bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental investigations of flow over NACA airfoils 0021 and 4412 of wind turbine blades with and without Tubercles
Authors: Butt Usman , Hussain Shafqat , Schacht Stephan , Ritschel Uwe
Published: April 2021

Experimental investigations of wind turbine blades having NACA airfoils 0021 and 4412 with and without tubercles on the leading edge have been performed in a wind tunnel. It was found that the lift coefficient of the airfoil 0021 with tubercles was higher at Re = 1.2×105 and 1.69×105 in post critical region (at higher angle of attach) than airfoils without tubercles but this difference relatively diminished at higher Reynolds numbers and beyond indicating that there is no effect on the lift coefficients of airfoils with tubercles at higher Reynolds numbers whereas drag coefficient remains unchanged. It is noted that at Re = 1.69×105, the lift coefficient of airfoil without tubercles drops from 0.96 to 0.42 as the angle of attack increases from 15° to 20° which is about 56% and the corresponding values of lift coefficient for airfoil with tubercles are 0.86 and 0.7 at respective angles with18% drop.
Short-Term Bone Fusion With Arthroscopic Double-Button Latarjet Versus Open-Screw Latarjet
Authors: Bonnevialle Nicolas , Girard Mathieu , Dalmas Yoann , Martinel Vincent , Faruch Marie , Mansat Pierre
Published: April 2021

Background:

Recently, arthroscopic double-button Latarjet (AL) has provided an alternative to conventional open Latarjet (OL) in the treatment of anterior shoulder instability with glenoid bone loss. Therefore, theoretically, the faster fusion is obtained, the sooner return to sports under safe conditions can occur. The emerging flexible fixation of the bone block has clearly offered a new approach to achieve bone fusion. However, the period required to achieve this goal remains controversial.

Purpose/Hypothesis:

The purpose was to compare computed tomography (CT) scan results of AL and OL in the early postoperative period. It was hypothesized that the bone block fusion with AL would require a longer time than that with OL.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

In a retrospective 1-year study, the authors compared 17 primary double-button AL to 22 primary 2-screw OL procedures indicated for anterior shoulder instability in patients with an Index Severity Instability Score >3 points. These patients were reviewed with a CT scan at 1 day, 3 months, and 6 months postoperatively. The characteristics for the 2 groups were comparable. CT scans aimed to analyze graft position, bone contact area with the scapula, and fusion at 3 and 6 months. Clinical assessment was based on the Walch-Duplay and Rowe scores.

Results:

The mean preoperative Index Severity Instability Score was 5.3 ± 1.9 points, with a mean anterior glenoid bone loss of 9.1% ± 4.6%. At 3 months, the rates of fusion were 41% and 100% for the AL and OL groups, respectively ( P < .001). This rate increased to 70% in the AL group at 6 months ( P = .006). In the axial and sagittal planes, there was no difference in graft position between the AL group and the OL group. The bone block was longer and there was a more extensive bone contact area in the OL group (AL, 131 mm2 vs OL, 223 mm2; P < .001). At 6 months of follow-up, no significant difference in clinical scores was noted between the groups: Walch-Duplay score, 93.0 ± 10.9 points versus 91.8 ± 12.5 points ( P = .867); and Rowe score, 99.0 ± 2.2 points versus 95.0 ± 8.4 points ( P = .307) for the AL and OL groups, respectively.

Conclusion:

AL required more time to achieve bone block fusion than OL. This finding should be taken into account when considering this procedure for patients in a hurry to return to sports involving the shoulder.
Effect of Anterior Cruciate Ligament Rupture on Physical Activity, Sports Participation, Patient-Reported Health Outcomes, and Physical Function in Young Female Athletes
Authors: Ezzat Allison M. , Brussoni Mariana , Mâsse Louise C. , Emery Carolyn A.
Published: April 2021

Background:

Return to sports (RTS) is frequently considered an indicator of successful recovery after anterior cruciate ligament reconstruction (ACLR). However, despite the well-recognized health benefits of physical activity (PA), little is known about objectively measured PA in the 1 to 2 years after ACLR. Given that young female athletes have a high prevalence of ACLR and lower RTS rates as compared with their male counterparts, an in-depth examination of PA in this subgroup is warranted.

Hypothesis:

We hypothesized that female youth and young adults who have had ACLR in the previous 1 to 2 years would have less moderate or vigorous PA (MVPA) compared with healthy matched controls. We also hypothesized that the ACLR group would report lower levels of sports participation, patient-reported health outcomes, and physical function.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Participants included 51 female athletes with primary unilateral ACLR for a sports-related injury in the previous 1 to 2 years and 51 age- and sports-matched controls. Outcomes included objectively measured PA (GT3X accelerometers), previous and current sports participation and RTS, body mass index, Knee injury and Osteoarthritis Outcome Score (KOOS), triple single-leg hop, and one-leg rise. Mean within-pair differences with 95% CIs were used to assess differences between groups across all outcomes. Multivariable linear regression (clustered by pair) was used to examine whether the ACLR group had less MVPA than did the age- and sports-matched control group, adjusting for total wear time, age, time since injury, and body mass index.

