bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of radiotherapy and suppression of Tregs enhances abscopal antitumor effect and inhibits metastasis in rectal cancer
Authors: Ji Dengbo , Song Can , Li Yongheng , Xia Jinhong , Wu Yanjing , Jia Jinying , Cui Xinxin , Yu Songmao , Gu Jin
Published: October 2020

Background

Distant metastasis is the major cause of mortality in patients with locally advanced rectal cancer (LARC) following neoadjuvant chemoradiotherapy. Local radiotherapy can trigger an abscopal response to metastatic tumor cells. However, the abscopal effect is a rare event. CD4+ regulatory T (Treg) cell is a highly immune-suppressive subset which impedes immune surveillance against cancer, prevents the development of effective antitumor immunity and promotes tumor progression. We assume that the exploitation of the proimmunogenic effects of radiotherapy with anti-CD25 or anti-Cytotoxic T-Lymphocyte Associated Protein 4 (anti-CTLA4) monoclonal antibodies (mAbs) may enhance the local and abscopal effects in rectal cancer and improve the therapeutic outcome.

Methods

mRNA expression profiling of 81 pretreatment biopsy samples from LARC patients who received neoadjuvant radiotherapy (nRT) was performed to analyze the correlation between gene expression and prognosis. A retrospective analysis of patients with rectal cancer with distant metastasis or synchronous extracolonic cancers was performed to evaluate the abscopal effect of radiotherapy on rectal cancer. Two different dual-tumor mouse models were established to investigate the efficacy of single dose and dose-fractionated radiotherapy combined with anti-CD25 or anti-CTLA4 and anti-Programmed cell death 1 ligand 1 (anti-PD1) mAbs on the local tumor growth and liver metastasis. The univariate Cox regression analysis, one-way analysis of variance, Dunnett’s test, a mixed-effect linear model and Kaplan-Meier survival analysis were used to calculate p values.

Results

The proportion of Tregs in pre-nRT biopsies was negatively correlated with prognosis (p=0.007). The retrospective analysis showed that regressing liver metastases were infiltrated by CD8+ T cells. In contrast, stable/progressing metastases and synchronous extracolonic cancers were characterized by PD1+ T cells and Tregs infiltration. Animal experiment results demonstrated that the combination of radiotherapy and anti-CD25/CTLA4 mAb resulted in a significant increase in CD8+ T cells and CD8+/CD4+ ratio in primary and secondary tumors compared with the irradiation alone group (all p<0.05 or p<0.01). The combined treatment was able to decrease Tregs, PD1+CD8+ and PD1+CD4+ T cells (p<0.05), suppress locally irradiated and distal unirradiated tumor growth, and improve overall survival rate. Radiotherapy in conjunction with anti-CTLA4 reduced liver metastasis (p<0.05).

Conclusions

These data indicated that radiotherapy plus depletion of Tregs was able to improve the antitumor response and generate an abscopal effect.
Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures
Authors: Catapano Joshua S , Ducruet Andrew F , Koester Stefan W , Cole Tyler S , Baranoski Jacob F , Rutledge Caleb , Majmundar Neil , Srinivasan Visish M , Wilkinson D Andrew , Lawton Michael T , Albuquerque Felipe C
Published: October 2020

Background

Transradial artery (TRA) access for neuroendovascular procedures is associated with fewer complications than transfemoral artery (TFA) access. This study compares hospital costs associated with TRA access to those associated with TFA access for neurointerventions.

Methods

Elective neuroendovascular procedures at a single center were retrospectively analyzed from October 1, 2018 to May 31, 2019. Hospital costs for each procedure were obtained from the hospital financial department. The primary outcome was the difference in the mean hospital costs after propensity adjustment between patients who underwent TRA compared with TFA access.

Results

Of the 338 elective procedures included, 63 (19%) were performed through TRA versus 275 (81%) through TFA access. Diagnostic procedures were more common in the TRA cohort (51 of 63, 81%) compared with the TFA cohort (197 of 275, 72%), but the difference was not significant (p=0.48). The TRA cohort had a shorter length of hospital stay (mean (SD) 0.3 (0.5) days) compared with the TFA cohort (mean 0.7 (1.3) days; p=0.02) and lower hospital costs (mean $12 968 ($6518) compared with the TFA cohort (mean $17 150 ($10 946); p=0.004). After propensity adjustment for age, sex, symptoms, angiographic findings, procedure type, sheath size, and catheter size, TRA access was associated with a mean hospital cost of $2514 less than that for TFA access (95% CI −$4931 to −$97; p=0.04).

Conclusion

Neuroendovascular procedures performed through TRA access are associated with lower hospital costs than TFA procedures. The lower cost is likely due to a decreased length of hospital stay for TRA.
Dual-roadmap guidance for endovascular recanalization of medically refractory non-acute intracranial arterial occlusions: consecutive multicenter series and technical review
Authors: Gao Feng , Guo Xu , Sun Xuan , Liu Yan , Wu Yingchun , Miao Zhongrong
Published: October 2020

Background

The optimal treatment for medically refractory non-acute intracranial artery occlusion is uncertain, and endovascular recanalization remains a technical challenge. Here, a multicenter clinical experience of dual-roadmap guidance for endovascular recanalization of non-acute intracranial artery occlusion is reported, focusing on the technical feasibility and safety.

