bluuebunny/crossref_metadata_2025 huggingface dataset:
ClC-3: A Novel Promising Therapeutic Target for Atherosclerosis
Authors: Niu Dun , Li Lanfang , Xie Zhizhong
Published: June 2021

Chloride channel 3 (ClC-3), a Cl−/H+ antiporter, has been well established as a member of volume-regulated chloride channels (VRCCs). ClC-3 may be a crucial mediator for activating inflammation-associated signaling pathways by regulating protein phosphorylation. A growing number of studies have indicated that ClC-3 overexpression plays a crucial role in mediating increased plasma low-density lipoprotein levels, vascular endothelium dysfunction, pro-inflammatory activation of macrophages, hyper-proliferation and hyper-migration of vascular smooth muscle cells (VSMCs), as well as oxidative stress and foam cell formation, which are the main factors responsible for atherosclerotic plaque formation in the arterial wall. In the present review, we summarize the molecular structures and classical functions of ClC-3. We further discuss its emerging role in the atherosclerotic process. In conclusion, we explore the potential role of ClC-3 as a therapeutic target for atherosclerosis.
Multidrug refractory aggressive metastatic TFE3 (+) renal cell carcinoma: A case report
Authors: Paksoy Nail , Erdem Selcuk , Karaca Mert , Ak Naziye , Pehlivan Metin , Yirgin Inci K. , Ozluk Yasemin , Ekiz Feza , Tural Deniz , Ekenel Meltem , Ozcan Faruk , Basaran Mert
Published: June 2021

Background

Transcription factor E3 (TFE3) related renal cell carcinomas constitute a very small percent of all renal tumors in adults. Prognosis mainly depends on the stage of the disease at the time of diagnosis which is often poor. There is yet to be a standardized treatment protocol. Treatment options include agents identical to TFE3(–) cell renal carcinoma treatment. We present a case of a young woman with a rapidly progressing metastatic TFE3 (+) renal cell carcinoma.

Case report

A 31 year old female presented with abdominal mass, distension, nausea. Initial tests and tumor markers found to be normal. Abdominal CT scan revealed a left retroperitoneal mass along with three other neighboring masses in liver manifesting as metastases. Trucut biopsy and immunohistochemical staining confirmed the retroperitoneal mass as TFE3 (+) renal cell carcinoma. Management and outcome: Sunitinib, pazopanib, nivolumab, axitinib treatments are consecutively given after surgery. It is noteworthy that rapid progression was observed under nivolumab treatment.

Discussion

During surveillance, rapid progression is noted under consecutive immunotherapy which was unexpected. Thus, there is a need for more standardized treatment protocols and invention of new agents for management of TFE3 (+) renal cell carcinoma.
Arsenic trioxide dose capping to decrease toxicity in the treatment of acute promyelocytic leukemia
Authors: Zacholski Kyle , Hambley Bryan , Hickey Erin , Kashanian Sarah , Li Andrew , Baer Maria R , Duong Vu H , Newman Matthew J , DeZern Amy , Gojo Ivana , Smith B Douglas , Levis Mark J , Varadhan Ravi , Gehrie Eric , Emadi Ashkan , Ghiaur Gabriel
Published: June 2021

Arsenic trioxide (ATO) and all-trans retinoic acid (ATRA) combination therapy yields high complete remission and disease-free survival rates in acute promyelocytic leukemia (APL). ATO is dosed on actual body weight and high ATO doses in overweight patients may contribute to increased toxicity. We performed a retrospective, two-center study comparing toxicities in patients who received the Lo-Coco et al ATRA/ATO regimen with capped ATO, ≤10 mg/dose, and non-capped ATO, >10 mg/dose. A total of 44 patients were included; 15 received doses ≤10 mg and 29 received >10 mg. During induction, there was no difference in the incidence of grade ≥3 hepatotoxicity, grade ≥3 QTc prolongation, neurotoxicity, and cardiac toxicity between groups. In consolidation, patients receiving >10 mg/dose experienced a greater incidence of neurotoxicity (66.7% vs 22.2%; p = 0.046). Capping doses saved $24634.37/patient and reduced waste of partially-used vials. At a median follow-up of 27 months, no disease relapses occurred in either group. This represents an opportunity to improve the safety profile of this highly effective regimen.
Nonclinical Safety Profile of Sotorasib, a KRASG12C-Specific Covalent Inhibitor for the Treatment of KRAS p.G12C-Mutated Cancer
Authors: Ishida Katsu , Werner Jonathan A. , Davies Rhian , Fan Fan , Thomas Barbara , Wahlstrom Jan , Lipford James Russell , Monticello Thomas
Published: June 2021

