bluuebunny/crossref_metadata_2025 huggingface dataset:
From the President: Long Range Planning – Your Ideas Will be Heard
Authors: Spear Karl
Published: April 2021

Our 202nd ECS meeting in Salt Lake City was a resounding success! Special thanks to all of you who organized, ran, or participated in the technical symposia and committee meetings.
Salt Lake City Meeting Highlights
Authors: Rajeshwar Krishnan , Yess Mary
Published: April 2021

With two spectacular geographic features (the great Salt Lake and the Wasatch Mountain Range) as its borders, Salt Lake City provided a gorgeous setting for the Society’s 202nd meeting.
The Electrochemical Society: A Forum for Electrochemistry and Solid State Science for 100 Years
Authors: Yess Mary , Turner Dennis R. , Trumbore Forrest
Published: April 2021

The Electrochemical Society (ECS) has a birthplace of historic distinction – Philadelphia – the home of Benjamin Franklin – (and his famous kite) and the birthplace of the United States. The Society originally was called the American Electrochemical Society, but, like the nation, it had its roots in distant lands. ECS was like the nation in other respects. It was a melting pot; in this case, a melting pot of scientific and technological disciplines, and of their adherents, who came from countries from Australia to Mexico to Russia and points in between.
ECS Launches A Centennial Campaign
Authors: Miller Troy M.
Published: April 2021

The Electrochemical Society (ECS) will launch its most significant fundraising campaign ever in September 2002. The ECS Centennial Campaign is significant for many reasons including its purpose, its scope, and the manner in which it was initiated. It is appropriate that a campaign of this magnitude, charged with ensuring the future of this Society and the fields it covers, is beginning in the Society’s centennial year.
Back to the Future: Return of the Hybrid
Authors: Kepros Michael A. , Van Schalkwijk Walter A.
Published: April 2021

In the last few years, the term “hybrid” has appeared in many different contexts associated with the concepts of improved portable power and better power quality. The term has many meanings ranging from its original use, some 400 years ago, to describe the offspring from the mating of a tame sow and wild boar to modern comments concerning new corn seeds or types of improved automobiles.
Organic- and Molecule-based Magnets
Authors: Miller Joel S.
Published: April 2021

Magnets have captivated mankind’s imagination for centuries and in the twentieth century their development was essential for the establishment of our present high-tech society. The number, proximity, and consequently the coupling among electron spins, dictate all magnetic behaviors.
Electrons at Work in Prussian Blue Analogues
Authors: Verdaguer Michel , Garde Raquel , Galvez Natividad , Desplanches Cédric
Published: April 2021

Molecular magnetism is an evolving discipline relying on quantum chemistry, orbitals and Hamiltonians, organic and coordination chemistries, physics, and devices. Among the exciting molecule-based magnetic systems, Prussian blue analogues occupy a peculiar position.
Two‐Way Feature Extraction Using Sequential and Multimodal Approach for Hateful Meme Classification
Authors: Aggarwal Apeksha , Sharma Vibhav , Trivedi Anshul , Yadav Mayank , Agrawal Chirag , Singh Dilbag , Mishra Vipul , Gritli Hassène
Published: April 2021

Millions of memes are created and shared every day on social media platforms. Memes are a great tool to spread humour. However, some people use it to target an individual or a group generating offensive content in a polite and sarcastic way. Lack of moderation of such memes spreads hatred and can lead to depression like psychological conditions. Many successful studies related to analysis of language such as sentiment analysis and analysis of images such as image classification have been performed. However, most of these studies rely only upon either one of these components. As classifying meme is one problem which cannot be solved by relying upon only any one of these aspects, the present work identifies, addresses, and ensembles both the aspects for analyzing such data. In this research, we propose a solution to the problems in which the classification depends on more than one model. This paper proposes two different approaches to solve the problem of identifying hate memes. The first approach uses sentiment analysis based on image captioning and text written on the meme. The second approach is to combine features from different modalities. These approaches utilize a combination of glove, encoder‐decoder, and OCR with Adamax optimizer deep learning algorithms. Facebook Challenge Hateful Meme Dataset is utilized which contains approximately 8500 meme images. Both the approaches are implemented on the live challenge competition by Facebook and predicted quite acceptable results. Both approaches are tested on the validation dataset, and results are found to be promising for both models.
Portfolio Selection with respect to the Probabilistic Preference in Variable Risk Appetites: A Double‐Hierarchy Analysis Method
Authors: Gu Ruitao , Chen Qingjuan , Zhang Qiaoyun
Published: April 2021

Traditional portfolio selection models mainly obtain the optimized portfolio ratio by focusing on the prices of financial products. However, investors’ multiple preferences and risk appetites are also significant factors that should be taken into account. In consideration of these two factors simultaneously, we propose a double‐hierarchy model in this paper. Specifically, the first hierarchy quantifies investors’ risk appetite based on a historical simulation method and probabilistic preference theory. This hierarchy can be utilized to describe investors’ variable risk appetites and ensure the obtained investment ratios meet investors’ immediate risk requirements. Then, using the cross‐efficiency evaluation principle, the optimal investment ratios can be derived by fusing investors’ multiple preferences and risk appetites in the second hierarchy. Lastly, an illustrative example about evaluating the 10 largest capitalized stocks on the Shenzhen Stock Exchange is given to verify the feasibility and effectiveness of our newly proposed model. We make the theoretical contribution to improve the traditional portfolio selection model, especially considering investors’ subjective preferences and risk appetite. Moreover, the proposed model can be practical for assisting investors with their investment strategies in real life.
Role of Annexin A1 in Squamous Cell Lung Cancer Progression
Authors: Elakad Omar , Li Yuchan , Gieser Natascha , Yao Sha , Küffer Stefan , Hinterthaner Marc , Danner Bernhard C. , von Hammerstein-Equord Alexander , Ströbel Philipp , Bohnenberger Hanibal
Published: April 2021