Methods

From January 2014 to December 2019, 52 consecutive patients with medically refractory atherosclerotic non-acute intracranial artery occlusion who underwent endovascular recanalization under dual-roadmap guidance in three large regional referral stroke centers were analyzed retrospectively. Four types of dual-roadmap technical schemes were applied during endovascular recanalization. The rates of technical success, periprocedural complications, any stroke or death within 30 days, and follow-up results were evaluated.

Results

The technical success rate was 92.3% (48/52). The perioperative complication rate was 7.7% (4/52), and the rate of any stroke or death within 30 days was 3.8% (2/52). Asymptomatic dissection occurred in two patients, acute in-stent thrombosis followed by postoperative mild stroke (National Institutes of Health Stroke Scale (NIHSS) 3) in one patient, and death due to reperfusion hemorrhage after successful recanalization in one patient. The rate of stroke or death beyond 30 days was 6.5% (3/46). The median clinical follow-up period was 19 months, and the median imaging follow-up period was 12 months. The restenosis rate was 13.2% (5/38).

Conclusions

Endovascular recanalization of non-acute intracranial occlusions can be performed with a high rate of technical success and few complications with assistance of the dual-roadmap technique for navigation. Four types of dual-roadmap schemes provide technical references.
Effectiveness of onabotulinumtoxinA (BOTOX) in pediatric patients experiencing migraines: a randomized, double-blinded, placebo-controlled crossover study in the pediatric pain population
Authors: Shah Shalini , Calderon Michael-David , Crain Nikhil , Pham Jason , Rinehart Joseph
Published: October 2020

Introduction

OnabotulinumtoxinA (OBTA) is approved for treating chronic headaches and migraines in adults, but there is limited scientific literature on the outcomes in pediatric patients. The aim of this study was to determine if subjects treated with OBTA reported a statistically significant improvement in the primary features (frequency, intensity, duration and disability scoring) associated with migraines compared with placebo at follow-up visits.

Methods

After obtaining approval by the appropriate local (HS# 2016–3108) and federal institutions, the principal investigator enrolled candidates aged 8 to 17 years old diagnosed with chronic migraines (at least 6 months), and 15 or more headache days in a 4-week baseline period. This randomized control trial consisted of two phases: double-blind and open-label for the first two and last two sets of treatments, respectively. Subjects were randomly assigned to receive a treatment protocol—155 units at 31 injection sites—in 3-month intervals and follow-up visits every 6 weeks. Non-parametric testing (Wilcoxon signed-rank test) was performed using widely available open-source statistical software (‘R’).

Results

From February 2017 to November 2018, 17 subjects presented for a screening visit; 15 met eligibility criteria. Subjects that received OBTA reported a statistically significant decrease from the following baseline values compared with placebo 6-week post-treatment compared with placebo: frequency (20 (7 to 17) vs 28 (23 to 28); p=0.038), intensity (5 (3 to 7) vs 7 (5 to 9); p=0.047), and PedMIDAS (Pediatric Migraine Disability Score) (3 (2 to 4) vs 4 (4 to 4); p=0.047). There was no statistically significant difference in the duration (10 (2 to 24) vs 24 (4 to 24); p=0.148) of migraines between the two groups.

Discussion

OnabotulinumtoxinA showed a statistically significant decrease in frequency and intensity of migraines compared with placebo. No adverse effects or serious adverse events related to the use of OBTA were reported. In the future, we aim to evaluate the specific nature of migraines, for example, quality/location of pain presented during an initial consult to predict the likelihood of OBTA being a truly effective modality of pain management for pediatric migraineurs.

Trial registration number

NCT03055767.
Quantum geometry II: the mathematics of loop quantum gravity—three-dimensional quantum gravity
Authors: García-Islas J. Manuel
Published: October 2020

Loop quantum gravity is a physical theory that aims at unifying general relativity and quantum mechanics. It takes general relativity very seriously and modifies it via quantisation. General relativity describes gravity in terms of geometry; therefore, quantising such theory must be equivalent to quantising geometry and that is what loop quantum gravity does. This sounds like a mathematical task as well, thus, in this paper we will present the mathematics of loop quantum gravity. We will do it from a mathematician’s point of view. This paper is intended to be an introduction to loop quantum gravity for postgraduate students of physics and mathematics. In this work we will restrict ourselves to the three-dimensional case.
COVID-19 ensemble models using representative clustering
Authors: Kim Joon-Seok , Kavak Hamdi , Züfle Andreas , Anderson Taylor
Published: October 2020

In response to the COVID-19 pandemic, there have been various attempts to develop realistic models to both predict the spread of the disease and evaluate policy measures aimed at mitigation. Different models that operate under different parameters and assumptions produce radically different predictions, creating confusion among policy-makers and the general population and limiting the usefulness of the models. This newsletter article proposes a novel ensemble modeling approach that uses representative clustering to identify where existing model predictions of COVID-19 spread agree and unify these predictions into a smaller set of predictions. The proposed ensemble prediction approach is composed of the following stages: (1) the selection of the ensemble components, (2) the imputation of missing predictions for each component, and (3) representative clustering in application to time-series data to determine the degree of agreement between simulation predictions. The results of the proposed approach will produce a set of ensemble model predictions that identify where simulation results converge so that policy-makers and the general public are informed with more comprehensive predictions and the uncertainty among them.
Morphology, Structure, and Thermal Stability Analysis of Aged Lithium-Ion Battery Materials
Authors: Wang Cong-jie , Zhu Yan-li , Gao Fei , Wang Kang-kang , Zhao Peng-long , Meng Qing-fen , Wu Qi-bing
Published: October 2020