Sotorasib is a first-in-class KRASG12C covalent inhibitor in clinical development for the treatment of tumors with the KRAS p.G12C mutation. A comprehensive nonclinical safety assessment package, including secondary/safety pharmacology and toxicology studies, was conducted to support the marketing application for sotorasib. Sotorasib was negative in a battery of genotoxicity assays and negative in an in vitro phototoxicity assay. Based on in vitro assays, sotorasib had no off-target effects against various receptors, enzymes (including numerous kinases), ion channels, or transporters. Consistent with the tumor-specific target distribution (ie, KRASG12C), there were no primary pharmacology-related on-target effects identified. The kidney was identified as a target organ in the rat but not the dog. Renal toxicity in the rat was characterized by tubular degeneration and necrosis restricted to a specific region suggesting that the toxicity was attributed to the local formation of a putative toxic reactive metabolite. In the 3-month dog study, adaptive changes of hepatocellular hypertrophy due to drug metabolizing enzyme induction were observed in the liver that was associated with secondary effects in the pituitary and thyroid gland. Sotorasib was not teratogenic and had no direct effect on embryo-fetal development in the rat or rabbit. Human, dog, and rat circulating metabolites, M24, M10, and M18, raised no clinically relevant safety concerns based on the general toxicology studies, primary/secondary pharmacology screening, an in vitro human ether-à-go-go-related gene assay, or mutagenicity assessment. Overall, the results of the nonclinical safety program support a high benefit/risk ratio of sotorasib for the treatment of patients with KRAS p.G12C-mutated tumors.
Complete Hydatidiform Mole and Coexisting Fetus With Gastroschisis: A Case Report Highlighting the Importance of Diagnostic Genotyping
Authors: McHenry Austin , Magriples Urania , Hui Pei , Morotti Raffaella
Published: June 2021

Twin pregnancy with a complete hydatidiform mole and a coexisting fetus (CHMCF) is an extremely rare occurrence, described only by a handful of published series and cases reports. The majority of the literature on CHMCF examines prenatal care and follow-up in relation to the increased risk of gestational trophoblastic neoplasia (GTN). At present, few reports elaborate on the diagnostic process and differential diagnosis, especially in the context of recent molecular advances in risk stratification for GTN. Here, we describe the first known case of a CHMCF with gastroschisis with liveborn delivery at 35 weeks gestation. This report aims to review the pre- and postnatal differential diagnosis and discuss recent updates on the importance of ancillary studies in the diagnosis of gestational trophoblastic disease.
Retinal microvascular density modifications during the water drinking test
Authors: Gameiro Gustavo Rosa , Gameiro Giovana Rosa , Farah Michel Eid , Wang Jianhua , Schor Paulo
Published: June 2021

Purpose:

The water drinking test (WDT) is a well-known stress test that increases intraocular pressure (IOP) momentarily and can indicate risk of glaucoma progression. This study focuses on correlating changes in the retinal microvascular plexus with the WDT in young healthy subjects.

Methods:

A total of 20 eyes of 20 healthy young subjects (mean age 24.37 ± 2.17 years) were included in this study. In our protocol, WDT consisted of drinking 1 L of water within 5 min. Outcome measures in this prospective observational study were mean arterial pressure (MAP), heart rate (HR), IOP, and retinal vessel density of both superficial and deep macular retina using optical coherence tomography angiography (OCTA), which were assessed before water ingestion and four times after at 15-min intervals. OCTA images were later quantified by fractal analysis (box counting [ Dbox]). One-way repeated measures analysis of variance (ANOVA) was used to assess the effects of WDT on each of the parameters.

Results:

The WDT resulted in significant peak changes of the following parameters compared to baseline: IOP: 15.63 ± 3.37 versus 18.38 ± 4.53 mmHg at 30 min, p < 0.001; HR: 75.74 ± 12.23 versus 64.95 ± 11.37 bpm at 15 min, p < 0.001; deep retinal vessel density 1.758 ± 0.14 versus 1.749 ± 0.16 at 15 min, p = 0.040.

Conclusions:

Besides IOP elevation and systemic effects in HR, WDT is associated with temporary modifications of the deep vascular plexus in young healthy subjects.
The predictors of catheter-related bloodstream infections in patients undergoing hemodialysis: A single center experience
Authors: Demirci Recep , Sahtiyancı Berrak , Bakan Ali , Akyuz Okan
Published: June 2021

Background:

Here we aimed to investigate the predictors of catheter-related bloodstream infections (CRBSI) in patients with acute kidney injury or chronic kidney disease who required renal replacement therapy through a non-tunneled hemodialysis catheter.

Methods:

A total of 111 patients who received non-tunneled hemodialysis catheters were retrospectively evaluated. Patients were divided into two groups; those who developed CRBSI and those who did not. Patient’s demographic data, laboratory results at admission, information regarding catheter infections, and culture results were obtained from electronic medical records.

Results:

The mean age of the patients was 64 ± 16 years, and 51 of them were male. CRBSI occurred in 14 patients (12.6%). Admission serum albumin level (OR: 0.119, 95% CI: 0.019–0.756, p = 0.024), admission mean platelet volume (OR: 2.207, 95% CI: 1.188–4.100, p = 0.012) and catheter duration (OR: 1.580, 95% CI: 1.210–2.064, p = 0.001) were independent predictors for the CRBSI development. ROC curve analysis demonstrated that a catheter duration of 22 days was predictive for presence of CRBSI (78% sensitivity, 76% specificity, AUC: 0.825, 95% CI: 0.724–0.925, p < 0.001).

Conclusions:

Prolonged catheter duration, low serum albumin, and high mean platelet volume independently predict the development of CRBSI in patients undergoing hemodialysis for acute kidney injury or chronic kidney disease.
Hidradenitis Suppurativa From a Patient Perspective Including Symptoms and Self-Treatment
Authors: Huang Christina M. , Kirchhof Mark G.
Published: June 2021

Introduction

Hidradenitis Suppurativa (HS) is a chronic inflammatory disordercommonly affecting body folds. It can significantly impair quality of life due to the physical, psychological, and socialturmoil experienced by patients. Treatment remains a challenge.Limited data on the HS patient experience, such as self-treatment exists.

Methods

This was a single-center cross-sectional study, utilizing a paper-based survey. Surveys were mailed out to all HS patients from the dermatology clinic and completed on a voluntary basis. Demographics, disease characteristics, medical and family history, treatments tried, and life quality were documented.

