 17 variables. The new tool was validated with real-life patients and 3 priority levels were defined.

Conclusions and relevance

We created a new pyramid of score thresholds to classify patients into priority levels. The new tool simplifies the 2017 model and improves its utility to help HIV-positive patients, owing to its multidimensional approach.
Robust product line pricing under the multinomial logit choice model
Authors: Qi Wei , Luo Xinggang , Liu Xuwang , Zhang Zhong-Liang
Published: June 2022

Incorporating consumer choice behavior into a product line design optimization model enhances the understanding of consumer choices and improves the opportunities to increase profit. Most product line optimization problems assume that parameters are precisely known in consumer choice model. However, the decision maker does not precisely know the model parameters because of insufficient sample data, measurement problems, and other factors. We investigate the problem of establishing robust product line pricing under a multinomial logit model to account for the uncertainty of the valuation parameter. First, we present a nominal product line model to maximize profit. We then establish a robust product line model to maximize the worst-case expected profit, where the valuation parameter lies in an uncertainty set. We consider both single and multiple products development and derive the optimal prices’ closed-form expressions. Through numerical experiments, we illustrate the benefit of robust product line pricing to address parameter uncertainty. We demonstrate that the difference between the expected nominal profit and the worst-case profit increases with the increase of the interval of the uncertainty set, and the robust profit relative to the worst-case nominal profit improves. The robust product line design can ensure steadier, even higher profit.
Malignant Mixed Mullerian Tumor Arising from Endometriosis in the Groin: A Case Report and Literature Review
Authors: Yao Ruisheng , Wu Peter , Sung C. James , Lamson Jill A. , Zhang Cunxian
Published: June 2022

This was a 57-year-old woman who presented with mild discomfort in the right groin. Physical examination revealed a mass in the right groin, and by ultrasound, the mass was hypoechoic and solid with some internal vascularity. The clinical differential diagnosis included lymphoma and others. The mass was excised for pathologic evaluation. Gross examination of the specimen revealed a 3 × 2.4 × 2 cm, solid and cystic mass. Microscopically, it was a biphasic tumor consisting of carcinomatous and sarcomatous components. The tumor was seen contiguous with endometriosis and atypical endometrioid hyperplasia. The histologic findings were consistent with malignant mixed Mullerian tumor (MMMT) arising from endometriosis in the right groin. The tumor involved the resection margin. Subsequent chest/abdominal/pelvic computed tomography did not reveal evidence of tumors, and diagnostic peritoneal/pelvic laparoscopy did not show diseases. Postoperatively, the patient received 6 cycles of chemotherapy consisting of carboplatin and paclitaxel, followed by radiation in the right groin. Malignant transformation from endometriosis occurs in less than 1% of endometriosis cases, and about 80% of the transformed tumors occur in the ovaries. The most commonly transformed malignant tumors are endometrioid and clear cell carcinomas, with rare adenosarcoma and endometrial stromal sarcoma reported. To our knowledge, we are reporting the first case of MMMT arising from endometriosis in the groin.
Pleomorphic Rhabdomyosarcoma: A Systematic Review with Outcome Analysis and Report of a Rare Abdominal Wall Lesion
Authors: Deb Pratik Q. , Chokshi Ravi J. , Li Sharon , Suster David I.
Published: June 2022

Introduction. Pleomorphic rhabdomyosarcoma (RMS) is an aggressive and rare malignant neoplasm with a poor prognosis. As its name suggests, this tumor exhibits extensive pleomorphism with features of skeletal muscle differentiation. Due to its rarity, its diagnosis is often a clinical and pathological challenge. Since only small case series and a few scattered case reports exist in the literature, the impact of different demographic features, tumor site, and/or treatment modality on patient outcomes has yet to be extensively studied. Methods. We report a case of a pleomorphic RMS presenting atypically as an abdominal wall mass. We have also analyzed the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database to determine the factors affecting the outcome of this neoplasm. Moreover, we present a review and summary of pleomorphic RMS cases arising from the abdominal wall reported in the English language literature. Results. We found two hundred and forty-two cases of pleomorphic RMS in the SEER database. The majority of the patients were diagnosed after the age of 40, with the age of diagnosis showing a unimodal distribution. The majority of the patients were Caucasian (82%) and male (59%). Age of diagnosis, tumor stage, and surgical management significantly affected the patients’ outcome, while patients’ ethnicity, sex, or tumor site did not affect the outcome. We only found five previously reported cases of pleomorphic RMS arising from the abdominal wall. Conclusions. Pleomorphic RMS arising from the abdominal wall is extremely rare. Our data sheds light on the factors affecting the outcome of pleomorphic RMS. We have also discussed the challenges involving the histopathological diagnosis of this rare neoplasm and how to best approach this task.
Predictive Value Analysis of in-Stent Restenosis Within Three Years in Older Acute Coronary Syndrome Patients: A Two-Center Retrospective Study
Authors: Zhou Jing , Chai Dayang , Dai Yuxiang , Wang Aichao , Yan Ting , Lu Shu
Published: June 2022