The morphology, structure and thermal stability of anode, cathode and separator of lithium-ion batters at different states of health (SOHs: 100%, 91.02%, 83.90% and 71.90%) under 100% state of charge were studied. The morphology analysis showed that the anode material was getting powdery with aging, and the inhomogeneity of lithium in anode increased. The change of cathode was not obvious, while the number and diameter of separator pores decreased, resulting in the increase of impedance. The analysis of structural and thermal stability showed that the grain size of cathode material decreased with aging, while the thermal decomposition temperature did not change significantly. The anode had the greatest impact on the battery safety based on the DSC test. The initial decomposition temperature of solid electrolyte interphase (SEI) decreased from 65.5 °C (100% SOH) to 61.5 °C (71.90% SOH), and the corresponding heat release increased by 59.7%, indicating that the initial self-heating reaction was more serious. The heat released by graphite collapse significantly reduced with aging, which was beneficial to reduce the high temperature hazard after thermal runaway. The research results can provide guidance for the reuse of retired batteries.
A Smart Parking System Based on Mini PC Platform and Mobile Application for Parking Space Detection
Authors: Sobeslav Vladimir , Horalek Josef
Published: October 2020

Car parking is a major problem in urban areas in developed and also in developing countries. The growing number of vehicles creates a problem with parking spaces mainly in the city center and the surrounding streets. The local authorities have to react with regulations, and the current situation is unpleasant for many citizens. Therefore, the aim of this article is to propose a complex outdoor smart parking lot system based on the mini PC platform with the pilot implementation, which would provide a solution for the aforementioned problem. Current outdoor car park management is dependent on human personnel keeping track of the available parking lots or a sensor-based system that monitors the availability of each car. The proposed solution utilizes a modern IoT approach and technologies such as mini PC platform, sensors, and IQRF. When compared to a specialized and expensive system, it is a solution that is cost-effective and has the potential in its expansion and integration with other IoT services.
Toe Web Infection: Epidemiology and Risk Factors in a Large Cohort Study
Authors: Solomon Michal , Greenbaum Hila , Shemer Avner , Barzilai Aviv , Baum Sharon
Published: October 2020

Introduction: Toe web infection (TWI) is a bacterial infection of the interdigital space. In most cases, the infection is caused by gram-negative bacteria, secondary to a chronic fungal infection (dermatophytosis). The typical presentation includes macerations and erosions in the interdigital space. Predisposing factors include interdigital tinea, hyperhidrosis, and humidity. Objective: The aim of this study was to characterize the TWI patient population and identify associated risk factors. Methods: We conducted a retrospective study of patients diagnosed with TWI from 2006 to 2020 at Sheba Medical Center, Israel. Collected data included patients’ demographics (age, sex, weight, and occupation), smoking pack-years, comorbidities, medications, and course of disease. Results: A total of 200 patients were diagnosed with TWI. The median age at diagnosis was 51 years. The majority of the patients were men (72.5%). The most common comorbidities were dyslipidemia, hypertension, diabetes, and ischemic heart disease. We found that 71.2% of patients were smokers, and 46.4% of patients had occupations that required closed-toe shoes. TWI incidence did not increase seasonally. Bilateral TWI was found in 50% of the patients, 33% had recurrent infections, and 20% had secondary cellulitis. Conclusions: Smoking and diabetes were more prevalent among TWI patients than in the general population, and there was a correlation between smoking and TWI recurrences. We identified risk factors for TWI to identify at-risk populations.
The Minimum Distance May Affect Perioperative Complications and Completed Occlusions of Endovascular Treatment for Tandem Intracranial Aneurysms: A Multi-Institutional Retrospective Study
Authors: Feng Xin , Tong Xin , Peng Fei , Wang Kun , Niu Hao , Qi Peng , Lu Jun , Wu Zhongxue , Chen Guangzhong , Liu Aihua , Wang Daming
Published: October 2020

