bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical efficacy of artificially carbonated water bathing on superficial bacterial folliculitis in dogs
Authors: Iyori Keita , Tamagawa Shinichi , Ide Kaori , Nishifuji Koji
Published: November 2021

Background

Bathing with artificially carbonated water is reported to be a valuable therapeutic option for various human skin disorders.

Objective

To evaluate the clinical efficacy of artificially carbonated water bathing on superficial bacterial folliculitis (SBF) caused by Staphylococcus pseudintermedius (SP) in dogs.

Animals

Nineteen dogs with SBF from whom SP was isolated from skin lesions were enrolled.

Methods and materials

Dogs with SBF were allocated randomly to either the artificially carbonated water bathing group or the control group bathed with tap water. The dogs were bathed with the designated water type on day (D)0, D7 and D14. Clinical scores and skin surface pH were evaluated on D0 and D21. Colony forming unit (cfu) assays were performed in vitro to investigate whether the artificially carbonated water affected growth of clinical SP isolates.

Results

The mean rate of improvement in the clinical scores was significantly higher in the carbonated water group than in the control group. Dogs bathed with carbonated water exhibited significant decreases in their skin surface pH after bathing; dogs bathed with tap water did not. No dogs experienced significant adverse events. The cfus of SP incubated in vitro with artificially carbonated water did not significantly differ from those incubated with tap water.

Conclusion

Bathing with artificially carbonated water might be an effective and safe adjunctive therapy for canine SP‐induced SBF.
Reduction of Reflected Light on Fluorescence Emission for Indocyanine Green
Authors: Kwon So Yoon , Yoon Ki-Cheol , Kim Kwang Gi
Published: November 2021

Inside the brain tumor, the blood vessels are intricately composed, and the tumors and blood vessels are similar in color. Therefore, when observing tumors and blood vessels with the naked eye or a surgical microscope, it is difficult to distinguish between tumors and blood vessels. Fluorescence staining with indocyanine green (ICG) is performed to distinguish between brain tumors and blood vessels using a surgical microscope. However, when observing the blood circulation state of a tumor or blood vessel through a surgical microscope, light reflection occurs from the camera. In the process of observing the state of the blood vessel, due to the occurrence of light reflection, an obstruction phenomenon in which the observation field is blocked by the blood vessel of the object to be observed occurs. Therefore, it is difficult to diagnose the vascular condition. In this experiment, the 780 nm light-emitting diode (LED) was irradiated to the ICG phantom, and then, when the fluorescence expression image was observed, the polarizing filter such as circular polarized light (CPL) filter and linear polarized light (LPL) filter was inserted into the camera, and the reflected light was reduced. Therefore, it is possible to reduce the reflected light from the fluorescence expression image by using a polarizing filter, and it is expected to be applicable to surgery and diagnostic fields of cancer such as surgery.
Age, material source, and formation mechanism of bedding-parallel calcite beef veins: Case from the mature Eocene lacustrine shales in the Biyang Sag, Nanxiang Basin, China
Authors: Su Ao , Bons Paul D. , Chen Honghan , Feng Yue-xing , Zhao Jian-xin , Song Jingwen
Published: November 2021

The mechanisms leading to the formation of bedding-parallel calcite beef veins have been widely debated, with discussions centered on timing or burial depth of vein generation, source of the vein material, driving forces for vein initiation and widening, and growth direction and mechanism. To address these issues, a comprehensive study of drill core samples containing beef veins in the mature Eocene lacustrine Hetaoyuan Formation in the Biyang Sag, Nanxiang Basin, China was undertaken through a combination of microstructural observation, isotopic geochronological, geochemical, and fluid inclusion analyses, as well as basin modeling.

X-ray diffraction and total organic carbon content analyses indicate that most of the beef veins accumulated in calcite-rich laminated shales with high organic matter contents. These beef veins yielded an absolute laser ablation−multi-collector−inductively coupled plasma−mass spectrometry U-Pb age of ca. 41.02 ± 0.44 Ma, which corresponds to a burial depth of 500−800 m. Such a shallow burial depth suggests that the full compaction and consolidation of sediments would not yet have been achieved, which is compatible with the following observations: (1) plastic deformation of shale laminae adjacent to the veins, and (2) a beef vein formation temperature of ∼59 °C derived from fluid-inclusion microthermometry. The radio-isotopic age of the beef veins is ∼1−3 m.y. younger than the stratigraphic age of the host rock (ca. 43.1 Ma) but earlier than the model-derived timing of oil generation (ca. 35.8 Ma) and tectonic extrusion (ca. 23.0−13.0 Ma). The beef vein formation predated bacterial sulfate reduction, as evidenced by crosscutting relationships with carbonate concretions, pyrite framboids, and apatite pellets.

A two-stage formation model for these beef veins is proposed. When burial depth of laminated shales rich in organic matter and calcite reaches the methanogenic zone, overpressure triggered by biogenetic gas generation results in horizontal hydrofracturing, initiating cracks that act as gas expulsion pathways. Once all the generated gas has migrated, the opened fractures close again due to overburden load. The materials fed by pressure solution of host-rock calcite fractions then mobilized into the unhealed horizontal fractures by diffusion. Subsequently, by a force of crystallization, antitaxial, displacive growth of calcite fibers commenced, contemporaneous with fracture dilation, eventually leading to the formation of bedding-parallel beef veins.
Patient safety during joint replacement surgery: experiences of operating room nurses
Authors: Nyberg Anette , Olofsson Birgitta , Otten Volker , Haney Michael , Fagerdahl Ann-Mari
Published: November 2021

Background

Avoidable complications for surgical patients still occur despite efforts to improve patient safety processes in operating rooms. Analysis of experiences of operating room nurses can contribute to better understanding of perioperative processes and flow, and why avoidable complications still occur.

