bluuebunny/crossref_metadata_2025 huggingface dataset:
Proposal of New Key Step in Lateral Approach Thyroidectomy in Light of Comparison of Surgical Outcomes of Medial versus Lateral Approach Thyroidectomy: A Randomised Controlled Study
Authors: Phookan Jyotirmoy , Gupta Shilpi , Saikia Nabajyoti , Sarma Debajit , Mili Mohan Kumar , Gohain Mridusmita , Dey Joydeep
Published: March 2021

Objective. Thyroid surgery has travelled a long path, from a surgery which once was considered deemed to fail and even led to death, to the current time when newer techniques are being tested to make the incision smaller and smaller. The aim of our study is to give a precise detailed stepwise description of medial and lateral surgical approach with the anatomical basis and to compare their feasibility and safety. Methods. 104 cases presenting with thyroid swelling in the Department of Otorhinolaryngology, Assam Medical College Dibrugarh from January 1, 2019, to December 31, 2019, were selected and randomisation was done based on day of admission from OPD. Basic demographic data, preoperative diagnosis, operative time, blood loss, need for transection of strap muscles, and complications were recorded. Result. The distribution of thyroid cases according to age ranged from 17 to 81 years. The prevalence of thyroid disorders was the highest (37.5%) in the age group of 31–40 yrs. Of a total of 104 thyroid cases, 49 were colloid goitre, 24 were multinodular goitre, 9 were follicular neoplasm category 4, 4 were papillary thyroid carcinoma, 2 were follicular neoplasm category 3, and 3 were follicular neoplasm category 5. Conclusion. Out of the two approaches, lateral approach thyroidectomy showed better results with fewer complications. A single structure (superior belly of omohyoid) can be used as a guide to preserving all vital structures related to the thyroid gland.
Quercetin as a Precursor for the Synthesis of Novel Nanoscale Cu (II) Complex as a Catalyst for Alcohol Oxidation with High Antibacterial Activity
Authors: Moodi Zahra , Bagherzade Ghodsieh , Peters Janny
Published: March 2021

Quercetin (3,3′,4′,5,7-pentahydroxyflavone) is one of the dietary flavonoids, distributed in medicinal plants, vegetables, and fruits. Quercetin has the ability to bind with several metal ions to increase its biological activities. In the last two decades, quercetin has attracted considerable attention due to the biological and pharmaceutical activities such as antioxidant, antibacterial, and anticancer. In the present study, quercetin and ethanolamine were used for the synthesis Schiff base complex, which was characterized by IR, 1H NMR, and 13C NMR spectroscopy. The Schiff base has been employed as a ligand for the synthesis of novel nanoscale Cu (II) complex. The product was characterized by FT-IR spectroscopy, FESEM, and XRD. Significantly, the product showed remarkable catalytic activity towards the oxidation of primary and secondary alcohols. The antibacterial activity of the final product was assessed against Staphylococcus aureus (Gram‐positive) and Escherichia coli (Gram‐negative) bacteria using an inhibition zone test. The synthesized nanoscale Cu (II) complex exhibited a strong antibacterial activity against both Gram-positive and Gram-negative bacteria.
Esophageal Dieulafoy Lesion: A Rare and Potentially Fatal Entity
Authors: Burke Eoghan P
Published: March 2021

A 35-year-old gentleman presented acutely to the emergency department with large volume haematemesis and melena. Following adequate initial resuscitation, the patient underwent emergency upper gastrointestinal endoscopy which revealed a dilated tortuous submucosal vessel which was actively bleeding at the midpoint of the esophagus. This was consistent with a Dieulafoy lesion. However, its position in the midpoint of the esophagus is rare. Our patient recovered well following intervention.
Efficacy of Decitabine plus Anti-PD-1 Camrelizumab in Patients with Hodgkin Lymphoma Who Progressed or Relapsed after PD-1 Blockade Monotherapy
Authors: Wang Chunmeng , Liu Yang , Dong Liang , Li Xiang , Yang Qingming , Brock Malcolm V. , Mei Qian , Liu Jiejie , Chen Meixia , Shi Fengxia , Liu Miao , Nie Jing , Han Weidong
Published: March 2021

Purpose:

Programmed death-1 (PD-1) blockade monotherapy is effective in relapsed/refractory classical Hodgkin lymphoma (cHL), but a subset of patients is recalcitrant to PD-1 inhibitors and only a minority of patients achieves durable remission. Effective treatment regimens for those with relapsed/progressive cHL after single-agent anti-PD-1 are urgently needed. Anti-PD-1 combination with the DNA-demethylating agent decitabine showed positive preliminary results in our test cohort patients who were resistant to anti-PD-1. Here, we assess the efficacy of decitabine plus anti-PD-1 therapy in an expansion cohort and after longer follow-up.

Patients and Methods:

We present the response and progression-free survival rates from patients with relapsed/refractory cHL who relapsed/progressed after prior anti-PD-1 monotherapy, and who received decitabine (10 mg/day, days 1–5) plus the anti-PD-1 camrelizumab (200 mg, day 8), every 3 weeks in a phase II trial (ClinicalTrials.gov: NCT02961101 and NCT03250962).

