bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of ultrasound-guided serratus anterior plane block with different doses of dexmedetomidine for patients undergoing modified radical mastectomy: A randomized controlled trial
Authors: Duan Caiping , Hao Zaijun , Yang Junling , Song Fei , Fan Xiujuan , Li Ruizhen
Published: May 2021

Background: Ultrasound-guided serratus anterior plane block (USG-SAPB) has been used for pain management of patients undergoing modified radical mastectomy (MRM), but evidence supporting the adjuvant analgesic benefits is limited. We explored the efficacy and safety of preemptive use of different concentrations of dexmedetomidine and ropivacaine in USG-SAPB for patients undergoing MRM.Patients and methods: Ninety-five female patients were randomly allocated to RD1 and RD2 groups. USG-SAPB was performed before anesthesia induction. Consumption of sufentanil, postoperative pain scores, and level of sedation were recorded 1–72 h postoperatively. Intraoperative hemodynamics, PACU length of stay, incidence of moderate-severe pain, one-time puncture success, block procedure time, time to first rescue analgesia, satisfaction scores of patients and surgeons, hospital length of stay, adverse events, the prevalence of chronic pain, and quality of postoperative functional recovery were recorded.Results: Dynamic VAS was significantly lower at 4, 8, and 12 h after surgery and sufentanil need was significantly lower at 4, 8, 12, 24, and 48 h after surgery in the RD2 group (P<0.05). The incidence of moderate-severe pain was significantly lower in the RD2 group (P<0.05). Time to first rescue analgesia was significantly longer in the RD2 group (P=0.047). Consumption of propofol, remifentanil, dexmedetomidine, use of vasoactive agents, and PACU length of stay (LOS) were significantly reduced in RD2 patients (P<0.05). There were no significant diﬀerences between the two groups with respect to procedural variables or satisfaction scores of patients and surgeons, and/or postoperative complications. The hospital LOS, global QoR-40, and prevalence of chronic pain were comparable.Conclusions: Use of 1 μg/kg dexmedetomidine and ropivacaine in USG-SAPB can provide superior postoperative analgesia for patients undergoing MRM without additional adverse effects, and result in similar quality of postoperative functional recovery and prevalence of chronic pain.
Prevalence use of nonsteroidal anti-inflammatory drugs in the general population with COVID-19 and associated COVID-19 risk, hospitalization, severity, death, and safety outcomes: A systematic review and meta-analysis
Authors: zhao huilei , huang Shanshan , mei kaibo , shao wen , zhang jing , ma jianyong , zhu wengen , jiang yuan , yu peng , liu xiao
Published: May 2021

Introduction:

Recent reports of potential harmful effects of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with Corona Virus Disease 2019 (COVID-19) have provoked great concern. Therefore, the safety of NSAIDs is still questioned.
Methods

We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases from December 2019 to January 2021 to examine use prevalence for NSAIDs in general, as well as associated COVID-19 risk and outcomes. This study has been registered with PROSPERO (CRD42019132063)
Results

We included 25 studies with a total of 101,215 COVID-19 patients. The use of NSAIDs in COVID-19 patients reached 19%. Exposure to NSAIDs was not associated with significantly increased risk of developing COVID-19 (odds ratio [OR] = 0.98, 95% confidence interval [CI]: 0.78–1.24; I2 = 82%), hospitalization (OR = 1.06, 95%CI: 0.76–1.48; I2 = 81%), mechanical ventilation (OR = 0.71, 95%CI: 0.47–1.06; I2 = 38%), and length of hospital stay. Moreover, use of NSAIDs was significantly associated with better outcomes, including severity of COVID-19 (OR = 0.79, 95%CI: 71–0.89; I2 = 0%) and death (OR = 0.68, 95%CI: 0.52–0.89; I2 = 85%) in patients with COVID-19. Regarding safety outcomes, exposure to NSAIDs was associated with increased risk of stroke (OR = 2.32, 95%CI: 1.04–5.2; I2 = 0%), but not with myocardial infraction (OR = 1.49; p = 0.66; I2 = 0%), overt thrombosis (OR = 0.76, p = 0.50; I2 = 28%) and major bleeding (p = 0.61).
Conclusion

Based on current evidence, exposure to NSAIDs is not linked to increased odds or exacerbation of COVID-19 in the general COVID-19 population. Furthermore, administration of NSAIDs might have better outcomes and survival benefits in the general COVID-19 population, although potentially increasing the risk of stroke. Use of NSAIDs might be safe and beneficial in COVID-19. Future observational and randomized control trials are needed for further confirmation.
Surgical Excision For Para-Aortic Lymph Node Metastases After Radical Colorectal Cancer Resection: Case Series of Six Patients
Authors: Kondo Hiroka , Hirano Yasumitsu , Yamaguchi Shigeki
Published: May 2021

