bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Fault Detection Method of Rolling Bearing Based on MCNN and GRU Network with an Attention Mechanism
Authors: Zhang Xiaochen , Cong Yiwen , Yuan Zhe , Zhang Tian , Bai Xiaotian
Published: March 2021

Aiming at the problem of early fault diagnosis of rolling bearing, an early fault detection method of rolling bearing based on a multiscale convolutional neural network and gated recurrent unit network with attention mechanism (MCNN‐AGRU) is proposed. This method first inputs multiple time scales rolling bearing vibration signals into the convolutional neural network to train the model through multiscale data processing and then adds the gated recurrent unit network with an attention mechanism to make the model predictive. Finally, the reconstruction error between the actual value and the predicted value is used to detect the early fault. The training data of this method is only normal data. The early fault detection in the operating condition monitoring and performance degradation assessment of the rolling bearing is effectively solved. It uses a multiscale data processing method to make the features extracted by CNN more robust and uses a GRU network with an attention mechanism to make the predictive ability of this method not affected by the length of the data. Experimental results show that the MCNN‐AGRU rolling bearing early fault diagnosis method proposed in this paper can effectively detect the early fault of the rolling bearing and can effectively identify the type of rolling bearing fault.
Synthesis of Colloidal Silicon Quantum Dot from Rice Husk Ash
Authors: Le Thu-Huong , Le Dang Thi Thanh , Tung Nguyen Van
Published: March 2021

This article describes the synthesis procedure of colloidal silicon quantum dot (Si QDs) from rice husk ash. The silicon quantum dots were capped with 1-octadecene by thermal hydrosilylation under argon gas to obtain octadecyl-Si QDs (ODE-Si QDs). The size separation of ODE-Si QDs was examined by the column chromatography method, which used silica gel (40–63 μm) as the stationary phase. Finally, we obtained two fractions of silicon quantum dot, exhibiting blue emission (B-Si QDs) with an average size of 2.5 ± 0.73 nm and red emission (R-Si QDs) with an average size of 5.1 ± 0.68 nm under a UV lamp (365 nm). The PL spectra of B-Si QDs and R-Si QDs samples show maximum peak energy at 410 nm (3.02 eV) and 700 nm (1.77 eV), respectively, while the quantum yield of Si QDs decreases from 5.8 to 34.6% when the average size decreases from 2.5 nm to 5.1 nm. The above results of PL emission spectroscopy and UV-vis absorption show quantum confined effect in Si QDs.
Hydrogen Sulfide Restored the Diurnal Variation in Cardiac Function of Aging Mice
Authors: Zhang Huaxing , Dai Jing , Tian Danyang , Xiao Lin , Xue Hongmei , Guo Qi , Zhang Xiangjian , Teng Xu , Jin Sheng , Wu Yuming
Published: March 2021

The present study was performed to investigate whether H2S could restore the diurnal variation in cardiac function of aging mice and explore the potential mechanisms. We found that ejection fraction (EF) and fractional shortening (FS) in 3‐month‐old mice exhibited diurnal variations over a 24‐hour period. However, the diurnal variations were disrupted in 18‐month‐old mice, and there was a decline in EF and FS. In addition, the plasma malondialdehyde (MDA) levels were increased, and H2S concentrations and superoxide dismutase (SOD) activities were decreased in 18‐month‐old mice. Then, CSE KO mice were used to determine if there was a relationship between endogenous H2S and diurnal variations in EF and FS. There was no difference in 12‐hour averaged EF and FS between dark and light periods in CSE KO mice accompanying increased MDA levels and decreased SOD activities in plasma, indicating that deficiency of endogenous H2S blunted diurnal variations of cardiac function. To determine whether oxidative stress disrupted the diurnal variations in cardiac function, D‐galactose‐induced subacute aging mice were employed. After 3‐month D‐gal treatment, both 12‐hour averaged EF and FS in dark or light periods were decreased; meanwhile, there was no difference in 12‐hour averaged EF and FS between dark and light periods. After 3‐month NaHS treatment in the D‐gal group, the plasma MDA levels were decreased and SOD activities were increased. The EF and FS were lower during the 12‐hour light period than those during the 12‐hour dark period which was fit to sine curves in the D‐gal+NaHS group. Identical findings were also observed in 18‐month‐old mice. In conclusion, our studies revealed that the disrupted diurnal variation in cardiac function was associated with increased oxidative stress and decreased H2S levels in aging mice. H2S could restore the diurnal variation in cardiac function of aging mice by reducing oxidative stress.
CD4 T Cell–Dependent Rejection of Beta-2 Microglobulin Null Mismatch Repair–Deficient Tumors
Authors: Germano Giovanni , Lu Steve , Rospo Giuseppe , Lamba Simona , Rousseau Benoit , Fanelli Sonia , Stenech Denise , Le Dung T. , Hays John , Totaro Maria Grazia , Amodio Vito , Chilà Rosaria , Mondino Anna , Diaz Luis A. , Di Nicolantonio Federica , Bardelli Alberto
Published: March 2021

Inactivation of beta-2 microglobulin (B2M) is considered a determinant of resistance to immune checkpoint inhibitors (ICPi) in melanoma and lung cancers. In contrast, B2M loss does not appear to affect response to ICPis in mismatch repair–deficient (MMRd) colorectal tumors where biallelic inactivation of B2M is frequently observed. We inactivated B2m in multiple murine MMRd cancer models. Although MMRd cells would not readily grow in immunocompetent mice, MMRd B2m null cells were tumorigenic and regressed when treated with anti–PD-1 and anti-CTLA4. The efficacy of ICPis against MMRd B2m null tumors did not require CD8+ T cells but relied on the presence of CD4+ T cells. Human tumors expressing low levels of B2M display increased intratumoral CD4+ T cells. We conclude that B2M inactivation does not blunt the efficacy of ICPi in MMRd tumors, and we identify a unique role for CD4+ T cells in tumor rejection.

