bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing the Collision Damage Done to the Tips of Steel Needles during Integrated Piercing by Using Shape Optimization with Feature Selection
Authors: Yang Jingzhao , Dong Jiuzhi , Jiang Xiuming , Chen Yunjun
Published: August 2020

Recent research has shown that, during integrated piercing, the yarn tension can displace the needles from the centers of the holes in the piercing template. To reduce the damage done to the needle tips when the needles and the hole walls collide when the needle displacement is too large, this paper proposes a method for optimizing the needle shape that satisfies the strength constraint while targeting minimum needle displacement. First, the optimal objective function and strength constraint conditions for the tip displacement of the integrated puncture needle are established, which are affected by many factors. Then, the feature selection method of machine learning is used to reduce the dimensionality of the objective function after data reduction, and the feasible region of key features is reduced to avoid falling into the local best point in the optimization iteration. Finally, machine vision is used to measure experimentally the tip displacement of a needle array. The results show that the average tip displacement is reduced by 18.16–31.42% and the collision risk is reduced from 43.14% to 5.54%. It shows that the optimization method of needle shape based on feature selection is effective for reducing needle tip impact damage during integrated piercing.
Prophylaxis of Upper Airway Infections in a Patient with Partial IgA Deficiency: Concurrent Use of Sublingual Immunotherapy with Inactivated Whole-Cell Bacterial Extract and Der p1
Authors: Aarestrup Paula F. , Aarestrup Matheus F. , Aarestrup Beatriz J. V. , Aarestrup Fernando M.
Published: August 2020

Selective IgA deficiency is the most common type of primary immunodeficiency, but there is not yet a specific effective treatment. The most prevalent clinical manifestations are infectious diseases of the respiratory system. We report herein the case of an 11-year-old female with selective IgA deficiency and recurring episodes of respiratory infections associated with rhinitis and asthma. We evaluated the efficacy of sublingual immunotherapy combined with inactivated whole-cell bacterial extract and Der p1-specific immunotherapy. After 18 months of clinical follow-up, we observed a significant reduction in the number of episodes of respiratory infections associated with control of atopic diseases. We also observed a 3-fold increase in serum IgA levels compared to treatment initiation. This case demonstrates the potential utility of the concurrent use of sublingual immunotherapy with inactivated whole-cell bacterial extract and Der p1 for successful control of allergy and infection in partial selective IgA deficiency.
Blood Transfusion Frequency and Indications in Yemeni Children with Sickle Cell Disease
Authors: Al-Saqladi Abdul-Wahab M. , Maddi Dikra M. , Al-Sadeeq Aida H.
Published: August 2020

Background. Blood transfusion is an essential component in the care of patients with sickle cell disease (SCD), but it might be associated with serious acute and delayed complications. This study was aimed to describe red cell transfusion patterns and indications among hospitalized SCD children in a low-resource setting. Patients and Methods. A retrospective, descriptive study of all children (≤16 years) with SCD who received blood transfusion therapy during their hospital admissions in the pediatric department at Al-Sadaqa Teaching Hospital in Aden, Yemen, for a period of one year. Results. Out of 217 hospitalized children with SCD, 169 (77.9%) were transfused and received 275 RBC transfusion episodes. The mean age of transfused children was 6.9 ± 4.6 years and 103 (60.9%) were males, with a male/female ratio of 1.6 : 1 (p=0.004). Hemoglobin (Hb) levels were significantly lower in the transfused than in the nontransfused (Hb 5.5 ± 1.5 vs. 7.7 ± 1.5 g/dL, p=0.03). Pretransfusion Hb levels were ˂7.0 g/dL in 86.2% and ˂5.0 g/dL in 39.3% of patients. Single transfusion was given to 122 (72.2%) and 5 or more transfusions in 9 (4.15%) of patients on different occasions. Simple (top-up) transfusion was used in all transfusion events. Commonest indications for transfusion were anemic crises (41.1%), vasoocclusive crises (VOC) (13.8%), VOC with anemic event (11.3%), acute chest syndrome (8.7%), and stroke (7.3%). Conclusion. Intermittent blood transfusion remains a common practice for the management of children with acute SCD complications. Main indications were acute anemic crises, severe pain crises, ACS, and stroke. In limited resource settings, such as Yemen, conservative transfusion policy appears to be appropriate.
Influence of Red Mud Proportion on Circular Concrete‐Filled Steel Tubular Short Columns
Authors: Bin Wu , Zhuoying Tan , Fan Li , Sun Wang
Published: August 2020

Tests on twelve circular concrete‐filled steel tube stub columns with mixed red mud and three circular concrete‐filled steel tube stub columns to investigate the influence of the mixed proportion of red mud on the mechanical behavior of axial compressive circular concrete‐filled steel tube stub columns are reported. It is found that with the increase of red mud content, the ultimate load increases first and then decreases; on the contrary, the ultimate displacement decreases first and then increases; the specimen stress reaches the proportion limitation as the steel tube longitudinal strain is around 160 με and reaches the yield limitation as the steel tubes’ longitudinal strain is around 4400∼5000 με. The axial compressive bearing capacity empirical formulation of concrete‐filled steel tubes stub columns mixed with red mud is proposed. The theoretical calculation results agree well with those experimental data.
Dynamic Behavior and Energy Evolution Characteristic of Deep Roadway Sandstone Containing Weakly Filled Joint at Various Angles
Authors: Ma Qinyong , Su Qingqing , Yuan Pu
Published: August 2020