Background: The reported frequency of colorectal cancer (CRC) metastasis to para-aortic lymph nodes (PLNs) varies but is quite low (approximately 1 to 4%), impeding present attempts at large-scale trials. In particular, there are few reports of PLN recurrences after radical resection of CRC. We report 6 cases of PLN dissection for PLN recurrence after radical CRC surgery.Case presentation: Six patients underwent surgery at our hospital between April 2007 and December 2018 for recurrence of PLN metastasis after radical resection of CRC. At preoperative imaging, 2 patients had lymph node metastases cephalad to the renal vein. One of them had complete R0 resection; the other had biopsy only, because R0 resection was not possible. Complete resection was performed in all 4 patients who had enlarged PLNs only caudal to the renal vein, and the 4 survivors who were confirmed during the observation period are the 4 patients who had PLN metastases caudad to the renal vein.Conclusions: Surgical removal of PLN metastases in the aftermath of CRC resection may improve the prognosis in those patients with isolated metastases caudad to the renal vein.
Characterization, Machinability Studies and Multi-response Optimization of AA 6082 Hybrid Metal Matrix Composite
Authors: Ononiwu Ndudim Henry , Ozoegwu Chigbogu G. , Madushele Nkosinathi , Akinlabi Esther T.
Published: May 2021

This work investigated the effect of carbonized eggshell and fly ash on the microstructure, mechanical properties and machinability of AA 6082. The fabrication method selected for this study was stir casting. For the hybrid metal matrix composite, the weight fraction was 2.5wt% carbonized eggshell and 2.5wt% fly ash. The microstructural examination of the cast composite showed an even dispersal of the reinforcing phases in the aluminium matrix. Density analysis saw a 10.66% reduction of the cast composite in comparison to the aluminium alloy. Improvements of 12.32%, 21.91%, and 8.30% were recorded for the microhardness, tensile strength and compressive strength respectively. The wear studies of the cast samples revealed coefficients of friction (CoF) of 0.499 and 0.290 for the base metal and the AMC respectively. For the machinability studies, the surface roughness and flank tool wear were the responses under consideration. The design of experiments was conducted using the Taguchi method. The input parameters for this investigation was the cutting speeds (100 mm/min, 200 mm/min, 300 mm/min), feeds (0.1 mm/rev, 0.2 mm/rev, 0.3 mm/rev) and depths of cut (0.5 mm, 1.0 mm, 1.5 mm). For the multi-response optimization, Taguchi based grey relational analysis was used. The analysis of variance (ANOVA) of the grey relational grade (GRG) revealed that the feed was the most influential factor on the surface roughness and tool wear. The initial optimization showed the optimal cutting speed, feed and depth of cut as 200 mm/min, 0.2 mm/rev and 1.5 mm respectively. The confirmatory experiments revealed that the optimal combination of factors was 200mm/min, 0.2 mm/rev and 0.5 mm for the cutting speed, feed and depth of cut respectively.
Smac BV6 Has Proapoptotic and Anti-Inflammatory Effects on Rheumatoid Arthritis Fibroblast-Like Synoviocytes Activated by TLR9 Ligand
Authors: lattuada donatella , Casnici Claudia , Crotta Katia , marelli Ornella
Published: May 2021

Rheumatoid arthritis synovial fibroblasts (RASF) are one of the most important cells contributing reumathoid artritis (RA) pathogenesis. The critical role of the Toll-like receptor in inflammation and on autoimmune disease is not fully known. Data rising predominantly from human patients and animal models of autoimmune disease indicate that inappropriate triggering of TLR pathways by exogenous or endogenous ligands may cause the initiation and/or perpetuation of autoimmune reactions and tissue damage. Particularly, the role of TLR9 in RA is still a subject of debate and among TLRs, TLR9 is the only receptor which detects unmethylated CpG motifs in DNA (ODN), and is located intracellularly in endosomes and endoplasmic reticulum. RASFs stimulated by ODN are apoptosis-resistant and contribute to the pathogenesis of RA by producing cytokines and proteolytic enzymes, which degrade the extracellular matrix. Then, we evaluated the proapoptotic and anti-inflammatory activity of the smac BV6 on RASF cultured in synovial fluid (SF), to reproduce the physiopathological environmental characteristics of RA joints. Furthermore, BV6 induces a significant inhibition of the secretion of IL15, TNF alpha, IL6, stimulation of pannus formation, and damage of bone and cartilage in RA. Moreover the secretion of the anti-inflammatory cytokine IL10 and the cleavage of capase 3 and 8 are dramatically increased in the presence of BV6. Furthermore, TLR9 elicited a robust IFN induction and we reported that in RASF treated with ODN and BV6 the expression of IRF7 is enhanced. Our observations demonstrate that BV6 has beneficial regulatory effects on the inflammatory state induced by TLR9 activation.
Nonlinearity, Scaling Trends of Quasi-Ballistic Graphene Field Effect Transistors Targeting RF Applications
Authors: Munindra  , Nand Deva
Published: May 2021

Ballistic transport based graphene field effect transistor (GFET) is the emerging nanoelectronics device technology, which is promising to add a new dimension to electronic devices and to replace conventional silicon technology, especially for radio frequency applications. In this paper, the radio (GHz) frequency static linearity and nonlinearity performance potential are analyzed for the ballistic approach GFET under the ballistic transport regime. This work explores the static linearity of graphene FET mathematically under the quasi-ballistic transport regime along with the scaling outlook of the GFETs at four different channel lengths. The proposed model explores close mathematical expressions for Harmonic distortion, intermodulation distortion, and interception points and also depicted them in graphical form. The second and third order harmonics and intermodulation distortions are analyzed with help of mathematical analysis of drain current equation formulated using Mckelvey’s flux theory (MFT). The presented expressions are validated through a nonlinear output characteristic curve (Drain current versus drain voltage) at channel lengths of 140, 240, 300, and 1000 nm. The nonlinearity effect and its impact on the radio frequency electronic application of the quasi-ballistic and ballistic approach GFETs is one of the important prospects and is tabulated in Table 1 for more clarity with the particular models and respective frequencies.
Lipopolysaccharides Increase the Risk of Colorectal Cancer Recurrence and Metastasis Due to the Induction of Neutrophil Extracellular Traps After Curative Resection
Authors: Wang Wei-wei , Wu Lipei , Lu Wenying , Chen Wei , Yan Wenhui , Qi Chunrun , Xuan Shihai , Shang Anquan
Published: May 2021

