bluuebunny/crossref_metadata_2025 huggingface dataset:
User-based fuzzy end-use modeling of indoor urban residential water demand
Authors: Mangalekar Rohit D , Gumaste Krishnakedar S
Published: April 2022

Stochastic models for estimating residential water demand use high-resolution field data consuming large costs and significant time. An attempt for the accurate estimation of water demand may result in its complex analytical model due to numerous factors affecting the water use event. Moreover, as the water supply system is always subjected to variations in demand, the accuracy of water demand estimation in its design can be side-lined. The water demand in residential buildings is mainly governed by the users’ characteristics and their daily schedule. In this view, the use of Fuzzy Logic can be advantageous to model the uncertainty in water demands. The presented study attempts to provide a methodology to estimate urban indoor residential water demand with the help of user-based end-use models in the absence of field data and generate various possible water demand patterns of fixtures. Usergroups were created for assuming spatial variations in water demand. Fuzzy Logic was used to develop the end-use models using data on urban users’ characteristics, their diurnal activities, and water use habits to estimate the demand characteristics of fixtures. The model may also facilitate the computation of pipe sizing in building water supply systems.
Intergenerational effects of posttraumatic stress symptoms in family: The roles of parenting behavior, feelings of safety, and self-disclosure
Authors: Zhou Xiao , Huang Jiali , Zhen Rui
Published: April 2022

This study examined the effects of parents’ posttraumatic stress symptoms (PTSS) and parenting behaviors, children’s feelings of safety, and children’s self-disclosure on children’s PTSS, to elucidate the mechanisms underlying intergenerational effect of PTSS. Three months after the Super Typhoon Lekima occurred in China, August 2019, self-report questionnaires were used to investigate 866 Chinese parent–child dyads (children’s mean age was 10.55 years, 52.2% were boys; parents’ mean age was 37.99 years, 23.2% were fathers) in the area most affected by the typhoon. The results found that parents’ PTSS may have disrupted the provision of emotionally warm parenting, in turn reducing children’s feelings of safety and limiting their self-disclosure, ultimately increasing the severity of children’s PTSS. This suggested that the mechanisms underlying the intergenerational effect of PTSS between parents and children involve the combined role of parents’ emotionally warm parenting, children’s feelings of safety, and children’s self-disclosure.
Continuous regulation of wind energy power system permitting protection of the system components against wind over-speed
Authors: Tounsi Souhir
Published: April 2022

In this paper is presented a methodology of design and control of an electromagnet braking system dedicated to the protection of the wind energy production systems against the strong rise of the current in the power chain attached to the strong elevation of the wind speed. This methodology focuses on the dimensioning of the electromagnet acting as a mechanical brake and its integration into the wind energy generation system. The electromagnet is designed jointly by the analytical method offering the advantages of compatibility with large-scale optimization approaches and the finite element method for verifying and increasing the accuracy of the analytical model. This study essentially involves the design and modeling phase of the electromagnet dissociated from the wind turbine and then by the phase of its integration with the wind turbine. The global model associating the electromagnet and the wind turbine controlled with a view to ensuring a continuous recharging of energy accumulator at a constant current equal to the nominal current of which the wind turbine is sized, is implanted under the Matlab-Simulink simulation environment. The results of simulations are encouraging and open the research trail to optimization work of the entire chain.
Business students’ perceptions of Dutch higher educational institutions in preparing them for artificial intelligence work environments
Authors: Abdelwahab Hanna Rahma , Rauf Abdul , Chen Dadi
Published: April 2022

The application of artificial intelligence (AI) brings new demand to the job market. The concern now is whether higher education institutions (HEIs) have adequately prepared young learners to work in an AI work environment. This research seeks to explore business students’ perceptions of their HEIs in the Netherlands in preparing them for AI work environments. A questionnaire-based survey was completed by 95 students from 27 HEIs in the Netherlands. The findings show that these students believe that their HEIs are not optimally equipped at this time and/or have not optimally utilized their facilities to adequately prepare them for AI work environments. This study reinforces the urgency of updating the curriculum and educational facilities for AI work environments and provides suggestions for future research.
Combined application of passive and active boundary layer aspiration in a transonic compressor rotor for shock wave/boundary layer interaction control
Authors: Zhou Xiaoxiao , Zhao Qingjun , Zhao Ben , Xu Qiangren , Zhao Wei
Published: April 2022