Lung cancer remains the primary cause of cancer-related death worldwide, and its molecular mechanisms of tumor progression need further characterization to improve the clinical management of affected patients. The role of Annexin A1 (ANXA1) in tumorigenesis and cancer progression in general and especially in lung cancer remains to be controversial and seems to be highly tissue specific and inconsistent among tumor initiation, progression, and metastasis. In the current study, we investigated ANXA1 expression in 81 squamous cell lung cancer (SQCLC), 86 pulmonary adenocarcinoma (AC), and 30 small cell lung cancer (SCLC) patient-derived tissue samples and its prognostic impact on patient’s survival. Mechanistically, we analyzed the impact of ANXA1 expression on proliferation and migration of SQCLC cell lines using CRISPR-Cas9 and mammalian overexpression vectors. Strong expression of ANXA1 was significantly correlated to longer overall survival only in SQCLC patients (

P
=
0.019

). Overexpression of ANXA1 promoted proliferation in SQCLC cell lines but suppressed their migration, while knockout of ANXA1 promoted cell migration and suppressed proliferation. In conclusion, ANXA1 expression might elongate patients’ survival by inhibiting tumor cell migration and subsequent metastasis.
CD28 Genetic Variants Increase Susceptibility to Diabetic Kidney Disease in Chinese Patients with Type 2 Diabetes: A Cross-Sectional Case Control Study
Authors: Li Yangyang , Jin Li , Yan Jing , Zhang Hong , Zhang Rong , Hu Cheng
Published: April 2021

Few studies have illuminated the genetic role of T cell costimulatory molecule CD28/CD80/CTLA4 variants in diabetic kidney disease (DKD) susceptibility. We aimed to investigate the causal role of genetic polymorphisms in CD28/CD80/CTLA4 with DKD susceptibility in patients with T2DM. A total of 3253 patients with T2DM were recruited for genotyping: including 204 DKD patients and 371 controls in stage 1 and 819 DKD patients and 563 controls in stage 2; besides, 1296 T2DM patients were selected for the analysis of association between loci and DKD-related traits. A subset of 227 T2DM patients (118 patients with DKD and 109 patients without DKD) from the total population above were selected to assess serum soluble CD28 (sCD28) levels. Then, we performed a candidate gene association study to identify single-nucleotide polymorphisms (SNPs) associated with DKD susceptibility and further used those SNPs to perform Mendelian randomization analyses of serum sCD28 level and DKD susceptibility. Under additive genetic models, CD28-rs3116494 (

OR
=
1.29

[95% CI 1.11, 1.51],

P
=
0.0011

) and CD80-rs3850890 (

OR
=
1.16

[95% CI 1.02, 1.31],

P
=
0.0283

) were associated with DKD susceptibility adjusted for age, gender, body mass index (BMI), duration of diabetes, and HbA1c. CD28-rs3116494 was associated with serum sCD28 level (

β
=
0.26

[95% CI 0.08, 0.44],

P
=
0.0043

). The Mendelian randomization analysis showed that CD28-rs3116494 played a causal role in DKD by influencing serum sCD28 levels (

β
=
1.15

[95% CI 0.46, 1.83],

P
=
0.0010

). In conclusion, we identified that two novel SNPs, CD28-rs3116494 and CD80-rs3850890, were associated with DKD susceptibility. Using the Mendelian randomization analysis, our study provided evidence for a causal relationship between serum CD28 levels and DKD with T2DM in the Chinese population.
Link Prediction and Node Classification Based on Multitask Graph Autoencoder
Authors: Chen Shicong , Yuan Deyu , Huang Shuhua , Chen Yang
Published: April 2021

The goal of network representation learning is to extract deep‐level abstraction from data features that can also be viewed as a process of transforming the high‐dimensional data to low‐dimensional features. Learning the mapping functions between two vector spaces is an essential problem. In this paper, we propose a new similarity index based on traditional machine learning, which integrates the concepts of common neighbor, local path, and preferential attachment. Furthermore, for applying the link prediction methods to the field of node classification, we have innovatively established an architecture named multitask graph autoencoder. Specifically, in the context of structural deep network embedding, the architecture designs a framework of high‐order loss function by calculating the node similarity from multiple angles so that the model can make up for the deficiency of the second‐order loss function. Through the parameter fine‐tuning, the high‐order loss function is introduced into the optimized autoencoder. Proved by the effective experiments, the framework is generally applicable to the majority of classical similarity indexes.
High-Quality Nursing Care for the Elderly in the Department of Otolaryngology
Authors: Huang Yeping , Chen Huili
Published: April 2021