Background: Intra-abdominal infection after curative surgery for colorectal cancer is a serious complication associated with an increased risk of recurrence. Lipopolysaccharides (LPS) – an essential component of the cell wall of Gram-negative bacteria – were found to exert a protumorigenic effect by stimulating the inflammatory pathology and formation of neutrophil extracellular traps (NETs). This study was conducted to test whether LPS-induced formation of NETs promotes the development of cancer and metastasis. Methods: The clinical characteristics, incidence of relapse, and serum myeloperoxidase–DNA complexes of 40 patients with infection and 40 patients without infection after curative surgery were analyzed. The effects of LPS on the induction of NETs were evaluated in a mouse model of colorectal cancer and liver metastasis. The toll-like receptor 9 (TLR9) – a DNA receptor – was knocked down to assess its effect on the mitogen-activated protein kinase pathway and activities implicated in the formation of NETs. Results: Analysis of the clinical data obtained from these patients showed the significant relation of the formation of NETs and incidence of metastasis and survival rates. Subsequent in-vitro experiments revealed an increased level of citrullinated-histone H3 and myeloperoxidase–DNA in LPS-injected mice with colorectal cancer. In the mimic metastatic model, injection of LPS enhanced the metastatic capacity, which was then attenuated by DNase I. This suggested that the formation of NETs was activated by LPS. Injection of TLR9-knockdown HCT116 cells in mice, followed by induction through LPS, mitigated the level of citrullinated-histone H3 and myeloperoxidase–DNA. This finding implied that the formation of NETs was suppressed. Conclusion: These findings shed light on the mechanism underlying the relationship between the elevated rate of colorectal cancer recurrence in patients who underwent surgery and the incidence of infection. This mechanism involves the protumorigenic activities of LPS-induced formation of NETs. The NETs which could be mediated by the TLR9 and the mitogen-activated protein kinase signaling pathway.
A Case Report of Rate Control With Ivabradine in a Patient With Refractory Atrial Tachycardia and Heart Failure
Authors: zhao lanting , he rong , liu yuanwei , she fei , xie ying , zhang ping
Published: May 2021

Background: Already known ivabradine’s effects in decreasing atrial spontaneous activity and in pulmonary veins, the focal atrial tachycardia, New information is that it is candidate for re-entrant atrial arrhythmias.Case presentation :An 85-year-old woman with a history of underlying ischemic cardiomyopathy complained of worsening heart failure symptoms due to rapid atrial tachycardia, which was resistant to several rate control drugs but responded well to ivabradine. An electrophysiology study demonstrated a roof dependent macro-reentrant tachycardia of the left atrium. Linear ablation at the left atrium roof resulted in termination of the tachycardia. Conclusion: Ivabradine can be used as an effective rate controll drug of reentrant atrial tachycardia.
Influence of Microbial Inoculant on Composting of Biodegradable Domestic Solid Wastes
Authors: Dang Hai Quang , Le Cuong Phuoc
Published: May 2021

This study investigated the effect of microbial inoculant (Emuniv) on composting of biodegradable domestic solid wastes for over 30 days. Three different types of treatments were used for the composting of source separated domestic solid waste. The results showed that the use of microbial inoculant in the composting of domestic solid wastes enhanced the biodegradation of composted organic material, which is evident from the considerable changes in temperature, moisture content and volume reduction with time. The compost treatments with Emuniv inoculant recorded higher temperature for the duration of composting phases, compared to treatment without Emuniv inoculant. Whereas, the moisture content and volume reduction of all treatments was showed a decreasing trend during the composting process. The larger reduction was seen in the treatments with Emuniv inoculant. Additionally, according to the results of analysis of variance (ANOVA), there was a statistically significant difference in temperature, moisture content and volume reduction between treatments. Moreover, the utilisation of microbial inoculant in composting was also can improve the quality of final compost product as reflected by the total nitrogen and available phosphorus contents in the compost product were higher than in the control.
Investigation of Difference Between the Three Representatives of the Functional Status According to Upper Limb Functions and Participation in Children with Congenital Hemiplegic Cerebral Palsy
Authors: Bingöl Hasan , Günel Mintaze Kerem , Sel Sinem asena
Published: May 2021

Background: Although there are many valid and reliable functional motor and communication functions classification tools to describe disabled children’s functional status in clinical or research environments; however, the actual difference among their levels based on actual performance remains to be determined.Aim: This study aimed to explore whether the three functional status representatives differentiate according to actual performance in everyday life in children with congenital hemiplegic cerebral palsy (CP).Method: High to moderate functional motor and communication performance levels as described by Manual Ability Classification System (MACS), Gross Motor Function Classification System, and Communication Function Classification System (CFCS) were investigated in the context of the scaled scores of upper limb functions and participation in different life situations on ABILHAND-Kids and Child and Adolescent Scale of Participation (CASP) questionnaires. The data were collected from 98 children with congenital hemiplegic CP from different rehabilitation centers (mean age 9,3 years [SD 3.0 years], [%95 CI:8.7-9.9]; 42 females, 56 males); 28,6% classified to level I, 29,6 % to level II, and 41,8 % to level III in MACS. Results: The study findings demonstrated that scaled scores of the upper limb functions and participation in different life situations clearly increased with the greater MACS, GMFCS, and CFCS level, except for CFCS levels closest to each other.Conclusion: MACS and GMFCS was strongest predictor of a child’s actual performance in daily life.
Hierarchical Extension H2/H∞ Control Methodology for Active Front Wheel Steering System of Emergency Rescue Vehicle
Authors: Xu Fei-xiang , Zhou Chen , Liu Xin-hui
Published: May 2021

