bluuebunny/crossref_metadata_2025 huggingface dataset:
New FORTRAN meanline code for investigating the volute to rotor interspace effect on mixed flow turbine performance
Authors: Ketata Ahmed , Driss Zied
Published: April 2021

Mixed flow turbines are widely used in several industrial applications covering turbomachinery, automotive engineering and electricity production. For decades, it is well known that mixed flow turbines are a seat of several loss phenomena such as the volute to rotor interspace loss, subject of this paper. Commonly, the meanline approach is the first step solution for building a preliminary design of such turbines and estimating subsequent losses. The accuracy of the code used in the meanline modeling is crucial for building an optimized turbine design with a minimized loss generation. This paper presents an improved validated meanline code, written in the newest object-oriented version of the FORTRAN language, for turbomachinery performance prediction. Unlike commercially available codes, the code allows the calculation of the rotor passage loss coefficient given the turbine expansion ratio without the need for additional test data. The standard deviation value between the code and test data is less than 10%, for all studied cases which ensure the validity of the developed model. Then, the developed code is exploited to investigate the effect of the volute to rotor interspace geometry on the loss generation and performance of a mixed flow turbine. Indeed, a performance distribution over a wide range of rotational speed and an energy loss breakdown are depicted and discussed showing a significant impact of the volute to rotor interspace. The results revealed an improvement in the turbine efficiency up to 2.9% with a volute to rotor interspace radii ratio of 0.59 at 80% of the design speed.
Visfatin facilitates gastric cancer malignancy by targeting snai1 via the NF-κB signaling
Authors: Cao D , Chu L , Xu Z , Gong J , Deng R , Wang B , Zhou S
Published: April 2021

Background:

Visfatin acts as an oncogenic factor in numerous tumors through a variety of cellular processes. Visfatin has been revealed to promote cell migration and invasion in gastric cancer (GC). Snai1 is a well-known regulator of EMT process in cancers. However, the relationship between visfatin and snai1 in GC remains unclear. The current study aimed to explore the role of visfatin in GC.

Methods:

The RT-qPCR and western blot analysis were used to measure RNA and protein levels, respectively. The cell migration and invasion were tested by Trans-well assays and western blot analysis.

Results:

Visfatin showed upregulation in GC cells. Additionally, Visfatin with increasing concentration facilitated epithelial-mesenchymal transition (EMT) process by increasing E-cadherin and reducing N-cadherin and Vimentin protein levels in GC cells. Moreover, endogenous overexpression and knockdown of visfatin promoted and inhibited migratory and invasive abilities of GC cells, respectively. Then, we found that snai1 protein level was positively regulated by visfatin in GC cells. In addition, visfatin activated the NF-κB signaling to modulate snai1 protein expression. Furthermore, the silencing of snai1 counteracted the promotive impact of visfatin on cell migration, invasion and EMT process in GC.

Conclusion:

Visfatin facilitates cell migration, invasion and EMT process by targeting snai1 via the NF-κB signaling, which provides a potential insight for the treatment of GC.
Net benefit separation and the determination curve: A probabilistic framework for cost-effectiveness estimation
Authors: Spieker Andrew J , Illenberger Nicholas , Roy Jason A , Mitra Nandita
Published: April 2021

Considerations regarding clinical effectiveness and cost are essential in comparing the overall value of two treatments. There has been growing interest in methodology to integrate cost and effectiveness measures in order to inform policy and promote adequate resource allocation. The net monetary benefit aggregates information on differences in mean cost and clinical outcomes; the cost-effectiveness acceptability curve was developed to characterize the extent to which the strength of evidence regarding net monetary benefit changes with fluctuations in the willingness-to-pay threshold. Methods to derive insights from characteristics of the cost/clinical outcomes besides mean differences remain undeveloped but may also be informative. We propose a novel probabilistic measure of cost-effectiveness based on the stochastic ordering of the individual net benefit distribution under each treatment. Our approach is able to accommodate features frequently encountered in observational data including confounding and censoring, and complements the net monetary benefit in the insights it provides. We conduct a range of simulations to evaluate finite-sample performance and illustrate our proposed approach using simulated data based on a study of endometrial cancer patients.
Structure-property-processing relationships in extruded liquid crystal polymer film
Authors: Sullivan Anthony , Saigal Anil , Zimmerman Michael A
Published: April 2021

Liquid crystal polymers (LCPs) derive favorable mechanical, chemical, and electrical behavior from long-range molecular ordering. The microstructure gives rise to anisotropic bulk properties that are problematic for industrial applications, and thus the ability to model the polymer directionality is essential to the design of isotropic material manufacturing processes. This investigation proposes a modeling methodology to simulate the 3D director field in full-scale film extrusion geometries. Wide-angle x-ray scattering (WAXS) is used to validate the predicted orientation for a standard coat-hanger die, and is compared with macroscopic mechanical, thermal, and dielectric testing of LCP film to illustrate the morphological dependence of the polymer properties. The highly anisotropic orientation state resulting from cast film extrusion is both predicted by the model and confirmed experimentally, and this preferred orientation is shown to correlate with observed anisotropy in the bulk properties. Additionally, a practical implementation of the modeling tool is presented to simulate directionality in two alternative die geometries designed to improve bulk isotropy, and it is demonstrated that the model is capable of simulating the resulting order for large, irregular domains typical of industrial processing.
Sport for Indigenous resurgence: Toward a critical settler-colonial reflection
Authors: Essa Mariana , Arellano Alexandra , Stuart Stephen , Sheps Stephen
Published: April 2021

