bluuebunny/crossref_metadata_2025 huggingface dataset:
Advancing Peace through Human Rights in UN Peace Operations
Authors: Giuliani Céline
Published: May 2021

The integration of human rights in United Nations peace operations has witnessed remarkable progress during the past fifteen years. This article analyzes the evolution of human rights integration in the peace and security architecture in relation to peace operations, focusing on the achievements and shortcomings of Headquarters-led policies and reforms of the last decade, as well as the impact of recent Security Council dynamics. The article reviews the significant realizations on both the substantive and structural fronts and argues that ownership of the human rights agenda and policies, as well as accountability and leadership for their implementation, warrants a greater commitment of the organization. Such commitment should translate into institutionalizing Headquarters’ cooperation mechanisms, creating further space for human rights in decision-making, allocating adequate resources, and strengthening accountability for risk-mitigation policies, inter alia. A stronger political will is equally required to better articulate human rights issues in relation to conflict analysis, prevention and peacebuilding, in support of political objectives of peace operations.
A Dove Grey Renaissance
Authors: Bennett Sarah
Published: May 2021

Launched in 1999, at a time of radical change for the publishing industry, Persephone Books has become a successful independent publisher of neglected female authors mainly from the 20th-century inter-war period. Publishing being an industry primarily shaped by the differential distribution of symbolic and economic capital (Bourdieu, ‘The Market for Symbolic Goods’, in The Rules of Art, Polity Press, 1996, p. 9), competing principles of cultural legitimacy within an increasingly commercial climate clarify the position of modern publishing at the intersection of culture and commerce (Bourdieu, The Field of Cultural Production, Columbia University Press, 1993, p. 27). This article explores how Persephone Books’ understated assertion of publishing’s ‘middle ground’ and commitment to the historically reviled ‘middlebrow’ genre have reconciled the perennial tension between culture and commerce to create a thriving yet unintentional publishing brand.
Control of in vitro shoot tip necrosis in Carob Ceratonia siliqua L.
Authors: Aguinaz Hayat , Qaddoury Ahmed , Anjarne Mohamed
Published: May 2021

Shoot tip necrosis (STN) is a physiological abnormality whereby the apical shoot initially becomes necrotic and subsequently dies leading to considerable loss of shoots and hampering any commercial application of carob (Ceratonia siliqua L.) micropropagation. The objective of the present study is the optimization of a method to alleviate STN during in vitro multiplication of carob dealing with a range of culture media compounds. Obtained results showed that macroelement strength of the culture medium as well as cytokinin and calcium concentrations were the most important factors in controlling STN incidence in carob. In fact, Zimmerman macroelements are most efficient in terms of STN reduction (only 5% STN observed) and shoot multiplication (28.75 shoots with 26.8 leaves and 4.73 cm length). Moreover, shoots cultured on Zimmerman or Ca enriched ½MS showed higher mineral nutrient contents than those cultured on low Ca media. On the other hand, most shoots recovered from STN have produced roots in presence of 1 mg.L-1 IAA (70%) and 83% survived after transfer to ex vitro conditions. The performance of Zimmerman macroelements is most likely due to its high Ca concentration (7.3 mM) compared to the other media. This is confirmed by the steep reduction of STN intensity obtained on ½MS enriched with Ca.
Adult Onset Bilateral Cochlear Nerve Atrophy and Cochlear Implantation: A Case Report and Review of the Literature
Authors: Leonhard Lucas , Brewer Kathryn , Roche Joseph
Published: May 2021

Objective:

To describe a case of idiopathic bilateral cochlear nerve atrophy acquired in adulthood.

Patient:

A 75-year-old male with acquired bilateral cochlear nerve atrophy.

Intervention(s):

Unilateral cochlear implantation.

Main Outcome and Results:

Description of a patient with acquired bilateral cochlear nerve atrophy diagnosed at the age of 75. The patient had normal hearing and no communication deficits until the age of 66. At this point, the patient demonstrated a slight asymmetric hearing loss, which progressed to severe sensorineural hearing loss. Due to the resulting communication deficit, cochlear device implantation candidacy was pursued. Pre-operative magnetic resonance imaging (MRI) showed severe atrophy versus absence of the cochlear nerves bilaterally. After careful counseling regarding the expected communication outcomes given the MRI findings, the patient underwent left-sided cochlear implantation. The patient gained sound awareness, but no additional communication benefit compared to pre-operative baseline abilities.

Conclusion:

Cochlear nerve deficiency is a known finding in certain cases of congenital and acquired hearing loss, but no cases of idiopathic adult-onset bilateral nerve atrophy have been reported. Without MR imaging, the clinically significant finding would not have been identified. Thus, MRI is advantageous when compared with other imaging modalities in patients with progressive sensorineural hearing loss and enables improved patient counseling regarding expected auditory and communication outcomes.
Effects of hostile solutions on the static and dynamic behavior of carbon/epoxy composites
Authors: Balcıoğlu H Ersen , Sakin Raif , Gün Halit
Published: May 2021