Results:

Overall, 51 patients (test cohort: 25, expansion cohort: 26) were treated and 50 evaluated for efficacy. The objective response rate was 52% [nine complete responses (CR); 36%] in the test cohort, and 68% (six CRs; 24%) in the expansion cohort. Median progression-free survival with decitabine plus camrelizumab was 20.0 and 21.6 months, respectively, which was significantly longer than that achieved with prior anti-PD-1 monotherapy. Durable response was observed in an estimated 78% of patients who achieved CR at 24 months. After decitabine plus camrelizumab, the ratio increase of circulating peripheral central memory T cells directly correlated with both clinical response and progression-free survival.

Conclusions:

Decitabine plus camrelizumab is associated with high response rates and long-term benefits in patients with relapsed/refractory cHL who failed PD-1 inhibitors.
Qa-1b Modulates Resistance to Anti–PD-1 Immune Checkpoint Blockade in Tumors with Defects in Antigen Processing
Authors: Zhang Xiao , Sabio Erich , Krishna Chirag , Ma Xiaoxiao , Wang Jingming , Jiang Hui , Havel Jonathan J. , Chan Timothy A.
Published: March 2021

Immune checkpoint blockade (ICB) has improved cancer care, but ICB is only effective in some patients. The molecular mechanisms that influence ICB therapy response are not completely understood. The non-classical MHC class I molecule HLA-E and its mouse ortholog, Qa-1b, present a limited set of peptides in a TAP1-dependent manner to the NKG2A/CD94 heterodimer to transduce an inhibitory signal to natural killer (NK) and CD8+ T cells. However, deficiency of TAP1 allows Qa-1b to present an alternative peptidome to Qa-1b–restricted T-cell receptors of cytotoxic T cells. In this study, we used CRISPR–Cas9 to study the relationship between TAP1, Qa-1b, and response to anti-PD1 therapy. We hypothesized that immunotherapy response in TAP1-deficient tumors would be influenced by Qa-1b. Strikingly, using a syngeneic orthotopic mouse model, we found that although TAP1-deficient tumors were resistant to anti-PD1 treatment, anti-PD1 response was significantly enhanced in tumors lacking both TAP1 and Qa-1b. This increased sensitivity is partially dependent on NK cells. TAP1-deficient tumors were associated with an increase of intratumoral regulatory T cells (Treg) and neutrophils, whereas tumors lacking both TAP1 and Qa-1b exhibited an increased CD8+ T-cell to Treg ratio. These data suggest that direct inhibition of Qa-1b may alter the immune microenvironment to reverse resistance to anti-PD1 therapy, particularly in the context of antigen-processing defects.

Implications:

This study reveals important functional crosstalk between classical TAP-dependent MHC complexes and Qa-1b/HLA-E, particularly in tumors with impaired antigen-processing machinery. This can dramatically influence immunotherapy efficacy.
Estimating the Breast Cancer Burden in Germany and Implications for Risk-based Screening
Authors: Quante Anne S. , Hüsing Anika , Chang-Claude Jenny , Kiechle Marion , Kaaks Rudolf , Pfeiffer Ruth M.
Published: March 2021

In Germany, it is currently recommended that women start mammographic breast cancer screening at age 50. However, recently updated guidelines state that for women younger than 50 and older than 70 years of age, screening decisions should be based on individual risk. International clinical guidelines recommend starting screening when a woman's 5-year risk of breast cancer exceeds 1.7%. We thus compared the performance of the current age-based screening practice with an alternative risk-adapted approach using data from a German population representative survey. We found that 10,498,000 German women ages 50–69 years are eligible for mammographic screening based on age alone. Applying the 5-year risk threshold of 1.7% to individual breast cancer risk estimated from a model that considers a woman's reproductive and personal characteristics, 39,000 German women ages 40–49 years would additionally be eligible. Among those women, the number needed to screen to detect one breast cancer case, NNS, was 282, which was close to the NNS = 292 among all 50- to 69-year-old women. In contrast, NNS = 703 for the 113,000 German women ages 50–69 years old with 5-year breast cancer risk <0.8%, the median 5-year breast cancer risk for German women ages 45–49 years, which we used as a low-risk threshold. For these low-risk women, longer screening intervals might be considered to avoid unnecessary diagnostic procedures. In conclusion, we show that risk-adapted mammographic screening could benefit German women ages 40–49 years who are at elevated breast cancer risk and reduce cost and burden among low-risk women ages 50–69 years.