ENT patients have different types of diseases and clinical symptoms, and generally, patients have a low level of understanding of their professional knowledge about their ENT diseases. In this paper, quality nursing interventions in otorhinolaryngology require nursing staff to implement relevant nursing interventions in the process of implementing relevant nursing care, which should be based on patients’ needs, and guide patients to perform rehabilitation exercises according to their individual conditions, in addition to establishing continuous nursing interventions with patients at the time of discharge with the help of modern technology. By comparing the nursing satisfaction of patients in the observation group and the control group, it was found that the nursing satisfaction of patients in the observation group who received humanistic nursing was higher, and the difference was statistically significant compared with that of the control group (

P
<
0.05

). The SCL-90 scale scores of patients in both groups were not significantly different on the day of admission as verified by t values, and the SCL-90 scale scores of patients in both groups changed to a certain extent after hospitalization. The difference between the two groups was verified by t value.
Large Rhinolith Mimicking Atypical Odontogenic Pain: Case Report and Brief Review of the Literature
Authors: Vasegh Zahra , Ghazizadeh Ahsaie Mitra
Published: April 2021

Rhinoliths are rare calcified entities in the nasal fossa, frequently originating around a nidus near the midway point in the inferior meatus, where the passage is the narrowest. They can be clinically asymptomatic and undetected for years. In this study, we present a rare case of large rhinolith mimicking atypical odontogenic pain in a 40-year-old Caucasian female in the left nasal cavity. The lesion was detected in the CBCT and removed uneventfully.
Concurrent Pulmonary and Cerebellar Cryptococcus Gattii Cryptococcoma in an Apparently Immunocompetent Patient in Florida
Authors: Billings Benjamin , Akhavan Neeka , Vittor Amy , Nagoshi Ying
Published: April 2021

Cryptococcus infection is caused by one of the two species, Cryptococcus neoformans, or the less common Cryptococcus gattii. While Cryptococcus neoformans commonly infects the immunocompromised population, Cryptococcus gattii has been seen more frequently in immunocompetent patients. Many seemingly immunocompetent patients, however, may have unidentified underlying immunodeficiencies. Recently, antigranulocyte-macrophage colony-stimulating (GM-CSF) antibodies have been identified as a risk factor for cryptococcosis. We describe a case of disseminated Cryptococcus gattii infection in a seemingly immunocompetent young man, who is found to have anti-GM-CSF antibodies.
Advances in the Development of Biomarkers for Poststroke Epilepsy
Authors: Liang Mengke , Zhang Liren , Geng Zhi
Published: April 2021

Stroke is the main cause of acquired epilepsy in elderly people. Poststroke epilepsy (PSE) not only affects functional recovery after stroke but also brings considerable social consequences. While some factors such as cortical involvement, hemorrhagic transformation, and stroke severity are associated with increased seizure risk, so far that remains controversial. In recent years, there are an increasing number of studies on potential biomarkers of PSE as tools for diagnosing and predicting epileptic seizures. Biomarkers such as interleukin‐6 (IL‐6), tumor necrosis factor‐α (TNF‐α), glutamate, and S100 calcium‐binding protein B (S100B) in blood are associated with the occurrence of PSE. This review is aimed at summarizing the progress on potential biomarkers of PSE.
Designs, Synthesis, Docking Studies, and Biological Evaluation of Novel Berberine Derivatives Targeting Zika Virus
Authors: Nguyen Cuong Quoc , Nguyen Thi Hong Minh , Nguyen Thi Thu Thuy , Bui Thi Buu Hue , Nguyen Trong Tuan , Huynh Nhu Thao , Le Thanh Do , Nguyen Thi Mai Phuong , Nguyen Duy Tuan , Nguyen Minh Tam , Pham Minh Quan , Tran Quang De , Nguyen Hong Phuong
Published: April 2021

The World Health Organization has designated Zika virus (ZIKV) as a dangerous, mosquito-borne flaviviral pathogen that was recently found to be responsible for a dramatically increased number of microcephaly cases and other congenital abnormalities in fetuses and newborns. There is neither a vaccine to prevent nor a drug to treat ZIKA virus infections, at the present time. Berberine (BBR) is a promising drug approved by FDA against flaviviral dengue virus, and BBR derivatives are of great interest in antiviral drug development. In this study, we synthesized eight BBR derivatives by introducing benzyl groups at the C-13 position of BBR and converting to respective 8-oxoberberine derivatives, performed molecular docking analysis, and evaluated their anti-Zika virus activity utilizing a cell‐based phenotypic assay. Binding mode analysis, absolute binding free energy calculation, and structure-activity relationship studies of these compounds with ZIKV NS3 receptor were collected. Amongst these studied compounds, compound 4d with a structure of 13-(2,6-difluoro)-benzylberberine showed high binding affinity (docking score of −7.31 kcal/mol) towards ZIKV NS2B-NS3 protease with critical binding formed within the active site. In the cell-based assay, compound 4d displayed the highest antiviral efficacy against ZIKV with a selective index (SI) of 15.3, with 3.7-fold greater than that of berberine. Together, our study suggests that the potential ZIKV NS2B-NS3 protease inhibitor, compound 4d, is the best alternative to BBR and, further, extends an assuring platform for developing antiviral competitive inhibitors against ZIKV infection.
q
-Hermite–Hadamard Inequalities for Generalized Exponentially

s
,
m
;
η

-Preinvex Functions
Authors: Wang Hua , Kalsoom Humaira , Budak Hüseyin , Idrees Muhammad
Published: April 2021

