bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Fund financing and human resources for health investments in the Eastern Mediterranean Region
Authors: Okunogbe Adeyemi , Bowser Diana , Gedik Gulin , Naseri Saha , Abu-Agla Ayat , Safi Najibullah
Published: July 2020

Background

Despite the large investments in donor-related health activities in areas of the globe prone to tension and conflict, few studies have examined in detail the role of these donor investments in human resources for health (HRH).

Methods

We used a mixed-methods research methodology comprising both quantitative and qualitative analyses to analyze the Enhanced Financial Reporting System of the Global Fund to Fight AIDS, Tuberculosis and Malaria budget and expenditure data from 2003 to 2017 for 13 countries in the Eastern Mediterranean Region (EMR). We analyzed additional detailed budgetary data over the period 2015–2017 for a sub-set of these countries. Two country-case studies were conducted in Afghanistan and Sudan for a more in-depth understanding of the HRH-related activities that occurred as a result of Global Fund grants.

Results

The results show that US$2.2 billion Global Fund dollars had been budgeted and US$1.6 billion were expended over the period 2003–2017 in 13 Eastern Mediterranean countries. The average expenditures for human resources for health (training and human resources) as a percentage of total expenditure are 28%. Additional detailed budgetary data analysis shows a more conservative investment in HRH with 13% of total budgets allocated to “direct” HRH activities such as salaries, training costs, and technical assistance. HRH-related activities supported by the Global Fund in Afghanistan and Sudan were similar, including pre-service and in-services training, hiring of program coordinators and staff, and top-ups for clinical staff.

Conclusions

HRH remains a key issue in strengthening the health systems of low- and middle-income countries. While this study suggests that Global Fund’s HRH investments in the EMR are not lagging behind the global average, there appears to be a need to further scale up these investments considering this region’s unique HRH challenges.
Phospho-Tyr705 of STAT3 is a therapeutic target for sepsis through regulating inflammation and coagulation
Authors: Xu Shunyao , Pan Xiaojun , Mao Lingjie , Pan Hao , Xu Wenwei , Hu Yufeng , Yu Xueshu , Chen Zhiqiang , Qian Songzan , Ye Yincai , Huang Yueyue , Pan Jingye
Published: July 2020

Background

Sepsis is an infection-induced aggressive and life-threatening organ dysfunction with high morbidity and mortality worldwide. Infection-associated inflammation and coagulation promote the progression of adverse outcomes in sepsis. Here, we report that phospho-Tyr705 of STAT3 (pY-STAT3), not total STAT3, contributes to systemic inflammation and coagulopathy in sepsis.

Methods

Cecal ligation and puncture (CLP)-induced septic mice were treated with BP-1-102, Napabucasin, or vehicle control respectively and then assessed for systemic inflammation, coagulation response, lung function and survival. Human pulmonary microvascular endothelial cells (HPMECs) and Raw264.7 cells were exposed to lipopolysaccharide (LPS) with pharmacological or genetic inhibition of pY-STAT3. Cells were assessed for inflammatory and coagulant factor expression, cell function and signaling.

Results

Pharmacological inhibition of pY-STAT3 expression by BP-1-102 reduced the proinflammatory factors, suppressed coagulation activation, attenuated lung injury, alleviated vascular leakage and improved the survival rate in septic mice. Pharmacological or genetic inhibition of pY-STAT3 diminished LPS-induced cytokine production in macrophages and protected pulmonary endothelial cells via the IL-6/JAK2/STAT3, NF-κB and MAPK signaling pathways. Moreover, the increase in procoagulant indicators induced by sepsis such as tissue factor (TF), the thrombin-antithrombin complex (TAT) and D-Dimer were down-regulated by pY-STAT3 inhibition.

Conclusions

Our results revealed a therapeutic role of pY-STAT3 in modulating the inflammatory response and defective coagulation during sepsis.
Correction to: l-Fucose ameliorates high-fat diet-induced obesity and hepatic steatosis in mice
Authors: Wu Guangyan , Niu Mengwei , Tang Wenli , Hu Jingjuan , Wei Guoquan , He Zhanke , Chen Yangping , Jiang Yong , Chen Peng
Published: July 2020

An amendment to this paper has been published and can be accessed via the original article.
Towards a better estimation of prevalence of female genital mutilation in the European Union: a situation analysis
Authors: De Schrijver L. , Van Baelen L. , Van Eekert N. , Leye E.
Published: July 2020

Background

Female genital mutilation (FGM) is a harmful cultural practice that is predominantly documented in Africa, but also occurs in other parts of the world. Due to migration, women who have undergone FGM can also be found in the European Union (EU). Due to a lack of systematic representative surveys on the topic in EU, the prevalence of FGM and the number of women and children subjected to the practice remains unknown. However, information on the magnitude of the problem in the EU is necessary for policy makers to design and track preventive measures and to determine resource allocation.

Methods

Between March 2015 and May 2015, we performed a situation analysis consisting of a critical interpretive synthesis and SWOT-analysis of available at the time peer reviewed and grey literature document on national prevalence studies on FGM in the EU. Studies estimating the prevalence of FGM and the number of girls and women subjected to the practice in the EU were mapped to analyse their methodologies and identify their Strengths, Weakness, Opportunities and Threats (SWOT). Distinction was made between direct and indirect estimation methods.