Results:

Median age was 17.8 years (range, 14.6-22.6 years). There was no significant difference between groups in MVPA. However, the injury group had fewer mean minutes per day of vigorous PA (–1.22; 95% CI, −2.40 to −0.04), poorer KOOS values on all subscales, and shorter triple single-leg hop distance. In the injury group, 28 (55%) returned to sports, including 14 (27.5%) who returned at preinjury performance level. Across both groups, over one-third changed their most important sport, shifting toward an individual-based sport.

Conclusion:

At 1 to 2 years after ACLR, female athletes demonstrated no differences in combined MVPA and only a very small reduction in vigorous PA, yet they had higher levels of self-reported knee pain and symptoms, reduced knee function in sports, lower quality of life, and poorer objective knee function compared with matched controls.
Treating Knee Osteoarthritis With Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy: A Systematic Review
Authors: Baria Michael R. , Vasileff W. Kelton , Borchers James , DiBartola Alex , Flanigan David C. , Plunkett Evan , Magnussen Robert A.
Published: April 2021

Background:

Platelet-rich plasma (PRP) and hyaluronic acid (HA) are injectable treatments for knee osteoarthritis. The focus of previous studies has compared their efficacy against each other as monotherapy. However, a new trend of combining these 2 injections has emerged in an attempt to have a synergistic effect.

Purpose:

To systematically review the clinical literature examining the combined use of PRP + HA.

Design:

Systematic review.

Methods:

A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed and Embase. The following search terms were used: knee osteoarthritis AND platelet rich plasma AND hyaluronic acid. The review was performed by 2 independent reviewers who applied the inclusion/exclusion criteria and independently extracted data, including methodologic scoring, PRP preparation technique, HA composition, and patient-reported outcomes (PROs).

Results:

A total of 431 articles were screened, 12 reviewed in full, and 8 included in the final analysis: 2 case series, 3 comparative, and 3 randomized studies. Average follow-up was 9 months. The modified Coleman Methodology Score was 38.13 ± 13.1 (mean ± SD). Combination therapy resulted in improved PROs in all studies. Of the comparative and randomized studies, 2 demonstrated that combination therapy was superior to HA alone. However, when PRP alone was used as the control arm (4 studies), combination therapy was not superior to PRP alone.

Conclusion:

Combination therapy with PRP + HA improves PROs and is superior to HA alone but is not superior to PRP alone.
Effect of Tibial Tunnel Placement Using the Lateral Meniscus as a Landmark on Clinical Outcomes of Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction
Authors: Büyükdoğan Kadir , Laidlaw Michael S. , Fox Michael A. , Kew Michelle E. , Miller Mark D.
Published: April 2021

Background:

It remains unclear if use of the lateral meniscus anterior horn (LMAH) as a landmark will produce consistent tunnel positions in the anteroposterior (AP) distance across the tibial plateau.

Purpose:

To evaluate the AP location of anterior cruciate ligament (ACL) reconstruction tibial tunnels utilizing the LMAH as an intra-articular landmark and to examine how tunnel placement affects knee stability and clinical outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective review was conducted of 98 patients who underwent primary ACL reconstruction with quadrupled hamstring tendon autografts between March 2013 and June 2017. Patients with unilateral ACL injuries and a minimum follow-up of 2 years were included in the study. All guide pins for the tibial tunnel were placed using the posterior border of the LMAH as an intra-articular landmark. Guide pins were evaluated with the Bernard-Hertel grid in the femur and the Stäubli-Rauschning method in the tibia. Patients were divided by the radiographic location of the articular entry point of the guide pin with relation to the anterior 40% of the tibial plateau. Outcomes were evaluated by the Marx Activity Scale and International Knee Documentation Committee (IKDC) form. Anterior knee laxity was evaluated using a KT-1000 arthrometer and graded with the objective portion of the IKDC form. Rotational stability was evaluated using the pivot-shift test.

Results:

A total of 60 patients were available for follow-up at a mean 28.6 months. The overall percentage of AP placement of the tibial tunnel was 39.3% ± 3.8% (mean ± SD; range, 31%-47%). Side-to-side difference of anterior knee laxity was significantly lower in the anterior group than the posterior group (1.2 ± 1.1 mm vs 2.5 ± 1.3 mm; P < .001; r = 0.51). The percentage of AP placement of the tibial tunnel demonstrated a positive medium correlation with side-to-side difference of anterior knee laxity as measured by a KT-1000 arthrometer ( r = 0.430; P < .001). The anterior group reported significantly better distribution of IKDC grading as compared with the posterior group (26 grade A and 6 grade B vs 15 grade A and 13 grade B; P = .043; V = 0.297). The pivot-shift test results and outcome scores showed no significant differences between the groups.

