bluuebunny/crossref_metadata_2025 huggingface dataset:
Lifestyle Factors and Disease Activity Over Time in Early Axial Spondyloarthritis: The SPondyloArthritis Caught Early (SPACE) Cohort
Authors: Exarchou Sofia , Turesson Carl , Lindström Ulf , Ramonda Roberta , Landewé Robert B. , Dagfinrud Hanne , van Gaalen Floris , van der Heijde Désirée , Jacobsson Lennart T.
Published: September 2021

Objective

Our aim was to study the importance of baseline BMI, smoking, and alcohol consumption (AC) for disease activity (DA) over 1 year in early axial spondyloarthritis (axSpA), stratified by sex.

Methods

In the SPondyloArthritis Caught Early cohort (patients with chronic back pain onset at age < 45 yrs, with pain for ≥ 3 months and ≤ 2 yrs), the Ankylosing Spondylitis Disease Activity Score (ASDAS) was recorded at inclusion, 3, and 12 months. All patients included in the analysis had axSpA based on a high physician’s level of confidence at baseline. Differences in ASDAS over 1 year by BMI (normal < 25 kg/m2, overweight 25–29.9 kg/m2, and obese ≥ 30 kg/m2), smoking history (never/previous/current), and AC (none, 0.1–2 units/week, 3–5 units/week, and ≥ 6 units/week) at baseline were estimated using mixed linear regression models.

Results

There were 344 subjects (mean age of 30.3 yrs; 49.4% men). In women, obesity was associated with 0.60 (95% CI 0.28–0.91) higher ASDAS compared to normal BMI. In both sexes, AC tended to be associated with lower DA over 1 year, with a significant association only in women with the highest AC (mean difference of –0.55, 95% CI –1.05 to –0.04). Smoking was associated with higher ASDAS over 1 year compared to never smoking in both sexes, although the difference reached statistical significance only in female former smokers. Results were similar in multivariable analysis, adjusted for all lifestyle factors and other confounders.

Conclusion

In early axSpA, BMI and smoking are associated with higher DA over 1 year, and AC with lower DA. The magnitude of the modest associations may differ between men and women.
Effectiveness of an Interprofessional Education Model to Influence Students' Perceptions on Interdisciplinary Work
Authors: Swinnen Eva , Fobelets Maaike , Adriaenssens Nele , Vandyck Ellen , Goelen Guido , Moortgat Elke , Laforge Dorothée , Peersman Wim
Published: September 2021

Background:

To prepare students adequately for the workplace, training on interprofessional practice should be included in the curricula of future health professionals. This study evaluated the effect of an interprofessional education session on undergraduate students' attitudes toward interprofessional collaboration.

Methods:

A total of 225 medicine, nursing, physiotherapy, and nutrition and dietetics students were randomized to either an intervention (working together interprofessionally,
n
= 111) or control group (working together with their own profession,
n
= 114). Pre- and posttest assessment was performed with an adapted version of the Interdisciplinary Education Perception Scale.

Results:

A statistically significant improvement in attitude for Perception of Competence Own Profession (0.82,
p
= .008) and Perception of Actual Cooperation (1.10,
p
= .004) was found for students in the intervention group compared with students in the control group.

Conclusion:

Interprofessional education sessions were likely to be effective on undergraduate students' attitudes toward interprofessional collaboration.

[
J Nurs Educ
. 2021;60(9):494–499.]
From the Classroom to the Virtual World: Faculty Response to COVID-19
Authors: Cygan Heide , Bejster Mallory
Published: September 2021

Background:

The coronavirus disease 2019 (COVID-19) pandemic forced nursing educators to switch face-to-face courses to virtual learning. This article describes how faculty transitioned a face-to-face public health nursing course to remote learning and examines student response to this transition.

Method:

Data were collected via a 12-question REDCap survey. Using a mixed-methods design, descriptive statistics were calculated for quantitative data, and a descriptive qualitative approach was used for qualitative data analysis.

Results:

Survey response rate was 35% (
n
= 26). Using a 4-point Likert scale, mean question score was 3.55 (range, 2.65 to 3.85). Themes within the transition facilitator category included emotional support for students, communication, availability, flexibility, and course organization. Themes within the transition challenges category included examinations, course-to-course communication, COVID-19 course content, and technology.

Conclusion:

It is essential for nursing educators to learn from the emergency transition of spring 2020 to capitalize on successes and mitigate challenges moving forward.

[
J Nurs Educ
. 2021;60(9):509–512.]
Exploring Student Perceptions of a Virtual Practicum
Authors: Singh Ashley , Spadaro Kathleen , Piotrowski Marilu , Dee Fisher Mary , Walter Lora , Doas Michelle
Published: September 2021

Background:

The coronavirus disease 2019 pandemic has disrupted and overwhelmed academia, adding many new challenges for nursing faculty. However, despite these challenges, nursing faculty at a small private university demonstrated resilience and innovation at the height of the acute phase of the crisis, transforming a traditional 2-day in-person Doctor of Nursing Practice (DNP) practicum to an abbreviated, interactive virtual format.

Method:

A qualitative study was conducted to explore DNP student perceptions of the virtual practicum. An anonymous survey was created to gather participant feedback; the link was embedded in an email invitation to practicum participants.