Aiming at improving the handling stability of the emergency rescue vehicle (ERV), this paper proposes the hierarchical extension H2/H∞ control strategy into investigating the active front wheel steering (AFS) system of the ERV. Considering uncertainties and the vehicle handling stability, mixed H2/H∞ control method is presented to generate the additional front wheel angle through tracking desired vehicle yaw rate in the upper level. Furthermore, in order to enhance the H2/H∞ control effect, the novel extension control is proposed to change the H2/H∞ control signal dynamically according to different domains defined by the vehicle states. To track front wheel angle from the upper level, this study puts forward the fractional order proportional-integral-derivative (FOPID) controller based on the electro-hydraulic proportional control strategy. The simulations and hardware-in-the-loop experiments are performed to demonstrate the hierarchical control theory. The test results indicate that: (1) the lower level FOPID control method performs better than the PID control on the term of the transient and tracking ability; (2) the hierarchical extension H2/H∞ control strategy proposed ameliorate the vehicle cornering stability well, as well as can make the ERV have better handling stability than conventional H2/H∞ control.
Safety and efficacy of current sclera fixation methods for intraocular lenses
Authors: Muth Daniel Rudolf , Wolf Armin , Kreutzer Thomas C. , Shajari Mehdi , Vounotrypidis Efstathios , Priglinger Siegfried G. , Mayer Wolfgang J.
Published: May 2021

Purpose

Evaluation of currently three most-common intraocular lens (IOL) sclera fixation techniques (1) Prolene® suture with Hoffman sclera pocket (2) GoreTex® suture four-point technique (3) sutureless flanged intrascleral IOL fixation double-needle (“Yamane”) technique.
Study design

: Retrospective, clinical case series (chart review) conducted at the Department of Ophthalmology of the Ludwig-Maximilians-University, Munich, Germany.
Methods

Fifty-seven eyes of 53 patients were included. Best-corrected visual acuity (BCVA), manifest refraction (OR), corneal tomography, biometry, central macular thickness (CMT), intraocular pressure (IOP) were recorded and compared before and at least 20 days after IOL sclera fixation surgery.
Results

GoreTex® suture was done in 15, Prolene® in 20, Yamane technique in 22 eyes. The GoreTex® group showed 2, Prolene® 3, Yamane 1 eye that needed refixation due to visual impairment. Analysis between pre- and post-surgery revealed a statistically significant difference in the total BCVA (p = 0.002) and the Yamane subgroup BCVA (p = 0.047). There was no statistical difference between pre- and post-surgery IOP, CMT and CCT. No retinal complications were found. Surgery time with Yamane technique was about 1.5 times faster than GoreTex® and Prolene®. The surgery times of the subgroups differed statistical significantly. Regarding safety aspects of the three techniques no statistically significant difference pre- and post-surgery existed.
Conclusion

A visual rehabilitation to the status pre-surgery seems to be possible with a considerable amount of revision rates. All three analyzed techniques are a successful option in secondary IOL implantation in terms of efficacy and safety. The Yamane technique seems to be the least time-consuming surgical procedure.
Divergence in Accuracy of Diabetes Screening Methods in Tuberculosis Patients: A Cross-Sectional Study from Brazil and Peru
Authors: Carmo Thomas A. , Fernandes Catarina D. , Neto José F. Fróes , Araújo Davi Neri , Vinhaes Caian L. , Cubillos-Angulo Juan M. , Nogueira Betânia M. F. , Rocha Michael S. , Nascimento Vanessa , Calderon Roger I. , Lecca Leonid , Netto Eduardo M. , Andrade Bruno B. , Arriaga María B.
Published: May 2021

To evaluate the accuracy of distinct diabetes mellitus (DM) screening methods in persons with active Tuberculosis PWTB.Levels of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) at the time of tuberculosis diagnosis at the study clinics were assessed from two distinct retrospective cohorts of PWTB from Brazil (n=116) and Peru (n=136) to evaluate accuracy for detecting pre-DM and DM cases. Additionally, we investigated the association of clinical and sociodemographic factors with tuberculosis and pre-DM or DM in each country.When comparing PWTB from Brazil and Peru, Peruvian individuals presented higher FPG levels at baseline (median [IQR] 91 [81–106 vs 95 [88.4–102.1]]; p=0.02), while those from Brazil had significant higher levels of HbA1c (median [IQR] 6.3 [5.7-7.15] vs 5.1 [4.9-5.4]; p<0.01). Additional analysis using the receiver operating characteristic curve revealed that the markers showed distinct accuracy to identify dysglycemia among PWTB in each country. Our findings indicate that there are significant differences in the total accuracy of the glycemic screening methods evaluated between PWTB from two highly endemic countries from South America, highlighting the need to revisit the diagnostic criteria of DM/PDM in individuals with tuberculosis.
Symmetric and Asymmetric Nexus between Institutional Quality and Sectorial Foreign Direct Investment Inflow in India: A Fresh Insight Using Simulated Dynamic ARDL Approach
Authors: Rehman Faheem Ur , Sohag Kazi , Ahmad Ejaz
Published: May 2021