Results

Thirteen publications matched the prioritized inclusion criteria. The situation analysis showed that both direct and indirect methodologies were used to estimate FGM prevalence and the number of girls and women subjected to FGM in the EU. The SWOT-analysis indicated that due to the large variations in the targeted population and the available secondary information in EU Member States, one single estimation method is not applicable in all Member States.

Conclusions

We suggest a twofold method for estimating the number of girls and women who have undergonefgmin the EU. For countries with a low expected prevalence of women who have undergonefgm, the indirect method will provide a good enough estimation of the FGM prevalence. The extrapolation-of-fgm-countries-prevalence-data-method, based on the documented FGM prevalence numbers in DHS and MICS surveys, can be used for indirect estimations of girls and women subjected to FGM in theeu. For countries with a high expected prevalence of FGM in the EU Member State, we recommend to combine both a direct estimation method (e.g. in the form of a survey conducted in the target population) and an indirect estimation method and to use a sample design as developed by the FGM-PREV project. The choice for a direct or indirect method will ultimately depend on available financial means and the purpose for the estimation.
The newly emerged COVID-19 disease: a systemic review
Authors: Abebe Endeshaw Chekol , Dejenie Tadesse Asmamaw , Shiferaw Mestet Yibeltal , Malik Tabarak
Published: July 2020

Coronaviruses are large family-RNA viruses that belong to the orderNidovirales, familyCoronaviridae, subfamilyCoronavirinae. The novel COVID-19 infection, caused by a beta coronavirus calledSARS-CoV-2, is a new outbreak that has been emerged in Wuhan, China in December 2019. The most common symptoms of COVID-19 are fever, cough, and dyspnea. As per the March 12, 2020, WHO report, more than 125,048 confirmed COVID-19 cases and over 4613 deaths have been identified in more than 117 countries. It is now regarded as a pandemic that seriously spread and attack the world. The primary means of transmission is person to person through droplets that occurred during coughing or sneezing, through personal contact (shaking hands), or by touching contaminated objects. So far, there is no effective therapy and vaccine available against this novel virus and therefore, only supportive care is used as the mainstay of management of patients with COVID-19. The mortality rate of COVID-19 is considerable. This work aimed to provide insight on the newly emerged COVID-19, in the hope to gain a better understanding on the general overview, epidemiology, transmission, clinical features, diagnosis, treatment, and clinical outcomes as well as the prevention and control of COVID-19.
Left atrial cardiac Tamponade complicating radical nephrectomy – case report
Authors: Thompson Dominic , Ali Ihab , Gilbert Michael , Zaidi Afzal
Published: July 2020

Background

We present an unusual case of pericardial tamponade occurring subsequent to a radical right nephrectomy performed entirely through a laparotomy.

Case presentation

A 43 year old gentleman who presented with large loculated posterior pericardial effusion compressing the left atrium, following a radical nephrectomy performed entirely through a laparotomy. He required an emergency sternotomy, pericardial and pleural drainage.

Conclusion

Cardiac tamponade is an extremely rare complication of radical nephrectomy. However, any procedure that involves opening of the pericardium does carry a risk of bleeding and therefore cardiac tamponade, particularly in the context of post-operative full anticoagulation.
Case report: uniportal video-assisted thoracoscopic resection of a solitary fibrous tumor preoperatively predicted visceral pleura origin using dynamic chest radiography
Authors: Tamura Masaya , Matsumoto Isao , Saito Daisuke , Yoshida Shuhei , Takata Munehisa , Takemura Hirofumi
Published: July 2020

Background

Dynamic chest radiography (DCR) is a flat-panel detector (FPD)-based functional X-ray imaging, which is performed as an additional examination in chest radiography. DCR provides objective and quantifiable information, such as diaphragm movement, pulmonary ventilation and circulation, and is reasonable for detecting tumor invasion or adhesion.

Case presentation

We present a case of Solitary Fibrous Tumor of Pleura (SFTP), preoperatively predicted visceral pleura origin using Dynamic chest radiography (DCR) and surgically resected through single-access (uniportal) video-assisted thoracoscopic surgery (UVATS).

Conclusions

UVATS may be a suitable surgical option for pedunculated SFTPs. Dynamic chest radiography provides information, such as tumor invasion or adhesion and helpful for predicting origin of the tumor.
Factors associated with refractory autoimmune necrotizing myopathy with anti-signal recognition particle antibodies
Authors: Zhao Yawen , Zhang Wei , Liu Yilin , Wang Zhaoxia , Yuan Yun
Published: July 2020

Background

Autoimmune necrotizing myopathy with anti-signal recognition particle antibodies (ANM-SRP) is regarded as refractory myositis, whereby some patients respond poorly to conventional immunosuppression and require B cell depletion treatment. This study aimed to evaluate factors associated with refractory ANM-SRP.