This article examines the field of sport for development (SFD) while considering Indigenous resurgence amidst Canada’s neoliberal settler-colonial landscape. While sharing challenges encountered within their practice, program staff from the Promoting Life-skills in Aboriginal Youth program revealed high levels of constructive self-criticism and reflexivity. There are three emergent themes, the adoption of which appeared essential for transforming the sector in recognition of Indigenous resurgence: growth and pace; Indigenous agency and knowledge; and political engagement. Grounded in settler colonialism and resurgence, this paper also reflects on the field of SFD and what it would mean to decolonize the practice. The article concludes by asking if non-Indigenous scholars can study SFD by subverting the colonial status quo that is also reproduced in this research field.
Intergenerational Solidarity and Being Primary Caregiver for Older Parents in Chinese American Families: Findings From PIETY Study
Authors: Xu Ling , Liu Jinyu , Mao Weiyu , Guo Man , Chi Iris , Dong Xinqi
Published: April 2021

Introduction:

Guided by the intergenerational solidarity theory, this study examined how different dimension of intergenerational solidarity of adult children associated with their choice of being a primary caregiver for aging parents in the Chinese American families.

Methodology:

Secondary data from PIETY study were used. Logistic regressions were conducted to examine the relationships between each dimension of intergenerational solidarity and the likelihood of being a primary caregiver to mother or father.

Results:

Associational solidarity (odds ratio [ OR] = 1.31, for father, OR = 1.27, for mother), normative solidarity ( OR = 1.06, for both father and mother), and structural solidarity ( OR = 0.95, for father, OR = 0.64, for mother) were significant associates of high chances of being primary caregivers for older parents.

Discussion:

Results from this study confirmed the importance of cultural construct of solidarity in caregiving choice. Practice implications for health care professionals, in particular the nurses were discussed.
Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications
Authors: Rydström Lise-Lott , Tavallali Azar , Sundborg Eva , Berlin Anita , Ranheim Albertine
Published: April 2021

Becoming a parent changes one’s life, and existential questions arise. Time and being oscillate between joy and powerlessness, vulnerability, and self-confidence, between harmony and unpreparedness. Breastfeeding, one of the first skills new mothers try to master, can be joyful and painful. The aim of this study was to develop a deeper understanding of the phenomenon of initial breastfeeding complications as they are lived and experienced by mothers and how these mothers can be supported. Twelve mothers were interviewed, and a phenomenological lifeworld approach was used. Nourishing an infant and having initial breastfeeding complications can be understood by the essence and its constituents. Expectations are fulfilled, and expectations come to naught when complications are experienced such as wavering between powerlessness and joy and finding solutions through resistance. The results suggest that lifeworld-led caring may lead to deepened acknowledgment and the possibility for mothers to feel supported in their extreme situations.
What Moves People Living With Dementia? Exploring Barriers and Motivators for Physical Activity Perceived by People Living With Dementia in Care Homes
Authors: Gebhard Doris , Mir Eva
Published: April 2021

There is a lack of intervention promoting physical activity targeted toward people living with dementia because their input has not been prioritized in the development of exercise programs. The aim of this study is to investigate motivators and barriers concerning physical activity in people living with dementia in care homes and to give recommendations for intervention development. Qualitative semi-structured interviews were conducted; transcripts were analyzed using qualitative content analysis. Following a tailored procedural model, inductive and deductive category development was applied. The value of Cohen’s κ = .94 indicates the high intercoder reliability of the category system developed. Ten interviewees reported 24 different barriers and 12 motivators concerning physical activity in the context of the social-ecological model. The strong impact of intrapersonal factors and the living environment became apparent. Points of reference for how people living with dementia can overcome barriers and activate their motivators to achieve more physical activity are provided.
Prenatal and Postnatal Intimate Partner Violence and Associated Factors Among HIV-Infected Women in Rural South Africa: A Longitudinal Study
Authors: Matseke Motlagabo G. , Ruiter Robert A. C. , Rodriguez Violeta J. , Peltzer Karl , Lee Tae Kyoung , Jean Jenny , Sifunda Sibusiso
Published: April 2021

Intimate partner violence (IPV) has been highlighted as one of the challenges to the effectiveness of the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs in rural areas in South Africa. This study aimed at assessing the prevalence of prenatal and postnatal physical as well as psychological IPV, and corresponding time-invariant and time-varying predictors, among HIV-positive women attending PMTCT services in rural South Africa. The Conflict Tactics Scale (CTS) was used to assess IPV at four time points prenatal and postnatal. This study highlighted high levels of physical and psychological IPV experienced by HIV-infected women during pregnancy and in the first year after childbirth. Time-invariant predictors and time-varying predictors of physical IPV and psychological IPV were individual, social, and behavioral factors. Multi-dimensional evidence-based interventions are needed to deal with the high levels of prenatal and postnatal physical as well as psychological IPV experienced by these women.
Do Migrants Receive Tuberculosis Education in China? Evidence From the China Migrants Dynamic Survey
Authors: Zhu Zheng , Guo Mengdi , Dong Tingyue , Gong Beibei , Zhao Xia , Hu Yan
Published: April 2021

Background

Migrants are the key population for tuberculosis (TB) transmission in China. However, it remains unknown how many migrants have received TB education and through what means.

