bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of physical activity level and exercise capacity in patients with varicose veins and chronic venous insufficiency
Authors: Erdal Elif Sakızlı , Demirgüç Arzu , Kabalcı Mehmet , Demirtaş Hüseyin
Published: March 2021

Objective

The clinical indication of chronic venous insufficiency (CVI) is related to functional performance and the benefits of physical activity in patients with CVI are known. Despite its importance, the literature is limited in this regard. This study aimed to determine exercise capacity and physical activity level in patients with varicose veins and CVI.

Methods

Volunteers who came to the polyclinic with leg pain complaints were enrolled in the study. Individual sociodemographic and clinical information was recorded. Individuals' pain severity was assessed by the visual analog scale (VAS) and exercise capacity was assessed by 6-minute walk test (6MWT). International Physical Activity Questionnaire (IPAQ) was used to assess the level of physical activity.

Results

The study group consisted of 51 individuals who were diagnosed with varicose veins and CVI. The control group consisted of 51 individuals without varicose veins and CVI diagnosis. In the study group, the VAS during activity was significantly higher compared to the control group. The 6MWT distance, distance %, IPAQ total score and IPAQ walking score of the control group were significantly higher in comparison with the study group (p<0.05).

Conclusions

We believe that our findings will lead the planning of interventions to increase the level of physical activity in CVI patients.
Single-center analysis of the inappropriate use of human albumin and nutritional support in hospitalized patients with hypoproteinemia in China
Authors: Zhang Jin , Zhang ZheTao , Shi TianLu
Published: March 2021

Background

This study used single-center analysis of human serum albumin clinical usage and enteral-parenteral nutritional support to establish clinical application standards for the rational use of human serum albumin.

Methods

A total of 1984 patients receiving human serum albumin were enrolled in this retrospective study to analyze the rational application of human serum albumin and enteral-parenteral nutritional support.

Results

Among 1984 patients, 1044 (52.6%) were found to have irrational applications for human serum albumin use. Major indications for irrational applications were hypoproteinemia (30.0%) and nutritional support (21.9%). Surgical departments including thoracic surgery, orthopedics, and neurosurgery had the most irrational applications, occupying 18.4%, 8.4%, and 4.2%, respectively. A total of 1627 patients (82%) required nutritional support and 745 (45.8%) had irrational nutritional support. Moreover, 694 patients (35.0%) received human serum albumin as the only source of nutritional support.

Conclusions

Clinical training and the establishment of an approval system should be used to enhance the rational use of human serum albumin, ensuring medication safety, reducing medical costs, and avoiding the waste of medical resources.
Revascularization of acute stent thrombosis after carotid artery stenting in a CYP2C19*2 heterozygote patient
Authors: Wei Wei , Wang Yan , Wang Pian , Li Zheng
Published: March 2021

Carotid artery stenting (CAS) is an alternative strategy to carotid endarterectomy for the prevention of ischemic stroke. Acute carotid stent thrombosis (ACST) is an extremely rare but devastating complication of CAS. Although cases of successful recanalization have been reported, there is still a lack of experience regarding the choice of ACST treatment methods and the timing of such treatments, especially when patients are confirmed CYP2C19*2 heterozygotes. Here, we report a case of successful revascularization after ACST in a patient with CYP2C19*2 heterozygosity. We also review the literature and discuss appropriate treatment strategies for this devastating and rare event.
Tocilizumab has no direct effect on cell lines infected with human T-cell leukemia virus type 1
Authors: Endo Yushiro , Fukui Shoichi , Koga Tomohiro , Sasaki Daisuke , Hasegawa Hiroo , Yanagihara Katsunori , Okayama Akihiko , Nakamura Tatsufumi , Kawakami Atsushi , Nakamura Hideki
Published: March 2021

Objective

It remains unclear whether human T-cell leukemia virus type 1 (HTLV-1) infection influences therapeutic responses in patients with rheumatic diseases and whether immunosuppressive treatments increase the risk of HTLV-1-related complications in HTLV-1 carriers with rheumatic diseases. We examined the effects of tocilizumab (TCZ), an interleukin (IL)-6 receptor antagonist, on two HTLV-1-infected T-cell lines (HCT-5 and MT-2) in vitro.

Methods

We evaluated production of cytokines and chemokines, expression of HTLV-I associated genes, HTLV-1 proviral load (PVL), expression of HTLV-1 structural proteins, and apoptosis.

Results

There were no significant differences in cytokine and chemokine levels in the culture supernatants of HCT-5 and MT-2 cells treated with phosphate-buffered saline (PBS) or TCZ. No significant differences were detected in mRNA abundance of Tax or HBZ, PVL, expression of the HTLV-1 structural protein GAG, or apoptosis among HCT-5 and MT-2 cells treated with PBS or TCZ.

Conclusions

TCZ had no effect the cytokine profiles, HTLV-1 gene and protein expression, PVL, or apoptosis in HTLV-1-infected T-cell lines. Thus, TCZ treatment has no effect on HTLV-1 infection in vitro.
Circulating tumour DNA methylation in hepatocellular carcinoma diagnosis using digital droplet PCR
Authors: Wang Juan , Yang Liu , Diao Yanjun , Liu Jiayun , Li Jinjie , Li Rui , Zheng Lianghong , Zhang Kang , Ma Yueyun , Hao Xiaoke
Published: March 2021

Objective

To evaluate the performance of a DNA methylation-based digital droplet polymerase chain reaction (ddPCR) assay to detect aberrant DNA methylation in cell-free DNA (cfDNA) and to determine its application in the detection of hepatocellular carcinoma (HCC).