Results

Clinical and pathological data from 48 patients with ANM-SRP were collected. We followed up clinical symptoms and image changes over 12 months. Univariate and multivariate analyses were undertaken to determine the associations between variables of interest and poor response to therapy. Refractory ANM-SRP appeared in 32.5% of patients who showed no or minimal improvement after 12 months of steroid therapy. The clinical risk factors for refractory patients were being male (OR, 19.57; P < 0.001), severe muscle weakness (OR, 7.51; P < 0.001) and concurrent interstitial lung disease (OR, 39.70; P < 0.001). The imaging refractory-related factor was the fatty infiltration rate of thigh muscles over 3 months (P = 0.022) and the pathological factor associated with refractory ANM-SRP was the high expression of B cell activating factor receptor (BAFF-R) in muscle (P = 0.036).

Conclusion

Being male, severe muscle weakness, concurrent interstitial lung disease, quick development of muscle fatty infiltration and more BAFF-R and B lymphocyte infiltration in muscle indicate a poor response to immunosuppressive therapy in patients with ANM-SRP.
Association between recipient survival and blood donor age after blood transfusion in a surgery intensive care unit: a multicenter randomized controlled trial study protocol
Authors: Zeng Xianfei , Liao Yan , Wu Xiaoshuang , Xu Jinmei , Da Chenxing , Tan Zhijun , Feng Fan , Yin Wen , Wang Dongjian , Hu Xingbin
Published: July 2020

Background

Blood from younger individuals has been shown to improve physiological function in recipients in laboratory research, and many proteins from human peripheral blood show antisenescence capabilities. Thus, researchers have questioned whether blood from young donors is superior to blood from older donors. Blood transfusion is a key supportive therapy for trauma patients, and recent studies have reported the influence of blood donor age on recipient patient prognosis. Although some retrospective results found that blood from young donors improves survival, no influence of blood donor age was observed on outcomes in other study groups. The reasons for this discrepancy are complicated, but the fact that data were not obtained from randomized controlled trial (RCT) data should be considered. The current protocol and analysis method provide a feasible RCT design to evaluate the prognosis of severely ill surgery patients who were transfused with blood products from blood donors of different ages.

Methods

The current study is a pragmatic multicenter RCT (open, parallel-group, non-masked, superiority trial). Recruited surgery intensive care unit patients will be randomized into three groups and transfused with blood products from male donors of different ages (< 25, 25–45, and > 45 years). Survival time will be measured within 28 days. The survival characteristics, possible interaction between variables, and potential factors associated with death will be analyzed by Kaplan–Meier analysis, two-way ANOVA, and Cox proportional hazards model, respectively.

Trial registration

ChiCTR: ChiCTR190002. Registered on 22 March 2019. http://www.chictr.org.cn/showproj.aspx?proj=36867.
Effect of preoperative immunonutrition on outcomes of colon cancer surgery: study protocol for a randomized controlled trial
Authors: Lee Soo Young , Yeom Seung-Seop , Kim Chang Hyun , Kim Hyeong Rok
Published: July 2020

Background

Current guidelines recommend the prescription of immune-enriched oral nutritional supplements for malnourished patients before major gastrointestinal surgery. However, the benefit of preoperative immunonutrition is still controversial. This randomized controlled trial aims to evaluate the effect of preoperative immunonutrition on the outcomes of surgery for colon cancer.

Methods/design

Patients with primary colon cancer will be included as study participants after screening. They will be randomly assigned (in a ratio of 1:1) to receive preoperative immunonutrition added to the normal diet (experimental arm) or consume normal diet alone (control arm). Patients in the experimental arm will receive oral supplementation (400 mL/day) with arginine and ω-3 fatty acids for 7 days before elective surgery. The primary endpoint is the rate of infectious complications, while the secondary endpoints are postoperative complication rate, change in body weight, length of hospital stay, and nature of fecal microbiome. The authors hypothesize that the rate of infectious complications would be 13% in the experimental arm and 30% in the control arm. With a two-sided alpha of 0.05 and a power of 0.8, the sample size is calculated as 176 patients (88 per arm).

Discussion

Although there have been many studies demonstrating significant benefits of preoperative immunonutrition, these were limited by a small sample size and potential publication bias. Despite the recommendation of immunonutrition before surgery in nutritional guidelines, its role in reduction of rate of infectious complications is still controversial. This trial is expected to provide evidence for the benefits of administration of preoperative immunonutrition in patients with colon cancer.

Trial registration

Clinical Research Information Service KCT0003770. Registered on 15 April 2019.
The implementation and utility of patient screening logs in a multicentre randomised controlled oncology trial
Authors: Lewis Rebecca , Todd Rachel , Newton Michelle , Jones Robert J. , Wilson Caroline , Donovan Jenny L. , Bryan Richard T. , Birtle Alison , Hall Emma ,   on behalf of the POUT Trial Management Group
Published: July 2020

Background

The utility of patient screening logs and their impact on improving trial recruitment rates are unclear. We conducted a retrospective exploratory analysis of screening data collected within a multicentre randomised controlled trial investigating chemotherapy for upper tract urothelial carcinoma.

Methods

Participating centres maintained a record of patients meeting basic screening criteria stipulated in the trial protocol, submitting logs regularly to the clinical trial coordinating centre (CTC). Sites recorded the number of patients ineligible, not approached, declined and randomised. The CTC monitored proportions of eligible patients, approach rate (proportion of eligible patients approached) and acceptance rate (proportion recruited of those approached). Data were retrospectively analysed to identify patterns of screening activity and correlation with recruitment.

