bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute abdominal pain induced by renal leiomyoma in a young patient: a case report
Authors: Ma Weina , Jiang Huali , Zhang Yunzhen , Zhang Jian , Jiang Hualong
Published: July 2021

Renal leiomyoma is a rare benign mesenchymal tumor of the kidney that predominantly originates from the renal capsule or pelvis. However, because of its nonspecific clinical and imaging features, renal leiomyoma remains poorly characterized and may even lead to radical or partial nephrectomy on the basis of preoperative suspicion of renal carcinoma. We herein present a case involving a 12-year-old boy with acute abdominal pain who was diagnosed with renal leiomyoma based on both clinical imaging and histopathological examination. One year after radical nephrectomy, the patient recovered to good condition. This case demonstrates that the comprehensive application of imaging and histology are essential for early clinical diagnosis and effective treatment of renal leiomyoma.
Comparison of Roll and Pitch Among Patients with Vertical and Horizontal Skeletal Patterns Using Cant-O-Meter: A New Gyroscopic Device for Measuring Occlusal Cant
Authors: Ravi Janani , Jnaneshwar Poornima , Krishnaraj R. , Ravi K.
Published: July 2021

In Orthodontics, initial classification of malocclusions was based on planar malocclusions in the anteroposterior, transverse and vertical planes that were based only on translation of the jaws in space. In 2007, Ackermann and Proffit introduced rotational components—roll, pitch, and yaw—analogous to the position of the airplane in space. These rotations can result in canting of the occlusal plane.

There are no quantitative methods available in the literature for a precise estimation of the occlusal cant.

Qualitative evaluation of occlusal cant is subjective and is associated with inter-individual variations. This article describes an indigenously devised simple chairside device that can quantify cant of the occlusal plane in terms of the roll and pitch in degrees. There is accurate quantification of cant, which can be used effectively in many clinical scenarios.
Curbspace Management Challenges and Opportunities from Public and Private Sector Perspectives
Authors: Diehl Caleb , Ranjbari Andisheh , Goodchild Anne
Published: July 2021

With rapid growth in on-demand delivery, ridehailing, and shared mobility use, cities are observing dramatic increases in demand for curbspace. In response, cities and private companies have proposed a diverse range of structural, policy and technology solutions to manage the curb lane more efficiently. Through structured interviews with public agency and private company staff and a review of existing pilot project evaluations and curb management guidelines, this study surveys contemporary approaches to curbspace management in 14 U.S. cities and documents the challenges and opportunities associated with them. A total of 17 public agencies (including public works departments, transportation agencies, and metropolitan planning organizations) in every census region of the U.S.A., and 10 technology companies were interviewed. The results show that the top curb management concerns among public officials are enforcement and communication, data collection and management, and interagency coordination. Interviewees reported success with policies such as allocating zones for passenger pick-ups and drop-offs, incentives for off-peak delivery, and requiring data sharing in exchange for reservable or additional curb spaces. Technology company representatives discussed new tools and technologies for curb management, including smart parking reservation systems, occupancy sensors and cameras, and automated enforcement. Both public and private sector staff expressed a desire for citywide policy goals around curb management, more consistent curb regulations across jurisdictions, and a common data standard for encoding curb information.
Applying the Maximum Entropy Model to Urban Freight Transportation Planning: An Exploratory Analysis of Warehouse Location in the Belo Horizonte Metropolitan Region
Authors: Oliveira Isabela Kopperschmidt de , Oliveira Leise Kelli de , Nóbrega Rodrigo Affonso de Albuquerque
Published: July 2021

In Brazil, neglect and lack of data have complicated urban freight transportation planning. Belo Horizonte is one such example, where the administration’s disregard for urban freight transport has led to multiple negative externalities. Using the maximum entropy method, this study analyzed the influence of urban planning factors on warehouse location in the Belo Horizonte Metropolitan Region. Warehouse location was analyzed using 19 factors, with the results recorded on a map of logistic probabilities concerning locating warehouses. Given this is exploratory research, the model was validated by visual comparison to address the four hypotheses: (i) warehouses tend to be located near roads and railroads; (ii) warehouses tend to be located close to their consumer markets; (iii) warehouses tend to be located in urban areas; and (iv) warehouses tend to be located next to each other, creating clusters. These hypotheses were based on the extant literature and confirmed from observations of the Belo Horizonte Metropolitan Region. The results also demonstrated that the maximum entropy method can suitably model freight transportation in support of urban planning policy.
Compared Heritability of Chronotype Instruments in a Single Population Sample
Authors: Leocadio-Miguel Mario A. , Ruiz Francieli S. , Ahmed Sabrina S. , Taporoski Tâmara P. , Horimoto Andréa R. V. R. , Beijamini Felipe , Pedrazzoli Mario , Knutson Kristen L. , Pereira Alexandre C. , von Schantz Malcolm
Published: July 2021