Aim

To explore aspects of patient safety practice during joint replacement surgery through assessment of operating room nurse experiences.

Method

A qualitative design using semistructured interviews with 21 operating room nurses currently involved in joint replacement surgery in Sweden. Inductive qualitative content analysis was used.

Results

The operating room nurses described experiences with patient safety hazards on an organisational, team and individual level. Uncertainties concerning a reliable plan for the procedure and functional reporting, as well as documentation practices, were identified as important. Teamwork and collaboration were described as crucial at the team level, including being respected as valuable, having shared goals and common expectations. On the individual level, professional knowledge, skills and experience were needed to make corrective steps.

Conclusion

The conditions to support patient safety, or limit complication risk, during joint replacement surgery continue to be at times inconsistent, and require steady performance attention. Operating room nurses make adjustments to help solve problems as they arise, where there are obvious risks for patient complications. The organisational patient safety management process still seems to allow deviation from established practice standards at times, and relies on individual-based corrective measures at the ‘bedside’ at times for good results.
PD-1/PD-L1 inhibitor plus chemotherapy versus bevacizumab plus chemotherapy in first-line treatment for non-squamous non-small-cell lung cancer
Authors: Yu Hui , Chen Ping , Xia Liangping , Fu Sha , Chen Chen , Zhang Xuanye , He Lina , Zhang Bei , Zhou Yixin , Hong Shaodong
Published: November 2021

Anti-PD-1)/programmed cell death-ligand 1 (PD-L1) antibody plus platinum-based chemotherapy (PBC) has replaced PBC as first-line treatment for patients with non-squamous (sq) non-small cell lung cancer (NSCLC) lacking targetable driver mutations. However, few studies have directly compared immune checkpoint inhibitor (ICI) plus chemotherapy with bevacizumab plus chemotherapy (beva +chemo) in this setting. Herein, we conducted an indirect comparison for anti-PD-1/PD-L1 antibody plus chemotherapy (ICI +chemo) versus beva +chemo in non-sq NSCLC using the frequentist methods. The main outcomes analyzed include progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Data were subtracted from randomized trials comparing ICI +chemo or beva +chemo against PBC. Fourteen trials involving 6165 patients were included. Direct meta-analyses showed that both ICI +chemo (PFS: HR 0.58, OS: HR 0.73, ORR: relative risk (RR) 1.66) and beva +chemo (PFS: HR 0.74, OS: HR 0.89, ORR: RR 1.62) improved clinical outcomes compared with PBC. Indirect comparison showed that ICI +chemo reduced the risk of disease progression (HR 0.78, 95% CI 0.60 to 1.00) and death (HR 0.82, 95% CI 0.71 to 0.94) compared with beva +chemo. The PFS benefits with ICI +chemo over beva +chemo were non-significant in those with negative PD-L1 expression and non-smokers. In conclusion, ICI +chemo is superior to beva +chemo in first-line treatment for non-sq NSCLC.
Controlling phase synchrony in the mean field coupled Hindmarsh–Rose neurons
Authors: Remi T. , Subha P. A. , Usha K.
Published: November 2021

The phase synchronization in a network of mean field coupled Hindmarsh–Rose neurons and the control of phase synchrony by an external input has been analyzed in this work. The analysis of interspike interval, with varying coupling strength, reveals the dynamical change induced in each neuron in the network. The bursting phase lines depict that mean field coupling induces phase synchrony in excitatory mode and desynchrony in inhibitory mode. The coefficient of variability, in spatial and temporal domain, signifies the deviations in firing times of neurons, in a collective manner. The Kuramoto order parameter quantifies the intermittent and complete phase synchrony, induced by excitatory mean field coupling. The capability of external input, in the form of spikes, to control the intermittent and complete phase synchrony has been analyzed. The coefficient of variability and Kuramoto order parameter has been studied by varying the amplitude, pulse width and frequency of the input. The studies have shown that high-frequency spike input, with optimum amplitude and pulse width, has high desynchronizing ability, which is substantiated by the parameter space analysis. The control of synchrony in the network of neurons may find application in rectifying neural disorders.
Error Performance of Subsampling Digital Power Estimation for Integrated Receivers
Authors: Khaleel Aymen , Zencir Ertan , Aksoy Hasan
Published: November 2021

Estimation of signal power levels at the output of integrated receiver building blocks is a vital function as the block voltage or power gains are set based on sensed power levels to maintain constant levels at block outputs in the receiver chain. RF and IF level real-time gain settings are determined with Automatic Gain Control (AGC) loops. AGC loop circuit topologies are usually based on analog detection circuits. These analog power detection circuits are based on techniques such as envelope detection, and logarithmic amplification usually accompanied by severe accuracy issues such as Process, Voltage and Temperature (PVT) spreads preventing correct gain adjustments. Adopting a dominantly digital approach to detect the signal power would ensure a significant reduction in PVT spreads. This work presents a review of the subsampling digital power estimation to create low power digital power estimations alternative to analog methods. The simulations of the method are applied to an AM and a 64-QAM signal. Simulation results show that the power estimation error is within the acceptable level of [Formula: see text][Formula: see text]dB.
Symbol-Pair Distances of Repeated-Root Negacyclic Codes of Length 2s over Galois Rings
Authors: Dinh Hai Q. , Liu Hualu , Tansuchat Roengchai , Vo Thang M.
Published: November 2021