Significance:

B2M alterations, which impair antigen presentation, occur frequently in microsatellite-unstable colorectal cancers. Although in melanoma and lung cancers B2M loss is a mechanism of resistance to immune checkpoint blockade, we show that MMRd tumors respond to ICPis through CD4+ T-cell activation.

This article is highlighted in the In This Issue feature, p. 1601
Pesquisas em design, gestão e tecnologia de Têxtil e Moda: volume 9
Authors:   Universidade de São Paulo. Escola de Artes, Ciências e Humanidades, Italiano Isabel Cristina , Marciano João Paulo ,   Universidade de São Paulo. Escola de Artes, Ciências e Humanidades, Ramos Júlia Baruque ,   Universidade de São Paulo. Escola de Artes, Ciências e Humanidades, Held Maria Sílvia Barros de ,   Universidade de São Paulo. Escola de Artes, Ciências e Humanidades, Sanches Regina Aparecida ,   Universidade de São Paulo. Escola de Artes, Ciências e Humanidades
Published: March 2021

Este livro é parte da coleção “Pesquisas em Design, Gestão e Tecnologia de Têxtil e Moda” e tem como principal objetivo contribuir para o desenvolvimento científico, tecnológico, social, cultural e artístico em Têxtil e Moda. Este trabalho, junto dos volumes anteriores, vem se tornando importante veículo de divulgação do desenvolvimento e dos resultados de pesquisas na área, a partir de trabalhos desenvolvidos em nível de pós-graduação no Brasil e no exterior. A coleção apresenta métodos e abordagens interdisciplinares e inovadores, com potencial de utilização tanto no âmbito acadêmico e da pesquisa como em outros campos.
Luba folklore and women’s ethno-gendered discourse of wifehood in “Cintu Wa Bujitu”
Authors: Mulamba Nshindi-Germain
Published: March 2021

This paper investigates Lubà-kasààyi folklore, particularly a folk song, in order to reveal an ethno-gendered construction of wifehood. It aims to show girls’ socialization into a sexist and patriarchal discourse and how such a practice ideologically initiates them into their future subservient role of caterers for the husbands’ alimentation needs. Moreover, folklore seems to perpetuate traditions, and so the gender inequality inscribed within them, a situation that is particularly apparent in villages.
Speaking denunciation: satire as confrontation language in contemporary Nigerian poetry
Authors: Akingbe Niyi
Published: March 2021

Contemporary Nigerian poets have had to contend with the social and political problems besetting Nigeria’s landscape by using satire as a suitable medium, to distil the presentation and portrayal of these social malaises in their linguistic disposition. Arguably, contemporary Nigerian poets, in an attempt to criticize social ills, have unobtrusively evinced a mastery of language patterns that have made their poetry not only inviting but easy to read. This epochal approach in the crafting of poetry has significantly evoked an inimitable sense of humour which endears these poems to the readers. In this regard, the selected poems in this paper are crowded with anecdotes, the effusive use of humour, suspense and curiosity. The over-arching argument of the paper is that satire is grounded in the poetics of contemporary Nigerian poetry in order to criticize certain aspects of the social ills plaguing Nigerian society. The paper will further examine how satire articulates social issues in the works of contemporary Nigerian poets, including Niyi Osundare, Tanure Ojaide, Chinweizu, Femi Fatoba, Odia Ofeimun, Ezenwa Ohaeto, Obiora Udechukwu and Ogaga Ifowodo. Viewed in the light of artistic commitment, the paper will demonstrate how satire accentuates the role of these poets as the synthesizers/conduits of social and cultural concerns of Nigerian society for which they claim to speak. As representatively exemplified in the selected poems, the paper will essentially focus on the mediation of satire for the impassioned criticism of social and moral vices, militating against Nigeria’s socio-political development.
Fertilizer supply chain in Ethiopia: structure, performance and policy analysis
Authors: Agbahey Johanes U.I. , Grethe Harald , Negatu Workneh
Published: March 2021

In Ethiopia, less than 40% of farmers use fertilizer and those who do, apply rates significantly below those recommended. This low fertilizer use is primarily due to prices being two to three times higher than prices on the world markets. Reducing the price of fertilizer requires a sound understanding of the product´s supply chain. This study investigates whether fertilizer is delivered to farmers in an efficient way and at the lowest possible costs using an institutional economics framework. It was conducted in the Arsi zone and relied on secondary data as well as primary data collected through interviews. The findings point out the presence of several formal and informal institutions regulating the market. A market monopoly at each stage of the supply chain and a striking correspondence between the central organization of the chain and the rise in left-over stocks were observed. This pinpoints the imperfect structure of the chain and a misallocation of resources locked up in fertilizer stockholding. In order to improve the demand estimation procedure, this study suggests that incentives should be instituted to enhance the reliability of the information transferred along the process. Additionally, expert knowledge used in the process should be well documented, stock inventories should not be limited to central warehouses and stockholding needs to be reduced.
La réforme de la fonction publique en Afrique subsaharienne : cas de laRépublique Démocratique du Congo
Authors: Muambi Richard Tshienda
Published: March 2021