Fiber-reinforced laminated composite is often used in harsh environments that may affect their static stability and long-term durability as well as residual strength. In this study, the effect of heavy chemical environments such as acid and alkaline and retaining time for these environments on flexural strength and flexural fatigue behavior of carbon/epoxy laminated composites were investigated. In this context, carbon/epoxy was retained into an acidic and alkaline solution having 5%, 15%, and 25% concentration by weight for 1–4 months. Fatigue behavior of carbon/epoxy was determined under dynamic flexural load, which corresponds to 80%, 70%, 60%, 50%, and 40% of static three-point bending strength of the test sample. SEM image of damaged specimens was taken to describe the failure mechanism of damage which occurs after fatigue. Also, to better understand environmental condition on the fatigue life, results were compared with results of carbon/epoxy laminated composites, which were not retained into any environments (unretained). The test results showed that the solution type, solution concentration, and retaining time caused noticeable changes in the static and dynamic strengths of carbon/epoxy laminated composites.
The assessment of patients undergoing cardiac surgery for Covid-19: Complications occurring during cardiopulmonary bypass
Authors: Stammers Alfred H , Mongero Linda B , Tesdahl Eric A , Patel Kirti P , Jacobs Jeffrey P , Firstenberg Michael S , Petersen Courtney , Barletti Shannon , Gibbs Autumn
Published: May 2021

The outbreak of the novel coronavirus pandemic (COVID-19) has resulted in dramatic changes to the conduct of surgery both from a patient management perspective and in protecting healthcare providers. The current study reports on the status of COVID-19 infections in patients presenting for cardiac surgery with cardiopulmonary bypass (CPB) on circuit complications. A tracking process for monitoring the presence of COVID-19 in adult cardiac surgery patients was integrated into a case documentation system across United States hospitals where out-sourced perfusion services were provided. Assessment included infection status, testing technique employed, surgery status and CPB complications. Records from 5612 adult patients who underwent cardiac surgery between November 1, 2020 and January 18, 2021 from 176 hospitals were reviewed. A sub-cohort of coronary artery bypass graft patients (3283) was compared using a mixed effect binary logistic regression analysis. 4297 patients had negative test results (76.6%) while 49 (0.9%) tested positive for COVID-19, and unknown or no results were reported in 693 (12.4%) and 573 (10.2%) respectively. Coagulation complications were reported at 0.2% in the negative test results group versus 4.1% in the positive test result group (p < 0.001). Oxygenator gas exchange complications were 0.2% in the negative test results group versus 2.0% in the positive test results group (p = 0.088). Coronary artery bypass graft patients with a positive test had significantly higher risk for any CPB complication (p = 0.003) [OR 10.38, CI 2.18–49.53] then negative test patients [OR 0.01, CI 0.00–0.20]. The present study has shown that patients undergoing cardiac surgery with CPB who test positive for COVID-19 have higher CPB complication rate than those who test negative.
Ultrasound-guided cyanoacrylate injection for the treatment of incompetent perforator veins
Authors: Mordhorst Alexa , Yang Gary K , Chen Jerry C , Lee Shung , Gagnon Joel
Published: May 2021

Objective

The use of cyanoacrylate products (CA) in incompetent perforator vein (IPV) treatment has not been thoroughly examined. The primary objective of this study is to describe the technique of ultra sound guided direct injection of IPV with CA, and secondarily to determine early closure rates and safety of this technique.

Methods

A retrospective analysis of patients undergoing IPV injection at two centres between 2015-2018 was conducted. Demographics, CEAP classification and IPV location were collected. Outcomes were assessed at two follow-up appointments.

Results

A total of 83 perforator vein injections were completed. CEAP classifications include C2 – C6 classes. Location of perforators were posteromedial (6%), femoral canal (9%), paratibial (14%), and posterior-tibial (71%). IPV closure rates were 96.3% at initial follow-up (16 ± 2 days). Closure rates decreased to 86.5% at second follow-up (72 ± 9 days). There were no deep vein thromboses during follow-up. One patient developed septic thrombophlebitis that was successfully managed with antibiotics.

Conclusion

Ultrasound-guided CA glue injection is a simple and low risk procedure that effectively closes incompetent perforator veins.
LIPIODOL reduces the lytic activity of detergent sclerosants in vitro
Authors: Gracé Joseph , Connor David , Bester Lourens , Rogan Christopher , Parsi Kurosh
Published: May 2021

Objectives

Contrast agents are used widely in the interventional setting and in particularly in the management of vascular anomalies and have also been used in combination with sclero-embolic agents. There is limited information on the interaction of contrast agents with sclerosant agents when used as mixtures. The aim of this study was to determine the effect of mixing radiological contrast agents with detergent sclerosants and measuring the effect on change in lytic activity of detergent sclerosants in vitro and by proxy the change in potency.

Methods

Red blood cell lysis was assessed following the incubation of two commonly used contrast agents, LIPIODOL® and ULTRAVIST®, mixed with detergent sclerosants, FIBROVEIN®, sodium tetradecyl sulfate (STS), and AETHOXYSKLEROL®, polidocanol (POL).

Results

The density of both contrast agents was higher than STS and POL and neither of the detergent sclerosants were miscible in LIPIODOL. LIPIODOL on its own caused cell lysis (1.01%, p < 0.05) whereas ULTRAVIST did not. Fifty per cent cell lysis for sclerosant and LIPIODOL mix occurred at concentrations of: 0.041% (2.4 times greater than the control, p < 0.05) and 0.08% (3.6 times greater than the control, p = 0.06) for STS and POL, respectively.