Results

Data were collected between May 2012 and August 2016, during which time 71 sites were activated—a recruitment period of 2768 centre months. A total of 1138 patients were reported on screening logs, with 2300 requests for logs sent by the CTC and 47% of expected logs received. A total of 758 patients were reported as ineligible, 36 eligible patients were not approached and 207 declined trial participation. The approach rate was 91% (344/380), and the acceptance rate was 40% (137/344); these rates remained consistent throughout the data collection. The main reason patients provided for declining (99/207, 48%) was not wanting to receive chemotherapy. There was a moderately strong correlation (r = 0.47) between the number reported on screening logs and the number recruited per site. Considerable variation in data between centres was observed, and 54/191 trial participants (28%) enrolled during this period were not reported on logs.

Conclusions

Central collection of screening logs can identify reasons for patients declining trial participation and help monitor trial activity at sites; however, obtaining complete data can be challenging. There was a correlation between the number of patients reported on logs and recruitment; however, this was likely confounded by sites’ available patient population. The use of screening logs may not be appropriate for all trials, and their use should be carefully considered in relation to the associated workload. No evidence was found that central collection of screening logs improved recruitment rates in this study, and their continued use warrants further investigation.

Trial registration

ISRCTN98387754. Registered on 31 January 2012
Stability and bifurcation analysis of an amensalism system with Allee effect
Authors: Zhao Ming , Du Yunfei
Published: July 2020

In this work, we propose and study a new amensalism system with Allee effect on the first species. First, we investigate the existence and stability of all possible coexistence equilibrium points and boundary equilibrium points of this system. Then, applying the Sotomayor theorem, we prove that there exists a saddle-node bifurcation under some suitable parameter conditions. Finally, we provide a specific example with corresponding numerical simulations to further demonstrate our theoretical results.
Characterisation of a hand-held CZT-based gamma camera for 177Lu imaging
Authors: Roth Daniel , Larsson Erik , Sundlöv Anna , Sjögreen Gleisner Katarina
Published: July 2020

Background

Currently, hand-held gamma cameras are being developed for 99mTc imaging, mainly for sentinel lymph node detection. These cameras offer advantages, such as mobility and ease of access, and may be useful also for other applications such as biokinetic studies in animals or for imaging of small, superficial structures in patients. In this work, the suitability of a CZT-based hand-held camera for 177Lu imaging is investigated. The energy response of CZT-based detectors combined with the multiple photon emissions of 177Lu poses new challenges compared to 99mTc imaging, and a thorough camera characterisation is thus warranted.

Methods

Three collimators (LEHR, LEHS, and MEGP) and three energy windows (55 keV, 113 keV, and 208 keV) are investigated. Characterised camera properties include the system spatial resolution, energy resolution, sensitivity, image uniformity, septal penetration, and temperature dependence. Characterisations are made starting from NEMA guidelines when applicable, with adjustments made when required. The applicability of the camera is demonstrated by imaging of a superficially located tumour in a patient undergoing [177 Lu]Lu-DOTA-TATE therapy.

Results

Overall, the results are encouraging. Compared to a conventional gamma camera, the hand-held camera generally has a higher sensitivity for a given collimator. For source-collimator distances below 3 cm, the spatial resolution FWHM is within 6 mm for the LEHR and MEGP collimators. Before uniformity correction, the central field-of-view integral uniformity shows best results for the 113-keV window, with values obtained between 11 and 14%. The corresponding values after uniformity correction are within 3%. Effects of septal penetration are observed but are manageable with a proper combination of collimator and energy window setting. Septal penetration and collimator scatter not only affect the 208-keV window but also contribute with counts in lower windows due to energy-tailing effects. The patient study revealed non-uniform uptake patterns in a region that appeared uniform in a conventional gamma camera image.

Conclusions

The results show that the hand-held camera can be used for 177Lu imaging. A 113-keV energy window combined with LEHR or MEGP collimators provides the best image system characteristics.
Regional ethnic autonomy: thinking and actions on the reconstruction of a unified multi-ethnic country by the CPC
Authors: Chen Jianyue
Published: July 2020

The founding of the People’s Republic of China (PRC) established and consolidated a new type of socialist ethnic relations, and the people of all ethnic groups in China have embarked on a socialist road since then. This “had never occurred in thousands of years” in the history of China’s ethnic relations and was based on the correct path for solving ethnic issues with Chinese characteristics pioneered by the Communist Party of China (CPC), the institutional core of which is the system of regional ethnic autonomy. So to speak, the system of regional ethnic autonomy, as a fundamental political system of the country, is the reconstruction of the important content and system of ethnic relations and the reconstruction of the governance system of a unified multi-ethnic country. Around the year of 1949, the Chinese communists planned the system of regional ethnic autonomy in a systematical and comprehensive manner, and established a basic discourse guiding the ethnic work, ethnic policies and ethnic studies in the PRC. On the basis of historical literature, this paper arranges and sorts out the ethic policies and thinking context at the early stage of the governance by the CPC.
Review on the succession process of Pinus densiflora forests in South Korea: progressive and disturbance-driven succession
Authors: Choung Yeonsook , Lee Jongsung , Cho Soyeon , Noh Jaesang
Published: July 2020

Background

Most of the Pinus densiflora forests, occupying the largest area, have been restored in South Korea since the 1970s. As young pioneer forests, the succession process is under way. Since the forests are distributed nationwide and are vulnerable to disturbances, the process may differ depending on the geography and/or site conditions. Therefore, we reviewed the direction, the seral communities, and the late-successional species of progressive and disturbance-driven succession nationwide in the cool-temperate zone through meta-analysis and empirical observations.