Prevention Relevance:

We show that a risk-based approach to mammography screening for German women can help detect breast cancer in women ages 40–49 years with increased risk and reduce screening costs and burdens for low-risk women ages 50–69 years. However, before recommending a particular implementation of a risk-based mammographic screening approach, further investigations of models and thresholds used are needed.
A robust high-speed sliding mode control of permanent magnet synchronous motor based on simplified hysteresis current comparison
Authors: Chinaeke-Ogbuka Ifeanyi , Ajibo Augustine , Odo Kenneth , Ogbuefi Uche , Mbunwe Muncho , Ogbuka Cosmas , Ejiogu Emenike
Published: March 2021

A robust high-speed sliding mode control (SMC) of three phase permanent magnet synchronous motor (PMSM) is presented. The SMC served for inner speed control while a simplified hysteresis current control (HCC) scheme was used in the outer current control to generate gating signals for the inverter switches. The present research leverages on the ability of SMC to directly access system speed error which it attempts driving to zero by cancelling modelling uncertainties and disturbances. Performance comparison was done for the SMC model and an existing model having classical PI controller. With the initial positive speed command of 200 rpm at 5 Nm constant loading, rotor speed with SMC neatly settled to the reference speed at 0.085 seconds without overshoot while the rotor speed of the model with PI controller settled at 0.217 seconds after overshoot. This translates to 155.3% speed enhancement. Similar superior speed performance of the SMC was also observed during recovering from sudden speed reversal. While the SMC model recovered and settled to the reference speed of -200 rpm at 0.369 seconds, the model with PI controller settled at 0.482 seconds. From the results, it can be seen that SMC demonstared superiority over the conventioanl PI controller for complex drives systems.
A dual-switch cubic SEPIC converter with extra high voltage gain
Authors: Fotso Mbobda Christophe Raoul , Dikandé Alain Moise
Published: March 2021

To provide a high votage conversion ratio, conventional non-isolated DC-DC boost topologies, which have reduced voltage boost capability, have to operate with extremely high duty cycle ratio, higher than 0.9. This paper proposes a DC-DC converter which is mainly based on the narrow range of duty cycle ratio to achieve extra high voltage conversion gain at relatively reduced voltage stress on semiconductors. In addition, it does include any magnetic coupling structure. The structure of the proposed converter combines the new hybrid SEPIC converter and voltage multiplier cells. From the steady-state analysis, this converter has wide conversion ratio and cubic dependence with respect to the duty ratio and then, can increase the output voltage several times more than the conventional and quadratic converters at the same duty cycle ratio. However, the proposed dual-switch cubic SEPIC converter must withstand higher voltage stress on output switches. To overcome this drawback, an extension of the proposed converter is also introduced and discussed. The superiority of the proposed converter is mainly based on its cubic dependence on the duty cycle ratio that allows it to achieve extra high voltage gain at reduced voltage stress on semiconductors. Simulation results are shown and they corroborate the feasibility, practicality and validity of the concepts of the proposed converter.
Multilevel diode clamped D-Statcom for power quality improvement in distribution systems
Authors: Babu Jasti Venkata Ramesh , Kumar Malligunta Kiran
Published: March 2021

Power quality is one big issue in power system and a big challenge for power engineers today. Electrical consumers (or otherwise load devices) expect electrical power received power should be of first-class. Bad quality in electrical power directs to fuse blowing, machine overheating, increase in distribution losses, damage to sensitive load devices and many more. DSTATCOM is one of the FACTS controllers designed to improve the quality in electrical power and thus improving the performance of distribution system. This paper presents a multilevel DSTATCOM topology to enhance power quality in power distribution system delivering high-quality power to the customer load devices. Diode-clamped structure is employed for multi-level DSTATCOM structure. ‘PQ’ based control strategy generates reference signal which is further processed through level-shifted multi-carrier PWM strategy for the generation of gate pulses to multi-level DSTATCOM structure. Simulation work of proposed system is developed and the result analysis is presented using MATLAB/SIMULINK software. Performance of multi-level DSTATCOM topology is verified with fixed and variable loads.
Improving output current of inductor-cell based five-level CSI using hysteresis current controller
Authors: Suroso Suroso , Winasis Winasis , Priswanto Priswanto , Sholikhah Sholikhah
Published: March 2021

Current source inverter (CSI) operates to output a specified ac current waveform from dc current sources. Talking about power quality, harmonics distortion of ac waveform is a problem of an inverter circuit. Generating a multilevel current waveform will have less harmonics content than a traditional three-level current waveform. In addition to non-ideal conditions of power switches, i.e. voltage drop in diodes, conductors or controlled switches, the performance of current controller applied in an inverter circuit will considerably affect the ac waveform quality produced by inverter circuit. This paper presents and discusses application of hysteresis current controller in the five-level H-bridge with inductor-cell current source inverter. The current controller performance was compared with the proportional integral current controller. Some test results are presented and discussed to explore the advantages of hysteresis controller in reducing the current ripple and harmonics distortion of output current.
Comparison and assessment of a different steel materials based on core losses reduction for three-phase induction motor
Authors: Yassin Yaser Atta , Hussain Ali Nasser , Ahmed Nagham Yassin
Published: March 2021

