bluuebunny/crossref_metadata_2025 huggingface dataset:
Parameter analysis and optimization of polling-based medium access control protocol for multi-sensor communication
Authors: Guo Jialin , Li Fufang , Wang Tian , Zhang Shaobo , Zhao Yuqing
Published: April 2021

In this article, a comprehensive parameter analysis for the polling-based medium access control protocol is executed. The theoretical expressions of the relationship between network parameters and performance including delay and energy consumption are given for the first time. The specific conclusions in this article are as follows: (1) awake duration is the parameter that has the greatest impact on delay and energy consumption. Increasing the duty cycle (awake duration) will effectively reduce the delay, but will also increase the energy consumption within a certain range; (2) increasing polling duration can reduce the delay, but it will also increase the energy consumption; and (3) more forwarding nodes cause a smaller delay, and it can save the energy with modest increase of delay by reducing the polling duration. An adaptive parameter optimization polling-based medium access control protocol is proposed to optimize network performance. In this protocol, the residual energy gets fully used to increase awake duration and polling duration, which makes the delay smaller, and the network maintains a long lifetime meanwhile. Based on the results of the analysis, the adaptive parameter optimization polling-based medium access control protocol proposed in this article reduces the delay by 22.40% and increases the energy efficiency by 23.25%.
A Novel Surgical Approach for Type 2 Mirizzi Syndrome: Based on a Decade of Clinical Experience at a Teaching Hospital
Authors: Yu Hong W , Zhang Guoqiang , Zhang Yingjie , Yan Wanneng
Published: April 2021

Background. The Mirizzi syndrome (MS) is a rare complication of cholecystolithiasis that is often accompanied by severe inflammation and fibrosis around Calot’s triangle. It is difficult to treat Type 2 MS surgically, and the treatment for this condition has not yet been standardized. The data on operative management are limited. The study aimed to review our institutional clinical experience regarding surgery and provide recommendations for treating Type 2 MS. Methods: We conducted a retrospective study on 6 patients with MS who were surgically treated at our institution between January 2010 and December 2019. The classification of MS by McSherry CK, Ferstenberg H, Virshup M. The Mirizzi syndrome: Suggested classification and surgical therapy. Surg Gastroenterol. 1982;1:219-225 was used. Mucosal approach was used to treat Type 2 MS. The parameters for comparison included patient demographics, operative procedures, operation time, blood loss, length of hospital stay, complications, and follow-up. Results: There were 23 patients with MS among 10 386 cholecystectomies in our area. Six patients with Type 2 MS had successful surgery, and the mucosal approach was used. The average operative time was 253.3 ± 32.5 minutes. The average blood loss was 70.0 ± 14.1 mL. The mean postoperative hospital stay was 9.5 ± 3.9 days. There was no postoperative mortality. The most frequent postoperative complications were bile leakage (16.7%), and postoperative intra-abdominal collection (16.7%). The mean postoperative follow-up was 10 months, and all patients are asymptomatic. The mucosal approach may decrease the risk of bile duct injury, biliary tract infection, and blood loss more than other surgical approaches. Conclusion: This study demonstrates that the mucosal approach is an effective surgical procedure for Type 2 MS.
Long-Term Outcome Comparison Between Two Specimen Extraction Approaches for Middle Rectum Cancer: A Retrospective Study
Authors: Zhong Yuchen , Qiao Tianyu , Ma Tianyi , Hu Hanqing , Jin Yinghu , Wang Yuliuming , Tang Qingchao , Huang Rui , Wang Guiyu , Wang Xishan
Published: April 2021

Objective. There are few studies comparing the long-term results of natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic-assisted resection (LA) in the treatment of middle rectal cancer. This retrospective analysis aimed to evaluate the reliability of NOSES. Method. From January 2013 to December 2017, all patients diagnosed with median rectal cancer in our hospital who underwent NOSES and LA were enrolled. We used propensity-score matching (PSM) to balance baseline data between the NOSES group and the laparoscopic group. The primary endpoint was overall survival (OS) and disease-free survival (DFS). We used the Kaplan–Meier method to estimate OS and DFS. Student’s t-test was used to analyze the difference of continuous data. Categorical data were compared using the Kruskal–Wallis test or Fisher’s exact test. Results. After PSM, 38 patients were included in each group. We found that surgical bleeding volume in the NOSES group was considerably lower than that in the LA group (49.5 ± 47.5 mL vs. 86.3 ± 83.5 mL, P = .01). From the short-term results, the first flatus and regular diet time in the NOSES group were shorter than those in the LA group (41.3 ± 25.2 vs. 54.0 ± 19.2 hours, P < .01 and 63.9 ± 42.6 hours vs. 105.1 ± 66.8 hours, P < .01, respectively). Long-term OS and DFS were not different between the groups. Conclusion. Therefore, NOSES is a reliable technique for middle rectal cancer treatment. Short-term outcomes are pointedly better than LA, while the two surgical approaches did not differ in the long-term outcomes or complication rate.
Super-Selective Intra-Arterial Indocyanine Green Administration for Near-Infrared Fluorescence-Based Positive Staining of Hepatic Segmentation: A Feasibility Study
Authors: Li Wei-Feng , Al-Taher Mahdi , Yu Chun-Yen , Liu Yueh-Wei , Liu Yu-Yin , Marescaux Jacques , Cheng Yu-Fan , Diana Michele , Wang Chih-Chi
Published: April 2021