Dynamic impact tests were carried out by implying split‐Hopkinson pressure bar (SHPB) apparatus under three‐dimensional stress state to investigate the influences of weakly filled joint at seven kinds of angles on dynamic behavior and energy evolution characteristic of deep roadway sandstone (985 m below the surface). The results indicated that rebound strain phenomenon was obvious and the growth rate of stress was in two kinds of phased variations. Dynamic peak strain was inversely proportional to joint angle under three different strain rates. Dynamic compressive strength, elastic deformation modulus, and plastic deformation modulus were in similar variable tendencies with incremental joint angles, showing firstly decrease to minimum value at joint angle of 45° and then increase to maximum value at joint angle of 90°. Moreover, the sensitivity of plastic deformation modulus to joint angle was obviously inferior to that of elastic deformation modulus when joint angle increased from 0° to 45°. Furthermore, both elastic deformation modulus and plastic deformation modulus were independent of strain rate, which was contrary to dynamic compressive strength and dynamic peak strain. Additionally, absorption energy release rate was introduced and defined to describe energy release and conversion characteristics of joint specimens. The changed trend of energy reflection coefficient was completely opposite to that of energy transmission coefficient and absorbed energy release rate. Absorbed energy density was linearly decreased with incremental joint angle and was increased with the increase of strain rate.
Influential Factors of the Static Shear Properties of Coral Mud in the South China Sea
Authors: Shen Yang , Rui Xiaoxi , Yang Long , Li Shaoyu , Shen Xue
Published: August 2020

Coral mud, a kind of special material used for constructing islets in reclamation projects, is widely spread in the South China Sea. Combined with microstructure research, a series of triaxial tests were performed in this paper to study the static shear strength characteristics and potential factors that can influence them. The effective stress path was similar to the total stress path because of the unique microstructure resulting in a high strength and a high dissipation rate of the pore pressure in the coral mud. The initial void ratio and the initial confining pressure affected the strength and deformation characteristics of the coral mud. When the soil came to failure, the pore pressure coefficient Af varied linearly with the initial void ratio. The critical friction angle was greatly influenced by the confining pressure, and its magnitude first developed to a peak value and then decreased as the void ratio increased. This change showed that there was a linear relationship between the initial elastic modulus E0i and lgp0 as well as between the secant modulus E50 and p0. The estimation ability of Cam‐Clay was verified in this research. The value of parameter λ was determined incrementally by a larger initial void ratio, while the value of parameter M decreased smoothly first and then rose slightly; the selection of parameter κ was approximately 0.0035. The results supported that the Cam‐Clay model is able to simulate the stress‐strain relationship of coral mud, and a referenced estimation can be reliably and efficiently obtained for the reclamation projects of constructing islets.
FSB-DReViSeR: Flow Splitting-Based Dynamic Replacement of Virtual Service Resources for Mobile Users in Virtual Heterogeneous Networks
Authors: Myoupo Jean Frédéric , Kengne Tchendji Vianney , Yankam Yannick Florian , Tagne Joël Casimir
Published: August 2020

Virtual networks are sets of virtual devices that are interconnected through a physical network to provide services to end users. These services are usually heterogeneous (VOIP, VoD, streaming, etc.), exploit various amounts of resources (bandwidth, computing power, servers, etc.), and have topologies different from those of the substrate network. These variations in requirements are traditionally known as the architectural flexibility of virtual networks. Each virtual service is provided through a server called a virtual service resource. When a virtual service resource can no longer provide a good quality of service to end users due to the traffic variation generated by their mobility, two approaches are commonly implemented: provisioning the virtual network with resources or replacing the virtual service resource by migrating the service to another node that offers the most suitable amount of resource to satisfy the quality of service (QoS). In this paper, we propose a flow splitting-based dynamic virtual service resource replacement approach that allows for virtual service replacement across multiple virtual paths. Our approach is based on a graph topology that differs from those in the literature, which are based on tree topologies. The simulations performed in this study show that our approach significantly reduces the virtual service resource replacement time compared to other approaches.
The Application of Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography in Macular Diseases
Authors: Wang Jing , Yin Lian-Rong
Published: August 2020

The choroid plays an essential role in the pathogenesis of various posterior segment diseases. However, traditional imaging methods still have limited cross-sectional observation of choroid. Enhanced depth imaging in spectral-domain optical coherence tomography (EDI SD-OCT) uses a closer scanning position to the eye to create an inverted SD-OCT image with the advantage of better depth sensitivity, which can observe choroidal structure and measure choroidal thickness (CT) accurately. At present, more and more choroidal thickness measurements have been made in normal and pathologic states, in order to understand the pathogenesis and differential diagnosis and prognosis of various diseases, especially for macular lesions. This paper would review relevant original literatures published from January 1, 2008, to February 1, 2020, to evaluate the relationship between the changes of CT with EDI SD-OCT and macular diseases.
DNA Primase Subunit 1 Expression in Hepatocellular Carcinoma and Its Clinical Implication
Authors: Zhang Yipeng , Li Lijun , Liu Renzhi , Zeng Changchun
Published: August 2020