Conclusions

LIPIODOL, when mixed with sclerosant detergents (ratio 1:1) causes a reduction in the lytic activity of sclerosants and this effect was statistically significant and most prominent in lower sclerosant concentration mixtures.
Medicare’s Hospital Value-Based Purchasing Program Values Quality over QALYs
Authors: Norton Edward C. , Li Jun , Das Anup , Ryan Andrew M. , Chen Lena M.
Published: May 2021

Medicare’s Hospital Value-Based Purchasing Program (HVBP) is the first national pay-for-performance program to combine measures of quality of care with a measure of episode spending. We estimated the implicit tradeoffs between mortality reduction and spending reduction. To earn points in HVBP, a hospital can either lower mortality or reduce spending, creating a tradeoff between the 2 measures. We analyzed the quality performance and earned points of 2814 hospitals using publicly available data. We then quantified the tradeoffs between spending and mortality in terms of quality-adjusted life-years (QALYs). If incentives in the program were balanced, then the tradeoff between spending and QALYs should be comparable with those of high-value health interventions, roughly $50,000 to $200,000 per QALY. Instead, the tradeoff in HVBP was about $1.2 million per QALY. HVBP overvalues improvements in quality of care relative to spending reductions. We propose 2 possible policy adjustments that could improve incentives for hospitals to deliver high-value care.
Activated phosphoinositide 3-kinase delta syndrome misdiagnosed as anti-neutrophil cytoplasmic antibody-associated vasculitis: a case report
Authors: Zhang Xiaojing , Wang Jingjing , Zhu Kun , Jin Yanyan , Fu Haidong , Mao Jianhua
Published: May 2021

Activated phosphoinositide 3-kinase delta syndrome (APDS) is a combined inborn error of immunity mainly caused by PIK3CD mutations. We herein describe a 4-year-old Chinese boy who was admitted for recurrent pneumonia and persistent hematuria and exhibited multisystem involvement and anti-neutrophil cytoplasmic antibody (ANCA) positivity. He was initially diagnosed with ANCA-associated vasculitis. However, genetic testing revealed a c.1574A>G PIK3CD mutation, resulting in a diagnosis of APDS1.
Guiding vacuum-assisted biopsy in prone position: digital breast tomosynthesis vs stereotactic
Authors: Scaperrotta Gianfranco P. , Boffelli Giulia , Depretto Catherine , Di Leo Giovanni , Liguori Alessandro , Monaco Cristian Giuseppe , Borelli Anna , Ferranti Claudio
Published: May 2021

Purpose:

To compare the performance of prone digital breast tomosynthesis (DBT)–vacuum-assisted biopsy (VAB) with prone stereotactic-guided VAB (sVAB), focusing on time of procedure, number of expositions, average glandular dose, and complications.

Methods:

The institutional review board approved this retrospective study and informed consent was waived. From July 2015 to January 2017, 306 patients with 306 suspicious mammographic findings (BI-RADS ⩾4) underwent mammography-guided biopsy, prone sVAB, or prone DBT-VAB. Student t test, chi-square, and multivariate regression statistics were used.

Results:

During the study period, 155 prone sVAB procedures in 155 patients (mean age, 56 years; age range, 39–84 years) and 151 DBT-VABs in 151 patients (mean age, 57 years; age range, 33–84 years) were performed. Mean procedure time was shorter with DBT-VAB versus sVAB (14.5 versus 17.4 minutes, respectively; p < 0.001), and fewer images were acquired with DBT-VAB versus sVAB (8 vs 11, respectively; p < 0.001); the average glandular dose was significantly lower in DBT-VAB versus sVAB (11.8 mGy versus 18 mGy, respectively; p < 0.001). There were no differences in the distribution of histologic results ( p = 0.74) or breast density ( p = 0.09) between the two groups. No major complications were observed in either group.

Conclusion:

Performance of prone DBT-VAB was superior to prone sVAB because it allowed a faster procedure with fewer radiologic expositions and lower radiation dose.
Diagnosis and incidence of acute kidney injury in a mixed paediatric intensive care unit: Retrospective analysis, 2005 and 2015
Authors: Basu Shreerupa K , Fincher Sophie H , Wilkins Barry H
Published: May 2021

Acute kidney injury (AKI) is common in intensive care patients. While creatinine definitions for AKI have been validated, oliguria criteria are less well evaluated in children. Our study compared the validity and agreement of creatinine and oliguria criteria for diagnosing AKI in a large mixed medical, surgical and cardiac paediatric intensive care unit (PICU), and assessed the significance of their independent and combined effects on predicted mortality relative to paediatric index of mortality (PIM risk of death) on admission. Creatinine measurements during PICU admissions in 2005 and 2015 were obtained from the electronic medical record. Urine output was reviewed to identify periods of oliguria of more than eight hours. We used the PIM3 model for predicted risk of death. AKI based on creatinine rise occurred in 23.6% of the total 2203 admissions (10.0%, 8.2% and 5.6% for mild, moderate and severe categories, respectively). Oliguria occurred in 11.4% (8.4%, 1.8% and 1.2% for mild, moderate and severe categories, respectively) and overlapped only partially with creatinine criteria. Mortality relative to predicted mortality increased with increasing creatinine and oliguria severity, but was lower than predicted where oliguria occurred without creatinine rise. AKI by creatinine criteria and/or oliguria are common in the PICU, but criteria overlap only partially. Increasing severity of creatinine rise and oliguria confers increasing risk-adjusted mortality, especially for admissions with low PIM3 risk of death. The mortality of patients with AKI defined by oliguria alone is low. Defining AKI by oliguria alone has less clinical utility and may not represent true AKI.
Performance Study of Cryo-Treated End Mill Via Wet, Cryogenic, and Hybrid Lubri-Coolant-Milling Induced Surface Integrity of Biocompatible Mg Alloy AZ91D
Authors: Davis Rahul , Singh Abhishek
Published: May 2021