Results:

The majority of respondents were English speaking, middle-aged, Black, non-Hispanic nurse practitioners. Content analysis revealed three themes: valuable interactions, supportive faculty, and enlightening feedback.

Conclusion:

Despite the crisis and ensuing consequences of the pandemic, DNP students who participated in the virtual practicum described a meaningful and valuable experience.

[
J Nurs Educ
. 2021;60(9):513–516.]
Preparation and characterization of novel environmentally sustainable mortars based on magnesium potassium phosphate cement for additive manufacturing
Authors: Volpe Stelladriana ,   DICATECH, Dipartimento di Ingegneria Civile, Ambientale, del Territorio, Edile e di Chimica, Politecnico di Bari, Via Edoardo Orabona 4, Bari, Italy, Petrella Andrea , Sangiorgio Valentino , Notarnicola Michele , Fiorito Francesco ,   ICITECH, Universitat Politècnica de València, Camí de Vera, s/n, 46022 València, Spain,   FEUP, Faculdade de Engenharia da Universidade do Porto, R. Dr. Roberto Frias, 4200-465 Porto, Portugal
Published: September 2021

The "Digital Transition" of the building sector and in particular the concrete 3D printing is profoundly changing building technologies and construction processes. However, the materials engineering is still a challenge for the research of even more effective and performing 3D printable concrete. In this context, we analysed magnesium potassium phosphate cement (MKPC) performance as an innovative cementitious material in terms of sustainability and possibility of its use in extrusion-based 3D concrete printing (3DPC). Starting from common formulations present in literature, we discussed the relationship between water to binder ratio and workability in two different quantities of retarders. Some mix compositions were also prepared by replacing sand with rubber aggregates or glass aggregates with the aim of creating lightweight aggregate-based mortars. In addition, the fly ash (FA), a widely material used (but that will not be available in the next few years), was replaced with silica fume (SF). We found that two formulations (samples 2 and 7) show rheological requirements and compressive strengths at 90 min of respectively about 2 MPa and 3 MPa, which are deemed to be suitable for 3D printing processes. Moreover, in sample 7, the use of the expanded recycled glass as aggregate opens new possibilities for reducing the carbon footprint of the process.
A multi-sample particle swarm optimization algorithm based on electric field force
Authors: Zhou Shangbo ,   College of Computer Science, Chongqing University, Chongqing 400044, China, Han Yuxiao , Sha Long , Zhu Shufang ,   Key Laboratory of Dependable Service Computing in Cyber Physical Society, Ministry of Education, Chongqing 400030, China
Published: September 2021

Aiming at the premature convergence problem of particle swarm optimization algorithm, a multi-sample particle swarm optimization (MSPSO) algorithm based on electric field force is proposed. Firstly, we introduce the concept of the electric field into the particle swarm optimization algorithm. The particles are affected by the electric field force, which makes the particles exhibit diverse behaviors. Secondly, MSPSO constructs multiple samples through two new strategies to guide particle learning. An electric field force-based comprehensive learning strategy (EFCLS) is proposed to build attractive samples and repulsive samples, thus improving search efficiency. To further enhance the convergence accuracy of the algorithm, a segment-based weighted learning strategy (SWLS) is employed to construct a global learning sample so that the particles learn more comprehensive information. In addition, the parameters of the model are adjusted adaptively to adapt to the population status in different periods. We have verified the effectiveness of these newly proposed strategies through experiments. Sixteen benchmark functions and eight well-known particle swarm optimization algorithm variants are employed to prove the superiority of MSPSO. The comparison results show that MSPSO has better performance in terms of accuracy, especially for high-dimensional spaces, while maintaining a faster convergence rate. Besides, a real-world problem also verified that MSPSO has practical application value.
Partitioning planar graphs with girth at least $ 9 $ into an edgeless graph and a graph with bounded size components
Authors: Tian Chunyu ,   School of Mathematics and Statistics, Shandong Normal University, Ji'nan, 250358, China, Sun Lei
Published: September 2021

In this paper, we study the problem of partitioning the vertex set of a planar graph with girth restriction into parts, also referred to as color classes, such that each part induces a graph with components of bounded order. An ($ \mathcal{I} $, $ \mathcal{O}_{k} $)-partition of a graph $ G $ is the partition of $ V(G) $ into two non-empty subsets $ V_{1} $ and $ V_{2} $, such that $ G[V_{1}] $ is an edgeless graph and $ G[V_{2}] $ is a graph with components of order at most $ k $. We prove that every planar graph with girth 9 and without intersecting $ 9 $-face admits an ($ \mathcal{I} $, $ \mathcal{O}_{6} $)-partition. This improves a result of Choi, Dross and Ochem (2020) which says every planar graph with girth at least $ 9 $ admits an ($ \mathcal{I} $, $ \mathcal{O}_{9} $)-partition.
Output controllability and observability of mix-valued logic control networks
Authors: Zhao Yuyang ,   College of Mathematics and Computer Science, Zhejiang Normal University, Jinhua 321004, China, Liu Yang
Published: September 2021

