bluuebunny/crossref_metadata_2025 huggingface dataset:
Delphi Study to Identify Best Practices for Rural Community Engagement in Transportation Planning
Authors: Uddin Mohammad Moin , Bright Candace , Foster Kelly
Published: May 2022

Public involvement is defined as a two-way communication aimed at providing information to the public and incorporating the views, concerns, and issues of the public in transportation decision making. According to U.S. Census data, 60% of U.S. counties are considered rural. Rural communities face unique challenges such as scarce resources, technological and geographical issues, and demographic shifts, which can limit effective engagement capabilities. Engagement strategies that are effective for urbanized and metropolitan areas may not be as effective for these rural communities. This study employed a mixed methods research approach to identify readily deployable practices for meaningful rural community engagement in transportation planning. The research methodology involves a literature review, interviews with supervisors from offices of community transportation, interviews with 24 community leaders in four case communities in Tennessee, and two rounds of Delphi community survey. The research process brought together all key stakeholders to build a true consensus of best practices to engage rural communities in transportation planning. Data analysis showed rural communities feel detached and unaware of the role of Departments of Transportation (DOT) in and their plans for community transportation. Engaging rural communities using social media and conducting virtual meetings can reach wider sections of the community. Lack of consistent internet coverage in rural communities, however, means this type of outreach cannot replace in-person engagement. Securing the support of community leaders, building partnerships, and having a presence in the community will increase trust in DOTs and foster better engagement. A list of recommendations is provided that will enhance rural community engagement for long-range transportation planning in predominantly rural states.
Characteristics and Quality of Diagnostic and Risk Prediction Models for Frailty in Older Adults: A Systematic Review
Authors: Gao Yinyan , Chen Yancong , Hu Mingyue , Gan Ting , Sun Xuemei , Zhang Zixuan , He Wenbo , Wu Irene X. Y.
Published: May 2022

Several prediction models for frailty in older adults have been published, but their characteristics and methodological quality are unclear. This review aims to summarize and critically appraise the prediction models. Studies describing multivariable prediction models for frailty among older adults were included. PubMed, Embase, Web of Science, and PsycINFO were searched from outset to Feb 21, 2021. Methodological and reporting quality of included models were evaluated by PROBAST and TRIPOD, respectively. All results were descriptively summarized. Twenty articles including 39 models were identified. The included models showed good predictive discrimination with C indices ranging from 0.70 to 0.98. However, all studies except one were assessed as high risk of bias mainly due to inappropriate analysis; meanwhile, poor reporting quality was also frequently observed. Few mature prediction models can be used in practice. Researchers should pay more attention to external validation and improving the quality both in methodology and reporting.
Genre and Register Features of Sixth-Grade Students’ Factual Writing
Authors: Fang Zhihui , Gresser Valerie , Cao Peijuan , Zhang Huibin
Published: May 2022

Factual writing is a key macrogenre of American K-12 schooling that is also valued in workplace and society. This study examined the genre and register features of two subgenres of factual writing—biography and report—composed by 48 sixth-grade students in a curriculum unit on scientists and science-related careers aimed at developing students’ understanding of the nature of science. These texts were analyzed for a range of schematic, lexical, and grammatical features that instantiate the two target genres. Statistical and descriptive analyses revealed that the students demonstrated a fairly mature control over the schematic and lexical features that realize the purpose of either genre and relied heavily on the grammatical resources characteristic of everyday registers in constructing both genres. Additionally, there was a positive relationship between the students’ genre/register familiarity and the holistic quality of their writing, and the students’ reading proficiency was a significant predictor of their genre familiarity and holistic writing quality, but not their register understanding. These findings suggest that learning the grammatical resources characteristic of academic registers remains a major and potentially daunting task for many adolescents.
Physical Activity Interventions Among American Indian and Alaska Native Persons: A Systematic Review
Authors: Kokenge Molly C. , Ruppar Todd M. , Buchholz Susan
Published: May 2022

Objective

The purpose of this review was to identify and describe physical activity (PA) interventions that have been implemented with American Indian and Alaska Natives (AIANs) in the U.S. and Canada since 2006.

Data Source

Searches were conducted in 8 databases plus grey literature sources.

Study Inclusion and Exclusion Criteria

Eligible studies: (a) described an intervention designed to increase PA; (b) targeted AIANs residing in the U.S. or Canada, or if a multiethnic population, contained an AIAN subanalysis; (c) were published in 2006 or later; and (d) reported a PA outcome.

Data Extraction

Two reviewers independently extracted data, with conflicts resolved through discussion.

Data Synthesis

Data were synthesized by participant characteristics, intervention strategies, PA outcomes, and impact.

Results

We identified 25 eligible studies, most targeting children and youth. Intergenerational, environmental policy, cultural adaptation, and curriculum-based approaches were used. Twenty studies used self-reported PA measures. 80% of studies used an element of cultural adaptation, mostly considering cultural needs in design, not program or outcome evaluation. Sedentary behavior and leisure-time PA were rarely assessed. Significant changes in PA outcomes were achieved post-intervention in 13 studies (52%).