Methods

The present study recruited patients with liver-related diseases and healthy control subjects. Blood samples were used for the extraction of cfDNA, which was then bisulfite converted and the extent of DNA methylation quantified using a ddPCR platform.

Results

A total of 97 patients with HCC, 80 healthy control subjects and 46 patients with chronic hepatitis B/C virus infection were enrolled in the study. The level of cfDNA in the HCC group was significantly higher than that in the healthy control group. For the detection of HCC, based on a cut-off value of 15.7% for the cfDNA methylation ratio, the sensitivity and specificity were 78.57% and 89.38%, respectively. The diagnostic accuracy was 85.27%, the positive predictive value was 81.91% and the negative predictive value was 87.20%. The positive likelihood ratio of 15.7% in HCC diagnosis was 7.40, while the negative likelihood ratio was 0.24.

Conclusions

A sensitive methylation-based assay might serve as a liquid biopsy test for diagnosing HCC.
Different effects of bronchoscopic interventions on children and adults with tracheobronchial mucoepidermoid carcinoma
Authors: Jieli Zhang , Yunzhi Zhou , Nan Zhang , Heng Zou , Hongwu Wang , Jiankun Liu , Dongmei Li , Hui Wang , Jing Lv , Changxin Li , Mao Jiangfeng
Published: March 2021

Aims:

To investigate the efficacy and safety of minimally invasive bronchoscopic interventions for patients with tracheobronchial mucoepidermoid carcinoma (MEC).

Methods:

Patients with tracheobronchial MEC were included in this retrospective study, and the clinical features, histologic grading, treatments, and cumulative survival rates were calculated. Patients were categorized into child (n = 16) and adult (n = 19) group according to their ages. Histologic grading, treatments, and survival status were compared between the two groups.

Results:

In pathology, high-grade MEC counts for 6.77% and 42.10% in the child and adult group, respectively. As tumor growth pattern was concerned, 93.33% and 21.05% tumors in the child and adult group present intratracheal type. Multiple bronchoscopic interventions were conducted, including rigid bronchoscopy, argon plasma coagulation (APC), dioxide carbon cryotherapy, and electric loop. Tumors could be removed by multiple bronchoscopic interventions. Bronchoscopy-associated complications were rare, including an oral mucosa injury and a glottis edema. In the child group, one patient underwent left upper lung lobectomy. In the adult group, lobectomy and/or chemotherapy and/or radiotherapy were conducted in seven patients. The 5-year survival rate was 100% and 68.90% in the child and the adult group, respectively.

Conclusions:

Almost all children have low-grade and intratracheal MEC; 2/5 adults have invasive high-grade MEC. Multiple bronchoscopic interventions are effective in erasing low-grade intratracheal MEC without severe complications. For high-grade invasive MEC, aggressive and comprehensive therapy should be considered.
Residual stresses in the aluminium alloy 2014A subject to PAG quenching and vibratory stress relief
Authors: Robinson Jeremy S , Hossain M Sayeed , Truman Christopher E
Published: March 2021

Generic hollow pump bodies made from aluminium alloy 2014A forgings have been solution heat treated and quenched into either cold water or polyalkylene glycol (PAG) solutions. An industry standard PAG type synthetic quenchant was evaluated, and the influence of two concentrations of the PAG solution on residual stress in the pump bodies was characterised, using neutron and X-ray diffraction. These residual stresses were then compared to those resulting after a pump in the as quenched condition was subject to a widely known but controversial commercial vibratory stress relieving procedure. The use of neutron diffraction allowed the through thickness residual stresses to be evaluated in the pumps. Results demonstrate that PAG quenching is highly effective at significantly reducing residual stress when compared to cold water quenching, but the impact is non uniform and cannot be simply quantified. In this investigation, we prove the effect of vibratory stress relief is negligible, and much less than that achieved by PAG quenching.
The Long Expansion and the Profit Squeeze: Output and Profit Cycles in Brazil (1996–2016)
Authors: Martins Guilherme Klein , Rugitsky Fernando
Published: March 2021

The present paper argues that the recent Brazilian crisis was related to a cyclical profit squeeze that took place between 2009 and 2014, following the long expansion that started in 2003. To do so, the cyclical trajectories of the output and the profit rate in the Brazilian economy for the period between 1996 and 2016 are examined by resorting to the framework established by Weisskopf (1979). The results indicate that profit squeezes are rare in the Brazilian economy, possibly due to the truncated character of the business cycles’ expansions. However, a profit squeeze did take place in the last cycle, partly as a result of the commodities boom, which attenuated the foreign vulnerability of the economy and allowed for a longer than usual expansion.