Background. Despite the increasing number of laparoscopic hepatic procedures for the resection of hepatocellular carcinoma (HCC), intraoperative tumor localization and demarcation remains challenging in comparison to open surgery. In this study, we evaluated the feasibility of positive liver segment staining through the super-selective intra-arterial indocyanine green (ICG) administration. Methods. Eight patients presenting with a single HCC underwent an interventional vascular procedure followed by laparoscopic surgery. A microcatheter was advanced into the hepatic artery branches perfusing the HCC followed by digital subtraction angiography and angiography computed tomography (angio-CT). Patients were then transferred to the operating room, and a laparoscopic hepatectomy was performed under ultrasound guidance. A 5 mL bolus of ICG with a concentration of .125 mg/mL was injected through the microcatheter, and a near-infrared laparoscope was used to detect the fluorescence signal to assess the correspondence between the fluorescence-based demarcation and the intraoperative ultrasound–based demarcation. Results. The duration for the angiography procedure was 32.7 +/− 5.3 min, and it took 242 +/− 118 min from the end of angiography procedure until the start of the surgical procedure. In all cases, the fluorescent liver segment was corresponding to the angio-CT findings. In 6/8 cases, fluorescence imaging was considered helpful in the identification of the resection line. In 3 patients, the resection line was changed according to the positively stained liver segment. Conclusion. We successfully demonstrated the feasibility of the super-selective intra-arterial ICG administration for fluorescence-based positive staining of hepatic segmentation during laparoscopic surgery for HCC (NCT04266548).
Behind the Streams: The Off-Camera Labour of Game Live Streaming
Authors: Johnson Mark R.
Published: April 2021

The live streaming of digital and analogue gaming has emerged as a major new topic in games research. One element involves understanding the labour of streaming: studies to date have focused on examining the ‘on-camera’ labour of streamers, but what has yet to be examined is their ‘off-camera’ labour. This includes developing stream aesthetics, networking with other streamers and viewers, building communities on other platforms and management and maintenance activities. These forms of labour are undertaken by those who broadcast for leisure purposes and those who aspire to a part-time or even full-time job in game streaming. Drawing on extensive interview data with professional and semi-professional live streamers, this article explores off-stream labour and the demands it makes on game broadcasters. The article sheds new light on the behind-the-scenes labours and lives of aspirational gaming live streamers, who are collectively becoming increasingly influential in global gaming communities.
Heritage Sites and Video Games: Questions of Authenticity and Immersion
Authors: Mochocki Michał
Published: April 2021

Can video games afford authentic heritage experiences, comparable to physical visits to a heritage site? How is authenticity of historical settings related to the player’s immersion? This article explores these questions by looking at the notions of experience and authenticity in tourism/heritage studies and the experience economy and mapping them onto the layers of game immersion. As both video games and site visitation are user-centred designed experiences, they share most of their experiential dimensions: five strategic experiential modules (SEMs) (sense, feel, think, act and relate). Linked through the SEMs, five forms of heritage authenticity reveal close correspondence with five (out of six) dimensions of game immersion/involvement. Therefore, player’s perception of heritage authenticity in historical settings seems to be intertwined with immersion/incorporation. The dual framework of authenticity/immersion presented here allows for detailed analysis of both, the central example being Assassin’s Creed Unity with its famous representation of the Notre-Dame cathedral.
Examining the Disconnect in Youth Pathways and Court Responses: How Bias Invades Across Gender, Race/Ethnicity, and Sexual Orientation
Authors: Rubino Laura L. , Anderson Valerie R. , McKenna Nicole C.
Published: April 2021

Understanding court-involved girls’ pathways has been an important area of inquiry among feminist criminologists, and is especially crucial through an intersectional lens. This research highlights the intersectional identities of youth in the system using qualitative interview data from a Midwestern juvenile court ( n  = 39). Modified analytic induction was used to develop assertions and examine perceived pathways present in the narratives of court staff. Findings indicate that juvenile practitioner biases affect the way the court responds to youth with a focus on girls across intersectional identities. These findings have implications for theory, practice, and policy for working with court-involved youth of all genders.
Gender Identity and Trans Equality: A Comment on Burt
Authors: Sherrick Alyse
Published: April 2021

Recently, Burt expressed concern that in allowing gender to supersede sex, The Equality Act will endanger ciswomen. Gender/sex identities, however, are not as simple as the sexual dimorphic structure Burt introduces. I argue that it is important to validate trans individuals’ identities and give trans women, in particular, access to women’s spaces to reduce the high rates of psychological stress and physical dangers that trans individuals face on a daily basis. I end with solutions that could allow gender to supersede sex while also protecting ciswomen.
Intelligent manufacturing of color blended yarn: Color matching algorithm and manufacturing process through computer numerically controlled ring spinning system
Authors: Cui Peng , Xue Yuan , Liu Yuexing , Sun Xianqiang
Published: April 2021

Yarn-dyed textiles complement digital printing textiles, which hold promise for high production and environmentally friendly energy efficiencies. However, the complicated structures of color-blended yarns lead to unpredictable colors in textile products and become a roadblock to developing nonpollution textile products. In the present work, we propose a framework of intelligent manufacturing of color blended yarn by combining the color prediction algorithm with a self-developed computer numerically controlled (CNC) ring spinning system. The S-N model is used for the prediction of the color blending effect of the ring-spun yarn. The optimized blending ratios of ring-spun yarn are obtained based on the proposed linear model of parameter W. Subsequently, the CNC ring-spinning frame is used to manufacture color-blended yarns, which can configure the constituent fibers in such a way that different sections of yarn exhibit different colors.
Bone Morphogenic Protein for Upper Extremity Fractures: A Systematic Review
Authors: Sandler Alexis B. , Scanaliato John P. , Raiciulescu Sorana , Nesti Leon , Dunn John C.
Published: April 2021

Background

This review discusses success, time to healing, and complications of bone morphogenic proteins (BMPs) 7 and 2 in treating upper extremity nonunions.