It is well established that the oldest chronotype questionnaire, the morningness-eveningness questionnaire (MEQ), has significant heritability, and several associations have been reported between MEQ score and polymorphisms in candidate clock genes, a number of them reproducibly across populations. By contrast, there are no reports of heritability and genetic associations for the Munich chronotype questionnaire (MCTQ). Recent genome-wide association studies (GWAS) from large cohorts have reported multiple associations with chronotype as assessed by a single self-evaluation question. We have taken advantage of the availability of data from all these instruments from a single sample of 597 participants from the Brazilian Baependi Heart Study. The family-based design of the cohort allowed us to calculate the heritability (h2) for these measures. Heritability values for the best-fitted models were 0.37 for MEQ, 0.32 for MCTQ, and 0.28 for single-question chronotype (MEQ Question 19). We also calculated the heritability for the two major factors recently derived from MEQ, “Dissipation of sleep pressure” (0.32) and “Build-up of sleep pressure” (0.28). This first heritability comparison of the major chronotype instruments in current use provides the first quantification of the genetic component of MCTQ score, supporting its future use in genetic analysis. Our findings also suggest that the single chronotype question that has been used for large GWAS analyses captures a larger proportion of the dimensions of chronotype than previously thought.
“I Am Almost a Breadwinner for My Family”: Exploring the Manifestation of Agency in Sex Workers’ Personal and Professional Contexts
Authors: Karandikar Sharvari , Casassa Kaitlin , Knight Logan , España Megan , Kagotho Njeri
Published: July 2021

While societal and structural factors often constrain women’s agency in patriarchal settings, women nevertheless find creative ways to manifest and develop agency. Female sex workers (FSWs), in particular, are regularly assumed to have little or no agency, but an important body of literature suggests otherwise. To add to this knowledge, this study sought to answer the question: How do FSWs in Mumbai, India, exert agency in personal and professional contexts? In-depth interviews were conducted with 12 FSWs in the Kamathipura red-light area. Four themes emerged: (a) sex work as a rational and empowering choice, (b) resources and assets, (c) sex work as a means of achievement, and (d) managing violence, retribution, and fear. These themes reveal expressions of agency that illustrate how sex workers are intentional, rational, goal-oriented, and resilient. The findings of this study can contribute to the removal of stigma surrounding sex work and inform service providers working with this population in their efforts to treat sex workers with dignity and respect. Further research is needed in this area, especially which centers on the voices of the agentic sex workers themselves.
Breastfeeding Motivation Predicts Infant Feeding Intention and Outcomes: Evaluation of a Novel Adaptation of the Treatment Self-Regulation Questionnaire
Authors: Martin Hayley , van Wijngaarden Edwin , Seplaki Christopher L. , Stringer Jenney , Williams Geoffrey C. , Dozier Ann M.
Published: July 2021

Background:

Identifying those at risk for suboptimal breastfeeding outcomes remains critical for improving maternal and child health. Prenatal breastfeeding motivation may be a key predictor useful for identifying those who would benefit from additional breastfeeding support.

Research Aims:

To (1) validate a breastfeeding-specific adaptation of the Treatment Self-Regulation Questionnaire (TSRQ-BF); and (2) determine if breastfeeding motivation predicts prenatal breastfeeding intentions and early breastfeeding outcomes.

Methods:

Participants in their third trimester of pregnancy ( N = 150) completed several instruments, including the TSRQ-BF and infant feeding intention, and could opt to participate in an assessment of early breastfeeding outcomes (by medical record review). TSRQ-BF subscales were derived from factor analysis, and multivariable regression was used to evaluate the association between TSRQ-BF subscale scores and breastfeeding intention and outcomes during the birth hospitalization.

Results:

Autonomous (related to personal values/beliefs regarding self) and Autonomous-Baby (values/benefits for the infant) subscale scores were positively associated with intended exclusivity (aOR [95% CI]: 2.22 [1.57, 3.30], 4.94 [2.49, 11.07], respectively) while higher scores on these subscales predicted longer time to planned cessation (aHR [95% CI]: 0.72 [0.61, 0.84],0.52 [0.34, 0.81]). Higher Amotivation (lack of motivation) scores were negatively associated with intended exclusivity (0.45 [0.26, 0.74]). Higher scores on Autonomous, Autonomous-Baby, and Controlled (avoidance of negative feelings/punishment or gaining reward) subscales were associated with greater odds of hospital exclusivity (aOR [95% CI]: 3.39 [1.75, 8.00], 3.44 [1.66, 9.04] and 6.05 [1.88, 29.04]) and lower odds of 2-day formula supplementation (aOR [95% CI]: 0.31 [0.14, 0.59],0.28 [0.11, 0.59], 0.19 [0.04, 0.62]).