JEL classification: B50, B51,E32
Analysis of plastic waste reduction and recycling in Taiwan
Authors: Tsai Wen-Tien
Published: March 2021

With the mass production and consumption of single-use plastics and other plastic products, plastic waste management and its resulting microplastic pollution have become the most noteworthy environmental issues. The main objectives of this paper were to review the regulatory measures for plastic waste reduction and recycling, analyse the trend changes on the recycled amounts of regulated plastic containers and also address the discussions on the impacts of COVID-19 on the expected increase in plastic waste. In the past two decades, the central competent authority (i.e. Environmental Protection Administration (EPA)) in Taiwan has promulgated some regulations governing plastic waste reduction and recycling, especially plastic containers. Based on the official statistics, it showed that total certified amounts of regulated plastic containers have increased from 45,552 tonnes in 1998 to 194,133 tonnes in 2019. This shift was in line with circular economy policies by the Zero Waste Program and Resource Recycling and Reuse Plan launched by the Taiwan EPA during this period. On the other hand, the COVID-19 pandemic will impact on the regulatory policies for plastic waste management because the excess use of regulated plastic products will be temporarily permitted due to the epidemic prevention and control measures. Although the increased proportion of plastic waste in municipal solid waste (MSW) will be beneficial for the energy efficiencies of waste-to-power systems in MSW incineration plants, the recycling and reduction rates of regulated plastic containers or products could decline during the COVID-19 breakout.
Nanda-Hamner Curves Show Huge Latitudinal Variation but No Circadian Components in Drosophila Montana Photoperiodism
Authors: Lankinen Pekka , Kastally Chedly , Hoikkala Anneli
Published: March 2021

Insect species with a wide distribution offer a great opportunity to trace latitudinal variation in the photoperiodic regulation of traits important in reproduction and stress tolerances. We measured this variation in the photoperiodic time-measuring system underlying reproductive diapause in Drosophila montana, using a Nanda-Hamner (NH) protocol. None of the study strains showed diel rhythmicity in female diapause proportions under a constant day length (12 h) and varying night lengths in photoperiods ranging from 16 to 84 h at 16°C. In the northernmost strains (above 55°N), nearly all females entered diapause under all photoperiods and about half of them even in continuous darkness, while the females of the southern strains showed high diapause proportions only in the circadian 24 h photoperiod. Significant correlation between the strains’ mean diapause proportions in ≥ 24 h photoperiods and critical day length (CDL; half of the females enter diapause) suggests at least partial causal connection between the traits. Interestingly, females of the northern strains entered diapause even in ≤ 24 h photoperiods, where the night length was shorter than their critical night length (24 h - CDL), but where the females experienced a higher number of Light:Dark cycles than in 24 h photoperiods. NH experiments, performed on the control and selection lines in our previous selection experiment, and completed here, gave similar results and confirmed that selection for shorter, southern-type CDL decreases female diapausing rate in non-circadian photoperiods. Overall, our study shows that D. montana females measure night length quantitatively, that the photoperiodic counter may play a prominent but slightly different role in extra short and extra long photoperiods and that northern strains show high stability against perturbations in the photoperiod length and in the presence of LD cycles. These features are best explained by the quantitative versions of the damped external coincidence model.
Gastrostomy Tubes Placed in Children With Neurologic Impairment: Associated Morbidity and Mortality
Authors: Lin Jody L. , Rigdon Joseph , Van Haren Keith , Buu MyMy , Saynina Olga , Bhattacharya Jay , Owens Douglas K. , Sanders Lee M.
Published: March 2021

Background:

Gastrostomy tube (G-tube) placement for children with neurologic impairment with dysphagia has been suggested for pneumonia prevention. However, prior studies demonstrated an association between G-tube placement and increased risk of pneumonia. We evaluate the association between timing of G-tube placement and death or severe pneumonia in children with neurologic impairment.

Methods:

We included all children enrolled in California Children’s Services between July 1, 2009, and June 30, 2014, with neurologic impairment and 1 pneumonia hospitalization. Prior to analysis, children with new G-tubes and those without were 1:2 propensity score matched on sociodemographics, medical complexity, and severity of index hospitalization. We used a time-varying Cox proportional hazard model for subsequent death or composite outcome of death or severe pneumonia to compare those with new G-tubes vs those without, adjusting for covariates described above.

Results:

A total of 2490 children met eligibility criteria, of whom 219 (9%) died and 789 (32%) had severe pneumonia. Compared to children without G-tubes, children with new G-tubes had decreased risk of death (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.39-0.55) but increased risk of the composite outcome (HR 1.21, CI 1.14-1.27). Sensitivity analyses using varied time criteria for definitions of G-tube and outcome found that more recent G-tube placement had greater associated risk reduction for death but increased risk of severe pneumonia.