Main text

As a result of a meta-analysis of the direct succession and vertical structure, we found that the P. densiflora forest is in a directionally progressive succession, changing to the broadleaved forest after forming a mixed forest with its overwhelming successor, Quercus species (particularly Q. mongolica and Q. serrata). In dry stands in a relative sense, the Quercus species was favored occupying over 80% of the abundance of the succeeding species. Therefore, in dry stands, it is presumed that Quercus-dominated stage would last for a long time due to the current dominance and long life span, and eventually, it settles as Quercus-broadleaved forest with a site change. Contrary to this, it is presumed that in mesic stands where Quercus species do not occur or have low abundance, the late-successional broadleaved species settle early to form a co-dominant forest with multiple species. Due to geographical limits, the species composition of the two late-successional forests is different. Disturbances such as insect pests and fire retrogressed vulnerable P. densiflora forest for a while. However, it was mostly restored to the Quercus forest and is expected to be incorporated in the pathway of the dry stand.

Conclusions

We revealed the succession process of P. densiflora forests according to geography and moisture and found that stand moisture had a decisive effect on the species and abundance of the successor. Although the P. densiflora forest is undergoing structural changes, the forest is still young; so within a few decades, physiognomy is not likely to change. Therefore, the decrease in the forest area may be due to other causes such as disturbances and forest conversion rather than due to succession.
The protective role of olive oil against gibberellic acid-induced embryotoxicity at prenatal stages of mice
Authors: Abu Amra El-Sabry , Lashein Fakhr El Din M. , Seleem Amin A. , Saleh Manar M.
Published: July 2020

Background

Gibberellic acid (GA3) is a plant growth regulator used to improve the quality of crops but its residues in food causes many hazardous effects. In contrast, olive oil has registered several health benefits including antioxidant, anti-inflammatory, and anti-cancer. Thus, the present study suggests the use of olive oil as a natural food source to counteract the GA3 toxicity during mice development. In a preliminary experiment, 18 mature females were classified into control and GA3-treated subgroups with ascending doses of GA3 (55, 110, 240, 480, 960 mg/kg B.W.) for 2 weeks. In the main experiment, 20 pregnant females at the 7th day of gestation were divided into four groups: G1 is control, G2 treated orally with GA3 (55 mg/kg), G3 treated with olive oil, and G4 treated with GA3-olive oil. The pregnant females were dissected at prenatal stages at E14 and E18 of gestation.

Results

The high doses of GA3 in the preliminary experiment showed decrease of uterine folds, reduction of carbohydrates content and TNFR2 expression of the uterine glands, degeneration of the ovarian follicles, blood vessels congestion, and altered TNFR2 expression in oocyte membrane as compared with the control. In the second experiment, GA3-treated embryo at E14 and E18 revealed histopathological changes and altered TNFR2 immunostaining in the developing liver, kidney, and skin tissues. Treatment of GA3 with olive oil improves the negative effects induced by GA3.

Conclusion

The study concluded that a supplementation rich diet with olive oil creates a protective effect against gibberellic acid-induced embryotoxicity during pregnancy.
Role of magnetic susceptibility-weighted imaging in characterization of cerebral microbleeds in acute ischemic stroke Egyptian obese patients
Authors: Abou Elmaaty Ali Ahmed , Zarad Carmen Ali
Published: July 2020

Objective

The study was done to investigate the role of susceptibility-weighted imaging (SWI) in characterization of cerebral microbleeds (CMBs) and incidence of CMBs in acute ischemic stroke obese patients.

Materials and methods

We recruited 120 acute ischemic stroke obese patients. All participants or their relatives gave written informed consent. MRI of the brain with SWI sequences was done for all patients.

Results

SWI showed 30% of the patients have CMBs. The total numbers of CMBs were statistically significant higher in small vessel diseases (SVDs) than large vessel diseases (LVDs) (P = 0.008). According to the severity scale, CMBs were more prominent in patients with grade 0 (70%) followed by grade III (25.8%) then grade II (4.2%). BMI was independent risk factors for developing CMBs as shown in simple regression analysis (х2 = 6.008, P = 0.002). SVDs and hypertension were statistically significant independent predictors and had higher odds to exhibit CMBs. Patients with SVDs had 5.3 times higher odds to exhibit CMBs (P = 0.002) while patients with hypertension had 3.9 times higher odds to exhibit CMBs (P = 0.032).