The excellent biodegradability of the magnesium (Mg) alloys is gradually proving them as the potential substitutes to several biomedical implants such as chemotherapy ports or screws, which are required to be removed via secondary surgeries after a specific period of time. However, an early degradation of these alloys even before the complete healing of the damaged tissue, when exposed to the physiological atmosphere, has been limiting their full-fledged application. Some latest research articles suggest that such challenges can be effectively overcome by improving the surface integrity of Mg alloys using the sustainable manufacturing techniques, such as cryogenic machining. Recent literatures also report the outperformance of the cryogenically treated (cryo-treated) cutting tools for achieving an enhanced surface integrity. In this relation, the present research attempts to improve the surface integrity of one of the most commonly used biocompatible alloys of magnesium, known as AZ91D. For this reason, a TiAlN coated-cemented carbide end mill was used in an untreated and cryo-treated state amid wet, cryogenic, and hybrid-lubri-coolant-milling conditions. The milling and FESEM (field emission scanning electron microscopy) results showed a considerable improvement in the surface integrity in terms of an augmented surface roughness and microhardness at 56.52 m/min cutting speed with the cryo-treated end mill during hybrid-lubri-coolant-milling. At the high cutting speed hybrid-lubri-coolant-milling, the cryo-treated end mill attained 35.71% and 48.07% better surface finish than that of cryo and wet-lubri-coolant-milling, respectively. Although, the highest surface microhardness was achieved by the cryo-treated end mill amid cryo-lubri-coolant-milling, due to the poorest surface quality observed in terms of the maximum number of machining-induced cracks, the hybrid-lubri-coolant-milled surface was preferred over the cryo and wet-lubri-coolant-milled surfaces. Further, the FESEM and EDS (energy-dispersive X-ray spectroscopy) analyses confirmed the oxide layer produced by the cryo-treated end mill amid hybrid-lubri-coolant-milling, to be the thinnest (12.16 µm) and most uniform passivation layer.
Multi-objective aerodynamic optimization using active multi-output Gaussian process and mesh deformation method
Authors: Yang Fan , Chen Zhaolin
Published: May 2021

A wing is an important part of the aircraft to improve aerodynamic performance. The current study is focused on an adaptive surrogate algorithm for airfoil aerodynamic optimization, which is based on a multi-output Gaussian process model. The conventional design method seriously relies on wind tunnel experiments and expensive computational simulations. The metamodels can significantly improve design efficiency and hence reduce the overall design costs. An active learning algorithm is proposed to improve the effectiveness of the multi-output Gaussian process model. The NSGA-II algorithm is adopted to obtain the optimal Pareto set with the optimization objectives of lift and drag coefficients for adaptive airfoil shapes. Besides, the Bezier curve and radial basis function are utilized in this study for airfoil mesh deformation. The results show that the airfoil shape can be obtained effectively by integrating the metamodel, active learning algorithm, and multi-objective optimization algorithm. The optimized results are of great engineering applications.
Who is entitled to family benefits? Lights and shadows of the ECJ rulings in WS and VR
Authors: Grossio Lorenzo
Published: May 2021

In WS and VR the Court of Justice interpreted the right to equal treatment afforded by EU law to third-country nationals holding a single permit or a long-term resident’s status as preventing national provisions which, differently from nationals and EU citizens, exclude their family members residing abroad from the calculation of a family unit allowance. While the two rulings upheld an established trend in Italian national case law, the reasoning of the Court raises critical concerns over the correct identification of the beneficiaries of family benefits. Thus, the interpretation supported by the Court is likely to restrict the scope of the right to equal treatment in an unexpected way. Having analysed the two judgments, the present paper discusses why the Court should have taken a different position in that specific regard.
Land grabbing or value grabbing? Land rent and wind energy in the Isthmus of Tehuantepec, Oaxaca
Authors: Alonso Serna Lourdes
Published: May 2021

The Isthmus of Tehuantepec in Oaxaca is the first region in Mexico with a large-scale wind energy development. The region holds 60% of the country’s installed capacity, but the new infrastructure has faced opposition from sectors of the local population concerned about wind farms’ social and environmental impacts. The opposition and ensuing conflicts have been widely studied; some of these studies have framed wind energy as part of the recent cycle of land grabbing. Nevertheless, this literature has overlooked landholders’ acceptance of wind energy. This paper aims to address this gap and argues that the main driver of the land grabbing process is land rent. The paper draws on recent insights from political ecology that highlight that the commodification of nature is predicated on rent. The paper uses the notion of value grabbing to look at the social struggles over property rights in the Isthmus and the conflicts for the increase and distribution of rents from wind energy.
The Efficacy of Physical Activity for Children with Attention Deficit Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials
Authors: Seiffer Britta , Hautzinger Martin , Ulrich Rolf , Wolf Sebastian
Published: May 2021

Background:

This systematic review and meta-analysis assesses the efficacy of regular, moderate to vigorous physical activity (MVPA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents in randomized controlled trials (RCTs).