In this article, we introduce a new extension of classical convexity which is called generalized exponentially

s
,
m
;
η

-preinvex functions. Also, it is seen that the new definition of generalized exponentially

s
,
m
;
η

-preinvex functions describes different new classes as special cases. To prove our main results, we derive a new

q

m

κ

2

-integral identity for the twice

q

m

κ

2

-differentiable function. By using this identity, we show essential new results for Hermite–Hadamard-type inequalities for the

q

m

κ

2

-integral by utilizing differentiable exponentially

s
,
m
;
η

-preinvex functions. The results presented in this article are unification and generalization of the comparable results in the literature.
The Time Effect and Micromechanism of the Unconfined Compressive Strength of Cement Modified Slurries
Authors: Jiang Ping , Chen Yewen , Zhou Lin , Mao Tianhao , Wang Wei , Yuan Junping , Li Na
Published: April 2021

This study investigated the unconfined compressive strength change law of cement modified slurries (CMS) under different curing ages. We conducted unconfined compressive strength tests using slurry and cement as raw materials. The cement contents were 5%, 10%, 15%, 20%, and 25%. The curing ages were 7, 14, 28, 56, 90, 120, 150, and 180 d. A time effect model of CMS strength was established based on the measured UCS strength‐curing age and the strength‐cement content curves. The test results proved that the UCS of the CMS increased significantly with an increase in the curing age, and after 90 days, the UCS gradually increased to a fixed value. The time effect model better characterized the relationship between the UCS of the CMS and the curing age and the cement content, as the predicted value had a high correlation with the measured value. We conducted scanning electron microscopy (SEM), energy dispersive X‐ray (EDX), and X‐ray diffraction (XRD) tests to analyze the microstructure and chemical composition of the CMS. The microscopic test results demonstrated that the increase of cement content and curing age increased the amount of gelling substances in the CMS and made the overall structure more compact, thereby increasing its macro strength.
An Adult Loa loa Worm in the Upper Eyelid: An Atypical Presentation of Loiasis in the United States
Authors: Rodriguez Linnet , White Julia Michelle , Richards Nikisha Q. , You Alan X. , Couser Natario L.
Published: April 2021

Purpose. To report a case of ocular involvement of Loa loa parasite. Observations. We present a rare case report of a Loiasis diagnosed in the United States from a patient presenting with subcutaneous migration of an adult worm within an eyelid who was found to have systemic disease with microfilaria in his blood. This is the second report in the United States and the eighth case in published literature worldwide. Conclusions and Importance. Due to the relatively mild disease course, Loiasis is relatively ignored in public health in low resource health districts. Understandably, the focus of public health in endemic areas must focus on basic health needs like malnutrition and diseases that entail a greater disease burden. As globalization has increased the amount of trade of physical goods, the effect of immigration also has implications for the spread of infectious disease. Medical practitioners in the United States should be aware of endemic diseases from foreign lands.
Pharmacokinetics of 10-Hydroxy Mesaconitine in Rat Plasma by Ultra-Performance Liquid Chromatography-Tandem Quadrupole Mass Spectrometry
Authors: Yang Jinzhao , Zeng Guowu , Ma Jianshe , Wang Xianqin , Zhou Quan
Published: April 2021

Mesaconitine is the predominant active ingredient in Aconitum carmichaelii Debx. The compound 10-hydroxy mesaconitine is one known metabolite of mesaconitine and is toxic. In order to better understand its pharmacokinetics, UPLC-MS/MS was used in this paper to measure the concentration of 10-hydroxy mesaconitine in the plasma of rats after oral (5 mg/kg) and intravenous (0.1 mg/kg) administration of 10-hydroxy mesaconitine. The concentrations of 10-hydroxy mesaconitine in rat plasma measured in the standard curve covered the range of 0.3–60 ng/mL. The intraday and interday precisions of the samples of 10-hydroxy mesaconitine in rat plasma were lower than 15%. In addition, the accuracies ranged between 96.0% and 109.3%, the matrix effects ranged between 88.9% and 98.1%, and the recoveries were all higher than 79.1%. The AUC(0 − t) values were 23.6 ± 5.9 and 207.6 ± 72.9 ng/mL·h for intravenous and oral administration, respectively, and the bioavailability of 10-hydroxy mesaconitine was 17.6%. Lastly, t1/2 was 1.3 ± 0.6 h and 3.1 ± 0.4 h for intravenous and oral administration, respectively.
Influence of Different Lateral Bending Angles on the Flow Pattern of Pumping Station Lateral Inflow
Authors: Zhou Jiren , Zhao Miaomiao , Wang Chuan , Gao Zhenjun
Published: April 2021

