bluuebunny/crossref_metadata_2025 huggingface dataset:
Prominent Hyperproinsulinemia in a Middle Age Patient
Authors: Yoshino Hiroshi , Kawakami Kyoko , Yoshino Kei , Yoshino Gen
Published: September 2021

Introduction:

Insulin is synthesized in the β-cells from preproinsulin. Preproinsulin becomes proinsulin after leaving the signal peptide. Proinsulin is separated into C-peptide and insulin by 2 enzymes. Hyperproinsulinemia is suspected to be a pancreatic β-cell defect that is augmented by the increased demand placed on the β-cell by hyperglycemia.

Case presentation:

A 39-year-old Japanese man visited to Shin-suma hospital in May 2013. Liver dysfunction, dyslipidemia, and hyperuricemia had been found in medical checkups in his workplace. Therefore, he visited Shin-suma hospital in order to receive intensive examination. Diet and exercise therapy were initiated. In November 2013, intact proinsulin and proinsulin per insulin (PI/I) ratio were evaluated as part of an ongoing study. His intact proinsulin level and PI/I ratio were markedly elevated. A 75 g oral OGTT revealed that his glucose tolerance was impaired. His glycosylated hemoglobin was 6.9%. He was diagnosed as having type 2 diabetes mellitus. Although, diet and exercise therapy continued, his hyperproinslinemia and diabetes mellitus remained. Therefore, aloguliptin was started in order to recover insulin secretion in November 2014. Thereafter, pioglitazone was added to improve insulin resistance. Finally, luseogliflozin was commenced to expect glucose-lowering effects. His HbA1c was stabilized. To the best of our knowledge, there have been few reports of patients with hyperproinsulinemia.

Conclusion:

When the physicians face treatment resistance in diabetes mellitus, we emphasize that evaluation of proinsulin should be considered as one of the methods.
Fabrication of flapping-wing micromechanism assembly using selective laser melting and aerodynamic performance measures
Authors: Ganesan Surendar , Esakki Balasubramanian , Yang Lung-Jieh , Rajamani D , Silambarsan M , Raghunath Karthik
Published: September 2021

The development of a flapping wing microaerial vehicle mechanism with a high strength-to-weight ratio to withstand high flapping frequency is of significant interest in aerospace applications. The traditional manufacturing methods such as injection moulding and wire-cut electrical discharge machining suffer from high cost, labour intensiveness, and time-to-market. However, the present disruptive additive manufacturing technology is considered a viable replacement for manufacturing micromechanism components. Significantly to withstand high cyclic loads, metal-based high strength-to-weight ratio flapping wing microaerial vehicle components are the need of the hour. Hence, the present work focused on the fabrication of flapping wing microaerial vehicle micromechanism components using selective laser melting with AlSi10Mg alloy. The manufactured micromechanism components attained 99% of dimensional accuracy, and the total weight of the Evans mechanism assembly is 4 g. The scanning electron microscopy analysis revealed the laser melting surface characteristics of the Al alloy. The assembled mechanism is tested in static and dynamic environments to ensure structural rigidity. Aerodynamic forces are measured using a wind tunnel setup, and 7.5 lift and 1.2 N thrust forces are experienced that will be sufficient enough to carry a payload of 1 g camera on-board for surveillance missions. The study suggested that the metal additive manufacturing technology is a prominent solution to realize the micromechanism components effortlessly compared to conventional subtractive manufacturing.
Light duty automotive drum brake squeal analysis using the finite-element method
Authors: Dias Anderson L , Rodrigues Rômulo do N , Bezerra Roberto de A , Lamary Pierre , Miranda Matheus HP
Published: September 2021

The method presented in this work intends to analyze drum brake design parameters of a light duty automotive drum brake system. The main objective of this work is to correlate brake materials and unstability parameters to identify which condition will effectively reduce squeal propensity. The methodology involves (a) the finite-element method of the brake components, namely, drum, shoes, and frictional linings, (b) static calculations to get a pre-stress state around which (c) is computed the complex eigenvalues of the system. Hence, positive real parts indicate dynamic instabilities which are explored by varying parameters, namely, the modulus of elasticity of the materials and the friction coefficient at the contact of the shoes with the drum. According to calculations, it was observed that there exist a given range of values for Young’s modulus and friction coefficient that are favorable to reduce drum brake squeal occurrence. In addition, the method proposed delivered results that match with brake squeal literature.
Thermal conduction modeling of composites by embedding technique
Authors: Corrêa Salomão Rafael , Carrazedo Rogério
Published: September 2021