Background: Tandem aneurysms (TAs) are a distinct type of multiple intracranial aneurysms (IAs), the treatment strategies for which remain controversial. We aimed to reveal the clinical and angiographic outcomes of endovascular treatment as well as their risk factors in these complex multiple IAs. Methods: This multicenter, retrospective follow-up study was carried out in 3 hospitals in China. In total, clinical and angiographical data of 137 patients with 145 lesions (7 patients had bilateral lesions) and 315 TAs were collected. The treatment strategies were divided into full or partial treatment, single- or multiple-session treatment, and coiling (including single coiling and stent-assisted coiling)- or flow-diverting stent (FDS) treatment. Perioperative complications, as well as angiographic and clinical outcomes and their risk factors, were analyzed using univariate analysis and a multiple regression model. Results: Of treated TA lesions, 17 (16.0%) perioperative complications were found. Significant differences were found between the single- and multiple-session treatment groups (p = 0.012). At the latest follow-up, there were no significant differences in the modified Raymond Scale scores between different treatment groups. Significant differences were found in the embolization degree between the coiling and FDS groups (p = 0.038) and between the single common stent (without coiling) and the other treatment groups (p < 0.001). In IAs managed by a single LVIS stent (without coiling), 60% achieved improved or completed occlusion. Multivariate regression analysis found that a shorter minimum distance (odds ratio [OR] 5.967, 95% confidence interval [CI] 1.366–26.074; p = 0.018), multiple-session treatment (OR 9.961, 95% CI 1.707–58.127; p = 0.011), and diabetes (OR 8.106, 95% CI 1.928–34.084; p = 0.004) were predictors of perioperative complications, while shorter minimum distance (OR 5.619, 95% CI 1.493–21.152; p = 0.011), greater diameter ratio (OR 3.621, 95% CI 1.014–12.937; p = 0.048), and greater size ratio (OR 2.424, 95% CI 1.007–5.834; p = 0.048) were predictors of low completed occlusion rate. Conclusions: Both coiling and FDS can be utilized safely and can achieve similar clinical outcomes. FDS and LVIS are recommended for IAs that do not require embolization but cannot be prevented from being covered by stents. A multiple-session treatment may increase the treatment risk, and the minimum distance may affect the incidence of perioperative complications and completed occlusions. Further hemodynamic and prospective studies on such TAs in close proximity to one another are needed.
The Activation of Cannabinoid Type-2 Receptor with JWH-133 Protects Uterine Ischemia/Reperfusion-Induced Damage
Authors: Aydogan Kirmizi Demet , Baser Emre , Doganyigit Zuleyha
Published: October 2020

Introduction: Uterus transplantation is a complex surgical procedure. Uterine ischemia/reperfusion (IR) damage occurring in this process may cause loss of function in the uterus. Cell damage must be prevented for a healthy uterine function and successful transplantation. Cannabinoids, with their increasing clinical use, are substances with strong anti-inflammatory and antioxidative effects and have a role in immune system regulation. However, their efficacy in uterine IR damage is still unknown. This study provides information on the potential applications cannabinoids agonist JWH-133 in uterine IR damage and, hence, in the transplant process. Methods: Rats were divided into 4 groups (n = 8), performed uterine IR, and treated 2 groups with JWH-133. After anesthesia, ischemia was applied for 1 h to the uterus while reperfusion was applied for 3 h. After the experiment, malondialdehyde (MDA) levels and phosphorylated nuclear factor-kappa B (p-NF-κB) expression were examined in the tissue samples. Also, cell damage was evaluated by histopathological imaging and TUNEL staining. Results: In the uterine IR group, NF-κB expression and MDA levels were detected at high levels. Histopathological examinations and TUNEL staining revealed extensive cell damage. On the other hand, in groups treated with JWH-133, dose-dependent NF-κB expression and MDA levels decreased (p < 0.05). Depending on the dose, the rate of surviving cells increased in TUNEL staining results. Conclusion: The results showed that JWH-133 was effective in reducing uterine IR damage. Cannabinoids may be a new alternative that may be used in the transplantation process in the future.
Hypecoum pendulum L. (Papaveraceae: Ranunculales): a new record for the flora of Haryana, India
Authors: Naina Palria  , Singh Nidhan , Bhoo Dev Vashistha
Published: October 2020

Hypecoum pendulum L., a rare, herbaceous angiosperm plant is being reported here as a new record for the flora of Haryana State.  In the present communication, a detailed account of the plant along with coloured photographic plates has been provided to facilitate its easy identification.

 

Keywords: New record,  wild herb
Implementation of a National 5‐Year Plan for Prehospital Emergency Care in Singapore and Impact on Out‐of‐Hospital Cardiac Arrest Outcomes From 2011 to 2016
Authors: Ho Andrew Fu Wah , De Souza Nurun Nisa Amatullah , Blewer Audrey L. , Wah Win , Shahidah Nur , White Alexander Elgin , Ng Yih Yng , Mao Desmond Renhao , Doctor Nausheen , Gan Han Nee , Chia Michael Yih Chong , Leong Benjamin Sieu‐Hon , Cheah Si Oon , Tham Lai Peng , Ong Marcus Eng Hock , Tiah Ling , Ng Wei Ming , Tay Wei Ling , Lim Shir Lynn
Published: October 2020

Background

Outcomes of patients from out‐of‐hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including community and prehospital initiatives. We aimed to document the impact of implementation of a national 5‐year Plan for prehospital emergency care in Singapore on OHCA outcomes from 2011 to 2016.

Methods and Results

Prospective, population‐based data of OHCA brought to Emergency Departments were obtained from the Pan‐Asian Resuscitation Outcomes Study cohort. The primary outcome was Utstein (bystander witnessed, shockable rhythm) survival‐to‐discharge or 30‐day postarrest. Mid‐year population estimates were used to calculate age‐standardized incidence. Multivariable logistic regression was performed to identify prehospital characteristics associated with survival‐to‐discharge across time. A total of 11 465 cases qualified for analysis. Age‐standardized incidence increased from 26.1 per 100 000 in 2011 to 39.2 per 100 000 in 2016. From 2011 to 2016, Utstein survival rates nearly doubled from 11.6% to 23.1% (
P
=0.006). Overall survival rates improved from 3.6% to 6.5% (
P
<0.001). Bystander cardiopulmonary resuscitation rates more than doubled from 21.9% to 56.3% and bystander automated external defibrillation rates also increased from 1.8% to 4.6%. Age ≤65 years, nonresidential location, witnessed arrest, shockable rhythm, bystander automated external defibrillation, and year 2016 were independently associated with improved survival.