A model of the pumping station lateral inflow forebay was established to explore the influence of different lateral bending angles of the pumping station lateral inflow. The lateral bending angles were set at 45° and 60°, and the two schemes were calculated separately. Analyzing the results of the numerical simulation showed that the flow patterns of the diversion passages of different schemes were good, but the advancing mainstream of the 1# inlet passage near the sidewall was seriously deviated after entering the forebay. Most of the water can flow smoothly into the inlet passage, while a small part of the water flowed into the sidewall and formed a backflow, resulting in a large‐scale backflow zone near the left sidewall of the forebay. Moreover, the flow in the backflow zone was turbulent, which affected the water inlet conditions of the 1# water flow passage. Comparing the water inlet conditions of the water passage with the numerical simulation results of 45° and 60° bending angles showed that the larger the lateral bending angle of the forebay was, the worse the flow pattern of the water flow, and the more unfavorable the pump operation.
“Intelligent” Technical Guidelines for Chongqing East Railway Station Building and Supporting Hub Area
Authors: Shi Jingyuan , Li Qiuna
Published: April 2021

In this paper, by drawing on the advanced experience and norms at home and abroad, the compilation and research of “intelligent technical guidelines” for Chongqing east railway station and its supporting hub area are completed. It includes “digital technology, intelligent construction,” “accurate and flexible, intelligent service,” and “panoramic management and control, intelligent operation, and maintenance,” and has formed the whole life cycle technical framework of “intelligent construction, intelligent service, intelligent management, and operation and maintenance.”
A Composable Multifactor Identity Authentication and Authorization Scheme for 5G Services
Authors: Luo Yurong , Li Hui , Ma Ruhui , Guo Zhenyang
Published: April 2021

The fifth-generation (5G) mobile communication technology has already deployed commercially and become a global research focus. The new features of 5G include unlimited information exchange, a large variety of connections with independent energy, and diversified high transmission rate services. Collective synergy of services is expected to change the way of life and future generations and introduce new converged services to the ICT industry. Different application services have to meet differentiated security demands. From the perspective of security, in order to support the multiservice of 5G services, it is necessary to consider the new security mechanism driven by the service. Based on 5G massive data stream, the 5G system can provide customized real-world services for potential users and reduce the user experience gap in different scenarios. However, 3GPP Extensible Authentication Protocol (EAP), which is the present entity authentication mechanism for the 5G service layer, is only an individual authentication architecture and unable to fulfill the flexible security objectives of differentiated services. In this paper, we present a new hierarchical identity management framework as well as an adaptable and composable three-factor authentication and session key agreement protocol for different applications in 5G multiservice systems. Finally, we propose an authorization process by combining with the proposed three-factor authentication mechanism and Service-Based Architecture (SBA) proposed by the 3GPP committee. The proposed mechanism can concurrently provide diverse identity authentication schemes corresponding to four different security levels by easily splitting or assembling three-factor authentication protocol blocks. The proposed scheme can be simultaneously applied to a variety of applications to improve the efficiency and quality of service and reduce the complexity of the whole 5G multiservice system, instead of designing or adopting several different authentication protocols. The performance evaluation results indicate that the proposed scheme can guarantee the multiple security of the system with ideal efficiency.
Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety
Authors: Clemente Wanessa T. , Faria Luciana C. , Cota Gláucia F. , Amado Leandro Ricardo de Navarro , Oliveira Jaqueline G. F. , Miranda Silvana Spíndola de , Cançado Omar Lopes , Romanelli Roberta M. C. , Lima Agnaldo S. , Frade Luiza Bastos , Lucas Fernando , Sanches Marcelo Dias
Published: April 2021

Donor-derived tuberculosis (DD-TB) accounts for less than 5% of TB cases and is considered a rare event. In the transplant setting, the frequency of active TB is estimated to be 20 to 74 times higher than that in the general population, and it is associated with high mortality. In this context, the main strategy to minimize the risk of DD transmission is to identify high-risk donors. Despite screening recommendations, failures may result in a breakdown of safety that ends in the transmission of potentially fatal diseases. This report describes a case of DD-TB and emphasizes communication gaps that may occur between organ procurement organizations and transplant centers. Failure in reporting results, lack of exchanging information regarding recipients from the same donor, and inefficient communication between organ procurement organizations and transplant centers are lacks that may be prevented by a more efficient approach towards screening protocols and communication.
Ultrasound-Targeted Microbubble Destruction Enhances Inhibitory Effect of Apatinib on Angiogenesis in Triple Negative Breast Carcinoma Xenografts
Authors: Hong Dengke , Yang Jiajia , Guo Jingjing , Zhang Yu , Chen Zhikui
Published: April 2021

Ultrasound-targeted microbubble destruction (UTMD) has been proven as an effective technique to assist drugs to cross the vascular wall and cell membrane. This study was aimed at evaluating the synergistic antiangiogenic and growth-inhibiting effects of apatinib (APA) and UTMD on the triple negative breast cancer (TNBC). The TNBC xenograft model was established in nude mice (

n
=
40

) which were then randomly divided into the APA plus UTMD (APA-U) group, UTMD group, APA group, and model control (M) group (

n
=
10

per group). Corresponding treatment was done once daily for 14 consecutive days. The general condition and body weight of tumor-bearing nude mice were monitored. Routine blood test and detection of liver and kidney function were done after treatments. The tumor size and microcirculation were examined by two-dimensional ultrasonography (2DUS) and contrast-enhanced ultrasonography (CEUS), respectively. Then, the tumor tissues were harvested for the detection of vascular endothelial growth factor (VEGF) by immunohistochemistry and for CD31-PAS double staining to assess microvessel density (MVD) and heterogeneous vascular positivity rate. After treatments, the tumor growth and angiogenesis were significantly inhibited in the APA group and the APA-U group, and these effects were more obvious in the APA-U group. The tumor volume, CEUS parameters, VEGF expression, and MVD in the APA-U group were significantly lower than those in the APA group (