Shock wave/boundary layer interaction (SWBLI) is one of the key factors that limits the improvement of aerodynamic performance and stability for supersonic/transonic compressors. In this research, a combined flow control device (CFCD) was designed for controlling SWBLI in the NASA transonic compressor Rotor 35. The original flow fields for Rotor 35 were numerically analyzed first. The results show that the SWBLI is severe, resulting in much flow loss and partly leading to the compressor instability. Based on this phenomenon, the CFCD was designed with a novel three-dimensional passive self-recirculation flow channel and an active suction slot. The flow channel is mounted on the rotor blade suction surface to connect the low- and high-pressure regions ahead of and behind the shock, respectively. The effect of the CFCD on the rotor performance and corresponding working mechanism are then researched as well. With the help of CFCD, the rotor-achieved total pressure ratio (TPR) is maximally increased by 3.0%, and the stall margin (SM) is improved by 4.1% as well. But the rotor isentropic efficiency (IE) considering additional energy expenditure caused by active suction flow has the maximum increment at choke point of 0.27% and highest reduction at near-stall point of 0.54%. The working mechanisms of CFCD include two aspects: one is forming a stable and low-entropy generated lambda shock wave and the other one is reducing the magnitude of flow separation. The dominant mechanism varies with the rotor working condition and depends on whether the leading-edge shock moves upstream of the passive bleed slot.
Impact of COVID-19 Pandemic on MSMEs: A Study of Karimnagar District of Telangana State
Authors: Reddy M. Malla , Srividya A. , Kavya V. , Bharath R. , Srikar M. , Kumar D. Vinay
Published: April 2022

The COVID-19 pandemic has impacted gravely all the economic activities across the world, and India is no exception. One of the victims and most vulnerable sectors of the Indian economy is the micro, small and medium enterprises (MSMEs) sector because of its size, scale of operations and financial resources. The present study is aimed at assessing the impact of COVID-19 on MSMEs operating in the Karimnagar district of Telangana State and diagnosing the issues and challenges being faced by the enterprises during the pandemic period. The study is an analytical and descriptive type of research in nature and it is based on both primary and secondary data. The primary data were collected from about 120 MSME units in the Karimnagar district by administering a structured and pretested questionnaire. Descriptive statistics along with chi-square and ANOVA were used with the help of SPSS to analyse the data. The study found that two-thirds of the enterprise’s operations were extremely affected and experienced the reduction of orders from the customers, while about 41.7% of the MSMEs’ sales turnover plummeted from 40% to 60% due to virulent virus. Shockingly, the majority of the enterprises i.e., 60% incurred losses, and about 26.7% of the MSMEs decided to scale down or sell their units or shut down the operations due to various issues and challenges such as lack of orders, mounting manufacturing costs, payment of EMIs and statutory expenses. The study suggests that the government should ensure to provide free access to loans, waiver of the interest on EMIs and statutory payments besides relaxing the taxes for some period to revive the MSME sector as it is widely acclaimed as the golden duck of the Indian economy!
Damage mechanism characterization of ±35° and ±55° FW composite tubes using acoustic emission method
Authors: Alimirzaei Sajad , Najafabadi Mehdi Ahmadi , Nikbakht Ali , Pahlavan Lotfollah
Published: April 2022

The focus of this study is to investigate the mechanical properties, of ±35° and ±55° filament wound (FW) composite tubes under axial compression loading using the acoustic emission technique. For this purpose, material failure, crashworthiness characteristics, and the effect of each mechanism on the energy absorption capacity were studied using numerical and experimental approaches. Also, to identify and estimate the contribution percentage of damage mechanisms as well as how the damage grows in the specimens, the analysis of acoustic emission signals recorded during loading was performed. Digital image correlation was additionally used to capture displacement/strain contour maps. Finally, to analyze the effect of the winding pattern in the experimental test, the tubes were simulated using finite element analysis (FEA). For modeling of damage mechanisms, a 3D continuum damage model was used. The results of signal processing showed that by increasing the weaving angle of fibers from ±35° to ±55°, the separation of fibers from the matrix decreases, and the percentage of matrix crushing and fiber failure increases. The assessment of damage percentages showed that the reason for the large drop in force at ±55° compared to ±35° is the increase in matrix crushing. Furthermore, the failure behavior of FW tubes appeared to be dominated by local buckling, and the FEA effectively predicted the linear behavior and maximum load value of the composite tubes.
Serious Mental Illness and Sexual Offending in Forensic Psychiatric Patients
Authors: Lam Austin A. , Penney Stephanie R. , Simpson Alexander I. F.
Published: April 2022

The role of serious mental illness among those who sexually offend is not well understood. We investigated clinical and risk-related areas of difference between male forensic psychiatric patients with ( n = 86) and without ( n = 245) a sexual offense history, including the age at which indications of mental disorder and criminal offending first emerged, from a registry of Ontario patients adjudicated Not Criminally Responsible on account of Mental Disorder (NCRMD) from 1999–2012. We further explored motivations for offending among a subset of patients deemed NCRMD for a sexual offense specifically ( n = 41). While no differences were found in the age onset of illness or offending across those with and without a sexual offending history, the former group was rated as having higher levels of historical/static risk for violence. Forensic patients with a sexual offense history were also more likely to offend against a stranger, and less likely to offend against a family member. Sexual index offenses were psychotically-motivated in the majority of cases, but with a meaningful proportion appearing to reflect criminogenic motivations, especially substance use and paraphilic interests. Results suggest greater similarity than difference among forensic patients with and without a sexual offense history, but also highlight an important divergence from the literature showing that victims of sexual offenses are frequently known to the individual committing them.
Inter-individual differences in Hindi–English code-switching: A quantitative approach
Authors: Si Aung , Mark Ellison T.
Published: April 2022

Aims and objectives:

Variationist studies on code-switching (CS) have focused on community-level differences driven by variables such as age, ethnicity, and socio-economic status. Studies on inter-individual variation that make use of naturalistic speech need to be prioritised, especially in countries with large, diverse populations, such as India. This article presents a quantitative analysis of the Hindi–English CS (HECS) patterns among speakers of comparable socio-economic status and clusters them based on similarities in their CS strategies.