We aimed to investigate prognostic factors of in-stent restenosis (ISR) within 3 years in older acute coronary syndrome (ACS) patients after drug-eluting stent (DES) implantation and establish a clinical model for predicting ISR. We retrospectively collected 215 older ACS patients who followed coronary angiography (CAG) after DES implantation, divided into ISR group and non in-stent restenosis (non-ISR) group according to the results of reviewed CAG. Logistic regression analysis was performed to screen independent predictors related to ISR and build the clinical predictive model, which clinical application was assessed by decision curve analysis (DCA) and clinical impact curve (CIC). Kaplan-Meier survival curves for ISR by independent predictors. In multivariate logistic regression analysis showed that the red cell distribution width (RDW) was higher in ISR group compared with non-ISR (odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.14–2.08, p < 0.01). Instead, a negative correlation was observed between minimum stent diameter and ISR (OR = 0.28, 95%CI:0.09-0.86, p = 0.03). A novel nomogram composed of these significant features presented a concordance index (C-index) of 0.710, DCA and CIC suggested that the predictive nomogram had clinical utility. Schoenfeld residuals showed the model RDW ≥ 12.6% with minimum stent diameter <3 mm was consistent with the proportional risk assumption. The Kaplan-Meier estimate for ISR showed statistical significance. Higher levels of RDW and lower minimum stent diameter were associated with incidence of ISR within 3 years in older ACS patients after DES implantation.
Lattice infill structure design of topology optimization considering size effect
Authors: Li Tian , Sun Bo , Gan Ning
Published: June 2022

The vigorous development of additive manufacturing technology promotes the tendency of lattice infill design to be miniaturized. The representative scale of the deformation field becomes equivalent to the length scale of the microstructures when the characteristics size of the lattice infill design is down to micron or nanoscale, and strain gradient effects or size effects arise in the structure. Due to the lack of microscopic material properties, the typical topology optimization framework based on classical mechanics for lattice infill structure cannot represent the performance difference induced by the size effect. Therefore, single-scale lattice infill structure design and couple stress theory are combined to explore the size effect on topology optimization. Numerical examples show that when the size ratio of the macroscopic feature size to the material characteristic length is reduced to a comparable range, the topological configurations and the target compliance values exhibit a significant size effect.
Investigated regional apparent diffusion coefficient values of the morphologically normal feline brain
Authors: Lindt Blanca , Richter Henning , Del Chicca Francesca
Published: June 2022

Objectives

Diffusion-weighted imaging (DWI) MRI is increasingly available in veterinary medicine for investigation of the brain. However, apparent diffusion coefficient (ADC) values have only been reported in a small number of cats or in research settings. The aim of this study was to investigate the ADC values of different anatomical regions of the morphologically normal brain in a feline patient population. Additionally, we aimed to assess the possible influence on the ADC values of different patient-related factors, such as sex, body weight, age, imaging of the left and right side of the cerebral hemispheres and white vs grey matter regions.

Methods

This retrospective study included cats undergoing an MRI (3T) examination with DWI sequences of the head at the Vetsuisse Faculty of the University Zurich between 2015 and 2021. Only cats with morphologically normal brains were included. On the ADC maps, 10 regions of interest (ROIs) were manually drawn on the following anatomical regions: caudate nucleus; internal capsule (two locations); piriform lobe; thalamus; hippocampus; cortex cerebri (two locations); cerebellar hemisphere; and one ROI in the centre of the cerebellar vermis. Except for the ROI at the cerebellar vermis, each ROI was drawn in the left and right hemisphere. The ADC values were calculated by the software and recorded.

Results

A total of 129 cats were included in this study. The ADC varied in the different ROIs, with the highest mean ADC value in the hippocampus and the lowest in the cerebellar hemisphere. ADC was significantly lower in the white cerebral matter compared with the grey matter. ADC values were not influenced by age, with the exception of the hippocampus and the cingulate gyrus.

Conclusion and relevance

ADC values of different anatomical regions of the morphologically normal feline brain in a patient population of 129 cats in a clinical setting are reported for the first time.