Methods

Systematic review identified 26 of 479 studies that met inclusion criteria. Publications described application of BMPs to acute and chronic upper extremity delayed unions/nonunions. Unions, complications, patient demographics, and fracture/healing patterns were pooled and analyzed.

Results

Nonunions treated with BMP-7 (n=302) involved the humerus (64%), forearm (22%), clavicle (11%), and hand/wrist (3%), with prior surgical correction attempted in 84%. Nonunions treated with BMP-2 (n=96) involved the humerus (58%), hand/wrist (27%), forearm (14%), and clavicle (1%), with prior surgical correction attempted in all. Most nonunions (80%) were present for over 12 months before BMP application. Union rates of BMP-7 varied according to site: hand/wrist (95%), humerus (74%), forearm (29%), and clavicle (6.2%) nonunions achieved union as defined by study authors in 232 days (confidence interval=96-369, Q<0.001) on average. While not significant across studies, BMP-2 union rates were 71% of hand/wrist and 75% of humerus nonunions. Comparison of the BMPs demonstrates different proportions of success in humerus and hand/wrist fractures ( P<.001) but not forearm fractures ( P<.77) and longer time to radiographic union with BMP-7 ( P<.011).

Conclusions

Most hand/wrist and humerus nonunions treated with BMP-7 and BMP-2 achieved union, with significant similarity among BMP-7 studies not observed in BMP-2 studies. Nonunions treated with BMP-7 have longer healing times yet similar complication rates compared with BMP-2. Overall, BMPs are an effective adjunct to fracture healing with acceptable complication profile.
Thumb-Basal Joint Arthroplasty Outcomes and Metacarpal Subsidence: A Prospective Cohort Analysis of Trapeziectomy With Suture Button Suspensionplasty Versus Ligament Reconstruction With Tendon Interposition
Authors: Shonuga Owolabi , Nicholson Kristen , Abboudi Jack , Gallant Gregory , Jones Christopher , Kirkpatrick William , Liss Frederic , Takei R. Robert , Wang Mark , Ilyas Asif M.
Published: April 2021

Background

Thumb carpometacarpal (CMC) joint arthroplasty is a common procedure in the surgical management of symptomatic thumb basal joint arthritis. Following trapeziectomy, a number of suspensionplasty techniques are often used, but limited comparative evidence exists between these techniques. The central aim of this study was to prospectively compare the outcomes of 2 suspensionplasty techniques following trapeziectomy: suture button (TightRope) versus ligament reconstruction and tendon interposition (LRTI).

Methods

Prospective data were collected on 112 consecutive patients with Eaton stage III-IV thumb CMC arthritis who underwent open trapeziectomy and suspensionplasty. There were 53 LRTI and 59 TightRope suspensionplasty procedures. Outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand ( QuickDASH) questionnaire, Visual Analogue Scale (VAS) for pain, radiographic analysis, and lateral pinch strength. Patient demographic data and complications were also recorded.

Results

Patients undergoing TightRope suspensionplasty had significantly higher trapeziometacarpal index and thus less subsidence than the LRTI group at 2 weeks (0.22 vs 0.17 [ P < .0001]) and 3 months (0.17 vs 0.15 [ P < .05]) postoperatively. TightRope suspensionplasty also had a significantly lower QuickDASH score at 2 weeks (64.7 vs 74.6 [ P < .05]), 3 months (20.7 vs 32.5 [ P < .05]), and 1 year postoperatively (7.57 vs 21.5 [ P < .05]) compared with the LRTI group. However, there was no difference in VAS pain, lateral pinch strength, reoperation, or complications at any time point between groups.

Conclusions

Thumb CMC joint arthroplasty performed with a TightRope suspensionplasty versus LRTI yielded short-term improved resistance to subsidence, long-term greater improvement in clinical outcome by QuickDASH, and no difference in pain or complication rates.
The Variable Insertional Anatomy of the Abductor Pollicis Longus: Functional Relevance and Relationship to Adjacent Thumb Extensors
Authors: Deivasigamani Shruthi , Azad Ali , Yang S. Steven
Published: April 2021

Background

The abductor pollicis longus (APL) is classically described as inserting on the base of the first metacarpal. This study analyzed APL insertional anatomy and quantified the size of various elements of the extensor side of the thumb to determine associations with size and function.

Methods

Twenty-four formalin-preserved upper limbs were dissected. The insertional anatomy of the APL, extensor pollicis brevis, and extensor pollicis longus were characterized, and the capacity of APL tendon slips to perform palmar abduction of the first digit was quantified based on slip size and insertion.

