bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Marriage and Its Determinants among Married Reproductive Age Group Women in Amhara Regional State, Ethiopia: A Multilevel Analysis
Authors: Aychiluhm Setognal Birara , Tesema Ayenew Kassie , Tadesse Abay Woday
Published: March 2021

Introduction. Amhara region has one of the highest rates of female child early marriage in Ethiopia, with eighty percent of girls in the region being married at the age of eighteen. Therefore, this study was intended to assess the prevalence and determinants of early marriage among women, in Amhara regional state. Methods. The data were extracted from the 2016 Ethiopian Demographic and Health Survey. The study included a sample of 2887 (weighted) married women from 645 clusters in Amhara regional state. The data were collected using a two‐stage cluster design that includes the selection of enumeration areas as a first stage and selection of households as a second stage. A multilevel logistic regression model was fitted to determine the individual and community‐level factors associated with early marriage. Result. The study revealed that 73% [95% CI 71.38, 74.62] of women aged 15–49 years were married before 18 years old. In the multilevel multivariable model; living as a rural dweller (AOR = 4.33; 95% CI: 2.17, 8.64), no education (AOR = 2.52; 95% CI: 2.23, 9.51), attending only primary education (AOR = 2.31; 95% CI: 1.68, 8.53), parental decision‐maker when to get marriage (AOR = 3.44; 95% CI: 2.20, 5.39), being poorer (AOR = 1.38; 95% CI: 1.16, 4.83), and poorest wealth status (AOR = 2.37; 95% CI: 2.19, 7.83) were the independent predictors of early marriage. Conclusion. The prevalence of early marriage was high in Amhara region compared to other regions of the country. Therefore, the regional government should give due attention to access to education and encourage women’s decision‐making power upon the time of marriage especially those residing in rural parts of the region.
Marshall–Olkin Alpha Power Weibull Distribution: Different Methods of Estimation Based on Type‐I and Type‐II Censoring
Authors: Almetwally Ehab M. , Sabry Mohamed A. H. , Alharbi Randa , Alnagar Dalia , Mubarak Sh. A. M. , Hafez E. H.
Published: March 2021

This paper introduces the new novel four‐parameter Weibull distribution named as the Marshall–Olkin alpha power Weibull (MOAPW) distribution. Some statistical properties of the distribution are examined. Based on Type‐I censored and Type‐II censored samples, maximum likelihood estimation (MLE), maximum product spacing (MPS), and Bayesian estimation for the MOAPW distribution parameters are discussed. Numerical analysis using real data sets and Monte Carlo simulation are accomplished to compare various estimation methods. This novel model’s supremacy upon some famous distributions is explained using two real data sets and it is shown that the MOAPW model can achieve better fits than other competitive distributions.
Theoretical Research and Numerical Simulation on Water Resistance Mechanism of Textile Bag in Water Passage
Authors: Li Ang , Yang Yuxuan , Zhu Mingcheng , Zhang Wenzhong , Ji Bingnan , Ding Xuesong
Published: March 2021

It is an important problem in the mine water disaster prevention and control to control the large passage moving water. Traditional grouting technology is to put coarse aggregate and fine aggregate downward first and then grouting treatment. But the aggregate and cement flow distance is long, consumption is large, cost is high, and easy to appear secondary water inrush. Centering on the technical difficulties in the rapid construction of the blocking body of the moving water passage, a water-blocking textile bag was invented. The purpose of blocking the tunnel water inrush was achieved by grouting inside the bag body, which fundamentally realized the rapid blocking of the large passage through water under the condition of moving water. However, the mechanism, water plugging law, and design parameters of water blocking roadway with textile bag are still unclear. In this paper, the slip law and stability of the textile bag in the moving water and the deformation characteristics caused by the dynamic water pressure are theoretically analyzed and simulated. Through theoretical analysis, the ultimate antihydraulic stress value of a textile bag of a certain specification is calculated, and the parameters of the textile bag that affect the stability of the bag body are also determined. Xflow was used for numerical simulation analysis to study the deformation characteristics of the textile bag under water and the law of water barrier. The simulation analysis focuses on the water resistance effect and flow field distribution characteristics of the textile bag in the water passage under the condition of low flow rate and low pressure, as well as the stability and self-deformation characteristics of the textile bag under the condition of high flow rate and high pressure. The accuracy of the limit resistance to water pressure of the textile bag obtained from theoretical analysis is verified. The results show that the theoretical analysis is consistent with the simulation results. The textile bag can realize the fast controllable plugging of the large water passage of moving water within the limit of the antihydraulic stress.
An LMI Approach-Based Mathematical Model to Control Aedes aegypti Mosquitoes Population via Biological Control
Authors: Dianavinnarasi J. , Raja R. , Alzabut J. , Niezabitowski M. , Selvam G. , Bagdasar O.
Published: March 2021

In this paper, a novel age-structured delayed mathematical model to control Aedes aegypti mosquitoes via Wolbachia-infected mosquitoes is introduced. To eliminate the deadly mosquito-borne diseases such as dengue, chikungunya, yellow fever, and Zika virus, the Wolbachia infection is introduced into the wild mosquito population at every stage. This method is one of the promising biological control strategies. To predict the optimal amount of Wolbachia release, the time varying delay is considered. Firstly, the positiveness of the solution and existence of both Wolbachia present and Wolbachia free equilibrium were discussed. Through linearization, construction of suitable Lyapunov–Krasovskii functional, and linear matrix inequality theory (LMI), the exponential stability is also analyzed. Finally, the simulation results are presented for the real-world data collected from the existing literature to show the effectiveness of the proposed model.
Determination of Blood Glucose, Total Protein, Certain Minerals, and Triiodothyronine during Late Pregnancy and Postpartum Periods in Crossbred Dairy Cows
Authors: Mohammed Shima Essameldin , Ahmad Faisal Omer , Frah Ehab A. M. , Elfaki Imadeldin
Published: March 2021