Methodology:

Television interviews of Hindi movie (Bollywood) personalities were transcribed and coded for Hindi and English lexemes. Bespoke software in Python was used to calculate five numerical indices to describe each speaker’s CS pattern.

Data and analysis:

The interviews from 28 speakers ranged between 20 and 40 minutes each. Cluster analysis was carried out in SPSS to produce a typology of CS strategies.

Findings/conclusions:

A total of six CS strategies were identified, with five being employed by both older and younger speakers and only one being used only by a single age group. Most CS strategies are therefore not age-specific. A number of hypothetical scenarios are presented, to demonstrate how individual CS strategies might change with time.

Originality:

This is the first study to systematically and quantitatively investigate inter-individual differences in HECS, using naturalistic speech in semi-controlled conditions. It is also the first to propose a typology of HECS strategies.

Implications:

There was significant variation in CS strategy even within the relatively homogeneous group of speakers investigated in this study. The overall variation in the whole of Hindi-speaking India must therefore be far greater. This suggests that certain predictions regarding the predictability of CS patterns from the contact situation (e.g., that postcolonial contexts result in insertional CS) may need to be refined.
A ‘north star’ in governing global labour migration? The ILO and the Fair Recruitment Initiative
Authors: Jones Katharine
Published: April 2022

In 2014, the International Labour Organization (ILO) launched the Fair Recruitment Initiative (FRI) with the aim of tackling labour exploitation widely associated with the recruitment of low-wage migrant workers. To date, scholars have largely neglected the ILO’s role in developing ‘fair recruitment’ as a mechanism of global social policy. In response, this article analyses the ILO’s harnessing of fair recruitment to the global governance of migration. Through engaging in significant knowledge production, the ILO has promoted ‘fair recruitment’ as a new norm, generating consensus, despite its absence from international legal standards. In utilising multiple and varied tools, the article argues that the FRI is an example of the ‘coordinated governance’ which the ILO has had to pragmatically resort to in externally and internally challenging environments, and regardless of whether states have ratified its main convention on recruitment, C181. However, as of 2022, the concept of fair recruitment remains a muted challenge to the hegemonic precarity and inequalities associated with international labour migration in the 21st century.
Regional Human Resource Development in ASEAN: An Institutional Theory Perspective
Authors: Tkachenko Oleksandr , Crocco Oliver S. , Nguyen Loi A. , Jonathan Victoria
Published: April 2022

With the growing influence of intergovernmental organizations such as the European Union and the Association of Southeast Asian Nations (ASEAN), the scope and complexity of human resource development (HRD) activities have expanded. Informed by an institutional theory perspective, we examined the evolution of HRD as well as HRD-related programs in ASEAN to illuminate the mechanisms and conditions shaping HRD in ASEAN. Our primary sources were archival data from ASEAN from 1967–2021 and relevant publications of international development agencies that feature HRD-related activities in the region. Our analysis suggests that the establishment of an intergovernmental organization (i.e., ASEAN), with its continuing efforts towards economic cooperation and community building among its member states, was central to the emergence and development of Regional HRD in Southeast Asia. This inquiry advances understanding of the role of intergovernmental institutions in influencing HRD activities. The study also showcases the critical role of HRD in furthering common interests around economic and socio-cultural initiatives in ASEAN.
Distributed consensus problem with caching on federated learning framework
Authors: Yan Xin , Qin Yiming , Hu Xiaodong , Xiao Xiaoling
Published: April 2022

Federated learning framework facilitates more applications of deep learning algorithms on the existing network architectures, where the model parameters are aggregated in a centralized manner. However, some of federated learning participants are often inaccessible, such as in a power shortage or dormant state. That will force us to explore the possibility that the parameter aggregation is operated in an ad hoc manner, which is based on consensus computing. On the contrary, since caching mechanism is indispensable to any federated learning mobile node, it is necessary to investigate the connection between it and consensus computing. In this article, we first propose a novel federated learning paradigm, which supports an ad hoc operation mode for federated learning participants. Second, a discrete-time dynamic equation and its control law are formulated to satisfy the demands from federated learning framework, with a quantized caching scheme designed to mask the uncertainties from both asynchronous updates and measurement noises. Then, the consensus conditions and the convergence of the consensus protocol are deduced analytically, and a quantized caching strategy to optimize the convergence speed is provided. Our major contribution is to give the basic theories of distributed consensus problem for federated learning framework, and the theoretical results are validated by numerical simulations.
Paternalistic leadership as a double-edged sword: Analysis of the Sri Lankan President’s response to the COVID-19 crisis
Authors: Gunasekara Asanka , Dahanayake Pradeepa , Attanayake Chulanee , Bertone Santina
Published: April 2022