Conclusions:

The TSRQ-BF predicted breastfeeding intent and outcomes, and may be helpful for identifying patients at risk for suboptimal breastfeeding outcomes before delivery.
Design approach of heavy goods vehicle underrun protection using morphological analysis
Authors: Lerspalungsanti Sarawut , Pitaksapsin Narong , Viriyarattanasak Perakit , Wattanawongsakun Prasit , Suebnunta Narongrit
Published: July 2021

One of the most harmful of two-vehicle crashes to passenger vehicle occupants is when the front of passenger vehicle hits and passes underneath the rear of truck. It resulted in 23% of total death from two-vehicle crashes with a truck in 2018 based on data from the U.S. Department of transportation’s Fatality Analysis Reporting System (FARS). To reduce the violence of such accidents, the rear underrun protective device (RUPD) is installed on the rear of heavy goods vehicle (HGV), to cause the crumple zone of the impacting passenger vehicle absorbing the impact energy and prevent the impacting passenger vehicle from getting crushed under the HGV. This article demonstrates an approach to design the RUPD based on design inputs, including the structural strength, the local RUPD builders, and the variation of commercial HGV types in Thailand. The morphological analysis is applied along with brainstorming among design team, local manufacturers, and government agency, to generate a total of 72 potential RUPD solutions. In this study, three potential RUPD designs were proposed as RUPD prototypes for different HGV types to investigate their structural strength in terms of strain, deformation, and maximum reaction force. The explicit dynamic finite element (FE) method was implemented to accurately simulate the structural strength of the RUPD prototype since its results were validated by the real test of full-scale prototype with reference to the UN R58 standard. From the results, all proposed RUPD prototypes satisfied the UN R58 standard and are not violated by test loads at all relevant positions. In addition, different designs of the protective beam, which was found to be the main load-bearing resstive component of RUPD, were proposed. Their structural strength and energy-absorbing capability were examined by FE simulation to allow local RUPD builders to have alternatives for RUPD fabrication depending on their resources and applications. Besides, the proposed design approach in this study could be further applied as a guideline design for other RUPD types in a commercial scale.
Factors associated with self-reported adherence to daily oral pre-exposure prophylaxis among men who have sex with man and transgender women: PrEP Brasil study
Authors: Monteiro Spindola Marins Luana , Silva Torres Thiago , Luz Paula Mendes , Moreira Ronaldo I , Leite Iuri C , Hoagland Brenda , Kallas Esper G , Madruga José V , Grinsztejn Beatriz , Veloso Valdilea Gonçalves ,   for the PrEP Brasil Study Group
Published: July 2021

Understanding the factors associated with pre-exposure prophylaxis (PrEP) adherence may help in the development of strategies to support, motivate and sustain PrEP use. This study estimated self-reported adherence, described perceived barriers and facilitators and investigated factors associated with adherence to daily oral PrEP among men who have sex with man (MSM) and transgender women after 1 year of PrEP use in Brazil. PrEP Brasil was a prospective, multicentre, open-label demonstration study with MSM and transgender women at high risk for HIV infection. We used logistic regression to evaluate factors associated with complete adherence (not forgetting to take any pills in the past 30 days) at week 48. Of 338 participants included in this analysis, 60% reported complete adherence to daily oral PrEP at week 48. Perceived barriers and facilitators to daily oral PrEP were reported by 38.2% and 98.5%, respectively. The most reported barrier and facilitator were ‘I forgot to take my pills’ (19.2%) and ‘Associate PrEP with a daily activity/task’ (58.6%), respectively. In final multivariable analysis, living in Rio de Janeiro (aOR: 0.38; 95% CI: 0.20–0.73), being transgender women (aOR: 0.22; 95% CI: 0.07–0.73), reporting stimulant use (a OR: 0.40; 95% CI: 0.20–0.80) and having any perceived barriers to daily oral PrEP (aOR: 0.12; 95% CI: 0.07–0.23) were associated with decreased odds of complete adherence. Our findings provide information for developing the best practices to promote PrEP adherence in the Brazilian context.
The pathology of natural and experimentally induced Campylobacter jejuni abortion in sheep
Authors: Yaeger Michael J. , Sahin Orhan , Plummer Paul J. , Wu Zuowei , Stasko Judith A. , Zhang Qijing
Published: July 2021

We describe here the gross and microscopic lesions in 18 experimentally induced and 120 natural Campylobacter abortions. In natural Campylobacter abortions, gross lesions were reported infrequently; placentitis was recorded in 6% and hepatic lesions in 4% of our field cases. Placentitis was the microscopic lesion identified most consistently in natural abortions (93%) and was often observed in association with abundant bacterial colonies in chorionic villi (54%) and less often with placental vasculitis (13%). In natural abortions, suppurative fetal pneumonia (48%), necrosuppurative hepatitis (16%), and purulent meningitis (7%) were also observed. The better-preserved specimens from experimentally induced abortions were utilized to define placental changes more precisely. Placentitis was identified in all 18 experimentally induced abortions and was observed most consistently in the chorionic villus stroma (100%), often accompanied by suppurative surface exudate (89%). An inflammatory infiltrate was less commonly identified in the cotyledonary hilus (39%) and intercotyledonary placenta (22%). Bacteria were visualized in H&E-stained sections in 89% of placentas from experimentally infected ewes, primarily as well-demarcated bacterial colonies within subtrophoblastic, sinusoidal capillaries (89%), in the cotyledonary villus stroma (89%), and within the cytoplasm of trophoblasts (22%). Transmission electron microscopy and immunohistochemistry confirmed that the vast majority of the well-demarcated bacterial colonies characteristic of Campylobacter abortion were within subtrophoblastic sinusoidal capillaries. The most characteristic microscopic lesions identified in cases of Campylobacter abortion in sheep were placentitis with placental bacterial colonies, placental vasculitis, and fetal pneumonia.
The Role of Schedule Volatility in Home Health Nursing Turnover
Authors: Bergman Alon , Song Hummy , David Guy , Spetz Joanne , Candon Molly
Published: July 2021