De nombreuses réformes de la fonction publique ont eu lieu au cours des trente dernières années dans le continent africain. Des stratégies différentes ont été mises en oeuvre afin de moderniser et d’améliorer le fonctionnement des structures administratives. L’objectif que poursuit cet article est de comprendre les stratégies déployées dans la conduite de réforme de la fonction publique en République Démocratique du Congo et d’essayer d’en évaluer les résultats.
Phenotypic variation in Pentaclethra macrophylla Benth (Fabaceae) from the humid lowlands of Cameroon
Authors: Tsobeng Alain , Tchoundjeu Zac , Degrande Ann , Asaah Ebenezer , Bertin Takoutsing , Van Damme Patrick
Published: March 2021

Pentaclethra macrophylla Benth (Fabaceae) has emerged as one of the top underutilized agroforestry species with considerable economic and nutritional value in West and Central Africa where the spe¬cies is endemic and exploited by farmers. However, the species suffers from a level of exploitation that is unsustainable. This dramatically decreases the natural resource base. Key information such as tree variation is needed to develop an efficient strategy for its domestication. This study there¬fore assesses the species phenotypic variation in two populations in the forest zone of Cameroon. Overall, 49 trees (19 in Lomie and 30 in Djoum) were sampled. Tree characteristics (diameter at breast height (DBH), height, crown diameter), pod (number of seeds per pod), seed (width, length, thickness, weight) and kernel traits (weight) were recorded. All these parameters were subjected to a combination of multivariate, PCA and cluster analyses. Results revealed four clusters of P. macrophylla trees with cluster IV considered as the best because it contains four elite trees (LOM/PM/09, LOM/PM/13, LOM/PM/15 and LOM/PM/16) with desirable tree characteristics. Clusters were further considered as different groups of trees, and seeds and kernel traits variation assessed using ANOVA analysis. Significant differences in mean kernel weight occured between groups. Cluster IV presented the highest mean kernel weight (19.25 ± 0.16 g), while cluster III had the lowest (13.28 ± 0.57 g). Within cluster IV, the highest kernel weight (25.83 ± 5.62 g) was found in tree number LOM/PM/09. Kernel weight was found to be positive and strongly correlated (r = 0.95) with seed weight. We can conclude that there is phenotypic variation between the trees of P. macrophylla in terms of DBH, height, crown diameter, number of seeds, seed width, seed length, seed thickness, seed and kernel weight. Results obtained in this study could serve as a useful guide for the selection of targeted P. macrophylla trees either for domestication or for conservation purposes.
Qu’est-ce que le théâtre africain?
Authors: Mbwangi Julien Mbwangi
Published: March 2021

This article gives the broad outlines of our thesis entitled: The African theatre and its characteristics. Analysis of some defining criteria through the urban kikongophone theatre”. We will give more information about the problem statement and the methodology used to write this thesis. This thesis is a contribution to the theorization and conceptualization of African aesthetics, more in particular African theatre.”
A Jesuit Utopian Project on Behalf of the Conversos: Fernando de Valdés and the Statutes of Purity of Blood (1632)
Authors: Franco Juan Hernández , Ortega-del-Cerro Pablo
Published: March 2021

In 1632, the Jesuit Father Fernando de Valdés (1584–1642) completed his Memorial para quitar o limitar Estatutos de limpieza. In this treatise, Valdés sought to abolish the statutes of purity of blood and reassess the longstanding division between New and Old Christians. Additionally, the Memorial offers a novel portrait of Castilian conversos. According to Valdés, New Christians were singled out for discrimination, despite their evident virtues as sincere Catholics and faithful subjects. He did not seek to break the existing social order, but rather to offer a profound critique of the Old Christian hegemony. Ultimately, Valdés proposed an essentially utopian model of society built on personal merits and behavior, rather than blood-based and inherited privileges. This article seeks to study this Memorial in the context of the debate about the statutes of purity of blood and as an important element of that debate within the Society of Jesus.
The Jesuit António Vieira on Paul’s Judeo-Gentile Universalism and Jewish Resiliency
Authors: Stuczynski Claude B.
Published: March 2021

This article reassesses António Vieira’s views on New Christians and Jews. Rather than presenting a reductive portrait of Vieira’s philosemitism as merely empathic, positive, and tolerant, I argue that his supportive attitudes included some enduring negative ideas of Jewishness. An analysis of Vieira’s pro-converso and prophetic writings (including his Inquisition trial) show that his more ambivalent and dialectical perceptions were ultimately grounded on a theological-political interpretation of Paul’s Judeo-Gentile universalism.
“Great Respect for Texts”: A Conversation with Joseph A. Munitiz
Authors: Colombo Emanuele
Published: March 2021

Father Joseph A. Munitiz, S.J. is one of the founders of the Series Graeca of the Corpus Christianorum and its sister series, Corpus Christianorum in Translation. Throughout his long career, Munitiz has published extensively on Byzantine literature, and his work had a lasting impact on the development of Byzantine studies. He likes to define himself as an “amateur” of Ignatian studies; however, a substantial part of his work has focused on Ignatius and the Society of Jesus, providing an extraordinary contribution in translating and editing early Jesuit sources. This interview is an outcome of the long-distance conversations Emanuele Colombo had with Father Munitiz in 2020.
Westward-Propagating Rossby Modes in Idealized GCMs
Authors: Zurita-Gotor Pablo , Held Isaac M.
Published: March 2021