This study investigates the bidirectional causal relationship between institutional quality and aggregated and disaggregated (primary, secondary and services sector) FDI inflow in India by employing new simulated autoregressive distributed lag (SARDL) dynamic techniques, which is an extended version of NARDL and ARDL. The empirical results supports that institutional quality strongly attract aggregated and disaggregated FDI and reversely FDI enhance the quality of institutions. The nexus between FDI inflow and institutional quality is good news for India to enhance the institutional quality and catch-up on advanced economies. The empirical findings detect cointegration and bidirectional causal-relationship between aggregated FDI and institutional quality.
Structure of Corrosion Layers on Archaeological Iron Artifacts From Nanhai I
Authors: Jia Minghao , Hu Pei , Gong Zisang , Xue Yadong , Hou Yufan , Sun Jian , Cui Yong , Hu Dongbo , Hu Gang
Published: May 2021

Thousands of archaeological irons were excavated from the Nanhai I ship of the Southern Song Dynasty sunk in South China Sea, most of which were severely corroded and fragmented. To understand the current corrosion state and guide the restoration and protection, one piece of these iron objects was selected for analysis. Using optical microscope, scanning electron microscope, micro-laser Raman spectroscopy, infrared spectroscopy, and X-ray diffraction, it was clear that the archaeological iron was hypereutectic white iron with carbon content of about 4.3-6.69% and had experienced low melt undercooling. There were many internal cracks formed by general corrosion extending to the iron core which was a tendency of instability. At the interface between the iron and rust, there was a black dense layer enriched with chlorine and a loose outer layer in yellow. The dense layer was mainly composed of magnetite, akaganeite and maghemite, while the rust of the loose layer was about lepidocrocite, goethite, feroxyhite, maghemite and hematite. Besides, the major phases of all corrosion products were akaganeite and lepidocrocite. Numerous holes and cracks in the rust layer had no barrier ability to the outside electrolyte, so that the iron core formed many redox electrochemical sites to be general corrosion with the rust. Meanwhile, the dense rust close to the iron core was broken locally by enriched chlorine layer, which was extremely detrimental to the stability of the archaeological iron. By electrochemical impedance spectroscopy, it could be determined that the rust layers had no protective effect on the internal iron core indeed under the condition of simulating seawater, even accelerating corrosion. The mechanism of the rust growth was proposed from the shipwreck sinking to the laboratory testing to explain the entire corrosion process. Based on the concept of authenticity on the preservation, the archaeological rusted iron of the Nanhai I ship excavated from marine environment should be properly dechlorinated and necessarily stabilized, such as corrosion inhibition and reinforcement, for the rust structure and the internal iron core well-retained together.
The Effect of Joint Number and Joint Angle on The Failure Mechanism of Mine Pillar
Authors: sarfarazi vahab , javid hossein karimi , asgari kaveh
Published: May 2021

Experimental and discrete element methods were used to investigate the effects of joints number and joint angle on the failure behaviour of rock pillars under uniaxial compressive test. Gypsum samples with dimension of 200 mm×200 mm×50 mm were prepared. The compressive strength of model material was Within the specimen, imbeded joint were provided. The joint lengthn was 6 cm. in constant joint length, the number of joints were one, two and three. In experimental test, the angle of diagonal plane related to horizontal axis were 0, 30, 60 and 90 degree. In numerical test, the angle of diagonal plane related to horizontal axis were 0, 15, 30, 45, 60, 75 and 90 degree. The axial load rate on the model was 0.05 mm/min. the results showed that the failure process was mostly governed by both of the non-persistent joint angle and joint nubmer. The compressive strengths of the specimens were related to the fracture pattern and failure mechanism of the discontinuities. Furthermore it was shown that the shear behaviour of discontinuities is related to the number of the induced tensile cracks which are increased by increasing the joint angle. The strength of samples increases by increasing both of the joint angle and joint number. Finally, the failure pattern and failure strength are similar in both methods i.e. the experimental testing and the numerical simulation methods.
Prevalence of Refractive Errors and Accuracy of School-Based Visual Acuity Screening Programs Among School Children In Vietnam
Authors: Anh Vu Tuan , D'Esposito Fabrizio , Xuan Le Thi Thanh , Van Pham Trong , Nga Tran Thi Hoang
Published: May 2021

Background

School-based visual acuity screening programs can help identify students with possible visual impairments, inform their parents of their status and the need for further examination and other conditions to assist students with visual impairments.
Objectives

This study aimed to calculate the prevalence of refractive errors among students and to describe the accuracy of visual acuity screening practices of school staff in some selected provinces in Viet Nam.
Methods

Visual acuity assessments were conducted by trained teachers and nurses at all schools participating in the survey, covering a sample size of 4,838 students. Around 30% of these students were then randomly selected for a close-up examination by ophthalmologists, making up a sub-sample of 1,404 students. The number of cases of low vision based on a set of criteria. The accuracy of visual acuity screening activities by comparing school staff’s and ophthalmologists’ results.
Results