Composite materials are extremely important in several industrial areas and have been thoroughly used to solve many engineering problems. In more recent years, new numerical models and manufacturing processes made interest grow on those materials. This work contributes to the state of the art of composite materials modeling by proposing an embedding technique for thermal problems using the finite element method. The technique relies on rewriting the reinforcement finite element variables according to the composite matrix finite element form functions. By doing so, it is possible to embed the reinforcement element without increasing the total number of degrees of freedom. The embedding method is capable of modeling the phase’s orientation as well as it’s placement. It’s also possible to make use of nonlinear conductive parameters to model nonlinear thermal problems. Numerical examples are described to show the technique’s capability. The numerical results show good agreement with references, as well as reducing the total number of degrees of freedom and being able to model nonlinear material behavior. Such characteristics make the model suitable to perform more complex analysis such as reliability, optimization, multi-physics, among others.
Active inclusion of people living with dementia in planning for dementia care and services in low- and middle-income countries
Authors: Breuer Erica , Freeman Emily , Alladi Suvarna , Breedt Marinda , Govia Ishtar , López-Ortega Mariana , Musyimi Christine , Oliveira Déborah , Pattabiraman Meera , Sani Tara Puspitarini , Schneider Marguerite , Swaffer Kate , Taylor Dubhglas , Taylor Eileen , Comas-Herrera Adelina
Published: September 2021

Involving people living with dementia in service design and planning has become more common in high-income countries. It remains rare in low- and middle-income countries where two-thirds of the world’s people with dementia live. In this commentary article, we explore the barriers to inclusion of people living with dementia in planning in low- and middle-income countries and make a case for the inclusion of people living with dementia in care and service planning. We suggest how this can be done at individual, community or national and state level using the following principles: 1) respecting the rights of people living with dementia to self-determination; 2) valuing people living with dementia’s unique understanding of dementia; 3) creating a culture of active inclusion which creates a space for people living with dementia to participate and 4) ensuring appropriate accommodations are in place to maximise participation.
Acts and distance—a commentary on Brummett's ‘when conscientious objection runs amok’
Authors: Pruski Michal
Published: September 2021

In his ‘When conscientious objection runs amok: A physician refusing human immunodeficiency virus (HIV) preventative to a bisexual patient’, Brummett has argued that Catholic physicians (or indeed any other healthcare practitioner) should not be able to raise conscientious objections to HIV pre-exposure prophylaxis for bisexual patients, as this constitutes discrimination. Brummett argues that such a conscientious objection represents an instance of conscience creep, which he argues is undesirable. Here I re-analyse the case presented by Brummett using a teleological framework and making reference to Catholic teaching on cooperation with evil. While I agree with Brummett that in this case the physician should not have had the right to conscientiously object, I argue that the teleological framework offers advantages over the argument Brummett has presented. I also comment on why only considering empirically measurable harm as a publicly defensible reason for one to hold a conscientious objection is problematic, as well as on the difficulties associated with cases of discrimination in a pluralistic society.
Exploring F. W. Parker’s notions regarding child education
Authors: Shih Yi-Huang
Published: September 2021

F. W. Parker (1837–1902), an American educationist, implemented various reforms in education. Parker had a considerable role in the development of progressive education in the United States. Parker is usually regarded as the father of progressive education. Using theoretical analysis, this article aims to explore the notions regarding child education advanced by Parker. First, his ideas of child education were as follows: (1) a unitary child made of body, mind, and spirit is a whole being; (2) education professionals depend on the touch of educational love; (3) teachers are mentors in the search for truths instead of dominators; (4) cultivate a democratic and cooperative attitude in the child; (5) the purpose of humanistic education is to assist the individual development of each child. Second, the learning content proposed for children was as follows: (1) the theory of concentration, (2) teachers should select courses that are familiar to the child, (3) teachers should let the child learn to release energy in a natural environment, (4) adapting subject matter to the child, and (5) assimilating music and story into children’s learning content. Finally, the suggested teaching priorities were as follows: (1) arouse learning interest of the child; (2) develop the child’s attention; (3) allow expression; (4) handwork; and (5) when the child reads, teachers should lead their thinking.
Percutaneous Femoropopliteal Bypass: 2-Year Results of the DETOUR System
Authors: Halena Grzegorz , Krievins Dainis K. , Scheinert Dierk , Savlovskis Janis , Szopiński Piotr , Krämer Albrecht , Ouriel Kenneth , Schmidt Andrej , Zdunek Michal , Lyden Sean P.
Published: September 2021

Purpose:

This study investigated the 2-year safety and effectiveness of the PQ Bypass DETOUR system as a percutaneous femoropopliteal bypass.

Materials and Methods:

Seventy-eight patients with 82 long-segment femoropopliteal lesions were enrolled in this prospective, single-arm, multicenter study. The DETOUR system deployed Torus stent grafts directed through a transvenous route. Eligible patients included those with lesions of >10 cm and average of 371±55 mm. Key safety endpoints included major adverse events (MAEs) and symptomatic deep venous thrombosis in the target limb. Effectiveness endpoints included primary patency defined as freedom from ≥50% stenosis, occlusion, or clinically-driven target vessel revascularization (CD-TVR), primary assisted, and secondary patency.

Results:

Chronic total occlusions and severe calcium occurred in 96% and 67% of lesions, respectively. Core laboratory-assessed total lesion length averaged 371±51 mm with a mean occlusion length of 159±88 mm. The rates of technical and procedural success were 96%, with satisfactory delivery and deployment of the device without in-hospital MAEs in 79/82 limbs. The MAE rate was 22.0%, with 3 unrelated deaths (4%), 12 CD-TVRs (16%), and 1 major amputation (1%). Deep venous thrombosis developed in 2.8% of target limbs, and there were no reported pulmonary emboli. Primary, assisted primary, and secondary patency rates by the Kaplan–Meier analysis were 79±5%, 79±5%, and 86±4%, respectively.