Methods:

RCTs including children and adolescents with clinically diagnosed ADHD, implementing regular MVPA, and assessing ADHD core-symptoms on a valid rating scale post-intervention (primary outcome) were included. Outcomes were pooled through random-effects meta-analysis. Prospero registration: CRD42019142166.

Results:

MVPA had a small effect on total ADHD core symptoms ( n = 11; g = −0.33; 95% CI [−0.63; −0.02]; p = .037).

Conclusions:

MVPA could serve as an alternative treatment for ADHD. New RCTs are necessary to increase the understanding of the effect regarding frequency, intensity, type of MVPA interventions, and differential effects on age groups.
Comparing Different Interventions’ Effects on Latinas’ Screening Mammography Attainment and Participant-Driven Information Diffusion
Authors: Molina Yamilé , San Miguel Liliana G. , Tamayo Lizeth , Pichardo Catherine , Torres Paola , Robledo Casandra , Diaz Leslie , Ruiz Izalia , Sánchez Díaz Carola T. , Arroyo Juanita , Medina Maria , Coronado Nora , Hernandez Olivia , Lucio Araceli , Fitzgibbon Marian L. , Kroenke Candyce H.
Published: May 2021

Evaluation of multiple community-based approaches to improve Latinas’ breast cancer (BC) screening utilization has resulted in inconsistent findings. Factors contributing to this variation include heterogeneity in approaches (e.g., types of conceptual frameworks) and study quality (e.g., lack of measurement of spillover effects). This pilot study sought to clarify which approach may be most effective by evaluating the relative efficacy of two conceptual approaches using an area-level design with 145 Latinas nonadherent to U.S. Preventive Services Taskforce (USPSTF) BC screening guidelines. Each study arm included identical intervention format and duration (e.g., three group-based sessions, logistic assistance (LA) via five monthly calls and referral to free/low-cost screening programs). However, study content differed. While educate+LA addressed participants’ BC prevention and screening behavior, empower+LA addressed participants’ and their social networks’ BC screening. After adjusting for age, insurance status, and baseline mammography intention, when compared with educate+LA participants, empower+LA participants were more likely to report obtaining mammograms, engaging more individuals about BC, initiating BC conversations in public settings, and discussing mammography specifically. Our study has important implications regarding the utility of evaluating behavioral interventions overall in terms of behavioral and spillover network effects.
Life routinization and clandestine photo-taking behavior among young people in Hong Kong: Implications for social work practice
Authors: Tam Hau-lin , To Siu-ming , Kwok Diana Kan , Chan Doris Ka Yin
Published: May 2021

With a growing number of reported offenses, clandestine photo-taking has become an increasingly noticeable phenomenon in Hong Kong and other parts of the world. This behavior is usually seen as a selfish act as it invades people’s privacy and sexual autonomy to satisfy one’s own sex drive. However, the present study provides new and varying insights into the problem. This is the qualitative section of an impact assessment including three focus group interviews with 10 young sexual offenders aged between 18 and 25 years who were either arrested or under probation. The results suggest that more than being sexually driven, people engaged in clandestine photo-taking to eliminate their sense of loneliness and break through the routinization of their everyday lifestyle. Living in a fast-paced and highly demanding metropolitan city, they felt lost and occupied to the extent that they were unaware of their purpose and meaning in life. In contrast, clandestine photo-taking allowed them to have a sense of control and satisfaction that they were lacking in their everyday lives. Based on the young offenders’ experiences and responses in the present study, social and parental understanding with early and preventive measures such as curriculum-based sexual education, and sufficient sexual and counseling support will be more important than imposing strong legal sanctions or social control to handle their sexually offending behavior. To assist young people in their need to overcome their everyday life’s boredom, stress, and routine, in combination with existing treatments, a meaning-centered approach is suggested for future practices.
Polytetrafluoroethylene coating fragments during neuroendovascular therapy: An analysis of two damaged microguidewires
Authors: Dahl Rasmus Holmboe , Larsen René Wugt , Thormann Esben , Benndorf Goetz
Published: May 2021

Cerebral polymer coating embolism from intravascular devices represents a potentially serious complication to endovascular therapy (EVT). We report two cases of neuroendovascular treatment where filamentous polymer fragments were noted possibly due to damage of the surface coating during manipulation and backloading of microguidewires. As the exact origin of the debris was initially not known, microguidewires and fragments were examined with light microscopy, stereomicroscopy, scanning electron microscopy and attenuated-total-reflection Fourier transform infrared spectroscopy. Fragments consisted of polytetrafluoroethylene and silicone oil stemming from the proximal shaft of a standard microguidewire. To our knowledge, this is the first report of polytetrafluoroethylene coating fragments created during EVT. Future studies should assess the mechanism of polymer coating delamination and its potential consequences during EVT including inadvertent fragment migration into the cerebral circulation.
Dependence of gas permeation and adsorption on temperature in vacuum insulation panels (VIPs) containing getter materials
Authors: Yamamoto Hideya , Ogura Daisuke
Published: May 2021