Conclusion

Future interventions should target AIAN adults to evaluate sedentary behavior and leisure-time PA. Interventions should incorporate psychometrically tested objective measures and prioritize the Native perspective from intervention design through project evaluation.
A novel temperature-responsive mixed matrix ultrafiltration membrane based on boron nitride nanomaterial
Authors: Srivastava Ashish , Raviya Mayur , Raval Hiren
Published: May 2022

A novel mixed matrix membrane was prepared by blending polysulfone with two-dimensional boron nitride followed by its hydroxyl functionalization. Prepared nanocomposite membranes were characterized for the surface morphology, surface roughness, zeta potential and hydrophilicity. Uniform dispersion of boron nitride nanoparticles in polysulfone matrix and consequent changes in membrane properties were confirmed by scanning electron microscope images, atomic force microscope images, zeta potential, contact angle analysis, and X-Ray photoelectron spectroscopy. Differential scanning calorimetry (DSC) technique was used to determine the glass transition temperature (Tg) of the modified membrane and the results revealed the presence of BN in the membrane matrix. The highest water flux of 329.52 Liters per sqm per hour (LMH) was obtained in case of PS/BN (1%) as compared to 151.87 LMH of virgin membrane and Albumin rejection also increased by nanocomposites membranes up to certain concentration of Boron nitride. A unique behavior of temperature responsiveness of nanocomposite membrane was observed, where a steep increment in permeate flux by 205% at higher temperature was noted as compared to the virgin Polysulfone membrane where only 103% increase was recorded for the same temperature range. Moreover, the water uptake capacity of nanocomposite membranes were measured to understand the changes with nanomaterial incorporation. The membrane showed a good promise for high-temperature separation applications.
From Near and Afar: International Secondary School Students’ Career Influences
Authors: Arthur Nancy , Lei Danni , Woodend Jon
Published: May 2022

During the previous decade, growth in the numbers of internationally mobile students included international high school students. Prior research on international students’ career development in higher education may not account for the unique context of younger international students in secondary schools. The current study investigated career influences for international secondary students, using the Systems Theory Framework ( Patton & McMahon, 2021 ). International students in senior years completed written, open-ended surveys and in-person interviews regarding their career aspirations, plans and key influences on their decision-making. International student coordinators and school staff also offered their perspectives about these influences. Results indicate the inter-related systemic influences of individuals, significant relationships, location and country contexts, the secondary school environment, and perceived characteristics of occupations and future career pathways. Implications for supporting international high school students in the school setting and future research directions are discussed.
The rationale for the need to study sodium-glucose co-transport 2 inhibitor usage in peritoneal dialysis patients
Authors: Borkum Megan , Jamal Abeed , Suneet Singh Rajinder , Levin Adeera
Published: May 2022

The wave of kidney and heart outcome trials, showing multiple potential benefits for sodium-glucose co-transport 2 (SGLT2) inhibitors, have excluded patients with an estimated glomerular filtration rate below 25 ml/min/1.73 m2. However, dialysis patients are at the highest risk of cardiovascular disease and would benefit most from effective cardioprotective therapies. There is emerging evidence from experimental studies and post hoc analyses of randomised clinical trials that SGLT2 inhibitors are well tolerated and may also be effective in preventing cardiovascular and mortality outcomes in patients with severe chronic kidney disease, including patients receiving dialysis. As such, extending the usage of SGLT2 inhibitors to dialysis patients could provide a major advancement in their care. Peritoneal dialysis (PD) patients have an additional unmet need for effective pharmacotherapy to preserve their residual kidney function (RKF), with its associated mortality benefits, and for treatment options that help reduce the risk of transfer to haemodialysis. Experimental data suggest that SGLT2 inhibitors, via various mechanisms, may preserve RKF and protect the peritoneal membrane. There is sound physiological rationale and an urgent clinical need to execute robust randomised control trials to study the use of SGLT2 inhibitors in PD patients to answer important questions of relevance to patients and healthcare systems.
The Question of Communist Violence and the Birth of Chinese Public Theology
Authors: Li Quan
Published: May 2022

This article is a critique of Chinese public theologians with a particular focus on their Christological notions as ambivalent responses to Communist violence, a specific form of extreme violence in postcolonial China. The critique is historical as well as theological. As a historical inquiry, the problem of guerrilla warfare as a constant form of Communist violence is discussed, exploring its historical roots and philosophical manifestations. As a theological critique, it is demonstrated how this issue penetrates mainstream theo-political readings of Christ in the formation of Chinese public theology. The article thus seeks to contribute to the moral reflections of the Chinese church and the critical response to a unique form of postcolonial violence for Christian ethics.
Energy consumption, carbon emissions, product cost, and process time in incremental sheet forming process: A holistic review from sustainability perspective
Authors: Riaz Asim Ahmad , Hussain Ghulam , Iqbal Asif , Esat Volkan , Alkahtani Mohammed , Khan Aqib Mashood , Ullah Naveed , Xiao Maohua , Khan Shaukat
Published: May 2022