Conclusions:

The PQ Bypass DETOUR system is a safe and effective percutaneous alternative to femoropopliteal open bypass with favorable results through 2 years. The DETOUR system provides a durable alternative to conventional endovascular modalities and open surgery for patients with long, severely calcified, or occluded femoropopliteal lesions.
Sound absorption and thermal insulation properties of composite thermoplastic polyurethane/polystyrene (TPU/PS) nanofiber web and TPU nanofiber web and PS-extracted TPU/PS microfiber web
Authors: Karaca Neslihan , Yüksek İlkay Özsev , Uçar Nuray , Önen Ayşen , Kirbaş Cafer
Published: September 2021

In this study, composite thermoplastic polyurethane (TPU)/polystyrene (PS) nanofiber web and TPU nanofiber web and PS-extracted TPU/PS microfiber web have been experimentally investigated with regard to sound absorption and thermal conductivity coefficients to observe a potential use in sound and thermal insulation areas. Moreover, other properties such as surface area, morphology, tensile strength/elongation, air permeability, and thermal degradation have been analyzed. It has been observed that nanofiber web properties such as fiber diameter, extensibility, pore volume, and porosity have been clearly changed by Soxhlet extraction of PS from the composite TPU/PS nanofibers. PS-extracted TPU/PS fibers can be preferred for the low frequency (600–800 Hz) due to higher SAC (0.7). On the other hand, TPU nanofibers were more effective at medium frequencies (around 3000 Hz, SAC 0.6). Both TPU and PS-extracted TPU/PS composite fibers had similar thermal conductivities, whereas TPU/PS composite nanofibers had lowest thermal conductivity (0.05 W/mK) with moderate maximum SAC value (around 1000 Hz, SAC 0.5–0.6).
Tensile properties of defect-prefabricated 3D woven composites: Experiments and simulations
Authors: Xu Liming , Cai Deng’an , Li Chao , Jin Xingyu , Zhou Guangming
Published: September 2021

Three-dimensional (3D) woven composites have been widely used in structural components due to their excellent mechanical and near-net-shape properties. However, for some special applications, it is expected that 3D woven composites can be damaged at designated locations under a specific load. In this research work, a new kind of defect-prefabricated 3D woven composites (DP3DWCs) are designed, where defects are prefabricated by cutting weft or warp yarns in defect-free 3D woven composites (DF3DWCs). The tensile mechanical properties of the DF3DWCs and the DP3DWCs are investigated experimentally and numerically. The mesoscopic geometry models of the DF3DWCs and the DP3DWCs were established by multi-objective searching algorithm. The progressive damage models were established using the 3D Hashin criteria and the von Mises failure criterion. Numerical results agree well with the experimental data. The influence of the number of defect layers on the mechanical properties was also discussed. The obtained results indicate that the defects have little effect on the elastic modulus, while tensile strengths decrease linearly with the increase of the number of defect layers. Failure mechanisms of yarns and matrix in the non-defective and defective materials were studied, and the volume fraction of elements of each failure mode was computed and analysed.
Effects of Short-Term Unsupervised Exercise, Based on Smart Bracelet Monitoring, on Body Composition in Patients Recovering from Breast Cancer
Authors: Xu Liuqing , Zhou Changming , Ling Yiqun , Ding Huiping , Wang Qiong , Wu Yan , Qian Yong , He Bingqing , Ni Tianhao
Published: September 2021

Objective:

We aimed to investigate the effects of exercise, monitored and managed using smart bracelets, on body composition, and quality of life in breast cancer survivors.

Methods:

A before-and-after study was conducted in 109 patients who were in the recovery phase of breast cancer and attended the Breast Surgery Department of the Cancer Hospital of Fudan University up to December 2017. Patients were advised to adhere to at least 150 minutes of moderate-intensity exercise per week, and a smart bracelet was issued to each participant to record their daily exercise data for 3 months. Bioelectrical impedance analysis was used to observe the effects of short-term unsupervised exercise intervention on body composition in patients recovering from breast cancer. Patients completed the Functional Assessment of Cancer Therapy-Breast to assess health-related quality of life.

Results:

Weight, body mass index (BMI), body fat mass (BFM), fat mass index (FMI), percent body fat (PBF), arm circumference (AC), arm muscle circumference (AMC), and visceral fat area (VFA) were lower than baseline after exercising for 3 months based on data from the wearable devices ( P < .05). The only significant improvement was found in the “additional concerns about breast cancer” category among the quality-of-life assessments ( P < .05). The average walking time was negatively associated with BFM, PBF, and FMI, while the average calorie consumption due to running was positively associated with fat free mass (FFM).