Objectives

To identify the rate and methods of TB education among migrants in China by using nationally representative data.

Method

This study used secondary data analysis. The data were derived from the China Migrants Dynamic Survey 2014–2017. A total sample of 745,926 migrants was included in the following analysis. Information on TB education was collected through a self-report questionnaire. We used hierarchical logistic regression models to explore the relationship between the independent variables and the receipt of TB education.

Results

Only 30.4% ( n = 226,458) received TB education. Among all age-groups, participants between 65 and 69 years old had the highest TB education rate (33.4%). Bulletin boards (86.5%–91%), media (73% to 86.7%), and books/magazines (59.2%–67.4%) were the most common ways for migrants to receive TB education.

Conclusions

Our study showed the rates of TB education in each region of China and indicated the significant disparity among the seven regions. Traditional media, off-line medical consultation, community advocacy, and bulletin boards should be the primary methods of delivering TB education. TB education campaigns targeting migrants with a low socioeconomic status should be actively promoted.
Protection Motivation During COVID-19: A Cross-Sectional Study of Family Health, Media, and Economic Influences
Authors: Hanson Carl L. , Crandall Ali , Barnes Michael D. , Novilla M. Lelinneth
Published: April 2021

Background

Protection motivation to practice preventive behaviors is necessary for sustained mitigation during coronavirus disease 2019 (COVID-19); however, limited research exists on the ecological sources of influence for COVID-19 protection motivation.

Aim

To explore sources of influence (family health, media consumption, and loss of work hours) on COVID-19 protection motivation.

Method

An online quantitative survey of U.S. adults ( N = 501) aged 18 years or older was administered using Qualtrics with participants recruited through Amazon Mechanical Turk. Data were collected on constructs related to the protection motivation theory and theory of planned behavior as well as sources of influence and intention to socially distance and socially isolate during COVID-19. Constructs were further defined through exploratory and confirmatory factor analyses. Structural equation modeling was used to determine relationships between constructs.

Results

A two-factor model was identified with threat appraisal as one factor and subjective norms appraisal, coping appraisal, and behavioral intention loading as another factor. Higher news media consumption and loss of work hours due to COVID-19 were both significant predictors of increased threat appraisal. Family healthy lifestyle and family health resources were significantly related to increases in the subjective norms, coping appraisal, and behavioral intention appraisal factor.

Conclusions

Family health, news media consumption, and loss of work hours are associated with COVID-19 protection motivation. COVID-19 protection motivation might be enhanced through policies and messaging that can affect ecological sources of influence.
Clinical practice patterns and ascertainment bias for cardiovascular events in a randomized trial: A survey of investigators in the BEST-CLI trial
Authors: Albaghdadi Mazen S , Young Michael N , Chowdhury Mohammed M. , Assmann Susan , Hamza Taye , Siami Sandra , Villarreal Maria , Strong Michael , Menard Matthew , Farber Alik , Rosenfield Kenneth
Published: April 2021

Ascertainment bias is a well-recognized source of bias in research, but few studies have systematically analyzed sources of ascertainment bias in randomized trials in which blinding is not possible and endpoint assessment is not protocolized. In the current study, we sought to evaluate differences in the clinical practice patterns of trial investigators with respect to bias in the ascertainment of pre-revascularization patient risk and the incidence of secondary endpoints post-revascularization. We conducted a cross-sectional survey of active investigators ( n = 936) from the Best Endovascular Versus Best Surgical Therapy for Patients with Critical Limb Ischemia (BEST-CLI) trial. The total survey response rate was 19.6% (183/936). Vascular surgeons were more likely than nonsurgical interventionalists to order tests for cardiac complications after both surgical bypass ( p < 0.001) and endovascular revascularization ( p = 0.038). Post-procedure, investigators were more likely to order additional testing for cardiac complications in open surgery versus endovascular cases (7% vs 16% never, 41% vs 65% rarely, 43% vs 17% sometimes, 9% vs 2% always, respectively; p < 0.0001). Significant variation in practice patterns exist in the pre- and post-procedure assessment of cardiac risk and events for patients with CLI undergoing revascularization. Variation in the ascertainment of risk and outcomes according to the type of revascularization procedure and physician specialty should be considered when interpreting the results of clinical studies, such as the BEST-CLI trial. ClinicalTrials.gov Identifier: NCT02060630
First-episode psychosis in the ultra-Orthodox Jewish population
Authors: Serfaty David R. , Biran-Ovadia Ateret , Strous Rael D.
Published: April 2021

