bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia
Authors: Rahmati Javad , Shahriari Mohammadali , Shahriari Ali , Nataj Masoomeh , Shabani Zeinab , Moodi Vihan
Published: April 2021

Objectives: This study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia. Methods: A total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared. Results: There were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001). Conclusions: According to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.
COVID-19 Related Acro-Ischemic Neuropathic-like Painful Lesions in Pediatric Patients: A Case Seriese
Authors: Papa Alfonso , Salzano Anna Maria , Di Dato Maria Teresa , Lo Bianco Giuliano , Tedesco Mariangela , Salzano Antonio , Myrcik Dariusz , Imani Farnad , Varrassi Giustino , Akhavan Akbari Ghodrat , Paladini Antonella
Published: April 2021

Background: A variety of skin manifestations have been associated with COVID-19 infection. Acral lesions on hands and feet, closely resembling chilblains, have been reported in association with COVID-19, which are nonspecific. These acro-ischemic painful lesions have been described mainly in asymptomatic and mildly symptomatic pediatric COVID-19 positive patients, without a precise pathogenetic mechanism.COVID-19-induced chilblains may portend an indolent course and a good outcome. In young patients, the IFN-1 response induces microangiopathic changes and produces a chilblain lupus erythematosus-like eruption with vasculitic neuropathic pain features. Objectives: This paper presented a case series of pediatric patients with COVID-19-related skin lesions and neuropathic-like pain. Methods: Clinical outcomes were collected from 11 patients diagnosed with painful erythematous skin lesions with neuropathic-like pain and positive IgG for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: It is a mildly symptomatic condition not related to severe pain rates, and it is treated with paracetamol due to the transitory nature of the problem, which provides good results. Conclusions: A particular point of interest is skin lesion manifestation as a further indirect sign of SARS-CoV-2 infection. Due to the initial manifestation of chilblains in pauci-symptomatic pediatric patients, they need to be immediately tested and isolated. Chilblains can be considered a clinical clue to suspect SARS-CoV-2 infection and help in early diagnosis, patient triage, and infection control.
The Effect of Pre-TURP Bladder Irrigation with 0.2% Chlorhexidine in Patients with Foley Catheter Regarding Postoperative Bacteremia Decrease
Authors: Khorrami Mohammad Hatef , Jahangiri Seyed Hamed , Alizadeh Farshid , Khorrami Farbod , Izadpanahi Mohammad Hossein , Tadayon Farhad , Mohammadi Sichani Mehrdad , Zargham Mahtab , Meidani Mohsen , Shokri Darioush
Published: April 2021

Background: Transurethral resection of the prostate (TURP) has been widely used for patients suffering from bladder colonization with bacteria, increasing the probability of bacteremia and sepsis despite consuming prophylaxis antibiotics. Objectives: The study aimed to evaluate the effect of pre- TURP bladder irrigation with 0.2% chlorhexidine in reducing postoperative bacteremia. Methods: This clinical trial study was conducted on 60 benign prostatic hyperplasia (BPH) patients who were candidates for TURP in the urology department of Al-Zahra Hospital. All patients suffered from urinary catheters, and they were allocated into two groups (n = 30). Antibiotic prophylaxis was prescribed for all the patients. In the case group, the bladder was rinsed by chlorhexidine 0.2% before TURP; however, and the bladder in the control group was rinsed by distilled water. Postoperative bacteremia were evaluated using procalcitonin (PCT) measurement and BACTEC automated blood culture six hours after surgery. Results: Positive BACTEC blood culture was observed in three (10%) and no (0%) patients in the control and case groups, respectively (P = 0.071). Moreover, 6.6 % and 46.6 % of the patients in the control group had low and high PCT levels, respectively. Furthermore, 40 % and 6.66 % of the patients in the case group had low and high PCT levels, respectively. There was a significant difference between the two groups in terms of the PCT level (P < 0.01). Conclusions: The frequency of patients with a high PCT level was higher in the control group than in the case group, suggesting that chlorhexidine in the catheterized patients undergoing TURP reduced the number of bacteria in the bladder.
Frequency of Nasal Carriage of Staphylococcus aureus Among Healthcare Workers (HCWs) and Patients in Bandar Abbas, Southern Iran
Authors: Amirizadeh Motahare , Rahimi Ali , Ansari Maryam , AtashAbParvar Ali , Hamadiyan Hosein , Farahani Abbas , Shoja Saeed
Published: April 2021