Results

The mean number of APL tendon slips observed was 2.3. Abductor pollicis longus insertion sites included the base of the first metacarpal, trapezium, abductor pollicis brevis, and opponens pollicis. Only 4 specimens had a solitary metacarpal slip, while 83% of specimens had insertions onto at least 1 thenar muscle. A total of 62.5% of APL tendons exhibited some form of branching that we categorized into “Y” and “Z” patterns. In assessing palmar abduction capacity, we found that APL tendon slips inserting into the base of the first metacarpal were larger in cross-sectional area than nonmetacarpal slips and reproduced complete palmar abduction of the digit in the absence of nonmetacarpal slips. The abduction capacity of APL tendon slips was not correlated to the cross-sectional area.

Conclusions

There is significant variability in APL tendon slips, branching patterns, and insertional anatomy. These findings provide further understanding of the function of the APL and its surgical implications.
Lifestyle Medicine for Women: The Time Is Now!
Authors: Geyer Cynthia , McHugh John , Tollefson Michelle
Published: April 2021

As the founders of the American College of Lifestyle Medicine’s Women’s Health Member Interest Group, we welcome this issue focused on the important issues facing women, their providers, and researchers in this field. Women’s health extends beyond sex-specific reproductive health issues, by also encompassing the medical conditions that are more prevalent in women as well as conditions that are expressed differently in women. Inadequate representation of women in clinical research has contributed to poorer outcomes. As lifestyle medicine forms the foundation of true health, the time is now to recognize and address these issues with research, education, and advocacy.
Systematic review of inframalleolar endovascular interventions and rates of limb salvage, wound healing, restenosis, rest pain, reintervention and complications
Authors: Machin M , Younan HC , Guéroult AM , Onida S , Shalhoub J , Davies AH
Published: April 2021

Objectives

Peripheral artery disease is estimated to affect 237 million individuals worldwide. Critical limb ischaemia, also known as chronic limb threatening ischaemia is a consequence of the progression of peripheral artery disease which occurs in ∼21% of patients over a five-year period. The aim of this systematic review is to assess the use of additional below-the-ankle angioplasty in comparison to the use of above-the-ankle angioplasty alone, and the subsequent rates of amputation, wound healing, restenosis, rest pain, reintervention and complications.

Methods

This systematic review was undertaken in accordance with PRISMA guidelines following a registered protocol (CRD42019154893). Online databases were searched using a search strategy of 20 keywords. Included articles reported the outcome for inframalleolar (pedal artery, pedal arch, plantar arteries) angioplasty with additional proximal angioplasty in comparison to proximal angioplasty alone. GRADE assessment was applied to assess the quality of the evidence.

Results

After screening 1089 articles, 10 articles met the inclusion criteria. Comparative performance assessment of below-the-ankle with above-the-ankle versus above-the-ankle angioplasty alone was undertaken in 3 articles, with the remaining 7 articles reporting outcomes of below-the-ankle with above-the-ankle angioplasty with no distinct comparator group. Significant decrease in major lower limb amputation at the last follow-up in the below-the-ankle group when compared with the above-the-ankle angioplasty alone group was observed in a single study (3.45% vs. 14.9%, p < 0.05). Improved wound healing rate at follow-up in the below-the-ankle group versus above-the-ankle angioplasty alone group was also reported in a single study (59.3% vs. 38.1%, p < 0.05). Subsequent rate of amputation after below-the-ankle angioplasty has been estimated as 23.5%.

Conclusion

To date, there is a lack of studies assessing inframalleolar interventions and their use in improving limb salvage, wound healing and symptomatology. Prospective RCTs should be undertaken with adequate participant numbers to be sufficiently powered and report clinically important end-points.
‘Unlocking Us’: Analyzing the US election and its aftermath
Authors: Chace Sarah
Published: April 2021

The American presidential election of 2020 ended in the early hours of Thursday 7 January 2021, when the US Congress counted and certified the ballots of the Electoral College in the aftermath of a violent, Trump-supporting mob breaching the US Capitol. The spectacle of this assault may be analyzed for years to come, yet it is immediately clear that it was the result of authoritarian impulses on the part of the defeated president. Critical Leadership Studies has concerned itself with the ‘problematization’ of leadership theory, often examining distributions of power both within society and within the discipline itself. This article takes its title from Brené Brown’s podcast, ‘Unlocking Us’, torqueing it in an effort to understand these events and their causes as a group dynamic that manifested between Trump and his supporters. I also make the argument that the anxiety fomented and falsely contained by Trump has its deeper origins in what Kuhn labeled ‘paradigm shifts’. To deconstruct the kind of leadership that took place in the run-up to and the aftermath of the 2020 election—darkly charismatic, authoritarian, and cultish—I employ three lenses of analysis: paradigm shifts as progenitors of crisis; ‘basic assumption’ patterns of work avoidance in groups; and ‘holding environments’ as the imposition of salutary boundaries that foster growth. In combination, these three lenses offer an interpretation of recent events in America that enhances the dialectical approach proposed by Critical Leadership Theory.
ASPECTS-based selection for late endovascular treatment: a retrospective two-site cohort study
Authors: Nannoni Stefania , Kaesmacher Johannes , Ricciardi Federico , Strambo Davide , Dunet Vincent , Hajdu Steven , Saliou Guillaume , Mordasini Pasquale , Hakim Arsany , Arnold Marcel , Gralla Jan , Fischer Urs , Michel Patrik
Published: April 2021

Introduction

The DAWN trial demonstrated the effectiveness of late endovascular treatment in acute ischemic stroke patients selected on the basis of a clinical-core mismatch. We explored in a real-world sample of endovascular treatment patients if a clinical-ASPECTS (Alberta Stroke Program Early CT Score) mismatch was associated with an outcome benefit after late endovascular treatment.