Few if any methodologically robust studies of first-episode psychosis have been carried out in the ultra-Orthodox Jewish population. The opening of an inpatient psychiatry department within an ultra-Orthodox neighborhood in Israel offered the unique opportunity to study the specifics of first -episode psychosis in this subpopulation. Medical records of 60 ultra-Orthodox male Jewish patients with first-episode psychosis were examined over the first 18 months of the new department’s operation. Data regarding the patients’ demographical status, anamnestic information, clinical presentation, and psychiatric care were analyzed. Participants were 18–30 years old; 15 (25%) were already engaged or married. Most patients (37, 61.7%) had not been employed in any formal activity prior to their hospitalization, with 21 patients (35%) studying in a Talmudical school. Religion-related delusions were noted in 20 patients (33.3%), and community/rabbi-related delusions in 18 patients (30%). Only three patients (5%) reported suicidal attempts. Duration of untreated psychosis (DUP) ranged between 1–48 months (mean 10.4, SD 9.5). In contrast to other first-episode psychosis studies, this study highlights specific features of first-episode psychosis in the ultra-Orthodox Jewish population, which is characterized by a high marriage rate, short DUP, low rates of substance use and suicidal attempts, expression of religious- and community-related themes in delusion content, and limited cooperation with health care providers. A better understanding of the cultural specifics of first-episode psychosis in this subpopulation may enable earlier treatment, improve prognosis, and facilitate compliance with medications and rehabilitation programs.
Bubble-wrapped sightseeing mobilities: Hop on–hop off bus experiences in Copenhagen
Authors: Larsen Jonas , Bastos Mónica Sylvia Gomes , Hansen Line Isselin Skovslund , Hevink Lieke Maureen , Jostova Katerina , Smagurauskaité Dovilé
Published: April 2021

This article explores the staging of the Hop On–Hop Off buses, bus-tour and actual embodied performances enacted by tourists on the move. We draw on a performance-inspired terminology to explore the co-production of mundane tourist experiences. Following calls for not making moral judgements or belittling sightseeing tourists and understanding the mundane dimensions of tourist practice, we conduct empathetic research with and about them. We also draw on performance metaphors to highlight the staged and scripted nature of these tours. However, to disavow assumptions that sightseeing is a uniform, fully choreographed practice, we identify different practices and motives within an otherwise much-scripted practice. We show that Hop On–Hop Off practices potentially undermine distinctions within tourism theory between (1) individual tourism and mass tourism, (2) self-directed active mobility (such as walking) and designed passive mobility (such as the sightseeing bus), (3) bubbles and local neighbourhoods and (4) gazing and glancing.
Establishment of validated stability indicating purity method based on the stress degradation behavior of gonadotropin-releasing hormone antagonist (ganirelix) in an injectable formulation using HPLC and LC-MS-QTOF
Authors: Ummiti Kumarswamy , Shanmukha Kumar JV
Published: April 2021

Stress study of a drug substance or pharmaceutical drug product provides a vision into degradation pathways and degradation products of the active pharmaceutical ingredient and helps in interpretation of the chemical structure of the degradation impurities. In the current study, Ganirelix active ingredient presented in the Orgalutran® was stressed with acidic and alkali hydrolysis, photolysis, thermal and oxidation conditions as per the guidelines of International Conference on Harmonization (ICH) Q1A (R2). Ganirelix was found to be labile under thermal and alkali hydrolytic stress conditions, while it was stable to acid hydrolytic, oxidative and photolytic stress. All degradation products were separated with a resolution > 1.5 on a C18 column (2.6 µm, 25 cm×4.6 mm) using a hydrophilic ion pair such as sodium perchlorate, at a concentration <0.04 M. In total, four major degradant impurities were found during stress study. These impurities were fractionated and desalted by flash chromatography for identification of chemical structures. LC-MS-QTOF analysis revealed that two degradation products are diastereomers of Ganirelix, one degradation product is a deamination compound and other degradation product result from the insertion of a new amino acid residue in the Ganirelix peptide sequence. The developed method is sensitive enough to quantify the related substances of Ganirelix at the 0.04% level with that of Ganirelix test concentration.
Two-part quantile regression models for semi-continuous longitudinal data: A finite mixture approach
Authors: Merlo Luca , Maruotti Antonello , Petrella Lea
Published: April 2021

This article develops a two-part finite mixture quantile regression model for semi-continuous longitudinal data. The proposed methodology allows heterogeneity sources that influence the model for the binary response variable to also influence the distribution of the positive outcomes. As is common in the quantile regression literature, estimation and inference on the model parameters are based on the asymmetric Laplace distribution. Maximum likelihood estimates are obtained through the EM algorithm without parametric assumptions on the random effects distribution. In addition, a penalized version of the EM algorithm is presented to tackle the problem of variable selection. The proposed statistical method is applied to the well-known RAND Health Insurance Experiment dataset which gives further insights on its empirical behaviour.
‘Landscape of exception’: Power inequalities and ethical planning challenges in the landscape transformation of south-eastern Sicily
Authors: Lo Piccolo Francesco , Todaro Vincenzo
Published: April 2021