Conclusion:

Recent G-tube placement is associated with reduced risk of death but increased risk of severe pneumonia. Decisions to place G-tubes for pulmonary indications in children with neurologic impairment should weigh the impact of severe pneumonia on quality of life.
A grounded theory of educational leadership development using generative dialogue
Authors: Hartney Elizabeth , Axe Jo , Borkowsky Keith
Published: March 2021

The aim of this research was to develop a grounded theory of educational leadership development, using generative dialogue (GD), as an approach to initiating and maintaining professional growth in school principals/vice principals in an urban school district in a relatively affluent region of Western Canada. In Wave I, GD interviews were conducted by a team of consultants, and anonymous data were voluntarily submitted to the research team (n = 37). In Wave II, confidential, one-on-one, audio-recorded virtual interviews were conducted with five participants. Data were transcribed and analysed using grounded theory. The grounded theory model integrated the findings from Wave I and Wave II. There were three final overarching themes: environment, relationships, and leadership. Professional growth was evident when a GD approach was used that emphasized both positive communication and self-reflection. Relationships were supported by a focus on safety and reflected honesty, which led to a positive school culture, while leadership was facilitated through supports and the supervisor role and led to improved accountability. In conclusion, GD serves a useful purpose for facilitating professional growth in educational leaders, but should be supplemented with other evidence-based approaches to meet school leaders’ broader professional development needs, and goals of school improvement. Applicability and limitations of the study are discussed.
The Humanbecoming Concept Inventing Model: Feeling Ashamed
Authors: Alanizi Amal W.
Published: March 2021

The scholar in this paper presents a concept inventing model of feeling ashamed. It consists of a literature review across many disciplines, an exploration of many artforms, dialoguing with others, and a distinctive description of feeling ashamed. With the humanbecoming concept inventing model, the scholar explored shame and created a novel idea that could develop approaches in the advancement of nursing knowledge. This exploration advances nursing knowledge within the humanbecoming paradigm. With the use of humanbecoming concept inventing model, the now-truth of feeling ashamed for the scholar was raised as unbearable stillness with desired escape arising with isolating affiliations. The ingenuous proclamation as a theoretical statement was communicated in the humanbecoming sciencing language as languaging the powering of connecting-separating with the artform of Shame by Rosa Gunasingha.
Watson’s Ten Caritas Processes with the Lens of Unitary Human Caring Science
Authors: Perkins Joyce B.
Published: March 2021

The author in this paper articulates how Watson’s caritas processes evolved to caritas-veritas light on virtues, facilitating unitary transformative experience. This shift builds harmonic coherence between major streams of consciousness that focus on (a) the physical and conceptually concrete (objective/quantitative/particulate/determinate); (b) the mental, emotional, meaningful/belief systems (subjective/qualitative/interactive/integrative); and (c) the gestalt of spirit and the natural environment (virtual/quantum/unitary/transformative). The lived experience of harmonically braided streams of consciousness melds human-environment, potentiating health, healing, love, and compassion. Unitary transformative pandimensional awareness unfolds in the consciousness and everyday life of the practicing nurse, facilitating a direct experience of sacred praxis.
Silencing touch and touching silence? Understanding the complex links between touch and silence in residential child care settings
Authors: Green Lorraine , Warwick Lisa , Moran Lisa
Published: March 2021

Touch and silence are neglected across most disciplines, including within child-specific academic literature, and their interconnections have not been studied before. This article focuses on touch/silence convergences in residential childcare in England, drawing from two qualitative studies. We reveal the fluidity, multidimensionality and intersectionality of touch and silence, illuminating the labyrinthine ways they frequently coalesce in children’s homes, often assuming ambiguous forms and meanings. We therefore offer new understandings of these concepts, as multifaceted, entwined, temporal and malleable.
Modifications of class-shape transformation driven by aerodynamic concerns over leading-edge region
Authors: Wang Shuyue , Wang Cong , Sun Gang
Published: March 2021

Geometrical representation method plays a fundamental role in aerodynamic design in that it makes preparation for design space. A good design space should be composed of design variables that are more likely to attain the solution to the problem than others. This study finds that due to the characteristics of Bernstein polynomials, a conventional class-shape transformation (CST) geometrical representation method is insufficiently focused on the leading-edge region of airfoils/wings. However, more aerodynamic attention is required there because it has strong relationship with the aerodynamic performance of whole geometry. The lack of design variables assigned to the leading-edge region is likely to compromise the effort in finding better optimization results in design space. While maintaining the convenience and accuracy of conventional CST, this study proposes two types of modifications to add more aerodynamic insights into the leading-edge region: (1) an approach of supplementary vertical CST aiming to describe the leading-edge region upon the fitting result of conventional CST; (2) an approach of globally transforming airfoil surfaces into a single-value function with respect to x-direction so that the leading-edge region avoids being split up into two separate parts. With those two modifications, the leading edge can be put to the center of geometric description by rotating the local coordinate system after tackling some other issues that come with the operation. Modification 1 is intuitive, although it requires additional attention to some parameters for the continuity between the leading-edge region and other regions of the airfoil. Modification 2 is convenient to implement, but has limitations on accuracy control because the result of shape error has to account for the introduction global transforming function. Two modifications are illustrated, and their applications are discussed in the study, showing the perspective of being utilized in aerodynamic design that involves delicate difference of aerodynamic performance brought by variations of leading-edge shape.
Numerical simulation on the oil capture performance of the oil scoop in the under-race lubrication system
Authors: Jiang Le , Liu Zhenxia , Lyu Yaguo , Qin Jingwen
Published: March 2021