Conclusion:

In this study, we demonstrated that short-term exercise may be beneficial for postoperative breast cancer survivors. A wearable device could help patients track physical data easily and promote a healthier and more positive life.
Operative Outcomes of Single-Incision Laparoscopic Hysterectomy vs Conventional Laparoscopic Total Hysterectomy: A Prospective Randomized Controlled Study
Authors: Fathi Adel , Saleh Mahmoud M. , Shetiwy Mosab , Elzahaby Islam A. , Farouk Omar , Shams Nazem , Elghandour Mohamed F. , Abouzid Amr
Published: September 2021

Background. Over time, there was an emerging need to shift from laparotomy to minimally invasive laparoscopic surgery, with the success of laparoscopic surgery in the last decade in gyne-oncology. Patients and Methods. This is a prospective randomized controlled trial conducted in Surgical Oncology Unit, Oncology Centre, Mansoura University, in the period between February 2016 and October 2019. Fifty female patients planned for total hysterectomy were randomized into two equal groups; the first underwent conventional laparoscopic hysterectomy (CLH), while the second underwent single-incision laparoscopic hysterectomy (SILH). Results. The mean operative time in the SILH group was 120.00 ± 28.72 minutes vs 103.20 ± 23.04 minutes in the CLH group ( P= .027). Median hospital stay in the SILH group was 1 day (range: 1–3 days), the same as that in the CLH group, with no statistical significance ( P= .384). Postoperative pain assessment using the Visual Analogue Scale (VAS) after 6 hours had a median score of 6 (2–8) in the SILH group and 6 (4–7) in the CLH group with significant increase in experienced pain in the SILH group ( P= .004), while no significant difference was noted after 12 hours and 24 hours in both SILH and CLH groups. Conclusion. Single-incision laparoscopic hysterectomy (SILH) has similar outcomes when compared to conventional laparoscopic hysterectomy as regard blood loss, hospital stay, conversion to laparotomy, intraoperative and postoperative complications with the disadvantages of longer operative time, increased surgeon’s workload, and relatively more postoperative pain.
Anti-Hyperuricemic and Uricosuric Potential of Berberis vulgaris in Oxonate-Induced Hyperuricemic Rats
Authors: Bilal Muhammad , Ahmad Saeed , Rehman Tayyeba , Ghauri Aymen Owais , Khalid Sana , Abbasi Waheed Mumtaz , Zakki Shahbaz Ahmad
Published: September 2021

Hyperuricemia is a metabolic disorder with characteristic elevated serum uric acid. Recently, several plant-based medicines are being used for the treatment of hyperuricemia. The study aimed to find the hypouricemic potential of Berberis vulgaris in in-vitro and in-vivo study models. In i n-vitro studies, xanthine oxidase inhibition assay was performed to evaluate IC50 value and capsule absorbance of the drug, respectively. For in-vivo experiment, the study comprised 15 groups of rats. In-vitro results revealed that significant xanthine oxidase inhibition was shown by Berberis vulgaris with an IC50 value of 272.73±.3 μg/mL. Similarly, oral administration of Berberis vulgaris with dosages of 250 and 500 mg/kg decreased serum and liver uric acid levels significantly in a dose- and time-dependent manner in oxonate-induced hyperuricemic rats. Furthermore, 3-day and 7-day administration of Berberis vulgaris showed more potential compared to 1-day administrations. The present study indicated marked hypouricemic effects of Berberis vulgaris in rats. Due to caveat of the small sample size, a firm assumption of the hypouricemic effect of Berberis vulgaris cannot be made. However, extensive study is needed to find out the exact molecular mechanism involved and to translate its effects into clinical trials for the further validation of the results.
Optimization of multi variant process parameters to reduce emissions of high sulfur coal during combustion in fluidized bed facility
Authors: Muhammad Mahmood Aslam Bhutta , Rehman Shafiq ur , Naeem Shah Asad , Kamran Muhammad Sajid , Naveed Ahmad , Sohail Rehman Syed Muhammad
Published: September 2021

Pakistan has 185 billion tonnes reserves of coal but unfortunately the quality of 80% of this coal is not good. As the country has a shortage of energy so it is necessary to refine the coal before it can be used to produce electricity. In this sense, this research is very important as it enables indigenous coal to meet the increasing energy demand. This study is focused on the control of sulfur emissions during the combustion of high sulfur Pakistani coal from the Trans Indus Range and the Salt Range. Parameters like Ca/S molar ratios (MRs), limestone particle size, bed temperature, and different percentages of biomass in co-firing with coal have been studied. It is showed that desulfurization of coal was maximum with the fine-sized particles of limestone. Co-firing of moderate quantity biomass exhibited a considerable decrease in SO2 emissions. Results achieved are presented in the form of tables and plots. This study for control of the gaseous emissions from combustion in FBC facility has great potential for new coal based power projects, especially in Pakistan.
Health promotion challenges for young adults living with intellectual disability and type 1 diabetes
Authors: Marks Anne L , Mahoney Natasha , Chen Yu-Wei , Cordier Reinie , Buchanan Angus , Wilson Nathan J
Published: September 2021

Background:

Self-management of type 1 diabetes mellitus (T1DM) can be challenging for people with intellectual disability. Often, parents provide health support due to lack of appropriate services outside the home. The study aim was to identify barriers and facilitators to T1DM self-management for young adults with intellectual disability and the implications for health promotion.

Methods:

Five male participants with intellectual disability, aged 17–26 years, and seven parents were interviewed between October 2017 and February 2019. Interview data were descriptively analysed.

Findings:

Two categories for barriers and facilitators were identified: 1) Diabetes self-management is complex (carbohydrate counting, blood glucose level monitoring, insulin therapy); 2) support for diabetes care (reliance on parents and carers, the National Disability Insurance Scheme, mainstream diabetes service support).