This paper focuses on output controllability and observability of mix-valued logic control networks (MLCNs), of which the updating of outputs is determined by both inputs and states via logical rules. First, as for output controllability, the number of different control sequences are derived to steer a MLCN from a given initial state to a destination output in a given number of time steps via semi-tensor product method. By construsting the output controllability matrix, criteria for the output controllability are obtained. Second, to solve the problem of observability, we construct an augmented MLCN with the same transition matrix, and use the set controllability approach to determine the observability of MLCNs. Finally, a hydrogeological example is presented to verify the obtained results.
Global existence of positive and negative solutions for IFDEs via Lyapunov-Razumikhin method
Authors: Xu Xipu ,   School of Mechanical & Automotive Engineering, Qingdao University of Technology, Qingdao 266520, China
Published: September 2021

This paper considers the global existence of positive and negative solutions for impulsive functional differential equations (IFDEs). First, we introduce the concept of $ \varepsilon $-unstability to IFDEs and establish some sufficient conditions to guarantee the $ \varepsilon $-unstability via Lyapunov-Razumikhin method. Based on the obtained results, we present some sufficient conditions for the global existence of positive and negative solutions of IFDEs. An example is also given to demonstrate the effectiveness of the results.
Psychometric Properties of the Fear of COVID-19 Scale (FCV-19S) in a Palestinian Context
Authors: Mahamid Fayez , Bdier Dana , Berte Denise
Published: September 2021

This study translated and validated the Fear of COVID-19 Scale (FCV-19S) in a Palestinian context. The FCV-19S is a newly emerging internationally standardized measure of anxiety related to being exposed to or contracting COVID-19. This research begins to identify factors that affect this phenomenon including gender (with females having more fear than males), education (individuals without college degrees demonstrating higher levels of fear) and smoking status (with smokers demonstrating higher levels of fear than non-smokers). The FCV-19 confirmed a one-factor structure in assessing fear of COVID-19 in the Palestinian context. Moreover, the measure demonstrated high levels of validity and reliability in a Palestinian context and therefor can be considered for future studies as the COVID-19 pandemic persists. Further investigations using the Arabic Language of FCV-19S may have far-reaching implications for measuring and combating the fear of COVID-19 at a personal and societal level for uniquely at-risk populations such as in the occupied territories of Palestine.
Tramas feministas na arte contemporânea brasileira e argentina: Rosana Paulino e Claudia Contreras
Authors: Saturnino Tvardovskas Luana
Published: September 2021

Esse artigo propõe analisar as produções das artistas contemporâneas Rosana Paulino (São Paulo, Brasil, 1967-) e Claudia Contreras (Buenos Aires, Argentina, 1956-) que criticam práticas misóginas, apresentando um espaço privilegiado de intersecção com o pensamento feminista. Suas experimentações artísticas oferecem elementos para a compreensão das relações entre arte e gênero na América Latina e são exemplos de tensões culturais e de intervenções críticas que atravessam diferentes mulheres artistas na atualidade.
Del naufragio al cautiverio: Pintores europeos, mujeres chilenas e indios Mapuche a mediados del siglo XIX
Authors: De La Maza Josefina
Published: September 2021

En 1859, después de años de viajar por Sudamérica y de un largo periodo en Chile, el artista francés Raymond Q Monvoisin (1790-1870) expuso en el salón parisino un grupo de obras que daban cuenta de sus “experiencias sudamericanas”. Entre ellas, Monvoisin presentó un díptico conformado por “El naufragio del joven Daniel” y “Elisa Bravo Jaramillo de Bañados, mujer del cacique” (ambas de 1859). Situándose más allá de los acontecimientos reales que gatillaron la concepción del díptico, Monvoisin transformó un naufragio producido en las costas del sur de Chile en una ficción bárbara cuyos principales actores eran los Mapuche. Utilizando como punto de partida la iconografía de la “cautiva”, un tema conocido y utilizado desde la época de la colonia, el díptico contribuyó a presentar a la Araucanía, zona Mapuche por excelencia, como una región indomable que debía ser conquistada y dominada por el estado chileno.Este artículo analizará el díptico de Elisa Bravo a la luz de la representación de la mujer al interior de discursos coloniales y de expansión imperial, reconstruyendo el lugar de la mujer decimonónica entre redes artísticas y simbólicas, entre Chile y Sudamérica y entre Sudamérica y Europa.
Clara Porset, diseño e identidad
Authors: Mallet Ana Elena
Published: September 2021

Este texto busca presentar algunos aspectos de la vida y obra de la diseñadora cubana radicada en México, Clara Porset, quien es uno de los personajes más destacados de la historia del diseño en México.Se narra desde su adolescencia en Cuba en busca de una vocación, su paso por instituciones destacadas en el diseño mundial como Black Mountain College donde estudió bajo la tutela de Josef Albers, hasta su llegada a México donde, impulsada por su marido el pintor Xavier Guerrero se adentra en la cultura mexicana encontrando en ella fuente de inspiración y de trabajo.El mobiliario tradicional mexicano y las artes populares fueron referencias fundamentales en el trabajo de esta diseñadora que tomó el Butaque como emblema de diseño y trabajó alrededor de él generando un referente cultural directamente asociado con la identidad local.
(Domestic) Spaces of Resistance: Three Artworks by Anna Maria Maiolino, Letícia Parente and Anna Bella Geiger
Authors: Lamoni Giulia
Published: September 2021