DNA Primase Subunit 1 (PRIM1) is crucial for cancer development and progression. However, there remains a lack of comprehension concerning the clinical implication of PRIM1 in HCC. Here, aberrant expression of PRIM1 was identified in HCC according to available databases. The prognostic value of PRIM1 in patients presenting with HCC was further assessed based on TCGA data. Gene set enrichment analysis (GSEA) was subsequently conducted to investigate the potential function of PRIM1. Additionally, the correlations between tumor‐infiltrating immune cells (TIICs) and PRIM1 expression were evaluated. The data from TCGA, GEO, ONCOMINE, and HCCDB databases illustrated that PRIM1 was overexpressed in HCC tissues, compared to normal liver tissues (all p < 0.05). Kaplan‐Meier analysis revealed that high PRIM1 expression in HCC was closely correlated with worse overall survival (p < 0.05). The univariate and multivariate analyses illustrated that PRIM1 expression was an independent novel prognostic indicator in HCC. Additionally, the area under the receiver operating characteristic (AUROC) curve for PRIM1 reached 0.8651, indicating the diagnostic significance of PRIM1 in patients with HCC. GSEA showed that PRIM1 overexpression was significantly enriched in several tumor‐related signaling pathways. Besides, TIIC analysis clarified the association between PRIM1 expression and TIICs in HCC. The findings disclose that PRIM1 profoundly implicated in promoting tumorigenesis might work as a desirable biomarker for HCC.
Questioning the Value of Brain Magnetic Resonance Imaging in the Evaluation of Children with Isolated Growth Hormone Deficiency
Authors: Oren Asaf , Singer Dana , Rachmiel Marianna , Hamiel Uri  , Shiran Shelly I. , Gruber Noah  , Levy-Shraga Yael , Modan-Moses Dalit , Eyal Ori
Published: August 2020

Background: Isolated growth hormone deficiency (IGHD) is a relatively common disorder. Current diagnostic protocol requires a brain magnetic resonance imaging (MRI) study of the hypothalamus and the hypophysis to determine the cause after establishment of the diagnosis. This study aimed to examine the yield of brain MRI in the evaluation of children with IGHD and to define clinical and laboratory parameters that justify its performance. Methods: A retrospective chart review of all children (<18 years) diagnosed with IGHD was conducted at 3 pediatric endocrinology units between 2008 and 2018. Results: The study included 192 children (107 boys) with confirmed IGHD. The mean age ± standard deviation (SD) at diagnosis was 8.2 ± 3.7 years (median 8.5 years, range 0.8–15.9). The mean height SD score (SDS) at diagnosis was –2.25 ± 0.73. The mean height deficit SDS (defined as the difference between height SDS at diagnosis and mid-parental height SDS) was –1.7 ± 0.9. Fifteen children (7.8%) had pathological MRI findings. No space-occupying lesion was detected. Children with pathological MRIs had greater height deficit SDS and lower peak growth hormone levels on provocative tests compared to children with normal MRIs: –2.3 ± 1.2 vs. –1.6 ± 0.8 (p = 0.02) and 4.4 ± 1.9 vs. 5.7 ± 1.3 (p = 0.01), respectively. Conclusion: Our preliminary data indicate that most brain MRIs performed for routine evaluation of children with IGHD are not essential for determining cause. Further studies with larger cohorts are needed in order to validate this proposed revision of current protocols.
Differences in Post-Cholecystectomy Bile Duct Injury Care: A Comparative Analysis of 2 Different Health-Care Public Institutions in a Low- and Middle-Income Country: Southeast Mexico
Authors: Martínez-Mier Gustavo , Moreno-Ley Pedro Ivan , Esquivel-Torres Sergio , Gonzalez-Grajeda José Luis , Mendez-Rico Daniel
Published: August 2020

Background: Mexican health system structure allows us to study the differences in bile duct injury (BDI) management. The study aimed to assess the differences in patients with complex BDI in 2 different public sector institutions using a new proposed standard terminology. Methods: Retrospective review (2008–2019) in 2 public institutions (IMSS/SESVER). Bismuth-Strasberg E injuries with hepaticojejunostomy were included. Data are presented in a tabular reporting system. The outcomes were percent of patients attaining primary patency, loss of primary patency, and actuarial primary patency rate. Results: Seventy-eight patients (IMSS: n = 37; SESVER: n = 41) without differences in demographic and preoperative assessment were studied. BDI occurred mostly in outside hospitals. Open cholecystectomy was the most common index operation in SESVER (73%, p = 0.02). IMSS had more surgeries (p = 0.007) and repair attempts (p = 0.06) prior to referral. Magnetic resonance cholangiopancreatography was more commonly used in IMSS patients. Biliary stents (45%) and cholangitis (29%) were more common in IMSS (p < 0.05). IMSS patients had longer follow-up than SESVER (p < 0.05). No differences in primary patency rates (IMSS: 89%, SESVER: 97%) and actuarial patency rates were noted. Discussion: Despite differences in referral, preoperative, and operative events, good BDI repair outcomes can be achieved. Longer follow-up is needed to monitor these outcomes.
Index Admission Characteristics and All-Cause Readmissions Analysis in Younger and Older Adults with Intracerebral Hemorrhage
Authors: Kim Brian Dongha , Kurian Christeena , Stein Laura K. , Tuhrim Stanley , Dhamoon Mandip S.
Published: August 2020