This paper presents a core losses and performance calculation with different type of steel materials in the core design for three-phase induction motor by using "ANSYS Maxwell" program in order to identify the core material that provides the most effective performance by iron losses reduction. The coefficients of core losses are calculated from the magnetization curve and core Loss curve based on the on steel material databases. Although the difficult to obtain because of the little of existing information. Results show the capability of the proposed Cobalt steel (Hiperco 50) to achieve the significant losses reduction in comparison to the Electrical Steel NGO–AK Steel’s M-19 and Low Carbon Steel-SAE1020.
Finite frequency H∞control design for nonlinear systems
Authors: Lahlou Zineb , EL-Amrani Abderrahim , Boumhidi Ismail
Published: March 2021

The work deals finite frequency H∞ control design for continuous time nonlinear systems, we provide sufficient conditions, ensuring that the closed-loop model is stable. Simulations will be gifted to show level of attenuation that a H∞ lower can be by our method obtained developed where further comparison.
Power quality improvement using fuzzy logic-based compensation in a hybrid power system
Authors: Das Soumya Ranjan , Mishra Debani Prasad , Ray Prakash Kumar , Salkuti Surender Reddy , Sahoo Arun Kumar
Published: March 2021

This paper is based on the improvement of power quality (PQ) using fuel cell and fuzzy based controller. By using the proposed controller, the quality of power in the grid system especially in micro grid connected with non- linear and unbalanced load is enhanced. The configuration of the system is combined with hybrid arrangement of photovoltaic ([PV) with wind energy conversion system (WECS), fuel cell (FC) including the compressed air energy storage system (CAES) where the power management is controlled by using the distributed power sharing technique. In this proposed system the distortions in voltage at point of common coupling (PCC) is decreased by using the FC which acts as compensator in hybrid system. Reference current is developed which depends on real and reactive power of the source connected to the compensator. Based on demand of power for nonlinear load, without using any external communication interfaces, the proposed control theory can change the modes of operation and can compensate the unbalance in the system which is caused due to single-phase micro sources and load changes. The complete productive design of the micro-sources and power electronic converters are presented in the paper. The operation and performance of the proposed controller used in microgrid is validated through simulation in MATLAB/Simulink environment.
Interaction of Obesity and Hypertension on Cardiac Metabolic Remodeling and Survival Following Myocardial Infarction
Authors: Mouton Alan J. , Flynn Elizabeth R. , Moak Sydney P. , Li Xuan , da Silva Alexandre A. , Wang Zhen , do Carmo Jussara M. , Hall Michael E. , Hall John E.
Published: March 2021

Background

Obesity and hypertension are risk factors for myocardial infarction (MI); however, their potential interactions on post‐MI outcomes are unclear. We examined interactions of obesity and hypertensionon post‐MI function, remodeling, metabolic changes, and recovery.

Methods and Results

Male and female C57BL/6J mice were provided standard chow or high‐fat/fructose diet for 8 weeks and then infused with angiotensin II for 2 weeks to induce hypertension. MI was then induced by surgical ligation of the left coronary artery for 7 days. Obesity alone did not cause cardiac injury or exacerbate hypertension‐induced cardiac dysfunction. After MI, however, obese‐normotensive mice had lower survival rates compared with chow‐fed mice (56% versus 89% males; 54% versus 75% females), which were further decreased by hypertension (29% males; and 35% females). Surviving obese‐normotensive males displayed less left ventricular dilation and pulmonary congestion compared with chow‐fed males after MI; hypertension reversed left ventricular dilation because of high‐fat/fructose diet and promoted significant pulmonary congestion compared with chow‐fed controls. Obese‐normotensive males displayed higher left ventricular α‐MHC (alpha‐myosin heavy chain) protein, phosphorylated Akt (protein kinase B) and AMPK (adenosine‐monophosphate activated kinase), PPAR‐γ (peroxisome proliferator activated receptor gamma), and plasma adiponectin levels after MI, indicating favorable contractile and metabolic changes. However, these favorable contractile and metabolic changes were attenuated by hypertension. Obese‐hypertensive males also had lower levels of collagen in the infarcted region, indicating decreased ability to promote an adaptive wound healing response to MI.

Conclusions

Obesity reduces post‐MI survival but is associated with improved post‐MI cardiac function and metabolism in surviving normotensive mice. When hypertension accompanies obesity, favorable metabolic pathways associated with obesity are attenuated and post‐MI cardiac function and remodeling are adversely impacted.
Semantic Data Set Construction from Human Clustering and Spatial Arrangement
Authors: Majewska Olga , McCarthy Diana , van den Bosch Jasper J. F. , Kriegeskorte Nikolaus , Vulić Ivan , Korhonen Anna
Published: March 2021