Vacuum insulation panels (VIPs) with a glass-fiber core has been considered to be difficult to operate for a long period of time, such as for building applications, because the thermal conductivity rises rapidly as the pressure increases. However, glass-fiber-core VIPs contain a material called a getter that continuously adsorbs permeated gas, and a theoretical model that considers the properties of the getter has not yet been developed. In this paper, the gas-adsorption mechanism by getters was investigated and a long-term-performance prediction model that considers the temperature dependence was proposed. Some gases were not adsorbed by the getter in the VIPs; however, a model was proposed that takes into account the non-absorbed gases by applying partial pressure to the adsorption isotherm in advance. The long-term performance of VIPs with different areas and volumes was compared with the measured values, and the validity of the calculation results was confirmed. These results show that the long-term performance of VIPs of different sizes can be accurately predicted when the getter performance is well understood.
The role of continuous glucose monitoring in pregnancy
Authors: Li Adrian , Brackenridge Anna
Published: May 2021

The risks associated with diabetes in pregnancy include congenital anomalies, stillbirth and miscarriage, and correlate with glycaemia. The optimisation of diabetes during pregnancy is therefore both challenging and essential. Technology has revolutionised how clinicians and patients manage diabetes. This review article focuses on the role of continuous glucose monitoring (CGM) in pregnancy, assessing the evidence available and providing an update on current guidance.
The role of tazemetostat in relapsed/refractory follicular lymphoma
Authors: von Keudell Gottfried , Salles Gilles
Published: May 2021

Large strides have been made in the treatment of follicular lymphoma (FL) over the last few years. Although the majority of patients respond to upfront therapy, many experience disease progression with a progressive shortening of subsequent treatment free intervals. New treatment options are therefore crucial for such patients. Tazemetostat is a first-in-class, selective, oral inhibitor of enhancer of zester homolog 2 (EZH2), a histone methyltransferase that is mutated in about a quarter of FL cases. Tazemetostat was recently approved for the treatment of patients with relapsed FL after 2 or more prior lines of therapy in the presence of an EZH2 mutation and for those without any other available therapeutic option, independently of EZH2 mutation status. In this review, we will summarize the background and key data that led to the development of tazemetostat, and, ultimately, to its approval for this indication.
Inference of activity patterns from urban sensing data using conditional random fields
Authors: Zhu Yi
Published: May 2021

The study of human activity–travel patterns for urban planning has evolved a long way in theories, methodologies, and applications. However, the scarcity of data has become a major barrier for the advancement of research in the field. Recently, the proliferation of urban sensing and location-based devices generates voluminous streams of spatio-temporal registered information. In this study, we propose an approach using the linear-chain Conditional Random Fields (CRFs) model to learn the spatio-temporal correspondences of different types of activities and the inter-dependencies among sequential activities from training dataset such as the household travel or time use surveys, and to infer the hidden activity types associated with urban sensing data. The performance of the CRFs model is compared against the Random Forest (RF) model, which has been used in a number of existing studies. The results show that the linear-chain CRFs models generally outperform the RF counterparts with respect to classification accuracy of activity types, in particular for those travelers having more outdoor daily activities. The proposed methodology is demonstrated by reconstructing the activity landscape of the surrounding area of a major Mass Rail Transit station in Singapore using the transit smart card transaction data. The inferred activities from the transit smart card data are expected to complement the ground surveys and improve our understanding of the interactions of different components of activities/travels as well as the relationship between urban space and human activities.
Successful prenatal therapy for anti-CD36-mediated severe FNAIT by deglycosylated antibodies in a novel murine model
Authors: Xu Xiuzhang , Chen Dawei , Ye Xin , Xia Wenjie , Xu Yaori , Chen Yangkai , Shao Yuan , Deng Jing , Ding Haoqiang , Liu Jing , Wang Jiali , Ni Heyu , Fu Yongshui , Santoso Sentot
Published: May 2021

Recent studies have shown that maternal anti-CD36 antibodies represent a frequent cause of fetal/neonatal alloimmune thrombocytopenia (FNAIT) in Asian and African populations. However, little is known about the pathomechanism and antenatal treatment of anti-CD36–mediated FNAIT. Here, we established a novel animal model to examine the clinical features of pups from immunized Cd36−/− female mice after breeding with wild-type male mice. Mild thrombocytopenia was observed, but high pup mortality was also documented (40.26%). Administration of intravenous immunoglobulin (IVIG) (1 g/kg) on days 7, 12, and 17 to immunized Cd36−/− mothers after breeding reduced fetal death (12.70%). However, delaying the IVIG administration series on days 10, 15, and 20 did not reduce fetal death (40.00%). In contrast, injection of deglycosylated anti-CD36 (deg-anti-CD36) polyclonal antibodies (5 mg/kg) on days 10, 15, and 20 significantly reduced fetal death (5.26%). Subsequently, monoclonal antibodies (mAbs) against mouse CD36 were developed, and one clone producing high-affinity anti-CD36 (termed 32-106) effectively inhibited maternal antibody binding and was therefore selected. Using the same approach of deg-anti-CD36, the administration of deg-32-106 significantly reduced fetal death (2.17%). Furthermore, immunized Cd36−/− mothers exhibited placental deficiency. Accordingly, maternal anti-CD36 antibodies inhibited angiogenesis of placenta endothelial cells, which could be restored by deg-32-106. In summary, maternal anti-CD36 antibodies caused a high frequency of fetal death in our animal model, associated with placental dysfunction. This deleterious effect could be diminished by the antenatal administration of IVIG and deg-mAb 32-106. Interestingly, treatment with deg-32-106 seems more beneficial considering the lower dose, later start of treatment, and therapy success.
Transcriptomic insights into the effects of CytCo, a novel nematotoxic protein, on the pine wood nematode Bursaphelenchus xylophilus
Authors: Chen Ye , Zhou Xiang , Guo Kai , Chen Sha-Ni , Su Xiu
Published: May 2021

Background

The pine wood nematodeBursaphelenchus xylophilusis a destructive pest ofPinustrees worldwide and lacks effective control measures. Screening for nematotoxic proteins has been undertaken to develop new strategies for nematode control.