The late pregnancy (3rd trimester) and the postpartum period (PPP) (calving date or day zero to day 45) are very critical periods for the fertility and production in dairy cows. This study was designed to investigate blood glucose, total protein (TP), calcium (Ca), phosphorus (P), magnesium (Mg), iron (Fe), and triiodothyronine (T3) during late pregnancy and the PPP. Twenty-seven apparently healthy multiparous crossbred dairy cows (Friesian × Kenana) were included in this study. The cows were randomly allocated into three groups: group A (n = 10), cows with late pregnancy, group B (n = 7), cows in the PPP, and group C (n = 10), nonpregnant cows as control. One-way ANOVA was used to analyze the data. The results of this study showed that blood glucose was higher in late pregnancy and the PPP than in nonpregnant cows. The TP was significantly lower in late pregnant cows than during the PPP and in nonpregnant cows. Ca, P, and Mg were not significantly different between periods. Serum Fe and T3 were significantly lower during the PPP than that in late pregnant and nonpregnant cows. The results can provide indications of the nutritional status of dairy cows and a diagnostic tool to avoid the metabolic disorders that may occur during late pregnancy and the PPP.
Relative Similarity Programming Model for Uncertain Multiple Attribute Decision-Making Objects and Its Application
Authors: Huang Zhili , Chen Qinglan , Chen Liu , Liu Qinyuan
Published: March 2021

This paper is concerned with the uncertain multiattribute decision-making (UMADM) of which the attribute value is triangular fuzzy number. Firstly, the max-relative similarity degree and min-relative similarity degree of alternative decision-making objects are given based on the relative similarity degree of triangular fuzzy number, the advantage relation theories to comparative relative similarity degree of triangular fuzzy number are proposed, and some good properties, relations, and conclusions are derived. Secondly, in order to determine the attribute weight vector, a triangular fuzzy number-based decision-making object relative similarity programming model is established with the help of maximizing possibility degree algorithm rules in the cooperative game theory. Subsequently, by aggregating the comparison overall relative similarity degree values of all decision-making objects, we could pick over and sort the set of alternative objects and gather a new model algorithm for the relative similarity programming of triangular fuzzy number-based multiple attribute decision-making alternatives. Finally, an example is given to illustrate the feasibility and practicability of the model algorithm presented in this paper.
Rapid Quantification of Chlorpromazine Residues in Pork Using Nanosphere-Based Time-Resolved Fluorescence Immunoassay Analyzer
Authors: Wang Wei , Wang Jingneng , Wang Min , Shen Juan
Published: March 2021

Immunochromatographic assays are good analytical tools for the detection of drug residues. We report a nanosphere-based time-resolved fluorescence immunoassay (nano-TRFIA) based on a monoclonal antibody and a portable TRFIA analyzer for the rapid quantification of chlorpromazine (CPZ) residues in pork. Under optimal conditions, the nano-TRFIA detected CPZ residues within 6 min of sample pretreatment. The results showed good linearity (R2 = 0.991), with a limit of detection (LOD) of 0.32 μg/kg, a wide dynamic range of 0.46–10.0 μg/kg, and coefficients of variation (CVs) of the overall intrabatch and interbatch assays of 7.34% and 7.65%, respectively. The nano-TRFIA was also used to detect CPZ at different spiked concentrations in pork, and the results were confirmed via ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The nano-TRFIA was evaluated for the analysis of six commercial pork samples, and the results agreed well with those obtained via UPLC-MS/MS, without significant differences (

P
>
0.05

). Therefore, the proposed nano-TRFIA is a powerful alternative for the rapid and accurate quantification of CPZ residues in pork to meet the required Chinese maximum residue limits for veterinary drugs in foods.
Congenital Adrenal Hyperplasia (CAH) and Gitelman Syndrome (GS): Overlapping Symptoms in an Uncommon Association
Authors: Calcaterra Valeria , Roberto Giulia , La Rocca Anna , Andrenacci Beatrice , Rossi Federico , Zuccotti Gian Vincenzo , Fabiano Valentina
Published: March 2021

Background. Classical salt-wasting (SW) congenital adrenal hyperplasia (CAH) and Gitelman syndrome (GS) are two genetic conditions in which dyselectrolytemia may occur. No association between the two conditions has been previously described. Case Presentation. We present the case of a boy with a neonatal diagnosis of SW-CAH who showed low potassium blood levels from the age of 15 years. This electrolytic alteration was, at first, attributed to an excessive action of mineralocorticoid drugs. Due to persistence of hypokalemia, SLC12A3 whole genome sequencing was performed, showing a heterozygous C to T base pair substitution at position 965 in gene SLC12A3. This mutation is related to Gitelman syndrome with autosomal recessive transmission. Conclusions. SW-CAH and GS determine opposite values of potassium in the absence of specific therapy, with a natural tendency to compensate each other. The symptom overlap makes diagnosis difficult. Organic causes of hypokalemia in patients undergoing life-saving therapy should not be excluded.
The Regulation of ROS‐ and BECN1‐Mediated Autophagy by Human Telomerase Reverse Transcriptase in Glioblastoma
Authors: Ding Xuelu , Nie Ziyang , She Zhaoyuan , Bai Xue , Yang Qiuhui , Wang Feng , Wang Fei , Geng Xin
Published: March 2021