Conclusions:

Parents are critical for the support of people with intellectual disability and T1DM in the absence of disability staff with appropriate health skills.
Early postnatal discharge during COVID-19: A cross-sectional study
Authors: Tesfaye Wondyifraw Yeshitila , Worku Bekelu Teka
Published: September 2021

Introduction:

Postnatal hospital stay is decreased by 30% during COVID-19 in developed countries. However, there is paucity of data in developing countries. Hence, this study aims to assess the prevalence of early postnatal discharge during COVID-19 in Jimma Health Centers.

Methods:

Facility-based cross-sectional study was conducted from 1 February to 30 March 2021. Sample was calculated using single population proportion formula and allocated proportionally to the health centers. Data were interred into Epidata version 3.1 and exported to SPSS version 22.0 for analysis. Multivariable regression was done to identify associating factors at p < 0.05.

Result:

Three hundred ninety women were included into study making a response rate of 96.8%. Early discharge prevalence was 316 (81.0%). Attending elementary school adjusted odds ratio = 0.26 (confidence interval = 0.087–0.798), plan for postnatal care within a week adjusted odds ratio = 0.410 (confidence interval = 0.221–0.760), knowing postnatal maternal danger sign adjusted odds ratio = 0.258 (confidence interval = 0.141–0.473), women adjusted odds ratio = 0.421 (confidence interval = 0.211–0.838), or husband adjusted odds ratio = 0.051 (confidence interval = 0.014–0.186) made decision of discharge were negatively and distance on foot <30 min adjusted odds ratio = 3 (confidence interval = 1.121–8.058) was positively associated with early discharge significantly.

Conclusion:

This study has identified early postnatal discharge is high which can contribute to reduce the risk of acquiring COVID-19. However, the authors recommend further study to differentiate whether early discharge is due to COVID-19 or other reasons.
The role of attention and ageing in the retrieval dynamics of value-directed remembering
Authors: Murphy Dillon H , Castel Alan D
Published: September 2021

For memory to be efficient, people need to remember important information. This involves selective encoding and retrieval operations to maximise the recall of valuable information at the expense of less important information. While past research has examined this in terms of strategic encoding operations, we investigated differences in the dynamics of retrieval in value-directed remembering tasks with younger adults under full and divided attention during encoding as well as in older adults. Participants typically initiated recall with the first presented, last presented, or highest valued words and also strategically organised retrieval according to information value such that high-value words tended to be recalled before low-value words. However, the average value of older adults’ first recalled word was greater than that of younger adults, likely contributing to their enhanced selectivity. In addition, there were no differences in lag-conditional-response probabilities in younger adults under full or divided attention, but older adults showed impairments in the retrieval of items sharing contextual features with nearby items, while younger adults relied more on temporal-contextual cues to recall words. Together, this study suggests that both strategic encoding and strategic retrieval operations contribute to selectivity for valuable information and older adults may be able to maximise retrieval operations despite displaying impairments in temporal binding during encoding and an overall recall deficit.
The current landscape of youth multi-sport training: athlete and parent insight data
Authors: Robinson Nicola J , McQuilliam Stephen J , Donovan Timothy F , Langan-Evans Carl , Whitehead Amy
Published: September 2021

The intent to improve a youth athlete’s ability is developed through structured focused training in the competencies within their sport. To date there is little evidence around how multi-discipline youth athletes organise their training load (TL) outlook in a multitude of sports. The aim of this study was to analyse the daily TL, distribution and wellness in aspiring 10-15yr old pentathletes (n = 31) over 152 ± 35 days. Athletes completed daily reports documenting sport mode, session duration, session rate of perceived exertion (sRPE) and wellness (sleep, stress, mood, fatigue, muscle soreness). Parental understanding of training periodisation was used to contextualise the athletes training patterns (n = 15) through semi-structured interviews. Weekly training duration was 5 h 59 min ± 3 h 38 min. The swimming discipline dominates the overall time spent training (50.5%). Pentathlon specific TL was significantly higher in the 14–15 yrs (3000 ± 1207 AUT) in comparison to 10–11 yrs (1837 ± 874 AUT). Weekly micro TL fluctuations showed significant peaks on the weekend compared to Tuesday and Friday (p < 0.05). Wellness scores were significantly worse on Monday to Wednesdays (p < 0.05), compared to Fridays. Parent interviews suggest a multitude of coach input from solo disciplines over a typical week, with little inter-coach discussions. In conclusion there is little structure on a micro or macro level in youth pentathletes training showing multiple-coach input with little coach crossover. Implications for the training/competition is based around convenience/holidays/availability of resources rather than overall individual development, which suggests the potential need for an early specialisation approach to support athletes within this style of multi-discipline sport.
Clinical and treatment characteristics of patients treated with the first therapeutic oncology biosimilars bevacizumab-awwb and trastuzumab-anns in the US
Authors: Jin Ran , Mahtani Reshma L. , Accortt Neil , Lawrence Tatiana , Sandschafer Darcie , Loaiza-Bonilla Arturo
Published: September 2021

Background:

In July 2019, bevacizumab-awwb and trastuzumab-anns were marketed in the USA as the first therapeutic oncology biosimilars. We aimed to investigate the initial real-world use of bevacizumab-awwb and trastuzumab-anns for cancer management in US oncology practices.