This work investigates the characteristics of westward-propagating Rossby modes in idealized global general circulation models. Using a nonlinear smoothing algorithm to estimate the background spectrum and an objective method to extract the spectral peaks, the four leading meridional modes can be identified for each of the first three zonal wavenumbers, with frequencies close to the predictions from the Hough modes obtained by linearizing about a state of rest. Variations in peak amplitude for different modes, both within a simulation and across simulations, may be understood under the assumption that the forcing of the modes scales with the background spectrum. Surface friction affects the amplitude and width of the peaks but both remain finite as friction goes to zero, which implies that some other mechanism, arguably nonlinear, must also contribute to the damping of the modes. Although spectral peaks are also observed for the precipitation field with idealized moist physics, there is no evidence of mode enhancement by the convective heating. Subject to the same friction, the amplitude of the peaks are very similar in the dry and moist models when both are normalized by the background spectra.
The Influence of Parental Religiosity on the Health of Children during Late Adolescence/Early Adulthood: A Test of Mediation
Authors: Freeman Jason Alan
Published: March 2021

The present study explores whether adolescent religiosity, health-related behaviors, and marital stability mediate the association between parental religiosity and health. Using data from the National Longitudinal Study of Adolescent to Adult (Add) Health, I model potential direct and indirect effects between three measures of parental religiosity (i.e., parental institutional religiosity, parental personal religiosity, and parental religious affiliation); three sets of mediators indicating adolescent religiosity, health-related behaviors, and marital stability; and self-rated health during late adolescence/early adulthood. Overall, I found that parental institutional religiosity has a direct effect on the self-rated health of children during late adolescence/early adulthood, and that it influences self-rated health by reducing adolescent and parental smoking. I also found evidence for deleterious effects of parental institutional religiosity on health as well. Future research should explore variation in the influence of parental religiosity on self-rated health between various sociodemographic groups and between different stages of the life course.
Albumin Utilization in Spontaneous Bacterial Peritonitis
Authors: Ebied Alex M. , Rattanasuwan Thakul , Chen Yiqing , Khoury Adonice P.
Published: March 2021

Background:

Albumin has been shown to decrease the incidence of mortality and acute kidney injury (AKI) in patients with spontaneous bacterial peritonitis (SBP). Albumin administration in SBP is recommended within 6 hours of diagnosis and for reserved use in high-risk patients with the following baseline laboratory tests: serum creatinine >1 mg/dL, blood urea nitrogen >30 mg/dL or total bilirubin >4 mg/dL.

Objective:

We aimed to assess the impact of an albumin order set restricted to high-risk SBP.

Methods:

A retrospective cohort study was conducted between Jan 1, 2013 to Feb 28, 2018. The albumin order set was implemented on Sep 20, 2016. Patients were included if they were diagnosed with SBP and had an ascitic fluid polymorphonuclear count ≥ 250 cells/mm3.

Results:

Out of a total of 137 patients reviewed, 88 met the inclusion criteria. The incidence of AKI in the pre-order set and post-order set were 63.93% and 33.33% (p = 0.01), respectively. The incidence of mortality in the pre-order set and post-order set were 36.07% and 7.41% (p = 0.005), respectively. The percentage of patients administered albumin within 6 hours were 24.59% to 40.74% (p = 0.14) in the pre-order set and post-order set, respectively. The percentage of patients who received the recommended albumin dosing regimen ordered was 42.62% vs 96.30% (p < 0.001), in the pre-order set and post-order set, respectively.

Conclusion:

The albumin order set restricted to high-risk SBP patients significantly reduced the incidence of AKI and mortality, and improved the appropriateness of albumin regimen ordered.
Mesenchymal Stromal Cell-Based Therapy: A Promising Approach for Severe COVID-19
Authors: Xiong Jing , Chen Long , Zhang Li , Bao Lei , Shi Yuan
Published: March 2021

During the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many critically ill patients died of severe pneumonia, acute respiratory distress syndrome (ARDS), or multiple organ dysfunction syndrome. To date, no specific treatments have been proven to be effective for coronavirus disease 2019 (COVID-19). In the animal models and clinical applications, mesenchymal stromal/stem cells (MSCs) have been shown safety and efficacy for the treatment of respiratory virus infection through their abilities of differentiation and immunomodulation. Besides, possessing several advantages of MSC-derived extracellular vesicles (EVs) over MSCs, EV-based therapy also holds potential therapeutic effects in respiratory virus infection. In this review, we summarized the basic characteristics and mechanisms of COVID-19 and MSCs, outlined some preclinical and clinical studies of MSCs or MSC-EVs for respiratory virus infection such as influenza virus and SARS-CoV-2, shed light on the common problems that we should overcome to translate MSC therapy into clinical application, and discussed some safe issues related to the use of MSCs.
Utility of venous‐to‐arterial carbon dioxide changes to arteriovenous oxygen content ratios in the prognosis of severe sepsis and septic shock: A systematic review and meta‐analysis
Authors: Wang Min , Liu Tianyu , Niu Zheng , Zuo Jingzhi , Qi Dunyi
Published: March 2021

Background:

Sepsis patients with insufficient tissue perfusion and hypoxia should be identified and resuscitated immediately. Recently, venous‐to‐arterial carbon dioxide pressure changes and the arteriovenous oxygen content difference ratio (Pcv‐aCO2/Ca‐vO2) as a predictor of tissue perfusion recovery and poor prognosis.