Introduction: Intracerebral hemorrhage (ICH) comprises 15–20% of all strokes with debilitating consequences. Data regarding characteristics and outcomes of primary ICH in the young are lacking, given its rarity, making comparisons between younger and older cohorts difficult to perform. Nationally representative administrative databases enable analysis of such rare events. Objective: To determine the baseline characteristics, all-cause readmission rates, and reasons for primary ICH in younger and older adults using a nationally representative database. Methods: A retrospective cohort analysis was performed using the Nationwide Readmissions Database 2013. Validated ICD-9-CM codes identified index ICH admissions, comorbidities, demographics, behavioral risk factors, procedures, and Elixhauser and Charlson Comorbidity indices. We compared “younger” (age ≤ 45 years) and “older” (age > 45) index ICH admissions by weighted 30-day all-cause readmission rates, primary diagnosis code for 30-day readmissions, most common comorbidities during the index hospitalization, and Kaplan-Meier cumulative risk of readmission up to 1 year. Results: Older admissions had higher comorbidity scores and mortality, but both groups had similar total comorbidities. Younger admissions exhibited longer length of stay with more procedures performed. Vascular anomalies (aneurysm 7.2 vs. 4.6% and arteriovenous malformation 5.9 vs. 0.8%) and behavioral risk factors (smoking 26.5 vs. 23.0%, alcohol abuse 6.7 vs. 4.6%, and substance use 13.5 vs. 2.9%) were more prevalent in younger admissions, while older patients had more cardiovascular comorbidities. All-cause 30-day readmission rates (13.1 vs. 13.0%) and 1-year cumulative risk of readmission (log-rank p value 0.7209) were similar. Readmissions in the younger cohort were primarily for neurological conditions, and those in the older cohort were for systemic conditions. Conclusions: Adults <45 years with ICH had similar total comorbidities as older adults but more procedures, longer hospital stay, and more behavioral risk factors. Readmission rates were similar though reasons differed; younger patients were more for neurological reasons than for other systemic causes.
CLL: Ibrutinib in der Erstlinienbehandlung junger und fitter Patienten
Authors: Mayr Patrick , Claus Rainer
Published: August 2020

Die erstmalig im Dezember 2018 auf der Jahrestagung der American Society of Hematology (ASH) präsentierte ECOG-ACRIN E1912-Studie untersuchte die Effektivität von Ibrutinib-Rituximab (IR) im direkten Vergleich zum CIT-Therapieschema Fludarabin, Cyclophosphamid, Rituximab (FCR) bei bislang therapienaiven, jüngeren (<70 Jahre) und körperlich fitteren CLL-Patienten [1]. In der ECOG-ACRIN E1912-Studie wurden insgesamt 529 Patienten im Verhältnis 2:1 (IR:FCR) randomisiert, ein Cross-Over in den IR-Arm war nicht vorgesehen. Nach einem medianen Follow-Up von 33,6 Monaten befanden sich 78,8% der IR- und 75,4% der FCR-Patienten weiter im Follow-Up. Das 3-Jahres-PFS war im IR-Arm mit 89,4% gegenüber 72,9% bei FCR-Patienten hochsignifikant überlegen (HR 0,35; 95%-KI 0,22–0,56; p < 0,001). Für Aufsehen sorgte ferner das im IR- gegenüber dem FCR-Arm signifikant überlegene Gesamtüberleben (OS) nach 3 Jahren (98,8% vs. 91,5 %; HR 0,17; 95%-KI 0,05–0,54; p < 0,001). Bezüglich des PFS war die Überlegenheit der Therapie mit IR unabhängig einer etwaigen ungünstigen Zytogenetik (11q22.3-Deletion). Ein signifikanter PFS-Vorteil nach 3 Jahren (90,7% vs. 62,5%, HR 0.26; 95%-KI, 0.14–0.50) fand sich insbesondere bei Patienten mit unmutiertem IGHV-Locus, die in der Regel im Vergleich zu IGHV-mutierten Patienten ein deutlich verkürztes PFS nach CIT aufweisen. Obwohl das klinische Ansprechen unter Ibrutinib höher als unter FCR war (95,8% vs. 81,1%), konnte, wie bereits aus vorhergehenden Studien bekannt, nur eine geringe Rate an Komplettremissionen (17,2% vs. 30,3%) beobachtet werden. Negativität für minimale Resterkrankung (MRD) im peripheren Blut war bei IR-behandelten Patienten ebenfalls deutlich seltener als unter FCR (8,3% vs. 59,2%). Die Frequenz zu erwartender, höhergradiger (Grad 3/4) unerwünschter Wirkungen unterschied sich in beiden Therapiearmen nicht, wenn auch Unterschiede im Spektrum der Nebenwirkungen vorlagen. Im FCR Arm überwogen hämatologische Komplikationen (Zytopenien) und Infektionen, im IR-Arm vor allem nicht-hämatologische Komplikationen, insbesondere kardiovaskulärer Genese einschließlich Hypertonie und Blutungen. Aktualisierte Studiendaten wurden im Rahmen der ASH-Jahrestagung im Dezember 2019 mit einer Nachbeobachtungszeit von nun 48 Monaten vorgestellt, wobei sich auch hier die bisherigen, beeindruckenden Ergebnisse mit einem Vorteil zugunsten von IR bestätigten. Etwa 73% der Patienten im IR-Arm erhielten weiterhin eine Dauertherapie mit Ibrutinib. 14% der Patienten hatten Ibrutinib aufgrund von Nebenwirkungen abgesetzt, nur 7% aufgrund eines Krankheitsprogress. Während die HR für das PFS nach 48 Monaten im Vergleich zum 33,6-Monate-Follow-Up von 0,35 auf 0,39 (95% KI 0,26–0,57; p < 0,0001) nur gering gestiegen war, ergab sich bezüglich des Gesamtüberlebensvorteils ein deutlicherer Trend mit Anstieg der HR von 0,17 auf 0,34 (95%-KI 0,15–0,80; p = 0,010).
DNA Content in Ischemic Stroke Thrombi Can Help Identify Cardioembolic Strokes Among Strokes of Undetermined Cause
Authors: Di Meglio Lucas , Desilles Jean-Philippe , Solonomenjanahary Mialitiana , Labreuche Julien , Ollivier Véronique , Dupont Sebastien , Deschildre Catherine , Maacha Malek Ben , Consoli Arturo , Lapergue Bertrand , Piotin Michel , Blanc Raphael , Ho-Tin-Noe Benoit , Mazighi Mikael , Désilles Jean-Philippe , Redjem Hocine , Smajda Stanislas , Ciccio Gabriele , Escalard Simon , Delvoye Francois , Maier Benjamin , Hebert Solene , Hamdani Mylene , Sabben Candice , Obadia Michael , Rodesch Georges , Di Maria Federico , Coskun Okuzan , Lopez Delphine , Bourcier Romain , Detraz Lili , Desal Hubert , Roy Monica , Clavier Delphine , Marnat Gaultier , Gariel Florent , Lucas Ludovic , Sibon Igor , Eugene Francois , Vannier Stéphane , Ferre Jean-Christophe , Le Bras Anthony , Raoult Hélène , Paya Christophe , Gauvrit Jean-Yves , Richard Sébastien , Gory Benjamin , Barbier Charlotte , Vivien Denis , Touzé Emmanuel , Gauberti Maxime , Blaizot Gaetane
Published: August 2020