The under-race lubrication system providing a moderate amount of oil to high-speed bearings is one of the key factors to ensure its good lubrication and cooling. To investigate the oil capture performance of the oil scoop, a complete numerical calculation model was established, and unsteady simulations of oil–gas two-phase flow inside the under-race lubrication system were carried out. The results indicate that the oil capture efficiency increases first and then decreases with increasing rotating speed at different oil jet velocities. The ratio of the rotating Reynolds number of the oil scoop to the Reynolds number of the oil jet corresponding to the maximum oil capture efficiency changes linearly with oil jet velocity. There are three variation trends of oil capture efficiency at different rotating speeds with the increase of oil jet velocity: monotonically decreasing, first increasing, and then decreasing and monotonically increasing. However, the amount of oil captured by the oil scoop increases monotonically under all operating conditions. The effect of oil temperature on oil capture efficiency is mainly due to the change of dynamic viscosity of the oil. The oil capture efficiency can be improved by appropriately increasing the oil temperature within a certain temperature range.
Influence of the basilar membrane shape and mechanical properties in the cochlear response: A numerical study
Authors: Areias Bruno , Parente Marco , Gentil Fernanda , Jorge Renato Natal
Published: March 2021

Hearing impairment is one of the most common health disorders, affecting individuals of all ages, reducing considerably their quality of life. At present, it is known that during an acoustic stimulation a travelling wave is developed inside the cochlea. Existing mathematical and numerical models available in the literature try to describe the shape of this travelling wave, the majority of them present a set of approaches based on some limitations either or both of the mechanical properties used and the geometrical description of the realistic representation. The present numerical study highlights the distinctions of using a spiral model of the cochlea, by comparing the obtained results with a straight, or simplified model. The influence of the implantation of transversely isotropic mechanical models was also studied, by comparing the basilar membrane with isotropic and transversely isotropic mechanical properties. Values of the root mean square error calculated for all models show a greater proximity of the cochlear mapping to the Greenwood function when the basilar membrane is assumed with transversely isotropic mechanical properties for both straight and spiral model. The root-mean square errors calculated were: 2.05, 1.70, 2.72, 2.08 mm, for the straight-isotropic, straight-transversely isotropic, spiral-isotropic and spiral-transversely isotropic model, respectively.
Analytical graphic statics
Authors: Baranyai Tamás
Published: March 2021

Graphic statics is undergoing a renaissance, with computerized visual representation becoming both easier and more spectacular as time passes. While methods of the past are revived, little emphasis has been placed on studying the mathematics behind these methods. Due to the considerable advances of our mathematical understanding since the birth of graphic statics, we can learn a lot by examining these old methods from a more modern viewpoint. As such, this work shows the mathematical fabric joining different aspects of graphic statics, like dualities, reciprocal diagrams, and discontinuous stress functions. This is done by introducing a new, three dimensional force diagram (containing the old two dimensional force diagram) depicting the three dimensional equilibrium of planar force systems. A corresponding three dimensional “form diagram” (dual diagram) is introduced, in which forces are treated as linear functionals (dual vectors). It is shown that the polyhedral stress function introduced by Maxwell is in fact a linear combination of these functionals; and the projective dualities connecting these three dimensional diagrams are also explained.
Impact of the rise of solo living and an ageing population on residential energy consumption in South Korea
Authors: Cho Seong-Hoon , Soh Moonwon , Park Kihyun , Kim Hyun Jae
Published: March 2021

Demographic changes have a profound impact on residential energy consumption. The number of single-person households is rapidly increasing around the world and the percentages of elderly individuals in the populations of almost all countries are expanding. The objective of our research was to analyze how single-person households and elderly households impact residential energy intensity, defined as annual residential energy consumption per capita per unit of finished area of the household’s house, and how those impacts interact with each other using South Korea as a case study. Our findings suggest that the rise of solo living and an ageing population have overlapping effects on energy consumption and threaten future improvements in residential energy intensity. Specifically, an increase of single-person households results in a decline in energy intensity regardless of whether the household is elderly or non-elderly and the effect of an increase in elderly households on energy intensity depends on whether the household is single- or multiple-person. Given the similar average size of finished area for single-person households, the difference in per unit energy consumption between elderly versus non-elderly households likely comes from behavioral differences such as a greater use of energy-intensive appliances by non-elderly households than elderly households. However, for multiple-person households, the effect of such behavioral differences seems to be dominated by the effect of a house’s shared amenities. The common space and energy-consuming amenities of a house are shared by more individuals in non-elderly households, leading to more intensive energy consumption by non-elderly multiple-person households than by elderly multiple-person households.
Myeloablative Haploidentical Transplant as an Alternative to Matched Sibling Transplant for Peripheral T-Cell Lymphomas
Authors: Zhenyang Gu , Nainong Li , Xiaoxiong Wu , Maihong Wang , Xiaorui Fu , Zhao Wang , Hanyun Ren , Yuhang Li , Xiaofan Li , Yamei Wu , Yao Liu , Mingzhi Zhang , Yini Wang , Daihong Liu , Yujun Dong , Liangding Hu , Wenrong Huang
Published: March 2021