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor with high morbidity and mortality. Human telomerase reverse transcriptase (hTERT), the catalytic subunit of human telomerase, is overexpressed in most cancers including GBM. It is well known that hTERT can compensate telomere shortening to immortalize cells. However, in addition to the canonical function, hTERT has the roles beyond canonical telomere maintenance. To further understand the effects of hTERT on glioblastoma progression, we investigated the role of hTERT in regulating autophagy—a conserved pathway, by which cells deliver cellular organic material and impaired organelles to the lysosomes for degradation and recycle these cargos to produce energy under a stressful condition. Our results showed that downregulation of hTERT impaired autophagy levels by suppressing BECN1/beclin‐1 and induced an increase of reactive oxygen species (ROS), which resulted in cell death ultimately. On the contrary, overexpression of BECN1 or treating cells with the antioxidant N‐acetylcysteine (NAC) could restore the survival of hTERT knockdown cells. Our study will provide an additional basis of telomerase‐targeting therapy for future clinical anticancer treatment.
Influence of Binder Types and Temperatures on the Mechanical Properties and Microstructure of Cemented Paste Backfill
Authors: Du Zhaowen , Chen Shaojie , Wang Sheng , Liu Rui , Yao Dehao , Mitri Hani S.
Published: March 2021

In order to study the influence of burial depth or fire on the core area of cemented paste backfill (CPB), the experiment of CPB with different types of binder and temperature was carried out. Three types of binders, red mud (RM), Portland cement (PC), and slag cement (SC), are used and tested at 20°C, 40°C, 60°C, and 80°C. The macroperformance and microstructural evolution of CPB are analyzed using slump, uniaxial compressive strength (UCS), X‐ray diffraction, and scanning electron microscopy (SEM). The results show that the coupled effects of binder type and temperature have a significant impact on the macroscopic performance and microstructural evolution of CPB. The CPB slump prepared with three types of binder meets the production requirement of the mine. Regardless of curing temperature and curing time, the uniaxial compressive strength of CPB samples with PC and SC is much higher than that of CPB samples with red mud. When cured for 12 hours, the uniaxial compressive strength of CPB samples containing PC and SC increases first, then decreases, and finally increases again with the increase of temperature. However, with the increase of temperature, the uniaxial compressive strength of CPB samples containing RM only increases first and then decreases. When the curing temperature is less than 40°C, the main reason for the increase in UCS was attributed to the fact that the temperature increase accelerates the hydration reaction and improves the density of the sample. When the curing temperature is 60°C, the main reason for the decrease in UCS is the formation of the expansive ettringite (AFt) which destroys the internal spatial structure of the sample. When the curing temperature is 80°C, the UCS increases again due to the fact that such high temperature can destroy the crystal structure of AFt and harden the hydration product C‐S‐H gel.
Challenges in Medicine: The Odyssey of a Patient with Isolated IgG4-Related Eosinophilic Angiocentric Fibrosis Presenting as a Locally Destructive Sinonasal Mass
Authors: Nutalapati Snigdha , O’Neal Richard , O’Connor William , Comer Brett T. , Hildebrandt Gerhard C.
Published: March 2021

Eosinophilic angiocentric fibrosis (EAF) is an exceeding rare clinical entity and is considered a part of the spectrum of IgG4-related disease (IgG4RD). We hereby present such an unusual case of a 60-year-old female who presented to us with recurrent sinonasal mass, after a decade long haul of multiple clinical evaluations, biopsies, and debulking surgery without a definitive diagnosis. Over this period, the mass eroded through the ethmoid cells along with nasal septal destruction leading to saddle nose deformity, extended superiorly through the cribriform plates to right frontal lobe, and compressed the optic nerve leading to visual loss. Although initial biopsy was negative, repeat biopsy was performed owing to high clinical suspicion due to all the classic histopathological findings compatible with the diagnosis of eosinophilic angiocentric fibrosis IgG4-related disease (EAF-IgG4RD). Steroids are the recommended first-line therapy; however, our case was resistant to steroids needing rituximab to halt the disease progression. Our case interestingly also had T-cell clonality and isolated isocitrate dehydrogenase 2 enzyme mutation on next-generation sequencing, suggesting a possible role of novel molecular-targeted therapies in this rare disease. This case highlights the clinical challenges physicians face towards diagnosing and treating EAF-IgG4RD, emphasizing the need for high clinical suspicion and the possible role of targeted therapies for this rare disease.
Sucrose-Sweetened Drinks Reduce the Physical Performance and Increase the Cardiovascular Risk in Physically Active Males
Authors: Baleeiro Raianne dos Santos , Guimarães Aparecida Patricia , Souza Perciliany Martins de , Andrade Rafael da Silva , Barbosa de Queiroz Karina , Coelho Daniel Barbosa , Oliveira Emerson Cruz de , Becker Lenice Kappes
Published: March 2021