Background and Purpose:

Identification of acute ischemic stroke (AIS) cause is crucial for guidance of secondary prevention. Previous studies have yielded inconsistent results regarding possible correlations between AIS cause and thrombus composition, as assessed by semiquantitative histological analysis. Here, we performed a correlation analysis between AIS cause and AIS thrombus cellular composition and content, as assessed using quantitative biochemical assays.

Methods:

Homogenates of 250 patients with AIS thrombi were prepared by mechanical grinding. Platelet, red blood cell, and leukocyte content of AIS thrombi were estimated by quantification of GP (glycoprotein) VI, heme, and DNA in thrombus homogenates. AIS cause was defined as cardioembolic, noncardioembolic, or embolic stroke of undetermined source, according to the TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment).

Results:

Cardioembolic thrombi were richer in DNA (35.8 versus 13.8 ng/mg,
P
<0.001) and poorer in GPVI (0.104 versus 0.117 ng/mg,
P
=0.045) than noncardioembolic ones. The area under the receiver operating characteristic curve of DNA content to discriminate cardioembolic thrombi from noncardioembolic was 0.72 (95% CI, 0.63–0.81). With a threshold of 44.7 ng DNA/mg thrombus, 47% of thrombi from undetermined cause would be classified as cardioembolic with a specificity of 90%.

Conclusions:

Thrombus DNA content may provide an accurate biomarker for identification of cardioembolic thrombi in patients with AIS with embolic stroke of undetermined source.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT03268668.
Cardiac Troponin I and Incident Stroke in European Cohorts
Authors: Camen Stephan , Palosaari Tarja , Reinikainen Jaakko , Sprünker Ngoc Anh , Niiranen Teemu , Gianfagna Francesco , Vishram-Nielsen Julie K.K. , Costanzo Simona , Söderberg Stefan , Palmieri Luigi , Ferrario Marco , Peters Annette , Vartiainen Erkki , Donati Maria Benedetta , Donfrancesco Chiara , Borchini Rossana , Börschel Christin Susanna , Giampaoli Simona , Di Castelnuovo Augusto , Magnussen Christina , Kee Frank , Koenig Wolfgang , Blankenberg Stefan , de Gaetano Giovanni , Tunstall-Pedoe Hugh , Rospleszcz Susanne , Jørgensen Torben , Zeller Tanja , Kuulasmaa Kari , Linneberg Allan , Salomaa Veikko , Iacoviello Licia , Schnabel Renate B. ,   on behalf of the BiomarCaRE Consortium
Published: August 2020

Background and Purpose:

Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce.

Methods:

High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82 881 individuals (median age, 50.7 years; 49.7% men) free of stroke or myocardial infarction at baseline from 9 prospective European community cohorts. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for overoptimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries.

Results:

Over a median follow-up of 12.7 years, 3033 individuals were diagnosed with incident nonfatal or fatal stroke (n=1654 ischemic strokes, n=612 hemorrhagic strokes, and n=767 indeterminate strokes). In multivariable regression models, hsTnI concentrations were associated with overall stroke (hazard ratio per 1-SD increase, 1.15 [95% CI, 1.10–1.21]), ischemic stroke (hazard ratio, 1.14 [95% CI, 1.09–1.21]), and hemorrhagic stroke (hazard ratio, 1.10 [95% CI, 1.01–1.20]). Adding hsTnI concentrations to classical cardiovascular risk factors (C indices, 0.809, 0.840, and 0.736 for overall, ischemic, and hemorrhagic stroke, respectively) increased the C index significantly but modestly. In individuals with an intermediate 10-year risk (5%–20%), the net reclassification improvement for overall stroke was 0.038 (
P
=0.021).