Despite the challenges facing small economies, leadership research has given scant attention to leaders’ behaviour in those countries during crises. Using seemingly paradoxical domains of paternalistic leadership theory: authoritarian, benevolent and moral leader behaviour, together with concepts like populism from the political science domain, we analyse how Sri Lanka’s ‘strongman’ President provided a façade of paternalistic leadership during the first phase of the COVID-19 pandemic. Through analysis of written and verbal content (public speeches, independent reports and government media output), we show how the power exercised through authoritarian, as opposed to authoritative behaviour, together with espoused morality and benevolence, appears to have been effective in the short term in containing the pandemic. However, sustained success in dealing with the crisis is hampered by the contradictions between this paternalistic façade and the dark realities of authoritarian and populist leadership. Accordingly, we offer theoretical insights into how the darker elements of paternalistic leadership can be better understood and averted.
Perioperative micronutrients, macroscopic benefits?
Authors: Stretton Brandon , Kovoor Joshua G , Vanlint Andrew , Maddern Guy , Thompson Campbell H
Published: April 2022

‘Micronutrients’ are vitamins and minerals vital for healthy metabolic function, wound healing and disease and infection prevention. Micronutrients may play a role in significantly improving postoperative recovery and indices of patient comfort; however, minimal research exists for surgical patients. Furthermore, current guidelines on perioperative nutrition have a macronutrient focus which may fail to guide detection and treatment of the subclinical micronutrient deficiency in a patient who is not obviously malnourished. Limited research into supplementation of some micronutrient deficiencies shows favourable results; however, given the financial implications of wound care, the prevalence of micronutrient deficiency and possible benefits from attention to micronutrition for postoperative recovery, further research into this area is urgently warranted. Interventions to guide optimal future clinical practice are suggested.
The management of cataract surgery in diabetic patients
Authors: Xia Yu
Published: April 2022

A cataract in the eye is a major cause of vision loss in diabetic patients, which occurs earlier and develops faster than non-diabetic patients, and often requires surgery for treatment. However, diabetic patients undergoing cataract surgery have a higher risk of intraoperative and postoperative complications than non-diabetic patients. For diabetic patients undergoing any surgery, careful perioperative assessment and management are required to reduce postoperative complications and improve surgical outcomes. Better understanding of their needs may guide perioperative practitioners to manage their care appropriately. This article presents recent evidence and guidance associated with the preoperative, intraoperative and postoperative management of diabetic patients undergoing cataract surgery and to inform perioperative practitioners of the challenges and potential complications to provide the best care and improve sight.
Early Outcomes of Patients Undergoing Neoaortic Valve Repair Incorporating Geometric Ring Annuloplasty
Authors: Kupferschmid John P. , Turek Joseph W. , Hughes G. Chad , Austin Erle H. , Alsoufi Bahaaldin , Smith J. Michael , Scholl Frank G. , Rankin J. Scott , Badhwar Vinay , Chen Jonathan M. , Nuri Muhammad A. , Romano Jennifer C. , Ohye Richard G. , Si Ming-Sing
Published: April 2022

Objectives

During congenital heart surgery, the pulmonary valve and root may be placed into the systemic position, yielding a “neoaortic” valve. With the stress of systemic pressure, the pulmonary roots can dilate, creating aneurysms and/or neoaortic insufficiency (neoAI). This report analyzes the early outcomes of patients undergoing neoaortic valve repair incorporating geometric ring annuloplasty.

Methods

Twenty-one patients underwent intended repair at six centers and formed the study cohort. Thirteen had previous Ross procedures, five had arterial switch operations, and three Fontan physiology. Average age was 21.7 ± 12.8 years (mean  ±  SD), 80% were male, and 11 (55%) had symptomatic heart failure. Preoperative neoAI Grade was 3.1  ±  1.1, and annular diameter was 30.7  ±  6.5 mm.

Results

Valve repair was accomplished in 20/21, using geometric annuloplasty rings and leaflet plication (n = 13) and/or nodular release (n = 7). Fourteen had neoaortic aneurysm replacement (13 with root remodeling). Two underwent bicuspid valve repair. Six had pulmonary conduit changes, one insertion of an artificial Nodulus Arantius, and one resection of a subaortic membrane. Ring size averaged 21.9  ±  2.3 mm, and aortic clamp time was 171  ±  54 minutes. No operative mortality or major morbidity occurred, and postoperative hospitalization was 4.3  ±  1.4 days. At discharge, neoAI grade was 0.2  ±  0.4 ( P < .0001), and valve mean gradient was ≤20 mm Hg. At average 18.0  ±  9.1 months of follow-up, all patients were asymptomatic with stable valve function.