Introduction. The intake of sugar-sweetened beverages (SSBs) has increased rapidly, but the effects of this habit on health and physical performance are unknown. This study assessed the effect of excessive SSB intake on biochemical, physical performance, and biochemical and cardiovascular parameters of physically active males. Methods. Seventeen volunteers consumed a placebo drink (Pd; carbohydrate free) and an excessive SSB drink (eSSBd = Pd plus 300 g sucrose). In a blind randomized crossover study, the subjects were assigned to Pd or eSSBd groups for 15 days. After an interval of 7 days, subjects were reassigned to the other condition. Results. After eSSBd intake, there was an increase in weight (69.34 ± 13.71 vs. 70.62 ± 14.06), body mass index (24.49 ± 4.01 vs. 24.97 ± 4.13), waist circumference (75.33 ± 11.22 vs. 76.79 ± 11.51), VLDL (19.54 ± 9.50 vs. 25.52 ± 11.18), triglycerides (78.94 ± 23.79 vs. 114.77 ± 43.65), and peak systolic blood pressure (178.57 ± 26.56 vs. 200.71 ± 24.64). The cardiorespiratory response to exercise (VO2max) (48.15 ± 10.42 vs. 40.98 ± 11.20), peak heart rate (186.64 ± 8.00 vs. 179.64 ± 6.28), total exercise time (15.02 ± 1.57 vs. 14.00 ± 2.18), and mechanical work (15.83 ± 4.53 vs. 13.68 ± 5.67) decreased after eSSBd intake (all values expressed in initial mean ± DP vs. final). The rates of perceived exertion were higher (1.300 vs.1.661 slope and −0.7186 vs. −1.118 y-intercept) after eSSBd intake. Conclusion. The present study shows that 15 days of eSSBd intake may negatively modulate biochemical parameters associated with cardiovascular risk. In addition, this overintake can impair the physical performance and cardiovascular responses to physical exercise.
Evolutionary Game Analysis of Information Sharing in Fresh Product Supply Chain
Authors: Li Yanhui , Xu He , Zhao Yan
Published: March 2021

Fresh produce has increasingly become an important part of people’s diet. However, the loss of fresh produce in the supply chain has existed for a long time and is difficult to overcome. Some companies use their own information management systems or use information systems built by other companies to release and manage fresh agricultural product information in a timely manner, thereby reducing product loss caused by the “bullwhip effect.” However, this will also bring pressure on construction costs and the risk of information leakage. Based on the evolutionary game model, this paper conducts process modeling and analysis on the behavior of enterprise groups participating in information sharing. It is concluded that the greater the difference between the income obtained through information sharing and the cost of building information system, the higher the likelihood of enterprises participating in information sharing. In addition, the greater the profit from the construction of information platform, the smaller the profit of “free rider,” and the smaller the risk of information leakage, the greater the enthusiasm of enterprises to participate in information sharing. Finally, some suggestions are proposed from the perspective of maximizing supply chain benefits.
An Application of ANN Ensemble for Estimating of Precipitation Using Regional Climate Models
Authors: Jang Dongwoo
Published: March 2021

Climate change scenarios are used for predicting future precipitation. More detailed regional climate change scenarios are being used through dynamic downscale based on global circulation model results. There is a global tendency to utilize simulated precipitation data from downscaled regional climate models (RCMs) suitable for each country. In Korea, there are studies for improving the accuracy of climate change scenario precipitation forecasts compared with observed precipitation. In this study, the precipitation of five regional climate models and actual observed precipitation provided in Korea are applied to ANN (artificial neural network), which suggests ways to improve prediction accuracy for precipitation. The ANN ensemble of RCMs simulates the actual observed precipitation more accurately than the individual RCM. In particular, it is more effective inland than in coastal areas, where precipitation patterns are complex. Pearson correlation coefficient of ANN is high as 0.04 compared with MRA. It is expected that more detailed analysis will be possible if it is applied not only to four cities but also to other regions in Korea. If observed precipitation data are collected in sufficient quantity, the applicability of the ANN model will widen.
Risk Factors for Acute Coronary Syndrome in Upper Gastrointestinal Bleeding Patients
Authors: Chi Tianyu , Zhao Quchuan , Wang Peili
Published: March 2021

Background. Upper gastrointestinal bleeding (UGIB) is a common critical disease with a certain fatality rate. Acute coronary syndrome (ACS), another critical ill condition, is a regular occurrence in the UGIB. We identified risk factors for ACS in UGIB. Methods. 676 patients diagnosed with UGIB were enrolled retrospectively. We assessed the occurrence of ACS in UGIB patients and identified the risk factors for ACS by logistic regression analysis and random forest analysis. Results. After propensity score matching (PSM), the ACS group (n=69) and non-ACS group (n=276) were analyzed. Logistic regression analysis showed that syncope (P=0.001), coronary heart disease history (P=0.001), Glasgow Blatchford score (P≤0.001), Rockall risk score (P=0.004), red blood cell distribution width (RDW) (P≤0.001), total bilirubin (TBil) (P=0.046), fibrinogen (P≤0.001), and hemoglobin (P=0.001) had important roles in ACS patients. With Mean Decrease Gini (MDG) sequencing, fibrinogen, RDW, and hemoglobin were ranked the top three risk factors associated with ACS. In ROC analysis, fibrinogen (AUC=0.841, 95% CI: 0.779-0.903) and RDW (AUC=0.826, 95% CI: 0.769-0.883) obtained good discrimination performance. According tosensitivity>80%, the pAUC of fibrinogen and RDW were 0.077 and 0.101, respectively, and there was no significant difference (P=0.326). However, according tospecificity>80%, the pAUC of fibrinogen was higher than that of RDW (0.126 vs. 0.088,P=0.018). Conclusion. Fibrinogen and RDW were important risk factors for ACS in UGIB. Additionally, combination with coronary heart disease, syncope, hemoglobin, and TBil played important roles in the occurrence of ACS. Meanwhile, it was also noted that Rockall score and Glasgow Blatchford score should be performed to predict the risk.
Impacts of Sea Surface Temperature and Atmospheric Teleconnection Patterns in the Northern Mid-Latitudes on Winter Extremely Cold Events in North China
Authors: Li Liping , Ni Wenjie , Li Yige , Guo Dong , Gao Hui
Published: March 2021