Research into representation learning models of lexical semantics usually utilizes some form of intrinsic evaluation to ensure that the learned representations reflect human semantic judgments. Lexical semantic similarity estimation is a widely used evaluation method, but efforts have typically focused on pairwise judgments of words in isolation, or are limited to specific contexts and lexical stimuli. There are limitations with these approaches that either do not provide any context for judgments, and thereby ignore ambiguity, or provide very specific sentential contexts that cannot then be used to generate a larger lexical resource. Furthermore, similarity between more than two items is not considered. We provide a full description and analysis of our recently proposed methodology for large-scale data set construction that produces a semantic classification of a large sample of verbs in the first phase, as well as multi-way similarity judgments made within the resultant semantic classes in the second phase. The methodology uses a spatial multi-arrangement approach proposed in the field of cognitive neuroscience for capturing multi-way similarity judgments of visual stimuli. We have adapted this method to handle polysemous linguistic stimuli and much larger samples than previous work. We specifically target verbs, but the method can equally be applied to other parts of speech. We perform cluster analysis on the data from the first phase and demonstrate how this might be useful in the construction of a comprehensive verb resource. We also analyze the semantic information captured by the second phase and discuss the potential of the spatially induced similarity judgments to better reflect human notions of word similarity. We demonstrate how the resultant data set can be used for fine-grained analyses and evaluation of representation learning models on the intrinsic tasks of semantic clustering and semantic similarity. In particular, we find that stronger static word embedding methods still outperform lexical representations emerging from more recent pre-training methods, both on word-level similarity and clustering. Moreover, thanks to the data set’s vast coverage, we are able to compare the benefits of specializing vector representations for a particular type of external knowledge by evaluating FrameNet- and VerbNet-retrofitted models on specific semantic domains such as “Heat” or “Motion.”
A Novel Integrated Information Processing Model of Presence
Authors: Berthiaume Maxine , Corno Giulia , Nolet Kevin , Bouchard Stéphane
Published: March 2021

The objective of this article is to conduct a narrative literature review on multisensory integration and propose a novel information processing model of presence in virtual reality (VR). The first half of the article introduces basic multisensory integration (implicit information processing) and the integration of coherent stimuli (explicit information processing) in the physical environment, offering an explanation for people's reactions during VR immersions and is an important component of our model. To help clarify these concepts, examples are provided. The second half of the article addresses multisensory integration in VR. Three models in the literature examine the role that multisensory integration plays in inducing various perceptual illusions and the relationship between embodiment and presence in VR. However, they do not relate specifically to presence and multisensory integration. We propose a novel model of presence using elements of these models and suggest that implicit and explicit information processing lead to presence. We refer to presence as a perceptual illusion that includes a plausibility illusion (the feeling that the scenario in the virtual environment is actually occurring) and a place illusion (the feeling of being in the place depicted in the virtual environment), based on efficient and congruent multisensory integration.
Fog and Low-Level Stratus in Coupled Ocean–Atmosphere Simulations of the Northern California Current System Upwelling Season
Authors: Samelson R. M. , de Szoeke S. P. , Skyllingstad E. D. , Barbour P. L. , Durski S. M.
Published: March 2021

Fog and low-level stratus during April–September 2009 are examined in a set of coupled ocean–atmosphere numerical simulations of the northern California Current System (CCS). The model configurations differ only in the choice of planetary boundary layer (PBL) parameterization scheme and, in one case, surface flux scheme. The results suggest that fog formation in this region primarily occurs through condensation at the surface induced locally by surface cooling, when moist offshore air is advected over cold upwelled waters and the shallow coastal marine PBL is further stabilized by warm, dry, continental air that extends offshore above the PBL inversion. These results are consistent with some but not all prior hypotheses for fog formation in the CCS region. Fog formation by downward growth of a preexisting stratus layer is also found in the simulations, but dominates only in those simulations with PBL schemes that produce an extensive and evidently unphysical stratus layer at 200 m height, which serves as the source for the downward growth. The stronger fog response in later summer months arises from seasonal warming of offshore SST, which increases the moisture content and temperature of the upstream air mass, while cool coastal SSTs are maintained by upwelling. On synoptic time scales, a similar influence of fog response on upstream conditions is found but controlled instead by changes in wind direction. These results suggest that the critical factors determining the evolution of the coastal fog regime in a warming climate are likely the temperature of upwelling source waters and the offshore flow of continental air.
‘The More we Wonder’: Union with God, Distance from God, and the Vexing Question of ‘Necessary Reasons’ in Aquinas’s Trinitarian Theology
Authors: Higgins Michael Joseph
Published: March 2021

Scholars have long noted that there is a tension between the strength of Thomas’s arguments for the Trinity and the limits he places on natural reason. Very few, however, have noted a curious pattern: it is often within the same passage that Thomas both seems to prove the Trinity and rules out the possibility of any such proof. This paper begins by drawing out this pattern. It then proposes that this tension in Thomas’s thought might be a reflection of, and an education into, a deeper tension: the tension between union with God and distance from God that structures the beatific vision into which Thomas’s Trinitarian theology hopes to initiate us.
A review on braking control and optimization techniques for electric vehicle
Authors: Jamadar Najmuddin M , Jadhav Himmat T
Published: March 2021