Methods

We retrospectively analyzed all consecutive acute ischemic stroke patients admitted 6–24 h after last proof of good health in two stroke centers, with initial National Institutes of Health Stroke Scale (NIHSS) ≥10 and an internal carotid artery or M1 occlusion. We defined clinical-ASPECTS mismatch as NIHSS ≥ 10 and ASPECTS ≥ 7, or NIHSS ≥ 20 and ASPECTS ≥ 5. We assessed the interaction between the presence of the clinical-ASPECTS mismatch and late endovascular treatment using ordinal shift analysis of the three-month modified Rankin Scale and adjusting for multiple confounders.

Results

The included 337 patients had a median age of 73 years (IQR = 61–82), admission NIHSS of 18 (15–22), and baseline ASPECTS of 7 (5–9). Out of 196 (58.2%) patients showing clinical-ASPECTS mismatch, 146 (74.5%) underwent late endovascular treatment. Among 141 (41.8%) mismatch negative patients, late endovascular treatment was performed in 72 (51.1%) patients. In the adjusted analysis, late endovascular treatment was significantly associated with a better outcome in the presence of clinical-ASPECTS mismatch (adjusted odd ratio, aOR = 2.83; 95% confidence interval, CI: 1.48–5.58) but not in its absence (aOR = 1.32; 95%CI: 0.61–2.84). The p-value for the interaction term between clinical-ASPECTS mismatch and late endovascular treatment was 0.073.

Conclusions

In our retrospective two-site analysis, late endovascular treatment seemed effective in the presence of a clinical-ASPECTS mismatch, but not in its absence. If confirmed in randomized trials, this finding could support the use of an ASPECTS-based selection for late endovascular treatment decisions, obviating the need for advanced imaging.
Synthesis, crystal structure, the Hirshfeld surface analysis, and antimicrobial activity of a three-dimensional Cu(II) complex with N-substituted biguanide
Authors: Shi Fei-Fei , Xu Qian , Wang Jing , Zheng Yi
Published: April 2021

A new antibacterial complex C4H15CuN5O7S, which is derived from the non-insulin-dependent diabetes mellitus drug metformin hydrochloride (MH) and cupric sulfate pentahydrate, is prepared and characterized. The complex shows that a three-dimensional supramolecular structure and the intermolecular interactions are analyzed by the Hirshfeld surface analysis. More importantly, compared with the MH free ligand, the present complex shows excellent antimicrobial activity, especially for Gram-negative bacteria.
The use of inertial measurement units for analyzing change of direction movement in sports: A scoping review
Authors: Alanen  AM , Räisänen AM , Benson LC , Pasanen K
Published: April 2021

Change of direction movement is common in sports and the ability to perform this complex movement efficiently is related to athlete's performance. Wearable devices have been used to evaluate aspects of change of direction movement, but so far there are no clear recommendations on specific metrics to be used.

The aims of this scoping review were to evaluate the reliability and validity of inertial measurement unit sensors to provide information on change of direction movement and to summarize the available evidence on inertial measurement units in analyzing change of direction movement in sports.

A systematic search was employed in MEDLINE (Ovid), CINAHL (EBSCO host), SPORTDiscus (EBSCO host), EMBASE and Cochrane Database of Systematic Reviews and Web of Science to identify eligible studies. A complementary grey literature search was employed to locate non-peer reviewed studies. The risk of bias of the studies evaluating validity and/or reliability was evaluated using the AXIS tool.

The initial search identified 15,165 studies. After duplicate removal and full-text screening 49 studies met the inclusion criteria, with 11 studies evaluating validity and/or reliability.

There are promising results on the validity and reliability, but the number of studies is still small and the quality of the studies is limited. Most of the studies were conducted with pre-planned movements and participants were usually adult males. Varying sensor locations limits the ability to generalize these findings. Inertial measurement units (IMU) can be used to detect change of direction (COD) movements and COD heading angles with acceptable validity, but IMU measured or derived kinetic or kinematic variables present inconsistency and over-estimation.

Studies can be improved with larger sample sizes and agreement on the metrics used and sensor placement. Future research should include more on-field studies.
Legitimation strategies in discourse surrounding Sino-American trade friction: A case study of Chinese government white papers
Authors: Cheng Xi
Published: April 2021

This article reports a critical discourse analysis of the legitimation strategies used in two Chinese government white papers about trade frictions between China and the United States. Drawing on the legitimation framework advanced by van Leeuwen to political discourse, it shows how the white papers use four main legitimation strategies: authorization, moralization, rationalization, and integration. It argues that the Chinese government uses these strategies to legitimate its responses to US trade policy and delegitimate the US government’s motives for initiating/escalating tensions. This article also discusses how the use of these legitimation strategies draws from certain traditional Chinese cultural values, such as Confucianism, the culture of face, and collectivism. This article is a part of a larger research project studying discursive strategies in trade friction discourse and hopes to shed light on the attributes and functions of this type of discourse.
Gender stereotypes and biases in early childhood: A systematic review
Authors: King Tania L , Scovelle Anna J , Meehl Anneke , Milner Allison J , Priest Naomi
Published: April 2021