Due to continuous worsening of the environment and depletion of natural resources, concept of sustainability in manufacturing sector is gaining an increasing attention. New processes and strategies characterized by efficient use of energy and materials, low processing time and zero or nearly zero green-house emissions are being explored. Incremental sheet forming (ISF) is a comparatively new sheet forming process with high economic payoff for small production runs and customized orders. The current study presents a comprehensive review on the sustainability aspects of the process. The process performance in terms of power demand, energy consumption, cost, CO2 emissions, processing time, and material wastage/usage is analyzed on the basis of published literature, and important conclusions and recommendations are drawn to utilize the process for cleaner, economical and time efficient production. The review establishes that ISF is more sustainable process than conventional forming methods for small production runs. Further, its sustainability performance can be further enhanced by choosing optimum process conditions especially lower spindle rotation, larger feed rate and step size. Shorter tool paths and advent of energy efficient machines is likely to further elevate the process performance. The review also identifies future work and presents fundamental guidelines and recommendations for establishing the sustainable ISF process.
Effect of lid height and blowing ratio on film cooling effectiveness of a novel lidded hole configuration
Authors: Guelailia Ahmed , Khorsi Azzeddine , Slimane Sid Ahmed , Blala Hamza , Slimane Abdelkader , Salem Houria , Bouferrouk Abdessalem
Published: May 2022

Film cooling is one of the promising technologies used for protecting rocket nozzles and turbine blades from combustion chamber hot gases. This paper proposes a novel shape of film cooling injection hole, called lidded hole, that can offer significant enhancement of cooling performance. ANSYS CFX is used to perform 3D numerical simulations of a flat plate with a single row of lidded holes, in which the k–ε model approximates turbulence effects. Four cases are investigated to highlight the influence of the hole's lid height (H/d = 0, 0.25, 0.5, 0.75). The effect of blowing ratios (M = 0.5, 1, 1.5) is also analyzed for each configuration. The numerical results of this study are compared with available experimental data, and, generally, a good agreement is achieved. The results obtained show that the lidded hole configuration reduces the coolant flow separation which improves significantly the film cooling effectiveness. In addition, increasing the blowing ratio leads to an increase in lateral and centerline cooling effectiveness. Comparing all studied cases, the optimum coolant coverage was obtained for the lidded hole configuration with H/d = 0.25 at M = 1.5.
Doravirine/tenofovir disoproxyl fumarate/lamivudine-induced alopecia: A case report
Authors: Cattaneo Dario , Riva Agostino , Poloni Andrea , Carrozzo Giorgia , Gervasoni Cristina
Published: May 2022

We report here a case of alopecia probably caused by the fixed dose combination of doravirine/tenofovir disproxil fumarate/lamivudine (DOR/TDF/3TC) in a 46-year-old male living with HIV, previously treated with tenofovir disproxil fumarate and lamivudine-containing antiretroviral combinations. After having excluded other causes of hair loss such as sexually transmitted disease or drugs associated with alopecia, as well as poor immune-virologic conditions (i.e. low CD4+ cell count and/or high HIV viral load), a toxic effect of doravirine might be hypothesized. DOR/TDF/3TC was immediately stopped and rilpivirine plus tenofovir alafenamide fumarate/emtricitabine was started. Four weeks after changing the antiretroviral regimen, the patient reported signs of hypopigmented hair regrowth. The association between the episode of alopecia and DOR/TDF/3TC was scored as probable according to the Naranjo causality scale. We concluded that alopecia was probably related to DOR but whether it is self-limiting, cannot be predicted at this stage.
The effect of endplate addition on the performance of the savonius wind turbine: A 3-D study
Authors: Kassab Sadek Z , Chemengich Sammy J , Lotfy Eslam R
Published: May 2022

The Savonius wind turbine is known for its simplicity, outstanding cost-effectiveness and low noise, making it ideal for wind energy harvesting in urban areas. However, its success is hampered by the low coefficient of performance. Several geometrical modifications have been proposed by researchers to improve its performance. The present study aims to investigate the impact of the endplate addition on the coefficient of performance of the Savonius wind turbine. The unsteady Reynolds Average Navier Stokes equations and the turbulence equations corresponding to SST κ-ω were solved using the commercial CFD package ANSYS FLUENT. An endplate-integrated 3D model and an endplate-free 3D model of the same geometrical configuration of 1 m diameter and height were simulated under the condition of tip speed ratio 0.8. The extracted results were compared with the existing experimental and numerical data under the same conditions and a close agreement was reached. The endplate-filled turbine showed a significant increase in performance. The lift and drag coefficients were enhanced by 4 and 1.8 times, respectively. Flow contours of pressure, velocity and turbulence intensity were obtained at an angular rotation of 90° where there was a maximum increase in performance to explain how the endplate brings about the change.
Robust H∞ output feedback control of uncertain fractional-order systems subject to input saturation
Authors: Fiuzy Mohammad , Shamaghdari Saeed
Published: May 2022