Negacyclic codes of length [Formula: see text] over the Galois ring [Formula: see text] are linearly ordered under set-theoretic inclusion, i.e., they are the ideals [Formula: see text], [Formula: see text], of the chain ring [Formula: see text]. This structure is used to obtain the symbol-pair distances of all such negacyclic codes. Among others, for the special case when the alphabet is the finite field [Formula: see text] (i.e., [Formula: see text]), the symbol-pair distance distribution of constacyclic codes over [Formula: see text] verifies the Singleton bound for such symbol-pair codes, and provides all maximum distance separable symbol-pair constacyclic codes of length [Formula: see text] over [Formula: see text].
Periodicities in Cluster Algebras and Cluster Automorphism Groups
Authors: Liu Siyang , Li Fang
Published: November 2021

We study the relations between two groups related to cluster automorphism groups which are defined by Assem, Schiffler and Shamchenko. We establish the relationships among (strict) direct cluster automorphism groups and those groups consisting of periodicities of labeled seeds and exchange matrices, respectively, in the language of short exact sequences. As an application, we characterize automorphism-finite cluster algebras in the cases of bipartite seeds or finite mutation type. Finally, we study the relation between the group [Formula: see text] for a cluster algebra [Formula: see text] and the group [Formula: see text] for a mutation group [Formula: see text] and a labeled mutation class [Formula: see text], and we give a negative answer via counter-examples to King and Pressland's problem.
Classification Algorithm-Based CT Imaging in Diagnosis of Acute Respiratory Distress Syndrome and Analysis of Pathogenic Factors
Authors: Chen Liang , Li Qiong
Published: November 2021

The study focused on the application value of classification algorithms in processing CT images of acute respiratory distress syndrome (ARDS) and aimed to analyze the pathogenic factors of ARDS. A total of 60 ARDS patients in hospital were selected, and they were divided into ARDS group (38 cases) and non-ARDS group (22 cases) as per diagnostic criteria. There was no significant difference in general data between the two groups (

P
>
0.05

). The FWAC algorithm was introduced into CT imaging to classify the image data more accurately. The two groups were compared for the left ventricular ejection fraction (LVEF), oxygenation index PaO2/FiO2 (P/F), Acute Physiology and Chronic Health Evaluation (APACHE II) scores, pH, and PaO2. The results showed that the PaO2, P/F, and APACHE II scores of the two groups were not statistically significant (

P
>
0.05

). The P/F of the ARDS group was 136.12, and that of the non-ARDS group was 143.04; the APACHE II score of the ARDS group was 40.1, and that of the non-ARDS group was 62.3, showing no significant difference (

P
>
0.05

); the LVEF of the ARDS group was 58.14, and that of the non-ARDS group was 46.26, showing statistically significant differences (

P
>
0.05

). When the minimum support was 0.3 and the minimum confidence was 0.5, the value of Recurrence was 0.7082 and the value of Diagnosis was 0.968. The rules generated by the FWAC algorithm can accurately predict the category and were consistent with the expected results. The accuracy of this algorithm was as high as 98.7%, which was significantly higher than that of the conventional CT imaging (88.4%). The rules generated by FWAC were more accurate, assisting doctors in the prevention and diagnosis of ARDS disease. Premature delivery and asphyxia are high-risk factors of ARDS. In conclusion, the FWAC algorithm has a good classification ability of the CT images of ARDS and demonstrates high accuracy.
Recognition Algorithm of Popular Elements of Ethnic Minority Traditional Clothing Based on PCA
Authors: Juan Hu
Published: November 2021

Image recognition of ethnic minority costumes is helpful for people to understand, carry forward, and inherit national culture. Taking the minority clothing image as the research object, the image enhancement and threshold segmentation are completed; the principal component features of the minority clothing image are extracted by PCA method; and the image matching degree is obtained according to the principle of minimizing the Euclidean distance. Finally, the calculation process of the PCA method is optimized by a wavelet transform algorithm to realize the recognition of popular elements of minority traditional clothing. The comparative experimental results show that the PCA + BP neural network algorithm is better than the other two recognition algorithms in recognition rate and recognition time.
Analysis of Optimal Oxygen Excess Ratio and Nonlinear Tracking Control of Vehicle PEMFC Air Supply System
Authors: Tang Xianzhi , Lin Jilong , Zhao Kun , Shi Longfei , Wang Bo
Published: November 2021

