bluuebunny/crossref_metadata_2025 huggingface dataset:
Machining characteristics investigations of duplex stainless steel by considering dual effect of chip breaker and cooling conditions
Authors: Aşcıoğlu Mümin , Boy Mehmet
Published: April 2022

Duplex stainless steels (DSSs) use in many applications because of their superior properties like high corrosion, good strength, and low cost. On the other hand, machinability of DSSs is very low due to its superior ductility. This study investigates optimization of cutting parameters, cutting environments (dry and cold air), and chip breaker forms by Taguchi–Grey relational analysis in turning of 2205 grade DSS. The turning tests were conducted using Taguchi’s L16 mixed design by measuring and evaluating the cutting force components and surface roughness criteria (Ra and Rz). When turning of DSS2205 material in medium cutting condition, it is suitable to use low feed rate and high cutting speed for reducing of cutting force and surface roughness. In addition, it was shown that the chip breaker form is as important as the cooling medium in terms of minimizing Built-Up-Edge (BUE), which negatively affects the machinability outputs. Grey relational grade (GRG) indicated that the optimum results for all cutting conditions were the cutting speed of 160 m/min, the feed rate of 0.15 mm/rev, GM chip breaker, and cold air cutting environment. Experimental and ANOVA results indicated that the feed rate is the most important parameter on turning of DSS2205, followed by chip breaker, and cutting environment.
Aerodynamic design and evaluation of an open-nose supersonic drone
Authors: Saheby Eiman B. , Hays Anthony P. , Xing Shen
Published: April 2022

The objective of this paper is to investigate the efficiency of a proposed supersonic drone configuration, in terms of drag, ram recovery, and fundamental flight performance factors. Sustainable supersonic cruise at Mach 1.6 is the major segment of the mission profile which affects the overall geometry resulting from the conceptual design phase, a tailless delta drone with an open-nose forebody, lofted around the inlet which consists of an analytical compression surface and a S-duct diffuser. Because the aerodynamics of this unconventional configuration is unknown, a series of CFD simulations using the ANSYS Fluent solver is coupled to the design process to predict both internal and external aerodynamics as a proof of the concept. The simulations indicate that the drone’s overall drag is significantly lower than the other configurations with side or underside integrated inlets while the inlet pressure recovery is adjusted to maximize the engine thrust. The parasite drag at design speed is about 0.022 which is considerably lower than conventional configurations and the pressure recovery more than 0.96 is possible by applying the boundary layer bypass. A comparative study, with a developed thrust model, shows that the configuration satisfies mission requirements and exceeds them at transonic and supersonic flight phases.
Public policies supporting families with children across welfare regimes: An empirical assessment of six European countries
Authors: Pezer Martina
Published: April 2022

Public policies supporting families with children differ among countries but with the same goal of improving the well-being of children. Using a microsimulation model, this article assesses the cash support which families receive for their children in Croatia, Greece, Germany, the Slovak Republic, Sweden and the United Kingdom. The impact of policies across the income distribution on different family sizes, child-rearing cost compensation and child poverty is estimated. A method for the calculation of child-contingent payments for each child by order of birth in the family is proposed as a complementary indicator of policy design. The results confirm that a combination of universal and targeted support (either from family or social assistance benefits) is the most effective in poverty reduction and cost compensation. While high support for larger families greatly reduces poverty, generous universal or even lower support for large families has proved to be at least equally effective.
Bonhoeffer's Christological Interpretation of the Psalms: Tensions, Subjectivity, and the Voice of Christ
Authors: Clark David A. R.
Published: April 2022

By closely examining three texts (“Christ in the Psalms,” Life Together, and Prayerbook of the Bible: An Introduction to the Psalms), this article investigates how Dietrich Bonhoeffer develops and formulates his Christological approach to the Psalms in response to two specific tensions. The first tension emerges as Bonhoeffer discerns a problematic duality in the Psalter as both human prayers and divine word; he resolves this tension by asserting that the Psalms present the voice and presence of Christ, notably amid human suffering. This Christological resolution introduces an interpretive tension, as Bonhoeffer concedes that certain psalms seem implausibly to present Christ's voice; yet by reconstruing the subjectivity of Christ's voice in the Psalms, Bonhoeffer also resolves this second tension Christologically. Thus, Bonhoeffer's Christological approach to the Psalms takes shape as he lingers with—and interprets into—the tensions of Christological exegesis.
3D Scanning and Head-Mounted Products
Authors: Bradtmiller Bruce
Published: April 2022

3D scans are especially useful for the design of products to fit the head and face, where anthropometric dimensions are poorly correlated. When combining multiple scans to design for a target group, scan alignment is critical. Scans can also help determine whether a design can accommodate the target population in a single size or whether multiple sizes are needed.
Continuous finite-time sliding mode control for synchronization of perturbed bistable electrostatic and piezoelectric transducers with external disturbances
Authors: Fang Shitong , Mirzaei Mohammad Javad , Asadollahi Mostafa , Chen Keyu , Liao Wei-Hsin
Published: April 2022