This article considers the problems of robust stability and stabilization for a class of fractional-order linear time-invariant systems via 0<α<1 subject to input saturation with convex polytopic uncertainties, by a kind of [Formula: see text]–proportional–integral–derivative control synthesis. A new saturation-based stability condition is suggested to estimate the stable region ([Formula: see text]) and region of attraction (ε) using the ellipsoid approach. The main concept of the presented strategy is based on transforming the proportional–integral–derivative controller design problem into the static output feedback control problem. Gronwall–Bellman lemma and sector bounded condition of the saturation function is used for stability investigation and stabilization of such systems. The static output feedback control laws are obtained with the aid of a non-iterative linear matrix inequality implication. From the static output feedback controller, the proportional–integral–derivative controller is then restored. Stability problem is addressed as an optimization problem to obtain the controller gains and the stable region, as well as the largest region of attraction. Some theorems and numerical examples are provided to illustrate the results of proposed mechanism.
Early history of skin preservation and transplantation; the role of Carl August Ljunggren
Authors: Uvelius Bengt , Andersson Karl-Erik
Published: May 2022

During the late 19th and the early 20th century there was an unprecedented development in medical research. Tissue and cell culture rapidly developed into areas with many contributing scientists. The same is true for tissue transplantation. When these achievements are described afterwards in a historical context and a mainline development is constructed, there are researchers whose pioneering work is forgotten. The present paper attempts to correct this and to present a correct description of the start of tissue preservation and transplantation. We have traced relevant original publications in international journals between 1870 and 1920. The traditional view is that Alexis Carrel was the first He received a Nobel Prize 1912 for his work on vascular suture and the transplantation of blood vessels and organs. The same year he published an article on human skin storage and transplantation. This was more than a decade later than Carl August Ljunggren (1860–1934) who 1898 published his pioneering but long forgotten work on human skin preservation and transplantation, and with a vision of tissue banks. Our article contains a brief biography of Ljunggren, and further reconstructs the processes that resulted in the lack of awareness today of his achievements. Conclusion: Carl August Ljunggren was the first to preserve human skin in vitro for prolonged periods, followed by transplantation of the specimens to other patients. He was also the first to propose the use of tissue banks.
Rapid Consumption Survey Methodology: An Empirical Study in Bangladesh
Authors: Mazumder Md. Saifur Rahman , Rayhan Md. Israt
Published: May 2022

Every unidimensional poverty measure is mostly based on consumption expenditure. In the household consumption expenditure survey, the questionnaire needs to record detailed information about food and non-food items. The lengthy administering time hampers the survey very often. This study applies a rapid consumption methodology on two-round panel data from the Bangladesh integrated household survey conducted by the International Food Policy Research Institute. The surveyed items for each household are partitioned into the core and optional modules. Any randomly taken optional module is assigned to a household, and missing modules are then estimated by the imputation method. In estimating the poverty indicators, the multiple imputation with chained equation model shows better estimates than the ordinary least squares (OLS) and median imputation techniques. The estimated poverty headcount ratio (FGT0) is 26.72%, whereas the full consumption data show FGT0 as 27.2%. These results suggest that the rapid consumption survey methodology in a risk-prone area can be a potential approach to estimate the consumption and poverty at a lower cost and lower administrative time.
Assessing the Dynamics of AI Driven Technologies in Indian Banking and Financial Sector
Authors: Deepthi. B  , Gupta Priya , Rai Pratibha , Arora Himanshu
Published: May 2022

Providing quality customer service is one of the crucial matters of concern for any organization as it ensures the best customer satisfaction levels. Organizations all around the globe are widely using newly evolving technologies like artificial intelligence (AI) and machine learning applications to provide the best customer experience. The banking and financial services industry is on the front line to adopt AI-driven technologies in various departments worldwide. However, the adoption rate of these technologies is low in India in comparison with developed economies. In this article, we discussed the significance of various factors (customer satisfaction, AI knowledge among employees, and third-party tie-ups) on implementing the AI-driven technologies from employees’ perspectives at various levels of the organization. We analysed the usefulness of these newly evolving technologies to increase customer satisfaction and studied the role of crucial factors like data security issues and third-party tie-ups on AI technology implementation. The study is based on the primary data collected from 97 employees working in the Indian banking and financial sector across various metro cities of India (Hyderabad, Mumbai, Delhi) in various departments. We identified and analysed various factors that could impact the implementation of the AI-driven technologies at various departments, and we used logistic regression to investigate their significance. Chi-square test was used to check the associations between different factors. The study identifies and examines three key factors—customer satisfaction, AI knowledge among employees, and third-party tie-ups—that could impact AI-driven technologies implementation. According to this study, AI technology considerably decreases the cost and improves the customer experience of services. However, despite of many advantages the adoption rate of AI technology in the Indian banking and financial sector found extremely low. The implications of this study can be extended to the organizations for 360 degrees comprehensive understanding about the AI implementation and repercussions as there is a limited study about this topic from the bottom of the organizational verticals. This analysis is purely based on survey responses received from banking and financial sector employees across various metro cities of India (Hyderabad, Mumbai and Delhi).
Single Versus Multiple Deprivations Among Children in India
Authors: Mishra Sunil Kumar , Dutta Swati
Published: May 2022