Conclusion:

Using the posterior border of the LMAH as an intraoperative landmark yields a wide range of tibial tunnel locations along the tibial plateau, with anterior placement of the tibial tunnel leading toward improved anterior knee stability.
Availability of Services and Caregiver Burden: Supporting Individuals With Neurogenetic Conditions During the COVID-19 Pandemic
Authors: Kowanda Michelle , Cartner Lindsey , Kentros Catherine , Geltzeiler Alexa R. , Singer Kaitlyn E. , Weaver W. Curtis , Lehman Christopher D. , Smith Simone , Smith Rebecca Sheedy , Walsh Lauren Kasparson , Diehl Katharine , Nagpal Natalie , Brooks Elizabeth , Mebane Caroline M. , Wilson Ashley L. , Marvin Alison R. , White L. Casey , Law J. Kiely , Jensen William , Daniels Amy M. , Tjernagel Jennifer , Snyder LeeAnne Green , Taylor Cora M. , Chung Wendy K.
Published: April 2021

Because of the COVID-19 pandemic, in-person services for individuals with neurodevelopmental disabilities were disrupted globally, resulting in a transition to remote delivery of services and therapies. For individuals with neurogenetic conditions, reliance on nonclinical caregivers to facilitate all therapies and care was unprecedented. The study aimed to (1) describe caregivers’ reported impact on their dependent’s services, therapies, medical needs, and impact on themselves as a result of the COVID-19 pandemic and (2) assess the relationship between the extent of disruption of services and the degree of self-reported caregiver burden. Two online questionnaires were completed by caregivers participating in Simons Searchlight in April and May 2020. Surveys were completed by caregivers of children or dependent adults with neurodevelopmental genetic conditions in Simons Searchlight. Caregivers reported that the impact of the COVID-19 pandemic moderately or severely disrupted services, therapies, or medical supports. The majority of caregivers were responsible for providing some aspect of therapy. Caregivers reported “feeling stressed but able to deal with problems as they arise,” and reported lower anxiety at follow-up. Caregivers reported that telehealth services were not meeting the needs of those with complex medical needs. Future surveys will assess if and how medical systems, educational programs, therapists, and caregivers adapt to the challenges arising during the COVID-19 pandemic.
Violence Against Prostitutes and Non-prostitutes: An Analysis of Frequency, Variety and Severity
Authors: Zara Georgia , Theobald Delphine , Veggi Sara , Freilone Franco , Biondi Eleonora , Mattutino Grazia , Gino Sarah
Published: April 2021

Violence against women is a form of gender violence, and the lethal aspect of it, defined as femicide, is a global health and human rights problem.

This study looked at 330 cases of femicide that occurred in North West Italy, between 1970 and 2020, committed by 303 male perpetrators. The victims included women who were prostitutes and those who were not.

Findings show that only a small proportion of femicide occurs within an anonymous setting: Victims were mostly killed by a man they knew. The type and intensity of the relationship was likely to affect how the violence occurred. In those cases in which victims and perpetrators had an intimate relationship, the risk of overkill, that is, an excessive use of violence that goes further than what is necessary to cause death, was four times higher in comparison with the murder of unknown victims. As with non-prostitutes, the risk of overkill was almost fourfold for those prostitutes who knew their perpetrators. Furthermore, when comparing prostitutes with any unknown victims, the risk of being overkilled was almost five times higher for the former, suggesting that prostitutes are more at risk of being murdered with excessive violence. In addition, prostitutes were more likely to be victims of sexual murder, postmortem mutilation, and being killed by men who had previous criminal records.

Women who are victims of violence are not a homogeneous group, although some of the psychosocial correlates are the same and relevance should be given to the features behind the type, intensity, and nature of the relationship between prostitutes and non-prostitutes and their perpetrators. These variables are what make violence against women a preventable problem.
Pandemic Fear and Weight Gain: Effects on Overweight and Obese Adults’ Purchasing Exercise Apparel Online
Authors: Shin Eonyou
Published: April 2021

The purpose of this study was to investigate the interactive effect of pandemic fear and weight gain on overweight and obese consumers’ decisions to purchase exercise apparel online based on the theory of planned behavior and body-related self-discrepancy theory. A sample of 515 male and female adults with BMIs of 25 and higher participated in this study. The effect of pandemic fear on the attitudes toward purchasing exercise apparel online was only positive for overweight and obese consumers who did not gain weight during pandemic. However, for those who gained weight during the pandemic, there was no significant effect of pandemic fear on the attitudes toward purchasing exercise apparel online. Attitudes, subjective norm, and perceived behavioral control were all significant predictors of intent to purchase exercise apparel online. This study extends the theory of planned behavior by adding the pandemic-related factors and provides practical implications for online retailers.
A systematic review of peritoneal dialysis-related peritonitis rates over time from national or regional population-based registries and databases
Authors: Marshall Mark R
Published: April 2021

Peritoneal dialysis (PD)-related peritonitis is one of the top priorities for care and research among PD stakeholders. This study summarizes PD peritonitis rates from available population-based national or regional registries around the world, examining trends over time. This is a systematic review of PD peritonitis rates in patients treated with PD for kidney failure, from census-based national or provincial/statewide/provider registries or databases. MEDLINE (via PubMed) was searched from inception to August 2020, and inquiries made to national registry personnel using the International Comparisons section of the 2018 United States Renal Data System Annual Data Report as a contact list. Quantitative synthesis was done using weighted random-effects Poisson regression. Of 81 countries that reported utilization of PD, 19 did not have a traditional dialysis registry (governed by either professional societies or government entities), and only 33 monitored PD peritonitis rates correctly and accessibly. There is wide variation in PD peritonitis rates between countries, although the global average has been decreasing over time, from 0.600 episodes/patient-year in 1992 to 0.303 in 2019. Other sources of variability include the continent in which the country is nested and the size of its PD population. PD peritonitis, despite its importance for PD stakeholders, is under-monitored. While the global rate is decreasing over time, the presence and extent of this improvement varies from country to country. There is an opportunity for better monitoring, research into underachieving and overachieving nations and development of international clinical support networks.
Improved Smoking Cessation Rates in a Pharmacist-Led Program Embedded in an Inflammatory Bowel Disease Specialty Medical Home
Authors: Tse Stacy Saithy , Sands Bruce E. , Keefer Laurie , Cohen Benjamin L. , Maser Elana , Ungaro Ryan C. , Marion James F. , Colombel Jean-Frédéric , Itzkowitz Steven H. , Gelman Jessica , Dubinsky Marla C.
Published: April 2021