Despite that the synchronization of chaotic systems has been extensively investigated and demonstrated to contribute to physical, chemical, financial, and biological applications, the synchronization of different perturbed bistable systems appears to be an open issue. This is significant with the fact that the bistability widely exists from the visual perception to the electrical and mechanical systems. Therefore, this paper proposes a continuous finite-time terminal sliding mode control method to synchronize two bistable electromechanical transducers, with the electrostatic one acting as the master system and the piezoelectric one acting as the slave system. The model of two systems as well as the control method considering external disturbances and unmodeled dynamics are presented. Numerical simulation results show that two bistable systems can be synchronized with our proposed control method in intrawell, chaotic, and interwell oscillation modes. Furthermore, the chattering issue in conventional discontinuous controllers is eliminated with our designed continuous finite-time terminal protocols for bistable chaotic systems so as to improve the robustness of the controller and avoid its failure. Interesting findings are discussed for the varying system responses and control inputs in different oscillation modes. This work also is expected to facilitate the development of applications where bistability is found such as power or communication systems to resist the external disturbances.
The authoritarian incubator: Examining the effect of conversion to Christianity on right-wing authoritarianism and social dominance orientation
Authors: Lockhart Christopher , Sibley Chris G. , Osborne Danny
Published: April 2022

Although religiosity correlates positively with authoritarianism, the temporal ordering of this relationship is unclear. Because religious teachings often promote authoritarian values, right-wing authoritarianism (RWA) should increase following religious conversion. Yet spiritual beliefs may also promote egalitarianism. As such, social dominance orientation (SDO) might decrease postconversion. We tested these hypotheses using data from a subset of participants who converted to Christianity at some point during a 9-year longitudinal panel study ( N = 536). We also examined a separate subsample who deconverted over the same period ( N = 696). As hypothesised, RWA was stable before conversion, but increased slightly after becoming religious. Unexpectedly, SDO was stable both pre- and postconversion. Conversely, those who deconverted from Christianity experienced declines in RWA both before and after losing their religion, whereas SDO declined only postdeconversion. These results suggest that religious conversion precedes increases in RWA (but not SDO), and that declines in RWA precede deconversion.
An improved micro model for stochastic traffic load simulation with consideration of axle load and microscopic behavior
Authors: He Min , Liang Peng , Wang Yang , Yang Fan , Wang Xiao-guang
Published: April 2022

Simulating the stochastic traffic load has been an important issue for bridge condition evaluation. This paper proposes an improved cellular automaton for stochastic traffic load simulation with consideration of axle load and microscopic interaction. The cells, neighbors, transition rules and boundary conditions in the improved model are all redefined. The cell length can be manually defined with any value. The vehicle load can be precisely simulated using axle load if the cell length is set small or using concentrated load when a large cell length is defined. Acceleration based transition rules are proposed, and different acceleration for each vehicle can be computed to more reasonably simulate the microscopic behavior. The feasibility of the proposed model is validated through comparisons on traffic flow simulation and load effect quantification with in-field weigh in motion data and other models. The results indicate that the proposed model improves the existing models both in vehicle load simulation and traffic flow simulation and can be used for stochastic traffic load simulation for bridges with any length.
Critical Reflection: John Dewey’s Relational View of Transformative Learning
Authors: Holdo Markus
Published: April 2022

How does critical reflection happen? And what circumstances influence the forms critical reflection takes and the issues it comes to address? Recent contributions suggest that we should pay greater attention to the ways social conditions and other factors affect what people reflect upon and how. Examining John Dewey’s perspective on the relationship between practical engagement, objects of knowledge, and democracy, this article develops a relational perspective. Dewey significantly affected how Jack Mezirow theorized transformative learning. But Mezirow’s theory is less attentive to the roles played by particular contextual features, such as structural circumstances, ideas and theories, and individuals’understanding and responses to diverse ways of viewing things and thinking. Rereading Dewey, this article suggests that these subtle features, or subtle “frames of reference,” help construct reflection. Consequently, to deepen critical reflection, these subtle features need to become accessible to people as additional objects of knowledge on which they may reflect.
Genetic and Neurophysiological Biomarkers of Neuroplasticity Inform Post-Stroke Language Recovery
Authors: Dresang Haley C. , Harvey Denise Y. , Xie Sharon X. , Shah-Basak Priyanka P. , DeLoretta Laura , Wurzman Rachel , Parchure Shreya Y. , Sacchetti Daniela , Faseyitan Olufunsho , Lohoff Falk W. , Hamilton Roy H.
Published: April 2022

Background

There is high variability in post-stroke aphasia severity and predicting recovery remains imprecise. Standard prognostics do not include neurophysiological indicators or genetic biomarkers of neuroplasticity, which may be critical sources of variability.

Objective

To evaluate whether a common polymorphism (Val66Met) in the gene for brain-derived neurotrophic factor (BDNF) contributes to variability in post-stroke aphasia, and to assess whether BDNF polymorphism interacts with neurophysiological indicators of neuroplasticity (cortical excitability and stimulation-induced neuroplasticity) to improve estimates of aphasia severity.

Methods

Saliva samples and motor-evoked potentials (MEPs) were collected from participants with chronic aphasia subsequent to left-hemisphere stroke. MEPs were collected prior to continuous theta burst stimulation (cTBS; index for cortical excitability) and 10 minutes following cTBS (index for stimulation-induced neuroplasticity) to the right primary motor cortex. Analyses assessed the extent to which BDNF polymorphism interacted with cortical excitability and stimulation-induced neuroplasticity to predict aphasia severity beyond established predictors.