The number of HLA-haploidentical allogeneic hematopoietic stem-cell transplantation (Haplo-HSCT) is increasing. Comparative studies about Haplo-HSCT versus allo-HSCT with HLA-matched sibling donors (MSD-HSCT) have been tried in leukemias and B-cell lymphomas. Few studies were reported in Peripheral T-cell lymphomas (PTCLs). We performed a multicenter retrospective study about 52 patients with PTCLs undergoing Haplo-HSCT ( n = 20) or MSD-HSCT ( n = 32). All Haplo-HSCT recipients received antithymocyte globulin (ATG) based graft versus host disease (GVHD) prophylaxis. The median follow-up for all survivors was 38 months. The 100-day cumulative incidence of grade II to IV acute GVHD was similar (19% in the MSD-HSCT group versus 28% in the Haplo-HSCT group, P = 0.52). The 2-year cumulative incidence of chronic GVHD (limited and extensive) after Haplo-HSCT (30%) was also similar with that in the MSD-HSCT group (50%, P = 0.15). The 3-year relapse rates (33% vs 27%, P = 0.84) and non-relapse mortality (21% vs 22%, P = 0.78) did not differ between these two groups. There were also no differences in 3-year overall survival (OS) (48% vs 50%, P = 0.78) and progression-free survival (47% vs 51%, P = 0.95) between these two groups. On multivariate analysis, prognostic index for T-cell lymphoma (PIT) score (higher than 1: hazard ratio [HR], 4.0; P = 0.003) and disease status (stable or progression disease before HSCT: HR, 2.8; P = 0.03) were independent variables associated with worse OS. We concluded that ATG-based haplo-HSCT platform could work as an alternative to MSD-HSCT for patients with PTCLs.
A Study of Multilayered Profitability Analysis by Using DuPont Model: Evidence from Indian Pharmaceutical Industry
Authors: Paul Pinku
Published: March 2021

Profitability is used as a prime indicator to measure the sustainable performance of an organization. The current study made an attempt to apply the DuPont model to investigate the multilevel profitability determinants for the pharmaceutical industry of India. The study also estimates an empirical model to predict the association of profitability with factors such as profit margin, asset utilization, leverage, interest load and tax load of firms in the pharmaceutical industry of India. For this purpose, a dataset for 170 companies from 2010–2011 to 2018–2019 was analysed initially by using panel data regression followed by stepwise panel data regression. The study successfully applied and tested the DuPont model with respect to the firms of the pharmaceutical industry in India. It was found that the factors such as profit margin, asset utilization and leverage had a significant positive effect on the firms’ profitability and the factor interest load had a significant negative effect on the firms’ profitability. The tax load does not have an impact on the profitability of the pharmaceutical firms in India. These findings are expected to provide a guide for understanding the profitability of the firms in a better way.
Urban Sprawl and Land Value in Batangas City, Philippines
Authors: Daguio Keith Gerard L. , Rivera Ryan Randle B. , Reyes Mario R. Delos , Santiago Joy T. , Mendoza Jerico E.
Published: March 2021

This article, using a combination of quantitative and qualitative approaches, illustrates that Batangas City for the period 1990–2015 was leaning towards a sprawling development. Areas where considerable sprawling has occurred were further investigated in relation to land value. The study also revealed that there is a moderate positive relationship between sprawl and land values in the city, which meant that land values have increased in areas where considerable sprawling has occurred.
Inequality and Urban Density: Socio-economic Drivers of Uneven Densification in Cape Town
Authors: Scheba Andreas , Turok Ivan , Visagie Justin
Published: March 2021

Global policies promote urban compaction to achieve sustainable development. This article highlights the limits of analysing densification at the city scale and advocates for a more granular approach. The case study of Cape Town shows how overall consolidation has been mainly driven by poor households crowding into already dense neighbourhoods on the urban periphery. This has aggravated historic segregation and intensified urban management challenges. Meanwhile, formal private sector driven densification strengthens the social and economic vibrancy of affluent neighbourhoods. This article argues that uneven residential patterns reflect deep-seated social inequalities that are amplified through labour and property markets. Satellite data also illustrates how Cape Town’s built-up area has changed between 1998 and 2019. Based on geo-spatial analyses, the article suggests that taking these drivers seriously is crucial to promoting a denser and more equitable urban form. Aligning housing policies with spatial transformation and economic development objectives offer possibilities for change.
Land Cover Changes and Urban Expansion in Chongqing, China: A Study Based on Remote Sensing Images
Authors: Sun Xuan , Liu Yunxia , Sun Tao , Yu Sihang , Li Chenguang , Zhai Lie
Published: March 2021

China has experienced an unprecedented rate of urbanization in recent decades. As a city with strong political and economic influences in the southwest of China, Chongqing is a typical example of rapidurban development in this period of time. To study the land cover changes and urban expansion of Chongqing, Landsat images from 1999 to 2018 were selected, processed, and quantitatively analysed The results showed that the built-up area of the city had increased tremendously during these years, yet vegetation still accounted for the vast majority of the city’s land area. Restricted by the local topography including mountains and hills and infrastructure constructions, the urbanization process that occurred in central Chongqing actually showed a dominant expansion direction, an obvious spatial clustering tendency, and significant spatio-temporal differences among various regions.
Family Traditions as a Condition for Socialization of Young Generation (Based on a Sample of Tuva Republic)
Authors: Maryuhina Valentina
Published: March 2021