Conclusion

SWI is a gold standard MR imaging technique in diagnosis and characterization of CMBs with more prevalence especially in obese patients suffering from acute ischemia stroke due to SVDs. Hypertension was an independent risk factor for development of CMBs but IHD, use of antiplatelet medications, increased BMI, and dyslipidemia must be taken into consideration.
Biophilic streets: a design framework for creating multiple urban benefits
Authors: Cabanek Agata , Zingoni de Baro Maria Elena , Newman Peter
Published: July 2020

Biophilic urbanism is bringing new perspectives to how natural systems need to be integrated into the fabric of cities. This paper shows how biophilic streets can be the front door to biophilic urbanism by integrating nature into a new street design, benefiting a range of economic, environmental and social functions. A theoretical integrated Biophilic Streets Design Framework, is outlined and evaluated through the analysis of four street revitalisation projects from Vitoria-Gasteiz, Berkeley, Portland and Melbourne. Its practical applications and multiple urban benefits will be of value to street designers globally. The Biophilic Streets Design Framework demonstrated that the four case studies meet the main design categories, which is favourable since multiple additional benefits are likely to be obtained. Future research is needed to monitor and quantify the performance of biophilic streets design to address the increasing effects of climate change, environmental degradation and biodiversity loss in a cost-effective way.
Strategic Operational Redesign for Successfully Navigating Prior Authorization Barriers at a Large-Volume Proton Therapy Center
Authors: Brooks Eric D. , Ning Matthew S. , Palmer Matthew B. , Gunn G. Brandon , Frank Steven J. , Shah Aashish K.
Published: July 2020

PURPOSE:

Prior authorization (PA) can be a resource-intensive barrier to oncologic care. To improve patient access and reduce delays at our large, academic proton therapy center, we implemented a novel payor-focused strategy to efficiently navigate the PA process while eliminating physician burden and reducing inappropriate denials.

METHODS:

In 2017, business operations were redesigned to better reflect the insurance process: (1) certified medical dosimetrists (CMDs), with their unique treatment expertise, replaced our historical PA team to function as an effective interface among physicians, patients, and payors; (2) a structured, tiered timeline was implemented to hold payors accountable to PA deadlines; and (3) our PA team provided administrative leadership with requisite insurance knowledge. PA outcomes were compared 6 months before and after the intervention.

RESULTS:

After implementation of this multifaceted strategy, the median time to successful appeal (after initial denial of coverage) decreased from 30 to 18 days ( P < .001), and the total number of overturned denials increased by 56%. Because of the efficiency of the CMDs, full-time equivalents on the PA team actually decreased by 44%, translating to a 34% reduction in team personnel expenses. Internal referrals increased by 29%, attributable to optimized communication and diminished administrative burden for providers. New treatment starts also increased, resulting in a 37% larger patient census on treatment.

CONCLUSION:

Incorporating payor-focused strategies can improve patient access in a cost-effective manner while decreasing time and administrative burden associated with the PA process. These operational concepts can be adapted for other oncologic practice settings facing analogous PA-related obstacles.
Migritude and Kala Pani Routes in Shumona Sinha’s Assommons les pauvres (Let Us Strike Down the Poor)
Authors: Mehta Brinda J.
Published: July 2020

The term migritude was first coined by French theorist Jacques Chevrier to characterize “extracontinental” francophone sub-Saharan literatures that have their roots in negritude and immigration. Kenyan cultural artist Shailja Patel later expanded the term to include South Asian “migrants with attitude.” This article further expands the current framings of migritude by linking it to the historical movement of kala pani, or nineteenth-century Indian indenture. The idea of kala pani migritude reveals an engagement with clandestine migration, identity, language, translation, and geography, both rooted in France and routed along treacherous seaways. Shumona Sinha’s novel Assommons les pauvres also focuses on the experiences of the privileged immigrant narrator whose story is a core part of the novel. Sinha has the privilege to narrate the stories of the migrants for them in her coveted role as a translator. Her stories are mediated by her ambivalence toward the migrants, for whom she feels shame and disgust, and her own tentative attempts to assimilate Frenchness as a normative ideal. This article offers a contrapuntal reading of Sinha’s novel through the lens of kala pani migritude to determine whether migrant subjectivity in a mediated narrative is an ultimately temporary, fleeting, or failed act.
The Abject Genealogies of Kenneth Halliwell (and Joe Orton)
Authors: Shelden Ashley T.
Published: July 2020

Staging a queer methodological provocation, this essay brings together Julia Kristeva’s abject and Michel Foucault’s genealogy, formulating the concept of “abject genealogy.” By doing so, it argues for pursuing combinations—of ideas, individuals, language, and methodologies—that do not necessarily “fit” with each other. In order to make this theoretical argument, the essay dwells on the figure of Kenneth Halliwell, the boyfriend and eventual murderer of the British playwright, Joe Orton. It examines archival materials in order to construct a microgenealogy of Halliwell, and of particular interest are the library books that Halliwell and Orton defaced in the early 1960s. This essay contends that these artworks dramatize the queer methodological provocation described above. In the spirit of Halliwell and Orton, this essay uses their abject genealogical collage method to think through the political and intellectual potential of the improper, queer, and conflictual juxtapositions their artistic practice enacts.
Systemic and heart autonomous effects of sphingosine Δ-4 desaturase deficiency in lipotoxic cardiac pathophysiology
Authors: Walls Stanley M. , Chatfield Dale A. , Ocorr Karen , Harris Greg L. , Bodmer Rolf
Published: July 2020