This review aimed to synthesise studies examining the presence of gender stereotypes and biases expressed by young children aged 3–5 years, with a focus on informing early childhood settings. Our review located only 21 separate studies in 16 articles, highlighting a dearth of research in this area. There was substantial heterogeneity in the operationalisation of gender stereotypes and biases. There was evidence that children in early childhood are aware of, and can apply, gender stereotypes. There was also evidence of the malleability of these biases and stereotypes. The social and cultural environment plays a large role in defining the cues by which young children classify on the basis of gender. Research is needed to understand ways to support the establishment of equitable gender attitudes amongst children in early childhood, as this could deliver important benefits to individuals across their lifetime, as well as society more broadly.
Public housing, intersectoral competition, and urban ground rent: Iran’s first public housing program that never was
Authors: Farahani Ilia , Yousefi Shadi
Published: April 2021

This paper investigates the structural political economic drivers of the housing market in urban Iran and the ways in which social and economic dynamics of the housing sector are rooted in peculiarities of Iranian capitalism, characterized by a relatively small public economy, low productivity of capital, and an underdeveloped financial system. The paper examines these processes and mechanisms in the light of the illustrative case of the country’s first and largest state-led housing program, the Mehr Housing Program (MHP). The paper argues that the program’s failure is due primarily to the state’s market-oriented approach toward housing. The MHP’s units were sold at their market prices, and the state subsidized the land to the developers with low rent, facilitating investments. Utilizing an intersectoral and multi-scalar analytical framework, we further argue that what drives the investment is absolute ground rent present in the housing sector due to its labor-intensive character. The high level of rent is due to persistently low profitability in the manufacturing sector and, subsequently, excess profits in construction and housing. Thus, rent-seeking investors tend to invest in housing. These peculiarities of the Iranian economy determined the trajectory and the failure of the MHP as a public housing initiative.
Therapeutic potential of adipose-derived mesenchymal stem cell exosomes in tissue-engineered bladders
Authors: Yang Tianli , Zhao Feng , Zhou Liuhua , Liu Jingyu , Xu Luwei , Dou Quanliang , Xu Zheng , Jia Ruipeng
Published: April 2021

Mesenchymal stem cells (MSCs) are a therapeutic tool for tissue engineering. However, many studies have recently shown that the therapeutic effects of MSCs are mediated by paracrine signaling and their secretory factors rather than their multidirectional differentiation ability. Exosomes isolated from the conditioned medium of MSCs are considered the main intercellular communication medium between MSCs and their target cells. Exosomes have been utilized in a novel cell-free therapy strategy that has attracted much attention. In this study, we evaluated the effects of a new cell-free tissue-engineered bladder (bladder acellular matrix combined with adipose-derived mesenchymal stem cell exosomes (AMEs)) in vivo and in vitro to prove that AMEs promoted tissue regeneration and functional recovery in a rat bladder replacement model.
Abnormal levels of apolipoprotein A‐I in chronic thromboembolic pulmonary hypertension
Authors: Khirfan Ghaleb , Li Manshi , Wang Xiaofeng , DiDonato Joseph A. , Dweik Raed A. , Heresi Gustavo A.
Published: April 2021

Recent studies have shown low high‐density lipoprotein cholesterol (HDL‐C) and dysregulated lipid metabolism in chronic thromboembolic pulmonary hypertension (CTEPH). Apolipoprotein A‐I (ApoA‐I) is the major protein component of HDL‐C and mediates most of its functions. We hypothesize that ApoA‐1 and its oxidative state might be more sensitive biomarkers in CTEPH. Plasma levels of HDL‐C, ApoA‐I, paraoxonase‐1 enzyme activity (PON1), and the oxidized dysfunctional ApoA‐I (oxTrp72‐ApoA‐I) were measured in patients with CTEPH and compared to those in healthy controls. Association with markers of disease severity in CTEPH was assessed. We included a total of 61 patients with CTEPH (age: 61.2 ± 15 years; male 52.5%) and 28 control subjects (age: 60.1 ± 8 years; male 59.3%). When adjusting for age, sex, body mass index, and statin use, ApoA‐I was lower in CTEPH compared to controls (CTEPH:125.2 ± 27 mg/dl; control:158.3 ± 29.4 mg/dl; p < 0.001), but HDL‐C levels were not statistically different. There were no significant differences in PON and oxTrp72‐ApoA‐I/ApoA‐I ratio. In exploratory analyses, ApoA‐I was associated with mean right atrial pressure (rs = −0.32, p = 0.013) and N‐terminal pro B‐type natriuretic peptide (rs = −0.31, p = 0.038). There were no significant associations between HDL‐C, PON1, or oxTrp72‐ApoA‐I/ApoA‐I ratio and markers of disease severity. We conclude that ApoA‐I is a more sensitive biomarker than HDL‐C in CTEPH, and may be associated with right heart dysfunction.
Ovarian reserve may influence the outcome of bone mineral density in patients with long-term use of dienogest
Authors: Yamamoto N , Wada-Hiraike O , Hirano M , Hirata T , Harada M , Hirota Y , Koga K , Fujii T , Osuga Y
Published: April 2021

Objective:

Long-term administration of dienogest, which is known to have effect on bone mineral density, is frequently done in patients with endometriosis and adenomyosis, but a few studies focused on the bone mineral density changes after finishing the long-term therapy. This study aimed to reveal the factors that adversely affect lumbar bone mineral density.