The proportion of students with untreated eye problems and that of students with uncorrected refractive error are currently quite high (at respectively 18.52% and 24.64%), especially in urban areas in Da Nang and Hai Duong provinces. Among every three children with refractive errors (RE), two of them have not received appropriate correction. The accuracy of the visual acuity screenings performed by teachers and school nurses in the project’s target area is demonstrated by a sensitivity of 60.92% and a specificity of 93.76%.
Conclusions

This indicates that efforts toward detecting school students with poor vision at school needs further investments to mitigate the current problems. This outcome suggests that teachers and school nurses need to be trained and equipped further with better skills and knowledge in conducting screening to improve their screening performance.
Implementation of Dialectical Behavioral Therapy for Adolescents (DBT-A) Skills Group in High Schools for At-Risk Youth: Going 4 Goals Protocol
Authors: Zapolski Tamika , Whitener MacKenzie , Khazvand Shirin , Crichlow Queenisha , Revilla Rebecca , Salgado Eduardo , Aaslma Matthew C. , Cyders Melissa A. , Salyers Michelle , Wu Wei
Published: May 2021

Adolescence is a developmental period marked by engaging in risk-taking behaviors, with higher risk among youth who are impulsive or emotionally dysregulated. Thus, interventions that teach skills to reduce the risk for negative outcomes as a consequence of dysregulation are needed. Social and Emotional Learning (SEL) programs have been developed to address both adolescent emotion dysregulation and risk-taking behaviors. However, current programs have mostly been implemented among younger youth and have rarely been empirically evaluated for their effectiveness among high school students. This current study outlines the implementation of a SEL intervention titled “Going 4 Goals,” which is a 9 session adaptation of the Dialectical Behavioral Therapy for Adolescents (DBT-A) program for schools delivered to at-risk high school students in a school setting. The primary outcomes of the study are to test whether participating in the skills group intervention produces significant increases in the core DBT-A skills of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness while also producing significant decreases in substance use and risky behaviors. These primary outcomes are based on changes in participant scores between baseline and post-intervention, as well as follow-ups at 1, 3, and 6 months in comparison to a control group of youth who are participating in the school’s health curriculum at the same time points. A secondary objective of this study is to also examine the acceptability, facilitators and barriers of the intervention through qualitative interviews with intervention participants and school staff. The current paper describes the protocol of the 9 session school-based adaptation of the DBT-A intervention and discussion of the strengths and limitations of the study, as well as future directions.
Rasch Analysis of The Brain Injury Screening Tool (BIST) in Mild Traumatic Brain Injury
Authors: Shaikh Nusratnaaz , Theadom Alice , Siegert Richard , Hardaker Natalie , King Doug , Hume Patria
Published: May 2021

Objective

To evaluate the psychometric properties of the Brain Injury Screening Tool (BIST) symptom scale in a sample of people with a mild Traumatic Brain Injury (mTBI) through Rasch analysis, and to obtain an interval level measurement score for potential clinical use.
Materials and Methods

Data were obtained from 114 adults aged over 16 years, who had experienced at least one mTBI in the past 10 years. Participants were recruited via social media, concussion clinics and sports organisations over a 4-month period between May and September 2020. Participants were asked to compete the symptom scale of the BIST tool via an anonymous online questionnaire. Internal construct validity, dimensionality, person separation index, and differential item functioning of the BIST were examined with Rasch analysis.
Results

BIST in its original form produced a satisfactory item-trait interaction, and good reliability, but was found to be multi-dimensional. Rasch analysis of the full scale with three domains as subtests resulted in acceptable model fit (χ2(6) = 3.8, p > 0.05), with good reliability (Person Separation Index = 0.84), and uni-dimensionality. Differential Item Functioning (DIF) analysis displayed no significant DIF effects for sex or age revealing that people responded consistently and similarly to the individual BIST items based on severity of symptom burden.
Conclusions

The 15-item symptom scale of the BIST tool is a psychometrically sound measure of symptom burden following mTBI. The findings provide support for use of both total and sub scale scores for clinical use. Ordinal to interval score conversions are recommended for use when using the scores for research purposes in mTBI.
Diagnostic and prognostic value of presepsin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study using Sepsis-3
Authors: Lee Sukyo , Song Juhyun , Park Dae Won , Seok Hyeri , Cha Jae-hyung , Ahn Sejoong , Kim Jooyeong , Park Jonghak , Cho Han-jin
Published: May 2021

We investigated the diagnostic and prognostic value of presepsin among patients with organ failure in the emergency department. This prospective observational study included 420 patients divided into three groups: non-infectious organ failure (n = 142), sepsis (n = 141), and septic shock (n = 137). Optimal cut-off values of presepsin to discriminate between the three groups were evaluated using receiver operating characteristic curve analysis. We extracted the optimal cut-off value of presepsin to predict mortality associated with sepsis and septic shock and performed Kaplan–Meier survival curve analysis according to the cut-off value. Presepsin levels were significantly higher in sepsis than in non-infectious organ failure (p < 0.001) and significantly higher in septic shock than in sepsis (p = 0.002). The optimal cut-off value for presepsin to discriminate between sepsis and non-infectious organ failure was 582 pg/mL (p < 0.001) and to discriminate between sepsis and septic shock was 1285 pg/mL (p < 0.001). The optimal cut-off value for presepsin for predicting 30-day mortality was 821 pg/mL (p = 0.005) in septic patients. Patients with higher presepsin levels (≥ 821 pg/mL) had significantly higher mortality rates than patients with lower presepsin levels (< 821 pg/mL) (log-rank test; p = 0.004). Presepsin levels could effectively differentiate sepsis from non-infectious organ failure and help clinicians identify sepsis patients with poor prognosis.
Does economic development widen or narrow the gap of public health service utilization among different subgroups of internal migrants? Evidence from the China Migrant Dynamic Survey in 2017
Authors: Yang Zhen , Jiang Chenghua
Published: May 2021