Background: Staphylococcus aureus is a problematic infectious agent in hospitals as well as in the community. Nasal carriage of healthcare workers (HCWs) and sometimes patients are an important source for transmitting this bacterium to vulnerable individuals. Objectives: The present study aimed to investigate the frequency of nasal carriage of S. aureus and the antimicrobial susceptibility pattern of this organism isolated from HCWs and patients at Shahid Mohammadi Hospital in Bandar Abbas, South of Iran. Methods: This cross-sectional study was conducted from November 2017 to December 2018. A total of 400 nasal swabs were taken from HCWs and patients to investigate the presence of S. aureus. An antimicrobial susceptibility pattern was carried out using the disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Methicillin resistance was determined using cefoxitin disc diffusion and PCR for mecA gene. Agar dilution was performed to determine MIC of vancomycin and mupirocin. Results: Of 130 HCWs, 11 (8.5%) subjects were nasal carriers, of which 5 (45.5%) harbored methicillin-resistant Staphylococcus aureus (MRSA). Of 270 patients, 21 (7.8%) patients were nasal carriers, of whom 9 (42.9%) patients were MRSA carriers. Linezolid and vancomycin were the most effective agents, and 100% of isolates were susceptible to these agents. Furthermore, high-level mupirocin-resistant S. aureus (HLMuRSA) was observed in 6.3% of the isolates. Conclusions: Our findings demonstrate that the rate of nasal carriage among HCWs and patients was lower than global reports. However, the frequency of MRSA was comparable with previously reported ranges and was approximately high. Vancomycin and linezolid are the most effective antimicrobial agents. Appropriate decolonization is recommended for the control of transmission of MRSA to vulnerable individuals.
The Effect of Acceptance and Commitment Therapy on Psychological Flexibility and Emotional Regulation in Patients with Spinal Cord Injuries: A Randomized Controlled Trial
Authors: Khanjani Mohammad Saeed , Kazemi Javad , Younesi Jalal , Dadkhah Asghar , Biglarian Akbar , Ebrahimi Barmi Banafsheh
Published: April 2021

Background: Patients with spinal cord injuries suffer from some psychological problems, such as inadequate emotional regulation and flexibility for adapting to the post-injury condition. In this regard, acceptance and commitment therapy (ACT) can improve psychological flexibility and emotional regulation. Objectives: The main goal of this study was to analyze the effectiveness of ACT in improving psychological flexibility and emotional regulation in patients with spinal cord injuries. Methods: This quasi-experimental design study was based on a pretest-posttest method with a control group. The study population consisted of all patients with spinal cord injury referred to Jalaeipour Rehabilitation Center in Tehran. The study sample included 30 patients with spinal cord injury selected by the purposive sampling method. The inclusion criteria were patients aged 20 to 55 years, residing in Tehran, and with at least a high school diploma. The injury duration varied between one and five years, and the injuries were thoracic and lumbar injuries and an intermediate score of psychological flexibility and emotion regulation. The exclusion criteria were patients with cervical spinal cord injuries, as well as patients who were simultaneously receiving another psychological treatment together with the subjects who suffered from brain damage. Patients were randomly assigned to the experimental and control groups based on random numbers. There were 15 patients in each group. The intervention group received ACT during eight sessions (1.5-hour group therapy) held once a week at Jalaeipour Rehabilitation Center in Tehran (2018), while the control group received routine care. Dennis and Vander Wal’s cognitive flexibility inventory (CFI) and Gross and John’s emotion regulation questionnaire (ERQ) were completed before and one week after the intervention. The data were analyzed using multivariate analysis of covariance (MANCOVA). Results: There was a significant difference in demographic indicators between the two groups. Based on MANCOVA with the baseline score, the mean scores of psychological flexibility and emotion regulation had a significant difference regarding the results of ACT between the experimental and control groups (P < 0.05). Conclusions: According to the findings, ACT can improve psychological flexibility and emotional regulation in patients with spinal cord injuries.
A Systematic Review and Meta-analysis of the Role of Toll-like Receptor 9 in Alzheimer's Disease: The Protocol for a Systematic Review
Authors: Hosseini Nasrin , Nadjafi Shabnam , Janani Leila , Faraji Zahra , Ashtari Behnaz , Jameie Seyed Behnamedin , Farhadi Mona , Okhovat Isfahani Batool
Published: April 2021

Context: Alzheimer’s disease (AD) is a neurodegenerative disease affecting many people around the world. Recently, it has been reported that toll-like receptors (TLRs) play a role in AD; therefore, the present study aimed to systematically review the studies and to meta-analyze the role of toll-like receptor 9 (TLR9) in AD. Methods: Seven main electronic databases, including PubMed/MEDLINE, Web of Science, Embase, Scopus, CINAHL, Cochrane, and Google Scholar, will be considered with no language restrictions. Full texts of articles will be prepared by a determined search strategy. Studies including the assessment of TLR9 function in adults with AD, published before June 15 2020, will be considered. Hence, this protocol will be presented based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statements for protocols. The related results and data analyses will be provided in the final review. This paper plans the protocol for a systematic review identifying TLR9 up-regulation and down-regulation in adults with AD. Conclusions: The meta-analysis of TLR9 may subsequently provide attractive therapeutic tools for AD.
Populist Improvisation
Authors: Macwan Sunil ,   Marquette University Press
Published: April 2021

Successfully creating polarizing narratives, several populist leaders have come to dominate the global political sphere in recent times. However, the coronavirus pandemic has raised serious questions over their ability to respond to its challenges effectively. Whether they will remain in power after the pandemic is an intriguing question. The key to understanding the dynamics of power among populist leaders lies in analyzing the tactics they employ for the appropriation of political power. In this context, reading Christopher Marlowe’s Tamburlaine the Great (1587) can play an important role. This essay, therefore, argues that through a unique characterization of Tamburlaine the Great, Marlowe critiques Queen Elizabeth’s aggressive political maneuvers of improvisation, which enabled her to reinforce her divine claim over the throne of England. Yet striking historical and literary references suggest that Queen Elizabeth and Marlowe’s Tamburlaine attempted to achieve improvisation through similar means but in the end encountered the transience and limits of their temporal powers, while facing the biological realities of barrenness and heredity – a fact that should serve as a warning to the current populist leaders across the world.
The Knower, the Sayer, and the Doer in Norman Maclean’s A River Runs Through It
Authors: Mayo James ,   Marquette University Press
Published: April 2021