Multidimensional deprivation among children is a critical issue. The present study explores the multidimensional deprivation of children based on India Human Development Survey data, 2011–2012. A modified Bristol method and multidimensional deprivation approach have been used to measure the extent of deprivation. The study compares the results of multidimensional deprivation based on non-monetary indicators with the monetary measure of poverty. Further, a logistic regression model is used to examine the determinants of multidimensional deprivation among children. Findings suggest that the multidimensional poverty among children was much higher in states such as Madhya Pradesh, Uttar Pradesh, Bihar and Rajasthan and was also much higher compared to monetary-based poverty measures. Logistic regression results indicate that if a child belongs to an educated mother, then the chances of multidimensional deprivation are lower. On the contrary, if a child belongs to a marginalised community, like the scheduled tribes or scheduled castes and/or rural areas and poorest consumption class, the chances of child deprivation increase. A major policy implication of the study is that dimension-specific social policy for children in the targeted regions needs to be developed.
The Development of Celtic Music Identity: Globalisation and Media Influences
Authors: Xuan Wong Zhi , Ying Loo Fung
Published: May 2022

The notion of Celtic music is constantly changing based on specific contexts. Mass media used as communication tools to promote and sustain an authentic tradition could be complicated in terms of contextualisation and commodification in a globalised world. Hence, this work investigates the formation of Celtic music identity, its transformation, tension, and adaptation to the global world. Prior work in the literature suggests more practical-based research in homogenising Celtic music’s historical and musicological discourse to discover its potential in cultural reconstruction and knowledge that links to its global development. Thus, this study explored the global development of Celtic music and analysed the impact on its definition through the influence of cultural hybridity and global media by investigating its origin, cultural changes, and possible sustainable interventions.
Clinical update on psychiatric outcome measurement: what is the purpose, what is known and what should be done about it?
Authors: Looi Jeffrey CL , Pring William , Allison Stephen , Bastiampillai Tarun
Published: May 2022

Objective

To provide a clinical update on the purposes, evidence-base and recommendations for both clinician and patient-rated outcome measures in psychiatric practice.

Conclusions

Private and public sector funders have implemented outcome measurement systems in Australian mental healthcare, in order to improve cost-effectiveness. It is important to consider the ultimate aims of outcome measurement from various perspectives in evaluating the evidence-base, as there are a number of measurement dimensions to address. For individual clinicians, the purpose may be to guide treatment-planning, as well as to assess treatment and clinician efficacy. For patients, the purpose is to assess outcomes in terms of their goals for recovery, as well as to evaluate their satisfaction with the care provided, and their healthcare providers. The other orthogonal dimensions of measurement comprise, the proximal to illness measures of symptomatic severity, and the distal measures of disability, which apply to both clinician and patient outcomes. In turn, these measures may be used by healthcare funders in public or private sectors as proxy measures of the cost-effectiveness of psychiatric care provided. Clinical registries linked to service-mapping would provide better data for patients, providers and funders to assess the availability and effectiveness of psychiatric care in Australia.
Intranasal esketamine for depression: Not so special K
Authors: Rosenman Stephen
Published: May 2022

Background

Intranasal esketamine has been recently approved for the treatment of resistant depression. It is the only form of ketamine approved. The formulation costs around $600 per dose while plain injected ketamine, on which most research has been done, costs less than $20 per dose. Research shows that intranasal esketamine is less effective and has more unwanted effects than injected ketamine, yet the approval means that this intranasal formulation will now be the form used and researched.

Conclusion

While the approval of an inferior treatment mode is understandable from the processes by which medicines are approved, we should think carefully about embracing this particular form of a promising treatment.
A Scoping Review on the Use of the Parents Evaluation of Developmental Status and PEDS: Developmental Milestones Screening Tools
Authors: Abdoola Shabnam , Swanepoel De Wet , Van Der Linde Jeannie
Published: May 2022

The Parents’ Evaluation of Developmental Status (PEDS), PEDS: Developmental Milestones (PEDS: DM) and PEDS tools (i.e., the PEDS and PEDS:DM combined for use) are parent-reported screening tools frequently used to identify young children requiring early intervention. An ideal screening tool for all contexts would be brief, inexpensive with appropriate test items and good psychometric properties. A scoping review was conducted to review studies that used the PEDS, PEDS:DM, and PEDS tools to screen for the need for further referrals and evaluation through parent report. Thirty articles, ranging from 2003 to 2020, conducted in high-income countries (HICs) and lower-middle income countries (LMICs), were included from the 1,468 records identified. Studies conducted in HICs ( n = 19) included screening of special population groups and comparing validated tools. LMIC studies ( n = 11) focused on translations, combination of the PEDS tools, validations of tools, and use of an app-based tool (mHealth). High referral rates were obtained with PEDS (23–41%) and PEDS:DM (12–54%) in LMICs where at-risk populations are more prevalent and cultural differences may affect tool validity. A global dearth of research on PEDS:DM and PEDS tools exist; the review highlights factors that influence the validity and impact widespread use of the screening measures, especially in diverse populations and LMICs.
Comparison of Managing Factor Xa Inhibitor to Unfractionated Heparin Transitions by aPTT Versus a Treatment Guideline Utilizing Heparin Anti-Xa Levels
Authors: Dingus Scott J. , Smith Alex R. , Dager William E. , Zochert Sara , Nothdurft Salli A. , Gulseth Michael P.
Published: May 2022

Background

There are inadequate data on the optimal strategy for transitioning factor Xa inhibitors (FXai; apixaban, rivaroxaban) to unfractionated heparin (UFH) infusions.