In some marginal contexts of Southern Italy, in light of specific economic, political and social conditions, certain relationships between ‘strong powers’ and ‘weak powers’ produce a suspension of norms/rights that is, paradoxically, ‘normalised’. This creates a particular spatial variation of Agamben’s (2005) state of exception concept: the ‘landscape of exception’. With respect to the possible conditions of ‘exception’, this article describes the ‘landscape of exception’ of the greenhouse system in South-Eastern Sicily. This ‘landscape of exception’ is generated by the greenhouses, in particular those dedicated to vegetable production, through an effective mechanism of spatial manipulation of the landscape and social control of migrant workers. In relation to these considerations, this work reflects on the ethical challenges and responsibilities of planning, highlighting (explicit and latent) conflicts and power inequalities in the ‘landscapes of exception’, where issues of environmental sustainability, social justice and the suspension of norms are closely intertwined.
Very Early Exercise Rehabilitation After Intracerebral Hemorrhage Promotes Inflammation in the Brain
Authors: Tamakoshi Keigo , Maeda Madoka , Nakamura Shinnosuke , Murohashi Nae
Published: April 2021

Background

Very early exercise has been reported to exacerbate motor dysfunction; however, its mechanism is largely unknown.

Objective

This study examined the effect of very early exercise on motor recovery and associated brain damage following intracerebral hemorrhage (ICH) in rats.

Methods

Collagenase solution was injected into the left striatum to induce ICH. Rats were randomly assigned to receive placebo surgery without exercise (SHAM) or ICH without (ICH) or with very early exercise within 24 hours of surgery (ICH+VET). We observed sensorimotor behaviors before surgery, and after surgery preexercise and postexercise. Postexercise brain tissue was collected 27 hours after surgery to investigate the hematoma area, brain edema, and Il1b, Tgfb1, and Igf1 mRNA levels in the striatum and sensorimotor cortex using real-time reverse transcription polymerase chain reaction. NeuN, PSD95, and GFAP protein expression was analyzed by Western blotting.

Results

We observed significantly increased skillful sensorimotor impairment in the horizontal ladder test and significantly higher Il1b mRNA levels in the striatum of the ICH+VET group compared with the ICH group. NeuN protein expression was significantly reduced in both brain regions of the ICH+VET group compared with the SHAM group.

Conclusion

Our results suggest that very early exercise may be associated with an exacerbation of motor dysfunction because of increased neuronal death and region-specific changes in inflammatory factors. These results indicate that implementing exercise within 24 hours after ICH should be performed with caution.
Relation of the C/T-13910 LCT Polymorphism with Body Composition Measures and Their Modulation by Dairy Products in a Caucasian Men
Authors: Popadowska Agnieszka , Kempinska-Podhorodecka Agnieszka
Published: April 2021

The C/T-13910 LCT is closely associated with lactase persistence and LCT has emerged as a new candidate gene for obesity, in particular in northern Europeans. The aim of this research is to investigate to what degree sex determines the association between the LCT variant and anthropometric traits in a cohort of healthy individuals. We recruited 1000 (500 males and 500 females aged 18–65 years) healthy blood donors. The C/T-13910 LCT polymorphism was genotyped using TaqMan assays. All individuals were phenotyped with respect to anthropometric characteristics. Prevalence of genotypes was 22.7% CC (lactase non-persistent, LNP), 58.6% CT, and 18.7% TT. LNP genotype was present less frequently among men p = .0005; OR 0.582 [0.425–0.794]. Therefore, in addition statistical calculations were performed separately for men and women. Additional analysis demonstrated an association between the CC genotypes and higher chest ( p = .03), waist ( p = .005), and forearm circumference ( p = .0004) or more lean body mass ( p = .04), than T-allele carriers in males. In females, they were not significantly different. Men consumed more milk ( p = .003), while women ate more yoghurt ( p = .001). Pearson’s correlation analysis showed that the higher intake of milk and dairy products was associated with higher fat body mass among men with lactase persistence. In Caucasian men, the LNP genotype is associated with reduced milk intake and dairy products, but more fat-free mass and higher forearm circumference, which may be relevant to dietary management for lactose intolerant.
Semi-automated cerebral aneurysm segmentation and geometric analysis for WEB sizing utilizing a cloud-based computational platform
Authors: Rai Ansaar T , Brotman Ryan G , Hobbs Gerald R , Boo SoHyun
Published: April 2021

Background

Accurate aneurysm measurements are important for selecting the WEB device. The objective was to validate a cloud-based platform, SurgicalPreview (SP) against manual measurements for aneurysm analysis.

Methods

Two sets of measurements each for SP and manual methods were obtained for 40 aneurysms. Reliability and agreement were assessed with intra-class correlation coefficient (ICC) and Bland-Altman plots respectively. Kappa coefficient was used to assess agreement for predicting WEB size.