Results

The results of the present study provided initial insights into the responses ofB. xylophilusexposed to a nematotoxic cytolytic-like protein (CytCo) based on transcriptome profiling. A large set of differentially expressed genes (DEGs = 1265) was found to be related to nematode development, reproduction, metabolism, motion, and immune system. In response to the toxic protein,B. xylophilusupregulated DEGs encoding cuticle collagens, transporters, and cytochrome P450. In addition, many DEGs related to cell death, lipid metabolism, major sperm proteins, proteinases/peptidases, phosphatases, kinases, virulence factors, and transthyretin-like proteins were downregulated. Gene Ontology enrichment analysis showed that the CytCo treatment substantially affected DEGs involved in muscle contraction, lipid localization, and the mitogen-activated protein kinase cascade. The pathway richness of the Kyoto Encyclopedia of Genes and Genomes showed that the DEGs were concentrated in lysosomes and involved in fatty acid degradation. Weighted co-expression network analysis indicated that the hub genes affected by CytCo were associated with the nematode cuticular collagen.

Conclusions

These results showed that CytCo toxin interferes with gene expression to exert multiple nematotoxic effects, thereby providing insights into its potential use in pine wood nematode control.
Subcapsular hepatic hematoma: a case of chronic expanding hematoma of the liver
Authors: Ono Yasuyuki , Kariya Shuji , Nakatani Miyuki , Ueno Yutaka , Maruyama Takuji , Komemushi Atsushi , Kaibori Masaki , Ikeda Masatoshi , Tanigawa Noboru
Published: May 2021

Background

A chronic expanding hematoma (CEH) enlarges as a result of slight bleeding over several months, and the tissue shows a mixture of blood breakdown products, granulation tissue with capillary ingrowth, and inflammatory tissue. This report presents a case of a subcapsular hepatic CEH that was treated with transarterial embolization (TAE) and hepatectomy.

Case presentation

A 56-year-old man presented with vomiting and right-sided abdominal pain. Plain abdominal computed tomography (CT) showed a high-density area of fluid collection beneath the capsule of the right hepatic lobe, which was diagnosed as a hematoma. From its anatomical position on the CT images, a subcapsular hepatic hematoma was diagnosed. Though conservative therapy was provided, CT-guided percutaneous drainage and TAE were performed due to worsening symptom. Because the patient's abdominal symptoms re-appeared, extended right segmentectomy including the hematoma was performed. In the resected specimen, the hematoma was located beneath the capsule of the right hepatic lobe, and it was displacing the hepatic parenchyma. Microscopic examination showed a thick fibrous capsule around the hematoma, peripheral lymphocyte and plasmacyte invasion, and aggregations of histiocytes containing phagocytosed hemosiderin.

Conclusions

Anatomically, this was a case of a subcapsular hepatic hematoma, and pathologically it was shown to be a CEH. Complete surgical resection was effective treatment for this CEH.
Genetic alteration of Chinese patients with rectal mucosal melanoma
Authors: Li Huan , Yang Lujing , Lai Yumei , Wang Xintong , Han Xinyin , Liu Siyao , Wang Dongliang , Li Xiaojuan , Hu Nana , Kong Yan , Si Lu , Li Zhongwu
Published: May 2021

Background

Rectal mucosal melanoma (RMM) is a rare and highly aggressive disease with a poor prognosis. Due to the rarity of RMM, there are few studies focusing on its genetic mechanism. This retrospective study aimed to analyze the genetic spectrum and prognosis of RMM in China and lay a foundation for targeted therapy.

Methods

36 patients with primary RMM from Peking University Cancer Hospital were enrolled in this study. The Next-generation sequencing (NGS) data of the tumor samples were fitted into the TruSight™ Oncology 500 (TSO500) Docker pipeline to detect genomic variants. Then, the univariate and multivariate Cox hazard analysis were performed to evaluate the correlations of the variants with the overall survival (OS), along with Kaplan-Meier and log-rank test to determine their significance.

Results

BRAF mutations, NRG1 deletions and mitotic index were significant prognostic factors in the univariate analysis. In multivariable analysis of the OS-related prognostic factors in primary RMM patients, it revealed 2 significant alterations: BRAF mutations [HR 7.732 (95%CI: 1.735–34.456), P = 0.007] and NRG1 deletions [HR 14.976 (95%CI: 2.305–97.300), P = 0.005].

Conclusions

This is the first study to show genetic alterations exclusively to Chinese patients with RMM. We confirmed genetic alterations of RMM differ from cutaneous melanoma (CM). Our study indicates that BRAF and NRG1 were correlated with a poor prognostic of RMM and may be potential therapeutic targets for RMM treatment.
Development of foot length in children with congenital clubfoot up to 7 years of age: a prospective follow-up study
Authors: Manousaki Evgenia , Esbjörnsson Anna-Clara , Hägglund Gunnar , Andriesse Hanneke
Published: May 2021

Background

Clubfeet are typically shorter than normal feet. This study aimed first to describe the development of foot length in a consecutive series of children with congenital clubfoot and second to relate foot length to development of relapse and motion quality.