Objective

In patients transitioning from an FXai to an UFH infusion, this study compared the safety and efficacy of monitoring UFH infusions using an activated partial thromboplastin time (aPTT) titration scale versus utilizing an UFH-calibrated anti-Xa titration scale aided by a novel institutional guideline.

Methods

A retrospective cohort analysis was conducted on adult patients transitioning from an FXai to an UFH infusion at 2 medical centers from June 1, 2018, to November 1, 2020. One institution utilized aPTT while the other institution primarily used UFH-calibrated anti-Xa. The primary endpoint was a composite of death, major bleeding, or new thrombosis during the hospitalization with a planned noninferiority analysis. Secondary outcomes were also collected including the amount and duration of UFH administered between cohorts.

Results

The incidence rate of the primary composite endpoint was 6.3% in the anti-Xa group and 11% in the aPTT group ( P < 0.001 for noninferiority, P = 0.138 for superiority) meeting noninferiority criteria. No statistical differences were seen in new thrombosis, major bleeding, or any bleeding.

Conclusion and Relevance

This represents the first report of a comparison between aPTT versus anti-Xa monitoring in relation to clinical outcomes for patients transitioning from an FXai to an UFH infusion. A transition guideline primarily utilizing an UFH-calibrated anti-Xa assay appears to be a safe alternative to aPTT monitoring and can aid facilities in the management of patients during these complex transitions.
Two Years of the COVID-19 Pandemic: What Lessons Have We Learned?
Authors: Inglet Shannon
Published: May 2022

Two years ago, the World Health Organization declared a global pandemic after an outbreak of a novel coronavirus. Since then, unprecedented challenges have shaped a “new normal.” As of early March 2022, more than 6 million lives have been lost globally to COVID-19. But we have learned much over the past 2 years. Some lessons have been heartening, inspiring innovation, and adaptability; others have been devastating and will have reverberating consequences for years to come. The COVID-19 pandemic has taught us lessons that span medical, economic, social, and environmental arenas. And we still have much to learn.
A Case Report on Apocrine Encapsulated Papillary Carcinoma of the Breast with Frank Invasion: A Diagnostic Quandary
Authors: Taniguchi Kohei , Yamasaki Rie , Kajiwara Yukiko , Ichimura Kouichi , Yoshino Tadashi
Published: May 2022

Encapsulated papillary carcinoma is a special type of breast cancer defined in the fifth edition of the World Health Organization breast tumor classification guidelines. Apocrine encapsulated papillary carcinoma is extremely rare, and only 10 cases have been described previously. We encountered a case of apocrine encapsulated papillary carcinoma with frank invasion. The patient was a 77-year-old woman with a painless mass in her right breast. Core needle biopsy revealed that the tumor cells had voluminous eosinophilic cytoplasm and enlarged nuclei with prominent nucleoli. We diagnosed this lesion as carcinoma with apocrine differentiation and suggested the possibility of an encapsulated papillary carcinoma. The patient underwent a right-sided mastectomy. Gross examination of the resected specimen revealed a multilobulated tumor. Microscopically, the tumor cells, which had voluminous eosinophilic cytoplasm and enlarged nuclei with prominent nucleoli, proliferated in papillary fashion with fibrous stalks in the cystic space. Myoepithelial cells were not observed around the cystic space. Frank invasion was also observed around the encapsulated papillary carcinoma. Immunohistochemistry analysis revealed that the tumor cells were negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 and positive for androgen receptor and gross cys­tic disease fluid protein 15. Based on these findings, we diagnosed this lesion as an apocrine encapsulated papillary carcinoma with frank invasion.
Tumoral and Parenchymal Morphological Assessment in Liver Metastases of Colorectal Carcinoma: Micrometastasis, Peritumoral Lymphocytes, Tumor Budding and Differentiation are Potential Prognostic Factors
Authors: Aysal Anil , Agalar Cihan , Egeli Tufan , Ozbilgin Mucahit , Unek Tarkan , Somali Isil , Oztop Ilhan , Obuz Funda , Astarcioglu Ibrahim , Sagol Ozgul
Published: May 2022