Despite considerable research on nursing turnover, few studies have considered turnover among nurses working in home health care. Using novel administrative data from one of the largest home health care organizations in the United States, this study examined turnover among home health nurses, focusing on the role of schedule volatility. We estimated separation rates among full-time and part-time registered nurses and licensed practical nurses and used daily visit logs to estimate schedule volatility, which was defined as the coefficient of variation of the number of daily visits in the prior four weeks. Between 2016 and 2019, the average annual separation rate of home health nurses was over 30%, with most separations occurring voluntarily. Schedule volatility and turnover were positively associated for full-time nurses, but not for part-time nurses. These results suggest that reducing schedule volatility for full-time nurses could mitigate nursing turnover in home health care.
Risk of Future Maltreatment: Examining Whether Worker Characteristics Predict Their Perception
Authors: Lwin Kristen , Filippelli Joanne , Fallon Barbara , King Jason , Trocmé Nico
Published: July 2021

Child welfare workers aim to promote the well-being and safety of children and are the link between the child welfare system and families. Families served by the child welfare system should expect similar service based on clinical factors, not based on their caseworker’s characteristics. Using secondary data analyses of the most recent Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2008) and multilevel modeling, this study examines whether child welfare worker characteristics, such as education level and field, age, and experience predict their perception of the risk of future maltreatment. A total of 1729 case-level investigations and 419 child welfare workers were included in this study. Several one-level logistic regression and two-level logistic regression analyses were run. The best-fit model suggests that caseworkers with a Master’s degree, more than 2 years of experience, and more than 18 cases were significantly more likely to perceive risk of future maltreatment. Further, the interaction between degree level and age also significantly predicted the perception of risk of future maltreatment. Results suggest that the perception of risk of future maltreatment may be influenced by caseworker factors, thus service to families may differ based on caseworker characteristics.
Imitation Recognition by Minimally Verbal Young Children: A Comparison Between Down Syndrome and Autism Spectrum Disorder
Authors: Töret Gökhan
Published: July 2021

Research has shown that children with autism spectrum disorder (ASD) display limited imitation recognition behaviors in comparison with typically developing children. However, the levels of imitation recognition of minimally verbal children with ASD relative to those with developmental disabilities are unknown. The purpose of this study was to compare the imitation recognition behaviors of 20 minimally verbal children with ASD and 20 minimally verbal children with Down syndrome (DS) when imitated by an adult in a play context. Results showed that children with ASD display more limited imitation recognition than children with DS. These results indicate that children with ASD are weaker in displaying imitation recognition. However, both groups displayed an association between imitation recognition and a variety of play actions in both groups.
Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study
Authors: Mengistu Yordanos , Dedefo Gobena , Arkew Mesay , Asefa Gebeyehu , Jebessa Gutema , Atnafu Abay , Ataro Zerihun , Kinde Samuel
Published: July 2021

Background:

Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia.

Objective:

Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects.

Method:

A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement.

Result:

(Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control.

Conclusion:

There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects.

Recommendation:

Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.
Understanding familial locative play: Exploring parent online social learning to play Pokémon Go
Authors: Saker Michael , Mercea Dan
Published: July 2021

Pokémon Go is a hybrid reality game (HRG) that research suggests is played by families in the context of joint-media engagement. Yet, the game interface itself provides little information about how to approach the game. Given this and the fact that many parents play this HRG with their young children, we examine the process of parent online social learning to play Pokémon Go. Drawing on an original study of Pokémon Go conducted between August and November 2019, including a Facebook survey on a non-probabilistic purposive sample, and semi-structured interviews with a range of parents who play this HRG with their children, the aim of this article is to explore parent online social learning as a path to optimising in-game performance. In the main, we found that the frequency with which parents followed tips provided by individuals online related inversely to how well they knew them and was differentially linked to the sources of information parents used. We nuance these findings with insights from the interviews.
Converging cultures of communication: A comparative study of Internet use in China, Europe, and the United States
Authors: Ørmen Jacob , Helles Rasmus , Bruhn Jensen Klaus
Published: July 2021

Global Internet use is circumscribed by local political and economic institutions and inscribed in distinctive cultural practices. This article presents a comparative study of Internet use in China, the United States, and five European countries. The empirical findings suggest a convergence of cultures, specifically regarding interpersonal communication, alongside characteristic national and sociodemographic configurations of different prototypes of human communication. Drawing on the classic understanding of communication as a cultural process producing, maintaining, repairing, and transforming a shared reality, we interpret such configurations as cultures of communication, which can be seen to differ, overlap, and converge across regions in distinctive ways. Looking beyond traditional media systems, we call for further cross-cultural research on the Internet as a generic communication system joining global and local forms of interaction.
Living with television and the Internet
Authors: Lull James
Published: July 2021