Results

The response rate was 49.4% (41/83), with a female predominance (26/41). Eighty-five percent (35/41) were Caucasian with an average age and BMI of 39.0 ± 16.78 and 30.71 ± 7.02, respectively. In total, 24.4% (10/41), 56.0% (23/41), and 19.5% (8/41) had Hurley I, II, and III, respectively. Lesions affected the genital region (75.6%), thigh/groin (68.2%), and axilla (46.3). Almost half (49%) of patients experienced an average of 1-2 flares per month. The most bothersome symptoms were pain (92.7%), discharge (68.3%), malodor (63.4%), and itch (61%). Depression (53.7%), severe facial acne (14.6%), and hypertension (14.6%) were the most common co-morbidities. Treatments used included antibiotics (82.9%) and surgical excision (34.2%) were. Over 90% of patients reportedself-treatment of lesions by squeezing (80.5%), soaking (53.7%), and lancing (41.4%).

Conclusions

This study provides insight into the patient perspective of HS. We identify itch as a symptom that is not frequently associated with HS and reveal how commonly patients utilize various types of self-treatment in their experience of disease.
Music lecturers’ professional development through distant coteaching between two universities in Finland
Authors: Hietanen Lenita , Sepp Anu , Ruismäki Heikki
Published: June 2021

At present, the idea of teacher professional development is widely highlighted in education. The present qualitative study examines whether coteaching in collaboration between music lecturers at two universities could enable their professional development and improve student learning. Our study consisted of piano courses in two independent primary school teacher education programs. In this conceptual work, it appears that the definitions of coteaching also allow a distant collaborative professional development of the two music lecturers. The main challenges were identified as access to a shared physical space and a common group of students, which could be diminished using digitalization.
Non-binary gender markers: Mobility, migration, and media reception in Europe and beyond
Authors: Quinan C L , Hunt Mina
Published: June 2021

Although European Union legal frameworks tend to conceive of sex and gender in binary terms, a growing number of countries in Europe and around the world have been increasingly allowing for third gender markers and non-binary possibilities in identity documents, passports, and public registries, of which the X marker in the sex or gender field has become the most common. However, initiatives like the X, which may initially signal trans-friendliness, must be considered alongside heightened border surveillance. As more and more European countries begin to follow this trend of expanding possibilities for registering (non-binary) gender (e.g. Malta, Denmark, Germany, the Netherlands), we look here to some illustrative examples (e.g. Nepal, Canada, Pakistan) that have been at the forefront of non-binary legal recognition to interrogate the complications and conundrums that these developments may provoke in European contexts.
Delivering adapted physical activity by videoconference to patients with fatigue under immune checkpoint inhibitors: Lessons learned from the PACTIMe-FEAS feasibility study
Authors: Charles Cécile , Bardet Aurélie , Ibrahimi Nusaïbah , Aromatario Olivier , Cambon Linda , Imbert Alexis , Pons Magali , Raynard Bruno , Sauveplane Dominique , Pouchepadass Camille , Baudinet Cédric , Lambotte Olivier , Marabelle Aurélien , Dauchy Sarah
Published: June 2021

Introduction

Fatigue is one of the most frequent symptoms in anti-cancer immune therapy. Physical activity has been proven effective in reducing fatigue, but unmet needs remain regarding the provision and access to adapted programmes, which efficiently addresses the main barriers to PA.

Methods

The PACTIMe-FEAS study primarily aimed at primarily to evaluate the feasibility and the acceptability of a videoconference-based 6-month programme promoting physical activity, and secondarily to assess its potential post-immediate and short-term effectiveness in reducing fatigue in cancer patients under immune therapy. Numeric self-reported questionnaires (Visual Analogue Scale-fatigue, Multidimensional Fatigue Inventory, International Physical Activity Questionnaire, Échelle de Motivation envers l’Activité Physique en contexte de Santé, Medical Outcomes Study 36-Item Short Form Health Survey, Hospital Anxiety and Depression Scale and Insomnia Severity Index) were completed by participants through an online secure platform at three time points: just before (T1), and after (T2) the programme, and 3 months later (T3).

Results

Sixteen participants (50% male, 50% female, mean age 54 years, 69% melanoma, 31% overweight), with moderate-to-severe fatigue, entered the internet-delivered intervention; 14 completed it, with an average completion rate of physical activity supervised sessions of 75%. Satisfaction was high, confirming a demand for group format, personalised approach, professional guidance and home-based device, to support the practice of regular physical activity. A decrease in fatigue was observed at the end of the programme.

Discussion

The recruitment process did prove to be challenging, with a relatively small eligible population, and will need to be reconsidered to envision a larger scale trial. But here and now, this feasibility study provides the first promising foundations to develop further research on the effectiveness of an original remote programme.
Disturbances of the transfer of cholesterol to high-density lipoprotein (HDL) in patients with peripheral artery disease with or without type 2 diabetes mellitus
Authors: de Macedo Ribeiro Flávio Roberto Cavalleiro , Ribeiro Carolina Heitmann Mares Azevedo , Tavoni Thauany Martins , dos Santos Sarges Erica , Freitas Fatima Rodrigues , Stolf Noedir Antonio Groppo , Kalil Filho Roberto , Maranhão Raul Cavalcante
Published: June 2021

Introduction:

Low high-density lipoprotein (HDL)-cholesterol is frequent in patients with peripheral artery disease (PAD) and also in type 2 diabetes mellitus (T2DM), the major risk factor for PAD. The transfer of cholesterol from the other lipoproteins to HDL is an important aspect of HDL metabolism and function, and may contribute to atherogenic mechanisms that lead to PAD development.