Results

Val66Val carriers showed less aphasia severity than Val66Met carriers, after controlling for lesion volume and time post-stroke. Furthermore, Val66Val carriers showed expected effects of age on aphasia severity, and positive associations between severity and both cortical excitability and stimulation-induced neuroplasticity. In contrast, Val66Met carriers showed weaker effects of age and negative associations between cortical excitability, stimulation-induced neuroplasticity and aphasia severity.

Conclusions

Neurophysiological indicators and genetic biomarkers of neuroplasticity improved aphasia severity predictions. Furthermore, BDNF polymorphism interacted with cortical excitability and stimulation-induced neuroplasticity to improve predictions. These findings provide novel insights into mechanisms of variability in stroke recovery and may improve aphasia prognostics.
Photodynamic Therapy for Colorectal Cancer: A Systematic Review of Clinical Research
Authors: Guidolin Keegan , Ding Lili , Yan Han , Englesakis HBA Marina , Chadi Sami , Quereshy Fayez , Zheng Gang
Published: April 2022

Background

Photodynamic therapy (PDT) is a therapeutic modality that can be used to ablate tumors using the localized generation of reactive oxygen species by combining a photosensitizer, light, and molecular oxygen. This modality holds promise as an adjunctive therapy in the management of colorectal cancer and could be incorporated into neoadjuvant treatment plans under the auspices of prospective clinical trials.

Methods

We conducted a search of primary literature published until January 2021, based on PRISMA guidelines. Primary clinical studies of PDT for the management of colorectal cancer were included. Screening, inclusion, quality assessment, and data collection were performed in duplicate. Analyses were descriptive or thematic.

Results

Nineteen studies were included, most of which were case series. The total number of patients reported to have received PDT for colorectal cancer was 137, almost all of whom received PDT with palliative intent. The most common photosensitizer was hematoporphyin derivative or Photofrin. The light dose used varied from 32 J/cm2 to 500 J/cm2. Complete tumor response (cure) was reported in 40%, with partial response reported in 43.2%. Symptomatic improvement was reported in 51.9% of patients. In total, 32 complications were reported, the most common of which was a skin photosensitivity reaction.

Conclusions

PDT for the management of colorectal cancer has not been well studied, despite promising results in early clinical case series. New, well designed, prospective clinical trials are required to establish and define the role of PDT in the management of colorectal cancer.
Becoming Afflicted, Becoming Virtuous: Darkest Dungeon and the Human Response to Stress
Authors: Cartlidge James
Published: April 2022

The developers of Red Hook Studios’ 2016 gothic horror “Darkest Dungeon” said that they wanted to “capture the human response to stress.” This paper analyzes how the game does this with its “stress,” “affliction,” and “virtue” mechanics. With reference to research literature on stress, I show how these mechanics, which could easily have been cheap gimmicks, approach the topic of stress with admirable detail, offering a complex reflection on the various aspects, positive and negative, of several possible human responses to stress. They show how different responses include similar symptoms, how stress impacts the people around the stressed person, and make the case that stress can break people, but also fuel heroism. It is a fantastic example of how video game mechanics can be used to educate people about complex subjects without explicitly saying this is what they are doing.
Orientations toward community leadership
Authors: Lind Colene J. , Ekwerike Onyedikachi
Published: April 2022

Communities need inclusive leadership that embraces adaptive change to address complex social problems. Implementing such a leadership has proven elusive, calling into question how people understand community leadership. Through interpretive analysis of autobiographical narratives, we identified three orientations toward community leadership, which we label traditional, liberal, and hybrid. Each suggests a different logic of community, power, and the will to leadership. We argue the hybrid perspective is most in keeping with inclusive and adaptive approaches and suggest ways community leadership educators might promote it.
On Becoming an Emerging Adult Parent in South Africa: Processes of Commitment, Exploration and Reconsideration of a Parental Identity
Authors: Naudé Luzelle , Piotrowski Konrad
Published: April 2022

This study aimed to explore perceptions and experiences of parental identity development, with a specific focus on how the developmental dynamics of emerging adulthood intersect with processes of commitment, exploration and reconsideration of the parental role. Twenty-four South-African emerging adult parents were interviewed. Thematic analysis revealed that the intersection of the transitions towards parenthood and adulthood culminates in a nuanced expression of parental roles in relation to the themes of possibility, instability, in-betweenness, self-focus and identity exploration. Heterogeneity was seen in the expression of mixed emotions of hope and excitement about parenthood together with insecurity and struggles in the attempt to balance multiple roles, especially when facing challenges related to the South-African context. Participants prioritised responsibility and commitment to the parental role, facilitated by the support from parents, extended families and cultural norms. This research presents first steps towards a qualitative inquiry into the three-dimensional conceptualisation of parental identity formation.
The Dimensions of School Discipline: Toward a Comprehensive Framework for Measuring Discipline Patterns and Outcomes in Schools
Authors: Rodriguez Luis A. , Welsh Richard O.
Published: April 2022