The purpose of this study is to regard the family traditions of a present-day Tuvan family as a precondition for the successful socialization of younger generations. We conducted a sociological survey to identify the significance of family traditions in the process of upbringing children. For this, 148 married couples, who had children under 18 years old, participated in the survey. A sociological research questionnaire was compiled and presented on the platform www.survey.yandex.ru : The questions were created on the website and distributed among the target audience through social networks. The respondents were asked 15 questions of both open-ended and close-ended types. The results of the study can be used while developing regional programs to support young families as well as an aspect of the family’s ability to educate the young generation. Moreover, the practical application of the results is possible in enhancing the activities of existing social entities while organizing events to maintain a respectful attitude to family traditions.
Comprehensive Intraprocedural Unfractionated Heparin Protocol During Catheter Ablation of Atrial Fibrillation in the Presence of Direct Oral Anticoagulants and Wide Spectrum of Body Mass Index
Authors: Safani Michael , Tobias Serge , Shandling Adrian H. , Redmond Kathryn , Lee Mark Young
Published: March 2021

Introduction:

Data on optimal dosing of unfractionated heparin (UFH) in the presence of a direct oral anticoagulant (DOAC) to achieve and maintain an activated clotting time (ACT) of ≥300 seconds during catheter ablation of atrial fibrillation (CA-AF) are limited and prevalence of obesity adds to the unpredictable response to UFH.

Methods and Results:

One hundred seventeen consecutive patients undergoing CA-AF were prospectively administered weight-adjusted, weight-based UFH using a pre-specified detailed protocol and retrospectively analyzed. Due to lack of distribution of UFH into muscle or adipose tissue and lower degree of vascularity in the latter compartment, each patient’s ideal and actual weights were used to determine the adjusted-weight for use in all UFH doses. A UFH bolus of 200 units/kg was administered intravenously followed by an infusion of 35 units/kg/hour. The mean age was 65 years, and 85 patients (72.6%) were male. The average body mass index (BMI) was 30 (range 18-50) kg/m2. After the initial UFH bolus dose, 99 patients (84.6%) achieved ACT ≥300 sec with a mean (± SD) of 380 ± 79 sec. The mean time to reach an ACT ≥300 in all patients was 14.6 ± 12.4 minutes. Among all measured ACT values, 423 (90.8%) were ≥300 seconds. These results were consistent within all BMI categories. There were no intraprocedural thrombotic or hemorrhagic complications. Two patients (1.7%) sustained groin vascular access site hematoma without subsequent intervention and 7 patients (6%) experienced minor oozing post-procedurally.

Conclusions:

Our comprehensive weight-adjusted, weight-based UFH protocol, during CA-AF in presence of a DOAC, rapidly achieved and maintained an effective ACT irrespective of BMI.
Research on dynamic characteristics of gear system considering the influence of temperature on material performance
Authors: Sun Zhou , Chen Siyu , Tao Xuan , Hu Zehua
Published: March 2021

Under high-speed and heavy-load conditions, the influence of temperature on the gear system is extremely important. Basically, the current work on the effect of temperature mostly considers the flash temperature or the overall temperature field to cause expansion at the meshing point and then affects nonlinear factors such as time-varying meshing stiffness, which lead to the deterioration of the dynamic transmission. This work considers the effect of temperature on the material’s elastic modulus and Poisson’s ratio and relates the temperature to the time-varying meshing stiffness. The effects of temperature on the elastic modulus and Poisson’s ratio are expressed as functions and brought into the improved energy method stiffness calculation formula. Then, the dynamic characteristics of the gear system are analyzed. With the bifurcation diagram, phase, Poincaré, and fast Fourier transform plots of the gear system, the influence of temperature on the nonlinear dynamics of the gear system is discussed. The numerical analysis results show that as the temperature increases, the dynamic response of the system in the middle-speed region gradually changes from periodic motion to chaos.
Fetal Urinoma Due to Circulatory Disorders in an Umbilical Artery: Case Report
Authors: Kozlova Daria , Gilboa Yinon , Sade-Zalts Chen , Gielchinsky Yuval , Shteingart Shimon , Kidron Debora
Published: March 2021

Fetal urinoma is defined as an encapsulated accumulation of extravasated urine within the perirenal space or retroperitoneum. It is an uncommon finding in prenatal practice, and the vast majority of known cases are strongly associated with the existence of a urinary obstruction, such as posterior urethral valves, ureteropelvic junction obstruction, or ureterocele. We report a unique case of prenatally detected fetal bladder urinoma that occurred in the absence of an apparent obstructive uropathy, but was associated with extensive ischemic necrosis and calcifications of adjacent bladder wall, coexistent with signs of vascular supply decompensation.
Combined phacoemulsification and iStent inject implantation in Asian eyes
Authors: Hu YW Jeremy , Ang CH Bryan , Tecson Ivan O’Neill C. , Kan Tsia-Chuen John , Yip WL Leonard
Published: March 2021

Purpose:

To evaluate the safety and efficacy of the iStent inject device combined with phacoemulsification in Asian eyes with primary open angle glaucoma.

Methods:

A retrospective study of combined phacoemulsification and iStent inject surgeries performed in a single institution from July 2017 to August 2019 on patients with co-existing cataracts and primary open angle glaucoma (POAG). Outcome measures included best-corrected visual acuity, intraocular pressure (IOP), number of glaucoma eyedrop medications, and surgical complications.