Objective:

The aim of this study was to investigate the status of cholesterol transfers in patients with PAD without or with T2DM.

Methods:

Patients with PAD ( n = 19), with PAD and T2DM (PAD + DM, n = 19), and healthy controls ( n = 20), all paired for age, sex, and BMI were studied. Transfer of both forms of cholesterol, unesterified (UC) and esterified (EC), was performed by incubating plasma with a donor nanoemulsion containing radioactive UC and EC, followed by chemical precipitation and HDL radioactive counting.

Results:

Low-density lipoprotein (LDL)-cholesterol and triglycerides were similar in the three groups. Compared to controls, HDL-C was lower in PAD + DM ( p < 0.05), but not in PAD. Transfer of UC was lower in PAD + DM than in PAD and controls (4.18 ± 1.17%, 5.13 ± 1.44%, 6.59 ± 1.25%, respectively, p < 0.001). EC transfer tended to be lower in PAD + DM than in controls (2.96 ± 0.60 vs 4.12 ± 0.89%, p = 0.05). Concentrations of cholesteryl ester transfer protein (CETP) and lecithin-cholesterol acyltransferase (LCAT), both involved in HDL metabolism, were not different among the three groups.

Conclusion:

Deficient cholesterol transfer to HDL may play a role in PAD pathogenesis. Since UC transfer to HDL was lower in PAD + DM compared to PAD alone, it is possible that defective HDL metabolism may contribute to the higher PAD incidence in patients with T2DM.Keywords
Medical and psychiatric differential diagnoses of pediatric globus sensation: A case study with review discussion
Authors: Pang Lindsy , Sareen Romil , Gorecki Amanda
Published: June 2021

Globus hystericus, also known as globus pharyngeus or globus sensation, is characterized by the physical sensation of a mass in one’s throat. Globus sensation is more common in adults and reported more rarely in children. Adult patients with globus sensation score higher on neuroticism, introversion, anxiety, and depression. However, not all patients with globus sensation have psychiatric abnormalities. Thus, it is important to share an atypical presentation in children and highlight the necessity of ruling out other organic causes. The present case study elucidates the process of ruling out medical etiologies of globus sensation in a young girl with anxiety and food aversion. We provide a review discussion of the differential diagnoses, both medical and psychiatric, of globus sensation in the pediatric population reported in past literature. The case study and review of pediatric globus sensation shows that the symptom can be associated with a wide array of psychological and medical diagnoses. The medical differential diagnoses of globus sensation include the gastroenteric system, laryngeal system, cardiovascular system, and nervous system. We encourage critical analysis of other potential diagnoses, given each patient’s unique history and physical presentation.
Fouta-Djallon linguistic ecology: Between polyglossia and small-scale multilingualism
Authors: Vydrina Alexandra
Published: June 2021

Aims and objectives:

The aim is to investigate, at the level of language ideology and language practice, a hybrid type of multilingualism attested in Guinea.

Design/methodology/approach:

The analysis is done in the framework of small-scale multilingualism studies, exploring, at the same time, the boundaries of the notion ‘small-scale multilingualism’.

Data and analysis:

The analysis is based on first-hand fieldwork data (2009–2020). I first analyze the historical and political circumstances that gave rise to language ideology with respect to Kakabe, and then I investigate how it coincides with language practice or diverges from it.

Findings/conclusions:

Fouta-Djallon multilingualism has evolved in the context of a highly stratified state based on institutionalized slavery. The hybrid nature of this language ecology is closely tied with the on-going process of emancipation. On the one hand, Kakabe, the descendants of slaves, strive to assimilate, politically and religiously, with the more prestigious social group. On the other hand, since this assimilation cannot be complete, a multicultural identity is being created which involves the use of multiple languages. This is expressed in a semi-receptive mode of language production, as opposed to receptive multilingualism, typical of many small-scale multilingual ecologies as well in the fact that code-switching within one sentence is avoided, the same way as in small-scale multilingualism, yet, in stark contrast to the latter, borrowings are very common in Kakabe.

Originality/implications:

This case represents an interest for the study of multilingualism, since it combines characteristics of a strongly inegalitarian polyglossic type, on the one hand, with such features as reciprocity both in language transmission and language production, on the other hand. It also reveals the existence of a semi-receptive language production mode that has not been described before.
The EU’s truth by omission: Learning and accountability after the Eurozone crisis
Authors: Kovras Iosif , Kutlay Mustafa
Published: June 2021

While the literature generally frames crises as catalysts for organisational learning, most theories focus on ‘success’ stories of learning – ex post facto explanations of why certain ideas gained traction after a specific crisis. Less emphasis has been placed on lessons that were likely to be drawn, but were not. In probing this point, we explore the European Union’s selective learning after the recent Eurozone crisis. Reforms were mostly top-down institutional and macroeconomic ones, while good practices developed by individual European states in the domain of accountability were ignored. In particular, we focus on the absence of a truth commission, an independent institutional mechanism mandated to carry out a forensic investigation of crisis management and convert past policy failures into lessons for future institutional reform. Why, despite the direct exposure of EU policymakers to these commissions, did this institutional mechanism not travel to Brussels? Drawing on semi-structured elite interviews and analyses of primary sources, we argue only organisations with an embedded institutional capacity for self-reflection (meta-learning) possess the required institutional skills to put certain issues into the spotlight.
‘It’s about keeping children safe, not spying’: A governmentality approach to Prevent in primary education
Authors: da Silva Raquel , Fontana Giuditta , Armstrong Megan A
Published: June 2021