The frequency distribution of winter extreme cold events (ECEs) in North China and the influences of mid-latitude sea surface temperature anomalies (SSTAs) in the Northern Hemisphere are studied. The results show that (1) the frequency of single station ECEs (SSECEs) in winter increases from southeast to northwest, with a decrease before 2008 and then a significant increase. This trend abrupt change occurs in late winter. (2) When the SST in the North Pacific shows an “El-Niño-like” anomaly in winter, it triggers the negative Arctic Oscillation (−AO), positive Pacific North America (+PNA), and positive Eurasia Pacific (+EUP) atmospheric teleconnection patterns in the mid-lower troposphere. As a result, the ridge to south of Lake Baikal becomes stronger. Meanwhile, SST in the North Atlantic shows a “reversed C” negative anomaly with North Atlantic Oscillation (+NAO), (+PNA)-like and (+EUP)-like patterns, and the ridge to southwest of Lake Baikal becomes stronger. Furthermore, both cause the Siberian High to become weaker in the north and stronger in the south. With the weaker East Asia subtropical jet and stronger East Asia winter monsoon, these factors lead to a significant increase of SSECE frequency in North China. (3) When the SSTA shows an “El Niño-like” developing pattern from summer to autumn in the North Pacific, the winter SSECE frequency will be higher. (4) The purported mechanism between the mid-latitude SSTA and the winter SSECE frequency in North China is the following: the SSTA in the North Pacific in summer and autumn excites atmospheric teleconnection wave trains, and the Atlantic stores these anomaly signals. In winter, the interaction between the SSTAs in the North Pacific and the North Atlantic enhances the Eurasian teleconnection wave train. With the upstream fluctuation energy dispersing downstream, the wave train centers move eastward with the season, resulting in an increase in the frequency of the SSECEs.
Oral Hygiene Practices, Knowledge, and Self-Reported Dental and Gingival Problems with Rural-Urban Disparities among Primary School children in Lilongwe, Malawi
Authors: Mlenga F. , Mumghamba E. G.
Published: March 2021

Aim. To determine oral hygiene practices, knowledge, and experience of dental caries and gingival problems among urban and rural primary schoolchildren in Lilongwe District, Malawi. Methodology. This was an analytical and quantitative descriptive cross-sectional study. Four urban and four rural primary schools were conveniently sampled. Pupils aged 11–14 years (n = 409) were recruited using self-administered structured questionnaire. Data were analyzed using SPSS program v20.0. Results. Out of 409 pupils, most of them had knowledge that dental caries is caused by consumption of sugary foodstuffs (91.4%), toothache is a symptom of dental caries (77.6%), gingivitis is caused by ineffective tooth brushing (92.7%), and gingival bleeding is a sign of gingivitis (85.3%). Most pupils experienced toothache (30.8%); many of them had parents with secondary education and above (35.0%) compared to those with primary education (23.5%). 24.4% experienced gingival bleeding with higher percentages from urban (30.1%) than rural (18.5%) schools. Plastic toothbrush users (95%) overshadowed chewing stick users (24.9%). The use of chewing stick was significantly higher in rural (49%) than in urban (1.9%) schools. Likewise, tooth brushing before bed was significantly higher in rural (33%) than in urban (17.2%) pupils. The use of toothpaste during tooth brushing was significantly higher among urban (91.9%) than among rural (64%) pupils. The prevalence of tongue cleaning was 70.2%, and the differences were significantly higher among pupils who had parents with secondary and higher education in urban schools and among pupils aged 11–12 years in comparison with their counterparts. Conclusions. Most pupils reported cleaning their teeth regularly, mostly using plastic toothbrush rather than chewing stick, using toothpaste, and having adequate knowledge about dental caries and gingival disease, and a quarter of them had suffered from these diseases with evidence of rural-urban disparities. Integration of oral health in school health promotion program and further research on its impact on oral health status are recommended.
Laboratory Investigation on Particle Breakage Characteristics of Calcareous Sands
Authors: Chen Qingsheng , Peng Wan , Yu Ronghu , Tao Gaoliang , Nimbalkar Sanjay
Published: March 2021

Many studies have demonstrated the fragility of calcareous sands even under small stresses. This bears an adverse influence on their engineering properties. A series of laboratory tests were carried out on poor‐graded calcareous sands to investigate the crushability mechanism. Einav’s relative breakage and fractal dimension were used as the particle breakage indices. The results show that the particles broke into smaller fragments at the low‐stress level by attrition which was caused by friction and slip between particles. In contrast, particles broke in the form of crushing at the relatively higher stresses. The evolution of the particle size was reflected by the variation in Einav’s relative breakage and fractal dimension. As testing commenced, the breakage index rapidly increased. When the stress was increased to 400 kPa, the rate of increase in the breakage index was retarded. As the stress was further increased beyond 800 kPa, the rate of increase in the fractal index became much smaller. This elucidated that the well‐graded calcareous sands could resist crushing depending on the range of applied stresses. Based on the test findings, a new breakage law is proposed.
Ximenia americana: Economic Importance, Medicinal Value, and Current Status in Ethiopia
Authors: Kefelegn Getachew Amare , Desta Bizuayehu
Published: March 2021