Background:

Cigarette smoking is associated with disease progression, poor outcomes, and increased biologic use in Crohn’s Disease (CD). In this prospective study, we describe the structure and results of a pharmacist-driven smoking cessation program in an Inflammatory Bowel Disease (IBD) Specialty Medical Home.

Methods:

One pharmacist designed and implemented a collaborative drug therapy management (CDTM) program, which allowed the pharmacist to initiate and modify smoking cessation aids, monitor medication safety and efficacy, and provide behavioral counseling. Crohn’s Disease patients who were current smokers and referred to the program were analyzed. Clinical and demographic data, disease activity, and smoking history were collected. The primary outcome was the proportion of patients in the enrolled group and the declined group who quit smoking at least once during the follow-up period. Secondary outcomes include demographic and clinical differences between enrolled and declined patients, and enrolled quitters and non-quitters.

Results:

Thirty-two patients were referred to the program and 19 participated. Over a median follow-up period of 305 [264-499] days, 42% (8/19) of enrolled patients quit smoking at least once. Fifteen percent (2/13) of declined patients quit smoking. Patients who continued to smoke had more instances of loss of response to a biologic, need to start a new biologic, or escalation of biologic therapy. The CDTM pharmacist was able to provide all necessary clinical services for smokers enrolled in the program.

Conclusions:

A pharmacist-led smoking cessation program in a specialty medical home is feasible. It may result in successful quit attempts and may optimize IBD medication use.
Influence of differential reduction rate in adjacent roll reduction zone on internal cracks of high carbon bloom induced by mechanical soft reduction
Authors: Zong Nanfu , Ma Sida , Sun Weizhao , Jing Tao , Lu Zhifang
Published: April 2021

To comprehensively investigate and alleviate internal cracks in high carbon bloom induced by mechanical soft reduction (MSR), a 3D thermal-mechanical coupled model, containing two adjacent pairs of reduction rolls, was developed to investigate the influence of differential reduction rate on evolution of stress concentration and displacement in as-cast bloom. In order to effectively provide theoretical basis for actual production, the reduction rate was calculated according to the appropriate reduction amount of each pair of reduction rolls, which can be adopted in the MSR to determinate the appropriate roll reduction amount in adjacent roll reduction zone. With the differential reduction rate of MSR increasing from −2.67 mm/m to 5.33 mm/m, the maximum equivalent stress of cracking area in as-cast bloom significantly decreased under first roll reduction position, the maximal displacement along the bloom width direction is significantly decreased with increasing of the differential reduction rate of MSR under end roll reduction position. According to the results of industrial experiment, the internal cracks were effectively alleviated and center shrinkage cavities were nearly eliminated by optimum designed experiments.
Variation of elastic modulus of high strength 21-6-9 tube and its influences on forming quality in numerical control rotary draw bending
Authors: Fang Jun , Ouyang Fang , Lu Shiqiang , Wang Kelu , Min Xuguang , Xiao Botao
Published: April 2021

Elastic modulus is one of the most crucial mechanical property parameters that affects the plastic forming quality of bent parts, especially for springback. Elastic modulus practically varies with plastic deformation, and its precise description is necessary to enhance simulation precision for tube bending and gain steady, high-precision bent components by actual bending. Using repeated loading-unloading tensile tests (RLUTTs), the variation of elastic modulus of high strength 21-6-9 stainless steel tube (21-6-9-HS tube) in terms of plastic strain has been obtained, which its decreases rapidly at the beginning, then decreases tardily and tends to be stable in the end with increasing the plastic strain. The variation can be expressed as a first order exponential decay function. By embedding the variation of elastic modulus with the plastic strain into ABAQUS software to simulate numerical control (NC) rotary draw bending of the 21-6-9-HS tube, the prediction precision for the springback angle, springback radius, maximum cross section distortion ratio and maximum wall thinning ratio can be improved by 11.98%, 7.62%, 35.53% and 11.55%, respectively.
Mathematical model and geometrical design method of noncircular face gear with intersecting axes
Authors: Liu Dawei , Lv Zhenzhen , Li Bingbing
Published: April 2021

In order to establish the design method of a noncircular face gear (NFG) with intersecting axes, the meshing theory of this gear is investigated based on the principle of space gear meshing. A generalized approach for designing closed pitch curve of the NFG with intersecting axes was proposed based on Fourier series. The mathematical model of the NFG generated by a shaper cutter was established. The fundamental design parameters of the gears were defined, with the principle for determining their values discussed. The prototype of a NFG was machined by 5-axis CNC milling and the motion rule was tested. Experimental results verify the feasibility of the innovative transmission mechanism and the correctness of the mathematical model of NFG with intersecting axes.
Efficiency considerations for Sommerfeld effect attenuation
Authors: Samantaray AK
Published: April 2021