From its inception in 2015, the Prevent Duty has required educators, and other members of the social sector, to exercise ‘due regard’ in preventing pupils from being drawn into terrorism, irrespective of the age of the child. This article explores how primary educators have understood and implemented this preventative security policy in their schools. Analysis is based on a survey of 345 primary school educators and 37 semi-structured interviews with primary school educators and Prevent Education Officers from the West Midlands. Through a lens of governmentality, we shed light on how this mandate has been broadly interpreted and exercised by educators within and outside the school gates. In so doing, we contribute to debates on the puzzling acceptance of Prevent in education, on the process whereby educators identify threats, and on the securitisation of educational spaces in a risk society.
“How it actually works”: Algorithmic lore videos as market devices
Authors: MacDonald Thomas WL
Published: June 2021

On YouTube, self-styled algorithmic experts claim to know how algorithms “actually work.” However, their knowledge is largely speculative. Developing recent work that pays attention to algorithmic expertise, I argue that algorithmic lore videos are “market devices” which are economically productive for the platform in four ways: they (1) legitimize platform narratives of algorithmic objectivity, (2) teach creators how to calculate the value of content and format it according to platform metrics, (3) encourage creators to build and govern audiences, and (4) justify continued content production even when it does not pay off for creators. Thus, despite claiming to describe “how the algorithm actually works,” algorithmic lore videos are performative; by teaching creators how to understand and act in the platform economy they do important work to bring the platform’s “visibility markets”—its labor market of content creators engaging in content production and its goods market of content to be watched—into being.
The instrumentation of public subsidies for private schools: Different regulatory models with concurrent equity implications
Authors: Zancajo Adrián , Verger Antoni , Fontdevila Clara
Published: June 2021

The availability of public funding for private schools, in both primary and secondary education, has become a common feature in a number of OECD countries. The expansion of public subsidies for privately owned schools has consequences that go far beyond the involvement of private actors in the provision of education. These include deepening forms of regulatory governance in educational systems and the blurring of frontiers between public and private education. Public subsidies for privately owned schools have been adopted following diverse rationalities and in pursuit of different goals. In light of the diversity, this research examines the regulatory configurations of private subsidized education provision across OECD countries, from a policy instruments’ perspective. Based on a systematic review of the literature, the article identifies four models of regulation of private subsidized education, and analyses why and how these models have been problematized and have evolved accordingly. The paper pays particular attention to recent educational reforms adopted, in most cases, to tackle the equity challenges posed by publicly subsidized private provision. Finally, the paper elaborates on the implications that this form of provision has for public education and the achievement of equity goals, and reflects on the potential and limits of regulatory reforms when confronting these issues.
Design of a single degree of freedom acoustic liner for a fan noise test rig
Authors: Spillere André MN , Braga Danilo S , Seki Leonardo A , Bonomo Lucas A , Cordioli Julio A , Rocamora Bernardo M , Greco Paulo C , dos Reis Danillo C , Coelho Eduardo LC
Published: June 2021

Acoustic liners are an essential part of noise reduction technologies commonly applied in aircraft turbofan engines. Fan noise suppression can be achieved by selecting an appropriate liner design with optimal acoustic impedance at the blade passing frequency. Great efforts have been made not only to improve experimental characterization and numerical methods for acoustic liners, but also to understand noise generation mechanisms, which ultimately impacts on the liner design itself. To gain confidence in the liner design process, a liner barrel was developed and fabricated for the Fan Noise Test Rig located at the University of São Paulo. To this end, analytical methods were used to determine the optimal acoustic impedance for the Fan Noise Test Rig, and a flat test sample was fabricated for experimental characterization with flow using both in-situ and impedance eduction techniques at the Federal University of Santa Catarina. A liner barrel of same nominal geometry was fabricated and placed at the Fan Noise Test Rig, and a modal decomposition indicated that the Tyler-Sofrin mode has been successfully suppressed at the first blade passing frequency. Numerical predictions of liner transmission loss considering the flat sample impedance showed good agreement with experimental results.
Foreign Direct Investment Liberalization in Communist Regimes: A Theoretical Model Based on the Comparison Among China, Cuba, North Korea, and Vietnam
Authors: Kriebitz Alexander , Max Raphael
Published: June 2021

What are the driving factors for foreign direct investment liberalization in formerly communist countries? Previous research explains foreign direct investment liberalization as a function of the intensification of international commerce and democratization; however, the likes of China, Cuba, North Korea, and Vietnam hardly fit into this narrative. The following contribution makes a theoretical argument about the causes of foreign direct investment liberalization in communist authoritarian regimes with highly centralized and closed economies. We argue that foreign direct investment liberalization is caused by external shocks materializing in policy adaptations. The degree of foreign direct investment liberalization depends on the balance of power between actors who favor liberalization and actors who stand to profit from rent-seeking economies. The relative power of both factions determines the magnitude and type of foreign direct investment liberalization. We test this theoretical argument using case studies, which include China and Vietnam as representatives of gradual transitions and Cuba and North Korea as representatives of traditional rent-seeking economies.
Impact of Dialysis Vintage and Renal Biomarkers on Mortality in Dialysis-Dependent Patients With Critical Limb Ischemia Undergoing Revascularization
Authors: Kobayashi Norihiro , Takahara Mitsuyoshi , Iida Osamu , Soga Yoshimitsu , Kodama Akio , Hirano Keisuke , Nakano Masatsugu , Yamauchi Yasutaka , Komai Hiroyoshi , Azuma Nobuyoshi
Published: June 2021

Purpose:

Revascularization of both endovascular therapy (EVT) and surgical reconstruction improve clinical outcomes of patients with critical limb ischemia (CLI); however, treatment of dialysis-dependent patients with CLI is still challenging. This study aimed to investigate the impact of dialysis-related parameters on the risk of mortality in dialysis-dependent patients undergoing revascularization for CLI.