Ximenia americana is one of the most valuable wild edible plants in the world. In different countries, it is utilized as food, medicine, an essential oil source, and the industrial component to other products. In Ethiopia, it was one of the most known and very important plants for a long period of time. It was utilized as food, a medicinal plant, and animal feed. It was also one of the most economically important and culturally valuable plants. But nowadays, it is not adequately available in the country due to deforestation problem in the years. In addition, its economic importance, current status, and medicinal roles are not well documented and understood. As for research studies, it is concluded that unless a collective effort is taken, the existence of this plant is under severe threat and needs to have some measures. This review article is aimed at addressing the abovelined topics in detail and to pinpoint and explain the importance and status of Ximenia americana.
Investigation on the Stability of Fissured Slopes Reinforced with Anchor Cables under Seismic Action
Authors: Zhang Jingwu , Li Mingdong , Yi Jinxiang , Liu Zhidan
Published: March 2021

Based on the upper bound theorem of limit analysis (UBLA) combined with the pseudostatic methods, this paper elaborates on a calculated procedure for evaluating fissured slope stability under seismic conditions reinforced with prestressed anchor cables. An existing simple slope case is presented as a case study in this work. The comparison is given to verify that the solution derived from this study is correct and feasible. By means of a numerical optimization procedure, the critical location of the crack is determined from the best upper bound solutions. The results demonstrate a significant influence of the depth of crack and seismic acceleration coefficient on the critical location distribution of the cracks. Meanwhile, the axial force of anchor cables is investigated via parametric studies. It is shown that the variation of the crack depth has little effect on the axial force of anchor cables. Moreover, this paper also illustrates the variation in the axial force of anchor cables under the impact of five marked factors (crack depth, anchor arrangement, anchor inclination angle, slope angle, and seismic conditions). Finally, the required critical length of the free section of anchor cables is determined to ensure the stability of fissured slopes subjected to seismic action.
Hypothermia Effectively Treats Tumors with Temperature-Sensitive p53 Mutations
Authors: Lu Junhao , Chen Lihong , Song Zheng , Das Mousumi , Chen Jiandong
Published: March 2021

The p53 tumor suppressor is frequently inactivated by mutations in cancer. Most p53 mutations are located in the DNA-binding domain, causing local disruption of DNA-binding surface or global misfolding. Rescuing the structural defect of mutant p53 is an attractive therapeutic strategy, but its potential remains unproven due to a lack of drugs capable of efficiently rescuing misfolded p53. Although mutant p53 in tumors is inactive at 37°C, approximately 15% are temperature sensitive (ts) and regain DNA-binding activity at 32°C to 34°C (ts mutants). This temperature is achievable using a therapeutic hypothermia procedure established for resuscitated cardiac arrest patients. To test whether hypothermia can be used to target tumors with ts p53 mutations, the core temperature of tumor-bearing mice was lowered to 32°C using the adenosine A1 receptor agonist N6-cyclohexyladenoxine that suppresses brain-regulated thermogenesis. Hypothermia treatment (32 hours at 32°C × 5 cycles) activated endogenous ts mutant p53 in xenograft tumors and inhibited tumor growth in a p53-dependent fashion. Tumor regression and durable remission in a ts p53 lymphoma model was achieved by combining hypothermia with chemotherapy. The results raise the possibility of treating tumors expressing ts p53 mutations with hypothermia.

Significance:

Pharmacologic inhibition of brain-regulated thermogenesis and induction of 32°C whole-body hypothermia specifically targets tumors with temperature-sensitive p53 mutations, rescuing p53 transcriptional activity and inducing tumor regression.

See related commentary by Hu and Feng, p. 3762
Clinical Findings and Diagnostic Yield of Arrhythmogenic Cardiomyopathy Through Genomic Screening of Pathogenic or Likely Pathogenic Desmosome Gene Variants
Authors: Carruth Eric D. , Beer Dominik , Alsaid Amro , Schwartz Marci L.B. , McMinn Megan , Kelly Melissa A. , Buchanan Adam H. , Nevius Christopher D. , Calkins Hugh , James Cynthia A. , Murray Brittney , Tichnell Crystal , Matsumura Martin E. , Kirchner H. Lester , Fornwalt Brandon K. , Sturm Amy C. , Haggerty Christopher M.
Published: March 2021

Background:

Genomic screening holds great promise for presymptomatic identification of hidden disease, and prevention of dramatic events, including sudden cardiac death associated with arrhythmogenic cardiomyopathy (ACM). Herein, we present findings from clinical follow-up of carriers of ACM-associated pathogenic/likely pathogenic desmosome variants ascertained through genomic screening.

Methods:

Of 64 548 eligible participants in Geisinger MyCode Genomic Screening and Counseling program (2015–present), 92 individuals (0.14%) identified with pathogenic/likely pathogenic desmosome variants by clinical laboratory testing were referred for evaluation. We reviewed preresult medical history, patient-reported family history, and diagnostic testing results to assess both arrhythmogenic right ventricular cardiomyopathy and left-dominant ACM.