Conclusions

Implementation of a national prehospital strategy doubled OHCA survival in Singapore from 2011 to 2016, along with corresponding increases in bystander cardiopulmonary resuscitation and bystander automated external defibrillation. This can be an implementation model for other systems trying to improve OHCA outcomes.
Surface Urban Heat and Cool Islands and Their Drivers: An Observational Study in Nanjing, China
Authors: Wang Liang , Li Dan , Zhang Ning , Sun Jianning , Guo Weidong
Published: October 2020

Urban heat islands (UHIs) are caused by a multitude of changes induced by urbanization. However, the relative importance of biophysical and atmospheric factors in controlling the UHI intensity remains elusive. In this study, we quantify the magnitude of surface UHIs (SUHIs), or surface urban cool islands (SUCIs), and elucidate their biophysical and atmospheric drivers on the basis of observational data collected from one urban site and two rural grassland sites in and near the city of Nanjing, China. Results show that during the daytime a strong SUCI effect is observed when the short grassland site is used as the reference site whereas a moderate SUHI effect is observed when the tall grassland is used as the reference site. We find that the former is mostly caused by the lower aerodynamic resistance for convective heat transfer at the urban site and the latter is primarily caused by the higher surface resistance for evapotranspiration at the urban site. At night, SUHIs are observed when either the short or the tall grassland site is used as the reference site and are predominantly caused by the stronger release of heat storage at the urban site. In general, the magnitude of SUHI is much weaker, and even becomes SUCI during daytime, with the short grassland site being the reference site because of its larger aerodynamic resistance. The study highlights that the magnitude of SUHIs and SUCIs is mostly controlled by urban–rural differences of biophysical factors, with urban–rural differences of atmospheric conditions playing a minor role.
Trends in the Extremes of Environments Associated with Severe U.S. Thunderstorms
Authors: Koch Erwan , Koh Jonathan , Davison Anthony C. , Lepore Chiara , Tippett Michael K.
Published: October 2020

Severe thunderstorms can have devastating impacts. Concurrently high values of convective available potential energy (CAPE) and storm relative helicity (SRH) are known to be conducive to severe weather, so high values of PROD = (CAPE)1/2 × SRH have been used to indicate high risk of severe thunderstorms. We consider the extreme values of these three variables for a large area of the contiguous United States over the period 1979–2015 and use extreme-value theory and a multiple testing procedure to show that there is a significant time trend in the extremes for PROD maxima in April, May, and August, for CAPE maxima in April, May, and June, and for maxima of SRH in April and May. These observed increases in CAPE are also relevant for rainfall extremes and are expected in a warmer climate but have not previously been reported. Moreover, we show that El Niño–Southern Oscillation explains variation in the extremes of PROD and SRH in February. Our results suggest that the risk from severe thunderstorms in April and May is increasing in parts of the United States where it was already high and that the risk from storms in February is increased over the main part of the region during La Niña years.
Economic Valuation of Coccidioidomycosis (Valley Fever) Projections in the United States in Response to Climate Change
Authors: Gorris Morgan E. , Neumann James E. , Kinney Patrick L. , Sheahan Megan , Sarofim Marcus C.
Published: October 2020

Coccidioidomycosis, or valley fever, is an infectious fungal disease currently endemic to the southwestern United States. Symptoms of valley fever range in severity from flu-like illness to severe morbidity and mortality. Warming temperatures and changes in precipitation patterns may cause the area of endemicity to expand northward throughout the western United States, putting more people at risk for contracting valley fever. This may increase the health and economic burdens from this disease. We developed an approach to describe the relationship between climate conditions and valley fever incidence using historical data and generated projections of future incidence in response to both climate change and population trends using the Climate Change Impacts and Risk Analysis (CIRA) framework developed by the U.S. Environmental Protection Agency. We also developed a method to estimate economic impacts of valley fever that is based on case counts. For our 2000–15 baseline time period, we estimated annual medical costs, lost income, and economic welfare losses for valley fever in the United States were $400,000 per case, and the annual average total cost was $3.9 billion per year. For a high greenhouse gas emission scenario and accounting for population growth, we found that total annual costs for valley fever may increase up to 164% by year 2050 and up to 380% by 2090. By the end of the twenty-first century, valley fever may cost $620,000 per case and the annual average total cost may reach $18.5 billion per year. This work contributes to the broader effort to monetize climate change–attributable damages in the United States.
Severe Pelvic Fracture in the Elderly: High Morbidity, Mortality, and Resource Utilization
Authors: Garcia Monika , Firek Matthew , Zakhary Bishoy , Brenner Megan , Hildebrand Frank , Coimbra Raul
Published: October 2020