Objectives:

Pcv‐aCO2/Ca‐vO2 is a substitute for respiratory entropy, the elevation of which indicates a lack of tissue perfusion. Pcv‐aCO2/Ca‐vO2 can be used as an indicator to predict the prognosis of patients with sepsis or septic shock, but its prognostic value has not been fully evaluated. Here, we have performed a meta‐analysis to assess its predictive value for mortality.

Methods:

Meta‐analysis of Observational Studies in Epidemiology group guidelines were followed for this meta‐analysis. We searched the comprehensive electronic databases of PubMed, EMBASE, Web of Science, and Cochrane libraries from inception to March 2019, using the terms including “venous‐arterial,” “carbon dioxide,” “Shock, Septic,” and related keywords. The Newcastle‐Ottawa scale was used for quality evaluation of the literature. A meta‐analysis was performed using RevMan 5.3 and Stata 14.0 software to evaluate the effects of Pcv‐aCO2/Ca‐vO2 on short‐term mortality, sequential organ failure assessment, and acute physiology and chronic health evaluation scores in patients with sepsis or septic shock.

Results:

The final analysis included 13 clinical studies involving a total of 940 subjects. The results of the meta‐analysis showed that non‐surviving patients had higher Pcv‐aCO2/Ca‐vO2 than survivors after fluid resuscitation (standardized mean difference = 0.68, 95% confidence interval = 0.24–1.12) and blood samples taken 6 h after resuscitation showed a greater risk of mortality (risk ratio = 1.89, 95% confidence interval = 1.48–2.41) and sequential organ failure assessment scores (mean difference = 1.58, 95% confidence interval = 0.88–2.28, P < 0.01) in patients with high Pcv‐aCO2/Ca‐vO2. These differences were statistically significant.

Conclusion:

This meta‐analysis indicates that Pcv‐aCO2/Ca‐vO2 has predictive value for mortality in patients with sepsis or septic shock. Further studies are now required to determine the optimal threshold for predicting sepsis mortality.

Prospero Registration:

The protocol for this systematic review was registered on PROSPERO (CRD 42019128134).
Factors Associated With Delay in Cleft Surgery at a Tertiary Children’s Hospital in a Major US Metropolitan City
Authors: Stoneburner Jacqueline , Munabi Naikhoba C. O. , Nagengast Eric S. , Williams Madeleine S. , Goel Pedram , Auslander Allyn , Howell Lori K. , Hammoudeh Jeffrey A. , Urata Mark M. , Magee William P.
Published: March 2021

Objective:

To identify factors associated with late cleft repair at a US tertiary children’s hospital.

Design:

Retrospective study of children with CL/P using Children’s Hospital Los Angeles (CHLA) records.

Setting:

US tertiary children’s hospital.

Patients/Participants:

Patients undergoing primary CL or CP repair at CHLA from 2009 to 2018.

Main Outcome Measures:

Proportion of children who had delayed primary CL repair or CP repair using CHLA and American Cleft Palate-Craniofacial Association (ACPA) guidelines and factors associated with late surgery.

Results:

In total, 805 patients—503 (62.5%) who had CL repair, 302 (37.5%) CP repair—were included. Using CHLA protocol, 14.3% of patients seeking CL repair had delayed surgery. Delay was significantly associated with female gender, non-Hispanic ethnicity, Spanish primary language, government insurance, bilateral cleft, cleft lip and palate (CLP), and syndromic diagnosis. Using ACPA guidelines, 5.4% had delayed surgery. Female gender and syndromic diagnosis were significantly associated with delay and remained significant after adjustment for confounders in multivariate models. For CP repair, 60.3% of patients had delayed surgery using CHLA protocol. Cleft lip and palate diagnosis, complete cleft, syndromic diagnosis, and longer travel distance were significantly associated with delay. Using ACPA guidelines, 28.5% had delayed surgery; however, significant association with patient variables was not consistently observed.

Conclusions:

Delay in cleft surgery occurs most often for patients seeking CP repair and is associated with female gender, non-Hispanic ethnicity, Spanish language, government insurance, and bilateral CL, CLP, or syndromic diagnoses. Initiatives should aim to optimize cleft surgery delivery for these subpopulations.
Percutaneous Enteral Feeding in Patients With 22q11.2 Deletion Syndrome
Authors: Ebert Bridget , Morrell Noelle , Zavala Hanan , Chinnadurai Sivakumar , Tibesar Robert , Roby Brianne Barnett
Published: March 2021

Objective:

To describe the incidence of percutaneous enteral feeding in patients with 22q11.2 deletion syndrome (22q11.2 DS) and determine factors associated with the need for percutaneous enteral feeding tube placement.

Design:

Retrospective chart review.

Methods:

The records of a 22q11.2 DS clinic and pediatric otolaryngology clinic at a tertiary pediatric hospital were reviewed from January 1, 2009, to December 31, 2019. All patients with confirmed 22q11.2 deletion were identified. Cardiac, otolaryngological, and feeding characteristics were recorded along with surgical history. A patient was defined to have a G-tube if the history was significant for any percutaneous gastric feeding tube placement, including a gastrostomy tube, gastrostomyjejunostomy tube, or a Mickey button.