This text elaborates a close reading of three artworks created in Brazil in the late sixties and seventies, A Espera (1967-2000) by Anna Maria Maiolino, Preparação I (1975) by LetíciaParente and Arte e decoração (1975) by Anna Bella Geiger. More specifically, the article aims to examine how, in these works, the multiple intersections and negotiations occurring between private and public space are explored by materializing heterogeneous images of the home. These artworks develop an iconography of the domestic, but also mobilize, in a more problematic way, the whole polysemic spectrum of the word home. Envisioning the home, and the house, as a site of passage and movement, instead of a protected and self-sufficient place, these works ironically comment on gendered divisions of space and look at how the political constantly infiltrates the private sphere.
A woman’s place is in the “home”: The spatial politics of Daniela Rossell’s "Ricas y Famosas"
Authors: Ratliff Jamie L.
Published: September 2021

The Ricas y Famosas series consists of nearly ninety photographs of mostly interior shots of elaborate and richly decorated houses inhabited by the women and men who own them, their friends, their children, and their domestic staff. The opulent surroundings and sheer abundance of material wealth sparked a general outcry that followed the photographs’ initial book-length publication in 2002. The female subjects bore the brunt of that criticism. In presenting such radically un-feminine representations of the home, Rossell deconstructs the symbolic exploitation of national womanhood and in doing so, exposes the fallacy of the home as a “private” space that is uncomplicated by the so-called “public” concerns of work, the economy, and mass media communication.
Del caballete al telar. La Academia Nacional de Bellas Artes, las escuelas profesionales y los debates en torno de la formación artística femenina en la Argentina de la primera mitad del siglo XX
Authors: Ariza Julia
Published: September 2021

En el paso del siglo XIX al XX, la aparición en Argentina de “escuelas profesionales”, instituciones de enseñanza de artes decorativas y aplicadas para mujeres de clase media y baja, significó para ellas la apertura de la profesión artística por fuera de la Academia. El artículo examina el contexto de creación de estos establecimientos y propone términos de comparación entre la educación artística ofrecida allí y en la Academia. Se analiza en qué medida factores como la pertenencia de clase, las representaciones sociales de la práctica artística y las representaciones de género mediaron tanto en la elección como en la valoración de las artes decorativas, que aunque ausentes de la historiografía canónica del arte argentino, fueron prácticas socialmente visibles cuya consideración fluctuó entre el “arte” y las “artes femeninas”.
Admission Glasgow Coma Scale Score as a Predictor of Outcome in Patients Without Traumatic Brain Injury
Authors: Li Amy , Atem Folefac D. , Venkatachalam Aardhra M. , Barnes Arianna , Stutzman Sonja E. , Olson DaiWai M.
Published: September 2021

Background

The Glasgow Coma Scale was developed in 1974 as an injury severity score to assess and predict outcome after traumatic brain injury. The tool is now used to score depth of impaired consciousness in patients with and without traumatic brain injury. However, evidence supporting the use of the Glasgow Coma Scale in the latter group is limited.

Objective

To assess Glasgow Coma Scale score on hospital admission as a predictor of outcome in patients without traumatic brain injury.

Methods

This was a secondary analysis of prospectively collected data from 3507 patients admitted to 4 hospitals between October 2015 and October 2019. Patients with a primary diagnosis of traumatic brain injury were excluded from this study.

Results

The mean age of the 3507 participants in the study was 57 years. Participants were primarily female (52%), White (77%), and non-Hispanic (89%). On admission, 90% of patients had a modified Rankin Scale score of 0 to 3 and 72% had a Glasgow Coma Scale score of 13 to 15 (mild injury). Generalized estimating equation modeling indicated that admission Glasgow Coma Scale score did not predict modified Rankin Scale score at discharge in patients not diagnosed with traumatic brain injury (Glasgow Coma Scale score <8: z = −7.89, P < .001; Glasgow Coma Scale score 8-12: z = −4.17, P < .001).

Conclusions

The Glasgow Coma Scale is not recommended for use in patients without traumatic brain injury; clinicians should use a more appropriate and validated clinical assessment instrument for this patient population.
Awareness and Willingness to Pay for Cassava Leaves as Livestock Feed Ingredient among Livestock Farmers in Osun State
Authors: Olatunde Grace O. , Adeciyan Oluwafunmilola F.
Published: September 2021

Purpose: This study described the nutritional benefit of cassava leaf, assessed its level of cyanide content; examined respondents’ awareness and perception; and analysed the factors determining livestock farmers’ Willingness to Pay (WTP) for cassava leaves as a livestock feed ingredient. Research Method: Multistage sampling method was employed to select 160 livestock farmers in Osun state and semi –structured interview method was used for data collection which were analysed using logistic regression model. Findings: Results showed that larger percentages of the respondents are not aware of the nutritional benefit of the cassava leaf with 83% of the respondents willing to buy cassava leaves as feed. In addition, age, perception, business purpose, herd size, awareness and income seem to have an effect on farmers’ WTP. Research Limitation: Recommended safe cyanogen level in livestock feed has not been ascertained in literature; a knowledge gap for further research validation. Originality/Value: Awareness, WTP and adoption of cassava leaf as a livestock feed ingredient could be made a generalized and sustainable economic development in animal feed sector if awareness could be increased.
Layilin Anchors Regulatory T Cells in Skin
Authors: Mehta Pooja , Gouirand Victoire , Boda Devi P , Zhang Jingxian , Gearty Sofia V , Zirak Bahar , Lowe Margaret M , Clancy Sean , Boothby Ian , Mahuron Kelly M , Fries Adam , Krummel Matthew F , Mankoo Parminder , Chang Hsin-Wen , Liu Jared , Moreau Joshua M , Scharschmidt Tiffany C , Daud Adil , Kim Esther , Neuhaus Isaac M , Harris Hobart W , Liao Wilson , Rosenblum Michael D
Published: September 2021