Severe pelvic fractures (PF) in the elderly are common and analysis of outcomes and resource utilization are lacking. Using the National Trauma Databank (2007-2016), 13 267 patients aged ≥65 years with severe PF (Abbreviated Injury Scale [AIS] pelvis ≥3; AIS 3 = 10 388; AIS 4 = 2124; AIS 5 = 805) were studied. Demographic data, management, resource utilization, complications, and mortality were analyzed for each group. Data are represented as % or median interquartile range (IQR). Multivariate logistic regression analyzed risk factors for mortality, Intensive Care Unit (ICU) admission, and ventilator use. Median age was 77, and most of them were females (59%). Falls occurred in 52%, motor vechicle crash in 21.5%, and pedestrian struck in 11.6%. Median injury severity score was 16 (IQR: 9,27). Shock on admission (9.4%) increased with injury severity. Glasgow Coma Scale < 8 occurred in 8%. Blood transfusion increased with injury severity (17%, 29%, and 51%). Angiography occurred in 9%, external fixation in 4%, internal fixation in 16%, and pelvic packing in 1%, the majority in the AIS 5 group. Overall, 46% required ICU admission and 30% underwent mechanical ventilation; median Hospital Length of Stay was 6 (IQR 4,11), ICU length of stay was 5 (IQR 2,10), and median ventilator days were 4 (IQR 1-11). Mortality rate was 13.3% (AIS 3 = 10%, AIS 4 = 19%, and AIS 5 = 44%).Severe PF in the elderly is associated with high resource utilization, complications, and mortality.
Social and QoS based trust model for secure clustering for wireless body area network
Authors: Ramaswamy Sangeetha , Norman Jasmine
Published: October 2020

Wireless Body Area Networks (WBAN) is an emerging technology, a subset of Wireless Sensor Network. WBAN is a collection of pieces of tiny wireless body sensors with small computational capability and communicates short distance using ZigBee or Bluetooth. The main application of WBAN is in healthcare industry like remote patient monitoring. The small pieces of sensor monitor health factors like body temperature, pulse rate, ECG, heart rate etc., and communicate it to the base station or central coordinator for aggregation or for data computation. The final data is communicated to remote monitoring devices through internet or cloud service providers. The main challenge of this technology is dead nodes due to high energy consumption with all the wireless node working on battery. Minimization of the energy consumption extends life of the network. Security is another major challenge. There are possibilities of internal attacks being executed by malicious nodes, creating problems for the network. This paper proposes a model which provides solution for extending the life span of the network by minimizing energy consumption and also proposes model to provide solution for internal soft attacks created within the network through calculation or trust, computation among nodes to identify malicious nodes with the help of social-and QoS-based trust computation for secure clustering and communication. The proposed model is compared with LEACH and LEACH-MM protocol and performance is measured with various parameters.
Placemaking in the Transnational Caribbean: A Rastafari Community in Ethiopia
Authors: Timcke Scott , Gomes Shelene
Published: October 2020

Considered a sacred place, Shashamane plays a foundational role in the Rastafari transnational social imaginary, especially when one considers how it is a purposeful response to the horrors of racial capitalism. Through an analysis of scenes of everyday life in Shashamane, Ethiopia, we examine the components of migrant Rastafari material culture and the resultant placemaking practices. Like other places in Ethiopia, in the last 20 years Shashamane has undergone a significant transformation in its basic infrastructure. The result is qualitative shift in everyday practices, with significant improvements to relations. We examine how some of these facilitate a culture of bonds that stave off extreme vulnerability.
Filament winding pattern generation for non-axisymmetric mandrels based on uniform quadrilateral elements
Authors: Man Ruidong , Kim Seongjun , Son Chungil , Kim Yeonsu , Jung Yoongho
Published: October 2020

High-strength, continuous and uniform filament winding patterns remain challenging to find for non-axisymmetric models under various loading conditions. In this study, various loading conditions are considered in the development of an algorithm for generating uniform winding patterns for axisymmetric and non-axisymmetric mandrel models with flexible rotation at the ends of the mandrel. First, the mandrel surface is divided into sections by uniform quadrilateral elements and the ideal winding angle at each boundary is calculated based on the stress field. Then, stability analysis is used to calculate suitable winding angles as close as possible to the ideal winding angle for each boundary. These suitable winding angles can be used to generate the uniform winding pattern maintaining non-slippage and non-bridging while realizing flexible rotation at both ends of the mandrel. Finally, uniform patterns for various mandrel models are generated based on their respective suitable winding angles. Stress analysis result demonstrates that the wound mandrel generated by the proposed method can have better carrying capacity.
An Exploration of Correctional Counselor Workloads in a Midwestern State
Authors: Matz Adam K. , Lowe Nathan
Published: October 2020

Time studies have been conducted across a variety of occupations. However, no known research has examined the workload of correctional counselors. In this study, the Iowa Department of Corrections, in partnership with the American Probation and Parole Association, performed a workload evaluation of over 100 correctional counselors who participated in a time study. The most common activities concerned inmate requests, classification, assessment, release planning, treatment group work, and administrative tasks. Most concerning, respondents indicated anywhere from 20% to 50% of the activities engaged in were unsatisfactorily completed.
Interpersonal Emotion Regulation and Psychological Distress: What Is the function of Negative Mood Regulation Expectancies in This Relationship?
Authors: Ray-Yol Elcin , Altan-Atalay Ayse
Published: October 2020