Background

China is promoting the equalization of National Essential Public Health Services (NEPHS) for the internal migrants (IMs). Studies have analyzed the impact of migration range (MR) and regional economic development level (REDL) on the IMs' NEPHS utilization (NEPHSU), but no studies have explored the interaction of MR and REDL on it.
Methods

Data from the China Migrant Dynamic Survey of 2017, involving 122656 IMs. Per capita GDP was set as the indicator for REDL, and 28 provinces were divided into three groups according to REDL: affluent, medium and poor. The MR was divided into inter-province and intra-province, and social capital (SC) was distinguished into cognitive (CSC) and structural social capital (SSC). Awareness of NEPHS (ANEPHS) and establishment of health record (EHR) were selected as indexes of NEPHSU. Multiple line charts and hierarchical logistic regression were used to investigate the interaction of MR, REDL and SC on NEPHSU.
Results

(1) The socioeconomic status (SES) and social capital (SC) of inter-provincial IMs were significantly lower than those of intra-provincial IMs, and the gap was most prominent in affluent areas. (2) From low to high, the NEPHSU of inter-provincial IMs was ranked as affluent, medium and poor, while the corresponding order of intra-provincial IMs was medium, poor and affluent areas, and the gap of NEPHSU between inter-provincial and intra-provincial IMs was the largest in affluent areas. (3) SC could significantly promote the IMs' NEPHSU, but there was a gap between inter-provincial and intra-provincial IMs, and the gap was the largest in affluent areas.
Conclution:

REDL can significantly affect the gaps of SES and SC among subgroups of IMs with different MR. Inter-provincial migrants in affluent areas have relatively lower SES and SC, which may be a major barrier to their access to NEPHS, and the government should pay special attention to this vulnerable group when promoting equalization of NEPHS for IMs.
Thromboembolic Events Burden in Patients With Solid Tumors and Their Predisposing Factors: A Cross-Sectional Study
Authors: Bazarbashi Shouki , Alkhaldi Turkiah , Melaibari Maryam , Almuhisen Sara , Al-Harbi Samar , Aljumaa Jihad , Eldali Abdelmoneim , Maraiki Fatma , Aseafan Mohamed , Owaidah Tarek , Alzahrani Hazzaa
Published: May 2021

Background: The relationship between cancers and thromboembolic events is well established. In our study we aim to determine the burden of thromboembolic events in patients with solid tumors and identify the risk factors related to their development.Methods: Data on patients with solid tumors and thromboembolism between January 2013 and September 2014 were collected and analyzed. Results: During the studied period 174 patients were identified, 172 (98.9%) of which had venous thrombus embolism. 137 (79%) were diagnosed with deep vein thromboses and 67 (38.5%) with pulmonary embolisms. 84 (48.3%) were symptomatic and 90 (51.7) were incidental at diagnosis. The most common risk factors were female sex, high Body mass index, metastatic stage, colorectal and breast primaries, and anti-neoplastic therapy.Conclusion: Our study confirmed the high burden of thromboembolic events in cancer patients and the relevant risk factors associated with its development.
Urinary Concentrations of Neonicotinoid Insecticides and Tubular Biomarkers, and Clinical Symptoms in Chronic Kidney Disease Patients, Their Family Members and Others in Dry-zone of Sri Lanka: a Small Scale Field-based Case-Control Study
Authors: Taira Kumiko , Kawakami Tomonori , Weragoda Sujithra Kaushaliya , Herath H.M.Ayala S. , Ikenaka Yoshinori , Fujioka Kazutoshi , Hamachandra Madhubhani , Pallewatta Nirmalie , Aoyama Yoshiko , Ishizuka Mayumi , Bonmatin Jean-Marc , Komori Makiko
Published: May 2021

Background: The growing worldwide prevalence of chronic kidney disease of unknown etiology (CKDu) has been reported since the 1990’s. Neonicotinoids are systemic insecticides started to use in 1990’s with nicotinic acetylcholine receptor competitive modulator action, which may cause renal dysfunction as well as neurological symptoms.Methods: We conducted a field-based case-control study in the North Central Dry-zone of Sri Lanka where CKDu was prevailing. We collected spot urine samples of 92 residents, including 15 CKD patients, 15 CKD family members, and 62 neighbors in May or in December 2015, and analyzed seven neonicotinoids and a metabolite by LC-ESI/MS/MS, in addition to two biomarkers of renal tubule activity, Cystatin-C and L-FABP. The symptoms they complained of were also investigated by interview.Results: Urine was almost acidic and significant correlation was found in urinary concentration of Cystatin-C and L-FABP (r=0.71, p<0.001). In CKD patients in compare to non-CKD participants, urine Cystatin-C and L-FABP were significantly higher (p=0.0013, p<0.001, respectively) and more symptoms complained, e.g. finger tremor, fever, and abnormal behavior, as well as high urine volume, appetite loss, and reduced body weight. The detection rates of neonicotinoids were highest in N-desmethyl-acetamiprid 92.4 %, following dinotefuran 17.4 %, thiamethoxam 17.4 %, clothianidin 9.8%, thiacloprid 3.3%, imidacloprid 2.2%, nitenpyram and acetamiprid 0%. Dinotefuran and thiacloprid had not registered in 2015 in Sri Lanka. Between the concentration of urine Cystatin-C and N-desmethyl-acetamiprid, weak negative correlation was observed (r=-0.19, p=0.077)Conclusions: In CKD patients in the area, high urine Cystatin-C/L-FABP and more neurological symptoms were observed. Neonicotinoids exposure of people living in CKDu-epidemic area in Sri Lanka was common. Further investigation is needed to elucidate that occupational neonicotinoid exposure is one of the causes of CKDu and some neurological symptoms, e.g. appropriate timing of urine sampling.
ACURATE neo™ Aortic Valve implantation via carotid artery access: First case report
Authors: Aludaat Chadi , Canville Alexandre , Landolff Quentin , Godin Matthieu , Bauer Fabrice , Doguet Fabien
Published: May 2021