P
<
0.05

), while there were no marked differences in the heterogeneous vascular positivity rate, body weight, and blood parameters between the two groups (

P
>
0.05

). In the UTMD group, the tumor growth and angiogenesis were not significantly inhibited, and all the parameters were similar to those in the M group (

P
>
0.05

). During the experiment, all mice survived and generally had good condition. In conclusion, APA combined with UTMD may exert synergistic antiangiogenic and growth-inhibiting effects on the TNBC and not increase the heterogeneous vasculature and the severity of APA-related systemic side effects.
Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study
Authors: Vuruskan Ediz , Ercil Hakan , Unal Umut , Alma Ergun , Anil Hakan , Sumbul Hilmi Erdem , Deniz Mehmet Eflatun , Goren Mehmet Resit
Published: April 2021

Introduction: The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. Methods: Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. Results: Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (p = 0.071, p = 0.973, respectively), but the increase in age and hypertension duration (p = 0.030 and p < 0.001, respectively) and the presence of metabolic syndrome (p = 0.002) significantly decreased the complete response rates. Conclusions: Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.
Can Changes in the Plasma Sodium Concentration Be Predicted Based on the Mass Balance of Sodium, Potassium, and Water in the Face of Osmotically Inactive Sodium Storage?
Authors: Nguyen Minhtri K. , Nguyen Dai-Scott , Nguyen Minh-Kevin
Published: April 2021

Context: Alterations in the plasma sodium concentration ([Na+]p) is predicted based on changes in the mass balance of Na+, K+, and H2O. However, it is well appreciated that Na+ retention results in both osmotically active and osmotically inactive Na+ storage and that only osmotically active Na+ contributes to the modulation of the [Na+]p. Subject of Review: Recent clinical studies suggested that prediction of changes in the [Na+]p based on the mass balance of Na+, K+, and H2O is inaccurate since the osmotically inactive Na+ storage pool is dynamically regulated. In contrast, animal studies demonstrated that changes in the [Na+]p can be predicted if the total body Na+, K+, and H2O were to be accurately accounted for. Second Opinion: Our analysis demonstrated that alterations in the [Na+]p are predictable at the total body level if all sources of input and output of Na+, K+, and H2O can be accurately accounted for despite the paradoxical finding that there are changes in the osmotically inactive Na+ storage pool at the tissue level. However, future prospective clinical studies are needed to corroborate the findings in the animal studies. We proposed that the fundamental question as to whether changes in the [Na+]p can be predicted in the face of osmotically inactive sodium storage is best addressed by serial measurements of total body exchangeable Na+ and K+ and total body water by isotope dilution at different time intervals.
Changes in Patient Volumes and Outcomes After Adding Thrombectomy Capability
Authors: Zhou Minerva H. , Kansagra Akash P.
Published: April 2021

Background and Purpose:

With the rising demand for endovascular thrombectomy (EVT) and introduction of thrombectomy-capable stroke centers (TSC), there is interest among existing stroke hospitals to add EVT capability to attract and retain stroke patient referrals. In this work, we quantify changes in patient volumes and outcomes when adding EVT capability to an existing stroke center.

Methods:

In MATLAB 2017a Simulink, we simulate a 3-center system comprising an EVT-capable comprehensive stroke center, an EVT-incapable primary stroke center, and an EVT-incapable primary stroke center that gains EVT capability (TSC). We model these changes in 2 geographic settings (urban and rural) using 2 routing paradigms (Nearest Center and Bypass). In Nearest Center, patients are sent to the nearest center regardless of EVT capability. In Bypass, patients with severe strokes are sent to the nearest EVT-capable center, and all others are sent to the nearest center. Probability of good clinical outcome is determined by type and timing of treatment using outcomes reported in clinical trials.

Results:

Adding EVT capability in the Bypass model produced an absolute increase of 40.1% in total volume of patients with stroke and 31.2% to 31.9% in total volume of acute stroke treatments at the TSC. In the Nearest Center model, the total volume of patients with stroke did not change, but total volume of acute stroke treatment at the TSC had an absolute increase of 9.3% to 9.5%. Good clinical outcomes saw an absolute increase of 0.2% to 0.6% in the whole population and 0.3% to 1.8% in the TSC population.

Conclusions:

Adding EVT capability shifts patient and treatment volume to the TSC. However, these changes produce modest improvement in overall population health. Health systems should weigh relative hospital and patient benefits when considering adding EVT capability.
Return to sport and patient satisfaction after arthroscopic Bankart repair: a single-institution experience
Authors: Tan Yeow Boon , Puah Ken Lee , Chong Roland Weng Wah , Ong Kee Leong , Lim Yi-Jia , Lee Dave Yee Han
Published: April 2021

Introduction:

Arthroscopic Bankart repair is a widely accepted procedure to treat recurrent shoulder dislocation. This study aims to describe our experience with arthroscopic Bankart repair and its functional outcome.