In rotating machinery with a flexible foundation used for vibration isolation, the drive (motor) is designed to provide maximum power at the critical speed so that the rotor can be coasted up to a supercritical operating speed. Over the time, rotors develop some degree of unbalance and it may be impossible to balance the rotors in-situ, such as in a wind turbine. Therefore, oversized motors are used in anticipation of some unbalance. To promote passage through resonance, without altering the motor, various kinds of additional hardware and/or control mechanisms have been proposed in the past. On the other hand, simply increasing the foundation (or structural) damping reduces the amplitude of unbalance induced vibrations and the motor power requirement at the critical speed. This appears to be the simplest possible solution and has been proposed in relevant mathematical research. However, it is shown in this article that increasing foundation damping significantly reduces the overall system efficiency at the supercritical operating speed and it should not be at all considered as a meaningful engineering solution. In fact, the loss of efficiency due to the increased foundation damping is so large that it may not be compensated by a redesigned motor.
Collaborative optimization design of lightweight and crashworthiness of the front-end structures of automobile body using HW–GRA for Pareto mining
Authors: Wang Dengfeng , Li Shenhua
Published: April 2021

To collaboratively improve the lightweight and frontal collision safety performance of the automobile body, the material–structure–performance integrated multi-objective optimization design of the front-end structure was implemented in this study. The hybrid weight–grey relational analysis (HW–GRA) method was proposed to address the problem that the Pareto optimal compromise solution of multi-objective optimization cannot be easily selected. The design variables of the material and structural parameters were recorded through material type coding and model parameterization. To satisfy the basic static–dynamic performance constraints of the body, the RSM–Kriging surrogate model, design of experiments, and multi-objective particle swarm optimization algorithm were used to optimize the material and structural parameters to improve the lightweight and crashworthiness of the body. The Pareto optimal compromise solution was determined using the HW–GRA method. The decision result of the proposed method was more robust and rational than those of single weighting techniques combined with GRA and hybrid weighting approach combined with TOPSIS. After the multi-objective optimization and decision-making, the basic static–dynamic performance of the body demonstrated a change of less than 2.0%, which satisfied the constraint requirements. The mass of the body was reduced by 2.4 kg, and the frontal collision safety performance of the body was significantly improved.
Luteolin attenuates doxorubicin-induced derangements of liver and kidney by reducing oxidative and inflammatory stress to suppress apoptosis
Authors: Owumi SE , Lewu DO , Arunsi UO , Oyelere AK
Published: April 2021

Doxorubicin is an effective anti-neoplastic agent; the reported toxicities of DOX limit its use. Luteolin is a polyphenolic phytochemical that exhibits beneficial biological effects via several mechanisms. We investigate luteolin protective effects on hepatorenal toxicity associated with doxorubicin treatment in rats. For 2 weeks, randomly assigned rat cohorts were treated as follows: control, luteolin (100 mg/kg; per os), doxorubicin alone (2mg/kg; by intraperitoneal injection), co-treated cohorts received luteolin (50 and 100 mg/kg) in addition to doxorubicin. Treatment with doxorubicin alone significantly (p < 0.05) increased biomarkers of hepatorenal toxicities in the serum. Doxorubicin also reduced relative organ weights, antioxidant capacity, and anti-inflammatory cytokine interleukine-10. Doxorubicin also increased reactive oxygen and nitrogen species, lipid peroxidation, pro-inflammatory-interleukin-1β and tumour necrosis factor-α-cytokine, and apoptotic caspases-3 and -9). Morphological damage accompanied these biochemical alterations in the rat’s liver and kidney treated with doxorubicin alone. Luteolin co-treatment dose-dependently abated doxorubicin-mediated toxic responses, improved antioxidant capacity and interleukine-10 level. Luteolin reduced (p < 0.05) lipid peroxidation, caspases-3 and -9 activities and marginally improved rats’ survivability. Similarly, luteolin co-treated rats exhibited improvement in hepatorenal pathological lesions observed in rats treated with doxorubicin alone. In summary, luteolin co-treatment blocked doxorubicin-mediated hepatorenal injuries linked with pro-oxidative, inflammatory, and apoptotic mechanisms. Therefore, luteolin can act as a chemoprotective agent in abating toxicities associated with doxorubicin usage and improve its therapeutic efficacy.
PRMT5 Promotes EMT Through Regulating Akt Activity in Human Lung Cancer
Authors: Huang Jianhao , Zheng Yonghua , Zheng Xiao , Qian Bao , Yin Qi , Lu Jingjing , Lei Han
Published: April 2021

The type II protein arginine methyltransferase 5 (PRMT5) has been engaged in various human cancer development and progression types. Nevertheless, few studies uncover the biological functions of PRMT5 in the epithelial-mesenchymal transition (EMT) of human lung cancer cells, and the associated molecular mechanisms and signaling cascades are entirely unknown. Here, we show that PRMT5 is the ectopic expression in human lung cancer tissues and cell lines. Further study reveals that silencing PRMT5 by lentivirus-mediated shRNA or blocking of PRMT5 by specific inhibitor GSK591 attenuates the expression levels of EMT-related markers in vivo, using the xenograft mouse model. Moreover, our results show that down-regulation of PRMT5 impairs EGFR/Akt signaling cascades in human lung cancer cells, whereas re-expression of PRMT5 recovers those changes, suggesting that PRMT5 regulates EMT probably through EGFR/Akt signaling axis. Altogether, our results demonstrate that PRMT5 serves as a critical oncogenic regulator and promotes EMT in human lung cancer cells. More importantly, our findings also suggest that PRMT5 may be a potential therapeutic candidate for the treatment of human lung cancer.
Development of bamboo polymer composites with improved impact resistance
Authors: Abhilash RM , Venkatesh GS , Chauhan Shakti Singh
Published: April 2021