Methods:

A retrospective, observational analysis of data from US cancer patients (⩾18 years of age) was carried out to describe the use of bevacizumab-awwb and trastuzumab-anns during the first 12 months following their market entry, using structured data from the Flatiron Health electronic health record-derived database.

Results:

A total of 2952 and 2997 patients with recorded use of bevacizumab-awwb and trastuzumab-anns, respectively, were included in the analysis. The first use of bevacizumab-awwb and trastuzumab-anns was in a patient with metastatic colorectal cancer (mCRC) within 10 days of market availability and in a patient with early stage breast cancer (eBC) within 4 days, respectively. The use of these biosimilars was observed across all approved cancer indications; 68% of bevacizumab-awwb users were those diagnosed with mCRC and 72% of trastuzumab-anns users were those diagnosed with eBC. Approximately half the patients were previously exposed to reference product (RP) prior to initiation of bevacizumab-awwb or trastuzumab-anns. Among pre-exposed patients, the majority received the biosimilars [bevacizumab-awwb (63–85%) or trastuzumab-anns (75–81%)] within 28 days of the last infusion of the RP. For both biosimilars, no major differences were observed in patient characteristics between RP-naïve and pre-exposed patients.

Conclusion:

Initial evidence from the first 12 months following market entry suggests rapid clinical adoption of bevacizumab-awwb and trastuzumab-anns across all approved tumor types. Usage of these two biosimilars was observed in both RP-naïve patients and patients who were previously treated with RP, with no distinctive differences in patient characteristics between the two groups. A video abstract is available for this article as part of the Kanjintionline supplemental material.
Relationships Between WUT (Body Weight, Urine Color, and Thirst Level) Criteria and Urine Indices of Hydration Status
Authors: Sekiguchi Yasuki , Benjamin Courteney L. , Butler Cody R. , Morrissey Margaret C. , Filep Erica M. , Stearns Rebecca L. , Lee Elaine C. , Casa Douglas J.
Published: September 2021

Background:

A Venn diagram consisting of percentage body mass loss, urine color, and thirst perception (weight, urine, thirst [WUT]) has been suggested as a practical method to assess hydration status. However, no study to date has examined relationships between WUT and urine hydration indices. Thus, the purpose of this study was to investigate relationships between urine specific gravity, urine osmolality, and the WUT criteria.

Hypothesis:

Urine specific gravity and urine osmolality indicate hypohydration when the WUT criteria demonstrate hypohydration (≥2 markers).

Study Design:

Laboratory cohort study.

Level of Evidence:

Level 3.

Methods:

A total of 22 women (mean ± SD; age, 20 ± 1 years; mass, 65.4 ± 12.6 kg) and 21 men (age, 21 ± 1 years; body mass, 78.7 ± 14.6 kg) participated in this study. First morning body mass, urine color, urine specific gravity, urine osmolality, and thirst level were collected for 10 consecutive days in a free-living situation. Body mass loss >1%, urine color >5, and thirst level ≥5 were used as the dehydration thresholds. The number of markers that indicated dehydration levels were counted and categorized into either 3, 2, 1, or 0 WUT markers that indicated dehydration. One-way analysis of variance with Tukey pairwise comparisons was used to assess the differences in urine specific gravity and urine osmolality between the different number of WUT markers.

Results:

Urine specific gravity in 3 WUT markers (mean ± SD [effect size], 1.021 ± 0.007 [0.57]; P = 0.025) and 2 WUT markers (1.019 ± 0.010 [0.31]; P = 0.026) was significantly higher than 1 WUT marker (1.016 ± 0.009). Urine mosmolality in 2 WUT markers (705 ± 253 mOsmol [0.43]; P = 0.018) was significantly higher than 1 WUT (597 ± 253 mOsmol). Meeting at 3 WUT resulted in specificity of 0.956 and at 0 WUT resulted in sensitivity of 0.937 for urine osmolality>700mOsm.

Conclusion:

These results suggest that when 3 WUT markers are met, urine specific gravity and urine osmolality indicated hypohydration and 0 WUT represents a high likelihood of euhydration. 1 and 2 WUT values are indeterminate of hydration status. The WUT criterion is a useful tool to use in field settings to assess hydration status when first morning urine sample was used.