Regulatory T cells (Tregs) reside in nonlymphoid tissues where they carry out unique functions. The molecular mechanisms responsible for Treg accumulation and maintenance in these tissues are relatively unknown. Using an unbiased discovery approach, we identified LAYN (layilin), a C-type lectin-like receptor, to be preferentially and highly expressed on a subset of activated Tregs in healthy and diseased human skin. Expression of layilin on Tregs was induced by TCR-mediated activation in the presence of IL-2 or TGF-β. Mice with a conditional deletion of layilin in Tregs had reduced accumulation of these cells in tumors. However, these animals somewhat paradoxically had enhanced immune regulation in the tumor microenvironment, resulting in increased tumor growth. Mechanistically, layilin expression on Tregs had a minimal effect on their activation and suppressive capacity in vitro. However, expression of this molecule resulted in a cumulative anchoring effect on Treg dynamic motility in vivo. Taken together, our results suggest a model whereby layilin facilitates Treg adhesion in skin and, in doing so, limits their suppressive capacity. These findings uncover a unique mechanism whereby reduced Treg motility acts to limit immune regulation in nonlymphoid organs and may help guide strategies to exploit this phenomenon for therapeutic benefit.
Liver-Dependent Lung Remodeling during Systemic Inflammation Shapes Responses to Secondary Infection
Authors: Odom Christine V , Kim Yuri , Burgess Claire L , Baird Lillia A , Korkmaz Filiz T , Na Elim , Shenoy Anukul T , Arafa Emad I , Lam TuKiet T , Jones Matthew R , Mizgerd Joseph P , Traber Katrina E , Quinton Lee J
Published: September 2021

Systemic duress, such as that elicited by sepsis, burns, or trauma, predisposes patients to secondary pneumonia, demanding better understanding of host pathways influencing this deleterious connection. These pre-existing circumstances are capable of triggering the hepatic acute-phase response (APR), which we previously demonstrated is essential for limiting susceptibility to secondary lung infections. To identify potential mechanisms underlying protection afforded by the lung–liver axis, our studies aimed to evaluate liver-dependent lung reprogramming when a systemic inflammatory challenge precedes pneumonia. Wild-type mice and APR-deficient littermate mice with hepatocyte-specific deletion of STAT3 (hepSTAT3−/−), a transcription factor necessary for full APR initiation, were challenged i.p. with LPS to induce endotoxemia. After 18 h, pneumonia was induced by intratracheal Escherichia coli instillation. Endotoxemia elicited significant transcriptional alterations in the lungs of wild-type and hepSTAT3−/− mice, with nearly 2000 differentially expressed genes between genotypes. The gene signatures revealed exaggerated immune activity in the lungs of hepSTAT3−/− mice, which were compromised in their capacity to launch additional cytokine responses to secondary infection. Proteomics revealed substantial liver-dependent modifications in the airspaces of pneumonic mice, implicating a network of dispatched liver-derived mediators influencing lung homeostasis. These results indicate that after systemic inflammation, liver acute-phase changes dramatically remodel the lungs, resulting in a modified landscape for any stimuli encountered thereafter. Based on the established vulnerability of hepSTAT3−/− mice to secondary lung infections, we believe that intact liver function is critical for maintaining the immunological responsiveness of the lungs.
A CFD-Based Examination of Rotor-Rotor Separation Effects on Interactional Aerodynamics for eVTOL Aircraft
Authors: Healy Richard , Misiorowski Matthew , Gandhi Farhan
Published: September 2021

This study systematically investigates the aerodynamic interactions of a two-rotor system with a front rotor and an aft rotor aligned with the direction of flow. The rotors are 5.5 ftdiameter fixed-pitch rotors operating at approximately 12 lb/ft2 disk loading, representative
of large eVTOL aircraft. Fluid flow is simulated using the commercial Navier–Stokes solver, AcuSolve, with a detached eddy simulation (DES) model. Simulations were performed nominally at 40 kt edgewise flight for nine cases corresponding to three values of longitudinal hub–hub
separation (2.5R, 3R, 3.5R) and three values of vertical offset (0, 0.25 R, 0.5 R ). Aft rotor performance was compared to an isolated rotor operating in the same conditions in order to quantify the effects of rotor–rotor interaction. For the cases where the aft
rotor is closest to the front rotor (2.5R longitudinal offset, zero vertical offset), the aft rotor produced 8.4% less thrust and required 13.4% higher torque than a rotor in isolation. When vertical rotor separation was increased, interactional aerodynamic effects decreased. For a
2.5R longitudinal offset, increasing the vertical offset to 0.5 R decreased the lift deficit to 4.6% and the torque penalty to 6.8%. Increasing the longitudinal offset to 3.5R (while keeping the vertical offset at zero) also reduced interactional aerodynamic effects, but reductions
in lift deficit and torque penalty were smaller than those observed with 0.5R vertical offset. Reducing disk loading was found to strengthen interactional aerodynamic effects, with an 11.5% thrust deficit at 6 lb/ft2 compared to 9.0% at 12 lb/ft2. An increase in
flight speed also increased interactional aerodynamic penalties from 5.4% thrust deficit at 20 kt to 12.2% at 60 kt. The increased interactional aerodynamic penalties with the reduction in disk loading and increase in flight speed were both attributed to an increase in wake skew angle and
the resulting decrease in separation between the aft rotor disk and front rotor wake.
Impact of asthma severity as risk factor to future exacerbations in patients admitted for asthma exacerbation
Authors: Nakwan Narongwit
Published: September 2021