Reinforcing thermoplastic polymers with natural fibres tends to improve tensile and flexural strength but adversely affect elongation and impact strength. This limits the application of such composites where toughness is a major criterion. In the present work, bamboo fibre reinforced polypropylene (PP) composites were prepared with bamboo fibre content varying from 30% to 50% with improved impact resistance. Homopolymer and copolymer PP were used as the matrix polymer and an elastomer was used (10% by wt.) as an additive in the formulation. Copolymer based composites exhibited superior elongation and impact strength as compared to homopolymer based composites. The adverse impact of elastomer on tensile and flexural strength was more pronounced in homopolymer based composites. The study suggested that the properties of the bamboo composites can be tailored to suit different applications by varying reinforcement and elastomer percentage.
Angélique Marguerite Le Boursier du Coudray (1712–1790) – Pioneer of simulation
Authors: Jandu Gurpreet Kaur , Khan Azizah
Published: April 2021

Madame du Coudray (1712–1790) was a French midwife who educated peers in rural areas. She was seen as a pioneer of simulation as she developed the first obstetric mannequin, known as 'the machine'. Complex cases could be simulated in a safe environment, which enabled midwives to improve their abilities in managing such deliveries.
Ethics simulation in nursing education: Nursing students' experiences
Authors: Honkavuo Leena
Published: April 2021

Background:

Ethics stimulation in nursing education focuses on human, non-technical factors in a clinical reality. Simulation as a teaching method began in the 1930s with flight simulators. In the beginning of the 1990s, simulations developed further in tandem with other technological and digital inventions, including touchscreen and three-dimensional anatomical models. Medical science first used simulation as a pedagogical teaching tool. In nursing education, simulation has been used for approximately a hundred years. Teaching has mainly focused on medical-technical, patient-specific interventions and their management.

Objective:

The objective of this study was, from a caring science didactic perspective, to deepen the understanding of ethics simulation in nursing education.

Design:

Qualitative design and explorative, descriptive and hermeneutic approach of an inductive character.

Methods:

Semi-structured face-to-face interviews in 2016–2017 with six Norwegian nursing students who were encouraged to narrate about their experiences of ethics simulation in nursing education.

Ethical considerations:

Informed consent was obtained from the participants. Anonymity and confidentiality regarding data material were guaranteed.

Results:

Interpretation of the nursing students’ narratives resulted in the following meaning units: ethical being and ethos, nursing students’ formation process, bridge-building between theory and clinical practice, and teacher and ethics simulation.

Conclusion:

Through ethics simulation, nursing students can obtain an increased knowledge and a sense of being able to handle difficult ethical situations. Nursing students’ values, moral actions and ethical value base offer a positive point of departure, for both theoretical and practical ethics teaching, and an awareness of the unique human being, the patient, in clinical reality. The implementation of ethics simulation needs more attention in nursing education.
Ethical dilemmas embedded in performing fieldwork with nurses in the ICU
Authors: Kvande Monica Evelyn , Delmar Charlotte , Lauritzen Jette , Damsgaard Janne Brammer
Published: April 2021

Background:

Background: In general, qualitative research design often involves merging together various data collection strategies, and researcher’s may need to be prepared to spend longer periods in the field to pursue data collection opportunities that were not foreseen. Furthermore, nurse researchers performing qualitative research among patients and their relatives often experience unforeseen ethical dilemmas.

Aim:

This paper aimed to explore aspects of ethical dilemmas related to qualitative nursing research among patients and their relatives in the intensive care unit (ICU).

Research design:

This paper is based on a qualitative researcher’s personal experience during a hermeneutic phenomenological study involving close observation and in-depth interviews with 11 intensive care nurses. Data were collected at two ICUs in two Norwegian university hospitals.

Ethical considerations:

The study was approved by the Norwegian Social Science Data Services (NSD). The Regional Committee for Medical and Health Research Ethics (REK) granted dispensation to the project regarding health personnels confidentiality of the patients who were present during the observation (2012/622-4).

Findings:

Close observation with nurses in the ICU requires the researcher to balance being a qualitative researcher, an ICU nurse and a sensitive fellow human being open to the suffering of the other—that is, being embodied, engaged and affected by sensitive situations and simultaneously constantly stepping back and reflecting on the meaning of those situations.

Conclusions:

The qualitative researcher’s ethical awareness also entails knowing and acknowledging his or her own vulnerability, which becomes apparent in the researcher-participant relationship and settings in which being a fellow human always overrules the researcher’s role in ethical dilemmas.
Right to health, autonomy, and access to prenatal services
Authors: Both Tatianne dos Santos Perez , de Souza Laís Alves , Teston Elen Ferraz , Júnior Antonio Rodrigues Ferreira , Ajalla Maria Elizabeth Araújo , Batiston Adriane Pires
Published: April 2021

Background:

The concept of the right to health includes decent conditions of work, housing, and leisure. It can be assessed through the evaluation of access to health services and programs. The creation of the Brazilian Unified Health System expanded access to healthcare for the entire Brazilian population.