Conclusions

Neoaortic aneurysms and neoAI are occasionally seen late following Ross, arterial switch, or Fontan procedures. Neoaortic valve repair using geometric ring annuloplasty, leaflet reconstruction, and root remodeling provides a patient-specific approach with favorable early outcomes.
Profiling ROPO Shoppers: Shopping Value Perspective
Authors: Patel Vipul
Published: April 2022

Today’s consumers are multichannel shoppers, that is, they have many channel options for searching product-related information and purchase. This study focuses on one such form of multichannel shopping behavior of online search and offline purchase sequence known as ROPO (research online and purchase offline) behavior in the post-COVID-19 pandemic context. As shoppers return to stores post-COVID-19 pandemic, understanding this ROPO behavior will help retailers to develop strategies to meet their needs. This study attempts to profile the shoppers showing ROPO behavior based on the theory of perceived value of shopping, that is, shoppers select the channels at each stage of shopping that provide maximum value considering the various costs associated with those channels. Six drivers of ROPO behaviors are confirmed based on the sample of 526 respondents using confirmatory factor analysis. Furthermore, three distinct segments of shoppers—risk averters, value maximizers, and convenience seekers—showing ROPO behaviors are identified using k-means cluster analysis. Knowledge of these distinct shopper segments will provide managerial insight for retailers to provide an excellent shopping experience to their customers during the post-COVID-19 pandemic.
A Perspective on Digital Transformation Among Indian Exporting Firms
Authors: Khan Surender , Goel Anuj
Published: April 2022

The objective of this prospective study is to demonstrate the challenges faced by business organizations while adapting to the new digital landscape. The idea is to assist in breaking down the complex process of digital transformation and strengthen the management perspective in the area. The study argues how manufacturing exporting firms could develop a digital transformation strategy that includes a different aspect of the strategy tailored to the nature of the Indian exporting firms. Dealing with different aspects of digital transformation, the study discusses different perspectives such as core competencies, internal drivers of digital transformation (IDDT) and external drivers of digital transformation (EDDT), enablers of digital transformation (EDT), new capabilities required and strategic imperatives of digital transformation. Synthesizing digitalization through these lenses can help in developing and implementing a successful digital transformation strategy.
Impact of Fluoride on Associations between Free Sugars Intake and Dental Caries in US Children
Authors: Melough M.M. , Sathyanarayana S. , Zohoori F.V. , Gustafsson H.C. , Sullivan E.L. , Chi D.L. , Levy S.M. , McKinney C.M.
Published: April 2022

Objective:

Dental caries is the most prevalent chronic disease in US children, with the highest burden among Black and Hispanic youth. Sugars are a primary risk factor, but few studies have specifically measured intakes of free sugars and related this to dental caries or explored the extent to which water fluoride mitigates the cariogenicity of free sugars. Furthermore, the cariogenicity of certain free sugars sources, such as extruded fruit and vegetable products, is unclear.

Methods:

Using cross-sectional data on 4,906 children aged 2 to 19 y in the US National Health and Nutrition Examination Survey 2013–2016, we examined associations of free sugars intake with counts of decayed or filled primary tooth surfaces (dfs) and decayed, missing, or filled permanent surfaces (DMFS) in negative binomial regressions. Stratified models examined these associations in children with home water fluoride above or below the Centers for Disease Control and Prevention (CDC)–recommended level of 0.7 ppm.

Results:

Free sugars accounted for 16.4% of energy, primarily contributed by added sugars. In adjusted models, a doubling in the percentage of energy from free sugars was associated with 22% (95% confidence interval [CI], 1%–47%) greater dfs among children aged 2 to 8. A doubling in energy from added sugars was associated with 20% (95% CI, 1%–42%) greater dfs and 10% (95% CI, 2%–20%) greater DMFS in children aged 6 to 19 y. Beverages were the most important source of added sugars associated with increased caries. Other free sugars were not associated with dfs or DMFS. Associations between free sugars and caries were diminished among children with home water fluoride of 0.7 ppm or greater.

Conclusions:

Free sugars intake, especially in the form of added sugars and specifically in sweetened beverages, was associated with higher dental caries. Water fluoride exposures modify these associations, reducing caries risk in the primary dentition of children whose home water meets recommended fluoride levels.

Knowledge Transfer Statement:

Intake of free sugars, especially in the form of added sugars and specifically in beverages, was associated with higher dental caries in US children in this study. Water fluoride exposure at CDC-recommended levels protected against caries, especially in the primary dentition. These findings suggest that household water fluoridation at CDC-recommended levels protects against the cariogenic potential of free and added sugars during childhood.
Resistance in Popular Visuals and Iconography: A Study of Dalit–Bahujan Calendar Art in North India
Authors: Kalyani Kalyani
Published: April 2022

The Dalit–Bahujan visual representation is uniquely constituted through cultural artefacts, symbols and iconography. The pictorial representations of cultural artefacts are meaningful as they signify and symbolise resistance. The new emerging visuality of the marginalised communities is questioning the dominant regimes of visuality. A calendar as the site of visuality is a signification of resistance to the Brahminical culture by the Dalit–Bahujan community. The Calendar art has engaged with a reiteration of anti-caste social icons that has generated a visual effect on the collective memory of the community. This article has traced the shifts that have happened in calendar art with the rise of anti-caste consciousness in North India. The article has methodologically engaged in observing and doing a content analysis of calendars that are gaining popularity among the Dalit–Bahujan community. The article has also presented an in-depth case study of the Samyak Prakashan calendar in North India. Through the study of the calendar’s iconography and symbols, the article reflects on the cultural practices of the Dalit–Bahujan community. The article also looks into the epistemological and historiographical gaps that are bridged through the reiteration of culturally significant dates in the calendar.
Respiratory viruses in hematopoietic cell transplant candidates: impact of preexisting lower tract disease on outcomes
Authors: Kim Yae-Jean , Waghmare Alpana , Xie Hu , Holmberg Leona , Pergam Steven A. , Jerome Keith R. , Leisenring Wendy M. , Ogimi Chikara , Campbell Angela P. , Englund Janet A. , Boeckh Michael
Published: April 2022