Results

There was good reliability for repeat SP measurements: aneurysm diameter (ICC-1, 95%CI 0.98–1), height (ICC-1, 95%CI 0.99–1) and neck diameter (ICC-0.96, 95%CI 0.93–0.98). There was good reliability for the two manual diameter (ICC-0.97, 95%CI 0.9–0.97) and height (ICC-0.93, 95%CI 0.87–0.96) measurements and moderate for neck diameter (ICC-0.76, 95%CI 0.54–0.87). There was greater agreement for SP versus manual repeat measurements on Bland-Altman plots. Reliability between the SP and manual methods was good for aneurysm diameter (ICC-0.98, 95%CI 0.95–1) and height (ICC-0.96, 95%CI-0.93–0.98) and moderate for neck. (ICC-0.6, 95%CI -0.22–0.87). The Bland-Altman plots confirmed better agreement between the two methods for the aneurysm diameter and height than the neck. There was strong agreement between the methods for predicting the WEB diameter (Kappa-0.84, 95%CI 0.71–0.97) and moderate for predicting WEB height (Kappa-0.66, 95%CI 0.43–0.89). There was moderate agreement for predicted versus deployed WEB diameter: SP (Kappa-0.56, 95%CI 0.38–0.74), Manual (Kappa-0.53, 95%CI 0.34–0.71).

Conclusion

The SurgicalPreview® had greater agreement for repeat measurements. There was good reliability between the two methods for predicting WEB diameter and height and moderate agreement between predicted versus deployed WEB diameter.
Per pass analysis of thrombus composition retrieved by mechanical thrombectomy
Authors: Abbasi Mehdi , Kvamme Peter , Layton Kennith F , Hanel Ricardo A , Almekhlafi Mohammed A , Delgado Josser E , Pereira Vitor M , Patel Biraj M , Jahromi Babak S , Yoo Albert J , Nogueira Raul G , Gounis Matthew J , Fitzgerald Seán , Mereuta Oana M , Dai Daying , Kadirvel Ramanathan , Kallmes David F , Doyle Karen M , Savastano Luis E , Cloft Harry J , Liu Yang , Thacker Ike C , Aghaebrahim Amin , Sauvageau Eric , Demchuk Andrew M , Kayan Yasha , Copelan Alexander Z , Entwistle John , Nazari Pouya , Cantrell Donald Robert , Bhuva Parita , Soomro Jazba , Haussen Diogo C , Al-Bayati Alhamza , Mohammaden Mahmoud , Pisani Leonardo , Rodrigues Gabriel , Puri Ajit S , Brinjikji Waleed
Published: April 2021

Background and aim

Mechanical thrombectomy (MT) for large vessel occlusion often requires multiple passes to retrieve the entire thrombus load. In this multi-institutional study we sought to examine the composition of thrombus fragments retrieved with each pass during MT.

Methods

Patients who required multiple passes during thrombectomy were included. Histopathological evaluation of thrombus fragments retrieved from each pass was performed using Martius Scarlet Blue staining and the composition of each thrombus component including RBC, fibrin and platelet was determined using image analysis software.

Results

154 patients underwent MT and 868 passes was performed which resulted in 263 thrombus fragments retrieval. The analysis of thrombus components per pass showed higher RBC, lower fibrin and platelet composition in the pass 1 and 2 when compared to pass 3 and passes 4 or more combined (P values <0.05). There were no significant differences between thrombus fragments retrieved in pass 1 and pass 2 in terms of RBC, WBC, fibrin, and platelet composition (P values >0.05). Similarly, when each composition of thrombus fragments retrieved in pass 3 and passes 4 or more combined were compared with each other, no significant difference was noted (P values >0.05).

Conclusion

Our findings confirm that thrombus fragments retrieved with each pass differed significantly in histological content. Fragments in the first passes were associated with lower fibrin and platelet composition compared to fragments retrieved in passes three and four or higher. Also, thrombus fragments retrieved after failed pass were associated with higher fibrin and platelet components.
Regulatory approaches: Global medical device tracking advancement in USA, EU and India
Authors: Saini Garima , Choudhary Manjusha , Budhwar Vikas , Hussain Tarif
Published: April 2021

Advancement in science & technology of medical industry is coming up with innovations. Medical devices play a vital role. Real Time Location System (RTLS) which includes Radio Frequency Identification (RFID) device, Wi-Fi technology that helps to look after adverse events and recall products when required, thereby, prevent theft by keeping regular check on their movement with location sensors. In 19th century two products of United States faced product withdrawal. After that, US felt the need to develop system for product record management and tracking. In 2004, FDA introduced Unique Device Identifier (UDI) for medical device tracking. With time, GHTF came up with UDI working groups and in 2013, new version of UDI guidelines for globally harmonized use was generated. In this article study about various countries has been done. It was found that countries like United States and Europe have introduced medical device tracking system and by 2022 this will be implemented in India.
Exploring the sources of self-efficacy by Flemish school principals in primary education
Authors: Bellemans Lore , Devos Geert
Published: April 2021