This essay addresses the connections between Emersonian and Wordsworthian concepts and Norman Maclean’s novella A River Runs through It, specifically those ideas of the Knower, the Sayer, and the Doer from Emerson’s “The Poet,” Emerson’s concept of what constitutes poetry and “The Poet,” as well as Wordsworth’s notions of poetic creativity. As discussed in the essay, Emerson’s concepts of the Knower, the Sayer, and the Doer line up with the three central characters of the novella—The Reverend Maclean, Norman Maclean (both the author and the narrator), and Paul Maclean respectively. It is the unique blending of Romantic poetic leanings and religion that make all three the characters they are, which the author represents through the use of fishing as metaphor. The difficulties faced by the Sayer, as he tries to relate the story of past events and “spots in time,” are central to my argument, as they present the central conflict of the novel and offer the readers a contradiction as well, as the character who’s known as the Sayer should have no trouble expressing himself. However, it is with Wordsworth’s notion of ideas reflected on in tranquility that allow the Sayer to tell the story of his brother, the great poet/artist in a Romantic sense.
The Real-Life Issue of Prepunishment
Authors: Greene Preston ,   Department of Philosophy, Florida State University
Published: April 2021

When someone is prepunished, they are punished for a predicted crime they will or would commit. I argue that cases of prepunishment universally assumed to be merely hypothetical—including those in Philip K. Dick’s “The Minority Report”—are equivalent to some instances of the real-life punishment of attempt offenses. This conclusion puts pressure in two directions. If prepunishment is morally impermissible, as philosophers argue, then this calls for amendments to criminal justice theory and practice. At the same time, if prepunishment is not imaginary, then the philosophers who reject it cannot claim that their view is supported by common sense.
A Two-Part Defense of Intuitionistic Mathematics
Authors: Elliott Samuel R. ,   Ball State University
Published: April 2021

The classical interpretation of mathematical statements can be seen as comprising two separate but related aspects: a domain and a truth-schema. L. E. J. Brouwer’s intuitionistic project lays the groundwork for an alternative conception of the objects in this domain, as well as an accompanying intuitionistic truth-schema. Drawing on the work of Arend Heyting and Michael Dummett, I present two objections to classical mathematical semantics, with the aim of creating an opening for an alternative interpretation. With this accomplished, I then make the case for intuitionism as a suitable candidate to fill this void.
Full-Blooded Conceptual Realism as a Response to Skeptical Relativism
Authors: Phillips-Gary Micah ,   Ball State University
Published: April 2021

In this paper, I discuss full-blooded Platonism (the claim that all possible mathematical objects exist) as a response to the skeptical problem in the philosophy of mathematics as to how empirical beings can cognize non-empirical mathematical objects. I then attempt to develop an analogous position regarding the applicability of concepts to reality in response to the skeptical problem regarding how we can cognize an objective reality through human-constructed concepts. If all concepts meeting certain minimal conditions structure reality under some aspect, then objective knowledge is possible, regardless of how these concepts arose historically.
Being Moral Isn’t Quite Enough
Authors: Hanlim Seyeong ,   Ball State University
Published: April 2021

Attempts to define morality or stress its importance are the center of ethical debates that aim to provide guidance for human life. Deviating from this goal, Susan Wolf shines a light on the significance of “nonmoral virtues” by discussing how a moral saint’s life, too immersed in morality, could be lacking in other spheres. She states that a moral saint’s life would be unattractive or dull, as one is not able to value or pursue nonmoral activities such as the arts or cooking due to one’s commitments under moral sainthood. I challenge this argument, which belittles moral sainthood in an attempt to give more credit to nonmoral qualities in life, by arguing that nonmoral virtues could be necessary and valuable for a moral saint in carrying out her duties.
Hegel’s Projected Nihilism
Authors: Curnow Ryan ,   Ball State University
Published: April 2021

Georg Wilhelm Friedrich Hegel’s historical analysis of Buddhist philosophy not only fails as a sound interpretation of that tradition, it also well-exemplifies the Western practice of Orientalism as elucidated by Edward Said. I attempt to demonstrate this in three major parts: the nature of Orientalism as a concept and practice, the Orientalist analytical process that Hegel employs in judging Buddhism as well as religions in general, and how Hegel’s understanding does not work against a more charitably interpreted Buddhist defense. Moreover, I argue that the Orientalist erroneousness of Hegel’s reading deeply complicates his hierarchical philosophy of world history.
A Deep Learning Convolutional Neural Network Can Differentiate Between Helicobacter Pylori Gastritis and Autoimmune Gastritis With Results Comparable to Gastrointestinal Pathologists
Authors: Franklin Michael M. , Schultz Fred A. , Tafoya Marissa A. , Kerwin Audra A. , Broehm Cory J. , Fischer Edgar G. , Gullapalli Rama R. , Clark Douglas P. , Hanson Joshua A. , Martin David R.
Published: April 2021

Context.—

Pathology studies using convolutional neural networks (CNNs) have focused on neoplasms, while studies in inflammatory pathology are rare. We previously demonstrated a CNN that differentiates reactive gastropathy, Helicobacter pylori gastritis (HPG), and normal gastric mucosa.