Background: To investigate the impact of disease severity on exacerbation patterns and identify its potential as a risk factor for future exacerbations in patients admitted for asthma exacerbations.Methods: We analyzed frequency and time to next exacerbation over a period of three years in 532 patients admitted for exacerbation. Disease severity was selected as a potential risk factor for the events. Kaplan-Meier analysis was used to identify the probability of future exacerbations. A Cox-proportional hazards model was used to assess independent relative risks.Results: Of 532 patients analyzed, the frequency of exacerbations rose as the severity of the asthma increased. The exacerbation rates in the following year were 1.66 per person for patients with mild asthma and 3.98 for patients with severe asthma. The median time to the next exacerbation in patients with mild asthma was 61.4 weeks (95% CI, 40.1-82.6) compared to 15.0 weeks (95% CI, 11.3-18.6) in patients with severe asthma (p<0.001). Multivariate analysis showed that asthma severity (severe vs mild asthma, HR=1.42, 95% CI, 1.07-1.89), a history of 1-2 exacerbations (HR=1.95, 95% CI, 1.45-2.63) or > 2 exacerbations (HR=2.32, 95% CI, 1.56-3.44) in the previous 12 months, and a high number of comorbidities (≥5 vs none, HR=2.5, 95% CI, 1.41-4.45) were independent predictors of the probability of future exacerbations.Conclusion: Asthma severity is a strong independent risk factor for future exacerbations, and exacerbation rates also become more frequent as the severity of the asthma increases. These findings help in better understanding of the natural course of exacerbations across the spectrum of asthma disease severity
Three-dimensional analysis of magnetotelluric data from the New Afton porphyry deposit, central British Columbia
Authors: Roots E , Craven J A , Schetselaar E , Enkin R , Wade D
Published: September 2021

Magnetotelluric data were collected along eight lines perpendicular to the mineralized zone and alteration halo of the New Afton Cu-Au porphyry deposit. The data were collected at an interstation spacing of 100 m and a line spacing of 300 m, and with a bandwidth
of approximately 0.01 to 10 000 Hz. Phase tensor maps show an approximately east-west delineation of the survey into northern and southern sections. Determinant phase maps show conductivities initially increasing with depth in the north and decreasing in the south, with this trend reversing at
depth. Preliminary results from 3-D inversions show conductive cover underlain by more resistive material throughout most of the survey area, with notably lower resistivities to the north. Two linear northeast-southwest features, spatially associated with the New Afton and Pothook mineralization,
are imaged crosscutting the primary east-west fault zone, with high resistivities in the north and low resistivities in the south.
Association of Serum Leptin with Anthropometric Indices of Obesity, Blood Lipids, Steroidal Hormones, and Insulin Resistance in Polycystic Ovarian Syndrome
Authors: Kumawat Manjulata , Choudhary Priyanka , Aggarwal Sameer
Published: September 2021

Background:

Polycystic ovarian syndrome (PCOS) is a major form of anovulatory infertility in women. It is often associated with obesity and insulin resistance (IR), both of which are linked to leptin and its receptors.

Aim:

The aim of this study was to evaluate the interrelationship between serum leptin level with anthropometric indices of obesity, lipid profile, IR, and with circulating steroidal hormones in PCOS women.

Settings and Design:

An observational case–control study was conducted in a medical college and hospital setting.

Methods:

Ninety diagnosed cases of PCOS along with ninety age-matched normal women were enrolled. Serum insulin, lipid profile, steroidal hormones, and serum leptin were estimated. IR was calculated using the Homeostatic Model Assessment-IR. Anthropometric measurements were also taken of each study participant.

Statistical Analysis:

Descriptive statistics along with independent sample t-test and Pearson (r) correlation coefficients were used.

Results:

Women with PCOS had high mean value of waist circumference (P = 0.00), hip circumference (P = 0.00), and hormonal levels than the control group (luteinizing hormone [LH] [P = 0.00], testosterone [P = 0.00], LH/follicle-stimulating hormone ratio [P = 0.00], leptin [P = 0.00], and IR [P = 0.00]). Serum insulin levels (P = 0.02), IR (P = 0.01), body mass index (BMI) (P = 0.03), and fasting blood sugar (P = 0.01) had a positive correlation with leptin. Insulin (P = 0.01), IR (P = 0.02), fasting blood sugar (P = 0.001), and leptin (P = 0.00) were more in the obese control group.