Introduction: Various potential prognostic histopathologic factors for colorectal carcinoma liver metastasis have been proposed. However, there is still no consensus on pathological reporting of colorectal carcinoma liver metastasis resection materials. The aim of this study was to investigate the relation between selected tumoral and parenchymal histopathologic features and prognostic factors for better characterization and prognostic prediction of the patients with colorectal carcinoma liver metastasis. Methods: Hematoxylin-eosin stained slides from 100 patients who underwent hepatic resection were evaluated. Pathologic characteristics; including number of tumor nodules, largest tumor size, status of surgical margin, tumor distance to closest margin, tumor necrosis, the presence of tumor capsule, tumor differentiation, perineural and lymphovascular invasion, micrometastasis, tumor budding, peritumoral lymphocytic infiltrate and parenchymal features including steatosis, steatohepatitis, lobular inflammation, confluent necrosis, hepatocyte ballooning, portal inflammation were assessed. For 49 patients who were treated with preoperative chemotherapy, tumor regression grade and chemotherapy-related parenchymal changes such as sinusoidal damage, venous obstruction, nodular regenerative hyperplasia, steatosis and steatohepatitis were also evaluated. Results: The presence of lymphovascular invasion (p < 0.001), micrometastasis (p=0.004), absent or mild peritumoral lymphocytic infiltration (p =0.013), high tumor budding score (p=0.033) and moderate/poor differentiation (p=0.022) were significantly associated with shorter overall survival. Lymphovascular invasion (p < 0.001) was an independent predictor of mortality in multivariate analysis. Conclusions: We conclude that tumor differentiation, lymphovascular invasion, micrometastasis, peritumoral lymphocytic reaction and tumor budding score are potential prognostic histopathological features and candidates for inclusion in pathology reports of colorectal carcinoma liver metastasis resections.
Atypical Spindle Cell/Pleomorphic Lipomatous Tumor with Pleomorphic Hyalinizing Angiectatic Tumor-Like Growth Pattern: A Search for Diagnostic Clues
Authors: Cordier Fleur , Candaele Ann-Sophie , Van Dorpe Jo , Creytens David
Published: May 2022

Atypical spindle cell/pleomorphic lipomatous tumor (ASPLT) is a newly described adipocytic tumor type, recently included as a separate tumor entity in the fifth edition of the World Health Organization (WHO) classification of soft tissue and bone tumors. Here, we describe a case of an ASPLT with a striking pleomorphic hyalinizing angiectatic tumor (PHAT)-like growth pattern and discuss the diagnostical clues, which led to the diagnosis of ASPLT. To our knowledge, a PHAT-like growth pattern has not yet been reported in the setting of ASPLT.
Therapeutic Landscape of Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer
Authors: Xie Jindong , Zou Yutian , Gao Ting , Xie Liming , Tan Duxun , Xie Xiaoming
Published: May 2022

Human epidermal growth factor receptor 2–positive breast cancer (HER2+BC) is a common malignancy that is prone to recurrence and metastasis in the early stages, resulting in a poor prognosis for patients. Many studies have suggested that targeted therapy promotes clinical outcomes in HER2+BC. With the introduction of trastuzumab in 1998, the prognosis of patients with early HER2+BC has improved significantly. However, owing to obstinate drug resistance and adverse events, the addition of new agents in standardized treatment has become a research hotspot. These promising agents include antibodies, antibody-drug conjugates, tyrosine kinase inhibitors, and anti-HER2 combined therapies. This article provides a brief description of the biology of BC and the expression of HER2, with the aim to provide an overview of the therapeutic landscape of HER2+BC by reviewing research results and introducing the latest evidence to provide a reference for clinical treatment.
Half sine shock on random control method for multi-axial vibration testing
Authors: Ma Yi , Chen Huaihai , Lu Xiangyu , Zheng Ronghui
Published: May 2022

Control method for the multi-axial half sine shock on random vibration test is studied in this article. From the Fourier spectrum analysis, it is found that the power of the half sine shock is mainly concentrated within a specific frequency band, which is only related to the sine frequency of the half sine shock. Compared with the broadband random signal, the frequency band occupies a small range. Therefore, a mixed signal separation method is proposed for the shock on random vibration control test. Firstly, the Fourier spectrum is divided into two parts, and then the Empirical Wavelet Transform (EWT) is used to extract the shock component from the mixed signal. Afterward, the random component is obtained by subtracting the shock component from the mixed signal. According to the deviations between each component and the specified references, the amplitudes of the shock component and the Power Spectral Densities (PSDs) of the random component are controlled by the amplitude correction algorithm and the matrix power control algorithm, respectively. An experiment with tri-axial shaker is implemented and the results show that the proposed method is feasible for the multi-axial half sine shock on broadband random vibration control test.
Application of High Hydrostatic Pressure in fresh purple smoothie: Microbial inactivation kinetic modelling and qualitative studies
Authors: González-Tejedor Gerardo , Garre Alberto , Egea Jose A , Aznar A , Artés-Hernández Francisco , Fernández Pablo S
Published: May 2022