Results:

One hundred ninety patients with confirmed 22q11.2 DS by genetic testing were included. Thirty-three percent (n = 63) required G-tube placement. G-tube placement was associated with cardiac diagnosis ( P < .01), history of cardiac surgery ( P < .01), aspiration ( P < .01), nasopharyngeal reflux ( P < .01), subglottic stenosis ( P < .01), laryngeal web ( P = .003), and tracheostomy ( P < .01). This suggests these conditions are associated with higher rates of G-tube placement in the 22q11.2 DS population.

Conclusions:

Patients with 22q11.2 DS often require supplemental nutritional support in the form of G-tube feeding, most often in the first year of life. Congenital heart abnormalities and surgery along with tracheostomy, subglottic stenosis, laryngeal web, aspiration, and nasopharyngeal reflux are significantly associated with the need for G-tube placement. Understanding associations between comorbid conditions and G-tube placement, especially those involving the head and neck, may assist with counseling of patients with 22q11.2 DS.
Anatomical-functional concordance of microperimetry and the simplified age-related macular degeneration study classification: A pilot study
Authors: Leal Cecilia , De Bats Flore , Morales Marco , Decullier Evelyne , Denis Philippe , Amoaku Winfried , Kodjikian Laurent
Published: March 2021

Purpose:

The principal aim of this pilot study was to investigate the concordance between the different stages of Age-Related Macular Degeneration (AMD), as determined by the simplified classification of the Age Related Eye Disease Study Group (AREDS), and new evaluation criteria using a microperimetry system.

Methods:

A complete eye examination and a microperimetry MAIATM (Macular Integrity Assessment, CenterVue, Padova, Italy) examination was performed on 59 eyes with early, intermediate or advanced AMD. We analysed 19 evaluation criteria for every clinical group category.

Results:

There were 20 female and 12 male participants included with a median age of 74 years (min: 54, max: 87). Thirteen eyes (22%) were classified as category 1, 11 eyes (18.6%) as category 2, 17 eyes (28.8%) as category 3 and 18 eyes (30.6%) as category 4 AMD. All evaluated microperimetry criteria related to retinal sensitivity were found to have a statistically significant difference among the stages ( p < 0.05). Fixation stability was unstable in 55.6% of the eyes classified as stage 4 ( p = 0.001). The analysis of the distance between the two PRLs – PRL_initial and PRL_final was larger for the stage 4 ( p = 0.0258). The mean sensitivity in stages 2 and 3 correlated with the presence or not of reticular pseudodrusen ( p = 0.0137).

Conclusions:

The mean sensitivity and the categorized sensitivity (set to 25, 15 and 5 dB), the five higher and lower stimuli sensitivity appeared to be the most sensitive criteria to differentiate the four AMD categories. Microperimetry provides a new reproducible method of anatomical-functional macular analysis.
We Should Do More to Offer Evidence-Based Treatment for an Important Modifiable Risk Factor for COVID-19: Obesity
Authors: Dutta Nirjhar , Ingraham Nicholas E. , Usher Michael G. , Fox Claudia , Tignanelli Christopher J. , Bramante Carolyn T.
Published: March 2021

Observational studies, from multiple countries, repeatedly demonstrate an association between obesity and severe COVID-19, which is defined as need for hospitalization, intensive care unit admission, invasive mechanical ventilation (IMV) or death. Meta-analysis of studies from China, USA, and France show odds ratio (OR) of 2.31 (95% CI 1.3-4.1) for obesity and severe COVID-19. Other studies show OR of 12.1 (95% CI 3.25-45.1) for mortality and OR of 7.36 (95% CI 1.63-33.14) for need for IMV for patients with body mass index (BMI) ≥ 35 kg/m2. Obesity is the only modifiable risk factor that is not routinely treated but treatment can lead to improvement in visceral adiposity, insulin sensitivity, and mortality risk. Increasing the awareness of the association between obesity and COVID-19 risk in the general population and medical community may serve as the impetus to make obesity identification and management a higher priority.
Save a Life: Implementation and Evaluation of a Community-Focused CPR Education Program in Houston, Texas
Authors: Ebunlomo Ebun O. , Gerik Laura , Ramon Rene
Published: March 2021

Over 350 000 people in the United States experience out-of-hospital cardiac arrest (OHCA) annually—and almost 90% die as a result. However, survival varies widely between counties, ranging from 3.4% to 22.0%—a disparity that the American Heart Association (AHA) largely attributes to variation in rates of bystander CPR. Studies show that regions with low rates of bystander CPR have low rates of CPR training, making CPR training initiatives a high-priority intervention to reduce OHCA mortality. In Houston, Texas, researchers have identified census tracts with higher OCHA incidence and lower rates of bystander CPR. We developed a free, annual Hands-Only CPR bilingual health education program central to these high-risk neighborhoods. In 5 years, this collaborative effort trained over 2700 individuals. In 2016, 2017, and 2018, we conducted a process evaluation to assess fidelity, dose delivered, and dose received. We also conducted an outcome evaluation using the Kirkpatrick Model for Training Evaluation to assess participants’ reactions and learning. Overall, the program yielded positive outcomes. Of the 261 respondents (from 314 attendees), 63% were first-time learners. The majority (87%) were satisfied with the event and 85% felt that information was presented clearly and concisely. Pre- and post-knowledge assessments showed a 51% increase in the proportion of respondents who could correctly identify the steps for Hands-Only CPR. This program exemplifies how collaborative education can impact a community’s health status. Leveraging each partner’s resources and linkages with the community can enhance the reach and sustainability of health education initiatives.
Parents’ Online School Reviews Reflect Several Racial and Socioeconomic Disparities in K–12 Education
Authors: Gillani Nabeel , Chu Eric , Beeferman Doug , Eynon Rebecca , Roy Deb
Published: March 2021