The school discipline literature has expanded rapidly in recent decades, yet the conceptualization and measurement of school discipline patterns remains overlooked. In this paper, we present a comprehensive analytic framework to examine school discipline patterns that encompasses school-level metrics that capture the prevalence and disparity in exclusionary discipline and regression-based approaches that examine the likelihood that students experience exclusionary discipline. We apply the framework to New York City and, based on school-level metrics, find that Black students have the highest prevalence and the highest disproportionality. Results from regression models affirm that Black students are most likely to receive office discipline referrals and suspensions and experience differential processing of suspensions for similar categories of infractions. The findings illustrate the nuances of the disciplinary process in schools and inform the consideration of a range of available analytic tools that educational stakeholders may employ to better measure and understand exclusionary discipline.
Keeping Your Glass Half Full: Cognitive Strategy Intervention for Older Adults
Authors: Vorwerk Thomas M. , Shelton Jill T. , Hood Ralph W.
Published: April 2022

When older adults experience memory dysfunction it often compromises their confidence. Older adults’ confidence in their memory can be improved through interventions designed to teach strategies for improving everyday memory functioning. The present study examines the efficacy of a five-session cognitive strategy program designed to be optimistic and inclusive for older adults living in a residential community. The memory self-efficacy of participants in the intervention group improved significantly relative to a control group. Additionally, participants’ knowledge of memory strategies improved overall after completion of this program. Such findings highlight the benefits of practical cognitive-behavioral interventions for bolstering older adults’ confidence and knowledge of memory strategies.
LIC Acquisition of IDBI Bank: The Corporate Marriage of Unfulfilled Promises
Authors: Jasrotia Sahil Singh , Agarwal Tarun , Sridhar I.
Published: April 2022

The insurance business model is fundamentally different from that of the banking business model. The Government of India (GoI) is the sole shareholder, both for Life Insurance Corporation (LIC) and Industrial Development Bank of India (IDBI); therefore, it made a business case for LIC’s acquisition of IDBI bank as a proposition for bailing out IDBI bank and then foray into bank assurance, giving LIC a unique footprint in the banking landscape. This case study highlights the rationale of this acquisition by evaluating synergies, economies of size and scale of opportunities, forward-backward integration of their products and services. This case study illustrates that forced corporate marriages, where the ownership is entirely with the GoI, both before and after the acquisition has its advantages, but on the flip side, has many disadvantages.
A new opportunity for enhancing trial efficiency: Can we investigate intervention implementation processes within trials using SWAT (study within a trial) methodology?
Authors: Ahmed Sadia , Airlie Jennifer , Clegg Andrew , Copsey Bethan , Cundill Bonnie , Forster Anne , Heaven Anne , Johansson Jessica F , Kime Nicola , Moreau Lauren , Ozer Seline , Parker Catriona , Richards Suzanne H , Thompson Ellen , Farrin Amanda J
Published: April 2022

Background

A study within a trial (SWAT) is a self-contained research study embedded within one or more host trials to evaluate or explore alternative ways of delivering or organising a particular trial process. There is limited evidence of SWATs evaluating trial processes other than recruitment and retention.

Purpose

Embedding a SWAT into a host trial provides a potential method of evaluating an aspect of intervention implementation, such as engagement or compliance with the intervention.

Research Design

This paper presents two case studies of SWATs which aim to test the use of video animations to improve intervention implementation, with particular focus on enhancing understanding, engagement and compliance. These are important aspects of intervention implementation as they are directly linked to intervention effectiveness and therefore, important to study.

Results

In this paper, we present the potential benefits of conducting SWATs of intervention implementation processes as well as discussing the methodological considerations for embedding a SWAT of this nature within a host trial. Benefits include the opportunity to test minor refinements to intervention implementation within trials through robust randomised SWATs, and the possibility of increasing trial efficiency by maximising the quality or quantity of intervention implementation. Methodological considerations surrounding the design and conduct of the SWAT as well as statistical and health economics considerations are discussed in this paper.

Conclusions

This paper presents a novel application of SWAT methodology in investigating intervention implementation processes within trial conduct.
Using iMovie for Soundscape Composition in General Music
Authors: Norman Timothy David
Published: April 2022

In this column, I discuss a soundscape composition activity that I implemented with primary/elementary music classes. During this activity, students used the iPad app, iMovie, to record, organize and edit sound to accompany photos of artworks that they had created. Overall, I found iMovie to be a useful app for music composition with general music classes.
Differential regulation of intramuscular fat and abdominal fat deposition in chickens
Authors: Luo Na , Shu Jingting , Yuan Xiaoya , Jin Yuxi , Cui Huanxian , Zhao Guiping , Wen Jie
Published: April 2022

Background

Chicken intramuscular fat (IMF) content is closely related to meat quality and performance, such as tenderness and flavor. Abdominal fat (AF) in chickens is one of the main waste products at slaughter. Excessive AF reduces feed efficiency and carcass quality.

Results

To analyze the differential deposition of IMF and AF in chickens, gene expression profiles in the breast muscle (BM) and AF tissues of 18 animals were analyzed by differential expression analysis and weighted co-expression network analysis. The results showed that IMF deposition in BM was associated with pyruvate and citric acid metabolism through GAPDH, LDHA, GPX1, GBE1, and other genes. In contrast, AF deposition was related to acetyl CoA and glycerol metabolism through FABP1, ELOVL6, SCD, ADIPOQ, and other genes. Carbohydrate metabolism plays an essential role in IMF deposition, and fatty acid and glycerol metabolism regulate AF deposition.