We communicate to survive. The social history of our species can be characterized by how we continuously expand our ability to connect with others. Television and the Internet function as unique resources people creatively use to fulfill their social needs and build communities. But they do so in very different ways. By placing television and the Internet in evolutionary perspective, this commentary compares the form, content, and contexts of how the two technologies are used as culturally embedded social resources. The methodological challenge of generating empirical data to reveal how the Internet is used socially is addressed. Quantitative and qualitative assessments, especially ethnography, play complementary roles in describing how multi-modal Internet users construct the social contacts and relationships that shape their everyday lives in the Communication Age.
CFD simulation-based predesign of an advanced gas-diesel combustion concept
Authors: Winter Hubert , Aßmus Kevin , Redtenbacher Christoph , Dimitrov Dimitar , Wimmer Andreas
Published: July 2021

The greenhouse gas saving potential of using gaseous fuels with high methane content (e.g. natural gas) in internal combustion engines instead of conventional liquid fossil fuels (e.g. petrol, diesel) is considerable due to the comparatively low emission of carbon dioxide resulting from the low C/H ratio of methane. However, to fully exploit this potential, it is of utmost importance to keep methane slip at a very low level. In contrast to mixture aspirated gas engines and diesel-gas engines, the gas-diesel combustion concept avoids methane slip nearly completely since the gaseous fuel is directly injected into the combustion chamber at the end of the high-pressure phase of the engine cycle, resulting in mixing-controlled combustion with low emission of unburned hydrocarbons. An advanced high-speed large engine concept based on the gas-diesel combustion process was developed. An effective and reliable virtual design methodology was applied during the development of the concept. The methodology comprehensively combines 3D CFD and 1D simulation tools in the combustion concept predesign phase with experiments on a single-cylinder research engine in the concept validation phase. A major challenge in the virtual design of this dual fuel combustion process is the large number of degrees of freedom that result in particular from the use of a fully flexible combined gas/diesel injector. This paper describes in detail the role of 3D CFD simulation in this approach, which allows precise prediction of the optimal geometries and operating strategies for high-efficiency and low-emission engine operation.
Tracing The Shapes of Multimodal Rhetoric: Showing the Epistemic Powers of Visualization
Authors: Pflaeging Jana , Stöckl Hartmut
Published: July 2021

This visual essay seeks to substantiate and illustrate the tenet that formal–structural elements in graphic design carry rhetorical functions. Based on a National Geographic feature article, the authors demonstrate methods for ‘measuring’ layout, colour and typography, and show the results in infographic visualizations. At the same time, the study showcases the epistemic value of these visualizations. The perspective adopted puts the double-page centre-stage.
Kra canal project and its influence on world maritime trade
Authors: Zuhdi Achmad , Turan Eda
Published: July 2021

Kra Canal that has been discussed since 1850’s, is a significant issue for world maritime shipping players and members of the industry. The main aims of constructing the canal are to reduce the overcrowd of Malacca/Singapore Straits and prevent piracy attacks. Vessels sailing from Indian Ocean to South China Sea could reduce up to 700 nautical miles (NM) or 1300 km. Kra canal would take place in the southern part of Thailand, with 102 km of length, 400 m of width, and 25 m of depth. Songkhla and Satun, two provinces in South of Thailand, are the starting and ending points of this canal. In this study, information regarding Kra Canal has been presented and voyage estimation of some ships in alteration of marine fuel oil consumption and costs have been calculated. It is estimated that Kra Canal could reduce up to 2 days with constant speed of 13 knots, without considering the congestion in Malacca/Singapore Straits. It is also predicted that the construction of the canal will effect world maritime transportation line and economy around canal.
Evaluation of methods for prediction of evaporation from water pools
Authors: Shah Mirza M
Published: July 2021

Calculation of evaporation is needed in many applications including swimming pools, water reservoirs, nuclear fuel pools, pools for rejection of heat from refrigeration systems, process tanks, etc. Hence accurate methods for prediction of evaporation are needed. Many prediction methods have been published including analytical models and empirical correlations. In the present study, 18 published prediction methods are compared to a very wide-ranging database which includes data from laboratory scale studies, swimming pools, and fuel pools in nuclear power plants. The data are from 25 sources. The range of data includes air temperatures from 6°C to 200°C, water temperatures from 7.1°C to 94.2°C, relative humidity from 0.21% to 98%, and air velocity from 0 to 8.5 m/s. The accuracy of prediction methods is examined for conditions in which natural convection dominates, that in which forced convection dominates, and that in which natural convection is absent. The results are reported and discussed. Recommendations are made for application.
Using formal methods for autonomous systems: Five recipes for formal verification
Authors: Luckcuck Matt
Published: July 2021