Methods:

107 patients who underwent arthroscopic Bankart repair from 2008 to 2013 were followed up for a minimum of three years and reviewed by an independent observer. 80 consented to being interviewed using the Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test.

Results:

82 shoulders (two bilateral) were studied. Mean age at first dislocation was 19.4 ± 3.4 (12.0–31.0) years. Mean follow-up was 4.4 ± 1.3 (3.0–9.0) years and 2.5 ± 3.0 (0.1–15.4) years elapsed from first dislocation to surgery. 41 (50.0%) patients played overhead or contact sports and 44 (53.7%) played competitive sports before injury; 8 (9.8%) patients reported recurrence of dislocation, which was significantly associated with playing competitive sports before injury (p <0.039), 5 (6.1%) underwent revision surgery and 22 (26.8%) reported residual instability after surgery. 49 (59.8%) patients returned to playing sports, 75 (91.5%) were satisfied with their surgery and 79 (96.3%) were willing to undergo the surgery again. 74 (90.2%) patients had two-year good/excellent OSIS, which was significantly associated with playing competitive sports before injury (p = 0.039), self-reported stability after surgery (p = 0.017), satisfaction with surgery (p = 0.018) and willingness to undergo surgery again (p = 0.024).

Conclusion:

Arthroscopic Bankart repair yields good functional outcomes and is associated with high patient satisfaction, although not all patients return to sports.
Simultaneous cardiocerebral infarctions: a five-year retrospective case series reviewing natural history
Authors: Chong Cheryl Zhiya , Tan Benjamin Yong-Qiang , Sia Ching-Hui , Khaing Thet , Yeo Leonard Leong Litt
Published: April 2021

Introduction:

Concurrent cardiocerebral infarction (CCI), a rare condition defined as simultaneous occlusions in the cerebrovascular and coronary vessels, has high mortality but very limited literature on optimum treatment methods. A better understanding of the natural history and effect of treatment would improve patient outcomes.

Methods:

Using our prospective stroke database from 2014 to 2018, ten consecutive patients with CCI were identified (incidence = 0.29%). We recorded patient demographics, cardiovascular risk factors, cardiac and cerebral occlusions, circumstances of admission and management of each patient. Patient notes and imaging findings were reviewed to determine the underlying cause of CCI.

Results:

Median National Institute of Health Stroke Scale score was 15 (range 4–27). Mean patient age was 59 years and 90% were men. Two patients were treated with intravenous tissue plasminogen activator (IV tPA) only and three underwent endovascular treatment in both the cerebral and coronary vessels sequentially. One patient underwent percutaneous coronary intervention (PCI) only and two underwent PCI after IV tPA therapy. Two patients were conservatively treated due to poor premorbid status. At the three-month follow-up, five patients had excellent functional outcomes (modified Rankin Scale 0–1) while three died.

Conclusion:

CCI is a rare but devastating clinical scenario, with high incidence of morbidity and mortality. Treatment strategy can impact patient outcome, and further research is warranted on the ideal acute and post-reperfusion treatments for CCI. In this series, IV tPA at stroke doses appeared to be the preferred initial step for its treatment, with subsequent coronary or cerebral endovascular therapy, if necessary.
Guidance for the clinical management of infants born to mothers with suspected/confirmed COVID-19 in Singapore
Authors: Yeo Kee Thai , Biswas Agnihotri , Ho Selina Kah Ying , Kong Juin Yee , Bharadwaj Srabani , Chinnadurai Amutha , Yip Wai Yan , Latiff Nurli Fadhillah Ab , Quek Bin Huey , Yeo Cheo Lian , Ng Yvonne Peng Mei , Ee Kenny Teong Tai , Chua Mei Chien , Poon Woei Bing , Amin Zubair
Published: April 2021

In this paper, we provide guidance to clinicians who care for infants born to mothers with suspected/confirmed COVID-19 during this current pandemic. We reviewed available literature and international guidelines based on the following themes: delivery room management; infection control and prevention strategies; neonatal severe acute respiratory syndrome coronavirus 2 testing; breastfeeding and breastmilk feeding; rooming-in of mother-infant; respiratory support precautions; visiting procedures; de-isolation and discharge of infant; outpatient clinic attendance; transport of infant; and training of healthcare staff. This guidance for clinical care was proposed and contextualised for the local setting via consensus by members of this workgroup and was based on evidence available as of 31 July 2020, and may change as new evidence emerges.
Perceptions of healthcare workers in high-risk areas of a Singapore hospital during COVID-19: a cross-sectional study
Authors: Au-Yong Phui-Sze Angie , Peh Wee-Ming , Koh Frederick Hong-Xiang , Teo Li-Ming , Ng Siok-Peng , Tan Alina Li-Na , Ng Aven Shan-Hua , Chew Min-Hoe
Published: April 2021

Introduction:

There is worldwide concern over the psycho-emotional impact of COVID-19 on healthcare workers (HCWs). This study aimed to elicit HCWs’ perceptions of the adequacy of protective measures in high-risk clinical areas and the factors associated with these perceptions.

Methods:

This was a cross-sectional study conducted in April 2020. An anonymous electronic survey was sent via email to operating theatre (OT) and intensive care unit (ICU) staff of Sengkang General Hospital, Singapore.