Conclusion

This study elucidated the molecular mechanism governing IMF and AF deposition through crucial genes and signaling pathways and provided a theoretical basis for producing high-quality broilers.
Wellens’ syndrome: incidence, characteristics, and long-term clinical outcomes
Authors: Zhou Li , Gong Xuhe , Dong Tianhui , Cui He-he , Chen Hui , Li Hongwei
Published: April 2022

Background

Few studies with large sample sizes are available regarding patients with Wellens’ syndrome. Therefore, we sought to assess the current incidence, risk factors, clinical presentation and long-term outcomes of this population.

Methods

Among a total of 3528 patients with ACS who underwent angioplasty from 2017 to 2019 in our centre, 2127 NSTE-ACS patients with culprit LAD vessels were enrolled in this study. According to electrocardiographic criteria, the patients were divided into a Wellens’ group (n = 200) and non-Wellens’ group (n = 1927). The primary endpoint was cardiac death; the secondary endpoint was MACCE, a composite of all-cause death, cardiac death, recurrent myocardial infarction, target lesion revascularization, heart failure and stroke.

Results

The incidence of Wellens’ syndrome was 5.7% (200 of 3528) of all ACS patients. Wellens’ syndrome more often manifested as NSTEMI (69% vs. 17.5%, P < 0.001). The percentages of preexisting coronary heart disease (39.6% vs. 23%) and previous PCI (19.5% vs. 9%) were significantly higher in the non-Wellens’ group than in the Wellens’ group (all P < 0.001). More importantly, the proportion of early PCI was higher in the Wellens’ group (68% vs. 59.3%, P = 0.017). At a median follow-up of 24 months, Wellens’ syndrome was not associated with an increased risk of MACCE (P = 0.05) or cardiac death (P = 0.188).

Conclusions

The presence of Wellens’ syndrome is not definitively associated with adverse prognosis in patients with NSTE-ACS. Age ≥ 65 years, diabetes, NSTEMI, eGFR < 60 ml/min and left main disease are associated with the incidence of cardiac death. Early recognition and aggressive intervention are critical, as they may help to attenuate adverse outcomes.
Relevance of presenting risks of frailty, sarcopaenia and osteopaenia to outcomes from aneurysmal subarachnoid haemorrhage
Authors: Lim Jia Xu , Lim Yuan Guang , Kumar Aravin , Cheong Tien Meng , Han Julian Xinguang , Chen Min Wei , Wen David , Lim Winston , Ng Ivan Hua Bak , Ng Vincent Yew Poh , Kirollos Ramez Wadie , Keong Nicole Chwee Har
Published: April 2022

Introduction

Aneurysmal subarachnoid haemorrhage (aSAH) is a condition with significant morbidity and mortality. Traditional markers of aSAH have established their utility in the prediction of aSAH outcomes while frailty markers have been validated in other surgical specialties. We aimed to compare the predictive value of frailty indices and markers of sarcopaenia and osteopaenia, against the traditional markers for aSAH outcomes.

Methods

An observational study in a tertiary neurosurgical unit on 51 consecutive patients with ruptured aSAH was performed. The best performing marker in predicting the modified Rankin scale (mRS) on discharge was selected and an appropriate threshold for the definition of frail and non-frail was derived. We compared various frailty indices (modified frailty index 11, and 5, and the National Surgical Quality Improvement Program score [NSQIP]) and markers of sarcopaenia and osteopaenia (temporalis [TMT] and zygoma thickness), against traditional markers (age, World Federation of Neurological Surgery and modified Fisher scale [MFS]) for aSAH outcomes. Univariable and multivariable analysis was then performed for various inpatient and long-term outcomes.

Results

TMT was the best performing marker in our cohort with an AUC of 0.82, Somers’ D statistic of 0.63 and Tau statistic 0.25. Of the frailty scores, the NSQIP performed the best (AUC 0.69), at levels comparable to traditional markers of aSAH, such as MFS (AUC 0.68). The threshold of 5.5 mm in TMT thickness was found to have a specificity of 0.93, sensitivity of 0.51, positive predictive value of 0.95 and negative predictive value of 0.42. After multivariate analysis, patients with TMT ≥ 5.5 mm (defined as non-frail), were less likely to experience delayed cerebral ischaemia (OR 0.11 [0.01 – 0.93], p = 0.042), any complications (OR 0.20 [0.06 – 0.069], p = 0.011), and had a larger proportion of favourable mRS on discharge (95.0% vs. 58.1%, p = 0.024) and at 3-months (95.0% vs. 64.5%, p = 0.048). However, the gap between unfavourable and favourable mRS was insignificant at the comparison of 1-year outcomes.

Conclusion

TMT, as a marker of sarcopaenia, correlated well with the presenting status, and outcomes of aSAH. Frailty, as defined by NSQIP, performed at levels equivalent to aSAH scores of clinical relevance, suggesting that, in patients presenting with acute brain injury, both non-neurological and neurological factors were complementary in the determination of eventual clinical outcomes. Further validation of these markers, in addition to exploration of other relevant frailty indices, may help to better prognosticate aSAH outcomes and allow for a precision medicine approach to decision making and optimization of best outcomes.
Disparities in the increases of cervical cancer incidence rates: observations from a city-wide population-based study
Authors: Li Ke , Xu Huan , Wang Suixiang , Qin Pengzhe , Liang Boheng
Published: April 2022

Background

Globally cervical cancer incidence rate has been declining continuously. However, an unfavorable trend has been observed in China during the past decades, and the underlying reasons remain unclear. We hereby explore the recent trends of cervical cancer incidence, as well as the underlying determinants using data from Guangzhou, one of biggest cities in China.