Formal Methods are mathematically-based techniques for software design and engineering, which enable the unambiguous description of and reasoning about a system’s behaviour. Autonomous systems use software to make decisions without human control, are often embedded in a robotic system, are often safety-critical, and are increasingly being introduced into everyday settings. Autonomous systems need robust development and verification methods, but formal methods practitioners are often asked: Why use Formal Methods for Autonomous Systems? To answer this question, this position paper describes five recipes for formally verifying aspects of an autonomous system, collected from the literature. The recipes are examples of how Formal Methods can be an effective tool for the development and verification of autonomous systems. During design, they enable unambiguous description of requirements; in development, formal specifications can be verified against requirements; software components may be synthesised from verified specifications; and behaviour can be monitored at runtime and compared to its original specification. Modern Formal Methods often include highly automated tool support, which enables exhaustive checking of a system’s state space. This paper argues that Formal Methods are a powerful tool for the repertoire of development techniques for safe autonomous systems, alongside other robust software engineering techniques.
Clinical evaluation of a wrist sensorimotor rehabilitation program for triangular fibrocartilage complex injuries
Authors: Chen Zhiqing
Published: July 2021

Introduction

Triangular fibrocartilage complex (TFCC) injuries are associated with distal radioulnar joint (DRUJ) instability and impaired wrist proprioception. Sensorimotor training of extensor carpi ulnaris (ECU) and pronator quadratus (PQ) can enhance DRUJ stability. With limited evidence on effectiveness of TFCC sensorimotor rehabilitation, this study aimed to evaluate the effects and feasibility of a novel wrist sensorimotor rehabilitation program (WSRP) for TFCC injuries.

Methods

Patients diagnosed with TFCC injuries were recruited from May 2018 to January 2020 at an outpatient hand clinic in Singapore General Hospital. There are four stages in WSRP: (1) pain control, (2) muscle re-education and joint awareness, (3) neuromuscular rehabilitation, and (4) movement normalization and function. WSRP also incorporated dart throwing motion and proprioceptive neuromuscular facilitation. Outcome measures included grip strength measured with grip dynamometer, numerical pain rating scale, joint position sense (JPS) measurement, weight bearing measured with the ‘push-off’ test, and wrist function reported on the Patient Rated Wrist Hand Evaluation.

Results

Ten patients completed the WSRP. Mean changes were compared with minimal clinically important differences (MCID) for outcomes. All patients achieved MCID on pain, 70% of patients achieved MCID on grip strength, weight bearing and wrist function. Paired t-tests and Cohen’s D for outcome measures were calculated. There were large effect sizes of 2.47, 1.35, and 2.81 for function, grip strength and pain respectively, and moderate effect sizes of 0.72 and 0.39 for axial loading and JPS respectively.

Discussion

WSRP presents a potential treatment approach in TFCC rehabilitation. There is a need for future prospective clinical trials with control groups.
CT Osteoabsorptiometry Assessment of Subchondral Bone Density Predicts Intervertebral Implant Subsidence in a Human ACDF Cadaver Model
Authors: Orías Alejandro A. Espinoza , Sheha Evan , Zavras Athan , John Paul , Fitch Ashlyn A. , An Howard S. , Inoue Nozomu , Colman Matthew
Published: July 2021

Study Design:

Cadaveric biomechanics study.

Objective:

Subchondral bone mineral density (sBMD) reflects the long-term mineralization and distribution of stress on joints. The use of 3-dimensional (3-D) methods to evaluate sBMD, including computed tomography osteoabsorptiometry (CT-OAM), enables the assessment of density distribution with emphasis on subchondral bone. This study sought to measure the sBMD of cervical endplates using CT-OAM and correlate it to mechanical implant subsidence in a cadaveric model.

Methods:

Fourteen fresh human cadaveric cervical spines were subjected to dynamic testing after single level discectomy and instrumentation using a PEEK interbody spacer. Specimens were imaged with CT 3 times: 1st) whole intact cervical spine, 2nd) after implantation, and 3 rd) after testing. These images were used to assess sBMD distributions using CT-OAM directly underneath the spacer. Subsidence was defined as the displacement of the device into the endplates.

Results:

The observed “failure mode” was consistently recorded as subsidence, with a mean of 0.45 ± 0.36 mm and 0.40 ± 0.18 mm for the C4-5 and C6-7 levels, respectively. There were no differences by level. The experimental cyclic test showed that denser endplates experienced less deformation under the same load.

Conclusions:

This study achieved its stated aim of validating the use of CT-OAM as a method to analyze the sBMD of the cervical endplates. Studies such as this are providing new information on available technology such as CT-OAM, providing new tools for clinicians treating spinal conditions in need of augmentation and stabilization via interbody devices.
Medial Ulnar Collateral Ligament Repair With Internal Brace Augmentation: Results in 40 Consecutive Patients
Authors: O’Connell Robert , Hoof Marcus , Heffernan John , O’Brien Michael , Savoie Felix
Published: July 2021

Background:

Medial ulnar collateral ligament (MUCL) repair has been proven to be effective in nonprofessional overhead-throwing athletes, with faster and higher rates of return to play (RTP) than the more traditional Tommy John reconstruction. Biomechanical studies and clinical data suggest that MUCL repair augmented with a collagen-coated internal brace may be an effective treatment option in this patient population.