Clinical Relevance:

Athletes, coaches, sports scientists, and medical professionals can use WUT criteria to monitor dehydration with reduced cost and time.
When Facebook Becomes Faithbook: Exploring Religious Communication in a Social Media Context
Authors: Åhman Henrik , Thorén Claes
Published: September 2021

Processes of digitalization continue to have a profound effect on many old, traditional organizations. In institutions such as banks, theaters, and churches, established structures and practices are being challenged by digitization in general and the participatory logic of social media in particular. This article draws on Mark C. Taylor’s concepts of figuring and disfiguring to analyze empirical data gathered from the Church of Sweden Facebook page. The aim is to discuss how social media affects the conditions for religious communication and what the consequences are for a traditional religious organization such as the Church of Sweden.
The effect of humor on remembering, understanding, and paraphrasing children’s video Bible stories
Authors: Gray Christina D , Shafer Daniel M
Published: September 2021

This study investigated the effect of humor in religious stories on a child’s ability to remember, understand, and paraphrase content, as well as on enjoyment. Ages of the children were also considered. Participants watched one of two videos teaching the story of Saul’s conversion found in Acts 9:1–22. Although inclusion of humor did not have a significant impact, there was a significant effect of age on remembering, understanding, and paraphrasing. Previous exposure to the story increased overall scores, which suggests that repetition is key to a successful learning experience.
Impact of the COVID-19 Pandemic on Congenital Cardiac Surgeries at a National Referral Center in Mexico
Authors: Ortega-Zhindón Diego B. , Calderón-Colmenero Juan , García-Montes José A. , Rivera-Buendía Frida , Cervantes-Salazar Jorge L.
Published: September 2021

Severe acute respiratory syndrome coronavirus 2, the etiologic agent of coronavirus disease 2019, has caused more than 160 million infections globally. The experience of our department showed that the execution of a strict surgery protocol, universal severe acute respiratory syndrome coronavirus 2 screening, surgical prioritization, and an orderly reactivation of the cardiac surgery program is a feasible way to keep congenital heart diseases surgery program.
White Americans’ Opposition to Affirmative Action, Revisited: New Racism, Principled Objections, or Both?
Authors: Hunt Matthew O. , Smith Ryan A.
Published: September 2021

In this short article, we provide an update and extension of Thomas C. Wilson’s study, “Whites’ Opposition to Affirmative Action: Rejection of Group-based Preferences as well as Rejection of Blacks.” Wilson drew on data from the 1996 General Social Survey (GSS) to revisit a long-standing debate in the racial attitudes literature concerning whether anti-black prejudice (e.g., “new racism”) or ostensibly race-neutral opposition to group-based policies generally (i.e., “principled objections”) is the primary determinant of whites’ opposition to affirmative action in the form of “preferential hiring and promotion for blacks.” We analyze data from the 2000–2018 GSS to replicate and extend key aspects of Wilson’s work. As in the prior study, we find mixed support for the new racism and principled objections perspectives, providing an important update on white Americans’ beliefs about affirmative action for the twenty-first century.
The Impact of COVID-19 on US and International Retina Specialists, Their Practices, and Their Patients
Authors: Hahn Paul , Blim Jill F. , Packo Kirk , Jumper J. Michael , Murray Timothy , Awh Carl C.
Published: September 2021

Purpose:

This work analyzes data from a series of surveys developed by the American Society of Retina Specialists (ASRS) that assesses the impact of COVID-19 on physicians, their practices, and their patients.

Methods:

Five surveys were sent by the ASRS between March and July 2020 to more than 2600 US and international retina specialists. Data and trends from these surveys were analyzed.

Results:

Most responding retina specialists (87%-95% in the United States and internationally) reported having no known COVID-related symptoms despite reported limitations in personal protective equipment. Clinic volumes globally were drastically reduced in March 2020 with only partial recovery through July 2020, which was slower internationally than in the United States. Practices were compelled to reduce staff and physician employment levels. Most respondents estimated some degree of delay in patient treatment with corresponding declines in vision and/or anatomy that were attributed most frequently to patients’ fears of the pandemic and least frequently to office unavailability.

Conclusions:

The reported impact of COVID-19 on retina specialists, their practices, and their patients has been substantial. Although retina specialists were quickly resilient in optimizing delivery of patient care in a manner safe for patients and providers, the reduction in clinic volume has been devastating in the United States and internationally, with negative impacts on patient outcomes, reductions in practices’ volume and employment, and risk to practices’ financial health. Future studies will be required to quantify losses associated with these unprecedented and ongoing circumstances caused by the pandemic.
The long non-coding RNA DKFZp434J0226 regulates the alternative splicing process through phosphorylation of SF3B6 in PDAC
Authors: Li Jinglei , Tong Hanxing , Li Dongping , Jiang Qiuyu , Zhang Yong , Tang Wenqing , Jin Dayong , Chen She , Qin Xinyu , Zhang Si , Xue Ruyi
Published: September 2021

Background

Long noncoding RNAs (lncRNAs), a type of pervasive genes that regulates various biological processes, are differentially expressed in different types of malignant tumors. The role of lncRNAs in the carcinogenesis of pancreatic ductal adenocarcinoma (PDAC) remains unclear. Here, we investigated the role of the lncRNA DKFZp434J0226 in PDAC.

Methods

Aberrantly expressed mRNAs and lncRNAs among six PDAC and paired non-tumorous tissues were profiled using microarray analysis. Quantitative real-time polymerase chain reaction was used to evaluate DKFZp434J0226 expression in PDAC tissues. CCK-8 assay, wound-healing assay, soft agar colony formation assay, and transwell assay were performed to assess the invasiveness and proliferation of PDAC cells. Furthermore, RNA pull-down, immunofluorescence, RNA immunoprecipitation, and western blotting assays were performed to investigate the association between DKFZp434J0226 and SF3B6. Tumor xenografts in mice were used to test for tumor formation in vivo.