Lipotoxic cardiomyopathy (LCM) is characterized by cardiac steatosis including accumulation of fatty acids, triglycerides and ceramides. Inhibition of ceramide biosynthesis has been shown in model systems to antagonize obesity and improve insulin sensitivity. Sphingosine Δ-4 desaturase (encoded by ifc in flies) enzymatically converts dihydroceramide into ceramide. Here, we examine ifc mutants to study the effects of desaturase deficiency on cardiac function in flies. Interestingly, ifc mutants exhibited classic hallmarks of LCM: cardiac chamber dilation, contractile defects and loss of fractional shortening. This was phenocopied in global ifc RNAi-mediated knockdowns. Surprisingly, cardiac-specific ifc knockdowns exhibited cardiac chamber restriction with no contractile defects, suggesting heart autonomous and systemic roles for ifc activity in cardiac function. Next, we determined that ifc mutants exhibit suppressed Sphingosine Kinase 1 expression (Sk1). Ectopic overexpression of Sk1 was sufficient to prevent cardiac chamber dilation and loss of fractional shortening in ifc mutants. Partial rescue was also observed with cardiac and fat body specific Sk1 overexpression. Finally, we showed that cardiac-specific expression of Inhibitor of Apoptosis (dIAP) also prevented cardiac dysfunction in ifc mutants, suggesting a role for caspase activity in the observed cardiac pathology. Collectively, we show that spatial regulation of sphingosine desaturase activity differentially effects cardiac function in heart autonomous and systemic mechanisms via tissue interplay.
Towards understanding the cell surface phenotype, metabolic properties and immune functions of resident macrophages of the peritoneal cavity and splenic red pulp using high resolution quantitative proteomics
Authors: Nagala Manjula , Crocker Paul R.
Published: July 2020

Background:Resident macrophages (Mϕs) are distributed throughout the body and are important for maintaining tissue homeostasis and for defence against infections. Tissue Mϕs are highly adapted to their microenvironment and thought to mediate tissue-specific functions involving metabolism and immune defence that are not fully elucidated. 

Methods:We have used high resolution quantitative proteomics to gain insights into the functions of two types of resident tissue Mϕs: peritoneal cavity Mϕs and splenic red pulp Mϕs.  The cellular expression levels of many proteins were validated by flow cytometry and were consistently in agreement with the proteomics data.

Results:Peritoneal and splenic red pulp macrophages displayed major differences in cell surface phenotype reflecting their adaptation to different tissue microenvironments and tissue-specific functions. Peritoneal Mϕs were shown to be enriched in a number of key enzymes and metabolic pathways normally associated with the liver, such as metabolism of fructose, detoxification, nitrogen homeostasis and the urea cycle. Supporting these observations, we show that peritoneal Mϕs are able to utilise glutamine and glutamate which are rich in peritoneum for urea generation.  In comparison, splenic red pulp Mϕs were enriched in proteins important for adaptive immunity such as antigen presenting MHC molecules, in addition to proteins required for erythrocyte homeostasis and iron turnover. We also show that these tissue Mϕs may utilise carbon and nitrogen substrates for different metabolic fates to support distinct tissue-specific roles.

Conclusions:This study provides new insights into the functions of tissue Mϕs in immunity and homeostasis.  The comprehensive proteomics data sets are a valuable resource for biologists and immunologists.
Crescentic glomerulonephritis: what’s different in South Asia? A single center observational cohort study
Authors: Alexander Suceena , Yusuf Sabina , Rajan Gautham , Elias John Elenjickal , Roy Sanjeet , Annamalai VC , Thomas Athul , Joseph Eapen Jeethu , T Valson Anna , George David Vinoi , Varughese Santosh
Published: July 2020

Background: The spectrum and outcomes of crescentic glomerulonephritis (Cr.GN) in South Asia is vastly different from that reported worldwide and there is a paucity of information. The aim of the study was to study the demography, clinical presentation, histology and predictors of longitudinal outcomes of Cr.GN in this population.

Methods: An observational cohort study of renal biopsies was performed in the largest tertiary center in South India over a period of 10 years (January 2006 to December 2015) with ≥50% crescents on renal histology indicating Cr.GN.

Results: A total of 8645 kidney biopsies were done; 200 (2.31%) were Cr.GN. Patients were categorized into three etiological groups: anti-glomerular basement membrane (type I), immune complex (type II), and pauci-immune (type III). Type II was the most common (96, 46.5%), followed by type III (73, 38%) and type I (31, 15.5%). Female preponderance was seen across all types. About half of all patients presented with recent onset hypertension. Type II had the highest median proteinuria (4.2 (2.1-6) g/day, p=0.06) and the median estimated glomerular filtration rate was lowest in type I (5 (4-8) ml/min/1.73m2, p<0.001). Among type III, anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis was seen only in ~50% of patients. Nearly one third of patients with type I were also positive for ANCA making them ‘double positive’. Acute glomerular insults like tuft necrosis and chronic changes as evidenced by moderate to severe interstitial fibrosis, was a predominant feature of type I.