Conclusions:

Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort but might be of some value in individuals at an intermediate risk.
Curative Performance: Introduction
Authors: Citron Atay
Published: August 2020

Shamans are expert healers and charismatic performers who induce their patients’ faith in their healing powers, leading to an expectation of a successful outcome—which in turn triggers a self-healing mechanism. Western doctors, on the other hand, lack performance awareness and training. Modern medicine practitioners can gain substantially by learning some of the performance techniques of traditional healers, thus bridging the increasing gap between traditional and Western medicine.
Healing through Gender Inversion in Korean Possession Trance Rituals
Authors: Sarfati Liora
Published: August 2020

Korean shamanism ( musok) considers problems of physical, social, and mental health to be a result of supernatural intervention. The unique position of male practitioners who become healers within a female-dominated sphere is especially telling as they perform cross-gender behavior that is perceived as related to homosexuality, which is stigmatized in Korea and often labeled as a “mental illness.” In contrast, musok frames these behaviors as responses to demands from the spirit world.
The Future Perfect, Autopsy, and Enfreakment on the 19th-Century Stage
Authors: Bainbridge Danielle
Published: August 2020

The public autopsies of 19th-century enfreaked performers remains a central issue in studies of 19th-century enslavement. While previously black performance studies focused on the instability of the historical past tense, the study of freak shows and enslavement dictates a reckoning with the future perfect tense, which sheds light on the history of the future by asking “what will have been” rather than “what was” or “what could have been.”
Conjuring Abolition Phonography in A Record Album Interpretation
Authors: Baron Derek
Published: August 2020

The Wooster Group’s 2017 The B-Side: “Negro Folklore from Texas State Prisons,” A Record Album Interpretation has three actors reanimate a 1965 vinyl LP of prison work songs. This formally simple production embeds a series of almost imperceptible shifts between past and present, thus “interinanimating” the men on the record and the men onstage, conjuring an “abolition phonography”: a mode of sensory (dis)formation that short-circuits the racial ideologies of the senses and points towards a collective future.
Molecular phylogeny of the genus Lasiopogon (Diptera: Asilidae) and a taxonomic revision of the bivittatus section
Authors: MCKNIGHT TRISTAN A. , CANNINGS ROBERT A.
Published: August 2020

Nearctic species of Lasiopogon Loew comprising the bivittatus section (the bivittatus group sensu Cannings 2002) are revised, with the description of 13 new species, elevation of one subspecies to species, and redescriptions of 13 previously described taxa. An updated key to western Nearctic Lasiopogon adults is provided, as are notes on taxonomy, distribution, phylogeny, and ecology. A Bayesian species tree for 67 species of Lasiopogon is estimated from one mitochondrial (COI) and three nuclear protein-coding loci (AATS, PEPCK, Wg), and compared to a previously published morphology-based phylogeny. The following new species of Lasiopogon are described (assigned to the bivittatus section except as noted): L. anaphlecter sp. nov., L. apoecus sp. nov., L. asilomar sp. nov., L. bitumineus sp. nov., L. canningsi sp. nov., L. condylophorus sp. nov., L. esau sp. nov., L. karli sp. nov. (assigned to cinereus group of opaculus section), L. nelsoni sp. nov., L. odontotus sp. nov., L. sierra sp. nov., L. tumulicola sp. nov., L. wilcoxi sp. nov.; L. puyallupi Cole & Wilcox 1938 stat. nov. is elevated from subspecies; and the following previously described species are considered valid: L. actius Melander 1923, L. albidus Cole & Wilcox 1938, L. arenicola (Osten Sacken 1877), L. bivittatus Loew 1866, L. californicus Cole & Wilcox 1938, L. dimicki Cole & Wilcox 1938, L. drabicolum Cole 1916, L. gabrieli Cole & Wilcox 1938, L. littoris Cole 1924, L. ripicola Melander 1923, L. willametti Cole & Wilcox 1938, L. zonatus Cole & Wilcox 1938. The species L. martinensis Cole & Wilcox 1938 is considered valid but transferred to the tetragrammus group of the opaculus section.
Taxonomic review of Tipula (Vestiplex Bezzi) crane flies (Diptera: Tipulidae) in Mongolia
Authors: STARKEVICH PAVEL , PODENAS SIGITAS , GELHAUS JON K.
Published: August 2020

Fourteen species of Tipula (Vestiplex Bezzi, 1924) crane flies (Diptera, Tipulidae) known from Mongolia are taxonomically revised. Identification keys for males and females, redescriptions and illustrations of all species are presented. Most genital structures are illustrated for the first time. Tipula (V.) jakut Alexander, 1934 is designated as junior synonym of T. (V.) sintenisi Lackschewitz, 1933; T. (V.) kamchatkana Alexander, 1934 is designated as junior synonym of T. (V.) mediovittata Mik, 1889. Tipula (V.) balioptera Loew, 1863 and T. (V.) leucoprocta Mik, 1889 are listed as new records for the Mongolian fauna.
Implementation of an Evidence-Based Protocol Significantly Reduces Opioid Prescribing After Ventral Hernia Repair
Authors: Peterman Diana E. , Knoedler Bryan P. , Ewing Joseph A. , Carbonell Alfredo M. , Cobb William S. , Warren Jeremy A.
Published: August 2020

Background

Increased recognition of the dangers of opioid analgesia has led to significant focus on strategies for reducing use through multimodal analgesia, enhanced recovery protocols, and standardized guidelines for prescribing. Our institution implemented a standard protocol for prescribing analgesics at discharge after ventral hernia repair (VHR). We hypothesize that this strategy significantly reduces opioid use.