Methods

City-wide cancer registration data were obtained from the Guangzhou Center for Disease Prevention and Control from 2004 to 2018. We used the Joinpoint regression models to estimate the average annual percentage change (AAPC) of age-standardized and age-specific incidence rates by regions and by histological subtype. Age-period-cohort models were applied to analyze the period and birth cohort effects on the time trends.

Results

The age-standardized rates (ASRs) of cervical cancer incidence increased at an annual rate of 2.1% [95% confidence interval (CI): 1.0%-3.2%] during 2004–2018. The largest increase in ASRs was found for rural regions, with AAPC of 6.6% [95% CI: 3.7%-9.5%], followed by the suburbs (2.2% [95% CI: 1.0%-3.4%]), while there was no statistically significant increase in urban regions. The ASRs of adenocarcinoma increased faster than those of the squamous cell carcinoma (AAPC = 6.53% [95% CI: 5.0%-8.1%] versus 1.79% [95% CI: 0.8%-2.8%]). A downward trend in urban regions was found in the 20–49 age group, whereas an upward trend was found in the 50 + age group, especially in rural regions. An inverted V-shape was found for cohort effects, with the peak varied by regions, i.e., peaked in the 1966 and 1971 birth cohort in the urban and suburb regions, respectively. Period effects kept increasing during the study period.

Conclusions

We systematically examine the disparities in the increases of cervical cancer incidence rates using city-wide data from Guangzhou. Extensive efforts are warranted to address the large urban–rural disparities in cervical cancer prevention. The combined strategies of vaccination, screening, and health education should be reinforced and locally customized.
Chest high-resolution computed tomography can make higher accurate stages for thoracic sarcoidosis than X-ray
Authors: Zhang Yuan , Du Shan-shan , Zhao Meng-meng , Li Qiu-hong , Zhou Ying , Song Jia-cui , Chen Tao , Shi Jing-yun , Jie Bing , Li Wei , Shen Li , Zhang Fen , Su Yi-liang , Hu Yang , Lower Elyse E. , Baughman Robert P. , Li Huiping
Published: April 2022

Background

To explore if chest high-resolution computed tomography (HRCT) can make higher accurate stages for thoracic sarcoidosis stage than X-ray (CRX) only.

Methods

Clinical data from medical records of consecutive patients with a confirmed diagnosis of pulmonary sarcoidosis at Shanghai Pulmonary Hospital from January 1 2012 to December 31 2016 and consecutive patients treated at the Sarcoidosis Center of University of Cincinnati Medical Center, Ohio, USA from January 1 2010 to December 31 2015 were reviewed. The clinical records of 227 patients diagnosed with sarcoidosis (140 Chinese and 87 American) were reviewed. Their sarcoidosis stage was determined by three thoracic radiologists based on CXR and HRCT presentations, respectively. The stage determined from CXR was compared with that determined from HRCT.

Results

Overall, 50.2% patients showed discordant sarcoidosis stage between CXR and HRCT (52.9% in Chinese and 44.8% in American, respectively). The primary reason for inconsistent stage between CXR and HRCT was failure to detect mediastinal lymph node enlargement in the shadow of the heart in CXR (22.1%) and small nodules because of the limited resolution of CXR (56.6%). Stage determined from HRCT negatively correlated with carbon monoxide diffusing capacity (DLCO) significantly (P < .01) but stage determined from CXR did not. Pleural involvement was detected by HRCT in 58 (25.6%) patients but only in 17 patients (7.5%) by CXR. Patients with pleural involvement had significantly lower forced vital capacity and DLCO than patients without it (both P < .05).

Conclusion

Revised staging criteria based on HRCT presentations included 5 stages with subtypes in the presence of pleural involvement were proposed. Thoracic sarcoidosis can be staged more accurately based on chest HRCT presentations than based on CXR presentations. Pleural involvement can be detected more accurately by HRCT.
Totally tubeless single access tract mini-percutaneous nephrolithotripsy in treatment of large burden > 2-cm and/or complex renal stones: a case series of 62 patients
Authors: Lin Chang-Heng , Lin Ying-Chen , Chiang Heng-Chieh , Yan Meng-Yi , Fang Wan-Yun , Chen Pao-Hwa
Published: April 2022

Background

Limited literature has focused on the use of totally tubeless mini-percutaneous nephrolithotomy (PCNL) for the treatment of large renal stones. We present our findings of treating patients with large and/or complex renal stones using single renal access totally tubeless mini-PCNL.

Methods

From March 2018 to May 2021, 62 consecutive cases in which single tract totally tubeless mini-PCNL was used to treat complex renal stones were enrolled, all with calculi > 2 cm. All procedure of puncture and dilation were guided by fluoroscope. The complexity of stones was assessed according to the Guy’s Scoring System (GSS). The surgical duration, length of hospital stay, analgesia requirement, stone-free rate, and perioperative morbidity were assessed.