Individuals’ tendency to use their interactions with others in the management of their own emotions is called Interpersonal Emotion Regulation (IER). Limited studies have explored the association between IER and psychological distress with none focusing on the role of mediating variables in this relationship. The current study aims to explore the role of negative mood regulation expectancies (NMRE), which is defined as one’s confidence in the effectiveness of their coping skills while dealing with difficult emotions, as a possible mechanism underlying the association between IER and psychological distress. The data were collected from 204 (164 women) Turkish speaking individuals whose age ranges between 18 and 32 ( M = 22.78, SD = 3.21). The participants completed measures of IER, NMRE and psychological distress. The results have indicated that NMRE has a significant mediating role in the relationship of Soothing dimension of IER with psychological distress. The present findings highlighted the maladaptive function of Soothing as an IER strategy in addition to shedding light on the important role of NMRE in this relationship.
Low-cost procedure for deformity correction in rheumatoid hands
Authors: Agarwal Pawan , Vaishya Raju , Sharma Dhananjaya
Published: October 2020

Background

Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumatoid arthritis (RA) is conventionally done by silicon joint arthroplasty which is expensive and may be associated with many complications. We report the outcome of low-cost autologous interpositional arthroplasty.

Material and methods

Five patients (8 hands, 32 arthroplasties) underwent correction of ulnar drift of MPJ by dorsal capsule interpositional arthroplasty. Results were assessed according to the degree of recovery of movement at the MPJ and correction of ulnar drift. Functional improvement was graded as excellent, good and fair. Pain alleviation was assessed by visual analogue score (VAS) score.

Results

Excellent results were seen in 3 patients (5 hands, 20 arthroplasties), good in 1 patient (2 hands, 8 arthroplasties) and fair in 1 patient (1 hand, 4 arthroplasties). VAS score for pain decreased from mean preoperative 8.2/10 to 1/10. On average follow up of 1.4 years there was good hand function, no recurrence of deformities and patients were pain free.

Conclusion

Interpositional arthroplasty for MPJ using dorsal capsule for correction of post RA ulnar drift is a low-cost option which improves the hand function and cosmesis. Additionally, it avoids all the complications related with the use of silicon joints.
Finite-time sliding mode control for a 3-DOF fully actuated autonomous surface vehicle
Authors: Abooee Ali , Hayeri Mehrizi Mohammad , Arefi Mohammad Mehdi , Yin Shen
Published: October 2020

This paper deals with the finite-time trajectory tracking problem for a typical 3-DOF (degree of freedom) autonomous surface vehicle (ASV) subjected to parametric uncertainties and environmental disturbances. Based on the nonsingular terminal sliding mode control (NTSMC) method, several separate classes of robust control inputs are designed to exactly steer all position states of the 3-DOF AVS to the desired paths during alterable finite times. By exploiting the Lyapunov stability theorem and using mathematical analysis, it is proven that all classes of designed robust control inputs are able to fulfill the mentioned finite-time tracking aim. Moreover, three applicable formulas (represented as several nonlinear inequalities) are extracted to determine the required total finite times for the suggested control schemes. Lastly, all designed control methods are numerically tested onto a benchmark 3-DOF AVS called CyberShip II. Provided computer-based numerical simulations (using MATLAB software) depicted the acceptable performance of the proposed control techniques.
On the design of extended state observer-based robust finite controller: For underactuated robotic system with multiple sources of uncertainties
Authors: Li Hui , Li Ruiqin , Zhang Jianwei
Published: October 2020

Controlling an underactuated robot is always an important research and engineering issue, especially when the robot is suffering from multiple sources of uncertainties, such as unmodeled dynamics, external disturbance, and parameter uncertainties. To cope with these uncertainties in such uncertain nonlinear systems which is not fully-actuated, this paper proposes a control method that can actively estimate these uncertainties via the extended state observer (ESO), under the scheme of output-feedback control, the lumped uncertainties can be online estimated and actively compensated. Every joint of the underactuated robotic system can robustly reach the pre-given state in finite-time even though there are only fewer joints than the actual number of joints that can be controlled directly. The experimental results demonstrate the control process and validate that the proposed method is feasible for the studied underactuated robotic system.
Enhancing governance for environmental sustainability in sub-Saharan Africa
Authors: Asongu Simplice A , Odhiambo Nicholas M
Published: October 2020

This study assesses whether improving governance standards affects environmental quality in 44 countries in sub-Saharan Africa for the period 2000–2012. The empirical evidence is based on generalized method of moments. Bundled and unbundled governance dynamics are used, notably: (i) political governance (consisting of political stability and “voice and accountability”); (ii) economic governance (entailing government effectiveness and regulation quality), (iii) institutional governance (represented by the rule of law and corruption-control); and (iv) general governance (encompassing political, economic, and institutional governance dynamics). The following hypotheses are tested: (i) Hypothesis 1 ( improving political governance is negatively related to carbon dioxide (CO2) emissions); (ii) Hypothesis 2 ( increasing economic governance is negatively related to CO2 emissions); and (iii) Hypothesis 3 ( enhancing institutional governance is negatively related to CO2 emissions). Results of the tested hypotheses show that the validity of Hypothesis 3 cannot be determined based on the results; Hypothesis 2 is not valid, while Hypothesis 1 is partially not valid. The main policy implication is that governance standards need to be further improved in order for government quality to generate the expected unfavorable effects on CO2 emissions.
Exploring Disproportionate Discipline for Latinx Students With and Without Disabilities: A National Analysis
Authors: Gage Nicholas A. , Katsiyannis Antonis , Carrero Kelly M. , Miller Rhonda , Pico Danielle
Published: October 2020