Methods

A standardized protocol for discharge prescribing was implemented in March 2018. Patients were prescribed ibuprofen, acetaminophen, and opioids based on milligram morphine equivalent (MME) use the 24 hours prior to discharge. We retrospectively reviewed prescriptions of opioids for two 6-month periods—July-December 2017 (PRE) and July-December 2018 (POST)—for comparison using EPIC report and the South Carolina Prescription Monitoring Program. Analysis performed included Mann-Kendall linear trend test and Student’s t-test for continuous variables.

Results

VHR was performed in 105 patients in the PRE and 75 patients in the POST group. Total MME prescribed decreased significantly from mean 322.7 + 261.3/median 225 (IQR 150-400) MME to 141.6 + 150.4/median 100 (50-184) MME ( P < .001). This represents a 57% reduction in mean opioid MME prescriptions. Acetaminophen prescribing increased from 10% to 65%, and ibuprofen from 7.6% to 61.3%. Refills were prescribed in 21 patients (20%) during the PRE period, which decreased to 10.7% during the POST group ( P = .141). Implementation of an evidence-based protocol significantly reduces opioid prescribing after VHR.

Discussion

A multimodal approach to postoperative pain management decreases the need for opioids. The additional implementation of an evidence-based prescribing protocol results in significant reduction of opioid use following VHR.
Political realism, legitimacy, and a place for external critique
Authors: Cozzaglio Ilaria
Published: August 2020

Political realists claim that politics should be regulated by a distinctive political normativity, one that does not rely on external, pre-political moral standards. It is in this sense that they distinguish political realism from ‘political moralism’, regarded as an approach that understands political theory as applied ethics. Importantly, realists’ anti-moralism is not motivated by the conviction that moral considerations do not play any role in the political realm. Rather, the target is the externalism of the normative resources on which moralist theories typically ground their conceptions of legitimacy. In contrast to moralists, some realists have argued for the need to elaborate internal theories of legitimacy, ones that develop normativity internally – that is, from within the political context under evaluation. This commitment entails the effort to reconnect legitimacy to the beliefs and attitudes of people subjected to the political power. In these accounts of legitimacy, critique is typically exercised internally, by means of self-reflection and ideology critique. Contra some realists, I argue that some forms of externalism are desirable and compatible with internalist accounts of legitimacy, and I show how to accommodate them within internalist theories of legitimacy. They are desirable because they strengthen the emancipatory potential of internal reflection and, in some cases, even stimulate it, as when, because of political circumstances, internal critique cannot be exercised. In addition, they prevent internalist approaches from falling into descriptive accounts of de facto acceptance of power. These forms of external critique can be compatible with internalist accounts of legitimacy, provided that they do not contrast with what I call methodological and substantive internalism. Accordingly, in the article, I discuss which stances of external critique can and should be accommodated within internalist accounts of legitimacy, without renouncing to the realist character of the approach.
Furan Induced Characteristic Glutathione S-Transferase Placental Form-Positive Foci in Terms of Cell Kinetics and Gene Expression
Authors: Takasu Shinji , Ishii Yuji , Kijima Aki , Ogawa Kumiko , Nakane Sae , Umemura Takashi
Published: August 2020

Glutathione S-transferase placental form-positive (GST-P+) foci are markers of preneoplastic lesions in rat hepatocarcinogenesis. Our previous studies using reporter gene transgenic rats showed that furan, a hepatocarcinogen in rodents, rapidly induces the formation of GST-P+ foci after short exposure without reporter gene mutation. We hypothesized that GST-P+ foci induced by furan may have biological characteristics different from those induced by diethylnitrosamine (DEN), a genotoxic hepatocarcinogen. Accordingly, we compared the cell kinetics of GST-P+ foci after cessation of DEN treatment and performed comprehensive gene expression in DEN- or furan-induced GST-P+ foci. The number and area of DEN-induced GST-P+ foci were increased after cessation of treatment, whereas furan decreased these parameters. Size distribution analysis showed that large furan-induced GST-P+ foci disappeared after cessation of treatment. Hierarchical cluster analysis showed that all samples from GST-P+ foci induced by furan were separated from those induced by DEN. SOX9 expression was upregulated in furan-induced GST-P+ foci and was detected by immunohistochemistry in large furan-induced GST-P+ foci. Our results indicated that large furan-induced GST-P+ foci were quite different from DEN-induced GST-P+ foci at the molecular and cellular levels. And one of the properties of disappearing large GST-P+ foci were characterized by inclusion of hepatocytes expressing SOX9.
Book review: Lucio Pegoraro and Angelo Rinella, Sistemi costituzionali
Authors: Viola Pasquale
Published: August 2020

Lucio Pegoraro and Angelo Rinella, Sistemi costituzionali (Torino: Giappichelli, 2020), xxi + 496 pp.
Information flows – Or does it? The complexity of enterprise information management
Authors: White Martin S
Published: August 2020