Results:

One carrier had a prior diagnosis of dilated cardiomyopathy with arrhythmia; no other related diagnoses or diagnostic family history criteria were reported. Fifty-nine carriers (64%) had diagnostic testing in follow-up. Excluding the variant, 21/59 carriers satisfied at least one arrhythmogenic right ventricular cardiomyopathy task force criterion, 11 (52%) of whom harbored
DSP
variants, but only 5 exhibited multiple criteria. Six (10%) carriers demonstrated evidence of left-dominant ACM, including high rates of atypical late gadolinium enhancement by magnetic resonance imaging and nonsustained ventricular tachycardia. Two individuals received new cardiomyopathy diagnoses and received defibrillators for primary prevention.

Conclusions:

Genomic screening for pathogenic/likely pathogenic variants in desmosome genes can uncover both left- and right-dominant ACM. Findings of overt cardiomyopathy were limited but were most common in
DSP
-variant carriers and notably absent in
PKP2
-variant carriers. Consideration of the pathogenic/likely pathogenic variant as a major criterion for diagnosis is inappropriate in the setting of genomic screening.
Benefit of Transcatheter Aortic Valve Replacement in Patients With Paradoxical Low-Flow Low-Gradient Versus High-Gradient Aortic Stenosis and Preserved Left Ventricular Function
Authors: Mosleh Wassim , Amer Mostafa R. , Ding Yuewen , Megaly Michael , Mather Jeffrey F. , McMahon Sean , Pershad Ashish , McKay Raymond G. , Arora Bhaskar
Published: March 2021

Background:

There is conflicting data regarding transcatheter aortic valve replacement in patients with paradoxical low-flow, low-gradient aortic stenosis (pLFLG-AS). The authors aimed to examine the hemodynamic and clinical benefit of transcatheter aortic valve replacement in symptomatic patients with pLFLG-AS compared with high-gradient severe AS.

Methods:

A single-center retrospective analysis of patients who underwent transcatheter aortic valve replacement using a transfemoral approach was performed. Patients with a mean gradient ≥40 mm Hg were included in the high-gradient aortic stenosis (HG-AS) group (n=217). Patients with mean gradient <40 mm Hg, Vmax <4.0 m/s, and stroke volume index ≤35 mL/m
2
were included in the pLFLG-AS group (n=73). Clinical end points including treatment futility, survival, changes in functional status and quality of life, and echocardiographic outcomes of left ventricular reverse remodeling were evaluated. Two primary composite outcomes were used for treatment futility. The first as a composite outcome defined as death or New York Heart Association class III/IV at 1 year. The second was a composite of death or Kansas City Cardiomyopathy Questionnaire 12 score of ≤25 at 1 year.

Results:

There were no differences in mortality, the Kansas City Cardiomyopathy Questionnaire-based treatment futility outcome (HG-AS: 8.8% versus pLFLG-AS: 6.1%;
P
=0.482), or New York Heart Association-based treatment futility outcome (HG-AS: 9.1% versus pLFLG-AS: 11.6%;
P
=0.546) at 1 year. Both groups had similar improvement in mean Kansas City Cardiomyopathy Questionnaire 12 score when compared to baseline (HG-AS: 88.56±12.38% versus pLFLG-AS: 137.24±31.75%;
P
=0.382). There was a similar relative interval decrease in the proportion of patients with New York Heart Association class III/IV (HG-AS: 53.6% versus pLFLG-AS: 55.1%;
P
=0.838). Echocardiographic evidence of reverse remodeling of the left ventricle in pLFLG-AS group was documented by improvements in global longitudinal strain (pre: −13.95±0.36% versus post: −14.83±0.38%,
P
=0.004) and stroke volume index at 30 days.

Conclusions:

pLFLG-AS did not confer a worse prognosis. Mortality rate and functional class improvement at 1 year was similar in both groups. Left ventricular reverse remodeling in the pLFLG-AS group was apparent.
Treatment of Varicose Veins Affects the Incidences of Venous Thromboembolism and Peripheral Artery Disease
Authors: Chang Shyue-Luen , Hu Sindy , Huang Yau-Li , Lee Mei-Ching , Chung Wen-Hung , Cheng Chun-Yu , Hsiao Yen-Chang , Chang Chee Jen , Lee Shu Ru , Chang Su-Wei , Wen Yu-Wen
Published: March 2021

Background:

Varicose veins are a common problem worldwide. Although it was reported that varicose veins have cosmetic and symptomatic effects and can also lead to an increased risk of incident deep venous thrombosis, pulmonary embolism, and peripheral artery disease, whether varicose vein treatment prevents those serious complications is unknown.

Methods:

This retrospective cohort study used claims data extracted from the Chang Gung Research Database and National Health Insurance Research Database in Taiwan. The study subjects were patients aged ≥20 years who underwent endovenous thermal ablation (ETA) from 2005 to 2016 and a group of untreated subjects who were matched by sex and year of birth. All patients were followed from the index date to the earliest occurrence of peripheral artery disease, deep venous thrombosis, or pulmonary embolism or death or the end of the study. To avoid possible selection bias, 1:4 propensity score matching was implemented and a Cox proportional-hazards model was applied while controlling for potential confounders. We also collected data on complications within 28 days of ETA.

Results:

In total, data on 1323 ETA-treated patients with varicose veins were extracted from the Chang Gung Research Database, while data on 149 586 untreated patients with varicose veins were extracted from the National Health Insurance Research Database. Compared with the untreated group, ETA-treated patients had decreased risks of deep venous thrombosis and peripheral artery disease (adjusted hazard ratio, 0.49 [95% CI, 0.32–0.75] and 0.64 [95% CI, 0.49–0.85]). The incidence rates of deep venous thrombosis and pulmonary embolism after ETA (≤28 days) were 0.296% and 0.074%, respectively.