Conclusions: ANCA-negative pauci-immune vasculitis, as well as double positive Cr.GN, are reported for the first time in South-Asia. Renal survival was significantly worse in type I/III compared to type II. Types I/III, moderate to severe interstitial fibrosis and tubular atrophy, presence of oliguria/anuria and increasing percentage of crescents in renal biopsy were significant predictors of end stage kidney disease in our cohort.
New Features of Correlation Leak Detector
Authors: Shikunenko Vyacheslav , Samoilov Evgeny
Published: July 2020

For organizations responsible for the uninterrupted operation of oil pipelines, hot and cold water pipelines, the urgent task is to detect leaks in advance, especially accidentally dangerous ones. If the inner diameter of the pipes does not allow the use of in-line diagnostics, methods are used to identify and localize leaks. Vibroacoustic sensors are installed at the ends of the examined area. Sensors detect pipe vibrations containing components from leaks. To extract information, a regular signal from a leak is extracted against a background of “white” noise using various filters. An analysis of the received signals makes it possible to identify leaks and assess the condition of the pipeline in the vicinity of leaks, i.e. detect accidentally dangerous defects. If you have specialized software, you can localize the leak and identify defects in the vicinity of the leak. The use of an additional inspection mode allows you to identify the technical condition of the pipeline in the vicinity of the leak and, if necessary, expand the boundaries of the repair, thereby eliminating repeated drilling in one place due to repeated damage.
New NDT Documents in the Field of Nuclear Energy. Radiographic Inspection
Authors: Makarov Alexey
Published: July 2020

The article discusses some inconsistencies in the regulatory documentation for radiographic inspection in the field of atomic energy use. Attention is drawn to differences in permissible values of the heat-affected zone for fillet welds in two regulatory documents NP-105-18 and GOST R 05.05.07-2018, intended for nuclear energy. The pros and cons of selective inspection of joints along the length or quantity are discussed. Possible ways to correct the situation are proposed. It is noted that in GOST R 05.05.07-2018 the approach to calculating images on fittings and nozzles for the first time is explained in a similar way to the calculation when monitoring pipelines through one wall. This is a useful working tool for calculating the number of images, very popular in the practice of inspection.
Non-Invasive Methods of Liquid Flow Expenditure Monitoring Using Overhead Transducers Taking into Account Deposits in Pipelines
Authors: Shablov Stanislav , Beloborodov V. , Ivanenko Larisa
Published: July 2020

Processes at the initial stages of the formation of latent image centers in silver halogen emulsions by the action of ionizing photon radiation are considered and analyzed. An algorithm for their formation is presented. Imbalance of two competing processes — exposure and processing — causes artifacts. Based on expert assessment radiographic images with artifacts were investigated. Various types of artifacts are described, reasons from origin are indicated, album of photos with artifacts is compiled. Recommendations are formulated to prevent the occurrence of artifacts while manual method of manual film processing.
Responding to the Challenges of Time: Distance Learning in the Field of Non-Destructive Rail Testing
Authors: Maksimova Ekaterina , Markov Anatoliy , Molotkov Sergey , Karelin Mihail
Published: July 2020

The first experience of remote training of Russian Railways specialists in rail inspection was considered. This modern form of training has proved to be quite effective for improving the qualifications of specialists who already have experience in work. Remote training of beginners is difficult because in a short period of time it is impossible to accommodate a significant amount of necessary knowledge. It is not possible to organize practical classes on setting up and working with flaws and rail samples with various defects. In conclusion, small reviews of the first students are given.
Coherent Adaptive Focusing to Inspection of Composite Materials with Complex Geometry
Authors: Boriskov Yury
Published: July 2020

Inspection of curved surfaces from polymer composite materials in aircraft manufacturing. The use of phased array technology and the method of coherent adaptive focusing to inspection of airframe parts: spars, beam ceilings, stringers, fairings and other parts with complex geometry.
Improving the Professional Competence of the Teacher in the Organization of Research Activities of Students
Authors: Sabel'nikova-Begashvili N. , Khudoverdova S.
Published: July 2020

The article justifies the need to organize research activities of students in conditions of creation of information and educational environment, introduction and implementation of federal state educational standards of general education, which require improvement of professional competence of the teacher. The features of conducting research activities, including using digital tools and digital laboratories, are considered.
Creativity development future employees of detective agencies
Authors: Kostina Elena
Published: July 2020

The article handles issues and techniques for the development of creative abilities of future employees of detective agencies of the Russian Ministry of Internal Affairs. The need for such work is due to the fact that the profession of an operative belonging to the “man-man” type involves constant intellectual activity, solving problems and making decisions in conditions of information uncertainty, personal risk and danger to life. The author notes the need for the development of creative abilities among cadets, appealing to examples of effective operational-search activities of prominent detectives of the past and present, who are creative people. The goals and objectives of experimental research, creative tasks and training exercises within the framework of the Literary Club, in which cadets of the Moscow University of the Ministry of Internal Affairs of Russia named after V.Ya.Kikotya (specialty 05/05/02 Law enforcement, specialization "Operational-search activity"). The author’s classification of flows of creative personalities is presented, created on the basis of the application of observation methods, a psychological analysis of creative activity and reflective self-reports of Club members. A convincing opinion is expressed that cadets can successfully carry out operational investigative activities in the future by transferring the creative state of the flow to educational, professional, communicative, organizational, and cognitive activities.