Results

The mean preoperative stone burden was 36.69 ± 19.76 mm (above 2 cm in all cases), mean surgical duration was 61.93 ± 40.84 min (range 15–180 min), and mean hematocrit reduction was 4.67 ± 2.83%. Postoperative Nalbuphine was used in 6 patients. The mean length of stay was 2.46 ± 1.19 days (range 2–8 days), and the postoperative stone-free rate was 83.9% (52/62), and 87.1% (54/62) after auxiliary ESWL. The overall complication rate was 14.5%, the majority of complications being postoperative transient fever.

Conclusion

For the treatment of large bursen > 2 cm and/or complex renal stones, totally tubeless single tract mini-PCNL ensures a feasible SFR, low morbidity and short hospital stay. According to the low complication rate in our study, the totally tubeless manner was not associated with an increased risk of postoperative morbidity, and patients benefited from decreased postoperative analgesics use.
Vertucci’s root canal configuration of 11,376 mandibular anteriors and its relationship with distolingual roots in mandibular first molars in a Cantonese population: a cone-beam computed tomography study
Authors: Yang Yeqing , Jiang Chong , Chen Ming , Zeng Junkai , Wu Buling
Published: April 2022

Background

Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation between the complicated root canal configurations of mandibular lateral incisors (MLIs) and the presence of distolingual roots (DLRs) in mandibular first molars (MFMs).

Methods

A total of 11,376 mandibular anterior teeth were scanned by CBCT. Those whose images met the inclusion criteria were first analysed according to Vertucci's root canal configuration and then grouped based on gender, age, and side, and their effects on root canal morphology were analysed. Finally, statistical analysis was used to evaluate the correlation between the complicated root canal configurations of MLIs and the existence of DLRs in MFMs. All statistical analyses were performed by using SPSS 25.0 software. Quantitative data are presented as the mean ± standard deviation. Student’s t tests were used to calculate statistical significance. P < 0.05 was considered statistically significant.

Results

In MAs in the Cantonese population, all mandibular central incisors (MCIs) and MLIs had one root, and 0.37% of mandibular canines (MCs) had two roots. The most common Vertucci's root canal configuration was Vertucci I followed by Vertucci III. A total of 30.91% of MLIs and approximately 8% of MCIs and MCs have complicated root canal configurations. There were no significant differences in the prevalence of DLRs in MFMs and the incidence of complicated root canal configurations of MLIs between males and females or between the right and left teeth. However, a significant difference was found in different age groups of root canal configurations in MLIs. Moreover, significant ipsilateral and contralateral correlations between MFMs with DLRs and MLIs with complicated root canal configurations were observed on both sides.

Conclusion

In Cantonese population, the possibility of complicated root canal configuration in MLIs was higher, when DLR appeared in MFMs.
Mean generation function model in AIDS epidemic estimation
Authors: Yuan Lei , Tian Shiyin , Zhao Zhe , Liu Pei , Liu Lijuan , Sun Jinhai
Published: April 2022

Background

Since the first case of HIV infection was reported in China in 1985, the incidence and mortality of AIDS have been increasing rapidly, which has caused serious damage to the life and health of people in China and all over the world. Therefore, it is of great significance to study the technique for predicting AIDS morbidity and mortality. The purpose of this research is to explore the applicability of the mean generation function model (MGFM) in the early warning of AIDS morbidity and mortality, to predict its prevalence trend, to enrich the prediction techniques and methods of AIDS research and to provide suggestions for AIDS transmission control.

Methods

In this research, the MGFM was applied to predict the incidence and mortality of AIDS in China. AIDS incidence and mortality data in China from 2008 to 2019 were used to construct the prediction model.

Results

The MGFM can predict the annual incidence and mortality of AIDS. The model constructed in this research predicted that the incidence and mortality of AIDS in China will continue to increase from 2020 to 2023.

Conclusion

The mean birth function model was an effective method to monitor and predict the changing trend of AIDS incidence and mortality in China.
Associations between the triglyceride-glucose index and cardiovascular disease in over 150,000 cancer survivors: a population-based cohort study
Authors: Jung Mi-Hyang , Yi Sang-Wook , An Sang Joon , Yi Jee-Jeon , Ihm Sang-Hyun , Han Seongwoo , Ryu Kyu-Hyung , Jung Hae Ok , Youn Ho-Joong
Published: April 2022

Background

The prevention of subsequent cardiovascular disease (CVD) is an essential part of cancer survivorship care. We conducted the present study to investigate the association between the TyG index (a surrogate marker of insulin resistance) and the risk of cardiovascular disease (CVD) events in cancer survivors.

Methods

Adult cancer patients, who underwent routine health examinations during 2009–2010 and were survived for more than 5 years as of January 1, 2011, were followed for hospitalization of CVD (either ischemic heart disease, stroke, or heart failure) until December 2020. Cox model was used to calculate hazard ratios associated with baseline TyG index (loge [fasting triglyceride (mg) × fasting glucose (mg)/2]) for the CVD hospitalization.