Materials and Methods:

We retrospectively identified 274 dialysis-dependent patients with CLI (196 males; mean age 71 years), who underwent revascularization, from the clinical database of the surgical reconstruction vs peripheral intervention in patients with critical limb ischemia (SPINACH) study, which was a prospective, multicenter, observational study. Of these patients, 175 patients underwent EVT and 99 patients received surgical reconstruction. The current study evaluated the impact of dialysis vintage and renal biomarkers on the mortality rate of dialysis-dependent patients with CLI undergoing revascularization.

Results:

During a mean follow-up period of 1.7 ± 1.1 years, 147 deaths were observed. The 3-year overall survival rate and its standard error were estimated to be 40.5% ± 8.1% using the Kaplan-Meier method. A Cox proportional hazard analysis revealed that dialysis vintage ≥4 years, serum creatinine levels <4.7 mg/dL, serum urea nitrogen ≥88 mg/dL, and calcium-phosphate product ≥62.6 mg2/dL2 were independent risk factors for mortality after adjustment for the detailed mortality risk score developed in the SPINACH study. Adding these parameters to the original mortality risk score slightly, but not significantly, increased the area under the time-dependent receiver operating characteristics curve from 0.74 (95% CI, 0.67 to 0.81) to 0.77 (0.71 to 0.84) (p=0.084), whereas continuous net reclassification improvement reached 0.75 (0.12 to 0.90) (p=0.027).

Conclusion:

We found that long dialysis vintage, low serum creatinine, high serum urea nitrogen, and high calcium-phosphate product were independently associated with the increased risk of mortality in dialysis-dependent patients with CLI undergoing revascularization.
Access Site Complications of Peripheral Endovascular Procedures: A Large, Prospective Registry on Predictors and Consequences
Authors: Ciprian Cacuci Andrei , Krankenberg Hans , Ingwersen Maja , Gayed Mohamed , Stein Sven Daniel , Kretzschmar Daniel , Schulze P. Christian , Thieme Marcus
Published: June 2021

Purpose

The purpose of this study was to investigate predictors and consequences of acute vascular access site complications (ASCs) related to peripheral endovascular diagnostic or interventional procedures. Despite improvement of puncture techniques, access site–related morbidity and mortality is still considerable.

Materials and Methods

A total of 5263 participants who underwent 5385 endovascular procedures at a single center were consecutively included in this prospective, observational study. Primary outcomes were ASCs defined as composite of puncture site hematoma, pseudoaneurysm, arteriovenous fistula, and overt puncture site bleeding on the first day after procedure.

Results

ASCs occurred in 16.6% of peripheral endovascular procedures (78.6% hematomas, 18.9% pseudoaneurysms, 1.4% arteriovenous fistulas, 1.1% overt bleedings). Independent predictors were advanced age [odds ratio (OR) per 10 years: 1.12, p=0.004], female sex (OR men, 0.77; p=0.001), lysis (OR 3.56; p<0.001), periprocedural heparin (OR 5000 IU, 1.96; p=0.001; OR >5000 IU, 3.56; p=0.02), time to access (OR per 10 seconds, 1.01; p<0.001), sheath size (OR per French, 1.59; p<0.001), brachial artery access (OR vs retrograde transfemoral, 4.58; p<0.001), and compression only (OR Angio-Seal, 0.57, p=0.02; ProGlide, 0.36, p<0.001; FemoSeal, 0.57, p<0.001). Treatment was required in 20.2% and prolonged hospitalization in 17.7% of ASC. Three participants died from access site–related bleeding.

Conclusion

ASCs after peripheral endovascular procedures are associated with advanced age, female sex, periprocedural antithrombotic medication, brachial artery access, postinterventional bleeding, and nonuse of vascular closure devices.
Gauging performance of biosynthesized silver nanoparticles loaded polypropylene nonwoven based textile electrodes for 3-lead health monitoring electro cardiogram on analogous system
Authors: Shaikh Tasnim N , Chaudhari SB , Patel BH , Patel Megha
Published: June 2021