Self-efficacy is a perceived judgment that one has the ability to execute a course of action that brings about a desired result. While a growing body of research demonstrates the importance of self-efficacy by school leaders, little is known about the different sources of principals’ self-efficacy. This qualitative study investigates the relevance of Bandura’s sources of self-efficacy and on potential additional sources. The analysis is based on semi-structured interviews with 23 primary school principals in Flanders (Belgium). The results reveal that mastery experiences prove to be the most powerful source of principal self-efficacy although they are mainly small successes and do not refer to extraordinary achievements or excellent results. This study also emphasizes the importance of verbal or social persuasion and gaining knowledge. Suggestions for further research, limitations and implications of this study are discussed.
Estimating collapse risk and reliability of concrete moment frame structure using response surface method and hybrid of artificial neural network with particle swarm optimization algorithm
Authors: Bayari Mohammad Amin , Shabakhty Naser , Izadi Zaman Abadi Esmaeel
Published: April 2021

Structural collapse performance assessment has been at the center of many researchers’ interest due to complications of this phenomenon and uncertainties involved in modeling the simulation of the structural collapse response. This research aims to predict the structural collapse responses including mean collapse capacity, collapse standard deviation, and collapse drift by considering modeling uncertainties and then estimating collapse fragility curves, collapse risk, and reliability using Response Surface Method (RSM) and Artificial Neural Network (ANN). Modeling uncertainties for evaluating collapse responses are the parameters of the modified Ibarra-Krawinkler moment-rotation curve. Moreover, to analyze the structural uncertainty, the correlation between the model parameters in one component and between two structural components was considered. The Latin Hypercube Sampling (LHS) method and Cholesky decomposition were used to produce independent and dependent random variables, respectively. To predict the collapse responses of the structure, taking into account the uncertainties, as the number of uncertainties increases, the number of simulations for the uncertainties also increases, leading to a significant increase in the computational effort to estimate the structural responses, in the presence of a limited number of samples for uncertainties, a hybrid of ANN with PSO algorithm was used to reduce the computational effort in order to estimate the collapse fragility curves, collapse risk, and structural reliability. The results show that structural collapse responses can be predicted with appropriate accuracy by producing a limited number of samples for uncertainties and using an ANN-PSO algorithm.
Principles and guidelines in the management of ankle fractures in adults
Authors: Kyriacou Harry , Mostafa Ahmed M H A M , Davies Benjamin M , Khan Wasim S
Published: April 2021

Ankle fractures are common injuries that have many physical and psychosocial complications. As a result, it is important to be aware of how these patients present and are managed perioperatively. Detailed guidelines from NICE and the British Orthopaedic Association have been produced on this topic, including recent developments such as the decision to weight-bear early after surgery and the use of virtual fracture clinics. This article provides an overview of the key perioperative factors that need to be considered in cases of ankle fracture and the relevant clinical guidelines.
Interprofessional Collaboration in School-Based Settings, Part 2: Team Members and Factors Contributing to Collaborative Success
Authors: Dale Brittany A. , Kruzliakova Natalie A. , McIntosh Constance E. , Kandiah Jayanthi
Published: April 2021

This article is the second in a series of three articles discussing the importance of interprofessional collaboration between the school nurse and other school-based and community professionals to create a healthcare team. Developing the healthcare team begins with identifying the individual medical, mental health, and educational needs of the student. Expertise in both education and healthcare systems makes school nurses ideal candidates for coordinating with the healthcare team to meet the needs of the student. This article builds on the first article by providing some examples of the collaboration that occurs between the school nurse and other team members, as well as identifying facilitators and barriers to this collaboration.
Pro-angiogenic and osteogenic composite scaffolds of fibrin, alginate and calcium phosphate for bone tissue engineering
Authors: Kohli Nupur , Sharma Vaibhav , Orera Alodia , Sawadkar Prasad , Owji Nazanin , Frost Oliver G , Bailey Russell J , Snow Martyn , Knowles Jonathan C , Blunn Gordon W , García-Gareta Elena
Published: April 2021

Due to the limitations of bone autografts, we aimed to develop new composite biomaterials with pro-angiogenic and osteogenic properties to be used as scaffolds in bone tissue engineering applications. We used a porous, cross-linked and slowly biodegradable fibrin/alginate scaffold originally developed in our laboratory for wound healing, throughout which deposits of calcium phosphate (CaP) were evenly incorporated using an established biomimetic method. Material characterisation revealed the porous nature and confirmed the deposition of CaP precursor phases throughout the scaffolds. MC3T3-E1 cells adhered to the scaffolds, proliferated, migrated and differentiated down the osteogenic pathway during the culture period. Chick chorioallantoic membrane (CAM) assay results showed that the scaffolds were pro-angiogenic and biocompatible. The work presented here gave useful insights into the potential of these pro-angiogenic and osteogenic scaffolds for bone tissue engineering and merits further research in a pre-clinical model prior to its clinical translation.
Correlation of Likert scores III–V with increasingly worse pathology in radical prostatectomy specimens significant only for men aged <60 or PSAD >0.15, with age <60 as good as PSAD <0.15 at discriminating lower risk in Likert III
Authors: Ord Jonathan J , Crockett Matthew , Green Jes , Bell Lawrence TO , Hicks Victoria , Crawford-Smith Hugh , Morss Amanda , Poulton Lucinda , Pellisery Bilgy , Hayes Mark , Ludeman Linmarie , Beasley Matthew , Fulmali Rahul , Anniss Mark , Barnes Elizabeth , Foy Christopher , Nayar Richard C , McMeekin Faith , Gilbert Hugh , Okeke Aloysius , Akhtar Mehmood , Patel Biral , Eaton Jonathan
Published: April 2021

Objectives:

This study aimed to compare Likert scores with radical prostatectomy specimens.