Results

A total of 155,167 cancer survivors (mean age 59.9 ± 12.0 years, female 59.1%) were included in this study. A graded positive association was observed between TyG and CVD hospitalization. An 8% elevated risk for CVD hospitalization was observed for a TyG index of 8-8.4 (aHR 1.08 [95% CI 1.01–1.14]); 10% elevated risk for a TyG index of 8.5–8.9 (aHR 1.10 [95% CI 1.03–1.17]); 23% elevated risk for a TyG index of 9.0-9.4 (aHR 1.23 [95% CI 1.15–1.31]); 34% elevated risk for a TyG index of 9.5–9.9 (aHR 1.34 [95% CI 1.23–1.47]); and 55% elevated risk for a TyG index ≥ 10 compared to the reference group (TyG index < 8). Per 1-unit increase in the TyG index, a 16% increase in CVD hospitalization and a 45% increase in acute myocardial infarction hospitalization were demonstrated. Graded positive associations were evident for atherosclerotic CVD subtypes, such as ischemic heart disease, acute myocardial infarction, and ischemic stroke, but not for hemorrhagic stroke or heart failure.

Conclusions

The TyG index may serve as a simple surrogate marker for the risk stratification of future CVD events, particularly atherosclerotic subtypes, in cancer survivors.
The cytokines interleukin-6 and interferon-α induce distinct microglia phenotypes
Authors: West Phillip K. , McCorkindale Andrew N. , Guennewig Boris , Ashhurst Thomas M. , Viengkhou Barney , Hayashida Emina , Jung So Ri , Butovsky Oleg , Campbell Iain L. , Hofer Markus J.
Published: April 2022

Background

Elevated production of the cytokines interleukin (IL)-6 or interferon (IFN)-α in the central nervous system (CNS) is implicated in the pathogenesis of neurological diseases such as neuromyelitis optica spectrum disorders or cerebral interferonopathies, respectively. Transgenic mice with CNS-targeted chronic production of IL-6 (GFAP-IL6) or IFN-α (GFAP-IFN) recapitulate important clinical and pathological features of these human diseases. The activation of microglia is a prominent manifestation found both in the human diseases and in the transgenic mice, yet little is known about how this contributes to disease pathology.

Methods

Here, we used a combination of ex vivo and in situ techniques to characterize the molecular, cellular and transcriptomic phenotypes of microglia in GFAP-IL6 versus GFAP-IFN mice. In addition, a transcriptomic meta-analysis was performed to compare the microglia response from GFAP-IL6 and GFAP-IFN mice to the response of microglia in a range of neurodegenerative and neuroinflammatory disorders.

Results

We demonstrated that microglia show stimulus-specific responses to IL-6 versus IFN-α in the brain resulting in unique and extensive molecular and cellular adaptations. In GFAP-IL6 mice, microglia proliferated, had shortened, less branched processes and elicited transcriptomic and molecular changes associated with phagocytosis and lipid processing. In comparison, microglia in the brain of GFAP-IFN mice exhibited increased proliferation and apoptosis, had larger, hyper-ramified processes and showed transcriptomic and surface marker changes associated with antigen presentation and antiviral response. Further, a transcriptomic meta-analysis revealed that IL-6 and IFN-α both contribute to the formation of a core microglia response in animal models of neurodegenerative and neuroinflammatory disorders, such as Alzheimer’s disease, tauopathy, multiple sclerosis and lipopolysaccharide-induced endotoxemia.

Conclusions

Our findings demonstrate that microglia responses to IL-6 and IFN-α are highly stimulus-specific, wide-ranging and give rise to divergent phenotypes that modulate microglia responses in neuroinflammatory and neurodegenerative diseases.
The fading popularity of a local ecological calendar from Brunei Darussalam, Borneo
Authors: Bakar Nurzahidah , Franco F. Merlin
Published: April 2022

Background

Local ecological calendars are ecocultural frameworks that link temporal and spatial scales, contributing to resilience and adaptive management of natural resources and landscapes. They also facilitate management, access and withdrawal of provisioning ecosystem services. In this article, we describe how the ecological calendar of the Kedayan people of Brunei Darussalam links skyscape and biodiversity with sociocultural aspirations to foster adaptive management of landscape, and provide an understanding of the transmission of calendric knowledge in the community.

Methods

In 2018, we collaborated with sixteen purposively sampled knowledge keepers from the Kedayan community of Brunei Darussalam to document the Kedayan local ecological calendar, and develop a calendrical pictogram. Using a structured questionnaire, we then interviewed 107 randomly selected community members, to understand the contemporary relevance and popularity of the Kedayan calendar, and the transmission of calendric knowledge in the community.

Results

Our findings reveal that very few respondents (n = 27, 25.3%) are aware of the existence of Kedayan ecological calendar; majority (n = 80, 74.7%) were not aware of its existence. There is no statistically significant correlation between consulting healers, knowledge on appropriate time requisite to consult healers, and awareness and self-professed knowledge of Kedayan calendar. Only 14 (13.1%) of the respondents reported to have received some form of calendric knowledge, while the majority (86.9%;n = 93) never received any calendric knowledge. Only a negligible 1.9% reported to have transmitted calendric knowledge to others indicating a breakdown in transmission of calendric knowledge.

Conclusion

The calendric pictogram would help the community in revitalizing their calendar. However, the community will have to invest on enhancing transmission of calendric knowledge.