To a large extent, the efficiency and durability of the proton exchange membrane fuel cell (PEMFC) depend on the effective control of air supply system. However, dynamic load scenarios, internal and external disturbances, and the characteristics of strong nonlinearity make the control of complex air supply systems challenging. This paper mainly studies the modeling of PEMFC air supply system and the design of a nonlinear controller for oxygen excess ratio tracking control. First, we analyze and calibrate the system’s optimal oxygen excess ratio control target and explore how the system temperature and humidity impact it, respectively; second, a second-order affine oriented control model which can represent the static and dynamic characteristics of the air supply system is derived, and a disturbance observer is designed to estimate and compensate the “lumped error” online. Then, aiming at the problem of unmeasurable cathode pressure, a state observer based on Kalman optimal estimation algorithm is proposed to realize the real-time estimation of cathode pressure; finally, a dynamic output feedback control system based on observer and backstepping nonlinear controller is proposed, and the comparison and evaluation of two control strategies based on constant oxygen excess ratio tracking and optimal oxygen excess ratio tracking are carried out. The simulation results show the effectiveness and superiority of the designed control system compared with the reference controller.
Chemically Defined Conditions Mediate an Efficient Induction of Dental Pulp Pluripotent-Like Stem Cells into Hepatocyte-Like Cells
Authors: Gil-Recio Carlos , Montori Sheyla , Al Demour Saddam , Ababneh Mera A. , Ferrés-Padró Eduard , Marti Carles , Ferrés-Amat Elvira , Barajas Miguel , Al Madhoun Ashraf , Atari Maher
Published: November 2021

Liver diseases are major causes of morbidity and mortality. Dental pulp pluripotent-like stem cells (DPPSCs) are of a considerable promise in tissue engineering and regenerative medicine as a new source of tissue-specific cells; therefore, this study is aimed at demonstrating their ability to generate functional hepatocyte-like cells in vitro. Cells were differentiated on a collagen scaffold in serum-free media supplemented with growth factors and cytokines to recapitulate liver development. At day 5, the differentiated DPPSC cells expressed the endodermal markers FOXA1 and FOXA2. Then, the cells were derived into the hepatic lineage generating hepatocyte-like cells. In addition to the associated morphological changes, the cells expressed the hepatic genes HNF6 and AFP. The terminally differentiated hepatocyte-like cells expressed the liver functional proteins albumin and CYP3A4. In this study, we report an efficient serum-free protocol to differentiate DPPSCs into functional hepatocyte-like cells. Our approach promotes the use of DPPSCs as a new source of adult stem cells for prospective use in liver regenerative medicine.
The Effects of Elgucare on Degenerated Intervertebral Disc-Induced Low Back Pain and Disc Regeneration: A Clinical Trial
Authors: Lo Wen-Cheng , Chen Yu Ting , Chen Chen Ching
Published: November 2021

Introduction. Chronic low back pain (LBP) has a wide range of causes. However, most cases are induced by degeneration of the lumbar intervertebral discs (IVDs), and the aching caused by local compression of the affected region has considerable impacts on quality of life. This clinical trial investigated the use of Elgucare, a Chinese herbal formula, as a food supplement to reduce the pain of patients with LBP induced by degeneration of the lumbar IVDs. Methods. The study assessed patient subjective quality of life, functional limitations caused by LBP, and variations in pain. The assessment was done through the visual analogue scale (VAS) and effects on lumbar IVD thickness, water content, and bone mineral density (BMD). These parameters were evaluated before and after the administration of Elgucare or a placebo, one of which was taken by each participant for a 12-month period. Results. Elgucare reduced the patients’ mean VAS pain score by 2.25 points and improved their mean LBP-hampered mobility as assessed by the Roland-Morris Questionnaire by 5.17 points. The results of another questionnaire indicated that Elgucare slowed the LBP-induced deterioration of patients’ quality of life, while objective assessment indices obtained through X-ray and magnetic resonance imaging showed that the height and water retention of their IVDs were increased. However, the BMD results showed no improvements. Conclusions. Elgucare can increase the water retention and height of IVDs and reduce LBP, thereby enhancing quality of life. Therefore, Elgucare can potentially be used as a clinical supplement.
Numerical Study on the Mechanical Properties of Transmission Tower K‐Joints under Cyclic Loading
Authors: Li Jia-xiang , Zhang Chao , Wang Shu-hong , Yin Sheng-qiang
Published: November 2021

During the vibration of a transmission tower, the joints will be subjected to a reciprocating load. To obtain the accurate state of the transmission tower under the load, the mechanical properties of the joints under the vibration load must be considered. In this paper, the mechanical properties of typical K‐joints in transmission tower structures are studied by numerical simulation. The failure mode of the K‐joint under cyclic loading is also analyzed. The mechanical properties of the K‐joint are discussed from the aspects of hysteretic characteristics, stiffness degradation, energy dissipation capacity, and ductility evaluation, and the influencing factors are discussed. The results show that the failure mode of the K‐joint is related to the bolt grade and steel strength. When analyzing K‐joints, the moment‐rotation hysteresis curve should be combined with the realistic parameters of joints to consider the hysteretic behavior of the K‐joint. The results provide a theoretical reference for the accurate modeling of transmission towers.
A Simultaneous Fault Diagnosis Method Based on Cohesion Evaluation and Improved BP‐MLL for Rotating Machinery
Authors: Zhang Yixuan , Yang Rui , Huang Mengjie , Han Yu , Wang Yiqi , Di Yun , Su Dongke , Lu Qidong
Published: November 2021

In this paper, an improved simultaneous fault diagnostic algorithm with cohesion‐based feature selection and improved backpropagation multilabel learning (BP‐MLL) classification is proposed to localize and diagnose different simultaneous faults on gearbox and bearings in rotating machinery. Cohesion evaluation algorithm selects high sensitivity feature parameters from time and frequency domain in high‐dimensional vectors to construct low‐dimensional feature vectors. The BP‐MLL neural network is utilized for fault diagnosis by classifying the feature vectors. An effective global error function is proposed in BP‐MLL neural network by modifying distance function to improve both generalization ability and fault diagnostic ability of full‐labeled and nonlabeled situations. To demonstrate the effectiveness of the proposed method, simultaneous fault diagnosis experiments are conducted via wind turbine drivetrain diagnostics simulator (WTDDS). The experiment results show that the proposed method has better overall performance compared with conventional BP‐MLL algorithm and some other learning algorithms.
Sports Competition Assistant System Based on Fuzzy Big Data and Health Exercise Recognition Algorithm
Authors: Ma Chao , Shou Minchao
Published: November 2021