Methods:

This study examined 443 men with validated pre-biopsy magnetic resonance imaging results and used cross-tabulation and chi-square significance testing with National Comprehensive Cancer Network risk categories.

Results:

The mean prostate-specific antigen (PSA) was 10, and the mean age was 64 years. Comparing Likert III to Likert V and Likert IV to Likert V, both (each p=0.02) were significantly associated with higher prostate cancer risk groups, but Likert III versus Likert IV was not ( p=0.1). Within the subgroup PSA density (PSAD) <0.15 ( n=140), the correlation of Likert score and final pathological risk group was lost ( p=0.5), but it was not lost within the subgroup PSAD >0.15 ( n=281; p=0.045 III vs. IV only and p=0.055 overall). Within the subgroup age <60 ( n=104), the correlation of Likert score and final pathological risk group was significant ( p=0.006 for III vs. IV and p=0.04 overall), whereas within the subgroup age >60 ( n=339) this significant difference was lost ( p=0.34). Further subgroup analysis within Likert III ( n=86) found that men <60 ( n=22) had neither high-grade (G3 or G4 or G5) nor very high-risk disease. There were only two high-risk cases, both of which were G2T3a (2/22; 10%). In men with Likert III and PSAD <0.15 ( n=31), there were seven high-risk and two very high-risk cases (9/31; 25%). This difference was not significant ( p=0.31)

Conclusion:

With these two findings, we recommend that men <60 with Likert III can be counselled like men with Likert III and PSAD <0.15, that they are unlikely to have unfavourable or high-risk disease and that they may wish to avoid biopsy or treatment.

Level of evidence:

Level 1b.
Women’s perceived support of parents and parents-in-law in China: Socioeconomic resources, reciprocity, and family context
Authors: Lee Trevor Tsz-lok , Luo Xing
Published: April 2021

Filial support has been recognized as a main source of social support for China’s aging population. While traditional Chinese families generally adhere to patrilineal, patriarchal, and patrilocal principles, there have been signs of an emerging trend of a complex, bilateral family system that has influenced the ways in which married women support elderly family members, both natal kin and in-laws, in contemporary China. However, little research exists focusing on the perspectives of married women in China on intergenerational support. Drawing on nationally representative data from the Chinese General Social Survey, this study investigates the patterns and determinants of women’s financial and instrumental support of their parents and parents-in-law in China. The main results show that, while education and income separately affect women’s support patterns, their husband’s income level is the crucial factor determining women’s financial support for parents and parents-in-law. In terms of instrumental support, norms of reciprocity are evident between women and parents/parents-in-law. Despite a positive association between financial support that women give to parents-in-law and that which they receive from parents-in-law, women’s financial support tends to be less frequent when their own parents have financially supported them. The implications of these findings for our understanding of intergenerational support mechanisms and for future research are discussed.
From the tax-sharing system to the program system: Institutional evolution and organizational mechanism
Authors: Jiao Changquan
Published: April 2021

Soon after implementing reforms to the tax-sharing system, the People’s Republic of China (PRC) implemented public budgeting reform, and thus formed a new kind of state governance system, the program system (PS). There are three categories of program expenditures available to local governments: “earmarked grants” from higher-level authorities; “non-grant program funds” from higher-level authorities; and program funds from same-level government departments. The convergence and reorganization of these three categories of program expenditure at the local level has, to a great extent, molded the fiscal structure of grassroots government in the PRC. The PS in essence does not mean discarding or surpassing the bureaucratic state system, rather, it is the active improvement and supplementing of the bureaucratic system by the state: a continuation and development of state regime construction. The overt purpose of the PS is to “solidify” budgetary constraints, while the underlying purpose is to enhance the government’s ability to respond to society. The two purposes present some tension in practice, as the rationalized and professionalized forms of governance that result do not necessarily enhance the ability to respond to public needs; in fact the reverse is quite possible.
Thick as thieves? Corruption, institutional trust, and investment locations
Authors: Panao Rogelio Alicor Labalan
Published: April 2021

What makes corrupt investment locations still attractive to investing economies? This article examines whether states’ tendency to ignore corruption in investment targets is due to their being accustomed to corruption at home, or is instead due to a perception that despite flaws institutions can be counted on to remain functional. We argue that economies where corruption is viewed permissively would still likely invest in states equally perceived as corrupt but not necessarily due to shared collective tolerance. Rather, a perception of institutional dependability motivates the selection of investment locations, regardless of how people in investing states view corruption. To test our conjecture, we analyzed bilateral foreign direct investment outflows for 96 countries between 2001 and 2012 using exponential random graph models alongside value-based typologies for corruption and institutional confidence. Our results suggest that, overall, it is trust in institutions and not necessarily trepidation about corruption that mediates the selection of investment locations.