Parents often select schools by relying on subjective assessments of quality made by other parents, which are increasingly becoming available through written reviews on school ratings websites. To identify relationships between review content and school quality, we apply recent advances in natural language processing to nearly half a million parent reviews posted for more than 50,000 publicly funded U.S. K–12 schools on a popular ratings website. We find: (1) schools in urban areas and those serving affluent families are more likely to receive reviews, (2) review language correlates with standardized test scores—which generally track race and family income—but not school effectiveness, measured by how much students improve in their test scores over time, and (3) the linguistics of reviews reveal several racial and income-based disparities in K–12 education. These findings suggest that parents who reference school reviews may be accessing, and making decisions based on, biased perspectives that reinforce achievement gaps.
The Clarion: A Social Enterprise Disrupting School Stationary Industry for Sustainability
Authors: Acharyulu A. V. Ramana , Agarwal Vaishali , Prabhakar Manoj
Published: March 2021

Clarion Education and Skills Private Limited Patna, is a start-up promoted to address the school stationery demand–supply gap in the rural elementary education delivery system and cater to the needs of the rural school children in the states of Bihar, Jharkhand and West Bengal. This case documents the way Clarion pursued disrupting the school notebooks market, with a goal of making a notebook affordable at one-sixth the existing cost of a notebook in the marketplace in 2016. Clarion was promoted by The Better World Foundation (BWF), Patna, a social enterprise working in the area of rural elementary education in Bihar. BWF was of the view that the challenges of school stationery supply chain need to be addressed through a commercial enterprise only, so as to drive changes in the sector, so that BWF could focus on its core objective of creating and developing meaningful elementary educational institutions in the remote rural villages in Bihar, India.

This case study details the strategy of Clarion in developing a business model to break the shackles of high-priced branded notebooks by linking the advertising of social marketing campaigns with insertions in the notebook covers, and thus converting the notebook into an advertising medium, and meticulously campaigning for supply of affordable notebooks through various governmental and non-governmental institutions. Clarion challenged the competitive forces on one side and pursued building a cost leadership position for itself through cost-value trade-off initiatives on the other.
Interruptions in Agile Software Development Teams
Authors: Wiesche Manuel
Published: March 2021

Agile approaches help software development project teams to better meet user needs and ensure flexibility in uncertain environments. But using agile approaches invites changes to the project and increases interactions between team members, which both cause interruptions in the workplace. While interruptions can help in task completion and increase process flexibility, they can also hinder employee productivity. We conducted an exploratory study of four agile software development teams. Our analysis identified (1) programming-related work impediments, (2) interaction-related interruptions, and (3) interruptions imposed by the external environment, which were managed by improved information retrieval and reduced team dependencies.
Dissection of the uterine wall in a scarred uterus: a case report
Authors: Zilver Sanne J. M. , Wegdam Wouter , Hooker Angelo B.
Published: March 2021

Uterine rupture is a potentially fatal complication during pregnancy, delivery, or postpartum. Women attempting a trial of labor after a cesarean section have an increased risk of a subsequent rupture. We report a case of a 24-year-old woman, gravida 2 para 1 with a previous cesarean section who underwent a trial of labor. During labor she complained of pain while labor progressed rapidly. Because of signs of fetal distress, a vacuum extraction was performed. Two hours after delivery, the patient complained again of severe abdominal pain. Blood accumulated in a previously non-existent area between the serosa and uterine muscle. A dissection of the uterine wall occurred with serious clinical consequences, compatible with a complete uterine rupture. Emergency laparotomy was performed to repair the uterine wall; a hysterectomy was prevented.
Quantitative evaluation of cellular internalization of polymeric nanoparticles within laryngeal cancer cells and immune cells for enhanced drug delivery
Authors: Ma Li-Juan , Niu Ruichao , Wu Xi , Wu Jun , Zhou En , Xiao Xu-Ping , Chen Jie
Published: March 2021