Methods

Foot length was measured every 6 months in 72 consecutive children with congenital clubfoot (29 bilateral) aged from 2 to 7 years. The initial treatment was nonsurgical followed by standardized orthotic treatment. Foot length growth rate was calculated every half year. In children with unilateral clubfeet, the difference in foot length between the clubfoot and the contralateral foot was calculated. Motion quality was evaluated by the Clubfoot Assessment Protocol (CAP). Student’s t test, the Mann–Whitney U test and Spearman’s correlation were used for group comparisons. Bonferroni correction was used when multiple comparisons were performed.

Results

Clubfeet were smaller (P < 0.001) than reference feet at all ages but had a similar growth rate up to age 7. Unilateral clubfeet with greater difference in size compared with the contralateral foot at the first measurement, relapsed more frequently (P = 0.016) and correlated with poorer motion quality (r = 0.4; P = 0.011).

Conclusions

As previously reported, clubfeet were smaller than reference feet at all ages. The growth rate, however, was similar between clubfeet and reference feet. Children with unilateral clubfeet and greater foot length difference at 2 years of age had a higher tendency to relapse and poorer motion quality at 7 years of age, indicating that foot length could be used as a prognostic tool.
Implementing enhanced patient care to promote patient engagement in HIV care in a rural setting in Kenya
Authors: Wachira Juddy , Genberg Becky , Chemutai Diana , Mwangi Ann , Galarraga Omar , Abraham Siika , Wilson Ira
Published: May 2021

Background

Patient engagement is effective in promoting adherence to HIV care. In an effort to promote patient-centered care, we implemented an enhanced patient care (EPC) intervention that addresses a combination of system-level barriers including provider training, continuity of clinician-patient relationship, enhanced treatment dialogue and better clinic scheduling. We describe the initial implementation of the EPC intervention in a rural HIV clinic in Kenya, and the factors that facilitated its implementation.

Methods

The intervention occurred in one of the rural Academic Model Providing Healthcare (AMPATHplus) health facilities in Busia County in the western region of Kenya. Both qualitative and quantitative data were collected through training and meeting proceedings/minutes, a patient tracking tool, treatment dialogue and a peer confirmation tool. Qualitative data were coded and emerging themes on the implementation and adaptation of the intervention were developed. Descriptive analysis including percentages and means were performed on the quantitative data.

Results

Our analysis identified four key factors that facilitated the implementation of this intervention. (1) The smooth integration of the intervention as part of care that was facilitated by provider training, biweekly meetings between the research and clinical team and having an intervention that promotes the health facility agenda. (2) Commitment of stakeholders including providers and patients to the intervention. (3) The adaptability of the intervention to the existing context while still maintaining fidelity to the intervention. (4) Embedding the intervention in a facility with adequate infrastructure to support its implementation.

Conclusions

This analysis demonstrates the value of using mixed methods approaches to study the implementation of an intervention. Our findings emphasize how critical local support, local infrastructure, and effective communication are to adapting a new intervention in a clinical care program.
Risk factors and clinical relevance of positive urine cultures in cats with subcutaneous ureteral bypass
Authors: Deprey Julie , Baldinger Arnaud , Livet Véronique , Blondel Margaux , Taroni Mathieu , Lefebvre Cynthia , Goy-Thollot Isabelle , Moissonnier Pierre , Viguier Éric , Pouzot-Nevoret Céline , Carozzo Claude , Cachon Thibaut
Published: May 2021

Background

The objective of the study was to report the incidence and risk factors associated with positive urine bacterial cultures as well as long-term outcome in cats with subcutaneous ureteral bypass (SUB) devices.

Results

Medical records of cats that underwent SUB device placement were retrospectively reviewed. Signalment of the cat, laterality of the ureteral obstruction, surgery, anesthesia and hospitalization duration, bacterial culture results and follow-up data were retrieved.

Thirty-two cats met the inclusion criteria. Four cats (12.5%) had a positive intraoperative culture, with two of them being treated successfully. Ten cats out of 28 (35.7%) were documented with a positive urine culture during follow-up period, with a median time between discharge and identification of the first positive urine culture of 159 days (range 8–703 days). Bacteriuria resolved in 60% of cats (6/10).Escherichia coliwas the most common organism, isolated in 4 out of 10 postoperative urine cultures. Overall, subclinical bacteriura was documented for 6 of 32 (18.8%) cats and 5 of 32 (15.6%) cats displayed clinicals signs suggestive of persistent UTI. One cat had subclinical bacteriuria. Three cats died during the follow-up period.

There was a significant difference between negative and positive urine bacterial culture groups in median hospitalization duration (5 days versus 6 days,P = 0.022) and in median body condition score (5/9 versus 4/9,P = 0.03). Cats with a longer hospital stay and with a lower body condition score were more likely to have a positive urine culture during follow-up period.

Conclusions

SUB device placement surgery is associated with complications such as chronic bacteriuria. Bacteriuria in our study resolved with appropriate antibiotic treatment in more than half of cats. Risk factors identified for positive urine culture were a longer hospitalization duration and a decreased body condition score.