In this modern world, due to limited fossil fuels, increasing cost, and environmental concerns a clean and sustainable transportation system in the form of electric vehicles (EV) is now becoming popular. On the other hand, electric vehicles have an advantage such as zero-emission, less maintenance, comfortable ride, less noise, etc. An electric vehicle is driven by an electric motor so considering driving patterns and road traffic conditions the vehicle often requires braking operation. The most common method is to employ mechanical brakes to reduce the speed of EV. However, mechanical braking mechanism results in friction which in turn, into heating losses and reduces the efficiency of EV. Therefore, regenerative braking system (RBS) and energy management system are employed in addition to mechanical braking for increasing the braking efficiency of the EV system. It is reported in many literatures about different regenerative braking control techniques for EV systems. This paper presents a review of regenerative braking and braking energy management techniques by considering different driving situations and road conditions.
Ageism in the time of COVID-19
Authors: Swift Hannah J. , Chasteen Alison L.
Published: March 2021

In this article, we outline how the response to the coronavirus (COVID-19) pandemic has the potential to fundamentally change how we think and feel about our own age, and how we think and feel about other age groups. Specifically, we outline how discourse surrounding the pandemic has strengthened the homogeneous view of older adults as vulnerable, has socially stigmatized being an older adult, and has exacerbated hostile and benevolent expressions of ageism. We explore the impact of these changing dynamics on intergenerational cohesion and relations, and propose that understanding theories of ageism will be essential for how we handle future pandemics in order to reduce the potential negative impact of crises on individuals as well as on communities and societies.
Unemployment prevention: The role of Human Resource Management in job-to-job transitions in the event of redundancy
Authors: Borghouts – van de Pas Irmgard , Bosmans Mark , Freese Charissa
Published: March 2021

In downsizing organisations, redundant workers suffer from insecurities about work and income. Social security provides income security to the unemployed in the event of job loss. The role played by employers in unemployment prevention for redundant workers, and the effects on unemployment spells and transitions on the labour market, are neglected in both the social policy and HRM literatures. This article addresses the following question: Which factors play a role in the decision to offer job-to-job support and in determining its effect? This article provides the context for the theoretical assumptions regarding why employers initiate job-to-job measures for redundant employees and distinguishes the different types of measures based on a literature review. Secondly, this article contributes to empirical knowledge in the field of unemployment prevention among employers and the effects of job-to-job activities facilitated by employers on redundant workers’ unemployment spells. A two-wave study was conducted on a sample of 2,258 Dutch redundant workers. The study shows that age, breadwinner status and gender are important predictors of unemployment duration after involuntary dismissal. The findings show that investing in the human capital of redundant workers by providing training and education and individual coaching, for example, are associated with a reduced unemployment spell. In our model, in which we controlled for other variables, we found that when one received training, education or individual coaching shortly before or after the dismissal, one was unemployed for an average of almost three months less.
Treatment response to cyclophosphamide, rituximab, and bortezomib in chronic immune-mediated sensorimotor neuropathies: a retrospective cohort study
Authors: Motte Jeremias , Fisse Anna Lena , Köse Nuray , Grüter Thomas , Mork Hannah , Athanasopoulos Diamantis , Fels Miriam , Otto Susanne , Siglienti Ines , Schneider-Gold Christiane , Hellwig Kerstin , Yoon Min-Suk , Gold Ralf , Pitarokoili Kalliopi
Published: March 2021

Background:

Up to 20% of patients with chronic immune-mediated sensorimotor neuropathies (CIN) do not respond adequately to first-line therapies. However, studies on further treatment are scarce.

Methods:

We analyzed retrospectively 200 CIN patients regarding disease characteristics and response to therapy with cyclophosphamide (CYP), rituximab (RTX), and bortezomib (BTZ). Treatment response was defined as improvement or stabilization of inflammatory neuropathy cause and treatment overall disability score (INCAT-ODSS).

Results:

A total of 48 of 181 patients (26.5%) received therapy with CYP, RTX, or BTZ. The most frequently and first used therapy was CYP (69%). More than 40% of patients needed a second or third treatment. Overall, 71 treatments were applied in 48 patients. The combination of up to all three treatments enhanced the response-rate to 90%. Treatment within 24 months after initial diagnosis resulted in significantly higher response rate than late treatment (79% versus 50 %, p = 0.04, χ2-test, n = 46) and in lower disability in long-term follow up (INCAT-ODSS 3.8 versus 5.8, p = 0.02, t-test, n = 48). Patients with Lewis-Sumner syndrome ( n = 9) and autoantibody mediated neuropathies ( n = 13) had excellent response rates after treatment with RTX (90–100%). In contrast, typical chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) showed a response rate of 64% in CYP, 64% in RTX, and 75% in BTZ.

Conclusion:

Treatment with CYP, RTX, or BTZ was effective in this cohort of CIN refractory to first-line treatment. Our data increase evidence for an early use of these therapies. High efficacy of RTX in Lewis-Sumner syndrome in contrast to typical CIDP suggests a distinct pathophysiology.
Intra-articular Morphine and Ropivacaine Injection Provides Efficacious Analgesia As Compared With Femoral Nerve Block in the First 24 Hours After ACL Reconstruction: Results From a Bone–Patellar Tendon–Bone Graft in an Adolescent Population
Authors: Mitchell Brendon C. , Siow Matthew Y. , Pennock Andrew T. , Edmonds Eric W. , Bastrom Tracey P. , Chambers Henry G.
Published: March 2021

Background:

Opioid consumption and patient satisfaction are influenced by a surgeon’s pain-management protocol as well as the use of adjunctive pain mediators. Two commonly utilized adjunctive pain modifiers for anterior cruciate ligament (ACL) reconstruction are femoral nerve blockade and intra-articular injection; however, debate remains regarding the more efficacious methodology.