This work reports the engineering of textile electrodes, considered safe for humans even if worn next to skin for a longer time. Obliging this phenomenon conductive Silver nanoparticles (AgNPs) were biosynthesized from Silver Sulphate (Ag2SO4) and medicinal values enriched Ocimum Sanctum (Tulsi)leaves extract. These conductive Silver nanoparticles were loaded by spray technique on polypropylene nonwoven fabric having inbuilt antifungal characteristics, to reduce its resistivity (10Ω) for the fabrication of textile electrodes. The adequate skin-electrode impedance values were observed for the fabricated textile electrodes, viz; 1.44 MΩ–1.83 MΩ and 1.01 MΩ–1.18 MΩ, in the dry and wet state respectively. The 3-lead health monitoring electrocardiograms (ECG) were obtained on the Analogous system with the textile electrodes; dry and wet state as well as gel electrodes. The cardiograms were also taken at a smaller triangle than usual, only for the high resistance textile electrodes. The wet electrodes have executed considerably better clarity of PQR wavelets than reference gel electrodes ECG plots, and their performance was found consistent when tested after six months’ time leap. However, higher motion artifacts caused in the case of dry electrodes have resulted in distorted PQR wavelets and the tracing became worsen with increased testing time leap. This was mainly due to the encapsulation of conductive AgNPs in the air voids of the fabric, increased resistivity. The cardiogram quality has not shown peculiar benefit for a higher heart pumping pressure at the smaller triangle in either of the cases.
Study of Spinal Cord Substructure Expansion Margin in Esophageal Cancer
Authors: Li Dingjie , Wei Shengtao , Li Tian , Liu Yang , Cai Jing , Ge Hong
Published: June 2021

Purpose:

To analyze the setup errors and residual errors of different spinal cord parts in esophageal cancer patients and to explore the necessity of spinal cord segmental expansion.

Methods and Materials:

Sixty cases of esophageal cancer were included with 20 patients subdivided into the following groups: neck, chest and abdomen as per the treatment site. The patients underwent intensity modulated radiation therapy (IMRT) between 2017 and 2019. Thermoplastic mask or vacuum bag were utilized for immobilization of different groups. CTVision (Siemens CT-On-Rail system) was used to acquire pre-treatment CT, and 20 consecutive pre-treatment CT datasets were collected for data analysis for each case. Images were exported to MIM (MIM Software Inc.) for processing and data analysis. Dice coefficient, maximum Hausdorff distance and centroid coordinate values between the spinal cord contours in the pre-treatment CTs and the planning CT were calculated and extracted. The contour expansion margin value is calculated as MPRV = 1.3 ∑ total + 0.5 σ total, where ∑ total and σ total are the systematic and random error, respectively.

Results:

For neck, chest, abdominal segments of the spinal cord, the mean Dice coefficients (± SD) are 0.73 ± 0.06, 0.80 ± 0.06, 0.82 ± 0.06, the maximum Hausdorff distance residual error (± SD) are 4.46 ± 0.55, 3.49 ± 0.53, 3.46 ± 0.69 mm, and the mean centroid coordinate residual error (± SD) are 2.40 ± 0.53, 1.66 ± 0.47, 2.14 ± 0.95 mm, respectively. The calculated margin using residual centroid method in medial-lateral (ML), anterior-posterior (AP), and cranial-caudal (CC) direction of spinal cord in neck, chest, abdominal segments are 3.86, 5.37, 6.36 mm, 3.45, 3.83, 4.51 mm, 4.05, 4.83, 7.06 mm, respectively, and the calculated margin using residual Hausdorff method are 3.10, 5.33 and 6.15 mm, 3.30, 3.77, 4.61 mm, 3.35, 4.76, 6.87 mm, respectively.

Conclusion:

The setup errors and residual errors are different in each segment of the spinal cord. Different margins expansion should be applied to different segment of spinal cord.
Oral Amylin Treatment Reduces the Pathological Cascade of Alzheimer’s Disease in a Mouse Model
Authors: Na Hana , Tian Hua , Zhang Zhengrong , Li Qiang , Yang Jack B. , Mcparland Liam , Gan Qini , Qiu Wei Qiao
Published: June 2021

Intraperitoneal injection of amylin or its analog reduces Alzheimer’s disease (AD) pathology in the brains. However, self-injecting amylin analogs is difficult for patients due to cognitive deficits. This work aims to study the effects of amylin on the brain could be achieved by oral delivery as some study reported that amylin receptor may be present in the gastrointestinal tract. A 6-week course of oral amylin treatment reduced components of AD pathology, including the levels of amyloid-β, phosphorylated tau, and ionized calcium binding adaptor molecule 1. The treatment reduced active forms of cyclin-dependent kinase 5. Oral amylin treatment led to improvements in social deficit in AD mouse. Using immunofluorescence, we observed the amylin receptor complexed with the calcitonin receptor and receptor activity-modifying proteins in the enteric neurons. The study suggests the potential of the oral delivery of amylin analogs for the treatment of AD and other neurodegenerative diseases through enteric neurons.
Reflection: Spirituality during COVID-19
Authors: Corpuz Jeff Clyde G.
Published: June 2021

In this article, the author describes how spirituality affect the lives of people during COVID-19 pandemic. The author reflects on the meaning of religiosity and spirituality (R/S) from a practical, theological and pastoral point of view. This article presents new insights on the ongoing search for meaning and purpose of life amidst the COVID-19 pandemic.
A Spoke in the Wheel: Enhancing Chaplaincy Documentation in Interdisciplinary Care Settings
Authors: Fudge Eric J.
Published: June 2021

Chaplaincy is a spoke in the wheel of interdisciplinary care that uses its disciplines to better the patient’s medical condition. Therefore, chaplains ought to consider how their emotional and spiritual support helps interdisciplinary teams treat patients’ illnesses/injuries. This essay explores how chaplains can contribute more effectively to interdisciplinary care by keeping their patients’ condition in focus throughout their spiritual assessments and using models that are familiar to the medical team.
Social and Behavioral Correlates of Sexually Transmitted Infections among Men who Have Sex with Men who Use Alcohol in the San Francisco Bay Area
Authors: Jain Jennifer P. , Gyamerah Akua O. , Baguso Glenda N. , Dawson-Rose Carol , Ikeda Janet , Santos Glenn-Milo
Published: June 2021