Conclusions:

ETA treatment of varicose veins was associated with a substantial decrease in the subsequent incidence of thromboembolism and peripheral artery disease compared with that in the absence of treatment. In addition, the incidence rate of postprocedural thromboembolic complications after ETA was low in the Asian population. We suggest that improved disease awareness and appropriate early treatment may help reduce the risk of serious complications.
On Internal Onto-Genesis of Virtues in the Analects: A Conceptual Analysis
Authors: Cheng Chung-Ying
Published: March 2021

Confucius must have inspired his disciples to identify the process and structure of the human self and required self-cultivation in embodying and developing virtues within and practicing virtues as potential ways for its full self-realization. My discussion will be carried out through a conceptual and onto-hermeneutic analysis of the underlying self (ji
) structure and its born nature and mind as content as deliberated in the Lunyu (the Analects
). On the basis of this approach we will come to see how a moral psychology of virtues is founded and how such a moral psychology has implications for moral onto-generative metaphysics and onto-generative ethics.
Post-Secularity within Contemporary Chinese Philosophical Contexts
Authors: Pfister Lauren F.
Published: March 2021

Based on publications addressing post-secularity in international contexts, this article identifies four basic interpretive positions manifest within our post-secular age: resistant post-secular secularists, strategic post-secular secularists, engaged post-secular intellectuals, and engaged post-secular religious intellectuals. Subsequently, an article addressing governance and religious studies in mainland China published by Zhuo Xinping in 2010 is assessed, indicating how Zhuo serves as an engaged post-secular intellectual position, charging Chinese Marxist officials to adopt a strategic post-secular secularist position. Finally, it is shown how in a major volume on philosophical studies in China published in 2008 by Li Jingyuan a strategic post-secularist position is manifest.
Names, Cranes, and the Later Moists
Authors: Robins Dan
Published: March 2021

The Later Moists grounded our linguistic abilities in our ability to distinguish between kinds on the basis of manifest similarities and differences among things. Proper names, however, require a different treatment. According to the Moists, when we use a proper name, we borrow a word for one kind of thing and use it to refer to something else, as when we name dogs “crane.”This view probably responds in part to arguments that the possibility of using any word to refer to any thing threatens the stability of language. Proper names may borrow from terms with existing uses, but arguably they do not thereby undermine those uses.
World Humanities and Self-Reflection of Humanity: A Confucian-Neo-Confucian Perspective
Authors: Cheng Chung-Ying
Published: March 2021

This article presents and develops Zhu Xi’s Neo-Confucian theory of heart-mind-will and human nature as the source and basis for the understanding of humanity. This article next shows how Kant and Confucius could be said to share the same vision of humanity in light of one particular historical connection between them. Finally, I have explored four forms of knowledge in light of a distinction between feeling and observation as well as their basic unity. This gives rise to our vision of humanity as world-rooted, and so indicates further how it can serve as a grounding for world-humanities.
Orality and the Transmission of Interpretations in Two Versions of Huang Kan’s Lunyu Yishu: Teaching Lunyu from the National University of the Liang to the Periphery of the Tang Empire
Authors: Fuehrer Bernhard
Published: March 2021

This article explores the received version of Huang Kan’s (488–545) Lunyu Yishu and a Tang manuscript fragment that stems from it, with a view to investigating residues of the oral transmission of glosses and interpretations of the Lunyu (the Analects). The discussion is based on close readings of passages that display remnants of the oral transmission of interpretations and attest to pedagogical techniques applied by Huang Kan during the Liang Dynasty (502–557) and by an unknown tutor in Dunhuang toward the end of the Tang Dynasty (618–907). The two versions of the Lunyu Yishu are read as texts of oral utterances that bear evidence of two distinct layers of recognizable oral vestiges.
How to Say What Cannot be Said: Metaphor in the Zhuangzi
Authors: Allinson Robert Elliott
Published: March 2021

I argue that it is only on the condition of a preconceptual understanding that Zhuangzi’s metaphors can be cognitive. Kimchong Chong holds that the choice between metaphors as noncognitive and cognitive is a choice between Allinson and Davidson. Chong’s view of metaphors possessing multivalence is reducible to Davidson’s choice, because there is no built-in parameter between multivalence and limitless valence. If Zhuangzi’s metaphors were multivalent, the text would be subject to infinite interpretive viewpoints and the logical consequence of relativism. It is only if metaphors are cognitive that the text of the Zhuangzi can convey the message of transcendent freedom.
Trade and Emerging Technologies
Authors: Whang Cindy
Published: March 2021

Export controls are domestic trade restrictions placed on technologies that have been determined to be important to the national security concerns of a country. In recent years, the policy purpose for maintaining export control regulations have shifted, and how these new export control regulations would interact with new emerging technologies is something that should be analyzed and considered. The passage of the United States (US) Export Control Reform Act (ecra) of 2018 and the proposed regulatory changes for the European Union’s (EU) Council Regulation (ec) No. 428/2009 have shifted the focus of dual-use export controls so that the national security goals of these controls have broadened to include economic security and human rights concerns. This paper argues that the infusion of geoeconomics into US national security considerations and the proposed expansion to include human rights considerations into EU export control regulations are made mutually exclusive of each other and were not made to expand the reach of export controls in a unifying way. Rather, the purpose and structural change to export control regulations serves to create more regulatory barriers on the trade of emerging technology industries that would not only impact the US and the EU, but also their international trading partners.