Objective.—

To determine whether a CNN can differentiate the following 2 gastric inflammatory patterns: autoimmune gastritis (AG) and HPG.

Design.—

Gold standard diagnoses were blindly established by 2 gastrointestinal (GI) pathologists. One hundred eighty-seven cases were scanned for analysis by HALO-AI. All levels and tissue fragments per slide were included for analysis. The cases were randomized, 112 (60%; 60 HPG, 52 AG) in the training set and 75 (40%; 40 HPG, 35 AG) in the test set. A HALO-AI correct area distribution (AD) cutoff of 50% or more was required to credit the CNN with the correct diagnosis. The test set was blindly reviewed by pathologists with different levels of GI pathology expertise as follows: 2 GI pathologists, 2 general surgical pathologists, and 2 residents. Each pathologist rendered their preferred diagnosis, HPG or AG.

Results.—

At the HALO-AI AD percentage cutoff of 50% or more, the CNN results were 100% concordant with the gold standard diagnoses. On average, autoimmune gastritis cases had 84.7% HALO-AI autoimmune gastritis AD and HP cases had 87.3% HALO-AI HP AD. The GI pathologists, general anatomic pathologists, and residents were on average, 100%, 86%, and 57% concordant with the gold standard diagnoses, respectively.

Conclusions.—

A CNN can distinguish between cases of HPG and autoimmune gastritis with accuracy equal to GI pathologists.
Collaborative Online Learning Using a Blended Learning Design for a Physiology Course in Nursing Education
Authors: Lid Reidun , Steindal Simen Alexander , Bingen Hanne Maria
Published: April 2021

Background: This paper is based on implementation of Salmon’s model for online collaborative learning in a blended learning context for part-time nursing students at a Norwegian university.
Objectives: The aim of this study was to explore and describe students’ experiences and to assess the relevance of Salmon’s model applied in a blended learning course in physiology.
Methods: The study used a qualitative descriptive design. Data were collected from students enrolled in a physiology course in 2011 and 2012. Qualitative data came from survey and focus group interviews. 
Findings: Three themes emerged from this study: participation in both steps of the two-step design is important but challenging; online socialisation and a sense of group community support student participation and learning in group e-tivities; and the students’ perception of responsibility when collaborating online.
Conclusions: The teacher’s facilitation of online socialisation, participation, collaboration, feedback and intervention promoted a sense of community and was crucial for the students’ learning of physiology. However, a lack of confidence concerning professional physiology knowledge led to a greater dependency on the teacher than Salmon’s model suggests. The model may have limited potential in physiology, which requires causal reasoning. We suggest combining Salmon’s asynchronous model with synchronous activities.
Road Traffic Offences in Nigeria: An Empirical Analysis using Buys-Ballot Approach
Authors: Dozie K. C. N. , Ibebuogu C.C
Published: April 2021

Road traffic offences in time series analysis when trend-cycle component is quadratic is discussed in this study. The study is to investigate the variance stability, trend pattern, seasonal indices and suitable model for decomposition of study data. The study shows that, the series is seasonal with evidence of upward trend or downward trend. There is an upsurge of the series in the months of March, August and November and a drop in January, June and December. The periodic standard deviations are stable while the seasonal standard deviations differ, suggesting that the series requires transformation to make the seasonal indices additive.
Toxicological Evaluation and Possible Reversal of Diabetic Toxicological Complications by PHF5 an Antidiabetic Herbal Formula in Wistar Albino Rats
Authors: Ikechukwu Egba Simeon , Polycarp N. Okafor , Patricia E. Mbah , Gavin C. Ikechukwu , Humphrey C. Omeoga , Chukwuka W. Eze
Published: April 2021

Aim: Medicinal potentials of herbs can be amplified greatly through synergism in a poly-herbal formulations. Toxic propensities of a plant can be masked out in poly-herbal preparations thus enhancing effectiveness. The aim of this study was to evaluate the potential toxicological effect and toxicity ameliorating properties of a poly-herbal formula (PHF5) prepared in a particular ratio from the leaves of Ocimmum gratissimum, Vernonia amygdalina, Gongronema latifolium, Gnetum africanum and Aloe barbadensis against alloxan-induced diabetic male rats.

Methods: Thirty-six (36) Wistar rats divided into 6 groups with 6 animals per group were used for this study. Group 1 served as normal control animals; group 2 had the diabetic rats treated with PHF5 (75 mg/kg bw); group 3, diabetic rats treated with PHF5 (150 mg/kg bw); group 4, diabetic rats treated with PHF5 (300 mg/kg bw); group 5, diabetic rats not given any intervention, group 6 diabetic animals treated with Glibenclamide (5 mg/kgbw). The induction of diabetes was done intraperitoneally using alloxan monohydrate (100 mg/kg bw). Administration of PHF5 was done orally for five weeks.