Conclusion:

Serum leptin level is raised in PCOS patients, and it is correlated positively with BMI, fasting blood sugar, insulin metabolism, and IR.
Acute respiratory distress syndrome
Authors: Saha Anurag , Amonkar Gayathri P , Desai Heena , Baro Bhanita , Agrawal Ruchi
Published: September 2021

Context:

In this autopsy study, the various morphological patterns of acute respiratory distress syndrome (ARDS) have been analyzed and compared along with their etiopathogenesis.

Aims:

We aimed to study the prevalence and clinicopathological correlation of ARDS based on age, gender, hospital stay, symptoms, clinical diagnosis, gross, and microscopy findings.

Subjects and Methods:

Total 130 cases of ARDS were studied over a period of 5 years. Age, gender, hospital stay duration, symptoms, clinical diagnosis, gross and microscopic lung finding, clinicopathological correlation, and cause of death were documented and analyzed. Special stains were done whenever required.

Statistical Analysis:

This is an observational study, and simple statistics such as mean, median, and standard deviation have been used for continuous variables.

Results:

The prevalence of ARDS among the adult autopsy was 6.05%. Majority of the cases were in the age group of 18–30 years (36.9%), with a male: female ratio of 1.7:1. Chief complaints were fever (71%), breathlessness (54.6%), and chills (43.8%). The main clinical diagnoses were ARDS (41.6%), sepsis (28.3%), acute febrile illness (17%), and lower respiratory tract infection (12.5%). Most of the patients had a hospital stay of <1 day. Associated conditions mostly included chronic alcoholism (16.1%), pregnancy (16.1%), and chronic smoking (10.7%). Major findings on gross examination were intrapulmonary hemorrhage (38.5%), ARDS (33%), pulmonary edema (13%), and pneumonia (15.3%).On microscopy, major findings were hyaline membrane (84.6%), intrapulmonary hemorrhage (76.1%), pulmonary edema (75.3%), organizing fibrin (55.3%), and bronchopneumonia (36.2%).

Conclusion:

Infections were one of the major predisposing causes of ARDS. Due to the short interval, the underlying cause for ARDS often goes undiagnosed.
Utility of various inflammatory markers in predicting outcomes of hospitalized patients with COVID-19 pneumonia
Authors: Marimuthu Aishwarya K , Anandhan Monisha , Sundararajan Lakshmikanthan , Chandrasekaran Jagadeesh , Ramakrishnan Balasubramaniam
Published: September 2021

Aim:

The aim of the study is to study the utility of various inflammatory markers in predicting outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia.

Primary Objective:

The primary objective of the study is to analyze the correlation between various inflammatory markers and in-hospital mortality.

Secondary Objectives:

The secondary objective of the study is to assess the correlation between the inflammatory markers and clinical category of patients, and other outcomes such as length of hospital stay and need for invasive ventilation.

Methods:

A retrospective cross-sectional observational study was done in 221 hospitalized patients who were diagnosed with COVID-19 pneumonia in a tertiary care hospital in South India from May 2020 to July 2020. Clinical and laboratory data of patients diagnosed with COVID-19 pneumonia were collected. This included epidemiological data, clinical data, laboratory parameter (neutrophil: lymphocyte [N: L] ratio, C-reactive protein [CRP], ferritin, interleukin-6 [IL-6], lactate dehydrogenase, D-dimer, and procalcitonin), treatment details, and outcomes.

Results:

IL-6 levels >60.5 pg/mL and D-dimer levels >0.5 mcg/mL predicted in-hospital mortality with sensitivities of 80% and 76.7%, respectively. N: L ratio and CRP levels had good correlation with the need for oxygen supplementation and/or invasive ventilation.

Conclusions:

Judicious use of COVID-19 biomarkers could help in disease prognostication and thereby provide guidance to devise appropriate management strategies.
Comparative performance of two protective barriers during tracheal intubation of COVID-19 patients
Authors: Abolkheir Abdullah B. , El-Kabbani Ahmed , Al Raffa Abdullah , AlFattani Areej , Norris Andrew
Published: September 2021

COVID-19 was declared a pandemic by the WHO in 2020. In light of the global shortage of PPE and concerns regarding the safety of healthcare providers, clinicians have resorted to the use of novel protective barriers, such as aerosol boxes and plastic sheets, during aerosol generating procedures, especially tracheal intubation. We compared the effect of these barriers on the tracheal intubation of simulated patients with severe COVID-19 in a crossover study. The study was approved by the Ethics Committee of King Faisal Specialist Hospital, and the procedures were compliant with the COVID-19 airway management guidelines of the Saudi Anesthesia Society. The time to intubation was our primary outcome. Secondary outcomes included number of optimization maneuvers, number of intubation attempts, time to glottic view and ventilation of the lungs, and damage to PPE. Thirteen consultant anesthetists performed 39 tracheal intubations on a manikin using each of three approaches (aerosol box, plastic sheet, and no-barrier). Data were collected via direct and video observation. The plastic sheet approach demonstrated the highest time to intubation (mean ± StE [95% CI]: 33.3s ± 3.5 [25.8– 40.9]) compared to the aerosol box (22.0s ± 2.5 [16.5 – 27.5], P < 0.01) and no-barrier approaches (16.1s ± 1.1 [13.7 – 18.4], P < 0.0001). Similarly, the plastic sheet approach had the highest time to glottic view, and ventilation intervals compared to the other two approaches, while the no-barrier approach had the shortest time intervals. There were no failed intubations or damage to the PPE sustained during the use of any of the three approaches. The aerosol box does not impose a significant delay in tracheal intubation using video laryngoscopy, unlike the plastic sheet barrier. Further research on the aerosolization risk is warranted before these protective barriers can be considered as mainstay approaches during aerosol generating procedures.
Endotracheal tube cuff position in relation to the cricoid in children
Authors: Wani Tariq M. , John Jiju , Bahun Vladimir , AlGhamdi Faris , Tumin Dmitry , Tobias Joseph D.
Published: September 2021