Results

In our study, 222 mRNAs and 128 lncRNAs were aberrantly expressed (≥ twofold change). Of these, 66 mRNAs and 53 lncRNAs were upregulated, while 75 lncRNAs and 156 mRNAs were downregulated. KEGG pathway analysis and the Gene ontology category indicated that these genes were associated with the regulation of mRNA alternative splicing and metabolic balance. Clinical analyses revealed that overexpression of DKFZp434J0226 was associated with worse tumor grading, frequent perineural invasion, advanced tumor-node-metastasis stage, and decreased overall survival and time to progression. Functional assays demonstrated that DKFZp434J0226 promoted PDAC cell migration, invasion, and growth in vitro and accelerated tumor proliferation in vivo. Mechanistically, DKFZp434J0226 interacted with the splicing factor SF3B6 and promoted its phosphorylation, which further regulated the alternative splicing of pre-mRNA.

Conclusions

This study indicates that DKFZp434J0226 regulates alternative splicing through phosphorylation of SF3B6 in PDAC and leads to an oncogenic phenotype in PDAC.
Moderating effect of self-efficacy on the association of intimate partner violence with risky sexual behaviors among men who have sex with men in China
Authors: Zhu Yang , Hou Fengsu , Chen Chun , Wei Dannuo , Peng Liping , You Xinyi , Gu Jing , Hao Chun , Hao Yuantao , Li Jinghua
Published: September 2021

Background

In China, men who have sex with men (MSM) face a high risk of HIV infection. Intimate partner violence (IPV) is common in this population and leads to various adverse consequences, including risky sexual behaviors, substance abuse, and poor mental health, which pose huge challenges to HIV prevention and control.

Methods

An anonymous cross-sectional study was conducted to investigate the lifetime prevalence of IPV and prevalence of risky sexual behaviors during the previous 6 months in a convenience sample of 578 MSM from 15 cities covering seven geographical divisions in mainland China. The associations between IPV and risky sexual behaviors and the moderating effect of self-efficacy on these associations were explored through univariate and multivariate regression analyses.

Results

The prevalence rates of IPV perpetration and victimization were 32.5% and 32.7%, respectively. The proportions of participants who reported inconsistent condom use with regular or casual partners and multiple regular or casual sexual partners were 25.8%, 8.3%, 22.2%, and 37.4%, respectively. Multiple IPV experiences were positively associated with risky sexual behaviors; for example, any IPV victimization was positively associated with multiple regular partners, adjusted odds ratio (ORa) = 1.54, 95% CI [1.02,2.32], and multiple casual partners, ORa = 1.93, 95% CI [1.33, 2.80]. Any IPV perpetration was positively associated with inconsistent condom use with regular partners, ORa = 1.58, 95% CI [1.04, 2.40], and multiple casual partners, ORa = 2.11, 95% CI [1.45, 3.06]. Self-efficacy was identified as a significant moderator of the association between multiple casual sexual partnership and emotional IPV.

Conclusions

In conclusion, given the high prevalence of both IPV and risky sexual behaviors among Chinese MSM in this study, the inclusion of self-efficacy in interventions targeting IPV and risky sexual behaviors should be considered.
Prevalence of myopia in 3–14-year-old Chinese children: a school-based cross-sectional study in Chengdu
Authors: Wang Jianglan , Liu Jinnan , Ma Wei , Zhang Qi , Li Rong , He Xiao , Liu Longqian
Published: September 2021

Background

The prevalence of myopia among children in Chengdu is unknown. The aim of this study was to determine the prevalence of myopia in 3- to 14-year-old Chinese children in Chengdu.

Methods

This study was a school-based cross-sectional study in children aged 3–14 years. Visual acuity (VA), spherical equivalent error (SER) with noncycloplegic autorefraction, axial length (AL) and corneal radius (CR) were measured.

Results

A total of 19,455 children were recruited for this study. The prevalence of myopia was 38.1 %; the prevalence of low myopia was 26.6 %, that of moderate myopia was 9.8 %, and that of high myopia was 1.7 %. The prevalence of myopia and SER increased with age from 6 years old. The prevalence of myopia was higher, and the SER indicated more severe myopia in the girls than in the boys (40.1 % vs. 36.2 %, χ2 = 30.67, df = 1, P < 0.001; -0.93 D ± 1.75 D vs. -0.84 D ± 1.74 D, t = 3.613, df=19,453, P < 0.001). The girls had a higher prevalence of myopia and myopic SER than did the boys aged 9 years and older (P < 0.05). Among the myopic children, the rates of uncorrected, undercorrected and fully corrected myopia were 54.8 %, 31.1 and 14.1 %, respectively. AL and AL/CR increased with age from 6 years old, but CR remained stable after 4 years old. The AL was longer, and the CR was flatter in the boys than in the girls aged 3 to 14 years old (P < 0.05).

Conclusions

The prevalence of myopia, AL and AL/CR increased, and the SER became more myopic with age from 6 years old. The girls had a higher prevalence of myopia and myopic SER than did the boys, but the boys had a longer AL, flatter CR and higher AL/CR ratio than did the girls. The rate of uncorrected myopia was very high in the myopic children. More actions need to be taken to decrease the prevalence of myopia, especially uncorrected myopia in children.