Purpose:

To evaluate the functional outcomes of young nonprofessional athletes who underwent MUCL repair with internal brace augmentation for medial elbow instability. The hypothesis was that these patients will have high rates of RTP and improved functional outcomes.

Study Design:

Case series; Level of evidence, 4.

Methods:

Nonprofessional overhead athletes treated with MUCL repair with internal brace augmentation between 2015 and 2017 were prospectively evaluated for a minimum of 1 year. Preoperatively, all patients had evidence of medial elbow pain caused by MUCL insufficiency, as confirmed by signal changes on magnetic resonance imaging and valgus instability on arthroscopic examination. These findings did not allow them to participate in their chosen sport or profession, and each patient had failed nonoperative treatment. Postoperative outcomes were evaluated using the Overhead Athlete Shoulder and Elbow Score of the Kerlan-Jobe Orthopaedic Clinic. Complications were recorded and detailed.

Results:

A total of 40 nonprofessional overhead athletes were included in this study (35 men and 5 women; mean age, 17.8 years [range, 14-28 years]). The mean follow-up time was 23.8 months (range, 12-44 months). The mean postoperative Kerlan-Jobe Orthopaedic Clinic score was 92.6 (range, 64-100). Overall, 37 athletes (92.5%) returned to play or profession at the same level or higher at a mean time of 6.9 months (range, 2-12 months). Three patients did not RTP: 1 was limited by a concomitant medical diagnosis, and the other 2 chose not to resume athletics after the procedure but remained symptom free.

Conclusion:

In the nonprofessional athlete, primary MUCL repair with internal brace augmentation is a viable alternative to traditional repair techniques or reconstruction, allowing for a rapid RTP and promising functional outcomes.
Only a Plate? Nine-Year Follow-Up After Partial Mandibulectomy and Reconstruction With Titanium Plate
Authors: Hashemi Helya , Thor Andreas
Published: July 2021

Background:

Oral squamous cell carcinoma is the main malignancy of the oral cavity; floor of the mouth and the lateral border of the tongue being the most affected sites. This kind of oral neoplasms may require mandibular resection and reconstruction. Treatment options for such mandibular defects include bone grafts, free flaps, and reconstruction plates. Today, the commonly used treatment method is vascularized fibula flaps due to its many advantages when compared to other methods. However, it is a complex procedure and demands much of both practitioners and the patient.

Case Presentation:

In this report, we present a case of oral squamous cell carcinoma of the gingiva of the mandible which was treated with a partial mandibulectomy and resection. Because of the patients age and fragility an immediate mandibular reconstruction with a pre-shaped reconstruction plate, without hard or soft tissue transfer, was performed. Yearly controls showed pleasing results both aesthetically and functionally and the patient showed no plate-related complications up until the patient’s death, 9 years later.

Conclusion:

With this case, we would like to illustrate that using reconstruction plates only may be a viable option in selected cases for continuity defects of the mandible, specifically in fragile patients less suitable for more demanding surgical interventions.
Asymmetric organelle inheritance predicts human blood stem cell fate
Authors: Loeffler Dirk , Schneiter Florin , Wang Weijia , Wehling Arne , Kull Tobias , Lengerke Claudia , Manz Markus G. , Schroeder Timm
Published: July 2021

Understanding human hematopoietic stem cell fate control is important for its improved therapeutic manipulation. Asymmetric cell division, the asymmetric inheritance of factors during division instructing future daughter cell fates, was recently described in mouse blood stem cells. In human blood stem cells, the possible existence of asymmetric cell division remained unclear because of technical challenges in its direct observation. Here, we use long-term quantitative single-cell imaging to show that lysosomes and active mitochondria are asymmetrically inherited in human blood stem cells and that their inheritance is a coordinated, nonrandom process. Furthermore, multiple additional organelles, including autophagosomes, mitophagosomes, autolysosomes, and recycling endosomes, show preferential asymmetric cosegregation with lysosomes. Importantly, asymmetric lysosomal inheritance predicts future asymmetric daughter cell-cycle length, differentiation, and stem cell marker expression, whereas asymmetric inheritance of active mitochondria correlates with daughter metabolic activity. Hence, human hematopoietic stem cell fates are regulated by asymmetric cell division, with both mechanistic evolutionary conservation and differences to the mouse system.
The impact of increasing karyotypic complexity and evolution on survival in patients with CLL treated with ibrutinib
Authors: Kittai Adam S. , Miller Cecelia , Goldstein Daniel , Huang Ying , Abruzzo Lynne V. , Beckwith Kyle , Bhat Seema A. , Bond David A. , Grever Michael R. , Heerema Nyla A. , Rogers Kerry A. , Ruppert Amy S. , Byrd John C. , Woyach Jennifer A.
Published: July 2021