Pretransplant respiratory virus infections (RVIs) have been shown to negatively affect hematopoietic cell transplantation (HCT) outcomes. The impact of and need for delay of HCT for pretransplant infection with human rhinovirus (HRV) or endemic human coronavirus (HCoV; 229E, OC43, NL63, and HKU1) remain controversial. We analyzed the impact of symptomatic RVI within ≤90 days before HCT on overall mortality, posttransplant lower respiratory tract disease (LRD), and days alive and out of hospital (DAOH) by day 100 post-HCT in multivariable models. Among 1,643 adult HCT recipients (58% allogeneic recipients), 704 (43%) were tested for RVI before HCT, and 307 (44%) tested positive. HRV was most commonly detected (56%). Forty-five (15%) of 307 HCT recipients had LRD with the same virus early after HCT. Pretransplant upper respiratory tract infection (URI) with influenza, respiratory syncytial virus, adenovirus, human metapneumovirus, parainfluenza virus, HRV, or endemic HCoV was not associated with increased overall mortality or fewer DAOH. However, in allogeneic recipients who received myeloablative conditioning, LRD due to any respiratory virus, including HRV alone, was associated with increased overall mortality (adjusted hazard ratio, 10.8 [95% confidence interval, 3.29-35.1] for HRV and 3.21 [95% confidence interval, 1.15-9.01] for all other viruses). HRV LRD was also associated with fewer DAOH. Thus, the presence of LRD due to common respiratory viruses, including HRV, before myeloablative allogeneic HCT was associated with increased mortality and hospitalization. Pretransplant URI due to HRV and endemic HCoV was not associated with these outcomes. Improved management strategies for pretransplant LRD are warranted.
Efficacy of combined immunosuppression with or without eltrombopag in children with newly diagnosed aplastic anemia
Authors: Goronkova Olga , Novichkova Galina , Salimova Tatiana , Kalinina Irina , Baidildina Dina , Petrova Ulyana , Antonova Kristina , Sadovskaya Maria , Suntsova Elena , Evseev Dmitry , Matveev Victor , Venyov Dmitry , Khachatryan Lili , Litvinov Dmitry , Pshonkin Alexey , Ovsyannikova Galina , Kotskaya Natalia , Gobadze Darina , Olshanskaya Yulia , Popov Alexander , Raykina Elena , Mironenko Olga , Voronin Kirill , Purbueva Bazarma , Boichenko Elmira , Dinikina Yulia , Guseynova Evgeniya , Sherstnev Dmitry , Kalinina Elena , Mezentsev Sergey , Streneva Olga , Yudina Natalia , Plaksina Olga , Erega Elena , Maschan Michael , Maschan Alexey
Published: April 2022

We compared the efficacy and safety of eltrombopag (ELTR) combined with immunosuppressive therapy (IST) and IST alone in treatment-naïve children with severe (SAA) and very severe (vSAA) aplastic anemia. Ninety-eight pediatric patients were randomized to receive horse antithymocyte globulin (hATG) and cyclosporin A (CsA) with (n = 49) or without (n = 49) ELTR. The primary endpoint was the overall response rate (ORR) at 4 months. After 4 months, nonresponders were crossed over to the alternative group. In all patients, the ORR in ELTR + IST and IST groups was similar (65% vs 53%; P = .218); however, the complete response (CR) rate was significantly higher in the ELTR + IST group (31% vs 12%; P = .027). In severity subgroups, the ORR was 89% vs 57% (P = .028) in favor of IST + ELTR in SAA, but it did not differ in patients with vSAA (52% vs 50%; P = .902). At 6 months after the crossover, 61% of initial ELTR(−) patients achieved a response compared with 17% of initial ELTR(+) patients (P = .016). No significant difference in ELTR + IST and IST groups was observed in the 3-year overall survival (OS) (89% vs 91%; P = .673) or the 3-year event-free survival (EFS) (53% vs 41%; P = .326). There was no unexpected toxicity related to ELTR. Adding ELTR to standard IST was well tolerated and increased the CR rate. The greatest benefit from ELTR combined with IST was observed in patients with SAA but not in those with vSAA. The second course of IST resulted in a high ORR in initial ELTR(−) patients who added ELTR and had limited efficacy among patients who received ELTR upfront. This trial was registered at Clinicaltrials.gov as #NCT03413306.
Noninvasive diagnosis of pulmonary hypertension with hyperpolarised129Xe magnetic resonance imaging and spectroscopy
Authors: Bier Elianna A. , Alenezi Fawaz , Lu Junlan , Wang Ziyi , Mammarappallil Joseph G. , O'Sullivan-Murphy Bryan , Erkanli Alaattin , Driehuys Bastiaan , Rajagopal Sudarshan
Published: April 2022

Background

The diagnosis of pulmonary hypertension (PH) remains challenging. Pre- and post-capillary PH have different signatures on noninvasive129Xe gas-exchange magnetic resonance imaging (MRI) and dynamic MR spectroscopy (MRS). We tested the accuracy of129Xe MRI/MRS to diagnose PH status compared to right heart catheterisation (RHC).