Results:

Of the 358 eligible participants, 292 (81.6%) responded to the survey. 93.2% of the participants felt that precautionary measures at work were sufficient and 94.9% acknowledged that adequate training was provided. More than 60% of the participants opined that their chances of contracting COVID-19 were moderate to high. Female gender, nursing occupation and duration of service <10 years were significantly associated with increased fear of contracting COVID-19, less control over occupational exposure and lower perceived need to care for COVID-19 patients. Having young children at home did not significantly affect these perceptions. The most important ICU precautions were availability of personal protective equipment outside the rooms of COVID-19 positive patients (95.3%) and having visitor restrictions (95.3%). The most important OT measures were having a dedicated OT for COVID-19 positive patients (91.2%) and having simulation as part of protocol familiarisation (91.7%).

Conclusion:

Overall, there was high confidence in the adequacy of COVID-19 protective measures to prevent healthcare transmission in Singapore. The pandemic had a lower degree of psycho-emotional impact on HCWs here as compared to other countries.
Preparing muslims with diabetes mellitus for Ramadan fasting in Singapore: a clinical approach and review of current practice
Authors: Zainudin Sueziani Binte , Yeoh Ester
Published: April 2021

Ramadan fasting, a month-long annual practice for Muslims, can be challenging for those who have diabetes mellitus with or without associated complications or pre-existing comorbidities, as well as healthcare providers involved in their care. Inadequate preparation for this fasting period can result in increased complications. We reviewed the current practice of Muslims with diabetes mellitus in Singapore who intend to fast during Ramadan, with particular attention on locally available evidence. Adequate preparation for Ramadan fasting, including pre-Ramadan assessment, optimisation of glycaemic control, structured Ramadan-focused diabetes education, medication adjustment, glucose monitoring and test fasting, can lead to benefits in terms of improvements in metabolic control and reduced risk of fasting-related complications in people with diabetes mellitus. While there are ongoing efforts to reduce risk during this period, larger-scale national programmes are needed to avert complications and assess the long-term effects of Ramadan fasting in the local population.
Clinical implications of prompt ascitic drain removal in cirrhosis with refractory ascites
Authors: Wong YJ , Lum HM , Tan PT , Teo EK , Tan JY , Kumar R , Thurairajah PH
Published: April 2021

INTRODUCTION Large-volume paracentesis (LVP) is the first-line treatment for decompensated cirrhosis with refractory ascites. While ascitic drain removal (ADR) within 72 hours of the procedure was once considered safe, it was uncertain whether ADR within 24 hours could further reduce the risk of ascitic drain-related bacterial peritonitis (AdBP). This study aimed to investigate the association between the timing of ADR and the presence of AdBP. METHODS All patients with cirrhosis with refractory ascites who underwent LVP in our institution from 2014 to 2017 were studied. AdBP was diagnosed based on an ascitic fluid neutrophil count ≥ 250 cells/mm3 or positive ascitic fluid culture following recent paracentesis within two weeks. RESULTS A total of 131 patients who underwent LVP were followed up for 1,806 patient-months. Their mean age was 68.3 ± 11.6 years, and 65.6% were male. Their mean Model for End-Stage Liver Disease score was 15.2. The overall incidence of AdBP was 5.3%. ADR beyond 24 hours was significantly associated with a longer median length of stay (five days vs. three days, p < 0.001), higher risk of AdBP (0% vs. 8.9%, p = 0.042) and acute kidney injury (AKI) following LVP (odds ratio 20.0, 95% confidence interval 2.4–164.2, p = 0.021). The overall survival was similar in patients who underwent ADR within and beyond 24 hours of LVP. CONCLUSION ADR within 24 hours of LVP is associated with a reduced risk of AdBP and AKI. As AdBP is associated with resistant organisms and AKI, we recommend prompt ADR within 24 hours, especially in patients who have Child-Pugh class C alcoholic cirrhosis.
Language Ideologies, Chinese Identities and Imagined Futures
Authors: Toh (陶琳琳) Audrey Lin Lin , Liu (刘宏) Hong
Published: April 2021

Since independence in 1965, the Singapore government has established a strongly mandated education policy with an English-first and official mother tongue Mandarin-second bilingualism. A majority of local-born Chinese have inclined toward a Western rather than Chinese identity, with some scholars regarding English as Singapore’s “new mother tongue.” Other research has found a more local identity built on Singlish, a localized form of English which adopts expressions from the ethnic mother tongues. However, a re-emergent China and new waves of mainland migrants over the past two decades seem to have strengthened Chinese language ideologies in the nation’s linguistic space. This article revisits the intriguing relationships between language and identity through a case study of Chineseness among young ethnic Chinese Singaporeans. Guided by a theory of identity and investment and founded on survey data, it investigates the Chinese language ideologies of university students and their agency in choosing for themselves a Chinese imagined identity and community. Our survey found that ethnic Chinese Singaporean university students still possess a strong affinity for Mandarin and a desire to develop this aspect of their identity, in the context of Singapore’s multiracial national identity. There exists a high propensity for imagined futures in Chineseness, with a majority of survey respondents who claimed English-speaking and bilingual identities also expressing the desire to become more bilingual and more Mandarin-speaking. This paper also deciphers the external and internal factors contributing to this development and suggests some areas of future research.