When material desires are satisfied, people begin to pursue more and more spiritual levels. Health exercises have an excellent auxiliary effect on people’s flexibility and physical fitness, so more and more people choose health exercises. However, the movement of health exercises returns to Chengdu and affects the efficiency of physical training. Therefore, we have designed a sports competition assistance system based on vague big data and a health exercise recognition algorithm. First of all, in this article, the standard score comparison database is created by extending the standard action data. In addition, the system architecture is further given, and the key 3D data-based acquisition module design is given. In addition, the system architecture is further given, and the basic 3D data acquisition unit design is given. In this document, the depth characteristics filtered by the Fourier Pyramid are fused to the bone characteristics, and the merged data is sorted based on the support engine, thus designing the action recognition unit. A hidden Markov model (HMM) human action recognition algorithm based on pose selection is proposed. This method uses two affine propagation (AP) clustering algorithms to cluster the features, automatically select the key posture of each action, and correspond to the hidden state of the HMM. These hidden state labels are used to initialize the parameters of the HMM to train the model, and the trained model is used to implement action classification. The result shows that the design in the article has a more accurate recognition result, which provides a powerful tool for the referee to score. Using the Fourier Pyramid filtering method, through a large number of health exercises for comparison, the ability to judge the degree of standard health exercises is significantly improved, the efficiency is increased by 25%, and the accuracy rate is increased by 15%.
Explain the Components of Urban Branding, Emphasizing the Dimensions of Tourism
Authors: Vahabian Maryam , Ghanbari Nowzar , Nori Said Ali , Kalhornia Bizhan
Published: November 2021

Currently, change in cities is advancing due to technological advances, information floods, increasing awareness, and raising living standards. Although the development of a city depends on the activation of urban marketing, an important and well‐known city stands out as a brand. One of the strategies of urban management in order to progress in the competitive world market is to plan for sustainable urban branding for the city, which introducing the capabilities of the city, the most important factors in achieving economic benefits of urban branding are tourism and physical space. The metropolis of Hamadan has been selected for this purpose, including urban tourism destinations with historical and touristic species and the capital of Iran’s history and civilization. The measurement tool in this study is a questionnaire that will be designed based on the conceptual framework of the research as well as related studies. For this purpose, the components and indicators of urban branding have been identified with emphasis on social, economic, cultural, and physical dimensions and have been used with the opinion of 30 urban experts and specialists and using SPSS25 software analysis at a significant level. It can be concluded that according to the respondents, these variables have a great impact on branding the metropolis of Hamadan.
Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia
Authors: Tomulescu Silviu , Uittenhove Kim , Boukakiou Reda
Published: November 2021

Clozapine is an effective antipsychotic for the treatment of resistant schizophrenia. However, clozapine can lead to serious side effects. One of the most common side effects is constipation and in rare cases ileus, which is associated with a considerable case fatality rate. Our patient exhibited repeated episodes of ileus while being treated with clozapine. We adapted the treatment of the patient in several ways to manage these severe side effects. First, we reduced clozapine dosage by opting for an augmentation strategy of clozapine through paliperidone. Then, we added linaclotide as a nonconventional laxative. We further adapted treatment after the occurrence of a volvulus prompting surgical intervention which revealed a malformation of the intestines’ peritoneal attachment. A gastrostomy to facilitate the treatment of any further episode was performed and bethanechol was introduced alongside linaclotide. Follow-up revealed the efficacy of our strategy involving the use of linaclotide in managing the side effects of clozapine in this patient.
Scheimpflug Topography Oriented Adequate Repositioning of a Misaligned Free Flap after Laser in situ Keratomileusis
Authors: Sim Ha Eun , Kang Min Ji , Lee Jee Hye , Baik Seung Hwa , Kim Sun Young , Lee Seong Woo , Hwang Je Hyung
Published: November 2021

This report describes a case of Scheimpflug topography oriented adequate repositioning of a misaligned thick free flap after laser in situ keratomileusis (LASIK). A 24-year-old patient consulted for irregular astigmatism and disoriented free right eye flap. The patient previously underwent binocular LASIK at a private clinic. During the right eye surgery, the flap was repositioned after laser ablation due to the free flap. The free flap was not repositioned to its original configuration due to insufficient preoperative corneal marking. On examination, the uncorrected visual acuity was 0.4, and refractive power was +2.00 Dsph with −4.25 Dcyl axis 66 in the right eye. Scheimpflug topography revealed irregular right eye astigmatism. The sagittal curvature of topography showed a 40° counterclockwise misalignment of the steep axis of the cornea. The free flap was repositioned by 40° clockwise rotation. After this, the refractive corneal power improved to −1.00 Dsph with −1.00 Dcyl Axis 19 in the right eye. The uncorrected and best-corrected visual acuity improved to 20/30 and 20/25 (x − 0.25Dsph −1.25 Dcyl A20), respectively. This is the first report on free flap repositioning using Scheimpflug topography. As proper flap positioning was compromised because of the free LASIK flap with no preoperative corneal marking, the flap was effectively repositioned using Scheimpflug topography.
Changes in Work Ability after Weight-Loss Surgery: Results of a Longitudinal Study of Persons with Morbid Obesity before and after Bariatric Surgery
Authors: Köhler Hinrich , Markov Valentin , Watschke Anna , Gruner-Labitzke Kerstin , Böker Clara , Kröger Christoph
Published: November 2021