Hypothesis:

We hypothesized that intra-articular injection with ropivacaine and morphine would be found to be as efficacious as a femoral nerve block for postoperative pain management in the first 24 hours after bone–patellar tendon–bone (BTB) ACL reconstruction.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Charts were retrospectively reviewed for BTB ACL reconstructions performed by a single pediatric orthopaedic surgeon from 2013 to 2019. Overall, 116 patients were identified: 58 received intra-articular injection, and 58 received single-shot femoral nerve block. All patients were admitted for 24 hours. Pain scores were assessed every 4 hours. Morphine milligram equivalents (MMEs) consumed were tabulated for each patient.

Results:

Opioid use was 24.3 MMEs in patients treated with intra-articular injection versus 28.5 MMEs in those with peripheral block ( P = .108). Consumption of MMEs was greater in the intra-articular group in the 0- to 4-hour period (7.1 vs 4.6 MMEs; P = .008). There was significantly less MME consumption in patients receiving intra-articular injection versus peripheral block at 16 to 20 hours (3.2 vs 5.6 MMEs; P = .01) and 20 to 24 hours (3.8 vs 6.5 MMEs; P < .001). Mean pain scores were not significantly different over the 24-hour period (peripheral block, 2.7; intra-articular injection, 3.0; P = .19).

Conclusion:

Within the limitations of this study, we could identify no significant difference in MME consumption between the single-shot femoral nerve block group and intra-articular injection group in the first 24 hours postoperatively. While peripheral block is associated with lower opioid consumption in the first 4 hours after surgery, patients receiving intra-articular block require fewer opioids 16 to 24 hours postoperatively. Given these findings, we propose that intra-articular injection is a viable alternative for analgesia in adolescent patients undergoing BTB ACL reconstruction.
Cross-sectional survey of depressive symptoms and suicide-related ideation at a Japanese national university during the COVID-19 stay-home order
Authors: Nomura Kyoko , Minamizono Sachiko , Maeda Eri , Kim Roseline , Iwata Toyoto , Hirayama Junko , Ono Kyoichi , Fushimi Masahito , Goto Takeshi , Mishima Kazuo , Yamamoto Fumio
Published: March 2021

Background

We aimed to estimate the prevalence of depressive symptoms as well as suicide-related ideation among Japanese university students during the stay-home order necessitated by the coronavirus disease 2019 pandemic in Japan, and offer evidence in support of future intervention to depression and suicide prevention strategies among college and university students.

Methods

The data for this cross-sectional study were derived from the Student Mental Health Survey conducted from May 20 to June 16, 2020 at a national university in Akita prefecture. Among the 5111 students recruited, 2712 participated in this study (response rate, 53%; mean age ± standard deviation, 20.5 ±3.5 years; men, 53.8%). Depressive symptoms were identified by using the Patient Health Questionnaire-9 (PHQ-9).

Results

The prevalence of moderate depressive symptoms based on a PHQ-9 score ≥10 and suicide-related ideation based on question 9 of PHQ-9 ≥1, which encompasses thoughts of both suicide and self-harm, was 11.7% and 6.7%, respectively. Multivariable logistic regression analyses showed that risk factors for depression included being a woman, smoking, alcohol consumption, and social network communication using either video or voice. For suicide-related ideation, alcohol consumption was the only risk factor. Exercise and having someone to consult about worries were associated with decreased risk of both depressive symptoms and suicide-related ideation.

Conclusions

Negative lifestyles of smoking and drinking, and being a woman, may be important risk factors for depressive symptoms, whereas exercise and having someone to consult about worries may be protective factors.
High-generation near-isogenic lines combined with multi-omics to study the mechanism of polima cytoplasmic male sterility
Authors: Wang Benqi , Farooq Zunaira , Chu Lei , Liu Jie , Wang Huadong , Guo Jian , Tu Jinxing , Ma Chaozhi , Dai Cheng , Wen Jin , Shen Jinxiong , Fu Tingdong , Yi Bin
Published: March 2021

Background

Cytoplasmic male sterility (CMS), which naturally exists in higher plants, is a useful mechanism for analyzing nuclear and mitochondrial genome functions and identifying the role of mitochondrial genes in the plant growth and development. Polima (pol) CMS is the most universally valued male sterility type in oil-seed rape. Previous studies have described the pol CMS restorer gene Rfp and the sterility-inducing gene orf224 in oil-seed rape, located in mitochondria. However, the mechanism of fertility restoration and infertility remains unknown. Moreover, it is still unknown how the fecundity restorer gene interferes with the sterility gene, provokes the sterility gene to lose its function, and leads to fertility restoration.