Clinical translation of poly (lactic-co-glycolic acid) (PLGA)-based nanomedicine is limited, partly because of the poor delivery efficiency resulting from non-specific phagocytosis by phagocytes. Understanding the nanoparticle interplay between cancer cells and immune cells remains largely elusive. In this study, a quantitative investigation on cellular internalization of fluorescent PLGA particles (100 nm, 500 nm, and 1 µm) against laryngeal carcinoma cells with or without monocytes/macrophages in monoculture or co-culture systems was first performed. PLGA particles at concentrations of 5–20 µg/mL show superior biocompatibility except for 500 nm and 1 µm PLGA particles at 20 µg/mL slightly reduce cell viability. Microscopic observation has discovered all three sizes of particles are effectively ingested by both cancer cells and macrophages; however, quantitative fluorescence examination has disclosed that the uptake index of cancer cells (mean intracellular particle fluorescence per cancer cell normalized to that of per macrophage) is substantially declined for all PLGA particles in co-cultures compared to that in monocultures (1.35–1.05, 1.50–0.59, and 1.4–0.47 for 100 nm, 500 nm, and 1 µm particles, respectively). Quantitative analysis using flow cytometry further confirmed the reduced uptake index of cancer cells in co-cultures, but higher particle counts per macrophage. It has also been found that the formation of multinucleated giant cells via the fusion of macrophages increased after PLGA treatment, which could be further exploited as a potential approach for tumor drug delivery. Overall, these findings provide new insights into the interaction of nanoparticle-immune-cancer cells, which may facilitate the application of PLGA-based nanocarriers for the treatment of laryngeal carcinoma.
Low impact of different SNP panels from two building-loci pipelines on RAD-Seq population genomic metrics: case study on five diverse aquatic species
Authors: Casanova Adrián , Maroso Francesco , Blanco Andrés , Hermida Miguel , Ríos Néstor , García Graciela , Manuzzi Alice , Zane Lorenzo , Verissimo Ana , García-Marín José-Luís , Bouza Carmen , Vera Manuel , Martínez Paulino
Published: March 2021

Background

The irruption of Next-generation sequencing (NGS) and restriction site-associated DNA sequencing (RAD-seq) in the last decade has led to the identification of thousands of molecular markers and their genotyping for refined genomic screening. This approach has been especially useful for non-model organisms with limited genomic resources. Many building-loci pipelines have been developed to obtain robust single nucleotide polymorphism (SNPs) genotyping datasets using a de novo RAD-seq approach, i.e. without reference genomes. Here, the performances of two building-loci pipelines, STACKS 2 and Meyer’s 2b-RAD v2.1 pipeline, were compared using a diverse set of aquatic species representing different genomic and/or population structure scenarios. Two bivalve species (Manila clam and common edible cockle) and three fish species (brown trout, silver catfish and small-spotted catshark) were studied. Four SNP panels were evaluated in each species to test both different building-loci pipelines and criteria for SNP selection. Furthermore, for Manila clam and brown trout, a reference genome approach was used as control.

Results

Despite different outcomes were observed between pipelines and species with the diverse SNP calling and filtering steps tested, no remarkable differences were found on genetic diversity and differentiation within species with the SNP panels obtained with a de novo approach. The main differences were found in brown trout between the de novo and reference genome approaches. Genotyped vs missing data mismatches were the main genotyping difference detected between the two building-loci pipelines or between the de novo and reference genome comparisons.

Conclusions

Tested building-loci pipelines for selection of SNP panels seem to have low influence on population genetics inference across the diverse case-study scenarios here studied. However, preliminary trials with different bioinformatic pipelines are suggested to evaluate their influence on population parameters according with the specific goals of each study.
Characteristics and antithrombotic treatment patterns of patients with concomitant coronary artery disease and atrial fibrillation from Thailand’s COOL-AF registry
Authors: Winijkul Arjbordin , Kaewkumdee Pontawee , Yindeengam Ahthit , Krittayaphong Rungroj
Published: March 2021

Background

Concomitant coronary artery disease (CAD) and atrial fibrillation (AF) are common in clinical practice. The aim of this study was to investigate the characteristics and antithrombotic treatment patterns of patients with concomitant CAD and AF from the COhort of antithrombotic use and Optimal INR Level in patients with non-valvular atrial fibrillation in Thailand (COOL-AF Thailand) registry.

Methods

Registry enrollment criteria included patients aged ≥ 18 years who were diagnosed with AF for any duration at any of 27 public hospitals located across Thailand during 2014–2017. The That Clinical Trials Registry study registration number is TCTR20160113002. Statistical comparisons of characteristics and treatment strategies were performed between patients with and without CAD.

Results

Of a total of 3461 AF patients, 557 had concomitant CAD (16.1%). Patients with concomitant CAD and AF were significantly older, more likely to be male, had more comorbidities, and had more cardiovascular implantable electronic devices. History of stroke/transient ischemic attack and prior bleeding was not significantly different between groups. CHA2DS2-VASc score and HAS-BLED score were both higher in patients with CAD than in patients without CAD (4.17 vs. 2.78, p < 0.001, and 2.01 vs. 1.45, p < 0.001, respectively). Utilization of oral anticoagulant was less in patients with CAD (76.0% vs. 84.3%, p < 0.001). Concomitant use of antiplatelet was found to be a major cause of oral anticoagulant (OAC) underutilization. Specifically, the rate of OAC prescription was 95.9% in patients without antiplatelet, and 43.7% in patients with antiplatelet. Among patients with CAD who were on OAC, the rate of concomitant antiplatelet prescription was still high. In this group, 63% of patients were on triple therapy when percutaneous coronary intervention (PCI) with drug eluting stent was performed within 1 year, and 32.2% of patients without prior PCI or acute coronary syndrome were taking at least one antiplatelet with OAC.

Conclusion

Among patients with concomitant CAD and AF, physicians were reluctant to discontinue antiplatelet. The use of antiplatelet discourages physicians from prescribing OAC. Underutilization of OAC may increase the risk of ischemic stroke, and an inappropriate combination of OAC and antiplatelet may increase the risk of bleeding.

Trial registration The trial has been registered with the Thai Clinical Trials Registry (TCTR) which complied with WHO International Clinical Trials Registry Platform dataset. The Registration Number is TCTR20160113002 (05/01/2016).