Although there has been a degree of acceptance that information is a core business asset almost no research has been carried out into the factors that affect the way that information flows around the enterprise as employees at all levels seek to make use of it to complete tasks and make decisions. These decisions can have a significant impact on business performance and on the career development of employees. The challenge lies in finding ways to track the flow of information, especially where workarounds have been developed by employees to overcome their frustration with ‘approved’ processes. Over the last few years computational ethnography, initially applied to assessing issues relating to culture and communication. is becoming increasing widely used to track the flow of documents. In the wake of Covid19 organisations are going to have to operate in a rapidly changing business environment. Unless the flow of information is better understood short-term changes may be implemented which turn out to be of limited benefit or even undermine the rate of achievement of new business objectives.
Xanthogranulomatous adrenalitis masquerading as a functioning adrenocortical malignancy: a case report
Authors: Jayanth Kalkunte Sriram , Balamurugan S. , Sureshkumar Sathasivam , Anandhi Amaranathan , Sree Rekha J. , Abdulbasith K.M. , Rajesh B.S. , Tajudeen Muhamed
Published: August 2020

Introduction:

Xanthogranulomatous adrenalitis (XA) is a rare chronic inflammatory disease of the adrenal glands and resembles adrenal neoplasm in clinical and radiologic characteristics. There is no report on XA presenting as a functioning adrenal mass in the literature. We present a case of XA mimicking a functioning adrenocortical carcinoma.

Case report:

A 52-year-old man presented with right flank pain, fever, vomiting, and loss of appetite for 2 weeks. He had signs of dehydration and elevated blood glucose level. Ultrasonography revealed a right adrenal mass. Contrast-enhanced computed tomography showed lobulated and necrotic mass replacing the right suprarenal gland and encasing the right renal vein, adjacent inferior vena cava, psoas, and diaphragm. There was loss of fat planes with liver and upper pole of the right kidney. Biochemical evaluation indicated increased serum and urine cortisol levels. As a sequel to hypercortisolism-induced hyperglycemia, he developed spontaneous chest wall abscess and bilateral sudden vision loss due to vitreous hemorrhages. Pus and blood culture grew methicillin-sensitive Staphylococcus aureus. Adrenal suppressant ketoconazole was administered for better glycemic control. With a diagnosis of locally advanced adrenocortical malignancy, right radical adreno-nephrectomy was performed, and cut section revealed a pus collection of around 100 mL. Histopathology examination showed xanthogranulomatous inflammation involving adrenal gland, Gerota’s fascia, psoas, and lymph nodes. Postoperatively, the patient recovered satisfactorily with favorable glycemic control.

Conclusion:

XA can mimic adrenal neoplasms both clinically and radiologically and is associated with staphylococcal infection. It warrants surgical excision and culture-based antibiotics and is mostly diagnosed on postoperative histopathology.
Evaluating the sensitivity of acoustic emission signal features to the variation of cutting parameters in milling aluminum alloys: Part A: frequency domain analysis
Authors: Anahid Mohamad Javad , Heydarnia Hoda , Niknam Seyed Ali , Mehmanparast Hedayeh
Published: August 2020

It is known that adequate knowledge of the sensitivity of acoustic emission signal parameters to various experimental parameters is indispensable. According to the review of the literature, a lack of knowledge was noticeable concerning the behavior of acoustic emission parameters under a broad range of machining parameters. This becomes more visible in milling operations that include sophisticated chip formation morphology and significant interaction effects and directional pressures and forces. To remedy the aforementioned lack of knowledge, the effect of the variation of cutting parameters on the time and frequency features of acoustic emission signals, extracted and computed from the milling operation, needs to be investigated in a wide aspect. The objective of this study is to investigate the effects of cutting parameters including the feed rate, cutting speed, depth of cut, material properties, as well as cutting tool coating/insert nose radius on computed acoustic emission signals featured in the frequency domain. Similar studies on time-domain signal features were already conducted. To conduct appropriate signal processing and feature extraction, a signal segmentation and processing approach is proposed based on dividing the recorded acoustic emission signals into three sections with specific signal durations associated with cutting tool movement within the work part. To define the sensitive acoustic emission parameters to the variation of cutting parameters, advanced signal processing and statistical approaches were used. Despite the time features of acoustic emission signals, frequency domain acoustic emission parameters seem to be insensitive to the variation of cutting parameters. Moreover, cutting factors governing the effectiveness of acoustic emission signal parameters are hinted. Among these, the cutting speed and feed rate seem to have the most noticeable effects on the variation of time–frequency domain acoustic emission signal information, respectively. The outcomes of this work, along with recently completed works in the time domain, can be integrated into advanced classification and artificial intelligence approaches for numerous applications, including real-time machining process monitoring.
Observer based direct adaptive fuzzy second-order-like sliding mode control for unknown nonlinear systems
Authors: Wu Hongzhuang , Liu Songyong , Cheng Cheng , Du Changlong
Published: August 2020

This work proposes a novel observer based direct adaptive fuzzy second-order-like sliding mode control (SMC) method for a certain class of high order unknown nonlinear dynamical systems with unmeasurable states. An observer is firstly developed to estimate the tracking error vector directly, and the stability of the observer is analyzed based on Meyer-Kalman-Yakubovich (MKY) lemma. Based on the observer, the equivalent control law is approximated by a double-input single-output fuzzy logic system (FLS), in which the observation of the sliding surface and its derivative are applied as the inputs. In addition, an adaptive switching control law is added to mitigate the system chattering and improve the stability of the system. The free parameters of the controller are adjusted online by the adaptive laws that are derived from the Lyapunov stability analysis. Finally, the convergence of the overall closed-loop system is demonstrated, and the simulation examples illustrate the efficacy of the proposed control method.