Results: Acute toxicity studies of PHF5 did not show any toxic symptoms in animals that received the PHF5 at up to 5000 mg/kg bw dose. The elevated liver (TP, AST, ALT and ALP) and kidney (BUN and Creatnine) markers in the diabetic animals were lowered significantly in the PHF5-treated animals.

Conclusion: The findings of this study suggests that PHF5 possess protective properties against hepatotoxicity and diabetic nephropathy and that the extract is quite safe for consumption
A Study of Non Alcoholic Fatty Liver Disease in Metabolic Syndrome Patients
Authors: Karam Pinky , Kalaiselvi V. S. , Shanthi B.
Published: April 2021

The study aims to determine the association of nonalcoholic fatty liver disease in metabolic syndrome patients to find out the prevalence of nonalcoholic fatty liver disease in the already diagnosed metabolic syndrome patients selected from the South Indian population. Find out the correlation and general characteristics of nonalcoholic fatty liver disease in patients with metabolic syndrome. To determine the potential risk factors for developing steatohepatitis in nonalcoholic fatty liver disease cases with metabolic syndrome and establish the risk categories for developing steatohepatitis in these patients. There is an increased prevalence of all the factors of metabolic syndrome and changes are seen in biochemical markers in nonalcoholic fatty liver cases.
Histopathological Study of Soft Tissue Lesions with Cytology Correlation
Authors: Fathimanifra M. , Vijayalakshmi N. Shanthi , Thanka J.
Published: April 2021

Soft tissue can be defined as non-epithelial extra skeletal tissue of the body, exclusive of the reticuloendothelial system, glia and supporting tissu e of various parenchymal organs. FNAC is a useful tool in distinguishing accurately between neoplastic and non-neoplastic lesions. To study the utility of fine needle aspiration cytology (FNAC) in the diagnosis of soft tissue tumours. To correlate FNAC with histopathological examination of soft tissue tumours with immunohistochemistry and / or histochemistry wherever required and assess the overall sensitivity and specificity of FNAC in diagnosing soft tissue tumours.
Comparison on Safety and Efficacy of Telmisartan and Losartan with their Effects on Cardiovascular – A Single Centre Study
Authors: Chandrasekar T. , Muniappan M. , Muthiah N. S.
Published: April 2021

Two of the major determinants of cardiovascular disease, hypertension and hyperlipidemia, commonly coexist. There is high prevalence (5 -25%) of low high  density lipoprotein (HDL) cholesterol and a higher  prevalence of elevated Triglyceride (TGL) levels in hypertensive compared to normotensive  individuals. Elevated total cholesterol (TC) levels augment the risk of cardiovascular disease associated with hypertension. This study aimed to determine the antihypertensive & pleiotropic effects of telmisartan and losartan in patients with mild to moderate hypertension. All the subjects were between the ages of 18 -65 years. 100 subjects were selected for the study and their serum total cholesterol, HDL, LDL, VLDL, Triglyceride, Systolic blood pressure, diastolic blood pressure, heart rate were analyzed at  the beginning of the study and 12th  and  24 the week. Adverse events are also noted in each visit. All data entered in SPSS 10 version and scores obtained were statistically evaluated using student t test, chi square test and ANOVA. The study showed both telmisartan and losartan good control over hypertension in patients. Telmisartan has pleiotropic positive effect on lipid profile.
Study of Serum Adenosine Deaminase Level in Type 2 Diabetes Mellitus and its Correlation with Glycemic Control
Authors: Hemalatha D. , Devi J. Manjula , Kalaiselvi P. R.
Published: April 2021

Diabetes mellitus is a cluster of abnormal metabolic disorder having common features of hyperglycaemia with a state of increased free radical activity. Chronic hyperglycemic status favours auto-oxidation and the formation of advanced glycation end products. Adenosine deaminase (ADA) is considered as a good marker of cell mediated immunity. Increased ADA activity in diabetic individuals could be due to altered insulin related T-lymphocyte function. Hyperglycaemia is associated with increased level of (ADA), which is one of the factor which leads to increase oxidative stress level by generatingthe reactve oxygen species (ROS) leading to insulin resistance. In our study, ADA level was significantly high in controlled diabetes mellitus type 2 (group II with HbA1c < 7) and was much higher in uncontrolled diabetics (group III with HbA1c > 7) compared to healthy controls (group I). The present study was aimed to find the level of Serum (ADA) among the patients with type 2 diabetes mellitus through a case control study and correlation of Adenosine deaminase with glycemic control (HbA1c). Comparison of the parameters fasting plasma glucose (FPG), post prandial plasma glucose (PPPG) HbA1c, and ADA between the 3 groups were done using Student t test and was statistically significant. Pearson’s coefficient correlation was done between ADA and HbA1c and a positive correlaion was seen that was also statistically significant. This indicates that ADA ses with the extent of severity of type 2 diabetes. Positive correlation of ADA with HbA1c provides the information that ADA can be considered to reflect the glycemic status of the individual.
Arabic Version of the Arc's Self-Determination Scale for Saudi Female Adolescents with Intellectual Disabilities, Learning Disabilities, and Multiple Disabilities
Authors: Alsuhaibani Aseel S. , Evmenova Anya S. , Graff Heidi J. , Duke Jodi M.
Published: April 2021