Aim:

This study aimed to understand the use of the Brazilian Unified Health System by pregnant women who live on the Brazil–Paraguay border, whose residents are known as Braziguayans.

Methods:

We conducted 16 semi-structured interviews with users of prenatal services at Unified Health System units located at the border of the municipalities of Ponta Porã and Pedro Juan Caballero.

Ethical considerations:

The Research Ethics Committee of the Federal University of Mato Grosso do Sul approved of this research. All participants were provided with project information and signed an informed consent form.

Findings:

Through content analysis of the interviews, “right to health” and “autonomy, pathways, and access” were two recurrent themes that have arisen. These suggested that Braziguayan women live in conditions of social vulnerability. They do not fully experience the right to healthcare, despite sufficient knowledge about the Brazilian and Paraguayan healthcare systems from which to choose prenatal care. The interviewees acknowledged that Unified Health System use is a right of Brazilian citizens and considered its units to be safe environments. These women also understand the structuring of Unified Health System and the mechanisms of accessing healthcare programs.

Conclusion:

We can conclude that, despite widely known difficulties, Unified Health System represents, for Braziguayan women, potential access to reliable health services for adequate prenatal and childbirth assistance.
Cervical Cancer Screening Among Immigrant Women Residing in Australia: A Systematic Review
Authors: Alam Zufishan , Shafiee Hanjani Leila , Dean Judith , Janda Monika
Published: April 2021

Since the introduction of systematic population-based cervical cancer screening in Australia in 1991, age-standardized incidence of cervical cancer has halved. Given recent advances in human papillomavirus (HPV) vaccination and screening, cervical cancer may be eliminated nationally within 20 years. However, immigrant women are not equitably reached by screening efforts. This study systematically reviewed evidence on cervical cancer screening practices among immigrant women in Australia. A systematic search of MEDLINE, Embase, PubMed, CINAHL, and PsycINFO and gray literature for English language studies published till March 1, 2019, was conducted. Observational and qualitative studies evaluating cervical cancer screening awareness and participation of immigrant women were screened. Of 125 potentially relevant studies, 25 were eligible: 16 quantitative (four cohort, 12 cross-sectional), six qualitative, and three mixed-methods studies. Quantitative studies indicated 1% to 16% lower screening rates among migrant women compared with Australian-born women, with participation of South Asian women being significantly lower. Qualitative studies illustrated factors affecting women’s willingness to participate in screening, including insufficient knowledge, low-risk perception, and unavailability of a female health professionals being key barriers. Future studies should focus on South Asian women, due to recent increase in their immigration.
Association Between Adherence to Healthy Lifestyles and Depressive Symptoms Among Japanese Hospital Workers During the COVID-19 Pandemic
Authors: Fukunaga Ami , Inoue Yosuke , Yamamoto Shohei , Miki Takako , Nanri Akiko , Ishiwari Hironori , Ishii Masamichi , Miyo Kengo , Konishi Maki , Ohmagari Norio , Mizoue Tetsuya
Published: April 2021

The objective of this study was to investigate the association between adherence to healthy lifestyles (as measured by the healthy lifestyle index [HLI]) and depressive symptoms among staff members at a large national medical institution in Tokyo, Japan, during the coronavirus disease 2019 (COVID-19) pandemic. The study sample consisted of 1228 staff members aged between 21 and 73 years who participated in a cross-sectional survey conducted in July 2020. We constructed the HLI by assigning one point to each healthy lifestyle factor: normal body mass index, sufficient physical activity, non-smoking status, non-to-moderate alcohol consumption, and sufficient sleep duration. The multivariate adjusted odds ratios for depressive symptoms were 1.00 (reference), 0.71, 0.66, and 0.56 for participants with HLI scores of 0 to 2, 3, 4, and 5, respectively. The present study suggests the role of healthy lifestyles in mental health among hospital staff working during the pandemic.
Adverse prognostic factors for rescuing patients with acute myocardial infarction–induced cardiac arrest receiving percutaneous coronary intervention under extracorporeal membrane oxygenation
Authors: Ye Jianxi
Published: April 2021

Background:

Acute myocardial infarction–induced cardiac arrest has high mortality rate.

Objective:

To investigate the risk factors of extracorporeal membrane oxygenation combined with percutaneous coronary intervention in rescuing acute myocardial infarction–induced cardiac arrest.

Methods:

Forty‐three eligible patients were assigned into death and survival groups. Their general clinical data, treatment outcomes, and various indicators 24, 48, and 72 h after extracorporeal membrane oxygenation implantation were compared. The factors affecting clinical outcomes were determined by multivariate logistic regression analysis. A nomogram prediction model was constructed and validated.