Introduction: Bariatric surgery is a life-changing treatment, but knowledge of its influence on changes in work ability is still limited. We hypothesized that self-reported work ability improves in response to surgery-induced weight loss and sociodemographical variables (e.g., age, sex, and marital status), and that psychosocial characteristics (e.g., depressive symptoms and dysfunctional eating) may have predictive value as to patients’ work ability. Methods: A total of 200 participants scheduled for bariatric surgery were recruited between September 2015 and June 2018. They completed several self-report measures at the preoperative examination (t1) and at 6- (t2) and 12 months (t3) after bariatric surgery. A repeated-measures analysis of variance was calculated to detect any changes in the work ability and body mass index (BMI) among the 3 time points. Further, a hierarchical multiple regression analysis was used to determine whether any demographical and psychosocial characteristics at (t1) would predict work ability at (t3). Results: Participants (82% of whom were women) were middle-aged and showed a BMI of nearly 46 at the preoperative medical examination. Excess weight loss at (t2) and at (t3) was 49 and 66%, respectively. Work ability increased toward a moderate level after weight-loss surgery. Work ability and dysfunctional eating at (t1) showed significant predictive value with respect to work ability at (t3). Discussion: The results suggest that weight-loss surgery has a positive impact on work ability, and indicate a predictive value for the extent of weight loss and dysfunctional eating behavior. Against our hypothesis and in contrast to former research, a predictive value for depressive symptoms and age was not revealed. Further research must show how interventions can support and maintain improvements in work ability after bariatric surgery, in order to reduce sick leave and unemployment in patients with preoperative morbid obesity.
Unusually High Prevalence of Stroke and Cerebral Vasculopathy in Hemoglobin SC Disease: A Retrospective Single Institution Study
Authors: Sathi Bindu Kanathezhath , Yoshida Yilin , Weaver Michael Raymond , Nolan Lila S. , Gruner Barbara , Balasa Vinod , Altes Talissa , Leiva-Salinas Carlos
Published: November 2021

Introduction: Unlike homozygous hemoglobin SS (HbSS) disease, stroke is a rare complication in hemoglobin SC (HbSC) disease. However, recent studies have demonstrated a high prevalence of silent stroke in HbSC disease. The factors associated with stroke and cerebral vasculopathy in the HbSC population are unknown. Methods: We conducted a retrospective study of all patients with sickle cell disease treated at the University of Missouri, Columbia, over an 18-year period (2000–2018). The goal of the study was to characterize the silent, overt stroke, and cerebral vasculopathy in HbSC patients and compare them to patients with HbSS and HbS/β thalassemia1 (thal) in this cohort. We also analyzed the laboratory and clinical factors associated with stroke and cerebral vasculopathy in the HbSC population. Results: Of the 34 HbSC individuals, we found that the overall prevalence of stroke and cerebral vasculopathy was 17.7%. Only females had evidence of stroke or cerebral vasculopathy in our HbSC cohort (33.3%, p = 0.019). Time-averaged means of maximum velocities were lower in the HbSC group than the HbSS group and did not correlate with stroke outcome. Among HbSC individuals, those with stroke and cerebral vasculopathy had a marginally higher serum creatinine than those without these complications (0.77 mg/dL vs. 0.88 mg/dL, p = 0.08). Stroke outcome was associated with recurrent vaso-occlusive pain crises (Rec VOCs) (75 vs. 25%, p = 0.003) in HbSC patients. The predominant cerebrovascular lesions in HbSC included microhemorrhages and leukoencephalopathy. Conclusion: There is a distinct subset of individuals with HbSC who developed overt, silent stroke, and cerebral vasculopathy. A female predominance and association with Rec VOCs were identified in our cohort; however, larger clinical trials are needed to identify and confirm specific clinical and laboratory markers associated with stroke and vasculopathy in HbSC disease.
Surgery to Oligometastatic Breast Cancer after Excellent Response to Palbociclib and Letrozole Therapy: Pitfall of Ultrasound Therapeutic Evaluation
Authors: Fujii Suzuka , Oura Shoji , Makimoto Shinichiro
Published: November 2021