Result

In this study, we used multi-omics joint analysis to discover candidate genes that interact with the sterility gene orf224 and the restorer gene Rfp of pol CMS to provide theoretical support for the occurrence and restoration mechanisms of sterility. Via multi-omics analysis, we screened 24 differential genes encoding proteins related to RNA editing, respiratory electron transport chain, anther development, energy transport, tapetum development, and oxidative phosphorylation. Using a yeast two-hybrid assay, we obtained a total of seven Rfp interaction proteins, with orf224 protein covering five interaction proteins.

Conclusions

We propose that Rfp and its interacting protein cleave the transcript of atp6/orf224, causing the infertility gene to lose its function and restore fertility. When Rfp is not cleaved, orf224 poisons the tapetum cells and anther development-related proteins, resulting in pol CMS mitochondrial dysfunction and male infertility. The data from the joint analysis of multiple omics provided information on pol CMS’s potential molecular mechanism and will help breed B. napus hybrids.
Long-term phlebotomy successfully alleviated hepatic iron accumulation in a ferroportin disease patient with a mutation in SLC40A1: a case report
Authors: Nishina Sohji , Tomiyama Yasuyuki , Ikuta Katsuya , Tatsumi Yasuaki , Toki Yasumichi , Kato Ayako , Kato Koichi , Yoshioka Naoko , Sasaki Kyo , Hara Yuichi , Hino Keisuke
Published: March 2021

Background

Hereditary hemochromatosis is a heterogenous group of inherited iron-overload conditions that is characterized by increased intestinal absorption and deposition in vital organs. Hepcidin is a soluble regulator that acts to attenuate both intestinal iron absorption and iron release from reticuloendothelial macrophages through internalization of ferroportin-1, an iron exporter. Ferroportin disease is hereditary hemochromatosis which is affected by SLC40A1, a gene coding ferroportin-1, and phenotypically classified into two forms (classical and nonclassical). In nonclassical form, ferroportin mutations are responsible for a gain of function with full iron export capability but insensitivity to downregulation by hepcidin. Here, we report a case of nonclassical ferroportin disease.

Case presentation

A 46-year-old Japanese man showed elevated serum iron (284 μg/dl), ferritin (1722 ng/ml), transferrin saturation ratio (91.3%), and hepcidin-25 level (139.6 ng/ml). Magnetic resonance imaging (MRI) demonstrated a marked reduction in the signal intensity of the liver in T1- and T2-weighted images. The liver histology exhibited a large amount of iron that had accumulated predominantly in hepatocytes. We identified a heterozygous 1520A > G (p.H507R) mutation in the SLC40A1 gene. Phlebotomy (400 ml at a time) was monthly performed for 3 years in this patient. Importantly, the serum hepcidin level (1.0 ng/ml) was normal when the serum ferritin level was normal and hepatic iron accumulation was remarkably reduced after 3 years of phlebotomy.

Conclusions

The present case demonstrated for the first time that there was a correlation between hepatic iron levels as measured by MRI and serum hepcidin levels through long-term phlebotomy in a patient with ferroportin disease with the p.H507R mutation of in SLC40A1.
Controlling Nutritional Status (CONUT) score as a predictive marker for short-term complications following gastrectomy of gastric cancer: a retrospective study
Authors: Sun Feng , Zhang Chen , Liu Zhijian , Ai Shichao , Guan Wenxian , Liu Song
Published: March 2021

Background

It is well established that the controlling nutritional status (CONUT) score was correlated with long-term outcomes in gastric cancer (GC), but the significance of CONUT for postoperative short-term outcomes remains unclear. The study aimed to characterize the relationship between CONUT and short-term complications following gastrectomy of GC.

Methods

We collected data on 1479 consecutive GC patients at Nanjing Drum Tower Hospital between January 2016 and December 2018. Univariate and multivariate analyses of predictive factors for postoperative complications were performed. The cutoff value of the CONUT score was determined by Youden index.

Results

Among all of the patients, 431 (29.3%) patients encountered postoperative complications. Multivariate analyses identified CONUT was an independent predictor for postoperative short-term complications (OR 1.156; 95% CI 1.077–1.240; P < 0.001). Subgroup analysis elucidated that CONUT was related to postoperative complications both in early gastric cancer and advanced gastric cancer. We further explored that patients with high CONUT score had prolonged hospital stay (12.3 ± 6.0 vs 11.1 ± 4.6, P < 0.001) and more total hospital charges (7.6 ± 2.4 vs 7.1 ± 1.6, P < 0.001).

Conclusions

The present study demonstrated that the preoperative CONUT was an independent predictor for short-term complications following gastrectomy of GC.
Facilitators and barriers to implement nurse-led interventions in long-term dementia care: a qualitative interview study with Swiss nursing experts and managers
Authors: Hirt Julian , Karrer Melanie , Adlbrecht Laura , Saxer Susi , Zeller Adelheid
Published: March 2021

Background

To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care.

Methods

We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript.

Results

Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention».

Conclusions

To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.