Method:

Fifty-seven premenopausal women who visited our hospital were diagnosed as either endometriosis or adenomyosis, and they were treated by dienogest for more than 115 weeks (26.5 months). Based on a previous report, bone mineral density changes less than 2% was categorized as the osteopenic group ( n = 30), and the others were assigned to the unchanged group ( n = 27). Bone mineral density was measured at the lumbar spine using dual-energy X-ray absorptiometry. A representative ovarian reserve marker, endogenous estradiol levels, and follicle-stimulating hormone levels were measured over time and were compared between the osteopenic and unchanged groups.

Result:

Duration of dienogest intake was 59.5 months (osteopenic group) versus 57.5 months (unchanged group). These patients experienced ovarian surgeries in a similar frequency, but the ovarian reserve in osteopenic group was impaired as suggested by the decline of endogenous estradiol level during intake of dienogest compared to that of unchanged group ( p = 0.0146). Endogenous follicle-stimulating hormone level between osteopenic group and unchanged group did not reach statistically significant difference, although the osteopenic group showed relatively higher level.

Conclusion:

This study might suggest that decreased ovarian reserve as judged by endogenous estradiol level is a factor that negatively affect bone mineral density, and measurement of endogenous estradiol level during intake of dienogest could have a predictive meaning of future decreased bone mineral density level.
Rate of blood pressure control and its determinants among adult hypertensive patients at Jimma University Medical Center, Ethiopia: Prospective cohort study
Authors: Kebede Bekalu , Chelkeba Legese , Dessie Bekalu
Published: April 2021

Introduction:

Despite the fact that the goals for the management of hypertension are well-defined and effective therapies are available, control of hypertension remains poor in countries with low resources including Ethiopia. This study aimed to determine blood pressure control rate and its determinants among ambulatory adult hypertensive patients at Jimma University Medical Center.

Methods:

A general prospective cohort study was conducted among adult hypertensive patients who had regular follow-up at Jimma University Cardiac Clinic from 20 March to 20 June 2018. Hypertensive patients who fulfilled the inclusion criteria were selected in the first month of the data collection period. Then, only those patients who visited the clinic at the first month were consequently followed-up for the next 3 months. The Eighth Joint National Committee guideline was used to categorize controlled and uncontrolled blood pressures. Patients’ specific data were collected using a structured data collection tool. Data were analyzed using the statistical software package SPSS version 21.0. Bivariate and multivariable logistic regression analysis was used to identify independent variables influencing blood pressure control. p-values of less than 0.05 were considered statistically significant.

Results:

From a total of 416 patients, 237 (57.0%) were male with a mean age of 56.50 ± 11.96 years. Two hundred and fifty eight (62.0%) participants had comorbid conditions and 275 (66.1%) were on combination therapy. The rate of blood pressure control was 42.8%. Age ⩾60 years was negatively associated with uncontrolled blood pressure (adjusted odd ratio = 0.52, confidence interval = 0.31–0.88, p = 0.015). Medication non-adherence (adjusted odd ratio = 1.64, confidence interval = 1.04–2.58, p = 0.034) and non-adherence to international guidelines (adjusted odd ratio = 2.33, confidence interval = 1.49–3.64, p < 0001) were positively associated with uncontrolled blood pressure.

Conclusion:

The rate of blood pressure control among hypertensive patients was suboptimal. Age, clinicians’ non-adherence to international guidelines, and patients’ non-adherence to medications were independent predictors of blood pressure control. Physicians and clinical pharmacists should adhere to guidelines for better treatment and care of hypertensive patients.
Association between adenoid bacteriology and clinical characteristics of adenoid-related diseases in children
Authors: Ungkanont Kitirat , Jootakarn Sujeenun , Leelaporn Amornrut , Kijsinthopchai Usa , Tanphaichitr Archwin , Vathanophas Vannipa , Komoltri Chulaluk
Published: April 2021

Introduction:

The aim of this research is to find the association between the pathogenic bacteria obtained from the adenoid culture and clinical characteristics of adenoid-related diseases in children.

Methods:

In this retrospective study, we reviewed the medical records of children who had adenoidectomy for adenoid-related diseases. Demographic data, diagnoses, indications for adenoidectomy and bacterial culture results were collected. The adenoid size was measured in the lateral skull X-ray as adenoid–nasopharyngeal ratio. Associations between the culture results and the demographic data, adenoid size, and the diagnoses were analyzed.

Results:

There were 407 children who had adenoidectomy for obstructive sleep-disordered breathing (75.2%), otitis media with effusion (19.2%), and chronic sinusitis (5.6%). Median age was 5.9 years. Common pathogenic bacteria in the adenoid were Haemophilus influenzae (26.2%), Staphylococcus aureus (23.5%), Streptococcus pneumoniae (18.2%), and Moraxella catarrhalis (12%). The patient’s age had significant association with the prevalence of pathogenic bacteria. S. pneumoniae was most prevalent in young children up to 7 years. S. aureus was more common in children over 7 years. H. influenzae had similar prevalence in all age groups. Size of the adenoid and type of adenoid-related diseases had no association with the outcome of bacterial culture.

Conclusion:

Age of the patients was the significant factor associated with the bacteriological findings of the adenoid while size and types of adenoid-related diseases were not associated with the outcome of bacterial culture.
Informed consent: What risks are material to patients consenting for urological procedures?
Authors: McCauley Nadine , Lodhia Siya , Ong Andrea , Clark Calum , Lane Tim
Published: April 2021

Objective:

This study aimed to assess patient recall of the consent discussion for urological procedures and to identify which risks were material to urology patients.