A 48-year-old woman with regional recurrences of breast cancer in the axillar and supraclavicular regions was referred to our hospital. Under the diagnosis of recurrent luminal breast cancer with a high Ki-67 labeling index of >30% and a disease-free interval of 13 years, the patient began to receive palbociclib, letrozole, and luteinizing hormone-releasing hormone agonist, resulting in marked response of the supraclavicular lesion and stable disease of the axillar lesion on ultrasound (US) evaluation. Positron emission tomography (PET)/computed tomography of the axillar and supraclavicular foci showed high and no avidities before and after treatment, respectively. The unmovable neck lesion became movable with the treatment. The patient, therefore, underwent surgical resection of the 2 metastatic foci to examine the discordant therapeutic efficacy against the 2 metastatic foci on 2 image modalities, that is, US and PET, and to possibly get a cure of the breast cancer oligometastasis. Pathological examination showed marked fibrosis and scant cancer cell residuals with microcalcifications in the neck tumor and massive sarcoid-like reaction with scant cancer cell residuals in the axillary nodes. The residual cancer cells showed estrogen and progesterone receptor positivities, human epidermal growth factor receptor type 2 negativity, and an extremely low Ki-67 labeling index of 2.5%. The patient recovered uneventfully and has continued palbociclib-containing endocrine therapy for 1 year without any recurrences. Breast oncologists should well understand the basic principles of internal echo formation on US and take the presence of sarcoid-like reaction in the cancer cell clusters into consideration on the therapeutic evaluation of metastatic breast cancer.
Reduction in Tumor Lesions and Exacerbation of Psoriatic Rash after Septic Shock in a Patient with Extramammary Paget’s Disease
Authors: Nakanishi Takehisa , Kondo Makoto , Nakai Yasuo , Habe Koji , Yamanaka Keiichi
Published: November 2021

We present a case of extramammary Paget’s disease with bilateral inguinal lymph node metastasis treated by monthly docetaxel chemotherapy. He has also well-controlled psoriasis vulgaris for 20 years. One day after completing monthly chemotherapy, cellulitis by Group G Streptococcus occurred on both legs, resulting in septic shock and disseminated intravascular coagulation. During the infection, the tumor nodule volume and the exudate from the tumor decreased, and tumor markers carcinoembryonic antigen and cancer antigen 19-9 showed low values. Simultaneously, the psoriatic eruption reoccurred. We proposed that cytokine storm including tumor necrosis factor-alpha (TNF-α) during sepsis might have suppressed tumor lesions, and also TNF-α-dependent psoriatic rash appeared temporarily on his body.
Focal Segmental Glomerulosclerosis Superimposed on Transplant Glomerulopathy: Implications for Graft Survival
Authors: Zhu Ying , Fan Yun , Xu Feng , Liang Shaoshan , Liang Dandan , Li Ping , Xia Yuanyuan , Zhu Xiaodong , Yang Fan , Chen Jinsong , Zeng Caihong
Published: November 2021

Introduction: Transplant glomerulopathy (TG) is a morphological lesion resulting from chronic glomerular endothelium injury, and it is strongly associated with poor graft survival. TG coexisting with focal segmental glomerulosclerosis (FSGS) can be found in renal allograft biopsies, but few related studies are available. Methods: Consecutive kidney transplant recipients with biopsy-proven TG were studied retrospectively. Patients concomitant with FSGS were identified and compared with those without FSGS. The influence of FSGS on allograft outcomes was assessed using univariate and multivariate Cox regression models. Results: Of the 66 patients with TG, 40 (60.6%) had concomitant FSGS. TG patients with FSGS had higher proteinuria (median, 2.6 vs. 0.8 g/24 h, p < 0.001) and serum creatinine levels (median, 2.5 vs. 2.1 mg/dL, p = 0.04), lower serum albumin levels, higher chronic glomerulopathy (cg) score, larger glomerular tuft area, lower number of podocytes, and higher incidences of podocyte hyperplasia, pseudotubule formation, and diffuse foot process effacement than those without FSGS (all p < 0.05). The kidney allograft loss rate of patients with FSGS was higher than that of patients without FSGS (65.7% vs. 37.5%, p = 0.03). The presence of FSGS was independently associated with allograft loss in TG (hazard ratio (HR) = 3.42, 95% confidence interval (CI): 1.30–8.98, p = 0.01). Other independent predictors were proteinuria (HR = 1.18, 95% CI: 1.02–1.37, p = 0.02), estimated glomerular filtration rate (HR = 0.94, 95% CI: 0.91–0.97, p < 0.001), and panel reactive antibody (HR = 3.99, 95% CI: 1.14–13.99, p = 0.03). Moreover, FSGS (odds ratio (OR) = 4.39, 95% CI: 1.29–14.92, p = 0.02) and cg (OR = 5.36, 95% CI: 1.56–18.40, p = 0.01) were independent risk factors for proteinuria. Conclusion: In this cohort of patients with TG, the presence of FSGS was strongly associated with more severe clinicopathological features and worse allograft survival.
Metastatic Breast Cancer to the Urinary Bladder in the Caribbean
Authors: Mohammed Saara , Bua Atiba Akii
Published: November 2021

One of the most common cancers amongst women is breast cancer. The most common metastatic sites are the lymph nodes, lungs, liver, and bone. Metastatic spread to the urinary bladder is rare, and this case, as far as we are aware, is the first reported in the Caribbean. This patient developed urinary symptoms 4 years after her diagnosis of breast cancer. CT imaging showed thickening of the bladder wall, and histology confirmed metastatic breast cancer. As imaging modalities and cancer treatment improve, patients live longer with metastatic disease, and we will potentially see more unusual presentations of metastatic disease.
Optic Nerve Head Microcirculation in Eyes with Vogt-Koyanagi-Harada Disease Accompanied by Anterior Ischemic Optic Neuropathy
Authors: Yamashita Yui , Hashimoto Yuki , Namba Kenichi , Mizuuchi Kazuomi , Ishida Susumu
Published: November 2021