There is limited recognition of the concept of self-determination in Middle Eastern cultures. Consequently, there are no adapted measures of self-determination for Arabic adolescents with intellectual disabilities, learning disabilities, or multiple disabilities (intellectual disability and physical impairment). The purpose of this study was to examine the internal consistency reliability and construct validity of a translated and adapted version of the Arc's Self-Determination Scale. The participants in this study were 364 Saudi female adolescents between 14 and 22 years old who had intellectual disabilities, learning disabilities, or multiple disabilities and were enrolled in educational organizations in Saudi Arabia. An Arabic version of the Arc's Self-Determination Scale was translated and back-translated by the researchers and then refined and validated by a panel of experts. The translated and adapted Arc's self-determination scale was administered to the participants by their teachers at their schools. Thirty-four items were deleted from the scale, and seven items were modified by the researchers because they were culturally inappropriate. Factorial analysis showed proof of construct validity. The findings of this study showed that the translated and adapted version of the Arc's Self-Determination Scale is a validated assessment within Saudi culture; however, further validation studies with larger samples are needed. This study replicated the findings of previous studies with an international sample and confirmed the universality of the concept of self-determination as well as differences in the operationalization of the self-determination construct across cultures.
US National Trends in Vascular Surgical Practice During the COVID-19 Pandemic
Authors: Ho Vy Thuy , Eberhard Anne V. , Asch Steven M. , Leeper Nicholas J. , Fukaya Eri , Arya Shipra , Ross Elsie Gyang
Published: April 2021

This national cohort study examines changes in the number of vascular surgical procedures completed in the US before and during the COVID-19 pandemic.
42 CFR Part 2 still in effect, regardless of CARES Act
Authors: Knopf Alison
Published: April 2021

Everyone was waiting for the CARES shoe to drop on 42 CFR Part 2 this month, but the Substance Abuse and Mental Health Services Administration (SAMHSA) surprised us by announcing on April 9 — just as the American Association for the Treatment of Opioid Dependence conference was beginning — that the confidentiality regulation would remain in place until the agency promulgates a rulemaking. Later this year, the agency will issue a notice of proposed rulemaking, there will be a comment period and then there will be a final rule. Until then, the current protections are still in effect. That means treatment centers must obtain consent before releasing substance use disorder treatment information on any patient. For the SAMHSA statement, go to https://www.samhsa.gov/newsroom/statements/2021/42‐cfr‐part‐2‐amendments‐process.
NIAAA warns of increased alcohol problems for college students during pandemic
Authors: Knopf Alison
Published: April 2021

Since the spring 2021 semester began, at least four college students have died due to alcohol‐related problems on campus, and as students headed to spring break the last week of March, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) warned of more underage and harmful drinking. Concerns about alcohol‐related tragedies, as well as increased transmission of COVID‐19, are up due to the crowds for spring break. In addition, young adults are facing unprecedented stressors, including uncertainty about their futures, lost income and social isolation. Research from early on in the pandemic already showed that drinking was up due to stress, and researchers at NIAAA are now concerned about a potential spike in alcohol use disorder, the agency warned in a press release last month. “Before the pandemic, young people were engaging in significant alcohol misuse,” said NIAAA Director George F. Koob, Ph.D. “Our concern is that these numbers could increase for young people during the pandemic. We must continue to encourage college students to take the appropriate measures to prevent the spread of the novel coronavirus and ensure that they have the tools, support, and strategies needed to cope with stress and avoid alcohol misuse.”
Structural Design and Dynamic Compressive Properties of Ti–6Al–4V Hollow Lattice Structures
Authors: Shen Haiting , Ren Huilan , Ning Jianguo
Published: April 2021

Herein, three groups of Ti–6Al–4V hollow lattice structures with different strengthening structures are designed and manufactured using a selective laser melting method. A basic structure (specimen BS), a basic structure with strengthening structures at joints (specimen SJ), and a basic structure with a strengthening structure on tube walls (specimen SW) are compressed by a split Hopkinson pressure bar system. The potential influence of strengthening structures and strain rates on dynamic compressive properties is investigated. The results indicate that the strengthening structures change the structural weaknesses and stress concentration regions inside the basic structures; thus, specimens BS and SJ collapse on the struts, whereas specimen SW breaks at the joints. The strengthening structures of specimen SJ reinforce the nonstructural weaknesses inside the basic structure, resulting in the mechanical properties showing limited improvement or even decrease. However, the strengthening structures of specimen SW strengthen the structural weaknesses inside the basic structure, so the collapse strength, specific collapse strength, energy absorption (EA), and specific EA (SEA) of specimen SW, respectively, increase by 46.1%, 8.4%, 42.0%, and 6.5%, which shows that specimen SW exhibits excellent mechanical properties. Moreover, strain rate sensitivity of specimen SW is dominated by the strain rate effect of Ti–6Al–4V material.
Radiation‐Type Metasurfaces for Advanced Electromagnetic Manipulation
Authors: Xu Peng , Tian Han Wei , Cai Xiao , Jiang Wei Xiang , Cui Tie Jun
Published: April 2021