The inactivation kinetics of Listeria monocytogenes during High Hydrostatic Pressure (HHP) treatments was studied in a purple smoothie based of fresh fruit and vegetables. Pressure intensity studied was 300, 350, 400 and 450 MPa. Untreated samples were used as control. Furthermore, the effects on quality attributes (sensory, total soluble solids content, colour, titratable acidity, pH, vitamin C and total phenolics content) were also monitored. Microbial inactivation was modelled as a function of the HHP intensity using the Geeraerd model. Shoulder and tail effects were observed only for the 300 MPa pressure assayed, supporting a multiple hit kinetic inactivation of critical factors. Increasing the HHP intensity resulted in a faster inactivation with tailing. A strong positive correlation was observed between the pressure level and the inactivation rate (k). Hence, a linear model was used to describe the relationship between both variables. Nevertheless, further data are required to confirm this secondary model. Quality was mostly unaffected by the HHP treatments, except for the vitamin C content, which reported reductions of 26 and 21% after 300 and 350 MPa, respectively. In conclusion, HHP can be a viable technology for processing fruit and vegetable-based smoothies to preserve quality and safety. A pressure of 400 MPa is advisable to ensure an efficient microbial inactivation with the best sensory and nutritional quality retention.
Effects of different antioxidants combined with high hydrostatic pressure on the color and anthocyanin retention of a blueberry juice blend during storage
Authors: Ning Nan , Wang Xiaoqiong , Li Jiarou , Bi Xiufang , Li Mingyuan , Xing Yage , Che Zhenming , Wang Yan
Published: May 2022

Blueberry juice has been found to undergo severe browning after treatment and cold storage, such as processing by high hydrostatic pressure (HHP) at 550 MPa/10 min/25 °C followed storage at 4 °C for 4 days. This browning may be due to the degradation of anthocyanin (AC) in the berries. Therefore, in this study, gallic acid (GA), ferulic acid (FA), ascorbic acid (VC), citric acid (CA), tea polyphenol (TP) and α-tocopherol (VE) were compared to determine their ability to improve the stability of the AC in HHP-treated blueberry juice. The juice was combined with the six abovementioned antioxidants at different concentrations, then treated by HHP at 550 MPa/10 min/25 °C and stored at 4 °C for 20 days. Thereafter, the pH levels, degrees °Brix, color parameters, total AC content and polyphenol oxidase (PPO) activity of the blueberry juice blend were measured and compared. Gallic acid at 2 g/L was found to be the most effective antioxidant to protect against AC degradation. After storage at 4 °C for 20 days, the AC content of the juice with no added antioxidants had decreased by 62.27% with a PPO relative activity of 50.78%, while the AC content of juice supplemented with 2 g/L GA had decreased by 13.42% with a PPO relative activity of 28.13%. The results of this study, thus, suggest that GA can stabilize the structure of AC in blueberry juice and reduce PPO activity, which may be beneficial in guiding the production of blueberry juice with high AC retention.
Impact of obstructive sleep apnea on the expression of inflammatory mediators in diabetic macular edema
Authors: Yang Yelin , Somani Sohel
Published: May 2022

Purpose

To determine differences in inflammatory markers expressed in diabetic macular edema (DME) patients with and without obstructive sleep apnea (OSA).

Methods

This was a prospective, cross-sectional study. Patients with treatment naive DME were enrolled in the study. They were stratified into 2 groups based on Apnea Hypopnea Index (AHI) from overnight polysomnography: OSA + (AHI ≥ 15) and OSA – (AHI<15). Multiplex immunoassay was performed for aqueous and serum cytokines including VEGF, placental growth factor (PGF), ICAM, IL2, IL3, IL6, IL8, IL10, IL17, vascular cell adhesion molecule-1 (VCAM1), monocyte attractant protein-1 (MCP1), epidermal growth factor (EGF) and platelet derived growth factor (PDGF). Statistical significance was defined as p < 0.004 using Bonferroni correction.

Results

32 DME positive patients were enrolled in the study; of which 17 patients were OSA + and 15 OSA-. The OSA + cohort had significantly higher levels of serum EGF (p = 0.003), and trended towards higher levels of most serum cytokines including ICAM and IL6. OSA- cohort had significantly higher levels of aqueous IL17 compared to the OSA + cohort (2.97 ± 1.7 vs. 1.4 ± 0.46 pg/mL, p = 0.004). There were no significant differences in other aqueous cytokines.

Conclusions

OSA + group trended towards higher levels of most serum inflammatory markers, suggesting a greater pro-inflammatory state. However, they did not have significantly greater level of aqueous cytokines.
It’s So Ridiculously Soulless: Geolocative Media, Place And Third Wave Gentrification
Authors: Walters Peter , Smith Naomi
Published: May 2022

The impact of gentrification in cities is well established. The continuous evolution in geolocation and social media is intensifying the contest between competing stakeholder claims to authenticity about gentrifying places. In this article, we examine the way that different geolocative social media define a struggle over the rights to authenticity in a rapidly gentrifying neighborhood in Brisbane, Australia. Local voices are often submerged by the voices of commercial imperative, particularly when the rent gap in gentrifying neighborhoods begins to attract abstract capital with a vested interest in commodifying local culture. We use Instagram and Facebook to critically examine how the hegemonic influence of social media can construct a gentrifying neighborhood in immaterial space and argue that these constructions work to eradicate the complex array of communities that comprise this neighborhood in material space.