Anterior ischemic optic neuropathy (AION) is infrequently complicated with Vogt-Koyanagi-Harada (VKH) disease. We quantitatively examined sequential changes in the morphology and circulation hemodynamics, using a C-scan of optical coherence tomography (OCT) and laser speckle flowgraphy (LSFG) in a patient with VKH disease accompanied by AION. A 65-year-old female complained of blurred vision in both of her eyes. The patient presented with optic disc swelling and remarkable choroidal thickening detected by OCT bilaterally. The diagnosis of VKH disease was established based on the presence of pleocytosis detected in the cerebrospinal fluid and hypofluorescent dark dots scattered all around the fundus, detected by indocyanine green angiography. Goldmann perimetry detected visual field defects, similar to superior altitudinal hemianopsia in the right eye and similar to inferior altitudinal hemianopsia in the left eye. The patient was suspected to have developed AION in both eyes. The patient received methylprednisolone pulse therapy, followed by oral prednisolone. With these treatments, the optic disc swelling disappeared. However, optic disc atrophy with visual field defects remained in both eyes. An OCT C-scan showed the ganglion cell complex (GCC) and circumpapillary retinal nerve fiber layer (cpRNFL) thickness getting thinner below the normal range, and LSFG showed the decrease in optic nerve head (ONH) tissue microcirculation. These results supported the occurrence of AION in this patient with VKH disease. The analysis of GCC and cpRNFL thickness and ONH microcirculation would be useful for supporting the occurrence of AION in a case of VKH disease.
Combination Effect of Diurnal Exposure to Sucrose and Nocturnal Exposure to Lactose on Enamel Demineralization
Authors: Campos Vieira Juliana , Cury Jaime Aparecido , Ricomini Filho Antonio Pedro
Published: November 2021

We have hypothesized that the association between human milk and caries in breastfeeding children could be explained by the combination of a diurnal cariogenic diet with the nocturnal lactose fermentation, conditions simulated in this experimental study. Cariogenic biofilm was formed on bovine enamel slabs, which were exposed 8x/day for 3 min to a 10% sucrose solution, simulating a highly cariogenic diurnal diet, or 50 mM NaCl solution (control). Simulating the nocturnal retention of milk in mouth, biofilms were transferred to culture medium containing 0.7% lactose for 2 h, or only to culture medium (control). Four groups were designed (n = 12): Ctrl, no exposure to diurnal sucrose or nocturnal lactose; Lac, only nocturnal exposure to lactose (2 h); Suc, only diurnal exposure to sucrose (8x/day); and Suc→Lac, diurnal exposure to sucrose (8x/day) followed by nocturnal exposure to lactose (2 h). The medium was changed 3x/day, at the beginning of the day and after diurnal and nocturnal exposures. Calcium in the medium was determined as a chemical indicator of partial demineralizations occurred during the diurnal and the nocturnal treatments; the medium pH was also determined. After 96 h of growth, biofilms were harvested to evaluate CFU, biomass, and extracellular polysaccharides, soluble and insoluble. The percentage of enamel surface hardness loss (%SHL) was evaluated as cumulative demineralization. Data were analyzed by one-way ANOVA and Tukey’s test (α = 5%). Highest %SHL (p < 0.05) was found for the Suc→Lac (40.6%) group when compared to Suc (32.1%), Lac (6.6%), and Ctrl (2.4%) groups. Calcium released during the diurnal and nocturnal treatments was, respectively, Suc→Lac = Suc > Lac = Ctrl and Suc→Lac > Lac > Suc = Ctrl (p < 0.05). Regarding the Ctrl group, calcium released from nocturnal lactose fermentation by the Suc→Lac group was 4-fold greater than that provoked by the Lac group. The findings were supported by the pH of the media. The data suggest that the biofilm formed under diurnal exposure to sucrose enhances the cariogenicity of nocturnal exposure to lactose.
Interest Rate Theory in Islamic Economic Perspective
Authors: Hidayat Robist
Published: November 2021

Inflation is a condition in which there is a sharp (absolute) increase in prices that lasts continuously for a long period of time followed by a decline in the real (intrinsic) value of a country's currency. circulating through an increase in bank interest rates. For this reason, the government carries out monetary policy by suppressing the money supply through increasing bank interest rates. However, the interest rate has various kinds, namely classical interest rate theory, neo classical, modern keyness and hicks. Therefore, this study focuses more on interest rates and the theory of interest rates by experts. So that it produces descriptive research.
Geographic Information System of College of Banyumas Regency Based on Android
Authors: SETYAWATI ENDANG , Suyudi  , Sari Ella Laela
Published: November 2021

Banyumas Regency is a student city in Central Java which has 21 tertiary institutions, consisting of state and private tertiary institutions, spread throughout the Banyumas region. With so many PTs available, it is often difficult for prospective students from out of town to get locations, so by building an Android-based Geographic Information System for Banyumas Higher Education Institutions that is built to help and facilitate the community or prospective students. With the prototype method with steps (communication, planning, modeling, prototype formation, and evaluation). The scope of the system includes the GPS assistance facilities. The main menu contained in the application of PTN and PTS about the brief description of information about tertiary institutions, facility menus from the ATM, gas station and hospital sub menus, emergency call menus containing important telephone numbers such as the police and fire department , and help menu how to use the application. Conclusions The study states that HI was accepted, namely "There is a significant time difference in the process of finding the location of tertiary institutions before and after using the Geographic Information System for Higher Education in Banyumas Regency on Android". Then based on the results of product tests that have been done show that the product test value to determine the quality of the system being built is 96.85, the value is greater than the feasibility limit of 75. Thus, the system built is suitable for use by the wider community.