The Latinx population is the largest group of racially and ethnically diverse students in the United States. Although disproportionality in school discipline has been documented for Latinx students, findings related to such disparities have been inconsistent. We examined disciplinary exclusion practices involving students with and without disabilities who are Latinx across the United States using risk ratios (RR) and weighted mixed-effect models. We leveraged data from the Civil Rights Data Collection (CRDC) data set for the 2015 to 2016 academic school year, which included data from more than 94,000 schools. The CRDC is collected by the U.S. Department of Education’s Office of Civil Rights every 2 years. All U.S. public schools are required to submit data to the CRDC. Results suggest that Latinx students with and without disabilities were statistically significantly more likely to receive exclusionary discipline than White students, but less likely than Black students. Implications for research and practice are provided.
Rupture of sinus of Valsalva aneurysm: case report and review of contemporary literature
Authors: Duval Jean-Luc , Ramsingh Richard AE , Rahaman Natasha C , Rampersad Risshi D , Angelini Gianni D , Teodori Giovanni
Published: October 2020

Sinus of Valsalva aneurysm rupture is a rare condition with a great potential for morbidity and mortality if not promptly diagnosed and managed. We present an unusual non-infected sinus of Valsalva aneurysm rupture in a 47-year-old female. This case report, a likely presentation of a late congenital heart defect, highlights the need for a high index of suspicion in a patient with atypical history of congestive cardiac failure.
A refractory anti-NMDA receptor encephalitis successfully treated by bilateral salpingo-oophorectomy and intrathecal injection of methotrexate and dexamethasone: a case report
Authors: Wang Dongmei , Wu Yongming , Ji Zhong , Wang Shengnan , Xu Yunqi , Huang Kaibin , Peng Yu , Zheng Hui , Wang Honghao , Zhang Xiaomei , Pan Suyue
Published: October 2020

Introduction

Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis is an autoimmune-mediated disease that is common in young female patients with ovarian teratomas. With appropriate immunotherapy, most patients achieve a good prognosis. Nevertheless, some patients may be refractory to first- and second-line immunotherapy, thus alternative treatments are required for these patients. Case presentation: We present a case of anti-NMDA receptor encephalitis with ovarian teratoma. After the prompt removal of the teratoma and intense immunotherapy was administered, including an intravenous methylprednisolone pulse, intravenous immunoglobin, plasmapheresis, immunoadsorption, intravenous cyclophosphamide, and rituximab, the patient’s neurologic status did not improve. Bilateral salpingo-oophorectomy was then conducted, and intrathecal injection of methotrexate (MTX) and dexamethasone (DXM) was performed. The patient’s neurological symptoms improved dramatically, and she achieved a good prognosis after 23 months.

Conclusions

Intrathecal injection of MTX and DXM may be beneficial for treatment of refractory cases of anti-NMDA receptor encephalitis. Additional research is required to elucidate the mechanisms of intrathecal treatment with this therapy.
Exploratory laparoscopy as first choice procedure for the diagnosis of giant peritoneal loose body: a case report
Authors: Li RuiBin , Wan ZhiHeng , Li HaoTian
Published: October 2020

Peritoneal loose body (PLB) is an extremely rare clinical entity, and its preoperative diagnosis is often difficult. We report a case of giant PLB (GPLB) confirmed by exploratory laparoscopy. A 46-year-old man was admitted to hospital with an abdominal mass and urinary frequency. He underwent clinical and laboratory tests and computed tomography (CT), which indicated a lesion at the bottom of the bladder. Exploratory laparoscopic surgery revealed a GPLB, which was subsequently removed. The patient was comfortable after surgery and was discharged 3 days later. His symptoms of frequent urination improved during the 1-month follow-up period. The egg-shaped mass excised from the peritoneal cavity measured 45 × 40 × 33 mm. This case indicates that exploratory laparoscopy can be considered as the first-choice diagnostic procedure for patients with GPLB.
Highly oxidized low-density lipoprotein does not facilitate platelet aggregation
Authors: Miyazaki Akari , Uehara Takeshi , Usami Yoko , Ishimine Nau , Sugano Mitsutoshi , Tozuka Minoru
Published: October 2020

Objective

This study aimed to examine whether oxidized low-density lipoprotein (oxLDL) facilitates platelet aggregation, which is one cause for development of cardiovascular disease.

Methods

The susceptibility of platelets to aggregation was monitored by light transmittance aggregometry and a laser light scattering method using low-density lipoprotein (LDL) and oxLDL as agonists. β-thromboglobulin (β-TG) levels released from platelets were also measured after incubation with or without oxLDL.

Results

Platelet aggregation was suppressed by oxLDL as estimated by maximum light transmission. Additionally, adenosine diphosphate-induced further aggregation was slightly reduced by the presence of oxLDL. Aggregation levels of a low number of platelets, which was determined by the laser light scattering method, were lower upon addition of oxLDL compared with unoxidized LDL. After a short time of incubation, oxLDL increased secreted β-TG levels in platelet-rich plasma. However, further incubation with oxLDL caused relatively lower secreted β-TG levels compared with incubation with unoxidized LDL. This fluctuation was not due to β-TG degradation by oxLDL.

Conclusions

Levels of oxLDL in vitro weakly activate platelets at an early stage, but then inhibit platelet function, such as aggregation and β-TG secretion.