Results:

After removing extracorporeal membrane oxygenation device, 19 patients recovered and 24 died (mortality rate: 55.81%). The two groups had different conventional cardiopulmonary resuscitation duration, number of diseased vessels, distribution of culprit vessel, time from cardiac arrest to extracorporeal membrane oxygenation implantation, length of stay in critical care unit, and mean arterial pressure 24 and 48 h after extracorporeal membrane oxygenation implantation (p < 0.05). Left anterior descending as the culprit vessel, number of diseased vessels, conventional cardiopulmonary resuscitation duration, time from cardiac arrest to extracorporeal membrane oxygenation implantation, and mean arterial pressure 48 h after extracorporeal membrane oxygenation resuscitation were independent risk factors for death. The predicted mortality rate was 72.6%, and the actual concordance index (C‐index) was 0.869. Such indices after internal and external validations were 0.861 and 0.848, respectively, suggesting a good concordance.

Conclusion:

Left anterior descending as the culprit vessel, number of diseased vessels, conventional cardiopulmonary resuscitation duration, time from cardiac arrest to extracorporeal membrane oxygenation implantation, and mean arterial pressure 48 h after extracorporeal membrane oxygenation resuscitation are independent risk factors for patients with acute myocardial infarction–induced cardiac arrest undergoing extracorporeal membrane oxygenation combined with percutaneous coronary intervention.
Puerto Rican Spiritualism and the Social Work Profession
Authors: Delgado Melvin
Published: April 2021

Uprooted people needing to turn to supernatural forces find an institutionalized outlet for the therapeutic discharge of unresolved frustration or aggression
Task-Centered Model for Work with the Aged
Authors: Cormican Elin J.
Published: April 2021

Underlying assumptions are that most elderly clients can, want, and need to make decisions for themselves in order to remain functioning in the community
Suffering and Symptoms At the End of Life in ICU Patients Undergoing Renal Replacement Therapy
Authors: Ramer Sarah J. , Viola Martin , Maciejewski Paul K. , Reid M. Carrington , Prigerson Holly G.
Published: April 2021

Background:

We know little about the end-of-life suffering and symptoms of intensive care unit (ICU) decedents in general and those who undergo renal replacement therapy (RRT) in particular.

Objectives:

To examine differences in end-of-life suffering and various symptoms’ contribution to suffering between ICU decedents who did not undergo RRT, those who underwent RRT for end-stage kidney disease (ESKD), and those who underwent RRT for acute kidney injury (AKI).

Methods:

This is a cross-sectional study conducted at a quaternary-level referral hospital September 2015-March 2017. Nurses completed interviews about ICU patients’ suffering and symptoms in their final week. We dichotomized overall suffering into elevated and non-elevated and each symptom as contributing or not to a patient’s suffering.

Results:

Sixty-four nurses completed interviews on 165 patients. Median patient age was 67 years (interquartile range 57, 78); 41% were female. In a multivariable model, undergoing RRT for AKI (odds ratio [OR] 2.95, 95% confidence interval [CI] 1.34-6.49) was significantly associated with elevated suffering compared to no RRT; undergoing RRT for ESKD was not. Adjusting for length of stay, AKI-RRT patients were more likely than non-RRT patients to have fecal incontinence (OR 2.21, 95% CI 1.00-4.93), painful broken skin (OR 2.41, 95% CI 1.14-5.12), and rashes (OR 3.61, 95% CI 1.35-9.67) contributing to their suffering.

Conclusions:

Undergoing RRT for AKI was associated with elevated suffering in the last week of life in ICU decedents. Painful broken skin, rashes, and fecal incontinence were more likely to contribute to suffering in AKI-RRT patients than in non-RRT patients. How to reduce suffering associated with AKI-RRT in ICU patients merits further study.
Beyond the Corporatization of Death Systems: Towards Green Death Practices
Authors: Shelvock Mark , Kinsella Elizabeth Anne , Harris Darcy
Published: April 2021

One less explored area of research concerns the response to the ecological crisis through environmentally sustainable death practices, which we broadly define in this paper as ‘green death practices’. In this paper, interdisciplinary research and scholarship are utilized to critically analyze death practices, and to demonstrate how contemporary Westernized death practices such as embalming, traditional burial, and cremation can have harmful environmental and public health implications. This paper also investigates the multi-billion-dollar funeral industry, and how death systems which place economic growth over human wellbeing can be socially exploitative, oppressive, and marginalizing towards recently bereaved persons and the environment. Death-care as corporatized care is explicitly questioned, and the paper provides a new social vision for death systems in industrialized Western societies. Ultimately, the paper advocates for how green death practices may offer new pathways for honoring our relationships to the planet, other human beings, and even our own deepest values.
Patients’ Perspective on the Psychological Impact of Multiple Sclerosis on Their Life
Authors: Baka Chrysoula , Chatira Kalliopi , Karademas Evangelos C. , Kafetsios Konstantinos G.
Published: April 2021

Multiple sclerosis is a chronic autoimmune disorder that greatly impacts on patients’ physical and psychosocial wellbeing. The purpose of this study is to investigate the experiences of people diagnosed with multiple sclerosis in Greece (N = 30), with regard to the way they coped with the diagnosis and the symptoms, the psychological implications of the disorder and the meaning they attributed to it. Data were collected through semi-structured interviews and they were analyzed using grounded theory. The findings showed that despite the negative implications of the disorder and the difficulty in managing the diagnosis and the symptoms, half of the patients attributed positive meaning to the disorder. Taking care of oneself, re-evaluation of life and a sense of liberation were described as the positive outcomes of experiencing multiple sclerosis.