Results:

A total of 95 eyes were included. Majority of subjects were male (59, 62.1%) and Chinese (83, 87.4%). Mean age was 74.7 ± 8.7 years. Pre-operatively, mean IOP was 16.2 ± 4.3 mmHg and number of medications was 1.9 ± 0.9. Significant post-operative reduction in mean IOP was observed at all timepoints – post-operative month (POM)1: 3.0 ± 5.6 mmHg reduction ( n = 95, p < 0.05); POM3: 1.6 ± 3.8 mmHg ( n = 66, p < 0.05); POM6: 1.8 ± 4.7 mmHg ( n = 55, p < 0.05); POM12: 1.3 ± 4.2 mmHg ( n = 48) ( p < 0.05). The number of glaucoma medications was also reduced from a mean of 1.9 ± 0.8 to 0.6 ± 1.0 at POM12 ( p < 0.05). Intraoperatively, one case of malignant glaucoma occurred. Post operatively, implant obstruction by iris was observed in two eyes post-operatively requiring iridoplasty. One case of cystoid macular edema and one case of drop in visual acuity due to glaucoma progression was/were also observed.

Conclusion:

Asian eyes undergoing combined phacoemulsification and iStent inject surgery demonstrate a significant and sustained reduction in both IOP and number of glaucoma medications. Overall, there is a good safety profile for iStent inject.
Primary Care Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Lebanon: A National Cross-sectional Study
Authors: Alayan Nour , Naal Hady , Makhoul Melissa , Avedissian Tamar , Assaf Ghada , Talih Farid , Hamadeh Randa
Published: March 2021

Introduction:

Substance use among adolescents is on the rise globally. Adolescents rarely seek help for problematic substance use and healthcare professionals can easily fail to identify adolescents with risky substance use. There is therefore a significant global need for substance use screening by healthcare professionals followed by appropriate intervention. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based practice that enables clinicians to determine adolescents’ risk for substance use and intervene accordingly. However, little effort has been placed on empowering primary care clinicians to use it in Lebanon. We explored the attitudes, perceptions, and practices of primary care nurses and physicians regarding adolescent SBIRT use.

Methods:

The study used a cross-sectional multisite survey design targeting urban and rural areas in Lebanon. A national sample of 140 physicians and nurses was recruited using random sampling stratified by governorate. Participants completed mailed or online surveys addressing their practices, attitudes, role perceptions, and self-efficacy regarding SBIRT use.

Results:

This study revealed that 57.8% of healthcare professionals were not familiar with the SBIRT model and that 76.2% did not practice SBIRT in their setting. The majority addressed the problem of substance use through educating and counseling adolescents about the dangers of substance use (84.2%) and encouraged them to stop (82%) but only 2% reported using standardized instruments for substance use screening. Most participants (88.1%) reported their willingness to use SBIRT in their clinical practice and 92.4% expressed an interest in receiving SBIRT training. Overall, the results showed positive attitudes ( M = 4.38, SD = 0.89) and role responsibility ( M = 4.47, SD = 1.62) toward addressing substance use in adolescents, in addition to a high level of perceived self-efficacy in addressing substance use ( M = 4.04, SD = 0.92). Our results showed minimal differences between nurses’ and physicians’ perceptions and self-efficacy regarding SBIRT use.

Conclusions:

Our study confirms the lack of a standardized approach toward adolescent substance use screening and intervention by primary healthcare providers in Lebanon but revealed the readiness and willingness to receive training and proper support to adopt an evidence-based approach such as SBIRT.
Childhood obesity and multiple sclerosis: A Mendelian randomization study
Authors: Harroud Adil , Mitchell Ruth E , Richardson Tom G , Morris John A , Forgetta Vincenzo , Davey Smith George , Baranzini Sergio E , Richards J Brent
Published: March 2021

Background:

Higher childhood body mass index (BMI) has been associated with an increased risk of multiple sclerosis (MS).

Objective:

To evaluate whether childhood BMI has a causal influence on MS, and whether this putative effect is independent from early adult obesity and pubertal timing.

Methods:

We performed Mendelian randomization (MR) using summary genetic data on 14,802 MS cases and 26,703 controls. Large-scale genome-wide association studies provided estimates for BMI in childhood ( n = 47,541) and adulthood ( n = 322,154). In multivariable MR, we examined the direct effects of each timepoint and further adjusted for age at puberty. Findings were replicated using the UK Biobank ( n = 453,169).

Results:

Higher genetically predicted childhood BMI was associated with increased odds of MS (odds ratio (OR) = 1.26/SD BMI increase, 95% confidence interval (CI): 1.07–1.50). However, there was little evidence of a direct effect after adjusting for adult BMI (OR = 1.03, 95% CI: 0.70–1.53). Conversely, the effect of adult BMI persisted independent of childhood BMI (OR = 1.43; 95% CI: 1.01–2.03). The addition of age at puberty did not alter the findings. UK Biobank analyses showed consistent results. Sensitivity analyses provided no evidence of pleiotropy.

Conclusion:

Genetic evidence supports an association between childhood obesity and MS susceptibility, mediated by persistence of obesity into early adulthood but independent of pubertal timing.