Manipulating the phase, polarization, and energy distribution of electromagnetic (EM) waves has facilitated numerous applications. Nowadays, metasurface provides an innovational scenario to carry out more promising and advanced control of EM waves. However, it is a great challenge to manipulate polarization, phase, and energy distribution simultaneously with a low profile. Herein, a class of single‐layer radiation‐type metasurfaces to achieve advanced EM manipulation is proposed. Desired EM functions can be achieved based on the geometric phase and resonant phase. Such metasurfaces enable the capability to manipulate arbitrary phases and linear polarization states simultaneously. Moreover, arbitrary energy distributions can be controlled. As examples of potential applications, three advanced EM functional devices are presented: a novel multiple‐input multiple‐output antenna with efficient crosstalk suppression and information encryption, an energy‐controllable router, and a metasurface holographic imaging based on power transmission algorithm, respectively. The proposed strategy may open up an alternative way of controlling EM waves with advanced performance and minimalist complexity. Moreover, it may lead to advances in information encoding and cryptography.
Fluorination‐Enhanced Surface Stability of Cation‐Disordered Rocksalt Cathodes for Li‐Ion Batteries
Authors: Li Linze , Lun Zhengyan , Chen Dongchang , Yue Yuan , Tong Wei , Chen Guoying , Ceder Gerbrand , Wang Chongmin
Published: April 2021

Cation‐disordered rocksalt (DRX) materials have emerged as a class of novel high‐capacity cathodes for Li‐ion batteries. However, the commercialization of DRX cathodes will require reducing their capacity decay, which has been associated with oxygen loss during cycling. Recent studies show that fluorination of DRX cathodes can effectively reduce oxygen loss and improve cycling stability; however, the underlying atomic‐scale mechanisms remain elusive. Herein, using a combination of electrochemical measurements, scanning transmission electron microscopy, and electron energy loss spectroscopy, the correlation between the electrochemical properties and structural evolution in Mn‐redox‐based DRX cathodes, Li1.2Ti0.4–xMn0.4+xO2.0‐xFx (x = 0 and 0.2) is examined. It is found that fluorination strongly suppresses structural amorphization and void formation initiated from the particle surface, therefore greatly enhancing the cyclability of the cathode. A novel rocksalt‐to‐spinel‐like structural transformation in the DRX bulk is further revealed, which surprisingly contributes to a gradual capacity increase during cycling. The results provide important insight for the design of novel DRX cathodes with high capacity and long cycle life.
Overcoming Limitations in Surface Geometry‐Driven Bubble Transport: Bidirectional and Unrestricted Movement of an Underwater Gas Bubble Using a Magnetocontrollable Nonwetting Surface
Authors: Han Kiduk , Yong Kijung
Published: April 2021

The movement of underwater gas bubbles significantly affects the core processes of a variety of applications in water electrolysis, heat transfer, optofluidics, and other fields. To maneuver the motion of bubbles, surface geometry‐driven transport is widely applied by employing asymmetric nonwetting surfaces, which induce Laplace pressure based on the bubble radius differences in confined states. Although this method has successfully demonstrated bubble manipulations in various geometries, it has inevitably shown some critical limitations; gas bubbles move unidirectionally from tip to root direction and cease their movements upon reaching unconfined states. This unidirectional and local bubble transport restrains the method's applicability to many fields, and overcoming this obstacle still remains an enormous challenge. Herein, a magnetocontrollable lubricant‐infused surface (MCLIS) is introduced as a key solution to this issue. MCLISs manipulate the adhesion of gas bubbles by controlling magneto‐responsive microwire alignments and rendering two reversible adhesion states, sticky (upright) and slippery (laying wires). This unique characteristic of MCLISs enables the bidirectional and geometry‐unrestricted transportation of bubbles by the wire geometry‐gradient force (Fwgg) generated at sticky–slippery interfaces. Furthermore, this novel magnetic responsive surface supports anti‐buoyancy transport and presents promising applications in microreactors and optical laser shutters in aqueous media.
Perovskite Solar Cells for Space Applications: Progress and Challenges
Authors: Tu Yongguang , Wu Jiang , Xu Guoning , Yang Xiaoyu , Cai Rong , Gong Qihuang , Zhu Rui , Huang Wei
Published: April 2021

Metal halide perovskites have aroused burgeoning interest in the field of photovoltaics owing to their versatile optoelectronic properties. The outstanding power conversion efficiency, high specific power (i.e., power to weight ratio), compatibility with flexible substrates, and excellent radiation resistance of perovskite solar cells (PSCs) enable them to be a promising candidate for next‐generation space photovoltaic technology. Nevertheless, compared with other practical space photovoltaics, such as silicon and III‐V multi‐junction compound solar cells, the research on PSCs for space applications is just in the infancy stage. Therefore, there are considerable interests in further strengthening relevant research from the perspective of both mechanism and technology. Consequently, the approaches used for and the consequences of PSCs for space applications are reviewed. This review provides an overview of recent progress in PSCs for space applications in terms of performance evolution and mechanism exploration of perovskite films and devices under space extreme environments.
Engineered Protein Photo‐Thermal Hydrogels for Outstanding In Situ Tongue Cancer Therapy
Authors: Su Juanjuan , Lu Shuang , Jiang Shengjie , Li Bo , Liu Bin , Sun Qiannan , Li Jingjing , Wang Fan , Wei Yan
Published: April 2021