Methods

129Xe MRI/MRS from 93 subjects was used to develop a diagnostic algorithm, which was tested in 32 patients undergoing RHC on the same day (n=20) or within 5 months (42±40 days) (n=12). Three expert readers, blinded to RHC, used129Xe MRI/MRS to classify subjects as pre-capillary PH, post-capillary PH, no PH and no interstitial lung disease (ILD), or ILD.

Results

For pre-capillary PH,129Xe MRI/MRS diagnostic accuracy was 75% (95% CI 66–84) with a sensitivity of 67% (95% CI 54–79) and a specificity of 86% (95% CI 75–96); for post-capillary PH accuracy was 69% (95% CI 59–78) with sensitivity of 54% (95% CI 34–74) and specificity of 74% (95% CI 63–84). The model performed well in straightforward cases of pre-capillary PH but was less accurate in its diagnosis in the presence of mixed disease, particularly in the presence of ILD or combined post- and pre-capillary PH.

Conclusion

This study demonstrates the potential to develop129Xe MRI/MRS into a modality with good accuracy in detecting pre- and post-capillary PH. Furthermore, the combination of129Xe dynamic MRS and gas-exchange MRI uniquely provide concurrent, noninvasive assessment of both haemodynamics and gas-exchange impairment that may aid in the detection of PH.
Impact of mental health and personality traits on the incidence of chronic cough in the Canadian Longitudinal Study on Aging
Authors: Satia Imran , Mayhew Alexandra J. , Sohel Nazmul , Kurmi Om , Killian Kieran J. , O'Byrne Paul M. , Raina Parminder
Published: April 2022

Background

Chronic cough is a common troublesome condition, but risk factors for developing chronic cough are poorly understood. The aim of this study was to understand the relationship between mental health disorders, personality traits and chronic cough.

Methods

The Canadian Longitudinal Study on Aging is a prospective, nationally generalisable, random sample of adults aged 45–85 years at baseline recruited between 2011 and 2015, and followed-up 3 years later. Chronic cough was defined as a daily cough over the last 12 months. Incident chronic cough was defined as those participants who reported new-onset chronic cough between baseline and follow-up 1. Current depressive symptoms and psychological distress were assessed using the Center for Epidemiologic Study Short Depression Scale (CESD-10) and Kessler Psychological Distress Scale (K-10), respectively. The “Big Five” personality traits were assessed using the Ten-Item Personality Inventory. Relative risks are reported using a multivariate mutually adjusted model.

Results

At follow-up 1, 2506 participants (11.1%) reported new-onset chronic cough during the ∼3-year interval. Depressive symptoms (CESD-10 ≥10: relative risk 1.22 (95% CI 1.03–1.44)) and psychological distress (K-10 ≥22: relative risk 1.20 (95% CI 1.07–1.36)) at baseline were both independent predictors of a higher risk of incident chronic cough. Prevalent and incident chronic cough were also independently associated with an increased risk of developing depressive symptoms and psychological distress. Personality traits did not influence the development of chronic cough but did increase the risk of depressive symptoms and psychological distress.

Conclusions

This study shows that there is a bidirectional relationship between chronic cough, and depressive symptoms and psychological distress, and personality traits do not independently influence the development of chronic cough.
The Global Campaign turns 18: a brief review of its activities and achievements
Authors: Steiner Timothy J. , Birbeck Gretchen L. , Jensen Rigmor H. , Martelletti Paolo , Stovner Lars Jacob , Uluduz Derya , Leonardi Matilde , Olesen Jes , Katsarava Zaza
Published: April 2022

The Global Campaign against Headache, as a collaborative activity with the World Health Organization (WHO), was formally launched in Copenhagen in March 2004. In the month it turns 18, we review its activities and achievements, from initial determination of its strategic objectives, through partnerships and project management, knowledge acquisition and awareness generation, to evidence-based proposals for change justified by cost-effectiveness analysis.
Developmental dynamics of sex reprogramming by high incubation temperatures in a dragon lizard
Authors: Whiteley Sarah L. , Holleley Clare E. , Georges Arthur
Published: April 2022

Background

In some vertebrate species, gene-environment interactions can determine sex, driving bipotential gonads to differentiate into either ovaries or testes. In the central bearded dragon (Pogona vitticeps), the genetic influence of sex chromosomes (ZZ/ZW) can be overridden by high incubation temperatures, causing ZZ male to female sex reversal. Previous research showed ovotestes, a rare gonadal phenotype with traits of both sexes, develop during sex reversal, leading to the hypothesis that sex reversal relies on high temperature feminisation to outcompete the male genetic cue. To test this, we conducted temperature switching experiments at key developmental stages, and analysed the effect on gonadal phenotypes using histology and transcriptomics.