Methods:

A total of 102 patients undergoing urological procedures were interviewed in the 24-hour period surrounding the procedure. A self-designed, piloted questionnaire recorded information from the patient’s signed consent form and patient-reported data of the consent discussion.

Results:

The mean patient recall was 2.06 risks, whereas the average number of risks listed by the operating surgeon on the consent form was 5.69 risks. The most frequently recalled risk was impotence (91%), followed by urinary incontinence (63%) and haematuria (61%). The risks associated with poorest patient recall were stent symptoms (0%), urethral catheter insertion (5%) and recurrence (8%).

Conclusions:

Poor patient recall of the consent discussion has again been demonstrated in this study. However, certain urological procedure risks are better recalled by patients, with impotence, urinary incontinence and haematuria being most frequently recalled. Medical terminology such as stent or catheter may be poorly recalled due to a disparity in understanding between patient and clinician. Clinicians should be aware of poor patient recall when consenting for urology procedures and should ensure precise documentation.

Level of evidence:

Level 2b.
Association between vitamin D deficiency and prostate cancer: Prospective case-control study
Authors: Kumawat Ghanshyam , Chaudhary Vijay , Garg Anurag , Mehta Nishkarsh , Talwar Gagan , Yadav SS , Tomar Vinay
Published: April 2021

Objective:

We aimed to find out the association of low serum vitamin D levels with the incidence of prostate cancer through a prospective case-control study.

Material and methods:

This study was carried out in the tertiary care hospital (India). All newly diagnosed patients of prostate cancer and age-matched controls were included. Serum vitamin D levels were measured in all of them. Vitamin D status (ng/mL) was classified as severe deficiency <10, moderate deficiency 10–<30, normal 30–100, and toxicity >100. Normality of the data was tested by the Kolmogorov–Smirnov test, s﻿tatistical analysis was done with Statistical Package for the Social Sciences version 26.0, p-value of <0.05 was considered significant.

Results:

In our study, 320 cases and 320 controls were included. The mean vitamin D levels in cases and controls were 15.71 ± 6.5 (ng/mL) and 17.63 ± 4.54 (ng/mL), respectively, ( p-Value <0.01). Patients with severe vitamin D deficiency (73.58%) had a Gleason score ⩾8 on biopsy and 79.24% of them had a serum prostate specific antigen (PSA) level >20 ng/mL.

Conclusion:

We had concluded that there was no significant association between vitamin D deficiency and increased risk of prostate cancer, although patients with higher-grade prostate cancer and with higher PSA level had severe vitamin D deficiency.

Level of evidence:

Not applicable for this multicentre audit.
Donor-specific antibodies development in renal living-donor receptors: Effect of a single cohort
Authors: Andrade-Sierra Jorge , Cueto-Manzano Alfonso M , Rojas-Campos Enrique , Cardona-Muñoz Ernesto , Cerrillos-Gutiérrez José I , González-Espinoza Eduardo , Evangelista-Carrillo Luis A , Medina-Pérez Miguel , Jalomo-Martínez Basilio , Nieves Hernández Juan , Pazarín-Villaseñor Leonardo , Mendoza-Cerpa Claudia A , Gómez-Navarro Benjamin , Miranda-Díaz Alejandra G
Published: April 2021

Minimization in immunosuppression could contribute to the appearance the donor-specific HLA antibodies (DSA) and graft failure. The objective was to compare the incidence of DSA in renal transplantation (RT) in recipients with immunosuppression with and without steroids. A prospective cohort from March 1st, 2013 to March 1st, 2014 and follow-up (1 year), ended in March 2015, was performed in living donor renal transplant (LDRT) recipients with immunosuppression and early steroid withdrawal (ESW) and compared with a control cohort (CC) of patients with steroid-sustained immunosuppression. All patients were negative cross-matched and for DSA pre-transplant. The regression model was used to associate the development of DSA antibodies and acute rejection (AR) in subjects with immunosuppressive regimens with and without steroids. Seventy-seven patients were included (30 ESW and 47 CC). The positivity of DSA class I (13% vs 2%; P < 0.05) and class II (17% vs 4%, P = 0.06) antibodies were higher in ESW versus CC. The ESW tended to predict DSA class II (RR 5.7; CI (0.93–34.5, P = 0.06). T-cell mediated rejection presented in 80% of patients with DSA class I ( P = 0.07), and 86% with DSA II ( P = 0.03), and was associated with DSA class II, (RR 7.23; CI (1.2–44), P = 0.03). ESW could favor the positivity of DSA. A most strictly monitoring the DSA is necessary for the early stages of the transplant to clarify the relationship between T-cell mediated rejection and DSA.
The outlook for China’s innovation-driven development beyond COVID-19
Authors: Li Ping
Published: April 2021

In the post-COVID-19 era, high-quality development will be a key characteristic of China’s economic development. Despite the disruption caused by the pandemic, China’s economy has remained on track for stable and long-term development. In the bid to drive China’s economic transition from factor-driven to innovation-driven development, it is imperative to improve total factor productivity, and that effort should focus on five key factors: urbanization and labour migration; the spillover effect of foreign technologies; human capital enhancement; scientific and technological progress; and marketization process. It is important to align with the main trends and directions of the scientific and technological revolution and industrial transformation. It will be increasingly necessary to focus on developing a dominant technological system represented by next-generation information technology, biotechnology, new energy sources and new materials and to leverage key accelerators of progress, including institutional reform, market optimization and indigenous innovation in order to advance high-quality economic development.