Background The ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) is predominantly implanted via femoral access. Implantation via the common carotid artery as an alternative arterial access has never been described.Case presentation We present the case of an 89-year-old woman referred to us for a transcatheter aortic valve replacement (TAVR). After apparatus imaging of the aortic annulus and the peripheral vascular pathway, the heart team was confronted with a triple challenge: (i) The preferable choice of a self-expanding valve because of a small aortic annulus in an obese woman. (ii) Gaining favorable access to the coronary ostia, considering multiple recent coronary stenting. (iii) Utilizing an alternative arterial access because of staggered iliac and femoral stenosis. Implanting the ACURATE neo™ transcatheter heart valve via carotidal access allowed us to overcome these challenges. The procedure was performed successfully without any short-term complications.Conclusion We report the first case of implantation of an ACURATE neo™ transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) via the right common carotid artery.
Water Droplet Can Mitigate Dust from Hydrophobized Micro-Post Array Surfaces
Authors: Abubakar Abba , Yilbas Bekir , Al-Qahtani Hussain , Hassan Ghassan , Adukwu Johnny Adukwu
Published: May 2021

Water droplet rolling motion over the hydrophobized and optically transparent micro-post array surfaces is examined towards dust removal pertinent to self-cleaning applications. Micro-post arrays are replicated over the optically transparent polydimethylsiloxane (PDMS) surfaces. The influence of micro-post array spacing on droplet rolling dynamics is explored for clean and dusty surfaces. The droplet motions over clean and dusty micro-post array surfaces are monitored and quantified. Flow inside the rolling droplet is simulated adopting the experimental conditions. Findings reveal that micro-post gap spacing significantly influences droplet velocity on clean and dusty hydrophobized surfaces. Air trapped within the micro-post gaps acts like a cushion reducing the three-phase contact line and interfacial contact area of the rolling droplet. This gives rise to increased droplet velocity over the micro-post array surface. Droplet kinetic energy dissipation remains large for plain and micro-post arrays with small gap spacings. A Rolling droplet can pick up dust particles from micro-post array gaps; however, few dust residues are observed for large gap spacings. Nevertheless, dust residues are small in quantity over hydrophobized micro-post array surfaces.
Low Awareness of Oral and Injectable PrEP Among High-risk Adolescent Girls and Young Women in Kampala, Uganda
Authors: LUNKUSE JANE FRANCES , Kamacooko Onesmus , Muturi-Kioi Vincent , Chinyenze Kundai , Kuteesa Monica O , Price Matt A , Mayanja Yunia
Published: May 2021

Background: Adolescent girls and young women (AGYW) account for a disproportionate number of new HIV infections worldwide, including Uganda. Although pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention method, awareness of PrEP among AGYW in Uganda has not been studied systematically. We aimed to assess awareness of PrEP and factors associated with awareness of PrEP among AGYW.Methods: We conducted a cross-sectional study among 14-24-year old AGYW at high risk of HIV infection in Kampala, Uganda from January to October 2019. Data on socio-demographics, behavioral and sexual risks were collected by interview. Awareness of oral or injectable PrEP, the latter of which is currently in late-stage trials, was defined as whether an individual had heard about PrEP as an HIV prevention method. Multivariable robust poisson regression model was used to assess factors associated with oral PrEP awareness.Results: We enrolled 285 participants of whom 39.3% were under 20 years old, 54.7% had completed secondary education, 68.8% had multiple sex partners in the past 3 months, 8.8% were screened as high risk drinkers/ alcohol dependent (AUDIT tool) and 21.0% reported sex work as main occupation. Only 23.2% were aware of oral PrEP and 3.9% had heard about injectable PrEP. The prevalence of oral PrEP awareness was significantly higher among volunteers screened as alcohol dependents (aPR 1.89, 95% CI 1.08-3.29) and those with multiple sexual partners (aPR 1.84, 95% CI 1.01-3.35), but was lower among those who reported consistent condom use with recent sexual partners (aPR 0.58, 95% CI 0.37-0.91). Conclusions: Majority of AGYW were not aware of any kind of PrEP. Those with higher risk behavior, i.e. alcohol dependents or multiple sexual partners, were more aware of oral PrEP. Interventions to increase awareness among female youth are needed. Improving PrEP awareness is critical to increasing PrEP uptake among high-risk AGYW in Uganda.