Surgical excision is the main choice for tongue cancer treatment. However, the physiological functions of oral and maxillofacial regions might be severely impaired and high risk of tongue tumor recurrence cannot be avoided. It is thus becoming urgently important to develop alternative strategies for tongue cancer therapy. In this regard, a new class of near‐infrared (NIR) light‐responsive and peritumoral injectable hydrogel is fabricated with extraordinary photothermal therapy (PTT) for in situ tongue tumors. The as‐prepared soft material exhibits good biocompatibility and ultra‐strong photothermal effect due to the formed network by negatively charged proteins, chitosan molecules, and Ag3AuS2 nanoparticles (NPs). In a well‐constructed in situ tongue tumor model, tumors can be efficiently eradicated by one‐time PTT treatment. Importantly, there are no side effects on surrounding normal tissues and potential tumor recurrence is inhibited. In stark contrast to traditional surgical excision, such biomaterials hold great potential for clinical treatment of oral cancers.
Self‐Assembled Wavy Optical Microfiber for Stretchable Wearable Sensor
Authors: Zhu Heng‐Tian , Zhan Liu‐Wei , Dai Qing , Xu Biao , Chen Ye , Lu Yan‐Qing , Xu Fei
Published: April 2021

Smart wearable devices have made remarkable success in medical‐grade human vital signal monitoring and have promoted the realization of precision medicine and telemedicine. The flexibility and stretchability are significant for wearable devices, which determine the adhesion to the skin and influence the signal accuracy. Here, a stretchable and ultrathin optical sensor based on a self‐assembled wavy microfiber is proposed. Thanks to the “bottom–up” strategy, the wave structure of the microfiber can be adjusted artificially, paving the way for the design of stretchable optical devices. Due to the microbend loss of the microfiber, the optical sensor has a sensitivity of ≈257 per unit strain and a good repetition (the standard deviation is 1.7% over 100 cycles). With the great sensor performance, the wrist pulse with a high signal‐to‐noise ratio is detected and the blood pressure is monitored successfully via the pulse arrival time, showing a potential application for human health monitoring.
MXene‐GaN van der Waals Heterostructures for High‐Speed Self‐Driven Photodetectors and Light‐Emitting Diodes
Authors: Yi Chujun , Chen Yibo , Kang Zhe , Ma Yanan , Yue Yang , Liu Weijie , Zhu Meng , Gao Yihua
Published: April 2021

Due to their excellent electrical conductivity, high transmittance, and adjustable work function, 2D transition‐metal carbides and nitrides have shown great promise in optoelectronic applications, especially in MXene‐semiconductor devices. In this work, Ti3C2TX/(n/p)‐GaN van der Waals heterostructures are fabricated and studied. The Ti3C2TX/(n/p)‐GaN Schottky junctions are confirmed by ultraviolet photoelectron spectroscopy (UPS) with a work function ≈4.2 eV of Ti3C2TX. Based on the Ti3C2TX/(n/p)‐GaN Schottky junctions, high‐speed photodetectors and stable orange light emitting diodes (LEDs) are fabricated. The Ti3C2TX/n‐GaN heterostructure photodetector shows a short rise time (60 ms) and decay time (20 ms), a high responsivity (44.3 mA W−1) and on/off ratio (≈11300) under a light source of 365 nm wavelength and 96.9 µW cm−2 power density. And the Ti3C2TX/p‐GaN heterostructure LED remains a stable orange light emission under bias voltage from 4 to 22 V. The chromaticity coordinates and color temperature of EL spectrum under 22 V are further calculated to be 0.4541, 0.4432, and 2953 K, respectively. The authors believe that this work provides fundamental insight into the applications of MXene in optoelectronic devices.
All‐Solid‐State Oxygen Ion Electrochemical Random‐Access Memory for Neuromorphic Computing
Authors: Nikam Revannath Dnyandeo , Kwak Myonghoon , Hwang Hyunsang
Published: April 2021

Artificial synapses based on electrochemical random‐access memory (ECRAM) have emerged as an important component for neuromorphic chips because they are capable to execute simultaneous signal transmission and memory operations. However, existing ECRAM synapse surfers with compatibility and rapid memory loss issue due to highly reactive Li+ and H+ cationic species. Here, all‐solid‐state oxygen ion‐based ECRAM (O‐ECRAM) synapse, which shows linear weight update characteristics through multi‐level nonvolatile analog conductance states is presented. Crucially, an O‐ECRAM device delivering the highly stable, nonvolatile multi‐level conductance states through reversibly controlling the O2– ion tunneling via oxygen vacancies in oxides heterostructure of ionically conducting Y2O3‐stabilized ZrO2 electrolyte (YSZ) and electrically conducting WO3. The kinetic of O2– induced reversible phase transition in WO3 under YSZ electrolyte gating is triggered using X‐ray photoelectron spectroscopy. Ionic conduction of O2– species through oxygen vacancies in YSZ electrolyte is traced by visualizing in situ conductive filament growth. Oxygen vacancy in YSZ electrolyte provides fast oxygen ion conduction, resulting in an analog switching in WO3 with a fast speed of 10 ms, high retention of more than 103 s, and excellent endurance up to 103 pulses. These benefits prove that the O‐ECRAM device can be a potential candidate for developing neuromorphic hardware.