The risk of acquiring sexually transmitted infections (STIs) among men who have sex with men (MSM) is driven by various socio-behavioral factors. From 2015-2017, 247 MSM ≥ 18 years-old who reported alcohol use in the past year, were recruited into a cross-sectional study in San Francisco. Participants completed a survey assessing socio-demographics, substance use and treatment, sexual behaviors, HIV status and self-reported STI diagnosis in the past 6 months. Multivariable logistic regression models stratified by HIV status were used to identify the correlates of STIs. Of 247 MSM, the prevalence of bacterial STIs were: gonorrhea (12.9%), chlamydia (9.3%) and syphilis (6.0%). Among 177 MSM living without HIV, factors significantly associated with recent STI diagnosis were: current pre-exposure prophylaxis (PrEP) use (aOR = 3.53, 95% CI: 1.42–8.75, p ≤ .01), popper use during sex in the past 6 months (aOR = 3.16, 95% CI = 1.34–7.47, p ≤ .01) and a history of alcohol treatment (aOR = 0.17, 95% CI = 0.04–0.68, p = .01). Also, in a sensitivity analysis (removing PrEP), any receptive condomless anal sex was independently associated with recent STI diagnosis (aOR = 2.86, 95% CI = 1.15–7.08, p = .02). Among 70 MSM living with HIV, factors significantly associated with recent STI diagnosis were: White race/ethnicity (adjusted odds ratio [aOR] = 7.36, 95% confidence interval [CI] = 1.48–36.62, p = .01), younger age (aOR = 0.90, 95% CI: 0.84–0.97, p < .01) and a higher number of male sexual partners in the past 6 months (aOR = 1.03, 95% CI = 1.00–1.06, p = .02). Sexual health interventions that address the unique needs of MSM living with and without HIV who use alcohol in San Francisco are needed to reduce STI acquisition and transmission.
Civil Aircraft Spare Parts Prediction and Configuration Management Techniques: Review and Prospect
Authors: Feng Yun-Wen , Chen Jun-Yu , Lu Cheng , Zhu Shun-Peng
Published: June 2021

Spare parts are treated as the basis to guarantee the safe and economic operation of civil aircraft, its scientific prediction and reasonable configuration play an important role in perfecting integrated logistics support (ILS) and achieving win-win situation of stakeholders (e.g. manufacturers, operators, maintenance providers). This paper studies the existing spare parts prediction and configuration methods of civil aircraft, and discusses future development trend of spare parts from the perspective of prediction and configuration, respectively. The current development status of civil aircraft spare parts prediction techniques are firstly introduced, according to demand characteristics of spare parts; the present research status of civil aircraft spare parts configuration methods are then elaborated, based on the traditional methods and machine learning methods; the development trend of civil aircraft spare parts prediction and configuration methods is finally analyzed, combined with the advantages and disadvantages of the existing methods of civil aircraft spare parts management methods. The efforts of this work provide a reference for the comprehensive management of civil aircraft spare parts and improve the perfection degree for the ILS of civil aircraft.
Popliteal artery patency is an indicator of ambulation and healing after below-knee amputation in vasculopaths
Authors: Alfawaz Abdullah , Kotha Vikas S , Nigam Manas , Bekeny Jenna C , Black Cara K , Tefera Eshetu , Wang Jing , Coerdt Kathleen M , Dekker Paige K , Kim Kevin G , Evans Karen K , Akbari Cameron M , Attinger Christopher E
Published: June 2021

Background

The posterior flap is a conventional technique for closing a below-knee amputation (BKA) that uses the gastrocnemius and soleus muscle and relies on the popliteal and posterior compartment arteries. If the prior mentioned arterial blood supply is compromised, this flap likely relies on collateral flow. The purpose of this study is to identify and differentiate any significant associations between preoperative popliteal and tibial arterial flow and BKA outcomes and patient-reported function.

Methods

A retrospective review identified patients from a single tertiary wound care center who received BKAs and angiogram between 2010 and 2017 by a single surgeon. BKA complications, wound healing, and amputee ambulatory status at latest follow-up were all stratified for differences according to baseline tibial vessel run-off (VRO) status, popliteal artery patency, and popliteal angioplasty outcome. Chi-square, Fisher’s exact, and Wilcoxon rank sum tests were used with significance defined as p ≤ 0.05 .

Results

BKAs were performed on 313 patients, of which, 167 underwent preoperative angiography. Thirty-two were excluded due to lack of adequate follow-up leaving a total of 135 patients in the studied population. Diabetes was present in 87%, and 36% had end-stage renal disease. By the study’s conclusion, 92% of BKAs had fully healed, with median time-to-healing of 79 days (range 19–1314 days). 60% of patients were ambulatory at 9.5 months. Higher VRO was associated with higher healing rates and lower complications and time-to-healing. The conversion rate of BKA to above-knee amputation (AKA) was 4%. Preoperative popliteal patency was associated with higher postoperative ambulation rates when compared to patients without popliteal flow preoperatively (patent: 71/109, 65%; occluded: 10/26, 40%; p = 0.02) and independently increased the likelihood of postoperative ambulation.

Conclusions

The posterior flap design for BKA works even in the setting of popliteal occlusion. Complication rates are higher in patients with more compromised blood flow, which may ultimately lead to AKA. Given poor ambulation rates in patients who undergo AKA, the results of this study should encourage surgeons to consider a more functional BKA, even in instances when the popliteal artery is occluded.