Background:

The use of cuffed endotracheal tubes (ETT) has become the standard of care in pediatric practice. The rationale for the use of a cuffed ETT is to minimize pressure around the cricoid while providing an effective airway seal. However, safe care requires that the cuff lie distal to the cricoid ring following endotracheal intubation. The current study demonstrates the capability of computed tomography (CT) imaging in identifying the position of the cuff of the ETT in intubated patients.

Methods:

In this retrospective study, the ETT cuff position was examined on the sagittal plane images of neck and chest CT scans of 44 children. The position of the proximal and the distal aspect of the ETT cuff inside the trachea was recorded in relation to the vertebral levels. The vertebral levels were used to estimate the location of the cricoid ring and its relationship to the cuff.

Results:

The vertebrae were used as the primary landmarks to define the position of the cricoid and its relationship to the cuff of the ETT. Correlating vertebral levels with the cricoid for different age groups, the proximal (cephalad) edge of the ETT cuff was below the cricoid in 41 of 44 patients (93%). The ETT cuff was deep in 6 patients, below the 1st thoracic vertebra, with 2 ETTs in the right mainstem bronchus.

Conclusion:

This is the first study demonstrating that the cuff of the ETT and its position in the trachea can be identified on CT imaging in children. The ETT cuff was below the level of the cricoid in the majority of patients irrespective of the patient's age as well as the size, make, and type of ETT.
Robust home brew fragment sizing assay for detection of MET exon 14 skipping mutation in non–small cell lung cancer patients in resource constrained community hospitals
Authors: Mehta Anurag , Nathany Shrinidhi , Chopra Aanchal , Mattoo Sakshi , Kumar Dushyant , Panigrahi Manoj Kumar
Published: September 2021

Background: A mutation/deletion involving donor or acceptor sites for exon 14 results in splicing out of exon 14 of the mesenchymal epithelial transition (MET) gene and is known as “MET exon 14 skipping” (ΔMET14). The two recent approvals with substantial objective responses and improved progression-free survival to MET inhibitors namely capmatinib and tepotinib necessitate the identification of this alteration upfront. We herein describe our experience of ΔMET14 detection by an mRNA-based assay using polymerase chain reaction followed by fragment sizing. Methods: This is a home brew assay which was developed with the concept that the transcripts from true ΔMET14 will be shorter by ~140 bases than their wild type counterparts. The cases which were called MET exon 14 skipping positive on next-generation sequencing (NGS) were subjected to this assay, along with 13 healthy controls in order to establish the validity for true negatives. Results: Thirteen cases of ΔMET14 mutation were detected on NGS using RNA-based sequencing. Considering NGS as a gold standard, the sizing assay using both gel and capillary electrophoresis that showed 100% specificity for both with concordance rates of 84.6% and 88.2% with NGS, respectively, were obtained. Conclusions: Owing to the cost-effective nature and easy to use procedures, this assay will prove beneficial for small- and medium-sized laboratories where skilled technical personnel and NGS platforms are unavailable.
Upward trend in follicular lymphoma among the Korean population: 10-year experience at a large tertiary institution
Authors: Kim Meejeong , Hwang Hee Sang , Cho Hyungwoo , Yoon Dok Hyun , Suh Cheolwon , Park Chan Sik , Go Heounjeong , Huh Jooryung
Published: September 2021

Background: Follicular lymphoma (FL) is the second most common non-Hodgkin lymphoma (NHL) in Western countries. However, it is relatively rare in Asia. This study examined epidemiologic characteristics of FL in South Korea, with an emphasis on recent trends of increase in cases. Methods: We retrospectively examined 239 cases of newly diagnosed FL at a large tertiary institution in Korea (Asan Medical Center, Seoul, Republic of Korea) between 2008 and 2017. Age-adjusted incidence rates and clinicopathological variables were analyzed, and joinpoint regression analysis was used to identify the changes. Results: The age-adjusted incidence of FL significantly increased during the study period (p = .034), and the ratio of (relative incidence) patients with FL to patients with NHL increased from 4.28% to 9.35% in the same period. Over the 10-year study assessment duration, the proportion of patients with stage III/IV FL (p = .035) and expression of BCL2 (p = .022) or BCL6 (p = .039) significantly increased. From 2013–2017, the proportion of patients with highrisk Follicular Lymphoma International Prognostic Index (FLIPI) score increased (21.5% to 28.7%), whereas that of low-risk FLIPI decreased (55.4% to 38.6%), although those results were not statistically significant (p = .066). Conclusions: We found an increasing incidence of FL, with a disproportionate increase in the incidence of high-stage disease and recent changes in the clinicopathologic features of the Korean patient population.