Complex karyotype, defined as ≥3 cytogenetic abnormalities, is prognostic of survival in patients treated with ibrutinib or venetoclax in relapsed/refractory (RR) chronic lymphocytic leukemia (CLL). Recent studies re-evaluating this dichotomous variable have shown that higher numbers of cytogenetic abnormalities (ie, ≥5) have a worse overall survival in patients treated with chemoimmunotherapy. We sought to determine if increasing karyotypic complexity, treated as a continuous variable, was prognostic of survival for patients treated with ibrutinib for CLL. We conducted a retrospective analysis of all patients with CLL treated with single-agent ibrutinib or in combination with an anti–CD20 antibody at our institution. We included 456 patients with both treatment-naive and RR disease. Median number of prior therapies was 2 (range, 0-13), 30% of patients had presence of del(17p), and 75% expressed unmutated IGHV. Fifty percent had ≥3 cytogenetic abnormalities, including 30% with ≥5. In a multivariable analysis, increasing karyotypic complexity was an independent predictor of shorter progression-free survival (hazard ratio, 1.07; 95% confidence interval, 1.04-1.10; P < .0001) and overall survival (hazard ratio, 1.09; 95% confidence interval, 1.05-1.12; P < .0001). Furthermore, we found that presence of clonal evolution determined by cytogenetic analysis at progression was prognostic of subsequent survival (P = .02). This solidifies karyotypic complexity as an important prognostic factor for patients with CLL treated with ibrutinib. Further research should consider sequential karyotypic analysis as a determination of risk of progression and death in patients with CLL.
Aberrant glycosylation of anti-SARS-CoV-2 spike IgG is a prothrombotic stimulus for platelets
Authors: Bye Alexander P. , Hoepel Willianne , Mitchell Joanne L. , Jégouic Sophie , Loureiro Silvia , Sage Tanya , Vidarsson Gestur , Nouta Jan , Wuhrer Manfred , de Taeye Steven , van Gils Marit , Kriek Neline , Cooper Nichola , Jones Ian , den Dunnen Jeroen , Gibbins Jonathan M.
Published: July 2021

A subset of patients with coronavirus disease 2019 (COVID-19) become critically ill, suffering from severe respiratory problems and also increased rates of thrombosis. The causes of thrombosis in severely ill patients with COVID-19 are still emerging, but the coincidence of critical illness with the timing of the onset of adaptive immunity could implicate an excessive immune response. We hypothesized that platelets might be susceptible to activation by anti–severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies and might contribute to thrombosis. We found that immune complexes containing recombinant SARS-CoV-2 spike protein and anti-spike immunoglobulin G enhanced platelet-mediated thrombosis on von Willebrand factor in vitro, but only when the glycosylation state of the Fc domain was modified to correspond with the aberrant glycosylation previously identified in patients with severe COVID-19. Furthermore, we found that activation was dependent on FcγRIIA, and we provide in vitro evidence that this pathogenic platelet activation can be counteracted by the therapeutic small molecules R406 (fostamatinib) and ibrutinib, which inhibit tyrosine kinases Syk and Btk, respectively, or by the P2Y12 antagonist cangrelor.
Improved Sézary cell detection and novel insights into immunophenotypic and molecular heterogeneity in Sézary syndrome
Authors: Najidh Safa , Tensen Cornelis P. , van der Sluijs-Gelling Alita J. , Teodosio Cristina , Cats Davy , Mei Hailiang , Kuipers Thomas B. , Out-Luijting Jacoba J. , Zoutman Willem H. , van Hall Thorbald , Orfao Alberto , Almeida Julia , van Dongen Jacques J. M. , Vermeer Maarten H.
Published: July 2021

Sézary syndrome (SS) is an aggressive leukemic form of cutaneous T-cell lymphoma with neoplastic CD4+ T cells present in skin, lymph nodes, and blood. Despite advances in therapy, prognosis remains poor, with a 5-year overall survival of 30%. The immunophenotype of Sézary cells is diverse, which hampers efficient diagnosis, sensitive disease monitoring, and accurate assessment of treatment response. Comprehensive immunophenotypic profiling of Sézary cells with an in-depth analysis of maturation and functional subsets has not been performed thus far. We immunophenotypically profiled 24 patients with SS using standardized and sensitive EuroFlow-based multiparameter flow cytometry. We accurately identified and quantified Sézary cells in blood and performed an in-depth assessment of their phenotypic characteristics in comparison with their normal counterparts in the blood CD4+ T-cell compartment. We observed inter- and intrapatient heterogeneity and phenotypic changes over time. Sézary cells exhibited phenotypes corresponding with classical and nonclassical T helper subsets with different maturation phenotypes. We combined multiparameter flow cytometry analyses with fluorescence-activated cell sorting and performed RNA sequencing studies on purified subsets of malignant Sézary cells and normal CD4+ T cells of the same patients. We confirmed pure monoclonality in Sézary subsets, compared transcriptomes of phenotypically distinct Sézary subsets, and identified novel downregulated genes, most remarkably THEMIS and LAIR1, which discriminate Sézary cells from normal residual CD4+ T cells. Together, these findings further unravel the heterogeneity of Sézary cell subpopulations within and between patients. These new data will support improved blood staging and more accurate disease monitoring.