Results

We found sexual fate is more strongly influenced by the ZZ genotype than temperature. Any exposure to low temperatures (28 °C) caused testes differentiation, whereas sex reversal required longer exposure to high temperatures. We revealed ovotestes exist along a spectrum of femaleness to male-ness at the transcriptional level. We found inter-individual variation in gene expression changes following temperature switches, suggesting both genetic sensitivity to, and the timing and duration of the temperature cue influences sex reversal.

Conclusions

These findings bring new insights to the mechanisms underlying sex reversal, improving our understanding of thermosensitive sex systems in vertebrates.
Nuclear respiratory factor 1 promotes the growth of liver hepatocellular carcinoma cells via E2F1 transcriptional activation
Authors: Wang Dan , Wan Baolan , Zhang Xiaojing , Sun Pingping , Lu Shu , Liu Chenxu , Zhu Li
Published: April 2022

Background

Recent studies have shown that functional mitochondria are essential for cancer cells. Nuclear respiratory factor 1 (NRF1) is a transcription factor that activates mitochondrial biogenesis and the expression of the respiratory chain, but little is known about its role and underlying mechanism in liver hepatocellular carcinoma (LIHC).

Methods

NRF1 expression was analyzed via public databases and 24 paired LIHC samples. Clinical-pathological information and follow-up data were collected from 165 patients with LIHC or online datasets. Furthermore, cellular proliferation and the cell cycle were analyzed by MTT, Clone-forming assay and flow cytometric analyses. NRF1 target genes were analyzed by Chromatin immunoprecipitation sequencing (ChIP-Seq). PCR and WB analysis was performed to detect the expression of related genes. ChIP and luciferase activity assays were used to identify NRF1 binding sites.

Results

Our results showed that NRF1 expression was upregulated in LIHC compared to normal tissues. NRF1 expression was associated with tumour size and poor prognosis in patients. Knockdown of NRF1 repressed cell proliferation and overexpression of NRF1 accelerated the G1/S phase transition. Additionally, data from ChIP-seq pointed out that some NRF1 target genes are involved in the cell cycle. Our findings indicated that NRF1 directly binds to the E2F1 promoter as a transcription factor and regulates its gene expression.

Conclusion

Therefore, this study revealed that NRF1 promotes cancer cell growth via the indirect transcriptional activation of E2F1 and is a potential biomarker in LIHC.
Long-term effectiveness and safety of ustekinumab in bio-naïve and bio-experienced anti-tumor necrosis factor patients with Crohn’s disease: a real-world multicenter Brazilian study
Authors: Parra Rogério Serafim , Chebli Júlio Maria Fonseca , Queiroz Natália Sousa Freitas , Damião Aderson Omar Mourão Cintra , de Azevedo Matheus Freitas Cardoso , Chebli Liliana Andrade , Bertges Erika Ruback , Alves Junior Antonio José Tiburcio , Ambrogini Junior Orlando , da Silva Bianca Loyo Pona Schiavetti , Lubini Marcio , Bafutto Mauro , Flores Cristina , Vilela Eduardo Garcia , Boratto Sandra Felice , Gasparetti Junior Newton Luiz Tricarico , Steinwurz Flavio , Carvalho Nayara Salgado , Féres Omar , da Rocha José Joaquim Ribeiro
Published: April 2022

Background

The effectiveness of ustekinumab (UST) in the treatment of Crohn’s disease (CD) has been demonstrated in the pivotal Phase 3 UNITI 1 and 2 and IM-UNITI studies in both anti-TNF-naïve and anti-TNF-exposed patients. Given the selective nature of pivotal trial designs, real-world effectiveness and safety studies are warranted. We report our experience with UST treatment in a large, real-world multicenter cohort of Brazilian patients with CD.

Methods

We performed a retrospective multicenter study including patients with CD, predominantly biologically refractory CD, who received UST. The primary endpoint was the proportion of patients in clinical remission at weeks 8, 24 and 56. Possible predictors of clinical and biological response/remission and safety outcomes were also assessed.

Results

Overall, 245 CD (mean age 39.9 [15–87]) patients were enrolled. Most patients (86.5%) had been previously exposed to biologics. According to nonresponder imputation analysis, the proportions of patients in clinical remission at weeks 8, 24 and 56 were 41.0% (n = 98/239), 64.0% (n = 153/239) and 39.3% (n = 94/239), respectively. A biological response was achieved in 55.4% of patients at week 8, and 59.3% were in steroid-free remission at the end of follow-up. No significant differences in either clinical or biological remission were noted between bio-naïve and bio-experienced patients. Forty-eight patients (19.6%) presented 60 adverse events during the follow-up, of which 8 (13.3%) were considered serious adverse events (3.2% of 245 patients). Overall, a proximal disease location, younger age, perianal involvement, and smoking were associated with lower rates of clinical remission over time.

Conclusions

UST therapy was effective and safe in the long term in this large real-life cohort of Brazilian patients with refractory CD, regardless of previous exposure to other biological agents.